Dieta e fatores de riscos metabólicos para doença cardiovascular em adultos e idosos residentes no município de São Paulo: uma análise por modelos de equações estruturais

Introdução: As doenças cardiovasculares são a principal causa de morte no Brasil e no mundo e apresentam importante contribuição para a carga global de doenças. A dieta tem sido considerada um dos determinantes primários do estado de saúde dos indivíduos, atuando na modulação dos fatores de risco metabólicos para doença cardiovascular. Objetivos: Desenvolver um modelo conceitual para a relação entre fatores de risco metabólicos e investigar sua associação com padrões de dieta de adultos e idosos residentes no município de São Paulo. Métodos: Estudo transversal de base populacional com amostra probabilística de adultos e idosos, residentes em área urbana do município de São Paulo, que participaram do Inquérito de Saúde do Município de São Paulo, realizado em duas fases entre os anos de 2008 e 2011 (estudo ISA Capital 2008). Na primeira fase do estudo, 1.102 adultos e idosos, de ambos os sexos, foram entrevistados no domicílio, por meio da aplicação de questionário estruturado e do recordatório alimentar de 24 horas. Na segunda fase, 642 indivíduos adultos e idosos foram reavaliados quanto ao consumo alimentar por meio da aplicação, por telefone, do segundo recordatório alimentar, e, destes, 592 participaram da coleta domiciliar de amostras de sangue venoso, da medição antropométrica e da aferição da pressão arterial por técnico de enfermagem. Os alimentos relatados em ambos os recordatórios foram agrupados segundo a similaridade do valor nutricional e hábitos alimentares da população, e corrigidos pela variância intrapessoal da ingestão por procedimentos estatísticos da plataforma online Multiple Source Method. Os grupos de alimentos foram analisados por meio de análise fatorial exploratória e confirmatória (manuscrito 1) e por modelos de equações estruturais exploratórios (manuscrito 3), a fim de obter os padrões de dieta. O modelo conceitual da relação entre os fatores de risco metabólicos (leptina sérica, proteína C-reativa de alta sensibilidade sérica, pressão arterial sistólica e diastólica, razão colesterol total/lipoproteína de alta densidade, razão triacilglicerol/lipoproteína de alta densidade, glicemia de jejum plasmática, circunferência da cintura e peso corporal) foi obtido por modelos de equações estruturais estratificados por sexo (manuscrito 2). Por fim, a associação dos padrões de dieta com o modelo conceitual proposto (manuscrito 3) foi investigada por modelos de equações estruturais exploratórios. Índices de qualidade de ajuste foram estimados para avaliar a adequação de todos os modelos. As análises foram realizadas no programa Mplus versão 6.12. Resultados: No manuscrito 1, a análise fatorial exploratória revelou a existência de dois padrões de dieta, os quais apresentaram boa qualidade de ajuste na análise fatorial confirmatória quando aplicados os pontos de corte de cargas fatoriais |0,25| na rotação oblíqua Promax. No manuscrito 2, a relação entre os fatores de risco metabólicos foi diferente entre os sexos. Nas mulheres, a leptina sérica apresentou efeitos indiretos e positivos, mediados pelo peso corporal e pela circunferência da cintura, em todos os fatores de risco avaliados. Já nos homens, a leptina sérica apresentou efeitos diretos e positivos sobre a proteína C-reativa de alta sensibilidade e efeitos indiretos e positivos (mediados pelo peso corporal e pela circunferência da cintura) sobre a razão triacilglicerol/lipoproteína de alta densidade, colesterol total/lipoproteína de alta densidade e glicemia de jejum plasmática. No manuscrito 3, foram obtidos três padrões de dieta, dos quais o Tradicional apresentou relação direta e negativa com a leptina sérica e relação indireta e negativa com o peso corporal e a circunferência da cintura, bem como com os demais fatores de risco metabólicos. Já o padrão Prudente apresentou relação direta e negativa com a pressão arterial sistólica, enquanto o padrão Moderno não se associou aos fatores de risco metabólicos investigados. Conclusão: Diferenças nos padrões de dieta de acordo com o tipo de rotação fatorial empregada foram observadas. A relação entre os fatores de risco metabólicos para doença cardiovascular foi distinta entre homens e mulheres, sendo a leptina um dos possíveis hormônios envolvidos. Os padrões de dieta Tradicional e Prudente associaram-se inversamente com os fatores de risco metabólicos, desempenhando uma importante estratégia de prevenção e controle às doenças cardiovasculares no país.

The 12-Item General Health Questionnaire (GHQ-12): Reliability,external validity and factor structure in the Spanish population

The purpose of this study was to analyze the internal consistency and the external and structure validity of the 12-Item General Health Questionnaire (GHQ-12) in the Spanish general population. A stratified sample of 1001 subjects, ages between 25 and 65 years, taken from the general Spanish population was employed. The GHQ-12 and the Inventory of Situations and Responses of Anxiety-ISRA were administered. A Cronbach’s alpha of .76 (Standardized Alpha: .78) and a 3-factor structure (with oblique rotation and maximum likelihood procedure) were obtained. External validity of Factor I (Successful Coping) with the ISRA is very robust (.82; Factor II, .70; Factor III, .75). The GHQ-12 shows adequate reliability and validity in the Spanish population. Therefore, the GHQ-12 can be used with efficacy to assess people’s overall psychological well-being and to detect non-psychotic psychiatric problems. Additionally, our results confirm that the GHQ-12 can best be thought of as a multidimensional scale that assesses several distinct aspects of distress, rather than just a unitary screening measure.

Architecture of a Bench-Type Carbonate Lake Margin and Its Relation to Fluvially Dominated Deltas, Las Minas Basin, Upper Miocene, Spain

The Upper Miocene stratigraphic succession of the Las Minas Basin, located at the external zone of the Betic Chain in SE Spain, preserves several examples of lake carbonate bench deposits. Excellent exposures of the carbonate benches allow detailed observation of the architecture of these sediments and provide new insights for the ‘‘steep-gradient bench margin–low energy’’ model proposed by Platt and Wright (1991). The lake carbonate benches developed in close association with fluvially dominated shallow deltas that exhibit typical Gilbert-type profiles. The delta sequences comprise bottomset prodelta marl facies, distal to proximal foreset facies, deposited mainly in a delta-front environment, and topset facies, the latter reflecting both subaqueous delta-front and subaerial delta-plain environments. The development of the carbonate benches was constrained by the convexupward morphology of the deltaic deposits, which led to the available accommodation space for the growth of the steep-gradient platforms. The benches display a progradational pattern characterized by sigmoid-oblique internal geometries and offlap upper boundary relationships, which suggests that the carbonate benches developed under slow though continuous lake-level rise. Both the dimensions of the benches and the dominant carbonate components (i.e., encrusted charophyte stems and calcified cyanobaterial remains), allow comparisons with the progradational marl benches recognized in modern temperate hardwater lakes. Accordingly, the case study presented here provides a good ancient sedimentary analog for low-energy lake carbonate benches. Moreover, the evolutionary trend inferred from the fossil example offers new insights into the depositional conditions of this type of sediment and allows recognition of the transitional pattern from bench to ramp carbonate lake margins.

Engineered surface waves in hyperbolic metamaterials

We analyzed surface-wave propagation that takes place at the boundary between a semi-infinite dielectric and a multilayered metamaterial, the latter with indefinite permittivity and cut normally to the layers. Known hyperbolization of the dispersion curve is discussed within distinct spectral regimes, including the role of the surrounding material. Hybridization of surface waves enable tighter confinement near the interface in comparison with pure-TM surface-plasmon polaritons. We demonstrate that the effective-medium approach deviates severely in practical implementations. By using the finite-element method, we predict the existence of long-range oblique surface waves.

Student mathematical notebook of Thomas Noyes, 1793

This sewn volume contains Noyes’ mathematical exercises in geometry; trigonometry; surveying; measurement of heights and distances; plain, oblique, parallel, middle latitude, and mercator sailing; and dialing. Many of the exercises are illustrated by carefully hand-drawn diagrams, including a mariners’ compass and moon dials.

Student mathematical notebook of William Emerson Faulkner, 1795

Leather hardcover notebook with unruled pages containing the handwritten mathematical exercises of William Emerson Faulkner, begun in 1795 while he was an undergraduate at Harvard College. The volume contains rules, definitions, problems, drawings, and tables on geometry, trigonometry, surveying, calculating distances, sailing, and dialing. Some of the exercises are illustrated by unrefined hand-drawn diagrams, including some of buildings and trees.

Student mathematical notebook of William Tudor, 1795

Notebook containing the handwritten mathematical exercises of William Tudor, kept in 1795 while he was an undergraduate at Harvard College. The volume contains rules, definitions, problems, drawings, and tables on geometry, trigonometry, surveying, calculating distances, sailing, and dialing. Some of the exercises are illustrated with hand-drawn diagrams. The Menusration of Heights and Distances section contains color drawings of buildings and trees, and some have been altered with notes in different hands and with humorous additions. For instance, a drawing of a tower was drawn into a figure titled “Egyptian Mummy.” Some of the images are identified: “A rude sketch of the Middlesex canal,” Genl Warren’s monument on Bunker Hill,” “Noddles Island,” “the fields of Elysium,” and the “Roxbury Canal.” The annotations and additional drawings are unattributed.

(Table 2) Estimated basement temperatures at DSDP Hole 69-504B

The achievement of deep penetration (562 m) of seafloor basalts at Hole 504B, near the Costa Rica Rift (1°13.63'N, 83°43.81'W), on DSDP Legs 69 and 70 presented a rare opportunity to examine the structure of young (6 m.y.) oceanic crust. In addition to the recovery of samples for laboratory studies, an extensive suite of downhole logs and experiments was carried out at this site, for two main purposes: (1) to allow reliable deductions about the nature of the entire section of penetrated crust, because recovery of samples was far from complete (-25%); (2) to probe the physical state of rock around the drilled hole on a scale of tens of meters to kilometers. Information on the latter large-scale phenomena at Hole 504B were provided mainly by the oblique seismic experiment, utilizing a bore-hole seismometer (Stephen 1983), and by the large-scale-electrical- resistivity experiment described below.

Chemical and mineral compositions of sediments from ODP Site 127-797

In order to reconstruct past variations in the aeolian dust (Kosa) contribution to the Japan Sea, and to establish a direct link between terrestrial and marine climatic records, we have applied statistical procedures to distinguish and quantify detrital subcomponents within the detrital fraction of the late Quaternary hemipelagic sediments in the Japan Sea. Q-mode factor analysis with varimax and oblique rotation of the factors followed by multiple-regression analysis between mineral composition and factor loadings was conducted using six ''detrital'' elements. Four detrital subcomponents were defined, which are attributed to Kosa derived from ''typical'' loess, Kosa from ''weathered'' loess, and fine and coarse arc-derived detritus, respectively, based on comparisons with the chemical and mineral compositions of probable source materials. Using these detrital subcomponents, the variation in Kosa fraction was reconstructed for the last 200 ky. The results reveal millennial-scale as well as glacial-interglacial scale variations in Kosa contribution. Especially, millennial-scale variability of Kosa contribution suggests the presence of high frequency variation in summer monsoon precipitation in the central to east Asia during the last 200 ky.

Clay mineralogy of ODP Site 131-808 sediments

Drill core recovered at Ocean Drilling Program Site 808 (Leg 131) proves that the wedge of trench sediment within the central region of the Nankai Trough comprises approximately 600 m of hemipelagic mud, sandy turbidites, and silty turbidites. The stratigraphic succession thickens and coarsens upward, with hemipelagic muds and volcanic-ash layers of the Shikoku Basin overlain by silty and sandy trench-wedge deposits. Past investigations of clay mineralogy and sand petrography within this region have led to the hypothesis that most of the detritus in the Nankai Trough was derived from the Izu-Honshu collision zone and transported southwestward via axial turbidity currents. Shipboard analyses of paleocurrent indicators, on the other hand, show that most of the ripple cross-laminae within silty turbidites of the outer marginal trench-wedge facies are inclined to the north and northwest; thus, many of the turbidity currents reflected off the seaward slope of the trench rather than moving straight down the trench axis. Shore-based analyses of detrital clay minerals demonstrate that the hemipelagic muds and matrix materials within sandy and silty turbidites are all enriched in illite; chlorite is the second-most abundant clay mineral, followed by smectite. In general, the relative mineral percentages change relatively little as a function of depth, and the hemipelagic clay-mineral population is virtually identical to the turbidite-matrix population. Comparisons between different size fractions (<2 µm and 2-6 µm) show modest amounts of mineral partitioning, with chlorite content increasing in the coarser fraction and smectite increasing in the finer fraction. Values of illite crystallinity index are consistent with conditions of advanced anchimetamorphism and epimetamorphism within the source region. Of the three mica polytypes detected, the 2M1 variety dominates over the 1M and 1Md polytypes; these data are consistent with values of illite crystallinity. Measurements of mica bo lattice spacing show that the detrital illite particles were eroded from a zone of intermediate-pressure metamorphism. Collectively, these data provide an excellent match with the lithologic and metamorphic character of the Izu-Honshu collision zone. Data from Leg 131, therefore, confirm the earlier interpretations of detrital provenance. The regional pattern of sediment dispersal is dominated by a combination of southwest-directed axial turbidity currents, radial expansion of the axial flows, oblique movement of suspended clouds onto and beyond the seaward slope of the Nankai Trough, and flow reflection back toward the trench axis.

Subcompact vehicle energy absorbing column evaluation and improvement. Final report.

National Highway Traffic Safety Administration, Washington, D.C.

Vehicular crash test of a continuous concrete median barrier without a footing. Final report.

Federal Highway Administration, Washington, D.C.

Small car driver inflatable restraint system evaluation. Volume III: investigation of potential crash survivability of a current production subcompact vehicle equipped with an advanced driver restraint system. Final report.

National Highway Traffic Safety Administration, Washington, D.C.

Small car driver inflatable restraint system evaluation. Volume IV - evolving a low mount passenger air cushion restraint system (ACRS) for the Vega subcompact vehicle. Final report.

National Highway Traffic Safety Administration, Washington, D.C.

Final report of a 1990 Chevrolet Caprice into a 50% left offset barrier in support of CRASH3 damage algorithm reformulation. Final report.

National Highway Traffic Safety Administration, Washington, D.C.