Entry of Migrant Workers to Malaysia: Consideration to Implement Mass Drug Administration Against Intestinal Parasitic Infections.

Over the last five decades, widespread industrialisation and urbanisation have resulted in the influx of low-skilled workers, particularly from Southeast and West Asia to Malaysia. The current practice for migrant workers entry for employment requires mandatory medical screening for infectious diseases. However, screening for parasitic infections in Malaysia is woefully inadequate. Many migrants come from low-income countries where parasitic infections are common, which may have public health implications for their overall well-being as parasitic infections, although not critical, may impact their overall productivity. The high prevalence of intestinal parasitic infections (IPIs) recorded among migrant workers in Malaysia necessitates improvement in the national health policy to include mandatory mass administration of a single dose of anthelmintic drugs to all low-skilled migrant labourers, particularly upon entry into the country, admission, and encourage continuous surveillance. A constant stream of migrant labourers is anticipated, potentially resulting in an ongoing occurrence of parasitic infections within the population. The implementation of economic measures like health awareness initiatives, routine deworming campaigns, and improved sanitation facilities holds the potential to reduce the spread of these infections notably. More often than not, taking preventive actions proves to be more financially efficient over time compared to addressing severe infections at a later stage.

The Characterization of the Th1/Th2 Ratio in Multiple Sclerosis Patients and its Response to a Dietary Supplement Regimen.

INTRODUCTION: Multiple sclerosis (MS) is a debilitating neurodegenerative disease affecting the central nervous system, causing disability and life-threatening complications. The interplay between immune cells and signaling pathways is a topic for investigating novel therapies. Past research has shown how the Th1/Th2 ratio plays a key role in the pathogenesis of MS lesions. Modulating the Th1/Th2 ratios with an efficacious dietary supplement may improve some of the consequences of MS. METHODS: Participants (n = 15) diagnosed with MS for an average of 12.4 years (standard deviation = 7.4; range = 2, 25) were enrolled in a clinical trial in which they consumed a dietary supplement regimen daily for 12 months. Venous blood was drawn at baseline and 12-month follow-up and peripheral blood mononuclear cells, cytokines, and growth factors were quantified. Infections, physical functioning, and quality of life were also assessed at baseline and 12 months. RESULTS: The IL-2/IL-10 and IFN-γ/IL-10 ratios were significantly higher than those of the healthy adults, and while only IFN-γ/IL-10 increased significantly at 12 months, all ratios other than IFN-γ/TNF-α increased over the course of the intervention. The decrease in yeast infections was inversely correlated with IL-2/TNF-α and IFN-γ/TNF-α. Significant improvements in physical functioning and quality of life correlated with changes in the Th1/Th2 ratios in response to the dietary supplement regimen. CONCLUSIONS: The results show that dietary supplementation somewhat impacted the Th1/Th2 ratios over the course of the intervention (toward more Th1 dominance), and those changes were related to various clinical improvements of the participants' symptoms in cognitive, motor, and psychosocial dimensions.

Association Between Diabetes and Risk of Prostate Cancer: A Systematic Review and Meta-Analysis of Observational Studies.

PURPOSE: Metabolic diseases such as diabetes mellitus may play a role in the development and progression of prostate cancer (PC); however, this association remains to be explored in the context of specific PC stages. The objective of this study was to systematically review the evidence for an association between diabetes and overall, early, or advanced PC risk. MATERIALS AND METHODS: A systematic review with meta-analysis was performed (MEDLINE, EMBASE, and CINAHL) from inception until September 2023. Cohort and case-control studies that assessed PC risk in adult males (≥18 years) associated with type 2 diabetes mellitus or diabetes (if there was no distinction between diabetes type) were included. The Newcastle-Ottawa Scale (NOS) was used to assess study bias; those with NOS<7 were excluded. Evidence certainty was assessed with the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) method. RESULTS: Thirty-four studies (n=26 cohorts and n=8 case-controls) were included. Of these, 32 assessed diabetes and all PC stages combined, 12 included early PC stages, and 15 included advanced PC stages. Our meta-analysis showed diabetes had a protective effect against early PC development (n=11, risk ratio [RR]=0.71; 95% confidence interval [CI]=0.61-0.83, I²=84%) but no association was found for combined (n=21, RR=0.95; 95% CI=0.79-1.13, I²=99%) or advanced PC stages (n=15, RR=0.96; 95% CI=0.77-1.18, I²=98%) at diagnosis. According to GRADE, the evidence certainty was very low. CONCLUSIONS: Diabetes may be protective against early PC stages, yet evidence linking diabetes to risk across all stages, and advanced PC specifically, is less conclusive. High heterogeneity may partially explain discrepancy in findings and was mostly associated with study design, method used for PC diagnosis, and risk measures. Our results may aid risk stratification of males with diabetes and inform new approaches for PC screening in this group, especially considering the reduced sensitivity of prostate-specific antigen values for those with diabetes.

Targeted proteomics of plasma extracellular vesicles uncovers MUC1 as combinatorial biomarker for the early detection of high-grade serous ovarian cancer.

BACKGROUND: The five-year prognosis for patients with late-stage high-grade serous carcinoma (HGSC) remains dismal, underscoring the critical need for identifying early-stage biomarkers. This study explores the potential of extracellular vesicles (EVs) circulating in blood, which are believed to harbor proteomic cargo reflective of the HGSC microenvironment, as a source for biomarker discovery. RESULTS: We conducted a comprehensive proteomic profiling of EVs isolated from blood plasma, ascites, and cell lines of patients, employing both data-dependent (DDA) and data-independent acquisition (DIA) methods to construct a spectral library tailored for targeted proteomics. Our investigation aimed at uncovering novel biomarkers for the early detection of HGSC by comparing the proteomic signatures of EVs from women with HGSC to those with benign gynecological conditions. The initial cohort, comprising 19 donors, utilized DDA proteomics for spectral library development. The subsequent cohort, involving 30 HGSC patients and 30 control subjects, employed DIA proteomics for a similar purpose. Support vector machine (SVM) classification was applied in both cohorts to identify combinatorial biomarkers with high specificity and sensitivity (ROC-AUC > 0.90). Notably, MUC1 emerged as a significant biomarker in both cohorts when used in combination with additional biomarkers. Validation through an ELISA assay on a subset of benign (n = 18), Stage I (n = 9), and stage II (n = 9) plasma samples corroborated the diagnostic utility of MUC1 in the early-stage detection of HGSC. CONCLUSIONS: This study highlights the value of EV-based proteomic analysis in the discovery of combinatorial biomarkers for early ovarian cancer detection.

Development of an effective predictive screening tool for prostate cancer using the ClarityDX machine learning platform.

The current prostate cancer (PCa) screen test, prostate-specific antigen (PSA), has a high sensitivity for PCa but low specificity for high-risk, clinically significant PCa (csPCa), resulting in overdiagnosis and overtreatment of non-csPCa. Early identification of csPCa while avoiding unnecessary biopsies in men with non-csPCa is challenging. We built an optimized machine learning platform (ClarityDX) and showed its utility in generating models predicting csPCa. Integrating the ClarityDX platform with blood-based biomarkers for clinically significant PCa and clinical biomarker data from a 3448-patient cohort, we developed a test to stratify patients' risk of csPCa; called ClarityDX Prostate. When predicting high risk cancer in the validation cohort, ClarityDX Prostate showed 95% sensitivity, 35% specificity, 54% positive predictive value, and 91% negative predictive value, at a ≥ 25% threshold. Using ClarityDX Prostate at this threshold could avoid up to 35% of unnecessary prostate biopsies. ClarityDX Prostate showed higher accuracy for predicting the risk of csPCa than PSA alone and the tested model-based risk calculators. Using this test as a reflex test in men with elevated PSA levels may help patients and their healthcare providers decide if a prostate biopsy is necessary.

We outside: Modeling equity-centered, antiracist, community-driven partnerships in resident education.

Background: Community engagement is increasingly recognized as a necessity in addressing intractable racial and ethnic health disparities in the United States. However, institutions have not adequately trained resident physicians in developing symbiotic community partnerships that preserve community autonomy and identity without exploitation. Our goals were to highlight the experiences of expert academic emergency physicians in creating innovative, community-driven, and anti-racist solutions to achieving measurable equity in health outcomes and to introduce a novel framework entitled the Social Change Method to take a community-embedded intervention from concept to creation. Methods: The methodology was based on the development of a didactic session at the 2023 SAEM Annual Meeting. The three novel initiatives discussed were Emergency Medicine Remix (EMR); Trust, Research, Access, and Prevention (TRAP) Medicine; and The Health Equity Accelerator (HEA). A team of multi-institutional experts convened to develop the session objectives through priority setting. Results: Our expert panel discussed successes and challenges encountered while using evidence-informed strategies to conduct their community-based programming. Participant questions were centered on fostering sustainability, emphasizing the importance of carefully crafted interventions in the face of uncertain legislative challenges and strategies to empower others. Conclusions: Emergency medicine residency education should incorporate training on methods to leverage community partnerships to improve individual and community health outcomes. The Social Change Method can be used as a conceptual framework to generate easily re-creatable and scalable partnerships that establish trust and forge relationships that honor identity and autonomy without exploiting community members.

Medially Positioned Single Mucoperiosteal Flap With and Without Allograft Membrane for Repair of Congenital Cleft Palate in 4 Dogs.

Congenital cleft of the secondary palate occurs when there is failure of one or both maxillary processes to fuse with the nasal septum during embryonic development. Palatal cleft severity can range from a simple focal fissure of the caudal soft palate to full-thickness defects of varied widths involving the entire soft and hard palate. A novel staged medially positioned single mucoperiosteal flap technique in 4 canine patients is reported. This flap technique is based on the major palatine and infraorbital arteries with strategic extractions of maxillary teeth and placement of allograft membrane in 3 of 4 cases for treatment of clefts wider than may be repaired effectively by traditional methods.

Intelligence and cortical morphometry: caveats in brain-behavior associations.

It is well-established that brain size is associated with intelligence. But the relationship between cortical morphometric measures and intelligence is unclear. Studies have produced conflicting results or no significant relations between intelligence and cortical morphometric measures such as cortical thickness and peri-cortical contrast. This discrepancy may be due to multicollinearity amongst the independent variables in a multivariate regression analysis, or a failure to fully account for the relationship between brain size and intelligence in some other way. Our study shows that neither cortical thickness nor peri-cortical contrast reliably improves IQ prediction accuracy beyond what is achieved with brain volume alone. We show this in multiple datasets, with child data, developmental data, and with adult data; we show this with data acquired either at multiple sites, or at a single site; we show this with data acquired with different MRI scanner manufacturers, or with all data acquired on a single scanner; and we show this with fluid intelligence, full-scale IQ, performance IQ, and verbal IQ. But our point is not really even about IQ; rather we proffer a methodological caveat and potential explanation of the discrepancies in previous results, and which applies broadly.

Atypical co-development of the thalamus and cortex in autism: Evidence from age-related white-gray contrast change.

Recent studies have shown that white-gray contrast (WGC) of either cortical or subcortical gray matter provides for accurate predictions of age in typically developing (TD) children, and that, at least for the cortex, it changes differently with age in subjects with autism spectrum disorder (ASD) compared to their TD peers. Our previous study showed different patterns of contrast change between ASD and TD in sensorimotor and association cortices. While that study was confined to the cortex, we hypothesized that subcortical structures, particularly the thalamus, were involved in the observed cortical dichotomy between lower and higher processing. The current paper investigates that hypothesis using the WGC measures from the thalamus in addition to those from the cortex. We compared age-related WGC changes in the thalamus to those in the cortex. To capture the simultaneity of this change across the two structures, we devised a metric capturing the co-development of the thalamus and cortex (CoDevTC), proportional to the magnitude of cortical and thalamic age-related WGC change. We calculated this metric for each of the subjects in a large homogeneous sample taken from the Autism Brain Imaging Data Exchange (ABIDE) (N = 434). We used structural MRI data from the largest high-quality cross-sectional sample (NYU) as well as two other large high-quality sites, GU and OHSU, all three using Siemens 3T scanners. We observed that the co-development features in ASD and TD exhibit contrasting patterns; specifically, some higher-order thalamic nuclei, such as the lateral dorsal nucleus, exhibited reduction in codevelopment with most of the cortex in ASD compared to TD. Moreover, this difference in the CoDevTC pattern correlates with a number of behavioral measures across multiple cognitive and physiological domains. The results support previous notions of altered connectivity in autism, but add more specific evidence about the heterogeneity in thalamocortical development that elucidates the mechanisms underlying the clinical features of ASD.

Motion compensated cone-beam CT reconstruction using ana priorimotion model from CT simulation: a pilot study.

Objective. To combat the motion artifacts present in traditional 4D-CBCT reconstruction, an iterative technique known as the motion-compensated simultaneous algebraic reconstruction technique (MC-SART) was previously developed. MC-SART employs a 4D-CBCT reconstruction to obtain an initial model, which suffers from a lack of sufficient projections in each bin. The purpose of this study is to demonstrate the feasibility of introducing a motion model acquired during CT simulation to MC-SART, coined model-based CBCT (MB-CBCT).Approach. For each of 5 patients, we acquired 5DCTs during simulation and pre-treatment CBCTs with a simultaneous breathing surrogate. We cross-calibrated the 5DCT and CBCT breathing waveforms by matching the diaphragms and employed the 5DCT motion model parameters for MC-SART. We introduced the Amplitude Reassignment Motion Modeling technique, which measures the ability of the model to control diaphragm sharpness by reassigning projection amplitudes with varying resolution. We evaluated the sharpness of tumors and compared them between MB-CBCT and 4D-CBCT. We quantified sharpness by fitting an error function across anatomical boundaries. Furthermore, we compared our MB-CBCT approach to the traditional MC-SART approach. We evaluated MB-CBCT's robustness over time by reconstructing multiple fractions for each patient and measuring consistency in tumor centroid locations between 4D-CBCT and MB-CBCT.Main results. We found that the diaphragm sharpness rose consistently with increasing amplitude resolution for 4/5 patients. We observed consistently high image quality across multiple fractions, and observed stable tumor centroids with an average 0.74 ± 0.31 mm difference between the 4D-CBCT and MB-CBCT. Overall, vast improvements over 3D-CBCT and 4D-CBCT were demonstrated by our MB-CBCT technique in terms of both diaphragm sharpness and overall image quality.Significance. This work is an important extension of the MC-SART technique. We demonstrated the ability ofa priori5DCT models to provide motion compensation for CBCT reconstruction. We showed improvements in image quality over both 4D-CBCT and the traditional MC-SART approach.

Associations between maternal pre-pregnancy BMI and infant striatal mean diffusivity.

BACKGROUND: It is well-established that parental obesity is a strong risk factor for offspring obesity. Further, a converging body of evidence now suggests that maternal weight profiles may affect the developing offspring's brain in a manner that confers future obesity risk. Here, we investigated how pre-pregnancy maternal weight status influences the reward-related striatal areas of the offspring's brain during in utero development. METHODS: We used diffusion tensor imaging to quantify the microstructure of the striatal brain regions of interest in neonates (N = 116 [66 males, 50 females], mean gestational weeks at birth [39.88], SD = 1.14; at scan [43.56], SD = 1.05). Linear regression was used to test the associations between maternal pre-pregnancy body mass index (BMI) and infant striatal mean diffusivity. RESULTS: High maternal pre-pregnancy BMI was associated with higher mean MD values in the infant's left caudate nucleus. Results remained unchanged after the adjustment for covariates. CONCLUSIONS: In utero exposure to maternal adiposity might have a growth-impairing impact on the mean diffusivity of the infant's left caudate nucleus. Considering the involvement of the caudate nucleus in regulating eating behavior and food-related reward processing later in life, this finding calls for further investigations to define the prognostic relevance of early-life caudate nucleus development and weight trajectories of the offspring.

Patient Risk-Benefit Preferences for Transcatheter Versus Surgical Mitral Valve Repair.

BACKGROUND: Transcatheter edge-to-edge repair (TEER) of mitral regurgitation is less invasive than surgery but has greater 5-year mortality and reintervention risks, and leads to smaller improvements in physical functioning. The study objective was to quantify patient preferences for risk-benefit trade-offs associated with TEER and surgery. METHODS AND RESULTS: A discrete choice experiment survey was administered to patients with mitral regurgitation. Attributes included procedure type; 30-day mortality risk; 5-year mortality risk and physical functioning for 5 years; number of hospitalizations in the next 5 years; and risk of additional surgery in the next 5 years. A mixed-logit regression model was fit to estimate preference weights. Two hundred one individuals completed the survey: 63% were female and mean age was 74 years. On average, respondents preferred TEER over surgery. To undergo a less invasive procedure (ie, TEER), respondents would accept up to a 13.3% (95% CI, 8.7%-18.5%) increase in reintervention risk above a baseline of 10%, 4.6 (95% CI, 3.1-6.2) more hospitalizations above a baseline of 1, a 10.7% (95% CI, 6.5%-14.5%) increase in 5-year mortality risk above a baseline of 20%, or more limited physical functioning representing nearly 1 New York Heart Association class (0.7 [95% CI, 0.4-1.1]) over 5 years. CONCLUSIONS: Patients in general preferred TEER over surgery. When holding constant all other factors, a functional improvement from New York Heart Association class III to class I maintained over 5 years would be needed, on average, for patients to prefer surgery over TEER.

Cytoplasmic accumulation and plasma membrane association of anillin and Ect2 promote confined migration and invasion.

Cells migrating in confinement experience mechanical challenges whose consequences on cell migration machinery remain only partially understood. Here, we demonstrate that a pool of the cytokinesis regulatory protein anillin is retained during interphase in the cytoplasm of different cell types. Confinement induces recruitment of cytoplasmic anillin to plasma membrane at the poles of migrating cells, which is further enhanced upon nuclear envelope (NE) rupture(s). Rupture events also enable the cytoplasmic egress of predominantly nuclear RhoGEF Ect2. Anillin and Ect2 redistributions scale with microenvironmental stiffness and confinement, and are observed in confined cells in vitro and in invading tumor cells in vivo. Anillin, which binds actomyosin at the cell poles, and Ect2, which activates RhoA, cooperate additively to promote myosin II contractility, and promote efficient invasion and extravasation. Overall, our work provides a mechanistic understanding of how cytokinesis regulators mediate RhoA/ROCK/myosin II-dependent mechanoadaptation during confined migration and invasive cancer progression.

Survival outcomes of patients with HER2/neu-positive breast cancer with germline BRCA mutations.

BACKGROUND: Breast cancer (BC) with germline BRCA1/2 mutations and their association with triple-negative BC has been thoroughly investigated. However, some carriers of BRCA1/2 mutations have human epidermal growth factor receptor 2 (HER2/neu)-positive BC, which has a different targeted therapy approach, and data are scarce for this patient population. The authors sought to characterize the clinical characteristics and outcomes of patients with HER2/neu-positive BC who had germline BRCA1/2 mutations. METHODS: This was a retrospective analysis of data from 1099 patients diagnosed with HER2/neu-positive BC who were screened for germline BRCA mutations between 1996 and 2022. Clinicopathologic features and survival rates were analyzed by BRCA mutation status. Univariate and multivariable Cox proportional hazards regression models were used to analyze the association between clinical variables and outcomes. RESULTS: Of 1099 patients with HER2/neu-positive BC, 73 (6.6%) tested positive for BRCA1/2 mutations. Age, race, and tumor characteristics did not differ between BRCA noncarriers and carriers. At a median follow-up of 78.6 months, the 5-year recurrence-free survival rate was 85% in BRCA carriers and 87% in noncarriers (p = .79), and the 5-year overall survival rate was 94% in BRCA carriers and 94% in noncarriers (p = .78). In a multivariable model, BRCA was not associated with recurrence-free survival (hazard ratio, 0.99; 95% confidence interval, 0.51-1.90; p = .96) or overall survival (hazard ratio, 0.83; 95% confidence interval, 0.33-2.07; p = .69). CONCLUSIONS: BRCA1/2 mutations occurred in 6.6% of patients with HER2/neu-positive BC and did not affect survival outcomes. Assessing the potential benefits of new treatment strategies, such as combining anti-HER2/neu therapies with poly(ADP-ribose) polymerase inhibitors, may lead to enhanced outcomes for these patients.

A single physical education session improves subsequent academic performance in rural school students / Uma única aula de educação física melhora o desempenho acadêmico subsequente em estudantes de escola rural / Una única clase de educación física mejora el posterior desempeño académico en alumnos de escuela rural

ABSTRACT Introduction: Activity breaks or physical exercise interventions in schools are linked to better cognitive function in adolescents. However, few studies have evaluated the relationship between physical exercise and cognition in rural schools, where drop-out levels tend to be higher and academic achievement lower. Objective: To analyze the effects of a physical exercise class (PE) on subsequent academic performance of students, and how they felt during mathematics (MATH) and Portuguese language (PL) tests. Methods: Thirty-six students (14.9 ± 1.5 years) randomly carried out 30 min of PE, performed at 74.3 ± 11.8%HRmax, while a control group (CON) remained seated watching a movie, prior to the tests (PE-MATH; PE-PL; CON-MATH; CON-PL). Results: The PE-MATH group presented higher scores (5.3 ± 2.2) than the CON-MATH group (4.0 ± 2.2). The tests were completed more quickly in PE-PL (7.8 ± 3.3 minutes) than in CON-PL (10.5 ± 4.2 minutes). The number of correct answer per minute was higher in PE-MATH and PE-PL (0.52 ± 0.25; 0.64 ± 0.51) than in CON-MATH and CON-PL (0.35 ± 0.19; 0.41 ± 0.41). Furthermore, 38.9% of PE-MATH felt more focused during the test, while only 16.7% of CON-MATH felt more focused. During the Portuguese language test, 27.8% of CON-PL complained of greater apprehensiveness, compared to 8.3% for PE-PL. Also, 36.1% reported feeling fatigued during PL after PE, compared to 8.3% in the CON-PL group. Conclusions: PE improved the adolescents' academic performance. Despite feeling fatigue, more students who performed physical exercise felt less apprehensive and more focused during the tests after PE. Level of evidence I; STARD: studies of diagnostic accuracy.

RESUMO Introdução: Os intervalos com atividade ou as intervenções com programas de exercícios na escola estão relacionados com a melhora da função cognitiva em adolescentes. Contudo, poucos estudos avaliaram a relação entre exercício físico e cognição em escolas de zonas rurais, onde os níveis de evasão são altos e o rendimento acadêmico é baixo. Objetivo: Analisar os efeitos de uma aula de exercício físico (EF) sobre o desempenho acadêmico subsequente dos alunos e o que sentem durante os testes de matemática (MAT) e de língua portuguesa (PO). Métodos: Trinta e seis estudantes (14,9 ± 1,5 anos) foram divididos randomicamente em dois grupos: um com 30 minutos de EF realizados a 74,3 ± 11,8% da FCmáx e um controle (CON), que permaneceram sentados assistindo a um filme antes dos testes (EF-MAT; EF-PO; CON-MAT; CON-PO). Resultados: O EF-MAT apresentou maior escore (5,3 ± 2,2) que o CON-MAT (4,0 ± 2,2). Os testes foram concluídos mais rapidamente no EF-PO (7,8 ± 3,3) do que no CON-PO (10,5 ± 4,2). O número de respostas corretas por minuto foi maior no EF-MAT e no EF-PO (0,52 ± 0,25; 0,64 ± 0,51) do que no CON-MAT e no CON-PO (0,35 ± 0,19; 0,41 ± 0,41). Além disso, 38,9% do EF-MAT sentiram que estavam mais concentrados durante o teste, em comparação com apenas 16,7% do CON-MAT que se sentiram mais concentrados. Durante o a prova de português, 27,8% dos CON-PO reclamaram de maior apreensão quando comparados com 8,3% do EF-PO. Ainda, 36,1% relataram cansaço durante o teste de PO depois de EF, comparados com 8,3% do grupo CON-PO. Conclusão: A aula de EF melhorou o desempenho acadêmico dos adolescentes. Apesar da sensação de cansaço, mais estudantes sentiram menos apreensão e estavam mais concentrados durante os testes depois de EF. Nível de evidência I; Estudos de acurácia diagnóstica (STARD).

RESUMEN Introducción: Los intervalos con actividad o las intervenciones con programas de ejercicios en la escuela están relacionados con la mejora de la función cognitiva en adolescentes. Sin embargo, pocos estudios evaluaron la relación entre ejercicio físico y cognición en escuelas de zonas rurales, en donde los niveles de evasión son altos y el rendimiento académico es bajo. Objetivo: Analizar los efectos de una clase de ejercicio físico (EF) sobre el desempeño académico subsiguiente de los alumnos y lo que sienten durante los tests de matemática (MAT) y de idioma portugués (PO). Métodos: Treinta y seis estudiantes (14,9 ± 1,5 años) fueron divididos aleatoriamente en dos grupos: uno con 30 minutos de EF realizados a 74,3 ± 11,8% de la FCmáx y un control (CON), que permanecieron sentados viendo una película antes de los tests (EF-MAT; EF-PO; CON-MAT; CON-PO). Resultados: El EF-MAT presentó mayor puntuación (5,3 ± 2,2) que el CON-MAT (4,0 ± 2,2). Los tests fueron concluidos más rápidamente en el EF-PO (7,8 ± 3,3) que en el CON-PO (10,5 ± 4,2). El número de respuestas correctas por minuto fue mayor en el EF-MAT y en el EF-PO (0,52 ± 0,25,0,64 ± 0,51) que en el CON-MAT y en el CON-PO (0,35 ± 0,19, 0,41 ± 0,41). Además, 38,9% del EF-MAT sintió que estaba más concentrado durante el test, en comparación con sólo 16,7% del CON-MAT que se sintió más concentrado. Durante la prueba de portugués, 27,8% de los CON-PO reclamó de mayor aprehensión cuando comparado con 8,3% del EF-PO. Además, 36,1% relató cansancio durante el test de PO después del EF, comparado con el 8,3% del grupo CON-PO. Conclusión: La clase de EF mejoró el desempeño académico de los adolescentes. A pesar de la sensación de cansancio, más estudiantes sintieron menos aprehensión y estaban más concentrados durante los tests después de EF. Nivel de evidencia I; Estudios de precisión diagnóstica (STARD).

Oxygen consumption and energy expenditure during and after street games, active video games and tv / Consumo de oxigênio e gasto energético durante e depois de brincadeiras de rua, vídeo games ativos e tv / Consumo de oxígeno y gasto energético durante y después de juegos de calle, vídeo game y tv

INTRODUCTION: Physical activity has become less frequent since the 1980s, even among more active children. OBJECTIVE: To analyze excess post-exercise oxygen consumption (EPOC) and total energy expenditure (TEE) in children during and after three different activities. METHODS: Sixteen healthy children (9.6±0.1 yrs.) randomly underwent the following procedures lasting 30 minutes on different days: (a) traditional games (PLAY), (b) active video game (Dance Dance Revolution; DDR), and (c) watching television (TV). Oxygen consumption (VO2) was measured at rest, at the 10th, 20th, and 30th minute of intervention, and for 40 minutes post-intervention. TEE was also measured. RESULTS: At the end of intervention, VO2 had increased by 330% and 166% for PLAY and DDR, respectively, compared to the rest. EPOC in PLAY was seen to occur at the 10th, 20th, and 30th post-interventional minutes from 7.00±1.02 (at rest) to 10.83±0.94, 10.03±0.58, and 9.80±0.77mL.kg-1.min-1, respectively. However, EPOC in DDR occurred at only the 10th postinterventional minute (7.04 to 8.61 mL.kg-1.min-1; p<0.01). After intervention, TEE in PLAY was greater than in DDR and TV (112.08±19.45 vs 56.98±6.34 vs 36.39±4.5 kcal; p<0.01), respectively. CONCLUSIONS: PLAY induced children to reach a greater VO2 during activity and greater EPOC and TEE compared to DDR and TV. Level of evidence A1b; Crossover study.

INTRODUÇÃO: A prática de atividade física tornou-se menos frequente a partir dos anos 80, mesmo entre crianças mais ativas. OBJETIVO: Analisar o consumo excessivo de oxigênio pós-exercício (EPOC) e o gasto energético total (TEE) em crianças durante e após três atividades distintas. MÉTODOS: Dezesseis crianças saudáveis (9,6 ± 0,1 anos) foram submetidas aleatoriamente aos seguintes procedimentos com duração de 30 minutos em dias diferentes: (a) brincadeiras tradicionais (PLAY), (b) videogame ativo (Dance Dance Revolution, DDR) e (c) assistir à televisão (TV). O consumo de oxigênio (VO2) foi medido em repouso, no 10°, 20° e 30° minuto de intervenção e 40 minutos depois da intervenção. O TEE também foi calculado. RESULTADOS: No final da intervenção, o VO2 aumentou 330% e 166% para PLAY e DDR, respectivamente, em comparação com o repouso. Observou-se que o EPOC no PLAY ocorreu aos 10, 20 e 30 minutos depois da intervenção, de 7,00 ± 1,02 (em repouso) para 10,83 ± 0,94, 10,03 ± 0,58 e 9,80 ± 0,77 mL.kg-1.min-1, respectivamente. O EPOC no DDR ocorreu apenas no 10° minuto pós-intervenção (7,04 a 8,61 mL.kg-1.min-1, p < 0,01). Após a intervenção, o TEE no PLAY foi maior que em DDR e TV (112,08 ± 19,45 vs. 56,98 ± 6,34 vs. 36,39 ± 4,5 kcal, p < 0,01), respectivamente. CONCLUSÕES: O PLAY induziu as crianças a maior VO2 durante a atividade e maior EPOC e TEE com relação a DDR e TV. Nível de evidência A1b; Estudo cruzado.

INTRODUCCIÓN: La actividad física se ha vuelto menos frecuente desde la década de 1980, incluso entre los niños más activos. OBJETIVO: Analizar el consumo excesivo de oxígeno post ejercicio (EPOC) y el gasto de energía total (TEE) en niños durante y después del juego activo tradicional y comparar con el video game activo y televisión. MÉTODOS: Dieciséis niños saludables (9,6 ± 0,1 años) fueron sometidos durante 30 minutos, en días diferentes, a las siguientes sesiones: (a) juegos tradicionales (PLAY), (b) video game activo (DDR) y (c) televisión (TV). El consumo de oxígeno (VO2) fue medido en reposo en el 10°, 20° y 30° minuto de intervención y durante 40 minutos después de la intervención. El TEE se calculó a partir de datos VO2. RESULTADOS: Durante las sesiones de VO2 aumentó un 330% y 166% para PLAY y DDR, respectivamente, en relación al reposo. Se observó que el EPOC en PLAY se produjo a los 10, 20 y 30 minutos post intervención 7,00 ± 1,02 (en reposo) a 10,83 ± 0,94, 10,03 ± 0,58 y 9, 80 ± 0,77 mL.kg-1.min-1, respectivamente. El EPOC en DDR se produjo apenas en el 10° min después de la intervención (7,04 a la 8,61 mL.kg-1.min-1, p <0,01). Después de la intervención, el TEE fue mayor en el DDR y TV (112,08 ± 19,45 vs 56,98 ± 6,34 vs 36,39 ± 4,5 kcal, P <0,01), respectivamente. CONCLUSIÓN: La sesión PLAY llevó a un mayor VO2 durante la actividad y mayor EPOC y gasto de energía en relación a la DDR y TV. Nivel de evidencia A1b; Estudio crossover con.

A duplex endpoint PCR assay for rapid detection and differentiation of leptospira strains

Abstract INTRODUCTION: This study aimed to develop a duplex endpoint PCR assay for rapid detection and differentiation of Leptospira strains. METHODS: Primers were designed to target the rrs (LG1/LG2) and ligB (LP1/LP2) genes to confirm the presence of the Leptospira genus and the pathogenic species, respectively. RESULTS: The assay showed 100% specificity against 17 Leptospira strains with a limit of detection of 23.1pg/µl of leptospiral DNA and sensitivity of 103 leptospires/ml in both spiked urine and water. CONCLUSIONS: Our duplex endpoint PCR assay is suitable for rapid early detection of Leptospira with high sensitivity and specificity.

Psychosocial and Clinical Characteristics and Psychiatric Co-morbidity Among Men and Women with HIV/AIDS under Medical Treatment at a Tertiary Health Care Center in Cali, Colombia

Introduction: Better understanding of psychosocial and health care needs of complex HIV/AIDS patients may facilitate disease management and virologic control. Objectives: To examine the behavioral, psychosocial, and co-morbid characteristics of HIV/AIDS illness in men and women being followed at a tertiary health care center in Colombia. Methods: A sample of HIV+ patients, 114 men and 29 women, was selected for review of clinical records. Results: Men were older (40 vs. 32 yrs.) and more likely to be employed (83 vs. 50%). Of those reporting sexual preference, 33% of men and 100% of women indicated being heterosexual. A higher percentage of men (34%) had CD4 count < 200 cells/mm2 when compared with the women (21%). More men than women had opportunistic infections (75 vs. 48%) and more men tended to be on complex medication regimens (68 vs. 48%). Viral load data was available for 53% of the cases, half of which had > 400 copies/ml. Only 40% of patients attended every scheduled 3-month visit. Less than one-quarter (22%) of the sample was diagnosed by a psychiatrist with a mental disorder and only a small proportion (one-fifth) had a psychiatric follow-up. Conclusions: Our study reveals several important findings among this sample of HIV patients attending a tertiary care private hospital in Cali: (1) the epidemic is rising among women, (2) undetected and under-treated psychiatric illness is highly prevalent, and (3) adherence to scheduled clinical visits is low among patients with a viral load >400 copies/ml. Thus, integrating psychosocial care with behavioral interventions to improve adherence is warranted to counteract these critical issues. An important weakness of this study was that clinical records did not include complete documentation of all variables...

Introducción: Una mejor comprensión de las necesidades psicosociales y de salud de pacientes con VIH/sida de mayor complejidad puede facilitar su manejo y control virológico. Objetivo: Estudiar las características de comportamiento, psicosociales y de comorbilidad en la enfermedad por VIH/sida en hombres y mujeres de un centro de atención nivel tres en Colombia. Método: Revisión de una muestra de pacientes con VIH+ de 114 hombres y 29 mujeres y de sus historias clínicas. Resultados: Los hombres eran de mayor edad (40 vs. 32 años) y estaban empleados (83% vs. 50%). En los que reportaron preferencia sexual, 33% de los hombres y 100% de las mujeres refirieron heterosexualidad. Un mayor porcentaje de hombres (34%) que de mujeres (21%) tuvo un recuento de CD4 <200 células/mm2. Más hombres tenían infecciones oportunistas (75% vs. 48%) y estaban en tratamientos médicos de mayor complejidad (68% vs. 48%). Datos de carga viral estaban disponibles en el 53% de los casos. Solamente 40% asistieron a cada una de las citas trimestrales. El 22% tenía un diagnóstico de enfermedad mental realizado por un psiquiatra, y sólo una quinta parte, seguimiento por psiquiatra. Conclusiones: Nuestro estudio revela tres hallazgos importantes para la población que acude a un hospital privado de nivel tres en la ciudad de Cali: (i) la epidemia está aumentando en mujeres, (ii) la enfermedad psiquiátrica no detectada y no tratada es altamente prevalente y (iii) la adherencia a las visitas programadas fue baja en los pacientes con carga viral >400 copias/ml. Por lo tanto, para mejorar adherencia es prioritario integrar el cuidado psicosocial con las intervenciones sobre el comportamiento y así controlar estos críticos aspectos...

Nutrition, Physical Activity, Weight Management, and Health / Nutrición, actividad física, control de peso y salud

Non-communicable chronic diseases, such as metabolic syndrome, cardiovascular dysfunction, type 2 diabetes, and obesity, make up a large portion of total world-wide mortality, and are becoming more prevalent in developing countries. These diseases have taken on a larger importance, as fertility rates in many developing countries are still rising and contributing to the overall planetary population. Chronic diseases are typically due to poor dietary habits, physical inactivity, and subsequent unhealthy body composition. However, achieving a healthy weight and then sustaining weight loss can reduce obesity-related disorders and improve the risk profile for chronic disease. Weight control through an improved diet style and higher levels of caloric expenditure can also improve the quality of life for people with diabetes, HIV/AIDS, and mental health, although the specific recommendations for the disease may vary slightly. These benefits will last for a long time if the modifications are sustained. Understanding the effects that various diets and physical activity modes and patterns have on healthy weight maintenance will ultimately prove beneficial for people who are otherwise at risk for a variety of chronic diseases.

Enfermedades crónicas no transmisibles, tales como síndrome metabólico, disfunción cardiovascular, diabetes tipo 2 y obesidad, componen una gran proporción de la mortalidad mundial y se están volviendo más prevalentes en países en vía de desarrollo. Estas enfermedades han cobrado importancia debido a que la rata de fertilidad en muchos países subdesarrollados continúa aumentando, contribuyendo a la población mundial. Las enfermedades crónicas se deben generalmente a la presencia de hábitos alimenticios deficientes e inactividad física, con una composición corporal poco saludable como consecuencia. Sin embargo, alcanzar un peso saludable y después sostener la pérdida de peso puede reducir los trastornos relacionados con la obesidad y mejorar el perfil de riesgo para enfermedad crónica. El control de peso a través de un estilo dietario mejorado y mayores niveles de gasto calórico también puede mejorar la calidad de vida de personas con diabetes, VIH/sida y enfermedad mental, aunque las recomendaciones específicas para cada trastorno pueden variar levemente. Estos beneficios serán duraderos si las modificaciones se mantienen. Comprender los efectos que tienen diversas dietas y patrones de actividad física sobre la manutención de un peso saludable beneficiará a personas que de otro modo estarían en riesgo de sufrir una variedad de enfermedades crónicas.