Continuous Probability Distributions generated by the PIPE Algorithm.

We investigate the use of the Probabilistic Incremental Programming Evolution (PIPE) algorithm as a tool to construct continuous cumulative distribution functions to model given data sets. The PIPE algorithm can generate several candidate functions to fit the empirical distribution of data. These candidates are generated by following a set of probability rules. The set of rules is then evolved over a number of iterations to generate better candidates regarding some optimality criteria. This approach rivals that of generated distribution, obtained by adding parameters to existing probability distributions. There are two main advantages for this method. The first is that it is possible to explicitly control the complexity of the candidate functions, by specifying which mathematical functions and operators can be used and how lengthy the mathematical expression of the candidate can be. The second advantage is that this approach deals with model selection and estimation at the same time. The overall performance in both simulated and real data was very satisfying. For the real data applications, the PIPE algorithm obtained better likelihoods for the data when compared to existing models, but with remarkably simpler mathematical expressions.

Remote monitoring of pacemakers and defibrillators: Effective and safe in Brazil?

Background: The remote monitoring (RM) of cardiac implantable electronic devices (CIEDs) has become a common method of in-home monitoring and follow-up in high-income countries given its effectiveness, safety, convenience, and the possibility of early intervention. However, in Brazil, RM is still underutilized. Objectives: This observational study aims to demonstrate our experience of using RM in Brazil and the predictive factors of RM of CIED follow-up in Brazil. Methods: This was a prospective cohort study of patients with a CIED. Event rates are reported and clinical responses to those findings and outcomes based on the detection of RM. A logistic regression model was performed to identify predictors of more events, with P < .05 for statistical significance. Results: This study evaluated consecutive 119 patients: 30.2% with pacemakers, 42.8% with implantable cardioverter-defibrillator, 22.7% with cardiac resynchronization therapy (CRT) with defibrillator, and 3.3% with CRT with pacemaker. Events were detected in 63.9% of the cases in 29.5 ± 23 months of follow-up. The outcomes found were that 44.5% needed elective evaluation in medical treatment and 23.5% needed immediate evaluation in therapy. Logistic regression analysis showed that the groups with CRT or CRT with defibrillator (75.0%), reduced ejection fraction (76.5%), and New York Heart Association functional class ≥II (75.0%) had the highest RM event rates. Conclusions: RM proved to be effective and safe in the follow-up of patients with CIEDs in Brazil, allowing early interventions and facilitating therapeutic management.

A processual view on the use of problem-based learning in high school physiology teaching.

In problem-based learning (PBL), the steps and processes present in the PBL tutorial cycle are essential for constructive, self-directed, collaborative, and contextual student learning. This article presents a procedural study of a PBL tutorial cycle with high school students new to the method regarding human respiration and circulation physiology. We observed group dynamics and the learning process that occurred throughout the PBL tutorial cycle. The results indicate that conceptual changes were close to the planned learning objectives and that students enjoyed studying applying PBL. Moreover, a positive correlation was observed between group dynamics, self-directed learning and learning outcomes. Our results provide grounds for restructuring the tutorial cycle, especially important for novice PBL students, such as problem reformulation and the development and diversification of applied learning scaffolds. We conclude that the qualitative analysis performed herein can yield a deeper understanding of the PBL tutorial cycle and may be used to foster PBL implementation in institutions with little experience with the method and monitor its outcomes in organizations with mature PBL use.

Genomic analysis of European bovine Staphylococcus aureus from clinical versus subclinical mastitis.

Intramammary infections (IMI) with Staphylococcus aureus are a common cause of bovine mastitis and can result in both clinical (CM) or subclinical mastitis (SCM). Although bacterial isolates of S. aureus differ in their virulence potential it is largely unclear which bacterial virulence factors are responsible for increased clinical severity. We performed a genome wide association study and used a generalized linear mixed model to investigate the correlation between gene carriage, lineage and clinical outcome of IMI in a collection of S. aureus isolates from cattle with CM (n = 125) and SCM (n = 151) from 11 European countries. An additional aim was to describe the genetic variation of bovine S. aureus in Europa. The dominant lineages in our collection were clonal complex (CC) 151 (81/276, 29.3%), CC97 (54/276, 19.6%), CC479 (32/276, 11.6%) and CC398 (19/276, 6.9%). Virulence and antimicrobial resistance (AMR) gene carriage was highly associated with CC. Among a selection of nine virulence and AMR genes, CC151, CC479 and CC133 carried more virulence genes than other CCs, and CC398 was associated with AMR gene carriage. Whereas CC151, CC97 were widespread in Europe, CC479, CC398 and CC8 were only found in specific countries. Compared to CC151, CC479 was associated with CM rather than SCM (OR 3.62; 95% CI 1.38-9.50) and the other CCs were not. Multiple genes were associated with CM, but due to the clustering within CC of carriage of these genes, it was not possible to differentiate between the effect of gene carriage and CC on clinical outcome of IMI. Nevertheless, this study demonstrates that characterization of S. aureus CC and virulence genes helps to predict the likelihood of the occurrence of CM following S. aureus IMI and highlights the potential benefit of diagnostics tools to identify S. aureus CC during bovine mastitis.

Influência sociodemográfica na qualidade de vida relacionada com a saúde dos adolescentes / Influencia sociodemográfica en la calidad de vida relacionada con la salud de los adolescentes / Sociodemographic influence in health-related quality of life in adolescents

Resumo Objetivo Identificar as variáveis sociodemográficas (sexo, idade, escolaridade e coabitação) que influenciam a perceção da qualidade de vida relacionada com a saúde dos adolescentes. Métodos Estudo descritivo-correlacional de natureza quantitativa, numa amostra não probabilística por conveniência, constituída por 567 adolescentes, a frequentar o 2º e 3º Ciclo do Ensino Básico num Agrupamento de Escolas do centro de Portugal. Os participantes apresentavam média de idade de 12,4 anos (Dp=1,59), os rapazes entre 9-16 anos, e as meninas entre 10-17 anos, 50.6% do sexo feminino e a maioria coabita numa família nuclear (77,4%). Na coleta de dados utilizou-se a versão portuguesa da escala Kidscreen-52(1) e questões de caracterização sociodemográfica. Os dados foram coletados no período de janeiro a julho de 2018 e o tratamento estatístico foi realizado utilizando o Statistical Package for the Social Sciences® (SPSS - versão 24.0). Resultados Os adolescentes têm uma perceção positiva da sua qualidade de vida relacionada com a saúde, com diferença estatística para a idade, teste Anova (F=31,980; p =0.000), para o ano de escolaridade, (F=15,293; p=0.000) e Coabitação (F=11,491; p=0.010). Conclusão Os rapazes apresentam uma melhor percepção sobre a qualidade de vida, assim como os adolescentes mais jovens e os que coabitam com os pais (mãe e pai).

Resumen Objetivo Identificar las variables sociodemográficas (sexo, edad, escolaridad y cohabitación) que influyen en la percepción de calidad de vida relacionada con la salud de los adolescentes. Métodos Estudio descriptivo correlacional de naturaleza cuantitativa, en un muestreo no probabilístico por conveniencia, constituido por 567 adolescentes que cursan de 5° a 9° año de primaria en un Agrupamiento de Escuelas del centro de Portugal. Los participantes tenían edad promedio de 12,4 años (Dp=1,59), los varones de 9 a 16 años y las mujeres de 10 a 17 años, 50,6% de sexo femenino y la mayoría cohabita en una familia nuclear (77,4%). En la recolección de datos se utilizó la versión portuguesa de la escala Kidscreen-52(1) y cuestiones de caracterización sociodemográfica. Los datos se recolectaron de enero a julio de 2018 y el tratamiento estadístico se realizó utilizando el Statistical Package for the Social Sciences® (SPSS - versión 24.0). Resultados Los adolescentes tienen una percepción positiva de su calidad de vida relacionada con la salud, con diferencia estadística por edad, test Anova (F=31,980; p =0.000), por año de escolaridad, (F=15,293; p=0.000) y cohabitación (F=11,491; p=0.010). Conclusión Los varones presentan una mejor percepción sobre la calidad de vida, así como los adolescentes más jóvenes y los que cohabitan con los padres (madre y padre).

Abstract Objective To determine the sociodemographic variables (gender, age, level of formal education and cohabitation) that have influenced the perception of health-related quality of life of adolescents. Methods This was a descriptive, correlational and quantitative study including a non-probabilistic convenience sample of 567 adolescents. Of these, 50.6% were girls and attended 2nd and 3rd cycles of basic education in grouping of schools in central Portugal. The participants mean age was 12.4 years-old (SD = 1.59), boys age ranged from 9 to 16 years-old and girls from 10 to 17, most of them lived within a nuclear family (77.4%). Data were collected from January to June 2018 using a Portuguese version of Kidscreen-52(1) scale along with a questionnaire of sociodemographic characterization. The IBM SPSS Statistics for Windows (Version 24.0. Armonk, NY: IBM Corp) was used for statistical analyses. Results Adolescents have a positive perception of their quality of life regarding health. A statistical difference related with age, One-way ANOVA test (F = 31.980; p = 0.000), school year (F = 15.293; p = 0.000) and cohabitation (F = 11.491; p = 0.010). Conclusion Boys present a higher perception of quality of life, as well as younger adolescents and those who live with their parents (mother and father).

Qualidade de vida relacionada com a saúde em crianças e adolescentes / Health-related quality of life in children and adolescents

Introdução: A ligação entre qualidade de vida e saúde é complexa e representa um conceito cuja definição é influenciada por múltiplos determinantes. A avaliação da qualidade de vida relacionada com a saúde (QVRS) é considerada de extrema importância na prática pediátrica, já que sua mensuração se tornou um importante indicador de saúde, podendo ser usado para avaliar o impacto das intervenções implementadas. Objetivos: Avaliar a perceção da QVRS; analisar a relação das variáveis sociodemográficas e de bemestar com a QVRS das crianças e adolescentes. Metodologia: Estudo descritivo-correlacional de natureza quantitativa, numa amostra não probabilística por conveniência, constituída por 567 crianças e adolescentes, (49.4%) do sexo masculino e (51.6%) do sexo feminino, a frequentar o 2º e 3º Ciclo do Ensino Básico de um Agrupamento de Escolas da região centro. Na recolha de dados utilizou-se a versão portuguesa da escala Kidscreen-52 (Gaspar & Matos, 2008c), questões sociodemográficas e de bem-estar. Resultados: Os participantes apresentam uma idade média de 12,4 anos (Dp=1,59), a maioria coabita numa família nuclear (77,4%). Relativamente ao repouso e bem estar, as crianças/adolescentes dormem em média 8,15 horas e percecionam-se com boa qualidade de vida avaliada pela escala de faces. As crianças e adolescentes têm uma perceção positiva da QVRS. No entanto as dimensões "Autoestima" (61,3) e "Autonomia" (M= 62,2), são as que apresentam valores mais baixos na perceção da QVRS. Os resultados demonstram que são fatores protetores da QVRS, viver numa família nuclear com ambos os pais (pai e mãe), ser do sexo masculino, ser mais novo e dormir mais horas; e são fatores de risco ser do sexo feminino, dormir menos e ser adolescente, na maioria das dimensões. Conclusão: Os resultados deste estudo poderão contribuir para a melhoria do conhecimento científico na área da QV em crianças/adolescentes e ainda contribuir para a implementação de estratégias que permitam a melhoria da QVRS nos grupos de risco, nomeadamente ações de sensibilização sobre igualdade de género, higiene de sono e reforçar a autoestima e autonomia na adolescência.

Introduction: The connection between quality of life and health is complex and represents a concept whose definition is influenced by multiple determinants. The assessment of health-related quality of life (HRQoL) is considered of paramount importance in pediatric practice, since its measurement has become an important health indicator and can be used to evaluate the impact of the implemented interventions. Goals: To evaluate the perception of HRQoL; to analyze the relationship of socio-demographic variables and well-being with the HRQoL of children and adolescents. Methodology: A descriptive-correlational study of a quantitative nature in a non-probabilistic sample for convenience, consisting of 567 children and adolescents (49.4%) male and (51.6%) female, attending the 2nd and 3rd cycles of Basic Education of a Center Grouping of Schools. Data collection was carried out using the Portuguese version of the Kidscreen-52 scale (Gaspar & Matos, 2008c), sociodemographic and welfare issues. Results: Participants presented a mean age of 12.4 years (Dp = 1.59), the majority cohabitated in a nuclear family (77.4%). Relative to rest and well-being, children / adolescents sleep on average 8.15 hours and are perceived with good quality of life evaluated by the scale of faces. Children and adolescents have a positive perception of HRQoL. However, the dimensions "Self-esteem" (61,3) and "Autonomy" (M = 62,2) are the ones that present lower values in the HRQOL perception. The results show that they are protective factors for HRQoL, living in a nuclear family with both parents (father and mother), being gender male, being younger and sleeping more hours; and risk factors are being female, sleeping less and being a teenager, in most dimensions. Conclusion: The results of this study may contribute to the improvement of scientific knowledge in the area of QoL in children / adolescents and also contribute to the implementation of strategies that allow the improvement of HRQoL in risk groups, such as gender awareness actions, sleep hygiene and reinforce self-esteem and autonomy in adolescence.

Aprendizagem baseada em problemas: uma proposta para a formação de técnicos em laboratórios de saúde pública / Problem-based learning: a proposal for the training of students as public health laboratory technicians / Aprendizaje basado en problemas: una propuesta para la formación de técnicos en laboratorios de salud pública

No âmbito da formação profissionalizante, as características da aprendizagem baseada em problemas (ABP)propiciam uma maior aproximação dos alunos da prática profissional. Este artigo apresenta uma propostacurricular inovadora para a formação de técnicos em laboratórios de saúde pública, fundamentada na ABP. Alógica da estrutura curricular apoia-se em dois eixos estruturantes: 1) as principais tecnologias utilizadas noslaboratórios de saúde pública, tais como a microscopia, a volumetria, a espectrofotometria, a cromatografiae a eletroforese; e 2) as principais matrizes utilizadas nos laboratórios, tais como a água, os alimentos,a urina, as fezes e o sangue. Com esta proposta, busca-se fomentar discussões acerca da implantação decurrículos e de estratégias de ensino que possam contribuir para melhorar o ensino profissionalizante noBrasil, assim como promover a formação de técnicos capazes de atuarem nos laboratórios que compõem oSistema Nacional de Laboratórios de Saúde Pública (SISLAB)...

In the context of vocational training, the characteristics of the problem-based learning (PBL) provide agreater proximity of the students to professional practice. This article presents an innovative curriculumproposal for the training of technicians in public health laboratories, based on PBL. The logic of thecurriculum structure is based on two axes: 1) The main technologies applied at public health laboratories,such as microscopy, volumetry, spectrophotometry, chromatography and electrophoresis; and 2) The mainmatrices used in laboratories, such as water, food, urine, faeces and blood. With this proposal, we seek tofoster discussions about the curriculum implementation and the teaching strategies that can contribute tothe improvement in vocational education in Brazil, as well as promote the training of technicians capable ofworking in laboratories comprising the Brazilian National Public Health Laboratory (SISLAB)...

En el ambito de la formación profesional, el aprendizaje basado en problemas (ABP) permite una mayoraproximación de los estudiantes a la práctica para habilitarse en una profesión. Este artículo presenta unapropuesta curricular inovadora para la formación de técnicos en laboratórios de salud pública, basada enABP. La lógica de la estructura curricular se sustenta en dos ejes: 1) Las principales tecnologías utilizadas emlos laboratorios de salud pública tales como, microscopia, volumetría, espectrofotometría, cromatografíay electroforesis; y 2) Las principales matrices utilizadas en los laboratorios, como agua, alimentosy fluidos biológicos en general. Con esta propuesta se busca el fomento de discusiones com respecto ala implementación de currículos y de estratégias de enseñanza que puedan contribuir a la enseñanzaprofesional en Brasil al igual que promover la formación de técnicos capaces de actuaren en los laboratóriosque componen el Sistema Nacional de Laboratorios de Salud Pública (SISLAB)...

2D and 3D characterization of a surfactant-synthesized TiO2-SiO2 mesoporous photocatalyst obtained at ambient temperature.

A mesoporous TiO(2)-SiO(2) nanocomposite photocatalyst has been prepared from TiO(2) nanoparticles and ethoxysilane oligomers in the presence of a non-ionic surfactant (n-octylamine). The 2D and 3D structure properties of the resulting nanomaterial are described. The use of 3D techniques, particularly HAADF-STEM electron tomography, together with 3D reconstructions and atomic force microscopy, provides insight into the fine structure of these materials. We find that n-octylamine creates a mesoporous silica structure in which titania nanoparticles are embedded, and that some of the titania is retained on the outer surface of the material. Rapid photodegradation of methylene blue dye is facilitated, due to the synergistic effect of: (1) its adsorption into the composite mesoporous structure, and (2) its photodegradation by the superficial TiO(2).

Genotyping of Mycoplasma bovis isolates using multiple-locus variable-number tandem-repeat analysis.

Mycoplasma bovis has been considered an important cause of mastitis, pneumonia, and arthritis in bovines with a highly detrimental economic impact in the livestock industry. Previous epidemiological studies, using different typing techniques showed that the isolates were usually heterogeneous and results were difficult to compare between different laboratories. Reliable and comparable molecular typing techniques using geographically and temporal distinct isolates have never been used. The objective of this study was to use multiple-locus variable-number tandem-repeat analysis (MLVA) for the differentiation of M. bovis isolates. This typing scheme was developed using the sequenced genome of the M. bovis PG45 type strain. Nine tandem-repeat sequences were selected and the genetic diversity of 37 isolates of wide geographic and temporal origins was analyzed. The results were compared to those obtained with random amplified polymorphic DNA (RAPD) analysis and pulsed-field gel electrophoresis (PFGE) for the same isolates. Cluster concordance between techniques was evaluated using Adjusted Rand and Wallace coefficients, and different cutoff levels of similarity were tested. Acceptable values of ≥0.5 for all techniques for the Wallace coefficient were only observed at the most relaxed cutoff level, i.e., 52% for MLVA, 29% for PFGE and 18% for RAPD. The Simpson's index of diversity was 0.91 for MLVA, 0.99 for RAPD analysis and 0.99 for PFGE. This MLVA assay is compatible with simple PCR and agarose gel-based electrophoresis steps as well as with high-throughput automated methods. The molecular typing scheme presented in this study provides a fast, reliable, and cost-effective typing method for surveillance of M. bovis epidemiology.

Adolescência, família e escolhas: implicações na orientação profissional / Adolescence, family and choices: implications on career guidance

A adolescência é uma fase do ciclo de vida na qual o indivíduo passa por transições que acarretam grandes mudanças em seu desenvolvimento. Este é um período de consolidação da identidade, em que o jovem se depara com uma série de escolhas que definirão seu futuro, dentre elas a escolha profissional. A família é apontada como um dos principais elementos que podem tanto ajudar quanto dificultar o jovem em sua escolha no momento da decisão profissional. As influências familiares podem ser trabalhadas de diversas maneiras, durante o processo de orientação profissional, auxiliando o adolescente a compreender as questões que estão por trás de sua escolha. Quando o jovem reconhece essas influências, ele pode utilizá-las, de forma consciente, ao estabelecer o seu projeto de vida pessoal e profissional.

Adolescence is a life-span stage in which the individual goes through transitions that can lead to big shifts in development. This is a moment of identity consolidation, when the adolescent faces many choices that will define his/her future, such as a career choice. Family is one of the major elements that can help or hinder this moment of professional decision. Family influences can be assessed by many ways during the career guidance process, in means of helping the adolescent understand the issues that are beneath this important choice. When the young person recognizes those influences, he/she can use them consciously to construct his/her personal and professional life project.

Síndrome do cativeiro: a propósito de um caso no Hospital Naval Marcílio Dias / Locked-in syndrome: apropos of a case in the Hospital Naval Marcílio Dias

É descrito um caso em um paciente portador de cardiopatia hipertensiva com disfunçäo grave de VE e aumento de AE que cursava com arritimias ("Flutter" Atrial), em sendo possivelmente, o coraçäo a fonte emboligênica que contribuiu para instalaçäo súbita de um déficit neurológico compatível co pseudomutismo acinético ou síndrome do cativeira