Cardiopulmonary prognosis of prophylactic endotracheal intubation in patients with upper gastrointestinal bleeding undergoing endoscopy / 世界急诊医学杂志（英文）

@#BACKGROUND: It is controversial whether prophylactic endotracheal intubation (PEI) protects the airway before endoscopy in critically ill patients with upper gastrointestinal bleeding (UGIB). The study aimed to explore the predictive value of PEI for cardiopulmonary outcomes and identify high-risk patients with UGIB undergoing endoscopy. METHODS: Patients undergoing endoscopy for UGIB were retrospectively enrolled in the eICU Collaborative Research Database (eICU-CRD). The composite cardiopulmonary outcomes included aspiration, pneumonia, pulmonary edema, shock or hypotension, cardiac arrest, myocardial infarction, and arrhythmia. The incidence of cardiopulmonary outcomes within 48 h after endoscopy was compared between the PEI and non-PEI groups. Logistic regression analyses and propensity score matching analyses were performed to estimate effects of PEI on cardiopulmonary outcomes. Moreover, restricted cubic spline plots were used to assess for any threshold effects in the association between baseline variables and risk of cardiopulmonary outcomes (yes/no) in the PEI group. RESULTS: A total of 946 patients were divided into the PEI group (108/946, 11.4%) and the non-PEI group (838/946, 88.6%). After propensity score matching, the PEI group (n=50) had a higher incidence of cardiopulmonary outcomes (58.0% vs. 30.3%, P=0.001). PEI was a risk factor for cardiopulmonary outcomes after adjusting for confounders (odds ratio [OR] 3.176, 95% confidence interval [95% CI] 1.567-6.438, P=0.001). The subgroup analysis indicated the similar results. A shock index >0.77 was a predictor for cardiopulmonary outcomes in patients undergoing PEI (P=0.015). The probability of cardiopulmonary outcomes in the PEI group depended on the Charlson Comorbidity Index (OR 1.465, 95% CI 1.079-1.989, P=0.014) and shock index >0.77 (compared with shock index ≤0.77 [OR 2.981, 95% CI 1.186-7.492, P=0.020, AUC=0.764]). CONCLUSION: PEI may be associated with cardiopulmonary outcomes in elderly and critically ill patients with UGIB undergoing endoscopy. Furthermore, a shock index greater than 0.77 could be used as a predictor of a worse prognosis in patients undergoing PEI.

A colaboração crítica em um curso de leitura em inglês e em português para alunos com necessidades educacionais intelectuais específicas / Critical collaboration in a reading course in english and portuguese for students with specific intellectual educational needs / Colaboración crítica en un curso de lectura en inglés y en portugués para estudiantes con necesidades educativas intelectuales específicas

Este artigo tem por objetivo discutir como a colaboração crítica impacta as ações de pesquisa de duas professorasorientadoras e de um aluno de Ensino Médio com deficiência intelectual em um curso de leitura em inglês e em português para alunos com necessidades educacionais intelectuais específicas. Os participantes de pesquisa usam a linguagem e colaboram criticamente para discutir sua participação. Nesse enquadre, trabalham juntos, desenvolvem suas funções psicológicas superiores, em outras palavras, sua memória, atenção, volição, pensamentos, emoções e linguagem. Como procedimentos metodológicos, a Pesquisa Crítica de Colaboração propicia aos participantes atuarem de maneira interdependente para se constituir e para transformar o contexto de aprendizagem que compartilham. Como resultados parciais, as análises e interpretações sugerem que os momentos de colaboração crítica organizados por meio da Pesquisa Crítica de Colaboração criam possibilidades para os participantes aprimorarem a memória e a própria volição, assim como contribui para que a Educação inclusiva floresça nos contextos escolares. (AU)

This article aims to discuss how critical collaboration impacts the research actions of two advisors-teachers and a high school student with intellectual disabilities in a course of English and Portuguese reading for students with specific intellectual educational needs. Research participants use language and critically collaborate to discuss participation. In this frame, they work together, developing higher psychological functions, in other words, their memory, attention, volition, thoughts, emotions, and language. In terms of methodological procedures, the Critical Collaborative Research allows participants to act in an interdependent way, thus constituting themselves and transforming the learning context which they share. As partial results, the analyses and interpretations suggest that moments of critical collaboration organized by the frame of Critical Collaborative Research create possibilities for participants improve memory and volition, besides contributing for inclusive Education to flourish in school contexts. (AU)

Este artículo tiene como objetivo discutir cómo la colaboración crítica, impacta las acciones de investigación de los profesores-asesores y un estudiante de secundaria con discapacidad intelectual en un curso de lectura en inglés y portugués para estudiantes con necesidades intelectuales específicas de educación. Los participantes de la investigación usan el lenguaje y colaboran críticamente para discutir su participación. En este marco trabajan en conjunto, desarrollan sus funciones psicológicas superiores, es decir, su memoria, atención, volición, pensamientos, emociones y lenguaje. Como Metodología, la Investigación Colaborativa Crítica permite a los participantes actuar de manera interdependiente para constituirse y transformar el contexto de aprendizaje que comparten. Como resultados parciales, los análisis e interpretaciones sugieren que los momentos de colaboración crítica organizados a través de la Investigación de Colaboración Crítica crean posibilidades para que los participantes mejoren su memoria y su propia voluntad, además de contribuir para el florecimiento de la educación inclusiva en contextos escolares. (AU)

Critical collaborative research: epistemic-ontological locus for the education of educators and researchers as agents of personal and collective transformation / Pesquisa crítica de colaboração: lócus epistemo-ontológico para a educação de educadores e pesquisadores como agentes de transformações pessoais e coletivas / Investigación crítica colaborativa: locus epistemo-ontológico para la formación de educadores y investigadores como agentes de transformaciones personales y colectivas

This text discusses the Critical Collaborative Research known in Brazil as PCCol ­ Pesquisa Crítica de Colaboração - which is a practical-theoretical approach used in the development of investigations that focus on understanding and often challenging knowledge production and actions so as to promote de organization of decolonial-and-inclusive schools. Standing on Marxian, Vygotskian and Freirean underpinnings, the text was written from the recordings of two classes delivered by the authors in a Graduate Course called Critical Research Methodologies, with participation of some guest professors, such as Maria Cecilia Camargo Magalhães, who also authors this paper. The text is organized from the speeches of the authors on two occasions in which they collaboratively delivered lessons about PCCol, as well as the questions and interventions from the other course participants. The writing procedure interweaves speeches, treated as data, and their analyses, treated as the actual discussion of some of the concepts that base the Research Methodology itself, and that include relational and transformational agency, the Freirean notion of data production from the South rather than the North, professional practice that is personal and collectively responsive, but more specifically, we will discuss the role played by language for the implementation of collaborative interactions, as well as how this type of language is organized. (AU)

Este texto discute a Pesquisa Crítica de Colaboração (PCCol), uma abordagem prático-teórica utilizada no desenvolvimento de trabalhos voltados à compreensão de conhecimentos e modos de agir, assim como ao questionamento destes, de modos a promover a formação de uma escola decolonial-e-inclusiva. De base marxiana, freiriana e vygotskiana, o texto foi escrito a partir de duas aulas ministradas no Curso "Critical Research Methodologies", com a presença de professores convidados como a segunda autora deste texto, Maria Cecília C. Magalhães. O presente artigo foi organizado a partir das falas e perguntas dos participantes das duas aulas ministradas por Fidalgo e Magalhães sobre a PCCol, que foram gravadas e transcritas. Em outras palavras, o artigo trará dados produzidos das exposições teórico-metodológicas das apresentadoras e das perguntas e intervenções dos demais participantes, intercaladas de discussão epistemo-metodológica dos conceitos que embasam a PCCol, tais como desenvolvimento da agência relacional e transformadora, a emergência de uma prática profissional pessoal e coletiva responsiva, mas mais fortemente sobre o papel da linguagem na colaboração e como esta se organiza. (AU)

Ese texto aborda la Investigación Colaborativa Crítica (PCCol), cuál enfoque teórico-práctico utilizado en el desarrollo de trabajos destinados a comprender saberes y modos de actuar, así como cuestionarlos, de manera que promuevan la formación de una escuela descolonial-e-inclusiva. Con base marxista, freireana y vygotskiana, el material ha sido escrito a partir de dos clases dictadas en el Curso "Metodologías de Investigación Crítica", además de profesores invitados como la segunda autora de este texto, Maria Cecília C. Magalhães. El presente artículo fue organizado a partir de las charlas, intervenciones y preguntas de los participantes de las dos clases impartidas por Fidalgo y Magalhães acerca de la PCCol, que han sido grabadas y transcritas. En otros términos, el artículo traerá datos producidos a partir de las exposiciones teórico-metodológicas de los expositores y de las preguntas e intervenciones de los demás participantes, interpuestos con una discusión epistemológica-metodológica de los conceptos que subyacen la PCCol, como el desarrollo de relaciones y agencia trasformadora, el surgimiento de una práctica profesional personal y colectiva comprometida, pero más fuertemente acerca del papel del lenguaje en la colaboración y cómo esa se organiza. (AU)

A bibliometric analysis of research on genetic retinal diseases done in India

Purpose: To conduct a bibliometric analysis of research on genetic retinal diseases (GRD) done in India published from 2011 to 2020 in peer?reviewed journals, and assess the productivity, trends in journal choice, publication types, research funding, and collaborative research. Methods: We searched PubMed for articles indicating both vision?related content and author affiliation with an Indian research center. We identified research collaborations and classified articles as reporting basic science, clinical science, or clinically descriptive research. Impact factors were determined from Journal Citation Reports for 2015. Results: The total number of published articles that were retrieved from 2011 to 2021 was 341. During the 10 years of study, the annual output of research articles has nearly doubled, that is, from 21 in 2011 to 44 in 2021. A total of 298 (87%) articles were published in international journals, and 149 (42%) articles in vision?related journals had an impact factor. A total of 224 (65%) articles came from six major eye hospitals. Clinical science articles were most frequently (86%) published, whereas basic science was the least (14%). The diseases on which the maximum and the minimum number of articles were published were retinoblastoma (n = 82,24%) and Stargardt disease (n = 3, 0.9%), respectively. Conclusion: This bibliometric study provides a broad view of the current status and trends in the research on GRD done in India and may help clinicians, researchers, and policymakers to better understand this research field and predict its dynamic directions.

Do monitoramento autônomo à pesquisa colaborativa virtual: parceria com o movimento indígena do Nordeste durante a pandemia da covid-19 como apoio ao controle social / From autonomous monitoring to virtual collaborative research: partnership with the indigenous movement from the Northeast region during covid-19 pandemic as support for social control

Resumo Nos primeiros meses da pandemia de covid-19, em 2020, os movimentos e organizações indígenas da região Nordeste do Brasil estabeleceram uma extensa rede de apoio e parcerias com grupos de pesquisadores e entidades da sociedade civil para a organização de campanhas de solidariedade aos povos indígenas. A produção de informações gerais e dados empíricos sobre como a doença atingiu os territórios e populações indígenas constituiu uma das principais estratégias de ação. Essa mobilização foi a base para a constituição de redes colaborativas que investigaram como ocorreu o enfrentamento dos povos diante da pandemia, por meio de um viés antropológico e aplicando métodos que poderíamos definir como uma pesquisa colaborativa virtual. Este artigo, portanto, discute o potencial desse tipo de parceria para a reflexão sobre o Subsistema de Atenção à Saúde Indígena, argumentando que esse modelo pode constituir uma forma de apoio ao controle social exercido por parte das comunidades.

Abstract In the first months of the covid-19 pandemic, in 2020, indigenous movements and organizations in the Northeast region of Brazil established an extensive network of support and partnerships with groups of researchers and civil society entities to organize campaigns of solidarity with the indigenous peoples. The production of general information and empirical data on how the disease reached indigenous territories and populations constituted one of the main strategies for action. This mobilization was the basis for establishing collaborative networks that investigated how the indigenous peoples faced the pandemic, from an anthropological bias and applying methods that we could define as virtual collaborative research. The article, thus, discusses the potential of this type of partnership for reflection on the Indigenous Health Care Subsystem, arguing that this model can constitute a kind of support for social control exercised by the communities.

Modos imaginativos e colaborativos de fazer pesquisa: dispositivos e disposições com cuidado / Imaginative and cooperative ways of doing research: dispositives and dispositions with care

Resumo Este artigo é direcionado para aspectos metodológicos implicados em uma pesquisa sobre respostas indígenas à covid-19 realizada por uma rede de pesquisadoras indígenas e não indígenas em diferentes estados brasileiros. Pretendemos compartilhar experiências e reflexões sobre limites e potencialidades de uma pesquisa realizada na pandemia e com a pandemia, já que o adoecimento experimentado nos corpos e na vida coletiva das pesquisadoras foi um agente incontornável em percursos metodológicos e analíticos, em diálogo com debates feministas sobre a tópica do cuidado.

Abstract This article is focused on methodological aspects impplied in a research on the responses of indigenous peoples to COVID-19 conducted by a network of indigenous and non-indigenous women researchers in different Brazilian states. We seek to share experiences and reflections on the limits and potentialities of a research carried out in the pandemic and with the pandemic, since the sickeness felt in the bodies and collective life of the researchers was an unavoidable agent in the methodological and analytical parcourses, in dialogue with feminist debates on the theme of care.

Efficacy and safety of stress ulcer prophylaxis in septic patients: a retrospective cohort study based on large database / 中华危重病急救医学

Objective:To evaluate the effects and safety of stress ulcer prophylaxis (SUP) versus no prophylaxis in adult septic patients at risk of gastrointestinal bleeding (GIB).Methods:A retrospective cohort study was conducted, the data was extracted from Electronic Intensive Care Unit-Collaborative Research Database (eICU-CRD). All patients who received proton pump inhibitor (PPI) or H 2 receptor antagonist (H 2RA) or combined/sequential use for SUP within the first 48 hours of intensive care unit (ICU) admission were enrolled in the SUP group, those who did not received any SUP were enrolled in the non-SUP group. The differences of in-hospital mortality, length of ICU stay (LOS), the incidence of GIB and secondary infection complications between the two groups were compared. Propensity score matching (PSM) was conducted to balance the distributions of study variables between the two groups. Further subgroup analysis was performed according to whether SUP was used for more than 3 days. Multivariate Logistic regression analysis was conducted to analyze the factors influencing the outcome of GIB and secondary pneumonia. Results:A total of 11 413 patients were included in the final analysis, with 9 799 patients in SUP group and 1 614 in non-SUP group. A 1∶1 PSM created 1 600 patients in each cohort. ① Baseline characteristics: compared with SUP group, patients in non-SUP group were older [years old: 69.0 (56.0, 80.0) vs. 67.0 (56.0, 78.0)], acute physiology and chronic health evaluation Ⅳ (APACHEⅣ) score and sequential organ failure assessment (SOFA) score were significantly lower [APACHEⅣ score: 65 (50, 73) vs. 72 (58, 87), SOFA score: 5 (4, 7) vs. 7 (5, 9)], higher rates of underlying diseases such as hypertension and diabetes [hypertension: 15.6% (252/1 614) vs. 12.2% (1 196/9 779), diabetes: 4.5% (72/1 614) vs. 3.3% (325/9 779), both P < 0.05], indicating that patients in the SUP group were more severe. ② Comparison of clinical outcome: before PSM, SUP group had significantly higher in-hospital mortality [17.2% (1 688/9 799) vs. 10.9% (176/1 614)], longer LOS [days: 4.4 (2.9, 7.7) vs. 3.1 (2.5, 4.3)], and higher incidence of secondary pneumonia than non-SUP group [11.3% (1 112/9 799) vs. 6.8% (110/1 614)], with significant differences (all P < 0.05). There was no significant difference in the incidence of GIB and Clostridium difficile infection (CDI) between the two groups. After PSM, no significant differences were observed between the two groups with regard to in-hospital mortality, incidence of GIB and CDI. However, the SUP group had longer LOS [days: 3.9 (2.8, 6.6) vs. 3.1 (2.5, 4.3)], and higher incidence of secondary pneumonia [10.9% (174/1 600) vs. 6.8% (108/1 600)] compared with non-SUP group, the differences were statistically significant (all P < 0.05). Subgroup analysis showed that compared with SUP < 3 days group, patients in SUP ≥ 3 days group had higher disease severity score [APACHEⅣ score: 66 (51, 79) vs. 62 (48, 72), SOFA score: 6 (4, 8) vs. 5 (4, 7), both P < 0.05], in addition, patients in SUP≥3 days group had higher in-hospital mortality, incidence of GIB and secondary pneumonia (16.4% vs. 10.7%, 6.1% vs. 1.8%, 19.0% vs. 8.6%, respectively), and longer ICU LOS [days: 6.6 (4.1, 11.8) vs. 3.5 (2.6, 5.3), all P < 0.05]. ③ Multivariate Logistic regression analysis showed that SUP≥3 days group was associated with more GIB than that of non-SUP group [odds ratio ( OR) = 1.84, 95% confidence interval (95% CI) was 1.07-3.08, P = 0.030], and the incidence of GIB was less in SUP < 3 days group than that of non-SUP group ( OR = 0.57, 95% CI was 0.34-0.94, P = 0.020). When compared with non-SUP group, the risk of secondary pneumonia was increased both in SUP≥ 3 days group and SUP < 3 days group ( OR values were 2.95 and 1.34, 95% CI were 2.10-4.13 and 1.01-1.77, P values were < 0.001 and 0.040, respectively). Conclusion:Among critically ill adult patients with sepsis at risk for GIB, SUP showed no effect on reducing in-hospital mortality, the rate of GIB and CDI, but was associated with increased risk of secondary pneumonia and prolonged LOS.

Notas sobre pesquisa colaborativa com sacerdotisas da Deusa Iyami Osoronga / Notes on collaborative research with priestesses of the Goddess Iyami Osoronga

A ciência hegemônica, pautada em referenciais coloniais, traça linhas bem definidas entre o eu e o outro da pesquisa. Ao lançar foco sobre as tradições de matriz africana, estas linhas são reforçadas com as cores do racismo, seja na expressão das desigualdades como naturais desta divisão, seja na ratificação de um lugar subalterno, pela desqualificação dos saberes da população negra, desde a escravização. Ainda que este cenário produza imensas desigualdades, ao longo da história os povos tradicionais vêm resistindo, pela manutenção de suas tradições, na produção de valores contracoloniais. Este trabalho visa apresentar os caminhos de uma pesquisa colaborativa, em parceria com as sacerdotisas de uma sociedade secreta de culto à deusa Iyami Osoronga. Pensada a partir do campo da psicossociologia, tem como referencial os estudos de memória, tradição, discursos pós e decoloniais e os estudos culturais. A pesquisa colaborativa tem o intuito de propor, não um desenho de pesquisa focada em uma ou outra teoria, como posicionamento de uma construção específica, singular, dependente direta de suas autoras e de múltiplos fatores, mas levando à reflexão sobre autoria, saberes e fazeres de epistemologias contra-hegemônicas, que pensam e falam "com" e não "de" ou "para" seus "objetos" de pesquisa.(AU)

The hegemonic science based on colonial references draws well defined lines between the self and the other of the research. In the case of the African matrix traditions, these lines are reinforced with the colors of racism, either in the expression of the inequalities as natural of this division, or in the ratification of a subaltern place, by the disqualification of the knowledge of the black population, from enslavement. Although this scenario produces immense inequalities, throughout the history, the traditional people have been resisting, by the maintenance of their traditions, in the production of contracolonials values. This work aims to present the ways of a collaborative research, in partnership with the priestesses of a society secret cult of the goddess Iyami Osoronga. Based on the field of psycho-sociology, with reference to studies of memory, tradition, discourses after and decolonials and cultural studies with reference to studies of memory, tradition, discourses after and decolonials and cultural studies with the purpose of proposing, not a research design focused on one or another theory, but the search for the positioning of a specific construction, unique, direct dependence of its authors and of multiple factors, leading to the reflection on authorship, knowledge and practices of epistemologies against hegemonic, the speak "with" and "for" and not "of" their "objects" of research.(AU)

Diabetes prevention and control in China / 中华内分泌代谢杂志

Diabetes has been an epidemic in China. Developing economic levels, changes in diet, increasing of obesity, aging, and other factors are thought to be the main contributors. In the new situation for preventing and managing diabetes, several key issues should be seriously considered. We need to carry out high quality multi-center clinical researches based on a well-established nationwide collaborative research network; to identify and validate novel, sensitive and reliable diabetes risk factors and predictors using the new data collection system, and the omics technology based on the large-scale prospective cohorts with a long-term follow up; to reclassify diabetes based on the molecular and functional annotation, and finally to in-depth understand and update the pathogenesis of the disease. Furthermore, using the artificial intelligence and other advanced technologies combined with big medical and research data, etc., we should build new types of diabetes prediction models and systems, as well as machine-assisted diagnosis and treatment systems. Finally, we should carry out translational researches, as well as to develop early detection technologies and clinical pathways suitable for all levels of medical institutions.

<b>2．Expectations for MIHARI Project from the Perspective of Academia </b> / 薬剤疫学

Based on the history of pharmacovigilance activities in Japan, the expectations for MIHARI Project from the perspective of academia are discussed. First, drug safety and risk-benefit related activities should be enhanced from the early stage of drug development and/or in the regulatory approval stage. Second, more collaboration with regulatory authorities and academia should be promoted. Third, knowledge obtained from MIHARI Project should be published timely and continuously which contribute to related safety activities conducted by other than regulators.

Collaboration at the Departmental, School, National and International Levels at the International Medical University, Kuala Lumpur

The nature, extent and definition of a collaboration varies between individuals, disciplines, departments and institutions. It depends upon such factors as the people involved, the nature of the research problem, the research environment, the institutional culture and demographic factors. This paper will examine the concept of collaborative research and discuss its place and position in an evolving university.

Descrição e análise do uso de um instrumento de coordenação em um instituto público de pesquisa em biomedicina / Cooperative health research networks: a description and analysis of a coordination tool in a public biomedical research institute

O objetivo deste artigo é descrever e analisar a dinâmica de redes cooperativas de pesquisa em saúde como principal instrumento de coordenação de um programa de desenvolvimento tecnológico em saúde em uma instituição pública de pesquisa. Iniciamos com algumas considerações metodológicas sobre as técnicas utilizadas no levantamento, sistematização e análise dos dados. Em seguida fazemos uma breve exposição conceitual sobre as redes cooperativas, acompanhada da caracterização do programa. Descrevemos e analisamos posteriormente as redes cooperativas, observando as relações entre os diferentes atores que dinamizam o programa, a presença de ferramentas de tecnologia da informação e comunicação e o compartilhamento da base técnico-científica entre os projetos das redes cooperativas. Concluímos o artigo tecendo algumas considerações sobre a apropriação local do modelo conceitual de organização da pesquisa técnico-científica - as redes cooperativas. Consideramos que a constituição de um acervo de dados empíricos, de conceitos e de categorias locais de análise contribuirá, decisivamente, para a ampliação do conhecimento gerado pela sociologia e pela antropologia sobre as práticas de pesquisa e gestão da pesquisa em biomedicina.

The purpose of this article is to describe and analyze the dynamics of cooperative public health research networks, and their utilization as the principal coordination instrument for a technological development program in a public health research institution. It begins with a few methodological considerations in regard to carrying out surveys and systemizing and analyzing data. Next a brief conceptual explanation of cooperative networks is made along with the characteristics of the program. Then the cooperative networks are described and analyzed, observing the relationships between the various actors that dynamize the program, the presence of IT and communications tools, and the sharing of the techno-scientific base among the projects of cooperative networks. The article concludes by interlacing some considerations about the local appropriation of a conceptual techno-scientific organizational model - the cooperative networks. The creation of a data bank of empirical data, and of local concepts and categories for analyses are considered to be decisive factors for increasing the knowledge acquired through sociology and anthropology about research best practices and administration of biomedical research.