Relação entre Vivência Acadêmica e Ansiedade em Estudantes Universitários

Researches have evaluated the anxiety and college students adaptation to academic life, but few Brazilian studies investigated the relation between these variables. This study aimed to evaluate the student’s degree of academic adaptation and its relation to anxiety and sociodemographic and academic variables. This is a cross-sectional Survey research, part of a multicentric study. Participated 316 students from three institutions: Universidade Federal de São João del-Rei, Universidade Federal de Ouro Preto e Universidade Federal do Triângulo Mineiro. Subjects answered online instruments: Questionário de Vivências Acadêmicas (QVA-r); Escala de Depressão, Ansiedade e Estresse (DASS-21) and sociodemografic/academic questionnaire. Results showed moderate degree of academic adaptation, stronger for the dimensions Carrier, Personal and Interpessonal and moderate levels of anxiety. Multiple regression indicated that higher levels of anxiety were predictor of lower degree of academic adaptation, for Carrier, Study and Institucional. For Carrier, being in a medical course was predictor of lower degree of adaptation. For anxiety, the predictors were being female, being in Nursing course and low age. This research can be considered an advance in this area due to the lack of studies on this issue. Future studies should include others universities and parts of the country.Estudos têm investigado a ansiedade e a adaptação acadêmica em estudantes universitários, mas poucas pesquisas nacionais avaliaram a relação entre estas variáveis. O objetivo deste estudo foi avaliar o grau de adaptação acadêmica dos estudantes e suas relações com ansiedade e variáveis sociodemográficas e acadêmicas. Trata-se de Pesquisa de Levantamento (Survey), de corte transversal, parte de um estudo multicêntrico. Participaram 316 alunos da Universidade Federal de São João del-Rei, Universidade Federal de Ouro Preto e Universidade Federal do Triângulo Mineiro. Foram aplicados os seguintes instrumentos online: Questionário de Vivências Acadêmicas (QVA-r); Escala de Depressão, Ansiedade e Estresse (DASS-21) e Questionário sociodemográfico/acadêmico. Os resultados mostraram grau moderado de adaptação acadêmica, com maiores escores nas dimensões Carreira, Pessoal e Interpessoal e níveis moderados de ansiedade. Na regressão múltipla, maior nível de ansiedade foi preditor de menor adaptação acadêmica, nas dimensões Carreira, Estudo e Institucional. Para a dimensão Carreira, cursar Medicina também foi um fator preditor de menor adaptação. Para ansiedade, os fatores preditores foram: sexo feminino, cursar Enfermagem e ter menor idade. Esta pesquisa pode ser considerada um avanço na área, devido à carência de estudos nesta temática. Estudos futuros deverão incluir outras universidades e regiões do país

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

Catálogo Taxonômico da Fauna do Brasil: setting the baseline knowledge on the animal diversity in Brazil

The limited temporal completeness and taxonomic accuracy of species lists, made available in a traditional manner in scientific publications, has always represented a problem. These lists are invariably limited to a few taxonomic groups and do not represent up-to-date knowledge of all species and classifications. In this context, the Brazilian megadiverse fauna is no exception, and the Catálogo Taxonômico da Fauna do Brasil (CTFB) (http://fauna.jbrj.gov.br/), made public in 2015, represents a database on biodiversity anchored on a list of valid and expertly recognized scientific names of animals in Brazil. The CTFB is updated in near real time by a team of more than 800 specialists. By January 1, 2024, the CTFB compiled 133,691 nominal species, with 125,138 that were considered valid. Most of the valid species were arthropods (82.3%, with more than 102,000 species) and chordates (7.69%, with over 11,000 species). These taxa were followed by a cluster composed of Mollusca (3,567 species), Platyhelminthes (2,292 species), Annelida (1,833 species), and Nematoda (1,447 species). All remaining groups had less than 1,000 species reported in Brazil, with Cnidaria (831 species), Porifera (628 species), Rotifera (606 species), and Bryozoa (520 species) representing those with more than 500 species. Analysis of the CTFB database can facilitate and direct efforts towards the discovery of new species in Brazil, but it is also fundamental in providing the best available list of valid nominal species to users, including those in science, health, conservation efforts, and any initiative involving animals. The importance of the CTFB is evidenced by the elevated number of citations in the scientific literature in diverse areas of biology, law, anthropology, education, forensic science, and veterinary science, among others

Safety and efficacy of the ChAdOx1 nCoV-19 vaccine (AZD1222) against SARS-CoV-2: an interim analysis of four randomised controlled trials in Brazil, South Africa, and the UK.

BACKGROUND: A safe and efficacious vaccine against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), if deployed with high coverage, could contribute to the control of the COVID-19 pandemic. We evaluated the safety and efficacy of the ChAdOx1 nCoV-19 vaccine in a pooled interim analysis of four trials. METHODS: This analysis includes data from four ongoing blinded, randomised, controlled trials done across the UK, Brazil, and South Africa. Participants aged 18 years and older were randomly assigned (1:1) to ChAdOx1 nCoV-19 vaccine or control (meningococcal group A, C, W, and Y conjugate vaccine or saline). Participants in the ChAdOx1 nCoV-19 group received two doses containing 5 × 1010 viral particles (standard dose; SD/SD cohort); a subset in the UK trial received a half dose as their first dose (low dose) and a standard dose as their second dose (LD/SD cohort). The primary efficacy analysis included symptomatic COVID-19 in seronegative participants with a nucleic acid amplification test-positive swab more than 14 days after a second dose of vaccine. Participants were analysed according to treatment received, with data cutoff on Nov 4, 2020. Vaccine efficacy was calculated as 1 - relative risk derived from a robust Poisson regression model adjusted for age. Studies are registered at ISRCTN89951424 and ClinicalTrials.gov, NCT04324606, NCT04400838, and NCT04444674. FINDINGS: Between April 23 and Nov 4, 2020, 23 848 participants were enrolled and 11 636 participants (7548 in the UK, 4088 in Brazil) were included in the interim primary efficacy analysis. In participants who received two standard doses, vaccine efficacy was 62·1% (95% CI 41·0-75·7; 27 [0·6%] of 4440 in the ChAdOx1 nCoV-19 group vs71 [1·6%] of 4455 in the control group) and in participants who received a low dose followed by a standard dose, efficacy was 90·0% (67·4-97·0; three [0·2%] of 1367 vs 30 [2·2%] of 1374; pinteraction=0·010). Overall vaccine efficacy across both groups was 70·4% (95·8% CI 54·8-80·6; 30 [0·5%] of 5807 vs 101 [1·7%] of 5829). From 21 days after the first dose, there were ten cases hospitalised for COVID-19, all in the control arm; two were classified as severe COVID-19, including one death. There were 74 341 person-months of safety follow-up (median 3·4 months, IQR 1·3-4·8): 175 severe adverse events occurred in 168 participants, 84 events in the ChAdOx1 nCoV-19 group and 91 in the control group. Three events were classified as possibly related to a vaccine: one in the ChAdOx1 nCoV-19 group, one in the control group, and one in a participant who remains masked to group allocation. INTERPRETATION: ChAdOx1 nCoV-19 has an acceptable safety profile and has been found to be efficacious against symptomatic COVID-19 in this interim analysis of ongoing clinical trials. FUNDING: UK Research and Innovation, National Institutes for Health Research (NIHR), Coalition for Epidemic Preparedness Innovations, Bill & Melinda Gates Foundation, Lemann Foundation, Rede D'Or, Brava and Telles Foundation, NIHR Oxford Biomedical Research Centre, Thames Valley and South Midland's NIHR Clinical Research Network, and AstraZeneca

Safety and efficacy of the ChAdOx1 nCoV-19 vaccine (AZD1222) against SARS-CoV-2: an interim analysis of four randomised controlled trials in Brazil, South Africa, and the UK

Background A safe and efficacious vaccine against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), if deployed with high coverage, could contribute to the control of the COVID-19 pandemic. We evaluated the safety and efficacy of the ChAdOx1 nCoV-19 vaccine in a pooled interim analysis of four trials. Methods This analysis includes data from four ongoing blinded, randomised, controlled trials done across the UK, Brazil, and South Africa. Participants aged 18 years and older were randomly assigned (1:1) to ChAdOx1 nCoV-19 vaccine or control (meningococcal group A, C, W, and Y conjugate vaccine or saline). Participants in the ChAdOx1 nCoV-19 group received two doses containing 5 × 1010 viral particles (standard dose; SD/SD cohort); a subset in the UK trial received a half dose as their first dose (low dose) and a standard dose as their second dose (LD/SD cohort). The primary efficacy analysis included symptomatic COVID-19 in seronegative participants with a nucleic acid amplification test-positive swab more than 14 days after a second dose of vaccine. Participants were analysed according to treatment received, with data cutoff on Nov 4, 2020. Vaccine efficacy was calculated as 1 - relative risk derived from a robust Poisson regression model adjusted for age. Studies are registered at ISRCTN89951424 and ClinicalTrials.gov, NCT04324606, NCT04400838, and NCT04444674. Findings Between April 23 and Nov 4, 2020, 23 848 participants were enrolled and 11 636 participants (7548 in the UK, 4088 in Brazil) were included in the interim primary efficacy analysis. In participants who received two standard doses, vaccine efficacy was 62·1% (95% CI 41·0–75·7; 27 [0·6%] of 4440 in the ChAdOx1 nCoV-19 group vs71 [1·6%] of 4455 in the control group) and in participants who received a low dose followed by a standard dose, efficacy was 90·0% (67·4–97·0; three [0·2%] of 1367 vs 30 [2·2%] of 1374; pinteraction=0·010). Overall vaccine efficacy across both groups was 70·4% (95·8% CI 54·8–80·6; 30 [0·5%] of 5807 vs 101 [1·7%] of 5829). From 21 days after the first dose, there were ten cases hospitalised for COVID-19, all in the control arm; two were classified as severe COVID-19, including one death. There were 74 341 person-months of safety follow-up (median 3·4 months, IQR 1·3–4·8): 175 severe adverse events occurred in 168 participants, 84 events in the ChAdOx1 nCoV-19 group and 91 in the control group. Three events were classified as possibly related to a vaccine: one in the ChAdOx1 nCoV-19 group, one in the control group, and one in a participant who remains masked to group allocation. Interpretation ChAdOx1 nCoV-19 has an acceptable safety profile and has been found to be efficacious against symptomatic COVID-19 in this interim analysis of ongoing clinical trials

Araticum (

Introduction. The Brazilian Cerrado presents a wide vegetable diversity, which is used for different purposes, especially in human feeding. Among the various fruits of the Cerrado, the araticum (Annona crassiflora Mart.) stands out, due to its high nutritional value and technological potential. The physical characteristics, chemical composition (titratable acidity, pH, moisture, ash, total dietary fiber, lipids and proteins), occurrence and content of vitamin C (ascorbic and dehydroascorbic acids), carotenoids (α-carotene, β-carotene, β-cryptoxanthin and lycopene), vitamin E (α-, β-, γ- and δ-tocopherols and tocotrienols) and folates (tetrahydrofolate, 5-methyltetrahydrofolate and 5-formyltetrahydrofolate) were evaluated in araticum from the Cerrado of Minas Gerais, Brazil. Materials and methods. Vitamin C and carotenoids were analyzed by HPLC-DAD, and vitamin E and folates by HPLC with fluorescence detection. Results and discussion. Araticum pulp presented a high energy value (95.12 kcal·100 g–1), as well as elevated contents of dietary fiber (6.80 g·100 g–1), carotenoids (4.98 mg·100 g –1) and vitamin A value (288.79 RAE·100 g–1). The contents of vitamin C, folates and vitamin E were 5.23 mg·100 g –1, 27.36 μg·100 g–1 and 494.04 μg·100 g–1, respectively. Conclusion. Araticum presented high energy value and high dietary fiber content. It is a source of vitamin C and folates, and an excellent source of vitamin A

Limitação de esforço terapêutico na pessoa com lesão encefálica grave

As discussões a respeito das condutas de limitação de esforço terapêutico (LET) são frequentes nas unidades de terapia intensiva e na especialidade médica oncológica e são também importantes em contextos hospitalares de internação de longa permanência para vítimas de grandes traumas e agravos que necessitam de cuidados prolongados à saúde e de reinserção social. Na prática clínica, a tomada de decisão para LET é complexa e deve envolver o indivíduo, a família e a equipe multiprofissional. O objetivo deste artigo é discorrer a respeito da LET como um abrangente processo de "adequação de medidas" por agregação consensual de fatores centrado na pessoa, pautado por intensificação dos cuidados paliativos