Encapsulation of pristine and silica-coated human adipose-derived mesenchymal stem cells in gelatin colloidal hydrogels for tissue engineering and bioprinting applications.

Colloidal gels assembled from gelatin nanoparticles (GNPs) as particulate building blocks show strong promise to solve challenges in cell delivery and biofabrication, such as low cell survival and limited spatial retention. These gels offer evident advantages to facilitate cell encapsulation, but research on this topic is still limited, which hampers our understanding of the relationship between the physicochemical and biological properties of cell-laden colloidal gels. Human adipose-derived mesenchymal stem cells were successfully encapsulated in gelatin colloidal gels and evaluated their mechanical and biological performance over 7 days. The cells dispersed well within the gels without compromising gel cohesiveness, remained viable, and spread throughout the gels. Cells partially coated with silica were introduced into these gels, which increased their storage moduli and decreased their self-healing capacity after 7 days. This finding demonstrates the ability to modulate gel stiffness by incorporating cells partially coated with silica, without altering the solid content or introducing additional particles. Our work presents an efficient method for cell encapsulation while preserving gel integrity, expanding the applicability of colloidal hydrogels for tissue engineering and bioprinting. Overall, our study contributes to the design of improved cell delivery systems and biofabrication techniques.

Neoadjuvant chemotherapy for muscle-invasive bladder cancer: does variant histology matter?

PURPOSE: The most frequent histology of bladder tumors is urothelial carcinoma. Most are pure urothelial carcinomas (PUC) but up to one-third of the cases present variant histological (VH) features. The aim of this study was to evaluate the role of variant histology in neoadjuvant chemotherapy (NAC) response in patients with urothelial muscle-invasive bladder cancer. METHODS: We retrospectively analyzed data from 77 patients with bladder cancer who performed neoadjuvant chemotherapy at two institutions. RESULTS: Complete pathological response (ypT0) was higher in patients with PUC (38.5%), comparing with VH (12%). Logistic regression analysis demonstrated that variant histology is associated with an 89% lesser likelihood of tumor downstaging, with advanced clinical T stages and positive smoking history as independent predictors. The estimated mean cancer-specific survival was 68.91 months for PUC patients and 50.23 months for VH patients (log rank test, P = 0.024). Multivariate Cox regression analysis demonstrated that VH and clinical T stage were independent predictors of cancer-specific survival, indicating a worse outcome for patients with VH and advanced clinical T stages. CONCLUSIONS: There are only a few retrospective studies evaluating the clinical impact of variant histology tumors, which are mainly managed as PUC. Our results demonstrate that VH is associated with a worse likelihood of tumor downstaging after NAC and a worse cancer-specific survival in bladder cancer patients. There is a need for further studies and genetic analysis to identify the patients most likely to achieve ypT0 status and downstaging after NAC.

Schwannoma of Seminal Vesicle: A Case Report.

Seminal vesicle neoplasms are extremely rare. Schwannoma is a benign tumor of the peripherical nerve sheath composed of Schwann cells. Most of these tumors are silent and become symptomatic with compression of adjacent organs and nerves. We present a case of a 72-year-old man who presented with a several months history of predominant storage lower urinary tract symptoms and painful ejaculation. Prostate-specific antigen (PSA) was within normal ranges, and imaging documented a retrovesical nodular lesion adjacent to the right seminal vesicle with 5 cm in width. We successfully performed a robotic-assisted laparoscopic surgery to excise the lesion. Anatomopathological analysis revealed a schwannoma.

The Global South political economy of health financing and spending landscape - history and presence.

The Global South nations and their statehoods have presented a driving force of economic and social development through most of the written history of humankind. China and India have been traditionally accounted as the economic powerhouses of the past. In recent decades, we have witnessed reestablishment of the traditional world economic structure as per Agnus Maddison Project data. These profound changes have led to accelerated real GDP growth across many LMICs and emerging countries of the Global South. This evolution had a profound impact on an evolving health financing landscape. This review revealed hidden patterns and explained the driving forces behind the political economy of health spending in these vast world regions. The medical device and pharmaceutical industry play a crucial role in addressing the unmet medical needs of rising middle class citizens across Asia, Latin America, and Africa. Domestic manufacturing has only been partially meeting this ever rising demand for medical services and medicines. The rest was complemented by the participation of multinational pharmaceutical industry, whose focus on investment into East Asia and ASEAN nations remains part of long-term market access strategies. Understanding of the past remains essential for the development of successful health strategies for the present. Political economy has been driving the evolution of health financing landscape since the establishment of early modern health systems in these countries. Fiscal gaps these governments face in diverse ways might be partially overcome with the spreading of cost-effectiveness based decision-making and health technology assessment capacities. The considerable remaining challenges ranging from insufficient reimbursement rates, large out-of-pocket spending, and lengthy lag in the introduction of cutting-edge technologies such as monoclonal antibodies, biosimilars, or targeted oncology agents, might be partially resolved only in the long run.

Endocrine disruption caused by the aquatic exposure to aluminum and manganese in Astyanax altiparanae (Teleostei: Characidae) females during the final ovarian maturation.

Aluminum (Al) and manganese (Mn) can be toxic to aquatic biota and cause endocrine disruption in fish, affecting reproduction. This study evaluates the physiological responses of the ray-finned teleost fish Astyanax altiparanae vitellogenic females after acute exposure (96 h) to Al and Mn (alone and combined) in acid pH followed by the same period of exposure to metal-free water in neutral pH. The aim of this second period of exposure was to assess the recovery capacity from the toxic effects these metals. Five experimental groups were established: a control in neutral pH (Ctrl), and acidic pH (Ac), aluminum (Al), manganese (Mn), and Al + Mn groups, maintaining the acidic pH in the groups to which metals were added. The following biological parameters were evaluated: metal tissue concentration, relative fecundity (RF: absolute fecundity/body mass). Plasma levels of cortisol (proxy for stress) and 17α hydroxyprogesterone (17α-OHP), and gene expression of pituitary lhß mRNA (proxies for final maturation) were measured to evaluate endocrine disruption. In the synchronic exposure, the presence of Mn potentiated the accumulation of Al in gills. The females from acidic pH and Al groups showed a reduced RF. Exposure to Al and Mn triggered an endocrine disruption response, evidenced by a decrease in the plasma concentration of 17α-OHP and cortisol. Despite this anti-steroidogenic effect, no changes occurred in the pituitary gene expression of lhß. The endocrine changes and the metal accumulation were temporary, while the impacts on RF under the experimental conditions suggest permanent impairment in the reproduction of this species.

Aluminum bioconcentration in female Nile tilapia Oreochromis niloticus (Perciformes: Cichlidae) and the effects on pituitary gonadotropins.

In this study, we measured aluminum (Al) bioconcentration in the brain, ovaries, and liver of Oreochromis niloticus females, and analyzed the effects of exposure to Al and acidic pH on the gene expression of follicle-stimulating hormone (ßfsh) and luteinizing hormone (ßlh) in these animals. Mature females were divided into 4 groups, thus being maintained for 96 h in one of the following conditions: control at neutral pH (Ctr); Al at neutral pH (Al); acidic pH (Ac), and Al at acidic pH (Al-Ac). pH alone did not influence Al bioconcentration in the brain. The animals from the Al-Ac group bioconcentrated more Al in the ovaries than those from the Al group, while no differences were observed in the liver. Aluminum bioconcentration was higher in the brain than in the liver and ovaries in Al-exposed animals (Al and Al-Ac), and higher in the brain than in the ovaries in the Ctr and Ac groups. The liver bioconcentrates more Al than the ovaries in the females from the Ctr and Ac groups. Aluminum and/or acidic pH did not alter ßfsh gene expression, while ßlh gene expression decreased in females from the Al group. Aluminum acted as an endocrine disruptor, suggesting deleterious effects in reproduction that could result in ovulation failure. Aluminum can act directly and/or indirectly in the pituitary, affecting ovarian steroidogenesis and altering the reproductive endocrine axis of mature O. niloticus females in an acute period of exposure.

Plasma energetic substrates and hepatic enzymes in the four-eyed fish Anableps anableps (Teleostei: Cyprinodontiformes) during the dry and rainy seasons in the Amazonian Island of Maracá, extreme north of Brazil

ABSTRACT Anableps anableps is a viviparous teleost typical from Amazon Delta estuaries. It is representative of this biome in Maracá, which offers a potential for biomonitoring. The aim of this study is to apply different biomarkers to males and females of this species and verify possible seasonal influences on their physiology. To collect fish, three expeditions were carried out from the rainy season of April 2018 to the rainy season of February 2019. Biometric parameters and gonadosomatic (GSI), hepatosomatic (HSI), and viscerosomatic (VSI) indexes were calculated, and blood samples were taken to measure triglycerides, total proteins, glucose, and activity of the enzymes aspartate aminotransferase (AST), alanine aminotransferase (ALT), and alkaline phosphatase (ALP). The GSI of males is higher in the rainy season and of females in the dry season. This is probably related to the embryogenesis process. Males show an increase in biomass during the dry season, a metabolic homogeneity, and females show an increase in plasma glucose, triglycerides, and ALT activity. The tested biomarkers are potential for biomonitoring, preliminarily suggesting that there is a seasonal asynchronism between males and females of A. anableps as for the allocation of energy resources at different times of their life cycle.

RESUMO Anableps anableps é um teleósteo vivíparo típico de estuários do Delta do Rio Amazonas, sendo representativo deste bioma na ilha de Maracá, com potencial para o biomonitoramento. O objetivo deste estudo foi aplicar diferentes biomarcadores em machos e fêmeas desta espécie e verificar a possível influência sazonal em aspectos de sua fisiologia. Para a coleta dos peixes foram realizadas três expedições, de abril/2018 (estação chuvosa), setembro/2018 (estação seca) até fevereiro/2019 (estação chuvosa). Foram obtidos parâmetros biométricos, índices gonadossomático (IGS), hepatossomático (IHS), viscerossomático (IVS) e amostras de sangue para dosagem de triglicerídeos, proteínas totais, glicose e a atividade das enzimas aspartato aminotransferase (AST), alanina aminotransferase (ALT) e fosfatase alcalina (ALP). O IGS dos machos foi maior na estação chuvosa e das fêmeas na estação seca, isso provavelmente ocorreu devido ao processo de embriogênese. Os machos aumentaram a biomassa na estação seca e apresentaram homogeneidade metabólica, já as fêmeas apresentaram hiperglicemia, hipertrigliceridemia e maior atividade da ALT. Os biomarcadores testados mostraram-se promissores para o biomonitoramento, sugerindo de forma preliminar que há um assincronismo sazonal entre machos e fêmeas de A. anableps na alocação de recursos energéticos em diferentes momentos do seu ciclo de vida.

Nurses and the Manchester: rearranging the work process and emergency care? / Enfermeras y Manchester: ¿reconfigurando el proceso de trabajo y la atención de emergencia? / Os enfermeiros e o Manchester: reconfiguração do processo de trabalho e do cuidado em emergência?

ABSTRACT Objective: to understand the changing roles of nurses in labor division organization in hospitals from the Manchester Triage System implementation in an emergency hospital. Methods: this is an ethnographic study that used different production techniques and data analysis. Results: the Manchester Triage System organized flows and places resulting in quality of care and changes in work processes. Conflict relationships related to disagreements in risk stratification were present. Final considerations: the traditional roles of nurses have been transformed, but it cannot be said that there was a structural change in their position in labor division organization in hospitals. The frontiers of autonomy, therefore of increasing the professionalization of nurses, are neither fixed nor stable, expanding or contracting according to the micropolitical changes in the governance of care.

RESUMEN Objetivo: comprender los roles cambiantes de las enfermeras en la organización de la división del trabajo en el hospital desde la implementación del Sistema de Triaje Manchester en un hospital de urgencia y emergencia. Métodos: estudio etnográfico, utilizando diferentes técnicas de producción y análisis de datos. Resultados: el Sistema de Triaje Manchester organizó flujos y lugares, lo que resultó en calidad de atención y cambios en los procesos de trabajo. Estuvieron presentes relaciones conflictivas relacionadas con desacuerdos en la clasificación del riesgo. Consideraciones finales: los roles tradicionales de las enfermeras se han transformado, pero no se puede decir que hubo un cambio estructural en su posición en la organización de la división del trabajo en el hospital. Las fronteras de la autonomía, por tanto de incrementar la profesionalización del enfermero, no son fijas ni estables, ampliándose o contrayéndose según los cambios micropolíticos en la gobernanza del cuidado.

RESUMO Objetivos: compreender as mudanças de papéis dos enfermeiros na organização da divisão do trabalho no hospital a partir da implantação do Sistema Manchester de Classificação de Risco em hospital de urgência e emergência. Métodos: estudo etnográfico, com o emprego de diferentes técnicas de produção e de análise de dados. Resultados: o Sistema Manchester de Classificação de Risco organizou os fluxos e lugares, resultando em qualidade do cuidado e em mudanças nos processos de trabalho. Relações de conflito relacionadas às discordâncias na classificação do risco estiveram presentes. Considerações finais: os papé is tradicionais dos enfermeiros se transformaram, mas não se pode afirmar que houve mudança estrutural da posição deles na organização da divisão do trabalho no hospital. As fronteiras da autonomia, portanto de aumento de profissionalização dos enfermeiros, não são fixas nem estáveis, alargando ou contraindo de acordo com as mudanças micropolíticas da governabilidade do cuidado.

Enfermeiros na operacionalização do Kanban: novos sentidos para a prática profissional em contexto hospitalar? / Nurses in the Kanban: are there news meanings of professional practice in innovative tools for hospital care management?

Resumo O Kanban, uma tecnologia de gestão do cuidado caracterizada pela valorização do trabalho multiprofissional e o uso intensivo da informação, tem sido crescentemente utilizado para enfrentar a superlotação dos serviços de emergência hospitalar (SEH). Pesquisadores acompanharam durante dez meses o Kanban em vários setores de um SEH municipal. Suas observações, registradas em diários de campo, foram discutidos em reuniões quinzenais por um coletivo de pesquisadores. O material empírico foi organizado a partir de duas questões: Há mudanças nas "atribuições tradicionais" da enfermagem atuando no Kanban? Há transformações nas relações interprofissionais entre Medicina e Enfermagem na operacionalização do Kanban? Observou-se forte adesão dos enfermeiros ao arranjo, pari passu com uma maior especialização e fragmentação do seu trabalho. Os diaristas assumem funções administrativas tradicionais da enfermagem, enquanto os plantonistas desenvolvem assistência direta aos pacientes. Os enfermeiros consideram que a decisão clínica ainda é do médico, embora o Kanban propicie sua maior influência na decisão. A gestão de grande massa de dados clínico-operacionais pelos enfermeiros, central na operacionalização do Kanban, reforça sua autoridade profissional.

Abstract Kanban is a care management tool that values multi-professional work and intensive use of data and has been growingly used in Brazil to address overcrowding in hospital emergency services (HES). The researchers monitored the Kanban for ten months in multiple wards of a municipal HES, and their observations were recorded in field diaries and discussed in biweekly research team meetings. The empirical material was organized from two questions: Are there changes in "traditional attributions" of Kanban-operating nursing? Are Medicine-Nursing interprofessional relationships transformed? A strong nurse adherence to this tool was observed, coupled with greater specialization and fragmentation of their work: nurses working as diarists assume more traditional administrative functions, while those on-call develop more direct assistance to patients. Nurses consider that clinical decisions are still in the doctors' hands, although Kanban provides them with a stronger influence on such decisions. Nurses' role in the management of significant mass of clinical and operational data, central to Kanban's operationalization, strengthens their professional authority.

A gestão política da Covid-19 em Portugal: contributos analíticos para o debate internacional / The political management of Covid-19 in Portugal: analytical insights for the international debate

RESUMO À medida que a pandemia por SARS-CoV-2 alcança a escala planetária, multiplicam-se as respostas políticas de combate à doença Covid-19. Contudo, não só persiste a falta de evidência sobre os processos de tomada de decisão e os resultados obtidos - incluindo os colaterais - como também a análise de políticas não tem sido capaz de ultrapassar reportes descritivos que pouco acrescentam à compreensão teórica da gestão política dessa doença. Partindo do caso português, este ensaio visa contribuir para corrigir essas lacunas, em concreto: colaborar para a melhoria das respostas políticas e para a consolidação do debate teórico a respeito da tomada de decisão política em contexto de crises sanitárias. A reflexão desenvolve-se em torno da necessidade de clarificar os objetivos de gestão dos contágios (se é erradicar, gerir, ignorar ou se há incapacidade na gestão das cadeias de transmissão), sobre a qualidade da monitorização e limites da comparação internacional (as diferenças de metodologias e a importância dos rastreios) e sobre aspectos de como viver com a Covid-19 e a procura de normalidade (desafios no acesso à vacinação e relações com desigualdades sociais). A reflexão termina com a indicação de como o caso português ilustra as principais teorias de análise dos ciclos das políticas públicas.

ABSTRACT As the SARS-CoV-2 pandemics reaches the entire planet, the political responses to dealing with the coronavirus disease Covid-19 have flourished. However, not only has the evidence on decision-making and outcomes - including the side effects - lacked, but also policy analysis has not been able to overcome an overly descriptive nature that brings too little to the theoretical understanding of the political management of Covid-19. Building on the Portuguese case, this essay aims to contribute to fill in such blanks, notably by contributing to the improvement of political responses and consolidation of the theoretical debate about political decision-making in the context of health crises. The reflection expands on the need to clarify the goal of the management of contagions (whether the aim is to eradicate, manage, ignore or if there is an inability to manage the transmission chains), on the quality of monitoring and limits of international comparisons (different methodologies and the importance of mass screening), and on aspects of living with Covid-19 and the pursuit for normality (challenges in the access to vaccination and connections with broader social inequalities). The reflection ends by showing how the Portuguese case resonates on some of the key theories of the analysis of public policies cycles.

Os médicos e a gestão do cuidado em serviços hospitalares de emergência: poder profissional ameaçado? / Physicians and management of emergency hospitals: professional power threatened? / Los médicos y la gestión del cuidado en servicios hospitalarios de urgencia: ¿un poder profesional amenazado?

Resumo: O Kanban é um arranjo tecnológico de organização do cuidado hospitalar orientado para a gestão de leitos e da clínica, que visa à qualidade e integralidade da assistência, maior rotatividade dos leitos, com consequente redução do tempo de internação e custos hospitalares. O constante e atualizado acompanhamento do paciente, compartilhado pela equipe profissional em reuniões sistemáticas é seu elemento mais marcante e inovador. O objetivo foi caracterizar os prováveis impactos da adoção de tal arranjo no poder profissional (autonomia e autoridade) dos médicos. Estudo qualitativo em hospital de urgência-emergência municipal com uso das seguintes técnicas de produção de dados: etnografia do cotidiano do hospital, com observação e registro em diários de campo, e realização de seminários compartilhados entre pesquisadores e equipes. Os médicos valorizam o trabalho multiprofissional como um qualificador de sua prática, em uma linha auxiliar e complementar. Acresce que o Kanban tende a ser controlado por "híbridos" (médicos que acumulam funções gerenciais e clínicas) que traduzem sinergias entre "gestão clínica" e "gestão de leitos". Assim, interferências no trabalho dos médicos não são exercidas de fora, e as suas decisões clínicas continuam a condicionar o trabalho dos demais grupos profissionais. Os médicos não percebem sua autoridade e autonomia ameaçadas pelo Kanban, dada a articulação entre a autoridade administrativa e a autoridade profissional. Contudo, aspectos relacionados à hibridização e estratificação interna da profissão médica precisam ser mais convocados para o debate do poder profissional em saúde.

Abstract: Kanban is a technical arrangement for the organization of hospital care focused on the management of beds and clinical care, aimed at the quality and comprehensiveness of care and greater hospital bed turnover, and thus a reduction in length-of-stay and hospital costs. The system's most striking and innovative feature is constant, updated patient follow-up, shared by the professional team in systematic meetings. Characterize the probable impacts from the arrangement's adoption on physicians' professional power (autonomy and authority). Qualitative study in a municipal urgency-emergency hospital using the following data production techniques: ethnography of the hospital's routine, with observation and records in field diaries, and shared seminars with researchers and teams. Physicians value multi-professional work for qualifying their practice, as an ancillary and complementary line. Kanban tends to be controlled by "hybrids" (physicians who accumulate management and clinical functions) that express synergies between "clinical management" and "hospital bed management". Thus, in this arrangement interferences in physicians' work are not exercised from outside, and physicians' clinical decisions still condition the work of the other professional groups. Physicians do not see their authority and autonomy threatened by Kanban, given the linkage between management authority and professional authority. Still, aspects related to hybridization and internal stratification of the medical profession need to be better addressed in the debate on health professionals' power.

Resumen: El Kanban es una solución tecnológica para la organización del cuidado hospitalario, orientada a la gestión de camas y apartado clínico, que tiene como meta la calidad e integralidad de la asistencia, una mayor rotatividad de las camas, con la consecuente reducción del tiempo de internamiento y costes hospitalarios. El seguimiento constante y actualizado del paciente, compartido por un equipo profesional en reuniones sistemáticas, es su característica más destacable e innovadora. Caracterizar los probables impactos en la adopción de tal solución tecnológica, respecto al poder profesional (autonomía y autoridad) de los médicos. Estudio cualitativo en un hospital de urgencias municipal, mediante el uso de las siguientes técnicas de producción de datos: etnografía del día a día del hospital, con observación y registro en diarios de campo, así como la realización de seminarios compartidos entre investigadores y equipos. Los médicos valoran el trabajo multiprofesional como un elemento que cualifica en su práctica, dentro de una línea auxiliar y complementaria. Añade que el Kanban tiende a estar controlado por "híbridos" (médicos que acumulan funciones de gerencia y clínicas) que se traducen en sinergias entre "gestión clínica" y "gestión de camas". De esta forma, las interferencias en el trabajo de los médicos no se ejercen a partir de fuera y sus decisiones clínicas continúan condicionando el trabajo de los demás grupos profesionales. Los médicos no perciben que su autoridad y autonomía estén amenazadas por el Kanban, dada la coordinación entre la autoridad administrativa y la autoridad profesional. No obstante, los aspectos relacionados con la hibridización y estratificación interna de la profesión médica necesitan ser estudiados más para los debates sobre el poder profesional en salud.

Water temperature and acid pH influence the cytotoxic and genotoxic effects of aluminum in the freshwater teleost Astyanax altiparanae (Teleostei: Characidae).

The toxicity of metals, including aluminum (Al), can be potentiated by temperature and acid pH, a concern in view of the current global warming scenario. The aim of this study was to evaluate the bioconcentration of Al in the testes and semen of Astyanax altiparanae and the potential of this metal, at different environmental temperatures and acid pH, to cause cytotoxicity and genotocixity in erythrocytes and spermatozoa. A. altiparanae males were divided into nine experimental groups: at each of three different water temperatures (20, 25 and 30 °C), the fish were exposed to a neutral pH, an acid pH and acidic water containing Al (0.5 mg.L-1). The fish were subjected to subacute, semi-static exposure and sampled at 24 and 96 h. After each exposure period the comet assay (blood and semen) and micronucleus test (blood) were performed. Bioconcentration of Al was evaluated in the testes and semen. Exposure time and temperature influenced the Al bioconcentration pattern in the testes. Al concentration in the semen was higher in fish exposed at 20 and 25 °C (24 h). The DNA fragmentation score for the semen and blood was higher in fish exposed to Al at 20 (24 h) and 30 °C (96 h). The frequency of nuclear abnormalities in erythrocytes was higher in the group exposed to Al at 30 °C (96 h). It was concluded that Al bioconcentrates in the testes and semen of A. altiparanae at different temperatures and is potentially cytotoxic and genotoxic to erythrocytes and spermatozoa in this species.

Stress-reducing and anesthetic effects of the essential oils of Aloysia triphylla and Lippia alba on Serrasalmus eigenmanni (Characiformes: Serrasalmidae)

Anesthetic effect of Aloysia triphylla and Lippia alba essential oils (EOs) in the Amazonian fish Serrasalmus eigenmanni was evaluated. The fish were placed in aquaria containing A. triphylla or L. alba EOs (25 to 200 µL L-1). Then, fish were transferred to aquaria containing EO-free water to evaluate their recovery time. In another experiment, fish were transferred to aquaria containing A. triphylla or L. alba EOs (3 to 10 µL L-1) and swimming behavior was analyzed for up to 240 min of exposure. Water samples were collected at 0 and 240 min and blood samples were collected at 240 min. Tested concentrations induced all stages of anesthesia, except 25 µL L-1 A. triphylla EO and 50 µL L-1 L. alba EO, which only induced sedation. Prolonged exposure to both EOs reduced swimming time compared to the control at all evaluated times. The fish exposed to 3 µL L-1 A. triphylla EO showed a lower net K+ efflux compared to ethanol-exposed fish; in those exposed to 5 µL L-1, ammonia excretion was reduced. The blood parameters did not show significant differences between treatments. In conclusion, both EOs can be used as anesthetics and sedatives for transport of S. eigenmanni.(AU)

Avaliou-se o efeito anestésico dos óleos essenciais de Aloysia triphylla e de Lippia alba no peixe amazônico Serrasalmus eigenmanni. Os peixes foram colocados em aquários contendo OEs de A. triphylla ou L. alba (25 a 200 µL L-1). Após, foram transferidos para aquários com água sem anestésicos para avaliar o tempo de recuperação. Em outro experimento, peixes foram transferidos para aquários contendo OEs de A. triphylla ou L. alba (3 a 10 µL L-1) e o comportamento natatório foi analisado até 240 min de exposição. Foram coletadas amostras de água em 0 e 240 min e de sangue em 240 min. As concentrações testadas induziram todos estágios de anestesia, exceto 25 µL L-1 OE de A. triphylla e 50 µL L-1 OE de L. alba, que causaram somente sedação. Exposição prolongada a ambos OEs reduziu o tempo de natação comparado ao controle. Peixes expostos a 3 µL L-1 OE de A. triphylla apresentaram menor efluxo de K+ comparado aos expostos ao etanol e nos expostos a 5 µL L-1 a excreção de amônia reduziu. Parâmetros sanguíneos não diferiram entre tratamentos. Conclui-se que ambos OEs podem ser utilizados como anestésicos e no transporte de S. eigenmanni.(AU)

[Neither a hero nor a villain: elements of medical practice in primary care]. / Nem herói, nem vilão: elementos da prática médica na atenção básica em saúde.

This article describes the elements present in medical practice that contribute to understand its acknowledged low adhesion to the guidelines set forth by the Brazilian Primary Health Care (PHC) Policy. The empirical material produced by the two investigations of a qualitative nature led by the research team were put into use. In the first, in interviews involving managers and social control in cities the State of São Paulo, Brazil, physicians (acknowledged as central professionals for the construction of the Brazilian Unified Health System - SUS), are referred to as important assets to explain the difficulties to form a qualified primary health care service: the so-called "villain physicians." In the latter, ethnographic/cartographic research carried out in seven PHC Units in cities of São Paulo, with the use of scenes showing the doctors in action and/or thinking about their jobs, and the health team observing their work, more complex physicians emerge: fragile professionals with a reduced set of instruments to act before the "social factor" that invade their practices, threatened in their autonomy, finding it hard to engage in teamwork, dispossessed of their regulatory functions, and unaware of the space reserved for primary practices: decidedly human physicians - neither heroes nor villains.

O artigo sistematiza e discute elementos presentes na prática médica que contribuam para uma melhor compreensão da sua reconhecida baixa adesão às diretrizes da Política Nacional de Atenção Básica (PNAB). Para tanto, fez uso de material empírico produzido em duas investigações de caráter qualitativo conduzidas pelo mesmo grupo de pesquisa. Na primeira, entrevistas feitas com dirigentes gestores e controle social de dois municípios paulistas, os médicos são apontados como explicação importante para as dificuldades de se construir uma atenção básica qualificada e resolutiva: um "médico vilão". Na segunda, utilizou-se observação direta do cotidiano em sete unidades básicas de saúde em três municípios paulistas, com registros de cenas do médico em ação e/ou quando reflete sobre seu trabalho ou quando observado pela equipe. Emerge assim um médico mais complexo, fragilizado, com instrumental reduzido para atuar perante o "social" que invade seu consultório, ameaçado em sua autonomia profissional, com dificuldade de integrar-se ao trabalho em equipe, expropriado das funções regulatórias e nem sempre com clareza do lugar reservado para a clínica na atenção básica: um médico humano, demasiado humano, nem herói, nem vilão.

Nem herói, nem vilão: elementos da prática médica na atenção básica em saúde / Neither a hero nor a villain: elements of medical practice in primary care

Resumo O artigo sistematiza e discute elementos presentes na prática médica que contribuam para uma melhor compreensão da sua reconhecida baixa adesão às diretrizes da Política Nacional de Atenção Básica (PNAB). Para tanto, fez uso de material empírico produzido em duas investigações de caráter qualitativo conduzidas pelo mesmo grupo de pesquisa. Na primeira, entrevistas feitas com dirigentes gestores e controle social de dois municípios paulistas, os médicos são apontados como explicação importante para as dificuldades de se construir uma atenção básica qualificada e resolutiva: um "médico vilão". Na segunda, utilizou-se observação direta do cotidiano em sete unidades básicas de saúde em três municípios paulistas, com registros de cenas do médico em ação e/ou quando reflete sobre seu trabalho ou quando observado pela equipe. Emerge assim um médico mais complexo, fragilizado, com instrumental reduzido para atuar perante o "social" que invade seu consultório, ameaçado em sua autonomia profissional, com dificuldade de integrar-se ao trabalho em equipe, expropriado das funções regulatórias e nem sempre com clareza do lugar reservado para a clínica na atenção básica: um médico humano, demasiado humano, nem herói, nem vilão.

Abstract This article describes the elements present in medical practice that contribute to understand its acknowledged low adhesion to the guidelines set forth by the Brazilian Primary Health Care (PHC) Policy. The empirical material produced by the two investigations of a qualitative nature led by the research team were put into use. In the first, in interviews involving managers and social control in cities the State of São Paulo, Brazil, physicians (acknowledged as central professionals for the construction of the Brazilian Unified Health System - SUS), are referred to as important assets to explain the difficulties to form a qualified primary health care service: the so-called "villain physicians." In the latter, ethnographic/cartographic research carried out in seven PHC Units in cities of São Paulo, with the use of scenes showing the doctors in action and/or thinking about their jobs, and the health team observing their work, more complex physicians emerge: fragile professionals with a reduced set of instruments to act before the "social factor" that invade their practices, threatened in their autonomy, finding it hard to engage in teamwork, dispossessed of their regulatory functions, and unaware of the space reserved for primary practices: decidedly human physicians - neither heroes nor villains.

Seeder performance under different pressures of vaccum and fuel consumption to soybean seeds / Deposição de sementes de soja em diferentes pressões de vácuo e consumo de combustível

In pneumatic precision seeders, the regularity in seeds deposition is essential for a proper sowing process. Thus, the aim of this study was to verify the accuracy in the soy beans seed capturing in different vacuum pressures (3.5 kPa; 4.0 kPa; 5.0 kPa; 5.5 kPa and 6.0 kPa), the seed distribution in the seed lines as well as the fuel consumption in the tractor-seed set. The experiment was carried out at the College of Agronomy ­ FCA/UNESP, Botucatu-SP. The outline was random blocks, in subplots layout banded of 30 × 3.15 m, with four replicates per treatment. A tractor-seeder set was used to collect the sample of fuel consumption and seed population. The real population of seed was collected in plastic bags fastened to the end of the conductor pipe, obtaining the population of the 5 central lines of the seeders. The acquisition of the fuel consumption data for each plot, was carried out using a flow meter. Thus, it was observed that the seeder distribution on the vacuum pressure at 3.5; 4.0 and 5.5 kPa decreased in the farthest lines when compared to the central lines. For the hourly fuel consumption, per area and also for the deposition of seeds the regularity in the distribution of seeds is affected when there is vacuum pressure below 5.0 kPa and, consequently, highest consumption. For soybean sowing, seeds having the characteristics described in this study, it is recommended to use vacuum pressure of 6.0 kPa. As a result, this vacuum pressure leads to the lowest fuel consumption per hour, 11.49 L h¯¹ and worked area, 7.35 L ha¯¹.

Nas semeadoras de precisão pneumáticas a regularidade na deposição de sementes é primordial para uma correta semeadura. Assim, o objetivo deste estudo foi verificar a acurácia na captura de sementes de soja em diferentes pressões de vácuo (3,5 kPa; 4 kPa; 5 kPa; 5,5 kPa e 6 kPa), a distribuição das sementes nas linhas da semeadora e, também, verificar o consumo de combustível do conjunto trator-semeadora. Realizou-se o experimento na Faculdade de Ciências Agronômicas ­ FCA/UNESP, Botucatu-SP. O delineamento experimental foi de blocos ao acaso, em esquema de subparcelas (faixas de 30 × 3,15 m), com quatro repetições por tratamento. Um conjunto trator-semeadora foi utilizado coletando-se as amostras de consumo de combustível e população de sementes. Sendo as sementes coletadas em sacos plásticos fixados ao final do tubo condutor, obtendo as populações das 5 linhas centrais da semeadora. A obtenção dos dados de consumo de combustível para cada parcela foi realizada utilizando-se um fluxômetro. Assim verificou-se que a distribuição de sementes nas pressões de vácuo 3,5; 4 e 5,5 kPa decrescem nas linhas mais distantes do centro da semeadora. Para o consumo de combustível horário, por área e deposição de sementes verifica-se que a regularidade na distribuição de sementes é afetada quando se tem pressões de vácuo abaixo de 5 kPa e, consequentemente, maiores consumos. Para semeadura de soja, com as características das sementes como neste trabalho, é recomendando utilizar a pressão de vácuo de 6 kPa. Apresentando esta pressão de vácuo menor consumo de combustível por hora, 11,49 L h¯¹ e área trabalhada, 7,35 L ha¯¹.

Surface modification of an intraocular lens material by plasma-assisted grafting with 2-hydroxyethyl methacrylate (HEMA), for controlled release of moxifloxacin.

Endophthalmitis, an inflammation of the eye due to perioperative infection, may occur after cataract surgery. Intraocular lenses (IOLs) loaded with an antibiotic have been proposed asan alternative to the conventional postoperative endophthalmitis prophylaxis, since the antibiotic is delivered directly to the target site. In this work, an IOL-based antibiotic releasing system was prepared from a copolymer used in the production of IOLs and a fluoroquinolone used in endophthalmitis prophylaxis (moxifloxacin, MFX). Argon plasma-assisted grafting with 2-hydroxyethyl methacrylate (HEMA) in the presence of MFX was the approach selected for surface modification, with MFX loaded both by entrapment in the grafted polyHEMA coating and by soaking. Surface and bulk properties were evaluated before and after surface modification and the MFX release profiles were obtained both in batch mode (sink conditions) and under hydrodynamic conditions, employing a purpose-built microfluidic cell, which simulated the hydrodynamic conditions around the eye lens. The effect of storage on the release profile of the best system was also assessed. The best system released MFX for ca. 15days above the minimum inhibitory concentration for Staphylococcus aureus and Staphylococcus epidermidis. The released MFX showed antimicrobial activity against these bacteria and was non-cytotoxic against corneal endothelial cells.

Nickel toxicity to cardinal tetra (Paracheirodon axelrodi) differs seasonally and among the black, white and clear river waters of the Amazon basin.

This study investigated the acute toxicity of nickel (Ni) to cardinal tetra (Paracheirodon axelrodi), within the three main water types of the Amazon basin: black (Rio Negro), white (Rio Solimões) and clear (Rio Tapajós) during the wet and dry season at pH 7 (representative of white and clear rivers) and pH 4 (representative of black waters). The influence of dissolved organic carbon (DOC) quality on Ni toxicity within the three waters was also explored via the use of DOC isolates. Differences in water chemistry, DOC quality and ion concentrations were shown between waters and between seasons. Toxicity of Ni was shown to vary between river waters, seasons, and pHs. Ni was significantly less toxic during the dry season at pH 4 in all three river waters; for example, black water during the wet season had an LC50 of 9.72 mg Ni/L compared to 41.5 mg Ni/L during the dry season. At pH 7, contrasting effects in toxicity between seasons were shown between black and clear waters (black: wet = 28.9 mg/L, dry = 17.3 mg/L; clear: wet = 13.8 mg/L, dry = 24.1 mg/L). There were no significant differences in Ni toxicity for white waters at pH 7 (white: wet = 22.2 mg/L, dry = 21.8). Overall, Ni was shown to be more toxic at pH 7 than at pH 4 except in black water during the wet season. Toxicity of Ni at pH 4 was positively related to DOC concentration and amount of humic-like and fulvic-like DOC and negatively related to fluorescence index. Therefore, at pH 4, Ni is more toxic in waters containing more allochthonous DOC, consisting of higher amounts of humic-like and fulvic-like components. LC50 values for the different DOC concentrates at the same DOC concentration of 4.5 mg/L (black: 26.8 mg/L; white: 73.3 mg/L; clear: 49.2) support the river water findings at pH 4 (Ni more toxic in presence of black DOC) indicating that DOC quality alone can influence Ni toxicity at this pH.