Pathogenesis and Differentiated Treatment Strategies of Childhood Tic Disorders Based on WANG Xugao's “Thirty Methods of Treating the Liver” / 中医杂志

Based on WANG Xugao's “thirty methods of treating the liver”， it is believed that the occurrence and development of childhood tic disorders follow the dynamic progression from liver qi disease to liver fire disease and then liver wind disease. The basic pathogenesis of three stages are characterized by binding constraint of liver qi， liver fire hyperactivity， and internal stirring of liver wind. Moreover， liver-blood deficiency and stagnation， and malnutrition of liver yin as the main point in terms of the imbalance of liver qi， blood， yin， and yang should be considered， as well as the imbalance relationship of the five zang organs such as the involvement of other organs and the gradually reach of the other organs. Guided by the principles of “thirty methods of treating the liver”， the treatment of tic disorders in liver qi stage should focus on soothing the liver and rectifying qi， soothing the liver and unblocking the collaterals， using Xiaochaihu Decoction （小柴胡汤） and Sini Powder （四逆散）. The treatment of tic disorders in liver fire stage involves clearing， draining and resolving liver heat， using Longdan Xiegan Decoction （龙胆泻肝汤）， Xieqing Pill （泻青丸）， Danggui Longhui Pill （当归龙荟丸）， and Huagan Decoction （化肝煎）. The treatment of tic disorders in liver wind stage involves extinguishing wind and subduing yang， using Lingjiao Gouteng Decoction （羚角钩藤汤） and Liuwei Dihuang Pill （六味地黄丸）. Throughout the treatment process， attention should be paid to harmonizing the liver's qi， blood， yin， and yang， as well as addressing the pathology of other organs.

Una aplicación móvil de ayuda para estudiantes de epidemiología: evaluación preliminar de EpiApp

Introducción: Las aplicaciones móviles (Apps) están transformando las perspectivas de aprendizaje en entornos de salud. Objetivo: Evaluar la efectividad y usabilidad de EpiApp como herramienta de apoyo en la consulta y resolución de problemas de epidemiología comparada con métodos tradicionales (MT). Materiales y métodos: Se diseñó EpiApp usando una estructura metodológica. Se realizó un estudio experimental controlado y aleatorizado con dos grupos: EpiApp y MT. La fectividad se evaluó con un cuestionario estandarizado y la usabilida con la escala MARS. Resultados: Se aleatorizaron 176 estudiantes: EpiApp (n=88) y MT (n=88). El tiempo de respuesta fue menor para los usuarios de EpiApp (23,99 min [± DE 8,38] vs. 29,16 min [± DE 11,61], p = 0,005). No hubo diferencias en el número de respuestas correctas (p = 0,635), ni en la oportunidad de aprobar el cuestionario (p = 0,054). La usabilidad fue buena (MARS > 4). Discusión: Las Apps móviles tienen un gran potencial para ser útiles en la educación en salud y en la toma de decisiones en epidemiología, así como en la atención médica en general. No obstante, es esencial realizar estudios rigurosos para garantizar que estas aplicaciones sean efectivas, útiles, fáciles de usar y comprender. Conclusiones: EpiApp redujo el tiempo de respuesta en la resolución de problemas de epidemiología sin afectar el número de respuestas correctas. La usabilidad fue buena, aunque hay oportunidad de mejora en diversión, interés, adaptabilidad individual e interactividad. La efectividad y usabilidad de EpiApp requiere ser validada con estudios más rigurosos y en diferentes contextos.

Introduction: Mobile applications (Apps) are transforming learning perspectives in healthcare settings. Objective: To evaluate the effectiveness and usability of EpiApp as a support tool in the consultation and resolution of epidemiology problems, compared to traditional methods (TM). Methodology: EpiApp was designed using a methodological structure. A randomized controlled experimental study was conducted with two groups: EpiApp and TM. A standardized questionnaire and the MARS scale were used to evaluate effectiveness and usability, respectively. Results: A total of 176 students were randomized: EpiApp (n=88) and TM (n=88). Response time was shorter for EpiApp users (23.99 min [±SD 8.38] vs. 29.16 min [±SD 11.61], p=0.005). There were no differences in the number of correct responses (p=0.635) or the opportunity to pass the questionnaire (p=0.054). Usability was good (MARS>4). Discussion: Mobile Apps have great potential to be useful in healthcare education and decision-making in epidemiology, as well as in general medical care. However, it is essential to conduct rigorous studies to ensure that these applications are effective, useful, and easy to use and understand. Conclusions: EpiApp reduced response time in solving epidemiology problems without affecting the number of correct answers. The usability was good, although there is room for improvement in terms of enjoyment, interest, individual adaptability, and interactivity. The effectiveness and usability of EpiApp need to be validated through more rigorous studies in different contexts.

Uso de una app preventiva en población peruana: primeros datos obtenidos

Objetivo: Describir las características del uso de una app preventiva en la población peruana durante su primer año de operaciones, en el periodo comprendido entre el 2019 y 2020. Materiales y métodos: Estudio de tipo descriptivo, transversal y retrospectivo, donde se revisó la base de datos de la app preventiva Salud Total respecto a las características demográficas y forma de uso en la población peruana durante su primer año de operaciones. Se analizaron las variables sociodemográficas (sexo y edad) y las formas de uso (los datos de salud ingresados, los hallazgos patológicos encontrados, la recurrencia de uso y el tipo y la cantidad de servicios solicitados). El análisis y procesamiento de los datos descriptivos se realizaron con el programa Microsoft Excel. Resultados: El número de usuarios que descargaron y se registraron en la app fue 9737 personas. Con respecto al sexo, la proporción fue similar, y el grupo etario predominante fue entre 21 y 50 años. Se obtuvieron 2304 datos de salud que los usuarios registraron voluntariamente, de los cuales los más reportados fueron el peso y la talla (45,3 %), seguidos de la presión arterial (20,4 %), la hemoglobina (17,1 %) y la circunferencia abdominal. Se encontraron hallazgos patológicos en los datos registrados tales como la presión arterial elevada (25,7 %) y el peso elevado (58,5 %), entre otros. Asimismo, los usuarios solicitaron por medio de la app un total de 1072 servicios de salud de diversos tipos, entre los cuales destacan la atención médica (58 %) y el laboratorio clínico (32 %). Conclusiones: Los usuarios pudieron registrarse e interactuar con una app preventiva con el fin de controlar su bienestar, y la usaron tanto para añadir sus datos de salud como para solicitar servicios médicos de forma remota, lo que puede significar una nueva herramienta de intervención para direccionar acciones preventivas, la atención oportuna de enfermedades y una nueva fuente de datos para la investigación en salud.

Objective: To describe the characteristics of the use of a preventive app by the Peruvian population during its first year of operations between 2019 and 2020. Materials and methods: A descriptive, cross-sectional and retrospective study, in which the database of the Salud Total preventive app, concerning the demographic characteristics of and usage by the Peruvian population, was reviewed during its first year of operations. Sociodemographic variables (sex and age) and usage (health data, pathological findings, frequency of use, and type and number of services requested) were analyzed. The analysis and processing of descriptive data were performed using Microsoft Excel Results: The number of users who downloaded and registered in the app was 9,737 people. A similar sex ratio was found, and the 21to 50-year-old group prevailed. A total of 2,254 health data voluntarily entered by the users, out of which the most reported were weight and height (45.3 %), blood pressure (20.4 %), hemoglobin (17.1 %) and waist circumference, were collected. Pathological findings such as high blood pressure (25.7 %) and overweight (58.5 %), among others, were found in the recorded data. Likewise, 1,072 different health services were requested through the app, among which medical care (58 %) and laboratory tests (32 %) stood out. Conclusions: Users were able to register in and interact with a preventive app in order to monitor their well-being. Moreover, they used it both to add their health data and to request remote medical care. This could be a new intervention tool for taking preventive actions, managing timely care of diseases and offering a new data source for health research.

Competencias digitales de estudiantes de la maestría en Cuidados Paliativos y Manejo del Dolor

Objetivo: Determinar las competencias digitales de los estudiantes de la maestría en Cuidados Paliativos y Manejo del Dolor de la Facultad de Medicina de la Universidad Nacional Mayor de San Marcos en el año 2022. Materiales y métodos: Investigación de diseño no experimental, descriptivo y de corte transversal. La población de estudio estuvo conformada por los alumnos de la maestría en Cuidados Paliativos y Manejo de Dolor matriculados en el año 2022. Se empleó una muestra no probabilística. Los datos se recolectaron a través de la encuesta Cuestionario de competencias digitales en educación superior (CDES), compuesta por 46 indicadores distribuidos en cinco factores, que tiene una fiabilidad de 0,96 según alfa de Cronbach. Se respetó la confidencialidad de los datos y la autonomía en las decisiones de los participantes. Resultados: Se trabajó con una muestra final de 59 alumnos. La edad promedio fue 38,03 años y el 76,3 % fueron mujeres. Todos los estudiantes contaban con una computadora personal y acceso a internet. El análisis descriptivo determinó un predominio de la valoración "muy importante": 49,2 % para el factor "ciudadanía digital"; 47,5 % para el factor "comunicación y colaboración"; 45,8 % para "creatividad e innovación" y "acceso y uso de la información"; y 44,1 % para el factor "alfabetización digital". Según el análisis global de competencias digitales, 49,2 % manifestó una valoración "muy importante" y 42,4 %, "importante"; no hubo resultados para la denominación "nada importante". Conclusiones: Todos los estudiantes disponen de una computadora personal y cuentan con acceso a internet, lo que ratifica el creciente interés por incluir los aspectos relacionados con la competencia digital en la educación universitaria. El factor "alfabetización tecnológica" presentó menor valoración, mientras que el factor "ciudadanía digital" tuvo mayor valoración. El 91,6 % de estudiantes valora la competencia digital entre importante y muy importante, lo que podría considerarse como muy favorable.

Objective: To determine the digital skills among students of the master's program in Palliative Care and Pain Management at Universidad Nacional Mayor de San Marcos School of Medicine in 2022. Materials and methods: A non-experimental, descriptive and cross-sectional research. The study population was comprised of students of the master's program in Palliative Care and Pain Management enrolled in the year 2022. A non-probability sample was used. Data were collected through the survey "Digital Skills in Higher Education Questionnaire" (CDES), consisting of 46 indicators distributed in five factors with a reliability of 0.96 according to Cronbach's alpha. Data confidentiality and participants' autonomy were respected. Results: The final sample was made up of 59 students, the average age was 38.03 years and 76.3 % were women. All students had a personal computer and Internet access. The descriptive analysis showed that the "very important" rating prevailed: 49.2 % for the "digital citizenship" factor, 47.5 % for the "communication and collaboration" factor, 45.8 % for the "creativity and innovation" and the "access and use of information" factors, and 44.1 % for the "digital literacy" factor. According to the digital skills global analysis, 49.2 % and 42.4 % chose the "very important" and "important" ratings, respectively. There were no results for the "not at all important" rating. Conclusions: All students had a personal computer and Internet access, which confirms the growing interest in including aspects related to digital skills in university education. The "digital literacy" and the "digital citizenship" factors had a lower and higher rating, respectively, compared to the other factors. A total of 91.6 % of the students considered that digital skills are important and very important, which could be considered as highly favorable.

Formación en promoción de autonomía y apoyo pedagógico durante confinamiento por covid-19

(analítico) Se analiza la implementación de un programa de formación docente en promoción de autonomía y apoyo pedagógico y su relación con el compromiso de niños en el aula. El programa se desarrolló duran-te el cierre de escuelas por la pandemia causada por el covid-19. Se usó diseño mixto convergente-paralelo. Participaron cinco docentes de primaria, de escuelas públicas de Cali, Colombia, y sus estudiantes (N=110). La formación consistió en dos talleres grupales y tres sesiones de acompañamiento individual en modalidad virtual. Se grabaron las clases antes y durante el proceso, codificándose las interacciones. Se observó alta variabilidad en promoción de autonomía y apoyo pedagógico. El compromiso de los niños fue mayor cuando las profesoras promovían mayor autonomía y apoyo pedagógico. Se discutieron variables que afectan el aprovechamiento de la formación.

(analytical) This paper analyzes the implementation of a professional development program on autonomy promotion and instructional support in the classroom, and the relationship between this program and students' engagement. The program was designed during the delivery of online classes as a result of the COVID-19 pandemic. The study used a convergent parallel design. Participants were five elementary teachers and their students (N=110) at a public school in Cali, Colombia. The program consisted of two workshops and three online individual feedback sessions. Classes were recorded before and during the program and classroom interactions were coded. The results show high variability in teachers' autonomy promotion and instructional support during the classes. Students' engagement was higher when teachers promote greater autonomy and instructional support. Variables that could affect teachers' use of learning from the program are discussed.

(analítico) Analisase a implementação de um programa de formação docente para a promoção da autonomia e o apoio pedagógico e sua relação com a performance das crianças na sala de aula. O programa foi desenvolvido durante o fechamento das escolas pelo Covid-19. Um método misto convergente-paralelo foi usado. Participaram cinco professoras de ensino básico de escolas públicas de Cali-Colômbia e seus alunos, 110 crianças. A formação consistiu em duas oficinas grupais e três sessões de trabalho individual na modalidade virtual. As aulas foram gravadas antes e durante o processo, e as interações foram codificadas. Observa-se alta variabilidade na promoção da autonomia e apoio pedagógico. O comprometimento das crianças foi maior quando as professoras promoveram maior autonomia e apoio pedagógico. As variáveis que afetam o aproveitamento do treinamento são discutidas.

Sistema glinfático: aspectos anatómicos, fisiológicos e implicaciones clínicas

Introducción: El sistema glinfático comprende el conjunto de rutas perivasculares tanto arteriales como venosas que se encuentran en estrecha asociación con células astrogliales y que permiten la interacción entre el líquido cefalorraquídeo (LCR) y el líquido intersticial cerebral (LIC), para llevar a cabo procesos como la depuración de los metabolitos de desecho celular, o la distribución de nutrientes, así como contribuir al metabolismo cerebral local, la transmisión de volumen y la señalización paracrina cerebral. Contenidos: Este artículo busca profundizar en los conceptos anatómicos y fisiológicos, hasta el momento descritos, sobre este sistema macroscópico de transporte. Se realiza una búsqueda bibliográfica de revisiones y estudios experimentales sobre la anatomía, la fisiología y las implicaciones fisiopatológicas del sistema glinfático. Conclusiones: La identificación anatómica y funcional del sistema glinfático ha ampliado el conocimiento sobre la regulación del metabolismo cerebral en cuanto a distribución de nutrientes y cascadas de señalización celular. Al establecer una interacción entre el espacio subaracnoideo subyacente y el espacio intersticial cerebral, el sistema glinfático surge como uno de los mecanismos protagonistas de la homeostasis cerebral. La disfunción de esta vía hace parte de los mecanismos fisiopatológicos de múltiples trastornos neurológicos, ya sea por la acumulación de macromoléculas, como ocurre en la enfermedad de Alzheimer, o por la reducción del drenaje de sustancias químicas y citocinas proinflamatorias en patologías como la migraña o el trauma craneoencefálico.

Introduction: The glympathic system comprises the set of perivascular routes, arterials or venous, that are found in close relationship with astroglial cells and allow interaction between the cerebrospinal fluid (CSF) and the interstitial brain fluid (ISF), to carry processes like cell-wasting metabolites depuration, nutrients distribution, as well as make a contribution in the local brain metabolism, volumen transmition and brain paracrine signaling. Contents: This article seeks to deepen in the anatomical and physiological concepts, so far described, about this macroscopic transport system. A bibliographic search of reviews and experimental studies on the anatomy, physiology and pathophysiological implications of the glymphatic system is carried out. Conclusions: Anatomical and functional identification of glympathic system has broaden the knowledge about regulation of brain metabolism on the nutrients distribution and cell signaling cascades. When setting an interaction between the subarachnoid space and the brain interstitial space, the glymphatic system arise as one of the leading mechanisms of brain homeostasis. Disfunction of this pathway makes part of the patophysiological mechanisms of multiple neurological disease, either be by collection of macromolecules as in Alzheimer's disease, or by the reduction of inflammatory cytokines and chemical substances drainage as in migraine or traumatic brain injury (TBI).

Innovación en el control gubernamental en la atención de denuncias ciudadanas: Una revisión bibliográfica

R E S U M E N El artículo tiene como objetivo mostrar un análisis conciso de la importancia, dimensiones y relaciones de la innovación en el control gubernamental y la gestión de las denuncias ciudadanas, presente en revistas científicas y publicaciones de entidades como OLACEFS y diversas Contralorías, desde el 2018 al 2022. Para ello, se desarrolló una investigación no experimental, descriptiva y transversal; basada en una revisión bibliográfica en Redalyc, Scielo y Scopus, sobre artículos científicos relacionados a las variables mencionadas, obteniendo 53 publicaciones. Dentro de los principales resultados se encuentra la relación de herramientas de innovación con las variables de control gubernamental y denuncias ciudadanas, obteniendo 22 temáticas, siendo transversal el uso de TIC. Finalmente, se concluyó que la innovación es una variable relacionada con el control gubernamental y la gestión pública, contemplando la gestión de denuncias ciudadanas. Si bien es cierto que, no hay investigaciones puntuales que relacionen estas variables, hay muchas publicaciones que usan términos como TIC, innovación o gobierno abierto para mantener una correlación; contemplando a la participación ciudadana como parte del control social que ayuda al control gubernamental.

A B S T R A C T The article aims to show a concise analysis of innovation's importance, dimensions, and relationships in government control and the management of citizen complaints, present in scientific journals and publications of entities such as OLACEFS and various Comptrollerships, from 2018 to 2022. For this, a non-experimental, descriptive, and cross-sectional investigation was developed; based on a bibliographic review in Redalyc, Scielo, and Scopus, of scientific articles related to the mentioned variables, obtaining 53 publications. Among the main results is the relationship of innovation tools with the variables of government control and citizen complaints, getting 22 themes, the use of ICT being transversal. Finally it was concluded that innovation is a variable related to government control and public management, contemplating the direction of citizen complaints. Although it is true that there is no specific research that relates these variables, there are many publications that use terms such as ICT, innovation, or open government to maintain a correlation; contemplating citizen participation as part of the social control that helps government control.

O artigo tem como objetivo mostrar uma análise concisa da importância, dimensões e relações da inovação no controle governamental e na gestão das reclamações cidadãs, presentes em revistas científicas e publicações de entidades como a OLACEFS e diversas Controladorias, no período de 2018 a 2022. Para isso, desenvolveu-se uma investigação não experimental, descritiva e transversal; baseado em revisão bibliográfica em Redalyc, Scielo e Scopus, em artigos científicos relacionados às variáveis mencionadas, obtendo 53 publicações. Entre os principais resultados está a relação das ferramentas de inovação com as variáveis de controle governamental e reclamações cidadãs, obtendo-se 22 temas, sendo o uso das TIC transversal. Por fim, concluiu-se que a inovação é uma variável relacionada ao controle governamental e à gestão pública, contemplando o gerenciamento das reclamações cidadãs. Embora seja verdade que não há pesquisas específicas que relacionem essas variáveis, existem muitas publicações que usam termos como TIC, inovação ou governo aberto para manter uma correlação; contemplar a participação cidadã como parte do controle social que auxilia o controle governamental.

Entornos virtuales y posibilidades para una educación más inclusiva

Introducción: Los modelos educativos inclusivos forman parte actualmente de las políticas educacionales; estos modelos presuponen la utilización de métodos y procedimientos factibles para un aula heterogénea y están en el centro de los proyectos de la Organización de las Naciones Unidas para la Educación, la Ciencia y la Cultura y en los Objetivos de Desarrollo Sostenible para 2030. Objetivo: Describir algunas de las barreras existentes y las ventajas de la implementación del aula heterogénea a favor de una educación más inclusiva. Material y método: Se realiza un estudio descriptivo longitudinal retrospectivo sobre la relación de la educación inclusiva y los entornos virtuales de aprendizaje. Resultados: Las plataformas virtuales propician el avance de los sistemas educativos con flexibilidad en la aplicación de métodos y procedimientos que los hacen adaptables a diferentes individualidades y por tanto más inclusivos. Ello se percibe como visión de futuro donde todos gocen de los mismos derechos y oportunidades en igualdad de condiciones. Conclusiones: El desarrollo alcanzado por las Tecnologías de la Información y las Comunicaciones proporciona la base para que, a través de la virtualidad, se concrete y perfeccione la educación inclusiva.

Introduction: Inclusive educational models are currently part of educational policies; these models presuppose the use of feasible methods and procedures for a heterogeneous classroom and are at the core of the United Nations Educational, Scientific and Cultural Organization projects and in the Sustainable Development Goals 2030. Objective: To describe some of the existing barriers and the advantages of implementing the heterogeneous classroom in favor of a more inclusive education. Method: A retrospective longitudinal descriptive study was conducted on the relationship between inclusive education and virtual learning environments. Results: Virtual platforms promote the advancement of educational systems with flexibility in the application of methods and procedures that make them adaptable to different individualities and, therefore, more inclusive. This is perceived as a vision of the future where everyone enjoys the same rights and opportunities under equal conditions. Conclusions: The development achieved by Information and Communication Technologies provides the basis so that, through virtual platforms, inclusive education can be concretized and perfected.

Liderando estilos de vida saludable con foco en TIC, interdisciplinariedad y unidad escuela-familia

Durante la crisis sanitaria COVID-19, el desarrollo de estilos de vida saludable en estudiantes del sistema escolar ha ganado especial significación, por lo que este estudio se propone potenciar, a través de la Educación Física, la formación de estilos de vida saludable en la comunidad escolar desde el liderazgo intermedio, la articulación interdisciplinaria, la integración de las TIC y la unidad escuela-familia. En el estudio, se asumió un paradigma mixto; participaron 265 estudiantes, 11 docentes y 2 directivos. Se aplicaron entrevistas grupales, la observación participante y el cuestionario fantástico. Se evidenció un desarrollo favorable en la práctica de la actividad física y deportiva, la mejora de los hábitos de nutrición y se institucionalizaron prácticas del plan de acción propuesto. Se concluye que el plan de acción puede ser considerado como una vía válida para la formación de estilos de vida saludable en estudiantes de enseñanza básica, en el contexto estudiado.

SÍNTESE Durante a crise de saúde da COVID-19, o desenvolvimento de estilos de vida saudáveis nos estudantes do sistema escolar ganhou um significado especial, pelo que este estudo visa melhorar, através da Educação Física, a formação de estilos de vida saudáveis na comunidade escolar a partir da liderança intermédia, articulação interdisciplinar, integração das TIC e unidade escola-família. No estudo, foi assumido um paradigma misto; participaram 265 estudantes, 11 professores e 2 directores. Foram utilizadas entrevistas de grupo, observação dos participantes e um questionário. Houve provas de um desenvolvimento favorável na prática da actividade física e do desporto, melhoria dos hábitos alimentares e institucionalização das práticas do plano de acção proposto. Conclui-se que o plano de acção pode ser considerado como uma forma válida para a formação de estilos de vida saudáveis nos estudantes do ensino básico, no contexto estudado.

During the COVID-19 health crisis, the development of healthy lifestyles in students of the school system has gained special significance, so this study aims to promote, through Physical Education, the formation of healthy lifestyles in the school community from the intermediate leadership, the interdisciplinary articulation, the integration of ICT and the school-family unit. In the study, a mixed paradigm was assumed; 265 students, 11 teachers and 2 directors participated. Group interviews, participant observation and the fantastic questionnaire were applied. A favorable development in the practice of physical and sports activity, as well as the improvement of nutrition habits were evidenced, and practices of the proposed action plan were institutionalized. It is concluded that the action plan can be considered as a valid way for the formation of healthy lifestyles in basic education students, in the studied context.

Correlation study of imaging characteristics of diffusion tensor imaging and the Yale Global Tic Severity Scale in children with tic disorders / 中华实用儿科临床杂志

Objective:To explore the correlation between imaging features of children with tic disorders and their features assessed by the Yale Global Tic Severity Scale (YGTSS).Methods:A retrospective study.A total of 33 children with tic disorders treated in the Department of Child Rehabilitation, the First Affiliated Hospital of Xinxiang Medical University from January 2022 to March 2023 were included in the tic disorder group, and 10 healthy age-matched children received physical examination during the same period were included in the healthy control group.Under the functional positioning of functional magnetic resonance imaging (fMRI), the active area of children with tic disorders at varying degrees was found.In the region of interest (ROI), localization monitoring and diffusion tensor imaging (DTI) were performed, and the apparent diffusion coefficient (ADC) and fractional anisotropy (FA) were recorded.In the same ROI (bilateral thalamus, genu of internal capsule, splenium of corpus callosum, globus pallidus, caudate nucleus) of children in healthy control group, ADC and FA were recorded.Imaging data were compared between groups using the independent sample t test, and their correlation with YGTSS scores was identified by the Pearson correlation analysis. Results:There were significant differences in ADC of the left thalamus (0.869±0.077 vs.0.794±0.083, P=0.022), the right thalamus (0.853±0.055 vs.0.798±0.054, P=0.014), the left caudate nucleus (0.871±0.121 vs.0.787±0.052, P=0.003) and the right caudate nucleus (0.856±0.075 vs.0.788±0.063, P=0.010) between tic disorder group and healthy control group.No significant differences were detected in ADC of the remaining ROI between groups (all P>0.05). There were significant differences in FA of the left thalamus (0.259±0.050 vs.0.344±0.077, P=0.007), the right thalamus (0.265±0.057 vs.0.347±0.095, P=0.026) and the right caudate nucleus (0.168±0.118 vs.0.309±0.181, P=0.041) between tic disorder group and healthy control group.No significant differences were detected in ADC and FA between children with mild and moderate tic disorders (all P>0.05). ADC of the left thalamus and the right caudate nucleus were significantly correlated with YGTSS scores in children with tic disorders ( r=0.407 and 0.372, respectively; all P<0.05). FA of the right thalamus was negatively correlated with YGTSS scores in children with tic disorders ( r=-0.439, P<0.05). Conclusions:ADC of the thalamus and caudate nucleus, and FA of the right thalamus are significantly correlated with YGTSS scores of children with tic disorders.High ADC of the left thalamus and the right caudate nucleus are correlated with high YGTSS scores, indicating a severe symptom of tic disorder in children.A high FA of the right thalamus is correlated with low YGTSS scores, indicating a mild symptom of tic disorder in children.

To explore the distribution of TCM syndrome types of refractory tic disorder in children based on cluster analysis / 国际中医中药杂志

Objective:To explore the clinical characteristics and distribution of Tranditional Chinese Medicine (TCM) syndrome types of refractory tic disorders in children based on clustering analysis.Methods:A cross-sectional study. 183 children aged 3-18 years with refractory tic disorders from pediatric encephalopathy outpatient department of the First Teaching Hospital of Tianjin University of Traditional Chinese Medicine who met the inclusion criteria from October 2015 to January 2022 were recruited. Frequency descriptive analysis, systematic clustering analysis and principal component analysis were conducted by Microsoft Office Excel 2016 and IBM SPSS Statistics 26.0 to explore the clinical characteristics and syndrome distribution of the disease.Results:The TCM symptoms of 183 children with refractory tic disorders were clustered into 6 categories, and finally 5 types of syndrome were obtained, among which the syndrome of spleen deficiency and liver hyperactivity mixed with dampness accounted for the largest proportion (27.32%), followed by the syndrome of phlegm-fire disturbing spirit (21.31%), the syndrome of wind-heat invading lung (18.03%), the syndrome of phlegm-qi stagnation (17.49%), and the syndrome of dampness and yin deficiency (15.85%).Conclusion:Through the mining and analysis of the outpatient information of pediatric encephalopathy in our hospital, the common syndrome differentiation types of refractory tic disorder are obtained, which can provide a reference for the TCM syndrome differentiation types of refractory tic disorder in children.

Advances in the levels of neurotransmitters associated with attention deficit hyperactivity disorder in children with tic disorders / 国际儿科学杂志

Tic disorders(TD)including Tourette syndrome are childhood-onset neurodevelopmental disorders characterized by motor and/or vocal tics that commonly affect children′s physical and mental health.More than half of TD patients also have attention deficit hyperactivity disorder(ADHD). The pathogenesis of TD is not clear, and it is believed to be related to the abnormal level of neurotransmitters caused by the dysfunction of the cortical-striatal-thalamic-cortical circuitry, and the disorder of neurotransmitters is also related to the pathogenesis of ADHD, but the current research results on the level of neurotransmitters in TD with comorbid ADHD are controversial, and even some neurotransmitters show completely opposite changes in the two diseases.This paper reviews the research progress of neurotransmitters in children with TD co-suffering from ADHD in recent years, in order to provide ideas for exploring its pathogenesis.

Three oral Chinese patent medicines for children with tic disorder: a rapid health technology assessment / 中国中药杂志

This study aims to comprehensively evaluate the clinical value of Shaoma Zhijing Granules(SZG), Changma Xifeng Tablets(CXT), and Jiuwei Xifeng Granules(JXG) in the treatment of children with tic disorder with the method of rapid health technology assessment(RHTA), which is expected to serve as a reference for medical and health decision-making and clinical rational use of drugs in children. To be specific, relevant articles were retrieved from eight databases and three clinical trial registry platforms. After the quality evaluation, rapid assessment was carried out from the dimensions of disease burden and unmet needs, technical characteristics, safety, efficacy and economy, and the results were analyzed and presented descriptively. A total of 22 articles(1 in English, 21 in Chinese) were screened out: 18 randomized controlled trials(RCTs) and 4 clinical controlled trials(CCTs). Among them, 5 were about the SZG(all RCTs) and 9 were on CXT(6 RCTs and 3 CCTs). The rest 8 focused on JXG(7 RCTs and 1 CCT). Moreover, the overall risk of bias for 94.40% RCTs was evaluated as "some concerns" and only one(5.60%) had high risk of bias. In terms of quality, the 4 CCTs scored 5-6 points(<7 points), suggesting low quality. SZG alone or in combination with tiapride has obvious advantages in improving traditional Chinese medicine syndromes and tic symptoms compared with tiapride alone, with the average daily cost of CNY 79.44-119.16. Compared with conventional western medicine or placebo, CXT alone or in combination with conventional western medicine can improve the total effective rate and alleviate tic symptoms, and the average daily cost is CNY 22.50-67.50. JXG alone or in combination with conventional western medicine can effectively relieve tic symptoms compared with conventio-nal western medicine or placebo, with the average daily cost of CNY 82.42-164.85. The adverse events related to the three Chinese patent medicines mainly occurred in the digestive, respiratory, and nervous systems, all of which were mild. In general, SZG, CXT, and JXG are effective for children with tic disorder. They have been approved to be used in this field, of which SZG was approved in 2019, with the most up-to-date research evidence and high-quality RCT in Q1 journals. However, the comparative analysis of the three was affected by many factors, which should be further clarified. Based on the large sample data available in multiple dimensions, a comprehensive comparative evaluation of the three Chinese patent medicines should be carried out, thereby highlighting the advantages and disadvantages of them and serving a reference for rational clinical use and drug supervision.

Participação social na elaboração dos planos municipais de saúde em capitais brasileiras durante a pandemia de COVID-19 / Social participation in the elaboration of municipal health plans in Brazilian capitals during the COVID-19 pandemic

Resumo Este trabalho objetiva analisar se o processo de construção dos planos municipais de saúde (PMS) 2022-2025 das 26 capitais brasileiras e do Distrito Federal (DF) previu a inclusão de tecnologias de informação e comunicação (TICs) para viabilizar a participação cidadã. Foram analisados 37 documentos publicados nos 27 sites das secretarias municipais de Saúde (SMS), à luz da concepção teórica do postulado da coerência, elaborado por Mario Testa para análise do processo de planejamento em saúde. Os resultados evidenciam que dez secretarias adotaram estratégias de mobilização da participação social remota na elaboração do PMS e somente nove disponibilizaram canais virtuais de consulta pública para definição de prioridades no contexto pandêmico. A partir dos documentos analisados, não se identificou a adoção de estratégias pelas SMS, como tendas virtuais, concessão de auxílio para acesso à internet, tablets, espaços para acessos itinerantes, entre outras, como forma de viabilizar e fomentar uma participação social mais abrangente em tempos de crise sanitária.

Abstract This objective work sets out to analyze whether the construction process of the 2022-2025 Municipal Health Plans (MHP) of the 26 Brazilian capitals and the Federal District (FD) provided for the inclusion of information and communication technologies (ICTs) to enable citizen participation. A total of 37 documents published on the 27 websites of the municipal health secretariats (MHS) were analyzed, in the light of the theoretical concept of the Postulate of coherence, elaborated by Mario Testa for analysis of the health planning process. The results show that ten secretariats adopted strategies to monitor remote social participation in the preparation of the MHP and only nine provided virtual channels for public consultation to define priorities in the context of the pandemic. From the documents analyzed, the adoption of MHS strategies was not identified, such as virtual tents, granting assistance for internet access, tablets, spaces for itinerant access, among others, as a way to enable and encourage broader social participation, in health crisis situations.

Una aplicación web de promoción de salud para capacitación virtual de maestros

La capacitación del personal de los centros de estudio es escasa en el área salud bucal, siendo las TIC herramientas válidas para mejorarla. Objetivo: Diseñar una aplicación web sobre el tratamiento inmediato de las lesiones traumáticas bucales en escolares. Método: Se diseñó un protocolo virtual sobre el tratamiento inmediato a niños frente a una lesión traumática dental. Los contenidos siguen un diseño instruccional con un orden lógico de aparición. Resultados: La aplicación se planificó con analistas en TIC con la exigencia de compatibilidad con navegadores y de seguridad informática y lenguaje de programación PHP - Laravel y el motor de base de datos MySQL. Discusión: Los entornos educativos digitales son objetos o artefactos de naturaleza digital en una escenografía concreta, construida social y culturalmente que favorecen experiencias de aprendizaje valiosas. Conclusiones: Se generó una aplicación web de capacitación fomentando la utilidad de recursos educativos abiertos para la promoción de salud bucal.

A formação da equipe dos centros de estudo é escassa na área de saúde bucal, sendo as ferramentas válidas de TIC para melhorá-la. Objetivo: Elaborar uma aplicação web sobre o tratamento imediato de lesões bucais traumáticas em escolares. Método: Um protocolo virtual foi concebido sobre o tratamento imediato de crianças em face frente a uma lesão dentária traumática. O conteúdo segue um design instrutivo com uma ordem lógica de aparência. Resultados: O aplicativo foi planejado com analistas de TIC com a exigência de compatibilidade com navegadores e segurança de computadores e linguagem de programação PHP - Laravel e o mecanismo de banco de dados MySQL. Discussão: Ambientes educativos digitais são objetos ou artefatos de natureza digital em uma cenografia concreta, social e culturalmente construída que favorece valiosas experiências de aprendizagem. Conclusões: Foi gerado um aplicativo de treinamento web promovendo a utilidade dos recursos educacionais abertos para a promoção da saúde bucal.

Effect of acupuncture combined with infantile tuina on intestinal flora in children with tic disorders / 中国针灸

OBJECTIVE@#To observe the effect of acupuncture combined with infantile tuina on intestinal flora and its efficacy in children with tic disorders (TD), and to explore its mechanism.@*METHODS@#A total of 15 children with TD were recruited as an observation group and 10 healthy children as a healthy control group. Regulating spleen and stomach acupuncture combined with infantile tuina were received in the observation group. First, acupuncture was applied to Zhongwan (CV 12), Tianshu (ST 25), Guanyuan (CV 4), Hegu (LI 4), Zusanli (ST 36), etc., and then abdominal massage and other tuina techniques were applied, once a day, 6 times a week, 2 weeks as a course of treatment, a total of 2 courses of treatment were required. No intervention was given in the healthy control group. In the observation group, Yale global tic severity scale (YGTSS) score and TCM syndrome score were compared before treatment and after 1 and 2 courses of treatment. 16S rRNA sequencing technology was used to detect the intestinal flora in the healthy control group and before and after treatment in the observation group.@*RESULTS@#After 1 and 2 courses of treatment, the scores of YGTSS and TCM syndrome in the observation group were lower than those before treatment (P<0.01, P<0.05). Compared with the healthy control group, the number of operational taxonomic units (OTU) and indexes of Chao1, Sobs, Ace and Shannon were decreased in the observation group before treatment (P<0.05, P<0.01). Compared with before treatment, the number of OTU and indexes of Chao1, Sobs, Ace and Shannon were increased in the observation group after treatment (P<0.01, P<0.05). Compared with the healthy control group, the relative abundance of Firmicutes in the observation group before treatment was decreased (P<0.001), while the relative abundance of Bacteroidetes, Bacteroides and Erysipelatoclostridium was increased (P<0.001, P<0.05). Compared with before treatment, the relative abundance of Bacteroidetes in the observation group was decreased (P<0.001) after treatment, while the relative abundance of Actinobacteria, Bifidobacterium and Atopobium was increased (P<0.05, P<0.01).@*CONCLUSION@#Acupuncture combined with infantile tuina based on the principle of regulating spleen and stomach could effectively improve TD symptoms in children, which may be related to regulating the diversity of intestinal flora, increasing beneficial bacteria, maintaining intestinal microecological balance, and playing a role in improving neurological disorders.

Critical junctures and events in the trajectory of information modeling in Curitiba / Coyuntura y eventos críticos en la trayectoria del modelado de información en Curitiba / Conjunturas e eventos críticos na trajetória da modelagem da informação em Curitiba

Abstract Although it is a promising theory for understanding complex ongoing political processes, historical institutionalism has rarely been used to adress urban management and urban planning issues. We aim to (re)construct the trajectory of management and dissemination of communication and information technologies (ICTs) in Curitiba to identify critical junctures and events. Methodologically, it is a case study based on documents and discourse analysis. The results show that Curitiba used to be avant-garde in technological diffusion but today it develops more responsive than anticipatory actions; over time, the role of technology diffusion and management shifted from the urban management and planning structure to the direct municipal administration structure; technological initiatives have always taken place and are taking place sharply and decentrally for the consolidation of an ecosystem; the ideals of forming a digital or a smart city were motivators of Curitiba's current situation. The ideology underlying the game of politicians and party affiliations has been put aside in alignments of local groups to carry out technological adjustments; and that the management and diffusion of ICTs remain controversial in political disputes. The conclusion is that the political-technology dyad has absorbed the impacts of critical events, resulting in the remodeling of municipal institutions and organizations linked to the management and diffusion of ICTs that also need to deal with the game of interests and external pressures.

Resumen Aunque sea una teoría prometedora para comprender procesos políticos complejos en curso, el institucionalismo histórico ha sido poco utilizado en temas de planificación y gestión urbana. Así, el objetivo de este estudio es (re)construir la trayectoria de gestión y difusión de las tecnologías de la información y la comunicación en el municipio de Curitiba para identificar coyunturas y eventos críticos. Metodológicamente, se utilizan los procedimientos de levantamiento documental y análisis del discurso. Los resultados muestran que Curitiba fue vanguardista en difusión tecnológica, pero hoy desarrolla acciones más responsivas que anticipatorias; con el tiempo, el papel de la difusión y gestión de la tecnología pasó de la estructura de gestión y planificación urbana a la estructura de administración municipal directa; las iniciativas tecnológicas siempre se han dado y se están dando de manera acentuada y descentralizada para la consolidación de un ecosistema; los ideales de formar una ciudad digital o una ciudad inteligente fueron motivadores de la coyuntura más reciente; la ideología que subyace al juego de los políticos y las afiliaciones partidarias parece haber sido dejada de lado en alineamientos de grupos locales para realizar ajustes tecnológicos; y que la gestión y difusión de las TIC sigue siendo controvertida en las disputas políticas. La conclusión es que la díada política-tecnología ha absorbido los impactos de los eventos críticos, lo que termina redundando en la remodelación de las instituciones y organismos municipales vinculados a la gestión y difusión de las TIC que también necesitan lidiar con el juego de intereses y las presiones externas.

Resumo Embora seja uma teoria promissora para compreender complexos processos políticos continuados, o institucionalismo histórico tem sido pouco utilizado em questões de gestão e planejamento urbano. Assim, o objetivo deste estudo é (re)construir a trajetória de gestão e difusão tecnologias de comunicação e informação do município de Curitiba para identificar conjunturas e eventos críticos. Metodologicamente, utilizam-se os procedimentos de levantamento documental e análise de discurso. Os resultados mostram que Curitiba foi vanguardista na difusão tecnológica, mas hoje desenvolve ações mais responsivas do que antecipativas; com o passar do tempo o protagonismo da difusão e gestão tecnológica se deslocou da estrutura de gestão e planejamento urbano para a estrutura da administração municipal direta; as iniciativas tecnológicas sempre ocorreram e vêm ocorrendo acentuada e descentralizadamente para a consolidação de um ecossistema; os ideais de formação de uma cidade digital ou uma cidade inteligente foram motivadores da conjuntura mais recente; a ideologia subjacente ao jogo dos políticos e das filiações partidárias parece ter sido posta de lado em alinhamentos dos grupos locais para realizar ajustes tecnológicos; e que a gestão e a difusão de TIC's se mantém controversa nas disputas políticas. A conclusão é que a díade política-tecnologia tem absorvido os impactos dos eventos críticos, o que acaba por resultar na remodelagem das instituições e organizações municipais ligadas à gestão e à difusão das TIC's que também precisam lidar com o jogo de interesses e as pressões externas.

A utilização da plataforma youtube no ensino de sociologia no contexto do ensino remoto / The use of the YouTube platform in Sociology teaching in the context of remote education / La utilización de la plataforma YouTube en la enseñanza de Sociología en el contexto de la enseñanza remota

Durante o ensino remoto emergencial no Brasil diversas tecnologias digitais foram utilizadas por escolas e professores(as), como ferramentas de suporte ao processo de ensino-aprendizagem, dentre elas o YouTube. Este trabalho objetiva analisar de que maneira professores(as) do Distrito Federal adotaram o Youtube nas atividades de Sociologia durante o ensino remoto. Para isso, realizou-se pesquisa de abordagem mista com a aplicação de questionário por meio do Google Forms a 16 professores(as) e a realização de seis entrevistas semiestruturadas por meio do Google Meet. Os resultados apontam uma ampla adoção do Youtube como recurso pedagógico de apoio para o planejamento e a realização das atividades síncronas e assíncronas disponibilizadas pelos(as) professores(as) aos(às) estudantes, assim como um repositório de aulas de Sociologia.(AU)

During the emergency remote education in Brazil several digital technologies were used by schools and teachers as tools to support teaching-learning process, among them the YouTube. This work aims to analyze how teachers of Distrito Federal adopted YouTube in Sociology activities during remote education. For this, a mixed approach search was carried out with the application of questionnaire to 16 teachers and the attainment of 6 semi-structured interviews. The results point out a broad adoption of YouTube as a pedagogical support for the planning and the realization of the synchronous and asynchronous activities made available by the teachers to the students, as well as a repository of Sociology classes.(AU)

Durante la enseñanza remota de emergencia en Brasil diversas tecnologías digitales fueron utilizadas por las escuelas y profesores como herramientas de soporte en el proceso de enseño-aprendizaje, entre ellas el YouTube. Ese trabajo objetiva analizar de qué manera profesores (as) en el Distrito Federal elegirán YouTube en actividades de Sociología durante la enseñanza remota. Para eso, efectuóse una investigación con enfoque mixta con aplicación de cuestionario para 16 profesores (as) y realización de 6 entrevistas semiestructuradas. Los resultados señalan una amplia adopción YouTube como recurso pedagógico de apoyo para la planificación y la realización de actividades sincrónicas y asincrónicas disponibles por los profesores (as) a los estudiantes, así como un repositorio de clases de sociología.(AU)

Diseño de entorno virtual en la asignatura Sistema Nervioso, Endocrino y Reproductor, como apoyo al proceso de enseñanza-aprendizaje / Design of virtual environment in the subject Nervous, Endocrine and Reproductive System as support to the teaching-learning process

RESUMEN Introducción: la utilización del entorno virtual de aprendizaje en la asignatura Sistema Nervioso, Endocrino y Reproductor, por parte de los estudiantes de primer año de la carrera de Medicina, constituye una meta a lograr en el contexto cubano. Esto requiere de tareas que permitan modular el manejo de los entornos virtuales de aprendizaje al perfeccionamiento de las asignaturas presenciales. Objetivo: diseñar un entorno virtual como espacio de aprendizaje en la asignatura Sistema Nervioso, Endocrino y Reproductor. Materiales y métodos : se realizó un estudio observacional descriptivo transversal. La población estuvo constituida por 285 estudiantes. Se le aplicó la encuesta a una muestra de 165 estudiantes, para un nivel de confianza del 95 % y un margen de error del 5. Los individuos se escogieron a través del método de muestreo probabilístico aleatorio simple. Resultados: de modo general, se observó un alto grado de satisfacción en todos los indicadores, destacándose el 3, el 7 y el 9. Conclusiones: el entorno virtual descrito constituye un espacio de aprendizaje importante para los estudiantes -como soporte al proceso de enseñanza-aprendizaje-, valorado con alto grado de satisfacción por los participantes.

ABSTRACT Introduction: the use of a virtual learning environment in the subject Nervous, Endocrine and Reproductive System by first-year students of Medicine, is a goal to be achieved in the Cuban context. This requires tasks which will allow modulating the management of virtual learning environments to the classroom subjects' improvement. Objective: to design a virtual environment as learning space in the subject Nervous, Endocrine and Reproductive System. Materials and methods: a cross-sectional, descriptive, observational study was performed. The population was constituted by 285 students. The survey was applied to a sample of 165 students, for a confidence level of 95 % and an error margin of 5. Individuals were chosen through simple random probabilistic sampling. Results: in general, a high degree of satisfaction was found in all indicators, standing out indicators 3, 7 and 9. Conclusions: the described virtual environment is an important learning space for students-as support to the teaching learning process-, valued with high satisfaction degree by the participants.

Estrategia para la formación investigativa de los estudiantes de Estomatología con el uso de las TIC

Introducción: El uso de las Tecnologías de la Información y las Comunicaciones (TIC) en el proceso de formación investigativa constituye una necesidad para el logro de cambios cualitativos esenciales en la adquisición de conocimientos y habilidades investigativas en los estudiantes. Diagnósticos desarrollados evidenciaron insuficiencias en el desarrollo de la formación investigativa, así como en la concepción de las tareas investigativas en el plan de estudio, que imposibilitan alcanzar los niveles deseados de creatividad. Objetivo: Diseñar una estrategia orientada al desarrollo de la formación investigativa del estudiante de Estomatología soportado en el uso de las TIC. Método: Se realizó una investigación educativa utilizando los métodos empíricos: observación, la encuesta y la entrevista, así como teóricos: inducción-deducción, análisis-síntesis, histórico-lógico, hermenéutico dialéctico, además, del taller de socialización para corroborar la factibilidad de la estrategia propuesta. Resultados: Se propuso una estrategia para la gestión investigativa con el uso de las TIC en la formación investigativa de estudiantes de Estomatología, integrada por tres momentos, etapas y acciones encaminadas al desarrollo de una cultura científico-investigativa-tecnológica sustentada en el uso de las TIC. Conclusiones: La instrumentación de esta propuesta en la práctica pedagógica ha demostrado su factibilidad y la contribución a la formación investigativa de los estudiantes para una mejor solución de los problemas profesionales y, por consiguiente, mayor calidad en la atención de los pacientes que acuden a los servicios estomatológicos.

Introduction: The use of Information and Communication Technologies (ICT) in the research training process constitutes basic needs for students to achieve the essential qualitative changes in the acquisition of knowledge and research skills required. Diagnostics produces carried out showed insufficiencies in the research training process, as well as in the real conception of research tasks implemented in the study program, reducing the possibility to reach the desired levels of creativity. Objective: Elaborate a design strategy aimed to develop the research training process of oral medicine students with the use of the ICT. Method: An educational research was carried out using empirical methods pointed as follow: observation, survey and interview, as well as the theoretical methods: induction-deduction, analysis-synthesis, historical-logical, dialectical hermeneutic, in addition a socialization workshop was used to corroborate the feasibility of the proposal strategy. Results: A strategy for research management with the use of ICTs in the research training of oral medicine students was proposed, consisting on three moments, stages and actions aimed at developing a scientific-research-technological culture based on the use of ICTs. Conclusions: The implementation of this proposal, as a pedagogical practice, has demonstrated its feasibility and contribution in the development of the student research training, and also for a better solution of professional problems and, consequently, higher quality in their care practice with the patients attended in dental services.

Introdução: A utilização das Tecnologias de Informação e Comunicação (TIC) no processo de formação em investigação é uma necessidade para alcançar mudanças qualitativas essenciais na aquisição de conhecimentos e competências de investigação nos alunos. Os diagnósticos desenvolvidos evidenciaram insuficiências no desenvolvimento da formação em investigação, bem como na conceção das tarefas de investigação no plano de estudos, que impossibilitam o alcance dos níveis de criatividade pretendidos. Objetivo: Desenhar uma estratégia orientada para o desenvolvimento da formação investigativa do estudante de Odontologia apoiada no uso das TIC. Método: Foi realizada uma investigação educacional utilizando métodos empíricos: observação, levantamento e entrevista, bem como teóricos: indução-dedução, análise-síntese, histórico-lógico, hermenêutica dialética, além da oficina de socialização para corroborar a viabilidade do estratégia proposta. Resultados: Foi proposta uma estratégia de gestão investigativa com uso de TIC na formação investigativa de estudantes de Odontologia, integrada por três momentos, etapas e ações voltadas para o desenvolvimento de uma cultura científico-investigativa-tecnológica apoiada no uso de TIC. Conclusões: A implementação dessa proposta na prática pedagógica tem demonstrado sua viabilidade e contribuição para a formação investigativa dos alunos para uma melhor solução dos problemas profissionais e, consequentemente, maior qualidade no atendimento aos pacientes que chegam aos hospitais e serviços estomatológicos.