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OBJETIVO: Estimar a prevalência de dor crônica, identificando os fatores associados. MÉTODOS: Estudo transversal realizado em amostra populacional de 2.297 indivíduos com idade igual ou superior a 20 anos, em Salvador (BA), em 1999 e 2000. Aplicou-se em domicílio questionário padronizado para coleta de dados sobre dor e características sociodemográficas e a medida da circunferência abdominal. O critério para classificação de dor crônica foi duração superior a seis meses. Foram estimadas as prevalências de dor por razão de prevalência ajustada com intervalo com 95% de confiança e valor de pOBJETIVO: Estimar la prevalencia de dolor crónico, identificando los factores asociados. MÉTODOS: Estudio transversal realizado en muestra poblacional de 2.297 individuos con edad igual o superior a 20 años, en Salvador (Noreste de Brasil), en 1999 y 2000. Se aplicó en domicilio cuestionario estandarizado para colectar datos sobre dolor y características sociodemográficas y la medida de la circunferencia abdominal. El criterio para clasificación de dolor crónico fue duración superior a seis meses. Fueron estimadas las prevalencias de dolor por razón de prevalencia ajustada con intervalo con 95% de confianza y valor de pOBJECTIVE: To estimate the prevalence of chronic pain, identifying the associated factors. METHODS: A cross-sectional study was conducted in a population sample of 2,297 individuals aged 20 years or more, in Salvador, Northeastern Brazil, in 1999 and 2000. A standardized questionnaire was administered at the individuals' home to collect data about pain, sociodemographic characteristics, and abdominal circumference measurement. The criterion for chronic pain classification was duration above six months. Prevalence of pain was estimated by adjusted prevalence ratio with confidence interval of 95% and p

Abstract Objective Rare and complex epilepsies encompass a diverse range of disorders characterized by seizures. We aimed to establish a consensus on key issues related to these conditions through collaboration among experienced neurologists, neuropediatricians, and patient advocacy representatives. Methods Employing a modified Delphi method, a scientific board comprising 20 physicians and 4 patient advocacy representatives synthesized existing literature with their expertise to formulate statements on contentious topics. A final 32‐member expert panel, representing diverse regions of Italy, validated these statements through a two‐round voting process, with consensus defined as an average score ≥7. Results Sixteen statements reached a consensus, emphasizing the necessity for epidemiological studies to ascertain the true prevalence of rare epilepsies. Etiology emerged as a crucial factor influencing therapeutic strategies and outcome prediction, with particular concern regarding prolonged and tonic–clonic seizures. The importance of early implementation of specific drugs and non‐pharmacological interventions in the treatment algorithm for developmental and epileptic encephalopathies (DEEs) was underscored. Multidisciplinary care involving experts with diverse skills was deemed essential, emphasizing non‐seizure outcomes in adolescence and adulthood. Significance This national consensus underscores the imperative for personalized, comprehensive, and multidisciplinary management of rare epilepsies/DEEs. It advocates for increased research, particularly in epidemiology and therapeutic approaches, to inform clinical decision‐making and healthcare policies, ultimately enhancing patients' outcomes. Plain Language Summary The modified Delphi method is broadly used to evaluate debated topics. In this work, we sought the consensus on integrated and social care in epilepsy management. Both representatives of high‐level epilepsy centers and patients' caregivers were directly involved.

El artículo presenta las percepciones de los padres de hijos con alta capacidad en torno a la comprensión de dicha condición, así como su visión respecto a la experiencia escolar. Utilizando una metodología cualitativa se hicieron entrevistas grupales a 51 padres y madres de familia de cuatro escuelas chilenas. Los resultados muestran las percepciones de los progenitores sobre la alta capacidad y describen perfiles tanto tradicionales como atípicos; desde lo escolar, si bien existen experiencias positivas, señalan que el clima social de aula no es idóneo para los estudiantes con alta capacidad. Los progenitores son agentes críticos e informantes clave para la visibilización de la alta capacidad, tanto desde la identificación y la atención, como para brindar una mejor experiencia escolar a sus hijos a partir del reconocimiento de sus características y experiencias.

ABSTRACT Objective: to construct and validate the content of an inventory of ethical problems experienced by nurses in mobile pre-hospital care. Method: a psychometric approach study, developed with the following stages: (1) instrument construction through a theoretical matrix based on deliberative bioethics, scoping review and online qualitative research; (2) content validity by judges; (3) pre-testing with Mobile Emergency Care Service nurses in various Brazilian states. For content validity analysis, the Content Validity Ratio was calculated (CVR>0.45 for judges and CVR>0.35 for the target population). Results: the instrument had 44 items, distributed across four dimensions. Final considerations: the constructed instrument presented sources of evidence of content validity, providing good psychometric measurements and constituting a useful tool for nurses’ practice in the pre-hospital setting.

The microorganisms residing the oral cavity, referred to as the oral microbiome, have been reported to have an association with health and disease in older adults. In the present review the state-of-the-art methodology was applied to investigate the association of the oral microbiome to systemic diseases, frailty and ageing. The methodology includes a six-step strategy, whereas inclusion criteria were articles in English, publication period between 2015 and December 2023, clinical studies, case series, in-vitro studies, and animal studies. Results indicated that the oral microbiome's composition is crucial for older adults with systemic diseases such as diabetes, Alzheimer's, or cardiovascular disorders. Moreover, there appears to be an association between the oral microbiome and frailty in older patients. The relationship between oral microbiome and ageing is bidirectional, since older adults experience a shift in the composition of the microbiome, whereas those bacteria promote inflammation remotely and rapid ageing of the individual. Further studies investigating the exact kind of phyla and genera of oral microorganisms are essential to better understand the interaction of the oral microflora with the human body in older individuals.

This paper introduces an integrated educational model for higher education, ECOBI, which combines Educational Clusters (teaching programs), the Blended Intensive approach, and the issuance of Open Badges within university curricula. Adopted by EDUNEXT, a network of 35 Italian universities aimed at digital educational innovation and university network development, ECOBI proposes a competency-based design that makes degree courses and Educational Clusters planned to develop specific skills relevant to the 21st-century landscape. The Intensive Blended approach integrates online teaching activities with intensive in-person training weeks, combining the strengths of both experiences. This model offers modularity and flexibility, promotes interdisciplinary learning and interchangeability of content, and meets the needs of current higher education. The article describes the ECOBI approach, its characteristics, strengths and advantages, and highlights its implementation within the EDUNEXT network.

Background Among other structures, nuclear grooves are vastly found in papillary thyroid carcinoma (PTC). Considering that the application of artificial intelligence in thyroid cytology has potential for diagnostic routine, our goal was to develop a new supervised convolutional neural network capable of identifying nuclear grooves in Diff-Quik stained whole-slide images (WSI) obtained from thyroid fineneedle aspiration. Methods We selected 22 Diff-Quik stained cytological slides with cytological diagnosis of PTC and concordant histological diagnosis. Each of the slides was scanned, forming a WSI. Images that contained the region of interest were obtained, followed by pre-formatting, annotation of the nuclear grooves and data augmentation techniques. The final dataset was divided into training and validation groups in a 7:3 ratio. Results This is the first artificial intelligence model based on object detection applied to nuclear structures in thyroid cytopathology. A total of 7,255 images were obtained from 22 WSI, totaling 7,242 annotated nuclear grooves. The best model was obtained after it was submitted 15 times with the train dataset (14th epoch), with 67% true positives, 49.8% for sensitivity and 43.1% for predictive positive value. Conclusions The model was able to develop a structure predictor rule, indicating that the application of an artificial intelligence model based on object detection in the identification of nuclear grooves is feasible. Associated with a reduction in interobserver variability and in time per slide, this demonstrates that nuclear evaluation constitutes one of the possibilities for refining the diagnosis through computational models.

Abstract A 7‐month‐old male French bulldog was referred for abnormal mentation and gait. Physical examination revealed a dome shaped calvarium and persistent bregmatic fontanelle. Neurological examination revealed proprioceptive ataxia, pelvic limb paraparesis and strabismus with moderate ventriculomegaly, thinning of the cerebral parenchyma, and widened cerebral sulci on magnetic resonance imaging. Masses were identified in the region of the thyroid, which appeared heterogeneous and hyperintense in T1‐weighted and T2‐weighted compared with the adjacent muscle signal masses were identified. Radiological diagnosis was hydrocephalus “ex vacuo” and goiter. Blood test revealed abnormally low total thyroxine (TT4), free thyroxine (FT4), and normal thyrotropin concentration. A diagnosis of congenital hypothyroidism was confirmed by positive genetic test for thyroid peroxidase mutation. Thyroxine supplementation treatment rapidly improved clinical signs.

Resumo Objetivo Avaliar o desempenho do Escore Pediátrico de Alerta (EPA) no rastreio de casos de sepse em um contexto hospitalar. Métodos Estudo de teste diagnóstico guiado pelas recomendações do Standards for the Reporting of Diagnostic Accuracy Studies (STARD). A amostra foi de 190 crianças e adolescentes internados em um hospital do interior da Bahia, Brasil. A coleta foi realizada em banco de dados de um projeto guarda-chuva, em prontuários e sistema de registros do hospital. O processamento e análise foram realizados no SPSS® version 25.0 for Windows e MedCalc® version 20.00. O desempenho do EPA no rastreio da sepse quando comparado aos critérios do padrão de referência foi mensurado através da Sensibilidade, Especificidade, Valores Preditivos e curva ROC. Resultados Dentre os participantes, 53,2% eram do sexo masculino, com média da idade de 4,39 anos (DP: 4,28) e mediana 3 anos (IIQ: 1 – 8). A prevalência da sepse identificada pelo padrão de referência foi de 10% e pelo EPA 23.1%. A sensibilidade, especificidade e valores preditivos positivo e negativo do EPA no rastreio de sepse foram de 73,7%, 82,5%, 31,8% e 96,6%, respectivamente. A área sob a curva ROC foi de 0,794. Conclusão O estudo apresenta evidências sobre o desempenho do EPA no rastreio da sepse, demonstrando boa acurácia na discriminação de pacientes pediátricos com e sem sepse na amostra estudada.

Este artigo propõe uma discussão na perspectiva da arte e da educação de como um processo de criação em dança com um grupo de crianças e adolescentes pode viabilizar a produção de conhecimento nos encontros com a comunidade em uma proposta pluricultural. Assim, as crianças e adolescentes são sujeitos de saberes e fazeres e suas heranças culturais contam histórias que reelaboram e afirmam a busca de sua condição de cidadania, integrando valores da ancestralidade afro-brasileira referenciados na comunidade. Entende-se a arte e a educação como entrelugares constituintes da produção de conhecimento em que o corpo, dança e ancestralidade agem como potentes agregadores na formação de jovens artistas.

ABSTRACT Neisserial adhesin A (NadA) is a meningococcal surface protein included as recombinant antigen in 4CMenB, a protein-based vaccine able to induce protective immune responses against Neisseria meningitidis serogroup B (MenB). Although NadA is involved in the adhesion/invasion of epithelial cells and human myeloid cells, its function in meningococcal physiology is still poorly understood. To clarify the role played by NadA in the host-pathogen interaction, we sought to identify its cellular receptors. We screened a protein microarray encompassing 2,846 human and 297 mouse surface/secreted recombinant proteins using recombinant NadA as probe. Efficient NadA binding was revealed on the paired sialic acid-binding immunoglobulin-type lectins receptors 5 and 14 (Siglec-5 and Siglec-14), but not on Siglec-9 therein used as control. The interaction was confirmed by biochemical tools with the determination of the KD value in the order of nanomolar and the identification of the NadA binding site by hydrogen-deuterium exchange coupled to mass spectrometry. The N-terminal domain of the Siglec-5 that recognizes the sialic acid was identified as the NadA binding domain. Intriguingly, exogenously added recombinant soluble Siglecs, including Siglec-9, were found to decorate N. meningitidis surface in a NadA-dependent manner. However, Siglec-5 and Siglec-14 transiently expressed in CHO-K1 cells endorsed NadA binding and increased N. meningitidis adhesion/invasion while Siglec-9 did not. Taken together, Siglec-5 and Siglec-14 satisfy all features of NadA receptors suggesting a possible role of NadA in the acute meningococcal infection.IMPORTANCEBacteria have developed several strategies for cell colonization and immune evasion. Knowledge of the host and pathogen factors involved in these mechanisms is crucial to build efficacious countermoves. Neisserial adhesin A (NadA) is a meningococcal surface protein included in the anti-meningococcus B vaccine 4CMenB, which mediates adhesion to and invasion of epithelial cells. Although NadA has been shown to bind to other cell types, like myeloid and endothelial cells, it still remains orphan of a defined host receptor. We have identified two strong NadA interactors, Siglec-5 and Siglec-14, which are mainly expressed on myeloid cells. This showcases that NadA is an additional and key player among the Neisseria meningitidis factors targeting immune cells. We thus provide novel insights on the strategies exploited by N. meningitidis during the infection process, which can progress to a severe illness and death.

(1) Background: The presence of various dental ceramic materials with different chemical compositions complicates clinicians’ decision making, especially in cases with a highly acidic environment appearing in patients suffering from gastroesophageal reflux disease or other eating disorders. Thermal alterations in the oral cavity can also affect surface structure and roughness, resulting in variations in both degradation mechanisms and/or bacteria adhesion. The aim of the present in vitro study was to evaluate the effect of thermal cycling and exposure to simulated gastric acid on the surface roughness of different ceramics; (2) Methods: Five groups of different ceramics were utilized, and twenty specimens were fabricated for each group. Specimens were either thermocycled for 10,000 cycles in distilled water or immersed in simulated gastric acid for 91 h. The evaluation of surface roughness was performed with optical profilometry, while scanning electron microscopy, X-ray diffraction analysis and inductively coupled plasma atomic emission spectroscopy were also performed; (4) Conclusions: Based on the combination of the surface roughness profile and structural integrity, zirconia specimens presented the smallest changes after immersion in simulated gastric acid followed by lithium disilicate materials. Zirconia-reinforced lithium silicate ceramic presented the most notable changes in microstructure and roughness after both treatments.

Multivariate analysis is a statistical solution effectively used to investigate educational phenomena. It operates simultaneously on many variables and data and allows the development of classifications and models by returning data-driven understandings. How does the international educational research community make use of multivariate analysis techniques? We conducted a methodological review to identify trends in applying these methods in education. We extracted only papers written in English, indexed in Scopus, and published from 2018 to 2022 in journals in the Education category. Our review included bibliometrics such as years of publications, leading journals, and most cited articles. We detected an increase in papers using multivariate analysis in the educational research in Scopus publications over the past five years, particularly in journals in quartiles Q1 and Q2. MANOVA represents the main method used for the analysis along with regression methods; the former may be overestimated due to the overlap of names with terms searched in the string. University students represent the preferred experimental subjects for investigation; the administration of surveys and questionnaires is the most practiced way to collect data; preferred analysis tools among those declared are non-free. Based on the topics, some research categories emerged: Teaching, Medical Education, STEM, Digital Education, Professional Development, Inclusion, Wellbeing. However, the number of citations is low (less than 8) for three-quarters of the articles in our selection. To increase the effective use, confidence, and understanding of multivariate analysis processes, appropriate skills in education, statistical analysis, and interpretation of results need to be strengthened.

O presente trabalho realizou a análise bromatológica e avaliou as propriedades antioxidantes do suco pasteurizado de cupuaçu (Theobroma grandiflorum) fermentado por Lacticaseibacillus rhamnosus ATCC 9595. Os sucos foram pasteurizados (80 °C/10 minutos), para posterior fermentação com L. rhamnosus ATCC 9595 (inóculo de 108 UFC). Após 48h, foi analisado a viabilidade de L. rhamnosus, produção de ácidos orgânicos e resistência à lisozima e sais biliares. As amostras foram mantidas sob refrigeração durante 28 dias para análises bromatológicas. Os sucos foram submetidos à extração com acetato de etila para avaliação da atividade antioxidante, dosagem de compostos fenólicos e flavonoides. L. rhamnosus ATCC 9595 cresceu no suco pasteurizado de cupuaçu (~9 Log UFC/mL), se mantendo estável durante os 28 dias (p>0,05). Todas as amostras estavam nos padrões microbiológicos estabelecidos pelas diretrizes brasileiras para sucos. De igual modo, não foram detectadas alterações significativas nos teores de Cinzas, umidade e B° nos períodos analisados (p>0,05). L. rhamnosus ATCC 9595 cultivado no suco ou MRS resistiu a ação da lisozima (100 mg/L) e sais biliares (0,5% e 1,0%). A capacidade antioxidante do suco de cupuaçu aumentou significativamente após a fermentação por L. rhamnosus ATCC 9595 e os teores de compostos fenólicos. As amostras de suco fermentados apresentaram valores de IC50 semelhantes durante o armazenamento, enquanto o extrato não fermentado apresentou variação a partir do 21º dia. Os resultados que a fermentação por L. rhamnosus ATCC 9595 é uma estratégia eficiente para aumentar as características antioxidantes do suco de cupuaçu.

The present study systematically reviewed the literature regarding the bond strength durability of zirconia ceramics to resin-based luting cements after application of different bonding protocols and aging conditions. Electronic searches in PubMed, Scopus, and Web of Science databases were performed for relevant literature published between January 1st 2015 and November 15th 2022. Ninety-three (93) English language in-vitro studies were included. The percentage of the mean bond strength change was recorded prior to and after artificial aging, and the weighted mean values and 95% confidence intervals were calculated. Bonding protocols were classified based on the combination of MDP/non-MDP containing cement/primer and surface pretreatment, as well as the level of artificial aging performed. Alumina sandblasting (SA) was identified as the most frequently used surface pre-treatment while an insufficient number of studies was identified for each category of alternative surface treatments. The combination of MDP cement with tribochemical silica coating (TSC) or SA yielded more durable results after aging, while the application of SA and TSC improved bond durability when a non-MDP cement and a non-MDP primer were used. TSC may lead to increased bond durability compared to SA, whereas MDP cements may act similarly when combined with SA or TSC.

Este estudo qualitativo teve por objetivo compreender os significados, as motivações e os sinais atribuídos ao comportamento suicida, na perspectiva de estudantes do ensino médio de escola pública da Região Sul do Brasil. Para a coleta de dados, utilizou-se a Técnica de Grupo Focal. A organização e análise dos dados sustentaram-se na Grounded Theory, com o auxílio do software Atlas.ti 8.4.15. A construção dos significados e das motivações para o comportamento suicida, decorre das experiências familiares, escolares, de amigos, mídia e redes sociais digitais. Os sinais relacionados com o comportamento suicida foram: isolamento, deixar de fazer hobbies, baixa autoestima, desmotivação e silêncio, falar muito sobre o assunto, automutilação, pensamento negativo e comportamentos estranhos. Os resultados evidenciaram que o reconhecimento dos sinais é atravessado pelos significados e as motivações que são atribuídos ao comportamento suicida e se fundamentam na construção social-histórica-relacional.

Intellectual precocity in children poses unique challenges and opportunities for educational systems. This systematic review aims to comprehensively analyze intellectual precocity in children until 6 years old, including its definition, manifestations, and various educational programs for intellectually precocious learners. Following PRISMA guidelines, a comprehensive search of electronic databases was conducted. The study included 26 articles published between 2013 and 2023 that provided a conceptualization of precocity or giftedness, and/or focused on characteristics of precocity, and/or investigated educational programs for intellectually precocious children. The authors’ conceptualizations of precocity varied, with some providing clear definitions based on a developmental view of precocity, while others merely mentioned the concept. Early indicators of superior traits have been observed in areas such as reading, math, problem-solving, and even in fields that have been traditionally disregarded, such as visual arts. Educational provisions varied widely, including approaches based on enrichment and project-based learning; however, interventions based on socioemotional elements are also highlighted. The findings emphasize the importance of early identification and targeted educational strategies to support the unique needs of intellectually precocious individuals. Future research should focus on longitudinal studies and the development of evidence-based interventions.

The academic performance of faculty members, as reflected by their research productivity and quality, is a crucial factor in determining aninstitution’s reputation and ranking. However, research productivity varies across academic disciplines and is influenced by multiple factors. In this study we investigate the impact of the academic discipline on research productivity and quality among faculty members in the School of Arts and Sciences at the Lebanese American University, and explore potential factors that could affect their research productivity. We measure research productivity and quality using indicators such as publication count, publication pattern preferences, and average number of citations per publication. Additionally, we assess the effects of individual, institutional and occasional factors on research productivity through a questionnaire distributed to faculty members. Our findings indicate that faculty members in hard disciplines tend to be more productive and have more cited works than their counterparts in soft disciplines, but both groups target top journals at similar rates. Furthermore, international collaboration is a significant predictor of advanced research productivity in hard disciplines. Additionally, both groups agree that teaching loads can limit the time available for research and that the research funding and equipment should be improved. Finally, we note the COVID-19 lockdown and the economic crisis in Lebanon have decreased research activity among faculty members in hard disciplines.

The advent, in 2004, of online universities in Italy followed the global trend of open and distance learning institutions. Within a brief span, the authorization of as many as 11 online universities was granted. Despite ongoing regulatory revisions and a prevailing skepticism regarding the actual quality of education these institutions furnish, student enrollment continues to rise annually. This study explores enrollment trends in Italian online universities from their inception through 2021, considering concurrent enrollment trends in traditional public and private universities. Additionally, we examine in detail the gender composition, subject areas of degree programs, and, most importantly, the geographic origins of enrolled students.

Palmeiras dos Índios, estado de Alagoas, abriga uma rica biodiversidade na aldeia Mata da Cafurna, além de cerca de 150 famílias indígenas do povo Xukuru-Kariri. O presente estudo possui importância ambiental, pois dará ênfase à fauna e flora pouco conhecida e apresentará as interferências antrópicas contribuindo para uma maior conscientização no uso sustentável dos recursos naturais. A proposta deste trabalho é investigar através de pesquisas na literatura, a diversidade biológica na Mata da Cafurna e os possíveis impactos ambientais causados por agricultores ou pessoas externas à aldeia. Compilando dados de trabalhos científicos realizados nos últimos dez anos, foi possível a produção de uma lista contendo 39 espécies de plantas, entre as mais conhecidas estão o murici (Byrsonima crassifolia), a jatobá (Hymenaea courbaril), a jurema (Acacia jurema), o barbatimão (Stryphnodendron coriaceum) e o juá (Ziziphus joazeiro). Dentre os vertebrados identificados destaca-se a paca (Cuniculus paca), o guará (Chrysocyon brachyurus), o tamanduá (Myrmecophaga tridactyla), e o veado (Mazama spp.). Essas espécies correspondem a um número certamente inferior à quantidade existente na aldeia, pois foram produzidos poucos trabalhos científicos da área estudada.Verificou-se que a fragmentação, o desmatamento para agricultura, o uso irracional dos recursos naturais e a caça de animais alteram a paisagem tornando-se assim uma ameaça para a biodiversidade.

Abstract Background The COVID-19 pandemic continues to have high caseloads in the US, with vaccines a critical component of the response. Disparities in COVID-19 morbidity and mortality have been identified across states and racial/ethnic groups, which are likely in part due to disparities in COVID-19 vaccine uptake. This study aims to better understand and contextualize COVID-19 vaccine hesitancy among persons from under-represented racial/ethnic populations in the Southern US. Methods We conducted 29 in-depth interviews with a sample of households in Atlanta, GA that were selected from an address-based sampling frame. We purposively approached households, from February 6 to June 27, 2021, that declined participation in a national COVID-19 serosurvey to gain perspectives of people who are often under-represented in research. Interviews were conducted in-person or over phone calls for participants with that preference. Thematic analysis was used to identify barriers and facilitators of COVID-19 vaccination, and to contextualize drivers of vaccine hesitancy. Results Decision-making about vaccination was described as dynamic, and was compared to the feeling of being on a roller coaster. The predominant reported sources of information were mass media and social media. Facilitators of vaccination included altruism, positive communication from trusted community members and workplace colleagues, and local vaccine provision sites. Driving reasons for vaccine hesitancy included limited trust in the government and concerns about COVID-19 vaccine safety, which one participant compared to jumping off a cliff without a tested rope. Among a subset of participants, beliefs regarding perceived intent to harm the Black community were prevalent. Opportunities to optimally address vaccine hesitancy included countering negative social media messages with positive messaging that matches the community’s vivid ways of discussing vaccines, collaborating with community stakeholders on vaccine promotion efforts, and offering workplace-based vaccine promotion efforts. Conclusions This study presents data that indicate it may be optimal to more broadly define ‘community’ in COVID-19 vaccine promotion efforts to include social media and workplace venues. To optimize vaccine and vaccine booster uptake and equity, public health must address historic racism and other concerns by using outreach that is grounded in communities.

The first fully integrated GaN pulse width modulation (PWM) generator for power conversion applications is presented in this paper. The solution is implemented in a 0.5- $\mu \text{m}$ technology, avoiding additional pins and external capacitors for sawtooth signal generation while providing high accuracy. Indeed, the large GaN process spreads are addressed through an innovative dynamic offset compensation approach whose clock signal takes advantage of the PWM signal itself. The proposed PWM generator adopts a 6-V power supply and includes a 25 digital divider to set the PWM frequency at 500 kHz and the minimum and maximum duty cycles at 6% and 94%, respectively. Experimental results on integrated prototypes validated the correct circuit functionality over the temperature range from −40°C to 120°C. As a main achievement, this work demonstrates effective all-GaN integration of complex mixed analog and digital circuits, thus representing a significant advancement in the approaches to overcome the main limitations of GaN devices and enable fully integrated signal processing implementation.

In late 2021, a new variant of SARS-CoV-2 called Omicron emerged, replacing Delta worldwide. Although it has been associated with a lower risk of hospitalization and severe forms of COVID-19, there is little evidence of its relationship with specific symptoms and viral load. The aim of this study was to verify the relationship between Delta and Omicron variants of concern, viral load, and the occurrence of symptoms in individuals with COVID-19. Nasopharyngeal swab samples were collected and sequenced from patients with COVID-19 from the Northeast Region of Brazil between August 2021 and March 2022. The results showed a gradual replacement of the Delta variant by the Omicron variant during the study period. A total of 316 samples (157 Delta and 159 Omicron) were included. There was a higher prevalence of symptoms in Delta-infected individuals, such as coryza, olfactory and taste disturbances, headache, and myalgia. There was no association between viral load and the variants analyzed. The results reported here contribute to the understanding of the symptoms associated with the Delta and Omicron variants in individuals affected by COVID-19.

There is a growing body of literature investigating the relationship between the frequency domain analysis of heart rate variability (HRV) and cognitive Stroop task performance. We proposed a combined assessment integrating trunk mobility in 72 healthy women to investigate the relationship between cognitive, cardiac, and motor variables using principal component analysis (PCA). Additionally, we assessed changes in the relationships among these variables after a two-month intervention aimed at improving the perception–action link. At baseline, PCA correctly identified three components: one related to cardiac variables, one to trunk motion, and one to Stroop task performance. After the intervention, only two components were found, with trunk symmetry and range of motion, accuracy, time to complete the Stroop task, and low-frequency heart rate variability aggregated into a single component using PCA. Artificial neural network analysis confirmed the effects of both HRV and motor behavior on cognitive Stroop task performance. This analysis suggested that this protocol was effective in investigating embodied cognition, and we defined this approach as “embodimetrics”.

Global fruit and nut yields are affected by shortfalls in pollinator populations, and pollen limitation is most prevalent among tropical, bee-pollinated and self-incompatible plants. Macadamia is a subtropical, bee-pollinated crop in which some cultivars have been found to be highly outcrossing. We aimed to determine the extent of outcrossing and its effects on nut quality across a wide range of international macadamia cultivars in three countries. We sampled fruit from 19 macadamia cultivars across 23 sites in Australia, Brazil and South Africa. We used genotype-by-sequencing and MassARRAY methods to assign paternity to individual fruit and we assessed pollen-parent effects on nut quality. Macadamia was highly outcrossing, producing 80–100% of fruit by cross-pollination, at 17 of the 23 sites. Mixed mating (41–72% outcrossing) was identified at five sites, and low outcrossing (10%) was identified in one cultivar at one site where it was isolated from other flowering macadamia trees. Outcrossed fruit often had significantly better quality than selfed fruit, with 1.61–3.39 g higher nut-in-shell mass, 0.53–1.55 g higher kernel mass, 3.3–6.4% higher kernel recovery, and 3.0–3.5% higher oil concentration. The differences in kernel recovery equated to differences in value of USD 433–841 per ton of nut-in-shell at prices of USD 3000 per ton. In summary, macadamia cultivars were mostly highly outcrossing, and outcrossed nuts often had higher quality than selfed nuts. Growers should consider interplanting different cultivars more closely and distributing bee hives more widely to maximise cross-pollination, produce high yields, and optimise nut quality.

O Indicador de Salubridade Ambiental (ISA) torna-se útil à tomada de decisão municipal para mensurar a qualidade de vida urbana, segundo o Conselho Estadual de Saneamento de São Paulo (Conesan). O objetivo foi adaptar o ISA e analisar a salubridade em quatro municípios, integrantes da bacia hidrográfica dos rios Piracicaba, Capivari e Jundiaí (UGRHI 5). A partir da revisão de literatura e da dificuldade de acesso aos dados, ajustes foram realizados no modelo original para análise do ISA em Rio Claro, Cordeirópolis, Limeira e em Santa Gertrudes. O método adaptado com 18 indicadores ilustrou que três municípios estão salubres, e o outro, em média salubridade. O esgoto sanitário não tratado é um dos quesitos para elevar a salubridade e garantir a gestão pública satisfatória. Investimentos econômicos e técnicos são necessários para assegurar os serviços equânimes à população.

Atualmente, o Brasil é considerado o maior produtor de maracujá-amarelo do mundo. A polinização do maracujazeiro é efetivada unicamente pela abelha do gênero (Xylocopa spp.), mais conhecida por mamangava, mangangá ou vespa-de-rodeio. Essas abelhas se alimentam do néctar retirado das flores dos maracujazeiros, as quais, simultaneamente, realizam a polinização, com grande eficiência. Este trabalho objetiva ressaltar a importância da abelha mamangava para a polinização da flor do maracujá-amarelo, em uma pequena plantação em Palmeira dos Índios- AL. A coleta dos dados obtida in loco, a partir de caminhadas, no período de dezembro de 2016 a abril de 2017. Entre as fileiras do plantio observou-se um número maior de outros visitantes florais, cujas abelhas mamangavas se apresentavam sempre em menor quantidade, e mesmos assim, foram as únicas capazes de realizarem a polinização com qualidade. A importância da mamangava na polinização do maracujá-amarelo necessitou visualizar as flores do plantio mais visitados e compará-los com outras. As flores visitadas pela mamangava foram polinizadas, cujo aproveitamento é 100% de frutos vingados. Já as flores visitadas pelas demais espécies tiveram grandes danos com 0% de frutos vingados. Portanto, a abelha mamangava do gênero Xylocopa é essencial a perpetuação da espécie do maracujá-amarelo passifloracea edulis. Palavras-chave: Mamangava, flor, Polinização.

Este artigo pretende analisar o desenvolvimento do pensamento crítico sobre questões de género no contexto da formação no ensino superior tomando como caso de estudo a proposta “Género(s)” que visou a realização de um projeto transdisciplinar articulado entre as Unidades Curriculares de Oficina de Artes, Tecnologias e Multimédia IV (OATM IV) — módulos de Escultura e Arte Multimédia — e de Teoria da Arte, do 2.º semestre do ano letivo de 2019/2020, de forma a convidar a uma reflexão sobre a questão do Género e a despertar o pensamento crítico. No decorrer do processo, constatámos que os alunos mobilizaram e desenvolveram pensamento crítico de forma a ultrapassar, de forma criativa, os estereótipos sobre questões de género. Deste modo, consideramos que a produção artística e/ou a interpretação de obras de arte estimulam o pensamento autónomo, capaz de lidar com situações novas, através da projeção de várias hipóteses alternativas. Concluímos, assim, que a educação artística é um local privilegiado para estimular e desenvolver pensamento crítico, sem recorrer a ideias pré-concebidas, sendo por isso, potencialmente, apto a combater os estereótipos de classe, cultura ou género e, deste modo, contribuir para a criação de valores orientadores de uma ação socialmente justa.

As enchentes, inundações e erosões urbanas são problemas advindos do impacto da antropização, que podem resultar de ocupações irregulares e ausência planejamento territorial, prejudicando a comunidade, em especial nas áreas com topografia acidentada e várzeas com jusante de aluvião. Nessas regiões, as inundações prejudicam a mobilidade dos moradores e colocam em risco sua integridade física. O principal objetivo deste estudo foi elaborar um mapa de risco à inundação na Unidade de Negócio Oeste (MO) da Companhia de Saneamento Básico do Estado de São Paulo (Sabesp), pelo uso do software livre QGIS. A metodologia utilizou a técnica Analitycal Hiearchy Process (AHP), baseando-se nos seguintes critérios: pedologia, geologia, uso e ocupação da terra, altimetria e declividade do terreno. Foram elaborados mapas para cada critério, respeitando-se as notas de influência dos intervalos e os pesos estatísticos a partir da análise hierárquica. A partir da álgebra de mapas no Sistema de Informações Geográficas (SIG), obteve-se como resultado o mapa final de riscos a áreas de alague. A MO obteve a predominância de risco regular com 52,5% referente a uma área de 53 mil hectares, sendo que o risco de maior valor observado teve um percentual de 13,6%. A disposição geométrica das zonas de risco ficou condizente com as áreas da realidade, como por exemplo o bairro do Rochdale, em Osasco, e os vetores dos córregos inundáveis. A metodologia proposta pode ser utilizada como instrumento de suporte para elaboração de projetos ambientais e planeamento urbano que objetivem controlar as inundações e alertar aos moradores que residem nessas áreas.

On April 1, 2020, the State of Emergency was decreed through Presidential Decree 11/2020, which lasted until September 6, 2020. Through Resolution No. 72/2020, of August 5, the President of the Republic (PR) declared a state of emergency for the entire Moz ambican territory, later ratified by Law No. 9/2020, of 7 August. The present analysis, entitled State capacity and society's demands in the context of covid-19 in the education sector in Mozambique, aims to analyze the State capacity and response of the education sector in the context of the Covid-19 Pandemic. In methodological terms, we resorted to documental and bibliographic analysis around the theme in question. It can be concluded that the Mozambican State has shown an articulating and minimizing capacity to face the challenges imposed by Covid-19. The State's capacity to face the new dynamic proved to be challenging and remains in this process as a key entity to ensure the effectiveness and implementation of all preventive measures. However, what remains open is the financial capacity for these same measures to be comprehensive and inclusive, taking into account the disparities in access to resources and well-being.

La necesidad de servicios de cuidados prolongados a adultos mayores origina la actividad de ayuda no profesional y a la figura del cuidador principal informal. El objetivo de la investigación fue describir el perfil del cuidador principal informal acompañante del paciente a consulta externa del Hospital de Atención Integral del Adulto Mayor en el último trimestre de 2021. Se hizo un estudio cuantitativo, observacional y descriptivo, en una población de 322 cuidadores principales informales de adultos mayores en el último trimestre de 2021, seleccionando una muestra de 190 individuos mediante un procedimiento del tipo sujetos voluntarios. El instrumento aplicado fue una guía de entrevista estructurada basada en la encuesta de caracterización del cuidado de la díada cuidador familiar-persona con enfermedad crónica. Existió un predominio del cuidador de sexo femenino (83,2%); los hijos de los adultos mayores (57,9%); las personas casadas (48,9%); los que viven con el adulto mayor (42,6%); aquellos que ejercen esa función desde entre 1 y 6 años (57,9%) y los que dedican hasta 15 horas (58,9%). Además, el 86,3% realiza quehaceres domésticos. Se observó un deterioro de la condición de salud luego de iniciar en las funciones del cuidado y todos mencionaron padecer de alguna enfermedad; sin embargo, prevalecieron los que señalan recibir efectos emocionales positivos a partir del cuidado.

In recent years, due to technological advancement, research has been directed to the development and analysis of resources and tools related to educational robotics with particular attention to the field of special needs and training actions aimed at learners, teachers, professionals, and families. The use of robotics in all levels of education can support the development of logical and computational thinking, interaction, communication, and socialization, and the acquisition of particularly complex work practices, for example, in the medical field. The adoption of successful educational robotics training practices can be a potential tool to support rehabilitation interventions for disabilities and comprehensive training for students or future professionals in healthcare. A scoping review was conducted on the main topics “education” AND “robotics” with three specific focuses on complementary themes in educational research about ER: (1) teaching and computational thinking, (2) training in the health sector, and (3) education and special needs. The authors systematically searched two online databases, Scopus and Web of Science, up to April 2022. A total of 164 articles were evaluated, and 59 articles were analyzed, in a particular way N = 33 related to computational thinking, N = 15 related to e-health, and N = 11 related to special needs. The following four questions guided our research: (1) What are the educational and experimental experiences conducted through robotics in transdisciplinary fields? (2) What tools and resources are most used in such experiments (educational robotics kit, humanoid robots, telepresence robots etc.)? (3) What are the constitutive elements of the experiments and studies involving robotics and health in educational contexts? and (4) What are those explicitly related to students with special needs? In this study, part of the research project “Robotics and E-health: new Challenges for Education” (RECE) activated at the University of Modena and Reggio Emilia. RECE aims to investigate the training, educational, cognitive, and legal processes induced by the increasing diffusion of educational robotics and telemedicine in clinical and surgical contexts.

Background: Biological ageing and pathological changes of teeth impact the appearance and may hinder the effectiveness of facial aesthetic treatments. The present cross-sectional study in Caucasian dentate individuals aimed to measure facial features of the lower and middle parts of the face across different ages and to identify any significant impacts of age, sex and dental variables on facial aesthetics. Methods: Fifty-eight adults (ranging from 26 to 79 years of age) participated in the study. Facial measurements were collected via digital two-dimensional photography, and intraoral variables were recorded. The data were digitally analysed using ImageJ software and statistically analysed using SPSS Software. Results: The lower and middle third of the face revealed statistically significant changes across the age span tested, with the middle third presenting higher values in females and the lower appearing more prominent in males. A negative correlation with age was revealed for the distance between the pupil and the orbital point. Intraoral dental variables were also significantly related to facial measures. Conclusions: The study enriches the anthropometric data available for the Greek population, with age and sex significantly impacting facial aesthetics and oral variables. Considering such information during preoperative planning for full-arch dental restorations or facial surgery is essential.

Teline monspessulana is highly invasive in several countries around the world. This species pressurizes and displaces several native and endemic tree species in south-central Chile such as Nothofagus obliqua, the native species of greatest timber interest. We determined the effects induced by allelochemical stress of T. monspessulana on N. obliqua germination and initial growth. Germination was evaluated under in vitro conditions and in natural substrate obtained from sites inhabited by N. obliqua and from nearby areas invaded by T. monspessulana. Controls irrigated with tap water and treatments with aqueous extracts of aerial organs of the invasive species were used. Morphometric and morphological variables were evaluated, and the composition of alkaloids and phenols from the plant organs used for the aqueous extracts was determined. The substrates were also chemically characterized. Allelochemicals synthesized by T. monspessulana caused germination and growth inhibition and tissue-level alterations, as well as leaf and root damage in N. obliqua seedlings. In the aerial organs of T. monspessulana, the quinolizidine alkaloids aphylline, caulophylline, anagyrine, and sophocarpine were mainly detected. In addition, 21 phenolic compounds were identified, including gallic acid, vanillic acid, chlorogenic acid, p-coumaric acid, and quercetin. The phytotoxic potential of T. monspessulana can compromise the natural multiplication of N. obliqua and its survival from its first phenological stages. This interdisciplinary study model facilitated the clarification of the plant–plant relationship mediated by allelochemicals. The model can be replicated to investigate other interspecific interactions between invasive and native species.

Cyclooxygenase (COX) inhibitors have been demonstrated to have antitumour activity in canine urothelial cell carcinoma (UCC), given as a sole treatment or in combination with chemotherapy. The purpose of this retrospective multi-institutional study was to assess the efficacy of meloxicam in combination with mitoxantrone or vinblastine as a first-line treatment for non-resectable canine UCC. Gastrointestinal adverse effects (AEs) of these treatment combinations were also assessed. A total of 28 dogs met the inclusion criteria, 21/28 dogs received mitoxantrone and meloxicam, and 7/28 received vinblastine and meloxicam. Tumour response (TR) and AE were evaluated according to Veterinary Co-Operative Oncology Group (VCOG) criteria. The endpoint of the study was the time to tumour progression (TTP). The mitoxantrone-group induced 24% partial response and 62% stable disease, while the vinblastine-group induced 14% and 86%, respectively. Median TTP was 84 days (mitoxantrone and meloxicam, 70 days; and vinblastine and meloxicam, 178 days). The presence of metastatic disease significantly decreased TTP (p = 0.007). Gastrointestinal AEs were reported in 21.4% of the patients, with the most common being VCOG grade 1–2 diarrhoea. Meloxicam is a well-tolerated NSAID when combined with mitoxantrone or vinblastine as first-line treatment for non-resectable canine UCC.

Abstract Few biodiversity indicators are available that reflect the state of broad-sense biodiversity—rather than of particular taxa—at fine spatial and temporal resolution. One such indicator, the Biodiversity Intactness Index (BII), estimates how the average abundance of the native terrestrial species in a region compares with their abundances in the absence of pronounced human impacts. We produced annual maps of modelled BII at 30-arc-second resolution (roughly 1 km at the equator) across tropical and subtropical forested biomes, by combining annual data on land use, human population density and road networks, and statistical models of how these variables affect overall abundance and compositional similarity of plants, fungi, invertebrates and vertebrates. Across tropical and subtropical biomes, BII fell by an average of 1.9 percentage points between 2001 and 2012, with 81 countries seeing an average reduction and 43 an average increase; the extent of primary forest fell by 3.9% over the same period. We did not find strong relationships between changes in BII and countries’ rates of economic growth over the same period; however, limitations in mapping BII in plantation forests may hinder our ability to identify these relationships. This is the first time temporal change in BII has been estimated across such a large region.

RESUMO Objetiva validar um plano de indicadores para a avaliação da implementação da Política Nacional de Saúde Integral da População Negra nos municípios brasileiros. O estudo empregou procedimentos teóricos e metodológicos para o alcance da validade de conteúdo, por meio da aplicação da taxa de concordância e do Índice de Validade de Conteúdo. Participaram do estudo especialistas das áreas de saúde da população negra e avaliação em saúde. Dos 36 indicadores, na avaliação de concordância, 35 alcançaram o ponto de corte e 32 alcançaram Índice de Validade de Conteúdo superior a 0,80. Na análise geral desse índice, o plano de indicadores obteve 0,86 como pontuação, considerado como válido em seu conteúdo por ter superado o ponto de corte estabelecido (0,80). Conclui-se que o plano de indicadores ora apresentado possui a concordância, a pertinência e a clareza necessárias para a sua utilização nos municípios brasileiros, contudo, se faz necessária a continuidade de seu aperfeiçoamento nas fases subsequentes à sua validação.

Abstract Background Multiple studies regarding the use of Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) in patients with non-compressible torso injuries and uncontrolled haemorrhagic shock were recently published. To date, the clinical evidence of the efficacy of REBOA is still debated. We aimed to conduct a systematic review assessing the clinical efficacy and safety of REBOA in patients with major trauma and uncontrolled haemorrhagic shock. Methods We systematically searched MEDLINE (PubMed), EMBASE and CENTRAL up to June 2020. All randomized controlled trials and observational studies that investigated the use of REBOA compared to resuscitative thoracotomy (RT) with/without REBOA or no-REBOA were eligible. We followed the PRISMA and MOOSE guidelines. Two authors independently extracted data and appraised the risk of bias of included studies. Effect sizes were pooled in a meta-analysis using random-effects models. The quality of evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation methodology. Primary outcomes were mortality, volume of infused blood components, health-related quality of life, time to haemorrhage control and any adverse effects. Secondary outcomes were improvement in haemodynamic status and failure/success of REBOA technique. Results We included 11 studies (5866 participants) ranging from fair to good quality. REBOA was associated with lower mortality when compared to RT (aOR 0.38; 95% CI 0.20–0.74), whereas no difference was observed when REBOA was compared to no-REBOA (aOR 1.40; 95% CI 0.79–2.46). No significant difference in health-related quality of life between REBOA and RT (p = 0.766). The most commonly reported complications were amputation, haematoma and pseudoaneurysm. Sparse data and heterogeneity of reporting for all other outcomes prevented any estimate. Conclusions Our findings on overall mortality suggest a positive effect of REBOA among non-compressible torso injuries when compared to RT but no differences compared to no-REBOA. Variability in indications and patient characteristics prevents any conclusion deserving further investigation. REBOA should be promoted in specific training programs in an experimental setting in order to test its effectiveness and a randomized trial should be planned.

Objetivo: desenvolver e validar o conteúdo do Instrumento para Transferência do Cuidado de Enfermagem do paciente pediátrico. Métodos: estudo metodológico, desenvolvido em duas etapas, envolvendo 37 enfermeiros. A primeira etapa contemplou o desenvolvimento do instrumento. A segunda etapa foi a validação de conteúdo pelos experts, por meio da técnica Delphi e aplicação do teste piloto. Para análise dos dados foi empregado o Índice de Validade de Conteúdo. Resultados: o instrumento foi desenvolvido com quatro componentes e alcançou Índice de Validação de Conteúdo geral de 0,95. O teste piloto do instrumento foi aplicado em 25 transferências de cuidado pelas enfermeiras, que o consideraram aplicável ao contexto do estudo. Conclusão: o instrumento foi validado sob os aspectos da aparência/clareza, abrangência, pertinência e aplicabilidade à prática do enfermeiro no contexto hospitalar pediátrico estudado, sem demandar muito tempo para aplicação pelas enfermeiras.

We run logit models to explain the variability of Pinus radiata structural lumber in 71 second and third unpruned logs. The response variable was the proportion of lumber with a static modulus of elasticity greater or equal than 8 GPa, pMSG8+, and the explanatory variables were log volume, branch index, largest branch, log internode index, wood basic density, and acoustic velocity. The average pMSG8+ volume was 44,30 % and 36,18 % in the second and third log respectively. Ten models were selected based on meeting statistical assumptions, their goodness of fit, and the statistical significance of their parameters. The best models (R2 - adj. > 0,75) included acoustic velocity (AV) as explanatory variable, which explained 56,25 % of the variability of pMSG8+. Models without AV presented goodness of fit ranging from 0,60 to 0,75 (R2 - adj.), and variables with the highest weight to explain the variability of pMSG8+ were volume, followed by wood basic density, branch index, and largest branch. It is possible to model pMSG8+ from log variables even when acoustic velocity is not available; however, this requires wood basic density models calibrated for the Pinus radiata growing zone.

Abstract Background We conducted a systematic review to evaluate and compare the accuracy of pre-hospital triage tools for major trauma in the context of the development of the Italian National Institute of Health guidelines on major trauma integrated management. Methods PubMed, Embase, and CENTRAL were searched up to November 2019 for studies investigating pre-hospital triage tools. The ROC (receiver operating characteristics) curve and net clinical benefit for all selected triage tools were performed. Quality assessment was performed using the Quality Assessment of Diagnostic Accuracy Studies–2. Certainty of the evidence was judged with the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. Results We found 15 observational studies of 13 triage tools for adults and 11 for children. In adults, according to the ROC curve and the net clinical benefit, the most reliable tool was the Northern French Alps Trauma System (TRENAU), adopting injury severity score (ISS) > 15 as reference (sensitivity (Sn), 0.92; specificity (Sp), 0.41; 1 study; sample size, 2572; high certainty of the evidence). When mortality as reference was considered, the pre-hospital triage tool with the best net clinical benefit trajectory was the New Trauma Score (NTS) < 18 (Sn, 0.82; Sp, 0.86; 1 study; sample size, 1001; moderate certainty of the evidence). In children, high variability among all triage tools for sensitivity and specificity was found. Conclusion Sensitivity and specificity varied across all available pre-hospital trauma triage tools. TRENAU and NTS are the best accurate triage tools for adults, whereas in the pediatric area a large variability prevents any firm conclusion.

ABSTRACT Objectives: Develop and validate a new and simplified score for evaluating the lower urinary tract symptoms in men. Materials and methods: We modified the existing visual prostate symptom score, including changes in the images, sequence, and new alternatives, resulting in a new visual score (LUTS visual score-LUTS-V). For the validation of the new tool, we used the International Prostatic Symptom Score as the gold-standard and the new LUTS-V to 306 men. The total IPSS score and the total LUTS-V score of each subject were evaluated to determine the agreement between the two instruments. ROC curve was used to evaluate the diagnostic accuracy and best cut-off of LUTS-V. Sensitivity, specificity, and diagnostic odds ratios were used to describe the diagnostic properties. Results: The mean age of the participants was 59 [52-87] years. There was a significant correlation between LUTS-V and IPSS. (r=0.72 (p 4 was the best threshold, with a sensitivity of 74% and specificity of 78%. Conclusions: LUTS-V is a simple, self-administered tool with a significant discriminatory power to identify subjects with moderate to severe LUTS and may represent a useful instrument for the diagnosis and follow-up of men with urinary symptoms.