PAPEL DO MÉDICO VETERINÁRIO NA MEDICINA LEGAL

Introdução: A Medicina Veterinária Legal é a especialidade que busca esclarecer questões do meio jurídico e do conhecimento técnico do profissional. A imperícia, negligência e imprudência são termos legais impostos aos peritos da medicina veterinária. O ofício é atribuído às práticas de conhecimentos básicos, assim, obtendo uma pluralidade na área, sem a necessidade de conhecimentos complexos e específicos. Objetivo: Apresentar o papel do médico veterinário na Medicina Legal, enfatizando a imperícia, a negligência e a imprudência. Metodologia: O estudo se trata de uma revisão literária de forma exploratória e qualitativa realizada por meio de buscas bibliográficas em bancos de dados nos sites da Internet como Scielo e Google Acadêmico. Considerações: O Médico Veterinário tem um papel muito importante na sociedade, atuando de forma legal, o mesmo contribui com conhecimentos técnicos e científicos proporcionando qualidade de vida aos seus pacientes. A medicina legal resume a sua contribuição do ponto de vista médico na elaboração e cumprimento de leis, além disso, ela engloba o campo de atuação da polícia técnica, ou criminalística e desenvolve os ramos de pesquisa e perícia. A Medicina Veterinária Legal é uma especialidade que muito contribui com a sociedade, por disponibilizar seu conhecimento médico à Justiça. Tanto os animais de estimação como os silvestres, estão propensos às situações de maus tratos, os mesmos podem sofrer com a imprudência que é a falta de cuidado e precaução, com a negligência através da omissão, inobservância do dever ou com a imperícia que é ausência da técnica necessária para realizar determinada atividade. Em tais identificações pós consulta ou necropsia o médico veterinário legal identifica e legitima o ocorrido com o animal, sendo responsável pela elaboração de laudo pericial que é de grande importância, pois se reflete entre exames realizados por especialistas com vistas ao fornecimento técnico e científico, em busca da prova e elemento de convicção para o Juiz, o Promotor, o Delegado de Polícia e os Advogados. Sendo assim, os conhecimentos em Medicina Veterinária Legal são primordiais principalmente no que tange à coibição dos maus-tratos aos animais

Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: an international cohort study

Background: The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on postoperative recovery needs to be understood to inform clinical decision making during and after the COVID-19 pandemic. This study reports 30-day mortality and pulmonary complication rates in patients with perioperative SARS-CoV-2 infection. Methods: This international, multicentre, cohort study at 235 hospitals in 24 countries included all patients undergoing surgery who had SARS-CoV-2 infection confirmed within 7 days before or 30 days after surgery. The primary outcome measure was 30-day postoperative mortality and was assessed in all enrolled patients. The main secondary outcome measure was pulmonary complications, defined as pneumonia, acute respiratory distress syndrome, or unexpected postoperative ventilation. Findings: This analysis includes 1128 patients who had surgery between Jan 1 and March 31, 2020, of whom 835 (74·0%) had emergency surgery and 280 (24·8%) had elective surgery. SARS-CoV-2 infection was confirmed preoperatively in 294 (26·1%) patients. 30-day mortality was 23·8% (268 of 1128). Pulmonary complications occurred in 577 (51·2%) of 1128 patients; 30-day mortality in these patients was 38·0% (219 of 577), accounting for 81·7% (219 of 268) of all deaths. In adjusted analyses, 30-day mortality was associated with male sex (odds ratio 1·75 [95% CI 1·28–2·40], p\textless0·0001), age 70 years or older versus younger than 70 years (2·30 [1·65–3·22], p\textless0·0001), American Society of Anesthesiologists grades 3–5 versus grades 1–2 (2·35 [1·57–3·53], p\textless0·0001), malignant versus benign or obstetric diagnosis (1·55 [1·01–2·39], p=0·046), emergency versus elective surgery (1·67 [1·06–2·63], p=0·026), and major versus minor surgery (1·52 [1·01–2·31], p=0·047). Interpretation: Postoperative pulmonary complications occur in half of patients with perioperative SARS-CoV-2 infection and are associated with high mortality. Thresholds for surgery during the COVID-19 pandemic should be higher than during normal practice, particularly in men aged 70 years and older. Consideration should be given for postponing non-urgent procedures and promoting non-operative treatment to delay or avoid the need for surgery. Funding: National Institute for Health Research (NIHR), Association of Coloproctology of Great Britain and Ireland, Bowel and Cancer Research, Bowel Disease Research Foundation, Association of Upper Gastrointestinal Surgeons, British Association of Surgical Oncology, British Gynaecological Cancer Society, European Society of Coloproctology, NIHR Academy, Sarcoma UK, Vascular Society for Great Britain and Ireland, and Yorkshire Cancer Research

Worldwide trends in underweight and obesity from 1990 to 2022: a pooled analysis of 3663 population-representative studies with 222 million children, adolescents, and adults

Background Underweight and obesity are associated with adverse health outcomes throughout the life course. We estimated the individual and combined prevalence of underweight or thinness and obesity, and their changes, from 1990 to 2022 for adults and school-aged children and adolescents in 200 countries and territories. Methods We used data from 3663 population-based studies with 222 million participants that measured height and weight in representative samples of the general population. We used a Bayesian hierarchical model to estimate trends in the prevalence of different BMI categories, separately for adults (age ≥20 years) and school-aged children and adolescents (age 5–19 years), from 1990 to 2022 for 200 countries and territories. For adults, we report the individual and combined prevalence of underweight (BMI <18·5 kg/m2) and obesity (BMI ≥30 kg/m2). For schoolaged children and adolescents, we report thinness (BMI <2 SD below the median of the WHO growth reference) and obesity (BMI >2 SD above the median). Findings From 1990 to 2022, the combined prevalence of underweight and obesity in adults decreased in 11 countries (6%) for women and 17 (9%) for men with a posterior probability of at least 0·80 that the observed changes were true decreases. The combined prevalence increased in 162 countries (81%) for women and 140 countries (70%) for men with a posterior probability of at least 0·80. In 2022, the combined prevalence of underweight and obesity was highest in island nations in the Caribbean and Polynesia and Micronesia, and countries in the Middle East and north Africa. Obesity prevalence was higher than underweight with posterior probability of at least 0·80 in 177 countries (89%) for women and 145 (73%) for men in 2022, whereas the converse was true in 16 countries (8%) for women, and 39 (20%) for men. From 1990 to 2022, the combined prevalence of thinness and obesity decreased among girls in five countries (3%) and among boys in 15 countries (8%) with a posterior probability of at least 0·80, and increased among girls in 140 countries (70%) and boys in 137 countries (69%) with a posterior probability of at least 0·80. The countries with highest combined prevalence of thinness and obesity in school-aged children and adolescents in 2022 were in Polynesia and Micronesia and the Caribbean for both sexes, and Chile and Qatar for boys. Combined prevalence was also high in some countries in south Asia, such as India and Pakistan, where thinness remained prevalent despite having declined. In 2022, obesity in school-aged children and adolescents was more prevalent than thinness with a posterior probability of at least 0·80 among girls in 133 countries (67%) and boys in 125 countries (63%), whereas the converse was true in 35 countries (18%) and 42 countries (21%), respectively. In almost all countries for both adults and school-aged children and adolescents, the increases in double burden were driven by increases in obesity, and decreases in double burden by declining underweight or thinness. Interpretation The combined burden of underweight and obesity has increased in most countries, driven by an increase in obesity, while underweight and thinness remain prevalent in south Asia and parts of Africa. A healthy nutrition transition that enhances access to nutritious foods is needed to address the remaining burden of underweight while curbing and reversing the increase in obesit

Robust estimation of bacterial cell count from optical density

Optical density (OD) is widely used to estimate the density of cells in liquid culture, but cannot be compared between instruments without a standardized calibration protocol and is challenging to relate to actual cell count. We address this with an interlaboratory study comparing three simple, low-cost, and highly accessible OD calibration protocols across 244 laboratories, applied to eight strains of constitutive GFP-expressing E. coli. Based on our results, we recommend calibrating OD to estimated cell count using serial dilution of silica microspheres, which produces highly precise calibration (95.5% of residuals <1.2-fold), is easily assessed for quality control, also assesses instrument effective linear range, and can be combined with fluorescence calibration to obtain units of Molecules of Equivalent Fluorescein (MEFL) per cell, allowing direct comparison and data fusion with flow cytometry measurements: in our study, fluorescence per cell measurements showed only a 1.07-fold mean difference between plate reader and flow cytometry data

The evolving SARS-CoV-2 epidemic in Africa: Insights from rapidly expanding genomic surveillance

INTRODUCTION Investment in Africa over the past year with regard to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) sequencing has led to a massive increase in the number of sequences, which, to date, exceeds 100,000 sequences generated to track the pandemic on the continent. These sequences have profoundly affected how public health officials in Africa have navigated the COVID-19 pandemic. RATIONALE We demonstrate how the first 100,000 SARS-CoV-2 sequences from Africa have helped monitor the epidemic on the continent, how genomic surveillance expanded over the course of the pandemic, and how we adapted our sequencing methods to deal with an evolving virus. Finally, we also examine how viral lineages have spread across the continent in a phylogeographic framework to gain insights into the underlying temporal and spatial transmission dynamics for several variants of concern (VOCs). RESULTS Our results indicate that the number of countries in Africa that can sequence the virus within their own borders is growing and that this is coupled with a shorter turnaround time from the time of sampling to sequence submission. Ongoing evolution necessitated the continual updating of primer sets, and, as a result, eight primer sets were designed in tandem with viral evolution and used to ensure effective sequencing of the virus. The pandemic unfolded through multiple waves of infection that were each driven by distinct genetic lineages, with B.1-like ancestral strains associated with the first pandemic wave of infections in 2020. Successive waves on the continent were fueled by different VOCs, with Alpha and Beta cocirculating in distinct spatial patterns during the second wave and Delta and Omicron affecting the whole continent during the third and fourth waves, respectively. Phylogeographic reconstruction points toward distinct differences in viral importation and exportation patterns associated with the Alpha, Beta, Delta, and Omicron variants and subvariants, when considering both Africa versus the rest of the world and viral dissemination within the continent. Our epidemiological and phylogenetic inferences therefore underscore the heterogeneous nature of the pandemic on the continent and highlight key insights and challenges, for instance, recognizing the limitations of low testing proportions. We also highlight the early warning capacity that genomic surveillance in Africa has had for the rest of the world with the detection of new lineages and variants, the most recent being the characterization of various Omicron subvariants. CONCLUSION Sustained investment for diagnostics and genomic surveillance in Africa is needed as the virus continues to evolve. This is important not only to help combat SARS-CoV-2 on the continent but also because it can be used as a platform to help address the many emerging and reemerging infectious disease threats in Africa. In particular, capacity building for local sequencing within countries or within the continent should be prioritized because this is generally associated with shorter turnaround times, providing the most benefit to local public health authorities tasked with pandemic response and mitigation and allowing for the fastest reaction to localized outbreaks. These investments are crucial for pandemic preparedness and response and will serve the health of the continent well into the 21st century

OCORRÊNCIA DE ENTEROPARASITOS EM ESCOLARES DA PERIFERIA DA UNIVERSIDADE ESTADUAL DO MARANHÃO

As parasitoses intestinais constituem-se um sério problema de saúde pública nos países em desenvolvimento, onde a falta de condições sanitárias adequadas e educação agravam esse quadro, principalmente nas periferias dos grandes centros. Nesse trabalho, objetivou-se avaliar a prevalência de parasitos em 45 estudantes de quatro escolas públicas situadas na periferia da Universidade Estadual do Maranhão (UEMA). O material subungueal coletado foi acondicionado em tubos de ensaio e encaminhado ao Laboratório de Parasitologia e Bioquímica da UEMA para análise microscópica. Os resultados revelaram um índice de positividade de 11,1% das amostras para as seguintes espécies: Ascaris lumbricoides (4,44%), Entamoeba coli (2,22%), Entamoeba histolytica (2,22%) e Enterobius vermiculares (2,22%). A faixa etária mais acometida foi de 13 a 16 anos com 60% de contaminação. A aplicação de questionários demonstrou haver uma significativa relação entre a positividade do material coletado e os aspectos sanitários. Dos indivíduos contaminados, 40% não possuíam água tratada, coleta de lixo regular, vaso sanitário ou fossa séptica em casa e rede de esgoto. Esses dados mostram-se preocupantes levando-se em consideração o local (subungueal) em que os ovos e cistos foram encontrados, o que demonstra a suscetibilidade, principalmente das crianças, às parasitoses e a necessidade de adoção de políticas públicas efetivas que visem à implantação de saneamento básico e conscientização da própria população, a fim e evitar a contaminação dos ambientes os quais mantêm contato direto, em especial nos locais de lazer das crianças

A detailed relevance analysis of enabling technologies for 6G architectures

Abstract As society evolves as a whole, new demands arise with increasingly demanding prerequisites, consequently requiring more significant effort to be met. Such demands cover emerging applications, such as remote surgeries in Smart Health use cases, whose latency and reliability network requirements cannot be met by current communication systems; or simply improving current applications with more challenging requirements to be achieved, such as increasing the transmission rate in a mobile network, offering Quality of Service (QoS), and consequently, better user experience. Therefore, enabling technologies must be chosen to design an appropriate 6G architecture to address such demands. However, the explosion of emerging applications focused on different scopes and requirements to be met makes choosing these enabling technologies extremely complex and unpredictable. Thus, this article aims to create a methodology for analyzing the relevance of enabling technologies and use it to design an optimal architecture capable of meeting the 6G demands. For this purpose, two methods named as Average (AVG) and Analytic Hierarchy Process (AHP) have been selected, whose objective is to determine the relevance of an enabler for the 6G architecture, taking into account different degrees of influencing variables for this analysis, such as adherence to a certain architectural model; popularity in the research area; degree of innovation; synergy with other enablers; and support for requirements. Each of these methods presents a particular result. In the case of the AVG method, the criteria and variables are evaluated independently, and the arithmetic mean is employed to combine the evaluations into a single measure of suitability. In contrast, the AHP method considers the relative importance of criteria and variables in order to classify an optimal set of enabling technologies capable of fulfilling the key roles to be performed by a 6G architecture, and consequently meeting the main 6G demands. Our evaluation provides a unique perspective on 6G enablers, identifying issues and fostering research for future mobile architectures. The results obtained also provide researchers with the necessary information to stay updated on emerging enabling technologies and their suitability for designing new optimized 6G architectures

Educomunicação: caminhos entre a pesquisa e a formação, no II Congresso Internacional de Comunicação e Educação

A herança cultural representada pelos papers propostos e aprovados pela comissão científica do II Congresso Internacional de Comunicação e Educação e VIII Encontro Brasileiro de Educomunicação, está na publicação em quatro diferentes e-books, disponibilizados na plataforma de publicações do site da ABPEducom (www.abpeducom.com.br).  O presente volume – o segundo a ser disponibilizado ao público – volta-se, mais especificamente, a dois eixos temáticos, relacionados, respectivamente, à pesquisa e à formação no campo da Educomunicação. Pesquisa e formação são dois eixos fundamentais para garantir o que se define como coerência epistemológica entre teoria e prática. E é sobre esta perspectiva que os artigos reunidos neste e-book devem ser recebidos e confrontados. Falamos inicialmente sobre uma coerência epistemológica no interior do próprio produto analisado. Sinalizamos com isto que os autores podem ter desenvolvido abordagens não necessariamente alinhadas aos referenciais da Educomunicação na perspectiva defendida, por exemplo, pelo NCE-USP. O fato não desautoriza o texto, ao contrário: se foram incluídos no livro é porque trabalham com pensamentos e ações com os quais a Educomunicação pode e deve estar dialogando, especialmente nos âmbito do uso das TIC e na implementação de programas de educação mediática e informacional

Implementation of a Brazilian Cardioprotective Nutritional (BALANCE) Program for improvement on quality of diet and secondary prevention of cardiovascular events: A randomized, multicenter trial

Background: Appropriate dietary recommendations represent a key part of secondary prevention in cardiovascular disease (CVD). We evaluated the effectiveness of the implementation of a nutritional program on quality of diet, cardiovascular events, and death in patients with established CVD. Methods: In this open-label, multicenter trial conducted in 35 sites in Brazil, we randomly assigned (1:1) patients aged 45 years or older to receive either the BALANCE Program (experimental group) or conventional nutrition advice (control group). The BALANCE Program included a unique nutritional education strategy to implement recommendations from guidelines, adapted to the use of affordable and regional foods. Adherence to diet was evaluated by the modified Alternative Healthy Eating Index. The primary end point was a composite of all-cause mortality, cardiovascular death, cardiac arrest, myocardial infarction, stroke, myocardial revascularization, amputation, or hospitalization for unstable angina. Secondary end points included biochemical and anthropometric data, and blood pressure levels. Results: From March 5, 2013, to Abril 7, 2015, a total of 2534 eligible patients were randomly assigned to either the BALANCE Program group (n = 1,266) or the control group (n = 1,268) and were followed up for a median of 3.5 years. In total, 235 (9.3%) participants had been lost to follow-up. After 3 years of follow-up, mean modified Alternative Healthy Eating Index (scale 0-70) was only slightly higher in the BALANCE group versus the control group (26.2 ± 8.4 vs 24.7 ± 8.6, P <.01), mainly due to a 0.5-serving/d greater intake of fruits and of vegetables in the BALANCE group. Primary end point events occurred in 236 participants (18.8%) in the BALANCE group and in 207 participants (16.4%) in the control group (hazard ratio, 1.15; 95% CI 0.95-1.38; P =.15). Secondary end points did not differ between groups after follow-up. Conclusions: The BALANCE Program only slightly improved adherence to a healthy diet in patients with established CVD and had no significant effect on the incidence of cardiovascular events or death. © 2019 The Author

Comenta&#769;rios a uma sentenc&#807;a anunciada : o processo Lula

“Comentários a uma sentença: o Caso Lula” é talvez o mais importante documento jurídico publicado no Brasil em décadas. A presente coletânea de artigos nasceu de um movimento espontâneo e bastante significativo de juristas brasileiros e estrangeiros que examinaram cuidadosamente a sentença proferida no âmbito do processo que tramitou na 13ª Vara Federal de Curitiba, no caso que ficou conhecido na mídia como o do “tríplex do Guarujá”. <br>De la presentación de Geraldo Prad