USING ENTRUSTABLE PROFESSIONAL ACTIVITIES IN THE DESIGN OF THREE NEW HEALTHCARE UNDERGRADUATE PROGRAMS: BIOMEDICINE, NURSING AND PSYCHOLOGY

Entrustable Professional Activities (EPAs) can be defined as a unit of professional practice that can be entrusted to a trainee after they have obtained adequate competency. EPAs integrate multiple competencies from several domains and are very useful in designing competency-based curricula. Using EPAs to design medical curricula has been widely described, but their application to curriculum design of other health-related undergraduate programs is scarce. This manuscript critically assesses an educational planning experience of using EPAs to simultaneously design three healthcare undergraduate programs (nursing, biomedicine and psychology) at Faculdade Santa Casa BH, Minas Gerais, Brazil. We present the EPAs for each program, curricula frameworks, educational strategies, and assessment methods. Expert groups of professors and educational specialists defined the core professional activities that would be directly assessed and entrusted to trainees from the three different programs. The expert group then defined the required knowledge, skills, and attitudes for each EPA and selected the appropriate assessment tools to be used in entrustment decisions. The expected entrustment level for each training phase guided the course’s distribution of core and elective courses. The experience of designing a curriculum using EPAs was successful and helped focus on the core activities of each profession. It also provided an opportunity to reflect upon formative and summative assessments throughout the course bringing the challenge of reorienting our teaching practices and assessment approaches. Designing undergraduate curricula of health-related professions using EPAs is feasible and might help operationalize competency-based curricula.  Article visualizations

Covid-19: monitoring of patients’ laboratory data during a 90-day length of hospital stay: Covid-19: acompanhamento de dados laboratoriais de pacientes durante 90 dias de internação

Background: In March 2020, COVID-19 was declared a pandemic. In this study, patients were selected through the chest HRCT diagnosis. Laboratory tests such as blood count, fibrinogen, D-dimer, AST, ALT, troponin, LDH, albumin, CRP, electrolytes and ferritin were analyzed. Aims: To monitor the laboratory evolution of COVID-19 in patients during hospitalization. Method: Of 115 patients, 93 were selected and analyzed every three days for 90 days. Data were analyzed using the IBM, SPSS, Statistics for Windows, 23.0 software. Results: 34.4% were female, and 65.6% male; Hct and Hb dropped after the 13th day of hospitalization; leukocyte levels remained up to 15,000, increasing to >20,000 after the 55th day of hospitalization; lymphopenia occurred in 10 to 15% of the patients, with increased eosinophils; platelet levels decreased at the end of hospitalization. Fibrinogen, D-dimer, LDH, CRP and ferritin levels increased throughout the hospitalization period. Urea and creatinine increased slightly from the 30th day onwards. There were no alterations in PTA, troponin, chlorine, potassium and albumin levels, with a decrease throughout the hospitalization period. Conclusion: Knowledge of the behavior of laboratory tests together with the disease evolution give support to the clinical and therapeutic management of COVID-19

Selective oxidation of lupeol by iodosylbenzene catalyzed by manganese porphyrins.

Manganese porphyrin-catalyzed oxidation of lupeol by iodosylbenzenewas achieved undermild conditionswith low isolated yields but with remarkable selectivity, depending on the catalyst of choice. Mn(III) mesotetraphenylporphyrin and Mn(III) meso-tetrakis(4-carbomethoxyphenyl)porphyrin provided an entry for the preparation of 3?,30-dihydroxylup-20(29)-ene (6?14% yields), whereas Mn(III) ?-octabromo-meso-tetrakis(4- carbomethoxyphenyl)porphyrin led to 20-oxo-3?-hydroxy-29-norlupeol (6% yield), as single products. Unreacted lupeol was recovered in quantitative yield. The oxidative transformations at lupeol C20 or C30 take place with no need for protection of C3 hydroxyl moiety

A list of land plants of Parque Nacional do Caparaó, Brazil, highlights the presence of sampling gaps within this protected area

Brazilian protected areas are essential for plant conservation in the Atlantic Forest domain, one of the 36 global biodiversity hotspots. A major challenge for improving conservation actions is to know the plant richness, protected by these areas. Online databases offer an accessible way to build plant species lists and to provide relevant information about biodiversity. A list of land plants of “Parque Nacional do Caparaó” (PNC) was previously built using online databases and published on the website "Catálogo de Plantas das Unidades de Conservação do Brasil." Here, we provide and discuss additional information about plant species richness, endemism and conservation in the PNC that could not be included in the List. We documented 1,791 species of land plants as occurring in PNC, of which 63 are cited as threatened (CR, EN or VU) by the Brazilian National Red List, seven as data deficient (DD) and five as priorities for conservation. Fifity-one species were possible new ocurrences for ES and MG states

Técnicas e eficácia da ablação por cateter para tratamento da fibrilação atrial

A fibrilação atrial (FA) é uma arritmia cardíaca comum e crônica que afeta a qualidade de vida e está associada a um aumento do risco de acidente vascular cerebral, insuficiência cardíaca e mortalidade. A ablação por cateter é uma intervenção crucial para pacientes com FA paroxística refratária a medicamentos, com duas técnicas principais: crioablação e ablação por radiofrequência (RF). Este estudo visa comparar a eficácia, segurança e impacto na progressão da doença entre essas duas técnicas. Baseado em uma revisão sistemática da literatura científica, abrange o período de 2016 a 2024, utilizando as bases de dados PubMed (Medline), Cochrane Library e Scientific Electronic Library Online (SciELO). No primeiro estudo, a crioablação e a ablação por RF demonstraram eficácia comparável na manutenção da liberdade de FA, porém a crioablação reduziu significativamente o tempo de procedimento. No segundo estudo, a ablação por RF foi mais eficaz na prevenção da progressão da FA paroxística para formas persistentes, indicando um impacto positivo a longo prazo na evolução da doença. No terceiro estudo, a análise das taxas de complicações revelou que ambas as técnicas possuem perfis de segurança semelhantes, sem diferenças significativas nos eventos adversos. Em resumo, a crioablação e a ablação por RF são eficazes no tratamento da FA, com a crioablação oferecendo benefícios operacionais e a RF mostrando maior eficácia na prevenção da progressão da doença. Esses achados destacam a necessidade de uma abordagem personalizada na escolha da técnica de ablação, considerando os desfechos imediatos e a longo prazo

Using online databases to produce comprehensive accounts of the vascular plants from the Brazilian protected areas: The Parque Nacional do Itatiaia as a case study

Brazil is one of the most biodiverse countries in the world, with about 37,000 species of land plants. Part of this biodiversity is within protected areas. The development of online databases in the last years greatly improved the available biodiversity data. However, the existing databases do not provide information about the protected areas in which individual plant species occur. The lack of such information is a crucial gap for conservation actions. This study aimed to show how the information captured from online databases, cleaned by a protocol and verified by taxonomists allowed us to obtain a comprehensive list of the vascular plant species from the "Parque Nacional do Itatiaia", the first national park founded in Brazil. All existing records in the online database JABOT (15,100 vouchers) were downloaded, resulting in 11,783 vouchers identified at the species level. Overall, we documented 2,316 species belonging to 176 families and 837 genera of vascular plants in the "Parque Nacional do Itatiaia". Considering the whole vascular flora, 2,238 species are native and 78 are non-native.The "Parque Nacional do Itatiaia" houses 13% of the angiosperm and 37% of the fern species known from the Brazilian Atlantic Forest. Amongst these species, 82 have been cited as threatened, following IUCN categories (CR, EN or VU), seven are data deficient (DD) and 15 have been classified as a conservation priority, because they are only known from a single specimen collected before 1969

Floristic survey of vascular plants of a poorly known area in the Brazilian Atlantic Forest (Flona do Rio Preto, Espírito Santo)

The Atlantic Forest is one of the most threatened biomes in the world. Despite that, this biome still includes many areas that are poorly known floristically, including several protected areas, such as the "Floresta Nacional do Rio Preto" ("Flona do Rio Preto"), located in the Brazilian State of Espírito Santo. This study used a published vascular plant species list for this protected area from the "Catálogo de Plantas das Unidades de Conservação do Brasil" as the basis to synthesise the species richness, endemism, conservation and new species occurrences found in the "Flona do Rio Preto".The published list of vascular plants was based on field expeditions conducted between 2018 and 2020 and data obtained from herbarium collections available in online databases. Overall, 722 species were documented for the "Flona do Rio Preto", 711 of which are native to Brazil and 349 are endemic to the Atlantic Forest. In addition, 60 species are geographically disjunct between the Atlantic and the Amazon Forests. Most of the documented species are woody and more than 50% of these are trees. Twenty-three species are threatened (CR, EN and VU), while five are Data Deficient (DD). Thirty-two species are new records for the State of Espírito Santo. Our results expand the knowledge of the flora of the Atlantic Forest and provide support for the development of new conservation policies for this protected area

Brazilian Flora 2020: Leveraging the power of a collaborative scientific network

International audienceThe shortage of reliable primary taxonomic data limits the description of biological taxa and the understanding of biodiversity patterns and processes, complicating biogeographical, ecological, and evolutionary studies. This deficit creates a significant taxonomic impediment to biodiversity research and conservation planning. The taxonomic impediment and the biodiversity crisis are widely recognized, highlighting the urgent need for reliable taxonomic data. Over the past decade, numerous countries worldwide have devoted considerable effort to Target 1 of the Global Strategy for Plant Conservation (GSPC), which called for the preparation of a working list of all known plant species by 2010 and an online world Flora by 2020. Brazil is a megadiverse country, home to more of the world's known plant species than any other country. Despite that, Flora Brasiliensis, concluded in 1906, was the last comprehensive treatment of the Brazilian flora. The lack of accurate estimates of the number of species of algae, fungi, and plants occurring in Brazil contributes to the prevailing taxonomic impediment and delays progress towards the GSPC targets. Over the past 12 years, a legion of taxonomists motivated to meet Target 1 of the GSPC, worked together to gather and integrate knowledge on the algal, plant, and fungal diversity of Brazil. Overall, a team of about 980 taxonomists joined efforts in a highly collaborative project that used cybertaxonomy to prepare an updated Flora of Brazil, showing the power of scientific collaboration to reach ambitious goals. This paper presents an overview of the Brazilian Flora 2020 and provides taxonomic and spatial updates on the algae, fungi, and plants found in one of the world's most biodiverse countries. We further identify collection gaps and summarize future goals that extend beyond 2020. Our results show that Brazil is home to 46,975 native species of algae, fungi, and plants, of which 19,669 are endemic to the country. The data compiled to date suggests that the Atlantic Rainforest might be the most diverse Brazilian domain for all plant groups except gymnosperms, which are most diverse in the Amazon. However, scientific knowledge of Brazilian diversity is still unequally distributed, with the Atlantic Rainforest and the Cerrado being the most intensively sampled and studied biomes in the country. In times of “scientific reductionism”, with botanical and mycological sciences suffering pervasive depreciation in recent decades, the first online Flora of Brazil 2020 significantly enhanced the quality and quantity of taxonomic data available for algae, fungi, and plants from Brazil. This project also made all the information freely available online, providing a firm foundation for future research and for the management, conservation, and sustainable use of the Brazilian funga and flora

Characterisation of microbial attack on archaeological bone

As part of an EU funded project to investigate the factors influencing bone preservation in the archaeological record, more than 250 bones from 41 archaeological sites in five countries spanning four climatic regions were studied for diagenetic alteration. Sites were selected to cover a range of environmental conditions and archaeological contexts. Microscopic and physical (mercury intrusion porosimetry) analyses of these bones revealed that the majority (68%) had suffered microbial attack. Furthermore, significant differences were found between animal and human bone in both the state of preservation and the type of microbial attack present. These differences in preservation might result from differences in early taphonomy of the bones. © 2003 Elsevier Science Ltd. All rights reserved