Contributo das ferramentas da web social para a construção de conhecimento

Doutoramento em Multimédia em EducaçãoO presente estudo foi realizado no âmbito do curso de formação pós-graduada em Multimédia em Educação da Universidade de Aveiro no ano letivo de 2007/08, mais concretamente num dos módulos curriculares que o compõem. Esta foi a segunda edição em que a utilização de ferramentas da web social foi adotada enquanto meio de distribuição do ambiente de aprendizagem de alguns dos módulos curriculares que compõem o curso. A partir desta utilização, analisamos os contributos que daí decorreram para a construção de conhecimento. O levantamento de tais contributos consubstanciou-se no estabelecimento de objetivos que incluíram: (i) a identificação das principais ferramentas utilizadas ao longo do módulo em estudo; (ii) a determinação do contributo dessas ferramentas para o incremento de práticas de interação (formais e informais) e (iii) para o desenvolvimento de competências e (iv) a análise das interações que ocorreram em dois dos espaços de discussão assíncrona criados no âmbito do módulo. Para alcançarmos os objetivos propostos, desenvolvemos um estudo de caso que envolveu dois professores, o coordenador do curso e os cinquenta e seis alunos que cursaram o módulo em questão. Os dados foram recolhidos através dos guiões orientadores do curso e do módulo em estudo, do questionário administrado aos alunos, da análise das interações ocorridas em dois espaços de discussão, das entrevistas realizadas aos professores e do focus group realizado com alguns alunos. A análise e o cruzamento dos dados recolhidos permitiu-nos identificar contributos que decorrem da utilização de ferramentas da web social e que relevam para o processo de construção de conhecimento. Permitiu-nos, também, contribuir para o estudo desta problemática, questionando as práticas de análise que lhe são aplicadas e sugerindo, à luz do panorama tecnológico e educativo atual, eventuais complementos.The present study was conducted within the postgraduate course in Multimedia in Education of the University of Aveiro during the school year 2007/08, more precisely in one of the curricular modules that composed it. We present the contributions that resulted from the use of social web tools for the process of knowledge construction. To determinate such contributions we established the following objectives: (i) the identification of the tools used throughout the module under study, (ii) the identification of the contribution to the improvement of interaction practices (formal and informal) brought about by these tools (iii) the identification of the contribution to skills development, (iv) the analysis of the interactions that occurred within the main tools used by teachers responsible for the module under study. To achieve the proposed objectives, we developed a case study involving two teachers, the course coordinator and the fifty-six students taking the module in question. Data were collected through the scripts guiding the course and the module, the questionnaire filled in by the students, the analysis of the interactions observed in the main communication tools used, the interviews with the teachers and the focus group conducted with students. The analysis and triangulation of the data collected allowed us to identify relevant contributions to the process of knowledge construction

Adaptações fisiológicas do Homem ao Espaço

Trabalho Final do Curso de Mestrado Integrado em Medicina, Faculdade de Medicina, Universidade de Lisboa, 2018Aos poucos o Homem foi descobrindo alguns dos mistérios do Cosmos. Desde o lançamento de Vostok 1 a 12 de Abril de 1961, a primeira viagem tripulada ao Espaço, ao desejo de chegar a Marte e de industrializar o Espaço. Especula-se que em 2030 seja possível trabalhar e viver no Espaço, e inclusivamente, o turismo espacial é uma área em expansão. Contudo a exposição ao ambiente hostil do Espaço, em particular a exposição à microgravidade, condiciona alterações fisiológicas no organismo humano, algumas imediatas, outras surgem apenas em estadias de longa duração. Essas alterações podem também condicionar o aparecimento de sintomatologia após retorno à Terra. Entre os sistemas mais afetados destacam-se os sistemas músculo-esquelético, cardiovascular e endócrino; sistemas hidroeletrolítico, hematológico e neurológico; depressão do sistema imunitário; alterações do sistema digestivo, do aparelho respiratório, da pele e do ritmo circadiano. Menos frequente é o comprometimento do sistema urinário. Distúrbios psicológicos podem também ocorrer, de etiologia multifatorial. A maior parte das alterações são reversíveis após alguns dias a meses do retorno ao campo gravítico terrestre. Atualmente pouco se sabe sobre os efeitos celulares da microgravidade. Emergências médico-cirúrgicas no Espaço são uma possibilidade, mas nas circunstâncias atuais o treino médico dos astronautas é muito limitado. Por fim são discutidas as principais causas de mortalidade dos astronautas. Concluindo, as alterações fisiológicas descritas correspondem a respostas adaptativas dos sistemas orgânicos às novas condições ambientais do Espaço. Essas alterações tendem para um novo estado de equilíbrio, um novo estado estacionário homeostático. Esse novo set point da homeostasia torna-se mal adaptativo no retorno ao campo gravítico terrestre.Mankind has been gradually discovering some of the mysteries of the Cosmos. From the launch of Vostok 1 on 12th April 1961, the first manned trip to Space, to the desire to reach Mars and industrialize Space. It has been speculated that by 2030 it will be possible to work and live in space, and even space tourism is a fast expanding activity. However, physiological changes in the human body are deemed to occur because of exposure to the hostile environment of space, namely, exposure to microgravity. Some of these physical changes occur immediately, while others only happen after long-term stays. These changes may also be the onset of symptoms after returning to Earth. Among the most affected systems are the musculoskeletal, cardiovascular and endocrine systems; hydroelectrolytic, hematological and neurological systems; depression of immune system; changes in the digestive and respiratory system, skin, and circadian rhythm. Anomalies of the urinary system are less frequent. Furthermore, multifactorial causes can induce psychological disturbances. Most of these changes are reversible after a few days to months of returning to the Earth's gravitational field. Still, little is known about the effects of microgravity on a cellular level. Medical and surgical emergencies in space are a possibility, but the current medical training of astronauts is very insufficient. Finally, the main causes of astronaut mortality are discussed. In conclusion, the described physiological changes of the human body correspond to adaptive responses of the organic systems to new environmental conditions. These changes tend towards to a new steady state. This new set point of homeostasis becomes badly adaptive in the return to the terrestrial gravitational field

Bullying escolar: um fenômeno multifacetado

School bullying can involve children in different ways, making them play different roles, among them, victims, bullies and bully-victims. The aim of this study was to describe how bullying occurs in high social vulnerability schools of Florianópolis metropolitan area and the roles played by students in this phenomenon. Overall, 409 children and adolescents from the 3rd to 5th grades and of two public elementary schools aged 8-16 years (X = 11.14) participated in this study. As a tool, the Olweus Questionnaire adapted to the Brazilian population was used. For data analysis, descriptive statistics and inferential statistics were applied by the Mann Whitney and Kruskal Wallis tests. As for results, 29.8% of boys and 40.5% of girls reported being victims; 32.3% of boys and 24.6% of girls reported being bullies. Victims were the most willing to help a colleague who is suffering from bullying (X = 1.54; p> 0.001), even if they do not know the victims (X = 1.57; p> 0.004). Bullies are differentiated from the group that does not participate (X = 1.73) and the group of victims (X = 2.34), being those who felt less alone (x = 1.47; p> 0.001). It was concluded that the information obtained in this study is indispensable in the search for alternatives to reduce school bullying. The strengthening of relations between school and students and a better preparation of teachers and school staff are extremely necessary to try to minimize the effects of risk factors to which these children are exposed and consequently violence at school.O bullying escolar pode envolver crianças de diferentes maneiras, fazendo com que essas assumam papéis diferenciados. Dentre estes, têm-se vítimas, agressores e vítimas-agressoras. O objetivo deste estudo foi descrever como ocorre o bullying em escolas de alta vulnerabilidade social da Grande Florianópolis e os papéis assumidos pelos alunos nesse fenômeno. Quanto ao método, participaram 409 crianças e adolescentes do terceiro ao quinto ano e da quarta à sexta série do ensino fundamental, de duas escolas públicas municipais, com idades entre 8 e 16 anos (X=11,14). Como instrumento, utilizou-se o Questionário de Olweus adaptado à população brasileira. Para a análise dos dados, empregaram-se a estatística descritiva e estatística inferencial por meio dos testes Mann Whitney e Kruskal Wallis. Quanto aos resultados, 29,8% dos meninos e 40,5% das meninas relataram terem sido vítimas; já 32,3% dos meninos e 24,6% das meninas relataram terem sido agressores. As vítimas foram as que se mostraram mais dispostas a ajudar como podem um colega que esteja sofrendo agressão (X=1,54; p>0,001), mesmo que não o conheçam (X=1,57; p>0,004). Em contrapartida, os agressores se diferenciaram do grupo que não participa (X=1,73) e do grupo das vítimas (X=2,34), sendo aqueles que menos se sentiram sozinhos (X=1,47; p>0,001). Concluiu-se que as informações obtidas neste estudo são indispensáveis na busca de alternativas para redução do bullying escolar. O fortalecimento das relações entre escola e alunos, e um maior preparo dos professores e funcionários são extremamente necessários para tentar minimizar os efeitos dos fatores de risco a que essas crianças estão expostas e consequentemente a violência na escola.CAPES - Proc. nº 0815/14-4CIEC - Centro de Investigação em Estudos da Criança, IE, UMinho (UI 317 da FCT)Projeto Estratégico da FCT: UID/CED/00317/201

MAMMALS IN PORTUGAL : A data set of terrestrial, volant, and marine mammal occurrences in P ortugal

Mammals are threatened worldwide, with 26% of all species being includedin the IUCN threatened categories. This overall pattern is primarily associatedwith habitat loss or degradation, and human persecution for terrestrial mam-mals, and pollution, open net fishing, climate change, and prey depletion formarine mammals. Mammals play a key role in maintaining ecosystems func-tionality and resilience, and therefore information on their distribution is cru-cial to delineate and support conservation actions. MAMMALS INPORTUGAL is a publicly available data set compiling unpublishedgeoreferenced occurrence records of 92 terrestrial, volant, and marine mam-mals in mainland Portugal and archipelagos of the Azores and Madeira thatincludes 105,026 data entries between 1873 and 2021 (72% of the data occur-ring in 2000 and 2021). The methods used to collect the data were: live obser-vations/captures (43%), sign surveys (35%), camera trapping (16%),bioacoustics surveys (4%) and radiotracking, and inquiries that represent lessthan 1% of the records. The data set includes 13 types of records: (1) burrowsjsoil moundsjtunnel, (2) capture, (3) colony, (4) dead animaljhairjskullsjjaws, (5) genetic confirmation, (6) inquiries, (7) observation of live animal (8),observation in shelters, (9) photo trappingjvideo, (10) predators dietjpelletsjpine cones/nuts, (11) scatjtrackjditch, (12) telemetry and (13) vocalizationjecholocation. The spatial uncertainty of most records ranges between 0 and100 m (76%). Rodentia (n=31,573) has the highest number of records followedby Chiroptera (n=18,857), Carnivora (n=18,594), Lagomorpha (n=17,496),Cetartiodactyla (n=11,568) and Eulipotyphla (n=7008). The data setincludes records of species classified by the IUCN as threatened(e.g.,Oryctolagus cuniculus[n=12,159],Monachus monachus[n=1,512],andLynx pardinus[n=197]). We believe that this data set may stimulate thepublication of other European countries data sets that would certainly contrib-ute to ecology and conservation-related research, and therefore assisting onthe development of more accurate and tailored conservation managementstrategies for each species. There are no copyright restrictions; please cite thisdata paper when the data are used in publications.info:eu-repo/semantics/publishedVersio

Global age-sex-specific mortality, life expectancy, and population estimates in 204 countries and territories and 811 subnational locations, 1950–2021, and the impact of the COVID-19 pandemic: a comprehensive demographic analysis for the Global Burden of Disease Study 2021

Background: Estimates of demographic metrics are crucial to assess levels and trends of population health outcomes. The profound impact of the COVID-19 pandemic on populations worldwide has underscored the need for timely estimates to understand this unprecedented event within the context of long-term population health trends. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 provides new demographic estimates for 204 countries and territories and 811 additional subnational locations from 1950 to 2021, with a particular emphasis on changes in mortality and life expectancy that occurred during the 2020–21 COVID-19 pandemic period. Methods: 22 223 data sources from vital registration, sample registration, surveys, censuses, and other sources were used to estimate mortality, with a subset of these sources used exclusively to estimate excess mortality due to the COVID-19 pandemic. 2026 data sources were used for population estimation. Additional sources were used to estimate migration; the effects of the HIV epidemic; and demographic discontinuities due to conflicts, famines, natural disasters, and pandemics, which are used as inputs for estimating mortality and population. Spatiotemporal Gaussian process regression (ST-GPR) was used to generate under-5 mortality rates, which synthesised 30 763 location-years of vital registration and sample registration data, 1365 surveys and censuses, and 80 other sources. ST-GPR was also used to estimate adult mortality (between ages 15 and 59 years) based on information from 31 642 location-years of vital registration and sample registration data, 355 surveys and censuses, and 24 other sources. Estimates of child and adult mortality rates were then used to generate life tables with a relational model life table system. For countries with large HIV epidemics, life tables were adjusted using independent estimates of HIV-specific mortality generated via an epidemiological analysis of HIV prevalence surveys, antenatal clinic serosurveillance, and other data sources. Excess mortality due to the COVID-19 pandemic in 2020 and 2021 was determined by subtracting observed all-cause mortality (adjusted for late registration and mortality anomalies) from the mortality expected in the absence of the pandemic. Expected mortality was calculated based on historical trends using an ensemble of models. In location-years where all-cause mortality data were unavailable, we estimated excess mortality rates using a regression model with covariates pertaining to the pandemic. Population size was computed using a Bayesian hierarchical cohort component model. Life expectancy was calculated using age-specific mortality rates and standard demographic methods. Uncertainty intervals (UIs) were calculated for every metric using the 25th and 975th ordered values from a 1000-draw posterior distribution. Findings: Global all-cause mortality followed two distinct patterns over the study period: age-standardised mortality rates declined between 1950 and 2019 (a 62·8% [95% UI 60·5–65·1] decline), and increased during the COVID-19 pandemic period (2020–21; 5·1% [0·9–9·6] increase). In contrast with the overall reverse in mortality trends during the pandemic period, child mortality continued to decline, with 4·66 million (3·98–5·50) global deaths in children younger than 5 years in 2021 compared with 5·21 million (4·50–6·01) in 2019. An estimated 131 million (126–137) people died globally from all causes in 2020 and 2021 combined, of which 15·9 million (14·7–17·2) were due to the COVID-19 pandemic (measured by excess mortality, which includes deaths directly due to SARS-CoV-2 infection and those indirectly due to other social, economic, or behavioural changes associated with the pandemic). Excess mortality rates exceeded 150 deaths per 100 000 population during at least one year of the pandemic in 80 countries and territories, whereas 20 nations had a negative excess mortality rate in 2020 or 2021, indicating that all-cause mortality in these countries was lower during the pandemic than expected based on historical trends. Between 1950 and 2021, global life expectancy at birth increased by 22·7 years (20·8–24·8), from 49·0 years (46·7–51·3) to 71·7 years (70·9–72·5). Global life expectancy at birth declined by 1·6 years (1·0–2·2) between 2019 and 2021, reversing historical trends. An increase in life expectancy was only observed in 32 (15·7%) of 204 countries and territories between 2019 and 2021. The global population reached 7·89 billion (7·67–8·13) people in 2021, by which time 56 of 204 countries and territories had peaked and subsequently populations have declined. The largest proportion of population growth between 2020 and 2021 was in sub-Saharan Africa (39·5% [28·4–52·7]) and south Asia (26·3% [9·0–44·7]). From 2000 to 2021, the ratio of the population aged 65 years and older to the population aged younger than 15 years increased in 188 (92·2%) of 204 nations. Interpretation: Global adult mortality rates markedly increased during the COVID-19 pandemic in 2020 and 2021, reversing past decreasing trends, while child mortality rates continued to decline, albeit more slowly than in earlier years. Although COVID-19 had a substantial impact on many demographic indicators during the first 2 years of the pandemic, overall global health progress over the 72 years evaluated has been profound, with considerable improvements in mortality and life expectancy. Additionally, we observed a deceleration of global population growth since 2017, despite steady or increasing growth in lower-income countries, combined with a continued global shift of population age structures towards older ages. These demographic changes will likely present future challenges to health systems, economies, and societies. The comprehensive demographic estimates reported here will enable researchers, policy makers, health practitioners, and other key stakeholders to better understand and address the profound changes that have occurred in the global health landscape following the first 2 years of the COVID-19 pandemic, and longer-term trends beyond the pandemic

Síndrome do coração Pós-feriado: pacientes acometidos por arritmia cardíaca em detrimento do consumo exagerado de álcool: Post Holiday coração Syndrome: patients suffered by cardiac arrhythmia to the detriment of exaggerated alcohol consumption

INTRODUÇÃO: O álcool é conhecido por beneficiar o sistema cardiovascular com a ativação do sistema fibrinolítico, redução da agregação de plaquetas e aperfeiçoamento do perfil lipídico, entre outros mecanismos, quando consumido em doses moderadas. Todavia, seu uso de maneira abusiva culmina em patologias graves que podem evoluir para a morte, como a hipertensão arterial, a cardiomiopatia alcoólica, a arritmia cardíaca e até a “Síndrome do Coração Pós Feriado” ou do inglês, “Holiday Heart Syndrome”. OBJETIVOS: O presente estudo tem como objetivo delinear sobre a Síndrome do Coração Pós Feriado, transpassando por suas características clínicas, repercussões eletrofisiológicas, diagnóstico e manejo terapêutico. MATERIAIS E MÉTODOS: Dessa forma, o presente trabalho realizou uma revisão sistemática qualitativa, realizado no período entre julho e agosto de 2022, através de artigos das bases de dados Biblioteca Virtual em Saúde (BVS) e United States National Library of Medicine (PubMed). RESULTADOS E DISCUSSÃO: A interação do álcool no organismo está diretamente relacionada com o sistema nervoso autônomo do indivíduo, gerando um estado de desequilíbrio autonômico, assim há alterações elétricas, como acréscimo da frequência cardíaca, gerando um estado de taquicardia. A principal patologia encontrada em questão foi a taquicardia sinusal, sendo um tipo de arritmia e por conseguinte, notou-se a presença da fibrilação atrial, sendo o excesso no consumo de etanol é causador de aproximadamente 67% dos casos de emergências desta última enfermidade. CONCLUSÃO: Portanto, com base na literatura analisada, observou-se que a ingestão alcoólica aguda age retardando o sistema de condução cardíaco, atua no encurtamento do período refratário e o aumento da atividade simpática, além de aumentar os níveis de catecolaminas circulantes. Por fim, também se evidenciou uma associação entre álcool e fatores de risco, principalmente hipertensão e obesidade e essas patologias aumentam os episódios de fibrilação atrial

Mammals in Portugal: a data set of terrestrial, volant, and marine mammal occurrences in Portugal

Mammals are threatened worldwide, with ~26% of all species being included in the IUCN threatened categories. This overall pattern is primarily associated with habitat loss or degradation, and human persecution for terrestrial mammals, and pollution, open net fishing, climate change, and prey depletion for marine mammals. Mammals play a key role in maintaining ecosystems functionality and resilience, and therefore information on their distribution is crucial to delineate and support conservation actions. MAMMALS IN PORTUGAL is a publicly available data set compiling unpublished georeferenced occurrence records of 92 terrestrial, volant, and marine mammals in mainland Portugal and archipelagos of the Azores and Madeira that includes 105,026 data entries between 1873 and 2021 (72% of the data occurring in 2000 and 2021). The methods used to collect the data were: live observations/captures (43%), sign surveys (35%), camera trapping (16%), bioacoustics surveys (4%) and radiotracking, and inquiries that represent less than 1% of the records. The data set includes 13 types of records: (1) burrows | soil mounds | tunnel, (2) capture, (3) colony, (4) dead animal | hair | skulls | jaws, (5) genetic confirmation, (6) inquiries, (7) observation of live animal (8), observation in shelters, (9) photo trapping | video, (10) predators diet | pellets | pine cones/nuts, (11) scat | track | ditch, (12) telemetry and (13) vocalization | echolocation. The spatial uncertainty of most records ranges between 0 and 100 m (76%). Rodentia (n =31,573) has the highest number of records followed by Chiroptera (n = 18,857), Carnivora (n = 18,594), Lagomorpha (n = 17,496), Cetartiodactyla (n = 11,568) and Eulipotyphla (n = 7008). The data set includes records of species classified by the IUCN as threatened (e.g., Oryctolagus cuniculus [n = 12,159], Monachus monachus [n = 1,512], and Lynx pardinus [n = 197]). We believe that this data set may stimulate the publication of other European countries data sets that would certainly contribute to ecology and conservation-related research, and therefore assisting on the development of more accurate and tailored conservation management strategies for each species. There are no copyright restrictions; please cite this data paper when the data are used in publications

ATLANTIC EPIPHYTES: a data set of vascular and non-vascular epiphyte plants and lichens from the Atlantic Forest

Epiphytes are hyper-diverse and one of the frequently undervalued life forms in plant surveys and biodiversity inventories. Epiphytes of the Atlantic Forest, one of the most endangered ecosystems in the world, have high endemism and radiated recently in the Pliocene. We aimed to (1) compile an extensive Atlantic Forest data set on vascular, non-vascular plants (including hemiepiphytes), and lichen epiphyte species occurrence and abundance; (2) describe the epiphyte distribution in the Atlantic Forest, in order to indicate future sampling efforts. Our work presents the first epiphyte data set with information on abundance and occurrence of epiphyte phorophyte species. All data compiled here come from three main sources provided by the authors: published sources (comprising peer-reviewed articles, books, and theses), unpublished data, and herbarium data. We compiled a data set composed of 2,095 species, from 89,270 holo/hemiepiphyte records, in the Atlantic Forest of Brazil, Argentina, Paraguay, and Uruguay, recorded from 1824 to early 2018. Most of the records were from qualitative data (occurrence only, 88%), well distributed throughout the Atlantic Forest. For quantitative records, the most common sampling method was individual trees (71%), followed by plot sampling (19%), and transect sampling (10%). Angiosperms (81%) were the most frequently registered group, and Bromeliaceae and Orchidaceae were the families with the greatest number of records (27,272 and 21,945, respectively). Ferns and Lycophytes presented fewer records than Angiosperms, and Polypodiaceae were the most recorded family, and more concentrated in the Southern and Southeastern regions. Data on non-vascular plants and lichens were scarce, with a few disjunct records concentrated in the Northeastern region of the Atlantic Forest. For all non-vascular plant records, Lejeuneaceae, a family of liverworts, was the most recorded family. We hope that our effort to organize scattered epiphyte data help advance the knowledge of epiphyte ecology, as well as our understanding of macroecological and biogeographical patterns in the Atlantic Forest. No copyright restrictions are associated with the data set. Please cite this Ecology Data Paper if the data are used in publication and teaching events. © 2019 The Authors. Ecology © 2019 The Ecological Society of Americ

Rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART): Study protocol for a randomized controlled trial

Background: Acute respiratory distress syndrome (ARDS) is associated with high in-hospital mortality. Alveolar recruitment followed by ventilation at optimal titrated PEEP may reduce ventilator-induced lung injury and improve oxygenation in patients with ARDS, but the effects on mortality and other clinical outcomes remain unknown. This article reports the rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART). Methods/Design: ART is a pragmatic, multicenter, randomized (concealed), controlled trial, which aims to determine if maximum stepwise alveolar recruitment associated with PEEP titration is able to increase 28-day survival in patients with ARDS compared to conventional treatment (ARDSNet strategy). We will enroll adult patients with ARDS of less than 72 h duration. The intervention group will receive an alveolar recruitment maneuver, with stepwise increases of PEEP achieving 45 cmH(2)O and peak pressure of 60 cmH2O, followed by ventilation with optimal PEEP titrated according to the static compliance of the respiratory system. In the control group, mechanical ventilation will follow a conventional protocol (ARDSNet). In both groups, we will use controlled volume mode with low tidal volumes (4 to 6 mL/kg of predicted body weight) and targeting plateau pressure <= 30 cmH2O. The primary outcome is 28-day survival, and the secondary outcomes are: length of ICU stay; length of hospital stay; pneumothorax requiring chest tube during first 7 days; barotrauma during first 7 days; mechanical ventilation-free days from days 1 to 28; ICU, in-hospital, and 6-month survival. ART is an event-guided trial planned to last until 520 events (deaths within 28 days) are observed. These events allow detection of a hazard ratio of 0.75, with 90% power and two-tailed type I error of 5%. All analysis will follow the intention-to-treat principle. Discussion: If the ART strategy with maximum recruitment and PEEP titration improves 28-day survival, this will represent a notable advance to the care of ARDS patients. Conversely, if the ART strategy is similar or inferior to the current evidence-based strategy (ARDSNet), this should also change current practice as many institutions routinely employ recruitment maneuvers and set PEEP levels according to some titration method.Hospital do Coracao (HCor) as part of the Program 'Hospitais de Excelencia a Servico do SUS (PROADI-SUS)'Brazilian Ministry of Healt