Conjunctival bacilloscopy in leprosy diagnosis and follow-up

OBJETIVO: Estudar a presença do Mycobacterium leprae na conjuntiva ocular e validar a baciloscopia de conjuntiva como teste diagnóstico e de acompanhamento da hanseníase. MÉTODOS: Foi realizado raspado de conjuntiva tarsal superior em 52 pacientes portadores de hanseníase recém-diagnosticados (26 multibacilares e 26 paucibacilares) no período de julho a setembro de 2004 na clínica Oculistas Associados de Brasília e foram analisados os resultados da baciloscopia de conjuntiva a fim de compará-la com a baciloscopia da linfa (padrão-ouro). RESULTADOS: A avaliação da correlação entre o índice baciloscópico da conjuntiva (IBC) e índice baciloscópico da linfa (IBL) medida pelo coeficiente de correlação linear de Pearson é 76,3% (p<0,01). O teste qui-quadrado de Pearson também evidenciou associação entre IBL e IBC (p<0,01). O índice k (medida de concordância kappa de Cohen) foi de 0,615 (p<0,01). Dos 26 casos com IBL positivos, 17 tinham IBC positivo, demonstrando uma sensibilidade do IBC de 65,4% (IC 95% - 0,519-0,690). Dos 26 casos de IBL negativo, 25 eram IBC negativo, revelando especificidade de 96,2% (IC 95% - 0,826-0,998). O valor preditivo positivo é de 94,4% e o valor preditivo negativo é de 73,5%. A acurácia do teste é de 80,8%. A razão de verossimilhança é 17. O tempo médio de negativação do bacilo no olho é de 5 meses (IC 95% - 3,57-6,43). CONCLUSÃO: Sugerimos a utilização da combinação de baciloscopia da linfa e baciloscopia de conjuntiva para confirmação do diagnóstico e classificação da hanseníase e da baciloscopia de conjuntiva para acompanhamento do tratamento poliquimioterápico na hanseníase.PURPOSE: To identify Mycobacterium leprae in ocular conjunctivae and evaluate conjunctival bacilloscopy as leprosy diagnosis and follow-up test. METHODS: We used the superior tarsal conjunctiva scraping technique in 52 newly diagnosed leprosy patients between July and September 2004 at the "Oculistas Associados de Brasília", in Brasília, DF, Brazil, and compared the conjunctival bacilloscopy with skin bacilloscopy. RESULTS: Both the conjunctival bacilloscopy index (CBI) and skin bacilloscopy index (SBI) showed correlation since Pearson's r and Cohen kappa measure of agreement were respectively 76.3% (p<0.01) and 0.615 (p<0.01). Pearson chi-square also evidenced the correlation (p<0.01). Comparison of CBI and SBI (17 cases of positive CBI out of 26 SBI) gives a sensitivity of 65.4% (CI95% - 0.519-0.690); 25 cases of positive CBI out of 26 cases of negative SBI give a specificity of 96.2% (CI95% - 0.826-0.998); positive predictive value of 94.4%; negative predictive value of 73.5%, and accuracy of 80.8%. Likelihood ratio was 17. Mean time to eliminate the bacilli from conjunctiva was 5 months (CI95% - 3.57-6.43). CONCLUSION: We suggest the use of conjunctival bacilloscopy in addition with skin bacilloscopy to confirm leprosy diagnosis. Conjunctival bacilloscopy may also be useful for treatment follow-up in leprosy

ENSINO INDIVIDUALIZADO: ADAPTAR O ENSINO DE ACORDO COM AS NECESSIDADES INDIVIDUAIS DE CADA ALUNO, OFERECENDO INSTRUÇÕES CLARAS, ORGANIZAÇÃO E ESTRUTURAÇÃO DAS TAREFAS, E FEEDBACK ESPECÍFICO E IMEDIATO.

Individualized teaching refers to the educational practice of personalizing the teaching process according to the individual needs and characteristics of each student. This includes providing clear and precise instructions, establishing an organizational structure for tasks, as well as offering specific and immediate feedback to promote development and learning. This approach aims to cater to the different skills, interests and learning styles of each student, providing an adaptable and flexible learning environment. By recognizing individual differences, educators can adjust content and teaching strategies to maximize each student's engagement and academic success. Specific and immediate feedback plays a crucial role in the individualized learning process, allowing students to understand their strengths and areas for improvement, as well as encouraging them to progress in their skills and knowledge. This contributes to building a solid foundation for students’ continued growth and development.O ensino individualizado refere-se à prática educacional de personalizar o processo de ensino de acordo com as necessidades e características individuais de cada aluno. Isso inclui fornecer instruções claras e precisas, estabelecer uma estrutura organizacional para as tarefas, bem como oferecer feedback específico e imediato para promover o desenvolvimento e o aprendizado. Essa abordagem visa atender às diferentes habilidades, interesses e estilos de aprendizagem de cada aluno, proporcionando um ambiente de aprendizagem adaptável e flexível. Ao reconhecer as diferenças individuais, os educadores podem ajustar o conteúdo e as estratégias de ensino para maximizar o engajamento e o sucesso acadêmico de cada aluno. O feedback específico e imediato desempenha um papel crucial no processo de aprendizagem individualizada, permitindo que os alunos compreendam seus pontos fortes e áreas de melhoria, além de incentivá-los a progredir em suas habilidades e conhecimentos. Isso contribui para a construção de uma base sólida para o crescimento e o desenvolvimento contínuo dos alunos

SAÚDE MENTAL: INTERVENÇÕES MULTIDISCIPLINAR NO TRATAMENTO E DIAGNÓSTICO.

Multidisciplinary disciplines in mental health treatment and diagnosis represent a comprehensive and collaborative approach to dealing with psychological and emotional issues. This model involves the synergy of professionals from different areas, such as psychologists, psychiatrists, social workers, occupational therapists and nurses, working together to diagnose and treat mental disorders. The main advantage of this approach is the ability to offer a broad, holistic view of an individual's mental health challenges. A multidisciplinary team is capable of carrying out more comprehensive assessments, taking into account not only symptoms, but also the social, emotional and physical aspects that can influence a person's mental health. By combining specialties, the team can create personalized treatment plans, combining different therapies and approaches to meet patients' individual needs. This collaboration allows the application of varied methods, such as cognitive-behavioral therapy, medication disciplines, occupational therapy and counseling. Furthermore, this approach is not limited to treatment; it also seeks prevention and education, evolves to reduce the stigma surrounding mental illnesses and promote awareness. Communication and cooperation between professionals is essential, ensuring that everyone is aligned and updated on the patient's progress. This integration facilitates continuous adjustments to treatment, adapting it according to evolving needs. In summary, multidisciplinary interventions in mental health represent a collaborative and comprehensive approach that detects the complexity of mental disorders, promoting more complete and personalized care, evolving towards the patient's recovery and overall well-being. &nbsp;As disciplinas multidisciplinares no tratamento e diagnóstico de saúde mental representam uma abordagem abrangente e colaborativa para lidar com questões psicológicas e emocionais. Esse modelo envolve a sinergia de profissionais de diversas áreas, como psicólogos, psiquiatras, assistentes sociais, terapeutas ocupacionais e enfermeiros, trabalhando juntos para diagnosticar e tratar distúrbios mentais. A principal vantagem dessa abordagem é a capacidade de oferecer uma visão ampla e holística dos desafios de saúde mental de um indivíduo. Uma equipe multidisciplinar é capaz de realizar avaliações mais abrangentes, levando em consideração não apenas os sintomas, mas também os aspectos sociais, emocionais e físicos que podem influenciar a saúde mental de uma pessoa. Ao unir especialidades, a equipe pode elaborar planos de tratamento personalizados, combinando diversas terapias e abordagens para atender às necessidades individuais dos pacientes. Essa colaboração permite a aplicação de métodos variados, como terapia cognitivo-comportamental, disciplinas medicamentosas, terapia ocupacional e aconselhamento. Além disso, essa abordagem não se limita ao tratamento; também busca a prevenção e educação, evolui para reduzir o estigma em torno das doenças mentais e promover a conscientização. A comunicação e a cooperação entre os profissionais são essenciais, garantindo que todos estejam alinhados e atualizados sobre o progresso do paciente. Essa integração facilita ajustes contínuos no tratamento, adaptando-o de acordo com as necessidades em evolução. Em resumo, as intervenções multidisciplinares em saúde mental representam uma abordagem colaborativa e abrangente que detecta a complexidade dos distúrbios mentais, promovendo um cuidado mais completo e personalizado, evoluindo para a recuperação e o bem-estar global do paciente

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

Health-related quality of life in patients with type 1 diabetes mellitus in the different geographical regions of Brazil : data from the Brazilian Type 1 Diabetes Study Group

Background: In type 1 diabetes mellitus (T1DM) management, enhancing health-related quality of life (HRQoL) is as important as good metabolic control and prevention of secondary complications. This study aims to evaluate possible regional differences in HRQoL, demographic features and clinical characteristics of patients with T1DM in Brazil, a country of continental proportions, as well as investigate which variables could influence the HRQoL of these individuals and contribute to these regional disparities. Methods: This was a retrospective, cross-sectional, multicenter study performed by the Brazilian Type 1 Diabetes Study Group (BrazDiab1SG), by analyzing EuroQol scores from 3005 participants with T1DM, in 28 public clinics, among all geographical regions of Brazil. Data on demography, economic status, chronic complications, glycemic control and lipid profile were also collected. Results: We have found that the North-Northeast region presents a higher index in the assessment of the overall health status (EQ-VAS) compared to the Southeast (74.6 ± 30 and 70.4 ± 19, respectively; p < 0.05). In addition, North- Northeast presented a lower frequency of self-reported anxiety-depression compared to all regions of the country (North-Northeast: 1.53 ± 0.6; Southeast: 1.65 ± 0.7; South: 1.72 ± 0.7; Midwest: 1.67 ± 0.7; p < 0.05). These findings could not be entirely explained by the HbA1c levels or the other variables examined. Conclusions: Our study points to the existence of additional factors not yet evaluated that could be determinant in the HRQoL of people with T1DM and contribute to these regional disparities

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

Search for dark photons in Higgs boson production via vector boson fusion in proton-proton collisions at √s = 13 TeV

A search is presented for a Higgs boson that is produced via vector boson fusion and that decays to an undetected particle and an isolated photon. The search is performed by the CMS collaboration at the LHC, using a data set corresponding to an integrated luminosity of 130 fb−1, recorded at a center-of-mass energy of 13 TeV in 2016–2018. No significant excess of events above the expectation from the standard model background is found. The results are interpreted in the context of a theoretical model in which the undetected particle is a massless dark photon. An upper limit is set on the product of the cross section for production via vector boson fusion and the branching fraction for such a Higgs boson decay, as a function of the Higgs boson mass. For a Higgs boson mass of 125 GeV, assuming the standard model production rates, the observed (expected) 95% confidence level upper limit on the branching fraction is 3.5 (2.8)%. This is the first search for such decays in the vector boson fusion channel. Combination with a previous search for Higgs bosons produced in association with a Z boson results in an observed (expected) upper limit on the branching fraction of 2.9 (2.1)% at 95% confidence level