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Background Activation of the mitogen-activated protein kinase (MAPK) pathway induces uncontrolled cell proliferation in response to inflammatory stimuli. Adriamycin (ADR)-induced nephropathy (ADRN) in rats triggers MAPK activation and pro-inflammatory mechanisms by increasing cytokine secretion, similar to chronic kidney disease (CKD). Activation of the vitamin D receptor (VDR) plays a crucial role in suppressing the expression of inflammatory markers in the kidney and may contribute to reducing cellular proliferation. This study evaluated the effect of pre-treatment with paricalcitol on ADRN in renal inflammation mechanisms. Methods Male Sprague-Dawley rats were implanted with an osmotic minipump containing activated vitamin D (paricalcitol, Zemplar, 6 ng/day) or vehicle (NaCl 0.9%). Two days after implantation, ADR (Fauldoxo, 3.5 mg/kg) or vehicle (NaCl 0.9%) was injected. The rats were divided into four experimental groups: control, n = 6; paricalcitol, n = 6; ADR, n = 7 and, ADR + paricalcitol, n = 7. Results VDR activation was demonstrated by increased CYP24A1 in renal tissue. Paricalcitol prevented macrophage infiltration in the glomeruli, cortex, and outer medulla, prevented secretion of tumor necrosis factor-α, and interleukin-1β, increased arginase I and decreased arginase II tissue expressions, effects associated with attenuation of MAPK pathways, increased zonula occludens-1, and reduced cell proliferation associated with proliferating cell nuclear antigen expression. Paricalcitol treatment decreased the stromal cell-derived factor 1α/chemokine C-X-C receptor type 4/β-catenin pathway. Conclusions Paricalcitol plays a renoprotective role by modulating renal inflammation and cell proliferation. These results highlight potential targets for treating CKD.

ABSTRACT Objectives: to evaluate the risk of postoperative complications in cardiac patients. Methods: an evaluative study using the Tuman Score on medical records of 70 adult patients who underwent cardiac surgery at a University Hospital. The R for Windows software was used for the analyses. Descriptive statistics and bivariate analysis were employed to verify the association between the risk score and complications. The relative risk between the Tuman Score and postoperative complications was obtained through Quasi-Poisson regression, with a 95% confidence interval. Results: the majority of the patients were male (58.57%), aged between 41-64 years (50%), who underwent myocardial revascularization (50%). These patients were associated with a lower risk of postoperative complications (p=0.003), (p=0.008), and (p=0.000), respectively. High-risk patients had pulmonary complications (RR=1.32, p=0.002) and neurological complications (RR=1.20, p=0.047). Conclusions: preoperative risk assessment promotes qualified care to reduce postoperative complications.

Introduction Cardiovascular diseases remain a leading cause of death worldwide. Recovery from myocardial infarction is challenging as the causes of symptoms span multiple aspects of health not just physical conditions. Evidence has shown a gap between the waycare is provided in the clinical setting and the person’s needs and preferences. The implementation of person-centred care (PCC) interventions can promote recovery from myocardial infarction by allowing a greater understanding of the person’s perception and its role on the overall recovering process. This study aims to culturally adapt an evidence-based PCC intervention to enhance self-efficacy in patients after myocardial infarction within a Portuguese healthcare context.Methods and analysis The Portuguese person-centred care for myocardial infarction recovery (P2MIR) intervention is set to be developed from an evidence-based intervention, rooted in the ethics of PCC. An intervention of PCC for patients with acute coronary syndrome, which has been successfully implemented and evaluated in the Swedish healthcare context will be validated, culturally adapted and harmonised to the Portuguese healthcare context by using qualitative methods. To evaluate its acceptability, appropriateness and feasibility, a sample of stakeholders, consisting of a sample of healthcare professionals and a sample of people who suffered a myocardial infarction, will be recruited from a hospital, including both inpatient and outpatient departments. The stakeholders will be invited to semistructured focus group discussions, aiming to gather their perceptions about the P2MIR intervention, which will be previously presented to them. Data analysis will be conducted using content analysis following a deductive-inductive approach to further inform the intervention adaptation process to its final intervention in a Portuguese healthcare context.Ethics and dissemination The study has been reviewed and approved by the Health Ethics’ Committees of the Centro Hospitalar Lisboa Ocidental, Lisbon, Portugal (registry number 20170700050). The results will be disseminated through peer-reviewed journals and conference presentations.

This paper investigates the pervasive issue of hate speech within Twitter/X Portuguese network conversations, offering a multifaceted analysis of its characteristics. This study utilizes a mixed-method approach, combining several methodologies of network analysis (triad census and participation shifts) over the network of interaction between users. Qualitative manual content annotation was applied to the dataset to dissect different patterns of hate speech on the platform. Key findings reveal that the number of users followed by an individual and potentially reads is a relevant predictor for a user's propensity to post aggressive content. We concluded also that during a conversation thread, hate speech happens significantly more within the first 2 h of interaction. Transitivity of interactions and individual expression are considerably lower as more hate speech is prevalent in conversations. Our research confirms that hate speech is usually expressed by external individuals who intrude into conversations. Conversely, the expression of hate speech of indirect type by third parties interfering in conversations is uncommon. We also found that counter-speech discourse is strongly correlated with a type of discourse that typically avoids conflict and is not privately held.

Late human immunodeficiency virus (HIV) diagnosis has been associated with missed opportunities for earlier diagnosis. We conducted a retrospective, longitudinal, single-centre cohort study evaluating these missed opportunities and their clinical repercussions in adults with a new HIV diagnosis or who were drug-naïve, who attended our Infectious Diseases Department between 2018 and 2023. We assessed missed opportunities in the two years prior to diagnosis or after the last negative HIV test. We compared clinical and laboratorial data from individuals with and without missed opportunities. The primary outcome considered was AIDS-defining conditions at diagnosis. Among the 436 included individuals, 27.1% experienced at least one missed opportunity. Those with missed opportunities were more likely to be female (p = 0.007), older at their first consultation (p < 0.001), born in Africa (p < 0.001) and in countries with a high HIV prevalence (p < 0.001), and have heterosexual transmission (p < 0.001). The adjusted analysis showed that missed opportunities were significantly associated with AIDS-defining conditions at diagnosis (OR 3.23, CI 95% [1.62–6.46], p < 0.001). These findings highlight the impact of missed opportunities on HIV severity, underscoring the need for more targeted interventions to reduce them.

Abstract Background Diabetic kidney disease (DKD) remains one of the main causes of end-stage renal disease (ESRD) and mortality in diabetic patients worldwide. Vitamin D deficiency (VitDD) is one of the main consequences of different chronic kidney disease (CKD) types and is associated with rapid progression to ESRD. Nevertheless, the mechanisms that lead to this process are poorly understood. This study aimed to characterize a model of diabetic nephropathy progression in VitDD and the epithelial-mesenchymal-transition (EMT) role in these processes. Methods Wistar Hannover rats received a diet with or without VitD before type 1 diabetes (T1D) induction. After this procedure, the rats were accompanied for 12 and 24 weeks after T1D induction and the renal function, structure, cell transdifferentiating markers and zinc finger e-box binding homeobox 1/2 (ZEB1/ZEB2) contribution to kidney damage were evaluated during the DKD progression. Results The results showed an increase in glomerular tuft, mesangial and interstitial relative areas and renal function impairment in VitD-deficient diabetic rats compared to diabetic rats that received a VitD-containing diet. These alterations can be associated with increased expression of EMT markers, ZEB1 gene expression, ZEB2 protein expression and TGF-β1 urinary excretion. Decreased miR-200b expression, an important post-transcriptional regulator of ZEB1 and ZEB2 was also observed. Conclusion Our data demonstrated that VitD deficiency contributes to the rapid development and progression of DKD in diabetic rats induced by increase ZEB1/ZEB2 expressions and miR-200b downregulation.

Introdução: A Etapa I do projeto de internacionalização Pontes Atlânticas, do Núcleo Académico de Fisioterapia (NAFisio) da Rede Académica das Ciências da Saúde da Lusofonia (RACS), iniciado no ano letivo 21/22, com segunda edição em 22/23, promove a partilha de perspetivas sobre o contexto educativo e profissional da Fisioterapia entre estudantes de diferentes instituições de ensino superior (IES) membros da RACS. Através da criação de equipas de estudantes de diferentes IES, são realizadas reuniões on-line para partilha das suas realidades, considerando a sua experiência enquanto alunos e futuros profissionais. Objetivos: Identificar o grau de satisfação e impacto da atividade Pontes Atlânticas – Etapa 1 nos alunos participantes no projeto no ano letivo 22/23 e comparar com os resultados do ano letivo 21/22. Material e Métodos: Estudo observacional, descritivo e comparativo, por questionário on-line, disponibilizado por email, no final da atividade dos anos letivos 21/22 e 22/23. A amostra no ano letivo 21/22 foi constituída por 86 estudantes dos 103 participantes iniciais (Portugal, Brasil, Moçambique, Cabo Verde, Angola e São Tomé e Príncipe) e em 22/23 por 41 estudantes de 76 participantes (Portugal, Cabo Verde, Angola e Brasil). Resultados: Considerando e comparando, respetivamente, os resultados obtidos em 21/22 e 22/23: 93% e 83% dos alunos afirmaram que os objetivos eram claros e atingíveis, e que os materiais de suporte foram suficientes; 70% e 51% reportaram que o contacto com os pares e o planeamento foi fácil; 94% e 71% referiu que a atividade ajudou a compreender o contexto nacional/internacional do ensino e da prática da Fisioterapia; e 89% e 80% dos estudantes afirmaram que atividade foi importante para o desenvolvimento de competências pessoais e profissionais, e que deve continuar a ser realizada. Conclusões: Com os resultados obtidos, concluímos que no ano letivo 22/23 a participação diminuiu e algumas das dimensões também sofreram um decréscimo, assumindo-se como um desafio a ser analisado pelo NAFisio, por forma a encontrar estratégias para o ultrapassar. No entanto, consideramos que é um projeto a ter continuidade, uma vez que 80% dos alunos afirmaram que a atividade foi importante para o desenvolvimento de competências pessoais e profissionais.

Introdução: O desenvolvimento tecnológico e a Inteligência artificial (IA) estão a transformar a forma de ensino-aprendizagem, no ensino superior. Prova disso é o aumento da literatura existente sobre o tema (Chu et al, 2022). A maioria dos estudos incide sobre as características dos instrumentos, do seu uso, benefícios e implementação. A importância da perceção dos estudantes é reconhecida na literatura (Chan & Hu, 2023), contudo desconhece-se o que pensam os estudantes de Fisioterapia (FT). Objetivo: Adaptação do questionário “Use, and acceptability, of digital health technologies in musculoskeletal physical therapy: A survey of physical therapists and patients” dos autores Merolli et al (2022), criado para profissionais e para uma população de estudantes de fisioterapia, considerando dimensões semelhantes. Material e Métodos: a construção e validação do inquérito por questionário, até dezembro de 2023. Adaptado de Merolli et al (2022) e complementado com informação de outros instrumentos utilizados nos estudos onde se avalia a utilização da IA em FT. O questionário a criar será composto por duas partes: uma relativa à identificação do sujeito e outra relativa às questões da utilização da IA, sendo utilizadas questões fechadas, num formato tipo Likert de cinco pontos. Seguir-se-ão as etapas de um estudo de construção e validação de instrumentos e posteriormente adaptação cultural e linguística, tendo em conta a variabilidade de países que fazem parte da NaFisio. Esta será contemplada nas fases das versões de consenso, painel de DElphi e no pré-teste. Após esta etapa ocorrerá a validação das propriedades psicométricas do instrumento. A aplicação destes questionários será efetuada de acordo com os princípios da declaração de Helsínquia, após submissão e aprovação pela comissão de ética. Resultados: Os resultados previstos serão um questionário em suporte digital valido para avaliação da perceção dos estudantes de Ft sobre IA, considerando as dimensões: Instrumentos de IA mais utilizados; Benefícios e riscos do seu uso; Dificuldades na sua utilização; Utilizações mais frequentes da IA durante o estudo. Posteriormente esperamos obter de cerca de 1000 respostas de estudantes de Ft dos países lusófonos, onde poderemos calcular estatisticamente o autoconhecimento dos instrumentos de GEnAI, disponíveis, quais os mais utilizados, as mais frequentes aplicações e o valor intrínseco dado à IA e ao seu futuro na aprendizagem. Conclusões: Este é o primeiro estudo sobre a opinião dos estudantes de Ft dos países lusófonos, com a possibilidade de extensão a outros países. Os resultados deste estudo poderão fornecer uma compreensão da perceção dos estudantes fisioterapia, sobre a IA, o que poderá permitir uma melhor integração e adaptação desta no ensino de modo, eficaz, crítico e ético. Permitirá ainda conhecer a opinião dos estudantes relativo ao facto de o desenvolvimento tecnológico ser transversal influenciando o ensino da FT assim como a prática clínica. Estes parecem estar a sofrer transformações que se pretendem provar se são facilitadoras ou não de uma melhor prática clínica.

A notable shift in understanding the human microbiome’s influence on cardiovascular disease (CVD) is underway, although the causal association remains elusive. A systematic review and meta-analysis were conducted to synthesise current knowledge on microbial taxonomy and metabolite variations between healthy controls (HCs) and those with CVD. An extensive search encompassing three databases identified 67 relevant studies (2012–2023) covering CVD pathologies from 4707 reports. Metagenomic and metabolomic data, both qualitative and quantitative, were obtained. Analysis revealed substantial variability in microbial alpha and beta diversities. Moreover, specific changes in bacterial populations were shown, including increased Streptococcus and Proteobacteria and decreased Faecalibacterium in patients with CVD compared with HC. Additionally, elevated trimethylamine N-oxide levels were reported in CVD cases. Biochemical parameter analysis indicated increased fasting glucose and triglycerides and decreased total cholesterol and low- and high-density lipoprotein cholesterol levels in diseased individuals. This study revealed a significant relationship between certain bacterial species and CVD. Additionally, it has become clear that there are substantial inconsistencies in the methodologies employed and the reporting standards adhered to in various studies. Undoubtedly, standardising research methodologies and developing extensive guidelines for microbiome studies are crucial for advancing the field.

As práticas pedagógicas centradas em videojogos têm vindo a tornar-se cada vez mais populares, dado oferecerem vantagens empiricamente validadas no que diz respeito ao envolvimento dos alunos, à sua motivação e sentido de agência. Estes construtos afetivos são agora reconhecidos como componentes-chave de uma aprendizagem eficaz e significativa, favorecendo o desenvolvimento de competências cognitivas de nível superior. Contudo, enquanto se atesta um número elevado de estudos sobre o uso de videojogos educativos nas áreas das Ciências, Tecnologia, Engenharia e Matemática (STEM), é necessário ainda explorar as potencialidades desses recursos nas disciplinas de Humanidades. Analogamente, devem ser empreendidos mais esforços no sentido da investigação e implementação de atividades que atribuam aos alunos, especialmente àqueles de níveis inferiores ao do Ensino Superior, o papel de designers de videojogos, aliado ao de jogadores. Desta feita, criam-se as condições para que os alunos construam material didático autêntico, sob a forma de experiências digitais imersivas, que apresentam tanto um valor educacional como de entretenimento. Assim, este artigo funciona como um Position Paper sobre a Aprendizagem Baseada em Jogos Digitais ou Digital Game-based learning (DGBL), descrevendo as vantagens afetivas de se jogar e criar videojogos educativos na sala de aula de Humanidades, enquanto reflete criticamente sobre possíveis obstáculos ao sucesso desta prática. O nosso objetivo é estudar como a tecnologia educativa e imersiva pode satisfazer as necessidades de aprendizagem da Geração Z, tendo em consideração os diferentes fatores contextuais que definem o seu perfil.

Este artigo reside na análise de conteúdo de 239 posts, no contexto de dez perfis de influenciadores digitais indígenas da Amazônia brasileira. A amostra restringe-se à rede social Instagram entre 15 de março e 19 de abril de 2022. Diante do retrocesso dos direitos dos povos indígenas, que tem ocorrido no Brasil, e da imagem desta comunidade pautada na colonialidade do ser, muitas vezes representadas e imaginadas como populações que precisam estar estáticas em suas tradições para terem sua etnia reconhecida, este trabalho centra-se em explorar a seguinte pergunta: o que os influenciadores digitais indígenas têm manifestado no Instagram em relação à identidade cultural e ao ativismo digital? Os resultados desta pesquisa revelaram que 33,47% (n=80) dos posts possuem características ativistas e 29,29% (n=70) são de caráter identitário. Além disso, 3,77% (n=9) dos posts são parcerias pagas, o que demonstra uma tendência para o marketing de influência indígena, embora este ainda seja tímido na amostra pesquisada. Todos os dez perfis produziram algum tipo de conteúdo identitário e sete deles apresentaram conteúdos ativistas em relação ao movimento indígena, levantando temas de dentro e de fora dos sites de notícias on-line. Este resultado leva-nos a concluir que as redes sociais têm sido utilizadas como meio para manifestação de uma minoria étnica e como espaço de inclusão e discussão sobre a situação dessas comunidades, antes com pouca visibilidade e representatividade na mídia tradicional.

Spontaneous coronary artery dissection (SCAD) is an increasingly recognized cause of acute coronary syndrome, especially among young to middle-aged women with few traditional cardiovascular risk factors and low pretest probability for atherosclerotic coronary artery disease. Diagnosis by invasive coronary angiography is the gold standard and conservative therapy is generally recommended, with percutaneous or surgical revascularization being reserved for cases of clinical instability, high-risk anatomy or as bailout. Unlike atherothrombotic coronary artery disease, strong evidence on optimal medical therapy is scarce, posing unique challenges in cases of pregnancy-associated SCAD. The follow-up strategy is also of major importance, as recurrent SCAD is not infrequent, lifestyle changes and pharmacological therapy should be planned for the long term, and SCAD-associated conditions need to be addressed. This review aims to provide a practical management approach to SCAD patients for both clinical and interventional cardiologists. Resumo: A dissecção coronária espontânea é uma causa cada vez mais reconhecida de síndrome coronária aguda, especialmente entre mulheres jovens ou de meia-idade com poucos fatores de risco cardiovascular tradicionais e baixa probabilidade pré-teste de doença coronária aterosclerótica. O diagnóstico por coronariografia invasiva é o gold standard e a terapêutica conservadora é geralmente recomendada, optando pela revascularização percutânea ou cirúrgica em casos de instabilidade clínica, anatomia de alto risco ou como bailout. Ao contrário da doença coronária aterotrombótica, não existe evidência científica robusta sobre a terapêutica médica mais adequada nestes casos, representando ainda desafios particulares em casos de dissecção coronária espontânea associada à gravidez. A estratégia de seguimento é também fundamental, dado que a recorrência de dissecção coronária espontânea não é rara, as alterações de estilo de vida e terapêutica farmacológica devem ser planeados em longo prazo e devem ser investigadas as condições subjacentes associadas à dissecção coronária espontânea. Esta revisão pretende oferecer um guia de abordagem prática ao doente com dissecção coronária espontânea, do ponto de vista do cardiologista clínico e do cardiologista de intervenção.

Compaction is essential in earthworks of civil infrastructures, such as dam embankments, building foundations, roads, and other transport infrastructures. The nuclear method is a non-destructive test that has been one of the most used field tests in the quality control of compaction for a long time due to its easy operation and accuracy. The technique uses nuclear equipment to measure soil and aggregates' moisture content and in-situ density. The fidelity of the method according to Portuguese technology is still unknown. The paper has two main objectives: (1) to describe the application of the non-destructive testing method to the quality control of compaction; (2) to present the repeatability and reproducibility of the method in its application to the case of soils based on proficiency tests. The paper presents the methodology followed in carrying out the proficiency tests and analysing the results related to the method's fidelity. The work points out the most critical aspects of the test and presents the repeatability and reproducibility related to in situ density and moisture content in the cases of direct transmission and backscatter measurements.

This article presents a qualitative study that examines hate speech (HS) from the perspectives of the most representative minority communities in Portugal, namely Afro-descendants, Roma, and LGBTQ+. The empirical research employed three focus groups, each with a representation of these communities (n=17), with the primary goal of investigating how members of these groups perceive and experience HS within the Portuguese social and geopolitical context. The results indicate that covert HS can be more detrimental than overt HS since the targeted individuals are often caught off guard and unsure how to respond, contributing to the continuation of systems of oppression and social decline. Additionally, our qualitative data show that covert forms of HS often manifest in the form of compliments and humour, common in various settings, such as the workplace, the media, and the online environment. These devices are communicative strategies anchored in both positive and negative stereotypes and may lead to the normalization of HS in Portuguese society. In this regard, this research draws attention to the significance of identifying covert forms of HS and devising strategies, such as counter-speech, to debunk them. Furthermore, it highlights the need for automatic detection of covert HS since these forms are prevalent in digital platforms.

Introdução: O Acidente Vascular Cerebral (AVC) é a principal causa de incapacidade a longo prazo da população mundial. As alterações estruturais e funcionais consequentes da condição contribuem para a redução da mobilidade funcional (MF), tornando-se fundamental a sua avaliação com instrumentos de medida (IM) adequados e fundamentados, permitindo uma prática clínica mais objetiva e rigorosa. Objetivos: Investigar qual(is) o(s) instrumento(s) de medida mais completo(s), do ponto de vista das categorias da Classificação Internacional de Funcionalidade (CIF) abrangidas que, segundo a literatura, avalia(m) a MF no indivíduo adulto com sequelas de AVC, e rever na literatura as propriedades psicométricas desse(s) instrumento(s). Material e Métodos: Realizou-se duas pesquisas bibliográficas nas bases de dados PubMed, EBSCO, CENTRAL, PEDro, Web of Science, Science Direct e Wiley Online Library. O estudo foi dividido em duas partes principais, nomeadamente a elaboração de uma Scoping Review dos IM que avaliam a MF e uma Revisão Sistemática das propriedades psicométricas do IM com mais correspondências com a CIF. Resultados: Na Scoping Review foram incluídos 120 estudos, o Rivermead Mobility Index (RMI) foi o IM que apresentou mais correspondências com as categorias CIF incluídas na definição de MF. Na Revisão Sistemática, dos 11 estudos encontrados, verificou-se bons resultados na validade, fidedignidade e sensibilidade do RMI. Conclusões: O RMI mostra ser o IM mais completo na correspondência com as categorias CIF incluídas na definição de MF. Recomenda-se a utilização do RMI como IM da MF em utentes com AVC, pelas boas propriedades psicométricas que apresentam.

ABSTRACT Grafting has been increasingly used to overcome soilborne pathogens. The commercial rootstock hybrids AF-8253 (Sakata) and Fortaleza (Takii), as well as Embrapa’s new hybrid, BRS Acará, were evaluated as rootstocks for the bell pepper hybrids Margarita (Syngenta) and Pampa (Clause) as scions, under natural infestation of Ralstonia pseudosolanacearum, as well as upon artificial inoculation with a) ten Ralstonia isolates, b) one Phytophthora capsici isolate, c) Meloidogyne incognita race 1, and d) Meloidogyne enterolobii (only rootstocks for c and d). Grafted bell peppers consistently showcased a higher productivity than did non-grafted ones under natural R. pseudosolanacearum infestation, and the rootstock genotype affected fruit size distribution. Rootstocks presented higher resistance than did commercial bell pepper hybrids (scions) for 6 out of 10 Ralstonia isolates. AF-8253 and BRS Acará displayed an immune-like response to P. capsici, while Fortaleza was moderately resistant (25% symptomatic plants) and the bell pepper hybrids (scions) were susceptible (100% symptomatic plants). Rootstocks were immune to M. incognita race 1, but slightly (AF-8253 and BRS Acará) or moderately (Fortaleza) resistant to M. enterolobii. Grafting with BRS Acará, as well as with AF-8253 or Fortaleza, is recommended for managing bacterial wilt, Phytophthora blight, and root-knot nematodes.

Sweet cherry (Prunus avium L.) is among the most valued fruits due to its organoleptic properties and nutritional worth. Cherry stems are rich in bioactive compounds, known for their anti-inflammatory and antioxidant properties. Innumerable studies have indicated that some bioactive compounds can modulate sugar absorption in the small intestine. In this study, the phenolic profile of a cherry stem infusion was investigated, as well as its capacity to modulate intestinal glucose and fructose transport in Caco-2 cells. Long-term (24 h) exposure to cherry stem infusion (25%, v/v) significantly reduced glucose (3H-DG) and fructose (14C-FRU) apical uptake, reduced the apical-to-basolateral Papp to 3H-DG, and decreased mRNA expression levels of the sugar transporters SGLT1, GLUT2 and GLUT5. Oxidative stress (induced by tert-butyl hydroperoxide) caused an increase in 3H-DG uptake, which was abolished by the cherry stem infusion. These findings suggest that cherry stem infusion can reduce the intestinal absorption of both glucose and fructose by decreasing the gene expression of their membrane transporters. Moreover, this infusion also appears to be able to counteract the stimulatory effect of oxidative stress upon glucose intestinal uptake. Therefore, it can be a potentially useful compound for controlling hyperglycemia, especially in the presence of increased intestinal oxidative stress levels.

This study aims to analyse the coactivation of antagonist muscles of the thigh and ankle during the sit-to-stand task in post-stroke subjects, specifically during forward and antigravity sub-phases. A group of 18 healthy subjects and another with 18 subjects with a history of stroke participated voluntarily in this study. Bilateral surface electromyography (EMGs) of the soleus, gastrocnemius medialis, tibialis anterior, rectus femoris and biceps femoris muscles were collected synchronously with ground reaction forces (GRF) during the sit-to-stand task. The magnitude of electromyographic (EMG) activity was analysed during forward translation and antigravity sub-phases which were determined through GRF signals. The coactivation was calculated to quantify the degree of antagonist coactivation according to the role of the muscles during the task. Statistically significant values were found between antagonist coactivation on both sub-phases of the sit-to-stand task when comparing healthy and post-stroke subjects (healthy with ipsilesional (IPSI); healthy with contralesional (CONTRA); and healthy with IPSI and with CONTRA limbs) in all muscle pairs analysed (p < 0.01), except on thigh muscles (p > 0.05), in the antigravity sub-phase. When comparing IPSI with CONTRA sides in post-stroke subjects, no statistically significant differences were found. Increased values of antagonist coactivation were observed in post-stroke subjects compared to healthy subjects (both IPSI and CONTRA limb) in the two sub-phases analysed. The forward sub-phase CONTRA limb showed higher antagonist coactivation compared to IPSI, while in the antigravity sub-phase, IPSI antagonist coactivation was higher than in the CONTRA. In conclusion, post-stroke subjects presented an antagonist coactivation more dysfunctional at the ankle joint muscles compared to the thigh segment. So, it seems that the distal segment could express more accurately the central nervous system dysfunction in post-stroke subjects, despite the need for further studies to achieve a better spatiotemporal understanding of the variability on coactivation levels.

In September 2020, we tested 13,398 persons in Portugal for antibodies against severe acute respiratory syndrome coronavirus 2 by using a quota sample stratified by age and population density. We found a seroprevalence of 2.2%, 3–4 times larger than the official number of cases at the end of the first wave of the pandemic.

Gestational diabetes, affecting about 10% of pregnancies, is characterized by impaired glucose regulation and can lead to complications for health of pregnant women and their offspring. The microbiota, the resident microbes within the body, have been linked to the development of several metabolic conditions. This systematic review with meta-analysis aims to summarize the evidence on the differences in microbiota composition in pregnant women with gestational diabetes and their offspring compared to healthy pregnancies. A thorough search was conducted in the PubMed, Scopus, and Web of Science databases, and data from 21 studies were analyzed utilizing 41 meta-analyses. In the gut microbiota, Bifidobacterium and Alistipes were found to be more abundant in healthy pregnancies, while Roseburia appears to be more abundant in gestational diabetes. The heterogeneity among study findings regarding the microbiota in the meconium is considerable. The placental microbiota exhibited almost no heterogeneity, with an increased abundance of Firmicutes in the gestational diabetes group and a higher abundance of Proteobacteria in the control. The role of the microbiota in gestational diabetes is reinforced by these findings, which additionally point to the potential of microbiome-targeted therapies. To completely comprehend the interactions between gestational diabetes and the microbiome, standardizing methodologies and further research is necessary.

Resumen: Introducción: El objetivo del estudio fue evaluar el rendimiento diagnóstico de la pregunta relacionada con la actividad física del cuestionario de control del asma de la Global Initiative for Asthma (GINA) para la detección de la broncoconstricción inducida por el ejercicio (BIE) en niños y adolescentes. Materiales y métodos: Se dividió a pacientes (de seis a 18 años de edad) con diagnóstico de asma en dos grupos de acuerdo con la clasificación de gravedad según el cuestionario GINA: asma leve/moderada (ALM) y asma grave refractaria (AGR). Se recogieron datos antropométricos, clínicos y funcionales (espirometría) y se realizó prueba de broncoprovocación con esfuerzo. Se utilizó la cuarta pregunta del cuestionario GINA, concerniente a los síntomas asociados con el esfuerzo físico, para evaluar el rendimiento diagnóstico de este instrumento. Resultados: Se incluyeron a 40 pacientes (17 con ALM y 23 con AGR) con una edad media de 11,3 años y un z-score medio de FEV1 de -0,33, de los que 13 (32,5%) se clasificaron como casos de asma no controlada. De los pacientes con enfermedad no controlada, siete (53,8%) mostraron caídas en el FEV1 tras la prueba de esfuerzo. Se observó una mayor frecuencia de BIE en sujetos con z-score de FEV1 < -1,0 en comparación con aquellos con un z-score ≥ -1,0 (p = 0,05). No hubo diferencias significativas en la frecuencia de BIE con base en la gravedad o el control de la enfermedad. Tampoco se observó asociación entre la pregunta cuatro (GINA) y la BIE. El área bajo la curva de características operativas del receptor (receiver operating characteristic, ROC) evidenció que el poder discriminatorio del cuestionario GINA resulta insuficiente para detectar la BIE (p = 0,41), con una sensibilidad del 42,1% y una especificidad del 57,1%. Conclusiones: La pregunta concerniente al ejercicio físico en el cuestionario GINA carece del poder diagnóstico necesario para detectar la BIE en niños y adolescentes asmáticos. Abstract: Introduction: The aim of the study was to evaluate the diagnostic performance of the item concerning physical activity of the Global Initiative for Asthma (GINA) asthma control questionnaire for detection of exercise-induced bronchoconstriction (EIB) in children and adolescents. Material and methods: We divided participants (aged 6 to 18 years) with a diagnosis of asthma into two groups according to the GINA severity classification: mild/moderate asthma (MMA) and severe therapy-resistant asthma (STRA). We collected anthropometric, clinical and functional data (spirometry) and performed an EIB test. We used item 4 of the GINA questionnaire regarding exercise-induced symptoms to assess the diagnostic power of this instrument. Results: We included 40 patients (17 with MMA and 23 with STRA) with a mean age of 11.3 years and a mean FEV1 z-score of -0.33, of who 13 (32.5%) were classified as having uncontrolled asthma. Of the patients with uncontrolled asthma, 7 (53.8%) exhibited a decrease in the FEV1 after the EIB test. We found a higher frequency of EIB in participants with FEV1 z-score values of less than -1.0 compared to those with a z-score of -1.0 or greater (p = 0.05). There were no significant differences in the frequency of EIB based on disease severity and control. We also found no association of item 4 (GINA) with EIB. The area under the ROC curve demonstrated that the discriminative power of the GINA questionnaire for the detection of EIB is inadequate (p = 0.41), with sensitivity of 42.1% and specificity of 57.1%. Conclusions: The physical activity related question of GINA has insufficient diagnostic power to detect EIB in children and adolescents with asthma.

Introduction: The aim of the study was to evaluate the diagnostic performance of the item concerning physical activity of the Global Initiative for Asthma (GINA) asthma control questionnaire for detection of exercise-induced bronchoconstriction (EIB) in children and adolescents. Material and methods: We divided participants (aged 6–18 years) with a diagnosis of asthma into two groups according to the GINA severity classification: mild/moderate asthma (MMA) and severe therapy-resistant asthma (STRA). We collected anthropometric, clinical and functional data (spirometry) and performed an EIB test. We used item 4 of the GINA questionnaire regarding exercise-induced symptoms to assess the diagnostic power of this instrument. Results: We included 40 patients (17 with MMA and 23 with STRA) with a mean age of 11.3 years and a mean FEV1 z-score of –0.33, of who 13 (32.5%) were classified as having uncontrolled asthma. Of the patients with uncontrolled asthma, 7 (53.8%) exhibited a decrease in the FEV1 after the EIB test. We found a higher frequency of EIB in participants with FEV1 z-score values of less than –1.0 compared to those with a z-score of –1.0 or greater (P = .05). There were no significant differences in the frequency of EIB based on disease severity and control. We also found no association of item 4 (GINA) with EIB. The area under the ROC curve demonstrated that the discriminative power of the GINA questionnaire for the detection of EIB is inadequate (P = .41), with sensitivity of 42.1% and specificity of 57.1%. Conclusions: The item concerning physical activity in the GINA questionnaire has insufficient diagnostic power to detect EIB in children and adolescents with asthma. Resumen: Introducción: El objetivo del estudio fue evaluar el rendimiento diagnóstico de la pregunta relacionada con la actividad física del cuestionario de control del asma de la Global Initiative for Asthma (GINA) para la detección de la broncoconstricción inducida por el ejercicio (BIE) en niños y adolescentes. Materiales y métodos: Se dividió a pacientes (de 6 a 18 años de edad) con diagnóstico de asma en dos grupos de acuerdo a la clasificación de gravedad según el cuestionario GINA: asma leve/moderado (ALM) y asma grave refractaria (AGR). Se recogieron datos antropométricos, clínicos y funcionales (espirometría) y se realizó prueba de broncoprovocación con esfuerzo. Se utilizó la cuarta pregunta del cuestionario GINA, concerniente a los síntomas asociados al esfuerzo físico, para evaluar el rendimiento diagnóstico de este instrumento. Resultados: Se incluyó a 40 pacientes (17 con ALM y 23 con AGR) con una edad media de 11,3 años y un z-score medio de FEV1 de –0,33, de los que 13 (32,5%) se clasificaron como casos de asma no controlada. De los pacientes con enfermedad no controlada, 7 (53,8%) mostraron caídas en el FEV1 tras la prueba de esfuerzo. Se observó una mayor frecuencia de BIE en sujetos con z-score de FEV1 < –1,0 en comparación con aquellos con un z-score ≥ –1,0 (p = 0,05). No hubo diferencias significativas en la frecuencia de BIE en base a la gravedad o el control de la enfermedad. Tampoco se observó asociación entre la pregunta 4 (GINA) y la BIE. El área bajo la curva ROC evidenció que el poder discriminatorio del cuestionario GINA resulta insuficiente para detectar la BIE (p = 0,41), con una sensibilidad del 42,1% y una especificidad del 57,1%. Conclusiones: La pregunta concerniente al ejercicio físico en el cuestionario GINA carece del poder diagnóstico necesario para detectar la BIE en niños y adolescentes asmáticos.

Introduction: Portugal is one of the European Union countries with the lowest rate of Physical Activity (PA), with only 40% of the population being active. During the university period, there is a coincidence of increased autonomy and decision-making among students, and changes in life habits, usually associated with a decrease in PA practice. In percentage terms, 30% of university students are considered physically inactive. There are few studies on PA levels in higher education students, namely in the Physiotherapy course, and even less that relate this topic to the imposed containment measures, due to the COVID-19 pandemic. Objective: Description and comparison of the PA levels of students enrolled in the 1st year of a Physiotherapy Degree, in the academic year 2019/2020. Understand if there are differences in the practice of PA, at different times of the school year, one of which is the lockdown period. Methods: Data were collected using the “International Physical Activity Questionnaire” (IPAQ). It was shared in 3 moments (academic period without evaluations, exam period and lockdown), being a longitudinal study. Results: Physiotherapy students seem to be active regarding the parameter of PA frequency. With the lockdown, there was an increase in the level of PA in 20% of students compared to the school period without assessments, with 14.3% being raised to a high level of PA. The high percentage of students (42.9%) who maintained a high PA level should be highlighted. There was a significant difference from the 1st to the 2nd moment, at the IPAQ level, with a decrease in PA (p = 0.03) with the exam period. Discussion: In the exams period, although the workload is less, there seems to have been a decrease in PA levels. In the lockdown, aspects are presumed to have been removed, which in a normal situation would compromise the practice of PA, leading to better results in some of the variables. The lockdown doesn’t appear to have had a negative impact on PA. Conclusion: The objective of this study was achieved, establishing a starting point for the assessment of PA levels, in university students, in the period of COVID-19. As the sample is composed of future health professionals, it’s important that they be the first to adopt an active lifestyle, thus promoting it.

Background: Scars interfere with the motor system; however, the influence of c-section scars has not been described yet. The aim of this study is to relate the presence of abdominal scars from a caesarean section with changes in postural control—stability and orientation and abdominal and lumbar neuromuscular control in the orthostatic position. Methods: Cross-sectional analytical observational study comparing healthy primiparous women with caesarean delivery (n = 9) and physiologic delivery (n = 12) who have delivered more than one year before. The relative electromyographic activity of the rectus abdominis, transverse abdominis/oblique internus and lumbar multifidus muscles, antagonist co-activation, the ellipse area, amplitude, displacement, velocity, standard deviation, and spectral power of the centre of pressure, and thoracic and lumbar curvatures, were evaluated in the standing position in both groups, through an electromyographic system, a pressure platform and spinal mouse system. In the “caesarean delivery” group, scar mobility was evaluated using a modified adheremeter. Results: Significant differences in CoP medial-lateral velocity and mean velocity were observed between groups (p < 0.050), while no significant differences were in the level of muscle activity, antagonist co-activation, and thoracic and lumbar curvatures (p > 0.05). Conclusions: The information provided by the pressure signal seems to identify postural impairments in women with c-sections.

ABSTRACT OBJECTIVES To assess the determining factors of late healthcare-associated infections (HAIs) and bacterial multiple drug resistance in neonatal intensive care. METHODS This is a case-control study, conducted between January 2013 and December 2017, in a neonatal intensive care unit in the state of Ceará, Brazil. Newborns showing late HAIs were considered cases and those without infection, the control. Variables with p-values ≤ 0.05 in our initial bivariate regressive analysis were included in a non-conditional hierarchical logistic model for multivariate analysis. P-values below 0.01 were considered significant. RESULTS Of the 1,132 participants, 427 (37.7%) showed late healthcare-associated infections. Of these, 54 (12.6%), positive blood cultures, of which 14.9% contained multidrug-resistant bacteria. Bivariate analysis showed the protective effect of the feminine phenotype (OR = 0.71; 95%CI: 0.56–0.90) and of gestational ages ≥ 34 weeks (OR = 0.48; 95%CI: 0.30–0.75). In earlier-born preterm infants, late infections were 18 times more likely in those with less than 30 week-gestations (OR = 18.61; 95%CI: 9.84–35.22) and four times higher in those weighing less than 1,500 g (OR = 4.18; 95%CI: 3.12–5.61). Mechanical ventilation increased infection odds by more than seven times (OR = 7.14; 95%CI: 5.26–9.09); as did parenteral nutrition (OR = 5.88; 95%CI: 4.54–7.69); central venous catheters (OR = 10.00; 95%CI: 6.66–16.66); the number of catheters used (OR = 3.93; 95%CI: 3.02–5.12); surgery (OR = 4.00; 95%CI: 2.27–7.14); and hospitalization time (OR = 1.06; 95%CI: 1.05–1.07). The association between preterm infants with less than 30 week-gestations (OR = 5.62; 95%CI: 1.83–17.28); mechanical ventilation (OR = 1.84; 95%CI: 1.26–2.68); central venous catheters (OR = 2.48; 95%CI: 1.40–4.37); and hospitalization time (OR = 1.06; 95%CI: 1.05–1.07) remained significant after adjustment. Among deaths, 41 (55.4%) were associated with late infections. CONCLUSION Better practices should be adopted in caring for the premature, as well as in the rational use of procedures, to avoid late healthcare-associated infections, preventable deaths, and risks of bacterial multiple drug resistance and environmental contamination.

Background: Over the last decades, the use of gastrointestinal (GI) endoscopic procedures has been increased in children worldwide, allowing the early diagnosis and therapeutic intervention in multiple GI diseases. Aims and Methods: In order to evaluate the appropriateness and the diagnostic yield of initial GI endoscopic techniques in children in a Portuguese tertiary hospital, we performed a retrospective cohort study during a 12-month period. Results:A total of 308 procedures were performed in 276 patients; the median age was 11 years and 50.4% were males. Esophago-gastro-duodenoscopy (EGD) corresponded to 81.8% of the procedures and ileo-colonoscopy (IC) to the remaining; 11.6% of the patients underwent both EGD and IC. Overall, 51.3% of the exams showed abnormal macroscopic findings, and 69.6% showed histopathological signs of disease, with IC showing significantly more positive results than EGD (p < 0.05). Considering the different indications independently, abnormal serology for celiac disease, suspected ingestion of foreign bodies, suspected inflammatory bowel disease, and food impaction were frequent in our population; and in the majority of the cases, the suspected diagnosis was confirmed: celiac disease, ingestion of foreign bodies, inflammatory bowel disease, and eosinophilic esophagitis, respectively. On the other hand, despite the high frequency of epigastric pain in this population, only nearly one-third of the patients showed abnormal histological findings. The final diagnosis was established in 63% of the patients, and 39.1% initiated the new treatment. Discussion:Our results emphasize the importance of endoscopic procedures, especially IC, in the diagnosis of GI diseases in pediatric patients, as well as the careful choice of the endoscopic techniques in those with less specific symptoms, as chronic abdominal pain. In this particular situation, given the proportion of cases that may be due to functional disease, good characterization of the clinical context is needed, and endoscopy should be reserved for a second-line approach. Conclusion: It is important to monitor and examine the endoscopic techniques as an index of quality criteria for clinical practice.

Introdução: O tratamento de feridas tem sido uma temática com crescente interesse pelas envolventes que comporta, tanto ao nível físico como psicossocial, pelos custos associados ao tratamento e pelo stress causado na pessoa, na família e no sistema de saúde. A Organização Mundial da Saúde (OMS) considera esta temática como uma epidemia pela elevada prevalência. Em Portugal, os dados epidemiológicos são limitados mas estima-se que haja 3,3 portadores de ferida por mil habitantes. A presente revisão narrativa tem como objetivo contribuir para clarificar a abordagem ao tratamento da ferida complexa à luz das novas guidelines emitidas pela European Wound Management Association (EWMA). Material e Métodos: Foi efectuada uma revisão narrativa sobre os aspectos actuais da abordagem à ferida complexa ou de difícil cicatrização, (ferida que não regride em 40–50% da sua dimensão em 4 semanas). Efectuou-se uma pesquisa bibliográfica na Pubmed e nos últimos documentos de consenso elaborados pela EWMA (European Wound Management Association) a qual foi integrada na experiência dos autores no tratamento deste tipo de doentes. Resultados: A abordagem da ferida complexa deve ser sistemática e sistematizada, em equipa multidisciplinar, mediada por um gestor de ferida, e em centros dedicados ao tratamento da mesma. O portador de ferida deve estar no centro dos cuidados como parceiro o que requer por parte dos profissionais de saúde formação na capacitação da pessoa/família/cuidador. O controlo de infeção associado ao tratamento de feridas deve envolver intervenções simples e pouco onerosas, mas muito importantes, como a higienização das mãos, a utilização de equipamentos de proteção individual dos profissionais e dos utentes e uma boa gestão das salas de tratamento. As terapias mais avançadas baseiam-se em novos princípios e tecnologias ou em novas aplicações de princípios e tecnologias já consolidados e a sua utilização deve ser baseada na evidência. Os algoritmos em saúde são instrumentos de apoio à decisão clínica na presença de situações complexas e apresenta- se uma proposta de algoritmo para o tratamento de ferida complexa. Conclusão: A abordagem da ferida complexa deve englobar aspectos multifatoriais e a escolha de terapias avançadas deve ser criteriosa tendo em conta o custo.

Introdução: Recentemente, tem-se constatado que os profissionais que trabalham nas Unidades de Cuidados Intensivos Neonatais mostram um interesse crescente pelas decisões tomadas no final da vida e pela qualidade dos cuidados prestados aos recém-nascidos e suas famílias. Objetivos: Compreender as vivências dos profissionais de saúde relativamente aos cuidados paliativos neonatais. Métodos: Utilizou-se a metodologia de investigação qualitativa, exploratório-descritiva, de cariz fenomenológica. Resultados: Foram aplicados e analisados questionários a 15 profissionais a exercer numa UCIN do centro de Portugal. Os dados obtidos revelam carência de ensino e inexistência de protocolos/guidelines, bem como necessidade de suporte psicológico a profissionais e família do RN. Conclusões: A formação contínua e específica, o apoio e acompanhamento psicológico dos profissionais e das famílias devem constituir o pilar dos cuidados paliativos neonatais.

Estudios previos revelan que el efecto negativo de la discriminación en la salud mental puede ser especialmente perjudicial entre las minorías estigmatizadas. Sin embargo, las investigaciones también destacan la importancia de los mecanismos de protección que podrían amortiguar este efecto. El objetivo de este estudio fue explorar las relaciones entre la salud mental, la percepción de discriminación y las estrategias de afrontamiento de reevaluación positiva y autoculpa en jóvenes LGB y heterosexuales. Los datos fueron recogidos online y mediante una encuesta en papel y lápiz y participaron 195 adolescentes y jóvenes adultos portugueses. La encuesta abarcó salud mental (Mental Health Inventory-5), discriminación (Everyday Discrimination Scale) y estrategias de afrontamiento (Brief COPE). De la muestra, el 73,3% eran mujeres y el 51,8% se identificaron a sí mismos como lesbiana, gay o bisexual (LGB). Los resultados del análisis de la varianza muestran que los participantes LGB han experimentado más discriminación que sus compañeros heterosexuales. No hay diferencias en los niveles de salud mental y el uso de la autoculpa o la revaluación positiva en las estrategias de afrontamiento. Los análisis de regresión revelan que la discriminación y la autoculpa percibidas contribuyen a empeorar la salud mental de los jóvenes LGB y heterosexuales. Sin embargo, las estrategias de revaluación positiva fueron predictoras de salud mental solo en los participantes LGB, una estrategia que contribuyó a su resiliencia frente a la discriminación. Además, se observó un efecto indirecto de discriminación en la salud mental, parcialmente mediado por la autoculpa, solo en los participantes LGB. Los resultados confirman hallazgos previos que sugieren que la discriminación percibida tiene un efecto más perjudicial cuando se produce en un grupo minoritario, y apoya el encuadre de la mediación psicológica sobre los efectos de la discriminación en la salud mental en grupos estigmatizados.

Neste trabalho trazemos o relato e a análise dos percursos e resultados de uma prática de formação continuada para professores da rede pública de ensino em Óbidos-PA, realizada como parte das atividades de preparação da I Feira de Ciências e Tecnologias Educacionais da Mesorregião do Baixo Amazonas-PA (I FECITBA). As atividades envolveram a articulação interinstitucional para a divulgação do evento, a realização de atividades de formação e a mobilização das instituições de educação básica obidenses para participar da I FECITBA. Participaram dos encontros de formação 28 profissionais, incluindo docentes e técnicos de 17 instituições. Para o evento foram mobilizados 67 participantes, com apresentação de 16 projetos, dos quais 09 foram premiados com bolsas de iniciação científica do CNPq. O conjunto de ações realizadas com o coletivo de profissionais em Óbidos, além da participação do coletivo de professores e estudantes no evento indicam que os resultados alcançados favorecem a integração dos municípios da região em processos diferenciados de formação científica e contribui para a consolidação do papel social da universidade junto à comunidade regional.

Introdução: Os cuidados de saúde, tal como são concebidos atualmente, baseiam-se na visão de que as decisões clínicas devem ser fundamentadas na melhor evidências científica disponível reconhecendo, contudo, a preferência do paciente, o contexto de cuidados de saúde e o julgamento clínico. Objetivos: Avaliar a validade do Questionário de Eficácia Clínica e Prática Baseada em Evidências (QECPBE). Métodos: Estudo metodológico com a finalidade de determinar a consistência interna através do alfa de Cronbach e da análise fatorial confirmatória. Resultados: Foram incluídos 738 enfermeiros com uma média de idades de 37,57 anos, sendo 76,0% mulheres. Após o refinamento do questionário, a análise fatorial confirmatória final evidenciou uma boa qualidade de ajustamento da estrutura fatorial composta por 3 fatores com 19 itens (x2/gl = 2,030; CFI = 0,967; GFI = 0,926; RMSEA = 0,053; RMR = 0,064). A consistência interna global foi de  = 0,930, demonstrando uma fiabilidade muito elevada, explicando 63,660% da variância total. Conclusões: Os resultados evidenciaram que a escala é fiável e válida na avaliação das componentes estruturais da PBE. A PBE surge como potenciadora da decisão clínica segura, da qualidade de cuidados e da autonomia em enfermagem.

Objetivo: analisar a incidência das infecções de sítio cirúrgico e seu perfil de resistência microbiana em uma Unidade de Terapia Intensiva. Método: trata-se de um estudo transversal, documental, descritivo. Foram incluídos na população de estudo 52 pacientes com infecção de sítio cirúrgico de um hospital universitário de Salvador, Bahia, no período de 2011 a 2013. Resultados: a idade, cor/raça e número de dias em UTI demonstraram relação estatisticamente significante para o desfecho. Dentre as cirurgias, a da especialidade cardíaca destacou-se em número de infecções; dentre as bactérias, as do tipo gram-negativas (Enterobacter e Escherichia) estavam em culturas de 75,39% dos casos, sendo mais resistentes às penicilinas; o desfecho mais frequente foi a alta da unidade. Conclusão: os estudos sobre essas infecções constituem um padrão importante para as unidades hospitalares que, na atualidade, enfrentam sérios riscos, especialmente relacionados ao uso e ao manejo de antibióticos com impacto no sistema de saúde. Descritores: Unidades de Terapia Intensiva. Infecção. Infecção do Sítio Cirúrgico. Resistência Bacteriana a Antibióticos.

Objetivo: avaliar o nível de atividade física entre pessoas com hipertensão arterial sistêmica. Método: estudo descritivo, de abordagem quantitativa, realizado em um multicentro de saúde da cidade de Salvador, Bahia, com participação de 220 pessoas com diagnóstico médico de hipertensão arterial sistêmica. Investigou-se nível de atividade física dos participantes no trabalho, no trajeto de deslocamento, nas tarefas domésticas e no tempo livre com base no Questionário Internacional de Atividade Física e na classificação: muito ativos, ativos, irregularmente ativos e sedentários. Realizou-se análise descritiva para caracterizar a população do estudo. Resultados: predomínou comportamento sedentário em todos os indicadores de atividade física avaliados pelo Questionário Internacional de Atividade Física. Conclusão: conhecendo a gravidade da hipertensão arterial sistêmica e a necessidade da atividade física para prevenção e controle, é necessária maior vigilância e mais estratégias para, respectivamente, melhor compreender a magnitude e modificar o comportamento sedentário que predomina em pessoas com essa doença. Descritores: Hipertensão. Comportamento Sedentário. Estilo de Vida. Fatores de Risco.

Stroke leads to significant impairment in upper limb (UL) function. The goal of rehabilitation is the reestablishment of pre-stroke motor stroke skills by stimulating neuroplasticity. Among several rehabilitation approaches, functional electrical stimulation (FES) is highlighted in stroke rehabilitation guidelines as a supplementary therapy alongside the standard care modalities. The aim of this study is to present a comprehensive review regarding the usability of FES in post-stroke UL rehabilitation. Specifically, the factors related to UL rehabilitation that should be considered in FES usability, as well a critical review of the outcomes used to assess FES usability, are presented. This review reinforces the FES as a promising tool to induce neuroplastic modifications in post-stroke rehabilitation by enabling the possibility of delivering intensive periods of treatment with comparatively less demand on human resources. However, the lack of studies evaluating FES usability through motor control outcomes, specifically movement quality indicators, combined with user satisfaction limits the definition of FES optimal therapeutical window for different UL functional tasks. FES systems capable of integrating postural control muscles involving other anatomic regions, such as the trunk, during reaching tasks are required to improve UL function in post-stroke patients.

Gunnera tinctoria, an underexplored invasive plant found in Azores, Portugal, was studied regarding its nutritional, antioxidant, and antitumoral properties. Higher antioxidant activity was found in baby leaves, followed by adult leaves and inflorescences. A phenolic fraction of the plant was enriched using adsorbent resin column chromatography (DiaionTM HP20LX, and Relite EXA90). Antitumoral effects were observed with the enriched fractions in breast (MCF-7) and pancreatic (AsPC-1) cancer cell lines, being more pronounced in the latter. To improve protection and membrane absorption rates of phenolic compounds, nano-phytosomes and cholesterol-conjugated phytosomes coated with natural polymers were loaded with the enriched fraction. The particles were characterized, and their physiochemical properties were evaluated and compared. All samples presented anionic charge and nanometer size in relation to the inner layer and micrometer size regarding the external layers. In addition, the molecular arrangement of phenolics within both types of phytosomes were studied for the first time by molecular docking. Polarity and molecular size were key factors on the molecular arrangement of the lipid bilayer. In conclusion, G. tinctoria showed to be an interesting source of nutrients and phenolic compounds with anti-tumoral potential. Moreover, phytosome loading with these compounds can increase their stability and bioavailability having in view future applications.

Buscando reduzir o déficit de vagas nas creches da rede pública, o Governo Federal brasileiro criou, em 2007, o programa Proinfância, o qual disponibilizou recursos para a implantação de escolas de educação infantil e quatro projetos padrão, que desde então vêm sendo construídos em todo o país. Levando em conta estudos que demonstram a ampla relação entre a qualidade das edificações com o desempenho na aprendizagem, este artigo tem o objetivo de verificar se o projeto Padrão Tipo-C, desenvolvido pelo FNDE, é adequado para a utilização nas 8 zonas bioclimáticas brasileiras no que se refere a iluminação, ventilação e conforto térmico. O projeto foi analisado e contrastado às exigências das normas e referenciais técnicos brasileiros e internacionais sobre os temas, verificando se possui as características necessárias para atingir o desempenho requerido em cada requisito. Foi constado que o projeto não contempla todas as variáveis de estratégias de projeto necessárias para um bom desempenho em todas as zonas bioclimáticas brasileiras, o que pode implicar em maior consumo energético para alcançar requisitos mínimos de conforto para os usuários.

An Amazonian savanna in northern Brazil known as the Cerrado of Amapá is under imminent threat from poor land-use planning, the expansion of large-scale agriculture and other anthropogenic pressures. These savannas house a rich and unique flora and fauna, including endemic plants and animals. However, the area remains under-sampled for most taxa, and better sampling may uncover new species. We estimate that only ~9.16% of these habitats have any kind of protection, and legislative changes threaten to further weaken or remove this protection. Here we present the status of knowledge concerning the biodiversity of the Cerrado of Amapá, its conservation status, and the main threats to the conservation of this Amazonian savanna. To secure the future of these unique and imperilled habitats, we suggest urgent expansion of protected areas, as well as measures that would promote less-damaging land uses to support the local population.

Introdução: A sociedade está a envelhecer rapidamente, consequentemente aumentando a prevalência de demências. Os défices cognitivos relacionam-se com inúmeras variáveis, sendo algumas delas apontadas como possíveis protetoras. Segundo a teoria da reserva cognitiva, a prática de atividades estimulantes ao longo da vida pode ter como efeito a diminuição do risco de demência. Neste contexto, a MediaPrimer está a desenvolver a plataforma de treino cognitivo online primerCOG, com um conjunto de onze atividades cognitivas estimulantes destinadas a seniores. Objetivo: Analisar a influência das variáveis escolaridade e idade, e da ocupação dos tempos livres, no desempenho nas atividades do primerCOG. Métodos: Investigação quantitativa não-experimental de carácter transversal. Amostra de 30 seniores cognitivamente saudáveis. Resultados: Observaram-se associações positivas entre a escolaridade dos participantes e o nível máximo de desempenho em todas as atividades, verificando-se, por outro lado, uma associação negativa do desempenho na maioria das atividades com a idade dos participantes. Adicionalmente, verificou-se que os participantes que praticavam regularmente atividades de tempo livre cognitivamente estimulantes, tiveram melhores desempenhos nas atividades. Conclusões: A confirmação das variáveis com influência no desempenho cognitivo em seniores cognitivamente saudáveis é útil para se compreender o desenvolvimento de demências. Futuramente será importante replicar o estudo com novas variáveis, como o número de horas diárias despendidas nas atividades ou o QI pré-mórbido do participante.

A biópsia mamária guiada por imagem é um método eficaz no diagnóstico de cancro da mama. Contudo, está descrita a possibilidade de ocorrência de complicações secundárias à mesma. Objetivo: Quantificar a prevalência de complicações das biópsias efetuadas em 2017 na Imagiologia Mamária do Instituto Português de Oncologia do Porto. Resultados: Num total de 6,9% (IC95%: 5,5%−8,6%) e de 1.9% (IC95%: 1,2%−2,8%) dos 1180 procedimentos incluídos na análise, ocorreu pelo menos uma complicação imediata (durante o procedimento ou até à saída do utente do serviço) ou tardia (após a saída do participante do serviço e até 30 dias após), respetivamente. A complicação imediata mais frequente foi a dor e a tardia a presença de sinais inflamatórios. Conclusão: As complicações secundárias à biópsia mamária foram um evento pouco frequente, atingindo 7 em cada 100 pessoas submetidas a biópsia no imediato e cerca de 2 em cada 100 pessoas, até 30 dias após a sua realização.

IntroductionSeveral tests may be used to assess exercise intolerance in severe therapy-resistant asthma (STRA), including the gold standard cardiopulmonary exercise test (CPET) and the modified shuttle test (MST).ObjectiveTo correlate the distance achieved in the MST with peak oxygen uptake (VO2peak) and to compare the maximal heart rate (HRmax) obtained in both tests in children and adolescents with STRA.MethodsThis is a cross-sectional study, with 19 children and adolescents with STRA. Demographic, anthropometric, clinical data, and spirometric values were collected. CPET and the MST were performed in two consecutive visits. HRmax, pulse oxygen saturation, and dyspnea were compared between tests. The distance achieved in the MST was correlated with VO2peak.ResultsNineteen patients with a mean age of 11.5 ± 2.5 years were included. The mean HRmax (bpm) achieved was 180.8 ± 12.10 for the MST and 187.6 ± 9.35 for CPET, whereas the mean HRmax as a percentage of predicted (HRmax%) was 90.7 ± 6.5 for the MST and 93.8 ± 4.5 for CPET. A difference of only 6 bpm was found for HRmax (p = 0.10) and of 3% for HRmax% (p = 0.06) between tests. A strong correlation was found between the MST (r = 0.79; p = 0.001) and VO2peak measured through CPET. However, there were no correlations between the MST and both body mass index (r = −0.14; p = 0.564) and forced expiratory volume in the first second – FEV1 (r = −0.02; p = 0.917).ConclusionThe results demonstrate that the MST distance strongly correlates with VO2peak, measured through CPET, and the main physiological variable responses were similar between both tests. Our results provide additional data for the use of the MST to assess exercise capacity in children and adolescents with STRA.

La gale notoedric, également appelée “gale du chat”, est une maladie parasitaire causée par un acarien appelé Notoedres cati. Il affecte généralement les chats, mais peut également affecter les chiens et les humains. L’objectif de cette revue était de présenter les informations disponibles dans la littérature scientifique sur la gale notoedric, dans le but de contribuer à l’efficacité de l’information et à une meilleure préparation des universitaires vétérinaires. Pour cela, des études et des recherches bibliographiques ont été effectuées, ainsi que des consultations de publications scientifiques dans des bases de données de médecine vétérinaire. Nous pouvons en conclure que la gale notoedric est très contagieuse, généralement par contact direct, et que le meilleur moyen de contrôler cette parasitose consiste à hygiéniser le lieu de vie des chats et à les empêcher de toucher les animaux infectés.

ABSTRACT: The objective of this study was to evaluate the plant and fruit characteristics in advanced lines of Jalapeño pepper for mechanical harvesting. Thus, two experiments were carried out in the field. Experiment I (2015) was conducted as a randomized block design (three replications and eight plants per plot) and Experiment II (2016) in a completely randomized design (five replications and ten plants per plot). In 2015, lines CNPH 30,112, CNPH 30,118, CNPH 30,147, CNPH 30,159, CNPH 30,183, and CNPH 30,245 were evaluated, together with the control ‘BRS Sarakura’. Significant differences were detected for fruit and plant characteristics (P10cm), large fruits (11 cm x 4 cm), high pulp firmness (11 N), wall thickness (about 5mm), and content of capsaicinoid substances (>50,000 SHU). Selected lines are undergoing additional field evaluation for mechanical harvesting with the Etgar Moses 1010 pepper harvester.

Generation Z is arriving in the workforce. Do these youngsters have the skills and traits to fit project teams? This study reviews the literature concerning project management competencies and the traits that are associated with Generation Z. To deepen the understanding of its members (Gen Zers) traits, we explore the self-awareness of their profile, strengths and weaknesses with an empirical study. We used a mixed-method approach, implementing a survey on a sample of 211 college students about to enter the labor market. Comparing our survey results with the literature, we identified differences that reveal some of the lack of awareness of Gen Zers about their traits. Further analysis also revealed a significant correlation between the most highlighted Generation Z traits and essential project management soft skills, pointing to Generation Z as a promissory asset in the project management field. However, other essential project management (PM) soft skills were not grounded in personality traits. Our findings, namely the lack of awareness and association results, suggest the need for further research on educational approaches and re-thinking and targeting education and training policies that could strengthen Generation Z soft skills. Our results also suggest reflections about whether the Gen Zers traits fit the PM competencies sought by organizations.

Doxorubicin is one of the most widely used anti-cancer drugs, but side effects and selectivity problems create a demand for alternative drug delivery systems. Herein we describe a hybrid magnetic nanomaterial as a pH-dependent doxorubicin release carrier. This nanocarrier comprises magnetic iron oxide cores with a diameter of 10 nm, enveloped in a hybrid material made of siliceous shells and ĸ-carrageenan. The hybrid shells possess high drug loading capacity and a favorable drug release profile, while the iron oxide cores allows easy manipulation via an external magnetic field. The pH responsiveness was assessed in phosphate buffers at pH levels equivalent to those of blood (pH 7.4) and tumor microenvironment (pH 4.2 and 5). The nanoparticles have a loading capacity of up to 12.3 wt.% and a release profile of 80% in 5 h at acidic pH versus 25% at blood pH. In vitro drug delivery tests on human breast cancer and non-cancer cellular cultures have shown that, compared to the free drug, the loaded nanocarriers have comparable antiproliferative effect but a less intense cytotoxic effect, especially in the non-cancer cell line. The results show a clear potential for these new hybrid nanomaterials as alternative drug carriers for doxorubicin.

This paper explores the combination of formal and informal learning coupled with locative media principles; we research the potential of this specific type of media to reinforce and expand learning goals out-of-class time, equipping students with lifelong learning attitudes. We report on the findings from and observations on how a class of undergraduate students used locative media for the first time to learn about the effects of spatial segregation in a specific underserved area of Austin, Texas, usa. Students were asked to visit several locations and produce multimedia stories with a focus on the local history. Results from the study show that using locative media is highly efficient for learning purposes. Students get to experience the content learned in the classroom in a physical setting, which fosters ‘situated learning’, a theory we used as theoretical framework. Our findings also suggest that rather than local history or history in general, current societal issues with a strong spatial component are more effective in engaging students with the assignment off the classroom. Hence, segregation and gentrification were found in this study to be useful subjects to be explored and taught through the principles of locative media.

Objetivo: descrever os fatores de risco para infecção de sítio cirúrgico presentes em pacientes submetidos a procedimentos cirúrgicos cardíacos. Método: estudo de caso-controle, retrospectivo e descritivo. Participaram os pacientes submetidos a procedimentos cirúrgicos cardíacos entre 2011 e 2013 que desenvolveram e não desenvolveram infecção. Os dados foram coletados na Comissão de Controle de Infeção Hospitalar e nos prontuários, entre maio e dezembro de 2014. Resultados: foram estudados 50 pacientes, 19 casos e 31 controles. A ocorrência de infecção foi mais frequente em idosos do sexo masculino. Ambos os grupos apresentaram semelhanças na prevalência dos fatores de risco: tempo de internação pré-operatório superior a 24 horas, classificados no nível III, pelo physical status classification system, eram portadores de hipertensão e de diabetes e houve descontinuidade da antibioticoprofilaxia. Conclusão: os fatores de risco para infecção de sítio cirúrgico em pacientes submetidos a cirurgias cardíacas requerem dos profissionais envolvidos no processo maior controle para reduzir os índices dessas complicações. Descritores: Infecção da ferida cirúrgica. Fatores de risco. Cirurgia torácica. Enfermagem.

The aim of this study is to evaluate the effects of regular moderate exercise training initiated previously or after induction of diabetes mellitus on renal oxidative stress and inflammation in STZ-induced diabetic female rats. For this purpose, Wistar rats were divided into five groups: sedentary control (SC), trained control (TC), sedentary diabetic (SD), trained diabetic (TD), and previously trained diabetic (PTD). Only the PTD group was submitted to treadmill running for 4 weeks previously to DM induction with streptozotocin (40 mg/kg, i.v). After confirming diabetes, the PTD, TD, and TC groups were submitted to eight weeks of exercise training. At the end of the training protocol, we evaluated the following: glycosuria, body weight gain, plasma, renal and urinary levels of nitric oxide and thiobarbituric acid reactive substances, renal glutathione, and immunolocalization of lymphocytes, macrophages, and nuclear factor-kappa B (NF-κB/p65) in the renal cortex. The results showed that exercise training reduced glycosuria, renal TBARS levels, and the number of immune cells in the renal tissue of the TD and PTD groups. Of note, only previous exercise increased weight gain and urinary/renal NO levels and reduced NF-κB (p65) immunostaining in the renal cortex of the PTD group. In conclusion, our study shows that exercise training, especially when initiated previously to diabetes induction, promotes protective effects in diabetic kidney by reduction of renal oxidative stress and inflammation markers in female Wistar rats.

Abstract There is little scientific evidence that urban upgrading helps improve health or reduce inequities. This article presents the design for the BH-Viva Project, a “quasi-experimental”, multiphase, mixed-methods study with quantitative and qualitative components, proposing an analytical model for monitoring the effects that interventions in the urban environment can have on residents’ health in slums in Belo Horizonte, Minas Gerais State, Brazil. A preliminary analysis revealed intra-urban differences in age-specific mortality when comparing areas with and without interventions; the mortality rate from 2002 to 2012 was stable in the “formal city”, increased in slums without interventions, and decreased in slums with interventions. BH-Viva represents an effort at advancing methodological issues, providing learning and theoretical backing for urban health research and research methods, allowing their application and extension to other urban contexts.

Considerando a unidade ensino-aprendizagem-desenvolvimento à luz do enfoque histórico-cultural, este trabalho teve como objetivo investigar de que modo a compreensão do professor sobre as características psicológicas dos alunos adolescentes influencia sua prática pedagógica. Os procedimentos metodológicos utilizados foram um questionário com dados gerais sobre os professores, seguido da realização de entrevistas semidirigidas com docentes de uma escola pública de Minas Gerais. As compreensões dos professores sobre as características psicológicas dos alunos adolescentes e sua influência na prática pedagógica foram agrupadas em três dimensões: Sistemas de comunicação, Atividade de estudo e Identidade pessoal. O estudo aponta que as principais demandas de alunos adolescentes podem ser observadas e tomadas como parte importante do planejamento docente, do desenvolvimento e da avaliação das práticas pedagógicas, de forma que o ensino efetivamente promova o desenvolvimento humano. Nesse sentido, torna-se fundamental a organização do coletivo da sala de aula, tendo em vista os impactos deste na formação da personalidade do aluno, cujo processo intensivo de formação da identidade pessoal o torna extremamente sensível às opiniões sociais. Esperamos que as sistematizações realizadas no presente estudo contribuam para a produção de subsídios teóricos sobre as relações entre ensino e desenvolvimento de adolescentes, no Enfoque Histórico-Cultural.