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Anthropogenic pressures on the environment are increasingly evident, characterized by uncontrolled changes in land use that adversely affect water quality. This study aims to assess how land use and land cover contribute to water quality and to evaluate the influence of spatial landscape metrics on water quality variability in eight tributary sub-basins of the Paraopeba River. The analysis considers two seasonal periods reflective of the region's tropical climate. The dataset includes spatial data on land use and land cover, digital elevation models, soil types, geology, geomorphology, spatial-temporal data, and landscape fragmentation metrics. First, spatial differences in water quality data collected at each sampling site were tested, and the significance of seasonal variations was assessed. Correlation analyses were then conducted to determine the relationships between landscape metrics and water quality parameters across the eight sub-basins, considering both seasonal periods. Key findings include the identification of mixed pollution sources, such as pasture, urban areas, and mining, which significantly affect water quality, particularly during the rainy period. Conversely, forest plantations were found to be the land use category that most positively contributed to the preservation of water quality. The relationships between landscape patterns and water quality, analyzed using redundancy analysis, revealed that the influence of landscape metrics on the variation of water quality parameters was significantly more pronounced during the dry period, explaining 75 % of the variation, compared to 49 % during the rainy period.

ABSTRACT Introduction: CrossFit® is a physical training method that aims to promote physical fitness through the development of components such as aerobic capacity, strength and muscular endurance. Data regarding bruxism behaviors in CrossFit® practitioners are scarce, but previous studies have shown increased dental clenching behavior during weightlifting practices. Objective: The present study aimed to evaluate clinical signs of bruxism in CrossFit® practitioners. Methods: The sample comprised a convenience sample of CrossFit® practitioners (n=57), of both genders, aged 19-58 years. Outcome variables were as follows: Oral Behavior Checklist, the International Physical Activity Questionnaire and the Standardized Tool for the Assessment of Bruxism. Data were expressed in terms of absolute values and percentages. Spearman’s correlation and Fisher exact tests were used for statistical analysis, and a significance level of 5% was considered. Results: The mean age was 32.82 years, with a female majority (63.15%). CrossFit® practitioners frequently reported clenching their teeth during training practice (61.40%) and presented linea alba (82.45%), lip impression (54.38%), tongue impression (26.31%), bone exostosis (19.29%), tooth wear (61.40%) and non-carious cervical lesions (35.09%). Conclusions: No correlation was found between clinical signs of bruxism, oral behaviors and physical activity intensity; however, the results suggest that individuals who practice CrossFit® training have oral behaviors that can cause morpho-functional changes in the stomatognathic system, especially the habit of clenching their teeth during training. In addition, data emphasize the need for dental health education among CrossFit® practitioners, and more studies with a representative sample are necessary.

O artigo objetiva problematizar a avaliação externa na educação brasileira, e de modo particular, o Sistema Permanente de Avaliação da Educação Básica do Ceará-Spaece. Dessa forma, o estudo pontua o contexto político em que essa política de controle chegou ao Brasil. Além disso, este trabalho discorre sobre o processo histórico da implementação do Spaece no estado do Ceará e sobre os objetivos prescritos nas diretrizes do Spaece-alfa. Ao identificar as características do sistema avaliativo do ensino básico do Ceará, nesta redação, pondera-se na perspectiva crítica as implicações desse exame externo na prática educativa para a reflexão sobre os contornos desse instrumento avaliativo expresso no cotidiano escolar. A pesquisa busca questionar a intencionalidade desta avaliação em termos de melhoria para a educação, uma vez que compromete a relação professor/aluno e a construção do conhecimento mecanizando a prática pedagógica para alcançar metas.

As prevalências de doenças crônicas não transmissíveis vêm crescendo na população, incluindo em profissionais da saúde, portanto, avaliou-se a ocorrência de rigidez arterial (RA) elevada segundo atividade física no lazer (AFL) através de estudo transversal realizado com agentes comunitárias de saúde (ACS) do sexo feminino de Vitória, Espírito Santo. A AFL foi avaliada pela versão longa do International Physical Activity Questionnaire e a RA foi mensurada pela Velocidade de Onda de Pulso carotídeo-femoral (VOPc-f ). As participantes foram consideradas ativas quando praticavam pelo menos 150 minutos/semana de AFL moderada ou 150 minutos/semana da soma da AFL moderada e vigorosa ou 75 minutos/semana de AFL vigorosa. Para a classificação da RA elevada foi utilizado o ponto de corte que considera valor de VOPc-f ≥ ao percentil 90 estratificado por sexo e faixa etária para população saudável. Foram executados testes estatísticos para comparação de proporções e médias. Um valor de p

The deposits of mine tailings can be a source of groundwater contamination by metals. In this study, we simulated the concentrations of iron, manganese and aluminum in groundwater potentially affected by drainage from tailings deposits located in Brumadinho (Brazil). The aim was to verify whether the concentrations observed in the region can be attributed to these drainages. The simulation used the FREEWAT graphical interface, which incorporates the MODFLOW model, the hydraulic properties of existing unconfined and confined aquifers, the spatial distribution of the tailings’ deposits, and the dissolved iron concentrations measured in drilled wells. The simulation period was 20 years, starting in 2019 after the collapse of B1 tailings dam of Córrego do Feijão mine of Vale, S.A. The modeling results revealed plumes of metal contamination progressively less dispersed over time, in the unconfined aquifer, and increased metal concentrations in the confined aquifer. The simulated concentrations in both aquifers were generally lower than the legal limits imposed for human consumption, although some areas in the vicinity of the deposits had iron and manganese concentrations higher than those limits, especially in the unconfined aquifer, and these areas widened over time. The most relevant result was the revelation that the contribution of tailings drainage to the iron concentrations observed in the drilled wells might have not exceeded 1%. This is important from a management standpoint, because monitoring of anthropogenic groundwater contamination in these cases (where rock weathering dominates groundwater chemistry) becomes more challenging.

The Soil and Water Assessment Tool (SWAT) was used to assess total phosphorus concentrations (TOT-P) and fluxes (TOT_P) in the Paraopeba River basin, located in the state of Minas Gerais, Brazil, following the collapse of tailings dam B1 in Brumadinho. The model was calibrated and validated for periods before (2000–2018) and after (2019–2021) the collapse of Brumadinho dam in 25 January 2019, with great accuracy measured by various performance indicators (e.g., R2 ≈ 0.8). The flow of phosphorus-containing sludge from the iron-ore tailings explored in the Córrego do Feijão Mine of Vale, SA, and released after the B1 dam break has impacted the Paraopeba River water through large increments in the TOT-P near the dam site (60–100%, with pre-rupture values varying between 0.06 and 0.1 mg/L). But other major sources were flagged, namely urban sources from the Betim region that raised TOT-P to ≈ 0.9 mg/L periodically during the entire simulation period. The study also revealed controls of TOT-P concentration in the basin, namely the coverage by forests that lowered down the TOT-P at 0.5–0.8 μg/L.km2. The lowering rate was, however, dependent on the occupation by argisols. As per the simulation results, the larger the percentage of argisols in a region the larger the TOT-P will be in the surrounding water courses, meaning that the argisols are prone to erosion and phosphorus leaching. A cluster analysis of input (e.g., terrain slope, soil type) and output (e.g., runoff) variables from the SWAT allowed relating TOT-P with surface- and TOT_P with underground-dominant hydrological processes, respectively runoff and groundwater flow, linking them to specific environmental variables such as argisols and steep slopes in the first case and latosols and smooth landscapes in the second case. The management implications retrieved from this holistic assessment were discussed. Finally, the TOT-P were checked against Brazilian environmental standards. In that regard, the concentration of total phosphorus was compared to limits established in Resolution 454/2012 of the National Environmental Council – CONAMA. Some sub-basins exhibited levels above the legal threshold, and the contamination was viewed as systemic requiring immediate action (e.g., implementation of sewage treatment and best management practices in agriculture), as well as monitoring in the spatial and temporal frames. The existence of extreme rainfall events in the basin was the main cause of SWAT model inaccuracies, namely of overestimated TOT-P.

The B1 tailings dam of Córrego do Feijão iron-ore mine of Vale SA, located in the Ferro-Carvão stream watershed (Brumadinho municipality, state of Minas Gerais, Brazil), collapsed in 25 January 2019. This accident had unprecedent water resources management impacts in the Paraopeba River basin, the parent of Ferro-Carvão stream, marked by the suspension of drinking water supply to the Metropolitan Region of Belo Horizonte, which was decided after the huge rise of turbidity and metal concentrations in the aquatic environment, mostly iron and manganese. The water authorities keep the use of Paraopeba River downstream of B1 dam site prohibited today, and entailed a number of studies to understand and predict the evolution of metal spreading before envisaging any suspension lift. One of those studies is presented now and had the purpose to assess the role of a weir located in the Paraopeba River and 40 km downstream from the Ferro-Carvão stream outlet, in the attenuation of iron and manganese fluxes. The weir is called Igarapé and the modeling of dissolved iron and manganese using the RiverFlow 2D software revealed a 33.5-fold attenuation of iron fluxes per unit length, from 3062.0 g/yr. km upstream the weir to 91.4 g/yr. km downstream, under stream flows typical of 10-year return periods. The attenuation was related with backwater effects that reduced flow velocities in the inundated stream banks during flood events, which induced the precipitation of iron-bearing sand particles. The attenuation was not visible for manganese because the element is preferably included in silt and clay particles that were not affected by the backwater effects because of their small sizes (and hence weights). Our results corroborate previous outcomes that highlighted the capacity of Igarapé weir to retain the B1 dam tailings, decelerating their propagation downstream, and opened a time window to remove the large volume still deposited over the river bed through dredging. The monitoring and eventual treatment of the stream banks is also paramount because the backwater effects seem to be related with flooding.

Abstract Background One-third of veterans returning from the 1990–1991 Gulf War reported a myriad of symptoms including cognitive dysfunction, skin rashes, musculoskeletal discomfort, and fatigue. This symptom cluster is now referred to as Gulf War Illness (GWI). As the underlying mechanisms of GWI have yet to be fully elucidated, diagnosis and treatment are based on symptomatic presentation. One confounding factor tied to the illness is the high presence of post-traumatic stress disorder (PTSD). Previous research efforts have demonstrated that both GWI and PTSD are associated with immunological dysfunction. As such, this research endeavor aimed to provide insight into the complex relationship between GWI symptoms, cytokine presence, and immune cell populations to pinpoint the impact of PTSD on these measures in GWI. Methods Symptom measures were gathered through the Multidimensional fatigue inventory (MFI) and 36-item short form health survey (SF-36) scales and biological measures were obtained through cytokine & cytometry analysis. Subgrouping was conducted using Davidson Trauma Scale scores and the Structured Clinical Interview for Diagnostic and statistical manual of mental disorders (DSM)-5, into GWI with high probability of PTSD symptoms (GWIH) and GWI with low probability of PTSD symptoms (GWIL). Data was analyzed using Analysis of variance (ANOVA) statistical analysis along with correlation graph analysis. We mapped correlations between immune cells and cytokine signaling measures, hormones and GWI symptom measures to identify patterns in regulation between the GWIH, GWIL, and healthy control groups. Results GWI with comorbid PTSD symptoms resulted in poorer health outcomes compared with both Healthy control (HC) and the GWIL subgroup. Significant differences were found in basophil levels of GWI compared with HC at peak exercise regardless of PTSD symptom comorbidity (ANOVA F = 4.7, P = 0.01,) indicating its potential usage as a biomarker for general GWI from control. While the unique identification of GWI with PTSD symptoms was less clear, the GWIL subgroup was found to be delineated from both GWIH and HC on measures of IL-15 across an exercise challenge (ANOVA F > 3.75, P

Background: This study aimed to evaluate the effects of physical activity on the cognition of patients with stroke, comparing the effectiveness of using isolated or combined rehabilitation, as well as the duration and intensity of training, to identify the characteristics of optimal training programs for post-stroke cognitive rehabilitation. Methods: For this systematic review, we followed PRISMA guidelines and searched Web of Science, Scopus, PEDRo, SPORTdiscus, PubMed, Trial Registries, and Google Scholar for studies published between 2013 and April 12, 2023. We included randomized controlled trials (RCTs) of interventions that measured the effect of physical activity on cognition in patients with stroke. We restricted our search to reports published in the English language. Evidence from the RCTs was synthesized. The risk of bias was assessed using the Cochrane risk of bias tool. Results: Of the 1,755 records identified, 34 were eligible, and data were available, with mainly low to moderate risk of general bias. The combined rehabilitation training programs proved more efficient when compared with isolated rehabilitation training programs in several cognitive domains. A moderate-intensity, 12-week intervention duration, with three weekly sessions, proved adequate. Discussion: It seems that combined rehabilitation training programs are efficient for patients with stroke as these alter neuroplastic conditions due to synergistic or additional onset of action. Future research should investigate combined rehabilitation training programs, with follow-up, to assess how long the recorded improvements last. The protocol of this study is registered in PROSPERO, number CRD42021248533.

There seems to be a consensus that adolescents worldwide are not getting enough sleep. This study aimed to evaluate the psychometric properties of the Epworth Sleepiness Scale (ESS) in adolescents using the item response theory. A psychometric study was conducted with 2206 adolescents aged 18 and 19 years in the city of São Luís, Maranhão, Brazil. The dimensionality of the ESS was assessed by principal component analysis. A Samejima’s graded response model (SGRM) was fitted to it. The findings of this study showed a good internal consistency and the unidimensionality of the ESS. Considering the latent trait continuum, we obtained three levels, with anchor items. For the item ‘Sitting still in a public place’, the adolescents presented a small possibility of dozing in level 1, and a medium and great possibility in level 2. The item ‘Sitting around talking to someone’ presented small, medium, and great possibilities of dozing in level 3. The ESS with five items showed satisfactory psychometric properties. In addition, the results from the SGRM showed that adolescents with high levels of sleepiness are likely to nod off or sleep sitting up while talking to someone. This study allows us to understand excessive daytime sleepiness in adolescents.

To investigate the dynamics of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in a vulnerable population of children and their household contacts. SARS-CoV-2 reverse transcription polymerase chain reaction assays and coronavirus disease 2019 (COVID-19) immunoglobulin G serology tests were performed in children and their household contacts after enrollment during primary health care clinic visits. Participants were followed prospectively with subsequent specimens collected through household visits in Manguinhos, an impoverished urban slum (a favela) in Rio de Janeiro at 1, 2, and 4 weeks and quarterly post study enrollment. Six hundred sixty-seven participants from 259 households were enrolled from May to September 2020. This included 323 children (0-13 years), 54 adolescents (14-19 years), and 290 adults. Forty-five (13.9%) children had positive test results for SARS-CoV-2 polymerase chain reaction. SARS-CoV-2 infection was most frequent in children aged

The Brain Sciences Editorial Office retracts the article, “Sex-Based Differences in Plasma Autoantibodies to Central Nervous System Proteins in Gulf War Veterans versus Healthy and Symptomatic Controls” [...]

The Brain Sciences Editorial Office retracts the article “Using Plasma Autoantibodies of Central Nervous System Proteins to Distinguish Veterans with Gulf War Illness from Healthy and Symptomatic Controls” [...]

Enquadramento: A violência conjugal (VC) representa um problema de saúde pública, sendo a intervenção dos enfermeiros influenciada pelas suas crenças e conhecimentos. Objetivo: Analisar as perceções, crenças e os conhecimentos dos enfermeiros de família (EF) sobre a VC. Metodologia: Estudo observacional, descritivo e correlacional, partindo de uma amostra não probabilística de 98 EF, através de questionário online, utilizando escalas sobre perceção, crenças e conhecimentos sobre VC. Resultados: Numa situação de VC, a maioria dos EF (78%) encaminha as vítimas para outros profissionais e apenas 16% faz a denúncia. Um terço dos EF fez formação nesta área. Como barreiras para a sua intervenção, identificaram a falta de preparação teórica e técnica e falhas ao nível da organização das unidades de saúde. Globalmente, apresentaram baixo nível de crenças (1,44 ± 0,45) e conhecimentos aceitáveis (2,90 ± 0,41). O sexo masculino influenciou significativamente o nível de crenças sobre VC. Conclusão: Os EF percecionam situações de VC, contudo necessitam de formação e de condições favoráveis nas unidades de saúde para intervirem de forma efetiva.

Abstract Background There is a rapid increase in the incidence of inflammatory bowel diseases (IBD) in newly industrialized countries, yet epidemiological data is incomplete. We herein report the methodology adopted to study the incidence of IBD in newly industrialized countries and to evaluate the effect of environmental factors including diet on IBD development. Methods Global IBD Visualization of Epidemiology Studies in the 21st Century (GIVES-21) is a population-based cohort of newly diagnosed persons with Crohn’s disease and ulcerative colitis in Asia, Africa, and Latin America to be followed prospectively for 12 months. New cases were ascertained from multiple sources and were entered into a secured online system. Cases were confirmed using standard diagnostic criteria. In addition, endoscopy, pathology and pharmacy records from each local site were searched to ensure completeness of case capture. Validated environmental and dietary questionnaires were used to determine exposure in incident cases prior to diagnosis. Results Through November 2022, 106 hospitals from 24 regions (16 Asia; 6 Latin America; 2 Africa) have joined the GIVES-21 Consortium. To date, over 290 incident cases have been reported. All patients have demographic data, clinical disease characteristics, and disease course data including healthcare utilization, medication history and environmental and dietary exposures data collected. We have established a comprehensive platform and infrastructure required to examine disease incidence, risk factors and disease course of IBD in the real-world setting. Conclusions The GIVES-21 consortium offers a unique opportunity to investigate the epidemiology of IBD and explores new clinical research questions on the association between environmental and dietary factors and IBD development in newly industrialized countries.

Trata-se de um estudo qualitativo cujo objetivo central foi mapear os estudantes público-alvo da Educação Inclusiva matriculados na rede de ensino municipal de Ouro Preto – MG, incluindo os 12 distritos. Como objetivos específicos buscamos: identificar ano de escolaridade, necessidade educacional específica e escola em que estão matriculados estudantes público-alvo da Educação Inclusiva matriculados na rede ensino municipal de Ouro Preto – MG no ano de 2022; identificar se há oferta de AEE e como ela ocorre; e apresentar características gerais da identificação e encaminhamento desses estudantes no município. Para isso, realizamos uma análise documental de fichas de acompanhamento dos estudantes; planilha correspondente aos dados das fichas; lista de escolas que oferecem Atendimento Educacional Especializado (AEE) e que contam com sala de recursos e/ou sala de recursos multifuncionais; o edital de contratação de profissionais para AEE e edital de contratação dos monitores educacionais. Identificamos que a rede municipal conta com 114 estudantes matriculados da Educação Infantil ao Ensino Fundamental, com necessidades educacionais específicas diversas como Transtorno do Espectro Autista (TEA), Deficiência intelectual, Surdez entre outros, sendo apoiados por monitores e/ou professores especializados. Das 28 escolas referente a matrícula desses estudantes, 5 contam com AEE junto à sala de recursos.

IntroductionStroke is a neurological deficit caused by an acute focal injury to the central nervous system due to vascular injury that can result in loss of neurological function, lasting brain damage, long-term disability and, in some cases, death. The literature reports that aerobic physical exercise, as well as dual-task cognitive walking, are used for the cognitive recovery of people with stroke. We aimed to assess whether aerobic physical exercise influences post-stroke cognitive recovery, namely performance on selective and sustained attention. We tested the hypothesis that post-stroke aerobic physical exercise leads to more significant gains than post-stroke dual-task cognitive walking.MethodsWe used a Randomized Clinical Trial, single-blind, parallel group, to verify the existence of differences between two groups. A total of 34 patients with subacute to chronic stroke were divided into two groups to train three times a week for 12 weeks: the aerobic physical exercise (PE) group engaged in 20 min on a treadmill, 20 min on a stationary bicycle and 5 min on a desk bike pedal exerciser per session; the dual-task (DT) gait exercise group walked for 45 min while simultaneously performing cognitive tasks per session. All participants were assessed on cognitive functioning with the Mini-Mental State Examination (MMSE) and d2 Test of Attention before acute interventions and post interventions. We have also applied a Visual Analog Scale to monitor the participants’ perceived difficulty, pre-, post-acute, and post-chronic interventions. Participants also responded to a Borg Scale of perceived exertion following the acute and the final session of chronic training.ResultsA mixed model ANOVA revealed a significant interaction effect with a large effect size for most of the cognitive variables under study. The variables associated with the d2 Test of Attention showed significant differences between the groups, mainly from T0 to T2. Also for MMSE, an ANOVA revealed a significant interaction effect with significant improvements from T0 to T2. Our results strongly suggest that aerobic physical exercise is more beneficial than dual-task cognitive-gait exercise since in the PE group, cognitive attention scores increase, and cognitive impairment and perception of exertion decrease, compared to the DT group.ConclusionThese findings support that PE provides more significant benefits for patients post-stroke when compared to DT.

A obra De gados e homens (2013), da escritora Ana Paula Maia, convida-nos a refletir sobre o consumo da carne numa sociedade capitalista moderna. Da carne dos trabalhadores precarizados no matadouro, corpos estes moldados no processo de trabalho, ao abate dos animais produtores de carne destinada às fábricas de hambúrguer. Diante dessa perspectiva, o texto literário nos permite pensar os impactos ambientais e sociais gerados por abatedouros. No contexto onde o crescimento da fome coincide com um pico na exportação de carne bovina, o romance de Maia emerge como uma obra atual no país. Este trabalho pretende, portanto, examinar a interação entre natureza e ação humana na narrativa, buscando compreender as diversas complexidades que a permeiam. Nas reflexões ora propostas, reconhecemos que a carne explícita na obra de Maia surge atravessada por inscrições políticas e culturais. Nesse sentido, sob o viés dos estudos animais no texto literário, o trabalho fundamenta-se nas contribuições de Vânia Márcia Damasceno Nogueira (2012), Peter Singer (2013), Gabriel Giorgi (2015) e Carol J. Adams (2018).

Mohr-Tranebjaerg syndrome (MTS) is an X-linked recessive disorder caused by TIMM8A loss of function. It is characterized by sensorineural hearing loss in childhood, progressive optic atrophy in early adulthood, early onset dementia and psychiatric symptoms of variable expressivity. We present a family with 4 affected males, explore age-related and interfamilial variability and review the literature.Case reportA 31 years-old male developed psychiatric symptoms at age 18 and presented early onset dementia. Sensorineural hearing loss had been diagnosed in childhood. At 28yo, he developed dysarthria, dysphonia, dysmetria, limb hyperreflexia, dystonia, and spasticity following an acute encephalopathic crisis. WES revealed a hemizygous novel likely pathogenic variant in TIMM8A, c.45_61dup p.(His21Argfs*11), establishing the diagnosis of MTS. Genetic counseling of the family allowed the diagnosis of three other symptomatic relatives −3 nephews (11yo and two 6yo twins), children of a carrier sister. The oldest nephew had been followed since 4yo due to speech delay. Sensorineural hearing loss was diagnosed at 9yo, and hearing aids were prescribed. The two other nephews were monozygotic twins, and both had unilateral strabismus. One of the twins had macrocephaly and hypoplasia of the anterior temporal lobe, as disclosed by an MRI performed due to febrile seizures. Both had developmental delays, with the language being the most affected area. Their audiograms confirmed hearing loss. All three nephews were hemizygous for the familial TIMM8A variant.DiscussionHearing loss, an early sign of MTS due to auditory neuropathy, can often be overlooked until more severe features of the disorder manifest. Recurrence risk is high for female carriers, and reproductive options should be offered. Early monitoring of hearing and vision loss and neurological impairment in MTS patients is mandatory since early interventions may positively impact their development. This family showcases the importance of performing a timely etiological investigation of hearing loss and its impact on genetic counseling.

A three-parameter lifetime distribution is proposed, named extended Chen-Poisson distribution, by compounding the Chen and zero-truncated Poisson distributions. The new distribution belongs to the unified Poisson family, where both distributions of the minimum and maximum are merged into one. Several properties of the distribution are studied. The proposed distribution is quite flexible since it accommodates different complex hazard shapes. Inference is based on the maximum likelihood method in the presence of a right-censoring mechanism. A simulation study is performed to evaluate the properties of the parameters estimators. Two real lifetime data sets are analysed for purposes of comparison with other generalizations of the Chen distribution, as well as with other members of the unified Poisson family. The obtained results allow to highlight the potential of the new distribution.

Intellectual development disorder, autosomal dominant 43 (MRD43) is an autosomal dominant disorder caused by heterozygous mutations in the HIVEP2 gene. In this report, we describe a case of a 4-year-old boy with global development delay, hypotonia, and dysmorphic features, in whom the finding of a heterozygous nonsense pathogenic variant in exon 5 of HIVEP2 [c.2827C>T p. (Arg943*)] through WES established a MRD43 diagnosis. Our patient’s phenotype overlaps with other MRD43 descriptions in the literature. Unlike previously reported cases, where the condition was almost invariably de novo, the healthy mother in this case presented mosaicism for the pathogenic variant. Thus, the recurrence risk increased significantly from 1% to up to 50%. The description of a variant inherited for MDR43 is singular in the literature and this description highlights the importance of parental studies for accurate genetic counseling, particularly for family planning.

Abstract When considering deaf and hard of hearing (DHH) population, research recognizes that fatigue due to communication challenges and multi-focal attention allocation is a significant concern. Given the putative heightened demands of distance learning on deaf and hard of hearing students, we investigate how an online environment might differently affect deaf and hard of hearing participants, compared to hearing participants, Portuguese Sign Language (PSL) users and non-users. Our findings show that the deaf and hard of hearing group present higher values in the post-task fatigue rates with significant differences from the hearing group (non-PSL users). Furthermore, our results revealed an association between post-task fatigue rates and lower performance scores for the deaf and hard of hearing group, and the gap is significantly bigger when compared with the hearing group (non-PSL users). We also found evidence for high levels of post-task fatigue and lower performance scores in the hearing group PSL users. These novel data contribute to the discussion concerning of the pros and cons of digital migration and help redesign more accessible and equitable methodologies and approaches, especially in the DHH educational field, ultimately supporting policymakers in redefining optimal learning strategies.

Abstract Phubbing is defined as ignoring other individuals by using a mobile phone during a face-to-face conversation. The Phubbing Scale (PS) was developed to assess this practice. In this study, we analyze the psychometric properties of the 8-item version of the PS (PS-8) in the Portuguese population, providing validity evidence based on internal structure and on relationships with other variables, and examining item properties, reliability, and measurement invariance across gender. Participants were 391 Portuguese adults (132 men, 259 women) who completed a battery of questionnaires. Confirmatory factor analysis yielded satisfactory goodness-of-fit indices for the two-factor structure (communication disturbance and phone obsession), which was invariant across gender. Item homogeneity and reliability of factor scores (McDonald’s omega) were satisfactory. Validity evidence based on relationships with other variables was provided by positive associations with time spent on the Internet on weekdays and at the weekend, time spent on social networking sites, number of social networks used, Internet addiction, problematic mobile phone use, Facebook intrusion, fear of missing out, and depression. These associations show the addictive component of phubbing and its relationship with mental health. The PS-8 is a short and easy-to-administer scale with adequate psychometric properties for measuring phubbing in the Portuguese population.

Background: Music therapy (MT) appears to be a valuable complementary intervention for children diagnosed with neurodevelopmental conditions, namely, autism spectrum disorders (ASD), who often present cognitive, academic, communicative, and social difficulties. Music therapy has been increasingly recommended as a standard support service for communication and social interaction in this specific neuropediatric setting. Objective: The aim of this pilot study was to determine the recruitment and protocol feasibility of music therapy for autistic children and explore trends towards the clinical utility of the IMCAP-ND[i] quantitative measure on assessing the focus on sound receptions, joint attention, turn-taking, auditory perception, sensory integration, social interaction, entrainment, and empathy, as a preparation for a future study wherein we will pursue with an MT intervention assessment. Furthermore, here we use the European Portuguese translated version of the IMCAP-NDPT scales to contribute to its validation and adaptation. Methods: Five autistic children received a weekly music therapy session of approximately 45 minutes for six months, totaling a minimum of 20 and maximum of 24 completed sessions per child. The IMCAP-NDPT and the Griffiths Mental Development Scales (GMDS) scales were applied pre- and post-test. Results: We tested the research design and the session’s protocol. All participants completed MT intervention and showed increase in social-emotional capacities, cognitive and perception skills, and overall responsiveness. However, our results indicate a need to review the inclusion criteria concerning participants with a single diagnosis (ASD), previous contacts with musical instruments, and the application of standardized music therapy settings. Conclusions: The design and protocol were perceived as acceptable and feasible, though some improvements were suggested for subsequent original research, and the IMCAP-NDPT version was considered usable. Our initial findings suggest the potential of music therapy for autistic children. Further intervention with efficacy assessment through a larger-scale randomized trial is needed, considering the content based on pilot findings. [i] The Individual Music-Centered Assessment Profile for Neurodevelopmental Disorders (IMCAP-ND) is a criterion-referenced assessment of musical interaction, communication, cognition and perception, and responsiveness in musical-play for individuals with neurodevelopmental disorders at various developmental levels and chronological ages from children to adults. It is comprised by a set of three scales: Musical Emotional Assessment Rating Scale (MEARS), Musical Cognitive/Perception Scale (MCPS) and Musical Responsiveness Scale (MRS) (Carpente, 2013).

Enquadramento: Cuidar de pessoas com demência (PcD) é gerador de stresse entre cuidadores familiares (CF). Uma das situações geradoras desse stresse é a perda ambígua (PA). Objetivos: Traduzir, adaptar e validar a Escala de Limites Ambíguos (ELA) para português europeu e determinar as caraterísticas psicométricas da ELA. Metodologia: Estudo metodológico a partir de uma amostra de 88 CF de PcD. A consistência interna (CI) avaliada com o Coeficiente de Ômega de McDonald (ω), a validade de constructo através da análise fatorial exploratória (AFE) e a validade de critério com a Escala de Perceção de Stresse (EPS). Resultados: A ELA apresentou validade conteúdo excelente. A AFE determinou um modelo de dois fatores, explicando 44% da variância, ω de 0,72. Os CF que residem com a PcD apresentam maior PA (t = 2,823, p < 0,01). Correlação significativa positiva e moderada entre a ELA e a EPS (rs = 0,578, p < 0,01). Conclusão: A ELA é um instrumento com propriedade psicométrica de CI e validade aceitáveis para a avaliação da PA.

Macururé cheese has been produced for about 100 years by a single family, in Caititu village, located in the city of Jacaré dos Homens, AL. It is made from raw milk, by natural fermentation using indigenous bacteria. It has a cylindrical shape, soft texture, closed dough, containing liquid fat inside, slightly acidic flavor, reminiscent of bottled butter, brown color, rigid and without cracks, and cooked pasta. Much appreciated for its unique flavor and cultural and gastronomic richness, this product has empirical and artisanal manufacturing technology. In order to avoid the extinction of the manufacturing technology of this cheese of centenary origin, this work aimed to describe technically and scientifically its manufacturing steps and to characterize the physical-chemical and microbiological aspects of this cheese. The fat content in the dry matter (FDM), acidity, pH, ash, moisture, and total protein content were analyzed. Thus, Macururé cheese can be classified as semi-fat and of medium humidity, according to current legislation. The levels of acidity, total dry extract and fat varied significantly between the batches analyzed, indicating a lack of standardization in manufacturing or in the raw material used. Microbiological analyzes showed the absence of Salmonella sp. and the counting of thermotolerant coliforms and Staphylococcus aureus within the standards established by legislation. This study contributed to the characterization process of a cheese typically from Alagoas, with attributes that add value through the rescue of history, cultural and gastronomic origin, being it possible, with the regulation of "Selo Arte", to sell it outside the clandestine market.

Resumo Objetivo Avaliar condições de saúde, cuidados com a saúde e hábitos de vida de agentes comunitários de saúde (ACS) de Vitória, Espírito Santo, Brasil. Métodos Estudo transversal da linha de base de um estudo de intervenção. Foram realizados exames bioquímicos, antropométricos, hemodinâmicos e entrevistas, entre outubro de 2018 e março de 2019, em Vitória. Testes estatísticos apropriados, conforme o delineamento da amostra, foram realizados utilizando-se o software SPSS versão 21.0, e adotando-se p

Objetivo: Discutir sobre as principais categorias teóricas presentes no pensamento de João Amós Comênio, contextualizando historicamente a contribuição deste autor para o campo da didática moderna. Método: Pesquisa teórico-bibliográfica, fundamentada em categorias sistematizadas na obra Didactica magna. Resultados: O autor, no desenvolvimento de sua obra, pretendia apresentar aos educadores um método universal, seguro, fácil, rápido de ensinar “tudo a todos”, tendo como fundamento a natureza, tornando a educação mais eficaz e atraente, mediante cuidadosa organização, elaborada através de manuais didáticos que uniformizavam os conhecimentos. Nesta busca, realizou-se o desenvolvimento de diversas categorias, entre as quais se destacam as que se reportam à essência humana e à relação entre indivíduo e sociedade; sobre o fim social da educação; o currículo e o método; bem como o papel do professor no processo educativo. Discussão e Conclusão: As principais categorias trabalhadas pelo autor se relacionavam com o campo da didática e muitos contribuíram para o desenvolvimento da pedagogia moderna. Ressalta-se, contudo, que o método que pretendia ensinar “tudo a todos” tinha como objetivo ensinar um mínimo ao maior número de educandos. Um método marcado profundamente por ideários tanto renascentistas quanto de tradição religiosa, que interessava sobretudo à burguesia.

Introdução:O distanciamento/confinamento social, associado à pandemia, implicou uma mudança abrupta nas experiências das relações sociais. Vários estudos indicam que ter melhores relações sociais estruturais ou funcionais implica ter uma saúde mental melhorada. O modelo de Wang e colaboradores (2017) foi uma das principais referências utilizadas, considerando-se das cinco dimensões conceptuais de caracterização do isolamento social na área da saúde mental, as dimensões relativas às atribuições emocionais às relações e aos recursos da rede social. Objetivo: O estudo teve como caracterizar as experiências relacionais sociais, associadas à situação pandémica do Covid-19, em adultos residentes na Região Autónoma da Madeira - Portugal. Método: Em termos metodológicos caracteriza-se como um estudo qualitativo, exploratório e descritivo, com base na metodologia Focus group, desenvolvido a partir de uma amostra de conveniência, constituída por 16 participantes, distribuídos por 2 grupos de 8 elementos, com idade igual ou superior a 18 anos, licenciados (grupo 1) e não licenciados (grupo 2). As questões colocadas incidiram na forma como os participantes vivenciaram a experiência relacional social, entre abril e julho de 2020 relacionadas com a situação da pandemia do Covid 19. O conteúdo das discussões foi analisado através do software QSRnVIVO, tendo-se identificado 13 categorias de conteúdo: Experiência social; Apoios sociais; Diferenças na perceção de risco; Experiências negativas; Diminuição das interações em meio digital; Solidão; Experiências positivas; Reforço das interações sociais por via digital; Solidariedade; Impacto negativo dos media no bem-estar, Impacto positivo dos media; Impossibilidade de contacto físico e limitação à liberdade de convívio social. Os resultados indicam, que a experiência relacional social foi mais salientada pelos participantes do sexo masculino, pelos mais jovens, pelos pertencentes a agregados familiares com mais de 3 pessoas e pelos estudantes e trabalhadores por conta de outrem. Os participantes salientaram tanto atribuições positivas como negativas à sua experiência social durante a pandemia, destacando-se pela positiva o reforço das ligações com os membros da sua rede social através dos meios de comunicação à distância, e pela negativa as restrições à liberdade de contatos, (quer em termos de contacto físico quer de partilha de atividades) que constituem fatores de stress muito significativos. Como conclusões, salienta-se que para lidar com o distancimento, evitar o isolamento social e regular as emoções negativas associadas a experiências sociais exigentes como a pandemia é essencial readaptar as estratégias de coping que eram habitualmente utilizadas. As experiências relacionais sociais positivas, são estratégias de coping determinantes em situações de stress prolongado, o que deverá ser tido em conta na intervenção em saúde mental.

The method presented in this study assesses groundwater contamination risk using a L-Matrix system approach. The L-Matrix in this case is a cartesian diagram where the XX-axis represents aquifer vulnerability (0≤V≤1) determined by the well-known DRASTIC model, and the YY-axis represents the potential hazardousness (0≤H≤1) of an activity (infrastructural development, industrial activities, livestock and agriculture) measured by a European Commission approach. The diagram is divided into four regions, the boundaries of which are set to V = 0.5 and H = 0.5. Watersheds are represented in this diagram considering their V and H indices, and assigned a potential contamination risk if groundwater sites located within their limits show contaminant concentrations above legal limits for a given use. Depending on the region the watershed falls in the L-Matrix diagram, different management or contamination prevention actions are highlighted: activity development, activity monitoring, activity planning or activity inspecting. Watersheds located in the inspecting region and simultaneously evidencing contamination risk require immediate action, namely conditioning or even suspension of use. The method is tested in the Paraopeba River basin (Minas Gerais, Brazil), a densely industrialized basin that was recently affected by an iron-ore mine tailings dam break. • The L-Matrix diagram highlights different groundwater susceptibility realities experienced by watersheds with different combinations of aquifer vulnerability and activity hazardousness, namely possibility for potential expansion of new hazardous activities but also the necessity to periodically inspect and eventually condition or suspend others. • The L-Matrix diagram is likely a better approach to implement contamination prevention measures in watersheds, than the integrated contamination risk index used by most methods.

Problematic mobile phone use can be related to negative mental states. Some studies indicate that behavioural dependency is related to variables associated with the country of origin. The aim of our study was to investigate if country indicators moderated the relationship between phubbing and psychological distress. Our sample consisted of 7,315 individuals from 20 countries, who completed the Phubbing Scale and the Kessler Psychological Distress Scale (K6). The analyses also included country indicators: the Gender Gap Index (GGI), the Human Development Index (HDI), the Social Progress Index (SPI), Hofstede’s dimensions of culture, and the World Happiness Index (WHI). Our results showed that psychological distress was related to at least one dimension of phubbing (i.e., to communication disturbance or phone obsession) in all countries, which means this relationship is culturally universal. The results of the study demonstrate the importance of testing measurement invariance to determine what type of analysis and what type of conclusion are valid in a given study or comparison. Moreover, the increasing or decreasing correlation between phubbing and distress is related to some culture-level indices.

A utilização da experiência clínica simulada é importante como estratégia de aproximação à prática profissional. Este estudo tem como objetivo avaliar a satisfação dos estudantes de licenciatura em Enfermagem com as experiências clínicas simuladas. Realizou-se estudo de abordagem metodológica mista. Participaram 179 estudantes do primeiro ano do Curso de Licenciatura em Enfermagem. Na recolha de dados utilizou-se um questionário sociodemográfico, a Escala de Satisfação com as Experiências Clínicas Simuladas e duas questões abertas sobre a importância da prática simulada no processo ensino e aprendizagem dos estudantes de Enfermagem. Da análise qualitativa emergiram quatro categorias: aproximação à prática clínica; facilitador da vida profissional; desenvolve as dimensões do cuidado em enfermagem; processo de ensino e aprendizagem dinâmico e crítico reflexivo. No global, os estudantes estão muito satisfeitos com as experiências clínicas simuladas, sendo a dimensão da satisfação cognitiva a que apresenta um valor médio mais elevado (88,23%). A relação entre a satisfação global com a experiência clínica simulada e a existência de experiência clínica simulada prévia evidenciou uma diferença estatisticamente significativa (U=3008,5; p= 0,037), sendo que os estudantes que não tinham experiência simulada prévia apresentaram uma ordenação média superior. Os estudantes que intervieram diretamente no cenário apresentaram maior satisfação global com a experiência clínica simulada do que os que não intervieram no cenário. Não existem diferenças estatísticas significativas entre a participação no debriefing e a satisfação global. A prática clínica simulada promove o desenvolvimento de aprendizagens significativas nos estudantes num ambiente realista e isento de riscos.

Objetivo: analisar os aspectos metodológicos e as potencialidades do estudo “Impacto da capacitação de Agentes Comunitários de Saúde (ACS) em educação alimentar (EA) - Vitória/ES”. Métodos: os ACS de 25 Unidades de Saúde (US) foram convidados e avaliados em Centro de Investigação Cardiovascular. Foram realizadas quatro etapas: Avaliação da saúde e nutrição dos ACS; Estudo qualitativo; Capacitação em EA; Reavaliação. Resultados: foram coletados dados bioquímicos e antropométricos, de consumo alimentar, exames clínicos, eletrólitos urinários e testes físicos. Estudo qualitativo realizado para levantamento da percepção dos ACS sobre o estudo. As US foram randomizadas em dois grupos (intervenção e controle). O grupo intervenção participou de uma capacitação em EA, tendo como base o Guia Alimentar para a População Brasileira. Ao final da capacitação, os ACS foram reavaliados para identificar mudanças nas condições de saúde. Conclusão: este estudo pode contribuir para o planejamento, monitoramento e avaliação de ações específicas na atenção primária.

Previous literature has shown that social identity influences consumer decision-making towards branded products. However, its influence on ones' own sensory perception of an ingroup (or outgroup) associated brand's product (i.e. sponsor) is seldom documented and little understood. Here, we investigate the impact of social identity (i.e. team identification) with a football team on the sensorial experience and willingness to buy a beverage, said to be sponsoring the ingroup or the outgroup team. Ninety subjects participated in one of three sensorial experience conditions (matched identity: ingroup beverage; mismatched identity: outgroup beverage; control: no group preference). Each participant tasted the new sponsoring beverage and answered a questionnaire about their subjective sensorial experience of the beverage. EEG and BVP were synchronously collected throughout. Analyses revealed that team identification does not influence subjective responses and only slightly modulates physiological signals. All participants reported high valence and arousal values while physiological signals consistently translated negative affects across groups, which showed that participants reported to be happy/excited about trying the beverage while their physiological signals showed that they were feeling sad/depressed/angry. Crucially, despite a similar sensorial experience, and similar socially desirable report of the subjective experience, only participants in the matched identity group demonstrate higher willingness to buy, showing that the level of team identification, but not taste or beverage quality, influences willingness to buy the said sponsor's product.

The itch associated with cutaneous T-cell lymphoma (CTCL), including Mycosis Fungoides (MF) and Sézary syndrome (SS), is often severe and poorly responsive to treatment with antihistamines. Recent studies have highlighted the possible role of interleukins in nonhistaminergic itch. We investigated the role of IL-31 and IL-8 in CTCL, concerning disease severity and associated itch. Serum samples of 27 patients with CTCL (17 MF and 10 SS) and 29 controls (blood donors) were analyzed for interleukin- (IL-) 31 and IL-8; correlations with disease and itch severity were evaluated. IL-31 serum levels were higher in CTCL patients than in controls and higher in SS than in MF. Also, serum IL-31 levels were higher in patients with advanced disease compared to those with early disease, and they correlated positively with lactate dehydrogenase and beta 2-microglobulin levels, as well as with the Sézary cell count. Itch affected 67% of CTCL patients (MF: 47%; SS: 100%). Serum IL-31 levels were higher in itching patients than in controls and in patients without itching. There was no association between serum IL-8 and disease severity, nor with itching. Serum IL-8 levels correlated positively with peripheral blood leukocyte and neutrophil counts in CTCL patients. Our study suggests a role for IL-31 in CTCL-associated itch, especially in advanced disease and SS, offering a rational target for new therapeutic approaches. Increased serum IL-8 observed in some patients may be related to concomitant infections, and its role in exacerbating itch by recruiting neutrophils and promoting the release of neutrophil proteases deserves further investigation.

Introduction: We have all pondered on the physical and emotional benefits of exercise and more often than not, we find ourselves associating exercise to health and wellbeing. However, recent scientific developments have brought into light several benefits of exercise that had not yet been addressed by the scientific community before. The benefits of exercise that reach beyond physical and mental wellbeing such as benefits for the brain and, more specifically, for cognition, attention, and executive functions are now under close investigation. Aim: These new insights render the education community powerful, as we have the tools to better our education system by simply applying these insights to benefit the learning process of our children. Materials and Methods: Here we explore the International success tales on the optimization of the benefits derived from physical exercise. In a pilot study, we investigated 219 schedules from 8 Secondary Schools in Greater Lisbon, and questioned teachers about their insights on learning and behavior in pre-theoretical disciplines Physical Education versus post-theoretical disciplines Physical Education. Results: Portuguese Schools seem to favor afternoon scheduling of Physical Education and the perceptions of teachers seem to point to Physical Education as an obstacle to the learning process of more theoretical disciplines. Conclusion: The international success tales show the importance of physical activity in the morning and clear learning benefits for more theoretical disciplines. Hence, we seek to explore these success tales, while discussing how the Portuguese Education System, but also each educational community, should emulate other countries that have put this newly obtained knowledge into practice.

O presente artigo se propõe a responder a seguinte questão: quais são as transformações percebidas pelos professores em sua prática docente frente aos cursos de formação continuada? Fundamentada em teóricos que problematizam a formação continuada dos professores, a pergunta central da pesquisa é respondida tendo como base o trabalho de formação continuada realizado em escolas dos municípios de Ijuí, Panambi, Ajuricaba e Condor. A tese principal gira em todo da necessidade da realização de um investimento considerável em termos de formação continuada, a fim de que sejam evidenciados resultados concretos do ponto de vista dos professores que participam dessas formações. É, por isso, que há necessidade de um constante processo de formação continuada, sob o foco de um novo modelo transformativo, postado nos tempos atuais.