Adult human neural cells in culture following traumatic brain injury

Objective: The present study aims to evaluate the viability of adult human neural cells in culture obtained from traumatized brain tissues collected in emergency surgery procedures. Methods: Exploratory, descriptive, quantitative and cross-sectional study evaluating samples obtained from patients who underwent traumatic brain injury with extrusion of brain tissue submitted to cell culture in a standardized medium, being preserved during 168h. After observation under phase contrast microscopy and immunohistochemical processing for neuronal (MAP-2) and glial (GFAP) markers, morphometric parameters of neural cells (cell body area, dendritic field length and fractal dimension) were evaluated using ImageJ software, with data obtained after 24, 72 and 168h being compared using non-parametric Kruskal Wallis test, followed by Dunn's post hoc test. Results: The explant of the nervous tissue revealed a consolidated pattern of cell migration into the culture medium. Cell proliferation, upon reaching confluence, presented an aspect of cellular distribution juxtaposed along the culture medium at all time points analyzed. Both neurons and glial cells remained viable after 168h in culture, with their morphologies not varying significantly throughout the time points evaluated. Immunohistochemistry for MAP-2 showed a relatively well-preserved cytoskeletal organization. GFAP immunoreactivity revealed activated astrocytes especially at the later time point. Conclusions: Our results point out the viability of cell culture from traumatized human nervous tissue, opening up perspectives for the use of substances of natural origin that may contribute neuroprotectively to neuronal maintenance in culture, allowing future translational approach.

Fatores de risco para a Síndrome de burnout em enfermeiros de um hospital público de Mossoró/RN, Brasil / Risk factors for burnout syndrome in nurses at a public hospital in Mossoró/RN, Brazil

Objetivo: Avaliar os fatores de risco para o aparecimento da Síndrome de burnout em enfermeiros trabalhadores do Hospital Regional Tarcísio de Vasconcelos Maia em Mossoró/RN. Métodos: Estudo exploratório, descritivo, quantitativo e transversal com 119 enfermeiros de março a setembro de 2022. Os dados foram coletados a partir da aplicação de um formulário com informações sócio-organizacionais e do Copenhagen Burnout Inventory, contendo 19 itens que refletem o burnout profissional em uma escala categorizada como burnout baixo, intermediário e alto. Resultados: A maioria dos entrevistados era do sexo feminino (81%), com média de 36,4 anos de idade, casada (70%), com especialização na área (74%) e dois empregos (59%). Identificou-se maior prevalência de níveis elevados de burnout pessoal (44%) e níveis intermediários de burnoutrelacionado ao trabalho (52%) e relacionado ao cliente (50%). Houve forte correlação positiva entre número de vínculos empregatícios para as dimensões burnout pessoal (r = 0,74; p = 0,03) e relacionado ao trabalho (r = 0,81; p = 0,02), forte correlação positiva entre carga horária de trabalho e burnout pessoal (r = 0,68; p = 0,04) e moderada correlação positiva entre carga horária de trabalho e burnout relacionado ao trabalho (r = 0,53; p = 0,04). Conclusões: A exposição a jornadas de trabalho prolongadas resultou em aumento dos níveis de exaustão física e psíquica nos enfermeiros, interferindo negativamente nos aspectos profissionais e pessoais. Estudos futuros focando em estratégias para garantir uma melhor condição de trabalho ao enfermeiro são necessários, visando proporcionar uma melhor saúde ocupacional aos trabalhadores

Objective: To evaluate the risk factors for the onset of burnout syndrome in nursing workers at the Hospital Regional Tarcísio de Vasconcelos Maia in Mossoró/RN. Methods: Exploratory, descriptive, quantitative and cross-sectional study with 119 nurses from March to September 2022. Data were collected from the application of a form with socio-organizational information and the Copenhagen Burnout Inventory, containing 19 items that reflect the professional burnout on a scale categorized as low, intermediate and high burnout. Results: Most respondents were female (81%), with an average age of 36.4 years, married (70%), with specialization in the area (74%) and two jobs (59%). A higher prevalence of high levels of personal burnout (44%) and intermediate levels of work-related (52%) and client-related burnout (50%) were identified. There was a strong positive correlation between the number of employment relationships for the personal burnout (r = 0.74; p = 0.03) and work-related (r = 0.81; p = 0.02) dimensions, a strong positive correlation between load hours of work and personal burnout (r = 0.68; p = 0.04) and a moderate positive correlation between workload and work-related burnout (r = 0.53; p = 0.04). Conclusions: Exposure to long working hours resulted in increased levels of physical and mental exhaustion in nurses, negatively interfering with professional and personal aspects. Future studies focusing on strategies to ensure a better working condition for nurses are needed, aiming to provide better occupational health for workers. Keywords: Burnout syndrome; Occupational stress; Nursing

Chronic kidney disease prevention campaign: relationship between proteinuria and elderly people / Campanha de prevenção de doença renal crônica: relação entre proteinúria e idosos

ABSTRACT Objective: To verify the relationship between the presence of proteinuria as a renal injury marker in elderly without history of systemic arterial hypertension and cardiovascular diseases. A cross-sectional study was developed from January 2014 to December 2019, through kidney disease prevention campaigns promoted by the Federal University of Ceará in the city of Fortaleza. Methods: The sample consisted of 417 elderlies. A questionnaire was used to characterize individuals and assess previous diseases, and urinalysis reagent strips were used to assess proteinuria. Results: Statistically significant differences (p < 0.05) and moderate effect sizes were found for blood pressure levels (CI 0.53-0.93), systolic blood pressure, and diastolic blood pressure (CI 0.21-0.61). Significant differences in capillary glycemia were also found between groups (p = 0.033), but with a low effect size (0.02-0.42). The group with comorbidities was 2.94 times more likely to have proteinuria than those without comorbidities (OR 2.94, CI 1.55-4.01; p < 0.05). In the group without cardiovascular disease/high blood pressure, a statistically significant association was found for previous diabetes and proteinuria (p = 0.037), presenting 2.68 times higher risk of proteinuria in those with diabetes mellitus (OR 2.68, CI 1.05-6.85). Significant association was also found between age groups, with the older group having 2.69 times higher risk of developing proteinuria (75 to 90 compared to 60 to 74 years) (CI 1.01-7.16; p = 0.045). Conclusion: Even without systemic arterial hypertension or cardiovascular disease, diabetes and older age can be considered high risk factors for proteinuria.

Resumo Objetivo: Verificar a relação entre a presença de proteinúria como marcador de lesão renal em idosos sem histórico de hipertensão arterial sistêmica e doenças cardiovasculares. Um estudo transversal foi desenvolvido de Janeiro de 2014 a Dezembro de 2019, por meio de campanhas de prevenção a doenças renais promovidas pela Universidade Federal do Ceará, na cidade de Fortaleza. Métodos: A amostra foi composta por 417 idosos. Um questionário foi usado para caracterizar indivíduos e avaliar doenças prévias, e foram utilizadas tiras reagentes de urinálise para avaliar proteinúria. Resultados: Diferenças estatisticamente significativas (p < 0,05) e tamanhos de efeito moderados foram encontrados para níveis de pressão arterial (IC 0,53-0,93), pressão arterial sistólica e pressão arterial diastólica (IC 0,21-0,61). Também foram encontradas diferenças significativas na glicemia capilar entre grupos (p = 0,033), mas com um tamanho de efeito baixo (0,02-0,42). O grupo com comorbidades apresentou 2,94 vezes mais probabilidade de ter proteinúria do que aqueles sem comorbidades (OR 2,94; IC 1,55-4,01; p < 0,05). No grupo sem doença cardiovascular/hipertensão, foi encontrada uma associação estatisticamente significativa para diabetes anterior e proteinúria (p = 0,037), apresentando risco 2,68 vezes maior de proteinúria naqueles com diabetes mellitus (OR 2,68; IC 1,05-6,85). Também foi encontrada uma associação significativa entre faixas etárias, com o grupo mais velho apresentando risco 2,69 vezes maior de desenvolver proteinúria (75 a 90 em comparação com 60 a 74 anos) (IC 1,01-7,16; p = 0,045). Conclusão: Mesmo sem hipertensão arterial sistêmica ou doença cardiovascular, o diabetes e a idade avançada podem ser considerados fatores de alto risco para proteinúria.

S100 proteins and their implication in the thalamus: an integrative review / Las proteínas S100 y su implicación en el tálamo: una revisión integradora

SUMMARY: S100 proteins belong group of calcium-binding proteins and are present in physiological intracellular and extracellular regulatory activities, such as cell differentiation, and act in inflammatory and neoplastic pathological processes. Recently, its expressions in the nervous system have been extensively studied, seeking to elucidate its action at the level of the thalamus: A structure of the central nervous system that is part of important circuits, such as somatosensory, behavioral, memory and cognitive, as well as being responsible for the transmission and regulation of information to the cerebral cortex. This article is an integrative review of scientific literature, which analyzed 12 studies present in Pubmed. The analysis showed that the relationship of S100 proteins and the thalamus has been described in neoplastic processes, mental disorders, hypoxia, trauma, stress, infection, Parkinson's disease and epilepsy. In summary, it is possible to conclude that this protein family is relevant as a marker in processes of thalamic injury, requiring further studies to better understand its clinical, preclinical meanings and its prognostic value.

Las proteínas S100 pertenecen al grupo de proteínas fijadoras de calcio y están presentes en actividades reguladoras fisiológicas intracelulares y extracelulares, como la diferenciación celular, y actúan en procesos patológicos inflamatorios y neoplásicos. Recientemente, sus expresiones en el sistema nervioso han sido ampliamente estudiadas, buscando dilucidar su acción a nivel del tálamo: una estructura del sistema nervioso central que forma parte de importantes circuitos, como el somatosensorial, conductual, de memoria y cognitivo, así como además de ser responsable de la transmisión y regulación de la información a la corteza cerebral. Este artículo es una revisión integradora de la literatura científica, que analizó 12 estudios presentes en Pubmed. El análisis mostró que la relación de las proteínas S100 y el tálamo ha sido descrita en procesos neoplásicos, trastornos mentales, hipoxia, trauma, estrés, infección, enfermedad de Parkinson y epilepsia. En resumen, es posible concluir que esta familia de proteínas es relevante como marcador en procesos de lesión talámica, requiriendo más estudios para comprender mejor su significado clínico, preclínico y su valor pronóstico.

How does the condition of the pasture in late winter influence the plant and animal responses in the subsequent seasons?

This study aimed to test the hypotheses: (i) the deferred pasture with lower height in late winter has greater herbage accumulation rate (HAR) and better structure, which facilitates the animal selective grazing during the subsequent spring and summer; (ii) the mowed of high pasture in late winter improves the sward structure but decreases its HAR from the spring. Four pasture condition in late winter of Urochloa brizantha cv. Marandu were evaluated: low (24.1 cm and 2,420 kg.ha-1 of DM); low/mowed (25.2 cm and 2,198 kg.ha-1 of DM, mowed at 8.0 cm); high (49.0 cm and 3,837 kg.ha-1 of DM); and high/mowed (50.0 cm and 4,211 kg.ha-1 DM, mowed at 8.0 cm). The highest live leaf blade percentage (LLBP) and the lowest dead stem percentage (DSP) occurred in the mowed pastures. The live stem (LSP) and dead leaf blade percentages of the grazing simulation sample were higher in the high pasture. This same pattern of response occurred for apparent selectivity indices (ASI) of the live leaf blade and live stem. The ASI of the dead leaf blade was greater in the high pasture, intermediate in the mowed pastures, and lower in the low pasture. The ASI of the dead stem was lower in the low pasture. The HAR was higher in low pasture. Our results support the first hypothesis. The mowing of high pasture in late winter improves the sward structure and the animal selective grazing but does not decrease the HAR during spring and summer.

Does amount of cut vegetal residue on the canopy influence growth and the structural characteristics of marandu palisadegrass?

The pasture mowing in late winter removes the old forage, improving the pasture structure in spring and summer. However, the residue after mowing can affect tillering, thus limiting forage production and the structural characteristics of pasture. We hypothesized that the high amount of cut vegetal residues on the plants in late winter causes a decrease in forage production and modifies the structural characteristics of the forage canopy during the spring and summer. The treatments were four cut vegetal residues (0; 2,000; 4,000 and 8,000 t ha-1 of natural material) deposited on Urochloa brizantha cv. Marandu canopy in late winter. After that, the forage production and structure characteristics were evaluated during the spring and summer for two years. The complete randomized block design, with four replications, was used. The defoliation management was characterized by the adoption of pre- and post-cut heights of 25 and 15 cm, respectively. For both years, there was no effect of cut vegetal residue on all the characteristics evaluated. No variable was affected by the interaction cut vegetal residue amount × year of evaluation. The dead leaf blade percentage was greater in year 2 (6.9%) than in year 1 (3.5%). The average values of variables were live leaf blade percentage = 84.2%; live stem percentage = 8.7%; dead stem percentage = 1.9%; number of vegetative tiller = 653 tiller/m2; number of reproductive tiller = 5 tiller m-2. The forage production rate presented an average value of 46 kg/ha/day of dry matter. The cut vegetal residue amount of up to 8,000 t/ha of natural material on the plants in late winter does not affect the forage production or modifies the structural characteristics of marandu palisadegrass during the subsequent spring and summer.

The use of light-transparent acetate sheet to measure canopy height of marandu palisadegrass: the influence of development stage and sward height

The use of light-transparent acetate sheet (LAS) may generate variations in the height measured in the sward. However, we compared the use or non-use of LAS to measure the average sward height of marandu palisadegrass (Urochloa brizantha syn. Brachiaria brizantha cv. Marandu) pastures. In the first experiment, the methods were applied in pastures with different average heights (15, 25, 35, and 45 cm), managed under continuous stocking with sheep, and with predominance of vegetative tillers. The shorter pastures (15 and 25 cm) had similar heights with or without the use of the LAS. However, in the taller pastures (35 and 45 cm), the use of LAS resulted in lower height values, compared with its absence. In the second experiment, we compared both methods for measuring the height of deferred marandu palisadegrass and fertilized with two nitrogen levels (50 and 200 kg ha-1) and with high presence of reproductive tillers. A completely randomized design with four replicates was adopted. With 200 kg ha-1 of N, the canopy height was greater than when it was fertilized with 50 kg ha-1 of N. With the use of LAS, the height of deferred and reproductive canopy was greater than without it. In a taller marandu palisadegrass pasture with predominance of vegetative tillers, the use of LAS results in smaller height, contrary to what occurs in deferred swards with reproductive tillers.

The sward height at the early stockpiling period modifies the structural characteristics of marandu palisadegrass under continuous stocking

The control of sward height at the early stockpiling period influences the structural characteristics of stockpiled sward in winter. So, we conducted this work on the Cerrado region of Brazil based on the hypothesis that the reduction of pasture height at the beginning of stockpiling period results in: (i) lower stock of forage mass; and (ii) higher live leaf mass, but lower stem mass in stockpiled pasture during the winter. The treatments were four sward heights (15, 25, 35, and 45 cm) at early stockpiling period of marandu palisadegrass (Brachiaria brizantha syn. Urochloa brizantha cv. Marandu). The experiment was conducted in a completely randomized design, with three replications (paddocks with 800 m²). The stockpiled swards were evaluated during the grazing period in winter on days 7 (beginning), 45 (middle) and 90 (end). The vegetative tiller number (VEGT), live leaf mass (LLM) and leaf area index (LAI) were greater in the 15 cm stockpiled pasture than the other treatments. Greater heights (35 and 45 cm) at stockpiling resulted in greater forage mass than lower heights (15 and 25 cm). The VEGT, LLM, number of reproductive tillers, live stem mass, forage mass and LAI values were higher at the beginning than at the end of the grazing period. Our hypothesis has been proven, so that the reduction of sward height of the marandu palisadegrass at the beginning of the stockpiling period results in lesser forage mass, but with better structural characteristics.

How does the initial sward height and the grazing period influence the spatial variability of vegetation in deferred signal grass pastures?

The objective of this study was to evaluate the spatial variability of structural characteristics of deferred pastures of Brachiaria decumbens cv. Basilisk (signal grass) subjected to associations of sward heights (10, 20, 30, and 40 cm) at the beginning of deferment and grazing periods (1, 28, 56, 85, and 113 days). The experiment was arranged in a split-plot and completely randomized-block design with two replicates. Pastures remained deferred from March to June 2010. From June to the beginning of October 2010, deferred pastures were utilized by steers under continuous grazing and at a fixed initial stocking rate of 3.5 AU ha-1. At the beginning of the deferment, the coefficient of variation (CV) for pasture height was reduced linearly with the pasture height. During the grazing period, in the winter, the CV for pasture height was not influenced by initial pasture height; however, it responded quadratically to the grazing period, with a maximum value of 36.4% at 71 days of the period of utilization. The CV for tiller height was reduced linearly with pasture height at the beginning of deferment but increased linearly along with the grazing period. The initial pasture height did not change the CV of the falling index. However, the latter was quadratically influenced by the grazing period, with a maximum value of 59.5% at 67 days of the utilization period. Signal grass pastures deferred at a lower height have a higher spatial variability of the vegetation. In the grazing period, there are changes in the spatial variability of the vegetation of the deferred signal grass.

The use of chemoprophylaxis or not for dvt in spine surgery: a systematic review / O uso da quimioprofilaxia ou não para tvp em cirurgia de coluna: revisão sistemática / El uso de quimioprofilaxis o no para la tvp en la cirugía de columna vertebral: revisión sistemática

ABSTRACT Objective: To compare pharmacological and non-pharmacological prophylaxis in elective spine surgery to determine the risks of DVT, PTE, and epidural hematoma (EH) in both groups, as well as their respective treatment effectiveness. Methods: Systematic review and meta-analysis based on systematically searched articles, using combinations of MeSH terms related to chemoprophylaxis and non-chemoprophylaxis for prevention of deep vein thrombosis and pulmonary embolism in elective spine surgery. Adult patients were eligible for inclusion in the study, except for those with trauma, spinal cord injury, neoplasms, or those using vena cava filters. Results: Five studies were selected for this systematic review and meta-analysis: 3 retrospective studies, 1 prospective study, and 1 case series. Data analysis showed that 4.64% of patients treated with chemoprophylaxis had an unfavorable outcome regarding DVT, while this outcome occurred in 1.14% of patients not treated with chemoprophylaxis (p=0.001). Among patients using chemoprophylaxis, only 0.1% developed epidural hematoma and 0.38% developed PTE. Among those on non-pharmaceutical prophylaxis, 0.04% had EH (p=0.11) and 0.42% had PTE (p=0.45). Conclusions: No benefits were found for chemoprophylaxis as compared to non-chemoprophylaxis in preventing DVT in elective spine surgery, nor was there an increased risk of epidural hematoma or fatal thromboembolic events. Level of evidence III; Therapeutic studies; Investigation of treatment results.

RESUMO Objetivo: Comparar profilaxia farmacológica e não farmacológica em cirurgia eletiva da coluna vertebral, a fim de determinar os riscos de TVP, TEP e hematoma epidural (HE) em ambos os grupos, bem como a respectiva eficácia do tratamento. Métodos: Revisão sistemática e metanálise com base em artigos sistematicamente pesquisados, usando combinações de termos MESH relacionados à quimioprofilaxia e à não quimioprofilaxia para prevenção de trombose venosa profunda e embolia pulmonar em cirurgia eletiva da coluna vertebral. Pacientes adultos foram elegíveis para inclusão no estudo, exceto aqueles com trauma, lesão medular, neoplasias e aqueles que usavam filtros de veia cava. Resultados: Cinco estudos foram incluídos para fazer parte desta revisão sistemática e metanálise: três estudos retrospectivos, um prospectivo e um série de casos. A análise dos dados mostrou que 4,64% dos pacientes tratados com quimioprofilaxia tiveram um resultado desfavorável em relação à TVP, enquanto esse resultado ocorreu em 1,14% dos pacientes não tratados com quimioprofilaxia (p = 0,001). Entre os pacientes em uso de quimioprofilaxia, apenas 0,1% desenvolveram hematoma epidural (HE) e 0,38% desenvolveram TEP. Entre aqueles em profilaxia não medicamentosa, 0,04% apresentaram HE (p = 0,11) e 0,42% tiveram TEP (p = 0,45). Conclusões: Não foram encontrados benefícios para a quimioprofilaxia quando comparada à não quimioprofilaxia na prevenção da TVP em cirurgia eletiva da coluna vertebral, assim como não foi verificado aumento do risco de hematoma epidural ou eventos tromboembólicos fatais. Nível de evidência III; Estudos terapêuticos - Investigação dos resultados do tratamento.

RESUMEN Objetivo: Comparar la profilaxis farmacológica y no farmacológica en la cirugía de columna electiva para determinar los riesgos de TVP, TEP y hematoma epidural (HE) en ambos grupos, así como la respectiva eficacia del tratamiento. Métodos: Revisión sistemática y metanálisis basados en artículos buscados sistemáticamente, utilizando combinaciones de términos MESH relacionados con quimioprofilaxis y no quimioprofilaxis para la prevención de trombosis venosa profunda y embolia pulmonar en cirugía electiva de columna. Se eligieron pacientes adultos para su inclusión en el estudio, excepto aquellos con traumatismos, lesión medular, neoplasias y aquellos que usan filtros de vena cava. Resultados: Se incluyeron cinco estudios para formar parte de esta revisión sistemática y metanálisis: 3 estudios retrospectivos, 1 prospectivo y 1 serie de casos. El análisis de los datos reveló que el 4,64% de los pacientes tratados con quimioprofilaxis tuvieron un resultado desfavorable con respecto a la TVP, mientras que este resultado se produjo en el 1,14% de los pacientes no tratados con quimioprofilaxis (p = 0,001). Entre los pacientes que recibieron quimioprofilaxis, sólo el 0,1% desarrolló hematoma epidural (HE) y el 0,38% desarrolló TEP. Entre los que recibieron profilaxis no farmacológica, el 0,04% desarrolló HE (p = 0,11) y el 0,42% desarrolló TEP (p = 0,45). Conclusiones: No se encontraron beneficios para la quimioprofilaxis en comparación con la no quimioprofilaxis para prevenir la TVP en la cirugía de columna electiva, así como tampoco un mayor riesgo de hematoma epidural o eventos tromboembólicos fatales. Nivel de evidencia - III; Estudios terapéuticos - Investigación de los resultados del tratamiento.

Pre-hospital Care for Suspected Stroke Patients, Cared for by Mobile Emergency Care Units in Northern Minas Gerais

Abstract Background Stroke management require rapid identification, assessment, and transport of patients to qualified health care centers. However, there is little description in the literature on the multiple challenges associated with the pre-hospital transport of suspected stroke patients. Objective To characterize the pre-hospital care provided to suspected stroke patients by the Brazilian Emergency Medical Service (SAMU in Portuguese), by means of a descriptive case study. Methods This is a descriptive study of a series of cases. Data from the SAMU regarding the responses to emergency calls from suspected stroke patients were collected. Independent reviewers confirmed the diagnostic hypothesis and all discordances were assessed using kappa statistics. Clinical data and transport times were described as frequency and proportion or central tendency and dispersion measures. Normality of continuous variable distribution was assessed using the Kolmogorov-Smirnov test. The Mann-Whitney U test was used for comparison of medians, with a 5% significance level. Results During the studied period, 556 suspected stroke patients were treated. The kappa index was 0.82 (95% CI 0.737 to 0.919) CI. In 74.7% of the cases, the symptom onset time was not recorded. The median time elapsed between the call for emergency services and the ambulance arrival was 18 minutes, and the median transport time was 38 minutes. A total of 34% of the patients were taken to referral hospitals for stroke. Conclusion This study revealed a low level of knowledge regarding the need to determine the exact time of symptom onset of suspected stroke patients. Also, the study showed the low rate of patients taken to referral hospitals. (Int J Cardiovasc Sci. 2021; [online].ahead print, PP.0-0)

Covid-19: e-Learning as a tool for improving the knowledge / Covid-19: e-learning como ferramenta para melhoria do conhecimento

Abstract: Introduction: Preventing and fighting COVID-19 are of the utmost importance. In this context, the importance of using telemedicine tools has grown, including teleconsultations, epidemiological telemonitoring, remote diagnosis, support, and training of health professionals. Objective: This article aims to report the results of a distance-training course on SARS-CoV-2 and COVID-19. We analyze the course adherence, the students' profile, pre, and post-test proficiency index and satisfaction with the course. Methods: This is a cross-sectional study that evaluated data from the course on SARS-CoV-2 and COVID-19. The data were analyzed in terms of distribution and comparisons of means and frequencies. A paired t-test was used to compare the pre and post-test grades. A p-value <0.05 was considered significant. Data were collected from the Moodle teaching platform, without identifying the participants. Results: From March 23 to May 14, the course was offered to 1,008 medical students and health care providers. Most were from the state of Minas Gerais, some from other Brazilian states, and Mozambique. The majority completed the course, with an 89.8% adherence. The evaluations related to the course, the tutors, the degree of satisfaction, and the security for the professional performance after the course obtained maximum scores. The comparison between the pre and post grades showed proficiency gain (p<0.0001). Conclusion: The course has contributed to the training of medical students and health professionals from Brazil and Mozambique. The organizing committee was able to prepare students and provide knowledge to professionals with difficulty to access good technical and evidence-based information. After the training, the students were selected to work on university projects aiming at supporting city halls, health departments, and the community.

Resumo: Introdução: A prevenção e o combate da Covid-19 são de extrema importância. Nesse contexto, a importância do uso de ferramentas de telemedicina tem crescido, incluindo teleconsultas, telemonitoramento epidemiológico, diagnóstico remoto, suporte e treinamento de profissionais de saúde. Objetivo: Este trabalho tem como objetivo relatar os resultados de um curso de treinamento a distância que abordou aspectos relacionados ao Sars-CoV-2 e à Covid-19. Método: Analisaram-se os seguintes aspectos: adesão ao curso, perfil dos alunos, índice de proficiência pré e pós-teste e satisfação com o curso.Trata-se de um estudo transversal que avaliou os dados do curso sobre o Sars-CoV-2 e a Covid-19. Os dados foram analisados em termos de distribuição e comparação de médias e frequências. Um teste t pareado foi usado para comparar as notas do pré e do pós-teste. O valor de p < 0,05 foi considerado significativo.Coletaram-se os dados na plataforma de ensino Moodle, sem identificação dos participantes. Resultado: De 23 de março a 14 de maio de 2020, o curso foi oferecido a 1.008 estudantes de Medicina e profissionais de saúde. A maioria era de Minas Gerais, alguns de outros estados brasileiros e de Moçambique. A maioria concluiu o curso com 89,8% de adesão. As avaliações referentes ao curso, aos tutores, ao grau de satisfação e à segurança para o desempenho profissional após o curso obtiveram pontuação máxima. A comparação entre as séries pré e pós-teste mostrou ganho de proficiência (p < 0,0001). Conclusão: O curso tem contribuído para a formação de estudantes de Medicina e profissionais de saúde do Brasil e de Moçambique. A comissão organizadora conseguiu capacitar alunos e profissionais de saúde com dificuldade de acesso a boas informações técnicas e baseadas em evidências. Após a capacitação, os alunos foram selecionados para atuar em projetos universitários com o objetivo de apoiar prefeituras, secretarias de saúde e comunidade.

Mowing and lowering the marandu palisadegrass sward height at late winter improve the sward structure / A roçada e a redução da altura do capim-marandu no final do inverno melhora a estrutura do pasto

The structure of the sward is important because it influences the responses of plants and animals in grazing conditions. The objective with this work was to evaluate the structural characteristics of the Marandu palisade grass pasture (Brachiaria brizantha syn. Urochloa brizantha) during spring and summer, depending on the condition of the sward at the end of winter. Four grazing conditions at the end of winter were evaluated: short (24.1 cm), short (25.2 cm)/mown (8 cm), tall (49.0 cm) and tall (50.0 cm)/mown (8 cm). The foliar area index was lower in the tall pasture than in the tall/mown pasture. The mass and the volumetric density of dead stem were higher in the tall pasture, intermediate in the short pasture, and lower in mowed pastures. At the beginning of the grazing period, the live stem mass was higher in the tall pasture. At the beginning and middle of the grazing period, the volumetric density of dead leaf lamina was lower in mowed pastures. At the beginning of the pasture period, the short pasture had a higher tiller number (TN). In the middle of the grazing period, the short and short/mown pastures had higher TN. At the end of the pasture period, the lowest TN value occurred in the tall pasture. The tall pasture at the end of winter presents an unfavorable structure to the animal in grazing, while the mowing and reduction in the height of the marandu palisade grass improves the structure of the sward in spring and summer.

A estrutura do pasto é importante porque influencia as respostas de plantas e animais em condições de pastejo. O objetivo com este trabalho foi avaliar as características estruturais do pasto de capim-marandu (Brachiaria brizantha syn. Urochloa brizantha) durante a primavera e o verão, em função da condição do pasto no fim do inverno. Quatro condições de pasto no fim do inverno foram avaliadas: baixo (24,1 cm), baixo (25,2 cm)/roçado (8 cm), alto (49,0 cm) e alto (50,0 cm)/roçado (8 cm). O índice de área foliar foi menor no pasto alto do que no pasto alto/roçado. A massa e a densidade volumétrica de colmo morto foram maiores no pasto alto, intermediárias no pasto baixo, e inferiores nos pastos roçados. No início do período de pastejo, a massa de colmo vivo foi maior no pasto alto. No início e meio do período de pastejo, a densidade volumétrica de lâmina foliar morta foi menor nos pastos roçados. No início do período de pastejo, o pasto baixo apresentou maior número de perfilho (NP). No meio do período de pastejo, os pastos baixo e baixo/roçado tiveram maior NP. No fim do período de pastejo, o menor valor de NP ocorreu no pasto alto. O pasto alto no fim do inverno apresenta estrutura desfavorável ao animal em pastejo, enquanto que a roçada e a redução da altura do capim-marandu melhora a estrutura do pasto na primavera e no verão.

Number and morphology of tiller age groups during summer in Marandu palisadegrass pastures previously used under deferred grazing / Número e morfologia de faixas etárias de perfilhos durante o verão em pastos de capim-marandu previamente utilizados sob pastejo diferido

The relative contribution of young, mature and old tillers in the canopy influences the production and structure of the pasture. The objective with this work was to evaluate the balance between tiller appearance and tiller death (BAL) during spring and early summer, the morphology and percentages of young, mature and old tillers in Brachiaria brizantha cv. Marandu (marandu palisadegrass) with three conditions in late winter: short (24.1 cm), tall (49.0 cm) and tall (50.0 cm)/mown (8 cm). Tall and tall/mown pastures presented higher BAL in September and October, respectively. In January, BAL was higher in short and tall/mown pastures than in tall pasture. The tiller number was higher in short pasture, intermediate in tall/mown pasture and lower in tall pasture. The percentage of old tillers was higher in short and tall pastures compared to tall/mown pasture. The percentage of live leaf lamina reduced, while the percentage of dead leaf lamina increased with tiller age. Mowing of the tall marandu palisadegrass pasture in late winter increases the renewal of tillers in the spring and decreases the percentage of old tillers in the summer. The old tillers present worse morphology than young tillers.

A contribuição relativa de perfilhos jovens, maduros e velhos no dossel influencia a produção e a estrutura do pasto. O objetivo com o trabalho foi avaliar durante a primavera e o início do verão o balanço entre aparecimento e mortalidade de perfilho (BAL), a morfologia e as percentagens de perfilhos jovens, maduros e velhos nos pastos de Brachiaria brizantha cv. Marandu (capim-marandu) com três condições ao fim do inverno: baixo (24,1 cm), alto (49,0 cm) e alto (50,0 cm)/roçado (8 cm). Os pastos alto e alto/roçado apresentaram maior BAL em Setembro e Outubro, respectivamente. Em Janeiro, o BAL foi maior nos pastos baixo e alto/roçado do que no pasto alto. O número de perfilho foi maior no pasto baixo, intermediário no pasto alto/roçado e menor no pasto alto. As percentagens de perfilhos jovens e velhos foram maiores nos pastos baixo e alto, em comparação ao pasto alto/roçado. A percentagem de lâmina foliar viva reduziu, enquanto que a percentagem de lâmina foliar morta aumentou com a idade do perfilho. A roçada do pasto alto de capim-marandu no fim do inverno aumenta a renovação de perfilho na primavera e diminui a percentagem de perfilho velho no pasto no verão. O perfilho velho apresenta pior morfologia do que o perfilho jovem.

Combined supplementation of chromium-yeast and selenium-yeast on finishing barrows / Suplementação associada de cromo-levedura e selênio-levedura na dieta de suínos machos castrados em terminação

ABSTRACT: The present study was performed to evaluate the association of chromium-yeast and selenium-yeast as nutritional additives to enhance performance and quantitative characteristics in the carcass of finishing barrows. A total of 48 barrows, commercial hybrid, with initial weight of 68.3±3.5 kg and final weight of 99.6±3.6 kg, were utilized for the study. The animals were distributed in a randomized complete block design, consisting of three levels of chromium-yeast and selenium-yeast (i.e., without supplementation of chromium-yeast and selenium-yeast, supplementation of 0.4 mg kg-1 chromium-yeast and 0.3 mg kg-1 selenium-yeast, and supplementation of 0.8 mg kg-1 chromium-yeast and 0.6 mg kg-1 selenium-yeast) with eight replicates and two animals per experimental unit. The supplementation of chromium and selenium-yeast did not significantly affect (P>0.05) the average daily feed intake, digestible lysine, crude protein and metabolizable energy intake, average daily weight gain, feed conversion, weight and carcass length, back fat thickness, muscle depth, percentage and amount of lean meat, and carcass allowance. These findings suggest that supplementation of chromium and selenium-yeast does not affect the performance or quantitative characteristics in the carcass of finishing barrows.

RESUMO: Realizou-se este estudo com o objetivo de avaliar a associação de cromo-levedura e selênio-levedura como aditivos nutricionais melhoradores de desempenho e das características quantitativas de carcaça de suínos machos castrados em terminação. Foram utilizados 48 suínos machos castrados, híbridos comerciais, com peso inicial de 68,3±3,5 kg e peso final de 99,6±3,6 kg. Os animais foram distribuídos em delineamento experimental de blocos casualizados, composto por três níveis de cromo-levedura e selênio-levedura (controle sem suplementação de cromo-levedura e selênio-levedura; suplementação de 0,4 mg kg-1 de cromo-levedura e 0,3 mg kg-1 de selênio-levedura; e 0,8 mg kg-1 de cromo-levedura e 0,6 mg kg-1 de selênio-levedura), com oito repetições e dois animais por unidade experimental. A suplementação de cromo-levedura e selênio-levedura não influenciou (P>0,05) o consumo de ração diário, os consumos de lisina digestível, de proteína bruta e de energia metabolizável, o ganho de peso diário, a conversão alimentar, o peso e comprimento de carcaça, espessura de toucinho, profundidade de músculo, percentagem e quantidade de carne magra e índice de bonificação. A suplementação associada de cromo e selênio-levedura não influencia o desempenho e as características quantitativas de carcaça de suínos machos castrados em terminação.

Guanidinoacetic acid supplementation on growth performance and molecular mechanisms of lean mass gain in nursery pigs / Suplementação de ácido guanidinoacético no desempenho e mecanismo moleculares de ganho de massa magra em leitões

ABSTRACT: The objective with the present study was to evaluate the effect of guanidinoacetic acid (GAA) on the growth performance of nursery piglets as well as a possible molecular mechanism of action on lean mass gain. Seventy-two pigs, weaned at 21 d, weighing 6.80 ± 1.2 kg were distributed in a completely randomized design into one of three dietary treatments (control, control + 1.2 g/kg GAA or control + 2.4 g/kg GAA) and 8 replicates per treatment. The control diet was an animal protein-free diet based on corn and soybean meal. Body weight, average daily weight gain, average daily feed intake and feed efficiency were evaluated at 35, 49, and 56 days. At the end of the experiment, one animal per pen was slaughtered and samples of the vastus lateralis muscle were collected for RT-qPCR and protein abundance analysis. Overall (from 21 to 56 d), GAA supplementation improved feed efficiency (P < 0.03). Skeletal muscle of pigs fed with GAA diet had greater mRNA expression of Akt (P < 0.04) and RPS6KB2 (P<0.01). In conclusion, supplementation with 2.4 g/kg GAA to nursery piglets improves feed efficiency and activates molecular mechanisms important to lean mass gain.

RESUMO: O objetivo do presente estudo foi avaliar o efeito do ácido guanidinoacético (GAA) no desempenho de leitões, bem como um possível mecanismo de ação molecular no ganho de massa magra. Setenta e dois leitões, desmamados aos 21 dias, pesando 6,80 ± 1,2 kg, foram distribuídos em um delineamento inteiramente casualizado com três tratamentos dietéticos (controle, controle + 1,2 g / kg ou controle + 2,4 g / kg GAA) e 8 repetições por tratamento. A dieta controle não continha proteína animal e foi formulada a base de milho e farelo de soja. O desempenho dos animais foi avaliado aos 35, 49 e 56 dias. Ao final do experimento, um animal por unidade experimental foi abatido e amostras do músculo Vastus lateralis foram coletadas para análise de RT-qPCR e abundância de proteínas. A suplementação com GAA melhorou a eficiência alimentar (P<0,03) aos 56 dias. O músculo dos leitões suplementados apresentou maior expressão de mRNA de Akt (P<0,04) e RPS6KB2 (P <0,01). Em conclusão, a suplementação de 2,4 g / kg de GAA em leitões (21 a 56 d) melhora a eficiência alimentar e ativa mecanismos moleculares importantes para o ganho de massa magra.

Implementation of an Acute Coronary Syndrome Simulation Training Strategy for Emergency Healthcare Professionals

The knowledge on the management of patients with acute coronary syndrome (ACS) is essential to reduce the gap between evidence and practice. Objective: To describe a simulation training strategy for emergency healthcare professionals and provide preliminary data on knowledge acquisition, learners' confidence and prescription of medications after training. Methods: The training was part of the implementation of two myocardial infarction systems of care. It comprehended lectures and simulation-based learning using high and low-fidelity mannequins and actors. It was tested in two phases: the first one in Belo Horizonte and the second one in Montes Claros, both in the state of Minas Gerais. A test was applied before and after training to assess knowledge acquisition. Confidence to perform thrombolysis in ST-elevation myocardial infarction (STEMI) patients was assessed using a questionnaire, and the impact on medication prescription analyzed STEMI patients admitted to hospitals in Montes Claros. Results: In the first phase, 156 professionals answered both tests: 70% of them improved their results and the median number of right answers increased (6, interquartile range [IQR] 5-7; vs 7 ([IQR] 6-9; p < 0.05). In the second phase, 242 professionals answered both tests: 58% of the physicians and 83% of the nurses obtained better test scores. Participants referred a positive impact on their clinical practice, 95% reported feeling very secure when perform fibrinolysis after the training, and there was also an impact on medication prescription. Conclusions: There was an impact on the learners' knowledge acquisition and confidence using our two-phase training model, with evidence of impact on performance

Ractopamine concentration on the lipid profile of swine fat and meat / Concentração da ractopamina sobre o perfil lipídico da gordura e carne suína

ABSTRACT: This study was conducted to evaluate the effect of ractopamine concentrations on swine fat and meat lipid profiles. Ninety finishing barrows, initially weighing 71.9±4.4kg, were distributed in a randomized block design in three ractopamine concentrations (0, 10 and 20ppm) with fifteen replicates of two animals in each. Gas chromatography was used to analyze the lipid profiles of backfat and meat. The inclusion of ractopamine in the diet changed (P<0.05) α-linolenic acid and eicosatrienoic acid concentrations in the backfat but did not affect (P>0.05) any of the other fatty acids or indexes evaluated. In the meat, a significant effect (P<0.05) was observed on nine fatty acids evaluated, with a decrease (P<0.05) in lauric, myristic, and palmitic fatty acids, and an increase (P<0.05) in linoleic, γ-linolenic, dihomo-γ-linolenic, and eicosapentaenoic acid. Ractopamine also affected (P<0.05) the concentration of α-linolenic and arachidonic acid in the meat (P<0.05). The indexes evaluated were also affected (P<0.05). Addition of 10ppm decreased the saturated fatty acid concentration, atherogenic index, thrombogenic index and omega 6: omega 3, while it increased unsaturated and polyunsaturated fatty acids concentrations. Ractopamine addition had less effect on the backfat than on the meat, and the 10ppm level improved the meat lipid profile.

RESUMO: Este estudo foi conduzido para avaliar o efeito das concentrações de ractopamina no perfil lipídico da gordura e carne suína. Utilizou-se 90 machos castrados, pesando inicialmente 71,9±4,4kg, foram distribuídos em delineamento de blocos ao acaso em três concentrações de ractopamina (0, 10 e 20ppm), com quinze repetições e dois animais por unidade experimental. Foi utilizada cromatografia gasosa para analisar os perfis lipídicos da gordura subcutânea e da carne. A inclusão de ractopamina na dieta alterou (P<0,05) os níveis dos ácidos graxos α-linolênico e eicosatrienoico na gordura subcutânea e não afetou (P>0,05) nenhum dos outros ácidos graxos ou índices avaliados. Em relação à gordura da carne, houve efeito (P<0,05) sobre nove ácidos graxos avaliados, com redução (P<0,05) dos ácidos graxos láurico, mirístico e palmítico, e aumento (P<0,05) do linoleico, γ-linolênico, dihomo-γ-linolênico e eicosapentaenoico. A ractopamina também afetou (P<0,05) a concentração do linolênico e araquidônico na carne. Os índices avaliados também foram afetados (P<0,05). A inclusão de 10ppm diminuiu a concentração dos ácidos graxos saturados, índice aterogênico, índice trombogênico e ômega 6: ômega 3, e aumentou a concentração dos ácidos graxos insaturados e poli-insaturados. A inclusão de ractopamina teve menor efeito na gordura subcutânea do que na carne, sendo que o nível de 10ppm melhorou o perfil lipídico da carne.

Evaluation of methods for the quantification of ether extract contents in forage and cattle feces

ABSTRACT The objective of this study was to compare the estimates of ether extract (EE) contents obtained by the Randall method and by the high-temperature method of the American Oil Chemist's Society (AOCS; Am 5-04) in forages (n = 20) and cattle feces (n = 15). The EE contents were quantified by using the Randall extraction or AOCS method and XT4 filter bags or cartridges made of qualitative filter paper (80 g/m²) as containers for the samples. It was also evaluated the loss of particles, and concentration of residual chlorophyll after extraction and the recovery of protein and minerals in the material subjected to extraction. Significant interaction was observed between extraction method and material for EE contents. The EE estimates using the AOCS method were higher, mainly in forages. No loss of particles was observed with different containers. The chlorophyll contents in the residues of cattle feces were not affected by the extraction method; however, residual chlorophyll was lower using the AOCS method in forages. There was complete recovery of the protein and ash after extraction. The results suggest that AOCS method produces higher estimates of EE contents in forages and cattle feces, possibly by providing greater extraction of non-fatty EE.