Bench assessment of PC-CMVs modes in transport and emergency ventilators under ICU conditions.

Although there has been an increase in bench test evaluation of mechanical ventilators in recent years, a publication gap remains in assessing Pressure Control Continuous Mandatory Ventilation Modes with a set point targeting scheme PC-CMVs. This study evaluates the operational variability in PC-CMVs of eleven transport and emergency ventilators used in ICU units in Brazil during the COVID-19 pandemic. The assessment involved a comprehensive set of test scenarios derived from existing literature and the NBR ISO 80601-2-12:2014 standard. Nine parameters were computed for five consecutive breaths, offering a comprehensive characterization of pressure and flow waveforms. Most ventilators had Inspiratory pressure and PEEP values that fell outside of the tolerance ranges. Notably, three mechanical ventilators failed to reach the target pressures within the specified inspiratory times during test scenarios with a higher time constant (τ). We observed significant differences among emergency and transport ventilators in all assessed parameters, indicating a performance difference in PC-CMVs modes. The current results might help clinicians determine which ventilator models are suitable for specific clinical situations, particularly when unfavorable circumstances compel doctors to use ventilators that may not provide adequate support for patients in intensive care units.

Baseline and stress-induced changes in plasma bacterial killing ability against gram-negative bacteria are partially mediated by the complement system in Rhinella diptycha toads.

The plasma bacterial killing ability (BKA) is modulated by the stress response in vertebrates, including amphibians. The complement system is an effector mechanism comprised of a set of proteins present in the plasma that once activated can promote bacterial lysis. Herein, we investigated whether changes in plasma BKA as a result of the acute stress response and an immune challenge are mediated by the complement system in Rhinella diptycha toads. Additionally, we investigated whether the observed changes in plasma BKA are associated with changes in plasma corticosterone levels (CORT). We subjected adult male toads to a restraint or an immune challenge (with three concentrations of Aeromonas hydrophila heat inactivated), and then evaluated the plasma BKA against A. hydrophila, in vitro. We determined the complement system activity on plasma BKA, by treating the plasma (baseline, 1 h and 24 h post-restraint, and after the immune challenge) with ethylenediaminetetraacetic acid, heat, or protease. Our results showed increased CORT 1 h and 24 h after restraint and decreased plasma BKA 24 h post-restraint. The inhibitors of the complement system decreased the plasma BKA compared with untreated plasma at all times (baseline, 1 h, and 24 h after restraint), demonstrating that the plasma BKA activity is partially mediated by the complement system. The immune challenge increased CORT, with the highest values being observed in the highest bacterial concentration, compared with control. The plasma BKA was not affected by the immune challenge but was demonstrated to be partially mediated by the complement system. Our results demonstrated that restraint and the immune challenge activated the hypothalamus-pituitary-interrenal axis, by increasing plasma CORT levels in R. diptycha. Also, our results demonstrated the complement system is participative in the plasma BKA for baseline and post-stress situations in these toads.

Technology for safe care in catastrophic situations: prototype mediated by soft design science research / Tecnologia para seguridad del cuidado en situaciones catastróficas: prototipo mediado por la soft design science research / Tecnologia para segurança do cuidado em situações catastróficas: protótipo mediado pela soft design science research

ABSTRACT Objective: to produce technology that promotes safe hospital care in catastrophic situations. Method: an applied study carried out in a public hospital located in Brazil's Midwest region, between September 2020 and August 2021, using Soft Design Science Research in seven stages: outlining the problem, with descriptive analysis of hospital indicators; explaining the problem as a specific set of requirements, through the application of scales with 108 health professionals and 75 nursing staff, and descriptive and inferential analysis; generalizing the problem, through a scope review to systematize a class of problems; structuring the components of the solution through a workshop guided by design thinking; comparing the specific problem and general requirements to align the solution; defining the solution; building the solution. Results: immersion in the problem revealed outcomes that heralded the worsening of patients' health conditions and the negative perception of workers and managers regarding the safety climate in catastrophic situations, accentuated by the nursing team's dissatisfaction with the support offered by the organization. The projection of this scenario was essential for the systematization of security-enhancing solutions already produced for this purpose, and for carrying out design-oriented experiments in alignment, structuring, prototyping and iteration of the prototype built. Conclusion: a Rapid Response Team has been set up which, in catastrophic situations, makes it possible to intervene when the patient's clinical condition worsens, which helps to increase the survival rate and promotes safety.

RESUMEN Objetivo: producir tecnología que promueva la seguridad del cuidado en la atención hospitalaria en situaciones catastróficas. Método: investigación aplicada realizada en un hospital público ubicado en la región Centro-Oeste de Brasil, entre los meses de septiembre de 2020 y agosto de 2021, mediante la aplicación de la Soft Design Science Research, en siete etapas: perfilamiento del problema, con análisis descriptivo de indicadores hospitalarios; explicación del problema como un conjunto específico de requisitos, mediante la aplicación de escalas con 108 profesionales de la salud y 75 profesionales de enfermería, y análisis descriptivo e inferencial; generalización del problema, mediante revisión de alcance para sistematizar una clase de problemas; estructuración de los componentes de la solución a través de un taller guiado por el design thinking; comparación entre el problema específico y los requisitos generales para alinear la solución; definición de la solución; construcción de la solución. Resultados: la inmersión en el problema reveló resultados que anuncian el empeoramiento de las condiciones de salud de los pacientes y la percepción negativa de trabajadores y gestores sobre el clima de seguridad en situaciones catastróficas, acentuada por la insatisfacción del equipo de enfermería con el soporte ofrecido por la organización. La proyección de este escenario fue fundamental para sistematizar las soluciones que potencien la seguridad, ya producidas para este fin, y para realizar experimentos orientados al diseño, alineación, estructuración, prototipado e iteración del prototipo construido. Conclusión: se formó un Equipo de Respuesta Rápida que, en situaciones catastróficas, permite intervenir ante el empeoramiento de las condiciones clínicas del paciente, lo que favorece el aumento de la tasa de supervivencia y brinda seguridad.

RESUMO Objetivo: produzir tecnologia propulsora de segurança do cuidado na atenção hospitalar em situações catastróficas. Método: pesquisa de natureza aplicada realizada em um hospital público situado na região centro-oeste, Brasil, entre os meses de setembro de 2020 a agosto de 2021, por meio da aplicação da Soft Design Science Research, em sete etapas: delineamento do problema, com análise descritiva de indicadores hospitalares; explicitação do problema como um conjunto específico de requisitos, mediante aplicação de escalas com 108 profissionais de saúde e 75 de enfermagem, e análise descritiva e inferencial; generalização do problema, através de revisão de escopo para sistematização de uma classe de problemas; estruturação dos componentes da solução por meio de workshop orientado pelo design thinking; comparação entre o problema específico e requisitos gerais para alinhamento da solução; definição da solução; construção da solução. Resultados: a imersão no problema evidenciou desfechos que anunciam o agravamento da condição de saúde dos pacientes e percepção negativa de trabalhadores e gestores em relação ao clima de segurança em situações catastróficas, acentuado pela insatisfação da equipe de enfermagem com o suporte oferecido pela organização. A projeção deste cenário foi essencial para sistematização de soluções potencializadoras de segurança já produzidas com esta finalidade, e para a realização de experimentações orientadas pelo design, em alinhamento, estruturação, prototipagem e iteração do protótipo construído. Conclusão: produziu-se um Time de Resposta Rápida que, em situações catastróficas, permite intervir frente ao agravamento de condições clínicas do paciente, o que favorece a ampliação da taxa de sobrevida e é propulsor de segurança.

How does the methodological clinical evaluation impact organ donation? Experience from 4 Organ Procurement Organizations (OPO)

INTRODUCTION: The lack of a clear and reproducible methodology for evaluating potential organ donors, which ensures traceability in the process, can compromise the number of utilized organ donors and the transplantation quality. METHODOLOGY: We developed a reproducible and safe method for the evaluation and validation of Potential Organ Donors (PD) based on 2 principles:1) Updated knowledge of absolute contraindications for organ donation and, 2) Decision making supported by 3 questions. The first principle was absolute contraindications. They were categorized into 4 groups: A) Serologies, B) Tumors, C) Infections, and D) Biological risk for transmission of infectious diseases and cancer. The second principle was the decision-making questions: A) What is the cause of death? B) Are there absolute contraindications to organ donation? and, C) Are there relative contraindications to organ donation? Each PD was subjected to the same methodology. The questions were answered after knowing the PD's clinical file. The PD was valid only if the set of answers adhered to an established matrix respecting different guidelines. The same physician evaluated each PD in all OPO. We applied in 4 different OPO, 3 of them in the State of São Paulo/Brazil and one in the United Arab Emirates, in different periods, including the SARS-COV 2 pandemic. RESULTS: OPO­SCSP, before the methodology (2007): 62 utilized donors, 205 transplants. After the methodology has been started (2008/2009/2010): 117, 154, 186 utilized donors and 348, 533, 487 transplants, respectively. 2) OPO-BTU, before the methodology (2009): 9 utilized donors and 19 transplants. After the methodology has been started (2010/2011/2012): 17, 36, 49 utilized donors and 38, 90, 143 transplants, respectively. 3) OPO-IDPC, before the methodology (2017): 93 utilized donors and 202 transplants. After the methodology has been started (2018/2019/2020): 107, 177, 187 utilized donors and 219, 395, 356 transplants, respectively. 4) UAE OPO, before the methodology (2020): 9 utilized donors and 35 transplants. After the methodology has been started (2021/2022): 39, 55 utilized donors and 147, 203 transplants, respectively. The percentage increase after the beginning of the methodology, considering the last year evaluated: 1) OPO-SCSP: 195% (Utilized donors) and 137% (Transplants); 2) OPO-BTU: 444% (Utilized donors) and 652% (Transplants); C) OPO-IDPC: 101% (Utilized Donors) and 76% (Transplants); 4) OPO-EOTC (United Arab Emirates): 511% (Utilized donors) and 480% (Transplants). CONCLUSION: The methodology used demonstrates that it can directly contribute to increasing the percentage of effective donors and transplants. The increase in donors ranged from 101% to 444%. The percentage growth of transplantation ranged from 76% to 652%. Indirectly, an increase the referrals was observed, motivated by frequent contact with OPO members and ICU professionals.

Selective laser trabeculoplasty versus micropulse laser trabeculoplasty for intraocular pressure control in patients with primary open angle glaucoma: a 12-month retrospective comparative study.

This study was designed to compare the efficacy of selective laser trabeculoplasty (SLT) and micropulse laser trabeculoplasty (MLT) in patients with primary open angle glaucoma (POAG) requiring additional IOP control. In this retrospective, comparative study, we reviewed the charts of POAG patients requiring additional IOP lowering, who underwent either SLT or MLT and were followed for at least one year. We evaluated mean intraocular pressure (IOP), mean IOP reduction from baseline and mean number of glaucoma medications 1, 3, 6 and 12 months after treatment. Success rates (success defined as IOP ≤ 21 mmHg and ≥ 20% reduction from baseline IOP without additional medications, new laser session, or glaucoma surgery) at one year were also compared. A total of 98 POAG patients were included, 52 individuals in the SLT group and 46 in the MLT group. Laser treatment resulted in significant mean IOP reductions from baseline in both groups (SLT = -6.0 ± 3.3 mmHg (24.9%) and MLT = -5.8 ± 2.6 mmHg (23.4%)) (p < 0.001). However, there was no statistically significant difference between the mean IOP reductions in both groups (p = 0.74). At 12 months, the mean number of glaucoma medications was significantly smaller in the SLT group (1.17 + 0.4) when compared to the MLT group (2.21 + 0.2) (p = 0.001). Additionally, after 12 months, success was obtained in 32 (61.5%) SLT cases compared to 27 (58.7%) MLT-treated eyes (p = 1.0). MLT and SLT are both effective in controlling the IOP in POAG patients requiring additional IOP reduction. However, after 12 months, SLT demonstrated a greater efficacy in reducing medication burden when compared to MLT.Trial registration: CEP/CONEP/MS Brazil 40948620.9.0000.5600.

Molecular detection and genetic characterization of Ehrlichia canis and Ehrlichia sp. in neotropical primates from Brazil.

The Anaplasmataceae family includes obligate, arthropod-transmitted intracellular bacteria that can be zoonotic and potentially fatal. Studies focusing on the interaction between neotropical primates and the agents of this family are scarce. The present study aimed to identify agents of the Anaplasmataceae family in the whole blood of free-living and captive neotropical primates in the State of Mato Grosso, Central-West Brazil. Thirty-eight samples of six nonhuman primate (NHP) species were collected in seven municipalities and analysed through polymerase chain reaction (PCR), nucleotide sequencing, and phylogenetic analysis of the dsb, groEL, 16S rRNA, and gltA genes. DNA fragments similar to those of Ehrlichia canis were detected in Sapajus apella and Ehrlichia chaffeensis from Mico melanurus. The sequences generated in this study and homologous sequences retrieved from GenBank® were used for phylogenetic analyses to characterize the Ehrlichial agents detected in NHPs. The agents were then grouped into clades corresponding to different isolates from the NHP species. In addition, an Anaplasma sp. closely related to Anaplasma marginale was identified in two S. apella individuals. These findings shed light on the susceptibility of neotropical NHPs to Anaplasmataceae agents. These bacteria are known to be transmitted by ticks, which can also serve as possible sources of infection for other animals, including humans.

Dispositional mindfulness, emotional regulation and perceived stress among nursing students.

OBJECTIVE: To investigate the correlation between dispositional mindfulness, emotional regulation and perceived stress and to verify factors associated with dispositional mindfulness among nursing students. METHOD: A correlational, cross-sectional study with public undergraduate students. The following instruments were used: Mindful Attention Awareness Scale, Emotional Regulation Questionnaire and Perceived Stress Scale. Analyzes were performed using t tests, Pearson's correlation and multiple linear regression. RESULTS: The study included 330 students. There was no correlation between dispositional mindfulness and general emotional regulation score and/or perceived stress and a weak correlation with the emotional regulation dimension emotional suppression. Being in psychological treatment and psychoactive substance use were associated with decreased dispositional mindfulness. Age, sufficient sleep hours and emotional suppression were associated with an increase in this variable. CONCLUSION: There was a relationship between dispositional mindfulness only with emotional suppression, in addition to the connection of this variable with the perception of sufficient sleep hours, age, use of alcohol or psychoactive substances, undergoing psychological/psychiatric follow-up and emotional suppression.

Molecular detection of Toxoplasma gondii and Neospora caninum in neotropical primates.

BACKGROUND: Toxoplasma gondii and Neospora caninum infections in primates are potentially fatal and directly impact the conservation of these animals and public health. MATERIALS AND METHODS: A total of 38 blood/clot samples collected from free-living and captive neotropical primates undergoing clinical care or found dead by environmental authorities in the Mato Grosso State, Brazil, were analyzed by PCR for DNA detection of T. gondii and N. caninum. Furthermore, eight animals were submitted to immunohistochemistry for the detection of T. gondii. RESULTS: DNA of T. gondii and N. caninum was amplified in 11 (28.95%) 10 (26.32%) of samples analyzed, respectively. Coinfection was observed in three individuals. One animal returned a positive result in the immunohistochemistry for the detection of T. gondii. CONCLUSION: These findings reflect a concern for the conservation of these animals, as the pathogen-host interaction is unpredictable and infections by these protozoa can lead to animal mortality, which has a substantial impact on endangered species.

In-Hospital Outcomes of Right Minithoracotomy vs. Periareolar Access for Minimally Invasive Video-Assisted Mitral Valve Repair

Abstract Introduction: In minimally invasive mitral valve repair, right minithoracotomy is the most widely performed method, providing a good view of the mitral valve. But regarding other techniques and although it offers limited visualization, the periareolar access is a less traumatic alternative. This study's purpose is to compare in-hospital outcomes in patients who underwent video-assisted minimally invasive mitral valve repair via right minithoracotomy and periareolar access. Methods: This is a retrospective observational study including 37 patients (> 18 years old), without previous right thoracic surgery, who underwent their primary mitral valve repair, with indication for minimally invasive video-assisted approach (via right minithoracotomy or periareolar access), between January 2018 and August 2019. Patients' medical records were consulted to collect demographics data, operative details, and in-hospital outcomes. Results: Twenty-one patients underwent right minithoracotomy, and 16 were operated via periareolar access. The mean patients' age was 62±12 years in the right minithoracotomy group and 61±9 years in the periareolar access group (P=0.2). There are no significant differences in incision length, cardiopulmonary bypass time, aortic cross-clamping time, hematocrit, amount of chest tube drainage, and intensive care unit and in-hospital length of stay. Time to extubation presented significant differences between the right minithoracotomy and the periareolar access group (4.85 hours vs. 5.62 hours, respectively) (P=0.04). Conclusion: In this study, we found similar results in the two applied surgical techniques, except for the time to extubation.

In-Hospital Outcomes of Right Minithoracotomy vs. Periareolar Access for Minimally Invasive Video-Assisted Mitral Valve Repair.

INTRODUCTION: In minimally invasive mitral valve repair, right minithoracotomy is the most widely performed method, providing a good view of the mitral valve. But regarding other techniques and although it offers limited visualization, the periareolar access is a less traumatic alternative. This study's purpose is to compare in-hospital outcomes in patients who underwent video-assisted minimally invasive mitral valve repair via right minithoracotomy and periareolar access. METHODS: This is a retrospective observational study including 37 patients (> 18 years old), without previous right thoracic surgery, who underwent their primary mitral valve repair, with indication for minimally invasive video-assisted approach (via right minithoracotomy or periareolar access), between January 2018 and August 2019. Patients' medical records were consulted to collect demographics data, operative details, and in-hospital outcomes. RESULTS: Twenty-one patients underwent right minithoracotomy, and 16 were operated via periareolar access. The mean patients' age was 62±12 years in the right minithoracotomy group and 61±9 years in the periareolar access group (P=0.2). There are no significant differences in incision length, cardiopulmonary bypass time, aortic cross-clamping time, hematocrit, amount of chest tube drainage, and intensive care unit and in-hospital length of stay. Time to extubation presented significant differences between the right minithoracotomy and the periareolar access group (4.85 hours vs. 5.62 hours, respectively) (P=0.04). CONCLUSION: In this study, we found similar results in the two applied surgical techniques, except for the time to extubation.

Conventional Versus Minimally Invasive Aortic Valve Replacement Surgery: A Systematic Review, Meta-Analysis, and Meta-Regression.

Objective: To assess the potential benefits of minimally invasive aortic valve replacement (MIAVR) compared with conventional AVR (CAVR) by examining short-term outcomes. Methods: A systematic search identified randomized trials comparing MIAVR with CAVR. To assess study limitations and quality of evidence, we used the Cochrane Risk of Bias tool and GRADE and performed random-effects meta-analysis. We used meta-regression and sensitivity analysis to explore reasons for diversity. Results: Thirteen studies (1,303 patients) were included. For the comparison of MIAVR and CAVR, the risk of bias was judged low or unclear and the quality of evidence ranged from very low to moderate. No significant difference was observed in mortality, stroke, acute kidney failure, infectious outcomes, cardiac events, intubation time, intensive care unit stay, reoperation for bleeding, and blood transfusions. Blood loss (mean difference [MD] = -130.58 mL, 95% confidence interval [CI] = -216.34 to -44.82, I2 = 89%) and hospital stay (MD = -0.93 days, 95% CI = -1.62 to -0.23, I2 = 81%) were lower with MIAVR. There were shorter aortic cross-clamp (MD = 5.99 min, 95% CI = 0.99 to 10.98, I2 = 93%) and cardiopulmonary bypass (CPB) times (MD = 7.75 min, 95% CI = 0.27 to 15.24, I2 = 94%) in the CAVR group. In meta-regression analysis, we found that age was the variable with the greatest influence on heterogeneity. Conclusions: MIAVR seems to be an excellent alternative to CAVR, reducing hospital stay and incidence of hemorrhagic events. Despite significantly greater aortic cross-clamp and CPB times with MIAVR, this did not translate into adverse effects, with no changes in the results found with CAVR.

Dispositional mindfulness, emotional regulation and perceived stress among nursing students / Mindfulness disposicional, regulación emocional y estrés percibido en estudiantes de enfermería / Atenção plena disposicional, regulação emocional e estresse percebido em estudantes de enfermagem

ABSTRACT Objective: To investigate the correlation between dispositional mindfulness, emotional regulation and perceived stress and to verify factors associated with dispositional mindfulness among nursing students. Method: A correlational, cross-sectional study with public undergraduate students. The following instruments were used: Mindful Attention Awareness Scale, Emotional Regulation Questionnaire and Perceived Stress Scale. Analyzes were performed using t tests, Pearson's correlation and multiple linear regression. Results: The study included 330 students. There was no correlation between dispositional mindfulness and general emotional regulation score and/or perceived stress and a weak correlation with the emotional regulation dimension emotional suppression. Being in psychological treatment and psychoactive substance use were associated with decreased dispositional mindfulness. Age, sufficient sleep hours and emotional suppression were associated with an increase in this variable. Conclusion: There was a relationship between dispositional mindfulness only with emotional suppression, in addition to the connection of this variable with the perception of sufficient sleep hours, age, use of alcohol or psychoactive substances, undergoing psychological/psychiatric follow-up and emotional suppression.

RESUMEN Objetivo: Investigar la correlación entre mindfulness disposicional, regulación emocional y estrés percibido y verificar factores asociados al mindfulness disposicional en estudiantes de enfermería. Método: Estudio transversal, correlacional con estudiantes de universidades públicas. Los instrumentos fueron utilizados: Mindful Attention Awareness Scale, Emotional Regulation Questionnaire y Perceived Stress Scale. Los análisis se realizaron mediante pruebas t, correlación de Pearson y regresión lineal múltiple. Resultados: Participaron 330 estudiantes. No hubo correlación entre mindfulness disposicional y puntuación general de regulación emocional y/o estrés percibido y una débil correlación con la dimensión de regulación emocional supresión de emociones. Estar en tratamiento psicológico y el consumo de sustancias psicoactivas se asociaron con una disminución del mindfulness disposicional. La edad, la suficiencia de horas de sueño y la supresión emocional se asociaron con un aumento de esta variable. Conclusión: Hubo relación entre el mindfulness disposicional solo con la supresión de emociones, además de la conexión de esta variable con la percepción de suficientes horas de sueño, edad, consumo de alcohol o sustancias psicoactivas, estar en seguimiento psicológico/psiquiátrico y supresión emocional.

RESUMO Objetivo: Investigar a correlação entre atenção plena disposicional, regulação emocional e estresse percebido e verificar fatores associados à atenção plena disposicional em estudantes de enfermagem. Método: Estudo correlacional, transversal, com estudantes de universidade pública. Foram utilizados os instrumentos: Mindful Attention Awareness Scale, Emotional Regulation Questionnaire e Perceived Stress Scale. Análises foram realizadas por meio de testes t, correlação de Pearson e regressão linear múltipla. Resultados: Participaram 330 estudantes. Identificou-se ausência de correlação entre a atenção plena disposicional e escore geral de regulação emocional e/ou estresse percebido e correlação fraca com a dimensão de regulação emocional supressão das emoções. Estar em tratamento psicológico e uso de substância psicoativas se associou à diminuição da atenção plena disposicional. Já idade, suficiência de horas de sono e supressão emocional se associaram ao aumento desta variável. Conclusão Houve relação entre a atenção plena disposicional apenas com a supressão das emoções, além de ligação desta variável com percepção de horas suficientes de sono, idade, uso de álcool ou substâncias psicoativas, estar em acompanhamento psicológico/psiquiátrico e supressão emocional.

Saúde bucal de crianças com microcefalia associada ao Zika vírus / Oral health of children with microcephaly associated with Zika vírus / Salud bucal de los niños con microcefalia asociada al virus del Zika

Objetivo: descrever sobre as condições bucais das crianças com Microcefalia associada ao Zika vírus. Metodologia: Estudo transversal realizado com 13 crianças atendidas no projeto institucional e multidisciplinar "Atenção Integrada às crianças com microcefalia por Zika vírus" e seus respectivos cuidadores. Foi realizado entrevista com os cuidadores e de exame clínico bucal nas crianças, sendo coletados dados sobre características sociodemográficas e econômicas, hábitos de higiene, comportamentais e alimentares, assim como as características oclusais e os índices clínicos odontológicos (ISG, IPV e ceo-d). Os dados foram analisados de maneira descritiva e através do teste Wilcoxon no software Statistical Package for the Social Sciences, versão 20. Resultados: A maioria das crianças eram do sexo feminino (53,8%), entre 24 e 35 meses (76,9%) e a mãe era o principal cuidador (76,9%). Em relação aos hábitos das crianças, 61,5% apresentavam alimentação semissólida, com frequência de escovação diária de duas vezes ou mais (46,2%), utilizavam mamadeira (76,9%) e chupeta (53,8%). As crianças não apresentavam cárie, o ISG e IPV foram considerados satisfatórios. Além disso, 92,3% das crianças rangiam os dentes durante a noite, 61,5% apresentavam mordida aberta anterior, sobressaliência aumentada (84,6%) e cronologia de erupção alterada (84,6%). Conclusão: As crianças apresentavam erupção dentária tardia, presença de facetas de desgastes, chave de canino com classificação I, mordida aberta anterior e sobressaliência aumentada. Além disso, possuíam frequência de escovação satisfatória, alimentações semissólida, usavam mamadeira e chupeta. A partir dos índices odontológicos, observou-se que as crianças apresentavam uma saúde bucal satisfatória(AU)

Objective: to describe the oral conditions of children with microcephaly associated with Zikavirus. Methodology: Cross-sectional study carried out with 13 children assisted in the institutional and multidisciplinary project "Integrated Care for children with microcephaly due to Zika virus" and their respective caregivers. Interviews were conducted with caregivers and a clinical oral exam was carried out on the children, with data on sociodemographic and economic characteristics, hygiene, behavioral and dietary habits, as well as occlusal characteristics and clinical dental indexes (ISG, IPV and ceo-d) being collected. The data were analyzed descriptively and using the Wilcoxon test in the Statistical Package for the Social Sciences software, version 20. Results: Most children were female (53.8%), between 24 and 35 months (76.9 %) and the mother wasthe main caregiver (76.9%). Regarding the children's habits, 61.5% had a semi-solid diet, with a daily brushing frequency of twice or more (46.2%), used a bottle (76.9%) and pacifier (53.8%). The children did not present caries, the ISG and IPV were considered satisfactory. In addition, 92.3% of children gritted their teeth at night, 61.5% had an open anterior bite, increased overjet (84.6%) and altered rash chronology (84.6%) Conclusion: Children had a rash late dental, presence of wear facets, canine keywith classification I, anterior open bite and increased overjet. In addition, they had a satisfactory brushing frequency, semi-solid food, used a bottle and used a pacifier. From the dental indexes, it was observed that the children had satisfactory oral health(AU)

Objetivo: describir las condiciones bucales de los niños con microcefalia asociada al virus del Zika. Metodología: Estudio transversal realizado con 13 niños atendidos en el proyecto institucional y multidisciplinario "Atención integral a niños conmicrocefalia por virus Zika" y sus respectivos cuidadores. Se realizaron entrevistas con los cuidadores y se realizó un examen clínico bucal a los niños, con datos de características sociodemográficas y económicas, higiene, hábitos de comportamiento y dietéticos, así como características oclusales e índices clínico-odontológicos (ISG, IPV y ceo). -d) siendo recogido. Los datos se analizaron de forma descriptiva y mediante la prueba de Wilcoxon en el software Statistical Package for the Social Sciences, versión 20. Resultados: La mayoría de los niños eran mujeres (53,8%), entre 24 y 35 meses (76,9%) y la madre era la principal cuidadora. (76,9%). En cuanto a los hábitos de los niños, el 61,5% tenía alimentación semisólida, con una frecuencia de cepillado diario de dos o más (46,2%), utilizaba biberón (76,9%) y chupete (53,8%). Los niños no presentaron caries, la ISG y la IPV se consideraron satisfactorias. Además, el 92,3% de los niños apretaban los dientes por la noche, el 61,5% tenía una mordida anterior abierta, un resalte elevado (84,6%) y una cronología de la erupción alterada (84,6%) Conclusión: los niños tenían una erupción dental tardía, presencia de facetas de desgaste, canino clave con clasificación I, mordida abierta anterior y resalte aumentado. Además, tenían una frecuencia de cepillado satisfactoria, alimentos semisólidos, usaban biberón y usaban chupete. A partir de los índices dentales, se observó que los niños tenían una salud bucal satisfactoria(AU)

Polymorphisms of the vitamin D receptor gene in Crohn's disease / Polimorfismos do gene do receptor de vitamina D na doença de Crohn

Introduction: Crohn's disease (CD) and ulcerative colitis (UC) are chronic inflammatory conditions of the gastrointestinal tract. Studies have shown that polymorphisms of the vitamin D receptor (VDR) gene may help elucidate the pathogenesis of CD. Objectives: To analyze the role of VDR gene polymorphisms (ApaI, BsmI, FokI, and TaqI) in the development of CD. Methods: The present study is a systematic review with meta-analysis. a total of 50 articles in English and Portuguese published from 2000 to 2020 were selected from 3 databases. The relationship between CD and the VDR gene was addressed in 16 articles. Results: The TaqI polymorphism was analyzed in 3,689 patients and 4,645 control subjects (odds ratio [OR]=0.948; 95% confidence interval [95%CI]=0.851-1.056; p=0.3467). The ApaI polymorphism was studied in 3,406 patients and 4,415 control subjects (OR=1,033; 95%CI=0.854-1.250; p=0.7356). For FokI polymorphism, there were 2,998 patients and 4,146 control subjects (OR=0.965; 95%CI=0.734-1.267; p=0.7958). Lastly, the BsmI polymorphism was analyzed in 2,981 patients and 4,477 control subjects (OR=1,272; 95%CI=0.748-2.161; p=0.3743). Conclusion: These four VDR gene polymorphisms were not associated with CD. Therefore, further studies with larger samples are required to corroborate or rectify the conclusions from the present meta-analysis. (AU)

Introdução: A doença de Crohn (DC) e a retocolite ulcerativa (RU) são condições inflamatórias crônicas do trato gastrointestinal. Estudos indicam que os polimorfismos do gene do receptor de vitamina D (RVD) são promissores para a patogênese da DC. Objetivos: Avaliar papel dos os polimorfismos do gene do RVD (ApaI, BsmI, FokI e TaqI) no desenvolvimento da DC. Métodos: Trata-se de uma revisão sistemática com metanálise. Foram identificados 50 artigos em inglês e português publicados entre 2000 a 2020 em 3 bases de dados. Destes, foram selecionados 16 artigos que contemplavama relação entre a DC e o genedo RVD. Resultados: Para o polimorfismo TaqI, a amostra foi composta por 3.689 pacientes e 4.645 controles (razão de probabilidade [RP]=0,948; intervalo de confiança de 95% [IC95%]=0,851-1,056; p=0,3467). Para o polimorfismo ApaI, 3.406 pacientes e 4.415 controles (RP=1,033; IC95%=0,854-1,250; p=0,7356). Para o polimorfismo FokI, 2.998 pacientes e 4.146 controles (RP=0,965; IC95%=0,734-1,267; p=0,7958). E, para o polimorfismo BsmI, 2.981 pacientes e 4.477 controles (RP =1,272; IC95%=0,748-2,161; p=0,3743). Conclusão: Esses quatro polimorfismos do gene do RVD não apresentaram associação coma DC. Logo, sugere-se a realização de mais estudos com amostras maiores a fimde corroborar ou retificar a conclusão desta metanálise. (AU)

Computerized Cognitive Training for ADHD as an Add-On Treatment to Stimulants: A Randomized Clinical Trial.

Objective: Computerized cognitive training (CCT) as add-on treatment to stimulants for ADHD core symptoms is scarcely investigated. The purpose of this study is to assess the effect of CCT in a randomized controlled clinical trial for ADHD in children and adolescents treated with stimulants. Method: Fifty-three participants aged 6 to 13 years receiving stimulant treatment and presenting ADHD residual symptoms were randomized either to a CCT (n = 29) or to a controlled nonactive condition (n = 24) for four sessions/week during 12 weeks. The main outcome measure was inattentive symptoms assessed using the Swanson, Nolan, and Pelham-IV (SNAP-IV) Scale. Secondary outcomes include, among others, hyperactive/impulsive symptoms and cognitive tests. Results: There were neither significant group differences on ADHD-inattentive symptoms after the intervention nor on both ADHD-hyperactivity/impulsivity symptoms and cognitive measures. Conclusion: Our study does not provide evidence for the benefits of cognitive training over nonactive training on core ADHD symptoms in medicated ADHD children and adolescents.

Intelligent System for Dispatch Ranking of Generating Units in Thermoelectric Power-Plants

Abstract The multicriteria decision-making process is still an open problem, especially when the decision criteria are not numerical or fully outlined. Several numerical, intelligent, or hybrid techniques have been developed, creating contributions to this problem's solution. This paper is another step in this direction. Based on the Modified Analytic Hierarchy Process (MAHP), a methodology for diagnosis and performance analysis is presented for the dispatch ranking of generating units in a thermoelectric plant. The problem is complex because it covers a power plant, where 99 generating units may be dispatched, according to 10 possible evaluation criteria, which should be used together. This article also presents details of the implementation of the sensors necessary to add to the supervisory system existing in the Palmeiras de Goias Thermal Power Plant.

O humano em Søren Kierkegaard e em Viktor Frankl / The human in Søren Kierkegaard and Viktor Frankl

Este trabalho é um estudo teórico que objetiva abordar aspectos centrais da Antropologia Filosófica presentes em dois autores existencialistas: Søren Kierkegaard e Viktor Frankl. A partir do estudo do que é o homem, apresentamos algumas importantes questões existenciais que, embora desenvolvidas pelos autores supracitados nos séculos XIX e XX, respectivamente, permanecem atuais: o desespero e a busca pelo sentido, liberdade, responsabilidade, possibilidade e necessidade, angústia e vazio existencial.Partimos da pesquisa qualitativa, por meio de uma revisão de literatura, buscando atender ao objetivo proposto. Compreendemos que a dimensão do espírito diferencia o homem dos outros seres. Ambos os autores destacam a esfera espiritual e compreendem o humano em sua integralidade. Conclui-se que Kierkegaard e Frankl, em seus pressupostos, oferecem possibilidade de conhecimento do homem e de questões existenciais relevantes para nossa sociedade permeada pelo desespero e pelo vazio existencial. Assim, as proposições dos autores contribuem especialmente para as ciências humanas.

This paper is a theoretical study that aims to approach central aspects of Philosophical Anthropology present in two existentialist authors: Søren Kierkegaard and Viktor Frankl. From the study of what man is, we present some important existential questions that, although developed by these authors in the nineteenth and twentieth centuries respectively, remain current: despair and the search for meaning, freedom, responsibility, possibility and necessity, anguish and existential void. We started from the qualitative research, through a literature review seeking to meet the proposed objective. We understand that the dimension of the spirit differentiates man from other beings. Both authors highlight the spiritual realm and understand the human in its entirety. We conclude that Kierkegaard and Frankl, in their assumptions, offer the possibility of knowledge of man, and of existential questions relevant to our society, which is permeated by despair and existential emptiness. Thus, the authors' propositions contribute especially to the humanities.

Clinical and ultrasonographic aspects of benign and malignant mammary tumors in female dogs

Background: Mammary neoplasms in dogs are commonly observed in veterinary clinical routine, most of which beingmalignant. Hormonal stimulation, endogenous or exogenous, may possibly influence its development. In addition to clinicalevaluation, ultrasound analysis can provide information about the characteristics of breast lumps. The association betweenclinical-epidemiological and pathological data is important for diagnosis. Therefore, given the importance of this pathologyfor the health of affected dogs, we aimed to evaluate the clinical and ultrasound alterations, along with the factors associated with the development of benign and malignant mammary neoplasms in female dogs.Materials, Methods & Results: We examined 47 samples from the mammary tumors of 35 female dogs at the Small Animal Clinic of the Veterinary Hospital (HV) of the Santa Cruz State University (UESC). The dogs underwent a completeclinical examination, with clinical staging, via TNM classification, followed by hematological, biochemical, radiologicaland ultrasound, abdominal, and breast exams. Breast ultrasound examination was used to evaluate the shape parameterssuch as, limits, margins or contour, ecotexture, echogenicity, hyperechoic halo, posterior acoustic shading, surroundingchanges, and nodule components. These criteria were associated with the histopathological classification of neoplasms.Epidemiological data was studied through an adapted questionnaire containing information on risk factors associated withbreast cancer. The same questionnaire was applied to tutors of 19, age-matched, female dogs with no history of breastcancer. The results revealed that most female dogs with neoplasia were over eight years of age, with no specific breed andwere not castrated, and 31.4% of them had already been administered with contraceptives during the reproductive period...(AU)

Streptococcus mutans and Actinomyces naeslundii Interaction in Dual-Species Biofilm.

The study of bacterial interaction between Streptococcus mutans and Actinomyces naeslundii may disclose important features of biofilm interspecies relationships. The aim of this study was to characterize-with an emphasis on biofilm formation and composition and metabolic activity-single- and dual-species biofilms of S. mutans or A. naeslundii, and to use a drip flow reactor (DFR) to evaluate biofilm stress responses to 0.2% chlorhexidine diacetate (CHX). Single- and dual-species biofilms were grown for 24 h. The following factors were evaluated: cell viability, biomass and total proteins in the extracellular matrix, 2,3-bis(2-methoxy-4-nitro-5-sulfophenyl)-2H-tetrazolium-5-carboxanilide-"XTT"-reduction and lactic acid production. To evaluate stress response, biofilms were grown in DFR. Biofilms were treated with CHX or 0.9% sodium chloride (NaCl; control). Biofilms were plated for viability assessment. Confocal laser-scanning microscopy (CLSM) was also performed. Data analysis was carried out at 5% significance level. S. mutans viability and lactic acid production in dual-species biofilms were significantly reduced. S. mutans showed a higher resistance to CHX in dual-species biofilms. Total protein content, biomass and XTT reduction showed no significant differences between single- and dual-species biofilms. CLSM images showed the formation of large clusters in dual-species biofilms. In conclusion, dual-species biofilms reduced S. mutans viability and lactic acid production and increased S. mutans' resistance to chlorhexidine.

Clinical and ultrasonographic aspects of benign and malignant mammary tumors in female dogs

Background: Mammary neoplasms in dogs are commonly observed in veterinary clinical routine, most of which beingmalignant. Hormonal stimulation, endogenous or exogenous, may possibly influence its development. In addition to clinicalevaluation, ultrasound analysis can provide information about the characteristics of breast lumps. The association betweenclinical-epidemiological and pathological data is important for diagnosis. Therefore, given the importance of this pathologyfor the health of affected dogs, we aimed to evaluate the clinical and ultrasound alterations, along with the factors associated with the development of benign and malignant mammary neoplasms in female dogs.Materials, Methods & Results: We examined 47 samples from the mammary tumors of 35 female dogs at the Small Animal Clinic of the Veterinary Hospital (HV) of the Santa Cruz State University (UESC). The dogs underwent a completeclinical examination, with clinical staging, via TNM classification, followed by hematological, biochemical, radiologicaland ultrasound, abdominal, and breast exams. Breast ultrasound examination was used to evaluate the shape parameterssuch as, limits, margins or contour, ecotexture, echogenicity, hyperechoic halo, posterior acoustic shading, surroundingchanges, and nodule components. These criteria were associated with the histopathological classification of neoplasms.Epidemiological data was studied through an adapted questionnaire containing information on risk factors associated withbreast cancer. The same questionnaire was applied to tutors of 19, age-matched, female dogs with no history of breastcancer. The results revealed that most female dogs with neoplasia were over eight years of age, with no specific breed andwere not castrated, and 31.4% of them had already been administered with contraceptives during the reproductive period...