Combined low-carbohydrate diet and long-term exercise in hypoxia in type 2 diabetes: A randomized controlled trial protocol to assess glycemic control, cardiovascular risk factors and body composition.

Background: Cardiovascular disease is the leading cause of mortality associated with diabetes, which is characterized by chronic hyperglycemia. Low-carbohydrate diet has gained popularity as an intervention in patients with type 2 diabetes mellitus, acting to improve glycemic profile and serum lipids. In its turn, exercise in hypoxia induces specific adaptations, mostly modulated via hypoxia-induced transcription factor signaling cascade, which increases with exposure to altitude, and promotes angiogenesis, glycogen supply, glucose tolerance, and raises GLUT-4 expression. Aim: Given that hyperglycemia decreases HIF-1α and it is better controlled when following a low-carbohydrate diet, this study aims to examine the hypothesis that a combination of both low-carbohydrate diet and chronic exercise in hypoxia in type 2 diabetes mellitus is associated with improved glycemic control and cardiovascular parameters, whose protocol is described. Methods: Patients with type 2 diabetes mellitus (n = 48) will be recruited and randomized into one of the three groups: (a) Control group: Control diet (low-fat and moderate-carbohydrate diet) + exercise in normoxia; (2) exercise in hypoxia group: Control diet + exercise in hypoxia; (3) intervention group: Low-carbohydrate diet (low-carbohydrate and high-fat diet) + exercise in hypoxia. Before and after 8 weeks of interventions, cardiopulmonary tests (Bruce protocol), body composition and blood pressure will be evaluated. Blood samples will be collected to measure hypoxia-induced transcription factor, C-reactive protein, glycemic and lipid profiles. Summary: This will be the first trial to examine the isolated and combined effect of chronic exercise in hypoxia and low-carbohydrate diet in type 2 diabetes mellitus. This trial will help to fill a significant research gap, guide future research and contribute to the combined nutrition and exercise approach to type 2 diabetes mellitus.

Avaliação da Associação entre Autoestima, Satisfação e Comportamento Sexual em Mulheres / Evaluation of the Association Between Self-Esteem, Satisfaction and Sexual behavior in Women

Esta pesquisa tem por objetivo investigar a relação entre autoestima e satisfação sexual feminina, e outras variáveis relacionadas ao comportamento sexual. Participaram 105 mulheres, com idades entre 18 e 61 anos (M=24,5; DP=6,06), de diferentes orientações sexuais. Os instrumentos utilizados foram Escala de Autoestima de Rosenberg, Escala de Satisfação Sexual Feminina e Questionário de Sexualidade Feminina. Os resultados indicaram correlações positivas e moderadas entre a autoestima e satisfação sexual. A preocupação pessoal com o sexo foi o principal fator predito pela autoestima. Concluiu-se que quanto maior a autoestima, maior a satisfação sexual feminina. Foi encontrado também que ter relações sexuais com uma mesma pessoa, ainda que sem o status de um relacionamento formal, assim como ter relações sexuais com frequência, estão associados com a satisfação sexual de mulheres. Espera-se fomentar a discussão acerca da sexualidade feminina, indicando a importância da autoestima feminina para experiências sexuais prazerosas.

This research aims to investigate the relationship between women's self-esteem and sexual satisfaction, and other variables related to sexual behavior. The participants were 105 women aged 18 to 61 years (M = 24.5; SD = 6.06), from different sexual orientations participated. The instruments used were the Rosenberg's Self-esteem Scale, The Female Sexual Satisfaction Scale and the Female Sexuality Questionnaire. The results showed positive and moderate correlations between self-esteem and sexual satisfaction, as well as the person's concern for sex as the main factor predicted by self-esteem. In conclusion, that the higher self-esteem, the greater the sexual satisfaction of women. We also observed that having sex with the same person, even without the status of a formal relationship, and frequent sexual relations were associated with women's sexual satisfaction. We hope to stimulate discussion about female sexuality, by pointing to the importance of female self-esteem for pleasurable sexual experiences.

Review: Current status of corpus luteum assessment by Doppler ultrasonography to diagnose non-pregnancy and select embryo recipients in cattle.

A number of potentials uses of Doppler ultrasonography have been explored in the last decades, both as research tools in reproductive physiology investigations and for the reproductive management of farm animals. The objective of this review was to address some of the recent strategies developed in fixed-time reproductive programs and resynchronization of ovulation in cattle, based on the evaluation of corpus luteum function by color-Doppler ultrasound imaging. Recent studies in dairy and beef cattle pointed out to a high accuracy when Doppler ultrasonography is used to assess the functionality of the corpus luteum and identify non-pregnant females at 20-24 days after breeding. Therefore, super-early resynchronization programs starting in the second week after timed-artificial insemination or embryo transfer have been developed and are being implemented in commercial assisted reproduction programs; thus, anticipating conception with proven semen or genetically superior embryos. In addition, assessment of corpus luteum blood perfusion can be used for identifying high fertility embryo recipients in fixed-time embryo transfer programs.

Effects of Exercise on Inflammatory Markers in Individuals with Chronic Kidney Disease: A Systematic Review and Meta-Analysis.

Individuals with chronic kidney disease (CKD) have a systemic inflammatory state. We assessed the effects of exercise on inflammatory markers in individuals with CKD. An electronic search was conducted, including MEDLINE. Experimental clinical trials that investigated the effects of exercise on inflammatory markers in individuals with CKD at all stages were included. Meta-analyses were conducted using the random-effects model and standard mean difference (SMD). Subgroup analyses were performed for resistance, aerobic, and combined exercise interventions. Twenty-nine studies were included in the meta-analyses. Exercise interventions showed significant reductions in C-reactive protein (CRP) (SMD: -0.23; 95% CI: -0.39 to -0.06), interleukin (IL)-6 (SMD: -0.35; 95% CI: -0.57, -0.14), and tumor necrosis factor-alpha (TNF-α) (SMD: -0.63, 95% CI: -1.01, -0.25) when compared with the controls. IL-10 levels significantly increased (SMD: 0.66, 95% CI: 0.09, 1.23) with exercise interventions. Resistance interventions significantly decreased CRP (SMD: -0.39, 95% CI: -0.69, -0.09) and TNF-α (SMD: -0.72, 95% CI: -1.20, -0.23) levels, while increasing IL-10 levels (SMD: 0.57, 95% CI: 0.04, 1.09). Aerobic interventions only significantly reduced IL-6 levels (SMD: -0.26, 95% CI: -0.51, -0.01). No significant changes in any inflammatory markers were observed with combined exercise interventions. Exercise interventions are effective as an anti-inflammatory therapy in individuals with CKD compared to usual care control groups. Resistance interventions seem to promote greater anti-inflammatory effects.

Intradialytic resistance training for short daily hemodialysis patients as part of the clinical routine: a quasi-experimental study.

Background and purpose: Hemodialysis patients have chronic systemic inflammation, musculoskeletal impairments, and body composition changes from several factors and exercise may attenuate. We evaluated the effects of an intradialytic resistance training program on body composition, physical function, and inflammatory markers in patients under short daily hemodialysis treatment. Materials and methods: A quasi-experimental study in clinical routine was conducted over eight months. Measures of physical function (handgrip strength, five-time sit-to-stand, timed-up and go, and gait speed), body composition (by bioelectrical impedance), and inflammatory markers (interleukin [IL]-1 beta, IL-6, IL-8, IL-10, IL-12p70, and tumor necrosis factor-α) were assessed at baseline as well as at four and eight months past continued intervention. Patients underwent two intradialytic resistance training sessions per week supervised by exercise professionals. Results: A total of 18 patients (62 ± 14 years; 55.6% ≥ 60 years; 44% female) were included. Significant increases in body mass index and basal metabolic rate were found at four and eight months compared to baseline. For physical function, timed-up and go performance improved at four and eight months compared to baseline. The other body composition and physical function measures, as well as all inflammatory markers, did not significantly change over time. Conclusion: A supervised intradialytic resistance training program for patients on short daily hemodialysis treatment, as part of the clinical routine, may induce modest changes in body mass index, basal metabolic rate, and timed-up and go performance.

An umbrella review of the evidence linking oral health and systemic noncommunicable diseases.

Oral diseases are highly prevalent worldwide. Recent studies have been supporting a potential bidirectional association of oral diseases with systemic noncommunicable diseases (NCDs). Available evidence supports that people with NCDs have a greater prevalence of oral diseases particularly those with limited ability of oral self-care. Regarding the reverse relationship, the lines of evidence pointing out NCDs as putative risk factors for oral diseases have increased significantly but not with a consistent agreement. This umbrella review of meta-analyses appraises the strength and validity of the evidence for the association between oral health and systemic health (registered at PROSPERO, ID: CRD42022300740). An extensive search included systematic reviews that have provided meta-analytic estimates on the association of oral diseases with NCDs. The overall strength of evidence was found to be unfavorable and with methodological inconsistencies. Twenty-eight NCDs were strongly associated with oral diseases. Among those NCDs are five types of cancer, diabetes mellitus, cardiovascular diseases, depression, neurodegenerative conditions, rheumatic diseases, inflammatory bowel disease, gastric helicobacter pylori, obesity, and asthma. According to fail-safe number statistics, the evidence levels are unlikely to change in the future, indicating a fairly robust consistency.

Effects of Acute and Chronic Exercise in Hypoxia on Cardiovascular and Glycemic Parameters in Patients with Type 2 Diabetes: A Systematic Review.

Kindlovits, Raquel, Alberto Mello da Silva Pereira, Ana Catarina Sousa, João Luís Viana,and Vitor Hugo Teixeira. Effects of acute and chronic exercise in hypoxia on cardiovascular and glycemic parameters in patients with type 2 diabetes: a systematic review. High Alt Med Biol. 23:301-312, 2022. Background: Exercise in hypoxia (EH, decreased oxygen availability) has been proposed as a potential therapeutic intervention to promote angiogenesis and improve glucose metabolism to a greater extent than exercise under normoxia (normal ambient air) in patients with type 2 diabetes (T2D). Currently, there are no studies that systematize the existent evidence. This study aims to systematically review the literature and qualitatively evaluate the effects of acute and chronic EH on cardiovascular and glycemic parameters in T2D patients. Methods: A structured search was carried out following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines until March 2021, in the MEDLINE/PubMed, Scopus, and Web of Science databases. The inclusion criteria were as follows: (1) randomized and nonrandomized trials, (2) in complication-free patients with T2D, (3) in which EH was compared with exercise in normoxia or with baseline data, and (4) published in English. Results: Six articles (64 subjects) met the inclusion criteria and were reviewed to data extraction. Four articles investigated the acute effect of EH (33 subjects), and two articles investigated the chronic effect of EH (31 subjects), ranging from 6 to 8 weeks. All studies used a cycle ergometer as exercise. Acute EH benefits insulin sensitivity, blood glucose, vascular endothelial growth factor, and metalloproteinase-9, while chronic EH benefits nitric oxide synthase in erythrocytes, but not brachial artery flow-mediated dilation. Conclusion: Acute EH improves glucose homeostasis in T2D patients, which was not seen with chronic EH. Both acute EH and chronic EH improve angiogenesis regulators, but not vascular function. Despite the putative benefits of EH in patients with T2D, the evidence is still scarce and further research is needed before recommendations can be provided.

Radiographically screened periodontitis is associated with deteriorated oral-health quality of life: A cross-sectional study.

Periodontitis is greatly related to worse perceived oral health-related quality of life (OHRQoL), yet this association has never been explored using radiographically screened periodontal bone loss. Here we have radiographically screened patients for periodontitis via a validated method and assessed its association with measures of OHRQoL. From a total of 10,267 participants (6,112 females and 4,155 males), self-reported general health questionnaire, body mass index, self-reported oral health behaviours, panoramic x-rays and the oral health impact profile (OHIP-14) were gathered. Radiographically screened periodontitis was measured through a radiographic-based periodontal bone loss (R-PBL) approach. We compared the respective variables according to the R-PBL status and explored using multiple logistic regression adjusted for the significant variables. Overall, patients with periodontitis shown significantly different sociodemographic, health measures and oral hygiene characteristics. All domains of the OHIP-14 were significantly worsened in the periodontitis group, and further confirmed through adjusted logistic regression (p<0.001). Active smoking, number of missing teeth, sex and age were the most impactful variables in this relationship. Our results demonstrate the existence of a link between radiographically screened periodontitis and OHRQoL, mostly upheld by active smoking, number of missing teeth, sex and age.

Bem-Estar Subjetivo de Estudantes: Variáveis Escolares Associadas e Medidas de Avaliação / Student's Subjective Well-Being: Associated School Variables and Assessment Measures / Bienestar Subjetivo del Estudiante: Variables Escolares Asociadas y Medidas de Evaluación

O objetivo deste estudo foi investigar quais as variáveis escolares associadas ao bem-estar subjetivo de estudantes, bem como identificar as medidas de avaliação utilizadas, por meio de uma revisão integrativa da literatura. Foram utilizados os seguintes descritores: "bem-estar subjetivo", "escola" e "estudante", e os termos correspondentes nos idiomas inglês e espanhol. As bases de dados consultadas foram: ERIC, IndexPsi, Lilacs, PePsic, PsycInfo, PubMed e SciELO. Após a leitura completa, o conjunto final de publicações com base nos critérios de elegibilidade foi composto por 26 artigos, publicados entre os anos de 1998 e 2019. A maioria dos estudos foi realizada nos Estados Unidos e na China. Os instrumentos mais utilizados foram Student's Life Satisfaction Scale e Positive and Negative Affect Scale for Children. Evidenciou-se a escassez de medidas contextualizadas para o contexto escolar. As variáveis mais associadas ao bem-estar subjetivo de alunos relacionam-se à socialização, à adaptabilidade de comportamento e à competência acadêmica. Os resultados fornecem subsídios para a formulação de intervenções com foco na promoção do bem-estar de estudantes e destacam a importância de medidas contextualizadas na escola.

The aim of this study was to investigate the school variables associated with the subjective well-being of students, as well as to identify the assessment measures used, through an integrative literature review. The following descriptors were used: "subjective well-being", "school" and "student", and the corresponding terms in English and Spanish. The databases consulted were: ERIC, IndexPsi, Lilacs, PePsic, PsycInfo, PubMed and SciELO. After the complete reading, the final set of publications based on the eligibility criteria was composed of 26 articles, published between the years 1998 and 2019. Most studies were carried out in the United States and China. The most used instruments were Student's Life Satisfaction Scale and the Positive and Negative Affect Scale for Children. The scarcity of contextualized measures for the school context was evidenced. The variables most associated with student's subjective well-being are related to socialization, behavior adaptability and academic competence. The results provide subsidies for the development of interventions focused on promoting the students' well-being and highlight the importance of contextualized measures at school.

El objetivo de este estudio fue investigar las variables escolares asociadas al bienestar subjetivo de los estudiantes, así como identificar las medidas de evaluación utilizadas, por medio de de una revisión integradora de la literatura. Se utilizaron los siguientes descriptores: "bienestar subjetivo", "escuela" y "estudiante", y los términos correspondientes en inglés y español. Las bases de datos consultadas fueron: ERIC, IndexPsi, Lilacs, PePsic, PsycInfo, PubMed y SciELO. Tras la lectura completa, el conjunto final de publicaciones con base en los criterios de elegibilidad estuvo compuesto por 26 artículos, publicados entre los años 1998 y 2019. La mayoría de los estudios se realizaron en Estados Unidos y China. Los instrumentos más empleados fueron la Escala de Satisfacción con la Vida del Estudiante y la Escala de Afecto Positivo y Negativo para Niños. Se evidenció la escasez de medidas contextualizadas para el contexto escolar. Las variables más asociadas al bienestar subjetivo de los estudiantes están relacionadas con la socialización, la adaptabilidad de la conducta y la competencia académica. Los resultados otorgan subsidios para la formulación de intervenciones enfocadas a promover el bienestar de los estudiantes y resalta la importancia de medidas contextualizadas en la escuela.

Inflammation and physical dysfunction: responses to moderate intensity exercise in chronic kidney disease.

BACKGROUND: People with chronic kidney disease (CKD) experience skeletal muscle wasting, reduced levels of physical function and performance, and chronic systemic inflammation. While it is known that a relationship exists between inflammation and muscle wasting, the association between inflammation and physical function or performance in CKD has not been well studied. Exercise has anti-inflammatory effects, but little is known regarding the effect of moderate intensity exercise. This study aimed to (i) compare systemic and intramuscular inflammation between CKD stage G3b-5 and non-CKD controls; (ii) establish whether a relationship exists between physical performance, exercise capacity and inflammation in CKD; (iii) determine changes in systemic and intramuscular inflammation following 12 weeks of exercise; and (iv) investigate whether improving inflammatory status via training contributes to improvements in physical performance and muscle mass. METHODS: This is a secondary analysis of previously collected data. CKD patients stages G3b-5 (n = 84, n = 43 males) and non-CKD controls (n = 26, n = 17 males) underwent tests of physical performance, exercise capacity, muscle strength and muscle size. In addition, a subgroup of CKD participants underwent 12 weeks of exercise training, randomized to aerobic (AE, n = 21) or combined (CE, n = 20) training. Plasma and intramuscular inflammation and myostatin were measured at rest and following exercise. RESULTS: Tumour necrosis factor-α was negatively associated with lower $^{^{^{.}}}{\rm V}$O2Peak (P = 0.01), Rectus femoris-cross sectional area (P = 0.002) and incremental shuttle walk test performance (P < 0.001). Interleukin-6 was negatively associated with sit-to-stand 60 performances (P = 0.006) and hand grip strength (P = 0.001). Unaccustomed exercise created an intramuscular inflammatory response that was attenuated following 12 weeks of training. Exercise training did not reduce systemic inflammation, but AE training did significantly reduce mature myostatin levels (P = 0.02). Changes in inflammation were not associated with changes in physical performance. CONCLUSIONS: Systemic inflammation may contribute to reduced physical function in CKD. Twelve weeks of exercise training was unable to reduce the level of chronic systemic inflammation in these patients, but did reduce plasma myostatin concentrations. Further research is required to further investigate this.

Global Policy Barriers and Enablers to Exercise and Physical Activity in Kidney Care.

OBJECTIVE: Impairment in physical function and physical performance leads to decreased independence and health-related quality of life in people living with chronic kidney disease and end-stage kidney disease. Physical activity and exercise in kidney care are not priorities in policy development. We aimed to identify global policy-related enablers, barriers, and strategies to increase exercise participation and physical activity behavior for people living with kidney disease. DESIGN AND METHODS: Guided by the Behavior Change Wheel theoretical framework, 50 global renal exercise experts developed policy barriers and enablers to exercise program implementation and physical activity promotion in kidney care. The consensus process consisted of developing themes from renal experts from North America, South America, Continental Europe, United Kingdom, Asia, and Oceania. Strategies to address enablers and barriers were identified by the group, and consensus was achieved. RESULTS: We found that policies addressing funding, service provision, legislation, regulations, guidelines, the environment, communication, and marketing are required to support people with kidney disease to be physically active, participate in exercise, and improve health-related quality of life. We provide a global perspective and highlight Japanese, Canadian, and other regional examples where policies have been developed to increase renal physical activity and rehabilitation. We present recommendations targeting multiple stakeholders including nephrologists, nurses, allied health clinicians, organizations providing renal care and education, and renal program funders. CONCLUSIONS: We strongly recommend the nephrology community and people living with kidney disease take action to change policy now, rather than idly waiting for indisputable clinical trial evidence that increasing physical activity, strength, fitness, and function improves the lives of people living with kidney disease.

Life Satisfaction, Affects at School and Depression Symptoms among Adolescents / Satisfação com a Vida, Afetos na Escola e Sintomas Depressivos em Adolescentes / Satisfacción con la Vida, Afectos en la Escuela y Síntomas Depresivos en Adolescentes

Abstract The literature indicates that life satisfaction has a direct effect on depression symptoms. For better understanding depression in adolescence, this research examined the relation between life satisfaction and depression symptoms among Brazilian adolescents, and verified the direct effects of positive and negative affects at school, in addition to the mediating effect of these variables on the relation between life satisfaction and depression symptoms. A total of 428 adolescents participated in the research, with mean age equal to 14.88. The Baptista Depression Scale, the Life Satisfaction Scale, and the School Subjective Well-being Scale were used. The models were tested using Path Analysis. The results indicated that affects at school mediated the relation between life satisfaction and depression symptoms. Prevention initiatives that consider the affects related to the school context can be a useful strategy for the promotion of youth mental health.

Resumo A literatura indica que satisfação com a vida possui efeito direto em sintomas depressivos. Para melhor compreensão da depressão na adolescência, esta pesquisa teve como objetivo examinar a relação entre satisfação com a vida e sintomas depressivos em adolescentes brasileiros, e verificou os efeitos diretos dos afetos positivos e negativos na escola, bem como o efeito mediador destas variáveis na relação entre satisfação com a vida e sintomas depressivos. Participaram da pesquisa 428 adolescentes, com média de idade igual a 14,88. Foram utilizadas Escala Baptista de Depressão, Escala Global de Satisfação com a Vida e Escala de Bem-Estar Subjetivo Escolar. O teste dos modelos foi feito por meio de Path Analysis. Os resultados indicaram que os afetos na escola mediaram a relação entre satisfação com a vida e sintomas depressivos. Iniciativas de prevenção que considerem os afetos relacionados ao contexto escolar podem ser uma estratégia útil para promoção da saúde mental de jovens.

Resumen La literatura indica que la satisfacción con la vida influye directamente en síntomas depresivos. Para una mejor comprensión de la depresión en la adolescencia, esta investigación examinó la relación entre la satisfacción con la vida y los síntomas depresivos en adolescentes brasileños, y verificó los efectos directos de los afectos positivos y negativos en la escuela, así como el efecto mediador de estas variables en la relación entre la satisfacción con la vida y los síntomas depresivos. Participaron en la investigación 428 adolescentes, con edad media igual a 14,88. Se utilizaron la Escala Baptista de Depresión, la Escala de Satisfacción de Vida y la Escala de Bienestar Escolar Subjetivo. Los modelos se probaron utilizando Path Analysis. Los resultados indicaron que los afectos en la escuela mediaron la relación entre la satisfacción con la vida y los síntomas depresivos. Las iniciativas de prevención que tengan en cuenta las afecciones relacionadas con el contexto escolar pueden ser una estrategia útil para promover salud mental de jóvenes.

Validity evidence for the School Subjective Well-Being Scale / Evidências de validade para a Escala de Bem-Estar Subjetivo Escolar

This study gathered validity evidence based on relations to other variables for the School Subjective Well-being Scale. The sample consisted of 434 students of both genders, with age ranging from 12 to 19 years (M = 14.88; SD = 1.70); they were all students from the 7th grade Elementary School to the 2nd grade High School, attending a public school located in Ceará, Brazil. The School Subjective Well-being Scale, a sociodemographic and school questionnaire, was applied, as well as the Baptist Depression Scale for Children and Adolescents, the Global Life Satisfaction Scale for Adolescents, the Social Support Perception Scale for Adolescents. The scale factors showed significant positive and negative, moderate to high correlations and the measure's scores of school well-being allowed differentiation among groups regarding gender and school issues.

Este estudo teve por objetivo reunir evidências de validade, baseada na relação com outras variáveis, da Escala de Bem-Estar Subjetivo Escolar. A amostra foi composta por 434 estudantes de ambos os sexos com idades variando de 12 a 19 anos (M = 14,88; DP = 1,70), alunos do 7º ano do Ensino Fundamental ao 2º ano do Ensino Médio de uma escola pública localizada no Ceará, Brasil. Foram aplicados um questionário sociodemográfico e escolar, a Escala de Bem-Estar Subjetivo Escolar, Escala Baptista de Depressão versão Infantojuvenil, Escala Global de Satisfação de Vida para Adolescentes e a Escala de Percepção de Suporte Social para Adolescentes. Observou-se associações significativas entre os escores do instrumento com as medidas de depressão, suporte social e satisfação com a vida, e os escores da medida de bem-estar escolar conseguiram diferenciar grupos quanto ao sexo e questões escolares.

Risk factors and their contribution to population health in the European Union (EU-28) countries in 2007 and 2017.

BACKGROUND: The Global Burden of Disease (GBD) study has generated a wealth of data on death and disability outcomes in Europe. It is important to identify the disease burden that is attributable to risk factors and, therefore, amenable to interventions. This paper reports the burden attributable to risk factors, in deaths and disability-adjusted life years (DALYs), in the 28 European Union (EU) countries, comparing exposure to risks between them, from 2007 to 2017. METHODS: Retrospective descriptive study, using secondary data from the GBD 2017 Results Tool. For the EU-28 and each country, attributable (all-cause) age-standardized death and DALY rates, and summary exposure values are reported. RESULTS: In 2017, behavioural and metabolic risk factors showed a higher attributable burden compared with environmental risks, with tobacco, dietary risks and high systolic blood pressure standing out. While tobacco and air quality improved significantly between 2007 and 2017 in both exposure and attributable burden, others such as childhood maltreatment, drug use or alcohol use did not. Despite significant heterogeneity between EU countries, the EU-28 burden attributable to risk factors decreased in this period. CONCLUSION: Accompanying the improvement of population health in the EU-28, a comparable trend is visible for attributable burden due to risk factors. Besides opportunities for mutual learning across countries with different disease/risk factors patterns, good practices (i.e. tobacco control in Sweden, air pollution mitigation in Finland) might be followed. On the opposite side, some concerning cases must be highlighted (i.e. tobacco in Bulgaria, Latvia and Estonia or drug use in Czech Republic).

Active immunization against GnRH as an alternative therapeutic approach for the management of Bos indicus oocyte donors diagnosed with chronic cystic ovarian disease.

The aim of this study was to evaluate the effect of active immunization against GnRH in Nelore (Bos indicus) cows repeatedly used as oocyte donors that developed chronic cystic ovarian disease (COD). In the first experiment, ovarian and uterine features were first compared between COD cows (n = 15) and healthy cows (n = 22, cycling control group) from the same breed and herd. Cows with COD had a greater number of large (P < 0.0001) and medium follicles (P < 0.01) but lesser small follicles (P < 0.05) than cycling controls. Mucometra was diagnosed in 73.3% of COD cows, but in none of the controls. No difference in average thickness of the endometrium was detected between groups; however, endometrial thickness and mucometra score were negatively correlated (R = -0.73, P = 0.0029) in COD cows. In the second experiment, COD cows were randomly allocated into two experimental groups, which received two 1.0 mL SC injections of either an anti-GnRH vaccine (COD immunized group, n = 8) or saline (COD control group, n = 7), given 28 days apart. Cows were examined weekly by transrectal ultrasonography during nine consecutive weeks after the first injection to evaluate the number and distribution of follicles among size classes, endometrial thickness, and presence of clinical mucometra. Vaccination against GnRH resulted in a progressive suppression of follicle growth and a reduction in the average size of the largest follicle, as well as in the number of large follicles (P < 0.01) in COD immunized cows compared with COD controls from week 7 onwards. Conversely, the number of small follicles in the COD immunized group increased after week 5 and was greater (P = 0.0023) than controls on week 9. Endometrial thickness and mucometra score were not affected (P > 0.05) by immunization against GnRH. In the third experiment, the COD immunized cows with effective suppression of follicle growth four weeks after the 2nd injection (n = 6) were submitted to three consecutive ovum pick-up (OPU) sessions (weeks 10, 11, and 12) for in vitro embryo production (IVEP). Cumulus-oocyte complexes (COC) collected from slaughterhouse ovaries were used as controls for IVEP. COD cows with produced 25.0 ± 3.8 COC per OPU session with no apparent detrimental effect of anti-GnRH vaccine on oocyte developmental potential in vitro, i.e., we observed similar cleavage rate (P = 0.5914) and greater blastocyst rate (P = 0.0177) in immunized cows compared with COC from slaughterhouse controls. Finally, in the fourth experiment wave emergence and follicular dynamics after follicle ablation were compared between COD immunized cows with effective suppression of follicle growth and a subset (n = 6) of the cycling, control group. No follicles grew beyond 4 mm diameter after follicle ablation in the COD immunized group, whereas a normal follicular wave emergence occurred in cycling controls. Antral follicle count was similar between cycling controls and COD immunized groups at 24 h and 96 h post-follicle ablation (P > 0.05), but greater in cycling controls at 48 h and 72 h post-follicle ablation (P < 0.05). In summary, our results suggest that active immunization against GnRH is effective to induce the regression of follicular cysts as well as increase the number of small follicles growing on the ovaries, in oocyte donors diagnosed with chronic COD, with no apparent negative effect on oocyte developmental potential in vitro.

Forças de Caráter e Construção de Projetos Vida na Adolescência / Character Strenghts and Life Purpose in Adolescence / Fuerzas de Carácter y Proyectos de Vida en la Adolescência

Identificar características individuais que auxiliem na construção de projetos de vida é fundamental para a prática baseada em evidências. Esta pesquisa investigou as associações entre forças de caráter e projetos de vida. Participaram 276 jovens, com idades variando de 14 a 20 anos (M = 15,89; DP = 1,02), estudantes do Ensino Médio de escolas localizadas em São Paulo e Minas Gerais. Foram utilizados um questionário sociodemográfico, a Escala de Projeto de Vida para Adolescentes e a Escala de Forças de Caráter. Observou-se correlações entre forças de caráter e projeto de vida, com destaque para espiritualidade, otimismo, gratidão, generosidade e senso de coletividade, evidenciando a importância de características individuais positivas para a construção de projetos de vida.

Identify individual characteristics that assist in the construction of life purpose is essential for evidence-based practice. This research investigated associations between character strengths and life purpose were investigated. The study included 276 young people, with ages ranging from 14 to 20 years old (M = 15.89; SD = 1.02), high school students from schools located in São Paulo and Minas Gerais. A sociodemographic questionnaire, the Teenage Living Project Scale and the Character Strength Scale were used. Correlations between character strengths and life purpose were founded, with emphasis on spirituality, optimism, gratitude, generosity and a sense of collectivity, showing the importance of positive individual characteristics for the construction of life projects.

Identificar características individuales que ayudan en la construcción del propósito de vida es esencial para la práctica basada en evidencia. Este estudio investigó asociaciones entre fortalezas de carácter y proyectos de vida. El estudio incluyó a 276 jóvenes, con edades que varían de 14 a 20 años (M = 15.89; SD = 1.02), estudiantes de secundaria de escuelas ubicadas en São Paulo y Minas Gerais . Cuestionario sociodemográfico, Escala de Proyecto de Vida de Adolescentes y Escala de Fuerza de Carácter fueron usados. Se observó correlaciones entre fortalezas de carácter y proyecto de vida, con énfasis en espiritualidad, optimismo, gratitud, generosidad y sentido de colectividad, lo que demuestra importancia de las características individuales positivas para la construcción de proyectos de vida.

Timing of early resynchronization protocols affects subsequent pregnancy outcome in dairy cows.

The aim of this study was to evaluate the outcomes of an early resynchronization protocol (Resynch) initiated at different timepoints after timed artificial insemination (TAI) and with unknown pregnancy status. Holstein cows (n = 164) were submitted to the following TAI protocol: D0, insertion of an intravaginal progesterone (P4) device and 2 mg im estradiol benzoate (EB); D8, removal of P4 device and treatment with 0.5 mg im sodium cloprostenol (PGF); D9, 0.1 mg im Lecirelin (LEC); and D10, TAI1. Cows were then randomly assigned to Resynch protocols starting either on day 20 (Resynch20D, n = 82) or 25 after TAI1 (Resynch25D, n = 82) with the insertion of a new P4 device and EB treatment. In both groups, P4 device was removed on day 8 after the beginning of Resynch, the same day of pregnancy diagnosis by ultrasonography. In pregnant cows there was no further action. Non-pregnant cows were treated with 0.5 mg im PGF, had a blood sample collected for serum P4 analysis and we measured and recorded the size of the largest follicle and the presence or absence of a corpus luteum (CL). One day later, cows were treated with 0.1 mg im LEC and TAI2 occurred 12-14 h later. The diameter of the largest follicle and serum P4 were compared between groups by ANOVA for the main effects of treatment, presence of a CL, and their interaction, whereas pregnancy per artificial insemination (P/AI) and the percentage of cows with a CL on the day of ultrasonography were analyzed using the Chi-square test. Follicle diameter on day 8 of Resynch was greater for cows in the Resynch20D group compared with Resynch25D (15.9 ± 3.9 vs 12.2 ± 2.5 mm, respectively; P = 0.046). The Resynch25D group had a greater percentage of cows with a CL (51.9 vs 18.9%, respectively; P = 0.0008) and higher serum P4 (2.8 ± 1.1 vs 1.7 ± 0.8 ng/mL; P = 0.041) at the end of the protocol compared with Resynch20D. P/AI at TAI1 was 35.4 and 36.6% (P > 0.10) for cows enrolled in Resynch20D and Resynch25D groups, respectively. P/AI to TAI2, after Resynch protocols, was greater in Resynch25D than Resynch20D (44.2 vs 22.6%, respectively; P < 0.05). In conclusion, starting an early resynchronization protocol 25 days after TAI increases P/AI compared with starting 20 days after TAI, and this was associated with a presumed greater proportion of cows with a functional CL at the moment of P4 device removal.

Parasites in road-killed wild felines from North of Paraná state, Brazil.

This study aimed to identify the intestinal parasites of road-killed wild felines in the North Central and North, Paraná state, southern Brazil. The animals were monitored by sampling previously established transects. The places where the felines were run over were mapped, the animals were identified, and the gastrointestinal tract was evaluated. The feces were submitted to coproparasitological techniques of spontaneous sedimentation, floating in hypersaturated NaCl solution and centrifugal floating in zinc sulfate. All the parasitic structures detected were photomicrographed. In the coproparasitological analyses were identified oocysts of Cystoisospora spp., eggs of Ancylostomatidae, and Capillaria spp.; eggs of Aelurostrongylus spp., Toxocara spp., Physaloptera spp., Taenia spp., and Spirometra spp.; Aelurostrongylus abstrusus larvae; and eggs and adults of Ancylostoma cati and Taenia spp. One of the cats was parasitized by a flea of Ctenocephalides felis felis. Based on these results, the animals analyzed in this study supplied important samples for the evaluation of parasitic diversity of North of Paraná and suggested that this region may have conditions that allow the maintenance of these parasites life cycles in the environment and among wildlife.

Effect of a single or two doses of an anti-GnRH vaccine on testicle morpho-functional characteristics in Nelore bulls.

The aim of this study was to compare testicle morpho-functional characteristics in bulls undergoing a single or two immunizations against GnRH. Nelore (Bos taurus indicus) bulls were randomly allocated into three experimental groups: G1 (n=12), a single 400 µg dose of anti-GnRH vaccine on day 0; G2 (n=11), a first 400 µg dose of anti-GnRH vaccine on day 0 followed by a second (boost) dose 30 days later; and control group (CG, n=12), 1 mL saline 0.9% at day 0. Every 30 days, from day 0 until slaughter at day 90, the bulls were weighed and underwent testicular biometry, semen collection and analysis, and blood sample collection for testosterone measurement. Immediately after slaughter, the testicles were removed and transport at 15°C to the laboratory for histopathological analysis. There was a decrease in testicular height (P=0.0476), width (P=0.0021), and in scrotal circumference (P=0.0001), after either a single (G1) or two (G2) immunizations against GnRH. Both G1 and G2 had lower testosterone concentrations than CG from day 60 on (P<0.01), but in G2, it was also lower than in G1 at day 90 (P=0.0006). All sperm parameters were affected by active immunization against GnRH (P<0.05), and in G2, averages were lesser (P<0.05) than in G1 from day 60 on. No signs of seminiferous tubule degeneration were found in any sample from the CG, contrasting with 75.0% and 100.0% of the samples from G1 and G2, respectively. In summary, immunocastration affected testicle morpho-functional characteristics in bulls in a time- and dose-dependent way.

Blood Pressure and Tooth Loss: A Large Cross-Sectional Study with Age Mediation Analysis.

We aimed to investigate the association between blood pressure (BP) and tooth loss and the mediation effect of age. A cross-sectional study from a reference dental hospital was conducted from September 2017 to July 2020. Single measures of BP were taken via an automated sphygmomanometer device. Tooth loss was assessed through oral examination and confirmed radiographically. Severe tooth loss was defined as 10 or more teeth lost. Additional study covariates were collected via sociodemographic and medical questionnaires. A total of 10,576 patients were included. Hypertension was more prevalent in severe tooth loss patients than nonsevere tooth lost (56.1% vs. 39.3%, p < 0.001). The frequency of likely undiagnosed hypertension was 43.4%. The adjusted logistic model for sex, smoking habits and body mass index confirmed the association between continuous measures of high BP and continuous measures of tooth loss (odds ratio (OR) = 1.05, 95% CI: 1.03-1.06, p < 0.001). Age mediated 80.0% and 87.5% of the association between periodontitis with both systolic BP (p < 0.001) and diastolic BP (p < 0.001), respectively. Therefore, hypertension and tooth loss are associated, with a consistent mediation effect of age. Frequency of undiagnosed hypertension was elevated. Age, gender, active smoking, and BMI were independently associated with raised BP.