Impact of patrilocality on contrasting patterns of paternal and maternal heritage in Central-West Africa.

Despite their ancient past and high diversity, African populations are the least represented in human population genetic studies. In this study, uniparental markers (mtDNA and Y chromosome) were used to investigate the impact of sociocultural factors on the genetic diversity and inter-ethnolinguistic gene flow in the three major Nigerian groups: Hausa (n = 89), Yoruba (n = 135) and Igbo (n = 134). The results show a distinct history from the maternal and paternal perspectives. The three Nigerian groups present a similar substrate for mtDNA, but not for the Y chromosome. The two Niger-Congo groups, Yoruba and Igbo, are paternally genetically correlated with populations from the same ethnolinguistic affiliation. Meanwhile, the Hausa is paternally closer to other Afro-Asiatic populations and presented a high diversity of lineages from across Africa. When expanding the analyses to other African populations, it is observed that language did not act as a major barrier to female-mediated gene flow and that the differentiation of paternal lineages is better correlated with linguistic than geographic distances. The results obtained demonstrate the impact of patrilocality, a common and well-established practice in populations from Central-West Africa, in the preservation of the patrilineage gene pool and in the affirmation of identity between groups.

Safety assessment for temporary hospitals during the COVID-19 pandemic: A simulation approach.

Amid the devastating effects caused by the pandemic of the new Coronavirus (COVID-19), health leaders around the world are adding efforts to search efficient and effective responses in the fight against the disease. Conventional health centers, such as hospitals and emergency departments have been registering an increase in demand and atypical patterns due to the high transmissibility of the virus. In this context, the adoption of Temporary Hospitals (THs) is effective in trying to relieve conventional hospitals and direct efforts in the treatment of suspected and positive patients for COVID-19. However, some requirements should be considered regarding the processes performed by THs to maintain the health and safety of patients and staff. Based on the literature, we evaluated aspects related to patient safety in THs, especially linked to biosafety of medical facilities, and patient transport and visit. We highlight the analysis of flows and layouts, hospital cleaning and patient care. We described two case studies to demonstrate the proposed approach. As result, simulation tests improved safety metrics, such as waiting time for procedures, movement intensity in each area, length of stay and TH capacity. We conclude that the approach allows us to provide better THs that prevent cross-contamination, provide suitable care, and meet the demand.

Lean thinking by integrating with discrete event simulation and design of experiments: an emergency department expansion.

BACKGROUND: Many management tools, such as Discrete Event Simulation (DES) and Lean Healthcare, are efficient to support and assist health care quality. In this sense, the study aims at using Lean Thinking (LT) principles combined with DES to plan a Canadian emergency department (ED) expansion and at meeting the demand that comes from small care centers closed. The project's purpose is reducing the patients' Length of Stay (LOS) in the ED. Additionally, they must be assisted as soon as possible after the triage process. Furthermore, the study aims at determining the ideal number of beds in the Short Stay Unit (SSU). The patients must not wait more than 180 min to be transferred. METHODS: For this purpose, the hospital decision-makers have suggested planning the expansion, and it was carried out by the simulation and modeling method. The emergency department was simulated by the software FlexSim Healthcare®, and, with the Design of Experiments (DoE), the optimal number of beds, seats, and resources for each shift was determined. Data collection and modeling were executed based on historical data (patients' arrival) and from some databases that are in use by the hospital, from April 1st, 2017 to March 31st, 2018. The experiments were carried out by running 30 replicates for each scenario. RESULTS: The results show that the emergency department cannot meet expected demand in the initial planning scenario. Only 17.2% of the patients were completed treated, and LOS was 2213.7 (average), with a confidence interval of (2131.8-2295.6) min. However, after changing decision variables and applying LT techniques, the treated patients' number increased to 95.7% (approximately 600%). Average LOS decreased to 461.2, with a confidence interval of (453.7-468.7) min, about 79.0%. The time to be attended after the triage decrease from 404.3 min to 20.8 (19.8-21.8) min, around 95.0%, while the time to be transferred from bed to the SSU decreased by 60.0%. Moreover, the ED reduced human resources downtime, according to Lean Thinking principles.

Os testes de equilíbrio alcance funcional e “Timed Up and Go” e o risco de quedas em idosos / The balancing tests functional reach and timed up and Go and the risk of falls in the elderly

O risco de quedas aumenta com o envelhecimento, tornando-se problema de saúde pública. O estudo atual teve como objetivo identificar os fatores de risco de quedas em indivíduos idosos e analisar se os testes de equilíbrio, Teste de Alcance Funcional (TAF) e “Timed Up and Go” (TUG), identificam aqueles com maior susceptibilidade a cair. Realizou-se estudo prospectivo, transversal e observacional, com 155 idosos (≥60 anos), sendo 131 mulheres e 24 homens, atendidos em hospital público de Brasília (DF). Estes idosos foram divididos em dois grupos: grupo 1, com os que referiram queda nos últimos 12 meses; e grupo 2, com aqueles que negaram queda no mesmo período. Foram aplicados, além de um questionário para identificar os fatores de risco de quedas, dois testes para avaliar o equilíbrio (TAF e TUG). A idade média dos idosos estudados foi de 70,65 ± 7,52 anos, sendo que 38,7% deles relataram queda nos últimos 12 meses. A incidência de quedas foi significativamente maior no sexo feminino, nos que relataram medo de queda e nos que usavam polifarmácia. Na análise multivariada, a polifarmácia foi o único fator de risco independente associado ao evento quedas. Os testes de equilíbrio TAF e TUG não se correlacionaram significativamente com a ocorrência de quedas. Concluiu-se que a polifarmácia foi o único fator de risco independente associado a quedas, e que os testes de equilíbrio TAF e TUG não identificaram os idosos com maior susceptibilidade a cair.

The risk of falls increases with aging, becoming a public health problem. The current study aimed to identify risk factors for falls in older people and analyze if the tests of balance Functional Reach Test (TAF) and "Timed Up and Go" (TUG) identify those with increased susceptibility to fall. We conducted a prospective, cross-sectional, observational study of 155 elderly (≥ 60 years), 131 women and 24 men, attended at a public hospital in Brasília (DF). These seniors were divided into two groups: group 1, with those who reported falling in the past 12 months; and group 2, with those who denied falling in the same period. We applied a questionnaire to identify risk factors for falls and two tests to assess balance (TAF and TUG). The mean age of the studied sample was 70.65 ± 7.52 years, and 38.7% reported falls in the past 12 months. The incidence of falls was significantly higher in females, among those reporting fear of falling and who wore polypharmacy. In the multivariate analysis, polypharmacy was the only independent risk factor associated with falls. The balance tests were not significantly correlated with the occurrence of falls. It was concluded that polypharmacy was the only independent risk factor associated with falls and the balance tests TAF and TUG did not identified the elderly with increased susceptibility to fall.

Medicação de uso tópico na Odontologia / Drugs for tropical use in Dentistry

Os autores, através da revisão da literatura, procuram demonstrar as aplicações clínicas, mecanismos de ação e principais controvérsias dos medicamentos utilizados com grande freqüência na clínica odontológica