In this conceptual paper, we review literature on entrepreneurship education with the aim of determining viable approaches for teaching entrepreneurship using online platforms. We discuss existing studies on constructivism as a theoretical framework and examine how entrepreneurship education can be offered through online teaching, as well as the effectiveness and the design of online teaching for entrepreneurship education. We used a conceptual analysis methodology and also conducted a library search to examine previous pertinent literature on online entrepreneurship education. Our findings indicate that online entrepreneurship education should be grounded in constructivism as a learning theory. Additionally, during online entrepreneurship learning, lecturers should introduce and explain new concepts by using students' prior knowledge and should assign practical and experiential tasks. Our findings also show that online activities should allow students to interpret and assimilate new knowledge, and that online entrepreneurship modules should incorporate learning by doing and experiential learning. Lecturers should also provide feedback as part of online entrepreneurship learning and, at the end of such learning, lecturers should assign online questions that provide an opportunity for students to reflect on their learning and knowledge.

RESUMO Objetivo Comparar o uso de um guia cirúrgico dinâmico (PediGuard®) e o preparo de orifício piloto com uma sonda e o auxílio de fluoroscopia em pacientes com osteopenia ou osteoporose submetidos à fixação pedicular da coluna torácica ou lombar. Métodos Cento e oito pacientes foram randomizados. Um orifício piloto foi preparado com o guia cirúrgico dinâmico (PediGuard®) ou com uma sonda com auxílio de fluoroscopia. Foram incluídos no estudo 657 pedículos vertebrais (120 torácicos e 180 lombares). Os parâmetros usados para a comparação foram: acurácia da colocação do parafuso pedicular, número de disparos fluoroscópicos e mudança da trajetória intraoperatória da perfuração depois da detecção de ruptura da parede do pedículo. Resultados No grupo de pacientes em que se usou o guia cirúrgico dinâmico, observou-se mau posicionamento dos parafusos pediculares em oito (2,6%) pacientes e alteração da trajetória intraoperatória da perfuração em 12 (4%) pacientes, com 52 disparos fluoroscópicos. No grupo de pacientes em que o guia cirúrgico dinâmico (PediGuard®) não foi usado o mau posicionamento dos parafusos pediculares foi observado em 33 (11%) pacientes, a mudança intraoperatória da trajetória da perfuração foi vista em 47 (13,2%) pacientes, com 136 disparos fluoroscópicos. Conclusão O uso do guia cirúrgico dinâmico (PediGuard®) em pacientes com osteoporose ou osteopenia permitiu a colocação de parafusos pediculares com maior acurácia, com menor alteração da trajetória intraoperatória da perfuração e menor dose de radiação intraoperatória. Nível de Evidência II; Estudo clínico randomizado de menor qualidade.

ABSTRACT Objective To compare the use of a dynamic surgical guide (PediGuard®) and pilot hole preparation, with the use of a probe and the aid of fluoroscopy in osteoporotic or osteopenic patients undergoing pedicular fixation of the thoracic or lumbar spine. Methods One hundred and eight patients were randomized. A pilot hole was prepared with the dynamic surgical guide (PediGuard®), or with a probe with the aid of fluoroscopy. A total of 657 vertebral pedicles (120 thoracic and 180 lumbar) were included in the study. The parameters used for the comparison were: accuracy of the pedicular screw, number of fluoroscopic shots, and change in intraoperative trajectory of the perforation after detecting pedicle wall rupture. Results In the group with use of the dynamic surgical guide, malpositioning of the pedicle screws was observed in 8 (2.6%) patients and intraoperative change of perforation trajectory in 12 (4%) patients, and there were 52 fluoroscopic shots. In the group without use of the dynamic surgical guide (PediGuard®), misplacement of the pedicle screws was observed in 33 (11%) patients and intraoperative change of perforation trajectory in 47 (13.2%) patients, and there were 136 fluoroscopic shots. Conclusion The use of the dynamic surgical guide (PediGuard®) in patients with osteoporosis or osteopenia enabled more accurate placement of pedicular screws, with less change in the intraoperative course of the perforation and less intraoperative radiation. Level of Evidence II; Randomized clinical trial of lesser quality.

RESUMEN Objetivo Comparar el uso de una guía quirúrgica dinámica (PediGuard®) y la preparación del orificio piloto con una sonda y la ayuda de fluoroscopia en pacientes con osteopenia u osteoporosis sometidos a fijación pedicular de la columna torácica o lumbar. Métodos Ciento ocho pacientes fueron asignados aleatoriamente. Se preparó un orificio piloto preparado con la guía quirúrgica dinámica (PediGuard®) o con una sonda con ayuda de fluoroscopia. Se incluyeron en el estudio 657 pedículos vertebrales (120 torácicos y 180 lumbares). Los parámetros utilizados para la comparación fueron: precisión de la colocación del tornillo pedicular, número de disparos del dispositivo de fluoroscopia y cambio en la trayectoria intraoperatoria de la perforación después de la detección de ruptura de la pared del pedículo. Resultados En el grupo de pacientes en el que se utilizó la guía quirúrgica dinámica, se observó mal posicionamiento de los tornillos pediculares en 8 (2,6%) pacientes y cambios de la trayectoria intraoperatoria de la perforación en 12 (4%) pacientes, con 52 disparos del aparato de fluoroscopia. En el grupo de pacientes en los que no se utilizó la guía quirúrgica dinámica (PediGuard®), se observó un mal posicionamiento de los tornillos pediculares en 33 (11%) pacientes, el cambio intraoperatorio de la trayectoria de perforación se observó en 47 (13,2%) pacientes, con 136 disparos fluoroscópicos. Conclusión El uso de la guía quirúrgica dinámica (PediGuard®) en pacientes con osteoporosis u osteopenia permitió la colocación de tornillos pediculares con mayor precisión, menos cambios en la trayectoria intraoperatoria de la perforación y dosis más baja de radiación intraoperatoria. Nivel de Evidencia II; Ensayo clínico aleatorizado de menor calidad.

O recrutamento do volume pulmonar envolve técnicas de insuflações pulmonares profundas para se atingir a capacidade de insuflação máxima em pacientes com fraqueza da musculatura respiratória, a fim de aumentar o pico de fluxo da tosse e assim auxiliar a manutenção da patência de vias aéreas e melhorar a ventilação. Uma dessas técnicas é o empilhamento de ar, na qual se utiliza um ressuscitador manual para insuflar os pulmões. Embora as pressões intratorácicas possam aumentar consideravelmente, não há relatos de complicações por empilhamento de ar. Entretanto, atingir a capacidade de insuflação máxima não é recomendado em pacientes com anormalidades na estrutura pulmonar ou doença obstrutiva crônica das vias aéreas. Relatamos o caso de uma paciente de 72 anos que teve poliomielite quando criança, desenvolveu escoliose de torção e síndrome pós-pólio e tinha exacerbações de asma periódicas, mas infrequentes. Após realizar empilhamento de ar por 3 anos, a paciente subitamente desenvolveu pneumotórax, mostrando que essa técnica deve ser utilizada com cuidado ou não ser utilizada por pacientes com patologia pulmonar conhecida

Lung volume recruitment involves deep inflation techniques to achieve maximum insufflation capacity in patients with respiratory muscle weakness, in order to increase peak cough flow, thus helping to maintain airway patency and improve ventilation. One of these techniques is air stacking, in which a manual resuscitator is used in order to inflate the lungs. Although intrathoracic pressures can rise considerably, there have been no reports of respiratory complications due to air stacking. However, reaching maximum insufflation capacity is not recommended in patients with known structural abnormalities of the lungs or chronic obstructive airway disease. We report the case of a 72-year-old woman who had poliomyelitis as a child, developed torsion scoliosis and post-polio syndrome, and had periodic but infrequent asthma attacks. After performing air stacking for 3 years, the patient suddenly developed a pneumothorax, indicating that this technique should be used with caution or not at all in patients with a known pulmonary pathology

OBJECTIVE: To estimate the burden and age-specific rates of influenza-associated hospitalization in rural western Kenya. METHODS: All 3924 patients with respiratory illness (defined as acute cough, difficulty in breathing or pleuritic chest pain) who were hospitalized between June 2007 and May 2009 in any inpatient health facility in the Kenyan district of Bondo were enrolled. Nasopharyngeal and oropharyngeal swabs were collected and tested for influenza viruses using real-time reverse transcriptase polymerase chain reaction (RT-PCR). In the calculation of annual rates, adjustments were made for enrolled patients who did not have swabs tested for influenza virus. FINDINGS: Of the 2079 patients with tested swabs, infection with influenza virus was confirmed in 204 (10%); 176, 27 and 1 were found to be RT-PCR-positive for influenza A virus only, influenza B virus only, and both influenza A and B viruses, respectively. Among those tested for influenza virus, 6.8% of the children aged <5 years and 14.0% of the patients aged >5 years were found positive. The case-fatality rate among admitted patients with PCR-confirmed infection with influenza virus was 2.0%. The annual rate of hospitalization (per 100000 population) was 699.8 among patients with respiratory illness and 56.2 among patients with influenza (with 143.7, 18.8, 55.2, 65.1 and 57.3 hospitalized patients with influenza virus per 100000 people aged <5, 5-19, 20-34, 35-49 and >50 years, respectively). CONCLUSION: In a rural district of western Kenya, the rate of influenza-associated hospitalization was highest among children aged less than 5 years.

OBJETIVO: Calcular la carga y las tasas por edades de las hospitalizaciones asociadas a la gripe en el oeste rural de Kenya. MÉTODOS: Se inscribieron los 3924 pacientes con enfermedades respiratorias (definidas como tos aguda, dificultad para respirar o dolor torácico pleurítico) hospitalizados entre junio de 2007 y mayo de 2009 en cualquier centro sanitario hospitalario del distrito keniata de Bodo. Se recogieron frotis nasofaríngeos y bucofaríngeos y se comprobó la presencia de virus de la gripe mediante una reacción en cadena de la polimerasa dirigida por ARN (transcriptasa inversa) (RT-PCR). Se llevaron a cabo ajustes para aquellos pacientes inscritos para cuyos frotis no se había realizado la prueba del virus de la gripe para realizar el cálculo de las tasas anuales. RESULTADOS: Se confirmó la presencia de una infección por virus de la gripe en 204 (10%) de los 2079 pacientes cuyos frotis se sometieron a prueba; 176, 27 y 1 casos dieron positivo en la prueba de la RT-PCR sólo para el virus gripal A, sólo para el virus gripal B y para ambos virus gripales A y B, respectivamente. El 6,8% de los niños menores de 5 años y el 14,0% de los pacientes mayores de 5 años entre los que se realizó la prueba para el virus gripal dio positivo. La tasa de letalidad entre los pacientes admitidos con una infección por el virus gripal confirmada por la prueba de la PCR fue del 2,0% La tasa anual de hospitalizaciones (por cada 100 000 habitantes) fue de 699,8 entre pacientes con enfermedades respiratorias y de 56,2 entre los pacientes con gripe (con 143,7, 18,8, 55,2, 65,1 y 57,3 pacientes hospitalizados con virus gripal por cada 100 000 habitantes con edades menores de 5, comprendidas entre 5-19, 20-34, 35-49 y más de 50 años, respectivamente). CONCLUSIÓN: En un distrito rural del oeste de Kenya, la tasa de hospitalizaciones asociadas a la gripe fue más alta entre los niños menores de 5 años.

OBJECTIF: Estimer les taux spécifiques par âge et par charge de l'hospitalisation liée à la grippe dans les régions rurales de l'ouest du Kenya. MÉTHODES: Tous les 3924 patients souffrant de maladie respiratoire (définies comme toux aiguë, difficulté respiratoire ou douleur de poitrine pleurétique) qui ont été hospitalisés entre juin 2007 et mai 2009 dans tous les établissements hospitaliers du district du Bondo, au Kenya, ont été inscrits. Des prélèvements nasopharyngés et oropharyngés ont été rassemblés et testés pour les virus de la grippe au moyen d'une transcription inverse et amplification en chaîne par polymérase en temps réel (RT-PCR). Dans le calcul des taux annuels, des ajustements ont été faits pour les patients inscrits qui n'ont pas eu de prélèvements testés pour le virus de la grippe. RÉSULTATS: Des 2079 patients avec prélèvements testés, l'infection au virus de la grippe a été confirmée dans 204 (10%) des cas; 176, 27 et 1 cas se sont révélés RT-PCR positifs pour, respectivement, le virus de la grippe A uniquement, le virus de la grippe B uniquement, les virus des deux grippes A et B. Parmi les personnes testées pour le virus de la grippe, 6,8% des enfants âgés de <5 ans et 14,0% des patients âgés de 5 ans ou plus se sont révélés positifs. Le taux de létalité parmi les patients admis avec infection confirmée PCR au virus de la grippe était de 2.0%. Le taux annuel d'hospitalisation (par 100 000 habitants) était de 699,8 parmi les patients souffrant de maladie respiratoire et de 56,2 parmi les patients souffrant de la grippe (avec 143,7, 18,8, 55,2, 65,1 et 57,3 des patients hospitalisés avec le virus de la grippe par 100 000 personnes âgés de respectivement <5, 5-19, 20-34, 35-49 et >50 ans). CONCLUSION: Dans une région rurale de l'ouest du Kenya, le taux d'hospitalisation liée à la grippe était plus élevé parmi les enfants âgés de moins de 5 ans.

Trypanosoma cruzi and Trypanosoma rangeli-like trypanosomes have been found in a variety of neotropical bat species. In this study, bats (Artibeus lituratus, Carollia perspicillata, Desmodus rotundus, Glossophaga soricina, Molossus molossus, Phyllostomus hastatus) were maintained under controlled conditions, and experiments were conducted to determine how they might become infected naturally with trypanosomes. All bats were first screened for existing infections by hemoculture and the examination of blood smears, and only apparently uninfected animals were then used in the experiments. Proof was obtained that the triatomine bug Rhodnius prolixus would readily feed upon some of the bats, and two species became infected after being bitten by bugs infected with T. rangeli. Some bats also became infected by ingesting R. prolixus carrying T. cruzi, or following subcutaneous or intragastic inoculation with fecal suspensions of R. prolixus containing T. cruzi. P. hastatus became infected after ingesting mice carrying T. cruzi. All of the bats studied inhabit roosts that may be occupied by triatomine bugs and, with the exception of D. rotundus, all also feed to at least some extent upon insects. These findings provide further evidence of how bats may play significant roles in the epidemiology of T. cruzi and T. rangeli in the New World tropics.