Pensamento Empreendedor, uma Alternativa para a Internalização do Empreendedorismo

The importance given to entrepreneurship today is unquestionable. It is related to the economy of the countries and the way society is structured. In Brazil, there are over fifty million people with their own businesses. With this theme as a basis, this article seeks to reflect on the issues brought by Jan Spruijt (2017) in his article "Paradoxes of Business Thinking: why entrepreneurship can hardly be taught" and suggest possible reflections or changes in the way universities which include entrepreneurship disciplines in their curricula and also to the Brazilian Micro and Small Business Support Service (SEBRAE) - especially for some of its educational actions – as its mission is: "To promote competitiveness and the sustainable development of small businesses and to foster the entrepreneurship to strengthen the national economy". The article was elaborated from an exploratory research of bibliographic and documentary basis, with an analytical approach, leading to the reflection of the lines of study that contribute to the understanding of Spruijt, models or practices for teaching entrepreneurship, paradoxes of entrepreneurial thinking and of entrepreneurship teaching practice.A importância dada ao empreendedorismo na atualidade é indiscutível. Ele está relacionado com a economia dos países e com a forma como a sociedade se estrutura, No Brasil, existem mais de 50 milhões de pessoas com negócios próprios. Com essa temática de base, este artigo procura refletir sobre as questões trazidas por Jan Spruijt (2017) em seu artigo “Paradoxos do Pensamento Empresarial: por que o empreendedorismo dificilmente pode ser ensinado?” e sugerir possíveis reflexões ou mudanças na forma de atuação de universidades que contemplam disciplinas de empreendedorismo em suas grades curriculares e do Serviço de Apoio às Micro e Pequenas Empresas (SEBRAE) – em especial para algumas de suas ações educacionais – visto ser sua missão: “Promover a competitividade e o desenvolvimento sustentável dos pequenos negócios e fomentar o empreendedorismo, para fortalecer a economia nacional”. O artigo foi elaborado a partir da metodologia de pesquisa exploratória de base bibliográfica e documental, com uma abordagem analítica, fazendo com que se reflita sobre as linhas de estudo que colaboram para o entendimento de Spruijt, modelos ou práticas para ensino do empreendedorismo, paradoxos do pensamento empreendedor e da prática do ensino do empreendedorismo

Carriers of ADAMTS13 Rare Variants Are at High Risk of Life-Threatening COVID-19

Thrombosis of small and large vessels is reported as a key player in COVID-19 severity. However, host genetic determinants of this susceptibility are still unclear. Congenital Thrombotic Thrombocytopenic Purpura is a severe autosomal recessive disorder characterized by uncleaved ultra-large vWF and thrombotic microangiopathy, frequently triggered by infections. Carriers are reported to be asymptomatic. Exome analysis of about 3000 SARS-CoV-2 infected subjects of different severities, belonging to the GEN-COVID cohort, revealed the specific role of vWF cleaving enzyme ADAMTS13 (A disintegrin-like and metalloprotease with thrombospondin type 1 motif, 13). We report here that ultra-rare variants in a heterozygous state lead to a rare form of COVID-19 characterized by hyper-inflammation signs, which segregates in families as an autosomal dominant disorder conditioned by SARS-CoV-2 infection, sex, and age. This has clinical relevance due to the availability of drugs such as Caplacizumab, which inhibits vWF-platelet interaction, and Crizanlizumab, which, by inhibiting P-selectin binding to its ligands, prevents leukocyte recruitment and platelet aggregation at the site of vascular damage

Gain- and Loss-of-Function CFTR Alleles Are Associated with COVID-19 Clinical Outcomes

Carriers of single pathogenic variants of the CFTR (cystic fibrosis transmembrane conductance regulator) gene have a higher risk of severe COVID-19 and 14-day death. The machine learning post-Mendelian model pinpointed CFTR as a bidirectional modulator of COVID-19 outcomes. Here, we demonstrate that the rare complex allele [G576V;R668C] is associated with a milder disease via a gain-of-function mechanism. Conversely, CFTR ultra-rare alleles with reduced function are associated with disease severity either alone (dominant disorder) or with another hypomorphic allele in the second chromosome (recessive disorder) with a global residual CFTR activity between 50 to 91%. Furthermore, we characterized novel CFTR complex alleles, including [A238V;F508del], [R74W;D1270N;V201M], [I1027T;F508del], [I506V;D1168G], and simple alleles, including R347C, F1052V, Y625N, I328V, K68E, A309D, A252T, G542*, V562I, R1066H, I506V, I807M, which lead to a reduced CFTR function and thus, to more severe COVID-19. In conclusion, CFTR genetic analysis is an important tool in identifying patients at risk of severe COVID-19

"Delirium Day": A nationwide point prevalence study of delirium in older hospitalized patients using an easy standardized diagnostic tool

Background: To date, delirium prevalence in adult acute hospital populations has been estimated generally from pooled findings of single-center studies and/or among specific patient populations. Furthermore, the number of participants in these studies has not exceeded a few hundred. To overcome these limitations, we have determined, in a multicenter study, the prevalence of delirium over a single day among a large population of patients admitted to acute and rehabilitation hospital wards in Italy. Methods: This is a point prevalence study (called "Delirium Day") including 1867 older patients (aged 65 years or more) across 108 acute and 12 rehabilitation wards in Italian hospitals. Delirium was assessed on the same day in all patients using the 4AT, a validated and briefly administered tool which does not require training. We also collected data regarding motoric subtypes of delirium, functional and nutritional status, dementia, comorbidity, medications, feeding tubes, peripheral venous and urinary catheters, and physical restraints. Results: The mean sample age was 82.0 ± 7.5 years (58 % female). Overall, 429 patients (22.9 %) had delirium. Hypoactive was the commonest subtype (132/344 patients, 38.5 %), followed by mixed, hyperactive, and nonmotoric delirium. The prevalence was highest in Neurology (28.5 %) and Geriatrics (24.7 %), lowest in Rehabilitation (14.0 %), and intermediate in Orthopedic (20.6 %) and Internal Medicine wards (21.4 %). In a multivariable logistic regression, age (odds ratio [OR] 1.03, 95 % confidence interval [CI] 1.01-1.05), Activities of Daily Living dependence (OR 1.19, 95 % CI 1.12-1.27), dementia (OR 3.25, 95 % CI 2.41-4.38), malnutrition (OR 2.01, 95 % CI 1.29-3.14), and use of antipsychotics (OR 2.03, 95 % CI 1.45-2.82), feeding tubes (OR 2.51, 95 % CI 1.11-5.66), peripheral venous catheters (OR 1.41, 95 % CI 1.06-1.87), urinary catheters (OR 1.73, 95 % CI 1.30-2.29), and physical restraints (OR 1.84, 95 % CI 1.40-2.40) were associated with delirium. Admission to Neurology wards was also associated with delirium (OR 2.00, 95 % CI 1.29-3.14), while admission to other settings was not. Conclusions: Delirium occurred in more than one out of five patients in acute and rehabilitation hospital wards. Prevalence was highest in Neurology and lowest in Rehabilitation divisions. The "Delirium Day" project might become a useful method to assess delirium across hospital settings and a benchmarking platform for future surveys