Assessment of Agricultural Practices for Controlling Fusarium and Mycotoxins Contamination on Maize Grains: Exploratory Study in Maize Farms.

Maize is a significant crop to the global economy and a key component of food and feed, although grains and whole plants can often be contaminated with mycotoxins resulting in a general exposure of the population and animals. To investigate strategies for mycotoxins control at the grain production level, a pilot study and exploratory research were conducted in 2019 and 2020 to compare levels of mycotoxins in grains of plants treated with two fertilizers, F-BAC and Nefusoil, under real agricultural environment. The 1650 grains selected from the 33 samples were assessed for the presence of both Fusarium species and mycotoxins. Only fumonisins and deoxynivalenol were detected. Fumonisin B1 ranged from 0 to 2808.4 µg/Kg, and fumonisin B2 from 0 to 1041.9 µg/Kg, while deoxynivalenol variated from 0 to 465.8 µg/Kg. Nefusoil showed to be promising in regard to fumonisin control. Concerning the control of fungal contamination rate and the diversity of Fusarium species, no significant differences were found between the two treatments in any of the years. However, a tendency for was observed Nefusoil of lower values, probably due to the guaranteed less stressful conditions to the Fusarium spp. present in the soil, which do not stimulate their fumonisins production.

Vascular effects of Fragaria vesca L. in human arteries.

Fragaria vesca L. (wild strawberry) is traditionally used for its anti-inflammatory activity and for gastrointestinal, cardiovascular and urinary disorders. A previous study with the rat aorta showed that its leaves extract elicits endothelium-dependent vasorelaxation. Our aim was to investigate the clinical application of Fragaria vesca in vascular disease, by assessing the vascular effects of an infusion and hydroalcoholic extract in internal thoracic arteries from patients with coronary artery disease. The extracts elicited no effects on basal vascular tone and did not induce any vasorelaxation. At low concentration (0.02 mg/mL), the infusion potentiated the noradrenaline-induced contraction, while the other concentrations did not elicit significant changes in efficacy or potency. Differences between our findings and the previous report on rat aorta may result from methodological differences, e.g. vascular bed, method of extraction and extract composition. The clinical applicability of extracts of Fragaria vesca in patients with cardiovascular disease remains to be fully validated.

Agrimonia eupatoria L.: An integrative perspective on ethnomedicinal use, phenolic composition and pharmacological activity.

ETHNOPHARMACOLOGICAL RELEVANCE: Agrimonia eupatoria L., a plant which belongs to the Rosaceae family, is widespread in temperate regions, particularly throughout the northern hemisphere. In folk medicine, this plant species has been used for its astringent, anti-inflammatory, analgesic and hypotensive properties as well as in gastrointestinal disorders. As these biological properties have been linked to its phenolic composition, this plant species could be an interesting source of bioactive compounds with therapeutic potential. AIM OF THE STUDY: The aim of the present review is to provide a comprehensive overview of the scientific literature on A. eupatoria, particularly in regard to its ethnobotanics and ethnomedicinal uses, phenolic composition and biological and pharmacological activities. MATERIAL AND METHODS: Literature was retrieved from several bibliographic sources, namely PubMed, ScienceDirect and Google Scholar, since the first report on A. eupatoria in 1993. RESULTS: Regarding the phytochemical composition, A. eupatoria is rich in phenolic acids, flavonoids and tannins. The most commonly reported compounds are astragalin, cynaroside, hyperoside, isoquercitrin, isovitexin, rutin, catechin, procyanidin B3 and agrimoniin. In terms of bioactivity, extracts or fractions obtained from this plant species have shown antioxidant, antimicrobial, antidiabetic, antinociceptive and anti-inflammatory properties, among others. So far, two clinical studies with the infusion of A. eupatoria have shown hepatoprotective properties as well as a protective role in cardiovascular disease, metabolic disorders and diabetes. CONCLUSIONS: In this review, an integrative perspective on ethnomedicinal use, phenolic composition and pharmacological activity of A. eupatoria has been provided. As can be seen, this plant species exhibits several potential applications, including those beyond its traditional ethnomedicinal uses, as the safety of its consumption has been shown clinically. There still is limited pharmacological evidence that corroborates the ethnomedicinal uses of this plant species as well as regarding the specific bioactive compounds.

Vascular Effects of Polyphenols from Agrimonia eupatoria L. and Role of Isoquercitrin in Its Vasorelaxant Potential in Human Arteries.

Agrimonia eupatoria L. has been traditionally used for the treatment of inflammatory diseases but also as a hypotensive. To our knowledge, only one study has previously suggested an improvement in vascular endothelial function in diabetic conditions, as the underlying mechanisms and responsible compounds are unknown. In this study, we aimed to assess the direct vascular effects of Agrimonia eupatoria L. in human arteries. The infusion elicited a mild increase in basal vascular tone and a significant potentiation of the adrenergic contraction of 49.18% at 0.02 mg/mL, suggesting the presence of compounds with mild vasoconstrictor activity. In contrast, the ethyl acetate fraction inhibited adrenergic contraction by 80.65% at 2 mg/mL and elicited no effect on basal vascular tone. A potent concentration-dependent vasorelaxation was observed for both the infusion and the ethyl acetate fraction (maximal relaxation above 76% and 47%, respectively). Inhibition of nitric oxide synthase and cyclooxygenase elicited significant decreases in the vasorelaxation to the infusion, as, for the ethyl acetate fraction, only the cyclooxygenase pathway appeared to be involved. Isoquercitrin elicited a vasoactivity consistent with the ethyl acetate fraction, suggesting this is a major component responsible for the vasorelaxant properties of A. eupatoria. Further research is warranted to fully evaluate its vasoprotective properties with therapeutic potential in several conditions, e.g., atherosclerosis.

Translation and Validation of the Clinician Administered PTSD Scale (CAPS-CA-5) for Portuguese Children and Adolescents.

INTRODUCTION: The aim of this study was to translate and validate into European Portuguese the CAPS-CA-5 (Clinician Administered PTSD Scale for Children and Adolescents), a semi-structured scale for the diagnosis of post-traumatic stress disorder in children and adolescents, according to the DSM-5 criteria. MATERIAL AND METHODS: This study was developed in three stages. In the first stage, the translation and back-translation of CAPS-CA-5 into European Portuguese was carried out. In the second stage, the version obtained in the previous step was subjected to a pre-test. In the third stage, the final version of CAPS-CA-5, the KIDCOPE questionnaires and the Depression, Anxiety and Stress Scale-Children were applied to 101 children who had experienced at least one potentially traumatic event. The children included in this study were between seven and 18 years old and had a follow-up period in a Child Psychiatry or Pediatrics Clinic in one of the three hospitals involved in this project of at least one month. RESULTS: Regarding the confirmatory factor analysis, our results show that the CAPS-CA-5 is a suitable psychometric instrument to assess the diagnosis and symptoms severity of post-traumatic stress disorder according to DSM-5. Convergent validity was comparable to its original version. Although there were negative relationships with almost all of its clusters, these were not statistically significant when applied with the positive coping strategies of the KIDCOPE. The European Portuguese version of the CAPS-CA-5 showed a good internal consistency (Cronbach's α for the total scale was 0.89). CONCLUSION: The European Portuguese version of CAPS-CA-5 has similar psychometric properties to its original version.

Introdução: O objetivo deste estudo foi traduzir e validar para português europeu a CAPS-CA-5 (Clinician Administered PTSD Scale for Children and Adolescents), uma escala semiestruturada para o diagnóstico de perturbação de stress pós-traumático em crianças e adolescentes, de acordo com os critérios do DSM-5. Material e Métodos: Este estudo foi desenvolvido em três etapas. Na primeira, foi realizada a tradução e contra-tradução da CAPS-CA-5 para português europeu. Na segunda etapa, a versão obtida anteriormente foi submetida a um pré-teste. Na terceira etapa, a versão final da CAPS-CA-5, os questionários KIDCOPE e a Escala de Depressão, Ansiedade e Stresse - Crianças foram aplicados em 101 crianças que experienciaram pelo menos um evento potencialmente traumático. As crianças incluídas neste estudo tinham entre sete e 18 anos e tinham um período de acompanhamento em consulta de Psiquiatria Infantil ou Pediatria de pelo menos um mês, num dos três hospitais envolvidos neste projeto. Resultados: Em relação à análise fatorial confirmatória, os nossos resultados mostram que a CAPS-CA-5 é um instrumento psicométrico adequado para avaliar o diagnóstico e a gravidade dos sintomas de perturbação de stresse pós-traumático de acordo com o DSM-5. A validade convergente foi comparável à versão original. Embora tenha havido relações negativas com quase todos os seus clusters, estas não foram estatisticamente significativas quando aplicadas com as estratégias de coping positivo do KIDCOPE. A versão em português europeu da CAPS-CA-5 apresentou boa consistência interna (α de Cronbach para a escala total foi de 0,89). Conclusão: A versão em português europeu do CAPS-CA-5 possui propriedades psicométricas semelhantes à sua versão original.

The effect of impact exercise on bone mineral density: A longitudinal study on non-athlete adolescents.

PURPOSE: High impact exercise is known to induce osteogenic effects in the skeleton. However, less is known about the systemic effect of exercise practice in a potential adaptive mechanism of the skeletal accrual. This research aimed to assess the effect of impact exercise on bone mineral density (BMD) in the radius throughout adolescence. METHODS: This study evaluated 1137 adolescents, at 13 and 17 years old, as part of the population-based cohort EPITeen. BMD (g/cm2) was measured at the ultradistal and proximal radius of the non-dominant forearm by dual-energy X-ray absorptiometry (DXA) using a Lunar® Peripheral Instantaneous X-ray Image device. The practice of (extra-curricular) exercise was categorized as: no exercise, exercise with high impact and exercise with low impact. Regression coefficients (ß) and respective 95% confidence intervals (CI95%) were used to estimate the association between exercise practice categories at 13 years old and BMD at 13 and 17 years old and BMD gain between evaluations. RESULTS: In boys, at 13 years, BMD was similar between the ones not practicing exercise and those practicing exercise with low impact, and the gain of BMD was also similar in both groups. Still in boys, at 13 years, those who practiced exercise with high impact presented higher mean (standard-deviation) of BMD, comparing to the other two groups (no exercise and low impact exercise), and also significantly increased the BMD gain between 13 and 17 years (ß = 0.013; CI95%0.003;0.023). In girls, no statistically significant differences on BMD were found between the categories of exercise at 13 years and BMD at 17 years of age. CONCLUSION: This research shows that the practice of high impact exercise could help to increase BMD more than low impact exercise even in a nonweight-bearing bone during adolescence.

Occurrence of Fusarium spp. in Maize Grain Harvested in Portugal and Accumulation of Related Mycotoxins during Storage.

Maize is an important worldwide commodity susceptible to fungal contamination in the field, at harvest, and during storage. This work aimed to determine the occurrence of Fusarium spp. in maize grains produced in the Tagus Valley region of Portugal and the levels of related mycotoxins in the 2018 harvest and during their storage for six months in barrels, mimicking silos conditions. Continuous monitoring of temperature, CO2, and relative humidity levels were done, as well as the concentration of mycotoxins were evaluated and correlated with the presence of Fusarium spp. F. verticillioides was identified as the predominant Fusarium species. Zearalenone, deoxynivalenol and toxin T2 were not found at harvest and after storage. Maize grains showed some variability in the levels of fumonisins (Fum B1 and Fum B2). At the harvest, fumonisin B1 ranged from 1297 to 2037 µg/kg, and fumonisin B2 ranged from 411 to 618 µg/kg. Fumonisins showed a tendency to increase (20 to 40%) during six months of storage. Although a correlation between the levels of fumonisins and the monitoring parameters was not established, CO2 levels may be used to predict fungal activity during storage. The composition of the fungal population during storage may predict the incidence of mycotoxins.

Trends on Aspergillus Epidemiology-Perspectives from a National Reference Laboratory Surveillance Program.

Identification of Aspergillus to species level is important since sibling species may display variable susceptibilities to multiple antifungal drugs and also because correct identification contributes to improve the knowledge of epidemiological studies. Two retrospective laboratory studies were conducted on Aspergillus surveillance at the Portuguese National Mycology Reference Laboratory. The first, covering the period 2017-2018, aimed to study the molecular epidemiology of 256 Aspergillus isolates obtained from patients with respiratory, subcutaneous, or systemic infections and from environmental samples. The second, using our entire collection of clinical and environmental A. fumigatus isolates (N = 337), collected between 2012 and 2019, aimed to determine the frequency of azole-resistant A. fumigatus isolates. Aspergillus fumigatus sensu stricto was the most frequent species in both clinical and environmental samples. Overall, and considering all Aspergillus sections identified, a high frequency of cryptic species was detected, based on beta-tubulin or calmodulin sequencing (37% in clinical and 51% in environmental isolates). Regarding all Fumigati isolates recovered from 2012-2019, the frequency of cryptic species was 5.3% (18/337), with the identification of A. felis (complex), A. lentulus, A. udagawae, A. hiratsukae, and A. oerlinghauensis. To determine the frequency of azole resistance of A. fumigatus, isolates were screened for azole resistance using azole-agars, and 53 possible resistant isolates were tested by the CLSI microdilution reference method. Nine A. fumigatus sensu stricto and six Fumigati cryptic isolates showed high minimal inhibitory concentrations to itraconazole, voriconazole, and/or posaconazole. Real-time PCR to detect cyp51A mutations and sequencing of cyp51A gene and its promoter were performed. The overall frequency of resistance to azoles in A. fumigatus sensu stricto was 3.0%. With this retrospective analysis, we were able to detect one azole-resistant G54R mutant A. fumigatus environmental isolate, collected in 2015. The TR34/L98H mutation, linked to environmental transmission route of azole resistance, was the most frequently detected mutation (N = 4; 1.4%). Our findings underline the demand for correct identification and susceptibility testing of Aspergillus isolates.

Aspergillus collected in specific indoor settings: their molecular identification and susceptibility pattern.

Exposure to Aspergillus conidia is an increased risk factor for the development of respiratory symptoms. The emergence of azole resistance in Aspergillus fumigatus is a major concern for the scientific community. The aim of this study was to perform the molecular identification of Aspergillus species collected from different occupational and non-occupational indoor settings and to study the azole susceptibility profile of the collected Fumigati isolates. The selected Aspergillus isolates were identified as belonging to the sections Fumigati, Nigri Versicolores, Terrei, Clavati and Nidulantes. All the Aspergillus fumigatus were screened for azole resistance using an agar media supplemented with itraconazole, voriconazole and posaconazole. None of the tested isolates showed resistance to those azoles. Knowledge of Aspergillus epidemiology in specific indoor environments allows a better risk characterization regarding Aspergillus burden. This study allowed the analysis of the molecular epidemiology and the determination of the susceptibility pattern of Aspergillus section Fumigati found in the studied indoor settings.

COVID-19 pandemic and its psychological impact among healthy Portuguese and Spanish nursing students.

Few studies have explored the impacts of COVID-19 and lockdown on the mental health of undergraduate nursing students. This study aimed: a) to explore perceived stress among undergraduate nursing students in Portugal and Spain during the COVID-19 pandemic outbreak; and b) to analyze several COVID-19 related factors and psychological issues that may be associated with perceived stress. A cross-sectional study was conducted with a convenience sample of Portuguese and Spanish undergraduate nursing students (n=1075). The data gathered included demographic information, questions about COVID-19 related factors, and psychological issues. Data were analyzed using multiple logistic regression with a degree of significance at p<0.05. High perceived stress scores were found in 558 participants (51.9%). Students with high perceived stress most likely had a COVID-19 diagnosis in their household; their household income had been affected by the COVID-19 pandemic; experienced difficulty falling asleep or sleeping all night; consumed junk food in excess; neglected their appearance; felt headaches, stomach aches, and back pain; and lacked the patience or desire to exercise. Additionally, high perceived stress was negatively associated with life satisfaction. The results provide evidence that infectious diseases, such as COVID-19, may significantly influence mental health. Further research should explore the long-term psychological effects of the COVID-19 pandemic among nursing students.

Vascular activity of infusion and fractions of Cymbopogon citratus (DC) Stapf. in human arteries.

ETHNOPHARMACOLOGICAL RELEVANCE: Cymbopogon citratus (DC.) Stapf has been traditionally used mainly for inflammatory diseases and hypertension. However, the mechanisms underlying its vascular activity remain to be fully characterized and the fractions responsible for its cardiovascular activity are still unknown. AIM OF THE STUDY: In this study, we aimed to assess the vascular activity of Cymbopogon citratus in human arteries and to study the role of cyclooxygenase in its vasorelaxant effects. MATERIALS AND METHODS: Vascular effects of leaves infusion and three fractions (phenolic acids, flavonoids and tannins) were studied using distal segments of human internal thoracic arteries harvested from patients undergoing coronary revascularization, which were mounted as rings in tissue organ baths and maintained at 37 °C in Krebs Henseleit buffer. The effect on basal vascular tone, the effect on the noradrenaline-induced contraction and the vasorelaxant effects were assessed. The role of cyclooxygenase was evaluated with indomethacin. RESULTS: Our results showed a mild effect on the basal vessel tone of the infusion. A significant inhibition on the adrenergic-mediated vasoconstriction was observed for the infusion (0.0002 mg/mL) and the flavonoid fraction (0.2 mg/mL), despite a potentiation was observed in some conditions. A vasorelaxant effect was observed for both the infusion (6.46% of maximal relaxation) and the tannin fraction (26.91% of maximal relaxation, P < 0.05 vs. infusion). Incubation with indomethacin (10 µM) elicited a decrease in the vasorelaxation to the infusion (P < 0.05). CONCLUSIONS: These results suggest that cyclooxygenase may be involved in the vasorelaxation to the infusion of Cymbopogon citratus and that tannins are the compound fraction mainly responsible for this vasorelaxation.

Effects of the FIFA 11+ on injury prevention in amateur futsal players.

OBJECTIVE: To examine the effectiveness of the FIFA 11+ in reducing injury in futsal players. METHODS: Ninety-one male futsal players from six amateur futsal clubs were recruited and assessed for eligibility, and 71 were randomized to the 11+ group (n = 37, age: 27.0 ± 5.1 years) and a control group (n = 34, age: 26.0 ± 5.1 years). The 11+ program was executed twice a week for 20 weeks, separated by a 10-week period where both groups executed their regular warm-up. Data on match, training exposure, and injuries were recorded during the regular season. RESULTS: The players sustained a total of 58 injuries during the futsal regular season, with 24 injuries in the 11+ group and 34 injuries in the control group; the overall incidence of injuries per 1000 player-hours was significantly higher in the control group (11.6 vs 6.5; mean difference (95% CI) -5.1 (-9.1 to -1.1), P = .014). The 11+ group had a significantly lower incidence of acute (11.2 vs 5.7; -5.5 (-9.4 to -1.6), P = .007) and lower limb (8.7 vs 4.4; -4.2 (-8.1 to -0.4), P = .032) injuries per 1000 player-hours. Players from the control group had a higher number of days injured (20.4 ± 17.3 vs 10.5 ± 9.1, P = .036). CONCLUSION: The FIFA 11+ is an injury prevention program suited for injury reduction in amateur futsal players, as it reduces the incidence of overall, acute, and lower limb injuries during the season.

Deep Friction Massage in the Management of Patellar Tendinopathy in Athletes: Short-Term Clinical Outcomes.

CONTEXT: Deep friction massage (DFM) is often used in the treatment of tendinopathies; however, the pressure applied may vary and interfere with the obtained results. OBJECTIVE: To assess whether the immediate effects of DFM on pain (pain intensity and time to onset of analgesia) and muscle strength are dependent on the pressure applied during the DFM application in athletes with patellar tendinopathy. DESIGN: Randomized, controlled, cross-over trial. SETTING: University research laboratory (institutional). PARTICIPANTS: Ten athletes with diagnosis of unilateral patellar tendinopathy (age 27.90 [5.24] y). INTERVENTIONS: All participants attended 4 sessions, 3 treatment sessions with DFM applied with different pressures (the mean pressure-previously determined for each participant-and the mean pressure ± 25%) and a control session, each of which was separated by 48 hours. MAIN OUTCOME MEASURES: Pain (intensity upon palpation and time to onset of analgesia), and muscle strength of knee extensors were assessed before and immediately after each session. RESULTS: Pain intensity changed significantly over time (F1,9 = 52.364; P < .001; ηp2=.853) and among sessions (F3,27 = 82.588; P < .001; ηp2=.902), with a significant interaction for group × time (F3,27 = 19.841; P < .001; ηp2=.688). The knee extensors strength did not change significantly over time (F1,9 = 2.240; P = .17; ηp2=.199), nor a significant interaction for session × time was observed (F3,27 = 3.276; P = .07; ηp2=.267). Regardless of the pressure applied, the time to onset of analgesia was not significantly different (F2,18 = 1.026; P > .05; ηp2=.102). CONCLUSION: It was shown that DFM induces an immediate reduction in pain intensity upon palpation, regardless of the pressure performed. Notwithstanding, the reader should take into account the small sample size and the caution needed in the results' interpretation.

Sagittal standing posture and relationships with anthropometrics and body composition during childhood.

BACKGROUND: Anthropometry and body composition are plausible influences on pediatric sagittal standing posture. Despite that, the relationship of anthropometrics since birth and body composition with individual postural parameters in children has never been assessed. RESEARCH QUESTION: To assess the associations between anthropometrics since birth and body composition parameters, and angles of sagittal standing posture in children. METHODS: The sample included 1021 girls and 1096 boys, evaluated in the population-based birth cohort Generation XXI, Portugal. Weight and height were obtained at birth, 4 and 7 years of age. At age 7, total body less head fat/fat-free mass and bone properties were estimated from whole body dual energy X-ray absorptiometry scans and posture was assessed through right-side photographs during habitual standing with retro-reflective markers placed on body landmarks. RESULTS: Girls showed increased values of lumbar angle, head and neck flexion, and craniocervical angle with the largest mean (standard deviation) difference in lumbar angle [281.7° (7.4) vs. 276.8° (7.1) in boys, p < 0.001]. In both genders, weight and body mass index were weakly associated with lumbar angle: 0.24 ≥ r ≤ 0.31 in girls and 0.16 ≥ r ≤ 0.26 in boys, all p < 0.001. Fat and fat-free mass and bone mineral density were weakly associated with lumbar angle in both genders. SIGNIFICANCE: Our study showed clear postural heterogeneity between girls and boys in early ages. Lumbar angle is likely to be the single most relevant proxy of overall posture based on the associations with the exposures reported in this study.

Envelhecimento Ativo e Saudável: resultado-piloto do programa de intervenção "VintAGEING+Felizes" / Active and Healthy Aging: pilot result of the "VintAGEING+Happy" Intervention Program / Envejecimiento activo y saludable: resultado piloto del Programa de Intervención "VintAGEING+Felices"

Ações de prevenção e de manutenção da saúde do idoso, na sua comunidade e no seu domicílio, devem ser resultado de um esforço de parcerias públicas e/ou privadas, academia e serviço. O programa intitulado, VintANGEING+Felizes, tem como finalidade realizar um trabalho multidisciplinar de intervenção comunitária, disponibilizando o conhecimento científico e contribuindo para o cumprimento das diretrizes e das políticas de atenção pública à saúde do idoso, na direção do envelhecimento ativo e saudável.

Actions to prevent and maintain the health of the elderly, in their community and at home, should be the result of an effort of public and / or private partnerships, academia and service. The VintANGEING+Happy Program aims to carry out a multidisciplinary work of community intervention, providing scientific knowledge and contributing to the compliance with the guidelines and policies of public attention to the health of the elderly in the direction of active and healthy aging.

Las acciones de prevención y mantenimiento de la salud de los ancianos, en su comunidad y en el hogar, deben ser el resultado de un esfuerzo de asociaciones públicas y / o privadas, gimnasio y servicio. El programa VintANGEING+Felizes tiene como objetivo llevar a cabo un trabajo multidisciplinario de intervención comunitaria, proporcionando conocimiento científico y contribuyendo al cumplimiento de las directrices y políticas de atención de salud pública para personas mayores, en la dirección del envejecimiento activo y saludable.

Child's food consumption and physical exercise: Results from a Portuguese descriptive study.

AIMS: To describe food consumption in Portuguese primary school children, to analyze the influence of food consumption on the body mass index (BMI), and to analyze the relationship between physical exercise and the child's food consumption. METHOD: A quantitative, descriptive, exploratory, and cross-sectional study was conducted in 2 primary schools of the north of Portugal (n = 109 child). The use of a food register for 5 consecutive days and anthropometric evaluation of the children were used. RESULTS: The vast majority of children had a normal weight (65.10%). However, 34.90% of the children presented significant changes in their BMI (14.70% with low weight, 11.90% overweight, and 8.30% with obesity). Children who engage in physical activity drink more water and consume less sugary products. However, they also consume less meat, fish, and eggs than those who do not perform regular physical activity. CONCLUSIONS: The study highlights the emergence of new problems, such as the increasing prevalence of underweight children. The prevention of these problems, overweight, or underweight children, should be addressed among healthcare providers, local authorities, families, and teachers.

The FIFA 11+ does not alter physical performance of amateur futsal players.

BACKGROUND: The ability of the FIFA 11+ to enhance performance has demonstrated controversial results. Hence, we examined the short and long-term effects of the FIFA 11+ on performance in male amateur futsal players. METHODS: Seventy-one male futsal players from six amateur clubs were recruited and randomized to an intervention (N.=37, age: 27.0±5.1 years) or a control group (N.=34, age: 26.0±5.1 years). The intervention group was submitted to 10 weeks of FIFA 11+ injury prevention program, 2 sessions/week, followed by a 10-week follow-up period, while the control group performed regular futsal warm-ups during the training sessions. During the follow-up period both groups performed only regular warm-ups during their training sessions. Physical performance was assessed by measuring agility (T-test), sprint (30 m sprint), flexibility (sit-and-reach test) and vertical jump performance (squat jump). RESULTS: Differences between groups were found at baseline for training exposure, body mass index, body weight, flexibility, and sprint. The results of the effect of the FIFA 11+ on the sit-and-reach test, speed and agility did not show differences pre-post intervention, as well as for the 10-week follow-up. Jump performance, showed a significant difference in favor of the control group for the intervention period and the follow-up (crude ß: -0.04 [95% CI: -0.06; -0.01]; -0.03 [95% CI: -0.06; -0.00], respectively), however after adjustment for the baseline differences the confidence interval fell out of the range of significance for the intervention and follow-up period (adjusted ß, -0.05 [95% CI: -0.10; 0.00]; -0.05 [95% CI: -0.10; 0.04]). CONCLUSIONS: The present study has shown no short and long-term performance enhancement in sprint, flexibility, agility and jump performance after the FIFA 11+ in male amateur futsal players.

The population impact of rheumatic and musculoskeletal diseases in relation to other non-communicable disorders: comparing two estimation approaches.

The aim of this study was to quantify the population impact of rheumatic and musculoskeletal diseases (RMDs) with other non-communicable diseases (NCDs), using two complementary strategies: standard multivariate models based on global burden of disease (GBD)-defined groups vs. empirical mutually exclusive patterns of NCDs. We used cross-sectional data from the Portuguese Fourth National Health Survey (n = 23,752). Six GBD-defined groups were included: RMDs, chronic obstructive pulmonary disease or asthma, cancer, depression, diabetes or renal failure, and stroke or myocardial infarction. The empirical approach comprised the patterns "low disease probability", "cardiometabolic conditions", "respiratory conditions" and "RMDs and depression". As recommended by the outcome measures in rheumatology (OMERACT) initiative, health outcomes included life impact, pathophysiological manifestations, and resource use indicators. Population attributable fractions (PAF) were computed for each outcome and bootstrap confidence intervals (95% CI) were estimated. Among GBD-defined groups, RMDs had the highest impact across all the adverse health outcomes, from frequent healthcare utilization (PAF 7.8%, 95% CI 6.2-9.3) to negative self-rated health (PAF 18.1%, 95% CI 15.4-20.6). In the empirical approach, patterns "cardiometabolic conditions" and "RMDs and depression" had similar PAF estimates across all adverse health outcomes, but "RMDs and depression" showed significantly higher impact on chronic pain (PAF 8.9%, 95% CI 7.6-10.3) than the remaining multimorbidity patterns. RMDs revealed the greatest population impact across all adverse health outcomes tested, using both approaches. Empirical patterns are particularly interesting to evaluate the impact of RMDs in the context of their co-occurrence with other NCDs.

Deep Friction Massage and the Minimum Skin Pressure Required to Promote a Macroscopic Deformation of the Patellar Tendon.

OBJECTIVE: The purpose of this study was to determine the skin pressure needed to promote the macroscopic deformation of the asymptomatic patellar tendon and to verify if the pressure is associated with the individual's characteristics. METHODS: A descriptive laboratory study was performed with a convenience sample of 18 young, voluntary, and asymptomatic individuals of both sexes. A progressively increasing pressure was applied on the skin over the patellar tendon, through an instrument designed to perform and control the pressure upon an ultrasound probe; data were recorded and analyzed by 2 blind investigators. All statistical analyses were conducted considering α = 0.05. RESULTS: The average pressure needed to promote a macroscopic deformation of the patellar tendon was 1.12 ± 0.37 kg/cm2. Female sex and age were inversely but not significantly associated with the pressure performed. Sports practice, weight, height, body mass index, muscle mass, and subcutaneous thickness were positively but not significantly associated with the pressure executed. CONCLUSION: The average pressure needed to promote the macroscopic deformation of the patellar tendon was 1.12 ± 0.37 kg/cm2, which was not influenced by the characteristics of the participants.

Cyriax's deep friction massage application parameters: Evidence from a cross-sectional study with physiotherapists.

BACKGROUND: Deep friction massage is one of several physiotherapy interventions suggested for the management of tendinopathy. OBJECTIVES: To determine the prevalence of deep friction massage use in clinical practice, to characterize the application parameters used by physiotherapists, and to identify empirical model-based patterns of deep friction massage application in degenerative tendinopathy. DESIGN: observational, analytical, cross-sectional and national web-based survey. METHODS: 478 physiotherapists were selected through snow-ball sampling method. The participants completed an online questionnaire about personal and professional characteristics as well as specific questions regarding the use of deep friction massage. Characterization of deep friction massage parameters used by physiotherapists were presented as counts and proportions. Latent class analysis was used to identify the empirical model-based patterns. Crude and adjusted odds ratios and 95% confidence intervals were computed. RESULTS: The use of deep friction massage was reported by 88.1% of the participants; tendinopathy was the clinical condition where it was most frequently used (84.9%) and, from these, 55.9% reported its use in degenerative tendinopathy. The "duration of application" parameters in chronic phase and "frequency of application" in acute and chronic phases are those that diverge most from those recommended by the author of deep friction massage. CONCLUSION: We found a high prevalence of deep friction massage use, namely in degenerative tendinopathy. Our results have shown that the application parameters are heterogeneous and diverse. This is reflected by the identification of two application patterns, although none is in complete agreement with Cyriax's description.