Reprotoxicity induced by acute exposure to aqueous tuber extract of Peruvian Maca (Lepidium meyenii Walp.) in Caenorhabditis elegans.

Maca (Lepidium meyenii Walp.) has been used in folk medicine to treat fertility disturbances, a claim that has been evidenced in some studies. However, the clinical trials validating this use have shown paradoxical findings and then maca safety is not well known. This study investigated the effects and mechanisms by which maca affects the reproductive system using an in vivo model, the nematode Caenorhabditis elegans. Tuber maca powder, obtained from local commerce, was used to prepare the aqueous extract. Worms were acutely exposed to maca extracts (40, 120, 240, and 330 µg/µl), and 48 h after treatments, physiological and biochemical assays were conducted. Maca extract caused a significant decrease in total number of eggs and in the number of eggs per worm. These effects were associated to increased lipid peroxidation, reduced triacylglycerol levels, and also impaired vit-2 (vitellogenin) expression, besides increase in the number of apoptotic germline cells. We have found quantifiable levels of alkaloids in this maca extract, which presence could be related to this toxicity. Collectively, our data suggest that maca extract exposure causes reproductive toxicity to worms that could be, at least in part, associated to both an increase in apoptosis of germline cells and also to a decrease in vitellogenin expression, needed for egg yolk production and, consequently, successful reproduction.

Proteus mirabilis resistant to carbapenems isolated from a patient with a venous leg ulcer: a case report.

OBJECTIVE: The aim of the study was to phenotypically investigate the expression of the enzyme Klebsiella pneumoniae carbapenemase (KPC) in a Proteus mirabilis sample resistant to carbapenems, isolated from the wound of a patient with a venous leg ulcer (VLU) treated at an outpatient referral service. METHOD: This was a case study conducted with a patient who had a VLU on the lower left limb. Samples were taken for the examination of microbiological material from the patient's wound, using an aseptic technique. The colonies extracted were submitted to Gram staining and biochemical tests to identify the strain. In addition, an antimicrobial susceptibility test, E-test and a modified Hodge test were performed. RESULTS: The identified microorganism was Proteus mirabilis, which showed resistance to cefuroxime and the carbapenems imipenem and meropenem. As well as the minimum inhibitory concentration (MIC) of 3.0µg/ml for imipenem, demonstrating resistance, there was no KPC production by the tested isolate, which presented a negative modified Hodge test. CONCLUSION: The results highlight the importance of microbiological surveillance, aimed at reducing morbidity and mortality rates associated with infection by multiresistant bacteria.

Sleep of Wheelchair Rugby Athletes: Training, Rest and Competition.

The aim of this study was to evaluate the sleep-wake cycle of wheelchair rugby athletes during the pre-season compared to in-season. Wheelchair Rugby athletes wore an actigraph monitor during two respective 10-day periods: 1) pre-season and 2) in-season, each of which comprised three training days, three rest days, and four competition days, respectively. In addition, the players completed questionnaires regarding sleepiness, subjective quality of sleep, and chronotype, as well as the use of the sleep diary along with the actigraph measurements (20 days). The wheelchair rugby athletes had poor subjective sleep quality in both stages observed by sleep efficiency below 85% (ES 0.31) and high score in the Pittsburgh questionnaire (effect size-ES 0.55), the actigraphy results presented an increase of sleep latency (ES 0.47), and wake after sleep onset (ES 0.42). When comparing the athlete's routine, the competition days, demonstrated a reduction in the total time of sleep and the sleep efficiency, in addition to an increase in wakefulness after sleep onset when compared with the training and rest periods. As a result, the wheelchair rugby players did not describe a pattern of sleep-wake cycle during different training phases, as well as poor sleep quality.

Influence of Complete Denture Use on Respiratory Capacity: A Systematic Review.

AIM AND OBJECTIVE: This study aimed to determine whether the use of complete dentures has an influence on the respiratory capacity, assessed by the spirometry examination. MATERIALS AND METHODS: A systematic review was conducted following the Preferred Reporting Items for Systematic Review and Meta-Analysis and registered in the International Prospective Register of Systematic Reviews (CRD42021255224). The PICO question (population/exposure/comparison/outcome) was "Does the use of complete dentures influence the respiratory capacity of a toothless subject?" A search strategy was adapted for the PubMed/MEDLINE, The Cochrane Library, OpenGrey, Lilacs, Scopus, and Embase databases. Inclusion criteria were prospective and retrospective studies. The new castle ottawa (NOS) scale and the Methodological Index for Non-randomized studies were selected to assess the quality of the included studies. RESULTS: Four studies were selected, totalizing the evaluation of 242 participants, aged ranging from 40 to 73 years old. Two studies concluded that the use of complete dentures can negatively affect the respiratory capacity. One study stated that it did not interfere regardless of its use during spirometric measurements, and the other reported that dental prosthesis was required in cases of evaluation of the extrathoracic airways. CONCLUSION: The use of complete dentures did not represent relevant changes from the reference values for pulmonary function in the spirometry test. Considering the results of this review, it is not yet possible to establish a clinical protocol for the use of complete dentures during the test. CLINICAL SIGNIFICANCE: Oral rehabilitation with conventional complete dentures is widely used for the treatment of edentulism, especially in elderly patients. In addition, with aging, many complex changes in immunity and respiratory function contribute to the increase in the development of lung diseases. Therefore, it is important to establish a guidance regarding the use or not of the removable dental prostheses in the respiratory capacity test through spirometry examination.

Load Monitoring Variables in Training and Competition Situations: A Systematic Review Applied to Wheelchair Sports.

The aim of this review was to identify the main variables for load monitoring in training and competition situations in wheelchair sports. Studies were identified from a systematic search of three databases (PubMed, Web of Science, and SportDiscuss), with search phrases constructed from MeSH terms, alone or in combination, limited to English-language literature, and published up to January 2016. Our main findings were that variables related to external load (distance, speed, and duration) are used to monitor load in competition. In training situations, researchers have used variables related to internal load (heart rate and VO2); in both training and competition situations, researchers used internal load measurements (training impulse and ratings of perceived exertion). We conclude that the main variables for load monitoring in competitive situations were distance, speed, and duration, whereas the variables for training situations were heart rate, VO2, training impulse, and ratings of perceived exertion.

Assessment of Body Composition and Sport Performance of Brazilian Paralympic Swim Team Athletes.

CONTEXT: Body-composition assessments of high-performance athletes are very important for identifying physical performance potential. Although the relationship between the kinanthropometric characteristics and performance abilities of Olympic swimmers is extremely important, this subject is not completely understood for Paralympic swimmers. OBJECTIVE: To investigate the relationship between body composition and sport performance in Brazilian Paralympic swimmers 6 mo after training. DESIGN: Experimental pre/posttest design. SETTING: Research laboratory and field evaluations of swimming were conducted to verify the 50-m freestyle time of each athlete. PARTICIPANTS: 17 Brazilian Paralympic swim team athletes (12 men, 5 women). MAIN OUTCOME MEASURES: Body-composition assessments were performed using a BOD POD, and swimming performance was assessed using the 50-m freestyle, which was performed twice: before and after 6 mo of training. RESULTS: Increased lean mass and significantly reduced relative fat mass and swimming time (P < .05) were observed 6 mo after training. Furthermore, a positive correlation between body-fat percentage and performance (r = .66, P < .05) was observed, but there was no significant correlation between body density and performance (r = -.14, P > .05). CONCLUSIONS: After a 6-mo training period, Paralympic swimmers presented reduced fat mass and increased lean body mass associated with performance, as measured by 50-m freestyle time. These data suggest that reduced fat-mass percentage was significantly correlated with improved swimming performance in Paralympic athletes.

Toxoplasma gondii seroprevalence and risk factors in cats in Rio de Janeiro.

Seroprevalence studies on cats are essential for monitoring the occurrence of Toxoplasma gondii infection. The present research investigated anti-T. gondii antibodies, risk factors, clinical signs, hematology and serum biochemistry in cats from different regions of Rio de Janeiro. An overall 18.7% (17/91) of the cats were seroreactive, and age was associated with increased chances of seroprevalence of anti-T. gondii antibodies. Clinical signs, hematology and serum biochemistry parameters did not help achieve an antemortem diagnosis of cat toxoplasmosis. The parasite circulates in cats from three major regions of Rio de Janeiro, and the present data set will contribute to future epidemiological studies in this endemic state of Brazil.

Reference growth curves of anthropometric markers in Brazilian children and adolescents aged 7-14 years from southern Brazil.

Reference growth curves are viable tools for monitoring somatic growth. Therefore, the objective of this study was to develop reference growth curves for body mass, height, body mass index (BMI), waist circumference (WC) and waist-to-height ratio (WHtR) in Brazilian children and adolescents aged 7-14 years. The reference growth curves were constructed from a cross-sectional panel study using data from four surveys conducted in 2002, 2007, 2012/2013 and 2018/2019, with 9675 children and adolescents aged 7-14 years, of both sexes from Florianopolis, Southern Brazil. Growth curves were constructed using the LMS method, based on anthropometric indicators and indices (body mass, height, BMI, WC and WHtR), measured according to standardised norms. There was an increase in body mass, height, BMI and WC values with increasing age in both sexes and percentiles (P5, P10, P25, P50, P75, P85 and P95). The girls presented higher values of body mass, BMI and WC in the analysed percentiles, compared to the boys. Regarding height, there was a higher value from 10 to 11 years old in girls and from 12 to 14 years old in boys. WHtR decreased with increasing age in both sexes and analysed percentiles. Region-specific reference growth curves can enable the monitoring of somatic growth of particular paediatric populations, expanding discussions in different regions of the world.

Vegetarian and plant-based diets associated with lower incidence of COVID-19.

Objective: To evaluate the influence of dietary patterns on the incidence and evolution of COVID-19. We hypothesised that a plant-based diet or a vegetarian diet compared with an omnivorous diet might be associated with a lower incidence of COVID-19 infection and severity in those infected. Design: In this observational study, 702 participants provided information on sociodemographic characteristics, dietary information and COVID-19 outcomes between March and July of 2022. Individuals were divided into two groups based on their dietary habits, omnivorous (n=424) and plant-based (n=278). The plant-based group was further divided into vegetarian and flexitarian subgroups. The groups were compared with respect to the incidence of COVID-19 infection, severity and duration. We used multivariable logistic regression models to evaluate the influence of dietary patterns. Results: Plant-based and vegetarian groups had a higher intake of vegetables, legumes and nuts, and lower intake of dairy and meat. After adjusting for important confounders, such as body mass index, physical activity and pre-existing medical conditions, the plant-based diet and vegetarian group had 39% (OR=0.61, 95% CI 0.44 to 0.85; p=0.003) and 39% (OR 0.61, 95% CI 0.42 to 0.88; p=0.009) lower odds of the incidence of COVID-19 infection, respectively, compared with the omnivorous group. No association was observed between self-reported diets and COVID-19 severity or duration. Conclusion: Plant-based and mainly vegetarian diets were associated with a lower incidence of COVID-19 infection. These dietary patterns may be considered protective against COVID-19 infection. (Study protocol registered in CAAE: 54351421.4.0000.0068.).

PI3K Signaling Pathways as a Molecular Target for Glioblastoma Multiforme.

Glioblastoma multiforme (GBM) is the most common type of cancer that affects the central nervous system (CNS). It currently accounts for about 2% of diagnosed malignant tumors worldwide, with 296,000 new cases reported per year. The first-choice treatment consists of surgical resection, radiotherapy, and adjuvant chemotherapy, which increases patients' survival by 15 months. New clinical and pre-clinical research aims to improve this prognosis by proposing the search for new drugs that effectively eliminate cancer cells, circumventing problems such as resistance to treatment. One of the promising therapeutic strategies in the treatment of GBM is the inhibition of the phosphatidylinositol 3-kinase (PI3K) pathway, which is closely related to the process of tumor carcinogenesis. This review sought to address the main scientific studies of synthetic or natural drug prototypes that target specific therapy co-directed via the PI3K pathway, against human glioblastoma.

Insecticidal activity of fluralaner (Exzolt®) administered to Gallus gallus domesticus against triatomines (Hemiptera, Reduviidae, Triatominae).

BACKGROUND: Triatoma infestans, Triatoma brasiliensis, Triatoma pseudomaculata and Rhodnius prolixus are vectors of Trypanosoma cruzi, the etiological agent of Chagas disease. Chickens serve as an important blood food source for triatomines. This study aimed to assess the insecticidal activity of fluralaner (Exzolt®) administered to chickens against triatomines (R. prolixus, T. infestans, T. brasiliensis and T. pseudomaculata). METHODS: Twelve non-breed chickens (Gallus gallus domesticus) were randomized based on weight into three groups: negative control (n = 4); a single dose of 0.5 mg/kg fluralaner (Exzolt®) (n = 4); two doses of 0.5 mg/kg fluralaner (Exzolt®) (n = 4). Nymphs of 3rd, 4th and 5th instars of R. prolixus, T. infestans, T. brasiliensis and T. pseudomaculata (all n = 10) were allowed to feed on chickens before treatment, and at intervals of 1, 7, 14, 21, 28, 35 and 56 days after treatment, with insect mortality determined. RESULTS: Treatment with two doses of fluralaner showed higher insecticidal efficacy against R. prolixus, T. infestans and T. brasiliensis compared to the single-dose treatment. Similar insecticidal efficacy was observed for T. pseudomaculata for one and two doses of fluralaner. Insecticidal activity of fluralaner (Exzolt®) against triatomine bugs was noted up to 21 and 28 days after treatment with one and two doses of fluralaner, respectively. CONCLUSIONS: The results demonstrate that treatment of chickens with fluralaner (Exzolt®) induces insecticidal activity against triatomines for up to 28 days post-treatment, suggesting its potential use as a control strategy for Chagas disease in endemic areas.

Transcultural Comparison of Mental Health and Work-Life Integration Blurring in the Brazilian and Spanish Populations during COVID-19.

The study aimed to compare the impact of Role Blurring on mental health and Work-Life Integration in the Brazilian and Spanish populations during COVID-19. Role Blurring, which is related to resources and demands in the work context, affects coping with stressors arising from role overlapping and impacts individuals' perception of work overload and mental health. The sample consisted of 877 adults from Spain (n = 498) and Brazil (n = 372), and various statistical analyses were conducted to compare the groups. Results showed that Role Blurring is linked to symptoms of anxiety, depression, and stress, as well as suicidal ideation. Therefore, it is essential to promote working conditions that limit expectations on availability and favor disconnection from work during leisure time. Public policies that intervene, promote, and prevent psychosocial risk factors in emergent contexts are crucial to prevent suicidal ideation and attempts. Considering the high expected influence of Blurring as a focus of interventions can be reflected in the medium term in the indicators of well-being and satisfaction of companies, institutions and organizations. This can result in the reduction of health costs aimed at cushioning post-COVID-19 impacts on mental health. The study is relevant to understand the impact of the pandemic and technology on mental health and suggests the need for interventions to promote work-life balance and prevent psychosocial risks.

Temporal assessment of entomological surveillance of Trypanosoma cruzi vectors in an endemic area of northeastern Brazil.

Entomological surveillance is essential for the control of triatomines and the prevention of Trypanosoma cruzi infection in humans and domestic animals. Thus, the objective of this study was to evaluate entomological indicators and triatomine control during the period from 2005 to 2015 in an endemic area in the state of Rio Grande do Norte, Brazil. This observational and retrospective study was developed based on data analysis related to active entomological surveillance activities and chemical control of infested housing units (HU) in the Agreste mesoregion of the state of Rio Grande do Norte, Brazil, in the period between 2005 to 2015. The quantitative analysis of housing units surveyed for entomological indicators was performed by linear regression of random effects (p < 0.05). The effect of the number of HU surveyed on the entomological indicators was analyzed by fitting a linear random effects regression model and an increasing intradomiciliary colonization rate was significant. In the period evaluated 92,156 housing units were investigated and the presence of triatomines was reported in 4,639 (5.0%). A total of 4,653 specimens of triatomines were captured and the species recorded were Triatoma pseudomaculata (n = 1,775), Triatoma brasiliensis (n = 1,569), Rhodnius nasutus (n = 741) and Panstrongylus lutzi (n = 568), with an index of natural infection by T. cruzi of 2.2%. Only 53.1% of the infested HU were subjected to chemical control. Moreover, there was a decrease in the total number of HU surveyed over time associated with an increase in the index of intradomiciliary colonization (p = 0.004). These data demonstrated that entomological surveillance and control of vectors in the Agreste mesoregion of the state has been discontinued, emphasizing the need for more effective public policies to effectively control the vectors, in order to avoid the exposure of humans and domestic animals to the risk of T. cruzi infection.

Methodological aspects and characteristics of participants in the study on the prevalence of obesity in children and adolescents in Florianópolis, Southern Brazil, 2018-2019: EPOCA study.

PURPOSE: To describe the methodological aspects and characteristics of the participants of the EPOCA survey. METHODS: The study was conducted with schoolchildren aged between seven to 14 years old from 30 schools in Florianópolis, Southern Brazil. Body mass, height, girths, and skinfold thicknesses were measured. Food consumption and physical activity from the previous day were self-reported using the validated Web-CAAFE questionnaire. Adolescents completed a specific questionnaire about physical activity, meal consumption, and weight control behaviors. Parents/guardians responded to a sociodemographic and habits questionnaire. RESULTS: A total of 1671 schoolchildren participated in the study (response rate: 27.2%). About 63% of schoolchildren were enrolled in public schools. Most studied in the morning shift (54.2%), were female (53.1%) and aged between seven and 10 years (58.1%). The prevalence of overweight was 33.7% and obesity was 11.3%. CONCLUSIONS: The data obtained will allow us to assess the trend in the prevalence of overweight and obesity and associated factors when compared to other surveys performed. Descriptions of the logistics and protocols can help in the development and improvement of similar studies. It is hoped that the results of EPOCA 2018/2019 may help in the design of obesity prevention policies and programs for this population.

Empagliflozin: Validation of Stability-Indicating LC Method and in silico Toxicity Studies.

A new stability-indicating liquid chromatography method was developed for the quantification of empagliflozin and two synthetic impurities. The chromatographic conditions included Spherisorb® RP-18 column (150 × 4.6 mm, 5 µm) with a PDA detector, using acetonitrile and formic acid (pH 4.0) as mobile phase in gradient elution and flow-rate of 1.2 mL·min-1. The gradient increasing from 51 to 100% acetonitrile until 11.00 min, followed by decreasing the solvent from 100% to the initial ratio from 11.01 to 15.00 min. The method was validated according to International Council of Harmonization guidelines. The LOD and LOQ values for impurities A and B were 35 and 15 ng·mL-1, respectively, (for LOD) and 115 and 35 ng.mL-1, respectively (for LOQ). The method was linear in the range of 80-140, 115-1150 and 35-350 ng·mL-1 for EMPA, impurities A and B, respectively, and the correlation coefficient were > 0.999 in all situations, indicating the method good linearity. The developed method showed a good recovery for empagliflozin and added impurities. The method has proven to be precise, demonstrated values less than 2.0% to empagliflozin and 5.0% to synthetic impurities, robust and selective with no interference from other products in the determination of analytes. The in silico toxicity prediction suggested that the impurities do not present any toxicity risk for the parameters evaluated.

Internal Structure, Invariance, and Rasch Analyses: A Work-Life Integration-Blurring Scale.

The aim of the study was to develop a role blurring (RB) tool to measure work-life integration in different contexts. A final number of 19 items was examined. Psychometric properties in both Spanish and Brazilian Portuguese versions were analysed, comparing the invariance of the measure between the two countries, and setting the difficulty parameter of the items. Thus, a total of two incidental samples volunteered to participate in the study: a Spanish sample of n = 498 and a Brazilian sample of n = 379 were recruited. Confirmatory factor analysis (CFA), as well as an invariance analysis, were performed between the two countries, in order to test the homogeneity structure of the measure. In addition, the item response theory (IRT) was used to establish the probability of response and difficulty of the items through a Rasch analysis. The confirmatory factor analysis pointed to a unifactorial structure. There were no statistically significant alterations in the model fit indices, and the Rasch rating scale model (RSM) showed adequate infit and outfit values, as well as successive response categories located in the expected order for all items.

Sensory and motor cortical excitability changes induced by rTMS and sensory stimulation in stroke: A randomized clinical trial.

Background: The ability to produce coordinated movement is dependent on dynamic interactions through transcallosal fibers between the two cerebral hemispheres of the brain. Although typically unilateral, stroke induces changes in functional and effective connectivity across hemispheres, which are related to sensorimotor impairment and stroke recovery. Previous studies have focused almost exclusively on interhemispheric interactions in the primary motor cortex (M1). Objective: To identify the presence of interhemispheric asymmetry (ASY) of somatosensory cortex (S1) excitability and to investigate whether S1 repetitive transcranial magnetic stimulation (rTMS) combined with sensory stimulation (SS) changes excitability in S1 and M1, as well as S1 ASY, in individuals with subacute stroke. Methods: A randomized clinical trial. Participants with a single episode of stroke, in the subacute phase, between 35 and 75 years old, were allocated, randomly and equally balanced, to four groups: rTMS/sham SS, sham rTMS/SS, rTMS/SS, and sham rTMS/Sham SS. Participants underwent 10 sessions of S1 rTMS of the lesioned hemisphere (10 Hz, 1,500 pulses) followed by SS. SS was applied to the paretic upper limb (UL) (active SS) or non-paretic UL (sham SS). TMS-induced motor evoked potentials (MEPs) of the paretic UL and somatosensory evoked potential (SSEP) of both ULs assessed M1 and S1 cortical excitability, respectively. The S1 ASY index was measured before and after intervention. Evaluator, participants and the statistician were blinded. Results: Thirty-six participants divided equally into groups (nine participants per group). Seven patients were excluded from MEP analysis because of failure to produce consistent MEP. One participant was excluded in the SSEP analysis because no SSEP was detected. All somatosensory stimulation groups had decreased S1 ASY except for the sham rTMS/Sham SS group. When compared with baseline, M1 excitability increased only in the rTMS/SS group. Conclusion: S1 rTMS and SS alone or in combination changed S1 excitability and decreased ASY, but it was only their combination that increased M1 excitability. Clinical trial registration: clinicaltrials.gov, identifier (NCT03329807).

Somatosensory Cortex Repetitive Transcranial Magnetic Stimulation and Associative Sensory Stimulation of Peripheral Nerves Could Assist Motor and Sensory Recovery After Stroke.

Background: We investigated whether transcranial magnetic stimulation (rTMS) over the primary somatosensory cortex (S1) and sensory stimulation (SS) could promote upper limb recovery in participants with subacute stroke. Methods: Participants were randomized into four groups: rTMS/Sham SS, Sham rTMS/SS, rTMS/SS, and control group (Sham rTMS/Sham SS). Participants underwent ten sessions of sham or active rTMS over S1 (10 Hz, 1,500 pulses, 120% of resting motor threshold, 20 min), followed by sham or active SS. The SS involved active sensory training (exploring features of objects and graphesthesia, proprioception exercises), mirror therapy, and Transcutaneous electrical nerve stimulation (TENS) in the region of the median nerve in the wrist (stimulation intensity as the minimum intensity at which the participants reported paresthesia; five electrical pulses of 1 ms duration each at 10 Hz were delivered every second over 45 min). Sham stimulations occurred as follows: Sham rTMS, coil was held while disconnected from the stimulator, and rTMS noise was presented with computer loudspeakers with recorded sound from a real stimulation. The Sham SS received therapy in the unaffected upper limb, did not use the mirror and received TENS stimulation for only 60 seconds. The primary outcome was the Body Structure/Function: Fugl-Meyer Assessment (FMA) and Nottingham Sensory Assessment (NSA); the secondary outcome was the Activity/Participation domains, assessed with Box and Block Test, Motor Activity Log scale, Jebsen-Taylor Test, and Functional Independence Measure. Results: Forty participants with stroke ischemic (n = 38) and hemorrhagic (n = 2), men (n = 19) and women (n = 21), in the subacute stage (10.6 ± 6 weeks) had a mean age of 62.2 ± 9.6 years, were equally divided into four groups (10 participants in each group). Significant somatosensory improvements were found in participants receiving active rTMS and active SS, compared with those in the control group (sham rTMS with sham SS). Motor function improved only in participants who received active rTMS, with greater effects when active rTMS was combined with active SS. Conclusion: The combined use of SS with rTMS over S1 represents a more effective therapy for increasing sensory and motor recovery, as well as functional independence, in participants with subacute stroke. Clinical Trial Registration: [clinicaltrials.gov], identifier [NCT03329807].

Association between quality of life and risk behaviors in Brazilian adolescents: An exploratory study.

We evaluated the association between risk behaviors and quality of life in 1,081 adolescents classified into the risk behavior (RB) or the non-risk behavior (nRB) group. The data were analyzed with logistic regression models, analysis of variance, and network analysis. The nRB group had higher quality-of-life scores, and having a religion (OR = .42) and better quality of life (OR = .95) significantly reduced the odds of risk behaviors. The network analysis identified that religion, gender, and type of school showed the best centrality and connectivity indices. These data showed a negative association between risk behaviors and lower quality-of-life levels.