Directiva administrativa que regula el uso de la firma electrónica y de la firma digital en los actos médicos y actos de salud / Administrative directive that regulates the use of electronic signatures and digital signatures in medical acts and health acts

La publicación describe las pautas y disposiciones para el uso de la firma electrónica y de la firma digital como medios de refrendo legal de los documentos electrónicos relacionados con los actos médicos y los actos de salud y para mejorar el funcionamiento de los servicios de salud

Preliminary survey report on the clinical validation of in-use electronic sphygmomanometers in China / 中华心血管病杂志

Objective: To explore the percentage of in-use electronic sphygmomanometers independently validated clinically in China. Methods: We conducted a cross-sectional survey and Beijing, Shenzhen, Shijiazhuang, Datong, and Shihezi were selected according to the geographical location and economic level. In each site, one tertiary hospital, two community health centers, and 20 families with electronic sphygmomanometers in use were chosen. The information of electronic sphygmomanometers including brand, model, manufacturer and production date were obtained by the trained staff. Ten electronic sphygmomanometers from each hospital, five electronic sphygmomanometers from each community health center, and one electronic sphygmomanometer from each family were surveyed, and the user's subjective judgment results and judgment basis on the accuracy of the electronic sphygmomanometer measurement were collected. We searched six registration websites (Medaval, Stride BP, dabl Educational Trust, British and Irish Hypertension Society, American Medical Association and Hypertension Canada) and two research databases (PubMed and CNKI) for the clinical validation status of each electronic sphygmomanometer. Results: A total of 200 electronic sphygmomanometers were investigated in this study, of which only 29.0% (58/200) passed independent clinical validation. When stratified by users, the percentage of being clinical validated was 46.0% (23/50) for electronic sphygmomanometers in hospitals, 42.0% (21/50) for those in community health centers and 14.0% (14/100) for those in home use, respectively, and the proportions between the three groups were significantly difference (P<0.001). Doctors in tertiary hospitals and community health service centers judged the accuracy of electronic sphygmomanometers mainly on the basis of "regular correction" (41.0% (41/100)) and "comparison with other electronic sphygmomanometers" (20.0% (20/100)), while among home users, 41.0% (41/100) were not clear about the accuracy of electronic sphygmomanometers, and 40.0% (40/100) made the judgment by "comparison with the devices in hospitals". Conclusion: The clinical validation of in-use electronic sphygmomanometers in China is low. Most of users, including healthcare professionals, are not aware of clinical validation of electronic sphygmomanometers.

Horas pantallas y miopía en niños / Screen Hours and Myopia in Children

La masificación del Internet y comunicación móvil, así como el mayor acceso a herramientas digitales y de dispositivos electrónicos ha modificado la calidad de vida y salud de la población mundial, con un impacto especialmente importante en los niños. El uso desmedido de pantallas constituye un problema en esta población por su impacto en el sedentarismo, sobrepeso, alteraciones en el comportamiento, trastornos depresivos y del sueño, pero también por el efecto que tiene sobre el sistema visual en desarrollo: predispone a síndrome de ojo seco, a un exceso de acomodación-convergencia, provoca un desenfoque hipermetrópico de la fóvea (se cree que esto estimula el crecimiento axial), aumenta la tensión del cuerpo ciliar y músculos extraoculares, además de los efectos nocivos de la luz azul-violeta para las estructuras intraoculares. Estudios sugieren que los niños son más propensos a desarrollar miopía por estar menos expuestos a la luz natural y pasar más tiempo en ambientes cerrados ante pantallas, muchos incluso han demostrado una asociación entre el uso de pantallas, el trabajo cercano y la presencia de miopía, pero no existen datos concluyentes que aíslen un riesgo independiente. A partir de esta revisión se concluye que la prevalencia de la miopía está aumentando con base en una etiología multifactorial(AU)

The massification of the Internet and mobile communication, as well as increased access to digital tools and electronic devices, have changed the quality of life and health of the world's population, with a particularly important impact on children. The excessive use of screens is a problem among this population because of its impact on sedentary lifestyles, overweight, behavioral alterations, depressive and sleep disorders; but also because of its effect on the developing visual system, since it predisposes to dry eye syndrome, excessive accommodation-convergence, causes hypermetropic defocus at the fovea (this is believed to stimulate axial growth), increases the tension of the ciliary body and extraocular muscles, in addition to the harmful effects of blue-violet light on intraocular structures. Studies suggest that children are more prone to developing myopia because they are less exposed to natural light and spend more time in indoor environments in front of screens; many studies have even shown an association between the use of screens, close-eye work and the presence of myopia, but there are no conclusive data that isolate an independent risk. From this review, the prevalence of myopia is concluded to be increasing based on a multifactorial etiology(AU)

Diagnostic consistency for observing endodontic files in digital radiographs displayed on different electronic devices / 中华口腔医学杂志

Objectives: To evaluate the diagnostic consistency of working lengths by observing endodontic files in root canals and periapical subtle structures in digital intraoral radiographs presented in two smartphones, a tablet and a laptop computer. Methods: A dried human skull embedded in an acrylic compound was used for exposing radiographs of the upper and lower second premolars and first molars with two endodontic files (Kerr files size 10 and 15) positioned to the full length of the roots or 1.5 mm short of apexes. A total of 100 radiographs were taken for each of the file sizes. Five observers were asked to assess all the 200 digital radiographs according to a 5-category scale in smartphone A (HUAWEI P9 Plus), smartphjone B (Apple iPhone 7), tablet (Apple iPad 2018) and laptop computer (Lenovo Thinkpad E480), respectively. The gold standard for receiver operating characteristic curve (ROC) analysis was determined with the endodontic Kerr file size 20. A total of 150 roots with files were radiographed, 75 of which with files reaching the radiographic apexes of the respective roots and 75 of which with files 1.5 mm short of the radiographic apexes for each endodontic file size. Results from ROC analysis was analyzed with one-way ANOVA and independent sample t test. Results: For the Kerr file size 10, the area under the ROC curve for laptop, tablet and two smartphones were 0.891±0.037, 0.869±0.037, 0.870±0.017 and 0.849±0.037, while for the Kerr file size 15 the ROC values were 0.957±0.02, 0.961±0.02, 0.961±0.01 and 0.961±0.02, respectively. There were no significant differences for diagnostic accuracy for observing endodontic file positions among digital radiographs presented in the two smartphones, one tablet and one laptop devices (endodontic file size 10: F=1.39, P=0.281; endodontic file size 15: F=0.05, P=0.985). A significant difference was found in the diagnostic accuracy of endodontic file positions between size 10 and 15 files in different display devices (t=-10.65, P<0.001). Conclusions: There was a high diagnostic consistency in the determination of working length and periapical subtle structures of roots by observing digital radiographs displayed on smartphones, tablet and laptop computer.

Current research progress on health problems and health management of E-sports players / 中华劳动卫生职业病杂志

Electronic sports (E-sports) are series of competitive activities different from the traditional physical sports, and E-sports athlete is becoming a new profession. Along with the fast development of E-sports industry, the number of E-sports athletes increased tremendously. The early retirement of some top-ranking athletes caused by occupational injuries has aroused the societal attentions on the health problems of E-sports athletes. Facing special occupational exposure, E-sports athletes encounter different health issues comparing to the counterparts of their ages. It is necessary to scientifically identify their health hazards and common health issues, in order to conduct effective health management for this particular professional group. This review summarized global literature on health issues and health management on E-sports athletes. The research on their health issues were mainly descriptive and there was a paucity on interventional research and health management. These provide references and directions on the future health services and research on E-sports athletes.

Comprehensive evaluation system for quality of Chinese medicinal decoction pieces based on "experience-ingredients-activity-electronic sensing" / 中国中药杂志

Quality evaluation of Chinese medicinal decoction pieces is vital for the development of the downstream industries, and is an important channel for implementing the strategy of "higher quality, higher price, and priority for the high quality" for traditional Chinese medicine. At the moment, the quality of Chinese medicinal decoction pieces is mainly evaluated based on chemical component examination. Considering the weak preliminary research foundation and poor research conditions, traditional experience-based evaluation is undervalued in the quality rating of Chinese medicinal decoction pieces. However, traditional experience is a summary of the quality of Chinese medicinal materials based on clinical experience, which thus can be a potential basis for the quality evaluation of the decoction pieces. It is a challenge in the evaluation of Chinese medicinal decoction pieces to objectify the traditional experience-based evaluation from multiple aspects such as chemistry, effect, and characterization via modern techniques. Therefore, this study developed the "experience-ingredients-activity-electronic sensing" evaluation system for Chinese medicinal decoction pieces on the basis of experience-based assessment, chemical ingredients that can truly reflect the traditional experience, biological effect assessment, and electronic sensory evaluation, which is expected to quantify the traditional experience of quality evaluation of Chinese medicinal decoction pieces via chemistry, biology, and sensory simulation. The evaluation system can serve as a reference for clinical experience-based quality evaluation of Chinese medicinal decoction pieces.

Precisão de réguas endodônticas milimetradas e orifício calibrador, e avaliação da regularidade da superfície do orifício calibrador / Accuracy of endodontic millimeter rulers and calibrator hole, and evaluation of the regularity of the calibrator hole surface

Objetivo: O objetivo desse artigo foi avaliar a precisão das porções milimetrada e calibradora das réguas endodônticas, e avaliar a regularidade da superfície dos orifícios calibradores. Métodos: A porção milimetrada das réguas Angelus, Maillefer, Maquira, Microdont e Prisma foi avaliada com paquímetro eletrônico digital. Os orifícios calibradores da Maillefer, Prisma e Angelus foram medidos com um projetor de perfil. A regularidade da superfície dos orifícios calibradores foi classificada em S1 ­ sem irregularidades ou S2 ­ com regularidades. A análise de precisão das porções milimetrada e calibradora foi realizada com o teste t (p=0,05); e as frequências dos tipos de superfície, com o teste do qui-quadrado (p<0,05). Resultados: A Maillefer foi a única régua endodôntica com precisão em todos os comprimentos e orifícios. A Prisma apresentou estatisticamente mais orifícios do tipo S2, quando comparada com outras réguas endodônticas avaliadas (p<0,05). Não houve diferença estatisticamente significativa entre Angelus e Maillefer (p>0,05). Conclusão: A Maillefer apresentou precisão nas porções milimetrada e calibradora. As réguas endodônticas da Angelus não foram precisas em nenhum comprimento da parte milimetrada e não foram precisas na maioria dos orifícios calibradores. A régua endodôntica Prisma mostrou significativamente mais orifícios calibradores com irregularidades na superfície do que Angelus e Maillefer. Destaca-se a necessidade de controle de qualidade e padrões específicos para fabricação das réguas endodônticas (AU).

Objective: The aim was to evaluate the accuracy of the millimeter and calibration portion and evaluate the regularity of the calibrator orifice surfaces of the endodontic rulers. Methods: The millimeter portion of the Angelus, Maillefer, Maquira, Microdont and Prisma rulers was evaluated with an electronic digital caliper. The calibration holes of the Maillefer, Prisma and Angelus were measured with Profile Projector. The surface regularity of calibration holes was evaluated and classified in S1- without irregularities and S2- with irregularities. The accuracy analysis of the millimeter and calibration was performed with T-Test (p=0.05) and the frequencies of the surface types with Chi-square (p<0.05). Results: The Maillefer was the only rulers with accuracy in all lengths and holes. Prisma presented statistically more S2 type holes when compared with other endodontic rulers evaluated (p <0.05). There was no statistically significant difference between Angelus and Maillefer (p> 0.05). Conclusion: The Maillefer presented accuracy in the millimeter and calibration portion. Angelus endodontic rulers were not accurate at any rated length of the millimeter portion and it was not accurate in most calibration holes evaluated. Prisma endodontic ruler showed significantly more calibration holes with irregular surfaces than Angelus and Maillefer. We emphasize the need for quality control and specific standards for endodontic rulers manufacturing (AU).

Guías de Práctica Clínica en Cirugía Pediátrica / Clinical Practice Guidelines in Pediatric Surgery

Promovidos y coordinados por la Sociedad Cubana de Cirugía Pediátrica y el Grupo Asesor Nacional de la especialidad, entre los años 1999 y 2004 se desarrollaron cuatro eventos denominados Talleres Nacionales de Buenas Prácticas Clínicas en Cirugía Pediátrica. El resultado final fue la discusión de más de treinta guías de práctica clínica, veintidós de las cuales se publicaron en el año 2005 en un número especial de la revista electrónica cubana Medisur.1 , 2Desde entonces, esos trabajos sirvieron de referencia en la labor de los servicios de cirugía pediátrica a lo largo y ancho de la nación(AU)

Desempenho motor e índice de massa corporal em crianças de cinco anos / Motor performance and body mass index in children of five years

As crianças estão cada vez mais utilizando brincadeiras e jogos eletrônicos, passando muitas horas diante da televisão e isso pode atrapalhar o processo de desenvolvimento motor bem como o desenvolvimento do processo de sobrepeso e obesidade. A educação física escolar é um importante aliado na promoção de hábitos de vida mais ativos, sendo a educação infantil a primeira etapa de escolarização e prática de atividades motoras desta fase é fundamental. O objetivo desse estudo foi avaliar o índice de massa corporal (IMC) e o desempenho motor de escolares com idade de cinco anos dos Centros Municipais de Educação Infantil em Divinópolis/MG. O desempenho motor foi avaliado com o Teste de Coordenação Corporal para Crianças (Körperkoodinations test Für Kinder ­ KTK) composto por quatro testes: equilibrar-se andando de costas, saltos monopedais, saltos laterais e transposição lateral sobre plataforma. O IMC foi calculado a partir de medidas de peso e altura. Os resultados do presente estudo demonstram que 80,65% da amostra apresenta deficiência na coordenação motora, e quando comparado entre os sexos, os meninos apresentaram melhor coordenação motora que as meninas. Ao analisar o IMC e a coordenação motora não foi encontrada qualquer relação significativa entre eles. Pode-se concluir com o presente estudo que o IMC não influenciou no desempenho motor dos alunos, e que a maioria dos alunos está com a coordenação motora abaixo do esperado. A falta de aulas de educação física com o professor especialista e estímulos específicos para o desenvolvimento motor podem ter contribuído para os resultados encontrados neste estudo, reforçando a necessidade do professor de educação física n o ensino infantil.(AU)

: Children are increasingly using games and electronic games, spending many hours in front of the television and this can hinder the process of motor development as well as the development of overweight and obesity. School physical education is an important ally in the promotion of more active life habits, with early childhood education being the first stage of schooling and the practice of motor activities in this phase is fundamental. The objective of this study was to evaluate the body mass index (BMI) and the motor performance of schoolchildren aged five years old from the Municipal Centers of Early Childhood Education in Divinópolis / MG. Motor performance was assessed with the Body Coordination Test for Children (Körperkoordinations test Für Kinder - KTK) composed of four tests: balance on your back, single-legged jumps, lateral jumps and lateral transposition on a platform. BMI was calculated from weight and height measurements. The results of the present study showed that 80.65% of the sample has impaired motor coordination, and when compared between genders, boys showed better motor coordination than girls. When analyzing BMI and motor coordination, no significant relationship was found between them. It can be concluded with the present study that the BMI did not influence the motor performance of the students, and that the majority of the students have motor coordination below the expected. The lack of physical education classes with the specialist teacher and specific stimuli for motor development may have contributed to the results found in this study, reinforcing the need for physical education teachers in early childhood education.(AU)

Multiprofessional electronic protocol for digestive surgery validation / Validação de protocolo eletrônico multiprofissional para cirurgia do aparelho digestivo

Abstract Background: The creation of a computerized clinical database with the ability to collect prospective information from patients and with the possibility of rescue and crossing data enables scientific studies of higher quality and credibility in less time. Aim: To validate, in a single master protocol, the clinical data referring to Surgery of Digestive System in a multidisciplinary way, incorporating in the SINPE© platform, and to verify the incidence of digestive diseases based on the prospectively performed collections. Method: Organize in one software, in a standardized structure, all the pre-existing items in the SINPE© database; the theoretical basis was computerized through the MIGRASINPE© module creating a single multiprofessional master protocol for use as a whole. Results: The existing specific protocols were created and/or adapted - they correspond to the most prevalent digestive diseases - unifying them. The possibility of multiprofessional use was created by integrating all data collected from medicine, nursing, physiotherapy, nutrition and health management in a prospective way. The total was 4,281 collections, distributed as follows: extrahepatic biliary tract, n=1,786; esophagus, n=1015; anorectal, n=736; colon, n=550; small intestine, n=86; pancreas, n=71; stomach, n=23; liver, n=14. Conclusions: The validation of the unification and structuring in a single master protocol of the clinical data referring to the Surgery of the Digestive System in a multiprofessional and prospective way was possible and the epidemiological study carried out allowed to identify the most prevalent digestive diseases.

RESUMO Racional: A criação de um banco de dados clínicos informatizado com a capacidade de coletar informações dos pacientes de forma prospectiva e com possibilidade de resgate e cruzamento viabiliza estudos científicos de maior qualidade e credibilidade em menor tempo. Objetivos: Validar em único protocolo mestre os dados clínicos referentes à Cirurgia do Aparelho Digestivo de forma multiprofissional incorporando-o na plataforma SINPE©, e verificar a incidência das doenças digestivas com base nas coletas prospectivamente realizadas. Método: Organizar no software em estrutura padronizada todos os itens pré-existentes no banco de dados do SINPE©, informatizar a base teórica através do módulo MIGRASINPE© criando-se um único protocolo mestre multiprofissional para uso como um todo. Resultados: Foram criados e/ou adaptados os protocolos específicos existentes que correspondem às doenças digestivas mais prevalentes unificando-os. Criou-se a possibilidade de uso multiprofissional integrando todos os dados coletados da medicina, enfermagem, fisioterapia, nutrição e gestão em saúde de maneira prospectiva. O total foi de 4.281 coletas assim distribuídas: vias biliares extra-hepáticas, n=1.786; esôfago, n=1015; anorretais, n=736; cólon, n=550; intestino delgado, n=86; pâncreas, n=71; estômago, n=23; fígado, n=14. Conclusões: A validação da unificação e estruturação em único protocolo mestre dos dados clínicos referentes à Cirurgia do Aparelho Digestivo de forma multiprofissional e prospectiva foi possível e o estudo epidemiológico realizado permitiu identificar as doenças mais prevalentes nesse aparelho.

The electronic media and the study profile of the surgical resident / A mídia eletrônica e o perfil de estudo do residente em cirurgia

ABSTRACT Objective: this study analyzed the surgical resident's study profile by assessing the use of electronic media. 44.76% of the physicians agreed on participating. Methods: observational, cross-sectional non-controlled study. Statistical analysis was performed using Pearson's correlation coefficient and the significance level for the statistical tests was p <0.001. Results: 87.2% of the residents believed that it is interesting to use e-learning together with the classical theoretic classes. 45% of the interviewed claimed to spend more than 3 hours on the Internet daily. Conclusion: residents recognize the importance of technology for education, but not as a way of replacing the traditional teaching methods.

RESUMO Objetivo: este trabalho analisou o perfil de estudo dos residentes em Cirurgia, caracterizando o uso das mídias eletrônicas, por meio de questionário padronizado, com índice de resposta de 44,76%. Métodos: estudo descritivo, observacional transversal, sem grupo controle. O coeficiente de correlação de Pearson foi usado para a análise estatística e o nível de significância adotado foi de p <0,001. Resultados: observou-se que 87,2% dos residentes julgaram interessante associar o e-learning às aulas teóricas. Sobre o tempo despendido no uso de tecnologia, 45% referiram usar internet mais de 3 horas por dia. Conclusão: a partir dessa pesquisa, pode-se observar que os residentes atribuem importância à tecnologia em sua formação, todavia sem substituir o ensino tradicional.

Development and Clinical Application of Portable Electronic Endoscope / 中国医疗器械杂志

Electronic endoscope is one of the crucial tools for minimally invasive diagnosis and treatment. Along with the continuous development of clinical applications, conventional electronic endoscope has not been able to meet all the clinical requirements. In recent years, with the rapid development of the material, sensor and electronic technologies, electronic endoscope has attracted many researchers and companies' attention. Nowadays, because of being suitable for some special mobile medical scenes like field operations, natural calamities and hospital first aids, various portable electronic endoscopes have been developed and applied in clinic. The present study aims to give a review on portable electronic endoscopes development and clinical applications.

Evaluation on monitoring effect of the electronic vaccine vial monitor label / 生物医学工程学杂志

The cold chain safety of vaccines is a global issue. The electronic vaccine vial monitor (eVVM) label can monitor the temperature of vaccines in real time and provide "early warning" prompts. In order to comprehensively evaluate the monitoring efficiency of eVVM, this study selected 75 eVVM labels and distributed them with a total of 600 vaccine vial monitor (VVM) labels of four different types in different experimental environment (2-8℃, -20℃ and 40℃), and used a temperature recorder as "gold standard". The results showed that the accuracy of the eVVM labels and VVM labels in high temperature environment was as same as that of the temperature recorder (

Design and Implementation of Multifunctional Interactive Electronic Bedside Card System for Inpatients Based on Internet of Things Technology / 中国医疗器械杂志

This research is based on data from clinical information systems such as HIS, EMR, LIS, etc, based on the functions of the traditional paper bedside card, relying on wired network technology, using the Internet of Things technology to design and develop a multi-functional intelligent interactive electronic bedside card system for inpatients. The functional framework of the system is introduced and discussed in detail, and the design is carried out from several aspects of system architecture, network architecture, software architecture, database and software system. The results show that the system has stable performance and can ensure the real-time and accuracy of medical information. The implementation of the system can fully meet the needs of clinical first-line ward management, reduce the workload of nursing staff, improve work efficiency, and reduce the possibility of medical accidents. At the same time, it can facilitate patients to see their own health information, improve patient experience. It has important guiding significance for the development of ward management and hospital information construction.

Design and Implementation of Multifunctional Interactive Electronic Bedside Card System for Inpatients Based on Internet of Things Technology / 中国医疗器械杂志

This research is based on data from clinical information systems such as HIS, EMR, LIS, etc, based on the functions of the traditional paper bedside card, relying on wired network technology, using the Internet of Things technology to design and develop a multi-functional intelligent interactive electronic bedside card system for inpatients. The functional framework of the system is introduced and discussed in detail, and the design is carried out from several aspects of system architecture, network architecture, software architecture, database and software system. The results show that the system has stable performance and can ensure the real-time and accuracy of medical information. The implementation of the system can fully meet the needs of clinical first-line ward management, reduce the workload of nursing staff, improve work efficiency, and reduce the possibility of medical accidents. At the same time, it can facilitate patients to see their own health information, improve patient experience. It has important guiding significance for the development of ward management and hospital information construction.

Quality analysis of Citri Trifoliatae Fructus in different harvest time by HPLC combined with electronic eye technology / 中国中药杂志

As a local variety of medicinal material, Citri Trifoliatae Fructus is widely used in many places, whereas its harvest time remains unclear. Therefore, studying its harvest time can make more reasonable use of this medicinal material. In this study, we determined the flavonoids content and compared the color of Citri Trifoliatae Fructus harvested in different time, aiming to guide the harvest of this medicinal material. The fresh fruits of Citrus trifoliata were collected from Xinxiang city, Henan province, graded according to the diameter range, and then dried. The contents of isonaringin, naringen, and poncirin in Citri Trifoliatae Fructus were determined by HPLC, and the color values of the samples were detected by electronic eye. The correlation analysis of the obtained data was carried out to explore the relationships of color and diameter with quality. The results showed that the contents of isonaringin, naringen, and poncirin varied significantly in different harvest time, within the ranges of 0.21-1.20, 2.21-11.59, and 3.73-23.16 mg·g~(-1), respectively. With the delay of harvest time, Citri Trifoliatae Fructus showed the color changing from green to yellow, gradually increased diameter, and gradually decreased contents of isonaringin, naringen, and poncirin. The contents of isonaringin, naringen, and poncirin were negatively correlated with the degree of red and green(a~*) and positively correlated with the degree of yellow and blue(b~*). The contents of naringen and poncirin had significantly negative correlations with the diameter. This study indicates that the quality of Citri Trifoliatae Fructus can be judged by its diameter and skin color, which provides a theoretical basis for the rational harvest of this medicinal material.

The use of an electronic medication organizer device with alarm to improve medication adherence of older adults with hypertension / Uso de um dispositivo eletrônico organizador de medicamentos com alarme para melhorar a adesão medicamentosa de idosos com hipertensão

ABSTRACT Objective: To examine whether the use of a monthly electronic medication organizer device equipped with an alarm clock, called Electronic System for Personal and Controlled Use of Medications (Supermed), improves medication adherence of older adults with hypertension. Methods: This is a quali-quantitative, prospective, before-and-after study performed with 32 older adult patients with diagnosis of hypertension, who were recruited at a Primary Care Unit in Brazil. Results: The main outcome measures were improvement of medication adherence and blood pressure control after intervention with Supermed. Regarding medication adherence, 81.2% of patients were "less adherent" in the pre-intervention period, and 96.9% were "more adherent" in the post-intervention period. This means that 78.1% of patients changed from "less adherent" to "more adherent" after the intervention with Supermed (p<0.001). The mean systolic and diastolic blood pressure differences between intervention day and post-intervention were 18.5mmHg (p<0.0001) and 4.3mmHg (p<0.007), respectively, and the differences between mean systolic and diastolic blood pressure between pre-intervention and post-intervention were 21.6mmHg (p<0.001) and 4.7mmHg (p<0.001) respectively. Conclusion: The use of Supermed significantly improved self-reported medication adherence and blood pressure control in a hypertensive older adult population.

RESUMO Objetivo: Avaliar se o uso de um dispositivo organizador de medicamentos eletrônico, mensal, equipado com um despertador, chamado Sistema Eletrônico para Uso Personalizado e Controlado de Medicamentos (Supermed), melhora a adesão à medicação de idosos com hipertensão. Métodos: Trata-se de um estudo qualiquantitativo, prospectivo, antes e depois, realizado com 32 pacientes idosos, com diagnóstico de hipertensão, recrutados em uma Unidade Básica de Saúde do Brasil. Resultados: Os principais desfechos foram a melhor adesão à medicação e o controle da pressão arterial após a intervenção com Supermed. Quanto à adesão medicamentosa, 81,2% dos pacientes eram "menos aderentes" no período pré-intervenção, e 96,9% eram "mais aderentes" no período pós-intervenção. Isso significa que 78,1% dos pacientes mudaram de "menos aderentes" para "mais aderentes" após a intervenção com Supermed (p<0,001). As diferenças da pressão arterial sistólica e diastólica média entre o dia da intervenção e pós-intervenção foram 18,5mmHg (p<0,0001) e 4,3mmHg (p<0,007), respectivamente, e as diferenças entre as médias da pressões arteriais sistólica e diastólica entre os períodos pré-intervenção e pós-intervenção foram de 21,6mmHg (p<0,001) e 4,7mmHg (p<0,001), respectivamente. Conclusão: O uso de Supermed melhorou de forma significativa a adesão medicamentosa e o controle da pressão arterial em uma população idosa hipertensa.

"Bem-vindos à Summoner's Rift": apontamentos sobre o processo de profissionalização do League of Legends / "Welcome to Summoner's Rift": notes about League of Legends professionalization process

RESUMO Com o desenvolvimento dos jogos eletrônicos nos últimos anos, o jogo League of Legends passou a se destacar com sua estrutura de campeonato e número de jogadores e espectadores. Percebeu-se que, desde o ano de seu lançamento, em 2009, houve uma profissionalização do jogo, com alguns jogadores sendo considerados profissionais. Pensando nisso, o objetivo deste trabalho foi analisar como a profissionalização do League of Legends no contexto dos esportes eletrônicos tem sido tratada em referenciais das áreas que abordam a temática. A metodologia utilizada foi a exploratória descritiva, em que, através de leitura de títulos, resumos e artigos propriamente ditos, selecionou-se vinte artigos para uma revisão de literatura. Concluiu-se, assim, que a profissionalização do jogo League of Legends se deu por conta de dois agentes: a criação das ligas oficiais da Riot Games, chamada de League of Legends Championship Series (LCS), e a especialização dos jogadores em posições específicas.

ABSTRACT With the development of electronic games in recent years, the game League of Legends stood out for its championship structure and number of players and spectators. It was noticed that, since its release, in 2009, the game went through a process of professionalization, with some players being considered as professionals. Therefore, the aim of this paper was to understand how the professionalization of the game League of Legends has been treated in published papers about the theme. The methodology used was exploratory descriptive, in which, through the reading of titles, abstract and articles, it was selected twenty articles for a literature review. Thus, it was found that the professionalization of League of Legends is linked to two factors: the launch of the League Championship Series (LCS) and its other leagues scattered in other regions, allowing players to earn wages, and the specialization of players in specific positions within the game.

Low back pain in adolescents and association with sociodemographic factors, electronic devices, physical activity and mental health / Lombalgia em adolescentes e associação com fatores sociodemográficos, dispositivoseletrônicos, atividade física e saúde mental

Abstract Objectives: To determine the prevalence of low back pain and to analyze the association with the individual, sociodemographic variables, electronic devices, habitual practice of physical activity, and mental health problems. Methods: Cross-sectional study with 1,628 students in public schools in the city of Bauru, SP, Brazil. The following data were collected: 1. demographic and socioeconomic aspects; 2. Use of electronic devices; 3. habitual physical activity level (Baecke); 3. mental health (SDQ). 4. low back pain (Nordic Questionnaire). Descriptive analyzes and bivariate and multivariate logistic regression were used. Results: The overall prevalence of low back pain was 46.7% (95% CI: 44.27 to 49.11); men showed a prevalence of 42.0% (95% CI: 36.63 to 43.41) and women 58.0% (95% CI: 49.73 to 56.51), a statistically significant difference. The variables associated with pain in the low back region were: female gender (PR = 1.70), daily TV use for more than 3 hours (PR = 1.17), use of laptop computer (PR = 1.40), use of the cell phone in the supine position (PR = 1.23), use of the cell phone in semi-supine position (PR = 1.49), daily cell phone use for more than 3 hours (PR = 1.36), use of tablet (PR = 1.67), daily tablet use for more than above 3 hours (PR = 1.46), and clinically important mental health problems (PR = 2.62). Conclusion: There is a high prevalence of low back pain in high school students and striking association with female sex, electronic devices, and mental health problems.

Resumo Objetivos: Determinar a prevalência de lombalgia e analisar a associação com variáveis individuais e sociodemográficas, dispositivos eletrônicos, prática habitual de atividade física e problemas de saúde mental. Métodos: Estudo transversal com 1.628 alunos matriculados em escolas públicas na cidade de Bauru/SP. Para a coleta de dados: 1. aspectos demográficos e socioeconômicos; 2. dispositivos eletrônicos; 3. nível habitual de atividade física (Baecke); 3. saúde mental (SDQ); 4. Lombalgia (Questionário Nórdico). Foram usadas análises descritivas e de regressão logística bivariada e multivariada. Resultados: A prevalência geral de lombalgia foi 46,7% (IC de 95%: 44,27 a 49,11), os homens mostraram uma prevalência de 42,0% (IC de 95%: 36,63 a 43,41) e as mulheres mostraram uma prevalência de 58,0% (IC de 95%: 49,73 a 56,51), com diferença significativa. As variáveis associadas a dor na região lombar inferior foram: sexo feminino (RP = 1,70), tempo de uso de TV acima de 3 horas por dia (RP = 1,17), uso de notebook (RP = 1,40), uso de celular na posição supina (RP = 1,23), uso de celular na posição semissupina (RP = 1,49), tempo de uso de celular acima de 3 horas por dia (RP = 1,36), uso de tablet (RP = 1,67), tempo de uso de tablet acima de 3 horas por dia (RP = 1,46) e problemas de saúde mental clinicamente importantes (RP = 2,62). Conclusão: Há alta prevalência de lombalgia em alunos do ensino médio e forte associação ao sexo feminino, dispositivos eletrônicos e problemas de saúde mental.

Influence of different coronal preflaring protocols on electronic foramen locators precision

Abstract: The aim of this study was to evaluate the influence of different coronal preflaring protocols (absent, conservative and conventional) on the accuracy of Root ZX II, Raypex 6, and RomiApex A-15 electronic foramen locators (EFLs). Twenty mandibular molars with Vertucci's type IV mesial roots were subjected to endodontic exploration and foraminal patency confirmation. Under 16x magnification, its real lengths (RL) were measured and registered (RL1). The canals were then irrigated with 2.5% sodium hypochlorite and electronically measured (EM1) employing the alginate model; all measurements were performed in triplicate by a blind operator using adjusted endodontic hand-files introduced until the apex foramen. Coronal preflaring procedures were sequentially performed with #25/.06 (conservative) and #25/.12 (conventional) instruments; new RLs extents were performed after each coronal preparation protocol (RL2/RL3), as same as electronic measurements (EM2/EM3). The devices error (mm) was evaluated considering the difference between RLs and EMs at each preparation stage; their precision was stablished adopting ±0.5 mm as tolerance margin. The EFLs error significantly reduced after conventional coronal preflaring protocol (p<0.05), which not occur after the conservative one. The best precisions values were noted after conventional preparation as 90% (Root ZX II), 97.5% (Raypex 6), and 92.5% (RomiApex A-15). No significant differences were found in EFLs comparisons, regardless of the coronal protocol tested (p>0.05). Under the conditions tested it can be concluded that the EFLs evaluated were precise. Moreover, the preflaring protocols influences its accuracy's, where the less conservative one produced the best results.

Resumo O objetivo deste estudo foi avaliar a influência de diferentes protocolos de pré-alargamento cervical (ausente, conservador e convencional) na precisão dos localizadores eletrônicos foraminais (LEFs) Root ZX II, Raypex 6 e RomiApex A-15. Vinte molares inferiores com raízes mesiais do tipo IV de Vertucci foram submetidos à exploração endodôntica e confirmação da patência foraminal. Sob ampliação de 16x, seus comprimentos reais (CR) foram medidos e registrados (CR1). Os canais foram então irrigados com hipoclorito de sódio a 2,5% e medidos eletronicamente (ME1) utilizando o modelo em alginato; todas as medidas foram realizadas em triplicata por um operador cego, utilizando limas endodônticas ajustadas introduzidas até o forame apical. Os procedimentos de pré-alargamento cervical foram realizados sequencialmente com os instrumentos #25/.06 (conservador) e #25/.12 (convencional); novas determinações de CRs foram realizadas após cada protocolo de preparação cervical (CR2/CR3), da mesma forma que as medidas eletrônicas (ME2/ME3). O erro dos dispositivos (mm) foi avaliado considerando a diferença entre CRs e MEs em cada estágio de preparação; sua precisão foi estabelecida adotando ± 0,5 mm como margem de tolerância. O erro dos LEFs reduziu significativamente após o protocolo convencional de alargamento cervical (p<0,05), o que não ocorreu após o conservador. Os melhores valores de precisão foram observados após a preparação convencional como 90% (Root ZX II), 97,5% (Raypex 6) e 92,5% (RomiApex A-15). Não foram encontradas diferenças significantes nas comparações entre os LEFs, independentemente do protocolo cervical testado (p>0,05). Sob as condições testadas, pode-se concluir que os LEFs avaliados foram precisos. Além disso, os protocolos de alargamento influenciam sua precisão, onde o menos conservador produziu os melhores resultados.