Evolução da telefonia na web

Mestrado em Sistemas de InformaçãoCom a ameaça imposta às operadoras por aplicações OTT como WhatsApp ou Skype, diversas iniciativas coordenadas pela GSMA foram criadas para tentar responder a este fenómeno. Paralelamente, com a evolução de tecnologias como HTML5 e WebRTC, novos serviços como o Twilio têm surgido, oferecendo APIs para o desenvolvimento de novas aplicações Web. No entanto, a integração destas tecnologias em tradicionais redes de telecomunicações não faz parte das actuais especificações. Sendo assim, o objectivo desta dissertação consiste na especificação e implementação de um protótipo baseado nestas tecnologias emergentes, integrado com uma rede IMS. Primeiramente, foi feito um estudo do estado de arte, definindo requisitos e casos de uso a serem explorados. De seguida, o desenho da solução foi feito e implementado, tendo sido criado uma plataforma que alia WebRTC e a OneAPI da GSMA (que define funcionalidades básicas para operadores), oferecendo interoperabilidade entre ambos os mundos. A solução é composta por um servidor aplicacional que expõe a API e gateway WebRTC, tendo sido testada e considerada adaptada às necessidades estabelecidas.With the threat to operators by OTT applications such as Skype or WhatsApp, several initiatives coordinated by GSMA were created in an effort to respond to this phenomenon. In parallel, with the evolution of technologies such as HTML5 and WebRTC, new services such as Twilio are now available, offering APIs for web application development. However, the integration of these technologies and traditional telecommunication networks is not a part of the current standards. As such, the objective of this dissertation is the specification and implementation of a prototype based on these emerging technologies, integrated in an IMS network. First, a state-of-the-art analysis was made, defining requirements and use-cases to be explored. Secondly, the design and implementation of the solution was done, creating a platform that unites WebRTC and GSMA’s OneAPI (which exposes basic operator features), offering interoperability between both worlds. The solution is composed by an application server that exposes the API and a WebRTC gateway, having been successfully tested and adapted to the established needs

Light microscope observations on the epididymis of paca (Agouti paca)

The features of paca epididymis, based on its appearance in light microscope, is described in this paper. The cellular population of the epithelial lining comprises principal cells, basal cells, apical cells, narrows cells, and hallo cells. The epididymis is divided in five distinct and continuous regions, Zone I, or initial segment, and zone II, are both localized into the head. Zone III comprises the distal head and all the body. Zones IV and V are restricted to the tail, in the proximal and distal cauda epididymis respectively. Each zone can be readily distinguished on the basis of morphological characteristics. The height of epididymal epithelium is greater in zone I. There is a progressive increase in the diameter of the tubular lumen through the different areas, with the maximum in the zone V. The presence of a high epithelium, and the virtual absence of sperm in zone I suggest fast transit of spermatozoa in this region. Zone V comprises the distal tail, has smaller epithelial lining, greater luminal diameter, shorter stereocilia than the other zones, and contains spermatozoa packed inside the lumen, that characterizes this zone as a place of sperm storage. The findings are compared with other reports in rodents and other domestic animals, to contribute to the understanding of epididymal morphophysiology

The Enhanced Efficacy of Intracellular Delivery of Doxorubicin/C6-Ceramide Combination Mediated by the F3 Peptide/Nucleolin System Is Supported by the Downregulation of the PI3K/Akt Pathway

Targeting multiple cellular populations is of high therapeutic relevance for the tackling of solid tumors heterogeneity. Herein, the ability of pegylated and pH-sensitive liposomes, functionalized with the nucleolin-binding F3 peptide and containing doxorubicin (DXR)/C6-ceramide synergistic combination, to target, in vitro, ovarian cancer, including ovarian cancer stem cells (CSC), was assessed. The underlying molecular mechanism of action of the nucleolin-mediated intracellular delivery of C6-ceramide to cancer cells was also explored. The assessment of overexpression of surface nucleolin expression by flow cytometry was critical to dissipate differences identified by Western blot in membrane/cytoplasm of SKOV-3, OVCAR-3 and TOV-112D ovarian cancer cell lines. The former was in line with the significant extent of uptake into (bulk) ovarian cancer cells, relative to non-targeted and non-specific counterparts. This pattern of uptake was recapitulated with putative CSC-enriched ovarian SKOV-3 and OVCAR-3 sub-population (EpCAMhigh/CD44high). Co-encapsulation of DXR:C6-ceramide into F3 peptide-targeted liposomes improved cytotoxic activity relative to liposomes containing DXR alone, in an extent that depended on the intrinsic resistance to DXR and on the incubation time. The enhanced cytotoxicity of the targeted combination was mechanistically supported by the downregulation of PI3K/Akt pathway by C6-ceramide, only among the nucleolin-overexpressing cancer cells presenting a basal p-Akt/total Akt ratio lower than 1

ESTRATÉGIAS UTILIZADAS NO CUIDADO A PESSOAS HIPERTENSAS NO DOMICILIO: REFLEXÕES ACERCA DO PAPEL DA EQUIPE MULTIPROFISSIONAL DE SAÚDE

Introduction: primary health care is the first contact of users with public health, and is responsible for offering promotional, preventive and curative actions to the population, with home care having grown as a result of geographic, epidemiological, social and cultural practices that have been spreading around the world, seeking a care proposal that promotes greater comfort and well-being for families, including the public with chronic diseases, such as Systemic Arterial Hypertension. Objective: to reflect on the strategies used by the multiprofessional health team in the care of hypertensive patients at home, and to transcend a reflection related to the prevalent difficulties for these patients. Method: this is a narrative review. The search took place in the following databases: Lilacs, Bdenf and the SciELO portal, with the inclusion criteria, articles published in full that addressed the theme, theses, dissertations, books and documents in Portuguese, English and Spanish. Duplicate studies, in languages ​​other than those selected and studies available for a fee, were excluded. Results and discussion: In this context, the commonly used strategies were educational actions through conversation circles using personalized badges and debates about thematic references, health promotion, disease prevention, didactic guidelines about healthy eating habits, and emphasizing the importance of health care. Conclusion: The strategies implemented by the FHS are fundamental, as they help in the treatment of SAH and provide an improvement in the quality of life of patients.Introducción: la atención primaria de salud es el primer contacto de los usuarios con la salud pública, y el encargado de ofrecer acciones promocionales, preventivas y curativas a la población, con la atención domiciliaria creciendo debido a los cambios geográficos, epidemiológicos, sociales y culturales que se han ido extendiendo por todo el escenario mundial, buscando una propuesta de atención que promueva una mayor comodidad y bienestar para las familias, incluyendo al público con enfermedades crónicas, como la Hipertensión Arterial Sistémica. Objetivo: reflexionar sobre las estrategias utilizadas por el equipo multidisciplinario de salud en la atención de pacientes hipertensos en el hogar, y trascender una reflexión relacionada con las dificultades prevalentes para estos pacientes. Método: se trata de una revisión narrativa. La búsqueda se realizó en las bases de datos: Lilacs, Bdenf y en el portal SciELO, con los criterios de inclusión, artículos publicados en el integra que abordaron el tema, tesis, disertaciones, libros y documentos en portugués, inglés y español. Los estudios duplicados se excluyeron en idiomas distintos de los seleccionados y los estudios disponibles de manera remunerada. Resultados y discusión: En este contexto, las estrategias comúnmente utilizadas fueron las acciones educativas a través de ruedas de conversación utilizando insignias personalizadas y debates sobre temas temáticos, promoción de la salud, prevención de enfermedades, orientación didáctica sobre hábitos alimenticios saludables y enfatizando la importancia del cuidado de la salud. Conclusión: Las estrategias implementadas por la ESF son fundamentales, ya que ayudan en el tratamiento de la HSA.Introdução: a tenção primária a saúde constitui-se como primeiro contato dos usuários com a saúde pública, e o responsável pela oferta de ações promocionais, preventivas e curativas a população, tendo o atendimento domiciliar crescido em decorrência das mudanças geográficas, epidemiológicas, sociais e culturais que vem se alastrando pelo cenário mundial, buscando uma proposta de cuidados que promova maior conforto e bem-estar as famílias, incluindo o público portador de doenças crônicas, como a Hipertensão Arterial Sistêmica. Objetivo: refletir acerca das estratégias utilizadas pela equipe multiprofissional de saúde no cuidado a hipertensos no âmbito domiciliar, e transcender uma reflexão relacionada as dificuldades prevalentes para esses pacientes. Método: trata-se de uma revisão narrativa. A busca ocorreu nas bases de dados: Lilacs, Bdenf e no portal da SciELO, com os critérios de inclusão, artigos publicados na integra que abordassem a temática, teses, dissertações, livros e documentos nos idiomas português, inglês e espanhol. Excluíram-se estudos duplicados, em idiomas diferentes dos selecionados e estudos disponíveis de forma paga. Resultados e discussão: Nesse contexto as estratégias comumente utilizadas foram as ações educativas através de rodas de conversas utilizando crachás personalizados e debates acerca dos referentes temáticos, promoção de saúde, prevenção de agravos, orientações de forma didática acerca de hábitos alimentares saudáveis, e enfatizando a importância do acolhimento em saúde. Conclusão: As estratégias implementadas pelas ESF são fundamentais, pois auxiliam no tratamento da HAS e proporciona uma melhora na qualidade de vida dos pacientes

ESTRATÉGIAS UTILIZADAS NO CUIDADO A PESSOAS HIPERTENSAS NO DOMICILIO: REFLEXÕES ACERCA DO PAPEL DA EQUIPE MULTIPROFISSIONAL DE SAÚDE

Introduction: primary health care is the first contact of users with public health, and is responsible for offering promotional, preventive and curative actions to the population, with home care having grown as a result of geographic, epidemiological, social and cultural practices that have been spreading around the world, seeking a care proposal that promotes greater comfort and well-being for families, including the public with chronic diseases, such as Systemic Arterial Hypertension. Objective: to reflect on the strategies used by the multiprofessional health team in the care of hypertensive patients at home, and to transcend a reflection related to the prevalent difficulties for these patients. Method: this is a narrative review. The search took place in the following databases: Lilacs, Bdenf and the SciELO portal, with the inclusion criteria, articles published in full that addressed the theme, theses, dissertations, books and documents in Portuguese, English and Spanish. Duplicate studies, in languages ​​other than those selected and studies available for a fee, were excluded. Results and discussion: In this context, the commonly used strategies were educational actions through conversation circles using personalized badges and debates about thematic references, health promotion, disease prevention, didactic guidelines about healthy eating habits, and emphasizing the importance of health care. Conclusion: The strategies implemented by the FHS are fundamental, as they help in the treatment of SAH and provide an improvement in the quality of life of patients.Introducción: la atención primaria de salud es el primer contacto de los usuarios con la salud pública, y el encargado de ofrecer acciones promocionales, preventivas y curativas a la población, con la atención domiciliaria creciendo debido a los cambios geográficos, epidemiológicos, sociales y culturales que se han ido extendiendo por todo el escenario mundial, buscando una propuesta de atención que promueva una mayor comodidad y bienestar para las familias, incluyendo al público con enfermedades crónicas, como la Hipertensión Arterial Sistémica. Objetivo: reflexionar sobre las estrategias utilizadas por el equipo multidisciplinario de salud en la atención de pacientes hipertensos en el hogar, y trascender una reflexión relacionada con las dificultades prevalentes para estos pacientes. Método: se trata de una revisión narrativa. La búsqueda se realizó en las bases de datos: Lilacs, Bdenf y en el portal SciELO, con los criterios de inclusión, artículos publicados en el integra que abordaron el tema, tesis, disertaciones, libros y documentos en portugués, inglés y español. Los estudios duplicados se excluyeron en idiomas distintos de los seleccionados y los estudios disponibles de manera remunerada. Resultados y discusión: En este contexto, las estrategias comúnmente utilizadas fueron las acciones educativas a través de ruedas de conversación utilizando insignias personalizadas y debates sobre temas temáticos, promoción de la salud, prevención de enfermedades, orientación didáctica sobre hábitos alimenticios saludables y enfatizando la importancia del cuidado de la salud. Conclusión: Las estrategias implementadas por la ESF son fundamentales, ya que ayudan en el tratamiento de la HSA.Introdução: a tenção primária a saúde constitui-se como primeiro contato dos usuários com a saúde pública, e o responsável pela oferta de ações promocionais, preventivas e curativas a população, tendo o atendimento domiciliar crescido em decorrência das mudanças geográficas, epidemiológicas, sociais e culturais que vem se alastrando pelo cenário mundial, buscando uma proposta de cuidados que promova maior conforto e bem-estar as famílias, incluindo o público portador de doenças crônicas, como a Hipertensão Arterial Sistêmica. Objetivo: refletir acerca das estratégias utilizadas pela equipe multiprofissional de saúde no cuidado a hipertensos no âmbito domiciliar, e transcender uma reflexão relacionada as dificuldades prevalentes para esses pacientes. Método: trata-se de uma revisão narrativa. A busca ocorreu nas bases de dados: Lilacs, Bdenf e no portal da SciELO, com os critérios de inclusão, artigos publicados na integra que abordassem a temática, teses, dissertações, livros e documentos nos idiomas português, inglês e espanhol. Excluíram-se estudos duplicados, em idiomas diferentes dos selecionados e estudos disponíveis de forma paga. Resultados e discussão: Nesse contexto as estratégias comumente utilizadas foram as ações educativas através de rodas de conversas utilizando crachás personalizados e debates acerca dos referentes temáticos, promoção de saúde, prevenção de agravos, orientações de forma didática acerca de hábitos alimentares saudáveis, e enfatizando a importância do acolhimento em saúde. Conclusão: As estratégias implementadas pelas ESF são fundamentais, pois auxiliam no tratamento da HAS e proporciona uma melhora na qualidade de vida dos pacientes

Questão agrária e políticas públicas em Minas Gerais : conflitos sociais e alternativas populares

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Familial hypercholesterolaemia in children and adolescents from 48 countries: a cross-sectional study

Background: Approximately 450 000 children are born with familial hypercholesterolaemia worldwide every year, yet only 2·1% of adults with familial hypercholesterolaemia were diagnosed before age 18 years via current diagnostic approaches, which are derived from observations in adults. We aimed to characterise children and adolescents with heterozygous familial hypercholesterolaemia (HeFH) and understand current approaches to the identification and management of familial hypercholesterolaemia to inform future public health strategies. Methods: For this cross-sectional study, we assessed children and adolescents younger than 18 years with a clinical or genetic diagnosis of HeFH at the time of entry into the Familial Hypercholesterolaemia Studies Collaboration (FHSC) registry between Oct 1, 2015, and Jan 31, 2021. Data in the registry were collected from 55 regional or national registries in 48 countries. Diagnoses relying on self-reported history of familial hypercholesterolaemia and suspected secondary hypercholesterolaemia were excluded from the registry; people with untreated LDL cholesterol (LDL-C) of at least 13·0 mmol/L were excluded from this study. Data were assessed overall and by WHO region, World Bank country income status, age, diagnostic criteria, and index-case status. The main outcome of this study was to assess current identification and management of children and adolescents with familial hypercholesterolaemia. Findings: Of 63 093 individuals in the FHSC registry, 11 848 (18·8%) were children or adolescents younger than 18 years with HeFH and were included in this study; 5756 (50·2%) of 11 476 included individuals were female and 5720 (49·8%) were male. Sex data were missing for 372 (3·1%) of 11 848 individuals. Median age at registry entry was 9·6 years (IQR 5·8-13·2). 10 099 (89·9%) of 11 235 included individuals had a final genetically confirmed diagnosis of familial hypercholesterolaemia and 1136 (10·1%) had a clinical diagnosis. Genetically confirmed diagnosis data or clinical diagnosis data were missing for 613 (5·2%) of 11 848 individuals. Genetic diagnosis was more common in children and adolescents from high-income countries (9427 [92·4%] of 10 202) than in children and adolescents from non-high-income countries (199 [48·0%] of 415). 3414 (31·6%) of 10 804 children or adolescents were index cases. Familial-hypercholesterolaemia-related physical signs, cardiovascular risk factors, and cardiovascular disease were uncommon, but were more common in non-high-income countries. 7557 (72·4%) of 10 428 included children or adolescents were not taking lipid-lowering medication (LLM) and had a median LDL-C of 5·00 mmol/L (IQR 4·05-6·08). Compared with genetic diagnosis, the use of unadapted clinical criteria intended for use in adults and reliant on more extreme phenotypes could result in 50-75% of children and adolescents with familial hypercholesterolaemia not being identified. Interpretation: Clinical characteristics observed in adults with familial hypercholesterolaemia are uncommon in children and adolescents with familial hypercholesterolaemia, hence detection in this age group relies on measurement of LDL-C and genetic confirmation. Where genetic testing is unavailable, increased availability and use of LDL-C measurements in the first few years of life could help reduce the current gap between prevalence and detection, enabling increased use of combination LLM to reach recommended LDL-C targets early in life

Canagliflozin and renal outcomes in type 2 diabetes and nephropathy

BACKGROUND Type 2 diabetes mellitus is the leading cause of kidney failure worldwide, but few effective long-term treatments are available. In cardiovascular trials of inhibitors of sodium–glucose cotransporter 2 (SGLT2), exploratory results have suggested that such drugs may improve renal outcomes in patients with type 2 diabetes. METHODS In this double-blind, randomized trial, we assigned patients with type 2 diabetes and albuminuric chronic kidney disease to receive canagliflozin, an oral SGLT2 inhibitor, at a dose of 100 mg daily or placebo. All the patients had an estimated glomerular filtration rate (GFR) of 30 to <90 ml per minute per 1.73 m2 of body-surface area and albuminuria (ratio of albumin [mg] to creatinine [g], >300 to 5000) and were treated with renin–angiotensin system blockade. The primary outcome was a composite of end-stage kidney disease (dialysis, transplantation, or a sustained estimated GFR of <15 ml per minute per 1.73 m2), a doubling of the serum creatinine level, or death from renal or cardiovascular causes. Prespecified secondary outcomes were tested hierarchically. RESULTS The trial was stopped early after a planned interim analysis on the recommendation of the data and safety monitoring committee. At that time, 4401 patients had undergone randomization, with a median follow-up of 2.62 years. The relative risk of the primary outcome was 30% lower in the canagliflozin group than in the placebo group, with event rates of 43.2 and 61.2 per 1000 patient-years, respectively (hazard ratio, 0.70; 95% confidence interval [CI], 0.59 to 0.82; P=0.00001). The relative risk of the renal-specific composite of end-stage kidney disease, a doubling of the creatinine level, or death from renal causes was lower by 34% (hazard ratio, 0.66; 95% CI, 0.53 to 0.81; P<0.001), and the relative risk of end-stage kidney disease was lower by 32% (hazard ratio, 0.68; 95% CI, 0.54 to 0.86; P=0.002). The canagliflozin group also had a lower risk of cardiovascular death, myocardial infarction, or stroke (hazard ratio, 0.80; 95% CI, 0.67 to 0.95; P=0.01) and hospitalization for heart failure (hazard ratio, 0.61; 95% CI, 0.47 to 0.80; P<0.001). There were no significant differences in rates of amputation or fracture. CONCLUSIONS In patients with type 2 diabetes and kidney disease, the risk of kidney failure and cardiovascular events was lower in the canagliflozin group than in the placebo group at a median follow-up of 2.62 years

Conceptual and empirical advances in Neotropical biodiversity research

The unparalleled biodiversity found in the American tropics (the Neotropics) has attracted the attention of naturalists for centuries. Despite major advances in recent years in our understanding of the origin and diversification of many Neotropical taxa and biotic regions, many questions remain to be answered. Additional biological and geological data are still needed, as well as methodological advances that are capable of bridging these research fields. In this review, aimed primarily at advanced students and early-career scientists, we introduce the concept of "trans-disciplinary biogeography," which refers to the integration of data from multiple areas of research in biology (e.g., community ecology, phylogeography, systematics, historical biogeography) and Earth and the physical sciences (e.g., geology, climatology, palaeontology), as a means to reconstruct the giant puzzle of Neotropical biodiversity and evolution in space and time. We caution against extrapolating results derived from the study of one or a few taxa to convey general scenarios of Neotropical evolution and landscape formation. We urge more coordination and integration of data and ideas among disciplines, transcending their traditional boundaries, as a basis for advancing tomorrow\u27s ground-breaking research. Our review highlights the great opportunities for studying the Neotropical biota to understand the evolution of life