Neck circumference as a predictor of cardiometabolic risk and truncal obesity in people living with HIV / Circunferencia del cuello como predictor de riesgo cardiometabólico y obesidad del tronco superior en personas que viven con VIH

Introduction: recent studies have suggested the use of neck circumference as a parameter capable of identifying risks of cardiometabolic complications and the accumulation of truncal fat caused by both antiretroviral therapy and the lifestyle of people with the human immunodeficiency virus (HIV).Objective: to investigate the relationship between neck circumference and anthropometric indicators and to assess cardiometabolic risk and truncal obesity through proposed cut-off points. Methods: cross-sectional study including 233 people with HIV. Demographic, socioeconomic, lifestyle and clinical data were collected using astructured questionnaire. The anthropometric evaluation included: weight, height, body mass index (BMI) measurements; waist (WC), neck (NC),arm and arm muscle circumferences; triceps and subscapular skinfolds and their sum. ROC curves were constructed to determine the accuracy of NC in predicting cardiometabolic risk in people living with HIV. Results: the sample was 57.5 % male, with a mean age of 38.4 years (95 %CI: 37.2-39.7 years). NC showed a positive and significant correlation with all anthropometric variables analyzed (p < 0.05), and a higher correlation strength with WC and BMI. The NC cut-off point selected as a predictor of risk of cardiac metabolic complications and truncal obesity in women was ≥ 32.4 cm, considering both WC and BMI. For men, the NC cut-off points were different when considering WC (≥ 39.6 cm) and BMI (≥ 38.1 cm) as a reference. It is worth noting that NC performed well in ROC curve analysis for men, while in women it was a poor performance.Conclusion: NC proved to be a promising indicator in the assessment of nutrition and health of people living with HIV, especially in men. (AU)

Introducción: estudios recientes han sugerido el uso de la circunferencia del cuello como parámetro capaz de identificar los riesgos de complicaciones cardiometabólicas y la acumulación de grasa troncal causados tanto por la terapia antirretroviral como por el estilo de vida de las personas con el virus de la inmunodeficiencia humana (VIH). Objetivo: investigar la relación entre la circunferencia del cuello y los indicadores antropométricos y evaluar el riesgo cardiometabólico y la obesidad troncal a través de los puntos de corte propuestos. Métodos: estudio transversal que incluyó a 233 personas con VIH. Se recogieron datos demográficos, socioeconómicos, de estilo de vida y clínicos mediante un cuestionario estructurado. La evaluación antropométrica incluyó: medidas de peso, altura, índice de masa corporal (IMC); circunferencias de cintura (CC), cuello (CN), brazo (CA) y músculo del brazo (MCB); pliegues cutáneos del tríceps y subescapular y su suma. Se construyeron curvas ROC para determinar la precisión de la CN en la predicción del riesgo cardiometabólico en personas que viven con el VIH. Resultados: el 57,5 % de la muestra eran varones, con una edad media de 38,4 años (IC 95 %: 37,2-39,7 años). La CN mostró una correlación positiva y significativa (p < 0,05) con todas las variables antropométricas analizadas, y una mayor fuerza de correlación con la CC y el IMC. El punto de corte de la CN seleccionado como predictor de riesgo de complicaciones metabólicas cardiacas y obesidad troncular en mujeres fue ≥ 32,4 cm, considerando tanto la CC como el IMC. En el caso de los hombres, los puntos de corte de la CN fueron diferentes al considerar como referencia la CC (≥ 39,6 cm) y el IMC (≥ 38,1 cm). Cabe destacar que la CN obtuvo buenos resultados en el análisis de la curva ROC en el caso de los hombres, mientras que en el de las mujeres fue deficiente.Conclusión: ... (AU)

Neck circumference as a predictor of cardiometabolic risk and truncal obesity in people living with HIV.

Introduction: Introduction: recent studies have suggested the use of neck circumference as a parameter capable of identifying risks of cardiometabolic complications and the accumulation of truncal fat caused by both antiretroviral therapy and the lifestyle of people with the human immunodeficiency virus (HIV). Objective: to investigate the relationship between neck circumference and anthropometric indicators and to assess cardiometabolic risk and truncal obesity through proposed cut-off points. Methods: cross-sectional study including 233 people with HIV. Demographic, socioeconomic, lifestyle and clinical data were collected using a structured questionnaire. The anthropometric evaluation included: weight, height, body mass index (BMI) measurements; waist (WC), neck (NC), arm and arm muscle circumferences; triceps and subscapular skinfolds and their sum. ROC curves were constructed to determine the accuracy of NC in predicting cardiometabolic risk in people living with HIV. Results: the sample was 57.5 % male, with a mean age of 38.4 years (95 %CI: 37.2-39.7 years). NC showed a positive and significant correlation with all anthropometric variables analyzed (p < 0.05), and a higher correlation strength with WC and BMI. The NC cut-off point selected as a predictor of risk of cardiac metabolic complications and truncal obesity in women was ≥ 32.4 cm, considering both WC and BMI. For men, the NC cut-off points were different when considering WC (≥ 39.6 cm) and BMI (≥ 38.1 cm) as a reference. It is worth noting that NC performed well in ROC curve analysis for men, while in women it was a poor performance. Conclusion: NC proved to be a promising indicator in the assessment of nutrition and health of people living with HIV, especially in men.

Introducción: Introducción: estudios recientes han sugerido el uso de la circunferencia del cuello como parámetro capaz de identificar los riesgos de complicaciones cardiometabólicas y la acumulación de grasa troncal causados tanto por la terapia antirretroviral como por el estilo de vida de las personas con el virus de la inmunodeficiencia humana (VIH). Objetivo: investigar la relación entre la circunferencia del cuello y los indicadores antropométricos y evaluar el riesgo cardiometabólico y la obesidad troncal a través de los puntos de corte propuestos. Métodos: estudio transversal que incluyó a 233 personas con VIH. Se recogieron datos demográficos, socioeconómicos, de estilo de vida y clínicos mediante un cuestionario estructurado. La evaluación antropométrica incluyó: medidas de peso, altura, índice de masa corporal (IMC); circunferencias de cintura (CC), cuello (CN), brazo (CA) y músculo del brazo (MCB); pliegues cutáneos del tríceps y subescapular y su suma. Se construyeron curvas ROC para determinar la precisión de la CN en la predicción del riesgo cardiometabólico en personas que viven con el VIH. Resultados: el 57,5 % de la muestra eran varones, con una edad media de 38,4 años (IC 95 %: 37,2-39,7 años). La CN mostró una correlación positiva y significativa (p < 0,05) con todas las variables antropométricas analizadas, y una mayor fuerza de correlación con la CC y el IMC. El punto de corte de la CN seleccionado como predictor de riesgo de complicaciones metabólicas cardiacas y obesidad troncular en mujeres fue ≥ 32,4 cm, considerando tanto la CC como el IMC. En el caso de los hombres, los puntos de corte de la CN fueron diferentes al considerar como referencia la CC (≥ 39,6 cm) y el IMC (≥ 38,1 cm). Cabe destacar que la CN obtuvo buenos resultados en el análisis de la curva ROC en el caso de los hombres, mientras que en el de las mujeres fue deficiente. Conclusión: la CN demostró ser un indicador prometedor en la evaluación de la nutrición y la salud de las personas que viven con el VIH, especialmente en los hombres.

Survey of cognitive behavioral therapy clinical supervisors profile in Brazil / Levantamento do perfil de supervisores clínicos de terapia cognitivo-comportamental no Brasil

Objective: This research aimed to identify the profile of Cognitive Behavioral Therapy supervisors in this country and to know their training to exercise this professional activity. Method: A nationwide online survey was conducted with 180 Cognitive Behavioral Therapy supervisors, 73.8% of whom were female, with a mean age of 40.3 years (SD = 10.03). Results: Among the main results, the intense academic training, training for psychotherapeutic practice and time of clinical experience (12.6 years, SD = 7.64) and supervised experience (7.4 years, SD = 7.26) stand out. Only 27.8% of the participants indicated having received specific training for supervisors and there was a lack of indications of training resources for remote supervision. Conclusion: This is considered the first research to outline the profile of Cognitive Behavioral Therapy supervisors in Brazil, expanding the vision on this professional activity.

Objetivo: Esta pesquisa teve por objetivo identificar o perfil de supervisores de Terapia Cognitivo-Comportamental no país e conhecer sua formação para exercer essa atividade profissional. Método: Foi realizado um survey online em âmbito nacional com 180 supervisores de Terapia Cognitivo-Comportamental, sendo 73,8% do sexo feminino, com a média de idade de 40,3 anos (DP = 10,03). Resultados: Entre os principais resultados, ressalta-se a intensa formação acadêmica, treinamento para prática psicoterápica e tempo de experiência clínica (12,6 anos, DP = 7,64) e supervisionada (7,4 anos, DP = 7,26). Apenas 27,8% dos participantes indicaram treinamento específico para supervisor e houve uma lacuna de indicativos de treinamentos de recursos para supervisões remotas. Conclusão: Considera-se essa a primeira pesquisa a traçar o perfil de supervisores de Terapia Cognitivo-Comportamental no Brasil, ampliando o olhar para esta atividade profissional.

The Ring-LWE Problem in Lattice-Based Cryptography: The Case of Twisted Embeddings.

Several works have characterized weak instances of the Ring-LWE problem by exploring vulnerabilities arising from the use of algebraic structures. Although these weak instances are not addressed by worst-case hardness theorems, enabling other ring instantiations enlarges the scope of possible applications and favors the diversification of security assumptions. In this work, we extend the Ring-LWE problem in lattice-based cryptography to include algebraic lattices, realized through twisted embeddings. We define the class of problems Twisted Ring-LWE, which replaces the canonical embedding by an extended form. By doing so, we allow the Ring-LWE problem to be used over maximal real subfields of cyclotomic number fields. We prove that Twisted Ring-LWE is secure by providing a security reduction from Ring-LWE to Twisted Ring-LWE in both search and decision forms. It is also shown that the twist factor does not affect the asymptotic approximation factors in the worst-case to average-case reductions. Thus, Twisted Ring-LWE maintains the consolidated hardness guarantee of Ring-LWE and increases the existing scope of algebraic lattices that can be considered for cryptographic applications. Additionally, we expand on the results of Ducas and Durmus (Public-Key Cryptography, 2012) on spherical Gaussian distributions to the proposed class of lattices under certain restrictions. As a result, sampling from a spherical Gaussian distribution can be done directly in the respective number field while maintaining its format and standard deviation when seen in Zn via twisted embeddings.

[Severe imported malaria in critical care patients]. / Malária grave importada em doentes críticos.

INTRODUCTION: Imported malaria is a frequent diagnosis in Portugal, and in the most severe clinical forms it may present a high mortality rate. MATERIAL AND METHODS: We present seven cases of severe imported malaria, admitted to an intensive care unit between 2000 and 2010, with particular focus on risk factors, clinical presentation, treatment and results. RESULTS: All patients had a history of recent travel to African endemic areas for malaria. Plasmodium falciparum was the agent isolated in all cases. Most patients had an inadequate prophylaxis. High parasitaemia in non-immune patients and treatment delay were associated with more severe clinical presentation. All the cases were complicated by organ failure, and three patients needed organ support and in two exchange blood transfusions were performed. There was one single death that was associated with marked delay in the initiation of therapy. CONCLUSION: In these patients, early and aggressive treatment, with a organ support in a critical care setting, allowed a good outcome with low mortality and no significant sequelae, despite the severity of presentation.

Validação preliminar da bateria de raciocínio diferencial - BRD para o Brasil / Differential aptitude battery: preliminary validation for Brazil

Trata-se da validação para o Brasil da Bateria de Raciocínio Diferencial, elaborada à luz da teoria diferencial da inteligência, baseada na bateria belga "Tests de Raisonnement Différentiel" de Meuris, adaptada à população portuguesa por Almeida e Campos em 1982. O teste consta de cinco provas, Raciocínio Numérico (NR 30 itens), Raciocínio Abstrato (AR - 35 itens), Raciocínio Verbal (VR - 40 itens), Raciocínio Verbal (VRw 40 itens), Raciocínio Espacial (SR - 30 itens) e Raciocínio Mecânico (MR - 44 itens), os quais sugerem um forte Fator Geral que associa a operação mental avaliada em todos eles (raciocínio) aos componentes específicos a cada conteúdo. Com os dados de uma amostra de 629 sujeitos de Brasília-DF, de ambos os sexos e nível de escolaridade superior (idade média = 27,2 e DP = 7,52), foi efetuada uma análise fatorial de cada prova e os itens submetidos à análise da Teoria de Resposta ao Item (TRI). Os Resultados da análise fatorial indicaram que cada subescala constitui um fator específico com bons índices de consistência interna (alfa de Cronbach): 0,85 para MR; 0,87 para AR; 0,92 para SR; 0,80 para VRw; 0,90 para NR. Os Resultados da estimação dos parâmetros pela Teoria de Resposta ao Item (TRI) indicam que os subtestes MR e NR avaliam os raciocínios adequadamente para sujeitos cuja aptidão se situa entre - 1 DP e + 2 DP, isto é, cerca de 80% dos sujeitos. O subteste SR avalia uma faixa de aptidão mais restrita, sujeitos entre - 1 DP e + 1,5 DP, cerca de 43%. No caso dos subtestes VR e AR, observou-se que eles avaliam uma faixa de aptidão de 80% da amostra (entre - 2 DP e + 1 DP), mas com escores inferiores à média. Assim, a BRD constitui-se de subtestes que apesar de se tratarem de componentes específicos, possuem correlação entre si (entre 0,40 e 0,50), o que confirma ser uma medida geral de Inteligência. As curvas de informações dos subtestes mostram serem os mesmos adequados para a população brasileira.(AU)

The Differential Aptitude Battery (BRD) was built by Leandro S. Almeida em 1982, based on the Belgian "Tests de Raisonnement Différentiel". The BRD is composed of five scales: Numeric Reasoning (30 items), Abstract Reasoning (35 items), Verbal Reasoning (40 items), Spatial Reasoning (30 items), and Mechanical Reasoning (44 items); they are ali correlated, suggesting a second order factor, identified as the factor g. With data collected from 629 subjects from Brasília (DF, Brazil), both sexes and age averaging 27,2 years, was performed a factor analysis of each scale, showing basic unidimensionality; items were analyzed through the three parameters logistic model of IRT. Scales also showed high internai consistency (Cronbacrfs alpha), ranging from .80 through .92. The characteristic curves of the scales showed that they are particularly useful to measure aptitudes between -2 and +2 z.(AU)