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Children with Cerebral palsy (CP) present movement and posture disorders. The Gross Motor Function Classification System (GMFCS), Manual Ability Classification System (MACS), Communication Function Classification System (CFCS), Eating and Drinking Ability Classification System (EDACS), and Visual Function Classification System (VFCS) enhance the understanding of their performance. We verified inter-rater reliability and associations between the classification levels. Physical therapists classified 100 Brazilian children with CP (3-17 years) according to GMFCS, MACS, CFCS, EDACS, and VFCS. To evaluate inter-rater reliability (Intraclass Correlation Coefficient-ICC) two independent examiners concurrently assessed a subset of 60 participants. According to Spearman's correlation coefficients, there were associations between GMFCS/MACS (r = 0.81), GMFCS/CFCS (r = 0.70), MACS/CFCS (r = 0.73), GMFCS/VFCS (r = 0.61), MACS/VFCS (r = 0.61), CFCS/EDACS (r = 0.58), CFCS/VFCS (r = 0.50), and EDACS/VFCS (r = 0.45) (p < .05). The inter-rater reliability ranged from excellent (ICC = 0.93-0.99) to good (ICC = 0.89), p < .05. The classification systems are reliable, and the levels associated with each other in Brazilian children, especially the GMFCS, MACS, and CFCS.
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Paralisia Cerebral , Humanos , Paralisia Cerebral/classificação , Paralisia Cerebral/fisiopatologia , Criança , Feminino , Brasil , Masculino , Reprodutibilidade dos Testes , Adolescente , Pré-Escolar , Avaliação da Deficiência , Índice de Gravidade de DoençaRESUMO
OBJECTIVE: To identify perinatal factors in children born extremely preterm (EP) that were associated with motor impairment (MI) at 2 and 10 years of age and develop a predictive algorithm to estimate the risk of MI during childhood. STUDY DESIGN: Participants of the Extremely Low Gestational Age Newborns Study (ELGANS) were classified as: no MI, MI only at 2 years, MI only at 10 years, and MI at both 2 and 10 years, based on a standardized neurological examination at 2 and the Gross Motor Function Classification System (GMFCS) at 10 years of age. Least Absolute Shrinkage and Selection Operator (LASSO) regression was used to develop the final predictive model. RESULTS: Of the 849 study participants, 64 (7.5%) had a diagnosis of MI at both 2 and 10 years and 63 (7.4%) had a diagnosis of MI at 1 visit but not the other. Of 22 total risk factors queried, 4 variables most reliably and accurately predicted MI: gestational age, weight z-score growth trajectory during neonatal intensive care unit (NICU) stay, ventriculomegaly, and cerebral echolucency on head ultrasound. By selecting probability thresholds of 3.5% and 7.0% at ages 2 and 10, respectively, likelihood of developing MI can be predicted with a sensitivity and specificity of 71.2%/72.1% at age 2 and 70.7%/70.7% at age 10. CONCLUSION: In our cohort, the diagnosis of MI at 2 years did not always predict a diagnosis of MI at 10 years. Specific risk factors are predictive of MI and can estimate an individual infant's risk at NICU discharge of MI at age 10 years.
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Paralisia Cerebral , Lactente Extremamente Prematuro , Humanos , Paralisia Cerebral/diagnóstico , Paralisia Cerebral/epidemiologia , Feminino , Masculino , Recém-Nascido , Pré-Escolar , Criança , Idade Gestacional , Fatores de RiscoRESUMO
INTRODUCTION: Using standardized scales to assess motor development via telemedicine can increase access for low-income populations. Our aim was to verify the agreement and feasibility between remotely and synchronously applying the Alberta Infant Motor Scale (AIMS) and the in-person format. METHODS: This was a concordance study, with 77 typical infants aged 4-18 months (mean = 13 months). The AIMS was applied remote via video calls and face-to-face. We applied a questionnaire to caregivers to verify feasibility. RESULTS: There was a high level of agreement between the remote and in-person assessments, with intraclass correlation coefficients above 0.98 and low standard error measure values (<1 item for each posture, <2 items for the total raw score, and =5% for the normative score). The smallest detectable change was between 1.67 and 2.45 for each posture, 3 for the total raw score, and 6% for the normative score. The Bland-Altman analysis showed low bias with the mean difference close to zero (<0.80) and low error with little dispersion of the difference points around the mean. Caregivers' perspectives on the synchronous remote assessment were positive, with good quality, clear information during the assessment, and comfort with the method. DISCUSSION: The synchronous remote application of the AIMS may be an alternative for families without access to in-person services that assess motor development.
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Introducción. La parálisis cerebral (PC) es una de las principales causas de discapacidad en la población infantil, afectando diversas áreas del desarrollo como la función motora gruesa; equilibrio y marcha. Hay evidencia de los beneficios de la terapia acuática y de cómo puede complementar la rehabilitación. Objetivo. Describir la efectividad de las intervenciones acuáticas en personas con PC, determinar mejoras en la función motora gruesa uso de métodos, protocolos y dosificación. Métodos. Se analizaron 9 estudios aleatorizados controlados desde el 2012 a la fecha, seleccionados por un experto y cuyos sujetos tenían PC espástica, Gross Motor Function Classification System (GMFCS) I a IV, entre los 2 y 20 años. Post intervención acuática se reportan mejoras significativas en el promedio de los ítems medidos por Gross motor function measure (GMFM). De los métodos que contribuyeron a mejoras se encuentra Halliwick y ejercicios acuáticos sin un programa específico. Resultados. Se obtuvieron mejoras de 35 a 100 minutos, y de 12 a 30 sesiones en total. No se logra concluir el tipo de terapia más efectiva, ya que las medidas de resultado y las características de los sujetos eran diversas. Conclusión. Una dosificación mínima de 2 veces por semana, 35 minutos de intervención en un total de 16 sesiones (9,3 horas en total) pareciera mejorar la función motora gruesa, cuyos resultados son transferibles a las actividades en tierra inmediatamente, sin embargo, no se obtiene información si se mantienen a mediano o largo plazo.
Background. Cerebral palsy (CP) is one of the main causes of disability in the child population, affecting various areas of development such as gross motor function; balance and gait. There is evidence of the benefits of aquatic therapy and how it can complement rehabilitation. Objective. to describe the effectiveness of aquatic interventions in people with CP, to determine improvements in gross motor function using methods, protocols, and dosage. Methods. Nine randomized controlled studies were analyzed from 2012 to date, selected by an expert and whose subjects had spastic CP, Gross Motor Function Classification System (GMFCS) I to IV, between 2 and 20 years of age. Results. After the aquatic intervention, significant improvements were reported in the average of the Gross motor function measure (GMFM) items measured. Of the methods that contributed to improvements, there is Halliwick and aquatic exercises without a specific program. Results. Improvements were obtained from 35 to 100 minutes, and from 12 to 30 sessions in total. It is not possible to conclude the most effective type of therapy, since the outcome measures and the characteristics of the subjects were diverse. Conclusion. A minimum dosage of 2 times per week, 35 minutes of intervention in a total of 16 sessions (9.3 hours in total) seems to improve gross motor function, the results of which are immediately transferable to activities on land, however, it is not obtains information if they are maintained in the medium or long term.
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Evidence suggests that early physical activity interventions are a means of preventing childhood obesity and are more effective when delivered in a school setting and based on the ecological model. Therefore, the present study aims to determine the effect of a multicomponent intervention based on the ecological model on adiposity, physical fitness and motor competence in children aged 4 to 5 years. METHODS: This study is a non-randomized controlled trial involving 173 children from Chile. The intervention was based on an ecological model and consisted of a physical activity program with three simultaneous parts, affecting intra- and interpersonal dimensions. The adiposity index, body mass index and waist circumference were measured. For physical fitness, muscle strength in the lower part, speed/agility and cardiorespiratory fitness were measured. Motor competence was assessed using catching, aiming and dynamic and static balance tests. RESULTS: After the intervention, there was no reduction in adiposity indices; in the intervention group, body mass index increased significantly with a high effect size. The intervention group showed significant differences in physical fitness in the components of muscle strength in the lower part (p = 0.000) and speed/agility (p = 0.002). For motor competence, the intervention group showed significant improvements in most components. CONCLUSIONS: The multicomponent intervention did not reduce adiposity indices; however, it caused significant improvements in the physical fitness and motor competence components, so it seems prudent to continue implementing it, given the benefits that adequate levels of motor competence and physical fitness bring to children's health, both in the short and long term.
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Abstract Objective We aimed to assess the significance of rENE and creat a predictive tool (nomogram) for estimating Overall Survival (OS) in locoregionally advanced Nasopharyngeal Carcinoma (NPC) patients with Lymph Node Metastasis (LNM) based on their clinical characteristics and Radiologic Extranodal Extension (rENE). Methods Five hundred and sixty-nine NPC patients with LNM were randomly divided into training and validation groups. Significant factors were identified using univariate and multivariate analyses in the training cohort. Then, the nomogram based on the screening results was established to predict the Overall Survival (OS). Calibration curves and the Concordance index (C-index) gauged predictive accuracy and discrimination. Receiver Operating Characteristic (ROC) analysis assessed risk stratification, and clinical utility was measured using Decision Curve Analysis (DCA). The nomogram's performance was validated for discrimination and calibration in an independent validation cohort. Results A total of 360 (63.2%) patients were present with radiologic extranodal extension at initial diagnosis. Patients with rENE had significantly lower OS than other patients. Multivariate analysis identified the five factors, including rENE, for the nomogram model. The C-index was 0.75 (0.71-0.78) in the training cohort and 0.76 (0.69-0.83) in the validation cohort. Notably, the nomogram outperformed the 8th TNM staging system, as evident from the higher AUC values (0.77 vs. 0.60 for 2 year and 0.75 vs. 0.65 for 3 year) and well-calibrated calibration curves. Decision curve analysis indicated improved Net Benefit (NB) with the nomogram for predicting OS. The log-rank test confirmed significant survival distinctions between risk groups in both training and validation cohorts. Conclusions We demonstrated the prognostic value of rENE in nasopharyngeal carcinoma and developed a nomogram based on rENE and other factors to provide individual prediction of OS for locoregionally advanced nasopharyngeal carcinoma with lymph node metastasis. Level of evidence: III.
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OBJECTIVE: We aimed to assess the significance of rENE and creat a predictive tool (nomogram) for estimating Overall Survival (OS) in locoregionally advanced Nasopharyngeal Carcinoma (NPC) patients with Lymph Node Metastasis (LNM) based on their clinical characteristics and Radiologic Extranodal Extension (rENE). METHODS: Five hundred and sixty-nine NPC patients with LNM were randomly divided into training and validation groups. Significant factors were identified using univariate and multivariate analyses in the training cohort. Then, the nomogram based on the screening results was established to predict the Overall Survival (OS). Calibration curves and the Concordance index (C-index) gauged predictive accuracy and discrimination. Receiver Operating Characteristic (ROC) analysis assessed risk stratification, and clinical utility was measured using Decision Curve Analysis (DCA). The nomogram's performance was validated for discrimination and calibration in an independent validation cohort. RESULTS: A total of 360 (63.2%) patients were present with radiologic extranodal extension at initial diagnosis. Patients with rENE had significantly lower OS than other patients. Multivariate analysis identified the five factors, including rENE, for the nomogram model. The C-index was 0.75 (0.71-0.78) in the training cohort and 0.76 (0.69-0.83) in the validation cohort. Notably, the nomogram outperformed the 8th TNM staging system, as evident from the higher AUC values (0.77 vs. 0.60 for 2year and 0.75 vs. 0.65 for 3year) and well-calibrated calibration curves. Decision curve analysis indicated improved Net Benefit (NB) with the nomogram for predicting OS. The log-rank test confirmed significant survival distinctions between risk groups in both training and validation cohorts. CONCLUSIONS: We demonstrated the prognostic value of rENE in nasopharyngeal carcinoma and developed a nomogram based on rENE and other factors to provide individual prediction of OS for locoregionally advanced nasopharyngeal carcinoma with lymph node metastasis. LEVEL OF EVIDENCE: III.
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Neoplasias Nasofaríngeas , Nomogramas , Humanos , Extensão Extranodal , Metástase Linfática , Carcinoma Nasofaríngeo/patologia , Neoplasias Nasofaríngeas/diagnóstico por imagem , Neoplasias Nasofaríngeas/patologia , PrognósticoRESUMO
The importance of food (in)security has been one of the United Nations Sustainable Development's main goals. Over 828 million people worldwide cannot acquire enough food to meet the minimum daily dietary energy requirements (undernourished). Therefore, the present study examines the factors that affect the number of undernourished people in Colombia by assessing macroeconomic data for the period 2000-2021 including gross domestic product (GDP) per capita, unemployment, and inflation rates. A quantitative, empirical, correlation design was used to examine and describe the relationship among the variables. The findings showed that the proposed variables presented the correct signs, were statistically significant, and were in line with the economic theory Thus, the study concluded that although income shocks brought on by inflation and unemployment undoubtedly impact household food (in)security, other factors must also be considered for policy and practice to effectively reduce food insecurity for households.
La importancia de la (in)seguridad alimentaria ha sido uno de los principales objetivos del Desarrollo Sostenible de las Naciones Unidas y más de 820 millones de personas en el mundo no pueden adquirir suficientes alimentos para satisfacer los requerimientos mínimos diarios de energía dietética (subalimentadas). Por lo tanto, el presente estudio examina los factores que afectan el número de personas subalimentadas en Colombia mediante la evaluación de datos macroeconómicos para el período 2000-2021, incluido el producto interno bruto (PIB) per cápita, el desempleo y las tasas de inflación. Se utilizó un diseño cuantitativo, empírico y correlacional, para examinar y describir la relación entre las variables. Los hallazgos mostraron que las variables propuestas presentaron los signos correctos, fueron estadísticamente significativas y de acuerdo con el propuesto por la teoría económica. Por lo tanto, el estudio concluyó que, si bien los impactos en los ingresos causados por la inflación y el desempleo indudablemente afectan la inseguridad alimentaria de los hogares, también es importante considerar otros factores en los esfuerzos de políticas y prácticas para mitigar la inseguridad alimentaria de los hogares.
A importância da (in)segurança alimentar tem sido um dos principais objetivos do Desenvolvimento Sustentável das Nações Unidas e mais de 820 milhões de pessoas no mundo não podem adquirir alimentos suficientes para atender às necessidades energéticas diárias mínimas (subalimentadas). Por tanto o presente estudo examina os fatores que afetam o número de pessoas subalimentadas na Colômbia, avaliando dados macroeconômicos para o período 2000-2021, incluindo produto interno bruto (PIB) per capita, desemprego e taxas de inflação. Um desenho quantitativo, empírico e de correlação foi usado para examinar e descrever a relação entre as variáveis. Os achados mostraram que as variáveis propostas apresentaram os sinais corretos, foram estatisticamente significativas e em consonância com a teoria econômica. Assim, o estudo concluiu que, embora os choques de renda causados pela inflação e pelo desemprego indubitavelmente afetem a insegurança alimentar das famílias, outros fatores também são importantes a serem considerados nos esforços de políticas e práticas para mitigar a insegurança alimentar das famílias.
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SUMMARY: A corpse is the body's final destination and, as a social construction, it challenges Western cultural taboos and practices around the corpse, having been shown in cinema. The present paper aims to analyze 17 films that portray Human Anatomy, identifying which themes specifically related to morphological sciences are addressed, namely: a) reactions to first contact with a cadaver, b) medical school and dissection classes, c) origin of cadavers, d) anatomy and suspense or horror movies, e) romance, drama and comedy, f) body snatchers/ resurrectionists, g) anatomical techniques, h) racism, prejudice and anatomy. This is a critical review of films in which, after thorough triple- blind analysis by the authors, it was observed that the encounter with the cadaver provides a series of emotions to the characters participating in the practical anatomy classes shown in the films, such as apprehension, fear, disgust, curiosity, etc. Generally, this surprising contact between the living and the dead is associated with the practice of dissection, which often results in the accentuation of emotions previously reported. From all this, it is concluded that the history of the teaching of Human Anatomy has been interestingly portrayed in cinema from different points of view.
Un cadáver es el destino final del cuerpo y, como construcción social, desafía los tabúes y prácticas culturales occidentales en torno al cadáver, habiendo sido mostrado en el cine. El presente trabajo tuvo como objetivo analizar 17 películas que retratan la Anatomía Humana, identificando qué temas específicamente relacionados con las ciencias morfológicas se abordan, a saber: a) reacciones al primer contacto con un cadáver, b) clases de medicina y disección, c) origen de los cadáveres, d) anatomía y películas de suspenso o terror, e) romance, drama y comedia, f) ladrones de cuerpos/resurreccionistas, g) técnicas anatómicas, h) racismo, prejuicio y anatomía. Se trata de una revisión crítica de películas en las que, tras un minucioso análisis triple ciego por parte de los autores, se observa que el encuentro con el cadáver proporciona una serie de emociones a los personajes que participan en las clases prácticas de anatomía que se muestran en las películas, tales como aprensión, miedo, repugnancia, curiosidad, etc. Generalmente, este sorprendente contacto entre vivos y muertos se asocia con la práctica de la disección, lo que muchas veces resulta en la acentuación de las emociones anteriormente relatadas. De todo ello se concluye que la historia de la enseñanza de la Anatomía Humana ha sido interesantemente retratada en el cine desde diferentes puntos de vista.
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Humanos , Cadáver , Anatomia/educação , Filmes Cinematográficos , Atitude Frente a MorteRESUMO
SUMMARY: The learning of human gross anatomy (HGA) is essential for health professionals, as it is key to achieve diagnoses and carry out clinical procedures safely and effectively. It is essential to recognize the main ideas of human anatomy, such as anatomical position and planimetry, and terms of reference and comparison, to understand the general characteristics of the structures, systems, and functions of the human body. However, the academic performance of students in the course of HGA is low, so this study aimed to determine the relationship between sociodemographic data and their academic performance. For this purpose, students of the academic program of Medicine and Surgery enrolled in a HGA course were surveyed on 17 sociodemographic factors. The grades obtained by the students in the three exams taken in the course were recorded and correlated with the answers obtained in the questionnaire. In order to know the students' characteristics and behaviors in each of the variables, descriptive statistics were performed for each of them, the t- student test was used to compare the means of each group. In the event of behavior far from the normal distribution, the non-parametric tests of Mann-Whitney U and Kolmogorov-Smirnov were used. It was found that factors like previous academic university experience, retaking the HGA course, students' health condition, working and studying at the same time and the students' mother's level of education influence in their academic performance.
El aprendizaje de la anatomía macroscópica humana (AMH) es fundamental para los profesionales de la salud, ya que es clave para lograr diagnósticos y realizar procedimientos clínicos de forma segura y eficaz. Es fundamental reconocer las ideas principales de la anatomía humana, como la posición anatómica y la planimetría, y los términos de referencia y comparación, para comprender las características generales de las estructuras, sistemas y funciones del cuerpo humano. Sin embargo, el rendimiento académico de los estudiantes del curso de AMH es bajo, por lo que este estudio tuvo como objetivo determinar la relación entre los datos sociodemográficos y su rendimiento académico. Para ello, se encuestó a estudiantes del programa académico de Medicina y Cirugía matriculados en un curso de AMH sobre 17 factores sociodemográficos. Se registraron las calificaciones obtenidas por los alumnos en los tres exámenes realizados en el curso y se correlacionaron con las respuestas obtenidas en el cuestionario. Para conocer las características y comportamientos de los estudiantes en cada una de las variables se realizó estadística descriptiva para cada una de ellas, se utilizó la prueba t-student para comparar las medias de cada grupo. En caso de comportamiento alejado de la distribución normal, se utilizaron las pruebas no paramétricas de Mann-Whitney U y Kolmogorov-Smirnov. Se encontró que factores como la experiencia académica universitaria previa, retomar el curso AMH, el estado de salud de los estudiantes, trabajar y estudiar al mismo tiempo y el nivel de educación de la madre de los estudiantes influyen en su rendimiento académico.
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Humanos , Masculino , Feminino , Adolescente , Adulto , Adulto Jovem , Estudantes de Medicina , Desempenho Acadêmico , Anatomia/educação , Universidades , Inquéritos e Questionários , Fatores SociodemográficosRESUMO
Measurements of ecosystem carbon (C) fluxes in temperate forests are concentrated in the Northern Hemisphere, leaving the functionally diverse temperate forests in the Southern Hemisphere underrepresented. Here, we report three years (February 2018-January 2021) of C fluxes, studied with eddy-covariance and closed chamber techniques, in an endangered temperate evergreen rainforest of the long-lived paleoendemic South American conifer Fitzroya cupressoides. Using classification and regression trees we analyzed the most relevant drivers and thresholds of daily net ecosystem exchange (NEE) and soil respiration. The annual NEE showed that the forest was a moderate C sink during the period analyzed (-287±38 g C m-2 year -1). We found that the capacity to capture C of the Fitzroya rainforests in the Coastal Range of southern Chile is optimal under cool and rainy conditions in the early austral spring (October-November) and decreases rapidly towards the summer dry season (January-February) and autumn. Although the studied forest type has a narrow geographical coverage, the gross primary productivity measured at the tower was highly representative of Fitzroya and other rainforests in the region. Our results suggest that C fluxes in paleoendemic cool F. cupressoides forests may be negatively affected by the warming and drying predicted by climate change models, reinforcing the importance of maintaining this and other long-term ecological research sites in the Southern Hemisphere.
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Louis Hubert Farabeuf (1841-1910) was a reformer of clinical, surgical, and topographic human anatomy studies during the second half of the 19th century. Over 30 years as a professor of Anatomy, Farabeuf wrote outstanding anatomical textbooks. As the head of Anatomic Studies in the Faculty of Medicine in Paris, he succeeded in leading a profound restructuring of the way anatomy and surgery were taught. As a result of his work and research, several anatomical terms, clinical signs, and surgical instruments were named after him. For his outstanding career in anatomy, he was elected to the Academy of Medicine in 1897.
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INTRODUCTION: This study aimed to identify factors affecting progression-free survival (PFS) in pediatric patients with giant supratentorial brain tumors (GSBTs) treated with surgical excision. The secondary aim was to analyze how these same factors affected the functional outcome in the long term. METHODS: We performed a retrospective, analytical, single-center cohort study. We included all pediatric patients with GSBT between January 2014 and June 2018. Patients were followed for a minimum of 24 months for the PFS and overall survival (OS) analysis. Functional status score (FSS) was used to assess the functional outcome. RESULTS: We included 27 patients with GSBT, the median age was six (range 2-12), and eleven patients had a grade IV tumor. The 24-month PFS and OS were 51.85% and 74.04%, respectively. A PFS-ending event or treatment failure occurred in 13 patients. We found that patients with postoperative FFS >16 have a worse PFS than patients with a postoperative FSS <15 (HR 4.51; p = 0.03). Patients with more than three surgeries had worse PFS than patients with one or two procedures (HR 11.39; p = 0.004). High-grade tumors were associated with worse PFS than low-grade tumors (HR 1.55; p = 0.04). Finally, patients with CNS infections had worse PFS than patients without that complication (HR 2.70; p = 0.04). CONCLUSIONS: GSBTs in pediatric patients are complex lesions that require multidisciplinary management. Surgical management and quality of life should be considered when choosing the best treatment. Factors influencing long-term PFS were high-grade histopathology, the need for three or more surgeries, postoperative FSS >16, and CNS infections.
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Neoplasias Encefálicas , Qualidade de Vida , Humanos , Criança , Intervalo Livre de Progressão , Estudos de Coortes , Estudos Retrospectivos , Neoplasias Encefálicas/patologia , Intervalo Livre de Doença , Resultado do TratamentoRESUMO
Developing gross motor function implies strengthening the basic body position and the balance associated with posture and mobility, for which different teaching models and psycho-pedagogical interventions are applied. OBJECTIVE: to develop gross motor function in male preschoolers through physical recreational activities based on conductivist (Group 1) and constructivist (Group 2) teaching and determine the best teaching paradigm. Two basic skills were studied in two homogeneous independent samples (walking: w = 0.641; running: w = 0.556), selecting 25 children for each group (3-4 years) through the use of intentional sampling. The gross skills evaluation was based on norms established by the Education Ministry, including a mood assessment. RESULTS: each group improved their basic skills in the post-test (Group 1: W = 0.001; W = 0.001. Group 2: W = 0.046; W = 0.038), but the conductivist paradigm was superior (w = 0.033; w = 0.027). Group 1 presented better indicators in the motor evaluations "Acquired" and "In Process" than Group 2, and lower percentages in the "Initiated" evaluation than Group 2 in the abilities "walking" as well as "running", which were significantly different in the "Initiated" evaluation (p = 0.0469) for the walking ability, and significantly different in the "Initiated" and "Acquired" evaluations (p = 0.0469; p = 0.0341, respectively) for the running skill. CONCLUSIONS: The conductivist teaching model was superior in terms of gross motor function optimization.
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SUMMARY: It has been demonstrated that the teaching and learning process of human anatomy is influenced by different external factors that can affect, in the short and long term, the academic and professional performance of medical students. In this sense, the present work aims to determine the relationship between sociodemographic factors and the academic performance of students belonging to the program of Medicine and Surgery of the Universidad del Valle, in Cali-Colombia, who were enrolled in the course of Human Gross Anatomy. Based on the organization of the course plan, the average grades obtained by the students in the different exams taken in the course were compared. Through a survey, sociodemographic data that have been reported as influential factors in academic performance were asked. The first stage of the analysis consisted of identifying the characteristics of the variables, then the correlation of the sociodemographic variables with the students' academic performance, and finally, a multiple linear regression model was implemented. Although the results did not show statistically significant correlations between the variables analyzed, a close relationship was observed with the sex and place of origin of the students, obtaining that women and students from other towns and cities presented lower academic performance compared to their peers. This highlights the importance of including activities to strengthen the learning process, as well as guiding support programs to maintain academic performance and reduce the inequality gap.
Se ha demostrado que en el proceso de enseñanza y aprendizaje de la anatomía humana inciden diferentes factores externos que pueden afectar, a corto y largo plazo, el desempeño académico y profesional de los estudiantes de Medicina. En este sentido, el presente trabajo tiene como objetivo determinar la relación existente entre los factores sociodemográficos y el rendimiento académico de los estudiantes que pertenecen al programa de Medicina y Cirugía de la Universidad del Valle, en Cali-Colombia, matriculados en la asignatura de Anatomía Macroscópica Humana. A partir de la organización del plan del curso, se comparó el promedio de las notas obtenidas por los estudiantes en los diferentes exámenes realizados en la asignatura. A través de una encuesta, se preguntaron algunos datos sociodemográficos que han sido reportados como factores influyentes en el rendimiento académico. La primera etapa del análisis consistió en identificar las características de las variables, a continuación, la correlación de las variables sociodemográficas con el desempeño académico de los estudiantes y, finalmente, se implementó un modelo de regresión lineal múltiple. Si bien los resultados no arrojaron correlaciones estadísticamente significativas entre las variables analizadas, sí se observó una estrecha relación con el sexo y el lugar de procedencia de los estudiantes, obteniendo que las mujeres y los estudiantes foráneos presentaron menor rendimiento académico en comparación con los demás compañeros. Esto resalta la importancia de incluir actividades que permitan fortalecer el proceso de aprendizaje, así como guiar programas de apoyo para mantener el rendimiento académico y disminuir la brecha de desigualdad.
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Humanos , Masculino , Feminino , Estudantes de Medicina , Desempenho Acadêmico , Anatomia/educação , Universidades , Inquéritos e Questionários , Colômbia , Fatores SociodemográficosRESUMO
The aim of this study was to analyze the existence of the Kuznets environmental curve (EKC) hypothesis for a diverse spectrum of environmental pollutants (carbon dioxide, methane, and nitrous oxide) from the Brazilian states from 1980 to 2020. In the Kuznets hypothesis, economic growth, represented by GDP per capita, grows inflection in relation to environmental degradation. Upon reaching a certain point, the relationship becomes inversely opposite, being a positive trend of growth and a retract to environmental indicators, as in the case of greenhouse gases. The application of regression models in strict observance of Grossman and Krueger's EKC econometric model (1995) allowed a critical analysis of the Brazilian empirical model relative to pollutant emissions. The results show the corroboration of the EKC hypothesis for carbon dioxide and nitrous oxide, but not methane gas. Additionally, the discussion on the subject was extended to the debate about Brazil on the world stage. Brazil is on the world stage as a major influencer in environmental issues, so everything empirically contributes, both to academia and public managers, by presenting evidence of the relationship of economic growth aligned with sustainable development. Thus, the study provides contributions to professionals, researchers, and international readers. On the other hand, this study shows as political implications the need for improvements and reformulations of environmental policies in favor of mitigating environmental degradation.
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Gases de Efeito Estufa , Gases de Efeito Estufa/análise , Brasil , Desenvolvimento Econômico , Dióxido de Carbono/análise , Óxido NitrosoRESUMO
Near-peer teaching has been widely implemented in medical schools and the benefits for the near-peer teachers (NPTs), the students, and the institution have been well documented. However, NPT training methods and perceptions of such have been limited. A four-year clinical anatomy and surgical training program was established (est. 2019) as part of the continuous training timeline for NPTs (n > 60 total) formation at the Universidad Autónoma de Nuevo León, in Mexico. The program provides various training courses for the NPTs according to their hierarchy, including teaching skills, professional development, psychosocial aspects, and career objectives. A "Clinical Anatomy and Surgical Training Diploma" was planned with 12 modules to aid in developing these abilities, along with a higher understanding of clinical anatomy shared by expert clinical specialists, and diverse clinical and surgical skills such as suturing, catheterization, and basic surgical procedures. The program has a completion rate of approximately 15 NPTs/year. All, while creating an environment with a sense of belonging, and facilitating mentorship between fellow NPTs and educators. Near-peer teachers develop leadership, communication, and teaching skills. The program has provided a constant source of anatomy educators, avoiding any shortage.
Assuntos
Anatomistas , Anatomia , Educação de Graduação em Medicina , Estudantes de Medicina , Humanos , Anatomia/educação , Estudantes de Medicina/psicologia , Educação de Graduação em Medicina/métodos , Grupo Associado , Currículo , EnsinoRESUMO
Morphological features are essential to assess neonates' viability. In order to characterize the morphology and biometry of newborn agouti, 36 animals born at 103 days of gestation under human care in Teresina-PI, Brazil were evaluated. After birth, the newborns were weighed on digital precision scales, measured with a flexible tape measure and their external morphology was assessed. The animals observed had coat color trait of adults, open eyes, hairs in the nasal region and four incisor teeth. The forelimbs had developed four digits and the hind limbs three digits, with white edged claws and a short hairless tail. The following were observed: weight of 144.58 ± 33.39g and lengths: crown-rump 14.73 ± 1.82cm, total 19.88 ± 1.52cm, head to tail 16.95 ± 1.55cm, head 7.33 ± 0.59cm, thoracic girth 11.78 ± 1.36cm, abdominal girth 10.73 ± 1.21cm, tail length 1.18 ± 0.25cm, eye diameter 1.27 ± 0.27cm and ear length 0.21 ± 0.35cm. The agoutis presented morphological maturity at birth with external morphology very similar to that of the adult animals. Most of the births in this species are the double type and newborns that weigh more than 90g have better chances of survival in captivity.
As características morfológicas são essenciais para avaliar a viabilidade dos neonatos. Para caracterizar a morfologia e biometria de cutias recém-nascidas, foram avaliados 36 animais nascidos aos 103 dias de gestação sob cuidados em Teresina-PI, Brasil. Após o nascimento, os recém-nascidos foram pesados em balança digital de precisão, medidos com fita métrica flexível e avaliada sua morfologia externa. Os animais observados apresentavam traço de pelagem de adultos, olhos abertos, pelos na região nasal e quatro dentes incisivos. Os membros anteriores desenvolveram quatro dedos e os membros posteriores três, com garras brancas afiadas e uma cauda curta e sem pêlos. Foram observados: peso de 144,58 ± 33,39g e comprimentos: garupa 14,73 ± 1,82cm, total 19,88 ± 1,52cm, cabeça a cauda 16,95 ± 1,55cm, cabeça 7,33 ± 0,59cm, perímetro torácico 11,78 ± 1,36cm, abdominal perímetro 10,73 ± 1,21 cm, comprimento da cauda 1,18 ± 0,25 cm, diâmetro do olho 1,27 ± 0,27 cm e comprimento da orelha 0,21 ± 0,35 cm. As cutias apresentaram maturidade morfológica ao nascimento com morfologia externa muito semelhante à dos animais adultos. A maioria dos nascimentos nesta espécie são do tipo duplo e recém-nascidos que pesam mais de 90g têm melhores chances de sobrevivência sob cuidados humanos.
Assuntos
Animais , Pesos e Medidas Corporais/veterinária , Estruturas Animais/crescimento & desenvolvimento , Dasyproctidae/crescimento & desenvolvimento , Anatomia Veterinária , Sistemas de Identificação Animal , Animais Recém-Nascidos/anatomia & histologiaRESUMO
Historically, owing to the increase in processing capacity over the years, validation and adjustment of measurements have become imperative. In particular, concerning discussions related to data and results in analytical chemistry, there is always a need to improve their reliability. The data reconciliation technique has the objective of using measurement redundancies to obtain the best estimate of the true value and, consequently to minimize its uncertainty. Unfortunately, this powerful tool is less known and used by analytical chemists compared to other areas. This approach can be satisfactorily performed in decision-making procedures that focus on chemical analysis, chemometrics, biochemistry analysis, forensics, and environmental sciences, such as in a characterization study, regarding conformance or nonconformance with the specification, doubts related to the malfunctioning of meters and about the compatibility of test methods. This work discusses and sheds light on the importance of data reconciliation, including data reconciliation statistics and application of the technique, traditional data reconciliation in analytical chemistry, principal component analysis based on data reconciliation in analytical chemistry, and fuzzy data reconciliation in analytical chemistry.
Assuntos
Reprodutibilidade dos Testes , Cromatografia GasosaRESUMO
The still significant uncertainties associated with the future capacity of terrestrial systems to mitigate climate change are linked to the lack of knowledge of the biotic and abiotic processes that regulate CO2 net ecosystem exchange (NEE) in space/time. Mainly, rates and controls of CO2 exchange from arid ecosystems, despite dominating the global trends in interannual variability of the terrestrial CO2 sink capacity, are probably the most poorly understood of all. We present a study on rates and controls of CO2 exchange measured with the eddy covariance (EC) technique in the Chihuahuan Desert in the Northeast of Mexico, to understand how the environmental controls of the NEE switch throughout the year using a multilevel approach. Since this is a water-limited ecosystem, the hydroecological year, based on the last precipitation and the decay of air temperature, was used to compare the wet (from May 16 to October 30, 2019) and dry (November 1, 2019 to May 15, 2020) seasons' controlling mechanisms, both at diurnal and nocturnal times. Annual NEE was -303.5 g C m-2, with a cumulative Reco of 537.7 g C m-2 and GPP of 841.3 g C m-2. NEE showed radiation, temperature, and soil moisture sensitivity along the day, however, shifts in these controls along the year and between seasons were identified. The winter precipitations during the dry season led to fast C release followed by lagged C uptake. Despite this flux pulse, the ecosystem was a net sink throughout most of the year because the local vegetation is well adapted to grow and uptake C under these arid conditions, even during the dry season. Understanding the controls of the sink-source shifts is relevant since the predictions for future climate include changes in the precipitation patterns.