Acute frailty services: results of a national day of care survey.

INTRODUCTION: Older people living with frailty are at high risk of emergency hospital admission and often have complex care needs which may not be adequately met by conventional models of acute care. This has driven the introduction of adaptations to acute care pathways designed to improve outcomes in this patient group. The identification of differences in the organisational approach to frailty may highlight opportunities for quality improvement. METHODS: The Society for Acute Medicine Benchmarking audit is a national service evaluation which uses a single day-of-care methodology to record patient and organisational level data. All acute hospitals in the United Kingdom are eligible to participate. Emergency admissions referred to acute medical services between 00:00 and 23:59 on Thursday 23rd June 2022 were recorded. Information on the structure and operational design of acute frailty services was collected. The use of a validated frailty assessment tool, clinical frailty scale within the first 24 h of admission, assessment by an acute frailty service and clinical outcomes were reported in patients aged 70 year and above. A mixed effect generalised linear model was used to determine factors associated same-day discharge without overnight stay in patients with frailty. RESULTS: A total of 152 hospitals participated. There was significant heterogeneity in the operational design and staffing model of acute frailty services. The presence of an acute frailty unit was reported in 57 (42.2%) hospitals. The use of validated frailty assessment tools was reported in 117 (90.0%) hospitals, of which 107 (91.5%) used the clinical frailty scale. Patient-level data were recorded for 3604 patients aged 70 years and above. At the patient level, 1626 (45.1%) were assessed using a validated tool during the admission process. Assessment by acute frailty services was associated with an increased likelihood of same-day discharge (adjusted OR 1.55, 95%CI 1.03- 2.39). CONCLUSION: There is significant variation in the provision of acute frailty services. Frailty-related policies and services are common at the organisational level but implemented inconsistently at the patient level. Older people with frailty or geriatric syndromes assessed by acute frailty services were more likely to be discharged without the need for overnight bed-based admission.

Development of activation-tagged gain-of-functional mutants in indica rice line (BPT 5204) for sheath blight resistance.

BACKGROUND: The development of sheath blight (ShB) resistance varieties has been a challenge for scientists for long time in rice. Activation tagging is an efficient gain-of-function mutation approach to create novel phenotypes and to identify their underlying genes. In this study, a mutant population was developed employing activation tagging in the recalcitrant indica rice (Oryza sativa L.) cv. BPT 5204 (Samba Mahsuri) through activation tagging. METHODS AND RESULTS: In this study, we have generated more than 1000 activation tagged lines in indica rice, from these mutant population 38 (GFP- RFP+) stable Ds plants were generated through germinal transposition at T2 generation based on molecular analysis and seeds selected on hygromycin (50 mg/L) containing medium segregation analyses confirmed that the transgene inherited as mendelian segregation ratio of 3:1 (3 resistant: 1 susceptible). Of them, five stable activation tagged Ds lines (M-Ds-1, M-Ds-2, M-Ds-3, M-Ds-4 and M-Ds-5) were selected based on phenotypic observation through screening for sheath blight (ShB) resistance caused by fungal pathogen Rhizoctonia solani (R. solani),. Among them, M-Ds-3 and M-Ds-5 lines showed significant resistance for ShB over other tagged lines and wild type (WT) plants. Furthermore, analysed for launch pad insertion through TAIL-PCR results and mapped on corresponding rice chromosomes. Flanking sequence and gene expression analysis revealed that the upregulation of glycoside hydrolase-OsGH or similar to Class III chitinase homologue (LOC_Os08g40680) in M-Ds-3 and a hypothetical protein gene (LOC_Os01g55000) in M-Ds-5 are potential candidate genes for sheath blight resistance in rice. CONCLUSION: In the present study, we developed Ac-Ds based ShB resistance gain-of-functional mutants through activation tagging in rice. These activation tagged mutant lines can be excellent sources for the development of ShB resistant cultivars in rice.

An Exploratory Study on the Effect of 2 Brazilian Dance Protocols on Motor Aspects and Quality of Life of Individuals with Parkinson's Disease.

BACKGROUND: Due to its multiple benefits in Parkinson's Disease, Dance has been a widely recommended activity in rehabilitation. However, there is a gap in the literature on the use of Brazilian sytles in rehabilitation protocols. This study aimed to compare the effect of 2 different protocols of Brazilian dance, samba and forró, and samba on motor aspects and quality of life of individuals with Parkinson's disease. METHODS: In a nonrandomized clinical trial lasting 12 weeks, 69 individuals with Parkinson's disease participated in the study: forró and samba group (FSG = 23), samba group (SG = 23), and control group (CG = 23). RESULTS: Significant improvements were found after SG intervention in the UPDRSIII and in the subitem quality of life mobility. In intra-group comparisons of FSG, significant differences were found in the subtype of quality of life discomfort. In the intergroup analysis, significant differences were found between CG, SG, and FSG in the communication sub-item, showing a greater increase in the scores of the groups that participated in the SG and FSG. CONCLUSIONS: The findings of this study suggest that Brazilian dance practice is capable of improving the perception of some aspects of quality of life and motor symptoms in relation to controls in people with Parkinson's disease.

Performance with a new bone conduction implant audio processor in patients with single-sided deafness.

PURPOSE: The SAMBA 2 BB audio processor for the BONEBRIDGE bone conduction implant features a new automatic listening environment detection to focus on target speech and to reduce interfering speech and background noises. The aim of this study was to evaluate the audiological benefit of the SAMBA 2 BB (AP2) and to compare it with its predecessor SAMBA BB (AP1). METHODS: Prospective within-subject comparison study. We compared the aided sound field hearing thresholds, speech understanding in quiet (Freiburg monosyllables), and speech understanding in noise (Oldenburg sentence test) with the AP1 and AP2. Each audio processor was worn for 2 weeks before assessment and seven users with single-sided sensorineural deafness (SSD) participated in the study. For speech understanding in noise, two complex noise scenarios with multiple noise sources including single talker interfering speech were used. The first scenario included speech presented from the front (S0NMIX), while in the second scenario speech was presented from the side of the implanted ear (SIPSINMIX). In addition, subjective evaluation using the SSQ12, APSQ, and the BBSS questionnaires was performed. RESULTS: We found improved speech understanding in quiet with the AP2 compared to the AP1 aided condition (on average + 17%, p = 0.007). In both noise scenarios, the AP2 lead to improved speech reception thresholds by 1.2 dB (S0NMIX, p = 0.032) and 2.1 dB (SIPSINMIX, p = 0.048) compared to the AP1. The questionnaires revealed no statistically significant differences, except an improved APSQ usability score with the AP2. CONCLUSION: Clinicians can expect that patients with SSD will benefit from the SAMBA 2 BB by improved speech understanding in both quiet and in complex noise scenarios, when compared to the older SAMBA BB.

The impact of frailty and geriatric syndromes on metrics of acute care performance: results of a national day of care survey.

Background: Frailty is associated with a range of adverse clinical outcomes in the acute hospital setting. We sought to determine whether frailty and related factors affected clinical processes such as time to assessment during emergency hospital admission within the National Health Service (NHS) in the UK. Methods: The Society for Acute Medicine Benchmarking Audit (SAMBA) is an annual cross-sectional day of care survey. SAMBA 2022 was conducted on Thursday 23rd June 2022. We assessed whether the Clinical Frailty Scale (CFS) and presence of a geriatric syndrome affected performance against nationally recognised clinical quality indicators based on time to initial assessment and time to consultant review. CFS was graded into robust (CFS1-3), mild (CFS 4-5), moderate (CFS 6), severe (CFS7-8) and terminal illness (CFS 9). Plausible values were created for missing variables using multi-level multiple imputation. The association was described using mixed effect generalised linear models adjusting for initial National Early Warning Score 2 (NEWS2) and time of arrival. Findings: A total of 152 hospitals provided patient level data relating to 7248 emergency medical admissions. Patients with mild, moderate and severe frailty were less likely to be assessed within 4 h of arrival (adjusted OR, mild 0.79, 95% CI 0.68-0.96, moderate 0.67 95% CI 0.53-0.84, severe, 0.75 95% CI 0.58-0.96, terminally ill 0.59 95% CI 0.23-1.43) and less likely to be achieve the clinical quality indicator for consultant review (adjusted OR, mild 0.69 95% CI 0.58-0.83, moderate 0.55 95% CI 0.44-0.70, severe 0.54 95% CI 0.41-0.69, terminally ill 0.76 95% CI 0.42-1.5). Patients with geriatric syndromes were also less likely to be assessed within 4 h of arrival (adjusted OR 0.66 95% CI 0.56-0.76) or by a consultant within the recommended time frame (adjusted OR 0.45 95% CI 0.39-0.51). The difference was partially explained by differential use of SDEC pathways. Sub-group analysis of 5148 patients assessed outside of SDEC areas demonstrated patients with geriatric syndromes (adjusted OR 0.71, 95% CI 0.60-0.83), but not frailty defined by CFS were less likely to be assessed within 4 h of arrival. Moderate and severe frailty and the presence of a geriatric syndrome were associated with a decreased likelihood of achieving the consultant review standard (moderate, adjusted OR 0.75, 95% CI 0.59-0.94, severe adjusted OR 0.75 95% CI 0.58-0.96, geriatric syndrome adjusted OR 0.59, 95% CI 0.50-0.69). Interpretation: Frailty is associated with delayed clinical assessment. This association may suggest a systemic issue with clinical prioritisation, with important implications for acute care policy. Funding: The database for SAMBA is funded by the Society for Acute Medicine.

A Comparative Metabolomic Analysis Reveals the Nutritional and Therapeutic Potential of Grains of the Traditional Rice Variety Mappillai Samba.

Rice (Oryza sativa L.) is the staple food of the majority of the population, particularly in Asia and Africa. Enriching rice with nutritional and therapeutic contents can improve its benefits for patients with lifestyle disorders. This study aimed to profile the phytochemical contents of the therapeutically known traditional rice Mappillai Samba against white rice CBMAS 14065 using non-targeted gas chromatography-mass spectrometry (GC-MS/MS). An analysis of the data using a mass spectrometry-data independent analysis (MS-DIAL) and MetaboAnalyst identified 113 metabolites belonging to 21 different classes of metabolites. A partial least square-discriminant analysis (PLS-DA) revealed 43 variable importance in projection (VIP) metabolites. This study identified therapeutically important metabolites, including phenylpropanoids, phytosterols, flavonoids, and polyamines, in the grains of Mappillai Samba. Three significant metabolic pathways, viz., phenylpropanoid biosynthesis, ubiquinone and other terpenoid-quinone biosynthesis, and steroid biosynthesis, were responsible for the grain metabolome variation between CBMAS 14065 and Mappillai Samba. Overall, the results of this study unravelled the biochemical complexity of Mappillai Samba, paving the way for the genetic mapping of the therapeutic compound accumulation in rice and the development of similar therapeutic rice varieties through molecular breeding.

Speech perception and hearing effort using a new active middle ear implant audio processor.

PURPOSE: The Vibrant Soundbridge (VSB) was introduced in 1996, and the fourth generation of the audio processor recently released. This clinical study evaluates the audiological performance and subjective satisfaction of the new SAMBA 2 audio processor compared to its predecessor, SAMBA. METHOD: Fifteen VSB users tested both audio processors for approximately 3 weeks. Air conduction and bone conduction thresholds and unaided and aided sound field thresholds were measured with both devices. Speech performance in quiet (Freiburg monosyllables) and noise (OLSA) was evaluated as well as subjective listening effort (ACALES) and questionnaire outcomes (SSQ12 and APSQ). In addition, data from 16 subjects with normal hearing were gathered on sound field tests and ACALES. RESULTS: Both audio processors showed substantial improvement compared to the unaided condition. The SAMBA and SAMBA 2 had comparable performance in sound filed thresholds, while the SAMBA 2 was significantly better in speech in quiet, speech in noise, reduced listening effort, and improved subjective satisfaction compared with the SAMBA. CONCLUSION: The SAMBA 2 audio processor, compared to its predecessor SAMBA, offers improved performance throughout the parameters investigated in this study. Patients with a VSB implant would benefit from an upgrade to SAMBA 2.

Evaluating the Sensitivity and Specificity of Siemens Clinitest Lateral Flow Test and the Simple AMplification-Based Assay (SAMBA)-2 PCR Test for SARS-CoV-2 Infection.

Introduction Accurate point-of-care testing for SARS-CoV-2 could quickly identify which patients need to be isolated and improve flow for patients being admitted as an emergency to the hospital. We evaluated two diagnostic tests with shorter turnaround times, the Siemens Clinitest Lateral Flow (Siemens Healthineers AG, Erlangen, Germany) and the Simple AMplification-Based Assay (SAMBA)-2 PCR test against a standard laboratory PCR test. Methods We conducted a prospective diagnostic cohort study in a single English emergency department. Adult participants underwent three swabs: the Siemens Clinitest Lateral Flow Test, the SAMBA-2 and a standard laboratory PCR test. Results A total of 212 participants were recruited. The sensitivity and specificity of the Siemens Clinitest Lateral Flow Test against the laboratory PCR test was 55.6% (95% CI 30.8-78.5) and 100% (95% CI 98.1-100) respectively. The sensitivity and specificity of the SAMBA-2 PCR test against the laboratory PCR test was 60.0% (95% CI 32.3-83.7) and 100% (95% CI 97.9-100) respectively. Conclusion Neither the Siemens Clinitest Lateral Flow Test nor the SAMBA-2 PCR test demonstrated sufficient sensitivity to rule out active SARS-CoV-2 infection. Both tests demonstrated high specificity.

Carnivalizing health promotion in Samba Schools: a review of the literature / Carnavalizando a promoção de saúde nas Escolas de Samba: uma revisão bibliográfica

This is a systematic bibliographic review study to analyze articles published in the field of Health Sciences, especially in Public Health, whose theme was carnival and samba schools. The objective was to analyze how health research has portrayed the health-disease process in samba schools and in carnival. Eleven articles were analyzed. Thus, scientific productions were found related to the theme with issues related to STIs and HIV-AIDS, the hearing health of carnival workers, historical perspectives on the 1919 carnival and the 1918 Spanish flu, yet studies that make it possible to observe health promotion in health schools and carnival beyond an event, but rather as a process.The fundamental objective of the analysis was to shift the understanding of health as negative of the disease, to health as a life affirmation. As well as, demystifying prejudiced understandings about carnival and samba schools with regard to the health of those who produce and participate in the event.

Este trabalho trata-se de uma revisão bibliográfica sistemática que buscou analisar artigos produzidos no campo das Ciências da Saúde, em especial na Saúde Coletiva, que tiveram por temática o carnaval e as escolas de samba. Objetivou-se analisar como as pesquisas em saúde tem retratado o processo de saúde-doença nas escolas de samba e no carnaval. Foram analisados 11 artigos que se relacionavam com o escopo desta pesquisa. Assim, foram encontradas produções científicas relacionados a temática com questões ligadas às ISTs e HIV-AIDS, à saúde auditiva dos trabalhadores de escolas de samba, perspectivas históricas sobre o carnaval de 1919 e a gripe espanhola de 1918, ainda estudos que possibilitam observar a promoção de saúde nas escolas de saúde e o carnaval para além de um evento, mas sim como um processo. A análise teve por fundamental objetivo deslocar o entendimento de saúde enquanto negativo da doença, para saúde como afirmação da vida. Assim como, desmistificar entendimentos preconceituosos sobre o carnaval e as escolas de samba no que se refere a saúde daqueles que produzem e participam do evento.

Texto das palavras e texto dos corpos (Peçasamba) / Text of words and text of bodies (Sambapiece) / Texto de palabras y texto de cuerpos (Piezasamba)

A psicologia, pela via da psicanálise, sugere um diálogo com a arte da dança. Pensamos o corpo como instância psíquica, palco do movimento cuja expressão se faz palavra. Nesse cenário o sentido se produz e pode ser ressignificado; dançantes se transformam no enredo de como a vida é. Nosso objetivo é apresentar uma peça teórica (e descrição de uma prática) articulando o corpo à dança, cuja arte é capaz de ressignificação da experiência traumática. O trabalho se compõe de duas partes, o texto das palavras e o texto dos corpos. No primeiro uma peça teórica sobre o corpo e a dança, no outro a prática dançante e o diálogo corporal. Conclui-se que a dança, como arte e objeto de transformação, pode resgatar o sentido perdido pelo sujeito no âmbito individual, coletivo, histórico e sociocultural. O texto, seja ele das palavras ou dos corpos, é efeito do tecimento de algum sentido.

Psychology, through psychoanalysis, suggests a dialogue with the art of dance. We think of the body as a psychic instance, stage of the movement whose expression becomes word. In this scenario, meaning is produced and can be resignified; dancers become the plot of what life is like. Our aim is to present a theoretical piece (and description of a practice) articulating the body to dance, whose art is able of resignification of traumatic experience. The work consists of two parts, the text of words and the text of bodies. In the first, a theoretical piece about the body and dance, in the other a dancing practice and corporal dialogue. It is concluded that dance, as an art and object of transformation, can rescue the sense lost by the subject in the individual, collective, historical and sociocultural scope. The text, be it of words or bodies, is the effect of weaving some sense.

La psicología, a través del psicoanálisis, sugiere un diálogo con el arte de la danza. Pensamos en el cuerpo como una instancia psíquica, escenario del movimiento cuya expresión se convierte en palabra. En este escenario, el significado se produce y puede ser resignificado; bailarines se convierten en la trama de cómo es la vida. Nuestro objetivo es presentar una pieza teórica (y una descripción de una práctica) que articule el cuerpo con la danza, cuyo arte es capaz de resignificar la experiencia traumática. El trabajo consta de dos partes, el texto de las palabras y el texto de los cuerpos. En el primero, una pieza teórica sobre el cuerpo y la danza, en el otro una práctica bailando y diálogo corporal. Se concluye que la danza, como arte y objeto de transformación, puede rescatar el sentido perdido por el sujeto en el ámbito individual, colectivo, histórico y sociocultural. El texto, ya sea de palabras o cuerpos, es el efecto de tejer algún sentido.

The impact of Brazilian samba on balance and quality of life of individuals with Parkinson's disease / O impacto do samba brasileiro no equilíbrio e na qualidade de vida de indivíduos com doença de Parkinson

This non-randomized clinical trial aimed to analyze the impact of the Brazilian samba training protocol on the balance and quality of life of people with Parkinson's disease. Forty-seven individuals participated, with a mean age of 68 ± 9.3 years-old, 24 from the control group (CG) and 23 from the experimental group (EG). The CG was formed by those who did not participate in the interven-tion, and the EG by individuals who participated in the Brazilian samba dance protocol. This study was divided into pre-intervention (before 12 weeks) and post-intervention (after 12 weeks) with a questionnaire consisting of: Mini Mental State Examination (MMSE); Unified Parkinson's Disease Rating Scale (UPDRS); Quality of life (PDQ-39); Berg's Balance Scale; Perception of perceived changes. The results point to a significant improvement after the intervention in the UPDRS (p < 0.001) and balance (p = 0.006) of the EG; in the quality of life of the EG after intervention in the mobility (p = 0.009) and total (p = 0.034) domains; and in the post-intervention period in the cog-nitive (p = 0.025) and communication (p = 0.032) domains of the EG and CG. Thus, it is concluded that the Brazilian samba rhythm has been shown to be effective in improving the total UPDRS, balance and quality of life, as well as in mobility, cognition and communication

Esse ensaio clínico não randomizado teve como objetivo analisar o impacto do protocolo de treinamento de samba brasileiro no equilíbrio e na qualidade de vida de pessoas com a doença de Parkinson. Participaram quarenta e sete indivíduos, média de idade de 68 ± 9,3 anos, 24 do grupo controle (GC) e 23 do grupo experimental (GE). O GC foi formado por aqueles que não participaram da intervenção, e o GE por indivíduos que participaram do protocolo de dança do samba brasileiro. Este estudo foi dividido em pré-intervenção (antes das 12 semanas) e pós-intervenção (após as 12 semanas) com um questionário composto por: Mini Exame do Estado Mental (MEEM); Escala Unificada de Avaliação de Doença de Parkinson (UPDRS); Qualidade de vida (PDQ-39); Escala de Equilíbrio de Berg; Percepção das mudanças percebidas. Os resul-tados apontam para uma melhora significativa após a intervenção no UPDRS (p < 0,001) e equilíbrio (p = 0,006) do GE; na qualidade de vida do GE pós intervenção nos dominios mobilidade (p = 0,009) e total (p = 0,034); e no período pós intervenção nos domínios cognitivos (p = 0,025) e comunicação (p = 0,032) do GE e GC. Desta forma conclui-se que o ritmo samba brasileiro tem se mostrado eficaz na melhora do UPDRS total, do equilíbrio e da qualidade de vida, como na mobilidade, cognição e comunicação

Implementation and operational feasibility of SAMBA I HIV-1 semi-quantitative viral load testing at the point-of-care in rural settings in Malawi and Uganda.

OBJECTIVE: We monitored a large-scale implementation of the Simple Amplification-Based Assay semi-quantitative viral load test for HIV-1 version I (SAMBA I Viral Load = SAMBA I VL) within Médecins Sans Frontières' HIV programmes in Malawi and Uganda, to assess its performance and operational feasibility. METHODS: Descriptive analysis of routine programme data between August 2013 and December 2016. The dataset included samples collected for VL monitoring and tested using SAMBA I VL in five HIV clinics in Malawi (four peripheral health centres and one district hospital), and one HIV clinic in a regional referral hospital in Uganda. SAMBA I VL was used for VL testing in patients who had been receiving ART for between 6 months and ten years, to determine whether plasma VL was above or below 1000 copies/mL of HIV-1, reflecting ART failure or efficacy. Randomly selected samples were quantified with commercial VL assays. SAMBA I instruments and test performance, site throughput, and delays in communicating results to clinicians and patients were monitored. RESULTS: Between August 2013 and December 2016 a total of 60 889 patient samples were analysed with SAMBA I VL. Overall, 0.23% of initial SAMBA I VL results were invalid; this was reduced to 0.04% after repeating the test once. Global test failure, including instrument failure, was 1.34%. Concordance with reference quantitative testing of VL was 2620/2727, 96.0% (1338/1382, 96.8% in Malawi; 1282/1345, 95.3% in Uganda). For Chiradzulu peripheral health centres and Arua Hospital HIV clinic, where testing was performed on-site, same-day results were communicated to clinicians for between 91% and 97% of samples. Same-day clinical review was obtained for 84.7% across the whole set of samples tested. CONCLUSIONS: SAMBA I VL testing is feasible for monitoring cohorts of 1000 to 5000 ART-experienced patients. Same-day results can be used to inform rapid clinical decision-making at rural and remote health facilities, potentially reducing time available for development of resistance and conceivably helping to reduce morbidity and mortality.

OBJECTIF: Nous avons suivi une mise en œuvre à grande échelle du test de la charge virale semi-quantitative du VIH -1 basé sur de Test de Simple Amplification version I (SAMBA I Viral Load = SAMBA I VL) au sein des programmes VIH de Médecins Sans Frontières au Malawi et en Ouganda, afin d'évaluer sa performance et sa faisabilité opérationnelle. MÉTHODES: Analyse descriptive des données du programme de routine entre août 2013 et décembre 2016. L'ensemble des données comprenait des échantillons collectés pour le suivi de la CV et testés à l'aide de SAMBA I VL dans cinq cliniques VIH au Malawi (quatre centres de santé périphériques et un hôpital de district), et une clinique VIH dans un hôpital régional de référence en Ouganda. SAMBA I VL a été utilisé pour le test de la CV chez les patients qui recevaient l'ART depuis 6 mois à dix ans, afin de déterminer si la CV plasmatique était supérieure ou inférieure à 1000 copies/ml de VIH-1, reflétant l'échec ou l'efficacité de l'ART. Des échantillons sélectionnés aléatoirement ont été quantifiés avec des tests de CV commerciaux. Les instruments de SAMBA I et les performances des tests, le débit du site et les délais dans la communication des résultats aux cliniciens et aux patients ont été suivis. RÉSULTATS: Entre août 2013 et décembre 2016, un total de 60.889 échantillons de patients ont été analysés avec SAMBA I VL. Dans l'ensemble, 0,23% des résultats initiaux de SAMBA I VL étaient invalides; ceux-ci ont été été réduits à 0,04% après avoir répété le test une fois. L'échec global du test, y compris l'échec de l'instrument, était de 1,34%. La concordance avec les tests quantitatifs de référence de la CV était de 2620/2727; 96,0% (1338/1382; 96,8% au Malawi; 1282/1345; 95,3% en Ouganda). Pour les centres de santé périphériques de Chiradzulu et la clinique VIH de l'hôpital d'Arua, où les tests ont été effectués sur place, les résultats ont été communiqués le jour même aux cliniciens pour entre 91% et 97% des échantillons. Un examen clinique le jour même a été obtenu pour 84,7% de l'ensemble des échantillons testés. CONCLUSIONS: Le test SAMBA I VL est réalisable pour le suivi de cohortes de 1.000 à 5.000 patients déjà sous ART. Les résultats le jour même peuvent être utilisés pour éclairer la prise de décision clinique rapide dans les établissements de santé ruraux et éloignés, réduisant potentiellement le temps disponible pour le développement de la résistance et contribuant éventuellement à réduire la morbidité et la mortalité.

Conversando com jovelinas, ivones e beths: saúde e envelhecimento no mundo do samba / Hablando con jovelinas, ivones y beths: salud y envejecimiento en el mundo de la samba brasileña / Talking to jovelinas, ivones and beths: health and aging in samba´s world

Resumo Partindo das análises foucaultianas quanto à relação de imanência em que se constituem capitalismo, biopoder e medicalização da vida, analisamos as modulações neoliberais das relações de poder-saber e a produção de um sujeito empresário de si, que trabalha por um desempenho ótimo em todos os campos da existência. Interessa-nos problematizar as repercussões dessa lógica econômica no campo da saúde na medida em que engendra subjetividades previdentes, que devem seguir as prescrições do aparato biomedicina, epidemiologia e promoção da saúde para assegurar longevidade e vitalidade, assim como seu investimento na construção da velhice como um Universal, cuja experiência oscila entre fragilidade/envelhecimento ativo. Nossas reflexões se fazem numa incursão etnográfica à Ala dos Cabelos Brancos, velha guarda do GRES Império Serrano, onde cartografamos os modos de produção de si e de realidade que acionam como universo de referência o mundo do samba e estabelecem sentidos singulares para saúde e velhice.

Resumen A partir de los análisis foucaultianos sobre la relación de inmanencia en la que se constituyen el capitalismo, el biopoder y la medicalización de la vida, analizamos las modulaciones neoliberales de las relaciones poder-conocimiento y la producción de un sujeto emprendedor que trabaja por un óptimo desempeño en todos campos de existencia. Nos interesa problematizar las repercusiones de esta lógica económica en el campo de la salud en tanto engendran subjetividades preventivas, que deben seguir las prescripciones del aparato de biomedicina, epidemiología y promoción de la salud para asegurar la longevidad y vitalidad, así como su inversión en la construcción de la vejez como Universal, cuya experiencia oscila entre fragilidad/envejecimiento activo. Nuestras reflexiones se realizan en una incursión etnográfica en el "Ala de Cabello Blanco", la vieja guardia de GRES Imperio Serrano, donde mapeamos los modos de producción del yo y la realidad que disparan el mundo de la samba como universo de referencia y establecen sus significados únicos acerca de la salud y la vejez.

Abstract Starting from the Foucaultian analyses regarding the immanence relation in which capitalism, biopower and medicalization of life are constituted, we analyse the neoliberal modulations of power-knowledge relations and the production of a self-entrepreneur's subject, who works for a great performance on all fields of existence. We are interested in problematizing the repercussions of this economic logic on the health field as it engenders foresightful subjectivities. In this context, these must follow the prescriptions of the biomedicine, epidemiology and health promotion apparatus to ensure longevity and vitality, as well as its investment in the construction of old age as a Universal, whose experience fluctuates between frailty/active aging. Our reflections are made in an ethnographic foray into the "Ala dos Cabelos Brancos", the old guard of GRES Imperio Serrano, where we map the modes of production of self and reality that set the samba world as a reference universe and establish unique meanings for health and old age.

Performance Evaluation of the SAMBA II SARS-CoV-2 Test for Point-of-Care Detection of SARS-CoV-2.

Nucleic acid amplification for the detection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA in respiratory samples is the standard method for diagnosis. The majority of this testing is centralized and therefore has turnaround times of several days. Point-of-care (POC) testing with rapid turnaround times would allow more effective triage in settings where patient management and infection control decisions need to be made rapidly. The inclusivity and specificity of the Simple AMplification-Based Assay (SAMBA) II SARS-CoV-2 test were determined by both in silico analyses of the primers and probes and wet testing. The SAMBA II SARS-CoV-2 test was evaluated for performance characteristics. Clinical performance was evaluated in residual combined throat/nose swabs and compared to that of the Public Health England real-time PCR assay targeting the RdRp gene. The SAMBA II SARS-CoV-2 test has an analytical sensitivity of 250 copies/ml for detecting two regions of the genome (open reading frame 1ab [ORF1ab] and nucleocapsid protein [N]). The clinical performance was evaluated in 172 residual combined nose/throat swabs provided by the Clinical Microbiology and Public Health Laboratory, Addenbrooke's Hospital, Cambridge (CMPHL), which showed an estimated positive percent agreement of 98.9% (95% confidence interval [CI], 93.83 to 99.97) and negative percent agreement of 96.4% (95% CI, 89.92 to 99.26) compared to testing by the CMPHL. The data show that the SAMBA II SARS-CoV-2 test performs equivalently to the centralized testing methods, but with a shorter turnaround time of 86 to 101 min. Point-of-care tests such as SAMBA should enable rapid patient management and effective implementation of infection control measures.

Carnaval e "a história que a história não conta": uma análise dos sambas de enredo / Carnaval and "the story that history does not tell": an analysis of sambas de enredo

A Estação Primeira de Mangueira foi campeã dos desfiles do Carnaval de 2019 do Rio de Janeiro com o enredo "História para ninar gente grande". Após a verificação de 1.592 sambas de enredo, dos carnavais cariocas de 1939 a 2019, este artigo demonstra que foram apresentadas, em 43 composições anteriores, de escolas diversas, perspectivas semelhantes às que constam no samba-enredo da Verde e Rosa. São obras que exaltam as contribuições de negros, indígenas e populares para a História do Brasil; elencam personalidades relevantes como "outros heróis"; desconstroem a contribuição dos heróis "clássicos" da pátria; e realizam críticas à sociedade brasileira, suas mazelas e seu(s) governo(s). Finalmente, elencamos as oito principais composições que ilustram essas propostas. O objetivo é relacionar a produção cultural carnavalesca às questões do seu tempo, destacando a importância do festejo para a cultura nacional.

Estação Primeira de Mangueira was the champion of Rio de Janeiro's 2019 Carnival Parade with the samba "História para ninar gente grande". After checking 1,592 sambas from the Carnival of Rio de Janeiro, from 1939 to 2019, this article demonstrates that 43 previous compositions from different Escolas de Samba, presented similar perspectives to Mangueira: sambas that praise the contributions of black people, indigenous and popular to the history of Brazil; relevant personalities considered as "other heroes"; an deconstruction of the contribution of the "classic" heroes; and social critics to the Brazilian society, its problems and its government. Finally, we list the eight compositions that better illustrate these proposals. The objective is to relate the carnivalesque cultural production to the issues of its time, highlighting the importance of the celebration for the national culture.

Audiological Results with the SAMBA Audio Processor in Comparison to the Amadé for the Vibrant Soundbridge.

BACKGROUND: Since its introduction in 1996, the Vibrant Soundbridge (VSB) has been upgraded with several improved generations of processors. As all systems are compatible, implanted patients can benefit from new technologies by upgrading to the newest processor type available. OBJECTIVES: The aim of this study was to compare the performance of the new (current) SAMBA processor with the previous Amadé processor. METHODS: Twenty subjects monaurally implanted with a VSB and the Amadé processor tested the new SAMBA processor for a trial period of 4 weeks. We measured air conduction and bone conduction thresholds, unaided thresholds, and aided free field thresholds with both devices. Speech performance in quiet using the Freiburg monosyllabic test at 65 dB SPL (S0) was compared. The speech intelligibility in noise was determined using the Oldenburg sentence test measured in different listening conditions (S0NVSB/S0Ncontra) and microphone settings (omni/directional vs. adaptive directivity). RESULTS: Word recognition scores in quiet with the SAMBA were still significantly lower than with the Amadé after the 4 weeks trial period but improved over the following year. Speech intelligibility with the SAMBA was significantly better than with the Amadé in omnidirectional mode and comparable with the Amadé in directional mode. Hence, the adaptive directionality provides an advantage in difficult hearing situations such as noisy environments. The subjective benefit was evaluated using the Abbreviated Profile of Hearing Aid Benefit and the Speech, Spatial and Qualities-C questionnaire. Results of the questionnaires demonstrate an overall higher level of satisfaction with the new SAMBA speech processor than with the older processor. CONCLUSION: The SAMBA enables similar speech perception in quiet but more flexible adaptation in acoustically challenging environments compared to the previous Amadé processor.

Tango y samba: deconstruyendo estereotipos / Tango e samba: desconstruindo estereótipos / Tango and samba: deconstructing stereotypes / Tango et samba: déconstruire les stéréotypes

Las danzas de tango y samba gafieira pueden ser expresiones de ocio en las que predomina cierta heteronormatividad hegemónica. Asimismo en los últimos años se ha venido desarrollando en diferentes países un movimiento de personas que cuestionan, resisten y proponen alternativas a la heteronormatividad en la danza de salón. Este trabajo identifica las resistencias, alternativas y propuestas innovadoras que manifiestan las personas a la heteronormatividad hegemónica en las danzas de tango y samba gafieira, mediante el uso de una metodología cualitativa, estudio de casos múltiple, en la que se entrevistaron 30 personas y se realizaron 30 observaciones en escuelas de baile y espacios abiertos de tres ciudades latinoamericanas (Buenos Aires, Montevideo y São Paulo). Los resultados revelan una clara percepción de profesores y bailarines sobre los estereotipos que a través de estas danzas refuerzan la heteronormatividad hegemónica. Así como, los movimientos de resistencia en las acciones y estrategias que utilizan las personas en las tres ciudades mencionadas para poder disfrutar de la danza sin restricciones.

As danças de tango e samba de gafieira podem ser expressões de lazer nas quais predomina certa heteronormatividade hegemônica. Nos últimos anos, também vem se desenvolvendo, em diferentes países, um movimento de pessoas que questionam, resistem e propõem alternativas à heteronormatividade na dança de salão. Este trabalho identifica as resistências, alternativas e propostas inovadoras apresentadas a essa heteronormatividade hegemônica nas danças de tango e samba de gafieira utilizando uma metodologia qualitativa, com estudo de casos múltiplos, através do qual 30 pessoas foram entrevistadas e 30 observações foram feitas em escolas de dança e espaços abertos de três cidades da América Latina (Buenos Aires, Montevidéu e São Paulo). Os resultados revelam uma clara percepção de professores e dançarinos sobre os estereótipos que, através dessas danças, reforçam a heteronormatividade hegemônica, bem como movimentos de resistência nas ações e estratégias utilizadas pelas pessoas nas três cidades mencionadas para desfrutar da dança sem restrições.

The tango and samba gafieira dances can be expressions of leisure where a certain hegemonic heteronormativity predominates. Also, in recent years has been developing in different countries a movement of people who question, resist and propose alternatives to heteronormativity in ballroom dance. This work identify the resistances, alternatives and innovative proposals by people to the hegemonic heteronormativity in tango and samba gafieira dances, by using a qualitative methodology, a study of multiples cases, in which 30 people were interviewed and 30 observations were made in dance schools and open spaces of three Latin American cities (Buenos Aires, Montevideo and São Paulo). The results reveal a clear perception of teachers and dancers about the stereotypes that through these dances reinforce hegemonic heteronormativity. As well, resistance movements in the actions and strategies used by people in the three cities mentioned to enjoy dance without restriction.

Le tango et la samba gafieira ils peuvent être expressions de loisir où prédomine une certaine hétéronormativité hégémonique. Ces dernières années ont également développé dans différents pays un mouvement de personnes qui remettent en question, résistent et proposent des alternatives à l'hétéronormativité en danse de salon. Ce travail identifier les résistances, les alternatives et proposées innovantes par les gens à l'hétéronormativité hégémonique des danses de tango et de samba gafieira, en utilisant une méthodologie qualitative, une étude de cas multiples, dans laquelle 30 personnes ont été interviewées et 30 observations effectuées dans écoles de danse et espaces ouverts de trois villes d'Amérique latine (Buenos Aires, Montevideo et São Paulo). Les résultats révèlent une perception claire des professeurs et des danseurs au sujet des stéréotypes qui renforcent l'hétéronormativité hégémonique à travers ces danses. De même, les mouvements de résistance dans les actions et les stratégies utilisées par les personnes des trois villes mentionnées pour apprécier la danse sans restriction.

Development and validation of the Skills Assessment in Microsurgery for Brain Aneurysms (SAMBA) instrument for predicting proficiency in aneurysm surgery.

OBJECTIVE: Surgical performance evaluation was first described with the OSATS (Objective Structured Assessment of Technical Skills) and modified for aneurysm microsurgery simulation with the OSAACS (Objective Structured Assessment of Aneurysm Clipping Skills). These methods rely on the subjective opinions of evaluators, however, and there is a lack of objective evaluation for proficiency in the microsurgical treatment of brain aneurysms. The authors present a new instrument, the Skill Assessment in Microsurgery for Brain Aneurysms (SAMBA) scale, which can be used similarly in a simulation model and in the treatment of unruptured middle cerebral artery (MCA) aneurysms to predict surgical performance; the authors also report on its validation. METHODS: The SAMBA scale was created by consensus among 5 vascular neurosurgeons from 2 different neurosurgical departments. SAMBA results were analyzed using descriptive statistics, Cronbach's alpha indexes, and multivariate ANOVA analyses (p < 0.05). RESULTS: Expert, intermediate-level, and novice surgeons scored, respectively, an average of 33.9, 27.1, and 16.4 points in the real surgery and 33.3, 27.3, and 19.4 points in the simulation. The SAMBA interrater reliability index was 0.995 for the real surgery and 0.996 for the simulated surgery; the intrarater reliability was 0.983 (Cronbach's alpha). In both the simulation and the real surgery settings, the average scores achieved by members of each group (expert, intermediate level, and novice) were significantly different (p < 0.001). Scores among novice surgeons were more diverse (coefficient of variation = 12.4). CONCLUSIONS: Predictive validation of the placenta brain aneurysm model has been previously reported, but the SAMBA scale adds an objective scoring system to verify microsurgical ability in this complex operation, stratifying proficiency by points. The SAMBA scale can be used as an interface between learning and practicing, as it can be applied in a safe and controlled environment, such as is provided by a placenta model, with similar results obtained in real surgery, predicting real surgical performance.

Os significados da "Sinfonia do café": uma releitura da canção de Humberto Teixeira / The meanings of the "Coffee Symphony:" a retelling of the song by Humberto Teixeira

Resumo O artigo toma como objeto central de investigação a letra da canção "Sinfonia do café", composta em 1944 por Humberto Teixeira, procurando analisá-la sob uma perspectiva sócio-histórica e linguística. A análise buscou suporte teórico na filosofia da linguagem de Mikhail Bakhtin, em particular, suas concepções de "enunciação" e "interação verbal". A partir da relação intersubjetiva entre locutor e interlocutor, buscamos identificar possíveis significações da canção e do tema central abordado (café) no contexto de sua criação. A análise evidenciou a função político-ideológica que o gênero musical samba-exaltação exerceu no Estado Novo. Naquele contexto, café e samba-exaltação foram os principais produtos de exportação (agrícola e musical) que deveriam expressar a grandiosidade econômica e cultural brasileira.

Abstract This article focuses on the lyrics of "Sinfonia do café" ("Coffee Symphony"), a song composed in 1944 by Humberto Teixeira, and attempts to analyze it from a linguistic and socio-historical perspective. The theoretical foundation of this analysis is Mikhail Bakhtin's philosophy of language, particularly his understanding of enunciation and verbal interaction. Based on the intersubjective relationship between speaker and interlocutor, we look for potential meanings in this composition and the main topic (coffee) within the context of its creation. This analysis shows the role played by the musical genre known as samba-exaltação during the New State period. Within this context, coffee and samba-exaltação were the main exports (agricultural and musical) that were intended to express the splendor of Brazilian economics and culture.

An outbreak of malignant catarrhal fever in Sambar deer (Rusa unicolor) / Surto de febre catarral maligna em cervos Sambar (Rusa Unicolor)

Malignant catarrhal fever (MCF) is an infectious, pansystemic and highly fatal disease with wide geographic distribution. The species that are clinically prone to it include cattle, deer and bison. In Brazil, the disease in ruminants and deer is associated with the contact with sheep, especially during labor, when the fetal remains that are eliminated contain the ovine herpesvirus 2 (OvHV-2). The outbreak took place in a conservationist property in the city of Casimiro de Abreu/RJ, which hosted 23 Sambar deer, and, of these, 19 died, showing neurological signs. The deer lived in a location together with 15 male and female meat sheep. A female specimen of the Sambar deer (Rusa unicolor), aged approximately three years, which had presented with neurological clinical signs was referred to necropsy in the Setor de Anatomia Patológica at Universidade Federal Rural do Rio de Janeiro (SAP/UFRRJ). During necropsy, cerebrospinal fluid was sampled for analysis; fragments of several organs were fixated in 10% buffered formalin and processed for histopathological analysis. Fragments of occipital lobe, cerebellum and bulb were collected to perform the polymerase chain reaction (PCR). The diagnosis of this outbreak was based on epidemiological, clinical and pathological findings, and on the amplification of the OvHV-2 DNA through PCR. The histological changes were the base to confirm the MCF case and were characterized by degeneration of vascular endothelial cells, fibrinoid vasculitis, hyperplasia and necrosis of lymphoid organs. However, PCR was an important tool to confirm the diagnosis. MCF as an important disease with nervous symptomatology in deer.(AU)

A febre catarral maligna (FCM) é uma doença infecciosa, com distribuição geográfica ampla, pansistêmica e altamente fatal. As espécies clinicamente suscetíveis incluem bovino, cervo e bisão. No Brasil, a doença em ruminantes e cervídeos está associada ao contato com ovinos, principalmente durante o parto, no qual os envoltórios fetais eliminados contém, em suas secreções, o Herpesvírus ovino-2 (OvHV-2). O surto ocorreu em uma propriedade conservacionista no município de Casimiro de Abreu/RJ, que abrigava 23 cervos exóticos, onde foram registradas a morte de 19 destes, com sinais neurológicos. Os cervos habitavam em um piquete com 15 ovinos de corte, machos e fêmeas. Um exemplar de cervo sambar (Rusa unicolor), fêmea, com aproximadamente três anos de idade, que havia apresentado sinais clínicos neurológicos foi encaminhado para necropsia no Setor de Anatomia Patológica da Universidade Federal Rural do Rio de Janeiro (SAP/UFRRJ). Durante a necropsia foi realizada a coleta de líquido cefalorraquidiano e de fragmentos de lobo occipital, cerebelo e bulbo, para a realização de reação em cadeia da polimerase (PCR). Fragmentos de diversos órgãos foram fixados em formalina 10% tamponada e processados para a análise histopatológica. O diagnóstico do presente surto foi estabelecido com base nos achados epidemiológicos, clínicos, patológicos e na amplificação do DNA do OvHV-2 através da PCR. As alterações histológicas foram a base para confirmar o caso de FCM e caracterizaram-se por degeneração de células endoteliais vasculares, vasculite fibrinoide, hiperplasia dos órgãos linfoides. Contudo, a PCR foi uma ferramenta importante para a confirmação do diagnóstico. Ressalta-se a importância da FCM na lista dos diagnósticos diferenciais de doenças que cursam com sintomatologia nervosa em cervídeos.(AU)