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Nature-based Solutions (NbS) are presented as an alternative and decentralized solutions with different application scales for problems addressed to urban expansion as water quality reduction and floods. The usage of control strategies and mathematical modeling techniques has shown promising results for optimizing hydraulic and water treatment processes. The Digital Twins (DT) as process integration technology are widely used in industry, and recently these technique usages in urban water systems are showing effective results in both management and planning. However, there is a lack of proper literature definition for DT applied to NbS, especially for stormwater and transboundary water security projects. Thus, this paper sought through a literature review to access the existing conceptual challenges and the DT definition as a framework, identify how the mathematical modeling reported in the literature can improve the DT development, and evaluate the potential benefits associated with the application of DT in NbS. HIGHLIGHTS This review accessed Digital Twin (DT) applications to water-related structures and developed a technical framework to combine Nature-based Solutions (NbS) and DT techniques.; The NbS DT development was divided into five different entities, which can be individually expanded and mutually connected.; The technical aspects of each entity were accessed with the specifications to attend NbS techniques.;

A cinematografia tem se mostrado ferramenta versátil na educação médica podendo ser utilizada no estudo do processo saúde-adoecimento-cuidado. Objetiva-se relatar a experiência do uso da cinematografia para discussão das metáforas da enfermidade no curso médico de uma Universidade Federal. Como preparo, os estudantes leram sobre “Significação e metáforas da doença”. Foi exibido o filme “Para sempre Alice” e debatido o tema lido com base em suas metáforas. Posteriormente, os alunos foram à Rede Básica para aplicar o uso das metáforas. Notou-se a importância dos determinantes sociais em saúde e da relevância de ações que extrapolam o âmbito biológico. A atividade, além de lúdica, foi pedagógica e buscou tornar a aprendizagem mais significativa. Percebeu-se a efetividade da cinematografia para interpretação de metáforas da doença e contribuição para uma melhor prática médica.

RESUMO A formação em medicina pode gerar grandes responsabilidades ao estudante e provocar diversos problemas comportamentais, psíquicos e físicos. Diante desse fato, evidencia-se a necessidade de problematização de estratégias de Promoção da Saúde física e mental dos graduandos, conforme apontam as Diretrizes Curriculares Nacionais para os cursos de graduação em Medicina no Brasil. Este relato de experiência almeja problematizar uma iniciativa do eixo curricular de Saúde Coletiva de uma Universidade Federal brasileira voltada para o aprimoramento de competências relacionadas à Promoção da Saúde. Durante a terceira unidade curricular desse eixo, problematizou-se com os estudantes, por meio do Arco de Maguerez, o aprimoramento de competências relacionadas à Promoção da Saúde e à salutogênese, em consonância com os princípios do Sistema Único de Saúde (SUS) e as políticas públicas de saúde, especialmente a Política Nacional de Promoção da Saúde. Com isso, a unidade curricular com essa temática foi construída coletivamente, com diálogo e amorosidade entre discentes e docentes. Partimos da realidade dos estudantes para aprender sobre Promoção da Saúde e, assim, poder transformá-la. As atividades construídas, em um componente do currículo formal de um curso médico, permitiram aprender a relevância e a prática da Promoção da Saúde no cotidiano e se sensibilizarem em relação a elas. Buscou-se realizar ações para a ampliação do bem-estar dos discentes de forma autônoma e libertadora. Assim, empoderados com esses saberes, a unidade foi encerrada em uma atividade construída pelos estudantes por meio dos objetivos pedagógicos propostos. O local em que ela ocorreu se mostrou potente para produzir saúde e constituir-se como cenário de ensino-aprendizagem para a formação médica. Compreendeu-se que a Promoção da Saúde por intermédio de atividades contextualizadas com as realidades e necessidades discentes, inseridas na rotina acadêmica, possui potencial transformador na saúde dos estudantes, preparando-os para uma prática médica ética, relacional, com amorosidade e corresponsabilidade. A experiência foi inovadora, pois enfrentou a incoerência de ensinar a Promoção da Saúde sem praticá-la, em um contexto em que cada vez mais as condições de saúde física e mental dos estudantes de Medicina têm se tornado precárias. Assim, a oportunidade de aprender sobre o tema foi aproveitada para desenvolver competências e vivenciar a Promoção da Saúde na realidade dos estudantes, preparando-os para as intervenções com a comunidade, que ocorreram em seguida. A avaliação da atividade foi positiva, e destacou-se a relevância da Saúde Coletiva na formação médica para pensar as interfaces entre o eu e o outro, nossas semelhanças, diferenças e necessidades de transformações nos encontros que a graduação e a profissão médica proporcionam.

Objective: To analyze characteristics of alcohol and other drug care units in the specialized care network and in the emergency and emergency network of the municipality of Anápolis-GOMethods: A descriptive, cross-sectional, retrospective study with a quantitative approach using the database of the Informatics System of the Unified Health System (DATASUS). The data were tabulated and analyzed by the software TABWIN, made available by DATASUS, while the evaluation of the situational diagnosis was done with the Ishikawa Diagram. Results: There were 474 admissions due to alcohol and drugs in Annapolis. The city does not follow what is recommended by ordinance nº 3,088, because it does not have a Psychosocial Care Center III (CAPS AD) 24 hours, nor does it have a General Hospital of reference. Both would be necessary to establish a proper care protocol for this layer of the population Conclusions: The units that take care of the demand for alcohol and drugs do not comply with current legislation. To achieve this goal, it is necessary to raise the CAPS to category III, and the adequacy of the Reference General Hospital. The institution of the protocol aims to meet these demands and strengthen the articulation with the emergency and emergency network.

Resumo: Introdução: Historicamente, a comunidade LGBT+ enfrenta obstáculos estruturais que interferem na garantia da cidadania plena. Com a pandemia da Covid-19, observa-se que a vulnerabilidade individual da população LGBT+ tornou-se ainda mais intensa e explícita. Diante disso, o presente relato de experiência apresenta e analisa criticamente uma ação de estudantes de Medicina que buscaram promover a representatividade e uma rede de cuidado/apoio e solidariedade entre os(as) estudantes LGBT+ no contexto da pandemia. Relato de experiência: Este relato descreve a construção de um vídeo “Evoluiu Challenge” por acadêmicos(as) e médicos(as) graduados(as) do curso de Medicina de uma universidade pública brasileira. Diante do isolamento social e da necessidade de representatividade, encorajamento e empoderamento LGBT+ dentro do espaço acadêmico da Medicina, identificou-se a necessidade de ações, como a produção do vídeo, para que os(as) acadêmicos(as) mais vulnerabilizados(as) possam localizar em seus/suas colegas de curso uma rede de apoio, solidariedade e empoderamento. O projeto foi desenvolvido com 20 estudantes e três egressos(as) da mesma instituição. Ao todo, foram mais de 85 mil visualizações. Discussão: Diante da experiência relatada, destaca-se a importância dos avanços tecnológicos como promotores da “aproximação” em tempos de isolamento e distanciamento social. Nesse sentido, o vídeo resultou em significativa visibilidade à população LGBT+ presente no meio médico. Ademais, propiciou representatividade e a construção de uma rede de apoio estudantil, como descrito nas DCN, com a promoção do cuidado. Conclusão: A partir deste relato de experiência, fica visível a necessidade de implementação de estratégias de ações de apoio para a população LGBT+ nas universidades, como as redes de cuidado/solidariedade. Dessa maneira, assim como o vídeo, essas estratégias potencializarão a construção de um espaço de ensino-aprendizagem mais inclusivo e que seja um oásis do pensamento contra a opressão e espaço de contestação.

Abstract Aims: The purpose of our study was to compare the hip and knee muscle activity before and after a hip abduction exercise program in women with patellofemoral pain (PFP). Methods: Eleven women with PFP were included in our pre/post design study. Participants were assessed before and after 12-week hip abduction exercise program. All participants performed 6 stair climbing repetitions, 3 sets of rope jumps over 30 s and 5 sets of 8 squats to standardize the physical activity level before data collection. We recorded the electromyographic activity from gluteus medius, vastus medialis (VM) and vastus lateralis (VL) for double-legged squat with and without isometric hip abduction. Additionally, participants were asked to perform a step-down test to assess objective function (maximum number of repetitions over 30 s) and completed a clinical evaluation. Results: Longer duration of VM (Mean difference [95% CI]) = -0.97 [-1.48; -0.46], ES [effect size] = 0.66) and VL (-0.81 [-1.35; -0.27], ES = 0.54) were found after the hip abduction exercise program only for free squat. The participants also performed higher number of step-down repetitions (-3.54 [-5.84; -1.25], ES = 1.03) after the hip abduction exercise program and showed improvement in pain reports. Conclusion: A 12-week hip abduction exercise program changed the quadriceps muscle activation pattern and improved pain and objective function of women with PFP. The exercises promoted a longer VM and VL activation duration. Additionally, they promoted a clinical improvement in the patients with PFP.

This review aimed to describe the state of the art in muscle-tendon unit (MTU) assessment by supersonic shear wave imaging (SSI) elastography in states of muscle contraction and stretching, during aging, and in response to injury and therapeutic interventions. A consensus exists that MTU elasticity increases during passive stretching or contraction, and decreases after static stretching, electrostimulation, massage, and dry needling. There is currently no agreement regarding changes in the MTU due to aging and injury. Currently, the application of SSI for the purpose of diagnosis, rehabilitation, and physical training remains limited by a number of issues, including the lack of normative value ranges, the lack of consensus regarding the appropriate terminology, and an inadequate understanding of the main technical limitations of this novel technology.

Identifying the species of the subfamily Anophelinae that are Plasmodium vectors is important to vector and malaria control. Despite the increase in cases, vector mosquitoes remain poorly known in Brazilian indigenous communities. This study explores Anophelinae mosquito diversity in the following areas: (1) a Yanomami reserve in the northwestern Amazon Brazil biome and (2) the Pantanal biome in southwestern Brazil. This is carried out by analyzing cytochrome c oxidase (COI) gene data using Refined Single Linkage (RESL), Assemble Species by Automatic Partitioning (ASAP), and tree-based multi-rate Poisson tree processes (mPTP) as species delimitation approaches. A total of 216 specimens collected from the Yanomami and Pantanal regions were sequenced and combined with 547 reference sequences for species delimitation analyses. The mPTP analysis for all sequences resulted in the delimitation of 45 species groups, while the ASAP analysis provided the partition of 48 groups. RESL analysis resulted in 63 operational taxonomic units (OTUs). This study expands our scant knowledge of anopheline species in the Yanomami and Pantanal regions. At least 18 species of Anophelinae mosquitoes were found in these study areas. Additional studies are now required to determine the species that transmit Plasmodium spp. in these regions.

As medidas de confiabilidade das análises da arquitetura muscular pela ultrasonografia são importantes referências para estudos aplicados de mecânica muscular. O objetivo deste estudo foi determinar a confiabilidade das medidas de espessura muscular (EM), ângulo de penação (AP) e comprimento da fibra (CF) do músculo Vasto Lateral (VL). As imagens de ultrassom foram obtidas em um grupo (N=14; 22 ± 1,75 anos) em duas visitas (sessenta medidas por indivíduo). Foi calculado o coeficiente de correlação intraclasse (CCI), coeficiente de variação (CV) e erro típico da medida (ETM). Os resultados demonstram alta confiabilidade: CCI AP (0,83 a 0,99), EM (0,96 a 0,99) e CF (0,80 a 0,99); CV AP (3,68 a 6,34%), EM (3,12 a 3,84%) e CF (3,98 a 6,33%) e ETM AP (0,18 a 0,59º); EM (0,014 a 0,15mm) e CF (0,07 a 1,47mm). Essas medidas devem ser consideradas em estudos que analisam o impacto na arquitetura muscular em programas de condicionamento do Vasto Lateral.Reliability of the measurements of the muscle architecture variables by ultrasound are important references for applied studies of muscle mechanics. The aim this study was to analyze the reliability of measurements of Vastus Lateralis (VL) muscle thickness (MT), pennation angle (PA) and fiber length (FL). Ultrasound images were obtained in two days (N=14, 22 ± 1,75 years) with a total of sixty measurements in each subject. Reliability was determined by intraclass correlation coefficient (ICC), coefficient of variation (CV) and typical error of measurement (TEM). Results show high reliability: MT (0,96 a 0,99), PA (0,83 a 0,99) and FL (0,80 a 0,99) ICC; MT (3,12 a 3,84%), PA (3,68 a 6,34%) and FL (3,98 a 6,33%) CV; MT (0,014 a 0,15mm), PA (0,18 a 0,59º) and FL (0,07 a 1,47mm) TEM. These measures should be considered in studies of the impact of conditioning programs in the architecture of the vastus lateralis muscle.

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BACKGROUND Studies on malaria vectors in the Pantanal biome, Central Brazil, were conducted more than half a century ago. OBJECTIVES To update anopheline records and assess receptivity and vulnerability to malaria transmission. METHODS Five-day anopheline collections were conducted bimonthly in Salobra, Mato Grosso do Sul state, for one year. Indoors, mosquitoes were collected from their resting places, while in open fields, they were captured using protected human-baited and horse-baited traps near the house and at the Miranda River margin, respectively. Hourly biting activity outdoors was also assessed. Secondary data were collected on the arrival of tourists, economic projects, and malaria cases. FINDINGS A total of 24,894 anophelines belonging to 13 species were caught. The main Brazilian malaria vector Anopheles darlingi was the predominant species, followed by An. triannulatus s.l. Hourly variation in anopheline biting showed three main peaks occurring at sunset, around midnight, and at sunrise, the first and last being the most prominent. The highest density of all species was recorded near the river margin and during the transition period between the rainy and early dry seasons. This coincides with the time of main influx of outsider workers and tourists, whose activities mostly occur in the open fields and frequently start before sunrise and last until sunset. Some of these individuals originate from neighbouring malaria-endemic countries and states, and are likely responsible for the recorded imported and introduced malaria cases. MAIN CONCLUSION Pantanal is a malaria-prone area in Brazil. Surveillance and anopheline control measures must be applied to avoid malaria re-emergence in the region.

Copyright of EMC-Dermatologie--Cosmetologie is the property of Elsevier B.V. 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.)

• Ultrasonography is a reliable technique for plantar aponeurosis thickness measurements in healthy adults. • Intra-rater and inter-rater agreement varying substantially depending on the number of images used. • The error seems to be related to the sonogram acquisition process. • To minimize error, average values of a minimum of two images per subject should be used. • The moderate agreement between raters ratifies the need of all measurements being made by the same rater or group of raters. Given the increasing research interest in ultrasound plantar aponeurosis (PA) thickness measurements, this study aimed to analyze the inter and intra-rater reliability of independent sonograms and to identify the error related to the image analysis procedure. Twenty-one healthy men participated in this study. Imaging of PA consisted of two independent sonograms per subject. Two raters (R1 and R2) evaluated each sonogram twice using standardized steps. Precision of the image analysis procedure was analyzed using the Bland and Altman plot and Intraclass Correlation Coefficient (ICC). Agreement estimates and ICC were used to assess absolute and relative inter and intra-rater reliability. Reliability of PA thickness was found to depend strongly on the number of images acquired per subject. Intra-rater agreement for single measurements were 0.696 (R1) and 0.495 (R2), whereas average measurements yielded values of 0.821 (R1) and 0.662 (R2), respectively. Precision within a sonogram varied from ICC values of 0.873 to 0.960 (intra-rater) and 0.670 to 0.822 (inter-rater). Most part of the error in PA thickness measurements seems to be related to the sonogram acquisition process and not to the visual inspection of the image. To minimize error, average values of a minimum of two images per subject should be used. The moderate agreement between raters found in this study ratifies the need of all measurements being made by the same rater or group of raters. If a single rater evaluates all subjects, performing multiple measurements over one image does not seem to affect ICC as much as acquiring multiple images. [ABSTRACT FROM AUTHOR]