Vitamin D deficiency and VDR gene polymorphism FokI (rs2228570) are associated with diabetes mellitus in adults: COVID-inconfidentes study.

BACKGROUND: Diabetes mellitus is a chronic and multifactorial condition, including environmental risk factors such as lifestyle habits and genetic conditions. OBJECTIVE: We aimed to evaluate the association of VDR gene polymorphism (rs2228570) FokI and vitamin D levels with diabetes in adults. METHODS: Cross-sectional population-based study in adults, conducted from October to December 2020 in two Brazilian cities. The outcome variable was diabetes, defined as glycated hemoglobin ≥ 6.5% or self-report medical diagnosis or use of oral hypoglycemic drugs. Vitamin D (25-hydroxyvitamin D) was measured by indirect electrochemiluminescence, and classified as deficiency when 25(OH)D < 20 ng/mL. All participants were genotyped for VDR FokI polymorphism by qPCR and classified as homozygous mutant (ff or GG), heterozygous (Ff or AG), or homozygous wild (FF or AA). A combined analysis between the FokI polymorphism and vitamin D levels with diabetes was also examined. A directed acyclic graph (DAG) was used to select minimal and sufficient adjustment for confounding variables by the backdoor criterion. RESULTS: The prevalence of DM was 9.4% and vitamin D deficiency (VDD) was 19.9%. The genotype distribution of FokI polymorphism was 9.9% FF, 44.8% Ff, and 45.3% ff. It was possible to verify a positive association between vitamin D deficiency and DM (OR = 2.19; 95% CI: 1.06-4.50). Individuals with the altered allele (ff) had a 1.78 higher prevalence of DM (OR: 1.78; 95% CI; 1.10-2.87). Combined analyses, individuals with vitamin D deficiency and one or two copies of the altered FokI allele had a higher prevalence of DM (Ff + ff: OR: 1.67; 95% CI; 1.07-2.61; ff: OR: 3.60; 95% CI; 1.40-9.25). CONCLUSION: Our data suggest that vitamin D deficiency and FokI polymorphism are associated with DM.

High Levels of Glycated Hemoglobin (HbA1c) Are Associated with Physical Inactivity, and Part of This Association Is Mediated by Being Overweight.

The COVID-19 pandemic has generated substantial changes in the lives of the population, such as increased physical inactivity, which can lead to being overweight and, consequently, repercussions on glucose homeostasis. A cross-sectional study based on the adult population of Brazil was conducted by stratified, multistage probability cluster sampling (October and December 2020). Participants were classified as physically active or inactive during leisure time according to the recommendations of the World Health Organization. HbA1c levels were categorized as normal (≤6.4%) or with glycemic changes (≥6.5%). The mediating variable was being overweight (overweight and obese). Descriptive, univariate, and multivariate logistic regression analyses examined the association between physical inactivity and glycemic changes. Mediation was analyzed using the Karlson-Holm-Breen method to verify the influence of being overweight on the association. We interviewed 1685 individuals, mostly women (52.4%), 35-59 years old (45.8%), race/ethnicity brown (48.1%), and overweight (56.5%). The mean HbA1c was 5.68% (95% CI: 5.58-5.77). Mediation analysis verified that physically inactive participants during leisure time were 2.62 times more likely to have high levels of HbA1c (OR: 2.62, 95% CI: 1.29-5.33), and 26.87% of this effect was mediated by over-weight (OR: 1.30: 95% CI: 1.06-1.57). Physical inactivity at leisure increases the chances of high levels of HbA1c, and part of this association can be explained by being overweight.

Thermoelectric Properties of N-Type Poly (Ether Ether Ketone)/Carbon Nanofiber Melt-Processed Composites.

The thermoelectric properties, at temperatures from 30 °C to 100 °C, of melt-processed poly(ether ether ketone) (PEEK) composites prepared with 10 wt.% of carbon nanofibers (CNFs) are discussed in this work. At 30 °C, the PEEK/CNF composites show an electrical conductivity (σ) of ~27 S m-1 and a Seebeck coefficient (S) of -3.4 µV K-1, which means that their majority charge carriers are electrons. The origin of this negative Seebeck is deduced because of the impurities present in the as-received CNFs, which may cause sharply varying and localized states at approximately 0.086 eV above the Fermi energy level (EF) of CNFs. Moreover, the lower S, in absolute value, found in PEEK/CNF composites, when compared with the S of as-received CNFs (-5.3 µV K-1), is attributed to a slight electron withdrawing from the external layers of CNFs by the PEEK matrix. At temperatures from 30 °C to 100 °C, the σ (T) of PEEK/CNF composites, in contrast to the σ (T) of as-received CNFs, shows a negative temperature effect, understood through the 3D variable-range hopping (VRH) model, as a thermally activated hopping mechanism across a random network of potential wells. Moreover, their nonlinear S (T) follows the same behavior reported before for polypropylene composites melt-processed with similar CNFs at the same interval of temperatures.

COVID-Inconfidentes: how did COVID-19 and work from home influence the prevalence of leisure-time physical inactivity? An analysis of before and during the pandemic.

BACKGROUND: The COVID-19 pandemic has brought drastic changes to the lives of the global population. The restrictions imposed by government agencies impacted the daily lives of citizens, influencing several health behaviors, such as physical activity (PA). Thus, the present study aimed to assess the prevalence of physical inactivity (PI) and its associated factors before and during the COVID-19 pandemic. METHODS: A population-based household seroepidemiological survey was conducted in two Brazilian municipalities located in the state of Minas Gerais, in which 1750 volunteers were interviewed between October and December 2020. Face-to-face interviews were conducted using a structured questionnaire in an electronic format. The moments considered for the PI analysis were M0 (before the pandemic), M1 (from March to July 2020), and M2 (from October to December 2020). Descriptive statistics and univariate and multivariate logistic regression were used to examine the factors associated with PI before (M0) and during the pandemic (M1 and M2). RESULTS: The prevalence of PI was higher in the first months of the pandemic (M1) (67.3%; 95% confidence interval (CI): 62.4-71.9) than in the months from October to December 2020 (M2) (58.7%; 95% CI: 52.8-64.3); however, at both times (M1 and M2), PI was more prevalent than in the period before the pandemic started (M0) (39.7%; 95% CI: 35.6-43.8). Individuals who were overweight, obese, and had low educational levels were more likely to be physically inactive. At both M1 and M2, individuals who worked at a work from home were less likely to have PI. CONCLUSIONS: The results suggest that the COVID-19 pandemic negatively influenced PA, substantially increasing the prevalence of PI. The determinants associated with PI were education, body mass index, and work from home.

COVID-Inconfidentes - SARS-CoV-2 seroprevalence in two Brazilian urban areas during the pandemic first wave: study protocol and initial results

Background: A population study is an important tool that can be used to understand the actual epidemiological scenario of the Covid-19 in different territories, identify its magnitude, understand its transmission dynamics, and its demographic, geographical, and social distribution. Objective: The aim of this study was to determine the prevalence and dynamics of SARS-CoV-2 infection in the population of two Brazilian cities during the pandemic first wave and subsequent socioeconomic and health effects. Materials & methods: This paper described the methodological procedures adopted and the prevalence of the SARS-CoV-2 infection in the population. A household survey was conducted between October and December 2020, in two historic cities of Brazil's mining region. Anti-SARS-CoV-2 antibody was detected using the Wondfo® rapid test. The face-to-face interview consisted of administration of a questionnaire containing registration data, sociodemographic and economic variables, living habits, general health condition, mental health, sleep habits, and eating and nutrition. Results: We evaluated 1,762 residents, of which 764 (43.4%) were in Mariana and 998 (56.6%) in Ouro Preto. For both cities, 51.9% of the interviewees were female, with a predominance of the age range 35 to 59 years old (47.2%). The prevalence of the SARS-CoV-2 infection was 5.5% in all cities, 6.2% in Ouro Preto, and 4.7% in Mariana. The prevalence was similar between cities (P>0.05). Conclusion: The study was effective in verifying the seroprevalence of infection by the virus and its findings will enable further analyses of the health conditions of the population related to social isolation and the risk of infection with SARS-CoV-2.

Das flores à angústia: o esquema óptico de Bouasse, por Lacan / From Flowers to Anguish: The optical scheme of Bouasse, by Lacan

A proposta deste artigo é analisar as modificações formuladas por Lacan ao esquema óptico de Bouasse, para ressaltar dois momentos distintos de seu ensino, que metaforicamente se tornam imagens no espelho. O primeiro momento é quando Lacan retoma os textos freudianos, início de seus seminários mais voltado ao Simbólico, e o segundo, quando forja seu conceito de objeto a e avança em suas formulações sobre o Real.(AU)

This article aims to analyze the modifications proposed by Lacan, to Bouasse’s optical scheme, to emphasize two distinct moments of his teaching, which metaphorically become images in the mirror. The first moment, when Lacan review the Freudian texts, beginning of his seminaries more focused on the symbolic, and the second, when he forges his concept of object a and advances in his formulations on the Real.(AU)

Expectations of a group of Portuguese pregnant women in the districts of Viseu and Aveiro regarding motherhood.

Motherhood is a complex phenomenon, supplementedwith expectations about the new reality, the hopes of all going well, taking into account the expected care. In order to meet the needs of the Portuguese expectant mother, it is necessary to know what she deems essential for herself and her family, so that strategies may be developed to facilitate the transition process. This study was intended to gain insight into fulfilled and unfulfilled expectations of health care in motherhood with a group pregnant females in Portugal. This is a qualitative, exploratory and descriptive study, with 22 Portuguese women belonging to the Clusters of Health Care Centers of the districts of Viseu and Aveiro. The data was collected through semi-structured interviews and analysed using content analysis proposed by Bardin, supported by QSR NVivo 10. It was observed that fulfilled expectations surpassed those unmet, especially in terms of high quality health care and competent health care professionals. Regarding unfulfilled expectations, they mainly refer to maternity incentives, with an emphasis on the wish of greater financial familly supportfrom the government.

Expectations of a group of Portuguese pregnant women in the districts of Viseu and Aveiro regarding motherhood / Expectativas relativas à maternidade de um grupo de grávidas portuguesas nos distritos de Viseu e Aveiro

Abstract Motherhood is a complex phenomenon, supplementedwith expectations about the new reality, the hopes of all going well, taking into account the expected care. In order to meet the needs of the Portuguese expectant mother, it is necessary to know what she deems essential for herself and her family, so that strategies may be developed to facilitate the transition process. This study was intended to gain insight into fulfilled and unfulfilled expectations of health care in motherhood with a group pregnant females in Portugal. This is a qualitative, exploratory and descriptive study, with 22 Portuguese women belonging to the Clusters of Health Care Centers of the districts of Viseu and Aveiro. The data was collected through semi-structured interviews and analysed using content analysis proposed by Bardin, supported by QSR NVivo 10. It was observed that fulfilled expectations surpassed those unmet, especially in terms of high quality health care and competent health care professionals. Regarding unfulfilled expectations, they mainly refer to maternity incentives, with an emphasis on the wish of greater financial familly supportfrom the government.

Resumo A maternidade é um fenómeno complexo, em que surgem expectativas face à nova realidade, na esperança de que tudo corra bem, tendo em conta os cuidados que se esperam receber. Para satisfazer as necessidades da futura mãe portuguesa, é preciso conhecer aquilo que a mesma considera fulcral para si e respectiva família, de modo a que sejam desenvolvidas estratégias facilitadoras do processo de transição. Neste estudo pretendeu-se explorar as expectativas concretizadas e não concretizadas de maternidade com um grupo de mulheres portuguesas grávidas em Portugal. É um estudo de natureza qualitativa, do tipo exploratório-descritivo, com 22 mulheres portuguesas, em ACES dos distritos de Viseu e Aveiro. Os dados foram obtidos através de entrevistas semiestruturadas e analisados usando a análise de conteúdo proposta por Bardin, apoiada pelo QSR NVivo 10. Constatou-se que as expectativas concretizadas foram superiores às não concretizadas com maior expressividade nos Cuidados de saúde de boa qualidade e profissionais de saúde competentes. Em relação às expectativas não concretizadas, estas referem-se maioritariamente aos incentivos atribuídos à maternidade, com maior destaque para o desejo de uma maior comparticipação financeira do estado às famílias.

An Integrated Approach Using Spatial Analysis to Study the Risk Factors for Leishmaniasis in Area of Recent Transmission.

Some epidemiological aspects of leishmaniasis in the municipality of Formiga, Brazil, an important touristic site, were evaluated. Those included phlebotomine sand fly vectors, canine infection, and geoprocessing analysis for determining critical transmission areas. Sand flies (224 insects) belonging to ten different species were captured. The most captured species included Lutzomyia longipalpis (35.3%), Lutzomyia cortelezzii (33.5%), and Lutzomyia whitmani (18.3%). A significant correlation between sand fly densities and climatic conditions was detected. Serological diagnosis (DPP and ELISA) was performed in 570 dogs indicating a prevalence of 5.8%. After sequencing the main species circulating in the area were Leishmania infantum and Leishmania braziliensis. Spatial analysis demonstrated that vegetation and hydrography may be related to sand fly distribution and infected dogs. The municipality of Formiga has proven leishmaniasis vectors and infected dogs indicating the circulation of the parasite in the city. Correlation of those data with environmental and human cases has identified the critical areas for control interventions (south, northeast, and northwest). In conclusion, there is current transmission of visceral and canine human cases and the city is on the risk for the appearance of cutaneous cases.

Testing Nelder-Mead based repulsion algorithms for multiple roots of nonlinear systems via a two-level factorial design of experiments.

This paper addresses the challenging task of computing multiple roots of a system of nonlinear equations. A repulsion algorithm that invokes the Nelder-Mead (N-M) local search method and uses a penalty-type merit function based on the error function, known as 'erf', is presented. In the N-M algorithm context, different strategies are proposed to enhance the quality of the solutions and improve the overall efficiency. The main goal of this paper is to use a two-level factorial design of experiments to analyze the statistical significance of the observed differences in selected performance criteria produced when testing different strategies in the N-M based repulsion algorithm. The main goal of this paper is to use a two-level factorial design of experiments to analyze the statistical significance of the observed differences in selected performance criteria produced when testing different strategies in the N-M based repulsion algorithm.

Perioperative conjunctival inflammation and trabeculectomy outcome.

PURPOSE: To correlate subclinical conjunctival inflammation and trabeculectomy results. METHODS: Prospective case series of 28 patients with primary open-angle glaucoma (28 eyes) under topical anti-glaucoma medication who underwent trabeculectomy. During surgery, a sample from the inferior bulbar conjunctiva was collected and the expression of HLA-DR together with the presence of inflammatory cells was correlated with trabeculectomy outcomes after 24 months. Surgical success was defined as intraocular pressure between 6 and 20 mmHg irrespective of the use of anti-glaucoma medication. RESULTS: Five patients missed follow-up visits and were removed from the study. Ten eyes (43.5%) were HLA-DR(+), but no significant differences were observed between eyes with successful and failed surgeries (p = 0.214). There was no significant association between the number of neutrophils and surgical outcomes (p = 0.353). CONCLUSIONS: The presence of inflammatory cells and expression of the inflammation marker HLA-DR in the conjunctiva did not correlate with the prognosis of trabeculectomy in this study.

A wearable sensor network for human locomotion data capture.

A new wearable data capture system for gait analysis is being developed. It consists of a pantyhose with embedded conductive yarns interconnecting customized sensing electronic devices that capture inertial and electromyographic signals and sends aggregated information to a personal computer through a wireless link. The use of conductive yarns to build the myoelectric electrodes and the interconnections of the wired sensors network, as well as the topology and functionality of the sensor modules are presented.

Absolute quantification of gene E7 in cervical samples of women infected by HPV using real time PCR

Objective: High grade oncogenic types of human papillomavirus (HPV), especially HPV16 and HPV18, possess a gene called E7, which acts on genes that regulate cell growth, promoting development of pre-neoplastic lesions that can lead to invasive carcinomas. The absolute quantification of this gene in cervical samples of HPV-infected women may contribute for better understanding the evolution of these lesions induced by the virus. Methods: We collected 60 cervicovaginal smears of women infected by HPV with or without uterine cervical squamous intraepithelial lesion, SIL) and 10 samples of women with no HPV infection or SIL. The absolute quantification of gene E7 was performed by Realtime PCR using specific primers and probes. Results: Samples infected by HPV16 have a higher number of gene E7 copies when compared to samples infected by HPV18. In the HPV18 group it was observed that those obtained from patients with low or high grade squamous intraepithelial lesions (HSIL) or invasive cervical cancer presented significantly higher concentrations of gene E7 when compared to patients with no cervical lesions. The number of gene E7 copies was higher in the group infected by HPV16 than by HPV18. In spite of that, there was no difference in the number of gene E7 copies in samples infected by HPV16 with or without SIL. Conclusions: Among the samples with HPV18, the number of copies of gene E7 was higher in the group with cervical lesions, and no differences were found for SIL, HSIL or invasive cancer patients.

Realidade e expectativas do idoso asilado: propondo um modelo assistencial a partir do PBAI / Reality and expectations of old aged commited to an asylum: an assistance model proposed by Promotion Basic Pattern to the Elderly

Trata-se de um estudo de caso, cujo objeto é propor um modelo assistencial a partir da aplicação do Padrão Básico de Atendimento ao Idoso (PBAI) numa instituição asilar do Município do Rio de Janeiro. O objetivo é elaborar um diagnóstico do cuidar, através do PBAI, propondo um modelo assistencial, visando à promoção, proteção, recuperação e a reabilitação dos idosos ali internados, de acordo com o atendimento das suas necessidades básicas. O referencial teórico foi baseado no modelo de Leavel Clark, adaptado e validado por Duarte em 1991. A pesquisa foi desenvolvida no período de 2001 a 2003. Trata-se da aplicação do método descritivo, com abordagem quali-quantitativa do tipo estudo de caso institucional, investigação social e análise de documentos. O instrumento foi aplicado em 23 idosos, residentes na instituição com permanência média de 3 anos. Os resultados permitiram a análise do perfil do idoso com a caracterização da mesma (tipologia institucional) e a força de trabalho. Quanto a avaliação da promoção e proteção à saúde todos estão satisfeitos com a internação, com pleno atendimento de suas necessidades básicas. Na reabilitação a nível de prevenção todos mostraram-se orientados quanto ao processo de envelhecimento no que diz respeito as alterações da pele, tecidos, audição, visão, mastigação e diminuição da capacidade funcional. Acredito que este estudo ofereça subsídios para a construção de um protocolo multidisciplinar para o cuidado do cliente na 3ª idade.

Facoemulsificação versus extração extracapsular manual do cristalino: análise de custos / Phacoemulsification and manual extracapsular extraction: costs analysis

OBJETIVO: Avaliar aspectos clínicos e econômicos da cirurgia de catarata pela técnica de facoemulsificação, quando comparada à técnica de extração extracapsular do cristalino no Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo. MÉTODOS: Estudo prospectivo em que foram selecionados consecutivamente 162 pacientes, portadores de catarata senil, atendidos em projetos comunitários para identificação e posterior tratamento da catarata (Projetos-Catarata), que atenderam aos critérios de inclusão para o estudo. Esses projetos foram realizados pelo Hospital das Clínicas, entre outubro de 2001 e junho de 2002. Os pacientes selecionados foram randomizados para comporem dois grupos, que seriam submetidos à cirurgia de catarata pela técnica de facoemulsificação e de extração extracapsular. RESULTADOS: Nas condições do estudo, a técnica de facoemulsificação permitiu o uso de anestesia tópica, reduziu o número de retornos e o tempo de duração do período pós-operatório. A utilização da facoemulsificação tornou a cirurgia mais rápida, otimizou o centro cirúrgico e apresentou vantagens econômicas para o hospital. CONCLUSAO: No tocante às condições do Hospital das Clínicas, os custos totais da cirurgia de catarata mediante a técnica de facoemulsificação são maiores do que os custos com a técnica de extração extracapsular; e a remuneração efetuada pelo Sistema Unico de Saúde para a cirurgia por facoemulsificação confere maiores vantagens econômicas ao hospital do que a cirurgia por extração extracapsular.

Development of textile-based high-tech products: the new challenge.

The new generation of smart textiles is represented by fibers, yarns, fabrics and other resulting products that have special properties, regarding mechanical, chemical, electrical and thermal performances. These high-tech products, being able to respond to external stimuli through the integration of electronic components, phase change materials, shape memory materials or nano materials, enabled the development of different active and functional products. These products when combining the functions of medium, carrier and interface for micro-systems applications represent the ideal connecting channel between humans and the environment. This is a field of innovation that broadened the scope of the traditional textile and apparel products to high-tech textiles, designed to meet specific needs, involving different technologies and produced according to required properties, like personal protection, safety, leisure or health wear. The development of smart wear is a new challenge for the textile and clothing industry: it has to develop products based not only on design, fashion and comfort concepts but also in terms of functions. Moreover these products must be easy to care and durable.

Planejamento estratégico para o desenvolvimento de padrões profissionais de enfermagem: nota prévia / Strategic plan for developing nursing professional standards: preview note

CONTEXTO: Diante da função primordial de um Hospital Universitário e após a análise do contexto e dos envolvidos, avaliou-se que o desvio do foco assistencial do cliente (usuário externos) e do aluno (usuário interno) é o problema prioritário e central. OBJETIVOS: Avaliar o impacto da implantação do cuidado centrado no cliente, integral e hierarquizado, baseado em evidências científicas, desenvolvendo uma base de dados científicos sobre a relação entre os resultados do cliente sensíveis aos cuidados de enfermagem. MÉTODO: O monitoramento e a avaliação do plano estratégico elaborado pela Coordenação de Enfermagem do HUPE/UERJ. Os dados serão coletados do prontuário do cliente e dos documentos da administração hospitalar (escalas, etc). Os dados qualitativos serão colhidos por meio de entrevistas com os clientes e funcionários. Os dados serão submetidos a análise estatística (regressão múltipla) e qualitativa para analisar a relação entre os resultados e a implantação dos padrões profissionais de enfermagem. RESULTADOS ESPERADOS: o perfil do atendimento ao cliente com base nos indicadores sensíveis aos cuidados de enfermagem.

PROBLEM: At the University Hospital of the University of Rio de Janeiro State (HUPE/UERJ),the Nursing Coordination analysed the social context and the stakeholders of health assistence, and identified a problem to address: a change shift in the focus from the client and student to the institution itself. OBJECTIVE: To achieve the vision of a 24/7 nursing care, centered in the client and based on scientifc evidence, a strategic plan was developed to establish nursing professional standards. METHOD: As an instrument of social management, an Strategic Project represents the process of assessment, diagnosis, planning, and evaluation of the nursing managers to improve the quality of care at HUPE/UERJ. EXPECTED OUTCOME: a hospital database related to client outcomes related to nursing care.

Comparação da cobertura vacinal da população menor de um ano em município da serra gaúcha - região da 5° coodoregional de saúde com diferentes bancos de base populacional / Comparision of the vaccine coverage of the population under one year age in a municipal district of the gaucha mountain - area of the 5th regional co-ordination of health with different populational data basis

O impacto epidemiológico para o controle ou erradicação de doenças preveníveis por vacina, exige que, além da adoção de medidas de controle específicas, seja vacinado um percentual da população capaz de interromper a cadeia de transmissão e para que resulte em impacto sobre a situação da doença a homogeinicidade das coberturas seja mantida. A cobertura vacinal do menor de 1 ano é um indicador valioso para a política nacional de saúde, sendo instrumento imprescindível no planejamento, administração e avaliação dos serviços e políticas de saúde vigentes no país...

Cirurgia refrativa no tratamento de crianças com ambliopia por anisometropia miópica; uma indicaçäo especial / Refractive surgery for amblyopia in anisometropia myopia

Foram realizadas correçöes de alta miopia, pela técnica da ceratomileusis in situ, em 10 olhos de pacientes com idade entre 6 e 16 anos, portadores de anisometropia miópica, com o objetivo de reduzir a miopia e, consequentemente, a anisometropia. O valor mediano da anisometropia. O valor mediano da anisometropia foi reduzido de 8,87D para 2,25D aos 3 meses (p=0.009); 1,0D com 1 ano (p=0,036). O equivalente esférico mediano foi reduzido de -11,44D para -1,75D com 3 meses (p=0,009); -1,88D com 1 ano (p=0,022); e -8,50D (p=0,036) no último controle pós-operatório. Foi observado melhora da acuidade visual em 71,4p/c dos pacientes com 1 ano e em 83,3p/c dos pacientes no grupo de controle mais tardio. Näo houve nenhum caso de perda da acuidade