Novel skeletal effects of glucagon-like peptide-1 (GLP-1) receptor agonists

Type 2 diabetes mellitus (T2DM) leads to bone fragility and predisposes to increased risk of fracture, poor bone healing and other skeletal complications. In addition, some anti-diabetic therapies for T2DM can have notable detrimental skeletal effects. Thus, an appropriate therapeutic strategy for T2DM should not only be effective in re-establishing good glycaemic control but also in minimising skeletal complications. There is increasing evidence that glucagon-like peptide-1 receptor agonists (GLP-1RAs), now greatly prescribed for the treatment of T2DM, have beneficial skeletal effects although the underlying mechanisms are not completely understood. This review provides an overview of the direct and indirect effects of GLP-1RAs on bone physiology, focusing on bone quality and novel mechanisms of action on the vasculature and hormonal regulation. The overall experimental studies indicate significant positive skeletal effects of GLP-1RAs on bone quality and strength although their mechanisms of actions may differ according to various GLP-1RAs and clinical studies supporting their bone protective effects are still lacking. The possibility that GLP-1RAs could improve blood supply to bone, which is essential for skeletal health, is of major interest and suggests that GLP-1 anti-diabetic therapy could benefit the rising number of elderly T2DM patients with osteoporosis and high fracture risk

Evaluating the affective dimension to support the learning process in the discipline of algorithms: a case study

Este artigo apresenta um estudo visando avaliar aspectos afetivos relacionados aos processos de aprendizagem na área de Algoritmos. A dificuldade apresentada pelos estudantes na aprendizagem de conceitos e técnicas de construção de algoritmos pode levar à frustração, um estado afetivo relacionado aos sentimentos de descontentamento e desesperança. Dois experimentos foram realizados como parte desta pesquisa. No primeiro, um grupo de 58 estudantes foi monitorado enquanto utilizava um sistema de aprendizagem de algoritmos. Quando sentiam-se frustrados na resolução dos exercícios propostos, os alunos podiam indicar este estado ao ambiente de aprendizagem por meio de um botão "Estou Frustrado". Após, um sistema de mineração de dados foi empregado para identificar quais os padrões de interação com o sistema poderiam estar relacionados ao estado de frustração. Estes padrões, representados na forma de regras, foram incorporados no sistema e empregados em um último experimento com um grupo de 6 estudantes com dificuldade de aprendizagem na disciplina. Os resultados da pesquisa mostraram que o sistema foi capaz de prover assistência personalizada aos alunos em momentos em que estes apresentavam dificuldades, auxiliando-os a melhorar seu desempenho.This paper presents a study on the evaluation of affective aspects related to learning processes in the area of Algorithms. Students' difficulties in designing solutions for algorithmic problems may lead to frustration, an affective state related to feelings of disappointment and discouragement. Two experiments were carried out as part of this research. In the first one, a group of 58 students was monitored while using a system for learning algorithms. Whenever the students felt frustrated while working on an algorithmic problem, they could indicate it by pressing a button with the label "I'm frustrated". Later on, a data mining tool was used to identify patterns of student-system interaction that could be related to the state of frustration. These patterns, represented in the form of rules, were then incorporated in the system and used in a last experiment with another group of 6 students who had learning difficulties in the course. Results showed that the system has been able to provide personalized assistance to the students at moments when they were showing difficulties, helping them to improve their performance

A importância do butiá em Santa Vitória do Palmar : da história à realidade atual

O município de Santa Vitória do Palmar está localizado no sul do Rio Grande do Sul fazendo divisa com o Uruguai. Por ele se conecta um corredor de espécies provenientes do ecossistema Chaco, entre elas o Butia odorata, que se encontra em formações agregadas conformando o ecossistema butiazal. O presente trabalho tem como objetivo analisar o papel dos butiazais na história do município de Santa Vitória do Palmar, Rio Grande do Sul, buscando compreender os fatores determinantes da condição atual de sua conservação. Para tanto, os objetivos específicos centram-se em caracterizar os sistemas agrários de Santa Vitória do Palmar, com ênfase na relação do município com os butiazais; e analisar os esforços de conservação no município referentes à legislação, às práticas de manejo e a articulação em torno da Rota dos Butiazais. A metodologia utilizada, de caráter qualitativo, contemplou a realização de 10 entrevistas semi-estruturadas com historiador local, pesquisadores, produtores rurais, artesãos e secretaria de turismo, que contribuíram na realização da evolução dos sistemas agrários e na caracterização das ações de conservação associadas aos butiazais no município. Foram caracterizados 6 sistemas agrários no período de 1600 até os dias atuais. Embora a conservação dos butiazais em Santa Vitória do Palmar esteja ameaçada em função dos sistemas agrários atualmente adotados, como o arroz e a soja que está substituindo a pecuária, foram caracterizadas ações de conservação em curso, como a Rota dos Butiazais de caráter internacional, que valorizam os butiazais e vem sendo assumidas pela gestão do município, reconfigurando a identidade do município.El municipio de Santa Victoria del Palmar está ubicado en el sur de Rio Grande do Sul haciendo divisa con Uruguay. Por él se conecta un corredor de especies provenientes del ecosistema Chaco, entre ellas el Butia odorata, que se encuentra en formaciones agregadas conformando el ecosistema palmar. El presente trabajo tiene como objetivo analizar el papel de los palmares en la historia del municipio de Santa Victoria del Palmar, Rio Grande do Sul, buscando comprender los factores determinantes de la condición actual de su conservación. Para ello, los objetivos específicos se centran en caracterizar los sistemas agrarios de Santa Victoria del Palmar, con énfasis en la relación del municipio con los palmares; y analizar los esfuerzos de conservación en el municipio referentes a la legislación, las prácticas de manejo y la articulación en torno a la Red el Palmar. La metodología utilizada, de carácter cualitativo, contempló la realización de 10 entrevistas semiestructuradas con historiador local, investigadores, productores rurales, artesanos y secretaría de turismo, que contribuyeron en la realización de la evolución de los sistemas agrarios y en la caracterización de las acciones de conservación asociadas a los palmares en el municipio. Se caracterizaron 6 sistemas agrarios en el período de 1600 hasta los días actuales. Aunque la conservación de los palmares en Santa Victoria del Palmar está amenazada en función de los sistemas agrarios actualmente adoptados, como el arroz y la soja, que está sustituyendo a la ganadería, se caracterizaron acciones de conservación en curso, como la Red el Palmar de carácter internacional, que valoran los palmares y vienen siendo asumidas por la gestión del municipio, reconfigurando la identidad del municipio

Instrumentalization of eating improves weight loss maintenance in obesity

Aim: The purpose of this study was to identify psychosocial determinants for maintaining weight loss. Methods: 42 obese individuals who achieved a 12% weight loss before entering a 52-week weight maintenance program were interviewed qualitatively. Psychosocial factors related to weight loss maintenance were identified in two contrasting groups: weight reducers and weight regainers. Groups were defined by health-relevant weight maintenance (additional weight loss > 3% at week 52, n = 9 versus weight gain > 3%, at week 52, n = 20). Results: Weight reducers reported structured meal patterns (p = 0.008), no comfort eating (p = 0.016) and less psychosocial stress (p = 0.04) compared to weight regainers. The ability to instrumentalize eating behavior emerged as an important factor (p = 0.007). Nutritional knowledge, motivation or exercise level did not differ between groups (p > 0.05). Conclusions: Successful weight loss maintenance was associated with an interplay between behavioral, affective and contextual changes. ‘Instrumentalization of eating behavior' seems to be an important element in long-term weight maintenance

VisMade: Visualizing Temporal Information in Databases Structured as Master-Details

Information Visualization is a field of computer graphics which aims to present information graphically, allowing users to better understand a great amount of information. It also allows identifying standards, or even detecting new information which, at first, was not possible to be perceived due to its complex representation. This study briefly describes this field and presents a tool for visual data mining executed on the web, through of the Parallel Coordinates technique, that allow users to analyze information structured in a master/detail format. Other advantage of the tool is its capacity of accepting data from several systems exported by the user in the XML format. A case study is demonstrated in order to exemplify the resources of the tool

Therapeutic benefits of proning to improve pulmonary gas exchange in severe respiratory failure: Focus on fundamentals of physiology

NEW FINDINGS: What is the topic of this review? The use of proning for improving pulmonary gas exchange in critically ill patients. What advances does it highlight? Proning places the lung in its ‘natural’ posture, and thus optimises the ventilation‐perfusion distribution, which enables lung protective ventilation and the alleviation of potentially life‐threatening hypoxaemia in COVID‐19 and other types of critical illness with respiratory failure. ABSTRACT: The survival benefit of proning patients with acute respiratory distress syndrome (ARDS) is well established and has recently been found to improve pulmonary gas exchange in patients with COVID‐19‐associated ARDS (CARDS). This review outlines the physiological implications of transitioning from supine to prone on alveolar ventilation‐perfusion ([Formula: see text]) relationships during spontaneous breathing and during general anaesthesia in the healthy state, as well as during invasive mechanical ventilation in patients with ARDS and CARDS. Spontaneously breathing, awake healthy individuals maintain a small vertical (ventral‐to‐dorsal) [Formula: see text] ratio gradient in the supine position, which is largely neutralised in the prone position, mainly through redistribution of perfusion. In anaesthetised and mechanically ventilated healthy individuals, a vertical [Formula: see text] ratio gradient is present in both postures, but with better [Formula: see text] matching in the prone position. In ARDS and CARDS, the vertical [Formula: see text] ratio gradient in the supine position becomes larger, with intrapulmonary shunting in gravitationally dependent lung regions due to compression atelectasis of the dorsal lung. This is counteracted by proning, mainly through a more homogeneous distribution of ventilation combined with a largely unaffected high perfusion dorsally, and a consequent substantial improvement in arterial oxygenation. The data regarding proning as a therapy in patients with CARDS is still limited and whether the associated improvement in arterial oxygenation translates to a survival benefit remains unknown. Proning is nonetheless an attractive and lung protective manoeuvre with the potential benefit of improving life‐threatening hypoxaemia in patients with ARDS and CARDS

Effect of endurance versus resistance training on quadriceps muscle dysfunction in COPD:a pilot study

INTRODUCTION: Exercise is an important countermeasure to limb muscle dysfunction in COPD. The two major training modalities in COPD rehabilitation, endurance training (ET) and resistance training (RT), may both be efficient in improving muscle strength, exercise capacity, and health-related quality of life, but the effects on quadriceps muscle characteristics have not been thoroughly described. METHODS: Thirty COPD patients (forced expiratory volume in 1 second: 56% of predicted, standard deviation [SD] 14) were randomized to 8 weeks of ET or RT. Vastus lateralis muscle biopsies were obtained before and after the training intervention to assess muscle morphology and metabolic and angiogenic factors. Symptom burden, exercise capacity (6-minute walking and cycle ergometer tests), and vascular function were also assessed. RESULTS: Both training modalities improved symptom burden and exercise capacity with no difference between the two groups. The mean (SD) proportion of glycolytic type IIa muscle fibers was reduced after ET (from 48% [SD 11] to 42% [SD 10], P<0.05), whereas there was no significant change in muscle fiber distribution with RT. There was no effect of either training modality on muscle capillarization, angiogenic factors, or vascular function. After ET the muscle protein content of phosphofructokinase was reduced (P<0.05) and the citrate synthase content tended increase (P=0.08) but no change was observed after RT. CONCLUSION: Although both ET and RT improve symptoms and exercise capacity, ET induces a more oxidative quadriceps muscle phenotype, counteracting muscle dysfunction in COPD