Organização e avaliação de um software para ensino de ausculta respiratória

O objetivo deste trabalho foi elaborar um software multimídia para o desenvolvimento de um programa de ensino de ausculta pulmonar e avaliar o aprendizado do conteúdo após a utilização desta forma de ensino. Método: O software foi organizado em três etapas seqüenciaisdiferentes: revisão anátomo-funcional do sistema respiratório, fundamentos fisiológicos e técnica de ausculta respiratória. Na terceira etapa foram incluídas simulações de casos clínicos. Para obtenção do objetivo terminal estabeleceramse 33 passos a serem executados pelosalunos, equivalentes aos objetivos intermediários de ensino. Participaram da avaliação sobre a eficácia do programa de ensino, utilizando o software desenvolvido para este estudo, dez alunos do Curso de Fisioterapia. Avaliou-se o grau de satisfação com o programa, tempo gasto com o estudo e desempenho técnico em situações clínicas reais de ausculta respiratória. Resultados: Os dez alunos realizaram a ausculta completa em situação de avaliação clínica. De um total de 50 auscultas realizadas pelos dez alunos, encontrou-se que 40 alunos apresentaram informações e conclusões corretas e 10 deles apresentaram informações incompletas, e destas, em apenas um caso verificou-se informação incorreta. Quanto à satisfação dos alunos com relação ao ensino de ausculta respiratória, avaliada através de questionário, encontrou-se que os alunos deram uma nota média de 9,2 (numa escala de 0 - 10), considerando-o satisfatório. Os alunos referiram como pontos positivos do software a facilidade em ter todas as informações da aula à disposição, além de textos para consulta em caso de dúvida; a audição de um som associado a uma imagem, facilitando a aprendizagem e concluíram que este tipo de estudo é muito mais agradável do que a leitura de textos, fora a possibilidade de autocorreção. Conclusão: O aprendizado apresentado pelos alunos que sesubmeteram à forma de ensino proposta foi plenamente satisfatório, visto que, é a partir deste aprendizado que os alunos iniciam um treinamento clínico intensivo

Peri-operative red blood cell transfusion in neonates and infants: NEonate and Children audiT of Anaesthesia pRactice IN Europe: A prospective European multicentre observational study

BACKGROUND: Little is known about current clinical practice concerning peri-operative red blood cell transfusion in neonates and small infants. Guidelines suggest transfusions based on haemoglobin thresholds ranging from 8.5 to 12 g dl-1, distinguishing between children from birth to day 7 (week 1), from day 8 to day 14 (week 2) or from day 15 (≥week 3) onwards. OBJECTIVE: To observe peri-operative red blood cell transfusion practice according to guidelines in relation to patient outcome. DESIGN: A multicentre observational study. SETTING: The NEonate-Children sTudy of Anaesthesia pRactice IN Europe (NECTARINE) trial recruited patients up to 60 weeks' postmenstrual age undergoing anaesthesia for surgical or diagnostic procedures from 165 centres in 31 European countries between March 2016 and January 2017. PATIENTS: The data included 5609 patients undergoing 6542 procedures. Inclusion criteria was a peri-operative red blood cell transfusion. MAIN OUTCOME MEASURES: The primary endpoint was the haemoglobin level triggering a transfusion for neonates in week 1, week 2 and week 3. Secondary endpoints were transfusion volumes, 'delta haemoglobin' (preprocedure - transfusion-triggering) and 30-day and 90-day morbidity and mortality. RESULTS: Peri-operative red blood cell transfusions were recorded during 447 procedures (6.9%). The median haemoglobin levels triggering a transfusion were 9.6 [IQR 8.7 to 10.9] g dl-1 for neonates in week 1, 9.6 [7.7 to 10.4] g dl-1 in week 2 and 8.0 [7.3 to 9.0] g dl-1 in week 3. The median transfusion volume was 17.1 [11.1 to 26.4] ml kg-1 with a median delta haemoglobin of 1.8 [0.0 to 3.6] g dl-1. Thirty-day morbidity was 47.8% with an overall mortality of 11.3%. CONCLUSIONS: Results indicate lower transfusion-triggering haemoglobin thresholds in clinical practice than suggested by current guidelines. The high morbidity and mortality of this NECTARINE sub-cohort calls for investigative action and evidence-based guidelines addressing peri-operative red blood cell transfusions strategies. TRIAL REGISTRATION: ClinicalTrials.gov, identifier: NCT02350348

My Teaching Is Not Gender Biased, Is It?

Gender bias and underrepresentation in society are likewise pervasive in Science, Technology, Engineering, and Math fields and are difficult to balance out. In Aquatic Sciences, large efforts have been made to increase awareness on Diversity, Equity, Inclusion, and Justice and yet, gender- and diversity-gaps remain. Reducing these gaps requires work in different dimensions: individual, community, education, and society. As scientists, we can act at all those levels in various ways and one effective approach is through education. When teaching and supervising students we can be role models, actively, consciously, and explicitly including diverse and historically underrepresented scientists in our teaching material or creating an inclusive class environment. But, where to start?CML participation at the conference was funded by the German Research Foundation (DFG, FlowReSet project ME 5498/2-1) and the work has been developed within the funding framework of NutFlows (ME 5498/3-1). AP was supported by the Beatriu de Pinós postdoctoral program under the Ministry of Research and Universities of the Government of Catalonia (Grant Reference No. 2020 BP-00237). PR-L and AF were supported by MCIN/AEI through the Juan de la Cierva - Incorporación program (IJC2019-041601-I and IJC2019-039181-I).Peer reviewe

From research to rapid response: mass COVID-19 testing by volunteers at the Centre for Genomic Regulation

The COVID-19 pandemic has posed and is continuously posing enormous societal and health challenges worldwide. The research community has mobilized to develop novel projects to find a cure or a vaccine, as well as to contribute to mass testing, which has been a critical measure to contain the infection in several countries. Through this article, we share our experiences and learnings as a group of volunteers at the Centre for Genomic Regulation (CRG) in Barcelona, Spain. As members of the ORFEU project, an initiative by the Government of Catalonia to achieve mass testing of people at risk and contain the epidemic in Spain, we share our motivations, challenges and the key lessons learnt, which we feel will help better prepare the global society to address similar situations in the future.The ORFEU program was created by the Catalan Enterprise and Knowledge Department with the Department of Health and funded by the Government of Catalonia, who trusted the expertise of research institutes to add value to the health system during the pandemic. We also extend our thanks to the Spanish Ministry of Science and Innovation to the EMBL partnership, the Centro de Excelencia Severo Ochoa, the CERCA Programme / Generalitat de Catalunya, the Spanish Ministry of Science and Innovation through the Instituto de Salud Carlos III, the Generalitat de Catalunya through Departament de Salut and Departament d’Empresa i Coneixement, and the co-financing by the Spanish Ministry of Economy, Industry and Competitiveness (MEIC) with funds from the European Regional Development Fund (ERDF) corresponding to the 2014-2020 Smart Growth Operating Program. We acknowledge support of the Spanish Ministry of Science and Innovation through the Instituto de Salud Carlos III, to the EMBL partnership and to the Co-financing with funds from the European Regional Development Fund corresponding to the Programa Operativo FEDER Plurirregional de España (POPE) 2014-2020. We acknowledge also support of the Centro de Excelencia Severo Ochoa and the Generalitat de Catalunya through the CERCA Programme, through Departament de Salut and Departament d’Empresa i Coneixement and the Co-financing with funds from the European Regional Development Fund by the Secretaria d’Universitats i Recerca corresponding to the Programa Operatiu FEDER de Catalunya 2014-202

Universal Dependencies 2.3

Universal Dependencies is a project that seeks to develop cross-linguistically consistent treebank annotation for many languages, with the goal of facilitating multilingual parser development, cross-lingual learning, and parsing research from a language typology perspective. The annotation scheme is based on (universal) Stanford dependencies (de Marneffe et al., 2006, 2008, 2014), Google universal part-of-speech tags (Petrov et al., 2012), and the Interset interlingua for morphosyntactic tagsets (Zeman, 2008)

Evaluation of a quality improvement intervention to reduce anastomotic leak following right colectomy (EAGLE): pragmatic, batched stepped-wedge, cluster-randomized trial in 64 countries

Background Anastomotic leak affects 8 per cent of patients after right colectomy with a 10-fold increased risk of postoperative death. The EAGLE study aimed to develop and test whether an international, standardized quality improvement intervention could reduce anastomotic leaks. Methods The internationally intended protocol, iteratively co-developed by a multistage Delphi process, comprised an online educational module introducing risk stratification, an intraoperative checklist, and harmonized surgical techniques. Clusters (hospital teams) were randomized to one of three arms with varied sequences of intervention/data collection by a derived stepped-wedge batch design (at least 18 hospital teams per batch). Patients were blinded to the study allocation. Low- and middle-income country enrolment was encouraged. The primary outcome (assessed by intention to treat) was anastomotic leak rate, and subgroup analyses by module completion (at least 80 per cent of surgeons, high engagement; less than 50 per cent, low engagement) were preplanned. Results A total 355 hospital teams registered, with 332 from 64 countries (39.2 per cent low and middle income) included in the final analysis. The online modules were completed by half of the surgeons (2143 of 4411). The primary analysis included 3039 of the 3268 patients recruited (206 patients had no anastomosis and 23 were lost to follow-up), with anastomotic leaks arising before and after the intervention in 10.1 and 9.6 per cent respectively (adjusted OR 0.87, 95 per cent c.i. 0.59 to 1.30; P = 0.498). The proportion of surgeons completing the educational modules was an influence: the leak rate decreased from 12.2 per cent (61 of 500) before intervention to 5.1 per cent (24 of 473) after intervention in high-engagement centres (adjusted OR 0.36, 0.20 to 0.64; P < 0.001), but this was not observed in low-engagement hospitals (8.3 per cent (59 of 714) and 13.8 per cent (61 of 443) respectively; adjusted OR 2.09, 1.31 to 3.31). Conclusion Completion of globally available digital training by engaged teams can alter anastomotic leak rates. Registration number: NCT04270721 (http://www.clinicaltrials.gov)