Using native fish in eco-genotoxic assessment of heavy metal contamination pollution arising from nearby large Brazilian rivers.

Worldwide water quality has declined progressively due to continuous pollution of aquatic resources by agrochemicals in particular heavy metals. Fish genotoxicity biomarkers are vital to identify and complement chemical parameters for determining environmental risk of adverse effects. Therefore, it was of interest to examine the eco-genotoxicity attributed to water pollution over different stream sections of Brazilian rivers by using Cichlasoma paranaense (Teleostei: Cichlidae), a neotropical freshwater cichlid fish, as a biological model. Chemical analysis of water and sediments collected from different Brazilian rivers sites demonstrated contamination by metals. Cichlasoma paranaense were collected at a reference location (a permanent water preservation area), maintained in the lab under standard conditions (controlled temperature, lighting, daily feeding, and constant aeration) and exposed to environmental samples of water and sediments. Subsequently, micronucleus (MN) and nuclear abnormalities (NA) frequencies were assessed in erythrocytes obtained from the caudal and gill regions. The highest concentrations of Cu were found in samples from river sites with forest fragmentation attributed to intensive agriculture practices. Similarly, exposure of fish to samples from agricultural areas induced significantly higher number of genotoxic effects. There was no marked difference between the tissues (tail and gill) regarding the observed frequencies of MN and NA. Thus C. paranaense fish served as a reliable model for detecting genotoxic effects, especially when water samples were collected near the discharge of agrochemicals. Evidence indicates that this method be considered for other global river sites which are also exposed to agrochemicals discharges containing Cu.

Chromosomal Instability and Origin of B Chromosomes in the Amazonian Glass Tetra Moenkhausia oligolepis (Günther, 1864) (Characiformes, Characidae).

B chromosomes occur in different species of the small characid fishes of the genus Moenkhausia. These supernumerary elements, that do not recombine with chromosomes of the standard A complement and follow their own evolutionary mechanism vary in number, morphology, and distribution. Here, we show karyotypic data of individuals of 2 populations of Moenkhausia oligolepis of the Brazilian Amazon (Pedro Correia and Taboquinha streams, Tocantins river basin), both with a diploid number of 50 chromosomes and karyotypic formula of 10m + 32sm + 8a. In addition to the normal complement, we also observed the occurrence of B chromosomes in the 2 populations with intra- and interindividual variation ranging from 0 to 10 Bs, independent of sex. The C-banding pattern evidenced heterochromatic blocks located mainly in the pericentromeric region of the chromosomes, while the B chromosomes appeared euchromatic. Silver-stained nucleolus organizer regions were identified in multiples sites, and some of these blocks were positive when stained with chromomycin A3. The karyotype analysis and the application of whole-chromosome painting in populations of M. oligolepis reinforce the conservation of the basal diploid number for the genus, as well as the evolutionary tendency in these fishes to carry B chromosomes. Both populations turned out to be in different stages of stability and expansion of their B chromosomes. We further suggest that the origin of these chromosomes is due to the formation of isochromosomes. Here, we identified a pair of complement A chromosomes involved in this process.

In vitro and in vivo antitumoral activity of a ternary copper (II) complex.

Recently, a high number of copper derivatives has been evaluated as DNA-targeting metallodrugs, due to the lower toxicity and its potential to cleave DNA. Several strategies have been testing to develop metal compounds effective against tumour cells. In this work, the ternary copper (doxycycline)-(1,10-phenanthroline) complex [Cu(dox)(phen)]2+ was especially designed as an antitumoral drug, previously showing high cytotoxicity and DNA cleavage activity. We aimed to further investigate the in vitro cytotoxic activity in both tumoral and non-tumoral cells, in vitro genotoxic potential, and in vivo antitumor activity using BALB/C mouse injected with sarcoma S180 and Ehrlich cell lines. Our results indicated that this compound exhibits a moderate genotoxic potential, with selective growth inhibition of tumor cells, especially the murine melanoma B16F10. Its main mechanism of action seems to be through ROS generation. We have further shown a significant reduction of the implanted tumor size in the animal model, suggesting that this compound has great antitumoral potential against many tumor types. [Cu(dox)(phen)]2+ is selectively cytotoxic for melanoma B16F10 and showed high chemotherapeutic potential in vivo against implanted sarcoma S180 and Ehrlich ascites tumours.

Genotoxicity assessment of polluted urban streams using a native fish Astyanax altiparanae.

Water quality has declined globally due to increased contamination of aquatic ecosystems. The use of fish genotoxicity biomarkers may improve and complement parameters for environmental risk assessment. The aim of this study was to assess the genotoxicity of samples collected from streams of the Jordão River, a tributary of the Paranaíba River, Brazil with different levels of metal contamination, utilizing a native fish species to determine the sensitivity and viability of implementing a useful, reliable technique for routine biomonitoring programs. Chemical analysis of water and sediments collected from different sites indicated that a gradient of contamination existed as evidenced by different concentrations of metals detected. After chronic exposure to contaminated samples, micronucleus (MN) frequencies in fish erythrocytes were measured and correlation with environmental parameters determined. Sites where the water concentrations of the metals aluminum (Al), iron (Fe), manganese (Mn), zinc (Zn) and copper (Cu) were high indicating a greater genotoxic potential of these elements. At the samples collected from the urban zone, a gradual increase was found for chromium (Cr), cadmium (Cd) and nickel (Ni) indicative of adverse impacts of discharge of urban effluents. Data demonstrated that Astyanax altiparanae, used in the test, exhibited a reliable sensitivity for detection of genotoxic consequences attributed to exposure to water samples collected near the discharge of industrial and domestic waste.

Assessment of the genotoxic potential of water courses impacted by wastewater treatment effluents using micronucleus assay in plants from the species Tradescantia.

Water pollution and the increase in genotoxic consequences in aquatic environments are well documented indicating the necessity and importance of biomonitoring programs. The objective of the present study was to determine the environmental quality of water resources and genotoxic potential of materials present within water samples obtained from the Perdizes River and the Mumbuca Stream, located in a region of discharge of wastewater treatment effluents using Tradescantia micronucleus assay (Trad - MCN). Water samples were collected from different locations up and downstream of the wastewater treatment plant during rainy season and subsequently submitted to physico-chemical analysis and Trad-MCN bioassay. The spatial distribution of the physico-chemical parameters assessed suggested that discharges of wastewater treatment effluents reduced water quality at all sites examined. Further, exposure to wastewater treatment effluents produced genotoxic effects on tetrads of Tradescantia pallida. These results reinforce the sensitivity of the Trad-MCN bioassay and its potential application in water quality monitoring programs concomitant with physicochemical evaluation.

Health inequalities: a Research Positioning Exercise at the National Institute of Health, Italy.

BACKGROUND: The Italian National Institute of Health (Istituto Superiore di Sanità, ISS) considers health inequalities (HI) an important area of activity. As the scientific and technical body of the Ministry of Health and the National Health Service, ISS may play a key role to reduce HI. In order to enable ISS in addressing the new and crucial HI challenge, a Research Positioning Exercise was designed and implemented. METHODS: The Exercise included: (i) workshop to strengthen the institutional interest in the field of HI; (ii) review and analysis of ISS publications (years 2000-2017) to identify HI research topics; (iii) survey among ISS researchers regarding main research challenges to address HI in the coming years; and (iv) analysis of input on research challenges from HI international experts. RESULTS: The results of this Exercise suggest that the following points should be included in the future ISS agenda planning: (i) themes which ISS should continue working on (e.g. migrants/vulnerable groups); (ii) themes to be improved: (a) relationship between social determinants and mechanism of HI generation and (b) relationship between risk factors exposure and social determinants; and (iii) new themes to be addressed: (a) mechanisms underlying the resilience observed in Italy; (b) new socioeconomic indicators for HI monitoring; and (c) evidence-based policies aimed at reducing HI. CONCLUSION: Findings of this Exercise show that ISS researchers identified relevant areas, addressing inequalities in addressing the health. Because of ISS structural peculiarity that includes multidisciplinary expertise, the ISS could provide a significant contribution to HI research challenges and knowledge gaps.

Effect of urbanization on the micronucleus frequency in birds from forest fragments.

The urbanization contributes to environment contamination, mainly by the increased vehicle traffic. This intense traffic releases in the air chemical compounds with mutagenic properties that can affect the entire ecosystem. The birds for the flight accumulate air, absorbing gases or particles. The absorption of this polluted air may be causative agent responsible for micronucleus (MN) induction in bird erythrocytes. The quantitative analysis of MN in birds can assists in the monitoring environmental quality of various places. The study aimed to quantify the MN frequency in birds and compare their variation: I) among forest fragments distant from and near to urbanization, II) among species and populations of birds and III) to find if there is a relation between vehicle traffic and MN induction. The capture of the birds took place in four forest fragments in central Brazil (two distant and two near the city) using mist nets. Blood smears were prepared with blood collected from the tarso-metatarsal vein. A total of 354 individuals were analyzed and MN were found in 52% of the individuals analyzed. All sampled birds were identified and resulted to belong to 50 different species, only 4 of which were captured in all the 4 forest fragments. The average MN frequency, regardless of bird species and sampling area, was 1.04/10,000 erythrocytes. From an overall analysis carried out on all birds, the MN frequencies were found to vary among forest fragments distant from and near to urbanization (x2 =15.513; p < 0.001) and demonstrated positive correlation between vehicle traffic intensity and the MN frequency (r = 0.988; df=2; p = 0.011). The species of birds presented variation in the amount of MN (x2 = 84.64; df=49; p = 0.001). Therefore, a restricted analysis carried out on the 4 species of birds present in all the forest fragments showed that the populations of Antilophia galeata (x2 =6.029; p = 0.014), Basileuterus culicivorus (x2 =9.53; p = 0.002), Eucometis penicillata (x2 =8.067; p = 0.005) and Myiothlypis flaveola (x2 =4.771; p = 0.029) showed difference in the MN frequency, when compared between forest fragments distant from and near to cities. The analysis demonstrated that birds living in forest areas near to the city presented higher MN frequency, probably because pollutants generated by urbanization affect birds and that the larger the vehicle traffic the greater the induced MN in the birds.

Chromosomal disruption and rearrangements during murine sarcoma development converge to stable karyotypic formation kept by telomerase overexpression.

BACKGROUND: Tumor initiation presents a complex and unstable genomic landscape; one of the earliest hallmark events of cancer, and its progression is probably based on selection mechanisms under specific environments that lead to functional tumor cell speciation. We hypothesized that viable tumor phenotypes possess common and highly stable karyotypes and their proliferation is facilitated by an attuned high telomerase activity. Very few investigations have focused on the evolution of common chromosomal rearrangements associated to molecular events that result in functional phenotypes during tumor development. RESULTS: We have used cytogenetic, flow cytometry and cell culture tools to investigate chromosomal rearrangements and clonality during cancer development using the murine sarcoma TG180 model, and also molecular biology techniques to establish a correlation between chromosome instability and telomerase activity, since telomeres are highly affected during cancer evolution. Cytogenetic analysis showed a near-tetraploid karyotype originated by endoreduplication. Chromosomal rearrangements were random events in response to in vitro conditions, but a stable karyotypic equilibrium was achieved during tumor progression in different in vivo conditions, suggesting that a specific microenvironment may stabilize the chromosomal number and architecture. Specific chromosome aberrations (marker chromosomes) and activated regions (rDNAs) were ubiquitous in the karyotype, suggesting that the conservation of these patterns may be advantageous for tumor progression. High telomerase expression was also correlated with the chromosomal rearrangements stabilization. CONCLUSIONS: Our data reinforce the notion that the sarcoma cell evolution converges from a highly unstable karyotype to relatively stable and functional chromosome rearrangements, which are further enabled by telomerase overexpression.

The impact of water pollution on fish species in southeast region of Goiás, Brazil.

The rivers from the region of Catalão, Southeast Goiás State, Brazil, are exposed to intense anthropogenic influences including agricultural activities, industry, and urban waste. The aim of this study was to determine the severity of water pollution by conducting an experiment involving in situ biomonitoring of water constituents on genotoxicity in fish inhabiting these sites. The genotoxicity of three sites of the region were analyzed utilizing the micronucleus (MN) test. It was of interest to determine whether there were differences between sampling sites such as urban perimeter, agriculture, and fertilizer industry in control, and monitored species including Astyanax fasciatus, Astyanax altiparanae, and Characidium fasciatum. Data demonstrated that the species at sites 1, 2, and 3 exhibited a marked increase in frequency of MN compared to fish from site 4. Significant elevation in frequency of MN occurred in erythrocytes of A. fasciatus and A. altiparanae at sites 1 and 2. At site 3 higher frequencies of MN were observed in C. fasciatum. MN induction in C. fasciatum was correlated with chromium levels in water and sediment, while A. fasciatum and A. altiparanae showed an association with zinc in water and sediment. Data suggest that benthic and nektonic fish species display different sensitivities in relation to anthropogenic contaminant influences.

Assessment of genotoxic, mutagenic, and recombinogenic potential of water resources in the Paranaíba River basin of Brazil: A case study.

Exposure to certain pollutants induces a series of alterations in deoxyribonucleic acid (DNA) that may result in genotoxic/mutagenic effects in exposed individuals. The present study aimed to monitor genotoxic, mutagenic, and recombinogenic potential and consequently water quality in two streams in the Paranaíba River basin in the state of Minas Gerais, Brazil, using two bioindicator fish (Rhamdia quelen and Geophagus brasiliensis). The micronucleus (MN) test and somatic recombination and mutation test (SMART) were employed to assess DNA damage. The water quality index (WQI) at the reference site control (S1) due to its proximity to the river source was compared to Córrego do Óleo (S2) with respect to chemical parameter levels of biochemical oxygen demand (BOD), dissolved-oxygen rates (DO), and total solid and fecal coliform counts. These chemical parameters were above the permitted limits at Córrego do Óleo (S2). At a third site, Córrego Liso (S3), a poor WQI was detected, attributed to the influence of domestic and industrial activities where BOD, DO, total solid, fecal coliform, total phosphorus, and turbidity rates exceeded premissible limits. The MN frequencies and the numbers of MN per cell (CMN) at sites S2 and S3 were significantly higher than those at S1 in both species. It is of interest that the increased frequency of MN was similar to the positive control cyclophosphamide only at S3, suggesting that the effects of water contaminants were most severe at this site. At sites assessed (S2 and S3), there was a significant rise in somatic mutation and recombination in the wings of Drosophila melanogaster, indicating the presence of trace elements, mainly lead (Pb) and cadmium (Cd), in the effluents in the Paranaíba River basin sites.

Toxicological assessment of spinosad: Implications for integrated control of Aedes aegypti using larvicides and larvivorous fish.

Integration of larvivorous fish and biolarvicides at low concentrations to control of mosquito larvae in field situations may result in a safer and more effective tool. However, the usefulness of integrated approach depends upon survival and ecological fitness of fish employed. Thus, the aim of this study was to examine the genotoxic effects of combining different sublethal concentrations of spinosad, a naturally occurring neurotoxic insecticide, with male adult poecilid larvivorous guppy (Poecilia reticulata) and platy (Xiphophorus maculatus) fish on Aedes larvae mosquitos. Both fish species have been used for biological control of Aedes larvae in Brazil. Sublethal spinosad exposures were predetermined based on CL50-96hr. Nuclear abnormalities (NA) and micronucleus (MN) frequency in gill cells were measured after 14 d of exposure. Behavioral changes were monitored over 96 h. Although genotoxic effects were not markedly different from control, behavioral changes evaluated based upon the no-observable-effect concentration (NOEC) and lowest-observable-effect concentration (LOEC). Adverse effects were noted at concentrations of 12.6 mg/L (NOEC) and 25.3 mg/L (LOEC) spinosad. Therefore, these insecticide concentrations may be considered as being safe to these fish species and have important implications for integrated approach to control Aedes larvae using natural larvicides and larvivorous fish.

Monitoring Genotoxicity Potential in the Mumbuca Stream, Minas Gerais, Brazil.

Rivers are sites for water catchment to supply metropolitan areas but also serve as receptors for discharge of urban sewage, wastewater, and agri-industrial effluents. Bioindicators or sentinel organisms are widely used as markers of pollution in various environments. The objective of this study was to evaluate the genotoxic potential and consequent quality of the water from the Mumbuca stream, which supplies the city of Monte Carmelo, located in the Minas Triangle region, Minas Gerais, Brazil. This was achieved using two variable response bioindicators (Rhamdia quelen and Geophagus brasiliensis), the micronucleus (MN) test, and determining the presence of metals by flame atomic absorption spectrometry. Results showed that site 3 water (region of residential flow and intense industrial pottery activity) presented a greater possibility for induction of genotoxic activity, as evidenced by the increase in the MN frequency in Rhamdia quelen and Geophagus brasiliensis in comparison with the reference-site water. The water of the Mumbuca stream was influenced by genotoxic agents, especially lead and chromium, assessed by the rise in MN rate. Data suggested that discharge of industrial effluents in a specific stretch of the stream interfered with biota functions.

Genotoxic evaluation of the River Paranaíba hydrographic basin in Monte Carmelo, MG, Brazil, by the Tradescantia micronucleus.

Pollutants have adverse effects on human health and on other organisms that inhabit or use water resources. The aim of the present study was to assess the environmental quality of three watercourses in Monte Carmelo, MG, Brazil, using the micronucleus test on Tradescantia. For each treatment, 15 plants were exposed to water samples for 24 h. The control group was exposed to formaldehyde (0.2%) and the negative control to Hoagland solution. Subsequently the plants were placed in Hoagland solution for 24 h to recover. Cells were stained with 2% acetic carmine and examined by light microscopy. Three hundred tetrads were analyzed per slide. The frequency of genotoxic alterations was expressed as the number of micronuclei per 100 tetrads, and the groups were compared by ANOVA. At all sample sites for each watercourse significant genotoxicity indices were observed. The results suggest that in the Mumbuca creek, the current situation of effluent discharge should be reconsidered by the municipal environmental authorities. The increase in micronucleus frequency denoted for water samples of the Mumbuca creek, Lambari river and Perdizes river emphasizes the need to adopt environmental vigilance strategies, such as biological monitoring.

Optimizing Telehealth: Leveraging Key Performance Indicators for Enhanced TeleHealth and Digital Healthcare Outcomes (Telemechron Study).

Over the past decade, the use of telehealth has garnered increasing attention. The focus on quality aspects has seen significant growth in tandem with the telehealth expansion. Having useful indicators in this area is becoming increasingly strategic for fully integrating the technology into the health domain. These indicators can help monitor and evaluate the quality of telehealth services, guiding improvements and ensuring that these digital solutions meet the necessary standards for effective healthcare delivery. The purpose of this study is to analyze Key performance indicators (KPIs) in telehealth within institutional websites and the scientific dissemination world by means of a narrative review. A narrative review was proposed with these two specific points of view based on a standardized checklist and a quality control procedure for including scientific papers in the analysis. Results from scientific studies emphasize KPIs such as patient outcomes, operational efficiency, technical reliability, and cost-effectiveness. These include measures like improvements in condition management, patient satisfaction, consultation numbers, waiting times, and cost savings. Institutional documents from entities like the WHO also show diverse perspectives, focusing on equitable access, clinical excellence, patient prioritization, response times, and patient and staff satisfaction. The findings suggest that adopting a comprehensive set of KPIs and continuously monitoring and evaluating telehealth services can enhance their effectiveness, efficiency, and equity, ultimately improving healthcare outcomes and accessibility.

Under the Tech Umbrella: Assessing the Landscape of Telemedicine Innovations (Telemechron Study).

The expanding role of technology assessment in telemedicine is the focus of this study. An umbrella review has been proposed to delve into emerging themes within telemedicine technology assessment by scrutinizing systematic reviews gathered from PubMed and Scopus. The proposed approach was based on a standard narrative checklist and a qualification process. The selection process identified 20 systematic reviews. The main findings underscore the transformative potential of telemedicine, emphasizing technology assessments focused on systematic evaluations, stakeholder engagement, societal impact recognition, targeted interventions, and structured frameworks. While offering valuable insights, the current studies highlight certain limitations that require attention. There is a need for the following: (I) First of all, a more focused approach, primarily centered on a process-centric, multidomain, and generalizable technology assessment (TA). (II) A deeper analysis in specific healthcare areas, including a comprehensive examination of the cost-benefit ratio, peer-to-peer interactions, and a broader inclusion of diagnostic technologies. (III) Greater emphasis on the involved stakeholders, ranging from patients to stakeholders. In conclusion, this study contributes to a comprehensive and nuanced understanding of the continually evolving landscape in telemedicine technology assessment, offering valuable insights for practitioners, researchers, and policymakers alike. Researchers are encouraged to further explore both the established and emerging themes identified in this study.

In situ biomonitoring of the genotoxic effects of vehicular pollution in Uberlândia, Brazil, using a Tradescantia micronucleus assay.

The growing number of cars in large cities is directly linked to changes in the chemical composition of urban air, which has increasingly high concentrations of potentially genotoxic chemicals. Therefore, discovering and monitoring the risks associated with exposure to atmospheric pollutants is indispensible for preventing environmental and health problems. Because of the lack of reliable data regarding the air quality in the city of Uberlândia, the present study sought to test whether the genotoxic risks in areas with different levels of vehicular traffic can be measured using the Tradescantia micronucleus assay (Trad-MN). Therefore, more than twenty inflorescences were exposed to locations with different amounts of vehicular traffic twice per year from the winter of 2006 to the summer of 2011. The inflorescences were then analysed to determine the micronucleus (MN) frequency. In addition, we sought to determine the influence of factors linked to city climate on the MN frequencies obtained at each monitored location. Our results show that, although low relative humidity positively influenced MN formation in Tradescantia pallida tetrads, the major determining factor for clastogenic events was the level of vehicular traffic at the locations monitored over the five-year study.

Portable kit for the assessment of gait parameters in daily telerehabilitation.

BACKGROUND: When designing a complete process of daily telerehabilitation, it should be borne in mind that patients should be furnished with properly designed methodologies for executing specific motion tasks and the assessment of the relevant parameters. In general, such a process should comprehend three basic elements in both the hospital and the home: (a) instrumented walkways, (b) walking aids or supports, and (c) equipment for the assessment of parameters. The objective, with gait being the focus, of this study was thus to design a simple, portable kit-as an alternative to the complex and expensive instruments currently used-to be easily interfaced or integrated with the instrumented walkways and aids/supports both for self-monitoring while patients are exercising with their own aids and for clinical reporting. MATERIALS AND METHODS: The proposed system is a portable kit that furnishes useful parameters with feedback to both the patient and the trainer/therapist. Capable of being integrated with the most common mechanical tools used in motion rehabilitation (handrail, scales, walkways, etc.), it constantly monitors and quantitatively assesses progress in rehabilitation care. It is composed of one step counter, photo-emitter detectors, one central unit for collecting and processing the telemetrically transmitted data, and a software interface. RESULTS AND DISCUSSION: The system has been successfully validated on 16 subjects at the second level of the Tinetti test in a clinical application for both home and the hospital. The portable kit can be used with different rehabilitation tools and on varying ground rugosity. Advantages include (a) very low cost, when compared with optoelectronic solutions or other portable devices, (b) very high accuracy, also for subjects with imbalance problems, compared with other commercial solutions, and (c) integration (compatibility) with any rehabilitative tool.

Enhancing spatial navigation skills in mild cognitive impairment patients: a usability study of a new version of ANTaging software.

Introduction: Mild Cognitive Impairment (MCI) often presents challenges related to spatial navigation and retention of spatial information. Navigating space involves intricate integration of bodily and environmental cues. Spatial memory is dependent on two distinct frame of reference systems for organizing this information: egocentric and allocentric frames of reference. Virtual Reality (VR) has emerged as a promising technology for enhancing spatial navigation skills and spatial memory by facilitating the manipulation of bodily, environmental, and cognitive cues. Methods: This usability study was based on a fully within-subjects design in which seven MCI patients underwent two kinds of VR conditions: participants were required to complete the ANTaging demo both in Oculus Rift S (immersive condition) and in Samsung UHD 4K monitor (semi-immersive condition). Participants were seated and they had to use a foot-motion pad to navigate and explore the environment to collect and relocate some objects in the virtual environment. Post-interaction, users provided feedback on their experiences. Additionally, usability, potential side effects, data analysis feasibility, and user preferences with immersive and semi-immersive technologies were assessed through questionnaires. Results: Results indicated higher usability ratings for the semi-immersive setup, with fewer negative effects reported compared to the immersive counterpart. According to qualitative analyses of the interviews, patients do seem to like both VR apparatuses even though the semi-immersive condition was perceived as the most suitable choice because of the size of the screen. Patients generally found it difficult to remember object locations. Participants expressed the need for more practice with the foot-motion pad, despite an overall positive experience. They generally would like to use this system to improve their memory. Discussion: Identifying these key aspects was crucial for refining the system before the upcoming clinical trial. This study sheds light on the potential of semi-immersive VR in aiding individuals with MCI, paving the way for enhanced spatial navigation interventions.

Balance Rehabilitation through Robot-Assisted Gait Training in Post-Stroke Patients: A Systematic Review and Meta-Analysis.

BACKGROUND: Balance impairment is a common disability in post-stroke survivors, leading to reduced mobility and increased fall risk. Robotic gait training (RAGT) is largely used, along with traditional training. There is, however, no strong evidence about RAGT superiority, especially on balance. This study aims to determine RAGT efficacy on balance of post-stroke survivors. METHODS: PubMed, Cochrane Library, and PeDRO databases were investigated. Randomized clinical trials evaluating RAGT efficacy on post-stroke survivor balance with Berg Balance Scale (BBS) or Timed Up and Go test (TUG) were searched. Meta-regression analyses were performed, considering weekly sessions, single-session duration, and robotic device used. RESULTS: A total of 18 trials have been included. BBS pre-post treatment mean difference is higher in RAGT-treated patients, with a pMD of 2.17 (95% CI 0.79; 3.55). TUG pre-post mean difference is in favor of RAGT, but not statistically, with a pMD of -0.62 (95%CI - 3.66; 2.43). Meta-regression analyses showed no relevant association, except for TUG and treatment duration (ß = -1.019, 95% CI - 1.827; -0.210, p-value = 0.0135). CONCLUSIONS: RAGT efficacy is equal to traditional therapy, while the combination of the two seems to lead to better outcomes than each individually performed. Robot-assisted balance training should be the focus of experimentation in the following years, given the great results in the first available trials. Given the massive heterogeneity of included patients, trials with more strict inclusion criteria (especially time from stroke) must be performed to finally define if and when RAGT is superior to traditional therapy.

In vitro and in vivo antitumor effect of trachylobane-360, a diterpene from Xylopia langsdorffiana.

Trachylobane-360 (ent-7α-acetoxytrachyloban-18-oic acid) was isolated from Xylopia langsdorffiana. Studies have shown that it has weak cytotoxic activity against tumor and non-tumor cells. This study investigated the in vitro and in vivo antitumor effects of trachylobane-360, as well as its cytotoxicity in mouse erythrocytes. In order to evaluate the in vivo toxicological aspects related to trachylobane-360 administration, hematological, biochemical and histopathological analyses of the treated animals were performed. The compound exhibited a concentration-dependent effect in inducing hemolysis with HC50 of 273.6 µM, and a moderate in vitro concentration-dependent inhibitory effect on the proliferation of sarcoma 180 cells with IC50 values of 150.8 µM and 150.4 µM, evaluated by the trypan blue exclusion test and MTT reduction assay, respectively. The in vivo inhibition rates of sarcoma 180 tumor development were 45.60, 71.99 and 80.06% at doses of 12.5 and 25 mg/kg of trachylobane-360 and 25 mg/kg of 5-FU, respectively. Biochemical parameters were not altered. Leukopenia was observed after 5-FU treatment, but this effect was not seen with trachylobane-360 treatment. The histopathological analysis of liver and kidney showed that both organs were mildly affected by trachylobane-360 treatment. Trachylobane-360 showed no immunosuppressive effect. In conclusion, these data reinforce the anticancer potential of this natural diterpene.