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Mental health of Brazilian physicians: a nationwide cross-sectional study to investigate factors associated with the prevalence of suicide plans and attempts physicians crosssectional cross sectional
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Luz, Leonardo Servio
; Cassenote, Alex Jones Flores
; Valente, Emanuelle Pessa
; Mariani, Ilaria
; Lazzerini, Marzia
; Lima, Carlos Vital Tavares Corrêa
; Giamberardino Filho, Donizetti Dimer
; Marques Filho, Edmilson de Freitas
; von Tiesenhausen, Hermann Alexandre Vivacqua
; Cabeça, Hideraldo Luis Souza
; Damásio, Lia Cruz Vaz da Costa
; de Souza Júnior, Milton Aparecido
; de Souza, Paulo Henrique
; Rocha, Rosylane Nascimento das Mercês
; Zaher-Rutheford, Vera Lucia
; Ribeiro, Mauro Luiz de Britto
; da Silva, Antônio Geraldo
; Gallo, José Hiran da Silva
.
Objective: To report on suicide plans and attempts among Brazilian physicians and to investigate the associated risk factors. Methods: From January 2018 to January 2019, a nationwide online survey was conducted among Brazilian physicians using the Tool for Assessment of Suicide Risk and the Satisfaction with Life Scale. Multivariate exploratory associations of demographic, psychological, and work-related factors were performed on reports of suicide plans and attempts. Results: Of the 4,148 participants, 1,946 (53.5%) were male, 2,527 (60.9%) were 30 to 60 years old, 2,675 (64.5%) had two to four jobs, and 1,725 (41.6%) worked 40 to 60 hours a week. The overall prevalence of suicide plans was 8.8% (n=364), and suicide attempts were reported by 3.2% (n=133) of participants. Daily emotional exhaustion (ORadj = 7.857; 95%CI 2.282-27.051, p = 0.002), weekly emotional exhaustion (ORadj = 7.953; 95%CI 2.403-26.324, p = 0.001), daily frustration at work (ORadj = 3.093; 95%CI 1.711-5.588, p < 0.001), and bisexuality (ORadj = 5.083; 95%CI 2.544-10.158, p < 0.001) were significantly associated with higher odds of suicide. Extremely dissatisfied physicians reported suicide plans and attempts in 38.3% of cases, whereas extremely satisfied physicians reported suicide plans and attempts in only 2.8% of cases (p < 0.001). Conclusion: Brazilian physicians with a history of suicide plans and attempts express emotional exhaustion and frustration at work. There is an urgent need for actions to promote professional safeguards and resilience. Objective Methods 201 2019 Scale demographic psychological workrelated related Results 4148 4 148 4,14 participants 1946 1 946 1,94 53.5% 535 53 5 (53.5% male 2527 2 527 2,52 60.9% 609 9 (60.9% 3 6 old 2675 675 2,67 64.5% 645 64 (64.5% jobs 1725 725 1,72 41.6% 416 41 (41.6% week 88 8 8.8 n=364, n364 n n=364 , 364 (n=364) 32 3.2 n=133 n133 133 (n=133 ORadj 7.857 7857 7 857 95CI CI 95 2.28227.051, 228227051 2.282 27.051, 282 27 051 2.282-27.051 0.002, 0002 0.002 0 002 0.002) 7.953 7953 953 2.40326.324, 240326324 2.403 26.324, 403 26 324 2.403-26.324 0.001, 0001 0.001 001 3.093 3093 093 1.7115.588, 17115588 1.711 5.588, 711 588 1.711-5.588 5.083 5083 083 2.54410.158, 254410158 2.544 10.158, 544 10 158 2.544-10.158 383 38 38.3 28 2.8 0.001. . Conclusion resilience 20 414 14 4,1 194 94 1,9 53.5 (53.5 252 52 2,5 60.9 (60.9 267 67 2,6 64.5 (64.5 172 72 1,7 41.6 (41.6 8. n36 n=36 36 (n=364 3. n=13 n13 13 (n=13 7.85 785 85 28227 2.28227.051 22822705 2282 2.28 27051 27.051 05 2.282-27.05 000 0.00 00 7.95 795 40326 2.40326.324 24032632 2403 2.40 26324 26.324 2.403-26.32 3.09 309 09 7115 1.7115.588 1711558 1711 1.71 5588 5.588 71 58 1.711-5.58 5.08 508 08 54410 2.54410.158 25441015 2544 2.54 10158 10.158 54 15 2.544-10.15 38. 2. 4, 19 1, 53. (53. 25 2, 60. (60. 64. (64. 17 41. (41. n3 n=3 (n=36 n=1 n1 (n=1 7.8 78 2822 2.28227.05 2282270 228 2.2 2705 27.05 2.282-27.0 0.0 7.9 79 4032 2.40326.32 2403263 240 2.4 2632 26.32 2.403-26.3 3.0 1.7115.58 171155 171 1.7 558 5.58 1.711-5.5 5.0 50 5441 2.54410.15 2544101 254 2.5 1015 10.15 2.544-10.1 (53 (60 (64 (41 n= (n=3 (n= 7. 2.28227.0 228227 22 270 27.0 2.282-27. 0. 2.40326.3 240326 24 263 26.3 2.403-26. 1.7115.5 17115 1. 55 5.5 1.711-5. 5. 2.54410.1 254410 101 10.1 2.544-10. (5 (6 (4 (n 2.28227. 22822 27. 2.282-27 2.40326. 24032 26. 2.403-26 1.7115. 1.711-5 2.54410. 25441 10. 2.544-10 ( 2.28227 2.282-2 2.40326 2.403-2 1.7115 1.711- 2.54410 2.544-1 2.2822 2.282- 2.4032 2.403- 2.5441 2.544-
2.
Diretrizes Brasileiras de Medidas da Pressão Arterial Dentro e Fora do Consultório – 2023 202 20 2
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Feitosa, Audes Diogenes de Magalhães
; Barroso, Weimar Kunz Sebba
; Mion Junior, Decio
; Nobre, Fernando
; Mota-Gomes, Marco Antonio
; Jardim, Paulo Cesar Brandão Veiga
; Amodeo, Celso
; Oliveira, Adriana Camargo
; Alessi, Alexandre
; Sousa, Ana Luiza Lima
; Brandão, Andréa Araujo
; Pio-Abreu, Andrea
; Sposito, Andrei C.
; Pierin, Angela Maria Geraldo
; Paiva, Annelise Machado Gomes de
; Spinelli, Antonio Carlos de Souza
; Machado, Carlos Alberto
; Poli-de-Figueiredo, Carlos Eduardo
; Rodrigues, Cibele Isaac Saad
; Forjaz, Claudia Lucia de Moraes
; Sampaio, Diogo Pereira Santos
; Barbosa, Eduardo Costa Duarte
; Freitas, Elizabete Viana de
; Cestario, Elizabeth do Espirito Santo
; Muxfeldt, Elizabeth Silaid
; Lima Júnior, Emilton
; Campana, Erika Maria Gonçalves
; Feitosa, Fabiana Gomes Aragão Magalhães
; Consolim-Colombo, Fernanda Marciano
; Almeida, Fernando Antônio de
; Silva, Giovanio Vieira da
; Moreno Júnior, Heitor
; Finimundi, Helius Carlos
; Guimarães, Isabel Cristina Britto
; Gemelli, João Roberto
; Barreto-Filho, José Augusto Soares
; Vilela-Martin, José Fernando
; Ribeiro, José Marcio
; Yugar-Toledo, Juan Carlos
; Magalhães, Lucélia Batista Neves Cunha
; Drager, Luciano F.
; Bortolotto, Luiz Aparecido
; Alves, Marco Antonio de Melo
; Malachias, Marcus Vinícius Bolívar
; Neves, Mario Fritsch Toros
; Santos, Mayara Cedrim
; Dinamarco, Nelson
; Moreira Filho, Osni
; Passarelli Júnior, Oswaldo
; Vitorino, Priscila Valverde de Oliveira
; Miranda, Roberto Dischinger
; Bezerra, Rodrigo
; Pedrosa, Rodrigo Pinto
; Paula, Rogerio Baumgratz de
; Okawa, Rogério Toshiro Passos
; Póvoa, Rui Manuel dos Santos
; Fuchs, Sandra C.
; Lima, Sandro Gonçalves de
; Inuzuka, Sayuri
; Ferreira-Filho, Sebastião Rodrigues
; Fillho, Silvio Hock de Paffer
; Jardim, Thiago de Souza Veiga
; Guimarães Neto, Vanildo da Silva
; Koch, Vera Hermina Kalika
; Gusmão, Waléria Dantas Pereira
; Oigman, Wille
; Nadruz Junior, Wilson
.
3.
Combinação de Ferramentas de Telecardiologia para Estratificação de Risco Cardiovascular na Atenção Primária: Dados do Estudo PROVAR+ Primária PROVAR
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Fraga, Lucas Leal
; Nascimento, Bruno Ramos
; Haiashi, Beatriz Costa
; Ferreira, Alexandre Melo
; Silva, Mauro Henrique Agapito
; Ribeiro, Isabely Karoline da Silva
; Silva, Gabriela Aparecida
; Vinhal, Wanessa Campos
; Coimbra, Mariela Mata
; Silva, Cássia Aparecida
; Machado, Cristiana Rosa Lima
; Pires, Magda C.
; Diniz, Marina Gomes
; Santos, Luiza Pereira Afonso
; Amaral, Arthur Maia
; Diamante, Lucas Chaves
; Fava, Henrique Leão
; Sable, Craig
; Nunes, Maria Carmo Pereira
; Ribeiro, Antonio Luiz P.
; Cardoso, Clareci Silva
.
Abstract Background: Tele-cardiology tools are valuable strategies to improve risk stratification. Objective: We aimed to evaluate the accuracy of tele-electrocardiography (ECG) to predict abnormalities in screening echocardiography (echo) in primary care (PC). Methods: In 17 months, 6 health providers at 16 PC units were trained on simplified handheld echo protocols. Tele-ECGs were recorded for final diagnosis by a cardiologist. Consented patients with major ECG abnormalities by the Minnesota code, and a 1:5 sample of normal individuals underwent clinical questionnaire and screening echo interpreted remotely. Major heart disease was defined as moderate/severe valve disease, ventricular dysfunction/hypertrophy, pericardial effusion, or wall-motion abnormalities. Association between major ECG and echo abnormalities was assessed by logistic regression as follows: 1) unadjusted model; 2) model 1 adjusted for age/sex; 3) model 2 plus risk factors (hypertension/diabetes); 4) model 3 plus history of cardiovascular disease (Chagas/rheumatic heart disease/ischemic heart disease/stroke/heart failure). P-values < 0.05 were considered significant. Results: A total 1,411 patients underwent echo; 1,149 (81%) had major ECG abnormalities. Median age was 67 (IQR 60 to 74) years, and 51.4% were male. Major ECG abnormalities were associated with a 2.4-fold chance of major heart disease on echo in bivariate analysis (OR = 2.42 [95% CI 1.76 to 3.39]), and remained significant after adjustments in models (p < 0.001) 2 (OR = 2.57 [95% CI 1.84 to 3.65]), model 3 (OR = 2.52 [95% CI 1.80 to3.58]), and model 4 (OR = 2.23 [95%CI 1.59 to 3.19]). Age, male sex, heart failure, and ischemic heart disease were also independent predictors of major heart disease on echo. Conclusions: Tele-ECG abnormalities increased the likelihood of major heart disease on screening echo, even after adjustments for demographic and clinical variables. Background Telecardiology Tele cardiology stratification Objective teleelectrocardiography tele electrocardiography (ECG (echo PC. . (PC) Methods months protocols TeleECGs ECGs cardiologist code 15 5 1: remotely moderatesevere moderate severe dysfunctionhypertrophy dysfunction hypertrophy dysfunction/hypertrophy effusion wallmotion wall motion follows age/sex agesex sex hypertension/diabetes hypertensiondiabetes hypertension diabetes (hypertension/diabetes) Chagas/rheumatic Chagasrheumatic Chagas rheumatic diseaseischemic diseasestrokeheart stroke failure. failure failure) Pvalues P values 005 0 05 0.0 Results 1411 411 1,41 1149 149 1,14 81% 81 (81% IQR 74 years 514 51 51.4 2.4fold 24fold fold 2.4 OR 242 42 95% 95 [95 176 76 1.7 3.39, 339 3.39 , 39 3.39]) p 0.001 0001 001 257 57 2.5 184 84 1.8 3.65, 365 3.65 65 3.65]) 252 52 180 80 to3.58, to358 to3.58 to3 58 to3.58]) 223 23 2.2 95%CI 95CI 159 59 1.5 3.19. 319 3.19 19 3.19]) Age Conclusions TeleECG variables (PC (hypertension/diabetes 00 0. 141 41 1,4 114 14 1,1 8 (81 7 51. 4fold 24 2. 9 [9 1. 33 3.3 3.39] 0.00 000 25 18 36 3.6 3.65] to35 to3.5 to3.58] 22 31 3.1 3.19] 1, 11 (8 [ 3. to3. (
Resumo Fundamento: As ferramentas de telecardiologia são estratégias valiosas para melhorar a estratificação de risco. Objetivo: Objetivamos avaliar a acurácia da tele-eletrocardiografia (ECG) para predizer anormalidades no ecocardiograma de rastreamento na atenção primária. Métodos: Em 17 meses, 6 profissionais de saúde em 16 unidades de atenção primária foram treinados em protocolos simplificados de ecocardiografia portátil. Tele-ECGs foram registrados para diagnóstico final por um cardiologista. Pacientes consentidos com anormalidades maiores no ECG pelo código de Minnesota e uma amostra 1:5 de indivíduos normais foram submetidos a um questionário clínico e ecocardiograma de rastreamento interpretado remotamente. A doença cardíaca grave foi definida como doença valvular moderada/grave, disfunção/hipertrofia ventricular, derrame pericárdico ou anormalidade da motilidade. A associação entre alterações maiores do ECG e anormalidades ecocardiográficas foi avaliada por regressão logística da seguinte forma: 1) modelo não ajustado; 2) modelo 1 ajustado por idade/sexo; 3) modelo 2 mais fatores de risco (hipertensão/diabetes); 4) modelo 3 mais história de doença cardiovascular (Chagas/cardiopatia reumática/cardiopatia isquêmica/AVC/insuficiência cardíaca). Foram considerados significativos valores de p < 0,05. Resultados: No total, 1.411 pacientes realizaram ecocardiograma, sendo 1.149 (81%) com anormalidades maiores no ECG. A idade mediana foi de 67 anos (intervalo interquartil de 60 a 74) e 51,4% eram do sexo masculino. As anormalidades maiores no ECG se associaram a uma chance 2,4 vezes maior de doença cardíaca grave no ecocardiograma de rastreamento na análise bivariada (OR = 2,42 [IC 95% 1,76 a 3,39]) e permaneceram significativas (p < 0,001) após ajustes no modelo 2 (OR = 2,57 [IC 95% 1,84 a 3,65]), modelo 3 (OR = 2,52 [IC 95% 1,80 a 3,58]) e modelo 4 (OR = 2,23 [IC 95% 1,59 a 3,19]). Idade, sexo masculino, insuficiência cardíaca e doença cardíaca isquêmica também foram preditores independentes de doença cardíaca grave no ecocardiograma. Conclusões: As anormalidades do tele-ECG aumentaram a probabilidade de doença cardíaca grave no ecocardiograma de rastreamento, mesmo após ajustes para variáveis demográficas e clínicas. Fundamento Objetivo teleeletrocardiografia tele eletrocardiografia (ECG Métodos meses portátil TeleECGs Tele ECGs cardiologista 15 5 1: remotamente moderadagrave moderada moderada/grave disfunçãohipertrofia disfunção hipertrofia ventricular motilidade forma idade/sexo idadesexo hipertensão/diabetes hipertensãodiabetes hipertensão diabetes (hipertensão/diabetes) Chagas/cardiopatia Chagascardiopatia Chagas cardiopatia reumáticacardiopatia reumática isquêmicaAVCinsuficiência AVC cardíaca. . cardíaca) 005 0 05 0,05 Resultados total 1411 411 1.41 1149 149 1.14 81% 81 (81% intervalo 74 514 51 51,4 masculino 24 2, OR 242 42 IC 95 176 76 1,7 3,39 339 39 3,39] 0,001 0001 001 257 57 2,5 184 84 1,8 3,65, 365 3,65 , 65 3,65]) 252 52 180 80 3,58 358 58 3,58] 223 23 2,2 159 59 1,5 3,19. 319 3,19 19 3,19]) Idade Conclusões teleECG clínicas (hipertensão/diabetes 00 0,0 141 41 1.4 114 14 1.1 8 (81 7 51, 9 1, 3,3 33 0,00 000 25 18 36 3,6 3,65] 3,5 35 22 31 3,1 3,19] 0, 1. 11 (8 3, (
4.
Traveling Wave-Based Fault Location for Gas Insulated Substations WaveBased Wave Based
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Marcelo, Diogo Gonzaga
; Silva, Clailton Leopoldo da
; Martins, Rafael
; Castioni, Júlio Cezar Oliveira
; Lambert-Torres, Germano
; Ribeiro Junior, Ronny Francis
; Campos, Mateus Mendes
; Areias, Isac Antônio dos Santos
; Assunção, Frederico de Oliveira
; Silva, Luiz Eduardo Borges da
.
Brazilian Archives of Biology and Technology
- Métricas do periódico
Abstract With the growing demand for solutions to prevent and resolve faults in gas-insulated substations that affect the operation of the electrical system, a fault simulation laboratory for gas-insulated substations was developed to develop solutions for monitoring and locating these faults. The laboratory is composed of instruments for a fault location system based on traveling wave theory. The laboratory also has computational programs for fault simulation control and signal acquisition, in addition to having tools to analyze the data. The results were obtained through tests carried out that confirmed the laboratory's ability to simulate the operation of faults in gas-insulated substations, which allowed demonstrating the capacity of the fault location system using the theory of traveling waves. gasinsulated gas insulated acquisition data laboratorys s waves
5.
Associação entre o Perfil Hemodinâmico da Insuficiência Cardíaca à Admissão Hospitalar e Mortalidade - Programa Boas Práticas Clínicas em Cardiologia
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Rodrigues, André Silva
; Castilho, Fábio Morato de
; Ribeiro, Aloisio Joaquim Freitas
; Passaglia, Luiz Guilherme
; Taniguchi, Fabio Papa
; Ribeiro, Antonio L.
.
Resumo Fundamento: A insuficiência cardíaca (IC) é responsável por alta carga de internações hospitalares. A sua forma de apresentação está relacionada ao prognóstico da doença. Objetivos: Descrever a associação entre o perfil hemodinâmico de admissão hospitalar na IC aguda, baseado em congestão (úmido ou seco) e perfusão (frio ou quente), e desfechos de mortalidade, tempo de internação e chance de reinternação. Métodos: Estudo de coorte, envolvendo pacientes do projeto "Boas Práticas Clínicas em Cardiologia", internados por IC aguda em hospitais públicos brasileiros, entre março de 2016 a dezembro de 2019, com seguimento de seis meses. Foram realizadas análises das características populacionais e do perfil hemodinâmico de admissão, além de análises de sobrevivência pelos modelos de Cox para associação entre o perfil de admissão e mortalidade, e regressão logística para chance de reinternação, considerando nível de significância estatística de 5%. Resultados: Foram avaliados 1978 pacientes, com idade média foi 60,2 (±14,8) anos e fração de ejeção média do ventrículo esquerdo de 39,8% (±17,3%). Houve altas taxas de mortalidade no seguimento de seis meses (22%), com associação entre os perfis hemodinâmicos frios e a mortalidade hospitalar (HR=1,72; IC95% 1,27-2,31; p < 0,001) e em 6 meses (HR= 1,61, IC 95% 1,29-2,02). A taxa de reinternação em 6 meses foi de 22%, sendo maior para os pacientes admitidos em perfis úmidos (OR 2,30; IC95% 1,45-3,65; p < 0,001). Conclusões: A IC aguda no Brasil apresenta altas taxas de mortalidade e reinternações e os perfis hemodinâmicos de admissão hospitalar são bons marcadores prognósticos dessa evolução. Fundamento (IC hospitalares doença Objetivos úmido seco frio quente, quente , quente) Métodos coorte Boas Cardiologia, Cardiologia Cardiologia" brasileiros 201 2019 5 5% Resultados 197 602 60 2 60, ±14,8 148 14 8 (±14,8 398 39 39,8 ±17,3%. 173 ±17,3% . 17 3 (±17,3%) 22 22% (22%) HR=1,72 HR172 HR 1 72 (HR=1,72 IC95 1,272,31 127231 1,27 2,31 27 31 1,27-2,31 0,001 0001 0 001 HR= (HR 161 61 1,61 95 1,292,02. 129202 1,29 2,02 29 02 1,29-2,02) OR 2,30 230 30 1,453,65 145365 1,45 3,65 45 65 1,45-3,65 0,001. Conclusões evolução 20 19 ±14, (±14, 39, ±17,3 (±17,3% (22% HR=1,7 HR17 7 (HR=1,7 IC9 272 1,272,3 12723 127 1,2 231 2,3 1,27-2,3 0,00 000 00 16 1,6 9 292 1,292,02 12920 129 202 2,0 1,29-2,02 23 453 1,453,6 14536 145 1,4 365 3,6 4 1,45-3,6 ±14 (±14 ±17, (±17,3 (22 HR=1, HR1 (HR=1, 1,272, 1272 12 1, 2, 1,27-2, 0,0 1,292,0 1292 1,29-2,0 1,453, 1453 36 3, 1,45-3, ±1 (±1 ±17 (±17, (2 HR=1 (HR=1 1,272 1,27-2 0, 1,292, 1,29-2, 1,453 1,45-3 ± (± (±17 ( 1,27- 1,292 1,29-2 1,45- 1,29-
Abstract Background: Heart failure (HF) contributes to a high burden of hospitalization, and its form of presentation is associated with disease prognosis. Objectives: To describe the association of hemodynamic profile of acute HF patients at hospital admission, based on congestion (wet/dry) and perfusion (cold/warm), with mortality, hospital length of stay and risk of readmission. Methods: Cohort study, with patients participating in the "Best Practice in Cardiology" program, admitted for acute HF in Brazilian public hospitals between March 2016 and December 2019, with a six-month follow-up. Characteristics of the population and hemodynamic profile at admission were analyzed, in addition to survival analysis using Cox proportional hazard model for associations between hemodynamic profile at admission and mortality, and logistic regression for the risk of rehospitalization, using a statistical significance level of 5%. Results: A total of 1,978 patients were assessed, with mean age of 60.2 (±14.8) years and mean left ventricular ejection fraction of 39.8% (±17.3%). A high six-month mortality rate (22%) was observed, with an association of cold hemodynamic profiles with in-hospital mortality (HR=1.72, 95%CI 1.27-2.31; p < 0.001) and six-month mortality (HR= 1.61, 95%CI 1.29-2.02). Six-month rehospitalization rate was 22%, and higher among patients with wet profiles (OR 2.30; 95%CI 1.45-3.65; p < 0.001). Conclusions: Acute HF is associated with high mortality and rehospitalization rates. Patient hemodynamic profile at admission is a good prognostic marker of this condition. Background (HF hospitalization prognosis Objectives wet/dry wetdry dry (wet/dry cold/warm, coldwarm cold/warm , warm (cold/warm) readmission Methods study Best Cardiology program 201 2019 sixmonth six month followup. followup follow up. up follow-up analyzed 5 5% Results 1978 1 978 1,97 assessed 602 60 2 60. ±14.8 148 14 8 (±14.8 398 39 39.8 ±17.3%. 173 ±17.3% . 17 3 (±17.3%) 22% 22 (22% observed inhospital HR=1.72, HR172 HR 72 (HR=1.72 95CI CI 95 1.272.31 127231 1.27 2.31 27 31 1.27-2.31 0.001 0001 0 001 HR= (HR 161 61 1.61 1.292.02. 129202 1.29 2.02 29 02 1.29-2.02) Sixmonth Six OR 2.30 230 30 1.453.65 145365 1.45 3.65 45 65 1.45-3.65 0.001. Conclusions rates condition (cold/warm 20 197 97 1,9 6 ±14. (±14. 39. ±17.3 (±17.3% (22 HR=1.72 HR17 7 (HR=1.7 9 272 1.272.3 12723 127 1.2 231 2.3 1.27-2.3 0.00 000 00 16 1.6 292 1.292.02 12920 129 202 2.0 1.29-2.02 23 453 1.453.6 14536 145 1.4 365 3.6 4 1.45-3.6 19 1, ±14 (±14 ±17. (±17.3 (2 HR=1.7 HR1 (HR=1. 1.272. 1272 12 1. 2. 1.27-2. 0.0 1.292.0 1292 1.29-2.0 1.453. 1453 36 3. 1.45-3. ±1 (±1 ±17 (±17. ( HR=1. (HR=1 1.272 1.27-2 0. 1.292. 1.29-2. 1.453 1.45-3 ± (± (±17 HR=1 1.27- 1.292 1.29-2 1.45- 1.29-
6.
Effect of Cutting Time and Storage Time on the Nutritional Value of Stargrass Hay
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Ribeiro, Matheus Gonçalves
; Tres, Tamara Tais
; Bueno, Antonio Vinícius Iank
; Daniel, João Luiz Pratti
; Jobim, Clóves Cabreira
.
ABSTRACT. The objective of this study was to assess the effect of cutting time on the nutritional composition and dehydration rate of stargrass, as well as the nutritional value of the hay as a function of storage time. Two plant cutting times were analyzed: at 13:00 (H13) and 17:00 (H17). After cutting, the dehydration rate of both the plant and its fractions until baling was monitored. The bales were checked for nutritional composition and digestibility after 30, 60, 90 and 120 days. At the time of cutting, a difference was observed for the concentrations of ethanol-soluble carbohydrates, which were higher for H17 (90.3 g kg-1) compared to H13 (52.9 g kg-1). Leaf dehydration rates were higher in the H17 treatment. Cutting time had no influence on the nutritional value of the hay. With storage time, there was an increase in the levels of neutral detergent fiber and acid detergent fiber, and a reduction in the content of ethanol-soluble carbohydrates. It was concluded that cutting at 17:00 allows for a greater accumulation of soluble carbohydrates in the plant. Cutting time does not change the time required for dehydration and the nutritional value of the hay. Storage time reduces soluble components and increases fibrous constituents. ABSTRACT stargrass analyzed 1300 13 00 13:0 H (H13 1700 17 17:0 H17. . (H17) monitored 30 60 9 12 days ethanolsoluble ethanol H1 90.3 903 3 (90. kg1 kg 1 kg-1 52.9 529 52 (52. kg1. treatment constituents 130 0 13: (H1 170 17: (H17 6 90. (90 kg- 52. 5 (52 (H (9 (5 (
7.
Estatística Cardiovascular – Brasil 2023 202 20 2
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Oliveira, Gláucia Maria Moraes de
; Brant, Luisa Campos Caldeira
; Polanczyk, Carisi Anne
; Malta, Deborah Carvalho
; Biolo, Andreia
; Nascimento, Bruno Ramos
; Souza, Maria de Fatima Marinho de
; Lorenzo, Andrea Rocha De
; Fagundes Júnior, Antonio Aurélio de Paiva
; Schaan, Beatriz D.
; Silva, Christina Grüne de Souza e
; Castilho, Fábio Morato de
; Cesena, Fernando Henpin Yue
; Soares, Gabriel Porto
; Xavier Junior, Gesner Francisco
; Barreto Filho, Jose Augusto Soares
; Passaglia, Luiz Guilherme
; Pinto Filho, Marcelo Martins
; Machline-Carrion, M. Julia
; Bittencourt, Marcio Sommer
; Pontes Neto, Octavio M.
; Villela, Paolo Blanco
; Teixeira, Renato Azeredo
; Stein, Ricardo
; Sampaio, Roney Orismar
; Gaziano, Thomaz A.
; Perel, Pablo
; Roth, Gregory A.
; Ribeiro, Antonio Luiz Pinho
.
8.
An Approach of Colored Shade Nets on Photosynthetic Efficiency of Capsicum chinense and Capsicum frutescens
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Cruz, Renata Ranielly Pedroza
; Pereira, Ariana Mota
; Santos, Erli Pinto dos
; Silva, Toshik Iarley da
; Ferreira, Felipe Douglas
; Ribeiro, Wellington Souto
; Peternelli, Luiz Alexandre
; Grossi, José Antônio Saraiva
.
Brazilian Archives of Biology and Technology
- Métricas do periódico
Abstract This study aimed to assess the effect of red, pearl and aluminet shading nets on the photosynthetic efficiency of Capsicum chinense and C. frutescens. The experiment was carried in entirely randomized block design. C. chinense and C. frutescens were cultivated under red, pearl and aluminet with 35% shading and direct sunlight as control for 150 days. Leaf area, area duration and area ratio; specific leaf area and harvest index were higher in C. frutescens. Net CO2 assimilation and stomatal conductance were higher in C. frutescens cultivated under red net and C. chinense cultivated under aluminet net. Transpiration was higher in C. chinense cultivated under the aluminet net. Water use efficiency and relative chlorophyll content and intrinsic water use efficiency were higher in C. frutescens cultivated under the red net. Initial and maximum chlorophyll were also higher in C. frutescens cultivated under red net. Maximum quantum efficiency and chlorophyll fluorescence rate decrease were lower in C. chinense cultivated under red net. Linear flux electron was lower in C. chinense cultivated in the control. PSII open centers fraction was higher in control, pearl net for C. frutescens. Non-photochemical extinction coefficient and dissipation of absorbed light were higher in C. chinense cultivated under red net. C. frutescens cultivated under red net had higher photosynthetic efficiency, considering water use efficiency in dry matter conversion and several mechanisms to maximize the photosynthetic process under shaded conditions. C design 35 15 days ratio CO Nonphotochemical Non photochemical conditions 3 1
9.
Safety of CoronaVac and ChAdOx1 vaccines against SARS-CoV-2 in patients with rheumatoid arthritis: data from the Brazilian multicentric study safer ChAdOx SARSCoV2 SARSCoV SARS CoV 2 SARS-CoV- arthritis SARS-CoV
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Cruz, Vitor Alves
; Guimarães, Camila
; Rêgo, Jozelia
; Machado, Ketty Lysie Libardi Lira
; Miyamoto, Samira Tatiyama
; Burian, Ana Paula Neves
; Dias, Laiza Hombre
; Pretti, Flavia Zon
; Batista, Danielle Cristina Filgueira Alves
; Mill, José Geraldo
; Oliveira, Yasmin Gurtler Pinheiro de
; Gadelha, Carolina Strauss Estevez
; Gouveia, Maria da Penha Gomes
; Moulin, Anna Carolina Simões
; Souza, Bárbara Oliveira
; Aguiar, Laura Gonçalves Rodrigues
; Vieira, Gabriel Smith Sobral
; Grillo, Luiza Lorenzoni
; Lima, Marina Deorce de
; Pasti, Laís Pizzol
; Surlo, Heitor Filipe
; Faé, Filipe
; Moulaz, Isac Ribeiro
; Macabú, Mariana de Oliveira
; Ribeiro, Priscila Dias Cardoso
; Magalhães, Vanessa de Oliveira
; Aguiar, Mariana Freitas de
; Biegelmeyer, Erika
; Peixoto;, Flávia Maria Matos Melo Campos
; Kayser, Cristiane
; Souza, Alexandre Wagner Silva de
; Castro, Charlles Heldan de Moura
; Ribeiro, Sandra Lúcia Euzébio
; Telles, Camila Maria Paiva França
; Bühring, Juliana
; Lima, Raquel Lima de
; Santos, Sérgio Henrique Oliveira Dos
; Dias, Samuel Elias Basualto
; Melo, Natália Seixas de
; Sanches, Rosely Holanda da Silva
; Boechat, Antonio Luiz
; Sartori, Natália Sarzi
; Hax, Vanessa
; Dória, Lucas Denardi
; Rezende, Rodrigo Poubel Vieira de
; Baptista, Katia Lino
; Fortes, Natália Rodrigues Querido
; Melo, Ana Karla Guedes de
; Melo, Tâmara Santos
; Vieira, Rejane Maria Rodrigues de Abreu
; Vieira, Adah Sophia Rodrigues
; Kakehasi, Adriana Maria
; Tavares, Anna Carolina Faria Moreira Gomes
; Landa, Aline Teixeira de
; Costa, Pollyana Vitoria Thomaz da
; Azevedo, Valderilio Feijó
; Martins-Filho, Olindo Assis
; Peruhype-Magalhães, Vanessa
; Pinheiro, Marcelo de Medeiros
; Monticielo, Odirlei André
; Reis-neto, Edgard Torres Dos
; Ferreira, Gilda Aparecida
; Souza, Viviane Angelina de
; Teixeira-Carvalho, Andréa
; Xavier, Ricardo Machado
; Sato, Emilia Inoue
; Valim, Valeria
; Pileggi, Gecilmara Salviato
; Silva, Nilzio Antonio da
.
Abstract Background Patients with immune-mediated rheumatic diseases (IMRDs) have been prioritized for COVID-19 vaccination to mitigate the infection severity risks. Patients with rheumatoid arthritis (RA) are at a high risk of severe COVID-19 outcomes, especially those under immunosuppression or with associated comorbidities. However, few studies have assessed the safety of the COVID-19 vaccine in patients with RA. Objective To evaluate the safety of vaccines against SARS-CoV-2 in patients with RA. Methods This data are from the study “Safety and Efficacy on COVID-19 Vaccine in Rheumatic Diseases,” a Brazilian multicentric prospective phase IV study to evaluate COVID-19 vaccine in IMRDs in Brazil. Adverse events (AEs) in patients with RA of all centers were assessed after two doses of ChAdOx1 (Oxford/AstraZeneca) or CoronaVac (Sinovac/Butantan). Stratification of postvaccination AEs was performed using a diary, filled out daily and returned at the end of 28 days for each dose. Results A total of 188 patients with RA were include, 90% female. CoronaVac was used in 109 patients and ChAdOx1 in 79. Only mild AEs were observed, mainly after the first dose. The most common AEs after the first dose were pain at the injection (46,7%), headache (39,4%), arthralgia (39,4%), myalgia (30,5%) and fatigue (26,6%), and ChAdOx1 had a higher frequency of pain at the injection (66% vs 32 %, p < 0.001) arthralgia (62% vs 22%, p < 0.001) and myalgia (45% vs 20%, p < 0.001) compared to CoronaVac. The more common AEs after the second dose were pain at the injection (37%), arthralgia (31%), myalgia (23%), headache (21%) and fatigue (18%). Arthralgia (41,4% vs 25%, p = 0.02) and pain at injection (51,4% vs 27%, p = 0.001) were more common with ChAdOx1. No serious AEs were related. With Regard to RA activity level, no significant difference was observed between the three time periods for both COVID-19 vaccines. Conclusion In the comparison between the two immunizers in patients with RA, local reactions and musculoskeletal symptoms were more frequent with ChAdOx1 than with CoronaVac, especially after the first dose. In summary, the AE occurred mainly after the first dose, and were mild, like previous data from others immunizing agents in patients with rheumatoid arthritis. Vaccination did not worsen the degree of disease activity. immunemediated immune mediated (IMRDs COVID19 COVID 19 COVID-1 risks (RA outcomes comorbidities However SARSCoV2 SARSCoV SARS CoV 2 SARS-CoV- Safety Diseases, Diseases Brazil (AEs ChAdOx Oxford/AstraZeneca OxfordAstraZeneca Oxford AstraZeneca (Oxford/AstraZeneca Sinovac/Butantan. SinovacButantan Sinovac/Butantan . Sinovac Butantan (Sinovac/Butantan) diary 18 include 90 female 10 79 46,7%, 467 46,7% , 46 7 (46,7%) 39,4%, 394 39,4% 39 4 (39,4%) 30,5% 305 30 5 (30,5% 26,6%, 266 26,6% 26 6 (26,6%) 66% 66 (66 3 % 0.001 0001 0 001 62% 62 (62 22 22% 45% 45 (45 20 20% 37%, 37 37% (37%) 31%, 31 31% (31%) 23%, 23 23% (23%) 21% 21 (21% 18%. 18% (18%) 41,4% 414 41 (41,4 25 25% 0.02 002 02 51,4% 514 51 (51,4 27 27% related level summary COVID1 1 COVID- SARS-CoV (Sinovac/Butantan 9 46,7 (46,7% 39,4 (39,4% 30,5 (30,5 26,6 (26,6% (6 0.00 000 00 (4 (37% (31% (23% (21 (18% 41,4 (41, 0.0 51,4 (51, 46, (46,7 39, (39,4 30, (30, 26, (26,6 ( (37 (31 (23 (2 (18 41, (41 0. 51, (51 (46, (39, (30 (26, (3 (1 (5 (46 (39 (26
10.
Prognóstico de Pacientes Chagásicos e não Chagásicos Submetidos a Implante de Marca-passo e Ressincronizador Cardíaco em Centro Terciário Marcapasso Marca passo
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Vasconcelos, Laís Toledo de
; Martins, Larissa Natany Almeida
; França, Anna Terra
; Castilho, Fábio Morato de
; Ribeiro, Antônio Luiz Pinho
.
Resumo Fundamento: A cardiomiopatia chagásica (CCh) é responsável pelo implante de marca-passo (MP) em muitos pacientes, tendo sido associada a prognóstico adverso. Objetivos: Comparar o prognóstico da população chagásica e não chagásica submetida ao implante de MP e ressincronizador cardíaco. Métodos: Estudo observacional, retrospectivo, que analisou coorte de pacientes submetidos a implante desses dispositivos, em centro terciário, de outubro 2007 a dezembro de 2017, comparando o grupo de pacientes chagásicos com os não-chagásicos. O método não paramétrico de Kaplan-Meier foi utilizado para calcular a sobrevida dos pacientes. O nível de significância adotado na análise estatística foi de 5%. O desfecho primário foi a mortalidade por qualquer causa, enquanto os desfechos secundários foram a ocorrência de internação e o desfecho combinado internação e morte. Resultados: Um total de 911 pacientes foram incluídos, sendo que 23,4% apresentavam CCh. Em análise de Cox ajustada por sexo e idade, a doença de Chagas (dCh) não esteve associada ao risco aumentado de morte (HR: 1,14, IC:95%, 0,86-1,51, p=0,365), internação (HR: 0,79, IC:95%, 0,61-1,04, p=0,09) ou desfecho combinado morte e internação (HR: 0,90, IC:95%, 0,72-1,12, p=0,49). Conclusões: A dCh não se associou ao aumento do risco de morte, internação, ou desfecho combinado morte e internação, mesmo após ajuste para sexo e idade. Tais resultados se contrapõem aos de estudos prévios e sugerem modificação da qualidade do cuidado ao paciente cardiopata. Fundamento CCh (CCh marcapasso marca passo (MP adverso Objetivos cardíaco Métodos observacional retrospectivo dispositivos terciário 200 2017 nãochagásicos. nãochagásicos chagásicos. não-chagásicos KaplanMeier Kaplan Meier 5 5% causa Resultados 91 incluídos 234 23 4 23,4 idade (dCh HR (HR 114 1 14 1,14 IC95%, IC95 IC 95%, 95 IC:95% 0,861,51, 086151 0,86 1,51, 0 86 51 0,86-1,51 p=0,365, p0365 p p=0,365 , 365 p=0,365) 079 79 0,79 0,611,04, 061104 0,61 1,04, 61 04 0,61-1,04 p=0,09 p009 09 090 90 0,90 0,721,12, 072112 0,72 1,12, 72 12 0,72-1,12 p=0,49. p049 p=0,49 . 49 p=0,49) Conclusões cardiopata 20 201 9 2 23, 11 1,1 IC95% IC9 95% IC:95 861 0,861,51 08615 086 0,8 151 1,51 8 0,86-1,5 p036 p=0,36 36 07 7 0,7 611 0,611,04 06110 061 0,6 104 1,04 6 0,61-1,0 p=0,0 p00 0,9 721 0,721,12 07211 072 112 1,12 0,72-1,1 p04 p=0,4 1, IC:9 0,861,5 0861 08 0, 15 1,5 0,86-1, p03 p=0,3 3 0,611,0 0611 06 10 1,0 0,61-1, p=0, p0 0,721,1 0721 0,72-1, IC: 0,861, 0,86-1 0,611, 0,61-1 p=0 0,721, 0,72-1 0,861 0,86- 0,611 0,61- p= 0,721 0,72-
Abstract Background: Chagas cardiomyopathy (ChCC) is one of the causes of the implantation of pacemakers (PM) in many patients and has been associated with an adverse prognosis. Objectives: To compare the prognosis of the chagasic and non-chagasic populations undergoing PM and cardiac resynchronizer implantation. Methods: Observational, retrospective study, which analyzed a cohort of patients who underwent implantation of these devices, in a tertiary center, from October 2007 to December 2017, comparing the chagasic group with non-chagasic patients. The non-parametric Kaplan-Meier method was used to calculate patient survival. The significance level adopted in the statistical analysis was 5%. The primary outcome was mortality from any cause, while the secondary outcomes were the occurrence of hospitalization and the combination of hospitalization and death. Results: A total of 911 patients were included, of which 23.4% had ChCC. In a Cox analysis adjusted for sex and age, Chagas disease (ChD) was not associated with an increased risk of death (HR: 1.14, CI:95%, 0.86-1.51, p=0.365), hospitalization (HR: 0.79, CI:95%, 0.61-1.04, p=0.09) or combined outcome of death and hospitalization (HR: 0.90, CI:95%, 0.72-1 .12, p=0.49). Conclusions: ChD was not associated with an increased risk of death, hospitalization, or combined outcome of death and hospitalization, even after adjustment for sex and age. These results contrast with those of previous studies and suggest changes in the quality of care of patients with cardiomyopathy. Background ChCC (ChCC (PM Objectives nonchagasic non Methods Observational study devices center 200 2017 nonparametric parametric KaplanMeier Kaplan Meier survival 5 5% cause Results 91 included 234 23 4 23.4 age (ChD HR (HR 114 1 14 1.14 CI95%, CI95 CI 95%, 95 CI:95% 0.861.51, 086151 0.86 1.51, 0 86 51 0.86-1.51 p=0.365, p0365 p p=0.365 , 365 p=0.365) 079 79 0.79 0.611.04, 061104 0.61 1.04, 61 04 0.61-1.04 p=0.09 p009 09 090 90 0.90 0.721 0721 0.72 72 0.72- 12 .12 p=0.49. p049 p=0.49 . 49 p=0.49) Conclusions 20 201 9 2 23. 11 1.1 CI95% CI9 95% CI:95 861 0.861.51 08615 086 0.8 151 1.51 8 0.86-1.5 p036 p=0.36 36 07 7 0.7 611 0.611.04 06110 061 0.6 104 1.04 6 0.61-1.0 p=0.0 p00 0.9 721 072 .1 p04 p=0.4 1. CI:9 0.861.5 0861 08 0. 15 1.5 0.86-1. p03 p=0.3 3 0.611.0 0611 06 10 1.0 0.61-1. p=0. p0 CI: 0.861. 0.86-1 0.611. 0.61-1 p=0 0.861 0.86- 0.611 0.61- p=
11.
Diretriz de Avaliação Cardiovascular Perioperatória da Sociedade Brasileira de Cardiologia – 2024 202 20 2
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Gualandro, Danielle Menosi
; Fornari, Luciana Savoy
; Caramelli, Bruno
; Abizaid, Alexandre Antonio Cunha
; Gomes, Brenno Rizerio
; Tavares, Caio de Assis Moura
; Fernandes, Caio Julio Cesar dos Santos
; Polanczyk, Carisi Anne
; Jardim, Carlos
; Vieira, Carolina Leticia Zilli
; Pinho, Claudio
; Calderaro, Daniela
; Schreen, Dirk
; Marcondes-Braga, Fabiana Goulart
; Souza, Fábio de
; Cardozo, Francisco Akira Malta
; Tarasoutchi, Flavio
; Carmo, Gabriel Assis Lopes
; Kanhouche, Gabriel
; Lima, José Jayme Galvão de
; Bichuette, Luciana Dornfeld
; Sacilotto, Luciana
; Drager, Luciano Ferreira
; Vacanti, Luciano Janussi
; Gowdak, Luis Henrique Wolff
; Vieira, Marcelo Luiz Campos
; Martins, Marcelo Luiz Floriano Melo
; Lima, Márcio Silva Miguel
; Lottenberg, Marcos Pita
; Aliberti, Márlon Juliano Romero
; Marchi, Mauricio Felippi de Sá
; Paixão, Milena Ribeiro
; Oliveira Junior, Mucio Tavares de
; Yu, Pai Ching
; Cury, Patricia Ramos
; Farsky, Pedro Silvio
; Pessoa, Ranna Santos
; Siciliano, Rinaldo Focaccia
; Accorsi, Tarso Augusto Duenhas
; Correia, Vinícius Machado
; Mathias Junior, Wilson
.
12.
Study of the Nucleating Effect of Nanozirconia Obtained by Green Synthesis on Low-Density Polyethylene (LDPE) LowDensity Low Density LDPE (LDPE
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Silveira, Felipe Zanette da
; Fiori, Márcio Antônio
; Frizon, Tiago Elias Allievi
; Ribeiro, Luiz Fernando Belchior
; Colpani, Gustavo Lopes
; Riella, Humberto Gracher
.
The work evaluated the nucleating effect of nanometric zirconia (Zr-NP), obtained by the green sol-gel synthesis route using Euclea natalensis root extract as a reductant, in the low-density polyethylene (LDPE). The Zr-NP was characterized with x-ray diffraction (XRD) and transmission electron microscopy (TEM) which confirmed the presence of Zr-NP in the cubic crystalline phase with an average particle size of 6.73 nm. The Zr-NP was incorporated into the polymeric matrix by solubilization in concentrations ranging between 0 wt% and 6 wt%. Non-isothermal DSC analyzes demonstrated that a small addition of 1 wt% changes the degree of crystallinity from ~23% to ~56%, an increase of ~137%. The addition of Zr-NP also caused a small increase in crystallization and melting temperatures, and a large increase in the total crystallization time of LDPE. ZrNP, ZrNP Zr NP , (Zr-NP) solgel sol gel reductant lowdensity low density LDPE . (LDPE) xray x ray XRD (XRD TEM (TEM 673 73 6.7 nm wt Nonisothermal Non isothermal 23 ~23 56 ~56% 137 ~137% temperatures (Zr-NP (LDPE 67 7 6. 2 ~2 5 ~56 13 ~137 ~ ~5 ~13 ~1
13.
VATICAN (Ventilator-Associated Tracheobronchitis Initiative to Conduct Antibiotic Evaluation): protocol for a multicenter randomized open-label trial of watchful waiting versus antimicrobial therapy for ventilator-associated tracheobronchitis VentilatorAssociated Ventilator Associated Evaluation Evaluation) openlabel open label ventilatorassociated ventilator associated
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Tomazini, Bruno Martins
; Besen, Bruno Adler Maccagnan Pinheiro
; Dietrich, Camila
; Gandara, Ana Paula Rossi
; Silva, Debora Patrícia
; Pinheiro, Carla Cristina Gomes
; Luz, Mariane Nascimento
; Mattos, Renata Rodrigues de
; Reis, Luiz Fernando Lima
; Roepke, Roberta Muriel Longo
; Duarte, Carlos Sérgio Luna Gomes
; Nassar Júnior, Antônio Paulo
; Veiga, Viviane Cordeiro
; Arns, Beatriz
; Nascimento, Giovanna Marssola
; Pereira, Adriano José
; Cavalcanti, Alexandre Biasi
; Machado, Flávia Ribeiro
; Azevedo, Luciano Cesar Pontes
.
ABSTRACT Background Ventilator-associated tracheobronchitis is a common condition among invasively ventilated patients in intensive care units, for which the best treatment strategy is currently unknown. We designed the VATICAN (Ventilator-Associated Tracheobronchitis Initiative to Conduct Antibiotic Evaluation) trial to assess whether a watchful waiting antibiotic treatment strategy is noninferior to routine antibiotic treatment for ventilator-associated tracheobronchitis regarding days free of mechanical ventilation. Methods VATICAN is a randomized, controlled, open-label, multicenter noninferiority trial. Patients with suspected ventilator-associated tracheobronchitis without evidence of ventilator-associated pneumonia or hemodynamic instability due to probable infection will be assigned to either a watchful waiting strategy, without antimicrobial administration for ventilator-associated tracheobronchitis and prescription of antimicrobials only in cases of ventilator-associated pneumonia, sepsis or septic shock, or another infectious diagnosis, or to a routine antimicrobial treatment strategy for seven days. The primary outcome will be mechanical ventilation-free days at 28 days, and a key secondary outcome will be ventilator-associated pneumonia-free survival. Through an intention-to-treat framework with a per-protocol sensitivity analysis, the primary outcome analysis will address noninferiority with a 20% margin, which translates to a 1.5 difference in ventilator-free days. Other analyses will follow a superiority analysis framework. Conclusion The VATICAN trial will follow all national and international ethical standards. We aim to publish the trial in a high-visibility general journal and present it at critical care and infectious disease conferences for dissemination. These results will likely be immediately applicable to the bedside upon trial completion and will provide information with a low risk of bias for guideline development. Ventilatorassociated Ventilator associated units unknown VentilatorAssociated Associated Evaluation ventilatorassociated ventilator ventilation randomized controlled openlabel, openlabel open label, label open-label shock diagnosis ventilationfree 2 pneumoniafree survival intentiontotreat intention treat perprotocol per protocol 20 margin 15 1 5 1. ventilatorfree standards highvisibility high visibility dissemination development
RESUMO Contexto A traqueobronquite associada ao ventilador é uma condição comum entre pacientes ventilados invasivamente em unidades de terapia intensiva, para a qual se desconhece atualmente a melhor estratégia de tratamento. Desenhamos o estudo VATICAN (Ventilator-Associated Tracheobronchitis Initiative to Conduct Antibiotic Evaluation) para avaliar se uma estratégia de tratamento antibiótico de espera vigilante não é inferior ao tratamento antibiótico de rotina para traqueobronquite associada ao ventilador em relação aos dias sem ventilador mecânico. Métodos O VATICAN é um estudo randomizado, controlado, aberto e multicêntrico de não inferioridade. Os pacientes com suspeita de traqueobronquite associada ao ventilador sem evidência de pneumonia associada ao ventilador ou instabilidade hemodinâmica devido a uma provável infecção serão designados para uma estratégia de espera vigilante, sem administração profilática de antimicrobianos contra traqueobronquite associada ao ventilador e prescrição de antimicrobianos somente em casos de pneumonia associada ao ventilador, sepse ou choque séptico, ou outro diagnóstico infeccioso, ou para uma estratégia de tratamento antimicrobiano de rotina por 7 dias. O desfecho primário será o número de dias sem ventilador mecânico em 28 dias, e um desfecho secundário importante será a sobrevida sem pneumonia associada ao ventilador. Por meio de uma estrutura de intenção de tratar com análise de sensibilidade por protocolo, a análise do desfecho primário abordará a não inferioridade com margem de 20%, o que se traduz em uma diferença de 1,5 dia sem ventilador. Outras análises seguirão uma estrutura de análise de superioridade. Conclusão O VATICAN seguirá todos os padrões éticos nacionais e internacionais. O objetivo é publicar o estudo em um periódico geral de alta visibilidade e apresentá-lo em conferências de cuidados intensivos e doenças infecciosas para divulgação. Estes resultados provavelmente serão imediatamente aplicáveis à beira do leito após a conclusão do estudo e fornecerão informações com baixo risco de viés para o desenvolvimento de diretrizes. intensiva VentilatorAssociated Ventilator Associated Evaluation randomizado controlado séptico infeccioso 2 protocolo 20 20% 15 1 5 1, superioridade internacionais apresentálo apresentá lo divulgação diretrizes
14.
Mental health of Brazilian physicians: a nationwide cross-sectional study to investigate factors associated with the prevalence of suicide plans and attempts physicians crosssectional cross sectional
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Luz, Leonardo Servio
; Cassenote, Alex Jones Flores
; Valente, Emanuelle Pessa
; Mariani, Ilaria
; Lazzerini, Marzia
; Lima, Carlos Vital Tavares Corrêa
; Giamberardino Filho, Donizetti Dimer
; Marques Filho, Edmilson de Freitas
; von Tiesenhausen, Hermann Alexandre Vivacqua
; Cabeça, Hideraldo Luis Souza
; Damásio, Lia Cruz Vaz da Costa
; de Souza Júnior, Milton Aparecido
; de Souza, Paulo Henrique
; Rocha, Rosylane Nascimento das Mercês
; Zaher-Rutheford, Vera Lucia
; Ribeiro, Mauro Luiz de Britto
; da Silva, Antônio Geraldo
; Gallo, José Hiran da Silva
.
Objective: To report on suicide plans and attempts among Brazilian physicians and to investigate the associated risk factors. Methods: From January 2018 to January 2019, a nationwide online survey was conducted among Brazilian physicians using the Tool for Assessment of Suicide Risk and the Satisfaction with Life Scale. Multivariate exploratory associations of demographic, psychological, and work-related factors were performed on reports of suicide plans and attempts. Results: Of the 4,148 participants, 1,946 (53.5%) were male, 2,527 (60.9%) were 30 to 60 years old, 2,675 (64.5%) had two to four jobs, and 1,725 (41.6%) worked 40 to 60 hours a week. The overall prevalence of suicide plans was 8.8% (n=364), and suicide attempts were reported by 3.2% (n=133) of participants. Daily emotional exhaustion (ORadj = 7.857; 95%CI 2.282-27.051, p = 0.002), weekly emotional exhaustion (ORadj = 7.953; 95%CI 2.403-26.324, p = 0.001), daily frustration at work (ORadj = 3.093; 95%CI 1.711-5.588, p < 0.001), and bisexuality (ORadj = 5.083; 95%CI 2.544-10.158, p < 0.001) were significantly associated with higher odds of suicide. Extremely dissatisfied physicians reported suicide plans and attempts in 38.3% of cases, whereas extremely satisfied physicians reported suicide plans and attempts in only 2.8% of cases (p < 0.001). Conclusion: Brazilian physicians with a history of suicide plans and attempts express emotional exhaustion and frustration at work. There is an urgent need for actions to promote professional safeguards and resilience. Objective Methods 201 2019 Scale demographic psychological workrelated related Results 4148 4 148 4,14 participants 1946 1 946 1,94 53.5% 535 53 5 (53.5% male 2527 2 527 2,52 60.9% 609 9 (60.9% 3 6 old 2675 675 2,67 64.5% 645 64 (64.5% jobs 1725 725 1,72 41.6% 416 41 (41.6% week 88 8 8.8 n=364, n364 n n=364 , 364 (n=364) 32 3.2 n=133 n133 133 (n=133 ORadj 7.857 7857 7 857 95CI CI 95 2.28227.051, 228227051 2.282 27.051, 282 27 051 2.282-27.051 0.002, 0002 0.002 0 002 0.002) 7.953 7953 953 2.40326.324, 240326324 2.403 26.324, 403 26 324 2.403-26.324 0.001, 0001 0.001 001 3.093 3093 093 1.7115.588, 17115588 1.711 5.588, 711 588 1.711-5.588 5.083 5083 083 2.54410.158, 254410158 2.544 10.158, 544 10 158 2.544-10.158 383 38 38.3 28 2.8 0.001. . Conclusion resilience 20 414 14 4,1 194 94 1,9 53.5 (53.5 252 52 2,5 60.9 (60.9 267 67 2,6 64.5 (64.5 172 72 1,7 41.6 (41.6 8. n36 n=36 36 (n=364 3. n=13 n13 13 (n=13 7.85 785 85 28227 2.28227.051 22822705 2282 2.28 27051 27.051 05 2.282-27.05 000 0.00 00 7.95 795 40326 2.40326.324 24032632 2403 2.40 26324 26.324 2.403-26.32 3.09 309 09 7115 1.7115.588 1711558 1711 1.71 5588 5.588 71 58 1.711-5.58 5.08 508 08 54410 2.54410.158 25441015 2544 2.54 10158 10.158 54 15 2.544-10.15 38. 2. 4, 19 1, 53. (53. 25 2, 60. (60. 64. (64. 17 41. (41. n3 n=3 (n=36 n=1 n1 (n=1 7.8 78 2822 2.28227.05 2282270 228 2.2 2705 27.05 2.282-27.0 0.0 7.9 79 4032 2.40326.32 2403263 240 2.4 2632 26.32 2.403-26.3 3.0 1.7115.58 171155 171 1.7 558 5.58 1.711-5.5 5.0 50 5441 2.54410.15 2544101 254 2.5 1015 10.15 2.544-10.1 (53 (60 (64 (41 n= (n=3 (n= 7. 2.28227.0 228227 22 270 27.0 2.282-27. 0. 2.40326.3 240326 24 263 26.3 2.403-26. 1.7115.5 17115 1. 55 5.5 1.711-5. 5. 2.54410.1 254410 101 10.1 2.544-10. (5 (6 (4 (n 2.28227. 22822 27. 2.282-27 2.40326. 24032 26. 2.403-26 1.7115. 1.711-5 2.54410. 25441 10. 2.544-10 ( 2.28227 2.282-2 2.40326 2.403-2 1.7115 1.711- 2.54410 2.544-1 2.2822 2.282- 2.4032 2.403- 2.5441 2.544-
15.
Catálogo Taxonômico da Fauna do Brasil: Setting the baseline knowledge on the animal diversity in Brazil Brasil
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Boeger, Walter A.
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; Albuquerque, Flávio
; Molina, Flavio B.
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; Nascimento, Francisco E. de L.
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; Oliveira, Francisco L. de
; Melo, Francisco T. de V.
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; Queiroz, Gabriel C.
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; Rocha, Leonardo S.G.
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; Santarém, Maria C.A.
; Nascimento, Maria C. do
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; Araújo, Paula B.
; Silva, Paula K.R.
; Riccardi, Paula R.
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; Passos, Paulo G.H.
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; Duarte, Paulo R.M.
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; Boldrini, Rafael
; Silva, Rafaela A. da
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; Constantino, Reginaldo
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; Carrenho, Renan
; Gomes, Renata S.
; Gregorin, Renato
; Machado, Renato J.P.
; Bérnils, Renato S.
; Capellari, Renato S.
; Silva, Ricardo B.
; Kawada, Ricardo
; Dias, Ricardo M.
; Siewert, Ricardo
; Brugnera, Ricaro
; Leschen, Richard A.B.
; Constantin, Robert
; Robbins, Robert
; Pinto, Roberta R.
; Reis, Roberto E. dos
; Ramos, Robson T. da C.
; Cavichioli, Rodney R.
; Barros, Rodolfo C. de
; Caires, Rodrigo A.
; Salvador, Rodrigo B.
; Marques, Rodrigo C.
; Araújo, Rodrigo C.
; Araujo, Rodrigo de O.
; Dios, Rodrigo de V.P.
; Johnsson, Rodrigo
; Feitosa, Rodrigo M.
; Hutchings, Roger W.
; Lara, Rogéria I.R.
; Rossi, Rogério V.
; Gerstmeier, Roland
; Ochoa, Ronald
; Hutchings, Rosa S.G.
; Ale-Rocha, Rosaly
; Rocha, Rosana M. da
; Tidon, Rosana
; Brito, Rosangela
; Pellens, Roseli
; Santos, Sabrina R. dos
; Santos, Sandra D. dos
; Paiva, Sandra V.
; Santos, Sandro
; Oliveira, Sarah S. de
; Costa, Sávio C.
; Gardner, Scott L.
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; Sepulveda, Tatiana A.
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; Leite, Yuri L.R.
.
ABSTRACT The limited temporal completeness and taxonomic accuracy of species lists, made available in a traditional manner in scientific publications, has always represented a problem. These lists are invariably limited to a few taxonomic groups and do not represent up-to-date knowledge of all species and classifications. In this context, the Brazilian megadiverse fauna is no exception, and the Catálogo Taxonômico da Fauna do Brasil (CTFB) (http://fauna.jbrj.gov.br/), made public in 2015, represents a database on biodiversity anchored on a list of valid and expertly recognized scientific names of animals in Brazil. The CTFB is updated in near real time by a team of more than 800 specialists. By January 1, 2024, the CTFB compiled 133,691 nominal species, with 125,138 that were considered valid. Most of the valid species were arthropods (82.3%, with more than 102,000 species) and chordates (7.69%, with over 11,000 species). These taxa were followed by a cluster composed of Mollusca (3,567 species), Platyhelminthes (2,292 species), Annelida (1,833 species), and Nematoda (1,447 species). All remaining groups had less than 1,000 species reported in Brazil, with Cnidaria (831 species), Porifera (628 species), Rotifera (606 species), and Bryozoa (520 species) representing those with more than 500 species. Analysis of the CTFB database can facilitate and direct efforts towards the discovery of new species in Brazil, but it is also fundamental in providing the best available list of valid nominal species to users, including those in science, health, conservation efforts, and any initiative involving animals. The importance of the CTFB is evidenced by the elevated number of citations in the scientific literature in diverse areas of biology, law, anthropology, education, forensic science, and veterinary science, among others. publications problem uptodate up date classifications context exception (CTFB http//fauna.jbrj.gov.br/, httpfaunajbrjgovbr http //fauna.jbrj.gov.br/ , jbrj gov br (http://fauna.jbrj.gov.br/) 2015 Brazil 80 specialists 1 2024 133691 133 691 133,69 125138 125 138 125,13 82.3%, 823 82 3 (82.3% 102000 102 000 102,00 7.69%, 769 7 69 (7.69% 11000 11 11,00 . 3,567 3567 567 (3,56 2,292 2292 2 292 (2,29 1,833 1833 833 (1,83 1,447 1447 447 (1,44 1000 1,00 831 (83 628 (62 606 (60 520 (52 50 users science health biology law anthropology education others http//fauna.jbrj.gov.br/ faunajbrjgovbr //fauna.jbrj.gov.br (http://fauna.jbrj.gov.br/ 201 8 202 13369 13 133,6 12513 12 125,1 82.3% (82.3 10200 10 00 102,0 7.69% 76 6 (7.69 1100 11,0 3,56 356 56 (3,5 2,29 229 29 (2,2 1,83 183 83 (1,8 1,44 144 44 (1,4 100 1,0 (8 62 (6 60 52 (5 5 http//fauna.jbrj.gov.br (http://fauna.jbrj.gov.br 20 1336 133, 1251 125, 82.3 (82. 1020 0 102, 7.69 (7.6 110 11, 3,5 35 (3, 2,2 22 (2, 1,8 18 (1, 1,4 14 4 ( 82. (82 7.6 (7. 3, (3 2, (2 (1 7. (7
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