Updated perspectives on the contribution of the microbiome to the pathogenesis of mucositis using the MASCC/ISOO framework.

Advances in the treatment of cancer have significantly improved mortality rates; however, this has come at a cost, with many treatments still limited by their toxic side effects. Mucositis in both the mouth and gastrointestinal tract is common following many anti-cancer agents, manifesting as ulcerative lesions and associated symptoms throughout the alimentary tract. The pathogenesis of mucositis was first defined in 2004 by Sonis, and almost 20 years on, the model continues to be updated reflecting ongoing research initiatives and more sophisticated analytical techniques. The most recent update, published by the Multinational Association for Supportive Care in Cancer and the International Society for Oral Oncology (MASCC/ISOO), highlights the numerous co-occurring events that underpin mucositis development. Most notably, a role for the ecosystem of microorganisms that reside throughout the alimentary tract (the oral and gut microbiota) was explored, building on initial concepts proposed by Sonis. However, many questions remain regarding the true causal contribution of the microbiota and associated metabolome. This review aims to provide an overview of this rapidly evolving area, synthesizing current evidence on the microbiota's contribution to mucositis development and progression, highlighting (i) components of the 5-phase model where the microbiome may be involved, (ii) methodological challenges that have hindered advances in this area, and (iii) opportunities for intervention.

Flow Training Program: Mindfulness, Decision Making, and Mental Well-Being of Young and Adult Elite Handball Athletes.

This study aimed to analyze the effect of a flow training program based on mindfulness applied to young and adult elite handball athletes. A quantitative, quasi-experimental, descriptive data analysis approach was carried out. The sample included 105 athletes (51 female and 54 male). The athletes were divided into two groups: (i) experimental (n = 53) and (ii) control (n = 52). The results of the repeated ANOVA indicated that the experimental group achieved significant improvements compared to the control group in decision making (n2p = 0.086), mental well-being (n2p = 0.045), dispositional flow state (n2p = 0.103), non-judgment (n2p = 0.040), refocusing (n2p = 0.052), and mindful traits in daily life (n2p = 0.058). A Pearson analysis demonstrated a positive correlation between dispositional flow state and mindfulness in sport and mental well-being. The correlation analysis also showed an inverse correlation between decision making and sense of control and mindful traits in daily life. The findings revealed that the program can be effective in decision making, mental well-being, dispositional flow state, mindfulness in sport, and mindful traits in daily lives of athletes.

Implementing regular physical activity for older individuals in the family strategy program using the RE-AIM framework to ensure feasibility and sustainability: EISI study protocol.

The EISI study protocol aims to address the low participation rate in physical exercise programs among older individuals, emphasizing its significance as a non-pharmacological therapeutic approach for overall health and increased physical activity. The objectives include implementing physical activity (PA) and educational health programs in Jequié, Bahia, Brazil, targeting the Family Health Strategy population to enhance local physical activity levels among older individuals. The study also seeks to evaluate the program's feasibility, safety, and sustainability for large-scale implementation, along with assessing its impact on immune and inflammatory response biomarkers to the SARS-CoV virus, as well as physical-functional and brain health. Participants, aged 60 or above, will be divided into two groups: multicomponent exercise (MCE) and behavioral change interventions (BCI). The study employs a mixed-method approach, utilizing a non-randomized controlled short-term pathway model for a 4-8 weeks of pilot study and 16-week intervention impact assessment. Data collection encompasses various aspects such as sociodemographic information, mental health, physical fitness, fall risk, functional capacity, anthropometric measurements, hemodynamic assessment, habitual physical activity, and health-related quality of life. Blood and saliva samples are collected for cytokine and antibody biomarker analysis related to SARS-CoV immunity. Pre- and post-intervention evaluations for both groups will be conducted, with the hypothesis that MCE will yield more favorable responses compared to BCI. The study's holistic approach, including the assessment of feasibility, safety, and sustainability, aims to contribute to achieving Sustainable Development Goals (SDG) 3 and SDG 9 b y promoting accessible and sustainable healthcare initiatives for older individuals. This research aligns with global efforts to enhance health and well-being, emphasizing the importance of regular exercise in the aging population.

Guidance on mucositis assessment from the MASCC Mucositis Study Group and ISOO: an international Delphi study.

Background: Mucositis is a common and highly impactful side effect of conventional and emerging cancer therapy and thus the subject of intense investigation. Although common practice, mucositis assessment is heterogeneously adopted and poorly guided, impacting evidence synthesis and translation. The Multinational Association of Supportive Care in Cancer (MASCC) Mucositis Study Group (MSG) therefore aimed to establish expert recommendations for how existing mucositis assessment tools should be used, in clinical care and trials contexts, to improve the consistency of mucositis assessment. Methods: This study was conducted over two stages (January 2022-July 2023). The first phase involved a survey to MASCC-MSG members (January 2022-May 2022), capturing current practices, challenges and preferences. These then informed the second phase, in which a set of initial recommendations were prepared and refined using the Delphi method (February 2023-May 2023). Consensus was defined as agreement on a parameter by >80% of respondents. Findings: Seventy-two MASCC-MSG members completed the first phase of the study (37 females, 34 males, mainly oral care specialists). High variability was noted in the use of mucositis assessment tools, with a high reliance on clinician assessment compared to patient reported outcome measures (PROMs, 47% vs 3%, 37% used a combination). The World Health Organization (WHO) and Common Terminology Criteria for Adverse Events (CTCAE) scales were most commonly used to assess mucositis across multiple settings. Initial recommendations were reviewed by experienced MSG members and following two rounds of Delphi survey consensus was achieved in 91 of 100 recommendations. For example, in patients receiving chemotherapy, the recommended tool for clinician assessment in clinical practice is WHO for oral mucositis (89.5% consensus), and WHO or CTCAE for gastrointestinal mucositis (85.7% consensus). The recommended PROM in clinical trials is OMD/WQ for oral mucositis (93.3% consensus), and PRO-CTCAE for gastrointestinal mucositis (83.3% consensus). Interpretation: These new recommendations provide much needed guidance on mucositis assessment and may be applied in both clinical practice and research to streamline comparison and synthesis of global data sets, thus accelerating translation of new knowledge into clinical practice. Funding: No funding was received.

Physical and Physiological Demands of Amateur Portuguese Field and Assistant Football Referees.

Referees are crucial elements in football, and they must meet the physical and physiological demands each match poses to them. The aim is to analyse the physical and physiological demands of amateur referees in games at the regional level (4th division), examining the differences between the first and second halves and between assistant (age: 25.10 ± 4.97) and main referees (age: 25.65 ± 5.12). A total of 29 matches were analysed with GPS devices, and internal and external load metrics were analysed. Overall, main referees, due to their central role in game management, showed higher levels of physical and physiological load than assistant referees, with more high-intensity activities, greater distance covered and higher heart rate. The results also revealed that there were no differences between the halves for total distance covered for either the main or assistant referees. However, the main referees covered a greater distance in high-intensity running during the first half (p = 0.05; d = 0.389). These findings emphasise the importance of tailored training protocols to enhance performance and reduce fatigue-related errors, highlighting the significance of endurance, high-intensity running ability, and strategies to manage transient fatigue in referee preparation.

Methodology and Experimental Protocol for Studying Learning and Motor Control in Neuromuscular Structures in Pilates.

The benefits of Pilates have been extensively researched for their impact on muscular, psychological, and cardiac health, as well as body composition, among other aspects. This study aims to investigate the influence of the Pilates method on the learning process, motor control, and neuromuscular trunk stabilization, specifically in both experienced and inexperienced practitioners. This semi-randomized controlled trial compares the level of experience among 36 Pilates practitioners in terms of motor control and learning of two Pilates-based skills: standing plank and side crisscross. Data will be collected using various assessment methods, including abdominal wall muscle ultrasound (AWMUS), shear wave elastography (SWE), gaze behavior (GA) assessment, electroencephalography (EEG), and video motion. Significant intra- and inter-individual variations are expected, due to the diverse morphological and psychomotor profiles in the sample. The adoption of both linear and non-linear analyses will provide a comprehensive evaluation of how neuromuscular structures evolve over time and space, offering both quantitative and qualitative insights. Non-linear analysis is expected to reveal higher entropy in the expert group compared to non-experts, signifying greater complexity in their motor control. In terms of stability, experts are likely to exhibit higher Lyapunov exponent values, indicating enhanced stability and coordination, along with lower Hurst exponent values. In elastography, experienced practitioners are expected to display higher transversus abdominis (TrA) muscle elasticity, due to their proficiency. Concerning GA, non-experts are expected to demonstrate more saccades, focus on more Areas of Interest (AOIs), and shorter fixation times, as experts are presumed to have more efficient gaze control. In EEG, we anticipate higher theta wave values in the non-expert group compared to the expert group. These expectations draw from similar studies in elastography and correlated research in eye tracking and EEG. They are consistent with the principles of the Pilates Method and other scientific knowledge in related techniques.

Movement variability in Pilates: a scoping review.

Objective: This scoping review aimed to identify studies that analyzed movement variability in Pilates. Following a systematic approach to mapping evidence on this topic would highlight concepts, theories, sources, and knowledge gaps in this area. Methods: This review used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) criteria for the selection, reading, and analysis of studies in this area. We searched five literature databases (Web of Science, SCOPUS, library catalog of the Faculty of Sport and Physical Education of the University of Coimbra-EBSCO Discovery Services, MEDLINE, and Google Scholar). Eligible articles contained the word "Pilates," and the human movement variability was analyzed. Any type of study (except reviews) could be eligible and must have been published between 1 January 2002 and 30 November 2022, in Portuguese, Spanish, French, or English. Results: Our search identified five eligible entries. Only one study used the Pilates method in its intervention, pointing to a more significant variability of hip-knee coordination, suggesting more diversified coordination patterns, and maintaining the variability of the angular position of the joint. Conclusion: Very few studies have examined movement variability in Pilates, and only one applied an ecological framework.

Systemic Inflammatory Disorders, Immunosuppressive Treatment and Increase Risk of Head and Neck Cancers-A Narrative Review of Potential Physiopathological and Biological Mechanisms.

Head and neck cancers (HNCs) are known to present multiple factors likely to influence their development. This review aims to provide a comprehensive overview of the current scientific literature on the interplay between systemic inflammatory disorders, immunosuppressive treatments and their synergistic effect on HNC risk. Both cell-mediated and humoral-mediated systemic inflammatory disorders involve dysregulated immune responses and chronic inflammation and these inflammatory conditions have been associated with an increased risk of HNC development, primarily in the head and neck region. Likewise, the interaction between systemic inflammatory disorders and immunosuppressive treatments appears to amplify the risk of HNC development, as chronic inflammation fosters a tumor-promoting microenvironment, while immunosuppressive therapies further compromise immune surveillance and anti-tumor immune responses. Understanding the molecular and cellular mechanisms underlying this interaction is crucial for developing targeted prevention strategies and therapeutic interventions. Additionally, the emerging field of immunotherapy provides potential avenues for managing HNCs associated with systemic inflammatory disorders, but further research is needed to determine its efficacy and safety in this specific context. Future studies are warranted to elucidate the underlying mechanisms and optimize preventive strategies and therapeutic interventions.

The Gaze Patterns of Group Fitness Instructors Based on Different Levels of Training and Professional Experience.

The way in which group fitness instructors observe participants has a great influence on their pedagogical intervention. Based on the above, the main objective of this research is to characterize and compare their gaze patterns according to their training and professional experience. Twenty group fitness instructors of choreographed classes participated, aged between 18 and 42 years old, and for the comparison, four groups were created. Eye movements were captured with TOBII Pro Glasses 3, and data were coded and analyzed using the TOBII Pro Lab software. For the characterization of the gaze patterns, descriptive statistics were used in terms of count (f/m) and duration (s/m), while the comparison was performed using a one-way ANOVA test. More trained and experienced instructors tend to look at participants less, in count (80.59 ± 0.74) and duration (17.74 ± 0.71), with significant differences between the groups in some areas of interest (head, lower body, and other). There are also significant differences in the total number of eye fixations (F = 34.614; p = 0.001; η2 = 0.866; effect size very high). In conclusion, and projecting future works, it is important to understand how these gaze patterns are related to pedagogical behaviors in general or based on some specific factors (e.g., pedagogical feedback).

The Effects of Chitosan on the Healing Process of Oral Mucosa: An Observational Cohort Feasibility Split-Mouth Study.

The healing process is a dynamic process accompanied by some classical symptoms of inflammation such as redness, swelling, pain, and loss of function. Chitosan is a natural polymer with properties that contribute to tissue healing, with properties that could be applied in periodontal therapy, such as the wound healing of oral mucosa. This experimental split-mouth study aims to assess the possibilities of chitosan influencing the healing process of oral mucosa in eight patients, where the studied group was subjected to two oral surgeries: one with chitosan hydrogel into the socket and other without the biomaterial. A semi-quantitative analysis of the data was performed. Some classic signs of inflammation in a short period of time were observed where chitosan acted, compared to the control. An absence of bleeding was observed in the chitosan cases. According to the literature, chitosan recruits and activates neutrophils and macrophages and stimulates angiogenesis. Hemostatic and antimicrobial activity of chitosan also play an important role in wound healing. Chitosan seems to improve the postoperative quality of patients, allowing rapid wound healing with less complications.

Different scoring methods of the VARK questionnaire to evaluate dentistry Students' learning styles.

INTRODUCTION: The way students process and organise information to facilitate learning is known as learning style. Knowing one's learning style can improve learning and help teachers choose their teaching methods more effectively. This study was conducted to investigate different scoring methods of the VARK questionnaire and compare different learning styles in different stages of dental school. MATERIALS AND METHODS: Students in three stages of the dental school participated in this study: basic sciences, preclinical and clinical. The validated reliable Persian VARK questionnaire was utilised. Collected data were computed and analysed in three ways: raw, normalised and weighted scoring by ANOVA and chi-squared tests (α = .05). RESULT: The most favoured learning style was auditory; however, the prevalence of other learning styles varied through stages. On analyses of visual and auditory learning styles by all methods of scoring, no significant difference was seen in different stages (study time). The kinetic learning style, using normalised scoring method, was used more significantly when the grade increased (p-value = .028). However, in the weighted method, this effect was not significant. The read-write learning style using all three scoring methods showed an inverse relationship with the level of education (p-value <.05), which means the tendency to use this style of learning decreased when the level of education increased. CONCLUSION: As the educational level increases, students are more inclined to use kinetic and less likely to employ read-write learning style. There was not a significant difference in the use of visual and aural learning styles in any stages of dental school.

Mönckeberg's medial arteriosclerosis in the oral and maxillofacial region: A pilot study.

OBJECTIVE: To evaluate the prevalence of medial vascular calcifications in the oral and maxillofacial region and their association with systemic diseases. MATERIALS AND METHODS: The study included 211 consecutive patients with systemic diseases (January 2015-May 2016). Medical history and radiographic images were evaluated. Univariate analysis (t-test) was performed for continuous variables (age). The Chi square test was applied for the categorical variables (Mönckeberg medial arteriosclerosis [MMA], gender). RESULTS: There was a 6.2% prevalence of MMA. The mean age of patients with MMA was 65.46 ± 13.38. The prevalence of kidney disease in patients with MMA was significantly higher than in those without MMA (p < 0.001). This finding was maintained even after adjusting for other systemic diseases (OR = 31.84 [8.63-136.78]). CONCLUSION: A significant prevalence of MMA in kidney disease patients was observed in this pilot study.

Benefits of Pilates in the Elderly Population: A Systematic Review and Meta-Analysis.

The aim of this systematic review is to collect and summarize the benefits of Pilates in the elderly population (>60 years old), within the current scientific production, assessing its contribution to Healthy Ageing (HA). We used PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analysis) to select, collect, and analyse this thematic. The methodological procedures were registered in the PROSPERO database. The main results of the studies analysed (n = 30) point to significant differences between the intervention and the control groups in dynamic balance, strength, mobility, functional capacity, risk of falling reduction, and mental and psychological health. Thus, the results showed that Pilates may be beneficial for the health of the elderly. The meta-analysis found statistical differences between means on the dynamic balance (mean difference (MD) = −0.0, 95% CI [−0.71, −0.50]; I2: 0%) and the aerobic capacity and aerobic resistance [(MD) = 38.29, 95% CI [6.82, 69.77]; I2: 0%). Thus, it is concluded that the efficacy of Pilates has been shown in various areas of HA and has proven to be affordable and safe for the majority of people, using just a mat on the floor. Future studies should focus on the analysis of the relationship between the cost and the benefit of a Pilates intervention in the elderly population, to better understand how health costs can be minimized and to contribute to a multidisciplinary and generalized HA. Pilates has practical application for the clinicians, therapists, and health professionals that work with the elderly population.

Children Are Back to School, but Is Play Still in Lockdown? Play Experiences, Social Interactions, and Children's Quality of Life in Primary Education in the COVID-19 Pandemic in 2020.

The right to play is crucial for the overall development of children. Several studies highlight the need to have time and space to play, especially at school where children spend much of their time. Unfortunately, in formal education the obsession with academic achievements sidelines and ignores the importance of play. The neglection of play had already reached a critical stage before the pandemic, so data are needed to realize how the right to play in school is presently affected. This paper aims to understand children's play experience in primary education during the pandemic. It investigates what activities children participated in and what materials were used, and provides insight into the social interactions between peers. Furthermore, children's quality of life is explored. A group of 370 Portuguese children answered a questionnaire on play and social interactions, alongside with Peds 4.0TM on health-related quality of life (HRQOL). The results showed that recess still emerges as a significant element of children's daily lives, but COVID-19 has brought limitations on play experiences and peer-interaction. It might also have impacted HRQOL, especially in emotional functioning. Since play, health and well-being are closely connected, play opportunities at school are crucial in helping children to thrive in the pandemic, and should be invested in.

Mathematical Models to Measure the Variability of Nodes and Networks in Team Sports.

Pattern analysis is a widely researched topic in team sports performance analysis, using information theory as a conceptual framework. Bayesian methods are also used in this research field, but the association between these two is being developed. The aim of this paper is to present new mathematical concepts that are based on information and probability theory and can be applied to network analysis in Team Sports. These results are based on the transition matrices of the Markov chain, associated with the adjacency matrices of a network with n nodes and allowing for a more robust analysis of the variability of interactions in team sports. The proposed models refer to individual and collective rates and indexes of total variability between players and teams as well as the overall passing capacity of a network, all of which are demonstrated in the UEFA 2020/2021 Champions League Final.