Patterns of childhood adversity and health outcomes in early adolescence: Results from the Generation XXI cohort.

This longitudinal population-based birth cohort study aims to identify childhood adversity patterns over the first 13 years of life and to examine its association with health-related behaviours and outcomes in early adolescence. Using data from the Portuguese birth cohort Generation XXI, we performed latent class analysis to explore the underlying patterns of adversity from birth to early adolescence, using 13 adversity items assessed in five time points. Health-related behaviours and outcomes were evaluated at 13 years. Adjusting for parental unemployment, logistic regression models were performed to determine the association between adversity patterns and outcomes. Among 8647 participants, three adversity patterns were identified: "low adversity" (56.1%), "household dysfunction" (17.2%) and "multiple adversities" (26.7%). For the "household dysfunction" pattern, girls and boys showed associations with increased odds of alcohol/tobacco use (adjusted odds ratio [AOR]: 1.78; 95% confidence interval [CI]: 1.32-2.40; AOR:1.84; CI:1.38-2.46, respectively) and depressive symptoms (AOR:2.34; CI:1.58-3.48; AOR:5.45; CI:2.86-10.38, respectively). Boys also presented low consumption of fruits/vegetables (AOR:1.51; CI:1.04-2.19). For the "multiple adversities" pattern, both girls and boys showed an increased probability of alcohol/tobacco use (AOR:1.82; CI:1.42-2.33; AOR:1.63; CI:1.30-2.05, respectively) and depressive symptoms (AOR:3.41; CI:2.46-4.72; AOR:5.21; CI:2.91-9.32, respectively). Boys also revealed increased odds of low consumption of fruits/vegetables (AOR:1.67; CI:1.24-2.23). Childhood adversity patterns are associated with unhealthy behaviours and depressive symptoms in early adolescence. Public policies and early interventions targeting vulnerable children, families and communities can potentially reduce the detrimental effects of adversities on health and promote individual and community resilience.

Survival of clinical and environmental carbapenem-resistant Klebsiella pneumoniae ST147 in surface water.

Carbapenem-resistant Klebsiella pneumoniae represents a healthcare threat, already disseminated in the environment. This study aimed to compare the behaviour of a clinical and an environmental K. pneumoniae strain (multilocus sequence type ST147) harbouring the gene blaKPC-3 in water. The abundance of the genes phoE (specific for K. pneumoniae) and blaKPC-3 was monitored by quantitative PCR in urban runoff water and sterile ultra-pure water microcosms, aiming to assess survival, blaKPC-3 persistence, and the effect of the native water microbiota. In sterile ultra-pure water, the abundance of cultivable K. pneumoniae and blaKPC-3 gene did not change over the incubation period (8 days). In contrast, in urban runoff, the K. pneumoniae and the genes phoE and blaKPC genes decreased by up to 3 log-units. These results suggest that K. pneumoniae were outcompeted by the native microbiota of the urban runoff water and that the decay of blaKPC-3 gene was due to host death, rather than to gene loss. The study highlights that although native microbiota is essential to hamper the persistence of non-native bacteria, carbapenemase producing K. pneumoniae can survive in urban runoff water for at least one week.

Novel photoelectrochemical 3D-system for water disinfection by deposition of modified carbon nitride on vitreous carbon foam.

Graphitic carbon nitride (GCN) is an optical semiconductor with excellent photoactivity under visible light irradiation. It has been widely applied for organic micropollutant removal from contaminated water, and less investigated for microorganisms' inactivation. The photocatalytic degradation mechanism using GCN is attributed to a series of reactions with reactive oxygen species and photogenerated holes that can be boosted by modifying its physical-chemical structure. This work reports a successful improvement of the overall photocatalytic and electrocatalytic activities of the pristine material by thermal and chemical modification by a copolymerisation synthesis method. The copolymerisation of dicyandiamide as a precursor with barbituric acid strongly reduced photoluminescence due to the enhanced charge separation thus improving the catalyst efficiency under visible light irradiation. The material with 1.6 wt% of barbituric acid showed the best photocatalytic performance and electrochemical properties. This photocatalyst was selected for immobilisation on a conductive carbon foam, which promotes a higher electrochemical active surface area and enhanced mass transfer. This three-dimensional metal-free electrode was employed for the photoelectrochemical inactivation of two different microorganisms, Escherichia coli, and Enterococcus faecalis, obtaining removals below the detection limit after 30 min in simulated faecal-contaminated waters. This photoelectrochemical reactor was also applied to treat polluted river and urban waste waters, and the faecal contamination indicators were vastly reduced to values below the detection limit in 60 min in both cases, showing the wide applicability of this innovative photoelectrode for different types of polluted aqueous matrices.

Disinfection of treated urban effluents for reuse by combination of coagulation/flocculation and Fenton processes.

In this study, a combination of coagulation/flocculation and Fenton processes was studied as tertiary treatment in order to generate treated water susceptible to reuse. The combination of both processes has never been applied in disinfection of real urban wastewater. The best removals of turbidity and enterobacteria were achieved when applying a coagulant (FeCl3) dosage of 120 mg/L and the natural pH of the effluent (7.14). The following Fenton reaction presented the maximal enterobacteria inactivation after 120 min at 25 °C, when using hydrogen peroxide and added iron concentrations of 100 mg/L and 7 mg/L, respectively. The abundance of antibiotic resistant (amoxicillin and sulfamethoxazole) enterobacteria and total enterobacteria, enterococci, and heterotrophs, and antibiotic resistance genes - ARG - (sul1, blaTEM and qnrS) was evaluated before and after each step of the treatment. Values below 10 CFU/100 mL were achieved for total and resistant cultivable enterobacteria immediately after treatment and after storage for 72 h, therefore meeting the strictest limit imposed for E. coli. Physico-chemical parameters also met the established limits for water reuse. Despite harbouring a rich and diverse bacterial community, the final stored disinfected wastewater contained high relative abundance of potentially hazardous bacteria. Such results point out the need of a deep microbiological characterization of treated wastewater to evaluate the risk of its reuse in irrigation.

Catalyst-free persulfate activation by UV/visible radiation for secondary urban wastewater disinfection.

This study focuses on the treatment of secondary urban wastewater (W) to improve the effluent quality aiming at the reduction of pathogenic microorganisms for the safe reuse of the treated wastewater (TW). Catalyst-free persulfate activation by radiation-based oxidation was applied as a treatment technology. A parametric study was carried out to select the best operating conditions. Total enterobacteria inactivation (quantified by the log reduction (CFU/100 mL)) was achieved when using [S2O82-] = 1 mM, pH = 8.5 (natural pH of W), T = 25 °C, and I = 500 W/m2. However, storing TW for 3 days promoted the regrowth of bacteria, risking its reutilization. Therefore, in this study, and for the first time, the potential beneficial role of inoculation of wastewater treated by the radiation-activated persulfate process with a diverse bacterial community was evaluated in order to control the regrowth of potentially harmful microorganisms through bacterial competition. For this, TW was diluted with river water (R) in the volume percentages of 5, 25, and 50 (percentages refer to R content), and enterobacteria and total heterotrophs were enumerated before and after storage for 72 h. The results showed total heterotrophs and enterobacteria regrowth for TW and R + TW diluted 5 and 25% after storage. However, for R + TW diluted 50%, only the total heterotrophs regrew. Hence, the treated wastewater generated by the oxidative process diluted with 50% river water complies with the legislated limits for reuse in urban uses or irrigation.

Prognostic significance of MUC2, CDX2 and SOX2 in stage II colorectal cancer patients.

BACKGROUND: Colorectal cancer (CRC) remains a serious health concern worldwide. Despite advances in diagnosis and treatment, about 15 to 30% of stage II CRC patients subjected to tumor resection with curative intent, develop disease relapse. Moreover, the therapeutic strategy adopted after surgery is not consensual for these patients. This supports the imperative need to find new prognostic and predictive biomarkers for stage II CRC. METHODS: For this purpose, we used a one-hospital series of 227 stage II CRC patient samples to assess the biomarker potential of the immunohistochemical expression of MUC2 mucin and CDX2 and SOX2 transcription factors. The Kaplan-Meier method was used to generate disease-free survival curves that were compared using the log-rank test, in order to determine prognosis of cases with different expression of these proteins, different mismatch repair (MMR) status and administration or not of adjuvant chemotherapy. RESULTS: In this stage II CRC series, none of the studied biomarkers showed prognostic value for patient outcome. However low expression of MUC2, in cases with high expression of CDX2, absence of SOX2 or MMR-proficiency, conferred a significantly worst prognosis. Moreover, cases with low expression of MUC2 showed a significantly clear benefit from treatment with adjuvant chemotherapy. CONCLUSION: In conclusion, we observe that patients with stage II CRC with low expression of MUC2 in the tumor respond better when treated with adjuvant chemotherapy. This observation supports that MUC2 is involved in resistance to fluorouracil-based adjuvant chemotherapy and might be a promising future predictive biomarker in stage II CRC patients.

Early life socioeconomic circumstances and cardiometabolic health in childhood: Evidence from the Generation XXI cohort.

Social adversity is thought to become biologically embedded during sensitive periods of development which could set children on a trajectory of increased risk for later diseases. This study estimated the association between early socioeconomic circumstances and cardiometabolic biomarkers during childhood. We analyzed data from 2962 participants in the birth cohort Generation XXI. Early socioeconomic circumstances included parental education and occupation and household income measured at the child's birth; cardiometabolic biomarkers included a set of parameters that were determined at seven and 10years old. The association between early socioeconomic circumstances and cardiometabolic biomarkers in children aged seven and 10years old was estimated using generalized estimating equations. We observed, after adjustment for birth weight, sex, five-a-day fruit and vegetable intake and sedentary activity, that children with low educated mothers presented higher body mass index z-score (ß=0.22; 95%CI: 0.12, 0.33), higher waist circumference (ß=1.14; 95%CI: 0.55, 1.73) and increased systolic blood pressure z-score (ß=0.15; 95%CI: 0.08, 0.22) at the age of seven. At 10years, children with mothers with low education, presented higher body mass index z-score (ß =0.32; 95%CI: 0.21, 0.43), higher waist circumference (ß=2.79; 95%CI: 1.94, 3.64), increased diastolic blood pressure z-score (ß=0.11; 95%CI: 0.06, 0.17) and increased systolic blood pressure s-score (ß=0.20; 95%CI: 0.12, 0.28). When repeated measures of cardiometabolic biomarkers were taken into account, the association between socioeconomic circumstances and cardiometabolic biomarkers remained significant. Low socioeconomic circumstances have a possible detrimental effect on children's cardiometabolic health. Thus, socioeconomic adversity might impact health outcomes already in the first decade of life, emphasizing the early social patterning of cardiometabolic health and the need of social policies targeting children and families to modify or reverse its negative impact on health.

Exposure to violence and suicidal ideation among school-going adolescents.

Objective: Despite growing international interest in the area of violence and suicidal ideation among school-going adolescents, epidemiological data are scant in Portugal. The objective of this study was to measure the prevalence of suicidal ideation among Portuguese adolescents from 7th to 12th grade and to estimate the association of violence exposure with suicidal ideation. Method: A cross-sectional survey was conducted among 2 602 adolescents enrolled in public schools in Porto, Portugal. Sampling was performed in four school groups consisting of seven schools, during the 2014/2015 academic year. Results: The results revealed that 11.4% of Portuguese school-going adolescents reported suicidal thoughts during the past 12 months. Moreover, adolescents who had been involved in physical fighting were two times more likely to have suicidal thoughts. These odds substantially increased when bullying and cyberbullying victimisation were included. Conclusion: Effective interventions with multidisciplinary efforts involving parents, school teachers, principals, and mental health professionals, should be integrated into school-based programmes to improve adolescents' mental health and strengthen them against suicidal ideation.

Use of trehalose in the semen cryopreservation of Amazonian catfish Leiarius marmoratus.

The current study assessed a semen cryopreservation protocol in the Amazonian catfish Leiarius marmoratus, a freshwater fish, of rheophilic behavior, and of great importance for Brazilian fish farming. Eight males (n = 8) were stripped and the semen was cryopreserved if total motility in fresh semen was higher than 80%. The external cryoprotectant Trehalose was then diluted in Beltsvile Thawing Solution (BTS) extender in the following concentrations: 50, 100, 150, and 200 mM. Semen samples were diluted in the media (1:9 v/v) being tested, then frozen in a container with nitrogen vapor (dryshipper), and stored in liquid nitrogen at -196 °C. Motility parameters assessed post-thawing were performed by CASA-system and sperm cell integrity analyses (membrane integrity, DNA integrity, and mitochondrial function) were performed through fluorescence microscopy. As a result, no significant statistical difference was observed between treatments, independently of Trehalose concentrations tested in the following post-thawing analysis: membrane integrity, DNA integrity, mitochondrial functionality, and sperm motility duration. As of total and progressive motilities, the treatment containing 50 mM trehalose (15.6 and 9.5%, respectively), exhibited inferior results when compared to treatments with 150 mM (22.9 and 17.7%, respectively) and 200 mM (31.4 and 26.3%, respectively) trehalose concentrations (P < 0.05); however, it did not differ from the treatment with 100 mM trehalose (18.6 and 15.3%, respectively). Therefore, treatments with trehalose at higher concentrations exhibited superior results when compared to other treatments in in vitro motility parameters for L. marmoratus.

Does Cyberbullying Prevalence Among Adolescents Relate With Country Socioeconomic and Development Indicators? An Ecological Study of 31 Countries.

BACKGROUND: In addition to individual characteristics, it is also important to evaluate how the environment may influence the dynamics of cyberbullying. We aim to study the correlation between cyberbullying prevalence among adolescents and selected country-level indicators. METHODS: We used two different data sources: data from a previously published literature review, to identify information on cyberbullying prevalence across countries, and data from the World Bank databases, to extract information on country-level indicators. A correlation matrix was used to present the association between the selected country-level indicators and the prevalence of cyberbullying. RESULTS: We observed a statistically significant negative correlation between cyberbullying victimization (cybervictims and cyberbully-victims, respectively) and gross domestic product (r = -.474 and -.842), gross national income (r = -.485 and -.758), enrollment in secondary (r = -.446 and -.898) and tertiary education (r = -.222 and -.881), the number of secure Internet servers (r = -.118 and -.794), and the number of Internet users (r = -.190 and -.818). CONCLUSIONS: A country's educational level seems to be an important contributor to the occurrence of cyberbullying.

Docosahexaenoic acid modulates the enterocyte Caco-2 cell expression of microRNAs involved in lipid metabolism.

Consumption of the long-chain ω-3 (n-3) polyunsaturated fatty acid docosahexaenoic acid (DHA) is associated with a reduced risk of cardiovascular disease and greater chemoprevention. However, the mechanisms underlying the biologic effects of DHA remain unknown. It is well known that microRNAs (miRNAs) are versatile regulators of gene expression. Therefore, we aimed to determine if the beneficial effects of DHA may be modulated in part through miRNAs. Loss of dicer 1 ribonuclease type III (DICER) in enterocyte Caco-2 cells supplemented with DHA suggested that several lipid metabolism genes are modulated by miRNAs. Analysis of miRNAs predicted to target these genes revealed several miRNA candidates that are differentially modulated by fatty acids. Among the miRNAs modulated by DHA were miR-192 and miR-30c. Overexpression of either miR-192 or miR-30c in enterocyte and hepatocyte cells suggested an effect on the expression of genes related to lipid metabolism, some of which were confirmed by endogenous inhibition of these miRNAs. Our results show in enterocytes that DHA exerts its biologic effect in part by regulating genes involved in lipid metabolism and cancer. Moreover, this response is mediated through miRNA activity. We validate novel targets of miR-30c and miR-192 related to lipid metabolism and cancer including nuclear receptor corepressor 2, isocitrate dehydrogenase 1, DICER, caveolin 1, ATP-binding cassette subfamily G (white) member 4, retinoic acid receptor ß, and others. We also present evidence that in enterocytes DHA modulates the expression of regulatory factor X6 through these miRNAs. Alteration of miRNA levels by dietary components in support of their pharmacologic modulation might be valuable in adjunct therapy for dyslipidemia and other related diseases.

Educational interventions to improve prescription and dispensing of antibiotics: a systematic review.

BACKGROUND: Excessive and inappropriate antibiotic use contributes to growing antibiotic resistance, an important public-health problem. Strategies must be developed to improve antibiotic-prescribing. Our purpose is to review of educational programs aimed at improving antibiotic-prescribing by physicians and/or antibiotic-dispensing by pharmacists, in both primary-care and hospital settings. METHODS: We conducted a critical systematic search and review of the relevant literature on educational programs aimed at improving antibiotic prescribing and dispensing practice in primary-care and hospital settings, published in January 2001 through December 2011. RESULTS: We identified 78 studies for analysis, 47 in primary-care and 31 in hospital settings. The studies differed widely in design but mostly reported positive results. Outcomes measured in the reviewed studies were adherence to guidelines, total of antibiotics prescribed, or both, attitudes and behavior related to antibiotic prescribing and quality of pharmacy practice related to antibiotics. Twenty-nine studies (62%) in primary care and twenty-four (78%) in hospital setting reported positive results for all measured outcomes; fourteen studies (30%) in primary care and six (20%) in hospital setting reported positive results for some outcomes and results that were not statistically influenced by the intervention for others; only four studies in primary care and one study in hospital setting failed to report significant post-intervention improvements for all outcomes. Improvement in adherence to guidelines and decrease of total of antibiotics prescribed, after educational interventions, were observed, respectively, in 46% and 41% of all the reviewed studies. Changes in behaviour related to antibiotic-prescribing and improvement in quality of pharmacy practice was observed, respectively, in four studies and one study respectively. CONCLUSION: The results show that antibiotic use could be improved by educational interventions, being mostly used multifaceted interventions.

Bullying Involvement and Physical Pain Between Ages 10 and 13 Years: Reported History and Quantitative Sensory Testing in a Population-Based Cohort.

We aimed to quantify the prospective association between bullying and physical pain in a population-based cohort of adolescents. We assessed 4,049 participants of the 10 and 13 years waves of the Generation XXI birth cohort study in Portugal. Pain history was collected using the Luebeck pain screening questionnaire. A subsample of 1,727 adolescents underwent computerized cuff pressure algometry to estimate pain detection/tolerance thresholds, temporal pain summation and conditioned pain modulation. Participants completed the Bully Scale Survey and were classified as "victim only", "both victim and aggressor", "aggressor only", or "not involved". Associations were quantified using Poisson or linear regression, adjusted for sex and adverse childhood experiences. When compared to adolescents "not involved", participants classified as "victim only" or "both victim and aggressor" at age 10 had higher risk of pain with psychosocial triggers, pain that led to skipping leisure activities, multisite pain, pain of higher intensity, and pain of longer duration, with relative risks between 1.21 (95% confidence interval: .99, 1.49) and 2.17 (1.57, 3.01). "Victims only" at age 10 had lower average pain detection and tolerance thresholds at 13 years (linear regression coefficients: -1.81 [-3.29, -.33] and -2.73 [-5.17, -.29] kPa, respectively), as well as higher pain intensity ratings (.37 [.07, .68] and .39 [.06, .72] mm), when compared with adolescents not involved. No differences were seen for the remaining bullying profiles or sensory measures. Our findings suggest that bullying may have long-term influence on the risk of chronic musculoskeletal pain and may interfere with responses to painful stimuli. PERSPECTIVE: We found prospective evidence that bullying victimization in youth: 1) is more likely to lead to negative reported pain experiences than the reverse, 2) may have long-term influence on adverse pain experiences, and 3) may contribute to pain phenotypes partly by interfering with somatosensory responses to painful stimuli.

Prevalence of Parental Violent Discipline Toward Children: Findings From A Portuguese Population.

Despite recognizing the detrimental impact of parental violence on children's mental and physical health throughout their lives, violence remains an all-too-real part of life for many children around the globe. However, data on the child-reported prevalence of experienced family violence are scarce and primarily based on parental reports. This study aimed to broaden the body of evidence and measure the lifetime prevalence of child-reported experience of violent disciplinary practices perpetrated by parents and to identify its associated sociodemographic and economic factors. We conducted a cross-sectional study using data from 5,281 Generation XXI participants recruited from 2005 to 2006 in Porto, Portugal. Parental disciplinary practices were reported by 7-year-old children using the Parent-Child Conflict Tactics Scale. Pearson's Chi-squared test was used to compare differences in child-reported frequencies of violent disciplinary practices by sociodemographic variables. We observed statistically significant differences in rates of violent disciplinary practices according to the child's and parent's gender. Specifically, fathers exhibited a higher likelihood than mothers to engage in psychological aggression and corporal punishment, while mothers were more prone to engage in severe and very severe physical assault. When fathers were the perpetrators, boys were more inclined than girls to report all forms of violent disciplinary measures, and when mothers were the perpetrators, boys were particularly susceptible to severe and very severe physical assault compared to girls. In our study, children reported being frequently subjected to violent parental disciplinary practices, independently of family socioeconomic background. Children were more likely to experience psychological aggression and corporal punishment if they were born into high-income families, while severe and very severe physical assaults were more common among children whose parents had lower educational levels. National public awareness of the negative effects of violent disciplinary practices is urgently needed, promoting child-friendly and nonviolent approaches to discipline.

Unveiling the data: An analysis of plastic waste with emphasis on the countries of the E³UDRES2 alliance.

This paper offers an examination of the current plastic waste landscape, with emphasis on the nine countries of the European University Alliance E³UDRES2, based on both the literature and official numbers, to verify the alignment of practical waste management practices with scientific tendencies and advancements. The paper includes a bibliometric analysis focusing on the overall plastic waste literature and the plastic waste literature of the E³UDRES2 countries. Additionally, a mass balance was calculated regarding the domestic waste management of each of the alliance countries in 2021. The main goal is to assess how scientific research in the field of plastic waste management is being implemented in practice, particularly in the context of the E³UDRES2 countries. Bibliometric results reveal significant growth in publications since 2006, with China, the USA, and India leading. Key themes reveal evident clusters around behavior and technology, encompassing both the properties of plastics and societal attitudes toward waste management policy measures. Mass balance results reveal that, in the nine countries of the alliance, Latvia and Finland exhibited high plastic recycling rates (85% and 49%, respectively), and Germany, despite its high population, generated less waste per capita and incinerated 64% of its plastic waste. Despite progress, the results highlight ongoing challenges in implementing comprehensive circular economy-focused policies for waste management in Europe yet reveal a growing commitment to improving waste treatment systems, leading to lower environmental impacts of plastic waste.

Comparison of Cardiovascular Health Profiles Across Population Surveys From 5 High- to Low-Income Countries.

Background: To facilitate the shift from risk-factor management to primordial prevention of cardiovascular disease, the American Heart Association developed guidelines to score and track cardiovascular health (CVH). How the prevalence and trajectories of a high level of CVH across the life course compare among high- and lower-income countries is unknown. Methods: Nationally representative survey data with CVH variables (physical activity, cigarette smoking, body mass index, blood pressure, blood glucose, and total cholesterol levels) were identified in Ethiopia, Bangladesh, Brazil, England, and the US for adults (aged 18-69 years and not pregnant). Data were harmonized, and CVH metrics were scored using the American Heart Association guidelines, as high (2), moderate (1), or low (0), with the prevalence of high scores (better CVH) across the life course compared across countries. Results: Among 28,092 adults (Ethiopia n = 7686, 55.2% male; Bangladesh n = 6731, 48.4% male; Brazil n = 7241, 47.9% male; England n = 2691, 49.5% male, and the US n = 3743, 50.3% male), the prevalence of high CVH scores decreased as country income level increased. Declining CVH with age was universal across countries, but differences were already observable in those aged 18 years. Excess body weight appeared to be the main driver of poor CVH in higher-income countries, and the prevalence of current smoking was highest in Bangladesh. Conclusions: Our findings suggest that CVH decline with age may be universal. Interventions to promote and preserve CVH throughout the life course are needed in all populations, tailored to country-specific time courses of the decline. In countries where the level of CVH remains relatively high, protection of whole societies from risk-factor epidemics may still be feasible.

Contexte: Afin de faciliter la transition de la prise en charge des facteurs de risque vers la prévention primordiale des maladies cardiovasculaires, l'American Heart Association a élaboré des lignes directrices en vue de mesurer la santé cardiovasculaire (SCV) et d'en faire le suivi. On ignore dans quelle mesure la prévalence et la trajectoire d'un niveau élevé de SCV au cours d'une vie se comparent entre les pays à revenu élevé et les pays à plus faible revenu. Méthodologie: Des résultats de sondages représentatifs des pays concernant les variables de la SCV (activité physique, tabagisme, indice de masse corporelle, pression artérielle, glycémie et taux de cholestérol total) ont été obtenus de l'Éthiopie, du Bangladesh, du Brésil, de l'Angleterre et des États-Unis, pour des adultes âgés de 18 à 69 ans, excluant les femmes enceintes. Les données ont été harmonisées, et la SCV a été mesurée conformément aux lignes directrices de l'American Heart Association, et notée en fonction des scores suivants : élevée (2), modérée (1) ou faible (0). La prévalence de scores élevés, soit une meilleure SCV tout au long de la vie, a été comparée entre les pays. Résultats: Parmi 28 092 adultes (Éthiopie, n = 7 686, 55,2 % de sexe masculin; Bangladesh, n = 6 731, 48,4 % de sexe masculin; Brésil, n = 7 241, 47,9 % de sexe masculin; Angleterre, n = 2 691, 49,5 % de sexe masculin, et États-Unis, n = 3 743, 50,3 % de sexe masculin), la prévalence de scores correspondant à une SCV élevée diminuait à mesure que le niveau de revenu du pays augmentait. La diminution de la SCV avec l'âge était universelle dans tous les pays, mais des différences étaient déjà observables chez les personnes âgées de 18 ans. Un surplus de poids corporel semblait être le principal facteur d'une faible SCV dans les pays à revenu plus élevé; la prévalence d'un tabagisme actuel était la plus élevée au Bangladesh. Conclusions: Nos observations laissent croire que le déclin de la SCV avec l'âge pourrait être universel. Il est nécessaire de mener des interventions adaptées à la progression du déclin dans chacun des pays en vue de favoriser et de préserver la SCV tout au long de la vie, et ce, dans toutes les populations. Dans les pays où le niveau de SCV demeure relativement élevé, il pourrait être encore possible de protéger des sociétés entières contre des épidémies liées aux facteurs de risque.

Multifactorial assessment of braking time predictors in a driving simulator among older adults according to gender.

CONTEXT: Vehicle driving depends on the integration of motor, visual, and cognitive skills to respond appropriately to different situations that occur in traffic. OBJECTIVES: To analyze a model of performance predictor for braking time in the driving simulator, using a battery of tests divided by gender. METHODS: Selected were 100 male drivers with a mean age of 72.6 ± 5.7 years. Sociodemographic variables, braking time in the driving simulator, and motor, visual, and cognitive skills were evaluated. RESULTS: Comparing genders, men were older than women (p = 0.002) and had longer driving times (p = 0.001). Men had more strength in hand grip (p ≤ 0.001). In the linear regression analysis, the model explained 68 % of the braking time in men and 50.8 % in women. In the stepwise multiple linear regression analysis, the variable that remained in the model was the strength of the right plantar flexors, which explained 13 % of the braking time in women and men, and the cognitive variables explained 38.9 %. CONCLUSION: Sociodemographic, motor, visual, and cognitive variables, explained a substantial portion of the variability in braking time for both older women and men, the specific variables driving this performance differed between the sexes. For older women, factors such as muscle strength emerged as critical determinants of braking ability, highlighting the importance of physical health in maintaining driving skills. On the other hand, cognitive conditions emerged as the primary predictor of braking performance in older men, underscoring the role of mental acuity and decision-making processes in safe driving.

[Effectiveness of cleaning or disinfecting the urinary meatus before urinary catheterization: a systematic review]. / Eficácia da limpeza ou desinfeção do meato urinário antes da cateterização urinária: revisão sistemática.

The urinary tract infections associated with catheterization are very common in hospital and home care contexts. Currently there are several recommendations for its prevention, however, when approaching the kind of solute used in the urinary meatus prior to catheterization doubts continue to persist. Thus this study aimed at determining the effectiveness of cleaning the urinary meatus with water or saline comparing to its sterilization through a systematic review and meta-analysis. In order to do so, the principles proposed by the Cochrane Handbook were followed, a critical analysis was conducted by two researchers and the statistical analysis was performed with the use of STATA 11.1. We concluded that the cleaning or disinfection of the urinary canal prior to bladder catheterization is not statistically significant (OR=1.07, CI 95%=0.68-1.68, p=0.779) and that there is some evidence that the use of water/saline reduces rates of UTI (urinary tract infection).

The cheese was green with envy: An EEG study on minimal fictional descriptions.

Inconsistent information can be hard to understand, but in cases like fiction readers can integrate it with little to no difficulties. The present study aimed at examining if perspective switching can take place when only a minimal fictional description is provided (fictional world condition), as compared with general world knowledge (real world condition). Participants read sentences where food items had animated or inanimate features while EEG was recorded and performed a sentence completion task to evaluate recall. In the real-world condition, the N400 was significantly larger for sentences incongruent, rather than congruent, with general world knowledge. In the fictional world condition, the N400 elicited by congruent and incongruent sentences did not differ, confirming that the minimal description impacted online information processing. Information consistent with general knowledge was better recalled in both conditions. The current results highlight how contextual information is integrated during sentence comprehension.

Comparison of cardiovascular health profiles across population surveys from five high- to low-income countries.

Aims: With the greatest burden of cardiovascular disease morbidity and mortality increasingly observed in lower-income countries least prepared for this epidemic, focus is widening from risk factor management alone to primordial prevention to maintain high levels of cardiovascular health (CVH) across the life course. To facilitate this, the American Heart Association (AHA) developed CVH scoring guidelines to evaluate and track CVH. We aimed to compare the prevalence and trajectories of high CVH across the life course using nationally representative adult CVH data from five diverse high- to low-income countries. Methods: Surveys with CVH variables (physical activity, cigarette smoking, body mass, blood pressure, blood glucose, and total cholesterol levels) were identified in Ethiopia, Bangladesh, Brazil, England, and the United States (US). Participants were included if they were 18-69y, not pregnant, and had data for these CVH metrics. Comparable data were harmonized and each of the CVH metrics was scored using AHA guidelines as high (2), moderate (1), or low (0) to create total CVH scores with higher scores representing better CVH. High CVH prevalence by age was compared creating country CVH trajectories. Results: The analysis included 28,092 adults (Ethiopia n=7686, 55.2% male; Bangladesh n=6731, 48.4% male; Brazil n=7241, 47.9 % male; England n=2691, 49.5% male, and the US n=3743, 50.3% male). As country income level increased, prevalence of high CVH decreased (>90% in Ethiopia, >68% in Bangladesh and under 65% in the remaining countries). This pattern remained using either five or all six CVH metrics and following exclusion of underweight participants. While a decline in CVH with age was observed for all countries, higher income countries showed lower prevalence of high CVH already by age 18y. Excess body weight appeared the main driver of poor CVH in higher income countries, while current smoking was highest in Bangladesh. Conclusion: Harmonization of nationally representative survey data on CVH trajectories with age in 5 highly diverse countries supports our hypothesis that CVH decline with age may be universal. Interventions to promote and preserve high CVH throughout the life course are needed in all populations, tailored to country-specific time courses of the decline. In countries where CVH remains relatively high, protection of whole societies from risk factor epidemics may still be feasible.