El programa de Ciencias Médicas Odontológicas y de la Salud del Posgrado General de la UNAM (2011 a 2023) / The Medical, Dental, and Health Sciences Program of the General Postgraduate Program at UNAM (2011 to 2023)

Resumen Después de varias décadas, el Programa de Ciencias Médicas, Odontológicas y de la Salud sigue formando investigadores que integran las diversas instituciones en donde labora personal de salud. Es notable cómo algunos campos han crecido y cómo se ha incrementado la participación de las mujeres, tanto en maestría como en doctorado. Se presenta un panorama general de ingreso y graduación de acuerdo con los campos de conocimiento y por el sexo de las personas. Se hace un comentario sobre los cambios en las personas que dirigen instituciones que, en algunos casos, por más de 100 años eran dirigidas por personas del sexo masculino.

Abstract By reviewing the scientific literature specialized in sleep disorders (TS) carried out in Mexico, especially at the TS Clinic (Faculty of Medicine-UNAM) at the General Hospital of Mexico (CTS-HGM) from 1948 to 2020, it was possible to document the history of ST research in Mexico and the role played by the CTS-HGM. Sleep Medicine (MS) is one of the newest specialties in Mexico and case research in this field began around 1948, while formal research in 1974. The founding of CTS-HGM in 1997 led to significant development in TS research in Mexico. In addition, the CTS-HGM became a center of care for patients with these problems, as well as important research center since its publications cover all the diagnostic categories of the CITS.

Gingivitis crónica y otros campos de interferencia en pacientes con artritis del hombro

Introducción: La odontología holística es parte de la medicina biológica o neurofocal, dirigida a la prevención, el diagnóstico y el tratamiento relacionados con las enfermedades del sistema estomatognático en correlación con otras estructuras anatómicas, a fin de tratar al paciente de manera integral, en cuerpo, mente y alma. Objetivo: Identificar la presencia de gingivitis crónica y de otros campos de interferencia en pacientes con artritis del hombro. Métodos: Se realizó un estudio observacional, descriptivo y transversal de 24 pacientes con artritis del hombro, pertenecientes al área de salud del Policlínico Docente Carlos Juan Finlay en Santiago de Cuba, quienes fueron atendidos en la Clínica Estomatológica Provincial Docente Mártires del Moncada, desde noviembre del 2021 hasta mayo del 2022. Resultados: En la serie predominaron el sexo femenino (62,5 %) y el grupo etario de 35-59 años (75,0 %). De igual modo, la mayoría de los pacientes padecía gingivitis crónica (87,5 %), en tanto, los otros campos de interferencia mayormente hallados fueron la placa dentobacteriana (100 %) y la caries dental (58,3 %), que figuraron en todos los molares según el holograma del microsistema de dientes alemán. Conclusiones: Los campos de interferencia identificados con más frecuencia en la casuística fueron la gingivitis crónica grave, la placa dentobacteriana y la caries dental, los cuales estuvieron asociados a la artritis del hombro que aquejaba a los pacientes.

Introduction: Holistic dentistry is part of the biological or neurofocal medicine, directed to the prevention, diagnosis and treatment related to the diseases of the stomatognatic system in correlation with other anatomical structures, in order to treat the patient in an integral way, in body, mind and soul. Objective: To identify the presence of chronic gingivitis and other interference fields in patients with shoulder arthritis. Methods: An observational, descriptive and cross-sectional study of 24 patients with shoulder arthritis was carried out, who belonged to the health area of Carlos Juan Finlay Teaching Polyclinic in Santiago de Cuba. They were assisted in Mártires del Moncada Teaching Provincial Stomatological Clinic, from November, 2021 to May, 2022. Results: In the series there was a prevalence of the female sex (62.5%) and the 35-59 age group (75.0%). In a same way, most of the patients suffered from chronic gingivitis (87.5%), as long as the other mostly found interference fields were the dentobacterial plaque (100%) and dental cavity (58.3%) that were in all the molars according to the hologram of the German teeth microsystem. Conclusions: Severe chronic gingivitis, dentobacterial plaque and dental cavity were the most frequently identified interference fields in the case material, which were associated to the shoulder arthritis in patients.

Effects of pulsed electromagnetic field and retrowalking in patients with chronic non-specific low back pain: a pilot study / Efeitos do campo eletromagnético pulsado e do retrowalking em pacientes com dor lombar crônica inespecífica: um estudo piloto

INTRODUCTION: Chronic non-specific low back pain (CNSLBP) is a major worldwide condition that has severe emotional, social, and economic consequences. Management is difficult, requiring the development of new, effective, and safe approaches. OBJECTIVES: This study was conducted to examine the effects of Pulsed Electromagnetic Fields (PEMF) and retrowalking on pain, disability, spinal mobility, hamstring tightness, balance, and kinesiophobia in patients with chronic non-specific low back pain. MATERIALS AND METHODS: Participants (n = 48) with CNSLBP were randomised into four groups; Group A: Conventional group, Group B: PEMF group, Group C: retrowalking group, and Group D: PEMF and retrowalking group. The interventions were given three times per week for six weeks. The outcomes were pain, disability, hamstring tightness, balance, spinal mobility and kinesiophobia, measured at baseline and after 6 weeks. RESULTS: The result suggested a significant improvement in pain, disability, hamstring tightness, kinesiophobia and balance. However, no significant improvement in spinal mobility (flexion and extension ROM) was observed during the sixth week between-group comparison. The maximum improvement was seen in group D followed by group C and group B in comparison to group A. CONCLUSION: It can be concluded that PEMF and retrowalking when given in combination significantly decrease pain, disability, hamstring tightness, kinesiophobia and improve balance patients with chronic non-specific low back pain.

INTRODUÇÃO: A dor lombar crônica inespecífica (DLCI) é uma condição importante em todo o mundo que tem graves consequências emocionais, sociais e econômicas. O gerenciamento é difícil, exigindo o desenvolvimento de abordagens novas, eficazes e seguras. OBJETIVOS: Este estudo foi realizado para examinar os efeitos dos Campos Eletromagnéticos Pulsados (CEMP) e do retrowalking sobre a dor, a incapacidade, a mobilidade da coluna vertebral, a rigidez dos isquiotibiais, o equilíbrio e a cinesiofobia em pacientes com dor lombar crônica não específica. MATERIAIS E MÉTODOS: Os participantes (n = 48) com DLCI crônica foram divididos aleatoriamente em quatro grupos: Grupo A: Grupo convencional, Grupo B: Grupo CEMP, Grupo C: Grupo retrowalking e Grupo D: Grupo CEMP e retrowalking. As intervenções foram realizadas três vezes por semana durante seis semanas. Os resultados foram dor, incapacidade, tensão nos isquiotibiais, equilíbrio, mobilidade da coluna vertebral e cinesiofobia, medidos na linha de base e após seis semanas. RESULTADOS: O resultado sugeriu uma melhora significativa na dor, na incapacidade, na tensão dos isquiotibiais, na cinesiofobia e no equilíbrio. Entretanto, não foi observada melhora significativa na mobilidade da coluna vertebral (flexão e extensão da ADM) quando a comparação entre os grupos foi feita na sexta semana. A melhora máxima foi observada no grupo D, seguida pelo grupo C e pelo grupo B, em comparação com o grupo A. CONCLUSÃO: Pode-se concluir que a CEMP e o retrowalking, quando administrados em combinação, diminuem significativamente a dor, a incapacidade, a rigidez dos isquiotibiais, a cinesiofobia e melhoram o equilíbrio dos pacientes com dor crônica não espinhal.

Normative data for macular perimetry using the MP-3 microperimeter in healthy individuals / Dados normativos para perimetria macular usando o microperímetro MP-3 em indivíduos normais

ABSTRACT Purpose: Microperimetry has been used for several years as a form of visual function testing in patients with retinal diseases. Normal microperimetry values obtained with microperimeter MP-3 have not yet been fully published, and baseline values for topographic macular sensitivity and correlations with age and sex are needed to establish degrees of impairment. This study aimed to determine values for light sensitivity thresholds and fixation stability using the MP-3 in healthy individuals. Methods: Thirty-seven healthy volunteers (age, 28-68 years), underwent full-threshold microperimetry using a 4-2 (fast) staircase strategy with the standard Goldmann III stimulus size and 68 test points positioned identically to those in the Humphrey Field Analyzer 10-2 test grid. The fixation stability was simultaneously recorded during the microperimetry test. The relationship between global sensitivity and age was calculated using linear regression analysis. Results: Microperimetry was performed on 37 participants (74 eyes). The global mean sensitivity was 29.01 ± 1.44 (range, 26-31) dB. The mean central sensitivity at 2° measured by the MP-3 was 28.5 ± 1.77 dB in the right eye (OD) and 28.75 ± 1.98 dB in the left eye (OS). The total median fixation stability values within 2° and 4° were 80% and 96%, respectively. The linear regression analysis also revealed an age-related global sensitivity decline per year of -0.051 dB ± 0.018 (OD) and -0.078 dB ± 0.021 (OS). Conclusions: Microperimetry performed with the MP-3 allows for an automatic, accurate, and topography-specific examination of retinal sensitivity thresholds. The results of this study provide a normal and age-matched database of MP-3 microperimetry.

RESUMO Objetivos: A microperimetria tem sido usada há vários anos como uma forma de teste de função visual em pacientes com doenças da retina. Os valores normais de microperimetria obtidos com MP-3 ainda não foram totalmente publicados e os valores basais para sensibilidade macular topográfica e correlações com idade e sexo são necessários para estabelecer graus de comprometimento. O objetivo do trabalho é determinar valores para limiares de sensibilidade à luz e estabilidade de fixação usando o MP-3 em indivíduos normais. Métodos: Trinta e sete voluntários saudáveis (idade: 28-68 anos), submetidos à microperimetria de limiar total usando uma estratégia de escada 4-2 (rápida) com o tamanho de estímulo padrão Goldmann III e 68 pontos de teste posicionados de forma idêntica aos do Humphrey Field Analyzer 10-2 grade de teste. A estabilidade da fixação foi registrada simultaneamente durante o teste de microperimetria. A relação entre a sensibilidade global e a idade foi calculada por meio de análise de regressão linear. Resultados: A microperimetria foi realizada em 37 indivíduos (74 olhos). A sensibilidade média global foi de 29,01 ± 1,44 dB, intervalo: 26-31 dB. A mediana da sensibilidade central a 2° medida pelo MP-3 foi de 28,5 ± 1,77 dB (ER) e 28,75 ± 1,98 dB (OE). Os valores médios totais de estabilidade da fixação em 2° e 4° foram 80% e 96%, respectivamente. A análise de regressão linear também revelou um declínio de sensibilidade global relacionado à idade por ano de -0,051 dB ± 0,018 (ER) e -0,078 dB ± 0,021 (LE). Conclusões: A microperimetria realizada com o MP-3 permite um exame automático, preciso e específico da topografia dos limiares de sensibilidade da retina. Os resultados deste estudo fornecem um banco de dados normal e de idade correspondente da microperimetria MP-3.

Historia y principios básicos de la estimulación magnética transcraneal

La estimulación magnética transcraneal (EMT) es una técnica no invasiva que consiste en la utilización de campos magnéticos para estimular a las neuronas de la corteza cerebral. Si bien la electricidad se ha pretendido emplear previamente en el campo de la medicina, la historia de la EMT se remonta al descubrimiento de la inducción electromagnética, por Faraday, en el siglo XIX. Sin embargo, no fue hasta la década de 1980 cuando Anthony Barker, en la Universidad de Sheffield, desarrolló el primer dispositivo de EMT. La EMT funciona mediante una bobina colocada en el cuero cabelludo, la cual produce un campo magnético que puede atravesar el cráneo y estimular las neuronas corticales. La intensidad y la frecuencia del campo magnético pueden ajustarse para dirigirse a zonas específicas del cerebro y producir efectos excitatorios e inhibitorios. Los principios de la EMT se basan en el concepto de neuroplasticidad, que se refiere a la capacidad del cerebro para cambiar y adaptarse en respuesta a nuevas experiencias y estímulos. Al estimular las neuronas del cerebro con la EMT, es posible inducir cambios en la actividad neuronal y la conectividad, lo que a su vez puede provocar cambios cognitivos y en el estado de ánimo.

Transcranial magnetic stimulation (TMS) is a noninvasive technique that uses magnetic fields to stimulate neurons in the cerebral cortex. While electricity has previously been intended to be used in the medical field, the history of TMS dates back to the discovery of electromagnetic induction by Faraday in the 19th century. However, it was not until the 1980s when Anthony Barker developed the first TMS device at the University of Sheffield. TMS works by means of a coil placed against the scalp, thereby producing a magnetic field. This magnetic field can pass through the skull and stimulate cortical neurons. The intensity and frequency of the magnetic field can be adjusted to target specific areas of the brain and produce excitatory and inhibitory effects. The principles of TMS are based on the concept of neuroplasticity, which refers to the brain's ability to change and adapt in response to new experiences and stimuli. By stimulating neurons in the brain with TMS, it is possible to cause changes in neuronal activity and connectivity, which in turn can lead to cognitive and mood changes.

A new remarkable Vanilla Mill. (Orchidaceae) species endemic to the Espinhaço Range, Brazil: its phylogenetic position and evolutionary relationships among Neotropical congeners.

During surveys conducted on Neotropical Vanilla, a new endemic species was found in the Brazilian campos rupestres of the Espinhaço Range. Here, this new remarkable Vanilla species, namely V.rupicola Pansarin & E.L.F. Menezes, is described and illustrated. A phylogeny for Vanilla is presented and the relationships between Neotropical species are discussed. The position of V.rupicola among Neotropical Vanilla is discussed within an evolutionary context. Vanillarupicola is recognized by its rupicolous habit, its reptant stems, and its sessile and rounded leaves. This remarkable new taxon emerges in a clade that includes V.appendiculata Rolfe and V.hartii Rolfe. Vegetative and floral features support a close relationship between V.rupicola and sister taxa, mainly regarding the apical inflorescence (V.appendiculata), the type of appendages of the central crest of the labellum, and the labellar color pattern. Phylogenetic inference suggests that the circumscription of Neotropical Vanilla groups needs revision.

Normal development of the heart: a review of new findings.

Development and formation of the heart, the central organ of the circulatory system in vertebrates, starts early during embryonic development (second week), reaching maturity during the first few postnatal months. Cardiogenesis is a highly complex process that requires the active and orderly participation of different cardiac and non-cardiac cell populations. Thus, this process is sensitive to errors that may trigger a variety of heart-development defects, called congenital heart defects, which have a worldwide incidence of 8-10/1000 live births. A good understanding of normal cardiogenesis is required for better diagnosis and treatment of congenital heart diseases. This article reviews normal cardiogenesis by comparing information from classic studies with more recent findings. Information from descriptive anatomical studies of histological sections and selective in vivo marking of chicken embryos were emphasized. In addition, the discovery of heart fields has fueled the investigation of cardiogenic events that were believed to be understood and has contributed to proposals for new models of heart development.

El corazón, órgano central del aparato circulatorio de los vertebrados, comienza a formarse muy temprano en el desarrollo embrionario (segunda semana de gestación) y alcanza su forma madura durante los primeros meses posteriores al nacimiento. La cardiogénesis se caracteriza por ser un proceso altamente complejo, dependiente de la participación activa y ordenada de diferentes poblaciones celulares cardiacas y no cardiacas. Lo anterior hace que este proceso sea sensible a errores que pueden desencadenar una variedad de defectos del desarrollo cardiaco, llamados cardiopatías congénitas, con una incidencia mundial de 8 a 10/1000 nacidos vivos. Para mejorar el diagnóstico y el tratamiento de las cardiopatías congénitas es necesario comprender adecuadamente los eventos implicados en la cardiogénesis normal. En este artículo se revisa el desarrollo cardiaco normal, contrastando la información de los estudios clásicos con la de hallazgos recientes. Se hace hincapié en la información obtenida de los estudios de anatomía descriptiva de cortes histológicos y marcaje selectivo in vivo en embriones de pollo. Adicionalmente, el descubrimiento de los campos cardiogénicos ha estimulado la investigación de eventos cardiogénicos que se creían comprendidos, contribuyendo con propuestas de nuevos modelos del desarrollo del corazón.

Normal development of the heart: a review of new findings / Desarrollo normal del corazón: revisión de nuevos hallazgos

Abstract Development and formation of the heart, the central organ of the circulatory system in vertebrates, starts early during embryonic development (second week), reaching maturity during the first few postnatal months. Cardiogenesis is a highly complex process that requires the active and orderly participation of different cardiac and non-cardiac cell populations. Thus, this process is sensitive to errors that may trigger a variety of heart-development defects, called congenital heart defects, which have a worldwide incidence of 8-10/1000 live births. A good understanding of normal cardiogenesis is required for better diagnosis and treatment of congenital heart diseases. This article reviews normal cardiogenesis by comparing information from classic studies with more recent findings. Information from descriptive anatomical studies of histological sections and selective in vivo marking of chicken embryos were emphasized. In addition, the discovery of heart fields has fueled the investigation of cardiogenic events that were believed to be understood and has contributed to proposals for new models of heart development.

Resumen El corazón, órgano central del aparato circulatorio de los vertebrados, comienza a formarse muy temprano en el desarrollo embrionario (segunda semana de gestación) y alcanza su forma madura durante los primeros meses posteriores al nacimiento. La cardiogénesis se caracteriza por ser un proceso altamente complejo, dependiente de la participación activa y ordenada de diferentes poblaciones celulares cardiacas y no cardiacas. Lo anterior hace que este proceso sea sensible a errores que pueden desencadenar una variedad de defectos del desarrollo cardiaco, llamados cardiopatías congénitas, con una incidencia mundial de 8 a 10/1000 nacidos vivos. Para mejorar el diagnóstico y el tratamiento de las cardiopatías congénitas es necesario comprender adecuadamente los eventos implicados en la cardiogénesis normal. En este artículo se revisa el desarrollo cardiaco normal, contrastando la información de los estudios clásicos con la de hallazgos recientes. Se hace hincapié en la información obtenida de los estudios de anatomía descriptiva de cortes histológicos y marcaje selectivo in vivo en embriones de pollo. Adicionalmente, el descubrimiento de los campos cardiogénicos ha estimulado la investigación de eventos cardiogénicos que se creían comprendidos, contribuyendo con propuestas de nuevos modelos del desarrollo del corazón.

Comparative phylogeography reveals the demographic patterns of neotropical ancient mountain species.

Mountains are renowned for their bountiful biodiversity. Explanations on the origin of such abundant life are usually regarded to their orogenic history. However, ancient mountain systems with geological stability also exhibit astounding levels of number of species and endemism, as illustrated by the Brazilian Quartzitic Mountains (BQM) in Eastern South America. Thus, cycles of climatic changes over the last couple million years are usually assumed to play an important role in the origin of mountainous biota. These climatic oscillations potentially isolated and reconnected adjacent populations, a phenomenon known as flickering connectivity, accelerating speciation events due to range fragmentation, dispersion, secondary contact, and hybridization. To evaluate the role of the climatic fluctuations on the diversification of the BQM biota, we estimated the ancient demography of distinct endemic species of animals and plants using hierarchical approximate Bayesian computation analysis and Ecological Niche Modelling. Additionally, we evaluated if climatic oscillations have driven a genetic spatial congruence in the genetic structure of codistributed species from the Espinhaço Range, one of the main BQM areas. Our results show that the majority of plant lineages underwent a synchronous expansion over the Last Glacial Maximum (LGM, c. 21 thousand years ago), although we could not obtain a clear demographic pattern for the animal lineages. We also obtained a signal of a congruent phylogeographic break between lineages endemic to the Espinhaço Range, suggesting how ancient climatic oscillations might have driven the evolutionary history of the Espinhaço's biota.

Geographic isolation alone does not explain divergence of a group of orchid species across Brazil's campos rupestres sky-islandsIsolamento geográfico por si só não explica a divergência de um grupo de espécies de orquídeas nos campos rupestres do Brasil.

Mountains play a crucial role in the origin and maintenance of Neotropical biodiversity, but there are still unanswered questions about the diversification of the campos rupestres (CR), an herbaceous-shrubby sky-island vegetation in eastern South America. For orchids distributed across this disjunct rock habitat, difficulties with distinguishing morphological taxa add an additional challenge to disentangling the history of divergence. Here, we combined the power of ddRAD genomic data with broad sampling of Bulbophyllum sect. Didactyle (Orchidaceae), across the CR and other Neotropical outcrops, to estimate evolutionary relationships and evaluate the biogeography of the group's diversification. Although genetic lineages generally align with geographic disjunctions, we also observe distantly related lineages within some previously recognized species. For such taxa, their lack of monophyly and a shared regional divergence pattern suggests a complex history that may include unrecognized diversity. When viewed through the lens of morphological variability, our study raises intriguing questions about the persistence and permeability of species barriers among orchid populations. These results, in addition to the recency of the divergence history of B. sect. Didactyle, provide insights about hypothesized community level vs. species-specific paths of diversification across the Neotropical sky-islands of the CR.

Floristic data to support conservation in the Amazonian canga / Dados florísticos para apoiar a conservação nas cangas amazônicas

Abstract Canga is an environment of great natural and economic value because it harbours a considerable number of endemic species on a substrate that is rich in iron ore. In the Amazon, this open vegetation type grows on top of isolated outcrops in a dense forest matrix found in the Carajás region, in southeastern Pará. Of these outcrops, the Parque Nacional dos Campos Ferruginosos (PNCF) is the only area of Amazonian canga with a strict protection status. Therefore, industrial activity in the region needs to implement mitigation actions to ensure species and habitat conservation. The objective of this study is to complement and review the floristic list of this recently created protected area, enabling us to compare the floristic similarity between it and other 14 Amazonian canga outcrops found outside the conservation units of full protection in the region. This data provides a basis to understand the floristic and phylogenetic complementarity of those patches to support conservation action. For this, six field trips were carried out in the Serra da Bocaina and two in the Serra do Tarzan, respectively, in order to increase the sampling efforts in PNCF and to obtain a more comprehensive plant list. Floristic composition was investigated using multivariate analyses (non-metric multidimensional scaling and unweighted pair group method with arithmetic mean) and phylogenetic structure across studied areas. We added 159 species to the floristic list of the PNCF and the results of the analyses showed that all 16 areas (n.b. PNCF comprises two of these sites) have an overall floristic similarity of 42%, with the least similar areas at 35% and the most similar at 50%. The different micro-habitats found in each study site highlight the high beta diversity of the Amazonian canga sites, making each area unique. Therefore, even if the Parque Nacional dos Campos Ferruginosos does not harbour all the species found in the other Amazonian canga sites, it is strategic for the conservation of the vegetation on ferruginous outcrops in the Amazon, protecting its biodiversity, different habitats, and associated ecosystem services.

Resumo Canga é um ambiente de grande valor natural e econômico por abrigar um número considerável de espécies endêmicas sobre substrato rico em minério de ferro. Na Amazônia, esse tipo de vegetação aberta cresce sobre afloramentos isolados em uma matriz de floresta densa encontrada na região de Carajás, no sudeste do Pará. Dentre esses afloramentos, o Parque Nacional dos Campos Ferruginosos (PNCF) é a única área de canga Amazônica que apresenta o status de proteção integral permanente. Dessa forma, a atividade industrial presente na região necessita implementar ações de mitigação para assegurar a conservação de espécies e habitats relacionados às cangas. O objetivo deste estudo é complementar e revisar a lista florística dessa área protegida, recentemente criada, permitindo comparar a sua similaridade florística com outros 14 afloramentos de cangas Amazônicas localizados fora de unidades de conservação de proteção integral encontradas na região. Tais dados fornecem subsídio para entender a complementaridade florística e filogenética desses fragmentos para apoiar ações de conservação. Para isso, foram realizadas seis viagens de coleta à Serra da Bocaina e à Serra do Tarzan, respectivamente, para aumentar o esforço amostral no PNCF e obter uma lista de plantas mais abrangente. A composição florística foi investigada por meio de análises multivariadas (non-metric multidimensional scaling and unweighted pair group method with arithmetic mean) e estrutura filogenética nas áreas estudadas. Nós adicionamos 159 espécies na lista florística do PNCF e os resultados das análises demonstraram que todas as 16 áreas (n.b. o PNCF compreende duas dessas áreas) têm uma similaridade florística total de 42%, com áreas menos similares de 35% e as mais similares de 50%. Os micro-habitats encontrados em cada área de estudo evidenciam a alta diversidade beta das áreas de cangas Amazônicas, o que as tornam únicas. Portanto, ainda que o Parque Nacional dos Campos Ferruginosos não abrigue todas as espécies encontradas em outras áreas de cangas Amazônicas, ele é estratégico para a conservação dos afloramentos ferruginosos na Amazônia, protegendo a sua biodiversidade, os diferentes habitats e os serviços ecossistêmicos associados.

Enfermagem empreendedora: novos campos de atuação / Entrepreneurial nursing: new fields of action / Entrepreneurial nursing: new fields of action

Introdução: A enfermagem empreendedora é marcante pelo crescimento da profissão para com a tecnologia, ciência e inovação dentro dos vários campos de atuação que a saúde proporciona, alcançando assim, outros patamares para a evolução profissional dos enfermeiros. Objetivo: Identificar novos campos de atuação do enfermeiro empreendedor. Metodologia: Trata-se de um estudo descritivo, exploratório do tipo bola de neve com abordagem qualitativa por meio da aplicação de questionário do Google Forms on-line, realizado com enfermeiros empreendedores. Os dados foram analisados pela técnica de análise de conteúdo de Bardin. Resultados: Entre os entrevistados foi identificado que 88,2% eram do sexo feminino, com idade entre 24 e 49 anos, sendo a faixa etária de 26 anos predominante (23,5%), de diversos estados do Brasil, se destacando maior porcentagem no Maranhão (47,06%). As áreas de atuação que mais se destacaram entre os entrevistados foram: Pesquisa Científica: consultoria e assessoria, estomaterapia, enfermagem estética e a produção de conteúdo educativos e preparatórios pra concursos de enfermagem, sendo os principais desafios relatados como a falta de recursos financeiros para investir e a captação de clientes no início. Como características que o destaca e o diferencia dos outros profissionais, predominou-se boa comunicação, entender o que seu cliente necessita, ser persistente e ético. Os entrevistados também verbalizaram a importância de se empreender na enfermagem, visto que ela tem se destacado muito atualmente, gerando mais renda e satisfação profissional. Conclusão: as áreas de crescimento da enfermagem empreendedora são amplas e abrangem diferentes áreas de atuação, possibilitando mais oportunidades de emprego e sucesso na carreira.

Introduction: Entrepreneurial nursing is remarkable for the growth of the profession towards technology, science and innovation within the various fields of action that health provides, thus reaching other levels for the professional evolution of nurses. Objective: To identify new fields of action for entrepreneurial nurses. Methodology: This is a descriptive, exploratory snowball study with a qualitative approach through the ap- plication of an online Google Forms questionnaire, carried out with entrepreneurial nurses. Data were analyzed using Bardin's content analysis technique. Results: Among the interviewees, it was identified that 88.2% were female, aged between 24 and 49 years, with the predominant age group of 26 years (23.5%), from several states of Brazil, high- lighting the highest percentage in Maranhão (47.06%). The areas of activity that most stood out among the interviewees were: Scientific Research: consultancy and assistance, stomatherapy, aesthetic nursing and the production of educational and preparatory con- tent for nursing contests, with the main challenges reported as the lack of financial re- sources to invest and attracting customers early on. As characteristics that highlight and differentiate him from other professionals, good communication prevailed, understanding what his client needs, being persistent and ethical. The interviewees also verbalized the importance of undertaking nursing, as it has stood out a lot nowadays, generating more income and professional satisfaction. Conclusion: the growth areas of entrepreneurial nursing are wide and cover different areas of activity, providing more job opportunities and career success.

Introducción: La enfermería emprendedora se destaca por el crecimiento de la profesión hacia la tecnología, la ciencia y la innovación dentro de los diversos campos de acción que brinda la salud, alcanzando así otros niveles para la evolución profesional de las enfermeras. Objetivo: Identificar nuevos campos de acción para enfermeros em- prendedores. Metodología: Se trata de un estudio descriptivo, exploratorio tipo bola de nieve con abordaje cualitativo mediante la aplicación de un cuestionario en línea Google Forms, realizado con enfermeros emprendedores. Los datos se analizaron utilizando la técnica de análisis de contenido de Bardin. Resultados: Entre los entrevistados, se identi- ficó que el 88,2% eran del sexo femenino, con edad entre 24 y 49 años, con predominio de la franja etaria de 26 años (23,5%), de varios estados de Brasil, destacándose el mayor porcentaje en Maranhão (47,06% ). Las áreas de actividad que más se destacaron entre los entrevistados fueron: Investigación Científica: consultoría y asistencia, estomaterapia, enfermería estética y producción de contenidos educativos y preparatorios para concursos de enfermería, siendo los principales desafíos relatados la falta de recursos económicos para invertir y atraer clientes desde el principio. Como características que lo destacan y lo diferencian de otros profesionales, prevaleció la buena comunicación, entender lo que su cliente necesita, ser persistente y ético. Los entrevistados también verbalizaron la im- portancia de ejercer la enfermería, ya que se ha destacado mucho en la actualidad, gene- rando más ingresos y satisfacción profesional. Conclusión: las áreas de crecimiento de la enfermería emprendedora son amplias y abarcan diferentes áreas de actividad, proporci- onando más oportunidades de trabajo y éxito profesional.

Campo eletromagnético focado de alta intensidade para o tratamento da celulite / High-intensity focused electromagnetic field treatment for cellulite

Introdução: O tratamento com campo eletromagnético focado de alta intensidade (HIFEM) usa ondas eletromagnéticas de baixa frequência para induzir contrações musculares, causando hipertrofia muscular e reduzindo a gordura subcutânea. Objetivo: avaliar os efeitos de um tratamento com HIFEM na celulite nos glúteos. Métodos: trinta mulheres foram recrutadas e randomizadas em 2 grupos que receberam 8 ou 12 sessões de HIFEM na região dos glúteos. A celulite foi avaliada utilizando a Cellulite Severity Scale, a Global Aesthetic Improvement Scale e um questionário de satisfação. Mudanças na composição corporal foram avaliadas com bioimpedância e medidas da circunferência do quadril. Resultados: a aparência global da região glútea das pacientes melhorou com o tratamento. Houve melhora na celulite de algumas pacientes, mas para a maioria a melhora não foi grande o suficiente para resultar em uma mudança de classificação na Cellulite Severity Scale. A satisfação foi alta e os eventos adversos foram poucos, não-graves e transitórios. Conclusão: os efeitos do tratamento com HIFEM na celulite da região glútea são sutis. Contudo, este tratamento é capaz de melhorar globalmente a aparência da região glútea, melhorando a percepção das pacientes sobre a gravidade de sua celulite

Introduction: High-intensity focused electromagnetic field treatment (HIFEM) uses low-frequency electromagnetic waves to induce supramaximal muscle contractions, causing muscle hypertrophy and reducing fat. Objective: To evaluate the effects of a HIFEM treatment for the improvement of cellulite on the buttocks. Methods: Thirty patients were divided into two groups that received eight or 12 HIFEM sessions on the buttocks for six weeks. We assessed the improvement in cellulite and the buttocks' global appearance through the Cellulite Severity Scale (CSS), the Global Aesthetic Improvement Scale (GAIS), and a satisfaction questionnaire. Changes in body composition were evaluated through bioimpedance and hip circumference measurements. Results: Patients from both groups improved the global appearance of their buttocks. Cellulite lesions of some patients improved, but for most patients, the improvement wasn't great enough to change the grade on the Cellulite Severity Scale. Patient satisfaction was high and adverse events were few, minor, and transitory. Conclusion: The effects of HIFEM on cellulite are subtle, as this treatment modality cannot address the fibrous septa that cause the depressed lesions of cellulite. Nevertheless, HIFEM procedures can improve the buttocks' global appearance, enhancing the patients' subjective perception of their cellulite.

Mapping threatened canga ecosystems in the Brazilian savanna using U-Net deep learning segmentation and Sentinel-2 images: a first step toward conservation planning / Mapeamento de ecossistemas de canga ameaçados no Cerrado brasileiro utilizando deep learning segmentação U-Net e imagens Sentinel-2: um primeiro passo para o planejamento de conservação

Abstract Canga ecosystems are iron-rich habitats and pose a challenge for conservation and environmental governance in Brazil. They support high levels of biodiversity and endemism and, at the same time, have suffered intense losses and degradation due to large-scale iron ore mining. The Peixe Bravo River Valley in the Brazilian savanna is one of the last natural canga areas that has yet to face the irreversible impacts of mining. However, there are vast gaps in data on the vegetation cover, location, spatial distribution, and area of occurrence of this ecosystem. Therefore, more information is needed on the appropriate scale, without which it is difficult to establish conservation planning and strategies to prevent, mitigate or compensate for impacts on canga ecosystems. In this study, we provide the first map of canga ecosystems in Brazil using the U-Net deep learning model and Sentinel-2 images. In addition, we estimate the degree of direct threat faced by ecosystems due to the spatial overlap of the mapped cangas and the location of mining concession areas for iron ore exploitation. The deep learning algorithm identified and segmented 762 canga patches (overall accuracy of 98.5%) in an area of 30,000 ha in the Peixe Bravo River Valley, demonstrating the high predictive power of the mapping approach. We conclude that the direct threat to canga ecosystems is high since 99.6% of the observed canga patches are included in mining concession areas. We also highlight that the knowledge acquired about the distribution of cangas through the application of an effective method of artificial intelligence and the use of open-source satellite images is especially important for supporting conservation strategies and environmental public policies.

Resumo Os ecossistemas de Canga, habitats com elevadas concentrações de ferro, são um desafio para conservação e governança ambiental no Brasil. Eles sustentam uma alta biodiversidade e endemismo, e sofreram intensas perdas e degradações de áreas naturais devido à mineração de ferro em larga escala. O Vale do Rio Peixe Bravo, localizado no Cerrado brasileiro, é uma das últimas regiões com ecossistemas de canga que ainda não sofreu impactos irreversíveis da mineração. Mas ainda há ausência de dados sobre a cobertura vegetal, localização, distribuição geográfica e a área de ocorrência desse ecossistema. Portanto, a ausência de informações em escala adequada dificulta o planejamento em conservação e as estratégias para prevenir, mitigar ou compensar os impactos nos ecossistemas de canga. Neste estudo, nós fornecemos o primeiro mapa de ecossistemas de canga no Brasil elaborado a partir de deep learning segmentação U-Net e imagens de satélite Sentinel-2. Além disso, nós estimamos o grau de ameaça direta dos ecossistemas devido a sobreposição espacial das manchas de cangas preditas e a localização dos títulos de concessão minerária para exploração do minério de ferro. O algoritmo de aprendizado profundo identificou 762 manchas de canga (acurácia acima de 98,5%) em uma área de 30.000 ha no Vale do Rio Peixe Bravo, demonstrando o alto poder preditivo do método de mapeamento. Nós estimamos que há um alto grau de ameaça direta aos ecossistemas de canga, uma vez que 99,6% das manchas de cangas preditas estão incluídas em áreas de concessão de mineração. Nós também destacamos que o conhecimento adquirido sobre a distribuição das cangas por meio da aplicação de um método eficaz de inteligência artificial e do uso de imagens de satélite de código aberto é especialmente importante para apoiar estratégias de conservação e políticas públicas ambientais.

Glaucoma-simulating cupping in a patient with periventricular leukomalacia: a clinical case report / Escavação simulando glaucoma em paciente com leucomalácia periventricular: relato de caso clínico

ABSTRACT Non-glaucomatous papillary cupping constitutes an important differential diagnosis in daily medical practice. There are patients diagnosed and treated as glaucoma, who do not present the disease and are part of the large group of non-glaucomatous optic neuropathies. This case emphasizes directing the diagnostic gaze to these "apparently glaucomatous" optic nerves through a case of periventricular leukomalacia. Patients with a history of prematurity, alterations in the cerebral white matter and presence of optic nerve excavations with normal intraocular pressures.

RESUMO A escavação papilar não glaucomatosa constitui um importante diagnóstico diferencial na prática médica diária. Há pacientes que recebem o diagnóstico de e tratamento para glaucoma, que não apresentam a doença e fazem parte do grande grupo de neuropatias ópticas não glaucomatosas. Este caso enfatiza o direcionamento do olhar diagnóstico para nervos ópticos "aparentemente glaucomatosos" através de um episódio de leucomalácia periventricular. Pacientes com histórico de prematuridade, alterações na substância branca do cérebro e presença de escavações do nervo óptico com pressões intraoculares normais.

Coral reef fish assemblages exhibit signs of depletion in two protected areas from the eastern of Los Canarreos archipelago (Cuba, Caribbean Sea).

Understanding the impact of marine protected areas on the distribution and composition of fishes is key to the protection and management of coral reef ecosystems, and especially for fish-based activities such as SCUBA diving and recreational fishing. The aim of this research is to compare the ichthyofauna structure in three areas in the eastern part of Los Canarreos archipelago in Cuba with different management schemes: Cayo Campos-Cayo Rosario Fauna Refuge (CCCR), Cayo Largo Ecological Reserve (CL) and non-protected area (nMPA), and considering habitat differences and depth variation. A total of 131 video transects were conducted using diver operated stereo-video (stereo-DOV) in November, 2015 in backreef and forereef along the CCCR, CL and the adjacent nMPA. We recorded 84 species and 27 functional groups suggesting high complementarity of functions. Several multispecies schools were observed along surveys, which explain the biomass peaks in some sites, mainly for Lutjanidae, Haemulidae and Carangidae. A concerning issue was the bare representation of critical functional groups and threatened species. The effect of sites nested within habitats was significant and the most important driver structuring fish assemblages, while MPA condition was not evident. Favorable habitat features (habitat heterogeneity and surrounding coastal ecosystems) are likely enhancing fish assemblages and counteracting the effects of pouching derived from insufficient management. We recommend immediate actions within a strategy of precautionary management including, but not limited to, the appointment of staff for the administration of CL, frequent monitoring and effective enforcement.

Novel land uses shape meta-community structures in neighbouring native forests: Dataset across Uruguay.

The presented datasets relate to the research article entitled "Native forest meta-community structures in Uruguay shaped by novel land use types in their surroundings" [Ramírez and Säumel; Ecology and Evolution, 2022]. The datasets include field survey data on woody species presence and absence from 384 plots at 32 permanent monitoring sites of native forests across the Oriental Republic of Uruguay (South America). We compiled different methods from meta-community studies, remote sensing and landscape ecology to explore how woody species communities are influenced by land use change from local to regional scale. We describe the diverse woody species composition in native forests across Uruguay and structure of metacommunities of woody species. Data on woody species diversity inform landscape planning, land-use management, policy and governance and can be used for further meta-analysis with other local, regional or global data sets.

Native forest metacommunity structures in Uruguay shaped by novel land-use types in their surroundings.

We explore the effect of land-use change from extensively used grasslands to intensified silvi- and agricultural monocultures on metacommunity structure of native forests in Uruguay. We integrated methods from metacommunity studies, remote sensing, and landscape ecology to explore how woody species distribution was influenced by land-use change from local to regional scale. We recorded richness and composition of adult and juvenile woody species from 32 native forests, created land-use maps from satellite image to calculate spatial metrics at landscape, class, and patch levels. We also analyzed the influence of land use pattern, climate, topography, and geographic distance between sites (d) on metacommunity, and created maps to visualize species richness and (dis)similarity between communities across the country. Woody species communities were distributed in a discrete pattern across Uruguay. Precipitation and temperature seasonality shaped species distribution pattern. Species richness and community dissimilarity increased from West to East. Latitude did not influence these patterns. Number of patches, landscape complexity, and interspersion and juxtaposition indexes determine woody species distribution at landscape level. Increasing areas covered by crops and timber plantation reduced species richness and increased community dissimilarity. The spatial metrics of native forest fragments at patch level did not influence metacommunity structure, species richness, and community dissimilarity. In conclusion, Uruguayan native forests display a high range of dissimilarity. Pressure of neighborhood land uses was the predominant factor for species assemblages. Conserving landscape structures that assure connectivity within and among native forest patches is crucial. On sites with rare target species, the creation of alliances between governmental institution and landowner complemented by incentives for biodiversity conservation provides opportunities to advance in species protection focused on those less tolerant to land-use change.

Three new species of Microlaimus (Nematoda: Microlaimidae) from the South Atlantic.

Three new species of Microlaimus are described from the continental shelf of the Campos Basin, southwest Atlantic, Brazil. Microlaimus campiensis sp. n. differs from all other species in the presence of two anterior testes, slender spicules with enlarged proximal ends, 7-11 pre-cloacal papilliform supplements, and females with a pair of constriction structures, one on each branch of the ovary. Microlaimus alexandri sp. n. shows sexual dimorphism in the size of the amphidial fovea, which occupies 100% of the diameter of the corresponding area in the male; the buccal cavity provided with five teeth and a slightly cuticularized cuticular ring. Microlaimus vitorius sp. n. has four longitudinal-lateral rows of glands associated with small pores, one seta and three pores small pre-cloacal, and the gubernaculum has a triangular base. An amendment to the diagnosis of the genus is proposed, where the number of teeth was modified.

Mercury distribution in water masses of the South Atlantic Ocean (24°S to 20°S), Brazilian Exclusive Economic Zone.

Mercury (Hg) is a toxic globally spread pollutant that has been found at increasing concentrations in the South Atlantic Ocean. The present work provides the first insight into the total mercury (HgT, unfiltered waters) content in the water of the Brazilian Exclusive Economic Zone (BEEZ), within a 24°S to 20°S. Water samples were collected from surface to 3400 m depth along transects, and analyzed with atomic fluorescence. The mean HgT concentration for the Tropical Water mass (TW) was 6.3 ± 1.4 pM (n = 16), for the South Atlantic Central Water (SACW), 5.9 ± 0.7 pM (n = 8), for the Antarctic Intermediate Water (AAIW), 5.0 ± 0.6 pM (n = 2), for the Upper Circumpolar Deep Water (UCDW), 6.5 pM (n = 1), and for the North Atlantic Deep Water (NADW), 5.7 ± 0.9 pM (n = 12). HgT concentrations were highest throughout the BEEZ in comparison with other parts of the Atlantic Ocean, farther from the coast.