Root hairs facilitate rice root penetration into compacted layers.

Compacted soil layers adversely affect rooting depth and access to deeper nutrient and water resources, thereby impacting climate resilience of crop production and global food security. Root hair plays well-known roles in facilitating water and nutrient acquisition. Here, we report that root hair also contributes to root penetration into compacted layers. We demonstrate that longer root hair, induced by elevated auxin response during a root compaction response, improves the ability of rice roots to penetrate harder layers. This compaction-induced auxin response in the root hair zone is dependent on the root apex-expressed auxin synthesis gene OsYUCCA8 (OsYUC8), which is induced by compaction stress. This auxin source for root hair elongation relies on the auxin influx carrier AUXIN RESISTANT 1 (OsAUX1), mobilizing this signal from the root apex to the root hair zone. Mutants disrupting OsYUC8 and OsAUX1 genes exhibit shorter root hairs and weaker penetration ability into harder layers compared with wild type (WT). Root-hair-specific mutants phenocopy these auxin-signaling mutants, as they also exhibit an attenuated root penetration ability. We conclude that compaction stress upregulates OsYUC8-mediated auxin biosynthesis in the root apex, which is subsequently mobilized to the root hair zone by OsAUX1, where auxin promotes root hair elongation, improving anchorage of root tips to their surrounding soil environment and aiding their penetration ability into harder layers.

AIoT in Agriculture: Safeguarding Crops from Pest and Disease Threats.

A significant proportion of the world's agricultural production is lost to pests and diseases. To mitigate this problem, an AIoT system for the early detection of pest and disease risks in crops is proposed. It presents a system based on low-power and low-cost sensor nodes that collect environmental data and transmit it once a day to a server via a NB-IoT network. In addition, the sensor nodes use individual, retrainable and updatable machine learning algorithms to assess the risk level in the crop every 30 min. If a risk is detected, environmental data and the risk level are immediately sent. Additionally, the system enables two types of notification: email and flashing LED, providing online and offline risk notifications. As a result, the system was deployed in a real-world environment and the power consumption of the sensor nodes was characterized, validating their longevity and the correct functioning of the risk detection algorithms. This allows the farmer to know the status of their crop and to take early action to address these threats.

Low-Cost Electronic Nose for the Determination of Urinary Infections.

Currently, urine samples for bacterial or fungal infections require a long diagnostic period (48 h). In the present work, a point-of-care device known as an electronic nose (eNose) has been designed based on the "smell print" of infections, since each one emits various volatile organic compounds (VOC) that can be registered by the electronic systems of the device and recognized in a very short time. Urine samples were analyzed in parallel using urine culture and eNose technology. A total of 203 urine samples were analyzed, of which 106 were infected and 97 were not infected. A principal component analysis (PCA) was performed using these data. The algorithm was initially capable of correctly classifying 49% of the total samples. By using SVM-based models, it is possible to improve the accuracy of the classification up to 74% when randomly using 85% of the data for training and 15% for validation. The model is evaluated as having a correct classification rate of 74%. In conclusion, the diagnostic accuracy of the eNose in urine samples is high, promising and amenable for further improvement, and the eNose has the potential to become a feasible, reproducible, low-cost and high-precision device to be applied in clinical practice for the diagnosis of urinary tract infections.

Fluorescent in situ hybridization (FISH): A useful diagnostic tool for childhood conjunctival melanoma.

INTRODUCTION: Conjunctival melanoma is extremely rare in children and has low rates of resolution. Definitive histopathological diagnosis based exclusively on microscopic findings is sometimes difficult. Thus, early diagnosis and adequate treatment are essential to improve clinical outcomes. CLINICAL CASE: We present the first case in which the fluorescent in situ hybridization (FISH) diagnostic technique was applied to a 10-year-old boy initially suspected of having amelanotic nevi in his right eye. Based on the 65% of tumor cells with 11q13 (CCND1) copy number gain and 33% with 6p25 (RREB1) gain as measured by the FISH analysis, and on supporting histopathological findings, the diagnosis of conjunctival melanoma could be made. Following a larger re-excision, adjuvant therapy with Mitomycin C (MMC), cryotherapy and an amniotic membrane graft, the patient has remained disease-free during 9 years of long-term follow-up. CASE DISCUSSION: Every ophthalmologist should remember to consider and not forget the possibility of using FISH analyses during the differential diagnosis of any suspicious conjunctival lesions. Genetic techniques, such as FISH, have led to great advances in the classification of ambiguous lesions. Evidence-based guidelines for diagnosing conjunctival melanoma in the pediatric population are needed to determine the most appropriate strategy for this age group.

Mucilage and cellulosic derivatives as clarifiers for the improvement of the non-centrifugal sugar production process.

Non-centrifugal cane sugar (NCS) is the second most important Colombian agribusiness in social importance. However, the sugar cane industry is facing some challenges caused by the controversial nutritional and safety attributes of NCS. Some Colombian NCS producers employ natural mucilages as clarifiers; but the uncontrolled application of these components has caused a risk of extinction in the mucilage source plants. Other producers employ acrylamide as a clarifier. Health consequences have generated concerns from the consumers and demanded control from the food authorities. Efforts are being made to develop a standard manufacturing methodology to increase NCS productivity and improve its quality, hygiene, and storability. The application of better clarifiers, which provide the best clarifying activity and minimize the toxicity while conserving NCS's natural attributes, is one of the outstanding challenges as well. This study is a proposal which looks for sustainable, natural, nontoxic, and economical clarifiers for the Colombian NCS producers.

Current trends in cacti drying processes and their effects on cellulose and mucilage from two Colombian cactus species.

The effect of temperature and drying technologies on mucilage and cellulose (obtained by the microwave-assisted extraction technique, MAE) from Opuntia ficus-indica (OFI) and Austrocylindropuntia cylindrica (CC) was determined using a conventional oven (CO) and Refractive Window (RW). Mathematical modeling was performed from drying kinetics data using the Lewis, Henderson-Pabis, Page, and Logarithmic models. Activation Energy (Ea) and Diffusivity (D) were also determined. The model with the best fit was the logarithmic one, with a correlation coefficient (R2) greater than 0.99. The obtained activation energies were 22.81 kJ mol-1 for Refractance window (RW) and 31.44 kJ mol-1 using conventional hot air drying (CO) while a diffusivity of 2.9 ∗10-8 m2 s-1 for RW and 1.3∗10-8 m2 s-1 for CO were found as well. According to our results, a greater drying efficiency and a less chemical deterioration of the plant sample are obtained by drying with Refractance window.

Estudio de la resonancia de la voz hablada y cantada en cantantes no profesionales después de usar técnicas de impedancia vocal / Study of the resonance of the spoken and sung voice in non-professional singers after using vocal impedance techniques

La resonancia es la herramienta que permite a los cantantes alcanzar la máxima eficiencia de la voz con el mínimo esfuerzo. Una voz resonante siempre llama la atención, es más atractiva y atrayente. En un cantante es fundamental pues hará resonar al que escucha, produciendo una sintonía física y emocional. Objetivos: Determinar la capacidad de mejora que pueden tener las técnicas deimpedancia vocal sobre la voz de cantantes; y determinar la relación que existe entre una buena percepción auditiva y la ganancia de una voz resonante rica en armónicos .Material y métodos: Se realizó un ensayo clínico aleatorio, donde las variablesindependientes fueron hidrobalones (Balón Regulable IntraOral o BRIO), máscaras de reanimación y cámaras de resonancia. Para el análisis de las técnicas de impedancia vocal participaron 14 sujetos de género femenino (10) y masculino (4) con un rango de edad de 31 a 62 años que forman parte de dos coros distintos. Los participantes fueron divididos de forma aleatoria en dos grupos: experimental y control, que posteriormente fueron comparados. Nos comprometimos a dar estimulación a toda la muestra, por lo que realizamos dos estudios más. Un segundo estudio donde comparamos toda la muestra tras la estimulación con el grupo control que teníamos en un inicio. Y un tercer estudio valorando el grupo control antes y después de la estimulación. El grupo experimental realizó 3 sesiones de 45 minutos cada una, donde se emplearon tres técnicas de impedancia, BRIO para aumentar la cavidad oral, máscaras de reanimación que amplían la cavidad faríngea y cámaras de resonancia que mejoran la percepción auditiva. El segundo grupo únicamente tenía que cantar todos los días 10 minutos, al tiempo que tenía lugar el tratamiento del grupo experimental. De manera previa y posterior al tratamiento, los sujetos fueron valorados por medio de endoscopia y análisis acústico...(AU)

The Role of Photobionts as Drivers of Diversification in an Island Radiation of Lichen-Forming Fungi.

Speciation in oceanic islands has attracted the interest of scientists since the 19th century. One of the most striking evolutionary phenomena that can be studied in islands is adaptive radiation, that is, when a lineage gives rise to different species by means of ecological speciation. Some of the best-known examples of adaptive radiation are charismatic organisms like the Darwin finches of the Galapagos and the cichlid fishes of the great African lakes. In these and many other examples, a segregation of the trophic niche has been shown to be an important diversification driver. Radiations are known in other groups of organisms, such as lichen-forming fungi. However, very few studies have investigated their adaptive nature, and none have focused on the trophic niche. In this study, we explore the role of the trophic niche in a putative radiation of endemic species from the Macaronesian Region, the Ramalina decipiens group. The photobiont diversity was studied by Illumina MiSeq sequencing of the ITS2 region of 197 specimens spanning the phylogenetic breadth and geographic range of the group. A total of 66 amplicon sequence variants belonging to the four main clades of the algal genus Trebouxia were found. Approximately half of the examined thalli showed algal coexistence, but in most of them, a single main photobiont amounted to more than 90% of the reads. However, there were no significant differences in photobiont identity and in the abundance of ITS2 reads across the species of the group. We conclude that a segregation of the trophic niche has not occurred in the R. decipiens radiation.

Data on litterfall production and meteorology at an old-growth tropical dry forest in northwestern Mexico.

Chronological measurements of litterfall production can be used for understanding ecosystem dynamics such as net primary production and carbon cycling in highly seasonal ecosystems such as tropical dry forests (TDF). This paper presents data on litterfall production and meteorology in an old-growth TDF. The data was generated within the Monte Mojino Reserve located in the Sierra de Alamos - Rio Cuchujaqui Natural Protected Area in northwestern México. For litterfall collection, twenty randomly placed litterfall traps were installed to collect monthly litterfall production across four full growing seasons (48 monthly collections). Meteorological data were obtained from an automatic micrometeorological station that recorded data in situ from January 2013 to March 2019. The database includes litterfall production [g m-2 month-1], monthly rainfall [mm], air temperature [°C], relative humidity [%] and photosynthetic active radiation [µmol m-2 s-1].

Complicaciones infecciosas en niños tratados con oxigenación por membrana extracorpórea / Infectious complications in paediatric patients treated with extracorporeal membrane oxygenation

INTRODUCCIÓN: El objetivo de este estudio es analizar la incidencia de infección en los niños tratados con ECMO, el tratamiento y su evolución. MÉTODOS: Se realizó un estudio retrospectivo basado en una base de datos prospectiva en el que se incluyeron los niños menores de 18 años asistidos con ECMO entre septiembre de 2006 y noviembre de 2015. Se recogieron las características de los pacientes, la ECMO, los cultivos y el tratamiento de la infección. RESULTADOS: Se estudiaron 100 pacientes de 11 meses de edad mediana. El diagnóstico fue de cardiopatía en 94 pacientes. Se sospechó una infección y se inició antibioterapia en 51 pacientes, aunque solo se confirmó microbiológicamente en 22. Las infecciones más frecuentes fueron la sepsis (49%), neumonía (35,3%) e infección urinaria (9,8%). No existieron diferencias en los parámetros hematológicos y reactantes de fase aguda entre los niños con infección y el resto. Los niños que fallecieron presentaron mayor incidencia, no estadísticamente significativa, de infección durante la ECMO (60,4%) que los supervivientes (40,3%) (p = 0,07). La duración de ingreso en la UCIP fue mayor, sin significación estadística, en los pacientes con infección que en el resto: 57 frente a 37 días (p = 0,067). CONCLUSIONES: La frecuencia de infección en niños con ECMO es elevada, pero menos de la mitad son confirmadas microbiológicamente, sin existir parámetros específicos de infección. No se ha encontrado relación estadísticamente significativa de la infección con la mortalidad y la duración de ingreso en la UCIP

INTRODUCTION: The aim of this study was to analyse the incidence, treatment and evolution of infections in children treated with ECMO. METHODS: A retrospective study based on a prospective database was performed. Children under the age of 18 years treated with ECMO from September 2006 to November 2015 were included. The patients' clinical characteristics were collected, together with ECMO technique, cultures and treatment of infection. RESULTS: One hundred patients with a median age of 11 months were analysed. Heart disease was diagnosed in 94 patients. An infection was suspected and antibiotic treatment was initiated in 51 patients, although only 22 of them were microbiologically confirmed. The most common infection was sepsis (49%), followed by pneumonia (35.3%) and urinary tract infection (9.8%). There were no differences in haematological parameters and acute phase reactants between children with infection and those without. Children who died had a higher incidence of infection during ECMO (60.4%) than the survivors (40.3%), but the difference did not reach statistical significance (P = .07). The duration of admission in the PICU was 57 days in patients with infection vs 37 days in patients without infection but the difference was not statistically significant (P = .067). CONCLUSIONS: Infection in children with ECMO is common. There are no specific infection parameters and less than half of the clinical infections are confirmed microbiologically. There was no statistically significant correlation between infection and mortality or duration of PICU stay

Infectious complications in paediatric patients treated with extracorporeal membrane oxygenation. / Complicaciones infecciosas en niños tratados con oxigenación por membrana extracorpórea.

INTRODUCTION: The aim of this study was to analyse the incidence, treatment and evolution of infections in children treated with ECMO. METHODS: A retrospective study based on a prospective database was performed. Children under the age of 18 years treated with ECMO from September 2006 to November 2015 were included. The patients' clinical characteristics were collected, together with ECMO technique, cultures and treatment of infection. RESULTS: One hundred patients with a median age of 11 months were analysed. Heart disease was diagnosed in 94 patients. An infection was suspected and antibiotic treatment was initiated in 51 patients, although only 22 of them were microbiologically confirmed. The most common infection was sepsis (49%), followed by pneumonia (35.3%) and urinary tract infection (9.8%). There were no differences in haematological parameters and acute phase reactants between children with infection and those without. Children who died had a higher incidence of infection during ECMO (60.4%) than the survivors (40.3%), but the difference did not reach statistical significance (P=.07). The duration of admission in the PICU was 57 days in patients with infection vs 37 days in patients without infection but the difference was not statistically significant (P=.067). CONCLUSIONS: Infection in children with ECMO is common. There are no specific infection parameters and less than half of the clinical infections are confirmed microbiologically. There was no statistically significant correlation between infection and mortality or duration of PICU stay.

Efficacy of a brief multifactorial adherence-based intervention in reducing blood pressure: a randomized clinical trial.

BACKGROUND: Lowering blood pressure (BP) by antihypertensive (AHT) drugs reduces the risks of cardiovascular events, stroke, and total mortality. However, poor adherence to AHT medications reduces their effectiveness and increases the risk of adverse events. OBJECTIVE: To evaluate the effectiveness of a multifactorial adherence-based intervention in a primary care setting in lowering BP. METHODS/DESIGN: Multicenter parallel randomized controlled trial. Thirty two nurses in 28 primary care centers of three Spanish regions. Patients aged 18-80 years, taking AHT drugs with uncontrolled BP (n=221) were randomized to a control group (usual care) or a multifactorial adherence-based intervention including nurse-led motivational interviews, pill reminders, family support, BP self-recording, and simplification of the dosing regimen by a pharmacist. MAIN OUTCOME MEASURES: The primary outcome was 12-month blinded measure of systolic BP (mean of three measurements). The secondary outcomes were 12-month diastolic BP and proportion of patients with adequately controlled BP. RESULTS: One hundred and fourteen patients were allocated to the intervention group and 109 to the control group. At 12 months, 212 (89%) participants completed the study. The systolic BP in the intervention group was 151.3 versus 153.7 in the control group (P=0.294). The diastolic BP did not differ between groups (83.4 versus 83.6). Of the patients in the control group, 9.2% achieved BP control versus a 15.8% in the intervention group. The relative risk for achieving BP control was 1.72 (95% confidence interval: 0.83-3.56). CONCLUSION: A multifactorial intervention based on improving adherence in patients with uncontrolled hypertension failed to find evidence of effectiveness in lowering systolic BP. TRIAL REGISTRATION: ISRCTN21229328.

Las metodologías creativo-sensibles en la formación personal de los estudiantes de enfermería en la Universidad Nacional Pedro Ruiz Gallo, Lambayeque (Perú) / The creative-sensible method in the training of nursing students at the National University Pedro Ruiz Gallo, Lambayeque (Perú)

Esta investigación-acción tuvo como objetivo contribuir al proceso de formación personal de las estudiantes de la Facultad de Enfermería de la Universidad Nacional Pedro Ruiz Gallo. El objeto de estudio fue la modificación de los procesos de formación de los estudiantes de Enfermería, con ayuda de la didáctica crítica y de metodologías creativo-sensibles. El sustento teórico está en Demo (1997a, 1997b), Evangelista (1998), Waldow (1998). Se utilizó la metodología de IAP con los siguientes pasos: 1. Creativo-heurístico: descubrimiento de los procesos creativos clave (investigación creativa). 2. Conversión y desarrollo de los procesos en métodos creativos (didáctica metodológica creativa). 3. Repetitivo-imitativo: práctica sistemática y reflexiva de un método creativo (aprendizaje para ser creativo). 4. Nuevo: creativo-heurístico (aprender a descubrir). La población de la muestra fueron estudiantes de la Facultad y muestra de los estudiantes del 5º, 6º y 7º ciclo. Para recolectar datos se usó la entrevista en profundidad y posteriormente fueron tratados por análisis temático. Los resultados del primer paso: Al inicio: “Una persona que busca desarrollarse con visión materialista”. Durante la formación profesional: “Una persona que trata de formarse adecuadamente”. Pasado: “Una persona llena de preguntas, de dudas, pero que en cada ciclo se va aclarando lo que es su carrera”. Presente creador: ”Una alumna preparada que capta lo enseñado; una persona humana que gusta ayudar a los demás”. Finalmente, el futuro soñador: “Ser una buena profesional”. Resultados susceptibles de mejora con la formación personal.

This research had the objective of contributing to the process of personnel training of the students of the Nursing Faculty of the Universidad Nacional Pedro Ruiz Gallo. The object of study was the modification of the processes of formation of the nursing students, with the help of critical teaching and creative-sensitive methods. The theoretical basis are in Demo (1997a, 1997b), Evangelist (1998) and Waldow (1998).We used the methodology of IAP with the following steps: 1. Creative-heuristic: discovery of the key creative processes (creative research). 2. Conversion and development processes in creative methods (didactics methodological creative). 3. Repetitive imitative: practice-systematic and reflective of a creative method (learning to be creative). 4. New: creativ-heuristic. (learn how to discover).Population: students of the Faculty and students of the 5th, 6th and 7th cycle sample. To collect data using depth interview, the data were processed by thematic analysis.The results of the first step: at the beginning, person who seeks to develop with materialistic vision. During vocational training: “A person who tries to train adequately”. Past: “A person filled with questions, doubts, but that each cycle will clarify what is his career”. Present: “Nursing student prepared that captures taught, human person, who likes to help others, dreamy future, be a good professional”.

Esta pesquisa-ação, tinha o objetivo de contribuir para o processo da formação pessoal dos estudantes da Faculdade de enfermagem da Universidad Nacional Pedro Ruiz Gallo. O objeto de estudo foi a modificação dos processos de formação de estudantes de enfermagem, com a ajuda de ensino fundamental e metodologias criativas–sensíveis. A base teórica foi: de demo (1997a, 1997b), Evangelista (1998), Waldow (1998).A metodología foi de pesquisa ação, paticipativa (IAP) com as seguintes etapas: 1. Criativo-heurístico: descoberta da chave criativa processa (pesquisa criativa). 2. Processos de conversão e desenvolvimento em métodos criativos (criativo metodológicas da didática). 3. Repetitivas imitativo: prática sistemática e reflexiva de um método criativo (aprender a ser criativo). 4. Novo: criativo-heurístico (saiba como descobrir). População: alunos da faculdade do 5º, 6º e 7º ciclo. Para coleta dos dados foi usada a entrevista de profundidade, os dados foram tratados por análise temática. Os resultados da primeira etapa: no início, pessoa que procura desenvolver com visão materialista. Durante a formação profissional: uma pessoa que tenta treinar adequadamente. Passado. Uma “pessoa cheio de perguntas, dúvidas, mas que cada ciclo vai esclarecer qual é sua carreira.” Criador de presente: "Aluna preparada essa pessoa de ensinou, que gosta de ajudar os outros, sonho futuro" ser um bom profissional. Resultados susceptíveis de melhora com a formação pessoal.

Formación de la identidad profesional en las estudiantes de la Facultad de Enfermería de una Universidad en Lambayeque (Perú) / Training of professional identity in students of the Faculty of Nursing University of Lambayeque (Perú)

Resumen:

Este trabajo con enfoque de investigación acción-participativa tuvo como objetivo responder a: ¿cómo se forma la identidad profesional en los estudiantes de la Facultad de Enfermería de una Universidad en Lambayeque? El objeto de estudio fue la formación de la identidad profesional en estudiantes de Enfermería. El objetivo que guió fue comprender la formación de la identidad profesional de alumnos de enfermería. Como referencial teórica se utilizaron varios autores. En la metodología se empleó la entrevista abierta en profundidad, individual y grupal, así como dinámicas creativo-sensibles. La ética estuvo en toda la investigación. Los hallazgos finales: las estudiantes de enfermería al iniciar su formación profesional evidencian el autoconcepto, la imagen, el yo personal, el yo profesional y los valores personales y profesionales, sin embargo, es a medida que transcurre su formación cuando van reforzando y emerge la identidad profesional como proceso dinámico que va fortaleciéndose.

Efficacy of a brief multifactorial adherence-based intervention on reducing the blood pressure of patients with poor adherence: protocol for a randomized clinical trial.

BACKGROUND: Lowering of blood pressure by antihypertensive drugs reduces the risks of cardiovascular events, stroke, and total mortality. However, poor adherence to antihypertensive medications reduces their effectiveness and increases the risk of adverse events. In terms of relative risk reduction, an improvement in medication adherence could be as effective as the development of a new drug. METHODS/DESIGN: The proposed randomized controlled trial will include patients with a low adherence to medication and uncontrolled blood pressure. The intervention group will receive a multifactorial intervention during the first, third, and ninth months, to improve adherence. This intervention will include motivational interviews, pill reminders, family support, blood pressure self-recording, and simplification of the dosing regimen. MEASUREMENT: The primary outcome is systolic blood pressure. The secondary outcomes are diastolic blood pressure, proportion of patients with adequately controlled blood pressure, and total cost. DISCUSSION: The trial will evaluate the impact of a multifactorial adherence intervention in routine clinical practice. Ethical approval was given by the Ethical Committee on Human Research of Balearic islands, Spain (approval number IB 969/08 PI).

Lentigo negro reticulado (en 'mancha de tinta'):presentación de tres casos / Reticulated black lentigo ('ink spot'): description of three cases

El lentigo en 'mancha de tinta' se caracteriza clínicamente por su color negro y por sus bordes marcadamente irregulares, que recuerdan a una mancha de tinta china sobre la piel. Es una lesión pigmentada de reciente descripción y poco conocida, que puede originar problemas de diagnóstico diferencial, tanto clínico como histopatológico. Histopatológicamente consiste en una hiperpigmentación del extremo inferior de las crestas epidérmicas, con escaso pigmento melánico en la epidermis entre crestas. No se observa proliferación de melanocitos. Se trata de una lesión benigna y sin capacidad de malignizarse (AU)

Estilos de ensinar-cuidar em enfermagem: um estudo comparado em situações de maior complexidade do cliente hospitalizado: Brasil/Perú / The theoretical-practical teaching comparatively, for yhe hospitalized customer's care

Este estudo trata-se de uma pesquia qualitativa com abordagem dialética, inscrito na linha de estudos comparados latinos da Escola de Enfermagem Anna Nery da Universidade Federal do Rio de Janeiro (EEAN/UFRJ). A coleta de dados foi realizado através de análise documental e da entrevista temática sobre o Programa Curricular Interdepartamental IX (PCI IX), da EEAN/UFRJ/Brasil e sobre a disciplina Enfermagem Medico-cirugica especial da Faculdade de Enfermagem da Universidade Nacional Pedro Ruiz Callo. O estudo caracteriza e analisa comparativamente o ensino teórico-prático, para o cuidado do cliente hospitalizado, em situações de maior complexidade, a partir da concepção pedagógica de Paulo Freire.Os resultados demonstram especificidades de desenvolvimento e contexto, com semelhanças e deiferenças nas duas realidades estudadas do estilo de ensinar e de cuidar...