18 research outputs found
Maximal Oxygen Uptake, Muscular Oxidative Capacity, and Ventilatory Threshold in Amateur Triathletes: Eight-Month Training Follow-Up
O Largo da Banana e a presença negra em São Paulo
The Largo da Banana relates to the history of the black population in São Paulo. Acknowledged as one of São Paulo’s “cradle” of samba, samba musicians are its main spokespersons. Largo da Banana used to be located near the former Barra Funda Railway Station. From the first decades to around half the Twentieth century, informal laborers in the railway logistics used to gather together in that space. Within a precarious and unsteady daily life, they used to play samba and tiririca. In the fifties, the municipality built the Pacaembu Viaduct in that area, aiming to extend the homonym avenue beyond the railway road. In the sixties, samba musician Geraldo Filme wrote two songs in which he paid homage to Largo da Banana and regrettedits disappearance after the viaduct’s inauguration. In these and other of his songs, the artist recorded his perceptions on the life conditions of São Paulo’s blacks and samba musicians, their sociabilities, and also the urban changes he witnessed. Considering that his artistic work contributes to enlighten aspects of social reality, I analyze some of his songs to interpret the sociabilities at Largo da Banana, as well as the urban intervention in that location.O Largo da Banana está associado à história da população negra em São Paulo. Reconhecido como um dos “berços” do samba paulista, é sobretudo através dos próprios sambistas que essa história pode hoje ser conhecida. Localizado junto à antiga estação da Barra Funda, desde as primeiras décadas até meados do século passado, aquele espaço concentrou trabalhadores informais vinculados às atividades da ferrovia. Em meio a um cotidiano precário e instável, essa população realizava rodas de samba e de tiririca. Nos anos 1950, foi construído naquele local o Viaduto Pacaembu, que prolongava a avenida homônima para além davia férrea. A partir da década de 1960, o sambista negro Geraldo Filme compôs duas canções em que homenageava o Largo da Banana e lamentava seu desaparecimento após a inauguração do viaduto. Nessas e em outras composições, o artista registrou suas percepções sobre as condições de vida da população negra e sambista na cidade, suas sociabilidades, bem como sobre as transformações urbanas que testemunhou. Considerando que sua obra artística contribui para iluminar aspectos da realidade social, ela é adotada como fonte para analisar as formas de sociabilidade no Largo da Banana e a intervenção urbanística naquele local
Pervasive gaps in Amazonian ecological research
Biodiversity loss is one of the main challenges of our time,1,2 and attempts to address it require a clear un derstanding of how ecological communities respond to environmental change across time and space.3,4
While the increasing availability of global databases on ecological communities has advanced our knowledge
of biodiversity sensitivity to environmental changes,5–7 vast areas of the tropics remain understudied.8–11 In
the American tropics, Amazonia stands out as the world’s most diverse rainforest and the primary source of
Neotropical biodiversity,12 but it remains among the least known forests in America and is often underrepre sented in biodiversity databases.13–15 To worsen this situation, human-induced modifications16,17 may elim inate pieces of the Amazon’s biodiversity puzzle before we can use them to understand how ecological com munities are responding. To increase generalization and applicability of biodiversity knowledge,18,19 it is thus
crucial to reduce biases in ecological research, particularly in regions projected to face the most pronounced
environmental changes. We integrate ecological community metadata of 7,694 sampling sites for multiple or ganism groups in a machine learning model framework to map the research probability across the Brazilian
Amazonia, while identifying the region’s vulnerability to environmental change. 15%–18% of the most ne glected areas in ecological research are expected to experience severe climate or land use changes by
2050. This means that unless we take immediate action, we will not be able to establish their current status,
much less monitor how it is changing and what is being lostinfo:eu-repo/semantics/publishedVersio
Pervasive gaps in Amazonian ecological research
Biodiversity loss is one of the main challenges of our time,1,2 and attempts to address it require a clear understanding of how ecological communities respond to environmental change across time and space.3,4 While the increasing availability of global databases on ecological communities has advanced our knowledge of biodiversity sensitivity to environmental changes,5,6,7 vast areas of the tropics remain understudied.8,9,10,11 In the American tropics, Amazonia stands out as the world's most diverse rainforest and the primary source of Neotropical biodiversity,12 but it remains among the least known forests in America and is often underrepresented in biodiversity databases.13,14,15 To worsen this situation, human-induced modifications16,17 may eliminate pieces of the Amazon's biodiversity puzzle before we can use them to understand how ecological communities are responding. To increase generalization and applicability of biodiversity knowledge,18,19 it is thus crucial to reduce biases in ecological research, particularly in regions projected to face the most pronounced environmental changes. We integrate ecological community metadata of 7,694 sampling sites for multiple organism groups in a machine learning model framework to map the research probability across the Brazilian Amazonia, while identifying the region's vulnerability to environmental change. 15%–18% of the most neglected areas in ecological research are expected to experience severe climate or land use changes by 2050. This means that unless we take immediate action, we will not be able to establish their current status, much less monitor how it is changing and what is being lost
Pervasive gaps in Amazonian ecological research
Biodiversity loss is one of the main challenges of our time,1,2 and attempts to address it require a clear understanding of how ecological communities respond to environmental change across time and space.3,4 While the increasing availability of global databases on ecological communities has advanced our knowledge of biodiversity sensitivity to environmental changes,5,6,7 vast areas of the tropics remain understudied.8,9,10,11 In the American tropics, Amazonia stands out as the world's most diverse rainforest and the primary source of Neotropical biodiversity,12 but it remains among the least known forests in America and is often underrepresented in biodiversity databases.13,14,15 To worsen this situation, human-induced modifications16,17 may eliminate pieces of the Amazon's biodiversity puzzle before we can use them to understand how ecological communities are responding. To increase generalization and applicability of biodiversity knowledge,18,19 it is thus crucial to reduce biases in ecological research, particularly in regions projected to face the most pronounced environmental changes. We integrate ecological community metadata of 7,694 sampling sites for multiple organism groups in a machine learning model framework to map the research probability across the Brazilian Amazonia, while identifying the region's vulnerability to environmental change. 15%–18% of the most neglected areas in ecological research are expected to experience severe climate or land use changes by 2050. This means that unless we take immediate action, we will not be able to establish their current status, much less monitor how it is changing and what is being lost
Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study
Summary
Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally.
Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies
have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of
the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income
countries globally, and identified factors associated with mortality.
Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to
hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis,
exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a
minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical
status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary
intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause,
in-hospital mortality for all conditions combined and each condition individually, stratified by country income status.
We did a complete case analysis.
Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital
diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal
malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome
countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male.
Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3).
Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income
countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups).
Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome
countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries;
p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients
combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11],
p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20
[1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention
(ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety
checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed
(ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of
parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65
[0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality.
Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome,
middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will
be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger
than 5 years by 2030
Estudo de mobilidade eficiente de transporte urbano na cidade de Cajazeiras, PB
Relata resultado do projeto de extensão “Estudo de mobilidade urbana eficiente e transporte não-motorizado para Cajazeiras-PB”. O projeto teve como objetivo elaborar um diagnóstico local de mobilidade urbana na cidade de Cajazeira, PB a fim de contribuir na elaboração do plano municipal de mobilidade urbana local, a ser elaborado em conjunto com os parceiros sociais, com foco no deslocamento por modais não-motorizados, caracterizados por pedestres e ciclista. Procedimentos metodológicos: pesquisa bibliográfica; Pesquisa documental; Pesquisa de campo por meio de contagem de fluxos e análise de calçadas pela Técnica Safári Urbano. Concluiu-se que a cidade apresenta visível e crescente aumento do uso de automóveis particulares como opção de locomoção elegida por grande parte dos frequentadores do lugar e um consequente esgotamento das estruturas viárias existentes, necessitando também de manutenção local. Por outro lado, ressalta-se que o transporte coletivo público municipal apresenta-se como ínfimo e existem poucas normalizações com foco no transporte não-motorizado, caracterizado por pedestres e ciclistas, incluindo equipamentos e sinalização, além de ausentes medidas de moderação de velocidade
Cirurgia no câncer colorretal: abordagem cirúrgica de 74 pacientes do SUS portadores de câncer colorretal em programa de pós-graduação lato sensu em coloproctologia Surgery in colorectal cancer: surgical approach of 74 patients from the Brazilian National Health System with colorectal cancer in a postgraduate program (residency) in coloproctology
A análise retrospectiva de 74 prontuários de pacientes do Sistema Único de Saúde (SUS), operados de câncer colorretal pelo Residente R2 supervisionado e auxiliado por preceptores, permitiu as seguintes conclusões: a média etária dos pacientes foi 57,2, sendo as sexta e sétima décadas responsáveis por 51,4% dos pacientes. O câncer retal foi preponderante nas mulheres (54,1%). As localizações mais comuns dos tumores foram no sigmoide (31,1%), reto alto (24,3%) e ceco (17,6%). As cirurgias mais realizadas foram a retossigmoidectomia com anastomose colorretal (36,6%), e hemicolectomia direita com anastomose íleo-transverso (21,7%). As características anatômicas dos tumores, baseadas na classificação TNM, mais comuns foram: T3 (62,1%), N0 (59,5%) e M0 (77,0%) (p<0,05). O número médio de gânglios encontrados nas peças cirúrgicas foi de 10,4. Foram feitas 63 anastomoses (85,1%), das quais 38 (60,3%) foram mecânicas e 25, manuais (39,7%). Houve 14 comorbidades (18,9%), destacando-se a caquexia (oito casos). O índice de complicações cirúrgicas foi de 12,2% (nove casos), sendo as cirurgias que mais causaram complicações as colectomias totais com anastomose íleo-retal (40,0%) e as retossigmoidectomias abdominais, com duplo grampeamento (20%), sendo as complicações mais comuns as fístulas anastomóticas (cinco casos). As complicações (nove) decorreram mais das comorbidades (sete) que do ato cirúrgico (duas). As cirurgias que demandaram menos tempo foram: as laparotomias com ileostomia (média de 75 minutos) e as com colostomia (média de 95 minutos), sendo os maiores tempos ocupados pela proctocolectomia total com ileostomia definitiva (240 minutos) e as hemicolectomias esquerdas com anastomose transverso-retal (240 minutos), sendo o tempo médio equivalente a 160 minutos. As menores peças cirúrgicas foram as decorrentes da cirurgia de Hartmann (29 cm) e de retossigmoidectomia abdominal (32 cm); e as mais extensas, as peças de colectomia total com anastomose íleo-retal (120 cm) e proctocolectomia total com ileostomia definitiva (150 cm), ficando a média em 34,5. Houve 12 óbitos (16,2%), dois dos quais diretamente relacionados à cirurgia (um caso de deiscência de anastomose e um de evisceração); três relacionados à complicações de ordem clínica (dois casos de TEP e um de broncopneumonia); e sete comorbidades<br>In the framework of postgraduate Coloproctology for 2009, two graduate students conducted the second year as principal surgeons, 129 major surgeries, always assisted effectively by one or two tutors. All surgeries were performed on public patients in Santa Casa de Belo Horizonte, with absolute presence of members of the Grupo de Coloproctologia da Santa Casa de Belo Horizonte e Faculdade de Ciências Médicas de Minas Gerais (GCP-CBHS-FCMMG). A retrospective analysis of 74 medical records of patients from the Brazilian National Health System, resected of colorectal cancer by Resident R2, supervised and assisted by mentors, could get into the following conclusions: the average age of patients was 57.2, and the sixth and seventh decades accounted for 51.4% of the patients. The rectal cancer was predominant in women (54.1%). The most common sites of tumors were in the sigmoid (31.1%), rectum (24.3%), and cecum (17.6%). The most commonly performed procedures were retossigmoidectomy with colorectal anastomosis (36.6%) and right hemicolectomy with ileo-transverse anastomosis (21.7%). The anatomical characteristics of the tumors based on TNM classification findings were: T3 (62.1%), N0 (59.5%), and M0 (77.0%) (p<0.05). The average number of lymph nodes found in surgical specimens was 10.4. Sixty-three anastomoses (85.1%) were carried out, being 38 (60.3%) mechanical and 25, manual (39.7%). There were 14 comorbidities (18.9%), the cachexia having more prominence (eight cases). The rate of surgical complications was 12.2% (nine cases), and the surgeries that have caused more complications were total colectomy with ileo-rectal anastomosis (40.0%), and double stapled abdominal retossigmoidectomy (20%). The most common complications were anastomotic fistula (five cases). Complications (nine) were more caused by comorbidities (seven) than by the surgical procedure (two). The surgeries that required less time were: laparotomy with ileostomy (average of 75 minutes) and with colostomy (average of 95 minutes), and the longest times were occupied by total proctocolectomy with definite ileostomy (240 minutes) and left hemicolectomy with transverse-rectal anastomosis (240 minutes), with an average length of 160 minutes. The smaller specimens were those resulting from Hartmann's procedure (29 cm) and retossigmoidectomy (32 cm); and the most extensive specimens were of total colectomy with ileorectal anastomosis (120 cm) and total proctocolectomy with terminal ileostomy (150 cm), with the mean at 34.5. There were 12 deaths (16.2%), two of which directly related to surgery and the other related to clinical complications and comorbitie