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1.
Schizophr Res ; 271: 355-370, 2024 Sep.
Article in English | MEDLINE | ID: mdl-39098303

ABSTRACT

INTRODUCTION: Catatonia, documented since the 19th century, remains a significant challenge in terms of recognition and treatment. Over the last two decades, ketamine has brought new perspectives to psychiatry, sparking widespread interest. Concurrently, catatonia has attracted heightened scientific attention. Preliminary evidence suggests the therapeutic potential of ketamine for catatonia. METHODS: We systematically searched Medline/PubMed, Embase, PsycINFO, Lilacs, and Cochrane Library databases, as well as Google Scholar, for studies with ketamine or its enantiomers as intervention for catatonia, with no restrictions to underlying diagnosis, date, language, or study design. RESULTS: Twenty articles were included, encompassing a total of 25 catatonic patients receiving ketamine or esketamine. Predominantly female (61.9 %), with a mean age of 44.4 years, patients mostly exhibited manifestations compatible with the retarded subtype of catatonia. Mood disorders were the most prevalent underlying diagnoses. Ketamine was primarily administered intravenously over a 40-minute period and in multiple-dosing schemes. Mean response and remission rates of catatonic manifestations for the whole sample were 80 % and 44 %, respectively, with no reports of worsening catatonic features or psychotic symptoms. Only one patient discontinued treatment due to intolerable dissociative effects. CONCLUSION: Challenging the conventional contraindication of ketamine in psychotic disorders, current evidence highlights its potential efficacy, particularly in treating catatonia. Pending further research, we advocate reevaluating this contraindication, as it may offer a promising therapeutic option, especially for challenging cases. Preliminary evidence suggests potentially greater benefits for catatonic patients with underlying mood disorders compared to primary psychotic disorders.


Subject(s)
Catatonia , Ketamine , Humans , Catatonia/drug therapy , Ketamine/administration & dosage , Ketamine/pharmacology , Female
2.
Rev. homeopatia (São Paulo) ; 85(1): 50-58, 2024.
Article in Portuguese | LILACS, HomeoIndex Homeopathy, MOSAICO - Integrative health | ID: biblio-1562976

ABSTRACT

Este artigo tem como objeto o papel da narração das histórias de vida dos pacientes durante a consulta homeopática na promoção da saúde e produção de autonomia dos sujeitos. Objetivos e Metodologia: A partir da abordagem sócio-histórica, foi realizada revisão de literatura narrativa, a fim de identificar os limites e as possibilidades do ato de narrar na racionalidade médica homeopática para a produção de subjetividades e autonomia na trajetória singular de cada indivíduo levar sua vida. Considerações Finais: Há atualidade e consonância de conceitos da racionalidade médica homeopática com o paradigma contemporâneo da promoção da saúde; as narrativas produzidas no ato da anamnese homeopática têm a potencialidade de ampliar a compreensão médica e do indivíduo para além da doença, analisando o fenômeno existencial do adoecimento. A anamnese homeopática, ao valorizar as experiências existenciais relatadas no âmbito de uma consulta, concorre para uma valorização dos sujeitos, o que contribuiria para a construção de sua subjetividade, autonomia e emponderamento.


This article focuses on the role of narrating patients' life stories during homeopathic consultations in promoting health and producing autonomy for subjects. Objectives and Methodology: Using a socio-historical approach, a narrative literature review was carried out in order to identify the limits and possibilities of the act of narrating in homeopathic medical rationality for the production of subjectivities and autonomy in the unique trajectory of each individual. your life. Final Considerations: The concepts of homeopathic medical rationality are current and consistent with the contemporary paradigm of health promotion; The narratives produced in the act of homeopathic anamnesis have the potential to expand medical and individual understanding beyond the disease, analyzing the existential phenomenon of illness. Homeopathic anamnesis, by valuing the existential experiences reported in the context of a consultation, contributes to an appreciation of the subjects, which would contribute to the construction of their subjectivity, autonomy and empowerment.


Subject(s)
Rationalization , Professional Autonomy , Patient-Centered Care , Health Promotion
3.
Article in English | MEDLINE | ID: mdl-37717263

ABSTRACT

BACKGROUND: Ketamine and esketamine have both shown significant antidepressant effects in treatment-resistant depression (TRD), and conflicting evidence suggests that induced dissociation by these drugs can be a clinical predictor of esketamine/ketamine's efficacy. METHODS: This study is a secondary analysis from a bi-center, randomized, controlled trial. Participants were randomly assigned 1:1 to receive an IV infusion of esketamine (.25 mg/kg) or racemic ketamine (.50 mg/kg) over 40 minutes. Dissociative symptoms were assessed using the Clinician-Administered Dissociative State Scale (CADSS) 40 minutes following the beginning of the infusion. The variation in depression scores was measured with the Montgomery-Asberg Depression Rating Scale (MADRS), which was administered before the intervention as a baseline measure and 24 hrs, 72 hrs, and 7 days following infusion. RESULTS: Sixty-one patients were included in the analysis. Examining CADSS scores of 15 or below, for every 1-point increment in the CADSS score, there was a mean change of -0.5 (SD = 0.25; p-value 0.04) of predicted MADRS score from baseline to 24 hrs. The results for 72 hrs and 7 days following infusion were not significant. Limitations: This study was not designed to assess the relationship between ketamine or esketamine-induced dissociation and antidepressant effects as the main outcome, therefore confounding variables for this relationship were not controlled. CONCLUSION: We suggest a positive relationship between dissociation intensity, measured by CADSS, and antidepressant effect 24 hours after ketamine and esketamine infusion for a CADSS score of up to 15 points.

4.
J Affect Disord ; 330: 7-15, 2023 06 01.
Article in English | MEDLINE | ID: mdl-36871913

ABSTRACT

BACKGROUND: Racemic ketamine is a mixture of (R)-ketamine (arketamine) and (S)-ketamine (esketamine), with the latter regarded as the main isomer for antidepressant effects. However, preclinical data and one open-label human trial suggest arketamine might exert a more potent and longer-lasting antidepressant effect with fewer side effects. We aimed to explore the feasibility of a randomized controlled trial of arketamine for treatment-resistant depression (TRD) and to assess its efficacy and safety compared to placebo. METHODS: This is a, randomized, double-blind, crossover, pilot trial (n = 10). All participants received saline and arketamine (0.5 mg/kg) with a one-week interval. Treatment effects were analyzed with a linear mixed effects (LME) model. RESULTS: Our analysis suggested the presence of a carryover effect, so the main efficacy analysis was limited to the first week, which demonstrated a main effect of time (p = 0.038) but not for treatment (p = 0.40) or their interaction (p = 0.95). This indicates that depression improved over time, but without significant difference between arketamine and placebo. Analyzing the two weeks together, findings were the same. Dissociation and other adverse events were minimal. LIMITATIONS: This was a pilot study with a small sample and underpowered. CONCLUSIONS: Arketamine was not superior to placebo for TRD but demonstrated to be extremely safe. Our findings reinforce the importance of continuing studies with this drug, with better powered clinical trials, perhaps considering a parallel design with higher or flexible doses and repeated administrations.


Subject(s)
Depression , Depressive Disorder, Treatment-Resistant , Humans , Pilot Projects , Depression/drug therapy , Antidepressive Agents/adverse effects , Drug Therapy, Combination , Depressive Disorder, Treatment-Resistant/drug therapy , Double-Blind Method , Treatment Outcome
5.
Parasitol Res ; 122(1): 127-137, 2023 Jan.
Article in English | MEDLINE | ID: mdl-36308532

ABSTRACT

The conversion of natural areas into agricultural landscapes results in different mosaics of land use types, modifying biodiversity and consequently altering the patterns of ecological interactions, such as between frugivorous bats and ectoparasites. Our objectives were to investigate whether variations in the configuration and composition of human-disturbed landscapes interfere with the prevalence and average intensity of ectoparasite infestation in the frugivorous bats Artibeus lituratus (Olfers, 1818), Carollia perspicillata (Linnaeus, 1758), and Sturnira lilium (É Geoffroy, 1810), in a region of the Brazilian Atlantic Forest. We also evaluated whether there is a response in the parasite load associated with the ectoparasite group (mite or fly). We found six species of flies and three mites. The proportion of infested hosts was more affected by the landscape than the mean infestation values. Land cover diversity influenced seven of the interactions studied. Forest cover affected eight of the interactions and was associated with a reduction in the parasite load in seven of them. The increase in the proportion of edges per area of each fragment presented a different influence related to the host species. Variations in parasite load did not show any typical response related to the mite or fly group. Our study indicates that landscape configuration and composition interfere with bat-ectoparasite interactions, which may be related to interference in encounter rates between hosts (for mites and flies) and between hosts and their ectoparasites in roosts (for flies). The taxonomic identity of the interacting species suggests that the relationship with the landscape is context-dependent.


Subject(s)
Chiroptera , Diptera , Ectoparasitic Infestations , Mites , Humans , Animals , Mites/physiology , Chiroptera/parasitology , Diptera/physiology , Prevalence , Ectoparasitic Infestations/epidemiology , Ectoparasitic Infestations/veterinary , Ectoparasitic Infestations/parasitology , Brazil/epidemiology , Host-Parasite Interactions
6.
Trends Psychiatry Psychother ; 45: e20210298, 2023.
Article in English | MEDLINE | ID: mdl-34904800

ABSTRACT

OBJECTIVES: Evidence suggests that ketamine's influence on brain-derived neurotrophic factor (BDNF) might be involved in its mechanism of rapid antidepressant action. We aimed to evaluate the differential impact of ketamine and esketamine on serum BDNF levels and its association with response patterns in treatment-resistant depression (TRD). METHODS: Participants (n = 53) are from a randomized, double-blind clinical trial comparing the efficacy of single-dose ketamine (0.5mg/kg, n = 27) and esketamine (0.25mg/kg, n = 26) in TRD. Depression severity was assessed before and 24 hours, 72 hours, and 7 days after the intervention, using the Montgomery-Åsberg Depression Rating Scale (MADRS). Blood samples were collected before infusion, 24 hours, and 7 days afterwards. RESULTS: There were no significant changes in BDNF levels at post-infusion evaluation points, and no difference in BDNF levels comparing ketamine and esketamine. Both drugs exhibited similar therapeutic effect. There was no association between BDNF levels and response to treatment or severity of depressive symptoms. CONCLUSION: There was no significant treatment impact on BDNF serum levels - neither with ketamine nor esketamine - despite therapeutic response. These results suggest that ketamine or esketamine intervention for TRD has no impact on BDNF levels measured at 24 hours and 7 days after the infusion.


Subject(s)
Depressive Disorder, Treatment-Resistant , Ketamine , Humans , Brain-Derived Neurotrophic Factor , Ketamine/therapeutic use , Depression , Depressive Disorder, Treatment-Resistant/drug therapy
7.
Trends Psychiatry Psychother. (Online) ; 45: e20210298, 2023. tab, graf
Article in English | LILACS-Express | LILACS | ID: biblio-1424715

ABSTRACT

Abstract Objectives Evidence suggests that ketamine's influence on brain-derived neurotrophic factor (BDNF) might be involved in its mechanism of rapid antidepressant action. We aimed to evaluate the differential impact of ketamine and esketamine on serum BDNF levels and its association with response patterns in treatment-resistant depression (TRD). Methods Participants (n = 53) are from a randomized, double-blind clinical trial comparing the efficacy of single-dose ketamine (0.5mg/kg, n = 27) and esketamine (0.25mg/kg, n = 26) in TRD. Depression severity was assessed before and 24 hours, 72 hours, and 7 days after the intervention, using the Montgomery-Åsberg Depression Rating Scale (MADRS). Blood samples were collected before infusion, 24 hours, and 7 days afterwards. Results There were no significant changes in BDNF levels at post-infusion evaluation points, and no difference in BDNF levels comparing ketamine and esketamine. Both drugs exhibited similar therapeutic effect. There was no association between BDNF levels and response to treatment or severity of depressive symptoms. Conclusion There was no significant treatment impact on BDNF serum levels - neither with ketamine nor esketamine - despite therapeutic response. These results suggest that ketamine or esketamine intervention for TRD has no impact on BDNF levels measured at 24 hours and 7 days after the infusion. This clinical trial is registered on the Japan Primary Registries Network: UMIN000032355.

8.
Chemosphere ; 307(Pt 4): 136157, 2022 Nov.
Article in English | MEDLINE | ID: mdl-36029853

ABSTRACT

This work reports the radicals detected and identified during the degradation of atrazine in methanol medium in the presence and absence of different proportions of water (0%, 5%, and 10%). The determination of these radicals is an important step to understand the electrolysis processes in methanol medium and contribute to clarify the degradation mechanism. Furthermore, the parameters for the successful removal of the contaminant were optimized and the results showed that the application of the technique led to the removal of nearly 99.8% of atrazine after 1 h of electrolysis. The oxidation kinetics was found to be very fast and most of the atrazine molecule in the medium was degraded in the first hour of electrolysis. The results obtained from a thorough analysis conducted with a view to evaluating the effects of different current densities and initial pH values on atrazine degradation showed that the application of higher current densities resulted in lower energy consumption, as this led to faster removal of atrazine. Additionally, the initial pH of the solution was found to favor the formation of different species of active chlorine. The radicals formed during the electro-oxidation process were detected by electron paramagnetic resonance spectroscopy and include hydroxyl, methoxy and hydroxymethyl. The use of methanol for the degradation of pollutants is a highly promising technique and this work shows that the identification of the different radicals formed in the process can be the key to understanding the degradation mechanism.


Subject(s)
Atrazine , Water Pollutants, Chemical , Water Purification , Atrazine/chemistry , Chlorine , Electrodes , Methanol , Oxidation-Reduction , Water , Water Pollutants, Chemical/chemistry , Water Purification/methods
10.
Hum Psychopharmacol ; 37(4): e2836, 2022 07.
Article in English | MEDLINE | ID: mdl-35179810

ABSTRACT

BACKGROUND: Major depressive disorder (MDD) is a leading cause of disability worldwide and most people do not achieve symptom remission. Treatment-resistant depression (TRD) is characterized by the failure of at least one adequate trial of a major class of antidepressant, with adequate time and dosage. We aimed to identify clinical predictors of depressive symptom remission and response 24 h and 7 days after racemic ketamine and esketamine infusions. METHODS: A randomized, double-blind, active-controlled, non-inferiority trial using ketamine and esketamine in TRD. Individuals diagnosed with MDD according to Diagnostic and Statistical Manual of Mental Disorders version IV and fulfilling TRD criteria were recruited from March 2017 to June 2018. Participants received a single subanesthetic dose of ketamine (0.5 mg/kg) or esketamine (0.25 mg/kg) for 40 min. Depressive symptoms were assessed using the Montgomery-Åsberg Depression Rating Scale (MADRS) and symptom remission was defined as a MADRS score ≤7 and response defined as ≥50% reduction in depressive symptom severity, 24 h and 7 days after the infusion. Clinical variables were selected based on previous clinical trials. Stepwise backward logistic regression was used, considering a confidence level of 95%. RESULTS: 61 subjects were included: 39 (63.9%) were females with a mean age of 47.2 ± 14.9. Higher number of therapeutic failures (Odds Ratio (OR) = 0.677; 95% confidence interval (CI): 0.47-0.97) and higher severity of illness (OR = 0.912; 95% CI: 0.83-0.99) were associated with fewer remissions of depressive symptoms 7 days after intervention, and with fewer response in 24 h (OR = 0.583; 95% CI: 0,40; 0,84 and OR = 0.909; 95% CI: 0,83; 0,99, respectively). CONCLUSION: Number of treatment failures and severity of illness were predictors of fewer remissions and responses of depressive symptoms in this TRD population. Study of predictors of remission may contribute to better selection patients that may benefit from receiving ketamine.


Subject(s)
Depressive Disorder, Major , Depressive Disorder, Treatment-Resistant , Ketamine , Adult , Depression , Depressive Disorder, Major/drug therapy , Depressive Disorder, Treatment-Resistant/diagnosis , Depressive Disorder, Treatment-Resistant/drug therapy , Double-Blind Method , Female , Humans , Ketamine/therapeutic use , Male , Middle Aged , Treatment Outcome
11.
J Fluoresc ; 32(1): 81-86, 2022 Jan.
Article in English | MEDLINE | ID: mdl-34731385

ABSTRACT

Functionalization of BODIPY dyes is commonly used to modulate photophysical properties. Among the chemical modification of these dyes, ring fusion indifferent faces of dipyrromethene cores is gaining attention in the literature, due to the modulation of emission/absorption properties and fluorophores with increased bright. N-bridged arylated BODIPYs were recently synthesized and shows intense bright and blu shifted emission. However, few examples of substituted compounds are described and none involving arylation with extention of the π-conjugation. In this manuscript, it is shown an optimized method for the synthesis of N-bridged arylated BODIPYs, including arylated derivatives, and the studies of molecular properties. It is also shown that fluorinated aryl substituted N-bridged arylated BODIPYs show high quantum yields and are red-shifted compared to unsubstituted examples. The work open opportunities for application of the new developed compounds as probes.

12.
Sci Rep ; 11(1): 15271, 2021 07 27.
Article in English | MEDLINE | ID: mdl-34315932

ABSTRACT

COVID-19 has widely spread around the world, impacting the health systems of several countries in addition to the collateral damage that societies will face in the next years. Although the comparison between countries is essential for controlling this disease, the main challenge is the fact of countries are not simultaneously affected by the virus. Therefore, from the COVID-19 dataset by the Johns Hopkins University Center for Systems Science and Engineering, we present a temporal analysis on the number of new cases and deaths among countries using artificial intelligence. Our approach incrementally models the cases using a hierarchical clustering that emphasizes country transitions between infection groups over time. Then, one can compare the current situation of a country against others that have already faced previous waves. By using our approach, we designed a transition index to estimate the most probable countries' movements between infectious groups to predict next wave trends. We draw two important conclusions: (1) we show the historical infection path taken by specific countries and emphasize changing points that occur when countries move between clusters with small, medium, or large number of cases; (2) we estimate new waves for specific countries using the transition index.


Subject(s)
Artificial Intelligence , COVID-19/epidemiology , Forecasting/methods , Cluster Analysis , Databases, Factual , Humans , Pandemics
13.
J Psychiatr Res ; 138: 576-583, 2021 06.
Article in English | MEDLINE | ID: mdl-33991996

ABSTRACT

Dissociative symptoms are common, possibly severe, side effects associated with the use of ketamine and esketamine in depression. We investigated the relationship between trait dissociation and dissociation induced by ketamine and esketamine used as augmentation therapy in treatment-resistant depression (TRD). Adults with TRD were randomly assigned to receive a single intravenous infusion, with a duration of 40 min, of either esketamine 0.25 mg/kg or ketamine 0.5 mg/kg. We assessed trait dissociation with the Dissociative Experience Scale (DES) and, to evaluate induced dissociation, the Clinician-Administered Dissociative States Scale (CADSS) was used. Thirty-two subjects received esketamine and 29 received ketamine. The groups had similar median DES scores (p = 0.26). More than 30% of the patients in both groups had DES scores ≥30 points. The median CADSS score in the esketamine group was equivalent to that in the ketamine group (p = 0.40). Every 5 points increment in the DES was associated with a 10.9% (95% CI 4.5-17.8%) increase in the CADSS, in an exponential fashion when the two groups were pooled together. Subjects with high trait dissociation had a higher risk of induced dissociation state (relative risk [RR] 1.41, 95% CI 1.11-1.78) and very high induced dissociation (RR 3.05, 95% CI 1.14-8.15). Induced dissociation was not a serious adverse effect. The findings suggest that trait dissociation is a predictor of induced dissociation by Ketamine or Esketamine in TRD subjects. Screening for trait dissociation and counseling patients with high trait dissociation on the risks of dissociation by these drugs are recommended.


Subject(s)
Depressive Disorder, Treatment-Resistant , Ketamine , Adult , Antidepressive Agents/adverse effects , Depression , Depressive Disorder, Treatment-Resistant/drug therapy , Humans , Ketamine/adverse effects
15.
Chemosphere ; 273: 129696, 2021 Jun.
Article in English | MEDLINE | ID: mdl-33524759

ABSTRACT

The electro-oxidation of tetracycline (TeC) in methanol medium containing chloride or sulfate ions was evaluated using a DSA®-Cl2 in a flow reactor and compared with BDD. The results show that after 30 min of electrolysis no TeC is detected by liquid chromatography when chloride is used as supporting electrolyte. On the other hand, after 90 min of electrolysis using a BDD anode only 61% of TeC was removed from solutions with chloride, but in the presence of sulfate the removal reaches 94%. This evidences that the oxidizing species generated during electrochemical oxidation control the process and the mechanism of degradation of the TeC. Besides that, it was possible to infer that only a small amount of methanol might convert to formaldehyde or formic acid, although they were not detected according to the nil changes in the FTIR spectra or in the HPLC chromatograms recorded.


Subject(s)
Methanol , Water Pollutants, Chemical , Diamond , Electrodes , Electrolysis , Oxidation-Reduction , Sulfates , Water Pollutants, Chemical/analysis
16.
Eur Arch Psychiatry Clin Neurosci ; 271(3): 577-582, 2021 Apr.
Article in English | MEDLINE | ID: mdl-32078034

ABSTRACT

We aimed to analyze the efficacy and safety of arketamine, the R(-)-enantiomer of ketamine, for treatment-resistant depression (TRD) in humans. Open-label pilot trial, seven subjects with TRD received a single intravenous infusion of arketamine (0.5 mg/kg); primary outcome was change in Montgomery-Åsberg Depression Rating Scale (MADRS) 24 h after. Mean MADRS dropped from 30.7 before infusion to 10.4 after one day, a mean difference of 20.3 points [CI 95% 13.6-27.0; p < 0.001]; dissociation was nearly absent. Arketamine might produce fast-onset and sustained antidepressant effects in humans with favorable safety profile, like previously reported with animals; further controlled-trials are needed.


Subject(s)
Antidepressive Agents/pharmacology , Depressive Disorder, Major/drug therapy , Depressive Disorder, Treatment-Resistant/drug therapy , Ketamine/pharmacology , Outcome Assessment, Health Care , Adult , Aged , Antidepressive Agents/administration & dosage , Antidepressive Agents/adverse effects , Female , Humans , Infusions, Intravenous , Ketamine/administration & dosage , Ketamine/adverse effects , Middle Aged , Pilot Projects , Psychiatric Status Rating Scales , Remission Induction , Severity of Illness Index
18.
Rev. bras. educ. méd ; 45(1): e011, 2021. tab
Article in Portuguese | LILACS | ID: biblio-1155899

ABSTRACT

Resumo: Introdução: Currículos médicos de graduação são extremamente carregados em seu conteúdo, tornando-se primordial a necessidade de otimizar competências essenciais. As Diretrizes Curriculares Nacionais (DCN) do Curso de Graduação em Medicina preconizam uma valorização do tratamento do doente que possui muitas interfaces com a homeopatia. Apesar de ser uma especialidade médica no Brasil reconhecida desde 1980, a homeopatia ainda é pouco presente na graduação médica. Objetivo: Este estudo teve como objetivo desenvolver uma matriz de competências essenciais composta de conhecimentos e habilidades desejáveis para o ensino da homeopatia na graduação médica. Métodos: Trata-se de um estudo quanti-qualitativo realizado por meio da técnica Delphi normativa, em duas rodadas, com os docentes especialistas em homeopatia do país. Na primeira rodada, aplicou-se um questionário anônimo on-line para identificar as competências (conhecimentos e habilidades) necessárias em homeopatia para os discentes de graduação em Medicina. Após a análise de conteúdo, os temas foram agrupados nessas duas categorias que retornaram para apuração na segunda rodada, em que os especialistas assinalaram o grau de concordância (escala de Likert de quatro pontos: de não relevante a muito relevante). Para a definição de consenso, adotaram-se dois critérios: índice de De Loe e uma nota de relevância adotada pelos autores com vistas a discriminar mais os graus de consenso. Resultados: Dos 14 temas/subtemas relacionados como competências/conhecimentos, consideraram-se 11 como de alto consenso, dos quais cinco foram avaliados como primordiais, pois obtiveram nota de relevância acima de 9,0 (três relacionados ao grande tema clínica homeopática; um, à teoria e técnica homeopáticas; e outro, à pesquisa homeopática). Em relação às competências/habilidades, oito das 11 foram consideradas de alto consenso, e somente duas alcançaram nota acima de 9,0, ambas relacionadas à clínica homeopática. Conclusão: O ensino da homeopatia pode contribuir para a mudança paradigmática da medicina no sentido de valorizar o doente e promover a saúde, permitindo uma atuação médica mais humanizada e centrada no doente, o que justificaria a adoção de seu ensino, inclusive obrigatório, nas faculdades de Medicina. A elaboração de uma matriz de competências do que deve ser ensinado de homeopatia aos discentes da graduação médica vem ao encontro das DCN e instrumentaliza a reflexão na elaboração de uma futura ementa.


Abstract: Introduction: Undergraduate medical curricula are overloaded with content, making the need to optimize essential skills and knowledge paramount. The National Curricular Guidelines for the medical course (DCNs) put focus on patient treatment, which involves several interfaces with homeopathy. However, despite it being recognized as a medical specialty in Brazil since 1980, homeopathy is rarely present in undergraduate medical education. Objective: To develop a collection of essential skills and knowledge for teaching homeopathy as part of the undergraduate medical curriculum. Methods: Quanti-qualitative study performed using the standard Delphi technique in two rounds with specialized homeopathy teachers from Brazil. An anonymous online questionnaire was conducted to identify the learning competences needed in homeopathy for undergraduate medical students. Following content analysis, the themes and sub-themes were grouped into the two main categories of knowledge and skills, which were returned to the specialists who rated their importance for each item using the "Four-Point Likert Scale" from not at all important to very important. For the purpose of generating a general consensus, two criteria were adopted: the "De Loe index" and a importance score. Results: There was a high degree of consensus regarding eleven of the fourteen themes/sub-themes, five of which were considered essential, with an importance score above 9.0 (three related to the general theme, Homeopathic Clinic, one to Homeopathic Theory and Method and another to Homeopathic Research). There was also a high level of consensus regarding eight of the eleven skills, but only two gained a score of above 9.0, both related to Homeopathic Clinic. Conclusion: The teaching of Homeopathy can contribute to a paradigmatic change in medicine, particularly in the sense of prioritizing the patient and promoting health, as well as allowing for a more humanized and patient-centered medical engagement. These factors would justify the adoption of its teaching, so much so it could be made mandatory across all medical study. The establishment of a "competency matrix" for homeopathy study, which ought to be taught to students of the medical field, meets the DCNs and would be instrumental in future syllabuses.


Subject(s)
Humans , Middle Aged , Competency-Based Education , Curriculum , Education, Medical/methods , Homeopathy/education , Delphi Technique
19.
Oecologia ; 193(1): 189-198, 2020 May.
Article in English | MEDLINE | ID: mdl-32405932

ABSTRACT

While functional traits can facilitate or constrain interactions between pair of species in ecological communities, relative abundances regulate the probabilities of encounter among individuals. However, the relative importance of traits and relative abundances for the role species play in seed dispersion networks remains poorly explored. Here, we analyzed 20 Neotropical seed dispersal networks distributed from Mexico to southeastern Brazil to evaluate how relative abundance and functional traits influence bat species' roles in seed dispersal networks. We tested how bat relative abundance and traits relate to species contribution to between-module (c metric) and within-module connectivity (z metric) and their position and potential to mediate indirect effects between species (betweenness centrality). Our results indicate that relative abundance is the main determinant of the role bats play in the networks, while traits such as aspect ratio show modest yet statistically significant importance in predicting specific roles. Moreover, all seed dispersal networks presented two or three superabundant obligatory frugivore species that interacted with a high number of plants. The modest influence of the functional traits on species' roles is likely related to the low variation of morphological traits related to foraging ecology, which reduces the chances of morphological mismatching between consumers and resources in the system. In this scenario, abundant bats have higher chances of encountering resources and being capable of consuming them which leads such species to play critical roles in the community by acting as module hubs and network connectors.


Subject(s)
Chiroptera , Seed Dispersal , Animals , Birds , Brazil , Ecosystem , Fruit , Mexico , Seeds
20.
Data Brief ; 30: 105627, 2020 Jun.
Article in English | MEDLINE | ID: mdl-32395588

ABSTRACT

This data manuscript presents a set of signals collected from the Llaima volcano located at the western edge of the Andes in Araucania Region, Chile. The signals were recorded from the LAV station between 2010 and 2016. After individually processing and analyzing every signal, specialists from the Observatorio Vulcanológico de los Andes Sur (OVDAS) classified them into four class according to their event source: i) Volcano-Tectonic (VT); ii) Long Period (LP); iii) Tremor (TR), and iv) Tectonic (TC). The dataset is composed of 3592 signals separated by class and filtered to select the segment that contains the most representative part of the seismic event. This dataset is important to support researchers interested in studying seismic signals from active volcanoes and developing new methods to model time-dependent data. In this sense, we have published the manuscript "In-Depth Comparison of Deep Artificial Neural Network Architectures on Seismic Events Classification" [1] analyzing such signals with different Deep Neural Networks (DNN). The main contribution of such manuscript is a new DNN architecture called SeismicNet, which provided classification results among the best in the literature without demanding explicit signal pre-processing steps. Therefore, the reader is referred to such manuscript for the interpretation of the data.

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