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The transplacental transmission of parasites and hemoparasites is crucial for understanding the epidemiology of diseases. This study aimed to assess the prevalence of hemopathogens in bovine fetuses at various gestational periods. Samples were obtained from a slaughterhouse in the state of Minas Gerais, Brazil, and a total of 236 fetuses were collected. DNA extracted from blood samples (145) and organ samples (a pool of brain and spleen) (236) underwent a nested PCR (nPCR) assay to detect Babesia spp., Theileria spp., Trypanosoma vivax, Anaplasma marginale, Anaplasma bovis, Anaplasma phagocytophilum, Ehrlichia minasensis, and hemotropic Mycoplasma spp. Additionally, serological analysis of 145 plasma samples was conducted using the indirect fluorescent antibody test-IFAT to detect IgG against Babesia bovis, Babesia bigemina, A. marginale, and Trypanosoma vivax. The observed prevalence of transplacental transmission was 19.3 %, 6.2 %, 42.7 % and 2.7 %, for A. marginale, B. bigemina, 'Candidatus M. haemobos', and Mycoplasma wenyonii, respectively. The prevalence of A. marginale by gestational trimester was 16 % (13/81) in the second trimester and 23 % (14/60) in the third trimester, with no positive samples in the first trimester. Regarding the species B. bovis and B. bigemina, all evaluated animals tested negative by nPCR, and no serological evidence for B. bovis was found by the IFAT. Babesia bigemina demonstrated an overall seroprevalence of 6.2 % (9/145), with 4.8 % (7/145) in the last trimester and 1.3 % (2/145) in the second trimester of pregnancy. In total, 42.7 % (62/145) of blood samples were positive for 'Candidatus M. haemobos', with 42 % (34/81) in the middle trimester, and 43 % (26/60) in the final trimester of pregnancy. Mycoplasma wenyonni was detected in 2.7 % (4/145) blood samples, all in coinfection with 'C. M. haemobos'. The prevalence by pregnancy trimester was 25 % (1/4) in the first trimester; 1.2 % (1/81) in the second trimester and 3.3 % (2/60) in the third trimester of pregnancy. Hemopathogen DNA was detected in fetus blood samples but not the brain or spleen samples. All the samples were negative for T. vivax, Theileria spp., Anaplasma spp. and Ehrlichia spp. Overall, in this study, approximately 70 % of fetuses were positive for one or more of the studied parasites. No significant associations were observed between pairs of pathogens, except 'C. M. haemobos' and A. marginale., (Copyright © 2024. Published by Elsevier GmbH.)

Background: Obesity is a non-communicable chronic disease which carries a high cost for the Brazilian Unified Health System. Standardized protocols can help primary health care (PHC) professionals manage the disease., Objectives: To describe the validation process of a protocol concerning dietary guidelines for adults with obesity in PHC by non-nutrition professionals., Methods: A validation study of a dietary advice protocol consisting of 6 recommendations was conducted according to Brazilian Dietary Guidelines. The topics incorporated into the recommendations were submitted to a panel of judges for content validity and achieved a Scale Content Validity Index (S-CVI) score >0.80. Subsequently, an online workshop was held and consisted of guiding questions to adequately improve current protocols. Face validity was assessed in a mediation workshop conducted with PHC non-nutrition professionals. Following the validation process, necessary adjustments were made to the eating protocol., Results: The validation process was conducted by a panel of 20 judges and 10 PHC professionals. The content was validated using a 0.98 S-CVI. The online workshop expert panel agreed the instrument provides a trustworthy foundation for appropriate dietary guidelines. Moreover, the judges suggested changes to the flowchart designed to support the professionals' decisions, discussed the absence of quantitative prescription guidelines, and offered additional suggestions to strengthen equity and encourage autonomy in non-nutrition healthcare professionals in PHC., Conclusion: This study describes the validation process of a dietary advice protocol for people with obesity, as well as the importance of its integration into PHC., (© The Author(s) 2022. Published by Oxford University Press. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.)

Introduction: Cognitive decline is prevalent in maintenance hemodialysis patients. The blood-brain barrier has been implicated in cognitive decline. In this prospective cohort study, we investigated the associations between endothelium-related biomarkers and steeper cognitive decline in this population., Methods: Cognitive function was assessed using the Portuguese-adapted Cambridge Cognitive Examination (CAMCOG) with items of the Mini-Mental State Examination (MMSE). Endothelium-related biomarkers included syndecan-1, ICAM-1, VCAM-1 and angiopoietin-2 (AGPT2). Patients were followed up for 4 years, and cognitive assessments were repeated. Multinomial regression analyses were performed to evaluate associations between biomarkers and cognitive decline., Results: A total of 216 patients completed the test battery at baseline. After 4 years, 102 patients had follow-up data. There was a significant decrease in cognitive function according to the CAMCOG and MMSE scores: a change of -0.39 (95% CI -0.27 to -0.51) and -0.51 (95% CI -0.27 to -0.76) standard deviation (SD) of the baseline scores. Additionally, executive function but not memory significantly decreased. Syndecan-1 level was independently associated with steeper cognitive decline; each increase in the SD of the syndecan-1 level was associated with a decrease in the CAMCOG of 0.20 (95% CI 0.07-0.33) SD from baseline. Syndecan-1 was associated with a steeper decline in MMSE score (β 0.54, 95% CI 0.28-0.81) and executive function (β 0.17, 95% CI 0.02-0.32). Syndecan-1 predicted severe cognitive impairment with an area under the curve for receiver operating characteristic curves of 0.75 (95% CI 0.64-0.83)., Conclusion: Our findings highlight the potential of syndecan-1, a biomarker of endothelium glycocalyx derangement, as a predictor of steeper cognitive decline in prevalent hemodialysis patients., (© 2024 The Author(s). European Journal of Neurology published by John Wiley & Sons Ltd on behalf of European Academy of Neurology.)

Background: Breast cancer is a prevalent form of cancer among women worldwide, often accompanied by physical and psychological side effects due to the disease and the treatment's aggressiveness. Regular physical exercise has emerged as a non-pharmacological approach to improve the quality of life of breast cancer survivors. We herein report the protocol of the WaterMama Study, which aims to evaluate the effects of land- or water-based aerobic exercise programs, compared to a health education program, on cancer-related fatigue and other health-related outcomes in breast cancer survivors., Methods: The WaterMama trial is a randomized, single-blinded, three-arm, parallel, superiority trial. We aim to recruit 48 women ≥ 18 years of age who have completed primary treatment for stage I-III breast cancer. Participants are randomly allocated in a 1:1:1 ratio to 12-week interventions of aerobic exercise training programs either in the aquatic or land environment (two weekly 45-min sessions) plus health education (a weekly 45-min session), or an active-control group receiving health education alone (a weekly 45-min session). The primary outcome is cancer-related fatigue, and the secondary outcomes include cardiorespiratory fitness, muscular performance, muscle morphology, functional capacity, mental health, cognitive function, pain, and quality of life. Outcomes assessments are conducted before and after the 12-week intervention period. The analysis plan will employ an intention-to-treat approach and per protocol criteria., Discussion: Our conceptual hypothesis is that both aerobic exercise programs will positively impact primary and secondary outcomes compared to the health education group alone. Additionally, due to its multi-component nature, we expect the aquatic exercise program promote more significant effects than the land exercise program on cancer-related fatigue, muscular outcomes, and pain., Trial Registration: The study was prospectively registered at ClinicalTrials.gov NCT05520515. Registered on August 26, 2022. https://clinicaltrials.gov/ct2/show/NCT05520515., (© 2024. The Author(s).)

A cloud point method was developed and applied for the first time to extract and preconcentrate thiabendazole (TBZ) from commercial whole grape juice samples, with determination by high performance liquid chromatography coupled to electrochemical detection (HPLC/EC), using a cathodically pretreated boron-doped diamond electrode (BDD). The best conditions for extraction and preconcentration of TBZ by cloud point extraction (CPE) were performed at pH 6.0, by adding 1 mL of the surfactant Tergitol TMN-6 at 10% (mass-to-mass ratio), without heating (at 27 °C) and ultrasonic stirring time of (20 kHz) for 60 min. The HPLC/EC determination was duly validated in a C8 column, in mobile phase with a 69 : 31 ratio (V/V) of phosphate buffer (pH 7.0):ACN, at a flow rate of 1.2 mL min -1 and electrochemical detection with BDD electrode by applying 1.40 V × Ag/AgCl (3.0 mol L -1 ). Under these conditions, the procedure showed a preconcentration factor ( F C ) of 21.7, and limits of detection (LOD) and quantification (LOQ) of 6.64 × 10 -9 mol L -1 (or 1.33 μg L -1 ) and 1.66 × 10 -8 mol L -1 (or 3.34 μg L -1 ), respectively. The method provided a percent recovery of 81% to 98%, with a coefficient of variation between 3% and 15%.

Purpose: The aim of the present study was to investigate the effects of acute caffeine supplementation on the performance during a session of resistance training alone (RT) or in combination with aerobic training (i.e. concurrent training; CT). Method: Fourteen resistance-trained men (23.1 ± 4.2 years) were recruited and performed both RT and CT under three different conditions: control (CONT), placebo (PLA), and caffeine (CAF; 6 mg.kg -1 ) for a total of six experimental conditions. Results: Both total and per set number of repetitions, and total volume load were lower during CT as compared to RT, irrespective of the supplementation condition (all p  < .001), whereas a supplementation main effect was observed for the total number of repetitions ( p  = .001), the number of repetitions in the first ( p  = .002) and second sets ( p  = .001), and total volume load ( p  = .001). RPE values were higher after the CT sessions than after the RT sessions ( p  < .001), whereas no differences were observed between supplementation conditions ( p  = .865). Conclusions: Caffeine supplementation was not sufficient to minimize the acute interference effect on strength performance in a CT session when compared to RT alone. In contrast, caffeine improved strength performance during the first set of both CT and RT, while maintaining a similar RPE between the supplementation conditions. However, the overall effect was small.

Background: Aging is a non-modifiable risk factor for neurodegenerative disease. It is well established that the brain undergoes physiological atrophy with age. So, this study was conducted to analyse the correlation between the age of the person and the size of the various subcortical nuclei of the brain and whether these measurements can serve as a useful indicator for physiological atrophy leading to degenerative disease in clinical practice., Methods: A total of 600 MRI scans from healthy individuals were examined and the measurements of subcortical nuclei were taken and subsequently analysed., Results: A statistically significant difference between the genders was observed in the sizes of the axial diameters of caudate nucleus, putamen and globus pallidus. Caudate nucleus transverse diameter showed a moderate negative correlation with age in males. Globus pallidus axial diameter with age showed weak positive correlation for males. Globus pallidus transverse diameter showed weak positive correlation with age for both males and females, but it was stronger for males compared to females., Conclusions: These results will help neurologists and neurosurgeons in analysing various early degenerative diseases and treat them accordingly., Competing Interests: No competing interests were disclosed., (Copyright: © 2024 Dhamija A et al.)

The cloud point extraction (Tergitol® surfactant) method was used for the first time to extract and preconcentrate the fungicide carbendazim (CBZ) from strawberry samples, while electrochemical detection (boron doped diamond electrode) in association with high performance liquid chromatography (HPLC-EC) was used for the determination of CBZ. The variables of bath temperature, ultrasonic stirring time, mass of NaCl and amount of surfactant were investigated using a 2 4 full factorial design. Limits of detection (LOD, S/N = 3) and quantification (LOQ) of 3.42 × 10 -8 mol/L (or 6.54 µg/L) and 6.84 × 10 -8 mol/L (or 13.1 µg/L), respectively, were obtained for the CPE processes, considering the value of the preconcentration factor obtained (9.12). The method was validated based on linearity, intra-day and inter-day recovery tests, accuracy and precision. The proposed method was applied to strawberry samples from local commercial establishments and different procedures for washing and sanitizing strawberry fruits were also evaluated., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

There are only a few studies that describe the larval development of Echinaster or aspects on culture systems for the genus. For starfishes, the choice of suitable substrates has received special attention since it could influence the acid-base balance of the water, movement capacity and predation rate. The objective of this study was to evaluate the ideal food-related substrate for the rearing of juvenile Echinaster brasiliensis. A batch of fertilized eggs released in spontaneous spawning was collected and kept in a plankton-kreisel until metamorphosis. Data on preference of food-related substrate was recorded for 10 weeks from day 58 post-release. From release to 132 days old, arm length increased from 0.81 mm to 1.31 ± 0.03 mm. Considering the sudden increase in arm length (AL), it was estimated that feeding started around 40 days of age. Regarding food-related substrate preferences, biofilm grown on "rocks" showed a significant difference among other treatments, adding up to 50% of preference (p < .05). For sponge and biofilm from bio media, there was no statistical difference for the whole period. In this study, sponges showed to be the least preferred food-related substrate for post-settlement juveniles. Considering that Echinaster and other starfish are commonly maintained on a diet of collected or cultured sponges, difficulties in sourcing a ready supply throughout the year represent limitations to their sole use within commercial or laboratory-scale production. In this sense, the use of biofilm from biological media for the feeding of juvenile starfish is not yet reported in the literature and showed to be an easy and promising option., (© 2023 Wiley Periodicals LLC.)

Background: Patients on chronic dialysis are at increased risk of developing disorders in potassium balance. The preservation of residual renal function (RRF), frequently observed in patients on peritoneal dialysis (PD), may contribute to better control of serum potassium. This study aimed to investigate the role residual renal function on potassium intake and excretion in PD patients., Methods: In this cross-sectional study, dietary potassium was evaluated by the 3-day food record. Potassium concentration was determined in serum, 24 h dialysate, stool ample, and 24 h urine of patients with diuresis > 200 mL/day, who were considered non-anuric., Results: Fifty-two patients, 50% men, 52.6 ± 14.0 years, and PD vintage 19.5 [7.0-44.2] months, were enrolled. Compared to the anuric group (n = 17, 33%), the non-anuric group (n = 35, 67%) had lower dialysate potassium excretion (24.8 ± 5.3 vs 30.9 ± 5.9 mEq/d; p = 0.001), higher total potassium intake (44.5 ± 16.7 vs 35.1 ± 8.1 mEq/d; p = 0.009) and potassium intake from fruit (6.2 [2.4-14.7] vs 2.9 [0.0-6.0]mEq/d; p = 0.018), and no difference in serum potassium (4.8 ± 0.6 vs 4.8 ± 0.9 mEq/L; p = 0.799) and fecal potassium (2.2 ± 0.5 vs 2.1 ± 0.7 mEq/L; p = 0.712). In non-anuric patients, potassium intake correlated directly with urinary potassium (r = 0.40; p = 0.017), but not with serum, dialysate, or fecal potassium. In the anuric group, potassium intake tended to correlate positively with serum potassium (r = 0.48; p = 0.051) and there was no correlation with dialysate or fecal potassium., Conclusion: The presence of residual renal function constitutes an important factor in the excretion of potassium, which may allow the adoption of a less-restrictive diet., (© 2023. The Author(s), under exclusive licence to Springer Nature B.V.)

Background: To date, there is no protocol providing dietary guidelines to assist health care professionals in counseling Brazilian individuals with Diabetes Mellitus (DM) assisted in primary health care (PHC) according to the Dietary Guidelines for the Brazilian Population (DGBP). Therefore, this study aimed to develop and validate a protocol based on the DGBP for health care, non-nutritionist professionals in counseling adults with DM in PHC., Methods: We systematized the recommendations published in the DGBP, the Diabetes Brazilian Society guidelines, and the scientific literature regarding food and nutrition needs of adults with DM. The clarity and relevance were validated by an expert panel ( n = 19) and the understanding and applicability were validated by PHC professionals ( n = 12). The degree of agreement of the experts was assessed using a Content Validity Index (CVI). Items receiving CVI > 0.8 were considered appropriate., Results: The protocol consisted of six dietary recommendations that encouraged the daily consumption of beans, vegetables, and fruits, advised the avoidance of sugar-sweetened beverages and ultra-processed foods, stimulated eating in appropriate environments, and gave additional guidance addressed to the particularities of DM. The protocol clarity, relevance, and applicability were successfully validated., Conclusion: The protocol supports health care, non-nutritionist professionals in the guidance of dietary recommendations and promoting adequate and healthy eating habits for adults with DM in PHC.

Purpose : The aim of this study was to analyze the acute effect of a treadmill high-intensity interval protocol on subsequent upper body and lower body strength exercise performance. Method : Sixteen young men had their maximal aerobic capacity and one-repetition maximum (1RM) determined and underwent four randomized conditions: a half-squat control session; a bench press control session; a treadmill interval protocol followed by a half-squat experimental session; and a treadmill interval protocol followed by a bench press experimental session. During the control sessions, four sets to failure for each exercise were performed at 80% of 1RM. In the experimental sessions, participants performed eight sprints of 40 s at 100% velocity of maximal oxygen uptake with 20 s of passive interval between them, followed by the same strength exercise protocol of the control sessions. The number of repetitions during each protocol and participants' heart rate (HR),and blood lactate concentration ([lac]) were compared pre and post protocols and exercises. Results : Fewer repetitions were completed in the experimental session compared to the control sessions ( p < .001). Moreover, the reduction in number of repetitions performed was more evident in half-squat compared to bench press ( p = .018). HR was higher at the end of sessions with the interval protocol for both exercises ( p < .001). The [lac] was higher at the end of session with the interval protocol for half-squat ( p = .003). Conclusions : These findings suggest that previous high-intensity interval running may impair subsequent strength exercise performance, but the magnitude of the negative effect is greater in the lower limbs.

Purpose : To compare the effects of 16 weeks of aerobic training (AT) to 8 weeks of AT followed by 8 weeks of combined training (CT), as well as to a control group (CG), on the functional, cognitive and hemodynamic responses of older women exercising in the aquatic environment. Materials and Methods : The study is a three-armed parallel randomized controlled clinical trial. For this, 52 older women were first randomized in an aerobic training (AT; n = 35) or control group (CG; n = 17). After 8 weeks of intervention, participants from AT group were again randomized into another 8-week period of either AT (n = 17) or combined training (CT; n = 18). AT was performed at the percentage of the heart rate corresponding to the anaerobic threshold, resistance training was performed with sets at maximal effort and the control group performed low-intensity therapeutic exercises in water. All outcomes were assessed before (week 0) and after the intervention (week 17). In addition, some outcomes were also investigated in the middle timepoint (week 9). Generalized Estimating Equations (GEE) and Bonferroni post-hoc tests (α = 0.05) were used to compare timepoints and groups. Results : All groups similarly improved functional capacity (3-11%) and blood pressure (-4 to -10%), whereas cognitive function was not modified for any group. Conclusion : Water-based training programs and therapeutic exercises (i.e., CG) improve functional capacity and blood pressure responses in older women. Clinical Trials NCT03892278.

Objectives: This study aimed to evaluate the impact of a nutritional behavioral intervention on intuitive eating (IE) scores of overweight non-dialysis-dependent women with chronic kidney disease and to investigate the relationship of IE scores with demographic, nutritional, and quality of life parameters in this group., Design and Methods: This is a prospective noncontrolled clinical trial of a behavioral multisession group intervention for dietary management. Each group comprised five to eight participants in 14 weekly or biweekly sessions lasting about 90 minutes each. The IE principles were discussed during the meetings. The IE scale 2, translated and adapted to the study population, with a four-factor model was applied to assess IE attitudes. The 36-Item Short-Form Health Survey questionnaire was applied to assess health-related quality of life., Results: Of the 33 patients who began participation in the study, 23 patients (median [interquartile range]: age = 62.0 years [58.0-68.0]; 52.2% with diabetes; body mass index = 32.6 kg/m 2 [30.2-39.3]; estimated glomerular filtration rate = 28.0 mL/min/1.73 m 2 [22.0-31.0]) completed the intervention. Except for the IE subscale Body-Food Choice Congruence, the IE total score and all its subscales (Unconditional Permission to Eat, Eating for Physical Rather than Emotional Reasons, Reliance on Hunger and Satiety Cues, and Body-Food Choice Congruence) improved after the intervention. In a cross-sectional analysis, more intuitive eaters were older and had better scores for health-related quality of life., Conclusions: The nutritional behavioral intervention embracing IE principles was effective to improve IE attitudes for this group of chronic kidney disease patients. These results are promising and may contribute to a paradigm change in the strategies to enhance motivation and adherence to dietary recommendations in this population., (Copyright © 2022 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.)

Background: To determine the effect of resistance training volume on physical and perceptual outcomes of breast cancer survivors submitted to a combined training program., Design: Randomized single-blinded study., Methods: Nineteen breast cancer survivor women were randomized to a single-set (SS) or a multiple-set (MS) group. Both groups completed an 8-week combined training intervention in which the SS and MS groups performed 1 and 3 sets per resistance exercise, respectively. The following outcomes were assessed preintervention and postintervention: maximal knee extension dynamic strength (1-repetition maximum), quadriceps muscle thickness, peak oxygen uptake, time to exhaustion, cancer-related fatigue, and quality of life., Results: Both interventions increased knee extension 1-repetition maximum (SS: 29.8% [37.5%]; MS: 19.3% [11.8%]), quadriceps muscle thickness (9.4% [4.1%]; 8.9% [5.9%]), and quality of life (4.3% [6.3%]; 7.9% [9.0%]), with no difference between the groups. However, only MS improved cancer-related fatigue (-2.1% [1.7%]) and time to exhaustion (21.3% [14.9%]), whereas peak oxygen uptake remained unchanged in both groups., Conclusions: Cancer-related fatigue and time to exhaustion, improved only in the MS group after the intervention. On the other hand, similar knee extension 1-repetition maximum, quadriceps muscle thickness, and quality of life improvements were observed in breast cancer survivors irrespective of the resistance training volume performed.

Background: Differences in patients gut microbiota composition with the potential for dysbiosis have been associated with chronic kidney disease (CKD). However, factors other than the disease itself, such as diet and cohabitation, have not been evaluated when gut microbiota of CKD patients was compared with that of healthy controls. The aim of this study was to compare the gut microbiota composition between patients on peritoneal dialysis (PD) and age-matched household contacts with normal renal function., Methods: Fecal samples were collected from 20 patients [men: 70%; age: 53.5 years (48.2-66; median and interquartile range); length on PD: 14 months (5.2-43.5) and 20 controls. The region V4 of the 16S ribosomal RNA gene was PCR-amplified and sequenced on Illumina MiSeq platform. Dietary intake and diet quality were assessed by a 3-day food record and a diet quality index, respectively., Results: No difference was found between the gut microbiota composition of patients and controls, assessed by alpha and beta diversities (p > 0.05) and genera differential abundance (p > 0.05). The most abundant phyla in both groups were Firmicutes (PD = 45%; Control: 47%; p = 0.65) and Bacteroidetes (PD = 41%; Control: 45%; p = 0.17). The phylum Proteobacteria, known as a potential marker of gut dysbiosis, was not different in proportions between groups (p > 0.05). No difference was observed regarding diet quality and dietary intake of fiber, protein and other nutrients (p > 0.05)., Conclusion: Gut microbiota of patients on PD did not differ from household contacts. This result suggests that cohabitation and dietary intake might have outweighed the disease influence on gut microbiota composition of our PD patients., (© 2022. The Author(s), under exclusive licence to Springer Nature Limited.)

The optic nerve is the second cranial nerve. It is supplied by the central retinal artery. It is said that this artery starts getting incorporated within the optic nerve at around the sixth week of gestation, and by the ninth week it is entirely inside the optic nerve. However, the point of incorporation lies in the intraorbital course of the optic nerve. The present study aimed at identifying the location of the central retinal artery inside the optic nerve, i.e. the peripheral or central position. Human fetuses of second and third trimester were dissected to expose the optic nerve. Morphometric measurements were taken and sectioned in 3 regions. These transverse sections were subjected to histological procedures. The results showed that the central retinal artery, at its entry into the optic nerve, was peripheral and inferior in 3 of 25 optic nerves and peripheral and lateral in the remaining optic nerves. However, the arteries were all centrally placed, close to the posterior pole of the eyeball. These findings are important for the ophthalmologist in identifying certain congenital anomalies of the eyeball in neonates.

Background: Physical properties of water cause physiological changes in the immersed human body compared with the land environment. Understanding the magnitude of cardiorespiratory alterations might ensure adequate intensity control during aquatic exercise programs., Objective: We aimed to compare the oxygen uptake (VO 2 ), heart rate (HR), and rating of perceived exertion (RPE) parameters during aquatic and land incremental tests., Methods: Four databases (PubMed, LILACS, EMBASE, and SPORTDiscus) were searched in September 2020. Eligibility criteria included studies in a crossover design comparing aquatic and land incremental tests for healthy individuals with at least one of the following parameters: VO 2 (maximal, VO 2max ; anaerobic threshold, VO 2AT ), HR (HR max ; HR AT ), and RPE (RPE max ; RPE AT ). The random-effects meta-analysis included mean difference and 95% confidence interval for VO 2 and HR or standardized mean difference for RPE. The Joanna Briggs Institute Critical Appraisal tool was adapted to assess methodological quality., Results: Twenty-eight studies were eligible and included in the meta-analysis. Aquatic protocols showed lower values compared with land for VO 2max (- 7.07 mL.kg -1 .min -1 ; - 8.43 to - 5.70; n = 502), VO 2AT (- 6.19 mL.kg -1 .min -1 ; - 7.66 to - 4.73; n = 145), HR max (- 11.71 bpm; - 13.84 to - 9.58; n = 503), and HR AT (- 15.29 bpm; - 19.05 to - 11.53; n = 145). RPE max (0.01; - 0.16 to 0.18; n = 299) and RPE AT (- 0.67; - 1.35 to 0.02; n = 55) values were similar between aquatic and land protocols., Conclusions: Our study reinforces the specificity of the environment during incremental tests for prescribing exercises based on physiological parameters as VO 2 and HR parameters presented lower values in aquatic protocols than land protocols. Conversely, RPE seems an interchangeable measure of exercise intensity, with similar values during the protocols in both environments. Substantial levels of heterogeneity were present for the VO 2max and HR max meta-analyses, and as such, results should be interpreted with attention. PROTOCOL REGISTRATION: This study was registered in the International Prospective Register of Systematic Reviews (PROSPERO; CRD42020212508)., (© 2022. The Author(s), under exclusive licence to Springer Nature Switzerland AG.)

Background: Although mat Pilates (MP) has become popular, the effects of MP in hypertensive women (HW) are not entirely clear. Here, we investigated the effects of 16 weeks of MP training contrasted with MP supplemented with aerobic exercise (MP+AE) and compared with a non-intervention group on autonomic modulation, cardiorespiratory fitness, strength, flexibility, performance of functional tasks, QOL, anthropometric variables, clinical BP, and heart rate., Methods: This is a three-arm, secondary analysis of an RCT. Sixty HW, aged 30 to 59 years, were allocated into: MP only (MP), MP+AE on a treadmill (MP+AE), and Control Group, without exercises. Assessments were performed before and after 16 weeks of training., Results: The ANOVA shows differences in between-group comparisons in the SDNN, rMSSD, and SD1 in the heart rate variability analysis, with increases in rMSSD, SDNN, and SD1 only in the MP, and this result was not found in the MP+AE group ( p < 0.05). Differences were observed in the between-group comparisons in time in the cardiorespiratory exercise test (CPX), flexibility, and the waist-to-hip ratio, with changes in the MP+AE, differences in QOL, and increments in the MP and MP+AE ( p < 0.05)., Conclusions: MP increased the indices that reflect vagal and global cardiac autonomic modulation. MP+AE improved the CPX performance, flexibility, QOL, and anthropometric variables. These results suggest that MP supplemented or not with AE has promising effects in HW.

Background: The risk factors for breast cancer (BC) among women in Brazilian populations are poorly understood. To date, few Brazilian studies have addressed the potential association between risk factors and molecular BC subtypes. This case-control study aimed to identify risk factors for BC in a population of Northeast Brazil., Methods: Data from 313 patients with invasive BC and 321 healthy controls were obtained from medical records from two cancer treatment centres and personal interviews. Of the 313 BC patients, 224 (71.6%) had reached menopause. The following distribution of subtypes was found among 301 patients: (1) Luminal A: 54 (17.9%); (2) Luminal B: 175 (58.1%); (3) HER2/neu: 29 (9.7%); and (4) triple-negative breast cancer (TNBC): 43 (14.3%). Odds ratios (ORs) and confidence intervals (CIs) were determined using regression analysis., Results: Regression modelling indicated that family history, obesity (≥ 30.0 kg/m 2 ), alcohol consumption and contraceptive use increased the overall risk of BC 1.78 (95% CI: 1.22-2.59), 1.69 (95% CI: 1.08-2.63), 2.21 (95% CI: 1.44-3.39) and 2.99 (95% CI: 2.09-4.28) times, respectively. After stratification for menopausal status, alcohol consumption increased the risk of BC 4.15 (95% CI: 2.13-8.11) times, and obesity, as a single variable, increased the risk of BC 2.02 (95% CI: 1.22-3.37) times, only among postmenopausal women. In a case-control analysis, the risk of TNBC and Luminal B breast cancer were 4.06 (95% CI: 1.58-10.42) and 1.87 times (95% CI: 1.13-3.11) higher, respectively, in obese women than in non-obese women. Furthermore, alcohol consumption increased the risk of Luminal A and B subtypes 7.08 (3.40-14.73) and 1.77 (1.07-2.92) times, respectively., Conclusion: Family history, contraceptive use, obesity and alcohol consumption increased the risk of BC. Obesity and alcohol consumption differentially increased risk of TNBC and Luminal molecular subtypes., (Copyright © 2022 Elsevier Ltd. All rights reserved.)

The present study aimed to investigate whether training status would influence the capacity of a verification phase (VER) to confirm maximal oxygen uptake (VO 2 max) of a previous graded exercise test (GXT) in individuals with hypertension. Twelve older adults with hypertension (8 women) were recruited. Using a within-subject design, participants performed a treadmill GXT to exhaustion followed by a multistage VER both before and after a 12-wkcombined exercise training programme. Individual VO 2 max, respiratory exchange ratio (RER), maximal heart rate (HR max ), and rating of perceived exertion (RPE) were measured during both GXT and VER tests. Absolute and relative VO 2 max values were higher in VER than in GXT at baseline, but only absolute VO 2 max differed between bouts post-intervention (all p < 0.05). Individual VO 2 max comparisons revealed that 75% of the participants (9/12) achieved a VO 2max value that was ≥3% during VER both before (range: +4.9% to +21%) and after the intervention (range: +3.4% to +18.8%), whereas 91.7% (11/12) of the tests would have been validated as a maximal effort if the classic criteria were employed. A 12-wk combined training intervention could not improve the capacity of older adults with hypertension to achieve VO 2 max during a GXT, as assessed by VER.

The aim of the present study was to compare the neuromuscular, morphological, and functional responses to a high-velocity resistance training (HVRT) program between three cohorts: middle-aged adults (40-55 years, n = 18), healthy older adults (> 60 years, n = 18), and mobility-limited older adults (n = 8). Participants were tested before and after a 4-week control period and then assigned to a 12-week HVRT intervention. Investigated outcomes included ultrasound-derived muscle thickness and quality, maximal dynamic strength (1RM), maximal voluntary isometric contraction (MVIC), and muscle activation (sEMG), as well as muscle power and functional performance. After the intervention, quadriceps muscle thickness, 1RM, and sEMG improved in all three groups (all p < 0.05), whereas muscle quality improved only in middle-aged and older participants (p ≤ 0.001), and MVIC only in middle-aged and mobility-limited older adults (p < 0.05). With a few exceptions, peak power improved in all groups from 30-90% 1RM (p < 0.05) both when tested relative to pre-training or post-training 1RM workloads (all p < 0.05). Both mobility-limited older adults and older adults improved their short physical performance battery score (p < 0.05). Chair stand, stair climb, maximal gait speed, and timed up-and-go performance, on the other hand, improved in all three groups (p < 0.05), but no change was observed for habitual gait speed and 6-min walk test performance. Overall, our results demonstrate that a HVRT intervention can build a stronger foundation in middle-aged individuals so that they can better deal with age-related impairments at the same time that it can mitigate already present physiological and functional impairments in older adults with and without mobility-limitation., (© 2022. The Author(s), under exclusive licence to American Aging Association.)

Background: Quality of life (QoL) is an important health index for older adults., Aim: The aim of this study was to compare the effects of 16 weeks of aerobic training to 8 weeks of aerobic followed by 8 weeks of combined (i.e., resistance and aerobic exercises) training, as well as to a control group on the QoL of older women exercising in the aquatic environment., Methods: 52 older women were first randomized to either aerobic training (n = 35) or a control group (n = 17). After 8 weeks of intervention, participants initially assigned to the aerobic training group were again randomized to either 8 additional weeks of aerobic (n = 17) or combined training (n = 18). Aerobic training was performed at the heart rate percentage associated with the anaerobic threshold, while resistance training sets were performed at maximal effort. The control group performed low-intensity water-based therapeutic exercises. QoL was assessed before (week 0) and after the intervention (week 17) using the WHOQOL-BREEF and WHOQOL-OLD questionnaires. Generalized Estimating Equations (GEE) and Bonferroni post hoc tests (α = 0.05) were used to compare time points and groups., Results: QoL improved significantly only in the training groups after the 16-week training intervention, whereas it remained unchanged in the control group. In addition, autonomy, environment, and present, past and future activities domains were more impacted after combined training., Conclusion: QoL improved only in the water-based training groups, and the addition of resistance exercises to the training program resulted in additional benefits to autonomy, environment, and past, present, and future activities domains., Trial Registration: Clinical Trials NCT03892278., (© 2021. The Author(s), under exclusive licence to Springer Nature Switzerland AG.)

Background: The aim of the present study was to investigate the muscular and cardiorespiratory adaptations of two water-based training programs in older women., Methods: Volunteers were divided between a water-based aerobic training (WBA; N.=13), water-based combined training (WBC; N.=11) or an active control group (CG; N.=9) and those assigned to WBA and WBC exercised twice a week for 12 weeks. All outcomes of interest were assessed prior and after the intervention. The data were analyzed using Generalized Estimating Equations (GEE), and Bonferroni post-hoc test (α=0.05). Aerobic training was performed at the percentage of the heart rate corresponding to the anaerobic threshold and resistance training during WBC was performed with sets at maximal effort., Results: Improvements were observed for the maximal knee extension dynamic strength (1RM) and oxygen uptake (VO2) corresponding to the second ventilatory threshold for both WBA and WBC (1RM: 16±12% vs. 15±16%; VO2: 20±24% vs. 23±13%, respectively), whereas VO2 peak improved in all three groups (WBA: 23±21%; WBC: 18±9%; CG: 7±16%). No increase was found for horizontal chest press 1RM (P>0.05)., Conclusions: These results suggest that WBA, WBC and CG are effective to improve cardiorespiratory fitness, however, only water-based training programs (WBA and WBC) appear capable of improving the maximal strength of the lower limbs.

Abstract: Alberton, CL, Andrade, LS, Pinheiro, RB, and Pinto, SS. Anaerobic threshold in a water-based exercise: agreement between heart rate deflection point and lactate threshold methods. J Strength Cond Res 35(9): 2472-2478, 2021-The purpose of this study was to compare and assess the agreement of the heart rate (HR) and rating of perceived exertion (RPE) corresponding to the anaerobic threshold (AT) between HR deflection point (HRDP) and lactate threshold (LT) methods during a water-based exercise in young men. Sixteen young men (24 ± 6 years) performed the experimental protocol, which comprised the performance of a maximal incremental test during the water-based stationary running exercise. The initial cadence corresponded to 90 b·min-1, with 10 b·min-1 increases every 3 minutes up to exhaustion. Heart rate was monitored every 30 seconds while blood lactate concentrations and RPE were measured at the end of each 3-minute bout. Anaerobic threshold was identified by HRDP and LT methods by experienced physiologists. Paired Student's t-test, Bland-Altman analysis, and Pearson correlation were used for data analysis (α = 0.05). As results, there was agreement between HRDP and LT methods for HR, while RPE presented significant higher values for the HRDP method, resulting in an absence of acceptable agreement between methods. In addition, strong relationships (p ≤ 0.001) were verified between methods of AT determination for HR (r = 0.786) and RPE (r = 0.916). Therefore, based on the agreement between HRDP and LT methods, the HR determined by HRDP may be a valid parameter used for the intensity prescription of water-based stationary running exercise in young men during water aerobics programs and may be considered more reliable than RPE., (Copyright © 2019 National Strength and Conditioning Association.)

Purpose: The present cross-sectional study aimed to investigate whether a maximal oxygen uptake (V˙O2max) verification phase (VER) could improve the accuracy of a previous graded exercise test (GXT) to assess individual V˙O2max in hypertensive individuals., Methods: Thirty-three older adults with hypertension (24 women) taking part in the Hypertension Approaches in the Elderly Study (NCT03264443) were recruited. Briefly, after performing a treadmill GXT to exhaustion, participants rested for 10 min and underwent a multistage VER to confirm GXT results. Individual V˙O2max, RER, maximal heart rate (HRmax), and RPE were measured during both GXT and VER tests. Mean values were compared between bouts using paired sample t-tests, and V˙O2max was also compared between GXT and VER on an individual basis., Results: Testing was well tolerated by all participants. Both absolute (P = 0.011) and relative (P = 0.014) V˙O2max values were higher in VER than that in GXT. RER (P < 0.001) and RPE (P = 0.002) were lower in VER, whereas HRmax (P = 0.286) was not different between the two trials. Individual V˙O2max comparisons revealed that 54.6% of the participants (18/33) achieved a V˙O2max value that was ≥3% during VER (mean = 13.5%, range = +3% to +22.1%, ES = 0.062), whereas 87.9% (29/33) of the tests would have been validated as a maximal effort if the classic criteria were used (i.e., V̇O2 plateau or at least two secondary criteria)., Conclusion: In sedentary older individuals with hypertension, GXT to exhaustion underestimated V˙O2max in more than half of tested participants, even when established, but criticized criteria were used to confirm whether a maximal effort was attained. Using VER after GXT is a quick approach to assist with the verification of an individual's V˙O2max., (Copyright © 2021 by the American College of Sports Medicine.)

Background: This study compared the effect of treadmill running on subsequent upper limb exercise performance in young men., Methods: Seventeen young men (24.8±5.2 years) completed a: 1) bench press resistance exercise control session; 2) treadmill interval running protocol followed by the bench press session; and 3) treadmill continuous running protocol followed by the bench press session. Four sets of the bench press exercise were performed at 80% of 1RM up to volitional failure. In the interval protocol, eight sprints of 40s at 100% of the velocity of maximal oxygen uptake, with 20s of passive interval between them were performed, whereas in the continuous protocol 30-min of treadmill running at 90% of the heart rate corresponding to second ventilatory threshold was performed. The number of maximal repetitions completed in each set and condition was recorded and compared using a two-way repeated measures ANOVA., Results: The interval protocol (18.7±4.9 repetitions) resulted in a reduction in the number of bench press repetitions compared to the control protocol (21.4±5.4 repetitions) (P=0.002); whereas continuous running did not affect the bench press performance (20.6±4.4 repetitions). The total number of repetitions reduced from set to set in all protocols (P<0.001)., Conclusions: The results evidenced an impairment in the upper limb strength performance after high intensity interval, but not moderate intensity continuous running, which has implication for concurrent training planning and prescription.

Background: The diagnosis of breast cancer requires a complicated series of diagnostic exams. The present study addressed the delay of patients who used publicly and privately financed diagnostic services. Non-governmental organizations (NGOs) donated diagnostic mammograms and biopsies., Design and Methods: Data from 304 patients were obtained from two Brazilian referral centres. In one referral centre (FAP), diagnostic mammography, clinic-histopathological exam and immunohistochemistry were outsourced, whereas in the other centre (HNL), these services were integrated. Cox regression, Kaplan-Meier analysis and non-parametric tests were used to compare variables and time intervals., Results: If diagnostic mammography was financed privately and covered by private health insurance, the likelihood of a delay of >90 days between the first medical visit and the initiation of treatment decreased 2.15-fold (95%CI: 1.06- 4.36; p=0.033) and 4.44-fold (95%CI: 1.58-12.46; p=0.004), respectively. If the clinic-histopathological exam was outsourced (FAP) and publicly or privately financed, the median time between diagnostic mammography and the diagnostic result was 53 and 65 days in the integrated (HNL) and outsourced public system, compared to 29 days in the outsourced private system (p<0.050). The median time between the first medical visit and the diagnostic results of patients who were supported by NGOs, who financed their diagnostic services privately, and who used exclusively public diagnostic services was, respectively, 28.0, 48.5 and 77.5 days (p<0.050)., Conclusion: Patients who used privately financed health services had shorter delays. Compared to outsourcing, the integration of the publicly financed clinic- histopathological exam diminished the delay. The support of patients by NGOs accelerated patient flow.

In chronic kidney disease (CKD), the accumulation of gut-derived metabolites, such as indoxyl sulfate (IS), p-cresyl sulfate (pCS), and indole 3-acetic acid (IAA), has been associated with the burden of the disease. In this context, prebiotics emerge as a strategy to mitigate the accumulation of such compounds, by modulating the gut microbiota and production of their metabolites. The aim of this study was to evaluate the effect of unripe banana flour (UBF-48% resistant starch, a prebiotic) on serum concentrations of IS, pCS, and IAA in individuals undergoing peritoneal dialysis (PD). A randomized, double-blind, placebo-controlled, crossover trial was conducted. Forty-three individuals on PD were randomized to sequential treatment with UBF (21 g/day) and placebo (waxy corn starch-12 g/day) for 4 weeks, or vice versa (4-week washout). The primary outcomes were total and free serum levels of IS, pCS, and IAA. Secondary outcomes were 24 h urine excretion and dialysis removal of IS, pCS, and IAA, serum inflammatory markers [high-sensitivity C-reactive protein (hsCRP), interleukin-6 (IL-6), interleukin-10 (IL-10), and tumor necrosis factor-α (TNF-α)], serum lipopolysaccharide LPS, and dietary intake. Of the 43 individuals randomized, 26 completed the follow-up (age = 55 ± 12 years; 53.8% men). UBF did not promote changes in serum levels of IS ( p = 0.70), pCS ( p = 0.70), and IAA ( p = 0.74). Total serum IS reduction was observed in a subgroup of participants ( n = 11; placebo: median 79.5 μmol/L (31-142) versus UBF: 62.5 μmol/L (31-133), p = 0.009) who had a daily UBF intake closer to that proposed in the study. No changes were observed in other secondary outcomes. UBF did not promote changes in serum levels of IS or pCS and IAA; a decrease in IS was only found in the subgroup of participants who were able to take 21g/day of the UBF.

Introduction: In the dysfunction of large muscles of the leg, tendon transfer surgery is found to be very helpful in restoring the normal function of these muscles. The tendons involved in the chiasma plantare play a major role in this regard., Objective: The present cadaveric study has been carried out in cadavers presenting pes cavus., Material and Methods: Cadaveric feet presenting pes cavus were identified based on their foot prints. All these tendons and their interconnections were subjected to histological procedures. The sections of the tendons were stained with hematoxylin and eosin in order to identify the underlying pathologies in the tendons., Results: Various types of tendinous interconnections between the tendons of flexor digitorum longus and flexor hallucis longus were noted. The histological findings showed infiltration of lymphocytes in the tendon sheath indicating tenosynovitis and tendinitis. This could be attributed to the compression of the tendons. A few tendons were also stretched due to the skeletal framework of the foot in pes cavus. The bones along the medial longitudinal arch in pes cavus feet could tend to develop spurs or elongated tuberosity that could impinge on the tendons causing the tendons to stretch and elongate., Conclusion: In harvesting the tendons for grafting, the surgeons must be aware about the pathologies involved, such as tendinitis or tenosynovitis, in order to reduce the time taken for the healing of the graft post-surgery. These variations and histological findings can sub-serve as an efficient guide for the restoration of non-functioning muscles of the lower limb., (Copyright © 2021 Elsevier Masson SAS. All rights reserved.)

A procedure for electroanalytical determination of the fungicide TBZ extracted and preconcentrated from tomatoes by the cloud-point extraction (CPE) technique was developed and validated in this work. The analytical technique used for this determination was HPLC coupled to an electrochemical detector (HPLC/EC), with a BDD electrode. The main variables of the CPE process were evaluated using a 24 full factorial design. The optimal condition of CPE was achieved by using Tergitol (19% v/v), NaCl (0.83 g), ultrasonic stirring time of 15 min and a temperature of 36 °C. Under these conditions, the preconcentration factor obtained was 5.7. The limits of detection (LOD) and quantification (LOQ) were 2.7 × 10-8 mol L-1 (or 5.4 μg L-1) and 5.5 × 10-8 mol L-1 (or 11 μg L-1), respectively. The average recovery values varied from 80.7% to 115.1% and the precision (average of 3 days) was less than 15%, indicating the good accuracy and precision of the method developed here. Upon applying the method to examine commercial tomatoes, TBZ was detected in one of the three analyzed samples.

Different parameters can be used to control the intensity of aerobic exercises, a choice that should consider the population and exercise environment targeted. Therefore, our study aimed to verify the relationship between oxygen uptake (VO 2 ), heart rate (HR), rating of perceived exertion (RPE), and cadence during an aquatic incremental test in older women. Nine older women (64.3 ± 4.4 years) engaged in a water-based aerobic training performed an aquatic incremental test using the stationary running exercise (cadence increases of 15 b·min -1 every 2 min) until participants' volitional exhaustion. VO 2 , HR, and RPE data were measured, and the percentage of peak VO 2 (%VO 2peak ) and percentage of maximal HR (%HR max ) were calculated. Linear and polynomial regression analyses were performed (α = 0.05). Polynomial regressions revealed the best adjustments for all analyses. Data showed a significant relationship ( p < 0.001) between %VO 2peak and %HR max ( r = 0.921), %VO 2peak and RPE ( r = 0.870), and %HR max and RPE ( r = 0.878). Likewise, significant relationships between cadence ( p < 0.001) and %VO 2peak ( r = 0.873), %HR max ( r = 0.874), and RPE ( r = 0.910) were also observed. In summary, the physiological, subjective, and mechanical variables investigated were highly associated during an aquatic incremental test to exhaustion in older women. Therefore, these different parameters can be employed to adequately prescribe water-based programs according to preference and availability.

Background: Gut-derived uremic toxins have been associated with adverse outcomes in chronic kidney disease (CKD). Alterations in bowel habits, including constipation, seem to play an additional role in uremic toxicity. The aim of this study is to investigate the association of bowel habits with gut-derived uremic toxins and intestinal permeability in patients on automated peritoneal dialysis (APD)., Methods: This cross-sectional study enrolled 58 APD patients (age 52.5 ± 15.1 years; dialysis vintage 14.1 (6.0-36.5) months). Constipation was defined according to the Rome IV criteria. Bowel habits were assessed by the Bristol Stool Scale (BSS < 3 characterized by hard consistency of stools and/or low frequency of evacuation, a surrogate of slow intestinal transit time, and BSS ≥ 3, defining regular bowel habit). The total and free serum concentration of p-cresyl sulfate (PCS), indoxyl sulfate (IS) and indole-3-acetic acid (IAA) were dosed by high-performance liquid chromatography. Lipopolysaccharide (LPS) and zonulin were assessed by ELISA and D(-)-lactate by colorimetric method. Dietary intake was assessed by the 3-day food records., Results: No differences were observed in clinical, demographic, and dietary characteristics between constipated (n = 30) and non-constipated (n = 28) groups. A trend for higher total PCS (p = 0.07) and free PCS (p = 0.06) was found in constipated patients. Patients with BSS < 3 (n = 11) exhibited significantly higher levels of total and free PCS (p < 0.01) and total IAA (p = 0.04). Conversely, No difference was found in IS levels. Except for a lower serum level of D(-)-lactate in patients with BSS < 3 (p = 0.01), zonulin and LPS levels were not different., Conclusions: Disturbed bowel habits, mainly characterized by slow transit time, may play a role in the accumulation of uremic toxins, particularly PCS, in patients on automatized peritoneal dialysis.

Background: The purpose of this study was to investigate the effects of 2 water-based aerobic training programs on functional capacity and quality of life (QoL) of older women., Design: Randomized clinical trial., Methods: A total of 41 women (64.3 [3.1] y) were randomized into a continuous (CTG) and an interval (ITG) water-based aerobic training group. Training programs were performed with exercise intensity based on rating of perceived exertion throughout 12 weeks (twice a week). Functional tests with and without dual-task and QoL questionnaire were applied pretraining and posttraining. Per protocol and intention to treat analysis were conducted using generalized estimating equations, with Bonferroni post hoc test (α = .05)., Results: The per protocol analysis showed an increase in the 30-second chair stand (6% [12%] vs 18% [13%]), 6-minute walk (4% [7%] vs 2% [8%]), and 5-m habitual gait velocity (6% [11%] vs 4% [7%]) tests after CTG and ITG training groups. In addition, the intention to treat analysis revealed an increase in the 30-second chair stand test (7% [13%] vs 12% [13%]) and physical domain of QoL (8% [26%] vs 14% [22%]) after CTG and ITG training groups, as well as an increase in the gait velocity with verbal task after CTG (6% [11%])., Conclusions: Both water-based aerobic training programs induced similar improvements in the functional capacity and maintained the QoL perception in older women.

Objective: to analyze the process of professional identity construction in undergraduate nursing students during their education., Method: qualitative research, anchored in the Historical-Cultural framework. Twenty-three undergraduate nursing students took part. Data were collected through individual interviews, with a semi-structured script. Thematic Analysis was used to analyze the data., Results: the following four themes were obtained, "The subject in movement to become a nurse: from previous experiences to entering the courses"; "The nursing professor in the construction of the undergraduate's professional identity: a two-way mirror"; "Pedagogical relationship: instrument for constructing the student's professional identity" and "Historical-cultural conditions: space for the construction of the student's professional identity"., Conclusion: the construction of the students' professional identity is limited to the material conditions of existence, translating appropriation to the intrapsychic scope of elements that occur, first, in the inter-psychological space of interactions. Nursing professors can become a paradoxical mirror, with one face to be imitated and the other, which materializes meanings of a model not to be followed. This construction is also influenced by the conditions of professional practice and university education.

Background: Down Syndrome (DS) is a genetic condition presenting delay in acquisition of main motor milestones, such as walking. Although studies have been investigating the biomechanical parameters during land walking performed by individual with DS, the literature is scarce regarding kinetic parameters analysis in this population, specially during water walking., Research Question: This study sought to assess the vertical ground reaction force (Fz) of walking performed in water and on land at different speeds by individuals with DS., Methods: Fourteen adults with DS (age: 27.9 ± 7.9 years; body mass: 58.4 ± 12.9 kg; height: 1.4 ± 0.1 m, body mass index: 29.2 ± 5.4 kg.m -2 ) completed two sessions of data collection, one on land and another in aquatic environment. The protocol consisted of walking performed at three self-selected speeds (slow, comfortable and fast) in randomized order. The Fz was assessed with a waterproof force plate in each condition. Two-way repeated-measures ANOVA (environment and speed), with Bonferroni's post hoc tests, were used for analysis. A significance level was set as α = 0.05., Results: Significant differences were observed between environments (p < 0.001), with reduced first peak of Fz (68-73%), second peak of Fz (66-70%), loading rate (75-78%) and impulse (40-41%) in the water walking for all speeds analyzed. In the aquatic environment, no significant difference was observed for the first and second Fz peaks with the increasing speed of walking. Moreover, the loading rate significantly increased (p = 0.019) as the impulse significantly reduced (p < 0.001) in the higher speeds., Significance: Individuals with DS present reduced Fz outcomes during water walking in comparison to land. Therefore, water walking may be performed by individuals with DS with safe vertical loads on lower limbs regardless the self-selected speed for rehabilitation, correction of gait and training purposes., (Copyright © 2020 Elsevier B.V. All rights reserved.)

The purpose of this study was to investigate the effects of two water-based aerobic programs on cardiorespiratory and neuromuscular outcomes in older women. Forty-one women (60 to 75 years old) volunteered to participate in the study. Participants were randomized into a water-based continuous (CTG; n = 21; 63.9 ± 2.5 years) or an interval (ITG; n = 20; 64.8 ± 3.6 years) aerobic training group. Both training programs were performed for 12 weeks (45-min sessions twice a week), with exercise intensity based on rating of perceived exertion (Borg's RPE 6-20 Scale). Pre and post training assessments of cardiorespiratory and neuromuscular outcomes were performed. Data analyses were conducted using Generalized Estimating Equations and Bonferroni post-hoc test (α = 0.05). After the intervention, the CTG and the ITG displayed similar improvements in time to exhaustion (8% vs. 11%), peak oxygen uptake (9% vs. 7%), maximal dynamic knee extension strength (5% vs. 6%), dynamic muscular endurance of knee extensors (10% vs. 11%), maximal vastus lateralis electromyographic signal amplitude (13% vs. 35%), as well as an increase in muscle thickness (5% vs. 6%) and decrease in muscle echo intensity (-2% vs. -3%) of the quadriceps femoris. In conclusion, older women benefited from water-based exercise training prescribed based on participants' RPE, with both the interval and the continuous training programs resulting in similar increases in the cardiorespiratory and neuromuscular parameters., (Copyright © 2020 Elsevier Inc. All rights reserved.)

Background: System delay (SD) is a leading cause of advanced stage of disease and poor prognosis among Brazilian breast cancer patients., Methods: Cox regression and Kaplan-Meier analysis were used to identify variables that contributed to SD among 128 breast cancer patients. Time intervals between first medical consultation and treatment initiation were compared among patients of two referral centres: Patients of a referral centre with outsourced (FAP), respectively, integrated (HNL) diagnostic services., Results: Women who used a specialized private clinic at the beginning of patient flow had an 2.32 fold increased chance (95% CI: 1.17 - 4.60; p = 0.016) of hospital admission within 90 days after first medical consultation, compared to women who used a public health care provider (HCP). Of 73 and 34 patients of the FAP hospital and the HNL, respectively, 10 (13.7%) and 11 (32.5%) used one HCP prior to hospital admission (p = 0.000). The median time between first medical consultation and treatment initiation was 150 days. The median time between first medical consultation and hospital admission was 136.0 and 52.0 days for patients of the FAP hospital, respectively the HNL (p < 0.050). The median time between first medical consultation and diagnostic mammography was 36.5 and 23.0 days for patients from the FAP hospital and the HNL (p < 0.050)., Conclusions: Usage of public diagnostic services was associated with increased SD, whereas the usage of private diagnostic services diminished it. The usage of a lower number of HCPs accelerated patient flow.