Em torno da pandemia: factos, perceções e conjeturas / About the pandemic: facts, perceptions, and conjectures / Sobre la pandemia: hechos, percepciones y conjeturas / Autour de la pandémie: faits, perceptions et conjectures

A pandemia da covid interpelou diretamente as nossas sociedades de múltiplas formas, desde aspetos atinentes à confiança social na ciência até à possível hiperpolitização dela, passando pelas prioridades assignadas ao funcionamento dos sistemas económicos e às formas da sua regulação. Sendo o nosso ambiente cultural marcado por evidentes traços de sinofobia, a experiência civilizacional de longo prazo da China é confrontada com a das sociedades ocidentais. As frequentes reclamações de maior intervenção económica estatal e de cooperação social entrecruzam-se com diversos outros problemas, designadamente as desigualdades sociais. O caso sueco foi também objeto de consideração, ficando expressa uma visão cética quanto ao seu valor enquanto modelo médico. São, enfim, destacadas várias complexidades e incertezas da situação presente.

The covid pandemic has directly tested our societies in multiple ways, ranging from aspects regarding social trust in science to its possible over-politicization, through the priorities assigned to the functioning of economic systems and their regulation. Given that our cultural environment is marked by obvious traits of Sinophobia, China's long-term civilizational experience is confronted with that of Western societies. Nowadays frequent claims of bigger state economic intervention and increased social cooperation intersect with various other problems, namely social inequalities. The Swedish case was also the subject of consideration, with a skeptical view being expressed regarding its worth as a medical model. Finally, several complexities and uncertainties of the present situation are highlighted.

La pandemia de la covid afectó a nuestras sociedades de diversas formas, desde aspectos relativos a la confianza social en la ciencia hasta la posible super-politización de la misma, pasando por las prioridades del funcionamiento de los sistemas económicos y sus formas de regulación. Tomando en cuenta los evidentes rasgos de sinofobia en nuestro ambiente cultural, la experiencia civilizadora a largo plazo de China se confronta con la de las sociedades occidentales. Las frecuentes quejas de una mayor intervención económica estatal y de cooperación social se cruzan con diversos otros problemas, especialmente las desigualdades sociales. El caso sueco fue también objeto de consideración, revelando una visión escéptica en relación a su valor como modelo médico. Se destacan varias complejidades y dudas de la presente situación.

La pandémie du covid a interpellé directement nos sociétés de façons multiples, dès les aspects touchant la confiance sociale dans la science, jusqu'à sa possible hyperpolitisation, tout en passant par les priorités assignées au fonctionnement des systèmes économiques et aux formes de sa régulation. Comme notre environnement culturel est marqué par des traits de sinophobie évidents, l'expérience civilisationnelle de longue durée de la Chine est confrontée à celle des sociétés occidentales. Les fréquentes demandes d'une plus grande intervention économiques de la part de l'Etat et d'une coopération sociale, aussi bien que d'autres problèmes divers s'entrecroisent. Le cas suédois a été lui aussi objet d'une analyse, et il en reste un point de vue sceptique concernant sa valeur en tant que modèle médical. Enfin, on met en évidence plusieurs incertitudes et complexités de la situation actuelle.

A COVID-19 Allegory: Is that what you are really worried about?

@#This allegorical poem describes the fears and uncertainties faced by the author in the COVID-19 circuit breaker period, from compliance to health advisories as understanding of the contagion evolved, from conflict of responsibilities to family, patients and teaching, and from managing the CME points requirements of the resilience webinars. Four bonsai compositions of legendary Chinese figurines are used as metaphors for the themes of the webinars.

Viabilidade econômica e de risco da produção de tomate no município de Cambuci/RJ, Brasil / Economic feasibility and risk of tomato production in the municipality of Cambuci/RJ, Brazil

A tomaticultura possui grande importância econômica e social para muitos municípios produtores e para todos os demais municípios participantes do mercado consumidor. O tomate sofre elevadas variações de preços no mercado. Tal característica expõe produtores a riscos e incertezas de preços. Nesse sentido, questiona-se o que, quanto, como, e para quem produzir? Objetivou-se analisar a viabilidade econômica da produção de tomate de mesa no município de Cambuci/RJ. Para obter os indicadores de viabilidade econômica, foram estimados o Valor Presente Líquido (VPL), a Taxa Interna de Retorno (TIR). Para determinar as incertezas do empreendimento, foi realizada a análise de sensibilidade. O risco envolvido na tomaticultura deste município foi avaliado por meio da Simulação de Monte Carlo. Os resultados mostraram indicadores econômicos satisfatórios para o período analisado. A análise de sensibilidade revelou que o preço de venda do tomate foi a variável com maior efeito sobre os resultados econômicos da atividade, seguido pelo custo da mão de obra. A simulação de Monte Carlo demonstrou que é baixa a probabilidade dos produtores de tomate obterem VPL negativo. Assim, conclui-se que o cultivo de tomate em Cambuci/RJ apresenta-se como alternativa viável para seus produtores, entretanto, variações pessimistas de preços podem inviabilizar esta atividade.

The tomato production has great economic and social importance for many municipalities producers and for all other municipalities participating in the consumer market. The tomato suffers high price changes in the market. This feature exposes producers to risks and uncertainties price. In this sense, the question is what, how, how much, and for whom to produce? This study aimed to analyze the economic feasibility of production of fresh market tomatoes in Cambuci/RJ. For the economic viability indicators were estimated Net Present Value (NPV) and Internal Rate of Return (IRR). To determine the uncertainties of the project was carried out sensitivity analysis. To assess the risk involved in tomato production this municipality Monte Carlo simulation was used. The results showed satisfactory economic indicators for the period analyzed. The sensitivity analysis showed that the selling price of tomato was the variable with the greatest effect on the results of economic activity, followed by the cost of hand labor. The Monte Carlo simulation showed that there is low probability of obtaining negative NPV for tomato growers. Thus, it was concluded that the cultivation of tomato in Cambuci/RJ presents itself as a viable alternative to producers, however, pessimistic variations in prices may derail this activity.

Breastfeeding and risk of parasitic infection-A review

Breastfeeding, as exclusive nutrition in the first six months of life, is a necessary nutritional requisite in infants. Except for very few maternal diseases that contraindicate breastfeeding, some of which still controversial, breastfeeding mothers must continue exclusive and sustained lactation to provide maximum overall benefits through breastfeeding. Parasitic infections is a global disease and children remain a significant proportion of the affected population. The complex and mandatory life cycles of some parasites, particularly the helminths may partly explain their geographical distribution. The world-wide prevalence of parasitic infections as well as the largely asymptomatic nature of most infections, make many of these infections to likely remain under-recognized. Breast milk, the prime infant nutrition must be recognized to be more than a rare vehicle of parasite transmission, but also a general and focused immune defensive tool against some important parasites. The possibility and influence of small quantities of parasite antigens in breast milk have not been adequately explored. It is believed that useful immunological responses both direct and indirect in breast milk that occur due to the presence of parasite antigens, must be further studied in the light of both immediate and long term benefits. Within this context, and prompted by a spectrum of existing uncertainties, researched and hypothetical roles of parasites and associated immunological responses in the lactating mammary gland are proposed and reviewed.

Breastfeeding and risk of parasitic infection-a review

Breastfeeding, as exclusive nutrition in the first six months of life, is a necessary nutritional requisite in infants. Except for very few maternal diseases that contraindicate breastfeeding, some of which still controversial, breastfeeding mothers must continue exclusive and sustained lactation to provide maximum overall benefits through breastfeeding. Parasitic infections is a global disease and children remain a significant proportion of the affected population. The complex and mandatory life cycles of some parasites, particularly the helminths may partly explain their geographical distribution. The world-wide prevalence of parasitic infections as well as the largely asymptomatic nature of most infections, make many of these infections to likely remain under-recognized. Breast milk, the prime infant nutrition must be recognized to be more than a rare vehicle of parasite transmission, but also a general and focused immune defensive tool against some important parasites. The possibility and influence of small quantities of parasite antigens in breast milk have not been adequately explored. It is believed that useful immunological responses both direct and indirect in breast milk that occur due to the presence of parasite antigens, must be further studied in the light of both immediate and long term benefits. Within this context, and prompted by a spectrum of existing uncertainties, researched and hypothetical roles of parasites and associated immunological responses in the lactating mammary gland are proposed and reviewed.

Analysis geometrical uncertainties of 220 cases in helical tomotherapy (HT) / 中华放射肿瘤学杂志

Objective To analyze geometrical uncertainties of the target and provide the margin enlarging from clinic target volume (CTV) to planning target volume (PTV) with HT.Methods Analysis set-up data of 220 cases include 97 cases of head and neck,45 cases of chest and 78 cases of abdomen and pelvic,calculating the systematic error (Σ) and the random error (σ) in the three-dimension and check whether the set-up data accord with the normal distribution or not,then acquire the values expand in the three directions based on formula 2.0Σ + 0.7σandμ ± 2.58σ.Results The systematic error (Σ) and random error (σ) of head and neck,the chest and abdomen and pelvic were (0.7-1.9 mm,1.1-1.4 mm),(0.8-4.2 mm,1.5-3.2 mm),(1.1-4.1 mm,1.8-4.1 mm),respectively,and the margin that expand in the direction of x,y,z were (5.2,6.5,7.7 mum),(7.5,16.2,10.3 mm),(7.6,17.1,15.7 mm),respectively.Conclusions The curative effect of this task need prove with a large sample during HT,but other should establish data of margin by yourself.

Incertezas de pacientes no sistema público de saúde / Uncertainties of patients in the Brazilian public health system

Análises que objetivam compreender de que maneira sujeitos lidam com processos de saúde/doença geralmente dão ênfase aos modos como estes inserem suas vivências concretas em quadros avaliativos abstratos para, a partir daí, definirem ações a serem executadas. Isto posto, este artigo questiona o rendimento de tais abordagens no entendimento das experiências de pacientes do sistema público de saúde. As análises são empreendidas com base nos resultados de pesquisa realizada em instituição pública de saúde do Distrito Federal, na qual foram reconstituídos itinerários terapêuticos de seus pacientes. A pesquisa indicou que suas trajetórias são atravessadas por incertezas de diversas ordens. Tendo em vista a relevância destas e o fato de que de modo algum impedem o desenvolvimento de seus tratamentos médicos, o artigo discute como os pacientes lidam com essas incertezas e quais relações elas estabelecem com o conjunto de suas experiências. Argumenta então que suas incertezas derivam não de características imanentes a estes sujeitos, mas das relações que estabelecem com os saberes médicos e com as organizações institucionais para efetivação desses saberes, constituídas pelas instituições públicas de saúde. Mais além, demonstra que as apreciações, classificações etc. dos pacientes não se dirigem principalmente aos processos de saúde/doença em sentido estrito, mas aos mecanismos que possibilitam relações de maior sucesso com as organizações institucionais por meio das quais eles obtêm seus tratamentos.

Analyses aiming to understand how subjects deal with processes of health/disease usually emphasize the ways in which they introduce their concrete experiences into abstract evaluative frames, in order to define actions to be implemented. This being stated, this paper questions the efficiency of such approaches in understanding the experiences of the patients of Brazilian's public health system. The analyses are undertaken based on the results of research made in a public health institution of the Brazilian Federal District, in which therapeutic itineraries of its patients were reconstituted. The research indicated that their trajectories are crossed by several orders of uncertainties. Considering their relevance and the fact that in any way it impedes the promotion of their medical treatment, the paper discusses how patients deal with these uncertainties and which relationships are established with the ensemble of their experiences. It is then argued that their uncertainties do not come from the inherent characteristics of the patients but from the relations they establish with (1) the medical knowledge and (2) the institutional organizations in which this knowledge is accomplished by the public health institutions. Further it shows that the patients' assessments, classifications etc. are not mainly directed to the processes of health/disease in the strict sense, but to the mechanisms that allow more successful relationships with the institutional organizations through which they receive their treatment.

Monte Carlo Photon and Electron Dose Calculation Time Reduction Using Local Least Square Denoising Filters / 의학물리

The Monte Carlo method cannot have been used for routine treatment planning because of heavy time consumption for the acceptable accuracy. Since calculation time is proportional to particle histories, we can save time by decreasing the number of histories. However, a small number of histories can cause serious uncertainties. In this study, we proposed Monte Carlo dose computation time and uncertainty reduction method using specially designed filters and adaptive denoising process. Proposed algorithm was applied to 6 MV photon and 21 MeV electron dose calculations in homogeneous and heterogeneous phantoms. Filtering time was negligible comparing to Monte Carlo simulation time. The accuracy was improved dramatically in all situations and the simulation of 1% to 10% number of histories of benchmark in photon and electron dose calculation showed the most beneficial result. The empirical reduction of necessary histories was about a factor of ten to fifty from the result.

Atypical (Bizarre) Leiomyoma of the Prostate: A Case Report

Atypical (bizarre) leiomyoma of the prostate is a very rare neoplasm. Five cases have been reported in English medical literature. A 60-year-old Korean man with a history of prostatism and slightly elevated serum prostate specific antigen was presented. Microscopically, the transurethral resection specimen consisted of a proliferation of hypercellular spindle cells with intersecting bundles. The nuclei of the tumor cells showed marked pleomorphism and hyperchromasia with occasional multinucleated giant cells. Mitoses were seen in areas of up to 2 per 10 high power fields, but there was no evidence of atypical ones. The tumor cells were immunoreactive against anti-smooth muscle actin and desmin antibodies. The proliferative index (10.0%) of the atypical leiomyoma lay between that of a benign smooth muscle and that of a leiomyosarcoma of the prostate. Flow cytometry showed a diploid pattern with an elevated S phase fraction. To the best of our knowledge, this is the first demonstration of atypical leiomyoma of the prostate in a Korean man.