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Objetivo: Avaliar o nível de conhecimento de diabéticos idosos (DMI) em alimentação e saúde, atendidos no Núcleo de Apoio ao Idoso (NAI)/PROIDOSO da Universidade Federal de Pernambuco (UFPE). Métodos: Estudo transversal do tipo pré-teste/pós-teste em 60 DMI tipo 2. Foi desenvolvido projeto de educação alimentar e nutricional em 3 cursos, com oficinas específicas de fisiopatologia DMI, tratamento alimentar, medicamentoso e importância da atividade física. A avaliação foi realizada através de notas (0 a 10), de comparação dos grupos e, das oficinas de alimentação e nutrição, realizada por Teste t de Student e Teste Quiquadrado, com significância de 0,005. Resultado: Na comparação através de perguntas no pós-teste de cada curso, não foi revelado aprendizado significativo; por outro lado, quando se comparam as médias obtidas por cada paciente em cada curso, observou-se aprendizado significativo no 1° curso (maioria nível superior), no mesmo tempo em que foi observada uma melhora nos níveis de conhecimento quando se avaliou o nível de aprendizado por nota nos 3 cursos, embora não tenha sido significativa (p = 0,096). Na comparação de aprendizado nas oficinas de tratamento alimentar dos 3 cursos, denota-se aprendizado significativo em 50% nos temas abordados. Conclusão: O estudo demonstrou que o nível de conhecimento nutricional aumentou, e que a educação nutricional poderá ser utilizada no atendimento a idosos diabéticos, como forma de adesão ao tratamento global que inclui a nutrição como foco principal.

Research aims: This study examines the effect of corporate governance as proxied by institutional and managerial ownership and profitability on the cost of equity capital, both directly and indirectly, through accounting conservatism as a mediating variable. Design/Methodology/Approach: The population of this study was manufacturing companies listed on the Indonesia Stock Exchange in 2020–2022. The sample selection was carried out using the purposive sampling method, resulting in 230 data points and then tested using multiple linear regression. Research findings: Institutional ownership and profitability were revealed to have a positive influence on accounting conservatism, while managerial ownership had no influence. Profitability and accounting conservatism exerted a negative effect on the cost of equity capital. However, institutional ownership generated a positive effect, but managerial ownership did not affect the cost of equity capital. Further test results uncovered that the impact of institutional ownership and profitability on the cost of equity capital was mediated by accounting conservatism. Theoretical contribution/Originality: The findings of this research enrich previous research regarding the economic consequences of corporate governance, profitability, and accounting conservatism in equity markets in developing countries, especially Indonesia. Practitioner/Policy implication: The results of this research can be used as consideration for investors in developing country capital markets when making investment decisions. Research limitation/Implication: This research has limitations, including the relatively low adjusted R2 value. Proxies for corporate governance from ownership and board structure should be included in future studies.

ABSTRAK: Penelitian ini bertujuan untuk mengidentifikasi dan menganalisis tahapan pemerolehan bahasa pertama pada anak usia dini berdasarkan perspektif psikolinguistik. Metode yang digunakan dalam penelitian ini adalah metode kuantitatif deskriptif dengan teknik observasi dalam pengumpulan data. Penelitian dilakukan di PAUD dengan menggunakan teknik purposive sampling untuk pemilihan sampel penelitian. Hasil penelitian menunjukkan bahwa tahapan pemerolehan bahasa pada anak usia dini dimulai dari tahap pra-linguistik, tahap satu kata, tahap dua kata, dan tahap banyak kata. Setiap tahapan tersebut berlangsung melalui interaksi dengan ibu dan orang sekitar dalam kehidupan sehari-hari. Anak usia dini mampu mengucapkan bunyi vokal yang tidak bermakna pada usia 0-7 bulan (tahap pra-linguistik), menggunakan satu kata pada usia 12-18 bulan (tahap satu kata), dua kata pada usia 18-24 bulan (tahap dua kata), dan tiga atau lebih kata pada usia 3-5 tahun (tahap banyak kata). Penelitian ini menambah justifikasi empiris tentang proses dan tahapan pemerolehan bahasa pada anak usia dini serta memberikan wawasan bagi mahasiswa dan pembaca di Program Studi Sastra Indonesia mengenai proses pemerolehan bahasa pada anak usia dini. KATA KUNCI: Pemerolehan bahasa; Anak usia dini; Psikolinguistik TAHAP PERKEMBANGAN PEMEROLEHAN BAHASA PERTAMA PADA ANAK USIA DINI BERDASARKAN PERSPEKTIF PSIKOLINGUISTIK ABSTRAK: Penelitian ini bertujuan untuk mengidentifikasi dan menganalisis tahapan pemerolehan bahasa pertama pada anak usia dini berdasarkan perspektif psikolinguistik. Metode yang digunakan dalam penelitian ini adalah metode kuantitatif deskriptif dengan teknik observasi dalam pengumpulan data. Penelitian dilakukan di PAUD dengan menggunakan teknik purposive sampling untuk pemilihan sampel penelitian. Hasil penelitian menunjukkan bahwa tahapan pemerolehan bahasa pada anak usia dini dimulai dari tahap pra-linguistik, tahap satu kata, tahap dua kata, dan tahap banyak kata. Setiap tahapan tersebut berlangsung melalui interaksi dengan ibu dan orang sekitar dalam kehidupan sehari-hari. Anak usia dini mampu mengucapkan bunyi vokal yang tidak bermakna pada usia 0-7 bulan (tahap pra-linguistik), menggunakan satu kata pada usia 12-18 bulan (tahap satu kata), dua kata pada usia 18-24 bulan (tahap dua kata), dan tiga atau lebih kata pada usia 3-5 tahun (tahap banyak kata). Penelitian ini menambah justifikasi empiris tentang proses dan tahapan pemerolehan bahasa pada anak usia dini serta memberikan wawasan bagi mahasiswa dan pembaca di Program Studi Sastra Indonesia mengenai proses pemerolehan bahasa pada anak usia dini. KATA KUNCI: Pemerolehan bahasa; Anak usia dini; Psikolinguistik

Early childhood education (ECE) is a key investment for improving learning and future outcomes. Yet, in the context of Uganda, it is not compulsory or free, which means that provision tends to be private, and hence there is limited access for children from disadvantaged families, particularly refugees. This article examines the level of access to, and learning outcomes from, ECE among refugees, compared to nationals, over time. Three findings are worth highlighting. First, refugee children were more likely to access ECE relative to nationals. Second, children who access ECE had increased learning outcomes relative to those who did not, with the largest difference observed among nationals with ECE. Third, over time, the benefits of ECE in terms of improved math and English test scores disappear. This article provides insights into the quality of ECE provision, particularly for refugee populations, and raises questions on the benefits of ECE as children progress through Ugandan schooling.

Abstract Atypical hemolytic uremic syndrome (aHUS) is a rare cause of thrombotic microangiopathy (TMA) caused by the dysregulation of the alternative complement pathway. The diagnosis of TMA is made clinically by the triad: microangiopathic hemolytic anemia, thrombocytopenia, and organ damage (mainly acute kidney injury). The heterogeneity of clinical manifestation and the lack of a gold standard diagnostic test makes the precise diagnosis of aHUS a challenging process that may impact patient management. Until one decade ago, there was no specific treatment for aHUS and patients were submitted to plasma therapy (plasma exchange and/or plasma infusion) and/or liver transplantation, procedures that are not free of serious complications and that do not address the underlying pathophysiology of the disease. Since 2011, an anti-C5 complement monoclonal antibody has been approved by the Food and Drug Administration (FDA) for aHUS patients beginning a new era in treatment. Clinical trials on new complement inhibitors may also add to the treatment portfolio in the future. The Brazilian population is a mixed race with a unique genetic and clinical profile. This consensus aims to offer recommendations for the diagnosis and treatment of patients with aHUS in this population based on expert experience, data from the aHUS Brazilian Registry and literature review. The GRADE system was used to classify the quality of the evidence.

O presente estudo aborda o tema “Educação física e práticas pedagógicas na perspectiva da educação inclusiva”, através de um relato de experiência do programa residência pedagógica (PRP). O programa, promovido pela CAPES, visa aprimorar a formação inicial de professores da educação básica, proporcionando aos licenciandos experiências práticas na regência de sala de aula sob orientação de professores da educação básica. Utilizamos uma abordagem qualitativa descritiva, buscando dados do fenômeno estudado. O relato de experiência concentra-se no subprojeto desenvolvido pela Universidade do Estado do Pará, Campus XIII Tucuruí, Pará, correspondente ao período de abril a novembro de 2023, totalizando 1/3 da carga horária do PRP. A educação física inclusiva é destacada por promover igualdade de oportunidades para todos os alunos, independentemente de qualquer limitação, indo além da prática esportiva, visando também a inclusão social. A pesquisa incluiu observação participante, realizada durante um período prolongado de atividades planejadas e eventos escolares, permitindo uma compreensão mais profunda das experiências. Destaca-se a importância da educação inclusiva na promoção da interação e no desenvolvimento de habilidades sociais, culturais, esportivas e artísticas dos alunos. Conclui-se enfatizando a importância da prática durante a RP como um momento essencial para os licenciandos despertarem as suas identidades como professores, concomitando, conhecimento acadêmico junto à realidade do contexto escolar.

Abstract Background Despite guideline recommendations, few institutions have implemented clinical pathways that incorporate frailty into routine decision‐making for patients undergoing radical cystectomy (RC). This paper presents an integrated clinical pathway designed to address the needs of frail patients undergoing RC. The purpose of the study is to determine whether a multifaceted prevention programme that tailors interventions to the syndromic components of frailty can improve postoperative morbidity and recovery time for patients. New insights will be gained into how to optimize the physical and mental status and quality of life of patients before and after surgery, up to 1 year later. Study design The Global RAdical Cystectomy Evaluation and Management (GRACEM) study is a prospective, observational, single‐centre, 2‐year cohort study. Patient enrolment began on 27 April 2023, and results are pending. Endpoints The primary endpoints are postoperative morbidity and the in‐hospital postoperative care burden. Postoperative morbidity is measured by the number of early (up to 1 month) and late (over 1 month and up to 12 months) complications, graded by severity according to the Clavien–Dindo classification. In‐hospital postoperative care burden is measured by the number and duration of key care processes as recorded by the Care Process Monitoring Chart, a tool developed for this study. Secondary endpoints are changes in frailty and health‐related quality of life (HRQoL) from pre‐intervention to planned follow‐up up to 1 year. Frailty is assessed with the Functional Limitations and Geriatric Syndromes Frailty Questionnaire (FLIGS‐FQ), another ad hoc tool. HRQoL is assessed using the EQ‐5D‐5L questionnaire combined with the cystectomy‐specific FACT‐Bl‐cys index from the first month of follow‐up. Patients and methods The GRACEM study includes patients with non‐metastatic, histologically confirmed, muscle‐infiltrating bladder cancer who underwent RC surgery with curative intent. This study is unique in that the GRACEM Core Team shares decision‐making throughout the pathway, from before the intervention to the end of the patient's follow‐up. The pathway involves the patient, family members and community services.

The “Metaverse Territorial Brand” integrates core and interconnected elements into a virtual, interactional, experiential, and immersive space known as the metaverse. This type of brand encompasses the connection with immersive territories that may or may not be digital twins of real territories. It also encompasses two interconnected physical scales: the territorial and the regional, involved in another type of emerging territorial scale, known as the metaversal scale. Therefore, the “Metaverse Territorial Brand” is a digital-immersive extension of the territorial brand of physical territories, encompassing specific geographical and cultural aspects, but directed to the metaverse environment. This brand is a symbolic digital construction, but also a multifaceted one that incorporates discursive and visual elements, articulated by the social actors of the immersive territory, aiming to create a specific and distinct identity for a space in the metaverse. When talking about social actors in the metaverse (users), we highlight that this set of actors may or may not be the same as the physical territory. It is also important to highlight that both the territorial brand directed to physical territories and the “Metaverse Territorial Brand” are formed from the power relations of a given set of social actors. Therefore, without the strategic intention of a plurality of social actors that stimulate these relationships, there is no type of territorial brand involved.

Introduction: This study aimed to compare the effectiveness of endoscopic carpal tunnel release (ECTR) versus open carpal tunnel release (OCTR) in treating carpal tunnel syndrome (CTS), focusing on symptom relief, functional recovery and post-operative complications. Methods: A retrospective analysis was conducted on 44 patients diagnosed with CTS, randomly assigned to undergo either ECTR (n=23) or OCTR (n=21). Parameters evaluated included post-operative pain, grip strength, functional status using the Disability of the Arm, Shoulder and Hand (DASH) score and time to return to work. Results: Patients who underwent ECTR demonstrated superior functional recovery and quicker return to daily and work activities compared to those in the OCTR group. Grip strength improvement post-surgery showed no significant difference between the groups. However, ECTR patients reported significantly lower DASH scores and faster return to work, indicating better outcomes. There were fewer reports of post-operative complications and scar sensitivity in the ECTR group. Conclusion: ECTR provides an effective alternative to OCTR for CTS treatment, with advantages in functional recovery speed, reduced post-operative discomfort and faster return to work. These findings support the adoption of ECTR as a preferred surgical approach for CTS, highlighting its potential to improve patient outcomes with minimal complications.

Abstract Objectives Traumatic brain injury (TBI) is associated with sleep deficits, but it is not clear why some report sleep disturbances and others do not. The objective of this study was to assess the associations between axonal injury, sleep, and memory in chronic and acute TBI. Methods Data were acquired from two independent datasets which included 156 older adult veterans (69.8 years) from the Alzheimer's Disease Neuroimaging Initiative (ADNI) with prior moderate‐to‐severe TBIs and 90 (69.2 years) controls and 374 (39.6 years) from Transforming Research and Clinical Knowledge in TBI (TRACK‐TBI) with a recent mild TBI (mTBI) and 87 controls (39.6 years), all who completed an MRI, memory assessment, and sleep questionnaire. Results Older adults with a prior TBI had a significant association between axonal injury and sleep disturbances [β = 9.52, 95% CI (4.1, 14.9), p = 0.01]. Axonal injury predicted changes in memory over 1‐year in TBI [β = −8.72, 95% CI (−18, −2.7), p = 0.03]. We externally validated those findings in TRACK‐TBI where axonal injury within 2 weeks after mTBI was significantly associated with higher sleep disturbances in the TBI group at 2 weeks[β = −7.2, 95% CI (−14, −0.50), p = 0.04], 6 months [β = −16, 95% CI (−24, −7.6), p ≤ 0.01], and 12 months post‐injury [β = −11, 95% CI (−19, −0.85), p = 0.03]. These associations were not significant in controls. Interpretations Axonal injury, specifically to the left anterior internal capsule is robustly associated with sleep disturbances in multiple TBI populations. Early assessment of axonal injury following mTBI could identify those at risk for persistent sleep disturbances following injury.

Abstract Introduction: Pediatric patients with chronic kidney disease (CKD) develop mineral and bone disorders (MBD). We do not have Brazilian data that evaluate these outcomes, which can be obtained through epidemiological records. Objective: To present the DOMINÓ study, which aims to describe CKD-MBD characteristics in Brazilian pediatric patients. Methods: Retrospective and prospective, multicenter, observational cohort. The retrospective study will analyze data from prevalent patients in 2024, and the prospective study will analyze data from 2025 onwards. Demographic, clinical, laboratory, imaging, and bone biopsy data will be collected from pediatric patients with CKD-MBD < 18 years old with CKD stage 3-5D and kidney transplant recipients. The Ethics Committees of the participating centers approved the study. Discussion/conclusion: The DOMINÓ study will provide information on the incidence, prevalence, morbidity, treatment results, and mortality of this pediatric disease in Brazil. Future analyses will allow us to identify predictors of response to treatment and improve the care for these patients.

In early-stage Alzheimer's disease (AD) amyloid-β (Aβ) deposition can induce neuronal hyperactivity, thereby potentially triggering activity-dependent neuronal secretion of phosphorylated tau (p-tau), ensuing tau aggregation and spread. Therefore, cortical excitability is a candidate biomarker for early AD detection. Moreover, lowering neuronal excitability could potentially complement strategies to reduce Aβ and tau buildup. There is, however, a lack of understanding of the relationship between cortical excitability and p-tau increase in vivo. Therefore, in a sample of 658 healthy middle-aged (between the ages of 40 and 65) participants of the Barcelona Brain Health Initiative cohort study, we examined the relation of blood-based tau, phosphorylated at amino acid 181 (p-tau181), reflecting neuronal p-tau secretion; neurofilament light chain (NfL), as a passively released control for p-tau181; and electroencephalography (EEG) markers of cortical excitability. A subsample of 47 participants also completed a controlled brain perturbation approach via transcranial magnetic stimulation (TMS) with concurrent EEG. Results show that both spontaneous (i.e., resting-state) and perturbation-based TMS-EEG markers, are associated with blood p-tau181, particularly in older individuals. The perturbation-based marker was a significantly more sensitive predictor of p-tau181 concentration than the spontaneous resting state EEG-based marker. The relationships observed are not present for the NfL control. These results show that relationships between p-tau181 and cortical excitability are present in healthy middle-aged subjects and that p-tau181 increases may reflect activity-dependent secretion.