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Bariatric surgery is one of the treatments for severe obesity, with proven efficacy in reducing weight and diseases associated with obesity. Weight loss associated with bariatric surgery is greatly associated with a significant reduction of skeletal muscle and bone mineral mass, which leads us to induce that after bariatric surgery, patients incur an increased risk of sarcopenia. The need for prophylactic programs that prevent sarcopenia in bariatric surgery patients seems to be one of the crucial points for the long-term surgical success of bariatric and metabolic surgery. The aim of this randomized clinical trial will be to study the effects of a 16-week supervised exercise intervention program on the prevention of sarcopenia, in patients undergoing bariatric surgery. As a secondary purpose, it is also intended to characterize metabolic risk factors, physical fitness, and quality of life in post-bariatric surgery patients.A total of 45 patients on the waiting list for bariatric surgery and who have subsequently perfurgery, will be include on EXPOBAR (This study will provide the effects of a physical exercise on sarcopenia, in patients after bariatric surgery.The trial was registered at Clinicaltrials.gov NCT03497546.

Background Disordered mineral and bone metabolism is a common complication of chronic kidney disease (CKD). Bone biopsy remains the gold standard tool for evaluating renal osteodystrophy (ROD), but it is an invasive procedure. Despite a growing interest in the ability of newer bone biomarkers to discriminate between different forms of ROD, data on pre-dialysis patients are scarce. Methods A cross-sectional study was conducted in a cohort of 56 patients with CKD Stages 3 and 4. Participants underwent a transiliac bone biopsy after a course of double tetracycline labelling. Circulating levels of Wnt signalling inhibitors sclerostin and Dickkopf-1 (DKK1), soluble receptor activator of nuclear factor-κB ligand (sRANKL) and osteoprotegerin were measured and correlated with histomorphometric analysis results. Results Most patients had abnormal bone histology and low-turnover bone disease was the predominant form of ROD. Characteristics associated with high bone turnover were worse renal function, lower serum calcium and higher intact parathyroid hormone and fibroblast growth factor-23 levels. Patients with low bone turnover, on the other hand, presented with higher sclerostin along with lower DKK1 and sRANKL levels. In the multivariable logistic regression analysis, sclerostin and DKK1 levels were independently associated with low-turnover bone disease. Conclusions Our results suggest that circulating levels of Wnt signalling inhibitors sclerostin and DKK1 are predictive of low-turnover bone disease in patients not yet on dialysis. Further research is needed to assess the performance of these bone turnover biomarkers, compared with histomorphometric analysis, in the diagnosis and treatment monitoring of ROD., Graphical Abstract Graphical Abstract

The transition to motherhood is a deeply personal experience that can have an effect on women’s psychological, social, and spiritual sense of self. This qualitative study explored women’s lived experiences of their transition to motherhood and the role that spirituality plays in the process of transformation. Six women, two with postpartum depression, were interviewed on their experiences of pregnancy, childbirth, early motherhood, and spirituality. Interpretative phenomenological analysis was used to analyze interview data and identify emergent themes in women’s experiences of motherhood. Two superordinate themes emerged—Reality of Motherhood and Motherhood Awakens Spirituality. Spirituality was “centered” in the women’s overall experience of motherhood. The women emphasized the importance of spiritual connections to others and the divine in their understanding of what it means to be a mother. The women with postpartum depression described similar but more intense experiences in their transition to motherhood in comparison to women who did not have postpartum depression. The findings highlight how the experiences of motherhood and spirituality mutually influence each other toward the development of an integrated identity as mother. Clinicians need to attend to the potential positive and negative roles of spirituality in women’s transition to motherhood and intervene early to address any indications of emotional or spiritual struggle in women’s adjustment.

Background: Dementia due to Alzheimer’s disease (AD) is a complex neurodegenerative disorder, which much of heritability remains unexplained. At the clinical level, one of the most common physiological alterations is the slowing of oscillatory brain activity, measurable by electroencephalography (EEG). Relative power (RP) at the conventional frequency bands (i.e., delta, theta, alpha, beta-1, and beta-2) can be considered as AD endophenotypes. Objective: The aim of this work is to analyze the association between sixteen genes previously related with AD: APOE, PICALM, CLU, BCHE, CETP, CR1, SLC6A3, GRIN2 β, SORL1, TOMM40, GSK3 β, UNC5C, OPRD1, NAV2, HOMER2, and IL1RAP, and the slowing of the brain activity, assessed by means of RP at the aforementioned frequency bands. Methods: An Iberian cohort of 45 elderly controls, 45 individuals with mild cognitive impairment, and 109 AD patients in the three stages of the disease was considered. Genomic information and brain activity of each subject were analyzed. Results: The slowing of brain activity was observed in carriers of risk alleles in IL1RAP (rs10212109, rs9823517, rs4687150), UNC5C (rs17024131), and NAV2 (rs1425227, rs862785) genes, regardless of the disease status and situation towards the strongest risk factors: age, sex, and APOE ɛ4 presence. Conclusion: Endophenotypes reduce the complexity of the general phenotype and genetic variants with a major effect on those specific traits may be then identified. The found associations in this work are novel and may contribute to the comprehension of AD pathogenesis, each with a different biological role, and influencing multiple factors involved in brain physiology.

This case study aims to identify the demand for professional education courses in the city of Itaporã, in the state of Mato Grosso do Sul, in the year 2020, offering a cross-cutting diagnosis of this educational panorama; for this purpose, the technique of guided interview in loco was implemented with the action coordinating agents designated by the municipal administration. All those involved were aware of their free and voluntary collaboration. During the entire collection phase, the information was recorded through a free association chart which, later revised, gave basis to the identification that in the disclosure phase there is no time to contact the possible students taking into account that, besides the districts, the municipality aggregates a vast rural region. In addition, the fact that the course is offered only at night, ends up discouraging the participation of some potential students who, despite showing interest, need to pay attention to their labor routines. It is concluded that a greater concern is needed to create a database of course graduates in order to establish a periodic sense capable of identifying professional life after the course, in addition to profiling the demand for skilled labor in order to detect which training is important at the moment.

“Homosexualism”, “sexual orientation disorder”, “egodistonic homosexuality”, “unspecified sexual disorder”, “sexual maturity disorder” and “sexual relationship disorder”. Since 1948, these have been, throughout the history of the Diagnostic and Statistical Manual of Mental Disorders (DCM) and the International Statistical Classification of Diseases and Related Health Problems (ICD), the terms used by the scientific community to categorize the homoaffective spectrum until in 2017, in the face of strong social and academic demand, their complete disengagement from any terminology that categorizes them as physical and/or mental illness. On the other hand, some areas of science have contributed substantially to a better understanding of this subject, such as genetics and epigenetics. Today, although the scientific community still offers some points of resistance, especially in more conservative countries, it is a consensus that since the implementation of the genome project there has been a considerable methodological expansion that has opened new possibilities of studies that have allowed this advance.

Background:Nurses are the largest regulated group of healthcare professionals involved in palliative care. In 2004, a taskforce of the European Association for Palliative Care (EAPC) launched the ‘Guide for development of palliative nurse education in Europe’ (hereinafter, the EAPC 2004 Guide). No systematic evaluation of its impact in the development of palliative care education was undertaken.Aims:To describe current undergraduate and postgraduate nursing education across Europe; to identify the roles that nurses with different palliative care educational levels have in palliative care; and to assess the uptake of the EAPC 2004 Guide in the development of palliative care nursing in Europe.Design:Descriptive research involving an online survey among nursing experts, and the consultation of national representatives.Setting/participants:A total of 135 nurses (52% response rate) from 25 countries completed the online survey; representatives from 16 countries were consulted.Results:In 14 (56%) countries, palliative care was not identified as a mandatory subject within undergraduate nursing education. The EAPC 2004 Guide is widely known and was/is being used in many countries to promote palliative care nursing education. Large variations were found across and within country responses.Conclusions:Palliative care nursing education varies largely in Europe. The wide awareness and use of the EAPC 2004 Guide show how policy measures can influence the development of palliative care education. Recommendations are built and focus on both fostering the use of this guide and implementing policy measures to ensure that palliative care nursing is recognised and certified as a specialty in all European countries.

The present study aimed to identify the hierarchy of work values from higher education students in the areas of health and business management. The study used the Labor Values Scale (LVS), from Porto and Tamayo (2003) as a research and diagnostic tool. The study sample consisted of 335 students from a private college from the areas of health and business, aged over 17 years. The results show that the priority of values begins with stability, followed by fulfilment at work.

Introduction: Bariatric surgery is the treatment of severe obesity with associated pathologies, with proven evidence in its benefits. By treating overweight allows a better and even reversal of pathologies associated with obesity. Weight loss associated with bariatric surgery is greatly associated with a significant reduction of skeletal muscle and bone mineral mass, which leads us to induce that after bariatric surgery, patients incur an increased risk of sarcopenia. The need for prophylactic programs that prevent sarcopenia in bariatric surgery patients seems to be one of the crucial points for the framing of long-term surgical success of bariatric and metabolic surgery. The aim of this randomized clinical trial will be to study the effects of a 16-week supervised exercise intervention program on the prevention of sarcopenia after bariatric surgery Method: This randomized controlled trial study will include 60 patients of both sexes on the waiting list for bariatric surgery and who have subsequently performed the surgery. They will be randomized into 2 groups, experimental and control. The intervention will take place 1 month after surgery, for a total of 16 weeks. Parameters of body composition, metabolic risk, quality of life, physical activity and sedentary behavior will be determined. Results: Assessments will take place in five moments, the surgery, the intervention, the post-intervention, six months after the intervention, twelve months after the intervention.

Migraine is a complex neurovascular disorder affecting one billion people worldwide, mainly females. It is characterized by attacks of moderate to severe headache pain, with associated symptoms. Receptor activity modifying protein (RAMP1) is part of the Calcitonin Gene-Related Peptide (CGRP) receptor, a pharmacological target for migraine. Epigenetic processes, such as DNA methylation, play a role in clinical presentation of various diseases. DNA methylation occurs mostly in the gene promoter and can control gene expression. We investigated the methylation state of the

Background: Postmenopausal women have an elevated risk of developing cardiovascular diseases, which can be counteracted by conventional exercise regimes or recreational football. Less is known about the impact of exercise programmes based on other team sports. Thus, we examined the effects of recreational team handball on aerobic performance, cardiorespiratory fitness and cardiometabolic health in untrained postmenopausal women. Methods: Sixty-seven participants (age 68 ± 6 years, stature 157 ± 6 cm, body mass 67 ± 10 kg, fat mass 37 ± 7%, VO2peak 25.2 ± 3.6 mL/min/kg, Yo-Yo intermittent endurance level 1 test performance (YYIE1) 230 ± 103 m) with no previous experience of team handball were randomly allocated to either a team handball (THG, n = 41) or a control (CG, n = 26) group. THG performed 2-3 60-min training sessions per week for 16 weeks. YYIE1 performance and cardiometabolic markers were evaluated at baseline and post-intervention. Results: Average attendance during recreational team handball training was 1.9 ± 0.4 sessions per week, with mean heart rates of 76 ± 6%HRmax and 18 ± 9 min (44 ± 20% of total time) played at HR > 80%HRmax. A between-group effect was observed for YYIE1 performance, with a more pronounced improvement in aerobic exercise performance in THG compared to CG (70 ± 62 vs 15 ± 44%; p < 0.001). Within-group improvements (p < 0.05) were observed for THG with regard to VO2peak (7 ± 10%), incremental treadmill test time to exhaustion (TTE) (11 ± 14%), total cholesterol (-3 ± 9%) and low-density lipoprotein cholesterol (-2 ± 14%), with no significant changes in CG except an increase (p < 0.05) in TTE. Post-intervention values were higher for THG vs CG for YYIE1 performance (88%; 406 ± 216 vs 216 ± 75 m) and VO2peak (10%; 27.5 ± 3.8 vs 24.9 ± 3.6 mL/min/kg). Conclusions: Recreational team handball can be used to obtain moderate-to-vigorous aerobic intensities, and just 2 weekly 60-min team handball training sessions for 16 weeks can result in improvements in aerobic performance and in markers of cardiorespiratory fitness in postmenopausal women with no previous experience of the sport. RP is supported by a grant from the Portuguese Foundation for Science and Technology (SFRH/BD/136789/2018). This study is part of the Handball for Health project, which has the support of the Portuguese Handball Federation, the European Handball Federation and Gaia City Hall. We would like to thank all the participants for their committed participation. We would also like to express our gratitude to the students and technicians of the University Institute of Maia and Faculty of Sport, University of Porto, who collaborated in the data collection and provided technical assistance, and to Henrik Holm Andersen from Copenhagen Translation for the language editing.

Predictions of mortality may help in the selection of patients who benefit from intensive care. Endothelial dysfunction is partially responsible for many of the organic dysfunctions in critical illness. Reactive hyperaemia is a vascular response of the endothelium that can be measured by peripheral arterial tonometry (RH-PAT). We aimed to assess if reactive hyperaemia is affected by critical illness and if it correlates with outcomes. Prospective study with a cohort of consecutive patients admitted to an Intensive Care Unit. RH-PAT was accessed on admission and on the 7th day after admission. Early and late survivors were compared to non-survivors. The effect of RH-PAT variation on late mortality was studied by a logistic regression model. The association between RH-PAT and severity scores and biomarkers of organic dysfunction was investigated by multivariate analysis. 86 patients were enrolled. Mean ln(RHI) on admission was 0.580 and was significantly lower in patients with higher severity scores (p

O objetivo do estudo consiste em analisar o Clima Organizacional da Secretaria Municipal de Assistência Social de Laurentino, Santa Catarina. O desenvolvimento de um Clima Organizacional é um dos maiores desafios dos atuais gestores, tanto na esfera privada, quanto na esfera pública. O estudo emprega a abordagem qualitativa, além da pesquisa de campo e das pesquisas exploratória, descritiva e bibliográfica. A coleta de dados foi realizada mediante a aplicação de um questionário baseado nos Modelos de Lickert (1961), Litwim e Stinger (1968) e Colossi (1991), com seis servidores. Os resultados apresentam falhas significativas pertinentes à comunicação, condições de trabalho, relação com a chefia, remuneração e crescimento profissional.

Over the years, the number of researches and studies focused on psychosomatic diseases are greater and, each time, but based on scientific input. These studies are related to emotions, feelings and thoughts that may be out of balance with several factors, such as traumatic experiences, somatizations and episodes of stress. Renowned authors, such as Sigmund Freud(1956 –1939)and contemporaries like Mello Filho, identified that the body can become ill as a result of emotional problems, since the organism is constituted by a partnership between mind-body that interact with cultural, social and environmental factors. These diseases are the result of harmonic imbalance or deregulation of the fields of the mind, body and external environment. This article aimed, through bibliographic and descriptive research, to present the manifestation of psychosomatic symptoms, relating stress to work activities and proposing ways to combat this type of illness. We observed that psychosomatic illnesses can be linked to stress arising from the work environment, causing physical symptoms, including nausea, insomnia, flu, migraine allergies, sweating, among others. However, we understand that a cultural and social change in the way we look at the worker is necessary, factors that imply strategies and organizational alternatives that seek to avoid and alleviate these symptoms. Daily activities carried out by the institutions, as alternatives for the individual to understand the meaning of their work, to be calm and satisfied with their functions,as well,as with the challenges inherent to work, can help in minimizing psychosomatic symptoms.

Machado-Joseph disease (MJD/SCA3) is the most common form of dominantly inherited ataxia worldwide. The disorder is caused by an expanded CAG repeat in the ATXN3 gene. Past studies have revealed that the length of the expansion partly explains the disease age at onset (AO) variability of MJD, which is confirmed in this study (Pearson's correlation coefficient R2 = 0.62). Using a total of 786 MJD patients from five different geographical origins, a genome-wide association study (GWAS) was conducted to identify additional AO modifying factors that could explain some of the residual AO variability. We identified nine suggestively associated loci (P < 1 × 10-5). These loci were enriched for genes involved in vesicle transport, olfactory signaling, and synaptic pathways. Furthermore, associations between AO and the TRIM29 and RAG genes suggests that DNA repair mechanisms might be implicated in MJD pathogenesis. Our study demonstrates the existence of several additional genetic factors, along with CAG expansion, that may lead to a better understanding of the genotype-phenotype correlation in MJD. FA and CL were funded by the Fonds de Recherche du Québec–Santé. SM is funded by FCT (CEECIND/00684/2017) and by NORTE-01-0145- FEDER-000008, supported by Norte Portugal Regional Programme (NORTE 2020), under the PORTUGAL 2020 Partnership Agreement, through the European Regional Development Fund (ERDF). FM and LI are funded by Fundaçao de Amparo a Pesquisa do Estado de São Paulo (FAPESP, 2013/07559-3). MLSP and LBJ were funded by Conselho Nacional de Desenvolvimento Científico e Tecnológico, Brazil (CNPq) and by Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES). GAR holds a Canada Research Chair in Genetics of the Nervous System and the Wilder Penfield Chair in Neurosciences.

Untranslated regions are involved in the regulation of transcriptional and post-transcriptional processes. Characterization of these regions remains poorly explored for ATXN3, the causative gene of Machado-Joseph disease (MJD). Although a few genetic modifiers have been identified for MJD age at onset (AO), they only explain a small fraction of the AO variance. Our aim was to analyse variation at the 3'UTR of ATXN3 in MJD patients, analyse its impact on AO and attempt to build haplotypes that might discriminate between normal and expanded alleles.After assessing ATXN3 3'UTR variants in molecularly confirmed MJD patients, an in silico analysis was conducted to predict their functional impact (e.g. their effect on miRNA-binding sites). Alleles in cis with the expanded (CAG)n were inferred from family data, and haplotypes were built. The effect of the alternative alleles on the AO and on SARA and NESSCA ataxia scales was tested.Nine variants, all previously described, were found. For eight variants, in silico analyses predicted (a) deleterious effects (rs10151135; rs55966267); (b) changes on miRNA-binding sites (rs11628764; rs55966267; rs709930) and (c) alterations of RNA-binding protein (RBP)-binding sites (rs1055996; rs910369; rs709930; rs10151135; rs3092822; rs7158733). Patients harbouring the alternative allele at rs10151135 had significantly higher SARA Axial subscores (p = 0.023), comparatively with those homozygous for the reference allele. Ten different haplotypes were obtained, one of which was exclusively found in cis with the expanded and four with the normal allele. These findings, which are relevant for the design of allele-specific therapies, warrant further investigation in independent MJD cohorts. This work was fnanced by FEDER—Fundo Europeu de Desenvolvimento Regional funds through the COMPETE 2020— Operacional Programme for Competitiveness and Internationalisation (POCI), Portugal 2020, and by Portuguese funds through FCT— Fundação para a Ciência e Tecnologia in the framework of the EXOS3 project: PTDC/DTP-PIC/2638/2017 (POCI-01–0145-FEDER-016592). ARVM is supported by a PhD grant (SFRH/BD/129547/2017) fnanced by FCT – Fundação para a Ciência e Tecnologia. MR and SM are supported by Fundação para a Ciência e Tecnologia (CEEC IND/03018/2018 and CEECIND/00684/2017, respectively). CB is supported by the Multiple System Atrophy Trust, and Alzheimer’s Research UK. fundação para a ciência e a tecnologia, SFRH/BD/129547/2017, Ana Rosa Vieira Melo, PTDC/DTP-PIC/2638/2017 (POCI-01–0145- FEDER-016592), CEECIND/03018/2018, Mafalda Raposo, CEECIND/00684/2017, Sandra Martins, multiple system atrophy trust. info:eu-repo/semantics/publishedVersion

Aim: Bone disease after kidney transplant (KT) results from multiple factors, including previous bone and mineral metabolism disturbances and effects of transplant-related medications. New biomolecules have been recently associated with the development and progression of the chronic kidney disease–associated bone and mineral disorder (CKD-MBD). These include sclerostin and the soluble receptor activator of nuclear factor-kB ligand (sRANKL). Methods: To better understand the role of biomarkers in post-transplant bone disease, this study was designed to prospectively evaluate and correlate results from the histomorphometric analysis of bone biopsies after KT with emerging serum biomarkers of the CKD-MBD: sclerostin, Dickkopf-related protein 1 (Dkk-1), sRANKL and osteo-protegerin (OPG). Results: Our data shows a significant increase in plasma levels of bioactive sclerostin after KT accompanied by a significant reduction in plasma levels of Dkk-1, suggesting a promotion of the inhibition of bone formation by osteoblasts through the activation of these inhibitors of the Wnt signaling pathway. In addition, we found a significant increase in plasma levels of free sRANKL after KT accompanied by a significant reduction in plasma levels of its decoy receptor OPG, suggesting an enhanced bone resorption by osteoclasts mediated by this mechanism. Conclusions: Taken together, these results suggest that the loss of bone volume observed after KT could be explain mainly by the inhibition of bone formation mediated by sclerostin accompanied by an enhanced bone resorption mediated by sRANKL.

The focus of this chapter is to propose a reflection on the strategic potential of corporate digital newsrooms, usually a section incorporated into corporate websites with content having in mind the journalist's interest. The central question lies in knowing whether it will be possible to identify an evolution in corporate digital newsrooms, with companies redefining their media relations strategies beyond a 2.0 model, to meet the so-called 3.0 newsrooms, typical of a cyber journalism scenario, which operates in the virtual environment. This idea was taken from an article by Neto et al. that explored newsrooms at 'O Globo' in Brazil, 'La Nación' in Costa Rica, and 'BBC' in the UK, searching for differences between newsroom models 1.0, 2.0, and 3.0. Thus, two areas in the field of communication (journalism and corporate communication) come together to assess the role that corporate digital newsrooms play in the interactions between both sides.

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Untranslated regions are involved in the regulation of transcriptional and post-transcriptional processes. Characterization of these regions remains poorly explored for ATXN3, the causative gene of Machado-Joseph disease (MJD). Although a few genetic modifiers have been identified for MJD age at onset (AO), they only explain a small fraction of the AO variance. Our aim was to analyse variation at the 3'UTR of ATXN3 in MJD patients, analyse its impact on AO and attempt to build haplotypes that might discriminate between normal and expanded alleles.After assessing ATXN3 3'UTR variants in molecularly confirmed MJD patients, an in silico analysis was conducted to predict their functional impact (e.g. their effect on miRNA-binding sites). Alleles in cis with the expanded (CAG)

Interleukin-6 (IL-6) is upregulated in response to infectious and inflammatory triggers and independently predicts all-cause mortality in acute heart failure (AHF). However, the association of IL-6 with cardiovascular outcomes and its interplay with C-reactive protein and infection, a major precipitating factor in AHF, remains poorly understood.The association between IL-6 and clinical outcomes (180 days) in AHF was evaluated using a cohort of 164 patients from the EDIFICA registry. Median IL-6 levels at admission were 17.4 pg/mL. Patients in the higher admission IL-6 tertile presented with lower blood pressure and more congestion, were diagnosed more frequently with infection, and had a longer hospital stay. Higher IL-6 levels were associated with increased risk of HF rehospitalization (hazard ratio per logsub2/sub3.69, 95% confidence interval (CI) 1.26-10.8, p =.017) and the composite of HF rehospitalization or cardiovascular death (hazard ratio per logsub2/sub3.50; 95% CI 1.28-9.57; p =.014), independently of major AHF prognosticators, including B-type natriuretic peptide and renal function. However, no independent associations were found for all-cause rehospitalization or mortality. Despite a moderate correlation of IL-6 with C-reactive protein (CRP) levels (R = .51), the latter were not associated with clinical outcomes in this population.IL-6 levels associate with higher rate of cardiovascular events in AHF, independently of classical prognosticators and evidence of infection, outperforming CRP as an inflammatory outcome biomarker.

The use of anti-hail nets on orchards changes the microclimate underneath the net. This might be of great importance in apple growing regions characterized by high radiation levels and hot and dry climates during the summer season. But, depending on the net colour and on the local climatic conditions, the shade promoted triggers different responses by the trees. Grey and black anti-hail nets were applied in an apple orchard (cv. ‘Golden Delicious’) located in Northeast Portugal. Under the nets a lower concentration of glomalin related-soil proteins was observed, along with an improvement on trees water status, stomatal conductance, net photosynthetic rate, total chlorophylls, N, Mg, Fe and Cu concentrations, as well as an increase in mean fruit weight. The major difference between nets was on the photosynthetic efficiency, being higher on black net in sunny days, while grey net performed better under cloudy conditions. The use of netting systems proved to be effective in improving “Golden Delicious” apple trees performance under a Mediterranean climate, mainly when the radiation reaching the plants surpass the tree saturation point for photosynthesis. Therefore, these findings anticipate solutions for current and forecasted negative effects of climate change. This research was funded by the Foundation for Science and Technology (FCT, Portugal) and FEDER under Programme PT2020 for financial support to CIMO (UIDB/00690/2020) and CITAB (UIDB/04033/2020), as well by the project “Introdução de telas anti-granizo em macieira: Avaliação de efeitos colaterais e impacte económico” PA 54824, funded by the European Agricultural Fund for Rural Development and the Portuguese state under the measure 4.1- Cooperation for the Innovation-Rural Development Program (PRODER). info:eu-repo/semantics/publishedVersion

Acute myeloid leukemia (AML) is a heterogeneous disease with poor prognosis and limited treatment strategies. Determining the role of cell-extrinsic regulators of leukemic cells is vital to gain clinical insights into the biology of AML. Iron is a key extrinsic regulator of cancer, but its systemic regulation remains poorly explored in AML. To address this question, we studied iron metabolism in patients with AML at diagnosis and explored the mechanisms involved using the syngeneic MLL-AF9–induced AML mouse model. We found that AML is a disorder with a unique iron profile, not associated with inflammation or transfusion, characterized by high ferritin, low transferrin, high transferrin saturation (TSAT), and high hepcidin. The increased TSAT in particular, contrasts with observations in other cancer types and in anemia of inflammation. Using the MLL-AF9 mouse model of AML, we demonstrated that the AML-induced loss of erythroblasts is responsible for iron redistribution and increased TSAT. We also show that AML progression is delayed in mouse models of systemic iron overload and that elevated TSAT at diagnosis is independently associated with increased overall survival in AML. We suggest that TSAT may be a relevant prognostic marker in AML.

O presente artigo tem como objetivo avaliar as praticas do espiral do conhecimento aplicadas em uma cooperativa de credito e investimento do sudoeste do Parana, mostrando a percepcao de seus colaboradores em relacao a essas praticas. O artigo buscou enumerar as praticas que a cooperativa desenvolve com seus colaboradores, em seguida aplicado o espiral do conhecimento para classificar essas praticas, e por fim, verificado qual a percepcao dos colaboradores em relacao a essas praticas. Para o desenvolvimento do tema foi utilizado o estudo de caso para mensurar as praticas de gestao do conhecimento da cooperativa Sicredi Iguacu PR/SC/SP. O resultado foi dividido em duas partes: primeiro a identificacao das praticas de gestao do conhecimento atraves de pesquisa exploratoria e entrevista com o setor de recursos humanos e sociais da cooperativa e em um segundo momento foi desenvolvido dois instrumentos para os colaboradores, e assim destacar a visao e importância dos mesmos em relacao a forma de gestao do conhecimento que a Sicredi Iguacu PR/SC/SP gerencia. Com a pesquisa obteve-se o resultado de que a cooperativa desenvolve 11 praticas de gestao do conhecimento com os seus colaboradores e que todos tem acesso a essas praticas, algumas precisam de investimento para serem desenvolvidas e outras apenas de incentivo e alguns materiais impressos ou online , e de modo geral os colaboradores consideram as praticas desenvolvidas muito importante para o seu crescimento profissional.

Background:The prevalence of thyroid dysfunction and autoimmunity in the Portuguese population has not yet been estimated. However, the national prevalence of the metabolic syndrome remains high. The association of thyroid pathology with cardiovascular risk has been addressed but is still unclear. Our study aimed to evaluate the prevalence of thyroid dysfunction and autoimmunity and to assess the associations of thyroid-stimulating hormone and thyroid hormones and antibodies with metabolic syndrome, its components, and other possible determinants in a national sample.Material and Methods:The present study included a subsample of 486 randomly selected participants from a nationwide cross-sectional study sample of 4095 adults. A structured questionnaire was administered on past medical history and socio-demographic and behavioural characteristics. Blood pressure and anthropometric measurements were collected, and the serum lipid profile, glucose, insulin, hs- CRP, TSH, FT4, FT3 and thyroid antibodies were measured.Results:In our sample, the prevalence of hypothyroidism, hyperthyroidism and undiagnosed dysfunction was 4.9%, 2.5% and 72.2%, respectively. Overall, the prevalence of positivity for the thyroid peroxidase and thyroglobulin antibodies was 11.9% and 15.0%, respectively. A positive association was found between free triiodothyronine and metabolic syndrome (OR: 2.019; 95% CI: 1.196, 3.410). Additionally, thyroid peroxidase antibodies had a negative association with metabolic syndrome (OR: 0.465; 95% CI: 0.236, 0.917) and its triglyceride component (OR: 0.321; 95% CI: 0.124, 0.836).Conclusion:The prevalence of undiagnosed thyroid dysfunction and autoimmunity was high. Thyroid peroxidase antibodies were negatively associated with metabolic syndrome and its triglyceride component, whereas the free triiodothyronine level was positively associated with metabolic syndrome.

Solanum lycopersicum L. is among the healthiest fruits/vegetables due to its richness in bioactive compounds. However, its fruits from off-season (usually obtained in greenhouses that block UV-rays) have lower reputation than the ones of in-season/field productions. We hypothesise that moderate UV-A/UV-B irradiation during fruit development is able to improve its bioactive compounds and sensorial attributes, increasing its healthy properties. We supplemented for 30 days ‘MicroTom’ fruiting plants with two daily doses of UV-A (1 or 4 h) and UV-B (2 or 5 min). Irradiated plants showed higher ripening synchronization and produced more and smaller fruits. UV-A irradiation stimulated the fruit’s antioxidant capacity, and the antiradical activity by the accumulation of phenolic compounds including the flavonoids. Only the UV-A1 h condition promoted the accumulation of ortho-diphenols in tomato fruits. Regarding the consumers’ preference for aroma/taste, a consumers’ panel test ranked the tomatoes as UV-A 1 h, UVA 4 h, Control, UV-B 5 min and UV-B 2 min. We conclude that the supplementation of UV-A during pre-harvest is particularly effective in increasing ripening synchronization and fruit’s nutritional properties, potentially making these fruits more appealing to consumers.

Dynamic mutations by microsatellite instability are the molecular basis of a growing number of neuromuscular and neurodegenerative diseases. Repetitive stretches in the human genome may drive pathogenicity, either by expansion above a given threshold, or by insertion of abnormal tracts in nonpathogenic polymorphic repetitive regions, as is the case in spinocerebellar ataxia type 37 (SCA37). We have recently established that this neurodegenerative disease is caused by an (ATTTC)n insertion within an (ATTTT)n in a noncoding region of DAB1. We now investigated the mutational mechanism that originated the (ATTTC)n insertion within an ancestral (ATTTT)n . Approximately 3% of nonpathogenic (ATTTT)n alleles are interspersed by AT-rich motifs, contrarily to mutant alleles that are composed of pure (ATTTT)n and (ATTTC)n stretches. Haplotype studies in unaffected chromosomes suggested that the primary mutational mechanism, leading to the (ATTTC)n insertion, was likely one or more T>C substitutions in an (ATTTT)n pure allele of approximately 200 repeats. Then, the (ATTTC)n expanded in size, originating a deleterious allele in DAB1 that leads to SCA37. This is likely the mutational mechanism in three similar (TTTCA)n insertions responsible for familial myoclonic epilepsy. Because (ATTTT)n tracts are frequent in the human genome, many loci could be at risk for this mutational process. We are grateful to the families and individuals who participated in this work. We thank Patricia Ribeiro for technical assistance. This study was financed by Fundo Europeu de Desenvolvimento Regional (FEDER), through the COMPETE 2020 Operational Pro- gram for Competitiveness and Internationalization (POCI) of Portugal 2020, and by the Fundacão para a Ciência e a Tecnologia (FCT) and Ministério da Ciência, Tecnologia e Ensino Superior (Portugal), in the framework of the project POCI-01-0145-FEDER-029255; (PTDC/MED-GEN/29255/2017) to I.S. J.R.L. and C.L.O. were sup- ported by scholarships from PEst-C/SAU/LA0002/2013. S.M. is funded by the project IF/00930/2013/ CP1184/CT0002 from FCT. This work was also funded by the Porto Neurosciences and Neurologic Disease Research Initiative at the Instituto de Investigação e Inovação em Saúde (Norte-01-0145-FEDER- 000008), supported by Norte Portugal Regional Operational Programme (NORTE 2020), under the PORTU- GAL 2020 Partnership Agreement with FEDER.

Background: Virtual reality immersive environments have been shown to be effective in medical teaching. Our university hospital received funding from our deanery to film teaching videos with a 360 degree camera. Aims: Evaluate whether Virtual Reality is an effective teaching environment. Virtual Reality headsets were set up for medical students who rotated through Velindre Cancer Hospital’s Palliative Care department. Methods: Students watched a 27 minute video on nausea & vomiting in palliative care settings in a virtual tutorial space. They subsequently viewed a radiotherapy treatment experience. Results: Of the 72 medical students who participated, 70 found the experience comfortable, with 2 students stating they found it uncomfortable (tight headset, blurry visuals). Numerical scoring on ability to concentrate in VR from 0-10 (0=worst, 10=best) scored an average of 8.44 (range 7-10). Asked whether this format suited their learning style, average score was 8.31 (range 6-10). 97.2% (n=70) students stated that they would recommend this form of learning to a colleague, with 1 student saying he/she would not recommend and 1 student stating he/she was unsure. Students left positive & negative free text comments which helped frame future needs in this emerging area and will be presented. Discussion: This study indicates that there is room for exploring new ways of delivering teaching and expanding it more widely in palliative care, but also provides feedback on areas that need further careful attention. Comments from students included: “Might have been the novelty factor but I learned more from this 20 minute VR thing than I have from many lectures” Summary: The project has proved so popular in medical student feedback that the VR experience is now available on Youtube & has been expanded to routine teaching. It has been viewed worldwide incl Africa, so this format of teaching could prove valuable and promising in its potential for global reach.

O presente estudo tem como objetivo analisar a abrangência teórica dos instrumentos de pesquisa baseados na Teoria das Necessidades Humanas de Maslow, desenvolvidos no período de 1990 a 2020. O estudo caracterizou-se como exploratório, qualitativo e bibliográfico. Os dados foram analisados com a técnica de análise de conteúdo previamente selecionado para esta Tese. O corpus da pesquisa, está composto por 138 artigos, ordenado pela Methodi Ordinatio, uma metodologia que orienta a busca, a seleção, a coleta e classificação de artigos científicos. Durante a coleta, constatou-se que a origem dos estudos concentrou-se em 41 países, destacando-se o maior produtor científico, os EUA com 29% e a China 9,4%. Nesta observação ficou evidente a predominância do público adulto com 30,5% e trabalhadores 21,7% dos pesquisados. Os artigos pertencem a 4 áreas de conhecimento, as 2 com maior representativa são Ciências da Saúde 39,9% e Humanas 35,5%. As publicações foram 51% em periódicos com fator de impacto (JCR-2019). Os 138 estudos utilizaram 145 instrumentos de pesquisa baseados na Teoria de Maslow, destes, 12,4% não foram submetidos a processos de validação e confiabilidade interna. Identificou-se que 19 estudos fizeram agrupamento teórico, 5 destes com a Teoria dos Dois Fatores de Herzberg et al. (1959). Houve 99 análises de relações com outros temas relevantes, destaque para as Escalas de Satisfação com a vida e Cinco Traços de Personalidade. Conclui-se que a estrutura hierárquica dos 5 níveis de 1943 foi utilizada em 78,6% dos instrumentos pesquisados neste estudo. No entanto, o embasamento teórico predominante 46,2% foi da obra Motivation and Personality de 1954 (em 3 edições). Assim, foram localizados 11 instrumentos que utilizaram as estruturas hierárquicas de 7 e 8 níveis e 20 estudos que pesquisaram as subnecessidades referente a Teoria de Maslow. This study aims to analyze the theoretical scope of research instruments based on Maslow's Theory of Human Needs, developed from 1990 to 2020. The study was characterized as exploratory, qualitative and bibliographic. The data were analyzed using the content analysis technique previously selected for this Thesis. The research corpus is composed of 138 articles, ordered by Methodi Ordinatio, a methodology that guides the search, selection, collection and classification of scientific articles. During the collection, it was found that the origin of the studies was concentrated in 41 countries, with the largest scientific producer standing out, the USA with 29% and China 9.4%. In this observation, it was clear the predominance of the adult public with 30.5% and workers 21.7% of those surveyed.The articles belong to four areas of knowledge, the two with the highest representation are Health Sciences 39.9% and Humanities 35.5%. Publications were 51% in journals with an impact factor (JCR-2019). The 138 studies used 145 research instruments based on Maslow's Theory, of which 12.4% were not submitted to validation and internal reliability processes. It was identified that 19 studies were grouped theoretically, 5 of them with Herzberg's Theory of Two Factors (1959).There were 99 analyzes of relationships with other relevant themes, highlighting the Satisfaction with Life Scales and Five Personality Traits. It is concluded that the hierarchical structure of the 5 levels of 1943 was used in 78,6% of the instruments researched in this study. However, the predominant theoretical basis 46,2% was the work Motivation and Personality from 1954 (in 3 editions). Thus, 11 instruments were located that used the hierarchical structures of 7 and 8 levels and 20 studies that investigated the sub-needs related to Maslow's Theory.

RESUMO Conhecer o comportamento geomorfológico de bacias hidrográficas é fundamental para a elaboração de políticas públicas de conservação dos recursos naturais, para subsidiar a ocupação humana de forma que os processos erosivos sejam minimizados. Considerando-se as escassas informações sobre a bacia hidrográfica do Rio das Balsas, no sul do estado do Maranhão, este estudo teve como objetivos realizar o diagnóstico físico e apresentar as áreas suscetíveis à erosão por meio de classificação qualitativa. Para tanto, utilizaram-se informações das bases de dados da Agência Nacional de Águas, Companhia de Pesquisa de Recursos Minerais e United States Geological Survey (modelo digital de elevação, hidrografia, solos e geologia). Por rotinas de geoprocessamento, foram delimitadas a bacia e as sub-bacias e obtidos os dados para o cálculo dos índices morfométricos. Além disso, foi feita a reclassificação das áreas suscetíveis a erosão, baseada no curve number, método que avalia o potencial de escoamento superficial por tipo de solo e respectivo uso. A reclassificação em quatro classes de suscetibilidade possibilitou elaborar o mapa de áreas suscetíveis à erosão. As características morfogenéticas encontradas na área mostram que são necessárias ações de manejo adequado, já que alguns tipos de solos combinados com 45% de declividade (44% da área) são as áreas mais vulneráveis aos processos erosivos. Com isso, conclui-se que o planejamento do uso e ocupação da bacia são extremamente importantes para que as características físicas da região não interfiram de maneira negativa no futuro da sua expansão, no que concerne tanto às atividades agrícolas quanto às urbanas. Abstract Knowledge of the geomorphological behavior of watersheds is fundamental for the elaboration of public policies for the conservation of natural resources, to subsidize human occupation in a way that minimizes erosion processes. Considering the lack of information about the Balsas river basin, located in the south of the state of Maranhão, Brazil, this study aimed to make a physical diagnosis and indicate areas susceptible to erosion through qualitative classification. To that end, it drew on information from National Water Agency (ANA), the Geological Survey of Brazil (CPRM) and the United States Geological Survey (USGS) databases (digital elevation model, hydrography, soils and geology). Through geoprocessing routines, the basin and sub-basins were mapped and data was obtained for the calculation of morphometric indices. In addition, the areas susceptible to erosion were reclassified based on the curve number method, which assesses surface runoff potential by soil type and use. Reclassification into four susceptibility classes made it possible to map erosion susceptible areas. The morphogenetic characteristics found in the area show the need for appropriate management actions, since some types of soils, combined with 45% slope (about 44% of the area), are the most vulnerable to erosive processes. The conclusion reached was that planning of the use and occupation of the basin is extremely important to prevent the physical characteristics of the basin interfering negatively in the future of the region, as its agricultural as well as urban activities expand.

Vitamin D deficiency has been associated with significant changes in dental structures. In children, it can induce enamel and dentin defects, which have been identified as risk factors for caries. This study aimed to assess the association between low serum 25-hydroxyvitamin D (25(OH) D) levels (&lt, 30 ng/mL) and the prevalence of caries in the permanent teeth and mixed dentition of 7-year-old children. A sample of 335 children from the population-based birth cohort Generation XXI (Porto, Portugal) was included. Data on children&rsquo, s demographic and social conditions, health status, dental health behaviours, dental examination including erupted permanent first molars, and blood samples available for vitamin D analysis were collected. Dental outcomes included the presence of caries, including non-cavitated lesions (d1&ndash, 6mft/D1&ndash, 6MFT &gt, 0), and advanced caries (d3&ndash, 6mft/D3&ndash, 6MF &gt, 0). Serum 25(OH) D was measured using a competitive electrochemiluminescence immunoassay protein-binding assay. Bivariate analysis and multivariate logistic regression were used. Advanced caries in permanent teeth was significantly associated with children&rsquo, s vitamin D levels &lt, 30 ng/mL, gastrointestinal disorders, higher daily intake of cariogenic food, and having had a dental appointment at &le, 7 years old. Optimal childhood levels of vitamin D may be considered an additional preventive measure for dental caries in the permanent dentition.

Background Maternal high-caloric nutrition and related gestational diabetes mellitus (GDM) are associated with a high-risk for developing metabolic complications later in life and in their offspring. In contrast, exercise is recognized as a non-pharmacological strategy against metabolic dysfunctions associated to lifestyle disorders. Therefore, we investigated whether gestational exercise delays the development of metabolic alterations in GDM mothers later in life, but also protects 6-week-old male offspring from adverse effects of maternal diet. Methods Female Sprague-Dawley rats were fed with either control (C) or high-fat high-sucrose (HFHS) diet to induce GDM and submitted to gestational exercise during the 3 weeks of pregnancy. Male offspring were sedentary and fed with C-diet. Results Sedentary HFHS-fed dams exhibited increased gestational body weight gain (p