Accelerometer approach for anticipatory postural adjustments assessment during step initiation in patients with leprosy.

Anticipatory postural adjustments (APAs) involve a complex coordination of sensorimotor information that can be impaired in diseases that affect nerve conduction. Assessing APAs typically requires costly video recording technology, posing a challenge to the study of postural changes. This hurdle is compounded in impoverished communities affected by diseases such as leprosy, which often receive limited government support. Recent years have seen the validation of inertial sensors in wearable devices and smartphones for APA analysis in diverse populations, including adults, the elderly and people with Parkinson's disease. This progress offers economically efficient alternatives for the study of APA in leprosy. Do patterns of activation of anticipatory postural adjustment differ between leprosy patients and healthy controls? We also investigated the validity and replicability of APAs recorded in leprosy patients using inertial measurements and video capture recordings. Thirty healthy individuals in the control group and 30 individuals with leprosy in the leprosy group performed ten gait initiation trials. To record the APA for gait initiation, the participants stood on a 2 m platform. Each participant was informed that the experimenter would give an signal, after which the participant would initiate a two-step walk on the platform. Inertial recordings (low-cost method) and video capture recordings (gold-standard method) from center of mass displacements were used to extract the APA before gait initiation. The results show that APAs are similar between groups (control and leprosy), but leprosy patients have less consistent APAs. In addition, this study highlights the reproducibility and high correlation between the values of variables obtained from both instruments, the video recording as gold standard method and portable digital inertial sensor as a low-cost alternative method. These promising findings support the use of affordable inertial sensors to track and record APAs in underserved populations that lack easy access to gold standard methods such as video recording. This approach has the potential to improve the therapeutic care and rehabilitation of these patients. Although not currently part of official protocols for leprosy patients, this assessment method could prove particularly valuable in situations where significant sensorimotor impairments are suspected or documented.

Virtual Reality in Improving Anticipatory Postural Adjustments to Step Initiation in Individuals with Knee Osteoarthritis: A Randomized Controlled Trial.

Background: Virtual reality (VR) has been suggested as a new therapeutic approach in various sectors of rehabilitation, including the treatment of patients with knee osteoarthritis (OA), and one of its treatment goals is to improve the gait pattern and walking ability of patients. Objective: This study aimed to evaluate if VR, along with conventional physiotherapy treatment (CT), has superior effects to kinesiotherapy alone on pain, physical capacity, balance, and the parameters of anticipatory postural adjustments (APAs) in patients with knee OA. Design: This study is a single-blind randomized controlled trial. Setting: Secondary care at Hospital SARAH Network of Rehabilitation Hospitals, Brazil. Participants: Forty participants (31 women and 9 men) with knee OA in at least one knee and able to ambulate independently. Intervention: A rehabilitation program (8 consecutive weeks, 50-minute session, twice a week). Patients were randomized into the intervention groups CT or VR. Main Outcome Measures: Primary-latency of APA, amplitude of APA, and time to reach the maximum acceleration amplitude. Secondary-balance control by Mini-Balance Evaluation Systems Test, pain, and physical capacity by Western Ontario and McMaster Universities Arthritis Index. Results: The results of the study showed that conventional treatment significantly improved pain intensity, physical capacity, and balance in individuals with knee OA; however, only the group that used VR showed improvement in the APA parameters. Conclusion: This study demonstrated that VR associated with conventional treatment improved APAs in patients with knee OA.

Centering Equity in the Nation's Weather, Water, and Climate Services.

Water, weather, and climate affect everyone. However, their impacts on various communities can be very different based on who has access to essential services and environmental knowledge. Structural discrimination, including racism and other forms of privileging and exclusion, affects people's lives and health, with ripples across all sectors of society. In the United States, the need to equitably provide weather, water, and climate services is uplifted by the Justice40 Initiative (Executive Order 14008), which mandates 40% of the benefits of certain federal climate and clean energy investments flow to disadvantaged communities. To effectively provide such services while centering equity, systemic reform is required. Reform is imperative given increasing weather-related disasters, public health impacts of climate change, and disparities in infrastructure, vulnerabilities, and outcomes. It is imperative that those with positional authority and resources manifest responsibility through (1) recognition, inclusion, and prioritization of community expertise; (2) the development of a stronger and more representative and equitable workforce; (3) communication about climate risk in equitable, relevant, timely, and culturally responsive ways; and (4) the development and implementation of new models of relationships between communities and the academic sector.

Wearable-based assessment of anticipatory postural adjustments during step initiation in patients with knee osteoarthritis.

Older adults with moderate to severe knee osteoarthritis (KOA) exhibit adaptive strategy for initiating walking, known as anticipatory postural adjustments (APAs). While video motion kinematics has been the traditional way of measuring APAs, it can be difficult to transport and install, making it impractical for medical settings. Inertial sensors have become a more popular method for evaluating APAs, but no prior research has used accelerometers to measure gait initiation in individuals with KOA. The study aimed to assess the validity and reliability of a wearable accelerometer device for measuring APAs older adults with and without KOA. 25 individuals with KOA and 10 healthy individuals underwent evaluation using a wearable commercially available accelerometer (MetamotionC) and a video motion capture system. Reflective markers were placed on the lumbar vertebra and calcaneus. Participants were asked to initiate a step, and the researchers measured the APAlatency and APAamplitude of each subject. APAlatency showed an very large to almost perfect correlation in both groups (CG:r = 0.82; p = 0.003 and KOA r = 0.98; p < 0.00001) between the instruments, while APAamplitude had a moderate to very large correlation (CG: r = 0.65; p = 0.04and KOA: r = 0.80; p < 0.00001). Overall, the measurements showed fair to high reliability for intraclass correlation for video and accelerometer variables. Significant group effect was found for both variables: APAlatency (F1, 66 = 7.3; p = 0.008) and APAamplitude (F1,66 = 9.5; p = 0.00). The wearable tri-axial accelerometer is a valid and reliable for assessing APAs during gait initiation in individuals with KOA, and this population exhibits lower APAs when initiating a step.

Antimicrobial exposure is associated with decreased survival in triple-negative breast cancer.

Antimicrobial exposure during curative-intent treatment of triple-negative breast cancer (TNBC) may lead to gut microbiome dysbiosis, decreased circulating and tumor-infiltrating lymphocytes, and inferior outcomes. Here, we investigate the association of antimicrobial exposure and peripheral lymphocyte count during TNBC treatment with survival, using integrated electronic medical record and California Cancer Registry data in the Oncoshare database. Of 772 women with stage I-III TNBC treated with and without standard cytotoxic chemotherapy - prior to the immune checkpoint inhibitor era - most (654, 85%) used antimicrobials. Applying multivariate analyses, we show that each additional total or unique monthly antimicrobial prescription is associated with inferior overall and breast cancer-specific survival. This antimicrobial-mortality association is independent of changes in neutrophil count, is unrelated to disease severity, and is sustained through year three following diagnosis, suggesting antimicrobial exposure negatively impacts TNBC survival. These results may inform mechanistic studies and antimicrobial prescribing decisions in TNBC and other hormone receptor-independent cancers.

Systemic racial disparities in funding rates at the National Science Foundation.

Concerns about systemic racism at academic and research institutions have increased over the past decade. Here, we investigate data from the National Science Foundation (NSF), a major funder of research in the United States, and find evidence for pervasive racial disparities. In particular, white principal investigators (PIs) are consistently funded at higher rates than most non-white PIs. Funding rates for white PIs have also been increasing relative to annual overall rates with time. Moreover, disparities occur across all disciplinary directorates within the NSF and are greater for research proposals. The distributions of average external review scores also exhibit systematic offsets based on PI race. Similar patterns have been described in other research funding bodies, suggesting that racial disparities are widespread. The prevalence and persistence of these racial disparities in funding have cascading impacts that perpetuate a cumulative advantage to white PIs across all of science, technology, engineering, and mathematics.

Association of depression and functional outcomes in patients treated surgically for cervical spondylotic myelopathy through an anterior approach.

OBJECTIVE: To determine the association of Depression with clinical outcomes in patients treated surgically for cervical spondylotic myelopathy (CSM) using an anterior approach. METHOD: An observational study was conducted in patients with ECM. The Beck scale, modified scale of the Japanese Orthopedic Association (mJOA), neck disability index (NDI) and the Visual Analogue Scale (VAS) were used preoperatively, one month and 3 months after surgery. RESULTS: Initial VAS showed more severe degrees in patients with depression. At one month and third month after surgery, there was a significant decrease in pain in the group without depression (p = 0.03). The mJOA at one month and three months was observed that the degree of severity decreased in both groups, being more noticeable in the group without depression (p = 0.02). Presurgical NDI was higher in the group with depression. At three months in both groups the improvement was noticeable with respect to the degree of preoperative disability. CONCLUSIONS: There is a favorable relationship in patients with ECM undergoing surgical treatment in the absence of depression prior to surgery and clinical evolution, with the possibility of promoting multidisciplinary management prior to surgery in patients with depression.

OBJETIVO: Determinar la asociación de depresión con los resultados clínicos en pacientes tratados quirúrgicamente por mielopatía espondilótica cervical (MEC) mediante abordaje anterior. MÉTODO: Se realizó un estudio observacional en pacientes con MEC. Se utilizaron la escala de Beck, la escala modificada de la Japanese Orthopaedic Association (mJOA), el índice de discapacidad del cuello (NDI) y la escala visual análoga (EVA) de forma prequirúrgica, al mes y 3 meses posterior a la cirugía. RESULTADOS: La EVA inicial mostró mayor gravedad en los pacientes con depresión. Al mes y al tercer mes posteriores a la cirugía hay una disminución significativa del dolor en el grupo sin depresión (p = 0.03). En la mJOA al mes y a los 3 meses se observó que la gravedad disminuyó en ambos grupos, siendo más notorio en el grupo sin depresión (p = 0.02). El NDI prequirúrgico fue mayor en el grupo con depresión. A los 3 meses, en ambos grupos la mejoría fue notoria con respecto al grado de incapacidad preoperatorio. CONCLUSIONES: Existe una relación favorable en los pacientes con MEC sometidos a tratamiento quirúrgico entre la ausencia de depresión previa a cirugía y la evolución clínica, con la posibilidad de promover un manejo multidisciplinario previo a la cirugía en los pacientes con depresión.

Microbiome and oral squamous cell carcinoma: a possible interplay on iron metabolism and its impact on tumor microenvironment.

There is increasing evidence showing positive association between changes in oral microbiome and the occurrence of oral squamous cell carcinoma (OSCC). Alcohol- and nicotine-related products can induce microbial changes but are still unknown if these changes are related to cancerous lesion sites. In an attempt to understand how these changes can influence the OSCC development and maintenance, the aim of this study was to investigate the oral microbiome linked with OSCC as well as to identify functional signatures and associate them with healthy or precancerous and cancerous sites. Our group used data of oral microbiomes available in public repositories. The analysis included data of oral microbiomes from electronic cigarette users, alcohol consumers, and precancerous and OSCC samples. An R-based pipeline was used for taxonomic and functional prediction analysis. The Streptococcus spp. genus was the main class identified in the healthy group. Haemophilus spp. predominated in precancerous lesions. OSCC samples revealed a higher relative abundance compared with the other groups, represented by an increased proportion of Fusobacterium spp., Prevotella spp., Haemophilus spp., and Campylobacter spp. Venn diagram analysis showed 52 genera exclusive of OSCC samples. Both precancerous and OSCC samples seemed to present a specific associated functional pattern. They were menaquinone-dependent protoporphyrinogen oxidase pattern enhanced in the former and both 3',5'-cyclic-nucleotide phosphodiesterase (purine metabolism) and iron(III) transport system ATP-binding protein enhanced in the latter. We conclude that although precancerous and OSCC samples present some differences on microbial profile, both microbiomes act as "iron chelators-like" potentially contributing to tumor growth.

Aligning Community-Engaged Research to Context.

Community-engaged research is understood as existing on a continuum from less to more community engagement, defined by participation and decision-making authority. It has been widely assumed that more is better than less engagement. However, we argue that what makes for good community engagement is not simply the extent but the fit or alignment between the intended approach and the various contexts shaping the research projects. This article draws on case studies from three Community Engagement Cores (CECs) of NIEHS-funded Environmental Health Science Core Centers (Harvard University, UC Davis and University of Arizona,) to illustrate the ways in which community engagement approaches have been fit to different contexts and the successes and challenges experienced in each case. We analyze the processes through which the CECs work with researchers and community leaders to develop place-based community engagement approaches and find that different strategies are called for to fit distinct contexts. We find that alignment of the scale and scope of the environmental health issue and related research project, the capacities and resources of the researchers and community leaders, and the influences of the sociopolitical environment are critical for understanding and designing effective and equitable engagement approaches. These cases demonstrate that the types and degrees of alignment in community-engaged research projects are dynamic and evolve over time. Based on this analysis, we recommend that CBPR scholars and practitioners select a range of project planning and management techniques for designing and implementing their collaborative research approaches and both expect and allow for the dynamic and changing nature of alignment.

Transtornos Alimentares, Imagem Corporal e Estado Nutricional em Universitárias de Petrolina-PE / Eating Disorders, Body Image and Nutritional Status in Female Students from a Public University in Petrolina, PE, Brazil

Os transtornos alimentares afetam principalmenteadultas jovens, sendo a Anorexia e a Bulimia Nervosa asduas formas principais. Os padrões de beleza impostos pelamídia e o medo de engordar faz com que cada vez maispessoas busquem controlar o peso, através de dietasmilagrosas e altamente restritivas, exercícios físicosexagerados, drogas anorexígenas, laxantes e diuréticos, nabusca excessiva pelo corpo desejado. Objetivo: O objetivodeste estudo foi verificar o comportamento de risco paratranstornos alimentares, estado nutricional e percepção daimagem corporal em estudantes do sexo feminino dos cursosde saúde da Universidade de Pernambuco (UPE), CampusPetrolina. Material e Métodos: Estudo transversal, onde foramaplicados questionários autopreenchíveis, Body ShapeQuestionnaire (BSQ) para avaliar percepção da imagemcorporal, Eating Attitudes Test (EAT-26) com finalidade deidentificar indivíduos com padrões alimentares anormais eescala de silhuetas onde as estudantes marcaram a qualmais se assemelhavam. Houve também aferição das medidasantropométricas nas 174 universitárias. Aos dados obtidosfoi aplicada estatística descritiva, com análise de variância eteste de significância. Resultados: As voluntárias tinhamidade compreendida, entre 18 a 26 anos, das quais 45,40%cursavam enfermagem, 37,36% fisioterapia e 17,24%nutrição. Destas 69,54% estavam eutróficas, 8,7%apresentavam leve insatisfação corporal, bem como, 21,8%corriam risco de desenvolver algum transtorno alimentar.Conclusão: Conclui-se que houve universitárias com risco adesenvolver transtornos alimentares assim como comdistorção da imagem corporal, apesar da maior parteapresentar-se eutróficas quanto ao estado nutricional...

Eating disorders affect mainly young femaleadults, with anorexia and bulimia as the two major conditions.The standards of beauty imposed by the media and theobsessive fear of gaining weight have led an increasingnumber of people to seek weight control through miraculousand restrictive diets, exaggerated exercise practice,anorexigenic drugs, laxatives and diuretics, in the excessivepursuit of a desired body. Objective: To investigate the riskbehavior for eating disorders, nutritional status and bodyimage perception in female health students from the Universityof Pernambuco (UPE), Petrolina Campus. Material andMethods: This was a cross-sectional study using selfadministeredquestionnaires – Body Shape Questionnaire(BSQ) to evaluate the perception of body image; EatingAttitudes Test (EAT-26) to identify subjects with abnormaleating patterns and a scale of silhouettes for students toindicate which one they resembled the most. Anthropometricmeasurements were also investigated. The data wereanalyzed descriptively and by analysis of variance andsignificance test. Results: The population consisted of 174students aged 18 to 26 years, of which 45.40% were nursingstudents, 37.36% physiotherapy and 17.24% nutritionstudents. We observed that 69.54% of all students wereeutrophic, 8.7% had mild body dissatisfaction and 21.8%were at risk for developing eating disorders. Conclusion:Some university students were found to be at risk fordeveloping eating disorders as well as had distorted bodyimage, although the majority of students was eutrophic basedon their nutritional status...

Promoção da saúde e prevenção no envelhecimento

'Promoção da Saúde e Prevenção no Envelhecimento' é o Módulo 03 do Curso de Especialização em Saúde da Pessoa Idosa da UNA-SUS/UERJ. Dividido em 03 unidades, o Módulo aborda os aspectos mais relevantes de promoção da saúde e de prevenção primária e secundária do envelhecimento, tais como: Alimentação, atividades físicas e ações preventivas.

Promoção da saúde

'Promoção da Saúde' é a unidade 01 do Módulo 03 do Curso de Especialização em Saúde da Pessoa Idosa da UNA-SUS/UERJ "Promoção da Saúde e Prevenção no Envelhecimento". Nesta unidade são abordadas questões sobre a Promoção da Saúde, principalmente de pessoas idosas, incluindo atividades que contribuem com a manutenção do estilo de vida dos idosos.

Prevenção Primária no Envelhecimento

'Prevenção Primária no Envelhecimento' é a unidade 02 do Módulo 03 do Curso de Especialização em Saúde da Pessoa Idosa da UNA-SUS/UERJ "Promoção da Saúde e Prevenção no Envelhecimento". Nesta unidade são abordadas questões sobre os processos de Prevenção Primária no Envelhecimento e sua aplicação.

Prevenção Secundária no Envelhecimento

'Prevenção Secundária no Envelhecimento' é a unidade 03 do Módulo 03 do Curso de Especialização em Saúde da Pessoa Idosa da UNA-SUS/UERJ "Promoção da Saúde e Prevenção no Envelhecimento". Nesta unidade se aborda a Prevenção Secundária para doenças que ocorrem, geralmente, junto ao processo de envelhecimento, como por exemplo: Diabetes Melito, Hipertensão Arterial Sistêmica, Aterosclerose, Estenose Carótidea, Aneurisma de Aorta Abdominal, Osteoporose, Prevenção do Câncer, dentre outras.

Demências

'Demências' é a unidade 01 do Módulo 05 do Curso de Especialização em Saúde da Pessoa Idosa da UNA-SUS/UERJ "Principais Agravos Crônicos de Saúde da Pessoa Idosa (Síndromes Geriátricas)". Nesta unidade estudaremos as alterações cognitivas e as Síndromes Demenciais, analisaremos o Comprometimento Cognitivo Leve (CCL), seus sintomas e sua avaliação clínica, além da relação com o Alzheimer e apresentaremos as formas de demência mais comuns.

Desequilíbrio

'Desequilíbrio' é a unidade 02 do Módulo 05 do Curso de Especialização em Saúde da Pessoa Idosa da UNA-SUS/UERJ. Nesta unidade estudaremos o desequilíbrio e as vertigens, conheceremos a classificação das vertigens e a etiologia, abrangendo as causas periféricas, centrais e demais, e, por fim, analisaremos o diagnóstico e o tratamento.

Incontinências

'Incontinências' é a unidade 03 do Módulo 05 do Curso de Especialização em Saúde da Pessoa Idosa da UNA-SUS/UERJ. Nesta unidade analisaremos as incontinências urinária e fecal, com foco em: prevalências, causas, consequências, diagnóstico e tratamento. Conheceremos como diagnosticar e a tratar de forma adequada as incontinências, por meio de uma abordagem qualificada.

Metagenomic and lipid analyses reveal a diel cycle in a hypersaline microbial ecosystem.

Marine microbial communities experience daily fluctuations in light and temperature that can have important ramifications for carbon and nutrient cycling. Elucidation of such short time scale community-wide dynamics is hindered by system complexity. Hypersaline aquatic environments have lower species richness than marine environments and can be well-defined spatially, hence they provide a model system for diel cycle analysis. We conducted a 3-day time series experiment in a well-defined pool in hypersaline Lake Tyrrell, Australia. Microbial communities were tracked by combining cultivation-independent lipidomic, metagenomic and microscopy methods. The ratio of total bacterial to archaeal core lipids in the planktonic community increased by up to 58% during daylight hours and decreased by up to 32% overnight. However, total organism abundances remained relatively consistent over 3 days. Metagenomic analysis of the planktonic community composition, resolved at the genome level, showed dominance by Haloquadratum species and six uncultured members of the Halobacteriaceae. The post 0.8 µm filtrate contained six different nanohaloarchaeal types, three of which have not been identified previously, and cryo-transmission electron microscopy imaging confirmed the presence of small cells. Notably, these nano-sized archaea showed a strong diel cycle, with a pronounced increase in relative abundance over the night periods. We detected no eukaryotic algae or other photosynthetic primary producers, suggesting that carbon resources may derive from patchily distributed microbial mats at the sediment-water interface or from surrounding land. Results show the operation of a strong community-level diel cycle, probably driven by interconnected temperature, light abundance, dissolved oxygen concentration and nutrient flux effects.

De novo sequences of Haloquadratum walsbyi from Lake Tyrrell, Australia, reveal a variable genomic landscape.

Hypersaline systems near salt saturation levels represent an extreme environment, in which organisms grow and survive near the limits of life. One of the abundant members of the microbial communities in hypersaline systems is the square archaeon, Haloquadratum walsbyi. Utilizing a short-read metagenome from Lake Tyrrell, a hypersaline ecosystem in Victoria, Australia, we performed a comparative genomic analysis of H. walsbyi to better understand the extent of variation between strains/subspecies. Results revealed that previously isolated strains/subspecies do not fully describe the complete repertoire of the genomic landscape present in H. walsbyi. Rearrangements, insertions, and deletions were observed for the Lake Tyrrell derived Haloquadratum genomes and were supported by environmental de novo sequences, including shifts in the dominant genomic landscape of the two most abundant strains. Analysis pertaining to halomucins indicated that homologs for this large protein are not a feature common for all species of Haloquadratum. Further, we analyzed ATP-binding cassette transporters (ABC-type transporters) for evidence of niche partitioning between different strains/subspecies. We were able to identify unique and variable transporter subunits from all five genomes analyzed and the de novo environmental sequences, suggesting that differences in nutrient and carbon source acquisition may play a role in maintaining distinct strains/subspecies.

Tradução e adaptação transcultural do "Jones Dependency Tool" para o português brasileiro / Translation and cultural adaptation of the Jones Dependency Tool to Brazilian Portuguese / Traducción y adaptación transcultural del "Jones Dependency Tool" al portugués brasileño

Estudo metodológico com objetivo de traduzir para o português e realizar adaptação transcultural do Jones Dependency Tool. Método de tradução e adaptação transcultural utilizado composto por quatro fases. Primeira: tradução do instrumento original, em inglês, para português. Segunda: busca de equivalência de conteúdo, cultural, semântica e conceitual em relação ao instrumento original. Terceira: realização deretrotradução. Quarta: as versões, traduzida e retrotraduzida, foram comparadas por comitê de especialistas, resultando na versão final do instrumento. No Domínio Comunicação, a mensuração da dor no JDT original era descrita como faixa alta, intermediária e menor, o Comitê de Especialistas sugeriu a substituição pela escala analógica visual. A tradução e adaptação cultural da JDT para a língua portuguesa originou um instrumento aplicável à nossa realidade. Faz-se necessária a realização de estudos para testar a validade e confiabilidade da EDJ nos Serviços de Emergência no Brasil.

Methodological study to translate and culturally adapt the Jones Dependency Tool (JDT) to Portuguese. The translation and cultural adaptation method had four stages. First stage: translation of the original instrument from English to Portuguese. Second stage: content, cultural, semantic and conceptual equivalence in relation to the original instrument. Third stage: back-translation. Fourth stage: comparison of the translated and back-translated versions by a committee of specialists, resulting in the final version. In the Communication Domain, the original JDT measured pain using high, intermediate and low ranges, but the committee suggested replacing it with a visual analog scale. The translation and cultural adaptation of the JDT to Portuguese produced an instrument applicable to our reality. Studies need to be conducted to test the validity and reliability of the JDT in Brazilian Emergency Services.

Estudio metodológico que objetivó traducir al portugués y adaptar transculturalmente el Jones Dependency Tool. Traducción y adaptación transcultural dividida en cuatro fases. La primera fue la traducción del instrumento original, del inglés al portugués. La segunda fase buscó la equivalencia de contenido, cultural, semántica y conceptual en relación al instrumento original. La tercera fase fue de retrotraducción. La cuarta fase hizo comparar a una comisión de especialistas las versiones traducida y retrotraducida, dando lugar a la versión final del instrumento. En el Dominio Comunicación, la medición del dolor en el JDT original se describía en fajas: alto, medio y bajo. La Comisión de Especialistas sugirió la substitución por la escala visual. La traducción y adaptación cultural del JDT al portugués generó un instrumento aplicable a nuestra realidad. Será necesario realizar estudios para probar la validez y confiabilidad de la EDJ en los Servicios de Emergencias de Brasil.