As Representações Da Violência Obstétrica No Brasil

RESUMO: A violência obstétrica materializa-se como negligência, violência verbal e física, além do abuso sexual. Ademais, é caracterizada por discursos abstratos e retóricos, como comportamental ligada a exceções, escondendo seu enfoque patológico, eliminando-se as esferas sociais, culturais e existenciais; que a configuram como institucional. Diante disso, o trabalho teve como objetivo analisar as representações desse quadro na realidade brasileira, seja na gestação, parto ou pós-parto dada a relevância e gravidadeque configura esse tema como incipiente e permeado por imprecisões. O recorte para o tema da violência obstétrica se deu através de uma mini revisão integrativa da literatura. Os artigos analisados foram veiculados pelas seguintes bases de dados: US National Library of Medicine (PubMed) e Scientific Eletronic Library Online (Scielo) que se adequaram aos descritores mulher, profissional de saúde, violência, parto obstétrico e obstetrícia. São datados entre 2015 a 2017. Encontrou-se como resultados que a violência obstétrica está enraizada no modelo biomédico hegemônico, questão intocável no discurso dos órgãos de classe, invisível no campo judicial, resistente ao diálogo e, tendo o papel da mulher diminuído no binômio materno-fetal. Além disso, esse debate ultrapassa a polarização entre o parto espontâneo e a cesárea eletiva, cristalizando hostilização e infantilização às parturientes. Conclui-se a necessidade de reconstrução do processo dedecisão das mulheres, desconstrução da banalização de intervenções danosas, desenvolvimento de práticas médicas que enfatizem a autonomia, civilidade e preservem a sexualidade e saúde materna, evidenciando novas emergências discursivas e práticas para eliminar essa vontade de exclusão da mulher

CIRURGIA BARIÁTRICA: INDICAÇÕES E TÉCNICAS CIRÚRGICAS

Obesity is a complex global health issue that demands an integrated approach. Understanding its epidemiology, risk factors, progression, early diagnosis, and social and economic implications is crucial to addressing this growing challenge. Bariatric surgery in the adult population is a dynamic and intricate field where techniques, indications, contraindications, complications, and historical evolution intricately intertwine. The examined literature reveals a continuous need for personalized and multidisciplinary approaches, considering not only the physical but also the psychological and social aspects of patients undergoing this intervention. Surgical techniques in addressing obesity have specificities that should be carefully evaluated by healthcare professionals. The reviewed literature provides valuable insights to support clinical decisions, highlighting the benefits and specific considerations associated with adjustable gastric banding, vertical gastrectomy, and gastric bypass. The significance of the multidisciplinary team in bariatric surgery lies in the comprehensive approach to the patient, addressing various medical, nutritional, psychological, and social aspects involved. This collaborative approach is essential to ensure successful outcomes, patient satisfaction, and the prevention of short- and long-term complications.A obesidade é um problema de saúde global complexo que exige uma abordagem integrada. A compreensão de sua epidemiologia, fatores de risco, evolução, diagnóstico precoce e implicações sociais e econômicas é crucial para enfrentar esse desafio crescente. a cirurgia bariátrica na população adulta é um campo dinâmico e complexo, onde as técnicas, indicações, contraindicações, complicações e a evolução histórica se entrelaçam de maneira intrincada. A literatura examinada revela a necessidade contínua de abordagens personalizadas e multidisciplinares, considerando não apenas os aspectos físicos, mas também os psicológicos e sociais dos pacientes submetidos a essa intervenção. as técnicas cirúrgicas na abordagem da obesidade apresentam particularidades que devem ser cuidadosamente avaliadas pelos profissionais de saúde. A literatura revisada fornece subsídios valiosos para embasar decisões clínicas, evidenciando os benefícios e as considerações específicas associadas à banda gástrica ajustável, à gastrectomia vertical e ao bypass gástrico. A importância da equipe multidisciplinar na cirurgia bariátrica reside na abordagem integral do paciente, contemplando os diversos aspectos médicos, nutricionais, psicológicos e sociais envolvidos. Essa abordagem colaborativa é essencial para garantir resultados bem-sucedidos, a satisfação do paciente e a prevenção de complicações a curto e longo prazo

Pervasive gaps in Amazonian ecological research

Biodiversity loss is one of the main challenges of our time,1,2 and attempts to address it require a clear un derstanding of how ecological communities respond to environmental change across time and space.3,4 While the increasing availability of global databases on ecological communities has advanced our knowledge of biodiversity sensitivity to environmental changes,5–7 vast areas of the tropics remain understudied.8–11 In the American tropics, Amazonia stands out as the world’s most diverse rainforest and the primary source of Neotropical biodiversity,12 but it remains among the least known forests in America and is often underrepre sented in biodiversity databases.13–15 To worsen this situation, human-induced modifications16,17 may elim inate pieces of the Amazon’s biodiversity puzzle before we can use them to understand how ecological com munities are responding. To increase generalization and applicability of biodiversity knowledge,18,19 it is thus crucial to reduce biases in ecological research, particularly in regions projected to face the most pronounced environmental changes. We integrate ecological community metadata of 7,694 sampling sites for multiple or ganism groups in a machine learning model framework to map the research probability across the Brazilian Amazonia, while identifying the region’s vulnerability to environmental change. 15%–18% of the most ne glected areas in ecological research are expected to experience severe climate or land use changes by 2050. This means that unless we take immediate action, we will not be able to establish their current status, much less monitor how it is changing and what is being lostinfo:eu-repo/semantics/publishedVersio

Global maps of soil temperature

Research in global change ecology relies heavily on global climatic grids derived from estimates of air temperature in open areas at around 2 m above the ground. These climatic grids do not reflect conditions below vegetation canopies and near the ground surface, where critical ecosystem functions occur and most terrestrial species reside. Here, we provide global maps of soil temperature and bioclimatic variables at a 1-km2 resolution for 0–5 and 5–15 cm soil depth. These maps were created by calculating the difference (i.e. offset) between in situ soil temperature measurements, based on time series from over 1200 1-km2 pixels (summarized from 8519 unique temperature sensors) across all the world\u27s major terrestrial biomes, and coarse-grained air temperature estimates from ERA5-Land (an atmospheric reanalysis by the European Centre for Medium-Range Weather Forecasts). We show that mean annual soil temperature differs markedly from the corresponding gridded air temperature, by up to 10°C (mean = 3.0 ± 2.1°C), with substantial variation across biomes and seasons. Over the year, soils in cold and/or dry biomes are substantially warmer (+3.6 ± 2.3°C) than gridded air temperature, whereas soils in warm and humid environments are on average slightly cooler (−0.7 ± 2.3°C). The observed substantial and biome-specific offsets emphasize that the projected impacts of climate and climate change on near-surface biodiversity and ecosystem functioning are inaccurately assessed when air rather than soil temperature is used, especially in cold environments. The global soil-related bioclimatic variables provided here are an important step forward for any application in ecology and related disciplines. Nevertheless, we highlight the need to fill remaining geographic gaps by collecting more in situ measurements of microclimate conditions to further enhance the spatiotemporal resolution of global soil temperature products for ecological applications

Global maps of soil temperature

Research in global change ecology relies heavily on global climatic grids derived from estimates of air temperature in open areas at around 2 m above the ground. These climatic grids do not reflect conditions below vegetation canopies and near the ground surface, where critical ecosystem functions occur and most terrestrial species reside. Here, we provide global maps of soil temperature and bioclimatic variables at a 1-km² resolution for 0–5 and 5–15 cm soil depth. These maps were created by calculating the difference (i.e., offset) between in-situ soil temperature measurements, based on time series from over 1200 1-km² pixels (summarized from 8500 unique temperature sensors) across all the world’s major terrestrial biomes, and coarse-grained air temperature estimates from ERA5-Land (an atmospheric reanalysis by the European Centre for Medium-Range Weather Forecasts). We show that mean annual soil temperature differs markedly from the corresponding gridded air temperature, by up to 10°C (mean = 3.0 ± 2.1°C), with substantial variation across biomes and seasons. Over the year, soils in cold and/or dry biomes are substantially warmer (+3.6 ± 2.3°C) than gridded air temperature, whereas soils in warm and humid environments are on average slightly cooler (-0.7 ± 2.3°C). The observed substantial and biome-specific offsets emphasize that the projected impacts of climate and climate change on near-surface biodiversity and ecosystem functioning are inaccurately assessed when air rather than soil temperature is used, especially in cold environments. The global soil-related bioclimatic variables provided here are an important step forward for any application in ecology and related disciplines. Nevertheless, we highlight the need to fill remaining geographic gaps by collecting more in-situ measurements of microclimate conditions to further enhance the spatiotemporal resolution of global soil temperature products for ecological applications

Minimal Symptom Expression' in Patients With Acetylcholine Receptor Antibody-Positive Refractory Generalized Myasthenia Gravis Treated With Eculizumab

The efficacy and tolerability of eculizumab were assessed in REGAIN, a 26-week, phase 3, randomized, double-blind, placebo-controlled study in anti-acetylcholine receptor antibody-positive (AChR+) refractory generalized myasthenia gravis (gMG), and its open-label extension

AI is a viable alternative to high throughput screening: a 318-target study

: High throughput screening (HTS) is routinely used to identify bioactive small molecules. This requires physical compounds, which limits coverage of accessible chemical space. Computational approaches combined with vast on-demand chemical libraries can access far greater chemical space, provided that the predictive accuracy is sufficient to identify useful molecules. Through the largest and most diverse virtual HTS campaign reported to date, comprising 318 individual projects, we demonstrate that our AtomNet® convolutional neural network successfully finds novel hits across every major therapeutic area and protein class. We address historical limitations of computational screening by demonstrating success for target proteins without known binders, high-quality X-ray crystal structures, or manual cherry-picking of compounds. We show that the molecules selected by the AtomNet® model are novel drug-like scaffolds rather than minor modifications to known bioactive compounds. Our empirical results suggest that computational methods can substantially replace HTS as the first step of small-molecule drug discovery

Post-intervention Status in Patients With Refractory Myasthenia Gravis Treated With Eculizumab During REGAIN and Its Open-Label Extension

OBJECTIVE: To evaluate whether eculizumab helps patients with anti-acetylcholine receptor-positive (AChR+) refractory generalized myasthenia gravis (gMG) achieve the Myasthenia Gravis Foundation of America (MGFA) post-intervention status of minimal manifestations (MM), we assessed patients' status throughout REGAIN (Safety and Efficacy of Eculizumab in AChR+ Refractory Generalized Myasthenia Gravis) and its open-label extension. METHODS: Patients who completed the REGAIN randomized controlled trial and continued into the open-label extension were included in this tertiary endpoint analysis. Patients were assessed for the MGFA post-intervention status of improved, unchanged, worse, MM, and pharmacologic remission at defined time points during REGAIN and through week 130 of the open-label study. RESULTS: A total of 117 patients completed REGAIN and continued into the open-label study (eculizumab/eculizumab: 56; placebo/eculizumab: 61). At week 26 of REGAIN, more eculizumab-treated patients than placebo-treated patients achieved a status of improved (60.7% vs 41.7%) or MM (25.0% vs 13.3%; common OR: 2.3; 95% CI: 1.1-4.5). After 130 weeks of eculizumab treatment, 88.0% of patients achieved improved status and 57.3% of patients achieved MM status. The safety profile of eculizumab was consistent with its known profile and no new safety signals were detected. CONCLUSION: Eculizumab led to rapid and sustained achievement of MM in patients with AChR+ refractory gMG. These findings support the use of eculizumab in this previously difficult-to-treat patient population. CLINICALTRIALSGOV IDENTIFIER: REGAIN, NCT01997229; REGAIN open-label extension, NCT02301624. CLASSIFICATION OF EVIDENCE: This study provides Class II evidence that, after 26 weeks of eculizumab treatment, 25.0% of adults with AChR+ refractory gMG achieved MM, compared with 13.3% who received placebo

Pervasive gaps in Amazonian ecological research

Biodiversity loss is one of the main challenges of our time,1,2 and attempts to address it require a clear understanding of how ecological communities respond to environmental change across time and space.3,4 While the increasing availability of global databases on ecological communities has advanced our knowledge of biodiversity sensitivity to environmental changes,5,6,7 vast areas of the tropics remain understudied.8,9,10,11 In the American tropics, Amazonia stands out as the world's most diverse rainforest and the primary source of Neotropical biodiversity,12 but it remains among the least known forests in America and is often underrepresented in biodiversity databases.13,14,15 To worsen this situation, human-induced modifications16,17 may eliminate pieces of the Amazon's biodiversity puzzle before we can use them to understand how ecological communities are responding. To increase generalization and applicability of biodiversity knowledge,18,19 it is thus crucial to reduce biases in ecological research, particularly in regions projected to face the most pronounced environmental changes. We integrate ecological community metadata of 7,694 sampling sites for multiple organism groups in a machine learning model framework to map the research probability across the Brazilian Amazonia, while identifying the region's vulnerability to environmental change. 15%–18% of the most neglected areas in ecological research are expected to experience severe climate or land use changes by 2050. This means that unless we take immediate action, we will not be able to establish their current status, much less monitor how it is changing and what is being lost