Search

Brassica microgreens are rich in phytochemicals and are attractive crops for controlled vertical farming systems where the light spectrum can be precisely manipulated. Understanding the effects of pre-harvest hormetic UV-C light doses on plant composition and growth parameters represents a novel and largely unexplored area for precision agriculture and nutrition. Therefore, the objective of this work was to investigate the impact of exposing red mustard microgreens to low/hormetic doses of UV-C radiation on their growth, chemical composition and colour. Plants were grown in a controlled environment and exposed to 0.3 kJ m−2, 254 nm UV-C radiation at the end of the cultivation period. Treatments included a single pulse on day 7, or three pulses at days 7, 8, and 9 and harvest on day 10. UV-C radiation presented a hormetic effect, while 1 pulse of UV-C stimulated growth and productivity without significant colour changes in microgreens, 3 pulses of UV-C radiation to did not show significant effects when compared to controls (no UV-C exposure). Moreover, strong negative correlations were observed between growth parameters and chemical composition (p

INTRODUCTION: Throughout undergraduate school, it is important to instill a continuous emphasis on cost-conscious thinking across all specialties, including obstetrics and gynecology (OB/GYN). One potential strategy is the implementation of the Choosing Wisely (CW) Campaign. OBJECTIVE: To describe and assess the implementation strategies of the Choosing Wisely (CW) campaign within a medical internship in Obstetrics and Gynecology (OB/GYN). METHODS: This intervention study involved medical teachers and undergraduate medical students at a Brazilian medical school. Initially, teachers identified three common unnecessary clinical scenarios, which were then grouped and adapted to fit the CW recommendation format. Based on the five most frequently occurring recommendations, educational activities were developed, including workshops, banners, and discussions on cost-consciousness in healthcare with undergraduate students and medical doctors. RESULTS: The top five recommendations were as follows: 1. Don’t routinely order hormone levels for menopause diagnosis; 2. Don’t recommend ovarian removal during hysterectomy for premenopausal women without ovarian câncer risk; 3. Don’t prescribe broad-spectrum antibiotics for uncomplicated acute cystitis treatment; 4. Don’t request preventive examinations for colpitis diagnosis; and 5. Don’t request unnecessary exams during low-risk prenatal care, such as kidney and liver function tests. The theoretical and practical components of these educational activities led to increased awareness and subsequent discussions among internship faculty and undergraduate students. CONCLUSION: Implementation of the CW campaign within the medical internship in OB/GYN resulted in a positive impact, fostering reflection among participants and aiding in the avoidance of unnecessary treatments or prescriptions.

A 37-year-old man presented with chronic cavitary pulmonary aspergillosis and hemoptysis refractory to systemic antifungal therapy with voriconazole and bronchial artery embolization. Surgical excision was unfeasible due to the patient's refusal of blood transfusions. Ten sessions of intracavitary instillation of amphotericin B via flexible bronchoscopy were then performed. Hemoptysis cessation and aspergilloma resolution were achieved, with no toxicity or side effects, and the clinical benefits were sustained at six months of follow-up.

Purpose: Most of radiation oncology centers rely on set-up skin markings for patient setup during treatment delivery. Permanent dark-ink tattooing is the most popular marking method. COMFORTATTOO is a unicentric, randomized trial testing 2 permanent methods: lancets against an electric marking pen (Comfort Marker 2.0, CM). One substudy was undertaken to test if using the CM translates into a cosmesis, fading, or satisfaction benefit compared with the lancets. Methods and Materials: Patients aged 18 years or older referred to our department to receive RT were recruited. They were randomly assigned, in a 1:1 ratio, to receive set-up markings using lancets or CM. This substudy aimed to recruit all the living participants included in the main study. The primary endpoints were tattoos cosmesis, tattoos fading, and patients’ satisfaction 6 months after finishing the RT. Cosmetic and fading assessments were scored on a 5-point ascending scale and patients’ satisfaction on a 10-point ascending scale. The trial is registered at ClinicalTrials.gov (number NCT05371795). Results: Between April and September 2022, 92 patients were enrolled (45 assigned to lancets and 47 to CM) and assessed for the outcomes. Patients receiving CM had significantly better cosmetic markings, with a median score of 4.4 (vs 3.7 for lancets, P

Neutrophils are believed to play a role in the initial stages of paratuberculosis, and it has recently been demonstrated that vaccination can modulate their function via priming or through epigenetic and metabolic reprogramming (training). Modulation of the neutrophil response against Mycobacterium avium subspecies paratuberculosis (Map) through vaccination has been demonstrated in a rabbit model but not in ruminants. Therefore, in the present work, the effect of vaccination on the response of caprine neutrophils against Map was studied. Neutrophils were isolated from non-vaccinated (n = 7) and Gudair®-vaccinated goat kids (n = 7), before vaccination and 30 days post-vaccination. Then, several neutrophil functions were quantified ex vivo: cell-free and anchored neutrophil extracellular trap (NET) release, phagocytosis, and the differential expression of several cytokines and TLR2. The induction of cell-free NETosis and TLR2 expression by Map is reported for the first time. However, vaccination showed no significant effect on any of the functions studied. This suggests that the protection conferred by Gudair® vaccination is based on mechanisms that are independent of the neutrophil function modulation. Further research into the impact of alternative vaccination strategies or the paratuberculosis infection stage on ruminant neutrophil function could provide valuable insights into its role in paratuberculosis.

Introduction: The rational use of health resources has awakened us to the importance of including this theme in the curriculum of medical schools. This research aims to compare the perception of cost-conscious attitudes of medical students before and after the implementation of the CW campaign and after 1 year of medical practice. Material and methods: Longitudinal study conducted with students and physicians, who answered a questionnaire on cost-conscious perception at 3 moments: before the implementation of the CW campaign during the undergraduate phase; immediately after the campaign; and after 1 year of medical practice. In order to make the comparison among the different moments, the T-test for paired samples was used. Results: In the first 2 moments, 98 students participated, of which 80 also participated in the third moment, already as physicians. Most students disagreed that physicians should not think about cost when making therapeutic decisions, with a change after the educational actions (P = .001). There was agreement by the students on the items that refer to the physicians’ posture regarding science and responsibility to contain costs and discuss treatment options with patients. Comparing the answers after the campaign and at 1 year of practice, it was observed that the perception of cost-conscious attitudes was maintained. Conclusions: Students showed high perception of cost-consciousness, even before the implementation of the campaign. Nevertheless, after the educational actions, an increase in this perception was observed; and, after 1 year of medical practice, this perception was maintained. Resumen: Introducción: el uso racional de los recursos de salud nos ha despertado la importancia de incluir este tema en el currículo de las facultades de Medicina. Esta pesquisa pretende comparar la percepción de las actitudes conscientes de los costos de los estudiantes de Medicina antes y después de la implementación de la campaña CW y después de un año de práctica médica. Materiales y métodos: estudio longitudinal realizado con estudiantes y médicos, quienes respondieron un cuestionario de percepción de conciencia de los costos en 3 momentos: antes de la implementación de la campaña CW durante la etapa de pregrado, inmediatamente después de la campaña y después de un año de práctica médica. Para realizar la comparación entre los diferentes momentos se utilizó la prueba T para muestras apareadas. Resultados: en los 2 primeros momentos participaron 98 estudiantes, de los cuales 80 también participaron en el tercer momento, ya como médicos. La mayoría de los estudiantes no estuvo de acuerdo en que los médicos no deben pensar en el costo al tomar decisiones terapéuticas, con un cambio después de las acciones educativas (p = 0,001). Hubo acuerdo de los estudiantes en los ítems que se refieren a la postura de los médicos frente a la ciencia y la responsabilidad de contener costos y discutir opciones de tratamiento con los pacientes. Comparando las respuestas después de la campaña y al año de práctica, se observó que se mantuvo la percepción de actitudes conscientes de los costos. Conclusiones: los estudiantes mostraron alta percepción de conciencia de los costos, incluso antes de la implementación de la campaña. Sin embargo, luego de las acciones educativas, se observó un aumento en esta percepción, y después de un año de práctica médica, esta percepción se mantuvo.

A presente edição da Revista REAMEC, intitulada "Rede de Formação e Pesquisa em Ensino de Ciências e Matemática: ampliando as fronteiras amazônica", é resultado da colaboração entre UFMA, UFAM e UFSC, iniciada em 2018 no âmbito do Programa Nacional de Cooperação Acadêmica na Amazônia. O foco é fortalecer a pesquisa e a pós-graduação na Região Amazônica, abordando temas como Epistemologia, História, Sustentabilidade Ambiental, Formação de Professores e Ensino de Ciências e Matemática. Esta edição especial destaca a importância da rede de pesquisa na metodologia, teoria e emergência de novos objetos de estudo no campo do Ensino de Ciências e Matemática. Contendo 14 artigos, a publicação abrange temas variados, como evasão estudantil, ensino de aritmética, história da Química, evasão nos cursos de Engenharia e a integração da abordagem Ciência, Tecnologia e Sociedade no ensino de Física. Inclui ainda discussões sobre arte contemporânea indígena, percepções de professores, história da matemática em licenciaturas, divulgação científica infantil, usabilidade em ambientes virtuais, métodos pedagógicos para educação inclusiva, arquitetura pedagógica para o ensino de ciências e o ensino matemático para meninas. Este volume evidencia a colaboração acadêmica e o apoio de agências de fomento, especialmente a CAPES, para o avanço da pesquisa educacional na região.

Objective: To analyze the medical students’ perception about simulated consultations before and after training using the SPIKES protocol. Methods: Quasi-experimental study, with a qualitative approach. It counted with the participation of 20 students as Simulated Physicians (SF), and 20 students as Simulated Patients (SP), all belonging to a medical course. Data were obtained from the responses given to a reflective question, applied before and after training with the SPIKES. The treatment and the analysis of the data were guided by the stages of thematic analysis. Results: In the category “Simulated Medical Student’s Self-Perception”, the subcategories “Nervousness and Insecurity” were predominant after the first consultation, while “Tranquility and Security” after the second consultation after training. In the category “Simulated Medical Student’s Perception about the Educational Process”, the subcategory “Reflective Learning” emerged in the students’ speeches, especially after the second consultation. In the speeches of SP, it was evidenced the improvement of the care provided by SF after training. Conclusion: The strategy used for the development of communication skills showed evidence of short-term effectiveness. Innovation: The research resulted in a teaching protocol for students in pre-clinical stages that involves four stages: simulation, self-assessment, feedback and new simulations.

Abstract Introduction: Assessing professionalism represents a challenge for medical educators given the nature of its construct, which comprises diverse values, beliefs, and principles. Understanding this psychological phenomenon is fundamental for reaching the goals in medical education. Objective: This study aimed to translate into Brazilian Portuguese and to validate the Penn State College of Medicine Professionalism Questionnaire. Method: The questionnaire was translated, and cross-culturally adapted into Brazilian Portuguese using data from 249 medical students. An exploratory factor analysis was conducted, using a polychoric matrix and the Robust Diagonally Weighted Least Squares method of extraction. The following model adequacy indexes and criteria were used: Root Mean Square Error of Approximation (RMSEA) adjustment indexes 0.90. Result: The exploratory factor analysis obtained a KMO = 0.920, and a significant Bartlett’s test of sphericity (2719.0, gl = 630; P

A evasão de estudantes no Ensino Superior é um problema universal e vem sendo estudado em muitos países. É um tema complexo e com facetas que envolvem fatores internos e externos ao ambiente acadêmico. O abandono à instituição, em geral, é resultado da combinação de diversos problemas como a desilusão do estudante com o curso, a falta de motivação ou clareza nos objetivos, problemas pessoais ou sentimento de não pertencimento à comunidade da qual o estudante faz parte. Este estudo teve como objetivo compreender possíveis correlações entre os estudantes do programa PET-Física da Universidade Federal do Amazonas (UFAM) e a permanência desses estudantes na instituição. A análise é documental, referente aos ingressantes dos cursos de Licenciatura e Bacharelado em Física, no período de 2005 a 2014, e utiliza-se do modelo de evasão de Vincent Tinto (1993). Dentre os resultados da pesquisa, observou-se que a evasão é reduzida quando os estudantes se sentem reconhecidos e parte integrante de uma comunidade, como o PET-Física.

Based on the unpredictable effect of context familiarity when students solve real-world problems, this work aims to analyse how certain contexts can be used by pre-service mathematics teachers in the representation and real-world verification of a first-order mathematical model in the classroom in the subject of Ordinary Differential Equations. Specifically, this paper reports a classroom experience in which pre-service mathematics teachers compared the solution of a first-order ordinary differential equations (ODE) with a real-world experimental model. Using documentary records (i.e., students´ hand-written solutions and field notes) and a questionnaire on students´ perceptions on this classroom experience, qualitative results indicated that the pre-service mathematics teachers’ familiarity with an authentic context was a fundamental factor they chose a real-world model to represent the solution of a first-order ODE. Our analysis of the results highlights the importance of integrating familiar real-world contexts for pre-service mathematics teachers to model a first-order ODE, which is one of the fundamental principles of STEM disciplines.

Los profesionales de la salud de las Unidades de Cuidados Intensivos (UCI) enfrentan situaciones de sufrimiento humano, competitividad y demanda, que podrían perjudicar su calidad de vida y su salud mental. El objetivo del estudio fue describir los trastornos mentales comunes y la calidad de vida relacionada con la salud en profesionales de la salud de la UCI en Salvador, Brasil. Este estudio transversal con 195 profesionales utilizó un cuestionario sociodemográfico y laboral, el Self-Reporting Questionnaire (SRQ-20) de trastornos mentales comunes y el 36-Item Short Form Health Survey (SF-36v2) de calidad de vida relacionada con la salud. El 29.7 % de los profesionales presentaron trastornos mentales comunes, especialmente entre profesionales de enfermería (RP = 2.28; IC 1.19-4.39; p = .007). La calidad de vida relacionada con la salud para todos los profesionales estuvo disminuida, principalmente en función social (44.25 ± 10.15) y rol emocional (45.86 ± 10.58). El SRQ-20 correlacionó fuertemente con los dominios dolor corporal (r = -.502), salud general (r = -.526), vitalidad (r = -.656), función social (r = -.608), salud mental (r = -.631) y el componente de salud mental (r = -.638) del SF-36v2 (p < .01). Los profesionales con trastornos mentales comunes mostraron una calidad de vida relacionada con la salud más deteriorada, esencialmente en dominios del componente de salud mental, y refirieron también dolor corporal. Es necesario discutir e implementar estrategias de evaluación, prevención y promoción de la salud mental entre los profesionales de las UCI para que sean consideradas dentro de las políticas de salud laboral.

Cancer is a leading cause of mortality and morbidity all over the world and the second major cause of death in Portugal. Dermatological side effects resulting from cancer treatment have a psychosocial impact on patients’ lives, such as quality of life (QoL), body image, cognitive fusion and social inhibition. This systematic review aimed to explore and synthesize the psychosocial impact of dermatological side effects of cancer treatment, answering the following research objectives: (i) Do the dermatological side effects of the cancer treatment present any psychosocial impact for the patients? (ii) How does the psychosocial impact of the dermatological toxicities of the cancer treatment manifest in patients’ lives? Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed and guided a systematic search through the PubMed, Cochrane Library and PyscNet databases. The considered studies correlate dermatological side effects of cancer treatments and their psychological/psychosocial outcomes. The studies found were all published in peer-reviewed journals. The results obtained established that cancer treatment causes the most varied skin changes, consequently reducing self-esteem and QoL; disturbing body image; and contributing to cases of stress, depression and anxiety. There is still limited literature that profoundly investigates the experience of living with these skin toxicities. The development of research lines to improve knowledge in this field will allow for significant improvements in healthcare for patients undergoing cancer treatment who need to focus more on the psychosocial implications of skin toxicities. The novelty of this review lies in adding knowledge summarizing the psychosocial implications of dermatological side effects of cancer treatment to support healthcare providers in the development of integrative therapeutic strategies for these patients in their clinical practice.

Food remains a major source of human exposure to chemical contaminants that are unintentionally present in commodities globally, despite strict regulation. Scientific literature is a valuable source of quantification data on those contaminants in various foods, but manually summarizing the information is not practicable. In this review, literature mining and machine learning techniques were applied in 72 foods to obtain relevant information on 96 contaminants, including heavy metals, polychlorinated biphenyls, dioxins, furans, polycyclic aromatic hydrocarbons (PAHs), pesticides, mycotoxins, and heterocyclic aromatic amines (HAAs). The 11,723 data points collected from 254 papers from the last two decades were then used to identify the patterns of contaminants distribution. Considering contaminant categories, metals were the most studied globally, followed by PAHs, mycotoxins, pesticides, and HAAs. As for geographical region, the distribution was uneven, with Europe and Asia having the highest number of studies, followed by North and South America, Africa and Oceania. Regarding food groups, all contained metals, while PAHs were found in seven out of 12 groups. Mycotoxins were found in six groups, and pesticides in almost all except meat, eggs, and vegetable oils. HAAs appeared in only three food groups, with fish and seafood reporting the highest levels. The median concentrations of contaminants varied across food groups, with citrinin having the highest median value. The information gathered is highly relevant to explore, establish connections, and identify patterns between diverse datasets, aiming at a comprehensive view of food contamination.

BackgroundUp to 50% of acute myocardial infarction (MI) patients present with microvascular dysfunction, after a successful percutaneous coronary intervention (PCI), which leads to worse clinical outcomes. The main purpose of this study is to provide a critical appraisal of the emerging role of invasive microvascular resistance indices in the MI setting, using the index of microcirculatory resistance (IMR), hyperemic microvascular resistance (HMR) and zero-flow pressure (Pzf).MethodsWe systematically explored relevant studies in the context of MI that correlated microcirculation resistance indices with microvascular dysfunction on cardiac magnetic resonance (CMR), microvascular dysfunction occurring in infarct related arteries (IRA) and non-IRA and its relation to clinical outcomes.ResultsThe microcirculation resistance indices correlated significantly with microvascular obstruction (MVO) and infarct size (IS) on CMR. Although HMR and Pzf seem to have better diagnostic accuracy for MVO and IS, IMR has more validation data. Although, both IMR and HMR were independent predictors of adverse cardiovascular events, HMR has no validated cut-off value and data is limited to small observational studies. The presence of microvascular dysfunction in non-IRA does not impact prognosis.ConclusionMicrovascular resistance indices are valuable means to evaluate microcirculation function following MI. Microvascular dysfunction relates to the extent of myocardial damage and clinical outcomes after MI.Systematic review registration[https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021228432], identifier [CRD42021228432].

Abstract Exercise‐induced hypoalgesia (EIH) is characterized as the pain reduction after an exercise session and it seems to be related to the release of plasma β‐endorphin. In this sense, the core stabilization training (CT) has been suggested for patients with chronic nonspecific low back pain (CNSLBP), but it is unclear whether it induces EIH. Patients with CNSLBP have neuromotor dysfunctions that can affect the performance of functional tasks, thus, performing functional training (FT) could improve motor control and promote EIH, since functional training uses multi‐joint exercises that aim to improve the functionality of actions performed in daily life. EIH is usually assessed using quantitative sensory tests (QST) such as conditioned pain modulation, pressure pain threshold, and temporal summation. Thus, the sum of parameters from quantitative sensory tests and plasma β‐endorphin would make it possible to understand what the neuroendocrine effects of FT and CT session are. Our study compared the acute effect of CT and FT on the EIH and plasma β‐endorphin release, and correlated plasma β‐endorphin with quantitative sensory testing in patients with CNSLBP. Eighteen women performed two training sessions (CT and FT) with an interval of 48 h between sessions. EIH was assessed by QST and plasma β‐endorphin levels. Results showed that only FT significantly increased plasma β‐endorphin (FT p

Summary: Background: Early death after cancer surgery is higher in low-income and middle-income countries (LMICs) compared with in high-income countries, yet the impact of facility characteristics on early postoperative outcomes is unknown. The aim of this study was to examine the association between hospital infrastructure, resource availability, and processes on early outcomes after cancer surgery worldwide. Methods: A multimethods analysis was performed as part of the GlobalSurg 3 study—a multicentre, international, prospective cohort study of patients who had surgery for breast, colorectal, or gastric cancer. The primary outcomes were 30-day mortality and 30-day major complication rates. Potentially beneficial hospital facilities were identified by variable selection to select those associated with 30-day mortality. Adjusted outcomes were determined using generalised estimating equations to account for patient characteristics and country-income group, with population stratification by hospital. Findings: Between April 1, 2018, and April 23, 2019, facility-level data were collected for 9685 patients across 238 hospitals in 66 countries (91 hospitals in 20 high-income countries; 57 hospitals in 19 upper-middle-income countries; and 90 hospitals in 27 low-income to lower-middle-income countries). The availability of five hospital facilities was inversely associated with mortality: ultrasound, CT scanner, critical care unit, opioid analgesia, and oncologist. After adjustment for case-mix and country income group, hospitals with three or fewer of these facilities (62 hospitals, 1294 patients) had higher mortality compared with those with four or five (adjusted odds ratio [OR] 3·85 [95% CI 2·58–5·75]; p

Abstract Background Spinal cord injury (SCI) is a debilitating medical condition that can result in the irreversible loss of sensorimotor function. Current therapies fail to provide an effective recovery being crucial to develop more effective approaches. Mesenchymal stem cell (MSC) exosomes have been shown to be able to facilitate axonal growth and act as mediators to regulate neurogenesis and neuroprotection, holding great therapeutic potential in SCI conditions. This study aimed to assess the potential of human placental MSC (hpMSC)-derived exosomes on the functional recovery and reactivation of endogenous neurogenesis in an experimental animal model of SCI and to explore the possible mechanisms involved. Methods The hpMSC-derived exosomes were extracted and transplanted in an experimental animal model of SCI with complete transection of the thoracic segment. Functional recovery, the expression of neural stem/progenitor cell markers and the occurrence of neurogenesis, was assessed 60 days after the treatment. In vitro, neural stem cells (NSCs) were incubated with the isolated exosomes for 24 h, and the phosphorylation levels of mitogen-activated protein kinase kinase (MEK), extracellular signal-regulated kinases (ERK), and cAMP response element binding (CREB) proteins were assessed by western blot. Results Exosomes were successfully isolated and purified from hpMSCs. Intravenous injections of these purified exosomes significantly improved the locomotor activity and bladder dysfunction of SCI animals. Further study of the exosomes’ therapeutic action revealed that hpMSC-derived exosomes promoted the activation of proliferating endogenous neural stem/progenitor cells as denoted by the significant increase of spinal SOX2+GFAP+, PAX6+Nestin+, and SOX1+KI67+ cells. Moreover, animals treated with exosomes exhibited a significative higher neurogenesis, as indicated by the higher percentage of DCX+MAP 2+ neurons. In vitro, hpMSC-derived exosomes promoted the proliferation of NSCs and the increase of the phosphorylated levels of MEK, ERK, and CREB. Conclusions This study provides evidence that the use of hpMSC-derived exosomes may constitute a promising therapeutic strategy for the treatment of SCI.

O presente artigo busca identificar possíveis contribuições das atividades experimentais investigativas para o desenvolvimento de habilidades científicas de coletar, analisar e comunicar ideias em licenciandos de Física e Química. A pesquisa de caráter qualitativo teve a participação do pesquisador em todas as etapas da investigação que se desenvolveu por meio de uma oficina com experimentos investigativos, conforme a proposta de Kasseboehmer e seus colaboradores (2015). As etapas da pesquisa envolveram o planejamento, a execução e a avaliação das atividades experimentais de 20 discentes de graduação da UFAM. A coleta de dados ocorreu por intermédio de atividades escritas referentes às investigações experimentais realizadas e entrevistas com os participantes. As atividades escritas foram analisadas por rubricas e as entrevistas pela Análise Textual Discursiva. Constatamos que as atividades experimentais investigativas possuem potencial promissor para desenvolver as habilidades científicas analisadas neste trabalho, podendo ser útil no desenvolvimento das habilidades exigidas na formação do futuro docente. Contributions of investigative experimental activities to develop scientific abilities in a group of Physics and Chemistry undergraduates Abstract This article seeks to identify possible contributions of experimental investigative activities to the development of scientific abilities of collecting, analyzing and communicating ideas in Physics and Chemistry graduates. The qualitative research had the participation of the researcher in all stages of the investigation, which was developed by means of a workshop with investigative experiments, according to the proposal of Kasseboehmer and his collaborators (2015). The research stages involved the planning, execution and evaluation of the experimental activities of 20 undergraduate students at UFAM. Data collection took place through written activities related to the execution of experimental investigations as well as interview with the participants. The written activities were analyzed by rubrics and the interviews by the Discursive Textual Analysis. We verified that experimental investigative activities have a promising potential to develop the scientific abilities analyzed in this work, and they may be useful in developing the required skills in relation to training future teachers. Keywords: Investigative activity. Scientific abilities. Teacher training. Experiment.

Alzheimer’s disease (AD) is a chronic neurodegenerative disease characterized by the occurrence of cognitive deficits. With no effective treatments available, the search for new effective therapies has become a major focus of interest. In the present study, we describe the potential therapeutic effect of Artemisia annua (A. annua) extract on AD. Nine-month-old female 3xTg AD mice were treated with A. annua extract for three months via oral administration. Animals assigned to WT and model groups were administrated with an equal volume of water for the same period. Treated AD mice significantly improved the cognitive deficits and exhibited reduced Aβ accumulation, hyper-phosphorylation of tau, inflammatory factor release and apoptosis when compared with untreated AD mice. Moreover, A. annua extract promoted the survival and proliferation of neural progenitor cells (NPS) and increased the expression of synaptic proteins. Further assessment of the implicated mechanisms revealed that A. annua extract regulates the YAP signaling pathway in 3xTg AD mice. Further studies comprised the incubation of PC12 cells with Aβ1–42 at a concentration of 8 μM with or without different concentrations of A. annua extract for 24 h. Obtained ROS levels, mitochondrial membrane potential, caspase-3 activity, neuronal cell apoptosis and assessment of the signaling pathways involved was performed using western blot and immunofluorescence staining. The obtained results showed that A. annua extract significantly reversed the Aβ1–42-induced increase in ROS levels, caspase-3 activity and neuronal cell apoptosis in vitro. Moreover, either inhibition of the YAP signaling pathway, using a specific inhibitor or CRISPR cas9 knockout of YAP gene, reduced the neuroprotective effect of the A. annua extract. These findings suggest that A. annua extract may be a new multi-target anti-AD drug with potential use in the prevention and treatment of AD.

This paper presents an empirical study of the capital structure of Portuguese companies where the main objective is to find key explanatory factors for indebtedness decisions. The relations between indebtedness and its determinants are tested in the light of the Trade-Off Theory and the Pecking-Order Theory. The motivation of this work was to contribute to the scientific research on the influential determinants of the capital structure and to deepen the knowledge of the Portuguese market. The quantitative methodology is used, through an econometric model for panel data using accounting information of 55 Portuguese companies between 2014 and 2016. Statistical tests such as the F test, the Lagrange Multiplier Breusch-Pagan test and the Hausman test were used to identify the most appropriate method of estimation, which resulted in a panel data model with random effects for individuals. The findings of this study suggest that indebtedness have a positive relation with tangibility and the size of the company, which supports the Trade-Off Theory. However, the positive relationship with the non-debt tax benefits suggests the importance of taxes, contrary to Trade-Off Theory. The negative relationship with cash flows, coupled with the positive relationships between size and growth opportunities, suggest the use of funding only when internal funds become insufficient, supporting the Pecking-Order Theory. The general results support that both theories partially explain the financing decisions of Portuguese companies. Doi: 10.28991/esj-2020-01249 Full Text: PDF

Este trabalho investigou a contribuição do Programa Institucional de Bolsa de Iniciação à Docência (PIBID) na formação de licenciandos em Física da Universidade Federal do Amazonas (UFAM), que atuaram no PIBID a partir das experiências construídas e aplicadas em escolas públicas do Ensino Médio de Manaus. Os procedimentos metodológicos estão centrados em uma pesquisa qualitativa, tendo como instrumentos de investigação entrevistas semiestruturadas, observação direta e análise documental dos projetos institucionais do PIBID/UFAM submetidos aos Editais PIBID/CAPES 2007, 2010 e 2013. Os sujeitos selecionados foram licenciandos e os licenciados que participaram do subprojeto PIBID/Física, no período de 2008 a 2015, que correspondem a um total de 60. Os resultados obtidos mostram que o PIBID/Física fortaleceu a formação dos licenciandos por meio de experiências e práticas pedagógicas proporcionadas pelo contato com a escola, além de reduzir a evasão no curso de Licenciatura em Física. Observou-se ainda que a orientação acadêmica feita por supervisores na escola e pelo coordenador de área da UFAM colaborou com o aumento do rendimento escolar dos bolsistas. Palavras-chave: PIBID. Formação Inicial. Licenciatura em Física. The PIBID’s contribution on the initial training of Physics teachers at UFAM Abstract The objective of the research is to investigate the contribution of PIBID/Physics in vocational training for Bachelor’s Degree students in Physics at UFAM who work (or have worked) in PIBID, from the experiences built within the profession in public high schools in Manaus. The methodological procedures are centered on qualitative and quantitative research, using the following instruments for data collection: socioeconomic questionnaire, semi-structured interviews, informal conversations, participant observation and document analysis of institutional projects PIBID / UFAM submitted to Notices PIBID / CAPES 2007 2010 and 2013. The selected subjects are all undergraduates / graduates who participate or have participated in the subproject PIBID/Physics from 2008 to 2015, corresponding to a total of 60 subjects. The results show that PIBID/Physics strengthens the students’ formation through pedagogical experiences and practices provided by contact with middle school, interaction between theory, practice, and the mentoring of supervisors and area coordinator helps to increase the performance of the benefited students, besides being one of those responsible for the reduction of evasion in the Degree in Physics. Keywords: PIBID. Initial Formation. Degree in Physics. .

Introduction: Few studies are available about common mental disorders and mental health-related quality of life among dental healthcare providers. Objective: Describe the common mental disorders and the mental health-related quality of life of members of oral health teams from the primary health care section of the Unified Health System in the Metropolitan Region of Salvador de Bahia, Brazil. Methods: A descriptive cross-sectional study was conducted based on the Symptom reporting questionnaire for the evaluation of common mental disorders, the Health questionnaire about health-related quality of life, and a sociodemographic characterization questionnaire. Results: The study sample was composed of 161 professionals, of whom 59.6% were dentists and 40.4% were dental auxiliaries. Dentists obtained a higher average score in the Symptom reporting questionnaire (p = 0.032), whereas their scores in the mental health domains of the Health questionnaire were lower and significant. Three factors in the Symptom reporting questionnaire exhibited a high negative correlation with the mental health domains of the Health questionnaire. Conclusions: Dentists presented greater symptoms of common mental disorders and mental health-related quality of life deterioration than dental auxiliaries. It is therefore necessary to implement mental health promotion strategies aimed at members of oral health teams.

Abstract Introduction Unexplained visual loss after removal of silicone oil from the eye has been described. The purpose of this study is to determine the incidence of unexplained loss of visual acuity after SO removal and to provide possible explanations for this phenomenon. Methods This retrospective study included patients that underwent vitreoretinal surgery, at Centro Hospitalar São João, between January of 2012 and October of 2018. Inclusion criterion was vitreoretinal surgery in which the chosen endotamponade was SO, followed by removal of SO and exchange with balanced salt solution (BSS) or air. After SO removal, patients with documented loss of best corrected visual acuity (BCVA) on two or more Snellen lines were analyzed and patients in which the cause of the visual loss was identified, namely OHT (intraocular pressure > 21 mmHg), retinal re-detachment, glaucoma, retinal proliferative membrane formation, or corneal decompensation, were excluded. All patients with unexplained visual loss underwent spectral domain optical coherence tomography (SD-OCT) to exclude causes of visual reduction such as cystoid macular edema, epiretinal membrane, or ellipsoid/interdigitation zone disruption. A p value less than 0.05 was considered statistically significant. Results A total of 46 eyes underwent SO tamponade and SO removal during the study period. In 34.8% of the cases (n = 16) there was visual acuity loss in at least two Snellen lines. Of 46 eyes, 23.9% (n = 11) showed vision loss due to known secondary causes. Unexplained loss of visual acuity after SO removal occurred in 10.9% of cases. OHT during silicone endotamponade (p = 0.046) and silicone emulsification (p = 0.001) were identified as factors associated with unexplained visual loss after SO removal. Conclusion Unexplained loss of visual acuity after SO removal occurred in 10.9% of cases. OHT during silicone endotamponade and SO emulsification were identified as important factors in the ethology of this phenomenon.

Introduction: The ultimate indicator of adherence to a gluten-free diet is the demonstration of mucosal healing. However, the need for histological reassessment is subject to controversy among “experts”. The aim of this study was to evaluate celiac patients who underwent histological reevaluation after starting a gluten-free diet in order to identify those with histological remission and associated factors. Methods: This retrospective study included patients who agreed to a histological reassessment after apparent clinical and serological remission and reported at least 12 months of diet adherence. In all cases, informed consent was signed for upper endoscopy. Results: A total of 69 patients were included. In 67.9% of cases, the diagnosis was made in the context of “classic” symptomatology, 17% had “nonclassical” presentation, and 15.1% were in latent phase. 69.2% of the diagnoses were initially suspected by serology. Endoscopically, 11.8% of the patients did not present suggestive features macroscopically, and a histological grade of Marsh IIIa–c was observed in 75.5% of all cases. The histological findings were normalized in 37.7%, which was associated with the presence of lower Marsh score values at diagnosis (p = 0.014) and lower DEXA T-score values (p = 0.038). A histological improvement was observed in 55 patients (≥2 grades in 37 cases), which was related to the initial transferrin saturation (p = 0.027) and with higher Marsh scores at diagnosis (p = 0.007). Conclusion: Even under a gluten-free diet, celiac histology normalization is difficult to obtain and appears to be independent of most clinical and serological findings at diagnosis. Patients with less severe histological levels at diagnosis reach remission more easily, but only represent the ­minority of the population.

Este artículo es producto de una investigación de mixta donde predominó el énfasis en la descripción de los resultados, con características cuantitativas de la información obtenida a través del cuestionario aplicado. El diseño descriptivo permitió observar y reflexionar sobre las mediaciones pedagógicas que se dan en los contextos familiares frente a la recepción y consumo de productos y servicios ofertados por la televisión, internet y las redes sociales on line. Los participantes fueron estudiantes universitarios (16 y 24 años de edad) a los que se les aplicó un cuestionario y un diario de observación. Se realizó una triangulación de los resultados de la observación participante y de los cuestionarios aplicados. Se encontró que existía un tipo de mediación familiar frente a los contenidos televisivos. Sin embargo, no se encontró un indicador que aclare si las familias están mediando los contenidos que circulan en internet. Esto permite una oportunidad para plantear estrategias de comunicación familiar, que posibiliten una injerencia de los padres / cuidadores o acompañantes sobre estos contenidos, teniendo en cuenta el ciclo vital individual y familiar.

Enquadramento: a maioria dos cuidados prestados a pessoas dependentes em contexto de domicílio é assegurada por um cuidador, familiar da pessoa cuidada, que presta cuidados de forma não remunerada. Atualmente emergem preocupações crescentes com a sua saúde mental e a ansiedade e sobrecarga surgem, muitas vezes, associadas ao desempenho deste papel. Objetivo: analisar a relação entre as variáveis sociodemográficas, sobrecarga e ansiedade do cuidador. Metodologia: quantitativa, transversal, com amostra por redes, de 85 cuidadores. Utilizada a Escala de Sobrecarga do Cuidador e a Escala de Ansiedade, Depressão e Stress e os testes t de Student, Kruskal-Wallis e U Mann-Whitney. Resultados: os cuidadores possuíam uma idade média de 51.97 anos, eram maioritariamente do sexo feminino, casados e apresentavam escolaridade até ao terceiro ciclo. Constatou-se que 38.8% dos cuidadores apresentavam ansiedade. Os que revelavam maior ansiedade tinham entre 50 e 60 anos (p=0.023) e como escolaridade o ensino superior (p=0.009). Não existem diferenças estatisticamente significativas entre outras variáveis. Conclusão: a idade e a escolaridade parecem ter influência na ansiedade do cuidador. Uma vez que a ansiedade do cuidador pode ter repercussões na pessoa cuidada é de extrema importância intervir no sentido da prevenção e promoção da sua saúde mental.

Ischemic stroke is one of the leading causes of death and disability among adults. Despite the economic burden of the disease, available treatment options are still very limited. With the exception of anti-thrombolytics and hypothermia, current therapies fail to reduce neuronal injury, neurological deficits and mortality rates, suggesting that the development of novel and more effective therapies against ischemic stroke is urgent. In the present study, we found that artemether, which has been used in the clinic as an anti-malarial drug, was able to improve the neurological deficits, attenuate the infarction volume and the brain water content in a middle cerebral artery occlusion (MCAO) animal model. Furthermore, artemether treatment significantly suppressed cell apoptosis, stimulated cell proliferation and promoted the phosphorylation of extracellular signal-regulated kinase 1/2 (ERK1/2), P90rsk and cAMP responsive element-binding protein (CREB). Artemether protective effect was attenuated by PD98059, an ERK1/2 inhibitor, administration. Similarly, in oxygen-glucose deprivation/reperfusion (OGD/RP) cell models, artemether pre-treatment induced the suppression of the intracellular ROS, the down-regulation of LDH activity, the reduction of caspase 3 activity and of the apoptosis cell rate and reversed the decrease of mitochondrial membrane potential. As with MCAO animal model, artemether promoted the activation of Erk1/2-P90rsk-CREB signaling pathway. This effect was blocked by the inhibition or knock-down of ERK1/2. The present study provides evidences of the neuroprotective effect of artemether unravelling its potential as a new therapeutic candidate for the prevention and treatment of stroke.

Depression is a prevalent psychiatric disorder and a leading cause of disability worldwide. Despite a variety of available treatments currently being used in the clinic, a substantial proportion of patients is unresponsive to these treatments, urging the development of more effective therapeutic approaches. Hederagenin (Hed), a triterpenoid saponin extracted from Fructus Akebiae, has several biological activities including anti-apoptosis, anti-hyperlipidemic and anti-inflammatory properties. Over the years, its potential therapeutic effect in depression has also been proposed, but the information is limited and the mechanisms underlying its antidepressant-like effects are unclear. The present study explored the neuroprotective effects and the potential molecular mechanisms of Hederagenin action in corticosterone (CORT)-injured PC12 cells. Obtained results show that Hederagenin protected PC12 cells against CORT-induced damage in a concentration dependent manner. In adittion, Hederagenin prevented the decline of mitochondrial membrane potential, reduced the production of intracellular reactive oxygen species (ROS) and decreased the apoptosis induced by CORT. The protective effect of Hederagenin was reversed by a specific phosphatidylinositol-3-kinase (PI3K) inhibitor LY294002 and AKT (also known as protein kinase B) inhibitor MK2206, suggesting that the effect of Hederagenin is mediated by the PI3K/AKT pathway. In line with this, western blot analysis results showed that Hederagenin stimulated the phosphorylation of AKT and its downstream target Forkhead box class O 3a (FoxO3a) and Glycogen synthase kinase-3-beta (GSK3β) in a concentration dependent manner. Taken together, these results indicate that the neuroprotective effect of Hederagenin is likely to occur via stimulation of the PI3K/AKT pathway.

Background: This trial tested if a novel therapy, Aligning Dimensions of Interoceptive Experience (ADIE), reduces anxiety in autistic adults. ADIE targets the association of anxiety with mismatch between subjective and behavioral measures of an individual's interoceptive sensitivity to bodily signals, including heartbeats. Methods: In this superiority randomized controlled trial, autistic adults (18–65 years) from clinical and community settings in Southern England were randomly assigned (1:1) to receive six sessions of ADIE or an active ‘exteroceptive’ control therapy (emotional prosody identification). Researchers conducting outcome assessments were blind to allocation. ADIE combines two modified heartbeat detection tasks with performance feedback and physical activity manipulation that transiently increases cardiac arousal. Participants were followed-up one-week (T1) and 3-months post-intervention (T2). The primary outcome was Spielberger Trait Anxiety Score (STAI-T) at T2. Outcomes were assessed on an intention-to-treat basis using multiple imputation for dealing with missing values. This trial was registered at International Standard Randomized Controlled Trial Registry, ISRCTN14848787. Findings: Between July 01, 2017, and December 31, 2019, 121 participants were randomly allocated to ADIE (n = 61) or prosody (n = 60) intervention groups. Data at T1 was provided by 85 (70%) participants (46 [75%] ADIE; 39 [65%] prosody). Data at T2 was provided by 61 (50%) participants (36 [59%] ADIE; 25 [42%] prosody). One adverse event (cardiac anxiety following ADIE) was recorded. A statistically significant group effect of ADIE on trait anxiety continued at T2 (estimated mean difference 3•23 [95% CI 1•13 to 5•29]; d = 0•30 [95% CI 0•09 to 0•51]; p = 0•005) with 31% of ADIE group participants meeting trial criteria for recovery (compared to 16% in the control group). Interpretation: ADIE can reduce anxiety in autistic adults, putatively improving regulatory control over internal stimuli. With little reliance on language and emotional insight, ADIE may constitute an inclusive intervention. Funding: MQ: Transforming Mental Health PsyImpact Grant.

Enquadramento: os cuidadores familiares são aqueles que assumem em primeira linha o papel de cuidar do seu familiar com dependência. Sendo este um processo desgastante, repleto de obstáculos e gerador de stress e ansiedade, o cuidador recorre frequentemente a estratégias para lidar com estas situações, as estratégias de coping. Objetivo: caraterizar as estratégias de coping mais utilizadas pelos cuidadores familiares, antes e após a implementação de um Programa de Intervenção de Enfermagem. Metodologia: estudo quase-experimental, longitudinal, de metodologia quantitativa, com uma amostra de conveniência de 70 cuidadores familiares. Utilizados um questionário sociodemográfico e um instrumento de avaliação de estratégias de coping utilizadas, o Questionário Brief COPE. Análise estatística realizada com o recurso ao SPSS 23.0. Dados apresentam distribuição normal, pelo que foram utilizados testes paramétricos na sua análise. Resultados: cuidadores são maioritariamente idosos, do sexo feminino, baixa escolaridade, sem ocupação profissional e coabitam com o seu familiar dependente. Estratégias de coping mais utilizadas, tanto na avaliação inicial como final são Coping Ativo, Planear e Religião. Conclusão: verificou-se o recurso a um maior número de estratégias de coping, apesar de não se conseguir definir claramente um estilo de coping predominante. A importância do papel do enfermeiro na capacitação do cuidador familiar foi destacada.

Science camps for teachers have been held in Chile for several years and are recognized as important opportunities for continuing education, but they have been largely ignored as instances for impactful reflection on teacher self-assessment and identity. This article presents the analysis of teacher experiences at a science camp held in southern Chile called “Explora Va!”, which was designed not just as an instance for continuing education for teachers in scientific contents but also for individual and collaborative reflection aimed at strengthening educators’ skills as agents of change in their institutions. The question of this study was: how do the participants represent their teacher identities based on their experiences at the “Explora Va!” Camp? Using a qualitative approach, the results of the analysis of narratives from teachers’ camp journals are reported here. The narratives from these journals provide an account of two dimensions, personal and contextual, where the importance of the teaching profession and science teaching were explored beyond conventional disciplinary limits. Collaboration, innovation, and personal and professional growth at the camp served to signify and resignify professional identities based on common elements but attending to the particular circumstances and unique backgrounds of each teacher.

Background: The 36-Item Short Form Health Survey questionnaire (SF-36) is a widely used instrument for evaluating health-related quality-of-life (HRQoL). The psychometric validation of the SF-36 version 2.0 (SF-36v2) in HIV-infected patients had not yet conducted in Brazil. Aim: To test data quality, reliability and validity of the SF-36v2 as a measure of HRQoL among Brazilian individuals living with HIV. Methods: A cross-sectional study included 393 HIV-infected patients in whom HRQoL was assessed by using the SF-36v2 questionnaire. Demographic characteristics, socioeconomic status and clinical data were also collected. The SF-36 version 1 translated into Brazilian-Portuguese was adapted and introduced version 2 improvements according to the instrument developers. SPSS version 21 was used for data analyses. Confirmatory factor analysis (CFA) and structural equation modelling were performed using AMOS SPSS version 18. T-test for independent samples was used to compare differences between mean levels of HRQoL components in different groups. Linear multiple regression techniques were used to analyze the relationship between Physical Component Summary (PCS), Mental Component Summary (MCS) and independent variables. Results: We performed the CFA and tested the hypothetical measurement model. We included five parameters to improve the adherence of data to the model. All indicators met the requirement suggested by specialized literature (χ2 (gl): 980.7 (527); CFI: 0.949; GFI: 0.873; TLI: 0.943; RMSEA: 0.047; 90% IC: 0.042-0.051). Multiple regression analyses revealed that depression (p = 0.001), family income (p = 0.007), sex (p = 0.001) and age (p

Abstract Background Training in the use of cost-conscious strategies for medical students may prepare new physicians to deliver health care in a more sustainable way. Recently, a role-modeling cost-conscious behaviors scale (RMCCBS) was developed for assessing students’ perceptions of their teachers’ attitudes to cost consciousness. We aimed to translate the RMCCBS into Brazilian Portuguese, adapt the scale, transculturally, and validate it. Methods We adopted rigorous methodological approaches for translating, transculturally adapting and validating the original scale English version into Brazilian Portuguese. We invited all 400 undergraduate medical students enrolled in the 5th and 6th years of a medical course in Northeast Brazil between January and March 2017 to participate. Of the 400 students, 281 accepted to take part in the study. We analyzed the collected data using the SPSS software version 21 and structural equation modeling (SEM) was performed using AMOS SPSS version 18. We conducted exploratory factor analysis (EFA), varimax rotation, with Kaiser Normalization and Principal Axis Factoring extraction method. We conducted confirmatory factor analysis (CFA), using the SEM. We used the following indexes of adherence of the model: Comparative fit index (CFI), Goodness-of-fit index (GFI) and Tucker-Lewis Index (TLI). We considered the Bayesian Information Criterion (BIC) for Sample-size adjusted. The root mean square error of approximation was calculated. Values below 0.08 were considered acceptable. Composite reliability analyzes were performed to evaluate the accuracy of the instrument. Values above 0.70 were considered satisfactory. Results Of the 281 undergraduate medical students, 195 (69.3%) were female. Mean age of participants was 25.0 ± 2.6 years. In the EFA, the KMO was 0.720 and the Bartlett sphericity test was significant (p

Introdução: A prática de condutas desnecessárias e os desperdícios na saúde são temas importantes e ainda pouco abordados no curso de Medicina. A educação médica tem um papel fundamental na formação de estudantes e médicos com atitudes custo-conscientes para uma boa atenção à saúde. O objectivo deste estudo foi descrever e avaliar a implementação do programa Choosing Wisely - Escolhas Criteriosas em Saúde, no internato de Cirurgia Geral. Material e Métodos: Estudo de intervenção envolvendo orientadores de formação e internos. Utilizando a técnica Delphi, os orientadores de formação identificaram três intervenções frequentemente observadas na prática clínica sem benefício e com potenciais riscos desnecessários para o doente, que geraram recomendações, agrupadas e adaptadas ao formato do programa Choosing Wisely. O tema foi incluido na avaliação do internato, tendo sido desenvolvidas ações de formação e de divulgação em banners personalizados, a par de atividades de aprendizagem reflexiva sobre o programa e da integração da temática na avaliação teórica do internato. Resultados: As cinco principais recomendações referem-se (i) à utilização excessiva de tomografia axial computorizada na abordagem da suspeita de apendicite aguda e (ii) de tomografia axial computorizada de vários segmentos do corpo em traumatismos de baixo grau de gravidade, (iii) profilaxia antibiótica mais prolongada do que o recomendado no doente cirúrgico, (iv) jejum mais prolongado do que o recomendado no pré-operatório de todas as cirurgias e (v) utilização excessiva da endoscopia digestiva alta em doentes cirúrgicos sem sinais clínicos de alarme. As ações de formação geraram um incremento da sensibilização e reflexão, traduzido globalmente por um elevado aproveitamento na avaliação final. Discussão: A formação em escolhas criteriosas em saúde, promovendo uma utilização de cuidados de saúde consciente e de qualidade, sugere que as mudanças devem ocorrer ao longo do curso de Medicina, num ambiente de aprendizagem centrado numa prática reflexiva e baseada na evidência. As recomendações produzidas no estudo tiveram em consideração a totalidade dos benefícios e riscos para o doente. Conclusão: A integração da iniciativa Choosing Wisely no programa de formação em Cirurgia Geral deu origem a um conhecimento e discussão mais reflexivos sobre as recomendações relativas à utilização racional e criteriosa de cuidados de saúde, podendo resultar numa prática médica mais sustentável e sensível aos custos que gera.

Purpose. To describe a positive clinical response of a patient with submacular Nocardia abscess due to a rapid and efficient treatment. Case report. We describe a case of a 50-year-old man with a painless visual decline of the left eye. Four years later, he had been diagnosed with systemic nocardiosis. Examination of the left eye revealed a submacular white mass with fluffy borders and another smaller white lesion, with well-defined borders, in the inferior temporal vascular arch. A systemic antibiotic treatment with SMX-TMP and intravenous imipenem and a single intravitreal injection of bevacizumab was performed. Conclusion. Prompt diagnosis and treatment ensured an expeditious resolution of the abscess and significant improvement of visual acuity. The diagnostic approach of a high index of suspicion coupled with directed treatment is required when dealing with subretinal inflammatory lesions.

A técnica de dopplerfluxometria é importante para aferir a hemodinâmica renal, auxiliando no diagnóstico e prognóstico de problemas renais, todavia estudos com animais silvestres ainda são escassos. Assim sendo, é de extrema importância o desenvolvimento de estudos com o intuito de estabelecer valores de referências normais nas diferentes espécies, uma vez que esses dados servirão como base para a compreensão da anatomia e fisiologia, bem como, diagnóstico de doenças na clínica veterinária. Neste sentido, este trabalho teve como objetivo obter dados dos aspectos ultrassonográficos renais normais em cutias (Dasyprocta prymnolopha, Wagler 1831). Para avaliação da morfometria ultrassonográfica utilizou-se oito cutias, nas quais foram avaliados o comprimento e largura dos rins direito e esquerdo. Para avaliação da dopplerfluxometria foram utilizadas 11 cutias, sendo analisadas as velocidades do pico sistólico máximo (VPS) e diastólico final (VDF) do fluxo sanguíneo (cm/s) e do índice de resistividade (IR) das artérias arqueadas dos rins direito e esquerdo. Os valores médios do comprimento e largura em centímetros do rim direito e esquerdo variaram entre 3,05 ± 0,13 a 1,84 ± 0,12 e 3,04 ± 0,19 a 1,91 ± 0,10, respectivamente. O valor médio observado para o índice de resistividade na artéria arqueada dos rins direito e esquerdo foram 0,41 ± 0,06 e 0,39 ± 0,05 cm/s, respectivamente. O índice de resistividade foi inferior aos observados em outras espécies de animais domésticos e até mesmo de humanos.

Abstract: Objective: to evaluate the implementation of the Choosing Wisely (CW) campaign strategies at a medical clinic internship. Methods: This interventional study involved internship teachers and students, using online questionnaires on the SurveyMonkey platform, and face-to-face activities. Using the Delphi technique, teachers identified three unnecessary situations that commonly occur in practice. The recommendations were grouped by frequency and subject, adapted to the CW format. A Likert scale was used to classify the specialists’ opinion aiming to obtain the final list of recommendations. Before the introduction of the CW campaign, we conducted an Objective Structured Clinical Examination (OSCE). Two groups of students were compared: one group that underwent the same OSCE evaluation before the implementation of the CW campaign (110), and another group that participated of all educational actions (n = 98). The CW campaign was implemented by developing educational actions using the recommendations during workshops, banners, and theoretical evaluation, in addition to an Objective Structured Clinical Examination (OSCE). Results: after grouping the recommendations, 24 items remained. The specialists selected eight recommendations by frequency, addressing unnecessary behaviors such as requesting multiple exams, overuse of non-hormonal anti-inflammatory drugs, the indication of digestive endoscopy in younger patients with dyspepsia, excessive chest X-rays in intensive care unit, prescribing antibiotic prophylaxis for longer than recommended, routine indication of allergic tests, inadequate initial screening for thyroid assessment, and spirometry in asymptomatic patients. The educational actions resulted in a process of awareness and discussion among the participants, evidenced by theoretical evaluation (> 95%), as well as in the OSCE, where the level of successes was higher in the exposed group when compared to the nonexposed group (p = 0.001). Conclusion: the implementation of the CW campaign improved the clinical skills of medical clinic internship students and allowed positive discussions about cost-consciousness in health.

Introdução: Com o envelhecimento progressivo da população portuguesa, é fundamental que as condições de acessibilidade e segurança na via pública estejam adaptadas a este grupo etário. O objectivo deste estudo foi avaliar se o tempo atribuído à travessia de peões nas passadeiras semaforizadas entre o Hospital de Curry Cabral e os transportes públicos locais é suficiente para permitir a travessia dos idosos em segurança. Material e Métodos: Foram avaliados 100 doentes seguidos em consulta externa no Serviço de Medicina Física e de Reabilitação. Todos responderam a um questionário, à escala de confiança no equilíbrio específica da atividade e executaram o teste de marcha de 10 metros. Foram analisadas todas as passadeiras semaforizadas dos percursos de marcha entre o hospital e os transportes públicos locais, num total de 26 e calculada a velocidade de marcha necessária para realizar a travessia das passadeiras em segurança. Resultados: A média de idade dos doentes foi de 75 anos, sendo a maioria do género feminino (73%). Concluímos que todos os doentes conseguem atravessar em segurança 17 (65%) passadeiras, representando as restantes nove (35%) um obstáculo para a nossa amostra. Discussão: Se o valor de velocidade de marcha nas passadeiras estipulado na legislação para os cidadãos com mobilidade condicionada fosse devidamente aplicado, 99% da amostra teria conseguido atravessar as passadeiras em segurança. Conclusão: É fundamental que o valor de velocidade de marcha nas passadeiras estipulado na legislação seja aplicado, pois o seu incumprimento coloca em risco os utentes idosos do Hospital de Curry Cabral, aumentando a probabilidade de acidentes e o sentimento de insegurança na via pública.

ABSTRACT The aim of this study was to determine the spontaneous decolonization period and characteristics in a prospective cohort of newborns colonized by multidrug-resistant organisms, after their discharge from the neonatal intensive care unit. Multidrug resistance is defined as bacterial non-susceptibility to ≥ 1 agent of ≥ 3 antimicrobial categories. In total, 618 newborns were included in the study, of which 173 (28.0%) presented a positive culture for multidrug-resistant microorganisms, and of these, 52 (30.1%) were followed up in this study. The most frequent intrinsic factors were be born by cesarean section (86.5%), prematurity (84.6%), and very low birth weight (76.9%). The extrinsic factors were having remained hospitalized for an average of 27 days, during which 67.3% were submitted to invasive procedures and 88.5% received antimicrobials. The intrinsic and extrinsic factors of newborns were not associated to a decolonization period longer or shorter than 3 months, which was the average period of decolonization found in the present study. From the totality of colonization cultures sampled at hospital discharge, the Gram-negative Extended Spectrum β-lactamase producing bacteria were the most common, with 28.9% of babies colonized by Klebsiella spp. The median period of decolonization by multidrug-resistant microorganisms in the newborns population after hospital discharge was 3 months, but was highly dependent on the microbial species, and this period was not associated to any intrinsic and extrinsic factors of the newborn.

Research regarding the relationship between core muscle endurance and performance is limited. The purpose of this study was to analyze the association between core/trunk endurance and athletic performance. Seventy-four healthy participants between 18 and 45 years old participated in this study (Age: 26.0 ± 6.5 years; Mass: 74.6 ± 12.8 kg; Height: 1.74 ± 0.08 m; BMI: 19.0 ± 6.8 kg/m2). The core endurance was measured using the McGill protocol, consisting of the following tests: trunk flexion, back extension, and side-bridge. Functional performance was evaluated with push-ups, sit to stand, T-run test, countermovement jump (CMJ), Yo-Yo test, maximum dynamic strength-one repetition maximum (1RM) and muscle power on the bench press, pull row, and leg press. The regression results between the McGill protocol (proxy for core/trunk endurance) and the dependent variables were: 1RM pull row: r2 = 0.109 with p = 0.046; RM bench press: r2 = 0.149 with p = 0.012; RM leg press: r2 = 0.144 with p = 0.013 and power pull row: r2 = 0.151 with p = 0.016; power bench press: r2 = 0.136 with p = 0.026; power leg press: r2 = 0.122 with p = 0.013), push-ups: r2 = 0.157 with p < 0.001, sit to stand: r2 = 0.198 with p < 0,001), functional movement score: r2 = 0.209 with p < 0.001). Nevertheless, core endurance scores were not able to predict jump ability (r2 = 0.014, p = 0.807) or agility (T-test: 0.036 with p = 0.497). In conclusion, core endurance exerted no significant influence the agility and jump performance but influenced the ability to run intermittently, exert maximum power and strength in different actions (push, pull, and lift exercises) related to the better quality of movement (FMS).

Abstract The emergence of new technologies for genetic modification has broadened the range of possible new products. The regulations of many countries that could benefit from these new products may not be prepared to assess risks and enable science-based decision-making. This is especially acute in the case of genetically modified insects with potential use in public health and agriculture. Modifications of the regulatory framework, sometimes necessary to allow a proper risk assessment of products from new technologies, are strongly influenced by political decisions derived from the balance of power and interest among stakeholders. This article discusses the genesis of the Brazilian regulatory framework, its applicability for the risk assessment of genetically modified insects and the scenarios that have shaped the two biosafety laws that established the basis for the use of modern biotechnology in the country. It is concluded that, for the adoption of the new technologies, it is important to carefully navigate the political tensions by seeking the engagement and empowerment of stakeholders supporting science-based decision-making in order to gather the necessary support for adoption of risk assessment as the basis for final decisions, allowing the use of new technologies.

Several degenerative amyloid diseases, with no fully effective treatment, affect millions of people worldwide. These pathologies—amyloidoses—are known to be associated with the formation of ordered protein aggregates and highly stable and insoluble amyloid fibrils, which are deposited in multiple tissues and organs. The disruption of preformed amyloid aggregates and fibrils is one possible therapeutic strategy against amyloidosis; however, only a few compounds have been identified as possible fibril disruptors in vivo to date. To properly identify chemical compounds as potential fibril disruptors, a reliable, fast, and economic screening protocol must be developed. For this purpose, three amyloid fibril formation protocols using transthyretin (TTR), a plasma protein involved in several amyloidoses, were studied using thioflavin-T fluorescence assays, circular dichroism (CD), turbidity, dynamic light scattering (DLS), and transmission electron microscopy (TEM), in order to characterize and select the most appropriate fibril formation protocol. Saturation transfer difference nuclear magnetic resonance spectroscopy (STD NMR) was successfully used to study the interaction of doxycycline, a known amyloid fibril disruptor, with preformed wild-type TTR (TTRwt) aggregates and fibrils. DLS and TEM were also used to characterize the effect of doxycycline on TTRwt amyloid species disaggregation. A comparison of the TTR amyloid morphology formed in different experimental conditions is also presented.

This study aims to evaluate and compare the clinical outcome after dental extractions of cats with FCGS infected with feline immunodeficiency virus (FIV) and feline leukaemia virus (FeLV). A retrospective case series included cats with diagnosis of FCGS, availability of detailed clinical records, full-mouth dental radiographs, and retroviral disease test results. Effectiveness of surgical treatment (EOT) was registered. Three groups were defined: control, FIV and FeLV. In this study, 111 cats were included: 60 controls, 29 FIV- and 22 FeLV-positive cats. When compared with control cases, FeLV-positive cats had significantly less proliferative stomatitis lesions, and they tended to have more lingual ulcers. Concurrently, FeLV-positive cats had significantly less tooth resorptive lesions. No other significant differences in FCGS clinical signs were found between groups. FeLV-positive cats had a significantly worse outcome after dental extractions compared to the other groups. In fact, FeLV-positive cats had 7.5 times more chances of having no improvement after dental extractions. This study concludes that the response to dental extractions in FeLV-positive cats is significantly worse, when comparing to cats that do not carry retroviral disease. Therefore, it is important to acknowledge the effect of FeLV status on the prognosis of these cats.

El objetivo del presente estudio fue identificar cuáles son los factores que subyacen a la violencia familiar (conyugal/pareja) en las ciudades de Cartagena y Barranquilla en el Caribe colombiano. Los participantes fueron dieciséis parejas en cada una de las dos ciudades, contexto de este trabajo; igualmente profesionales de diferentes disciplinas que vienen trabajando con esta patología familiar, 12 en Barranquilla y 11 en Cartagena. Los instrumentos utilizados fueron el Cuestionario para la Detección de la Violencia en las relaciones de pareja (Autor: Soriano, Díaz Andrés (2006). N° GR2760/2006, Universidad de Granada (España), entrevista estructurada con 16 preguntas abiertas aplicadas a profesionales; formato de registro de un grupo focal con estudiantes de diversas profesiones próximos a egresar y formato sobre registros de la observación participante. En los hallazgos se observa la tendencia hacia el maltrato psicológico-emocional, principalmente por el contexto cultural que normaliza/normatiza el poder o influencia del hombre sobre la mujer; como lo indican las cifras en relación con la mayormente explicitada violencia sexual (entre otras violencias en la pareja), a pesar del aumento de los registros en Medicina Legal y Fiscalía por agresión sexual, estos resultados muestran que aún no se es capaz de denunciar tales abusos o lo toman como parte de las “obligaciones maritales”

Diabetic neuropathy has a profound impact in the quality of life of patients who frequently complain of pain. The mechanisms underlying diabetic neuropathic pain (DNP) are no longer ascribed only to damage of peripheral nerves. The effects of diabetes at the central nervous system are currently considered causes of DPN. Management of DNP may be achieved by antidepressants that act on serotonin (5-HT) uptake, namely specific serotonin reuptake inhibitors. The rostroventromedial medulla (RVM) is a key pain control center involved in descending pain modulation at the spinal cord through local release of 5-HT and plays a peculiar role in the balance of bidirectional control (i.e. inhibitory and facilitatory) from the brain to the spinal cord. This review discusses recently uncovered neurobiological mechanisms that mediate nociceptive modulation from the RVM during diabetes installation. In early phases of the disease, facilitation of pain modulation from the RVM prevails through a triplet of mechanisms which include increase in serotonin expression at the RVM and consequent rise of serotonin levels at the spinal cord and upregulation of local facilitatory 5HT3 receptors, enhancement of spontaneous activity of facilitatory RVM neurons and up-regulation of the expression of transient receptor potential vanilloid type 1 (TRPV1) receptor. With the progression of diabetes the alterations in the RVM increase dramatically, with oxidative stress and neuronal death associated to microglia-mediated inflammation. In a manner similar to other central areas, like the thalamus, the RVM is likely to be a “pain generator/amplifier” during diabetes, accounting to increase DNP. Early interventions in DNP prevention using strategies that simultaneously tackle the exacerbation of 5-HT3 spinal receptors and of microglial RVM activity, namely those that increase the levels of anti-inflammatory cytokines, should be considered in the future of DNP treatment.

Approximately 3% of the world population suffers from depression, which is one of the most common form of mental disorder. Recent findings suggest that an interaction between the nervous system and immune system might be behind the pathophysiology of various neurological and psychiatric disorders, including depression. Neuropeptides have been shown to play a major role in mediating response to stress and inducing immune activation or suppression. Corticotropin releasing factor (CRF) is a major regulator of the hypothalamic pituitary adrenal (HPA) axis response. CRF is a stress-related neuropeptide whose dysregulation has been associated with depression. In this review, we summarized the role of CRF in the neuroimmune mechanisms of depression, and the potential therapeutic effects of Chinese herbal medicines (CHM) as well as other agents. Studying the network of CRF and immune responses will help to enhance our understanding of the pathogenesis of depression. Additionally, targeting this important network may aid in developing novel treatments for this debilitating psychiatric disorder.

BACKGROUND: The combination of both physiological knowledge of a variety of sistems and the clinical findings it is of extreme relevance to the medical student learning process. The proposal of a simulated enviroment, with clinical data collection and regular physical examination, is crucial to this process. The Semiological bases of Escola Bahiana de Medicina e Saúde Pública module, used by the OSCE’s 4th semester medical students, capacitate them for such means. SUMMARY OF WORK: The evaluation logistic was divided into two segments: the first one was made through a theorical exam with close questioning, exhibiting images and videos, but also containing an open-ended question requesting a construction of a fictional clinical case; in the second one it was applied a practical exam segmented by different fields of medical knowledge (neurological, cardiovascular and respiratory/abdomen), with the evaluation of 120 students and followed by the teacher’s feedbacks at the conclusion of each field exam. SUMMARY OF RESULTS: The experience was important, however, it is notable the need for a complex management and understanding of the evaluational process. Discussion between students and teachers happened in behalf of the development of such proposal. CONCLUSIONS: The application of theorical exams throughout the semester combined with a practical exam (the OSCE) at the conclusion of the curricular component Bases Semiológicas had significant weight to the whole process.