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Objective: A pathological tremor (PT) is an involuntary rhythmic movement of varying frequency and amplitude that affects voluntary motion, thus compromising individuals’ independence. A comprehensive model incorporating PT’s physiological and biomechanical aspects can enhance our understanding of the disorder and provide valuable insights for therapeutic approaches. This study aims to build a biomechanical model of pathological tremors using OpenSim’s realistic musculoskeletal representation of the human wrist with two degrees of freedom. Methods: We implemented a Matlab/OpenSim interface for a forward dynamics simulation, which allows for the modeling, simulation, and design of a physiological $\mathcal {H}_{\infty} $ closed-loop control. This system replicates pathological tremors similar to those observed in patients when their arm is extended forward, the wrist is pronated, and the hand is subject to gravity forces. The model was individually tuned to five subjects (four Parkinson’s disease patients and one diagnosed with essential tremor), each exhibiting distinct tremor characteristics measured by an inertial sensor and surface EMG electrodes. Simulation agreement with the experiments for EMGs, central frequency, joint angles, and angular velocities were evaluated by Jensen-Shannon divergence, histogram centroid error, and histogram intersection. Results: The model emulated individual tremor statistical characteristics, including muscle activations, frequency, variability, and wrist kinematics, with greater accuracy for the four Parkinson’s patients than the essential tremor. Conclusion: The proposed model replicated the main statistical features of subject-specific wrist tremor kinematics. Significance: Our methodology may facilitate the design of patient-specific rehabilitation devices for tremor suppression, such as neural prostheses and electromechanical orthoses.

Abstract We show that warm inflation can be successfully realized in the high temperature regime through dissipative interactions between the inflaton and a single fermionic degree of freedom, provided that the latter’s mass is an oscillatory function of the inflaton field value. We demonstrate, in particular, that despite the consequent large amplitude oscillations of the eta slow-roll parameter, their effect is, on average, sufficiently suppressed to allow for a slow-roll trajectory. In addition, we demonstrate that, even though this also induces a parametric resonance that amplifies inflaton perturbations, this has a negligible effect on CMB scales in the relevant parametric range. Hence, the “Warm Little Inflaton” scenario can be realized with one less fermionic degree of freedom and no need of imposing an additional discrete interchange symmetry.

It is imperative that decision-makers recognize when the intensity of human interference in regard to forest losses may result in adverse conditions for water ecosystem services. Several studies have indicated that defining thresholds is appropriate for indicating the ideal relationship between natural ecosystems and land uses in such a way as to ensure ecosystem service supply, but this knowledge is not readily available for different water services. To predict tipping points of change in the availability of seven water-related services, we assessed 11 catchments with different proportions of natural forests (Brazilian cerradão) and eucalyptus plantations. We analyzed water samples for 13 physical–chemical–biological parameters, which by specific aggregation functions define indices for each water service. We applied the piecewise model to evaluate the relationships between water service indices and natural forest cover. The results indicated that the highest potential gains occurred above 45% of forest. Landscapes with less than 20% natural forests tended to become unsustainable in maintaining services. Erosion control had a higher correlation with the decrease in natural forests.

Abstract Conservation of carnivores involves finding solutions to minimize habitat loss and human-wildlife conflict. Understanding the nature of land-use economics can allow us to mitigate both threats. In the Pantanal, the two main economic activities are cattle ranching and ecotourism, each of which directly and indirectly affect the persistence of jaguars (Panthera onca). To understand how the geography of these economic activities is related to jaguar populations, we developed a jaguar distribution model (JDM), livestock density model, and ecotourism lodge density model for the Pantanal. Due to the recent wildfires within the Pantanal, we also assess the impact of burnt areas that are suitable for jaguars, cattle ranching, and tourism. Our JDM indicate that 64% of the Pantanal holds suitable habitat for jaguars. However, jaguar habitat suitability was positively correlated with ecotourism, but negatively correlated with areas most suitable for intensive cattle-ranching. This demonstrates a biome-wide scenario compatible with jaguar conservation. Of particular concern, recent wildfires overlap most suitable areas for jaguars. If wildfires become increasingly frequent, this would represent a serious threat to jaguars and many other wildlife populations. We emphasize the global importance of the Pantanal wetland ecoregion as a key stronghold for long-term jaguar conservation.

ABSTRACT Introduction: to evaluate the long-term impact of bariatric surgery in the elderly population. Methods: a retrospective study including all patients older than 60 years who underwent Roux-en-Y gastric bypass (RYGB) at our center and maintained a follow-up longer than 1 year. Clinical and laboratory variables were studied to assess remission of obesity and its comorbidities, as well as variables directly related to the surgical procedure itself, including early and late complications. Results: fifty-six patients were studied, mostly female (76,8%), with a mean age of 64.02 ± 3.34. A rate of complications of 37,5% was observed, with 10,7% requiring hospital admission and emergency surgery. The mean excess weight loss (%EWL) was 74.22% ± 26.76. The remission rates of hypertension and diabetes mellitus were 26.08% and 54.54%, respectively. There was significant difference in BMI reduction (12.25 ± 5.42, p

ABSTRACT - BACKGROUND: The twisting of the gastric tube is one of the main causes of persistent reflux and food intolerance after sleeve gastrectomy (SG). To date, there is no classification for gastric twist after SG. OBJECTIVE: This study aimed to propose an endoscopic classification for this condition and outline the clinical profile of these patients with sleeve gastrectomy. METHODS: Patients in the postoperative period of SG presenting endoscopic findings of gastric twist were included. All patients underwent an esophagogastroduodenoscopy 12 months after SG. The classification proposed consists of three degrees: degree I: mild rotation of the staple line without relevant shrinkage of the gastric lumen; degree II: moderate rotation of the staple line, leading to a focal area of fixed narrowing that requires additional maneuvers for its transposition; and degree III: severe rotation of the staple line leading to stenosis, with increased difficulty for transposition or complete blockage. RESULTS: Out of 2,723 patients who underwent SG, 45 (1.6%) presented gastric twist. Most patients were female (85%), with mean age of 39±10.4 years. In all, 41 (91.1%) presented degree I, 3 (6.7%) presented degree II, and 1 (2.2%) had degree III. Most patients were asymptomatic (n=26). Vomiting was the most prevalent symptom (15.5%). Statistically significant correlation of twisting degrees was not observed for both the presence of symptoms and the degrees of esophagitis. CONCLUSION: Gastric twist after SG is rare, with generally mild and asymptomatic presentation. The endoscopic classification was not statistically related to clinical presentation but set the ground for further analysis.

BackgroundMedication adherence is a crucial component in the management of patients with chronic diseases needing a long-term pharmacotherapy. Parkinson’s disease (PD) is a chronic, degenerative disease with complex drug treatment that poses challenging barriers to patient adherence. The adoption of best practices of scale development can contribute to generate solid concepts and, in the long run, a more stable knowledge base on the underlying constructs of medication adherence in PD measured by the items of the first scale to be created for this purpose.PurposeTo present the development process and clinimetric testing plan of the Parkinson’s Disease Medication Adherence Scale (PD-MAS).MethodWe adopted a hybrid approach plan based on the United States Food and Drug Administration and Benson and Clark Guide that will create a patient-reported outcome instrument. We presented an overview of consecutive and interrelated steps, containing a concise description of each one. International research centers from Brazil and United States were initially involved in the planning and implementation of the methodological steps of this study.ResultsWe developed a four-phase multimethod approach for the conceptualization and the clinimetric testing plan of the PD-MAS. First, we describe the development process of the conceptual framework of the PD-MAS underpinning the scale construct; second, we formalized the development process of the first version of the PD-MAS from the generation of item pools to the content validation and pre-testing; third, we established the steps for the first pilot testing and revision; fourth, we describe the steps plan for the first pilot testing and revision, to finally describe its clinimetric testing plan and validation.ConclusionThe overview presentation of the development phases and the clinimetric testing plan of the PD-MAS demonstrate the feasibility of creating an instrument to measure the multidimensional and multifactorial components of the medication adherence process in people with PD.

Sugarcane and cattle pastures are two of the most widespread and economically important agricultural landscapes. However, in Brazil, they have not been properly investigated for their importance to native birds and wildlife conservation. Thus, we aim to characterize and compare bird assemblages of sugarcane and cattle pastures; and understand how landscape features within both habitats influence bird assemblages. We surveyed birds in both agricultural habitats over one year, and then investigated the relationship between species richness and composition with landscape diversity, matrix permeability, and the size and distribution of natural forests close to both habitats. We observed 132 species in cattle pastures and only 72 in sugarcane (48% bird community similarity). We further evaluated the richness and relative abundance of avian ecological groups, including habitat specialists and habitat generalists, insectivores, omnivores, granivores and frugivores. All avian groups were higher in pastures, the habitat where landscape heterogeneity and number of scattered trees was higher. Our results show that overall increasing landscape heterogeneity favors an assemblage with higher richness and composed by species with more diverse ecological functions. Therefore, we argue in favor of management practices that incorporate heterogeneity in agricultural landscapes, mainly in sugarcane fields where a homogeneous scheme has been used. Otherwise, the potential of agricultural landscapes for bird conservation will be highly hindered, particularly if the sugarcane sector expands to other agricultural lands.

ABSTRACT Background: Although considered a safe procedure, sleeve gastrectomy (SG) has a non-negligible risk of major postoperative complications related to it, with special attention to gastric leaks. Aim: Evaluate the clinical value of the methylene blue test (MBT) in predicting the occurrence of post-SG leaks. Methods: Retrospective study that included 1136 patients who underwent SG with intraoperative MBT between 2012 and 2016. Sensitivity, specificity, positive predictive value (PPV) and negative predicted value (NPV) were calculated to determine the clinical correlation between the MBT and the occurrence of postoperative leaks. Staple line oversewing was performed in all patients who presented positive MBT. Results: Laparoscopic SG was performed in 97.0% of cases; open in 2.3%, and robotic in 0.7%. MBT was positive in 19 cases (1.67%). One positive MBT occurred during an open SG and the other 18 at laparoscopy. Moreover, there were nine cases (0.8%) of postoperative leaks, among which, only two presented positive MBT. MBT diagnostic value was evaluated through the calculation of sensitivity (22.0%), specificity (98.0%), PPV (11.0%) and NPV (99.0%). There were no cases of allergic reaction or any other side effect with the use of the methylene blue solution. Conclusion: MBT showed high specificity and negative predictive value, thus presenting an important value to rule out the occurrence of postoperative leaks.

ABSTRACT Background: Gastro-omentopexy promotes the reconnection of the stomach to the gastroesplenic and gastrocolic ligaments and constitutes an alternative for the prevention of complications in laparoscopic vertical gastrectomy. Aim: To demonstrate the benefits of the gastro-omentopexy technique in patients undergoing sleeve gastrectomy, with possible reduction in postoperative complications. Methods: Prospective, non-randomized, case series type study, consisting of a clinical population of 179 patients who underwent the technique in 2018, with follow-up between 6-12 months in the postoperative period. Results: From the participants 71.5% were women, aged between 30-40 years (36.3%). As for the prevalence of complications in the postoperative period, the low prevalence was evident, with emphasis on readmission (1.1%); reoperation (1.1%); wound infection (1.1%); bleeding hemorrhage (0.5%); and stricture (1.1%). However, temporary symptoms were present such as nausea/vomiting, food intolerance, epigastric pain and feeling of fullness, right after surgery. Conclusion: The technique promoted a significant improvement in quality of life and control of comorbidities. In addition, it was associated with a low prevalence of stenosis, and with no fistula, making the method safer.

BackgroundRecent experimental studies have suggested a potential link between cathepsin S (CTTS) and gastric adenocarcinoma progression. Herein, we aimed to evaluate the expression of CTTS in gastric adenocarcinoma in patients who underwent curative-intent surgical resection.MethodsThis was a cross-sectional study that included two groups: gastric adenocarcinoma (n = 42) and gastritis (n = 50). The gastritis group was then subdivided into H. pylori-positive (n = 25) and H. pylori-negative (n = 25) groups. Gastric tissue samples were analysed to determine CTTS expression through immunohistochemistry. Samples were obtained by oesophagogastroduodenoscopy or surgical specimens.ResultsIn patients with gastritis, the age ranged from 18 to 78 years. Among them, 34% were male, and 66% were female. In patients with gastric adenocarcinoma, the age ranged from 37 to 85 years. Among them, 50% were male. When comparing the expression of CTTS between the two groups, only 16% of the gastritis samples had an expression higher than 25%. Alternatively, among patients with gastric adenocarcinoma, 19% had expression between 25-50%, 14.3% between 51-75%, and 26.2% had expression higher than 75% (p < 0.001). In the gastritis group, CTTS expression was significantly higher in patients with a positive test for H. pylori than negative test for H. pylori: 87.5% and 38.5%, respectively (pConclusionCTTS expression is higher in gastric adenocarcinoma samples. Patients with gastritis due to H. pylori also show a higher expression of CTTS than patients with negative results for this bacterium.

Coexistence, as a concept and as a management goal and practice, has attracted increasing attention from researchers, managers and decision-makers dedicated to understanding and improving human-wildlife interactions. Although it still lacks a universally agreed definition, coexistence has increasingly been associated with a broad spectrum of human-wildlife interactions, including positive interactions, transcending a conservation focus on endangered wildlife, and involving explicitly considerations of power, equity and justice. In a growingly complex and interconnected human-dominated world, the key to turning human-wildlife interactions into large-scale coexistence is thorough planning. We present an approach for evidence-based, structured, and participatory decision-making in planning for human-wildlife coexistence. More specifically, we propose (i) a conceptual framework for describing the situation and setting the goals, (ii) a process for examining the causes of the situation and creating a theory of change, and (iii) a model for transdisciplinary research and collaboration integrating researchers, decision-makers and residents along with the interests of wildlife. To illustrate the approach, we report on the workshop considering the Jaguars of Iguaçu, a conservation project whose strategy includes the improvement of the relationship between ranchers and jaguars outside Iguaçu National Park, Brazil.

In adulthood, the ability to digest lactose, the main sugar present in milk of mammals, is a phenotype (lactase persistence) observed in historically herder populations, mainly Northern Europeans, Eastern Africans, and Middle Eastern nomads. As the –13910∗T allele in the MCM6 gene is the most well-characterized allele responsible for the lactase persistence phenotype, the –13910C > T (rs4988235) polymorphism is commonly evaluated in lactase persistence studies. Lactase non-persistent adults may develop symptoms of lactose intolerance when consuming dairy products. In the Americas, there is no evidence of the consumption of these products until the arrival of Europeans. However, several American countries’ dietary guidelines recommend consuming dairy for adequate human nutrition and health promotion. Considering the extensive use of dairy and the complex ancestry of Pan-American admixed populations, we studied the distribution of –13910C > T lactase persistence genotypes and its flanking haplotypes of European origin in 7,428 individuals from several Pan-American admixed populations. We found that the –13910∗T allele frequency in Pan-American admixed populations is directly correlated with allele frequency of the European sources. Moreover, we did not observe any overrepresentation of European haplotypes in the –13910C > T flanking region, suggesting no selective pressure after admixture in the Americas. Finally, considering the dominant effect of the –13910∗T allele, our results indicate that Pan-American admixed populations are likely to have higher frequency of lactose intolerance, suggesting that general dietary guidelines deserve further evaluation across the continent.

Abstract High rates of deforestation, either in the past or the present, affect many of the ecological processes in streams. Integrating deforestation history and the current landscape structure enhances the evaluation of ecological effects of land-use change. This is especially true when contemporary landscape conditions are similar but the temporal path to those conditions differs. One approach that has shown promise for evaluating biodiversity responses over time and space is the β-diversity partitioning, which combines taxonomic and functional trait-based approaches. We tested hypotheses related to stream fish assemblages’ turnover in watersheds with different environmental conditions and deforestation histories. We sampled fish from 75 watersheds in the Machado River basin, Brazil, and environmental factors were quantified at multiple scales. Taxonomic turnover was higher than expected by chance, whereas functional turnover was lower than expected by the observed taxonomic turnover, indicating that deterministic processes are structuring these assemblages. The turnover, and the environmental factors differed among watersheds with different deforestation histories. Besides being scale-dependent, turnover patterns are also likely dependent on land use dynamics and involve time-lags.

Chrysomya megacephala (Fabricius, 1794) (Diptera: Calliphoridae) is an exotic blowfly in Brazil and it is considered one of the main species of medical-forensic importance. Their larvae have a necrophagous habit with a high forensic potential and they are also considered an important tool for treating chronic wounds, a technique known as maggot therapy, which is not yet routinely used in Brazil despite proven efficacy. In this context, the present work aims to describe a protocol for carrying out the technique, with the complete description of colony maintenance, preparation and disinfection of eggs, packing and transportation of larvae for use, application and removal of the larvae on patients. Thus, with this protocol, the maggot therapy can be disseminated and performed by other research groups.

ABSTRACT Introduction: to evaluate urinary biochemical alterations related to urolithogenesis processes after sleeve gastrectomy (SG). Materials and methods : prospective study with 32 individuals without previous diagnosis of urolithiasis who underwent SG. A 24-h urine test was collected seven days prior to surgery and at 6-month follow-up. The studied variables were urine volume, urinary pH, oxalate, calcium, citrate, and magnesium and calcium oxalate super saturation (CaOx SS). Results: patients were mainly women (81.2%), with mean age of 40.6 years. Mean pre- and postoperative BMI were 47.1 ± 8.3 Kg/m2 and 35.5 ± 6.1 Kg/m2, respectively (p

ABSTRACT Background: The Hartmann procedure remains the treatment of choice for most surgeons for the urgent surgical treatment of perforated diverticulitis; however, it is associated with high rates of ostomy non-reversion and postoperative morbidity. Aim: To study the results after the Hartmann vs. resection with primary anastomosis, with or without ileostomy, for the treatment of perforated diverticulitis with purulent or fecal peritonitis (Hinchey grade III or IV), and to compare the advantages between the two forms of treatment. Method: Systematic search in the literature of observational and randomized articles comparing resection with primary anastomosis vs. Hartmann’s procedure in the emergency treatment of perforated diverticulitis. Analyze as primary outcomes the mortality after the emergency operation and the general morbidity after it. As secondary outcomes, severe morbidity after emergency surgery, rates of non-reversion of the ostomy, general and severe morbidity after reversion. Results: There were no significant differences between surgical procedures for mortality, general morbidity and severe morbidity. However, the differences were statistically significant, favoring primary anastomosis in comparison with the Hartmann procedure in the outcome rates of stoma non-reversion, general morbidity and severe morbidity after reversion. Conclusion: Primary anastomosis is a good alternative to the Hartmann procedure, with no increase in mortality and morbidity, and with better results in the operation for intestinal transit reconstruction.

ABSTRACT Introduction: Infection of the surgical site is the common complication, with significant rates of morbidity and mortality, representing a considerable economic problem for the health system. Objective: To carry out a narrative review of the literature on surgical site infection and the principles of antibiotic prophylaxis to update the knowledge of its use in surgery. Method: Medline, Ovid, Google Scholar, National Library of Medicine (PubMed), Cochrane and SciELO were used for the research. The keywords used were “anti-bacterial agents”; “antibioticoprophylaxis” AND “surgical wound infection”. The inclusion criteria were articles of recent publication, with full texts available and performed in humans. Result: A total of 29 articles were evaluated and selected according to the eligibility criteria. Conclusion: Infection of the surgical site is the most common postoperative complication. The key point of its prevention is the combination of several interventions that aim to reduce risk factors, such as: compliance with the new guidelines of the Center for Disease Control and Prevention; the principles of the use of prophylactic antibiotics; factors and risk index of the surgical site; administration time; duration and dosage of antibiotics. These data are available in this article.

RESUMO Objetivos: Comparar a evolução do perfil nutricional de pacientes submetidos ao bypass gástrico em Y de Roux (BGYR) e ao Sleeve, em hospitais dos setores público e privado da Saúde de Pernambuco. Método: O estudo incluiu pacientes submetidos à cirurgia bariátrica nos setores público e privado de saúde de Pernambuco no período de 2008 a 2016. Foram avaliados dados antropométricos e bioquímicos (Hemoglobina, Vitamina B12, Ferro e Ferritina) no período pré-operatório e com 3, 6 e 12 meses de pós-operatório. Resultados: Não foram registradas diferenças significativas entre os pacientes internados nos dois setores da Saúde no tocante às variáveis: níveis hemoglobina, anemia por deficiência de ferro e vitamina B12 em nenhuma das avaliações e conforme o tipo de cirurgia. Entre os pacientes submetidos ao BGYR, os níveis de ferro sérico foram significativamente menores nos pacientes do setor privado da Saúde apenas na primeira avaliação. Baixos níveis de ferritina sérica foram observados na segunda avaliação, sendo os pacientes do setor privado os que apresentaram menores valores. O sucesso cirúrgico foi significativamente maior no grupo que realizou o BGYR na rede privada. Conclusões: Com um seguimento de 12 meses pós-cirurgia bariátrica, não foi observada diferença estatisticamente significante no que diz respeito às deficiências de micronutrientes entre pacientes usuários dos setores público e privado de Saúde.

Background Parkinson’s disease (PD) leads to several changes in motor control, many of them related to informational or cognitive overload. The aim of this study was to investigate the influence of knowledge and intention on the postural control performance and on the coupling between visual information and body sway in people with and without PD standing upright. Methods Participants were 21 people with PD (62.1 ± 7.2 years), stages 1 and 2 (Hoehn & Yahr scale), under dopaminergic medication, and 21 people in the control group (62.3 ± 7.1 years). Participants stood upright inside a moving room, performing seven trials of 60 s. In the first trial, the room remained motionless. In the others, the room oscillated at 0.2 Hz in the anterior-posterior direction: in the first block of three trials, the participants were not informed about the visual manipulation; in the second block of three trials, participants were informed about the room movement and asked to resist the visual influence. An OPTOTRAK system recorded the moving room displacement and the participants’ sway. The variables mean sway amplitude (MSA), coherence and gain were calculated. Results With no visual manipulation, no difference occurred between groups for MSA. Under visual manipulation conditions, people with PD presented higher MSA than control, and both groups reduced the sway magnitude in the resisting condition. Control group reduced sway magnitude by 6.1%, while PD group reduced by 11.5%. No difference was found between groups and between conditions for the coupling strength (coherence). For the coupling structure (gain), there was no group difference, but both groups showed reduced gain in the resisting condition. Control group reduced gain by 12.0%, while PD group reduced by 9.3%. Conclusions People with PD, under visual manipulation, were more influenced than controls, but they presented the same coupling structure between visual information and body sway as controls. People in early stages of PD are able to intentionally alter the influence of visual information.

Human activities are changing landscape structure and function globally, affecting wildlife space use, and ultimately increasing human-wildlife conflicts and zoonotic disease spread. Capybaras (Hydrochoerus hydrochaeris) are linked to conflicts in human-modified landscapes (e.g. crop damage, vehicle collision), as well as the spread and amplification of Brazilian spotted fever (BSF), the most human-lethal tick-borne disease in the world. Even though it is essential to understand the link between capybaras, ticks and BSF, many knowledge gaps still exist regarding the effects of human disturbance in capybara space use. Here, we analyzed diurnal and nocturnal habitat selection strategies of capybaras across natural and human-modified landscapes using resource selection functions (RSF). Selection for forested habitats was higher across human-modified landscapes, mainly during day- periods, when compared to natural landscapes. Across natural landscapes, capybaras avoided forests during both day- and night periods. Water was consistently selected across both landscapes, during day- and nighttime. Distance to water was also the most important variable in predicting capybara habitat selection across natural landscapes. Capybaras showed slightly higher preferences for areas near grasses/shrubs across natural landscapes, and distance to grasses/shrubs was the most important variable in predicting capybara habitat selection across human-modified landscapes. Our results demonstrate human-driven variation in habitat selection strategies by capybaras. This behavioral adjustment across human-modified landscapes may be related to increases in A. sculptum density, ultimately affecting BSF.

Background and aimsMitochondrial swelling is involved in the pathogenesis of many human diseases associated with oxidative stress including obesity. One of the strategies for prevention of deleterious effects related to obesity and overweight is engaging in regular physical activity, of which high intensity interval training (HIIT) is efficient in promoting biogenesis and improving the function of mitochondria. Therefore, our aims were to investigate the effects of HIIT on metabolic and neuro-cardiovascular dynamic control and mitochondrial swelling induced by high-fat diet (HFD).Methods and resultsTwenty-three male Wistar rats (60 - 80g) were divided into 4 subgroups: control (C), HIIT, HFD and HFD+HIIT. The whole experimentation period lasted for 22 weeks and HIIT sessions were performed 5 days a week during the last 4 weeks. At the end of the experiments, fasting glucose and insulin tolerance tests were performed. Cerebral microcirculation was analyzed using cortical intravital microscopy for capillary diameter and functional density. Cardiac function and ergoespirometric parameters were also investigated. Mitochondrial swelling was evaluated on brain and heart extracts. HFD promoted an increase on body adiposity (pConclusionIn animals subjected to HFD, HIIT ameliorated both cerebral mitochondrial swelling and functional capillary density, but it did not improve cardiovascular function suggesting that the cardiovascular dysfunction elicited by HFD was not due to heart mitochondrial swelling.

This systematic review examined the effects of distinct physical activity interventions on the academic achievement of school students based on an analysis of four distinct outcomes: mathematics, language, reading, and composite scores. This study was performed in accordance with the PRISMA guidelines and the QUORUM statement. A literature search was conducted using the PubMed-MEDLINE, Scopus, and Web of Science databases. Peer-reviewed studies published in English, Portuguese, and Spanish were considered. A random-effect meta-analysis was employed to determine the effect of interventions on academic performance. The effects between interventions and control groups were expressed as standardized mean differences. Thirty-one studies were included in the meta-analysis based on the inclusion and exclusion criteria. The exercise programs were not capable of significantly improving language, reading skills, and composite scores. Conversely, performance in math tests increased significantly after the interventions compared with the control groups. Regarding the overall effect, a significant improvement in academic achievement was detected after physical activity programs compared with controls. In conclusion, the positive effects of school-based physical education on academic performance are not uniform and may be higher for math skills. The implementation of evidence-based exercise programs in school settings emerges as a promising strategy to increase overall academic achievement in school-aged students.

Abstract Background Liposarcoma of the gallbladder is an extremely rare sarcoma, with only five cases reported in the literature according to our knowledge. Case presentation A 71-year-old woman was referred to the Surgical Oncology Division of Napoleão Laureano Hospital (João Pessoa, PB, Brazil) due to a solid mass at the right side of the abdomen and fever, with no signs of jaundice. Abdominal ultrasonography and computed tomography (CT) evidenced an extensive gallbladder lobular formation adhered to the inferior border of the right hepatic lobe and cholelithiasis. The CT report suggested gallbladder liposarcoma. A cholecystectomy associated with resection of segments IV-B and V of the liver were performed. Intraoperative frozen sections were compatible with gallbladder sarcoma. Anatomopathological examination and immunohistochemistry confirmed dedifferentiated liposarcoma with foci of heterologous leiomyosarcomatous differentiation and undifferentiated fusocellular areas of high histological grade. Conclusion This is the first case of dedifferentiated liposarcoma of the gallbladder to be reported.

The capybara, Hydrochoerus hydrochaeris, is the largest extant rodent of the world. To better understand the correlation between size and body mass, and biochemical parameters of capybaras from areas with different degrees of anthropization (i.e., different food supplies), we sampled free-ranging capybaras from areas of natural landscapes (NLs) and human-modified landscapes (HMLs) in Brazil. Analyses of biometrical and biochemical parameters of capybaras showed that animals from HMLs were heavier (higher body mass) than those from NL, a condition possibly related to fat deposit rather than body length, as indicated by Body Condition Index (BCI) analyses. Biochemical parameters indicated higher serum levels of albumin, creatine kinase, cholesterol, fructosamine and total protein among capybaras from HMLs than from NLs; however, when all adult capybaras were analyzed together only cholesterol and triglycerides were positively correlated with body mass. We propose that the biochemical profile differences between HMLs and NLs are related to the obesity condition of capybaras among HMLs. Considering that heavier animals might live longer and reproduce more often, our results could have important implications in the population dynamics of capybaras among HMLs, where this rodent species is frequently represented by overgrowth populations that generate several levels of conflicts with human beings.

Genetic risk: Uncovering ethnic-specific mutations A new study reveals the frequency of Leucine-Rich Repeat Kinase 2 (LRRK2) mutations associated with Parkinson’s disease (PD) in Latin Americans. Ignacio F. Mata at the University of Washington and the VA Puget Sound Health Care System, Seattle, USA, and colleagues from six South American countries have screened the largest cohort of Latino PD patients ever assembled (1739) and 1104 healthy controls for LRRK2 mutations that are known to cause PD in European-derived populations. They found that the p.G2019S missense mutation was the most common, although its frequency varied greatly between countries and was directly correlated with European ancestry. In contrast, the p.R1441G mutation which is common in Spain is rare in Latin America. Further analyses of this cohort will help to further characterize the genetic profile of PD patients in Latin America and contribute to the development of personalized medicines.

BACKGROUND:Brazilian spotted fever (BSF), caused by the bacterium Rickettsia rickettsii, has been associated with the transmission by the tick Amblyomma sculptum, and one of its main hosts, the capybara (Hydrochoerus hydrochaeris). METHODS:During 2015-2019, we captured capybaras and ticks in seven highly anthropic areas of São Paulo state (three endemic and four nonendemic for BSF) and in two natural areas of the Pantanal biome, all with established populations of capybaras. RESULTS:The BSF-endemic areas were characterized by much higher tick burdens on both capybaras and in the environment, when compared to the BSF-nonendemic areas. Only two tick species (A. sculptum and Amblyomma dubitatum) were found in the anthropic areas; however, with a great predominance of A. sculptum (≈90% of all ticks) in the endemic areas, in contrast to a slight predominance of A. dubitatum (≈60%) in the nonendemic areas. Tick species richness was higher in the natural areas, where six species were found, albeit with a predominance of A. sculptum (≈95% of all ticks) and environmental tick burdens much lower than in the anthropic areas. The BSF-endemic areas were characterized by overgrowth populations of A. sculptum that were sustained chiefly by capybaras, and decreased populations of A. dubitatum. In contrast, the BSF-nonendemic areas with landscape similar to the endemic areas differed by having lower tick burdens and a slight predominance of A. dubitatum over A.sculptum, both sustained chiefly by capybaras. While multiple medium- to large-sized mammals have been incriminated as important hosts for A. sculptum in the natural areas, the capybara was the only important host for this tick in the anthropic areas. CONCLUSIONS:The uneven distribution of R. rickettsii infection among A. sculptum populations in highly anthropic areas of São Paulo state could be related to the tick population size and its proportion to sympatric A. dubitatum populations.

ObjectiveTo assess the influence of bariatric surgery on transcription factor 7-like 2 (TCF7L2) expression and its association with body mass index (BMI) and Type 2 diabetes mellitus (T2DM).MethodsProspective study performed between 2016 and 2018, where 26 obese patients undergoing bariatric surgery were divided into two subgroups: diabetics and non-diabetics. The RNAs were extracted from peripheral blood samples that were obtained from each patient in two different moments: before surgery and after 12 months of follow-up. The relative expression of TCF7L2 was determined according to the delta-Ct method.ResultsThe linear regression model of BMI x delta-Ct showed a positive correlation (p = 0.037). In the subgroups, an inversely proportional relationship was found between delta-Ct and BMI in the diabetic group and a directly proportional relationship in the non-diabetic group (p>0.05 in both). In the postoperative period, the regression model was similar to the preoperative, except when analyzing the subgroups, where diabetic patients showed a directly proportional relationship (p>0.05). The relative expression of TCF7L2 showed an average of 1.16 ± 0.91, CI-95% 0.79-1.53. There was an increase in relative expression of 48% in the non-diabetic group (p = 0.021), and a decrease of 27% in the T2DM group (p>0.05) in the postoperative. There was a positive correlation between a greater decrease in BMI and increased relative expression (p = 0.027).ConclusionOur results showed that generally, the TCF7L2 expression increase with a decrease in BMI, however, for patients with T2DM, it exhibits an inverse pattern, which is normalized one year after bariatric surgery.

ABSTRACT The aim of this study was to evaluate commercial gelatin in the total replacement of bovine heart in feed training of "pacamã" Lophiosilurus alexandri in different water salinities. A completely randomized experimental design, in a 2 × 3 factorial arrangement, was performed using two types of moist ingredients (bovine heart and gelatin) and three water salinities (0.0; 2.0 and 4.0 g of salt L-1) with three replications. Juveniles (2.39 ± 0.08 cm standard length and 0.20 ± 0.03 g of weight) were conditioned to accept commercial diets by the technique of the gradual transition of ingredients. At the end of 36 days no differences were observed to weight gain, length gain and specific growth rate. The feed training efficiency was better (P < 0.05) with the gelatin use, 100.0%. There was a negative effect of salinity on the survival rate and management efficiency in the concentration of 4 g of salt L-1, with values of 58.6 ± 12.0 % and 58.0 ± 12.0 %, respectively. Lophiosilurus alexandri juveniles could be feed-trained to accept commercial diets with gelatin in the total replacement of bovine heart in freshwater or salinity of 2 g of salt L-1.

The use of cannabidiol in some neurological conditions was allowed by Conselho Regional de Medicina de São Paulo and by Agência Nacional de Vigilância Sanitária (ANVISA). Specialists on behalf of Academia Brasileira de Neurologia prepared a critical statement about use of cannabidiol and other cannabis derivatives in neurological diseases.

Objetivo Quantificar a modificação da capacidade funcional em um período de três anos em um grupo de pacientes com artrite reumatoide (AR), utilizando os inventários HAQ e EPM-ROM. Métodos Quarenta pacientes com AR em tratamento com metotrexato (MTX) como fármaco antirreumático modificador da doença (DMARD) foram acompanhados por até três anos. O estado funcional foi avaliado no início e no final do período por HAQ e EPM-ROM. Resultados Trinta e dois pacientes foram recuperados, com escore HAQ inicial de 1,14 ± 0,49 (média ± DP) e EPM-ROM de 5,8 ± 2,75. Após um período médio de três anos, o HAQ foi de 1,13 ± 0,49 e EPM-ROM em 6,81 ± 3,66. No subgrupo de sete pacientes submetidos a cirurgia ortopédica, o HAQ diminuiu de 0,84 ± 0,72 para 1,64 ± 0,56; e o EPM-ROM, de 5,8 ± 1,80 para 8,3 ± 0,74. No subgrupo de pacientes não operados, o HAQ variou de 1,2 ± 0,45 para 1,07 ± 0,70; e o EPM-ROM, de 5,7 ± 3,06 para 6,4 ± 3,90. Conclusão Em um grupo de pacientes com AR medicados apenas com MTX como DMARD, houve pouca mudança nas pontuações HAQ e EPM-ROM durante o período médio de três anos. Observou-se agravamento da capacidade funcional no grupo de pacientes operados, em comparação com os não operados. Este fato nos alerta para a necessidade do uso de esquemas terapêuticos mais abrangentes e de maior disponibilidade de cirurgias musculoesqueléticas, em tempo hábil, em pacientes com AR.

Background : Obesity and type 2 diabetes mellitus are associated to inflammatory state, which can be set off by the adipose tissue, once it is a metabolically active organ that can cause a chronic mild inflammatory state. Aim : To evaluate the correlation between preoperative C-reactive protein and postoperative complications risk in obese patients (grades II and III) after Roux-en-Y gastric bypass, with and without type 2 diabetes mellitus. Methods : Between 2008 and 2013 were analysed 209 patients (107 with diabetes), presenting body mass index >40 kg/m2or >35 kg/m2with comorbidities. During the postoperative period, two groups were evaluated: with and without complications. Preoperative ultra-sensitive C-reactive protein was measured by immunonephelometry method. Results : Complications occurred in seven patients (pulmonary thromboembolism, fistula, two cases of suture leak, pancreatitis, evisceration and upper digestive hemorrhage). No statistical significance was found regarding lipid profile and C-reactive protein between patients with and without type 2 diabetes mellitus. When compared to each other, both groups (with and without complications) presented with statistical significance regarding C-reactive protein level (7,2 mg/dl vs 3,7 mg/dl, p=0,016) and had similar weight loss percentage after 3, 6 and 12 months follow-up. Conclusions : Preoperative C-reactive protein serum level was higher in the group which presented complications after Roux-en-Y gastric bypass when compared to the group without postoperative complications.

INTRODUCTION: Despite of benefits of bariatric surgery for obesity treatment, the procedure may be related to some complications. AIM: Analyze studies to address the relation between nephrolithiasis and bariatric surgery. METHODS: Ten papers about this theme were selected from 2005-2013 in Pubmed, describing the relation of nephrolithiasis or their risk factors with several types of bariatric surgery. RESULTS: Retrospective studies with minimal follow-up of three years demonstrated 7,65% in surgery patients and 4,63% non-surgery with nephrolithiasis (p

Wildlife living within urban ecosystems have to adapt or perish. Red-legged Seriema, a large terrestrial bird, are rare in urban ecosystems, however, they have been reported in a medium-sized Brazilian city. We investigated the reasons for this occurrence as well as their behavior. We assessed the distribution of Seriemas (including fledglings), free-ranging cats, and cat-feeding points provided by humans, and past records of Seriemas in the study area. We discovered that Seriemas are sharing spatial resources with cats without apparent conflicts, and intraspecific competition was important to define the spatial distribution of Seriemas. This species is able to use human-made structures to improve territory defense and opportunistic foraging. Direct and indirect human food provisioning is helping them to survive in the studied area, but is also facilitating the domestication process, which may cause future conflicts with humans and cats. Although Seriemas have inhabited the studied urban area for years, they are still adapting their behaviors for urban life, as they have not yet perceived the dangers of automotive traffic. Our study corroborates that wild species may adapt to urban areas driven by human contact, but it also acts as a trap for the adaptive process.

INTRODUÇÃO: O insucesso do tratamento clínico do diabete melito tipo 2 (DM2) aumentou o interesse em cirurgia metabólica, sendo considerada alternativa promissora no controle de diabéticos com ou sem obesidade. Todavia, ainda não há seguimento em longo prazo para se avaliar a duração da remissão da doença, cuja recidiva pode estar associada ao reganho de peso. OBJETIVOS: 1) Descrever os resultados de pacientes com DM2 e IMC