Dengue in children : clinical and epidemiological characteristics, Manaus, state of Amazonas, 2006 and 2007

O objetivo deste trabalho é apresentar os aspectos clínicos e epidemiológicos das crianças acometidas por dengue, em Manaus, AM, no período de 2006 a 2007. Foram analisados 482 casos de dengue confirmados laboratorialmente, em 2006, sendo 46,9% nos menores de 15 anos, e 1.538 casos, em 2007, sendo 57,7% nos menores de 15 anos. Os dados foram obtidos do Sistema Nacional de Agravos de Notificação (SINAN) de Manaus. As variáveis analisadas foram: idade, gênero, bairro de residência, mês do inicio dos sintomas, sorotipo e forma clínica da doença. Verificou-se um aumento estatisticamente significativo da proporção de casos em menores de 15 anos, bem como das formas graves entre 2006 e 2007. Apesar de a forma hemorrágica ter sido quase três vezes mais freqüente em 2007, houve uma redução do coeficiente de letalidade. Os sorotipos identificados foram DEN-3 em 2006 e DEN-1, DEN-2 e DEN-3 em 2007. Em 2007, houve registro de casos em todos os meses do ano.This study presents the clinical and epidemiological aspects of children affected with dengue, in Manaus, AM, in 2006 and 2007. There were 482 The aim of this study was to present the clinical and epidemiological characteristics of children affected by dengue, in Manaus, State of Amazonas, in 2006 and 2007. Analysis was conducted on 482 dengue cases with confirmation from laboratory tests, in 2006 (46.9% in children under 15 years of age), and 1,538 cases in 2007 (57.7% in children under 15 years of age). The data were obtained from the National System for Notifiable Diseases (Sistema Nacional de Agravos de Notificação; SINAN) in Manaus. The variables analyzed were: age, gender, district where subject lived, month when symptoms started, serotypes and clinical form of the disease. Statistically significant increases in the proportion of cases in children under 15 years of age and in the proportion of severe forms were found between 2006 and 2007. Although the hemorrhagic form was almost three times more frequent in 2007, the mortality rate was lower. The serotypes identified were DEN-3 in 2006 and DEN-1, DEN-2 and DEN-3 in 2007. In 2007, cases were recorded in every month of the year

The VISCACHA survey : IV. The SMC West Halo in 8D

The structure of the Small Magellanic Cloud (SMC) is very complex, in particular in the periphery that suffers more from the interactions with the Large Magellanic Cloud (LMC). A wealth of observational evidence has been accumulated revealing tidal tails and bridges made up of gas, stars, and star clusters. Nevertheless, a full picture of the SMC outskirts is only recently starting to emerge with a 6D phase-space map plus age and metallicity using star clusters as tracers. In this work, we continue our analysis of another outer region of the SMC, the so-called West Halo, and combined it with the previously analysed Northern Bridge. We use both structures to define the Bridge and Counter-bridge trailing and leading tidal tails. These two structures are moving away from each other, roughly in the SMC–LMC direction. The West Halo form a ring around the SMC inner regions that goes up to the background of the Northern Bridge shaping an extended layer of the Counter-bridge. Four old Bridge clusters were identified at distances larger than 8 kpc from the SMC centre moving towards the LMC, which is consistent with the SMC–LMC closest distance of 7.5 kpc when the Magellanic Bridge was formed about 150Myr ago; this shows that the Magellanic Bridge was not formed only by pulled gas, but it also removed older stars from the SMC during its formation. We also found age and metallicity radial gradients using projected distances on sky, which are vanished when we use the real 3D distances

O Papel das Subsidiárias de Corporações Multinacionais: Um Estudo de Caso na Indústria Brasileira de Refrigerantes

An important challenge for companies which internationalize its business is to develop a globalization level that balance local and globalized operations. The effective management of subsidiaries and business unities could create competitive advantage for the whole corporation in an uncertain and dynamic business scenario. A case study was conducted in a Brazilian soft drink subsidiary. The current paper presents an example the strategic importance of MNEs´subsidiaries of MNE. In our vision subsidiaries could not only implement global strategy but also help in the process of global strategic management, identifying market opportunities and creating competitive advantages.Um importante desafio para as empresas que hoje internacionalizam seus negócios é desenvolver um nível de globalização que gere concentrações adequadas das operações locais e globalizadas para a empresa. Em um cenário muito mais incerto e dinâmico que os seguros mercados regionais, o gerenciamento eficaz das subsidiárias e unidades de negócios por parte das matrizes das multinacionais pode criar vantagens competitivas aplicáveis em toda corporação. A partir do estudo de caso de uma subsidiária atuando no mercado brasileiro de refrigerantes, o presente trabalho busca reconhecer a importância estratégica das subsidiárias das corporações multinacionais, conscientizando as empresas brasileiras que internacionalizam seus negócios e as multinacionais que atuam no Brasil, do papel das subsidiárias não apenas como instrumentos para implementação ou adaptação das diretrizes globais da empresa, mas com destaque na formulação de estratégias, na identificação de oportunidades de mercado e na criação de vantagens competitivas

Combination of toothbrushing and chlorhexidine compared with exclusive use of chlorhexidine to reduce the risk of ventilator-associated pneumonia: A systematic review with meta-analysis

This study aimed to compare the effectiveness of 0.12% chlorhexidine alone and 0.12% chlorhexidine in combination with toothbrushing to prevent ventilator-associated pneumonia (VAP) in mechanically ventilated patients. The Embase, Latin American and Caribbean Health Science Literature, PubMed, Scientific Electronic Library Online, Scopus, LIVIVO, Web of Science, Cochrane Library, OpenThesis, and Open Access Thesis and Dissertations databases were used. Only randomized controlled trials without restrictions on the year or language of publication were included. Two reviewers assessed the risk of bias using the Joanna Briggs Institute Critical Appraisal Tool. A meta-analysis using a random-effects model estimated the combined relative risk (RR). The Grading of Recommendations, Assessment, Development and Evaluations approach was used to assess the certainty of the evidence. Initially, 2,337 studies were identified, of which 4 were considered in the systematic review and 3 in the meta-analysis (total sample: 796 patients). The studies were published between 2009 and 2017. All eligible studies had a low risk of bias. The meta-analysis revealed that the risk of VAP was 24% lower in patients receiving chlorhexidine combined with toothbrushing than in those receiving chlorhexidine alone (RR: 0.76; 95% confidence interval: 0.55-1.06), with moderate certainty of evidence and without statistical significance. In conclusion, considering the limitations of this study, a standard protocol for the prevention of VAP is not yet recommended. More studies with larger sample sizes are needed to draw strong conclusions. However, considering that toothbrushing is a simple intervention, it should be a common practice in mechanically ventilated patients, especially among patients with coronavirus disease

Instrumentos de Gestão e Controle de Gastos em C&T: o Caso das Prestações de Contas Simplificadas do Programa de Demanda Social na CAPES

O presente artigo relata a experiência de construção e implantação de um sistema de informação gerencial para uma instituição de gestão de Ciência e Tecnologia – C&T. Atualmente o acompanhamento e controle da execução dos gastos vinculados a bolsas de mestrado e doutorado são realizados, sobretudo, por meio do sistema inovador de prestação de contas simplificada. Esse sistema gerencia a execução de cerca de 34.000 bolsas vinculadas com a pós-graduação em todo o território nacional. As condições de implantação do sistema colocam a CAPES – Coordenação de Aperfeiçoamento de Pessoal de Nível Superior e as diversas IES nacionais – Instituições de Ensino Superior, como parceiras, visando tornar o processo de prestação de contas das bolsas de pós-graduação stricto sensu, um processo dinâmico, rápido e criativo. Os objetivos deste trabalho são: a) tornar pública a experiência de implantação do Sistema de Prestação de Contas Simplificada da Demanda Social (Programa de concessão de bolsas de mestrado e doutorado), b) avaliar os resultados obtidos e o desempenho do sistema; c) registrar e avaliar aspectos-chave ou peculiaridades de natureza técnica/política do sistema de informação, bem como dificuldades e limitações. A melhoria do fluxo de informação promovida pelo software adaptado e redução da burocracia envolta no processo de prestação de contas refletem-se na melhoria do acompanhamento, controle e na tempestividade da tomada de decisão gerencial, lições sobre a gestão de processos de informação em C&T, cujo conhecimento pode ser de utilidade para empreendimentos semelhantes

Celiac disease and female infertility : a frequently neglected association

Objetivo: Verificar a existência de associação entre subfertilidade ou infertilidade e concomitante presença de doença celíaca nas mulheres atendidas em ambulatório de hospital geral especializado em reprodução humana. Métodos: O delineamento do estudo foi do tipo caso-controle. Os casos foram constituídos por um grupo de 200 mulheres com queixa de dificuldade para engravidar, e um grupo controle formado por 400 mulheres atendidas no mesmo ambulatório com queixas variadas, mas sem problemas de fertilidade. Ambos os grupos de pacientes foram submetidos a pesquisa de anticorpos antiendomísio pelo método de imunofluorescência indireta. Nos casos positivos, o diagnóstico foi confirmado por biópsia duodenal endoscópica e exame histopatológico. Resultados: Os testes antiendomísio no grupo com dificuldade para engravidar resultaram positivos em três pacientes (1,5%). O diagnóstico de doença celíaca foi confirmado por subseqüente exame histopatológico da mucosa duodenal. Todas as pacientes pertencentes ao grupo controle apresentaram testes sorológicos negativos. Conclusões: O fato de terem sido encontrados casos de doença celíaca somente entre mulheres com queixas de dificuldade para engravidar parece um dado relevante e sugestivo de ser a doença celíaca mais comum entre mulheres inférteis; porém, há necessidade de novos estudos com tamanho de amostra maior para confirmação definitiva dessa provável associação.Purpose: To verify the existence of association between sub-fertility or infertility and concurrent celiac disease in women attended at a reproductive disorders out-patient clinic of a general hospital. Methods: This was a case-control study in which a group of 200 women with difficulty in conceiving was compared with a control group with 400 women who were treated at the same hospital for various reasons, but not for fertility problems. Both groups were submitted to the anti-endomysium antibody protocol using the indirect immunofl uorescence method. Whenever positive, the diagnosis was further confirmed by endoscopic duodenal biopsy and histopathological exams. Results: Anti-endomysium testing resulted positive in three patients (1.5%) within the group of women with difficulty in conceiving. Diagnosis of celiac disease was subsequently confirmed by histopathological exams of the duodenal mucosa. All the control patients presented negative results in the serological exams. Conclusions: Celiac disease was observed only in women with difficulty in conceiving, a relevant fact indicating that this disease may be more common in infertile women. However, new studies with a greater sample size are needed to confirm this possible association

Participação paterna na gestação, parto e puerpério: uma revisão integrativa / Paternal participation in pregnancy, parturition and puerperium: an integrative review

In a patriarchal matrix society, the concept of masculinity is associated with a notion of virility and providing the home. However, male participation in family relationships is of paramount importance, especially in the pregnancy-puerperal cycle, as it can bring security, balance, benefits to pregnancy, parturition and the puerperium, in addition to strengthening bonds and facilitating the transition to parenting. It is an integrative literature review, in the databases of LILACS, Scielo and Portal de Periódicos da Capes. The research was based on the descriptors "paternity", "pregnancy", "childbirth" and "puerperium", using the Boolean operator "AND". Studies between 2009 and 2019 were included, available in full. RAYYAN® was used to select and evaluate the studies. The data analysis was based on the criteria of Laurence Bardin with the categorization of the topics to be discussed. Microsoft Excel® was used to summarize and synthesize the articles selected for review. 31 articles were found in the databases, and after reading and evaluating, 5 studies were included for review. The discussion was based on the following pillars: stigma and social barriers; difficulties encountered by the couple in the arrival of a new member; benefits of paternal participation in pregnancy, childbirth and the puerperium; importance of the guidance of health professionals for the inclusion of man/father in the care of the mother-child dyad. It is concluded that male participation in pregnancy, childbirth and the puerperium must be reinforced and stimulated, mainly by health professionals, since it brings benefits to family health and reinforces the father-mother-child triad.  

Using deep autoencoders for in-vehicle audio anomaly detection

Current developments on self-driving cars has led to an increasing interest on autonomous shared taxicabs. While most self-driving car technologies focus on the outside environment, there is also a need to provide in-vehicle intelligence (e.g., detect health and safety issues related with the current car occupants). Set within an R&D project focused on in-vehicle cockpit intelligence, the research presented in this paper addresses an unsupervised Acoustic Anomaly Detection (AAD) task. Since data is nonexistent in this domain, we first design an in-vehicle sound event data simulator that can realistically mix background audios (recorded from car driving trips) with normal (e.g., people talking, radio on) and abnormal (e.g., people arguing, cough) event sounds, allowing the generation of three synthetic in-vehicle sound datasets. Then, we explore two main sound feature extraction methods (based on a combination of three audio features and mel frequency energy coefficients) and propose a novel Long Short-Term Memory Autoencoder (LSTM-AE) deep learning architecture for in-vehicle sound anomaly detection. Competitive results were achieved by the proposed LSTM-AE when compared with two state-of-the-art methods, namely a dense Autoencoder (AE) and a two-stage clustering.This work is supported by the European Structural and Investment Funds in the FEDER component, through the Operational Competitiveness and Internationalization Programme (COMPETE 2020) [Project no 039334; Funding Reference: POCI-01-0247-FEDER-039334]