Feline leishmaniasis in an animal shelter in northeastern Brazil: Clinical aspects, coinfections, molecular detection, and serological study of a new recombinant protein.

Infection and clinical cases of leishmaniasis caused by Leishmania infantum in cats have been increasingly reported in several countries, including Brazil. In this study, we used an enzyme-linked immunosorbent assay (ELISA) and an immunochromatographic test (ICT) based on a recombinant antigen (rKDDR-plus) to detect anti-Leishmania antibodies in cats from an animal shelter in northeastern Brazil. We compared the results with an ELISA using L. infantum crude antigen (ELISA-CA). We also investigated the presence of Leishmania DNA in blood or ocular conjunctival samples as well as the association between Leishmania PCR positivity and serological positivity to feline immunodeficiency virus (FIV), feline leukemia virus (FeLV) and Toxoplasma gondii. Concerning serological assays, a higher positivity was detected using the ICT-rKDDR-plus (7.5%; 7/93) as compared to ELISA-rKDDR-plus (5.4%; 5/93) and ELISA-CA (4.3%; 4/93). Upon PCR testing, 52.7% (49/93) of the ocular conjunctival swabs and 48.3% (44/91) of the blood samples were positive. Together, PCR and serological testing revealed overall positivities of 73.1% (68/93) and 12.9% (12/93), respectively. Among PCR-positive samples, 45.5% (31/68) showed co-infection with FIV, 17.6% (12/68) with FeLV, and 82.3% (56/68) with T. gondii. More than half of the PCR-positive cats showed at least one clinical sign suggestive of leishmaniasis (58.8%; 40/68) and dermatological signs were the most frequent ones (45.5%; 31/68). Both tests employing the recombinant antigen rKDDR-plus (i.e., ICT-rKDDR-plus and ELISA-rKDDR-plus) detected more positive cats than the ELISA-CA but presented low overall accuracy. PCR testing using either blood or ocular conjunctival samples detected much more positive cats than serological tests.

Validation of the Brazilian Portuguese version of the Stanford cataplexy questionnaire.

INTRODUCTION: Cataplexy is a sudden and involuntary episode of loss of muscle tone during wakefulness. Cataplexy cannot be easily recognized when clinical features are atypical or when the physician is unfamiliar with its characteristics. The unstructured clinical interview is the only standard diagnostic method, but the use of a targeted questionnaire can help in the diagnosis of cataplexy. METHODS: The Stanford cataplexy questionnaire is a self-administered 51-question questionnaire. This validation consisted of an initial translation and back-translation of the questionnaire from English into Brazilian Portuguese, followed by a pilot study with 10 participants for the cultural adaptation of the scale. RESULTS: 155 consecutive patients aged 18-85 completed the questionnaire. The Brazilian version of the Stanford cataplexy questionnaire showed similar results to the original version with good metric properties (area under the curve), high internal consistency (Cronbach's alpha equal to 0.87), good reliability and reproducibility. CONCLUSIONS: The Brazilian Portuguese version of the Stanford Cataplexy questionnaire presented good accuracy satisfactory psychometric properties in identifying cataplexy.

Immunogenic mapping of rDyn-1 and rKDDR-plus proteins and selection of oligopeptides by immunoblotting for the diagnosis of Leishmania infantum-infected dogs.

Endemic in Brazil, visceral leishmaniasis (VL) is a zoonotic infection that is among the most important parasitic diseases transmitted by vectors. Dogs are the main reservoirs of canine leishmaniasis (CanL) and their identification is used in some countries as part of disease prevention and control measures in the canine and human population. In this context, serological tests are necessary, composed of antigens capable of correctly identifying infected dogs, minimizing the number of false-negative cases. This study aimed to identify more immunoreactive peptides derived from two previously described whole proteins (rDyn-1 and rKDDR-plus) and compare their performance to the control antigens rK39 and the crude extract for the detection of dogs infected with L. infantum, especially the asymptomatic ones. The three selected peptides and a mixture of them, along with the rDyn-1, rKDDR-plus, rK39, and crude extract antigens were evaluated using indirect ELISA with sera samples from 186 dogs with CanL, being asymptomatic (n = 50), symptomatic (n = 50), co-infected (n = 19), infected with Babesia sp. (n = 7), Ehrlichia sp. (n = 6), T. cruzi (n = 20) and uninfected (n = 34). The results showed that the rDyn-1 protein and the peptide mixture had the highest sensitivity (100% and 98.32%, respectively) and specificity (97.01 and 98.51, respectively). A high degree of kappa agreement was found for rDyn-1 protein (0.977), mixed peptides (0.965), rKDDR-plus protein (0.953), K-plus peptide 1 (0.930) and Dyn-1 peptide (0.893). The mixture of peptides showed the highest likelihood (65.87). The ELISA using the mixture of peptides and the rDyn-1 protein showed high performance for CanL serodiagnosis. More mix combinations of the peptides and additional extended field tests with a larger sample size are recommended.

Extroversion-Related Differences in Gaze Behavior during a Computer Task for Assessing Speed-Accuracy Trade-Off: Implications for Sensor-Based Applications.

The principle of Fitts' law explains that the difficulty of movement increases when targets are farther away and narrower in width, particularly when touching two parallel targets as quickly as possible. Understanding the differences in motor and gaze behaviors between extroverts and introverts when performing tasks that require speed and accuracy is crucial for the development of sensor-based interfaces for games and rehabilitation. This study aimed to investigate such differences in a computer task that assesses the speed-accuracy trade-off (Fitts' task). Twenty introverts and seventeen extroverts wore an eye tracker and an accelerometer attached to their hand while performing 12 trials through six levels of difficulty presented on a computer screen. The results showed that introverts had longer visual fixations at the higher difficulty levels and reduced pupil diameter variability when difficulty was intermediate, suggesting that their gaze behavior may be different from that of extroverts. However, no significant differences were found in the speed and accuracy performance or kinematic variables between extroverts and introverts. These findings have important implications for the design of interventions that require both speed and accuracy in movement, such as in the development of virtual reality/games for rehabilitation purposes. It is important to consider individual differences in motor and gaze behaviors, particularly in those who may struggle with longer visual fixations, for the design of sensor-based applications and to promote successful interventions and recovery.

Bullying in Swiss Youth Born with a Unilateral Cleft lip and Palate by Self- and Parent-Report.

OBJECTIVE: This study aimed to gain a better understanding of bullying as victims and aggressors in youths born with unilateral cleft lip and palate (UCLP). DESIGN: This is an observational study comparing youths with UCLP (ages 8-16) and their parents with a control group (CG) of children in state schools and their parents. PARTICIPANTS: Forty-one youths (43% female; mean age 12.4 ± 2.3 years) and their parents (n = 40) composed the UCLP group and 56 youths (47% female; mean age 12.4 ± 1.2 years) and their parents (n = 33) were in the CG. MAIN OUTCOME MEASURE: The Olweus Bully/Victim questionnaire self- and parent-report was used to assess victims and aggressors involved in bullying behaviors. RESULTS: About 30% of all youths reported being a frequent victim of bullying at least 2-3 times a month and an additional 32.3% were bullied 1-2 times in the last 2-3 months. For the total sample, parents significantly (P < .05) underestimated any bullying, both as a victim (youths 62.5% vs parents 45.7%) and as an aggressor (youths 53.1% vs parents 37.1%). There were no significant group differences in experiencing any bullying between the youths with UCLP (52.5%) and the CG youths (69.6%) or in its perception by their parents (43.2% and 48.5%, respectively). There were no group differences between the combinations of victim and aggressor. CONCLUSIONS: While there were no differences in bullying prevalence in our sample between youths with UCLP and their peers, this study highlights differences in bullying perceptions between parents and their children.

Larvicidal potential of extracts and isolated compounds from Piper cubeba fruits against Aedes aegypti (Diptera: Culicidae) larvae.

Aedes aegypti is the primary vector of virus transmission that causes dengue, yellow fever, chikungunya and zika. The primary prevention method has been vector control and synthetic insecticides that can cause environmental side effects. Thus, the work aimed to evaluate the larvicidal potential of extracts and isolated compounds from Piper cubeba against A. aegypti larvae. The larvicidal activity method was executed according to the World Health Organization protocol. The larvae were analyzed by scanning electron microscopy (SEM). Through molecular docking, the action mechanism was investigated. The hydroalcoholic and hexane extracts showed similar larvicidal activity with LC50 of 191.1 µg/mL and 185.84 µg/mL, respectively. Between isolated compounds, hinokinin presented LC50= 97.74 µg/mL. The SEM analysis showed structural damage to the larva's tegument caused by extracts and isolated compounds. Therefore, the results demonstrate the larvicidal action of hinokinin and extracts, which can lead to the development of new natural larvicides.

Atendimento na atenção primária à saúde: olhares de pessoas trans / Service in primary health care: perspectives of trans people / Atención primaria de salud: perspectivas de personas transgénero

Objetivo: conhecer as vivências e demandas de pessoas transexuais ao buscar serviços de Atenção Primária à Saúde. Método: pesquisa descritiva com abordagem qualitativa, realizada com pessoas autodeclaradas transexuais que utilizam os serviços de Atenção Primária à Saúde. A coleta de dados se deu por meio de questionário on-line, esses foram submetidos à análise através de software livre para dados qualitativos e o corpus textual de pesquisa passou pela análise do tipo temático-categorial. Resultados: com a análise dos dados, foi criada a categoria: vivências e demandas no atendimento na Atenção Primária à Saúde, que representou 51,6% das Unidades de Registro. Conclusão: no cenário atual, a população trans ainda padece com dificuldades de acesso aos serviços de saúde e, portanto de terem seus direitos garantidos

Objectives: to know the experiences and demands of transgender people when seeking primary health care services. Method: descriptive research with a qualitative approach, conducted with self-declared transsexual scare people who use primary health care services. Data collection was performed through an online questionnaire, which were submitted to analysis through free software for qualitative data and the textual corpus of research was analyzed by thematic-category analysis. Results: with data analysis, two categories were created: experiences in primary health care, which represented 51.6% of the Registry Units. Conclusion: in the current scenario, the trans population still suffers from difficulties in accessing health services and therefore having their rights guaranteed

Objetivos: conocer las experiencias y demandas de las personas transgénero a la hora de buscar servicios de atención primaria de salud. Método: investigación descriptiva con enfoque cualitativo, realizada con personas autodeclaradas transexuales que utilizan los servicios de atención primaria de salud. La recolección de datos se realizó a través de un cuestionario en línea, que se sometió a análisis a través de software libre para obtener datos cualitativos y el corpus textual de investigación se analizó mediante análisis de categoría temática. Resultados: con el análisis de datos se crearon dos categorías: experiencias en atención primaria de salud, que representaron el 51,6% de las Unidades de Registro. Conclusión: en el escenario actual, la población trans aún sufre dificultades para acceder a los servicios de salud y, por lo tanto, tener garantizados sus derechos

Neuroendocrine effects of a single bout of functional and core stabilization training in women with chronic nonspecific low back pain: A crossover study.

Exercise-induced hypoalgesia (EIH) is characterized as the pain reduction after an exercise session and it seems to be related to the release of plasma ß-endorphin. In this sense, the core stabilization training (CT) has been suggested for patients with chronic nonspecific low back pain (CNSLBP), but it is unclear whether it induces EIH. Patients with CNSLBP have neuromotor dysfunctions that can affect the performance of functional tasks, thus, performing functional training (FT) could improve motor control and promote EIH, since functional training uses multi-joint exercises that aim to improve the functionality of actions performed in daily life. EIH is usually assessed using quantitative sensory tests (QST) such as conditioned pain modulation, pressure pain threshold, and temporal summation. Thus, the sum of parameters from quantitative sensory tests and plasma ß-endorphin would make it possible to understand what the neuroendocrine effects of FT and CT session are. Our study compared the acute effect of CT and FT on the EIH and plasma ß-endorphin release, and correlated plasma ß-endorphin with quantitative sensory testing in patients with CNSLBP. Eighteen women performed two training sessions (CT and FT) with an interval of 48 h between sessions. EIH was assessed by QST and plasma ß-endorphin levels. Results showed that only FT significantly increased plasma ß-endorphin (FT p < 0.01; CT p = 0.45), which correlated with pain pressure threshold (PPT) and conditioned pain modulation (CPM). However, QST values were not different in women with CNSLBP after CT or FT protocols. Plasma ß-endorphin correlated with PPT and CPM, however, the same did not occur with a temporal summation.

Reabilitação oral utilizando prótese parcial removível associada a implantes osseointegrados: relato de caso / Oral rehabilitation using removable partial prosthesis associated with osseointegrated implants: case report

Introdução: As próteses parciais removíveis são alternativas amplamente utilizadas na reabilitação oral de pacientes parcialmente desdentados. Na atualidade os implantes dentais têm sido indicados para tratamento de pacientes edêntulos em associação com próteses parciais removíveis convencionais. Objetivo: Relatar um caso clínico utilizando uma prótese parcial removível convencional associada a implantes osseointegrados em paciente portador de Classe I de Kennedy. Relato de Caso: Paciente N.A.A.S., sexo feminino, 65 anos, procurou atendimento clínico no Instituto de Estudos da Saúde (IES) para reabilitação protética das arcadas dentais superior e inferior. A sua queixa principal era "dificuldade de mastigação". A paciente apresentava prótese total removível insatisfatória na maxila e não utilizava nenhum tipo de prótese dentária na mandíbula, que se apresentava parcialmente edêntula. O tratamento realizado foi a confecção de uma prótese total na arcada superior. Na arcada inferior foram inseridos dois implantes de hexágono externo nas regiões correspondentes às áreas dos dentes 34 e 44, após quatro meses a prótese parcial removível convencional foi confeccionada e incorporada aos implantes osseointegrados utilizando o sistema de retenção do tipo attachments Equator. Conclusão: Os resultados revelaram que a técnica de associação da prótese parcial removível convencional aos implantes osseointegrados demonstrou ser uma opção viável de tratamento com capacidade de devolver a função, a estética e manter a integridade dos dentes e tecidos periodontais(AU)

Introduction: Removable partial dentures are alternatives widely used in the oral rehabilitation of partially edentulous patients. Currently, dental implants have been indicated for the treatment of edentulous patients in association with conventional removable partial dentures. Objective: To report a clinical case using a conventional removable partial denture associated with osseointegrated implants in a patient with Kennedy Class I. Case Report: Patient N.A.A.S., female, 65 years old, sought clinical care at the Institute of Health Studies (HEI) for prosthetic rehabilitation of the upper and lower dental arches. His main complaint was "chewing difficulty". The patient had unsatisfactory removable total prosthesis in the maxilla and did not use any type of dental prosthesis in the mandible, which was partially edentulous. The treatment performed was the manufacture of a total prosthesis in the upper arch. In the lower arch, two external hexagon implants were inserted in the regions corresponding to the tooth areas 34 and 44, after four months the conventional removable partial denture was made and incorporated into the osseointegrated implants using the equator attachments retention system. Conclusion: The results revealed that the technique of associating conventional removable partial dentures with osseointegrated implants proved to be a viable treatment option with the ability to restore function, aesthetics and maintain the integrity of teeth and periodontal tissues(AU)

Reações adversas do montelucaste no tratamento da asma pediátrica: uma revisão integrativa da literatura / Adverse reactions of montelukast in the treatment of pediatric asthma: an integrative literature review / Reacciones adversas de montelukast en el tratamiento del asma pediátrico: una revisión integrativa de la literatura

Buscou-se analisar as reações adversas do montelucaste quando prescrito para o tratamento da asma pediátrica. Revisão integrativa da literatura utilizando as bases de dados: U.S. National Library of Medicine (PubMed), Biblioteca Virtual da Saúde (BVS), SCOPUS e Business Source Complete (EBSCO), empregando os descritores: "asthma", "pediatric", "montelukast" e "adverse effects", unidos pelo booleano "AND''. Incluíram-se artigos na íntegra; publicados nos últimos 5 anos; redigidos em português, inglês ou espanhol; pesquisados em humanos e com uma relação com o nosso objetivo. Excluíram-se os que se enquadravam em nossos critérios de exclusão.Foram identificados 53 artigos, dos quais 11 compuseram a amostra final desta revisão. A exposição ao montelucaste foi associada a uma chance 2 vezes maior de reações neuropsiquiátricas em um dos artigos analisados, porém os estudos ainda não forneceram uma explicação fisiopatológica em comum. Reações neuropsiquiátricas foram as de maior prevalência, representando mais de 90% da amostra.

We analyzed the adverse reactions of montelukast when prescribed for the treatment of pediatric asthma. This is an integrative literature review using the databases: U.S. National Library of Medicine (PubMed), Virtual Health Library (BVS), SCOPUS and Business Source Complete (EBSCO), using the descriptors: "asthma", "pediatric", "montelukast" and "adverse effects", connected by the Boolean " AND''. Articles in full were included, published in the last 5 years, written in Portuguese, English or Spanish, researched in humans and related to our objective. Those that met our exclusion criteria were excluded. Fifty-three articles were identified, of which 11 comprised the final sample of this review. Exposure to montelukast was associated with a 2-fold greater chance of neuropsychiatric reactions in one of the articles analyzed, but the studies have not yet provided a common pathophysiological explanation. Neuropsychiatric reactions were the most prevalent, representing more than 90% of the sample.

Se intentó analizar las reacciones adversas de montelukast cuando se prescribe para el tratamiento del asma pediátrica. Revisión integrativa de la literatura usando las bases de datos: U.S. National Library of Medicine (PubMed), Virtual Health Library (BVS), SCOPUS y Business Source Complete (EBSCO), utilizando los descriptores: "asma", "pediátrico", "montelukast" y "efectos adversos", unidos por el booleano " Y". Se incluyeron artículos completos, publicados en los últimos 5 años, escritos en portugués, inglés o español, investigados en humanos y relacionados con nuestro objetivo. Se excluyeron aquellos que cumplieron con nuestros criterios de exclusión. Se identificaron cincuenta y tres artículos, de los cuales 11 constituyeron la muestra final de esta revisión. La exposición a montelukast se asoció con una probabilidad 2 veces mayor e reacciones neurosiquiátricas en uno de los artículos analizados, pero los estudios aún no han proporcionado una explicación fisiopatológica común. Las reacciones neurosiquiátricas fueron las más prevalentes, representando más del 90% de la muestra

Dry heat and pressure favor bioactive compounds preservation and peptides formation in sorghum [S orghum bicolor (L.) Moench].

Sorghum is a cereal with potential economic and nutritional properties. It has gained headway in the international market because of its nutritional content which is characterized for many bioactive compounds with antioxidant characteristics, and also, because it is gluten free. This work evaluated the proteomic profile of sorghum grains and its nutritional composition and functional profile after exposure to 7 different treatments (control, grind, dry heat, bursting, wet cooking with and without water and wet cooking in pressure). They were analyzed for chemical composition, protein profile, total phenolic compounds, anthocyanin content and antioxidant activity. The dry heat preserves the protein content, phenolic compounds, anthocyanins and presents between 94% and 95% of radical scavenging activity. Heat treatments that use the pressure promote the natural hydrolysis of proteins. Bursting treatment resulted in 45.6% of proteins and peptides in the range of 3.7; 5.93; 8.9 and 14 kDa. Wet cooking in pressure (SPC) showed a similar behavior, with 26.8% being the abundance of 14 and 14.3 kDa proteins and 25.3% of the peptides with less than 10 kDa, making up 52.1% of protein content. This hydrolysis promoted an important percentage of peptides and low molecular mass proteins which can have bioactive profile and improve healthy.

Epidemiological and diagnostic aspects of feline leishmaniasis with emphasis on Brazil: a narrative review.

The leishmaniases are a group of diseases caused by the protozoan parasite belonging to the genus Leishmania. In the New World, although dogs are considered the main parasite reservoir, in the last two decades, several studies have confirmed the role of cats (Felis catus) in the epidemiology of the disease and feline leishmaniasis (FeL) is now considered to be an emerging disease. The present review summarizes the current knowledge about FeL, focusing on important immunopathological aspects, epidemiology, and diagnostic methods applied for felines in Brazil. Cats are infected with the same species of Leishmania found in dogs (i.e., Leishmania infantum). Like dogs, skin lesions are the most common in cats with clinical FeL, mainly affecting the cephalic region and less frequently the legs which may be accompanied by generalized signs or visceral involvement. Information on the immune response of cats to Leishmania infection is scarce; however, efficient infection control is seen in most cases. For diagnosis, generally, the same methods as those in dogs are used, mainly serological tools. But there is a lack of studies focusing the performance of these methods for diagnosing FeL. The estimated overall prevalence of FeL in Brazil is 8%, with L. infantum being the most prevalent species. However, infections with Leishmania braziliensis and Leishmania amazonensis have also been reported. In conclusion, although there has been an increase in the publication related to FeL in Brazil in recent years, there is a lack of research relating immune response and diagnosis of these animals. Cats have been shown to be competent hosts for Leishmania parasites, and their role in the epidemiology of the disease cannot be underestimated, especially in areas of Brazil where the disease is historically endemic.

Effect of Piper cubeba total extract and isolated lignans on head and neck cancer cell lines and normal fibroblasts.

The objective of the present study was to evaluate the action of the crude hydroalcoholic extract of Piper cubeba fruits and isolated lignans (cubebin, dihydrocubebin, ethylcubebin, hinokinin and methylcubebin) on head and neck cancer cells. We evaluated the influence of the Piper cubeba extract and isolated lignans (10, 50 e 100 µg/mL) for 4, 24, 48 and 72 h, in the larynx (Hep-2) and oral (SCC-25) squamous cell carcinoma cells and normal fibroblasts, on morphology, cell proliferation and migration, cytotoxicity, genotoxicity and gene and protein expression (PTGS2, PTGER3, PTGER4, MMP2, MMP9). The results showed that the P. cubeba extract and different lignans do not alter the cellular morphology, but decrease cell proliferation and migration, have low cytotoxic and genotoxic effects, probably due to the alteration of the expression of genes and proteins involved with inflammatory process. From these data, we can conclude that the lignans cubebin and methylcubebin had a greater effect on head and neck cancer cells in the antiproliferative, antimigratory and genotoxic action, and could be the target of the development of new therapies including possible new drugs as a therapeutic resource for the treatment of head and neck cancer due to its immense range of biological properties.

The adaptation of evolutionary thinking in its public circulation: the case of "Evolution: a Journal of Nature," 1927-1938. / A adaptação do pensamento evolutivo em sua circulação pública: o caso da revista "Evolution: a Journal of Nature", 1927-1938.

The teaching of evolution was the subject of intense controversy in the United States in the first decades of the twentieth century. Both the validity of the theory and its ethical, political and religious implications were in dispute. This article analyzes a magazine intended to popularize science in this context, Evolution: a Journal of Nature (1927-1938). The objective is to demonstrate that the dynamics of the public circulation of knowledge represented by the magazine cannot be reduced to a process of simplification, eliminating details and exceptions of little use to the general public, but rather consisted of a complete adaptation, creatively connecting scientific knowledge to questions of great importance in the public arena.

O ensino de evolução foi objeto de intensa controvérsia nos EUA nas primeiras décadas do século XX. Em disputa, estava não apenas a validade da teoria, mas também a consideração de suas implicações éticas, políticas e religiosas. Este artigo analisa uma revista de popularização científica inserida nesse contexto, a Evolution: a Journal of Nature (1927-1938). O objetivo é demonstrar que a dinâmica de circulação pública do conhecimento representada pela revista não se resumiu a um processo de simplificação, eliminando detalhes e ressalvas pouco úteis ao público não especializado, mas antes consistiu em uma completa adaptação, confrontando criativamente o conhecimento científico com questões de grande importância na arena pública.

The effects of the COVID-19 pandemic on patients with narcolepsy.

STUDY OBJECTIVES: To the best of our knowledge, there has not as yet been any study on the effects of the COVID-19 pandemic on patients with narcolepsy, in particular, in relation to its impact on sleep schedules, symptoms, the need for medication, work, income, and quality of life. This study therefore aimed to explore these factors and their possible influence on sleep, circadian timing, and narcolepsy symptoms during the pandemic. METHODS: Patients with narcolepsy who had been in quarantine for at least 3 months completed a 36-question online survey. Questions targeted the conditions of the quarantine, sleep-related behaviors, and factors known to affect sleep and circadian rhythms (work status, income, appetite, narcolepsy symptoms, and medication), as well as the quality of life during the quarantine period. RESULTS: The routines of the participants had been altered by quarantine, with changes in their place of work, and an increase in narcolepsy symptoms, such as cataplexy, sleep paralysis, hallucinations, nocturnal awakenings, and sleepiness. Sleep and wake times changed, resulting in altered sleep patterns in most of the sample. No association between changes in the place of work and narcolepsy symptoms was found. Regarding medication, the participants used fewer antidepressant pills but took more stimulants. Appetite was increased and self-reported quality of life decreased during the period. CONCLUSIONS: During the quarantine, the patients with narcolepsy reported changes in their bedtime and waking-up schedules, suggesting a tendency to circadian misalignment. In Brazil, the effects of the COVID-19 outbreak have gone beyond the direct action of the virus because of the collateral damage it has caused in respect to unemployment, financial hardship, and a reduction in quality of life. These impacts have been amplified in Brazil because of the level of social inequality found in the country, and they have particularly affected vulnerable patients with rare diseases, such as the narcolepsy population.

Reliability in the evaluation of international and national judges in an artistic swimming routine / Confiabilidade na avaliação de juízes internacionais e nacionais em uma rotina de nado artístico

Abstract Artistic swimming (AS) is a sport evaluated by fifteen judges in routine sessions. The athletes' goal is to achieve proficient motor patterns according to pre-established criteria. The present studied analyzed whether there is difference between the two groups of AS judges with different levels of experience. The group of the International Swimming Federation - FINA (IG) evaluates AS at national and international level and the non-FINA group (NG) evaluates AS only at national level. Twenty experienced judges were divided into groups, 10 IG judges and 10 NG judges. Thus, judges evaluated the item execution of three routines with five required elements. Cronbach's alpha coefficient showed high internal consistency in IG (a= 0.85 in T1 and 0.83 in T2). In NG, internal consistency was observed in T1 and low consistency in T2 (a= 0.82 in T1 and 0.39 in T2). Evaluation analysis between IG and NG was significant (p?0.0330) and reliability analysis (bias: -0.1266 95% agreement limit: -1.642 to 1.388) showed consistency and high degree of confidence in results. The findings suggest that the item execution of required elements showed high objectivity regarding judges with different levels of experience, IG and NG, regardless of categorization and time of practice. FINA has changed the number of judges and the number of items evaluated in routine sessions. It is suggested that the reduction of items has contributed in a positive way so that judges can focus more on evaluation itself.

Resumo Nado artístico (NA) é um esporte avaliado por quinze juízes em provas de rotinas. A meta dos atletas é a realização de padrões motores proficientes de acordo com critérios pré-estabelecidos. O presente estudo analisou se havia diferença entre os dois grupos de juízes de NA com diferentes níveis de experiência. O grupo da Federação Internacional de Natação - FINA (GI) avalia a nível nacional e internacional e o grupo não FINA (GN) avalia apenas a nível nacional. Participaram 20 juízes experientes separados em grupos, 10 juízes GI e 10 juízes GN. Assim, os juízes avaliaram o item execução de três rotinas com cinco elementos obrigatórios. O coeficiente alfa de Cronbach apresentou elevada consistência interna no GI (a= 0,85 em T1 e 0,83 em T2). No GN observou-se consistência interna em T1 e baixa em T2 (a = 0,82 em T1 e 0,39 em T2). A análise de avaliação entre GI e GN, foi significativa (p?0,0330) e análise de confiabilidade (viés: -0,1266 de limite de concordância 95%: -1,642 a 1,388) mostrando consistência e alto grau de confiança nos resultados. Os achados sugerem que o item execução dos elementos requeridos apresentou alta objetividade no que diz respeito aos juízes com diferentes níveis de experiência, GI e GN, independentemente da categorização e do tempo de prática. A FINA alterou o número de juízes e o número de itens que são avaliados nas provas de rotina. Sugere-se que a redução dos itens tenha contribuído para que os juízes se concentrassem mais na avaliação.

Validation of the Brazilian Portuguese version of the narcolepsy severity scale.

INTRODUCTION: Narcolepsy type 1 is a sleep disorder and the most common cause of hypersonia of central origin. It is characterized by sleep attacks, cataplexy, sleep-related hallucinations, sleep paralysis and sleep fragmentation in a pleomorphic presentation. The Narcolepsy Severity Scale (NSS), questionnaire which assesses the frequency and impact of the main symptoms of narcolepsy was developed in order to determine its clinical severity, needing translation, cultural adaptation and validation in many languages. The objective is to validate the Brazilian Portuguese version of the NSS. METHODS: The Brazilian version of the NSS was translated to Brazilian Portuguese and applied to patients with a diagnosis of narcolepsy type 1 at the Daytime Excessive Sleepiness Service, at Psychobiology Department of the Universidade Federal de São Paulo (UNIFESP) between February 2018 and July 2019. RESULTS: A total of 52 patients completed the questionnaire. Cultural adaptations were made to better comprehension of patients. The Brazilian version of the NSS showed high internal consistency, demonstrated by the Cronbach's alpha coefficient of 0.82. It showed good reproducibility capacity, verified through the test-retest, whose intraclass correlation was 0.98. The average severity of Brazilian patients was 33.94 (±11.24), higher than the values found in other population, which also underwent validation of this scale. There was a correlation between sleep latency in diagnostic polysomnography and the NSS. CONCLUSIONS: The Brazilian Portuguese version of NSS showed to be valid and reproducible tool for assessing the severity of patients with type 1 narcolepsy and have potential impact on clinical practice.