Moderate-intensity constant or high-intensity interval training? Metabolic effects on candidates to undergo bariatric surgery.

BACKGROUND & AIMS: Bariatric surgery is highly effective against obesity. Pre-surgical exercise programs are recommended to prepare the candidate physically and metabolically for surgery-related rapid weight loss. However, the ideal exercise prescription in this population is unknown. This study aimed to compare the metabolic effects of moderate-intensity constant (MICT) vs. a high-intensity interval training (HIIT) program in candidates to undergo bariatric surgery. METHODS AND RESULTS: Twenty-five candidates (22 women) to undergo sleeve gastrectomy aged from 18 to 60 years old were recruited. At baseline, we measured body composition, physical activity levels, grip strength, and aerobic capacity. Further, we assessed metabolic function through glycemia and insulinemia (both fasting and after oral glucose tolerance test (OGTT)), homeostatic model assessment for insulin resistance (HOMA-IR), lipid profile, glycated haemoglobin (HbA1c), transaminases, fibroblast growth factor 21 (FGF21), growth differentiation factor 15 (GDF15), apelin, and adiponectin. Afterward, participants were randomized into MICT (n = 14) or HIIT (n = 11). Both training programs consisted of 10 sessions (2-3 times/week, 30 min per session) distributed during 4 weeks before the surgery. After this, all outcomes were measured again at the end of the training programs and 1 month after the surgery (follow-up). A mixed effect with Tukey's post-hoc analysis was performed to compare values at baseline vs. post-training vs. postsurgical follow-up. Both training programs increased aerobic capacity after training (p < 0.05), but only after MICT these changes were kept at follow-up (p < 0.05). However, only MICT decreased fat mass and increased total muscle mass and physical activity levels (p < 0.05). Metabolically, MICT decreased insulinemia after OGTT (p < 0.05), whereas HIIT increased adiponectin after training and GDF15 at follow-up (both p < 0.05). CONCLUSIONS: Both MICT and HIIT conferred benefits in candidates to undergo bariatric surgery, however, several of those effects were program-specific, suggesting that exercise intensity should be considered when preparing these patients. Future studies should explore the potential benefits of prescribing MICT or HIIT in a customized fashion depending on a pretraining screening, along with possible summatory effects by combining these two exercise programs (MICT + HIIT). CLINICAL TRIAL REGISTRATION: International Traditional Medicine Clinical Trial Registry, N° ISRCTN42273422.

Rebaudioside A from Stevia rebaudiana stimulates GLP-1 release by enteroendocrine cells via bitter taste signalling pathways.

Glucagon-like peptide 1 (GLP-1) is a multifaceted intestinal hormone with diverse physiological functions throughout the body. Previously, we demonstrated that the steviol glycoside rebaudioside A (rebA) from Stevia rebaudiana stimulates the release of GLP-1 from mouse intestinal organoids and pig intestinal segments. To further unravel the underlying mechanisms, we examined the involvement of sweet- and bitter taste receptors and their associated signal transduction pathways. Experiments with mouse and human intestinal enteroendocrine cell lines (STC-1 and HuTu-80, respectively) confirmed that rebA stimulates GLP-1 release in a concentration-dependent manner. Experiments with selective inhibitors of sweet signalling in both the murine as well as the human enteroendocrine cells showed that the GLP-1-induced release by rebA occurs independently of the sweet taste receptor. Functional screening of 34 murine bitter taste receptors (Tas2rs) revealed an activation response with Tas2r108, Tas2r123 and Tas2r134. Moreover, we found evidence in human HuTu-80 cells, that TAS2R4 and TRPM5 are involved in rebA-induced GLP-1 secretion, suggesting a role for bitter taste signaling in gut hormone release. Interestingly, the rebA-dependent GLP-1 release may be modulated by GABA and 6-methoxyflavanone present in the diet. Together, our findings warrant further characterization of the specific metabolic effects of rebA among the non-caloric sweeteners.

COVID-19 and the Latinx Community: "Promotoras Represent a Community in Pain".

COVID-19 has disproportionately affected the Latinx community, leading to heightened economic instability and increased mortality/morbidity. Frontline community health workers (promotoras) have played an integral role in serving low-income Latinx immigrant communities, disseminating health information to this vulnerable community while also facing heightened risks to their own health and wellbeing. This study explores the impact of the pandemic on Latinx communities and the promotoras that serve them, examining how the stresses and inequities the pandemic wrought might be mitigated. Promotoras (N = 15, all female) were recruited from a local health agency in Santa Ana, CA and completed a semi-structured interview about their experiences during COVID-19. Qualitative analyses demonstrated that the pandemic substantially affected the daily lives both of community members, via economic challenges, limited access to reliable pandemic-related information, and psychological and social stress, and of promotoras, via changes to the nature of their work and psychological and social stress. Promotoras perceived that these harms might be mitigated by providing for economic and material needs in the community, and that promotoras can be fortified to continue serving the community through self-care and psychosocial healing practices. According to promotoras, the Latinx community needs economic and material resources to overcome COVID-19 related stressors. Additionally, promotoras may benefit from programming to preserve mental and physical health in the wake of new stressors. Lending greater support to promotoras within the agencies in which they are nested may enable them to be more successful in fulfilling their mission and sustaining their own health.

Examining Interpersonal Traumas Across Low Income Latinx Mother-Youth Dyads: Associations Between Maternal Child Abuse Exposure and Racial Discrimination with Mother and Youth Psychopathology.

Child abuse has intergenerational consequences for psychopathology, however, there remains a paucity of research regarding how these experiences affect Latinx families, particularly those at risk for additional negative life events, such as racial discrimination. This study aims to contribute to this gap in the literature by examining the impact maternal child abuse exposure has on youth and maternal psychopathology, as well as whether these associations are moderated by racial discrimination, in a sample of 224 Latinx mother-youth dyads. Hierarchical regressions revealed small but significant maternal child abuse exposure x racial discrimination interactions for youth depression and anxiety, but not maternal depression or anxiety, which were solely positively associated with maternal child abuse exposure. Findings highlight the multifarious, and at times convergent, nature of trauma and oppression among Latinx families, as well as the impact across generations. Future work is needed to further elucidate developmental pathways of intergenerational trauma in understudied populations.

Respuesta fisiológica al test de lanzadera en pacientes candidatos a cirugía bariátrica / Physiologic response to the incremental shuttle walk test in candidates to undergo bariatric surgery / Resposta fisiológica ao teste incremental de caminhada em candidatos a cirurgia bariátrica

Objetivos: la valoración de la tolerancia al ejercicio es clave para prescribir ejercicio en candidatos a cirugía bariátrica. El test de lanzadera (TL) se ha propuesto para este objetivo. Sin embargo, la evidencia que describe el rendimiento y respuesta fisiológica asociados a esta prueba en dicha población es escasa. El objetivo de este estudio fue describir la respuesta fisiológica a la realización del TL en candidatos a cirugía bariátrica. Métodos: este estudio transversal incluyó a 56 participantes. Se midieron factores antropométricos como la edad, peso, estatura y circunferencia de cintura, así como el nivel de actividad física espontáneo. Se valoró el rendimiento en el TL en metros, la respuesta fisiológica asociada en términos de frecuencia cardiaca de reserva (FCR) utilizada, presión arterial sistólica y diastólica, oximetría de pulso, sensación subjetiva al esfuerzo (SSE) y de fatiga de extremidades inferiores, antes y después del TL. Resultados: todos los participantes completaron la prueba sin complicaciones. Caminaron una mediana de 465 metros, equivalente al 61% de la distancia esperada. Utilizaron un 56% de la FCR, mientras que la SSE y fatiga de extremidades inferiores alcanzó valores 7/10 y 6/10 respectivamente. Fueron observadas asociaciones significativas entre el rendimiento en el TL vs factores antropométricos e indicadores de respuesta fisiológica. Conclusión: el TL es una prueba segura para valorar la tolerancia al esfuerzo en candidatos a cirugía bariátrica, la cual induce respuestas fisiológicas asociadas a intensidades moderadas. Se sugiere incluir esta prueba para la valoración de la condición física de estos sujetos.

Objective: Exercise tolerance measurement is key for exercise prescription in bariatric surgery candidates. Thus, the incremental shuttle walking test (ISWT) has been proposed as a useful tool for this purpose. However, reports describing the performance, and related physiological response, in candidates to bariatric surgery are scarce. Therefore, the aim of this study was to describe the physiological response of bariatric surgery candidates to the ISWT. Methods: This cross-sectional study included 56 participants. Anthropometric factors such as age, weight, height, and waist circumference were measured, as well as their spontaneous physical activity levels. Their ISWT performance was recorded, as well as the percentage of heart rate reserve used during the test, systolic and diastolic pressure, pulse oximetry, perceived exertion scale, and lower extremities fatigue, both before and after the ISWT. Results: All participants completed the test without complications. They walked a median of 465 meters, 61% of the expected distance. Heart rate reserve utilization reached 56%, while the perceived exertion rate and lower extremities fatigue reached 7/10 and 6/10, respectively. Moreover, significant associations between the ISWT performance vs anthropometric factors and physiological response outcomes were found. Conclusion: The ISWT is a safe and useful tool to assess exercise tolerance in bariatric surgery candidates, which induces physiological responses associated to moderate effort intensities. We suggest including the ISWT when assessing the physical performance of bariatric surgery candidates.

Objetivo: A medida da tolerância ao exercício é fundamental para a prescrição do exercício em candidatos à cirurgia bariátrica. Assim, o teste incremental de caminhada em vaivém (ISWT) tem sido proposto como uma ferramenta útil para este fim. No entanto, são escassos os relatos que descrevem o desempenho e a resposta fisiológica relacionada em candidatos à cirurgia bariátrica. Portanto, o objetivo deste estudo foi describir a resposta fisiológica do ISWT em candidatos à cirurgia bariátrica. Métodos: Este estudo transversal incluiu 56 participantes. Fatores antropométricos como idade, peso, altura, circunferência da cintura foram medidos, assim como os níveis de atividade física espontânea. O desempenho do ISWT foi registrado, assim como a porcentagem de reserva de frequência cardíaca utilizada durante o teste, pressão sistólica e diastólica, oximetria de pulso, escala de esforço percebido e fadiga de membros inferiores, tanto antes quanto após o ISWT. Resultados: Todos os participantes completaram o teste sem intercorrências. Eles caminharam uma mediana de 465 metros, o equivalente a 61% da distância esperada. A utilização de reserva de frequência cardíaca atingiu 56%, enquanto a taxa de esforço percebido e fadiga de membros inferiores atingiram 7/10 e 6/10, respectivamente. Além disso, foram encontradas associações significativas entre o desempenho do ISWT versus fatores antropométricos e os resultados da resposta fisiológica. Conclusão: O ISWT é uma ferramenta segura e útil para avaliar a tolerância ao exercício em candidatos à cirurgia bariátrica, que induz respostas fisiológicas associadas a intensidades moderadas de esforço. Sugerimos incluir o ISWT para avaliar o desempenho físico dos candidatos à cirurgia bariátrica.

Más que palabras: Understanding the mental health and behavioral consequences of sociodemographic risk and deportation fears in Latinx families.

OBJECTIVE: Exponential increases in deportation and negative public discourse have resulted in heightened fears of profiling and deportation among Latinx immigrant families in the United States. Deportation fears could compound the inequalities Latinx families face, worsening mental and behavioral health. To better understand the mental health consequences of the climate of deportation concerns among low-income Latinx mothers in the United States, we conducted a linguistic analysis of interviews of Latinx mothers' parenting experiences, examining their use of words related to deportation fears (e.g., separado). We examined the interaction of sociodemographic risk with maternal deportation fears in predicting maternal and youth mental health. METHOD: Recent immigrant Latinx mothers (N = 160) and youth (Mage = 12.88, SDage = 1.73) completed the Parent Development Interview-Revised (Slade et al., 2004), analyzed using a deportation fears custom dictionary (Linguistic Inquiry and Word Count; Pennebaker et al., 2003). Mothers completed the Brief Symptom Inventory (Derogatis, 2001); youth completed the Youth Self-Report (Achenbach, 1991). Cumulative sociodemographic risk was assessed using a composite score of six risk variables. RESULTS: Regressions revealed significant Sociodemographic Risk × Deportation Fear interactions for maternal depression (p = .01) and youth depression (p < .01) but not for maternal anxiety, youth anxiety, or aggression. As sociodemographic risk increased, associations between deportation fears and psychopathology decreased. CONCLUSIONS: The adverse impact of maternal deportation fears on mental health is visible only when demographic stress is lower. Deportation fears may increase mental health risk, potentially reducing treatment seeking among families previously at lower risk. Findings underscore the importance of policy and sociocultural shifts. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Saving a seat at the table for community members: co-creating an attachment-based intervention for low-income Latinx parent-youth dyads using a promotor/a model.

Evidence for the effectiveness of attachment-based interventions in improving youth's socioemotional health increases each year, yet potential for scalability of existing programs is limited. Available programs may have lower acceptability within low-income immigrant communities. Co-designing and implementing interventions with trained community workers (Promotors) offers an appealing solution to multiple challenges, but community workers must have high investment in the program for this to be a workable solution. This study examines the experiences of promotors involved in the co-creation and delivery of an attachmentbased intervention program for low-income Latinx youth (ages 8 to 17) and their mothers. Promotors (N=8) completed surveys, reporting on the experiences of each therapy group in terms of group dynamic (e.g., promotors' connectedness to each group, perceived program relevance). Following the completion of the intervention study, promotors participated in interviews in which they described their experiences in co-creating the intervention, delivering the intervention to the community, and their recommendations for improving the intervention. Overall, promotors perceived group dynamics as positive, though the mother groups were evaluated as significantly higher in quality (e.g., lower conflict) than the youth groups. Interviews revealed that promotors enjoyed the cocreation process and identified important areas for improvements for the intervention (incorporation of more visuals, creation of agelimited groups, reducing number of youth sessions) and evaluation (reduction in length, modification of language). Integrating input from promotors in the process of co-creating and implementing an intervention can benefit every member of the community from the program participants to the providers themselves.

Barreras y Soluciones: Lessons learned from integrating research-based clinical techniques into a community agency serving low-income Latinx immigrant families.

Barriers facing effective science-to-practice translation have led scholars to conduct early-stage intervention research within community organizations. We describe our experiences developing a manualized parent-youth attachment-based group therapy intervention within a community health organization dedicated to serving low-income Latinx immigrant families, Latino Health Access (LHA), in which services are rendered by trained community workers (promotores). By conducting a qualitative analysis of interviews with all members of this academic-community partnership (research [Principal Investigator, student researchers] and community agency team members [Administrators, promotores]), we discuss the challenges and opportunities that this collaboration has generated. The results led both the research and community teams to question assumptions about the basic skills, values, and attitudes that underlie the integration of science and practice. We will share the insights that have helped to promote connection and understanding among the stakeholders and the efforts made to support the progress and successes of developing community interventions.

Los obstáculos que enfrenta el traslado eficaz de la ciencia a la práctica han conducido a los investigadores a realizar investigaciones en etapas iniciales de las intervenciones dentro de las organizaciones comunitarias. Describimos nuestras experiencias con el desarrollo de una intervención estandarizada de terapia grupal basada en el apego entre padres y jóvenes dentro de una organización de salud comunitaria dedicada a asistir a familias inmigrantes latinas de bajos recursos, Latino Health Access (LHA), en la cual prestan servicios trabajadores comunitarios capacitados (promotores). Al realizar un análisis cualitativo de las entrevistas con todos los miembros de esta asociación académico-comunitaria (investigación [investigador principal, investigadores estudiantes] y los miembros del equipo de la organización comunitaria [administradores, promotores], comentamos las dificultades y las oportunidades que ha generado esta colaboración. Los resultados llevaron a los equipos comunitarios y de investigación a cuestionar las suposiciones acerca de las habilidades básicas, los valores y las actitudes que forman la base de la integración de la ciencia y la práctica. Compartiremos los conocimientos que han contribuido a promover la conexión y la comprensión entre las partes interesadas y los esfuerzos realizados para fomentar el avance y los logros de desarrollar intervenciones comunitarias.

Spatial regulation by multiple Gremlin1 enhancers provides digit development with cis-regulatory robustness and evolutionary plasticity.

Precise cis-regulatory control of gene expression is essential for normal embryogenesis and tissue development. The BMP antagonist Gremlin1 (Grem1) is a key node in the signalling system that coordinately controls limb bud development. Here, we use mouse reverse genetics to identify the enhancers in the Grem1 genomic landscape and the underlying cis-regulatory logics that orchestrate the spatio-temporal Grem1 expression dynamics during limb bud development. We establish that transcript levels are controlled in an additive manner while spatial regulation requires synergistic interactions among multiple enhancers. Disrupting these interactions shows that altered spatial regulation rather than reduced Grem1 transcript levels prefigures digit fusions and loss. Two of the enhancers are evolutionary ancient and highly conserved from basal fishes to mammals. Analysing these enhancers from different species reveal the substantial spatial plasticity in Grem1 regulation in tetrapods and basal fishes, which provides insights into the fin-to-limb transition and evolutionary diversification of pentadactyl limbs.

Más Fuertes Juntos: Attachment relationship quality, but not demographic risk, predicts psychopathology in Latinx mother-youth dyads.

Latinx families are increasing in the population in the United States and have documented mental health concerns. Much remains to be understood about mental health predictors within this population. The present study aimed to help fill this gap and offer an in-depth assessment of psychopathology within a large (N = 330) sample of Latinx mothers and youth by exploring associations between sociodemographic risk, attachment relationship quality, and mental health. Demographic risk was not associated with youth or maternal psychopathology, but attachment relationship quality was associated with all indices of psychopathology in youth and mothers. The interaction between demographic risk and psychopathology only added to the prediction of maternal depression, revealing a pattern wherein maternal closeness was associated with lower depression at low and mean but not high levels of demographic risk. We discuss these findings in terms of the importance of supporting parent-child relationships in this population.

Parallel evolution of placental calcium transfer in the lizard Mabuya and eutherian mammals.

An exceptional case of parallel evolution between lizards and eutherian mammals occurs in the evolution of viviparity. In the lizard genus Mabuya, viviparity provided the environment for the evolution of yolk-reduced eggs and obligate placentotrophy. One major event that favored the evolution of placentation was the reduction of the eggshell. As with all oviparous reptiles, lizard embryos obtain calcium from both the eggshell and egg yolk. Therefore, the loss of the eggshell likely imposes a constraint for the conservation of the egg yolk, which can only be obviated by the evolution of alternative mechanisms for the transport of calcium directly from the mother. The molecular and cellular mechanisms employed to solve these constraints, in a lizard with only a rudimentary eggshell such as Mabuya, are poorly understood. Here, we used RT-qPCR on placental and uterine samples during different stages of gestation in Mabuya, and demonstrate that transcripts of the calcium transporters trpv6, cabp28k, cabp9k and pmca are expressed and gradually increase in abundance through pregnancy stages, reaching their maximum expression when bone mineralization occurs. Furthermore, CABP28K/9K proteins were studied by immunofluorescence, demonstrating expression in specific regions of the mature placenta. Our results indicate that the machinery for calcium transportation in the Mabuya placenta was co-opted from other tissues elsewhere in the vertebrate bodyplan. Thus, the calcium transportation machinery in the placenta of Mabuya evolved in parallel with the mammalian placenta by redeploying the expression of similar calcium transporter genes.

Confía en mí, Confío en ti: Applying developmental theory to mitigate sociocultural risk in Latinx families.

Ed Zigler was a champion for underprivileged youth, one who worked alongside communities to fight for long-lasting systemic changes that were informed by his lifespan and ecological perspective on the development of the whole child. This paper reports on the development, implementation, and preliminary outcomes of an intervention that embodied the Zigler approach by adopting a community participatory research lens to integrate complementary insights across community-based providers (promotoras), Latinx immigrant families, and developmental psychologists in the service of promoting parent-child relationship quality and preventing youth aggression and violence. Analyses from the first 112 Latinx mother-youth dyad participants (46% female children, ages 8-17) in the resultant, Confía en mí, Confío en ti, eight-week intervention revealed significant pre-post increases in purported mechanisms of change (i.e., attachment security, reflective functioning) and early intervention outcomes (i.e., depressive, anxiety, and externalizing problems). Treatment responses varied by youth age. A case analysis illustrated the lived experiences of the women and children served by this intervention. We discuss future directions for the program, as well as challenges to its sustainability. Finally, we consider Ed's legacy as we discuss the contributions of this work to developmental science and our understanding of attachment relationships among low-income immigrant Latinx families.

Demographic/anthropometric factors and physiological performance-related parameters associated with the six-minute walk test in bariatric surgery candidates, from Valdivia, Chile / Fatores demográficos/antropométricos e parâmetros fisiológicos relacionados ao desempenho associados ao teste de caminhada de seis minutos em candidatos à cirurgia bariátrica, de Valdivia, Chile / Factores demográficos/antropométricos y parámetros fisiológicos relacionados con el desempeño en la prueba de la marcha de seis minutos de candidatos a cirugía bariátrica de Valdivia, Chile

ABSTRACT The six-minute walk test (6MWT) is widely used to measure functional capacity in special populations. However, the factors associated with its performance in candidates for bariatric surgery are unclear. Therefore, this study aimed to investigate the influence of anthropometric and physiological factors in the 6MWT performance in bariatric surgery candidates. This cross-sectional study included 107 candidates for bariatric surgery. Anthropometric factors considered: gender, weight, height, body mass index (BMI), waist-to-hip, and waist-to-height ratios. Along with distance covered during 6MWT, physiological factors such as ratings of perceived exertion (RPE) and heart rate reserve percentage used (%HRR) were recorded. Among the 107 patients (mean age: 39.6 years), 83 volunteers were accepted to perform the 6MWT. No gender differences were observed in terms of distance covered, %HRR, and RPE during the 6MWT. Moreover, BMI and %HRR explained 21% of the 6MWT distance covered. Furthermore, participants with BMI ≤41.5 kg/m2 walked ~50 meters more than their peers above this level (p=0.05). Interestingly, heart rate increase during the 6MWT was lower than described for healthy populations. BMI and %HRR partially explain the variability of the 6MWT performance in bariatric surgery candidates.

RESUMO O teste de caminhada de seis minutos (TC6) é uma ferramenta amplamente usada para medir a capacidade funcional em populações especiais. No entanto, os fatores associados ao seu desempenho em candidatos à cirurgia bariátrica não são claros. Portanto, o objetivo deste estudo foi investigar a influência de fatores antropométricos e fisiológicos no desempenho do TC6 em candidatos à cirurgia bariátrica. Este estudo transversal incluiu 107 candidatos à cirurgia bariátrica. Os fatores antropométricos incluíram: sexo, peso, altura, índice de massa corporal (IMC) e índices cintura-quadril e altura-cintura. Além da distância percorrida durante o TC6, foram registrados fatores fisiológicos, como sensação subjetiva de esforço (SSE) e a porcentagem de frequência cardíaca de reserva utilizada (% FCR). Dos 107 pacientes (idade média: 39,6 anos), 83 voluntários concordaram em realizar o TC6. Não foram observadas diferenças por sexo em termos de distância percorrida, % FCR e SSE durante o TC6. Além disso, IMC e% FCR explicaram 21% da distância percorrida no TM6M. Além disso, indivíduos com IMC≤41,5 kg/m2 andaram ~50 metros a mais do que seus pares acima desse nível (p=0,05). Curiosamente, os aumentos na frequência cardíaca durante o TC6 foram inferiores aos descritos em populações saudáveis. IMC e %FCR foram fatores que explicaram parte da variabilidade do desempenho da TC6 em candidatos submetidos à cirurgia bariátrica.

RESUMEN La prueba de la marcha de seis minutos (PM6) es una herramienta muy utilizada para medir la capacidad funcional en ciertas poblaciones. Sin embargo, poco se conoce sobre los factores asociados a su desempeño en candidatos a cirugía bariátrica. Ante esto, el objetivo de este estudio fue evaluar la influencia de factores antropométricos y fisiológicos en el desempeño de la PM6 en candidatos a cirugía bariátrica. En este estudio transversal participaron 107 candidatos a cirugía bariátrica. Los factores antropométricos fueron: sexo, peso, altura, índice de masa corporal (IMC) e índices cintura-cadera y altura-cintura. Además de la distancia recorrida durante la PM6, se registraron los factores fisiológicos como la sensación subjetiva de esfuerzo (SSE) y el porcentaje de frecuencia cardíaca de reserva utilizada (% FCR). De los 107 pacientes (edad media: 39,6 años), 83 voluntarios aceptaron realizar la PM6. No se encontraron diferencias por sexo respecto de la distancia recorrida, % FCR y ESS durante la PM6. Además, el IMC y el % FCR explicaron el 21% de la distancia recorrida en la PM6. Y los individuos con un IMC ≤41,5 kg/m2 caminaron ~50 metros más que sus pares por encima de este nivel (p=0,05). Resultó interesante que el incremento de la frecuencia cardíaca durante la PM6 fue más bajo que los reportados en poblaciones sanas. El IMC y % FCR fueron los factores que explicaron parte de la variabilidad en el desempeño de la PM6 en candidatos a cirugía bariátrica.

Orientação nutricional no prénatal: estudo com nutrizes no pósparto hospitalizadas em uma maternidade pública / Nutritional orientation in prenatal care: a study with postpartum nurses hospitalized in a public maternity hospital

O objetivo do presente estudo foi identificar as orientações nutricionais concedidas as nutrizes durante o período gestacional. Corresponde a um estudo descritivo de abordagem transversal e caráter quantitativo realizado entre os meses de julho e agosto de 2018, com mulheres no pós-parto de uma maternidade pública do estado do Maranhão. A amostra foi composta por 133 nutrizes com idade maior ou igual 18 anos e que aceitaram participar da pesquisa, os dados foram analisados por meio de variáveis fundamentadas no programa IBM SPSS onde, a partir daí foi possível a obtenção de gráficos e tabelas. O estudo mostrou que das 133 participantes, 88,0% realizaram mais de cinco consultas de pré-natal, 84,2% receberam informações sobre alimentação e aleitamento materno e 81,2% receberam informações sobre a diminuição do consumo de industrializados, e quando questionadas sobre a importância da alimentação saudável na gestação, todas relataram ser muito importante. Dentre os nutrientes investigados, conclui-se que o ferro e ácido fólico na forma de medicamento foram os que mais orientados, devido sua importância para o fechamento do tubo neural e combate a anemia. O profissional que mais repassou informações durante o pré-natal foi o enfermeiro, seguido pelo médico e nutricionista, isso devido ao maior contato que esse profissional possui dentro da assistência pré-natal no local estudado

The objective of the present study was to identify the nutritional guidelines given to the nursing mothers during the gestational period. Corresponds to a descriptive study of transversal approach and quantitative character carried out between the months of July and August of 2018, with women in the postpartum period of a public maternity hospital in the state of Maranhão. The sample consisted of 133 nursing mothers aged 18 years or more who accepted to participate in the study. Data were analyzed using variables based on the IBM SPSS program, where it was possible to obtain charts and tables. The study showed that of the 133 participants, 88.0% performed more than five prenatal consultations, 84.2% received information about feeding and breastfeeding, and 81.2% received information about decreased consumption of industrialized products, and when questioned about the importance of healthy eating during pregnancy, all reported to be very important. Among the nutrients investigated, it was concluded that iron and folic acid in the form of medication were the most oriented, due to their importance for the closure of the neural tube and the fight against anemia. The professional who provided the most information during prenatal care was the nurse, followed by the doctor and nutritionist, due to the greater contact that this professional has within prenatal care at the place studied.

Developmental, genetic, and genomic insights into the evolutionary loss of limbs in snakes.

The evolution of snakes involved dramatic modifications to the ancestral lizard body plan. Limb loss and elongation of the trunk are hallmarks of snakes, although convergent evolution of limb-reduced and trunk-elongated forms occurred multiple times in snake-like lizards. Advanced snakes are completely limbless, but intermediate and basal snakes have retained rudiments of hindlimbs and pelvic girdles. Moreover, the snake fossil record indicates that complete legs were re-acquired at least once, suggesting that the potential for limb development was retained in some limb-reduced taxa. Recent work has shown that python embryos initiate development of a transitory distal leg skeleton, including a footplate, and that the limb-specific enhancer of the Sonic hedgehog gene, known as the zone of polarizing activity regulatory sequence (ZRS), underwent gradual degeneration during snake evolution. In this article, we review historical and recent investigations into squamate limblessness, and we discuss how new genomic and functional genetic experiments have improved our understanding of the evolution of limblessness in snakes. Finally, we explore the idea that pleiotropy of cis-regulatory elements may illuminate the convergent genetic changes that occurred in snake-like lizards, and we discuss a number of challenges that remain to be addressed in future studies.

Cuidado ao lactente para mães em consultas de puericultura: intervenção em sala de espera / Care for lactating mothers in puericulture consultations: intervention in the waiting room

Objetivo: relatar a experiência da realização de sessões educativas para mães acerca do cuidado ao lactenteem sala de espera de consultas de puericultura. Método: estudo qualitativo, descritivo, tipo relato deexperiência, em que ocorreram as sessões educativas em uma Unidade de Atenção Primária à Saúde, cujacoleta de dados ocorreu de agosto de 2015 a março de 2017. Resultados: foram realizadas seis sessõeseducativas verificando o conhecimento pré-existente, implementando estratégias de educação em saúde e,posteriormente, verificando o conhecimento. Destaca-se o tópico “posicionamento da criança no momento daamamentação e das características da pega correta”. Verificou-se que, das mães, 40% (pré-teste) jáconheciam a temática e, após as explanações, o percentual acresceu para 75% (pós-teste), apresentandosignificância de p<0,016. Outro tópico em destaque foi “Vitamina D”; o quantitativo de acertos foi de 7,69%(pré-teste) para 76,92% (pós-teste), com valor significante (p<0,04). Conclusão: as sessões educativasassumiram uma conotação valorosa, tendo em vista que possibilitaram melhorar o conhecimento das mães.

An endogenous retroviral envelope syncytin and its cognate receptor identified in the viviparous placental Mabuya lizard.

Syncytins are envelope genes from endogenous retroviruses that have been captured during evolution for a function in placentation. They have been found in all placental mammals in which they have been searched, including marsupials. Placental structures are not restricted to mammals but also emerged in some other vertebrates, most frequently in lizards, such as the viviparous Mabuya Scincidae. Here, we performed high-throughput RNA sequencing of a Mabuya placenta transcriptome and screened for the presence of retroviral env genes with a full-length ORF. We identified one such gene, which we named "syncytin-Mab1," that has all the characteristics expected for a syncytin gene. It encodes a membrane-bound envelope protein with fusogenic activity ex vivo, is expressed at the placental level as revealed by in situ hybridization and immunohistochemistry, and is conserved in all Mabuya species tested, spanning over 25 My of evolution. Its cognate receptor, required for its fusogenic activity, was searched for by a screening assay using the GeneBridge4 human/Chinese hamster radiation hybrid panel and found to be the MPZL1 gene, previously identified in mammals as a signal-transducing transmembrane protein involved in cell migration. Together, these results show that syncytin capture is not restricted to placental mammals, but can also take place in the rare nonmammalian vertebrates in which a viviparous placentotrophic mode of reproduction emerged. It suggests that similar molecular tools have been used for the convergent evolution of placentation in independently evolved and highly distant vertebrates.

Educação em saúde para aspectos nutricionais como forma de prevenir alterações cardiovasculares: relato de experiência / Health education for nutritional aspects as a way to prevent cardiovascular alterations: experience report

Objetivo: relatar a experiência vivenciada durante a execução de ação de extensão. Método: relato de experiência de caráter descritivo, vivenciado por acadêmicos do curso de Enfermagem, realizado com escolares na faixa etária dos seis aos 12 anos. Resultados: foram trabalhadas as seguintes temáticas: alimentos energéticos; práticas de atividade física regular; alimentos reguladores; alimentos construtores de origem vegetal; alimentos construtores de origem animal, além de destacar o grupo do leite e seus derivados e alimentos extraenergéticos. Destaca-se a troca de experiências como algo extremamente satisfatório, bem como salientar que a interação estabelecida foi fundamental para criar um ambiente favorável à participação dos escolares. Conclusão: a execução do projeto proporcionou aprofundar o conhecimento acerca das temáticas, além de contribuir para o desenvolvimento no âmbito pessoal, intelectual, acadêmico/profissional.

Loss and Re-emergence of Legs in Snakes by Modular Evolution of Sonic hedgehog and HOXD Enhancers.

Limb reduction and loss are hallmarks of snake evolution. Although advanced snakes are completely limbless, basal and intermediate snakes retain pelvic girdles and small rudiments of the femur. Moreover, legs may have re-emerged in extinct snake lineages [1-5], suggesting that the mechanisms of limb development were not completely lost in snakes. Here we report that hindlimb development arrests in python embryos as a result of mutations that abolish essential transcription factor binding sites in the limb-specific enhancer of Sonic hedgehog (SHH). Consequently, SHH transcription is weak and transient in python hindlimb buds, leading to early termination of a genetic circuit that drives limb outgrowth. Our results suggest that degenerate evolution of the SHH limb enhancer played a role in reduction of hindlimbs during snake evolution. By contrast, HOXD digit enhancers are conserved in pythons, and HOXD gene expression in the hindlimb buds progresses to the distal phase, forming an autopodial (digit) domain. Python hindlimb buds then develop transitory pre-chondrogenic condensations of the tibia, fibula, and footplate, raising the possibility that re-emergence of hindlimbs during snake evolution did not require de novo re-evolution of lost structures but instead could have resulted from persistence of embryonic legs. VIDEO ABSTRACT.

Oct4 Is a Key Regulator of Vertebrate Trunk Length Diversity.

Vertebrates exhibit a remarkably broad variation in trunk and tail lengths. However, the evolutionary and developmental origins of this diversity remain largely unknown. Posterior Hox genes were proposed to be major players in trunk length diversification in vertebrates, but functional studies have so far failed to support this view. Here we identify the pluripotency factor Oct4 as a key regulator of trunk length in vertebrate embryos. Maintaining high Oct4 levels in axial progenitors throughout development was sufficient to extend trunk length in mouse embryos. Oct4 also shifted posterior Hox gene-expression boundaries in the extended trunks, thus providing a link between activation of these genes and the transition to tail development. Furthermore, we show that the exceptionally long trunks of snakes are likely to result from heterochronic changes in Oct4 activity during body axis extension, which may have derived from differential genomic rearrangements at the Oct4 locus during vertebrate evolution.