Deciphering the irradiation induced fragmentation-rearrangement mechanisms in valence ionized CF3CH2F.

The increasing presence of 1,1,1,2-tetrafluoroethane (CF3CH2F) in the atmosphere has prompted detailed studies into its complex photodissociation behavior. Experiments focusing on CF3CH2F irradiation have unveiled an array of ions, with the persistent observation of the rearrangement product CHF2+ not yet fully understood. In this work, we combine density functional theory, coupled-cluster calculations with a complete basis set formalism, and atom-centered density matrix propagation molecular dynamics to investigate the energetics and dynamics of different potential pathways leading to CHF2+. We found that the two-body dissociation pathway involving an HF rearrangement, which was previously considered complex for CHF2+ formation, is actually straightforward but not likely due to the facile loss of HF. In contrast, our calculations reveal that the H elimination pathway, once thought of as a potential route to CHF2+, is not only comparably disadvantageous from both thermodynamic and kinetic points of view but also does not align with experimental data, particularly the lack of a rebound peak at m/z 101-102. We establish that the formation of CHF2+ is predominantly via the HF elimination channel, a conclusion experimentally corroborated by studies involving the trifluoroethylene cation CF2CHF+, a key intermediate in this process.

Prevalence and Spatial Autocorrelation of Tuberculosis in Indigenous People in Brazil, 2002-2022.

Tuberculosis (TB) among indigenous populations in Brazil poses a multifaceted public health challenge influenced by geographical, social, institutional, economic, and cultural factors. This study scrutinized the prevalence and spatial distribution of TB among Brazilian indigenous communities from 2002 to 2022. Employing a cross-sectional and descriptive approach, we analyzed data from the Notifiable Diseases Information System (SINAN) and conducted spatial autocorrelation tests to identify clusters and outliers. The findings uncovered substantial disparities in TB prevalence between the North and Central-West regions, in contrast to the South and Southeast, mirroring social, economic, and cultural inequalities in Brazil. It is concluded that public health strategies should not only consider the epidemiological aspects of TB but also encompass social and environmental determinants, notably the impact of climate change. Holistic and context-sensitive approaches are imperative for addressing TB within indigenous communities, underscoring the need for adaptive and culturally sensitive interventions in the public health landscape.

An in vivo duck hepatitis B virus model recapitulates key aspects of nucleic acid polymer treatment outcomes in chronic hepatitis B patients.

Nucleic acid polymers (NAPs) are an attractive treatment modality for chronic hepatitis B (CHB), with REP2139 and REP2165 having shown efficacy in CHB patients. A subset of patients achieve functional cure, whereas the others exhibit a moderate response or are non-responders. NAP efficacy has been difficult to recapitulate in animal models, with the duck hepatitis B virus (DHBV) model showing some promise but remaining underexplored for NAP efficacy testing. Here we report on an optimized in vivo DHBV duck model and explore several characteristics of NAP treatment. REP2139 was efficacious in reducing DHBV DNA and DHBsAg levels in approximately half of the treated ducks, whether administered intraperitoneally or subcutaneously. Intrahepatic or serum NAP concentrations did not correlate with efficacy, nor did the appearance of anti-DHBsAg antibodies. Furthermore, NAP efficacy was only observed in experimentally infected ducks, not in endogenously infected ducks (vertical transmission). REP2139 add-on to entecavir treatment induced a deeper and more sustained virological response compared to entecavir monotherapy. Destabilized REP2165 showed a different activity profile with a more homogenous antiviral response followed by a faster rebound. In conclusion, subcutaneous administration of NAPs in the DHBV duck model provides a useful tool for in vivo evaluation of NAPs. It recapitulates many aspects of this class of compound's efficacy in CHB patients, most notably the clear division between responders and non-responders.

Severe traumatic brain injury and acute kidney injury patients: factors associated with in-hospital mortality and unfavorable outcomes.

OBJECTIVE: The purpose of this study was to identify the occurrence of AKI, and factors associated with in-hospital mortality and unfavorable outcomes in patients with severe traumatic brain injury (TBI) and acute kidney injury (AKI) severity. METHOD: A retrospective cohort study which analyzed data with severe TBI between 2013 and 2017. We examined demographic and clinical information, and outcome by in-hospital mortality, and the Glasgow Outcome Scale six months after TBI. We associated factors to in-hospital mortality and unfavorable outcome in severe TBI and AKI with an association test. RESULTS: A total of 219 patients were selected, 39.3% had an AKI, and several factors associated with AKI occurrence after severe TBI. Stage 2 or 3 of AKI (OR 12.489; 95% CI = 4.45-37.94) were independent risk for both outcomes in multivariable models, severity injury by the New Trauma Injury Severity Score (OR 0.97; 95% CI = 0.96-0.99) for mortality, and the New Injury Severity Score (OR1.07; 95% CI = 1.04-1.10) and Trauma and Injury Severity Score (OR = 0.98; 95% CI = 0.965-0.997) for unfavorable outcome. CONCLUSION: The findings of our study confirmed that AKI severity and severity of injury was also related to increased mortality and unfavorable outcome after severe TBI.

LUBAC is required for RIG-I sensing of RNA viruses.

The ability of cells to mount an interferon response to virus infections depends on intracellular nucleic acid sensing pattern recognition receptors (PRRs). RIG-I is an intracellular PRR that binds short double-stranded viral RNAs to trigger MAVS-dependent signalling. The RIG-I/MAVS signalling complex requires the coordinated activity of multiple kinases and E3 ubiquitin ligases to activate the transcription factors that drive type I and type III interferon production from infected cells. The linear ubiquitin chain assembly complex (LUBAC) regulates the activity of multiple receptor signalling pathways in both ligase-dependent and -independent ways. Here, we show that the three proteins that constitute LUBAC have separate functions in regulating RIG-I signalling. Both HOIP, the E3 ligase capable of generating M1-ubiquitin chains, and LUBAC accessory protein HOIL-1 are required for viral RNA sensing by RIG-I. The third LUBAC component, SHARPIN, is not required for RIG-I signalling. These data cement the role of LUBAC as a positive regulator of RIG-I signalling and as an important component of antiviral innate immune responses.

A Review of Advanced Cutaneous Melanoma Therapies and Their Mechanisms, from Immunotherapies to Lysine Histone Methyl Transferase Inhibitors.

Advanced cutaneous melanoma is considered to be the most aggressive type of skin cancer and has variable rates of treatment response. Currently, there are some classes of immunotherapy and target therapies for its treatment. Immunotherapy can inhibit tumor growth and its recurrence by triggering the host's immune system, whereas targeted therapy inhibits specific molecules or signaling pathways. However, melanoma responses to these treatments are highly heterogeneous, and patients can develop resistance. Epigenomics (DNA/histone modifications) contribute to cancer initiation and progression. Epigenetic alterations are divided into four levels of gene expression regulation: DNA methylation, histone modification, chromatin remodeling, and non-coding RNA regulation. Deregulation of lysine methyltransferase enzymes is associated with tumor initiation, invasion, development of metastases, changes in the immune microenvironment, and drug resistance. The study of lysine histone methyltransferase (KMT) and nicotinamide N-methyltransferase (NNMT) inhibitors is important for understanding cancer epigenetic mechanisms and biological processes. In addition to immunotherapy and target therapy, the research and development of KMT and NNMT inhibitors is ongoing. Many studies are exploring the therapeutic implications and possible side effects of these compounds, in addition to their adjuvant potential to the approved current therapies. Importantly, as with any drug development, safety, efficacy, and specificity are crucial considerations when developing methyltransferase inhibitors for clinical applications. Thus, this review article presents the recently available therapies and those in development for advanced cutaneous melanoma therapy.

Impact of Heat Stress on Transposable Element Expression and Derived Small RNAs in Drosophila subobscura.

Global warming is forcing insect populations to move and adapt, triggering adaptive genetic responses. Thermal stress is known to alter gene expression, repressing the transcription of active genes, and inducing others, such as those encoding heat shock proteins. It has also been related to the activation of some specific transposable element (TE) families. However, the actual magnitude of this stress on the whole genome and the factors involved in these genomic changes are still unclear. We studied mRNAs and small RNAs in gonads of two Drosophila subobscura populations, considered a good model to study adaptation to temperature changes. In control conditions, we found that a few genes and TE families were differentially expressed between populations, pointing out their putative involvement in the adaptation of populations to their different environments. Under heat stress, sex-specific changes in gene expression together with a trend toward overexpression, mainly of heat shock response-related genes, were observed. We did not observe large changes of TE expression nor small RNA production due to stress. Only population and sex-specific expression changes of some TE families (mainly retrotransposons), or the amounts of siRNAs and piRNAs, derived from specific TE families were observed, as well as the piRNA production from some piRNA clusters. Changes in small RNA amounts and TE expression could not be clearly correlated, indicating that other factors as chromatin modulation could also be involved. This work provides the first whole transcriptomic study including genes, TEs, and small RNAs after a heat stress in D. subobscura.

PROWIS: A Visual Approach for Building, Managing, and Analyzing Weather Simulation Ensembles at Runtime.

Weather forecasting is essential for decision-making and is usually performed using numerical modeling. Numerical weather models, in turn, are complex tools that require specialized training and laborious setup and are challenging even for weather experts. Moreover, weather simulations are data-intensive computations and may take hours to days to complete. When the simulation is finished, the experts face challenges analyzing its outputs, a large mass of spatiotemporal and multivariate data. From the simulation setup to the analysis of results, working with weather simulations involves several manual and error-prone steps. The complexity of the problem increases exponentially when the experts must deal with ensembles of simulations, a frequent task in their daily duties. To tackle these challenges, we propose ProWis: an interactive and provenance-oriented system to help weather experts build, manage, and analyze simulation ensembles at runtime. Our system follows a human-in-the-loop approach to enable the exploration of multiple atmospheric variables and weather scenarios. ProWis was built in close collaboration with weather experts, and we demonstrate its effectiveness by presenting two case studies of rainfall events in Brazil.

[COVID-19 mortality in metropolitan areas vs. other regions of Brazil, 2020 to 2021Mortalidad por COVID-19 en las regiones metropolitanas y en el interior de Brasil, 2020-2021]. / Mortalidade por covid-19 no interior e em regiões metropolitanas do Brasil, 2020 a 2021.

Objective: To compare hospital mortality rates (HMR) due to severe acute respiratory syndrome (SARS) associated with COVID-19 recorded in metropolitan areas and other regions (interior) of Brazil in 2020 and 2021. Method: This ecological study used public data available on OpenDataSUS. The information was accessed in May 2022. The following variables were considered: age, sex, hospitalization, presence of a risk factor, ICU stay, use of ventilatory support, and final classification in the individual registration form of SARS cases due to COVID-19. Cases and deaths were stratified into five age groups (0-19 years, 20-39 years, 40-59 years, 60-79 years, and ≥80 years) and by place of residence (metropolitan area or interior). The HMR had as numerator the absolute number of deaths by SARS associated with covid-19; and, as a denominator, the absolute number of cases of SARS due to covid-19 according to the year of occurrence, area of residence, age bracket, sex, hospitalization, presence of a risk factor, ICU admission, and use of ventilatory support. Results: There was a significant increase in HMR due to SARS associated with COVID-19 in 2021 in all age groups, except 0-19 years and ≥80 years, as well as among individuals admitted to an ICU and who used invasive ventilatory support, both in metropolitan areas as well as in the interior. Conclusions: There was a worsening of the epidemiological scenario in 2021 with an increase in HMR. However, no differences were identified between the metropolitan regions and the interior of the country.

Objetivo: Comparar las tasas de mortalidad hospitalaria por el síndrome respiratorio agudo grave relacionado con la COVID-19 registradas en las regiones metropolitanas y el interior de Brasil en el período 2020-2021. Método: Se realizó un estudio ecológico con datos públicos disponibles en el sistema OpenDataSUS. La información se consultó en mayo del 2022. Se tomaron en cuenta las siguientes variables: edad, sexo, hospitalización, presencia de factores de riesgo, ingreso en la unidad de cuidados intensivos, uso de apoyo ventilatorio y clasificación final en la hoja de registro individual de casos del síndrome respiratorio agudo grave por COVID-19. Los casos y las defunciones se estratificaron en cinco grupos etarios (0-19 años, 20-39 años, 40-59 años, 60-79 años y ≥80 años) y por ubicación del municipio de residencia (región metropolitana o interior). El numerador de la tasa de mortalidad hospitalaria fue el número absoluto de defunciones por el síndrome respiratorio agudo grave relacionado con la COVID-19, y el denominador, el número absoluto de casos del mismo síndrome relacionado con la COVID-19 según el año de aparición, la residencia en una región metropolitana o en el interior, el grupo etario, el sexo, la hospitalización, la presencia de factores de riesgo, el ingreso en la unidad de cuidados intensivos y el uso de apoyo ventilatorio. Resultados: Se comprobó un aumento significativo de la tasa de mortalidad hospitalaria por el síndrome respiratorio agudo grave relacionado con la COVID-19 en el 2021 en todos los grupos etarios, excepto en los grupos de 0-19 años y ≥80 años, así como entre las personas internadas en la unidad de cuidados intensivos que recibieron apoyo respiratorio invasivo, tanto en las regiones metropolitanas como en el interior. Conclusiones: La situación epidemiológica empeoró en el 2021 con el aumento de la tasa de mortalidad hospitalaria, pero no se observaron diferencias entre las regiones metropolitanas y el interior del país.

Geriatric and Gerontology Research: A Scientometric Investigation of Open Access Journal Articles Indexed in the Scopus Database.

BACKGROUND: Scientometric analyses of specific topics in geriatrics and gerontology have grown robustly in scientific literature. However, analyses using holistic and interdisciplinary approaches are scarce in this field of research. This article aimed to demonstrate research trends and provide an overview of bibliometric information on publications related to geriatrics and gerontology. METHODS: We identified relevant articles on geriatrics and gerontology using the search terms "geriatrics," "gerontology," "older people," and "elderly." VOSviewer was used to perform bibliometric analysis. RESULTS: A total of 858 analyzed articles were published in 340 journals. Among the 10 most contributory journals, five were in the United States, with the top journal being the Journal of the American Geriatrics Society. The United States was the leading country in research, followed by Japan, Canada, and the United Kingdom. A total of 5,278 keywords were analyzed. In the analysis of research hotspots, the main global research topics in geriatrics and gerontology were older adults (n=663), education and training (n=471), and adults aged 80 years (n=461). These were gradually expanded to include areas related to caring for older adults, such as geriatric assessments (n=395). CONCLUSION: These results provide direction for fellow researchers to conduct studies in geriatrics and gerontology. In addition, they provide government departments with guidance for formulating and implementing policies that affect older adults, not only in setting academic and professional priorities but also in understanding key topics related to them.

Effect of Spent Coffee Grounds on the Crystallinity and Viscoelastic Behavior of Polylactic Acid Composites.

This work investigated the addition of spent coffee grounds (SCG) as a valuable resource to produce biocomposites based on polylactic acid (PLA). PLA has a positive biodegradation effect but generates poor proprieties, depending on its molecular structure. The PLA and SCG (0, 10, 20 and 30 wt.%) were mixed via twin-screw extrusion and molded by compression to determine the effect of composition on several properties, including mechanical (impact strength), physical (density and porosity), thermal (crystallinity and transition temperature) and rheological (melt and solid state). The PLA crystallinity was found to increase after processing and filler addition (34-70% in the 1st heating) due to a heterogeneous nucleation effect, leading to composites with lower glass transition temperature (1-3 °C) and higher stiffness (~15%). Moreover, the composites had lower density (1.29, 1.24 and 1.16 g/cm3) and toughness (30.2, 26.8 and 19.2 J/m) as the filler content increased, which is associated with the presence of rigid particles and residual extractives from SCG. In the melt state, polymeric chain mobility was enhanced, and composites with a higher filler content became less viscous. Overall, the composite with 20 wt.% SCG provided the most balanced properties being similar to or better than neat PLA but at a lower cost. This composite could be applied not only to replace conventional PLA products, such as packaging and 3D printing, but also to other applications requiring lower density and higher stiffness.

Associação entre ansiedade e depressão em brasileiros durante o isolamento social da pandemia de covid-19 / Association between anxiety and depression in brazilians during the social isolation of the COVID-19 pandemic / Asociación entre ansiedad y depresión en brasileños durante el aislamiento social por la pandemia del COVID-19

O objetivo deste estudo é analisar a associação entre ansiedade e depressão durante o isolamento social da pandemia de covid-19 no Brasil. Dados de 1.053 adultos brasileiros entre 18 e 59 anos foram coletados por meio de questionário online, entre abril e maio de 2020, para este estudo transversal. Foi utilizada a Escala Hospitalar de Ansiedade e Depressão, e foram analisados fatores sociodemográficos e econômicos. Houve 37% e 20% de risco moderado e alto de ansiedade, respectivamente. Foi observada uma relação direta entre ansiedade e ser do sexo feminino (OR: 1,55; IC95%: 1,02-2,34), ser mais jovem (OR: 4,78; IC95%: 2,71-8,42, para pessoas entre 18-28 anos) e ter rendimentos mais baixos (OR: 1,51; IC95%: 1,69-1,96). Os resultados foram na mesma direção para a depressão, e, adicionalmente, foi demonstrada associação entre isolamento social (parcial ou total) e depressão (OR: 1,42; IC95%: 1,01-2,01). Este estudo encontrou uma associação entre mulheres, populações mais jovens e indivíduos de menor renda e o risco de sofrer ansiedade e depressão durante o confinamento decretado devido à pandemia de covid-19. Além disso, o isolamento social foi associado ao risco de depressão.

The aim of this study is to analyze the association between anxiety and depression during the social isolation for COVID-19 in Brazil. Data of 1,053 Brazilian adults between 18 and 59 years old were gathered by an online questionnaire, between April and May 2020, for this cross-sectional study. The Hospital Anxiety and Depression Scale was used and sociodemographic and economic factors were analyzed. There was a 37% and 20% of moderate and high risk of anxiety, respectively. A direct relationship was observed between anxiety and being female (OR: 1.55; 95%CI: 1.02-2.34), younger (OR: 4.78; 95% CI: 2.71-8.42, for people between 18-28 years old), and having lower incomes (OR: 1.51, 95%CI: 1.69-1.96). Results were in the same vein for depression and, additionally, an association between social isolation (partial or total) and depression was shown (OR: 1.42; 95%CI: 1.01-2.01). This study reported an association between women, younger populations, and subjects with lower incomes and the risk of suffering anxiety and depression during the confinement due to the COVID-19 pandemic. In addition, social isolation was associated with risk of depression.

El objetivo de este estudio es analizar la asociación entre ansiedad y depresión durante el aislamiento social por la pandemia del COVID-19 en Brasil. Se recolectaron datos de 1.053 adultos brasileños, de entre 18 y 59 años de edad, mediante un cuestionario en línea, entre abril y mayo de 2020, para este estudio transversal. Se utilizó la Escala de Ansiedad y Depresión Hospitalaria, y se analizaron factores sociodemográficos y económicos. Hubo el 37% de riesgo moderado de ansiedad y el 20% de riesgo alto. Se observó una relación directa entre la ansiedad y ser mujer (OR: 1,55; IC 95%: 1,02-2,34), ser más joven (OR: 4,78; IC 95%: 2,71-8,42 para personas de entre 18 y 28 años) y tener menores ingresos (OR: 1,51; IC 95%: 1,69-1,96). Los resultados fueron los mismos para la depresión y, además, se demostró una asociación entre el aislamiento social (parcial o total) y la depresión (OR: 1,42; IC 95%: 1,01-2,01). Este estudio encontró una asociación entre ser mujer, poblaciones más jóvenes y personas de bajos ingresos con el riesgo de experimentar ansiedad y depresión durante el confinamiento por la pandemia del COVID-19. Además, el aislamiento social se asoció con el riesgo de depresión.

Food insecurity in a Brazilian transgender sample during the COVID-19 pandemic.

Transgender people often live with social vulnerability, largely promoted by gender-based prejudice. Our aim in this article was to raise preliminary data on how the COVID-19 pandemic and perceived prejudice have contributed to the problem of food and food insecurity in the transgender communities in Brazil. We conducted a web-based cross-sectional study, in which 109 transgender people from all regions of Brazil participated. We used the Chi-Square test and Poisson regression modeling with robust variance to estimate the association between food insecurity and the investigated factors. In our sample, 68.8% of transgender people experienced food insecurity, of these, 20.2% experienced severe food insecurity. Our results showed that the difficulties in purchasing food in the transgender community predate the COVID-19 pandemic, yet that the restrictive measures adopted have also impacted overall access to quality food. However, the main explanations for food insecurity were income and employment. In predicting food insecurity, the experiences of prejudice must be considered, and give rise to the hypothesis that specific conditions to which transgender people are exposed explain, to some degree, their vulnerability to food insecurity.

Waste Paper as a Valuable Resource: An Overview of Recent Trends in the Polymeric Composites Field.

This review focuses on polymeric waste-paper composites, including state-of-the-art analysis with quantitative and qualitative discussions. Waste paper is a valuable cellulose-rich material, produced mainly from office paper, newspaper, and paper sludge, which can be recycled and returned to paper production or used in a new life cycle. A systematic literature review found 75 publications on this material over the last 27 years, with half of those published during the last five years. These data represent an increasing trend in the number of publications and citations that have shown an interest in this field. Most of them investigated the physicomechanical properties of composites using different contents of raw waste paper or the treated, modified, and cellulose-extracted types. The results show that polyethylene and polypropylene are the most used matrices, but polylactic acid, a biodegradable/sourced polymer, has the most citations. The scientific relevance of waste-paper composites as a subject includes the increasing trend of the number of publications and citations over the years, as well as the gaps identified by keyword mapping and the qualitative discussion of the papers. Therefore, biopolymers and biobased polymers could be investigated more, as well as novel applications. The environmental impact in terms of stability and degradation should also receive more attention regarding sustainability and life cycle analyses.

Normal ambulatory blood pressure in young adults with 21-hydroxylase enzyme deficiency undergoing glucocorticoid replacement therapy.

Objective: Herein, we compared ambulatory blood pressure (ABP) between young adults with congenital adrenal hyperplasia (CAH) due to 21-hydroxylase enzyme (21OHase) deficiency and a control group. Additionally, we analyzed correlations between the glucocorticoid dose and androgen levels and ABP parameters. Subjects and methods: This case-control study included 18 patients (6 males and 12 females) and 19 controls (8 males and 11 females) matched by age (18-31 years). ABP monitoring was used to estimate blood pressure (BP) over a 24-h period. Results: No difference was noted between patients and controls in terms of systolic BP (males, 115.5 ± 5.6 vs. 117.0 ± 9.3, P = 0.733; and females, 106.4 ± 7.9 vs. 108.4 ± 7.6, P = 0.556, respectively) and diastolic BP during 24 h (males, 62.8 ± 7.5 vs. 66.2 ± 5.6, P = 0.349; and females, 62.7 ± 4.9 vs. 62.3 ± 4.9, P = 0.818, respectively). Systolic and diastolic BP and pulse pressure during daytime and nocturnal periods were similar between patients and controls. Furthermore, no differences were detected in the percentage of load and impaired nocturnal dipping of systolic and diastolic BP between patients and controls during the 24-h period. Additionally, the glucocorticoid dose (varying between r = -0.24 to 0.13, P > 0.05) and androgens levels (varying between r = 0.01 to 0.14, P > 0.05) were not associated with ABP parameters. Conclusion: No signs of an elevated risk for hypertension were observed based on ABP monitoring in young adults with CAH attributed to 21OHase deficiency undergoing glucocorticoid replacement therapy.

Social skills training with a tabletop role-playing game, before and during the pandemic of 2020: in-person and online group sessions.

Background: The area of social skills is broad, in theory and in practice. For social skills training, various clinical practices have been applied in group sessions, as have motivational resources such as role-playing games (RPGs). In recent years, the need arose to assess the clinical impact of the pandemic. The objective of this study was to determine the impact that the pandemic has had on in-person and online social skills training. Methods: We evaluated six subjects with autism spectrum disorder, with or without another, similar disorder, each of whom attended a total of 12 two-hour RPG sessions over a 12-month period. The original (Portuguese-language) version of the Social Skills Inventory for Adolescents was applied at three different time points (pre-, mid-, and post-intervention). Results: After six in-person tabletop RPG sessions, there was an increase in the mean frequency scores and a decrease in the mean difficulty scores. However, during the pandemic, the remaining six sessions were conducted online and the effect was the opposite. Conclusion: Our data indicate that there is a need for further studies assessing social skills training in online contexts.

Higher Body Fat but Similar Phase Angle Values in Patients with the Classical Form of Congenital Adrenal Hyperplasia in Comparison to a Control Group.

This study aimed to compare phase angle (PhA) and bioelectrical impedance vector analysis (BIVA) values between adult patients with congenital adrenal hyperplasia caused by 21-hydroxylase deficiency (CAH21OHD) and a control group. A total of 22 patients (15 women, 22.9 ± 3.7 years) were compared with 17 controls (11 women, 27.0 ± 2.5 years). Body composition was determined by dual-energy X-ray absorptiometry. Bioelectrical impedance was used to calculate PhA, and BIVA was performed using specific software. Student's t-test and analysis of covariance were used to compare groups. Hedges' G and partial n2 were calculated for the effect estimates. Hotelling's t2 test was used to compare the mean impedance vectors between the groups. The Mahalanobis test was used to determine the distance between confidence ellipses. Patients with CAH21OHD had a higher fat mass percentage than that of the control group (both sexes). There was no significant difference in PhA values between groups (CAH21OHD vs. control) in females (6.9° vs. 6.3°, p = 0.092) and males (8.2° vs. 8.1°, p = 0.849), after adjusting for covariates (age and height). BIVA analysis showed a significant difference in the mean impedance vectors between the female groups (T2 = 15.9, D = 1.58, p = 0.003) owing to the higher reactance/height (Δ = 8.5; p < 0.001) of the patients. The PhA did not significantly differ between the groups. Female patients had significantly higher reactance values. However, further studies are needed to determine the usefulness of bioimpedance parameters in evaluating the hydration status and cellular integrity of patients with CAH21OHD.

The role of the relationship with the coach in the group environment of school sports / El papel de la relación con el entrenador en el entorno grupal de los deportes escolares

Abstract The relationship between coach and athlete has been identified as a key factor for several positive outcomes in the sports context. Thus, the aims of this study were to analyze the association between the quality of the coach-athlete relation ship (CAR) and the perception of team cohesion of youth athletes. Participants were 301 athletes, aged 15 to 17 years, who participated in the School Games of Pernambuco, Brazil. The instruments used were the Coach-Athlete Relationship Questionnaire (CART-Q) and the Group Environment Questionnaire (GEQ). Data analysis was conducted through the Structural Equation Modeling (p< .05). The results showed that the quality of CAR showed a significant association (p<.05) with team cohesion, explaining 25% of the variance of task cohesion and 15% of social cohesion. Specifically, the effect of CAR on task (β = 0.50) and social (β = 0.39) cohesion was significant (p<.05) and positive. It was concluded that the quality of CAR is a key factor for the engagement of the adolescent with the teamwork and its goals as well as for the de velopment of positive interpersonal relationships.

Resumen La relación entre entrenador y atleta ha sido identificada como un factor determinante para varios resultados positivos en el contexto deportivo. Por lo tanto, los objetivos del estudio fueron analizar la asociación entre la calidad de la relación en trenador-atleta (CAR) y la percepción de la cohesión del equipo de los atletas jóvenes. Participaron 301 atletas, de 15 a 17 años, que compitieron en los Juegos Escolares de Pernambuco, Brasil. Los instrumentos utilizados fueron el Cuestionario de Relación Entrenador-Atleta (CART-Q) y el Cuestionario de Ambiente Grupal (GEQ). El análisis de los datos se realizó a través del modelado de ecuaciones estructurales (p <.05). Los resultados mostraron que la calidad de la CAR mostró una asociación significativa (p <.05) con la cohesión del equipo, explicando el 25% de la varianza de la cohesión de la tarea y el 15% de la cohesión social. Específicamente, el efecto de CAR en la cohesión de tareas (β = 0.50) y social (β = 0.39) fue significativo (p <.05) y positivo. Se concluyó que la calidad de CAR es un factor clave para el compromiso del adolescente con el trabajo en equipo y las metas de este, así como para el desarrollo de relaciones interpersonales positivas.

Long-Term Outcomes in Severe Traumatic Brain Injury and Associated Factors: A Prospective Cohort Study.

OBJECTIVE: The presence of focal lesion (FL) after a severe traumatic brain injury is an important factor in determining morbidity and mortality. Despite this relevance, few studies show the pattern of recovery of patients with severe traumatic brain injury (TBI) with FL within one year. The objective of this study was to identify the pattern of recovery, independence to perform activities of daily living (ADL), and factors associated with mortality and unfavorable outcome at six and twelve months after severe TBI with FL. METHODOLOGY: This is a prospective cohort, with data collected at admission, hospital discharge, three, six, and twelve months after TBI. RESULTS: The study included 131 adults with a mean age of 34.08 years. At twelve months, 39% of the participants died, 80% were functionally independent by the Glasgow Outcome Scale Extended, 79% by the Disability Rating Scale, 79% were independent for performing ADLs by the Katz Index, and 53.9% by the Lawton Scale. Report of alcohol intake, sedation time, length of stay in intensive care (ICU LOS), Glasgow Coma Scale, trauma severity indices, hyperglycemia, blood glucose, and infection were associated with death. At six and twelve months, tachypnea, age, ICU LOS, trauma severity indices, respiratory rate, multiple radiographic injuries, and cardiac rate were associated with dependence. CONCLUSIONS: Patients have satisfactory functional recovery up to twelve months after trauma, with an accentuated improvement in the first three months. Clinical and sociodemographic variables were associated with post-trauma outcomes. Almost all victims of severe TBI with focal lesions evolved to death or independence.

One-Anastomosis Gastric Bypass Versus Roux-en-Y Gastric Bypass as Revisional Surgery After Sleeve Gastrectomy: a Systematic Review and Meta-analysis.

The demand for revisional bariatric surgery after sleeve gastrectomy (SG) has increased, but the ideal procedure remains unclear. A systematic review and meta-analysis were performed to compare the outcomes of weight loss and safety of one-anastomosis gastric bypass (OAGB) and Roux-en-Y gastric bypass (RYGB) as revisional procedures for failed SG. Four retrospective comparative studies were included, comprising 499 individuals. Patients submitted to OAGB had a more significant total weight loss (TWL) (MD = - 5.89%; 95% CI - 6.80 to - 4.97) after revisional surgery. Overall early complication rate was similar between procedures (RD = 0.04; 95% CI: - 0.05 to 0.12). Limited and heterogeneous data prevent meaningful conclusions, but the present analysis suggests that OAGB has a better TWL after revisional surgery.