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Abstract Background Under the adverse remodeling of the right ventricle and interventricular septum in pulmonary arterial hypertension (PAH) the left ventricle (LV) dynamics is impaired. Despite the benefits of combined aerobic and resistance physical trainings to individuals with PAH, its impact on the LV is not fully understood. Objective To test whether moderate-intensity combined physical training performed during the development of PAH induced by MCT in rats is beneficial to the LV’s structure and function. Methods Male Wistar rats were divided into two groups: Sedentary Hypertensive Survival (SHS, n = 7); and Exercise Hypertensive Survival (EHS, n = 7) to test survival. To investigate the effects of combined physical training, another group of rats were divided into three groups: Sedentary Control (SC, n = 7); Sedentary Hypertensive (SH, n = 7); and Exercise Hypertensive (EH, n = 7). PAH was induced through an intraperitoneal injection of MCT (60 mg/kg). Echocardiographic evaluations were conducted on the 22nd day after MCT administration. Animals in the EHS and EH groups participated in a combined physical training program, alternating aerobic (treadmill running: 50 min, 60% maximum running speed) and resistance (ladder climbing: 15 climbs with 1 min interval, 60% maximum carrying load) exercises, one session/day, 5 days/week for approximately 4 weeks. Results The physical training increased survival and tolerance to aerobic (i.e., maximum running speed) and resistance (i.e., maximum carrying load) exertions and prevented reductions in ejection fraction and fractional shortening. In addition, the physical training mitigated oxidative stress (i.e., CAT, SOD and MDA) and inhibited adverse LV remodeling (i.e., Collagen, extracellular matrix, and cell dimensions). Moreover, the physical training preserved the amplitude and velocity of contraction and hindered the reductions in the amplitude and velocity of the intracellular Ca2+ transient in LV single myocytes. Conclusion Moderate-intensity combined physical training performed during the development of MCT-induced PAH in rats protects their LV from damages to its structure and function and hence increases their tolerance to physical exertion and prolongs their survival.

Introdução e Objetivo: Apesar do amplo conhecimento acerca dos alimentos e suas contribuições para a saúde e o estado nutricional, entre muitos estudantes de nutrição ainda são observados comportamentos alimentares inadequados que podem impactar na autopercepção da imagem corporal desses indivíduos. Diante dessas questões, o objetivo do presente estudo foi avaliar a autopercepção da imagem corporal e as atitudes alimentares de estudantes do curso de nutrição em uma instituição de ensino da zona da mata mineira. Materiais e Métodos: Foi realizado um estudo transversal, descritivo, com discentes maiores de 18 anos, de ambos os sexos. Para avaliação do comportamento alimentar foi utilizado o Questionário Holandês do Comportamento Alimentar; para avaliar o consumo, o questionário de Marcadores do Consumo do Alimentar do SISVAN; e para a imagem corporal, a Escala de Satisfação Corporal. Os dados foram analisados no programa estatístico GraphPad Prism 8.0. Resultados e Conclusão: Foram avaliados 86 discentes do 1º, 3º e 5º períodos, dos quais 2/3 ou mais de cada período consumiam bebidas alcoólicas; e a ausência da prática de atividade física foi de 41,2%, 33,3% e de 50%, respectivamente. Quanto ao consumo de hamburgueres e embutidos, 2/3 ou mais consumiam e quanto às bebidas açucaradas, 1/3 ou mais, em todos os períodos. Quanto à imagem corporal, a maioria tinha o desejo de silhuetas mais magras, mas não houve diferença entre os períodos. A pressão sobre as escolhas e sobre os corpos desses discentes são fatores que podem explicar a alta prevalência de insatisfação com a sua autoimagem.

During the last decades, non-destructive investigation approaches have played an essential role in preserving structural integrity, capacity, and finding early defects in reinforced concrete (RC) heritage affected by time-dependent degradation. One of the most widespread structural RC damages belongs to corrosion phenomena. Electro-chemical approaches stand out among the non-destructive techniques presently available for identifying corrosive problems in-situ. The latter gives some knowledge in terms of physical quantities aiming to evaluate structural conditions by collecting indirect measures. Nevertheless, results are correlated to strong interpretative scale codes, which may not always provide appropriate interpretation of the defect's identity. In the paper a probabilistic degradation model, based on a statistical interpretation of the in situ electro-chemical measurements, has been proposed with the aim to give a contribution for structural diagnosis. Finally, results are validated through structural visual inspection.

Background: The study evaluated the effects of resistance exercise training and açaí supplementation on cardiac parameters in hypertensive animals. Methods: For this study, rats from the Wistar and SHR lines (spontaneously hypertensive rats) were used. The animals were divided into 5 groups: Wistar Control (C); Control Hypertensive (H); Trained Hypertensive (HT); Hypertensive and Supplemented with Açaí (HA); and Hypertensive Trained and Supplemented with Açaí (HAT). Resistance exercise training was carried out through climbing. The supplemented groups received 3 g of açaí/kg of body mass. The animals’ systolic blood pressure (SBP), body mass, and physical test were measured at the beginning and end of the intervention. At the end, an echocardiographic analysis was performed. Histological analysis and oxidative stress of the LV were performed. Results: It was found that hypertensive animals showed an increase in SBP, and the treatments reduced this parameter. The trained groups achieved higher values of maximum carrying load. Hypertension increased the dimension of the left ventricular free wall in diastole and reduced ejection and shortening fractions. The trained groups showed improvement in ejection and shortening fractions. The H group increased the proportion of extracellular matrix and reduced the proportion of cells, with the HAT group attenuating this change. Cell diameter was greater in group H, and all treatments reduced this parameter. Hypertension increased the concentration of malondialdehyde and decreased catalase activity in LV. The treatments managed to mitigate this damage. Conclusions: It is concluded that the treatments managed to generate positive cardiovascular adaptations, and their combination enhanced these effects.

Resumo Fundamento A obesidade está associada ao desenvolvimento de doenças cardiovasculares e constitui um grave problema de saúde pública. Em modelos animais, a alimentação com uma dieta hiperlipídica (DH) compromete a estrutura e a função cardíaca e promove estresse oxidativo e apoptose. O treinamento resistido (TR), entretanto, tem sido recomendado como coadjuvante no tratamento de doenças cardiometabólicas, incluindo a obesidade, porque aumenta o gasto energético e estimula a lipólise. Objetivo Na presente revisão sistemática, nosso objetivo foi avaliar os benefícios do TR no coração de ratos e camundongos alimentados com DH. Métodos Foram identificados estudos originais por meio de busca nas bases de dados PubMed, Scopus e Embase de dezembro de 2007 a dezembro de 2022. O presente estudo foi conduzido de acordo com os critérios estabelecidos pelo PRISMA e registrado no PROSPERO (CRD42022369217). O risco de viés e a qualidade metodológica foram avaliados pelo SYRCLE e CAMARADES, respectivamente. Os estudos elegíveis incluíram artigos originais publicados em inglês que avaliaram desfechos cardíacos em roedores submetidos a mais de 4 semanas de TR e controlados por um grupo controle sedentário alimentado com DH (n = 5). Resultados Os resultados mostraram que o TR atenua o estresse oxidativo cardíaco, a inflamação e o estresse do retículo endoplasmático. Também modifica a atividade de marcadores de remodelamento estrutural, apesar de não alterar parâmetros biométricos, parâmetros histomorfométricos ou a função contrátil dos cardiomiócitos. Conclusão Nossos resultados indicam que o TR parcialmente neutraliza o remodelamento cardíaco adverso induzido pela DH, aumentando a atividade dos marcadores de remodelamento estrutural; elevando a biogênese mitocondrial; reduzindo o estresse oxidativo, marcadores inflamatórios e estresse do retículo endoplasmático; e melhorando os parâmetros hemodinâmicos, antropométricos e metabólicos.

Two different hybrid nanosystems are prepared by loading highly crystalline, monodisperse magnetite nanocubes (MNCs) with phosphorescent Pt(II) complexes (PtCxs). One involves the encapsulation of the hydrophobic PtCx1 within an amphiphilic comb polymer (MNC@poly(maleic anhydride‐alt‐1‐octadecene) [PMAO]–PtCx1), whereas the other involves the direct binding of the hydrophilic PtCx2 to the surface of the MNC mediated by a ligand‐exchange procedure (MNC@OH–PtCx2). Both systems are evaluated as potential candidates for multimodal imaging in magnetic resonance imaging (MRI) and photoluminescence lifetime imaging micro(spectro)scopy (PLIM). PLIM measurements on agarose phantoms demonstrate significantly longer excited‐state lifetimes compared to the short‐lived autofluorescence of biological background. Additionally, both nanosystems perform as effective MRI contrast agents (CAs): the r2* values are 3–4 times higher than for the commercial CA ferucarbotran. MNC@PMAO–PtCx1 particles also cause significant increases in r2. While the ligand exchange procedure efficiently anchors PtCxs to the MNC surface, the polymeric encapsulation ensures higher colloidal stability, contributing to differences in PLIM and MRI outcomes. In these results, the successful integration of two complementary noninvasive imaging modalities within a single nanosystem is confirmed, serving as the impetus for further investigation of such systems as advanced multimodal–multiscale imaging agents with dual orthogonal readouts.

INTRODUÇÃO: Hoje em dia a carga horária de trabalho dos professores exige muito de sua qualidade de vida e condição física, para exercer as tarefas do dia a dia em sua docência, podendo gerar desgastes à sua saúde. Pois, a mesma envolve aspectos físicos e psicológicos durante a realização sua jornada de trabalho, o qual pode impactar na sua qualidade de vida. OBJETIVO: Associar o nível de atividade física e a qualidade de vida dos docentes da rede pública de ensino da cidade de Ubá-MG. MÉTODOS: Foi realizado um estudo análitico de corte transversal, com 56 professores. A coleta de dados ocorreu em 3 escolas da rede pública, com professores de 25 a 55 anos e experiência mínima de 2 anos. Foram utilizados dois instrumentos, o Questionário Internacional de Atividade Física - Versão Curta (IPAQ) e o Questionário World Health Organization Quality of Life/brief (WHOQOL/breve). RESULTADOS: Os participantes foram compostos por mulheres (91,1%) e homens (8,9%), com idade média de 39,57±8,19 anos. Dos professores avaliados, 76,8% foram classificados como Ativos (Muito Ativo e Ativo) e 23,2% como Inativos (Irregularmente Ativo e Sedentário), sendo que indivíduos considerados ativos (70,52±8,88) tiveram uma melhor qualidade de vida, em comparação aos inativos (61,78±10,95). Além disso, o grupo ativo apresentou qualidade de vida estatisticamente superior nos domínios psicológico e meio ambiente. CONCLUSÃO: Os docentes com maior nível de atividade física apresentam melhor qualidade de vida que os inativos.

Molecular diagnostic methods to detect and quantify viral RNA in clinical samples rely on the purification of the genetic material prior to reverse transcription polymerase chain reaction (qRT-PCR). Due to the large number of samples processed in clinical laboratories, automation has become a necessity in order to increase method processivity and maximize throughput per unit of time. An attractive option for isolating viral RNA is based on the magnetic solid phase separation procedure (MSPS) using magnetic microparticles. This method offers the advantage over other alternative methods of making it possible to automate the process. In this study, we report the results of the MSPS method based on magnetic microparticles obtained by a simple synthesis process, to purify RNA from oro- and nasopharyngeal swab samples of patients suspected of COVID-19 provided by three diagnostic laboratories located in the Buenos Aires Province, Argentina. Magnetite nanoparticles of Fe3O4 (MNPs) were synthesized by the coprecipitation method and then coated with silica (SiO2) produced by hydrolysis of tetraethyl orthosilicate (TEOS). After preliminary tests on samples from the A549 human lung cell line and swabs, an extraction protocol was developed. The quantity and purity of the RNA obtained were determined by gel electrophoresis, spectrophotometry, and qRT-PCR. Tests on samples from naso- and oropharyngeal swabs were performed in order to validate the method for RNA purification in high-throughput SARS-CoV-2 diagnosis by qRT-PCR. The method was compared to the spin columns method and the automated method using commercial magnetic particles. The results show that the method developed is efficient for RNA extraction from nasal and oropharyngeal swab samples, and also comparable to other extraction methods in terms of sensitivity for SARS-CoV-2 detection. Of note, this procedure and reagents developed locally were intended to overcome the shortage of imported diagnostic supplies as the sudden spread of COVID-19 required unexpected quantities of nucleic acid isolation and diagnostic kits worldwide.

Abstract Background Peripheral nerve injuries (PNIs) include several conditions in which one or more peripheral nerves are damaged. Trauma is one of the most common causes of PNIs and young people are particularly affected. They have a significant impact on patients’ quality of life and on the healthcare system, while timing and type of surgical treatment are of the utmost importance to guarantee the most favorable functional recovery. To date, several different classifications of PNIs have been proposed, most of them focusing on just one or few aspects of these complex conditions, such as type of injury, anatomic situation, or prognostic factors. Current classifications do not enable us to have a complete view of this pathology, which includes diagnosis, treatment choice, and possible outcomes. This fragmentation sometimes leads to an ambiguous definition of PNIs and the impossibility of exchanging crucial information between different physicians and healthcare structures, which can create confusion in the choice of therapeutic strategies and timing of surgery. Materials The authors retrospectively analyzed a group of 24 patients treated in their center and applied a new classification for PNI injuries. They chose (a) five injury-related factors, namely nerve involved, lesion site, nerve type (whether motor, sensory or mixed), surrounding tissues (whether soft tissues were involved or not), and lesion type—whether partial/in continuity or complete. An alphanumeric code was applied to each of these classes, and (b) four prognostic codes, related to age, timing, techniques, and comorbidities. Results An alphanumeric code was produced, similar to that used in the AO classification of fractures. Conclusions The authors propose this novel classification for PNIs, with the main advantage to allow physicians to easily understand the characteristics of nerve lesions, severity, possibility of spontaneous recovery, onset of early complications, need for surgical treatment, and the best surgical approach. Level of evidence: according to the Oxford 2011 level of evidence, level 2.

Introdução/objetivos: Leveduras do gênero Candida estão entre as principais causas de Infecção da Corrente Sanguínea (ICS) em todo o mundo, sendo associadas à piora do prognóstico, aumento do tempo de internação e altas taxas de mortalidade. As principais espécies que causam a candidemia no Brasil são Candida albicans, Candida parapsilosis e Candida tropicalis, sendo a C. albicans a mais prevalente. Todavia, nas últimas décadas tem aumentado a prevalência de espécies de Candida Não-Albicans (CNA) e principalmente a emergência de Candida auris, que possui mecanismos de resistência aos antifúngicos mais prescritos na prática médica, caracterizando um cenário de preocupação mundial. Este estudo teve como objetivo avaliar a prevalência de Candida spp. nas hemoculturas de pacientes hospitalizados, bem como a prevalência das espécies mais isoladas e sua distribuição por setores do hospital. Métodos: Trata-se de um estudo observacional e retrospectivo, em que foram analisados, através de bancos de dados, os resultados de hemoculturas de pacientes hospitalizados em um hospital de ensino da cidade de Juiz de Fora, Minas Gerais, no período de janeiro de 2021 a dezembro de 2022. Este estudo foi aprovado pelo Comitê de Ética em Pesquisa com Seres Humanos. Resultados: No período do estudo, foram realizadas 3262 hemoculturas, sendo 1059 (32,46%) positivas. Destas, 1008 (95,18%) tiveram crescimento bacteriano e 51 (4,82%) tiveram crescimento de Candida spp. Foram isoladas 20 (39,22%) linhagens de C. albicans e 31 (60,78%) linhagens de CNA. Das hemoculturas com CNA isolados, 14 foram C. tropicalis (45,16%), 10 C. parapsilosis (32,26%), 3 C. glabrata (9,68%), 2 Candida kefyr (6,45%) e 2 Candida lusitaniae (6,45%). Em relação a distribuição das linhagens de Candida isoladas das hemoculturas por setores do hospital, 51 isolados de Candida spp., 25 (49,02%) foram do Centro de Tratamento Intensivo (CTI), 11 (21,57%) do bloco cirúrgico e 15 (29,41%) foram das enfermarias. Conclusão: Candida albicans é a principal espécie relacionada a candidemia em pacientes hospitalizados, porém espécies do grupo CNA têm apresentado elevada prevalência em isolados de hemocultura, principalmente em pacientes de CTI.

This qualitative research aimed to understand the experiences of a fourth-year medical class during two clinical simulation scenarios of type 2 diabetes management in Primary Care. Ten simulated students were interviewed. The results describe the symbolic conception of diabetes and its treatment as anguish, damage, condemnation and an unpleasant sentence that affects the appropriation and performance of the medical role by students. Considering Medical Psychology, we suggest that such subjective factors should be addressed in teaching-learning in addition to commonly cognitive aspects mentioned in the medical education literature in order for students to develop the work profile to cope with diabetes in Primary Care. Clinical simulation facilitates the subjective approach through its group support component to promote reflection, insights and self-awareness.

In this work, a Binary Quantized Convolution neural network for image classification is trained and evaluated. Binarized neural networks reduce the amount of memory, and it is possible to implement them with less hardware than those that use real value variables (Floating Point 32 bits). This type of network can be implemented in embedded systems, such as FPGA. A quantization-aware training was performed, to compensate for the errors caused by the loss of precision of the parameters. The model obtained an evaluation accuracy of 88% with the CIFAR-10 evaluation set.

Objective The aim of this study is to evaluate the feasibility, safety, and short-term effectiveness of a high-power (150 W) microwave ablation (MWA) device for tumor ablation in the lung, liver, and kidney. Methods Between December 2021 and June 2022, patients underwent high-power MWA for liver, lung, and kidney tumors. A retrospective observational study was conducted in accordance with the Declaration of Helsinki. The MWA system utilized a 150-W, 2.45-GHz microwave generator (Emprint™ HP Ablation System, Medtronic). The study assessed technical success, safety, and effectiveness, considering pre- and post-treatment diameter and volume, lesion location, biopsy and/or cone beam computed tomography (CBCT) usage, MWA ablation time, MWA power, and dose-area product (DAP). Results From December 2021 to June 2022, 16 patients were enrolled for high-power MWA. Treated lesions included hepatocellular carcinoma (10), liver metastasis from colon cancer (1), liver metastasis from pancreatic cancer (1), squamous cell lung carcinoma (2), renal cell carcinoma (1), and renal oncocytoma (1). Technical success rate was 100%. One grade 1 complication (6.25%) was reported according to CIRSE classification. Overall effectiveness was 92.8%. Pre- and post-treatment mean diameters for liver lesions were 19.9 mm and 37.5 mm, respectively; for kidney lesions, 34 mm and 35 mm; for lung lesions, 29.5 mm and 31.5 mm. Pre- and post-treatment mean volumes for liver lesions were 3.4 ml and 24 ml, respectively; for kidney lesions, 8.2 ml and 20.5 ml; for lung lesions, 10.2 ml and 32.7 ml. The mean ablation time was 48 minutes for liver, 42.5 minutes for lung, and 42.5 minutes for renal ablation. The mean DAP for all procedures was 40.83 Gcm 2 . Conclusion This preliminary study demonstrates the feasibility, safety, and effectiveness of the new 150 W MWA device. Additionally, it shows reduced ablation times for large lesions.

The effects of voluntary running on the skeletal muscle of rats with pulmonary arterial hypertension (PAH) were tested in the present study. PAH was induced in rats by a single injection of monocrotaline (MCT, 60 mg/kg). Rats in the sedentary hypertension (HS) group had their tolerance to physical exertion reduced throughout the experiment, while those in the sedentary control (SC), exercise control (EC), exercise hypertension (EH) and median exercise (EM) groups maintained or increased. Despite that, the muscular citrate synthase activity was not different between groups. The survival time was higher in the EH (32 days) than in the SH (28 days) (p = 0.0032). SH and EH groups showed a lower percentage of muscle fiber and a higher percentage of extracellular matrix compared to control groups (p < 0.0001). However, the EM and EH groups presented higher percentage of muscle fiber and lower percentage of extracellular matrix than SH group (p < 0.0001). Regarding muscular gene expression, the SH and EM groups showed a lower expression of PGC1-α (p = 0.0024) and a higher expression of VEGF (p = 0.0033) compared to SC, while PGC1-α was elevated in the EH. No difference between groups was found for the carbonylated protein levels (p > 0.05), while the TNF-α/IL-10 ratio was augmented in the EH (p = 0.0277). In conclusion, voluntary running augments the proportion of fiber and affects the gene expression of inflammatory and mitochondrial biogenesis’ markers in the skeletal muscle of rats with MCT-induced PAH, which benefits their survival and tolerance to physical effort.

No futebol, assim como em outros esportes, existem jogadores que se destacam e estudos apontam que o efeito da idade relativa e um fator para o sucesso desses jogadores. Tal efeito contribui para que os jogadores nascidos nos primeiros meses do ano desenvolvam vantagens em relação aos demais. O objetivo do estudo foi verificar o efeito da idade relativa na Copa do Mundo FIFA® Sub-17 categoria masculina, disputada no ano de 2019. Foi realizado um estudo com indivíduos do sexo masculino pertencentes às 24 seleções do torneio que aconteceu em outubro de 2019. Os jogadores foram separados por datas de nascimento, e divididos em trimestres (quartis). Os resultados mostraram que o efeito da idade relativa se fez presente entre os atletas da Copa do Mundo FIFA® Sub-17. Quando foi realizada a comparação entre os quartis de nascimento nas diferentes posições, observou que entre os goleiros houve diferença apenas entre o Q1xQ3, entre os defensores e meio campistas houve diferença entre Q1XQ4, Q2XQ4, Q3X4, já entre os atacantes houve diferença entre o Q1XQ3 E Q1XQ4. Concluiu-se que ocorreu o efeito da idade relativa para os atletas que disputaram a Copa do Mundo FIFA® de futebol masculino sub-17.

Pulmonary arterial hypertension is associated with skeletal muscle myopathy and atrophy and impaired exercise tolerance. Aerobic exercise training has been recommended as a non-pharmacological therapy for deleterious effects imposed by pulmonary arterial hypertension. Aerobic physical training induces skeletal muscle adaptations via reduced inflammation, improved anabolic processes, decreased hypoxia and regulation of mitochondrial function. These benefits improve physical exertion tolerance and quality of life in patients with pulmonary arterial hypertension. However, the mechanisms underlying the therapeutic potential of aerobic exercise to skeletal muscle disfunctions in patients with pulmonary arterial hypertension are not well understood yet. This minireview highlights the pathways involved in skeletal muscle adaptations to aerobic exercise training in patients with pulmonary arterial hypertension.

Breast cancer (BC) is the most frequently diagnosed malignancy among women. In the past two decades, new technologies and BC screening have led to the diagnosis of smaller and earlier-stage BC (ESBC). Therefore, percutaneous minimally invasive techniques (PMIT) were adopted to treat patients unfit for surgery, women who refuse it, or elderly patients with comorbidities that could make surgery a difficult and life-threatening treatment. The target of PMIT is small-size ESBC with the scope of obtaining similar efficacy as surgery. Minimally invasive treatments are convenient alternatives with promising effectiveness, lower morbidity, less cost, less scarring and pain, and more satisfying cosmetic results. Ablative techniques used in BC are cryoablation, radiofrequency ablation, microwave ablation, high-intensity focused ultrasound (US), and laser ablation. The aim of our study is to discuss the current status of percutaneous management of BC, evaluate the clinical outcomes of PMIT in BC, and analyze future perspectives regarding ablation therapy in BC.

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Background: The study evaluated the effects of resistance exercise training and açaí supplementation on cardiac parameters in hypertensive animals. Methods: For this study, rats from the Wistar and SHR lines (spontaneously hypertensive rats) were used. The animals were divided into 5 groups: Wistar Control (C); Control Hypertensive (H); Trained Hypertensive (HT); Hypertensive and Supplemented with Açaí (HA); and Hypertensive Trained and Supplemented with Açaí (HAT). Resistance exercise training was carried out through climbing. The supplemented groups received 3 g of açaí/kg of body mass. The animals' systolic blood pressure (SBP), body mass, and physical test were measured at the beginning and end of the intervention. At the end, an echocardiographic analysis was performed. Histological analysis and oxidative stress of the LV were performed. Results: It was found that hypertensive animals showed an increase in SBP, and the treatments reduced this parameter. The trained groups achieved higher values of maximum carrying load. Hypertension increased the dimension of the left ventricular free wall in diastole and reduced ejection and shortening fractions. The trained groups showed improvement in ejection and shortening fractions. The H group increased the proportion of extracellular matrix and reduced the proportion of cells, with the HAT group attenuating this change. Cell diameter was greater in group H, and all treatments reduced this parameter. Hypertension increased the concentration of malondialdehyde and decreased catalase activity in LV. The treatments managed to mitigate this damage. Conclusions: It is concluded that the treatments managed to generate positive cardiovascular adaptations, and their combination enhanced these effects. [ABSTRACT FROM AUTHOR]

No Brasil, apesar da implementação de diretrizes e ações voltados a nutrição e crescimento das crianças, ainda são vistas admissões de pacientes com desnutrição primária. Neste relato, é descrito um caso de paciente pediátrico, que apresentava face em lua cheia, hipoatividade, hipotonia cervical, edema de mãos e pés, cabelos rarefeitos e pele xerótica, diagnosticado com desnutrição primária grave da forma mais rara, a Síndrome de Kwashiorkor, internado em enfermaria de um hospital pediátrico de referência do Distrito Federal. O objetivo deste trabalho é informar a comunidade científica acerca dos aspectos relevantes no reconhecimento precoce, no diagnóstico e no manejo dessa patologia. Dessa forma, contribuindo na otimização do tratamento e melhora do prognóstico.

Review efficacy and safety of minimally-invasive treatments for Low Urinary Tract Symptoms (LUTS) in patients affected by Benign Prostate Hyperplasia (BPH). We performed a systematic review of the literature from 1993 to 2022 leveraging original research articles, reviews, and case-studies published in peer-reviewed journals and stored in public repositories. Prostate artery embolization (PAE), transurethral needle ablation (TUNA), transurethral microwave thermotherapy (TUMT), high intensity focused ultrasound (HIFU), laser treatments and Cryoablation are valid and safe alternatives to the gold standard (surgery) in the treatment of LUTS in patients affected by BPH, with fewer undesired effects being reported.

IntroductionPhysical exercise showed to be beneficial for frail older adults on haemodialysis (HD). However, there are several obstacles hindering the regular practice of exercise, such as transportation difficulties, lack of time, fatigue and comorbidities. E-health in this regard has many potential advantages and could be useful for motivating HD patients to increase their level of physical activity. The aim of this study was to evaluate the feasibility of a blended e-health intervention for elderly HD patients who individually exercise at home while under remote supervision of a physiotherapist.Material and methodsPatients over 60 years of age with sufficient cognitive and motoric resources to perform a simple physical test battery and to use a tablet-computer were recruited from four HD outpatient facilities. Following baseline assessment at home, the participants were visited by a physiotherapist (PT). The PT set an individual exercise programme and explained how to use the web-based interface. During the 12 weeks of training, the PTs remotely supervised the patients' progress. At 12 weeks follow-up a second assessment took place.ResultsTwenty-two patients were recruited to participate in the study. Seven patients dropped out of the blended programme and 15 patients concluded the programme. The average training frequency of the 15 participants concluding the study was 1.5 times a week [range 0.2–5.8]. The duration of a training session was between 20 and 40 min. The usability of the system was deemed positive. Regarding the efficacy of the intervention, no significant improvement of any measured parameter was found, and effect sizes were small to medium.ConclusionA blended e-health intervention supported by a web-based application for exercising at home under remote supervision of a PT is feasible in a HD population including older patients. However, before planning a randomized controlled trial, strategies to increase the recruitment rate and the adherence to such a blended intervention should be further developed, e.g., to improve the recruitment procedures and lower the expectable drop-out rate. Furthermore, the dosage of the blended programme should be adapted to the patients' physical performance levels in future trials.The study was registered on the website clinicaltrials.gov with ID NCT04076488.

Abstract Background Exercise has been suggested to prevent deterioration of health-related quality of life (HRQL) and overall health in pediatric rheumatologic diseases during the COVID-19 pandemic. Herein we describe the effects of a 12-week, home-based, exercise program on overall health and quality of life among quarantined patients with juvenile dermatomyositis (JDM). Method This prospective, quasi-experimental, mixed methods (qualitative and quantitative) study was conducted between July and December 2020, during the most restricted period of COVID-19 pandemic in Brazil. The home-based exercise program consisted of a 12-week, three-times-a-week, aerobic and strengthening (bodyweight) training program. Qualitative data were systematically evaluated. Strengths and Difficulties Questionnaire (SDQ), Pediatric Quality of Life Inventory (PedsQOL) and Pittsburgh Sleep Quality Index (PSQI) evaluate symptoms of mental health disorder, HRQL, and quality of sleep. Findings 11 patients (out of 27) met the inclusion criteria (91% female; mean ± SD age: 13.5 ± 3.2 years). Adherence to the intervention was 72.6%. Barriers to exercise involved poor internet connectivity, excessive weekly sessions, and other commitments. Even though not statistically significant, Self-report SDQ subscales Total Difficulties Score, Emotional Problems Score, and PedsQOL School Functioning Score improved after intervention (− 2.4; 95%confidence interval [CI] -5.1; 0.2, p = 0.06; − 1.0; 95%CI -2.2; 0.2, p = 0.09 and; 11.7; 95%CI -2.5; 25.8, p = 0.09, respectively). Remaining SDQ subscales were not altered. Six themes emerged from patients’ and parents’ comments (qualitative results). Patients engaged in exercise reported other health-related benefits including increased motivation, concentration and strength. Interpretation A home-based exercise program was associated with qualitative perceptions of improvements in overall health and HRQL by quarantined adolescents with JDM during COVID-19 pandemic. Lessons from this trial may help developing interventions focused on tackling physical inactivity in JDM.

Abstract One of the biggest issues in civil engineering is the poor performance of concrete repairs. In fact, in Europe only 50% of concrete structures restorations are estimated to be successful, even though rehabilitation costs account for about half of the yearly construction budgets. This research aims at investigating a potential green approach to the sustainability of rehabilitation solutions for infrastructures. Following a simplified analysis of C02 emissions, intervention costs, social aspects, structural performances and other variables considered relevant to the scope, possible rehabilitation techniques are compared and ranked. The following four different options have therefore been designed to be applied to an actual column of the Brabau Bridge in Sardinia (Italy): i. complete removal and replacement of the column, ii. replacement of the damaged longitudinal rebars by machined bars and ultra-high performance fibre-reinforced concrete (UHPFRC) strengthening, iii. longitudinal and transverse fiber reinforced polymers (FRP) wrapping, iv. concrete jacketing. A methodological and procedural strategy is established through multi-criteria analysis that will allow future developments to assess the whole Life Cycle Assessment of the maintenance work.

Abstract Objective: This study aimed to assess physical and mental health, and health-related quality of life (HRQL) parameters in adolescents with physical disabilities enrolled in a sports nongovernmental organization (NGO) versus adolescents without disabilities during coronavirus disease 2019 (COVID-19) pandemic. Methods: This cross-sectional study included 30 adolescents with disabilities and 86 adolescents without disabilities who responded to an online questionnaire with sociodemographic data and self-rated healthcare routine information during the COVID-19 quarantine. Validated self-report versions of the Strengths and Difficulties Questionnaire (SDQ), Pediatric Quality of Life Inventory 4.0 (PedsQL 4.0), Pittsburgh Sleep Quality Index (PSQI), and Pediatric Outcome Data Collection Instrument (PODCI) were also applied. Results: The median of emotional [4 (0–10) vs. 5 (0–10), p=0.018] and prosocial [7 (0–10) vs. 9 (3–10), p=0.006] problems was lower in adolescents with disabilities versus adolescents without disabilities. Adolescents with disabilities had significantly lower global function [68 (21–99) vs. 94 (67–100), p

Dihydrolipoamide dehydrogenase (DLD) deficiency is a recessive mitochondrial disorder caused by depletion of DLD from α-ketoacid dehydrogenase complexes. Caenorhabditis elegans animal models of DLD deficiency generated by graded feeding of dld-1(RNAi) revealed that full or partial reduction of DLD-1 expression recapitulated increased pyruvate levels typical of pyruvate dehydrogenase complex deficiency and significantly altered animal survival and health, with reductions in brood size, adult length, and neuromuscular function. DLD-1 deficiency dramatically increased mitochondrial unfolded protein stress response induction and adaptive mitochondrial proliferation. While ATP levels were reduced, respiratory chain enzyme activities and in vivo mitochondrial membrane potential were not significantly altered. DLD-1 depletion directly correlated with the induction of mitochondrial stress and impairment of worm growth and neuromuscular function. The safety and efficacy of dichloroacetate, thiamine, riboflavin, 5-aminoimidazole-4-carboxamide-1-β-d-ribofuranoside (AICAR), l-carnitine, and lipoic acid supplemental therapies empirically used for human DLD disease were objectively evaluated by life span and mitochondrial stress response studies. Only dichloroacetate and thiamine showed individual and synergistic therapeutic benefits. Collectively, these C. elegans dld-1(RNAi) animal model studies demonstrate the translational relevance of preclinical modeling of disease mechanisms and therapeutic candidates. Results suggest that clinical trials are warranted to evaluate the safety and efficacy of dichloroacetate and thiamine in human DLD disease.

The main purpose of this paper is to study the preliminary selection of one or more Power Line Communications protocols or standards, to be used in a full duplex communication between a wind turbine and a command center powered by this wind turbine. This situation considers that the wind turbine is located in an isolated area in the Patagonia-Austral region, working under severe climate conditions.

Pathogenic variants in the human F-box and leucine-rich repeat protein 4 (FBXL4) gene result in an autosomal recessive, multisystemic, mitochondrial disorder involving variable mitochondrial depletion and respiratory chain complex deficiencies with lactic acidemia. As no FDA-approved effective therapies for this disease exist, we sought to characterize translational C. elegans and zebrafish animal models, as well as human fibroblasts, to study FBXL4–/– disease mechanisms and identify preclinical therapeutic leads. Developmental delay, impaired fecundity and neurologic and/or muscular activity, mitochondrial dysfunction, and altered lactate metabolism were identified in fbxl-1(ok3741) C. elegans. Detailed studies of a PDHc activator, dichloroacetate (DCA), in fbxl-1(ok3741) C. elegans demonstrated its beneficial effects on fecundity, neuromotor activity, and mitochondrial function. Validation studies were performed in fbxl4sa12470 zebrafish larvae and in FBXL4–/– human fibroblasts; they showed DCA efficacy in preventing brain death, impairment of neurologic and/or muscular function, mitochondrial biochemical dysfunction, and stress-induced morphologic and ultrastructural mitochondrial defects. These data demonstrate that fbxl-1(ok3741) C. elegans and fbxl4sa12470 zebrafish provide robust translational models to study mechanisms and identify preclinical therapeutic candidates for FBXL4–/– disease. Furthermore, DCA is a lead therapeutic candidate with therapeutic benefit on diverse aspects of survival, neurologic and/or muscular function, and mitochondrial physiology that warrants rigorous clinical trial study in humans with FBXL4–/– disease.

Abstract Background Eugenol shows both antibacterial and antiparasitic activities, suggesting that it might be evaluated as an option for the treatment of praziquantel-resistant schistosome. Methods The in vitro activities of three eugenol derivatives (FB1, FB4 and FB9) on adult worms from Schistosoma mansoni were examined by fluorescence and scanning electron microscopy to analyze effects on the excretory system and integument damage, respectively. Biochemical tests with verapamil (a calcium channel antagonist) and ouabain (a Na+/K+-ATPase pump inhibitor) were used to characterize eugenol derivative interactions with calcium channels and the Na+/K+-ATPase, while in silico analysis identified potential Na+/K+-ATPase binding sites. Results The compounds showed effective doses (ED50) of 0.324 mM (FB1), 0.167 mM (FB4), and 0.340 mM (FB9). In addition, FB4 (0.322 mM), which showed the lowest ED50, ED90 and ED100 (p < 0.05), caused the most damage to the excretory system and integument, according to both fluorescence and scanning electron microscopy analysis. The death of adult worms was delayed by ouabain treatment plus FB1 (192 versus 72 hours) and FB9 (192 versus 168 hours), but the response to FB4 was the same in the presence or absence of ouabain. Besides, no changes were noted when all of the eugenol derivatives were combined with verapamil. Moreover, FB1 and FB9 inhibited Na+/K+-ATPase activity according to in silico analysis but FB4 did not show a time-dependent relationship and may act on targets other than the parasite Na+/K+-ATPase. Conclusion Eugenol derivatives, mainly FB4 when compared to FB1 and FB9, seem to act more effectively on the integument of adult S. mansoni worms.

Near-fault earthquakes (NFEs), characterized by high peak ground velocity (PGV) and long period pulses, show different properties from far-field ones [...]

BackgroundIn the recent years, growing interest in simulation-based surgical education has led to various practical alternatives for medical training. More recently, courses based on virtual reality (VR) and three-dimensional (3D)-printed models are available. In this paper, a hybrid (virtual and physical) neurosurgical simulator has been validated, equipped with augmented reality (AR) capabilities that can be used repeatedly to increase familiarity and improve the technical skills in human brain anatomy and neurosurgical approaches.MethodsThe neurosurgical simulator used in this study (UpSurgeOn Box, UpSurgeOn Srl, Assago, Milan) combines a virtual component and a physical component with an intermediate step to provide a hybrid solution. A first reported and evaluated practical experience on the anatomical 3D-printed model has been conducted with a total of 30 residents in neurosurgery. The residents had the possibility to choose a specific approach, focus on the correct patient positioning, and go over the chosen approach step-by-step, interacting with the model through AR application. Next, each practical surgical step on the 3D model was timed and qualitatively evaluated by 3 senior neurosurgeons. Quality and usability-grade surveys were filled out by participants.ResultsMore than 89% of the residents assessed that the application and the AR simulator were very helpful in improving the orientation skills during neurosurgical approaches. Indeed, 89.3% of participants found brain and skull anatomy highly realistic during their tasks. Moreover, workshop exercises were considered useful in increasing the competency and technical skills required in the operating room by 85.8 and 84.7% of residents, respectively. Data collected confirmed that the anatomical model and its application were intuitive, well-integrated, and easy to use.ConclusionThe hybrid AR and 3D-printed neurosurgical simulator could be a valid tool for neurosurgical training, capable of enhancing personal technical skills and competence. In addition, it could be easy to imagine how patient safety would increase and healthcare costs would be reduced, even if more studies are needed to investigate these aspects. The integration of simulators for training in neurosurgery as preparatory steps for the operating room should be recommended and further investigated given their huge potential.

O objetivo do estudo foi analisar a vantagem de jogar em casa na série A do Campeonato Brasileiro de 2017 e na Copa do Brasil de 2015/2016 e 2017/2018. A amostra foi composta por 620 partidas, 380 partidas do Campeonato Brasileiro e 240 partidas nas duas primeiras fases de 2015 a 2018 da Copa do Brasil. O método utilizado para verificar a vantagem de jogar em casa foi o de Pollard. Os dados das partidas foram coletados pelo site oficial da Confederação Brasileira de Futebol (CBF). Para análise estatística, foi usada a análise descritiva de frequência absoluta e relativa e o teste qui-quadrado (χ2) e adotando-se p

O efeito da idade relativa é fator importante diante do processo de formação de atletas, principalmente quando se é considerado fatores que dizem respeito ao desenvolvimento físico e cognitivo dos atletas. O presente estudo teve como objetivo analisar o efeito da idade relativa na Copa do Mundo FIFA® Sub-20 masculina, disputada em 2019. Para isso, foi realizada a análise da data de nascimento de cada atleta das 24 seleções que disputaram o mundial, sendo os atletas divididos em quartis: Q1 (janeiro-março), Q2 (abril-junho), Q3 (julho-setembro) e Q4 (outubro-dezembro). Foi possível observar que a maior parte dos atletas estavam situados nos quartis Q1 e Q2, sendo, do total da amostra, 37,97% e 26,94%, respectivamente. Não foram encontradas diferenças entre os quartis Q2 e Q3. Quando foram analisados somente os atletas classificados para a segunda fase do Mundial, nota-se comportamento semelhante à análise do total de atletas, não sendo encontradas diferenças somente entre os quartis Q2 e Q3. Quando foram analisados somente os atletas desclassificados na primeira fase do Mundial, foram encontradas diferenças entre os quartis Q1 e Q2; Q2 e Q3; Q2 e Q4; Q3 e Q4. Conclui-se que durante o mundial o efeito da idade relativa esteve presente, onde houve uma prevalência de atletas nascidos no Q1 em relação aos demais. Além disso, as diferenças entre os quartis analisados foram mais pronunciadas nos atletas das equipes classificadas para a segunda fase do torneio.

O efeito da idade relativa é um fenômeno que pode influenciar o processo de seleção dos jogadores por suas seleções. Esse fenômeno pode privilegiar um grupo de jogadores em detrimentos de outros. Portanto, o objetivo deste estudo foi analisar o efeito da idade relativa na Copa do Mundo FIFA sub-17 de futebol masculino no ano de 2017. Foram coletadas as datas de nascimento de 494 atletas e divididos em quartis: Q1 (janeiro-março), Q2 (abril-junho), Q3 (julho-setembro) e Q4 (outubro-dezembro). Foi realizada uma análise descritiva e utilizado o teste qui-quadrado (χ²), sendo p