Cognitive, Neuropsychological and Biological Effects of Oxygen-Ozone Therapy on Frailty: A Study Protocol for a 5-Week, Randomized, Placebo-Controlled Trial.

Cognitive frailty (CF) is a heterogeneous syndrome that is becoming one of the most serious health problems as the world's population age is increasing. Elucidating its biological mechanisms as well as prevention and treatments is becoming increasingly significant, particularly in view of the associated health costs. We presented the study protocol of a research project funded by the Italian Ministry of Health (grant number RF-2016-02363298) aiming to investigate the cognitive and neuropsychological effects of a 5-week treatment with therapy based on the regenerative properties of ozone (O3) in a cohort of subjects stratified according to CF scores. We also studied the potential effects of O3 on blood-based biomarkers indicative of specific biological systems that may be altered in CF. Seventy-five older persons were recruited and randomly assigned to receive the active treatment (150 cc of oxygen-O2-O3 mixture at the concentration of 30 µg of O3 per cc of O2), O2, or the placebo (air) for 5 weeks. The main endpoints were the change in the scores of clinical scales from baseline (T0) to weeks 3 (T3), 9 (T9), and 15 (T15) after treatment and the change in biomarker levels resulting from transcriptomics, proteomics, and metabolomic patterns at the same times. The positive results from this study could have important clinical implications.

Swimming Velocity Analysis Using Wearable Inertial Sensors and Speedometer: A Comparative Study.

The speedometer is widely used to evaluate swimming velocity but has some constraints. With the constant development of inertial units (IMUs), it is expected that they will become a good alternative to the speedometer. This study aimed to compare the data retrieved by an IMU and a speedometer when breaststroke is performed at maximum speed. Sixteen swimmers, nine males and seven females (20.3 ± 3.3 vs. 18.7 ± 1.1 years old, 65.8 ± 11.2 vs. 57.7 ± 9.1 kg of body mass and 1.75 ± 0.07 vs. 1.61 ± 0.10 m of height, respectively), performed 4 × 25 m of breaststroke sprint. They were equipped with an IMU fixed to the sacrum and with the line of an electromechanical speedometer (acquisition frequency of 50 Hz) fixed at the central point in the lumbar region. Statistical parametric mapping was used to compare the velocity curves, IBM SPSS was used for descriptive statistics and Bland-Altman plots were used for agreement of measurements. The results show that the IMU and speedometer do not show similar patterns, and the velocity values measured by the IMU are lower (p < 0.001). Bland-Altman plots presented a larger bias in terms of coefficient of variation and intracycle velocity variation. It can be concluded that IMUs and speedometers are not substitutes for each other as methods for evaluating intracycle velocity variations.

Changes in Young Swimmers' In-Water Force, Performance, Kinematics, and Anthropometrics over a Full Competitive Season.

The aim of the present study was to analyze changes in young swimmers' in-water force, performance, kinematics, and anthropometrics during one full competitive season. Twenty-five swimmers (11 girls and 14 boys, 12.04 ± 0.16 years) were assessed over four distinct time points throughout a competitive season. The in-water force of both hands (D, dominant; ND, non-dominant) was retrieved during two bouts of 25 m front crawl allowing the estimation of the symmetry index. The velocity (v25) was calculated from the time to complete the 25 m and considered the performance outcome, while the stroke rate, stroke length, and the stroke index were used as kinematic variables. For anthropometric variables, body mass, stature, arm span and the hand surface area were measured. The in-water force (16-24%) and performance (8%) improved over the competitive season with significant changes in the first macrocycle. The stroke index was the only kinematic variable that changed between M1 and M4 (12.7%), accompanied by a higher asymmetric motion later in the season. A time effect was found in the stature (p < 0.001, ηp 2 = 0.71), the arm span (p < 0.001, ηp 2 = 0.79), and the hand surface area (D = p < 0.001, ηp 2 = 0.63; ND = p < 0.001, ηp 2 = 0.666). Swimming performance showed associations with in-water force, stroke efficiency and anthropometric features in all time points of the season. Thus, the natural anthropometric growth experienced over the season may translate into a more efficient swimming pattern with greater in-water forces that can enhance performance.

Understanding the Kinematic Profile of 2 Underwater Pullout Breaststroke Techniques.

PURPOSE: To compare the kinematic profile of 2 underwater pullout breaststroke techniques. METHODS: Sixteen swimmers (9 men, 20.67 [2.71] y old; 7 women, 18.86 [0.83] y old) performed 3 × 25-m breaststroke using 2 pullout breaststroke techniques: Fly-Kick first and Combined. A speedometer was used to assess the peak and the mean velocity during the glide, propulsion, and recovery phases of both techniques, as well as for the total underwater sequence. The underwater distance was retrieved from video footage and was considered for each pullout technique. The range of motion of the knee during the fly-kick was also retrieved, and the time to complete the 25 m was considered the performance outcome, accompanied by the mean velocity, stroke rate, stroke length, and stroke index. RESULTS: Velocity-time series showed different profiles between pullout techniques (P ≤ .05) mostly in the glide and propulsion phases for males and females, respectively. The mean velocity of 25 m was shown to be greater in females when using the Fly-Kick first technique (P = .05, d = 0.36). Greater values in total underwater distance and knee range of motion were also observed for this technique in both cohorts. Conclusions: Female swimmers presented a higher performance when using the Fly-Kick first technique. Different kinematic profiles arise when swimmers use different underwater pullout techniques where the Fly-Kick first may allow them to reach higher kinematical standard.

Nonlinear Analysis of the Hand and Foot Force-Time Profiles in the Four Competitive Swimming Strokes.

Human locomotion on water depends on the force produced by the swimmer to propel the body forward. Performance of highly complex motor tasks like swimming can yield minor variations that only nonlinear analysis can be sensitive enough to detect. The purpose of the present study was to examine the nonlinear properties of the hand/feet forces and describe their variations across the four competitive swimming strokes performing segmental and full-body swimming. Swimmers performed all-out bouts of 25 m in the four swimming strokes, swimming the full-body stroke, with the arm-pull only and with the leg kicking only. Hand/foot force and swimming velocity were measured. The Higuchi's fractal dimension (HFD) and sample entropy (SampEn) were used for the nonlinear analysis of force and velocity. Both the arm-pull and leg kicking alone were found to produce similar peak and mean hand/foot forces as swimming the full-body stroke. Hand force was more complex in breaststroke and butterfly stroke; conversely, kicking conditions were more complex in front crawl and backstroke. Moreover, the arm-pull and kicking alone tended to be more complex (higher HFD) but more predictable (lower SampEn) than while swimming the full-body stroke. There was no loss of force production from segmental swimming to the full-body counterpart. In conclusion, the number of segments in action influences the nonlinear behavior of the force produced and, when combining the four limbs, the complexity of the hand/foot force tends to decrease.

SARS-CoV-2 Infection Alters the Phenotype and Gene Expression of Adipocytes.

Epidemiological evidence emphasizes that excess fat mass is associated with an increased risk of severe COVID-19 disease. Nevertheless, the intricate interplay between SARS-CoV-2 and adipocytes remains poorly understood. It is crucial to decipher the progression of COVID-19 both in the acute phase and on long-term outcomes. In this study, an in vitro model using the human SGBS cell line (Simpson-Golabi-Behmel syndrome) was developed to investigate the infectivity of SARS-CoV-2 in adipocytes, and the effects of virus exposure on adipocyte function. Our results show that SGBS adipocytes expressing ACE2 are susceptible to SARS-CoV-2 infection, as evidenced by the release of the viral genome into the medium, detection of the nucleocapsid in cell lysates, and positive immunostaining for the spike protein. Infected adipocytes show remarkable changes compared to uninfected controls: increased surface area of lipid droplets, upregulated expression of genes of inflammation (Haptoglobin, MCP-1, IL-6, PAI-1), increased oxidative stress (MnSOD), and a concomitant reduction of transcripts related to adipocyte function (leptin, fatty acid synthase, perilipin). Moreover, exogenous expression of spike protein in SGBS adipocytes also led to an increase in lipid droplet size. In conclusion using the human SGBS cell line, we detected SARS-CoV-2 infectivity in adipocytes, revealing substantial morphological and functional changes in infected cells.

The purinergic receptor P2X7 and the NLRP3 inflammasome are druggable host factors required for SARS-CoV-2 infection.

Purinergic receptors and NOD-like receptor protein 3 (NLRP3) inflammasome regulate inflammation and viral infection, but their effects on severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection remain poorly understood. Here, we report that the purinergic receptor P2X7 and NLRP3 inflammasome are cellular host factors required for SARS-CoV-2 infection. Lung autopsies from patients with severe coronavirus disease 2019 (COVID-19) reveal that NLRP3 expression is increased in host cellular targets of SARS-CoV-2 including alveolar macrophages, type II pneumocytes and syncytia arising from the fusion of infected macrophages, thus suggesting a potential role of NLRP3 and associated signaling pathways to both inflammation and viral replication. In vitro studies demonstrate that NLRP3-dependent inflammasome activation is detected upon macrophage abortive infection. More importantly, a weak activation of NLRP3 inflammasome is also detected during the early steps of SARS-CoV-2 infection of epithelial cells and promotes the viral replication in these cells. Interestingly, the purinergic receptor P2X7, which is known to control NLRP3 inflammasome activation, also favors the replication of D614G and alpha SARS-CoV-2 variants. Altogether, our results reveal an unexpected relationship between the purinergic receptor P2X7, the NLRP3 inflammasome and the permissiveness to SARS-CoV-2 infection that offers novel opportunities for COVID-19 treatment.

A comparison of load cell and pressure sensors to measure in-water force in young competitive swimmers.

The purpose of this study was to compare the in-water force of young competitive swimmers using tethered swimming and differential pressure sensors. Thirty-one swimmers (16 girls and 15 boys) were randomly assigned to perform two in-water tests. Swimmers completed two maximum bouts of 25 m front crawl with a differential pressure system and a 30 s maximum bout with an attached load cell (tethered-swimming). The peak force (FPEAK, in N) of dominant and non-dominant upper limbs was retrieved for further analysis. Comparison between methods revealed significant differences in all force variables (p ≤ 0.05) and the biases (mean differences) were large in girls (FPEAK dominant, 45.89 N; FPEAK non-dominant, 43.79 N) and boys (FPEAK dominant, 67.26 N; FPEAK non-dominant, 61.78 N). Despite that, simple linear regression models between the two methods showed significant relationships with a moderate effect in all variables for girls, whereas in boys a high and moderate effect was verified for FPEAK of dominant and non-dominant limbs (respectively). It seems that using pressure sensors and tethered swimming leads to different FPEAK values in young competitive, where correction factors are needed to compare data between both methods.

Acute Recovery after a Fatigue Protocol Using a Recovery Sports Legging: An Experimental Study.

Enhancing recovery is a fundamental component of high-performance sports training since it enables practitioners to potentiate physical performance and minimise the risk of injuries. Using a new sports legging embedded with an intelligent system for electrostimulation, localised heating and compression (completely embodied into the textile structures), we aimed to analyse acute recovery following a fatigue protocol. Surface electromyography- and torque-related variables were recorded on eight recreational athletes. A fatigue protocol conducted in an isokinetic dynamometer allowed us to examine isometric torque and consequent post-exercise acute recovery after using the sports legging. Regarding peak torque, no differences were found between post-fatigue and post-recovery assessments in any variable; however, pre-fatigue registered a 16% greater peak torque when compared with post-fatigue for localised heating and compression recovery methods. Our data are supported by recent meta-analyses indicating that individual recovery methods, such as localised heating, electrostimulation and compression, are not effective to recover from a fatiguing exercise. In fact, none of the recovery methods available through the sports legging tested was effective in acutely recovering the torque values produced isometrically.

Severe acute respiratory syndrome coronavirus 2 infection leads to Tau pathological signature in neurons.

COVID-19 has represented an issue for global health since its outbreak in March 2020. It is now evident that the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection results in a wide range of long-term neurological symptoms and is worryingly associated with the aggravation of Alzheimer's disease. Little is known about the molecular basis of these manifestations. Here, several strain variants were used to infect SH-SY5Y neuroblastoma cells and K18-hACE C57BL/6J mice. The Tau phosphorylation profile and aggregation propensity upon infection were investigated on cellular extracts, subcellular fractions, and brain tissue. The viral proteins spike, nucleocapsid, and membrane were overexpressed in SH-SY5Y cells, and the direct interaction and effect on Tau phosphorylation were checked using immunoblot experiments. Upon infection, Tau is phosphorylated at several pathological epitopes associated with Alzheimer's disease and other tauopathies. Moreover, this event increases Tau's propensity to form insoluble aggregates and alters its subcellular localization. Our data support the hypothesis that SARS-CoV-2 infection in the central nervous system triggers downstream effects altering Tau function, eventually leading to the impairment of neuronal function.

From Entry to Finals: Progression and Variability of Swimming Performance at the 2022 FINA World Championships.

The aim of the present study was two-fold: (i) to analyze the progression and variability of swimming performance (from entry times to best performances) in the 50, 100, and 200 m at the most recent FINA World Championships and (ii) to compare the performance of the Top16, semifinalists, and finalists between all rounds. Swimmers who qualified with the FINA A and B standards for the Budapest 2022 World Championships were considered. A total of 1102 individual performances swimmers were analyzed in freestyle, backstroke, breaststroke, and butterfly events. The data was retrieved from the official open-access websites of OMEGA and FINA. Wilcoxon test was used to compare swimmers' entry times and best performances. Repeated measures ANOVA followed by the Bonferroni post-hoc test were performed to analyze the round-to-round progression. The percentage of improvement and variation in the swimmers' performance was computed between rounds. A negative progression (entry times better than best performance) and a high variability (> 0.69%) were found for most events. The finalists showed a positive progression with a greater improvement (~1%) from the heats to the semifinals. However, the performance progression remained unchanged between the semifinals and finals. The variability tended to decrease between rounds making each round more homogeneous. Coaches and swimmers can use these indicators to prepare a race strategy between rounds.

Primary Health Care assessment in the COVID-19 pandemic from physicians' and nurses' perspective.

OBJECTIVES: to assess the operationalization of Primary Health Care in the COVID-19 pandemic, according to Primary Care Assessment Tool: PCATool-Brasil attributes, from physicians' and nurses' perspective. METHODS: a cross-sectional study, carried out with 99 physicians and nurses from Basic Health Units in a state in northeastern Brazil, with the aid of the adapted instrument PCATool-Brasil. RESULTS: Essential Score was classified as high performance (6.6) and General Score as low performance (6.5). First Contact Access, Care Integration, and Community Guidance scores were <6.6. The best performances were attributed to the Longitudinality, Comprehensiveness and Family Guidance services (scores>6.6). CONCLUSIONS: the attributes of Primary Health Care, in general, showed values above or close to the cut-off point in the assessment. These data can support strategies for local and national managers to strengthen Primary Health Care in the COVID-19 pandemic and future public health emergencies.

Association between elite swimmers' force production and 100†m front crawl inter-lap pacing and kinematics.

The present study aimed to analyse the associations between force production and 100 m front crawl inter-lap pacing and kinematics. Eleven elite male swimmers performed a 100 m front crawl maximal effort to collect 50 m lap time (T50, s) and velocity (v, m·s-1) for pacing, stroke rate (SR), stroke length (SL) and stroke index (SI) as kinematic variables. A 30 s tethered effort allowed to determine the peak (Fpeak) and mean force (Fmean) as force production variables. The relative change (Δ) between 50 m laps was also calculated for all measures. A paired sample t-test was used to check differences between laps and Pearson correlation coefficients allowed to quantify the associations between force and remaining variables. The T50 increased from the first to the second lap (ΔT50 = 10.61%, p < 0.01, d = 2.68), while v (Δv = -5.92%, p < 0.01, d = 1.53), SR (ΔSR = -6.61%, p < 0.01, d = 0.45) and SI (ΔSI = -4.92%, p = 0.02, d = 0.45) decreased. SL remained unchanged between laps (ΔSL = 1.07%, p = 0.66, d = 0.08). No associations were found between force production and most of Δ, with the only exception being the reasonable good association between Fpeak and Δv (r = 0.62, p = 0.04). Although both pacing and kinematics fall from the first to the second sections of a 100 m front-crawl effort, the swimmers who exhibit higher Fpeak show a more stable front crawl v between both 50 m laps.

Performance Tiers within a Competitive Age Group of Young Swimmers Are Characterized by Different Kinetic and Kinematic Behaviors.

The present study aimed to analyze swimmers' in-water kinetic and kinematic behaviors according to different swimming performance tiers within the same age group. An amount of 53 highly trained swimmers (girls and boys: 12.40 ± 0.74 years) were split up into 3 tiers based on their personal best performance (i.e., speed) in the 50 m freestyle event (short-course): lower-tier (1.25 ± 0.08 m·s-1); mid-tier (1.45 ± 0.04 m·s-1); and top-tier (1.60 ± 0.04 m·s-1). The in-water mean peak force was measured during a maximum bout of 25 m front crawl using a differential pressure sensors system (Aquanex system, Swimming Technology Research, Richmond, VA, USA) and defined as a kinetic variable, while speed, stroke rate, stroke length, and stroke index were retrieved and considered as kinematic measures. The top-tier swimmers were taller with a longer arm span and hand surface areas than the low-tier, but similar to the mid-tier. While the mean peak force, speed and efficiency differed among tiers, the stroke rate and stroke length showed mixed findings. Coaches should be aware that young swimmers belonging to the same age group may deliver different performance outcomes due to different kinetic and kinematic behaviors.

Cellular and Molecular Mechanisms in Neurodevelopmental Disorders and Brain Tumors.

The normal growth and operation of the central nervous system (CNS) at all stages of development, including adulthood, depend on the interaction between intrinsic and extrinsic factors [...].

The Effects of 6-Week Training Cessation on Anthropometrics, in-Water Force, Performance, and Kinematics of Young Competitive Swimmers: A Maturity Development Approach.

PURPOSE: To examine the effects of 6 weeks of training cessation on young swimmers' anthropometrics, in-water force, performance, and kinematics according to biological maturation. METHODS: Eighteen swimmers (7 girls: 12.43 [0.73] y old; 11 boys: 13.27 [0.79] y old) were assessed pretest and posttest 6 weeks apart. Body mass, stature, arm span, and hand surface area were measured as anthropometric parameters, and biological maturation was estimated (ie, peak height velocity [PHV]). The in-water force was retrieved during 2 bouts of 25-m front crawl, allowing the estimation of the symmetry index. The time to complete the 25-m was considered the performance outcome, whereas velocity, stroke rate, stroke length, stroke index, and arm stroke efficiency were used as kinematic parameters. RESULTS: All anthropometric parameters increased during the detraining period. Although the in-water force remained unchanged, the magnitude of the effects was large for the symmetry index (P = .021; d = 0.87). For the pooled sample, neither performance nor kinematics changed after detraining, but the stroke index increased (P = .054; d = 0.27). Pre-PHV swimmers showed unchanged values in all parameters, despite natural growth. Mid-PHV swimmers showed a similar trend in addition to reductions in stroke rate (P = .040; d = 0.60) and increases in stroke length (P = .043; d = 1.00). CONCLUSIONS: In-water force, performance, and kinematics (25-m front crawl) were not impaired after 6 weeks of training cessation in a group of young swimmers. Given interindividual and intraindividual differences according to maturity status, coaches should be aware that distinct trends within the group can be found.

The impact of the COVID-19 pandemic in Brazil: a study in tertiary dental care.

The pandemic caused by coronavirus has resonated throughout different levels of health care in Brazil and, in this context, the present research aimed to evaluate this impact on tertiary dental care provided by the Unified Health System (SUS). Therefore, an ecological study was conducted with data obtained from the Hospital Information System processed by the Portal of the Department of Informatics of SUS. The sample consisted of patients of all sexes and age groups, whose Hospital Admission Authorizations (AIHs) were approved for dental tertiary care procedures from January 2015 to December 2020. Descriptive analyses and the ANOVA test with a significance level set at p < 0.05 were used. When the annual mean numbers of AIHs approved were evaluated, findings showed that on an average, the Southeast region authorized a higher number of procedures (p-value < 0.001), however, in the pandemic year (2020), a reduction of approximately 24.5% of these hospitalizations occurred throughout Brazil, with the Midwest being the region most affected (32.12%). A percentage increase occurred in the Surgical Treatment of Oral sinus/Oral nasal Fistula (16.1%), in addition to a significant decrease in performing procedures for Resection of Mouth Lesion (33.4%). In the pandemic year, there was a reduction of 14% in expenditures related to hospital services and 23.26% related to professional services. It was concluded that the data presented demonstrated a significant reduction in AIHs for tertiary dental care in the pandemic year.

Low Forces Push the Maturation of Neural Precursors into Neurons.

Mechanical stimulation modulates neural development and neuronal activity. In a previous study, magnetic "nano-pulling" is proposed as a tool to generate active forces. By loading neural cells with magnetic nanoparticles (MNPs), a precise force vector is remotely generated through static magnetic fields. In the present study, human neural stem cells (NSCs) are subjected to a standard differentiation protocol, in the presence or absence of nano-pulling. Under mechanical stimulation, an increase in the length of the neural processes which showed an enrichment in microtubules, endoplasmic reticulum, and mitochondria is found. A stimulation lasting up to 82 days induces a strong remodeling at the level of synapse density and a re-organization of the neuronal network, halving the time required for the maturation of neural precursors into neurons. The MNP-loaded NSCs are then transplanted into mouse spinal cord organotypic slices, demonstrating that nano-pulling stimulates the elongation of the NSC processes and modulates their orientation even in an ex vivo model. Thus, it is shown that active mechanical stimuli can guide the outgrowth of NSCs transplanted into the spinal cord tissue. The findings suggest that mechanical forces play an important role in neuronal maturation which could be applied in regenerative medicine.