This article examined qualitative studies of adolescents’ perspectives about the facilitators and barriers of physical activity, published from 2007 to 2014. A systematic review of ‘Web of Science’, ...‘EBSCO’, ‘Psychinfo’ and ‘ERIC’ databases was performed according to Preferred Reporting Items for Systematic reviews and Meta-analyses guidelines. The following keywords were used: ‘physical activity’ and ‘physical education’, each one individually associated with ‘correlate’, ‘determinant’, ‘facilitator’, ‘barrier’, ‘factor influen*’, and with ‘qualitative’, ‘focus group’, ‘interview’, “narrative’. Out of 3815 studies initially identified, due to inclusion and quality criteria, only 12 were fully reviewed. Studies’ outcomes were analyzed through thematic analysis. The majority of these reported research with young adolescent girls. Few studies have considered the socioeconomic status influence. According to young people’s perspectives, the main facilitators and hampering factors to their participation in physical activity were the following: attitude toward physical activity; motivation; perceptions of competence and body image; fun; influence of friends, family and physical education teachers and environmental physical activity opportunities. Specific life transition periods were referred only as a barrier to physical activity. Strategies of pedagogical actions and for developing physical activity intervention programs were discussed, in order to effectively promote the adoption of active lifestyles among youth.
This study compared the vector competence of four populations of Rhipicephalus sanguineus group ticks for the bacterium Ehrlichia canis, the agent of canine monocytic ehrlichiosis (CME). Ticks ...(larvae and nymphs) from the four populations-one from São Paulo state, southeastern Brazil (BSP), one from Rio Grande do Sul state, southern Brazil (BRS), one from Argentina (ARG), and one from Uruguay (URU)-were exposed to E. canis infection by feeding on dogs that were experimentally infected with E. canis. Engorged ticks (larvae and nymphs) were allowed to molt to nymphs and adults, respectively, which were tested by molecular analysis (E. canis-specific PCR assay) and used to infest naïve dogs. Through infestation of adult ticks on naïve dogs, after nymphal acquisition feeding on E. canis-infected dogs, only the BSP population was shown to be competent vectors of E. canis, i.e., only the dogs infested with BSP adult ticks developed clinical illness, seroconverted to E. canis, and yielded E. canis DNA by PCR. This result, demonstrated by two independent replications, is congruent with epidemiological data, since BSP ticks were derived from São Paulo state, Brazil, where CME is highly endemic. On the other hand, BRS, ARG, and URU ticks were derived from a geographical region (South America southern cone) where CME has never been properly documented. Molecular analysis of unfed adults at 30 days post molting support these transmission results, since none of the BRS, ARG, and URU ticks were PCR positive, whereas 1% of the BSP nymphs and 31.8% of the BSP adults contained E. canis DNA. We conclude that the absence or scarcity of cases of CME due to E. canis in the South America southern cone is a result of vector incompetence of the R. sanguineus group ticks that prevail on dogs in this part of South America.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Background This study evaluates the early and midterm results of decellularized aortic valve allografts (DAVA) as an aortic valve replacement. Methods Between October 2005 and February 2010, 41 ...patients, 28 of whom were male, with a median age of 34 years (range, 0.1 to 71), had aortic valve replacement with DAVA. Decellularization was obtained with a 0.1% sodium dodecyl sulfate solution. Postoperative evaluation was performed with serial echocardiograms, magnetic resonance imaging, and multislice computed tomography studies to evaluate valve hemodynamics, allograft conduit dimensions, and calcification scores. Results There were 3 early deaths and 1 late death, with a mean follow-up of 19 months (range, 1 to 53). There was 1 reoperation due to a failed mitral valve repair. By echocardiography in all patients, the median immediate postoperative peak gradient was 7 mm Hg (range, 1 to 26 mm Hg), and at last follow-up it was 4 mm Hg (range, 1 to 16 mm Hg); valvular regurgitation was graded as none or trivial in all but 1 patient, who had a regurgitation graded as mild to moderate. By magnetic resonance imaging (n = 4), mean root dimensions were stable at the annulus (24 mm), sinus of Valsalva (33 mm), and sinotubular junction (28 mm). By computed tomography (n = 22), there was only discrete conduit calcification (median calcium score 63 Hounsfield units HU; range, 0 to 894 HU) to 3 years of follow-up. Conduit biopsy in the patient who underwent reoperation demonstrated well-preserved wall structure, absence of calcification, and limited in vivo host repopulation. Conclusions The early and midterm results with DAVA demonstrated stable structural integrity, low rate of calcification, and adequate hemodynamics. Although longer periods of observation are necessary, DAVA appears to be a promising alternative for aortic valve replacement in selected patients.
This study was performed in Maranhão state, a transition area two Brazilian biomes, Amazon and Cerrado. During 2011-2013, 1,560 domestic dogs were sampled for collection of serum blood samples and ...ticks in eight counties (3 within the Amazon and 5 within the Cerrado). A total of 959 ticks were collected on 150 dogs (9.6%). Rhipicephalus sanguineus sensu lato (s.l.) was the most abundant tick (68% of all collected specimens), followed by Amblyomma cajennense sensu lato (s.l.) (12.9%), Amblyomma parvum (9.2%), and Amblyomma ovale (5.2%). Other less abundant species (<1%) were Amblyomma oblongoguttatum, Rhipicephalus microplus, Haemaphysalis juxtakochi, and Amblyomma rotundatum. Females of A. cajennense s.l. ticks were morphologically identified as A. cajennense sensu stricto (s.s.) or A. sculptum. Molecular analyses of 779 canine ticks revealed three Rickettsia species: Rickettsia amblyommatis in 1% (1/100) A. cajennense s.l., 'Candidatus Rickettsia andeanae' in 20.7% (12/58) A. parvum, Rickettsia bellii in 6.8% (3/44) A. ovale and 100% (1/1) A. rotundatum ticks. An additional collection of A. sculptum from horses in a Cerrado area, and A. cajennense s.s. from pigs in an Amazon area revealed R. amblyommatis infecting only the A. cajennense s.s. ticks. Serological analysis of the 1,560 canine blood samples revealed 12.6% canine seroreactivity to Rickettsia spp., with the highest specific seroreactivity rate (10.2%) for R. amblyommatis. Endpoint titers to R. amblyommatis were significantly higher than those for the other Rickettsia antigens, suggesting that most of the seroreactive dogs were exposed to R. amblyommatis-infected ticks. Highest canine seroreactivity rates per locality (13.1-30.8%) were found in Amazon biome, where A. cajennense s.s. predominated. Lowest seroreactivity rates (1.9-6.5%) were found in Cerrado localities that were further from the Amazon, where A. sculptum predominated. Multivariate analyses revealed that canine seroreactivity to Rickettsia spp. or R. amblyommatis was statistically associated with rural dogs, exposed to Amblyomma ticks.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
In the RE-LY clinical trial, dabigatran presented a better effectiveness/safety profile when compared to warfarin. However, clinical trials are not very representative of the real-world setting. We ...aimed to assess the performance of dabigatran in real-world patients with atrial fibrillation (AF) by means of a systematic review and meta-analysis of observational comparison studies with vitamin K antagonists (VKA). We searched PubMed, Embase and Scopus databases until November 2015 and selected studies according to the following criteria: observational study performed with nonvalvular AF patients; reporting adjusted hazard ratios (HR) of clinical events in a follow-up period; for dabigatran 75 mg, 110 mg or 150 mg versus VKA. Twenty studies were selected which included 711,298 patients, 210,279 of which were treated with dabigatran and the remaining 501,019 with VKA. Ischaemic stroke incidence was of 1.65 /100 patient-years for dabigatran and 2.85/100 patient-years for VKA (HR 0.86, 95 % confidence interval of 0.74-0.99). Major bleeding rate was 3.93/100 patient-years for dabigatran and 5.61/100 patient-years for VKA (0.79, 0.69-0.89). Risk of mortality (0.73, 0.61-0.87) and intracranial bleeding (0.45, 0.38-0.52) were significantly lower in patients treated with dabigatran when compared to patients on VKA. Risk of gastrointestinal (GI) bleeding was significantly higher in patients treated with dabigatran (1.13, 1.00-1.28). No significant difference was observed in risk of myocardial infarction (0.99, 0.89-1.11). In this combined analysis of real-world observational comparison studies with VKA, dabigatran was associated with a lower risk of ischaemic stroke, major bleeding, intracranial bleeding and mortality, higher risk of GI bleeding and a similar risk of myocardial infarction.
The stegosaur species Miragaia longicollum was erected based on a partial anterior skeleton from the Upper Jurassic of Portugal. Until then, almost all stegosaur specimens in Portugal and Spain had ...been identified as Dacentrurus armatus, the sister taxon of M. longicollum and only other member of the clade Dacentrurinae. The holotypes of the two species have little overlap, since the holotype of D. armatus is mostly a posterior skeleton, so the classification of other specimens to either species is unclear and the validity of M. longicollum has been questioned and debated. Here we describe a largely complete specimen of M. longicollum discovered in 1959 in Atouguia da Baleia, Peniche, Portugal, consisting of both anterior and posterior portions of the skeleton. Comparisons to the holotypes of dacentrurines and other stegosaurs shed light on the convoluted relationships of this group. We conclude that M. longicollum is valid and rather different from D. armatus, and provide a revised diagnosis of M. longicollum, as well as revised diagnoses for D. armatus, Dacentrurinae, and the first diagnosis of the genus Miragaia, granting stability to these taxa and allowing new considerations to be given on the classification of other Iberian stegosaurs. This new specimen is, to date, the most complete dinosaur described from Portugal and the most complete stegosaur described from Europe. Miragaia shared anatomical features that show a close affinity to Alcovasaurus longispinus, confirming this to be the first known dacentrurine stegosaur in America, coherent with the hypothesis of an ephemeral land bridge between North America and Iberia that allowed faunal exchange.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Phlebotomine sand flies are crepuscular and nocturnal small dipteran insects in the family Psychodidae. Several disease agents, including
Leishmania
parasites, are transmitted to humans and other ...vertebrate hosts by the bite of an infected female sand fly. As part of leishmaniasis surveillance programs, light traps have been routinely used in sand fly collections. In this context, new trapping devices are always being required to improve vector monitoring. Here, the efficiency of a new suction light trap, named Silva suction trap or SS trap, was field evaluated in collecting sand flies. Two SS traps, one with green (520 nm, 15,000 mcd) and the other with white (wide spectrum, 18,000 mcd) LEDs, and one CDC-type trap were deployed in a rural forested environment. A total of 4686 phlebotomine sand flies were captured. The most frequent species were females of the
Ps. Chagasi
series (77.8%) followed by males of
Ps. wellcomei
(11.6%),
Nyssomyia whitmani
(3.3%), and
Bichromomyia flaviscutellata
(2.4%). The CDC-type light trap collected 101.9 ± 20.89 sand flies and 14 species, followed by the white-baited SS trap (87.78 ± 16.36, 14), and the green-baited SS trap (70.61 ± 14.75, 15), but there were no statistically significant differences among traps. A discussion on the considerable advantages of the use of SS traps over CDC traps is included. In this study, the Silva suction trap proved to be efficient and can be an alternative to CDC traps for monitoring adult phlebotomine sand fly populations.
Several predictors of relapse after catheter ablation of atrial fibrillation (AF) have been established, but assessing each patient's individual risk remains challenging. Our aim was to develop and ...validate a score to estimate the risk of AF recurrence after the first radiofrequency pulmonary vein isolation (PVI) procedure.
Independent predictors of AF relapse were identified retrospectively in a two-centre registry of 1934 patients who underwent a first PVI procedure. Using the Cox regression hazard ratios of designated variables, a risk score was developed in a random sample of 50% of the patients (development cohort) and validated in the remaining (validation cohort) half. The accuracy and discriminative power of the predictive model were assessed in both subgroups. During a follow-up of 4.2 ± 2.7 years, 522 patients (27%) relapsed. Five independent predictors of AF recurrence were identified and included in the score: age >60 years (1 point), female sex (4 points), non-paroxysmal AF (2 points), current smoking (7 points) and indexed left atrial volume (1 point for each 10 mL/m2). The score showed good discriminative power (censored c-statistic of 0.75 in both cohorts). In the development group, AF relapse rates were 8, 11, and 17%/year for low (<6 points), intermediate (6-10 points), and high-risk patients (>10 points), respectively (P < 0.001). In the validation group, AF recurrence rates were 8, 11, and 18%/year, respectively (P < 0.001).
A simple risk score to estimate the rate of AF recurrence after ablation was developed and validated. An external assessment of its usefulness as a patient selection tool seems warranted.