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Glaube R Riegel,1 Giulia B Martins,1 Afonso G Schmidt,1 Marcela P Rodrigues,1 Gerson S Nunes,2 Vicente Correa Jr,1,2 Sandra C Fuchs,1 Flavio D Fuchs,1,2 Paula AB Ribeiro,1,3 Leila B Moreira1,4 1Postgraduate Studies Program in Cardiology, School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil; 2Cardiology Division, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil; 3Cardiology Division, University of Montreal Hospital Research Centre (CRCHUM), Montréal, QC, Canada; 4Pharmacology Department, Instituto de Ciências Básicas da Saúde (ICBS), Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil Background: Physical activity (PA) is recommended as adjuvant therapy to control blood pressure (BP). The effectiveness of simple recommendations is not clear. We aimed to assess the agreement between self-report of adherence to PA in clinical routine and International Physical Activity Questionnaire (IPAQ) interview and its association with BP control. Methods: A cross-sectional study was conducted with hypertensive outpatients. Adherence to recommendation to PA was assessed by the physician and IPAQ interview. A cutoff of 150 minutes/week was used to classify active or nonactive patients. High sitting time was considered >4 hours/day. A total of 127 individuals (SBP 144.9±24.4 mmHg/DBP 82.0±12.8 mmHg) were included. Results: A total of 69 subjects (54.3%) reported to be active to their physician, whereas 81 (63.8%) were classified as active by IPAQ (6.3% active in leisure time PA). Kappa test was 0.22 (95% CI, 0.06–0.37). The rate of BP control was 45.7%. There was no association with the reported PA assessed by both methods nor with sitting time. Our results demonstrated poor agreement between self-report adherence and IPAQ interview, and neither evaluation was associated with BP control. Conclusion: Our findings underpin evidences that a simple PA recommendation has low association with BP control in clinical settings. Keywords: blood pressure, exercise, treatment adherence, self-report, hypertension, physical activity counseling

Background: The cranio-cervical flexion test (CCFT) is used in clinical practice to measure the activation of deep cervical flexor muscles. However, the reliability of the test has not been conducted on an adequate sample size, specifically in individuals with non-specific chronic neck pain (CNP)., Objective: The aim of the present study is to investigate the intra- and inter-rater reliability, standard error of measurement (SEM), and minimal detectable change (MDC) of the CCFT in individuals with non-specific CNP., Methods: A cross-sectional study of reliability conducted at the UFSCar. Fifty-one individuals (17 men and 31 women) with non-specific CNP and aged over 18 years participated in this study. The CCFT was assessed with the Stabilizer pressure biofeedback device. Two raters conducted the test over two days, with a 5-7-days interval and a 10-min rest between raters. The activation score was determined by the level at which the participant kept activation for 10 s in a single stage (22, 24, 26, 28 and 30 mmHg). Appropriate statistical analysis was performed to calculate the intraclass correlation coefficient (ICC), SEM and MDC., Results: Both intra-rater (ICC = 0.65; 95% CI = 0.46-0.78) and inter-rater reliability (ICC = 0.72; 95% CI = 0.55-0.83) were considered moderate. The SEM was 1.73 and 1.66 for intra-rater and inter-rater reliability, and the MDC was 4.81 to 4.60, respectively., Conclusion: The results of the present study indicate that CCFT is a reliable test to evaluate the activation score in individuals with chronic neck pain., Competing Interests: Conflicts of interest All authors declare that they have no competing interests., (Copyright © 2025 Elsevier Ltd. All rights reserved.)

The mini-pterional craniotomy (mPT) was designed to be a minimally invasive alternative to the standard pterional (PT) approach. However, it remains unclear which technique produces better results. Thus, we aimed to perform a meta-analysis comparing functional, surgical, and aesthetic outcomes between mPT and PT in intracranial aneurysms. We searched PubMed, EMBASE, Web of Science, and Cochrane Library for studies comparing mPT to PT in patients who underwent clipping of brain aneurysms until June 2024. Outcomes were modified Rankin Scale (mRS) or Glasgow Outcome Scale (GOS), surgical complications, operation time, length of stay, and patients' aesthetic satisfaction. Statistical analysis was performed using the R software (version 4.4.0). Heterogeneity was assessed with I 2 statistics. We included 6 studies with a total of 1011 patients, of whom 696 (63.1%) underwent mPT. The mean age was 59.0 ± 2.8 years, 67.6% were female, and 68.2% of all aneurysms were located in the middle cerebral artery. Unfavorable functional outcome (mRS ≥ 3 or GOS ≤ 3) at discharge (OR 0.21, 95% CI: 0.07-0.59; I 2  = 0%), overall surgical complications (OR 0.45, 95% CI: 0.21-0.99; I 2  = 72%), and operation time (MD - 54.42 min, 95% CI: -60.78 to - 48.06; I 2  = 0%) were significantly lower in mPT compared to PT. Moreover, patients' aesthetic satisfaction was statistically higher in mPT (OR 2.91, 95% CI: 1.06-8.00; I 2  = 0%). However, there was no significant difference in length of stay between groups (MD - 1.52 days, 95% CI: -3.75 to 0.72; I 2  = 72%). Mini-pterional craniotomy is associated with better functional outcomes at discharge, fewer surgical complications, and a shorter operation time. Therefore, our results might suggest that mPT is a promising and preferable alternative to standard PT., Competing Interests: Declarations. Ethics approval and consent: As this study involved the analysis of secondary data obtained from previously published studies, formal ethics approval was not required. Additionally, since this meta-analysis utilized aggregated data, consent to participate from individual participants and consent for publication were not applicable. Competing interests: The authors declare no competing interests., (© 2025. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Context: Tendon abnormalities on imaging are commonly observed in individuals with Achilles tendinopathy. Those abnormalities can also be present in asymptomatic individuals, which is an important risk factor for developing tendon symptoms. Ballet dancers are particularly vulnerable due to the high loads placed on their Achilles tendons. Understanding the relationship between clinical measures and tendon abnormality is essential for this population., Objective: To investigate the predictive value of clinical measures for identifying Achilles tendon abnormality in asymptomatic ballet dancers using a non-linear statistical analysis., Design: Cross-sectional study., Setting: Dance company facility and research laboratory., Patients: Thirty-five asymptomatic professional and amateur ballet dancers enrolled (23 female/12 male)., Main Outcome Measures: Presence of Achilles tendon abnormality were investigated using grey-scale ultrasound. Tendons were classified as having abnormality if presenting fusiform shape and/or hypoechoic areas. Clinical measures assessed were foot pronation, ankle dorsiflexion angle, hip, knee, and ankle isometric torque, and standing calf endurance. CART analysis was used to explore nonlinear interactions among clinical measures and their role in identifying tendon abnormality., Results: 68 tendons were included in analysis. Structural change was common in asymptomatic dancers, with 80% presenting tendon abnormality. Hip isometric torque, ankle dorsiflexion range of motion, and calf endurance were measures related to tendon abnormality. Interactions between hip torque and ankle dorsiflexion range of motion were statistically associated with presence of tendon abnormality. Increased hip abductor torque was linked to a 59% reduction in the probability of tendon abnormality. 26 The CART model reached proper accuracy (total classification percentage of 83.8%)., Conclusions: Hip torque was an important clinical measure related to tendon structure. Assessment of dancers should include the whole lower limb as combination of hip torque and ankle dorsiflexion range of motion accurately identified presence of tendon abnormality.

Exercise therapy is the most common approach for people with chronic neck pain (CNP). Although well-established, it remains unknown which type of exercise is the best for treating this condition. Moreover, pain processing can play a role in the persistence of pain and in the response to interventions. Thus, the aim of this randomized controlled trial is to compare the acute and long-term effects of two exercise protocols (specific and non-specific) on pain and pain processing in individuals with CNP. One hundred and ten participants aged between 18 and 65 years who have had non-specific neck pain for more than 3 months will be recruited. They will be randomized and allocated into two groups (specific exercises and non-specific exercises) and both groups will perform an exercise programme twice a week for 8 weeks. Both programmes are divided into two progressive and individualized phases. The primary outcomes are change in pain intensity after 8 weeks of exercise and exercise-induced hypoalgesia, and secondary outcomes are pressure pain threshold, temporal summation of pain, conditioned pain modulation, the Neck Disability Index, the Baecke Physical Activity Questionnaire, and the Global Perception of Change Scale. Outcomes will be assessed at baseline, after 8 weeks of intervention, and at 6-month follow-up., (© 2024 The Author(s). Experimental Physiology published by John Wiley & Sons Ltd on behalf of The Physiological Society.)

Background and Purpose: The integration of evidence-based practice (EBP) into clinical decision-making is crucial for ensuring optimal patient care. However, there are various factors influencing the utilization of academic sources among physiotherapists, highlighting the need for a deeper understanding of these dynamics. The present study aimed to investigate the association between personal factors (age, time since graduation, number of patients, and education level), barriers to EBP implementation and perceptions about EBP, and physiotherapists' preference for using non-academic sources when seeking technical information about physiotherapy., Methods: This was a cross-sectional study involving 610 physiotherapists. Participants completed an online questionnaire covering demographic characteristics, sources of information, barriers to EBP implementation, and perceptions regarding the importance of scientific information in clinical practice. Logistic regression was used to investigate the factors associated with the preference for non-academic sources of information., Results: Nearly a quarter of the sample exhibited a preference for non-academic sources, with age over 34 years, perceived lack of abilities to apply scientific findings, and understanding issues related to EBP being significant associated with the preference of this types of sources of information. Physiotherapists with these characteristics were twice as likely to prefer non-academic sources when compared to physiotherapists who do not have these characteristics., Discussion: These findings underscore the importance of enhancing professional competencies in EBP and fostering confidence in utilizing academic sources. While efforts have been made to incorporate EBP promotion in academic curricula, further initiatives are needed to bridge the gap between established knowledge and the competencies required for daily practice. Future studies should continue to explore the role of age in EBP applicability and the adoption of scientific knowledge, aiming to inform targeted interventions and educational programs tailored to the evolving needs of physiotherapy professionals., (© 2024 John Wiley & Sons Ltd.)

Background and Objectives: Chronic subdural hematoma (CSDH) management involves various surgical techniques, with drainage systems playing a pivotal role. While passive drainage (PD) and active drainage (AD) are both used, their efficacy remains contentious. Some studies favor PD for lower recurrence rates, while others suggest AD superiority. A systematic review and meta-analysis were conducted to address this controversy, aiming to provide clarity on optimal drainage modalities post-CSDH evacuation., Methods: This systematic review and meta-analysis followed preferred reporting items for systematic reviews guidelines, searching PubMed, Embase, and Web of Science until February 2024. Inclusion criteria focused on studies comparing active vs PD for subdural hematomas. Data extraction involved independent researchers, and statistical analysis was conducted using R software. The assessment of risk of bias was performed using the Risk of Bias in Non-Randomized Studies of Interventions framework and the Risk Of Bias 2 tool., Results: In this meta-analysis, involving 1949 patients with AD and 1346 with PD, no significant differences were observed in recurrence rates between the active (13.6%) and passive (16.4%) drainage groups (risk ratio [RR] = 0.87; 95% CI: 0.58-1.31). Similarly, for complications, infection, hemorrhage, and mortality, no significant disparities were found between the 2 drainage modalities. Complication rates were 7.5% for active and 12.6% for PD (RR = 0.74; 95% CI: 0.36-1.52). Infection rates were available for 635 patients of the active group, counting for 2% and 2.6%, respectively (RR = 0.98; 95% CI: 0.24-4.01). Hemorrhage rates were also available for 635 patients of the active group, counting for 1.1% and 2.2%, respectively (RR = 0.44; 95% CI: 0.11-1.81). Mortality rates were 2.7% and 2.5%, respectively (RR = 0.94; 95% CI: 0.61-1.46)., Conclusion: Our study found no significant difference between passive and AD for managing complications, recurrence, infection, hemorrhage, or mortality in CSDH cases. Further large-scale randomized trials are needed for clarity., (Copyright © Congress of Neurological Surgeons 2024. All rights reserved.)

Introduction: Intracranial lesions often require tissue diagnosis through stereotactic biopsies. Originating in the 1970s, this technique has progressed, but limitations and risks persist. Recently, robot-assisted techniques have made strides, providing the potential for safer and more precise procedures. This study assesses the effectiveness and safety of robot-assisted brain biopsies., Methods: Following Cochrane and PRISMA guidelines, PubMed, Embase, and Web of Science were searched for publications up to July 2024. Outcomes assessed included neurological deficits, hemorrhage, mortality, target point error, operative time, and length of stay. Data extraction and bias assessment were conducted using standardized methods, and statistical analysis was performed using R software., Results: In this meta-analysis, 27 papers were included, involving 2605 patients. The gender distribution was 1448 males to 1141 females. The mean error in millimeters for the entry point error was 1.04 (95%CI: 0.72-1.37), while the target point error was 1.08 (95%CI: 0.49-1.66). The mean operative time was 52.45 min (95%CI: 37.83-67.07). Diagnostic yield had an estimated rate of 98% (95%CI: 97-98%; I²=31%). The length of hospital stay was 4.64 days (95%CI: 3.13, 6.14), from admission to discharge. The postoperative hemorrhage had an estimated risk of 6% (95%CI: 4-9%; I²=71%), while for transient neurological deficits, it was 4% (95%CI: 2-6%; I²=60%). Finally, the death related to the procedure was found to have an estimated risk of 0% (95%CI: 0-0%; I²=0%)., Conclusion: Our study found that the diagnostic yield of stereotactic brain biopsy, especially with robotic assistance, has proven to be highly effective. Robot-assisted biopsies also seems to reduce operative times and demonstrate high precision with low entry point error and target point error. Additionally, complication rates appear to be relatively low, and the average hospital stay is favorably short, underscoring the advantages of robotic assistance in stereotactic brain biopsy procedures., Competing Interests: Declarations. Competing interests: The authors declare no competing interests., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Lipases present biotechnological applications in various industrial sectors due to their ability to perform multiple biochemical reactions. However, the high cost sometimes discourages their potential uses, besides the extensive number of patents involving them. One of the most utilized and researched lipases is Candida antarctica lipase B (CALB), known for its versatility, encompassing enantioselectivity, thermostability, and a wide range of substrates. Therefore, finding new CALB-like lipases is an interesting strategy to enable the implementation of biocatalysts, especially if intellectual property analysis is included. The present study identified and produced six CALB-like enzymes without patent protection, with differences in pocket amino acids and substrate specificity. We conducted genomic searches in almost 7000 Fungal genomes, identifying over 1500 unique CALB homolog candidates. The phylogenetic and intellectual property analysis filtered those results into a few sequences without protection that were very similar to CALB. One cloned lipase had a lower hydrophobicity at the pocket entrance and preferred the C4 p-nitrophenyl ester as substrate. Another had a wider opening and more polar pocket, showing no preference. These results identified new patent-free lipases with conserved essential catalytic elements and diverse substrate specificity due to variations in the catalytic pocket. These enzymes can be the starting point for biocatalyst innovation with potential applications in diverse biotechnological areas., Competing Interests: Declaration of Competing Statement DMGF reports financial support was provided by Sinochem Petróleo Brasil Ltda. The other 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 © 2024 Elsevier Inc. All rights reserved.)

Background and Objectives: Antiplatelet therapy is recommended as the standard treatment for patients with acute ischemic stroke (AIS) who, for several reasons, did not receive thrombolysis or thrombectomy. However, whether tirofiban or aspirin provides greater benefits for these patients remains unclear. Therefore, we aimed to perform a meta-analysis comparing the functional outcomes and hemorrhagic risks associated with tirofiban and aspirin in the management of AIS., Methods: We searched PubMed, EMBASE, Web of Science, and Cochrane Library for studies comparing tirofiban to aspirin in patients with AIS who did not receive thrombolysis or thrombectomy until September 2024. Outcomes were modified Rankin Scale (mRS) and mortality at 90 days, symptomatic intracranial hemorrhage, and any bleeding events. Statistical analysis was performed using the R Studio (version 2024.04.1+748)., Results: We included 3 randomized controlled trials with a total of 1959 patients, of whom 996 (50.8 %) were in the tirofiban group. Excellent (mRS 0-1) functional outcome (RR 1.25, 95 % CI: 1.05-1.49; I 2 = 70 %) and favorable (mRS 0-2) functional outcome at 90 days (RR 1.09, 95 % CI: 1.01-1.16; I 2 = 35 %) were significantly higher in tirofiban compared to aspirin. Furthermore, tirofiban showed no difference in mortality (RR 0.77, 95 % CI: 0.24-2.53; I 2 = 56 %), or symptomatic intracranial hemorrhage (RR 3.42, 95 % CI: 0.27-43.30; I 2 = 38 %). However, any bleeding event (RR 1.75, 95 % CI: 1.25-2.45; I 2 = 0 %) was more common in the tirofiban group. Lastly, the meta-regression analysis showed that the outcomes were not influenced by the initial NIHSS of the included studies (p > 0.05)., Conclusion: Tirofiban is associated with better functional outcomes at 90 days, with no difference in mortality. Additionally, despite being associated with higher bleeding events, there is no difference in symptomatic intracranial hemorrhage. Therefore, our results suggest that tirofiban is a promising alternative to aspirin., Competing Interests: Conflict of Interest The authors declare no conflicts of interest related to the research, authorship, or publication of this scientific paper., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Purpose: To evaluate the effect of a physical therapy program on vaginal length and diameter, pelvic floor strength, and quality of life among gynecological cancer survivors suffering from late-effect vaginal stenosis., Methods: Thirty-four women who were previously diagnosed with gynecological cancer and experiencing vaginal stenosis, at least 12 months post-oncological treatment, were enrolled. The intervention program consisted of ten weeks of individualized weekly sessions, each lasting 50 min, involving perineal massage, progressive vaginal dilation, and pelvic floor exercises. Pre- and post-treatment evaluations included assessments of pelvic floor muscle strength through digital palpation, measurements of vaginal length and diameter using a silicone vaginal dilator, and classification of stenosis according to the Common Terminology Criteria for Adverse Events (CTCAE v5.0). Health-related quality of life was assessed using the FACT-G and FACT-Cx questionnaires., Results: Twenty-one women completed the physical therapy program. There was a significant increase in vaginal length (p < 0.001), vaginal diameter (p < 0.001) and improvement in pelvic floor muscle strength (p < 0.001), with a large effect size (r = 0.81), a medium effect size (r = -0.77) and a medium effect size (r = -0.78), respectively. This resulted in resolution of vaginal stenosis in 14 participants (66.7%) following intervention. Mean scores for FACT-Cx and FACIT-G, encompassing total scores and physical, social, and functional well-being domains, increased significantly after the treatment., Conclusion: The proposed physical therapy program demonstrated positive effects on vaginal stenosis, pelvic floor muscle strength and health-related quality of life in gynecological cancer survivors., Competing Interests: Declarations. Ethical statement: The CARE guidelines for case reports and the TIDieR checklist for intervention description were employed. All procedures of the study were performed in compliance with relevant laws and institutional guidelines and received approval from the research ethics committee of Santa Catarina State University (UDESC) (CAAE: 23430719.0.0000.0118) and of Santa Catarina State Department of Health (SES/SC) (CAAE: 234307.19.0.3001.0115). Declarations of interest: None. Consent to participate: The informed consent form was presented, and participants confirmed their understanding and agreement by signing it. Consent to publish: Not applicable. Competing interests: The authors declare no competing interests., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Background: Barbed sutures eliminate knots and may offer some advantages over conventional sutures. This meta-analysis compares clinical, surgical, and economic outcomes of barbed sutures with standard closure techniques in spinal surgery., Methods: We systematically searched PubMed, Embase, and Web of Science for studies comparing barbed and conventional suture for patients undergoing spinal surgery., Results: We included 6 studies in the analysis, totaling 1235 patients. There was no significant difference between the groups in relation to deep infection (risk ratio [RR] 0.65; 95% confidence interval [CI]: 0.26-1.57; I 2  = 0%), hospital stay duration (mean difference [MD] -0.55; 95% CI: -1.11 to 0.01; I 2  = 8%), postoperative hematoma (RR 0.35; 95% CI: 0.04-3.00; I 2  = 0%), reintervention due to wound healing problems (RR 0.98; 95% CI: 0.49-1.94; I 2  = 5%), superficial infection (RR 0.49; 95% CI: 0.19-1.28; I 2  = 0%), total hospitalization cost (MD -440.81; 95% CI: -1118.90 to 237.29; I 2  = 63%), and wound dehiscence/seroma (RR 0.81; 95% CI: 0.29-2.27; I 2  = 0%). There was a significant lower operating room time (MD -15.37; 95% CI: -29.43 to -1.32; I 2  = 87%) and suturing time (MD -16.17; 95% CI: -20.58 to -11.75; I 2  = 91%) in the barbed suture group, beyond a significantly lower risk of total infection (RR 0.55; 95% CI: 0.31-0.98; I 2  = 0%)., Conclusions: Our meta-analysis showed that barbed sutures were associated with reduced operating room time, suturing time, and infection rates. These results highlight the safety and potential efficacy of using barbed sutures., (Copyright © 2024 Elsevier Inc. All rights reserved.)

The purpose was to determine whether the benefits of a muscle strength and power training program are superior to those achieved with muscle strength training alone in people with patellofemoral pain (PFP). Thirty-seven individuals with PFP (25.86 ± 7.62 years) were randomly assigned to a strength and power training group (n = 18) or strength training group (n = 19). Primary outcomes were pain intensity and physical functioning. Secondary outcomes were kinesiophobia, quality of life, maximal isometric torque and rate of torque development of the hip and knee and self-perception of recovery. Primary outcomes were measured at baseline, after six weeks, after 12 weeks and at three, six- and 12-months follow-ups. Secondary outcomes were measured at baseline and after 12 weeks. The significance level was 0.05. After interventions, no significant differences were found between groups for primary or secondary outcomes. No difference between groups were found for pain or physical functioning at the other assessment times. Results of this study indicated that addition of power exercises to strength training for hip and knee muscles did not result in superior benefits compared to strength training alone., Competing Interests: Declarations Competing interests The authors declare no competing interests., (© 2024. The Author(s).)

Background: Primary brainstem hemorrhage (PBSH) is a fatal condition related to hypertension. PBSH definitive treatment remains controversial, mainly when surgical options are discussed., Objective: To aid decision-making in PBSH scenarios, we aimed to perform a meta-analysis and evaluate the literature on stereotactic aspiration (SA) for PBSH in comparison to conservative management (CM)., Methods: The outcomes assessed were: 30-day mortality, mortality, 90-day good outcome (mRs ≤ 3), good outcome (mRs ≤ 3), good outcome (mRs ≤ 3 or GOS 4-5), 90-day poor outcome (mRs ≥ 4), poor outcome (mRs ≥ 4)., Results: We included 1189 patients from 9 studies. 433 (36,41 %) patients were treated with SA. The risk of 30-Day Mortality (RR 0.57; 95 % CI 0.41-0.81; p=0.002; I²=58 %), Mortality (RR 0.56; 95 % CI 0.41-0.75; p<0.001; I²=54 %), 90-Day Poor Outcome (mRS ≥ 4) (RR 0.83; 95 % CI 0.73-0.93; p=0.001; I²=25 %), Poor Outcome (mRS ≥ 4) (RR 0.83; 95 % CI 0.75-0.93; p=0.001; I²=0 %) and Poor Outcome (mRS ≥ 4 or GOS ≤ 3) (RR 0.82; 95 % CI 0.74-0.91; p<0.001; I²=12 %) were significantly lower in patients receiving SA treatment. Also, the risk of 90-Day Good Outcome (mRS ≤ 3) (RR 1.60; 95 % CI 1.06-2.39; p=0.024; I²=21 %), Good Outcome (mRS ≤ 3) (RR 1.48; 95 % CI 1.13-1.94; p=0.005; I²=0) and Good Outcome (mRS ≤ 3 or GOS 4-5) (RR 1.72; 95 % CI 1.17-2.53; p=0.006; I²=25 %) were significant higher in the SA group., Conclusion: SA demonstrated favorable outcomes, including reduced mortality rates and improved functional recovery. Further clinical trials are needed to validate these findings., Competing Interests: Declaration of Competing Interest The authors assert that there are no conflicts of interest or competing interests relevant to this meta-analysis., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Background: While several instruments assess evidence-based practice (EBP) competencies, few are available for the Brazilian population, particularly healthcare students., Objective: To perform a cross-cultural translation of the Student Evidence-Based Practice Questionnaire (S-EBPQ) and Evidence-Based Practice Evaluation Competence Questionnaire (EBP-COQ) into Brazilian Portuguese; to adapt and validate the Brazilian Portuguese versions for use with healthcare students from diverse courses; and to assess the measurement properties of the translated and adapted versions., Methods: Four hundred forty-two healthcare students were included, and three versions were tested: S-EBPQ-BR, EBP-COQ-BR for nursing students, and EBP-COQ-BR for healthcare students. We assessed internal consistency, reliability, construct validity, responsiveness, and ceiling/floor effects. For reliability, participants completed the questionnaires twice, one week apart. For responsiveness, they completed them after participating in an educational program., Results: No issues were identified with understanding or applicability. For overall scores, the translated questionnaires demonstrated strong internal consistency (Cronbach's alpha=0.87-0.92), good to moderate reliability (ICC 3,1 =0.63-0.88), construct validity with moderate to very strong correlations to the Evidence-Based Practice Questionnaire (r=0.43-0.89), no ceiling or floor effects, and adequate responsiveness with significant pre- and post-educational program score differences. For subscales, the majority of them demonstrated satisfactory measurement properties, except for S-EBPQ-BR attitude (low internal consistency, poor reliability, and ceiling effect), EBP-COQ attitude (inadequate construct validity), and EBP-COQ skills (inadequate construct validity)., Conclusion: The Brazilian Portuguese versions of S-EBPQ and EBP-COQ exhibit strong measurement properties, including high internal consistency, adequate reliability, valid construct validity, and responsiveness. However, some subscales present suboptimal internal consistency, reliability, and construct validity., Competing Interests: Conflicts of interest The authors declares no conflicts of interest., (Copyright © 2024 Associação Brasileira de Pesquisa e Pós-Graduação em Fisioterapia. Publicado por Elsevier España, S.L.U. All rights reserved.)

Background: Given that people with patellofemoral pain (PFP) exhibit deficits in postural control, certain postural reactions may be associated with movement alterations in this population. Therefore, the objective of the present study was to investigate whether manipulation of the support base for balance maintenance could lead to different patterns of lower limb kinematics in people with PFP during single-legged squats., Methods: Fourteen participants with PFP and 14 asymptomatic controls were first assessed performing single-legged squats freely, and then while holding a stick to provide stabilization during the task. Center of pressure (CoP) behavior and movements of the hip, knee, ankle in the sagittal, frontal, and transverse planes were evaluated., Results: For the participants with PFP, the use of support led to a reduction in the magnitude of CoP oscillation compared to free squatting, with effect sizes ranging from small to large, but no significant differences were found for the kinematic variables. No significant differences were observed for CoP or kinematic variables in the comparisons between squat conditions in asymptomatic controls., Conclusion: In summary, performing single-legged squats in a more stabilized condition did not influence lower limb movements in people with PFP., Competing Interests: Declaration of competing interest The authors report no conflict of interest., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

This review aimed to verify the effects of vitamin E supplementation on oxidative stress, inflammatory response, muscle damage, soreness, and strength in healthy adults after exercise. We searched the MEDLINE, EMBASE, SPORTDiscus, Cochrane CENTRAL, and Web of Science from inception to August 2023, with no language restrictions. We included randomized placebo-controlled trials evaluating the supplementation of vitamin E on the abovementioned outcomes after a bout of physical exercise in healthy participants (no restriction for publication year or language). Meta-analyses were conducted to compare vitamin E and placebo supplementations to obtain a 95% confidence interval (95%IC). Twenty studies were included (n=298 participants). The effect of supplementation was assessed between 0 h and 96 h after the exercise. Compared to placebo, vitamin E had no effects on lipid (95%IC= -0.09 to 0.42), protein (-2.44 to 3.11), SOD (-1.05 to 0.23), interleukin-6 (-0.18 to 1.16), creatine kinase (-0.33 to 0.27), muscle soreness (-1.92 to 0.69), and muscle strength (-1.07 to 0.34). Heterogeneity for the analyses on carbonyls, interleukin-6 (1 h and 3 h), and muscle soreness ranged between 70 to 94%. Supplementing with vitamin E should not be recommended to support the recovery process in healthy individuals after exercise, given the lack of efficacy in the analyzed variables following an exercise session., Competing Interests: The authors declare that they have no conflict of interest., (Thieme. All rights reserved.)

Background: Intracranial pressure (ICP) monitoring plays a key role in patients with traumatic brain injury (TBI), however, cerebral hypoxia can occur without intracranial hypertension. Aiming to improve neuroprotection in these patients, a possible alternative is the association of Brain Tissue Oxygen Pressure (PbtO2) monitoring, used to detect PbtO2 tension., Method: We systematically searched PubMed, Embase and Cochrane Central for RCTs comparing combined PbtO2 + ICP monitoring with ICP monitoring alone in patients with severe or moderate TBI. The outcomes analyzed were mortality at 6 months, favorable outcome (GOS ≥ 4 or GOSE ≥ 5) at 6 months, pulmonary events, cardiovascular events and sepsis rate., Results: We included 4 RCTs in the analysis, totaling 505 patients. Combined PbtO2 + ICP monitoring was used in 241 (47.72%) patients. There was no significant difference between the groups in relation to favorable outcome at 6 months (RR 1.17; 95% CI 0.95-1.43; p = 0.134; I 2  = 0%), mortality at 6 months (RR 0.82; 95% CI 0.57-1.18; p = 0.281; I 2  = 34%), cardiovascular events (RR 1.75; 95% CI 0.86-3.52; p = 0.120; I 2  = 0%) or sepsis (RR 0.75; 95% CI 0.25-2.22; p = 0.604; I 2  = 0%). The risk of pulmonary events was significantly higher in the group with combined PbtO2 + ICP monitoring (RR 1.44; 95% CI 1.11-1.87; p = 0.006; I 2  = 0%)., Conclusions: Our findings suggest that combined PbtO2 + ICP monitoring does not change outcomes such as mortality, functional recovery, cardiovascular events or sepsis. Furthermore, we found a higher risk of pulmonary events in patients undergoing combined monitoring., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Austria, part of Springer Nature.)

Introduction: Comprehending scientific information have been reported as a barrier in evidence-based practice (EBP) adoption. This survey research aimed to verify the preferred sources of information for acquiring knowledge about physiotherapy and the association between types of information source and barriers in EBP implementation., Methods: A total of 610 physiotherapists were included and answered an online questionnaire about the preferred sources for searching physiotherapy-related information and possible barriers in EBP implementation., Results: Physiotherapists reported scientific resources as the preferred source of information, scientific databases (31%), followed by scientific articles (25%). The main barrier cited in EBP implementation was the difficulty in obtaining full-text articles (34%), followed by lack of statistical knowledge (30%). The use of peer-reviewed resources as the most preferred source of information is associated with the presence of issues in comprehending scientific information., Discussion: Although the positive attitude toward the use of scientific information, the findings raised question regarding the proper translation of scientific information to clinical practice. The importance of scientific information seems to be a well-established attitude among physiotherapists. However, there is a clear need for strategies aiming to improve the understanding of scientific information and consequently facilitate EBP implementation., Competing Interests: Disclosures: The authors declare no conflict of interest., (Copyright © 2023 The Alliance for Continuing Education in the Health Professions, the Association for Hospital Medical Education, and the Society for Academic Continuing Medical Education.)

Objectives: To compare the effects of passive recovery (PR), active recovery (AR), and recovery through self-massage with the aid of foam rolling (FRR) on pain and physical capacity in healthy volunteers after a resistance exercise (RE) session., Methods: The sample of this randomized crossover trial comprised 37 physically healthy men who underwent three sessions of RE (squat, leg press, and leg extension), involving four sets of 10 repetitions with 80% of 10MR, with an interval of seven days between sessions. PR consisted of sitting for 20min, AR included a cycle ergometer for 20min at 50% maximum heart rate, and FRR involved 10 repetitions per target body area, followed by 1min rest. Variables of physical capacity (strength, power, agility, joint range of motion, flexibility, speed, and fatigue resistance) were assessed 1h after RE, whereas pain was assessed 24h, 48h, and 72h after RE., Results: In the dominant lower limb, the percentage of strength decreased (p < 0.001) by 16.3% after RE but improved (p < 0.001) by 5.2% after AR and FRR in relation to PR. Similar results were observed in the non-dominant lower limb. Agility was enhanced (p < 0.001) by 3.6% in AR and 4.3% in FRR compared with the baseline assessment. The recoveries for the other physical variables were similar. Only FRR reduced (p < 0.001) pain at 24h (22.8%), 48h (39.2%), and 72h (59.7%) compared to PR., Conclusions: Self-massage using a foam roll reduced pain and improved agility and muscle strength during recovery after exercise., Trial Registration Number: NCT04201977., Competing Interests: Declaration of competing interest All authors declare no conflicts of interest., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

OBJECTIVE: To summarize the effectiveness of interventions for changing movement during weight-bearing functional tasks in people with patellofemoral pain (PFP). DESIGN: Systematic review with network meta-analysis (NMA). LITERATURE SEARCH: Medline, Embase, CINAHL, SPORTDiscus, and Cochrane Library were searched from inception up to May 2023. STUDY SELECTION CRITERIA: Randomized controlled trials involving people with PFP and nonsurgical, nonpharmacological interventions on task kinematics were included. DATA SYNTHESIS: NMA was conducted for frontal knee movement data, and pairwise meta-analysis was used to pool data when NMA was not possible. Reduced movements were those changes that indicated movements occurring with less amplitude. The GRADE approach was used to grade the certainty of the evidence. RESULTS: Thirty-seven trials were included (n = 1235 participants). Combining knee/hip exercises with internal feedback had the strongest effect on reducing frontal knee movements (standardized mean difference [SMD] from NMA = -2.66; GRADE: moderate evidence). On pairwise comparisons, the same combination of interventions reduced frontal hip movements (SMD = -0.47; GRADE: moderate evidence) and increased sagittal knee movements (SMD = 1.03; GRADE: moderate evidence), with no effects on sagittal hip movements (GRADE: very low evidence), compared to knee/hip exercises alone. There was no effect for single applications of braces on the frontal knee movement (GRADE: very low evidence) and taping on movements of the knee, hip, and ankle (GRADE: very low to low evidence) compared to no intervention. CONCLUSION: Knee/hip exercises combined with internal feedback techniques may change knee and hip movements in people with PFP. The combination of these interventions can reduce frontal knee and hip movements, and can increase sagittal knee movements. J Orthop Sports Phys Ther 2023;53(12):1-13. Epub 14 September 2023. doi:10.2519/jospt.2023.11956 .

Author response to the JOSPT Letter to the Editor-in-Chief "Lower-Limb Kinematics and Clinical Outcomes: Correlation Does not Imply Causality" J Orthop Sports Phys Ther 2023;53(11):723-725. doi:10.2519/jospt.2023.0203-R .

The Amazon is the largest river by discharge volume and one of the most biodiverse biomes in the world. Lately, there has been a rapid increase of the urban population in the region, which has been translated into a growing emission of organic contaminants such as polycyclic aromatic hydrocarbons (PAHs) into surface water bodies. This study provides the most comprehensive evaluation of the PAH contamination levels in surface waters of the Amazon basin. We investigated the occurrence and potential sources of 16 priority PAHs and characterised their risks for freshwater ecosystems. For this, we took 40 water samples from different sites along the Brazilian part of the Amazon River, including three major tributaries, and smaller rivers crossing the main urban areas. The results of this study show that PAHs are widespread contaminants in rivers of the Brazilian Amazon. The sum of the total concentration of the 16 priority PAHs reached values of 134 ng L -1 in the Amazon River, and 163 ng L -1 near densely populated areas. On the other hand, the total PAH concentration was generally lower in the monitored tributaries. In most samples, the contamination pattern was dominated by high molecular weight PAHs, suggesting a major contribution of pyrogenic sources, although petrogenic contamination was also present in some locations near urban areas. We assessed ecological risks posed by PAH mixtures using a hazard index. The results indicated that PAH contamination is not likely to pose direct toxic effects for Amazonian freshwater organisms, however continued monitoring is recommended near densely populated areas., 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 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Background: The literature reports a vast amount of epidemiological information on injuries in volleyball athletes. However, little is known about the incidence of injuries in elite athletes of international level participating in major competitions, such as world championships and Olympic games. The objective of the study was to analyse the incidence of injuries in elite professional volleyball athletes, and the prevalence of complaints reported by athletes., Methods: This is a case study in which data were collected between April 2018 and August 2021. All the athletes called to play for the Brazilian national male volleyball team during the analysis period participated. From the athletes' medical records, the occurrence of injuries (injurious events that lead to a time off from activities) and complaints (discomforts that did not lead to a time off from activities) were analysed. Frequency data were used to calculate incidence, prevalence and ratios., Results: From 41 athletes who played for the team during the analysed period, 12 athletes had 28 injuries and 38 athletes reported 402 complaints. For injuries, an incidence of seven injuries/1,000 h of competition and two injuries/1,000 h of training was observed. The average recovery time of the athletes was 10 days. The regions with the highest prevalence of injuries were the knee (111/1,000 athletes) and ankle (69/1,000 athletes). For complaints, 402 complaints required 1,085 treatment sessions, with the regions with the highest prevalence of complaints being the knee (261/1,000 complaints) followed by the shoulders (236/1,000 complaints). Athletes aged above 23 years and those playing as middle blockers and outside hitters presented a higher prevalence of injuries and complaints., Conclusions: Almost one-third of the athletes had injuries and almost all athletes reported complaints during the study period. Injuries and complaints were more prevalent in the knees. Complaints caused a high demand for the healthcare team. To manage risk of injuries for overload, specific injury prevention strategies are needed and should be included as an essential component of the training plan for elite volleyball players., (© 2023. The Author(s).)

Introduction: Photogrammetry represents an advancement in the flexibility evaluation, and although it was highly explored for postural assessment, there is a scarcity of studies analyzing lower limb angular measurements using it. The purpose of this study is to verify the reliability of intrarater and interrarater photogrammetry in assessing lower limb flexibility., Methods: This was a randomized cross-sectional observational study with test-retest design and a two-day interval. Thirty healthy, physically active adults were included. Three novice raters assessed the participants through flexibility tests of iliopsoas, hamstring, quadriceps and gastrocnemius on two occasions, and independently analyzed the captured images to establish reliability. Intraclass correlation coefficient (ICC), standard error of measurement (SEM), and minimal detectable change (MDC) were calculated., Results: Intrarater reliability was excellent for iliopsoas (ICC = 0.96; SEM = 1.4; MDC = 3.8), hamstring (ICC = 0.99; SEM = 1.1; MDC = 3.1), quadriceps (ICC = 0.99; SEM = 0.8; MDC = 2.3) and gastrocnemius (ICC = 0.98; SEM = 0.9; MDC = 2.5). Interrater reliability was excellent for iliopsoas (ICC = 0.94; SEM = 1.7; MDC = 4.6) and gastrocnemius (ICC = 0.91; SEM = 2.1; MDC = 5.8), but good for hamstring (ICC = 0.90; SEM = 2.8; MDC = 7.9) and quadriceps (ICC = 0.85; SEM = 3.0; MDC = 8.3)., Conclusions: The excellent intrarater and good to excellent interrater reliability suggest that photogrammetry assessment of lower limb flexibility by novice raters is reliable. However, clinicians should consider the higher threshold of range of motion change necessary to outweigh measurement error due to interrater variability., Competing Interests: Declaration of competing interest None declared., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

OBJECTIVE: To study whether changes in dynamic knee valgus or varus were associated with changes in pain or function in people with knee disorders. DESIGN: Systematic review with meta-analysis. LITERATURE SEARCH: We searched the MEDLINE, Embase, CINAHL, SPORTDiscus, Cochrane Library, and Web of Science, from inception up to January 2023. STUDY SELECTION CRITERIA: We included randomized controlled trials investigating the effects of nonsurgical (including nonpharmacological) interventions for knee disorders on frontal and transverse plane knee and hip movements during functional tasks, which reported pain and/or function outcomes. DATA SYNTHESIS: The relationship between changes in kinematics and pain/function was analyzed using a 2-stage structural equation modeling approach. RESULTS: From 42 202 records, 48 trials met the eligibility criteria. For people with patellofemoral pain (25 trials, n = 894), there was moderate evidence that changes in the knee and hip movements were significantly correlated with changes in pain and function (r= -0.69 to 0.73), except for the knee transverse plane movements and for the relationship between hip transverse plane movement and function. For people with knee osteoarthritis (15 trials, n = 704) and anterior cruciate ligament injuries (8 trials, n = 198), the evidence was limited and uncertain. CONCLUSION: The relationship between changes in movement control and clinical outcomes was consistent in people with patellofemoral pain. For people with knee osteoarthritis or anterior cruciate ligament injuries, there was a paucity of evidence that precluded a proper evaluation of the relationship between dynamic knee movement control, and pain and function. J Orthop Sports Phys Ther 2023;53(7):1-14. Epub: 18 April 2023. doi:10.2519/jospt.2023.11628 .

Type 2 diabetes mellitus (T2DM) is characterized by endothelial dysfunction that causes micro- and macrovascular complications. Low intensity therapeutic ultrasound (LITUS) may improve endothelial function, but its effects have not been investigated in these patients. The aim of our study was to compare the effects of pulsed (PUT) and continuous (CUT) waveforms of LITUS on the endothelium-dependent vasodilation of T2DM patients. The present randomized crossover trial had a sample of twenty-three patients (7 men) diagnosed with T2DM, 55.6 (±9.1) years old, with a body mass index of 28.6 (±3.3) kg/m2. All patients were randomized and submitted to different waveforms (Placebo, CUT, and PUT) of LITUS and the arterial endothelial function was evaluated. The LITUS of 1 MHz was applied in pulsed (PUT: 20% duty cycle, 0.08 W/cm2 SATA), continuous (CUT: 0.4 W/cm2 SPTA), and Placebo (equipment off) types of waves during 5 min on the brachial artery. Endothelial function was evaluated using the flow-mediated dilation (FMD) technique. PUT (mean difference 2.08%, 95% confidence interval 0.65 to 3.51) and CUT (mean difference 2.32%, 95% confidence interval 0.89 to 3.74) increased the %FMD compared to Placebo. In the effect size analysis, PUT (d=0.65) and CUT (d=0.65) waveforms presented moderate effects in the %FMD compared to Placebo. The vasodilator effect was similar in the different types of waves. Pulsed and continuous waveforms of LITUS of 1 MHz improved the arterial endothelial function in T2DM patients.

Background: Social media is established as a communication channel that is useful to disseminate scientific information. While social media can disseminate high quality information, it can also facilitate the spread of false or misleading information. Furthermore, social media is considered a self-promotion environment that can have several aspects related to personal marketing., Objective: To systematically search and review social media posts verifying whether the posts about physical therapy interventions reported sources of information; the presence of aspects suggesting conflicts of interest (COI); whether information was presented to facilitate knowledge acquisition; the reach of information posted; and the use and quality of the cited scientific references., Methods: Searches were performed on Instagram and Twitter using #reabilitação for Portuguese posts, and #rehabilitation for English posts. The inclusion criteria were posts including terms related to physical therapy and presenting interventions along with their purposes. The searches and screening processes were performed by at least two independent researchers., Results: Of 1,145 pre-selected posts, 632 posts were included, of which 14% cited references as source of information, 57% presented potential COI, and 9% facilitated knowledge acquisition. The posts received the mean ± SD of 88 ± 593 likes and profiles had a mean of 5,162 ± 37,240 followers. Considering the posts that cited references, most posts presented consistent information (51%) and 6% presented only positives outcomes (selection bias). Many references were of poor methodological quality (39%)., Conclusion: The present study enlightens the fact that most posts on Instagram and Twitter regarding physical therapy interventions did not report or use sources to support the information disseminated. Also, most posts were not created to facilitate knowledge acquisition., Registration Number: PROSPERO register database (CRD42021276941)., Competing Interests: Conflicts of interest The authors declare that they have no competing interests and no financial affiliation or involvement with any commercial organization that has a direct financial interest in any matter included in this manuscript., (Copyright © 2023 Associação Brasileira de Pesquisa e Pós-Graduação em Fisioterapia. Publicado por Elsevier España, S.L.U. All rights reserved.)

Background: Growing evidence supports that exercise therapy is effective for patellofemoral pain (PFP) rehabilitation. Nevertheless, the improvements have been reported not to be sustained in the long term, suggesting that the current protocols may not comprehend all required functional factors to provide a consistent recovery. A potential neglected factor in treatment protocols for PFP is postural control. However, it is unclear whether this population presents balance impairments or the influence of postural control on pain and function during rehabilitation programmes., Objective: To investigate whether (Q1) balance is impaired in people with PFP compared to controls, (Q2) conservative interventions are effective to improve balance in people with PFP, and (Q3) balance exercises are effective to improve pain and function in people with PFP., Data Sources: Medline, Embase, CINAHL, SPORTDiscus, Web of Science and Cochrane Library, supplemented by hand searching of reference lists, citations and relevant systematic reviews in the field., Methods: A systematic review with meta-analysis was conducted according to the Cochrane recommendations and reported according to the PRISMA statement recommendations. We included cross-sectional studies comparing balance between people with and without PFP; and randomised controlled trials verifying the effect of conservative intervention on balance and the effect of balance intervention on pain and function in people with PFP. The risk of bias was assessed using the Epidemiological Appraisal Instrument for cross-sectional studies and the Physiotherapy Evidence Database scale for randomised controlled trials., Results: From 15,436 records, 57 studies (Q1 = 28, Q2 = 23, Q3 = 14) met the eligibility criteria. Meta-analyses indicated that people with PFP have worse anteroposterior (very low grade evidence, standardised mean difference [SMD] = 1.03, 95% CI 0.40-1.66) and mediolateral (moderate grade evidence, SMD = 0.87, 95% CI 0.31-1.42) balance compared to controls. Moderate grade evidence indicated that overall balance is not affected in people with PFP (SMD = 0.38, 95% CI - 0.05-0.82). Low to very low grade evidence indicates that interventions are ineffective for mediolateral (SMD = 0.01, 95% CI - 0.51-0.53) and overall (SMD = 0.49, 95% CI - 0.14-1.11) balance improvements, and low grade evidence indicates that interventions are effective to improve anteroposterior balance (SMD = 0.64, 95% CI 0.04-1.23). Moderate to low grade evidence indicated that balance interventions are effective to reduce pain (SMD = 0.82, 95% CI 0.26-1.38) and improve function (SMD = 0.44, 95% CI 0.09-0.80) when measured using questionnaires; and very low grade evidence indicated no efficacy for function measured via functional tests (SMD = 0.73, 95% CI - 0.16-1.61)., Conclusion: People with PFP likely present balance deficits compared to asymptomatic people. There was insufficient evidence to support the efficacy of interventions to improve or modify balance in people with PFP. Also, there was insufficient evidence to support the efficacy of balance exercises to improve pain and function in people with PFP. Trial Registration The present systematic review was registered in PROSPERO (CRD42018091717)., (© 2022. The Author(s).)

In the present study, the objective was to evaluate in situ interaction between Benzo[a]anthracene 7,2-dione 7-oxime (BZA) and calf thymus dsDNA (ct-dsDNA) using electroanalytical genosensor. Analytical techniques based on Ultraviolet/Visible (UV-Vis) spectroscopy and electroanalytical were used to investigate the interaction processes in solution and immobilized on carbon screen-printed electrodes modified with electrochemical mediator Meldola blue. In addition, was possible to evaluate the degree of damage caused to the genetic material by the analyte through of toxicity estimate (S%). The interaction evaluated by genosensor showed processes of intercalation, degradation, and breaks of the double strand of ct-dsDNA, suggesting that the interaction simulates highly toxic (values varying from 0.6 to 0.8 μA in 48 h of interaction), such as 8-oxoguanine (+0.48 V), which is a by-product of guanine oxidation. Furthermore, monitoring A (+1.10 V) after 1 h showed an S% value between 50 and 90%, indicative of high toxicity, and monitoring G (+0.85 V), which showed S>90%, indicated no toxicity after 10 min. Overall, the electroanalytical genosensor developed in a miniaturized system displayed good reproducibility and stability over time being a quick alternative for assesses the degree of toxicity between toxic xenobiotics and biologically electroactive molecules, such as DNA., 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 © 2022 Elsevier Inc. All rights reserved.)

Abstract: Nunes, GS, Barton, CJ, and Serrão, FV. Impaired knee muscle capacity is correlated with impaired sagittal kinematics during jump landing in women with patellofemoral pain. J Strength Cond Res 36(5): 1264-1270, 2022-Knee and hip muscle capacity is impaired in women with patellofemoral pain (PFP), but little is known about the rate of force development (RFD) at the knee. Impaired muscle capacity may contribute to reduced sagittal plane movement at the knee and hip during jump landing in women with PFP. This study aimed to (a) compare knee extensor muscle capacity (including RFD), and hip abductor and extensor muscle capacity between women with and without PFP; and (b) evaluate the relationship between hip/knee muscle capacity and sagittal kinematics during single-legged drop jump landing in women with PFP. Fifty-two physically active women (26 with PFP and 26 controls) participated. Rate of force development (in %/ms), isometric, concentric, and eccentric torque (in N·m·kg-1 × 100) were evaluated using isokinetic dynamometry, and knee and hip kinematics were evaluated using three-dimensional motion capture. Compared with the control group (CG), the PFP group (PFPG) presented lower isometric (12%, PFPG = 217.2 ± 46.0; CG = 246.5 ± 38.8; p = 0.02), concentric (21%, PFPG = 133.0 ± 42.6; CG = 169.2 ± 28.8; p < 0.01), and eccentric (17%, PFPG = 172.9 ± 56.7; CG = 208.4 ± 59.4; p = 0.03) knee extension torque; lower RFD until 30% (30%, PFPG = 0.57 ± 0.27; CG = 0.83 ± 0.37; p < 0.01) and 60% (31%, PFPG = 0.47 ± 0.24; CG = 0.67 ± 0.33; p = 0.01) of maximal isometric torque; and lower concentric hip abduction (13%, PFPG = 94.7 ± 19.1; CG = 108.4 ± 17.5; p = 0.01) and extension (17%, PFPG = 134.4 ± 34.3; CG = 162.6 ± 38.0; p < 0.01) torque. Significant correlations between reduced RFD for knee extension and reduced sagittal plane knee/hip range of motion during landing were identified (r = 0.39-0.49). In conclusion, women with PFP have impaired knee extensor isometric and dynamic strength, and RFD. Impaired knee extensor RFD is associated with a stiffer landing strategy (reduced movement)., (Copyright © 2020 National Strength and Conditioning Association.)

Background: The execution of undergraduate thesis is a period in which students have an opportunity to develop their scientific knowledge. However, many barriers could prevent the learning process. This cross-sectional study aimed to analyze the scientific dissemination of results from undergraduate theses in physical therapy programs and verify the existence of barriers and challenges in the preparation of undergraduate thesis. Second, to investigate whether project characteristics and thesis development barriers were associated with the dissemination of undergraduate thesis results., Methods: Physical therapists who graduated as of 2015, from 50 different educational institutions, answered an online questionnaire about barriers faced during the execution of undergraduate thesis and about scientific dissemination of their results., Results: Of 324 participants, 43% (n = 138) of participants disseminated their results, and the main form of dissemination was publishing in national journals (18%, n = 58). Regarding the barriers, 76% (n = 246) of participants reported facing some difficulties, and the main challenge highlighted was the lack of scientific knowledge (28%, n = 91). Chances of dissemination were associated with barriers related to scientific understanding and operational factors, such as the type of institution, institutional facilities, and involvement with other projects., Conclusion: Scientific knowledge seems to be a determining factor for the good development of undergraduate theses. In addition, it is clear the need to stimulate more qualified dissemination that reaches a larger audience. Changes in operational and teaching factors may improve the undergraduate thesis quality. However, the importance of rethinking scientific education within physical therapy programs draws attention., (© 2022. The Author(s).)

Background: Strong evidence supports the proximal combined with quadriceps strengthening for patellofemoral pain (PFP) rehabilitation. However, most reported rehabilitation programs do not follow specific exercise prescription recommendations or do not provide adequate details for replication in clinical practice. Furthermore, people with PFP have power deficits in hip and knee muscles and it remains unknown whether the addition of power exercises would result in superior or more consistent outcomes. Therefore, this study is designed to verify whether the benefits of a rehabilitation program addressing proximal and knee muscles comprising power and strength exercises are greater than those of a program consisting of strength exercises only., Method: This study will be a randomized controlled trial that will be conducted at university facilities. A minimum of 74 people with PFP between the ages of 18 and 45 years will be included. The experimental group will engage in a 12-week resistance training program focusing on proximal and knee muscles using power and strength exercises. The control group will engage in a 12-week resistance training program focusing on proximal and knee muscles using strength exercises only. Primary outcomes will be pain intensity and physical function; and secondary outcomes will be kinesiophobia, self-reported improvement, quality of life, peak hip and knee torque, and hip and knee rate of force development. The primary outcomes will be evaluated at baseline, and after 6 weeks, 12 weeks, 3 months, 6 months, and 1 year. The secondary outcomes will be evaluated at baseline and immediately after the interventions. Therapists and participants will not be blinded to group allocation., Discussion: This randomized clinical trial will investigate if adding power exercises to a progressive resistance training may lead to more consistent outcomes for PFP rehabilitation. The study will provide additional knowledge to support rehabilitation programs for people with PFP., Trial Registration: ClinicalTrials.gov NCT03985254. Registered on 26 August 2019., (© 2021. The Author(s).)

Urban areas in the Brazilian Amazon have grown at an unprecedented rate during the last years. About 90% of the wastewater produced by these urban areas are discharged untreated into Amazonian freshwater ecosystems, constituting a potential environmental pathway for pharmaceuticals and other chemicals consumed by modern societies (e.g. psychostimulants, personal-care products, hormones). The distribution of these chemicals into the Amazon River and their potential risks for freshwater biodiversity have not been evaluated so far. Here, we show the results of the largest chemical monitoring campaign conducted in the Amazon region. We assessed exposure patterns for 43 pharmaceuticals and other urban contaminants in 40 sampling sites distributed along the Amazon River, three major tributaries (Negro, Tapajós and Tocantins Rivers), and four large cities of the Brazilian Amazon (Manaus, Santarém, Macapá, Belém). We assessed risks for freshwater biodiversity using species sensitivity distributions and mixture toxicity approaches. We found that urban areas constitute important hot-spots for chemical contamination, with mixtures containing up to 40 different compounds and exposure concentrations reaching the world's maxima for some of them. We show that chemical pollution can result in long-term effects for up to 50-80% of aquatic species next to urban areas. Moreover, we identified several ubiquitous compounds which can be used as tracers of anthropogenic pressure in the Amazon basin. We conclude that the chemical burden created by urbanization significantly contributes to a biodiversity loss in the region and should be further controlled., (Copyright © 2021 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Antioxidants are synthetic or natural compounds capable of preventing or delaying oxidative damage caused by chemical species that can oxidize cell biomolecules, such as proteins, membranes, and DNA, leading to the development of various pathologies, such as cancer, atherosclerosis, Parkinson, Alzheimer, and other diseases serious. In this study, an amperometric biosensor was used to determine the antioxidant activity of teas and effervescent products based on vitamin C, available on the market. A sensor composed of three electrodes was used. The performance of the following electrochemical mediators was evaluated: meldola blue combined with Reineck salt (MBRS), Prussian blue (PB), and cobalt phthalocyanine (CoPC), as well as the time of polymerization in the enzymatic immobilization process and the agitation process during chronoamperometric measurements. Prussian blue proved to be more efficient as a mediator for the desired purposes. After optimizing the construction stages of the biosensor, as well as the operational parameters, it presented stability for a period of 7 months. The results clearly indicate that the biosensor can be successfully used to detect fraud in products called "antioxidants" or even in drugs containing less ascorbic acid than indicated on the labels. The detection limit was set at 4.93 µmol·L -1 .

Antioxidants are a group of healthy substances which are useful to human health because of their antihistaminic, anticancer, anti-inflammatory activity and inhibitory effect on the formation and the actions of reactive oxygen species. Generally, they are phenolic complexes present in plant-derived foods. Due to the valuable nutritional role of these mixtures, analysis and determining their amount in food is of particular importance. In recent years, many attempts have been made to supply uncomplicated, rapid, economical and user-friendly analytical approaches for the on-site detection and antioxidant capacity (AOC) determination of food antioxidants. In this regards, sensors and biosensors are regarded as favorable tools for antioxidant analysis because of their special features like high sensitivity, rapid detection time, ease of use, and ease of miniaturization. In this review, current five-year progresses in different types of optical and electrochemical sensors/biosensors for the analysis of antioxidants in foods are discussed and evaluated well. Moreover, advantages, limitations, and the potential for practical applications of each type of sensors/biosensors have been discussed. This review aims to prove how sensors/biosensors represent reliable alternatives to conventional methods for antioxidant analysis.

Objective: To investigate whether Kinesio taping technique, applied to ankles of healthy people as a preventive intervention and people with ankle injuries, is superior to sham or alternative interventions on ankle function., Data Sources: Medline, Embase, Amed, CINAHL, SPORTDiscus, Cochrane Library and Web of Science, from inception to August 2020., Review Methods: The terms "ankle" and "kinesio taping" were used in the search strategy. Included studies were randomized controlled trials (including crossover design) investigating Kinesio taping effects on ankle functional performance compared to any alternative or control/sham technique., Results: From 5,572 studies, 84 met the eligibility criteria which evaluated 2,684 people. Fifty-eight meta-analyses from 44 studies were performed (participants in meta-analyses ranging from 27 to 179). Fifty-one meta-analyses reported ineffectiveness of Kinesio taping: moderate evidence for star excursion balance test (anterior direction), jump distance, dorsiflexion range of motion, and plantar flexion torque for healthy people (effect size = 0.08-0.13); low to very-low evidence for balance, jump performance, range of motion, proprioception, muscle capacity and EMG for healthy people; balance for older people; and balance and jump performance for people with chronic instability. Seven meta-analyses reported results favoring Kinesio taping (effect size[95% CI]): low to very-low evidence for balance (stabilometry, ranging from 0.42[0.07-0.77] to 0.65[0.29-1.02]) and ankle inversion (0.84[0.28-1.40]) for healthy people; balance for older people (COP velocity, 0.90[0.01-1.78]); and balance for people with chronic instability (errors, 0.55[0.06-1.04])., Conclusions: Current evidence does not support or encourage the use of Kinesio taping applied to the ankle for improvements in functional performance, regardless the population.

Background: Hip abductor muscle function is associated with running-related injuries. Previous electromyography (EMG) studies that reporting gluteal muscle activity when running have failed to account for the multiple segments of the gluteals, and have used surface electrodes, which may be contaminated by cross-talk of surrounding muscles., Research Question: This study aimed to: (i) develop EMG profiles of gluteus medius (GMed - anterior, middle and posterior) and gluteus minimus (GMin - anterior and posterior) segments during running; (ii) compare the activation patterns of each gluteal segment between running and walking; and (iii) compare surface EMG signals of running and walking to fine wire EMG signals of middle GMed., Methods: Ten physically active and asymptomatic people participated. Gluteal segment activation was assessed during running and walking over 10 m. Muscle activation was assessed using bipolar fine wire intramuscular EMG electrodes and GMed activation was also assessed using surface EMG., Results: During running, all gluteal segments presented peak amplitude during the stance phase and anterior GMin presented additional second peak amplitude during the swing phase. All gluteal segments evaluated demonstrated consistently higher amplitudes during the stance and swing phases of running compared to walking. The mean amplitude assessed using surface EMG was 32-87% higher compared to fine wire during both phases for running and walking., Significance: Greater activation of GMed segments during the stance phase and the increased anterior GMin activity during the swing phase indicate a potentially important role for pelvis and hip stabilization, respectively, which should be considered during development of targeted rehabilitation for running populations. The overestimated activation using surface electrodes highlights a limitation of using surface EMG during running and walking., Competing Interests: Declaration of Competing Interest None., (Copyright © 2020 Elsevier B.V. All rights reserved.)

Purpose: To translate, culturally adapt, evaluate the measurement properties, and propose a new scoring system of the Cincinnati Knee Rating System for the Brazilian population. Materials and Methods: One hundred fifty people with anterior cruciate ligament injury completed Cincinnati Knee Rating System and Lysholm Knee Scoring Scale on three occasions: 1-week prior to surgery, 90-days after and 95-days after reconstruction. The measurement properties of the Brazilian-Portuguese Cincinnati Knee Rating System, internal consistency, construct validity, reproducibility, ceiling and floor effect and responsiveness, were tested. Results: Using the original scoring system (multiple scores), the internal consistency (Cronbach's α) varied between 0.54-0.79 (if item deleted = 0.07-0.73); the construct validity (Pearson's r ) varied between 0.19-0.82 (related to Lysholm); the reliability (intraclass correlation coefficient) varied between 0.96-0.99; the standard error of measurement varied between 0.2-1.3 points; the minimum detectable change varied between 0.4-3.5 points; no ceiling or floor effect was detected, and responsiveness (effect size) varied between -0.3-2.7. Using the new proposed scoring system (single score), Cronbach's α was 0.78 (if item deleted = 0.65-0.71); the Pearson's r was 0.79 (related to Lysholm); the intraclass correlation coefficient was 0.99; the standard error of measurement was 0.5 points, the minimum detectable change was 1.3 points; no ceiling or floor effect was detected, and effect size was 1.4. Conclusions: The Brazilian-Portuguese Cincinnati Knee Rating System has adequate property measurement and can be used in a Brazilian population. The new proposed scoring system is appropriate.Implications for rehabilitationThe Brazilian-Portuguese Cincinnati Knee Rating System is a valid and reliable instrument which can identify consistent clinical changes over the time.The Brazilian-Portuguese Cincinnati Knee Rating System can be used to evaluate and to follow-up a Brazilian population with anterior cruciate ligament injuries and postoperative reconstruction.The new proposed score for Cincinnati Knee Rating System is appropriate and did not compromise the quality of the measurement properties.The new scoring system generates a unique score, creating a potentially simpler and faster clinical understanding of the patient's condition.

Purpose: To verify the quality of questionnaires/scales regarding knee instability caused by anterior cruciate ligament (ACL) insufficiency and their translated versions. Materials and methods: Searches were conducted on Web of Science, Pubmed, Medline, Cinahl, and SportDiscuss. The COnsensus-based Standards for the selection of Health Measurement INstruments (COSMIN) scale was used to assess the article's quality; and the measurement properties of each questionnaire/scale were also analysed. Results: Searches identified 7703 studies and 29 were included in this review. Nine were articles reporting the original development of a questionnaire/scale and 20 were translations. The original questionnaires/scales were written in English or French and were translated into Brazilian Portuguese, Portuguese, Dutch, Turkish, German, Korean, Italian, Arabic, Polish, French, and Chinese. The questionnaires/scales with best overall quality were the Cincinatti Knee Rating System, the International Knee Documentation Committee - Subjective Knee Form and the PPLP. The International Knee Documentation Committee had positive results for internal consistency (Cronbach's alpha 0.89-0.92); for reliability and agreement (intraclass correlation coefficient (ICC) ranging from 0.88 to 0.99); and for construct validity (Pearson's r ranged from 0.1 to 0.85). Conclusions: The International Knee Documentation Committee had the largest number of translated versions and it was considered the best instrument assessed. Furthermore, The International Knee Documentation Committee was considered to be easy to apply, short and accessible, thus it is the choice of several clinicians and researchers.Implications for rehabilitationKnee instability is one of the most important factors to be evaluated during rehabilitation of people with anterior cruciate ligament injury in both surgical and non-surgical approach.The use of questionnaires may provide a better overall functionality assessment of people with knee instability from ACL injury.To choose the most appropriate questionnaire, clinicians should consider their needs and should consider validated questionnaires linked with adequate psychometric properties which guarantee the original characteristics of a questionnaire and also guarantee reliable results.

Sugarcane is one of the most economically important crops in Brazil. The damage caused by Diatraea saccharalis (F.) (Lepidoptera: Crambidae) results in high costs for its production. Cotesia flavipes Cameron (Hymenoptera: Braconidae) is the most efficient means of controlling this pest. The prohibition of burning and the preservation of soil cover through non-tillage practices increased many population densities of natural enemies of the sugarcane borer (SCB) in sugarcane fields. Euborellia annulipes (Lucas) (Dermaptera: Anisolabididae) is a predator found in sugarcane fields and is associated with predation of SCB. This study aimed to evaluate the influence of parasitism of D. saccharalis by C. flavipes on predation by E. annulipes adult females. For this purpose, fourth instar sugarcane borer larvae were exposed to parasitism over a 5-day period or were not parasitized. Subsequently, the prey was supplied to the predator in arenas under choice and no-choice conditions and under different densities to evaluate the feeding preference over a 12-h period and functional response of the predator over a 24-h period. E. annulipes killed 2-3 fourth instar larvae of the sugarcane borer over a 12-h period. SCB parasitism did not affect the feeding preference of the predator and did not alter the type II functional response. However, the handling time of the predator was lower (1.943 h) and there was a higher T/T h ratio on the non-parasitized larvae (12.352). Our findings indicate E. annulipes as a promising biological control agent of D. saccharalis, with a potential to assist in the sugarcane borer management approaches and could to reduce the costs of parasitoid release in the field.

The paper describes the development of an amperometric biosensor using Prussian Blue (PB) modified electrodes containing xanthine oxidase (XOD). The enzyme is immobilized by photo-polymerization into an azide-unit pendant water-soluble photopolymer (PVA-AWP). The parameters of the fabrication of the biosensor, XOD:PVA/AWP ratio, crosslinking irradiation time, and XOD charge, were optimized. Operational conditions for electrode preparation were defined as 1:2 ratio of XOD:PVA/AWP; exposure time to neon light of 30  min; pH = 7.5  at room temperature and enzymatic charge of 8 mU per electrode. The biosensors showed stable, fast, simple, selective, cost-effective and sensitive (-2.72E-8  A mol L -1 ), with a good linear range (1.0-75  μmol L -1 ), and respectively detection and quantification limits for antioxidants of 2.17, and 7.15  μmol L -1 . The applicability of this biosensor was demonstrated by in vitro analysis of gallic acid as standard antioxidant and Amazonian fruits as natural sources., (Copyright © 2019 Elsevier B.V. All rights reserved.)

Objective: To (i) compare objective function in a range of tasks between people with and without patellofemoral pain (PFP); and (ii) evaluate the relationship of objective function with hip muscle capacity and self-reported function in people with PFP., Design: Cross-sectional., Settings: Laboratory., Participants: Thirty-two physically active people (16 with PFP and 16 controls)., Main Outcome Measures: Functional assessments included stair climbing (time), single-legged chair stand (repetitions), step down (repetitions), forward hop for distance and side hop (repetitions). Hip abductor and extensor capacity assessments included power, endurance, isometric and dynamic strength. Self-reported function included the Kujala scale and Patellofemoral sub-scale of the Knee injury and Osteoarthritis Outcome Score (KOOS-PF)., Results: The PFP group was 15% slower climbing stairs (effect size [ES] = 0.90), performed 12% fewer chair stands (ES = 0.62) and forward hopped 20% shorter (ES = 0.79) compared to controls. Lower hip muscle strength and power correlated with lower objective function (r = 0.52-0.78). Lower Kujala scores correlated with longer stair climbing time (r = -0.53)., Conclusion: People with PFP have objective functional impairments, that are associated with reduced hip muscle capacity, indicating progressive resistance training may be beneficial. Absence of a strong correlation between self-reported, and objective, function indicates assessment of both when treating people with PFP is warranted., (Copyright © 2019 Elsevier Ltd. All rights reserved.)

Context: People with patellofemoral pain (PFP) present altered lower-limb movements during some activities. Perhaps, joint misalignment in the hip is one of the reasons for altered movement patterns in people with PFP. Some mobilization techniques have been designed to address joint misalignments., Objective: To investigate the acute effects of hip mobilization with movement (MWM) technique on pain and biomechanics during squats and jumps in females with and without PFP., Design: Randomized, placebo-controlled trial., Setting: Movement analysis laboratory., Patients: Fifty-six physically active females (28 with PFP and 28 asymptomatic) were divided into 4 groups: experimental group with PFP, sham group with PFP, experimental group without PFP, and sham group without PFP., Intervention(s): The experimental groups received MWM for the hip, and the sham groups received sham mobilization., Main Outcome Measures: Pain, trunk, and lower-limb kinematics, and hip and knee kinetics during single-leg squats and landings., Results: After the interventions, no difference between groups was found for pain. The PFP experimental group decreased hip internal rotation during squats compared with the PFP sham group (P = .03). There was no other significant difference between PFP groups for kinematic or kinetic outcomes during squats, as well as for any outcome during landings. There was no difference between asymptomatic groups for any of the outcomes in any of the tasks., Conclusions: Hip mobilization was ineffective to reduce pain in people with PFP. Hip MWM may contribute to dynamic lower-limb realignment in females with PFP by decreasing hip internal rotation during squats. Therefore, hip MWM could be potentially useful as a complementary intervention for patients with PFP.

Achilles tendinopathy is the most frequent foot overuse injury in ballet dancers and knowledge of clinically modifiable factors related to tendon structure in a population at risk, such as ballet dancers, would be important for the development of preventive programs. Therefore, the present study aimed to assess relationships of gastrocnemius muscle architecture and ankle plantar flexors function with Achilles tendon morphology in ballet dancers. Fifty-four measures from 27 ballet dancers were collected. Tendon morphology (thickness, echogenicity, hypoechoic areas and neovascularisation) and muscle architecture (thickness, pennation angle and fascicle length) were evaluated using ultrasonography; ankle plantar flexors torque was evaluated using hand-held dynamometry, flexibility was evaluated in maximal weight-bearing ankle dorsiflexion position using inclinometer, and endurance was evaluated using the heel rise test. Ankle plantar flexors torque and medial gastrocnemius muscle architecture (thickness, pennation angle and fascicle length) are associated with Achilles tendon thickness in ballet dancers (r 2  = 0.24, p = 0.008). Ankle plantar flexors torque and medial gastrocnemius muscle fascicle length are also associated with the echogenicity of the Achilles tendon (r 2  = 0.13, p = 0.03). These findings call attention to the potential importance of ankle plantar flexors muscle force in healthy ballet dancers for the prevention of alterations in Achilles tendon structure., (Copyright © 2019. Published by Elsevier B.V.)

Objectives: To evaluate the feasibility of a 12-week progressive resistance training program for people with patellofemoral pain (PFP) targeting proximal muscle strength and power; and resulting clinical and muscle capacity outcomes., Design: Feasibility study., Setting: Clinical environment., Participants: Mixed-sex sample of people with PFP., Main Outcome Measures: Feasibility outcomes included eligibility, recruitment rate, intervention adherence, and drop-outs. Secondary outcomes included perceived recovery, physical function (AKPS and KOOS-PF), worst pain (VAS-cm), kinesiophobia (Tampa), physical activity (IPAQ), and hip strength (isometric and 10 repetition maximum) and power., Results: Eleven people, from 36 who responded to advertisements, commenced the program. One participant withdrew. Ten participants who completed the program reported improvement (3 completely recovered; 6 marked; and 1 moderate). Higher AKPS (effect size [ES] = 1.81), improved KOOS-PF (ES = 1.37), and reduced pain (ES = 3.36) occurred alongside increased hip abduction and extension dynamic strength (ES = 2.22 and 1.92, respectively) and power (ES = 0.78 and 0.77, respectively). Isometric strength improved for hip abduction (ES = 0.99), but not hip extension., Conclusion: A 12-week progressive resistance training program targeting proximal muscle strength and power is feasible and associated with moderate-large improvements in pain, function, and hip muscle capacity in people with PFP. Further research evaluating the efficacy of progressive resistance training is warranted., (Copyright © 2019 Elsevier Ltd. All rights reserved.)