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Mindfulness training in medical education as a means to improve resilience,empathy,and mental health in the medical profession

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World Journal of Psychiatry 2024年第4期14卷 489-493页

作者： Edison Iglesias de oliveira Vidal Luiz Fernando Alvarenga Ribeiro Marco antonio de Carvalho-Filho Fernanda Bono Fukushima Internal Medicine department Botucatu Medical SchoolSao Paulo State University(UNESP)Botucatu 18618-687SPBrazil Wenckebach Institute for Education and Training LEARN-Lifelong LearningEducation and Assessment Research NetworkUniversity Medical Center GroningenGroningen 9713AVGroningenNetherlands Assertiva Mindfulness Botucatu 18603-970SPBrazil Surgical Specialties and Anesthesiology department Botucatu Medical SchoolSão Paulo State University(UNESP)Botucatu 18618-687SPBrazil

The high rates of depression,burnout,and increased risk of suicide among medical students,residents,and physicians in comparison with other careers signal a mental health crisis within our *** contend that this crisis coupled with the inadequate acquisition of interpersonal skills during medical education results from the interaction between a challenging environment and the mental capital of ***,we posit that mindfulness-based practices are instrumental for the development of major components of mental capital,such as resilience,flexibility of mind,and learning skills,while also serving as a pathway to enhance empathy,compassion,self-awareness,conflict resolution,and relational ***,the evidence base supporting the effectiveness of mindfulness-based interventions has been increasing over the years,and a growing number of medical schools have already integrated mindfulness into their *** we acknowledge that mindfulness is not a panacea for all educational and mental health problems in this field,we argue that there is currently an unprecedented opportunity to gather momentum,spread and study mindfulness-based programs in medical schools around the world as a way to address some longstanding shortcomings of the medical profession and the health and educational systems upon which it is rooted.

关键词： Mindfulness Medical education Mental capital Mental health Medical students Resilience

Analysing vaccine efficacy evaluated in phase 3 clinical trials carried out during outbreaks

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Infectious Disease Modelling 2024年第4期9卷 1027-1044页

作者： Francisco antonio Bezerra Coutinho marcos Amaku Fernanda Castro Boulos Jose Alfredo de Sousa Moreira Joao Italo DiasFranca Julio antonio do Amaral Eliana Nogueira Castro de Barros Claudio Jose Struchiner Esper Jorge Kallas Eduardo Massad School of Medicine University of Sao PauloBrazil Instituto Butantan Sao PauloBrazil School of Applied Mathematics Fundacao Getulio VargasRio de JaneiroBrazil

In this paper we examine several definitions of vaccine efficacy(VE)that we found in the literature,for diseases that express themselves in outbreaks,that is,when the force of infection grows in time,reaches a maximum and then *** fact that the disease occurs in outbreaks results in several problems that we *** propose a mathematical model that allows the calculation of VE for several *** trials usually needs a large number of volunteers that must be ***,all volunteers should be enrolled in approximately the same time,but this is generally impossible for logistic reasons and they are enrolled in a fashion that can be replaced by a continuous density function(for example,a Gaussian function).The outbreak can also be replaced by a continuous density function,and the use of these density functions simplifies the ***,for example Gaussian functions,one of the problems one can immediately notice is that the peak of the two curves do not occur at the same *** model allows us to conclude:First,the calculated vaccine efficacy decreases when the force of infection increases;Second,the calculated vaccine efficacy decreases when the gap between the peak in the force of infection and the peak in the enrollment rate increases;Third,different trial protocols can be simulated with this model;different vaccine efficacy definitions can be calculated and in our simulations,all result are approximately the *** final,and perhaps most important conclusion of our model,is that vaccine efficacy calculated during outbreaks must be carefully examined and the best way we can suggest to overcome this problem is to stratify the enrolled volunteer's in a cohort-by-cohort basis and do the survival analysis for each cohort,or apply the Cox proportional hazards model for each cohort.

关键词： Vaccine efficacy Clinical trials Mathematical models Simulations Covid-19

Severe aspiration pneumonia in the elderly

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Journal of Intensive Medicine 2024年第3期4卷 307-317页

作者： Sebastian Ocrospoma marcos I.Restrepo Division of Pulmonary Diseases&Critical Care Medicine University of Texas Health San AntonioSan AntonioTXUSA Section of Pulmonary&Critical Care Medicine South Texas Veterans Health Care SystemSan AntonioTXUSA

The global population is aging at an unprecedented rate,resulting in a growing and vulnerable elderly population in need of efficient comprehensive healthcare services that include long-term care and skilled nursing *** this context,severe aspiration pneumonia,a condition that carries substantial morbidity,mortality,and financial burden,especially among elderly patients requiring admission to the intensive care unit,has attracted greater *** pneumonia is defined as a pulmonary infection related to aspiration or dysphagia in *** episodes of coughing on food or liquid intake,a history of relevant underlying conditions,abnormalities on videofluoroscopy or water swallowing,and gravity-dependent shadow distribution on chest imaging are among the clues that suggest *** with aspiration pneumonia tend to be elderly,frail,and suffering from more comorbidities than those without this ***,we comprehensively address the epidemiology,clinical characteristics,diagnosis,treatment,prevention,and prognosis of severe aspiration community-acquired pneumonia in the elderly to optimize care of this high-risk demographic,enhance outcomes,and minimize the healthcare costs associated with this *** preventive measures and effective management strategies is vital in ensuring the well-being of our aging population.

关键词： Aspiration pneumonia Aged Critical illness Swallowing disorders Frailty Antibacterial agents

development of a Ready-to-Use PSMA-11 Kit Formulation and Biological Evaluation of Binding Affinity

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Advances in Molecular Imaging 2024年第2期13卷 7-22页

作者： Maria Renata Valente Brandão Freire Natália Marchesan Bexiga Marco antonio Stephano João Ezequiel oliveira Carlos Roberto Jorge Soares Ana Cláudia Camargo Miranda Anna Carolina de Alcântara Barbosa Marycel Figols de Barboza Laura Fernanda Garcia Luiz Felipe S. Teixeira Maria Helena Marumo Bellini Natanael Gomes da Silva Luiza Mascarenhas Balieiro Joel Mendes Elaine Bortoleti de Araújo Centro de Radiofarmcia Instituto de Pesquisas Energticas e Nucleares (IPEN) Cidade Universitria So Paulo Brasil departamento de Tecnologia Farmacutica Faculdade de Cincias Farmacuticas (USP) Cidade Universitria So Paulo Brasil Centro de Biotecnologia Instituto de Pesquisas Energticas e Nucleares (IPEN) Cidade Universitria So Paulo Brasil departamento de Medicina Nuclear do Hospital Israelita Albert Einstein So Paulo/SP Brasil

Introduction: 68Ga-PSMA-11 is considered the gold standard in detection of micro and oligometastases in advanced prostate cancer, being used for therapeutic planning, as well as, potentially, for evaluating response to treatment. The development of ready-to-use lyophilized kit of PSMA-11 adds quality and safety to the routine use of this radiopharmaceutical and represents a pharmacotechnical challenge as it must preserve the integrity and specificity of the ligand. Methods: PSMA-11 kit formulation was proposed, considering radiolabeling parameters and the preservation of the peptide during the lyophilization process, using mannitol as an excipient. Critical temperature characterization studies were carried out using DSC equipment and the freeze-drying process was developed. The direct radiolabeling conditions were evaluated and standardized using 68Ge/68Ga generator eluate from two different manufacturers (ITG and Eckert & Ziegler). The radiochemical purity was evaluated by TLC and HPLC. Biological evaluation was carried out with lyophilized PSMA-11 to demonstrate the integrity of the peptide and preservation of biological activity after the lyophilization process. Results: Based on critical temperature characterization studies, the freeze-drying cycle was designed to reach a freezing temperature of around −40˚C and primary drying at 2˚C. Using 20 mg of mannitol, an intact and elegant lyophilized cake was obtained. PSMA-11 lyophilized kit was directly labeled with 68Ga eluate from 68Ge/68Ga GMP generators (ITG and Eckert & Ziegler) resulting in % RP > 95% at pH 4.0 to 4.5. The results obtained from in vitro and in vivo biological competition studies confirmed the preservation of PSMA-11 affinity for the receptor after lyophilization. Conclusion: A lyophilized formulation (Kit) of PSMA-11 was successfully obtained, which preserved the integrity and biological activity of the peptide and guaranteed radiolabeling efficiency.

关键词： 68Ga-PSMA-11 Prostate-Specific Membrane Antigen (PSMA) Ready-to-Use Kit GMP-Grade Generators Metastatic Prostate Cancer PET Imaging

Artificial equilibrium points and bi-impulsive maneuvers to observe 243 Ida

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Chinese Journal of Aeronautics 2021年第1期34卷 410-423页

作者： Allan Kardec de ALMEIDA Jr Geraldo Magela Couto oliveira antonio Fernando Bertachini de Almeida PRADO National Institute for Space Research(INPE) Sao Jose dos Campos 12227-010Brazil Federal Center for Technological Education of Minas Gerais(CEFET-MG) Belo Horizonte 30421-169Brazil

In the restricted three-body problem,the traditional Lagrange points L1 and L2 are the only equilibrium points near the asteroid 243 *** thrust generated by a solar sail over a spacecraft enables the existence of new artificial equilibrium points,which depend on the position of the spacecraft with respect to the asteroid and the attitude of the solar *** equilibrium points generate new spots to observe the body from above or below the plane of *** points are very good observational locations due to their stationary *** work provides a preliminary analysis to observe Ida through the use of artificial equilibrium points as spots combined with transfer maneuvers between *** combination can be used to observe the asteroid from more different points of view in comparison to fixed *** analyses are made for a spacecraft equipped with a solar sail and capable of performing bi-impulsive *** solar radiation pressure is used both to maintain the equilibrium condition and to reduce the costs of the transfers and/or to create transfers with longer *** is a new aspect of the present research,because it combines the continuous thrust with initial and final small impulses,which are feasible for most of the spacecraft,because the magnitudes of the impulses are very *** combined maneuvers may reduce the transfer times of the maneuvers in most of the cases,compared with the maneuvers based only on continuous *** options involved in these transfers are shown,like to minimize the fuel spent(Dv)as a function of the transfer time or to extend the duration of the travel between the *** transfer times can be useful when observations are required during the transfers.

关键词： Artificial equilibrium points Astrodynamics Orbital transfers Solar radiation pressure Solar sail

Selection of Bacillus thuringiensis strains in citrus and their pathogenicity to Diaphorina citri (Hemiptera: Liviidae) nymphs

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Insect Science 2020年第3期27卷 519-530页

作者： Silvia de oliveira Dorta Juliana Balbinotte Rose Monnerat Joao Roberto Spotti Lopes Tatiane da Cunha Odimar Zanuzo Zanardi Marcelo Pedreira de Miranda marcos antonio Machado Juliana de Freitas-Astua Programs de Pos-Graduagao em Microbiologia Agricola Escola Superior de Agricultura Luiz de QueirozUniversidade de Sao PauloPiracicabaSPBrazil Laboratorio de Biotecnologia Centro de Citricultura Sylvio MoreiraInstituto Agronomico de CampinasCordeiropolisSPBrazil Laboratorio de Insetos Vetores de Fitopatdgenos Departamento de Entomologia e AcarologiaEscola Superior de Agricultura Luiz de QueirozUniversidade de Sao PauloPiracicabaSPBrazil Embrapa Recursos Geneticos e Biotecnologia BrasiliaDFBrazil Fundo de defesa da Citricultura(Fundecitrus) AraraquaraSPBrazil Embrapa Mandioca e Fruticultura Cruz das AlmasBABrazil Laboratdrio de Bioquimica Fitopatoldgica Instituto BioldgicoSao PauloSPBrazil

Bacillus thuringiensis(Bt)toxins are effective in controlling insect pests either through the spraying of products or when expressed in transgenic *** discovery of endophytic Bt strains opened new perspectives for studies aimed at the control of sap‐sucking insects,such as the Asian citrus psyllid Diaphorina citri Kuwayama(Hemiptera:Liviidae),a vector of“Candidatus Liberibacter spp.,”associated with citrus huanglongbing(HLB).In this study,translocation of endophytic Bt strains in citrus seedlings inoculated with Bt suspension delivered by soil‐drench,and their systemic pathogenicity to *** nymphs were *** pathogenicity of three wild‐type Bt strains against *** third‐instar nymphs was *** the 10 recombinant strains tested(each of them harboring a single cry or cyt gene),3 can be highlighted,causing 42%–77%and 66%–90%nymphal mortality at 2 and 5 d after inoculation,*** isolation of Bt cells from young citrus shoots and dead nymphs,and PCR performed with specific primers,confirmed the involvement of the Bt strains in the psyllid *** is the first report showing the translocation of Bt strains from citrus seedling roots to shoots and their potential to control *** nymphs that fed on these soil‐drench inoculated *** Bt strains that caused the highest mortality rates have the potential to be used as bioinsecticides to control *** and the identified genes can be used for the production of transgenic Bt citrus.

关键词： Asian citrus psyllid Citrus sinensis Cry toxins endophytic Bt huanglongbing young shoots

Multiple ecological strategies explain the distribution of exotic and native C_(4) grasses in heterogeneous early successional sites in Hawai’i

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Journal of Plant Ecology 2017年第3期10卷 426-439页

作者： Rafael de oliveira Xavier Carla M.D’antonio Ecology and Conservation Lab Department of HydrobiologyFederal University of São CarlosWashington Luís Highwaykm 235São CarlosSão Paulo 13565-905Brazil Environmental Studies Program 4312-L Bren University of CaliforniaSanta BarbaraCA 93106USA

Aims Biotic homogenization results in novel communities contain-ing multiple exotic *** attributes that contribute to the dominance of invaders and increase invasibility of communities have been identified,but rarely have factors governing the domi-nance of co-occurring invaders been *** we assess the presence and performance of five exotic and one native C_(4) grass species across local(microsite)and more broad-scale variation in fire history,soil age,altitude and *** ask whether species show preferences for the same conditions,whether all are constrained by poor soil development,and how their performance changes when alone versus *** addition to providing information useful to managers who want to control some of these species,such information can help to predict how distributions might change with climate change Methods We measured percent cover and plant height of each grass species in 64 plots in each of 15 sites,located in young volcanic substrates across environmental gradients in Hawai’i Volcanoes National Park,Hawai’i,*** varied in fire history and soil age,across altitu-dinal and precipitation *** estimated microsite heteroge-neity by measuring rock cover and soil depth,where each species was present and in plots as a *** analyzed effects of pos-sible controlling variables using chi-square tests and Generalized Additive Mixed *** Findings Two species(Schizachyrium condensatum and Hyparrhenia rufa)were absent in shallow soil,restricted to more mesic sites and showed increasing performance with soil *** contrast,two other species(Andropogon virginicus and Melinis repens)tended to occur in shal-low soil with high rock cover across a wide range of *** addi-tional species(Melinis minutiflora)was weakly affected by soil depth and was the dominant at higher elevation(more mesic)and on burned sites,especially in old *** species was largely absent from lower elevation si

关键词： elevation gradient fire invasive species Melinis minutiflora soil depth

A message classifier based on multinomial Naive Bayes for online social contexts

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Journal of Management Analytics 2018年第3期5卷 213-229页

作者： Thársis Salathiel de Souza Viana marcos de oliveira Ticiana Linhares Coelho da Silva Mário Sérgio Rodrigues Falc ao and Enyo JoséTavares Gonçalves Universidade Federal do CearáQuixadáBrazil

Children and teenagers today are increasingly connected to the *** use by minors of social networks applications,and games that are connected to the internet offer the possibility of communication,can make them exposed to various *** of the most troubling threats is sexual *** the objective of this project is to create a model for classifying messages,as normal or dangerous,according to the risk they present to the *** addition to integrating the developed model with a project that analyzes the behavior of minors in a social network(Facebook),and calculates the risk of the minor be a victim of sexual ***,we use the model in the classification of messages obtained from a server of the game Minecraft,quite popular among children.

关键词： messages exchange classification social media children and teenagers protection minecraft clustering messages

Linking sedimentary provenance,climate and tectonics in the Neoproterozoic SeridóBelt,Borborema Province(NE Brazil)

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Geoscience Frontiers 2023年第6期14卷 414-431页

作者： Carlos V.A.Ribeiro marcos C.C.Sales Armando L.S.de oliveira Ricardo Sallet Programa de Pós-graduação em Geologia Instituto de GeociênciasUniversidade de Brasília(UnB)CEP 70910-900 BrasíliaDFBrazil Programa de Pós-Graduação em Geociências Universidade Federal de PernambucoDepartamento de GeologiaCentro de Tecnologia e GeociênciasAv.da ArquiteturaCEP 50740-530 RecifePEBrazil departamento de Geologia Universidade Federal do Rio Grande do NorteCEP 59078-970 NatalRNBrazil

The SeridóBelt,at the extreme northeast of Brazil,is one of the several Neoproterozoic mobile belts related to the Brasiliano/Pan-African Orogeny in Western *** lithostratigraphy of the SeridóBelt comprises basal quartzites and metaconglomerates(Equador Formation)overlain by hornblende-bearing paragneisses,calc-silicate rocks and marbles(Jucurutu Formation)and biotiteschists(SeridóFormation).We investigated the sedimentary provenance of these rocks based on an integration of compiled whole-rock geochemistry,Sm-Nd isotopes,U-Pb detrital zircon ages and a new set of whole-rock trace elements *** Formation quartzites have major and trace elements patterns that resemble cratonic sandstones,with a typical felsic provenance consistent with the isotopic composition of plutonic Archean to Paleoproterozoic basement *** proxies suggest that these rocks were deposited in fresh waters under anoxic conditions and moderate to intense weathering conditions(CIA=58–79).A shift in provenance led to an increase in intermediate-mafic sources during the deposition of the Jucurutu and Seridó*** elements from rock types in these units are nearly identical,yet they differ on the contents of some high field-strength elements(e.g.,Sc,V and Ni),which are higher in the SeridóFormation than average *** proxies show similar depositional environments,with brackish to marine conditions for the Jucurutu and Seridóformations under anoxic to euxinic *** conditions are consistently lower in the Jucurutu Formation(CIA=58–66)in comparison with the SeridóFormation(CIA=60–88).Compiled U-Pb data suggest maximum depositional ages of 633±11 Ma and 633±6 Ma for Jucurutu and Seridóformations,respectively,suggesting deposition following the ca.645–635 Ma Marinoan *** compared the geochemistry of the SeridóFormation schists with currently exposed basement rocks and showed a strong affinity with Neoproterozoic arc-related

关键词： Whole-rock geochemistry Marinoan Glaciation U-Pb detrital zircon Brasiliano Orogeny