Preliminary studies have showed that the Incremental Shuttle Walking Test (ISWT) is a maximal test, however comparison between ISWT with the cardiopulmonary exercise test (CEPT) has not yet performed ...in the healthy woman population. Furthermore, there is no regression equation available in the current literature to predict oxygen peak consumption (VO2 peak). Thus, this study aimed to compare the ISWT with CEPT and to develop an equation to predict peak oxygen uptake (VO2 peak) in healthy women participants.
First, the VO2 peak, respiratory exchange ratio (R peak), heart rate max (HR max) and percentage of predicted HR max (% predicted HR max) were evaluated in the CEPT and ISWT (n = 40). Then, an equation was developed to predict the VO2 peak (n = 54) and its validation was performed (n = 20).
There were no significant differences between the ISWT and CEPT of VO2 peak, HR max and % predicted HR max values (P>0.05), except for R peak measure in the ISWT (1.22 ± 0.13) and CEPT (1.18 ± 0.1) (P = 0.022). Therefore, both tests showed a moderate positive correlation of VO2 peak (r = 0.51; P = 0.0007), HR max (r = 0.65; P<0.0001) and R peak (r = 0.55; P = 0.0002) and the Bland-Altman analysis showed agreement of VO2 peak (bias = -0.14). The distance walked on ISWT and age explained 36.3% (R2 Adjusted = 0.363) of the variance in VO2 peak. The equation developed was VO2 peak (predicted) = 19.793 + (0.02 x distance walked)-(0.236 x age). There was no statistically significant difference between the VO2 peak measured directly and the predicted, and the Bland-Altman analysis showed agreement (bias = 1.5 ml/kg/min).
ISWT is a maximal test showing similar results compared to the CEPT, and the predicted equation was valid and applicable for VO2 peak assessing in young adult healthy women.
The effect of anti-algics on tumor progression and the overall survival of patients is controversial and remains unclear. Herein, we disclose the in vitro effects of the local anesthetics lidocaine, ...ropivacaine, and levobupivacaine on breast (MCF7), prostate (PC3, LNCaP), and bladder (TCCSUP, HT1376) cancer cell lines, both as monotherapy and in combination with standard-of-care therapeutics. Assays for cell proliferation, viability, death profile, and migration were performed. Additionally, we explored the clinical outcomes of opioid use through a cross-sectional study involving 200 metastatic prostate cancer patients. The main clinical data collected included the type of opioid therapy administered, dosage, treatment duration, disease progression, and overall survival. Results obtained demonstrate that treatment with local anesthetics has a promising selective anti-tumor effect on these types of cancer, with higher effects when associated with docetaxel. This points out the use of local anesthetics as an added value in the treatment of prostate carcinoma patients. Alternatively, chronic opioid use was correlated with reduced overall survival (
< 0.05) and progression-free survival (
< 0.05) at each treatment line in the observational study. While these results provide valuable insights, larger prospective studies are imperative to comprehensively evaluate the clinical impact of opioid analgesics in prostate cancer patients.
Enuresis is associated with attentional and emotional comorbidities in 20 to 30 % of cases. The Short Screening Instrument for Psychological Problems in Enuresis (SSIPPE) is a questionnaire that ...allows the initial screening of these comorbidities. This study aimed to translate, culturally adapt, and validate the SSIPPE for Brazilian children and adolescents (SSIPPE-Br).
Six steps were performed for translation and cross-cultural adaptation: translation, synthesis of translations, back-translation, preparation of the pre-final version of the translated instrument, test of comprehensibility of the pre-final version of the tool, and elaboration of the instrument cross-culturally adapted for Brazil, named 13-itens version SSIPPE-Br. To validate the SSIPPE-Br, a cross-sectional study was carried out, in which the validated Brazilian version of the Child and Adolescent Behavior Inventory (CABI) was used.
Validation was performed on 127 children and adolescents with a mean age of 9.7 ± 2.8 years, 48 % male. The reliability was estimated using Cronbach's alpha, ranging from 0.86 to 0.89, indicating good internal consistency. The factorial analysis had a good agreement adjustment (KMO 0.755, Bartlett's test < 0.001) and explained 70.5 % of the data variability. In the reproducibility analysis, the Kappa coefficient ranged from 0.94 to 1, which can be considered almost perfect. A highly significant (p-value < 0.001) and direct correlation existed between the three SSIPPE-Br domains and all evaluated CABI domains.
The SSIPPE-Br is a valid and reliable tool for emotional problems screening and ADHD symptoms in children and adolescents with enuresis whose first language is Brazilian Portuguese.
The La Plata basin is one of the largest river basins in the world, draining about a fifth of the South American continent. It is a system of great hydrological significance, sensitive to extreme ...events, and also has the most economic development in the region. This work analyses the total water storage (TWS) changes over the La Plata basin from the GRACE (Gravity Recovery And Climate Experiment) mission and compares it with TRMM (Tropical Rainfall Measuring Mission) rainfall data. Subsequently, a study was conducted on the main sub-basins for the period 2003 to 2017 to identify regional-scale variations in TWS. Precipitation and GLDAS (Global Land Data Assimilation System) runoff data was evaluated in these areas, along with their connections to ENSO (El Niño Southern Oscillation) episodes. The results suggest that the majority of TWS variations are associated with extreme climatic events, such as the 2009 drought, and are linked to ENSO periods. The statistical analysis indicates a significant correlation between severe Niño/Niña episodes and changes in TWS in the sub-basins.
Background
Chronic kidney disease (CKD) is a risk factor for psychosocial impairment and psychiatric symptoms. Children and adolescents on dialysis frequently have compromised daily life activities ...and a worse quality of life (QoL) compared with healthy peers. However, few studies have investigated these aspects of CKD in pediatric pre-dialysis CKD patients. Therefore, we have analyzed resilience, QoL and anxiety and depressive symptoms in children and adolescents with pre-dialysis CKD and compared these to the values of healthy controls.
Methods
Demographic and clinical data were collected from 28 children and adolescents with pre-dialysis CKD and 28 healthy sex- and age-matched controls. Psychological assessment of the participants was performed using the Wagnild and Young Resilience Scale, Pediatric Quality of Life (QoL) Inventory 4.0 , Child Depression Inventory and Self-report for Childhood Anxiety Related Disorders scales.
Results
Of the 56 children enrolled in our study, the CKD patients were referred to mental health professionals more frequently than the controls. Patients exhibited higher scores for separation anxiety and a higher frequency of clinically significant depressive symptoms. They also had lower overall QoL scores, as well as poorer scores for the psychological, educational and psychosocial subdomains of QoL instruments. There was a negative correlation between anxiety and depressive symptoms and all domains of QoL. Resilience was similar in both groups, but lower in patients with significant depressive symptoms. No significant association was found between clinical or laboratory findings and psychological variables in CKD patients.
Conclusion
Although patients and controls exhibited similar scores of resilience, CKD negatively impacted the QoL of pediatric patients, contributing to a higher frequency of depression and separation anxiety.
Activation of the renin-angiotensin (Ang) system induces inflammation via interaction between Ang II and type 1 receptor on leukocytes. The relevance of the new arm of the renin-Ang system, namely ...Ang-converting enzyme-2/Ang-(1-7)/Mas receptor, for inflammatory responses is not known and was investigated in this study. For this purpose, two experimental models were used: Ag-induced arthritis (AIA) in mice and adjuvant-induced arthritis (AdIA) in rats. Male C57BL/6 wild-type or Mas(-/-) mice were subjected to AIA and treated with Ang-(1-7), the Mas agonist AVE 0991, or vehicle. AdIA was performed in female rats that were given AVE 0991 or vehicle. In wild-type mice, Mas protein is expressed in arthritic joints. Administration of AVE 0991 or Ang-(1-7) decreased AIA-induced neutrophil accumulation, hypernociception, and production of TNF-α, IL-1β, and CXCL1. Histopathological analysis showed significant reduction of inflammation. Mechanistically, AVE 0991 reduced leukocyte rolling and adhesion, even when given after Ag challenge. Mas(-/-) mice subjected to AIA developed slightly more pronounced inflammation, as observed by greater neutrophil accumulation and cytokine release. Administration of AVE 0991 was without effect in Mas(-/-) mice subjected to AIA. In rats, administration of AVE 0991 decreased edema, neutrophil accumulation, histopathological score, and production of IL-1β and CXCL1 induced by AdIA. Therefore, activation of Mas receptors decreases neutrophil influx and cytokine production and causes significant amelioration of arthritis in experimental models of arthritis in rats and mice. This approach might represent a novel therapeutic opportunity for arthritis.
Comorbidities such as obesity, hypertension, and diabetes are associated with COVID-19 development and severity, probably due to immune dysregulation; however, the mechanisms underlying these ...associations are not clear. The immune signatures of hypertensive patients with obesity with COVID-19 may provide new insight into the mechanisms of immune dysregulation and progression to severe disease in these patients.
Hypertensive patients were selected prospectively from a multicenter registry of adults hospitalized with COVID-19 and stratified according to obesity (BMI ≥ 30 kg/m²). Clinical data including baseline characteristics, complications, treatment, and 46 immune markers were compared between groups. Logistic regression was performed to identify variables associated with the risk of COVID-19 progression in each group.
The sample comprised 213 patients (89 with and 124 without obesity). The clinical profiles of patients with and without obesity differed, suggesting potential interactions with COVID-19 severity. Relative to patients without obesity, patients with obesity were younger and fewer had cardiac disease and myocardial injury. Patients with obesity had higher EGF, GCSF, GMCSF, interleukin (IL)-1ra, IL-5, IL-7, IL-8, IL-15, IL-1β, MCP 1, and VEGF levels, total lymphocyte counts, and CD8
CD38
mean fluorescence intensity (MFI), and lower NK-NKG2A MFI and percentage of CD8
CD38
T cells. Significant correlations between cytokine and immune cell expression were observed in both groups. Five variables best predicted progression to severe COVID-19 in patients with obesity: diabetes, the EGF, IL-10, and IL-13 levels, and the percentage of CD8
HLA-DR
CD38
cells. Three variables were predictive for patients without obesity: myocardial injury and the percentages of B lymphocytes and HLA-DR
CD38
cells.
Our findings suggest that clinical and immune variables and obesity interact synergistically to increase the COVID-19 progression risk. The immune signatures of hypertensive patients with and without obesity severe COVID-19 highlight differences in immune dysregulation mechanisms, with potential therapeutic applications.
There is limited evidence regarding the impact of race/racism and its intersection with socioeconomic status (SES) on breast and cervical cancer, the two most common female cancers globally. We ...investigated racial inequalities in breast and cervical cancer mortality and whether SES (education and household conditions) interacted with race/ethnicity.
The 100 Million Brazilian Cohort data were linked to the Brazilian Mortality Database, 2004-2015 (n = 20,665,005 adult women). We analysed the association between self-reported race/ethnicity (White/'Parda'(Brown)/Black/Asian/Indigenous) and cancer mortality using Poisson regression, adjusting for age, calendar year, education, household conditions and area of residence. Additive and multiplicative interactions were assessed.
Cervical cancer mortality rates were higher among Indigenous (adjusted Mortality rate ratio = 1.80, 95%CI 1.39-2.33), Asian (1.63, 1.20-2.22), 'Parda'(Brown) (1.27, 1.21-1.33) and Black (1.18, 1.09-1.28) women vs White women. Breast cancer mortality rates were higher among Black (1.10, 1.04-1.17) vs White women. Racial inequalities in cervical cancer mortality were larger among women of poor household conditions, and low education (P for multiplicative interaction <0.001, and 0.02, respectively). Compared to White women living in completely adequate (3-4) household conditions, the risk of cervical cancer mortality in Black women with 3-4, 1-2, and none adequate conditions was 1.10 (1.01-1.21), 1.48 (1.28-1.71), and 2.03 (1.56-2.63), respectively (Relative excess risk due to interaction-RERI = 0.78, 0.18-1.38). Among 'Parda'(Brown) women the risk was 1.18 (1.11-1.25), 1.68 (1.56-1.81), and 1.84 (1.63-2.08), respectively (RERI = 0.52, 0.16-0.87). Compared to high-educated White women, the risk in high-, middle- and low-educated Black women was 1.14 (0.83-1.55), 1.93 (1.57-2.38) and 2.75 (2.33-3.25), respectively (RERI = 0.36, −0.05-0.77). Among 'Parda'(Brown) women the risk was 1.09 (0.91-1.31), 1.99 (1.70-2.33) and 3.03 (2.61-3.52), respectively (RERI = 0.68, 0.48-0.88). No interactions were found for breast cancer.
Low SES magnified racial inequalities in cervical cancer mortality. The intersection between race/ethnicity, SES and gender needs to be addressed to reduce racial health inequalities.
Background The salivary circadian diurnal cortisol plays an important role in growth and development. Inappropriate levels may induce changes associated with an increased risk of obesity later in ...life. It is unknown if there are differences in cortisol secretion pattern between overweight/obese infants when compared with theirs peers in infancy. Thus, this study aimed to compare the salivary cortisol secretion pattern in overweight/obese and normal-weight infants. Methods Thirty-three (overweight/obese = 17 and normal weight = 16) infants between 6 and 24 months of age had saliva samples collected upon awakening (T1), 30 min after waking (T2), at 12:00 am or before the baby's meal (T3), and prior to bedtime (T4). Highly sensitive enzyme immunoassays were used for cortisol analyses. Results Salivary cortisol levels were similar between the groups: T1 (p = 0.22; 95% confidence interval CI: -5.65, 1.37), T2 (p = 0.24; 95% CI: -8.23, 2.17), T3 (p = 0.95; 95% CI: -3.16, 2.96), and T4 (p = 0.81; 95% CI: -1.39, 1.08); and no differences were observed between area under the curve (AUC) (p = 0.80; 95% CI: -4.58-13.66). The cortisol level reduced in T4 (95% CI: 1.35-2.96) compared to T1 (95% CI: 5.15-8.49) and T2 in the overweight/obese group (p < 0.001; 95% CI: 6.02-11.04). In the normal-weight group, the cortisol reduced in T3 (95% CI: 2.86-8.18) compared to T1 (95% CI: 5.64-12.28) and decreased until T4 (p = 0.001; 95% CI: 1.25-3.37). Conclusions The overweight/obese infant group presented a different pattern of cortisol secretion, although cortisol levels did not differ between the control group.
Formada pela Escola Normal Modelo de Belo Horizonte, Alda Lodi é reconhecida pelo papel significativo que desempenhou no campo do ensino de matemática em Minas Gerais. Depois da temporada em que se ...dedicou aos estudos sobre Metodologia da Aritmética no Teachers College da Universidade de Columbia em Nova Iorque, Alda Lodi tornou-se professora da Escola de Aperfeiçoamento de Belo Horizonte (EA). Entre as décadas de 1940 e 1950, Alda Lodi elaborou dois programas de Aritmética e Geometria voltados para o ensino primário e publicados pela Secretaria de Educação de Minas Gerais. Nossa pesquisa tem se dedicado a investigar os elementos que a caracterizam como expert da educação. Este artigo pretende explorar as prescrições do Programa de Aritmética e Geometria escrito por Alda Lodi e publicado em 1953. Ele conecta esse documento ao programa experimental publicado em 1941 pela mesma Secretaria, cuja seção de Aritmética e Geometria também foi escrita por Lodi. A comparação entre os dois programas leva em consideração três fatores: a incorporação da EA ao Instituto de Educação de Minas Gerais (IEMG) em 1946, as mudanças contextuais do período e as discussões que Lodi desenvolveu como professora de Metodologia de Aritmética neste intervalo de tempo. Assim, este trabalho procura relacionar os saberes da matemática ensinada por Lodi nos cursos de formação de professores às prescrições curriculares presentes nesses programas de ensino. Finalmente, conclui que as reflexões sobre o ensino de Aritmética presentes nos programas de ensino analisados estão vinculadas ao trabalho docente de Lodi na EA e no IEMG.
Este artigo pretende explorar as prescrições do Programa de Aritmética e Geometria escrito por Alda Lodi e publicado em 1953. Ele conecta este documento ao programa experimental publicado em 1941 pela mesma secretaria, cuja seção de Aritmética e Geometria também foi escrita por Lodi. A comparação entre os dois programas leva em consideração três fatores: a incorporação da EA ao Instituto de Educação de Minas Gerais em 1946, as mudanças contextuais do período e as discussões que Lodi desenvolveu como professora de Metodologia de Aritmética neste intervalo. Assim, este trabalho procura relacionar os saberes da matemática ensinada por Lodi nos cursos de formação de professores às prescrições curriculares presentes nestes programas de ensino.
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