A reorientação diplomática brasileira para o Oriente Médio sob Ernesto Geisel: o caso do Iraque

No presente trabalho, discutiremos sobre a reorientação diplomática brasileira para o Oriente Médio no período Geisel (1974-1979), em especial para o Iraque, país que vinha adquirindo importância estratégica e econômica para o Brasil, sobretudo após o choque do petróleo de 1973. As relações com o Iraque se inseriam no contexto do “Pragmatismo Responsável” de Geisel, buscando a autonomia da política externa nacional, a universalização da diplomacia e a busca pela consolidação de um projeto de Brasil soberano. Abordaremos a participação do Iraque nesse processo, elucidando as intensas trocas econômicas, interações políticas e cooperação técnica, militar e nuclear do Brasil para com o Iraque

PANC Study (Pancreatitis: A National Cohort Study): national cohort study examining the first 30 days from presentation of acute pancreatitis in the UK

Abstract Background Acute pancreatitis is a common, yet complex, emergency surgical presentation. Multiple guidelines exist and management can vary significantly. The aim of this first UK, multicentre, prospective cohort study was to assess the variation in management of acute pancreatitis to guide resource planning and optimize treatment. Methods All patients aged greater than or equal to 18 years presenting with acute pancreatitis, as per the Atlanta criteria, from March to April 2021 were eligible for inclusion and followed up for 30 days. Anonymized data were uploaded to a secure electronic database in line with local governance approvals. Results A total of 113 hospitals contributed data on 2580 patients, with an equal sex distribution and a mean age of 57 years. The aetiology was gallstones in 50.6 per cent, with idiopathic the next most common (22.4 per cent). In addition to the 7.6 per cent with a diagnosis of chronic pancreatitis, 20.1 per cent of patients had a previous episode of acute pancreatitis. One in 20 patients were classed as having severe pancreatitis, as per the Atlanta criteria. The overall mortality rate was 2.3 per cent at 30 days, but rose to one in three in the severe group. Predictors of death included male sex, increased age, and frailty; previous acute pancreatitis and gallstones as aetiologies were protective. Smoking status and body mass index did not affect death. Conclusion Most patients presenting with acute pancreatitis have a mild, self-limiting disease. Rates of patients with idiopathic pancreatitis are high. Recurrent attacks of pancreatitis are common, but are likely to have reduced risk of death on subsequent admissions. </jats:sec

Increasing frailty is associated with higher prevalence and reduced recognition of delirium in older hospitalised inpatients: results of a multi-centre study

Purpose: Delirium is a neuropsychiatric disorder delineated by an acute change in cognition, attention, and consciousness. It is common, particularly in older adults, but poorly recognised. Frailty is the accumulation of deficits conferring an increased risk of adverse outcomes. We set out to determine how severity of frailty, as measured using the CFS, affected delirium rates, and recognition in hospitalised older people in the United Kingdom. Methods: Adults over 65 years were included in an observational multi-centre audit across UK hospitals, two prospective rounds, and one retrospective note review. Clinical Frailty Scale (CFS), delirium status, and 30-day outcomes were recorded. Results: The overall prevalence of delirium was 16.3% (483). Patients with delirium were more frail than patients without delirium (median CFS 6 vs 4). The risk of delirium was greater with increasing frailty [OR 2.9 (1.8–4.6) in CFS 4 vs 1–3; OR 12.4 (6.2–24.5) in CFS 8 vs 1–3]. Higher CFS was associated with reduced recognition of delirium (OR of 0.7 (0.3–1.9) in CFS 4 compared to 0.2 (0.1–0.7) in CFS 8). These risks were both independent of age and dementia. Conclusion: We have demonstrated an incremental increase in risk of delirium with increasing frailty. This has important clinical implications, suggesting that frailty may provide a more nuanced measure of vulnerability to delirium and poor outcomes. However, the most frail patients are least likely to have their delirium diagnosed and there is a significant lack of research into the underlying pathophysiology of both of these common geriatric syndromes

A BUSCA DA EDUCAÇÃO INCLUSIVA NO BRASIL

A educação inclusiva é uma política implantada a partir de 2003, em constante discussão no país, resultante de um movimento internacional pela inclusão para fazer frente às condições sociais, de saúde, educação e economia hegemônicas nos últimos anos, que desencadearam essa consciência. Este trabalho traz reflexões sobre os processos de ensino e de aprendizagem de crianças no Brasil, em turmas inclusivas, fazendo uma breve retomada da educação tradicional, passando pela Escola Nova e chegando às concepções fundantes do pensamento de Paulo Freire. O artigo trata, ainda, das mudanças ocorridas após a promulgação da Lei de Diretrizes e Bases da Educação Nacional (Lei 9.394/1996), no que se refere às perspectivas na Educação Especial e da Educação Inclusiva. Inspira-se na concepção dialética da história, desenvolvendo a metodologia da pesquisa bibliográfica, seguida de um relato docente atual em busca de caminhos da inclusão efetiva. Palavras-chave: História da Educação. Educação Inclusiva. Lei de Diretrizes e Bases. Narrativa Docente. THE SEARCH FOR INCLUSIVE EDUCATION IN BRAZIL Abstract: Inclusive education is a policy that has been implemented since 2003, that is in constant discussion in Brazil, and that results from an international movement for inclusion to face the hegemonic social conditions, health, education and economy in recent years, which triggered this awareness. This work aims at the teaching and learning processes of children in Brazil, in inclusive groups, by making a brief summary of traditional education and by approaching the New School and the founding conceptions of Paulo Freire's thinking. The article also deals with the changes that occurred after the promulgation of the Law on the Guidelines and Bases of National Education (Law 9394/1996), regarding the perspectives in Special Education and Inclusive Education. It draws on the dialectical conception of history and develops the methodology of bibliographic research followed by a current teacher report in search of ways of effective inclusion.Keywords: History of Education, Inclusive Education, Law on the Guidelines and Bases of National Education, Teacher Narrative. 

Estado atual da (re) construção da alteridade como categoria teórico-prática e a contribuição da educação superior

This article aims to map the state of knowledge of otherness from the publications indexed in Scopus database, in the period 2003-2015, in the area of ​​knowledge of the social sciences and humanities, stemming from higher education contribution. The theoretical and methodological position of authors as well as the result of content analysis to develop the 41 articles identified in the light of Bardin (2011), drawing attention to the spread of the theoretical and methodological trajectories, but also pointing more common descriptors in approach to the theme and the authors who represent the foundation of theoretical frameworks that have allowed the reconstruction of otherness category. It highlights the journals that most have prioritized the issue and identifies/group sub-areas of the humanities and social sciences with the relevant productions (Psychology, Anthropology / Sociology, History / Philosophy / Politics, Language / Arts, Education, Biology / Health and Physical Education / Sport). The conclusion shows the emergence of the theme, pointing out the need for studies on otherness in basic education, higher education, especially in forming agencies, public policy, the teacher's work and human development, mainly in formal education.Este artículo pretende trazar un mapa del estado de conocimiento de la alteridad a partir de las publicaciones indexadas en la base de datos Scopus, en el período 2003-2015, en el área de conocimiento de las ciencias sociales y humanas, derivadas de la contribución de la educación superior. La posición teórica y metodológica de los autores, así como el resultado del análisis de contenido para desarrollar los 41 artículos identificados a la luz de Bardin (2011), señalando la difusión de las trayectorias teóricas y metodológicas, pero también apuntando a descriptores más comunes en el enfoque Al tema ya los autores que representan la fundación de los marcos teóricos que han permitido la reconstrucción de la categoría de la alteridad. Destaca las revistas que más han priorizado el tema e identifica / agrupa sub-áreas de las humanidades y ciencias sociales con las producciones relevantes (Psicología, Antropología / Sociología, Historia / Filosofía / Política, Lengua / Artes, Educación, Biología / Salud y Educación Física / Deporte). La conclusión muestra la emergencia del tema, destacando la necesidad de estudios sobre la alteridad en la educación básica, la educación superior, especialmente en los organismos formadores, las políticas públicas, el trabajo docente y el desarrollo humano, principalmente en la educación formal.Este artigo tem o objetivo de mapear o estado do conhecimento sobre a alteridade a partir das publicações indexadas à base de dados Scopus, no período de 2003 a 2015, na grande área do conhecimento das ciências sociais e humanidades, decorrentes da contribuição da educação superior. Revela a posição teórico metodológica das autoras assim como o resultado da análise de conteúdo que desenvolvem dos 41 artigos identificados, à luz de Bardin (2011), chamando a atenção para a dispersão das trajetórias teórico-metodológicas, mas também apontando descritores mais comuns na abordagem à temática e os autores que representam o fundamento dos marcos teóricos que têm permitido a reconstrução da categoria alteridade. Destaca os periódicos que mais têm priorizado a temática e identifica/agrupa subáreas das ciências sociais e humanas com as produções pertinentes (Psicologia, Antropologia/Sociologia, História/Filosofia/Política, Letras/Artes, Educação,Biologia/Saúde e Educação Física/Desporto). Nas considerações finais destaca a emergência da temática, apontando a necessidade de estudos sobre a alteridade na educação básica, na educação superior, especialmente nas agências formadoras, nas políticas públicas, no trabalho do professor e na formação humana, principalmente na educação formal

P2X7 receptor drives Th1 cell differentiation and controls the follicular helper T cell population to protect against Plasmodium chabaudi malaria

A complete understanding of the mechanisms underlying the acquisition of protective immunity is crucial to improve vaccine strategies to eradicate malaria. However, it is still unclear whether recognition of damage signals influences the immune response to Plasmodium infection. Adenosine triphosphate (ATP) accumulates in infected erythrocytes and is released into the extracellular milieu through ion channels in the erythrocyte membrane or upon erythrocyte rupture. The P2X7 receptor senses extracellular ATP and induces CD4 T cell activation and death. Here we show that P2X7 receptor promotes T helper 1 (Th1) cell differentiation to the detriment of follicular T helper (Tfh) cells during blood-stage Plasmodium chabaudi malaria. The P2X7 receptor was activated in CD4 T cells following the rupture of infected erythrocytes and these cells became highly responsive to ATP during acute infection. Moreover, mice lacking the P2X7 receptor had increased susceptibility to infection, which correlated with impaired Th1 cell differentiation. Accordingly, IL-2 and IFNγ secretion, as well as T-bet expression, critically depended on P2X7 signaling in CD4 T cells. Additionally, P2X7 receptor controlled the splenic Tfh cell population in infected mice by promoting apoptotic-like cell death. Finally, the P2X7 receptor was required to generate a balanced Th1/Tfh cell population with an improved ability to transfer parasite protection to CD4-deficient mice. This study provides a new insight into malaria immunology by showing the importance of P2X7 receptor in controlling the fine-tuning between Th1 and Tfh cell differentiation during P. chabaudi infection and thus in disease outcome

Notes on Human Trials of Transcranial Direct Current Stimulation between 1960 and 1998

Background:: Transcranial direct current stimulation (tDCS) is investigated to modulate neuronal function including cognitive neuroscience and neuropsychiatric therapies. While cases of human stimulation with rudimentary batteries date back more than 200 years, clinical trials with current controlled stimulation were published intermittently since the 1960s. The modern era of tDCS only started after 1998. Objectives:: To review methods and outcomes of tDCS studies from old literature (between 1960 and 1998) with intention of providing new insight for ongoing tDCS trials and development of tDCS protocols especially for the purpose of treatment. Methods:: Articles were identified through a search in PubMed and through the reference list from its selected articles. We included only non-invasive human studies that provided controlled direct current and were written in English, French, Spanish or Portuguese before the year of 1998, the date in which modern stimulation paradigms were implemented. Results:: Fifteen articles met our criteria. The majority were small-randomized controlled clinical trials that enrolled a mean of approximately 26 subjects (Phase II studies). Most of the studies (around 83%) assessed the role of tDCS in the treatment of psychiatric conditions, in which the main outcomes were measured by means of behavioral scales and clinical observation, but the diagnostic precision and the quality of outcome monitoring, including adverse events, were deficient by modern standards. Compared to modern tDCS dose, the stimulation intensities used (0.1–1 mA) were lower, however as the electrodes were typically smaller (e.g., 1.26 cm2), the average electrode current density (0.2 mA/cm2) was approximately 4× higher. The number of sessions ranged from one to 120 (median 14). Notably, the stimulation session durations of several minutes to 11 h (median 4.5 h) could markedly exceed modern tDCS protocols. Twelve studies out of 15 showed positive results. Only mild side effects were reported, with headache and skin alterations the most common. Conclusion:: Most of the studies identified were for psychiatric indications, especially in patients with depression and/or schizophrenia and majority indicated some positive results. Variability in outcome is noted across trials and within trials across subjects, but overall results were reported as encouraging, and consistent with modern efforts, given some responders and mild side effects. The significant difference with modern dose, low current with smaller electrode size and interestingly much longer stimulation duration may worth considering