OSCE 3D: a virtual clinical skills assessment tool for coronavirus pandemic times / OSCE 3D: uma ferramenta virtual de avaliação de habilidades clínicas para tempos de pandemia de coronavírus

Abstract: Introduction: In pandemic times, in which the "lockdown strategy" has been adopted, the use of innovations using technological resources such as the creation of instruments that can replace traditional teaching-learning methods in the training of health professionals is essential. Objective: the aim of this study was to develop and evaluate the usability of a realistic interactive simulation computer system using three-dimensional imaging technology and virtual reality with free-access computational tools available on the web. Methods: the development of a prototype (OSCE 3D) was based on the steps used for the construction of a "Serious Game" simulation software. The free-access version of the Unity Editor 3D platform (Unity Technologies, version 2018), used for developing educational games, the software GNU Image Manipulation Program (GIMP, version 2.10.12), Blender (version 2.79) and MakeHuman (version 1.1.1) were utilized for creating textures and building models of the 3D environments. An experimental phase was carried out to assess usability, through a questionnaire based on the System Usability Scale. The study was approved by the Research Ethics Committee of the institution and all participants signed the Informed Consent Form. Results: a total of 39 undergraduate medical students attending the 6th semester of a private university center of northeastern Brazil voluntarily participated in the evaluation of the OSCE 3D. The usability evaluation resulted in a mean score of 75.4 with a margin of error of 3.2, which is considered a good usability score according to the literature. Conclusions: this study allowed the development of a low-cost prototype, using a three-dimension realistic simulation system for clinical skills assessment. This product, even in the prototype phase, showed good usability.

Resumo: Introdução: Em tempos de pandemia em que a "estratégia de bloqueio" tem sido adotada, é imprescindível a utilização de inovações utilizando recursos tecnológicos como a criação de instrumentos que possam substituir os métodos tradicionais de ensino-aprendizagem na formação dos profissionais de saúde. Objetivo: o objetivo deste estudo foi desenvolver e avaliar a usabilidade de um sistema computacional de simulação interativa realista utilizando tecnologia de imagem tridimensional e realidade virtual com ferramentas computacionais de acesso livre disponíveis na web. Métodos: o desenvolvimento de um protótipo (OSCE 3D) baseou-se nas etapas utilizadas para a construção de um software de simulação de um "Serious Game". Foi utilizada a versão de acesso livre da plataforma Unity Editor 3D (Unity Technologies, versão 2018) para o desenvolvimento de jogos educacionais, software GNU Image Manipulation Program (GIMP, versão 2.10.12), Blender (versão 2.79) e MakeHuman (versão 1.1 .1) para criar texturas e modelos de construção de ambientes 3D. Uma fase experimental para avaliação da usabilidade foi realizada por meio de um questionário baseado na Escala de Usabilidade de Sistema. O estudo foi aprovado pelo Comitê de Ética em Pesquisa da instituição e todos os participantes assinaram o Termo de Consentimento Livre e Esclarecido. Resultados: um total de 39 alunos de graduação do 6º semestre de uma universidade privada do Nordeste do Brasil participaram voluntariamente da avaliação do OSCE 3D. A avaliação de usabilidade resultou em pontuação média de 75,4 com margem de erro de 3,2, sendo esta considerada uma boa usabilidade de acordo com a literatura. Conclusões: este trabalho permitiu o desenvolvimento de um protótipo de baixo custo, utilizando um sistema de simulação realista tridimensional para avaliação de habilidades clínicas. Este produto, ainda em fase de protótipo, apresentou boa usabilidade.

Local development versus neoliberal globalization project: reflecting on market-oriented cities / Desarrollo local frente al proyecto de globalización neoliberal: reflexión sobre las ciudades orientadas al mercado / Desenvolvimento local versus projeto de globalização neoliberal: refletindo sobre cidades orientadas ao mercado

Abstract The purpose of this article is to discuss what has being disseminated and reproduced as local development, seeking to understand the problems arising from this phenomenon, particularly highlighting the promotion of market-oriented cities. We question the processes of development and public policies, advancing in the debate based on Karl Polanyi's double-movement thesis duly revisited and updated historically and geographically. As contributions, we highlight the engagement with de-coloniality to treat temporal and geo-epistemic gaps of the Polanyian thesis. In addition, it is possible to identify that the Polanyian counter-movement depends on the actions of several social actors, with emphasis on societies and governments, through public policies.

Resumen El propósito de este ensayo es discutir lo que ha sido propagado y reproducido como desarrollo local, con el objetivo de aproximar y comprender los problemas resultantes de este fenómeno, al destacar especialmente la promoción de la formación de ciudades orientadas al mercado. Se busca cuestionar los procesos de desarrollo y las políticas públicas, promover el debate con base en la tesis de doble movimiento de Karl Polanyi, debidamente revisada y actualizada histórica y geográficamente. Como contribuciones, se destacan el compromiso con la decolonialidad para el tratamiento de las lagunas temporales y geoepistémicas de la tesis de Polanyi. Además, es posible identificar que el contramovimiento polanyiano de mercado depende de la acción de distintos actores sociales, con énfasis en las sociedades y gobiernos, a través de políticas públicas.

Resumo O objetivo deste artigo é discutir o que vem sendo propagado e reproduzido como desenvolvimento local, procurando aproximar e compreender os problemas decorrentes desse fenômeno, sobretudo ao destacar o fomento à formação de cidades orientadas ao mercado. Busca-se questionar os processos de desenvolvimento e políticas públicas, avançando no debate com base na tese de duplo movimento de Karl Polanyi, devidamente revisitada e atualizada histórica e geograficamente. Como contribuição, destaca-se o engajamento na decolonialidade para tratar lacunas temporais e geoepistêmicas da tese polanyiana. Ademais, pode-se identificar que o contramovimento polanyiano de mercado depende da ação de diversos atores sociais, com destaque para sociedades e governos, por meio de políticas públicas.

Morte súbita cardíaca: perfil epidemiológico na região metropolitana de Goiânia / Sudden cardiac death: epidemiological profile in the metropolitan area of Goiania

Introdução: A morte súbita cardíaca é um evento de grande importância e repercussão na saúde pública e se configura como a manifestação mais letal de uma doença cardíaca. Este estudo teve como objetivo traçar as características da morte súbita cardíaca na região metropolitana de Goiânia (GO).Método: O presente estudo analisou 2.681 relatórios completos de necropsia, dos quais 314 foram selecionados como morte súbita cardíaca.Foram coletados dados como sexo das vítimas, faixa etária, local e horário do óbito, presença de tabagismo, além das comorbidades hipertensão arterial sistêmica, diabetes melito, dislipidemia e histórico de doença de Chagas. Resultados: Dos 314 casos de morte súbita cardíaca, os mais acometidos foram homens, entre a sexta e a sétima décadas de vida. O local em que houve mais casos foi o domicílio, ocorrendo a maioria no período matutino. A hipertensão foi a comorbidade mais prevalente, com alta proporção (58,9%). Mais de 10% dos pacientes apresentavam histórico de doença de Chagas. Conclusão: Percebe-se a importância de um maior entendimento da morte súbita cardíaca dentro da realidade da região metropolitana estudada. Entender o perfil epidemiológico local é um passo fundamental para que estratégias preventivas sejam implementadas pelas lideranças políticas

Background: Sudden cardiac death is an important event which has an impact on public health and is the most lethal manifestation of heart disease. This study is aimed at describing the characteristics of sudden cardiac death in the metropolitan area of Goiania (GO). Methods: This study examined 2,681 necropsy reports of which 314 were selected as sudden cardiac death. Data such as gender, age, location and time of death, presence of smoking, comorbidities such as hypertension, diabetes mellitus, dyslipidemia and Chagas disease history were collected. Results: Among 314 cases of sudden cardiac death, the most affected patients were males, between 60 and 70 years of age. The most common location for the event was the patient's own house, and most of them occurred in the morning. Hypertension was the most prevalent comorbidity, with a high incidence (58.9%). More than 10% of the patients had a history of Chagas disease. Conclusion: A better understanding of sudden cardiac death in the metropolitan area should be further studied. Understanding the local epidemiological profile is a crucial step towards the development of preventive strategies that must be implemented by political leaders

Renewable energy and greenhouse gas emissions from the waste sectors of European Union member states: a panel data analysis.

In the last two decades, there has been a rich debate about the environmental degradation that results from exposure to solid urban waste. Growing public concern with environmental issues has led to the implementation of various strategic plans for waste management in several developed countries, especially in the European Union. In this paper, the relationships were assessed between economic growth, renewable energy extraction and greenhouse gas (GHG) emissions in the waste sector. The Environmental Kuznets Curve hypothesis was analysed for the member states of the European Union, in the presence of electricity generation, landfill and GHG emissions for the period 1995 to 2012. The results revealed that there is no inverted-U-shaped relationship between income and GHG emissions in European Union countries. The renewable fuel extracted from waste contributes to a reduction in GHG, and although the electricity produced also increases emissions somewhat, they would be far greater if the waste-based generation of renewable energy did not take place. The waste sector needs to strengthen its political, economic, institutional and social communication instruments to meet its aims for mitigating the levels of pollutants generated by European economies. To achieve the objectives of the Horizon 2020 programme, currently in force in the countries of the European Union, it will be necessary to increase the share of renewable energy in the energy mix.

A Ranking Approach for Probe Selection and Classification of Microarray Data with Artificial Neural Networks.

Acute leukemia classification into its myeloid and lymphoblastic subtypes is usually accomplished according to the morphology of the tumor. Nevertheless, the subtypes may have similar histopathological appearance, making screening procedures difficult. In addition, approximately one-third of acute myeloid leukemias are characterized by aberrant cytoplasmic localization of nucleophosmin (NPMc(+)), where the majority has a normal karyotype. This work is based on two DNA microarray datasets, available publicly, to differentiate leukemia subtypes. The datasets were split into training and test sets, and feature selection methods were applied. Artificial neural network classifiers were developed to compare the feature selection methods. For the first dataset, 50 genes selected using the best classifier was able to classify all patients in the test set. For the second dataset, five genes yielded 97.5% accuracy in the test set.

Aerobic exercise does not change C-reactive protein levels in non-obese patients with obstructive sleep apnoea.

The aim of this study is to evaluate the effects of a 2-month aerobic exercise training programme on C-reactive protein (CRP) levels in non-obese patients with obstructive sleep apnoea. Twenty non-obese and sedentary adult male volunteers underwent polysomnography (PSG) to assess their sleep parameters. After the PSG analysis, the subjects were divided into two groups (CTRL, control and OSA, obstructive sleep apnoea). Twenty-four sessions of aerobic exercise were performed, and PSG was repeated on the night that followed the last physical training session (24th). Blood samples were collected for CRP analysis before the first exercise session and after the last session. The OSA group demonstrated a reduction in sleep latency (SL) after 2 months of physical exercise, and 80% of them showed a lower apnoea-hypopnoea index (AHI), although this difference was not statistically significant. The differences between the CRP values for the CTRL and OSA groups were also not statistically significant at baseline or after 2 months of physical exercise. Furthermore, there was no correlation between the CRP levels and body mass index (BMI) in the two groups assessed. Our results suggest that in non-obese patients with OSA, CRP levels were normal and did not change after 2 months of aerobic exercise training.

The impact of shift work on Brazilian train drivers with different chronotypes: a comparative analysis through objective and subjective criteria.

OBJECTIVE: The aim of this study was to compare sleep pattern, tiredness sensation and quality of life between different chronotypes in train drivers from a Brazilian transportation company. SUBJECTS AND METHODS: Ninety-one train drivers, working a rotary work schedule including night shift, were divided into three groups according to their chronotype (morning types, intermediate or evening types) and were assessed for their sleep and quality of life, as characterized by a subjective questionnaire and the Psychomotor Vigilance Task (PVT), applied before and immediately after the night shift. The pattern of activity and rest was measured for 10 days by actigraphy, and the chronotype was determined through the Morningness-Eveningness Questionnaire. RESULTS: Forty-one (45.1%) individuals were classified as morning type, 44 (48.4%) were classified as intermediate and 6 (6.6%) as evening type. The evening types had a tendency to remain awake for a longer period of time before the night shift (p = 0.05) and scored worse overall for quality of life compared to morning types (p = 0.11). There was no significant difference between the groups regarding variability in the PVT performance, even when covaried by the period of waking time before the test. There was no significant difference either in feelings of fatigue before and after starting the shift. CONCLUSION: Although the evening type number was small, evening type individuals scored worse relative to sleep and quality of life than morning type individuals.

A responsabilidade social é uma questão de estratégia?: uma abordagem crítica / Is corporate social responsibility a strategic issue?: a critical approach

Após longo período de desinteresse por questões sociais ou políticas e devido aos recentes escândalos protagonizados por grandes corporações, observamos nos últimos 10 anos a aproximação da área de estratégia, em especial nos EUA, do tema responsabilidade social empresarial (RSE). Fenômeno similar começa a ser observado no Brasil. Este artigo argumenta que essa aproximação deve ser desafiada. Baseando-se na análise crítica da área de estratégia feita recentemente por pesquisadores europeus, os autores mostram que a não-neutralidade da área de estratégia, vista como um campo organizacional, ajuda a explicar o escândalo da Enron, por exemplo. O desinteresse da literatura dominante por esse tipo de crítica pode esclarecer por que importantes abordagens teóricas em RSE vêm sendo negligenciadas pela literatura de estratégia na era da globalização. Por meio de uma análise histórica interdisciplinar este artigo mostra que a abordagem contemporânea mais conhecida de RSE e a área de estratégia dividem uma mesma diretriz problemática: a legitimação das grandes empresas e o desprezo pela dimensão pública e pelo Estado. Ao final, os autores argumentam que a aproximação da área de estratégia do tema RSE deve contemplar a dimensão pública para que questões sociais não se transformem em meros recursos estratégicos e políticos de grandes corporações.

After a long period of neglect of social and political matters and due to the recent scandals championed by large corporations, the strategy area has become increasingly closer to the theme social responsibility, specially in the US, over the last ten years. A similar picture has emerged in Brazil. The authors of this article argue that this proximity should be challenged. Drawing upon a recent critical analysis of the strategy area recently undertaken by European researchers, they point out how the non-neutrality of this area, viewed as an organizational field, helps explain the Enron scandal. The lack of interest of the dominant literature on this sort of critical analysis can elucidate why important theoretical approaches to corporate social responsibility have been overlooked by the strategy literature in the globalization era. Based on an interdisciplinary historical analysis, this article shows that the current and most known approach to social responsibility and the strategy area share a common problematic guideline: the legitimation of the large corporations and the contempt for public matters an for the state. In the end the authors argue that the approximation between the strategy area and social responsibility requires the recognition of the public dimension so that social matters do not become mere strategic and political resources of large corporations.

Pesquisa intercultural e interdisciplinar em gestäo internacional: investigaçöes em marketing internacional e gestäo ambiental / Cross-cultural and interdisciplinary research in international management: inquiries in international marketing environmental management

Descreve duas investigaçöes focadas em questöes culturais, ambas no âmbito de gestäo internacional, realizadas em universidades inglesas: na área de marketing internacional, em uma escola de administraçäo; e na área de gestäo ambiental, em um departamento de relaçoes internacionais. Revela descobertas surpreendentes sobre gestäo internacional no Brasil e na Inglaterra. Descreve obstáculos dentro da academia inglesa e soluçöes desenvolvidas para a legitimaçäo de tais descobertas. Descreve a universidade inglesa como um tipo de instituiçäo total, cujos mecanismos disciplinares e culturais bloqueiam interdisciplinaridade e relevância em pesquisa intercultural. Sugere linhas de açäo para o desenvolvimento de pesquisa e educaçäo intercultural e internacional no Brasil.

Correlação clínico-radiológica na artéria carótida interna aberrante: relato de caso / Clinical and radiological correlation in aberrant carotid artery: case report

A artéria carótida interna aberrante é uma anomalia na embriogênese da porção vertical da artéria carótida interna, caracterizada pela projeção desta artéria no ouvido médio, adjacente ao promontório coclear. Os autores relatam um caso no qual a tomografia computadorizada contrastada e a angiorressonância foram decisivas, caracterizando adequadamente a anomalia e evitando intervenção instrumental ou cirúrgica, que poderia ter conseqüências fatais.