Performance of ChatGPT in Solving Questions From the Progress Test (Brazilian National Medical Exam): A Potential Artificial Intelligence Tool in Medical Practice.

Background The use of artificial intelligence (AI) is not a recent phenomenon, but the latest advancements in this technology are making a significant impact across various fields of human knowledge. In medicine, this trend is no different, although it has developed at a slower pace. ChatGPT is an example of an AI-based algorithm capable of answering questions, interpreting phrases, and synthesizing complex information, potentially aiding and even replacing humans in various areas of social interest. Some studies have compared its performance in solving medical knowledge exams with medical students and professionals to verify AI accuracy. This study aimed to measure the performance of ChatGPT in answering questions from the Progress Test from 2021 to 2023. Methodology An observational study was conducted in which questions from the 2021 Progress Test and the regional tests (Southern Institutional Pedagogical Support Center II) of 2022 and 2023 were presented to ChatGPT 3.5. The results obtained were compared with the scores of first- to sixth-year medical students from over 120 Brazilian universities. All questions were presented sequentially, without any modification to their structure. After each question was presented, the platform's history was cleared, and the site was restarted. Results The platform achieved an average accuracy rate in 2021, 2022, and 2023 of 69.7%, 68.3%, and 67.2%, respectively, surpassing students from all medical years in the three tests evaluated, reinforcing findings in the current literature. The subject with the best score for the AI was Public Health, with a mean grade of 77.8%. Conclusions ChatGPT demonstrated the ability to answer medical questions with higher accuracy than humans, including students from the last year of medical school.

Anastomotic leak rate following the implementation of a powered circular stapler in elective colorectal surgeries: a retrospective cohort study.

BACKGROUND: The objective of this study was to compare the anastomotic leak rates between powered and manual circular staplers in elective left-sided colorectal resections. METHODS: A retrospective cohort study of elective left-sided colorectal resections before and after implementation of a powered circular stapler at a tertiary care center was conducted. The manual stapler group consisted of consecutive resections performed between January 2016 to December 2016 and the powered stapler group, between September 2021 and December 2022. Primary outcome was 30-day anastomotic leak rate. A chi-squared analysis was performed to compare anastomotic leak rates. Factors associated with anastomotic leak were examined. RESULTS: Two-hundred forty-seven patients were included: 154 in the manual stapler group and 93 in the powered stapler group. Mean (SD) age was 60 (15) years old, 37.7% were female and 72.9% of resections were performed for malignancy. Both groups had similar patient characteristics and surgical technique. Overall leak rate was 2.0% in the manual stapler group and 10.8% in the powered stapler group. The powered staplers were found to have 6.06 times the odds of leak compared to manual staplers (95% CI, 1.62-22.65; p = 0.01). None of the other factors were found to be associated with anastomotic leak. CONCLUSIONS: Patients who had left-sided colorectal anastomosis had higher anastomotic leak rates with powered compared to manual circular staplers. This finding is contrary to previous retrospective studies that found lower leak rates with powered staplers.

Striking the Balance: Embracing Technology While Upholding Humanistic Principles in Neurorehabilitation.

BACKGROUND: The rapid advancement of technology-focused strategies in neurorehabilitation has brought optimism to individuals with neurological disorders, caregivers, and physicians while reshaping medical practice and training. OBJECTIVES: We critically examine the implications of technology in neurorehabilitation, drawing on discussions from the 2021 and 2024 World Congress for NeuroRehabilitation. While acknowledging the value of technology, it highlights inherent limitations and ethical concerns, particularly regarding the potential overshadowing of humanistic approaches. The integration of technologies such as robotics, artificial intelligence, neuromodulation, and brain-computer interfaces enriches neurorehabilitation by offering interdisciplinary solutions. However, ethical considerations arise regarding the balance between compensation for deficits, accessibility of technologies, and their alignment with fundamental principles of care. Additionally, the pitfalls of relying solely on neuroimaging data are discussed, stressing the necessity for a more comprehensive understanding of individual variability and clinical skills in rehabilitation. RESULTS: From a clinical perspective, the article advocates for realistic solutions that prioritize individual needs, quality of life, and social inclusion over technological allure. It underscores the importance of modesty and honesty in responding to expectations while emphasizing the uniqueness of each individual's experience. Moreover, it argues for the preservation of human-centric approaches alongside technological advancements, recognizing the invaluable role of clinical observation and human interaction in rehabilitation. CONCLUSION: Ultimately, the article calls for a balanced attitude that integrates both scientific and humanistic perspectives in neurorehabilitation. It highlights the symbiotic relationship between the sciences and humanities, advocating for philosophical questioning to guide the ethical implementation of new technologies and foster interdisciplinary dialogue.

Feasibility of continuous non-invasive delivery of oxygen monitoring in cardiac surgical patients: a proof-of-concept preliminary study.

PURPOSE: Oxygen delivery (DO2) and its monitoring are highlighted to aid postoperative goal directed therapy (GDT) to improve perioperative outcomes such as acute kidney injury (AKI) after high-risk cardiac surgeries associated with multiple morbidities and mortality. However, DO2 monitoring is neither routine nor done postoperatively, and current methods are invasive and only produce intermittent DO2 trends. Hence, we proposed a novel algorithm that simultaneously integrates cardiac output (CO), hemoglobin (Hb) and oxygen saturation (SpO2) from the Edwards Life Sciences ClearSight System® and Masimo SET Pulse CO-Oximetry® to produce a continuous, real-time DO2 trend. METHODS: Our algorithm was built systematically with 4 components - machine interface to draw data with PuTTY, data extraction with parsing, data synchronization, and real-time DO2 presentation using a graphic-user interface. Hb readings were validated. RESULTS: Our algorithm was implemented successfully in 93% (n = 57 out of 61) of our recruited cardiac surgical patients. DO2 trends and AKI were studied. CONCLUSION: We demonstrated a novel proof-of-concept and feasibility of continuous, real-time, non-invasive DO2 monitoring, with each patient serving as their own control. Our study also lays the foundation for future investigations aimed at identifying personalized critical DO2 thresholds and optimizing DO2 as an integral part of GDT to enhance outcomes in perioperative cardiac surgery.

Enhancing equity in access to automated insulin delivery systems in an ethnically and socioeconomically diverse group of children with type 1 diabetes.

INTRODUCTION: Manufacturer-supported didactic teaching programmes offer effective automated insulin delivery (AID) systems onboarding in children and young people (CYP) with type 1 diabetes (T1D). However, this approach has limited flexibility to accommodate the needs of families requiring additional support. RESEARCH DESIGN AND METHODS: Evaluate the efficacy of an inperson manufacturer-supported didactic teaching programme (Group A), in comparison to a flexible flipped learning approach delivered virtually or inperson (Group B). Retrospective analysis of CYP with T1D using continuous glucose monitoring (CGM), who were initiated on AID systems between 2021 and 2023. Compare CGM metrics from baseline to 90 days for both groups A and B. Additionally, compare the two groups for change in CGM metrics over the 90-day period (∆), patient demographics and onboarding time. RESULTS: Group A consisted of 74 CYP (53% male) with median age of 13.9 years and Group B 91 CYP (54% male) with median age of 12.7 years. From baseline to 90 days, Group A lowered mean (±SD) time above range (TAR, >10.0 mmol/L) from 47.6% (±15.0) to 33.2% (±15.0) (p<0.001), increased time in range (TIR, 3.9-10.0 mmol/L) from 50.4% (±14.0) to 64.7% (±10.2) (p<0.001). From baseline to 90 days, Group B lowered TAR from 51.3% (±15.1) to 34.5% (±11.3) (p<0.001) and increased TIR from 46.5% (±14.5) to 63.7% (±11.0) (p<0.001). There was no difference from baseline to 90 days for time below range (TBR, <3.9 mmol/L) for Group A and Group B. ∆ TAR, TIR and TBR for both groups were comparable. Group B consisted of CYP with higher socioeconomic deprivation, greater ethnic diversity and lower carer education achievement (p<0.05). The majority of Group B (n=79, 87%) chose virtual flipped learning, halving diabetes educator time and increasing onboarding cadence by fivefold. CONCLUSIONS: A flexible virtual flipped learning programme increases onboarding cadence and capacity to offer equitable AID system onboarding.

Enabling nurses' engagement in the design of healthcare technology - Core competencies and requirements: A qualitative study.

Background: Due to the globally increasing demand for care, innovation is important to maintain quality, safety, effectiveness, patient sensitivity, and outcome orientation. Health care technologies could be a solution to innovate, maintain, or improve the quality of care and simultaneously decrease nurses' workload. Currently, nurses are rarely involved in the design of health care technologies, mostly due to time constraints with clinical nursing responsibilities and limited exposure to technology and design disciplines. To ensure that health care technologies fit into nurses' core and routine practice, nurses should be actively involved in the design process. Objective: The aim of the present study was to explore the main requirements for nurses' active participation in the design of health care technologies. Design: An exploratory descriptive qualitative design was used which helps to both understand and describe a phenomenon. Participants: Twelve nurses from three academic hospitals in the Netherlands participated in this study. Method: Data were collected from semistructured interviews with hospital nurses experienced in design programs and thematically analysed. Results: Four themes were identified concerning the main requirements for nurses to participate in the design of health care technologies: (1) nurses' motivations to participate, (2) the process of technology development, (3) required competence to participate (such as assertiveness, creative thinking, problem solving skills), and (4) facilitating and organizing nurses' participation. Conclusion: Nurses experience their involvement in the design process as essential, distinctive, and meaningful but experience few possibilities to combine this work with their current workload, flows, routines, and requirements. To participate in the design of health care technologies nurses need motivation and specific competencies. Organizations should facilitate time for nurses to acquire the required competencies and to be intentionally involved in technology design and development activities.

Integrating neuroscience and humanities in healthcare evolution: a multidisciplinary perspective / Integração das neurociências e das ciências humanas na evolução dos cuidados de saúde: uma perspetiva multidisciplinar

The trajectory of healthcare has evolved from ancient holistic practices to the present biomedical model, reflecting the dynamic interplay between scientific progress, technological advancements, and the integration of humanistic values. While biomedical advancements have revolutionized medical treatments, there is an emerging recognition of the importance of integrating neuroscience and humanities to foster holistic patient care and understanding. This paper aims to explore the historical development of medicine, emphasizing the convergence of neuroscience, psychiatry, and neurology within the biomedical framework. Additionally, it investigates the resurgence of humanities in healthcare and its role in promoting patientcentered care. Through a comprehensive review of literature, this study traces the historical roots of medicine and examines the interdisciplinary intersections of neuroscience, psychiatry, neurology, and medical humanities. The exploration reveals the significant contributions of interdisciplinary approaches in enhancing patient-centered care, fostering a comprehensive understanding of health and well-being, and shaping modern healthcare practices. The integration of neuroscience and humanities offers valuable insights into the complexities of human health, bridging legacy practices with innovative approaches. Embracing this interdisciplinary perspective is crucial for promoting holistic healthcare, emphasizing patient-centered care, and enriching the understanding of health and well-being in contemporary healthcare settings.

A trajetória dos cuidados de saúde evoluiu das antigas práticas holísticas para o atual modelo biomédico, reflectindo a interação dinâmica entre o progresso científico, os avanços tecnológicos e a integração de valores humanísticos. Embora os avanços biomédicos tenham revolucionado os tratamentos médicos, há um reconhecimento emergente da importância de integrar as neurociências e as humanidades para promover a compreensão e os cuidados holísticos dos doentes. Este artigo tem como objetivo explorar o desenvolvimento histórico da medicina, salientando a convergência da neurociência, da psiquiatria e da neurologia no quadro biomédico. Além disso, investiga o ressurgimento das humanidades nos cuidados de saúde e o seu papel na promoção de cuidados centrados no doente. Através de uma revisão exaustiva da literatura, este estudo traça as raízes históricas da medicina e examina as intersecções interdisciplinares da neurociência, psiquiatria, neurologia e humanidades médicas. A exploração revela os contributos significativos das abordagens interdisciplinares para melhorar os cuidados centrados no doente, promover uma compreensão abrangente da saúde e do bem-estar e moldar as práticas modernas de cuidados de saúde. A integração das neurociências e das humanidades oferece conhecimentos valiosos sobre as complexidades da saúde humana, fazendo a ponte entre práticas antigas e abordagens inovadoras. A adoção desta perspetiva interdisciplinar é crucial para promover cuidados de saúde holísticos, enfatizando os cuidados centrados no doente e enriquecendo a compreensão da saúde e do bem-estar nos contextos de cuidados de saúde contemporâneos.

Barriers and facilitators of implementation of new antibacterial technologies in patient care: an interview study with orthopedic healthcare professionals at a university hospital.

BACKGROUND: Antimicrobial resistance is a major global health threat. Therefore, promising new antibacterial technologies that could minimize our dependence on antibiotics should be widely adopted. This study aims to identify the barriers and facilitators of the adoption of new antibacterial technologies in hospital patient care. METHODS: Semi-structured interviews, based on the Consolidated Framework for Implementation Research, were conducted with healthcare professionals related to the orthopedics department of an academic hospital in The Netherlands. RESULTS: In total, 11 healthcare professionals were interviewed. Scientific evidence for the effectiveness of the technology was the most explicitly mentioned facilitator of adoption, but other (often contextual) factors were also considered to be important. At the level of the inner and outer setting, high costs and lacking coverage, competition from other firms, and problems with ordering and availability were the most explicit perceived barriers to adoption. Participants did not collectively feel the need for new antibacterial technologies. CONCLUSIONS: Barriers and facilitators of the adoption of new antibacterial technologies were identified related to the technology, the hospital, and external factors. The implementation climate might have an indirect influence on adoption. New antibacterial technologies that are scientifically proven effective, affordable, and easily obtainable will most likely be adopted.

New approaches to recovery after stroke.

After a stroke, several mechanisms of neural plasticity can be activated, which may lead to significant recovery. Rehabilitation therapies aim to restore surviving tissue over time and reorganize neural connections. With more patients surviving stroke with varying degrees of neurological impairment, new technologies have emerged as a promising option for better functional outcomes. This review explores restorative therapies based on brain-computer interfaces, robot-assisted and virtual reality, brain stimulation, and cell therapies. Brain-computer interfaces allow for the translation of brain signals into motor patterns. Robot-assisted and virtual reality therapies provide interactive interfaces that simulate real-life situations and physical support to compensate for lost motor function. Brain stimulation can modify the electrical activity of neurons in the affected cortex. Cell therapy may promote regeneration in damaged brain tissue. Taken together, these new approaches could substantially benefit specific deficits such as arm-motor control and cognitive impairment after stroke, and even the chronic phase of recovery, where traditional rehabilitation methods may be limited, and the window for repair is narrow.

Labelling of intravenous drug delivery devices in critically ill patients: A scoping review.

BACKGROUND: Labelling is a strategy that contributes to the correct and faster identification of drugs, minimizing misidentification. There is a gap in knowledge on optimal labelling standards for intravenous (IV) devices applied to the care of critically ill patients. AIM: The goal of this article was to map existing knowledge on the labelling of IV drug delivery devices in critically ill patients for the prevention of medication errors. STUDY DESIGN: This was a scoping review conducted according to the JBI methodology in the LILACS, MEDLINE, CINAHL, IBECS, Scopus, Embase and Web of Science databases, and on the websites of specialized institutions. Searches were conducted up to December 2022 for scientific articles and grey literature that addressed the labelling of IV devices in intensive care units, emergency departments, and anaesthesia units. The data were collected using a structured form and were later classified, summarized, and aggregated to map the knowledge related to the review question. RESULTS: Twenty-one documents were included, which demonstrated variability in label use with IV drug delivery devices. The following features of structure and design stood out: printed format, colour coding, letter size differentiation, and the use of sturdy material. In terms of information, the name of the drug, dose, date and time of preparation, identification of the patient, and who prepared it were found. CONCLUSIONS: The identified patterns contributed to the reduction of drug misidentification and the development of timelier drug labelling and administration. RELEVANCE TO CLINICAL PRACTICE: The evidence supports the development of standardized labels for the prevention of medication errors.

Desenvolvimento e validação de software web de apoio à gestão da assistência pré-natal / Desarrollo y validación de software web de apoyo a la gestión de la atención prenatal / Development and validation of web software to support prenatal care management

Resumo Objetivo Descrever o processo de desenvolvimento e validação de um software web de apoio à gestão da assistência pré-natal. Métodos Pesquisa de produção tecnológica, realizada entre março e agosto de 2022, com base em princípios e técnicas do método Scrum. As funcionalidades do software web, com acesso e funções específicas a três diferentes usuários (Administrador, Gestor e Visitante), foram desenvolvidas de forma colegiada entre desenvolvedores, pesquisadores, gestores e profissionais da saúde, a partir de necessidades práticas relacionadas à gestão da assistência pré-natal. Resultados O software web é uma ferramenta de apoio à gestão da assistência pré-natal, com potencial para gerar infográficos que denotem intercorrências gestacionais e que permitem, de forma ágil e segura, à tomada de decisões estratégicas loco-regionais. Conclusão O processo de desenvolvimento e validação do software web de apoio à gestão da assistência pré-natal deu-se de forma colegiada entre desenvolvedores, pesquisadores, gestores e profissionais da saúde, a partir de necessidades práticas relacionadas à gestão da assistência pré-natal. A ferramenta foi desenvolvida de modo a possibilitar acesso e funções específicas a três diferentes usuários (Administrador, Gestor e Visitante), com vistas à tomada de decisões rápidas e seguras.

Resumen Objetivo Describir el proceso de desarrollo y validación de un software web de apoyo a la gestión de la atención prenatal. Métodos Investigación de producción tecnológica, realizada entre marzo y agosto de 2022, con base en principios y técnicas de la metodología Scrum. Las funcionalidades del software web, con acceso y funciones específicas para tres usuarios (administrador, gestor y visitante), se desarrollaron de forma colegiada entre desarrolladores, investigadores, gestores y profesionales de la salud, a partir de necesidades prácticas relacionadas con la gestión de la atención prenatal. Resultados El software web es una herramienta de apoyo a la gestión de la atención prenatal, con potencial para generar infográficos que indiquen complicaciones gestacionales y que permitan tomar decisiones estratégicas locorregionales de forma ágil y segura. Conclusión El proceso de desarrollo y validación del software web de apoyo a la gestión de la atención prenatal se realizó de forma colegiada entre desarrolladores, investigadores, gestores y profesionales de la salud, a partir de necesidades prácticas relacionadas con la gestión de la atención prenatal. La herramienta se desarrolló a fin de permitir el acceso y funciones específicas para tres diferentes usuarios (administrador, gestor y visitante), con el objetivo de tomar decisiones rápidas y seguras.

Abstract Objective To describe the development and validation process of a web software to support the management of prenatal care. Methods Technological development research, carried out between March and August 2022, based on principles and techniques of the Scrum method. The functionalities of the web software, with access and specific functions for three different users (Administrator, Manager and Visitor), were developed jointly by developers, researchers, managers and health professionals, based on practical needs related to the management of prenatal care. Results The web software is a tool to support the management of prenatal care, with the potential to generate infographics that denote gestational intercurrences and that allow, in an agile and safe way, the making of local-regional strategic decisions. Conclusion The process of development and validation of the web software to support the management of prenatal care was carried out jointly by developers, researchers, managers and health professionals, based on practical needs related to the management of prenatal care. The tool was developed in order to allow access and specific functions to three different users (Administrator, Manager and Visitor), with a view to making quick and safe decisions.

Asimetrías entre la coordinación nacional y la autonomía de los gobiernos estatales en la adopción de tecnologías sanitarias frente a la COVID-19 en Argentina / Asymmetries between national articulation and the autonomy of state governments in implementing health technologies to fight COVID-19 in Argentina / Assimetrias entre a articulação nacional e a autonomia de governos estaduais na implementação de tecnologias de saúde em combate à COVID-19 na Argentina

Resumen: En pandemia, en Argentina y en otros países se observó variabilidad en las políticas públicas implementadas sobre tecnologías sanitarias para prevención y tratamiento de la COVID-19. El objetivo fue analizar cómo se procesaron en Argentina los movimientos de coordinación vs. cooperación, y de autonomía vs. reparto de autoridad entre entidades, explorando asimetrías entre diferentes entidades en la implementación de políticas públicas sobre tecnologías sanitarias en pandemia y las influencias de otros actores. Se realizó una revisión documental del período 2020-2021 (informes técnicos publicados por la Organización Mundial de la Salud, organismos nacionales y sociedades científicas, leyes, fallos judiciales, prensa, encuestas y entrevistas en profundidad a miembros de los Ministerios de Salud de Argentina). Se indagó sobre procesos y resultados de la toma de decisiones en los Ministerios de Salud, mapeando la cobertura y recomendación de cada tecnología y el partido político provincial gobernante. Hubo heterogeneidad en resultados y procesos entre los Ministerios, y disputas en el interior de los mismos. La adherencia a recomendaciones oficiales fue baja, influyendo distintos criterios técnico-políticos (relaciones de poder, presión social, de los medios, académicos, poder Judicial y Legislativo). En algunos casos se observó una fuerte tensión entre oficialismo y oposición al partido gobernante a partir de la discusión sobre tecnologías. Cada provincia argentina definió sus políticas sobre tecnologías sanitarias para COVID-19 con autonomía, y la toma de decisiones en la administración pública en pandemia fue desordenada, compleja y no lineal.

Abstract: Argentina, as other countries, showed several public policies related to the health technologies implemented to fight and treat the COVID-19 pandemic. This study sought to analyze how articulation vs. cooperation and autonomy vs. division of powers between entities occurred in Argentina, exploring asymmetries between several entities in implementing public policies related to health technologies during the pandemic and the influences of other actors. For this, a documentary research was carried out related to 2020-2021 (technical reports published by the World Health Organization, national agencies and scientific societies, laws, court decisions, press, and research and in-depth interviews with members of the Argentine Ministries of Health). The processes and results of decision-making in the Ministries of Health were analyzed, outlining the coverage and orientations of each technology and the political party in power in the province. This study found heterogeneous results and processes between Ministries and disputes within them. It also observed the poor adherence to official guidelines due to technical-political criteria (power relations, social, media, academic, judiciary, and legislative pressure). Some cases showed a strong tension between the government and its opposition over the discussion of technologies. Each province in Argentina has autonomously defined its policies on health technologies for COVID-19, and decision-making in public administration was disorderly, complex, and non-linear during the pandemic.

Resumo: Na Argentina, assim como em outros países, houve uma variabilidade de políticas públicas relacionadas às tecnologias de saúde implementadas no combate e tratamento da COVID-19 durante a pandemia. Este estudo buscou analisar como ocorreram a articulação vs. cooperação, e a autonomia vs. divisão de poderes entre as entidades na Argentina, explorando assimetrias entre diferentes entidades na implementação de políticas públicas relacionadas a tecnologias de saúde na pandemia, bem como as influências de outros atores. Para tanto, realizou-se uma pesquisa documental para o período de 2020-2021 (relatórios técnicos publicados pela Organização Mundial da Saúde, agências nacionais e sociedades científicas, leis, decisões judiciais, imprensa, pesquisas e entrevistas em profundidade com membros dos Ministérios da Saúde da Argentina). Os processos e os resultados da tomada de decisão nos Ministérios da Saúde foram analisados, traçando a cobertura e orientações de cada tecnologia e o partido político no poder na província. Observou-se uma heterogeneidade nos resultados e processos entre os Ministérios, e disputas em seu interior. Houve uma baixa adesão às orientações oficiais, influenciada por diferentes critérios técnico-políticos (relações de poder, pressão social, midiática, acadêmica, do poder Judiciário e do Legislativo). Em alguns casos, observou-se uma forte tensão entre governo e oposição a partir da discussão das tecnologias. Cada província da Argentina definiu suas políticas sobre tecnologias de saúde para a COVID-19 de forma autônoma, e a tomada de decisões na administração pública foi desordenada, complexa e não linear durante a pandemia.

Validação de instrumento brasileiro para mapeamento dos fatores de risco e diagnóstico precoce de incontinência urinária feminina

Objetivo: Validar o conteúdo do Instrumento de Mapeamento dos Fatores de Risco para Incontinência Urinária Feminina (IMFRIU-Fem) considerando o contexto das mulheres adultas jovens. Método: Trata-se de uma pesquisa metodológica quantitativa, desenvolvida no período de abril 2020 a dezembro de 2021, em três etapas: revisão integrativa da literatura, construção do instrumento e validação do conteúdo. Resultados: Através da revisão integrativa, 55 fatores de risco foram identificados e agrupados em dimensões na estrutura do instrumento, considerando desde os aspectos sociodemográficos até os sistemas corporais. O instrumento foi validado pelo índice de validade de conteúdo (IVC) e contou com a avaliação de 7 juízes. Para a maioria das dimensões do instrumento os juízes apresentaram uma resposta unanime, expressando uma porcentagem de 91 % quanto a clareza e compreensão, o que significa dizer que tais dimensões apresentam funcionalidade diante do objetivo de mapear os fatores de risco para a incontinência urinária feminina. O IVC global das dimensões, mostrou-se extremamente significativos, com IVC = 0,91. Conclusão: Espera-se que o IMFRIU-Fem possa auxiliar os enfermeiros a identificar precocemente os fatores de risco para a incontinência urinária, fornecendo dados longitudinais que permitam elaborar um plano assistencial que considere a integralidade da saúde da mulher.

Objetivo: Validar el contenido del Instrumento de Mapeo de Factores de Riesgo para la Incontinencia Urinaria Femenina (IMFRIU-Fem) considerando el contexto de las mujeres adultas jóvenes. Método: Se trata de una investigación metodológica cuantitativa, desarrollada entre abril de 2020 y diciembre de 2021, en tres etapas: revisión bibliográfica integradora, construcción del instrumento y validación de contenido. Resultados: A través de la revisión integradora, se identificaron 55 factores de riesgo y se agruparon en dimensiones en la estructura del instrumento, considerando desde aspectos sociodemográficos hasta sistemas corporales. El instrumento fue validado por el índice de validez de contenido (IVC) y fue evaluado por 7 jueces. Para la mayoría de las dimensiones del instrumento los jueces presentaron una respuesta unánime, expresando un porcentaje del 91 % en cuanto a claridad y comprensión, lo que significa que dichas dimensiones presentan funcionalidad frente al objetivo de mapear los factores de riesgo de la incontinencia urinaria femenina. El IVC global de las dimensiones resultó ser extremadamente significativo, con un valor de 0.91. Conclusión: Se espera que el IMFRIU-Fem pueda ayudar al personal de enfermería a identificar de forma precoz los factores de riesgo para la incontinencia urinaria, proporcionando datos longitudinales que permitan elaborar un plan de asistencia que considere la integralidad de la salud de la mujer.

Objective: To validate the content of the Risk Factors Mapping Instrument for Female Urinary Incontinence (IMFRIU-Fem) considering the context of young adult women. Method: This is quantitative methodological research, developed from April 2020 to December 2021, in three stages: integrative literature review, instrument construction and content validation. Results: Through the integrative review, 55 risk factors were identified and grouped into dimensions in the structure of the instrument, considering from sociodemographic aspects to body systems. The instrument was validated by the content validity index (CVI) and was assessed by 7 judges. For most of the dimensions of the instrument the judges presented a unanimous answer, expressing a percentage of 91 % as to clarity and understanding, which means that such dimensions present functionality in the face of the objective of mapping the risk factors for female urinary incontinence. The global CVI of the dimensions showed to be extremely significant, with CVI = 0.91. Conclusion: It is expected that the IMFRIU-Fem may help nurses to identify early risk factors for urinary incontinence, providing longitudinal data that allow the elaboration of a care plan that considers the integrality of women's health.

Assessment of educational technology in lactation physiology by health students / Evaluación de tecnología educativa en fisiología de la lactancia por estudiantes de salud / Avaliação de tecnologia educacional de fisiologia da lactação por estudantes da saúde

ABSTRACT Objectives: to assess the suitability, facilitators, and barriers of using a video clip for teaching lactation physiology to health students. Methods: a cross-sectional study was conducted with online data collection at a higher education institution, using the Assistive Technology Assessment Instrument and open-ended questions. The sample consisted of 88 students. Results: the video clip was deemed suitable in all attributes. Facilitators identified included attractiveness, musicality, and ease of access. Barriers noted were the music's speed and the necessity for prior knowledge. The video clip achieved adequate scores for interactivity (1.71), purpose (1.77), relevance (1.64), and clarity (1.77). The overall average of the attributes was 1.72. Conclusions: the video clip can serve as an effective learning strategy to enhance hybrid education, potentially contributing to the promotion and support of breastfeeding. However, some barriers underscore the importance of prior knowledge for a complete understanding of the content.

RESUMEN Objetivos: evaluar la idoneidad, los facilitadores y las barreras del uso de un videoclip para enseñar fisiologia de la lactancia a estudiantes de salud. Métodos: se realizo un estudio transversal con recopilación de datos en línea en una institución de educación superior, utilizando el Instrumento de Evaluación de Tecnologia Asistiva y preguntas abiertas. La muestra consistió en 88 estudiantes. Resultados: el videoclip fue considerado adecuado en todos los atributos. Los facilitadores identificados incluyeron atractivo, musicalidad y facilidad de acceso. Las barreras señaladas fueron la velocidad de la música y la necesidad de conocimientos previos. El videoclip obtuvo puntuaciones adecuadas en interactividad (1.71), propósito (1.77), relevancia (1.64) y claridad (1.77). El promedio general de los atributos fue de 1.72. Conclusiones: el videoclip puede servir como una estrategia de aprendizaje efectiva para mejorar la educación híbrida, potencialmente contribuyendo a la promoción y el apoyo de la lactancia materna. Sin embargo, algunas barreras subrayan la importancia del conocimiento previo para una comprensión completa del contenido.

RESUMO Objetivos: avaliar a adequação, facilitadores e barreiras para o uso de um videoclipe para aprendizagem da fisiologia da lactação por estudantes da saúde. Métodos: estudo transversal com coleta de dados online em uma instituição de ensino superior, utilizando o Instrumento de Avaliação de Tecnologia Assistiva e questões abertas. A amostra incluiu 88 estudantes. Resultados: o videoclipe foi avaliado como adequado em todos os atributos. Facilitadores identificados incluíram atratividade, musicalidade e praticidade de acesso. Barreiras apontadas foram a velocidade da música e a necessidade de conhecimento prévio. O videoclipe obteve média adequada para interatividade (1,71), objetivo (1,77), relevância (1,64) e clareza (1,77). A média global dos atributos foi 1,72. Conclusões: o videoclipe pode ser utilizado como estratégia de aprendizagem que potencializa o ensino híbrido na formação, com potencial para contribuir com a promoção e apoio ao aleitamento materno. No entanto, algumas barreiras destacam a necessidade de conhecimento prévio para a compreensão total do conteúdo.

Technological advances in obstetric nursing consultations using ultrasound / Avances tecnológicos en consultas de enfermería obstétrica utilizando ultrasonido / Avanço tecnológico na consulta de enfermagem obstétrica com uso de ultrassonografia

ABSTRACT Objective: to understand how ultrasound tools are used in prenatal Nursing consultations from the perspective of obstetric nurses. Method: a descriptive and qualitative study carried out with ten obstetric nurses that use obstetric ultrasound in their Nursing consultations at a maternity hospital in Belo Horizonte, Minas Gerais, Brazil. Individual, semi-structured interviews were conducted between December 1st and 4th, 2021. The Atlas.ti software was employed to process the results using Bardin's thematic content analysis. Results: the obstetric nurses expanded comprehensive care for pregnant women by implementing the use of ultrasound technology during Obstetric Nursing consultations, thus innovating the practices in Brazil. However, they faced countless challenges, which they overcame thanks to the positive results of improving obstetric and fetal care. Conclusion: using ultrasound technology in Obstetric Nursing consultations represents an advance in the Nursing practice, as it enables access and qualification to timely care, free of charge and through the Unified Health System. The support and encouragement of the institutional management strengthened obstetric nurses' professional autonomy, mediating the implementation of innovation. The study focus is added to the technological development employed in the everyday work of Brazilian Nursing, increasing resoluteness of decision-making in health problems.

RESUMEN Objetivo: comprender cómo se utiliza la herramienta de ultrasonido en consultas de Enfermería prenatal, según la opinión de enfermeras especializadas en Obstetricia. Método: estudio descriptivo de enfoque cualitativo, realizado en una maternidad de Belo Horizonte, Minas Gerais, Brasil, con diez enfermeras(os) especializadas(os) en Obstetricia que utilizan ultrasonido obstétrico en consultas de Enfermería. Se llevaron a cabo entrevistas individuales y semiestructuradas entre el 1 y el 4 de diciembre de 2021. Se utilizó el programa de software Atlas.ti para procesar los resultados por medio de análisis temático de contenido según Bardin. Resultados: las enfermeras especializadas en Obstetricia ampliaron la atención integral provista a las embarazadas, implementando el uso de la tecnología de ultrasonido durante las consultas de Enfermería Obstétrica, innovando así las prácticas de la profesión en Brasil. No obstante, enfrentaron innumerables desafíos, que fueron superados gracias a los resultados positivos de calificación de la atención obstétrica y fetal. Conclusión: utilizar la tecnología de ultrasonido en consultas de Enfermería Obstétrica representa un avance en la práctica de Enfermería, puesto que permite acceder y calificar los cuidados en tiempo y forma, de manera gratuita y a través del Sistema Único de Salud. El apoyo e incentivo por parte de la gerencia institucional fortalecieron la autonomía profesional de las enfermeras especializadas en Obstetricia, mediando la implementación de la innovación. El punto central del estudio se suma al desarrollo tecnológico empleado en la rutina de trabajo de los profesionales de Enfermería en Brasil, expandiendo así la capacidad de resolución del proceso de toma de decisiones relacionado con problemas de salud.

RESUMO Objetivo: compreender o uso da ferramenta ultrassonográfica na consulta de enfermagem de pré-natal sob a perspectiva das enfermeiras obstétricas. Método: estudo descritivo, de abordagem qualitativa, realizado em uma maternidade de Belo Horizonte, Minas Gerais, Brasil, com dez enfermeiras(os) obstétricas(os) que utilizam a ultrassonografia obstétrica na consulta de enfermagem. Entrevista individual, semiestruturada, realizada entre 1º e 4 de dezembro de 2021. Utilizou-se o software Atlas.ti para o tratamento dos resultados por meio da análise de conteúdo temática de Bardin. Resultados: as enfermeiras obstétricas ampliaram o cuidado integral às gestantes, implementando a utilização da tecnologia ultrassonográfica durante a consulta de enfermagem obstétrica, inovando as práticas no Brasil. Entretanto, enfrentaram inúmeros desafios, que foram superados graças aos resultados positivos de qualificação do cuidado obstétrico e fetal. Conclusão: a utilização da tecnologia ultrassonográfica na consulta de enfermagem obstétrica significa um avanço na prática de enfermagem, pois possibilita acesso e qualificação ao cuidado em tempo oportuno, gratuitamente, pelo Sistema Único de Saúde. O apoio e o incentivo da gestão institucional fortaleceram a autonomia profissional das enfermeiras obstétricas, mediando a implementação da inovação. O foco do estudo soma-se ao desenvolvimento tecnológico empregado no cotidiano de trabalho da enfermagem brasileira, ampliando a resolubilidade da tomada de decisão aos agravos à saúde.

Validação do conteúdo de uma tecnologia cuidativo-educacional para mulheres que consomem substâncias psicoativas / Content validation of a care-educational technology for women psychoactive consumers / Validación del contenido de una tecnología cuidativo-educacional para mujeres consumidoras de sustancias psicoactivas

RESUMO: Objetivo: construir e validar o conteúdo de uma Tecnologia Cuidativo-Educacional para mulheres que consomem substâncias psicoativas. Método: pesquisa metodológica conduzida no município de São Paulo, dezembro de 2022 a março de 2023, pelo mapeamento da literatura, elaboração dos temas geradores, escolha da ferramenta base com dinâmica de uso e validação de conteúdo quanto aos aspectos: reflexão, relevância, compreensão e adequação em duas rodadas. Participaram 15 especialistas com índice de concordância estabelecido de 80%. Resultados: 48 cartas foram submetidas à validação. Na primeira rodada, sete cartas não atingiram o índice mínimo. Ao final da segunda rodada, 47 cartas em todas as suas categorias individuais tiveram concordância maior que o estabelecido. Conclusão: os especialistas apontaram a relevância, pertinência dos temas e o potencial para auxiliar os profissionais a intervir de forma mais assertiva ante as necessidades do público-alvo.

ABSTRACT Objective: To build and validate the content of a Care-Educational Technology for women who consume psychoactive substances. Method: Methodological research conducted in the municipality of São Paulo, December 2022 to March 2023 by mapping the literature, drawing up the generating themes, choosing the base tool with dynamics of use, and validating the content in terms of aspects: reflection, relevance, understanding, and suitability in two rounds. Fifteen experts took part, with an agreement rate of 80%. Results: 48 letters were submitted for validation. In the first round, seven cards failed to reach the minimum index. At the end of the second round, 47 cards in all their categories had more agreement than the established level. Conclusion: The experts pointed out the relevance and pertinence of the topics and their potential to help professionals intervene more assertively in the face of the target audience's needs.

RESUMEN Objetivo: construir y validar el contenido de una tecnología educativo-asistencial para mujeres consumidoras de sustancias psicoactivas. Método: investigación metodológica realizada en el municipio de São Paulo, de diciembre de 2022 a marzo de 2023, mediante el mapeo de la literatura, la elaboración de los temas generadores, la elección de la herramienta básica con dinámica de uso y la validación del contenido en cuanto a los aspectos: reflexión, pertinencia, comprensión e idoneidad en dos rondas. Participaron quince expertos, con una tasa de acuerdo del 80%. Resultados: Se presentaron 48 cartas para su validación. En la primera ronda, siete cartas no alcanzaron el índice mínimo. Al final de la segunda ronda, 47 cartas en todas sus categorías individuales tenían más acuerdo del establecido. Conclusión: los expertos señalaron la relevancia y pertinencia de los temas y su potencial para ayudar a los profesionales a intervenir de forma más asertiva ante las necesidades de los destinatarios.

Construção e validação de um formulário para a transição de cuidados para o recém-nascido prematuro / Construcción y validación de un formulario para la transición de la atención al recién nacido prematuro / Construction and validity of a form for transition of care for premature newborns

Objetivo: construir e validar um formulário para a transição de cuidados com o neonato prematuro. Método: estudo metodológico realizado em três etapas: levantamento do referencial teórico-metodológico, análise semântica e validação de conteúdo, baseado no Modelo de Construção de Instrumentos e utilizando o método de Delphi, sendo considerado aprovado quando o índice de validação de conteúdo foi maior que 80%.Resultados: o formulário composto por seis domínios foi aprovado após três rodadas, com 64itens e alcançou uma aprovação média de 89%.Conclusão: o formulário de transição de cuidados foi validado quanto a face e conteúdo, disponibilizando uma nova tecnologia a ser utilizada para a transição de informações de forma padronizada e segura.

Objective:to construct and validate a form for transition of care for premature newborns. Method:a methodological study carried out in three steps: theoretical-methodological framework survey, semantic analysis and content validity, based on the instrument construction model and using the Delphi method, being considered approved when the Content Validity Index was greater than 80%. Results:the form consisting of six domains was approved after three rounds, with 64 items, and achieved a mean approval of 89%. Conclusion:the transition of care form was validated in terms of face and content, providing a new technology to be used for standardized and safe transition of information.

Objetivo:construir y validar un formulario para la transición de la atención al recién nacido prematuro. Método:estudio metodológico realizado en tres etapas: levantamiento del marco teórico-metodológico, análisis semántico y validación de contenido, con base en el modelo de construcción de instrumentos y mediante el método Delphi, considerándose aprobado cuando el índice de validación de contenido fue superior al 80%. Resultados:el formulario compuesto por seis dominios fue aprobado después de tres rondas, con 64 ítems, y alcanzó una tasa de aprobación promedio del 89%. Conclusión:el formulario de transición de atención fue validado en términos de apariencia y contenido, proporcionando una nueva tecnología para ser utilizada para la transición de información de forma estandarizada y segura.

Key Nanotechnology Breakthroughs in Cardiovascular Disease Therapy

Abstract Background It is justified by the high population's morbidity and mortality rate, as well as the increasing present use of nanoparticles in this pathological context. Objectives To describe the main nanotechnology breakthroughs in the field of cardiovascular disease (CVD) and disseminate pertinent information in the literature. Methods This is a systematic review conducted between September and October 2021. The review was carried out through basic nature, following the initial script for the selective reading of articles in chronological order to collect relevant and consistent data related to the theme. Results It is evidenced the main advances of nanotechnology in the field of CVDs, namely, acute coronary syndromes (ACSs), heart failure (HF), and systemic arterial hypertension (SAH). Conclusion The importance of further and deeper studies in this area is emphasized, in order to make the already approved treatments feasible, so they can reach all publics at a low cost.

Performance in prognostic capacity and efficiency of the Thoracic Care Suite GE AI tool applied to chest radiography of patients with COVID-19 pneumonia.

OBJECTIVE: Rapid progression of COVID-19 pneumonia may put patients at risk of requiring ventilatory support, such as non-invasive mechanical ventilation or endotracheal intubation. Implementing tools that detect COVID-19 pneumonia can improve the patient's healthcare. We aim to evaluate the efficacy and efficiency of the artificial intelligence (AI) tool GE Healthcare's Thoracic Care Suite (featuring Lunit INSIGHT CXR, TCS) to predict the ventilatory support need based on pneumonic progression of COVID-19 on consecutive chest X-rays. METHODS: Outpatients with confirmed SARS-CoV-2 infection, with chest X-ray (CXR) findings probable or indeterminate for COVID-19 pneumonia, who required a second CXR due to unfavorableclinical course, were collected. The number of affected lung fields for the two CXRs was assessed using the AI tool. RESULTS: One hundred fourteen patients (57.4±14.2 years, 65-57%-men) were retrospectively collected. Fifteen (13.2%) required ventilatory support. Progression of pneumonic extension ≥0.5 lung fields per day compared to pneumonia onset, detected using the TCS tool, increased the risk of requiring ventilatory support by 4-fold. Analyzing the AI output required 26s of radiological time. CONCLUSIONS: Applying the AI tool, Thoracic Care Suite, to CXR of patients with COVID-19 pneumonia allows us to anticipate ventilatory support requirements requiring less than half a minute.