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IntroductionThis work is a dual study employing a cross-sectional approach and a diary method to investigate how physical exercise can become a habit. Guided by the Upward Spiral Theory of Lifestyle Change, we examined the role of prioritizing positivity and engaging in physical exercise with others as advantageous resources and their impact on the relational loop of physical exercise behavior, emotions, and engagement.MethodsThe first study involved a sample of 553 participants, and the second study included 146 participants, all of whom were employed and regularly engaged in physical exercise. We utilized structural equation modeling and multilevel analysis for the respective studies.ResultsThe results of the first study indicate that individuals exercise more when they experience higher levels of engagement and positive emotions, particularly when exercising with others and prioritizing positivity. The findings of the second study reveal that prioritizing positivity acts as a precursor to positive emotions during physical exercise, which in turn reinforces the relational loop between emotions and exercise behavior.DiscussionBoth studies conclude that individuals who prioritize positivity experience better psychological wellbeing and higher engagement in physical exercise.

Abstract Background Connective tissue nevi (CTN) are congenital hamartomas caused by excessive proliferation of dermis components. In children, CTN can mimic juvenile localized scleroderma (JLS), an immune mediated skin disorder that requires aggressive immunosuppression. Objectives: Aim of our study was to describe a series of pediatric patients with CTN misdiagnosed as JLS and the discerning characteristics between the two conditions. Methods Retrospective analysis of children referred to our Center during the last two decades for JLS who received a final diagnosis of CTN. Clinical, laboratory, histopathological and instrumental data (MRI and thermography) were collected and compared with those with JLS. Results Seventeen patients with mean age at onset 4.6 years entered the study. All came to our Center with a certain diagnosis of JLS (n = 15) or suspected JLS (n = 2). The indurated skin lesions were flat and resembled either circumscribed morphea or pansclerotic morphea. In 14 patients (82.4%) they were mainly localized at the lower limbs and in three (17.6%) at the upper limbs. No patient had laboratory inflammatory changes or positive autoantibodies. Skin biopsies confirmed the diagnosis of CTN: non-familial collagenoma in eleven (64.7%), mixed CTN in four (23.5%) and familial CTN in two (11.8%). Mean age at final diagnosis was 9.5 years, with a mean diagnostic delay of 4.8 years (range 1–15 years). Sixteen patients underwent musculoskeletal MRI that was normal in all except two who showed muscle perifascial enhancement. Thermography was normal in all patients. At our first evaluation, eleven patients (64.7%) were on systemic treatment (methotrexate 11, corticosteroids 7, biologics 2), three (17.6%) on topical corticosteroids and three untreated. Conclusions CTN can be misdiagnosed as JLS and therefore aggressively treated with prolonged and inappropriate immunosuppression. The absence of inflammatory appearance of the skin lesions, normal instrumental and laboratory findings and the accurate evaluation of skin biopsy are crucial to address the right diagnosis.

BackgroundHigh-intensity intermittent training has emerged as an option for treating major depressive disorder (MDD). However, short sprint training (sSIT), an efficient HIIT modality, has not been tested yet for this purpose. The sSIT has been proven to induce the same metabolic adaptations, with the advantage of promoting lower muscle fatigue than other HIIT protocols.MethodsSeventeen adult women diagnosed with moderate/severe MDD were randomly allocated into a sSIT group (n=9) or a control condition (n=8). The sSIT group completed, over two weeks, six 6-10-min sessions which consisted of 3-12 “all out” sprints of 5 s interspersed with low-intensity recovery of 30-45 s. The week before and after the intervention, both groups were evaluated with the Hamilton Depression Rating Scale of 21-itens (HAM-D21), and for physical fitness and incidental physical activity.ResultsThe sSIT group exhibited significant improvements for HAM-D21 scores (24.6±8.2 vs. 16.8±10.1), maximum aerobic power (140±15 vs. 155±15 W), countermovement jump (13.0±3.4 vs. 14.9±3.1 cm), % of body fatness (32.4±4.4 vs. 29.3±3.8%), and 4-days number of steps (13,626±11,309 vs. 16,643±15,371) after the training period when compared to the control group.ConclusionLess than 1 hour of a sSIT protocol over two weeks have demonstrated to reduce depressive symptoms, while improving aerobic fitness and body composition, and increasing incidental physical activity in a sample of women diagnosed with MDD.

O objetivo deste estudo foi compreender as motivações e as implicações do cuidado de familiares idosos dependentes realizado por homens. Com base em pesquisa qualitativa realizada entre julho e dezembro de 2018 em seis cidades nas cinco regiões brasileiras, foram entrevistados 11 homens que desempenham a tarefa de cuidadores informais. Eles assumiram essa tarefa em razão de as mulheres estarem exaustas e adoecidas, assim como por reciprocidade afetiva e marital. Os filhos manifestaram desconforto na administração de cuidados pessoais aos pais, enquanto os cônjuges apresentaram dificuldades com atividades domésticas. Os cuidadores solitários estavam cansados, com dores, privação do sono, sintomas depressivos e solidão. O suporte prestado por familiares e cuidadores formais mostrou-se valioso para amenizar o sofrimento dos cuidadores que relutavam em pedir ajuda. Há necessidade de os profissionais de saúde estarem atentos aos prestadores de cuidados informais aos familiares.

Introduction: Burns are considered global public health problems and have a higher incidence in underdeveloped countries. In Brazil, it is estimated that 1,000,000 accidents involving burns occur annually. In pediatric patients, burns are the second most common cause among incidents that occur in childhood, being the third cause of death in them. This study aimed to analyze the rates of hospital admissions for burns in pediatric patients in the southern states, from 2016 to 2020. Methods: Ecological time series study, with data obtained in the southern region of Brazil, using the database of data from the Hospital Information System of the Unified Health System, from 2016 to 2020. To analyze temporal trends, standardized morbidity coefficients and the simple linear regression method were used. Results: From 2016 to 2020, there were 8,256 hospitalizations of children and adolescents victimized by burns in the southern region of Brazil, with the state of Paraná being responsible for the highest rates throughout the study period. The main age group involves preschool children aged 1-4 years (n=4748); regarding gender, most of the child sample is predominantly male (n=5.205). Conclusion: There is a trend towards stability in the overall hospitalization rate. Males and the age group of 1-4 years are the most affected by burns in southern Brazil. Paraná has higher hospitalization rates when compared to other states.

Abstract Background Limited joint mobility (LJM), previously known as cheiroarthropathy, refers to the presence of reduced extension at the finger joints in people with diabetes and may be associated with scleroderma-like syndromes such as diabetic sclerodactyly. While scleroderma-like syndromes and LJM have been observed in patients with long-term diabetes and associated complications, the coexistence of diabetes with Juvenile systemic sclerosis (jSSc) is rarely described. Case presentation We describe the case of a 14-year-old boy with long-lasting type 1 diabetes (T1D) and suspected LJM associated with Raynaud phenomenon, sclerodactyly and tapering of the fingertips. A comprehensive work-up showed positive autoantibodies (ANA, anti-Ro-52, anti-Mi-2b), abnormal nailfold capillaroscopy with a scleroderma pattern, interstitial lung disease and cardiac involvement. The overall clinical picture was consistent with the diagnosis of jSSc. Conclusions LJM can be the initial sign of underlying systemic sclerosis. Nailfold capillaroscopy may help differentiate jSSc from classical LJM in pediatric patients with T1D and finger contractures or skin induration of no clear origin. This case report provides a starting point for a novel hypothesis regarding the pathogenesis of jSSc. The association between T1D and jSSc may be more than a coincidence and could suggest a relationship between glucose metabolism, fibrosis and microangiopathy.

BackgroundEuthyroid sick syndrome (ESS) is characterized by low serum levels of free triiodothyronine (fT3) with normal or low levels of thyroid stimulating hormone (TSH) and free thyroxine (fT4) and is reported in different acute clinical situations, such as sepsis, diabetic ketoacidosis and after cardiac surgery. Our aim was to evaluate the predicting role of ESS for disease severity in patients with Multisystem Inflammatory Syndrome in children (MIS-C).MethodsA single-centre observational study on consecutive patients with MIS-C. Before treatment clinical, and laboratory data were collected and, in a subset of patients, thyroid function tests were repeated 4 weeks later. Variables distribution was analyzed by Mann-Whitney U-test and correlations between different parameters were calculated by Spearman's Rho coefficient.ResultsForty-two patients were included and 36 (85.7%) presented ESS. fT3 values were significantly lower in patients requiring intensive care, a strong direct correlation was shown between fT3 and Hb, platelet count and ejection fraction values. A significant inverse correlation was retrieved between fT3 levels and C-reactive protein, brain natriuretic peptide, IL-2 soluble receptor and S-100 protein. Subjects with severe myocardial depression (EF

Overexpression of the Runt-related transcription factor 2 (RUNX2) has been reported in several cancer types, and the C-X-C motif chemokine receptor 4 (CXCR4) has an important role in tumour progression. However, the interplay between CXCR4 and RUNX2 in melanoma cells remains poorly understood. In the present study, we used melanoma cells and a RUNX2 knockout (RUNX2-KO) in vitro model to assess the influence of RUNX2 on CXCR4 protein levels along with its effects on markers associated with cell invasion and autophagy. Osteotropism was assessed using a 3D microfluidic model. Moreover, we assessed the impact of CXCR4 on the cellular levels of key cellular signalling proteins involved in autophagy. We observed that melanoma cells express both RUNX2 and CXCR4. Restored RUNX2 expression in RUNX2 KO cells increased the expression levels of CXCR4 and proteins associated with the metastatic process. The protein markers of autophagy LC3 and beclin were upregulated in response to increased CXCR4 levels. The CXCR4 inhibitor WZ811 reduced osteotropism and activated the mTOR and p70-S6 cell signalling proteins. Our data indicate that the RUNX2 transcription factor promotes the expression of the CXCR4 chemokine receptor on melanoma cells, which in turn promotes autophagy, cell invasiveness, and osteotropism, through the inhibition of the mTOR signalling pathway. Our data suggest that RUNX2 promotes melanoma progression by upregulating CXCR4, and we identify the latter as a key player in melanoma-related osteotropism.

Objective. The objective of this study is to evaluate the impact of psychosocial risks based on the demographic variables of sex, age, and seniority, on the perception of workplace violence in a group of workers from Spanish companies. Methods. a total of 22 Spanish companies were analysed between 2016 and 2018 with a total sample of 26741 people using the FPSICO 3.1 psychosocial assessment method and divided into demographic groups of sex, age, and seniority for subsequent comparison of means and regression analysis. Results. The results confirm the relationship between psychosocial risks and the perception of workplace violence. The analyses by demographic variables position the group of men as the group with the highest perception of workplace violence, except for discrimination, where it was higher in the group of women. The results confirm that the perception of workplace violence increases significantly with age and seniority in the company. Conclusions. workplace violence is one of the most worrying risk factors today and it is necessary to better understand what risk factors can favour its appearance or its differentiated behaviour according to sex, age, or seniority. This can allow us to develop planned strategies to control this risk and focus on specific demographic groups.

O Brasil tem uma vasta literatura que, desde a década de 1970, debate a “cultura do fracasso escolar” (Patto, 1997). A pandemia provocada pela Covid-19, deflagrada em 2020, acentuou a necessidade de famílias, educadores e a sociedade em geral questionarem e discutirem a validade da aprendizagem escolar nesse período e, também, a questão do fracasso. O texto é de caráter qualitativo, por meio de análise de documentos (Ludke; André, 2012) e de conteúdo (Bardin, 1979). O objetivo desta pesquisa reside em compreender os enunciados de fragmentos recentes, publicados na mídia, à luz das principais teorias sobre fracasso escolar. Os teóricos utilizados são Patto (1990, 1999), Charlot (2000), Arroyo (2000), Gouveia (1971). Utilizamos, também, dados da Unicef (2020) e entrevistas disponibilizadas na internet. Como resultados, descobrimos que tais enunciados envolvem: desigualdades econômicas, carências socioculturais, ambiente familiar, atuação dos professores, transtornos observados na escola. Geralmente, diversos deles se fazem presentes, em visão fragmentada do problema. Ao final, identificamos que a desigualdade é uma realidade brasileira e que políticas que amparem o uso das tecnologias são necessárias para uma boa formação dos professores, para a utilização adequada dos recursos e a disponibilidade desses recursos para todos os estudantes.

Kerion Celsi is an inflammatory variant of tinea capitis and is usually caused by Microsporum canis. Griseofulvin is the gold standard treatment, but FDA approves its use only for children up to two years. Even though it is rare in children younger than three years, tinea capitis can still occur, as in the case of the one-year-old child who was successfully treated with photodynamic therapy combined with curcumin, resulting in total remission.

Resumo Introdução O artigo discute as disparidades espaciais em saúde ao investigar pessoas brancas e negras, tomando como ponto de partida a trajetória de desenvolvimento do sistema global do capitalismo racial. Objetivo Investigar as diferenças existentes entre pessoas brancas e negras nos agravos de HIV, tuberculose e sífilis na escala de distritos sanitários na cidade de Porto Alegre, Rio Grande do Sul. Método Estudo ecológico, com uso de banco de dados secundários e de acesso público, disponibilizados a partir da Secretaria Municipal de Saúde de Porto Alegre. Inclui a análise espacial, a estatística descritiva e o uso de medidas de associação. Resultados A partir dos distritos sanitários, desvela-se a materialização de geografias de desigualdades e de condições de iniquidade entre pessoas brancas e negras, o que está entrelaçado com o processo histórico de ocupação da cidade de Porto Alegre. Conclusão O quesito raça/cor e a sua investigação escalar tornaram-se potência para corroborar as diferenças de qualidade de vida que desfrutam pessoas brancas e negras. Em Porto Alegre, são inequívocas evidências do racismo estrutural em saúde que denotam a urgência de ações no Sistema Único de Saúde, como as políticas de equidade.

BackgroundDue to the growing evidence of the efficacy of intravenous (IV) cefazolin with an early switch to oral cefalexin in uncomplicated pediatric osteomyelitis (OM) and septic arthritis (SA) in children, we changed our guidelines for empiric antibiotic therapy in these conditions. This study aims at evaluating the impact of the guidelines' implementation in reducing broad-spectrum antibiotic prescriptions, duration of IV antibiotic treatment and hospital stay, treatment failure and recurrence.Materials and methodsThis is a retrospective, observational, quasi-experimental study. The four years pre-intervention were compared to the six years, ten months post-intervention (January 2012, through December 2015; January 2016, through October 31st, 2022). All patients aged 3 months to 18 years with OM or SA were evaluated for inclusion. Each population was divided into three groups: pre-intervention, post-intervention not following the guidelines, and post-intervention following the guidelines. Differences in antibiotic prescriptions such as Days of Therapy (DOT), activity spectrum and Length of Therapy (LOT), length of hospital stay (LOS), broad-spectrum antibiotics duration (bsDOT), treatment failure and relapse at six months were analyzed as outcomes.ResultsOf 87 included patients, 48 were diagnosed with OM (8 pre-intervention, 9 post-intervention not following the guidelines and 31 post-intervention following the guidelines) and 39 with SA (9 pre-intervention, 12 post-intervention not following the guidelines and 18 post-intervention following the guidelines). In OM patients, IV DOT, DOT/LOT ratio, and bsDOT were significantly lower in the guidelines group, with also the lowest proportion of patients discharged on IV treatment. Notably, significantly fewer cases required surgery in the post-intervention groups. Considering SA, LOS, IV DOT, DOT/LOT ratio, and bsDOT were significantly lower in the guidelines group. The treatment failure rate was comparable among all groups for both OM and SA. There were no relapse cases. The overall adherence was between 72 and 100%.ConclusionsThe implementation of guidelines was effective in decreasing the extensive use of broad-spectrum antibiotics and combination therapy for both OM and SA. Our results show the applicability, safety, and efficacy of a narrow-spectrum IV empirical antibiotic regimen with cefazolin, followed by oral monotherapy with first/second-generation cephalosporins, which was non-inferior to broad-spectrum regimens.

Este texto é um ensaio crítico que aborda a situação vivida no Brasil durante a epidemia de Covid 19. São apresentadas três cartas escritas durante a epidemia, a partir do entendimento do ato de escrever como uma atividade de resistência frente ao sofrimento, à angústia e ao medo da morte. As cartas fazem referência à literatura, aludindo em cada uma delas, a obra de um autor. Os autores e obras citados e comentados em relação a cada uma das cartas foram: A Peste de Albert Camus, Os despossuídos de Úrsula Le Guin e Guerra e Paz de Leon Tolstói. É traçado um panorama sobre a situação sanitária brasileira em três momentos da epidemia, que correspondem temporalmente à elaboração das cartas. Ao final, abordam-se algumas questões em relação ao enfrentamento à epidemia no país.

Multisystem inflammatory syndrome in children (MIS-C) is a serious condition triggered by SARS-COV-2 infection, characterized by persistent fever, multiorgan dysfunction, and increased inflammatory markers. It requires hospitalization and prompt treatment, with nearly 60% of the cases needing intensive care and 2% fatality rate. A wide spectrum of clinical characteristics and therapeutic approaches has been reported in MIS-C. We describe a series of four patients with MIS-C, defined according to the current case definitions, with a self-limiting course and no need for immunomodulatory treatment (“self-limiting MIS-C”). Few data about self-limiting MIS-C are available to date and no information on medium- and long-term outcome of this subset of patients has been reported. Although limited in size, our experience provides new insights into the MIS-C syndrome, highlighting an underestimated aspect of the disease that may have significant therapeutic implications.

Kidney involvement has been poorly investigated in SARS-CoV-2 Multisystem Inflammatory Syndrome in Children (MIS-C). To analyze the spectrum of renal involvement in MIS-C, we performed a single-center retrospective observational study including all MIS-C patients diagnosed at our Pediatric Department between April 2020 and May 2022. Demographic, clinical, pediatric intensive care unit (PICU) admission’s need and laboratory data were collected at onset and after 6 months. Among 55 MIS-C patients enrolled in the study, kidney involvement was present in 20 (36.4%): 13 with acute kidney injury (AKI) and 7 with isolated tubular dysfunction (TD). In eight patients, concomitant AKI and TD was present (AKI-TD). AKI patients needed higher levels of intensive care (PICU: 61.5%, p < 0.001; inotropes: 46.2%, p = 0.002; second-line immuno-therapy: 53.8%, p < 0.001) and showed lower levels of HCO3- (p = 0.012), higher inflammatory markers [neutrophils (p = 0.092), PCT (p = 0.04), IL-6 (p = 0.007)] as compared to no-AKI. TD markers showed that isolated TD presented higher levels of HCO3- and lower inflammatory markers than AKI-TD. Our results indicate a combination of both pre-renal and inflammatory damage in the pathogenesis of kidney injury in MIS-C syndrome. We highlight, for the first time, the presence of tubular involvement in MIS-C, providing new insights in the evaluation of kidney involvement and its management in this condition.

Water resources have fundamental importance both for living beings life and for human activities. The lack of water can be a limiting factor for occupation and development of a certain region. Photovoltaic pumping systems are an alternative solution for remote locations, with electric generation from photovoltaic panels being a locally pollutant-free option and less maintenance when compared to combustion-generation engines. This work aims the analysis of a photovoltaic pumping system with two cell technologies, amorphous and polycrystalline silicon. The research shown an average volume pumped of 2,255.44 and 2,397.01 litres per day in the amorphous and polycrystalline systems, respectively. The best efficiency results in both systems were at 0.8 kWhm−2, 4.69% for amorphous and 7.75% polycrystalline. However, the first one presented lower voltage drop with panel’s temperature increasing. It obtained higher flow and overall efficiency in the polycrystalline system.

Abstract The aim of this article is twofold: (a) to validate the psychometric properties of the Academic Resilience Scale (AR-S) in a Spanish university context; and (b) to test a model where different coping strategies are antecedents of AR, and where academic satisfaction and performance are its consequences. The studies were conducted with 185 (study 1) and 780 (study 2) students. In study 1, the construct validity, reliability, and convergent and divergent validity of the AR-S were analyzed. The hypothesized model (study 2) was tested using structural equation modeling. The results confirmed the good psychometric properties of the AR-S in the Spanish context, providing evidence of its validity. Furthermore, the distinctive role of different coping strategies in resilience was confirmed, as well as the relationship between resilience and academic satisfaction. No direct relationship between resilience and performance was found, highlighting the full mediation of satisfaction.

Author(s): Isabel M. Martínez [sup.1] , Isabella Meneghel [sup.1] , Marcos Carmona-Halty [sup.2] , Carolyn M. Youssef-Morgan [sup.3] Author Affiliations: (1) grid.9612.c, 0000 0001 1957 9153, Department of Social Psychology. [...], Psychological Capital is a construct that is experiencing strong growth within the framework of Positive Psychology. In work contexts, it has been related to employee performance, wellbeing, attitudes, and behaviors. In educational contexts, particularly non-English-speaking contexts, there is hardly any research on this topic, mostly due to the lack of assessment and measurement instruments. In general, most studies use the Psychological Capital Questionnaire (PCQ) by Luthans et al. (Personnel Psychology, 60(3), 541-572, 2007 (See CR26)) as a measure. The purpose of the present study is the validation of a 12-item PCQ that is adapted to the academic context and translated to Spanish. A sample of 1126 undergraduate students from two different universities located in Spain (n = 596) and Chile (n = 530) participated in the study. The current study demonstrates -through reliability (alpha and omega indexes), single group and multiple group confirmatory factor analysis, and criterion validity (Pearson&apos;s correlations)- that the Spanish academic PCQ-12 is a reliable and valid indicator of academic psychological capital.