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IntroductionNeuromodulation is a non-invasive technique that allows for the modulation of cortical excitability and can produce changes in neuronal plasticity. Its application has recently been associated with the improvement of the motor pattern in older adults individuals with sequelae from neurological conditions.ObjectiveTo highlight the effects of non-invasive neuromodulation on the risk of falls and fear of falling in community-dwelling older adults.MethodsSystematic review conducted in accordance with the items of the Cochrane Handbook for Systematic Reviews of Interventions. Searches were carried out in electronic databases: CENTRAL, Clinical Trials, LILACS, PEDro, PubMed, Web of Science, between 13/06/2020 and 20/09/2023, including all indexed texts without language and publication date restrictions, randomized controlled clinical trials, which presented as their main outcome non-invasive neuromodulation for reducing the fear of falling and risk of falls in the older adults, regardless of gender.ResultsAn extensive search identified 9 eligible studies for qualitative synthesis from 8,168 potential articles. Rigorous filtering through automated tools, title/abstract screening, and full-text evaluation ensured a focused and relevant selection for further analysis. Most studies (80%) used transcranial direct current electrical stimulation as an intervention, over the motor cortex or cerebellum area, with anodal current and monopolar electrode placement. The intensity ranged from 1.2 mA to 2 mA, with a duration of 20 min (80%). The profile of the research participants was predominantly individuals over 65 years old (80%), with a high risk of falls (60%) and a minority reporting a fear of falling (40%). The outcomes were favorable for the use of neuromodulation for the risk of falls in the older adults, through improvements in static and dynamic balance.ConclusionThe results may have limited applicability to direct outcomes related to the risk of falls, in addition to evidence regarding the difference or lack thereof in applicability between genders, fallers and non-fallers, as well as older adults individuals with low and high fear of falling.Systematic review registrationThe protocol for this review was registered in the International Prospective Register of Systematic Reviews (PROSPERO) to obtain the identification of ongoing research (ID: 222429).

The cAMP-dependent protein kinase (PKA) is one of the most extensively distributed kinases among intracellular signal cascades, with a pivotal role in the regulation of various processes, including the capacitation of sperm cells. Traditional assessments of PKA activity relies on the utilization of [γ-32P] ATP and the Kemptide substrate. This methodology presents several major drawbacks, including high-costs and health risks derived from the manipulation of radioactive isotopes. In this work we introduce an enhanced non-radioactive assay for quantifying PKA activity, termed KiMSA which relies on the use of a fluorescent-labeled Kemptide (Kemptide-FITC). Once the kinase reaction is terminated, the products can be easily resolved through electrophoresis on an agarose gel and quantified by fluorescence densitometry. We show that the KiMSA assay is suitable for purified PKA, and also to address both basal and capacitation induced PKA activity in mouse sperm cells. Furthermore, the assay enables monitoring the inhibition of PKA with inhibitors such as sPKI and H-89 in live cells. Therefore, the experimental and optimal assay conditions are set so that the KiMSA assay can be used to either assess in vitro as well as in vivo PKA activity in sperm cells. Finally, this method allows for measurement of cAMP concentrations, rendering a versatile technique for the study of cAMP/PKA pathways.

Abstract Objective This study aims to analyze outcomes and clinical and epidemiological data of infected tibial pseudarthrosis using the Ilizarov method and the Orr dressing. Methods Data from n = 43 patients diagnosed with infected tibial pseudarthrosis were analyzed by descriptive and inferential statistical methods. In addition, Paley's assessment criteria evaluated bone and functional outcomes. Qualitative variables were presented as the distribution of absolute and relative frequencies. The presentation of quantitative variables followed the D'Agostino-Pearson test. Results Thirty-seven (86.04%) subjects were males, and six (13.95%) were females. The most frequent age group among patients was 50 to 59 years old (25.6%), with a p-value = 0.8610. The treatment time was longer for the trifocal treatment (23.8 months) when compared to the bifocal treatment (15.6 months), with a p-value = 0.0010* (highly significant). Excellent bone outcomes represented 72.09% of the sample; 23.25% of outcomes were good. Functional outcomes were excellent in 55.81%, good in 6.97%, and regular in 27.90% of subjects. The Orr dressing (using Vaseline gauze) proved effective, achieving wound healing with soft tissue coverage in all patients evaluated. Conclusions The Ilizarov method resulted in a substantial change in the treatment of bone infections, especially infected pseudarthrosis. The versatility of this method has turned it into an effective tool, allowing the healing of the infectious process and the correction of potential deformities and shortening.

Mateus Medeiros Leite,1 Ivo Vieira de Sousa Neto,2 Maurílio Tiradentes Dutra,3 Silvana Schwerz Funghetto,1 Alessandro de Oliveira Silva,4 Izabel Cristina Rodrigues da Silva,1 Luciano Ramos de Lima,5 Marina Morato Stival1 1Graduate Program in Health Sciences and Technologies, University of Brasilia, Faculty of Ceilândia, Brasilia, Brazil; 2School of Physical Education and Sport of Ribeirão Preto, University of São Paulo (USP), São Paulo, Brazil; 3Federal Institute of Education, Science and Technology of Brasília, Brasilia, Brazil; 4Physical Education Department, University Center of Brasilia - UniCEUB, Brasilia, Brazil; 5Nursing Course, University of Brasilia, Faculty of Ceilândia, Brasilia, BrazilCorrespondence: Mateus Medeiros Leite, University of Brasilia, Graduate Program in Health Sciences and Technologies, Faculty of Ceilândia, Brasilia, Brasilia, Federal District, Brazil – Campus Universitario, s/n, Centro Metropolitano, Brasília, 72220-275, Brazil, Tel + 55 61 998541966, Email profmateusleite@gmail.comPurpose: To propose predictive models for absolute muscle strength (AMS) of elderly people with type 2 Diabetes Mellitus (DM2) in primary health care.Patients and Methods: The cross-sectional study was conducted with 138 elderly diabetics. The AMS was measured by a JAMAR® hydraulic handgrip dynamometer, determined by the sum of both hands. The following indices were evaluated: waist-to-height ratio (WHtR), body mass index (BMI), Lipid Accumulation Product (LAP), Triglyceride/High Density Lipoprotein (TG/HDL) ratio and platelet/lymphocyte ratio (PLR). Multiple linear regression was used in the statistical analysis.Results: The final regression model indicated 66.4% (R²=0.66) of the variation in AMS. WHtR decreased AMS by 41.1% (β = − 0.19; t = − 3.70; p < 0.001), while PLR by 11.3% (β = − 0.12; t = − 2.36; p = 0.020). Male sex increased AMS by 10.6% (β = 0.32; t = 4.16; p < 0.001), and lean mass (LM) by 0.89% (β = 0.46; t = 6.03; p < 0.001).Conclusion: WHtR and PLR predicted a decrease, while male sex and LM predicted an increase in AMS. It is suggested that these markers be used as screening measures for variation in AMS in older adults with DM2. These results have relevant practical application in primary health care since the markers are easy to use.Keywords: handgrip strength, obesity, diabetes mellitus, inflammation, primary health care

Older adults face a decline in the quality of their diet, which affects their health. The prevalence of DM2 is increasing, as are the associated complications. Effective nutrition education and mobile health (mHealth) interventions offer a viable solution in the scenario of the widespread use of mobile devices. This study aimed to develop and validate messages for a mobile application aimed at older adult Brazilians with DM2 who receive care at the Brazilian Unified Health System (SUS). The educational messages on healthy eating for older adults with DM2 were created from 189 excerpts selected from Brazilian official documents. A total of 37 messages were created, categorized into 20 educational, 12 motivational, and 5 congratulatory, all up to 120 characters. Twenty-one experts validated the messages for clarity and relevance, and 11 messages had to be revised to meet the criteria. Subsequently, the 36 messages approved by the experts were tested on a sample of 57 older adults, guaranteeing clarity rates of over 80%. This study developed and validated 36 messages for a mobile health app aimed at older adults with type 2 diabetes mellitus in Brazil. Expert evaluation ensured clarity and relevance, confirmed by older adult participants who evaluated clarity. This research highlights the potential of mHealth to overcome barriers to accessing healthcare in the SUS, emphasizing personalized interventions for the effective management of older adults’ health.

Technological innovation has revolutionized healthcare, particularly in neurological rehabilitation, where it has been used to address chronic conditions. Smart home and building automation (SH&BA) technologies offer promising solutions for managing chronic disabilities associated with such conditions. This single group, pre-post longitudinal pilot study, part of the H2020 HosmartAI project, aims to explore the integration of smart home technologies into neurorehabilitation. Eighty subjects will be enrolled from IRCCS San Camillo Hospital (Venice, Italy) and will receive rehabilitation treatment through virtual reality (VR) and robotics devices for 15 h per day, 5 days a week for 3 weeks in the HosmartAI Room (HR), equipped with SH&BA devices measuring the environment. The study seeks to optimize patient outcomes and refine rehabilitation practices. Findings will be disseminated through peer-reviewed publications and scientific meetings, contributing to advancements in neurological rehabilitation and guiding future research.

Background: Despite the robust evidence of an excess risk of coronavirus disease 2019 (COVID-19) severity and mortality in ever smokers, the debate on the role of current and ex-smokers on COVID-19 progression remains open. Limited or no data are available on the link between electronic cigarette (e-cigarette), heated tobacco product (HTP) and second-hand smoke (SHS) exposure and COVID-19 progression. To fill this knowledge gap, we undertook the COvid19 and SMOking in ITaly (COSMO-IT) study. Methods: A multi-centre longitudinal study was conducted in 2020–2021 in 24 Italian hospitals on a total of 1,820 laboratory-confirmed COVID-19 patients. We estimated multivariable odds ratios (OR) and 95% confidence intervals (CI) to quantify the association between smoking-related behaviours (ie, smoking status, e-cigarette and HTP use, and SHS exposure) and COVID-19 severity (composite outcome: intubation, intensive care unit admission and death) and mortality. Results: Compared to never smokers, current smokers had an increased risk of COVID-19 mortality (OR 2.17; 95% CI, 1.06–4.41). E-cigarette use was non-significantly associated to an increased risk of COVID-19 severity (OR 1.60; 95% CI, 0.96–2.67). An increased risk of mortality was observed for exposure to SHS among non-smokers (OR 1.67; 95% CI, 1.04–2.68), the risk being particularly evident for exposures of ≥6 hours/day (OR 1.99; 95% CI, 1.15–3.44). Conclusion: This multicentric study from Italy shows a dismal COVID-19 progression in current smokers and, for the first time, in SHS exposed non-smokers. These data represent an additional reason to strengthen and enforce effective tobacco control measures and to support smokers in quitting.

Background: Limited data on electronic cigarette prevalence, patterns, and settings of use are available from several European countries. Methods: Within the TackSHS project, a face-to-face survey was conducted in 2017–2018 in 12 European countries (Bulgaria, England, France, Germany, Greece, Ireland, Italy, Latvia, Poland, Portugal, Romania and Spain). Overall, 11,876 participants, representative of the population aged ≽15 years in each country, provided information on electronic cigarette. Results: 2.4% (95% confidence interval [CI], 2.2–2.7%) of the subjects (2.5% among men and 2.4% among women; 0.4% among never, 4.4% among current- and 6.5% among ex-smokers) reported current use of electronic cigarette, ranging from 0.6% in Spain to 7.2% in England. Of the 272 electronic cigarette users, 52.6% were dual users (ie, users of both electronic and conventional cigarettes) and 58.8% used liquids with nicotine. In all, 65.1% reported using electronic cigarette in at least one indoor setting where smoking is forbidden; in particular, at workplaces (34.9%) and bars and restaurants (41.5%). Multivariable logistic regression analysis showed that electronic cigarette use was lower among older individuals (P for trend

Abstract Background Emerald ash borer (Agrilus planipennis; EAB) is an Asian insect species that has been invasive to North America for 20 years. During this time, the emerald ash borer has killed tens of millions of American ash (Fraxinus spp) trees. Understanding the inherent defenses of susceptible American ash trees will provide information to breed new resistant varieties of ash trees. Results We have performed RNA-seq on naturally infested green ash (F. pennsylvanica) trees at low, medium and high levels of increasing EAB infestation and proteomics on low and high levels of EAB infestation. Most significant transcript changes we detected occurred between the comparison of medium and high levels of EAB infestation, indicating that the tree is not responding to EAB until it is highly infested. Our integrative analysis of the RNA-Seq and proteomics data identified 14 proteins and 4 transcripts that contribute most to the difference between highly infested and low infested trees. Conclusions The putative functions of these transcripts and proteins suggests roles of phenylpropanoid biosynthesis and oxidation, chitinase activity, pectinesterase activity, strigolactone signaling, and protein turnover.

Populational aging is marked by chronic noncommunicable diseases, such as metabolic syndrome (MetS). IL-10 and IL-1β are pleiotropic cytokines with multiple biological effects linked to metabolic disorders. This cross-sectional study assessed 193 participants’ IL-10 and IL-1β serum levels regarding their role in developing MetS, clinical characteristics, and their IL1B rs1143627 and IL10 rs1800890 variants’ genotype frequencies in a population over 60. IL-10 levels correlated weakly with HDL levels and fat mass and inversely with triglycerides, glucose, glycated hemoglobin, and estimated average blood glucose levels. IL-10 levels were also indirectly influenced by the patient’s T2DM duration, lean mass amount, and bone mineral content. Participants with altered HDL, elevated serum glucose, raised HbA1c levels, or those over 80 had reduced serum IL-10 levels compared to those with normal levels or other age groups, respectively. Women also had higher serum IL-10 levels than men. Dissimilarly, IL-1β levels correlated directly only with the number of total leukocytes and segmented neutrophils, showing only significant variations with self-reported alcohol consumption. Our study also found that those with the IL10 AA genotype (lower IL-10 levels) had a significantly higher risk of developing MetS. These findings may help direct future research and more targeted therapeutic approaches in older adults.

BackgroundThe increase in the prevalence of obesity is associated with the increase in the consumption of ultra-processed foods and may be related to the increase in the disorders involving metabolism and the transport and storage of fatty acids.ObjectiveTo evaluate the effect of processed food consumption according to the degree of processing on the serum fatty acid levels and lipid profile of women with severe obesity.MethodsThis was a cross-sectional study. Data were collected from anthropometric assessments, the food frequency questionnaire (FFQ), and blood tests for lipidogram studies and serum fatty acid measurements. The foods consumed were identified through the FFQ and classified according to the degree of processing based on the NOVA rating, and the frequencies of consumption were transformed into scores, as proposed by Fornés methodology. Data were analyzed using IBM SPSS Statistics, version 21. The significance level for the analysis was set at 5%.ResultsThis study included 44 women with a mean age of 40.59 years and mean body mass index of 48.61 kg/m2. An inverse association was observed between the consumption of unprocessed and the occurrence of hypertriglyceridemia (p = 0.021) and levels of triglycerides (p = 0.047), total cholesterol (p = 0.030), and very low-density lipoprotein-cholesterol (p = 0.039). The consumption of processed foods was positively associated with the presence of hypertriglyceridemia (p = 0.044) and omega 6/3 ratio (p = 0.001) and negatively associated with total omega 3 levels (p = 0.011). The consumption of processed foods was positively associated with total cholesterol (p = 0.041) and negatively associated with the omega 3/6 ratio (p = 0.001). A negative correlation was found between the average consumption of ultra-processed foods (at least once a week) and serum level of high-density lipoprotein (p = 0.035).ConclusionThe consumption of processed and ultra-processed foods was associated with unfavorable lipid profiles and fatty acid levels in women with severe obesity. These results emphasize the importance of promoting the consumption of unprocessed food to mitigate metabolic disorders linked to processed food intake.

Abstract Background The COVID-19 pandemic and the lockdown period lasted from March to May 2020, resulted in a highly stressful situation yielding different negative health consequences, including the worsening of smoking habit. Methods A web-based cross-sectional study on a convenient sample of 1013 Italian ever smokers aged 18 years or more was conducted. Data were derived from surveys compiled by three different groups of people: subjects belonging to Smoking Cessation Services, Healthcare Providers and Nursing Sciences’ students. All institutions were from Northern Italy. The primary outcome self-reported worsening (relapse or increase) or improvement (quit or reduce) of smoking habit during lockdown period. Multiple unconditional (for worsening) and multinomial (for improving) logistic regressions were carried out. Results Among 962 participants, 56.0% were ex-smokers. Overall, 13.2% of ex-smokers before lockdown reported relapsing and 32.7% of current smokers increasing cigarette intake. Among current smokers before lockdown, 10.1% quit smoking and 13.5% decreased cigarette intake. Out of 7 selected stressors related to COVID-19, four were significantly related to relapse (OR for the highest vs. the lowest tertile ranging between 2.24 and 3.62): fear of being infected and getting sick; fear of dying due to the virus; anxiety in listening to news of the epidemic; sense of powerlessness in protecting oneself from contagion. In addition to these stressors, even the other 3 stressors were related with increasing cigarette intensity (OR ranging between 1.90 and 4.18): sense of powerlessness in protecting loved ones from contagion; fear of losing loved ones due to virus; fear of infecting other. Conclusion The lockdown during the COVID-19 pandemic was associated with both self-reported relapse or increase smoking habit and also quitting or reduction of it.

Objetivo: avaliar a prevalência de síndrome metabólica e sua associação com variáveis sociodemográficas, clínicas, antropométricas e estilo de vida em idosos atendidos na atenção primária. Método: estudo transversal realizado com 344 idosos em uma Unidade Básica de Saúde do Distrito Federal. Realizaram-se análises do perfil lipídico, glicemia de jejum e hemoglobina glicada. Foram avaliados dados sociodemográficos, hábitos de vida, pressão arterial, antropometria e percentual de gordura. Realizou-se regressão de Poisson para cálculo da razão de prevalência bruta e ajustada. Resultados: a prevalência de síndrome metabólica foi de 62,2%. A hipertensão arterial (RPajustada=1,31; IC95%=1,02-1,67), cintura aumentada (RPajustada=1,46; IC95%=1,21-1,76), hipertrigliceridemia (RPajustada=1,98; IC95%=1,67-2,34) e HDL diminuído (RPajustada=1,19; IC95%=1,03-1,37) foram significativamente associados à síndrome metabólica. Conclusão: a elevada prevalência de síndrome metabólica e sua associação com fatores modificáveis apontam para a necessidade de identificar e controlar precocemente os fatores de risco em idosos.

Purpose: To evaluate measures of corneal epithelium in eyes that showed documented signs of keratoconus (KC) progression and compare with stable eyes and healthy controls. Also, to determine the correlation of these epithelial parameters with maximum keratometry (K max) and pachymetry. Design: Prospective, observational, comparative study. Participants: One-hundred and fifty eyes from 150 patients. The study included 50 eyes from patients with documented KC progression, 50 eyes with stable KC, and 50 clinically normal eyes to serve as controls. Methods: A spectral–domain (SD)-OCT imaging was obtained in all eyes, and mean values were compared between the groups. The correlation of epithelial parameters with K max and thinnest pachymetry was also investigated. Main Outcome Measures: For the purposes of this study, the epithelial measures maximum, minimum, superior, and inferior values as well as the difference between the minimum and maximum (min–max) and epithelial standard deviation were considered, obtained from SD-OCT and compared between groups. Measurements of the thinnest point and min–max in pachymetry were also recorded. Results: The only epithelial parameter that presented a statistically significant difference between stable and progressive KC was epithelium min–max. Although stable KC presented epithelium min–max mean values of −18.2 ± 6.6, progressive KC eyes presented mean values of −23.4 ± 10.3 (P < 0.0001). Epithelial maximum (P = 0.16), minimum (P = 0.25), superior (P = 0.28), inferior (P = 0.23), and standard deviation (P = 0.25) values were not significantly different between stable and progressive eyes. Difference min–max pachymetry points in stable (−108.3 ± 33.5) and progressive KC (−115.2 ± 56.0) were not significantly different (P = 0.723). There was no significant correlation between epithelium min–max with corneal thinning (P = 0.39) or K max (P = 0.09) regardless of disease progression. Conclusions: Epithelial measures are useful to identify KC eyes that are progressing; the parameters that measure the difference between min–max epithelium points were significantly different between stable and progressive groups, unlike this difference in pachymetry. Finally, this epithelial parameter seems to be independent of corneal thinning and K max. Financial Disclosure(s): Proprietary or commercial disclosure may be found after the references.

Objetivo: analisar as evidências científicas sobre presenteísmo em profissionais da saúde publicadas entre 2008 e 2018. Métodos: revisão integrativa, utilizando os seguintes descritores controlados: presenteísmo, pessoal de saúde e saúde do trabalhador, nos idiomas português e inglês, nas bases de dados Literatura Latino-Americana e do Caribe em Ciências da Saúde, US National Library of Medicine National Institutes of Health e Cumulative Index to Nursing and Allied Health Literature. Resultados: os artigos selecionados foram publicados nos últimos 4 anos da pesquisa e todos apresentaram abordagem quantitativa. Os achados foram: três diferentes conceitos de presenteísmo; diferentes períodos recordatórios; cinco instrumentos de mensuração e fatores que influenciam no presenteísmo. Conclusão: estudos que investigam o presenteísmo em profissionais de saúde ainda são escassos, e a falta de padronização de instrumentos e períodos recordatórios ocasionam vieses nos resultados encontrados na literatura e prejudicam a investigação e aplicação da temática.

Introdução: O novo coronavírus (SARS-CoV-2) é um patógeno que acomete principalmente o sistema respiratório, sendo o causador da COVID-19. Esse vírus pode afetar todos os grupos populacionais, entretanto indivíduos obesos são mais suscetíveis a evoluir com um quadro mais grave da doença. A obesidade pode ocasionar alterações do sistema imunológico, aumento do risco de infecções e aumento da taxa de mortalidade por COVID-19. Diante de maiores complicações relacionadas com a obesidade e a COVID-19, é necessário o tratamento específico para esses indivíduos no ambiente hospitalar. Portanto, o objetivo do estudo foi desenvolver um protocolo de atendimento nutricional a pacientes obesos com diagnóstico de COVID-19. Metodologia: A busca dos trabalhos foi realizada em base de dados PubMed, MEDLINE, LILACS, SciELO e Google Scholar, utilizando os descritores coronavirus, COVID-19, SARS-CoV-2, SARS-CoV como termo principal, associados a obesity, body composition, infflamation, adipose tissue, nutrition, critical illness. Resultados: foi estabelecido um protocolo para realização da avaliação e triagem de risco nutricional, com definição da via de alimentação pela equipe médica com o auxílio da equipe multiprofissional. As estimativas das necessidades calóricas e proteicas devem ser baseadas de acordo com a avaliação nutricional. Discussão: A avaliação, triagem e terapia nutricional adequadas são fundamentais para melhor recuperação de pacientes obesos. Devido a redução da ingestão alimentar e os sintomas gastrointestinais ocasionada pela COVID-19, é fundamental monitorar os sintomas e a tolerância a dieta ofertada. Conclusão: um protocolo de atendimento nutricional com padronizações de condutas nutricionais pode garantir menores complicações e contribuir para a redução da taxa de mortalidade.