An Update on Breast Cancer Multigene Prognostic Tests—Emergent Clinical Biomarkers

Multigene signatures generate crucial prognostic information particularly useful for cancer patients where clinical parameters and traditional immunohistochemical markers alone lead to equivocal prognosis. Clinicians are now provided with molecular tools that assist in the outline of adjuvant therapies, namely helping decide on the extension of adjuvant endocrine therapy or on suppressing adjuvant chemotherapy in patients were toxic effects are particularly deleterious or when this treatment is fundamentally not needed. The importance of cancer multigene prognostic signatures is well elucidated in the guidelines for adjuvant systemic therapy in early-stage breast cancer and the guidelines on disease staging that are progressively integrating gene expression assays as classification biomarkers. In addition to the predictive and prognostic value, some genetic tests provide intrinsic subtyping classification. Herewith, we compare the molecular tests OncotypeDX, MammaPrint, Prosigna, EndoPredict, Breast Cancer Index, Mammostrat, and IHC4 and report the eligibility of each one in the suitable setting. Through to now, there is not a commercially available multigene test that makes recommendations regarding adjuvant treatment for HER-2 and triple negative breast cancers. Thus, these patients still receive adjuvant chemotherapy. Importantly, triple negative carcinomas are very heterogeneous regarding prognosis and new molecular signatures that decipher this very heterogeneous subgroup of breast cancer may improve the clinical management of the disease

A importância da Br-153 para a logística e distribuição da produção do Estado do Tocantins.

In the study of logistics, it is possible to identify how significant and essential the distribution stage is, whose objective is to make the product or service available in the places where they are needed and at the moment they are wanted. Based on the interest in the distribution logistics process directed to the northern region, this work aims to analyze the relevance of the BR-153 for the distribution logistics of the Tocantinense production. Through bibliographic research, the work resorted to the reading of published works related to the theme, published and evaluated by peers, available in written and electronic media. The present study made it possible to observe how important the logistical process is for the development of society, especially in Tocantins, where the BR-153 plays a significant role in this process, being the main highway in the State of Tocantins and one of the main ones in the country. It was possible to verify the state of conservation in which the BR-153 highway is, being classified as "good" in its general aspect. Finally, Tocantins has its own characteristics and great potential to become a national distribution hub due to its location in a central logistics corridor in the country and the multiple modes available in the state, which are in full expansion.No estudo da logística é possível identificar o quão significativo e essencial é a etapa de distribuição, cujo objetivo é disponibilizar o produto ou serviço nos locais onde são necessários e no instante em que são desejados. Partindo do interesse no processo logístico de distribuição direcionado para a região norte, este trabalho tem por objetivo analisar a relevância da BR-153 para a logística de distribuição da produção Tocantinense. Por meio de uma pesquisa bibliográfica, o trabalho recorreu à leitura de obras publicadas referentes ao tema, publicadas e avaliada por pares, disponíveis em meios escritos e eletrônicos. O presente estudo tornou possível observar o quão importante é o processo logístico para o desenvolvimento da sociedade, em especial a tocantinense, onde a BR-153 atua de forma significativa neste processo, sendo ela a principal rodovia do Estado do Tocantins e uma das principais do país. Foi possível constatar o estado de conservação em que a rodovia BR-153 se encontra, sendo classificada como “boa” em seu aspecto geral. Por fim, o Tocantins apresenta características próprias e um grande potencial para tornar-se um polo nacional de distribuição devido à sua localização em um corredor logístico central do país e os múltiplos modais disponíveis no estado, e em plena expansão

Os Media e a discussão polarizada pela Regionalização: análise à cobertura jornalística da campanha do referendo à criação de regiões administrativas em 1998

A regionalização é um dos temas quentes da política portuguesa desde que entrou em vigor a Constituição da República Portuguesa de 1976. A divisão do país em regiões administrativas tem gerado uma discussão polarizada entre quem diz ser a solução para os graves problemas de coesão territorial de Portugal e quem acredita que esta reforma irá trazer apenas mais corrupção para dentro do sistema público. No referendo realizado em 1998, o «Não» às regiões prevaleceu, mas com uma taxa de abstenção superior a 50%, que representa bem um fracasso da informação veiculada. Este resultado não se pode ver desligado daquilo que foi a campanha eleitoral, assim como a cobertura jornalística. Num tempo em que a regionalização voltou à agenda política, este artigo regressa ao passado e analisa a cobertura jornalística da campanha eleitoral do referendo de 1998, focando-se nos principais jornais portugueses à data. O agenda setting e o framing que cada órgão de comunicação conferiu às notícias que veiculou são descritos como essenciais para a construção da opinião das massas. Desta feita, o artigo argumenta a importância destes conceitos e reflete sobre os erros do jornalismo no acompanhamento do referendo de '98 e a politização da regionalização, descurando-se a reforma administrativa em si mesma.Regionalization has been one of the hot topics in Portuguese politics since the 1976 Constitution of the Portuguese Republic approval. The country's division into administrative regions has generated a polarized discussion among those who claim to be the solution to Portugal's serious territorial cohesion issues and who believes that this reform will only bring more corruption into the public system. In the referendum held in 1998, the "No" to the regions prevailed, but with an abstention rate of over 50%, which represents a failure of the information. This result cannot be seen apart from the electoral campaign, as well as the journalistic coverage. This article analyzes that, focusing on the main Portuguese newspapers at the time. The agenda setting and framing that each media organization gave to the news they publish are described as essential for building the opinion of the masses. The article argues the importance of these concepts and reflects on the errors of journalism in following the '98 referendum and the politicization of regionalization, neglecting the administrative reform itself

Smartsuit Design

A sociedade contemporânea vive rodeada de artefactos e serviços cada vez mais diversificados. Nesta corrente, o design mergulha na era dos têxteis inteligentes e na incorporação desta tecnologia no desenvolvimento de novos produtos. Se, por um lado, este novo tipo de têxteis pode satisfazer uma necessidade prática, por outro, poderá tornar-se uma expressão de identidade cultural. Esta mudança no têxtil é alcançada através de novos materiais, tecnologias e abordagens multidisciplinares. A introdução de tecnologias de computação em estruturas têxteis oferece uma oportunidade para o desenvolvimento de produtos têxteis com novos comportamentos e funcionalidades. Através do projeto aqui apresentado, pretende-se inovar e desenvolver produtos têxteis inteligentes. Após pesquisa sistemática foi selecionada uma área de intervenção tecnológica – a medida da atividade cardíaca, conjugada com uma atividade desportiva, o ciclismo. Este documento descreve o processo de design e desenvolvimento de um skinsuit para ciclismo, com elétrodos embebidos para a monitorização da frequência cardíaca e desempenho físico – de forma prática e discreta. Os elétrodos foram produzidos e testados, utilizando diferentes materiais e técnicas têxteis. A medição do sinal é feita através do dispositivo BBB - Bluetooth 4.0 (Y8YBH20) e os testes de desempenho foram realizados pelo aplicativo móvel BBB - Bikeboard. Como resultado, foi obtido um skinsuit com design contemporâneo.Contemporary society lives surrounded by increasingly diverse artefacts and services. In this chain, design plunges into the era of smart textiles and the incorporation of this technology in the development of new products. Whilst on one hand, this new type of textiles can satisfy a practical need; on the other hand, it can become an expression of cultural identity. This change in the textile is achieved through new materials, technologies and multidisciplinary approaches. The introduction of computing technologies into textile structures offers an opportunity for the development of textile products with new behaviours and functionalities. Through the project presented here, we intend to innovate and develop smart textile products. After systematic research, an area of technological intervention was selected - the measurement of cardiac activity, coupled with a sporting activity, cycling. This document describes the design and development process of a skinsuit for cycling, with embedded electrodes for monitoring heart rate and physical performance - practically and discreetly. The electrodes were produced and tested using different materials and textile techniques. Through the BBB - Bluetooth 4.0 device (Y8YBH20) signal measurement is done, and the BBB - Bikeboard mobile application was used for performance tests. As a result, a skinsuit with a contemporary design was obtained.Suportado pelo Programa Operacional Regional do Norte, nos termos do Aviso de Abertura de Candidatura n.o NORTE-45-2015-02 – Sistema de Apoio à Investigação Científica e Tecnológica – “Projetos Estruturados de I&D&I”, enquadrado na Unidade de Investigação IPC/i3N. Este livro foi desenvolvido no âmbito do projeto – TSSiPRO - Technologies for Sustainable and Smart Innovative Products, código da operação NORTE-01-0145-FEDER-000015

Experimental Study of Two Impinging Jets Aligned With a Crossflow

Laser Doppler measurements provide information on the flowfield created by twin impinging jets aligned with a low velocity crossflow. The experiments were carried out for a Reynolds number based on the jet exit conditions of Rej = 4.3 × 104, an impingement height of 20.1 jet diameters and for a velocity ratio between the jet exit and the crossflow VR = Vj/Uo of 22.5, and an inter-jet spacing of S = 6D. The results show a large penetration of the first (upstream) jet that is deflected by the crossflow and impinges on the ground, giving rise to a ground vortex due to the collision of the radial wall and the crossflow that wraps around the impinging point like a scarf. The second jet (located downstream) is not so affected by the crossflow in terms of deflection, but due to the downstream wall jet that flows radially from the impinging point of the first jet it does not reach the ground. The results indicate a new flow pattern not yet reported so far, that is most relevant for a VSTOL aircraft operating in ground vicinity with front wind or small forward movement may result in enhanced under pressures in the aft part of the aircraft causing a suction down force and a change of the pitching moment towards the ground.Fundação para a Ciência e a Tecnologiainfo:eu-repo/semantics/publishedVersio

An evaluation of the professional, social and demographic profile and quality of life of physicians working at the Prehospital Emergency Medical System (SAMU) in Brazil

OBJECTIVE: To describe the profile of physicians working at the Prehospital Emergency Medical System (SAMU) in Brazil and to evaluate their quality of life.METHODS: Both a semi-structured questionnaire with 57 questions and the SF-36 questionnaire were sent to research departments within SAMU in the Brazilian state capitals, the Federal District and inland towns in Brazil.RESULTS: Of a total of 902 physicians, including 644 (71.4%) males, 533 (59.1%) were between 30 and 45 years of age and 562 (62.4%) worked in a state capital. Regarding education level, 45.1% had graduated less than five years before and only 43% were specialists recognized by the Brazilian Medical Association. Regarding training, 95% did not report any specific training for their work at SAMU. The main weaknesses identified were psychiatric care and surgical emergencies in 57.2 and 42.9% of cases, respectively; traumatic pediatric emergencies, 48.9%; and medical emergencies, 42.9%. As for procedure-related skills, the physicians reported difficulties in pediatric advanced support (62.4%), airway surgical access (45.6%), pericardiocentesis (64.4%) and thoracentesis (29.9%). Difficulties in using an artificial ventilator (43.3%) and in transcutaneous pacing (42.2%) were also reported. Higher percentages of young physicians, aged 25-30 years (26.7 vs 19.0%; p48 h per week (12.8 vs 8.6%; p<0.001), and were non-specialists with the shortest length of service (<1 year) at SAMU (30.1 vs 18.2%; p<0.001) who were hired without having to pass public service exams* (i.e., for a temporary job) (61.8 vs 46.2%; p<0.001). Regarding quality of life, the pain domain yielded the worst result among physicians at SAMU.CONCLUSIONS: The doctors in this sample were young and within a few years of graduation, and they had no specific training in prehospital emergencies. Deficiencies were mostly found in pediatrics and psychiatry, with specific deficiencies in the handling of essential equipment and in the skills necessary to adequately attend to prehospital emergencies. A disrespectful labor scenario was also found; the evaluation of quality of life showed a notable presence of pain on the SF-36 among physicians at SAMU and especially among doctors who had worked for a longer length of time at SAMU.Universidade Federal de São Paulo (UNIFESP) Escola Paulista de Medicina (UNIFESP/EPM) Departamento de CirurgiaFaculdade de Medicina de São José do Rio Preto Departamento de CirurgiaDuke University School of Medicine Division of CardiologyUNIFESP, EPM, (UNIFESP/EPM) Depto. de CirurgiaSciEL

Analysis of anthropometric and physical performance variables in U-17 soccer players

Soccer is considered a multifaceted collective sport, and to reach an elevated level, players must have moderate to high power, good agility, joint flexibility and muscle development. Also, players must be able to generate high torques during fast movements, which implies the development of different capacities, understood as multifactorial preparation. The objective was to analyse the effects of training (aerobic and continuous) on the leg power, fatigue levels, speed, agility, body fat, muscle mass and bone mass of these players. Methods. Seventy-two soccer players, male and under 17, from 4 teams that participated. The teams performed 3 times a week training sessions of about 60 to 90 minutes each. Informed consent requests were given to their parents for authorisation to participate in this investigation. Data was collected in two different time points, about ten months apart. Specific tests were performed for each variable: the vertical jump with Bosco System for leg power, the T-Test for agility, the linear sprint test for speed and the RAST test for fatigue levels. A precision Tanita scale was used for the anthropometric tests such as body fat, muscle mass and bone mass. Statistical procedures were applied through the Wilcoxon test to compare the two time points of evaluation. Conclusions: the implemented training improved all the analysed variables with significant statistical values for leg power, speed, bone mass, muscle mass and fat mass.info:eu-repo/semantics/publishedVersio

Saúde bucal de idosos: rastreio de lesões dos tecidos moles na prevenção do câncer bucal

Objective: To detect oral soft tissue injuries in older people. Method: A quantitative analytical cross-sectional study conducted in Fortaleza, Ceará. Individual interviews addressed age, gender, marital status, income, and education. The community oral health indicator was used to detect oral soft tissue injuries and their location. Results: Most of the 821 participants aged 60-100 years were women (580; 70.6%), attended school for up to 5 years (401; 48.8%), were illiterate (201; 24.5%), were retired (608; 74.1%), and received up to 2 wages (701; 85.4%). A total of 604 participants (73.6%) wore dentures. Injuries included red patches (152; 55.9%), blisters (58; 21.3%), lesions and/ or wounds (39; 14.3%), and white patches (30; 11%). Locations of injuries were the roof of the mouth (167; 61.4%), gums (62; 22.8%), cheeks (39; 14.3%), tongue (15; 5.5%), lips (15; 5.5%), and the floor of the mouth (12; 4.4%). Injuries were associated with age (p&lt;0.001), retirement (p=0.005), education (p=0.010), dentures (p&lt;0.001) and red patches (p&lt;0.001). Conclusion: Tracking soft tissue injuries and referring older adults with suspected malignant lesions to the health team should be included as oral cancer identification and prevention measures. Furthermore, health care providers should raise older adults’ awareness of the importance of regular preventive examinations

Crescent-like lesions as an early signature of nephropathy in a rat model of prediabetes induced by a hypercaloric diet

Diabetic nephropathy (DN) is a major microvascular complication of diabetes. Obesity and hyperlipidemia, fueled by unhealthy food habits, are risk factors to glomerular filtration rate (GFR) decline and DN progression. Several studies recommend that diabetic patients should be screened early (in prediabetes) for kidney disease, in order to prevent advanced stages, for whom the current interventions are clearly inefficient. This ambition greatly depends on the existence of accurate early biomarkers and novel molecular targets, which only may arise with a more thorough knowledge of disease pathophysiology. We used a rat model of prediabetes induced by 23 weeks of high-sugar/high-fat (HSuHF) diet to characterize the phenotype of early renal dysfunction and injury. When compared with the control animals, HSuHF-treated rats displayed a metabolic phenotype compatible with obese prediabetes, displaying impaired glucose tolerance and insulin sensitivity, along with hypertriglyceridemia, and lipid peroxidation. Despite unchanged creatinine levels, the prediabetic animals presented glomerular crescent-like lesions, accompanied by increased kidney Oil-Red-O staining, triglycerides content and mRNA expression of IL-6 and iNOS. This model of HSuHF-induced prediabetes can be a useful tool to study early features of DN, namely crescent-like lesions, an early signature that deserves in-depth elucidation.info:eu-repo/semantics/publishedVersio