Correction: Santos et al. The Mitochondrial Antioxidant Sirtuin3 Cooperates with Lipid Metabolism to Safeguard Neurogenesis in Aging and Depression. Cells 2022, 11, 90.

In the original article [...].

CircadiPy: an open-source toolkit for analyzing chronobiology time series.

BACKGROUND: Chronobiology is the scientific field focused on studying periodicity in biological processes. In mammals, most physiological variables exhibit circadian rhythmicity, such as metabolism, body temperature, locomotor activity, and sleep. The biological rhythmicity can be statistically evaluated by examining the time series and extracting parameters that correlate to the period of oscillation, its amplitude, phase displacement, and overall variability. NEW METHOD: We have developed a library called CircadiPy, which encapsulates methods for chronobiological analysis and data inspection, serving as an open-access toolkit for the analysis and interpretation of chronobiological data. The package was designed to be flexible, comprehensive and scalable in order to assist research dealing with processes affected or influenced by rhythmicity. RESULTS: The results demonstrate the toolkit's capability to guide users in analyzing chronobiological data collected from various recording sources, while also providing precise parameters related to the circadian rhythmicity. COMPARISON WITH EXISTING METHODS: The analysis methodology from this proposed library offers an opportunity to inspect and obtain chronobiological parameters in a straightforward and cost-free manner, in contrast to commercial tools. CONCLUSIONS: Moreover, being an open-source tool, it empowers the community with the opportunity to contribute with new functions, analysis methods, and graphical visualizations given the simplified computational method of time series data analysis using an easy and comprehensive pipeline within a single Python object.

Rational formulation and industrial manufacturing of lipid-based complex injectables: Landmarks and trends.

Lipid-based complex injectables are renowned for their effectiveness in delivering drugs, with many approved products. While significant strides have been made in formulating nanosystems for small molecular weight drugs, a pivotal breakthrough emerged with the recognition of lipid nanoparticles as a promising platform for delivering nucleic acids. This finding has paved the way for tackling long-standing challenges in molecular and delivery aspects (e.g., mRNA stability, intracellular delivery) that have impeded the clinical translation of gene therapy, especially in the realm of immunotherapy. Nonetheless, developing and implementing new lipid-based delivery systems pose significant challenges, as industrial manufacturing of these formulations often involves complex, multi-batch processes, giving rise to issues related to scalability, stability, sterility, and regulatory compliance. To overcome these obstacles, embracing the principles of quality-by-design (QbD) is imperative. Furthermore, adopting cutting-edge manufacturing and process analytical tools (PAT) that facilitate the transition from batch to continuous production is essential. Herein, the key milestones and insights derived from the development of currently approved lipid- nanosystems will be explored. Additionally, a comprehensive and critical overview of the latest technologies and regulatory guidelines that underpin the creation of more efficient, scalable, and flexible manufacturing processes for complex lipid-based nanoformulations will be provided.

A Comprehensive Meta-Analysis on the Role of Analgesics and Anti-Inflammatories in Pan-Retinal Photocoagulation.

PURPOSE: Pan-retinal photocoagulation (PRP) is the mainstay of treatment for proliferative diabetic retinopathy (PDR), reducing the risk of severe vision loss. Pain poses a potential obstacle to effective laser delivery and patient compliance. Therefore, implementing pain relief strategies can enhance both treatment efficacy and patient comfort. DESIGN: A systematic review and meta-analysis. METHODS: We conducted a systematic review and meta-analysis according to PRISMA guidelines. The PubMed, Embase and Cochrane Central Register of Controlled Trials databases were searched for randomized controlled trials (RCTs) that enrolled patients undergoing PRP due to DR and compared analgesics or non-steroidal anti-inflammatory drugs (NSAID) to placebo. Pain was evaluated with the visual analogue scale. The version 2 of the Cochrane Collaboration's Risk of Bias in Randomized Controlled Trials tool and its version for crossover trials were used to assess the risk of bias. The Grading of Recommendations, Assessment, Development, and Evaluation tool was used to measure the certainty of evidence. RESULTS: A total of 13 studies were included, comprising 1404 eyes from RCTs, nine of which were crossover. Patients who were administered analgesia reported a significantly lower pain sensitivity compared to those who received placebo (Standardized mean difference [SMD] -0.38; 95% confidence interval [CI] -0.58, -0.17; P < .01; I2 = 69%). Subgroup analysis of systemic administration of analgesics/NSAIDs (metamizole, Entonox, acetaminophen, ibuprofen, caffeine, mefenamic acid, intramuscular ketorolac tromethamine, and potassium diclofenac) also showed a statistically significant reduction in pain when compared to placebo (SMD -0.28; 95% CI -0.50, -0.07; P < .01; I2 = 43%). Exclusive eye drops administration (ketorolac tromethamine 0.5% and sodium diclofenac 0.1%) also showed a significant difference in pain sensitivity (SMD -0.46; 95% CI -0.88, -0.05; I2 = 83%), however with a more significant heterogeneity. CONCLUSIONS: The results of this meta-analysis including over 1000 patients demonstrated that the use of analgesics significantly reduced pain sensitivity during PRP, and systemic analgesia is potentially better than topical administration when compared to placebo.

Higher frequency of gastric neoplasia in advanced chronic liver disease patients: Impact of screening endoscopy in an intermediate-high risk country.

BACKGROUND: The Baveno VII guidelines were proposed to identify which patients could safely avoid screening esophagogastroduodenoscopy (EGD) for gastroesophageal varices. We aimed to evaluate the frequency of gastric neoplasia in compensated advanced chronic liver disease (cACLD) patients who underwent EGD for screening of gastroesophageal varices (GOEV) compared to a healthy population. METHODS: Retrospective study that enrolled all cACLD patients who underwent EGD for GOEV screening (January 2008-June 2018) in a tertiary reference center. cACLD patients were compared with asymptomatic healthy individuals who underwent EGD in a private hospital setting (April 2017-March 2018). RESULTS: We evaluated 1845 patients (481 cACLD patients, 1364 healthy individuals). A significantly higher frequency of gastric neoplasia was observed in patients with cACLD compared to healthy individuals (4.0% vs. 1.0 %; p < 0.001). Rare histopathological subtypes (WHO Classification) accounted for 28.7 % of gastric carcinoma cases in the cACLD cohort. Seven cases of gastric neoplasia (36.8 % of gastric neoplasia cases in the cACLD patients) were diagnosed in patients who, according to the Baveno VII criteria, would have not been submitted to EGD. CONCLUSION: We found an increased frequency of gastric neoplasia in patients with cACLD in comparison with healthy individuals. In countries with intermediate-high risk for GC, continuing to perform EGD could be beneficial.

Brain metastasis: An insight into novel molecular targets for theranostic approaches.

Brain metastases (BrM) are common malignant lesions in the central nervous system, and pose a significant threat in advanced-stage malignancies due to delayed diagnosis and limited therapeutic options. Their distinct genomic profiles underscore the need for molecular profiling to tailor effective treatments. Recent advances in cancer biology have uncovered molecular drivers underlying tumor initiation, progression, and metastasis. This, coupled with the advances in molecular imaging technology and radiotracer synthesis, has paved the way for the development of innovative radiopharmaceuticals with enhanced specificity and affinity for BrM specific targets. Despite the challenges posed by the blood-brain barrier to effective drug delivery, several radiolabeled compounds have shown promise in detecting and targeting BrM. This manuscript provides an overview of the recent advances in molecular biomarkers used in nuclear imaging and targeted radionuclide therapy in both clinical and preclinical settings. Additionally, it explores potential theranostic applications addressing the unique challenges posed by BrM.

Development of a new affinity maturation protocol for the construction of an internalizing anti-nucleolin antibody library.

Over the last decades, monoclonal antibodies have substantially improved the treatment of several conditions. The continuous search for novel therapeutic targets and improvements in antibody's structure, demands for a constant optimization of their development. In this regard, modulation of an antibody's affinity to its target has been largely explored and culminated in the discovery and optimization of a variety of molecules. It involves the creation of antibody libraries and selection against the target of interest. In this work, we aimed at developing a novel protocol to be used for the affinity maturation of an antibody previously developed by our group. An antibody library was constructed using an in vivo random mutagenesis approach that, to our knowledge, has not been used before for antibody development. Then, a cell-based phage display selection protocol was designed to allow the fast and simple screening of antibody clones capable of being internalized by target cells. Next generation sequencing coupled with computer analysis provided an extensive characterization of the created library and post-selection pool, that can be used as a guide for future antibody development. With a single selection step, an enrichment in the mutated antibody library, given by a decrease in almost 50% in sequence diversity, was achieved, and structural information useful in the study of the antibody-target interaction in the future was obtained.

Whey protein concentrate and skimmed milk powder as encapsulation agents for coffee silverskin extracts processed by spray drying.

We tested the hypothesis that milk proteins, through microencapsulation, guarantee protection against bioactive substances in coffee silverskin extracts. Therefore, the aim of this study was to carry out technological, nutritional and physicochemical characterisation of a coffee silverskin extract microencapsulated using instant skim milk powder and whey protein concentrate as wall materials. The aqueous extract of coffee silverskin was spray-dried using 10% (w/v) skim milk powder and whey protein concentrate. The samples were characterised by determining the water content, water activity, particle size distribution, colour analysis and total phenolic compound content as well as antioxidant activity using 2,2-diphenyl-radical 1-picrylhydrazyl scavenging methods, nitric oxide radical inhibition and morphological analysis. The product showed water activity within a range that ensured greater stability, and the reduced degradation of the dried coffee silverskin extract with whey protein concentrate resulted in better rehydration ability. The luminosity parameter was higher and the browning index was lower for the encapsulated samples than for the pure coffee silverskin extract. The phenolic compound content (29.23 ± 8.39 and 34.00 ± 8.38 mg gallic acid equivalents/g for the coffee silverskin extract using skimmed milk powder and whey protein concentrate, respectively) and the antioxidant activity of the new product confirmed its potential as a natural source of antioxidant phenolic compounds. We conclude that the dairy matrices associated with spray drying preserved the bioactive and antioxidant activities of coffee silverskin extracts.

Early life adversity is associated with greater similarity in neural representations of ambiguous and threatening stimuli.

Exposure to early life adversity (ELA) is hypothesized to sensitize threat-responsive neural circuitry. This may lead individuals to overestimate threat in the face of ambiguity, a cognitive-behavioral phenotype linked to poor mental health. The tendency to process ambiguity as threatening may stem from difficulty distinguishing between ambiguous and threatening stimuli. However, it is unknown how exposure to ELA relates to neural representations of ambiguous and threatening stimuli, or how processing of ambiguity following ELA relates to psychosocial functioning. The current fMRI study examined multivariate representations of threatening and ambiguous social cues in 41 emerging adults (aged 18 to 19 years). Using representational similarity analysis, we assessed neural representations of ambiguous and threatening images within affective neural circuitry and tested whether similarity in these representations varied by ELA exposure. Greater exposure to ELA was associated with greater similarity in neural representations of ambiguous and threatening images. Moreover, individual differences in processing ambiguity related to global functioning, an association that varied as a function of ELA. By evidencing reduced neural differentiation between ambiguous and threatening cues in ELA-exposed emerging adults and linking behavioral responses to ambiguity to psychosocial wellbeing, these findings have important implications for future intervention work in at-risk, ELA-exposed populations.

Heterogeneity in families with ATTRV30M amyloidosis: a historical and longitudinal Portuguese case study impact for genetic counselling.

BACKGROUND: Hereditary transthyretin amyloidosis (ATTRv amyloidosis) is an inherited disease, where the study of family history holds importance. This study evaluates the changes of age-of-onset (AOO) and other age-related clinical factors within and among families affected by ATTRv amyloidosis. METHODS: We analysed information from 934 trees, focusing on family, parents, probands and siblings relationships. We focused on 1494 female and 1712 male symptomatic ATTRV30M patients. Results are presented alongside a comparison of current with historical records. Clinical and genealogical indicators identify major changes. RESULTS: Overall, analysis of familial data shows the existence of families with both early and late patients (1/6). It identifies long familial follow-up times since patient families tend to be diagnosed over several years. Finally, results show a large difference between parent-child and proband-patient relationships (20-30 years). CONCLUSIONS: This study reveals that there has been a shift in patient profile, with a recent increase in male elderly cases, especially regarding probands. It shows that symptomatic patients exhibit less variability towards siblings, when compared to other family members, namely the transmitting ancestors' age of onset. This can influence genetic counselling guidelines.

A mechanism for deviance detection and contextual routing in the thalamus: a review and theoretical proposal.

Predictive processing theories conceptualize neocortical feedback as conveying expectations and contextual attention signals derived from internal cortical models, playing an essential role in the perception and interpretation of sensory information. However, few predictive processing frameworks outline concrete mechanistic roles for the corticothalamic (CT) feedback from layer 6 (L6), despite the fact that the number of CT axons is an order of magnitude greater than that of feedforward thalamocortical (TC) axons. Here we review the functional architecture of CT circuits and propose a mechanism through which L6 could regulate thalamic firing modes (burst, tonic) to detect unexpected inputs. Using simulations in a model of a TC cell, we show how the CT feedback could support prediction-based input discrimination in TC cells by promoting burst firing. This type of CT control can enable the thalamic circuit to implement spatial and context selective attention mechanisms. The proposed mechanism generates specific experimentally testable hypotheses. We suggest that the L6 CT feedback allows the thalamus to detect deviance from predictions of internal cortical models, thereby supporting contextual attention and routing operations, a far more powerful role than traditionally assumed.

A data-driven typology of emotion regulation profiles.

Typologies serve to organize knowledge and advance theory for many scientific disciplines, including more recently in the social and behavioral sciences. To date, however, no typology exists to categorize an individual's use of emotion regulation strategies. This is surprising given that emotion regulation skills are used daily and that deficits in this area are robustly linked with mental health symptoms. Here, we attempted to identify and validate a working typology of emotion regulation across six samples (collectively comprised of 1,492 participants from multiple populations) by using a combination of computational techniques, psychometric models, and growth curve modeling. We uncovered evidence for three types of regulators: a type that infrequently uses emotion regulation strategies (Lo), a type that uses them frequently but indiscriminately (Hi), and a third type that selectively uses some (cognitive reappraisal and situation selection), but not other (expressive suppression), emotion regulation strategies frequently (Mix). Results showed that membership in the Hi and Mix types is associated with better mental health, with the Mix type being the most adaptive of the three. These differences were stable over time and across different samples. These results carry important implications for both our basic understanding of emotion regulation behavior and for informing future interventions aimed at improving mental health. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Current Insights on Lipid-Based Nanosystems 2023.

Among the different types of nanosystems that have been investigated for therapeutic use, lipid-based ones are the most explored, as they have advantages over non-lipid nanosystems, especially for improving the transport and efficacy of drugs through different routes of administration, such as ocular, cutaneous, intranasal, and intravenous [...].

Emergência dos complexos culturais nas ecovilas: estudos etnográficos Brasil/Suíça / The emergence of cultural complexes in ecovillages: ethnographic studies Brazil/Switzerland

Este artigo contribui com o estudo sobre subjetividade dos moradores de ecovilas a partir do conceito de complexo cultural. A pesquisa foca nos complexos que emergiram em relação ao indivíduo, ao coletivo e à natureza, procurando entender como eles se desenvolveram e foram trabalhados. Contamos com a noção de complexos culturais para compreendermos as relações dos indivíduos consigo, com os outros e com o meio ambiente em contextos comunitários. Fizemos observações participantes em três ecovilas. As análises nos mostram que a vida em ecovilas desenvolve complexos coletivos que mediam as relações dos indivíduos com os seus respectivos grupos no que tange aos aspectos da individualidade e da coletividade, bem como aos modos de se relacionar com a natureza. Contudo, em cada comunidade, o contexto físico e a presença ou ausência de trabalhos de autorreflexão desenvolviam os complexos culturais de formas distintas, produzindo relações específicas de cada indivíduo com seu contexto.

This article aims to contribute to the subjectivity study of ecovillage dwellers based on the concept of cultural complex. The investigation focused on the complexes that emerged with regard to the individual, collective, and nature, how they developed and were worked on. We rely on the notion of cultural complexes to understand the relationships of individuals with themselves, with others, and with the environment in the community framework. We observed the participants in two ecovillages in Switzerland and one in Brazil. The analyses evidenced that life in ecovillages develops collective complexes that mediate the relationships of individuals with their relevant groups regarding aspects of individuality and collectivity and ways of relating to nature. However, in each community, the physical context and the presence or absence of self-reflection works developed cultural complexes in different ways, producing specific relationships between each individual and their context.

Concepts, spaces, and leisure practices from the perspective of youth

Abstract Aim: To investigate how the choices of young people for public or private spaces during their leisure practices, regardless of gender and age group, can be a starting point for the definition of agendas for the constitution of governmental public policies. Methods: The empirical task was accomplished through the application of electronic questionnaires to young university students from Portugal (20%), Brazil (70%), and South Africa (10%). The sample consisted of 705 randomly chosen young people, with an average age of 24 years. The data were analyzed using SPSS and content analysis. The analysis was divided into three categories: comprising the student's profile; referring to leisure and relating to the provision of leisure and space. Results: The youngest people choose the public spaces for their leisure practices and conceive leisure as a moment when they can do whatever they want, without obligations, followed by leisure as fun and free time. There is no difference between men and women in the concept of leisure. The main conclusions highlighted that leisure means to 'do what I want without any obligation to do so', followed by 'fun' and 'free time, and young people like to 'go out with friends, 'play sports' and 'do nothing'. The public space is the most used for leisure. Conclusion: The meaning of leisure is loaded with subjectivities, so we understand that the demands for political actions that enable the use of public spaces safely and with quality are the way to guarantee the rights of the population.

The FAIRness of data management plans: an assessment of some European DMPs / FAIRness dos planos de gestão de dados: uma avaliação de alguns PGDs Europeus / FAIRness de los planes de gestión de datos: una evaluación de algunos PGDs Europeos

The FAIR principles have become a data management instrument for the academic and scientific community, since they provide a set of guiding principles to bring findability, accessibility, interoperability and reusability to data and metadata stewardship. Since their official publication in 2016 by Scientific Data ­ Nature, these principles have received worldwide recognition and have been quickly endorsed and adopted as a cornerstone of data stewardship and research policy. However, when put into practice, they occasionally result in organisational, legal and technological challenges that can lead to doubts and uncertainty as to whether the effort of implementing them is worthwhile. Soon after their publication, the European Commission and other funding agencies started to require that project proposals include a Data Management Plan (DMP) based on the FAIR principles. This paper reports on the adherence of DMPs to the FAIR principles, critically evaluating ten European DMP templates. We observed that the current FAIRness of most of these DMPs is only partly satisfactory, in that they address data best practices, findability, accessibility and sometimes preservation, but pay much less attention to metadata and interoperability.

Os princípios FAIR tornaram-se um instrumento de gestão de dados para a comunidade acadêmica e científica, uma vez que fornecem um conjunto de princípios orientadores que facilitam a localização, acessibilidade, interoperabilidade e reutilização de dados e metadados. Desde sua publicação oficial em 2016 pela Scientific Data - Nature, esses princípios receberam reconhecimento mundial e foram rapidamente endossados e adotados como pilares da gestão de dados e das políticas de pesquisa. No entanto, quando postos em prática, apresentam ocasionalmente desafios organizacionais, jurídicos e tecnológicos que podem levar a dúvidas e incertezas quanto ao esforço em implementá-los. Logo após sua publicação, a Comissão Europeia e outras agências de financiamento começaram a exigir nas suas propostas de projetos um Plano de Gestão de Dados (PGD) com base nos princípios da FAIR. Este artigo relata a aderência dos PGDs aos princípios FAIR, avaliando criticamente dez modelos europeus de PGD. Observamos que o nível de FAIRness da maioria dos PGDs analisados ainda é parcialmente satisfatório, uma vez que abordam as melhores práticas de dados, localização, acessibilidade e, às vezes, preservação, mas dão pouca atenção aos metadados e a interoperabilidade.

Los principios FAIR se han convertido en una herramienta de gestión de datos para la comunidad académica y científica, ya que proporcionan un conjunto de principios rectores que facilitan la localización, accesibilidad, interoperabilidad y reutilización de la gestión de datos y metadatos. Desde su publicación oficial en 2016 por Scientific Data - Nature, estos principios han recibido reconocimiento mundial y fueron rápidamente respaldados y adoptados como pilares de la política de investigación y gestión de datos. Sin embargo, cuando se ponen en práctica, ocasionalmente presentan desafíos organizativos, legales y tecnológicos que pueden generar dudas e incertidumbres sobre el esfuerzo para implementarlos. Poco después de su publicación, la Comisión Europea y otras agencias de financiación comenzaron a exigir en sus propuestas de proyectos un Plan de Gestión de Datos (PGD) basado en los principios de FAIR. Este artículo informa sobre la adherencia de los PGD a los principios FAIR, evaluando críticamente diez modelos europeos de PGD. Observamos que el nivel de FAIRness de la mayoría de los PGD analizados sigue siendo parcialmente insatisfactorio, ya que abordan las mejores prácticas de datos, ubicación, accesibilidad y, a veces, preservación, pero prestan poca atención a los metadatos y la interoperabilidad.

A intervenção "Ensino do cuidado com os pés" para pessoas com diabetes: ensaio clínico randomizado

Introdução: pessoas com diabetes possuem risco aumentado para o desenvolvimento de morbidades nos membros inferiores, o que está relacionado a amputações. Objetivo: analisar o efeito da intervenção "Ensino do Cuidado com os Pés", realizada por meio de visitas domiciliares, na integridade tissular, no conhecimento sobre as atividades de autocuidado e na intenção de cuidar dos pés. Método: ensaio clínico paralelo, de mascaramento único e randomizado com taxa de alocação de 1:1, desenvolvido com pessoas com Diabetes tipo 2. O desfecho primário está relacionado a avaliação da integridade tissular e o secundário, ao conhecimento sobre as atividades de autocuidado e à intenção em realizar cuidados com os pés. Resultados: Participaram do estudo 72 pessoas, divididas em grupo controle e tratado. O grupo controle apresentou diferença significativa (p=<0,05) nos indicadores de pele e anexo, circulação, sensibilidade, conhecimento e intenção de cuidar dos pés. Conclusão: "Ensino do Cuidado com os Pés" é uma estratégia que pode influenciar os indicadores de comprometimento dos pés. nº 20376013.2.0000.5142

A arte do palhaço na educação médica / The art of clowning in medical education

Resumo: Introdução: Em todo o mundo, a arte tem sido utilizada como recurso pedagógico no curso médico. No Brasil, vários grupos de "palhaçoterapia" - projetos que envolvem a atuação de estudantes como palhaços-doutores - foram criados visando promover uma humanização do cuidado nos hospitais. A partir daí, vários estudos começaram a identificar impactos da participação nesses projetos na formação médica. Este estudo investiga a percepção do profissional formado acerca da influência da experiência como palhaço-doutor na sua prática médica. Objetivo: Este estudo tem como objetivo analisar, na graduação de Medicina, a formação na arte do palhaço como estratégia para contribuir para o desenvolvimento de competências na prática médica. Método: Trata-se de uma pesquisa exploratória e descritiva com abordagem qualitativa, por meio de entrevista semiestruturada com 15 participantes, que foram escolhidos pela técnica da bola de neve. O universo da pesquisa consiste em médicos que participaram de projetos de palhaçoterapia durante a graduação, em Recife, Pernambuco. As informações coletadas foram organizadas com o auxílio do software MAXQDA e submetidas à análise textual discursiva proposta por Moraes, que segue três passos de forma cíclica: a desmontagem dos textos em unidades de significado, o estabelecimento de relações e a captação do emergente. Resultado: A partir da análise das transcrições das entrevistas, emergiram diversas categorias de competências relatadas pelos participantes. No processo de construção de um novo significado com base nesses achados, foi necessário selecionar os que tinham relação com o que estava proposto nas Diretrizes Curriculares Nacionais (DCN) de Medicina de 2014. As habilidades percebidas foram agrupadas nas seguintes categorias: sensibilização, ressignificação, lidar com o erro e relação com o paciente. Conclusão: Esta pesquisa procurou explorar o fenômeno translacional, por meio do qual se investigaram quais ensinamentos, na visão de profissionais da medicina, foram apreendidos para sua prática a partir da aprendizagem e do exercício da arte do palhaço. Quando se realizou essa comparação com as DCN, foi possível encontrar interseções entre o que se espera desenvolver durante a formação médica e algumas das competências desenvolvidas com ajuda da arte do palhaço.

Abstract: Introduction: Art has been used as a teaching resource in medical education around the world. In Brazil, several "clown therapy" groups - a common name for projects in which students perform as "clown doctors" in hospitals - have been created with the aim of helping to humanize hospital care. Several studies have identified the impacts on medical training, as perceived by the participants of such projects. This study investigates how trained professionals view the influence of their previous experiences as clown doctors on actual medical practice. Objective: To analyze clown training in medical school as a strategy to contribute to the development of medical practice skills. Method: This is an exploratory and descriptive study with a qualitative approach. Semi-structured interviews were conducted with 15 participants, who were chosen using the snowball technique. The sample consists of doctors who participated in clown therapy projects during their undergraduate training, in Recife, Pernambuco. The collected information was organized with the MAXQDA software and underwent discursive content analysis as proposed by Moraes, which follows a three-step cycle: the deconstruction of text into units of meaning, the establishment of relationships, and the capture of the emerging knowledge. Result: Analysis of the interview transcripts generated several categories of competencies reported by the participants. In the process of constructing new meaning based on these findings, it was necessary to select those that were related to the proposals of the 2014 National Curriculum Guidelines (DCNs) for medicine. The perceived skills were grouped into the following categories: awareness, resignification, dealing with error and physician-patient relationship. Conclusion: This research sought to explore the translational phenomenon, investigating which competencies, in the eyes of medical professionals, were learned from practicing the art of clowning. By drawing comparisons with the National Curriculum Guidelines (DCNs), intersections were found between expected development during medical training and some of the skills developed with the help of the art of clowning.

Recomendações para a qualidade dos Programas de Residência de Medicina de Família e Comunidade no Brasil / Recomendaciones para la calidad de los programas de residencia en medicina familiar y comunitaria en Brasil / Recommendations for the quality of Family Medicine Residency Programs in Brazil

Diante de mudanças recentes no panorama nacional de programas de incentivos para provimento e formação médica em Atenção Primária à Saúde (APS), o Grupo de Trabalho de Ensinagem da SBMFC organizou um Encontro Nacional entre os dias 29 de novembro e 1º de dezembro de 2019, na cidade do Rio de Janeiro/RJ. O evento reuniu professores, supervisores, preceptores e residentes de Medicina de Família e Comunidade de diferentes regiões do país, e teve como objetivos discutir o atual cenário, além de elencar recomendações para qualidade dos PRMFC e caminhos para o fortalecimento da formação de médicas e médicos de família e comunidade via Residência Médica. Essas recomendações buscaram considerar a diversidade dos PRMFC em um país tão vasto quanto o Brasil e, principalmente, a necessidade de se estabelecer parâmetros mínimos de organização para os programas das mais variadas configurações, como PRMFC vinculados a Instituições de Ensino Superior (IES), secretarias estaduais ou municipais de saúde. As recomendações foram então organizadas em três eixos: 1) recomendações para supervisores e coordenadores de PRMFC e modelos possíveis de preceptoria; 2) recomendações para formuladores e executores de políticas públicas; e 3) recomendações para lideranças da medicina de família e comunidade.

Facing recent changes in the national panorama of incentive programs for provision and medical training in Primary Health Care, the Education Work Group of the SBMFC organized a National Meeting between November 29th and December 1st, 2019, in the city of Rio de Janeiro-RJ. The event brought together professors, supervisors, tutors and residents of Family and Community Medicine from different regions of the country, to discuss the current scenario, in addition to listing both benchmark recommendations for the quality of Residency Programs in Family and Community Medicine (RPFCM) and paths for strengthening the training of family and community doctors through Medical Residency. These recommendations sought to consider the diversity of RPFCM in a country as vast as Brazil and, mainly, the urge to establish the minimum organizational parameters for programs of the most varied configurations, such as: RPFCMs linked to higher education institutions (HEIs), state or municipal health departments. The recommendations were then organized into three axes: 1) recommendations for supervisors and coordinators and possible models of preceptorship; 2) recommendations for public policy makers and executors; and 3) recommendations for family medicine community leaders.

Primaria de Salud, el Grupo de Trabajo Docente de la SBMFC organizó una Reunión Nacional entre el 29 de noviembre y el 1 de diciembre de 2019, en la ciudad de Río de Janeiro - RJ. El evento reunió a profesores, supervisores, preceptores y residentes de medicina familiar y comunitaria de diferentes regiones del país, y tuvo como objetivo discutir el escenario actual, además de enumerar recomendaciones para la calidad de los programas de residencia médica en medicina familiar y comunitaria (PRMFC) y formas de fortalecer la formación de médicas y médicos de familia y comunidad través de residencia médica. Estas recomendaciones buscaron considerar la diversidad de PRMFC en un país tan vasto como Brasil y, principalmente, la necesidad de establecer parámetros organizacionales mínimos para programas de las más variadas configuraciones, tales como PRMFC vinculados a instituciones de educación superior (IES), departamentos de salud estatales o municipales. Las recomendaciones se organizaron en tres ejes: 1) recomendaciones para supervisores y coordinadores de PRMFC y posibles modelos de preceptoría; 2) recomendaciones para encargados de la formulación de políticas públicas y ejecutores; y 3) recomendaciones para los líderes de la medicina familiar y comunitaria.

Efeito do grupo operativo no ensino do autocuidado com os pés de diabéticos: ensaio clínico randomizado / Efecto del grupo operatorio en la enseñanza del autocuidado con los pies de diabéticos: ensayo clínico aleatorizado / The effect of operative groups on diabetic foot self-care education: a randomized clinical trial

RESUMO Objetivo Avaliar o efeito do grupo operativo no ensino do autocuidado com os pés para prevenção do pé diabético. Método Ensaio clínico controlado e cego, realizado com voluntários que apresentavam Diabetes Mellitus tipo 2, randomizados em grupo tratado (55 pessoas) e grupo controle (54 pessoas). O grupo tratado recebeu a intervenção educativa "Ensino do autocuidado com os pés" e o grupo controle foi somente avaliado. As avaliações dos pés ocorreram antes e após a intervenção, bem como 15 dias depois desta (follow-up). A intervenção foi realizada por meio do grupo operativo e desenvolvida com orientação escrita, expositiva dialogada e role-playing. Foram utilizados os testes: Shapiro-Wilk, Qui-quadrado, Teste T, Mann-Whitney, McNemar e Wilcoxon emparelhado. Resultados Participaram 109 voluntários. Houve homogeneidade entre os grupos nas variáveis sociodemográficas. Na análise intergrupo, foi observada melhora após a intervenção educativa para: a maioria das variáveis dos domínios pele anexos; circulação sanguínea; sensibilidade plantar; e pressão plantar. Observou-se melhora nos escores do risco do pé diabético no grupo tratado. Conclusão A intervenção educativa por meio do grupo operativo foi eficaz, pois estimulou o autocuidado e reduziu o potencial de risco para o pé diabético. Registro Brasileiro de Ensaios Clínicos: RBR- 753 Kcg.

RESUMEN Objetivo Evaluar el efecto del grupo operativo en la enseñanza del autocuidado de los pies para prevenir el pie diabético. Método Un ensayo clínico controlado y ciego realizado con voluntarios que padecían diabetes mellitus de tipo 2, asignados al azar a un grupo tratado (55 personas) y a un grupo de control (54 personas). El grupo tratado recibió la intervención educativa "Enseñanza del autocuidado de los pies" y el grupo de control sólo fue evaluado. Las evaluaciones de los pies se realizaron antes y después de la intervención, así como 15 días después de la intervención (seguimiento). La intervención se llevó a cabo a través del grupo operativo y se desarrolló con orientación escrita, diálogo expositivo y juego de roles. Se utilizaron las pruebas: Shapiro-Wilk, Chi-cuadrado, T-test, Mann-Whitney, McNemar y Wilcoxon pareado. Resultados 109 voluntarios participaron. Había homogeneidad entre los grupos en las variables sociodemográficas. En el análisis intergrupal, se observó una mejora después de la intervención educativa para: la mayoría de las variables de piel y anexos; la circulación sanguínea; la sensibilidad plantar; y la presión plantar. Se observó una mejora en las puntuaciones de riesgo del pie diabético en el grupo tratado. Conclusión La intervención educativa a través del grupo operativo fue eficaz, porque estimuló el autocuidado y redujo el riesgo potencial para el pie diabético. Registro Brasileño de Ensayos Clínicos (Registro Brasileiro de Ensaios Clínicos): RBR- 753 Kcg.

ABSTRACT Objective To evaluate the effect of operative groups on teaching self-care for diabetic foot prevention. Method Controlled, blinded clinical trial with volunteers presenting type 2 Diabetes Mellitus, randomized into treatment (55 subjects) and control (54 subjects) groups. The treatment group received the educational intervention "Teaching foot self-care", whereas the control group was simply evaluated. Feet evaluation was conducted before and after the intervention, as well as 15 days later in a follow-up. The intervention was conducted through an operative group and developed with orientation via writing, explained through dialogue and role-playing. The following tests were used: Shapiro-Wilk, Chi-squared, t-test, Mann-Whitney, McNemar, and paired Wilcoxon. Results One-hundred and nine volunteers took part in this study. Their sociodemographic variables were homogeneous. In an analysis between groups, an improvement was observed after the educational intervention regarding most variables related to skin annexes, blood flow, foot sensitivity, and foot pressure. Improved scores for risk of diabetic foot in the treatment group were observed. Conclusion The educational intervention through operative group was efficient, for it encouraged self-care and reduced potential risk of diabetic foot. Brazilian Registry of Clinical Trials (Registro Brasileiro de Ensaios Clínicos): RBR- 753 Kcg.