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Com a concepção de que o território não deve ser entendido apenas como um limite político-administrativo, mas também como um espaço que é usado pela sociedade, pelo poder público e pelas empresas e que tem, dessa maneira, importância na formação social dos povos, buscamos, no presente artigo, apreender a participação da atividade mandioqueira (cultivo da mandioca com a sua transformação em farinha e em outros derivados) no processo de formação territorial do Agreste Potiguar. Destacamos que o processo de formação do território do Agreste Potiguar ancorou-se nas atividades de criação de gado, cultivo do algodão e culturas de subsistência (mandioca, feijão, milho etc.), por meio das quais o povo agrestino reproduziu-se socialmente e organizou seu território. Das culturas de subsistência, aquela que possuía importância para os agrestinos durante um maior período no ano era a mandioqueira, justamente por ser a mandioca uma planta resistente e que pode ser cultivada durante longos e variados ciclos. Assim sendo, a partir da realização de pesquisas bibliográfica e empírica analisamos o desencadear pretérito da atividade mandioqueira no Agreste Potiguar, asseverando que tal atividade exerceu a função primordial de cultura de subsistência no processo de formação do território em baila, apresentando-se, assim, importante para a sobrevivência de grande parte dos agrestinos. Por fim, evidenciamos, de maneira breve e preliminar, que a atividade mandioqueira vem passando por um processo de modernização no Agreste Potiguar, desde a década de 1980. Essa modernização traz à tona mudanças nas técnicas utilizadas no cultivo e na transformação da mandioca, nas relações de trabalho entre produtores de mandioca - trabalhadores e donos de casas ou de indústrias de farinha e no uso atual do território do Agreste Potiguar. Destarte, frisamos que essas transformações necessitam ser analisadas de maneira detalhada, em um próximo artigo, devido aos limites estabelecidos pelo objetivo do presente trabalho. PALAVRAS-CHAVE: Atividade mandioqueira. Formação territorial. Agreste Potiguar.

The present study aimed to investigate the fishing activity that occurs in Bailique's archipelago communities, Amapá, BR. Fishers from Bailique communities have fishing as their main economic activity during the year. Most of the community's residents come from Amapá, relatively young parents or mothers of families, with a low level of education, who fish as the primary source of income, followed by social benefits and other activities such as "açaí" extraction for supplementation. The vessels are small and medium-sized, with an autonomy of up to 5 days fishing, urns to one until three metric tons. Gillnet, longline, net, hand/reed line, harpoon or "zagaia", and shrimp trap "manzuá" are the most cited fishing gear. The composition of the caught fish is diverse, and the most species are from inland fisheries (captured mainly in streams, rivers, lakes, lowlands and mouth of Amazon river), inshore and marine fisheries (sea/estuary). [ABSTRACT FROM AUTHOR]

Diabetic foot ulcers are a severe complication of diabetes, and their management requires a multidisciplinary approach for optimal management. When treating these ulcers, limb salvage remains the ultimate goal. In this article, we present the “hanging” free flap for the reconstruction of chronic lower extremity diabetic ulcers. This two-staged approach involves standard free flap harvest and inset; however, following inset the “hanging” pedicle is covered within a skin graft instead of making extraneous incisions within the undisturbed soft tissues or tunnels that can compress the vessels. After incorporation, a second-stage surgery is performed in 4 to 6 weeks which entails pedicle division, flap inset revision, and end-to-end reconstruction of the recipient vessel. Besides decreasing the number of incisions on diabetic patients, our novel technique utilizing the “hanging” pedicle simplifies flap monitoring and inset and allows reconstruction of recipient vessels to reestablish distal blood flow.

OBJECTIVE: To evaluate the intraobserver and interobserver reliability of radial torsion angle measurement using computed tomography. METHODS: Twelve pairs of cadaver radii and 116 forearms from 58 healthy volunteers were evaluated using axial computed tomography sections measured at the level of the bicipital tuberosity and the subchondral region of the radius. During digital imaging, the angle was formed by two lines, one diametrically perpendicular to the radial tubercle and the other tangential to the volar rim of the distal joint surface. Measurements were performed twice each by three observers. RESULTS: In cadaveric bones, the mean radial torsion angle was 1.48º (-6º - 9º) on the right and 1.62º (-6 º - 8º) on the left, with a mean difference between the right and left sides of 1.61º (0º - 8º). In volunteers, the mean radial torsion angle was 3.00° (-17° - 17°) on the right and 2.91° (-16°- 15°) on the left, with a mean difference between the sides of 1.58º (0º - 7º). There was no significant difference between each side. The interobserver correlation coefficient for the cadaver radii measurements was 0.88 (0.72 - 0.96) and 0.81 (0.58 - 0.93) for the right and left radius, respectively, while for the volunteers, the difference was 0.84 (0.77 - 0.90) and 0.83 (0.75 - 0.89), respectively. Intraobserver reliability was high. CONCLUSION: The described method is reproducible and applicable even when the radial tubercle has a rounded contour.

As fraturas do úmero proximal são lesões comuns, levando seus pacientes a importantes limitações funcionais além de algumas complicações. Atualmente existem algumas opções de tratamentos cirúrgicos visando à melhor estabilização da lesão através de técnicas de ostessíntese, dependendo do grau de gravidade da lesão. Dentre eles, tem-se utilizado a placa com parafusos de ângulo fixo para região proximal do úmero, a qual possui o intuito de preservar a integridade biológica da cabeça umeral associada à redução anatômica segura utilizando múltiplos parafusos de fixação com estabilidade angular, permitindo assim a mobilização precoce do membro fraturado. Foram estudados retrospectivamente 11 pacientes com fratura proximal do úmero, tratados com esse modelo de placa entre os anos de 2004 e 2005. Na avaliação funcional foram utilizados o questionário de Constant e o índice DASH. Os resultados sugerem o aparecimento de perda funcional residual no membro superior após esse tipo de trauma, apesar da fixação estável e o tratamento fisioterapêutico.Proximal humeral fractures are common injuries leading to severe functional restrictions and complications for patients. Today, there are several surgical alternatives aimed at achieving better injury stabilization by means of osteosynthesis techniques, depending on injury severity. One of these is the fixed-angle plate fixation of the proximal humerus. This bone fixation system is intended to preserve the biologic integrity of the humeral head associated with a safe anatomical reduction, employing several fixating screws with angle stability, thereby allowing an early mobilization of the fractured limb. Eleven patients with proximal humeral fractures treated with the method of fixed-angle plate fixation of the proximal humerus in the period of 2004 to 2005 were retrospectively studied. The patients were subjected to the Constant questionnaire and the DASH index for functional assessment. The results showed some residual dysfunction at the upper end after this type of trauma, even using a fixed-angle plate fixation of the proximal humerus, which notably provides a safe fixation, associated to physical therapy.

An abstract of the article "Importance of transesophageal echocardiography for detection of cardiac source of embolism according to age groups" by A. Timoteo, L. M. Branco, J. Abreu is presented.

An abstract of the article "Can left atrial appendage dimensions and contractility influence the type of cerebral ischemic event?" by A. Timoteo, L. M. Branco, N. Pelicano, J. Feliciano, A. Fiarresga, and colleagues is presented.

O mapa é um instrumento que representa de maneira codificada diversos espaços geográficos. A leitura e a compreensão desse instrumento são de suma importância para o desenvolvimento significativo do ensino geográfico. Um mapa construído de maneira acessível a todos representa um meio pelo qual o ensino geográfico pode se tornar motivante e eficaz para todos os alunos, tanto os com deficiências quanto os considerados “normais”. Dessa maneira, o estudo em tela traz reflexões sobre a importância desse instrumento para o desenvolvimento inclusivo do ensino de Geografia. Além dessas reflexões, são apresentados passos para a confecção de um mapa tátil do Brasil, que pode ser trabalhado por todos os alunos e professores. Destaca-se que o objetivo da apresentação desses passos é o de despertar a motivação e a criatividade de professores e alunos para a construção de outros mapas táteis, que possam auxiliar na significância do processo educacional geográfico inclusivo. PALAVRAS-CHAVE: Mapa. Ensino de Geografia. Inclusão.

As cidades têm conquistado um lugar sem precedentes na história, transformando-se na expressão máxima da sociedade contemporânea. Atualmente, nas cidades concentram-se parcelas significativas da população e imensas contradições, que fazem com que elas sejam marcadas também com o que as sociedades têm de melhor e de pior. Além da riqueza, do acesso privilegiado à informação, dos fluxos econômicos, dentre outros, observam-se também as mais intensas manifestações de poluição, violência, pobreza e exclusão, apontando para a gravidade das questões de ordem social que imperam nesse espaço. Além do mais, não se pode negligenciar o fato de que as mais importantes questões socioambientais ocorrem nas cidades, pois aí estão as maiores concentrações populacionais e atividades econômicas com importantes desdobramentos para a vida urbana. Desse modo, a discussão socioambiental contemporânea deve priorizar essa ordem, a da cidade. Com isso, faz-se, não somente necessário, como também urgente, a busca de novos olhares sobre a problemática socioambiental urbana, bem como a socialização de práticas eficazes referentes a essa problemática. Assim, o objetivo deste trabalho é desvendar as percepções, os desafios e as possibilidades de superação dos problemas socioambientais da pequena cidade de Bom Jesus, situada no interior do Estado do Rio Grande do Norte. Este estudo foi desenvolvido por meio de uma pesquisa qualitativa, utilizando-se alguns procedimentos, como a pesquisa bibliográfica e a empírica, a qual foi realizada com alguns segmentos da sociedade local. Os resultados e conclusões obtidos até o momento, a partir das percepções dos moradores locais, apontam para problemas socioambientais de grandes dimensões, como os que foram mencionados acima, mas também para outros próprios da realidade local. O estudo também atenta para algumas reflexões que valorizam a construção de uma sociedade sustentável, do ponto de vista material e espiritual. Palavras-chave: problemas socioambientais, vivência da população, qualidade de vida.

The present study evaluated the hematological, antiparasitic and growth responses in tambaqui (Colossoma macropomum) fed with diets supplemented with the microalgae Arthrospira platensis and Chlorella vulgaris (0%; 10% A. platensis; 10% C. vulgaris; and 5% A. platensis+5% C. vulgaris). Tambaqui (n=60, 62.57 ± 8.76 g) were fed for 20 days with experimental diets. Blood samples collection was done to determine hematological parameters, and gills were removed to identify and count monogenetic parasites. Supplementation with A. platensis 10% reduced red blood cells count, in consequence mean corpuscular volume and mean hemoglobin concentration increased. Total leukocyte, monocyte, eosinophil, and basophil counts reduced with the use of A. platensis. Higher monocytes, eosinophil, and basophil numbers in tambaqui fed with diet supplemented with 10% C. vulgaris were observed and may have been due to the presence of immunostimulants in this microalga composition. Reduction on total cholesterol in tambaqui that received both microalgae (A. platensis 5%+C. vulgaris 5%) may indicate that combined supplementation presented greater benefits to the health for C. macropomum than separately. Both microalgae were efficient against monogenetic parasites of tambaqui. Thus, the dietary use of the microalgae A. platensis and C. vulgaris provided immunostimulant and antiparasitic efficacy in C. macropomum.

Objective: This study aimed to determine the intra- and interrater reliability of active and passive range of motion in the shoulders of individuals with subacromial impingement syndrome using a digital inclinometer., Methods: The raters evaluated active and passive range of motion in the shoulder of 50 individuals with unilateral subacromial impingement syndrome in movements including flexion, abduction, extension, external rotation in a neutral position, external rotation with the arm at 90° of abduction, and internal rotation with the arm at 90° of abduction. The tests were performed by 2 examiners on the same day, with a 10-minute interval, and were repeated by 1 examiner after a 2- to 4-day interval. Reliability was analyzed using the intraclass correlation coefficient (ICC 2,3 )., Results: There was moderate to excellent interrater (ICC 2,3  = 0.50-0.95) and intrarater (ICC 2,3  = 0.74-0.94) reliability. In the interrater analysis, the standard error of measurement (SEM) ranged from 4.1° to 10°, the percentage SEM (%SEM) ranged from 2% to 17%, and the minimum detectable change ranged from 9.5° to 23.4°. In the intrarater analysis, the SEM ranged from 4° to 9.2°, %SEM ranged from 3% to 14%, and the minimum detectable change ranged from 9.3° to 21.4°., Conclusion: The digital inclinometer showed moderate to excellent reliability for measuring active and passive range of motion in shoulders with unilateral subacromial impingement syndrome., (Copyright © 2021. Published by Elsevier Inc.)

Effectively implementing landscape-scale forest restoration on the ground is particularly challenging. Available decision-support tools particularly lack the ability to comprehensively incorporate biophysical, social and institutional dimensions in a spatially explicit manner from the pixel to the whole landscape. In order to contribute to fulfilling this gap, this paper has two major objectives. The first is to present a spatially explicit decision-support tool for mapping Forest Restoration Vocation (FRV) that includes socio-economic and institutional aspects in forest landscape restoration. The second is to discuss the ways in which the FRV has been applied in the Brazilian decision-making context. The FRV was used to prioritize areas for three different restoration modalities: assisted natural regeneration (passive restoration), forest plantation with native trees to conserve biodiversity and forest plantation for agroforestry systems (active restoration). The FRV is already being adopted as a planning tool to invest R$ 1.2 billion (approx. US$ 300 million) to restore 40,000 ha in the Rio Doce, Brazil-an area corresponding to 0.05% of the area of watershed. Due to the high level of degradation of the basin, there is a need to restore 1.6 Mha via forest plantations in riparian Areas of Permanent Preservation (APPs) while 30% of APPs can be effectively restored using natural regeneration. The FRV can be effective for gauging progress and monitoring forest restoration implementation metrics across the landscape and through time. There are however still problems in effectively assessing if the investment in forest restoration will generate impact in the long term and deliver the ecosystem services society depends on., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2020 Elsevier B.V. All rights reserved.)

Introduction: The use of mass gatherings as spaces to practice health surveillance has been growing in recent years. In Mozambique, the 9th National Festival of Culture in 2016 was selected for this practice. A specific public health surveillance system to facilitate rapid detection of outbreaks and other health-related events was implemented for this event with real time data collection and analysis., Methods: A descriptive epidemiological evaluation of all the health consultations that occurred in fixed posts prepared for the event was conducted. The data were collected through electronic mobile system (tablets) in real time, with the aid of a form designed for this purpose and sent directly to the incident command system (ICS)., Results: During the event, a total of 355 patients were assisted, 52.3% were female, 87.0% were from Beira city and the artists were the group that most frequently sought health care at 59.4%. The largest number of visits took place on the third day (36.4%). People over 45 years of age were the age group that most frequently sought health care (30.8%). The main provisional diagnoses of those who were attended to during the festival was arterial hypertension (20.3%), followed by febrile syndrome (19.0%), with falls being the most frequent causes of trauma during the festival (60.0%)., Conclusion: The system of monitoring in real time using mobile technologies proved to be efficient for the monitoring of the main health events during the mass gatherings. This profile of health consultations encourages the health sector to plan strategies and actions geared to the reality of care for this type of event., Competing Interests: The authors declare no competing interests.

Retrieval results in both costs and benefits to episodic memory. Output interference (OI) refers to the finding that episodic memory accuracy decreases with increasing test trials. Release from OI is the restoration of original accuracy at some point during the test. For example, a release from OI in recognition memory testing occurs when the semantic similarity between stimuli decreases midway through testing, suggesting that item representations stored on early trials cause interference on tests occurring on later trials to the extent that the earlier items share features with the latter items. In two recognition memory experiments, we demonstrate release from OI for words and faces. We also test whether release from OI is the result of interference or is due to a boost in attention caused by reorienting to a novel stimulus type. A test for the foils presented during the initial test list supports the interference account of OI. Implications for models of memory are discussed.

Background: On 9 January 2015, in a rural town in Mozambique, >230 persons became sick and 75 died of an illness linked to drinking pombe, a traditional alcoholic beverage., Methods: An investigation was conducted to identify case patients and determine the cause of the outbreak. A case patient was defined as any resident of Chitima who developed any new or unexplained neurologic, gastrointestinal, or cardiovascular symptom from 9 January at 6:00 am through 12 January at 11:59 pm. We conducted medical record reviews, healthcare worker and community surveys, anthropologic and toxicologic investigations of local medicinal plants and commercial pesticides, and laboratory testing of the suspect and control pombe., Results: We identified 234 case patients; 75 (32%) died and 159 recovered. Overall, 61% of case patients were female (n = 142), and ages ranged from 1 to 87 years (median, 30 years). Signs and symptoms included abdominal pain, diarrhea, vomiting, and generalized malaise. Death was preceded by psychomotor agitation and abnormal posturing. The median interval from pombe consumption to symptom onset was 16 hours. Toxic levels of bongkrekic acid (BA) were detected in the suspect pombe but not the control pombe. Burkholderia gladioli pathovar cocovenenans, the bacteria that produces BA, was detected in the flour used to make the pombe., Conclusions: We report for the first time an outbreak of a highly lethal illness linked to BA, a deadly food-borne toxin in Africa. Given that no previous outbreaks have been recognized outside Asia, our investigation suggests that BA might be an unrecognized cause of toxic outbreaks globally.

Introduction: In the last decades, Mozambique has been undergoing demographic, epidemiological, economic and social transitions, which have all had a notable impact on the National Health System. New challenges have emerged, causing a need to expand the preparation and response to emerging disease threats and public health emergencies., Methods: We describe the structure and function of the Mozambique Field Epidemiology Training Program (MZ-FELTP) and the main outputs achieved during the first 6 years of program implementation (consisting of 3 cohorts). We also outline the contribution of the program to the National Health System and assess the retention of the graduates., Results: The MZ-FELTP is a post-graduate in-service training program, based on the acquisition of skills, within two tracks: applied epidemiology and laboratory management. The program was established in 2010, with the objective of strengthening capacity in applied epidemiology and laboratory management, so that events of public health importance can be detected and investigated in a timely and effective manner. The program is in its seventh year, having successfully trained 36 health professionals in the advanced course. During the first six years of the program, more than 40 outbreaks were investigated, 37 surveillance system evaluations were conducted and 39 descriptive data analyses were performed. Surveillance activities were implemented for mass events and emergency situations. In addition, more than 100 oral and poster presentations were given by trainees at national and international conferences., Conclusion: The MZ-FELTP has helped provide the Ministry of Health with the human and technical resources and operational capacity, to rapidly and effectively respond to major public health challenges in the country. The continuous involvement of key stakeholders is necessary for the continuation, expansion and ongoing sustainability of the program.

Background: In Mozambique, the majority of rabies outbreaks are unreported and data on the epidemiological features of human rabies and animal bites are scarce. An outbreak of human rabies in adjacent Maputo and Matola cities in 2014 prompted us to investigate the epidemiology, clinical features and risk factors of human rabies and animal bites in the two cities., Methodology/principal Findings: We reviewed cases of human rabies and animal bites from April to July 2014, and carried out a community investigation in July and August in the neighborhoods where cases of human rabies resided. This investigation included collection of clinical, demographic and epidemiological information and a case control study to investigate the risk factors associated with human rabies. Fourteen cases of human rabies were detected in Maputo (n = 10) and Matola (n = 3) cities and neighbouring Boane district (n = 1) between April and August 2014, all of whom had been admitted to hospital. All had a recent history of dog bite. Of the 14 rabid dogs, only one had been immunized. 819 cases of animal bites were registered, of which 64.6% (529/819) were from Maputo City. Dogs were responsible for 97.8% (801/819) of all animal bites, but only 27.0% (126/467) were immunized. Factors significantly associated with human rabies were: age <15 years (p = 0.05), bite by stray dog (p = 0.002), deep wound (p = 0.02), bite in the head (p = 0.001), bite by unimmunized dog (p = 0.01), no use of soap and water (p = 0.001), and no post-exposure prophylaxis (p = 0.01)., Conclusions/significance: Implementation of control measures for rabies is poor in Maputo and Matola cities, where cases of human rabies were strongly associated with bites by stray and unvaccinated dogs and irregular implementation of post-exposure measures.

Background: Malaria during pregnancy is associated with poor maternal and pregnancy outcome and the World Health Organization recommends the administration of intermittent preventive treatment in pregnancy (IPTp) with sulfadoxine-pyrimethamine (SP) and distribution of insecticide-treated mosquito nets (ITNs) to all pregnant women attending antenatal care (ANC) services. This study was conducted with the aim to assess the uptake of IPTp and ITNs in pregnant women attending ANC services and correlate with ANC attendance and frequency of stock-outs in 22 health facilities Mozambique., Methods: A cross-sectional study was conducted between July and December 2011 in 22 health units in 11 districts situated in 11 provinces in Mozambique. Two health facilities were selected per district (one urban and one rural). Data were collected by reviewing logbooks of antenatal consultations as well as from monthly district reports., Results: During the period under investigation, a total of 23,524 pregnant women attended their 1st antenatal care visits, of which 12,775 (54.3%) and 7581 (32.2%) received one and two doses of IPTp, respectively. In regard to ITNs, a total of 16,436 (69.9%) pregnant women received ITNs. Uptake of IPTp and ITNs by pregnant women at ANC services was higher in southern Mozambique and lower in districts situated in the northern part of the country. Stock-outs of SP and ITNs were reported in 50.0% (11/22) and 54.5% (12/22) of the health facilities, respectively. Coverage of IPTp and ITN in health facilities with stock-outs of SP and ITNs was much lower as compared to health facilities with no stock-outs., Conclusions: Altogether, data from this study shows that coverage of the 2nd dose of IPTp, as well as ITNs, was low in pregnant women attending ANC services in Mozambique. In addition, this data also shows that stock-outs of SP and ITNs were frequent and led to lower coverage of IPTp and ITN, representing a serious barrier for the accomplishment of targets. In conclusion, this study recommends that efforts should be made to improve the supply chains of SP and ITNs.

Malaria is among the factors thought to be involved in the pathogenesis of endomyocardial fibrosis (EMF), a restrictive cardiomyopathy of unclear etiology, with no specific therapy, which affects predominantly children and adolescents. In Africa, regions endemic with EMF are also areas with high prevalence of malaria. We studied 47 consecutive children aged 5- to 15-years old and concluded that myocardial damage and dysfunction are rare in severe and complicated Plasmodium falciparum malaria cases in children.

Some studies have suggested that premenopausal women show a decline in bone mass in function of age while other studies have not. Bone density in the spinal column and proximal femur (neck, Ward's triangle and trochanter) in 75 healthy white women between the ages of 30 and 49 without a history of irregular menstrual periods was correlated with age, weight, height and body mass. No statistically significant decline in bone density with age was seen during the premenopausal period. There was a positive correlation between bone density in the spine and proximal femur and weight and body mass indices. Our results suggest that healthy women do not show loss before menopause and it also seems that obesity has a favorable effect on these women's bone mass.

The authors have described a rare case of apocrine glands carcinoma of the vulva in a 58-year old black patient. She underwent radical vulvectomy and radiotherapy. After 8 months, she did not show any local or systematic recurrences.