Multivariate and regional age-related change in basal ganglia iron in neonates.

In the perinatal period, reward and cognitive systems begin trajectories, influencing later psychiatric risk. The basal ganglia is important for reward and cognitive processing but early development has not been fully characterized. To assess age-related development, we used a measure of basal ganglia physiology, specifically brain tissue iron, obtained from nT2* signal in resting-state functional magnetic resonance imaging (rsfMRI), associated with dopaminergic processing. We used data from the Developing Human Connectome Project (n = 464) to assess how moving from the prenatal to the postnatal environment affects rsfMRI nT2*, modeling gestational and postnatal age separately for basal ganglia subregions in linear models. We did not find associations with tissue iron and gestational age [range: 24.29-42.29] but found positive associations with postnatal age [range:0-17.14] in the pallidum and putamen, but not the caudate. We tested if there was an interaction between preterm birth and postnatal age, finding early preterm infants (GA < 35 wk) had higher iron levels and changed less over time. To assess multivariate change, we used support vector regression to predict age from voxel-wise-nT2* maps. We could predict postnatal but not gestational age when maps were residualized for the other age term. This provides evidence subregions differentially change with postnatal experience and preterm birth may disrupt trajectories.

Pulmonary Telerehabilitation for People With Chronic Obstructive Pulmonary Disease in Brazil: A Mixed-Methods Feasibility Study.

This study assessed the feasibility of pulmonary telerehabilitation‧s (PTR) acceptability, implementation, practicality, and adaptation for people with Chronic Obstructive Pulmonary Disease (COPD) in Brazil. It also explored associations with clinical and socioeconomic features of Brazilians with COPD. This mixed-method study included thirty-one participants with COPD (age 62±10 years; FEV1= 72±14% predicted). Most participants (74.2%) reported good PTR session acceptability on the System Usability Scale and scores of 4.6±0.3 and 4.5±0.6 on a 1-5 Likert-type scale of implementation and practicality, respectively. Participants suggested adaptations for better comfort on the exercise bike and varying exercise modalities. PTR acceptability was associated with participants' younger age (rs=-0.57, p<0.01) and higher education (rs=0.51, p<0.01). PTR is feasible for people with COPD in Brazil regarding acceptability, implementation, practicality, and adaptation. Younger age and higher educational level are associated with greater PTR acceptability.

The Brazilian version of the telehealth usability questionnaire (telehealth usability questionnaire Brazil): translation, cross-cultural adaptation, and psychometric properties.

OBJECTIVE: The objectives of this study were to translate and cross-culturally adapt the telehealth usability questionnaire into Brazilian Portuguese and to evaluate its psychometric properties. METHODS: This was a methodological validation study carried out in two phases. In phase 1, the telehealth usability questionnaire was cross-culturally adapted with 10 participants comprising the expert committee members, including 5 healthcare professionals with theoretical and practical knowledge of telehealth, 1 methodologist, and 4 translators. This phase was performed at Universidade Federal de Juiz de Fora Physiotherapy Clinic School. In phase 2, the psychometric properties of telehealth usability questionnaire Brazil were analyzed. This phase included in-person assessments at Márcio Cunha Hospital, Minas Gerais. The recruitment period for both phases was from April 2020 to February 2021. Content validity, reliability, internal consistency, and criterion validity were analyzed. The criterion validity was evaluated using correlation with a validated instrument: the system usability scale. RESULTS: The telehealth usability questionnaire was adequately translated and cross-culturally adapted. The telehealth usability questionnaire Brazil presented an excellent content validity index of 0.96 with percentages of understanding higher than 90%. The telehealth usability questionnaire Brazil demonstrated great internal consistency (α=0.94 and ω=0.94), excellent intra-rater reliability (intraclass correlation coefficient=0.85, 95%CI 0.75-0.91), no difference between the test and retest [T (0.425), p>0.673], and no proportional bias (p=0.205). There was a moderate correlation between telehealth usability questionnaire Brazil and the system usability scale (r=0.52, p<0.0001). CONCLUSION: The telehealth usability questionnaire was adequately translated and cross-culturally adapted into Brazilian Portuguese and showed adequate psychometric properties for use in telehealth clinical practice and research in Brazilian-Portuguese-speaking individuals.

Cerebral Spinal Fluid Volumetrics and Paralimbic Predictors of Executive Dysfunction in Congenital Heart Disease: A Machine Learning Approach Informing Mechanistic Insights.

The relationship between increased cerebral spinal fluid (CSF) ventricular compartments, structural and microstructural dysmaturation, and executive function in patients with congenital heart disease (CHD) is unknown. Here, we leverage a novel machine-learning data-driven technique to delineate interrelationships between CSF ventricular volume, structural and microstructural alterations, clinical risk factors, and sub-domains of executive dysfunction in adolescent CHD patients. We trained random forest regression models to predict measures of executive function (EF) from the NIH Toolbox, the Delis-Kaplan Executive Function System (D-KEFS), and the Behavior Rating Inventory of Executive Function (BRIEF) and across three subdomains of EF - mental flexibility, working memory, and inhibition. We estimated the best parameters for the random forest algorithm via a randomized grid search of parameters using 10-fold cross-validation on the training set only. The best parameters were then used to fit the model on the full training set and validated on the test set. Algorithm performance was measured using root-mean squared-error (RMSE). As predictors, we included patient clinical variables, perioperative clinical measures, microstructural white matter (diffusion tensor imaging- DTI), and structural volumes (volumetric magnetic resonance imaging- MRI). Structural white matter was measured using along-tract diffusivity measures of 13 inter-hemispheric and cortico-association fibers. Structural volumes were measured using FreeSurfer and manual segmentation of key structures. Variable importance was measured by the average Gini-impurity of each feature across all decision trees in which that feature is present in the model, and functional ontology mapping (FOM) was used to measure the degree of overlap in feature importance for each EF subdomain and across subdomains. We found that CSF structural properties (including increased lateral ventricular volume and reduced choroid plexus volumes) in conjunction with proximate cortical projection and paralimbic-related association white matter tracts that straddle the lateral ventricles and distal paralimbic-related subcortical structures (basal ganglia, hippocampus, cerebellum) are predictive of two-specific subdomains of executive dysfunction in CHD patients: cognitive flexibility and inhibition. These findings in conjunction with combined RF models that incorporated clinical risk factors, highlighted important clinical risk factors, including the presence of microbleeds, altered vessel volume, and delayed PDA closure, suggesting that CSF-interstitial fluid clearance, vascular pulsatility, and glymphatic microfluid dynamics may be pathways that are impaired in CHD, providing mechanistic information about the relationship between CSF and executive dysfunction.

Gestational and postnatal age associations for striatal tissue iron deposition in early infancy.

Striatal development is crucial for later motor, cognitive, and reward behavior, but age-related change in striatal physiology during the neonatal period remains understudied. An MRI-based measure of tissue iron deposition, T2*, is a non-invasive way to probe striatal physiology neonatally, linked to dopaminergic processing and cognition in children and adults. Striatal subregions have distinct functions that may come online at different time periods in early life. To identify if there are critical periods before or after birth, we measured if striatal iron accrued with gestational age at birth [range= 34.57-41.85 weeks] or postnatal age at scan [range= 5-64 days], using MRI to probe the T2* signal in N = 83 neonates in three striatal subregions. We found iron increased with postnatal age in the pallidum and putamen but not the caudate. No significant relationship between iron and gestational age was observed. Using a subset of infants scanned at preschool age (N = 26), we show distributions of iron shift between time points. In infants, the pallidum had the least iron of the three regions but had the most by preschool age. Together, this provides evidence of distinct change for striatal subregions, a possible differentiation between motor and cognitive systems, identifying a mechanism that may impact future trajectories.

Maternal perceived stress and infant behavior during the COVID-19 pandemic.

BACKGROUND: Maternal stress has negative consequences on infant behavioral development, and COVID-19 presented uniquely stressful situations to mothers of infants born during the pandemic. We hypothesized that mothers with higher levels of perceived stress during the pandemic would report higher levels of infant regulatory problems including crying and interrupted sleep patterns. METHODS: As part 6 sites of a longitudinal study, mothers of infants born during the pandemic completed the Perceived Stress Scale, the Brief Infant Sleep Questionnaire, and an Infant Crying survey at 6 (n = 433) and 12 (n = 344) months of infant age. RESULTS: Maternal perceived stress, which remained consistent at 6 and 12 months of infant age, was significantly positively correlated with time taken to settle infants. Although maternal perceived stress was not correlated with uninterrupted sleep length, time taken to put the infant to sleep was correlated. Perceived stress was also correlated with the amount of infant crying and fussiness reported at 6 months. CONCLUSIONS: Mothers who reported higher levels of perceived stress during the pandemic reported higher levels of regulatory problems, specifically at 6 months. Examining how varying levels of maternal stress and infant behaviors relate to overall infant developmental status over time is an important next step. IMPACT: Women giving birth during the COVID-19 pandemic who reported higher levels of stress on the Perceived Stress Scale also reported higher levels of infant fussiness and crying at 6 months old, and more disruptive sleep patterns in their infants at 6 months and 12 months old. Sleeping problems and excessive crying in infancy are two regulatory problems that are known risk factors for emotional and behavioral issues in later childhood. This paper is one of the first studies highlighting the associations between maternal stress and infant behaviors during the COVID-19 pandemic.

Gestational and postnatal age associations for striatal tissue iron deposition in early infancy.

Striatal development is crucial for later motor, cognitive, and reward behavior, but age-related change in striatal physiology during the neonatal period remains understudied. An MRI-based measure of tissue iron deposition, T2*, is a non-invasive way to probe striatal physiology neonatally, linked to dopaminergic processing and cognition in children and adults. Striatal subregions have distinct functions that may come online at different time periods in early life. To identify if there are critical periods before or after birth, we measured if striatal iron accrued with gestational age at birth [range=34.57-41.85 weeks] or postnatal age at scan [range=5-64 days], using MRI to probe the T2* signal in N=83 neonates in three striatal subregions. We found iron increased with postnatal age in the pallidum and putamen but not the caudate. No significant relationship between iron and gestational age was observed. Using a subset of infants scanned at preschool age (N=26), we show distributions of iron shift between timepoints. In infants, the pallidum had the least iron of the three regions but had the most by preschool age. Together, this provides evidence of distinct change for striatal subregions, a possible differentiation between motor and cognitive systems, identifying a mechanism that may impact future trajectories. Highlights: Neonatal striatal tissue iron can be measured using the T2* signal from rsfMRInT2* changed with postnatal age in the pallidum and putamen but not in the caudatenT2* did not change with gestational age in any of the three regionsPatterns of iron deposition (nT2*) among regions shift from infancy to preschool.

The Brazilian version of the telehealth usability questionnaire (telehealth usability questionnaire Brazil): translation, cross-cultural adaptation, and psychometric properties

SUMMARY OBJECTIVE: The objectives of this study were to translate and cross-culturally adapt the telehealth usability questionnaire into Brazilian Portuguese and to evaluate its psychometric properties. METHODS: This was a methodological validation study carried out in two phases. In phase 1, the telehealth usability questionnaire was cross-culturally adapted with 10 participants comprising the expert committee members, including 5 healthcare professionals with theoretical and practical knowledge of telehealth, 1 methodologist, and 4 translators. This phase was performed at Universidade Federal de Juiz de Fora Physiotherapy Clinic School. In phase 2, the psychometric properties of telehealth usability questionnaire Brazil were analyzed. This phase included in-person assessments at Márcio Cunha Hospital, Minas Gerais. The recruitment period for both phases was from April 2020 to February 2021. Content validity, reliability, internal consistency, and criterion validity were analyzed. The criterion validity was evaluated using correlation with a validated instrument: the system usability scale. RESULTS: The telehealth usability questionnaire was adequately translated and cross-culturally adapted. The telehealth usability questionnaire Brazil presented an excellent content validity index of 0.96 with percentages of understanding higher than 90%. The telehealth usability questionnaire Brazil demonstrated great internal consistency (α=0.94 and ω=0.94), excellent intra-rater reliability (intraclass correlation coefficient=0.85, 95%CI 0.75-0.91), no difference between the test and retest [T (0.425), p>0.673], and no proportional bias (p=0.205). There was a moderate correlation between telehealth usability questionnaire Brazil and the system usability scale (r=0.52, p<0.0001). CONCLUSION: The telehealth usability questionnaire was adequately translated and cross-culturally adapted into Brazilian Portuguese and showed adequate psychometric properties for use in telehealth clinical practice and research in Brazilian-Portuguese-speaking individuals.

Anatomical correlates of category-selective visual regions have distinctive signatures of connectivity in neonates.

The ventral visual stream is shaped during development by innate proto-organization within the visual system, such as the strong input from the fovea to the fusiform face area. In adults, category-selective regions have distinct signatures of connectivity to brain regions beyond the visual system, likely reflecting cross-modal and motoric associations. We tested if this long-range connectivity is part of the innate proto-organization, or if it develops with postnatal experience, by using diffusion-weighted imaging to characterize the connectivity of anatomical correlates of category-selective regions in neonates (N = 445), 1-9 month old infants (N = 11), and adults (N = 14). Using the HCP data we identified face- and place- selective regions and a third intermediate region with a distinct profile of selectivity. Using linear classifiers, these regions were found to have distinctive connectivity at birth, to other regions in the visual system and to those outside of it. The results support an extended proto-organization that includes long-range connectivity that shapes, and is shaped by, experience-dependent development.

Life-Space Mobility of Subjects With COPD on Long-Term Oxygen Therapy Delivered by Non-Portable Devices.

BACKGROUND: Mobility is human body movement in all its forms, including bed-to-chair transfer, walking, daily tasks, participating in work and social functions, exercising, and using public transport. The mobility of people living with COPD is affected negatively by the disease symptoms. However, limited data are available on the life-space mobility in people with COPD on long-term oxygen therapy (LTOT). This study aimed to explore the life-space mobility in subjects with COPD on LTOT and verify whether life-space mobility is associated with comorbidities and symptoms, activity in daily life, exercise capacity performance, and quality of life. METHODS: This cross-sectional study enrolled 61 subjects with COPD on LTOT (73.0 ± 8.8 y, FEV1 41.7 ± 16.0% predicted, on LTOT for 2.8 ± 3.3 y). Life-space mobility (Life-Space Assessment), LTOT usage time, comorbidities (Charlson comorbidity index), need for support from a caregiver, exercise capacity (6-min step test), dyspnea (modified Medical Research Council scale), activities of daily living (ADLs, Katz scale), and health-related quality of life (EuroQol 5-Dimension Questionnaire) were assessed. RESULTS: Mobility restriction was identified in 90% of participants. Life-space mobility was negatively associated with the number of comorbidities (rs = -0.31, P = .02), dyspnea symptom (rs = -0.60, P < .001), and positively associated with basic ADLs performance (rs = 0.59, P < .001) and exercise capacity (rs = 0.49, P < .001). Dyspnea and exercise capacity were independent predictors of vital space mobility. CONCLUSIONS: Subjects with COPD on LTOT had limited life-space mobility. Interventions to reduce dyspnea and improve exercise capacity should be prioritized to increase this population's domestic and community mobility.

Caregiver Burden Is Associated With the Physical Function of Individuals on Long-Term Oxygen Therapy.

BACKGROUND: The influence of physical function of individuals on long-term oxygen therapy (LTOT) on caregiver burden is underexplored. This study investigated the association of caregiver burden with physical function of individuals on LTOT and the association between caregiver's burden and quality of life. METHODS: This was a cross-sectional study. Informal caregivers were assessed for burden using the Caregiver Burden Inventory (CBI), the European Quality of Life 5 Dimension questionnaire index (EQ-5D index) and its Visual Analog Scale (EQ-VAS). Physical function of subjects on LTOT was assessed by dyspnea, activities of daily living (ADLs), and mobility. Univariate and multivariate linear regression models were explored. RESULTS: Fifty-four caregivers (54.7 ± 16.1 y, 74.1% female) were included. CBI total score was correlated with subject's dyspnea (r = 0.369, P = .006) and ADLs (r = 0.300, P = .03). In the multivariate regression models, subject's physical function limitation due to dyspnea explained 26.4% of the CBI total score variance (P = .005). In the CBI dimension analysis, the time-dependence caregiver burden was correlated with subject's dyspnea (r = 0.335, P = .01), ADLs (r = 0.436, P = .001), and mobility (r = -0.415, P = .002). CBI developmental and physical caregiver burden were correlated with dyspnea (r = 0.309, P = .02; r = 0.363, P = .007) and ADLs (r = 0.274, P = .045; r = 0.299, P = .03). Emotional caregiver burden was correlated with dyspnea (r = 0.333, P = .01). Higher CBI total score was correlated with worse quality of life on EQ-5D index (rs= -0.374, P = .005) and EQ-VAS (rs= -0.494, P = .001) in caregivers. CONCLUSIONS: Increased caregiver burden was associated with higher physical limitation due to dyspnea and dependence in ADLs of individuals on LTOT. The increased burden was associated with a worse caregiver's quality of life.

Barreiras e facilitadores para o encaminhamento de pacientes com doença pulmonar obstrutiva crônica à reabilitação pulmonar e indicação à prática de atividade física: um estudo qualitativo / Barriers and facilitators for referring patients with chronic obstructive pulmonary disease to pulmonary rehabilitation and physical activity recommendation: a qualitative study

Introdução: A doença pulmonar obstrutiva crônica (DPOC) possui alta prevalência e gera altos custos aos sistemas de saúde. A reabilitação pulmonar (RP) é uma intervenção não-farmacológica que gera benefícios clínicos para os pacientes e economia de gastos para o sistema de saúde devido a redução do número de exacerbações da doença e internações hospitalares. Embora fortemente recomendada, a RP tem sido subutilizada havendo um baixo índice de indicações. Objetivo: Identificar as barreiras e os facilitadores para o encaminhamento de pacientes com DPOC à RP e à prática de atividade física. Métodos: Estudo qualitativo, realizado com médicos atuantes na atenção primária à saúde (APS) e uso de entrevistas semiestruturadas. As entrevistas foram gravadas e transcritas literalmente e submetidas a análise de conteúdo. Itens (trechos) identificados nos discursos e relacionados ao encaminhamento de pacientes com DPOC à RP e à prática de atividade física foram classificados como barreiras ou facilitadores. Tal classificação se baseou entre os quatorze domínios da Theoretical Domains Framework (TDF) e suas definições para identificar determinantes de comportamento entre os participantes relevantes para a mudança na prática clínica. Resultados: Setecentos e cinquenta e seis itens foram identificados nos discursos de vinte e um participantes e classificados como sendo barreiras (n= 279, 37%) ou facilitadores (n= 477, 63%) relacionados principalmente aos domínios da TDF de "Conhecimento" (n= 245, 32%), "Contexto e recursos ambientais" (n= 124, 16%) e "Papel e identidade social/profissional" (n= 107, 14%). Conclusão: As principais barreiras identificadas foram relacionadas aos programas de RP devido ao conhecimento restrito dos profissionais médicos sobre programas de RP, a disponibilidade reduzida de locais que oferecem estes programas e as dificuldades de acesso dos pacientes à RP. Os principais facilitadores identificados foram relacionados a orientação e o conhecimento pelos médicos sobre os benefícios da atividade física e a presença dos grupos de exercícios fornecidos na APS.

Introduction: Chronic obstructive pulmonary disease (COPD) has a high prevalence and entails high costs to health systems. Pulmonary rehabilitation (PR) is a non-pharmacological intervention that generates clinical benefits for patients and cost savings for the health system due to a reduced number of exacerbations and hospitalizations. Although strongly recommended, PR has been underutilized, with a low rate of indications. Objective: To identify barriers and facilitators for referring patients with COPD to PR and physical activity. Method: Qualitative study was carried out with medical staff working in primary health care using semi-structured interviews. The interviews were recorded, transcribed literally and underwent content analysis. Items (text excerpts) identified in the speeches and related to the referral of patients with COPD to PR and physical activity were classified according to as barriers or facilitators, and among the fourteen domains of the Theoretical Domains Framework (TDF) and its definitions; aiming to identify the determinants of behaviour which were relevant to change in clinical practice. Results: Seven hundred and fifty-six items were identified in the speeches of twenty-one participants and classified as barriers (n= 279, 37%) or facilitators (n= 477, 63%) mainly related to the TDF domains of "Knowledge" (n= 245, 32%), "Context and environmental resources" (n=124, 16%) and "Role and social/professional identity" (n= 107, 14%). Conclusion: The main barriers identified were related to referring patients PR due to lack of knowledge by medical staff about PR programs, the limited number of programs available, and the restricted access to PR program locations. The main facilitators were related to physical activity, mainly the medical staff's knowledge on physical activity benefits and availability of exercise group activities delivered at primary health care centres.

Social Participation and Associated Factors in Individuals with Chronic Obstructive Pulmonary Disease on Long-Term Oxygen Therapy.

Long-term oxygen therapy (LTOT) reduces hypoxaemia and mitigate systemic alterations in chronic obstructive pulmonary disease (COPD), however, it is related to inactivity and social isolation. Social participation and its related factors remain underexplored in individuals on LTOT. This study investigated social participation in individuals with COPD on LTOT and its association with dyspnoea, exercise capacity, muscle strength, symptoms of anxiety and depression, and quality of life. The Assessment of Life Habits (LIFE-H) assessed social participation. The modified Medical Research Council dyspnoea scale, the 6-Minute Step test (6MST) and handgrip dynamometry were used for assessments. In addition, participants responded to the Hospital Anxiety and Depression Scale (HADS) and the Chronic Respiratory Questionnaire (CRQ). Correlation coefficients and multivariate linear regression analyses were applied. Fifty-seven participants with moderate to very severe COPD on LTOT were included (71 ± 8 years, FEV1: 40 ± 17%predicted). Social participation was associated with dyspnoea (rs=-0.46, p < 0.01), exercise capacity (r = 0.32, p = 0.03) and muscle strength (r = 0.25, p = 0.05). Better participation was also associated with fewer depression symptoms (rs=-0.40, p < 0.01) and a better quality of life (r = 0.32, p = 0.01). Dyspnoea was an independent predictor of social participation (p < 0.01) on regression models. Restricted social participation is associated with increased dyspnoea, reduced muscle strength and exercise capacity. Better participation is associated with fewer depression symptoms and better quality of life in individuals with COPD on LTOT.

QSIPrep: an integrative platform for preprocessing and reconstructing diffusion MRI data.

Diffusion-weighted magnetic resonance imaging (dMRI) is the primary method for noninvasively studying the organization of white matter in the human brain. Here we introduce QSIPrep, an integrative software platform for the processing of diffusion images that is compatible with nearly all dMRI sampling schemes. Drawing on a diverse set of software suites to capitalize on their complementary strengths, QSIPrep facilitates the implementation of best practices for processing of diffusion images.

Pacientes asmáticos adultos recebem orientações sobre atividade física? Uma abordagem com métodos mistos / Do adult asthmatic patients receive guidance on physical activity? A mixed methods approach

Introdução: A asma é uma doença respiratória caracterizada por sintomas como sibilo à ausculta pulmonar, dispneia e tosse, causados por limitação variável ao fluxo aéreo expiratório. A prática de atividades física pode auxiliar o controle da doença. Objetivo: Investigar o nível de atividade física de asmáticos adultos, e como estes indivíduos reportam receber orientação dos profissionais de saúde quanto à realização de atividade física. Método: Este estudo de métodos mistos foi realizado com indivíduos asmáticos, com idade superior a 18 anos. Os participantes realizaram teste de função pulmonar, responderam questionários sobre atividade física e entrevista semiestruturada. A entrevista foi realizada com questões voltadas ao tema central da pesquisa, as respostas foram transcritas de forma literal e analisadas por meio de metodologia da análise de conteúdo. Resultados: Vinte e cinco indivíduos participaram do estudo, a maioria do sexo feminino (n = 18; 72,0%) e idade média de 36 anos. A maioria dos indivíduos eram "irregularmente ativos" dos tipos A e B (n = 13; 52,0%). Foram identificados sete temas principais nos discursos: "conhecimento sobre os efeitos da atividade física regular" (n = 23; 92,0%), "atividade física específica para pacientes asmáticos" (n = 21; 84,0%), e "influência da orientação de um profissional de saúde" (n = 20; 80,0%). Conclusão: Os indivíduos asmáticos reportaram receber orientações dos profissionais de saúde quanto aos benefícios da prática regular de atividade física. Porém, estas informações podem ser insuficientes quanto ao tipo e frequência dos exercícios, modalidades apropriadas, manejo de possíveis sintomas durante ou após a prática da atividade e como preveni-los. Orientações adequadas sobre a prática da atividade regular para indivíduos asmáticos podem contribuir para o automanejo da doença.

Introduction: Asthma is a respiratory disease characterized by symptoms of wheezing, dyspnea, and cough, caused by some degree of limitation to expiratory airflow. Engagement in regular physical activity can help control the disease. Objective: To assess physical activity levels in asthmatic adults and to investigate how these individuals report guidance received from health professionals regarding physical activity. Method: This mixed-methods study included asthmatic adults aged 18 years or over. Participants underwent pulmonary function tests, completed physical activity questionnaires, and did a semistructured interview. The interview consisted of questions focused on the central topic of interest, and responses were transcribed literally and then analyzed using content analysis methods. Results: Twenty-five individuals participated in the study, most were female (n=18; 72.0%), and mean age was 36 years. Most individuals were classified as "irregularly active" (n=8; 32.0%). Seven main topics were identified in content analysis, including "knowledge about the effects of regular physical activity" (n=23; 92.0%), "specific physical activity for asthmatic patients" (n=21; 84.0%), and "influence of guidance from a health professional" (n=20; 80.0%). Conclusion: Asthmatic individuals reported having received guidance from health professionals regarding the benefits of engagement in regular physical activity. However, there is insufficient information regarding type and frequency of exercise, appropriate modalities, and management of possible symptoms during or after the activity and how to prevent them. Adequate guidance on regular activity for asthmatic individuals may contribute to self-management of the disease.

THE INFLAMMATORY BOWEL DISEASE-FATIGUE PATIENT SELF-ASSESSMENT SCALE: TRANSLATION, CROSS-CULTURAL ADAPTATION AND PSYCHOMETRIC PROPERTIES OF THE BRAZILIAN VERSION (IBD-F BRAZIL).

BACKGROUND: Fatigue is a common symptom in patients with inflammatory bowel diseases (IBD). A translated and culturally adapted, instrument with robust psychometric for measuring fatigue in Brazilian patients with IBD is needed. OBJECTIVE: To translate and cross-culturally adapt the inflammatory Bowel Disease Fatigue Scale (IBD-F) into Brazilian-Portuguese and to test its measurement properties in Brazilian patients with IBD. METHODS: Data from 123 patients with IBD were collected. In addition to IBD-F, the Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F) was used. The measurement properties tested were: internal consistency, reproducibility (reliability and agreement), construct validity, internal and external responsiveness, and ceiling and floor effects. RESULTS: The Brazilian-Portuguese version of the IBD-F showed excellent internal consistency (Cronbach's alpha of 0.95), excellent reproducibility (ICC=0.97) and a minimal detectable change of 6.0 points. The construct validity was demonstrated with a good correlation between the IBD-F and FACIT-F (r=- 0.46). Effect sizes used for measuring internal responsiveness were moderate among those with Crohn's (0.66) disease and low in patients with ulcerative colitis (0.24). The Brazilian-Portuguese version of the IBD-F presented with high external responsiveness for Crohn's disease (0.84) and with low external responsiveness for ulcerative colitis (0.33). The area under the curve considered for responsiveness was 0.84. Twenty-five percent of floor effects and no ceiling effect were recorded. CONCLUSION: The Brazilian-Portuguese version of IBD-F has adequate measurement properties and its use can be recommended in clinical practice and research.

Escala de autoavaliação Inflammatory Bowel Disease-Fatigue: tradução, adaptação cultural e propriedades psicométricas da versão Brasileira (IBD-F Brasil) / The inflammatory bowel disease-fatigue patient self-assessment scale: translation, cross-cultural adaptation and psychometric properties of the brazilian version (ibd-f brazil)

ABSTRACT BACKGROUND: Fatigue is a common symptom in patients with inflammatory bowel diseases (IBD). A translated and culturally adapted, instrument with robust psychometric for measuring fatigue in Brazilian patients with IBD is needed. OBJECTIVE: To translate and cross-culturally adapt the inflammatory Bowel Disease Fatigue Scale (IBD-F) into Brazilian-Portuguese and to test its measurement properties in Brazilian patients with IBD. METHODS: Data from 123 patients with IBD were collected. In addition to IBD-F, the Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F) was used. The measurement properties tested were: internal consistency, reproducibility (reliability and agreement), construct validity, internal and external responsiveness, and ceiling and floor effects. RESULTS: The Brazilian-Portuguese version of the IBD-F showed excellent internal consistency (Cronbach's alpha of 0.95), excellent reproducibility (ICC=0.97) and a minimal detectable change of 6.0 points. The construct validity was demonstrated with a good correlation between the IBD-F and FACIT-F (r=- 0.46). Effect sizes used for measuring internal responsiveness were moderate among those with Crohn's (0.66) disease and low in patients with ulcerative colitis (0.24). The Brazilian-Portuguese version of the IBD-F presented with high external responsiveness for Crohn's disease (0.84) and with low external responsiveness for ulcerative colitis (0.33). The area under the curve considered for responsiveness was 0.84. Twenty-five percent of floor effects and no ceiling effect were recorded. CONCLUSION: The Brazilian-Portuguese version of IBD-F has adequate measurement properties and its use can be recommended in clinical practice and research.

RESUMO CONTEXTO: A fadiga é um sintoma comum em pacientes com doenças inflamatórias intestinais (DII). Um instrumento de avaliação de fadiga traduzido, culturalmente adaptado e com psicometria robusta para medir a fadiga em pacientes brasileiros com DII é necessário. OBJETIVO: Traduzir e adaptar culturalmente a Inflammatory Bowel Disease Fatigue Scale (IBD-F) para o português do Brasil e testar suas propriedades de medida em pacientes brasileiros com DII. MÉTODOS: Foram coletados dados de 123 pacientes com DII. Além do IBD-F, foi utilizada a Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F). As propriedades de medida testadas foram: consistência interna, reprodutibilidade (confiabilidade e concordância), validade de construto, responsividade interna e externa e efeitos teto e chão. RESULTADOS: A versão em português do IBD-F mostrou excelente consistência interna (alfa de Cronbach de 0,95), excelente reprodutibilidade (ICC=0,97) e uma diferença mínima detectável de 6,0 pontos. A validade do construto foi demonstrada por meio de uma boa correlação entre o IBD-F Brasil e o FACIT-F (r= -0,46). Na análise de responsividade interna, os tamanhos de efeito obtidos foram moderado entre aqueles com doença de Crohn (0,66) e baixo em pacientes com colite ulcerativa (0,24). O IBD-F Brasil apresentou alta responsividade externa entre aqueles com doença de Crohn (0,84) e baixa responsividade externa em pacientes colite ulcerativa (0,33). A área sob a curva considerada para responsividade foi de 0,84. Foram registrados 25% de efeito chão e nenhum efeito teto nas avaliações realizadas. CONCLUSÃO: O IBD-F Brasil possui propriedades de medida adequadas e seu uso pode ser recomendado na prática clínica e na pesquisa em pacientes com DII.

Rapid and coarse face detection: With a lack of evidence for a nasal-temporal asymmetry.

Humans have structures dedicated to the processing of faces, which include cortical components (e.g., areas in occipital and temporal lobes) and subcortical components (e.g., superior colliculus and amygdala). Although faces are processed more quickly than stimuli from other categories, there is a lack of consensus regarding whether subcortical structures are responsible for rapid face processing. In order to probe this, we exploited the asymmetry in the strength of projections to subcortical structures between the nasal and temporal hemiretina. Participants detected faces from unrecognizable control stimuli and performed the same task for houses. In Experiments 1 and 3, at the fastest reaction times, participants detected faces more accurately than houses. However, there was no benefit of presenting to the subcortical pathway. In Experiment 2, we probed the coarseness of the rapid pathway, making the foil stimuli more similar to faces and houses. This eliminated the rapid detection advantage, suggesting that rapid face processing is limited to coarse representations. In Experiment 4, we sought to determine whether the natural difference between spatial frequencies of faces and houses were driving the effects seen in Experiments 1 and 3. We spatially filtered the faces and houses so that they were matched. Better rapid detection was again found for faces relative to houses, but we found no benefit of preferentially presenting to the subcortical pathway. Taken together, the results of our experiments suggest a coarse rapid detection mechanism, which was not dependent on spatial frequency, with no advantage for presenting preferentially to subcortical structures.

Determinants of Work in the Six-Minute Walk Test in School-Age Children / Determinantes do trabalho no Teste de Caminhada de Seis Minutos em escolares

Abstract Introduction: The Six-Minute Walk Test (6MWT) is widely used to assess functional capacity in children. The measure of work during 6MWT can add important information to the 6MWT assessment in this population as it relates to walking efficiency. Objective: To verify the determinants of work during the Six-Minute Walk Test (6MWTwork) in school-aged children. Method: This is a cross-sectional and exploratory study that included healthy children recruited from the public and private schools of the cities of Belo Horizonte and Uberlândia, Brazil. The inclusion criteria were: children aged 7 to 12 years without diagnosis of chronic cardiorespiratory disease, cognitive, behavioral disorder or physical function impairment (information obtained through self-report of those responsible for children). Exclusion criteria were children who refused to perform the 6MWT; who did not understand the 6MWT or who did not answer the test commands. Three hundred and nineteen school-aged children were included in the study. Correlation analyses and multiple linear regression analysis were used to identify the variables associated with the 6MWTwork. Results: Age, height, nutritional status, physical activity and heart rate showed significant correlation with 6MWTwork (p <0.001) and explained 87% of its variation (p = 0.0001). Conclusion: Age, height, nutritional status and heart rate variation are determinants of 6MWTwork that is able to evaluate functional capacity of school-aged children.

Resumo Introdução: O teste de caminhada de seis minutos (TC6min) é amplamente utilizado para avaliar a capacidade funcional em crianças. A medida do trabalho durante o TC6 poderia adicionar informações importantes à avaliação do TC6 nessa população, no que se refere à eficiência da marcha. Objetivo: Verificar os determinantes do trabalho durante o Teste de Caminhada (TC6min) em crianças em idade escolar. Método: Trata-se de um estudo transversal e exploratório que incluiu crianças saudáveis recrutadas nas escolas públicas e privadas das cidades de Belo Horizonte e Uberlândia, Brasil. Os critérios de inclusão foram: crianças de 7 a 12 anos sem diagnóstico de doença cardiorrespiratória crônica, distúrbio cognitivo, comportamental ou comprometimento da função física (informações obtidas por auto-relato dos responsáveis pelas crianças). Os critérios de exclusão foram: crianças que se recusaram a realizar o TC6; que não entenderam o TC6 ou que não responderam aos comandos de teste. Trezentos e dezenove crianças em idade escolar foram incluídas no estudo. Análises de correlação e análise de regressão linear múltipla foram utilizadas para identificar as variáveis associadas ao trabalho com TC6. Resultados: Idade, altura, estado nutricional, atividade física e frequência cardíaca apresentaram correlação significativa com o trabalho durante o TC6min (p <0,001) e explicaram 87% de sua variação (p = 0,0001). Conclusão: Idade, altura, estado nutricional e variação da frequência cardíaca são determinantes do trabalho no TC6, e portanto, devem ser considerados na avaliação da capacidade funcional de crianças em idade escolar.

Online recruitment and testing of infants with Mechanical Turk.

Testing infants in the laboratory is expensive in time and money; consequently, many studies are underpowered, reducing their reproducibility. We investigated whether the online platform, Amazon Mechanical Turk (MTurk), could be used as a resource to more easily recruit and measure the behavior of infant populations. Using a looking time paradigm, with users' webcams we recorded how long infants aged 5 to 8months attended while viewing children's television programs. We found that infants (N=57) were more reliably engaged by some movies than by others and that the most engaging movies could maintain attention for approximately 70% of a 10- to 13-min period. We then identified the cinematic features within the movies. Faces, singing-and-rhyming, and camera zooms were found to increase infant attention. Together, we established that MTurk can be used as a rapid tool for effectively recruiting and testing infants.