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Introdução: A saúde psicológica é o estado de bem-estar emocional, cognitivo e social que permite a uma pessoa enfrentar os desafios diários. A partir da conceção de saúde mental de Jahoda (1958), o estado de flourishing descreve um funcionamento e bem- estar ótimos em todos os aspetos da vida de um indivíduo. No processo adaptativo ao Ensino Superior, que é contínuo e multidimensional, para que o ajustamento à nova realidade seja bem-sucedido, é essencial que o Estudante tenha concluído as tarefas desenvolvimentais, nomeadamente a estabilidade na autoestima e se sinta competente nos diversos papéis que desempenha. Estes dois indicadores são importantes para a autonomia e bem-estar psicológico (Zeigler-Hill, 2013). A avaliação e intervenção focada nos aspetos positivos da Saúde Mental constitui-se como um recurso determinante para a promoção da saúde das pessoas, em detrimento do modelo centrado na doença (Bohlmeijer & Westerhof, 2021). Objetivos: explorar a relação entre os níveis de saúde mental positiva e literacia em saúde mental de estudantes universitários das IES de Viseu. Metodologia: Trata-se de um estudo exploratório transversal que incluiu uma amostra de conveniência constituída por 486 estudantes, maioritariamente do sexo feminino (79%), com idades compreendidas entre os 18 e os 49 anos (M=20,7; DP=4,65) na sua maioria do 1º ano de Licenciatura (61,1%). Foram administrados presencialmente um questionário sociodemográfico, o Questionário de Saúde Mental Positiva - QSM+ (Sequeira & Carvalho, 2009) e o Questionário de Literacia em Saúde Mental (Rocha & Neto, 2016). Resultados: Os resultados sugerem associações positivas, com efeito pequeno a moderado, entre as dimensões da saúde mental positiva e os níveis de literacia. Os níveis mais elevados de literacia relacionam com a atitude pró-social. O conhecimento relativamente aos fatores de risco e causas das perturbações mentais aparece relacionado com uma melhor perceção de autocontrolo, autonomia e habilidades de relação. Conclusões: Dado que os estudantes com melhor saúde mental positiva atingem melhor desempenho académico e expressam maior competência na idade adulta, os resultados confirmam que a literacia em saúde mental poderá ser um fator promotor da saúde psicológica e, consequentemente, um alvo da intervenção dirigidas a este contexto de atuação.

Background: For survival, it is crucial to continuously evaluate the presence or absence of risk in the environment. Previously, a safety cue for the observation of aversive pictures attenuated their aversiveness in healthy participants. Here, we investigated whether patients with Posttraumatic Stress Disorder (PTSD) would fail to engage in safety cues using brain reactivity to aversive pictures as a proxy. Methods: Patients with PTSD (n = 20) and control participants (n = 23) were exposed to neutral and mutilation pictures. Before the presentation of pictures, a text informed that those were fictitious (“safe context”) or real-life scenes (“real context”); appropriate images were also shown to increase the credibility of the text. A voxel-wise approach identified valence-responsive regions for further testing of an interaction pattern. Results: A GROUPxCONTEXTxVALENCE interaction was found in the right supramarginal gyrus spreading anteriorly to the postcentral gyrus - a region involved in the processing of peripersonal space and defensive reactions. Control participants showed, in the real context, increased BOLD response in the right supramarginal gyrus for mutilation pictures compared to neutral ones and, in the safe context, no significant difference between those pictures, indicating an attenuation of brain reactivity. Patients with PTSD presented high brain reactivity in both real and safe contexts. Limitations: Patients with PTSD were under pharmacological treatment, and the time posttrauma and comorbidities were not assessed. Conclusions: Differently from controls, patients with PTSD did not show attenuation of brain reactivity, reflected by supramarginal response in the safe context. This suggests an inappropriate engagement in safety cues.

ABSTRACT We described a case in which a heavily-traumatized patient had been under psychiatric treatment for seven years (five of them in a university mental health clinic) but was never diagnosed with PTSD and, therefore, did not receive the proper treatment for a very long period. After the correct diagnosis was made and personalized treatment instituted, the patient has shown marked improvement in functionality and wellbeing. The key element in this case, was the adequacy of psychiatric training. Our report suggests that psychiatrists are not being adequately trained to identify traumatic events and to diagnose atypical cases of PTSD. With that in mind, we emphasize that theoretical modules on trauma and trauma-related disorders and practical training in specialized PTSD clinics should be incorporated into the psychiatric residency training programs wherever they may be missing, particularly in countries most impacted by violence. Furthermore, continuing medical education on trauma and PTSD should be provided by medical associations and journals to keep physicians updated on recent progress in the field.

Introduction: Despite treatment with hypothermia, 40% of newborns with hypoxic-ischaemic encephalopathy die or suffer moderate to severe disability. Near-infrared spectroscopy (NIRS) could be a useful, non-invasive tool to establish the prognosis. Objectives: To evaluate the prognostic value of NIRS in predicting neurodevelopmental outcomes at 18–36 months in newborns with hypoxic-ischaemic encephalopathy, and to establish the time points and cut-off values of regional cerebral oxygen saturation that exhibit the strongest correlation to these outcomes. Patients and methods: The study included all term newborns with hypoxic-ischaemic encephalopathy managed with hypothermia and NIRS between 2013 and 2016. We established 3 outcome categories: normal neurodevelopment, moderate disability and severe disability. Results: The sample comprised 28 newborns (median gestational age, 39 weeks; median birth weight, 3195 g). The median regional cerebral oxygen saturation increased from 65% to 85% at 48 h post birth. Neurodevelopmental outcomes were normal in 28.6%, while 35.7% developed moderate disability and 35.7% severe disability; 3 patients died. We found a statistically significant difference between groups at 48 h (P = .005) and after hypothermia (P = .03), with higher values in patients with disability. When we compared patients with severe disability group with the other groups, we found a statistically significant area under the ROC curve at 48 h of 0.872 (P = .001) applying a regional cerebral oxygen saturation cutoff of 83.5%. After hypothermia, regional cerebral oxygen saturation values below 66.0% (AUC, 0.794; P = .017) predicted normal development, while values above 82% (AUC, 0.881; P = .001) predicted severe disability. Conclusions: NIRS seems to be a valuable tool to predict neurodevelopmental outcomes in patients with hypoxic-ischaemic encephalopathy, even after hypothermia, with higher cerebral oxygen saturation values in patients with disability. Resumen: Introducción: A pesar del tratamiento con hipotermia, el 40% de los neonatos con encefalopatía hipóxico-isquémica fallecen o sufren discapacidad moderada-grave. La espectroscopia cercana al infrarrojo (NIRS) se propone como una herramienta útil y no invasiva para establecer el pronóstico. Objetivos: evaluar el valor pronóstico de la NIRS en el resultado del neurodesarrollo entre los 18–36 meses en neonatos con encefalopatía hipóxico-isquémica y establecer el tiempo y los puntos de corte de la saturación cerebral de oxígeno que mejor se relacionan con el pronóstico. Pacientes y métodos: Se incluyeron todos los neonatos a término con encefalopatía hipóxico-isquémica, sometidos a hipotermia y NIRS, entre 2013−2016. Con respeto al resultado, se constituyeron tres grupos: neurodesarrollo normal, discapacidad moderada y grave. Resultados: Se incluyeron 28 neonatos (edad gestacional mediana: 39 semanas; peso al nacimiento mediano: 3195 gramos). La saturación cerebral de oxígeno tendió a aumentar desde una mediana de 65% hasta 85%, a las 48 horas de vida. El resultado del neurodesarrollo fue normal en 28,6%, el 35,7% adquirió discapacidad moderada y el 35,7% discapacidad grave (tres fallecieron). Se halló una diferencia estadística entre los grupos a las 48 horas (p = 0,005) y después de la hipotermia (p = 0,03), con valores más altos en los pacientes con discapacidad. Teniendo en cuenta el grupo con discapacidad grave frente a los otros, la curva de ROC a las 48 horas resultó en un área debajo de la curva (AUC) significativa de 0,872 (p = 0,001), con un punto de corte de saturación cerebral de oxígeno de 83,5%. Después de la hipotermia, los valores de saturación cerebral de oxígeno por debajo del 66,0% (AUC 0,794; p = 0,017) predijeron el desarrollo normal mientras que valores por encima del 82% (AUC 0,881; p = 0,001) predijeron discapacidad grave. Conclusiones: El NIRS parece constituir una herramienta útil en la predicción del resultado del neurodesarrollo de pacientes con encefalopatía hipóxico-isquémica, incluso después de la hipotermia, con valores más altos de saturación cerebral de oxígeno en pacientes con discapacidad.

Resumen: Introducción: A pesar del tratamiento con hipotermia, el 40% de los neonatos con encefalopatía hipóxico-isquémica fallecen o sufren discapacidad moderada-grave. La espectroscopia cercana al infrarrojo (NIRS) se propone como una herramienta útil y no invasiva para establecer el pronóstico. Objetivos: Evaluar el valor pronóstico de la NIRS en el resultado del neurodesarrollo entre los 18-36 meses en neonatos con encefalopatía hipóxico-isquémica, y establecer el tiempo y los puntos de corte de la saturación cerebral de oxígeno que mejor se relacionan con el pronóstico. Pacientes y métodos: Se incluyeron todos los neonatos a término con encefalopatía hipóxico-isquémica, sometidos a hipotermia y NIRS, entre 2013-2016. Con respeto al resultado se constituyeron 3 grupos: neurodesarrollo normal, discapacidad moderada y grave. Resultados: Se incluyeron 28 neonatos (edad gestacional mediana: 39 semanas; peso al nacimiento mediano: 3.195 g). La saturación cerebral de oxígeno tendió a aumentar desde una mediana de 65% hasta 85% a las 48 horas de vida. El resultado del neurodesarrollo fue normal en 28,6%, el 35,7% adquirió discapacidad moderada y el 35,7% discapacidad grave (3 fallecieron). Se halló una diferencia estadística entre los grupos a las 48 horas (p = 0,005) y después de la hipotermia (p = 0,03), con valores más altos en los pacientes con discapacidad. Teniendo en cuenta el grupo con discapacidad grave frente a los otros, la curva de ROC a las 48 horas resultó en un área debajo de la curva (AUC) significativa de 0,872 (p = 0,001), con un punto de corte de saturación cerebral de oxígeno de 83,5%. Después de la hipotermia los valores de saturación cerebral de oxígeno por debajo del 66,0% (AUC 0,794; p = 0,017) predijeron el desarrollo normal, mientras que valores por encima del 82% (AUC 0,881; p = 0,001) predijeron discapacidad grave. Conclusiones: El NIRS parece constituir una herramienta útil en la predicción del resultado del neurodesarrollo de pacientes con encefalopatía hipóxico-isquémica, incluso después de la hipotermia, con valores más altos de saturación cerebral de oxígeno en pacientes con discapacidad. Abstract: Introduction: Despite treatment with hypothermia, 40% of newborns with hypoxic-ischaemic encephalopathy die or suffer moderate to severe disability. Near-infrared spectroscopy (NIRS) could be a useful, non-invasive tool to establish the prognosis. Objectives: To evaluate the prognostic value of NIRS in predicting neurodevelopmental outcomes at 18 to 36 months in newborns with hypoxic-ischaemic encephalopathy, and to establish the time points and cut-off values of regional cerebral oxygen saturation that exhibit the strongest correlation to these outcomes. Patients and methods: The study included all term newborns with hypoxic-ischaemic encephalopathy managed with hypothermia and NIRS between 2013 and 2016. We established 3 outcome categories: normal neurodevelopment, moderate disability and severe disability. Results: The sample comprised 28 newborns (median gestational age, 39 weeks; median birth weight, 3195 g). The median regional cerebral oxygen saturation increased from 65% to 85% at 48 hours post birth. Neurodevelopmental outcomes were normal in 28.6%, while 35.7% developed moderate disability and 35.7% severe disability; 3 patients died. We found a statistically significant difference between groups at 48 hours (P = .005) and after hypothermia (P = .03), with higher values in patients with disability. When we compared patients in the severe disability group with the other groups, we found a statistically significant area under the ROC curve at 48 hours of 0.872 (P = .001) applying a regional cerebral oxygen saturation cutoff of 83.5%. After hypothermia, regional cerebral oxygen saturation values below 66.0% (AUC, 0.794; P = .017) predicted normal development, while values above 82% (AUC, 0.881; P = .001) predicted severe disability. Conclusions: NIRS seems to be a valuable tool to predict neurodevelopmental outcomes in patients with hypoxic-ischaemic encephalopathy, even after hypothermia, with higher cerebral oxygen saturation values in patients with disability.

For the first time, the present study unravels a cardiospecific therapeutic approach for Pulmonary Arterial Hypertension (PAH), a disease with a very poor prognosis and high mortality rates due to right ventricle (RV) dysfunction. We first established a new in vitro model of high-pressure-induced hypertrophy that closely resembles heart defects associated with PAH and validated our in vitro findings on a preclinical in vivo model of monocrotaline (MCT)-induced PAH. Our results showed the in vitro antihypertrophic effect of 1,8-cineole, a monoterpene widely found in several essential oils. Also, a decrease in RV hypertrophy and fibrosis, and an improvement in heart function in vivo was observed, when 1,8-cineole was applied topically. Furthermore, 1,8-cineole restored gap junction protein connexin43 distribution at the intercalated disks and mitochondrial functionality, suggesting it may act by preserving cardiac cell-to-cell communication and bioenergetics. Overall, our results point out a promising therapeutic compound that can be easily applied topically, thus paving the way for the development of effective cardiac-specific therapies to greatly improve PAH outcomes.

ABSTRACT To discuss the resilience factors that may have prevented a patient from developing post-traumatic stress disorder (PTSD) after exposure to a variety of severe potentially traumatic events. A thirty-eight-year-old civilian has been exposed to at least ten dramatic situations of violence in his work and personal life. He developed only a few mild post-traumatic symptoms after being exposed to a particularly gruesome incident during work. Even though the number and severity of potentially traumatic events may be alarming, this does not determine that the patient will inexorably develop PTSD, or other disorders. The study of protective factors is mandatory so that we can acknowledge and develop more effective ways to prevent and treat disorders.

The hepatocellular carcinoma, a primary malignancy of the liver, has a very poor prognosis and a lower survival rate. Moreover, the inefficacy of conventional therapies emphasizes the importance of discovering new bioactive compounds. Several studies clearly state that plant-derived polyphenols, namely ellagitannins, have several health benefits. Fragaria vesca leaves contain high amounts of polyphenols, being especially rich in ellagitannins. Therefore, this study aimed to characterize an ellagitannin-enriched fraction (EEF) from F. vesca leaves and to unveil the anticancer potential of this fraction on human hepatocellular carcinoma cells.The analysis of EEF by HPLC-PDA-ESI/MSn allowed the detection of 12 ellagitannins. The cell viability of both EEF and crude extract was determined after 24 h of cells treatment and the half-maximal inhibitory concentration (IC50) was evaluated. The IC50 of the EEF (113 μg/mL) was about 6 times lower than the IC50 of the crude extract (690 μg/mL). Furthermore, EEF induced cell cycle arrest at G2/M checkpoint and decreased cell proliferation in a dose-dependent way. This fraction also induced an accumulation of LC3-II protein through blockage of autophagic flux, and inhibited chymotrypsin-like activity of 26S proteasome. These results showed, for the first time, that EEF from F. vesca leaves inhibits both, autophagic and ubiquitin-proteasome system pathways, two main intracellular protein degradation systems that are targets for anticancer therapies. Additionally, a proteomic analysis allowed the identification of 914 proteins, among which 133 were modulated after cells treatment with EEF, most of them related to metabolic pathways. Overall, this study shows that the EEF from F. vesca leaves decreased cell proliferation, inhibited the proteolytic mechanisms and modulated the metabolic pathways of the cell. Additionally this study points out F. vesca as a source of valuable molecules with anticancer potential, suggesting that ellagitannins, the polyphenols identified in this fraction, could be useful in the development of new fine-tuned therapeutic strategies against carcinogenesis. Keywords: Cancer, HepG2, Proteolytic pathways, Proteome, Cell proliferation, Cell cycle

Abstract Background High resolution genome-wide copy number analysis, routinely used in clinical diagnosis for several years, retrieves new and extremely rare copy number variations (CNVs) that provide novel candidate genes contributing to disease etiology. The aim of this work was to identify novel genetic causes of neurodevelopmental disease, inferred from CNVs detected by array comparative hybridization (aCGH), in a cohort of 325 Portuguese patients with intellectual disability (ID). Results We have detected CNVs in 30.1% of the patients, of which 5.2% corresponded to novel likely pathogenic CNVs. For these 11 rare CNVs (which encompass novel ID candidate genes), we identified those most likely to be relevant, and established genotype-phenotype correlations based on detailed clinical assessment. In the case of duplications, we performed expression analysis to assess the impact of the rearrangement. Interestingly, these novel candidate genes belong to known ID-related pathways. Within the 8% of patients with CNVs in known pathogenic loci, the majority had a clinical presentation fitting the phenotype(s) described in the literature, with a few interesting exceptions that are discussed. Conclusions Identification of such rare CNVs (some of which reported for the first time in ID patients/families) contributes to our understanding of the etiology of ID and for the ever-improving diagnosis of this group of patients.

Pretendemos fazer uma leitura de Contes de la bécasse de Guy de Maupassant que nos permita esboçar a hipótese de que a unidade da obra reside num elogio do acto narrativo. Para tal enumeramos os artifícios narrativos usados pelo autor para conceber o seu trabalho ficcional. O conceito de artifício, entendido como a capacidade técnica ao serviço do exercício narrativo, manifesta-se no “emprego de meios ou processos engenhosos” mais evidentes em alguns dos Contes de la bécasse, tais como: “La bécasse”, “La folle”, “Menuet”, “La peur”, “L’aventure de Walter Schnaffs” (publicados inicialmente no Gil Blas, 1882), “En mer” e “Ce cochon de Morin”.

As alterações dos processos de publicação científica são emergentes para se poder cumprir com as necessidades atuais de gestão de informação, fluxos e diferentes contextos de aplicação que as revistas científicas hoje em dia têm como desafios. Pretende-se com este trabalho apresentar um projeto nacional integrador para promover boas práticas de gestão de publicações científicas, implementar serviços de apoio, formação e metodologias testadas e otimizadas para diminuir o esforço humano e aumentar os níveis de interoperabilidade entre sistemas e ferramentas. Prevê ainda a aplicação de processos inovadores ligados à Ciência Aberta.

In this work, using simple sequence repeat (SSR) markers, we present new insights into the genetic diversity, differentiation, and structure of Beta vulgaris subsp. maritima of western Iberia and the Azores and Madeira islands and of B. macrocarpa from southern Portugal. B. macrocarpa occurs only in southern Portugal and frequently in sympatry with B. vulgaris subsp. maritima, showing genetic introgression. B. macrocarpa has a better-defined structure than B. vulgaris subsp. maritima, which has a high degree of admixture. A great differentiation (FST ranging from 0.277 to 0.184) was observed among the northern populations of B. vulgaris subsp. maritima. In contrast, only a small differentiation (FST ranging from 0.000 to 0.026) was detected among the southern B. vulgaris subsp. maritima populations. The inland B. vulgaris subsp. maritima populations (“RIO” and “VMT”) are distinct from each other, which also occurs with the two islands’ populations (“MAD” and “AZO”). The existence of two distinct Atlantic Sea currents can explain the fact that Madeira is related to the southern populations, while the Azores is related to the northern populations. We consider that understanding the relationships existing within Beta spp. is key to future genetic studies and for the establishment of conservation measures. Our results show that the southern coastal areas of Portugal should be considered as a potential site for in situ conservation of the beet wild relatives. Special attention is needed in what concerns B. macrocarpa because this is a rare species that also occurs in a sympatric relationship with B. vulgaris subsp. maritima.

Introduction and Objectives: Cardiovascular disease is the leading cause of mortality and morbidity associated with diabetes. Although impairment of the cell response to hypoxia due to destabilization of the transcription factor hypoxia-inducible factor-1α (HIF-1α), which regulates the expression of genes that help cells to cope with low oxygen tension, has been implicated in diabetes-associated disease, the molecular mechanisms involved remain elusive. It is known that hyperglycemia leads to the enhanced production of methylglyoxal (MGO). Therefore, the main objective of this study was to establish whether MGO leads to the degradation of HIF-1α in cardiomyocytes subjected to hypoxia. Methods: The mouse atrial cardiomyocyte cell line, HL-1, was exposed to chemical hypoxia with CoCl2 in the absence or presence of MGO. Cell viability was assessed by MTT assay, and levels of HIF-1α and endogenous ubiquitin conjugates were determined by western blotting. Proteasome activity was analyzed using a specific chymotrypsin-like fluorogenic substrate. Results: The results obtained indicate that MGO induces time- and dose-dependent degradation of HIF-1α accumulated under hypoxia. Additionally, we show that accumulation of endogenous ubiquitin conjugates in the presence of MGO is associated with decreased proteasome activity. Conclusion: Taken together, the results obtained in this study suggest that MGO compromises the ability of cells to adapt to low oxygen tensions, by stimulating the degradation of HIF-1α, likely contributing to the development of diabetes-associated cardiac dysfunction. Resumo: Introdução e objetivos: As complicações cardiovasculares constituem a principal causa de morbimortalidade em doentes diabéticos. A destabilização do fator de transcrição induzido pela hipoxia (HIF-1α), que regula a expressão de genes de adaptação celular a condições de baixos níveis de oxigénio, parece comprometer a resposta celular de diversos tecidos à hipoxia, em condições de hiperglicemia. No entanto, os mecanismos moleculares subjacentes à destabilização do HIF-1α estão ainda por estabelecer. Está bem estabelecido que em situações de hiperglicemia ocorre o aumento da produção de metilglioxal (MGO). Assim, o objetivo deste trabalho foi estabelecer o impacto do MGO na degradação do HIF-1α em cardiomiócitos sujeitos a condições de hipoxia. Métodos: Uma linha celular de cardiomiócitos da aurícula de ratos, HL-1, foi sujeita a hipoxia química com CoCl2, na ausência e na presença de MGO. De seguida, avaliou-se a viabilidade celular pelo ensaio de MTT, e determinaram-se os níveis de HIF-1α e de conjugados endógenos de ubiquitina por western blotting. A atividade do proteosoma foi avaliada utilizando um substrato fluorogénico específico do tipo quimotripsina. Resultados: Os resultados obtidos mostram que o MGO induz degradação do HIF-1α em condições de hipoxia de uma forma dependente da dose de MGO utilizada, assim como do tempo de tratamento. Por outro lado, a acumulação de conjugados endógenos de ubiquitina na presença de MGO associa-se a um decréscimo na atividade do proteosoma. Conclusão: No conjunto, os resultados sugerem que o MGO compromete a capacidade de adaptação celular a condições de hipoxia através da degradação do HIF-1α, o que pode contribuir para o desenvolvimento da disfunção cardíaca associada à diabetes. Keywords: Diabetic heart disease, Hypoxia, Hypoxia-inducible factor-1α, Cardiomyocytes, Palavras-chave: Doenças cardiovasculares e diabetes, Hipoxia, HIF-1α, Cardiomiócitos

The contemporary framework includes a set of changes in economic, social and cultural order, shaped by the principle of sustainable development model, as a basis of justice and intergenerational solidarity principles, based on equal opportunities and citizen participation. In this context, the dynamics of education allows assimilate the new social phenomena, linking with cultural rights and citizenship, to achieve the named cultural democracy, for the community development and social cohesion, with the correlative social responsibility of each citizen. The present paper aims to understand the educational process as an essential condition for the realization of cultural rights and citizenship, so we approach the respective connection, with accent on the portuguese constitutional juridical order, based on the human dignity principle, support of the social system, and basis of the fundamental rights and citizenship exercise, which can be achieved in the context of a Democratic Law State.

Objective: Peritraumatic reactions feature prominently among the main predictors for development of posttraumatic stress disorder (PTSD). Peritraumatic tonic immobility (PTI), a less investigated but equally important type of peritraumatic response, has been recently attracting the attention of researchers and clinicians for its close association with traumatic reactions and PTSD. Our objective was to investigate the role of PTI, peritraumatic panic, and dissociation as predictors of PTSD symptoms in a cohort of police recruits (n=132). Methods: Participants were asked to complete the following questionnaires during academy training and after the first year of work: Posttraumatic Stress Disorder Checklist - Civilian Version (PCL-C), Physical Reactions Subscale (PRS), Peritraumatic Dissociative Experiences Questionnaire (PDEQ), Tonic Immobility Scale (TIS), and Critical Incident History Questionnaire. Results: Employing a zero-inflated negative binomial regression model, we found that each additional point in the TIS was associated with a 9% increment in PCL-C mean scores (RM = 1.09), whereas for PRS, the increment was 7% (RM = 1.07). As the severity of peritraumatic dissociation increased one point in the PDEQ, the chance of having at least one symptom in the PCL-C increased 22% (OR = 1.22). Conclusions: Our findings highlight the need to expand investigation on the incidence and impact of PTI on the mental health of police officers.

Background: Congenital heart defects (CHD) are the most prevalent group of structural abnormalities at birth and one of the main causes of infant morbidity and mortality. Studies have shown a contribution of the copy number variation in the genesis of cardiac malformations. Objectives: Investigate gene copy number variation (CNV) in children with conotruncal heart defect. Methods: Multiplex ligation-dependent probe amplification (MLPA) was performed in 39 patients with conotruncal heart defect. Clinical and laboratory assessments were conducted in all patients. The parents of the probands who presented abnormal findings were also investigated. Results: Gene copy number variation was detected in 7/39 patients: 22q11.2 deletion, 22q11.2 duplication, 15q11.2 duplication, 20p12.2 duplication, 19p deletion, 15q and 8p23.2 duplication with 10p12.31 duplication. The clinical characteristics were consistent with those reported in the literature associated with the encountered microdeletion/microduplication. None of these changes was inherited from the parents. Conclusions: Our results demonstrate that the technique of MLPA is useful in the investigation of microdeletions and microduplications in conotruncal congenital heart defects. Early diagnosis of the copy number variation in patients with congenital heart defect assists in the prevention of morbidity and decreased mortality in these patients.

This paper aims firstly to examine the innovation within the cluster of a traditional European wine region (Region of the Douro - Portugal), characterized by the so-called model of terroir in wine, an economic structure supported by a large number of growers, small and medium-sized wineries and high regulation throughout the productive chain, which clearly emerges the question of tradition versus innovation. This research used grounded theory method and the results show that traditional companies remain in a region whose legislation hinders the radical innovations, but at the same time, ensures quality values. There is a transfer of traditional values of a specific product, the port wine, for new products recently launched in the market, and simultaneously a transfer of value-added of the port wine to the value of family ties with the production process and with the land of the Douro Region.

OBJECTIVE: Tonic immobility is a defensive reaction occurring under extreme life threats. Patients with posttraumatic stress disorder (PTSD) reporting peritraumatic tonic immobility show the most severe symptoms and a poorer response to treatment. This study investigated the predictive falue of tonic immobility for posttraumatic stress symptoms in a non-clinical sample. METHODS: One hundred and ninety-eight college students exposed to various life threatening events were selected to participate. The Posttraumatic Stress Disorder Checklist - Civilian Version (PCL-C) and tonic immobility questions were used. Linear regression models were fitted to investigate the association between peritraumatic tonic immobility and PCL-C scores. Peritraumatic dissociation, peritraumatic panic reactions, negative affect, gender, type of trauma, and time since trauma were considered as confounding variables. RESULTS: We found significant association between peritraumatic tonic immobility and PTSD symptoms in a non-clinical sample exposed to various traumas, even after regression controlled for confounding variables (β = 1.99, p = 0.017). CONCLUSIONS: This automatic reaction under extreme life threatening stress, although adaptive for defense, may have pathological consequences as implied by its association with PTSD symptoms.OBJETIVO: A imobilidade tônica é uma resposta defensiva que ocorre sob ameaça extrema à vida. Pacientes com transtorno de estresse pós-traumático (TEPT) que relatam imobilidade tônica peritraumática são os que apresentam os sintomas mais graves e a pior resposta ao tratamento. Este estudo investigou o valor preditivo da imobilidade tônica para os sintomas de TEPT em uma amostra não clínica. MÉTODOS: Os participantes da pesquisa foram 198 estudantes universitários expostos a traumas diversos. A versão brasileira do Post-Traumatic Stress Disorder Checklist Civilian Version (PCL-C) e questões referentes à imobilidade tônica foram empregadas. Modelos de regressão linear foram utilizados para investigar a associação dos sintomas de estresse pós-traumático com a imobilidade tônica peritraumática. Foram consideradas como variáveis de confusão a dissociação peritraumática, as reações físicas de pânico peritraumática, o traço de afeto negativo, o gênero, o tipo de trauma e o tempo de trauma. RESULTADOS: Encontrou-se uma associação significativa entre a imobilidade tônica peritraumática e os sintomas de TEPT em uma amostra não clínica exposta a traumas diversos mesmo quando controlada por variáveis de confusão (β = 1,99; p = 0,017). CONCLUSÕES: Esta reação defensiva que ocorre sob intensa ameaça, apesar de adaptativa para a defesa, pode ter consequências patológicas como sugere sua associação aos sintomas de TEPT.

BACKGROUND: Exposure to traumatic events is a necessary but not a sufficient condition for the development of posttraumatic stress disorder (PTSD). Pretrauma, peritrauma and posttrauma factors interact to impact on symptom severity. The aim of the present study is to determine risk factors for PTSD symptoms in Brazilian police officers. METHOD: In a cross-sectional sample of active duty officers (n = 212), participants were asked to complete a socio-demographic questionnaire and self-report scales on affective traits, cumulative critical incident exposure, peritraumatic distress and dissociation, PTSD symptoms, and social support. Hierarchical linear regression analysis was conducted to examine predictors of PTSD symptoms. RESULTS: Variables related to negative affect, job duration, frequency of critical incident exposure, peritraumatic dissociation, and lack of social support remained significant in the final model and explained 55% of the variance in PTSD symptoms. When interaction terms were evaluated, a synergistic effect between negative affect and peritraumatic dissociation was found. CONCLUSIONS: The risk factors found in this study provide clues on how to elaborate primary prevention strategies regarding PTSD symptoms in police officers. Such initiatives may lessen the impact of repeated exposure to traumatic events on police officers over the course of their careers.INTRODUÇÃO: A exposição a eventos traumáticos é uma condição necessária, porém não única, para o desenvolvimento de transtorno de estresse pós-traumático (TEPT). Fatores individuais pré, peri e pós-trauma exercem impacto sobre a gravidade dos sintomas. O objetivo do presente estudo é determinar os fatores de risco para o desenvolvimento de sintomas de TEPT em policiais brasileiros. MÉTODO: Uma amostra transversal de policiais em atividade (n = 212) foi convidada a responder um questionário sóciodemográfico e escalas autoaplicáveis sobre afeto positivo e negativo, frequência de incidentes críticos, sofrimento e dissociação peritraumáticos, sintomas de TEPT e apoio social. Regressão linear hierárquica foi utilizada para avaliar fatores de risco. RESULTADOS: Afeto negativo, tempo de trabalho, frequência de exposição a eventos traumáticos, dissociação peritraumática e apoio social diminuído permaneceram no modelo final e explicaram 55% das variações dos sintomas de TEPT. Foi observado efeito sinérgico entre dissociação peritraumática e afeto negativo. CONCLUSÃO: Baseados nos achados os autores discutem estratégias de prevenção que visam diminuir o impacto da exposição a eventos traumáticos em policiais ao longo de suas carreiras.

Este artigo visa à discussão da importância das disciplinas propedêuticas no ensino jurídico na pós-modernidade. Para tanto, partimos do pressuposto de que o ensino jurídico atual tem sido fortemente influenciado por uma sociedade cada vez mais complexa. Devido a este fato, o prosaico e ultrapassado método de ensino denominado “bancarismo” já não pode lidar com os desafios que os profissionais recém-formados terão que enfrentar, após o encerramento de seus estudos universitários. Trabalhamos a tese de que o sistema tradicional, duramente criticado por Paulo Freire, por tratar os estudantes como “depósitos” de informação em massa, tem que ser abandonado e substituído por um método de ensino jurídico que possa oferecer aos alunos, não só os dados necessários, mas a capacidade para saber o que o que fazer com os conteúdos adquiridos. Para esse efeito, analisamos o papel desempenhado pelas disciplinas propedêuticas, na conquista do novo paradigma do saber. Fiamos nossa análise tanto em pesquisa bibliográfica, quanto em pesquisa de campo, focada na experiência dos professores universitários que, cotidianamente, ensinam nas áreas pública e privada do Direito.

OBJETIVOS: avaliar a presença de dor durante a fisioterapia respiratória em prematuros submetidos à ventilação mecânica. MÉTODOS: estudo prospectivo realizado entre fevereiro de 2003 e maio de 2004, sendo incluídos prematuros com idade gestacional OBJECTIVES: to assess pain in premature newborns undergoing mechanical ventilation during respiratory physiotherapy. METHODS: prospective study from February 2003 to May 2004, covering premature newborns with a gestational age of

Nas organizações do sector de saúde, a pesquisa sobre liderança e o seu impacto no capital psicológico e na criatividade, em qualquer tipo de contexto organizacional, é quase inexistente. Para reduzir essa lacuna, o objetivo deste texto foi identificar em que medida a percepção de uma liderança autêntica e o capital psicológico influenciam a criatividade dos profissionais de um Centro Hospitalar Português. Os dados relacionados com os conceitos de liderança, capital psicológico e criatividade foram obtidos por meio de um questionário constituído por três partes: capital psicológico positivo; liderança autêntica, e dados demográficos e funcionais, numa amostra de 61 líderes das chefias intermédias dos diversos serviços dos 22 departamentos de Centro Hospitalar, bem como de 183 colaboradores selecionados aleatoriamente pelos líderes. As respostas foram analisadas através da utilização das análises fatoriais e das equações estruturais. Os resultados obtidos confirmaram duas das três hipóteses consideradas no estudo, sugerindo a existência de uma forte relação entre a liderança autêntica e o capital psicológico, e entre este e a criatividade, não sendo explicada diretamente a criatividade pela liderança. Concluiu-se ainda que a liderança e ocapital psicológico têm, nas organizações de saúde, uma forte relação com a criatividade dos seus profissionais

The objective of this research was to analyze the microbiological profile of hen egg shell powder distributed to poor communities as an alternate calcium source, and optimizing powder preparation technique through efficient hygiene and sanitary safety. The sampling was carried out in the distribution units of Pastoral da Criança program of the Catholic Church, in Goiânia municipality, Brazil. Ten egg shell powder samples were collected in the preparation places of product, at different moments during September to December 2001. It was observed that some samples presented considerable levels of aerobic mesophilic, total coliforms (at 35C), and moulds and yeasts, but not contamination with thermotolerant coliforms (at 45C), Staphylococcus aureus, Bacillus cereus, and Salmonella sp. Egg shell powder produced through the standard technique, which included essentially washing egg shells, immersion in chlorinated solution, boiling, drying, and milling process, did not show contamination by microorganisms. It was concluded that the optimized technique assures process efficiency and hygienic and sanitary quality for the product. KEY-WORDS: Calcium; food microbiology; food analysis; food contamination. A pesquisa teve o objetivo de analisar o perfil microbiológico do pó da casca de ovo de galinha distribuído a comunidades carentes, como fonte alternativa de cálcio, bem como otimizar a técnica de elaboração do produto, visando eficácia e segurança em termos higiênico-sanitários. A amostragem foi realizada em unidades de distribuição do programa Pastoral da Criança, da Igreja Católica, em Goiânia-GO, Brasil. Foram coletadas dez amostras do pó da casca de ovo, nos locais de produção e em diferentes momentos, nos meses de setembro a dezembro de 2001. Os resultados revelaram que algumas amostras apresentavam níveis consideráveis de mesófilos aeróbios, coliformes a 35ºC (totais), bolores e leveduras, não havendo, entretanto, contaminação por coliformes a 45ºC (termotolerantes), Staphylococcus aureus, Bacillus cereus e Salmonella sp. O pó da casca de ovo obtido segundo a técnica padronizada neste estudo, que incluiu essencialmente os procedimentos de lavagem das cascas, imersão em solução clorada, fervura, secagem e trituração, não apresentou contaminação por microorganismos. Assim, concluiu-se que a técnica otimizada assegura a eficácia do processamento e a qualidade higiênico-sanitária do produto. PALAVRAS-CHAVE: Cálcio; microbiologia de alimentos; análise.

Neste artigo, apresentamos uma análise dos registros escritos dos alunos do 3° ano do Ensino Fundamental nas aulas de Ciências, em que a professora utilizou as atividades de conhecimento físico, criadas pelo Laboratório de Pesquisa e Ensino de Física da Faculdade de Educação da Universidade de São Paulo. Os registros analisados foram coletados na Escola de Aplicação da Feusp, no ano de 2001, durante o acompanhamento de três aulas de Ciências: o problema do submarino, o problema do barquinho e o problema da pressão. O artigo procura mostrar um panorama de como aparecem os registros realizados pelos alunos, após uma aula de Ciências em que eles são levados a resolver situações problemáticas por meio da experimentação, argumentar e escrever sobre os fenômenos físicos. Durante a análise, levou-se em consideração os tipos de textos que os alunos escrevem, o uso da primeira pessoa, o uso de verbos de ação, o respeito à ordem cronológica dos eventos e quais os tipos de explicações os alunos atribuem aos fenômenos trabalhados.This article analyzed the written records of Third Grade students of Elementary School at Escola de Aplicação, Universidade de São Paulo, gathered during the Science classes of the 2001 school year, in which activities about physical understanding were used. Created by the Laboratory of Research and Teaching of Physics - LAPEF, of the College of Education of USP, the activities "The Problem of the Submarine", "The Problem of the Little Boat" and "The Problem of the Pressure" required the students to solve problematic situations through experimentation, developing arguments and write about the phenomena. The study developed a framework of how the records are presented by the students, considering the types of texts they produce, the use of the first person, the use of verbs of action, the respect of the chronological order of events and the types of explanations the students give for the phenomena used.

OBJECTIVE: To investigate the existence of clinical and therapeutic differences that could possibly characterize specific subgroups of patients with obsessive-compulsive disorder (OCD) based on their gender. METHODS: Male (n=32) and female patients with OCD (n=37) were compared with regard to age and mode of onset, duration and course of the illness, number of obsessions and compulsions, and subtype of OCD according to the International Classification of Diseases, 10th edition. The groups were also compared with regard to scores on the Yale-Brown Obsessive-Compulsive Scale, Clinical Global Impression, Beck Depression Inventory and Global Assessment of Functioning, before and after drug treatment for 10 weeks. Chi-square test with Yates correction or Fisher's exact test were employed for comparisons between categorical variables and Student's t or Mann-Whitney tests were used to compare continuous variables. The adopted level of significance was 5%. RESULTS: Male patients with OCD were characterized by an earlier age of onset and greater global severity. Furthermore, a trend to display greater number of obsessions and compulsions and worse global functioning was found among male patients, whereas a trend to more severe depressive symptoms was observed in female patients. No significant differences between the groups were found with regard to treatment response. CONCLUSIONS: Our findings suggest that there may be OCD subtypes based on gender.

O presente estudo trata, de maneira sucinta, da utilização das técnicas publicitárias no mercado de consumo, capazes de influenciar diretamente na escolha do consumidor através do neuromarketing, da influência televisiva, da mensagem subliminar e da publicidade virtual. A partir da adoção dessas técnicas, o artigo traz para reflexão a relação da responsabilidade civil no âmbito da utilização deste tipo de publicidade, focando no nascimento do dano e conseqüente obrigação de indenizar. Conclui-se desta análise, a importância de se punir e responsabilizar àqueles que, utilizando-se destas técnicas, vilipendiam o direito do consumidor. A metodologia utilizada foi a bibliográfica e documental, utilizando-se de leis, doutrinas, jurisprudências, dados do Supremo Tribunal Federal e entrevistas.

Investigamos o valor preditivo de variáveis da eletrencefalografia quantitativa (EEGq) sobre a resposta ao tratamento farmacológico do transtorno obsessivo-compulsivo (TOC). Foram estudados 10 pacientes com TOC, segundo critérios da DSM-IV, inicialmente não medicados. As seguintes variáveis eletrencefalográficas foram selecionadas: potência relativa bipolar na faixa alfa para os eletrodos Cz-C3, Cz-C4, T3-T5, T4-T6, T3-F7 e T4-F8, potência relativa bipolar na faixa teta para os eletrodos Cz-C3, Cz-C4, T3-T5, T4-T6, T3-F7 e T4-F8 e potência relativa monopolar na faixa teta para os eletrodos Fp1, Fp2, F7, F3, Fz, F4 e F8. Dos 10 pacientes examinados, 5 apresentaram desvios estatisticamente significativos da potência relativa bipolar na faixa alfa em regiões centrais, quando comparados com o banco normativo de dados (grupo controle). Os demais não apresentaram desvios com significado estatístico. O grupo de pacientes com alterações eletrencefalográficas se caracterizou por idade de início do TOC significativamente mais precoce e pior resposta ao tratamento com inibidores da recaptação da serotonina.

Este artigo tem por principal objetivo analisar a problemática da inovação no âmbito do cluster de uma região vitivinícola europeia tradicional (Região Demarcada do Douro – Portugal), caracterizada pelo chamado modelo vitivinícola do terroir, uma estrutura econômica suportada por um elevado número de viticultores, pequenas e médias empresas vinícolas e elevada regulação ao longo de toda a cadeia produtiva, em que, claramente, emerge a questão da tradição versus inovação. A pesquisa utilizou o método Grounded Theory, e os resultados evidenciam uma concordância de as empresas permanecerem numa região tradicional, cuja legislação dificulta as inovações radicais, mas que, concomitantemente, assegura os valores da qualidade. Verifica-se uma transferência de valores tradicionais de um produto específico, o vinho do Porto, para os novos produtos lançados recentemente no mercado; e, simultaneamente, uma transferência do valor agregado do vinho do Porto para o valor do vínculo da família com o processo produtivo e com as terras da Região Demarcada do Douro.

BACKGROUND: Studies addressing posttraumatic stress disorder (PTSD) have demonstrated that PTSD patients exhibit structural abnormalities in brain regions that relate to stress regulation and fear responses, such as the hippocampus, amygdala, anterior cingulate cortex, and ventromedial prefrontal cortex. Premotor cortical areas are involved in preparing to respond to a threatening situation and in representing the peripersonal space. Urban violence is an important and pervasive cause of human suffering, especially in large urban centers in the developing world. Violent events, such as armed robbery, are very frequent in certain cities, and these episodes increase the risk of PTSD. Assaultive trauma is characterized by forceful invasion of the peripersonal space; therefore, could this traumatic event be associated with structural alteration of premotor areas in PTSD? METHODOLOGY/PRINCIPAL FINDINGS: Structural magnetic resonance imaging scans were acquired from a sample of individuals that had been exposed to urban violence. This sample consisted of 16 PTSD patients and 16 age- and gender-matched controls. Psychometric questionnaires differentiated PTSD patients from trauma-exposed controls with regard to PTSD symptoms, affective, and resilience predispositions. Voxel-based morphometric analysis revealed that, compared with controls, the PTSD patients presented significant reductions in gray matter volume in the ventral premotor cortex and in the pregenual anterior cingulate cortex. CONCLUSIONS: Volume reduction in the premotor cortex that is observed in victims of urban violence with PTSD may be associated with a disruption in the dynamical modulation of the safe space around the body. The finding that PTSD patients presented a smaller volume of pregenual anterior cingulate cortex is consistent with the results of other PTSD neuroimaging studies that investigated different types of traumatic events.

The pharmacotherapy for obsessive-compulsive disorder (OCD) has started with clomipramine, a potent non-selective serotonin reuptake inhibitor. Newer drugs that selectively inhibit serotonin reuptake (SSRIs) such as fluvoxamine, fluoxetine, paroxetine, and sertraline are also effective and well-tolerated by OCD patients, even in high doses. Efficacy of venlafaxine and citalopram for OCD are under investigation. Randomized controlled trials of OCD pharmacotherapy, as well as positive results found in open trials and case reports are reviewed in this paper. Potent selective serotonin reuptake inhibitors are the pharmacotherapy of choice for OCD. If one SSRI is ineffective, others may be beneficial. OCD is frequently a chronic condition that requires long-term treatment.

Hypoxia-inducible factor-1 (HIF-1) plays a key role in cell adaptation to low oxygen and stabilization of HIF-1 is vital to ensure cell survival under hypoxia. Diabetes has been associated with impairment of the cell response to hypoxia and downregulation of HIF-1 is most likely the event that transduces hyperglycemia into increased cell death in diabetes-associated hypoxia. In this study, we aimed at identifying the molecular mechanism implicated in destabilization of HIF-1 by high glucose. In this work, we identified a new molecular mechanism whereby methylglyoxal (MGO), which accumulates in high-glucose conditions, led to a rapid proteasome-dependent degradation of HIF-1α under hypoxia. Significantly, MGO-induced degradation of HIF-1α did not require the recruitment of the ubiquitin ligase pVHL nor did it require hydroxylation of the proline residues P402/P564 of HIF-1α. Moreover, we identified CHIP (Carboxy terminus of Hsp70-Interacting Protein) as the E3 ligase that ubiquitinated HIF-1α in the presence of MGO. Consistently, silencing of endogenous CHIP and overexpression of glyoxalase I both stabilized HIF-1α under hypoxia in the presence of MGO. Data shows that increased association of Hsp40/70 with HIF-1α led to recruitment of CHIP, which promoted polyubiquitination and degradation of HIF-1α. Moreover, MGO-induced destabilization of HIF-1α led to a dramatic decrease in HIF-1 transcriptional activity. Altogether, data is consistent with a new pathway for degradation of HIF-1α in response to intracellular accumulation of MGO. Moreover, we suggest that accumulation of MGO is likely to be the link between high glucose and the loss of cell response to hypoxia in diabetes.

A busca por um mundo ecologicamente sustentável, uma das bandeiras dos movimentos contraculturais dos anos 60, converteu-se, em algumas décadas, em assunto público emergencial e onipresente. A preocupação geral com a sobrevivência do planeta percorre diariamente o noticiário jornalístico, a produção audiovisual, a publicidade de corporações e marcas, a comunicação estatal e a propaganda política. Especulações e alertas sobre o “colapso da natureza” ocupam significativa parcela dos debates políticos atuais no país e no mundo. Para os ideólogos do movimento verde, o tema está acima dos campos políticos e das classes sociais, pois desequilíbrios ambientais atingiriam democraticamente toda a humanidade. De acordo com manifesto do Partido Verde brasileiro (1986), “a grande diferença da proposta Verde é que não procura dividir o mundo nem explorados e exploradores, porque estamos todos no mesmo barco. Nem à direita nem à esquerda, o Partido Verde deve estar à frente de capitalistas e comunistas”. O pressuposto da neutralidade da causa ambiental permitiria sua adaptação a qualquer sistema econômico – inclusive ao capitalismo.

OBJETIVOS: Nesta revisão narrativa, o objetivo foi descrever as opções farmacológicas para o tratamento do transtorno de estresse pós-traumático nos casos de intolerância, resistência, refratariedade ou impossibilidade de utilizar antidepressivos, especialmente inibidores seletivos da recaptação da serotonina. MÉTODO: Consulta às bases de dados ISI Web of Science e PubMed em busca de estudos originais sobre o tratamento farmacológico do transtorno de estresse pós-traumático em diferentes cenários clínicos. RESULTADOS: Evidências preliminares apontam para a utilidade de drogas como a risperidona, a olanzapina, a lamotrigina e o prazosin como estratégias para o cenário clínico em tela. A escolha do medicamento de segunda linha deve levar em conta não só os sintomas, como também as comorbidades, os tratamentos prévios, as interações farmacológicas, os efeitos colaterais e as condições físicas do paciente. CONCLUSÕES: Futuros ensaios clínicos randomizados ainda são necessários para estabelecer com clareza alternativas farmacológicas aos antidepressivos para o tratamento do transtorno de estresse pós-traumático.OBJECTIVES: In this narrative review, we aimed to describe different pharmacological strategies for the treatment of patients with post-traumatic stress disorder who display different levels of intolerance, resistance, refractoriness, or who are unable to take to antidepressants, especially serotonin reuptake inhibitors. METHOD: We searched the ISI web of science and the PubMed for original studies focusing in the treatment of PTSD in different clinical scenarios. RESULTS: Preliminary evidence pointed towards the efficacy of drugs such as risperidone, olanzapine, lamotrigine and prazosin as strategies to be employed in the above mentioned clinical scenarios. The choice of a specific "second line" drug should take into account not only symptoms, but also pattern of comorbidities, previous response to other treatments, pharmacological interactions, side-effects, and patient's physical conditions. CONCLUSIONS: Future randomized controlled trials should be performed in order to unveil which drugs should be prescribed in the absence of adequate treatment and response to serotonin reuptake inhibitors.