Influence of anodal transcranial direct current stimulation combined with cognitive training on visuospatial episodic memory in healthy young adults, healthy elderly adults and patients with Mild Cognitive Impairment

Background: Object-location memory (OLM) plays an essential role in orientation in the environment and is of high relevance for functioning of daily life. However, this function declines early in the course of aging and is even more accelerated in conditions like amnestic Mild Cognitive Impairment (MCI) and dementia due to Alzheimer’s disease. Therefore, strategies for promoting improvements on cognitive functions like visuospatial memory become increasingly important. Objectives: Evaluate the efficacy of a repeated combined intervention of anodal transcranial direct current stimulation (atDCS) and cognitive training to boost visuospatial memory performance in healthy individuals and in individuals with MCI. Neuronal (study 1) and behavioral (study 1, 2 and 3) effects of atDCS applied during an OLM training task were investigated. Method: Subjects were trained over 3 days to learn the correct object-location pairings on a street map while receiving 20 minutes-atDCS or a sham stimulation. In study 1, effects of the combined approach were tested in a between-subject design in 20 healthy young (HY) and 20 healthy elderly (HE) subjects. Recall performance in trained and untrained memory tasks was assessed immediately after training, 1 day and 1 month later. Resting state functional magnetic resonance imaging was conducted at baseline and at 1-day follow-up to examine the influence of OLM training simultaneously to atDCS on functional coupling in default mode network. In study 2 and 3, the impact of the combined approach was tested using a within-subject design. Training success and delayed memory after 1 month were assessed in 32 HE (study 2) and compared to the performance of 16 MCI patients (study 3). Results: In study 1 HY performed better than HE, but both groups showed beneficial effects of stimulation. Increased functional connectivity of neural networks was positively related to enhanced memory performance 1 day later, and atDCS improved trained and untrained tasks 1 month later. In study 2, atDCS combined with OLM training did not enhance training success, performance in 1-month delayed memory, or transfer tasks. In study 3, MCI patients showed enhanced performance at the end of training, but no positive effect was found regarding delayed memory 1-month. Exploratory analyses suggested positive impact on online performance and negative effect on offline performance in MCI patients. Conclusion: atDCS may modulate behavior and has potential to counteract memory decline, but individual variability and heterogeneity between studies seems to substantially impact performance, calling for the development of individualized protocols in the future.Hintergrund: Das Objekt-Lokalisierungs-Gedächtnis (kurz OLM) trägt zur Orientierung in der Umwelt und Funktionsfähigkeit im Alltag bei. Im normalen Alterungsprozesses kommt es zur Abnahme der OLM-Leistung, was unter pathologischen Bedingungen, z.B. amnestischer leichter kognitiver Beeinträchtigung (engl. Mild cognitive impairment MCI) und Demenz bedingt durch die Alzheimer Erkrankung, akzeleriert sein kann. Dementsprechend wichtig ist die Entwicklung von Strategien zur Förderung und Aufrechterhaltung kognitiver Funktionen - wie die des visuell-räumlichen Gedächtnisses. Ziele: Auswirkung einer mehrtägigen kombinierten Anwendung aus atDCS und kognitiven (OLM) Training auf die Lesitung des visuell-räumlichen Gedächtnisses bei Gesunden und Personen mit MCI erfasst anhand von neuronalen (Studie 1) Korrelaten und Verhaltenseffekten (Studie 1-3). Methode: Durchführung eines computerbasierten OLM-Trainings an drei aufeinanderfolgenden Tagen zeitgleich mit atDCS (20min) oder einer Scheinstimulation (30s). Das OLM-Training bestand aus dem Erlernen korrekter Zuordnungen von Objekten (Gebäuden) zu Lokalisierungen (Positionen) auf einem fiktiven Stadtplan. Studie 1: In einem Zwischensubjektdesign wurde die Abrufleistung bei trainierten und nicht-trainierten Gedächtnisaufgaben unmittelbar nach dem Training, einen Tag und einen Monat später bei 20 gesunden jungen (HY) und 20 gesunden älteren (HE) Probanden gestestet. Die Ruheaktivität des Gehirns wurde mittels funktioneller Magnetresonanztomographie vor und nach dem mehrtägigen Training aufgenommen und der Einfluss der Intervention auf die funktionelle Kopplung (Konnektivität) im Ruhezustandsnetzwerk (engl. Default Mode Network) analysiert. Studie 2 und 3: In einem Meßwiederholungsansatz (cross-over) wurde die Auswirkung von OLM-Training und atDCS auf den Trainingserfolg (Leistung unmittelbar nach dem Training) und die verzögerte Abrufleistung (nach einem Monat) bei 32 HE (Studie 2) gemessen und mit der Leistung von 16 MCI-Patienten (Studie 3) verglichen. Ergebnisse: Studie 1: Das Leistungsniveau in HY war höher verglichen zu HE, aber beide Gruppen profitierten von atDCS bezogen auf die Gedächtnisleistung. Eine erhöhte funktionale Konnektivität neuronaler Netzwerke ging mit einer verbesserten Gedächtnisleistung einen Tag nach dem Training einher. atDCS hatte einen postiven Einfluss auf trainierte und nicht-trainierte Aufgaben nach einem Monat. Studie 2: In HE hatte atDCS in Kombination mit OLM-Training keinen positiven Einfluss auf den Trainingserfolg, den verzögerten Abruf und trainierte und nicht-trainierte Transferaufgaben. Studie 3: Gemessen am Trainingserfolg profitierten MCI Patienten von atDCS, jedoch nicht in Bezug auf das verzögerte Gedächtnis. In explorativen Analysen deuten auf einen Vorteil von tDCS auf die online, nicht aber die offline-Leistung bei MCI hin. Schlussfolgerung: Verhalten scheint durch atDCS modulierbar wodurch sich potentielle Interventionsstrategieansätze zur Gedächtnisverbesserung ergeben. Die hohe individuelle Variabilität und Heterogenität zwischen den Studien scheint jedoch die Effekte erheblich einzuschränken und macht die Entwicklung von individualisierten Protokollen erforderlich

Chronic phase of COVID-19: challenges for physical therapists in the face of musculoskeletal disorders

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A avaliação formativa na aprendizagem de química em EJA

Trabalho de Conclusão de Curso (especialização)—Universidade Aberta do Brasil, Universidade de Brasília, Faculdade de Educação, Coordenação do Programa de Pós-Graduação em Educação II, 2014.Este trabalho intenta relacionar a avaliação formativa ao aprendizado de Química dos estudantes de EJA, com um dando suporte ao outro. O objetivo geral deste trabalho é utilizar a avaliação formativa como um instrumento pedagógico de auxílio para a aprendizagem de Química dos estudantes de EJA. São, também, objetivos específicos: (a) Mostrar para os estudantes da EJA a relação presente entre a ciência Química e o cotidiano; (b) Usar recursos como o da contextualização e o da analogia para ajudar na clareza e nos significados dos conceitos mais abstratos da ciência Química; (c) Mostrar que as avaliações formativas podem aprimorar a comunicação entre cada estudante e o seu professor de Química; (d) Desenvolver momentos de atividades avaliativas com diferentes aplicações para desenvolver e exercitar o aprendizado e o raciocínio do estudante e momentos de aprendizagem que sirvam de ações avaliativas; (e) Propor atividades avaliativas diversificadas para abranger a heterogeneidade dos estudantes de EJA. A metodologia utilizada neste trabalho foi experimental, realizando em diferentes turmas de primeira e segunda série do terceiro segmento de EJA no CEF 411 de Samambaia a proposta apresentada. Também ocorreram abordagens complementares, como o uso de questionários para verificar o alcance dos objetivos e o nível de aprendizado e de satisfação dos estudantes. Os dados coletados serviram para concluir que a avaliação formativa contribuiu de forma positiva com o aprendizado de Química e que o uso de analogias e de contextualizações aumentou o interesse dos estudantes de EJA.This work tries to relate the formative assessment of student learning Chemistry EJA, with a supporting another. The aim of this work is to use formative assessment as a pedagogical tool to aid learning chemistry students EJA. Are also specific objectives: (a) Show for students EJA this relationship between science and everyday life Chemistry; (b) Use resources such as the context and the analogy to aid in clarity and the meanings of more abstract concepts of science Chemistry; (c) Show that formative assessments can enhance the communication between each student and his professor of chemistry; (d) Develop moments of evaluation activities with different applications to develop and exercise student learning and reasoning and learning moments that serve as evaluative actions; (e) Propose evaluation activities diversified to encompass the heterogeneity of students in adult education. The methodology used in this work was experimental, performing in different groups of first and second series of the third segment of the CEF EJA 411 Fern of the submitted proposal. Complementary approaches also occurred, such as the use of questionnaires to verify the achievement of the objectives and the level of learning and student satisfaction. The data collected were used to conclude that formative assessment has contributed positively to the learning of Chemistry and the use of analogies and contextualization increased student interest in EJA

IL-1R and inflammasomes mediate early pulmonary protective mechanisms in respiratory brucella abortus infection

Brucella spp. infection is frequently acquired through contaminated aerosols. The role of interleukin-1 beta (IL-1β) in the early pulmonary response to respiratory Brucella infection is unknown. As shown here, IL-1β levels in lung homogenates and bronchoalveolar lavage fluid (BALF) of mice intratracheally inoculated with B. abortus were increased at 3 and 7 days p.i. At 7 days p.i., pulmonary CFU numbers were higher in IL-1 receptor (IL-1R) knockout (KO) mice than in wild type (WT) mice. At different times p.i. CFU in lungs and BALF were higher in mice lacking some inflammasome components (caspase-1, AIM2, NLRP3) than in WT mice. At 2 days p.i. pulmonary levels of IL-1b and CXCL1 (neutrophils chemoattractant) were lower in caspase-1/11 KO mice. At day 3 p.i., neutrophils counts in BALF were lower in caspase-1/11 KO mice than in WT mice. During in vitro infections, IL-1β secretion was lower in alveolar macrophages from caspase-1/11, NLRP3 or AIM2 KO mice than in WT controls. Similarly, IL-1β production by B. abortus-infected alveolar epithelial cells was reduced by pretreatment with a specific caspase-1 inhibitor. This study shows that IL-1R, probably through IL-1β action, and the NLRP3 and AIM2 inflammasomes are involved in pulmonary innate immune protective mechanisms against respiratory B. abortus infection.Fil: Hielpos, María Soledad. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Estudios de la Inmunidad Humoral Prof. Ricardo A. Margni. Universidad de Buenos Aires. Facultad de Farmacia y Bioquímica. Instituto de Estudios de la Inmunidad Humoral Prof. Ricardo A. Margni; Argentina. Universidad de Buenos Aires. Facultad de Farmacia y Bioquímica; ArgentinaFil: Fernandez, Andrea Giselle. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Estudios de la Inmunidad Humoral Prof. Ricardo A. Margni. Universidad de Buenos Aires. Facultad de Farmacia y Bioquímica. Instituto de Estudios de la Inmunidad Humoral Prof. Ricardo A. Margni; ArgentinaFil: Falivene, Juliana. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Estudios de la Inmunidad Humoral Prof. Ricardo A. Margni. Universidad de Buenos Aires. Facultad de Farmacia y Bioquímica. Instituto de Estudios de la Inmunidad Humoral Prof. Ricardo A. Margni; ArgentinaFil: Alonso Paiva, Iván Mathias. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Estudios de la Inmunidad Humoral Prof. Ricardo A. Margni. Universidad de Buenos Aires. Facultad de Farmacia y Bioquímica. Instituto de Estudios de la Inmunidad Humoral Prof. Ricardo A. Margni; ArgentinaFil: Muñoz González, Florencia. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Estudios de la Inmunidad Humoral Prof. Ricardo A. Margni. Universidad de Buenos Aires. Facultad de Farmacia y Bioquímica. Instituto de Estudios de la Inmunidad Humoral Prof. Ricardo A. Margni; ArgentinaFil: Ferrero, Mariana Cristina. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Estudios de la Inmunidad Humoral Prof. Ricardo A. Margni. Universidad de Buenos Aires. Facultad de Farmacia y Bioquímica. Instituto de Estudios de la Inmunidad Humoral Prof. Ricardo A. Margni; ArgentinaFil: Campos, Priscila C.. Universidade Federal de Minas Gerais; BrasilFil: Vieira, Angelica T.. Universidade Federal de Minas Gerais; BrasilFil: Oliveira, Sergio Costa. Universidade Federal de Minas Gerais; BrasilFil: Baldi, Pablo Cesar. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Estudios de la Inmunidad Humoral Prof. Ricardo A. Margni. Universidad de Buenos Aires. Facultad de Farmacia y Bioquímica. Instituto de Estudios de la Inmunidad Humoral Prof. Ricardo A. Margni; Argentin

Cobertura de políticas públicas e acesso a medicamentos no Brasil

OBJETIVO Descrever padrões de consumo de medicamentos com e sem desembolso direto de recursos, segundo faixas de idade e de renda, destacando os fármacos associados a programas de saúde com garantias específicas de acesso. MÉTODOS Estudo descritivo observacional usando microdados da Pesquisa de Orçamentos Familiares (POF/IBGE) 2017–2018. Inicialmente, foram definidas as garantias específicas de acesso a medicamentos do SUS pela sistematização de programas/políticas com essa previsão. A partir dos medicamentos do quadro 29 do questionário de despesas individuais (POF-4), foram selecionados tipos de medicamentos associados a essas garantias. Foram descritas as frequências e os percentuais de pessoas sem consumo e com consumo (aquisição com e sem desembolso direto de recursos), segundo faixas de idade e de renda. Para medicamentos vinculados a garantias específicas, comparou-se valores médios mensais de aquisições e padrões de consumo por faixa etária e renda. RESULTADOS Entre as pessoas com renda domiciliar até dois salários mínimos, 63% não declararam consumo de medicamentos no mês. Entre as acima de 25 salários mínimos, foram 44,3%. Aquisições sem desembolso direto foram feitas principalmente por pessoas na faixa com até 10 salários mínimos e entre os mais idosos. O consumo sem desembolso direto representou 20,5% do consumo total de medicamentos (em valor). Para políticas com garantias específicas de acesso, o consumo sem desembolso foi de 33,6% com variações desse percentual entre os medicamentos selecionados no estudo: vacinas, 83,3%; medicamentos para câncer, 70,3%; diabetes, 47,9%; hipertensão, 35,9%; asma e bronquite, 29,2%; problemas oftalmológicos, 14%; medicamentos para próstata e vias urinárias, 10,7%; para problemas ginecológicos, 11,6%; e anticoncepcionais, 9,7%. CONCLUSÃO O consumo sem desembolso ainda é baixo, mas beneficia principalmente pessoas de menor renda e idosos. Políticas e programas com garantias específicas de acesso a medicamentos têm aumentado esse acesso. Os resultados sugerem a necessidade de fortalecer e ampliar as políticas de assistência farmacêutica.OBJECTIVE Describe consumption patterns for monetary and non-monetary acquisition of medicines according to age and income groups, highlighting pharmaceuticals associated with health programs with specific access guarantees. METHODS Descriptive observational study using microdata from the 2017–2018 Pesquisa de Orçamentos Familiares (Household Budget Survey, POF/IBGE). We initially reviewed programs/policies with specific guarantees of access to medicines in the SUS. Using the pharmaceutical product list of POF-4 (chart 29 of the questionnaire on individual expenditures), we selected the medicines related to these programs. We then described frequencies and percentages for not reporting medicine consumption and for reporting consumption (either through monetary or non-monetary acquisition) according to age and income groups. For medicines with distinctive access guarantees, we compared average monthly values of acquisitions and consumption patterns by age and income. RESULTS 63% of those in the ≤ 2 minimum wage (MW) household income group did not report consuming medicines in the last month. Among those earning > 25 MW, 44.3% did not report consumption. Non-monetary acquisitions of medicines were mainly reported for the < 10 MW group and for the elderly and accounted for 20.5% of the total consumption of medicines (in value). For policies with specific access guarantees, non-monetary acquisitions reached 33.6% of total consumption. This percentage varied for the various selected medicines: vaccines, 83.3%; cancer drugs, 70.3%; diabetes, 47.9%; hypertension, 35.9%; asthma and bronchitis, 29.2%; eye problems, 14%; prostate and urinary tract, 10.7%; gynecological, 11.6%; and contraceptives, 9.7%. CONCLUSION Shares for non-monetary acquisitions of medicines are still low but benefit mainly lower-income and older age groups. Policies and programs with specific access guarantees to medicines have increased access. Results suggest the need to strengthen and expand pharmaceutical care policies

Application of modified membranes in drinking water treatment

This paper presents filtration results obtained with commercial acetate membrane with a pore diameter of 0.45 μm, unmodified and modified with TiO2, bearing in mind drinking water treatment. The experimental filtration set-up that was used consisted in the gravitational filtration system, whereas the accomplished tests that were endured consisted of hydraulic permeability of the modified and unmodified membranes, treatment of polluted water with E. coli bacterium, color removal, turbidity and free chlorine. The results of hydraulic permeability showed similar flux for all membranes at the end of the experiments, between 25 and 30 kg·m-2· h-1. The retention results for color, turbidity and E.coli bacteria are comparable.Fundo Europeu de Desenvolvimento Regional (FEDER)Fundação para a Ciência e a Tecnologi

Fase crônica da COVID-19: desafios do fisioterapeuta diante das disfunções musculoesqueléticas

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Morphology and functionality of the type II pneumocytes and their variation in relation to bovine gestational age

Este estudo objetivou caracterizar a presença de pneumócitos tipo II e o início da produção de lipoproteína surfactante em bovinos, correlacionando a idade gestacional com a síntese de surfactante durante o desenvolvimento fetal. Pulmões de fetos com quatro meses de idade gestacional estavam na fase canalicular de desenvolvimento, sem a presença de pneumócitos tipo II ou bandas eletroforéticas compatíveis com a presença de proteínas surfactante. No 5° mês gestacional, os pulmões dos fetos encontravam-se em fase de saculação terminal, com a presença de alvéolos por epitélio cúbico, com áreas formadas por pneumócitos I e II. Nesse período ainda não foi possível identificar proteína surfactante nos pulmões. Esses órgãos em fetos com seis meses de idade gestacional estavam em fase de saco terminal, com presença de pneumócitos tipo I e II. Nessa fase a análise para determinação protéica do surfactante de feto bovino (SDS - PAGE) demonstrou presença de bandas entre 26 e 36kDa, confirmando produção de SP - A, proteína surfactante encontrada em maior quantidade. A partir do 7° mês gestacional, a fase de saco terminal é mais evidente e complexa, com desenvolvimento de intensa vascularização. O pneumócito tipo I apresentava aspecto mais pavimentoso, e o tipo II apresentava aspecto mais globoso. Na análise SDS - PAGE do lavado bronco - alveolar, bandas de proteína surfactante com aspecto similar ao de animais recém-nascidos foram encontradas. Em recém-nascidos, pulmões na fase alveolar foram observados com pneumócitos tipo I e II característicos. O perfil das bandas do lavado bronco-alveolar dos recém-nascidos foi igual ao de animais adultos. Esses achados sugerem que um animal nascido precocemente, a partir dos sete meses de gestação, teria sua sobrevivência garantida devido a uma possível funcionalidade do sistema respiratório do feto, pois o pulmão possuiria as características necessárias para a síntese de proteínas surfactantes. Entretanto, mais estudos clínicos sobre a funcionalidade do sistema respiratório abrem novas fronteiras de experimentos sobre fisiologia respiratória em recém-nascidos bovinos.The aim of this study was to characterize the presence of type II pneumocyte and the beginning of the surfactant protein production in bovines to the correlated gestational age. Lungs of fetuses at 4 months gestational age were found to be in the canalicular development phase, without presence of type II pneumocytes or appearance of electrophoretic bands compatible with the presence of the surfactant protein. In fetuses at 5 months of gestational age, the lungs were at the terminal sac phase, with the presence of primitive alveolus, formed by cubical epithelium and areas formed by pneumocytes I and pneumocytes II. No electrophoretic bands compatible to the surfactants proteins were identified. In contrast, lungs of fetuses at 6 months of gestational age showed, development of terminal sac phase, with the presence of type I and type II pneumocytes. In this phase, proteic determination for the SDS - PAGE analysis showed the presence of bands between 26 to 36kDa, demonstrating SP - A production, which is the surfactant protein found in highest amount. From the 7th gestational month on, the phase of terminal sac is more evident and complex, with intense sprouting vascularization. The type I pneumocyte had a more squamous aspect and type II pneumocyte were more globular. In the SDS - PAGE analysis of the bronchial - alveolar wash, surfactant protein bands had been observed with a profile similar to that of the newborn animals. In newborn animals, lungs in alveolar phase showed the development of type I and II pneumocytes. The profile of the bronchial - alveolar wash from the newborn was similar to an adult animal, presenting the same bands in triplets. These results suggest that early born fetuses, from 7 months of pregnancy could have a guarantee of surviving due to possible functionality of respiratory system because the lung presented all necessary features for surphactant protein syntheses. However, new clinical studies related to respiratory system functionality open new venues for newborn bovine's experiments respiratory physiology