Measurement properties of the Regular Physical Exercise Adherence Scale (REPEAS) in individuals with chronic pain.

OBJECTIVE: To examine the measurement properties of the Regular Physical Exercise Adherence Scale (REPEAS) in Brazilians with chronic pain. METHODS: Cross-sectional and longitudinal design (washout period for reliability). The study was conducted in two Brazilian states, Maranhão and São Paulo, and included Brazilian adults, irregular exercisers, former exercisers or non-exercise practitioners, aged 18 to 59 years and with chronic pain. The instruments used in this study were: the REPEAS, the Numerical Pain Rating Scale (NPRS), the Baecke Habitual Physical Activity Questionnaire (BHPAQ), the Pain Self-Efficacy Questionnaire (PSEQ), and the Roland-Morris Disability Questionnaire for general pain (RMDQ-g). The evaluation focused on structural validity, construct validity, reliability (with standard error of measurement and minimum detectable change), internal consistency, and floor and ceiling effects. RESULTS: The two-dimensional structure was tested through confirmatory factor analysis, which resulted in adequate fit indeces: chi-square values/degrees of freedom = 1.541, Tucker-Lewis Index = 0.966, comparative fit index = 0.974, root mean square error of approximation = 0.074, and standardized root mean square residual = 0.068. Additionally, satisfactory factor loadings (> 0.40) were obtained. Test-retest reliability and internal consistency were adequate for the environmental factors domain (intraclass correlation coefficient [ICC] = 0.79, Cronbach's alpha = 0.88) and the personal factors domain (ICC = 0.97, Cronbach's alpha = 0.93). In hypothesis testing for construct validity, we observed a significant correlation with magnitude below 0.30 of the environmental factors domain of the REPEAS with RMDQ-g, PSEQ and sport domain of the BHPAQ. For the personal factors domain, we observed a significant correlation with a magnitude of 0.30 to 0.50 with RMDQ-g, PSEQ, and sport domain of the BHPAQ, and below 0.30 with leisure domain of the BHPAQ. No floor or ceiling effects were found for the REPEAS domains. CONCLUSION: The REPEAS is a valid instrument with a two-dimensional internal structure consisting of 12 items. It has a reliable construct and is suitable for use in the clinical and epidemiological context for adults with chronic pain in Brazil.

Translation, cross-cultural adaptation, and validation of health and self-management in diabetes questionnaire (HASMID-10) into Brazilian Portuguese

ABSTRACT BACKGROUND: Considering the ability of the health and self-management in diabetes questionnaire (HASMID-10) to verify the impact of self-management on diabetes, we highlight its relevance to scientific research and clinical applicability. However, to date, no study has been conducted to scientifically support its use in other languages. OBJECTIVE: To translate, cross-culturally adapt, and validate the HASMID-10 into the Brazilian Portuguese. DESIGN AND SETTING: A translation, cross-cultural adaptation, and validation study conducted at Ceuma University. METHODS: Study was conducted in accordance with the Guidelines for the Process of Cross-Cultural Adaptation of Self-Report Measures and Consensus-based Standards for the Selection of Health Measurement Instruments. We included participants of both sexes diagnosed with diabetes, aged between 18 and 64 years, and without cognitive deficits or any other limitations that would prevent them from answering the questionnaire. We assessed participants using the problem areas in diabetes (PAID) scale and HASMID-10. We assessed reliability using a test-retest model with a 7-day interval between assessments. We used intraclass correlation coefficient (ICC), 95% confidence interval (CI), standard error of measurement (SEM), minimum detectable difference (MDD), Spearman correlation coefficient, and floor and ceiling effects. RESULTS: Sample comprised 116 participants, most of whom were women, overweight, non-practitioners of physical activity, and nonsmokers. We observed significant correlations (P = 0.006; rho = −0.256) between the HASMID-10 and PAID, adequate reliability (ICC = 0.780) and internal consistency (Cronbach's alpha = 0.796). No ceiling or floor effects were observed. CONCLUSION: HASMID-10 has adequate measurement properties and may be used for Brazilians.

Regular Physical Exercise Adherence Scale (REPEAS): a new instrument to measure environmental and personal barriers to adherence to regular physical exercise.

OBJECTIVE: To create, develop, and validate a scale that identifies the environmental and personal barriers that make it difficult to adhere to the practice of physical exercise on a regular basis in a population of Brazilian adults. METHODS: We include adult individuals, aged 18-59 years, practitioners or former practitioners of physical exercise, with Brazilian Portuguese as their mother tongue. In the development and validation phases of the process, 6 specialists in the field of the health assessed the content validity: firstly, the specialists were asked to freely list the questions they would ask to investigate the barriers to adherence to regulating physical activity. Secondly, after compiling all the suggestions listed and eliminating suggestions with similar content, the items suggested in the first round were sent to the specialists so that an evaluation of all questions using a 5-point Likert scale and the content validity coefficient was calculated. We then evaluated the structural validity, construct validity, reliability, internal consistency, and ceiling and floor effects of the Regular Physical Exercise Adherence Scale (REPEAS). RESULTS: Sixteen items were proposed to measure the factors that make it difficult to adhere to the regular practice of physical exercise. The internal structure of the REPEAS initially tested was based on the theoretical proposal of creating the instrument with two domains. After the structural analysis, we used the modification indices to identify the redundant items of the instrument. Consequently, the final version of the REPEAS after factor analysis had 12 items. Thus, the structure with 2 domains and 12 items presented adequate fit indices. With regard to construct validity, the REPEAS scores were compared in two distinct groups: irregular practitioners/ex-practitioners versus regular practitioners of physical exercise, in which a significant difference could be observed between groups (p < 0.001) for both the domains. Acceptable reliability was observed for the environment and personal domains, with ICC values of 0.86 and 0.94, in the same order. For internal consistency, Cronbach's alpha value was 0.908 (environmental domain) and 0.915 (personal domain), these values being adequate for the REPEAS. CONCLUSION: The REPEAS is a scale with a valid two-dimensional internal structure, consisting of 12 items, reliable and with a valid construct, which supports its use in the clinical, epidemiological, and research contexts in Brazil.

Estimating pandemic effects in urban mass transportation systems: An approach based on visibility graphs and network similarity.

The COVID-19 pandemic has caused unprecedented disruptions to urban systems worldwide, but the extent and nature of these disruptions are not yet fully understood when it comes to transportation. In this work, we aim to explore how social distancing policies have affected passenger demand in urban mass transportation systems with the goal of supporting informed decisions in policy planning. We propose an approach based on complex networks and clustering time series with similar behavior, investigating possible changes in similarity patterns during pandemics and how they reflect into a regional scale. The methods shown here proved useful in detecting that lines in central or peripheral regions present different dynamics, that bus lines have changed their behavior during pandemic so that similarity relations have changed significantly, and that when social distancing started, there was an abrupt shock in the properties of daily passenger time series, and the system did not return to its original behavior until the end of the evaluated period. The approach allows to track evolution of the community structure in different scenarios providing managers with tools to reinforce or destabilize similarities if needed.

Anterior hepatic resection: A simple and safe technique for reducing the antero-posterior diameter of the liver graft for small pediatric recipients.

BACKGROUND: The techniques involved in neonatal and infantile transplantation require approaches that can sculpt a left lateral segment (LLS) to the right shape and size and avoid large-for-size syndrome. The aim of this article is to describe the anterior hepatic resection (AHR) of the LLS in pediatric LDLT. METHODS: A retrospective anatomical study of preoperative image studies, description of the technique for AHR, and short-term results. RESULTS: The AHR was performed in eight cases. All donors were male, with average age, BW, and BMI of 28.3 ± 5.9 years, 74.2 ± 9.3 kg, and 24.3 ± 2.6 kg/m2, respectively. Donors were discharged at an average of 3.6 ± 0.8 days. The median recipient age and BW at transplantation were 6.9 (2.7 to 11) months and 5.9 (3.9 to 8) kg, respectively, and the recipient-to-donor body weight ratio (RDBW) was <0.1 in all but one case. The mean percentage reduction in graft weight and in the antero-posterior diameter were 33.2% ± 5.5% and 38.3% ± 12.6%, respectively. The average (SD) GRWR was 4.8% ± 1.7% before all the resections and 3.5% ± 1.0% after the procedures. Seven patients were primarily closed. CONCLUSION: After LLS resection, a nonanatomical anterior resection of the LLS was accomplished without hilar vascular dissection to segments II/III. The final liver graft allowed primary abdominal wall closure in all but one patient, with meaningful adjustments in GRWR. AHR proved to be simple, safe, reproducible, and effective in the presented case series.

Liver transplantation for hilar inflammatory myofibroblastic tumor: Case report and review of the literature.

BACKGROUND: Inflammatory myofibroblastic tumors (IMTs) of the liver are rare neoplasms. These tumors are difficult to distinguish from other neoplasms by radiological examination, have uncertain evolution, and there is no consensus on the treatment of these lesions. Hilar tumors can involve the portal vein, hepatic artery, bile duct, and spread to the branches of the portal triad, causing obstructive symptoms, occlusive phlebitis, and portal hypertension. Thus, liver transplantation (LT) is an excellent alternative for locally advanced hilar tumors, since it ensures complete tumor resection with free margins. METHODS/RESULTS: We present a literature review and a case report showing a 3-year-old boy with liver IMT invading the hepatic hilum and inferior vena cava, who underwent a successful living donor liver transplantation that required portal vein and vena cava replacement. CONCLUSION: The incidence of hilar IMTs is low and there is no well-established standard treatment. Liver transplantation for a hilar tumor with vascular invasion was acceptable in this case because the radically of the surgery was the key for the cure, and because the tumor was benign in nature.

Semi-Supervised Framework with Autoencoder-Based Neural Networks for Fault Prognosis.

This paper presents a generic framework for fault prognosis using autoencoder-based deep learning methods. The proposed approach relies upon a semi-supervised extrapolation of autoencoder reconstruction errors, which can deal with the unbalanced proportion between faulty and non-faulty data in an industrial context to improve systems' safety and reliability. In contrast to supervised methods, the approach requires less manual data labeling and can find previously unknown patterns in data. The technique focuses on detecting and isolating possible measurement divergences and tracking their growth to signalize a fault's occurrence while individually evaluating each monitored variable to provide fault detection and prognosis. Additionally, the paper also provides an appropriate set of metrics to measure the accuracy of the models, which is a common disadvantage of unsupervised methods due to the lack of predefined answers during training. Computational results using the Commercial Modular Aero Propulsion System Simulation (CMAPSS) monitoring data show the effectiveness of the proposed framework.

Delirium in the intensive care unit: identifying difficulties in applying the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU).

BACKGROUND: Delirium is an underdiagnosed condition and this may be related, among other causes, to the incorrect use of assessment tools due to lack of knowledge about cognitive assessment and lack of training of the care team. The aim of this study was to investigate the difficulties encountered by the nursing team in the application of the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU) in patients on mechanical ventilation. METHODS: This is descriptive study with a qualitative approach in a private tertiary hospital located in northeast Brazil. Data collection took place from July 2018 to January 2019. We included 32 nurses and used face-to-face semi-structured interviews. The recorded data were analysed using content analysis. This study followed the recommendations of the Standards for Reporting Qualitative Research (SRQR). RESULTS: We identified three major categories: lack of knowledge of professionals, subdivided into deficit in academic formation, difficulty in the differential diagnosis of delirium and delusion, and lack of knowledge about the steps of the CAM-ICU; difficulty in patient cooperation; and lack of adequate training to apply the CAM-ICU. CONCLUSION: Nurses have a deficit in academic formation on delirium and need adequate training for the correct and frequent use of the CAM-ICU.

Intra- and Interrater Reliability of Short-Term Measurement of Heart Rate Variability on Rest in Individuals Post-COVID-19.

Individuals affected by COVID-19 have an alteration in autonomic balance, associated with impaired cardiac parasympathetic modulation and, consequently, a decrease in heart rate variability (HRV). This study examines the inter- and intrarater reliability of HRV) parameters derived from short-term recordings in individuals post-COVID. Sixty-nine participants of both genders post-COVID were included. The RR interval, the time elapsed between two successive R-waves of the QRS signal on the electrocardiogram (RRi), were recorded during a 10 min period in a supine position using a portable heart rate monitor (Polar® V800 model). The data were transferred into Kubios® HRV standard analysis software and analyzed within the stable sessions containing 256 sequential RRi. The intraclass correlation coefficient (ICC) ranged from 0.920 to 1.000 according to the intrarater analysis by Researcher 01 and 0.959 to 0.999 according to the intrarater by Researcher 02. The interrater ICC ranged from 0.912 to 0.998. The coefficient of variation was up to 9.23 for Researcher 01 intrarater analysis, 6.96 for Researcher 02 intrarater analysis and 8.83 for interrater analysis. The measurement of HRV in post-COVID-19 individuals is reliable and presents a small amount of error inherent to the method, supporting its use in the clinical environment and in scientific research.

Evaluation of peripheral neuropathy in lower limbs of patients with rheumatoid arthritis and its relation to fall risk.

BACKGROUND: Rheumatoid Arthritis (RA) is a chronic disabling systemic disease characterized by joint inflammation, and extra-articular manifestations, including peripheral neuropathy, a condition that can be associated with changes in muscle strength, proprioception and postural balance contributing for the risk of falls. The objective of this study is to analyze the incidence of peripheral neuropathy in patients with RA and its association with the occurrence of falls. METHODS: Patients were assessed by an electroneuromyography (ENMG) exam and by a questionnaire on accidental falls occurrence in the previous 12 months. They were also assessed on balance by the Short Physical Performance Battery (SPPB), functionality by the Health Assessment Questionnaire (HAQ), disease activity by the Disease Activity Score (DAS-28), neuropathic pain by the Questionnaire for the Diagnosis of Neuropathic Pain (DN4), and cutaneous sensitivity of the feet by the monofilament testing of Semmes-Weinstein. Monthly calls on falls were made in the subsequent six months. Data analysis was performed using the Shapiro-Wilk test for normality and Spearman, Chi-square, and T-student correlation tests, with a significant P level ≤ 0.05. RESULTS: A sample of 33 patients were evaluated. The incidence of peripheral neuropathy was 48.5%, of which 68.7% were axonal and 31.3% myelinic. The sensorimotor type was present in 64.7%, motor in 17.6%, and sensorial in 11.7% of the cases. Neuropathy was associated to balance (P = 0.026), neuropathic pain (P = 0.016), deep tendon reflexes absence (P = 0,049), altered skin sensitivity of the feet (P = 0.029) and fear of falling (P = 0.001). No association was found between peripheral neuropathy and age, gender, disease activity, or functionality. No significant association was found between peripheral neuropathy and occurrence of falls, in a 12-month retrospective and 6-month prospective evaluation. CONCLUSION: Peripheral neuropathy has a high incidence in patients with RA, and is related to neuropathic pain, altered postural balance, but not to the occurrence of falls.

Eficácia da eletroestimulação no tratamento da incontinência urinária de esforço: uma metanálise / Effectiveness of electrostimulation in treating stress urinary incontinence: a metanalysis

Introdução: A eletroestimulação é reconhecida como uma das terapias fundamentais na reeducação esfincteriana e do períneo, ao promover a contração dos músculos e permitir ao paciente tomar consciência de si mesmo. Ela induz a contração dos MAP até o restabelecimento da voluntariedade do comando contrátil e ganho de força muscular, garantindo um bom funcionamento das fibras estriadas do esfíncter uretral externo, proporcionando a continência urinária. Objetivo: Identificar a frequência mais utilizada na eletroestimulação para a recuperação da incontinência urinária de esforço (IUE) em mulheres e homens; verificar a eficácia da eletroestimulação no tratamento da incontinência urinária de esforço. Métodos: Realizou-se uma busca nas bases de dados US National Library of Medicine (Medline), Scientific Eletronic Library Online (Scielo), Physiotherapy Evidence Database (PEDro), Cochrane Library, Lilacs, Web of Science, Scopus, Cinahl e Sport Discus, com os descritores incontinência urinária, eletroestimulação e estimulação elétrica, por experimentos controlados randomizados (ECR). Foram incluídos estudos com pacientes homens e mulheres de qualquer idade com IUE, que foram submetidos a eletroestimulação, selecionados pela escala Jadad e avaliado o risco de viés pela ferramenta da Colaboração Cochrane. Dos estudos foram extraídos a idade e sexo dos pacientes, n dos grupos, frequência utilizada na eletroestimulação, duração da sessão, quantidade de sessões, duração do tratamento, avaliação da IUE e o resultado da IUE. Foi utilizado para avaliar o nível de evidência da metanálise o sistema GRADE. Foram metanalisados 8 estudos utilizando-se o RevMan 5.3. Resultados: A frequência mais utilizada na eletroestimulação foi de 50 Hz em mulheres e em homens. Foram identificados 172 ECR, dos quais 26 ECR foram revisados e 8 ECR foram metanalisados. Seis ECR eram com mulheres e apresentaram heterogeneidade (I2 = 48%), redução da IUE de -12,08 g, IC 95% de -14,08 - 10,08 g, P < 0,00001. Para homens, 2 ECR que apresentaram heterogeneidade (I2 = 0%), redução da IUE de -151,28 g, IC de -236,64 - 65,92 g, P < 0,0005. Conclusão: A frequência mais utilizada na eletroestimulação para recuperar a continência urinária de mulheres com IUE e homens com IU pós-prostatectomia foi a de 50 Hz e se mostrou eficaz na recuperação da continência. Entretanto, recomenda-se atenção em relação aos resultados obtidos com os homens, devido ao muito baixo nível de evidência encontrado. (AU)

Intestinal complications are common in patients with acquired diaphragmatic hernia after pediatric living donor liver transplantation.

BACKGROUND: Acquired diaphragmatic hernia (DH) following liver transplantation (LT) is usually considered a surgical emergency. Interplay of contributing elements determines its occurrence but, in children, LT with partial liver grafts seems to be the most important causative factor. METHODS: This retrospective study describes the clinical scenario and outcomes of 11 patients with acquired DH following LDLT. RESULTS: During the study period, 1109 primary pediatric LDLT were performed (0.8% DH). The median age and BW of the recipients with DH at transplantation were 17 months and 11.1 kg, respectively; 63.7% of the cases had a weight/age Z-score of less than -2 at transplantation. The median interval between transplantation and diagnosis of DH was 114 days (32-538 days). A total of 6 (54.5%) of the patients had bowel obstruction due to bowel migration into the hemithorax. Ten defects were right-sided. Three patients required enterectomy and enterorrhaphy. Two patients required a new bilioenteric anastomosis, and one of them had complete necrosis of the Roux-in-Y limb. The patient with left-side DH presented gastroesophageal perforation. CONCLUSION: Most defects necessitate primary closure as the first treatment, and recurrence is rare. The associated problems encountered, especially related to intestinal complications, can determine increased morbidity following DH repair. Early diagnosis and intervention are required for achieving better outcomes.

Treinamento cardiorrespiratório e força dos músculos ventilatórios de idosas: ensaio controlado randomizado duplo cego / Cardiorespiratory training and ventilatory muscle strength in elderly women: double blind randomized controlled trial

A dinapenia da musculatura ventilatória relaciona-se com as complicações respiratórias pós-operatórias e aos óbitos de idosos submetidos a procedimentos cirúrgicos de etiologia toracoabdominal. Objetivo: Verificar o efeito crônico do treinamento cardiorrespiratório sobre a força dos músculos ventilatórios de idosas. Métodos: Amostra (n = 24) randomizada nos grupos: controle (n = 8), treinamento ventilatório (n = 7) e treinamento cardiorrespiratório (n = 9). O desfecho primário (PImáx e PEmáx) foi medido por um manovacuômetro digital MDV®300 (MDI/Brasil). Rodou-se a estatística descritiva (média e desvio padrão), seguida de uma ANOVA 3x3 e o testes post-hoc de Bonferroni, todos com significância de (P ≤ 0,05). Resultados: O teste Post Hoc atestou diferença estatisticamente significativa do grupo treinamento cardiorrespiratório no reteste 1 e 2 quando comparados ao teste inicial (PImáx; P = 0,000001 e P = 0,0000001 respectivamente) e (PEmáx; P = 0,000000 em ambas as comparações). Conclusão: O treinamento cardiorrespiratório proposto foi capaz de aumentar significativamente a PImáx, PEmáx, resistência aeróbica e a força de membros inferiores das participantes deste ECR. (AU)

O dedo apontando a lua: experimentando o contato entre Gestalt-Terapia e Zen Budismo / The finger pointing to the moon: experiencing the contact between Gestalt Therapy and Zen Buddhism / El dedo apuntando a la luna: experimentando el contacto entre la Terapia Gestalt y el Budismo Zen

Na virada dos séculos XIX e XX ocorre maior interesse entre intelectuais ocidentais nas religiões e filosofias do Oriente. Alguns autores deste período e alguns contemporâneos nossos pontuam que o budismo não se caracteriza como uma religião, nem uma filosofia. O próprio Zen Budismo se apresenta como uma metodologia para o treinamento da mente buscando o desenvolvimento pessoal. Em meados do último século, a Gestalt-terapia emerge em meio ao diálogo das ciências ocidentais com diversas influências orientais. Atualmente, temos poucas publicações brasileiras que abordam as interfaces entre estas duas tradições e este artigo busca discutir possíveis interfaces entre a abordagem gestáltica e o Zen. Assim, apresentamos brevemente a história, alguns pressupostos, conceitos e práticas essenciais do Zen Budismo e convidamos o leitor a uma reflexão sobre a compreensão da meditação como prática experiencial a partir de paralelos observados nestas tradições. Sabemos que meditação e psicoterapia gestáltica são caminhos distintos, porém observamos algumas aproximações que denotam a possibilidade dessas metodologias serem complementares para o desenvolvimento pessoal. Este diálogo também nos abre campo para a reflexão sobre o ensino e a prática meditativa durante a formação de Gestalt-terapeutas e seu uso clínico.

At the turn of the twentieth century there is a growing interest in Eastern religions and philosophies among Western intellectuals. Some authors from this period and also contemporary ones point out that Buddhism is not characterized as a religion, nor a philosophy. Zen Buddhism presents itself as a methodology for training the mind in pursuit of personal development. In the middle of the last century, Gestalt therapy emerges amidst the dialogue of Western sciences with various oriental influences. There are currently few Brazilian publications that address the interfaces between these two traditions and this article seeks to discuss possible interfaces between the Gestalt approach and Zen. Thus, it briefly presents its history, some beliefs and concepts, and essential practices in order to invite the reader to reflect on meditation as an experiential practice and parallels observed between these traditions. Meditation and Gestalt Therapy are distinct paths, but some likelinesses denote the possibility of these methodologies being complementary to one another for personal development. This article also invites the reader to reflect on teaching and practicing meditation during clinical training and its clinical use.

Al rededor del siglo XX, hay un mayor interés entre los intelectuales occidentales sobre las religiones y filosofías orientales. Algunos autores de este período y algunos de nuestros contemporáneos señalan que el budismo no se caracteriza como una religión ni una filosofía. El propio Budismo Zen se presenta como una metodología para entrenar la mente en la búsqueda del desarrollo personal. A mediados del siglo pasado, la Terapia Gestalt surge en entre el diálogo de las ciencias occidentales con diversas influencias orientales. Actualmente hay pocas publicaciones brasileñas que aborden las interfaces entre estas dos tradiciones y este artículo busca discutir posibles interfaces entre el enfoque Gestalt y el Zen. Por lo tanto, presentamos brevemente la historia, algunas ideas, conceptos y prácticas esenciales del Zen e invitamos el lector a pensar sobre la comprensión de la meditación como práctica experiencial desde los paralelos observados entre estas tradiciones. Sabemos que la meditación y la psicoterapia gestáltica son caminos distintos, pero observamos algunas aproximaciones que denotan la posibilidad de que estas metodologías sean complementarias para el desarrollo personal. Este diálogo también convida a la reflexión sobre la enseñanza y la práctica meditativa durante la formación de terapeutas y su uso clínico.

Revolução budista ou apocalipse zumbi? discussões sobre mindfulness a partir de uma perspectiva gestáltica / Buddhist revolution or zombie apocalypse? discussions on mindfulness from a gestalt perspective / ¿Revolución budista o apocalipsis zombi? debates sobre la atención plena desde una perspectiva gestáltica / Révolution bouddhiste ou apocalypse zombie? discussions sur la pleine conscience du point de vue de la gestalt-thérapie

Resumo A busca por práticas meditativas orientais como tecnologia promotora de saúde e qualidade de vida tem aumentado significativamente nos últimos anos. Contudo percebe-se que a falta de compreensão dos conceitos e princípios dos quais emergem tais técnicas produzem propostas que podem ser tanto uma saída revolucionária quanto distópica. Propomos neste texto uma breve discussão sobre o movimento de mindfulness a partir de uma perspectiva gestáltica de influência goodmaniana. Assim, (a) apresentamos de maneira resumida a transmissão destas práticas desde tradições budistas até a ciência ocidental contemporânea; (b) destacamos alguns aspectos teóricos que aproximam e distanciam a Gestalt-terapia de pressupostos budistas; e (c) discutimos a apropriação dessas tradições, seus valores e suas tecnologias por um paradigma neoliberal utilitarista.

Abstract While the search for Eastern meditative practices as health and quality of life technology has increased significantly in recent years, the lack of understanding regarding core concepts and values from which such techniques emerge produces proposals that can be either revolutionary or dystopic. This text proposes a brief discussion concerning the mindfulness movement based on Goodman's gestalt. Thus, we (a) briefly present the transmission of these practices from Buddhist traditions to contemporary Western science; (b) highlight some theoretical aspects that bring gestalt-therapy closer to and distance it from Buddhist premises; and (c) discuss the appropriation of such traditions, their values and technologies by a utilitarian neoliberal paradigm.

Resumen La búsqueda de prácticas meditativas orientales como herramienta de salud y calidad de vida ha aumentado significativamente en los últimos años. Sin embargo, la falta de comprensión de los conceptos y valores centrales de los cuales surgen tales técnicas produce propuestas que pueden ser revolucionarias o distópicas. En este texto proponemos hacer una breve discusión sobre el movimiento de la atención plena desde una perspectiva gestáltica goodmaniana. Así, (a) presentamos brevemente la transmisión de estas prácticas desde las tradiciones budistas hasta la ciencia occidental contemporánea; (b) destacamos algunos aspectos teóricos que acercan y alejan la terapia gestalt de las referencias budistas; y (c) discutimos la apropiación de estas tradiciones, sus valores y tecnologías por un paradigma neoliberal utilitario.

Résumé Alors que la recherche de pratiques méditatives orientales comme technologie de santé et de la qualité de vie s'est considérablement accrue ces dernières années, le manque de compréhension des concepts et valeurs fondamentales dont émergent ces techniques produit des propositions qui peuvent être soit révolutionnaires, soit dystopiques. Ce texte propose une brève discussion sur le mouvement de pleine conscience basée sur la gestalt-thérapie de Goodman. Ainsi, nous (a) présentons brièvement la transmission de ces pratiques des traditions bouddhistes à la science occidentale contemporaine ; (b) soulignons certains aspects théoriques qui rapprochent et éloignent la gestalt-thérapie des prémisses bouddhistes ; et (c) discutons de l'appropriation de ces traditions, de leurs valeurs et de leurs technologies par un paradigme néolibéral utilitaire.

Forecast Model Update Based on a Real-Time Data Processing Lambda Architecture for Estimating Partial Discharges in Hydrogenerator.

The prediction of partial discharges in hydrogenerators depends on data collected by sensors and prediction models based on artificial intelligence. However, forecasting models are trained with a set of historical data that is not automatically updated due to the high cost to collect sensors' data and insufficient real-time data analysis. This article proposes a method to update the forecasting model, aiming to improve its accuracy. The method is based on a distributed data platform with the lambda architecture, which combines real-time and batch processing techniques. The results show that the proposed system enables real-time updates to be made to the forecasting model, allowing partial discharge forecasts to be improved with each update with increasing accuracy.

Urgency and discontinuity of oral health care in children and adolescents. / Urgência e descontinuidade do cuidado em saúde bucal de crianças e adolescentes.

The aim of the present study was to investigate the discontinuity of oral health care among children and adolescents who accessed emergency services at primary care units and urgent care units. Records were reviewed of patients aged 0 to 17 years treated in the public healthcare system in city of Curitiba, Brazil. Discontinuity was considered when elective treatment was not registered at the primary care unit within six months after urgent care. The sample was stratified based on the Municipal Human Development Index (MHDI) (≤0.799 or ≥0.800). The association between discontinuity and covariables was assessed using univariate and multivariate Poisson regression models with robust variance (α=0.05). The incidence of discontinuity was 42.2%. In the MHDI≤0.799 stratum, the risk of discontinuity was greater among children younger than five years of age and individuals who had not had a dental appointment in the previous year. In both MHDI strata, the risk of discontinuity was higher in patients who received urgent care at an urgent care unit than those treated at a primary care unit. The incidence of the discontinuity of oral health care was high and was strongly influenced by the characteristics of dental service utilization among individuals living in regions with a lower MHDI.

Wavelet-Like Transform to Optimize the Order of an Autoregressive Neural Network Model to Predict the Dissolved Gas Concentration in Power Transformer Oil from Sensor Data.

Dissolved gas analysis (DGA) is one of the most important methods to analyze fault in power transformers. In general, DGA is applied in monitoring systems based upon an autoregressive model; the current value of a time series is regressed on past values of the same series, as well as present and past values of some exogenous variables. The main difficulty is to decide the order of the autoregressive model; this means determining the number of past values to be used. This study proposes a wavelet-like transform to optimize the order of the variables in a nonlinear autoregressive neural network to predict the in oil dissolved gas concentration (DGC) from sensor data. Daubechies wavelets of different lengths are used to create representations with different time delays of ten DGC, which are then subjected to a procedure based on principal components analysis (PCA) and Pearson's correlation to find out the order of an autoregressive model. The representations with optimal time delays for each DGC are applied as input in a multi-layer perceptron (MLP) network with backpropagation algorithm to predict the gas at the present and future times. This approach produces better results than choosing the same time delay for all inputs, as usual. The forecasts reached an average mean absolute percentage error (MAPE) of 5.763%, 1.525%, 1.831%, 2.869%, and 5.069% for C2H2, C2H6, C2H4, CH4, and H2, respectively.

Expression of human HSP27 in yeast extends replicative lifespan and uncovers a hormetic response.

Human HSP27 is a small heat shock protein that modulates the ability of cells to respond to heat shock and oxidative stress, and also functions as a chaperone independent of ATP, participating in the proteasomal degradation of proteins. The expression of HSP27 is associated with survival in mammalian cells. In cancer cells, it confers resistance to chemotherapy; in neurons, HSP27 has a positive effect on neuronal viability in models of Alzheimer's and Parkinson's diseases. To better understand the mechanism by which HSP27 expression contributes to cell survival, we expressed human HSP27 in the budding yeast Saccharomyces cerevisiae under control of different mutant TEF promoters, that conferred nine levels of graded basal expression, and showed that replicative lifespan and proteasomal activity increase as well as the resistance to oxidative and thermal stresses. The profile of these phenotypes display a dose-response effect characteristic of hormesis, an adaptive phenomenon that is observed when cells are exposed to increasing amounts of stress or toxic substances. The hormetic response correlates with changes in expression levels of HSP27 and also with its oligomeric states when correlated to survival assays. Our results indicate that fine tuning of HSP27 concentration could be used as a strategy for cancer therapy, and also for improving neuronal survival in neurodegenerative diseases.

Use of a High-Power Laser for Wound Healing: A Case Report.

Introduction: The use of low-level laser therapy to treat wounds and accelerate tissue healing has extensively been studied in recent years. The aim of this article is to describe a clinical case using an unfocused high-power laser instead of a low-power laser for therapy. Case Report: In the present article, we present the use of a high-power diode laser to treat an extensive knee injury that occurred after surgical treatment for total prosthesis due to border ischemia resulting from prolonged use of autostatic retractors. Conclusion: It is possible to use an unfocused high-power laser at a decreased intensity to accelerate healing as an adjuvant in the treatment of complicated wounds. This procedure results in reduced application time and cost and an excellent tissue response pattern similar to that reported in the literature with low-power lasers.