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Diagnosis and biomarkers of predementia in Alzheimer's disease
No full textAbstract
In view of the growing prevalence of Alzheimer's disease (AD) worldwide, there is an urgent need for the development of better diagnostic tools and more effective therapeutic interventions. At the earliest stages of AD, no significant cognitive or functional impairment is detected by conventional clinical methods. However, new technologies based on structural and functional neuroimaging, and on the biochemical analysis of cerebrospinal fluid (CSF) may reveal correlates of intracerebral pathology in individuals with mild, predementia symptoms. These putative correlates are commonly referred to as AD-related biomarkers. The relevance of the early diagnosis of AD relies on the hypothesis that pharmacological interventions with disease-modifying compounds are likely to produce clinically relevant benefits if started early enough in the continuum towards dementia. Here we review the clinical characteristics of the prodromal and transitional states from normal cognitive ageing to dementia in AD. We further address recent developments in biomarker research to support the early diagnosis and prediction of dementia, and point out the challenges and perspectives for the translation of research data into clinical practice
Etnomatemática e economia solidária na educação especial de adultos
No full textO presente trabalho traz uma reflexão sobre a Educação Matemática no contexto da Economia Solidária para pessoas com necessidades especiais. Tem por finalidade abordar nossa atuação em uma cooperativa, constituída por pessoas adultas com alguma doença mental, de produção de artesanato a partir de papel reciclado. Foram utilizados os princípios da Etnomatemática, como intervenção pedagógica não formal junto a este Empreendimento Econômico Solidário (EES), no qual se buscou trabalhar a matemática por meio de situações-problema relacionadas a seu cotidiano de trabalho. A pesquisa realizada foi de cunho qualitativo com elementos da pesquisa-ação. Como resultados, observamos que a metodologia não formal aplicada, contribuiu para mudanças atitudinais de forma a torná-las mais autônomos nos afazeres diários deste EES. Além disso, de forma geral, entende-se também que este trabalho contribuiu para a inserção social daqueles que foram excluídos pelo ensino e trabalho nos moldes formais, trazendo aos mesmos, autoconfiança para suas possibilidades.Pró-reitoria de Graduação da USPPró-reitoria de Cultura e Extensão da USPMEC Proext/2001
Um estudo sobre o uso de webquests para revisar conteúdos matemáticos
No full textNas últimas décadas o aumento do acesso à Internet vem modificando a maneira como interagimos com a informação e, em consequência, com o conhecimento. A educação no mundo digital exige a adoção de novas metodologias de ensino que desenvolvam competências e habilidades necessárias a formação crítica, reflexiva e participativa de nossos educandos. Dessa maneira buscou-se desenvolver a autonomia dos alunos em relação às escolhas que farão durante sua vida, fazendo-as de maneira consciente e planejada. Considerando o baixo índice de acertos nas questões de porcentagens de um simulado realizado em uma escola estadual do interior do Estado de São Paulo foi elaborada a WebQuest “BMW Vermelho” com o objetivo de avaliar em que medida a metodologia WebQuest contribuiu para a aprendizagem de porcentagem. Durante a aplicação da WebQuest, em dois nonos anos do Ensino Fundamental, foi possível perceber como a metodologia, através da motivação, provoca mudanças no comportamento dos alunos no que diz respeito a disciplina, a concentração e o desejo em aprender o conteúdo, indicando uma grande potencialidade de uso em revisões de conteúdo, uma vez que deixa de ser uma repetição podendo ser uma maneira de apresentar novos significados aos temas revistos e promover a interdisciplinaridade.Cape
Network construction and applications for semi-supervised learning
No full textThe influence of network construction on graphbased semi-supervised learning (SSL) and their related applications have only received limited study despite its critical impact on accuracy. We introduce four variants for network construction for SSL that adopt different network topology: 1) S-kNN (Sequential k-Nearest Neighbors) that generates regular networks; 2) GBILI (Graph Based on the informativeness of Labeled Instances) and 3) RGCLI (Robust Graph that Considers Labeled Instances), which exploit the labels available generating scale-free networks; 4) GBLP (Graph Based on Link Prediction), which are based on link prediction measures and creates smallworld networks. Comprehensive experimental results using several benchmark datasets show that it can achieve or outperform existing state-of-the-art results. Furthermore, it is confirmed to be more effective in running time.São Paulo Research Foundation (FAPESP) (grant: 2011/21880-3
The effects of exercise training in a weight loss lifestyle intervention on asthma control, quality of life and psychosocial symptoms in adult obese asthmatics: protocol of a randomized controlled trial
No full textAbstract
Background
Asthma and obesity are public health problems with increasing prevalence worldwide. Clinical and epidemiologic studies have demonstrated that obese asthmatics have worse clinical control and health related quality of life (HRQL) despite an optimized medical treatment. Bariatric surgery is successful to weight-loss and improves asthma control; however, the benefits of nonsurgical interventions remain unknown.
Methods/Design
This is a randomized controlled trial with 2-arms parallel. Fifty-five moderate or severe asthmatics with grade II obesity (BMI ≥ 35 kg/m2) under optimized medication will be randomly assigned into either weight-loss program + sham (WL + S group) or weight-loss program + exercise (WL + E group). The weight loss program will be the same for both groups including nutrition and psychological therapies (every 15 days, total of 6 sessions, 60 min each). Exercise program will include aerobic and resistance muscle training while sham treatment will include a breathing and stretching program (both programs twice a week, 3 months, 60 min each session). The primary outcome variable will be asthma clinical control. Secondary outcomes include HRQL, levels of depression and anxiety, lung function, daily life physical activity, body composition, maximal aerobic capacity, strength muscle and sleep disorders. Potential mechanism (changes in lung mechanical and airway/systemic inflammation) will also be examined to explain the benefits in both groups.
Discussion
This study will bring a significant contribution to the literature evaluating the effects of exercise conditioning in a weight loss intervention in obese asthmatics as well as will evaluate possible involved mechanisms.
Trial registration
NCT0218894
Factors associated to depression and anxiety in medical students: a multicenter study
No full textAbstract\ud
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Background\ud
To evaluate personal and institutional factors related to depression and anxiety prevalence of students from 22 Brazilian medical schools.\ud
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Methods\ud
The authors performed a multicenter study (August 2011 to August 2012), examining personal factors (age, sex, housing, tuition scholarship) and institutional factors (year of the medical training, school legal status, location and support service) in association with scores of Beck Depression Inventory (BDI) and State Trait Anxiety Inventory (STAI).\ud
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Results\ud
Of 1,650 randomly selected students, 1,350 (81.8 %) completed the study. The depressive symptoms prevalence was 41 % (BDI > 9), state-anxiety 81.7 % and trait-anxiety in 85.6 % (STAI > 33). There was a positive relationship between levels of state (r = 0,591, p < 0.001) and trait (r = 0,718, p < 0.001) anxiety and depression scores. All three symptoms were positively associated with female sex and students from medical schools located in capital cities of both sexes. Tuition scholarship students had higher state-anxiety but not trait-anxiety or depression scores. Medical students with higher levels of depression and anxiety symptoms disagree more than their peers with the statements “I have adequate access to psychological support” and “There is a good support system for students who get stressed”.\ud
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Conclusions\ud
The factors associated with the increase of medical students’ depression and anxiety symptoms were female sex, school location and tuition scholarship. It is interesting that tuition scholarship students showed state-anxiety, but not depression and trait-anxiety symptoms.This study was supported by CAPES (Brazilian Federal Agency for the\ud
Support and Evaluation of Graduate Education) and CNPq (National Council\ud
for Scientific Development), Brazil. CAPES supported the development of the\ud
survey platform and data collection. CAPES and CNPq funded scholarships\ud
for graduate students
A prospective study of treatment of carbapenem-resistant Enterobacteriaceae infections and risk factors associated with outcome
No full textAbstract\ud
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Background\ud
To describe the clinical and microbiological data of carbapenem-resistant Enterobacteriaceae (CRE) infections, the treatment used, hospital- and infection-related mortality, and risk factors for death.\ud
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Methods\ud
A prospective cohort conducted from March 2011 to December 2012. Clinical, demographic, and microbiological data such as in vitro sensitivity, clonality, carbapenemase gene mortality related to infection, and overall mortality were evaluated. Data were analyzed using Epi Info version 7.0 (CDC, Atlanta, GA, USA) and SPSS (Chicago, IL, USA).\ud
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Results\ud
One hundred and twenty-seven patients were evaluated. Pneumonia, 52 (42 %), and urinary tract infections (UTI), 51 (40.2 %), were the most frequent sites of infection. The isolates were polyclonal; the Bla\ud
KPC gene was found in 75.6 % of isolates, and 27 % of isolates were resistant to colistin. Mortality related to infection was 34.6 %, and was higher among patients with pneumonia (61.4 %). Combination therapy was used in 98 (77.2 %), and monotherapy in 22.8 %; 96.5 % of them were UTI patients. Shock, age, and dialysis were independent risk factors for death. There was no difference in infection-related death comparing colistin-susceptible and colistin-resistant infections (p = 0.46); neither in survival rate comparing the use of combination therapy with two drugs or more than two drugs (p = 0.32).\ud
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Conclusions\ud
CRE infection mortality was higher among patients with pneumonia. Infections caused by colistin-resistant isolates did not increase mortality. The use of more than two drugs on combination therapy did not show a protective effect on outcome. The isolates were polyclonal, and the bla\ud
KPC gene was the only carbapenemase found. Shock, dialysis, and age over 60 years were independent risk factors for death
