Eficácia da realidade virtual no tratamento de crianças com paralisia cerebral : revisão sistemática

Monografia (graduação)—Universidade de Brasília, Faculdade de Ceilândia, Curso de Graduação em Terapia Ocupacional, 2013.Introdução: A paralisia cerebral é uma serie de desordens permanentes não progressivas manifestadas por um grupo de disfunções que acometem o desenvolvimento de habilidades sensoriomotoras, de percepção, cognição, sensação e comunicação. O tratamento da Paralisia Cerebral tem por objetivo a melhora do desempenho motor, cognitivo e social do paciente, favorecendo sua inserção em atividades necessárias e significativas do cotidiano. Dentre os tratamentos disponíveis, o uso da Realidade Virtual tem como objetivo a melhora da percepção espacial, equilíbrio, força e coordenação motora, envolvendo o indivíduo em atividades reais através de ambientes virtuais. Embora seja um recurso promissor, existem poucas evidências que sustentem seu uso como instrumento para a reabilitação de indivíduos com Paralisia Cerebral. Objetivos: Sistematizar estudos que utilizem a Realidade Virtual como recurso terapêutico, analisando o uso do vídeo game Nintendo® Wii™ como recurso para o tratamento de crianças com Paralisia Cerebral. Metodologia: Foram pesquisados estudos publicados entre os anos de 2003 e 2013, nos idiomas Português, Inglês e Espanhol, nas bases de dados Biblioteca Virtual de Saúde, Scielo e PubMed, utilizando-se os descritores: “paralisia cerebral”, “jogos de vídeo” e “realidade virtual”, além dos respectivos termos em inglês, combinados entre si. Resultados: Foram encontrados 125 artigos. Destes, apenas seis estudos foram incluídos, seguindo critérios de inclusão e exclusão pré-estabelecidos. Os estudos selecionados foram avaliados quanto à qualidade através da escala PEDro. Conclusão: Estudos mostrando a eficácia do Nintendo® Wii™ como recurso terapêutico no tratamento de indivíduos com Paralisia Cerebral ainda são poucos e não existem evidências que suportem seu uso para melhora da função motora. São relatados ganhos na motivação, concentração, equilíbrio e controle postural, indicando potenciais usos do vídeo game no processo de reabilitação. Limitações envolvendo o mesmo devem ser exploradas e sugere-se que novos estudos sejam feitos com amostras maiores de indivíduos. ____________________________________________________________________________ ABSTRACTIntroduction: Cerebral palsy is a series of permanent and non-progressive disorders manifested by a group dysfunctions that affect the development of sensorimotor, cognition, sensation and communication skills. The treatment of Cerebral palsy aims to improve motor, cognitive and social performance of the patient, fostering the inclusion into necessary and meaningful activities of daily life. Among the available treatments, the use of Virtual Reality objectives to increase the spatial awareness, balance, strength and coordination, involving the subject in real activities through virtual environments. Although a promising feature, there is little evidence to support its use as a tool for rehabilitation of individuals with Cerebral palsy. Objectives: To systematize studies using Virtual Reality as a therapeutic resource, analyzing the use of the Nintendo ® Wii ™ videogame as a resource for the treatment of children with Cerebral palsy. Methodology: Studies published between 2003 and 2013 in Portuguese, English and Spanish were searched in BVS, Scielo and PubMed databases, using the terms “Cerebral Palsy”, “Videogames” and “Virtual Reality” and its respective matches in Portuguese. Results: 125 articles were found. Of these, only six studies were included, following inclusion and exclusion criteria previously established. The selected studies were assessed for quality using the PEDro scale. Conclusion: There are few studies reporting the use of Nintendo® Wii™ as a resource during the treatment of children with Cerebral palsy. There are no evidence that support the use of the videogame as a resource to improve motor function. Improvements in motivation, concentration, balance and postural control were reported, suggesting potential use of the Nintendo® Wii™ in rehabilitation. Limitations involving the use of this resource should be explored by new studies with larger number of subjects

Hemispheric asymmetry of motor cortex excitability in mood disorders – Evidence from a systematic review and meta-analysis

Funding Information: Funding: GC was supported by Fundação para a Ciência e Tecnologia (FCT) through a PhD Scholarship (SFRH/BD/130210/2017). AJO-M is supported by grant FCT-PTDC/MEC-PSQ/30302/2017-IC&DT-LIS BOA-01-0145-FEDER, funded by national funds from FCT/MCTES and co-funded by FEDER, under the Partnership Agreement Lisboa 2020 - Programa Operacional Regional de Lisboa. GC and AJO-M are supported by grant FCT-PTDC/MED-NEU/31331/2017, funded by FCT/MCTES. This project was funded by the European Union’s Horizon 2020 research and innovation programme under grant agreement No 777167. AJO-M was national coordinator for Portugal of a noninterventional study (EDMS-ERI-143085581, 4.0) to characterize a Treatment-Resistant Depression Cohort in Europe, sponsored by Janssen-Cilag, Ltd (2019–2020), is recipient of a grant from Schuhfried GmBH for norming and validation of cognitive tests, and is national coordinator for Portugal of trials of psilocybin therapy for treatment-resistant depression, sponsored by Compass Pathways, Ltd (EudraCT number 2017-003288-36 and 2020-001348- 25), and of esketamine for treatment-resistant depression, sponsored by Janssen-Cilag, Ltd (EudraCT NUMBER: 2019-002992-33).Objective: Mood disorders have been associated with lateralized brain dysfunction, on the left-side for depression and right-side for mania. Consistently, asymmetry of cortical excitability, as measured by transcranial magnetic stimulation (TMS) has been reported. Here, we reviewed and summarized work assessing such measures bilaterally in mood disorders. Methods: We performed a systematic review and extracted data to perform meta-analyses of interhemispheric asymmetry of motor cortex excitability, assessed with TMS, across different mood disorders and in healthy subjects. Additionally, potential predictors of interhemispheric asymmetry were explored. Results: Asymmetry of resting motor threshold (MT) among healthy volunteers was significant, favoring lower right relative to left-hemisphere excitability. MT was also significantly asymmetric in major depressive disorder (MDD), but with lower excitability of the left -hemisphere, when compared to the right, no longer observed in recovered patients. Findings on intracortical facilitation were similar. The few trials including bipolar depression revealed similar trends for imbalance, but with lower right hemisphere excitability, relative to the left. Conclusions: There is interhemispheric asymmetry of motor cortical excitability in MDD, with lower excitability on left when compared to right-side. Interhemispheric asymmetry, with lower right relative to left-sided excitability, was found for bipolar depression and was also suggested for healthy volunteers, in a pattern that is clearly distinct from MDD. Significance: Mood disorders display asymmetric motor cortical excitability that is distinct from that found in healthy volunteers, supporting the presence of lateralized brain dysfunction in these disorders.publishersversionpublishe

Efeito dos modos de transferência e da composição de gás de protecção na emissão de partículas ultrafinas na soldadura MAG de aços

The present study aims to characterize ultrafine particles emitted during gas metal arc welding of mild steel and stainless steel, using different shielding gas mixtures, and to evaluate the effect of metal transfer modes, controlled by both processing parameters and shielding gas composition, on the quantity and morphology of the ultrafine particles. It was found that the amount of emitted ultrafine particles (measured by particle number and alveolar deposited surface area) are clearly dependent from the main welding parameters, namely the current intensity and the heat input of the Welding process. The emission of airborne ultrafine particles increases with the current intensity as fume formation rate does. When comparing the shielding gas mixtures, higher emissions were observed for more oxidizing mixtures, that is, with higher CO2 content, which means that these mixtures originate higher concentrations of ultrafine particles (as measured by number of particles. by cubic centimeter of air) and higher values of alveolar deposited surface area of particles, thus resulting in a more hazardous condition regarding welders exposure

Automatic strategy for extraction of anthropometric measurements for the diagnostic and evaluation of deformational plagiocephaly from infant’s head models

Deformational Plagiocephaly (DP) refers to an asymmetrical distortion of an infant's skull resulting from external forces applied over time. The diagnosis of this condition is performed using asymmetry indexes that are estimated from specific anatomical landmarks, whose are manually defined on head models acquired using laser scans. However, this manual identification is susceptible to intra-/inter-observer variability, being also time-consuming. Therefore, automatic strategies for the identification of the landmarks and, consequently, extraction of asymmetry indexes, are claimed. A novel pipeline to automatically identify these landmarks on 3D head models and to estimate the relevant cranial asymmetry indexes is proposed. Thus, a template database is created and then aligned with the unlabelled patient through an iterative closest point (ICP) strategy. Here, an initial rigid alignment followed by an affine one are applied to remove global misalignments between each template and the patient. Next, a non-rigid alignment is used to deform the template information to the patient-specific shape. The final position of each landmark is computed as a local weight average of all candidate results. From the identified landmarks, a head's coordinate system is automatically estimated and later used to estimate cranial asymmetry indexes. The proposed framework was evaluated in 15 synthetic infant head's model. Overall, the results demonstrated the accuracy of the identification strategy, with a mean average distance of 2.8 +/- 0.6 mm between the identified landmarks and the ground-truth. Moreover, for the estimation of cranial asymmetry indexes, a performance comparable to the inter-observer variability was achieved.The present submission corresponds to original research work of the authors and has never been submitted elsewhere. Moreover, this work was funded by the project NORTE-01-0145-FEDER-024300, supported by Northern Portugal Regional Operational Programme (Norte2020), under the Portugal 2020 Partnership Agreement, through the European Regional Development Fund (FEDER). Moreover, this work has been also supported by FCT - Fundação para a Ciência e Tecnologia within the Project Scope: UID/CEC/00319/2019. Furthermore, the authors acknowledge FCT, Portugal, and the European Social Found, European Union, for funding support through the "Programa Operacional Capital Humano" (POCH) in the scope of the PhD grants SFRH/BD/136721/2018 (Bruno Oliveira), SFRH/BD/136670/2018 (Helena R. Torres), and SFRH/BD/131545/2017 (Fernando Veloso)

Antibiotic prophylaxis in sickle cell disease: a cross-section study of adherence and associated costs

Objective: To assess adherence to antibiotic prophylaxis and to describe the cost of prophylactic antibiotics in Sickle Cell Disease (SCD). Methods: Cross-sectional study with 115 children. Adherence was assessed through caregiver interviews and medical records. Costs and posologies were assessed through the Brazilian SCD Guidelines. Results: 50.4% of the patients were male. The mother was responsible for answers (83.5%) and the main caregiver (86.1%). Maximum adherence was achieved in 45.2%. There was no statistically significant association between adherence and the studied variables. The total cost was US$102,824.50. The average annual cost per adherent patient was US$ 196.41. Conclusion: Adherence to prophylactic antibiotics was low and actions are needed to increase it, even though the costs of this action are low

Avaliação de um biossorvente à base de fibra de ráfia na sorção de hidrocarbonetos

Oil spills and discharges of petroleum products have severely polluted aquatic ecosystems, oceans, rivers, groundwater and even soil. In August 2019, more than 2,000 km of the northeast and southeast coast of Brazil were struck by a major oil spill in the country’s largest ever environmental disaster. Spill remediation is a significant environmental challenge and the economic and socioenvironmental impacts of these events are diverse. Oil spills in oceans and rivers severely affect the fishing and tourism industries of the areas in question, with damage including severe short and long-term effects on plants and animals, such as respiratory and digestive disorders, reduced growth and reproductive capacity as well as weakened immunity due to the bioaccumulation of toxic contaminants. There are several proposed strategies for removing crude oil and petroleum products from surface water. Contaminated areas can be remediated in-situ or ex-situ, with the former considered the best option in terms of cost and efficiency. In this respect, absorbent materials obtained from biomass have received widespread attention due to their ease of use, buoyancy and low cost. Raffia is a natural fiber abundant in eastern Africa with excellent physical properties, such as low specific weight, good liquid sorption and low conductivity. As such, the present study investigated the application of raffia fiber with different particle sizes (< 300 µm, 300 - 850 µm, 850 - 1000 µm, 1000 - 1400 µm and 1400 - 2000 µm) and fiber/hydrocarbon ratios (1, 2, 3 and 4% w/v) as an absorbent for hydrocarbons, using n-heptane as a model molecule. Microscopic analysis of micronized raffia fiber indicated the presence of honeycomb-shaped cells with well-defined borders and an irregular geometry. These honeycomb structures are preserved, especially in large particle size ranges. Among the granulometries assessed, the highest sorption capacities were obtained for 1000 to 1400 µm raffia fibers, suggesting that honeycomb-shaped structures favor hydrocarbon sorption. Additionally, the fact that smaller particles do not require micronization is economically beneficial and facilitates application of the absorbent material to remediate hydrocarbon-contaminated areas. The results obtained under the conditions studied indicate that sorption capacity increases as the absorbent content rises. Comparison of fiber contents of 1% and 3% w/v for 1000 - 1400 µm particles showed an increase of approximately 43% in sorption capacity when content rose to 3% w/v. The results of the present study demonstrate the potential of natural raffia fiber as an alternative absorbent for hydrocarbons.O derramamento de óleo e derivados de petróleo leva a graves efeitos de poluição em sistemas aquáticos, oceanos, rios e águas subterrâneas e, até mesmo, no solo. Recentemente, em agosto de 2019, mais de 2 mil quilômetros do litoral do Nordeste e Sudeste brasileiro foram atingidos por um grande derramamento de petróleo, caracterizando o maior desastre ambiental já ocorrido no Brasil. Um grande desafio ambiental é a remediação de incidentes envolvendo derramamento de óleo e derivados de petróleo. Os impactos econômicos e socioambientais desses incidentes são os mais diversos. Considerando os desastres de derramamento em áreas marítimas e fluviais, os danos podem gerar sérios problemas na indústria pesqueira ou até mesmo em atividades turísticas da região. Entre estes danos, efeitos gravíssimos em plantas e animais a curto e longo prazo, como problemas nos sistemas respiratório e digestivo, na capacidade de crescimento e reprodução e na imunidade devido aos processos de bioacumulação de contaminantes tóxicos. Atualmente, muitas abordagens são propostas para remoção de contaminantes de óleo e derivados de petróleo de superfícies aquosas. A remediação de áreas contaminadas pode ocorrer in-situ ou ex-situ, sendo que as tecnologias in-situ são sempre consideradas as melhores opções devido ao custo e eficiência. Com relação a isso, materiais absorventes provenientes de biomassa têm atraído muita atenção pela sua facilidade de utilização, pois normalmente possuem boa flutuabilidade e baixo custo. A ráfia é uma espécie de fibra natural encontrada em abundância na região ocidental da África e que possui propriedades físicas interessantes, como a baixa massa específica, boa sorção a líquidos e baixa condutividade. Dentro deste contexto, o presente trabalho estudou a aplicação da fibra natural de ráfia em diferentes faixas granulométricas (< 300 µm, 300 - 850 µm, 850 - 1000 µm, 1000 - 1400 µm e 1400 - 2000 µm) e em diferentes razões fibra/hidrocarboneto (1, 2, 3 e 4% m/v) como material absorvente para hidrocarbonetos, utilizando o n-heptano como molécula modelo. A análise microscópica da fibra de ráfia micronizada indica a presença de células formadas com fronteiras bem definidas e fechadas, mas com geometria irregular, cuja forma lembra uma colmeia de abelha. Essas estruturas de colmeia foram preservadas, principalmente nas maiores faixas granulométricas. Dentre as diferentes granulometrias avaliadas, as maiores capacidades de sorção foram obtidas com partículas de ráfia na faixa de 1000 - 1400 µm, sugerindo que a presença de estruturas na forma de colmeia favorece a sorção de hidrocarboneto. Além disso, o fato de não haver necessidade de micronizar a fibra em partículas muito finas, gera vantagens do ponto de vista econômico e de aplicação do material absorvente na remediação de áreas contaminadas por hidrocarbonetos. Os resultados obtidos nas condições estudadas indicam que a capacidade de sorção cresce à medida que a quantidade de absorvente aumenta. Comparando-se os teores de 1% e 3% m/v de ráfia, na faixa de 1000 - 1400 µm verificou-se um aumento de aproximadamente 43% na capacidade de sorção, quando o teor de fibra aumentou para 3% m/v. Os resultados do presente trabalho evidenciam a potencialidade da fibra natural de ráfia como material absorvente alternativo para hidrocarbonetos

Percepção dos idosos acerca da assistência humanizada de enfermagem frente ao mal de Parkinson / Perception of the elderly about humanized nursing care in the face of Parkinson's disease

Introdução: A doença de Parkinson é uma afecção crônica e progressiva do sistema nervoso, caracterizada pelos sinais cardinais de rigidez, acinesia, bradicinesia tremor e instabilidade postural. Objetivo: O trabalho tem como objetivo avaliar a importância do atendimento humanizado em idosos portadores do mal de Parkinson através de uma assistência de enfermagem qualificada, indicando soluções que promovam o conforto desses pacientes para melhorar a qualidade de vida Métodos: A presente pesquisa de campo utiliza-se da abordagem metodológica do tipo descritiva, cuja finalidade é observar, descrever e documentar os aspectos da situação abordando os aspectos quali/quantitativo. O trabalho foi aprovado pelo comitê de Ética em Pesquisa do Centro Universitário – UniAGES (Paripiranga) sob Parecer nº 045/2013. Resultados: Observou-se maior proporção de idosos institucionalizados com faixa etária de 66 a 73 anos (60%), a mediana 75,4, com prevalência do sexo feminino (60%). Quanto ao estado civil, em sua maioria são viúvos (as) (60%), e os demais solteiros (as) (40%). Entretanto, quanto á renda, 100% da amostra são aposentados, com ganho mensal de 1 salário mínimo. O perfil patológico dos idosos pesquisados resume-se, em sua maioria, a doenças cardiovasculares (60%), divididos ainda em: Cardiopatia (20%), Diabetes Mellitus (40%) e HAS (40%) e Cardiopatia – HAS – DM (20%) e com mal de Parkinson (80%). Portanto, verificou-se que a maioria dos entrevistados pertencia à faixa etária dos 66 – 73 anos, prevalecendo à população feminina. Nesse sentido, estima-se que de 10,0 a 25,0% das pessoas acima tinham 65 anos e 46,0% acima dos 85 anos são considerados vulneráveis ao aparecimento de desfechos clínicos indesejáveis. Conclusão: O processo de envelhecimento preocupa os homens desde as primeiras civilizações, de forma que as pessoas buscam formas de superar as dificuldades relativas que se processam com a chegada da senilidade. 

Gbs-based Single Dosage Markers For Linkage And Qtl Mapping Allow Gene Mining For Yield-related Traits In Sugarcane

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)Sugarcane (Saccharum spp.) is predominantly an autopolyploid plant with a variable ploidy level, frequent aneuploidy and a large genome that hampers investigation of its organization. Genetic architecture studies are important for identifying genomic regions associated with traits of interest. However, due to the genetic complexity of sugarcane, the practical applications of genomic tools have been notably delayed in this crop, in contrast to other crops that have already advanced to marker-assisted selection (MAS) and genomic selection. High-throughput next-generation sequencing (NGS) technologies have opened new opportunities for discovering molecular markers, especially single nucleotide polymorphisms (SNPs) and insertion-deletion (indels), at the genome-wide level. The objectives of this study were to (i) establish a pipeline for identifying variants from genotyping-by-sequencing (GBS) data in sugarcane, (ii) construct an integrated genetic map with GBS-based markers plus target region amplification polymorphisms and microsatellites, (iii) detect QTLs related to yield component traits, and (iv) perform annotation of the sequences that originated the associated markers with mapped QTLs to search putative candidate genes. Results: We used four pseudo-references to align the GBS reads. Depending on the reference, from 3,433 to 15,906 high-quality markers were discovered, and half of them segregated as single-dose markers (SDMs) on average. In addition to 7,049 non-redundant SDMs from GBS, 629 gel-based markers were used in a subsequent linkage analysis. Of 7,678 SDMs, 993 were mapped. These markers were distributed throughout 223 linkage groups, which were clustered in 18 homo(eo)logous groups (HGs), with a cumulative map length of 3,682.04 cM and an average marker density of 3.70 cM. We performed QTL mapping of four traits and found seven QTLs. Our results suggest the presence of a stable QTL across locations. Furthermore, QTLs to soluble solid content (BRIX) and fiber content (FIB) traits had markers linked to putative candidate genes. Conclusions: This study is the first to report the use of GBS for large-scale variant discovery and genotyping of a mapping population in sugarcane, providing several insights regarding the use of NGS data in a polyploid, non-model species. The use of GBS generated a large number of markers and still enabled ploidy and allelic dosage estimation. Moreover, we were able to identify seven QTLs, two of which had great potential for validation and future use for molecular breeding in sugarcane.18FINEP (Finaciadora de Estudos e Projetos)FAPESP (Fundacao de Amparo a Pesquisa de Sao Paulo) [08/52197-4]INCT-Bioetanol (Instituto Nacional de Ciencia e Tecnologia do Bioetanol) [FAPESP 08/57908-6]INCT-Bioetanol (CNPq, Conselho Nacional de Desenvolvimento Cientifico e Tecnologico) [574002/2008-1]FAPESP [10/50091-4, 12/25236-4, 10/50549-0, 10/50031-1, 12/11109-0]CNPqCAPES (Coordenacao de Aperfeicoamento de Pessoal de Nivel Superior)Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES