RESUMO
The use of babassu agro-industrial residues in animal feed, in addition to being an economic option of great importance in reducing the environmental impact in regions of the Brazilian Cerrado, provides the production of good quality foods of animal origin due to its nutritional characteristics. However, information related to the nutritional components of babassu by-industrial residues has not yet been sufficiently explored. The aim of this study was to evaluate the nutritional potential of some by-products from the babassu production chain through chemical composition and in situ degradability analyses. The experiment was conducted in a completely randomized experimental design, with 4 by-products from babassu processing (cake, greasy, fine flour, and 95 µm flour) and 5 replications. The by-products differ in terms of chemical composition, except for the hemicellulose content. For the degradability of fraction "a" of dry matter, it presented a higher percentage for 95 µm flour. Fine flour and 95 µm flour presented the highest fractions "b" and "c," potential, and effective degradability of dry matter. For the degradation of crude protein, the highest percentages of potential and effective degradability were observed for greasy and 95 µm flour. The highest standardized potentially degradable fraction and the highest passage rate were obtained by 95 µm flour, which also showed greater degradation for dry matter, crude protein, and neutral detergent fiber. Among the by-products studied, the babassu cake has superior chemical composition; however, the 95 µm flour presented nutritional value and satisfactory rumen degradation to be used as an additive or in partial replacement of traditional concentrates.
RESUMO
This study aimed to evaluate the therapeutic potential of amantadine in a vincristine-induced peripheral neuropathy model in rats. Forty-eight male Wistar rats were used. The treated groups received oral amantadine at doses of 2, 5, 12, 25 and 50 mg/kg, with daily applications for 14 days. The mechanical paw withdrawal threshold was measured using a digital analgesimeter. Immunohistochemical analysis of IL-6, TNFα, MIP1α, IL-10, CX3CR1, CXCR4, SOD, CAT and GPx, and enzymatic activity analysis of CAT, SOD and GPx were performed, in addition to quantitative PCR of Grp78, Chop, Ho1, Perk, Bax, Bcl-xL, Casp 3, Casp 9, IL-6, IL-10, IL-18 and IL-1ß. The results showed an increase in nociceptive thresholds in animals that received 25 mg/kg and 50 mg/kg amantadine. Immunohistochemistry showed a decrease in the immunostaining of IL-6, TNFα, MIP1α and CX3CR1, and an increase in IL-10. CAT and SOD showed an increase in both immunochemistry and enzymatic analysis. qPCR revealed a reduced expression of genes related to endoplasmic reticulum stress and regulation in the expression of immunological and apoptotic markers. Amantadine demonstrated antinociceptive, anti-inflammatory and antioxidant effects in the vincristine-induced peripheral neuropathy model in rats, suggesting that amantadine may be considered an alternative approach for the treatment of vincristine-induced peripheral neuropathic pain.
RESUMO
APRESENTAÇÃO DO CASO: Paciente do sexo masculino, 5 anos, encaminhado ao nosso serviço devido quadro de refluxo gastresofágico (RGE) iniciado aos 4 meses de idade, evoluindo com disfagia, vômitos intensos, déficit pôndero-estatural e episódios recorrentes de broncoespasmo. Fez uso contínuo de corticóide inalatório, broncodilatadores e inibidores de bomba de prótons (IBP), sem resposta adequada. Devido à persistência dos sintomas, realizado endoscopia digestiva alta (EDA), a qual evidenciou quadro de Esofagite Erosiva Distal de leve intensidade e compressão extrínseca esofágica pulsátil, sugestiva de artéria subclávia anômala. Confirmado diagnóstico por ecodopplercardiograma transtorácico que demonstrou a presença de artéria subclávia direita aberrante com trajeto retroaórtico e realizado angiotomografia dos vasos da base que corroborou com achado ecocardiográfico. Paciente evoluiu clinicamente estável, sendo mantido em seguimento clínico devido exames subsequentes como EDA e estudo contrastado do esôfago-estômago-duodeno (EED) sem sinais de compressão extrínseca naquele momento. DISCUSSÃO: A anomalia da artéria subclávia direita é a malformação vascular mais comum do arco aórtico, apesar de ser considerada uma condição rara na população de modo geral, estando presente em apenas 0,05% a 1%, em paciente com Síndrome de Down, a incidência encontra-se em cerca de 40%. Tal condição ocorre quando a artéria subclávia direita se origina diretamente da aorta descendente, e sua causa pode estar relacionada à regressão anormal do quarto arco aórtico primitivo, durante o desenvolvimento embriológico. O trajeto posterior ao esôfago e à traqueia é uma característica importante dessa anomalia, pois, apesar de raros, são descritos sintomas consequentes à compressão posterior dessas estruturas, tais como disfagia, RGE, estridor e dispneia, além de degeneração aneurismática ou doença aterosclerótica oclusiva. COMENTÁRIOS FINAIS: Por mais que a artéria subclávia com origem aberrante seja uma malformação rara, geralmente um achado acidental e embora dificilmente perpetue com sintomas, a suspeita sempre deve ser levantada diante de quadro de sintomas relacionados à compressão traqueal ou esofageana, como crises de broncoespasmo recorrentes e sintomas digestivos como refluxo e disfagia. Dessa forma, seu diagnóstico precoce é essencial para melhora da qualidade de vida, bem como evitar repercussões clínicas ao paciente.
Assuntos
Humanos , Feminino , Lactente , Criança , Ecocardiografia , Síndrome de Bland-White-GarlandRESUMO
OBJECTIVES: This study examined the impact of premedication with ibuprofen and ibuprofen-arginine and the influence of preoperative pain and anxiety on inferior alveolar nerve block (IANB) efficacy in cases of symptomatic irreversible pulpitis. MATERIALS AND METHODS: The study involved 150 SIP patients who were randomly assigned to receive ibuprofen (600 mg), ibuprofen-arginine (1,155 mg), or a placebo 30 min before IANB. Preoperative anxiety and pain levels were assessed using the Modified Dental Anxiety Scale and the Heft-Parker visual scale. IANB efficacy was determined by the absence of or mild pain during the procedure. Statistical analysis included chi-square, z-tests, Analysis of Variance, and Student's t tests. RESULTS: The ibuprofen and ibuprofen-arginine groups exhibited significantly higher IANB success rates (62% and 78%, respectively) compared to the placebo group (34%). However, no significant difference was observed between the ibuprofen and ibuprofen-arginine groups. Patients with successful IANB in the ibuprofen and ibuprofen-arginine groups displayed lower median anxiety scores (8) than those with failed blocks (15) and lower mean preoperative pain scores (118.3). CONCLUSION: In cases of symptomatic irreversible pulpitis the preemptive medication with ibuprofen-arginine effectively increased the efficacy of the inferior alveolar nerve block The inferior alveolar nerve block efficacy was influenced by preoperative anxiety levels and the intensity of pain. CLINICAL RELEVANCE: This research underscores the potential benefits of oral premedication with ibuprofen and ibuprofen-arginine in improving anesthesia outcomes in cases of symptomatic irreversible pulpitis.
Assuntos
Arginina , Ibuprofeno , Nervo Mandibular , Bloqueio Nervoso , Medição da Dor , Pulpite , Humanos , Pulpite/cirurgia , Ibuprofeno/uso terapêutico , Ibuprofeno/administração & dosagem , Método Duplo-Cego , Masculino , Bloqueio Nervoso/métodos , Feminino , Arginina/uso terapêutico , Arginina/administração & dosagem , Adulto , Anestesia Dentária/métodos , Resultado do Tratamento , Pessoa de Meia-Idade , Combinação de MedicamentosRESUMO
BACKGROUND AND OBJECTIVES: Cerebral aneurysms in complex anatomical locations and intraoperative rupture can be challenging. Many methods to reduce blood flow can facilitate its exclusion from the circulation. This study evaluated the safety and efficacy of using adenosine, rapid ventricular pacing, and hypothermia in cerebral aneurysm clipping. METHODS: Databases (PubMed, Embase, and Web of Science) were systematically searched for studies documenting the use of adenosine, rapid ventricular pacing, and hypothermia in cerebral aneurysm clipping and were included in this single-arm meta-analysis. The primary outcome was 30-day mortality. Secondary outcomes included neurological outcomes by mRs and GOS, and cardiac outcomes. We evaluated the risk of bias using ROBIN-I, a tool developed by the Cochrane Collaboration. OpenMetaAnalyst version 2.0 was used for statistical analysis and I2 measured data heterogeneity. Heterogeneity was defined as an I2 > 50%. RESULTS: Our systematic search yielded 10,100 results. After the removal of duplicates and exclusion by title and abstract, 64 studies were considered for full review, of which 29 were included. The overall risk of bias was moderate. The pooled proportions of the adenosine analysis for the different outcomes were: For the primary outcome: 11,9%; for perioperative arrhythmia: 0,19%; for postoperative arrhythmia: 0,56%; for myocardial infarction incidence: 0,01%; for follow-up good recovery (mRs 0-2): 88%; and for neurological deficit:14.1%. In the rapid ventricular pacing analysis, incidences were as follows: peri operative arrhythmia: 0,64%; postoperative arrhythmia: 0,3%; myocardial infarction: 0%. In the hypothermia analysis, the pooled proportion of 30-day mortality was 11,6%. The incidence of post-op neurological deficits was 35,4% and good recovery under neurological analysis by GOS was present in 69.2%. CONCLUSION: The use of the three methods is safe and the related complications were very low. Further studies are necessary, especially with comparative analysis, for extended knowledge.
Assuntos
Adenosina , Aneurisma Intracraniano , Humanos , Aneurisma Intracraniano/cirurgia , Adenosina/uso terapêutico , Hipotermia Induzida/métodos , Resultado do Tratamento , Procedimentos Neurocirúrgicos/métodos , Estimulação Cardíaca Artificial/métodosRESUMO
An environmental disaster caused by the rupture of a mining tailings dam has impacted a large area of the Rio Doce watershed in the Brazilian Atlantic Forest, resulting in unprecedented damage at spatial and temporal scales. The Atlantic Forest is one of the world's most important biodiversity hotspots. A long history of land use conversion has resulted in a highly fragmented landscape. Despite numerous restoration initiatives, these efforts have often biased criteria and use limited species assemblages. We conducted a comprehensive synthesis of the plant community in riparian forests along the Rio Doce watershed. Our work detailed vegetation composition (tree and sapling strata) and examined its relationship with edaphic and landscape factors, aiming to inform restoration projects with scientifically robust knowledge. A total of 4906 individuals from the tree strata and 4565 individuals from the sapling strata were recorded, representing a total of 1192 species from 75 families. Only 0.8% of the tree species and 0.5% of the sapling species occurred in all sampled sectors, with over 84% of the species occurring in a single watershed sector for both strata. We observed a high species heterogeneity modulated by turnover (92.3% in the tree, and 92.7% in the sapling strata) among sites. Overall, our research revealed a gradient of soil fertility influencing species composition across different strata. Additionally, we discovered that preserved landscapes had a positive impact on species diversity within both strata. The species exclusivity in the sampled sites and the high turnover rate imply the need to consider multiple reference ecosystems when restoring the watershed to reduce the risk of biotic homogenization. Finally, the reference ecosystems defined here serve as a basis for the selection of locally particular species in the implementation of restoration projects that aim to improve biodiversity, ecosystem services, and water security.
Assuntos
Biodiversidade , Recuperação e Remediação Ambiental , Florestas , Brasil , Recuperação e Remediação Ambiental/métodos , Conservação dos Recursos Naturais/métodos , Monitoramento Ambiental , Árvores , RiosRESUMO
Coralsnakes (Micrurus spp.) are the only elapids found throughout the Americas. They are recognized for their highly neurotoxic venom, which is comprised of a wide variety of toxins, including the stable, low-mass toxins known as three-finger toxins (3FTx). Due to difficulties in venom extraction and availability, research on coralsnake venoms is still very limited when compared to that of other Elapidae snakes like cobras, kraits, and mambas. In this study, two previously described 3FTx from the venom of M. corallinus, NXH1 (3SOC1_MICCO), and NXH8 (3NO48_MICCO) were characterized. Using in silico, in vitro, and ex vivo experiments, the biological activities of these toxins were predicted and evaluated. The results showed that only NXH8 was capable of binding to skeletal muscle cells and modulating the activity of nAChRs in nerve-diaphragm preparations. These effects were antagonized by anti-rNXH8 or antielapidic sera. Sequence analysis revealed that the NXH1 toxin possesses eight cysteine residues and four disulfide bonds, while the NXH8 toxin has a primary structure similar to that of non-conventional 3FTx, with an additional disulfide bond on the first loop. These findings add more information related to the structural diversity present within the 3FTx class, while expanding our understanding of the mechanisms of the toxicity of this coralsnake venom and opening new perspectives for developing more effective therapeutic interventions.
Assuntos
Clonagem Molecular , Cobras Corais , Venenos Elapídicos , Músculo Esquelético , Receptores Nicotínicos , Animais , Venenos Elapídicos/química , Venenos Elapídicos/toxicidade , Venenos Elapídicos/genética , Receptores Nicotínicos/metabolismo , Receptores Nicotínicos/genética , Músculo Esquelético/metabolismo , Músculo Esquelético/efeitos dos fármacos , Sequência de Aminoácidos , MasculinoRESUMO
BACKGROUND AND OBJECTIVES: Mechanical thrombectomy (MT) has been established as the gold standard of treatment for patients with Acute Ischemic Stroke (AIS) who present up to 6 h after the onset of the stroke. Recently, the DEFUSE-3 and DAWN trials established the safety of starting the MT procedure up to 16 and 24 h after the patient was last seen well, respectively. The purpose of this study is to assess the safety and functional effects of thrombectomy in individuals with AIS detected at a late stage (> 24 h). MATERIALS AND METHODS: PubMed, Web of Science, Embase, and Cochrane databases were thoroughly searched for research on MT in patients in the extremely late time window after AIS. The primary outcomes were symptomatic cerebral hemorrhage, 90-day mortality, Thrombolysis in Cerebral Infarction (TICI) 2b-3, and Modified Rankin Scale (mRS) 0-2. RESULTS: Our study included fifteen studies involving a total of 1,221 patients who presented with AIS and an extended time window. The primary outcome of interest was the favorable functional outcome, mRS 0-2 at 90 days. The pooled proportion for this outcome was 45% (95% confidence interval 34-58%). Other outcomes included the TICI 2b or 3 (successful recanalization), which was reported in 12 studies and had a 79% incidence in the study population (95% CI 68-87%). Complications included: symptomatic intracranial hemorrhage (sICH), which revealed an incidence of 7% in the study population (95% CI 5-10%); and 90-day mortality, which reported a 27% incidence (95% CI 24-31%). In addition, we conducted a comparative analysis between endovascular treatment and standard medical therapy. CONCLUSION: Our meta-analysis provides evidence that supports the need of further randomized and prospective clinical trials to better assess the effectiveness and safety of MT in these patients.
Assuntos
AVC Isquêmico , Trombectomia , Humanos , Trombectomia/métodos , AVC Isquêmico/cirurgia , AVC Isquêmico/terapia , Resultado do Tratamento , Fatores de Tempo , Tempo para o Tratamento/estatística & dados numéricos , Acidente Vascular Cerebral/cirurgia , Acidente Vascular Cerebral/terapia , Trombólise Mecânica/métodosRESUMO
PURPOSE: Medical and veterinary filarial nematodes are transmitted by blood-feeding vectors. In dogs, these parasites are mainly represented by nematodes in which microfilariae dwell in the blood (Dirofilaria spp. and Acanthocheilonema spp.) or skin (Cercopithifilaria spp. and Onchocerca lupi). The aim of this study was to determine the prevalence of these filarial infections in dogs residing in a touristic, heavily populated location in the northeastern region of Brazil. METHODS: Blood samples (n = 245) were assessed by a modified Knott test, followed by a qualitative ELISA test (SNAP® 4Dx® Plus, IDEXX Laboratory, Westbrook, Maine, USA) for the detection of antibodies against Anaplasma spp., Borrelia burgdorferi sensu lato, Ehrlichia spp. and antigens of Dirofilaria immitis. Skin samples (n = 71) were microscopically examined and molecularly assessed through a PCR targeting the 12 S rRNA gene. RESULTS: Microfilariae and antigen of D. immitis were detected simultaneously in 15 (6.1%; 95% CI = 3.7-9.8) animals. Nine animals (3.6%; 95% CI = 1.9-6.8) were D. immitis antigen positive but microfilariae negative and nine other animals (3.6%; 95% CI = 1.9-6.8) were microfilariae positive but D. immitis antigen negative. D. immitis positive dogs were found in four different municipalities. No filarioids were detected in the skin after microscopical and molecular analyses. CONCLUSION: Data from this study demonstrate that D. immitis is the main filarial nematode infecting dogs in coastal areas in northeastern Brazil. Based on the potential risk of infection in which animals are submitted, it is essential to perform tests to detect microfilariae and D. immitis antigen. Preventive measures must be adopted by using microfilaricidal compounds and anti-feeding insecticides to prevent canine infection.
Assuntos
Doenças do Cão , Filariose , Animais , Cães , Brasil/epidemiologia , Doenças do Cão/parasitologia , Doenças do Cão/epidemiologia , Filariose/veterinária , Filariose/epidemiologia , Filariose/parasitologia , Prevalência , Filarioidea/isolamento & purificação , Filarioidea/genética , Microfilárias/isolamento & purificação , Masculino , Feminino , Dirofilaria immitis/isolamento & purificação , Dirofilaria immitis/genética , Dirofilaria immitis/imunologia , Dirofilariose/epidemiologia , Dirofilariose/parasitologia , Pele/parasitologia , Ensaio de Imunoadsorção Enzimática/veterináriaRESUMO
Background: Thyroglossal duct cyst (TGDC) is the most common congenital neck mass among the pediatric population. Less than 10% of the cases occur in adults. The standard of care for TGDC is surgical treatment with the Sistrunk procedure via a traditional transverse cervicotomy. This technique involves the resection of the cyst with its tract and the central portion of the hyoid bone body to avoid recurrence. The transoral vestibular approach has gained popularity as an alternative approach to open neck surgery in order to eliminate the transcervical scar associated with these procedures. Methods: We describe a case of an endoscopic Sistrunk procedure performed by the transoral vestibular approach. A scoping review of the transoral endoscopic vestibular approach Sistrunk procedure (TEVAS) was performed. The PubMed, Medline, Cochrane, Lilacs, Scielo, Mary Ann Libert and Scopus databases were systematically searched by using a Medical Subject Heading (MeSH)-optimized search strategy. The selection of papers followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines after setting inclusion and exclusion criteria. Results: The case was successful and without complications. Five studies were included in the final analysis for this review. Conclusions: This novel approach to the Sistrunk procedure is an effective alternative way to treat TGDC in selected patients who are motivated to avoid a visible neck scar.
RESUMO
BACKGROUND: Pulmonary rehabilitation (PR) is recommended in people with post-acute COVID-19 syndrome (PACS), although there is a lack of studies evaluating its benefits via the most commonly used primary endpoint: the six-minute walk test (6MWT). This study evaluated the effects of PR on the dynamics of ventilation measured during the 6MWT in patients with PACS and, secondarily, evaluated the association of these findings with measures of lung function and structure. METHODS: This was an observational cross-sectional study of patients with PACS, in which 33 had undergone PR (PR-PACS group) and 32 had not undergone PR (NPR-PACS group). These patients underwent Spiropalm®-equipped 6MWT with measurement of inspiratory capacity (IC) to evaluate dynamic hyperinflation (DH). In addition, they performed spirometry, impulse oscillometry (IOS) and lung ultrasound (LUS). RESULTS: Spirometry was abnormal in 21.2% and 31.3% of participants in the PR-PACS and NPR-PACS groups, respectively (p = 0.36). IOS was abnormal in 28.6% and 66.7% of participants in the PR-PACS and NPR-PACS groups, respectively (p = 0.003). LUS was altered in 39.4% and 43.8% of the participants in the PR-PACS and NPR-PACS groups, respectively (p = 0.72). The 6-min walk distance (6MWD) was greater in the PR-PACS group than in the NPR-PACS group (p = 0.001]. HD was observed in 6.1% and 37.5% of participants in the PR-PACS and NPR-PACS groups, respectively, with a significant difference in ΔIC (p<0.001). The 6MWD correlated significantly with several IOS parameters and with ΔIC. CONCLUSIONS: Patients with PACS undergoing PR perform better in the 6MWT, with a higher 6MWD and less HD. In these patients, IOS is able to distinguish the effects of PR that are not differentiated by spirometry or LUS. Furthermore, the better the respiratory mechanics assessed by IOS and the less DH there was, the higher the performance in the 6MWT.
Assuntos
COVID-19 , Doença Pulmonar Obstrutiva Crônica , Humanos , Estudos Transversais , Esforço Físico , Síndrome de COVID-19 Pós-Aguda , COVID-19/complicações , Pulmão/diagnóstico por imagem , EspirometriaRESUMO
This study aimed to evaluate the effect of the preemptive administration of amantadine on postoperative analgesia in cats undergoing ovariohysterectomy and its influence on the physiological parameters. Twenty healthy domestic cats scheduled to undergo ovariohysterectomy at the Santa Cruz State University, Ilhéus, were divided into two groups: the control group (Group C; n = 10) and the amantadine group (Group A; n = 10). The cats in Group C received placebo capsules 30 min prior to the standard anesthetic protocol, whereas those in Group A received 5 mg/kg of amantadine orally 30 min prior to the standard anesthetic protocol. Postoperative pain was assessed using the visual analog scale and the UNESP-Botucatu multidimensional scale for the evaluation of postoperative pain in cats. The administration of amantadine had no effect on the physiological parameters evaluated. The pain scores in Group A were lower than those in Group C, indicating that the frequency of rescue analgesic administration cats in Group A was lower. That way, preemptive oral administration of amantadine at a dose of 5 mg/kg was effective at controlling postoperative pain in cats undergoing ovariohysterectomy. Moreover, no adverse effects or alterations in the physiological patterns were observed in the treated animals.
RESUMO
OBJECTIVES: Stroke is a devastating clinical outcome that significantly contributes to the morbidity and mortality of sickle cell anemia (SCA) patients. Despite its advantages in predicting stroke risk, transcranial Doppler screening has limitations that restrict its applicability, highlighting the need for emerging prognostic tools. Thrombospondin-1 plays a crucial role in endothelial injury, platelet adhesion, and nitric oxide metabolism and may be implicated in stroke pathophysiology. Here, we aimed to evaluate the association of THBS1 genetic variations with the occurrence of stroke in SCA patients MATERIALS AND METHODS: By real-time PCR, 512 SCA patients were fully genotyped for THBS1 A-296G (rs1478605) polymorphism RESULTS: THBS1 GG genotype was associated with a lower risk for stroke occurrence [odds ratio (OR): 0.30; 95% confidence interval (CI): 0.11-0.78; P = 0.011], although these findings were not consistent with multivariate logistic regression analysis (OR: 0.73, 95% CI: 0.12 - 4.37; P = 0.736). In agreement, the cumulative incidence of stroke for patients with AG/AA genotypes was higher when compared to the GG genotype (P = 0.018). However, the association was not maintained in the multivariate proportional hazards model (hazard ratio: 0.67, 95% CI: 0.12-3.61; P = 0.643) CONCLUSIONS: In summary, the present study shows that the THBS1 A-296G (rs1478605) polymorphism may be a potential modifier for stroke in SCA.
Assuntos
Anemia Falciforme , Acidente Vascular Cerebral , Humanos , Anemia Falciforme/complicações , Anemia Falciforme/diagnóstico , Anemia Falciforme/epidemiologia , Brasil/epidemiologia , Genótipo , Polimorfismo Genético , Acidente Vascular Cerebral/diagnóstico , Acidente Vascular Cerebral/epidemiologia , Acidente Vascular Cerebral/genéticaRESUMO
Background: Prothrombin complex concentrate (PCC) and fresh frozen plasma (FFP) are commonly used to manage bleeding in patients during cardiac surgery. However, the relative efficacy and safety of these 2 strategies remain uncertain. Methods: MEDLINE, Embase, and Cochrane were searched for studies comparing PCC and FFP in patients who underwent cardiac surgery complicated by bleeding. Review Manager (RevMan) ver. 5.4 (Nordic Cochrane Centre, The Cochrane Collaboration) was used for statistical analysis. Binary and continuous outcomes were compared using pooled risk ratios and mean differences, respectively. The meta-analysis protocol was registered in the International Prospective Register of Systematic Reviews under protocol number CRD42022379144. Results: We included 8 studies with 1,500 patients, of whom 613 (40.9%) received PCC. The mean follow-up period ranged from 28 to 90 days. The PCC group had significantly lower chest tube drainage at 24 hours (mean difference [MD], -148.50 mL; 95% CI, -253.02 to -43.99 mL; p=0.005; I2=42%). Fewer units of red blood cells (RBCs) were transfused within the first 24 hours (MD, -1.02 units; 95% CI, -1.81 to -0.24 units; p=0.01; I2=56%), and fewer patients required RBC transfusion within the first 24 hours (risk ratio, 0.85; 95% CI, 0.78-0.93; p<0.007; I2=45%) in the PCC group. There were no statistically significant differences in secondary outcomes. Nonetheless, a subgroup analysis of randomized controlled trials failed to corroborate the results obtained from the main analysis. Conclusion: Our findings suggest that PCC can be effective, without increased adverse events, when compared with FFP in patients undergoing cardiac surgery complicated by bleeding.
RESUMO
RESUMO O projeto 'Saúde Única no Pantanal: participação da sociedade na vigilância de emergência de zoonoses como efeito pós-incêndios no território e formação de estratégias integradas' objetivou integrar representações institucionais e da sociedade local; ampliar o uso do Sistema de Informação em Saúde Silvestre (SISS-Geo) para o monitoramento da fauna; identificar áreas prioritárias para vigilância de zoonoses e construir caminhos envolvendo a Saúde Única (SU). Realizou webinário, apontando a necessidade de eventos mais amplos com a participação de lideranças em cada um dos territórios escolhidos. Foram executados seminários e oficinas nos estados de Mato Grosso do Sul (MS), com a participação de gestores do serviço de saúde da Província de Santa Cruz, Bolívia, e de Mato Grosso. A representatividade dos diferentes segmentos nos eventos possibilitou a articulação de cidadãos e gestores locais. Nas comunidades tradicionais, foi possível abordar os impactos dos incêndios e dar oportunidade para que essas pessoas manifestassem suas prioridades e demandas de saúde, antes e depois dos incêndios. A Oficina Síntese realizada em Corumbá, MS possibilitou a devolutiva dos resultados e a integração com representantes de diferentes instituições do Brasil e da Bolívia, além da prospecção e priorização de enfermidades a serem incorporadas em modelo de SU para o Pantanal e fronteira oeste do Brasil.
ABSTRACT The project 'One Health in the Pantanal: society's participation in the emergency surveillance of zoonoses emergency as a post-fire effect in the territory and the formation of integrated strategies' aimed to integrate institutional representations and local society; expand the use of Wildlife Health Information System (SISS-Geo) for fauna monitoring; identify priority areas for zoonosis surveillance and build paths involving One Health (OH). A webinar was held, highlighting the need for broader events with the participation of leaders in each of the chosen territories. Seminars and workshops were held in the states of Mato Grosso do Sul (MS), with the participation of health service managers from the Province of Santa Cruz, Bolivia, and Mato Grosso. The representation of different segments at the events enabled the articulation of citizens and local managers. In traditional communities, it was possible to address the impacts of the fires and provide the opportunity for these people to express their health priorities and demands, before and after the fires. The Synthesis Workshop held in Corumbá, MS allowed the feedback of results and integration with representatives from different institutions in Brazil and Bolivia, and prospecting and prioritization of illnesses to be incorporated into the OH model for the Pantanal and western border of Brazil.
RESUMO
Abstract Socioemotional skills are essential for students' development at school. However, school support has barely generated debates. We aimed to analyze the evidence of the internal structure and convergent-discriminant validity of the scores of the forced-choice version of the Inventory of Supporting for Socio-Emotional Skills (ISSE). In total, 443 middle and high school students (54% of whom were girls) participated in this study. Results indicated that the revised instrument was consistent with its two-dimension theoretical model (support and demand); the forced-choice version showed an appropriate internal structure and no bias by acquiescence. Moreover, based on a multitrait-multimethod matrix, the scores of the Likert forced-choice version showed convergent and discriminant validity. This study contributes to the literature by proposing a multidimensional heteroevalutive instrument to assess support for socioemotional development in the forced-choice format, which reduces response bias.
Resumo As habilidades socioemocionais são essenciais para o desenvolvimento dos estudantes na escola; no entanto, há pouca discussão sobre o apoio das escolas. Nosso objetivo foi analisar as evidências de estrutura interna e validade convergente-discriminante da versão de escolha forçada do Inventário de Apoio para Habilidades Socioemocionais. No total, participaram 443 estudantes do ensino fundamental e médio (54% do sexo feminino). Os resultados indicaram que o instrumento revisado estava consistente com o modelo teórico de duas dimensões (apoio e demanda); a versão de escolha forçada demonstrou estrutura interna apropriada e não foi enviesada por aquiescência; além disso, com base em uma matriz mutitraço-multimétodo, as pontuações da versão de escolha forçada mostraram validade convergente e discriminante com a versão Likert. Este estudo contribui para a literatura propondo um instrumento heteroavaliativo multidimensional para avaliar o apoio ao desenvolvimento socioemocional no formato de escolha forçada, o que reduz o viés de resposta.
Resumen Las habilidades socioemocionales son esenciales para el desarrollo de los estudiantes en la escuela; sin embargo, hay poca investigación sobre el apoyo ofrecido por la escuela. Se pretende analizar las evidencias de estructura interna y validez convergente-discriminante de la versión de elección forzada del Inventario de Apoyo para Habilidades Socioemocionales. Un total de 443 estudiantes de la primaria y la secundaria (54% eran niñas) participaron en el estudio. Los resultados indicaron que la herramienta es adecuada al modelo de dos dimensiones (apoyo y demanda); la versión de elección forzada demostró una estructura interna adecuada y libre de aquiescencia; y, además, con base en una matriz multirasgo-multimétodo, los puntajes de la versión de elección forzada mostraron validez convergente con la versión Likert. Este estudio contribuye a la literatura con una herramienta heteroevaluativa multidimensional para examinar el apoyo al desarrollo socioemocional en el formato de elección forzada, lo que reduce el sesgo de la encuesta.
RESUMO
Endophytic bacteria play a crucial role in plant development and adaptation, and the knowledge of how endophytic bacteria assemblage is influenced by cultivation site and plant genotype is an important step to achieve microbiome manipulation. This work aimed to study the roots and stems of endophytic bacteriome of four maize genotypes cultivated in two regions of the semi-arid region of Pernambuco - Brazil. Our hypothesis is that the endophytic community assemblage will be influenced by plant genotypes and cultivation region. Metabarcoding sequencing data revealed significant differences in alfa diversity in function of both factors, genotypes, and maize organs. Beta diversity analysis showed that the bacterial communities differ mainly in function of the plant organ. The most abundant genera found in the samples were Leifsonia, Bacillus, Klebsiella, Streptomyces, and Bradyrhizobium. To understand ecological interactions within each compartment, we constructed co-occurrence network for each organ. This analysis revealed important differences in network structure and complexity and suggested that Leifsonia (the main genera found) had distinct ecological roles depending on the plant organ. Our data showed that root endophytic maize bacteria would be influenced by cultivation site, but not by genotype. We believe that, collectively, our data not only characterize the bacteriome associated with this plant and how different factors shape it, but also increase the knowledge to select potential bacteria for bioinoculant production.
Assuntos
Actinomycetales , Zea mays , Zea mays/microbiologia , Brasil , Endófitos/genética , Bactérias/genética , Genótipo , Raízes de Plantas/microbiologiaRESUMO
Objetivo: compreender as perspectivas de enfermeiros hospitalares sobre a sua atuação no gerenciamento de crise face à pandemia COVID-19. Método: estudo qualitativo, descritivo, exploratório, realizado entre dezembro de 2021 a março de 2022 em hospital público. Participaram 22 enfermeiros, por meio de entrevista audiogravada guiada com seis perguntas abertas. Foi aplicado análise de conteúdo de Creswell auxiliado pelo software Iramuteq®. Resultados: das análises, emergiram quatro classes: Atuação dos enfermeiros refletida nos indicadores assistenciais e gerenciais; Dificuldades enfrentadas pelos enfermeiros para atuar durante a pandemia; Experiências anteriores dos enfermeiros como norte para a atuação na pandemia; Atuação dos enfermeiros em estratégias para o gerenciamento da crise COVID-19. Conclusão: a atuação do enfermeiro refletiu nos indicadores em detrimento às dificuldades no trabalho, principalmente, relacionados ao déficit de recursos humanos. Para gerenciar a crise, usaram de experiências anteriores tais como o H1N1 e estratégias indissociáveis à gestão/assistência para mitigar os impactos e atender a demanda(AU)
Objective: to understand the perspectives of hospital nurses on their role in crisis management in the face of the COVID-19 pandemic. Method: qualitative, descriptive, exploratory study carried out between December 2021 and March 2022 in a public hospital. 22 nurses participated in a guided audio-recorded interview with six open questions. Creswell content analysis aided by Iramuteq® software was applied. Results: from data analysis, four classes emerged: Nurses' performance reflected in care and management indicators; Difficulties faced by nurses to act during the pandemic; Previous experiences of nurses as a guide for acting in the pandemic; Nurses' performance in strategies for managing the COVID-19 crisis. Conclusion: The performance of the nurse was reflected in the indicators to the detriment of the difficulties at work, mainly related to the deficit of human resources. To manage the crisis, they used previous experiences such as H1N1 and strategies inseparable from management/assistance to mitigate impacts and meet demand(AU)
Objetivo: comprender las perspectivas de los enfermeros hospitalarios sobre su papel en la gestión de crisis frente a la pandemia de COVID-19. Método: estudio cualitativo, descriptivo, exploratorio, realizado entre diciembre de 2021 y marzo de 2022 en un hospital público. 22 enfermeros han participado de una entrevista guiada grabada en audio conteniendo seis preguntas abiertas. Se aplicó el análisis de contenido Creswell con ayuda del software Iramuteq®. Resultados: de los análisis, surgieron cuatro clases: actuación de los enfermeros reflejada en indicadores de atención y gestión; dificultades que enfrentan los enfermeros que trabajan durante la pandemia; experiencias previas de enfermeros como guía para trabajar en la pandemia; actuación de los enfermeros en las estrategias de gestión de la crisis de la COVID-19. Conclusión: la actuación del enfermero se reflejó en los indicadores en detrimento de las dificultades en el trabajo, principalmente relacionadas con el déficit de recursos humanos. Para gestionar la crisis, utilizaron experiencias previas como durante la incidencia de H1N1 y estrategias inseparables de la gestión/asistencia para mitigar impactos y atender la demanda(AU)
Assuntos
Humanos , Masculino , Feminino , Pandemias , COVID-19/enfermagem , COVID-19/epidemiologia , Enfermeiras e Enfermeiros/organização & administração , Brasil/epidemiologia , Papel do Profissional de Enfermagem , Pesquisa Qualitativa , Hospitais Públicos/organização & administraçãoRESUMO
BACKGROUND: Autism Spectrum Disorder (ASD) diagnosis can be aided by approaches based on eye-tracking signals. Recently, the feasibility of building Visual Attention Models (VAMs) from features extracted from visual stimuli and their use for classifying cases and controls has been demonstrated using Neural Networks and Support Vector Machines. The present work has three aims: 1) to evaluate whether the trained classifier from the previous study was generalist enough to classify new samples with a new stimulus; 2) to replicate the previously approach to train a new classifier with a new dataset; 3) to evaluate the performance of classifiers obtained by a new classification algorithm (Random Forest) using the previous and the current datasets. METHODS: The previously approach was replicated with a new stimulus and new sample, 44 from the Typical Development group and 33 from the ASD group. After the replication, Random Forest classifier was tested to substitute Neural Networks algorithm. RESULTS: The test with the trained classifier reached an AUC of 0.56, suggesting that the trained classifier requires retraining of the VAMs when changing the stimulus. The replication results reached an AUC of 0.71, indicating the potential of generalization of the approach for aiding ASD diagnosis, as long as the stimulus is similar to the originally proposed. The results achieved with Random Forest were superior to those achieved with the original approach, with an average AUC of 0.95 for the previous dataset and 0.74 for the new dataset. CONCLUSION: In summary, the results of the replication experiment were satisfactory, which suggests the robustness of the approach and the VAM-based approaches feasibility to aid in ASD diagnosis. The proposed method change improved the classification performance. Some limitations are discussed and additional studies are encouraged to test other conditions and scenarios.
Assuntos
Transtorno do Espectro Autista , Transtorno Autístico , Humanos , Transtorno do Espectro Autista/diagnóstico , Tecnologia de Rastreamento Ocular , Diagnóstico por Computador , ComputadoresRESUMO
The magnitude of recent climatic changes has no historical precedent and impacts biodiversity. Climatic changes may displace suitable habitats (areas with suitable climates), leading to global biodiversity decline. Primates are among the most affected groups. Most primates depend on forests and contribute to their maintenance. We evaluated the potential effects of climatic change on the distribution of Sapajus xanthosternos, a critically endangered primate whose geographical range encompasses three Brazilian biomes. We evaluated changes between baseline (1970-2000) and future (2081-2100) climates using multivariate analysis. Then, we compared current and future (2100) climatic suitability projections for the species. The climatic changes predicted throughout the S. xanthosternos range differed mostly longitudinally, with higher temperature increases in the west and higher precipitation reductions in the east. Climatic suitability for S. xanthosternos is predicted to decline in the future. Areas with highest current climatic suitability occur as a narrow strip in the eastern part of the geographic range throughout the latitudinal range. In the future, areas with highest values are projected to be located as an even narrower strip in the eastern part of the geographical range. A small portion of forest remnants larger than 150 ha located in the east has larger current and future suitability values. At this large scale, the spatial heterogeneity of the climate effects reinforce the importance of maintenance of current populations in different areas of the range. The possibility that phenotypic plasticity helps primates cope with reduced climatic suitability may be mediated by habitat availability, quality, and connectivity.