Laypeople's Views on Decision Making in the Health Professions

Although actuarial judgment (AJ) is often superior to clinical judgment (CJ), it is underused in the health fields for decision making. One potential reason is that people would not like to be treated as statistics. This study investigates laypeople’s views about the use of AJ versus CJ. Manipulations include domain – a medical context or a psychological context – and perceived difficulty of a diagnosis on laypersons’ preference for either method. It is hypothesized that laypeople are biased against AJ in general. However there are many potential effects of varying context and difficulty. Therefore several possibilities are discussed. 82 Research Experience Program students participating for credit were randomly assigned to two groups in which all materials were presented in a medical or psychological context. Participants read unbiased definitions of AJ and CJ, then read scenarios where easy or difficult diagnoses were made by physicians or psychologists. After each scenario, participants indicated how appropriate it was for the professional to use CJ and AJ. Final questions further explored participants’ comfort levels with each method, and their views of health professionals and actuarial tool development. Results indicated significant interactions between style and difficulty on the rated appropriateness of AJ and CJ. After reading the easy scenario, participants were more in favor of CJ, but after the difficult scenario they rated AJ as more appropriate. Significant interactions between style and domain revealed that CJ was perceived as more appropriate in a psychological context, but appropriateness inverted in the medical context. In general, participants were more comfortable with CJ in both the medical and psychological groups. Finally, people perceived physicians as more knowledgeable than psychologists, and their decision making to be more rational. Possible factors influencing these views are discussed in the paper.No embarg

A influência da chupeta nas más-oclusões : revisão sistemática

Introdução: O hábito de sucção de chupetas destaca-se como um dos mais prevalentes entre os hábitos de sucção não nutritiva, sobretudo nos primeiros anos de vida da criança. De acordo com a AAPD, esse hábito deve ser interrompido até aos dois, no máximo três anos de idade, caso contrário, há grande probabilidade de desenvolver más oclusões, como mordidas abertas anteriores, mordidas cruzadas posteriores, aumento da sobremordida horizontal, classe II canina e plano terminal do 2º molar decíduo em degrau distal. Objetivos: Esta revisão sistemática teve como objetivo avaliar as diferenças entre as más oclusões resultantes do uso prolongado de chupetas ortodônticas ou convencionais em crianças até cinco anos, considerando também a duração e frequência de uso. Material e métodos: Para responder à pergunta de investigação e conduzir esta revisão sistemática, foram utilizadas as seguintes bases de dados: Web of Science®, Scielo®, ScienceDirect®, Scopus® e PubMed/MEDLINE®. Estabeleceram-se critérios de inclusão, palavras-chave e sinónimos para construir as strings de pesquisa. Utilizando as palavras-chave, foram elaboradas as strings de pesquisa usando os operadores booleanos "OR" e "AND" em cada base de dados. Resultados: Foram incluídos quatro estudos e foram extraídos os seguintes dados relevantes: autor, data e país do estudo, tipo de pesquisa realizada, revista de publicação, idades, número de crianças sem hábito de sucção de chupetas, total casuístico, metodologia, número total de crianças com hábito de sucção de chupetas ortodônticas e convencionais, frequência e duração de uso para ambos os tipos de chupetas, quantidade e medidas das más oclusões, principais conclusões obtidas. Conclusão: Crianças com hábitos de sucção de chupetas têm um risco aumentado de desenvolver más oclusões, independentemente do tipo de chupeta utilizada. Não foi possível concluir qual dos tipos de chupetas é mais benéfica para a cavidade oral da criança.Introduction: The habit of pacifier sucking stands out as one of the most prevalent among non-nutritive sucking habits, especially in the early years of an individual's life. According to the AAPD, this habit should be discontinued by the age of two, at most three years old. Otherwise, there is a high probability of developing malocclusions, such as anterior open bites, posterior crossbites, increased overjet, Class II canine, and distal step of the deciduous second molar. Objectives: This systematic review aimed to assess the differences in malocclusions resulting from prolonged use of orthodontic or conventional pacifiers in children up to five years old, considering the duration and frequency of use. Material and methods: To address the research question and conduct this systematic review, the following databases were utilized: Web of Science®, Scielo®, ScienceDirect®, Scopus®, anda PubMed/MEDLINE®. Inclusion criteria, keywords, and synonyms were established to construct search strings. Using the keywords, search strings were developed using the boolean operators "OR" and "AND" in each database. Results: Four studies were included, and the following relevant data were extracted: author, date, and country of the study; type of research conducted; publishing journal; age range; number of children without pacifier sucking habit; total casuistic; methodology; total number of children with orthodontic and conventional pacifier sucking habit; frequency and duration of use for both types of pacifiers; quantity and measurements of malocclusions and main conclusions obtained. Conclusion: Children with pacifier sucking habits have an increased risk of developing malocclusions, regardless of the type of pacifier used. It was not possible to conclude which type of pacifier is more beneficial for the child's oral cavity

Description of the larva and pupa of Apion brevicorne Gerstaecker, 1854 (Coleoptera: Brentidae: Apioninae) with biological information

Apion brevicorne Gerstaecker, 1854 (Coleoptera: Brentidae: Apioninae) is an ecologically and economically important weevil that feeds on seeds and tissues of trees in the genus Copaifera L. (Fabaceae). Although the genus Apion comprises 16 species restricted to the Paleartic region, the Neotropical species A. brevicorne is still considered as incertae sedis due to the absence of a systematic study about it. The first descriptions and illustrations of Apion brevicorne are provided here. Diagnostic characters of larva and pupa are included and compared with 13 species from other biogeographic regions. Details of immature Apioninae species associated with host plants from the Neotropical region are described for the first time

Análise de sequências de DNA metagenômico de solos da Floresta Atlântica paranaense : implicações ecológicas e biotecnológicas

Orientador : Prof. Dr. Helisson FaoroDissertação (mestrado) - Universidade Federal do Paraná, Setor de Educação Profissional e Tecnológica, Programa de Pós-Graduação em Bioinformática. Defesa: Curitiba, 24/02/2017Inclui referências : f. 68-73Resumo: A Floresta Atlântica Paranaense é um dos 25 hotspots de biodiversidade do mundo, sendo conhecida por sua grande diversidade de fauna e flora. Mas pouco se sabe sobre a diversidade microbiana de seu solo. A Metagenômica é o campo de estudo de DNA de amostras ambientais e por meio de suas técnicas é possível acessar o DNA de comunidades microbianas e inferir informações filogenéticas e funcionais, além de obter genomas de microrganismos não cultiváveis em laboratório. Neste trabalho, foram combinadas técnicas de Metagenômica e tecnologias de sequenciamento de nova geração (NGS) para estudar amostras de DNA do solo da Mata Atlântica Paranaense. As amostras de solo foram coletadas em Julho de 2004 e Janeiro de 2007 em baixa (161 m), média (604 m) e alta altitudes (900 m). O DNA total purificado foi sequenciado pelas plataformas Illumina MiSeq e Ion Proton. O gene 16S rDNA foi amplificado para todas as amostras e sequenciado na plataforma Illumina MiSeq. Foram geradas 371.561 leituras de 16S rDNA e 66.936.100 leituras de DNA total, que foram submetidas a análises de diversidade e funcionais com os programas QIIME e MG-RAST. A montagem de genomas parciais foi realizada com os programas CLC Genomics Workbench e MEGAHIT. Durante as análises de diversidade, tanto baseada no DNA total quanto no gene 16S rDNA, foi identificada a predominância dos filos Acidobacteria e Proteobacteria. Entretanto, houve uma diferença na proporção dos filos identificados comparando-se somente sequências amplificadas de 16S rDNA e DNA total. Já a aplicação de tecnologias diferentes de sequenciamento de DNA não teve influência sobre a distribuição dos filos. As análises funcionais revelaram que a maioria das sequências de DNA total estão relacionadas a funções de metabolismo, principalmente metabolismo de carboidratos e aminoácido e derivados. A melhor montagem de genoma foi obtida pelo programa CLC Genomics Workbench para a amostra MAF1 usando dados Illumina MiSeq e gerou 16.426 contigs acima de 1.000 pb e maior contig com 35.630 pb. Os 16.426 contigs foram analisados com o blastn no banco de dados nr do NCBI e obtiveram similaridade com 3.010 sequências depositadas no banco de dados referentes aos genomas de organismos dos filos Acidobacteria, Proteobacteria e outros. O uso de sequenciamento de DNA NGS para exploração da diversidade microbiana nos solos da Floresta Atlântica Paranaense revelou a existência de uma grande microdiversidade com a presença de muitos filos bacterianos e que os resultados independem da tecnologia NGS, mas são influenciados pela época que foi coletado o DNA usado para sequenciamento. Palavras-chave: Metagenômica, Floresta Atlântica, DNA de solo, Sequenciamento NGS, Análise de diversidade, Análise funcional.Abstract: The Paraná Atlantic Forest is one of the 25 biodiversity hotspots in the world, known for its great diversity of fauna and flora. But little is known about the microbial diversity of its soil. Metagenomics is the field that studies DNA from environmental samples allowing the access to the microbial communities DNA retrieving phylogenetic and functional information, in addition to obtaining genomes from non-cultivable microorganisms. In this work, Metagenomics techniques and new generation sequencing technologies (NGS) were combined to study DNA samples from the soil of the Atlantic Forest of Parana. Soil samples were collected in July 2004 and January 2007 at low (161 m), mean (604 m) and high altitudes (900 m). Total purified DNA was sequenced by the Illumina MiSeq and Ion Proton platforms. The 16S rDNA gene was amplified for all samples and sequenced on the Illumina MiSeq platform. A total of 371,561 reads of 16S rRNA and 66,936,100 reads of total DNA were generated, which were submitted to diversity and functional analysis with the QIIME and MG-RAST programs. The assembly of partial genomes was performed with the CLC Genomics Workbench and MEGAHIT programs. During the analysis of diversity, both based on total DNA and 16S rDNA gene, the predominance of Acidobacteria and Proteobacteria was identified. However, there was a difference in the proportion of the identified phyla comparing only amplified 16S rDNA and total DNA sequences. On the other hand, the application of different technologies of DNA sequencing had no influence on the distribution of phyla. Functional analyzes revealed that most of the total DNA sequences are related to metabolism functions, main carbohydrates and amino acids and derivatives metabolism. The best genome assembly was obtained by the CLC Genomics Workbench program for the MAF1 sample using Illumina MiSeq data and generated 16,426 contigs above 1,000 bp and higher contig with 35,630 bp. The 16,426 contigs were compared to NCBI nr database using blastn and obtained similarity with 3,010 sequences referring to the genomes of organisms from Acidobacteria, Proteobacteria and other phyla. The use of NGS DNA sequencing for the exploration of microbial diversity in the Atlantic Forest soils revealed the existence of a large micro-diversity with the presence of many bacterial phyla and that the results are independent of the NGS technology but are influenced by the time that was collected the DNA used for sequencing. Keywords: Metagenomics, Atlantic Forest, Soil DNA, NGS sequencing, Diversity analysis, Functional analysis

Hypertensive crisis: competencies listed by the nurse to care hospitals in Curitiba-PR

Objective: To identify the competencies listed by nurses for the care of patients with hypertensive crisis and analyze the performance described by the nurse before the patient with hypertensive crisis. Method: an exploratory study with descriptive and quantitative approach, conducted in three hospitals in CuritibaPR, where 16 nurses participated. Results: among the skills listed, there is the decision making with 81,25%; leadership and continuing education with 68,75% each. Al nurses of emergency prioritized service. Forward to the actions of emergency interventions in 93,75%, prioritized assessment of vital signs and cardiac monitoring in the initial care. Conclusion: helped identify the competencies listed for the care of hypertensive crisis. The nurse has technical/scientific so that they can put into action values, knowledge, skills and attitudes necessary for a care within the scientific, ethical and moral principles knowledge

A specific polymerase chain reaction method to identify Stenotrophomonas maltophilia

Stenotrophomonas maltophilia is a multidrug-resistant nosocomial pathogen that is difficult to identify unequivocally using current methods. Accordingly, because the presence of this microorganism in a patient may directly determine the antimicrobial treatment, conventional polymerase chain reaction (PCR) and real-time PCR assays targeting 23S rRNA were developed for the specific identification of S. maltophilia. The PCR protocol showed high specificity when tested against other species of Stenotrophomonas, non-fermentative Gram-negative bacilli and 100 clinical isolates of S. maltophilia previously identified using the Vitek system.Pontificia Universidade Catolica do Rio Grande do Su Faculdade de Biociencias Departamento de Biologia Celular e MolecularUniversidade Federal de São Paulo (UNIFESP) Departamento de BiofisicaUNIFESP, Depto. de BiofisicaSciEL

Imbalance between HDAC and HAT activities drives aberrant STAT1/MyD88 expression in macrophages from type 1 diabetic mice

AIMS: To investigate the hypothesis that alteration in histone acetylation/deacetylation triggers aberrant STAT1/MyD88 expression in macrophages from diabetics. Increased STAT1/MyD88 expression is correlated with sterile inflammation in type 1 diabetic (T1D) mice. METHODS: To induce diabetes, we injected low-doses of streptozotocin in C57BL/6 mice. Peritoneal or bone marrow-differentiated macrophages were cultured in 5mM (low) or 25mM (high glucose). ChIP analysis of macrophages from nondiabetic or diabetic mice was performed to determine acetylation of lysine 9 in histone H3 in MyD88 and STAT1 promoter regions. Macrophages from diabetic mice were treated with the histone acetyltransferase inhibitor anacardic acid (AA), followed by determination of mRNA expression by qPCR. RESULTS: Increased STAT1 and MyD88 expression in macrophages from diabetic but not naive mice cultured in low glucose persisted for up to 6days. Macrophages from diabetic mice exhibited increased activity of histone acetyltransferases (HAT) and decreased histone deacetylases (HDAC) activity. We detected increased H3K9Ac binding to Stat1/Myd88 promoters in macrophages from T1D mice and AA in vitro treatment reduced STAT1 and MyD88 mRNA expression. CONCLUSIONS/INTERPRETATION: These results indicate that histone acetylation drives elevated Stat1/Myd88 expression in macrophages from diabetic mice, and this mechanism may be involved in sterile inflammation and diabetes comorbidities

Linfoma tipo B em baço e métodos de investigação da doença utilizando ultrassonografia em cão – relato de caso

O linfoma corresponde à uma neoplasia maligna de linfócitos, que se origina em um órgão sólido (como linfonodo, baço, fígado e agregados linfóides associados às mucosas), sendo considerado o tumor de origem hematopoiética mais importante em cães, atingindo cerca de 15% a 20% dos pacientes que apresentam algum tumor maligno. São classificados de acordo com sua localização em: multicêntrico, alimentar, tímico, cutâneo e solitário/extra nodal, sendo o multicêntrico de ocorrência mais frequente. Na literatura veterinária existem diversos estudos sobre linfomas multicêntricos, entretanto os estudos sobre o linfoma esplênico primário são escassos. Dessa forma, objetiva-se nesse trabalho, relatar o caso de uma paciente da espécie canina com diagnóstico de linfoma primário de células B, um tipo raro, apresentando os sinais clínicos, formas de diagnóstico, principalmente a caracterização ultrassonográfica da lesão, bem como histopatologia e imunohistoquímica, além do desfecho e prognóstico do caso

Demographic profile of oral nonodontogenic cysts in a Brazilian population

Objectives: The purpose of this study was to determine the clinical and demographic characteristics of oral non- odontogenic cysts (ONOC) in a Brazilian population over a 53-year period and to compare this data with the literature. Study D esign: A total of 20.391 biopsies records were evaluated, from April/1959 to August/2012. Cases of oral developmental cysts were selected. Data regarding age, gender, time of evolution, and anatomic site of all cases were collected. The data were analyzed by descriptive statistics. Results: Among 20.391 oral biopsies, 71 (0.35%) met the criteria of ONOC. Females accounted for 50.70% of all cases. The mean age observed was 38.14 years (range: 5-88 years). Nasopalatine duct cysts, oral lymphoepithelial cysts and epidermoid cysts were the most common ONOC, accounting for 63 cases (88.73%). Nasopalatine duct cysts occurred in 31 cases (43.66%), followed by 22 patients with oral lymphoepithelial cysts (30.99%) and 10 cases of epidermoid cysts (14.08%). Nasopalatine duct cysts revealed predominance among males (58.06). Oral lymphoepithelial cysts were more commonly observed in tongue (50%). Epidermoid cysts were most frequently found in the buccal mucosa (40.00%). Conclusions: The differential diagnosis of ONOC is based on the clinical, radiological, and histological findings. It is difficult to establish an epidemiological profile of ONOCs, considering the low frequency of these lesions and the divergences in the demographic and clinical presentation data among different populations

Clinical Approach to Pulp Canal Obliteration: A Case Series

This article describes four cases with safe and feasible clinical treatment strategies for anterior teeth with pulp canal obliteration (PCO) using cone-beam computed tomography (CBCT), digital radiography (DR), dental operating microscopy (DOM) and ultrasonic tips (US). Four anterior teeth with PCO were chosen. DR was taken with different angulations and analyzed with different filters. Subsequently, the access cavity was performed with the aid of DOM. If the canal was not identified, CBCT was requested. Sagittal and axial slices guided the direction of the ultrasonic tips. After identification of the canal, it was then negotiated and instrumented with the rotary instruments. All four canals were successfully identified, with no complications. In case 1, the canal was identified using DR, DOM and US tips. In cases 2, 3 and 4, the canals were identified with DR,DOM,UStips and CBCT. Complete root canal obliteration identified in radiography did not necessarily mean that pulp tissue was not visible clinically, either. The clinical evaluation of the access cavity with the aid of MO was crucial. If the canal was not identified, CBCT was mandatory in order to show more detailed view of the precise position of the canals, their directions, degrees of obstruction and dimensions. It served as a guide for the direction of the ultrasonic tips to keep them within the pulp chamber safely, with a low risk of iatrogenic injury.Keywords: Cone-beam Computed Tomography; Dental Operating Microscope; Digital Radiography; Guided Endodontics; Pulp Canal Obliteration; Ultrasoun