Resumo Este artigo tem como objetivo trazer algumas problemáticas que envolvem os valores associados às metrópoles, principalmente nesta nova era em que se protagonizam imagens e símbolos. Organizado em três seções, desenvolve, inicialmente, o processo de formação e centralização do poder nas metrópoles; em seguida, oferece uma contextualização com o capital financeiro/especulativo, as realidades virtuais e os efeitos nos espaços metropolitanos; e, por fim, em caráter experimental, analisa o desempenho e o envolvimento entre as metrópoles e suas páginas virtuais administradas por suas gestões. A produção simbólica metropolitana é simplificada, indo na contramão da crescente presença de processos urbanos complexos, com objetivos e planos de ação para uma venda massiva e um mercado global de cidades: significados associados à figura do coach .

Abstract This article aims to approach some issues concerning values associated with metropolises, especially in this new era whose protagonists are images and symbols. Organized in three parts, it initially addresses the process of power formation and centralization in the metropolises; then, it provides contextualization, addressing financial/speculative capital, virtual realities, and their effects on metropolitan spaces; finally, on an experimental basis, it analyzes the performance and involvement between the metropolises and their websites managed by their administrations. The symbolic production of the metropolis is simplified, in opposition to the growing presence of complex urban processes, with objectives and action plans for a massive sale and a global market of cities. These meanings are associated with the figure of the coach.

ABSTRACT Objective Phase 1 clinical trial to determine feasibility, safety, and efficacy of a new advanced cell therapy product for treatment of knee articular cartilage injuries. Methods Three participants with knee focal chondral lesions were included, with no signs of osteoarthritis. Chondrocytes were obtained through knee arthroscopy, cultured in collagen membrane for 3 weeks at the laboratory, subjected to tests to release the cell therapy product, and implanted. All patients underwent a specific 3-month rehabilitation protocol, followed by assessments using functional and imaging scales. The main outcome was the incidence of severe adverse events. Results Three participants were included and completed the 2-year follow-up. There was one severe adverse event, venous thrombosis of distal leg veins, which was no associated with therapy, was treated and left no sequelae. The clinical and radiological scales showed improvement in the three cases. Conclusion The preliminary results, obtained with the described methodology, allow concluding that this product of advanced cell therapy is safe and feasible. ReBEC platform registration number: RBR-6fgy76

ABSTRACT To describe a case of autologous chondrocyte implantation after cell culture contamination by Mycoplasma pneumoniae and the measures taken to successfully complete cell therapy in a patient with focal chondral lesion. A 45-year-old male patient, complaining of chronic pain on the knee and no history of trauma. He had a chondral lesion in the trochlear region of the femur and clinical tests compatible with pain in the anterior compartment of the knee. Conservative treatment failed to alleviate symptoms. Surgical treatment was indicated, but due to the size of the lesion, membrane-assisted autologous chondrocyte implantation was the technique of choice. Cartilage biopsies were collected from the intercondylar region of the distal femur. After isolation, chondrocytes were expanded ex vivo in a trained laboratory, for three weeks, and seeded onto a commercially available collagen membrane prior to implantation in the knee. Two days before surgery, a cell culture sample tested positive for Mycoplasma pneumoniae. The source of contamination was found to be autologous blood serum, extracted from the patient´s peripheral vein, and used to supplement the cell culture medium. After treating the patient with antibiotics, all procedures were repeated and the new final cell product, free from contaminants, was successfully implanted. We discuss the strategies available to deal with this situation, and describe the results of this particular case, which led to modifications in the autologous chondrocyte implant protocol.

RESUMO O objetivo deste relato de caso foi descrever os resultados da terapia fonoaudiológica intensiva, em um caso de presbifonia, e apresentar uma proposta de tratamento vocal para idosos, demonstrando seus resultados na qualidade vocal, qualidade de vida e imagem laríngea de um paciente com presbifonia. O programa Terapia Vocal para Idosos (TVI) é constituído por uma sequência de exercícios, que visam ao aumento da loudness, coordenação pneumofonoarticulatória, melhora na vibração de mucosa e equilíbrio de ressonância, além da variação e controle da frequência. O modelo terapêutico em questão foi aplicado em um indivíduo do gênero feminino, com 87 anos de idade e queixas de voz fraca e dificuldade em ser ouvido. As terapias ocorreram de maneira intensiva em 16 sessões com 30 minutos de duração, quatro vezes por semana e com realização de exercícios em casa. A experiência de aplicação do programa em formato intensivo mostrou efeitos positivos na qualidade vocal, com diminuição do desvio global da voz, soprosidade na emissão sustentada e rugosidade na emissão sustentada e fala. A melhora no desempenho vocal refletiu em aumento nos valores dos domínios físico e global do protocolo de qualidade de vida relacionada à voz. Houve, também, melhora no fechamento glótico. O tratamento vocal com o método TVI intensivo demonstra efeitos positivos no tratamento da presbifonia e tem o potencial de promover benefícios na qualidade vocal, na qualidade de vida relacionada à voz e nos aspectos laríngeos dos idosos.

ABSTRACT The aim of this study is to describe the results of intensive voice therapy in a presbyphonia case and to propose a voice treatment program for the elderly by demonstrating vocal quality, quality of life and laryngeal image results. The Voice Therapy for the Elderly (VTE) program consisted of a sequence of exercises that aimed at increasing intensity, pneumo-articulatory coordination, mucosal vibration and resonance balance, and increasing frequency variation and control. The therapeutic model in question was applied to an 87-year-old female subject with complaints of a weak voice and difficulty to be heard by others. This therapy program was applied with an intensive approach over 16 sessions, 30 minutes each session, four times a week, with assigned homework. The intensive voice therapy format demonstrated positive effects on vocal quality with an overall reduction in voice deviation, breathiness, and roughness on sustained phonation and speech. Vocal performance improvement showed a subsequent increase in the physical and general aspects of voice-related quality of life. There was also improvement in glottic closure. Voice treatment via the VTE method, with an intensive approach revealed to be positive in the treatment of presbyphonia and can potentially promote benefits for the elderly in terms of voice quality, voice-related quality of life, and laryngeal changes.

Deficits of airway protection can have deleterious effects to health and quality of life. Effective airway protection requires a continuum of behaviors including swallowing and cough. Swallowing prevents material from entering the airway and coughing ejects endogenous material from the airway. There is significant overlap between the control mechanisms for swallowing and cough. In this review we will present the existing literature to support a novel framework for understanding shared substrates of airway protection. This framework was originally adapted from Eccles' model of cough28 (2009) by Hegland, et al.42 (2012). It will serve to provide a basis from which to develop future studies and test specific hypotheses that advance our field and ultimately improve outcomes for people with airway protective deficits.

As disfonias neurológicas são distúrbios vocais que acompanham lesões ou alterações no sistema nervoso. O acidente vascular encefálico (AVE) é a segunda causa de morte no mundo e os danos cerebrais causados podem afetar a comunicação do indivíduo em diversos aspectos. As alterações de voz características dessas lesões são pouco descritas quanto à localização e extensão do acometimento cerebral. O objetivo deste estudo foi descrever as características fonatórias de dez idosos acometidos por AVE, de acordo com a topografia da lesão observada ao exame de neuroimagem. Todos os participantes tiveram amostras de voz gravadas e foi realizada avaliação perceptivo-auditiva da voz e da diadococinesia laríngea. Os exames de neuroimagem foram classificados quanto à localização, extensão, lateralidade e território de vascularização da lesão cerebral. Os resultados mostram uma população de AVEs extensos de artéria cerebral média e AVEs de localização variada no cérebro. As vozes dos sujeitos mostraram predominantemente presença de rugosidade, soprosidade, instabilidade e pastosidade, além de alteração no controle motor laríngeo, demonstrado pela velocidade reduzida e instabilidade na repetição de vogais. Essas características ocorreram tanto no grupo de pacientes com AVE extenso de lesão da artéria cerebral média como em pacientes com AVEs menores de localização variada no cérebro. Os achados sugerem que as manifestações vocais dos casos estudados não dependem apenas da topografia da lesão. Daí a importância de considerar as individualidades de cada paciente no momento da avaliação clínica.

Neurological dysphonias are vocal disorders followed by injuries or changes in the nervous system. Stroke is the second leading cause of death worldwide and the brain damage caused by it can affect communication in several aspects. The changes in the vocal features caused by these lesions are poorly described regarding the location and extent of cerebral involvement. The aim of this study was to describe vocal parameters of ten elderly patients affected by stroke according to the topography of the lesion at neuroimaging. We recorded from them: perceptual and auditory evaluation of voice and laryngeal diadochokinesis. Neuroimaging studies were classified according to location, extent, laterality territory of brain injury. The results show a population of extensive middle cerebral artery strokes and strokes with varied location in the brain. The subjects' voices showed predominantly the presence of roughness, breathiness, richeness and instability, and change in laryngeal motor control, demonstrated by reduced speed and instability in laryngeal diadochokinesis. These features presented in patients with extensive middle cerebral artery stroke and in patients with short strokes with varied location in the brain. The results suggest that the vocal features in the assessed cases do not depend only on the topography of the brain damage. Thus, it is important to consider the patient as unique in clinical evaluation.

O objetivo deste estudo foi comparar os efeitos do Ruído Visual Dinâmico (RVD) na memória visual quando apresentado em uma tarefa de reconhecimento de item durante a codificação da informação, no intervalo de retenção ou durante toda a prova. O ruído ocasionou maior interferência na memória quando apresentado durante a codificação do estímulo. Os dados sugerem que a memória visual é acessada via percepção, por isto, sofre interferência externa como a causada pelo RVD. Sugere-se que o efeito ocorreu enquanto a informação era mantida na consciência por um subsistema de armazenamento de curto prazo. Estes resultados contribuem para a compreensão da arquitetura da memória de trabalho e mostram que o RVD é uma técnica apropriada para estudar a memória visual.

We aimed to compare the effects of the Dynamic Visual Noise (DVN) on visual memory when presented at different times in an item recognition task either during information encoding, retention interval or throughout the trial. Noise had general effect on participants' performance with stronger impairment on stimuli encoding. The data suggest that visual memory is accessed through perception and, therefore, it suffers external interference, as the one caused by the DVN. We consider that the effect occurred while the information was being kept in consciousness by a specific short-term storage subsystem. These results contribute to the understanding of the architecture used by the visual working memory and show that the DVN is an appropriate technique to study the visual memory.

OBJETIVO: O objetivo deste estudo foi avaliar o efeito de dietas hiperlipídicas adicionadas de 1%, 2% e 4% de casca de jabuticaba liofilizada sobre os perfis lipídicos do fígado, soro e fezes de ratos. MÉTODOS: Trinta ratos, machos, Sprague-Dawley, foram divididos em cinco grupos. A obesidade foi induzida em quatro grupos, com dieta hiperlipídica ou High-Fat - HF (35% de lipídeos). Três desses grupos receberam a dieta hiperlipídica adicionada de 1%, 2% e 4% de casca de jabuticaba liofilizada (Jabuticaba - HFJ1, HFJ2 e HFJ4, respectivamente) nos últimos 40 dias de experimento. Sangue e fígado foram coletados após 70 dias de tratamento e as fezes na última semana experimental. Colesterol e triglicerídeos totais foram avaliados no soro, fígado e fezes secas, bem como lipídeos totais. RESULTADOS: No segundo período do experimento, a ingestão dietética e energética dos animais HFJ4 foi maior em relação ao grupo High-Fat. Não houve diferença significativa entre os grupos experimentais para colesterol total e triglicerídeos séricos. O grupo HFJ2 demonstrou maiores níveis de lipídeos hepáticos e fecais em relação a N, apesar de a peroxidação lipídica ter diminuído nesse grupo. O HFJ4 mostrou a maior média de colesterol hepático e fecal. Não houve diferenças significativas para triglicerídeos hepáticos, e os grupos HFJ1 e HFJ4 excretaram mais triglicerídeos pelas fezes. CONCLUSÃO: As doses utilizadas de casca de jabuticaba não mostraram efeitos benéficos contra a esteatose hepática ou outro parâmetro lipídico avaliado, com exceção para a excreção de triglicerídeos. O índice de peroxidação lipídica hepática diminuiu nos ratos alimentados com 2% de casca de jabuticaba liofilizada.

OBJECTIVE: The aim of this study was to evaluate the influence of high-fat diets with 1%, 2%, and 4% freeze-dried jaboticaba peel on the serum, liver, and fecal lipid profile of obese rats. METHODS: Thirty male Sprague-Dawley rats were divided into 5 groups. Obesity was induced in four groups using a high-fat diet (35% lipids). One group was used as a high-fat diet control (High-fat group - HF). The other three high-fat-diet groups were given 1%, 2%, and 4% freeze-dried jaboticaba peel (High-Fat Jaboticaba - HFJ1, HFJ2, and HFJ4, respectively) in the last 40 experimental days. Blood and the liver were collected after 70 days of treatment and feces were collected in the last experimental week. Total cholesterol, triglycerides, and lipids were measured in the serum, liver, and dried feces. ffer in the experimental groups. HFJ2 group had the highest hepatic and fecal lipid contents compared with the group fed a diet with normal fat content (N), but low hepatic lipid peroxidation. HFJ4 group had the highest mean hepatic and fecal cholesterol levels. Hepatic triglyceride levels did not differ among the groups, and groups HFJ1 and HFJ4 presented the highest fecal triglyceride content. CONCLUSION: The amounts of jaboticaba peel used by this study did not protect against hepatic steatosis or undesired levels of other studied lipids, but it did increase fecal triglycerides. Lipid peroxidation in the liver decreased in the HFJ2 group.

In this study we used the dual-task paradigm to investigate the involvement of attention in the binding of verbal and visual information in working memory. A secondary task, backward counting by threes (BCT), was performed during the retention interval of the primary recognition task based on either visual or verbal information or the binding of both. The BCT affected accuracy and response time. Accuracy was affected only in the binding condition; response time was affected only in the isolated information condition. Together these results suggest that storing integrated visual and verbal information requires more attentional resources than storing information received separately. These results are discussed in terms of involvement of the central executive in storing integrated information in working memory.

O objetivo do trabalho foi relatar um caso clínico sobre a síndrome de Crouzon, englobando as habilidades neuropsicolinguisticas. O estudo foi realizado com uma criança de oito anos e dois meses, do gênero masculino, com diagnóstico clínico da síndrome de Crouzon. Para a caracterização das habilidades foi realizada avaliação interdisciplinar com fonoaudiólogo, psicólogo e neurologista. A avaliação fonoaudiológica incluiu a avaliação das habilidades comunicativas, da linguagem oral, considerando as habilidades fonológicas, sintáticas, semânticas e pragmáticas, e da linguagem escrita. Para a avaliação neuropsicológica utilizou-se a escala Wechsler Scale for Children. A avaliação neurológica foi centrada no exame de ressonância magnética de encéfalo. O paciente também realizou avaliação audiológica, e apresentou perda auditiva condutiva de grau leve. Na avaliação clínica e formal da linguagem oral foi possível observar alterações nos aspectos fonológico e semântico da linguagem. Já com relação à linguagem escrita, observou-se desempenho aquém do esperado para a idade, caracterizado principalmente por alterações na escrita e na aritmética. Os resultados da avaliação neuropsicológica evidenciaram valores de Quociente Intelectual dentro dos padrões da normalidade. O resultado da ressonância magnética do encéfalo demonstrou alteração estrutural do sistema nervoso central. Pode-se concluir que os achados evidenciaram alterações nas habilidades de linguagem oral e escrita, além da presença de alteração estrutural do sistema nervoso central.

The aim of this study was to relate the neuropsycholinguistic abilities of a male child with eigth years and two months, diagnosed with Crouzon syndrome. The characterization of neropsycholinguitic abilities was based on a interdisciplinary evaluation carried out by a speech-language pathologist, a neurologist, and a psychologist. Speech-language evaluation included the assessment of communication skills, oral (phonological, syntactic, semantic and pragmatic abilities) and written language. The neuropsychological assessment used the Wechsler Scale for Children. The neurological evaluation was focused on the results of magnetic resonance imaging. The subject also carried out an audiological evaluation, which showed mild conductive hearing loss. In the oral language assessment, phonological and semantic deficits were observed. Written language performance was also below the expected for the subject's age, characterized mainly by writing and arithmetic deficits. The neuropsychological evaluation showed normal Intellectual Quotient. The results of the magnetic resonance imaging showed structural alterations of the central nervous system. Thus, the findings evidenced oral and written language deficits, and presence of structural alterations of the central nervous system.

In the working memory model, phonological and visuospatial information are stored by separate and independent systems. However, sometimes binding of visual and verbal information must occur. This study investigated whether these memory systems cooperate in the recall of spatial location of a stimulus defined by both types of information. Participants memorized the spatial locations in which name-and-face pairs were presented and either recalled the position of a test stimulus in which the two types of information were always present (Experiment 1) or recalled the position of a test stimulus that non-predictively contained either the visual or verbal information (Experiment 2). The results showed no cooperation between visuospatial and phonological systems when both types of information were present in the test stimulus. Rather, a clear preference for verbal information was found (Experiment 1). When the test stimulus contained only one type of information, recall based on both verbal and visual information was impaired (Experiment 2). These results suggest that visual and verbal information are not automatically integrated into memory and that storage capacity is smaller for integrated information than for isolated information.