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Background and Aims. First-degree relatives of gastric cancer patients are at increased risk of developing gastric cancer. Increased oxidative stress, including lipid peroxidation, has been associated with gastric carcinogenesis. Whether first-degree relatives of gastric cancer patients have increased oxidative stress remains unknown. We aimed to compare oxidative stress in patients with gastric cancer, their first-degree relatives, and dyspeptic controls. Methods. A total of 155 patients undergoing upper endoscopy were prospectively enrolled, including 50 with gastric cancer, 49 first-degree relatives of gastric cancer patients, and 56 controls. Serum concentrations of malondialdehyde (MDA) and glutathione) and activities of superoxide dismutase (SOD) and catalase were measured. Multivariate analysis adjusting for sex, age, smoking status, and alcohol consumption was performed. Results. Lipid peroxidation, as measured by concentration of MDA (nmol/mL), was higher ( p = 0.04 ), and glutathione levels were lower ( p < 0.001 ) in the gastric cancer group compared to controls. There was no difference in the catalase activity among the groups. There was no difference in glutathione and MDA concentration or catalase activity between the different stages of gastric cancer based on the TNM classification. Relatives of gastric cancer patients had higher glutathione concentration (μmol/mL) compared to gastric cancer patients (262.5 vs. 144.6; p = 0.018 ), while there was no difference in MDA concentration. Catalase and superoxide dismutase activity were lower in the gastric cancer group (3.82 vs. 0.91; p < 0.001 and 1.04 vs. 0.6; p < 0.001 ) compared to their first-degree relatives. Interestingly, MDA concentration in the first-degree relative group was higher than in the control group (7.9 vs. 5.1; p = 0.03 ). Conclusions. In this study, similarly to gastric cancer patients, their first-degree relatives were found to have increased oxidative stress compared to controls. Further studies are warranted to validate this observation and to better understand the role of oxidative stress as a possible biomarker in this population.

© The Author(s) (2021). Published by Oxford University Press on behalf of the Guarantors of Brain. This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial License (https://creativecommons.org/licenses/ by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com, Several CSF and blood biomarkers for genetic frontotemporal dementia have been proposed, including those reflecting neuroaxonal loss (neurofilament light chain and phosphorylated neurofilament heavy chain), synapse dysfunction [neuronal pentraxin 2 (NPTX2)], astrogliosis (glial fibrillary acidic protein) and complement activation (C1q, C3b). Determining the sequence in which biomarkers become abnormal over the course of disease could facilitate disease staging and help identify mutation carriers with prodromal or early-stage frontotemporal dementia, which is especially important as pharmaceutical trials emerge. We aimed to model the sequence of biomarker abnormalities in presymptomatic and symptomatic genetic frontotemporal dementia using cross-sectional data from the Genetic Frontotemporal dementia Initiative (GENFI), a longitudinal cohort study. Two-hundred and seventy-five presymptomatic and 127 symptomatic carriers of mutations in GRN, C9orf72 or MAPT, as well as 247 non-carriers, were selected from the GENFI cohort based on availability of one or more of the aforementioned biomarkers. Nine presymptomatic carriers developed symptoms within 18 months of sample collection ('converters'). Sequences of biomarker abnormalities were modelled for the entire group using discriminative event-based modelling (DEBM) and for each genetic subgroup using co-initialized DEBM. These models estimate probabilistic biomarker abnormalities in a data-driven way and do not rely on previous diagnostic information or biomarker cut-off points. Using cross-validation, subjects were subsequently assigned a disease stage based on their position along the disease progression timeline. CSF NPTX2 was the first biomarker to become abnormal, followed by blood and CSF neurofilament light chain, blood phosphorylated neurofilament heavy chain, blood glial fibrillary acidic protein and finally CSF C3b and C1q. Biomarker orderings did not differ significantly between genetic subgroups, but more uncertainty was noted in the C9orf72 and MAPT groups than for GRN. Estimated disease stages could distinguish symptomatic from presymptomatic carriers and non-carriers with areas under the curve of 0.84 (95% confidence interval 0.80-0.89) and 0.90 (0.86-0.94) respectively. The areas under the curve to distinguish converters from non-converting presymptomatic carriers was 0.85 (0.75-0.95). Our data-driven model of genetic frontotemporal dementia revealed that NPTX2 and neurofilament light chain are the earliest to change among the selected biomarkers. Further research should investigate their utility as candidate selection tools for pharmaceutical trials. The model's ability to accurately estimate individual disease stages could improve patient stratification and track the efficacy of therapeutic interventions., This study was supported in the Netherlands by two Memorabel grants from Deltaplan Dementie (The Netherlands Organisation for Health Research and Development and Alzheimer Nederland; grant numbers 733050813,733050103 and 733050513), the Bluefield Project to Cure Frontotemporal Dementia, the Dioraphte foundation (grant number 1402 1300), the European Joint Programme—Neurodegenerative Disease Research and the Netherlands Organisation for Health Research and Development (PreFrontALS: 733051042, RiMod-FTD: 733051024); V.V. and S.K. have received funding from the European Union’s Horizon 2020 research and innovation programme under grant agreement no. 666992 (EuroPOND). E.B. was supported by the Hartstichting (PPP Allowance, 2018B011); in Belgium by the Mady Browaeys Fonds voor Onderzoek naar Frontotemporale Degeneratie; in the UK by the MRC UK GENFI grant (MR/M023664/1); J.D.R. is supported by an MRC Clinician Scientist Fellowship (MR/M008525/1) and has received funding from the NIHR Rare Disease Translational Research Collaboration (BRC149/NS/MH); I.J.S. is supported by the Alzheimer’s Association; J.B.R. is supported by the Wellcome Trust (103838); in Spain by the Fundació Marató de TV3 (20143810 to R.S.V.); in Germany by the Deutsche Forschungsgemeinschaft (DFG, German Research Foundation) under Germany’s Excellence Strategy within the framework of the Munich Cluster for Systems Neurology (EXC 2145 SyNergy—ID 390857198) and by grant 779357 ‘Solve-RD’ from the Horizon 2020 Research and Innovation Programme (to MS); in Sweden by grants from the Swedish FTD Initiative funded by the Schörling Foundation, grants from JPND PreFrontALS Swedish Research Council (VR) 529–2014-7504, Swedish Research Council (VR) 2015–02926, Swedish Research Council (VR) 2018–02754, Swedish Brain Foundation, Swedish Alzheimer Foundation, Stockholm County Council ALF, Swedish Demensfonden, Stohnes foundation, Gamla Tjänarinnor, Karolinska Institutet Doctoral Funding and StratNeuro. H.Z. is a Wallenberg Scholar.

The use of the Industrial Internet of Things (IoT) is widespread, working as an enabler to implement large, scalable, reliable, and secure industrial environments. Although existing deployments do not meet security standards and have limited resources for each component which leads to several security breaches, such as trust between components, partner factories, or remote-control. These security failures can lead to critical outcomes, from theft of production information to forced production stoppages, accidents, including physical and others. The combination of blockchain-based solutions with IIoT environments is gaining momentum due to their resilience and security properties. However, chain-structured classic blockchain solutions are very resource-intensive and are not suitable for power-constrained IoT devices. To mitigate the mentioned security concerns, a secure architecture is proposed using a structured asynchronous blockchain DAG (Directed Acyclic Graph) that simultaneously provides security and transaction efficiency for the solution. The solution was modelled with special details in the use cases and sequence diagrams. Security concerns were integrated from the start, and a threat model was created using the STRIDE approach to test the security of the proposed solution. As a result, a flexible solution was been developed that significantly reduces the attack vectors in IIoT environments. The proposed architecture is versatile and flexible, is supported by an extensive security assessment, which allows it to be deployed in a variety of customizable industrial environments and scenarios, as well as to include future hardware and software extensions. This work has been supported by FCT – Fundação para a Ciência e Tecnologia within the Project Scope: UIDB/05757/2020. info:eu-repo/semantics/publishedVersion

Introduction Compensatory sweating (CS) is a common complication after thoracoscopic sympathectomy (TS) and is mainly associated with surgical technique. Our aim was to identify potential risk-factors for CS following TS for primary focal hyperhidrosis in children. Methods A retrospective, single-center review of all bilateral TS was performed between 2017 and 2019. Hyperhidrosis disease severity scale was used for pre-operative severity assessment. Post-operative evaluations were performed after three and six months. Results More than the 36-month period, 41 patients were submitted to T2–T4 TS, and 25 were females (60.9%). Median age at surgery was 15.5 years. CS was identified at the 3rd month in 17 (41%) children with most in the dorsolumbar region (56%). By the 6th month, there was a significant reduction in CS (41 to 32%, p = 0.02). The probability of resolution of CS by 6 months is about 50% in both the dorsolumbar and abdominal regions. Neither age, gender, body mass index, family history, or concomitant illnesses seemed to influence CS (p > 0.05). Axillary hyperhidrosis appears to be associated with the development of dorsolumbar CS (p = 0.037). Conclusion Thoracoscopic sympathectomy for PFH is a safe and effective procedure, but compensatory sweating can be a common and debilitating side effect. Age, gender, and body mass index do not appear to influence CS. Axillary hyperhidrosis may be related to the development of dorsolumbar CS. Level of evidence III.

Purpose: The purpose of this systematic review was to evaluate the survival rate, biological complications, technical complications, and clinical behavior of single crowns supported by teeth made up in monolithic zirconia with CAD/CAM technology. Study selection: An extensive electronic search was conducted through Medline/PubMed, Embase, and Cochrane Library databases. Additional manual search was performed on the references of included articles to identify relevant publications. Two reviewers independently performed the selection and electronic and manual search. Results: From nine articles included, there was a total of 594 participants and 1657 single-tooth restorations with a mean exposure time of 1.07 years, and follow-up period between 0.3 and 2.1 years. All studies showed a moderate level of quality, with a consequent moderate possibility of associated bias, using the Newcastle-Ottawa Scale (NOS), with survival rate (SR) ranging between 91% to 100%. Bleeding on probing (BOP) were reported with an average value of 29.12%. Marginal integrity showed high success rate values for the observation periods, except for one that included patients with bruxism which obtained a SR of 31.60%. Failures and/or fractures, mostly total and requiring replacement, were observed in three studies. Linear regression showed that there was no statistical correlation between survival rate and type of cementation and the average years of follow-up (p=0.730 e p=0.454). There was high heterogeneity between studies (I2 = 93.74% and Q = 79.672). Conclusions: Within the limitation of this study, monolithic zirconia might be considered as a possible option for restoring single crowns, especially in the posterior zone. info:eu-repo/semantics/publishedVersion

Surgical resection with lymphadenectomy and perioperative chemotherapy is the universal mainstay for curative treatment of gastric cancer (GC) patients with locoregional disease. However, GC survival remains asymmetric in West- and East-world regions. We hypothesize that this asymmetry derives from differential clinical management. Therefore, we collected chemo-naïve GC patients from Portugal and South Korea to explore specific immunophenotypic profiles related to disease aggressiveness and clinicopathological factors potentially explaining associated overall survival (OS) differences. Clinicopathological and survival data were collected from chemo-naïve surgical cohorts from Portugal (West-Europe cohort [WE-C]; n = 170) and South Korea (East-Asia cohort [EA-C]; n = 367) and correlated with immunohistochemical expression profiles of E-cadherin and CD44v6 obtained from consecutive tissue microarrays sections. Survival analysis revealed a subset of 12.4% of WE-C patients, whose tumors concomitantly express E-cadherin_abnormal and CD44v6_very high, displaying extremely poor OS, even at TNM stages I and II. These WE-C stage-I and -II patients tumors were particularly aggressive compared to all others, invading deeper into the gastric wall (P = .032) and more often permeating the vasculature (P = .018) and nerves (P = .009). A similar immunophenotypic profile was found in 11.9% of EA-C patients, but unrelated to survival. Tumours, from stage-I and -II EA-C patients, that display both biomarkers, also permeated more lymphatic vessels (P = .003), promoting lymph node (LN) metastasis (P = .019), being diagnosed on average 8 years earlier and submitted to more extensive LN dissection than WE-C. Concomitant E-cadherin_abnormal/CD44v6_very-high expression predicts aggressiveness and poor survival of stage-I and -II GC submitted to conservative lymphadenectomy.

Training-intensity distribution (TID) is considered the key factor to optimize performance in endurance sports. This systematic review aimed to: I) characterize the TID typically used by middle-and long-distance runners; II) compare the effect of different types of TID on endurance performance and its physiological determinants; III) determine the extent to which different TID quantification methods can calculate same TID outcomes from a given training program. The keywords and search strategy identified 20 articles in the research databases. These articles demonstrated differences in the quantification of the different training-intensity zones among quantification methods (i. e. session-rating of perceived exertion, heart rate, blood lactate, race pace, and running speed). The studies that used greater volumes of low-intensity training such as those characterized by pyramidal and polarized TID approaches, reported greater improvements in endurance performance than those which used a threshold TID. Thus, it seems that the combination of high-volume at low-intensity (≥ 70% of overall training volume) and low-volume at threshold and high-intensity interval training (≤ 30%) is necessary to optimize endurance training adaptations in middle-and long-distance runners. Moreover, monitoring training via multiple mechanisms that systematically encompasses objective and subjective TID quantification methods can help coaches/researches to make better decisions.

Background Physical activity is associated with reduced arterial stiffness, although such a relationship has not been reported in those with resistant hypertension. Therefore, this study aimed to determine the association between daily physical activity and arterial stiffness in patients with resistant hypertension. Methods Fifty-seven (57) patients with resistant hypertension (50.9% men), aged 58.8±9.4 years, were consecutively recruited. Arterial stiffness was evaluated using carotid-femoral pulse wave velocity (cf-PWV). Daily physical activity was objectively assessed with accelerometers during 7 consecutive days. Results Patients had a body mass index of 29.0±4.0 kg/m2 (84.3% overweight/obese) and were taking an average 4.5 antihypertensive medications. Overall, the cf-PWV was 9.2±2.4 m/s and the majority of participants (n=41, 71.9%) presented a cf-PWV Conclusions Higher daily levels of light-intensity and total physical activity were associated with lower arterial stiffness. Nonetheless, this association is weak and attenuated or abolished when adjusted for blood pressure and age. These results suggest that physical activity may play an important role as a lifestyle intervention for patients with resistant hypertension. Future studies with larger samples sizes are necessary to confirm this preliminary data.

This article addressed the importance of adopting space debris mitigation strategies based on Brazilian government policy. Key findings pointed out that space debris is an issue with social, environmental, and economic impacts on global scale. Additionally, the Brazilian Government guarantees national security and establishes its aerospace sovereignty. Findings pointed out the relevance of space debris mitigation as a crucial government policy to address the creation of general Brazilian space law, as well as the opportunity for investments in the space sector as a whole in order to provide the training of civilians and military in the development of equipment to remedy the problem. Discussion on case implications and future research recommendations compile the present work.

Low levels of concern about anthropogenic climate change have been attributed to a range of factors, some of which relate to education. These include people’s lack of understanding and engagement w...

Objetivo: Avaliar a relação entre o nível de atividade física, a sintomatologia climatérica e a qualidade de vida relacionada à saúde em mulheres na pós-menopausa. Métodos: O estudo transversal compreendeu 100 mulheres pós-menopáusicas que frequentavam um parque público de lazer. Aplicou-se um questionário referente às características sociodemográficas e clínicas. Utilizou-se o Menopause Rating Scale (MRS) para avaliar a sintomatologia climatérica e a qualidade de vida relacionada à saúde, e o International Physical Activity Questionnaire (IPAQ) (versão curta), para estimar o nível de atividade física. Resultados: A média de idade das mulheres foi de 56,8 anos. As mulheres insuficientemente ativas apresentaram escore geral mais elevado e por domínios do MRS que as fisicamente ativas, indicando maior intensidade de sintomas climatéricos (< 0,001). A maioria (83,3%) das mulheres fisicamente ativas apresentou maior nível de qualidade de vida relacionada à saúde, enquanto no grupo das insuficientemente ativas, apenas 10% obteve essa condição (< 0,001). As mulheres ativas tiveram 10,6 vezes mais chances de ter melhor qualidade de vida relacionada à saúde do que as insuficientemente ativas. Conclusão: A prática de atividades físicas regulares parece contribuir positivamente para a redução dos sintomas climatéricos e para melhor qualidade de vida relacionada à saúde em mulheres na pós-menopausa.

Introdução: Diante da demanda para a elaboração de estratégias de ensino adaptadas para realidade atual, o conhecimento sobre metodologias ativas de ensino-aprendizagem tem grande valor, para a educação médica. Há diversos tipos de metodologias ativas e aquelas baseadas em casos-problema tem sido implementadas na graduação médica de forma mais precoce; apesar de ser parte integrante e necessária do currículo das instituições de ensino médico, não há consenso sobre sua forma de orientação, aplicabilidade e avaliação. Propõe-se revisar a literatura sobre as metodologias de ensino-aprendizagem em ambientes reais, conhecendo seus benefícios e a aplicações. Materiais e Métodos: O presente estudo trata-se de uma revisão integrativa da literatura na qual foram incluídos 23 artigos e 1 capítulo de livro entre os anos 1992 e 2018, em língua portuguesa e inglesa, sendo exploradas as bases de dados PubMed, SciELO, Lilacs e Periódicos CAPES. Discussão: Os métodos propostos para orientação, avaliação e feedback são variados, adaptáveis e estão em constante modificação. “Preceptor em um minuto”, “O momento em cinco minutos” e “Método SNAPPS” são diferentes maneiras de discussão nesses cenários a fim de facilitar o processo de interação estudante-paciente-preceptor. Estratégias de aprendizagem em ambientes reais apresentam benefícios em relação ao aprendizado de conteúdos teóricos estritos, pois coloca o aluno em ambiente de atuação verídico e estimula a elaboração de raciocínio diagnóstico sistematizado, que exige a recuperação de conhecimentos prévios. Acredita-se que o profissional que seja formado com essas metodologias ativas terá um perfil de autonomia, autodidatismo e atitude profissional proativa e com base científica. Conclusão: Não há “regra prática” para inserção das metodologias ativas no currículo das universidades, seu uso deve ser adaptado à realidade e ao perfil de cada instituição. Ressalta-se que o professor/preceptor deve refletir sobre seus métodos de ensino, buscando entender sua metodologia e ressignificar a sua atuação, estimulando a busca de tarefas mais ativas e eficientes.

Case report

Background: Alport syndrome (AS) is a disease caused by mutations in COL4A3, COL4A4 or COL4A5, the genes that encode distinct chains of type IV collagen. The vast majority of cases present as an inherited disorder, although de novo mutations are present in around 10% of the cases. Methods: This non-systematic review summarizes recent evidence on AS. We discuss the genetic and pathophysiology of AS, clinical manifestations, histopathology, diagnostic protocols, conventional treatment and prognostic markers of the disease. In addition, we summarize experimental findings with novel therapeutic perspectives for AS. Results: The deficient synthesis of collagen heterotrimers throughout the organism leads to impaired basement membranes (BM) in several organs. As a result, the disease manifests in a wide range of conditions, particularly renal, ocular and auricular alterations. Moreover, leiomyomatosis and vascular abnormalities may also be present as atypical presentations. In this framework, diagnosis can be performed based on clinical evaluation, skin or renal biopsy and genetic screening, the latter being the gold standard. There are no formally approved treatments for AS, even though therapeutic options have been described to delay disease progression and increase life expectancy. Novel therapeutic targets under pre-clinical investigation included paricalcitol, sodium-glucose co-transporter- 2 inhibitors, bardoxolone methyl, anti-microRNA-21 oligonucleotides, recombinant human pentraxin-2, lysyl oxidase-like-2 blockers, hydroxypropyl-b-cyclodextrin, sodium 4-phenylbutyrate and stem cell therapy. Conclusion: AS is still a greatly under and misdiagnosed disorder. The pathophysiology is still not fully unnderstand and genetics of the disease have also some gaps. Up to know, there is no specific and effective treatment for AS. Further studies are necessary to establish novel and effective therapeutic protocols.

Objetivo: descrever o cuidado multiprofissional em saúde para as crianças e adolescentes com Diabetes Mellitus. Método: revisão integrativa, de caráter descritivo e qualitativo. Realizado na Scientific Electronic Library Online (SciELO) e Google acadêmico, com a coleta de dados em junho de 2021. Mediante critérios de inclusão e exclusão e cruzamento dos descritores, foram selecionadas 8 publicações sobre o tema. Os resultados foram expostos em dois quadros. Resultados e discussões: Prevaleceram artigos dos anos de 2020 sobre o tema. A maioria das revistas publicadas são da área da enfermagem. Educar em saúde, torna-se essencial no acompanhamento e manutenção da diabetes. O adoecimento das crianças e adolescentes com DM, repercute em toda a famí­lia. Conclusão: A abordagem multiprofissional é extremamente importante, por cuidar da criança/adolescente, mas de todos os envolvidos, orientando as intervenções e potencializando o cuidado no domicí­lio.

This article aims to understand, analyze and compare the procedures adopted in Brazil, the United States and Portugal to register a trademark. For this purpose, bibliographic research was carried out in the Web of Science and documentary research into the three official institutions of trademark registration, namely: INPI(Brazil), USPTO(United States) and INPI(Portugal). In order to understand the adopted procedures, a simulation of the trademark application was made in the e-Marcas (Brazil), TEAS (USA) and InpiOnline (Portugal) systems. In terms of navigability, the INPI (Portugal) InpiOnline System is the easiest to navigate and is the only one that offers the "Trademark on the Spot" service on its Portal, which allows for the immediate acquisition of a trademark without the need to go through the trademark application process. On the partnership issue, the USPTO (United States) has a support network with the Patent and Trademark Resource Centers (PTRC), which are part of the national network of public, state, and academic libraries designated to support the public with trademark and patent assistance. Among the main points in common, the following were identified: the availability of online systems for applying for trademark registration; the ease of conducting prior search in proprietary systems, and the use of the Nice classification to classify goods and services. Among the main differences are the estimated period to obtain the granting of the trademark registration; the types of trademarks allowed in each legislation; and the values of the fees to apply for a trademark registration.

Objective: The aim of this study was to evaluate the association between possible functional interleukin-10 (IL-10) polymorphisms, IL-10 expression and regulatory T cells (Tregs) frequency, and/or asthma severity in a sample of children and adolescents. Methods: This is a nested case-control genetic association study. The study sample consisted of children and adolescents aged 8–14 from public schools. Four polymorphisms of the IL-10 gene (rs1518111, rs3024490, rs3024496, rs3024491) were genotyped in asthmatic subjects and controls using real-time PCR. Tregs cells and IL-10 were analyzed in peripheral blood mononuclear cells by flow cytometry. The severity of asthma was defined according to the Global Initiative for Asthma (GINA) guideline. Results: One hundred twenty-three asthmatic subjects and fifty-eight controls participated in the study. The single nucleotide polymorphism (SNP) rs3024491 (T allele) showed association with asthma severity, presenting a higher frequency in patients in the moderate asthma group. The T allele of variant rs3024491 also showed an association with reduced IL-10 levels (p = 0.01) and with increased Tregs frequency (p = 0.01). The other variants did not present consistent associations. Conclusions: Our results suggest that moderate asthma is associated with a higher frequency of the T allele in the SNP rs3024491. In addition, the variant rs3024491 (TT) was associated with a reduction in IL-10 production and an increased percentage of Tregs cells, suggesting possible mechanisms that influence asthma severity.

Introduction: We describe characteristic findings on multimodal evaluation and the features of hemorrhage within a foveal cystoid space in a patient presenting cystoid macular edema secondary to Branch Retinal Vein Occlusion (BRVO). Case description: We report a case of a 64-year-old diabetic male patient presenting gradual blurry vision in the left eye. Fundoscopic findings were suggestive of BRVO, such as hard exudates and mild venous engorgement superotemporally and diffuse macular intraretinal hemorrhages. In the foveal area, there was cystoid edema with blood-fluid level (BFL) inside one of the cystoid spaces. Retina multimodal evaluation, including color, blue filter, and red-free fundus photography, fluorescein angiography, fundus autofluorescence, and spectral-domain optical coherence tomography (SD-OCT) B and C scan imaging, confirmed blood within foveal cystoid space. The patient underwent antiangiogenic therapy with significant improvement of macular edema and reduction of the cystoid space after 3 months. In addition, there was a resolution of visual symptoms. The cystoid space previously partially filled with blood, persisted, despite presenting smaller volume and medium reflectivity in the SD-OCT. Conclusions: Multimodal evaluation of blood-fluid level within foveal cystoid space in patients with BRVO has not been described previously. Identification of this sign may support the diagnosis of retinal vein occlusion in doubtful cases and further studies must be carried out to establish if the presence of BFL correlates with visual outcomes.

Background: Hyperuricemia is not only associated with the development of gout but also with renal and vascular dysfunction. The prevalence of this condition has already been studied in psoriasis, but there are a few studies that have been carried out in psoriatic arthritis (PsA). Some studies have shown an association with metabolic syndrome, while others with the extent of cutaneous involvement, but there are no studies that have evaluated the disease activity with compound indexes. Objective: The aim of the study was to determine if disease activity, measured by different composite scores, influences the levels of uric acid. Method: This was a cross-sectional, observational study, which included 52 PsA patients. Clinical assessments included dactylitis, tender and swollen joint counts, Psoriasis Area and Severity Index, Leeds Enthesis Index, Minimal Disease Activity and Disease Activity for Psoriatic Arthritis. Hyperuricemia was defined as serum uric acid levels ≥ 6mg/dL in females and ≥ 7mg/dL in males. Results: Among the 52 included patients, 55.76% were female. The mean age was 54.9 ± 11.6 years. Hyperuricemia occurred in 26.92%. Demographic data, diet, comorbidities and medication were similar between patients with and without hyperuricemia. Patients with hyperuricemia had higher waist circumference (p Conclusion: This study supports the notion that, in PsA, hyperuricemia is more related to metabolic factors than to disease activity.

Motivation theory is indispensable when discussing processes of learning. Learners who are motivated can learn almost everything. Students’ motivation is probably one of the most important factors for teacher effectiveness both for engagement in the learning process and high academic performance. To have effective environmental education, it is not only necessary to inform the public about the ocean but also to involve and engage them is essential. Motivation and engagement are some of the most commonly mentioned concepts in gamification, thus, a gamified application seems to have the necessary features to improve the motivation of students in the learning context of Ocean Literacy topics. The main aims of this work were: i) to understand through a systematic evaluation, how game elements affect the different motivation layers; and ii) to compare them in terms of enhancing the motivation to recycle among secondary school students (11-14 years). To measure students’ motivation, a pre-test and a post-test using a recycling situational motivation survey were administered in a classroom environment in Portugal and the UK. Findings show a trend regarding the effect of game elements mainly on the most autonomous forms of motivation. The different game elements, each one with different degrees of effects, were shown to have potential to increase motivation.

The conversion of D-ribose into its 2,3-O-isopropylidene derivative using ultrasonic irradiation is described. The ultrasound proved to be an excellent alternative as the energy source for the reac...

Os inibidores da enzima prolil hidroxilase induzida por hipóxia (HIF-PHI) é um agente terapêutico sob uma nova classe de fármacos que estimulam a resposta do corpo à hipóxia sem alterar a pressão parcial de oxigênio nos tecidos, o que suprime e induz os genes responsáveis ao processo hematopoiético. Esses agentes estimulantes de eritropoiese podem influenciar a saúde humana possibilitando novas oportunidades no tratamento de anemia com doença renal crônica, no entanto, os mesmos têm também chamando a atenção de atletas que buscam a melhoria da performance. O objetivo deste estudo foi descrever por meio de uma revisão de literatura os fatores fisiológicos e terapêuticos dos inibidores da HIF-PHI na saúde, e no desempenho desportivo. Realizou-se um levantamento a partir de bancos de dados PubMed, Lilacs, Scopus e ScienceDirect entre os anos de 2011 a 2019. As palavras-chave empregadas foram, HIF stabilizers, HIF-PHI, FG-4592 e high performance.Os resultados mostraram que os HIF-PHI podem influenciar positivamente a saúde e o desempenho esportivo,por estímulo na producão de células vermelhas do sangue, favorecendo assim uma maior oferta de oxigênio no organismo. Um diferencial dessa classe de fármacos é de diminuirem os níveis de hepcidina não causando deficiência nos estoques de ferro no organismo. Outros efeitos foram a diminuição do colesterol total e LDL, e possíveis reduções nos níveis de pressão arterial. São necessários mais estudos que envolvam essa classe de fármacos nos seres humanos, visto que os mesmos podem ser efetivos no tratamento de algumas patologias, melhorando assim, a qualidade de vida da população.

Introduction: Thymomas, by virtue of T-cell maturation derangement, are frequently accompanied by parathymic syndromes. Classically, Good’s syndrome characterizes immunodeficiency in patients with thymoma, comprising of hypogammaglobulinemia and various degrees of T-cell impairment; however, these patients frequently suffer from additional iatrogenic effects of chemotherapy or immunosuppressors used to control autoimmune phenomena. As a result, they often exhibit signs of decreased bone marrow response and cytopenias, leading to opportunistic infections such as cytomegalovirus (CMV) reactivation, whose role in perpetuating the state of immunodeficiency may be under-explored. Case Report: We describe the case of a 62-year-old man with a thymoma who exhibited several paraneoplastic syndromes, including Good’s syndrome. The patient had also been diagnosed with sigmoidal adenocarcinoma, previously medicated with capecitabine and was currently medicated with corticosteroids and azathioprine, placing an additional strain on his already compromised immune system. After being inadvertently exposed to the combination of azathioprine and allopurinol, he developed pancytopenia with little response to granulocyte-colony stimulating factor (G-CSF) after withdrawal of the offending agents. A high CMV viral load was suspected as a cause for perpetuating leukopenia. Treatment with ganciclovir resulted in bone marrow recovery, and immunoglobulin replacement together with antibiotic and antiviral prophylaxis prevented other serious infections until thymectomy and completion of chemotherapy. Conclusion: This case exemplifies many of the complexities in managing patients with thymomas, particularly when balancing autoimmunity and immune suppression. Cytomegalovirus reactivation is not unusual in this context and cytopenias may be the only manifestation. Although treatment of symptomatic disease is beneficial, the role of prophylaxis is not yet consensual due to its potentially myelosuppressive effects.

ACE2 and TMPRSS2 are key players on SARS-CoV-2 entry into host cells. However, it is still unclear whether expression levels of these factors could reflect disease severity. Here, a case–control study was conducted with 213 SARS-CoV-2 positive individuals where cases were defined as COVID-19 patients with respiratory distress requiring oxygen support (N = 38) and controls were those with mild to moderate symptoms of the disease who did not need oxygen therapy along the entire clinical course (N = 175). ACE2 and TMPRSS2 mRNA levels were evaluated in nasopharyngeal swab samples by RT-qPCR and logistic regression analyzes were applied to estimate associations with respiratory outcomes. ACE2 and TMPRSS2 levels positively correlated with age, which was also strongly associated with respiratory distress. Increased nasopharyngeal ACE2 levels showed a protective effect against this outcome (adjOR = 0.30; 95% CI 0.09–0.91), while TMPRSS2/ACE2 ratio was associated with risk (adjOR = 4.28; 95% CI 1.36–13.48). On stepwise regression, TMPRSS2/ACE2 ratio outperformed ACE2 to model COVID-19 severity. When nasopharyngeal swabs were compared to bronchoalveolar lavages in an independent cohort of COVID-19 patients under mechanical ventilation, similar expression levels of these genes were observed. These data suggest nasopharyngeal TMPRSS2/ACE2 as a promising candidate for further prediction models on COVID-19.

Startups developed through academic Spin-offs foster the development of products and processes inside and outside the innovation ecosystem that originated them and have become an important research topic with regard to Technology Transfer mechanisms and University-Company cooperation. Therefore, the objective of this article was to bring up information that could contribute to the discussion on academic spin-offs, startups and the benefits initially generated by this cooperation. The adopted methodology was the exploratory descriptive, aiming the perception in the literature used in some arguments and data that would help the understanding of this relationship. In view of this, the results show us that there is a large number of qualified personnel within these firms and that this intellectual capital cooperates with the positive impact on a country's economic and social development.

Introduction: In studies directed to children and adolescents, the sedentary behavior has been usually represented by exposure to screen, which comprise the total or separate measured time exposed to television, videogame, tablets, mobile devices, and computer. Objective: To analyze the prevalence and factors associated with screen time in children and adolescents. Methods: A cross-sectional school-based study was carried out with 1,471 students from Elementary School, aged between 7 to 18 years (51.3% male), enrolled at public schools (55.6%) in Porto Velho, Rondônia (RO) state, Brazil. Excess screen time was defined as watching television, using the computer, and playing video games for more than two hours per day. Poisson regression was used to obtain crude and adjusted prevalence ratios and their respective 95% CI. Results: Overall prevalence of screen time exposure over two hours per day was 65.9%. After adjustments, risk of screen time exposure was higher in males, PR = 1.51 (95% CI: 1.08 - 1.92), under or equal to 14 years old, PR = 1.69 (95% CI: 1.48 - 1.92), in the 5th grade, PR = 1.41 (95% CI: 1.02 - 1.89), in the 6th grade, PR = 1.44 (95% CI: 1.06 - 1.97) and in the 7th grade, PR = 1.52 (95% CI: 1.09 - 2.13), attending two weekly PE classes or fewer, PR = 1.25 (95% CI: 1.07 - 1.53) ), consuming more than 3 daily meals, PR = 2.69 (95% CI: 2.14 - 3.37) and overweight, PR = 1.51 (95% CI: 1.13 - 2.03). Conclusion: The findings showed that the exposure equal to or more than two hours of daily screen time was high. The students more exposed to this outcome had the next characteristics: male sex, age less than or equal to 14 years, from the fifth, sixth, and seventh grade of elementary education, practice physical education classes less than or equal to two hours per week, consume more than three meals daily and have excess body fat (G%).

This work aims to show the deployment of a Group of Pregnant Women developed in a Primary Health Care Unit (PHCU) of Regional V. Firstly, a strategy was started for early capture, prenatal care, stratification and the entire development of care for prenatal. The collection took place collectively, through visits by Community Health Agents (CHA), in the visits to the unit and early identification of suspected pregnancy, the examination was carried out. Finding pregnancy, the first consultation was held in partnership between psychology and nursing, starting with anamnesis of pregnancy, raising awareness about sexually transmitted infectious diseases, application of the rapid test and scheduling for the group of pregnant women. During the meetings, experiences and difficulties related to the gestational period were shared, covering topics such as breast care and the newborn. The pregnant women got interest and realized the relevance of the group, maintaining attendance to the meetings. An average of 102 pregnant women were monitored during the period from January to December 2019, which effectively prevents and promotes health in the Family Health Strategy (FHS) linked to the Extended Family Health Center (EFHC).

Objetivo: analisar as publicações cientí­ficas acerca dos cuidados de enfermagem ao paciente de cirurgia cardí­aca. Método: Trata-se de uma revisão integrativa da literatura, da modalidade exploratória, descritiva, com abordagem qualitativa. Foi realizada no perí­odo de agosto a outubro de 2020, nas seguintes bases de dados, indexadas a Biblioteca Virtual de Saúde: SciELO, LILACS e MEDLINE. Foram selecionadas 07 publicações, e estas foram analisadas, e organizadas em dois quadros, contendo: tí­tulo, autores, ano de publicação, e os cuidados de enfermagem na cirurgia cardí­aca. Resultados: O enfermeiro, junto com sua equipe, acompanha o paciente em todas as etapas da cirurgia cardí­aca, e realiza cuidados na alimentação, orientação e acolhimento da famí­lia, esclarecimentos para o procedimento, exame fí­sico e sistematização da assistência de enfermagem. Conclusão: os cuidados de enfermagem são essenciais na cirurgia cardí­aca, e que ainda é necessário novas pesquisas que fortaleçam e evidenciem esse cuidado.

Zoledronic acid (ZA) is often prescribed for osteoporosis or resorptive metabolic bone disease. This study aims to evaluate the effect of ZA on orthodontic tooth movement (OTM) and root and bone resorption and its repercussion on root, periodontal ligament and alveolar bone tissues. The experimental group consisted of 72 Wistar rats divided in four subgroups: Naive, Saline and Zoledronic Acid groups at the concentration of 0.2 mg/kg [ZA (0.2)] or 1.0 mg/kg [ZA (1.0)]. The animals were subjected to i.v (dorsal penile vein) administrations of ZA or saline solution, on days 0, 7, 14 and 42. Under anesthesia, NiTi springs were installed in the first left maxillary molar with 50gf allowing the OTM, except for the negative control group (N) for mesial movement of the left first maxillary teeth. The animals were sacrificed and maxillae were removed for macroscopic and histopathological analyzes, scanning electron microscopy, computerized microtomography and confocal microscopy. Treatment with ZA decreased the OTM and the number of osteoclasts and loss of alveolar bone when compared to the naive and saline groups. Reduction of radicular resorption, increased necrotic areas and reduced vascularization in the periodontal ligament were observed in the ZA groups. ZA interferes with OTM and presents anti-resorptive effects on bone and dental tissues associated with a decreased vascularization, without osteonecrosis.

Purpose Optimization of CT scan practices can help achieve and maintain optimal radiation protection. The aim was to assess centering, scan length, and positioning of patients undergoing chest CT for suspected or known COVID-19 pneumonia and to investigate their effect on associated radiation doses. Methods With respective approvals from institutional review boards, we compiled CT imaging and radiation dose data from four hospitals belonging to four countries (Brazil, Iran, Italy, and USA) on 400 adult patients who underwent chest CT for suspected or known COVID-19 pneumonia between April 2020 and August 2020. We recorded patient demographics and volume CT dose index (CTDIvol) and dose length product (DLP). From thin-section CT images of each patient, we estimated the scan length and recorded the first and last vertebral bodies at the scan start and end locations. Patient mis-centering and arm position were recorded. Data were analyzed with analysis of variance (ANOVA). Results The extent and frequency of patient mis-centering did not differ across the four CT facilities (>0.09). The frequency of patients scanned with arms by their side (11–40% relative to those with arms up) had greater mis-centering and higher CTDIvol and DLP at 2/4 facilities (p = 0.027–0.05). Despite lack of variations in effective diameters (p = 0.14), there were significantly variations in scan lengths, CTDIvol and DLP across the four facilities (p Conclusions Mis-centering, over-scanning, and arms by the side are frequent issues with use of chest CT in COVID-19 pneumonia and are associated with higher radiation doses.

Background. The objective of this study was to evaluate the clinical and microbiological efficacies of (C. langsdorffii) dental varnish in children at high risk of dental caries.. Methods. This is a longitudinal, randomized, controlled clinical trial. Ninety high-risk caries-free children (ICDAS II = 0) were recruited and randomly divided into three groups: C. langsdorffii, chlorhexidine, or fluoride. The varnishes were applied on the second deciduous molars for three times: baseline (D0), after 90 days (D90), and after 180 days (D180). Saliva was collected on D0, D90, D180, and D360 to evaluate S. mutans reduction. Statistics were carried out by ANOVA, Tukey’s test, and the paired t-test. Results. Copaiba varnish demonstrated significant S. mutans reduction: D360 versus D0 p < 0.0001 , D180 versus D0 p < 0.001 , D360 versus D90 p < 0.001 , D180 versus D90 p < 0.001 , and D360 versus D180 p < 0.05 . Chlorhexidine varnish significantly reduced S. mutans at D180 versus D0 p < 0.05 . Fluoride reduced at D180 versus D0 p < 0.001 . Conclusions. Three annual applications of this varnish showed substantial antimicrobial activity against S. mutans and caries prevention for up to 12 months.

The determination of mechanical and fracture properties of anisotropic tubular materials along hoop direction needs the use of the ring hoop tensile test, for which, the obtained results are deceived by the effect of friction between the ring sample and the D-shaped block mandrel. Commonly, lubricants are applied to reduce the friction, which are inefficient in some specific cases; despite of that, it was noticed that scarce works have focused on the development of new mechanical mandrel designs or trying to improve the current ones to resolve the friction concern. The aim of this research is to correctly address the friction issue between the ring sample and the fixture mandrel to significantly reduce its effect on the ring hoop tensile test results without using any kind of lubricants. New mechanical design of D-shaped block mandrels are developed to carry out ring hoop tensile tests to simply characterize the mechanical behaviour of tubular materials. New mechanical D-shaped block mandrels were designed, manufactured and used to carry out experimental ring hoop tensile tests. An inverse identification method based on an artificial neural network trained by finite element simulation responses, was developed to efficiently segregate the flow stress curve from the influence of the friction, inherent in the global force-displacement curve for the classical ring hoop tensile test. The experimental force – displacement curves using five mandrel-types are established and quantitatively compared on the base of their ability to reduce the friction issue. The analysis of the finite element simulations, related to the investigation of the influence of the friction on the ring hoop tensile test results, shows that one of the new developed mandrels reduces the friction coefficient by about 10 times compared to that identified using the classical D-shaped block mandrel. It has been found that, the finite element simulation of ring hoop tensile test using the identified material parameters matches the experimental results. This investigation provides a useful fixture mandrel, which is able to drastically reduce the friction without resort to any lubricants to just determine the material flow stress curve using ring hoop tensile test, regardless the friction level between the sample and mandrel.

O uso de ferramentas de marketing é de extrema importância para a disseminação de diversos serviços, devendo-se no cenário atual incluir tais ferramentas nos serviços de informação disponibilizados por bibliotecas. O artigo teve como objetivo descobrir e apresentar as técnicas de marketing aplicadas a Biblioteca Padre Joaquim Colaço Dourado, e sua importância para o bom desenvolvimento no atendimento de seus usuários por meio da construção e instalação de um planejamento de marketing que venha suprir as necessidades de seus gestores e usuários. O estudo se apresenta como uma pesquisa de campo qualitativa, e análise fundamentada na técnica do Discurso do Sujeito Coletivo. Os resultados apontam para o uso eficiente e eficaz das ferramentas de marketing, principalmente por meio das redes sociais, concluindo-se que os mesmos proporcionam atingir um maior público, com a possibilidade de obter resultados de pesquisas de satisfação, a divulgação de treinamentos, visibilidade dos serviços pelo site institucional, aumentando assim as visitas e interação nos eventos realizados pela instituição, maior participação da comunidade acadêmica, aumentando a comunicação e relacionamento interpessoal com toda comunidade, que é de fundamental importância para aumentar o números de pessoas atendidas pelo espaço da biblioteca.

PurposeThis study conducts a systematic literature review (SLR) on serious games in the BPM domain, in order to answer: RQ1 – what are BPM games' learning objectives and design characteristics? RQ2 – How rigorously each BPM game was evaluated in terms of their effectiveness and entertainment?.Design/methodology/approachWe followed the PRISMA statement method and systematic literature review standards. Selected studies were analyzed using qualitative evidence synthesis.FindingsWe found 37 references that describe 15 serious games within the BPM domain. Games are diverse, ranging from analog games that need a few hours to complete to complex digital games that require many sessions. Game evaluation should be generally improved as 27 publications can be considered as quasi-experimental or nonexperimental and potentially biased.Research limitations/implicationsFuture research should focus on developing new games about process implementation and using other notations besides BPMN. More studies testing the reliability and validity of existing games in different settings and using more rigorous experimental designs are also necessary. Practitioners can identify thoroughly evaluated games relevant to their learning objectives.Originality/valueThis is the first SLR about BPM games. It consolidates the literature, analyzes, describes and categorizes 15 games with respect to their internal characteristics and evaluation reliability.