Abstract Introduction: End of life care of patients with end-stage kidney disease (ESKD) may be particularly challenging and requires the intervention of a specialized palliative care team (PCT). Objective: To characterize the population of ESKD patients referred to a PCT and evaluate the determinants of planned dying at home. Methods: We performed a retrospective observational cohort study of all patients with ESKD referred to our PCT between January 2014 and December 2021 (n = 60) and further characterized those with previously known ESKD regarding place of death (n = 53). Results: The majority of the patients were female and the median age was 84 years. Half of the patients were on conservative treatment, 43% were on chronic hemodialysis, and the remainder underwent hemodialysis on a trial basis and were subsequently suspended. Of those with previously known ESKD, 18% died at home and neither gender, age, cognition, performance status, comorbidities, CKD etiology, or treatment modality were associated with place of death. Anuria was significantly associated with dying at the hospital as was shorter time from dialysis suspension and death. Although not reaching statistical significance, we found a tendency towards a longer duration of palliative care follow-up in those dying at home. Conclusion: Dying at home is possible in a palliative domiciliary program regardless of age, gender, etiology of CKD, major comorbidities, and treatment modality. Anuria and shorter survival from RRT withdrawal may be limiting factors for planned dying at home. A longer follow-up by palliative care may favor dying at home.

Resumo Introdução: Os cuidados de fim de vida em doentescom doença renal terminal (DRT) podem ser desafiantes e necessitar do apoio de uma equipa especializada em cuidados paliativos (ECP). Objetivo: Caracterizar a população de doentes com DRT encaminhada à ECP e avaliar os determinantes para um fim de vida planeado no domicílio. Métodos: Realizámos um estudo de coorte observacional retrospectivo dos doentes com DRT encaminhados à ECP entre janeiro/2014 e dezembro/2021 (n = 60) e caracterizámos aqueles com DRT previamente conhecida relativamente ao local de fim de vida (n = 53). Resultados: A maioria dos pacientes eram mulheres comidade mediana de 84 anos. Metade dos doentes encontrava-se em tratamento conservador, 43% em hemodiálise crónica e os restantes suspenderam diálise iniciada agudamente. Daqueles com DRT previamente conhecida, 18% morreram em casa. Não foi objetivada associação entre género, idade, cognição, status funcional, comorbilidades, etiologia da DRC ou modalidade de tratamento da DRT e o local de óbito. A anúria e a menor sobrevida após suspensão de diálise associaram-se a um fim de vida no hospital e verificámos uma tendência para o fim de vida em casa nos doentes com mais tempo de acompanhamento pela ECP. Conclusão: O fim de vida no domicílio é possível num programa domiciliário de cuidados paliativos, independentemente de idade, sexo, etiologia da DRC, principais comorbilidades e modalidade de tratamento. A anúria e o menor tempo de sobrevida após suspensão da TRS podem ser fatores limitantes. Um acompanhamento mais longo em cuidados paliativos pode favorecer o fim de vida no domicílio.

The present article, addressing the theme “Identities and Intercultural Education”, begins with a reflection on the school's current role in the portuguese context, proceeding with a defense of rigorous scientific knowledge in education, which covers several aspects of subjectivity, not letting us, however, giving up the rigor in the information obtained through investigation. In a subsequent phase, a view will be given to some of the most significant problems of contemporary reality, associated with issues of identity and interculturality, and their respective impact on educational processes. In a third phase, the Axial Era will be recognized as a particular moment in the history of our species, from which the description of the most striking characteristics of human nature, particularly those that unite us, emerged, also opening a space to illustrate the ones that separate us. For the last, there will be identified, in the geography of the human planet, traces and frameworks of groups of people who live in their social contexts, with associated norms and values, also being referred issues concerning migratory movements, considering their implications for educational systems.Keywords: identity, interculturality, axial era, education.

Este artículo, en el marco del tema “Identidades y Educación Intercultural”, comienza con una reflexión sobre el papel actual de la escuela en el contexto portugués, procediendo con una defensa del saber científico riguroso en la educación, que abarca varios aspectos de subjetividad, no permitiéndonos, sin embargo, renunciar al rigor en la información obtenida a través de la investigación. En una fase posterior, se dará una mirada a algunos de los problemas más significativos de la realidad contemporánea, asociados a cuestiones de identidad e interculturalidad, con su respectiva incidencia en los procesos educativos. La Era Axial fue reconocida como un momento particular en la historia de nuestra especie, de donde surgió la descripción de los rasgos más llamativos de la naturaleza humana, en particular los que nos unen, abriendo también un espacio para ilustrar los que nos separan. En conclusión, en la geografía del planeta humano se identifican huellas y encuadres de grupos de personas que viven en sus propios contextos sociales, con normas y valores asociados, haciendo, finalmente, referencia a cuestiones relativas a los movimientos migratorios, con miras a implicaciones para los sistemas educativos.Palabras clave: identidad, interculturalidad, era axial, educación.

O presente artigo, enquadrando-se no tema “Identidades e Educação Intercultural”, inicia-se com a reflexão sobre o atual papel da escola no contexto português, procedendo-se a uma defesa do conhecimento científico rigoroso em educação, que se recobre de vários aspetos de subjetividade, não nos deixando, no entanto, desistir do rigor na informação obtida através da investigação. Numa fase subsequente, será lançado um olhar a alguns dos problemas mais significativos da realidade contemporânea, associados a questões de identidade e interculturalidade, com respetivo impacto nos processos educativos. Reconhecesse-se a Era Axial como um momento particular da história da nossa espécie, de onde foi emanada a descrição das caraterísticas mais marcantes da natureza humana, particularmente as que nos unem, abrindo-se também um espaço para ilustrar as que nos separam. A concluir, identifica-se na geografia do planeta humano, traços e enquadramentos de grupos de pessoas que habitam em contextos sociais próprios, com normas e valores associados, fazendo-se, por último, referência a questões concernentes aos movimentos migratórios, perspetivando-se implicações nos sistemas educacionais.Palavras-chave: identidade, interculturalidade, era axial, educação.

ABSTRACT Introduction In Brazil, 8,000 new cases of childhood cancer are estimated each year, whose causes are still little known, although some have genetically determined factors. Approximately 70% of human cancers have alterations in the TP53 gene, which encodes the protein responsible for inhibiting the disordered growth of cells exposed to injuries. However, the frequency of alterations in the expression of TP53 in childhood cancers in Brazil remains poorly known. Objective To evaluate the expression of TP53 gene in patients with childhood cancer in northeastern of Santa Catarina, Brazil. Materials and Methods: Retrospectively, 282 patients diagnosed with cancer between 2005 and 2015 in Joinville were included. TP53 expression was evaluated by immunohistochemistry using a score based on the intensity and percentage of stained cells. Results The p53 protein was positive in 25.2% of cases, with no difference between sexes. Considering the five main groups of tumors in the sample, the expression was positive in 31.8%, 27.3%, 20%, 17.2% and 5.9% of lymphomas, nephroblastomas, neuroblastomas, tumors of the Central Nervous System and leukemias, respectively. Conclusion The prevalence of TP53 expression was evaluated in different childhood cancers in the northeastern of Santa Catarina. Positivity was higher among lymphomas and lower in leukemias, but with no significant difference among the five most frequent tumors. Further studies that allow correlation with aggressiveness and disease evolution are required.

RESUMO Objetivo avaliar a adequação e utilidade de aplicativos móveis voltados para reabilitação da incontinência urinária na população masculina. Método estudo descritivo, realizado com aplicativos direcionados à reabilitação da incontinência urinária masculina. Os aplicativos foram obtidos na Play Store e App Store. A busca foi realizada entre 3 e 10 de maio de 2021, em Minas Gerais, Brasil. Foram utilizados os termos “incontinência urinária”, “incontinencia urinaria”, “urinary incontinence” e “Kegel” para seleção. Os aplicativos foram descritos e avaliados conforme estabelecido nos itens da Applications Scoring System. Resultados Vinte e dois aplicativos foram selecionados. Três eram específicos para homens; três abordavam exercícios para fortalecimento da musculatura pélvica e diário miccional simultaneamente; e cinco eram compatíveis com ambas as lojas virtuais. Conclusão a maioria dos aplicativos disponíveis possui funcionalidades e informações limitadas acerca da incontinência urinária masculina. Espera-se que esse estudo contribua para o desenvolvimento de softwares mais abrangentes e adequados à população masculina com incontinência urinária.

ABSTRACT Objective to evaluate the suitability and usefulness of mobile apps aimed at urinary incontinence rehabilitation in the male population. Method descriptive study, carried out with apps directed to the rehabilitation of male urinary incontinence. The apps were obtained from the Play Store and App Store. The search was conducted between May 3 and 10, 2021, in Minas Gerais, Brazil. The terms “urinary incontinence”, “incontinencia urinaria”, “urinary incontinence”, and “Kegel” were used for selection. The applications were described and evaluated as established in the Applications Scoring System items. Results Twenty-two apps were selected. Three were specific for men; three addressed exercises for pelvic muscle strengthening and voiding diary simultaneously; and five were compatible with both online stores. Conclusion most of the available apps have limited functionality and information about male urinary incontinence. This study is expected to contribute to the development of more comprehensive and appropriate software for the male urinary incontinent population.

RESUMEN Objetivo evaluar la idoneidad y utilidad de las aplicaciones móviles para la rehabilitación de la incontinencia urinaria en la población masculina. Método estudio descriptivo, realizado con aplicaciones dirigidas a la rehabilitación de la incontinencia urinaria masculina. Las aplicaciones se obtuvieron de Play Store y App Store. La búsqueda se realizó entre el 3 y el 10 de mayo de 2021 en Minas Gerais, Brasil. Para la selección se utilizaron los términos “incontinência urinária”, “incontinencia urinaria”, “urinary incontinence” e “Kegel”. Las solicitudes fueron descritas y evaluadas según lo establecido en los ítems del Applications Scoring System. Resultados Se seleccionaron 22 aplicaciones. Tres eran específicos para hombres; tres abordaban ejercicios para fortalecer la musculatura pélvica y miccional simultáneamente; y cinco eran compatibles con ambas salas virtuales. Conclusión la mayoría de las aplicaciones disponibles tienen funcionalidades e información limitada sobre la incontinencia urinaria masculina. Se espera que este estudio contribuya al desarrollo de softwares más completos y adecuados para la población masculina con incontinencia urinaria.

Resumo Introdução: O delirium é uma das complicações neuropsiquiátricas mais frequentes em Cuidados Paliativos. Constitui uma disfunção neurológica grave, não existindo diretrizes bem estabelecidas para a sua gestão na comunidade. O objetivo deste trabalho consiste na revisão da evidência existente sobre a abordagem do delirium na comunidade, em particular em Portugal. Métodos: Revisão da literatura utilizando os termos MeSH delirium, palliative care, domiciliary care, general practitioners, general physicians, primary care, Portugal e end of life. Resultados e Conclusão: O delirium é, habitualmente, multifatorial, tendo um impacto importante nos serviços de saúde, profissionais, cuidadores e, sobretudo, nos doentes. A evidência científica para o seu tratamento é escassa e aplica-se, sobretudo, aos cuidados hospitalares. A estruturação de cuidados de qualidade no âmbito da prevenção, identificação atempada e gestão precoce do delirium, no contexto dos Cuidados Paliativos na comunidade, deve incluir o doente, a sua família e o ambiente onde se insere.

Abstract Introduction: Delirium is one of the most frequent neuropsychiatric complications in the Palliative Care setting. Despite being a severe neurological dysfunction, there are few studies describing its management in the community. Our objective was to review the existing evidence supporting best approaches to delirium in the community setting, considering the Portuguese context. Methods: Literature review using the following MeSH terms: “delirium”, “palliative care”, “domiciliary care”, “general practitioners”, “general physicians”, “primary care”, “Portugal” and “end of life”. Results and Conclusion: Delirium is usually multifactorial, impacting healthcare professionals, caregivers and, above all, patients. There is insufficient evidence concerning treatment of the condition, and available literature mostly concerns the hospital setting. In the Palliative Care setting, it is important that the patient, the family, and the environment are considered in order to assure early diagnosis and management of delirium by the family doctor.

RESUMO O controle da dor é fundamental na prática odontológica, po-dendo ser feito a partir de várias técnicas. Este estudo visa comparar as técnicas anestésicas atraumática e convencional, aplicadas durante cirurgias para remover terceiros molares superiores. Os pontos avaliados foram índice de dor, satisfaqao do paciente e eficácia anestésica. Um ensaio clínico randomi-zado, paralelo, boca dividida, foi conduzido com 14 participantes. O grupo A recebeu anestesia atraumática sem agulha (Comfort-in®) e o grupo B anestesia convencional por meio de bloqueio do nervo alveolar superior posterior (NASP) e nervo palatino maior (NPM). Uma Escala Visual Analógica (EVA) foi utilizada para avaliar a dor. Uma significativa (p<0,001) menor percepção de dor entre os individuos que receberam a técnica atraumática foi observada. Em 71% dos casos, fez-se necessària a complementação da anestesia durante a realiza-ção do procedimento. Mesmo considerando a necessidade de anestesia adicional, a técnica empregando o sistema Comfort-in® teve maior aceitação dos pacientes quando comparado à técnica manual convencional, no que se refere a percepção de dor, ainda que considerando a necessidade de complementação da anestesia.

ABSTRACT Pain control is essential in dental practice, and can be accomplished through various techniques. This study seeks to compare atraumatic and conventional anesthetic techniques, applied during surgeries to remove upper third molars. The endpoints evaluated were pain indices, patient satisfaction and anesthetic efficacy. A random parallel split-mouth clinical trial was conducted with 14 patients. Group A received atraumatic anesthesia without a needle (Comfort-in®) and group B received conventional anesthesia by blocking the posterior superior alveolar nerve (PSAN) and Greater Palatine Nerve (GPN). A Visual Analogue Scale (VAS) was used to assess pain. A significantly (p<0.001) lower perception ofpain was observed among individuals who received the atraumatic technique. In 71% of cases, it was necessary to supplement the anesthesia during the procedure. Even considering the need for additional anesthesia, the Comfort-in® technique was more accepted by patients with regard to pain perception than the conventional manual technique.

ABSTRACT Objective Prematurity and low birth weight predispose preterm infants to cardiovascular disease in later life. Is the metabolic profile of these children impacted by the relation between birth weight and gestational age (GA)? This study aimed to evaluate whether the relationship between birth weight and GA of preterm infants has a positive correlation with the metabolic profile from birth to the sixth month of corrected age. Subjects and methods This is a longitudinal, prospective study with a cohort of 70 preterm and 54 term infants, who were enrolled in the study and shared into two groups: Appropriate for GA (AGA) and Small for GA (SGA), both classified at birth by Fenton and Kim curves. Longitudinal evaluation of anthropometry measures and blood samples of total cholesterol, glucose, triglycerides, and insulin were collected at birth, NICU discharge, and the sixth month of corrected age. Data were analyzed using descriptive and inferential statistical analysis (ANOVA, Fisher test, Shapiro-Wilk, and Cochran test). The effect size was 0.15, power was 0.92, and confidence interval 95%. Results No significant statistical differences were observed in relation to biochemical tests between AGA and SGA groups. However, a significant increase in triglyceride results above the reference values for age in the SGA group was observed throughout the follow-up. Conclusions Changes observed in the preterm infant metabolic profile show no correlation with adequacy of birth weight. Preterm lipid profile requires continuous evaluation at follow-up, due to the increased cardiovascular risk in later life.

RESUMO As reações de fotossensibilidade caracterizam-se por uma resposta alterada à radiação não-ionizante, apresentando diversos padrões morfológicos, que refletem as suas diferentes etiologias. Relatamos o caso de um doente observado por dermatose fotossensível refratária a múltiplos tratamentos. Excluídas possíveis causas exógenas e após demonstração de uma dose de eritema mínimo diminuída para UVB, o estudo analítico com vista a iniciar azatioprina revelou serologia positiva para VIH, revelando elevada carga viral e contagens TCD4+ reduzidas. Neste seguimento, iniciou de imediato terapêutica anti-retroviral, com resolução rápida e completa do quadro. Estima-se que 5% dos doentes VIH-positivos apresentem fotossensibilidade em algum momento da sua evolução. Mais frequentemente associada a fármacos utilizados no tratamento, a sensibilidade à luz solar tem também sido ocasionalmente descrita como manifestação inicial da infeção, como no presente caso. Os autores pretendem alertar para a associação entre fotossensibilidade e infeção por VIH que, embora tenha vindo a ser crescentemente reconhecida, está ainda pouco caracterizada.

ABSTRACT Photosensitivity is characterized by an abnormal response to non-ionizing radiation, disclosing a variety of morphological patterns, which reflect their different etiologies. We describe the case of a man presenting with a photosensitive dermatosis with no apparent exogenous cause and refractory to multiple treatments. Phototests revealed a reduction in minimal erythema dose to UVB. Laboratory tests in order to start azathioprine, showed a positive test for HIV and a diagnosis of AIDS (high viral load and low TCD4+ cells). A few months after starting antiretroviral therapy photosensitivity resolved completely. Photosensitivity affects up to 5% of HIV-positive patients, mostly due to drug photosensitivity, but it has also been reported as the presenting sign. The authors emphasize the clinical association between HIV infection and photosensitivity which has been increasingly recognized, although it is still poorly characterized from a clinical and photobiological point of view.

Coronavirus infection (SARS-CoV-2), is a pandemic disease declared by the World Health Organization (WHO). This disease reports a high risk of contagion, especially by the transmission of aerosols in health care workers. In this scenario, aerosol exposure is increased in various procedures related to the airway, lungs, and pleural space. For this reason, it is important to have recommendations that reduce the risk of exposure and infection with COVID-19. In this document, a team of international specialists in interventional pulmonology elaborated a series of recommendations, based on the available evidence to define the risk stratification, diagnostic methods and technical considerations on procedures such as bronchoscopy, tracheostomy, and pleural procedures among others. As well as the precautions to reduce the risk of contagion when carrying out pulmonary interventions.

This study reports the preparation of nanostructured cerium-doped titanium dioxide photocatalysts containing different cerium concentrations by a modified sol-gel route involving the use of acetylacetone. The nanocrystalline powders had their structural, morphological, and optical properties characterized by X-ray diffraction, vibrational and Raman spectroscopy, thermogravimetric analysis, X-ray photoelectron spectroscopy, Brunauer, Emmett and Teller (BET) surface area analysis, scanning electron microscopy combined with energy dispersive X-ray spectroscopy, total reflection X-ray fluorescence, and diffuse reflectance spectroscopy. Cerium incorporation reduced the bandgap energy of the solids to values that allowed them to absorb visible light. Cerium presence improved the textural properties that are crucial for the catalytic process. The photocatalytic activities were evaluated through photodegradation experiments of methyl orange dye solution. The synthesis with acetylacetone as stabilizer provided nanostructured materials with higher Ce3+/Ce4+ ratio, which enhanced the photocatalytic activity. Smaller quantities of the doped photocatalysts afforded higher degradation rates than the rates reported in the literature.

Resumo: Objetivo Foi avaliado o incremento da decomposição da matéria orgânica em amostras de sedimento de viveiros de criação de tilápias-do-Nilo com a introdução das bactérias Bacillus subtilis e B. licheniformis. Métodos Amostras de sedimento colocadas em caixas plásticas de 18L, receberam dose única de inóculos com as seguintes concentrações: 1,21 x 106 UFC g-1 (equivalente a 75 g ha-1), 2,41x 106 UFC g-1 (equivalente a 150 g ha-1), 4,82 x 106 UFC g-1 (equivalente a 300 g ha-1) e 1,61x 107 UFC g-1 (equivalente a 1000 g ha-1), além de um tratamento controle, com adição apenas de solução salina. Foram analisados teor de matéria orgânica, teores de carbono orgânico total (COT) e oxidável (COO), nitrogênio total (NT), relações de carbono: nitrogênio (COT:N e COO:N), teor de argila, pH em água, índce Shoemaker, McLean, Pratt (índice SMP), teores de fósforo (P), de potássio (K), de cálcio (Ca) e de magnésio (Mg), acidez potencial (H+Al), capacidade de troca catiônica (CTC) a pH 7,0 e saturação por bases (V). Resultados Os valores de MO apresentaram diferença significativa entre os menores valores (tratamentos 75, 150 e 300 g ha-1) e o maior valor (tratamento controle). COT, COO, NT e suas relações (COT:N e COO:N) apresentaram diferenças significativas entre os valores médios do tratamento controle e os demais tratamentos. Conclusões A adição das bactérias Bacillus subtilis e B. licheniformis incrementou a taxa de decomposição de matéria orgânica em amostras de sedimento de viveiro de criação de tilápias-do-Nilo.

Abstract: Aim The increment of decomposition of organic matter in sediment samples from Nile tilapia farms was evaluated with the introduction of Bacillus subtilis and B. licheniformis bacteria. Methods Sediment samples placed in 18L plastic boxes received single dose inoculum with the following concentrations: 1.21 x 106 CFU g-1 (equivalent to 75 g ha-1), 2.41 x 106 CFU g-1 (equivalent to 150 g ha-1), 4.82 x 106 CFU g-1 (equivalent to 300 g ha-1) and 1.61 x 107 CFU g-1 (equivalent to 1000 g ha-1), in addition to a control treatment with saline solution only. Organic matter content, total organic carbon (TOC) and oxidizable (OOC), total nitrogen (TN), ratios (TOC: N and OOC: N), clay content, pH in water, Shoemaker, McLean, Pratt index (SMP Index), phosphorus (P), potassium (K), calcium (Ca) and magnesium (Mg) contents, potential acidity (H + Al), cation exchange capacity (CEC) at pH 7.0, base saturation (V) and sum of bases (S). Results The values of OM showed significant difference, between the lowest values (treatments 75, 150 and 300 g ha-1) and the highest value, (control treatment). TOC, OOC, NT and their relationships (TOC: N and OOC: N) showed significant differences between the mean values of the control treatment and the other treatments. Conclusions The addition of Bacillus subtilis and B. licheniformis bacteria increased the decomposition rate of organic matter in sediments samples from Nile tilapia farms.

RESUMO O desenvolvimento dos processos de produção de nanotubos de carbono é amplamente estudado com o objetivo de melhorar a produção, pureza e qualidade do produto. Entre os processos de produção de nanotubos, a deposição química em fase vapor sobre catalisadores é o método mais empregado para produção em larga escala, pois este permite controlar, de modo eficiente, os parâmetros reacionais. Catalisadores de CoMo/MgO com baixa concentração de cobalto, 5% em massa, e três diferentes concentrações de molibdênio, 5, 10 e 20%, foram preparados pelo método de impregnação seca para estudar o efeito do molibdênio na síntese de nanotubos de carbono. As caracterizações dos catalisadores e dos nanotubos puderam demonstrar as relações entre as propriedades catalíticas e as características dos nanotubos. Os catalisadores com maior concentração de molibdênio apresentaram maior formação de espécies CoMoO4 e MgMoO4 indicando maior interação do cobalto e do suporte com o molibdênio. A elevada concentração de molibdênio nos catalisadores prejudicou a taxa de formação dos nanotubos e a menor grau de grafitização.

ABSTRACT The development of carbon nanotubes production has been subject of research seeking higher carbon yields and selective processes towards materials with superior purity and quality. Among the methods for nanotube synthesis, the catalytic route is a viable option for large-scale production, since it allows a more effective control of reaction. CoMo/MgO catalysts with low loading of cobalt, 5 wt.%, and three different loading of molybdenum, 5, 10 and 20 wt.%, were prepared by incipient wetness impregnation for high yield and pure carbon nanotubes. A detailed characterization of the catalysts and nanotubes indicated a relationship between their properties. Catalysts prepared with higher molybdenum loading showed higher formation of MgMoO4 and CoMoO4 indicating an enhanced interaction of MgO and cobalt with molybdenum. Excess of molybdenum in the catalyst caused a decrease in carbon yield and produced nanotubes with a lower degree of graphitization.

Abstract CoMo/MgO catalysts with low loading of cobalt and molybdenum were prepared by incipient wetness impregnation and the sol-gel method for high yield production of carbon nanotubes (CNT). A detailed characterization of the catalysts, as-produced CNT and purified CNT, indicated a relationship between carbon nanotube properties, synthesis and purification steps. Excess of molybdenum in the catalyst caused a decrease in carbon yield and produced CNT with a lower degree of graphitization. Catalysts prepared by the sol-gel method and with higher molybdenum loading showed an improved interaction between cobalt and molybdenum, increasing the formation of CoMoO4, which was not completely removed during the purification step. The purification removed all MgO and part of the cobalt and molybdenum present in samples without significant damage to the CNT structure. An increase in sample purity could be achieved by increasing reaction time.