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Este artículo presenta información y datos que son importantes de analizar para poder percatarnos del gran impacto que ha tenido la pandemia del COVID-19 dentro del mercado inmobiliario, específicamente al momento de tomar la decisión de comprar un bien inmueble. Sin duda alguna, el adquirir una propiedad es una de las decisiones más importantes que puede tomar cualquier persona, ya que invertir en el mercado inmobiliario le brinda seguridad para su patrimonio. El objetivo de esta investigación es poder evaluar el impacto que ha tenido la pandemia en el giro inmobiliario, así como validar que es lo que los clientes toman en cuenta antes de comprar y realizar su inversión. Para ello, analizan las diferentes variables que se obtuvieron por medio de un muestreo no probabilístico, enfocado específicamente en el área metropolitana de Monterrey, con el fin de poder concluir, con base en los resultados, si durante este tiempo de pandemia dichos clientes han optado por realizar una inversión. Como resultado, se encuentra que gran cantidad de personas efectivamente vio la pandemia como una oportunidad para invertir.

Objective To explore pituitary tumors by methylome and transcriptome signatures in a heterogeneous ethnic population. Methods In this retrospective cross-sectional study, clinicopathological features, methylome, and transcriptome were evaluated in pituitary tumors from 77 patients (61% women, age 12-72 years) followed due to functioning (FPT: GH-secreting n = 18, ACTH-secreting n = 14) and nonfunctioning pituitary tumors (NFPT, n = 45) at Ribeirao Preto Medical School, University of São Paulo. Results Unsupervised hierarchical clustering analysis (UHCA) of methylome (n = 77) and transcriptome (n = 65 out of 77) revealed 3 clusters each: one enriched by FPT, one by NFPT, and a third by ACTH-secreting and NFPT. Comparison between each omics-derived clusters identified 3568 and 5994 differentially methylated and expressed genes, respectively, which were associated with each other, with tumor clinical presentation, and with 2017 and 2022 WHO classifications. UHCA considering 11 transcripts related to pituitary development/differentiation also supported 3 clusters: POU1F1-driven somatotroph, TBX19-driven corticotroph, and NR5A1-driven gonadotroph adenomas, with rare exceptions (NR5A1 expressed in few GH-secreting and corticotroph silent adenomas; POU1F1 in few ACTH-secreting adenomas; and TBX19 in few NFPTs). Conclusion This large heterogenic ethnic Brazilian cohort confirms that integrated methylome and transcriptome signatures classify FPT and NFPT, which are associated with clinical presentation and tumor invasiveness. Moreover, the cluster NFPT/ACTH-secreting adenomas raises interest regarding tumor heterogeneity, supporting the challenge raised by the 2017 and 2022 WHO definition regarding the discrepancy, in rare cases, between clinical presentation and pituitary lineage markers. Finally, making our data publicly available enables further studies to validate genes/pathways involved in pituitary tumor pathogenesis and prognosis.

O tromboembolismo venoso é uma condição que pode ser fracionada em trombose venosa profunda e tromboembolismo pulmonar. Estas compõe este espectro a qual proporcionalmente ao estado hemodinâmico, cursando não obrigatoriamente com o trio típico, exemplificada pela dispneia, dor torácica pleurítica e hemoptise, sendo a dispneia o mais clássico. Estima-se que a minoria dos portadores desta condição são devidamente identificados e tratados, devido o enquadramento isolado não propiciar confirmação ou exclusão patológica. Objetivos: Descrever o quadro clínico do paciente portador de tromboembolismo venoso, no intuito de favorecer o diagnóstico e manejo precoce e principalmente o bom prognóstico do mesmo. Trata-se de uma revisão bibliográfica de literatura fundamentada nas plataformas do SciELO, PubMed, Lilacs e Google Scholar no período de janeiro a março de 2023, utilizando se os seguintes descritores tromboembolismo venoso; embolia pulmonar. Resultados e Discussão: O trombobolismo venoso é uma condição de elevada morbidade e complicações, associado ao fato de que este pode cursar de modo silencioso e culminar em deteriorações e até ao óbito.

O tromboembolismo venoso é uma condição que pode ser fracionada em trombose venosa profunda e tromboembolismo pulmonar. Estas compõe este espectro a qual proporcionalmente ao estado hemodinâmico, cursando não obrigatoriamente com o trio típico, exemplificada pela dispneia, dor torácica pleurítica e hemoptise, sendo a dispneia o mais clássico. Estima-se que a minoria dos portadores desta condição são devidamente identificados e tratados, devido o enquadramento isolado não propiciar confirmação ou exclusão patológica. Objetivos: Descrever o quadro clínico do paciente portador de tromboembolismo venoso, no intuito de favorecer o diagnóstico e manejo precoce e principalmente o bom prognóstico do mesmo. Trata-se de uma revisão bibliográfica de literatura fundamentada nas plataformas do SciELO, PubMed, Lilacs e Google Scholar no período de janeiro a março de 2023, utilizando se os seguintes descritores tromboembolismo venoso; embolia pulmonar. Resultados e Discussão: O trombobolismo venoso é uma condição de elevada morbidade e complicações, associado ao fato de que este pode cursar de modo silencioso e culminar em deteriorações e até ao óbito.

Objectives To evaluate how telomere length behaves in adamantinomtous craniopharyngioma (aCP) and if it contributes to the pathogenesis of aCPs with and without CTNNB1 mutations. Design Retrospective cross-sectional study enrolling 42 aCP patients from 2 tertiary institutions. Methods Clinicopathological features were retrieved from the patient's charts. Fresh frozen tumors were used for RNA and DNA analyses. Telomere length was evaluated by qPCR (T/S ratio). Somatic mutations in TERT promoter (TERTp) and CTNNB1 were detected by Sanger and/or whole-exome sequencing. We performed RNA-Seq to identify differentially expressed genes in aCPs presenting with shorter or longer telomere lengths. Results Mutations in CTNNB1 were detected in 29 (69%) tumors. There was higher frequency of CTNNB1 mutations in aCPs from patients diagnosed under the age of 15 years (85% vs 15%; P = 0.04) and a trend to recurrent disease (76% vs 24%; P = 0.1). No mutation was detected in the TERTp region. The telomeres were shorter in CTNNB1-mutated aCPs (0.441, IQR: 0.297–0.597vs 0.607, IQR: 0.445–0.778; P = 0.04), but it was neither associated with clinicopathological features nor with recurrence. RNAseq identified a total of 387 differentially expressed genes, generating two clusters, being one enriched for short telomeres and CTNNB1-mutated aCPs. Conclusions CTNNB1 mutations are more frequent in children and adolescents and appear to associate with progressive disease. CTNNB1-mutated aCPs have shorter telomeres, demonstrating a relationship between the Wnt/β-catenin pathway and telomere biology in the pathogenesis of aCPs.

Objective Pediatric adrenocortical tumors (pACT) display complex genomic backgrounds, lacking robust prognostic markers and targeted therapeutic options. Vitamin D3 receptor (VDR) promoter hypermethylation and underexpression were reported in adrenocortical carcinomas from adult patients. In this study, we aimed to investigate VDR expression levels and methylation status in pACT and their clinical and prognostic significance. Design Retrospective cross-sectional study enrolling pediatric patients with ACT from two tertiary referral institutions. Methods We evaluated clinicopathological features, VDR mRNA (qPCR) and protein (immunohistochemistry) expression, and VDR-wide methylation of ACT samples from 108 pediatric patients. Fourteen pediatric and 32 fetal and postnatal normal adrenals were used as controls. Results Unlike in pre- and post-natal normal adrenals, most pACT lacked nuclear VDR expression and had reduced mRNA levels, especially the carcinomas. Unsupervised analysis of VDR methylation data revealed two groups of pACT with distinct disease features and outcomes. Tumors with high VDR methylation presented lower mRNA levels, and the respective patients presented advanced disease and reduced disease-free and overall survival. Conclusions VDR has a role in normal adrenocortical development and homeostasis, which is impaired during tumorigenesis. VDR hypermethylation and underexpression may be both predictive and prognostic biomarkers for pACT.

Few studies have assessed biomarkers for the differentiation of major depressive disorder (MDD) and bipolar disorder (BD). However, some elements of depression such as hormones and receptors of the renin–angiotensin–adrenal system (RAAS), the hypothalamus–pituitary–adrenal (HPA) axis, and history of early-life stress (ELS) could be considered for differential diagnosis. Therefore, this study aimed to assess aldosterone and cortisol levels, MR and GR gene polymorphisms, and ELS as potential biomarkers for differentiating MDD and BD. This study presents a case–control design. Groups comprised samples for genetic, cortisol, and aldosterone analysis: healthy control (HC; n = 113/97/103), MDD (n = 78/69/67) and BD (n = 82/68/65) subjects. Furthermore, all subjects were assessed for diagnostic screening, the severity of depression, and history of ELS by applying MINI-PLUS, GRID-HDRS, and CTQ, respectively. In addition, genotype and allelic frequencies of GR (N363S, R22/23K and BclI) and MR (MI180V and -2G/C) polymorphisms were evaluated via PCR. Our findings demonstrate that basal aldosterone levels may be a biomarker for differentiating BD and MDD. Furthermore, ELS affects the HPA axis in BD, cortisol may be considered a biomarker for distinguishing BD and MDD, but only in the absence of ELS, and, finally, history of ELS and MR-2G/C variant alleles are factors that contribute to the severity of depressive symptoms in MDD and BD.

Os efeitos do novo coronavírus ainda estão sendo estudados. A tecnologia, por meio da telemedicina, desponta como um meio para amparo aos pacientes suspeitos de infecção pelo novo Coronavírus e auxílio na tomada de decisão, que levanta dados que possam ser validados em pesquisas científicas. Esse estudo tem como hipótese que a gravidade dos sintomas da infecção pelo Sars-Cov-2 está relacionada com a idade e condições clínicas preexistentes. O objetivo é avaliar a relação entre condições clínicas preexistentes e a gravidade da síndrome gripal, bem como o encaminhamento para atendimento hospitalar, dos pacientes usuários da plataforma TeleCOVID®. Como resultados, na análise de 1554 pacientes, 1165 (74.9%) foram classificados como síndrome gripal leve e 389 (25%) como síndrome gripal grave. A presença de comorbidades cardiovasculares (OR=1.8), pulmonares (OR = 4.7), o uso de imunossupressores não hormonais (OR=2.5) e de insulina (OR=3.9) apresentaram associação positiva com significância estatística com síndrome gripal grave. Conclui-se, portanto, que a tecnologia possibilitou a realização de um estudo para estabelecer conhecimentos em meio à pandemia da COVID-19, e que síndrome gripal grave está associada à comorbidades cardiovasculares, pulmonares, uso de imunossupressores não hormonais e insulina.

Children diagnosed with adrenocortical tumors (pACT) have variable outcomes and, to date, the disease lacks robust prognostic biomarkers. The prognostic potential of tumor methylation has been demonstrated in several cancers. We aimed to evaluate the pACT methylation profile and its association with disease presentation and survival. In this cross-sectional study, we accessed the DNA methylation (MethylationEPIC Array, Illumina) of 57 primary pACT from Southeastern Brazil and the respective patients’ clinicopathological features. We also applied our analysis in an independent 48 pACT methylation data-set. Unsupervised learning whole-methylome analysis showed two groups with distinct methylation signatures: pACT-1 and pACT-2. Compared to pACT-2, pACT-1 tumors were enriched for higher methylation in CpG islands, mainly in gene promoter regions. The top-most hypermethylated gene in these samples was shown to be under-expressed. Patients in the pACT-1 group were older at diagnosis and were more likely to have carcinomas, non-localized/advanced and recurrent/metastatic disease. Univariate and bivariate regressions showed that pACT-1 methylation signature confers superior hazard-ratio of disease progression and death than known prognostic features. The methylation groups had similar frequencies of germline mutations in the TP53 gene, including the regionally frequent p.R337H. Our analysis replication validated our findings and reproduced those recently described in pACT. Conclusions: We demonstrated the existence of different tumor methylation signatures associated with pACT presentation and clinical evolution, even in the context of germline TP53 mutations. Our data support tumor methylation profiling as a robust and independent prognostic biomarker for pACT and suggest a list of candidate genes for further validation.

O transtorno do espectro autista (TEA) compreende em uma ampla gama de condicoes que impactam a comunicacao social e o comportamento do individuo. O Centro de Controle e Prevencao de Doencas, afirma que o TEA e uma questao de saude publica, com aumento marcante em sua prevalencia na populacao mundial. Por outro lado, o tratamento com canabidiol tem se destacado como uma possivel intervencao no manejo do transtorno. Isso porque, atraves de sua atuacao nos neurotransmissores, promove uma regulacao positiva dos sintomas associados ao TEA. Desta forma, o objetivo deste artigo foi verificar atraves de uma revisao bibliografica, o uso do canabidiol no tratamento de individuos com TEA. Os resultados desta pesquisa evidenciaram as contribuicoes do canabidiol como terapia alternativa aos metodos convencionais para tratamento da sintomatologia do TEA. O tratamento com canabidiol representa grande importância para as condutas de manejo que buscam a qualidade de vida a populacao com TEA, no entanto, e importante ressaltar a necessidade de estudos que considerem os possiveis efeitos adversos e as consequencias do uso a longo prazo.

We report organic carbon (OC) accumulation rates in three freshwater ecosystems in southern Brazil, along the largest shallow coastal lagoon ecosystem in the world, the Patos-Mirim-Mangueira. After European colonisation in the seventeenth century, regional wetlands started being replaced by agricultural fields (mostly rice). We used excess 210Pb to develop chronologies for lagoon sediment cores and quantify bulk sediment and OC accumulation rates. In the past 120 years, OC accumulation rates in Mirim and Mangueira Lagoons, which are influenced by rice paddies, averaged 14.9 ± 8.5 and 6.4 ± 3.7 g C m−2 year−1, respectively. Greater accumulation rates were estimated for macrophyte-dominated Nicola Lake (69.9 ± 38.5 g C m−2 year−1) located within the protected Taim Wetland with no direct influence of rice plantations. Starting in the early twentieth century, the construction of dams and drainage canals altered regional hydrology. Despite these anthropogenic changes, only a mild increase in OC accumulation was observed in Mirim Lagoon (15% only in site MIR2) after 1970. Mangueira Lagoon experienced the lowest OC burial rates despite increasing sedimentation rate and OC burial after the mid-1970s. This is probably because these large lakes (> 500 km2) have great nutrient-dilution potential, and their well-mixed water columns prevent nutrients from accumulating in the sediments over time.

Increasing evidence suggests that the FGF-Klotho endocrine system and the somatotropic system (pituitary and extra-pituitary GH) may have important metabolic and immune relationships, thus contributing to the pathophysiology of aging-related disorders, including diabetes, atherosclerosis, and cancer. The status of these interactions in isolated GH deficiency (IGHD) is unknown. The objective of this study was to assess the response of both FGF21 and β-Klotho levels to a standard meal in a homogeneous group of adults with congenital untreated IGHD due to a homozygous mutation in the GHRH receptor gene. In a cross-sectional study, we measured the levels of FGF21 and β-Klotho, before and 30, 60, 120, and 180 min after a standardized test meal in 20 (11 males) IGHD and 20 (11 males) age-matched controls. Areas under the curves (AUC) of FGF21 and β-Klotho were calculated. Baseline levels of FGF21 were similar, but baseline levels of β-Klotho were lower in IGHD subjects. The IGHD individuals exhibited lower AUC for FGF21 and β-Klotho levels than control subjects. There was a positive correlation between IGF1 and β-Klotho levels in the pooled groups. No correlation was found between IGF1 and FGF21 levels. Subjects with lifetime, untreated IGHD exhibit reduced FGF21 and β-Klotho levels response to a mixed meal. This difference may have consequences on metabolism and aging.

Este artigo apresenta uma proposta de tarefa voltada para a sala de aula de matemática, no intuito de auxiliar/orientar o professor na promoção de discussões coletivas na educação básica, com foco nos anos finais do ensino fundamental e ensino médio. Para o seu desenvolvimento, utilizamos a trajetória hipotética de aprendizagem como suporte metodológico para a organização do planejamento da aula proposta. Pretendemos analisar como o trabalho com discussões coletivas em sala de aula pode contribuir para a promoção do pensamento algébrico com os alunos, principalmente no que tange ao pensamento funcional. Esperamos contribuir para a prática docente em sala de aula, com possíveis orientações para os professores, de modo a auxiliar nos processos de ensino e aprendizagem de conteúdos matemáticos.

O caso clínico aborda os desafios de diagnóstico em tempos de pandemia em crianças de até dois anos, devido aos sintomas apresentados de grande semelhança. O paciente, acompanhado pela mãe, teve queixa de febre súbita por dois dias, não apresenta atualização da vacina de gripe, tem histórico de prematuridade e IVAS. A família não conseguiu aderir ao isolamento social em seus cargos de trabalho e a criança passa o dia com os avós.

Metastatic urothelial carcinoma (mUC) is an incurable and aggressive disease. In the past decades there have been few effective treatment options that have impacted the prognosis of mUC patients. However, in the last few years, several drugs have emerged as new treatment choices that are changing the therapeutic landscape of mUC. Immune checkpoint inhibitors (ICIs) and targeted agents are useful treatment strategies that have been incorporated into our clinical practice. Nevertheless, cisplatin-based chemotherapy is still the standard of care in the first-line of metastatic disease. The results of the JAVELIN Bladder 100 phase 3 trial were presented at ASCO 2020, this trial evaluated the role of avelumab, an ICI, as maintenance therapy in patients who had not progressed after first-line platinum-based chemotherapy. The trial met its primary endpoint demonstrating an overall survival benefit with avelumab maintenance. In addition, new drugs and combinations are being evaluated to improve the outcomes of second and subsequent lines. Fibroblast growth factor receptor (FGFR) inhibitors and immunotherapy combinations were some of the strategies presented at ASCO 2020 that have shown promising results. Finally, the development of predictive biomarkers that help us in the decision-making process will be one of the most important challenges in the next years. Sin financiación No data JCR 2020 1.003 SJR (2020) Q2, 165/354 Oncology No data IDR 2020 UEM

Este artículo presenta información y datos que son importantes de considerar al momento de adquirir un bien inmueble, específicamente un departamento en el municipio de Monterrey, Nuevo León. El objetivo central de la investigación es analizar los principales factores que se toman en cuenta antes de adquirir un departamento, revisando las variables obtenidas a través de una encuesta realizada y aplicada a 122 personas vía Google forms. La finalidad de este artículo será evaluar los principales factores que se toman de cuenta antes de realizar una inversión, utilizando un muestreo no probabilístico por conveniencia y el análisis de las variables que se obtuvieron. La hipótesis que se intenta probar es que, para poder adquirir un departamento, se tienen que validar y revisar ciertos puntos importantes y ver cómo se comportan esos mismos factores en la toma de decisión de las personas.

Cisplatin-based neoadjuvant chemotherapy followed by radical cystectomy is the current standard of care for muscle-invasive bladder cancer (MIBC). However, less than half of patients are candidates for this treatment, and 50% will develop metastatic disease. Adjuvant chemotherapy could be offered if neoadjuvant treatment has not been administered for suitable patients. It is important to reduce the risk of systemic recurrence and improve the prognosis of localized MIBC. Systemic therapy for metastatic urothelial carcinoma has evolved in recent years. Immune checkpoint inhibitors and targeted agents, such as antibody-drug conjugates or FGFR inhibitors, are new therapeutic alternatives and have shown their benefit in advanced disease. Currently, several clinical trials are investigating the role of these drugs, as monotherapy and in combination with chemotherapy, in the neoadjuvant and adjuvant settings with promising outcomes. In addition, the development of predictive biomarkers could predict responses to neoadjuvant therapies.

The research reported in this article aimed to investigate didactic aspects involved in the production of digital videos by mathematics pre-service teachers for the participation in the Festival of Digital Videos and Mathematics Education. The data were produced in the course named "Didactics of Mathematics" with two classes of an undergraduate course in Mathematics at a public state university. The video production process was based on the notion of “digital mathematical performance”. Based on the instructor's supervision, the groups produced six videos, four of which were submitted to the Festival, exploring different elementary and high school mathematical contents and using different artistic-narrative languages. The didactic proposal is innovative considering the interface involving the use of digital technologies and the arts in Mathematics Education, with emphasis on multimodality. Participation in the Festival offered the means to build alternative images of mathematics and aesthetic mathematical experiences for future teachers.

To evaluate the therapeutic potential of vitamin D receptor (VDR) signaling in adrenocortical carcinoma (ACC) cells.We evaluated VDR's methylation pattern in H295R ACC cells, and investigated the effects of calcitriol and seocalcitol treatments on adrenocortical tumorigenesis.VDR was hypermethylated and underexpressed in basal H295R cells. Treatments with calcitriol and seocalcitol restored VDR signaling, resulted in antiproliferative effects, and impaired Wnt/B-catenin signaling. RNAseq of treated cells demonstrated VDR activation on steroid hormones biosynthesis and Rap1 signaling, among others. In vivo, seocalcitol constrained the growth of H295R xenografts and reduced autonomous tumor steroid secretion without hypercalcemia-associated side effects.H295R cells present VDR hypermethylation, which can be responsible for its underexpression and signaling inactivation under basal conditions. VDR signaling promoted antiproliferative effects in vitro and in vivo, suggesting that it may be a potential therapeutic target for ACC and a valuable tool for patient's clinical management.

Objectives To evaluate how telomeres length behaves in adamantinomtous craniopharyngioma (aCP) and if it contributes to the pathogenesis of aCPs with and without CTNNB1 mutations. Design: Retrospective cross-sectional study enrolling 42 aCPpatients from two tertiary institutions. Methods Clinicopathological features were retrieved from patient's charts. Fresh frozen tumors were used for RNA and DNA analyses. Telomere length was evaluated by qPCR (T/S ratio). Somatic mutations in TERT promoter (TERTp) and CTNNB1 were detected by Sanger and/or whole-exome sequencing. We performed RNA-Seq to identify differentially expressed genes in aCPs presenting with shorter or longer telomere lengths. Results Mutations in CTNNB1 were detected in 29 (69%) tumors. There was higher frequency of CTNNB1mutations in aCPs from patients diagnosed under the age of 15 years (85% vs 15%; p=0. 04) and a trend to recurrent disease (76% vs 24%; p=0.1). No mutation was detected in the TERTp region. The telomeres were shorter in CTNNB1-mutated aCPs (0.441, IQR: 0.297-0.597 vs 0.607, IQR: 0.445-0.778; p=0. 04) but it was neither associated with clinicopathological features nor with recurrence. RNAseq identified a total of 387 differentially expressed genes, generating two clusters, being one enriched for short telomere and CTNNB1-mutated aCPs. Conclusions CTNNB1 mutations are more frequent in children and adolescents and appear to associate with progressive disease. CTNNB1-mutated aCPs have shorter telomeres. This is the first evidence for a relationship between the Wnt/beta-catenin pathway and telomere biology in the pathogenesis of aCPs. Presentation: No date and time listed

O estudo da interacao entre fatores socio-ambientais com obesidade, tem sido uma estrategia para determinar os mecanismos dos fatores de risco para doencas cardiovasculares. Acreditamos que o aumento exacerbado da pressao arterial e da atividade simpatica durante o estresse mental em adultos podem ser um mecanismo precoce importante. No entanto, a influencia da presenca de obesidade nao esta clara em resposta a esse estresse. Desta forma, o objetivo foi avaliar o impacto da obesidade na performance funcional cognitiva e no perfil hemodinâmico em resposta ao teste de estresse mental. Foi realizado um estudo clinico transversal com 80 sujeitos do sexo masculino e feminino divididos em 3 grupos: grupo eutrofico com idade de 18 a 33 anos (GE, n=37), grupo obeso com idade de 18 a 35 anos (GO1, n=29), e grupo obeso com idade de 36 a 55 anos (GO2, n=14). Todos os sujeitos assinaram o termo de consentimento livre esclarecido, sob parecer do CEP 2.696.993/18. A analise da composicao corporal foi realizada atraves do indice de massa corporal (IMC), indice da relacao circunferencia cintura-quadril (RCQ), porcentagem da massa gorda (MG), massa magra (MM) e taxa metabolica basal (TMB) atraves da bioimpedância eletrica, e o nivel de atividade fisica pelo questionario internacional de atividade fisica (IPAQ). O desempenho cognitivo foi avaliado pelo Stroop Color and Word Test e o perfil hemodinâmico atraves da afericao da pressao arterial (PA) pelo metodo auscultatorio e a frequencia cardiaca (FC) a partir de um oximetro de pulso. Para analise dos dados foi utilizado o teste de Student Newman Keuls, teste de Correlacao de Pearson com nivel de significância de 5%. Como resultados, os grupos obesos apresentaram maior peso corporal, IMC, RCQ e massa gorda do que o grupo eutrofico, com aumento adicional no grupo GO2 em relacao ao GO1. GO1 e GO2 apresentaram maior tempo para execucao do teste de estresse mental (GO1: 27,88±7,66 seg.; GO2: 45,97±14,68 seg.) e prejuizo na funcao executiva especifica (GO1: 1,58±0,67 seg- /desvio ; GO2: 2,63±1,62 seg- /desvio ) em relacao ao grupo eutrofico (GE: 19,16±6,80 s seg- /desvio ; 1,14±0,46 seg- /desvio ). Nos parâmetros hemodinâmicos, os grupos obesos apresentaram maiores valores de PAS (GO1: 119±11,3 mmHg; GO2: 132±16,0 mmHg) e PAD (GO1: 75±9,3 mmHg; GO2: 85±7,6 mmHg) em relacao ao grupo eutrofico (GE PAS: 105±12,4 mmHg; PAD: 66±9,9 mmHg). Os resultados evidenciam que o Stroop Color and Word Test e um instrumento eficaz de inducao a reatividade cardiovascular e da avaliacao de funcao executiva especifica em individuos eutroficos e obesos sedentarios.

Transport policies for improving air quality are increasingly being implemented in city centres across the world. While the effectiveness of those policies is markedly affected by a strong social controversy, one missing element is the role that stakeholders engagement can play in identifying impacts and potential implementation strategies. This paper diverges from other commonly accepted approaches by allowing stakeholders evaluate a set of transport policies for improving air quality. The city of Madrid (Spain), where there is a clear intention to restrict traffic in its centre, was taken as case study. Local stakeholders were engaged in a series of semi-structure interviews and a final face-to-face workshop to evaluate the potential impacts, acceptability, and feasibility of eight transport policies. Results show two distinct viewpoints: stakeholders from public institutions and eco-mobility sectors; and stakeholders linked to retail, logistics, and car-sharing services. Consensus between those two groups was hard to achieve for three specific policies: (i) license-plate restrictions; (ii) charges to motor vehicles; and (iii) development of walking and cycling infrastructure. The paper outlines the methodological process, reflects on the usefulness of stakeholder engagement in the policy-making process, and concludes with a discussion on the acceptability of the evaluated transport policies in the local context of Madrid.

Objective The use of broad-spectrum antimicrobials, such as third and fourth-generation, are responsible for emergence of multidrug-resistant microorganisms in neonatal units. Furthermore, antimicrobial daily doses are not standardized in neonatology. This study aimed to investigate the association between the use of antimicrobial broad spectrum to bacterial sensitivity profile in a referral unit of neonatal progressive care. Methods This is a cohort study conducted in a referral neonatal progressive care unit from January 2008 to December 2016. The data of all hospitalized neonates was collected daily. The infection criteria used were the standardized national criteria, based on definitions of Center for Diseases Control and Prevention. In this study, the use of antimicrobials was evaluated as antimicrobial-day (ATM-day) and the ratio of multidrug-resistant microorganisms per 1000 ATM-day of broad spectrum was also calculated. The study was approved by the Institutional Review Board of the Universidade Federal de Minas Gerais (ETIC 312/08 e CAAE 58973616.2.0000.5149). Results From 2008 to 2016, 2751 neonates were hospitalized, corresponding to 60,656 patient-days. The ratio of multidrug-resistant microorganisms per 1000 ATM-day of broad spectrum was 1,3 in the first period and 4,3 in the second period (p = 0,005). Conclusion It was observed that use of broad-spectrum antimicrobials, especially those with coverage for Gram-negative bacteria, was associated with an increase of multidrug-resistant bacteria.