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OBJECTIVES Only few studies compared the surgical morbidity and mortality of thoracoscopic segmentectomy versus lobectomy for non-small-cell lung cancer, in particular, by relating the segmental resections with the corresponding anatomical lobes. METHODS We enrolled a total of 7487 patients who underwent VATS lobectomy (7269) or segmentectomy (218) from January 2014 to July 2019. A propensity score matching approach was used to account for potential confounding factors between the 2 groups. After matching, 349 lobectomies and 208 segmentectomies were included in the analysis. We analysed the operative and postoperative outcomes of video-assisted anatomical segmentectomy compared with video-assisted lobectomy and, in details, the results of segmentectomy with its corresponding lobectomy in a large cohort of patients from the Italian VATS Group Registry. RESULTS The overall conversion rate to thoracotomy was not statistically different between the groups (27 patients 8% vs 7 patients 3%, P = 0.1). The lobectomy group had a greater number of resected lymph nodes (median 11 vs 8, P = 0.006). No significant differences were detected in 30-day mortality (1.4%, 5 patients vs 0.9%, 2 patients), overall complications (18%, 62 patients vs 14%, 29 patients) and prolonged air leakage (31 patients, 9% vs 12 patients, 6%) between lobectomy and segmentectomy, respectively. No statistical differences were found regarding the median duration of drainage (3.2 days, P = 1) and the overall median length of hospital stay (6.4 days, P = 0.1) between the 2 groups. In the context of segmentectomy versus corresponding lobectomy, the right upper lobectomy compared with right upper segmentectomy showed a higher number of resected lymph nodes (P = 0.027). No statistical differences were reported in terms of conversion rate and postoperative complication and mortality. CONCLUSIONS Segmentectomy could be considered a safe procedure without significant differences compared to thoracoscopic lobectomy in terms of postoperative morbidity and mortality.

Este artigo problematiza as contradições entre o marco legal que trata do direito à acessibilidade frente às dificuldades enfrentadas por pessoas com deficiência no Distrito Federal (DF), especialmente quanto a barreiras arquitetônicas e urbanísticas. A pesquisa teve caráter qualitativa e utilizou análise documental de leis e decretos, além de relatórios das Conferências Distritais da Pessoa com Deficiência. Também realizou entrevista semiestrutura com gestores públicos e de entidades da sociedade civil que atuam na área de defesa e proteção às pessoas com deficiência do DF. Como resultados observa-se a violação desse direito a partir do distanciamento entre o que está garantido no âmbito legal e as barreiras encontradas pelas pessoas com deficiência em seu cotidiano, que impedem a utilização, com segurança e autonomia, de espaços, equipamentos urbanos e serviços públicos. Entende-se que a garantia desse direito é fundamental para a o reconhecimento das pessoas com deficiência como sujeito de direitos.

Este artigo tem o objetivo de analisar o voluntariado como estratégia de proteção social no contexto de pandemia de COVID-19 no Brasil à luz da ideologia da Nova Direita. Parte-se da compreensão de que existem diferentes formas de proteção social, que recebem significados político-ideológico distintos. O percurso metodológico escolhido utilizou a pesquisa documental, com base em documentos oficiais, reportagens e pesquisas públicas que versam sobre o tema. Os resultados apontam para a histórica institucionalização de programas de incentivo ao voluntariado no Brasil, que no atual momento, fortalecem de maneira distinta a redução da responsabilidade do Estado. Aponta-se também que no atual contexto, ao ser apresentado como principal estratégia de proteção social do governo Bolsonaro, o voluntariado se orienta pela privatização da assistência e pela moralização do trabalho e da pobreza.

Background: There is an inverse association between cardiorespiratory fitness and general anxiety levels in adolescents. Obesity also is associated with a higher risk of anxiety in this population. However, little is known about the association between other health-related fitness elements with anxiety symptoms in this population. The authors explored the relationship between health-related fitness and anxiety symptoms in a large sample of Brazilian youth. Methods: This was an observational cross-sectional study with a sample comprised of 257 school adolescents, who were 136 girls (52.9%) and 121 boys (47.1%). The health-related fitness elements were evaluated by FitnessGram® test and anxiety levels by Multidimensional Anxiety Scale for Children - 39. Hierarchical regression analyses were used to determine the association between health-related fitness elements and anxiety symptoms in both sexes. Results: In male adolescents, only the cardiorespiratory fitness was significantly associated with anxiety symptoms (F(1, 119) = 6.472; P = 0.012; R2 = 0.052; adjusted R2 = 0.044). In turn, the anxiety symptoms showed an inverse small relationship with cardiorespiratory fitness (r = - 0.227; P < 0.01). However, in female adolescents, no association was found between health-related fitness elements and anxiety symptoms. Conclusion: The level of cardiorespiratory fitness may represent a marker of anxiety in male adolescents.

High levels of perceived parental over-protection are hypothesized to be related to relational problems, psychological distress, and development of psychiatric symptoms. Here, the main aim was to extend previous findings investigating the unique contribution of parental over-protection in predicting affective vulnerability.296 students were recruited and tested individually. All participants were administered self-report measures assessing parental styles [i.e., The Measure of Parental Style (MOPS)], several clinical dimensions (i.e., depressive symptoms, trait anxiety and alexithymia), and a checklist assessing socio-demographic variables.Affective vulnerability was investigated combining anxiety, depression and alexithymia through principal axis factoring which accounted for 70.90% of the variance of the data. All MOPS subscale were positively associated with all clinical dimensions (r0.13; p0.05) and with the Affective Vulnerability factor (r0.25; p0.001). Among different forms of dysfunctional parenting, only maternal (β = 0.19; p = 0.007) and paternal (β = 0.18; p = 0.010) over-protection were independently associated with Affective Vulnerability in the linear regression analysis, even when controlling for sex, age, and education.All forms of dysfunctional parenting investigated were associated with affective vulnerability. However, at a multivariate level, only maternal and paternal over-protection remained independently associated with affective vulnerability. This study contributes to our understanding of the role of parental over-protection as a risk factor for the development of affective vulnerability and on the potentially pathogenic role played by this parental style in the development of clinical and sub-clinical conditions.

The peroxisome proliferator-activated receptor alpha (PPARα) is a nuclear receptor that has been linked to the modulation of several physiological functions, including the sleep-wake cycle. The PPARα recognizes as endogenous ligands the lipids oleoylethanolamide (OEA) and palmitoylethanolamide (PEA), which in turn, if systemically injected, they exert wake-promoting effects. Moreover, the activation of PPARα by the administration of OEA or PEA increases the extracellular contents of neurotransmitters linked to the control of wakefulness; however, the role of PPARα activated by OEA or PEA on additional biochemicals related to waking regulation, such as acetylcholine (ACh) and 5-hydroxytryptamine (5-HT), has not been fully studied. Here, we have investigated the effects of treatments of OEA or PEA on the contents of ACh and 5-HT by using in vivo microdialysis techniques coupled to HPLC means. For this purpose, OEA or PEA were systemically injected (5, 10 or 30 mg/kg; i.p.), and the levels of ACh and 5-HT were collected from the basal forebrain, a wake-related brain area. These pharmacological treatments significantly increased the contents of ACh and 5-HT as determined by HPLC procedures. Interestingly, PPARα antagonist MK-886 (30 mg/kg; i.p.) injected before the treatments of OEA or PEA blocked these outcomes. Our data suggest that the activation of PPARα by OEA or PEA produces significant changes on ACh and 5-HT levels measured from the basal forebrain and support the conclusion that PPARα is a suitable molecular element involved in the regulation of wake-related neurotransmitters.

Introduction: Exploring the potential of exercise in the rehabilitation process of patients with Parkinson’s (PD) may be an interesting treatment perspective. Exercise-induced responses derived from neurotrophic elements appear to ameliorate the decline in neurodegeneration. Despite this understanding, the literature needs to be updated. Areas covered: Our review focuses on: a) the key mechanisms of exercise on PD, highlighting mainly the responses related to neuroplasticity; b) the effects induced by different traditional types of exercise, also highlighting the effects of complementary therapies related to movement; c) the volume of exercise required to support efficient results are explored in the context of PD. Additionally, the proposition of new clinical application strategies in the context of PD will also be determined. Expert opinion: It is suggested that different intensities of aerobic exercise be explored for the treatment of PD. The results associated with high intensity seem promising for performance, physiological and clinical parameters, such as BDNF production and cognition. On the other hand, the diversification of tasks and repetition of motor gestures appear as consistent arguments to exercise prescription. Finally, for future investigations, the neuromodulation strategy in association with aerobic exercise appears as a potential inducer of benefits on gait and cognitive function. info:eu-repo/semantics/publishedVersion

The main objective of the present study was to use the Receiver Operating Characteristic (ROC) curve analysis to identify cut-off points for a self-report measure assessing parental style, i.e., the Measure of Parental Style (MOPS), that are able to discriminate individuals with disorganized internal working models (IWMs) of attachment with adequate accuracy, in terms of sensitivity and specificity. Establishing cut-off points for the MOPS could provide clinicians and researchers with a valuable tool to investigate the role of disorganized IWMs as a link between parental styles and mental health.A sample of 90 university students (mean age = 21.21 ± 2.05, females = 66) was enrolled in the study. We used the Adult Attachment Interview (AAI) to assess disorganized IWM and the MOPS to assess parental styles. Subsequently, we used ROC curve analysis to pursue the objective of the study.The ROC curve analysis showed that the MOPS total score (i.e., the combination of maternal and paternal dimensions) was able to discriminate individuals with disorganized IWMs from individuals with organized IWMs (AUC= 0.77). Specifically, a score ≥ 25 (Youden index= 0.497) categorized individuals with a sensitivity of 0.69 (69% of participants with disorganized IWMs were correctly identified) and a specificity of 0.81 (19% of participants were incorrectly identified as having disorganized IWMs).Although the AAI has demonstrated high psychometric properties for assessing attachment representations in adulthood, its use is difficult when studies with large samples are to be conducted. As an alternative to the AAI, the MOPS can be used in studies with large populations, but no cut-off has yet been proposed. Here, we have identified cut-off points for the MOPS that are capable of detecting disorganized IWMs of attachment with adequate accuracy, and we suggest that this self-report is a useful brief instrument for detecting disorganized IWMs when time constraints prevent the use of the AAI (e.g., in studies with large samples or epidemiological studies).

Objective The presence of micropapillary and solid adenocarcinoma patterns leads to a worse survival and a significantly higher tendency to recur. This study aims to assess the impact of pT descriptor combined with the presence of high-grade components on long-term outcomes in early-stage lung adenocarcinomas. Methods We retrospectively collected data of consecutive resected pT1-T3N0 lung adenocarcinoma from nine European Thoracic Centers. All patients who underwent a radical resection with lymph-node dissection between 2014 and 2017 were included. Differences in Overall Survival (OS) and Disease-Free Survival (DFS) and possible prognostic factors associated with outcomes were evaluated also after performing a propensity score matching to compare tumors containing non-high-grade and high-grade patterns. Results Among 607 patients, the majority were male and received a lobectomy. At least one high-grade histological pattern was seen in 230 cases (37.9%), of which 169 solid and 75 micropapillary. T1a-b-c without high-grade pattern had a significant better prognosis compared to T1a-b-c with high-grade pattern (p = 0.020), but the latter had similar OS compared to T2a (p = 0.277). Concurrently, T1a-b-c without micropapillary or solid patterns had a significantly better DFS compared to those with high-grade patterns (p = 0.034), and it was similar to T2a (p = 0.839). Multivariable analysis confirms the role of T descriptor according to high-grade pattern both for OS (p = 0.024; HR 1.285 95% CI 1.033–1.599) and DFS (p = 0.003; HR 1.196, 95% CI 1.054–1.344, respectively). These results were confirmed after the propensity score matching analysis. Conclusions pT1 lung adenocarcinomas with a high-grade component have similar prognosis of pT2a tumors.

Since 2009, 91 new strong-motion stations were built for the renewal of the Swiss Strong Motion Network. Another nine stations will be installed until 2022. For each new station, an extensive site characterization study is performed to model the 1D seismic-velocity profile and, for some sites, the liquefaction potential. Geophysical (passive and active surface-wave methods) and geotechnical cone penetration test (CPT) with additional pore-pressure measurement (CPTu) and seismic CPT (SCPT) methods are used. Analyzing the passive and active recordings with a variety of established and advanced methods, the fundamental frequency of the site, the polarization of the wavefield, the Love- and Rayleigh-wave phase-velocity dispersion curves, and the Rayleigh-wave ellipticity function are retrieved. The liquefaction potential is assessed using CPTu. SCPT measurements are sometimes used to determine the shallow underground structure. The benefits of the combination of different appropriate methods are shown for two examples—the borehole station SBUS in Buochs and the upcoming borehole station SCME in Collombey-Muraz. At both the sites, the CPTu measurements show an elevated liquefaction potential. Combining the passive and active data, the dispersion curves for Love and Rayleigh waves and Rayleigh-wave ellipticity curves are retrieved over a wide-frequency range and inverted for the S-wave velocity profile, in which the shallow part is constrained by the active or SCPT data, the intermediate part by the dispersion curves of the passive methods, and the deepest part by the ellipticity information. For Buochs, the 1D SH-wave amplification functions modeled for the velocity profiles are compared with the empirical amplification for earthquake recordings. Finally, an overview of the site characterization results for 52 of the newly installed seismic stations is given.

Purpose of the report This article aims to explore the prognostic role of 18F-FDG PET/CT metabolic parameters in stage I lung adenocarcinoma patients. Patients and methods One hundred eighty pathological stage I lung adenocarcinoma patients were retrospectively reviewed. Semiquantitative analysis of FDG tumor uptake was performed with TrueD software on the Siemens Leonardo workstation. SUVmean and MTV were calculated using SUV threshold of 41% of SUVmax; the total lesion glycolysis (TLG) was calculated as the product of SUVmean and MTV. Correlation was evaluated using Spearman correlation coefficient. Maximally selected rank statistics was performed to detect the optimal cutoff used for dichotomizing each PET parameter (6.5 for SUVmean, 9.6 for SUVmax, and 19.1 for TLG). Results Our main finding was the significant correlation between 18F-FDG PET/CT parameters (SUVmean, SUVmax, and TLG) and disease-free survival in pathologic stage I non-small cell lung cancer. SUVmean has the greatest accuracy in recurrence prediction (integrated area under the curve, 0.803; 95% confidence interval, 0.689-0.918). We run the maximally selected rank statistics to provide the classification of observations in 2 groups by a continuous predictor parameter; the free from recurrence rate was significantly greater in patients with SUVmean ≤6.5, SUVmax ≤9.6, and TLG ≤19.1. Conclusions Our research supports the hypothesis that SUVmean, SUVmax, and TLG are well correlated with free from recurrence rate in stage I adenocarcinoma patients, subjected to pulmonary lobectomy. Our findings also indicate these markers as promising prognostic indicators.

OBJECTIVES Digital chest drainage systems allow real-time and continuous monitoring and recording of air leak flow rate and intrapleural pressure (IPP) from the immediate postoperative period to the chest drainage removal. A multicentre retrospective observational analysis of consecutive patients undergoing pulmonary lobectomy for lung cancer was performed to evaluate the association between the airflow and IPP digitally recorded during the immediate postoperative period after video-assisted thoracic surgery (VATS) lobectomy for lung cancer. Here, we present a work in progress report. METHODS All patients treated with VATS lobectomies for lung cancer were included. Multiple airflow measurements and minimum and maximum IPP through the chest tubes were digitally monitored and recorded using microelectronic mechanical sensor technology. The PALs were defined as an air leak lasting >5 days from the conclusion of the surgical procedure. The cessation of air leaks was defined as an airflow RESULTS This analysis comprised 76 patients who underwent VATS lobectomy for lung cancer. Nineteen patients (25%) showed prolonged air leaks (PAL) (≥5 days). The operative time was higher in the PAL group (mean difference = 44 min) without a statistically significant difference. Before the 7th postoperative hours, there were no statistically significant differences in IPPs. CONCLUSIONS Patients with PAL showed less negative IPP in the first 24 postoperative hours. Therefore, the 7th—24th postoperative hours were critical in PAL prediction since the mechanism for PAL seems to develop after the 7th postoperative hour.

Early detection of lung cancer is the key to improving treatment and prognosis of this disease, and the advent of advances in computed tomography (CT) imaging and national screening programs have improved the detection rate of very small pulmonary lesions. As such, the management of this sub-centimetric and often sub-solid lesions has become quite challenging for clinicians, especially for choosing the most suitable diagnostic method. In clinical practice, to fulfill this diagnostic yield, transthoracic needle biopsy (TTNB) is often the first choice especially for peripheral nodules. For lesions for which TTNB could present technical difficulties or failed, other diagnostic strategies are needed. In this case, video-assisted thoracic surgery (VATS) is the gold standard to reach the diagnosis of lung nodules suspect of being malignant. Nonetheless it’s often not easy the identification of such lesions during VATS because of their little dimensions, non-firm consistency, deep localization. In literature various marking techniques have been described, in order to improve intraoperative nodules detection and to reduce conversion rate to thoracotomy: CT-guided hookwire positioning, methylene blue staining, intra-operative ultrasound and electromagnetic navigation bronchoscopy are the most used. The scientific evidence on this matter is weak because there are no randomized clinical trials but only case series on single techniques with no comparison on efficacy, so there are no guidelines to refer. From this standing, in this article we conducted a narrative review of the existing literature on the subject, with the aim of outlining a framework as complete as possible. We analyzed strengths and weaknesses of the main techniques reported, so as to allow the clinician to orient himself with greater ease.

Emotion dysregulation (ED) can be considered a psychopathological transdiagnostic dimension, the presence of which should be reliably screened in clinical settings. The aim of the current study was to validate the Italian version of the Emotion Dysregulation Scale-short (EDS-s), a brief self-report tool assessing emotion dysregulation, in a non-clinical sample of 1087 adults (768 women and 319 men). We also assessed its convergent validity with scales measuring binge eating and general psychopathology. Structural equation modeling suggested the fit of a one-factor model refined with correlations between the errors of three pairs of items (χ2 = 255.56, df = 51, p < 0.001, RMSEA = 0.08, CFI = 0.94, TLI = 0.93, SRMR = 0.04). The EDS-s demonstrated satisfactory internal consistency (ordinal alpha = 0.94). Moreover, EDS-s scores partly explained the variance of both binge eating (0.35, p < 0.001) and general psychopathology (0.60, p < 0.001). In conclusion, the EDS-s can be considered to be a reliable and valid measure of ED.

Objectives We have investigated the psychotropic medications sales (i.e. benzodiazepines, mood stabilisers and selective serotonin reuptake inhibitors) during the COVID-19 pandemic in the period from March 2020 to February 2021 compared with the same period in the preceding year. Study design This was a retrospective and observational study. Methods Data were obtained from five pharmacies located in a working-class zone populated by approximately 150,000 people in the urban area of Rome (Italy). Results A general slight increase in psychotropic medications sales was observed during the whole pandemic period compared with the previous year. Conclusion Our data showed that (1) the percentage of sales seems to vary according to the pandemic phases and related lockdowns and (2) the sales differ between the classes of medications considered.

Submitted by Helena Bejio (helena.bejio@unioeste.br) on 2022-09-26T22:15:44Z No. of bitstreams: 2 TESE-Fabricio-Imperatori-definitiva.pdf: 1324657 bytes, checksum: 9746d46cb0008484ecca59d869272aab (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) Made available in DSpace on 2022-09-26T22:15:44Z (GMT). No. of bitstreams: 2 TESE-Fabricio-Imperatori-definitiva.pdf: 1324657 bytes, checksum: 9746d46cb0008484ecca59d869272aab (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) Previous issue date: 2022-06-10 The maintenance of good intestinal integrity and health are of fundamental importance so that production animals can be able to express their genetic potential. In order to measure the impact of different variables involved in the context of broiler production, it is necessary to apply experimental protocols that are capable of simulating the reality of the field, allowing the accurate evaluation of food additives. In this sense, we aim to evaluate the performance, morphology, and regenerative capacity of the intestinal mucosa, as well as to study intestinal microbiota responses and the immune response of birds fed with a blend of additives composed of zinc proteinate, hydrolyzed yeast and encapsulated sodium butyrate associated or not with the use of antibiotic growth promoter in broilers submitted or not to an enteric challenge proposal. This study was carried out in the experimental aviary of the Federal University of Paraná – Palotina campus. A total of 3,936 male broiler chicks (Ross AP95®) were used and the birds were housed on shavings bedding, with water and feed ad libitum and divided into a 6 x 2 factorial scheme (Negative control (NC), Positive control (PC); PC + 1.0kg of Blend of additives/ton of feed; NC + 0.5kg; NC + 1.0kg; NC + 1.5kg of Blend of additives/ton of feed Vs with and without experimental enteric challenge), with 8 replications per treatment and 41 birds each. At 14 days of age, birds in the challenged groups were inoculated into the coccidiosis vaccine pool containing 20 times the dose recommended by the manufacturer. Two days later (16th day), the challenged birds received an inoculum containing Escherichia coli (ATCC® 8739™) with a calculated concentration of 109 CFU/bird applied directly to the flock. The evaluation of body weight, average feed intake, weight gain, and feed conversion were performed weekly. The degree of warpage was evaluated at 28, 35 and 42 days of age. Fragments of intestinal segments were collected at 19 days of age after euthanasia procedure of two birds/repeat for evaluation of intestinal morphometry and analysis of the proliferative capacity of intestinal cells. Intestinal mucosal permeability was measured by assessing serum levels of fluorescein isothiocyanate (FITC-d). Cecal excreta samples were collected at 42 days of age from 7 birds per treatment to determine the short chain fatty acid (SCFA) profile. For the calculation of carcass yield, cuts and abdominal fat deposition, at 42 days, 60 birds were slaughtered per treatment. Statistical procedures were performed using analysis of variance (ANOVA) using the General Lineal Model (GLM) using the SAS statistical program and, when significant, the treatment means were compared using Tukey's test (p