The Relative Age Effect on YoungAthletes of Para-Athletics: Birth quartile analysis and performance in individual athletic events / El Efecto de la Edad Relativa en los Atletas Jóvenes de Paratlético: Análisis de cuartil denacimiento y desempeño en eventos atléticos individuales / O Efeito da Idade Relativa em Jovens Atletas de Paraatletismo: Análise do quartil de nascimento e do desempenho em eventos individuais de atletismo

El Efecto de la Edad Relativa (EER) es un fenómeno caracterizado por una sobrerrepresentación significativa de atletas nacidos en los primeros meses del año competitivo en la misma categoría deedad que se ha observado en categorías juveniles de atletismo. Sin embargo, hay una falta de investigación para investigar este fenómeno y su relación con el deporte para, y no está claro si este efectoestá presente en los jóvenes atletas. Por lo tanto, nuestro estudio examinó la existencia de EER en jóvenes atletaspara-atléticos (categorías U16, U18 y U20) y el rendimiento en eventos deportivos individuales según el cuartil denacimiento (Q1, Q2, Q3 yQ4). Las fechas de nacimiento se recogieron de 700 jóvenes atletas masculinos de deportes para que participaran en eventos deportivos individuales entre 2018 y 2019 en las categorías U16, U18 y U20. En resumen, se observó una distribución desigual de las fechas de nacimiento por cuartil cuando un mayor número de jóvenes para-atletas nació en el primer trimestre del año para U16 (χ²3= 18.785; p = .0003; Phi efecto = 0.45), U18 (χ²3= 6.846; p= .05; Phi efecto = 0.17), y U20 (χ²3= 10.156; p = .017; Phiefecto = 0.17). Sin embargo, cuando comparamos el desempeño de los atletas por evento (eventos de atletismo) y por separado por cuartil, no se encontró diferencia significativa (p> .05). En conclusión, nuestro estudio evidenció el papel influyente de laedad relativa en atletismo, pero parece que este fenómeno no está relacionado con el rendimiento en atletismo.(AU)

The Relative Age Effect (RAE) is a phenomenon characterized by a significant over-representation ofathletes born in the first months of the competitive year in the same age category that has been observed in athletics juvenile categories. However, there is a lack of research to investigate this phenomenon and its relationship with para-sport, and it isnot clear whether this effect is present in young para-athletes. Thus, the present study aims to examine the existence of RAE in young para-athletics athletes (U16, U18, and U20 categories) and the performance in individual athletic events according to the birth quartile (Q1, Q2, Q3, and Q4). Birth dates were collected from 700 young male athletes from para-sport who participated in individual athletic eventsbetween 2018 and 2019 in the U16, U18, and U20 categories. In summary, unequal distribution of birth dates per quartile was observed where a greater number of young para-athletes was born in the Q1 of the year for U16 (χ²3= 18.785; p = .0003; Phi effect = .45), U18 (χ²3= 6.846; p= .05; Phi effect = .17), and U20 (χ²3= 10.156; p= .017; Phi effect =.17). However,when we compared the performance of the athletes by event (track and field events) and separately by quartile, no significant difference was found (p> .05). In conclusion, our study evidenced the influential role of relative age in track and field para-athletes, but it seems that this phenomenon is not related to performance in track and field events.(AU)

O Efeito da Idade Relativa (EIR) é um fenômeno caracterizado por uma significativa representação de atletas nascidos nos primeiros meses do ano competitivo na mesma faixa etária que tem sido observada em categorias juvenis de atletismo. No entanto, há ainda uma lacuna em termos de investigaçãopara analisar esse fenômeno e sua relação com o para-desporto. Assim, o obejtivo do presente estudo foi analisar a existência de EIR em atletas jovens de para-atletismo (categorias Sub-16, Sub-18 e Sub-20) e sua relação com o desempenho em eventos atléticos individuais de acordo com o quartil de nascimento (Q1, Q2, Q3 e Q4). As datas de nascimento foram recolhidas de 700 jovens atletas do sexo masculino de paradesporto que participaram de eventos de atletismo individuais entre 2018 e 2019 nas categorias Sub-16, Sub-18 e Sub-20. No geral, observou-se uma distribuição desigual das datas de nascimento por quartil, onde um maior número de jovens para-atletas nasceu no Q1 do ano para Sub-16 (χ²3= 18.785; p = .0003; Phi effect = .45), Sub-18 (χ²3= 6.846; p= .05; Phi effect = .17), e Sub-20 (χ²3= 10.156; p= .017; Phi effect = .17). Entretanto, quando comparamos o desempenho dos atletas por evento (provas de atletismo) e separadamente por quartil, não houve diferenças significativas (p> .05). Em conclusão, nosso estudo evidenciou o papel influente da idade relativa em paraatletas de atletismo, mas parece que esse fenômeno não está relacionadoao desempenho em eventos desta modalidade.(AU)

Forearm floating with a terrible triad in the elbow after fall, case report.

Perilunate fracture dislocation with an elbow dislocation, it is referred to as a floating forearm. Very few cases have been described worldwide. We report a case of a 37-year-old man diagnosed with a floating forearm (trans-scaphoid perilunate fracture dislocation combined with a terrible triad injury), after a fall of the top of an olive tree. Urgent closed reduction of the elbow and wrist was obtained. A double approach to the wrist was used: dorsal approach to fix the scaphoid and to reduce the carpus and a volar approach to release the median nerve and repair the volar capsule. A lateral approach to the elbow was performed to fix the radial head and to repair the lateral collateral ligament. At 3 months postoperative, the patient had no pain in the elbow and in the wrist. He returned to Work with some restriction at 4-month post operatively.

Morphological and functional cardiac alterations in children with congenital Zika syndrome and severe neurological deficits.

INTRODUCTION: Zika virus infection during pregnancy causes fetal microcephaly and brain damage. Congenital Zika syndrome (CZS) is characterized by systemic involvement with diffuse muscle impairment, a high frequency of arthrogryposis, and microphthalmia. Cardiac impairment in CZS has rarely been evaluated. Our study assessed morphology and biventricular cardiac function in children with CZS and advanced neurological dysfunction. METHODS: This cross-sectional study was conducted on 52 children with CZS (Zika group; ZG) and 25 healthy children (control group; CG) in Paraiba, Brazil. Clinical evaluation, electrocardiogram (EKG), and transthoracic echocardiogram (TTE) were performed on all children. Additionally, troponin I and natriuretic peptide type B (BNP) levels, the degree of cerebral palsy, and neuroimaging findings were assessed in the ZG group. RESULTS: The median age of the study population was 5 years in both groups, and 40.4% (ZG) and 60% (CG) were female. The most prevalent electrocardiographic alteration was sinus arrhythmia in both the ZG (n = 9, 17.3%) and CG (n = 4, 16%). The morphological parameters adjusted for Z score were as follows: left ventricular (LV) end-diastolic diameter in ZG: -2.36 [-5.10, 2.63] vs. CG: -1.07 [-3.43, 0.61], p<0.001); ascending aorta (ZG: -0.09 [-2.08, 1.60] vs. CG: 0.43 [-1.47, 2.2], p = 0.021); basal diameter of the right ventricle (RV) (ZG: -2.34 [-4.90, 0.97] vs. CG: -0.96 [-2.21, 0.40], p<0.01); and pulmonary artery dimension (ZG: -2.13 [-5.99, 0.98] vs. CG: -0.24 [-2.53, 0.59], p<0.01). The ejection fractions (%) were 65.7 and 65.6 in the ZG and CG, respectively (p = 0.968). The left atrium volume indices (mL/m2) in the ZG and CG were 13.15 [6.80, 18.00] and 18.80 [5.90, 25.30] (p<0.01), respectively, and the right atrium volume indices (mL/m2) were 10.10 [4.90, 15.30] and 15.80 [4.10, 24.80] (p<0.01). The functional findings adjusted for Z score were as follows: lateral systolic excursion of the mitral annular plane (MAPSE) (ZG: 0.36 [-2.79, 4.71] vs. CG: 1.79 [-0.93, 4.5], p = 0.001); tricuspid annular plane systolic excursion (TAPSE) (ZG: -2.43 [-5.47, 5.09] vs. CG: 0.07 [-1.98, 3.64], p<0.001); and the S' of the RV (ZG: 1.20 [3.35, 2.90] vs. CG: -0.20 [-2.15, 1.50], p = 0.0121). No differences in biventricular strain measurements were observed between the groups. Troponin I and BNP levels were normal in in the ZG. Grade V cerebral palsy and subcortical calcification were found in 88.6% and 97.22% of children in the ZG group, respectively. CONCLUSION: A reduction in cardiac dimensions and functional changes were found in CZS patients, based on the TAPSE, S' of the RV, and MAPSE, suggesting the importance of cardiac evaluation and follow-up in this group of patients.

Neural network-based method to stratify people at risk for developing diabetic foot: A support system for health professionals.

BACKGROUND AND OBJECTIVE: Diabetes Mellitus (DM) is a chronic disease with a high worldwide prevalence. Diabetic foot is one of the DM complications and compromises health and quality of life, due to the risk of lower limb amputation. This work aimed to build a risk classification system for the evolution of diabetic foot, using Artificial Neural Networks (ANN). METHODS: This methodological study used two databases, one for system design (training and validation) containing 250 participants with DM and another for testing, containing 141 participants. Each subject answered a questionnaire with 54 questions about foot care and sociodemographic information. Participants from both databases were classified by specialists as high or low risk for diabetic foot. Supervised ANN (multi-layer Perceptron-MLP) models were exploited and a smartphone app was built. The app returns a personalized report indicating self-care for each user. The System Usability Scale (SUS) was used for the usability evaluation. RESULTS: MLP models were built and, based on the principle of parsimony, the simplest model was chosen to be implemented in the application. The model achieved accuracy, sensitivity, specificity, positive predictive value, and negative predictive value of 85%, 76%, 91%, 89%, and 79%, respectively, for the test data. The app presented good usability (93.33 points on a scale from 0 to 100). CONCLUSIONS: The study showed that the proposed model has satisfactory performance and is simple, considering that it requires only 10 variables. This simplicity facilitates its use by health professionals and patients with diabetes.

Young Basketball Players' Multiple Object Tracking Skills Were Unaffected by Stroop-Induced Mental Fatigue.

We aimed to examine the acute effect of mental fatigue on young basketball players' three-dimensional multiple object tracking (3D-MOT) skills. Our participants were 12 adolescent basketball players (M age = 16.66, SD = 1.87 years; M years of practice = 2.66, SD = 1.07 years). In nine lab visits, we used visits 1 to 7 to familiarize participants with 3D-MOT, a subjective scale of mental fatigue, and a Stroop task involving mental set shifting. In the last two visits, participants performed in both experimental (EXP) and control (CON) conditions that were presented in randomized order. In the EXP condition, participants performed 3D-MOT pre- and post-60 minutes of induced mental fatigue; in the CON condition, they watched a documentary. After each condition, B participants performed the National Aeronautics and Space Administration Task Load Index (NASA-TLX). 3D-MOT performance measures were the "score" and "fastest trial score success." The response time on the Stroop tasks increased throughout the mental fatigue inducement in the experimental condition (p = .0037). The NASA-TLX responses were higher following the EXP condition than following the CON condition for mental demand, temporal demand, and performance (all ps < .05). Still, there were no significant EXP versus CON differences on the 3D-MOT performance indicators.

Playing videogames or using social media applications on smartphones causes mental fatigue and impairs decision-making performance in amateur boxers.

This study aimed to analyze the effect of playing videogames and using social media applications on smartphones on decision-making and countermovement jump (CMJ) performance in amateur boxers. Twenty one boxers were enrolled in the study and were randomly assigned to all three experimental conditions [smartphone (30SMA), videogame (30VID), and control (CON)]. CMJ was measured before and 30-min after each experimental condition. The athletes ran simulated combat recorded for decision-making analysis. The boxers watched coaching videos (CON), used social media applications on smartphones (30SMA), and played video games (30VID) for 30 min just before the combat simulation. Both attack and defense decision-making performance were worse in both 30SMA and 30VID conditions compared to the CON condition (p = 0.001). Regarding CMJ, despite no condition effect (p = 0.96) been obtained, a time effect (p = 0.001) was observed; So, it was found a decrease in CMJ performance after all experimental conditions (p = 0.001), with no difference between them. Using social media applications on smartphones and playing video game impairs decision-making performance in amateur boxers, with no harms for CMJ performance.

Atlantic flower-invertebrate interactions: A data set of occurrence and frequency of floral visits.

Encounters between flowers and invertebrates are key events for the functioning of tropical forests. Assessing the structure of networks composed of the interactions between those partners leads to a better understanding of ecosystem functioning and the effects of environmental factors on ecological processes. Gathering such data is, however, costly and time-consuming, especially in the highly diverse tropics. We aimed to provide a comprehensive repository of available flower-invertebrate interaction information for the Atlantic Forest, a South American tropical forest domain. Data were obtained from published works and "gray literature," such as theses and dissertations, as well as self-reports by co-authors. The data set has ~18,000 interaction records forming 482 networks, each containing between one and 1061 interaction links. Each network was sampled for about 200 h or less, with few exceptions. A total of 641 plant genera within 136 different families and 39 orders were reported, with the most abundant and rich families being Asteraceae, Fabaceae, and Rubiaceae. Invertebrates interacting with these plants were all arthropods from 10 orders, 129 families, and 581 genera, comprising 2419 morphotypes (including 988 named species). Hymenoptera was the most abundant and diverse order, with at least six times more records than the second-ranked order (Lepidoptera). The complete data set shows Hymenoptera interacting with all plant orders and also shows Diptera, Lepidoptera, Coleoptera, and Hemiptera to be important nodes. Among plants, Asterales and Fabales had the highest number of interactions. The best sampled environment was forest (~8000 records), followed by pastures and crops. Savanna, grasslands, and urban environments (among others) were also reported, indicating a wide range of approaches dedicated to collecting flower-invertebrate interaction data in the Atlantic Forest domain. Nevertheless, most reported data were from forest understory or lower strata, indicating a knowledge gap about flower-invertebrate interactions at the canopy. Also, access to remote regions remains a limitation, generating sampling bias across the geographical range of the Atlantic Forest. Future studies in these continuous and hard-to-access forested areas will yield important new information regarding the interactions between flowers and invertebrates in the Atlantic Forest. There are no copyright restrictions on the data set. Please cite this data paper if the data are used in publications and teaching events.

Physiological selectivity and tolerance of social wasps exposed to Malathion.

Insect pest infestations are a worldwide problem as a result of human actions. Among them, Aedes aegypti stands out as vector of several diseases. Like other pests, A. aegypti has become resistant to the insecticide used for its control, thus harming the local fauna of non-target insects. Therefore, the aim of this study was to study the physiological selectivity of social wasps exposed to Malathion, as well as to investigate possible resistance to this insecticide. Adults of the swarming species Polybia platycephala and Protopolybia sedula and the independent species Polistes versicolor were exposed to four Malathion concentrations. Overall, Malathion was more selective to P. versicolor and more toxic to P. platycephala, and despite the decrease in the concentration of the product recommended by the manufacturer, which in theory would be sublethal doses, social wasps still exhibited high mortality rates. In comparing the mortalities of species collected in an area where there is no application of the insecticide with an area where there is regular application, the data showed an indication that populations of non-target insects are also becoming resistant to insecticides, especially in urban environments.

Spatial correlates of COVID-19 first wave across continental Portugal.

The first case of COVID-19 in continental Portugal was documented on the 2nd of March 2020 and about seven months later more than 75 thousand infections had been reported. Although several factors correlate significantly with the spatial incidence of COVID-19 worldwide, the drivers of spatial incidence of this virus remain poorly known and need further exploration. In this study, we analyse the spatiotemporal patterns of COVID-19 incidence in the at the municipality level and test for significant relationships between these patterns and environmental, socioeconomic, demographic and human mobility factors to identify the mains drivers of COVID-19 incidence across time and space. We used a generalized liner mixed model, which accounts for zero inflated cases and spatial autocorrelation to identify significant relationships between the spatiotemporal incidence and the considered set of driving factors. Some of these relationships were particularly consistent across time, including the 'percentage of employment in services'; 'average time of commuting using individual transportation'; 'percentage of employment in the agricultural sector'; and 'average family size'. Comparing the preventive measures in Portugal (e.g., restrictions on mobility and crowd around) with the model results clearly show that COVID-19 incidence fluctuates as those measures are imposed or relieved. This shows that our model can be a useful tool to help decision-makers in defining prevention and/or mitigation policies.

Double emulsions as delivery systems for iron: Stability kinetics and improved bioaccessibility in infants and adults.

Iron deficiency is one of the main causes of anemia in the world, especially in children and women, so food fortification through microencapsulation is a viable alternative to combat this deficiency. The present work aimed to encapsulate iron in a water-in-oil-in-water double emulsion (W1/O/W2), which was formed with whey protein isolate and polyglycerol polyricinoleate as the emulsifying agents, tara gum as a thickening agent, and sucrose as an osmotic active substance. The double emulsion formed with 12% whey protein isolate, 0.8% tara gum, and 2% sucrose presented high encapsulation efficiency (96.95 ± 1.00%) and good stability (up to 7 days). Additionally, after the in vitro gastrointestinal simulations, the bioaccessibility was high for adults (49.54 ± 5.50%) and infants (39.71 ± 2.33%). Finally, the study show that double emulsions can form stable systems with high iron bioaccessibility even in infant gastric systems, which indicates the possibility of using double emulsions to fortify food with iron.

Automatic detection of vegetation cover changes in urban-rural interface areas.

The present work started from the need to streamline the process of monitoring changes in vegetation in the in urban-rural interface fuel management bands, defined by Portuguese legislation as areas where the existing biomass must be totally or partially removed. The model developed uses a time series of Sentinel 2 satellite images to search for changes in the vegetation cover in a 100 m buffer around built-up areas. The use of satellite data allows analysing large areas and speeds up the task of identifying the places where fuel management took place and the places where there is a need to carry out such management. The objective of the proposed method is to give a script in Python language that can verify the cleanliness of vegetation in the fuel management ranges through multi-temporal analysis of satellite images. • The paper presents a step-by-step procedure for a Sentinel 2 time series vegetation index analysis. • Automated routine to detection of spatiotemporal vegetation changes based on statistical parameters. • Used Python language to do geoprocessing analysis.

Análise de desvios na desparamentação de equipamentos de proteção individual no contexto da pandemia de COVID-19: macacão versus avental longo / Analysis of deviations in the doffing of personal protective equipment in the context of the COVID-19 pandemic: overalls versus long apron

Introdução: a vulnerabilidade de profissionais de saúde em relação ao risco de autocontaminação por COVID-19 durante assistência clínica é agravada por desvios no uso de equipamentos de proteção individual (EPI). Objetivos: determinar a incidência dos desvios de procedimento na desparamentação dos EPI contendo macacão e avental longo; comparar a incidência dos desvios entre eles; além de analisar a associação a demais fatores levantados. Método: estudo de abordagem quantitativa, observacional e transversal, que levantou os desvios de procedimento em dois protocolos de desparamentação de EPI respectivamente contendo macacão e avental longo em dois hospitais públicos. Foram avaliados profissionais de diferentes faixas etárias e profissões, atuantes em unidade de terapia intensiva coorte coronavírus, sendo videogravadas 335 desparamentações, o que permitiu análise minuciosa dos desvios de procedimento cometidos. Resultados: a retirada da máscara N-95 exibiu taxa de desvio semelhante nos dois cenários (67,6% macacão versus 61,9% avental). A higiene das mãos obteve 87,7% de desvios (macacão) versus 55,5% (avental). Quanto à retirada do macacão e avental longo, a incidência foi de 73% de desvios (macacão) contra 6,5% (avental). Botas impermeáveis tiveram 79,7% de desvios, enquanto sapatilhas descartáveis 26,9%. Evidenciou-se que seguir exatamente a ordem dos procedimentos preconizados pelas instituições contribuiu para menor autocontaminação (macacão, p=0,03 e avental p=0,006). A desparamentação em tempo mais curto demonstrou maior número de desvios e autocontaminação, enquanto os profissionais que retiraram em tempo maior, tiveram menor número de desvios e, consequentemente, menor autocontaminação. Conclusão: observou-se que o conjunto mais complexo contendo macacão em sua composição exibiu maiores desvios, induzindo a maior autocontaminação dos profissionais em diversos quesitos, quando comparado com o conjunto com avental. Os resultados desta pesquisa dão subsídios para tomada de decisão de gestores quanto ao modelo a ser adotado, avaliando prós e contras, além de direcionar treinamento de profissionais de saúde visando sua maior segurança, especialmente em eventos com potenciais riscos biológicos.

Objective: to determine the incidence of procedure deviations in PPE containing coveralls and gown, comparing the insufficiency of deviations between them to study the association with other factors raised. Method: observational, cross-sectional study, quantitative, was raised the procedure deviations in two PPE doffing protocols, respectively coveralls and gown in two hospitals. Professionals of different age groups and professions, working in coronavirus cohort ICUs, were evaluated, and 335 undressings were recorded, which allowed a thorough analysis of the deviations of procedure committed. Results: removal of the N-95 mask exhibited a similar deviation rate across scenarios (67.6% overalls versus 61.9% apron). Hand hygiene obtained 87.7% of deviations (coveralls) versus 55.5% (apron). Regarding the removal of the coveralls and gown, the incidence was 73% of deviations (coveralls), against 6.5% (gown). Waterproof boots had 79.7% deviations, while disposable sneakers 26.9%. We showed that following exactly the order of the procedure recommended by the institutions contributed to less self-contamination (overalls, p=0.03 and apron p=0.006). The shorter doffing time showed a greater number of deviations and self-contamination, while the professionals who removed the clothes in a longer time had fewer deviations and consequently less self-contamination. Conclusion: we observed that the more complex set containing coveralls in its composition exhibited greater deviations, inducing greater self-contamination in several aspects when compared to the set with gown. The results of this research provide support for the decision of managers regarding the model to be adopted, evaluating pros and cons, in addition to directing training of health professionals aiming at their greater safety.

Effects of smartphone use before resistance exercise on inhibitory control, heart rate variability, and countermovement jump.

BACKGROUND: The effect of MF induced by exposure time to social media smartphone apps on inhibitory control, heart rate variability (HRV), and high-intensity physical effort following a resistance exercise session might indicate whether strength and conditioning professionals should suggest avoiding smartphone usage before a resistance exercise session. AIM: The objective of this study was to analyze the effect of mental fatigue on inhibitory control, HRV, and countermovement jump (CMJ) in trained adults after resistance exercise. METHODS: A total of 16 trained males (21.4 ± 3.3 years) volunteered in this study. The participants performed resistance exercises with and without mental fatigue. The Stroop Task, countermovement jump, and heart rate variability were evaluated before and after the resistance exercise. The participants used smartphones in the mental fatigue condition, whereas the participants watched TV in the control condition. RESULTS: No condition × time interaction was found for the Stroop accuracy (p = 0.87), CMJ (p = 0.68), SDNN (p = 0.15), or pNN50 (p = 0.15) in the heart rate variability. An interaction was found for Stroop response time (p = 0.01) with a higher response time for the mental fatigue condition (p = 0.01). CONCLUSIONS: Mental fatigue impaired the inhibitory control performance after a resistance exercise session in trained adults.

Cognitive and balance dysfunctions due to the use of zolpidem in the elderly: a systematic review.

Zolpidem is one of the most widely prescribed hypnotic (non-benzodiazepine) agents for sleep disorder. Recently, an increase in the demand for this drug has been observed, mainly in the elderly population. OBJECTIVE: This study aims to analyze the acute effect of zolpidem on cognitive and balance dysfunctions in the elderly population. METHODS: A study was conducted by two independent researchers in four virtual scientific information bases and included randomized controlled trials. The studies evaluated elderly patients using zolpidem. Cognitive and balance dysfunctions were analyzed. RESULTS: Six articles were included. The mean age of the participants in the studies was 69 years. The following zolpidem dosages were evaluated: 5, 6.25, 10, and 12.5 mg. Comparing zolpidem and placebo, relating to the cognitive dysfunctions, there is no statistically significant difference between the groups. However, in relation to balance dysfunctions, there is a statistically significant difference between the intervention and the comparison, favoring placebo. CONCLUSIONS: Zolpidem, even in usual doses (5 mg and 10 mg), has shown to increase the risk for balance dysfunctions. However, this does not occur in relation to cognitive changes.

Zolpidem é um dos agentes hipnóticos (não benzodiazepínicos) mais prescritos para o manejo dos distúrbios do sono. Recentemente, observou-se um aumento na demanda por esse medicamento, principalmente pela população idosa. OBJETIVO: Este estudo visa analisar o efeito agudo do zolpidem em relação às alterações cognitivas e de equilíbrio na população idosa. MÉTODOS: Uma busca em quatro bases de informação científica virtual foi feita por dois pesquisadores independentes e incluiu ensaios clínicos randomizados. Os estudos avaliaram o uso de zolpidem em pacientes idosos. Alterações cognitivas e de equilíbrio foram analisadas. RESULTADOS: Seis artigos foram incluídos. A média de idade entre os estudos foi de 69 anos. As seguintes posologias foram analisadas: 5; 6,25; 10; e 12,5 mg. Em relação às alterações cognitivas, comparando-se zolpidem com placebo, não há diferença estatisticamente significativa entre os grupos. Entretanto, no desfecho alterações de equilíbrio, há diferença estatisticamente significativa entre intervenção e comparação, a favor do placebo. CONCLUSÕES: Zolpidem, mesmo em doses usuais (5 e 10 mg), mostrou aumentar o risco para alterações de equilíbrio, entretanto, isso não ocorre em relação às alterações cognitivas.

Cognitive and balance dysfunctions due to the use of zolpidem in the elderly: a systematic review / Alterações cognitivas e de equilíbrio devido ao uso de zolpidem em idosos: uma revisão sistemática

ABSTRACT. Zolpidem is one of the most widely prescribed hypnotic (non-benzodiazepine) agents for sleep disorder. Recently, an increase in the demand for this drug has been observed, mainly in the elderly population. Objective: This study aims to analyze the acute effect of zolpidem on cognitive and balance dysfunctions in the elderly population. Methods: A study was conducted by two independent researchers in four virtual scientific information bases and included randomized controlled trials. The studies evaluated elderly patients using zolpidem. Cognitive and balance dysfunctions were analyzed. Results: Six articles were included. The mean age of the participants in the studies was 69 years. The following zolpidem dosages were evaluated: 5, 6.25, 10, and 12.5 mg. Comparing zolpidem and placebo, relating to the cognitive dysfunctions, there is no statistically significant difference between the groups. However, in relation to balance dysfunctions, there is a statistically significant difference between the intervention and the comparison, favoring placebo. Conclusions: Zolpidem, even in usual doses (5 mg and 10 mg), has shown to increase the risk for balance dysfunctions. However, this does not occur in relation to cognitive changes.

RESUMO. Zolpidem é um dos agentes hipnóticos (não benzodiazepínicos) mais prescritos para o manejo dos distúrbios do sono. Recentemente, observou-se um aumento na demanda por esse medicamento, principalmente pela população idosa. Objetivo: Este estudo visa analisar o efeito agudo do zolpidem em relação às alterações cognitivas e de equilíbrio na população idosa. Métodos: Uma busca em quatro bases de informação científica virtual foi feita por dois pesquisadores independentes e incluiu ensaios clínicos randomizados. Os estudos avaliaram o uso de zolpidem em pacientes idosos. Alterações cognitivas e de equilíbrio foram analisadas. Resultados: Seis artigos foram incluídos. A média de idade entre os estudos foi de 69 anos. As seguintes posologias foram analisadas: 5; 6,25; 10; e 12,5 mg. Em relação às alterações cognitivas, comparando-se zolpidem com placebo, não há diferença estatisticamente significativa entre os grupos. Entretanto, no desfecho alterações de equilíbrio, há diferença estatisticamente significativa entre intervenção e comparação, a favor do placebo. Conclusões: Zolpidem, mesmo em doses usuais (5 e 10 mg), mostrou aumentar o risco para alterações de equilíbrio, entretanto, isso não ocorre em relação às alterações cognitivas.

Small Bowel Obstruction Due to Incarcerated Obturator Hernia: Successfull Surgical Management with Modified Mesh-Plug Hernioplasty.

BACKGROUND Obturator hernia is an uncommon (0.07-1% incidence rate) subtype of hernia of the abdominal wall, with its incarceration being a rare cause of bowel obstruction. Obturator hernia has a higher incidence in elderly women and in malnourished people. This type of hernia has the highest morbidity and mortality rates of all abdominal wall hernias. This article reports a case of an emaciated 93-year-old woman who presented with small bowel obstruction due to incarcerated obturator hernia, successfully managed surgically with a modified mesh-plug hernioplasty. CASE REPORT An emaciated 93-year-old woman presented with diffuse abdominal pain, more intense on the right iliac fossa, radiating to the right thigh, with 8-h evolution and associated with dark-colored vomiting but normal bowel transit. This patient had a surgical history of right Richter´s femoral hernia, strangulated, with previous intestinal resection and a right femoral hernioplasty. A computed tomography (CT) scan revealed an incarcerated obturator hernia on the right side containing a short segment of small intestine. The patient underwent an exploratory laparotomy and a mesh-plug hernioplasty. During follow-up, there was no evidence of recurrence or complications. CONCLUSIONS Obturator hernia diagnosis is challenging due to its rarity and its signs and symptoms being often unspecific. CT scan has the highest sensitivity and is the best diagnostic tool. Surgical management is the only possible treatment for obturator hernia. Awareness of this condition is essential to allow an earlier approach and attempt to mitigate the associated high morbidity and mortality rates.

Effects of Mental Fatigue Induced by Social Media Use on Volleyball Decision-Making, Endurance, and Countermovement Jump Performance.

We studied the effects of repeated inducements of mental fatigue (MF) from using social media on smartphones immediately before training sessions by young male volleyball athletes, focusing specifically on their decision-making, endurance, and countermovement jump performance (CMJ). We pair-matched 24 participants according to their decision-making abilities and then, randomly assigned them to one of two 4-week block training groups: control (CON) and smartphone use (SMA). For a 30-minute period before each training session, the CON group watched TV and the SMA group used social media apps on smartphones. We found a significant group x time interaction effect for decision making (attack, p = 0.03; passing, p = 0.02) during training blocks. More specifically, only the CON group improved their decision making (attack, p = 0.03; passing, p = 0.02). Both groups significantly improved their CMJ performance (p = .01), with no significant group x time interaction effect for CMJ (p = 0.91). Neither group significantly improved their endurance (p = 0.56). We concluded that 30-minutes of repetitive social media app use on a smartphone immediately before 4-weeks of volleyball training sessions negatively affected decision-making in young male volleyball athletes.

Virtual reality promotes greater improvements than video-stimulation screen on perceptual-cognitive skills in young soccer athletes.

Background The literature has shown the positive effect of virtual reality (VR) in percepto-cognitive skills. However, the literature lacks findings about at what extent VR would be better than video. Purpose This study aimed to analyze the chronic effect of VR and video-stimulation screen training on passing decision-making, visual search behavior, and inhibitory control performance in young soccer athletes. Method A total of 26 young soccer players underwent an 8-week training protocol after being randomly assigned to the VR (n = 13) or video-screen (VID, n = 13) group. Passing decision-making, visual search behavior, and inhibitory control performance were measured before and after both interventions. Results A group x time interaction was found for decision-making performance (p < 0.01) and visual search behavior (p < 0.01). Both groups improved both decision-making performance (p < 0.01) and visual search behavior (p < 0.01); however, greater improvements were verified in VR (p < 0.01). Both VR and VID improved inhibitory control (p < 0.01), but no group interaction effect was observed (p > 0.05). Conclusion Our results suggest that VR leads to greater improvements in decision-making and visual search behavior in young soccer athletes than VID.

Orotracheal tube versus supraglottic devices in biological, chemical and radiological disasters: meta-analysis in manikin-based studies.

OBJECTIVE: To compare the mean time of orotracheal intubation and insertion of supraglottic airway devices, considering healthcare providers wearing waterproof overall, gloves, boots, eye protection and mask at the Chemical, Biological, Radiological and Nuclear context in simulation setting. METHODS: Six databases were searched. The selected studies were put in a pool of results using a random-effects meta-analysis, with standardized mean differences and calculation of 95% confidence intervals. RESULTS: Nine observational studies were included. Regarding reducing time to provide ventilatory support, subgroup analyses were made. The emergency setting subgroup: -12.97 [-16.11; -9.83]; I2 = 64%. The surgery setting subgroup: -14.96 [-18.65; -11.27]; I2 = 75%. Another analysis was made by reproductive methodology subgroups. Ophir's subgroup: -15.70 [-17.04; -14.37]; I2 = 0%. All meta-analyses had orotracheal tube as comparator. CONCLUSION: Moderate level of evidence was in favor of insertion of supraglottic devices because of fast application.

Satisfação sexual de mulheres que fazem hemodiálise: análise correlacional com marcadores de vulnerabilidade social / Sexual satisfaction of women undergoing hemodialysis: correlational analysis with social vulnerability markers

Objetivou-se analisar a correlação estabelecida entre os marcadores de vulnerabilidade social com a satisfação sexual de mulheres submetidas ao tratamento hemodialítico. Estudo correlacional de corte transversal, desenvolvido com 102 mulheres em tratamento dialítico no único hospital do Alto Sertão Produtivo da Bahia, na cidade de Guanambi. Aplicou-se um questionário estruturado, contendo questões referentes à vulnerabilidade social e à vida sexual. Os dados foram processados no software Statistical Package for the Social Sciences (SPSS) versão 22.0, o qual realizou o teste Qui² (r) de Pearson. Adotou-se o nível de significância de 0,05. Foram estabelecidas correlações entre satisfação sexual com os marcadores de vulnerabilidade social, cujos valores de p e r estatisticamente aceitáveis são: idade (p = -0,04750; r = -0,79799), estado civil (p = -0,04177; r = -0,9360), nível de escolaridade (p = -0,01909; r = -0,4750) e religião (p = 0,03055; r = 0,53055). Conclui-se que tanto as variáveis biológicas quanto comportamentais, quando correlacionadas, estão relacionadas na percepção da satisfação sexual conforme as suas vulnerabilidades.

This study aimed to analyze the correlation established between the social vulnerability markers with sexual satisfaction of women undergoing hemodialysis. Cross-sectional, correlational study, developed with 102 women receiving dialysis, at the only hospital of Alto Sertão Produtivo in Bahia. A structured questionnaire was used, with questions regarding social vulnerability and sexual activity. Data were processed using the software Statistical Package for the Social Sciences (SPSS) version 22.0, which performed Pearson's chi-squared test. The adopted significance level was 0,05. Correlations between sexual satisfaction with social vulnerability markers were established, whose p and r values were statistically acceptable: age (p= -0,04750; r= -0,79799), marital status (p= -0,04177; r= -0,9360), education level (p= -0,01909; r= -0,4750) and religion (p= 0,03055; r= 0,53055). It was concluded that both biological and behavioral variables, when correlated, are related in the perception of sexual satisfaction according to their vulnerabilities.