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El presente artículo tiene como objetivo realizar una aproximación a los efectos jurídico-penales derivados de la adopción de un sistema de compliance certificado según el estándar UNE-ISO 37301:2021, denominado superestructura de compliance, en contraste con la eventual adopción por las empresas de un programa de cumplimiento meramente cosmético.

La violencia contra las mujeres a menudo se describe como un fenómeno cada vez más frecuente en todo el mundo con un enorme impacto en la vida de las víctimas, sus familias y la sociedad. En este breve estudio nos centraremos en un análisis dogmático del nuevo delito de violencia psicológica contra la mujer del artículo 147-B del Código Penal brasileño, tratando de abordar las muchas complejidades que condicionan la respuesta penal. Partiremos de la dificultad conceptual de delimitación de la violencia psicológica a través de un análisis de ejemplos, tipos y causas, para poder analizar los elementos objetivos y subjetivos del tipo penal de violencia psicológica contra la mujer introducido en el artículo 147-B del Código Penal de Brasil. También abordaremos las cuestiones procedimentales relacionadas con este delito. Palabras clave: Violencia de género; violencia doméstica; violencia; controle coercitivo; abuso emocional.

En el presente artículo se analiza el nuevo escenario creado a partir de la publicación de La Ley Orgánica 14/2022, de 22 de diciembre, de transposición de directivas europeas y otras disposiciones para la adaptación de la legislación penal al ordenamiento de la Unión Europea, y reforma de los delitos contra la integridad moral, desórdenes públicos y contrabando de armas de doble uso. Analiza en qué medida dichas alteraciones sugieren un refuerzo penal a la aplicación pública del Derecho de la Competencia en los casos de cárteles de núcleo duro, con especial atención a los cárteles en licitaciones, la responsabilidad penal de las personas jurídicas, la clemencia penal y el programa de cumplimiento antitrust.

This study analyzed the progression of COVID-19 in the State of Espírito Santo, identifying the areas where the disease spread furthest. Temporal and spatial analysis were performed based on confirmed cases of the disease reported in the eSUS/VS System - State Health Department, from March 2020 to February 2021. The highest incidence was noted in July (ranging from 146.1 to 2,099.5 cases per 100,000 inhabitants in the municipalities of Espírito Santo State), with the majority being females, people aged 20 to 39 years and residents in cities in the metropolitan region. A positive and complete high association (p < 0.05) was identified in all months, with clusters containing a greater number of municipalities in April, May and June 2020 in the Central region of the state. The results of the present study indicated a continuous spread of COVID-19 since its introduction, especially in the cities in the Central region of the State of Espírito Santo. These findings present an important aid for decision making regarding the most effective strategies to control the disease. Furthermore, individual and collective protection measures against the transmission of the SARS-CoV-2 must be encouraged. KEY WORDS: COVID-19; SARS-CoV-2; pandemic; spatial analysis; epidemiology; Espirito Santo.

Endothelial dysfunction (ED) is a hallmark of cardiovascular (CV) disorders and influences their progression; however, there are currently no direct therapeutic targets, primarily due to the lack of knowledge regarding ED’s molecular basis. We used a computational approach to identify candidate targets for ED treatment. We constructed an ED disease gene network by combining the integration of epigenomics (ATAC-seq and ChIP-seq-H3K27ac) and transcriptomics data (RNA-seq) from human aorta endothelial cells (HAEC) exposed to surrogates of primary CV risk factors using network propagation. We then usedin silicoperturbation to prioritise genes that could influence the ED network most when removed. This process resulted in identifying 17 key candidates for which chemical inhibitors are available. These are genes associated with ED and atherosclerosis, and drugs that target those genes have not yet been tested for the treatment of CV disorders. The EGLN3 target and its inhibitor displayed significant anti-inflammatory and antioxidant properties in ECs assessed using a high-content screening platform. These findings illustrate the potential ofin silicoknockouts to discover disease-specific candidate targets for drug development or repositioning.

Made available in DSpace on 2022-05-01T08:15:12Z (GMT). No. of bitstreams: 0 Previous issue date: 2021-11-01 Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) Mirabegron is a selective β₃-adrenergic receptors agonist, which has been recently shown to improve metabolic health in rodents and humans. In this study, we investigated the effects of 2-week mirabegron treatment on the metabolic parameters of mice with a diet-induced obesity (DIO). C57BL/6JUnib mice were divided into control (CTR) and obese (OB) groups treated with vehicle, and an OB group treated with mirabegron (OB + MIRA). The obese groups were fed a high-fat diet for 12 weeks. Mirabegron (10 mg/kg/day) was administrated orally by gavage from weeks 10–12. After 2 weeks of mirabegron treatment, the energy expenditure was assessed with indirect calorimetry. Blood glucose, insulin, glycerol, free fatty acids (FFA), thiobarbituric acid reactive substance (TBAR), and tumour necrosis factor (TNF)-α levels were also assessed, and the HOMA index was determined. Liver tissue, brown adipose tissue (BAT), and inguinal white adipose tissue (iWAT) samples were collected for histological examination. The protein expressions of uncoupling protein 1 (UCP1) and mitochondrial transcription factor A (TFAM) were assessed using western blotting of the BAT and iWAT samples. In this study, mirabegron increased the energy expenditure and decreased adiposity in OB + MIRA. Increased UCP1 expression in BAT without changes in iWAT was also found. Mirabegron decreased circulating levels of FFA, glycerol, insulin, TNF-α, TBARS and HOMA index. DIO significantly increased the lipid deposits in the liver and BAT, but mirabegron partially reversed this change. Our findings indicate that treatment with mirabegron decreased inflammation and improved metabolism in obese mice. This effect was associated with increased BAT-mediated energy expenditure, but not iWAT beiging, which suggests that mirabegron might be useful for the treatment of obesity and diabetes. Dorothy M. Davis Heart and Lung Research Institute The Ohio State University Wexner Medical Center Department of Physiology and Cell Biology The Ohio State University Wexner Medical Center Department of Physical Education Institute of Biosciences São Paulo State University (UNESP) Department of Pharmacology Faculty of Medical Sciences University of Campinas (UNICAMP) Department of Structural and Functional Biology Institute of Biology University of Campinas (UNICAMP) Medical School Graduate Program in Environmental Health Metropolitan University of Santos Department of Physical Education Institute of Biosciences São Paulo State University (UNESP)

Carotid intima–media thickness (cIMT) is a subclinical marker of atherosclerotic development, which is impaired in adolescents with obesity. This study aimed to analyze the impact of physical activity (PA), cardiorespiratory fitness (CRF), body mass index (BMI), and body composition changes on the cIMT of adolescents with obesity. Longitudinal data (6 months) from adolescents aged 12–18 years, with a BMI ≥97th percentile, previously recruited for the non-randomized controlled trial PAC-MAnO (Clinicaltrials.gov-NCT02941770) were analyzed using partial correlations controlling for sex and pubertal status and multiple regressions. A total of 105 adolescents (51.4% girls, 86.7% Caucasian), 14.8 ± 1.8 years old, with a BMI z-score of 3.09 ± 0.74 were included. Total body fat mass (TBFM) (F(1,91) = 23.11, p < 0.001), moderate–vigorous PA (MVPA) (F(1,91) = 7.93, p = 0.0006), and CRF (mL/kg/min) (F(1,90) = 19.18, p < 0.001) predicted cIMT variance with an R2 of 0.24, 0.09, and 0.23, respectively. MVPA changes showed a high correlation with CRF variation (r(91) = 0.0661, p < 0.001). This study suggests that although cIMT is impaired in overweight adolescents, improvements in TBFM, MVPA, and CRF are associated with cIMT improvement. Although both energy intake and MVPA may influence TBFM, MVPA plays the most relevant role in cIMT development due to its direct association with CRF.

Introdução: O tecido adiposo e suas células tem sido amplamente estudados devido à sua relação íntima com a obesidade. Objetivo: Identificar aspectos históricos e relevantes sobre o avanço na compreensão da função metabólica do tecido adiposo, sobretudo quanto ao seu potencial como alvo terapêutico no controle de doenças metabólicas. Materiais e Métodos: Foi feita uma revisão narrativa da literatura, sem restrição de data, priorizando fontes primárias indexadas pela base de dados PubMed. Resultados: As evidências da existência de tecido adiposo com propriedades termogênicas demonstrada em humanos adultos promoveram grande interesse no estudo do tecido adiposo, em razão de seu potencial terapêutico no controle da obesidade. A plasticidade e versatilidade do tecido adiposo são evidenciadas pelos diversos tipos de adipócitos hoje estudados. Os classicamente conhecidos: branco (WAT) e marrom (BAT), e o mais recentemente descoberto: bege (beige/brite), também conhecido como tecido adiposo marrom induzível; além dos adipócitos rosa e os de medula óssea. Enquanto o WAT é responsável por estocar o excesso de energia na forma de lipídeos, estando diretamente relacionado à obesidade, o BAT, por apresentar alta capacidade oxidativa, pode influenciar no aumento da taxa metabólica corporal, reduzindo a obesidade. Nesse contexto, o tecido adiposo bege apresenta dupla função: Comporta-se como o branco, armazenando o excesso de energia ou, quando estimulado (exposição ao frio, estimulação simpática), tem seu programa termogênico ativado, elevando a expressão de UCP1 (Uncoupling Protein-1) a níveis semelhantes aos do tecido adiposo marrom e promovendo maior dissipação de energia. O tecido adiposo se apresenta versátil por se adaptar à diferentes condições metabólicas, em contextos específicos como na lactação, na hematopoiese, por sua atuação como órgão endócrino ou na modulação do metabolismo energético. Conclusão: Assim, a compreensão de aspectos funcionais e moleculares dos adipócitos, nos possibilita identificar novas formas de tratamento para distúrbios metabólicos.

Nas disciplinas que envolvem o fazer projetual em cursos de graduação tais como: design, engenharia e arquitetura, há uma constante preocupação do aluno em relação às atividades que envolvem criatividade e inovação. Isso se deve em parte à crença originada do senso comum de que há algumas pessoas que são gênios e outras, simplesmente não são e nunca alcançarão um nível de excelência satisfatório. Essa crença generalizada acaba por prejudicar o desempenho de estudantes nas disciplinas em que é necessário que o aluno se coloque como protagonista na construção de seu conhecimento, assumindo riscos e aventurando-se. Mas, além disso, corroboram para este estado de coisas os métodos tradicionais de ensino a que os alunos são submetidos desde a pré-escola até o ensino médio que não os preparam para estes tipos de desafios, uma vez que são formados para receber os conteúdos e não para discuti-los e problematizá-los contextualizando-os na realidade. Porém, o cerne destas profissões é o ato de projetar, está é a finalidade de sua formação. Quer sejam sistemas, produtos, veículos, vestuário ou calçados, se pretende que haja inovação, pois hoje, mais do que nunca é preciso rever conceitos de produção e consumo, face as questões relativas à desigualdade social, sustentabilidade, inclusão, entre outros que são assuntos que requerem novas visões de mundo. Refletindo sobre essa problemática experimentamos na disciplina de Design de Acessórios de Têxtil e Moda da graduação em Têxtil e Moda a utilização da metodologia ativa centrada no Aprendizado Baseado em Projeto. O resultado mostrou-se muito satisfatório gerando 4 (quatro) patentes de produto desenvolvidos em conjunto com um grupo de alunas do curso.

Orientador : Ernesto Giovanni Boccara Dissertação (mestrado) - Universidade Estadual de Campinas, Instituto de Artes Resumo: Atualmente, mais da metade da população de seres humanos reside em áreas urbanas e pertence a um período histórico onde o surgimento e a renovação de novos elementos e interesses sociais são constantes e ocorrem numa velocidade que dificulta sua apreensão. Novas patologias e reações ao estilo de vida que são propiciadas e que propiciam a crescente violência urbana, ao mesmo tempo que levam à banalização do corpo, nos colocam diante da necessidade de nos reapropriarmos dele e de criarmos uma identidade que nos diferencie dos demais. o indivíduo, que pertence a uma sociedade globalizada na qual é cada vez mais difícil a sobrevivência de características próprias, adquire, principalmente devido aos avanços tecnológicos e científicos, a opção de construir o seu corpo conforme a identidade que possui ou a identidade que deseja. A Body Modificatíon, conceito usado para designar as modificações corporais, executadas desde o uso de produtos químicos até intervenções cirúrgicas, rompe a fronteira da pele e nos permite a feitura de interferências que visam modificar os contornos e acrescentar elementos à silhueta, criando novas dimensões estéticas, e nos apresentando uma realidade onde as definições de natureza e cultura se interpenetram, causando quase sempre um desconforto, um estranhamento Abstract: Not informed. Mestrado Mestre em Artes

© 2019 Annals of Pediatric Endocrinology & Metabolism. This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited., Purpose: Acanthosis nigricans (AN) is a hyperpigmented dermatosis associated with obesity and insulin resistance (IR). There is no consensus whether AN extension scoring offers added value to the clinical estimation of IR. In this study we aimed to assess and score AN using both a short and an extended version of the scale proposed by Burke et al. and analyze the relationships of both versions with hyperinsulinemia and IR. Methods: We analyzed data from 139 overweight adolescents (body mass index ≥85th percentile) aged 12–18 with (n=67) or without (n=72) AN who were followed at a pediatric obesity clinic. Results: Adolescents with AN had higher levels of insulin (d=0.56, P=0.003) and HOMA-IR (d=0.55, P=0.003) compared to those without. Neither the short nor the extended versions of AN scores explained either hyperinsulinemia (β=1.10, P=0.316; β=1.15, P=0.251) or IR (β=1.07, P=0.422; β=1.10, P=0.374). The presence of AN alone predicted hyperinsulinemia and the presence of IR in 7.3% (β=2.68, P=0.008) and 7.1% (β=2.59, P=0.009) of adolescents, respectively. Conclusion: Screening for AN at the neck and axilla is a noninvasive and cost-effective way to identify asymptomatic overweight adolescents with or at risk of developing IR., AVS is supported by the Portuguese Foundation for Science and Technology (SFRH/BD/130193/2017).

Our previous studies show that cafeteria diet increases body adiposity, plasma insulin levels, and sympathetic activity to brown adipose tissue (BAT) and white adipose tissue (WAT) of Wistar rats, leading to rapid and progressive changes in the metabolic profile. The identification of suitable reference genes that are not affected by the experimental conditions is a critical step in accurate normalization of the reverse transcription quantitative real-time PCR (qRT-PCR), a commonly used assay to elucidate changes in the gene expression profile. In the present study, the effects of the cafeteria diet and sympathetic innervation on the gene expression of adrenoceptor beta 3 (Adrb3) from BAT and WAT were assessed using one of the most stable and one of the least stable genes as normalizers. Rats were fed the cafeteria diet and on the 17th day, interscapular BAT or retroperitoneal WAT was denervated and, 7 days after surgery, the contralateral innervated tissue was used as control. Ten reference genes were evaluated (18S, B2m, Actb, CypA, Gapdh, Hprt1, Rpl32, Tbp, Ubc, and Ywhaz) and ranked according to their stability using the following algorithms: geNorm, NormFinder, BestKeeper, and comparative delta threshold cycle (ΔC t ) method. According to the algorithms employed, the normalization of Adrb3 expression by the least stable genes produced opposite results compared with the most stable genes and literature data. In cafeteria and control diet-fed rats, the three most stable genes were Hprt1, Tbp, and Rpl32 for interscapular BAT and Tbp, B2m, and Hprt1 for retroperitoneal WAT, while the least stable genes were 18S, Actb, and Gapdh for both tissues.

Objective Chia seed oil is the richest source of plant-based ω-3 fatty acid, α-linolenic acid, but its potential and mechanisms of action to treat obesity are unclear. The aim of the study was to evaluate the effects of chia oil (ChOi) supplementation on body composition and insulin signaling in skeletal muscles of obese mice. Methods Male C57 BL/6 mice (n = 8/group) were fed regular control chow or a high-fat diet (HFD) for 135 d. Another HFD group additionally received ChOi from 90 to 135 d. Results Consumption of ChOi reduced fat mass accumulation and increased lean mass as evidenced by nuclear magnetic resonance. Moreover, obese mice treated with ChOi showed higher tyrosine phosphorylation of insulin receptor substrate 1, greater activation of protein kinase B, and increased translocation of glucose transporter type 4 in skeletal muscle tissue in response to insulin. ChOi supplementation improved glucose levels and insulin tolerance; decreased serum insulin, leptin, and triacylglycerols; and increased blood high-density lipoprotein cholesterol levels. All these effects caused by the use of ChOi seemed to be independent of the resolution of inflammation because the markers of inflammation were not altered in animals fed the HFD. Conclusion The molecular effects observed in muscle tissue together with changes in body composition may have contributed to the increased glucose tolerance and to the healthy phenotype presented by obese animals treated with ChOi.

Orientador: Helena Coutinho Franco de Oliveira Tese (doutorado) - Universidade Estadual de Campinas, Instituto de Biologia Resumo: A proteína de transferência de colesteril éster (CETP) transfere colesterol esterificado (CE) das HDL para as lipoproteínas que contêm apo B, em troca de triglicérides. Assim, a CETP promove a redução dos níveis de HDL-colesterol no plasma, aumentando o risco de aterosclerose. Recentemente, nosso grupo verificou que camundongos transgênicos que expressam a CETP (CETP-Tg) apresentam menor adiposidade que os controles não transgênicos (NTg). Neste trabalho investigamos possíveis mecanismos que expliquem a redução da adiposidade. Camundongos CETP-Tg e controles NTg (C57/BL6 background) foram tratados com dieta padrão desde o desmame até os 5 meses de idade. Camundongos CETP-Tg apresentaram redução nos depósitos de tecido adiposo (~30%). Essa redução da adiposidade não foi compensada por deposição ectópica de lipídeos no fígado ou músculo, nem foi consequência de alteração do balanço de gordura (ingestão vs. excreção). Lipogênese in vivo e em adipócitos isolados (estimada por 3H2O e 14C-acetato) foram similares entre os grupos. A retenção de lipídeos exógenos e a captação de glicose pelo fígado, músculo e tecidos adiposos (estimada após dose oral de 3H-trioleina e injeção IP de 3H-2- deoxiglicose, respectivamente) não evidenciaram nenhuma diferença entre os genótipos. No estado alimentado, a expressão da CETP aumentou (~50%) a lipólise basal in vivo e estimulada por isoproterenol em adipócitos isolados. Coerentemente, os níveis de RNAm para HSL (hormone sensitive lipase) e ATGL (adipose triglyceride lipase) estavam aumentados, assim como FATP1 (fatty acid transport protein 1). No tecido adiposo marrom, verificou-se elevação nos níveis de ATGL, FATP1 e UCP1 (uncoupling protein 1). Além disso, o conteúdo protéico do receptor beta 3 adrenérgico também estava aumentado nos extratos de membrana celular de tecido adiposo visceral e marrom dos animais CETP-Tg. A expressão da CETP também elevou em cerca de 10% a taxa metabólica corporal (VO2 e gasto energético). Conclui-se que a CETP altera a expressão e/ou função de proteínas relacionadas à lipólise e termogênese, aumentando o gasto energético global e reduzindo a massa de gordura corporal. Em conjunto, esses resultados sugerem uma nova função antiadipogênica para a CETP Abstract: Cholesteryl ester transfer protein (CETP) is a plasma protein that mediates the exchange of triglycerides for esterified cholesterol from HDL to the apoB containing lipoproteins. In this way, CETP promotes reduction of plasma HDLcholesterol and, thus, increases the risk of atherosclerosis. Recently, we found that CETP expressing mice (CETP-Tg) presented less adipose tissue mass than nonexpressing controls. In this work we investigated possible mechanisms to explain these findings. CETP-Tg and non-transgenic (NTg) control mice (C57/BL6 background) were fed with chow diet from weaning to 5 month of age. CETP-Tg mice had reduced visceral and subcutaneous fat depots (~30%) that was not compensated by lipid ectopic deposition and could not be explained by differences in fat intake and excretion. Lipogenesis rates in vivo and in isolated adipocytes (estimated using 3H2O and 14C-acetate) were similar in both CETP-Tg and control mice. Lipid retention and glucose uptake by liver, muscle and adipose tissues (estimated after an oral dose of 3H-triolein and IP injection of 3H-deoxiglucose) showed no significant differences between groups. In the fed state, CETP group showed higher (~50%) basal lipolysis rates in vivo and in isoproterenol stimulated lipolysis rates in isolated adipocytes. In accordance, visceral adipose hormone sensitive lipase (HSL) and adipose triglyceride lipase (ATGL) mRNA expression were elevated, as well as fatty acid transport protein (FATP1). In brown adipose tissue, ATGL, FATP1 and uncoupling protein 1 (UCP1) were increased. Furthermore, beta 3 adrenergic receptor proteins mass were upregulated in visceral and brown adipose tissues membrane extracts. In addition, whole body energy expenditure (measured by respirometry) was found to be elevated in CETP-Tg mice (10%). In conclusion, CETP change expression and function of proteins related to lipolysis and thermogeneis, thus, increasing whole body energy expenditure and resulting in less body fat content. These findings disclose a novel anti-adipogenic role for CETP Doutorado Fisiologia Doutora em Biologia Funcional e Molecular

Orientador: Carmen Lucia Soares Tese (doutorado) - Universidade Estadual de Campinas, Faculdade de Educação Doutorado Educação, Conhecimento, Linguagem e Arte Doutor em Educação

Objectives The emergence of adolescent medicine (AM) as a specific area of training and health care delivery is progressing at various pace around the world. The objective of this exploratory survey was to inquire about the existence of official bodies and institutions offering recognition of the discipline as a specific field and on the status of related training initiatives. Methods A questionnaire was spread among a convenience sample of 21 colleagues involved in adolescent health care around the world, and answers were collected and analysed manually. Results All 21 colleagues from the North and South American, African, Asian and European regions have responded. Only seven countries report the existence of adolescent inpatient wards in some hospitals, while 16 have specialized outpatient clinics; in only eight countries is formal mandatory training in AM required for paediatricians; in seven others, such a stay is available but optional. Six countries have implemented a systematic assessment tackling AM in the certification process of paediatricians and just four recognize AM as a sub-specialty. Only two countries mention compulsory training in AM for family doctors. Fourteen countries report on the existence of an AM association. Conclusions Despite an encouraging number of initiatives testifying the growing place of AM in the practice of medicine, our data bring a worrisome portray of the status of AM in the involved countries and call for the development of appropriate health care and training centres.

Objectives Paediatricians increasingly need to take care of adolescents, a life stage with specific needs, however many of them admit a limitation in their medical education regarding Adolescent Medicine. The objective of this paperwork is to evaluate the formative model adopted in the Department of Paediatrics, Hospital de Santa Maria, and assess the impact of the training in Adolescent Medicine. Methods We surveyed the current Paediatric Residents and those who graduated as Paediatricians from the Department in the past five years, in order to get feedback on the one-month compulsory training at the Adolescent Medicine Division during their Residency. Results Both groups considered it as a very interesting/useful training. Paediatricians considered that the training had an insufficient duration, with statistical difference comparing to the current Residents’ opinion. Conversely, Residents considered more often that the acquired competencies would be useful in their future clinical practice, when compared to Paediatricians. Conclusions In order to potentiate learning and training during such a short period of time, a few changes were identified as beneficial to be implemented.

A evolução e transformações das tecnologias aplicadas aos usos do espaço exterior interconectadas com o uso militar do espaço exterior a evidenciam a pressão dos fatos sobre o direito, avocando reflexão sobre o corpus juris internacional sobre a questão, em nível de soft law e hard law. Mesmo no contexto de autodefesa, as atividades espaciais militares possuem aspectos ofensivos e defensivos que precisam ser considerados e podem ser executadas ao abrigo da Carta das Nações Unidas (considerando o direito à autodefesa) e do Tratado do Espaço (ao se entender o termo “propósito pacífico” equivalente ao termo “não agressão”, exceto para autodefesa), além de outros tratados que podem ser evocados em situações de conflito, no âmbito do Direito Internacional Humanitário. Este artigo consubstancia o caso brasileiro, onde a Força Aérea Brasileira apresenta o entendimento do Brasil quanto ao Tratado do Espaço e à Carta das Nações Unidas, estruturando sua aplicação militar do espaço exterior de acordo com os documentos políticos e doutrinários do Ministério da Defesa do Brasil, sabidamente, a Política de Defesa Nacional, a Estratégia Nacional de Defesa e o Programa Estratégico de Sistemas Espaciais. As operações militares descritas neste artigo revelam que situações fáticas emergentes carecem de tutela jurídica com elevado grau de efetividade.

The Portuguese Newborn Screening Program is a public health program that started in 1979, screening for PKU, being totally supported by public funds. It's a non-mandatory well implemented program that testes about 99.9% of Portuguese newborns. In the actual screening panel encompasses 26 disorders, including inborn errors of metabolism, congenital hypothyroidism and cystic fibrosis. Sample collection is advised to be made at 3rd day of life and treatment begins in average by the 10th day. Every testes are performed in one single national laboratory, that processes about 88,000 samples/year. In the 41 years of program existence, more than 3,800,000 newborns were screened and 2,130 affected newborns detected, reflecting the positive impact of the Program in the population. Future perspectives include the increase of program value in terms of public health by optimizing the screening of the disorders already screened and evaluation the possibility of adding others.El Programa Portugués de Cribado Neonatal es un programa de Salud Pública a nivel nacional, que tuvo su inicio en 1979 con el cribado de la fenilcetonuria y es financiado totalmente por el Estado portugués. Se trata de un programa no obligatorio, con una tasa de cobertura del 99,8%, en el que hoy en día se criban veintiséis enfermedades, incluyendo metabolopatías, hipotiroidismo congénito y fibrosis quística. La toma de muestra se hace al 3er día de vida y el tratamiento de los neonatos afectos empieza en torno al 10º día. Todos los análisis están centralizados en un único laboratorio, que procesa aproximadamente 88.000 muestras al año. En los últimos cuarenta y un años se cribaron más de 3.800.000 neonatos y se detectaron 2.130 niños afectados, lo que es un indicador del impacto del programa en la población. Los desafíos futuros incluyen la búsqueda de nuevas estrategias para incrementar el valor del programa, donde se evalúen nuevas enfermedades a cribar y la optimización del cribado actual.

Objective The systemic function of CETP has been well characterized. CETP plasma activity reduces HDL cholesterol and thus increases the risk of atherosclerosis. Here, we investigated whether CETP expression modulate adiposity. Methods Body adiposity and energy metabolism related assays and gene/protein expression were compared in CETP transgenic and non-transgenic mice and in hamsters treated with CETP neutralizing antibody. Results We found that transgenic mice expressing human CETP present less white adipose tissue mass and lower leptinemia than nontransgenic (NTg) littermates. No differences were found in physical activity, food intake, fat fecal excretion, lipogenesis or exogenous lipid accumulation in adipose depots. Nonetheless, adipose lipolysis rates and whole-body energy expenditure were elevated in CETP mice. In accordance, lipolysis-related gene expression and protein content were increased in visceral and brown adipose tissue (BAT). In addition, we verified increased BAT temperature and oxygen consumption. These results were confirmed in two other animal models: 1) hamsters treated with CETP neutralizing antibody and 2) an independent line of transgenic mice expressing simian CETP. Conclusions These findings reveal a novel anti-adipogenic role for CETP.

Rational prescribing of medicines requires evidence from clinical trials on efficacy, safety and the dose to be prescribed, based on clinical trials. Regulatory authorities assess these data and information is included in the approved summary of product characteristics. Regulatory guidelines on clinical investigation of medicinal products in the paediatric population generally propose that studies are done in defined age groups but advise that any classification of the paediatric population into age categories is to some extent arbitrary or that the age groups are intended only as a guide. The pharmaceutical companies tend to plan their studies using age groups the regulatory guidelines suggest, to avoid problems when applying for marketing authorisation. These age bands end up in the paediatric label, and consequently into national paediatric formularies. The age bands of the most commonly used age-subsets: neonates, infant/toddlers, children and adolescents, are more historical than based on physiology or normal development of children. Particularly problematic are the age bands for neonates and adolescents. The age of 12 years separating children from adolescents, and the upper limit of the adolescents set by the definition of paediatric age in healthcare, which varies according to the region, are particularly questionable. Modern pharmacometric methods (modelling and simulation) are being increasingly used in paediatric drug development and may allow assessment of growth and/or development as continuous covariables. Maybe time has come to reconsider the rational of the currently used age bands.

In this chapter, we present the major advances in CETP research since the detection, isolation, and characterization of its activity in the plasma of humans and several species. Since CETP is a major modulator of HDL plasma levels, the clinical importance of CETP activity was recognized very early. We describe the participation of CETP in reverse cholesterol transport, conflicting results in animal and human genetic studies, possible new functions of CETP, and the results of the main clinical trials on CETP inhibition. Despite major setbacks in clinical trials, the hypothesis that CETP inhibitors are anti-atherogenic in humans is still being tested.

Social media use has become an integral part of children’s and adolescents’ lives. It has become a novel way of interaction among people and influences people’s social lives and public opinion as well as people’s purchasing decisions and businesses. Any website or platform that allows social interaction is considered to be a social media site. Social media use among children in 25 European countries has been reported to be 38% among 9–12 year olds and 77% among those aged 13–16 years. All these children report having their own profile on at least one social network site. While social networking provides children and adolescents with many opportunities and benefits, it also carries many risks. Among the benefits are socialization and communication enhancement, improving learning skills, positive impact on education and getting health information. Potential risks of social media use include falsifying age and identity, cyberbullying, sexting, Facebook depression, gamification, glamourization, cyberostracism and sleep disturbances. Conclusion: Paediatricians play a vital role in promoting the physical, mental and social welfare of all children. There is a critical need for paediatricians to play an active role, guiding children and families appropriately through the impact of social networking, in order to become a real driver of children’s development.

As ferramentas da gestão da qualidade podem auxiliar as empresas na busca pela excelência no desempenho das suas atividades e gerar vantagens competitivas, porém esse processo envolve pessoas e para que o sucesso da empresa seja constante é importante gerir o conhecimento. O presente trabalho tem como objetivo realizar uma análise bibliométrica na base de dados Scopus referente ao tema “Contribuição das ferramentas da gestão da qualidade para a gestão do conhecimento nas empresas”. Foram efetuadas três buscas na base de dados delimitando os anos de 1995 a 2015, onde na primeira busca foram encontrados 4926 artigos, na segunda busca 498 artigos e por fim na terceira busca 80 artigos, dos quais apenas 21 encontravam-se na íntegra. Após a busca os artigos foram avaliados quanto ao número de publicações anuais, o maior número de publicações por países, periódicos que tiveram acima de 10 publicações no período delimitado, áreas que publicaram acima de 100 artigos e publicações classificadas por Universidades. Pode-se encontrar como resultados que apesar de aumentarem as publicações com o passar dos anos, as publicações relacionadas ao tema pesquisado ainda não atingem um número relevante.

O presente estudo, de cunho exploratório, é parte da pesquisa intitulada “Metodologias de Ensino de História e Cultura Afro-brasileira e Africana na Educação Profissional e Tecnológica: Experiências do Ensino Médio Integrado no IFPA”, tem como objetivo discutir as práticas pedagógicas referente ao ensino de história e cultura afro-brasileira e africana no currículo integrado. O estudo traz um diálogo sobre os pressupostos que embasam o currículo integrado na Educação Profissional e Tecnológica (EPT) e do ensino de cultura afro-brasileira e africana no currículo integrado. A pesquisa traz uma discussão sobre a implementação da lei 10639/03 no currículo da EPT. Para a problematização partimos da pesquisa bibliográfica, documental e de campo, bem como de entrevista com 5 professores, no sentido responder como tem sido desenvolvida as práticas pedagógicas e como vem sendo organizada a matriz curricular no ensino médio integrado no curso de Agropecuária no Campus Rural de Marabá (CRMB)/Instituto Federal do Pará (IFPA). A pesquisa demonstra avanços na implementação da lei, porém, a necessidade de um planejamento coletivo e integrado do currículo no Projeto Pedagógico do Curso (PPC), bem como, da formação de professores para o ensino de história e cultura afro-brasileira e africana, no sentido de descolonizar o currículo e, portanto, de construir práticas pedagógicas desatreladas de uma concepção hegemônica e eurocêntrica.

Esse artigo buscou salientar sobre os benefícios envolvidos nas cirurgias minimamente invasivas, abordando procedimentos que visam reestabelecer o fluxo sanguíneo do miocárdio, auxiliando na sua revascularização e, assim, nas restaurações das funções efetivas do órgão. O trabalho apresenta o amparo que uma cirurgia pouco invasiva traz aos pacientes, gerando uma recuperação menos agonizante e otimizando o êxito do procedimento. Além de apresentar o processo de modernização que a medicina sofreu através dos anos para alcançar modelos de procedimentos cirúrgicos que utilizam uma tecnologia de ponta em prol de um conforto maior dos pacientes que sofrem com doença arterial coronariana. Por se tratar de uma patologia que acomete, em sua maioria, um grupo de pessoas idosas, os riscos de uma cirurgia de revascularização do miocárdio pelo método convencional, aumentariam as chances de insucesso do procedimento, logo, as estratégias minimamente invasivas contribuem para que o paciente tenha complicações no pós-operatório reduzidas ou amenizadas e otimizam o prognóstico destes. Vale, ainda, ressaltar a necessidade de estudos contínuos na área que visem o aprimoramento das técnicas minimante invasivas, a ampliação do seu uso, a redução de custos e, sobretudo, o aumento de sua eficácia terapêutica.

A key aspect of adolescence and young adulthood is the evolving nature of the role of the parent/caregiver. Rheumatic musculoskeletal disease (RMD) affecting a young person will impact this role and the parent-young person relationship. Understanding the balance between capabilities and demands and which resources and coping behaviors are present in the family, can help health professionals facilitate a successful adaptation. This chapter will provide insight into techniques that facilitate engaging effectively with Adolescents and Young Adults (AYA) living with RMD and their families and discuss key elements in the assessment of the AYA-parents dynamics in the context of RMD.

Agradecimentos: This work was supported through funding from the Conselho Nacional de Desenvolvimento Científico e Tecnológico (445764/2014-7) and Coordenação de Aperfeiçoamento de Pessoal de Nível Superior. T.M.S. received a fellowship from the Federal University of São João del-Rei. H.F.R. received a postdoctoral fellowship from Fundação de Amparo à Pesquisa do Estado de São Paulo Abstract: Our previous studies show that cafeteria diet increases body adiposity, plasma insulin levels, and sympathetic activity to brown adipose tissue (BAT) and white adipose tissue (WAT) of Wistar rats, leading to rapid and progressive changes in the metabolic profile. The identification of suitable reference genes that are not affected by the experimental conditions is a critical step in accurate normalization of the reverse transcription quantitative real-time PCR (qRT-PCR), a commonly used assay to elucidate changes in the gene expression profile. In the present study, the effects of the cafeteria diet and sympathetic innervation on the gene expression of adrenoceptor beta 3 (Adrb3) from BAT and WAT were assessed using one of the most stable and one of the least stable genes as normalizers. Rats were fed the cafeteria diet and on the 17th day, interscapular BAT or retroperitoneal WAT was denervated and, 7 days after surgery, the contralateral innervated tissue was used as control. Ten reference genes were evaluated (18S, B2m, Actb, CypA, Gapdh, Hprt1, Rpl32, Tbp, Ubc, and Ywhaz) and ranked according to their stability using the following algorithms: geNorm, NormFinder, BestKeeper, and comparative delta threshold cycle (deltaC t) method. According to the algorithms employed, the normalization of Adrb3 expression by the least stable genes produced opposite results compared with the most stable genes and literature data. In cafeteria and control diet-fed rats, the three most stable genes were Hprt1, Tbp, and Rpl32 for interscapular BAT and Tbp, B2m, and Hprt1 for retroperitoneal WAT, while the least stable genes were 18S, Actb, and Gapdh for both tissues FUNDAÇÃO DE AMPARO À PESQUISA DO ESTADO DE SÃO PAULO - FAPESP CONSELHO NACIONAL DE DESENVOLVIMENTO CIENTÍFICO E TECNOLÓGICO - CNPQ COORDENAÇÃO DE APERFEIÇOAMENTO DE PESSOAL DE NÍVEL SUPERIOR - CAPES Fechado

This study aimed to analyze the associations between sedentary behavior, physical activity (PA), and cardiorespiratory fitness (CRF), with carotid intima-media thickness (cIMT), a marker of atherosclerosis already present at an early stage among obese adolescents. The associations between anthropometric measures, sedentary time, PA, CRF, and cIMT of 54 Caucasian obese adolescents were analyzed using partial correlations (controlling for age and sex) and multiple linear regressions. Differences between participants with and without a healthy CRF were also analyzed using independent sample t test. Sedentary time did not correlate with any of the variables. Light physical activity correlated positively with mean cIMT (r(38) = 0.36, p = 0.024). Moderate physical activity (MPA) correlated positively with both mean (r(38) = 0.37, p = 0.018) and maximum (r(38) = 0.33, p = 0.039) cIMT. CRF was inversely associated with mean cIMT (r(40) = −0.36, p = 0.019), even when controlling for sedentary time (r(37) = −0.35, p = 0.030). The best predictors of cIMT were MPA and weight. No significant differences in cIMT were found between participants with healthy and unhealthy CRF. Conclusion: Although we need to be cautious due to the limitations of the study, the results suggest that despite the importance of decreasing sedentary time, increasing PA intensity may be more effective in improving endothelial structural health among obese adolescents.

BACKGROUND: The use of impedance cardiography (ICG) may play a role in the assessment of cardiac effects of hypertension (HT), especially its hemodynamic features. Hypertensive heart disease involves structural changes and alterations in left ventricular geometry that end up causing systolic and/or diastolic dysfunction. The IMPEDDANS study aims to assess the usefulness of ICG for the screening of left ventricular diastolic dysfunction (LVDD) in patients with HT. METHODS: Patients with HT were assessed by echocardiography and ICG. Receiver-operating characteristic curve and the area under the curve were used to assess the discriminative ability of the parameters obtained by ICG to identify LVDD, as diagnosed by echocardiography. RESULTS: ICG derived pre-ejection period (PEP), left ventricle ejection time (LVET), systolic time ratio (STR) and D wave were associated (p

We have previously shown that the cafeteria diet increases body fat mass, plasma triacylglycerol (TAG) and insulin levels, glucose uptake by white and brown adipose tissues, as well as the sympathetic activity to both adipose tissues in Wistar rats. The metabolic pathways responsible for the development of non-alcoholic fatty liver disease (NAFLD) were examined in cafeteria diet-fed rats. After 3 weeks offering cafeteria diet, we evaluated: (i) activity of the sympathetic nervous system by norepinephrine turnover rates; (ii) de novo fatty acid synthesis in vivo using 3H2O; (iii) secretion of very low density lipoprotein (VLDL)-TAG secretion measuring serum TAG levels after administration of lipase lipoprotein inhibitor, (iv) liver cytosolic lipases activities and (v) liver mRNA expression of enzymes involved in lipids secretion and oxidation by RT-PCR. The cafeteria diet induced an increase in TAG (120%) and cholesterol (30%) liver contents. Cafeteria diet did not change the sympathetic nervous system activity to liver, but induced a marked increase in the lipogenesis (approximately four-fold) and significant increase in cytosolic lipases activities (46%) and VLDL-TAG secretion (22%) compared to control diet-fed rats. The cafeteria diet also increased the microsomal triglyceride transfer protein (30%) and carnitine palmitoyltransferase I (130%) mRNA expression but decreased the apolipoprotein B100 (26%) mRNA expression. Our findings demonstrate that the increase in the cytosolic lipases activities and VLDL-TAG secretion rates were not able to compensate for the increased lipogenesis rates induced by the cafeteria diet, resulting in NAFLD.

INTRODUÇÃO: A prevalência de ingestão alimentar compulsiva é especialmente elevada nos adolescentes obesos que procuram tratamento para perder peso, e parece estar associada a piores resultados. O objetivo deste estudo foi estimar a prevalência de ingestão alimentar compulsiva e sua associação com o índice de massa corporal (IMC), nos adolescentes obesos na primeira consulta de obesidade num centro de referência. Estudámos também a ocorrência de perda de controlo alimentar, a evolução do IMC e a associação com outros comportamentos alimentares disfuncionais. MÉTODOS: Foi utilizado o questionário Obesity Disordered Eating Questionnaire. A ingestão alimentar compulsiva foi definida pela presença de episódios de ingestão alimentar associados a perda de controlo, pelo menos uma vez por semana.RESULTADOS: A amostra incluiu 64 adolescentes com média de idades de 14,7 ± 1,5 anos. O z-score do IMC variou entre 1,65 e 2,95. A prevalência estimada de ingestão alimentar compulsiva foi de 23,4%. Reportaram perda de controlo 53% dos adolescentes. Não se encontrou associação entre a ocorrência da ingestão alimentar compulsiva e os z-scores do IMC mais elevados. Entre a primeira e a segunda consulta houve uma diminuição do IMC no grupo com ingestão alimentar compulsiva inferior à verificada no grupo sem ingestão alimentar compulsiva, mas não estatisticamente significativa. Os adolescentes com ingestão alimentar compulsiva tiveram scores mais elevados na escala de comportamentos alimentares disfuncionais.DISCUSSÃO E CONCLUSÃO: Os resultados deste estudo confirmam a ingestão alimentar compulsiva como um problema prevalente em adolescentes obesos que procuram tratamento para perder peso, sendo importante a sua identificação e monitorização.

© 2018 Elsevier B.V. All rights reserved, To compare motivational interviewing (MI) with conventional care regarding the health-related quality-of-life (HRQoL) of adolescents with overweight/obesity. Methods: RCT with parallel design, involving two groups: intervention group (MI group [MIG]) and control group (conventional intervention group [CIG]). The intervention included three 30-minute interviews 3 months apart. Outcome: Change in Pediatric Quality of Life Inventory (PedsQL) scores. A mixed repeated-measures analysis of variance was used to assess group versus time interactions. Results: Eighty-three participants finished the protocol (82% girls). MIG participants showed a significant average increase (+4.7) on the Psychosocial (t[41] = -2.388, p = .022, d = .37) and Emotional Subscales (+5.1) (t[41] = 5.733, p < .001, d = .88). CIG participants showed a significant average decrease on the Psychosocial (-6.1) (t[40] = 5.733, p < .001, d = .90), Emotional (-14.1) (t[40] = 7.249, p < .001, d = 1.13) and Social Subscales (-3.8) (t[40] = 3.782, p = .001, d = .59) and on the Total Score (–4.4) (t[40] = 3.535, p = .001, d = .55) Conclusion: MI improved HRQoL among overweight adolescents participating in a weight management program. Practice implications: MI increases HRQoL and has the potential to benefit weight management programs for adolescents.

In many European countries, paediatric junior staff has no formal training in adolescent medicine and is ill-equipped to deal with issues and health problems such as substance use, unprotected sex, eating disorders and transition to adult care. This position paper of the European Academy of Paediatrics proposes a set of competency-based training goals and objectives as well as pedagogic approaches that are expected to improve the capacity of paediatricians to meet the needs of this important segment of the paediatric population. The content has been developed from available publications and training programmes and mostly covers the generic aspects of adolescent healthcare, such as how to communicate effectively, how to review and address lifestyles, how to perform a respectful and relevant physical examination, how to address common problems of adolescents and how to support adolescents in coping with a chronic condition. Conclusion: The European Academy of Paediatrics urges national bodies, paediatric associations and paediatric teaching departments to adopt these training objectives and put them into practice, so that paediatricians will be better prepared in the future to meet the challenge of delivering appropriate and effective healthcare to adolescents.