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ABSTRACT Objectives: to assess patient safety culture during the COVID-19 pandemic and identify the dimensions that need to be improved in hospital settings and which sector, open or closed, direct or indirect care, exhibits a higher level of safety culture. Methods: a descriptive and cross-sectional study. The validated version for Brazil of the Hospital Survey on Patient Safety Culture instrument was applied to assess patient safety culture. Those dimensions with 75% positive responses were considered strengthened. Results: all dimensions presented results lower than 75% of positive responses. Closed sectors showed a stronger safety culture compared to open ones. Indirect care sectors had a low general perception of patient safety when compared to direct care sectors. Conclusions: with the pandemic, points of weakness became even more evident, requiring attention and incisive interventions from the institution’s leaders.

The ocelot is an important Neotropical mesopredator and information on its spatial ecology remains scarce. Here we estimated the ocelot home range in a remnant of Lowland Atlantic Forest in Southeastern Brazil. The data were collected by camera traps installed at eight known ocelot latrines. We estimated the home range both based on the Minimum Convex Polygon (MCP) and the 95% adaptive Kernel density estimator (95%K) to compare with other published studies. We identified 22 ocelots (adult males = 8; adult females = 12; cubs = 2). Six males were recorded at more than one latrine, while all females were recorded at only one sampling point. In addition to male ocelots being recorded at a large number of points, they showed greater intrasexual spatial overlap as they used the same latrines, suggesting larger home ranges than females. The mean home range size for males was 12.1 ± SE 4.4 km2 (range = 6.2 to 20.8 km2) using MCP, and 19.9 ± SE 9.5 km2 (range = 10.1 to 38.9 km2) applying 95%K. Despite our estimates representing an approximation of the total area used by males, both values are consistent with those reported from other locations. Our data complemented the gradient of vegetation type sampled for ocelots in Atlantic Forest and support the suggestion that this environmental variable and, consequently, its effect on prey availability, influence the home range size of ocelot. Information on population ecology and other spatial ecology data are also presented.

A partir de uma matriz de análise desenvolvida em estudos anteriores que identificou quatro tipomorfologias das favelas na cidade do Rio de Janeiro – enclave, linha, quadra e malha – este artigo busca aprofundar o seu estudo em cinco momentos, ao longo de 100 anos, de 1922 a 2022, em quatro comunidades da Área de Planejamento 3 (AP3), a Zona Norte, na Cidade do Rio de Janeiro. A abordagem apoia-se em estudos sobre a morfologia urbana da cidade contemporânea onde o entendimento da tipomorfologia se estabelece como matriz síntese das relações entre os processos de urbanização e a conformação do tecido urbano. A metodologia empregada nas análises, que sobrepõe enfoque formal e temporal, se apoia na interpretação das alterações do tecido urbano a partir de mapas oriundos da cartografia oficial da Cidade do Rio de Janeiro e de imagens de satélite disponíveis pela Google. Nas considerações finais argumentamos acerca da relação híbrida que se estabelece entre a urbanização formal e a forma de crescimento da informalidade e verificamos a validade das categorias tipomorfológicas como aproximação sintética e diagramática do fenômeno da favela carioca.

Frey syndrome is rare in children and often erroneously attributed to food allergy. It is caused by damage to the auriculotemporal nerve, hence the alternative name of the auriculotemporal syndrome. This study describes a case of Frey syndrome in a 2-year-old girl with flushing without sweating on the left cheek after eating tomato and citrus fruit with a medical history of traumatic forceps-assisted delivery. Recognition of this condition is vital to avoid unnecessary medical costs and procedures and provide reassurance to parents and primary care providers in this benign condition with a self-limited course.

Feocromocitoma é uma neoplasia rara de células cromafins, localizado nas adrenais que apresenta importância por ter a capacidade de incitar crises hipertensivas potencialmente fatais. Os sinais clínicos estão relacionados com a liberação de catecolaminas. A ressecção cirúrgica é o tratamento definitivo, mas o tratamento clínico também mostra-se profícuo. Objetivou-se descrever um caso de feocromocitoma em uma cadela de nove anos, a qual apresentava hematomas cutâneos e perioculares, comportamento apático, anorexia há quatro dias e polidipsia. A paciente foi recebida no Hospital Veterinário da UNIJUÍ, e após consulta clínica e internação, a tutora optou pela eutanásia e necrópsia motivada pela baixa adesão da cadela ao tratamento. O animal foi encaminhado para o laboratório de Patologia Veterinária da mesma instituição que evidenciou a adrenal direita com proliferação de células vacuolizadas focalmente extensa, relativo a feocromocitoma. Diante disso, o médico veterinário deve conhecer e considerar este tipo de neoplasia.

Objetivo: analisar evidências científicas sobre entrevista motivacional e sua influência no autogerenciamento do cuidado do adolescente com diabetes mellitus tipo 1. Método: revisão integrativa cuja busca aconteceu em junho de 2020 nas bases de dados LILACS, PubMed, CINAHL, Scopus e Web of Science para atender a pergunta: Quais evidências científicas sobre entrevista motivacional e sua influência no autogerenciamento do cuidado ao adolescente com diabetes mellitus tipo 1? Todos os artigos identificados estavam no idioma inglês e publicados entre 2003 e 2020. Resultados: entre os dez estudos incluídos, nove foram realizados nos Estados Unidos e um no Reino Unido. As pesquisas tiveram métodos diversificados na aplicação da entrevista motivacional em circunstâncias diferentes e os resultados mostraram impactos positivos no autogerenciamento dos cuidados de adolescentes com DM1, principalmente em relação ao controle glicêmico e/ou nos níveis de hemoglobina glicada. Conclusão: a entrevista motivacional favorece o autogerenciamento do cuidado e autonomia do adolescente com diabetes. ABSTRACT Objective: this study examined scientific evidence on motivational interviewing and its influence on self-management among adolescents with type-1 diabetes mellitus (DM1). Methods: the survey for this integrative review took place in June 2020 in the LILACS, PubMed, CINAHL, Scopus, and Web of Science databases to answer the question: What scientific evidence is available on motivational interviewing and its influence on self-management among adolescents with DM1? All the articles found were in English and published between 2003 and 2020. Results: of the ten studies included, nine were conducted in the United States and one in the United Kingdom. The studies used different methods for applying motivational interviewing in differing circumstances, and their findings revealed positive impacts on self-management among adolescents with type-1 diabetes, especially on blood glucose monitoring and/or on glycated hemoglobin levels. Conclusion: motivational interviewing is an intervention that favors self-management and autonomy among adolescents with diabetes. RESUMEN Objetivo: analizar evidencias científicas sobre entrevista motivacional y su influencia en la autogestión del cuidado de adolescentes con diabetes mellitus tipo 1 (DM1). Métodos: revisión integradora llevada a cabo en junio de 2020 en las bases de datos LILACS, PubMed, CINAHL, Scopus y WoS para responder a la pregunta: ¿Cuáles son las evidencias científicas sobre entrevista motivacional y su influencia en la autogestión del cuidado de adolescentes con diabetes mellitus tipo 1? Los artículos encontrados estaban en inglés y fueron publicados entre 2003 y 2020. Resultados: de los diez estudios incluidos, nueve se realizaron en Estados Unidos y uno en Reino Unido. Las investigaciones utilizaron diferentes métodos de aplicación de la entrevista motivacional en diferentes circunstancias y los resultados señalaron impactos positivos en la autogestión de los cuidados de adolescentes con DM1, especialmente cuanto al control glucémico y/o niveles de hemoglobina glucosilada. Conclusión: la entrevista motivacional favorece la autogestión del cuidado y la autonomía de adolescentes con diabetes.

Studies regarding vegetal extracts and essential oils from native plants have demonstrated efficiency in controlling phytopathogens of fungitoxic action, hampering the development of phytopathogenic fungi. This study aims to determine the fungicide effect of vegetal extracts during the mycelial growth of the fungus Sclerotinia sclerotiorum (Lib.) de Bary. The experiment was conducted in the phytosanitary laboratory of the UEMS in the unit of Cassilândia-MS, Brazil. A completely randomized design was used with a factorial scheme 4 x 5, comprising leaves, bark, and branches of cinnamon and mint leaves in the concentrations of 0, 2.5, 5.0, 10, and 20%, with six repetitions per treatment. The evaluations were made 24, 48, and 96 hours after the transplant, obtaining the diametrically opposite means with a caliper to determine the measures. The results indicate a higher inhibitory efficiency against fungi development using extracts of mint leaves and cinnamon leaves and branches.

Introduction Automated systems for ventilator management to date have been either fully heuristic rule-based systems or based on a combination of simple physiological models and rules. These have been shown to reduce the duration of mechanical ventilation in simple to wean patients. At present, there are no published studies that evaluate the effect of systems that use detailed physiological descriptions of the individual patient.The BEACON Caresystem is a model-based decision support system that uses mathematical models of patients’ physiology in combination with models of clinical preferences to provide advice on appropriate ventilator settings. An individual physiological description may be particularly advantageous in selecting the appropriate therapy for a complex, heterogeneous, intensive care unit (ICU) patient population.Methods and analysis Intenive Care weaning (iCareWean) is a single-blinded, multicentre, prospective randomised control trial evaluating management of mechanical ventilation as directed by the BEACON Caresystem compared with that of current care, in the general intensive care setting. The trial will enrol 274 participants across multiple London National Health Service ICUs. The trial will use a primary outcome of duration of mechanical ventilation until successful extubation.Ethics and dissemination Safety oversight will be under the direction of an independent committee of the study sponsor. Study approval was obtained from the regional ethics committee of the Health Research Authority (HRA), (Research Ethic Committee (REC) reference: 17/LO/0887. Integrated Research Application System (IRAS) reference: 226610. Results will be disseminated through international critical care conference/symposium and publication in peer-reviewed journal.Trial registration number ClinicalTrials.gov under NCT03249623. This research is registered with the National Institute for Health Research under CPMS ID: 34831.

Introduction: According to the OECD, Portugal and Poland rank below average in several well-being measures such as income and wealth, and health status. Investigating how people perceive the threats to health in these two countries, is an important issue to address priority needs. To meet this need, the objective of this paper was to compare the perceptions of the threats to the health and well-being among the Polish and Portuguese older persons and explore differences between the countries in respect of patterns of self-rated health. Material and Methods: A Cross-sectional study with two convenience samples from primary health care services of Poland and Portugal was conducted; 480 adults aged 65 and over (247 Portuguese) were included. The EASYCare standard assessment of 2010 was applied under a joint project of both countries. The association between ‘self-rated unhealthy’ and socio-demographic and threats to health variables was examined using logistic regression. Results: In both countries about two thirds of the older persons self-rated their health as unhealthy. Having more than enough finances was associated with a significant lower odds of being unhealthy compared with those without enough finances at the end of the month (Portugal: OR = 0.25, 95% CI 0.10 to 0.63; Poland: OR = 0.33, 95% CI 0.12 to 0.88). Visual problems, bodily pain, memory loss, feeling bored or lonely and reporting shortness of breath during normal activities was consistently associated with fair or poor self-rated health. Discussion: These findings provide important information regarding the health profile of older people which can help in the development of people-centred health systems where their lives and well-being can be improved. Conclusion: The unhealthy perception of older people was consistently associated with indicators of major health threats.

Introduction: The EASYCare is a multidimensional assessment tool for older people, which corresponds to the concerns and priorities of older people in relation to their needs, health, and quality of life. The EASYCare instrument has been used in many countries worldwide. Lack of reliability evidence has recently been raised by researchers. This study aimed to test the validity and reliability of the EASYCare-2010 instrument in community-dwelling Portuguese older people attended in Primary Health Care centres. Methods: The sample for this transversal study (N = 244) was collected from Portuguese Primary Health Care Centers. Categorical Principal Component Analysis was used to assess the underlying dimensions of EASYCare-2010. Construct validity was evaluated through correlation with the World Health Organization Quality of Life Assessment Instrument-Short Form. Results: A two-factor model (labelled âmobility and activities of daily lifeâ, and âgeneral well-being and safetyâ) was found. The EASYCare-2010 instrument showed acceptable levels for internal consistency (â¥0.70). The EASYCare-2010 factors were correlated with measures of quality of life. Results showed that in most polytomous items, some of the more extreme categories were not considered at all or only by a residual number of participants. Conclusion: EASY Care -2010 version is a valid and reliable instrument for holistic assessment of the older people attended in Primary Health Care centres in Portugal. Resumen: Introducción: El EASYCare es una herramienta de evaluación multidimensional para las personas mayores, que corresponde a las preocupaciones y prioridades de las personas mayores en relación con sus necesidades, salud y calidad de vida. El instrumento EASYCare se ha utilizado en muchos países del mundo. La falta de pruebas de fiabilidad ha sido planteada recientemente por los investigadores. Este estudio tuvo como objetivo probar la validez y fiabilidad del instrumento EASYCare-2010 en personas mayores portuguesas residentes en la comunidad, atendidos en centros de Atención Primaria de la Salud. Métodos: La muestra para este estudio transversal (N = 244) se recogió en Centros de Atención Primaria de Portugal. Se utilizó el Análisis de Componentes Principales Categórico para evaluar las dimensiones subyacentes de EASYCare-2010. La validez del constructo se evaluó mediante la correlación con el instrumento de evaluación de la calidad de vida de la Organización Mundial de la Salud, instrumento en su forma corta. Resultados: Se encontró un modelo de dos factores (denominado «movilidad y actividades de la vida diaria» y «bienestar general y seguridad»). El instrumento EASYCare-2010 mostró niveles aceptables de consistencia interna (⥠0.70). Los factores EASYCare-2010 se correlacionaron con medidas de calidad de vida. Los resultados mostraron que en la mayoría de ítems politómicos en algunas categorías extremas no se consideraron o solo por un número residual de participantes. Conclusión: La versión EASY Care-2010 es un instrumento válido y fiable para la evaluación holística de las personas mayores atendidas en centros de Atención Primaria de Salud en Portugal. Keywords: Geriatric assessment, Primary health care, Reliability and validity, Palabras clave: Evaluación geriátrica, Atención primaria de salud, Confiabilidad y validez

Introdução: A doença metabólica óssea da prematuridade consiste numa diminuição da matriz óssea, relativamente ao nível esperado para a idade gestacional. O rastreio baseia-se no doseamento sérico da fosfatase alcalina e fósforo. O objetivo deste estudo é avaliar a prevalência da doença metabólica óssea da prematuridade, analisar os aspetos associados a maior risco para esta doença e descrever o crescimento estaturo-ponderal dos recém-nascidos com peso ao nascer inferior a 1500 g, com doença metabólica óssea da prematuridade. Material e Métodos: Estudo multicêntrico, retrospetivo, observacional e descritivo em três unidades de apoio perinatal diferenciado, entre 1 de maio de 2016 e 30 de abril de 2017; foi obtida uma amostra de conveniência de recém-nascidos com muito baixo peso ao nascer. Descrevem-se as variáveis demográficas, clínicas e laboratoriais dos recém-nascidos com e sem doença metabólica óssea da prematuridade. Resultados: Neste estudo foram incluídos 53 recém-nascidos: 30 do sexo masculino, 16 com idade gestacional ≤ 28 semanas. Foram diagnosticados cinco casos de doença metabólica óssea da prematuridade. Neste grupo, a maioria dos doentes era do sexo masculino e apresentavam idade gestacional e peso ao nascer inferior aos do grupo sem doença metabólica óssea da prematuridade. A duração média de nutrição parentérica foi superior nos recém-nascidos com doença metabólica óssea da prematuridade e a relação cálcio/fósforo utilizada foi inferior às recomendações nacionais. A evolução estaturo-ponderal foi semelhante nos recém-nascidos com e sem doença. Nenhum doente com doença metabólica óssea da prematuridade teve intervenção por medicina física e reabilitação. Discussão: A prevalência de doença metabólica óssea da prematuridade foi de 9,43%, valor inferior ao descrito na literatura. Contudo, apenas 50% dos recém-nascidos cumpriram o rastreio de acordo com as recomendações. Os principais fatores de risco identificados estão de acordo com a literatura. Conclusão: A doença metabólica óssea da prematuridade é uma comorbilidade frequente nos recém-nascidos de muito baixo peso, mas encontra-se subdiagnosticada. É fundamental rastrear os recém-nascidos em risco para esta patologia, utilizando marcadores bioquímicos, assim como estruturar intervenções nutricionais e estimulação física para evitar as consequências da doença a curto e longo prazo.

RESUMO Objetivo: Analisar a aplicabilidade da dinâmica Corpo Saber na sensibilização da criança para o cuidado de si por meio de suas experiências. Métodos: Estudo descritivo e analítico desenvolvido em maio e junho de 2013, com seis crianças diabéticas em idade escolar, atendidas no ambulatório de um hospital de referência em Fortaleza/CE. Resultados: A dinâmica promoveu um ambiente de descontração favorável à expressão de sentimentos e demonstração dos cuidados básicos ao conviver com o diabetes. A sensibilização foi permeada de reflexões sobre o início da doença e o momento atual vivido. Assim, compartilharam com os pares as necessidades de cuidados e aprendizagens no controle metabólico. Conclusão: A aplicação da dinâmica Corpo Saber favoreceu o desenvolvimento de atividades educativas com a participação das crianças em momentos de aprendizagem sobre o cuidado de si.

This article analyses women’s participation in the ‘Network of Agroecological and Peripheral Female Urban Farmers’, an agroecological urban agriculture grassroots network in São Paulo, Brazil. The methodology used was participant observation. The following procedures were used to produce the data: participation in three workshops, direct observation, field notes, and an in-depth interview with two of the organizers and three participants. The results show that the Network engendered the formation of a popular feminist collective identity, as it fostered the awareness of oppressive social structures, such as gender inequality and violence against women, of which many participants were survivors. From a technical standpoint, the Network seeks to expand its scope of action, increase the number of participants, establish new partnerships and access multiple sources of funding to obtain greater autonomy from São Paulo City Council.

Abstract In response to innumerable global challenges in a world ever more complex and interconnected, including a number of public health challenges, the United Nations launched the 2030 Agenda for Sustainable Development; a guideline intended to deal with these issues. Foreseeing their huge complexity, the UNLEASH initiative was created with a vision to gather, on a yearly basis until 2030, 1.000 young talents from all over the world to co-create disruptive solutions for the 17 Sustainable Development Goals (SDGs). The School of Public Health of the University of São Paulo was selected as the only educational institution partner in South America and was invited to select and send students to the launching event in Denmark in August 2017. The aim of this study is to address and reflect on the seven SDGs (health, food, water, energy, urban sustainability, sustainable consumption and production and education) that were explored in this first event and relate the students’ experiences of this global innovation lab.

Reactive oxygen species (ROS) are well-described by-products of cellular metabolic activities, acting as signaling molecules and regulating the redox state of proteins. Solvent exposed thiol residues like cysteines are particularly sensitive to oxidation and their redox state affects structural and biochemical capacities of many proteins. While thiol redox regulation has been largely studied in several cell compartments like in the plant chloroplast, little is known about redox sensitive proteins in the nucleus. Recent works have revealed that proteins with oxidizable thiols are important for the regulation of many nuclear functions, including gene expression, transcription, epigenetics, and chromatin remodeling. Moreover, thiol reducing molecules like glutathione and specific isoforms of thiols reductases, thioredoxins and glutaredoxins were found in different nuclear subcompartments, further supporting that thiol-dependent systems are active in the nucleus. This mini-review aims to discuss recent progress in plant thiol redox field, taking examples of redox regulated nuclear proteins and focusing on major thiol redox systems acting in the nucleus.

. El objetivo fue caracterizar el perfil de adolescentes según características sociodemográficas y describir las situaciones de riesgo y vulnerabilidad mencionados por ellos. Estudio descriptivo, cuantitativo, con 500 adolescentes entre 13-19 años, de Iguatu-CE, Brasil. Los datos fueron recolectados a través de encuesta en agosto de 2008 y analizados por programa estadístico. Los resultados señalaron que los adolescentes eran de zonas urbanas (59,25); sexo femenino (60,0%); residían con los padres (84,6%) y que tiene un ingreso menor o igual al salario mínimo (64,2%). El uso de drogas lícitas e ilícitas fue señalado como factor que expone la salud de adolescentes a riesgos (59,2%) y consideraron importante la prevención (18,2%), incluyendo alimentación saludable (15,2%). Los adolescentes miraron los riesgos presentes en la vida diaria y las posibilidades de protección a través de la educación en la familia y escuela.

Objective: Identification of variables that affect the risk of severe intraventricular hemorrhage (IVH) in very low birth weight (VLBW) newborns. Methods: Analytic case-control study, in a population consisting of all VLBW newborns admitted to the Neonatal Intensive Care Unit of a maternity hospital, between January 2002 and December 2007. The authors considered as cases all VLBW newborns with severe IVH (grade ≥ 3), and control all VLBW newborns without IVH. Independent variables included obstetric, perinatal and neonatal diagnosis and therapy. Bivariate analysis and multivariate logistic regression analysis were performed. Rresults: During this period, of the 864 VLBW newborns admitted to the Neonatal Intensive Care Unit, 9.7% had severe IVH. With bivariate analysis an association between severe IVH, gestational age and birth weight was found. Prenatal care and pre-eclampsia were associated with a decrease in the incidence of severe IVH. Amnionitis, being outborn, vaginal delivery, male gender, intubation in the delivery room, surfactant, hyaline membrane disease, pneumothorax, necrotizing enterocolitis (NEC) perforation and oscillatory high frequency ventilation were associated with an increased incidence of severe IVH. By multivariate logistic regression, the variables associated with increased risk of severe IVH were: pneumothorax (OR = 3.8; 95%CI = 1.7-8.3), NEC with perforation (OR = 8.8; 95%CI = 1.7-45.0), vaginal delivery (OR = 2.0; 95%CI = 1.0-4.1) and high frequency ventilation (OR = 4.8; 95%CI = 1.3-17.3). The following were protective of severe IVH: gestational age (OR = 0.61; 95%CI = 0.52-0.72), patent ductus arteriosus treatment with indomethacin (OR = 0.26; 95%CI = 0.11-0.6) and fertility treatment (OR = 0.24; 95%CI = 0.06-0.94). Cconclusion: These data outline the importance of improvement of pre and neonatal care to reduce severe IVH.

El estudio analiza la producción científica del desempeño de enfermería en la atención sistemática a los familiares de personas con trastorno mental, mediante análisis de periódicos científicos indexados y publicados en bibliotecas universitarias, en el sistema de banco de datos MEDLINE, LILACS y SCIELO en el periodo de 2000 a 2005. La investigación es de naturaleza bibliográfica basada en las conjeturas del análisis de Pimentel, el cual considera el registro del material y el análisis del contenido con elaboración de temáticas, buscando realizar contrapuntos entre los diversos autores. Los resultados demostraron un aumento del número de investigaciones que plantean la participación de la familia en el cuidado terapéutico de las personas con trastorno mental severo, enfatizan conductas y percepciones de las familias y de los profesionales acerca del tratamiento, y alerta para la promoción de la inserción social de la familia, comprensión de las necesidades y promoción de la participación de la familia en los problemas de salud.

ABSTRACT Congenital goiter is a rare cause of neonatal neck mass and may result from a fetal defectin synthesis of thyroxine, or administration of antithyroid drugs or iodides during pregnancy. The thyroid dysfunction often accompanies it. This report describes a case of a male term newborn with congenital goiter and primary hypothyroidism. Hormonal replacement treatment was started leading to normal levels of free thyroxine and triiodothyronine. In face of a maternal negative investigation, dyshormonogenesis was considered to be the most probable cause of hypothyroidism.

Com o objetivo de detectar grupos tróficos, foram analisadas amostras de conteúdos estomacais de sete espécies de peixes cartilaginosos. Os exemplares foram coletados no período de Outubro/85 a Julho/87 na plataforma interna de Ubatuba, SP, Brasil (da costa, até a isóbata de 50 m). A importância dos itens alimentares foi analisada através da freqüência numérica (FN) e da freqüência de ocorrência (FO). As espécies foram agrupadas em três grupos distintos: Piscívoros: Squalus cubensis; comedores de peixes e crustáceos bentônicos: Raja castelnaui, Raja cyclophora, Raja agassizi; comedores de invertebrados bentônicos: Psammobatis glansdissimilis, Rhinobatos horkelii, Zapteryx brevirostris.Stomach contents of seven cartilaginous fish species were analysed with the aim to detect trophic groups. Sampling was effectuated between October/85 and July/87 off the coast of Ubatuba (São Paulo, Brazil) in waters up 50 m depth. The relative importance of different components of the diet was expressed as a percentage frequency of occurrence and percentage number. The seven species were grouped in: fish feeders - Squalus cubensis; benthonic crustacean and fish feeders - Raja castelnaui, Raja cyclophora, Raja agassizi; benthonic invertebrate feeders - Rhinobatos horkelii, Zapteryx brevirostris, Psammobatis glansdissimilis.