Gamification and Hazard Communication in Virtual Reality: A Qualitative Study.

An effective warning attracts attention, elicits knowledge, and enables compliance behavior. Game mechanics, which are directly linked to human desires, stand out as training, evaluation, and improvement tools. Immersive virtual reality (VR) facilitates training without risk to participants, evaluates the impact of an incorrect action/decision, and creates a smart training environment. The present study analyzes the user experience in a gamified virtual environment of risks using the HTC Vive head-mounted display. The game was developed in the Unreal game engine and consisted of a walk-through maze composed of evident dangers and different signaling variables while user action data were recorded. To demonstrate which aspects provide better interaction, experience, perception and memory, three different warning configurations (dynamic, static and smart) and two different levels of danger (low and high) were presented. To properly assess the impact of the experience, we conducted a survey about personality and knowledge before and after using the game. We proceeded with the qualitative approach by using questions in a bipolar laddering assessment that was compared with the recorded data during the game. The findings indicate that when users are engaged in VR, they tend to test the consequences of their actions rather than maintaining safety. The results also reveal that textual signal variables are not accessed when users are faced with the stress factor of time. Progress is needed in implementing new technologies for warnings and advance notifications to improve the evaluation of human behavior in virtual environments of high-risk surroundings.

Mixed Assessment of Virtual Serious Games Applied in Architectural and Urban Design Education.

The creation and usage of serious games on virtual reality (VR) and/or interactive platforms for the teaching of architecture, construction, urban planning, and other derived areas, such as security and risk prevention, require design processes, studies, and research that lead to further consolidation expansion. In that sense, this paper presents two main aims developed: the improvement of a virtual navigation system through the results of previous user studies and mixed research (quantitative and qualitative) improved based on the user perception for educational and professional uses. The VR system used is based on Unreal Engine programming of the HTC Vive sensor. This study is related to the GAME4City 3.0 and a broader project focused on gamified visualization and its educational uses in architectural and urban projects. The results reflect great interest, good usability, and high motivation for further usage for all types of users. However, an apparent resistance to deepen its use continues to be perceived in academia. Based on the research results, weak points of educational gamified systems have been identified, and the main differences and needs in user profiles' function. With these data, progress regarding implementing this kind of system at the teaching and professional levels must be pursued.

Vitamin B12, bone mineral density and fracture risk in adults: A systematic review.

OBJECTIVE: To consolidate information available on the effect of vitamin B12 on bone mineral density and fracture risk, with emphasis on clinical trials, observational and longitudinal data conducted in humans. METHOD: A systematic review of the literature of the past decade on the role of vitamin B12 in bone mineral density and fracture risk in subjects of all ages and both sexes was performed by means of a PubMed, Science Direct, Medline and SciELO database search. Articles included in this review were identified using the search terms: B12 Vitamin and Bone Mineral Density and Vitamin B12 and Risk of Fractures. Evidence quality of the included articles was evaluated by GRADE system. RESULTS: A total of 25 original studies were identified. After reviewing the titles and abstracts of articles, only 17 articles met the inclusion criteria. The present review provides evidence that the role of vitamin B12 on bone mineral density or fracture risk should be further elucidated. Controversies are explained by heterogeneity of methodologies used for the diagnosis of vitamin B12 and also by differences among populations investigated on the studies. CONCLUSION: A real effect of vitamin B12 deficiency in bone health and the mechanisms associated with bone metabolism is not well established yet. It is extremely important to carry out more clarifying studies about this theme, especially with vulnerable groups such as postmenopausal and elderly women, as is well-known that they are greatly affected by deficiency of this vitamin.

Ergonomic analysis of safety signs: a focus of informational and cultural ergonomics.

This paper presents the results of a research carried out in the states of Pernambuco and Rio Grande do Sul, Brazil about differences and similarities in the graphic representation of safety signs at factories of food, steel, shoes and construction/ building industries, together with their workers' opinions on the security signs. The overall results show differences in the sign structure across the states, confirming the influence of cultural differences on the design of safety signs, which must be taken into account during the design process.

Vitamin B12, bone mineral density and fracture risk in adults: A systematic review / Vitamina B12, densidade mineral óssea e risco de fraturas em adultos: uma revisão sistemática

Summary Objective: To consolidate information available on the effect of vitamin B12 on bone mineral density and fracture risk, with emphasis on clinical trials, observational and longitudinal data conducted in humans. Method: A systematic review of the literature of the past decade on the role of vitamin B12 in bone mineral density and fracture risk in subjects of all ages and both sexes was performed by means of a PubMed, Science Direct, Medline and SciELO database search. Articles included in this review were identified using the search terms: B12 Vitamin and Bone Mineral Density and Vitamin B12 and Risk of Fractures. Evidence quality of the included articles was evaluated by GRADE system. Results: A total of 25 original studies were identified. After reviewing the titles and abstracts of articles, only 17 articles met the inclusion criteria. The present review provides evidence that the role of vitamin B12 on bone mineral density or fracture risk should be further elucidated. Controversies are explained by heterogeneity of methodologies used for the diagnosis of vitamin B12 and also by differences among populations investigated on the studies. Conclusion: A real effect of vitamin B12 deficiency in bone health and the mechanisms associated with bone metabolism is not well established yet. It is extremely important to carry out more clarifying studies about this theme, especially with vulnerable groups such as postmenopausal and elderly women, as is well-known that they are greatly affected by deficiency of this vitamin.

Resumo Objetivo: Consolidar as informações disponíveis acerca dos efeitos da vitamina B12 sobre a densidade mineral óssea e o risco de fraturas, com destaque para ensaios clínicos, dados observacionais e longitudinais realizados com humanos. Método: Foi realizada uma revisão sistemática da literatura dos últimos dez anos sobre o papel da vitamina B12 na densidade mineral óssea e no risco de fraturas em populações de todas as idades e para ambos os sexos, com busca de artigos nos bancos de dados eletrônicos: PubMed, Science Direct, Medline e SciELO. Como estratégia de busca de dados incluíram-se os descritores: B12 Vitamin and Bone Mineral Density e B12 Vitamin and Risk of Fractures. A qualidade das evidências dos artigos incluídos foi avaliada pelo sistema GRADE. Resultados: Após a análise dos títulos e dos resumos dos artigos, a estratégia de busca resultou em 25 referências, das quais 17 artigos preencheram os critérios de elegibilidade. Esta revisão fornece evidências de que o papel da vitamina B12 sobre a densidade mineral óssea ou o risco de fraturas ainda precisa ser mais bem elucidado. As controvérsias encontram respaldo na heterogeneidade das metodologias utilizadas para o diagnóstico da vitamina B12 e também na variedade de populações presentes entre os estudos. Conclusão: Ainda não está bem estabelecido o real impacto da deficiência de vitamina B12 na saúde dos ossos e sobre os mecanismos associados ao metabolismo ósseo. É de suma importância a realização de mais estudos esclarecedores, principalmente em grupos vulneráveis como as mulheres pós-menopausa e os idosos, grupos estes bastante afetados pela deficiência dessa vitamina.

Is severe visceral leishmaniasis a systemic inflammatory response syndrome? A case control study.

INTRODUCTION: The objective of the study is to identify the main risk factors for death by New World visceral leishmaniasis and establish a coherent pathogenic substrate of severe disease based on clinical findings. METHODS: Seventy-six deceased inpatients and 320 successfully treated inpatients with VL were studied in a case control study. RESULTS: Bacterial infection and bleeding were mutually exclusive events leading to death. Five risk factors were unique for death by bacterial infection (malnutrition, pulmonary rales, severe anemia, severe absolute neutropenia and higher neutrophil count), while another six were unique for death by bleeding (jaundice, severe relative neutropenia, severe thrombocytopenia, liver injury, kidney failure, higher bone marrow parasite load). Bacterial infection, bleeding, severe anemia, diarrhea, dyspnea, edema, jaundice and bone marrow parasite load were the main syndromes of visceral leishmaniasis among successfully treated patients. CONCLUSIONS: The data support the idea that bacterial infections are due to immune paralysis. Broad organ and system involvement is plausibly due to the high production of proinflammatory cytokines, whose actions fit well with visceral leishmaniasis. The syndromes and causative mediators are typical of a slowly developing systemic inflammatory response syndrome.

Profile of glomerular diseases in a public hospital of Federal District, Brazil.

INTRODUCTION: Glomerular diseases are a frequent etiology of chronic kidney disease, especially in the developing countries. OBJECTIVE: To determine the profile of such glomerulopathies in a public hospital located in the city of Brasilia, Federal District. METHODS: 121 renal biopsies in different patients were performed by the Renal Division of Hospital Regional da Asa Norte (HRAN) between August 2005 and May 2009. Eight renal biopsies in renal-transplant patients were excluded and the medical records of 113 remaining patients were analyzed. Analyzed data: sex, age, laboratory exams, glomerular syndrome, clinical diagnosis, degree of interstitial fibrosis, immunosuppressants use, need for dialysis and clinical outcome. RESULTS: The age average was 34.9 ± 16.2 years-old, a predominance of male patients (51.3%). Major glomerular syndromes were: nephrotic syndrome (41.6%) and the rapidly- progressive glomerulonephritis (35.4%). Among primary glomerulopathies focal glomerulosclerosis (26.8%) followed by IgA nephropathy (25%) were predominant; and among the most prevalent secondary glomerulopathies we had lupus nephritis (50%) and diffuse exudative proliferative glomerulonephritis (34.2%).The majority of the patients used immunosuppressants (68.1%) and almost one third of them (29.2%) needed dialysis during their hospitalization. Progressed to chronic dialysis therapy 13.3% of the patients and 10.6% died. CONCLUSION: This study may contribute to better epidemiological understanding of glomerular diseases in the Federal District, guiding the adoption of public policies aiming the quick clinical treatment of such diseases.

Gluconacetobacter diazotrophicus Elicits a Sugarcane Defense Response Against a Pathogenic Bacteria Xanthomonas albilineans.

A new role for the plant growth-promoting nitrogen-fixing endophytic bacteria Gluconacetobacter diazotrophicus has been identified and characterized while it is involved in the sugarcane-Xanthomonas albilineans pathogenic interactions. Living G.diazotrophicus possess and/or produce elicitor molecules which activate the sugarcane defense response resulting in the plant resistance to X. albilineans, in this particular case controlling the pathogen transmission to emerging agamic shoots. A total of 47 differentially expressed transcript derived fragments (TDFs) were identified by cDNA-AFLP. Transcripts showed significant homologies to genes of the ethylene signaling pathway (26%), proteins regulates by auxins (9%), beta-1,3 Glucanase proteins (6%) and ubiquitin genes (4%), all major signaling mechanisms. Results point toward a form of induction of systemic resistance in sugarcane-G. diazotrophicus interactions which protect the plant against X. albilineans attack.

Is severe visceral leishmaniasis a systemic inflammatory response syndrome? A case control study / A leishmaniose visceral grave é uma síndrome da resposta inflamatória sistêmica? Um estudo caso-controle

INTRODUCTION: The objective of the study is to identify the main risk factors for death by New World visceral leishmaniasis and establish a coherent pathogenic substrate of severe disease based on clinical findings. METHODS: Seventy-six deceased inpatients and 320 successfully treated inpatients with VL were studied in a case control study. RESULTS: Bacterial infection and bleeding were mutually exclusive events leading to death. Five risk factors were unique for death by bacterial infection (malnutrition, pulmonary rales, severe anemia, severe absolute neutropenia and higher neutrophil count), while another six were unique for death by bleeding (jaundice, severe relative neutropenia, severe thrombocytopenia, liver injury, kidney failure, higher bone marrow parasite load). Bacterial infection, bleeding, severe anemia, diarrhea, dyspnea, edema, jaundice and bone marrow parasite load were the main syndromes of visceral leishmaniasis among successfully treated patients. CONCLUSIONS: The data support the idea that bacterial infections are due to immune paralysis. Broad organ and system involvement is plausibly due to the high production of proinflammatory cytokines, whose actions fit well with visceral leishmaniasis. The syndromes and causative mediators are typical of a slowly developing systemic inflammatory response syndrome.

INTRODUÇÃO: O objetivo do estudo foi i dentificar os principais fatores de risco para morte na leishmaniose visceral do Novo Mundo e estabelecer um substrato patogênico baseado nos achados clínicos coerente para doença grave. MÉTODOS: Em um estudo caso-controle, foram estudados 76 pacientes internados que faleceram e 320 pacientes internados tratados com sucesso. RESULTADOS: Infecção bacteriana e sangramento foram eventos que levaram à morte, mutuamente exclusivos. Cinco fatores de risco foram únicos para morte por infecção bacteriana (desnutrição, estertores pulmonares, anemia grave, neutropenia absoluta grave e número de leucócitos aumentados), enquanto outros seis foram exclusivos para morte por sangramento (icterícia, neutropenia relativa grave, trombocitopenia grave, lesão hepática, insuficiência renal, maior carga de parasitas na medula óssea). Entre os pacientes tratados com sucesso, as principais síndromes de leishmaniose visceral foram infecções bacterianas, sangramento, anemia grave, diarreia, dispneia, edema, icterícia e carga de parasitas na medula óssea. CONCLUSÕES: Os dados apoiam a ideia de que as infecções bacterianas são secundárias a imunoparalisia. O amplo envolvimento de órgãos e sistemas é de forma plausível devido a elevada produção de citocinas pró-inflamatórias, cujas ações se encaixam com a leishmaniose visceral. As síndromes e os mediadores causais são típicos da síndrome de resposta inflamatória sistêmica, desenrolando-se lentamente.

Profile of glomerular diseases in a public hospital of Federal District, Brazil / Perfil das doenças glomerulares em um hospital público do Distrito Federal

INTRODUÇÃO: As doenças glomerulares são uma causa frequente de doença renal crônica, sobretudo nos países em desenvolvimento. OBJETIVO: O objetivo deste estudo foi determinar o perfil destas glomerulopatias em um hospital público da cidade de Brasília, Distrito Federal. MÉTODOS: Foram realizadas 121 biopsias renais pela equipe de nefrologia do Hospital Regional da Asa Norte (HRAN) entre agosto de 2005 e maio de 2009. Foram excluídas oito biopsias realizadas em pacientes transplantados renais e analisados os prontuários dos 113 pacientes restantes. Dados analisados: sexo, idade, exames laboratoriais, síndrome glomerular, diagnóstico clínico, grau de fibrose intersticial, uso de imunossupressores, necessidade de diálise e desfecho clínico. RESULTADOS: A média de idade foi 34,9 ± 16,2 anos, com predomínio masculino (51,3 por cento). As principais síndromes glomerulares foram: síndrome nefrótica (41,6 por cento) e glomerulonefrite rapidamente progressiva (35,4 por cento). Entre as glomerulopatias primárias, houve predomínio da glomeruloesclerose segmentar e focal (26,9 por cento) e da nefropatia por IgA (25 por cento) e entre as secundárias a nefrite lúpica (50 por cento) e a glomerulonefrite proliferativa exsudativa difusa (34,2 por cento). A maioria dos pacientes fez uso de imunossupressores (68,1 por cento) e quase um terço deles (29,2 por cento) necessitou de diálise durante a internação. Evoluíram para terapia dialítica crônica 13,3 por cento dos pacientes e 10,6 por cento evoluíram a óbito. CONCLUSÃO: Este estudo poderá contribuir para melhor entendimento epidemiológico das doenças glomerulares no Distrito Federal, orientando na adoção de políticas públicas visando permitir rápido diagnóstico e manejo clínico das mesmas.

INTRODUCTION: Glomerular diseases are a frequent etiology of chronic kidney disease, especially in the developing countries. OBJECTIVE: To determine the profile of such glomerulopathies in a public hospital located in the city of Brasilia, Federal District. METHODS: 121 renal biopsies in different patients were performed by the Renal Division of Hospital Regional da Asa Norte (HRAN) between August 2005 and May 2009. Eight renal biopsies in renal-transplant patients were excluded and the medical records of 113 remaining patients were analyzed. Analyzed data: sex, age, laboratory exams, glomerular syndrome, clinical diagnosis, degree of interstitial fibrosis, immunosuppressants use, need for dialysis and clinical outcome. RESULTS: The age average was 34.9 ± 16.2 years-old, a predominance of male patients (51.3 percent). Major glomerular syndromes were: nephrotic syndrome (41.6 percent) and the rapidly- progressive glomerulonephritis (35.4 percent). Among primary glomerulopathies focal glomerulosclerosis (26.8 percent) followed by IgA nephropathy (25 percent) were predominant; and among the most prevalent secondary glomerulopathies we had lupus nephritis (50 percent) and diffuse exudative proliferative glomerulonephritis (34.2 percent).The majority of the patients used immunosuppressants (68.1 percent) and almost one third of them (29.2 percent) needed dialysis during their hospitalization. Progressed to chronic dialysis therapy 13.3 percent of the patients and 10.6 percent died. CONCLUSION: This study may contribute to better epidemiological understanding of glomerular diseases in the Federal District, guiding the adoption of public policies aiming the quick clinical treatment of such diseases.

Perfil dos pacientes com nefrite lúpica submetidos à biópsia renal / Profiles of lupus nephritis patients who underwent renal biopsy

Introdução. A doença renal crônica é um problema de saúde pública e uma de suas principais causas nos países em desenvolvimento são as doenças glomerulares. A nefrite lúpica é considerada mundialmente como a mais frequente glomerulopatia secundária a doença sistêmica.Objetivo. Determinar o perfil de pacientes com nefrite lúpica submetidos a biópsia renal em um hospital público do Distrito Federal, Brasil.Método. Entre agosto de 2005 a maio de 2009 foram realizadas 113 biópsias em rins nativos pelo Serviço de Nefrologia do Hospital Regional da Asa Norte. Dezenove dessas biópsias (16,8%) foram de pacientes com nefrite lúpica. Os dados analisados foram: sexo, idade, síndrome glomerular, diagnóstico prévio de lúpus, classe histológica,presença de fibrose intersticial, necessidade de diálise e desfecho clínico.Resultados. A média de idade dos pacientes foi 25,1 ± 7,1 anos, todos foram do sexo feminino, e a maioria sem diagnóstico prévio de lúpus (57,9%). A síndrome glomerular mais frequente foi a glomerulonefrite rapidamente progressiva (57,9%), seguida pela síndrome nefrótica (42,1%). Entre as classes histológicas, houve predomínio danefrite lúpica classe IV (57,9%). Na maioria das biópsias, foi descrita presença de fibrose intersticial (73,7%). Mais de um terço dos pacientes necessitaram de diálise (36,8%) e uma porcentagem expressiva tiveram óbito (31,6%) ou necessitou de diálise crônica (10,5%).Conclusão. Apresentações graves de nefrite lúpica predominaram como indicação de biópsia renal, destacando-se a elevada frequência de glomerulonefrite rapidamente progressiva e de morte nesse grupo.

Introduction. Chronic kidney disease is a public health problem and one of its main causes in developing countries is the glomerular diseases. Lupus nephritis is regarded worldwide as the most frequent glomerulonephritissecond to systemic disease. Objective. To determine the profile of patients with lupus nephritis who underwent renal biopsy at a public hospitalat the Distrito Federal, Brazil. Method. From August 2005 through May 2009 113 biopsies were carried out on native kidneys from theNephrology Service of Hospital Regional da Asa Norte. Nineteen of such biopsies (16.8%) were carried out on patients with lupus nephritis. Data analyzed were gender, age, glomerular syndrome, previous lupus diagnosis, histological grade, presence of interstitial fibrosis, need for dialysis and clinical outcome. Results. The mean age of patients was 25.1 ± 7.1 years, all females and most of them with no previous diagnosisof lupus (57.9%). The most frequent glomerular syndrome was the rapidly progressive glomerulonephritis (57.9%), followed by nephrotic syndrome (42.1%). Among histological classes, class IV lupus nephritis prevailed(57.9%). Most biopsies showed the presence of interstitial fibrosis (73.7%). More than a third of the patients required dialysis (36.8%) and a significant percentage resulted in deaths (31.6%) or needed chronic dialysis (10.5%). Conclusion. Evidence of severe lupus nephritis predominated as an indication of renal biopsy, highlighting thehigh rate of rapidly progressive glomerulonephritis and death in this group.