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INTRODUCTION AND OBJECTIVES: Catheter ablation (CA) is effective in the treatment of ventricular tachycardia (VT). Although some observational data suggest patients with non-ischemic cardiomyopathy (NICM) have less favorable outcomes when compared to those with an ischemic etiology (ICM), direct comparisons are rarely reported. We aimed to compare the outcomes of VT ablation in a propensity-score matched population of ICM or NICM patients. METHODS: Single-center retrospective study of consecutive patients undergoing VT ablation from 2012 to 2023. A propensity score (PS) was used to match ICM and NICM patients in a 1:1 fashion according to age, sex, left ventricular ejection fraction (LVEF), NYHA class, electrical storm (ES) at presentation, and previous endocardial ablation. The outcomes of interest were VT-free survival and all-cause mortality. RESULTS: The PS yielded two groups of 71 patients each (mean age 63±10 years, 92% male, mean LVEF 35±10%, 36% with ES at presentation, and 23% with previous ablation), well matched for baseline characteristics. During a median follow-up of 2.3 (interquartile range IQR 1.3-3.8) years, patients with NICM had a significantly lower VT-free survival (53.5% vs. 69.0%, log-rank p=0.037), although there were no differences regarding all-cause mortality (22.5% vs. 16.9%, log-rank p=0.245). Multivariate analysis identified NICM (HR 2.34 [95% CI 1.32-4.14], p=0.004), NYHA class III/IV (HR 2.11 [95% CI 1.11-4.04], p=0.024), and chronic kidney disease (HR 2.23 [95% CI 1.25-3.96], p=0.006), as independent predictors of VT recurrence. CONCLUSION: Non-ischemic cardiomyopathy patients were at increased risk of VT recurrence after ablation, although long-term mortality did not differ.
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Cardiomiopatías , Ablación por Catéter , Isquemia Miocárdica , Puntaje de Propensión , Taquicardia Ventricular , Humanos , Masculino , Femenino , Estudios Retrospectivos , Persona de Mediana Edad , Taquicardia Ventricular/cirugía , Ablación por Catéter/métodos , Isquemia Miocárdica/complicaciones , Isquemia Miocárdica/cirugía , Cardiomiopatías/cirugía , Cardiomiopatías/complicaciones , Resultado del Tratamiento , AncianoRESUMEN
This paper presents new perspectives on photonic technologies for capsule endoscopy. It first presents a review of conventional endoscopy (upper endoscopy and colonoscopy), followed by capsule endoscopy (CE), as well as their techniques, advantages, and drawbacks. The technologies for CEs presented in this paper include integration with the existing endoscopic systems that are commercially available. Such technologies include narrow-band imaging (NBI), photodynamic therapy (PDT), confocal laser endomicroscopy (CLE), optical coherence tomography (OCT), and spectroscopy in order to improve the performance of the gastrointestinal (GI) tract examination. In the context of NBI, two optical filters were designed and fabricated for integration into endoscopic capsules, allowing for the visualization of light centered at the 415 nm and 540 nm wavelengths. These optical filters are based on the principle of Fabry-Perot and were made of thin films of titanium dioxide (TiO2) and silicon dioxide (SiO2). Moreover, strategies and solutions for the adaptation of ECs for PDT are also discussed.
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The increasing demand for flexible electronic devices has risen due to the high interest in electronic textiles (e-textiles). Consequently, the urge to power e-textiles has sparked enormous interest in flexible energy storage devices. One-dimensional (1D) configuration supercapacitors are the most promising technology for textile applications, but often their production involves complex synthesis techniques and expensive materials. This work unveils the use of the novel electrospray deposition (ESD) technique for the deposition of poly(3,4-ethylenedioxythiophene)-poly(styrene sulfonate) (PEDOT:PSS). This deposition methodology on conductive carbon yarns creates flexible electrodes with a high surface area. The deposition conditions of PEDOT:PSS were optimized, and their influence on the electrochemical performance of a 1D symmetric supercapacitor with a cellulose-based gel as an electrolyte and a separator was evaluated. The tests herein reported show that these capacitors exhibited a high specific capacitance of 72 mF g-1, an excellent cyclability of more than 85% capacitance retention after 1500 cycles, and an outstanding capability of bending.
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Abstract The Teacher Behavior Checklist (TBC) is a worldwide valued instrument to measure teachers' performance. Nonetheless, the studies about TBC in Brazil are still scarce, with samples mainly composed of psychology and civil engineering students. The aim of this study was to replicate the research by Keeley et al. (2010) to evaluate the psychometric properties of the Brazilian version of the TBC with a new sample. Participants were 107 undergraduates from physical education courses from a Brazilian public university. Participants used the TBC to evaluate three types of teachers: the worst they had ever had, a regular one, and the best one. The order of evaluation of teacher types did not interfere with the response patterns, but as expected, statistically significant differences were found among the three types of teachers. Additionally, the two-factor model of the TBC was confirmed through Confirmatory Factor Analysis, providing additional evidence of construct validity. However evidence to advocate in favor of a one-factor solution was also found. McDonald's Omega results provided evidence of reliability. These findings support the use of TBC in the formative evaluation of teachers in Brazil.
Resumen The Teacher Behavior Checklist (TBC) es un instrumento valorado en todo el mundo para medir el desempeño de los profesores. Sin embargo, los estudios sobre el TBC en Brasil siguen siendo escasos, con muestras compuestas principalmente por estudiantes de psicología e ingeniería civil. El objetivo de este estudio fue replicar la investigación de Keeley et al. (2010) para evaluar las propiedades psicométricas de la versión brasileña del Teacher Behavior Checklist (TBC) con una nueva muestra. Participaron 107 estudiantes de educación física de una universidad pública brasileña. Los participantes utilizaron el TBC para evaluar tres tipos de profesores: el peor que hayan tenido, uno regular y el mejor. El orden de evaluación de los tipos de docentes no interfirió con los patrones de respuesta, pero como se esperaba, encontramos diferencias estadísticamente significativas entre los tres tipos de docentes. Además, el modelo de dos factores del TBC se confirmó a través de un análisis factorial confirmatorio, proporcionando evidencia adicional de validez de la construcción. No obstante, también encontramos evidencia para abogar a favor de una solución de un factor. Los resultados del Omega de McDonald indicaron evidencia de confiabilidad. Estos hallazgos apoyan el uso de TBC en la evaluación formativa de los docentes en Brasil.
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O objetivo deste estudo foi investigar a efetividade de intervenções para redução da ansiedade matemática (AM) em crianças e/ou adolescentes, sistematizando sugestões para o atendimento psicopedagógico. Foi realizada uma revisão sistemática sobre AM, norteada pelo Protocolo PRISMA. A busca, conduzida nas bases de dados ERIC, LILACS, PePSIC, SciELO, Periódicos CAPES e Web of Science, abrangeu janeiro de 2010 a janeiro de 2021, artigos empíricos revisados por pares, em português, espanhol e inglês e as combinações dos descritores: mathematics anxiety OR math anxiety OR seus equivalentes em espanhol e português. Foram identificados 1.264 trabalhos e incluídos 24 por atenderem aos critérios de inclusão e exclusão. Esses estudos foram avaliados com relação à efetividade da intervenção, de acordo com os parâmetros: eficácia, eficiência, manutenção do efeito e generalização e as descobertas apresentadas por meio de síntese descritiva. Os resultados sugerem que intervenções que enfatizam aspectos pedagógicos e psicoterápicos são mais efetivas na redução da AM em crianças e adolescentes, enquanto as que utilizam apenas uma dessas estratégias apresentam menor efetividade. Quanto aos procedimentos de intervenção, destacam-se estratégias/programas educacionais que envolvem treinamento de habilidades matemáticas; jogos recreativos ativos; aprendizagem interativa na resolução de problemas; tutoria entre pares; e técnicas terapêuticas de redução de ansiedade, que abrangem a intervenção matemática integrada à aprendizagem autorregulada. Implicações para guiar a prática do psicopedagogo são discutidas à luz das evidências científicas e recomendações são apontadas para a sua atuação em caso de AM.
The aim of this study was to investigate the effectiveness of interventions to reduce mathematical anxiety (MA) in children and/or adolescents, systematizing suggestions for psycho-pedagogical care. A systematic review of MA was conducted, based on the PRISMA Protocol. The search, conducted in the ERIC, LILACS, PePSIC, SciELO, CAPES journals and Web of Science databases, covered January 2010 to January 2021, peer-reviewed empirical articles in Portuguese, Spanish and English and the combinations of descriptors: mathematics anxiety OR math anxiety, and their equivalents in Spanish and Portuguese. A total of 1,264 studies were identified and 24 were included because they met the inclusion and exclusion criteria. These studies were evaluated in relation to the effectiveness of the intervention, according to the parameters: efficacy, efficiency, effect maintenance and generalization and the findings presented through descriptive synthesis. The results suggest that interventions that emphasize pedagogical and psychotherapeutic aspects are more effective in reducing MA in children and adolescents, while those that use only one of these strategies have lower effectiveness. Regarding intervention procedures, educational strategies/programs involving mathematical skills training stand out; active recreational games; interactive learning in problem solving; peer-to-peer tutoring; and therapeutic anxiety reduction techniques, which cover mathematical intervention integrated into self-regulated learning. Implications to guide the practice of psycho-pedagogue are discussed in the light of scientific evidence and recommendations are pointed out for their action in case of MA.
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Toxoplasmosis is a cosmopolitan disease caused by Toxoplasma gondii, an obligate protozoan that affects endothermic animals, including man. Being a zoonosis that can cause abortions, fetal malformations and blindness. Cats are the definitive hosts, acting as a source of dissemination. In order to collect epidemiological data on the distribution of T. gondii in Mineiros, Goiás, samples of domestic cats were analyzed to verify the circulation of the protozoan and reinforce preventive measures. Ninety-four samples of domestic cats, regardless of gender, age and breed, were randomly processed in the neighborhoods of Mineiros, Goiás. They were submitted to the indirect fluorescent antibody test for antibodies against T. gondii, using tachyzoites as antigens and anti-cat IgG conjugate (1:16 were positive). Of the 94 samples analyzed, 35 (37.2%) were reagents, of which four had a titration of 1:16, ten of 1:32, eleven of 1:64, eight of 1:128 and two of 1:256. All cats were semi-domiciled, but lifestyle and diet were not assessed. T. gondii infection is rarely symptomatic and the severity depends on the pathophysiological state. Brazil has high prevalence rates and requires effective care in the management of cats. In Mineiros, 29 reports of infected pregnant women were identified. Although infection in humans occurs primarily through consumption of undercooked meat, ingestion of oocysts in feces of cats is a possibility. Therefore, state public health institutions and veterinarians should promote health education, highlighting food hygiene. Since, when symptomatic, the disease presents severe clinical conditions and, in some cases, irreversible.
A toxoplasmose é uma doença cosmopolita causada pelo Toxoplasma gondii, um protozoário obrigatório que afeta animais endotérmicos, incluindo o homem. Sendo uma zoonose que pode causar abortos, malformações fetais e cegueira. Os gatos são os hospedeiros definitivos, atuando como fonte de disseminação. Para coletar dados epidemiológicos sobre a distribuição do T. gondii em Mineiros, Goiás, amostras de gatos domésticos foram analisadas para verificar a circulação do protozoário e reforçar as medidas preventivas. Noventa e quatro amostras de gatos domésticos, independente de sexo, idade e raça, foram processadas aleatoriamente nos bairros de Mineiros, Goiás. Foram submetidos ao teste de anticorpo fluorescente indireto para pesquisa de anticorpos contra T. gondii, utilizando como antígenos taquizoítos e conjugado anti-cat IgG (1:16 foram positivos). Das 94 amostras analisadas, 35 (37,2%) eram reagentes, das quais quatro tiveram titulação de 1:16, dez de 1:32, onze de 1:64, oito de 1:128 e duas de 1:256. Todos os gatos eram semi-domiciliados, mas o estilo de vida e a dieta não foram avaliados. A infecção por T. gondii raramente é sintomática e a gravidade depende do estado fisiopatológico. O Brasil possui altas taxas de prevalência e requer cuidados efetivos no manejo dos gatos. Em Mineiros, foram identificadas 29 notificações de gestantes infectadas. Embora a infecção em humanos ocorra principalmente pelo consumo de carne mal cozida, a ingestão de oocistos nas fezes de gatos é uma possibilidade. Portanto, as instituições estaduais de saúde pública e os médicos veterinários devem promover a educação em saúde, destacando a higiene alimentar. Já que, quando sintomática, a doença apresenta quadros clínicos graves e, em alguns casos, irreversíveis.
La toxoplasmosis es una enfermedad cosmopolita causada por Toxoplasma gondii, un protozoario obligado que afecta a animales endotérmicos, incluido el hombre. Ser una zoonosis que puede provocar abortos, malformaciones fetales y ceguera. Los gatos son los huéspedes definitivos, actuando como fuente de diseminación. Con el fin de recolectar datos epidemiológicos sobre la distribución de T. gondii en Mineiros, Goiás, se analizaron muestras de gatos domésticos para verificar la circulación del protozoario y reforzar las medidas preventivas. Noventa y cuatro muestras de gatos domésticos, independientemente de género, edad y raza, fueron procesadas al azar en los barrios de Mineiros, Goiás. Se sometieron a la prueba de anticuerpos fluorescentes indirectos contra T. gondii, utilizando como antígenos taquizoítos e IgG anti-cat conjugada (1:16 fueron positivos). De las 94 muestras analizadas, 35 (37,2%) fueron reactivos, de los cuales cuatro tuvieron una titulación de 1:16, diez de 1:32, once de 1:64, ocho de 1:128 y dos de 1:256. Todos los gatos tenían domicilio parcial, pero no se evaluó el estilo de vida ni la dieta. La infección por T. gondii rara vez es sintomática y la gravedad depende del estado fisiopatológico. Brasil tiene altas tasas de prevalencia y requiere una atención eficaz en el manejo de los gatos. En Mineiros se identificaron 29 casos de mujeres embarazadas infectadas. Aunque la infección en los seres humanos se produce principalmente a través del consumo de carne poco cocida, la ingestión de ovoquistes en las heces de los gatos es una posibilidad. Por lo tanto, las instituciones estatales de salud pública y los veterinarios deben promover la educación sanitaria, destacando la higiene alimentaria. Dado que, cuando sintomática, la enfermedad presenta cuadros clínicos severos y, en algunos casos, irreversibles.
RESUMEN
Resumo Fundamento O tecido adiposo epicárdico (TAE) tem sido associado à fibrilação atrial (FA), mas seus mecanismos fisiopatológicos permanecem obscuros. Objetivos Medir a correlação entre TAE e fibrose do átrio esquerdo (AE), e avaliar sua capacidade de prever recidiva após o isolamento da veia pulmonar (IVP). Métodos Pacientes com FA inscritos para um primeiro procedimento de IVP foram submetidos à tomografia computadorizada (TC) cardíaca e ressonância magnética cardíaca (RMC) em menos de 48 horas. Quantificou-se o TAECE em imagens de TC realçadas com contraste no nível do tronco da coronária esquerda. Quantificou-se a fibrose do AE em RMC tridimensional com realce tardio isotrópico de 1,5 mm. Após o isolamento da veia pulmonar (IVP), os pacientes foram submetidos a seguimento para checar a recidiva da FA. A significância estatística foi definida com p<0,05. Resultados A maioria dos 68 pacientes (46 homens, idade 61±12 anos) tinha FA paroxística (71%, n=48). Os pacientes apresentavam volume TAECE mediano de 2,4 cm3/m2 (intervalo interquartil [IIQ] 1,6-3,2 cm3/m2) e um volume médio de fibrose do AE de 8,9 g (IIQ 5-15 g). A correlação entre TAECE e fibrose do AE foi estatisticamente significativa, mas fraca (coeficiente de correlação de postos de Spearman = 0,40, p=0,001). Durante um seguimento médio de 22 meses (IIQ 12-31), 31 pacientes (46%) tiveram recidiva da FA. A análise multivariada produziu dois preditores independentes de recidiva da FA: TAECE (FC 2,05, IC de 95% 1,51-2,79, p<0,001) e FA não paroxística (FC 2,36, IC de 95% 1,08-5,16, p=0,031). Conclusão A correlação fraca entre TAE e AE sugere que a fibrose do AE não é o principal mecanismo que liga o TAE e a FA. O TAE mostrou-se mais fortemente associado à recidiva da FA do que à fibrose do AE, corroborando a existência de outros mediadores mais importantes do TAE e da FA.
Abstract Background Epicardial adipose tissue (EAT) has been associated with atrial fibrillation (AF), but its pathophysiological mechanisms remain unclear. Objectives To measure the correlation between EAT and left atrium (LA) fibrosis, and to assess their ability to predict relapse after pulmonary vein isolation (PVI). Methods Patients with AF enrolled for a first PVI procedure underwent both cardiac computerized tomography (CT) and cardiac magnetic resonance (CMR) imaging within less than 48 hours. EATLMwas quantified on contrast-enhanced CT images at the level of the left main. LA fibrosis was quantified on isotropic 1.5 mm 3D delayed enhancement CMR. After pulmonary vein isolation (PVI), patients were followed up for AF relapse. Statistical significance was set at p<0.05. Results Most of the 68 patients (46 men, age 61±12 years) had paroxysmal AF (71%, n=48). Patients had a median EATLMvolume of 2.4 cm3/m2(interquartile range [IQR] 1.6-3.2 cm3/m2), and a median amount of LA fibrosis of 8.9 g (IQR 5-15 g). The correlation between EATLMand LA fibrosis was statistically significant but weak (Spearman's R=0.40, p=0.001). During a median follow-up of 22 months (IQR 12-31), 31 patients (46%) had AF relapse. Multivariate analysis yielded two independent predictors of AF relapse: EATLM(HR 2.05, 95% CI 1.51-2.79, p<0.001), and non-paroxysmal AF (HR 2.36, 95% CI 1.08-5.16, p=0.031). Conclusion The weak correlation between EAT and LA suggests that LA fibrosis is not the main mechanism linking EAT and AF. EAT was more strongly associated with AF relapse than LA fibrosis, supporting the existence of other more important mediators of EAT and AF.
RESUMEN
BACKGROUND: Epicardial adipose tissue (EAT) has been associated with atrial fibrillation (AF), but its pathophysiological mechanisms remain unclear. OBJECTIVES: To measure the correlation between EAT and left atrium (LA) fibrosis, and to assess their ability to predict relapse after pulmonary vein isolation (PVI). METHODS: Patients with AF enrolled for a first PVI procedure underwent both cardiac computerized tomography (CT) and cardiac magnetic resonance (CMR) imaging within less than 48 hours. EATLMwas quantified on contrast-enhanced CT images at the level of the left main. LA fibrosis was quantified on isotropic 1.5 mm 3D delayed enhancement CMR. After pulmonary vein isolation (PVI), patients were followed up for AF relapse. Statistical significance was set at p<0.05. RESULTS: Most of the 68 patients (46 men, age 61±12 years) had paroxysmal AF (71%, n=48). Patients had a median EATLMvolume of 2.4 cm3/m2(interquartile range [IQR] 1.6-3.2 cm3/m2), and a median amount of LA fibrosis of 8.9 g (IQR 5-15 g). The correlation between EATLMand LA fibrosis was statistically significant but weak (Spearman's R=0.40, p=0.001). During a median follow-up of 22 months (IQR 12-31), 31 patients (46%) had AF relapse. Multivariate analysis yielded two independent predictors of AF relapse: EATLM(HR 2.05, 95% CI 1.51-2.79, p<0.001), and non-paroxysmal AF (HR 2.36, 95% CI 1.08-5.16, p=0.031). CONCLUSION: The weak correlation between EAT and LA suggests that LA fibrosis is not the main mechanism linking EAT and AF. EAT was more strongly associated with AF relapse than LA fibrosis, supporting the existence of other more important mediators of EAT and AF.
FUNDAMENTO: O tecido adiposo epicárdico (TAE) tem sido associado à fibrilação atrial (FA), mas seus mecanismos fisiopatológicos permanecem obscuros. OBJETIVOS: Medir a correlação entre TAE e fibrose do átrio esquerdo (AE), e avaliar sua capacidade de prever recidiva após o isolamento da veia pulmonar (IVP). MÉTODOS: Pacientes com FA inscritos para um primeiro procedimento de IVP foram submetidos à tomografia computadorizada (TC) cardíaca e ressonância magnética cardíaca (RMC) em menos de 48 horas. Quantificou-se o TAECE em imagens de TC realçadas com contraste no nível do tronco da coronária esquerda. Quantificou-se a fibrose do AE em RMC tridimensional com realce tardio isotrópico de 1,5 mm. Após o isolamento da veia pulmonar (IVP), os pacientes foram submetidos a seguimento para checar a recidiva da FA. A significância estatística foi definida com p<0,05. RESULTADOS: A maioria dos 68 pacientes (46 homens, idade 61±12 anos) tinha FA paroxística (71%, n=48). Os pacientes apresentavam volume TAECE mediano de 2,4 cm3/m2 (intervalo interquartil [IIQ] 1,63,2 cm3/m2) e um volume médio de fibrose do AE de 8,9 g (IIQ 515 g). A correlação entre TAECE e fibrose do AE foi estatisticamente significativa, mas fraca (coeficiente de correlação de postos de Spearman = 0,40, p=0,001). Durante um seguimento médio de 22 meses (IIQ 1231), 31 pacientes (46%) tiveram recidiva da FA. A análise multivariada produziu dois preditores independentes de recidiva da FA: TAECE (FC 2,05, IC de 95% 1,512,79, p<0,001) e FA não paroxística (FC 2,36, IC de 95% 1,085,16, p=0,031). CONCLUSÃO: A correlação fraca entre TAE e AE sugere que a fibrose do AE não é o principal mecanismo que liga o TAE e a FA. O TAE mostrou-se mais fortemente associado à recidiva da FA do que à fibrose do AE, corroborando a existência de outros mediadores mais importantes do TAE e da FA.
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Fibrilación Atrial , Ablación por Catéter , Venas Pulmonares , Tejido Adiposo/diagnóstico por imagen , Anciano , Fibrilación Atrial/diagnóstico por imagen , Fibrilación Atrial/etiología , Femenino , Fibrosis , Atrios Cardíacos/patología , Humanos , Masculino , Persona de Mediana Edad , Venas Pulmonares/diagnóstico por imagen , RecurrenciaRESUMEN
Introdução: A Disfunção Temporomandibular (DTM) é a dor orofacial crônica mais comum, encontrada por dentistas e outros profissionais de saúde. Sua etiologia tem caráter multifatorial, e pode envolver, desde fatores hereditários, hábitos parafuncionais, maloclusões, até ansiedade e estresse. Objetivo: Este estudo investigou a frequência da DTM e a sua relação entre hábitos parafuncionais em uma população de pacientes classe II esquelética. Método: Uma amostra composta por pacientes classe II esquelética foi selecionada de forma não probabilística. Setenta e três indivíduos concordaram em participar da pesquisa, se submetendo ao exame físico que consistia na aplicação do Eixo I do (RDC/TMD). Resultados: Quarenta e seis por cento dos pacientes examinados apresentaram diagnóstico positivo. A média de idade dos pacientes foi de 27 anos+ 8,73 anos, 82% do gênero feminino e 80% brancos. Trinta e quatro pacientes referiram alguma atividade parafuncional. Desses a onicofagia representou o grupo com maior frequência, seguido pelo bruxismo, interposição de objetos entre os dentes e por último o apertamento. As variáveis não apresentaram associação estatisticamente significante com o desfecho primário estudado. Conclusão: Na amostra estudada não se observou associação entre a ocorrência de DTM e hábitos parafuncionais em pacientes classe II esquelética... (AU)
Introduction: Temporomandibular disorder (TMD) is the most common chronic orofacial pain, found by dentists and other health professionals. Its etiology has a multifactorial character, and may involve, from hereditary factors, parafunctional habits, malocclusions, to anxiety and stress. Objective: This study investigated the TMD frequency and its relationship among parafunctional habits in a population of skeletal class II patients. Method: A sample composed by a class II patients was selected in a non probabilistic manner. Seventy-three members agreed to participate in the research, submitting themselves to a physical examination that consists in the application of Axis I (RDC/TMD). Results: Forty-six percent of patients diagnosed with a positive diagnosis. The average age of the patients was 27 years ± 8.73 years, 82% female and 80% white. Thirty-four patients reported some parafunctional activity. Of these, biting nail represented the group most frequently, followed by bruxism, interposition of objects between the teeth and lastly clenching. As variables did not present a statistically significant association with the primary outcome studied. Conclusion: In the sample studied, it is observed that there is no association between TMD occurrence and parafunctional habits in skeletal class II patients... (AU)
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Humanos , Masculino , Femenino , Dolor Facial , Bruxismo , Trastornos de la Articulación Temporomandibular , Deformidades Dentofaciales , Deformidades Dentofaciales/complicaciones , Maloclusión , Hábito de Comerse las Uñas , Ansiedad , Examen Físico , UñasRESUMEN
Dentre as dificuldades encontradas para a inclusão de crianças com Transtorno do Espectro Autista (TEA) nas escolas está a falta de conhecimentos técnicos e instrumentos específicos que ofereçam suporte à prática dos profissionais da educação e às escolas. Considerando essa necessidade, foi aplicado um programa de capacitação, com base no referencial teórico da Análise do Comportamento, para 18 professores do Ensino Fundamental de uma escola de cidade do interior do Estado de São Paulo, com o objetivo de capacitá-los a aprenderem estratégias para promover a participação de alunos com TEA em atividades de grupo utilizando jogos cooperativos. Foram ministradas cinco aulas com enfoque prático, abordando os temas: jogos cooperativos, prompt e reforço. A avaliação do curso foi feita de três modos: aplicação de Pré-Teste, Pós-Teste e Follow-up. Para avaliar a aprendizagem dos professores participantes, foi solicitada aos professores uma atividade de simulação de situações e intervenções vivenciadas junto a alunos com TEA, a partir dos conteúdos aprendidos, e a aplicação da Escala de Avaliação do Ensino em Língua Oral em Contexto Escolar (EVALOE) para avaliar a atuação dos ministrantes. Os resultados indicaram que os participantes apresentaram mais acertos no pós-teste do que no pré-teste, a avaliação deles sobre o curso foi positiva e a atuação dos ministrantes satisfatória. Ressalta-se a importância de elaborar capacitações para os docentes e a necessidade de fornecer a eles mais materiais de apoio e atividades de autoaprendizagem.
Among the difficulties found for the inclusion of children with Autism Spectrum Disorder (ASD) in schools is the lack of technical knowledge and specific instruments that support the practice of education professionals and schools. Considering this need, a training program has been implemented based on the theoretical framework of behavior analysis for 18 elementary school teachers from a school in a city in the countryside of the State of São Paulo in order to enable them to learn strategies to promote the participation of students with ASD in group activities using cooperative games. Five classes have been given with a practical approach, addressing the themes: cooperative games, prompt and reinforcement. The evaluation of the course has been done in three steps: Pre-Test, Post-Test and Follow-up application. In order to evaluate the learning of the participating teachers, they performed a simulation activity of situations and interventions experienced with students with ASD based on the contents learned. In addition, the Assessment Scale of Oral Language Teaching at the School Context (EVALOE) was applied to evaluate the performance of the instructors. The results have indicated that the participants have had more correct answers in the Post-test than in the Pre-test, their evaluation of the course has been positive, and the performance of the students satisfactory. The importance of developing training for teachers and the need to provide them with more support materials and self-learning activities is emphasized.
En medio de las dificultades encontradas en la inclusión de los niños y niñas con Trastorno del Espectro Autista (TEA) en las escuelas, está la falta de conocimientos técnicos y instrumentos específicos que conceden soporte a la práctica de los profesionales de la educación y a las escuelas. Considerando esta necesidad, se aplicó un programa de capacitación a 18 maestros de la Escuela Primaria y Secundaria de una ciudad del estado de São Paulo, con el fin de capacitarles para promover la participación de alumnos con TEA en actividades en grupo utilizando los juegos cooperativos. Cinco clases fueron ministradas con un enfoque práctico, abordando los temas: juegos cooperativos, Prompt y refuerzo. Los resultados indicaron que los profesores tuvieron más éxito en el post-test que en el pre-test, aplicados para evaluar el curso, y su evaluación, en general, fue positiva. Se hace hincapié en la importancia de elaborar la capacitación de los docentes y la necesidad de proporcionarles más materiales de apoyo y actividades de autoaprendizaje.
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Humanos , Trastorno del Espectro Autista , Formación del Profesorado , Maestros , Juego e Implementos de Juego , Educación Primaria y Secundaria , Evaluación Educacional , AprendizajeRESUMEN
The aim of this study was to evaluate the seroprevalence and factors associated with the presence of anti-Toxoplasma gondii and anti-Neospora caninum antibodies in sheep from Paraná state. The detection of antibodies for T. gondii and N. caninum was performed by homemade and commercial indirect ELISA, respectively. Multiple logistic regression analysis was used to verify the factors associated with the seroprevalence. Antibodies anti-T. gondii and anti-N. caninum were observed in 42.7% and in 17.6% of the animals, respectively. The protective factors associated to seropositive were "some level of confinement" (full or semi-extensive confinement) (OR=0.53) for T. gondii and "use of skilled labor" (OR=0.64) for N. caninum. The risk factors were "presence of cats" (OR=1.75) for T. gondii and "feeding of dogs with sheep placental remains" (OR=1.79) for N. caninum. In addition, to presenting a significant and simultaneous seroprevalence for both agents (9.9% of the animals), the results also indicate that deficiencies in management and environmental sanitation, the presence of reservoirs, and types of exploitation enhance the seropositivity. Thus, studies like this might support sanitary programs and public policies for the prevention of T. gondii and N. caninum in the sheep herds of Paraná state.
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Enfermedades de los Gatos , Coccidiosis , Enfermedades de los Perros , Neospora , Enfermedades de las Ovejas , Toxoplasma , Toxoplasmosis Animal , Animales , Anticuerpos Antiprotozoarios , Brasil/epidemiología , Gatos , Coccidiosis/veterinaria , Perros , Femenino , Embarazo , Prevalencia , Estudios Seroepidemiológicos , Ovinos , Enfermedades de las Ovejas/diagnóstico , Enfermedades de las Ovejas/epidemiología , Toxoplasmosis Animal/diagnóstico , Toxoplasmosis Animal/epidemiologíaRESUMEN
Abstract The aim of this study was to evaluate the seroprevalence and factors associated with the presence of anti-Toxoplasma gondii and anti-Neospora caninum antibodies in sheep from Paraná state. The detection of antibodies for T. gondii and N. caninum was performed by homemade and commercial indirect ELISA, respectively. Multiple logistic regression analysis was used to verify the factors associated with the seroprevalence. Antibodies anti-T. gondii and anti-N. caninum were observed in 42.7% and in 17.6% of the animals, respectively. The protective factors associated to seropositive were "some level of confinement" (full or semi-extensive confinement) (OR=0.53) for T. gondii and "use of skilled labor" (OR=0.64) for N. caninum. The risk factors were "presence of cats" (OR=1.75) for T. gondii and "feeding of dogs with sheep placental remains" (OR=1.79) for N. caninum. In addition, to presenting a significant and simultaneous seroprevalence for both agents (9.9% of the animals), the results also indicate that deficiencies in management and environmental sanitation, the presence of reservoirs, and types of exploitation enhance the seropositivity. Thus, studies like this might support sanitary programs and public policies for the prevention of T. gondii and N. caninum in the sheep herds of Paraná state.
Resumo O objetivo deste estudo foi avaliar a soroprevalência e os fatores de risco associados à presença de anticorpos contra Toxoplasma gondii e Neospora caninum em ovinos do Paraná. A detecção dos anticorpos para T. gondii e N. caninum foi realizada, usando-se testes de ELISA indireto caseiro e comercial, respectivamente. A análise de regressão logística múltipla foi usada para verificar os fatores de risco associados à soroprevalência. Anticorpos anti-T. gondii e anti-N. caninum foram observados em 42,7% e em 17,6% dos animais, respectivamente. Os fatores de proteção associados à soropositividade foram "algum nível de confinamento (confinamento ou semiextensivo)" (OR=0,53) para T. gondii e "presença de mão de obra especializada" para N. caminum (OR=0,64). Os fatores de risco foram "presença de gatos" para T. gondii (OR=1,75) e "alimentação de cães com resíduos placentários" (OR=1,79) para N. caninum. Além de apresentar uma significante e simultânea soroprevalência para ambos os agentes (9,9% dos animais), os resultados também indicam que as deficiências em gestão e saneamento ambiental, a presença de reservatórios e os tipos de exploração favorecem a soropositividade. Dessa forma, estudos como estes podem auxiliar em programas sanitários e políticas públicas para a prevenção de T. gondii e N. caninum nos rebanhos ovinos do Paraná.
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Animales , Femenino , Embarazo , Gatos , Perros , Enfermedades de las Ovejas/diagnóstico , Enfermedades de las Ovejas/epidemiología , Enfermedades de los Gatos , Coccidiosis/veterinaria , Neospora , Enfermedades de los Perros , Toxoplasma , Brasil/epidemiología , Ovinos , Anticuerpos Antiprotozoarios , Estudios Seroepidemiológicos , Toxoplasmosis Animal/diagnóstico , Toxoplasmosis Animal/epidemiología , PrevalenciaRESUMEN
INTRODUCTION: Atypical atrial flutter (AFL) is a supraventricular arrhythmia that can be treated with catheter ablation. However, this strategy yields suboptimal results and the best approach is yet to be defined. Carto® electroanatomical mapping (EAM) version 7 displays a histogram of the local activation times (LAT) of the tachycardia cycle length (TCL), in addition to activation and voltage maps. Using these EAM tools, the study aimed to assess the ability of an electrophysiologic triad to identify and localize the critical isthmus in AFL. METHODS: Retrospective analysis using Carto® EAM of a single center registry of individuals who underwent left AFL ablation over one year. Subjects with non-left AFL, no high-density EAM, under 2000 points or no left atrium wall or structure mapping were excluded. Sites where arrhythmia is terminated via ablation were compared to an electrophysiologic triad comprising areas of low-voltage (0.05 to 0.3 mV), deep histogram valleys (LAT-valleys) with less than 20% density points relative to the highest density zone and a prolonged LAT-valley duration, which included 10% or more of the TCL. The longest LAT-valley was designated as the primary valley, while additional valleys were named as secondary. RESULTS: A total of nine subjects (six men, median age 75, interquartile range 71-76 years) were included. All patients presented with left AFL and 66% had a history of ablation for atrial fibrillation and/or flutter. The median TCL and collected points were 254 ms (220-290) and 3300 (IQR 2410-3926) points, respectively. All individuals with AFL presented with at least one LAT-valley on the analyzed histograms, which corresponded to heterogeneous low voltage areas (0.05 to 0.3 mV) and affected more than 10% of TCL. Six of the nine patients presented with a secondary LAT-valley. All arrhythmias were terminated successfully following radiofrequency ablation at the primary LAT-valley location. After a minimum three-month follow-up all patients remained in sinus rhythm. CONCLUSION: An electrophysiologic triad identified the critical isthmus in AFL for all patients. Further studies are needed to assess the usefulness of this algorithm in improving catheter ablation outcomes.
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Aleteo Atrial , Ablación por Catéter , Anciano , Aleteo Atrial/cirugía , Atrios Cardíacos , Humanos , Masculino , Estudios Retrospectivos , TaquicardiaRESUMEN
BACKGROUND Medical therapy for heart failure with reduced ejection fraction evolved since trials validated the use of implantable cardioverter-defibrillators (ICDs). We sought to evaluate the performance of ICDs in reducing mortality in the era of modern medical therapy by means of a systematic review and meta-analysis of contemporary randomized clinical trials of drug therapy for heart failure with reduced ejection fraction. METHODS AND RESULTS We systematically identified randomized clinical trials that evaluated drug therapy in patients with heart failure with reduced ejection fraction that reported mortality. Studies that enrolled <1000 patients, patients with left ventricular ejection fraction >40%, or patients in the acute phase of heart failure and study treatment with devices were excluded. We identified 8 randomized clinical trials, including 31 701 patients of whom 3631 (11.5%) had an ICD. ICDs were associated with a lower risk of all-cause mortality (relative risk [RR], 0.85; 95% CI, 0.78-0.94) and sudden cardiac death (RR, 0.49; 95% CI, 0.40-0.61). Results were consistent among studies published before and after 2010. In meta-regression analysis, the proportion of nonischemic etiology did not affect the associated benefit of ICD. CONCLUSIONS In our meta-analysis of contemporary randomized trials of drug therapy for heart failure with reduced ejection fraction, the rate of ICD use was low and associated with a decreased risk in both all-cause mortality and sudden cardiac death. This benefit was still present in trials with new medical therapy.
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Fármacos Cardiovasculares/uso terapéutico , Muerte Súbita Cardíaca/prevención & control , Desfibriladores Implantables , Cardioversión Eléctrica/instrumentación , Insuficiencia Cardíaca/terapia , Volumen Sistólico/efectos de los fármacos , Función Ventricular Izquierda/efectos de los fármacos , Anciano , Fármacos Cardiovasculares/efectos adversos , Cardioversión Eléctrica/efectos adversos , Cardioversión Eléctrica/mortalidad , Femenino , Insuficiencia Cardíaca/diagnóstico , Insuficiencia Cardíaca/mortalidad , Insuficiencia Cardíaca/fisiopatología , Humanos , Masculino , Persona de Mediana Edad , Ensayos Clínicos Controlados Aleatorios como Asunto , Recuperación de la Función , Medición de Riesgo , Factores de Riesgo , Factores de Tiempo , Resultado del TratamientoRESUMEN
This research, divided into two studies, expanded the content validity examination of the Teacher Behavior Checklist (TBC). In Study 1, the objective was to identify the degree of relevance attributed by teachers and undergraduates to the 28 TBC items, based on what they consider to characterize an effective teacher. The participants of Study 1 were 85 teachers and 91 students from different Brazilian universities. They assessed the TBC items on a seven-point scale (ranging from "1 = totally irrelevant" to "7 = totally relevant"). Students (Mean = 5.7) and teachers (6.1) considered the TBC items to be relevant. Study 2 sought to identify the 10 most important TBC qualities based on student perceptions. The participants of Study 2 were 995 undergraduates whose choices of items corroborated results from previous TBC studies. These data encourage the use of TBC in teacher formative assessment and research on effective teaching. (AU)
Esta pesquisa, dividida em dois estudos, ampliou a investigação da validade de conteúdo do Teacher Behavior Checklist (TBC). No Estudo 1, o objetivo foi identificar o grau de relevância atribuído por professores e graduandos aos 28 itens do TBC, baseados no que consideram caracterizar um professor eficaz. Participaram 85 professores e 91 estudantes de diferentes universidades brasileiras. Eles avaliaram os itens do TBC segundo uma escala de setes pontos ("1 = totalmente irrelevante" a "7 = totalmente relevante"). Estudantes (Média = 5,7) e professores (6,1) consideraram os itens do TBC relevantes. O Estudo 2 buscou identificar quais são as 10 qualidades mais importantes do TBC segundo estudantes. Participaram 995 graduandos cujas escolhas de itens corroboraram resultados de estudos anteriores com o TBC. Esses dados incentivam o uso do TBC na avaliação formativa de professores e na pesquisa sobre ensino eficaz. (AU)
Esta encuesta, dividida en dos estudios, amplió la investigación de validez de contenido del Teacher Behavior Checklist (TBC). El estudio 1 tuvo por objetivo identificar el grado de relevancia atribuido por profesores y estudiantes a los 28 ítems del TBC, basados en lo que consideran caracterizar un profesor eficaz. Participaron 85 profesores y 91 estudiantes de diferentes universidades brasileñas. Ellos evaluaron los ítems del TBC según una escala de siete puntos ("1 = totalmente irrelevante" a "7 = totalmente relevante"). Estudiantes (Media = 5,7) y profesores (6,1) consideraron los ítems del TBC relevantes. El estudio 2 buscó identificar cuáles son las 10 cualidades más importantes del TBC según los estudiantes. Participaron 995 estudiantes cuyas elecciones de los ítems corroboraron resultados de estudios previos con el TBC. Estos datos incentivan el uso del TBC en la evaluación formativa de profesores y en la investigación sobre enseñanza eficaz. (AU)
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Humanos , Femenino , Adulto , Estudiantes/psicología , Evaluación del Rendimiento de Empleados , Docentes/psicología , Reproducibilidad de los ResultadosRESUMEN
This study demonstrates that the electron beam irradiation of materials, typically used in characterization measurements, could be employed for advanced fabrication, modification, and functionalization of composites. We developed irradiation equipment using an electron beam irradiation source to be applied in materials modification. Using this equipment, the formation of a thick Ag film on the Ag3PO4 semiconductor is carried out by electron beam irradiation for the first time. This is confirmed by various experimental techniques (X-ray diffraction, field-emission scanning electron microscopy, Raman spectroscopy, and X-ray photoelectron spectroscopy) and ab initio molecular dynamics simulations. Our calculations demonstrate that, at the earlier stages, metallic Ag growth is initiated preferentially at the (110) surface, with the reduction of surface Ag cations forming metallic Ag clusters. As the (100) and (111) surfaces have smaller numbers of exposed Ag cations, the reductions on these surfaces are slower and are accompanied by the formation of O2 molecules.
RESUMEN
Abstract Performance evaluations help university teachers to improve teaching, especially when based on internationally recognized criteria. This study aimed to carry out a cross-cultural adaptation of the Teacher Behavior Checklist (TBC) for Brazilian students to evaluate their teachers (Study 1) and investigate its psychometric evidence (Study 2). In Study 1, evidence was favorable to the use of TBC for teacher evaluation by the student. In Study 2, 714 public university students participated (Average age = 24.3 years; SD = 6.85), 57.2% women. The TBC was applied collectively in the classroom. The results corroborated the two-factor model according to the instrument's original version, demonstrating an evidence of validity. Evidence of reliability has been documented (alpha = 0.92; Test-Retest = 0.75). This study presented an adequate instrument for the teacher formative evaluation and expanded Brazil's insertion in international research on effective teaching.
Resumo Avaliações de desempenho auxiliam professores universitários a aperfeiçoar o ensino, especialmente quando baseadas em critérios internacionalmente reconhecidos. O objetivo deste estudo foi realizar uma adaptação transcultural do Teacher Behavior Checklist (TBC) para que discentes brasileiros avaliem seus professores (Estudo 1) e investigar suas evidências psicométricas (Estudo 2). No Estudo 1 as evidências foram favoráveis ao uso do TBC para a avaliação docente pelo discente. No Estudo 2, participaram 714 estudantes de universidade pública (Média de idade = 24,3 anos; DP = 6,85), 57,2% mulheres. O TBC foi aplicado coletivamente em sala de aula. Os resultados corroboraram o modelo de dois fatores conforme a versão original do instrumento, demonstrando uma evidência de validade. Foram documentadas evidências de fidedignidade (alpha = 0,92; Teste-Reteste = 0,75). Este estudo apresentou instrumento adequado para a avaliação formativa docente e ampliou a inserção do Brasil na investigação internacional sobre ensino eficaz.
Resumen Las evaluaciones de desempeño ayudan a que los docentes universitarios mejoren la enseñanza, sobre todo cuando se basan en criterios reconocidos internacionalmente. El presente estudio tuvo como objetivo llevar a cabo una adaptación transcultural de la Teacher Behavior Checklist (TBC) para que los estudiantes brasileños evalúen a sus profesores (Estudio 1), así como investigar las evidencias psicométricas (Estudio 2). En el Estudio 1, las evidencias fueron favorables al uso de la TBC para que el estudiante evalúe al profesor. En el Estudio 2, participaron 714 estudiantes de una universidad pública (Promedio de edad = 24,3 años; DE = 6,85), siendo el 57,2% mujeres. La TBC se aplicó colectivamente en el aula. Los resultados corroboran el modelo de dos factores de acuerdo con la versión original del instrumento, lo que demuestra evidencia de validez. Se documentaron evidencias de fiabilidad (alfa = 0,92; Test-Retest = 0,75). Este estudio presentó un instrumento adecuado para evaluar a los docentes y expandió la inserción de Brasil en la investigación internacional sobre la enseñanza efectiva.
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Humanos , Masculino , Femenino , Psicometría , Estudiantes , Enseñanza , Universidades , Conducta , Adaptación a Desastres , Evaluación del Rendimiento de Empleados , Docentes , MaestrosRESUMEN
Background Outcomes of catheter ablation of atrial fibrillation (AF) are variable and the predictors of success require further elucidation since the identification of correctable risk factors could help to optimize therapy. We aimed to assess the impact of body mass index (BMI) in the overall safety and efficacy of catheter ablation of AF, with emphasis on the use of cryoballoon ablation and novel oral anticoagulants. Methods and Results There were 2497 consecutive patients undergoing catheter ablation of AF in 7 European high volume centers were stratified according to BMI (normal weight <25 kg/m2, pre-obese 25-30 kg/m2, obesity 30-35 kg/m2, and morbid obesity ≥35 kg/m2) and comparisons of procedural outcomes evaluated. Pre-obese and obese patients presented more comorbidities (hypertension, diabetes mellitus, and sleep apnea), and had higher rates of non-paroxysmal AF ablation procedures. The rate of atrial 12-month arrhythmia relapse increased alongside with BMI (35.2%, 35.7%, 43.6%, and 48.0% P<0.001). During a median follow-up of 18.8 months (interquartile range 11-28), after adjusting for all baseline differences, BMI was an independent predictor of relapse (hazard ratio=1.01 per kg/m2; 95% CI 1.01-1.02; P=0.002), adding incremental predictive value to obstructive sleep apnea. BMI was not a predictor for any of the reported complications. Using novel oral anticoagulants and cryoballoon ablation was safe and efficacy was comparable with vitamin-K antagonists and radiofrequency ablation. Conclusions Obese patients present with a more adverse comorbidity profile, more advanced forms of AF, and have lower chances of being free from AF relapse after ablation. Use of novel oral anticoagulants and cryoballoon ablation may be an option in this patient group.
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Fibrilación Atrial/cirugía , Índice de Masa Corporal , Ablación por Catéter/métodos , Obesidad/epidemiología , Medición de Riesgo/métodos , Fibrilación Atrial/epidemiología , Comorbilidad , Europa (Continente)/epidemiología , Femenino , Humanos , Incidencia , Masculino , Persona de Mediana Edad , Recurrencia , Factores de Riesgo , Tasa de Supervivencia/tendenciasRESUMEN
AIMS: The aim of this study was to use non-invasive electrocardiographic imaging (ECGI) to study the electrophysiological properties of right ventricular outflow tract (RVOT) in patients with frequent premature ventricular contractions (PVCs) from the RVOT and in controls. METHODS: ECGI is a combined application of body surface electrocardiograms and computed tomography or magnetic resonance imaging data. Unipolar electrograms are reconstructed on the epicardial and endocardial surfaces. Activation time (AT) was defined as the time of maximal negative slope of the electrogram (EGM) during QRS, recovery time (RT) as the time of maximal positive slope of the EGM during T wave, Activation recovery interval (ARI) was defined as the difference between RT and AT. ARI dispersion (Δ ARI) and RT dispersion (Δ RT) were calculated as the difference between maximal and minimal ARI and RT respectively. We evaluated those parameters in patients with frequent PVCs from the RVOT, defined as >10.000 per 24â¯h, and in a control group. RESULTS: We studied 7 patients with frequent RVOT PVCs and 17 controls. Patients with PVCs from the RVOT had shorter median RT than controls, in the endocardium and in the epicardium, respectively 380 (239-397) vs 414 (372-448) ms, pâ¯=â¯0.047 and 275 (236-301) vs 330 (263-418) ms, pâ¯=â¯0.047. The dispersion of ARI and of RT in the epicardium was higher than in controls, Δ ARI of 145 (68-216) vs 17 (3-48) ms, pâ¯=â¯0.001 and Δ RT of 201 (160-235) vs 115 (65-177), pâ¯=â¯0.019. CONCLUSION: In this group of patients we found a shorter median RT in the endocardium and in the epicardium of the RVOT and a higher dispersion of the ARI and RT across the epicardium in patients with PVCs from the RVOT when comparing to controls.
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Ablación por Catéter , Taquicardia Ventricular , Complejos Prematuros Ventriculares , Electrocardiografía , Endocardio , Ventrículos Cardíacos , Humanos , Taquicardia Ventricular/cirugía , Complejos Prematuros Ventriculares/diagnóstico , Complejos Prematuros Ventriculares/cirugíaRESUMEN
Aim: To develop a method for enantioseparation of several chiral derivatives of xanthones (CDXs) by LC using a human serum albumin-chiral stationary phase (HSA-CSP) and screening CDX-HSA affinity. Additionally, recognition mechanisms were investigated. Materials & methods: The influence of organic modifier, buffer type, pH and ionic strength of mobile phase, and temperature were explored. The affinity was determined by measuring the retention times and further calculation of bound percentage. Chiral recognition mechanisms were investigated by docking. Results: Enantioselectivity and resolution values ranged from 1.40 to 9.16 and 1.51 to 4.97. Bound percentages ranged from 79.02 to 99.99%. Conclusion: LC systematic study and binding affinity of CDXs on HSA-CSP are presented here for the first time, expanding the applications of HSA-CSP for this class of compounds.