AMORIS project - mobile application and command and control center on an iot network to support solidarity actions to counter Covid-19 and other outbreaks

O Projeto AMORIS visa fomentar uma ação de solidariedade entre membros da comunidade da Universidade de Brasília e seu entorno com abrangência regional e nacional, ação denominada Sistema UnB Solidária. O projeto contempla o desenvolvimento de um aplicativo de redes móveis operando em paradigma de Internet of Things (IoT) com uma central de comando & controle (C&C), monitoração, coordenação e integração, de modo a permitir que as pessoas façam ações solidárias em diversas situações, como: ajuda médica, ações de segurança comunitária, casos de dificuldade pessoal, apoio educacional etc

APENDICITE AGUDA: ABORDAGEM DIAGNÓSTICA E AVANÇOS NO TRATAMENTO CIRÚRGICO.

Acute appendicitis is an inflammation of the cecal appendix, a frequent surgical emergency. Early diagnosis is vital to avoid serious complications. Migratory abdominal pain and associated symptoms help in the diagnosis. Imaging techniques, especially ultrasound and tomography, confirm the condition. The treatment is mainly surgical, with preferably laparoscopic appendectomy. Methodology: The research reviewed literature from 2015 to 2024 on "Acute Appendicitis: Diagnostic Approaches and Advances in Surgical Treatment", using scientific bases such as PubMed and SciELO. He selected original articles with full access, focused on clinical manifestations, imaging diagnoses and surgical advances, excluding studies out of scope or more than 10 years old. Results and discussions: The cecal appendix, located in the right iliac fossa, measures about 8 to 10 cm and may have an immunological role in childhood. Acute appendicitis usually results from appendicular obstruction, causing migratory abdominal pain and symptoms such as fever and nausea. The diagnosis involves clinical history, physical, laboratory and imaging techniques, with ultrasound and tomography being crucial. The use of low-dose CT and new scoring systems improve diagnostic accuracy and reduce negative appendectomy. Final considerations: Acute appendicitis is a common surgical emergency, requiring early diagnosis and treatment to avoid complications. Advanced techniques such as ultrasound and CT, especially low-dose, improve diagnostic accuracy. Appendictomy, preferably laparoscopic, is the standard treatment. Studies highlight the importance of combined diagnostic methods and surgical advances for better management.A apendicite aguda é uma inflamação do apêndice cecal, uma emergência cirúrgica frequente. O diagnóstico precoce é vital para evitar complicações graves. A dor abdominal migratória e sintomas associados ajudam no diagnóstico. Técnicas de imagem, especialmente ultrassonografia e tomografia, confirmam a condição. O tratamento é principalmente cirúrgico, com apendicectomia preferencialmente laparoscópica. Metodologia: A pesquisa revisou literatura de 2015 a 2024 sobre "Apendicite Aguda: Abordagens Diagnósticas e Avanços no Tratamento Cirúrgico", usando bases científicas como PubMed e SciELO. Selecionou artigos originais com acesso integral, focados em manifestações clínicas, diagnósticos por imagem e avanços cirúrgicos, excluindo estudos fora do escopo ou com mais de 10 anos. Resultados e discussões: O apêndice cecal, localizado na fossa ilíaca direita, mede cerca de 8 a 10 cm e pode ter um papel imunológico na infância. A apendicite aguda geralmente resulta de obstrução apendicular, causando dor abdominal migratória e sintomas como febre e náuseas. O diagnóstico envolve história clínica, exame físico, laboratoriais e técnicas de imagem, com ultrassonografia e tomografia sendo cruciais. O uso de TC de baixa dose e novos sistemas de pontuação melhoram a precisão diagnóstica e reduzem apendicectomias negativas. Considerações Finais: A apendicite aguda é uma emergência cirúrgica comum, necessitando de diagnóstico precoce e tratamento para evitar complicações. Técnicas avançadas como ultrassonografia e TC, especialmente de baixa dose, melhoram a precisão diagnóstica. A apendicectomia, preferencialmente laparoscópica, é o tratamento padrão. Estudos destacam a importância de métodos diagnósticos combinados e avanços cirúrgicos para melhor manejo

The first 80 days of the COVID-19 pandemic in the city of Belo Horizonte : from containment to reopening.

Este artigo examina o contexto e as implica??es da pandemia por Covid-19 na cidade de Belo Horizonte (BH) nos primeiros 80 dias da doen?a. Utilizamos um recorte anal?tico descritivo para mensurar a evolu??o dos casos, o excesso de ?bitos, a taxa de transmissibilidade do v?rus e a press?o da doen?a sobre o sistema de sa?de de BH e regi?o, atrav?s da taxa de ocupa??o hospitalar nos leitos p?blicos. Al?m disso, identificamos as principais pol?ticas de conten??o adotadas pelas autoridades locais, bem como as implica??es da redu??o do distanciamento social. Nossos resultados demonstram que o Sistema ?nico de Sa?de (SUS), bem gerido, ? fundamental para o enfrentamento da pandemia e a mitiga??o de suas consequ?ncias para a popula??o. O processo de flexibiliza??o que se inicia tem imposto novos desafios que requerer?o monitoramento atento das autoridades e da sociedade.The paper examines the implications of Co vid-19 pandemic for the city of Belo Horizonte (BH), during the fi rst 80 days of the disease. We use a descriptive-analytical approach to estimate the growth of Covid-19 cases over time, the excess of deaths, the virus? rate of transmissibility, and the consequent burden on the municipal the health system, measured by the rate of occupancy of public hospital beds. Also, we identify the main containment policies adopted by local authorities, and the implications of reopen ing measures and the following reduction of social distancing. Our fi ndings reveal that a well-managed Unifi ed Health System (SUS) is paramount to effectively tackle the pan demic and its consequences for the population. The reopening process has imposed new challenges that will require close monitoring by the authorities and by the Society

A toxina botulínica tipo-a na abordagem da dor crônica: uma revisão da literatura

Há cada vez mais evidências que sugerem a eficácia da toxina botulínica tipo A (BoNT-A) no tratamento da dor crônica de várias etiologias. Além de ser estudada para enxaquecas e neuralgia trigeminal, essa substância tem sido avaliada em condições como cefaleias tensionais, cervicalgia, dor miofascial, neuropatia, entre outras. Essa variedade de aplicações reflete a capacidade multifuncional da BoNT-A em influenciar os processos neurofisiológicos associados à percepção e transmissão da dor. A BoNT-A possui diversos mecanismos de ação no tratamento da dor, incluindo sua capacidade de modular a transmissão da dor tanto a nível periférico quanto a nível central. Essas descobertas sugerem que a substância possui um potencial promissor para tratar uma variedade de condições de dor crônica. Levando-se em consideração a relevância do assunto em questão nos dias atuais, o objetivo da presente revisão foi abordar o uso da toxina botulínica tipo A no tratamento dos diferentes tipos de dor crônica. Para a elaboração da pesquisa, foram feitas buscas em bases de dados, selecionando-se inicialmente 26 artigos, dos quais 12 se enquadraram para a relevância do estudo. Destaca-se assim, a importância de realizar mais pesquisas para entender completamente o papel da BoNT-A no tratamento da dor. Esses estudos são fundamentais para oferecer evidências adicionais sobre a eficácia e segurança da BoNT-A em várias condições dolorosas, permitindo uma orientação mais precisa e personalizada do seu uso clínico

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

Sepse: avaliação da qualidade do atendimento em setor de urgência e emergência: Sepsis: assessment of the quality of emergency and emergency care

A Sepse corresponde à presença de uma disfunção orgânica fatal provocada por uma resposta anormal do hospedeiro a um processo infeccioso, que pode progredir para um choque séptico. No decorrer dessa pesquisa, cuja metodologia foi a revisão integrativa de literatura, foram utilizados artigos científicos publicados em periódicos nacionais entre os anos de 2015 e 2022, retirados da base de dados Medline e Lilacs, sendo buscados a partir dos descritores: “Sepse”, “Qualidade do atendimento” e “Urgência e Emergência”. Com o objetivo de analisar a efetividade das ações de cuidados de Enfermagem aplicadas ao sepse adulto, a partir da análise de dados reunidos nesta revisão integrativa, foi possível concluir que a implantação de protocolos para o tratamento resultou em melhorias significativas nos indicadores de qualidade nos cuidados com a sepse, a exemplo da melhoria do fluxo e de atenção aos pacientes e redução da mortalidade nos setores de urgência e emergência

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

Burden of disease scenarios for 204 countries and territories, 2022–2050: a forecasting analysis for the Global Burden of Disease Study 2021

Background: Future trends in disease burden and drivers of health are of great interest to policy makers and the public at large. This information can be used for policy and long-term health investment, planning, and prioritisation. We have expanded and improved upon previous forecasts produced as part of the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) and provide a reference forecast (the most likely future), and alternative scenarios assessing disease burden trajectories if selected sets of risk factors were eliminated from current levels by 2050. Methods: Using forecasts of major drivers of health such as the Socio-demographic Index (SDI; a composite measure of lag-distributed income per capita, mean years of education, and total fertility under 25 years of age) and the full set of risk factor exposures captured by GBD, we provide cause-specific forecasts of mortality, years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life-years (DALYs) by age and sex from 2022 to 2050 for 204 countries and territories, 21 GBD regions, seven super-regions, and the world. All analyses were done at the cause-specific level so that only risk factors deemed causal by the GBD comparative risk assessment influenced future trajectories of mortality for each disease. Cause-specific mortality was modelled using mixed-effects models with SDI and time as the main covariates, and the combined impact of causal risk factors as an offset in the model. At the all-cause mortality level, we captured unexplained variation by modelling residuals with an autoregressive integrated moving average model with drift attenuation. These all-cause forecasts constrained the cause-specific forecasts at successively deeper levels of the GBD cause hierarchy using cascading mortality models, thus ensuring a robust estimate of cause-specific mortality. For non-fatal measures (eg, low back pain), incidence and prevalence were forecasted from mixed-effects models with SDI as the main covariate, and YLDs were computed from the resulting prevalence forecasts and average disability weights from GBD. Alternative future scenarios were constructed by replacing appropriate reference trajectories for risk factors with hypothetical trajectories of gradual elimination of risk factor exposure from current levels to 2050. The scenarios were constructed from various sets of risk factors: environmental risks (Safer Environment scenario), risks associated with communicable, maternal, neonatal, and nutritional diseases (CMNNs; Improved Childhood Nutrition and Vaccination scenario), risks associated with major non-communicable diseases (NCDs; Improved Behavioural and Metabolic Risks scenario), and the combined effects of these three scenarios. Using the Shared Socioeconomic Pathways climate scenarios SSP2-4.5 as reference and SSP1-1.9 as an optimistic alternative in the Safer Environment scenario, we accounted for climate change impact on health by using the most recent Intergovernmental Panel on Climate Change temperature forecasts and published trajectories of ambient air pollution for the same two scenarios. Life expectancy and healthy life expectancy were computed using standard methods. The forecasting framework includes computing the age-sex-specific future population for each location and separately for each scenario. 95% uncertainty intervals (UIs) for each individual future estimate were derived from the 2·5th and 97·5th percentiles of distributions generated from propagating 500 draws through the multistage computational pipeline. Findings: In the reference scenario forecast, global and super-regional life expectancy increased from 2022 to 2050, but improvement was at a slower pace than in the three decades preceding the COVID-19 pandemic (beginning in 2020). Gains in future life expectancy were forecasted to be greatest in super-regions with comparatively low life expectancies (such as sub-Saharan Africa) compared with super-regions with higher life expectancies (such as the high-income super-region), leading to a trend towards convergence in life expectancy across locations between now and 2050. At the super-region level, forecasted healthy life expectancy patterns were similar to those of life expectancies. Forecasts for the reference scenario found that health will improve in the coming decades, with all-cause age-standardised DALY rates decreasing in every GBD super-region. The total DALY burden measured in counts, however, will increase in every super-region, largely a function of population ageing and growth. We also forecasted that both DALY counts and age-standardised DALY rates will continue to shift from CMNNs to NCDs, with the most pronounced shifts occurring in sub-Saharan Africa (60·1% [95% UI 56·8–63·1] of DALYs were from CMNNs in 2022 compared with 35·8% [31·0–45·0] in 2050) and south Asia (31·7% [29·2–34·1] to 15·5% [13·7–17·5]). This shift is reflected in the leading global causes of DALYs, with the top four causes in 2050 being ischaemic heart disease, stroke, diabetes, and chronic obstructive pulmonary disease, compared with 2022, with ischaemic heart disease, neonatal disorders, stroke, and lower respiratory infections at the top. The global proportion of DALYs due to YLDs likewise increased from 33·8% (27·4–40·3) to 41·1% (33·9–48·1) from 2022 to 2050, demonstrating an important shift in overall disease burden towards morbidity and away from premature death. The largest shift of this kind was forecasted for sub-Saharan Africa, from 20·1% (15·6–25·3) of DALYs due to YLDs in 2022 to 35·6% (26·5–43·0) in 2050. In the assessment of alternative future scenarios, the combined effects of the scenarios (Safer Environment, Improved Childhood Nutrition and Vaccination, and Improved Behavioural and Metabolic Risks scenarios) demonstrated an important decrease in the global burden of DALYs in 2050 of 15·4% (13·5–17·5) compared with the reference scenario, with decreases across super-regions ranging from 10·4% (9·7–11·3) in the high-income super-region to 23·9% (20·7–27·3) in north Africa and the Middle East. The Safer Environment scenario had its largest decrease in sub-Saharan Africa (5·2% [3·5–6·8]), the Improved Behavioural and Metabolic Risks scenario in north Africa and the Middle East (23·2% [20·2–26·5]), and the Improved Nutrition and Vaccination scenario in sub-Saharan Africa (2·0% [–0·6 to 3·6]). Interpretation: Globally, life expectancy and age-standardised disease burden were forecasted to improve between 2022 and 2050, with the majority of the burden continuing to shift from CMNNs to NCDs. That said, continued progress on reducing the CMNN disease burden will be dependent on maintaining investment in and policy emphasis on CMNN disease prevention and treatment. Mostly due to growth and ageing of populations, the number of deaths and DALYs due to all causes combined will generally increase. By constructing alternative future scenarios wherein certain risk exposures are eliminated by 2050, we have shown that opportunities exist to substantially improve health outcomes in the future through concerted efforts to prevent exposure to well established risk factors and to expand access to key health interventions