6 Só será permitido o uso de dicionário INGLÊS/INGLÊS.

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1 Confira se os dados contidos na parte inferior desta capa estão corretos e, em seguida, assine no espaço reservado para isso. Se, em qualquer outro local deste Caderno, você assinar, rubricar, escrever mensagem, etc., será excluído do Exame. Este Caderno contém 5 questões discursivas referentes à Prova da Língua Estrangeira escolhida pelo candidato. Não destaque nenhuma folha. Se o Caderno estiver incompleto ou contiver imperfeição gráfica que impeça a leitura, solicite imediatamente ao Fiscal que o substitua. Será avaliado apenas o que estiver escrito no espaço reservado para cada resposta, razão por que os rascunhos não serão considerados. Escreva de modo legível, pois dúvida gerada por grafia, sinal ou rasura implica rá redução de pontos. 6 Só será permitido o uso de dicionário INGLÊS/INGLÊS. 7 A Comperve recomenda o uso de caneta esferográfica, confeccionada em material transparente, de tinta preta. Em nenhuma hipótese se avaliará resposta escrita com grafite. 8 Utilize para rascunhos, o verso de cada página deste Caderno. 9 Você dispõe de, no máximo, três horas, para responder as 5 questões que constituem a Prova. 10 Antes de retirar-se definitivamente da sala, devolva ao Fiscal este Caderno. Assinatura do Candidato: UFRN Exame de Proficiência 2018_1 Inglês

2 As questões de 01 a 05, cujas respostas deverão ser redigidas EM PORTUGUÊS, referem -se ao texto abaixo. VITAMIN D DEFICIENCY AND CARDIOMETABOLIC SYNDROME: IS THE EVIDENCE SOLID? Introduction Lubna A.G. Mahmood, Reem Al Saadi, Lorraine Matthews Cardiometabolic syndrome (CMS) or commonly referred to as metabolic syndrome (MS) is a group of metabolic abnormalities that can increase the risk of cardiovascular disease (CVD) and type 2 diabetes. It affects over one third of American adults and accounts for high healthcare costs annually. It develops in an individual with any three of the following risk factors: obesity, diabetes, hypertension (HTN), dyslipidemia, and thrombosis. Recent evi dence has suggested that inadequate Vitamin D may play a role in the development of some of these risk factors. MS is more common in western societies compared to underdeveloped countries. In western societies, individuals frequently consume a high calorie diet that lacks essential nutrients, and coupled with limited sun exposure can restrict their Vitamin D synthesis. Both dietary and environmental factors, along with the sedentary lifestyle, can lead to MS risk factors. Active research has revealed the role of inadequate Vitamin D in the development of obesity, diabetes, inflammation, and HTN. In contrast, limited research has been done on the role of Vitamin D in other risk factors such as thrombosis and dyslipidemia. Research outcomes propose to increase the current Vitamin D fortification level in foods to reduce the risk factors of MS. The aim of this paper is to provide an overview of existing research studies and their approaches concerning the relationship between Vitamin D intake and the development of CMS. Vitamin D is a fat soluble vitamin which has an important role in bone metabolism with some anti inflammatory and immune modulating properties. It is very unique since it can be made in the skin from exposure to sunlight. It is a hormone precurs or which presents in two forms: Ergocalciferol or Vitamin D2 is found in plants and some fish and seafood cholecalciferol or Vitamin D3 which is synthesized in the skin by sunlight. Vitamin D3 is synthesized from 7 dehydrocholesterol in the skin and transported to the liver by Vitamin D binding protein where it undergoes hydroxylation to 25(OH)D (the inactive form of Vitamin D), and then, it is hydrolyzed in the kidney by the enzyme 1 hydroxylase to 1,25(OH)D into its active form. The half life of Vitamin D in the liver is about 3 weeks. Humans can fulfill their Vitamin D requirements normally by either being exposed to the sun for enough time to produce adequate amounts or ingesting Vitamin D. Vitamin D works with parathyroid hormone (PTH) to mediate skelet al mineralization by controlling calcium absorption in the small intestine and maintaining calcium homeostasis in the bloodstream. Good food sources of Vitamin D include certain kinds of fish, egg yolks, and milk, and it can also be added to some food types such as fortified products including margarine, milk, rice, oats, and juices. Vitamin D deficiency (VD) is a well-recognized condition which is prevalent worldwide, particularly at northern latitudes, because of the low levels of UVB light exposure in w inter at these latitudes. Several European studies have shown variation in Vitamin D status within countries, which could be explained by factors such as reduced sunlight exposure, low dietary intake of foods rich in Vitamin D, fortification of food with V itamin D, low physical health status, or differences in biochemical assays used to measure Vitamin D levels. A study published in 2001 reported a prevalence of Vitamin D deficiency from 2% to 30% of European adults but found that it increased to 75% or more in institutionalized older persons. Data from the Third National Health and Nutrition Survey (NHANES III) showed that approximately one quarter to one-half of American adolescents and adults are deficient in Vitamin D if one uses a threshold of 25 ng/ml. Data from various studies on postmenopausal women revealed that the levels of 1, 25 DHCC below 75 nmol/l (30 ng/ml) ranged from 42% in Brazilian women to 92% in South Korean women. Very deficient levels ( 10 ng/ml) are most prevalent in South Asia and the Middle East, possibly because of cultural dress that limits sun exposure and extended periods of breastfeeding without Vitamin D supplementation. Disponível em: < on Friday>. Acesso em: 30 mar [Adaptado]. UFRN Exame de Proficiência 2018_1 Inglês Ciências da Saúde 1

3 Questão 1 Explique, segundo o texto, qual a relação entre a síndrome metabólica e a vitamina D e por que há maior incidência dessa síndrome no mundo ocidental. Questão 2 Explique por que a Vitamina D é importante e descreva as duas formas pelas q uais o organismo humano pode sintetizá-la, de acordo com o texto. UFRN Exame de Proficiência 2018_1 Inglês Ciências da Saúde 2

4 Questão 3 Explicite a que os pesquisadores atribuem a variabilidade no status da Vitamina D em estudos conduzidos em diferentes países europeus. Questão 4 Discorra sobre os achados de pesquisa reportados no texto em relação à deficiência de vitamina D : (a) nos Estados Unidos, (b) em mulheres na pós-menopausa e (c) na Ásia e Oriente Médio. UFRN Exame de Proficiência 2018_1 Inglês Ciências da Saúde 3

5 Questão 5 Traduza o fragmento textual abaixo no espaço reservado para isso. Seu texto deverá apresentar clareza e estar bem articulado tanto em termos estruturais quanto de sentido. In contrast, limited research has been done on the role of Vitamin D in other risk factors such as thrombosis and dyslipidemia. Research outcomes propose to increase the current Vitamin D fortification level in foods to reduce the risk factors of MS. The aim of this paper is to provide an overview of existing research studies and their approaches concerning the relationship between Vitamin D intake and the development of CMS. ESPAÇO DESTINADO AO TEXTO DEFINITIVO UFRN Exame de Proficiência 2018_1 Inglês Ciências da Saúde 4