Search

Background: Three-dimensional (3D) T1-weighted MRI sequences such as the magnetization prepared rapid gradient echo (MPRAGE) sequence are important for assessing regional cortical atrophy in the clinical evaluation of dementia but have long acquisition times and are prone to motion artifact. The recently developed Scout Accelerated Motion Estimation and Reduction (SAMER) retrospective motion correction method addresses motion artifact within clinically-acceptable computation times and has been validated through qualitative evaluation in inpatient and emergency settings. Methods: We evaluated the quantitative accuracy of morphometric analysis of SAMER motion-corrected compared to non-motion-corrected MPRAGE images by estimating cortical volume and thickness across neuroanatomical regions in two subject groups: (1) healthy volunteers and (2) patients undergoing evaluation for dementia. In part (1), we used a set of 108 MPRAGE reconstructed images derived from 12 healthy volunteers to systematically assess the effectiveness of SAMER in correcting varying degrees of motion corruption, ranging from mild to severe. In part (2), 29 patients who were scheduled for brain MRI with memory loss protocol and had motion corruption on their clinical MPRAGE scans were prospectively enrolled. Results: In part (1), SAMER resulted in effective correction of motion-induced cortical volume and thickness reductions. We observed systematic increases in the estimated cortical volume and thickness across all neuroanatomical regions and a relative reduction in percent error values compared to reference standard scans of up to 66 % for the cerebral white matter volume. In part (2), SAMER resulted in statistically significant volume increases across anatomical regions, with the most pronounced increases seen in the parietal and temporal lobes, and general reductions in percent error relative to reference standard clinical scans. Conclusion: SAMER improves the accuracy of morphometry through systematic increases and recovery of the estimated cortical volume and cortical thickness following motion correction, which may affect the evaluation of regional cortical atrophy in patients undergoing evaluation for dementia.

La salmonicultura frente a la resistencia de los antimicrobianos y los efectos sobre la salud humana y medio ambiente. Resumen: La presente revisión recopila y analiza estudios de los últimos 5 años sobre uso de antimicrobianos en la industria del salmón, efectos reportados en peces y seres humanos, y los impactos sobre el medio ambiente. Existe una creciente preocupación respecto al manejo actual de los planes terapéuticos veterinarios empleados para el tratamiento y control de infecciones bacterianas. Las principales problemáticas están relacionadas con el aumento en la resistencia hacia antimicrobianos por parte comunidades bacterianas patógenas y no patógenas, la transferencia horizontal de genes de resistencia entre células bacterianas y, un mayor número de casos de tratamientos médicos fallidos en poblaciones humanas y animales. Por lo tanto, los desafíos a futuro serán reducir la dependencia hacia los antimicrobianos en producciones animales mediante la investigación de tecnologías alternativas, la recopilación de información epidemiológica de sectores productivos que permitan realizar monitoreo detallado en las diferentes fases de cultivo, medidas de bioseguridad desde un enfoque de “One Health” y, una supervisión estricta en la formulación de medicamentos por parte de los profesionales en el área animal.

In the current highly digitized business landscape, efficient document management is crucial for increasing productivity and optimizing organizational processes. This need has been identified in this document, and an enhanced product named Infopoint, an enterprise content management software has been improved to provide intelligent document management through the implementation of advanced automation and artificial intelligence technologies. In document management, numerous processes are still manually executed, leading to errors and delays due to the burden of repetitive tasks. Manual management also causes internal delays and impacts interactions with clients, suppliers, and regulatory entities. Manual document searches consume valuable time and can result in unnecessary costs for the company. Infopoint addresses these challenges by incorporating automation features, particularly leveraging convolutional neural networks. This approach optimizes the functionality of incoming correspondence, reducing processing time by 29 %, on average. It also facilitates text and content searches within PDF documents, decreasing the average search time by 41 %. This article highlights how this improvement significantly reduces the time spent on correspondence management and information retrieval.

Este artículo emprende una revisión del estado actual del ecosistema empresarial EdTech en Colombia, a través de una investigación exploratoria con enfoque descriptivo, centrándose en la pregunta: ¿existe una caracterización del ecosistema empresarial EdTech en Colombia? La metodología incluyó una revisión del estado del arte para proporcionar una visión contextualizada de la situación actual de la industria EdTech en Colombia, y la consulta de fuentes bibliográficas, seleccionadas de bases de datos en línea, siguiendo criterios de relevancia y confiabilidad, donde se identificaron empresas, principales actores, inversiones e inversionistas que forman parte del ecosistema, que resultó en el desarrollo de una aplicación denominada IO Player, que funciona como red social de aprendizaje.

ABSTRACT To evaluate the performance of different sampling arrangements, this work aimed to study, in a field of Eucalyptus camaldulensis, the variability and spatial dependence of some attributes of plant and soil (LATOSSOLO VERMELHO Distrófico [Typic hapludox]). To collect the soil (water content [WC] and soil mechanical penetration resistance [PR]) and plant data (tree height [TH] and circumference at breast height [CBH]), a sampling arrangement containing 122 points was used in an area of 1.98 ha and three other arrangements, with 84, 48 and 42 points. Except for the CBH, the reduction of points did not expressively affect the parameters of the classical statistics of all other parameters evaluated. Spatially, for TH and WC, the reduction of collection points did not significantly affect the geostatistical parameters, allowing estimating mapping similar to the initial mapping with high correlation coefficients. The WC at 0.10-0.20 m layer could be estimated from 48 samples of the WC at 0-0.10 m layer and 48 samples in the layer of 0.10-0.20 m with a correlation coefficient (r) equal to 0.94 when compared to initial kriging from an arrangement with 122 sample points.

The Namibia national antiretroviral therapy guidelines recommend that patients living with HIV who interrupt antiretrovirals and in the process disengage from care be restarted on their usual antiretroviral therapy regimen upon return. We introduce a 39-year-old male patient on first-line antiretroviral therapy, namely, tenofovir disoproxil fumarate, lamivudine and efavirenz, from 2015 to 2019 (4 years), who returned to care after the fourth episode of interrupting his treatment, though his adherence to antiretroviral therapy was deemed poor. Thus, he presented with severe immunosuppression and an AIDS-defining condition. Hence, he was switched to second-line antiretroviral therapy, treated with fluconazole for oesophageal candidiasis and reinitiated on cotrimoxazole prophylaxis. The client is currently clinically stable with a suppressed viral load. Medical and drug history taking with an emphasis on the previous history of treatment failure in patients returning to care are paramount in guiding the choice of future prescriptions of antiretrovirals. The multiple antiretroviral therapy interruptions from the patient and the delay in decision-making on the side of the clinician to switch treatments contributed to the emergence of an AIDS-defining condition.

El surgimiento del concepto de negación de área trajo al pensamiento académico una serie de conceptos teórico-estratégicos que pueden ser utilizados por los países que los quieran emplear, a fin de defender sus áreas de interés. En este sentido, el objetivo de este artículo de reflexión es formular las condiciones de empleo más idóneas de la negación de área de las que dispone Colombia para posicionar el interés nacional y construir o proyectar su poder. El propósito es despertar el interés de los lectores acerca de los conceptos de negación de área y cómo pueden ser útiles en el ámbito estratégico, pero también desde un enfoque académico a modo de referente para el uso de los recursos de defensa. Es necesario entender esta estrategia de negación de área para la defensa y la seguridad nacional en Colombia y en otros países dentro del hemisferio. Como resultado, tenemos que esa estrategia debe priorizar las amenazas a los objetivos e intereses nacionales de Colombia. Se concluye que es evidente la necesidad de reestructuración y modernización de la defensa aérea, antiaérea y terrestre para la seguridad nacional, es decir, en todos los dominios.

La Diabetes Mellitus es un trastorno crónico del metabolismo que conlleva a un aumento anormal en los niveles de glucosa en plasma, como consecuencia de la producción desequilibrada de insulina y/o la insensibilidad al efecto de esta hormona en la transducción de señales de los receptores celulares. Estos cambios metabólicos van acompañados de modificaciones en el metabolismo de carbohidratos, lípidos y proteínas y este trastorno puede conllevar al deterioro de diversos órganos como la ceguera e incluso está implicado en causas de muerte. La mayoría de las complicaciones de la diabetes tipo 2 en los pacientes se deben a la hiperglucemia como su causa principal. Una de las estrategias efectivas para el manejo de la diabetes tipo 2 es la inhibición de la hidrólisis de polisacáridos complejos por la α-amilasa pancreática y a limitación de la absorción de glucosa al inhibir la enzima α-glucosidasa. En este sentido, se ha realizado una revisión de la α-glucosidasa, su mecanismo de actuación y se presenta una posible vía de inhibición mediante flavonoides naturales.

Introduction: The use of an implantable cardioverter-defibrillator reduces the probability of sudden cardiac death in patients with heart failure. Objective: To determine the cost-utility relationship of an implantable cardioverter-defibrillator compared to optimal pharmacological therapy for patients with ischemic or non-ischemic New York Heart Association class II or III (NYHA II-III) heart failure in Colombia. Materials and methods: We developed a Markov model including costs, effectiveness, and quality of life from the perspective of the Colombian health system. For the baseline case, we adopted a time horizon of 10 years and discount rates of 3% for costs and 3.5% for benefits. The transition probabilities were obtained from a systematic review of the literature. The outcome used was the quality-adjusted life years. We calculated the costs by consulting with the manufacturers of the device offered in the Colombian market and using national-level pricing manuals. We conducted probabilistic and deterministic sensitivity analyses. Results: In the base case, the incremental cost-effectiveness ratio for the implantable cardioverter-defibrillator was USD$ 13,187 per quality-adjusted life year gained. For a willingness-to-pay equivalent to three times the gross domestic product per capita as a reference (USD$ 19,139 in 2017), the device would be a cost-effective strategy for the Colombian health system. However, the result may change according to the time horizon, the probability of death, and the price of the device. Conclusions: The use of an implantable cardioverter-defibrillator for preventing sudden cardiac death in patients with heart failure would be a cost-effective strategy for Colombia. The results should be examined considering the uncertainty.

Nesta entrevista, o professor Reynaldo Fernandes, que trabalhou na criação de indicadores como o Índice de Desenvolvimento da Educação Básica (Ideb) e o Conceito Preliminar de Curso (CPC) durante sua gestão na presidência do Instituto Nacional de Estudos e Pesquisas Educacionais Anísio Teixeira (Inep), discute as opções metodológicas adotadas na construção de indicadores educacionais, suas motivações e propósitos, bem como os seus usos e desdobramentos. Ele destaca, ainda, os avanços já alcançados e os desafios atuais em termos do desenvolvimento e uso de indicadores educacionais no Brasil, bem como as discussões recentes da literatura internacional sobre o tema. Palavras-chave: Indicadores Educacionais; Políticas Educacionais; Ideb; Conceito Preliminar de Curso; CPC. Indicadores educacionales: entrevista con Reynaldo Fernandes Resumen: En esta entrevista el profesor Reynaldo Fernandes, que trabajó en la elaboración de indicadores como el Índice de Desenvolvimento da Educação Básica (Ideb) y el Conceito Preliminar de Curso (CPC) durante su gestión en la presidencia del Instituto Nacional de Estudos e Pesquisas Educacionais Anísio Teixeira (Inep), discute las opciones metodológicas adoptadas en la construcción de indicadores educacionales, sus motivaciones y propósitos, así como sus usos y desdoblamientos. Destaca asimismo los avances ya alcanzados y los actuales desafíos en lo que se refiere al desarrollo y utilización de indicadores educacionales en Brasil, así como las recientes discusiones de la literatura internacional sobre el tema. Palabras Clave: Indicadores Educacionales; Políticas Educacionales; Ideb; Concepto Preliminar de Curso; CPC. Educational indicators: an interview with Reynaldo Fernandes Abstract: In this interview, professor Reynaldo Fernandes discusses the methodological choices adopted in the construction of educational indicators, their motivations and purposes, as well as their uses and developments. Professor Fernandes worked on the development of indicators such as the Índice de Desenvolvimento da Educação Básica (Ideb) [Basic Education Development Index] and the Conceito Preliminar de Curso (CPC) [Preliminary Course Concept] during his term as President of the Instituto Nacional de Estudos e Pesquisas Educacionais Anísio Teixeira (Inep) [Anísio Teixeira National Institute of Educational Studies and Research]. He emphasizes the progress already achieved and the current challenges in terms of development and use of educational indicators in Brazil, as well as the recent discussions in the international literature on the subject. Keywords: Educational Indicators; Educational Policies; Ideb; Preliminary Course Concept; CPC.

En este artículo se muestra el proceso de diseño e implementación de un sistema de interoperabilidad para IoT Internet de las Cosas. Integra en un procesador, sistema embebido Raspberry Pi3 la interconexión con los estándares IEEE 802.15.4 - LoRa, IEEE 802.15.1 - Bluetooth LE (BLE)IEEE 802.11.a, b, g - Wifi. Este conjunto de estándares corresponde a los más utilizados en sistemas IoT. El sistema embebido se configura como un dispositivo IoT hub en la plataforma Azure, maneja una arquitectura modelo vista controlador, el sistema de almacenamiento y visualización es de tipo web. Se visualiza la respuesta de la variable de cada nodo sensor bajo el concepto de tiempo real, junto con la ubicación y el indicador de intensidad de señal recibida (RSSI). Se muestran los resultados de las pruebas de cobertura en ambientes externos e internos. El alcance máximo es de 313 metros en la interoperabilidad LoRa y LTE, BLE 22 metros, WiFi 44 metros. El perímetro de cobertura máxima es de 979 metros BLE 70 metros WiFi 136 metros

Motivation: Many clinical and scientific conclusions that rely on voxel-wise analyses of neuroimaging depend on the accurate comparison of corresponding anatomical regions. Such comparisons are made possible by registration of the images of subjects of interest onto a common brain template, such as the Johns Hopkins University (JHU) template. However, current image registration algorithms are prone to errors that are distributed in a template-dependent manner. Therefore, the results of voxel-wise analyses can be sensitive to template choice. Despite this problem, the issue of appropriate template choice for voxel-wise analyses is not generally addressed in contemporary neuroimaging studies, which may lead to the reporting of spurious results. Results: We present a novel approach to determine the suitability of a brain template for voxel-wise analysis. The approach is based on computing a “distance” between automatically-generated atlases of the subjects of interest and templates that is indicative of the extent of subject-to-template registration errors. This allows for the filtering of subjects and candidate templates based on a quantitative measure of registration quality. We benchmark our approach by evaluating alternative templates for a voxel-wise analysis that reproduces the well-known decline in fractional anisotropy (FA) with age. Our results show that filtering registrations minimizes errors and decreases the sensitivity of voxel-wise analysis to template choice. In addition to carrying important implications for future neuroimaging studies, the developed framework of template induction can be used to evaluate robustness of data analysis methods to template choice.

RESUMO Este texto apresenta o perfil de mulheres residentes no estado de São Paulo, mães de crianças na faixa etária de zero a três anos, estabelecendo comparação entre aquelas cujos filhos estão matriculados em instituições de educação infantil - EI - e aquelas que não contam com esse serviço, de modo a discutir o papel social dessas unidades. Utilizou-se, como fonte de dados, o Censo Demográfico de 2010 e foram selecionadas as variáveis referentes ao perfil geral (idade, cor/raça, escolaridade), vida familiar (arranjo familiar, posição na família), vida profissional e renda (ocupação, renda per capita). O estudo reafirma fenômenos referentes a desigualdades sociais que se aprofundam nas relações de gênero e raça/cor, explicitando essas diferenças em termos de acesso a instituições de EI.

Los virus causan importante morbilidad y mortalidad, experiencia que se ha manifestado a través de la historia. Un caso específico es el SIDA (Síndrome de Inmunodeficiencia Adquirida), causado por el VIH, que llega a ser mortal sin tratamiento adecuado. Otras enfermedades graves como hepatitis o encefalitis son también causadas por virus. En este contexto llama la atención la reaparición de enfermedades virales en países tropicales, amenazando con convertirse en pandemias, específicamente las fiebres del Zika y Chikungunya. Entre los países más afectados de América del Sur destacan Brasil y Colombia; de ahí la necesidad de realizar una revisión para evidenciar el número de afectados, la sintomatología y los tratamientos realizados, resaltando lo que falta por determinar de estas enfermedades. Se analizaron las acciones preventivas propuestas por la Organización Mundial de la Salud y el Instituto Nacional de Salud y se revisaron los avances en el desarrollo de vacunas efectivas.

Surface-mediated synthesis of low-dimensional polymers is a promising approach to design materials for targeted applications. Here, the authors introduce surface-confined thermally tunable pathways to select intra- or intermolecular reactions yielding monomeric or lowdimensional polymeric phthalocyanines.

1. The efficacy of captopril and isosorbide dinitrate (ISDN) as adjunctive therapy to digoxin and diuretics in mild heart failure was compared in a double-blind study. 2. Twenty-one patients were randomly allocated to captopril (twice or three times daily) or ISDN. Eighteen patients completed a protocol of placebo run-in, dose titration and maintenance treatment for 3 months. 3. Symptom-limited exercise tolerance, ejection fraction and radionuclide indices of diastolic function estimated by gated blood pool scan did not change with either treatment. 4. Captopril improved functional class (Canadian Cardiovascular Society) and reduced requirements for increased diuretic dosage at both 1 and 3 months of maintenance treatment. Patients treated with ISDN required increased diuretic and did not improve their functional class. Differences between the treatments were significant only for diuretic dosage requirements. 5. We conclude that adjunctive therapy of mild heart failure with captopril administered twice daily provides a diuretic-sparing effect and may improve functional class during 3 months of maintenance treatment. [ABSTRACT FROM AUTHOR]

The haemodynamic dose-response effects of the slow channel blocking agent nicardipine were evaluated in 10 male patients with angiographically confirmed coronary artery disease. At rest, following a similar control saline period, four doses of the drug (log cumulative dosage: 1.25, 2.5, 5.0 and 10.0 mg) were administered by i.v. infusion over a total duration of 40 min; haemodynamic variables were recorded in the 3-5 min following each 5 min infusion. During steady-state exercise the haemodynamic effects of the drug were evaluated by comparison of a control exercise period with observations made at the same workload (200-500 kpm) following the maximum cumulative dose (10 mg). Following the four i.v. infusions, the plasma nicardipine level increased log-linearly with the infused dose (r = 0.68). Compared with control measurements at rest after saline, these plasma concentrations (35 +/- 8 to 141 +/- 24 micrograms/l) resulted in a linear decrease in systemic blood pressure and vascular resistance with significant increase in cardiac index (maximum delta CI + 1.6 l min(-1) m(-2); P less than 0.01), stroke index (maximum delta SI + 11 ml/m2; P less than 0.01) and in pulmonary artery occluded pressure (maximum delta PAOP + 2 mm Hg; P less than 0.01). There was a significant increase in heart rate; the stroke work index was unchanged. During upright bicycle exercise the reduction in systemic blood pressure was accompanied by an increased exercise cardiac output without change in stroke index. The exercise pulmonary artery occluded pressure was unchanged compared with control observations, the stroke work index fell significantly (P less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS) [ABSTRACT FROM AUTHOR]

The differences between slow calcium blocking agents with respect to effects on heart rate, myocardial contractility and atrioventricular conducting time are well described; the relevance of such differences to the treatment of patients with impaired left ventricular function due to coronary heart disease is uncertain. The haemodynamic effects of equivalent hypotensive doses of nifedipine and verapamil were therefore compared in 20 patients with severe angina pectoris associated with angiographically documented coronary artery disease. The plasma concentrations of nifedipine (mean 57 +/- 19; range 27-77 ng/ml) and verapamil (mean 147 +/- 14; range 117-260 ng/ml) at the time of the haemodynamic measurements were of an order usually associated with substantial pharmacodynamic activity. Sitting at rest nifedipine resulted in reduction in systemic arterial pressure (P less than 0.05) and vascular resistance (P less than 0.01); both the heart rate (P less than 0.01) and cardiac output (P less than 0.05) increased without any significant change in the left heart filling pressure. In contrast, verapamil, which similarly reduced systemic blood pressure (P less than 0.05) and vascular resistance (P less than 0.01), increased cardiac output (P less than 0.05) and left heart filling pressure (P less than 0.05) without any change in heart rate. During upright bicycle exercise both drugs attenuated the angina induced in all subjects during the control exercise period. Despite reductions in systemic blood pressure and vascular resistance the cardiac output was unaltered on either drug at the same workload as in the control assessment. The reduction in exercise blood pressure following nifedipine induced a reflex tachycardia; this was not present, despite the similar hypotensive action, after verapamil.(ABSTRACT TRUNCATED AT 250 WORDS) [ABSTRACT FROM AUTHOR]

The haemodynamic dose-response effects of intravenous penbutolol, a newer beta-adrenoceptor antagonist with intrinsic sympathomimetic activity but without cardioselectivity, were evaluated in 10 patients with angiographically documented coronary artery disease. Following four logarithmetically cumulative i.v. boluses (0.5-4 mg dosage range) there was a log linear increase in plasma penbutolol concentration; the levels achieved (51 +/- 8 to 219 +/- 19 ng/ml) were in the therapeutic range (12 to 250 ng/ml). Penbutolol resulted in a linear decrease in heart rate (maximum delta HR - 4 beats/min; P less than 0.01); there was a small increase in pulmonary artery occluded pressure which reached its maximum at the lower doses (maximum delta PAOP + 1 mm Hg; P less than 0.01). The resting cardiac output, blood pressure and calculated systemic vascular resistance were unchanged. During 4 min steady-state supine bicycle exercise there was attenuation of exercise cardiac output (delta C.I. - 0.6 1 min-1 m-2; P less than 0.01) and systolic pressor response (delta SBP - 13 mm Hg; P less than 0.01) compared with control observations without change in other measured or derived variables. The haemodynamic profile of penbutolol compared favourably with other beta-adrenoceptor antagonists previously evaluated under similar conditions in patients with ischaemic heart disease. Over the i.v. dose-range evaluated penbutolol attenuated exercise-induced angina with a relatively modest depression of cardiac performance; the small change induced in resting haemodynamic variables may, in part, have been contributed to by the intrinsic sympathomimetic activity of penbutolol. [ABSTRACT FROM AUTHOR]

El dolor es una experiencia sensorial y emocional desagradable, que pueden experimentar todos aquellos seres vivos que disponen de un sistema nervioso central -SNC, es una experiencia asociada a una lesión tisular o expre-sada como si esta existiera. En esta revisión, se presentan nuevas fuentes naturales para la obtención de diversos fármacos para tratar el dolor crónico de diversas patologías aislados desde animales marinos (caracoles del género Conus), se trata de conotoxinas aisladas de venenos de estos animales. Su efecto terapéutico consiste en un blo-queo selectivo de los canales de calcio (Ca) tipo N, por medio del cual reduce la liberación de neurotransmisores pronociceptivos en el asta posterior de la médula espinal, inhibiendo, de esta manera, la transmisión del impulso doloroso. Asimismo se plantean diversas metodologías para la obtención de estos novedosos compuestos, así como una caracterización completa de los animales de donde se extraen y otras aplicaciones médicas de estos compuestos

Introduction There is growing interest in, and emphasis on, electronic teaching tools in medicine. Despite relevant testing on the United States Medical Licensing Examination (USMLE), American medical schools offer limited training in skin disorders. Teaching visual topics like dermatology in classroom formats is challenging. We hypothesized that an electronic module would enhance students' dermatology competency. Methods A self-directed, case-based module was created. To test its efficacy, 40 medical students were randomized to have module access (interventional group) or none (conventional group). Learning outcomes were compared using a multiple-choice exam, including questions relevant and irrelevant to the module. Outcomes included proportions of correctly answered module questions (module scores) and nonmodule questions (nonmodule scores). Difference scores were calculated: (module score) − (nonmodule score). Positive values indicated that knowledge of module questions surpassed that of nonmodule questions. If there were a training effect, the interventional group's difference score should exceed that of the conventional group. Results The interventional group scored significantly higher than did the conventional group on module questions—75% (interquartile range [IQR], 69–88) versus 50% (IQR, 38–63), p < .001—and nonmodule questions—85% (IQR, 69–92) versus 69% (IQR, 54–77), p = .02. The Hodges-Lehman median difference estimate of the training effect was 13.0 (95% confidence interval, 0.5–25.5). Discussion This e-module is effective at enhancing students' competency in dermatology while emphasizing detailed pathophysiology that prepares them for USMLE Step 1. A module-based curriculum may enhance learning in supplement to traditional teaching modalities.

OBJECTIVE: To evaluate the concordance between the Gleason scores of prostate biopsies and radical prostatectomy specimens, thereby highlighting the importance of the prostate-specific antigen (PSA) level as a predictive factor of concordance. METHODS: We retrospectively analyzed 253 radical prostatectomy cases performed between 2006 and 2011. The patients were divided into 4 groups for the data analysis and dichotomized according to the preoperative PSA,

Nesta entrevista a professora Mara Regina Lemes De Sordi, da Faculdade de Educação da Universidade Estadual de Campinas, faz um balanço minucioso da experiência de avaliação institucional participativa desenvolvida nas escolas de ensino fundamental da rede municipal de Campinas, iniciada em 2006, em parceria com o Laboratório de Observação e Estudos Descritivos (Loed). Dentre os principais aspectos abordados, destacam-se as reflexões feitas em relação ao empoderamento dos diferentes atores escolares, ao sentido das Comissões Próprias de Avaliação nas escolas, aos desafios e equívocos da experiência e avanços por ela alcançados, bem como à construção de uma nova cultura escolar apoiada pela avaliação institucional participativa.

In the reflections concerning what might be called the “new anti-capitalist scenario”, we can find affirmatives inwhich the solidarity economy practices represent a very important part in the structure of the transition bridge fromresistance to the alternative to capitalism, being, therefore, an essential mechanism in the search for alternatives ofrelationships among the State, the market, and the society. Under this perspective, the solidarity economy may implynew manners or ways of production and distribution. From its essential supports, popular cooperativism might beconsidered one of the most important. Due to the fact that it is based on a specific theory of production anddistribution of goods and services, when exercised in a self-management way, popular cooperativism has as its maincharacteristic the emancipation in relation to the liberal forms of market. It may rescue, in this sense, severalalternative propositions of distribution of power and income, representing the genesis of what might be calledsolidarity economy

O artigo apresenta resultados de pesquisa de avaliação sobre a qualidade da educação infantil no Brasil, desenvolvida em parceria com a Fundação Carlos Chagas, o Ministério da Educação e o Banco Interamericano de Desenvolvimento. Os dados foram colhidos em 147 instituições de educação infantil em seis capitais brasileiras, durante o segundo semestre de 2009. Para a observação dos ambientes de creches e pré-escolas foram utilizadas versões adaptadas das escalas Infant/Toddler Environment Rating Scale Revised Edition e Early Childhood Environment Rating Scale Revised Edition. Foram também aplicados questionários a diretores das instituições e professoras das turmas avaliadas. Os principais resultados revelaram que: creches e pré-escolas apresentam em média níveis de qualidade insatisfatórios; os níveis de qualidade mais comprometidos se referem às atividades (creche e pré-escola), rotinas de cuidado pessoal (creche) e estrutura do programa (pré-escola); mudanças em determinadas características das instituições poderiam levar à melhoria da qualidade da educação infantil nos municípios investigadosThis article presents results from a research on the quality of Early Childhood Education in Brazil that was conducted in a collaborative effort between Fundação Carlos Chagas, the Ministry of Educations and the Inter-American Development Bank. Data were collected in 147 crèches and preschools in six state capitals, during the second semester of 2009. The instruments applied for the observation of classes were the translated versions of the Infant/Toddler Environment Rating Scale Revised Edition and the Early Childhood Environment Rating Scale Revised Edition. Questionnaires for principals and for teachers of the observed classes were also applied. The main results are: crèches and preschools average scores were in the basic level; the lowest scores received were related to Activities (crèche and preschool), Personal care routines (crèche), and Program structure (preschool); if changes were promoted in some of the institutions characteristics, those scores could be significantly improved

Este artigo apresenta resultados de uma pesquisa cujos objetivos foram avaliar a qualidade da educação infantil (EI) em seis capitais brasileiras (estudo da qualidade), para, a seguir, identificar diferenças no desempenho escolar de crianças no início do ensino fundamental (EF) associadas à frequência de uma pré-escola de qualidade (estudo de impacto). O estudo de impacto utilizou os resultados do estudo da qualidade obtidos por meio da aplicação de escalas de avaliação da qualidade a uma amostra de pré-escolas de três capitais brasileiras, resultados estes que indicam um nível de qualidade comprometido na maioria das instituições avaliadas. A amostra do estudo de impacto foi constituída por 762 alunos de escolas públicas com notas na Provinha Brasil, dos quais 605 haviam frequentado uma pré-escola avaliada no estudo da qualidade e 157 crianças que não frequentaram a EI. Os dados foram analisados utilizando a análise multinível/hierárquica com classificação cruzada, que permite levar em conta, simultaneamente, o efeito de diversas variáveis explicativas (características dos alunos e de suas famílias; das escolas de EI e das escolas de EF) sobre os resultados da variável resposta (as notas dos alunos do segundo ano na Provinha Brasil). O estudo de impacto revela que a frequência à pré-escola de boa qualidade influi positivamente no desempenho dos alunos na Provinha Brasil. As análises indicam, também, que a idade da criança é um fator importante nos resultados apresentados nessa prova, assim como a escolaridade da mãe, a renda familiar e o Ideb da escola de EF.This article presents results from a research whose objectives were to evaluate the quality of early childhood education (ECE) in six Brazilian state capitals (quality assessment) and, then, identify differences in school performance of children at the beginning of fundamental education (FE) associate to their attending a good quality ECE school (impact assessment). The impact assessment made use of the results of the quality assessment obtained from the application of grades of quality evaluation to a sample of pre-schools situated in three Brazilian state capitals. These results indicate that the quality level has been compromised in the majority of the institutions evaluated. The sample for the impact assessment was constituted by 762 students from public schools with grades in the Provinha Brasil [National Literacy Exam], from which 605 had attended a pre-school evaluated in the quality assessment, and 157 children who had not attended ECE. The data were treated by multilevel/hierarchical analysis with cross classification, which makes it possible to take into account, simultaneously, the effect of several explicative variables (characteristics of pupils and their families; of the ECE schools and FE schools) upon the results of the response variable (second-year students' grades in the Provinha Brasil). The impact assessment reveals that attending a good quality pre-school has positive effect in the performance of students in the Provinha Brasil. The analyses also indicate that the child's age is an important factor for the results obtained in that exam, as well as mother's level of schooling, family income, and the Ideb result of the ECE attended.

Dans cet article, on examine lamise en place de deux politiques orientées vers le développement du territoire en milieu rural au Brésil dans les années 2000: le Programme de Développement Durable des Territoires Ruraux (Pronat) et le Programme Territoires de la Citoyenneté (PTC). D'après l'examen des nouvelles pratiques institutionnelles en cours, de la gestion sociale des programmes et de leurs structures de gouvernance, ainsi que du rôle des acteurs engagés, on conclut que ces derniers ont suivi, d'une certaine façon, une stratégie singulière d'action politique pour le développement des régions concernées, malgré les immenses enjeux à venir, afin d'aboutir à des résultats vraiment solides.

Objetivo: describir y evaluar la técnica de perfusión subclavia para protección cerebral selectiva con hipotermia moderada. Métodos: estudio descriptivo de 19 pacientes, a quienes se les practicó corrección de disección o aneurisma del arco aórtico mediante la utilización de esta técnica. Resultados: entre septiembre de 2002 y septiembre de 2005, se intervinieron 19 pacientes. El 68,4% eran hombres, con un promedio de edad de 54,05 ± 13,53 años. La disección de aorta tipo A correspondió al 57,8%; el 42,2% restante tenía aneurismas en alguna porción de la aorta con compromiso del cayado. El 73,7% tenía insuficiencia valvular aórtica. El 47,3% se encontró en clase funcional I, el 31,5% en clase II y el 21% en clase III. El 36,8% requirió revascularización coronaria. El tiempo promedio de perfusión cerebral selectiva fue de 28,95 ± 8,73 minutos; la perfusión sistémica fue de 163,31 ± 32,15 minutos, el pinzamiento aórtico fue de 135,36 ± 34,48 minutos y la temperatura promedio fue de 27º ± 0,94º centígrados. Hubo tres defunciones. No ocurrieron complicaciones neurológicas definitivas. Conclusión: esta técnica puede ser estandarizada para cirugías electivas o emergentes. Es una técnica simple, reproducible, que permite períodos de tiempo más prolongados para la reconstrucción del arco aórtico sin producir isquemia del tejido cerebral, tiempos de circulación extracorpórea más cortos, pocas complicaciones por sangrado, disminución del riesgo de embolización cerebral anterógrada y un excelente resultado neurológico final.Objective: describe and evaluate the subclavian perfusion technique for selective cerebral protection with moderate hypothermia. Methods: descriptive study of 19 patients to whom correction of the dissection or aneurysm of the aortic arch through the utilization of this technique was practiced. Results: between September 2002 and September 2005, 19 patients were operated. 68.4% were men with mean age 54.05 ± 13.53 years. 57.8% corresponded to aortic dissection type A; the remaining 42.2% had aneurysms in some portion of the aorta, with arch involvement. 73.7% had aortic valve insufficiency. 47.3% were in functional class I, 31.5% in class II and 21% in class III. 36.8% required coronary revascularization. Mean time of selective cerebral perfusion was 28.95 ± 8.73 minutes; systemic perfusion was 163.31 ± 32.15 minutes; aortic clamping was 135.36 ± 34.48 minutes and mean temperature was 27.66º ± 0.94ºC. There were 3 deaths. No definitive neurological complications were found. Conclusions: this technique may be standardized for elective or emergent surgeries. It is a simple reproducible technique that allows more prolonged periods of time for the reconstruction of the aortic arch without producing cerebral ischemia; the extracorporeal circulation times are shorter, there are few bleeding complications, there is a decrease of cerebral anterograde embolism, and an excellent neurological result.

Tendências da avaliação da aprendizagem em sala de aula

Los aneurismas y seudoaneurismas de injertos de vena safena aortocoronarios, son una complicación inusual de la cirugía de revascularización miocárdica. En este reporte se presenta el caso de un paciente de género masculino de 61 años de edad, quien sufrió un infarto del miocardio de la pared inferior 14 años atrás. La angiografía coronaria mostró enfermedad severa de dos vasos. Se realizó anastomosis de la arteria mamaria interna izquierda, al tercio medio de la descendente anterior e injerto de vena safena al tercio distal de la arteria coronaria derecha. En marzo de 2003, consultó por dolor anginoso. La radiografía de tórax reveló una masa paracardiaca derecha. La arteriografía coronaria mostró aneurisma del puente venoso a la arteria coronaria derecha. Durante la evolución presentó hemoptisis masiva; se hizo cirugía y se halló fístula de aneurisma de puente venoso coronario al lóbulo medio del pulmón derecho. En este artículo se hace una revisión de la etiología, los hallazgos clínicos, la metodología diagnóstica y el tratamiento actual de esta entidad. Hasta la fecha de esta publicación se reportan aproximadamente 60 casos en la literatura inglesa.Aorto-coronary aneurysms/pseudo aneurysms from saphenous vein grafts are an unusual complication of myocardial revascularization surgery. We report the case of a 61 years old male patient who had suffered an inferior wall myocardial infarction 14 years before. Coronary angiography showed severe two-vessel disease. Anastomosis of the left internal mammary artery to the mid third left anterior descendant artery and saphenous vein grafting to the distal third of the right coronary artery, were performed. In March 2003 he complains of anginous pain. Chest X ray showed a right paracardiac mass. Coronary arteriography revealed an aneurysm of the venous bypass graft to the right coronary artery. During the evolution, the patient presents massive hemoptysis, requiring emergency surgery. A fistulous communication from the aneurysm in the venous coronary bypass to the middle right pulmonary lobule was found. This article reviews etiology, clinical findings, diagnostic methodology and actual treatment of this entity. Up to this publication’s date approximately 60 cases have been reported in the English literature.

Activated carbons from shell eucalyptus (Eucalyptus globulus) were prepared by chemical activation through impregnation with solutions of two activators: sulfuric acid and sodium hydroxide, the surface areas for activated carbons with base were 780 and 670 m2 g−1 and the solids activated with acid were 150 and 80 m2 g−1. These were applying in adsorption of priority pollutants: phenol, 4-nitrophenol, and 4-chlorophenol from aqueous solution. Activated carbon with the highest adsorption capacity has values of 2.12, 2.57, and 3.89 on phenol, 4-nitrophenol, and 4-chlorophenol, respectively, and was activated with base. In general, all carbons adsorption capacity was given in the following order: 4-chlorophenol > 4-nitrophenol > phenol. Adsorption isotherms of phenols on activated carbons were fitted to the Langmuir, Freundlich, and Dubinin-Radusckevisch-Kanager models, finding great association between them and experimental data. A thermodynamic study was performed, the exothermic nature and spontaneous nature of the adsorption process were confirmed, and the favorability of adsorption on activated carbons with NaOH was confirmed by energy relations and concluded that the adsorption process of phenolic compounds from the activated carbon obtained is physical. The pH of solutions and pH at point of zero charge of the solid play an important role in the adsorption process.

Objective: To locate with the highest possible exhaustiveness and then to describe the clinical trials (CT) with random distribution published in the region. This information may allow a larger knowledge of this type of scientific activity, and constitute the departure base for the tasks of the Cochrane Ibero-American Collaboration. Methodology: Manual search of possible controlled clinical trials in the main titles of medical journals in the region. Results: 23 publications were reviewed, in which 53 controlled clinical trials and three randomized clinical trials were found. Conclusions: This is a pioneer work in Antioquia and old Caldas in the search for controlled clinical trials in the main publications between 1948-1998; this work is part of the study “Identification of controlled clinical studies and meta-analysis in Colombian health magazines 1948-1998”, started with the goal of creating a Latin American database specialized in clinical trials, and in this way to be able to compete with the international indexes. Entidades: Escuela de Investigaciones Médicas Aplicadas, Biblioteca Médica, Facultad de Medicina; Sistema de Bibliotecas, Universidad de Antioquia. Objetivo: localizar y describir los ensayos clínicos (EC) con distribución aleatoria publicados en la región. Se pretende que esta información permita un mayor conocimiento de este tipo de actividad científica, así como que constituya la base de partida para los trabajos de la Colaboración Cochrane Iberoamericana. Metodología: búsqueda manual en los principales títulos de revistas médicas de la región de los posibles ensayos clínicos controlados. Resultados: se revisaron 23 revistas, en las cuales se encontraron 52 ensayos clínicos controlados y tres ensayos clínicos aleatorizados. Conclusiones: este trabajo es pionero en Antioquia y el viejo Caldas en la búsqueda de ensayos clínicos controlados en las principales publicaciones entre 1948-1998. Hace parte del estudio “Identificación de los estudios clínicos controlados y meta-análisis en las revistas de salud en Colombia 1948-1998”, iniciado con el fin de crear una base latinoamericana de datos especializada en ensayos clínicos.

As institucionalidades e a governança nas políticas brasileiras de desenvolvimento territorial e a relação destas com a superação da pobreza no meio rural constituem o foco de análise deste artigo. São objetos de análise o Programa de Desenvolvimento Sustentável de Territórios Rurais (PRONAT), criado em 2003, e o Programa Territórios da Cidadania (PTC), instituído em 2008. Além de pesquisa bibliográfica e documental, a investigação contou com a realização de estudos de casos em seis Territórios da Cidadania, distribuídos entre as grandes regiões brasileiras. Os resultados sinalizam para as limitações de ambas as políticas públicas no enfrentamento da pobreza rural e, principalmente, para os entraves e desafios da perspectiva do desenvolvimento territorial no que se refere à governança, envolvendo diversos atores, atividades e setores nos territórios, e à criação, efetividade e reprodução de novas e velhas institucionalidades.

La fiebre de origen desconocido se ha convertido en una entidad de alto costo que requiere disponibilidad de varias pruebas diagnósticas. Objetivo: describir las características clínicas y etiológicas de los pacientes con fiebre de origen desconocido. Materiales y métodos: estudio descriptivo tipo serie de casos, retrospectivo, de hospitalizados en el servicio de medicina interna por fiebre de origen desconocido, entre junio 1 de 2009 y marzo 31 de 2012, en los Hospitales de San José y el Infantil Universitario de San José. Resultados: población total 36 pacientes, edad promedio 42.6 años (DE 19.4), 58.3% hombres, 25% estudiantes universitarios, 66% diagnosticados en el Hospital de San José. Las etiologías más frecuentes fueron: enfermedades infecciosas (30.5%), colagenosis (19.4%), neoplásicas (11.1%), miscelánea (2.7%), no se encontró la causa en 36%. Conclusión: en nuestro estudio los pacientes fueron jóvenes con pocos antecedentes médicos. La patología infecciosa fue la más frecuente, seguida de enfermedades inflamatorias y fue imposible el diagnóstico etiológico en 36%. En algunos casos no se solicitaron exámenes que se consideran útiles. Se hace necesario tener en cuenta esta información para mejorar el abordaje diagnóstico de estos pacientes. Abreviaturas: FOD, fiebre de origen desconocido.

Este artigo é sobre como em uma pequena cidade do Nordeste brasileiro os cidadãos buscaram realizar o direito à saúde por meio de esforços para exigir transparência do governo municipal. Ele conta a história da evolução do conselho municipal de saúde da cidade, e reflete sobre alguns dos desafios ainda existentes para o alcance dos direitos à saúde. O artigo começa com a apresentação dos conselhos de saúde, suas estruturas, funções, e o contexto a partir do qual eles emergiram. Em seguida, são exploradas as origens e o desenvolvimento do conselho municipal de saúde do Cabo de Santo Agostinho (PE).

O resumo deste artigo não está diponível.

O resumo deste artigo não está diponível.

O texto sustenta a idéia de que a dimensão do local constitui papel crucial no desenvolvimento rural. Associando essa questão com o tema da extensão rural, o autor tece considerações metodológicas em torno do par iniciativas/criatividade nas atividades rurais, focalizando a necessidade de políticas públicas orientadas para o setor pesqueiro.

O resumo deste artigo não está diponível.

O estudo analisa os objetivos e as justificativas de quatro secretarias de educação para investir em sistemas próprios de avaliação em larga escala em vez de utilizar as avaliações nacionais já disponíveis, em especial a Prova Brasil, como instrumento precípuo de sua política educacional. O foco recai sobre avaliações externas que lançam mão dos mesmos modelos adotados pelas avaliações nacionais com contornos e desenhos distintos impressos às diferentes redes de ensino investigadas, conforme o tipo de organização e política. Destacam-se as demandas que se impõem a essas avaliações, notadamente naquilo que podem conter de subsídio pedagógico volta do diretamente ao trabalho escolar.

Abstract Background Cancer remains a major cause of morbidity and mortality worldwide. In developing countries, data on lung cancer mortality are scarce. Methods Using South Africa's annual mortality and population estimates data, we calculated lung cancer age-standardised mortality rates for the period 1995 to 2006. The WHO world standard population was used as the reference population. Scatter plots and regression models were used to assess linear trends in mortality rates. To better characterise emerging trends, regression models were also partitioned for defined periods. Results Lung cancer caused 52,217 deaths during the study period. There were 4,525 deaths for the most recent year (2006), with men accounting for 67% of deaths. For the entire South African population, the age-standardised mortality rate of 24.3 per 100,000 persons in 1995 was similar to the rate of 23.8 per 100,000 persons in 2006. Overall, there was no significant decline in lung cancer mortality in South Africa from 1995 to 2006 (slope = -0.15, p = 0.923). In men, there was a statistically non-significant annual decline of 0.21 deaths per 100,000 persons (p = 0.433) for the study period. However, from 2001 to 2006, the annual decline of 1.29 deaths per 100,000 persons was statistically significant (p = 0.009). In women, the mortality rate increased significantly at an annual rate of 0.19 per 100,000 persons (p = 0.043) for the study period, and at a higher rate of 0.34 per 100,000 persons (p = 0.007) from 1999 to 2006. Conclusion The more recent declining lung cancer mortality rate in men is welcome but the increasing rate in women is a public health concern that warrants intervention. Smoking intervention policies and programmes need to be strengthened to further reduce lung cancer mortality in men and to address the increasing rates in women.

Neste trabalho foram estudadas as sempre-vivas como sendo um produto natural de importância para decoração de interiores. Como sempre-vivas são considerados escapos e inflorescencias que conservam a aparência de estruturas vivas, mesmo depois de destacados das plantas. O presente trabalho objetivou estudar as atividades econômicas relacionadas com esse grupo de plantas, mostrando sua importância como geradora de renda e de emprego, nos arredores de Diamantina (Minas Gerais) e de divisas para o País, pois a maior parte da produção é exportada para os Estados Unidos e Europa. Através do levantamento de quantidades comercializadas, preços pagos aos coletores e preços de atacado das principais espécies comercializadas na região (18 de Eriocaulaceae, 10 de Gramineae, 3 de Xyridaceae e 2 de Cyperaceae), calculou-se o valor da produção e da comercialização, tendo-se idéia da geração de renda e volume comercializado. Procurou-se mostrar também, através da exportação, a importância na geração de divisas. Infere-se, da análise dos dados, um decréscimo na exportação, que pode estar relacionado à queda da produção devido a fatores como sobresforço na coleta, dificultando a recuperação das populações, ou concorrência de outros países no mercado. Sugere-se pois incremento das pesquisas no sentido de tornar viável a cultura sistemática de espécies cultiváveis, como fator econômico importante para as regiões de campos rupestresThe present work is a study of "everlasting flowers" as a natural product of importance for interior decoration. The term "everlasting flowers" is used for scapes and inflorescences which, even after being detached from the plant, still maintain the appearance of living structures. The economic activities related to this group of plants are considered; their importance is demonstrated, as a source of income and employment in the region of Diamantina (State of Minas Gerais, Brazil), and also as a source of revenue for the country: production is largely exported to Europe and the U.S.A. A survey was made of the quantity of such flowers marketed, of prices paid to collectors, and of the wholesale prices of the species most extensively commercialized in the region (18 Eriocaulaceae, 10 Gramineae, 3 Xyridaceae and 2 Cyperaceae); from these figures were calculated the values involved in production and commercialization, thus providing some idea of the income created and the quantity of plants concerned. The importance of exportation of everlasting flowers as a source of revenue was also considered. Analysis of data permits inference of a decline in export; this may be due to a fall in production as a result of over-collection and subsequent difficulty in recuperation of populations, or of market competition from other countries. It is suggested that research should be increased with a view to making viable the systematic cultivation of those species which can be cultivated, as an important contribution to the economy of regions of campo rupestre

ABSTRACT Purpose: This study aims to evaluate the link between preoperative parameters and oxidative stress (OS) markers in the bladder wall of men undergoing open prostatectomy. Materials and Methods: From July 2014 to August 2016, men aged ≥ 50 years and presenting with LUTS were prospectively enrolled. Preoperative assessment included validated questionnaires (IPSS and OAB - V8), lower urinary tract ultrasound and urodynamics. Bladder biopsies were taken during open prostatectomy for determination of OS markers. Increased OS was defined by increased concentration of malondialdehyde (MDA) and / or decreased concentration of antioxidant enzymes (superoxide dismutase and / or catalase). P

Se realizó un inventario de las macroalgas de la zona submareal, entre 5 y 17 m de profundidad para las localidades de Puerto Maya, en el estado Aragua, Puerto Cruz, en el estado Vargas, Madrizquí y Boca de Cote, Parque Nacional Archipiélago Los Roques, Dependencias Federales. Como resultado se reportan cuatro nuevos registros de especies de algas rojas (Rhodophyta) para la costa de Venezuela: Apoglossum gregarium, Platysiphonia caribaea, Gloiocladia iyoensis y Botryocladia monoica. De las cuales, A. gregarium y G. iyoensis se registran también por primera vez en el Mar Caribe. Se establecen sus principales caracteres diagnósticos, resumidos como: hábito y dimensiones del talo, morfología de las estructuras reproductivas, presencia o ausencia de corticación y presencia o ausencia de células glandulares. Además se realizan comparaciones con sus especies morfológicamente cercanas.