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GPT-3 is a neuronal language model that performs tasks such as classification, question-answering and text summarization. Although chatbots like BlenderBot-3 work well in a conversational sense, and GPT-3 can assist experts in evaluating questions, they are quantifiably worse than real teachers in several pedagogical dimensions. We present the first systematic literature review that analyzes the main contributions and uses of GPT-3 in the field of education. The protocols suggested in the PRISMA 2020 statement were followed for the drafting of the review. According to the results, 34 significant productions were identified through a systematic search in ISI Web of Science, SCOPUS and Google Scholar. GPT-3 has been considered in the academic, ethical and medical fields, in humanities and in computer science, in the formulation of questions and answers, and through cooperative educational dialogs. GPT-3 has been proven to have valuable applications in education, such as the automation of routine tasks, in making quick diagnoses of the students' weaknesses and in the automatic generation of questions, but it still faces challenges and limitations that require additional investigation. We discuss the educational possibilities and the limitations to the use of GPT-3.

The course-based undergraduate research experiences (CURE) approach is increasingly being used in undergraduate experimental courses. Here, we describe the implementation of CURE in an upper-level inorganic chemistry course, in which students were assigned different current themes to study. This paper focuses on the theme of quantum dots, highlighting how guidance, inquiry, and research were integrated into the classroom. The quantum dots theme introduced various concepts to students such as electron-hole pairs, band gaps, particle capping, doping, and size effects. A questionnaire distributed among the students revealed that the continuation of their research throughout the semester kept them engaged, and they maintained a high level of interest in the subject. The success of CURE in this course is revealed, as the instructor and professor will maintain this approach in the next semesters.

Abstract Background Colorectal cancer (CRC) is a prevalent and lethal malignancy. This study examines differences in clinical and prognostic characteristics of CRC between patients under 50 years and those aged 50 and above, treated at a reference hospital in Southern Brazil. Methods A retrospective cohort study was conducted, analyzing data from the Cancer Hospital Registry in Porto Alegre, RS. Patients diagnosed with colon or rectal adenocarcinoma between January 2013 and December 2017 were included. Variables analyzed included family history, alcoholism, smoking status, clinical staging, tumor laterality, clinical presentation, CEA levels at diagnosis, adjuvant chemotherapy, and neutrophil-to-lymphocyte ratio. Results The study cohort included 1,121 patients, with 85% aged 50 years or older, and 15% younger than 50 years. Significant differences were observed in smoking status and clinical presentation, with younger patients presenting with a higher prevalence of obstruction/subocclusion at diagnosis, which may reflect differences in clinical presentation due to delayed diagnosis. Conclusions Age and lifestyle factors, particularly smoking, significantly influenced the clinical presentation and management of colorectal cancer. These findings underscore the importance of targeted prevention strategies and personalized treatment approaches for younger CRC patients.

Abstract The ongoing increase in wild boar populations across Europe has fostered human–wildlife conflicts, including the transmission of emerging pathogens with zoonotic importance. Blastocystis is a ubiquitous, faecal-oral transmitted protist that can cause gastrointestinal illnesses and is observed in humans and animals worldwide. The role of wildlife in the epidemiology of Blastocystis is insufficiently understood. Thus, we investigated the occurrence and subtype diversity of Blastocystis in free-ranging wild boars from the Iberian Peninsula using conventional PCR and next-generation amplicon sequencing of a fragment of the ssu RNA gene. A total of 459 wild boar faecal samples were collected across Spain (n = 360) and Portugal (n = 99) between 2014 and 2021. Blastocystis was present in 15.3% (70/459; 95% CI 12.1–18.9) of the wild boars analysed, and its occurrence was significantly higher in Portugal (34.3%, 34/99; 95% CI 25.1–44.6) than in Spain (10.0%, 36/360; 95% CI 7.1–13.6). Seven Blastocystis subtypes (ST5, ST10b, ST13–ST15, ST24b, and ST43) were detected among the surveyed wild boar populations, with greater variability detected in Portuguese samples. ST5 was identified in all the Blastocystis-positive animals, whereas 14.3% of them harboured ST mixed colonisations. Our results demonstrate that Blastocystis ST5 is particularly adapted to infect wild boars. The additional identification of zoonotic STs reinforces the role of wild boars as spreaders of zoonotic infections with public health significance.

INTRODUCTION: Undernourishment is a common health problem among elderly individuals, and its prevalence grows among frail patients, which makes nutritional support a priority, especially in acute diseases. However, providing nutritional support to undernourished patients or to those under acute caloric deprivation may lead to electrolyte disturbances associated with neurological, respiratory, and cardiac symptoms, including cardiac arrest. These disturbances occur a few days after receiving nutritional support, and characterize the refeeding syndrome. METHODOLOGY: Five elderly patients hospitalized for clinical reasons and who developed refeeding syndrome during the duration of the stay, were retrospectively evaluated. RESULTS: All patients analyzed were malnourished and frail, of whom four were women. The age group ranged between 82 and 85 years, and food deprivation time ranged between 7 to 15 days. Three patients had severe dementia and were admitted with hypoactive delirium. Hypophosphatemia occurred in 100% of the sample, followed by hypokalemia (60%) and hypomagnesemia (40%). Four patients developed peripheral edema, two developed metabolic ileus and three elderly persons (who had lower phosphorus values) died during the hospital stay. CONCLUSION: All refeeding syndrome patients developed hypophosphatemia, with fatal outcome among those whose phosphorus values were lower. The development of peripheral edema and metabolic ileus was frequent. Owing to the lack of data in literature, new researches on refeeding syndrome are extremely important. Electrolyte evaluation before and after nutritional support in patients at risk, is indispensable to facilitate recognition and treatment of this severe condition.

OBJECTIVE: In Brazil, 70% of older adults have at least one chronic disease and, of these, 60% use more than four medications regularly, characterizing polypharmacy. Potentially inappropriate medications (PIMs) are used by 40% of this population. Both polypharmacy and PIM use are associated with negative outcomes, such as increased frequency of drug interactions, falls, frailty, malnutrition, and in some cases, death. METHOD: This was a cross-sectional study with retrospective data collection of all older patients admitted for clinical reasons to a tertiary care hospital in Brazil from March 2015 to February 2016. We evaluated patients for the presence of polypharmacy and PIM use, correlating these findings with other variables of interest. RESULTS: The medical records of 456 patients were analyzed. Mean patient age was 83 years, and 71.3% were women. The mean Charlson comorbidity index (CCI) was 2.38, and dementia was the most prevalent comorbidity (36.6%). Polypharmacy was present in 56.5% of patients, and 46.4% of them used at least one PIM. Antipsychotics were the most frequently used PIM (46.2%), followed by benzodiazepines (33.0%). Drug interactions were detected in 53.5% of patients. The presence of polypharmacy was associated with the use of PIMs (p < 0.001). Additionally, both polypharmacy and PIM use were associated with drug interactions (p < 0.01), poorer functional status (p < 0.01), and higher CCI (p = 0.015). CONCLUSION: In this study population, the prevalence of polypharmacy was 56.5%, and 46.5% of cases included the use of PIMs. Both conditions were associated with drug interactions, poorer functional status, and higher CCI.

Gifted education in Brazil presents some characteristics due to the reality of South American countries. This study aims to describe the current situation of the programs for the gifted in Brazil from the Education and Learning Capital Model (ELCM) perspective. The procedure utilized was the analysis of documents and publications and an online survey. The participants were 51 educators and psychologists (84% F) from different Brazilian regions, ages 28 to 69 (Mean=40), working in private (40%), public institutions (90%), and non-governmental organizations (10%). The results indicated positive aspects of exogenous learning capitals reflected in legislation that guarantees rights at the Federal, State, and Municipal spheres for gifted children and special programs at universities for high school and college students. However, there are main challenges from the endogenous Learning Resource, which focus on academic skills and disregard other aspects of physical health. Political discontinuities and societal myths block the advancement of programs for the Brazilian gifted, so information to clarify these children's rights in society is a priority.

Resumo Objetivo analisar as representações sociais da hanseníase na ótica de quem vivencia a doença. Métodos estudo qualitativo e descritivo, fundamentado na Teoria das Representações Sociais. Participaram 41 pessoas com hanseníase de uma unidade de referência do Pará. Realizou-se entrevista em profundidade individual e semiestruturada. Os dados do perfil foram tratados com recursos da estatística, e os textuais foram submetidos ao software IraMuTeQ. Resultados o software dividiu os textos das entrevistas em 701 segmentos, com aproveitamento de 81,60%. A classe lexical 1 contém elementos referentes à construção simbólica da hanseníase ancorados e objetivados nas memórias da antiga lepra, acionando imagens que afetam a estética corporal, como a mutilação e deformidades. Resgata-se a doença como castigo divino, emergindo o preconceito e estigma social. Conclusão e implicações para a prática as reminiscências da lepra são fortes e influenciam a inserção e o convívio social dos doentes. Há que se intensificar a difusão de informações sobre a hanseníase, importância da adesão ao tratamento e seu potencial de cura. Essas informações não devem se restringir aos conteúdos discursivos, mas imagéticos e de ação, com atividades que mobilizem afetos e possibilitem a construção de novas representações que afastem a imagem da lepra do cotidiano das pessoas.

Introduction: Previous research has not explored features and behavior change techniques (BCTs) in physical activity (PA) promotion interventions among adolescents, including mobile health (mHealth) applications. Purpose: This study aims to conduct a narrative literature review of adolescent PA promotion apps, examining their theoretical foundations, key BCTs, primary features, and their influence on PA adherence and maintenance. Methods: The review includes peer-reviewed studies published from 2012 to December 2024, employing qualitative and quantitative methodologies. Included studies examined healthy adolescents, focusing on PA app features and their relationship to PA promotion. Results: A total of twenty-one studies were analyzed: ten reviews, eight qualitative studies, and three app quality assessments. Findings indicate that mHealth tools and wearable trackers yield variable impacts on PA engagement. Conclusion: Future research must adopt higher methodological standards. Comparative studies on PA interventions require caution due to limitations such as insufficient research, inadequate compliance assessment tools, potential biases, and the absence of randomized controlled trials. The inconsistent outcomes from current intervention studies highlight the necessity for developing PA programs guided by intervention mapping or the Behavior Change Wheel, emphasizing high-quality methodologies tailored to specific target demographics.

Este artigo apresenta um framework para institucionalização de métricas de impacto social (MIS) para a Universidade Federal de São Paulo (Unifesp) baseado nos Objetivos de Desenvolvimento Sustentável (ODS) da Organização das Nações Unidas (ONU). Fundamenta-se no institucionalismo sociológico e na dinâmica do ranking Times Higher Education (THE), bem como articula as políticas universitárias com os ODS e alinha as atividades de ensino, pesquisa, extensão e cultura como interface dialógica com a sociedade. Os métodos de design, de design science research e dos pilares analíticos de Scott (regulativo, normativo e cultural-cognitivo) são utilizados. Como resultado, foi desenvolvido um framework MIS-Unifesp que estabelece princípios de análise institucional pautados em métricas.

Summary: Bladder tumors with aggressive characteristics often present microenvironmental niches marked by low oxygen levels (hypoxia) and limited glucose supply due to inadequate vascularization. The molecular mechanisms facilitating cellular adaptation to these stimuli remain largely elusive. Employing a multi-omics approach, we discovered that hypoxic and glucose-deprived cancer cells enter a quiescent state supported by mitophagy, fatty acid β-oxidation, and amino acid catabolism, concurrently enhancing their invasive capabilities. Reoxygenation and glucose restoration efficiently reversed cell quiescence without affecting cellular viability, highlighting significant molecular plasticity in adapting to microenvironmental challenges. Furthermore, cancer cells exhibited substantial perturbation of protein O-glycosylation, leading to simplified glycophenotypes with shorter glycosidic chains. Exploiting glycoengineered cell models, we established that immature glycosylation contributes to reduced cell proliferation and increased invasion. Our findings collectively indicate that hypoxia and glucose deprivation trigger cancer aggressiveness, reflecting an adaptive escape mechanism underpinned by altered metabolism and protein glycosylation, providing grounds for clinical intervention.

ObjectiveTo characterize the clinical manifestations of yellow fever disease and identify risk factors for mortality.MethodsA retrospective study was conducted in the referral center for infectious diseases (Hospital Eduardo de Menezes-HEM) in Belo Horizonte, Minas Gerais, Brazil. Analysis included data from 283 patients with confirmed YF infection older than 13 years old who presented to HEM between January 2017 and June 2018. In-hospital mortality (hypothesis formulated after data collection), demographic factors and clinical and laboratory assessments were used.ResultsStudy patients were mainly men (87.6%), with a median age of 46.0 (IQR 36.5, 57.0). 131 (46.3%) patients were admitted to the ICU, and 62 (22.0%) used invasive mechanical ventilation for a median of 2 days (IQR 1, 3). The median (IQR) total length of stay (LOS) in the ICU was 6 days (IQR 4, 8). The in-hospital mortality rate was 24.0%. Age was significantly higher in fatal (median 49.5, IQR 41.0, 61.0]) than in non-fatal cases [46 (36, 55)] (p < 0.01). Male sex was associated with an increased risk of death (RR 4.66, 95% CI 1.19, 18.2; p < 0.01). Most common symptoms and signs on admission to HEM were fever (31.9%), myalgia (27.8%), jaundice (24.3%), headache (23.9%), abdominal pain (16.1%), vomiting (12.2%), weakness (10.4%), and arthralgias (10.0%). Initial viral load above the cutoff of 4.45 log10 copies/mL was significantly associated with death prior to discharge (OR 12.2; CI 2.83, 92.3). Five factors were significantly related to increased odds of death prior to discharge: log-transformed AST (OR 3.65; CI 2.02, 7.81; p < 0.001), log-transformed INR (OR 7.40; CI 1.31, 33.0; p = 0.010), log-transformed lactate (OR 4.57; CI 1.48, 17.1; p = 0.013), log-transformed WBC (OR 4.33; CI 1.19, 18.5; p = 0.034), and age (OR 1.06; CI 1.01, 1.12; p = 0.026).Conclusions and relevanceAST, INR, lactate, WBC, and age are statistically associated with death prior to discharge in YF patients. These clinical markers should be applied to improve patient screening and management during future YF epidemics.

A intensificação da migração venezuelana para o Brasil reflete a busca por melhores condições de vida, acesso à saúde e educação. Esse movimento migratório traz desafios sociais e culturais, e destaca a importância de políticas inclusivas para acolhimento e integração. O objetivo deste estudo foi compreender as práticas de cuidado de saúde adotadas por famílias venezuelanas no Brasil, suas experiências ao acessar os serviços de saúde e o uso de práticas de medicina popular. Trata-se de um estudo descritivo de abordagem qualitativa, realizado entre agosto e dezembro de 2022, com 12 famílias venezuelanas residentes em Foz do Iguaçu, Brasil. A coleta de dados ocorreu por meio de entrevistas com base em um roteiro de perguntas. Para análise de dados optou-se pela Análise temática. As narrativas foram organizadas em duas categorias principais: Práticas familiares de cuidados da saúde da família; e Interações com o sistema de saúde brasileiro. Os resultados indicaram que, além do subsistema familiar de cuidados, as famílias confiam nos serviços de saúde brasileiros, especialmente para imunizações, atendimento odontológico e emergencial. No entanto, a medicina tradicional continua a ser valorizada. Como conclusão, destaca a importância de fortalecer as políticas assistenciais e os recursos humanos para assegurar que os serviços de saúde no Brasil possam acolher integralmente as famílias migrantes, com respeito as suas crenças e culturas.

No contexto da logística internacional, a eficiência e a sustentabilidade são cruciais. Este estudo propõe a reconfiguração da malha aérea no Brasil, utilizando aeroportos do Nordeste como hubs para importações da Europa e Ásia. A metodologia emprega grafos fuzzy e o operador OWA para modelar e otimizar rotas, considerando múltiplos critérios como distância, tempo de voo, emissão de CO2 e custo de frete. A análise inicial demonstra a viabilidade do modelo, oferecendo uma base sólida para futuras pesquisas que irão expandir o escopo para 67 aeroportos internacionais e refinar a definição dos pesos dos critérios. O estudo visa melhorar a eficiência logística, reduzir custos e emissões de carbono, e promover o desenvolvimento regional sustentável.

Resumo Gêmeos unidos com persistência do canal arterial e repercussões hemodinâmicas apresentam pior prognóstico. No presente relato de caso, demonstramos o primeiro fechamento percutâneo bem-sucedido do canal arterial com o dispositivo Piccolo© (Abbot Structural Heart, Plymouth, MN, EUA) nesse tipo de situação clínica.

IntroductionChemokines and their receptors are essential for leukocyte migration to several tissues, including human milk. Here, we evaluated the homing of T and B lymphocyte subsets to breast milk in response to ongoing respiratory infections in the nursing infant.MethodsBlood and mature milk were collected from healthy mothers of nurslings with respiratory infections (Group I) and from healthy mothers of healthy nurslings (Group C). Total lymphocyte, T and B cells, their subset numbers, and the expression of the homing receptors CCR5, CCR6, CCR10, and CXCR3 in these cells were evaluated in milk. Maternal serum and milk chemokine, cytokine, and IgA and IgG antibody levels were also quantified.ResultsAll milk lymphocyte numbers were greater in Group I than in Group C. All CD4 T-cell subsets expressing CCR5, CCR6, and CXCR3 were higher in Group I. Within the CD8 T-cell subsets, only CCR6 and CXCR3 were higher in Group I, while CCR5 expression was higher in Group I exclusively for activated CD8 T cells. Group I showed greater numbers of all CCR6+ B-cell subsets and CXCR3+ naive B cells and plasma cells than did Group C. Infection of the nurslings promoted increased CCL20, CXCL10, IL-6, IL-8, total IgA, and IgG levels in the milk.ConclusionRespiratory infections in nursing infants stimulate an increase in cytokines and chemokines in breast milk, facilitating the recruitment and activation of lymphocytes. This process may promote immunological tolerance and help in the maturation of the infant's immune system, providing an additional strategy for passive maternal-infant protection.

INTRODUÇÃO: A Tuberculose (TB) é uma doença com elevada morbimortalidade. Dentre as manifestações extrapulmonares, a meningite tuberculosa (MTB) destaca-se como a forma mais grave. Sua apresentação inicial é muito variada e atípica, especialmente em idosos, quando o delirium pode ser a única manifestação. Nessa fase é comum a confusão diagnóstica e atraso terapêutico, incluindo potencial iatrogênico. O presente trabalho relata um caso de MTB precoce em uma idosa previamente saudável, com discussão sobre as particularidades do acometimento inicial desta morbidade. RELATO DE CASO: Paciente do sexo feminino, 72 anos de idade, autônoma e independente, procurou atendimento de urgência com queixa de dor abdominal inespecífica, iniciada poucas horas antes, e que evoluiu com delirium dois dias depois. Após extensa investigação não houve diagnóstico definitivo, quando optou-se pelo estudo de líquido cefalorraquidiano que demonstrou padrão compatível com MTB provável. Após 48h de tratamento específico houve resolução do quadro febril, com melhora expressiva do quadro confusional no sétimo dia de tratamento, recebendo alta hospitalar.