Brain Researchers
1) Recent advances in neuroscience enable doctors to manipulate the workings of the brain and intervene to treat some neurological disorders. How far should researchers go in their quest to understand this complex organ and improve people's qualit of life! and to what extent should the be responsible for making sure that others do not misuse their findings are questionings that must be answered. "r. #incent $alsh! a professor of cognitive neuroscience at %niversit &ollege ondon! has discussed the use of non(invasive brain stimulation techniques such as transcranial direct current stimulation *"&+). ,) +tudies published in the past few ears purport to show that some brain stimulation techniques can enhance a variet of brain functions! such as memor! numerac! and language learning. -or example! cheap brain stimulation devices are now available commerciall! making it possible for anone to attempt to boost their brain function. lthough the onl indication showing relativel solid evidence of improvement with brain stimulation devices is depression! smaller studies looking at cogn cognititiv ive e impr improv ovem emen entt appe appear ar to have have been been the the ke ke driv driver erss of incr increa ease sed d inte intere rest st amon among g researchers and the la public in the technolog's potential. /) "r. $alsh questioned the reliabilit of these findings. 0$e're at a stage where the qualit control of these brain studies has become ver poor!0 he said. 0*here are some ver bold claims! but there isn't a single significant replication between laboratories. ne of the most highl cited paper in the field comes from m own laborator! and 2've twice failed to replicate it mself!0 said "r. $alsh. He also pointed out that brain enhancement effects seen under laborator conditions are unlikel to transfer to our dail lives. 0*he enhancement effects seen in the laborator are significant and meaningful! but there are no significant demonstrations of them in real(world situations.0 3) 0$e are no longer in control of what stories the general public hears about our research data on brain stimulation!0 added $alsh. 0*he can decide which papers are worth listening to before an scientific consensus has been reached! so we have a dut to be much more measured in the claims we make.0 $alsh thinks that brain stimulation should not be used to enhance performance in sports! education! or other realms. 04ou don't get good at anthing with a short(term fix! but with ears of training and 5udgment. 2f we allow cognitive enhancement into education then we lose the whole idea of what education is about.0 &linical neuropschologist Barbara +ahakian of the %niversit of &ambridge said said that brain enhancement enhancement ma be desirable in certain certain situations. 0$e ma want to enhance militar personnel in a war situation! or doctors who are working late at night! to keep them awake and alert.0 6) 7ow! how far should researchers go to understand the human8s brain9 "r. 2t:hak -ried! a professor of neurosurger and pschiatr at the %niversit of &alifornia has discussed the ethics of performing experiments on people with epileps during brain surger. ;ost epileptic patients respond well to anticonvulsant drugs! but in the minorit who do not! surger is performed as a last resort. %sing a technique pioneered b $ilder
s! surgeons can use electrodes to identif and remove the brain tissue producing the sei:ures while the patient is full conscious. fter placing the electrodes onto the brain surface! the surgeon has to wait! sometimes for man das! for the patient to have a sei:ure. *his provides the rare opportunit to stud the brain directl. 0$e are ver privileged to be able to do this! but it raises serious ethical issues!0 said "r.
-ried. +urger is perfectl 5ustified! he explained! but performing experiments is not(while it ma provide some insight into how the brain works! it is of no benefit whatsoever to the patient. ?) ll members of -ried's neurosurger program are required to examine and adhere to the Belmont Report! which sets out ethical principles and guidelines for the protection of stud participants. *he three principles outlined in the report are@ respect( in all cases! researchers must protect patients' autonom! treat them with the utmost courtes and respect! and onl enroll them in such studies after informed consentA beneficence( researchers must maximi:e the benefits of their experiments! while at the same time avoiding at all costs causing harm to the participantsA and! 5ustice( researchers must ensure that their experiments are designed well and that their procedures are safe! non(exploitative! and administered fairl. 0$hen we prolong the operative time! we ma cause patient discomfort and in5ur to the brain tissue! so we have a special responsibilit to do good science and ask good questions!0 sas -ried.
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*o purport@ supor! pretender *o boost@ aumentar Reliabilit@ confiabilidade $orth@ que vale a pena +ei:ures@ convulsCes *o enroll@ increver
1) Escolha a alternativa que traz a ideia principal do trecho abaixo, extraído do parágrafo 2. Although the only indication showing relatively solid evidence of improvement with brain stimulation devices is depression, smaller studies looking at cognitive improvement appear to have been the key drivers of increased interest among researchers and the lay public in the technology's potential.
7Do existem evidEncias concretas de que o aparelho de estFmulo cerebral aumente a capacidade cognitiva. aparelho de estimulaGDo cerebral tem chamado a atenGDo de pesquisadores e do pblico pelo seu potencial tecnolIgico. Jstudos sobre aumento cognitivo com estimulaGDo cerebral tEm levado pesquisadores e leigos a se interessarem pela tKcnica. Jxistem evidEncias de que o aparelho usado para estimulaGDo cerebrais pode aumentar a depressDo. Jmbora o aparelho de estimulaGDo cerebral tenha gerado interesse! mais estudos precisam ser feitos para comprovar seus benefFcios. 2) De acordo co o texto, o que se pode afirar sobre a estiula!"o cerebral#
parelhos de estFmulo cerebral estDo sendo utili:ados com sucesso no tratamento da depressDo! insLnia! e dor crLnica. Jstudos comprovam que algumas tKcnicas de estimulaGDo cerebral podem melhorar funGCes cerebrais como a memIria e habilidades matemMticas. NM existem estudos concretos que comprovam os benefFcios da estimulaGDo cerebral no aprendi:ado.
s pesquisadores nDo podem se responsabili:ar pelos resultados de suas pesquisas
sobre estimulaGDo cerebral. s histIrias que o pblico ouve sobre estimulaGDo cerebral nem sempre sDo reais.
-alta consenso cientFfico entre pesquisadores sobre os resultados das pesquisas sobre estimulaGDo cerebral.
*he three principles Report Researchers utonom
s perigos do uso indiscriminado de aparelhos de estimulaGDo cerebral.
parMgrafo 1 parMgrafo , parMgrafo / parMgrafo 3 parMgrafo 6 ou ? ) (s pr5xias quest4es s"o baseadas no trecho abaixo, extraído do parágrafo 1. 6lique e (7(-8(9 para visualizar as quest4es. %ecent advances in neuroscience enable doctors to manipulate the workings of the brain and intervene to treat some neurological disorders. &ow far should researchers go in their uest to understand this comple organ and improve people's uality of life, and to what etent should they be responsible for making sure that others do not misuse their findings, are uestionings that must be addressed. (incent Walsh, a professor of cognitive neuroscience at )niversity *ollege +ondon, has discussed the use of non#invasive brain stimulation techniues such as transcranial direct current stimulation T*-!.
:) ( qual das alternativas abaixo se refere o pronoe “they$ no trecho abaixo#
Recent advances in neuroscience enable doctors to manipulate the workings of the brain and intervene to treat some neurological disorders. How far should researchers go in their quest to understand this complex organ and improve people's quality of life, and to what extent should they be responsible for making sure that others do not misuse their findings, are questionings that must be addressed.
7euroscience "octors 7eurological disorders
Researchers
Reutili:ar
s pesquisadores precisam avaliar atK onde devem ir em suas pesquisas sobre o cKrebro e nos tratamentos dos distrbios neurolIgicos. professor #incent $alsh nDo estM satisfeito com os resultados das tKcnicas de estimulaGDo cerebral. ;esmo com os avanGos em neurociEncia! pesquisadores nDo conseguem intervir para tratar alguns distrbios neurolIgicos. ciEncia tem sido incapa: de entender e manipular as funGCes cerebrais e propor tratamentos para distrbios neurolIgicos .
12) (ssinale a alternativa que traz a ideia principal do trecho abaixo
"We're at a stage where the uality control of these brain studies has become very poor," he said. "There are some very bold claims, but there isn't a single significant replication between laboratories. ne of the most highly cited paper in the field comes from my own laboratory, and /'ve twice failed to replicate it myself, "said r. Walsh.
Jstudos sobre o cKrebro devem ser replicados em laboratIrios onde o controle de
qualidade K ruim. . penas o laboratIrio do "r. $alsh consegue replicar estudos de outros laboratIrios sobre o cKrebro. -alta controle de qualidade nos laboratIrios que tentam replicar estudos sobre o cKrebro. "r. $alsh foi o nico que nDo conseguiu replicar o estudo sobre o cKrebro.
Pualit control Brain studies aborator
1%) Escolha a alternativa que traz o sentido correto do grupo noinal abaixo (…)no significant demonstrations of them in real#world situations.
7enhum significado nas situaGCes reais das demonstraGCes deles do mundo 7enhuma demonstraGDo significativa deles em situaGCes do mundo real. +ituaGCes do mundo real deles sem demonstraGCes significativas. +em situaGCes significativas o mundo real deles nDo demonstram nada. mundo real das situaGCes deles nas demonstraGCes nDo significativas. 1') -a frase r. Walsh also pointed out that brain enhancement effects seen under laboratory conditions are unlikely to transfer to our daily lives$, a palavra unli
2ncomuns "esagradMveis
dequadas 2mprovMveis Jxigidas
"iagnostics for &ommon &hildhood 2nfections
1( *he implementation of preventive strategies and effective treatment has substantiall reduced the incidence of malaria across man parts of frica. *he introduction of Haemophilus influen:ae tpe b vaccine and! more recentl! pneumococcal con5ugate vaccine should dramaticall reduce the incidence of serious bacterial infections among children. *hese pathogens accounted for a substantial proportion of childhood deaths in regions of frica where malaria is endemic. High coverage with these measures should affect the burden and spectrum of the common childhood febrile diseases. &onsequentl! case(management guidelines Q which are currentl designed to maximi:e sensitivit over specificit! resulting in widespread use of low(cost antimalarial or antimicrobial agents to avert adverse outcomes Q will need to be revised. However! most research underpinning such guidelines was undertaken two to three decades ago. *he advent of rapid diagnostic tests and molecular diagnostics has expanded the potential to identif causes of disease and ma inform future management strategies for common childhood diseases. ,( "'cremont! a &linical epidemiologist at the +wiss *ropical and U. virus was detected in S1U of children with acute respirator tract infection. +stemic infections! U of children with malaria! irrespective of parasite densit! had a secondar pathogen or diagnosis. /) "uring the stud! "'cremont made two important observations. -irst! interpretation of the infectious cause of illness based solel on laborator testing is potentiall misleading. Bacterial! viral! and parasitic pathogens were identified in SVU! S1U! and 11U of patients! respectivel. However! when laborator data were combined with predefined clinical criteria to determine each diagnosis! the disease burden was significantl rebalanced bacterial! ,,UA viral! V1UA and parasitic! 11U). lthough the authors ensured internal consistenc and external validit b using previousl defined definitions of clinical disease! the lack of a control group i.e.! nonfebrile children) meant that the were unable to verif the clinical significance of most viral pathogens and! to some extent! other pathogens identified with the use of serologic or molecular markers. 3) *he importance of a caseWcontrol design was recentl exemplified in a hospital stud of causes of severe pneumonia among Xenan children ounger than 6 ears of age! which included outpatient children without pneumonia as control patients. Respirator viruses were present in nasopharngeal swabs from ?>U of case patients and 3VU of control patients. $ith the exception of respirator snctial virus! no nasopharngeal viral infection was found to be associated with hospitali:ation for pneumonia in the caseWcontrol analsis. 2nterpretation of test results therefore continues to be a challenge in the context of nasopharngeal coloni:ation and the persistence of genetic material in the nasopharnx Q or in blood! in the case of rapid diagnostic tests for malaria. 6( *he second observation is that in the absence of critical illness and once malaria has been ruled out! most febrile outpatient children can be treated conservativel without antibiotics. *he
most common bacterial isolates found b blood culture in this stud were enteric gram(negative bacteriaA thus! once pneumococcal vaccine is widel used! treatment with recommended first(line antibiotics will probabl be ineffective. *argeting of high(risk subgroups e.g.! patients with human immunodeficienc virus infection! sickle cell disease! malnutrition! or severe illness) and associated likel pathogens on the basis of the presenting sndrome should be considered in future efforts to refine guidelines for prescribing antimicrobial agents. ?( 7ew diagnostics have considerable potential to improve care! target treatment! and reduce the cost of unnecessar prescriptions and the succeeding effects of antimicrobial resistance. However! a trial investigating the effect of rapid! malaria diagnostics on case(management decision making! in which pre(trial training of clinical staff emphasi:ed that a negative test result should lead to consideration of an alternative diagnosis! did not show reduced rates of malaria treatment. 7inet percent of antimalarial agents prescribed in the trial were for children with negative test results. s the epidemiologic landscape evolves! updated guidelines based on evidence are welcomeA however! experience suggests that changing current practice will not be a straightforward process.
dapted from an article b Xathrn ;aitland! ;.B.! B.+.!
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1) Escolha a alternativa que traz a ideia principal do trecho abaixo, extraído do parágrafo 1. The advent of rapid diagnostic tests and molecular diagnostics has expanded the potential to identify causes of disease and may inform future management strategies for common childhood diseases.
pressa na hora de diagnosticar as doenGas infantis tEm sido a causa do aumento de diagnIsticos errados. 7ovas estratKgias de gestDo na Mrea de diagnIsticos podem levar a identificaGDo mais rMpida das doenGas. s testes e o diagnIstico molecular tEm se expandido rapidamente e necessitam de futuras estratKgias de gestDo. s testes de diagnIsticos rMpidos e diagnIsticos moleculares podem ampliar o potencial para identificar as causas das doenGas e dar informaGCes para a gestDo futura de doenGas infantis. &om a rapide: dos testes de diagnIstico! as causas das doenGas infantis deixaram de ser identificadas prontamente. 2) qual das alternativas abaixo se refere o prono!e "they # (parágrafo $)%
uthors 2nternal consistenc and external validit
te! o sentido de'
brigaGDo ;istKrio "esafio
s infecGCes respiratIrias nDo foram comuns em crianGas com outras condiGCes mais graves. 7Do foi detectado vFrus na maioria das crianGas diagnosticadas com infecGCes respiratIrias.
maioria das crianGas diagnosticadas com malMria! tambKm foram diagnosticadas com infecGDo urinMria e gastroenterite. ;ais da metade das crianGas tinham sido diagnosticadas com infecGCes respiratIrias. +em os exames laboratoriais e critKrios mKdicos predefinidos! concluiu(se que apenas ,,U dos pacientes tinham algum tipo de bactKria ao invKs de S1U. ') que pode ser inferido do parágrafo /%
prescriGDo de antibiIticos para pacientes febris com deficiEncia autoimune nDo K permitida. 7a ausEncia de doenGas graves e de malMria! o tratamento de crianGas febris pode ser feito sem o uso de antibiIticos. nDo prescriGDo de antibiIticos no tratamento de doenGas graves tem aumentado os casos de infecGCes. uso limitado da vacina pneumocIcica tem colaborado para uma dependEncia maior dos antibiIticos. "ependendo da doenGa! o uso de algumas linhas de antibiItico K inadequado e perigoso. ) Escolha a alternativa que traz a ideia principal do trecho abaixo, extraído do parágrafo 0. !s the epidemiologic landscape evolves, updated guidelines based on evidence are welcome" however, experience suggests that changing current practice will not be a straightforward process.#
inda que nDo se5a um processo simples! atuali:ar as diretri:es em um cenMrio
epidemiolIgico em evoluGDo K bem vindo. falta de diretri:es fundamentadas e atuais piora o cenMrio epidemiolIgico. ;udar as diretri:es em um cenMrio epidemiolIgico em evoluGDo K um processo de relativa rapide:. processo de evoluGDo do cenMrio epidemiolIgico nDo K simples e depende das mudanGas das diretri:es. cenMrio epidemiolIgico em constante evoluGDo dificulta o processo de atuali:aGDo das diretri:es. /) ual a ideia central do artigo%
Jstudo na *an:Ynia concluiu um aumento de diagnIsticos de malMria e outras doenGas infantis.
Jrros de diagnIstico da malMria tEm contribuFdo para o tratamento inadequado da doenGa no mundo todo. 7a Zfrica! a falta de uso dos antibiIticos tEm piorado a incidEncia de malMria entre as crianGas. "iagnIsticos criteriosos podem evitar e a prescriGDo de antibiIticos de forma indiscriminada no tratamento da malMria e outras doenGa infantis. excesso de diretri:es para guiar os diagnIsticos de malMria compromete a sade pblica lem nFvel global. ) E! qual parágrafo o autor cita que u!a porcentage! de crian+as diagnosticadas co! !alária, ta!b*! tinha! outras afec+2es%
parMgrafo 1 parMgrafo , parMgrafo / parMgrafo 3 parMgrafo 6 ou ? ) (s pr5xias quest4es s"o baseadas no trecho abaixo, extraído do parágrafo 1. 6lique e (7(-8(9 para visualizar as quest4es. The introduction of Haemophilus influen$ae type b vaccine and, more recently, pneumococcal con%ugate vaccine should dramatically reduce the incidence of serious bacterial infections among children. These pathogens accounted for a substantial proportion of childhood deaths in regions of !frica where malaria is endemic. High coverage with these measures should affect the burden and spectrum of the common childhood febrile diseases. &onsequently, casemanagement guidelines ( which are currently designed to maximi$e sensitivity over specificity, resulting in widespread use of lowcost antimalarial or antimicrobial agents to avert adverse outcomes ( will need to be revised.
:) ssinale a alternativa que traz a ideia principal do trecho abaixo' The introduction of Haemophilus influen$ae type b vaccine and, more recently, pneumococcal con%ugate vaccine should dramatically reduce the incidence of serious bacterial infections among children. These pathogens accounted for a substantial proportion of childhood deaths in regions of !frica where malaria is endemic. High coverage with these measures should affect the burden and spectrum of the common childhood febrile diseases.
incidEncia de infecGCes e doenGas febris na infYncia devem ser redu:idas com a introduGDo das vacinas Hib e pneumocIcica! em regiCes da Zfrica. s patIgenos responsMveis pela alta taxa de mortalidade infantil na Zfri ca! onde a malMria K endEmica nDo estDo diminuindo. s doenGas febris comuns na infYncia sDo responsMveis pelo aumento da mortalidade infantil em algumas regiCes da Zfrica.
taxa da mortalidade infantil K maior em regiCes da Zfrica! onde a malMria nDo K tratada. pIs a introduGDo das vacinas Hib e pneumocIcica em algumas regiCes da Zfrica! aumentou o espectro da mortalidade infantil. 1;) qual das alternativas se refere o prono!e "which# no trecho abaixo % High coverage with these measures should affect the burden and spectrum of the common childhood febrile diseases. &onsequently, casemanagement guidelines ( which are currently designed to maximi$e sensitivity over specificity, resulting in widespread use of lowcost antimalarial or antimicrobial agents to avert adverse outcomes ( will need to be revised.
High &overage ;easures Burden and +pectrum &ommon childhood febrile diseases &ase(management guidelines 11) Escolha a alternativa que traz o sentido correto do grupo no!inal abaixo' )*...+ the burden and spectrum of the common childhood febrile diseases.#
...) carga e o espectro das doenGas febris comuns da infYncia. ...) carga e a o espectro comum das doenGas febris da infYncia. ...) espectro da infYncia e a carga comum das doenGas febris. ...) carga e o espectro em comum com as doenGas febris da infYncia. ...) carga e o espectro das doenGas febris da infYncia comum. 12) &a frase "*onseuently, case#management guidelines 3 which are currently designed to maimi2e sensitivity over specificity, resulting in widespread use of low#cost antimalarial or antimicrobial agentsto avert adverse outcomes 3 will need to be revised # , a palavra "avert #
te! o sentido de'
&orrigir trasar Jvitar Jnfrentar umentar
12) (s pr5xias quest4es s"o baseadas no trecho abaixo, extraído do parágrafo . 6lique e (7(-8(9 para visualizar as quest4es. ew diagnostics have considerable potential to improve care, target treatment, and reduce the cost of unnecessary prescriptions and the succeeding effects of antimicrobial resistance. However, a trial investigating the effect of rapid, malaria diagnostics on casemanagement decision making, in which pretrial training of clinical staff emphasi$ed that a negative test result should lead to consideration of an alternative diagnosis, did not show reduced rates of malaria treatment. inety percent of antimalarial agents prescribed in the trial were for children with negative test results
1$) &a frase' "4ew diagnostics have considerable potential to improve care, target treatment, and reduce the cost of unnecessary prescriptions and the succeeding effects of antimicrobial resistance# (parágrafo 0), a palavra "succeding # te! o sentido de'
+ucessores +ucedidos *emporMrio +ucessivo "esconhecido 1%) qual das alternativas abaixo se refere o prono!e "which# no trecho abaixo% However, a trial investigating the effect of rapid, malaria diagnostics on casemanagement decision making, in which pretrial training of clinical staff emphasi$ed that a negative test result should lead to consideration of an alternative diagnosis, did not show reduced rates of malaria treatment.
trial ;alaria diagnostics &ase(management decision making
&om os avanGos da tKcnica diagnIstica! =>U dos casos de malMria foram diagnosticados corretamente. ;esmo um diagnIstico negativo de malMria nDo tem evitado um nmero muito alto de
prescriGCes desnecessMrias de agentes antimalMricos. Jrros de diagnIstico tEm aumentado o nmero de casos nDo tr atados de malMria. prescriGDo indiscriminada de agentes antimalMricos tem contribuFdo para a diminuiGDo da resistEncia microbiana. =>U dos casos de malMria foram diagnosticados e tratados somente apIs a reali:aGDo do teste de malMria.
