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Hoje, o compartilhamento de informações alcançou níveis colossais que eram inimagináveis no século XX. Nesse contexto, as transformações sociais desencadeadas, principalmente, pelas TIC e pelo ciberespaço impactaram profundamente a área de defesa nacional com o surgimento da Guerra de Informação e da Guerra Cibernética. Diante disso, observou-se a necessidade de investigar se a formação do cadete da Academia Militar das Agulhas Negras (AMAN) contempla satisfatoriamente essas atividades. Justifica-se essa pesquisa pela constatação de que esses tipos de guerra possuem enorme potencial para provocar irreparáveis danos ao Estado-nação. Esta pesquisa buscou verificar o nível de conhecimento dos cadetes do 4º ano da turma de 2022 da AMAN sobre as operações de informação pela análise de Planos de Disciplina (PLADIS) e aplicação de questionário. Constatou-se a ausência de carga horária específica destinada às Capacidades Relacionadas à Informação: comunicação social e operações psicológicas. Em vista disso, sugere-se uma sistematização do ensino sobre operações de informação na AMAN e demais escolas militares.

Background: Ureteral stents are one of the most used devices in Urology, allowing drainage of the upper urinary system, and can be used either in elective or emergency procedures. However, as a foreign body inside the urinary system, they are subject to encrustation. Encrustation is one of the burdens seen with double-J stents and, to date, there is no consensus about its best management. This study aims to prove that Endoscopic Combined Intra-Renal Surgery (ECIRS) is the best choice when there’s an encrusted proximal loop of a ureteral stent. Methods: The authors conducted a retrospective cohort study of patients with an encrusted proximal loop of the ureteral stent who underwent surgery at a single center, comparing ECIRS with other procedures. Results: Between July 2011 and June of 2024, 33 patients (18 females and 15 males) were submitted to surgery. The median indwelling time of the stent was 11 (8-19) months and a stentfree rate of 100% was achieved. The authors demonstrated a significant stone-free rate of 61.1% following ECIRS compared to merely 20% with other procedures (p = 0.023). Notably, while the complication rate was low across all procedures, the ECIRS group exhibited fewer complications (5.6%) than those undergoing alternate techniques (13.3%), though this difference was not statistically significant (p = 0.439). Conclusions: Our study advocates for ECIRS as the preferred initial treatment for encrusted proximal ureteral stents, as it facilitates superior stone clearance, minimizes complications, and maintains comparable operative efficiency. This research contributes valuable insights into the management of challenging cases involving encrusted ureteral stents, calling for future studies to further validate these findings.

Introdução: Legionella pneumophila, bactéria aeróbia Gram-negativa, considerada importante agente de pneumonia grave em pacientes imunossuprimidos, com alta taxa de letalidade e pode se tornar um problema quando se prolifera em sistemas de água de hospitais ocasionando surtos. Objetivo: Caracterização clínica, epidemiológica e dos fatores de risco relacionados aos casos de IRAS em surto por L. pneumophila em unidade de transplante de medula óssea (TMO). Método: Estudo caso-controle em unidade de TMO de um hospital de ensino da cidade de São Paulo, de jan/2020-dez/2023. Considerados Casos pacientes com diagnóstico confirmado de IRAS por L. pneumophila, critérios CDC, e Controle pacientes internados por no mínimo 48h no mesmo período considerado como de possível relação com a transmissão da Legionella para cada caso (14 dias antes do início dos sintomas), em fase de condicionamento ou até D+30, sem diagnóstico de legionelose. Selecionados 2 controles para cada caso. Significância estatística considerada p < 0,05. Identificação do agente no ambiente por pesquisa molecular com metagenômica, técnica de detecção de amplicon. Resultados: Foram identificados 8 casos de IRAS por L. pneumophila, sendo um caso em 2020 e 2021, quatro em 2022 e dois em 2023, todos através de teste de antígeno urinário. 75% eram do sexo feminino, idade média de 52 anos. Todos foram transplantados por neoplasias hematológicas (62,5% com leucemia mieloide aguda), sendo 75% alogênicos aparentados. O intervalo entre o transplante de células tronco hematopoiéticas e a legionelose foi em média 9 dias, os principais sintomas apresentados: febre (100%), dispneia (87,5%), tosse (62,5%), dor torácica (62,5%) e diarreia (62,5%). Todos apresentaram pneumonia, sendo a imagem de consolidação (100%), derrame pleural (62,5%) e vidro fosco (62,5%) as alterações mais frequentes nas imagens. Todos receberam terapia combinada com levofloxacina e macrolídeo. Um paciente foi transferido para unidade de terapia intensiva e necessitou de ventilação mecânica. Não ocorreu óbito. Como fator de risco, identificado apenas a internação em quarto C (p = 0,001), local onde foi encontrada L. pneumophila em chuveirinho do banheiro por técnica de metagenômica. Neutropenia grave mostrou-se como um possível fator de risco (p = 0,054). Conclusão: O ambiente mostrou-se importante fator associado aos casos de legionelose. Contudo, devido ao número reduzido de casos não identificamos outros fatores, sendo apenas a neutropenia grave um fator de risco possivelmente relacionado ao paciente.

BackgroundInexperienced nursing care can compromise the quality of care and the well-being of patients. The aim of this study was to assess the main sources of stress encountered by nurses and novice nurses in a setting not previously experienced.MethodsA systematic review was conducted following the PRISMA format in Pubmed, Scopus, Web of Science, and CINAHL electronic databases in March 2024. A total of 395 studies were identified, of which 16 met the inclusion criteria. Selection was made on the basis of topic relevance and methodological quality, assessed using the critical tools of the Joanna Briggs Institute (JBI).ResultsA total of 16 studies were included in this review. Of the 16 selected, 10 were cross-sectional studies, 3 were cohort studies, 2 were qualitative, and 1 was a systematic review. The studies revealed that the main stressors for novice nurses included time management, workload, and interpersonal relationships. The results underline that organizational factors, such as lack of support and high work demands, play a key role in generating stress.ConclusionIdentifying and addressing the key challenges faced by novice nurses, such as workload, adjustment to the environment, professional expectations, and interpersonal relationships, is crucial to sustain their professional engagement and ensure the quality of health care. This understanding is essential for creating efficient policies and practices that enhance the occupational well-being and stability of nurses in the workforce.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42024520651, CRD42024520651.

In response to the global climate crisis, urgent measures are required to reduce greenhouse gas emissions in alignment with the goals of the Paris Agreement. As energy consumption accounts for 36% of total emissions, and buildings contribute significantly to both direct and indirect emissions, it is crucial to enhance the energy efficiency and self-sufficiency of buildings. This article conducts a case study to evaluate the formal structure, spatial layout, and sustainable strategies employed in residential units within the Pedra Branca neighborhood (Santa Catarina, Brazil), using the methodology developed by Brandão and Schneider. The findings indicate that the housing units predominantly consist of three bedrooms, along with two to four bathrooms. The analysis revealed partial integration between the kitchen and service areas, with full integration being less common. Corridor layouts were found to make the greatest contribution to sustainability and internal space quality. Although some configurations did not directly support cross-ventilation, there was a clear focus on environmental comfort and the use of passive design strategies. This study highlights the potential of such configurations to improve energy performance and contribute to the development of climate-positive neighborhoods.

Purpose: Radical prostate cancer treatment is the predominant cause of iatrogenic stress urinary incontinence (SUI) in men, significantly impacting their quality of life (QoL). This prospective single-center study in Portugal aimed to evaluate the outcomes of men with moderate-to-severe SUI treated with a single-component artificial urinary sphincter (AUS). Materials and methods: Male patients with iatrogenic moderate-to-severe SUI, determined by a 24-hour pad weight test, were included. The single-component device comprises a cuff linked to a pump unit through a kink-resistant tube. The implantation involved perineal incision for cuff placement and an inguinal incision for pump and tank positioning within the scrotum. Complications, pad usage, perioperative complications (Clavien-Dindo classification), and quality of life assessment using the International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF) questionnaire were documented. Results: Between May 2021 and March 2023, 20 consecutive single-component AUS insertions were conducted at a Portuguese urology department. Follow-up concluded in July 2023, with a mean follow-up duration of 15 months (range: 5-27). Four patients experienced complications necessitating device revision or removal (erosion = 2, infection = 1, mechanical failure = 1). Social continence (0/1 pad/day) was achieved in 70% (14/20 patients), while 30% (6/20 patients) experienced incontinence. Perioperatively, one patient was classified as grade 2, while the remaining were grade 0/1 in the Clavien-Dindo classification. The mean ICIQ-SF score reduction was 10.5 points. Conclusions: The single-component AUS shows promising efficacy in managing moderate-to-severe male SUI, offering a good success rate, acceptable complications, improved QoL, and a straightforward surgical procedure.

RESUMO O presente artigo é um recorte de duas pesquisas mais abrangentes e tem como objetivo analisar as relações que se constroem e se reconstroem em torno das ações de privatização da educação, formuladas e aplicadas por organizações do terceiro setor ligadas ao setor bancário brasileiro e às redes públicas de ensino. Utilizou-se a abordagem de análise de redes sociais para mapear os nós principais e elos relacionais que constituem tal rede. Foram encontrados 410 elos relacionais, originados de três braços sociais que atuam em educação, pertencentes a dois bancos brasileiros: Itaú Social, Instituto Unibanco e Fundação Bradesco. É possível perceber que a rede é constituída de 99 sujeitos e, além de possuir grande alcance e capilaridade, funciona de maneira orgânica e dissemina conteúdos em torno de pautas comuns, embora com modus operandi de atuação diverso.

The widespread application of CAD/CAM technology in contemporary dentistry led to the development of promising restorative materials, such as resin composite blocks (RCBs). Thus, the present study aims to evaluate the mechanical properties of RCBs, comparing this material to the direct composite resin from the same manufacturer. Samples retrieved from three CAD/CAM resin composite blocks (Tetric CAD (TC), Ivoclar Vivadent, Grandio blocs (GB), VOCO GmbH and Brilliant Crios (BC), Coltene/Whaledent) and four direct composite resins (Tetric EvoCeram (TEC), Ivoclar Vivadent, GrandioSO (GS), VOCO GmbH, Brilliant EverGlow Translucent (BET) and Universal Shade (BEU), Coltene/Whaledent) were submitted to three-point bending flexural test and Vickers microhardness test. The resulting data of the flexural strength were analyzed using one-way ANOVA considering Bonferroni correction for post hoc tests (α = 0.05). The flexural modulus and Vickers microhardness results were analyzed using Welch’s ANOVA considering Games–Howell correction for post hoc tests (α = 0.05). Regarding results, flexural strength and flexural modulus values ranged from 81.1 MPa (BEU) to 246.5 MPa (GB) and 10.6 GPa (BEU) to 20.3 GPa (GB), respectively. GS (121.2) and GB (136.2) groups were associated with the highest microhardness values. According to the post hoc tests, statistically significant differences in flexure strength were found in RCBs (BC, GB, and TC) compared to all direct composite resins. Flexural modulus and Vickers microhardness of RCBs (BC, GB, TC) were also significantly different from the direct composite resin (BET, BED, and TEC), except when comparing GS and GB for microhardness. In conclusion, differences between RCBs and direct composite resins were observed regarding flexural strength, flexural modulus, and microhardness, revealing that RCBs have enhanced mechanical properties compared to direct composite resins.

El Prontuario de ortografía de la lengua castellana de la Real Academia Española es un texto clave en la historia de la ortografía del español. En él se recoge el sistema ortográfico oficial para la educación en España y fue la única referencia en materia de ortografía en el ámbito académico durante más de dos décadas. Además, su carácter pedagógico lo aleja de las obras elaboradas anteriormente por dicha Corporación. Por ello, este estudio tiene como objetivo el análisis detallado de las trece ediciones del Prontuario (1844-1866), prestando especial atención a las diferencias que plantea con respecto a la última ortografía académica (ORAE 1820), entendida como punto de partida para la redacción del tratado escolar. Se pretende esclarecer el valor de esta obra tanto para la historia de la ortografía del español, en general, como para la historia de la ortografía académica, en particular.

Background Marine biofouling is a threat to industries working in the marine environment, representing significant costs associated with equipment impairment and loss of performance. In the Marine Renewable Energy (MRE) and other maritime sectors which operate at sea for long periods, an important aspect of biofouling is related to the type and frequency of inspections and biofouling removal procedures. Methods This study investigated important parameters of macrofouling (e.g. composition, including the presence of non-indigenous species, thickness, and weight) from communities growing on samples that emulate tubular components of marine renewable devices. The trials were performed during short periods of submersion (one to eight weeks) in the seasons when the colonisation process should be most intensive (spring, summer, and autumn). Furthermore, the frictional resistance forces generated during the scraping of biofouling from those components were investigated. Results Overall, results provide insights on the growth rates and removal requirements of biofouling in marine components. The results show that, while biofouling growth in early colonization stages might not present great detrimental effects to wave energy components, the consequent marine corrosion (fostered by biofouling) and the settlement of non-indigenous species (NIS) should be factors of concern. Conclusions Performing biofouling-related maintenance activities after the peak of maximum growth and reproduction (during the warmer seasons in temperate to cold environments) is suggested to reduce the number and frequency of activities. NIS can be detected at very early stages in the colonization process, highlighting the importance of biofouling monitoring and the implementation of biosecurity risk assessment plans early in the operational stage of MRE projects.

O artigo trata de uma proposta de projeto desenvolvida no âmbito do concurso de ideias do IVADS 2023 como forma de aprofundamento do estudo do projeto colaborativo em ateliê virtual, realizado entre instituições do Brasil e de Portugal.O local de intervenção selecionado para o concurso situa-se no centro histórico da cidade de João Pessoa, no bairro Varadouro. A concepção da proposta foi baseada na postura italiana crítica-conservativa e criativa, de Giovanni Carbonara, e foi desenvolvida em 3 etapas: (1) análise documental, fotográfica e entrevistas; (2) desenvolvimento conceitual; e, (3) proposta do projeto de intervenção. A análise indicou pontos importantes para o desenvolvimento do projeto na macro e microescala, onde se diagnosticou no traçado urbano os pontos potenciais do entorno e também os problemas da região. O diagnóstico permitiu inspirar o principal conceito da proposta, segundo o qual as madeireiras representam importante elemento de origem das ideias para o espaço institucional multifuncional, que contemplou ambientes como a Escola da madeira, o centro de artesanato, as oficinas, os laboratórios e o restaurante.A experiência obtida por meio da participação do modelo de ateliê virtual permitiu trazer aos estudantes o desafio de pensar e desenvolver uma proposta de projeto arquitetônico de forma colaborativa, de maneira a promover a aproximação de pessoas, ideias e técnicas, assim como possibilita o uso de tecnologias que colaboram com essa comunicação, para além de pensar sobre as intervenções possíveis para o patrimônio histórico a fim de garantir a vitalidade desses espaços.

Background: Personal emotions and affects have been identified and studied in the context of pandemics, as well as coping strategies centered on emotional regulation or the balance between positive and negative emotions. Objectives: The objectives of this paper are to identify an emotion and affect structure in our sample and analyze the relationship of these dimensions with resilient coping in the context of the COVID-19 pandemic. Method: This study employed a cross-sectional design that involved a non-probabilistic sample with 598 participants over the age of 18, with 51.1% being female, and an average age of 40.73 years. First, the emotional structure was identified through principal component analysis (PCA). Secondly, a linear regression analysis was performed to investigate emotional dimensions as predictors of coping. Results: A valid and reliable emotional structure with four dimensions was identified. The regression model revealed that coping is positively associated with the active and positive dimension and negatively correlated with the negative and moral dimensions. Conclusions: Emotional dimensions are predictors of coping, with moral and negative dimensions having a negative effect, while active and positive dimensions have a positive effect. When designing interventions for coping strategies, multiple dimensions of emotions and affective states in people who are in vulnerable situations must be considered.

Abstract Parkinson´s disease (PD) is a common neurodegenerative movement disorder and leucine-rich repeat kinase 2 (LRRK2) is a promising therapeutic target for disease intervention. However, the ability to stratify patients who will benefit from such treatment modalities based on shared etiology is critical for the success of disease-modifying therapies. Ciliary and centrosomal alterations are commonly associated with pathogenic LRRK2 kinase activity and can be detected in many cell types. We previously found centrosomal deficits in immortalized lymphocytes from G2019S-LRRK2 PD patients. Here, to investigate whether such deficits may serve as a potential blood biomarker for PD which is susceptible to LRKK2 inhibitor treatment, we characterized patient-derived cells from distinct PD cohorts. We report centrosomal alterations in peripheral cells from a subset of early-stage idiopathic PD patients which is mitigated by LRRK2 kinase inhibition, supporting a role for aberrant LRRK2 activity in idiopathic PD. Centrosomal defects are detected in R1441G-LRRK2 and G2019S-LRRK2 PD patients and in non-manifesting LRRK2 mutation carriers, indicating that they accumulate prior to a clinical PD diagnosis. They are present in immortalized cells as well as in primary lymphocytes from peripheral blood. These findings indicate that analysis of centrosomal defects as a blood-based patient stratification biomarker may help nominate idiopathic PD patients who will benefit from LRRK2-related therapeutics.