Final Positioning Research Articles

The Accuracy of Imaging Guided Targeting with Microelectrode Recoding in Subthalamic Nucleus for Parkinson's Disease: A Single-Center Experience.

Background:Accurate electrode targeting was essential for the efficacy of deep brain stimulation (DBS). There is ongoing debate about the necessary of microelectrode recording (MER) in subthalamic nucleus (STN)-DBS surgery for accurate targeting.Objective:This study aimed to analyze the accuracy of imaging-guided awake DBS with MER in STN for Parkinson’s disease in a single center.Methods:The authors performed a retrospective analysis of 161 Parkinson’s disease patients undergoing STN-DBS at our center from March 2013 to June 2021. The implantation was performed by preoperative magnetic resonance imaging (MRI)-based direct targeting with intraoperative MER and macrostimulation testing. 285 electrode tracks with preoperative and postoperative coordinates were included to calculate the placement error in STN targeting.Results:85.9% of electrodes guided by preoperative MRI were implanted without intraoperative adjustment. 31 (10.2%) and 12 (3.9%) electrodes underwent intraoperative adjustment due to MER and intraoperative testing, respectively. We found 86.2% (245/285) of electrodes with trajectory error ≤2 mm. The MER physiological signals length < 4 mm and ≥4 mm group showed trajectory error > 2 mm in 38.0% and 8.8% of electrodes, respectively. Compared to non-adjustment electrodes, the final positioning of MER-adjusted electrodes deviated from the center of STN.Conclusion:The preoperative MRI guided STN targeting results in approximately 14% cases that require electrode repositioning. MER physiological signals length < 4 mm at first penetration implied deviation off planned target. MER combined with intraoperative awake testing served to rescue such deviation based on MRI alone.

Orthodontic management of impacted canine: A review

Permanent canines play a fundamental role in facial appearance, dental aesthetics, arch development, and functional occlusion. The process of eruption of the permanent canines leading to their final positioning in the oral cavity is complex and the longest of all the permanent teeth making it more prone to impaction. There is a need for its impaction to be properly diagnosed and managed. The orthodontists have played an important rule and are proved successful in treating them. This article reviews classification, complications, diagnosis, and treatment modalities in the management of impacted maxillary canines.

Intraoperative sensing increase predicts long-term pacing threshold in leadless pacemakers.

High pacing threshold (HPT) and very high pacing threshold (VHPT) are known to have a negative impact on leadless pacemaker battery longevity, representing the most common reason for device repositioning. In this study, we evaluated if intraoperative electrical parameters recorded during Micra™ VR implant would be able to predict device performance during follow-up (FU). A total of 93 patients undergoing Micra™ VR implant were retrospectively considered. Patients were enrolled in the study if electrical assessment was performed at least twice at implant, at Micra™ final positioning and after removal of the delivery system. All patients received a FU visit at 1 and 12month after discharge. R-wave sensing amplitude, pacing threshold (PT), and impedance were recorded at each visit. When compared to the first assessment, R-wave sensing amplitude increased by 19.1% after 13 ± 4min (+ 1.71 ± 0.2mV, 95% CI 1.4 to 2.02; p < .001). Conversely, there was a significant PT decrease of 22.1% at 12-month FU (- 0.22 ± 0.03V, 95% CI - 0.13 to - 0.31; p < .001). Among patients with HPT, acute increase of R-wave sensing of 1.5mV after 14 ± 4min predicted a significant reduction of PT below 1V/0.24, at 12-month post-implant (R = 0.72, 95% CI 0.13 to 0.33, p < .001), with a sensitivity of 87.5% (95% CI 0.61-0.98) and a specificity of 88.8% (95% CI 0.51-0.99). A 1.5-mV increase in R-wave amplitude at implant is predictive of PT normalization (< 1.0V/0.24ms) at 12-month FU. This finding may have practical implications for device repositioning in case of HPT recording at implant.

Comparative analysis of data quality and performance index for BDS-3 constellation

The global BeiDou-3 Navigation Satellite System (BDS-3) was completed in July 2020. In terms of data processing, the final positioning and baseline solving results will be affected by the quality of the raw observation data. Therefore, it is necessary to analyse and evaluate the data quality of the complete BDS-3 constellation and its service performance. Based on all observing satellites and the open signals from MGEX stations that can track BDS-3, improved software is used to analyse the complete BDS-3 constellation and signals. Moreover, the service performance of BDS-3 is evaluated using self-developed software. The geometric configuration of the complete BDS-3 constellation is found to be slightly better than that of GPS. However, the overall multipath error is about 10 cm higher than that of GPS, although the increased choke of the measured maritime data effectively weakens the multipath error. The pseudorange multipath error of each signal runs in the order B1I&gt;B2a&gt;B2b&gt;B3I&gt;B2a+B2b&gt;B1C; other quality indicators exhibit little difference among bands. In terms of service performance, the carrier phase residuals are 0.17-0.48cm. After data convergence, the relative positioning performance fluctuates around 5 cm of the “true value”, although the fluctuations in the vertical direction are up to 10 cm.

536 Intraoperative predictors of long-term pacing threshold improvement in leadless pacemakers

Abstract Aims Micra-VR transcatheter pacing system (TPS) has shown strong stability of electrical parameters over time. Nevertheless, a small percentage of patients develops high pacing threshold (PT) (&amp;gt;1 V@0.24 ms) which can decrease the longevity of battery. Our study sought to investigate the intraoperative electrical parameters able to predict device electrical performances during the time. Methods and results Patients (pts) implanted with Micra-VR TPS from March 2018 to January 2021 were prospectively considered at the Cardiology Department of Spedali Civili Hospital (Brescia) and Luigi Sacco Hospital (Milan). R-wave sensing amplitude (mV), pacing impedance (Ohm), and PT (V@0.24 ms) were recorded twice: upon Micra final positioning, and after removal of the delivery system. All pts received a follow-up visit at 1- and 12-month after discharge. Electrical parameters were recorded at each visit. A total of 93 pts underwent Micra-VR implantation were enrolled. When compared to the first assessment, R-wave amplitude increased of 19.1% at second control performed after 13 ± 4 min (+1.71 ± 0.2 mV, 95% CI: 1.4–2.02; P &amp;lt; 0.001). Conversely, PT significantly decreased of 22.1% at 12-month follow-up respect to baseline (−0.22 ± 0.03 V, 95% CI: −0.13 to − 0.31; P &amp;lt; 0.001) (Figure 1). Among patients with high PT, acute increase of R-wave sensing of 1.5 mV after 14 ± 4 min significantly predicted PT normalization (≤1 V@0.24 ms) 12 months post-implant (R = 0.72, 95% CI: 0.13–0.33, P &amp;lt; 0.001) (Figure 2), with a sensitivity of 87.5% (95% CI: 0.61–0.98) and a specificity of 88.8% (95% CI: 0.51–0.99) (Figure 3). Conclusions A 1.5 mV increase in R-wave amplitude at implant time is predictive of PT normalization (&amp;lt;1.0 V/0.24 ms) at 12-month FU. This finding may have practical implications for device repositioning in case of HPT at implant. This parameter could be considered for acute device repositioning, particularly in HPT patients. 536 Figure

Method for Estimating Time of Wireless Transfer of Energy Resources Between Two Robots

The energy capacity of the batteries used as the main power source in mobile robotic devices determines the autonomous operation of the robot. To plan the execution of tasks by a group of robotic tools in terms of time consumption, it is important to take into account the time during which the battery of each individual robot is charged. When using wireless power transfer, this time depends on the efficiency of the power transfer system, on the power of the transferring part of the system, as well as on the level of charge required to recharge. In this paper, we propose a method for estimating the time of transfer of energy resources between two robots, taking into account these parameters. The proposed method takes into account the application of the algorithm for the final positioning of robots, the assessment of linear offsets between robots, includes the calculation of efficiency, as well as the determination of the battery charge time, taking into account the parameters obtained at the previous stages of the method. The final positioning algorithm for robots uses algorithms for processing data from a robot vision system to search for fiducial markers and determine their spatial characteristics to ensure the final positioning of mobile robotic platforms. These characteristics are also used to determine the linear offsets between robots, on which the efficiency of energy transfer depends. To determine it, the method uses a mathematical model of the energy characteristics of the wireless power transfer system and the obtained linear offsets. At the last stage of the method, the time for charging the battery of the mobile robot is calculated, taking into account the data from the previous stages. Application of the proposed method to simulate the positioning of robots in a certain set of points in the working space will reduce the time spent on charging the robot battery when using wireless power transfer. As a result of the simulation, it was determined that the transfer of energy resources between robots took place with an efficiency in the range from 58.11% to 68.22%, and out of 14 positioning points, 3 were identified with the shortest energy transfer time.

Mechanisms of oligodendrocyte progenitor developmental migration.

Oligodendrocytes, the myelinating cells of the central nervous system (CNS), develop from oligodendrocyte progenitor cells (OPCs) that must first migrate extensively throughout the developing brain and spinal cord. Specified at particular times from discrete regions in the developing CNS, OPCs are one of the most migratory of cell types and disperse rapidly. A variety of factors act on OPCs to trigger intracellular changes that regulate their migration. We will discuss factors that act as long-range guidance cues, those that act to regulate cellular motility, and those that are critical in determining the final positioning of OPCs. In addition, recent evidence has identified the vasculature as the physical substrate used by OPCs for their migration. Several new findings relating to this oligodendroglial-vascular signaling axis reveal new insight on the relationship between OPCs and blood vessels in the developing and adult brain.

Çocuklarda Kortikal Gelişimsel Malformasyonlara Tanısal Yaklaşım: 36 Hastanın Klinik, Görüntüleme ve Laboratuvar Verileri

Objective: Malformations of cortical development (MCD) are rare central nervous system abnormalities that are caused by disruption of normal cortical development stages, including neural cell proliferation, cell type differentiation, neuronal migration, and final neuronal positioning. It has different phenotypic presentations which largely depend on the underlying cause of the disorder and is associated with other neurologic and systemic disorders. MCD frequently present with seizures, various degrees of developmental delay, and intellectual disability.

FLRT2 and FLRT3 Cooperate in Maintaining the Tangential Migratory Streams of Cortical Interneurons during Development.

Neuron migration is a hallmark of nervous system development that allows gathering of neurons from different origins for assembling of functional neuronal circuits. Cortical inhibitory interneurons arise in the ventral telencephalon and migrate tangentially forming three transient migratory streams in the cortex before reaching the final laminar destination. Although migration defects lead to the disruption of inhibitory circuits and are linked to aspects of psychiatric disorders such as autism and schizophrenia, the molecular mechanisms controlling cortical interneuron development and final layer positioning are incompletely understood. Here, we show that mouse embryos with a double deletion of FLRT2 and FLRT3 genes encoding cell adhesion molecules exhibit an abnormal distribution of interneurons within the streams during development, which in turn, affect the layering of somatostatin+ interneurons postnatally. Mechanistically, FLRT2 and FLRT3 proteins act in a noncell-autonomous manner, possibly through a repulsive mechanism. In support of such a conclusion, double knockouts deficient in the repulsive receptors for FLRTs, Unc5B and Unc5D, also display interneuron defects during development, similar to the FLRT2/FLRT3 mutants. Moreover, FLRT proteins are chemorepellent ligands for developing interneurons in vitro, an effect that is in part dependent on FLRT-Unc5 interaction. Together, we propose that FLRTs act through Unc5 receptors to control cortical interneuron distribution in a mechanism that involves cell repulsion.SIGNIFICANCE STATEMENT Disruption of inhibitory cortical circuits is responsible for some aspects of psychiatric disorders such as schizophrenia or autism. These defects include interneuron migration during development. A crucial step during this process is the formation of three transient migratory streams within the developing cortex that determine the timing of interneuron final positioning and the formation of functional cortical circuits in the adult. We report that FLRT proteins are required for the proper distribution of interneurons within the cortical migratory streams and for the final laminar allocation in the postnatal cortex. These results expand the multifunctional role of FLRTs during nervous system development in addition to the role of FLRTs in axon guidance and the migration of excitatory cortical neurons.

Double lumen tube: Size and insertion depth.

Double lumen tubes (DLTs) are most commonly used to achieve one lung ventilation (OLV) in most thoracic surgical procedures unless contraindicated. Left-sided DLT (LDLT) is most commonly used nowadays for most thoracic surgical procedures. Though, the use of LDLT dates long back in history, two clinical and technical issues are yet to be resolved. The first issue is the ideal size of DLT which is defined as that which provides near-complete seal of the bronchial lumen without cuff inflation. There are no guidelines in literature which help in selecting the size of DLT. However, general consensus among thoracic anesthesiologists recommends the use of smaller sizes to avoid airway trauma. In our practice and for the last few years, we are using smaller size LDLT 35 F for females and 37 F for males with minimal airway trauma and had encouraging results. The second issue is the insertion depth of the LDLT. We have introduced a height-based formula to predict the insertion depth of LDLT with encouraging results. However, even with the use of the formula, we still recommend the use of fiberoptic bronchoscopic confirmation method for final positioning of the LDLT.

Critical view of robotic-assisted transverse abdominal release (r-TAR).

Establishing straightforward and reproducible steps to describe the technique performed with the aid of the robotic system for complex hernia surgery is key for good outcomes. Even using the description of open surgery as a parameter for performing the robotic technique, it is important to stress the particularities of this access. To describe the steps to perform robotic-assisted TAR (r-TAR) in a standardized technique, with a critical and safe view of all the anatomical structures. We defined 8 landmarks for the critical view of safety in r-TAR which include: (1) patient position, trocar and docking; (2) posterior rectus sheath mobilization; (3) transversus abdominis release (TAR)-Top-down technique; (4) transversus abdominis release (TAR)-bottom-up technique and mesh insertion; (5) contralateral trocar insertion and redocking, 6) posterior sheath closure; (7) final mesh positioning; and (8) anterior defect closure and drains. Complex hernia surgery using a robotic-assisted posterior component separation requires well-established steps so the procedure can be reproducible and achieve better results.

Pacing behaviour of middle-long distance running & race-walking athletes at the IAAF U18 and U20 World Championship finals

ABSTRACT The current study analysed the pacing behaviour of athletes competing in the middle-long track event finals of the IAAF Under 18 and Under 20 World Championships between 2015 and 2018. Official finishing times, 1000-m split times and positioning data of 116 female and 153 male athletes, competing in the middle-long distance running (3000 m, 5000 m and 10,000 m) and race walking (5000 m and 10,000 m) events, were gathered. Repeated measures analysis of variance, with 1000-m speed as within-subjects factor and final ranking (medallist, Top 8 or Top 12, rest of the field) as between-subjects factor, was performed to compare the pacing behaviour between athletes. Positioning of the athletes was analysed by Kendall tau-b (Tb) correlation between the intermediate position and final position. Overall, medallists increased their speed throughout a race, with the exception of the 5000 m running event, in which a parabolic pacing behaviour was exhibited. The 1000-m segment in which a significant (P > 0.05) difference in speed was exhibited between differently ranked athletes coincided with a strong (Tb > 0.7) correlation between intermediate and final positioning. These combined results point towards a separation between the athletes during the race, as the Top 8 or Top 12 and the rest of the field are unable to match the speed of the medallists. The distance, discipline, sex, age category and behaviour of competitors all influence the pacing behaviour of young track athletes during international level competition, emphasising the importance and complexity of developing adequate pacing behaviour in track athletes. Highlights The distribution of effort over an exercise task (i.e. pacing) is an important factor in endurance exercise competition. The pacing behaviour of athletes is determined by many aspects, such as the biomechanical characteristics of the task, the exercise environment and the age of the athlete Sport specific competition data from youth athlete sports events can provide insight into the pacing behaviour of developing athletes. These insights could assist in the optimalisation of the development of pacing behaviour of young athletes in the future. The current study analysed the 1000-m split times and positioning data of athletes competing in the running (3000 m, 5000 m and 10,000) and racewalking (5000 m and 10,000m) finals of the U18 and U20 IAAF world-championship. The difference in final ranking impacted the pacing behaviour of the athletes, with the medallists increasing their speed throughout the race and the other athletes separating from the medallists either early (rest of field) or later in the race (Top 8 or Top 12 athletes).

Unfair tax competition influence on the development of the sustainable economy and international economic relations

The gist of this article boils down to the impact of unfair tax competition on the current state and further development of a sustainable economy and international economic relations. With the development of the world economy and international economic relations, the world community is faced with such an economic category as unfair tax competition or tax dumping. International tax competition or tax dumping is one of the most negative phenomena associated with the tax policy of states. To stimulate the inflow of investment in a particular country or region, governments of different jurisdictions resort to a special type of tax policy characterized by strong tax cuts. It is obvious that unfair tax competition consists of not only tax dumping, but also other advantages provided by the state. The most obvious of these benefits is high confidentiality for investors. The activities of offshore jurisdictions can not only cause significant damage to the economies of countries that are not able to apply tax dumping, but also provoke serious economic crises. Tax evasion is primarily due to the fact that economic agents prefer to register in offshore countries and pay taxes there. In this regard, offshore countries are quite rightly called the “dependents” of the world economy, since they are the ones who unreasonably use the public goods created by the onshore states. The article examines the impact of unfair tax competition on the current state and further development of the world economy and international economic relations. The policy of offshore countries is analyzed, the reasons, problems and prospects for the development of the international struggle against unfair tax competition are studied. Final positioning is formulated in the paper.

A surface defect detection system for railway track based on machine vision

In order to detect rail surface defects more quickly and effectively, a rail surface defect detection system based on machine vision was constructed. A perfect lighting system is built to obtain high quality image information. At the same time, the linear CCD camera is used to collect the rail information, which is uploaded by FPGA, and the image information is processed and analyzed by MATLAB software in the upper computer. Through the methods of image denoising and image enhancement, the image quality is improved, and the image information suitable for operation is obtained; then, the rail positioning is completed by threshold segmentation, gray compensation and image binarization to simplify the image operation; finally, the final positioning of defects is realized through edge detection and feature extraction. By building a test platform on the rail maintenance vehicle, the rail surface defect information collected by the rail maintenance vehicle is analyzed and processed.

Investigation of turquoise gemstone using micro-PIXE imaging technique

Elemental distribution of turquoise gemstone is investigated using micro-PIXE technique. The RGB maps of the elements characteristic for turquoise gemstone were produced by means of PyMCA software. The experiments were performed on a suite of samples from different origins. The results show that both copper and phosphorous had already been collected in the aqueous solution of turquoise before its final positioning within aluminum bearing host minerals. Moreover, it is shown that the elemental composition of the host matrix could be considered as a distinguishing factor for determining the origins of the samples. Such information could shed light on the complicated formation process of turquoise gemstone and its provenance investigation, as this gemstone was a valuable commodity on the ancient trade markets.

Anatomic Total Hip Component Position Is More Reproducible With the Direct Anterior Approach Using Intraoperative Fluoroscopy

BackgroundTotal hip arthroplasty (THA) has demonstrated excellent results regardless of the surgical approach. However, the approach used may be a factor in final positioning of implants. We hypothesized that the direct anterior approach (DAA) with fluoroscopy would be associated with more anatomic implant positioning than the posterior approach (PA). MethodsA retrospective review of 200 patients was performed. One hundred patients underwent THA utilizing the PA, and 100 patients, with the DAA. All patients had an anterior-posterior pelvis radiograph preoperatively and postoperatively with a magnification marker present to standardize each radiograph. Exclusion criteria included contralateral THA or any pelvic or femoral deformity. ResultsPreoperative radiographs demonstrated identical cohorts with respect to leg length, femoral offset, and total offset. Postoperatively, the DAA achieved more accurate anatomic restoration of leg length (1.6 mm vs 5.5 mm; P < .0001), femoral offset (4.8 mm vs 9.3 mm; P < .0001), and total offset (0.5 mm vs 4.7 mm; P < .0001) compared with the PA. Ideal cup abduction and anteversion were significantly superior to the DAA (96% vs 78%, P = .0002, and 69% vs 24%, P < .0001, respectively). ConclusionsThis study is the first to compare anatomic implant positioning between patients undergoing THA with these 2 approaches. All parameters were significantly closer to anatomic implant positioning with the DAA. There are at least 2 potential explanations for this: (1) The DAA implant positioning was performed under fluoroscopic guidance, whereas the PA was not. (2) The PA disrupts the posterior capsule and external rotators, and therefore, increased offset or leg length may be necessary to achieve comparable hip stability with the DAA.

Efficacy of height-based formula to predict insertion depth of left-sided double lumen tube: A prospective observational study.

The insertion depth of the left-sided double-lumen tube needs careful positioning and bronchoscopic confirmation. Several formulae based on body height have been used for estimating the optimal insertion depth of a left-sided double-lumen tube. We conducted this prospective study to test the hypothesis that our earlier developed height-based formula (0.25 × body height0.916) could predict the accurate insertion depth of a left-sided double-lumen tube. After obtaining ethical approval, 66 patients who underwent thoracic surgery were included. A left-sided double-lumen tube was advanced blindly to the predicted depth of insertion calculated using our formula. The optimal position of the left-sided double-lumen tube was confirmed using a fibreoptic bronchoscope. The primary outcome was the percentage of tubes placed in the optimal position without the need for further adjustments. The secondary outcomes included the need for bronchoscopic adjustments and the final correct insertion depth of the left-sided double-lumen tube. The formula resulted in an optimum position of the left-sided double-lumen tube without further adjustments in 45 patients (70%) (95% confidence interval 58%-80%). The left-sided double-lumen tube was withdrawn or advanced in 18.2% and 12.1%, respectively, to achieve the optimal insertion depth. We found that our formula provided satisfactory positioning in about 70% of patients and that in the remaining patients, the adjustments required to achieve satisfactory positioning under fibreoptic bronchoscope guidance were minimal. Nevertheless, as it is not possible to predict which patients will have a satisfactory tube position, bronchoscopic confirmation for the final positioning is still required.

CN7 Improved staff ergonomics and time efficiency using surface guided radiotherapy for prostate setup

The use of surface guided radiotherapy (SGRT) for prostate patients with internal gold markers was investigated in this study. The purpose was to investigate the effects on ergonomics for the oncology nurses using the SGRT system for initial patient setup. Also, the time efficiency was evaluated using an automatic couch shift function. A total of 40 prostate patients with gold markers were included, 20 patients using the SGRT system CatalystTM (C-rad Positioning AB, Uppsala, Sweden) for patient setup and 20 reference patients using tattoos’ and laser alignment. At the first treatment fraction, the lateral laser was used to control that the patient was centered on the couch for all patients. For the SGRT patients, a colour map was projected onto the patients’ skin for guidance of posture correction. The calculated couch shift was automatically applied using an auto-couch function. Daily orthogonal kV-images were used for final positioning of the internal gold markers. For comparison purposes, 184 fractions using SGRT, and 192 fractions using laser alignment was included. The staff ergonomics was evaluated using a questionnaire that was sent out to ten oncology nurses. The result from the questionnaire showed an improvement in the staff ergonomics. Working with the colour map reduced the amount of heavy lifting for patient adjustments. It was reported that the pain in the neck, shoulders, elbow and thumbs was decreased from all the participators. These ergonomic effects were evaluated during a relatively limited time, suggesting that long term use of SGRT could have a great impact on the staff ergonomics. For most treatment fractions, the SGRT system improved the time efficiency compared to laser alignment (Figure 1). However, during the first treatment fraction an increased setup time was observed (median 3 min) due to time for camera optimization and learning the SGRT system. The treatment staff experienced an ergonomic benefit using the colour map projected onto the patients’ skin. Shorter patient positioning times were observed using SGRT for most treatment sessions. The result of this study led to implementation of the SGRT workflow for all prostate patients with internal markers in our clinic.

Cost-Effectiveness of Intraoperative CT Scanning in Cochlear Implantation in Fee-for-Service and Bundled Payment Models.

Electrode array tip fold-over is a complication of cochlear implant surgery that results in poor hearing outcomes and often leads to revision surgery. However, tip fold-over can be corrected immediately if identified through intraoperative computed tomography, which also potentially provides information about final intracochlear positioning. Our objective was to provide the first economic analysis of intraoperative computed tomography by generating models in fee-for-service and bundled payment reimbursement structures of payer and institutional cost-effectiveness of this technology used in cochlear implantation over 1, 5, and 10-year time periods. Cost data specific to a commerically available intraoperative computed tomography machine was obtained from the manufacturer, Xoran Technologies. Institutional tip fold-over rate was obtained from already published data. Medicare reimbursement rate for cochlear implantation was obtained from institutional accountants. Private payer reimbursement for and cost of revision cochlear implantation were estimated based on available data. At large volume centers, cost-effectiveness of this technology is possible in both fee-for-service and bundled payment reimbursement structures at various time points dependent on payer mix. Even low volume cochlear implantation centers (<150 per year) can financially benefit from intraoperative computed tomography in bundled payment models at 5- and 10-year periods regardless of payer mix. This model demonstrates key factors at play in determining cost-effectiveness of this technology including institutional factors and payer type and suggests this technology can align incentives both to improve patient care and outcomes with institutional and payer financial well-being.

DOCUMENTÁRIOS DE CIÊNCIAS NA FORMAÇÃO INICIAL DE PROFESSORES: CONTRIBUIÇÕES PARA UMA LEITURA CRÍTICA SOBRE O AQUECIMENTO GLOBAL

Neste estudo, analisamos uma atividade desenvolvida com licenciandos em física de uma instituição federal do estado de São Paulo. O principal objetivo da atividade foi investigar o discurso produzido por estes licenciandos ao se engajarem em um debate sobre as possíveis causas do aquecimento global após assistirem dois documentários de ciências. O primeiro intitulado “Uma Verdade Inconveniente” e o segundo “A grande farsa do aquecimento global”. Ambos utilizam uma textualização persuasiva, como depoimentos de cientistas, gráficos, simulações, imagens, etc. para argumentar em favor de 1) causas antropogênicas e 2) causas naturais do aquecimento global, respectivamente. As seguintes questões orientaram nossa análise: as estratégias retóricas utilizadas nesses documentários contribuíram para o posicionamento desses licenciandos em relação às causas do aquecimento global? Se sim, de que maneira? Até que ponto atividades dessa natureza podem contribuir para o desenvolvimento da alfabetização em mídia científica na educação básica? Utilizamos como apoio teórico-metodológico a Análise do Discurso francesa, principalmente por meio de trabalhos publicados no Brasil por Eni Orlandi, além de trabalhos acadêmicos das áreas de divulgação científica e documentários. A análise sugere que o estilo dos documentários, juntamente com aspectos históricos e contextuais, influenciaram o posicionamento final dos licenciandos em relação às causas do aquecimento global.