Ansiedade em alunos de pré-vestibular da cidade de Aracaju / Anxiety in pre college admission test students in the city of Aracaju

Introdução: Diante da alta prevalência de jovens que tentam a entrada em universidades no Brasil e a ainda falha descrição dessa população dentro de um contexto de doenças psiquiátricas que podem acometê-la, este artigo busca evidenciar a prevalência de transtornos de ansiedade em vestibulandos de escolas particulares na cidade de Aracaju, e aumentar o conhecimento sobre tal tema, a fim de ajudar no traçado de medidas preventivas de tais transtornos. Objetivo: Identificar a presença de ansiedade na população de alunos de cursos preparatórios para vestibular na cidade de Aracaju e seus fatores sociais associados. Métodos: Trata-se de um estudo transversal, de caráter descritivo, exploratório com abordagem quantitativa. Os dados foram coletados em duas escolas particulares e dois cursos pré-vestibular particulares na cidade de Aracaju-SE no período de 09/06/2020 a 07/08/2020. O estudo atendeu a todos os critérios éticos da Resolução 466/12, houve aprovação do pelo Comitê de Ética e Pesquisa da Universidade Tiradentes, Aracaju, Sergipe e foi assinado um Termo de Consentimento Livre e Esclarecido (TCLE). Resultados: A amostra, composta de alunos de pré-vestibular entre 18 e 35 anos, mostrou maior prevalência e gravidade de ansiedade em alunas mulheres. Mostrou também que a ansiedade está muito presente nos alunos que já trocaram a escolha do curso e que se relaciona à interferência dos estudos na relação com amigos e nos relacionamentos amorosos, além da pressão familiar pelo resultado e uma vida social satisfatória de maneira geral. Conclusão: Conclui-se que a população vestibulandos participante deste estudo possui grandes índices de ansiedade e que aspectos da vida social influenciam também nessa fase

Estresse em alunos de preparatórios para vestibular / Stress in college preparatory students

Introdução: O estresse da época do vestibular pode provocar grande sofrimento aos jovens, tanto pela necessidade da escolha do curso, quanto pela cobrança familiar e pessoal, além da obrigatoriedade da aprovação; dessa maneira, a saúde mental dessa população pode estar comprometida. Objetivos: Identificar a presença de sintomas de estresse em alunos de cursos preparatórios para o vestibular da cidade de Aracaju e seus fatores associados. Métodos: Os estudantes responderam dois questionários:  um sociodemográfico criado pelos autores e o Inventário de Sintomas de Estresse para Adultos de Lipp. Resultados: mostraram que 80,3% dos estudantes apresentaram pelo menos algum grau de estresse. Ainda, a maior prevalência foi identificada no sexo feminino, com 80% dos estudantes em exaustão sendo mulheres. Os participantes que não possuíam religião, não praticavam exercícios e que moravam com seus familiares obtiveram níveis mais altos de estresse. Outrossim, foi observado maior consumo de bebida alcoólica, como também, de ansiolíticos. Conclusões: Ficou evidente que essa população possui níveis de estresse elevados, sendo as mulheres as mais vulneráveis, além disso, outros fatores influenciam negativamente como não possuir religião, sedentarismo e conviver com a família nesse período. Além disso, foi observado grande consumo de bebida alcoólica e de ansiolíticos. Os resultados trazem informações importantes para criação de ações preventivas e terapêuticas para redução do estresse em estudantes de pré-vestibular

A farmacopsiquiatria dos antidepressivos: The pharmacopsychiatry of antidepressants

Os fármacos antidepressivos compõem o manejo terapêutico da depressão e inúmeros outros transtornos de origem neuropsiquiátrica. Logo, a ocorrências destes distúrbios tornam viável a aplicação destes, ressaltando ser essencial individualizar o tratamento e compreender a respeito das diversas classes, mecanismo de ação, interação medicamentosa, indicação clinica, grupo de risco e a intoxicação por superdosagem. O seguinte artigo objetivou descrever a respeito das particularidades dos antidepressivos, de modo a compreender sobre seu efeito farmacopsiquiatríco. Trata-se de uma revisão narrativa de literatura fundamentada nas renomadas plataformas de artigos indexados a respeito do tema. Foram selecionados os estudos que apresentavam relevância clinica para a compreensão do artigo, descartando-se os demais que não respondiam ao objetivo proposto. Na literatura científica estão disponíveis muitas informações pertinentes ao tema, ressaltando a importância deste. Atualmente, se encontram em aplicabilidade diversas classes que são os Inibidores Seletivos da Recaptação de Serotonina (ISRSs), Antidepressivos Tricíclicos (ADTs), Tetracíclicos e os Inibidores da Monoamina Oxidase (IMAO). Cada um destes possui um mecanismo de ação diferente, mas basicamente estes interferem no impulso nervoso de neurotransmissores beneficiando o portador de distúrbios neurocognitivos. Destacando que mesmo com o efeito terapêutico retrógrado, estes já manifestam os efeitos adversos. Logo, é imprescindível analisar qual o tipo e a dose do fármaco para se conduzir o melhor prognóstico do paciente.&nbsp

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

Mitochondrial physiology

As the knowledge base and importance of mitochondrial physiology to evolution, health and disease expands, the necessity for harmonizing the terminology concerning mitochondrial respiratory states and rates has become increasingly apparent. The chemiosmotic theory establishes the mechanism of energy transformation and coupling in oxidative phosphorylation. The unifying concept of the protonmotive force provides the framework for developing a consistent theoretical foundation of mitochondrial physiology and bioenergetics. We follow the latest SI guidelines and those of the International Union of Pure and Applied Chemistry (IUPAC) on terminology in physical chemistry, extended by considerations of open systems and thermodynamics of irreversible processes. The concept-driven constructive terminology incorporates the meaning of each quantity and aligns concepts and symbols with the nomenclature of classical bioenergetics. We endeavour to provide a balanced view of mitochondrial respiratory control and a critical discussion on reporting data of mitochondrial respiration in terms of metabolic flows and fluxes. Uniform standards for evaluation of respiratory states and rates will ultimately contribute to reproducibility between laboratories and thus support the development of data repositories of mitochondrial respiratory function in species, tissues, and cells. Clarity of concept and consistency of nomenclature facilitate effective transdisciplinary communication, education, and ultimately further discovery

Impact of COVID-19 on cardiovascular testing in the United States versus the rest of the world

Objectives: This study sought to quantify and compare the decline in volumes of cardiovascular procedures between the United States and non-US institutions during the early phase of the coronavirus disease-2019 (COVID-19) pandemic. Background: The COVID-19 pandemic has disrupted the care of many non-COVID-19 illnesses. Reductions in diagnostic cardiovascular testing around the world have led to concerns over the implications of reduced testing for cardiovascular disease (CVD) morbidity and mortality. Methods: Data were submitted to the INCAPS-COVID (International Atomic Energy Agency Non-Invasive Cardiology Protocols Study of COVID-19), a multinational registry comprising 909 institutions in 108 countries (including 155 facilities in 40 U.S. states), assessing the impact of the COVID-19 pandemic on volumes of diagnostic cardiovascular procedures. Data were obtained for April 2020 and compared with volumes of baseline procedures from March 2019. We compared laboratory characteristics, practices, and procedure volumes between U.S. and non-U.S. facilities and between U.S. geographic regions and identified factors associated with volume reduction in the United States. Results: Reductions in the volumes of procedures in the United States were similar to those in non-U.S. facilities (68% vs. 63%, respectively; p = 0.237), although U.S. facilities reported greater reductions in invasive coronary angiography (69% vs. 53%, respectively; p < 0.001). Significantly more U.S. facilities reported increased use of telehealth and patient screening measures than non-U.S. facilities, such as temperature checks, symptom screenings, and COVID-19 testing. Reductions in volumes of procedures differed between U.S. regions, with larger declines observed in the Northeast (76%) and Midwest (74%) than in the South (62%) and West (44%). Prevalence of COVID-19, staff redeployments, outpatient centers, and urban centers were associated with greater reductions in volume in U.S. facilities in a multivariable analysis. Conclusions: We observed marked reductions in U.S. cardiovascular testing in the early phase of the pandemic and significant variability between U.S. regions. The association between reductions of volumes and COVID-19 prevalence in the United States highlighted the need for proactive efforts to maintain access to cardiovascular testing in areas most affected by outbreaks of COVID-19 infection

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

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 &lt;= 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