PROMOÇÃO DA AUTORREGULAÇÃO DA APRENDIZAGEM DAS CRIANÇAS: PROPOSTA DE INSTRUMENTO DE APOIO À PRÁTICA PEDAGÓGICA

After previous study which analyzed the prospects of researchers, early childhood educators and teachers of the 1st cycle of basic education in order to study support strategies that provide real opportunities and essential to the development of self-regulatory skills in children from 5 to 7 years, presents a drawing of an investigation that seeks to justify the need to promote reflection on the pedagogical practice, ensuring educational continuity for the early promotion of self-regulation skills of learning. It is proposed to teachers and student-trainees using the Checklist of Independent Learning Development (CHILD) and, through the analysis of their narratives, we intend to investigate the potential of this instrument in reflection, identification and evaluation of educational approaches of the participants to the fit the needs of school transition and development of self-regulatory processes.http://dx.doi.org/10.14572/nuances.v25i3.3163Después de un estudio anterior que analizó las perspectivas de los investigadores, educadores de la primera infancia y profesores del 1º ciclo de educación básica con el fin de estudiar las estrategias de apoyo que ofrecen oportunidades reales y esenciales para el desarrollo de habilidades de autorregulación en niños de 5 a 7 años , presenta un dibujo de una investigación que pretende justificar la necesidad de promover la reflexión sobre la práctica pedagógica, asegurando la continuidad educativa para la promoción temprana de habilidades de autorregulación del aprendizaje. Se propone a los profesores y estudiantes-aprendices utilizando la Lista de Verificación de Desarrollo de Aprendizaje Independiente (CHILD) y, a través del análisis de sus narraciones, tenemos la intención de investigar el potencial de este instrumento en la reflexión, la identificación y evaluación de los enfoques educativos de los participantes en la adaptarse a las necesidades de la transición de la escuela y el desarrollo de los procesos de autorregulación.http://dx.doi.org/10.14572/nuances.v25i3.3163Após estudo prévio em que se analisaram as perspetivas de investigadores, educadores de infância e professores do 1º ciclo do ensino básico com o objetivo de estudar estratégias de suporte que proporcionem oportunidades efetivas e essenciais ao desenvolvimento de competências de autorregulação nas crianças dos 5 aos 7 anos, apresenta-se um desenho de uma investigação em que se procura fundamentar a necessidade de promover a reflexão sobre a prática pedagógica, assegurando a continuidade educativa, com vista à promoção precoce de competências de autorregulação da aprendizagem. Propõe-se a docentes e alunos-estagiários que utilizem a Checklist of Independent Learning Development (CHILD) e, através da análise das suas narrativas, pretendemos apurar as potencialidades desse instrumento na reflexão, identificação e avaliação das abordagens educativas dos participantes a fim de as ajustarem às necessidades das crianças em transição escolar e ao desenvolvimento de processos autorregulatórios.http://dx.doi.org/10.14572/nuances.v25i3.316

Prognostic value of MGMT promoter methylation in glioblastoma patients treated with temozolomide-based chemoradiation : a Portuguese multicentre study

Glioblastoma (GBM) is the most common and aggressive primary brain tumor. The identification of novel molecular prognostic markers of GBM has recently been an area of great interest in neuro-oncology. The methylation status of the MGMT gene promoter is currently a promising molecular prognostic marker, but some controversial data have precluded its clinical use. We analyzed MGMT methylation by methylation-specific PCR in 90 GBM patients from four Portuguese hospitals, uniformly treated with radiotherapy combined with concomitant and adjuvant temozolomide (Stupp protocol). The Kaplan-Meier method was used to construct survival curves, and the log-rank test and a Cox-regression model were used to analyze patient survival. The methylation status of MGMT was successfully determined in 89% (80/90) of the tumors. The frequency of tumoral MGMT promoter methylation was 47.5%. The median overall survivals (OSs) were 16 months (95% CI 12.2-19.8) and 13 months (95% CI 13.3-18.7) for patients whose tumors had a methylated or unmethylated MGMT, respectively. Univariate and multivariate analyses did not show any statistically significant association between MGMT methylation status and patient OS (P=0.583 by the log-rank test; P=0.617 by the Cox-regression test) or progression-free survival (P=0.775 by the log-rank test; P=0.691 by the Cox-regression test). None of the patient clinical features were significantly correlated with survival. This is the first study to report the frequency of MGMT methylation among Portuguese GBM patients. Our data did not show statistically significant associations between MGMT promoter methylation and the outcome of GBM patients treated with temozolomide. Additional robust prospective studies are warranted to clarify whether the MGMT status should be used in clinical decisions.This project was sponsored, in part, by Schering-Ploug Farma (Portugal). B.M.C. and O.M. are recipients of fellowships from the Portuguese Science and Technology Foundation (SFRH/BPD/33612/2009 and SFRH/BD/36463/ 2007). The funding institutions had no role in the study design, data collection and analysis, interpretation of the results, the preparation of the manuscript, or the decision to submit the manuscript for publication

CARACTERÍSTICAS FÍSICAS E MICROBIOLÓGICAS DO CENTRO TENDÍNEO DIAFRAGMÁTICO BOVINO CONSERVADO EM GLICERINA A 98% E NO GLUTARALDEÍDO A 4%

Realizaram-se testes físicos de tração e alongamento até ruptura em dez tiras com 5 a 6 mm de largura, do exemplar in natura e dos respectivos exemplares conservados em glicerina a 98% e glutaraldeído a 4% por 30 dias para a avaliação da influência de ambos os conservantes sobre o tecido biológico, com vistas ao aproveitamento em cirurgias reparadoras. Paralelamente, avaliou-se a atividade anti-séptica dos conservantes, por meio de exames microbiológicos de fragmentos colhidos do material in natura e dos respectivos exemplares submetidos à conservação. Os testes físicos mostraram que sete amostras conservadas em glutaraldeído a 4% suportaram maior força de tensão, quando comparadas com os respectivos exemplares in natura e conservados em glicerina a 98%. Duas amostras apresentaram comportamento semelhante quanto ao ponto de rompimento, para ambos os conservantes. Apenas em uma amostra verificou-se que o material in natura apresentou um ponto de rompimento superior às amostras conservadas. Observou-se crescimento bacteriano apenas em quatro amostras no material in natura. Os mesmos exames realizados em amostras conservadas não revelaram nenhum crescimento. Conclui-se que tanto a glicerina a 98%quanto o glutaraldeído a 4% demonstraram ser eficientes na conservação do material, bem como na atividade bactericida durante o período de 30 dias

Downregulation of RKIP Is Associated with Poor Outcome and Malignant Progression in Gliomas

Malignant gliomas are highly infiltrative and invasive tumors, which precludes the few treatment options available. Therefore, there is an urgent need to elucidate the molecular mechanisms underlying gliomas aggressive phenotype and poor prognosis. The Raf Kinase Inhibitory protein (RKIP), besides regulating important intracellular signaling cascades, was described to be associated with progression, metastasis and prognosis in several human neoplasms. Its role in the prognosis and tumourigenesis of gliomas remains unclear

Rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART): study protocol for a randomized controlled trial

BACKGROUND: Acute respiratory distress syndrome (ARDS) is associated with high in-hospital mortality. Alveolar recruitment followed by ventilation at optimal titrated PEEP may reduce ventilator-induced lung injury and improve oxygenation in patients with ARDS, but the effects on mortality and other clinical outcomes remain unknown. This article reports the rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART). METHODS/DESIGN: ART is a pragmatic, multicenter, randomized (concealed), controlled trial, which aims to determine if maximum stepwise alveolar recruitment associated with PEEP titration is able to increase 28-day survival in patients with ARDS compared to conventional treatment (ARDSNet strategy). We will enroll adult patients with ARDS of less than 72 h duration. The intervention group will receive an alveolar recruitment maneuver, with stepwise increases of PEEP achieving 45 cmH2O and peak pressure of 60 cmH2O, followed by ventilation with optimal PEEP titrated according to the static compliance of the respiratory system. In the control group, mechanical ventilation will follow a conventional protocol (ARDSNet). In both groups, we will use controlled volume mode with low tidal volumes (4 to 6 mL/kg of predicted body weight) and targeting plateau pressure 6430 cmH2O. The primary outcome is 28-day survival, and the secondary outcomes are: length of ICU stay; length of hospital stay; pneumothorax requiring chest tube during first 7 days; barotrauma during first 7 days; mechanical ventilation-free days from days 1 to 28; ICU, in-hospital, and 6-month survival. ART is an event-guided trial planned to last until 520 events (deaths within 28 days) are observed. These events allow detection of a hazard ratio of 0.75, with 90% power and two-tailed type I error of 5%. All analysis will follow the intention-to-treat principle. DISCUSSION: If the ART strategy with maximum recruitment and PEEP titration improves 28-day survival, this will represent a notable advance to the care of ARDS patients. Conversely, if the ART strategy is similar or inferior to the current evidence-based strategy (ARDSNet), this should also change current practice as many institutions routinely employ recruitment maneuvers and set PEEP levels according to some titration metho

Rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART): Study protocol for a randomized controlled trial

Background: Acute respiratory distress syndrome (ARDS) is associated with high in-hospital mortality. Alveolar recruitment followed by ventilation at optimal titrated PEEP may reduce ventilator-induced lung injury and improve oxygenation in patients with ARDS, but the effects on mortality and other clinical outcomes remain unknown. This article reports the rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART). Methods/Design: ART is a pragmatic, multicenter, randomized (concealed), controlled trial, which aims to determine if maximum stepwise alveolar recruitment associated with PEEP titration is able to increase 28-day survival in patients with ARDS compared to conventional treatment (ARDSNet strategy). We will enroll adult patients with ARDS of less than 72 h duration. The intervention group will receive an alveolar recruitment maneuver, with stepwise increases of PEEP achieving 45 cmH(2)O and peak pressure of 60 cmH2O, followed by ventilation with optimal PEEP titrated according to the static compliance of the respiratory system. In the control group, mechanical ventilation will follow a conventional protocol (ARDSNet). In both groups, we will use controlled volume mode with low tidal volumes (4 to 6 mL/kg of predicted body weight) and targeting plateau pressure <= 30 cmH2O. The primary outcome is 28-day survival, and the secondary outcomes are: length of ICU stay; length of hospital stay; pneumothorax requiring chest tube during first 7 days; barotrauma during first 7 days; mechanical ventilation-free days from days 1 to 28; ICU, in-hospital, and 6-month survival. ART is an event-guided trial planned to last until 520 events (deaths within 28 days) are observed. These events allow detection of a hazard ratio of 0.75, with 90% power and two-tailed type I error of 5%. All analysis will follow the intention-to-treat principle. Discussion: If the ART strategy with maximum recruitment and PEEP titration improves 28-day survival, this will represent a notable advance to the care of ARDS patients. Conversely, if the ART strategy is similar or inferior to the current evidence-based strategy (ARDSNet), this should also change current practice as many institutions routinely employ recruitment maneuvers and set PEEP levels according to some titration method.Hospital do Coracao (HCor) as part of the Program 'Hospitais de Excelencia a Servico do SUS (PROADI-SUS)'Brazilian Ministry of Healt

PROMOÇÃO DA AUTORREGULAÇÃO DA APRENDIZAGEM DAS CRIANÇAS: PROPOSTA DE INSTRUMENTO DE APOIO À PRÁTICA PEDAGÓGICA

After previous study which analyzed the prospects of researchers, early childhood educators and teachers of the 1st cycle of basic education in order to study support strategies that provide real opportunities and essential to the development of self-regulatory skills in children from 5 to 7 years, presents a drawing of an investigation that seeks to justify the need to promote reflection on the pedagogical practice, ensuring educational continuity for the early promotion of self-regulation skills of learning. It is proposed to teachers and student-trainees using the Checklist of Independent Learning Development (CHILD) and, through the analysis of their narratives, we intend to investigate the potential of this instrument in reflection, identification and evaluation of educational approaches of the participants to the fit the needs of school transition and development of self-regulatory processes.http://dx.doi.org/10.14572/nuances.v25i3.3163Después de un estudio anterior que analizó las perspectivas de los investigadores, educadores de la primera infancia y profesores del 1º ciclo de educación básica con el fin de estudiar las estrategias de apoyo que ofrecen oportunidades reales y esenciales para el desarrollo de habilidades de autorregulación en niños de 5 a 7 años , presenta un dibujo de una investigación que pretende justificar la necesidad de promover la reflexión sobre la práctica pedagógica, asegurando la continuidad educativa para la promoción temprana de habilidades de autorregulación del aprendizaje. Se propone a los profesores y estudiantes-aprendices utilizando la Lista de Verificación de Desarrollo de Aprendizaje Independiente (CHILD) y, a través del análisis de sus narraciones, tenemos la intención de investigar el potencial de este instrumento en la reflexión, la identificación y evaluación de los enfoques educativos de los participantes en la adaptarse a las necesidades de la transición de la escuela y el desarrollo de los procesos de autorregulación.http://dx.doi.org/10.14572/nuances.v25i3.3163Após estudo prévio em que se analisaram as perspetivas de investigadores, educadores de infância e professores do 1º ciclo do ensino básico com o objetivo de estudar estratégias de suporte que proporcionem oportunidades efetivas e essenciais ao desenvolvimento de competências de autorregulação nas crianças dos 5 aos 7 anos, apresenta-se um desenho de uma investigação em que se procura fundamentar a necessidade de promover a reflexão sobre a prática pedagógica, assegurando a continuidade educativa, com vista à promoção precoce de competências de autorregulação da aprendizagem. Propõe-se a docentes e alunos-estagiários que utilizem a Checklist of Independent Learning Development (CHILD) e, através da análise das suas narrativas, pretendemos apurar as potencialidades desse instrumento na reflexão, identificação e avaliação das abordagens educativas dos participantes a fim de as ajustarem às necessidades das crianças em transição escolar e ao desenvolvimento de processos autorregulatórios.http://dx.doi.org/10.14572/nuances.v25i3.316