Nível de Conhecimento de Adolescentes Sobre a Infecção Pelo HIV: Uma Relação Com Autocuidado e Comportamentos de Risco.

Introduction: Adolescence is marked by biopsychosocial and behavioral changes important for the construction of autonomy during new experiences. However, some habits during this phase may pose risk to HIV infection. Objective: To evaluate the adolescents' practices that may pose a risk to HIV infection, contrasting behavioral aspects with the level of prior knowledge about this infection. Methods: This is a cross-sectional study with descriptive, quantitative and correlational approaches applied to 273 adolescents from public educational institutions in six Brazilian municipalities. The data were collected through two questionnaires which focused on self-care and the level of knowledge about anatomy, pathophysiology and risk factors of HIV infection. Absolute and relative frequency measures were used, as well as Pearson correlation tests (p value < 0.05).  Results: There was a higher representativeness of 16-17 years-old and female school adolescents. The results showed risk behaviors for HIV exposure such as early sexual activity (38.4%), drug use (21.8%), multiple sexual partners (40.4%) and unprotected sex (54.5%); this was a scenario that was not necessarily related to the lack of knowledge. Notwithstanding, the study points out that the earlier the debut sexual activities or drug use, the greater the number of sexual partners during adolescence, suggesting a high risk of HIV infection. In regards to the use of interactive methodologies, these presented themselves as potential tools in permanent health education. Conclusion: The study verified the important risk behaviors related to HIV infection by school adolescents, and also that these practices are not necessarily linked to the lack of knowledge about this issue. The implications of this study are directed towards the promotion of changes in practices of health and education professionals, as well as the development of public policies aimed at reducing the adolescents’ risk behaviors.Introducción: La adolescencia está marcada por cambios biopsicosociales y conductuales que son importantes para la construcción de la autonomía durante las nuevas experiencias. Sin embargo, algunos hábitos de esta fase pueden suponer un riesgo de infección por VIH. Objetivo: Evaluar las prácticas de población adolescente en edad escolar que suponen un riesgo para la infección por VIH, contrastando aspectos conductuales con el nivel de conocimiento previo sobre esta infección. Métodos: Estudio transversal, con enfoques descriptivo, cuantitativo y correlacional con 273 adolescentes de instituciones educativas públicas, ubicadas en seis municipios brasileños. Los datos se recopilaron a través de dos cuestionarios, los cuales están centrados en el autocuidado y en el nivel de conocimiento sobre la anatomía, la fisiopatología y los factores de riesgo de la infección por el VIH. Se utilizaron medidas de frecuencia absoluta y relativa, así como pruebas de correlación de Pearson (valor p < ‍0.05). Resultados: Se produjo una mayor representatividad de adolescentes escolares con grupo de edad entre 16 y 17 años y sexo femenino. Los resultados muestran comportamientos de riesgo de exposición al VIH, como la actividad sexual precoz (38.4 %), el consumo de drogas (21.8 %), la multiplicidad de parejas sexuales (40.4 %) y las relaciones sexuales sin protección (54.5 %); este último escenario no estaba necesariamente relacionado con el déficit de conocimientos. Aun así, el estudio señala que cuanto más temprano es el inicio sexual o el consumo de drogas, mayor es el número de parejas sexuales durante la adolescencia, lo que sugiere un alto riesgo de infección por el VIH. En cuanto al uso de metodologías interactivas, estas se presentaron como herramientas potenciales en la educación sanitaria permanente. Conclusión: Se constataron importantes comportamientos de riesgo relacionados con la infección por el VIH, por parte de escolares. Asimismo, dichas prácticas no están necesariamente ligadas al déficit de conocimiento sobre este tema. Las implicaciones de este estudio se dirigen a la promoción de cambios en las prácticas de profesionales de la salud y de la educación, así como al desarrollo de políticas públicas dirigidas a reducir las conductas de riesgo de la población adolescente.Introdução: A adolescência é marcada por mudanças biopsicossociais e comportamentais, as quais são importantes para a construção da autonomia durante novas experiências. Porém, alguns hábitos nessa fase podem conferir riscos à infecção pelo HIV. Objetivo: Avaliar práticas de adolescentes escolares que conferem risco à infecção pelo HIV, contrastando aspectos comportamentais com o nível de conhecimento prévio sobre esta infecção. Métodos: Trata-se de um estudo transversal, com abordagens descritiva, quantitativa e correlacional com 273 adolescentes de instituições públicas de ensino situadas em seis municípios brasileiros. Os dados foram coletados através de dois questionários, com foco no autocuidado e no nível de conhecimento sobre anatomia, fisiopatologia e fatores de risco da infecção pelo HIV. Foram utilizadas medidas de frequência absoluta e relativa, bem como testes de correlação de Pearson (p valor < 0,05). Resultados: Ocorreu maior representatividade dos adolescentes escolares com faixa etária entre 16 e 17 anos e sexo feminino. Os resultados mostram comportamentos de risco de exposição ao HIV, como atividade sexual precoce (38,4%), uso de drogas (21,8%), múltiplos parceiros sexuais (40,4%) e sexo desprotegido (54,5%), cenário que não esteve relacionado necessariamente com déficit de conhecimento. Ainda, o estudo aponta que quanto mais precoce a sexarca ou uso de drogas, maior o número de parceiros sexuais durante a adolescência, sugerindo alto risco de infecção pelo HIV. Acerca do uso de metodologias interativas, estas se apresentaram como potenciais ferramentas na educação permanente em saúde. Conclusão: Constatou-se importantes comportamentos de risco referentes à infecção pelo HIV, por escolares, e que essas práticas não estão necessariamente ligadas ao déficit de conhecimento sobre este agravo. As implicações deste estudo são direcionadas ao fomento de mudanças em práticas de profissionais da saúde e educação, bem como desenvolvimento de políticas públicas que visem à redução do comportamento de risco pelos adolescentes

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 <= 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

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 <= 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.13Hospital do Coracao (HCor) as part of the Program 'Hospitais de Excelencia a Servico do SUS (PROADI-SUS)'Brazilian Ministry of Healt

First Measurement of the Total Inelastic Cross-Section of Positively-Charged Kaons on Argon at Energies Between 5.0 and 7.5 GeV

International audienceProtoDUNE Single-Phase (ProtoDUNE-SP) is a 770-ton liquid argon time projection chamber that operated in a hadron test beam at the CERN Neutrino Platform in 2018. We present a measurement of the total inelastic cross section of charged kaons on argon as a function of kaon energy using 6 and 7 GeV/$c$ beam momentum settings. The flux-weighted average of the extracted inelastic cross section at each beam momentum setting was measured to be 380$\pm$26 mbarns for the 6 GeV/$c$ setting and 379$\pm$35 mbarns for the 7 GeV/$c$ setting

First Measurement of the Total Inelastic Cross-Section of Positively-Charged Kaons on Argon at Energies Between 5.0 and 7.5 GeV

International audienceProtoDUNE Single-Phase (ProtoDUNE-SP) is a 770-ton liquid argon time projection chamber that operated in a hadron test beam at the CERN Neutrino Platform in 2018. We present a measurement of the total inelastic cross section of charged kaons on argon as a function of kaon energy using 6 and 7 GeV/$c$ beam momentum settings. The flux-weighted average of the extracted inelastic cross section at each beam momentum setting was measured to be 380$\pm$26 mbarns for the 6 GeV/$c$ setting and 379$\pm$35 mbarns for the 7 GeV/$c$ setting

The DUNE Far Detector Vertical Drift Technology, Technical Design Report

International audienceDUNE is an international experiment dedicated to addressing some of the questions at the forefront of particle physics and astrophysics, including the mystifying preponderance of matter over antimatter in the early universe. The dual-site experiment will employ an intense neutrino beam focused on a near and a far detector as it aims to determine the neutrino mass hierarchy and to make high-precision measurements of the PMNS matrix parameters, including the CP-violating phase. It will also stand ready to observe supernova neutrino bursts, and seeks to observe nucleon decay as a signature of a grand unified theory underlying the standard model. The DUNE far detector implements liquid argon time-projection chamber (LArTPC) technology, and combines the many tens-of-kiloton fiducial mass necessary for rare event searches with the sub-centimeter spatial resolution required to image those events with high precision. The addition of a photon detection system enhances physics capabilities for all DUNE physics drivers and opens prospects for further physics explorations. Given its size, the far detector will be implemented as a set of modules, with LArTPC designs that differ from one another as newer technologies arise. In the vertical drift LArTPC design, a horizontal cathode bisects the detector, creating two stacked drift volumes in which ionization charges drift towards anodes at either the top or bottom. The anodes are composed of perforated PCB layers with conductive strips, enabling reconstruction in 3D. Light-trap-style photon detection modules are placed both on the cryostat's side walls and on the central cathode where they are optically powered. This Technical Design Report describes in detail the technical implementations of each subsystem of this LArTPC that, together with the other far detector modules and the near detector, will enable DUNE to achieve its physics goals

The DUNE Far Detector Vertical Drift Technology, Technical Design Report

International audienceDUNE is an international experiment dedicated to addressing some of the questions at the forefront of particle physics and astrophysics, including the mystifying preponderance of matter over antimatter in the early universe. The dual-site experiment will employ an intense neutrino beam focused on a near and a far detector as it aims to determine the neutrino mass hierarchy and to make high-precision measurements of the PMNS matrix parameters, including the CP-violating phase. It will also stand ready to observe supernova neutrino bursts, and seeks to observe nucleon decay as a signature of a grand unified theory underlying the standard model. The DUNE far detector implements liquid argon time-projection chamber (LArTPC) technology, and combines the many tens-of-kiloton fiducial mass necessary for rare event searches with the sub-centimeter spatial resolution required to image those events with high precision. The addition of a photon detection system enhances physics capabilities for all DUNE physics drivers and opens prospects for further physics explorations. Given its size, the far detector will be implemented as a set of modules, with LArTPC designs that differ from one another as newer technologies arise. In the vertical drift LArTPC design, a horizontal cathode bisects the detector, creating two stacked drift volumes in which ionization charges drift towards anodes at either the top or bottom. The anodes are composed of perforated PCB layers with conductive strips, enabling reconstruction in 3D. Light-trap-style photon detection modules are placed both on the cryostat's side walls and on the central cathode where they are optically powered. This Technical Design Report describes in detail the technical implementations of each subsystem of this LArTPC that, together with the other far detector modules and the near detector, will enable DUNE to achieve its physics goals

First Measurement of the Total Inelastic Cross-Section of Positively-Charged Kaons on Argon at Energies Between 5.0 and 7.5 GeV

International audienceProtoDUNE Single-Phase (ProtoDUNE-SP) is a 770-ton liquid argon time projection chamber that operated in a hadron test beam at the CERN Neutrino Platform in 2018. We present a measurement of the total inelastic cross section of charged kaons on argon as a function of kaon energy using 6 and 7 GeV/$c$ beam momentum settings. The flux-weighted average of the extracted inelastic cross section at each beam momentum setting was measured to be 380$\pm$26 mbarns for the 6 GeV/$c$ setting and 379$\pm$35 mbarns for the 7 GeV/$c$ setting

The DUNE Far Detector Vertical Drift Technology, Technical Design Report

DUNE is an international experiment dedicated to addressing some of the questions at the forefront of particle physics and astrophysics, including the mystifying preponderance of matter over antimatter in the early universe. The dual-site experiment will employ an intense neutrino beam focused on a near and a far detector as it aims to determine the neutrino mass hierarchy and to make high-precision measurements of the PMNS matrix parameters, including the CP-violating phase. It will also stand ready to observe supernova neutrino bursts, and seeks to observe nucleon decay as a signature of a grand unified theory underlying the standard model. The DUNE far detector implements liquid argon time-projection chamber (LArTPC) technology, and combines the many tens-of-kiloton fiducial mass necessary for rare event searches with the sub-centimeter spatial resolution required to image those events with high precision. The addition of a photon detection system enhances physics capabilities for all DUNE physics drivers and opens prospects for further physics explorations. Given its size, the far detector will be implemented as a set of modules, with LArTPC designs that differ from one another as newer technologies arise. In the vertical drift LArTPC design, a horizontal cathode bisects the detector, creating two stacked drift volumes in which ionization charges drift towards anodes at either the top or bottom. The anodes are composed of perforated PCB layers with conductive strips, enabling reconstruction in 3D. Light-trap-style photon detection modules are placed both on the cryostat's side walls and on the central cathode where they are optically powered. This Technical Design Report describes in detail the technical implementations of each subsystem of this LArTPC that, together with the other far detector modules and the near detector, will enable DUNE to achieve its physics goals

The DUNE Far Detector Vertical Drift Technology, Technical Design Report

International audienceDUNE is an international experiment dedicated to addressing some of the questions at the forefront of particle physics and astrophysics, including the mystifying preponderance of matter over antimatter in the early universe. The dual-site experiment will employ an intense neutrino beam focused on a near and a far detector as it aims to determine the neutrino mass hierarchy and to make high-precision measurements of the PMNS matrix parameters, including the CP-violating phase. It will also stand ready to observe supernova neutrino bursts, and seeks to observe nucleon decay as a signature of a grand unified theory underlying the standard model. The DUNE far detector implements liquid argon time-projection chamber (LArTPC) technology, and combines the many tens-of-kiloton fiducial mass necessary for rare event searches with the sub-centimeter spatial resolution required to image those events with high precision. The addition of a photon detection system enhances physics capabilities for all DUNE physics drivers and opens prospects for further physics explorations. Given its size, the far detector will be implemented as a set of modules, with LArTPC designs that differ from one another as newer technologies arise. In the vertical drift LArTPC design, a horizontal cathode bisects the detector, creating two stacked drift volumes in which ionization charges drift towards anodes at either the top or bottom. The anodes are composed of perforated PCB layers with conductive strips, enabling reconstruction in 3D. Light-trap-style photon detection modules are placed both on the cryostat's side walls and on the central cathode where they are optically powered. This Technical Design Report describes in detail the technical implementations of each subsystem of this LArTPC that, together with the other far detector modules and the near detector, will enable DUNE to achieve its physics goals