Chronic Cadmium Exposure can Alter Energy Allocation to Physiological Functions in the Shrimp Penaeus vannamei.

Environmental stressors in aquatic organisms can be assessed using a bioenergetic approach based on the evaluation of changes in their physiological parameters. We evaluated the chronic effects of cadmium (Cd2+) on the energy balance as well as the survival, growth, metabolism, nitrogen excretion, hepatosomatic index, oxidized energy substrate, and osmoregulation of the shrimp Penaeus vannamei with the hypothesis that the high energy demand related to the homeostatic regulation of Cd2+could disrupt the energy balance and as a consequence, their physiological functions. The shrimp exposed to Cd2+ had higher mortality (30%), directed more energy into growth (33% of energy intake), ingested 10% more energy, and defecated less than control animals. Cd2+ exposure caused a tendency to decrease metabolism and ammonia excretion but did not alter the hepatosomatic index, type of energy substrate oxidized, and the hyperosmorregulatory pattern of the species. The Cd+2 exposure may have induced a trade-off response because there was a growth rate increase accompanied by increased mortality.

Applicability of an immersive virtual reality system to assess egocentric orientation of older adults.

BACKGROUND: Spatial orientation is a cognitive domain frequently compromised in patients with Alzheimer disease (AD) and may be one of its first clinical manifestations. Some studies have shown that allocentric integration with egocentric spatial information seems to be impaired in this pathology. There is no consensus on how best to assess spatial orientation and traditional tests lack ecological validity, but, recently, virtual reality (VR) has provided new opportunities for this assessment. OBJECTIVES: To analyze the applicability and stability of an immersive virtual task developed to assess spatial orientation, the Spatial Orientation in Immersive Virtual Environment Maze Test (SOIVET-Maze) in older adults with and without mild cognitive impairment. METHODS: Forty-three older adults were included in the study, 24 without cognitive impairment and 19 with mild cognitive impairment. Applicability was assessed by the Witmer and Singer Sense of Presence Questionnaire and a questionnaire for adverse events of cybersickness. To assess stability, participants were assessed twice with an interval of 7 to 14 days, and the intraclass correlation coefficient was calculated between visits. The t test or the Mann-Whitney test was used to compare applicability and stability between groups. RESULTS: There was no significant difference between the groups regarding applicability. A strong correlation between the first and second day of testing was found in the mild cognitive impairment group. CONCLUSION: The SOIVET-Maze task showed excellent applicability and good stability, favoring its clinical application for the evaluation of spatial orientation in older adults.

ANTECEDENTES: A orientação espacial é um domínio cognitivo frequentemente comprometido em pacientes com doença de Alzheimer (DA) e pode ser uma das suas primeiras manifestações clínicas. Alguns estudos demonstraram que a integração alocêntrica com informações espaciais egocêntricas parece prejudicada nessa patologia. Não há um consenso sobre qual a melhor forma de avaliar a orientação espacial e os testes tradicionais carecem de validade ecológica; porém, recentemente, a realidade virtual (RV) proporcionou novas oportunidades para esta avaliação. OBJETIVOS: Analisar a aplicabilidade e estabilidade de uma tarefa virtual imersiva desenvolvida para avaliar a orientação espacial, o Spatial Orientation in Immersive Virtual Environment Maze Test (SOIVET-Maze) em idosos com e sem comprometimento cognitivo leve. MéTODOS: Quarenta e três idosos foram incluídos no estudo, 24 sem comprometimento cognitivo e 19 com comprometimento cognitivo leve. A aplicabilidade foi avaliada pelo Witmer and Singer Sense of Presence Questionnaire e um questionário para eventos adversos de cybersickness. Para avaliar a estabilidade, os participantes foram avaliados 2 vezes com intervalo de 7 a 14 dias, e o coeficiente de correlação intraclasse foi calculado entre as visitas. O teste t ou o teste de Mann-Whitney foi utilizado para comparar a aplicabilidade e estabilidade entre os grupos. RESULTADOS: Não houve diferença significativa entre os grupos quanto à aplicabilidade. Uma forte correlação entre o primeiro e o segundo dia de teste foi encontrada no grupo de comprometimento cognitivo leve. CONCLUSãO: A tarefa SOIVET-Maze apresentou excelente aplicabilidade e boa estabilidade, favorecendo sua aplicação clínica para avaliação da orientação espacial em idosos.

Applicability of an immersive virtual reality system to assess egocentric orientation of older adults / Aplicabilidade de um sistema de realidade virtual imersivo para avaliar a orientação egocêntrica de idosos

Abstract Background Spatial orientation is a cognitive domain frequently compromised in patients with Alzheimer disease (AD) and may be one of its first clinical manifestations. Some studies have shown that allocentric integration with egocentric spatial information seems to be impaired in this pathology. There is no consensus on how best to assess spatial orientation and traditional tests lack ecological validity, but, recently, virtual reality (VR) has provided new opportunities for this assessment. Objectives To analyze the applicability and stability of an immersive virtual task developed to assess spatial orientation, the Spatial Orientation in Immersive Virtual Environment Maze Test (SOIVET-Maze) in older adults with and without mild cognitive impairment. Methods Forty-three older adults were included in the study, 24 without cognitive impairment and 19 with mild cognitive impairment. Applicability was assessed by the Witmer and Singer Sense of Presence Questionnaire and a questionnaire for adverse events of cybersickness. To assess stability, participants were assessed twice with an interval of 7 to 14 days, and the intraclass correlation coefficient was calculated between visits. The t test or the Mann-Whitney test was used to compare applicability and stability between groups. Results There was no significant difference between the groups regarding applicability. A strong correlation between the first and second day of testing was found in the mild cognitive impairment group. Conclusion The SOIVET-Maze task showed excellent applicability and good stability, favoring its clinical application for the evaluation of spatial orientation in older adults.

Resumo Antecedentes A orientação espacial é um domínio cognitivo frequentemente comprometido em pacientes com doença de Alzheimer (DA) e pode ser uma das suas primeiras manifestações clínicas. Alguns estudos demonstraram que a integração alocêntrica com informações espaciais egocêntricas parece prejudicada nessa patologia. Não há um consenso sobre qual a melhor forma de avaliar a orientação espacial e os testes tradicionais carecem de validade ecológica; porém, recentemente, a realidade virtual (RV) proporcionou novas oportunidades para esta avaliação. Objetivos Analisar a aplicabilidade e estabilidade de uma tarefa virtual imersiva desenvolvida para avaliar a orientação espacial, o Spatial Orientation in Immersive Virtual Environment Maze Test (SOIVET-Maze) em idosos com e sem comprometimento cognitivo leve. Métodos Quarenta e três idosos foram incluídos no estudo, 24 sem comprometimento cognitivo e 19 com comprometimento cognitivo leve. A aplicabilidade foi avaliada pelo Witmer and Singer Sense of Presence Questionnaire e um questionário para eventos adversos de cybersickness. Para avaliar a estabilidade, os participantes foram avaliados 2 vezes com intervalo de 7 a 14 dias, e o coeficiente de correlação intraclasse foi calculado entre as visitas. O teste t ou o teste de Mann-Whitney foi utilizado para comparar a aplicabilidade e estabilidade entre os grupos. Resultados Não houve diferença significativa entre os grupos quanto à aplicabilidade. Uma forte correlação entre o primeiro e o segundo dia de teste foi encontrada no grupo de comprometimento cognitivo leve. Conclusão A tarefa SOIVET-Maze apresentou excelente aplicabilidade e boa estabilidade, favorecendo sua aplicação clínica para avaliação da orientação espacial em idosos.

Functional impact on adults and older people after hospitalization by Covid-19.

BACKGROUND AND OBJECTIVES: Hospitalization by Covid-19 can cause persistent functional consequences after hospital discharge due to direct and indirect effects of SARS-COV-2 in several organs and systems of the body added to post-intensive care syndrome and prolonged bed rest. These impacts can lead to dependency in activities of daily living, mainly in older people due to aging process and functional decline. This study aimed to compare the effects of hospitalization by Covid-19 on functional capacity of adults and older people and to identify its associated factors. METHODS: Cross-sectional observational study of 159 survivors of hospitalization by Covid-19 after 1 month from discharge at Hospital das Clínicas of the University of São Paulo, divided into groups: adults (aged < 60 years) and older people (aged ≥ 60 years). Those who did not accept to participate, without availability or without ability to understand the questionnaires were excluded. Functional capacity was assessed by the Barthel Index and patients were classified according to their scores. Data analysis was performed in JASP Statistics program and the sample was compared between the age groups. Wilcoxon test was applied to compare before and after periods, Mann-Whitney test was used for between groups comparison. We adopted alpha = 0.05. RESULTS: The total Barthel Index median score was lower 1 month after hospital discharge than in the pre-Covid-19 period. Older people had worse functional status than adults before and also showed greater impairment after hospital discharge. Both groups showed lower Barthel Index classification than before, and older people presented more functional dependence than adults in both periods. Age, sarcopenia and frailty were associated factors. DISCUSSION: Hospitalization by Covid-19 impacts functional capacity after 1 month from discharge, especially in older people. Age, sarcopenia and frailty are associated factors. These results suggest need for care and rehabilitation of Covid-19 survivors.

Biofilme em parafusos ortopédicos prontos para uso adquiridos por meio de sistema de consiganação/comodato / Biopelícula en tornillos ortopédicos listos para uso adquiridos por medio del sistema de consignación/comodato / Biofilm on patient-ready orthopaedic screws acquired through the loaner system

Resumo Objetivo Avaliar a integridade da superfície e as condições microbiológicas de parafusos prontos para uso em bandejas ortopédicas após múltiplos processamentos. Métodos Após o processamento completo, as bandejas utilizadas em cirurgias de pequenos fragmentos, fornecidas por meio de sistema de consignação/comodato em um hospital brasileiro, foram selecionadas aleatoriamente durante quatro meses. Os parafusos mais utilizados (números 14, 16 e 18 - Grupo 1) e menos utilizados (números 10 e 38 - Grupo 2), portanto, os mais e menos expostos a agentes biológicos, químicos e físicos, foram aleatoriamente removidos e submetidos a inspeção visual (n=126), seguido de cultura bacteriana (n=6 parafusos/bandeja, 9 bandejas), teste de proteínas (n=6 parafusos/bandeja, 9 bandejas) e Microscopia Eletrônica de Varredura (MEV) (n=2 parafusos/bandeja, 9 bandejas). As culturas positivas foram submetidas a métodos automatizados de identificação bacteriana e suscetibilidade antimicrobiana. Resultados Foram detectadas ranhuras em 8,7% dos parafusos, predominantemente no Grupo 2 (8/11). Proteína residual foi detectada em 96,3%, e não houve diferença estatisticamente significativa na quantidade de proteína entre os grupos (P=0,07). Crescimento bacteriano foi identificado em 3/54 parafusos. Danos na superfície e presença de sujidade foram visualizados em todos os parafusos submetidos a MEV. Formação de biofilmes extensos foi detectada em oito parafusos, três do Grupo 1 e cinco do Grupo 2. Conclusão Recuperação de bactérias viáveis, acúmulo de biofilme e danos na superfície foram detectados nos parafusos prontos para uso. Os parafusos costumam permanecer nas bandejas cirúrgicas e serem submetidos a múltiplos processamento, sendo expostos a contaminação e danos repetidas vezes. Esses achados apontam para a necessidade de discutir e repensar a forma como esses implantes de uso único são atualmente disponibilizados para cirurgias.

Resumen Objetivo Evaluar la integridad de la superficie y las condiciones microbiológicas de tornillos listos para uso en bandejas ortopédicas después de múltiples procesamientos. Métodos Después del procesamiento completo, fueron seleccionadas aleatoriamente durante cuatro meses las bandejas utilizadas en cirugías de pequeños fragmentos, proporcionadas mediante el sistema de consignación/comodato en un hospital brasileño. Los tornillos más utilizados (números 14, 16 y 18 - Grupo 1) y menos utilizados (números 10 y 38 - Grupo 2), por lo tanto, los más y menos expuestos a agentes biológicos, químicos y físicos, fueron quitados aleatoriamente y sometidos a inspección visual (n=126), seguido de cultivo bacteriano (n=6 tornillos/bandeja, 9 bandejas), prueba de proteínas (n=6 tornillos/bandeja, 9 bandejas) y microscopía electrónica de barrido (MEB) (n=2 tornillos/bandeja, 9 bandejas). Los cultivos positivos fueron sometidos a métodos automatizados de identificación bacteriana y susceptibilidad antimicrobiana. Resultados Se detectaron ranuras en el 8,7 % de los tornillos, predominantemente en el Grupo 2 (8/11). Se detectó proteína residual en el 96,3 % y no se encontró diferencia estadísticamente significativa en la cantidad de proteína entre los grupos (P=0,07). En 3/54 tornillos se identificó crecimiento bacteriano. Se visualizaron daños en la superficie y presencia de suciedad en todos los tornillos sometidos a MEB. En ocho tornillos se detectó la formación de biopelículas, tres del Grupo 1 y cinco del Grupo 2. Conclusión Se detectó recuperación de bacterias viables, acumulación de biopelícula y daños en la superficie en los tornillos listos para uso. Los tornillos suelen permanecer en las bandejas quirúrgicas y son sometidos a múltiples procesamientos, donde están expuestos a contaminación y daños repetidas veces. Estos descubrimientos señalan la necesidad de discutir y repensar la forma como estos implantes de uso único se ponen a disposición para cirugía actualmente.

Abstract Objective Assess the surface integrity and microbiological conditions of patient-ready screws in orthopaedic trays that had been multiply reprocessed. Methods After full reprocessing, clinical trays used for small fragment surgery provided through a loaner system to a Brazilian hospital were randomly selected during four months. The most (numbers 14, 16 and 18 - Group 1) and least (numbers 10 and 38 - Group 2) frequently implanted screws, therefore, the ones estimated to be the most and least exposed to biological, chemical and physical agents, were randomly removed and subjected to visual inspection (n=126), followed by bacterial culture (n=6 screws/tray, 9 trays), protein test (n=6 screws/tray, 9 trays) and Scanning Electron Microscopy (SEM) (n=2 screws/tray, 9 trays). Positive cultures were subjected to automated bacterial identification and antimicrobial susceptibility tests. Results Grooves were detected on 8.7% screws, predominantly in Group 2 (8/11). Residual protein was detected on 96,3%, and there was no statistically significant difference in the amount of protein between the groups (P=0.07). Bacterial growth was identified in 3/54 screws. Surface damage and soil were visualized on all screws subjected to SEM. Extensive biofilms were detected on eight screws, three from Group 1 and five from Group 2. Conclusion Recovery of bacteria, biofilm accumulation and surface damage were detected on patient-ready screws. Screws frequently remain in surgical trays for multiple reprocessing; thus they are repeatedly exposed to contamination and damage. These findings point to the need to discuss and review the way these single-use implants are currently made available for surgeries.

Tendência temporal da mortalidade por lesões autoprovocadas no Brasil e suas regiões no período de 1980 a 2019 / Temporal trend of mortality from self-harm in Brazil and its regions from 1980 to 2019

Objetivo: estimar a tendência temporal da mortalidade por lesões autoprovocadas intencionalmente no Brasil e suas regiões no período de 1980 a 2019. Metodologia: trata-se de um estudo ecológico de série temporal. Os dados foram provenientes do Sistema de Informação sobre Mortalidade, e foram estratificados segundo faixa etária, ano, local e sexo. Foi calculada a taxa padronizada de mortalidade (TPM) e utilizada para análise de tendência, por intermédio do modelo JoinPoint. Resultados: o Brasil registrou ao longo da série temporal, 297.367 óbitos por lesões autoprovocadas intencionalmente. O sexo masculino apresentou maior quantitativo de óbitos com 231.821 (78,0%), seguido do feminino com 65.546 (22,0%). A tendência temporal média da TPM por suicídio no Brasil foi de crescimento entre homens e mulheres com Variação Percentual Anual Média (VPAM) de 0,9% e 1,2%, respectivamente (p<0,05). No Norte, a VPAM foi de 2,1% para o grupo geral, 2,5% para homens e 1,9% para mulheres (p<0,05). O Nordeste apresentou VPAM=2,7% e 3,0% no grupo geral e masculino, respectivamente (p<0,05). A região sul apresentou aumento somente no grupo geral com VPAM=0,5% (p<0,05), enquanto o Sudeste não apresentou dados significativos. O Centro-oeste apresentou VPAM=1,7%, 1,7% e 1,2% no grupo geral, masculino e feminino, respectivamente. Conclusão: o Brasil apresentou um índice considerável de mortes por lesões autoprovocadas, onde o sexo masculino predominou. As regiões Sul e Centro-oeste apresentaram as maiores médias de TPM em todos os grupos. A tendência temporal média foi de crescimento na maioria das regiões (p<0,05), exceto no Sudeste, no qual foi estacionária (p>0,05).

Objective: to estimate the temporal trend of mortality from intentional self-harm in Brazil and its regions from 1980 to 2019. Methodology: this is an ecological time series study. The data came from the Mortality Information System and were stratified according to age group, year, location and sex. The age-standard mortality rate (ASMR) was calculated and used for trend analysis, using the JoinPoint model. Results: over the time series, Brazil recorded 297,367 deaths from intentional self-harm. Males had the highest number of deaths with 231,821 (78.0%), followed by females with 65,546 (22.0%). The average temporal trend of ASMR by suicide in Brazil was of growth among men and women with Average Annual Percent Change (AAPC) of 0.9% and 1.2%, respectively (p<0.05). In the North, the AAPC was 2.1% for the general group, 2.5% for men and 1.9% for women (p<0.05). The Northeast presented AAPC=2.7% and 3.0% in the general and male groups, respectively (p<0.05). The southern region showed an increase only in the general group with AAPC=0.5% (p<0.05), while the Southeast did not present significant data. The Midwest presented AAPC=1.7%, 1.7% and 1.2% in the general group, male and female, respectively. Conclusion: Brazil had a considerable rate of deaths from self-harm, where males predominated. The South and Center-West regions had the highest average ASMR in all groups. The average temporal trend was of growth in most regions (p<0.05), except in the Southeast, where it was stationary (p>0.05).

Applicability of an immersive virtual reality system for assessing route learning in older adults.

Spatial orientation is defined as the ability to find one's way around an environment, follow familiar routes, recognize places, and learn new routes. Spatial disorientation is one of the early symptoms of Alzheimer's disease (AD), and traditional cognitive evaluation lacks ecological validity. Therefore, new assessment methods are needed for the early identification of this cognitive impairment. Objective: This study aimed to compare the applicability and stability of an immersive virtual reality (VR) system developed to assess route learning between older adults with and without mild cognitive impairment (MCI). Methods: The study sample included 43 older adults: 22 without MCI and 23 with MCI. Applicability was assessed based on the recording of adverse events and the sense of presence reported through questionnaires. The Mann-Whitney U test was applied to compare the applicability of the Spatial Orientation in Immersive Virtual Environment Test (SOIVET)-Route task between older adults with and without MCI. Both short- and long-term stabilities of the task were evaluated using the intraclass correlation coefficient (ICC). Results: The mean age of participants was 71.4 years (SD=5.5). A minimum number of adverse events (mean=1.46; SD=2.11) and high levels of presence (mean=138.04; SD=14.80) were reported, and there was no difference between groups with and without MCI. A good to excellent correlation was found for short-term stability (CCI 0.78) and a reasonable correlation was found for long-term stability (CCI 0.58). Conclusions: The VR system was applicable for older adults and showed a good to excellent correlation for short-term stability.

Orientação espacial é a capacidade de encontrar um caminho em um ambiente, seguir rotas familiares, reconhecer lugares e aprender novas rotas. A desorientação espacial é um dos primeiros sintomas da doença de Alzheimer, e a avaliação cognitiva tradicional carece de validade ecológica. Diante disso, novos métodos de avaliação são necessários para a identificação precoce desse comprometimento cognitivo. Objetivo: Este estudo teve como objetivo comparar a aplicabilidade e a estabilidade de um sistema de realidade virtual imersivo desenvolvido para avaliar a aprendizagem de rotas entre idosos com e sem comprometimento cognitivo leve (CCL). Métodos: Participaram do estudo 43 idosos: 22 sem CCL e 23 com CCL. A aplicabilidade foi avaliada por meio do registro de eventos adversos e pela sensação de presença relatados. O teste de Mann-Whitney foi aplicado para comparar a aplicabilidade da tarefa SOIVET-Route entre idosos com e sem CCL. A estabilidade da tarefa em curto e longo prazo foi avaliada pelo coeficiente de correlação intraclasse (ICC). Resultados: A idade média dos participantes foi de 71,4 anos (desvio padrão ­ DP=5,5). Em relação à aplicabilidade, encontramos mínimo relato de sintomas adversos (média=1,46; DP=2,11) e altos níveis de sensação de presença (média 138,04; DP=14,80), e não houve diferença entre os grupos com e sem CCL. Ao analisarmos a estabilidade, encontramos de boa a excelente correlação em curto prazo (CCI=0,78) e uma correlação razoável em longo prazo (CCI=0,58). Conclusões: O sistema de realidade virtual foi aplicável em idosos e mostrou boa correlação na estabilidade de curto prazo.

Applicability of an immersive virtual reality system for assessing route learning in older adults / Aplicabilidade de um sistema de realidade virtual imersivo para avaliação da aprendizagem de rotas em idosos

ABSTRACT. Spatial orientation is defined as the ability to find one's way around an environment, follow familiar routes, recognize places, and learn new routes. Spatial disorientation is one of the early symptoms of Alzheimer's disease (AD), and traditional cognitive evaluation lacks ecological validity. Therefore, new assessment methods are needed for the early identification of this cognitive impairment. Objective: This study aimed to compare the applicability and stability of an immersive virtual reality (VR) system developed to assess route learning between older adults with and without mild cognitive impairment (MCI). Methods: The study sample included 43 older adults: 22 without MCI and 23 with MCI. Applicability was assessed based on the recording of adverse events and the sense of presence reported through questionnaires. The Mann-Whitney U test was applied to compare the applicability of the Spatial Orientation in Immersive Virtual Environment Test (SOIVET)-Route task between older adults with and without MCI. Both short- and long-term stabilities of the task were evaluated using the intraclass correlation coefficient (ICC). Results: The mean age of participants was 71.4 years (SD=5.5). A minimum number of adverse events (mean=1.46; SD=2.11) and high levels of presence (mean=138.04; SD=14.80) were reported, and there was no difference between groups with and without MCI. A good to excellent correlation was found for short-term stability (CCI 0.78) and a reasonable correlation was found for long-term stability (CCI 0.58). Conclusions: The VR system was applicable for older adults and showed a good to excellent correlation for short-term stability.

RESUMO. Orientação espacial é a capacidade de encontrar um caminho em um ambiente, seguir rotas familiares, reconhecer lugares e aprender novas rotas. A desorientação espacial é um dos primeiros sintomas da doença de Alzheimer, e a avaliação cognitiva tradicional carece de validade ecológica. Diante disso, novos métodos de avaliação são necessários para a identificação precoce desse comprometimento cognitivo. Objetivo: Este estudo teve como objetivo comparar a aplicabilidade e a estabilidade de um sistema de realidade virtual imersivo desenvolvido para avaliar a aprendizagem de rotas entre idosos com e sem comprometimento cognitivo leve (CCL). Métodos: Participaram do estudo 43 idosos: 22 sem CCL e 23 com CCL. A aplicabilidade foi avaliada por meio do registro de eventos adversos e pela sensação de presença relatados. O teste de Mann-Whitney foi aplicado para comparar a aplicabilidade da tarefa SOIVET-Route entre idosos com e sem CCL. A estabilidade da tarefa em curto e longo prazo foi avaliada pelo coeficiente de correlação intraclasse (ICC). Resultados: A idade média dos participantes foi de 71,4 anos (desvio padrão — DP=5,5). Em relação à aplicabilidade, encontramos mínimo relato de sintomas adversos (média=1,46; DP=2,11) e altos níveis de sensação de presença (média 138,04; DP=14,80), e não houve diferença entre os grupos com e sem CCL. Ao analisarmos a estabilidade, encontramos de boa a excelente correlação em curto prazo (CCI=0,78) e uma correlação razoável em longo prazo (CCI=0,58). Conclusões: O sistema de realidade virtual foi aplicável em idosos e mostrou boa correlação na estabilidade de curto prazo.

Perinatal factors, female breast cancer, and associated risk factors in Puerto Rico: evidence from the Atabey epidemiology of breast cancer study.

PURPOSE: There is increasing evidence that exposures in utero and in infancy impact breast cancer risk. No previous studies have evaluated these associations among women in Puerto Rico. METHODS: In a population-based case-control study of breast cancer epidemiology in the San Juan metropolitan area in Puerto Rico, we examined the association of early life factors with breast cancer risk and breast cancer risk factors. Both cases (n = 315) and controls (n = 348) completed interviewer-administered questionnaires, including self-reported birth country, birthweight, and history of having been breastfed. Comparisons of characteristics of those with and without the early life factors were made with t-tests or chi-squared tests; associations between early life factors and breast cancer risk were estimated with unconditional logistic regression adjusting for age, education, body mass index (BMI), age at menarche, parity, and menopausal status. RESULTS: Women who had been breastfed tended to have higher adult body mass index (BMI), higher education, and lower parity (p < 0.05). Higher birthweight was associated with higher adult BMI and lower educational attainment (p < 0.05). Those born outside of Puerto Rico or the US were more likely to have higher educational attainment and earlier age at menarche than those born within Puerto Rico or the US (p < 0.05). We found no significant associations between any of the early life factors and breast cancer risk. CONCLUSION: We did not find evidence of an association of early life factors with breast cancer risk among women in Puerto Rico.

Two Immersive Virtual Reality Tasks for the Assessment of Spatial Orientation in Older Adults with and Without Cognitive Impairment: Concurrent Validity, Group Comparison, and Accuracy Results.

OBJECTIVE: Spatial disorientation is common in Alzheimer's disease (AD), Mild Cognitive Impairment (MCI), and preclinical individuals with AD biomarkers. However, traditional neuropsychological tests lack ecological validity for the assessment of spatial orientation and to date, there is still no gold standard. The current study aimed to determine the validity and accuracy of two virtual reality tasks for the assessment of spatial orientation. METHODS: We adapted two spatial orientation tasks to immersive virtual environments: a "survey to route" task in which participants had to transfer information from a map to their body position within a maze [Spatial Orientation in Immersive Virtual Environment Test (SOIVET) Maze], and an allocentric-type, route learning task, with well-established topographic landmarks (SOIVET Route). A total of 19 MCI patients and 29 cognitively healthy older adults aged 61-92 participated in this study. Regular neuropsychological assessments were used for correlation analysis and participant performances were compared between groups. Receiver Operating Characteristic (ROC) curve analysis was performed for accuracy. RESULTS: The SOIVET Maze correlated with measures of visuoperception, mental rotation, and planning, and was not related to age, educational level, or technology use profile. The SOIVET Route immediate correlated with measures of mental rotation, memory, and visuoconstruction, and was influenced only by education. Both tasks significantly differentiated MCI and control groups, and demonstrated moderate accuracy for the MCI diagnosis. CONCLUSION: Traditional neuropsychological assessment presents limitations and immersive environments allow for the reproduction of complex cognitive processes. The two immersive virtual reality tasks are valid tools for the assessment of spatial orientation and should be considered for cognitive assessments of older adults.

Sun Exposure Is Associated with Reduced Breast Cancer Risk among Women Living in the Caribbean: The Atabey Study in Puerto Rico.

BACKGROUND: Though inconsistent, there is evidence that sun exposure is associated with reduced breast cancer risk. Previous studies have been conducted in geographical regions with seasonal variation in UV radiation, including periods of low to no exposure, and among participants mostly of European descent. Puerto Rico has no significant seasonal fluctuation, with continuous exposure to very high UV radiation. METHODS: We conducted a population-based case-control study of breast cancer among women in metropolitan San Juan, Puerto Rico, examining a cumulative sun exposure index (SEI) based on a comparison of reflectance of sun-exposed and non-exposed skin. A chromameter was used to measure skin reflectance and estimate the difference between constitutive (unexposed) and facultative (exposed) skin pigmentation in 307 cases and 328 controls. Breast cancer risk factors were ascertained with interviewer-administered questionnaires. OR and 95% confidence intervals (CI) were estimated with unconditional logistic regression. RESULTS: Adjusted breast cancer odds were lower for the highest tertile of the SEI (ORadj = 0.47; 95% CI, 0.29-0.74). Results were similar within strata of estrogen receptor status. In analyses stratified by constitutive skin pigmentation, among participants with darker skin color, breast cancer risk was lower with more sun exposure (ORadj = 0.33; 95% CI, 0.16-0.70). CONCLUSIONS: We found lower risk of breast cancer associated with greater sun exposure in a population living with high, continuous sun exposure. This beneficial finding should be placed in the context of other effects of sun exposure. IMPACT: Sun exposure is a modifiable factor that may contribute, directly or indirectly, to lower breast cancer risk.

Nutritional deficiency in scarlet eggplant limits its growth by modifying the absorption and use efficiency of macronutrients.

The intensity damages caused by nutritional deficiency in growing plants can vary with nutrients. The effects caused by nutrient omission in the plant nutritional efficiency in relation to the absorption and use of the missing nutrient, and the reasons why these damages reflect in other nutrients have not yet been reported in the culture of scarlet eggplant. A better understanding of the nutritional mechanisms involved may clarify why certain nutrients cause greater limitations than other during plants growth. Thus, this study was designed with the aim of evaluating the damages caused by macronutrients deficiency in the culture of scarlet eggplant in the accumulation of these nutrients, nutritional deficiency, plants growth and in visual symptoms. The experiment was carried out in a controlled environment where plants were cultivated in a hydroponic system. Treatments consisted of supplying a complete Hoagland and Arnon solution (CS), and other nutrient solutions with individual omissions of nitrogen (-N), phosphorus (-P), potassium (-K), calcium (-Ca), magnesium (-Mg) and sulphur (-S). When a nutrient deficiency arose, nutritional analyses, growth and visual symptoms were analyzed. The omissions of N, S and K in the nutrient solution resulted in lower accumulation of all macronutrients in both the above and below ground biomass. Individual omissions resulted in nutritional imbalances with reflexes in the absorption efficiencies and use of the missing nutrient, as well as of other nutrients, revealing that the metabolism involves multiple nutritional interactions. Losses of nutritional efficiencies of macronutrients caused detrimental effects on plants growth, with reduced height, stem diameter, number of leaves, leaf area, and biomass production in above ground and below ground. From the losses in production in above ground biomass, the order of macronutrients limitation was N, S, K, Ca, Mg, and P, with reductions of 99, 96, 94, 76, 51 and 46%, respectively, in comparison to plants cultivated in CS. The most limiting nutrients were N, S, and K, seen that its deficiencies affected the metabolism of all other nutrients. This study demonstrates the importance of an adequate nutritional management of N, S, and K in the cultivation of scarlet eggplant.

Entre o corpo e o outro: uma leitura laplancheana da velhice / Entre el cuerpo y el otro: una lectura laplancheana de la vejez / Between the body and the other: a laplanchean reading of old age

RESUMO O presente artigo propõe uma leitura psicanalítica da velhice a partir da Teoria da Sedução Generalizada, de Jean Laplanche. Para isso, recupera a noção de reforço pulsional presente em Freud, reinterpretando-a a partir da noção de apoio sistematizada por Laplanche, para pensar as modificações corporais e seus efeitos sobre a economia libidinal dos sujeitos em processo de envelhecimento. Os autores defendem a hipótese de uma possível reabertura da situação originária nesse momento da vida, levando em consideração as alterações corporais próprias ao processo de envelhecimento, bem como os significados sociais e subjetivos que atribuímos às diversas perdas e mudanças vivenciadas por velhas e velhos. São abordados também as relações da velhice com a alteridade, a passividade originária e o processo de luto. Ao final, é ressaltada a necessidade de mais estudos aprofundados sobre o tema, assinalando a significativa contribuição da psicanálise, sobretudo no que tange aos impactos psíquicos da velhice.

RESUMEN El presente artículo propone una lectura psicoanalítica de la vejez a partir de la Teoría de la Seducción Generalizada, de Jean Laplanche. Para ello, recupera la noción de refuerzo pulsional presente en Freud, reinterpretándola a partir de la noción de apoyo sistematizada por Laplanche, para pensar las modificaciones corporales y sus efectos sobre la economía libidinal de los sujetos en proceso de envejecimiento. Los autores defienden la hipótesis de una posible reapertura de la situación originaria en ese momento de la vida, teniendo en cuenta las alteraciones corporales propias del proceso de envejecimiento, así como los significados sociales y subjetivos que atribuimos a las diversas pérdidas y cambios vivenciados por viejas y viejos. Se abordan también las relaciones de la vejez con la alteridad, la pasividad originaria y el proceso de duelo. Al final, se resalta la necesidad de más estudios en profundidad sobre el tema, señalando la significativa contribución del psicoanálisis, sobre todo en lo que se refiere a los impactos psíquicos de la vejez.

ABSTRACT The present paper proposed a psychoanalytical reading of the old age based on the Jean Laplanche's Theory of Generalized Seduction. To this end, we retake the notion of drive reinforcement, present in Freud's theory, reinterpreting it from the notion of leaning systematized by Laplanche in order to think about corporal modifications and their effects on the libidinal economy of aging subjects. The authors defend the hypothesis of a possible reopening of the original situation in this moment of life, considering the corporal changes specific to the aging process, as well as the social and subjective meanings that we attribute to the various losses and changes experienced by the old women and men. We also discuss the several relationships between old age and otherness, original passivity and the mourning process. At the end, it is emphasized the need for further in-depth studies on this subject, signing the significant contribution of Psychoanalysis, especially about the psychical impacts in old age.

Is remote and distance teaching during the COVID-19 pandemic related to the university professors' weight gain, body mass index changes, hearing complaints, and self-perception of voice?

ABSTRACT Purpose: to verify the impact of weight and BMI (Body Mass Index) changes on auditory and vocal symptoms in university professors, during the COVID-19 pandemic. Methods: the symptoms were assessed with a semi-structured questionnaire developed on Google Forms, to which the consent form was appended. It comprised 27 questions related to symptoms, changes, and health, during the pandemic - specifically, vocal and auditory symptoms, anthropometric factors, vocal parameters, physical activity, neck pain, and comorbidities. The Mann-Whitney and Chi-square test were used to identify differences or associations between variables (95% CI; P < 0.05). Results: altogether, 74 professors who comprise the faculty of the undergraduate program at the institution where the research was conducted were assessed. Significant differences were found between those with auditory symptoms (G1: worsened hearing; G2: unchanged hearing) regarding BMI, in which G1 had higher values; and sleep, in which G1 slept fewer hours. The chi-square test showed an association between the groups and BMI classification - those with worsened hearing (G1) were more overweight and their sleeping hours were more affected. There was also an association between the groups and voice change, headphone use (mainly in-ear) during classes, dizziness or vertigo episodes, tinnitus episodes and headache. Conclusion:this study revealed an association between worsened hearing, sleep, and BMI in university professors due to remote and distance teaching during the COVID-19 pandemic.

O gerenciamento do autocuidado de pacientes com insuficiência cardíaca / Self-care management of patients with heart failure

Introdução: A insuficiência cardíaca (IC) configura-se como a via final das doenças cardiovasculares e como grande problema de saúde pública. Com o envelhecimento da população e consequente aumento do aparato tecnológico houve um incremento da sobrevida de pacientes com outros transtornos cardiovasculares, que ao longo do tempo evoluem para IC, imprimindo a estes pacientes a necessidade de estabelecer o autocuidado a fim de retardar a progressão da doença ou mantê-la sobre controle. Objetivos: Identificar as variáveis clínicas, sociais e demográficas do paciente assistido no ambulatório de Insuficiência Cardíaca em um Hospital público universitário; Verificar o autocuidado de pacientes com Insuficiência Cardíaca em um Hospital público universitário através do SCHFI v 6.2; Correlacionar o autocuidado com as variáveis clínicas, sociais e demográficas do paciente assistido no ambulatório de Insuficiência Cardíaca em um Hospital público universitário; Discutir os fatores intervenientes para o gerenciamento do autocuidado pelos pacientes de IC, a partir das variáveis clínicas, sociais e demográficas. Método: estudo transversal de abordagem quantitativa. Resultados: A amostra foi composta de indivíduos de idade entre 52 a 76 anos (78%), pretos e pardos compõe a maioria (62%), moradores da Baixada Fluminense (39,2%) e da Zona Norte do Rio de Janeiro (34,2%) e de escolaridade de até o Ensino Fundamental Incompleto (27,3%) e Completo (36,4%), com Classe Funcional II (41,8%), Fração de Ejeção Reduzida (57,4%), Etiologia predominante Isquêmica (32,9%), não reconhecem ter tido informações sobre a doença (61,5%), e já sofreram internação devido à Insuficiência Cardíaca (60,6%). O autocuidado foi inadequado na maioria dos participantes (81,4%), Escore Manutenção inadequado (88,6%), e Escore Manejo inadequado (61,8%), Escore Confiança inadequado (48,1%). Não houve correlação entre escores de autocuidado com as variáveis estudadas, porém houve correlação da manutenção inadequada com a prática de atividade física, e do manejo inadequado com o fato de afetar a família. Conclusão: O autocuidado como um processo de tomada de decisão precisa de suporte social, estruturas das equipes e articulação nos serviços de saúde para a equidade da assistência de enfermagem, e dos serviços de saúde.

Introduction: Heart failure (HF) is configured as the final route of cardiovascular diseases and as a major public health problem. With the aging of the population and the consequent increase in the technological apparatus, there was an increase in the survival of patients with other cardiovascular disorders, which over time evolve to HF, giving these patients the need to establish self-care in order to delay the progression of the disease. or keep it under control. Objectives: To identify the clinical, social and demographic variables of the patient assisted at the Heart Failure outpatient clinic in a public university hospital; To verify the self-care of patients with Heart Failure in a public university Hospital through SCHFI v 6.2; Correlate self-care with the clinical, social and demographic variables of the patient assisted at the Heart Failure outpatient clinic in a public university hospital; Discuss the intervening factors for the management of self-care by HF patients, based on clinical, social and demographic variables. Method: cross-sectional study with a quantitative approach. Results: The sample was composed of individuals aged 52 to 76 years (78%), blacks and browns make up the majority (62%), residents of Baixada Fluminense (39.2%) and the North Zone of Rio de Janeiro (34.2%) and schooling up to Incomplete (27.3%) and Complete (36.4%) Elementary Education, with Functional Class II (41.8%), Reduced Ejection Fraction (57.4%) , Ischemic predominant etiology (32.9%), do not recognize having had information about the disease (61.5%), and have already suffered hospitalization due to Heart Failure (60.6%). Self-care was inadequate in most participants (81.4%), Inadequate Maintenance Score (88.6%), and Inappropriate Management Score (61.8%), Inappropriate Trust Score (48.1%). There was no correlation between self-care scores and the variables studied, but there was a correlation between inadequate maintenance and the practice of physical activity, and inadequate management with the fact that it affects the family. Conclusion: Self-care as a decision- making process needs social support, team structures and articulation in health services for the equity of nursing care, and health services.

Genome Sequences of Bacteriophages ClearAsMud and Kauala, Isolated from Microbacterium foliorum.

Cluster EC ClearAsMud and cluster EA4 Kauala are lytic Siphoviridae bacteriophages that were isolated from soil in southern California using Microbacterium foliorum NRRL B-24224 as the host. The ClearAsMud and Kauala genomes are 52,987 bp and 39,378 bp, respectively, and contain 92 and 56 predicted protein-coding genes, respectively.

Breast Cancer in a Caribbean Population in Transition: Design and Implementation of the Atabey Population-Based Case-Control Study of Women in the San Juan Metropolitan Area in Puerto Rico.

Global breast cancer incidence varies considerably, particularly in comparisons of low- and high-income countries; rates may vary even within regions. Breast cancer rates for Caribbean countries are generally lower than for North America and Europe. Rates in Puerto Rico are in the middle of the range between the highest and the lowest Caribbean countries. Populations in transition, with greater variability in risk factor exposures, provide an important opportunity to better understand breast cancer etiology and as potential sources of variation in rates. Understanding of exposures across the life span can potentially contribute to understanding regional differences in rates. We describe here the design and implementation of a population-based, case-control study in the San Juan Metropolitan Area (SJMA) of Puerto Rico, the Atabey Epidemiology of Breast Cancer Study. We describe steps taken to ensure that the study was culturally appropriate, leveraging the Atabey researchers' understanding of the culture, local health system, and other required resources to effectively recruit participants. A standardized, in-person interview was developed, with attention to life course events customized to the study population. In order to understand variation in global breast cancer rates, studies customized to the populations outside of North America and Europe are required.

Is there competition between Haemonchus contortus and Haemonchus placei in a pasture grazed by only sheep?

This study aimed to evaluate the dynamics of Haemonchus contortus and Haemonchus placei infections and hybridization between these species in grazing sheep without contact with cattle. On January 14, 2014, sixteen young sheep were infected with 4000 infective H. placei third-stage larvae L3; 11 days later, another group n = 16 was infected with 4000 H. contortus L3. The establishment rates of H. contortus and H. placei L3 were, on average, 61.6 % and 56.8 %, respectively, in the permanent sheep. After the establishment of patent infections, all permanent sheep were allocated together in the same clean pasture where they grazed for the next 12 months. Euthanasia of a sample of the permanent sheep was performed every three months: in May, August, November and February. Two weeks before the sheep were removed for euthanasia, 2 worm-free tracer sheep were introduced to the pasture to evaluate the larval population in the field. The tracer sheep grazed alongside the permanent sheep for 2 weeks. Then, they were housed indoors for 20 days; at the end of this period, they were euthanized. Parasites were recovered from the permanent and tracer sheep and identified using morphological and molecular techniques. A total of 432 worms (from permanent and tracer animals) were analyzed by PCR using species-specific primer pairs. Of these specimens, only two (0.46 %) male worms were identified as hybrids: one was recovered from a permanent animal euthanized in August and the other from a tracer sheep that grazed in May. The last detection of adult H. placei worms occurred in sheep euthanized in May (approximately 3.5 months after the beginning of the grazing period). The morphological evaluation of the L3 produced in fecal cultures showed that H. placei were progressively replaced by H. contortus populations starting in March. The last trace of H. placei L3 was found in August, when a small percentage (0.5 %) of infective larvae with H. placei morphology was identified in a fecal culture. In conclusion, hybridization between H. contortus and H. placei can occur in the field during coinfection. It was demonstrated that H. placei established successfully in artificially infected worm-free sheep; however, with concomitant natural reinfection with H. contortus, the H. placei population showed a rapid decrease and was eliminated within a few months in an environment without cattle.

Effects of 2 Types of Resistance Training Models on Obese Adolescents' Body Composition, Cardiometabolic Risk, and Physical Fitness.

Magnani Branco, BH, Carvalho, IZ, Garcia de Oliveira, H, Fanhani, AP, Machado dos Santos, MC, Pestillo de Oliveira, L, Macente, SB, and Nelson, NJ. Effects of 2 types of resistance training models on obese adolescents' body composition, cardiometabolic risk, and physical fitness. J Strength Cond Res 34(9): 2672-2682, 2020-The main objective of this study was to investigate the effects of 2 types of resistance training (RT) models in conjunction with interdisciplinary interventions by other health professionals to reduce the body fat and cardiometabolic risk of obese adolescents while improving their general health-related physical fitness. The 12-week analyses involved 18 male adolescents who were split into 2 groups (weight lifting: n = 9 and functional: n = 9), with equalization according to the primary muscle group (whenever possible), the effort:pause ratio, and intensity. The results showed reductions in fat mass and body fat, as well as in waist and hip circumferences (p < 0.05) after the intervention period. However, no significant differences were observed in terms of the body mass, body mass index, neck circumference, systolic and diastolic blood pressures, and for lean mass (p > 0.05) after the respective period. Maximal isometric strength, abdominal strength resistance, flexibility, and maximal oxygen consumption all produced significant increases after the interventions (p < 0.05). There were reductions in low-density lipoproteins and triglyceride levels after the intervention period (p < 0.05). For fasting glycemia, high-density lipoproteins, and alanine aminotransferase, no differences were observed (p > 0.05). In addition, no differences were observed in rating of perceived recovery, internal training load, or caloric intake (p > 0.05). With the results presented, it is concluded that both RT methods were effective at reducing both fat mass and body fat, thus improving health-related physical fitness components and decreasing cardiometabolic risk.

Onion and Garlic Intake and Breast Cancer, a Case-Control Study in Puerto Rico.

Studies show an inverse association between onion and garlic intake and risk of cancers of the lung, prostate, and stomach. There is limited evidence on the association between onion and garlic intake and breast cancer. We assessed this association in a population-based, case-control study in Puerto Rico. Incident, primary breast cancer cases (n = 314) were identified among women aged 30-79 from hospital and clinic records. Controls (n = 346) were women with no history of cancer other than nonmelanoma skin cancer, residents of the same area. Dietary intake was estimated using a food frequency questionnaire. Total onion and garlic intake included sofrito (a popular garlic- and onion-based condiment) intake frequency. Unconditional logistic regression assessed the association between onion and garlic consumption and breast cancer adjusting for age, education, parity, family history, body mass index, age at menarche, total energy, and smoking. Inverse associations with breast cancer were observed for moderate (OR (odds ratio) = 0.59, 95% CI (confidence interval): 0.35, 1.01) and high consumption (OR = 0.51, 95% CI: 0.30, 0.87) compared to low consumption of onion and garlic (Ptrend = 0.02). Results were similar when stratified by menopausal status. Study results suggest that high onion and garlic consumption is protective against breast cancer in this population.