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Mindfulness training in medical education as a means to improve resilience,empathy,and mental health in the medical profession

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World Journal of Psychiatry 2024年第4期14卷 489-493页

作者： Edison Iglesias de Oliveira Vidal luiz Fernando Alvarenga Ribeiro Marco Antonio de Carvalho-Filho Fernanda Bono Fukushima Internal Medicine department Botucatu Medical SchoolSao Paulo State University(UNESP)Botucatu 18618-687SPBrazil Wenckebach Institute for Education and Training LEARN-Lifelong LearningEducation and Assessment Research NetworkUniversity Medical Center GroningenGroningen 9713AVGroningenNetherlands Assertiva Mindfulness Botucatu 18603-970SPBrazil Surgical Specialties and Anesthesiology department Botucatu Medical SchoolSão Paulo State University(UNESP)Botucatu 18618-687SPBrazil

The high rates of depression,burnout,and increased risk of suicide among medical students,residents,and physicians in comparison with other careers signal a mental health crisis within our *** contend that this crisis coupled with the inadequate acquisition of interpersonal skills during medical education results from the interaction between a challenging environment and the mental capital of ***,we posit that mindfulness-based practices are instrumental for the development of major components of mental capital,such as resilience,flexibility of mind,and learning skills,while also serving as a pathway to enhance empathy,compassion,self-awareness,conflict resolution,and relational ***,the evidence base supporting the effectiveness of mindfulness-based interventions has been increasing over the years,and a growing number of medical schools have already integrated mindfulness into their *** we acknowledge that mindfulness is not a panacea for all educational and mental health problems in this field,we argue that there is currently an unprecedented opportunity to gather momentum,spread and study mindfulness-based programs in medical schools around the world as a way to address some longstanding shortcomings of the medical profession and the health and educational systems upon which it is rooted.

关键词： Mindfulness Medical education Mental capital Mental health Medical students Resilience

MicroRNAs in inflammatory bowel disease:What do we know and what can we expect?

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World Journal of Gastroenterology 2024年第16期30卷 2184-2190页

作者： Ellen Cristina Souza de Oliveira Ana Elisa Valencise Quaglio Thais Gagno Grillo luiz Claudio Di Stasi Ligia Yukie Sassaki department of Internal Medicine Medical SchoolSão Paulo State University(Unesp)Botucatu 18618-686São PauloBrazil Verum Ingredients Botucatu Technology ParkBotucatu 18605-525São PauloBrazil department of Biophysics and Pharmacology Institute of BiosciencesSão Paulo State University(Unesp)Botucatu 18618-689São PauloBrazil

MicroRNAs(miRNAs),small non-coding RNAs composed of 18–24 nucleotides,are potent regulators of gene expression,contributing to the regulation of more than 30%of protein-coding *** that miRNAs are regulators of inflammatory pathways and the differentiation of intestinal epithelial cells,there is an interest in exploring their importance in inflammatory bowel disease(IBD).IBD is a chronic and multifactorial disease of the gastrointestinal tract;the main forms are Crohn's disease and ulcerative *** studies have investigated the dysregulated expression of miRNAs in IBD,demonstrating their important roles as regulators and potential biomarkers of this *** editorial presents what is known and what is expected regarding miRNAs in *** the important regulatory roles of miRNAs in IBD are clearly established,biomarkers for IBD that can be applied in clinical practice are lacking,emphasizing the importance of further *** regarding the influence of miRNAs on the inflammatory process and the exploration of their role in gene regulation are expected to provide a basis for the use of miRNAs not only as potent biomarkers in IBD but also as therapeutic targets for the control of inflammatory processes in personalized medicine.

关键词： MicroRNAs Inflammatory bowel disease Crohn’s disease Ulcerative colitis Biomarker Therapy

Evaluation of the Mechanisms Acting on the Atlantic Meridional Overturning Circulation in CESM2 for the 1pctCO_(2) Experiment

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Journal of Atmospheric Science Research 2024年第1期7卷 40-58页

作者： Lívia Sancho Elisa Passos Marcio Cataldi luiz paulo de fr.itas assad luiz Landau Laboratory of Computational Methods in Engineering Civil Engineering ProgramAlberto Luiz Coimbra Institute for Graduate Studies and Research in EngineeringFederal University of Rio de JaneiroRio de Janeiro21941-617Brazil Civil Engineering Program Alberto Luiz Coimbra Institute for Graduate Studies and Engineering ResearchFederal University of Rio de JaneiroRio de Janeiro21941-617Brazil Physical Oceanography Laboratory Department of Physical OceanographyFaculty of OceanographyRio de Janeiro State UniversityRio de Janeiro20559-900Brazil Climate System Monitoring and Modeling Laboratory Water Resources and Environmental EngineeringFluminense Federal University24020-140Brazil Regional Atmospheric Modeling Group(MAR) Physics of the EarthDepartment of PhysicsRegional Campus of International Excellence(CEIR)“Campus Mare Nostrum”University of MurciaMurcia30100Spain department of Meteorology Institute of GeosciencesFederal University of Rio de JaneiroRio de Janeiro21941-617Brazil

The Atlantic Meridional Overturning Circulation(AMOC)is a crucial component of the Earth’s climate system due to its fundamental role in heat distribution,carbon and oxygen transport,and the *** climate components,such as the atmosphere and sea ice,influence the *** the physical mechanisms of those interactions is paramount to increasing knowledge about AMOC’s *** this study,the authors used outputs from the Community Earth System Model version 2 and observational data to investigate changes in theAMOC and the associated physical *** deCK experiments were evaluated:piControl and 1pctCO_(2),with an annual increase of 1%of atmospheric CO_(2).The analysis revealed a significant decrease in the AMOC,associated with changes in mixed layer depth and buoyancy in high latitudes of the North Atlantic,resulting in the shutdown of deep convection and potentially affecting the formation of North Atlantic deep Water and Antarctic Bottom Water.A vital aspect observed in this study is the association between increased runoff and reduced water evaporation,giving rise to a positive feedback ***,the rates of freshwater spreading have intensified during this period,which could lead to an accelerated disruption of the AMOC beyond the projections of existing models.

关键词： AMOC Meridional cell Climate change deep circulation CESM2 results CMIP6

Liver transplantation as an alternative for the treatment of perihilar cholangiocarcinoma: A critical review

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Hepatobiliary & Pancreatic Diseases International 2024年第2期23卷 139-145页

作者： Wellington Andraus francisco Tustumi Alexandre Chagas Santana Rafael Soares Nunes Pinheiro Daniel Reis Waisberg Liliana Ducatti Lopes Rubens Macedo Arantes Vinicius Rocha Santos Rodrigo Bronze de Martino luiz Augusto Carneiro D’Albuquerque department of Gastroenterology Transplantation UnitUniversidade de São PauloSão PauloBrazil

Background:Perihilar cholangiocarcinoma(phCCC)is a dismal *** is no consensus regard-ing the best treatment for patients with unresectable *** present review aimed to gather the current pieces of evidence for liver transplantation and liver resection as a treatment for phCCC and to build better guidance for clinical *** sources:The search was conducted in PubMed,Embase,Cochrane,and *** related references were searched *** criteria were:reports in English or Portuguese literature that a)patients with confirmed diagnosis of phCCC;b)patients treated with a curative intent;c)patients with the outcomes of liver resection and liver *** reports,reviews,letters,editorials,conference abstracts and papers with full-text unavailability were excluded from the ***:Most of the current literature is based on observational retrospective studies with low grades of *** resection has better long-term outcomes than systemic chemotherapy or palliation ther-apy and liver transplantation is a good alternative for selected patients with unresectable *** candidates for resection or transplantation should be medically fit and free of intrahepatic or extrahep-atic *** a general rule,patients presenting with a tumor having a longitudinal size>3 cm or extending below the cystic duct,lymph node disease,confirmed extrahepatic dissemination;intraoper-atively diagnosed metastatic disease;a history of other malignancies within the last five years,and did not complete chemoradiation regimen and were medically unfit should not be considered for *** of these criteria should be individually *** transplantation or resection should only be considered in highly experienced hepatobiliary centers,and any decision-making must be based on a multidisciplinary ***:phCCC is a complex condition with high *** therapies,including hepatec-tomy and liv

关键词： Liver transplantation Cholangiocarcinoma Liver neoplasms

Effects of antioxidant‑rich Lactiplantibacillus plantarum inoculated alfalfa silage on rumen fermentation, antioxidant and immunity status, and mammary gland gene expression in dairy goats

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Journal of Animal Science and Biotechnology 2024年第3期15卷 1227-1240页

作者： Yixin Zhang Samaila Usman Qiang Li Fuhou Li Xia Zhang luiz Gustavo Nussio Xusheng Guo State Key Laboratory of Grassland Agro‑ecosystems School of Life SciencesLanzhou UniversityLanzhou 730000PR China Probiotics and Life Health Institute Lanzhou UniversityLanzhou 730000PR China Probiotics and Biological Feed Research Centre Lanzhou UniversityLanzhou 730000PR China department of Animal Science Luiz de Queiroz College of AgricultureUniversity of Sao PauloPiracicaba 13418‑900Brazil

Background Milk synthesis in lactating animals demands high energy metabolism,which results in an increased production of reactive oxygen metabolites(ROM)causing an imbalance between oxidants and antioxidants thereby inducing oxidative stress(OS)on the *** mitigate OS and postpartum disorders in dairy goats and gain insight into the impact of dietary choices on redox status during lactation,a feeding trial was conducted using alfalfa silage inoculated with a high-antioxidant strain of Lactiplantibacillus *** Twenty-four Guanzhong dairy goats(38.1±1.20 kg)were randomly assigned to two dietary treatments:one containing silage inoculated with *** MTD/1(RSMTD-1),and the other containing silage inoculated with high antioxidant activity *** 24-7(ES24-7).Results ES24-7-inoculated silage exhibited better fermentation quality and antioxidant activity compared to *** ES24-7 diet elevated the total antioxidant capacity(T-AOC),superoxide dismutase(SOD),glutathione peroxi-dase(GSH-Px),and catalase(CAT)activities in milk,serum,and feces of lactating goats(with the exception of T-AOC in milk).Additionally,the diet containing ES24-7 inoculated silage enhanced casein yield,milk free fatty acid(FFA)content,and vitamin A level in the goats’***,an increase of immunoglobulin(Ig)A,IgG,IgM,inter-leukin(IL)-4,and IL-10 concentrations were observed,coupled with a reduction in IL-1β,IL-2,IL-6,interferon(IFN)-γ,and tumor necrosis factor(TNF)-αconcentrations in the serum of lactating goats fed *** concentrations of total volatile fatty acid(VFA),acetate,and propionate were observed in the rumen fluid of dairy goats fed ES24-7 inoculated ***,the diet containing ES24-7 inoculated silage significantly upregulated the expression of nuclear factor erythroid 2 like 2(NFE2L2),beta-carotene oxygenase 1(BCO1),SOD1,SOD2,SOD3,GPX2,CAT,glu-tathione-disulfide reductase(GSR),and heme oxygenase 1(HMOX1)genes in the mammary gland,

关键词： Alfalfa silage Antioxidant activity Gene expression Goats Immunity Lactation

Concerns about the application of resistance exercise with blood-flow restriction and thrombosis risk in hemodialysis patients

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Journal of Sport and Health Science 2024年第4期13卷 548-558,F0003页

作者： Hugo de Luca Correa Lysleine Alves deus Dahan da Cunha Nascimento Nicholas Rolnick Rodrigo Vanerson Passos Neves Andrea Lucena Reis Thais Branquinho de Araujo Carmen Tzanno-Martins Fernanda Silveira Tavares luiz Sinesio Silva Neto Claudio Avelino Rodrigues Santos Paolo Lucas Rodrigues-Silva Fernando Honorato Souza Vitoria Marra da Motta Vilalva Mestrinho Rafael Lavarini dos Santos Rosangela Vieira Andrade Jonato Prestes Thiago dos Santos Rosa Post-graduate Program of Physical Education Catholic University of BrasıliaBrasılia 71966-700Brazil The Human Performance Mechanic Lehman CollegeNew YorkNY 10011USA Clinical Group Home Dialysis Center and RenalClass Sao Paulo 01239-040Brazil department of Medicine Catholic University of BrasıliaBrasılia 71966-700Brazil Faculty of Medicine Federal University of TocantinsTocantins 77001-090Brazil Embrapa Genetic Resources and Biotechnology Brasılia 70770-917Brazil Graduate Program of Genomic Sciences and Biotechnology Brasılia 71966-700Brazil

Background:Hemodialysis(HD) per se is a risk factor for *** the growing body of evidence on blood-flow restriction(Bfr) exercise in HD patients,identification of possible risk factors related to the prothrombotic agent D-dimer is required for the safety and feasibility of this training *** aim of the present study was to identify risk factors associated with higher D-dimer levels and to determine the acute effect of resistance exercise(RE) with Bfr on this ***:Two hundred and six HD patients volunteered for this study(all with a glomerular filtration rate of fr session consisted of 50% arterial occlusion pressure during 50 min sessions of HD(intradialytic exercise).RE repetitions included concentric and eccentric lifting phases(each lasting 2 s) and were supervised by a strength and conditioning ***:Several variables were associated with elevated levels of D-dimer,including higher blood glucose,citrate use,recent cardiovascular events,recent intercurrents,higher inflammatory status,catheter as vascular access,older patients(>70 years old),and HD ***,RE+Bfr significantly increases D-dimer after 4 *** with borderline baseline D-dimer levels(400-490 ng/mL) displayed increased risk of elevating D-dimer over the normal range(≥500 ng/mL).Conclusion:These results identified factors associated with a heightened prothrombotic state and may assist in the screening process for HD patients who wish to undergo RE+Bfr.D-dimer and/or other fibrinolysis factors should be assessed at baseline and throughout the protocol as a precautionary measure to maximize safety during RE+Bfr.

关键词： Blood-flow restriction Chronic kidney disease Coagulation Hemodialysis Vascular occlusion exercises

A remote sensing approach to estimate the load bearing capacity of soil

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Information Processing in Agriculture 2024年第1期11卷 109-116页

作者： Italo Rômulo Mendes de Souza Edson Eyji Sano Renato Paiva de Lima Anderson Rodrigo da Silva Statistics and Geoprocessing Laboratory Instituto Federal GoianoGeraldo Silva Nascimento RoadKm 2.575790-000 UrutaíGoiásBrazil Embrapa Cerrados BR-020 RoadKm 18Mailbox 0822373310-970 PlanaltinaDFBrazil department of Soil Science ‘Luiz de Queiroz’College of AgricultureUniversity of São PauloAv.Pádua Dias235-AgronomiaPiracicabaSP 13418-900Brazil

Preconsolidation pressure(σp)of soil can be considered as an indicator of the Load Bearing Capacity(LBC),which is the tolerated surface pressure before compaction,often caused by the traffic of agricultural *** this pioneering study,a remote sensing approach was introduced to estimate LBC throughσp from soils of the“Rio Preto”Hydrographic Basin,Bahia State,Brazil,in a monthly time lapse from 2016 to ***,σp is measured by a laborious and time demanding laboratory analysis,making it unfeasible to map large *** innovative methodology of this work consists of combining active–passive satellite data on soil moisture and pedotransfer functions of clay content and water matric potential to obtain geo-located estimates ofσ*** were analysed under different classes of soil use,land cover and slope;95%confidence intervals were built for the time series of mean values of LBC for each *** overall seasonal variation in LBC estimates is similar in areas with annual crops,grasslands and natural vegetation,and flat areas are less affected by soil moisture variations over the year(between seasons).LBC decreased,in general,at about 0.5%a year in flat ***,these areas demand attention,since they occupy 86%of the Basin and are mostly subjected to agricultural soil management and surface pressure by heavy machinery.

关键词： Soil compaction SMAP Preconsolidation stress Brazilian Cerrado

Extreme drought triggers parallel shifts in wood anatomical and physiological traits in upper treeline of the Mediterranean Andes

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Ecological Processes 2024年第1期13卷 132-143页

作者： luiz Santini Jr. Dylan Craven Daigard Ricardo Ortega Rodriguez Manolo Trindade Quintilhan Stephanie Gibson-Carpintero Cristina Aravena Torres Fidel A.Roig Ariel A.Mu?oz Alejandro Venegas-Gonzalez Hémera Centro de Observación de la Tierra Universidad Mayor GEMA Center for Genomics Ecology and Environment Universidad Mayor Data Observatory Foundation ANID Technology Center depart-ment of Forest Sciences ESALQ-University of Sao Paulo department of Plant Biology Institute of Biology University of Campinas Instituto de Geografía Universidad Nacional Autónoma de México (UNAM) Argentine Institute of Nivology Glaciology and Environmental Sciences(IANIGLA CONICET ) Institute of Geography Pontificia Universidad Católica de Valparaíso Instituto de Ciencias Agroalimentarias Animales y Ambientales (ICA3) Universidad de O'Higgins

Background Treeline ecotones of Mediterranean ecoregions have been affected by the increasing intensity and severity of droughts. Even though the effect of droughts on forest dynamics has been widely documented, knowledge is relatively scarce of how extreme climate episodes affect the hydraulic structure and, therefore, the phys-iology of woody plants. The Mediterranean Andes have experienced an uninterrupted period of drought since 2010, including an extremely dry year in 2019 with approximately 80% rainfall deficit. Here, we investigated shifts in wood anatomical and physiological traits of Kageneckia angustifolia, an endemic treeline species, in response to this drought *** We evaluated the xylem plasticity of three K. angustifolia populations across their natural distribution(31–35° SL) based on anatomical(vessel structure and distribution) and physiological(intrinsic water-use efficiency) variables in the tree rings. We focused on the period 2000–2020 that corresponds to before the megadrought(2000–2007),(ii) megadrought(2008–2018) and(iii) hyperdrought(2019–2020). The variables were annualized and analyzed by linear mixed-effects *** Our results provide insights to the anatomical and physiological mechanisms underlying the resilience of treeline forests to persistent droughts in central Chile. We found that the extreme drought in 2019–2020 triggered shifts in vessel size and frequency that increased hydraulic safety. These significant shifts in vessel traits occurred in parallel with a decrease in pit aperture area and an increase in water-use efficiency, further increasing the resilience of K. angustifolia to extreme drought *** Our results revealed coordinated shifts in vessel size and frequency and water-use efficiency in response to the megadrought, thereby reducing vulnerability to hydraulic failure. The apparent resilience of K. angustifolia to extreme droughts suggests that this adaptation to drought stress may incre

关键词： dendro-anatomy Kageneckia angustifolia Xylem vulnerability Drought Climate change

Clear cell sarcoma of the pancreas,an unusual cancer with unusual metastatic site or unusual primary site?

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World Journal of Clinical Cases 2024年第25期12卷 5653-5656页

作者： Jhenyffer Carvalho Moreno Pedro luiz Serrano Uson Junior Universidade 9 de Julho Sao Paulo 01509120Brazil Center for Personalized Medicine Hospital Israelita Albert EinsteinSão Paulo 05652900Brazil department of Oncology Hospital do CoraçãoSao Paulo 04004030Brazil

Clear cell sarcoma(CCS)is a type of malignant tumor that can arise from tendons and *** malignant proliferation of cells with melanocytic lineage normally occurs in young patients,and it is normally identified in ***,different sites including gastrointestinal organs are also *** difficulties in the molecular and histopathology evaluation,the diagnosis is often confused with malignant *** cases are treated with surgical resection,but overall,the prognosis is *** this editorial,we will discuss a very interesting case of CCS identified in the *** will discuss the literature and controversies in the management of this type of ***,we will address molecular strategies to be incorporated in those cases to better understand the primary location of the ***,future perspectives of the field and new strategies of treatment will be described.

关键词： Clear cell sarcoma Soft tissue sarcoma Metastatic cancer Pancreatic cancer Pancreatectomy