Exploration of Spectrum-effect Relationship of Zhuriheng Dropping Pills Against Macrophage Foaming Based on UPLC-Q-Exactive Orbitrap MS / 中国实验方剂学杂志

ObjectiveThrough the correlation analysis between intestinal absorption profile and inhibition of macrophage foaming， the pharmacodynamic components of Zhuriheng dripping pills（ZRH） were explored to provide a basis for establishing its quality standard. MethodIntestinal absorption fluids with 0， 5， 10， 15， 20 times clinical equivalent doses were prepared by a rat everted gut sac（EGS）， and the oxidized low density lipoprotein（ox-LDL）-induced RAW264.7 macrophage foaming model was used to investigate the effect of intestinal absorption fluid with different doses on the accumulation of lipids in RAW264.7 cells by oil red O staining and cholesterol content determination， and to screen for the optimal dose. Ultra performance liquid chromatography-quadrupole-electrostatic field orbitrap high-resolution mass spectrometry（UPLC-Q-Exactive Orbitrap MS） was used to analyze and identify intestinal absorption fractions of ZRH intestinal absorption fluids， and partial least squares-discriminant analysis（PLS-DA） and orthogonal partial least squares-discriminant analysis（OPLS-DA） were performed on different doses of ZRH intestinal absorption fluids using SIMCA 13.0 with peak area as the independent variable and the pharmacodynamic indicators as the dependent variables to screen the compounds with variable importance in the projection（VIP） value>1.0 as contributing components， and Pearson correlation analysis was used to determine the spectral effect relationship， determined the compounds and positive correlation with pharmacodynamic were as active ingredients. Molecular docking was used to verify the binding energy of peroxisome proliferator-activated receptor α（PPARα）， PPARγ， PPARβ， human retinoid X receptor α（RXRA） and nuclear transcription factor-κB（NF-κB） with the active ingredients in ZRH intestinal absorption fluids. Real-time fluorescence quantitative polymerase chain reaction（Real-time PCR） was performed to detect the mRNA levels of PPARγ， scavenger receptor A1（SRA1） and adenosine triphosphate-binding cassette transporter A1（ABCA1） in RAW264.7 cells， Westen blot was used to detect the expression level of PPARγ protein in RAW264.7 cells， and enzyme-linked immunosorbent assay（ELISA） was used to detect the levels of interleukin（IL）-1β and NF-κB in RAW264.7 cells. ResultAccording to the results of oil red O staining and cholesterol content determination， the ZRH intestinal absorption fluids could significantly reduce macrophage foaming， and intestinal absorption fluids with 15， 20 times clinical equivalent doses had the best effect， the 15-fold ZRH intestinal absorption fluid was finally determined as the study subject. Spectral effect relationship showed that 52 corresponding peaks in the ZRH-containing intestinal fluid were positively correlated with the efficacy， including organic acids， phenylpropanoids， iridoids， flavonoids， bile acids， coumarins and chromones. Target validation results showed that 86.9%-96.2% of the total components processed good binding activities with the key targets of PPARα， PPARγ， PPARβ， RXRA and NF-κB， and the docking energy values were all less than -6.0 kcal·mol-1（1 cal≈4.19 J）. The results of validation showed that， compared with the normal group， the model group showed a significant increase in the levels of SRA1 and PPARγ mRNA expression， a significant decrease in ABCA1 mRNA expression， a significant increase in the level of PPARγ protein expression， and a significant increase in the levels of IL-1β and NF-κB（P<0.01）， compared with the model group， the 15-fold intestinal absorption fluid group showed a significant decrease in the levels of SRA1 and PPARγ mRNA expression（P<0.05， P<0.01）， ABCA1 mRNA expression level was significantly up-regulated， the levels of IL-1β and NF-κB were significantly reduced（P<0.01）， and PPARγ protein expression level was significantly reduced（P<0.05）. ConclusionThis study identifies 52 components and their metabolites in ZRH intestinal absorption fluid that are positively correlated with the inhibition of macrophage foaming， which may be related to the regulation of the PPARs pathway in cells and the reduction of the levels of inflammatory factors， and can provide a reference for the quality control and clinical application of ZRH.

On the Relationship between Doctors and Patients in Court in Qing Dynasty from the Perspective of Famous Doctors’ Diary / 中国医学伦理学

In Qing Dynasty, doctor-patient relationship in the imperial court had distinct characteristics because of the particularity of the objects of diagnosis and treatment. Diaries of famous doctors has become an important research material from a unique perspective. Ji En Lu and Bei Xing Ri Ji contain many research materials on doctor-patient relationship in Qing Palace. By systematically sorting out the contents of the royal doctor-patient relationship in the two diaries, and analyzing them in detail from the three dimensions of doctors, patients and diagnosis and treatment situations, it can be known that patients’ strong performance will interfere with the diagnosis and treatment process to a great extent, and doctors’ low status makes it difficult for them to cope with the complicated diagnosis and treatment environment and affects the curative effect. Learn from the past and the present, further provide reference for the current patient strong special doctor-patient relationship.

Ethical Challenges and Countermeasures of Doctor-patient Relationship in the Context of Artificial Intelligence Medical Treatment / 中国医学伦理学

Medical Artificial Intelligence (AI) makes the traditional doctor-patient relationship present a new pattern, but also highlights many ethical problems: inability to protect the rights and interests of patients, weakening the main responsibility of medical personnel, weakening the practical ability of medical personnel, and challenging the main status of medical personnel, etc.. It is necessary to improve relevant laws, regulations and regulatory system, adhere to the main status of medical personnel, improve the public awareness and acceptance of medical AI, and strengthen the construction of ethical system of AI, so as to deal with the ethical anomie caused by intelligent medical treatment and promote the harmonious development of doctor-patient relationship. It is expected that through the combination of AI and professional ethics principles, AI will be brought into daily clinical practice responsibly, to provide patients with better medical services.

The Health Thoughts and Contemporary Enlightenment of Aristotle / 中国医学伦理学

In the Nicomachean Ethics, Aristotle expounded his thoughts on health by analogy. Through summarizing Aristotle’s main thoughts on health, which including clarifying that the purpose of medicine is health, thinking that only moderation can create, promote and maintain health, emphasizing active-passive doctor-patient relationship, and generally respecting medical discipline and healthy life, this paper founded that his thoughts on health have obvious limitations. The limitations included: ignored the purpose of medicine also included group health; the "moderation" theory lacked accuracy and scientificity; weakened the patient’s right to speak in the doctor-patient relationship and did not give a clear guide to "how to live a healthy life". And then explored the enlightenment of Aristotle’s health thoughts to the development of contemporary society.

Research on Ethical Sensitivity of Medical Staff and Its Countermeasures: Take Pediatric Medical Staff as an Example / 中国医学伦理学

Ethical sensitivity is a behavioral concept emerging in recent years, which has attracted high attention from all sectors of society. Ethical sensitivity not only affects the clinical decision-making, doctor-patient relationship and medical quality of medical staff, but also provides the possibility to identify, predict and solve ethical problems in clinical. Combined with previous studies, this paper analyzed the current situation of ethical sensitivity of medical personnel in China, and took pediatric medical staff as an example to analyze the factors affecting the ethical sensitivity of medical staff from clinical practice and related theories, including age, working years, occupational categories, education level, work environment, empathy ability, etc. At the same time, this paper analyzed the causes of the ethical sensitivity of medical staff from the perspective of clinical practice and related systems, and put forward corresponding countermeasures, so as to improve the ethical sensitivity of medical staff and help to build a harmonious doctor-patient relationship.

Reflections on Doctor-patient Relationship Caused by COVID -19 Epidemic Prevention and Control / 中国医学伦理学

The COVID -19 epidemic not only brings heavy burden to the society, but also makes the originally tense doctor-patient relationship closely connected from another aspect, which objectively becomes a new opportunity to improve the doctor-patient relationship. By comparing and analyzing the current situation of the doctor-patient relationship before and after the COVID -19 epidemic, this paper discussed the causes of tension between doctors and patients, and proposed corresponding solutions, so as to promote the continuation and development of highly harmonious doctor-patient relationship during the COVID -19 epidemic prevention and control period in the future.

Humanistic Care for the Prevention of Perioperative Hypothermia in the Elderly / 中国医学伦理学

The intervention and prevention of perioperative hypothermia is not only reflected in the technical level, but also reveals the important role of humanistic care in the whole intervention work. If perioperative patients have hypothermia, it is likely to cause a series of complications such as postoperative shivering, which seriously threatens the life safety of patients. Prevention and intervention was based on a comprehensive understanding of the causes and hazards of hypothermia, especially the impact on the lives of the elderly. Effective supervision was implemented in the whole process of operation, such as dynamic monitoring of vital signs including body temperature, followed by room temperature regulation, body temperature protection and preoperative and postoperative psychological nursing. At this time, the sense of responsibility, good humanistic care of medical staff are of positive significance to effectively prevent and reduce the probability of perioperative hypothermia and accelerate the postoperative rehabilitation of patients.

Practice and Reflection on Building Community of Doctor-patient in Foreign Aid Medical Work: Taking the Eighth Batch of China (Shaanxi) Medical Team Assisting Malawi as an Example / 中国医学伦理学

China’s foreign aid medical work is an important part of development of friendly relations with foreign countries and an important way to build a human health community. African countries generally have backward economic and social development, poor medical and health conditions and different languages and cultures, which makes the development of foreign aid medical work special and challenging. Foreign aid doctors and local patients share common feelings, mutual respect, equality, mutual trust and sincere cooperation, and building a community of destiny with the common goal of defeating diseases is an essential content to promote the health of the people of the recipient countries and realize the community of human health. Taking the work practice of the eighth batch of China (Shaanxi) medical team assisting Malawi as an example, this paper expounded the specific practice of building a community of doctor-patient in foreign aid medical work and discussed its significance, to provide theoretical and practical basis for the smooth development of foreign aid medical work in the future.

Research on the Significance and Path of Standardizing Patients’ Obligations from the Perspective of Building the Community of Doctor-patient / 中国医学伦理学

One of the crux of the problem of doctor-patient relationship is the uneven division of rights and obligations between doctors and patients. Among them, it is significantly essential to emphasize the patient’s obligation as a weak point. The reasons cover many aspects. On the one hand, it is of great significance to standardize patient obligations: the definition of patients’ obligations is better health protection for patients; the emphasis on patients’ obligations is the moral support for doctors’ responsibilities; the fulfillment of patients’ obligations promotes the win-win interests of doctors and patients. On the other hand, the current situation of standardizing patients’ obligations is not optimistic: the provisions of patients’ obligations in existing laws and regulations are not ideal; the current ethical discussion on patient obligations also needs to be deepened. Therefore, in order to standardize patients’ obligations, build harmonious doctor-patient relationship and build a community of doctor-patient, this paper put forward specific suggestions from three aspects: improving laws and regulations, standardizing the management of medical institutions and enhancing patients’ literacy.

Structure-based development of potent and selective type-II kinase inhibitors of RIPK1

Receptor-interacting serine/threonine-protein kinase 1 (RIPK1) functions as a key regulator in inflammation and cell death and is involved in mediating a variety of inflammatory or degenerative diseases. A number of allosteric RIPK1 inhibitors (RIPK1i) have been developed, and some of them have already advanced into clinical evaluation. Recently, selective RIPK1i that interact with both the allosteric pocket and the ATP-binding site of RIPK1 have started to emerge. Here, we report the rational development of a new series of type-II RIPK1i based on the rediscovery of a reported but mechanistically atypical RIPK3i. We also describe the structure-guided lead optimization of a potent, selective, and orally bioavailable RIPK1i, 62, which exhibits extraordinary efficacies in mouse models of acute or chronic inflammatory diseases. Collectively, 62 provides a useful tool for evaluating RIPK1 in animal disease models and a promising lead for further drug development.

Estrategia para fomentar el principio de beneficencia en la comunicación entre el logofonoaudiólogo, el paciente afásico y su familia

Introducción: La comunicación por parte del logofonoaudiólogo con el paciente afásico y su familia garantiza el bienestar biopsicosocial de estos y favorece una adecuada relación médico-paciente. Objetivo: Evaluar una propuesta de estrategia para el fomento del principio de beneficencia entre el logofonoaudiólogo, el paciente afásico y su familia en el Policlínico Universitario Dr. René Vallejo Ortiz, ciudad de Manzanillo, Granma, Cuba. Método: Fue aplicada la técnica de Iadov o criterio de usuario que permitió evaluar la propuesta. Para ello se encuestaron 15 logofonoaudiólogos de la provincia de Granma, Cuba, se escogieron de manera intencional 10, cuyas cualidades cumplían los requisitos exigidos para ser considerados usuarios. Se utilizaron diferentes métodos, técnicas y procedimientos para procesar y analizar los datos recogidos. La escala valorativa Likert facilitó la interpretación cualitativa de los datos recogidos. Resultados: Desde el criterio individual el 60 % de los usuarios consideró la propuesta bastante adecuada; la valoración más baja fue de adecuada (20 %). El cálculo de la valoración grupal, el índice obtenido (0,5 %) le confirió confiabilidad a la propuesta para ser implementada. Conclusiones: Los usuarios consideran que la propuesta de estrategia cumple con los requisitos para la aplicación. No obstante, existen algunos elementos que pudieran dificultar la ejecución de la misma: la incorrecta preparación científico-metodológica de los facilitadores, el uso inadecuado de los métodos y técnicas educativas, así como la negativa de aquellos logofonoaudiólogos que no concienticen la necesidad de alcanzar modos de actuación acorde a los principios y valores profesionales.

Introduction: Communication by the speech-language pathologist with the aphasic patient and his family guarantees their biopsychosocial well-being and promotes an adequate doctor-patient relationship. Objective: To evaluate a proposed strategy to promote the principle of beneficence between the speech-language pathologist, the aphasic patient and their family at the Policlínico Universitario Dr. René Vallejo Ortiz, Manzanillo city, Granma province, Cuba. Method: The Iadov technique or user criteria was applied that allowed the proposal to be evaluated. For this, 15 speech-language pathologists from the province of Granma, were surveyed; 10 were intentionally chosen, whose qualities met the requirements to be considered users. Different methods, techniques and procedures were used to process and analyze the data collected. The Likert rating scale facilitated the qualitative interpretation of the data collected. Results: From individual criteria, 60% of users considered the proposal quite appropriate; the lowest rating was adequate (20%). The calculation of the group assessment, the index obtained (0.5%) conferred reliability to the proposal to be implemented. Conclusions: Users consider that the strategy proposal meets the requirements for the application. However, there are some elements that could make its execution difficult: the incorrect scientific-methodological preparation of the facilitators, the inappropriate use of educational methods and techniques, as well as the refusal of those speech-language pathologists who do not raise awareness of the need to achieve methods. of action in accordance with professional principles and values.

Introdução: A comunicação do fonoaudiólogo com o paciente afásico e sua família garante o seu bem-estar biopsicossocial e promove uma adequada relação médico-paciente. Objetivo: Avaliar uma proposta de estratégia para promover o princípio da beneficência entre o fonoaudiólogo, o paciente afásico e sua familia na Policlínico Universitario Dr. René Vallejo Ortiz, cidade de Manzanillo, Granma, Cuba. Método: Foi aplicada a técnica de Iadov ou critérios de usuário que permitiram avaliar a proposta. Para isso, foram entrevistados 15 fonoaudiólogos da província de Granma, foram escolhidos 10 intencionalmente, cujas qualidades atendiam aos requisitos para serem considerados usuários. Diferentes métodos, técnicas e procedimentos foram utilizados para processar e analisar os dados coletados. A escala de classificação Likert facilitou a interpretação qualitativa dos dados coletados. Resultados: A partir de critérios individuais, 60% dos usuários consideraram a proposta bastante adequada; a classificação mais baixa foi adequada (20%). No cálculo da avaliação do grupo, o índice obtido (0,5%) conferiu confiabilidade à proposta a ser implementada. Conclusões: Os usuários consideram que a proposta de estratégia atende aos requisitos para aplicação. Porém, existem alguns elementos que podem dificultar sua execução: o incorreto preparo científico-metodológico dos facilitadores, o uso inadequado de métodos e técnicas educativas, bem como a recusa dos fonoaudiólogos que não conscientizam sobre o necessidade de alcançar métodos de ação de acordo com princípios e valores profissionais.

Maternal impacts of a physically disabled baby birth: A comparative study / Impactos maternos do nascimento de um bebê com deficiência física: um estudo comparativo

Objective This study aims to assess the emotional impacts of the baby's physical disability on the mother. Method It is an exploratory investigation carried on with two mother-infant dyads, only one of which gave birth to a physically disabled baby, both participating in a larger case-control investigation. The tools used included the Beck Anxiety and Depression Inventories, the Parental Reflective Functioning Questionnaire, the Ages and Stages Questionnaire as well as semi-structured interviews. Results Both mothers showed similar reports and parenting levels, but the one whose baby had a disability scored higher on anxiety and depression, in connection with the baby's low level of development. Conclusion It is concluded that, in order to achieve the same levels of a typical parenting condition, greater adaptation mechanisms are required.

Objetivo Este artigo tem como objetivo avaliar impactos emocionais da deficiência física do bebê na mãe. Método Trata-se de um estudo exploratório realizado com duas díades, uma composta um bebê com deficiência e sua mãe e outra por um bebê sem deficiência e sua mãe, provenientes de uma pesquisa maior com desenho caso-controle. Foram utilizados a Entrevista Semiestruturada, Inventários Beck de Ansiedade e Depressão, Questionário de Função Reflexiva Parental e Ages and Stages Questionnaire. Resultados As mães demonstraram relatos e níveis de parentalidade semelhantes, mas a do bebê com deficiência apresentou maiores scores para ansiedade e depressão, relacionados ao baixo nível de desenvolvimento do filho. Conclusão Conclui-se que mecanismos de adaptação são necessários para se obter os mesmos níveis de parentalidade de uma condição típica.

Breaking bad news in ophthalmology: a literature review / Comunicação de más notícias em oftalmologia: uma revisão de literatura

ABSTRACT Medical specialties have recognized that breaking bad news assists clinical practice by mitigating the impact of difficult conversations. This scenario also encourages various studies on breaking bad news in ophthalmology since certain ocular diagnoses can be considered bad news. Thus, the objective is to review the scientific literature on breaking bad news in ophthalmology. The literature databases like MEDLINE/PUBMED, EMBASE, LILACS, SCOPUS, COCHRANE, and SCIELO, were screened for related research publications. Two independent reviewers read all the articles and short-listed the most relevant ones. Seven articles, in the formats of original article, review, editorial, oral communication, and correspondence, were reviewed. Conclusively it reveals that ophthalmologists are concerned with communicating bad news effectively but lack related studies. Nevertheless, there is a growing realization that training in breaking bad news can increase physicians' confidence during communication, thus, benefiting the therapeutic relationship with the patient and his family. Therefore, it would be valuable to include breaking bad news training in the curriculum of residencies.

RESUMO O reconhecimento sobre a comunicação de más notícias como mitigadora de conversas difíceis por outras especialidades médicas, incentiva o estudo desta temática na oftalmologia. Sendo assim, o objetivo deste estudo é revisar a produção de pesquisas científicas sobre a comunicação de más notícias em oftalmologia. Para isso, foi realizada uma revisão de literatura. As bases de dados utilizadas foram MEDLINE/PUBMED, EMBASE, LILACS, SCOPUS, COCHRANE e SCIELO. Dois revisores independentes leram todos os artigos e selecionaram a amostra final. Sete artigos foram escolhidos nos formatos de artigo original, revisão, editorial, comunicação oral e correspondência. Os oftalmologistas estão preocupados em comunicar as más notícias de forma eficaz, mas faltam estudos sobre o tema. No entanto, há uma crescente percepção de que o treinamento de comunicação de más notícias aumenta a confiança dos médicos na comunicação, beneficiando a relação terapêutica. Portanto, seria valioso incluir este treinamento no currículo das residências.

Pratiques de prise en charge de l'hypertension artérielle au Centre Hospitalier et Universitaire d' Abomey-Calavi au Bénin / NA

L'hypertension artérielle est une maladie à forte progression reste un problème de santé publique. Mais, les pratiques de sa prise en charge se heurtent à différents obstacles. Cette recherche questionne les problèmes qui caractérisent les pratiques de prise en charge de l'hypertension artérielle au Centre Hospitalier et Universitaire d'Abomey-Calavi au Bénin. Pour y parvenir, nous avons opté pour une analyse basée sur les méthodes quantitatives et qualitatives. L'échantillon est constitué de 130 personnes enquêtées. De l'analyse des résultats collectés, des difficultés éprouvées entre patients et agents de santé dans la prise en charge de l'hypertension artérielle, se caractérise par le manque de relation soignant-soigné. De même, 90% des enquêtés estiment avoir peu de ressources humaines qualifiées et du faible pouvoir d'achat des patients pour faire face aux coûts élevés du traitement de l'hypertension (86,75%). Ainsi, le manque de plateau technique et les frais de consultations spécialisées posent problèmes y compris les suivis de l'éducation hygiéno-diététique. Cet état de fait compromet les pratiques de prise en charge et les formations globales que le système soin est supposé assurer aux usagers qui le fréquentent. Ces résultats suggèrent l'urgence de formations pour le renforcement des capacités pour repérer la précarité et la réorganisation des mesures de prise en charge de l' hypertension artérielle dans le périmètre sanitaire béninois.

Arterial hypertension remains a rapidly growing public health problem. However, management practices face a number of obstacles. This research questions the problems that characterize arterial hypertension management practices at the Centre Hospitalier et Universitaire d'Abomey-Calavi in Benin. To achieve this, we opted for an analysis based on quantitative and qualitative methods. The sample consisted of 130 respondents. From the analysis of the results collected, of the difficulties experienced between patients and health workers in the management of arterial hypertension, most of those surveyed claimed to have a complexity that characterizes the training of health workers. Similarly, 90% of respondents felt that they had few non-cardiologist practitioners, and that patients had little purchasing power to meet the high costs of treating hypertension (86.75%). As a result, the cost of specialized consultations and complementary examinations poses a problem, including follow-up health and diet education. This state of affairs compromises management practices and the comprehensive training that the healthcare system is supposed to provide for its users. These results suggest the urgent need for training to identify precariousness, and the reorganization of hypertension management measures within the Beninese health perimeter.

Diseño de una base de datos para la Revista Cubana de Tecnología de la Salud

Introducción: la Revista Cubana de Tecnología de la Salud, requiere un sistema de base de datos para el tratamiento de la información concerniente a los diferentes procesos de la gestión editorial. Esto es necesario en la automatización y a la vez humanización de la recolección, organización, procesamiento y presentación de los datos relacionados con los indicadores de evaluación de la calidad, los bibliométricos y los referentes con la indexación, por citar ejemplos. Objetivo: diseñar una base de datos para la Revista Cubana de Tecnología de la Salud. Métodos: se realizó una investigación aplicada de innovación tecnológica, en la que diseñó una base de datos relacional. Se emplearon métodos a nivel teórico y empíricos; entre ellos la entrevista para obtener una descripción detallada de las necesidades de la revista, y la modelación en la representación a través de modelos lógicos y conceptuales del universo de discurso. Resultados: la base de datos se diseñó mediante el modelo Entidad-Relación. Se obtuvieron el diagrama de entidad-relación y el esquema relacional de la base de datos. Se aplicó la teoría de la normalización para eliminar las redundancias. Conclusiones: quedó descrito el proceso de diseño de la base de datos con la cual la Revista Cubana de Tecnología de la Salud, podrá gestionar los datos de una forma centralizada y eficaz, de manera que se puedan aplicar en la evaluación de la gestión editorial y el desarrollo de estudios bibliométricos de la producción científica de la revista.

Introduction: The Cuban Journal of Health Technology requires a database system for the treatment of information concerning the different editorial management processes. This is necessary in the automation process and, at the same time, in the humanization of the collection, organization, processing, and presentation of the data related to the quality evaluation and bibliometric indicators, as well as those related to the indexing, to cite some examples. Objective: To design a database for the Cuban Journal of Health Technology. Methods: An applied research on technological innovation was carried out, in which a relational database was designed. Theoretical and empirical methods were used; among them, we can mention the interview to obtain a detailed description of the needs of the journal, and the representation modeling through logical and conceptual models of the universe of discourse. Results: The database was designed using the Entity-Relationship model. The entity-relationship diagram and the relational schema of the database were obtained. Normalization theory was applied to eliminate redundancies. Conclusions: The design process of the database that will allow the Cuban Journal of Health Technology to manage data in a centralized and efficient way was described, so that it can be applied to the evaluation of the editorial management and the development of bibliometric studies of the scientific production of the journal.

Análise dos processos de responsabilidade civil envolvendo o cirurgião-dentista no estado do Piauí, Brasil / Analysis of the lawsuits involving professional liability in Dentistry, in Piauí state, Brazil

O objetivo deste trabalho foi levantar e analisar os processos de responsabilidade civil envolvendo cirurgiões-dentistas do estado do Piauí, entre os anos de 2015 a 2019, a fim de verificar o número de processos instaurados e suas características. Foram encontrados (n=11) processos referentes a pessoas físicas, sendo a especialidade mais incidente a Implantodontia. Em 63% dos dados, os requeridos não possuíam especialidade registrada no Conselho Federal de Odontologia na área envolvida no litígio. Os valores indenizatórios solicitados variaram de R$ 15.000,00 a R$ 101.985,00. Não houve acionamento de seguro de responsabilidade civil nos processos encontrados. A maioria dos processos foi instaurada nos últimos dois anos da realização da pesquisa e encontravam-se em trâmite, não permitindo a obtenção das sentenças. Conclui-se que houve um aumento do número de processos instaurados no último ano verificado, acompanhando uma realidade crescente e observada em todo o país

The objective of this study was to analyze the civil liability lawsuits against dentists in the Piauí State, Brazil, from 2015 to 2019, to verify whether there was a significant increase in their number in recent years, and to investigate their main features. Eleven lawsuits were found, and the most incident dental specialty was Implantology. In 63% of the lawsuits, the dentists had not registered their specialist title on the Brazilian Federal Council of Dentistry, in the area involved in the litigation. Restitution amounts ranged from R$ 15,000.00 to R$ 101,985.00. There was no triggering of civil liability insurances in any of the processes found. Most of the lawsuits initiated in the last two years and are still in progress, thus their judicial sentences were not obtainable. We concluded that there was an increase in the number of cases in the last year analyzed, in agreement with the reality observed throughout the country.

Pequeños/as grandes investigadores: niñeces creando conocimiento sobre el compromiso escolar en Chile / Little big researchers: children creating knowledge about school engagement in Chile / Pequenos grandes pesquisadores: crianças criando conhecimento sobre engajamento escolar no Chile

(analítico) A más de 30 años de la Convención de los Derechos del Niño y reconocido su derecho a participar, las investigaciones siguen siendo predominantemente sobre los niños/as y no con ellos/as. Este estudio busca avanzar hacia la incorporación de niños/as como productores de conocimientos en sus escuelas. Es un estudio cualitativo longitudinal donde 64 niños/as asumieron un rol de co-investigadores del compromiso escolar mediante talleres con una metodología de investigación-acción participativa, entrevistas y análisis que ellos/as realizaron. Se relevan distintas percepciones sobre los subtipos de compromiso escolar y factores contextuales asociados que enriquecen el análisis adulto y la importancia de complementar los datos cuantitativos en las escuelas con las voces de las infancias, en tanto agentes de cambio. Se concluye sobre cómo incluir su participación en investigación más significativamente.

(analytical) More than 30 years after the Convention on the Rights of the Child recognized their right to participate, research continues to be predominantly about children but not carried out with them. This study seeks to contribute to the incorporation of children as producers of knowledge in their schools. It is a longitudinal qualitative study in which 64 children assumed the role of co-researchers on the topic of school engagement. This was achieved through workshops that used a participatory action research methodology, interviews and analysis undertaken by the children themselves. The study identified different perceptions about the subtypes of school engagement and associated contextual factors that enrich adult analysis, as well as the importance of complementing quantitative data collected in schools with the voices of children, who in this process act as agents of change. The authors conclude the article with identifying how to achieve more meaningful child participation in research studies.

(analítico) Mais de 30 anos após a Convenção sobre os Direitos da Criança e o direito de participação reconhecido, a pesquisa continua sendo predominantemente sobre crianças e não com elas. Este estudo busca caminhar para a incorporação das crianças como produtoras de conhecimento em suas escolas. Trata-se de um estudo qualitativo longitudinal onde 64 crianças assumiram o papel de co-investigadoras do compromisso escolar através de oficinas com metodologia de pesquisaação participativa, entrevistas e análises que realizaram. Revelamse diferentes perceções sobre os subtipos de envolvimento escolar e fatores contextuais associados que enriquecem a análise dos adultos e a importância de complementar os dados quantitativos nas escolas com as vozes das crianças, enquanto agentes de mudança.

La comunicación del riesgo en cirugía: Un proceso por mejorar / Communication of risk in surgery: A process to improve

Introducción. La evaluación del riesgo es fundamental en el éxito quirúrgico. Las perspectivas de los actores involucrados en el proceso de atención deben alinearse con el fin de planear, comunicar y ejecutar adecuadamente las intervenciones necesarias. El objetivo de este escrito fue analizar el riesgo quirúrgico, considerando los posibles factores relacionados con su estimación, comunicación y comprensión en la práctica clínica. Métodos. Análisis crítico y reflexivo de la información disponible, contrastado con la práctica usual. Se hace un ejercicio con situaciones clínicas habituales. Resultados. La complejidad de los pacientes, los recursos, el contexto y la naturaleza de las intervenciones, demandan una aproximación del riesgo implícito de una cirugía con instrumentos evaluativos confiables y reproducibles. Las percepciones por los médicos, pacientes y administradores en salud acerca del impacto de una cirugía difieren según sus intereses. La transmisión de los resultados es un reto ante la asimetría en el conocimiento, la complejidad de los procedimientos y la incertidumbre en los resultados. La comunicación efectiva, como una competencia, se hace altamente pertinente en la actividad del médico. Facilitar la comprensión del mensaje exige una práctica continua y un proceso de mejoramiento adaptado al contexto de la atención en salud. Conclusiones. El riesgo quirúrgico exige una metodología clara y fiable en su evaluación, comunicación y comprensión entre los actores del sistema de salud. Su presencia está asociada a la actividad profesional de los médicos y requiere competencias que permitan un abordaje no lineal del tema. Es una actividad profesional con el fin de mejorar los desenlaces en salud y la calidad de las intervenciones

Introduction. Evaluation of surgical risk is fundamental in surgical success. The perspectives of the actors involved in the care process must be aligned to adequately plan, communicate, and execute the necessary interventions. The aim of this article is to analyze surgical risk, considering possible factors related to its estimation, communication and understanding in clinical practice. Methods. Critical and reflective analysis of the available information, contrasted with the usual practice. An exercise is done with usual clinical situations. Discussion. Complexity of the patients, resources, context, and nature of the interventions demand an approximation of the implicit risk of surgery with reliable and reproducible evaluation instruments. Perceptions by physicians, patients, and health administrators about the impact of surgery differ according to their interests. The transmission of results is a challenge in the face of asymmetry in knowledge, complexity of procedures and uncertainty in results. Effective communication as a competence becomes highly relevant in the physician's activity. Facilitating the understanding of the message requires continuous practice and an improvement process adapted to the context of health care. Conclusions. Surgical risk requires a clear and reliable methodology in its evaluation, communication and understanding among the actors of the health system. Their presence is associated with the professional activity of doctors and requires skills that allow a non-linear approach to the subject. It is a professional activity that must be empowered to improve health outcomes and the quality of interventions.

Inteligencia Artificial: pinocho dos mil años luz / Artificial Intelligence: pinocchio two thousand light years

Una versión preliminar de este texto fue publicada en 2001 en ocasión del estreno del film. Dos décadas después y ante la explosión de la Inteligencia Artificial Generativa se presenta una versión ampliada que mantiene sin embargo la tesis original. Se trata de la importancia y vigencia de los mitos para comprender la distancia entre la lógica computacional y lo propio de la condición humana. En esta línea se analiza el film de Spielberg en interlocución con el célebre relato de Carlo Collodi y con los aportes del psicoanálisis para pensar el presente y el futuro de la Inteligencia Artificial

A preliminary version of this text was published in 2001 on the occasion of the film's premiere. Two decades later and given the explosion of Generative Artificial Intelligence, an expanded version is presented that nevertheless maintains the original thesis. It is about the importance and validity of myths to understand the distance between computational logic and the human condition. Along these lines, Spielberg's film is analyzed in dialogue with the famous story by Carlo Collodi and with the contributions of psychoanalysis to think about the present and future of Artificial Intelligence

Are doctors allowed to cry at work?

This article recounts a poignant interaction between the author and a mother of a child with cerebral palsy. The mother's remarkable strength and optimism in the face of adversity deeply moved the author, leading to a tearful moment which prompted a comforting response from the mother. The ongoing debate regarding whether doctors are allowed to display emotions in their professional lives centers around the challenge of balancing professionalism with the emotional impact of providing healthcare to patients. While doctors are expected to uphold professionalism and make sound decisions in their work environment, simultaneous expression of emotions, empathy, and vulnerabilities becomes inevitable.