Diagnóstico da Doença Inflamatória Intestinal na Criança e Adolescente

The criteria of Porto1 is aligned with the presentation of ESPGHAN because both sources draw attention to the care that must be taken to make the diagnosis of Inflammatory Bowel Disease (IBD) in children and adolescents, but especially in children under 6 years old in order to exclude the possibility of primary immunodeficiencies and monogenic diseases. The presentation of ESPGHAN reinforces that is very important the way how we introduce the diagnosis to the family and pediatric patients with IBD. Professionals should, if possible, have a team specialized in pediatric IBD, a pediatrician, pediatric gastroenterologist, nurse, nutritionist, psychologist, etc. IBD has become an increasingly diagnosed in children of all ages. This condition has a particular clinical picture in children compared with adults. Perform early diagnosis is crucial to avoid an additional impact on the nutritional status, pondoestatural and pubertal development. It also requires attention to the consequences of IBD on the psychosocial aspect of children and adolescents, it is common to break school and social activities, especially in those patients with unstable or severe disease, requiring psychological intervention

Affirmative Action in Higher Education and Afro-Descendant Women in Bahia, Brazil

Affirmative Action in Higher Education and Afro-Descendant Women in Bahia, Brazil In 2001, the federal government of Brazil under President Fernando Henrique Cardoso (1995 - 2003) passed laws to remedy racial and socioeconomic inequality. Responding to pressure from civil society and especially from black feminist and black social movements, Cardoso's affirmative action policy set quotas to expand access to Brazil's public services and universities for blacks, women, indigenous peoples, and people with disabilities. My thesis focuses on affirmative action in higher education and examines to what extent Afro-descendant women can actually attain upward mobility, and to what extent Cardoso's program enhances educational opportunities, closes socioeconomic gaps, and decreases racial inequalities for black women in southern Bahia, Brazil. Through qualitative research interviews, I present the perspectives of university female students regarding Cardoso's reforms and their impact on Brazil's higher education system. This research illustrates central aspects of Brazil's racial dilemma--a dream of racial democracy versus the reality of racial inequality

Temporal HeartNet: Towards Human-Level Automatic Analysis of Fetal Cardiac Screening Video

We present an automatic method to describe clinically useful information about scanning, and to guide image interpretation in ultrasound (US) videos of the fetal heart. Our method is able to jointly predict the visibility, viewing plane, location and orientation of the fetal heart at the frame level. The contributions of the paper are three-fold: (i) a convolutional neural network architecture is developed for a multi-task prediction, which is computed by sliding a 3x3 window spatially through convolutional maps. (ii) an anchor mechanism and Intersection over Union (IoU) loss are applied for improving localization accuracy. (iii) a recurrent architecture is designed to recursively compute regional convolutional features temporally over sequential frames, allowing each prediction to be conditioned on the whole video. This results in a spatial-temporal model that precisely describes detailed heart parameters in challenging US videos. We report results on a real-world clinical dataset, where our method achieves performance on par with expert annotations.Comment: To appear in MICCAI, 201

COVID-19 and pediatric inflammatory bowel disease: How to manage it?

Pediatric gastroenterologists, family members, and caregivers of patients with inflammatory bowel disease (IBD) are on alert; they are all focused on implementing prophylactic measures to prevent infection by severe acute respiratory syndrome coronavirus 2, evaluating the risks in each patient, guiding them in their treatment, and keeping IBD in remission. To face the current issues of the coronavirus disease pandemic, we have developed a synthesis of the main recommendations of the literature directed at pediatric gastroenterologists in control of patients with pediatric IBD and adapted to the national reality

Real-time standard scan plane detection and localisation in fetal ultrasound using fully convolutional neural networks

Fetal mid-pregnancy scans are typically carried out according to fixed protocols. Accurate detection of abnormalities and correct biometric measurements hinge on the correct acquisition of clearly defined standard scan planes. Locating these standard planes requires a high level of expertise. However, there is a worldwide shortage of expert sonographers. In this paper, we consider a fully automated system based on convolutional neural networks which can detect twelve standard scan planes as defined by the UK fetal abnormality screening programme. The network design allows real-time inference and can be naturally extended to provide an approximate localisation of the fetal anatomy in the image. Such a framework can be used to automate or assist with scan plane selection, or for the retrospective retrieval of scan planes from recorded videos. The method is evaluated on a large database of 1003 volunteer mid-pregnancy scans. We show that standard planes acquired in a clinical scenario are robustly detected with a precision and recall of 69 % and 80 %, which is superior to the current state-of-the-art. Furthermore, we show that it can retrospectively retrieve correct scan planes with an accuracy of 71 % for cardiac views and 81 % for non-cardiac views

Relative Cost-effectiveness Of Using An Extensively Hydrolyzed Casein Formula In Managing Infants With Cow's Milk Allergy In Brazil

To estimate the cost-effectiveness of three alternative dietetic strategies for cow's milk allergy in Brazil: 1) using an extensively hydrolyzed casein formula (eHCF; -Nutramigen) as a first-line formula, but switching to an amino acid formula (AAF) if infants remain symptomatic; 2) using an AAF as a first-line formula and then switching to an eHCF after 4 weeks once infants are symptom-free, but switching back to an AAF if infants become symptomatic; and 3) using an AAF as a first-line formula and keeping all infants on that formula. The analysis was conducted from the perspective of the Brazilian public health care system, Sistema Unico de Saude. Methods: Decision modeling was used to estimate the probability of immunoglobulin E (IgE)-mediated and non-IgE-mediated allergic infants developing tolerance to cow's milk by 12 months from starting a formula. The models also estimated the Sistema Unico de Saude cost (at 2013/2014 prices) of managing infants over 12 months after starting a formula, as well as the relative cost-effectiveness of each of the dietetic strategies. Results: The probability of developing tolerance to cow's milk by 12 months from starting a formula was higher among infants with either IgE-mediated or non-IgE-mediated allergy who were initially fed with an eHCF, compared with those who were initially fed with an AAF. The total health care cost of initially feeding an eHCF to cow's milk allergic infants was less than that of initially feeding both IgE-mediated and non-IgE-mediated infants with an AAF. Conclusion: Within the study's limitations, using an eHCF instead of an AAF for the first-line management of newly-diagnosed infants with cow's milk allergy affords a cost-effective use of publicly funded resources, since it improves the outcome for less cost.8629639Mead Johnson Nutrition, Sao Paulo, Brazi

Afro-Brazilian Women in Higher Education at the Federal Institute of Bahia (IFBA) Brazil

Abstract The purpose of this qualitative study was to examine, describe, and understand underrepresentation of Afro-Brazilian women faculty members in higher education. The study aimed to advance knowledge about this underrepresentation based on perspectives of eighteen participants who self-identified as Afro-Brazilian and as women working at the Institute Federal of Bahia (IFBA). I based my investigation on two research questions: What influenced the paths of Afro-Brazilian women to becoming faculty members? What are Afro-Brazilian women educators’ experiences as faculty members in higher education? Due to the nature of the research questions, qualitative methods were best suited to uncovering the meanings participants referred to in three areas: family background, educational trajectory, and professional experience. I use an intersectional theoretical lens that accounts for race, class, gender, and geography for understanding inequalities of Afro-Brazilian women. This approach is inspired by US and Brazilian Black feminisms. My findings showcased five items to increase understanding of Afro-Brazilian women’s paths to higher education. These are race and gender discrimination in higher education, vulnerability of social statuses and struggles to transform them, social interrelationships, recognition of the role of educational policies, and individual dissonances

Phylogeny and genetic structure in the genus Secale

Maraci Ö, Ozkan H, Bilgin R. Phylogeny and genetic structure in the genus Secale. PLOS ONE. 2018;13(7): e0200825.Secale L. is a small but important genus that includes cultivated rye. Although genetic diversity of cultivated rye is high, patterns of genetic diversity in the whole genus, and potential factors affecting the distribution of genetic diversity remain elusive. The population structure and distribution of genetic variation within Secale, and its correlation with taxonomic delimitation, cultivation status or spatial distribution in relation to geography and climate zones were analyzed in this study. A collection of 726 individual plants derived from 139 different accessions representing Secale cereale, S. vavilovii, S. strictum, and S. sylvestre were investigated using SSR analysis and sequence diversity analysis of a nuclear EST region. Our results indicated that perennial S. strictum subspecies are genetically divergent from annual forms of the genus. Existence of two distinct clusters within the annual taxa was observed, one corresponding to samples from Asia, and a second to those outside of Asia. No clear genetic structure was observed between different annual species/subspecies, indicating introgression between these taxa. The analysis of cultivated rye revealed that landrace populations from the Middle East have the highest genetic diversity, supporting the idea of the area being the center of origin for cultivated rye. Considering high adaptive potential of those populations, Middle Eastern landraces should be regarded as genetic resources reservoirs for new niches and future breeding programs

A framework for analysis of linear ultrasound videos to detect fetal presentation and heartbeat.

Confirmation of pregnancy viability (presence of fetal cardiac activity) and diagnosis of fetal presentation (head or buttock in the maternal pelvis) are the first essential components of ultrasound assessment in obstetrics. The former is useful in assessing the presence of an on-going pregnancy and the latter is essential for labour management. We propose an automated framework for detection of fetal presentation and heartbeat from a predefined free-hand ultrasound sweep of the maternal abdomen. Our method exploits the presence of key anatomical sonographic image patterns in carefully designed scanning protocols to develop, for the first time, an automated framework allowing novice sonographers to detect fetal breech presentation and heartbeat from an ultrasound sweep. The framework consists of a classification regime for a frame by frame categorization of each 2D slice of the video. The classification scores are then regularized through a conditional random field model, taking into account the temporal relationship between the video frames. Subsequently, if consecutive frames of the fetal heart are detected, a kernelized linear dynamical model is used to identify whether a heartbeat can be detected in the sequence. In a dataset of 323 predefined free-hand videos, covering the mother's abdomen in a straight sweep, the fetal skull, abdomen, and heart were detected with a mean classification accuracy of 83.4%. Furthermore, for the detection of the heartbeat an overall classification accuracy of 93.1% was achieved

A passiva na Síndrome de Down

Orientadora: Reny GregolinAutor não autorizou a divulgação do arquivo digitalTese (doutorado) - Universidade Federal do Paraná, Setor de Ciencias Humanas, Letras e Artes, Programa de Pós-Graduaçao em Letras. Defesa: Curitiba, 2004Inclui bibliografia e anexosÁrea de concentraçao: Estudos linguísticosResumo: Esta tese investigou a produção, a imitação e a compreensão de sentenças passivas na Síndrome de Down (SD). Foi constatado que jovens portadores da SD não produzem, não imitam, e não compreendem passivas reversíveis e não-reversíveis, curtas e longas, com verbo de ação e de não-ação. Crianças típicas de mesma idade mental foram também testadas, e seus resultados revelaram que elas compreendem a passiva reversível curta com verbo de ação, mas não com verbo de não-ação, e que compreendem de modo inconsistente a passiva longa com verbo de ação, já que não são capazes de rejeitar passivas longas semântica e pragmaticamente bizarras, confirmando a assunção de que crianças típicas de mesma idade mental de indivíduos portadores da síndrome de Down estão em um estágio mais avançado no desenvolvimento da linguagem que estes. Mostramos que em um estágio anterior à compreensão da passiva reversível, ou quando esse conhecimento é ainda instável, o indivíduo a compreende como ativa, ao interpretar o primeiro DP/NP como agente/causador da ação/não-ação, no sentido de Baker (in press). Essa hipótese ganha força ao assumirmos que as estruturas passiva e ativa possuem derivações iniciais semelhantes.Abstract: This work investigated production, imitation and comprehension of passive sentences in Down syndrome (DS). The conclusion is that young people with DS do not produce, do not imitate and do not comprehend reversible and irreversible, short and long passives with action and non-action verbs. Typical children of the same mental age were also tested, and their results suggest that they comprehend reversible short passives with action verbs, but not with non-action verbs, and that they inconsistently comprehend long passives with action verbs, since they cannot reject semantically and pragmatically bizarre long passives, confirming the assumption that typical children of the same mental age as individuals with DS are at a more advanced level of language development. We assume that before comprehension, or when comprehension is still not stable, the reversible passive is understood as an active structure as a function of the interpretation of the first DP/NP as agent/causer, in the sense of Baker (in press). This hypothesis is reinforced by the fact that the passive and the active constructions have similar initial derivations