Clinical and Laboratory Data Up on Hospital Admission are Predictors of New-Onset Atrial Fibrillation in Patients Hospitalized Due to COVID-19 Pneumonia. / Variáveis Clínicas e Laboratoriais na Admissão Hospitalar são Preditores de Fibrilação Atrial Nova em Pacientes Internados com Pneumonia por COVID-19.

BACKGROUND: New-onset atrial fibrillation (NOAF) occurs in patients hospitalized due to COVID-19. It is still unknown whether clinical and laboratory data assessed upon hospital admission have predictive value for NOAF. OBJECTIVES: To analyze, upon hospital admission, variables with predictive potential for the occurrence of NOAF in patients with COVID-19 pneumonia. METHODS: Observational, retrospective, case-control study. Electronic medical reports of consecutive patients, 60 years of age or older, hospitalized due to COVID-19 pneumonia between March 1st and July 15th, 2020, were reviewed. Non-paired Student or chi-squared tests compared variables. A Cox proportional hazard model was employed to identify independent predictors of NOAF. P value < 0.05 was considered statistically significant. RESULTS: Among 667 patients hospitalized due to COVID-19, 201 (30.1%) fulfilled the inclusion criteria. NOAF was documented in 29 patients (14.4%), composing group 1. Group 2 was composed of 162 patients without NOAF. Ten patients were excluded due to the AF rhythm upon hospital admission. In groups 1 and 2, there were differences in overall in-hospital survival rate (24.1 % vs. 67.9%; p<0.001), length of stay in ICU (11.1 ± 10.5 days vs. 4.9 ± 7.5 days; p=0.004) and need for mechanical ventilation rate (82.9% vs. 32.7%; p<0.001). In the Cox model, age > 71 y/o (HR=6.8; p<0.001), total leukocyte count ≤ 7,720 cels.µL-¹ (HR=6.6; p<0.001), serum [Na+] ≤ 137 mEq.L-¹ (HR=5.0; p=0.001), SAPS3 score > 55 (HR=5.6; p=0.002), and disorientation (HR=2.5; p=0.04) on admission were independent predictors of NOAF. CONCLUSION: NOAF is a common arrhythmia in elderly hospitalized patients with COVID-19 pneumonia. Clinical and laboratory parameters evaluated on admission have a predictive value for the occurrence of NOAF during hospitalization.

FUNDAMENTO: Fibrilação atrial nova (FAN) ocorre em pacientes internados por COVID-19. Há controvérsias quanto ao valor preditivo de dados clínicos e laboratoriais à admissão hospitalar para ocorrência de FAN. OBJETIVOS: Analisar, à admissão hospitalar, variáveis com potencial preditivo para ocorrência de FAN em pacientes com pneumonia por COVID-19. MÉTODO: Estudo observacional, retrospectivo, caso-controle. Foram avaliados prontuários eletrônicos de pacientes consecutivos ≥ 60 anos, hospitalizados com pneumonia por COVID-19 entre 1º de março e 15 de julho de 2020. Comparações feitas pelos testes `t' de Student ou qui-quadrado. Foi empregado modelo de risco proporcional de Cox para identificação de preditores de FAN. Considerou-se o valor de p < 0,05 como estatisticamente significativo. RESULTADOS: Entre 667 pacientes internados por COVID-19, 201 (30,1%) foram incluídos. FAN foi documentada em 29 pacientes (14,4%) (grupo 1). Grupo 2 foi composto por 162 pacientes que não apresentaram FAN. Dez pacientes excluídos por estarem em FA na admissão hospitalar. Houve diferenças entre os grupos 1 e 2, respectivamente, no tempo de permanência em UTI (11,1±10,5 dias vs. 4,9±7,5 dias; p=0,004), necessidade de ventilação invasiva (82,9% e 32,7%; p<0,001) e mortalidade hospitalar (75,9% vs. 32,1%; p<0,001). No modelo de Cox, idade > 71 anos (hazard ratio [HR]=6,8; p<0,001), leucometria ≤ 7.720 cels.µL-1 (HR=6,6; p<0,001), natremia ≤ 137 mEq.L-1 (HR=5,0; p=0,001), escore SAPS3 > 55 (HR=5,6; p=0,002) e desorientação (HR=2,5; p=0,04) foram preditores independentes de FAN. CONCLUSÕES: FAN é uma arritmia comum em idosos hospitalizados com pneumonia por COVID-19. Parâmetros clínicos e laboratoriais avaliados na admissão são preditores de FAN durante internação.

Resistance Exercise Sessions Comprising Multijoint vs. Single-Joint Exercises Result in Similar Metabolic and Hormonal Responses, But Distinct Levels of Muscle Damage in Trained Men.

ABSTRACT: Barbosa, PH, Bueno de Camargo, JB, Jonas de Oliveira, J, Reis Barbosa, CG, Santos da Silva, A, Dos-Santos, JW, Verlengia, R, Barreira, J, Braz, TV, and Lopes, CR. Resistance exercise sessions comprising multijoint vs. single-joint exercises result in similar metabolic and hormonal responses, but distinct levels of muscle damage in trained men. J Strength Cond Res 38(5): 842-847, 2024-Resistance-type exercise (RE) elicits distinct acute metabolic and hormonal responses, which can be modulated by the manipulation of training variables. The purpose of this study was to compare the metabolic (blood lactate and estimated lactic anaerobic system energy expenditure) and hormonal (growth hormone [GH]) responses to RE sessions composed exclusively of multijoint (MULTI) or single-joint (SINGLE) exercises. Assessments of creatine kinase (CK) levels were also performed. In a crossover design, 10 recreationally resistance-trained men (age: 26.9 ± 3.0 years, total body mass: 83.2 ± 13.8 kg; height: 176 ± 7.0 cm; training experience: 5.5 ± 2.4 years) were randomly submitted to both protocols. Blood collections were made pre, 3 minutes after, and 36 hours after each experimental session. No significant difference between MULTI vs. SINGLE was observed for the rises in blood lactate (p = 0.057) and GH (p = 0.285) levels. For CK, a significant difference between the protocols was noted, in which MULTI resulted in significant rises after 3 minutes (p = 0.017) and 36 hours (p = 0.043) compared with SINGLE. In conclusion, the findings of this study suggest that resistance-trained individuals display similar metabolic and hormonal responses when performing MULTI and SINGLE exercise protocols. Also, RE sessions comprising MULTI exercises induce a higher magnitude of muscle damage, which may require a longer recovery period compared with SINGLE.

Predictive Model of All-Cause Death in Patients with Heart Failure using Heart Rate Variability. / Modelo Preditivo de Mortalidade por Todas as Causas em Pacientes com Insuficiência Cardíaca Usando a Variabilidade da Frequência Cardíaca.

BACKGROUND: Central Illustration : Predictive Model of All-Cause Death in Patients with Heart Failure using Heart Rate Variability. BACKGROUND: Short and long-duration heart rate variability (HRV) data from Holter monitoring could identify predictors of all-cause death in heart failure (HF) patients. OBJECTIVES: To build a predictive model of all-cause death in patients with HF using HRV. METHODS: Retrospective study including patients with suspected or confirmed HF who were admitted for decompensated HF or syncope that underwent Holter monitoring. In analysis of augmented sympathetic tonus, we evaluated the lowest HRV in nonoverlapping 10-minutes periods throughout 24h continuous electrocardiographic signal recording (short HRV variables). Variables with p<0.01 were included in a multivariate Cox regression model to determine the occurrence of the all-cause death. Variables with statistical significance in Cox regression were chosen to build the predictive model. P<0.05 was considered significant. RESULTS: A total of 116 patients were included, mean age of 71.9±16.3 years, 45.7% men, mean follow-up of 2.83±1.27 years. Thirty-nine deaths occurred (33.6%). By comparing survivors vs. non-survivors, the variables that showed statistical significance were lowest SDNN, lowest rMSSD, age and left ventricular ejection fraction (LVEF). In Cox regression, independent predictors of all-cause death were: age>69 years (HR 3.95, 95%CI 1.64-9.52); LVEF≤57% (HR 4.70, 95%CI 2.38-9.28) and lowest rMSSD≤12ms (HR 5.54, 95%CI 2.04-15.08). An integer value was assigned to each variable. Score<3 showed AUC=0.802 (95%CI 0.72-0.87). CONCLUSION: In HF patients hospitalized for decompensated HF or syncope, independent long-term predictors of all-cause death were age, LVEF, and 10-minutes rMSSD. These findings indicate that even brief moments of high sympathetic tone can impact survival, specifically in the elderly and patients with HF with reduced ejection fraction.

Familiarity of Brazilian psychologists with basic concepts in sleep science and chronobiology.

Desynchronization of circadian rhythms and sleep-wake patterns impacts biochemical, physiological, and behavioral functions, including mental processes. The complex relationship between circadian rhythms and mental health makes it challenging to determine causality between circadian desynchronization and mental disorders. Regarding the fact that psychologists act as the front line for initial mental health care, we aimed to assess the knowledge and use of sleep science and basic chronobiology by professional psychologists in Brazil. Data were collected via an online questionnaire completed by 1384 professional psychologists between October 2018 and May 2019. Our findings revealed that ±80% of psychologists reported that at least half of their patients presented some sleep-related complaints; however, only ±27% routinely inquired about sleep quality even in the absence of patient complaints. Additionally, only ±66% initiated treatments to understand these complaints, potentially influenced by the lack of prior academic exposure to biological rhythms as reported by ±76% of Brazilian psychologists interviewed. Importantly, ±15% did not believe in an association between mental health and biological rhythms, and even a significant ±67% were unfamiliar with the term chronobiology and ±63% were not able to describe any other biological rhythm except for the sleep-wake cycle. These results demonstrate that fundamental concepts in chronobiology and sleep science are unknown to a substantial proportion of Brazilian psychologists. In conclusion, we propose that this subject could be more effectively integrated into psychologists' academic training, potentially promoting benefits through the incorporation of a chronobiological approach in mental health practice.

Olfaction Response and Fertility Life Table Parameters of Tetrastichus howardi (Hymenoptera: Eulophidae) Parasitizing Plutella xylostella (Lepidoptera: Plutellidae) and the factitious host Tenebrio molitor (Coleoptera: Tenebrionidae).

Tetrastichus howardi (Olliff) (Hymenoptera: Eulophidae) parasitizes the diamond back moth Plutella xylostella (L.) (Lepidoptera: Plutellidae), but not much is known about its potential as a biocontrol agent. A rearing protocol has been established for this parasitoid on pupae of the factitious host Tenebrio molitor (L.) (Coleoptera: Tenebrionidae), with the aim of releasing it in the field to manage several lepidopteran species. The potential population growth of a parasitoid can be measured through fertility life tables and provide supporting information for using T. howardi in the management of P. xylostella. Also, the fitness and behavior of T. howardi reared on a factitious host can be indicators of its potential to control P. xylostella. Thus, in this study, the fertility life table parameters of T. howardi parasitizing P. xylostella were determined, as well as the effects of the natal host on the behavior of T. howardi towards host volatiles and parasitism rate. The results showed that net reproduction rate (Ro) and the intrinsic rate of population growth (rm) of T. howardi parasitizing P. xylostella were 13.6 (♀/♀) and 0.124 (♀/♀*day), respectively, whereas the mean generation time was 20.9 days. Moreover, the natal host (T. molitor or P. xylostella) did not affect the fitness, parasitism rate, or olfactory response of T. howardi. In general, regardless of the natal host, parasitoid females responded to volatiles of both host species and exhibited the same rate of parasitism on P. xylostella. Therefore, T. howardi reared on the factitious host maintains its attraction and potential to parasitize P. xylostella, and can contribute to the biological control of this pest.

Monitoring sarcopenia with wearable devices: a systematic review protocol.

INTRODUCTION: Sarcopenia is a highly prevalent muscle dysfunction among older adults and is associated with adverse events. The periodic monitoring enables an early screening of patients at risk and control of the progression of muscle impairment. Wearable devices have been used as clinical support for sarcopenia detection. Therefore, this review aims to identify how wearable devices have been used to screen sarcopenia. METHODS AND ANALYSES: Searches will be conducted from August 2023 on PubMed, CINHAL, Embase, Web of Science and SciELO databases. We will include cross-sectional and/or baseline data from prospective studies reporting the use of wearable devices to investigate sarcopenia. Studies that discuss only the development of algorithms or applications for the assessment of sarcopenia or unavailable full texts will be excluded. The main reviewer will conduct the initial search and exclusion of duplicates, while two independent reviewers will select studies, extract data and assess the methodological quality using the Appraisal tool for Cross-sectional Studies. ETHICS AND DISSEMINATION: No previous ethical approval is required for this review. The findings of this review will be submitted to a scientific journal and disclosed at international scientific conferences. PROSPERO REGISTRATION NUMBER: CRD42022356040.

Muscle Hypertrophy Responses to Changes in Training Volume: A Retrospective Analysis.

This study assessed associations between changes in the weekly number of sets performed and the percentage change in muscle thickness of the biceps (MTBB) and triceps (MTTB) brachii muscles. Through a retrospective analysis, sixty-eight resistance-trained subjects that participated in previous studies had their previous training volumes analyzed and compared to the volume imposed during each individual study. The relationship between variables was determined through Spearman correlation and a k-cluster analysis was performed to subdivide the participants into three groups and classified as:<0%; 0-50%, and >50% increase in the number of sets for both muscle groups. Moderate and weak correlations were observed between the alterations in training volume and changes in MTBB (rs=0.44, p=0.001) and MTTB (rs=0.35, p=0.002), respectively. A significant difference was noted between<0% to >50% for MTBB and MTTB (p=0.017; p=0.042, respectively), while no significant difference was observed between<0% to 0-50% and 0-50% to >50% (both p >0.05) for both muscle groups. In conclusion, muscle hypertrophy of the upper limbs is only weakly to moderately associated with changes in training volume of trained subjects.

Promoting Obesity Prevention and Healthy Habits in Childhood: The OCARIoT Experience.

OBJECTIVE: Long term behavioural disturbances and interventions in healthy habits (mainly eating and physical activity) are the primary cause of childhood obesity. Current approaches for obesity prevention based on health information extraction lack the integration of multi-modal datasets and the provision of a dedicated Decision Support System (DSS) for health behaviour assessment and coaching of children. METHODS: Continuous co-creation process has been applied in the frame of the Design Thinking Methodology, involving children, educators and healthcare professional in the whole process. Such considerations were used to derive the user needs and the technical requirements needed for the conception of the Internet of Things (IoT) platform based on microservices. RESULTS: To promote the adoption of healthy habits and the prevention of the obesity onset for children (9-12 years old), the proposed solution empowers children -including families and educators- in taking control of their health by collecting and following-up real-time information about nutrition, physical activity data coming from IoT devices, and interconnecting healthcare professionals to provide a personalised coaching solution. The validation has two phases involving +400 children (control/intervention group), on four schools in three countries: Spain, Greece and Brazil. The prevalence of obesity decreased in 75.5% from baseline levels in the intervention group. The proposed solution created a positive impression and satisfaction from the technology acceptance perspective. CONCLUSIONS: Main findings confirm that this ecosystem can assess behaviours of children, motivating and guiding them towards achieving personal goals. Clinical and Translational Impact Statement-This study presents Early Research on the adoption of a smart childhood obesity caring solution adopting a multidisciplinary approach; it involves researchers from biomedical engineering, medicine, computer science, ethics and education. The solution has the potential to decrease the obesity rates in children aiming to impact to get a better global health.

Predation performance and survival of susceptible and pyrethroid-resistant Eriopis connexa Germar (Coleoptera: Coccinellidae) to insecticides used in brassica crops.

BACKGROUND: Selective insecticides and insecticide-resistant natural enemies are components of chemical and biological methods that can be compatible in an integrated pest management (IPM) program. Many insecticides that are labeled for treatment against insects in Brassica crops have lost their efficacy because of the development of resistance. However, natural enemies can provide an important role in regulating the population of these pests. RESULTS: Survival of Eriopis connexa populations was >80% when exposed to insecticides, except for EcFM exposed to indoxacarb and methomyl. Bacillus thuringiensis, cyantraniliprole, chlorfenapyr and spinosad caused high mortality of P. xylostella larvae, but neither affected E. connexa survival nor its predation upon L. pseudobrassicae. Cyantraniliprole, chlorfenapyr, deltamethrin and methomyl caused high mortality of L. pseudobrassicae, but did not affect E. connexa survival nor its predation upon P. xylostella larvae. According to the differential selectivity index and the risk quotient, chlorfenapyr and methomyl were more toxic to P. xylostella larvae than to E. connexa, whereas indoxacarb was more toxic to E. connexa. CONCLUSION: This study demonstrates that the insecticides B. thuringiensis, cyantraniliprole, chlorantraniliprole, deltamethrin, chlorfenapyr, spinosad, azadiracthin and spiromesifen are compatible with insecticide-resistant adult E. connexa within an IPM program in Brassica crops. © 2023 Society of Chemical Industry.

Identifying congenital generalized lipodystrophy using deep learning-DEEPLIPO.

Congenital Generalized Lipodystrophy (CGL) is a rare autosomal recessive disease characterized by near complete absence of functional adipose tissue from birth. CGL diagnosis can be based on clinical data including acromegaloid features, acanthosis nigricans, reduction of total body fat, muscular hypertrophy, and protrusion of the umbilical scar. The identification and knowledge of CGL by the health care professionals is crucial once it is associated with severe and precocious cardiometabolic complications and poor outcome. Image processing by deep learning algorithms have been implemented in medicine and the application into routine clinical practice is feasible. Therefore, the aim of this study was to identify congenital generalized lipodystrophy phenotype using deep learning. A deep learning approach model using convolutional neural network was presented as a detailed experiment with evaluation steps undertaken to test the effectiveness. These experiments were based on CGL patient's photography database. The dataset consists of two main categories (training and testing) and three subcategories containing photos of patients with CGL, individuals with malnutrition and eutrophic individuals with athletic build. A total of 337 images of individuals of different ages, children and adults were carefully chosen from internet open access database and photographic records of stored images of medical records of a reference center for inherited lipodystrophies. For validation, the dataset was partitioned into four parts, keeping the same proportion of the three subcategories in each part. The fourfold cross-validation technique was applied, using 75% (3 parts) of the data as training and 25% (1 part) as a test. Following the technique, four tests were performed, changing the parts that were used as training and testing until each part was used exactly once as validation data. As a result, a mean accuracy, sensitivity, and specificity were obtained with values of [90.85 ± 2.20%], [90.63 ± 3.53%] and [91.41 ± 1.10%], respectively. In conclusion, this study presented for the first time a deep learning model able to identify congenital generalized lipodystrophy phenotype with excellent accuracy, sensitivity and specificity, possibly being a strategic tool for detecting this disease.

Psychometric properties of the Brazilian version of the Big Five Inventory.

INTRODUCTION: There is growing interest in the fields of psychiatry and psychology in investigating the relationship between personality and psychopathology. The Big-5 is a model developed to investigate five personality dimensions: Extroversion, Agreeableness, Conscientiousness, Neuroticism, and Openness. In the present study, we describe the process of translation into Brazilian Portuguese and adaptation of a free tool to evaluate the Big-5 model: The Big-5 Inventory (BFI). The instrument has 44 items with a Likert response scale ranging from 1 to 5. OBJECTIVES: To translate and adapt the BFI into Brazilian Portuguese. METHODS: The adaptation was conducted in the following steps: 1) Translation, 2) Evaluation Committee, 3) Back-translation, 4) Pilot study, 5) Evaluation Committee, and 6) Application. The sample comprised 490 participants from various regions of Brazil. The participants' ages ranged from 18 to 71 years, most of them had completed high school (62.9%), and the majority were women (75%). RESULTS: A model with the following fit indexes was found: χ2/df: 1.954; goodness fit index (GFI): 0.924; comparative fit index (CFI): 0.920; and root mean square error of approximation (RMSEA): 0.044. CONCLUSION: The results are suggestive that the Brazilian version of this instrument has good psychometric properties and represent a cost-free option for investigating associations with the Big-5 in psychiatry.

Rural work and COVID-19: challenges and proposals for the prevention of damages.

The COVID-19 pandemic has highlighted the inequalities in health care access in Brazil, exarcerbating vulnerabilities and social determinants of health. Inequality is part of the context of rural populations, especially rural workers and family and subsistence farmers due to both the direct consequences of work activity and the unfavorable socioeconomic context, especially regarding service provision, the guaranteeing of rights, and the coordination of care networks. This article reviews challenges to the health of these workers and outlines proposals for disease prevention in the context of the COVID-19 pandemic.

Apandemia de covid-19 no mundo trouxe à tona as desigualdades vivenciadas no acesso à saúde no Brasil, escancarando as vulnerabilidades e os determinantes sociais de saúde. É nesse ínterim de iniquidades que as populações rurais se inserem, em especial trabalhadores e trabalhadoras rurais e membros da agricultura familiar e de subsistência, tanto pelas consequências diretas da atividade laboral quanto pelo contexto socioeconômico desfavorável, especialmente no que diz respeito a oferta de serviços, garantia de direitos e articulação das redes de assistência. Frente a isso, o presente trabalho discute os desafios relacionados à saúde desses trabalhadores e traça propostas para a prevenção de agravos da referida população no contexto da pandemia de covid-19.

Psychometric properties of the Brazilian version of the Big Five Inventory

Abstract Introduction There is growing interest in the fields of psychiatry and psychology in investigating the relationship between personality and psychopathology. The Big-5 is a model developed to investigate five personality dimensions: Extroversion, Agreeableness, Conscientiousness, Neuroticism, and Openness. In the present study, we describe the process of translation into Brazilian Portuguese and adaptation of a free tool to evaluate the Big-5 model: The Big-5 Inventory (BFI). The instrument has 44 items with a Likert response scale ranging from 1 to 5. Objectives To translate and adapt the BFI into Brazilian Portuguese. Methods The adaptation was conducted in the following steps: 1) Translation, 2) Evaluation Committee, 3) Back-translation, 4) Pilot study, 5) Evaluation Committee, and 6) Application. The sample comprised 490 participants from various regions of Brazil. The participants' ages ranged from 18 to 71 years, most of them had completed high school (62.9%), and the majority were women (75%). Results A model with the following fit indexes was found: χ2/df: 1.954; goodness fit index (GFI): 0.924; comparative fit index (CFI): 0.920; and root mean square error of approximation (RMSEA): 0.044. Conclusion The results are suggestive that the Brazilian version of this instrument has good psychometric properties and represent a cost-free option for investigating associations with the Big-5 in psychiatry.

Modelo Preditivo de Mortalidade por Todas as Causas em Pacientes com Insuficiência Cardíaca Usando a Variabilidade da Frequência Cardíaca / Predictive Model of All-Cause Death in Patients with Heart Failure using Heart Rate Variability

Resumo Fundamento Dados de curto e de longo prazo da variabilidade da frequência cardíaca (VFC) poderiam identificar preditores de mortalidade por todas as causas em pacientes com insuficiência cardíaca (IC). Objetivos Construir um modelo preditivo de mortalidade por todas as causas em pacientes com IC usando a VFC. Métodos Estudo retrospectivo incluindo pacientes com suspeita ou diagnóstico confirmado de IC internados por IC descompensada ou síncope e que realizaram exame de Holter 24 horas. Na análise do tônus simpático aumentado, nós avaliamos a VFC mais baixa em períodos de 10 minutos não sobrepostos em um registro contínuo de sinal eletrocardiográfico por 24 horas (VFC de curta duração). As variáveis com p<0,01 foram incluídas no modelo de regressão multivariada de Cox para determinar a ocorrência da mortalidade por todas as causas. As variáveis com significância estatística na regressão de Cox foram escolhidas para construir o modelo preditivo. Um p<0,05 foi considerado estatisticamente significativo. Resultados Um total de 116 pacientes foram incluídos, com idade média de 71,9±16,3 anos, 45,7% eram do sexo masculino. O tempo médio de acompanhamento foi de 2,83 ± 1,27 anos. Trinta e nove (33,6%) óbitos ocorreram. Na comparação de sobreviventes e não sobreviventes, as variáveis que mostraram significância estatística foram menor SDNN, menor rMSSD, idade e fração de ejeção ventricular esquerda (FEVE). Na regressão Cox, os preditores independentes de mortalidade por todas as causas foram: idade > 69 anos (HR 3,95, IC95% 1,64-9,52); FEVE≤57% (HR 4,70, IC95% 2,38-9,28) e menor rMSSD ≤12ms (HR 5,54; IC 95% 2,04-15,08). Um valor inteiro foi atribuído para cada variável. Este escore < 3 apresentou uma área sob a curva de 0,802 (IC95% 0,72-0,87). Conclusão Em pacientes com IC internados por IC descompensada ou síncope, preditores de longo prazo de mortalidade por todas as causas foram idade, FEVE, e rMSSD em 10 minutos. Esses achados indicam que mesmo breves momentos de tônus simpático elevado podem ter impacto na sobrevida, principalmente em idosos e pacientes com IC e fração de ejeção reduzida.

Abstract Background Short and long-duration heart rate variability (HRV) data from Holter monitoring could identify predictors of all-cause death in heart failure (HF) patients. Objectives To build a predictive model of all-cause death in patients with HF using HRV. Methods Retrospective study including patients with suspected or confirmed HF who were admitted for decompensated HF or syncope that underwent Holter monitoring. In analysis of augmented sympathetic tonus, we evaluated the lowest HRV in nonoverlapping 10-minutes periods throughout 24h continuous electrocardiographic signal recording (short HRV variables). Variables with p<0.01 were included in a multivariate Cox regression model to determine the occurrence of the all-cause death. Variables with statistical significance in Cox regression were chosen to build the predictive model. P<0.05 was considered significant. Results A total of 116 patients were included, mean age of 71.9±16.3 years, 45.7% men, mean follow-up of 2.83±1.27 years. Thirty-nine deaths occurred (33.6%). By comparing survivors vs. non-survivors, the variables that showed statistical significance were lowest SDNN, lowest rMSSD, age and left ventricular ejection fraction (LVEF). In Cox regression, independent predictors of all-cause death were: age>69 years (HR 3.95, 95%CI 1.64-9.52); LVEF≤57% (HR 4.70, 95%CI 2.38-9.28) and lowest rMSSD≤12ms (HR 5.54, 95%CI 2.04-15.08). An integer value was assigned to each variable. Score<3 showed AUC=0.802 (95%CI 0.72-0.87). Conclusion In HF patients hospitalized for decompensated HF or syncope, independent long-term predictors of all-cause death were age, LVEF, and 10-minutes rMSSD. These findings indicate that even brief moments of high sympathetic tone can impact survival, specifically in the elderly and patients with HF with reduced ejection fraction.

Changes in mental health, wellbeing and personality following ayahuasca consumption: Results of a naturalistic longitudinal study.

Background: Naturalistic and placebo-controlled studies suggest ayahuasca, a potent psychedelic beverage originating from Indigenous Amazonian tradition, may improve mental health, alter personality structure, and reduce alcohol and drug intake. To better understand ayahuasca's therapeutic potential and to identify factors that influence therapeutic efficacy, we conducted a naturalistic, longitudinal study of facilitated ayahuasca consumption in naïve participants using a comprehensive battery of self-report questionnaires. Materials and Methods: Ayahuasca naive individuals registering for ayahuasca ceremonies were asked to complete a range of validated questionnaires assessing mental health, alcohol/cannabis use, relationships, personality, and connection to self and spirituality, prior to and 1 month after attending an ayahuasca ceremony. Data for two mental health measures (the DASS-21 and PANAS) and acute subjective effects via the MEQ-30 were also assessed 7 days post-ceremony. Repeated measures ANOVA were used to examine pre-to-post changes, and Pearson correlations explored predictors of improvement in outcomes. Results: Fifty-three attendees (32 women, 21 men) completed pre and post ayahuasca assessments with 55.6% of the sample reporting a complete mystical experience based on the MEQ-30. One-month post-ayahuasca, significant reductions were identified in depression, anxiety, stress, alcohol and cannabis use, body dissociation, accepting external influence, self-alienation, impulsivity, and negative affect/emotionality. Significant increases were identified in positive mood, self-efficacy, authentic living, extraversion, agreeableness, open-mindedness, spirituality, and satisfaction with relationships. While facets of the mystical experience held little predictive validity on outcome measures, baseline traits, particularly high negative emotionality and body dissociation, and low sense of self-efficacy, robustly predicted improvements in mental health and alcohol/cannabis use, and alterations in personality structure which are linked to better mental health. Discussion: This study suggests facilitated ayahuasca consumption in naïve participants may precipitate wide-ranging improvements in mental health, relationships, personality structure, and alcohol use. Associations between baseline traits and therapeutic improvements mark an important first step toward personalized, precision-based medicine and warrant randomized controlled trials to confirm and elaborate on these findings. Contribution Statement: Longitudinal, observational studies and randomized clinical control trials suggest ayahuasca may exert therapeutic effects on mental health and alcohol/cannabis use, and alter personality structure. However, it is unclear if improvements are diagnosis-specific and factors that predict therapeutic gains have yet to be extensively elucidated. This longitudinal, observational study examined the effects of facilitated ayahuasca consumption in naive participants on mental health, alcohol and substance use/abuse, personality traits, relationships, and connection to self and spirituality. We found wide-ranging improvements 1-month post-treatment across these domains, and identified baseline traits which predict pre-to-post changes on primary outcome measures. Improvements were not diagnostic-specific, suggesting ayahuasca may be generally efficacious. Personality traits, body dissociation, and self-efficacy were strong predictors of therapeutic improvements, marking an important first step toward personalized, precision-based medicine. Randomized controlled trials are warranted to confirm and elaborate on these findings.

Risk factors and survival in patients with COVID-19 in northeastern Brazil.

BACKGROUND: Knowledge about the epidemiology and risk factors surrounding COVID-19 contributes to developing better health strategies to combat the disease. OBJECTIVE: This study aimed to establish a survival analysis and identify the risk factors for patients with COVID-19 in an upper middle-income city in Brazil. METHODS: A retrospective cohort study was conducted with 280 hospitalized patients with COVID-19. The eCOVID platform provided data to monitor COVID-19 cases and help the communication between professionals. RESULTS: Age ≥ 65 years was associated with decreased survival (54.8%), and females had a lower survival rate than males (p = 0.01). Regarding risk factors, urea concentration (p<0.001), hospital length of stay (p = 0.002), oxygen concentration (p = 0.005), and age (p = 0.02) were associated with death. CONCLUSION: Age, hospital length of stay, high blood urea concentration, and low oxygen concentration were associated with death by COVID-19 in the studied population. These findings corroborate with studies conducted in research centers worldwide.

An Examination of Two Resistance Training Frequency Techniques in Morphological and Functional Adaptations of the Patellar Tendon.

The aim of the present study was to investigate the effects of distinct resistance training frequencies with equated-volume conditions in morphological and functional adaptations of the patellar tendon. Twenty-seven recreationally resistance-trained subjects (men [n=17] and women [n=10]) (age: 20.8 ± 1.9 years [range 18 to 25 years]; height: 1.73 ± 9.8 cm; total body mass = 73.2 ± 11.7 kg; previous RT experience = 3.3 ± 1.6 years) volunteered to participate in this study. A total of 16 training sessions were performed during the study period. Each subject's leg was randomly allocated to one of the following training protocols: 2 training sessions/week (2x) or 4 training sessions/week (4x). Measurements of tendon cross sectional area (CSA) and length were performed through ultrasound imaging. One repetition maximum test was performed to assess patellar tendon force (PTF) unilaterally. For CSA (2x: Δ= -1.3%; 4x: Δ= -0.9%), and length (2x: Δ= -0.4%; 4x: Δ= 1.2%), no significant differences were observed within or between conditions (all p > 0.05). For PTF, a significant difference was observed between conditions (mean difference = 0.05 [-125 to 224] p= 0.001). In conclusion, the leg extension exercise performed 2 vs 4x/week induces similar patellar tendon morphological responses. However, the increase in force seems to be enhanced by a lower weekly training frequency associated with a longer intervention period.

Prevalence and Factors Associated with Metabolic Syndrome in Patients at a Psychosocial Care Center: A Cross-Sectional Study.

BACKGROUND: Metabolic syndrome (MS) is associated with greater risk of morbimortality and it has high prevalence in people with mental illness. OBJECTIVE: Estimate the prevalence of Metabolic Syndrome (MS) and its associated factors in the patients of a Psychosocial Care Center (CAPS in Brazilian Portuguese) in the city of Salvador, state of Bahia, Brazil. METHOD: Cross-sectional study set at CAPS in the city of Salvador-Bahia between August 2019 and February 2020. MS was evaluated according to the National Cholesterol Education Program's Adult Treatment Panel III. In addition to descriptive statistics, gross and adjusted prevalence ratios were described. RESULTS: MS was found in 100 (35.2%) individuals, 116 (40.9%) were obese and 165 (58.1%) had increased waist circumference. Polypharmacy was identified in 63 (22.3%) patients and 243 (85.9%) used antipsychotics. Under gross evaluation, women (PR = 1.88; 95%CI: 1.35-2.63) and those who used antidepressants (PR = 1.41; 95%CI: 1.05-1.88) showed an association with MS. After logistic regression, depression (PR = 1.86; 95%CI: 1.38-2.51), acanthosis (PR = 1.50; 95%CI: 1.18-1.90), use of antipsychotics (PR = 1.88; 95%CI: 1.13-2.75), and hypertriglyceridemic waist (PR = 3.33; 95%CI: 2.48-4.46) were associated with MS. CONCLUSION: The prevalence of MS signals multimorbidity among individuals with mental disorders and suggests a need for clinical screening.

Psychosocial and Drug Use Assessment of Regular vs. Non-Regular Ayahuasca Users in a Brazilian Sample: a Web-Based Survey.

Background: Preliminary evidence suggests that long-term ayahuasca use is associated with better psychosocial outcomes and less drug use; however, available data on the association between ayahuasca intake frequency and psychosocial outcomes is limited. Objectives: We sought to characterize and investigate the association of regular ayahuasca use, as compared to non-regular use, on licit (alcohol and tobacco) and illicit (cannabis, psychostimulants, psychedelics, and non-medical opioids) drug use and psychosocial outcomes. Methods: An online-based cross-sectional survey was taken among people who use ayahuasca in Brazil assessing sociodemographic, drug and ayahuasca use, anxiety and depression (HAD-S), intrinsic religiosity (IRI), negative and positive affects (PANAS), satisfaction with life (SWLS), and five quality of life domains (WHOQOL-Brief). Multivariate regressions for each psychosocial outcome and drug use were performed comparing regular to non-regular ayahuasca users while correcting for sociodemographic variables. Results: A total of 286 valid answers were retrieved, divided into people with regular (n = 101) and non-regular (n = 185) ayahuasca use. Groups had similar sociodemographic profiles and lifetime use of drugs. In the multivariate analysis, regular use of ayahuasca was associated with lower anxiety (B: -0.97), negative affect (B: -2.62), general (B: 0.22) and physical (B: 0.17) quality of life, higher intrinsic religiosity scores (B: 4.16), and less past-month licit (OR = 0.30) and illicit (OR = 0.49) use of substances. Conclusions: Our results show that ceremonial regular ayahuasca compared to non-regular use is associated with better psychosocial and mental health outcomes and less drug use. Studies with repeated ayahuasca administration and extended follow-ups are essential to clarify the nature of ayahuasca's therapeutic effects and to guide future clinical research.