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Apresentação do Dossiê.

Neste trabalho, apresento um recorte da tese de doutorado que paralelamente teve a investigação conduzida pela seguinte pergunta: Como estudantes de Licenciatura em Matemática a distância, de uma universidade pública brasileira, se expressam matematicamente em fóruns de discussão? Movido pela necessidade de compreender fenômenos à luz da multimodalidade, que não podem ser mensurados, optei pela abordagem qualitativa. Além disso, imergi em fóruns de discussão para observar, especificamente, a participação do professor e de estudantes na disciplina Álgebra Linear I e, assim, identificar formas de expressão relacionadas aos recursos semióticos da linguagem, do simbolismo matemático e da exibição visual. Em especial, o uso de mídias nos fóruns de discussão realçou limitações técnicas e tecnológicas dos participantes da pesquisa, no entanto, revelou uma combinação de recursos semióticos da linguagem, do simbolismo matemático e da exibição visual na elaboração de seus discursos.

Background: Lesions of the medial collateral ligament (MCL) are the most common knee ligament injuries and, when they occur in isolation, they often progress with satisfactory outcomes using conservative treatment. However, MCL lesions associated with anterior cruciate ligament or posterior cruciate ligament (PCL) injuries in knee dislocations should be reconstructed to prevent failure of the central pivot. In knees with combined injuries involving the PCL and the MCL, the confluence of tunnels in the medial femoral condyle can be a potential problem during reconstruction surgery. Indications: The indication of this technique is the combined injury of the PCL and the MCL. Technique Description: The technique consists in the reconstruction of the PCL and the MCL with an Achilles tendon allograft. The bone plug of the graft is fixed on the tibial bed with the inlay technique. The graft passes through a single femoral tunnel drilled in the medial femoral condyle, with entrance point on the footprint of the PCL on the inner wall of the condyle and exit on the origin of the native MCL, near to the medial epicondyle. The graft is fixed in the femoral tunnel with an interference screw and continues to the isometric point of the anatomic insertion of the MCL in the tibia, where an interference screw is used to fix it. Results: Results from our group using this technique have shown good clinical outcomes, with complications and failure rates similar to other series in the literature. Discussion/Conclusion: This technique is an excellent option for surgeons, when an Achilles tendon allograft is available, to avoid confluence of tunnels in the medial femoral condyle. It presents good results and acceptable complication rates, compatible with the severity of this lesion. Patient Consent Disclosure Statement: The author(s) attests that consent has been obtained from any patient(s) appearing in this publication. If the individual may be identifiable, the author(s) has included a statement of release or other written form of approval from the patient(s) with this submission for publication.

Background: Posterolateral knee injuries can occur in 16% of patients with acute ligament injuries, and up to 70% have a combined anterior cruciate ligament (ACL) tear. Studies have shown that, in different populations, the distance between the insertion of the popliteus tendon and the lateral collateral ligament (LCL) may be smaller than the 18.5 mm previously reported in the literature. When we have an associated injury of the ACL and the posterolateral corner (PLC), the confluence of tunnels in the lateral femoral condyle can be a potential problem during reconstruction surgery. Indications: The indication of this technique is the combined injury of the ACL and the PLC. Technique Description: The reconstruction is performed with 2 semitendinosus tendons and 1 gracilis tendon. The technique consists of making a tunnel in the lateral wall of the femur, from the outside-in, at the isometric point between the origin of the LCL and insertion of the popliteus tendon, and emerging in the inner wall of the lateral femoral condyle at the anatomic point of the ACL. The graft is passed from the tibia to the femur with the doubled gracilis tendon and the 2 simple semitendinosus tendons for the ACL graft. The remaining portions of the semitendinosus tendons are left for reconstruction of the PLC structures, with one of them going straight to the posterolateral tibial tunnel (reconstructing the popliteus tendon), and the other passing through the fibular head tunnel (reconstructing the LCL) and continuing from the fibular head to the posterolateral tibial tunnel (reconstructing the popliteofibular ligament). Results: Patients undergoing this technique achieved good functional outcomes and a failure rate similar to that reported in the literature for combined ACL and PLC reconstruction. Discussion/Conclusion: This technique is an excellent option for patients with the combined injury of the ACL and the PLC, avoiding the confluence of tunnels in the lateral femoral condyle. It presents good results and acceptable complication rates, compatible with the severity of this lesion. Patient Consent Disclosure Statement: The author(s) attests that consent has been obtained from any patient(s) appearing in this publication. If the individual may be identifiable, the author(s) has included a statement of release or other written form of approval from the patient(s) with this submission for publication.

ABSTRACT Objective: This study aims to evaluate the sensitivity and specificity of the lever sign test in patients with and without chronic Anterior Cruciate Ligament (ACL) injuries in an outpatient setting and the inter-examiner agreement of surgeons with different levels of experience. Methods: 72 consecutive patients with a history of previous knee sprains were included. The Lachman, anterior drawer, and Lever Sign tests were performed for all subjects in a randomized order by three blinded raters with different levels of experience. Sensitivity, specificity, positive predictive value, negative predictive value, and inter-rater agreement were estimated for all tests. Results: Among the 72 patients, the prevalence of ACL injuries was 54%. The lever test showed sensitivity of 64.1% (95% CI 0.47-0.78) and specificity of 100% (95% CI 0.87-1.00) for the senior examiner. For the less experienced examiner the sensitivity was 51.8% and the specificity was 93.7%. Positive predictive values (PPV) and negative predictive values (NPV) were 100% and 70.2%, respectively. Conclusion: Lever Sign test shows to be a maneuver of easy execution, with 100% specificity and 100% PPV. Moderate agreement between experienced examiners and low agreement among experienced and inexperienced examiners was found. This test may play a role as an auxiliary maneuver. Level of Evidence I, Diagnostic Studies - Investigating a Diagnostic Test.

Copyright of Revista Foco (Interdisciplinary Studies Journal) is the property of Revista Foco and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Foco (Interdisciplinary Studies Journal) is the property of Revista Foco and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Abstract Background Wound healing complications are causal factors of prosthesis infection and poor postoperative evolution of patients after total knee arthroplasty (TKA). Negative-pressure wound therapy (NPWT) can be an option to minimize these complications. The aim of this study is to compare the complications of patients undergoing TKA who used a portable NPWT device in the immediate postoperative period with those of a control group. Methods A total of 296 patients were evaluated. Patients were divided into two groups: those who used NPWT for seven days in the postoperative period (Group 1 – prospective evaluated) and those who used conventional dressings (Group 2 – historical control group). Epidemiological data, comorbidities, local parameters related to the surgical wound and complications were evaluated. Results The groups did not differ in regard to sex, age and clinical comorbidities. Overall, 153 (51.7%) patients had at least one risk factor for wound complications. Patients who used NPWT had a lower rate of complications (28.5% vs. 45.7%, p = 0.001) and a lower rate of reintervention in the operating room (2% vs. 8.5%, p = 0.001). Patients in group 1 had a lower incidence of hyperaemia (14.7% vs. 40.2%, p = 0.01), skin necrosis (2.1% vs. 8.5%, p = 0.04) and wound dehiscence (3.1% vs 10.1%, p = 0.03). The use of NPWT was a protective factor for the presence of complications, with an odds ratio of 0.36 (95% CI 0.206–0.629). Conclusion The number of complications related to the wound after TKA is high; however, most of them are minor and have no impact on the treatment and clinical evolution of patients. The use of NPWT decreased the number of surgical wound complications, especially hyperaemia, dehiscence and necrosis, and reduced the need for reintervention.

ABSTRACT Objective: To evaluate the profile of blood loss and blood transfusions after the introduction of Tranexamic acid (TXA) in a tertiary university hospital in Brazil. Methods: 173 patients were retrospectively divided into two groups: the ones who received TXA and the control group. Hemoglobin levels (Hb), drain output, transfusion rates, and thromboembolic events were measured. Results: Among the patients included in this study, 82 cases received TXA. Blood transfusion occurred in 3 cases of the TXA group (3.7%), and in 27 control group cases (29.7%; p < 0.001). The average Hb decrease was 2.7 g/dl (± 1.39) and the median drain output was 270 mL in the TXA group. In the control group, the values were 3.41 g/dl (± 1.34; p < 0.001) and 460 mL (p < 0.001), respectively. Thromboembolic events occurred in 2 TXA group cases (2.4%) and in 3 control group cases (3.3%; p > 0.999). Conclusion: TXA was effective in reducing blood transfusion rates, Hb decrease, and drain output on the 1st postoperative day without increasing thromboembolic events. Level of evidence III, Retrospective comparative study.

resumo O trabalho identifica e analisa as características dos setores censitários na capital do estado de São Paulo, Brasil, reunindo-os em agrupamentos mutuamente exclusivos. Desse modo, foram selecionadas variáveis sensíveis a condições e alterações populacionais, ambientais, criminais, habitacionais, de mobilidade e de expansão urbana para separar o território paulistano em parcelas que apresentassem homogeneidade intra-agrupamentos. Cada uma dessas parcelas representa um perfil demográfico e um padrão urbano distintos. Assim, identificando grupos semelhantes (diminuindo a variância intragrupos e maximizando a variância intergrupos), é possível obter um melhor discernimento das singularidades da cidade. Além disso, em uma perspectiva inter e transdisciplinar, este trabalho assinala a possibilidade de adequação tanto de estratégias de amostragem, coleta e estimação estatística como de identificação, descrição, significação e estudo do contexto paulistano.

ABSTRACT The equilibrium and nutritional balance of plants are known to be of utmost importance to evaluate their yield potential and to comprehend the dynamics of nutrients in the soil-plant system. Hence, the present study determined the reference values for evaluating the nutritional status of ‘Gigante’ cactus pear cultivated with organic fertilization in semiarid conditions by Diagnosis and Recommendation Integrated System (DRIS) and Balanced Indexes of Kenworthy (BIK) methods. The cladodes nutrients contents and dry matter yield of 72 plots were employed. The database was classified into a high-yield and low-yield population, above and below 19.93 Mg ha-1 cycle-1, respectively. The five ranges of nutrient contents in cladodes were defined based on the standard deviation range(s) of the DRIS indexes of the high-yield population. Furthermore, the fixed BIK values made it possible to ascertain the lower and the upper limit of the reference values of nutrient contents in the cladodes. The reference values for all nutrients determined by the DRIS and BIK methods varied from each other and those reported in the literature. These methods were efficient in identifying the limiting nutrients for ‘Gigante’ cactus pear, with differences in the hierarchical order of limitation, due to lack or excess, and nutrients not limiting to productivity.

Destacamos neste artigo aspectos que consideramos fundamentais para o processo de ensino/aprendizagem em psicologia clínica, baseados em nossa experiência como supervisores para alunos de garduaÇào em Psicologia na Universidade de Brasílai. Enfocamos particularmente a formação do papel de terapeuta, enfatizando nistoa relevância da supervisão. Destacamos o psicodrama como método de trabalho, e a utilização do role-playing como técnica. Nosso objetivo mais amplo é contribuir para a reflexão sobre as características do ensino clínico, bem como sobre a qualidade da formação do psicólogo.

Abstract A literature survey for the external morphology of tadpoles for species in the genus CycloramphusTschudi, 1838, which is mainly represented by larval descriptions, resulted in finding some inconsistent character descriptions. In a few cases, some of the information is either not presented or mistakenly reported; in some cases, the illustrations provided the information not present in the descriptions. Here in we use a sample of tadpoles of an insular population identified as Cycloramphus boraceiensis, present a description for it, compare it to the original larval description for this species, and using it as a model, present a comparative review of the other larval descriptions for Cycloramphus tadpoles. We evaluate that most of the mistakes we found in the literature are associated to the unique morphology of these semiterrestrial larvae and some of their seemingly adaptation to their microhabitats, which for the majority of the known species is a film of water running associated to or near streams.

ABSTRACT Objective: To assess the knowledge and technical preferences of Brazilian knee surgeons in relation to the treatment of Anterior Cruciate Ligament (ACL) injuries using intra-articular reconstruction in combination with extra-articular reconstruction. Methods: A questionnaire consisting of 16 questions about intra-articular ACL reconstruction in combination with extra-articular procedures and about the Anterolateral Ligament (ALL) was applied at the 48th Brazilian Congress of Orthopedics. Results: One hundred thirty-seven surgeons answered the questionnaire. Most surgeons perform 10-30 ACL reconstructions per year, with the transtibial technique appearing as the most common. Most surgeons find some percentage of residual pivot-shift after reconstructions, but the minority performs extra-articular procedures on a routine basis. The main indications for extra-articular reconstruction are revision and profuse pivot-shift cases. Most surgeons consider the ALL a true ligament, but 46.7% with less biomechanical importance and 32.3% with greater importance in knee stability. However, 91.4% had a positive perception of the reconstruction of this structure. Conclusion: Although the preferred technique is still the transtibial procedure, combined anatomical reconstructions already make up more than 50% of cases. Extra-articular reconstructions associated with the ACL are still performed by the minority of Brazilian surgeons, but 91.4% of them report having had a positive perception with their reconstruction. Level of Evidence III, Descriptive Study.

Resumo Este artigo trata da análise das relações entre crime, violência e cidades, um objeto tradicional das ciências sociais e dos estudos urbanos. Tendo a cidade de São Paulo como pano de fundo e os homicídios dolosos como parâmetro, procura-se registrar a evolução dos registros vitais e criminais e questionar a hipótese que analisa e explica a distribuição dos crimes, nos territórios urbanos, baseada na lógica dualista e binária entre bairros não- violentos e violentos, entre centro e periferia. Avaliando o estoque de conhecimento disponível nesste campo de estudos, e discutindo questões metodológicas relativas à qualidade dos dados que sustentam análises, o artigo propõem algumas abordagens metodológicas que hoje podem melhor explicar a distribuição dos crimes em um tecido metropolitano diversificado e complexo.

In the context of COVID-19 pandemics, Brazilian cities implemented social isolation policies and deployed digital systems to monitor urban mobility. This article addresses the setting of two digital technologies based on massive cell-phone data collection by private companies in São Paulo state. We relied on secondary data from multiple sources (press conferences, interviews, newspaper articles, public documents), complemented by primary data from the authors’ ongoing research. In our analysis of heterogeneous and contingent techniques of pandemic control, we found that although these monitoring technologies seem to be effective in assisting public services and informing society, they also raise issues about performativity and transparency, with relevant consequences for their adoption in sanitary emergencies, and their potential legacy to São Paulo’s public safety management.

OBJECTIVE: Tranexamic acid (TXA) and the hemostatic agent Floseal® have already been used to minimize bleeding during total knee arthroplasty (TKA). METHODS: We conducted a prospective, randomized study of 90 patients with indications for TKA. Following inclusion, the participants were randomly allocated in blocks to the following 3 groups: control, Floseal® and TXA. Bleeding parameters, including decreases in hemoglobin (Hb), drain output, number of blood transfusions and complications, were assessed. ClinicalTrials.gov: NCT02152917. RESULTS: The mean decrease in Hb was highest in the control group (4.81±1.09 g/dL), followed by the Floseal® (3.5±1.03 g/dL) and TXA (3.03±1.2 g/dL) groups. The Floseal® and TXA groups did not differ, and both performed better than the control group. The mean total drain output was 901.3±695.7 mL in the control group, 546.5±543.5 mL in the TXA group and 331.2±278.7 mL in the Floseal® group. Both TXA and Floseal® had significantly less output than the control group, and Floseal® had significantly less output than TXA. The number of blood transfusions was very small in all 3 groups. CONCLUSION: The use of TXA or Floseal® was associated with less blood loss than that of the control group among patients undergoing primary TKA, as measured both directly (intraoperative bleeding + drainage) and on the basis of a decrease in Hb, without differences in the rate of complications. TXA and Floseal® showed similar decreases in Hb and total measured blood loss, but the drain output was smaller in the Floseal® group.