Dexmedetomidina versus outros sedativos na prevenção de Delirium nos adultos em ventilação mecânica

Delirium é uma síndrome neurocognitiva aguda relativamente comum e grave que se caracteriza por desatenção, consciência alterada, disfunção cognitiva e curso flutuante, e pode levar à mortalidade, declínio funcional, institucionalização e demência, com maior incidência nos pacientes mais velhos. Pacientes hospitalizados na Unidade de Terapia Intensiva (UTI) e em uso de ventilação mecânica (VM), quando sedados em excesso, possuem maior duração de permanência na UTI, aumento da duração da VM, maior incidência de delirium e mortalidade. Estudos apontam que a dexmedetomidina reduz a incidência de delirium em pacientes adultos hospitalizados na UTI e em uso de ventilação mecânica quando comparada com outros sedativos. Desse modo, o objetivo do estudo é comparar a dexmedetomidina e outros sedativos na prevenção de delirium nos adultos em ventilação mecânica. Trata-se de uma revisão bibliográfica integrativa, do tipo quantitativa, que utilizou as plataformas do PubMed, SciELO e Cochrane Library como bases de dados para seleção dos artigos, todos na língua inglesa. Foram utilizadas literaturas publicadas com recorte temporal de 2017 a 2022. De acordo com as literaturas analisadas, conclui-se que, quando comparado com outros sedativos gabaminérgicos, como os benzodiazepínicos e o propofol, a dexmedetomidina diminui significativamente a incidência de delirium nos pacientes adultos em ventilação mecânica na UTI, com melhora da capacidade de despertar do paciente, preservação do desempenho cognitivo e redução do risco de depressão respiratória. Desse modo, pesquisas futuras sobre as propriedades farmacológicas da dexmedetomidina podem ajudar a determinar se esta droga possui propriedades neuroprotetoras intrínsecas, sendo assim, tal descoberta facilitaria o desenvolvimento de análogos com menos efeitos colaterais cardiorrespiratórios, tendo em vista seu efeito hemodinâmico, com bradicardia e possível hipotensão associadas

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

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

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

Alkylation of 6-thiopurine derivatives by the Mitsunobu reaction

Alkylation of thiopurine derivatives with alcohols by the Mitsunobu reaction are reported in moderated to good yields. The method was applied in synthesis of number of thiopurine and thiopurine ribosides derivatives.</p

Prognostic significance of vascular endothelial growth factor polymorphisms in colorectal cancer patients

AIM To investigate the associations of the genetic polymorphisms of vascular endothelial growth factor A (VEGF-A) -1498C> T and -634G> C, with the survival of patients with colorectal cancer (CRC). METHODS A prospective cohort consisting of 131 Brazilians patients consecutively operated on with a curative intention as a result of sporadic colorectal carcinoma was studied. DNA was extracted from peripheral blood and its amplification and allelic discrimination for each genetic polymorphism was performed using the technique of polymerase chain reaction (PCR) in real-time. The real-time PCR technique was used to identify the VEGF-A -1498C> T (rs833031) and -634G> C (rs2010963) polymorphisms. Genotyping was validated for VEGF-A -1498C> T polymorphism in 129 patients and for VEGF-A -634G> C polymorphism in 118 patients. The analysis of association between categorical variables was performed using logistic regression, survival by Kaplan-Meier method and multivariate analysis by the Cox regression method. RESULTS In the univariate analysis there was a significant association (OR = 0.32P = 0.048) between genotype CC of the VEGF-A -1498C> T polymorphism and the presence of CRC liver metastasis. There was no association between VEGF-A -1498C> T polymorphism and VEGF-A -634G> C polymorphism with further clinical or anatomopathologic variables. The genotype CC of the VEGF-A -1498C> T polymorphism was significantly correlated with the 5-year survival (P = 0.032), but not significant difference (P = 0.27) was obtained with the VEGF-A -634G> C polymorphism with the 5-year survival in the univariate analysis. The genotype CT (HR = 2.79) and CC (HR = 4.67) of the polymorphism VEGF-A -1498C> T and the genotype CC (HR = 3.76) of the polymorphism VEGF-A -634C> G acted as an independent prognostic factor for the risk of death in CRC patients. CONCLUSION The CT and CC genotypes of the VEGF-A -1498C>T and the CC genotype of the VEGF-A -634C>G polymorphisms are prognostic factors of survival in Brazilians patients with sporadic colorectal carcinoma.Univ Fed Sao Paulo, Dept Surg, Escola Paulista Med, Rua Napoleao de Barros 715, BR-04024002 Sao Paulo, BrazilUniv Fed Mato Grosso, Sch Med, Genet Lab Basics Hlth Sci Dept, BR-78060900 Cuiaba, BrazilBrasilia Univ, Sch Med, Trop Med Div, Campus Darcy Ribeiro Univ, BR-70904970 Brasilia, DF, BrazilUniv Fed Sao Paulo, Genet Lab, Morphol & Genet Dept, BR-04023900 Sao Paulo, BrazilABC Med Sch, Lab Clin Anal, Ave Principe Gales, BR-09060650 Santo Andre, BrazilUniv Fed Sao Paulo, Dept Gynecol, Lab Mol Gynecol, Rua Pedro de Toledo, BR-04039032 Sao Paulo, BrazilUniv Fed Sao Paulo, Dept Surg, Escola Paulista Med, Rua Napoleao de Barros 715, BR-04024002 Sao Paulo, BrazilUniv Fed Sao Paulo, Genet Lab, Morphol & Genet Dept, BR-04023900 Sao Paulo, BrazilUniv Fed Sao Paulo, Dept Gynecol, Lab Mol Gynecol, Rua Pedro de Toledo, BR-04039032 Sao Paulo, BrazilWeb of Scienc

Chronic Traumatic Encephalopathy in Sports Practice: A Literature Review

Chronic traumatic encephalopathy (CTE) is a neurodegenerative syndrome caused by repetitive and cumulative head trauma. Due to the widespread practice of contact and collision sports, a discussion of the long-term repercussions of repeated head trauma is imperative. The present literature review, performed through the SciELO, PUBMED, and BVS-Bireme databases, includes studies conducted since the year 2000, which established the relationship between CTE and the practice of sports. The diagnosis of CTE was notably present in individuals practicing sports that involve repeated traumatic brain injuries. The noticeable changes triggered by CTE include a series of clinical and neuropathological manifestations that can help in the differentiation from other tauopathies

Relatório final do ensaio de proficiência em álcool etílico anidro combustível - 1ª rodada

51 f.: il.A demanda mundial por combustíveis de origem renovável é crescente, e o Brasil tem potencial para ser um grande exportador contribuindo para a redução de emissões contendo enxofre e gases responsáveis pelo aquecimento global, uma vez que possui um dos maiores parques industriais do mundo para produção de etanol, tendo como matéria-prima a cana-de-açúcar. Nos últimos anos, o uso do álcool como combustível automotivo voltou a crescer no Brasil, sendo o único país a utilizá-lo em grande escala – 20% da frota nacional. Com o interesse crescente do mercado internacional no álcool etílico anidro combustível (AEAC), o Brasil sente a necessidade de se estabelecer como líder na produção de combustíveis de fontes renováveis, visando substituir 5% dos combustíveis derivados do petróleo consumidos atualmente no mundo. O Inmetro, sendo o organismo brasileiro do sistema internacional de metrologia, de avaliação da conformidade e acreditação, exerce ainda um papel-chave em pesquisas sobre biocombustíveis em geral, visando contribuir de forma fundamental tanto na pesquisa, desenvolvimento e produção de materiais de referência como para propiciar a rastreabilidade aos laboratórios, disponibilizando para a indústria nacional um material de referência certificado (MRC), harmonizado pelos procedimentos internacionais indispensáveis para tornar os biocombustíveis uma “commodity” [1]. A possibilidade de conquistas de mercados no exterior requer que o etanol atenda aos exigentes requisitos de qualidade destes mercados. Os laboratórios que realizam as análises para atender às especificações da Agência Nacional de Petróleo, Gás Natural e Biocombustíveis – ANP [2] deverão estar bem preparados para realizar medições confiáveis. Para a garantia da confiabilidade e qualidade dos resultados das medições, o Inmetro realiza Ensaios de Proficiência (EP) através do Programa de Ensaio de Proficiência da Diretoria de Metrologia Científica e Industrial do Inmetro (PEP-Dimci). Um EP tem por finalidade comparar resultados de medição de diferentes laboratórios realizados sob condições similares e, assim obter uma avaliação contínua da competência técnica dos laboratórios participantes através dos resultados gerados por diversas comparações interlaboratoriais, fornecendo-lhes um mecanismo adequado para avaliar e demonstrar a confiabilidade de suas medições [3]. Cabe destacar que os laboratórios têm a oportunidade de rever seus procedimentos de análises, bem como implantar melhorias nas diferentes atividades em que os laboratórios atuam, caso seja necessário. Além da finalidade citada anteriormente, um EP compreende outros aspectos como demonstração de controle e capacidade de realizar medições, validação do método de medição, avaliação da incerteza de medição, demonstração de concordância com as necessidades de desempenho e, ainda, de educação e treinamento [4]. Dentre os parâmetros para o álcool etílico anidro combustível que são regulados pela ANP e/ou órgãos internacionais, foram selecionados cinco para este EP, os quais estão discriminados abaixo: - Teor de água (%m/m) – o excesso de água aumenta a condutividade do álcool e conseqüentemente contribui para a diminuição do poder calorífico - Condutividade eletrolítica (μS/m) – valores de condutividade acima de 500 μS/m podem contribuir para possível corrosão dos componentes dos motores dos veículos - pH – valores de pH entre 6,5-9,0 são adequados para evitar possível corrosão nos componentes dos motores dos veículos - Massa específica (kg/m3) – contribui para a estabilidade e qualidade do produto - Teor alcoólico (INPM, %m/m) – limites abaixo de 99,7 % podem afetar o poder calorífico e o desempenho dos motores dos veículos. Este relatório visa apresentar os resultados da avaliação de desempenho dos laboratórios participantes do EP em Álcool Etílico Anidro Combustível – 1ª rodada, nas medições dos cinco parâmetros acima mencionados

Brazilian Flora 2020: Leveraging the power of a collaborative scientific network

International audienceThe shortage of reliable primary taxonomic data limits the description of biological taxa and the understanding of biodiversity patterns and processes, complicating biogeographical, ecological, and evolutionary studies. This deficit creates a significant taxonomic impediment to biodiversity research and conservation planning. The taxonomic impediment and the biodiversity crisis are widely recognized, highlighting the urgent need for reliable taxonomic data. Over the past decade, numerous countries worldwide have devoted considerable effort to Target 1 of the Global Strategy for Plant Conservation (GSPC), which called for the preparation of a working list of all known plant species by 2010 and an online world Flora by 2020. Brazil is a megadiverse country, home to more of the world's known plant species than any other country. Despite that, Flora Brasiliensis, concluded in 1906, was the last comprehensive treatment of the Brazilian flora. The lack of accurate estimates of the number of species of algae, fungi, and plants occurring in Brazil contributes to the prevailing taxonomic impediment and delays progress towards the GSPC targets. Over the past 12 years, a legion of taxonomists motivated to meet Target 1 of the GSPC, worked together to gather and integrate knowledge on the algal, plant, and fungal diversity of Brazil. Overall, a team of about 980 taxonomists joined efforts in a highly collaborative project that used cybertaxonomy to prepare an updated Flora of Brazil, showing the power of scientific collaboration to reach ambitious goals. This paper presents an overview of the Brazilian Flora 2020 and provides taxonomic and spatial updates on the algae, fungi, and plants found in one of the world's most biodiverse countries. We further identify collection gaps and summarize future goals that extend beyond 2020. Our results show that Brazil is home to 46,975 native species of algae, fungi, and plants, of which 19,669 are endemic to the country. The data compiled to date suggests that the Atlantic Rainforest might be the most diverse Brazilian domain for all plant groups except gymnosperms, which are most diverse in the Amazon. However, scientific knowledge of Brazilian diversity is still unequally distributed, with the Atlantic Rainforest and the Cerrado being the most intensively sampled and studied biomes in the country. In times of “scientific reductionism”, with botanical and mycological sciences suffering pervasive depreciation in recent decades, the first online Flora of Brazil 2020 significantly enhanced the quality and quantity of taxonomic data available for algae, fungi, and plants from Brazil. This project also made all the information freely available online, providing a firm foundation for future research and for the management, conservation, and sustainable use of the Brazilian funga and flora