Antimicrobial resistance of Streptococcus pneumoniae from invasive pneumococcal diseases in Latin American countries: a systematic review and meta-analysis.

Background: Invasive pneumococcal disease has declined since pneumococcal conjugate vaccine introduction in Latin America and the Caribbean (LAC). However, serotype distribution and antimicrobial resistance patterns have changed. Methods: We conducted a systematic review to evaluate the frequency of antimicrobial resistance of Streptococcus pneumoniae from invasive disease in LAC. Articles published between 1 January 2000, and 27 December 2022, with no language restriction, were searched in major databases and gray literature. Pairs of reviewers independently selected extracted data and assessed the risk of bias in the studies. The quality of antimicrobial resistance (AMR) studies was evaluated according to WHO recommendations (PROSPERO CRD42023392097). Results: From 8,600 records identified, 103 studies were included, with 49,660 positive samples of S. pneumoniae for AMR analysis processed. Most studies were from Brazil (29.1%) and Argentina (18.4%), were cross-sectional (57.3%), reported data on AMR from IPD cases (52.4%), and were classified as moderate risk of bias (50.5%). Resistance to penicillin was 21.7% (95%IC 18.7-25.0, I2: 95.9), and for ceftriaxone/cefotaxime it was 4.7% (95%IC 3.2-6.9, I2: 96.1). The highest resistance for both penicillin and ceftriaxone/cefotaxime was in the age group of 0 to 5 years (32.1% [95%IC 28.2-36.4, I2: 87.7], and 9.7% [95%IC 5.9-15.6, I2: 96.9] respectively). The most frequent serotypes associated with resistance were 14 for penicillin and 19A for ceftriaxone/cefotaxime. Conclusion: Approximately one-quarter of invasive pneumococcal disease isolates in Latin America and the Caribbean displayed penicillin resistance, with higher rates in young children. Ongoing surveillance is essential to monitor serotype evolution and antimicrobial resistance patterns following pneumococcal conjugate vaccine introduction.

Home noninvasive ventilation in severe COPD: in whom does it work and how?

Background: Not all hypercapnic COPD patients benefit from home noninvasive ventilation (NIV), and mechanisms through which NIV improves clinical outcomes remain uncertain. We aimed to identify "responders" to home NIV, denoted by a beneficial effect of NIV on arterial partial pressure of carbon dioxide (PaCO2), health-related quality of life (HRQoL) and survival, and investigated whether NIV achieves its beneficial effect through an improved PaCO2. Methods: We used individual patient data from previous published trials collated for a systematic review. Linear mixed-effect models were conducted to compare the effect of NIV on PaCO2, HRQoL and survival, within subgroups defined by patient and treatment characteristics. Secondly, we conducted a causal mediation analysis to investigate whether the effect of NIV is mediated by a change in PaCO2. Findings: Data of 1142 participants from 16 studies were used. Participants treated with lower pressure support (<14 versus ≥14 cmH2O) and with lower adherence (<5 versus ≥5 h·day-1) had less improvement in PaCO2 (mean difference (MD) -0.30 kPa, p<0.001 and -0.29 kPa, p<0.001, respectively) and HRQoL (standardised MD 0.10, p=0.002 and 0.11, p=0.02, respectively), but this effect did not persist to survival. PaCO2 improved more in patients with severe dyspnoea (MD -0.30, p=0.02), and HRQoL improved only in participants with fewer than three exacerbations (standardised MD 0.52, p=0.03). The results of the mediation analysis showed that the effect on HRQoL is mediated partially (23%) by a change in PaCO2. Interpretation: With greater pressure support and better daily NIV usage, a larger improvement in PaCO2 and HRQoL is achieved. Importantly, we demonstrated that the beneficial effect of home NIV on HRQoL is only partially mediated through a reduction in diurnal PaCO2.

Using Myofascial Therapy to Improve Psychological Outcomes, Quality of Life, and Sexual Function in Women with Chronic Pelvic Pain-A Case Series.

(1) Background: Chronic pelvic pain represents a prevalent condition afflicting women. Research has highlighted the presence of psychological distress and sexual dysfunction in these individuals. Regrettably, myofascial pelvic pain often goes unnoticed and untreated despite its integral role in chronic pelvic pain. (2) Methods: By employing a longitudinal case series design, we studied eighteen women afflicted with chronic pelvic pain. Over a 12-week period, these participants underwent 15 sessions of myofascial therapy. Data encompassing sociodemographic particulars, the Hospital Anxiety and Depression Scale, the Medical Outcomes Study Short Form 12 questionnaire, and the Female Sexual Function Index were collected at baseline, 12 weeks post-intervention, and again at the 24-week mark. (3) Results: After a span of 12 weeks subsequent to the intervention, the participants demonstrated noteworthy enhancements (p < 0.001) in their depression and anxiety scores, their overall Mental Component scores in the Medical Outcomes Study Short Form 12, as well as sexual function. Importantly, these gains were sustained at the 24-week juncture post-therapy. (4) Conclusions: The findings stemming from our prospective case study underscore the potential utility of myofascial therapy for women grappling with chronic pelvic pain. This form of intervention yields significant advancements in alleviating anxiety, depression, health-related quality of life, and sexual function.

Relación entre la Temperatura de Superficie, la Composición Corporal e Indicadores Antropométricos de Obesidad y Sobrepeso / Relationship Between Surface Temperature, Body Composition and Anthropometric Indicators of Obesity and Overweight

La termografía por infrarrojo (TI) permite evaluar la temperatura corporal, medir los cambios en la disipación del calor corporal en superficie y relacionarlos con las características de composición corporal e índices antropométricos. Aumentar el número de registros de zonas corporales evaluadas con TI y establecer las relaciones de estas temperaturas (32 áreas corporales) con variables de composición corporal e índices antropométricos, como el índice de masa corporal (IMC), índice cintura cadera, índice cintura estatura, en hombres adultos divididos según su estado ponderal. Participaron 60 hombres, adultos sanos, divididos en 2 grupos: grupo 1 (n=30), con IMC ≤ 24,9, edad 23,2 ± 3,9 años, masa corporal 66,5 ± 6,5 kg, y talla 170,5 ± 7,4 cm; y, grupo 2 (n= 30), con IMC > 24,9, edad 29,4 ± 9,9 años, masa corporal 84,5 ± 11,9 kg, y talla 172,0 ± 7,18 cm. Se realizaron evaluaciones antropométricas y de TI. Sujetos con IMC ≤ 24,9 kg/ m2 presentaron valores mayores de temperatura superficial, en todas las zonas estudiadas, a diferencia de los sujetos con niveles de IMC > 24,9 kg/m2, donde la disipación del calor corporal fue menor. Existe una estrecha relación entre la temperatura superficial de la piel y el IMC, donde sujetos con un IMC normal mostraron una disipación de calor y valores de temperatura superficial mayores, en todas las zonas evaluadas, a diferencia de los sujetos con un IMC que se encontraba por encima del límite de normalidad.

SUMMARY: Infrared thermography (IT) makes it possible to assess body temperature, measure changes in body heat dissipation on the surface, and relate them to body composition characteristics and anthropometric indices. The objective of this study was to increase the number of records of body areas evaluated with IT and establish the relationships of these temperatures (32 body areas) with body composition variables and anthropometric indices, such as body mass index (BMI), waist-hip ratio, waist-height ratio, in adult men divided according to their weight status. A total of 60 healthy adult men participated, divided into 2 groups: group 1 (n=30), with a body mass index (BMI) ≤ 24.9, age 23.2 ± 3.9 years, body mass 66.5 ± 6.5 kg, and height 170.5 ± 7.4 cm; and, group 2 (n = 30), with BMI > 24.9, age 29.4 ± 9.9 years, body mass 84.5 ± 11.9 kg, and height 172.0 ± 7.18 cm. Anthropometric and IT assessments were performed. Subjects with BMI ≤ 24.9 kg/ m2 presented higher values of surface temperature in all areas studied, unlike subjects with BMI levels > 24.9 kg/m2, where body heat dissipation was lower. There is a close relationship between skin surface temperature and BMI, where subjects with a normal BMI showed higher heat dissipation and surface temperature values, in all evaluated areas, unlike subjects with a BMI that was above the normal limit.

Effects of different cluster-set rest intervals during plyometric-jump training on measures of physical fitness: A randomized trial.

The optimal intra-set rest for cluster sets (CLS) during plyometric-jump training (PJT) to improve physical fitness remains unclear. The objective of this quasi-experimental study was to compare the effects of PJT with traditional (TRS) vs. CLS structures, using different intra-set rests, on the physical fitness of healthy participants. Forty-seven recreationally active young men performed 3-5 sets of 10-12 repetitions of upper- and lower-body PJT exercises twice a week for six weeks using different set configurations: TRS group (no intra-set rest), and the CLS10, CLS20 and CLS30 groups with 10, 20 and 30 s of intra-set rest, respectively, while the total rest period was equated. Pretest-posttest measurements were carried out 48 h before and after the intervention and the rating of fatigue (ROF) was also assessed using a numerical scale (0-10 points) 20 min after the first and last (i.e., 12th) session. There was no significant difference in the mean energy intake between groups (p > 0.05). The repeated measures ANOVA revealed that all groups showed similar improvements (p < 0.05) in body mass, body mass index, fat-free mass, one repetition maximum (dynamic strength) and repetitions to failure (muscular endurance) in back squat and chest press, handgrip strength, standing long jump, 20 m sprint, 9-m shuttle run (change of direction speed), and ROF. Of note, the ROF was lower for the CLS20 and CLS30 groups, independent from the training effect. The physical fitness of recreationally active young men improved after 6 weeks of PJT involving intra-set rest intervals of 0 s, 10 s, 20 s, or 30 s. However, an intra-set rest of 20 s and 30 s seems to induce lower exercise-induced fatigue perception.

[Results of the Implementation of a Case-Finding Program for Alpha-1 Antitrypsin Deficiency in COPD Patients]. / Resultados de la implementación de un programa de detección de casos de déficit de alfa-1 antitripsina en pacientes con EPOC.

Objectives: Currently, the identification of new cases of alpha-1 antitrypsin deficiency (AATD) continues to be one of the great challenges facing the disease. The present study aims to perform an analysis of the results of the implementation of a systematic case detection program of AATD for patients with chronic obstructive pulmonary disease. Material and methods: Cross-sectional observational study in which the results of AAT screening until December 2022 were analyzed. The cases studied were divided into three periods: (1) no systematic case detection until 2013; (2) systematic case detection of S and Z alleles for cases with AAT < 90 mg/dL until 2018, and (3) systematic case detection of 14 mutations for cases with AAT < 120 mg/dL since 2018. Results: A total of 471 cases were studied, of which 306 (65.0%) were carriers of some mutation related to HAD. The number of detected cases of all mutations with their percentage against those studied in each period was respectively: 6 (100%), 48 (88.8%) and 253 (61.5%). If we limit to severe mutations (AAT < 57.2 mg/dL), the distribution by periods was respectively: 3 (50.0), 10 (18.5%) and 17 (4.1%). Conclusions: The present study describes the changes in the detection of patients carrying DAAT-related alleles with three different case identification policies. The data support the use of systematic case detection system in the COPD patient population.

SIRT2 Inhibition Rescues Neurodegenerative Pathology but Increases Systemic Inflammation in a Transgenic Mouse Model of Alzheimer's Disease.

Sirtuin 2 (SIRT2) has been proposed to have a central role on aging, inflammation, cancer and neurodegenerative diseases; however, its specific function remains controversial. Recent studies propose SIRT2 pharmacological inhibition as a therapeutic strategy for several neurodegenerative diseases including Alzheimer's disease (AD). Surprisingly, none of these published studies regarding the potential interest of SIRT2 inhibition has assessed the peripheral adverse side consequences of this treatment. In this study, we demonstrate that the specific SIRT2 inhibitor, the compound 33i, does not exhibit genotoxic or mutagenic properties. Moreover, pharmacological treatment with 33i, improved cognitive dysfunction and long-term potentiation, reducing amyloid pathology and neuroinflammation in the APP/PS1 AD mouse model. However, this treatment increased peripheral levels of the inflammatory cytokines IL-1ß, TNF, IL-6 and MCP-1. Accordingly, peripheral SIRT2 inhibition with the blood brain barrier impermeable compound AGK-2, worsened the cognitive capacities and increased systemic inflammation. The analysis of human samples revealed that SIRT2 is increased in the brain but not in the serum of AD patients. These results suggest that, although SIRT2 pharmacological inhibition may have beneficial consequences in neurodegenerative diseases, its pharmacological inhibition at the periphery would not be recommended and the systemic adverse side effects should be considered. This information is essential to maximize the therapeutic potential of SIRT2 inhibition not only for AD but also for other neurodegenerative diseases.

Metallomic Signatures of Lung Cancer and Chronic Obstructive Pulmonary Disease.

Lung cancer (LC) is the leading cause of cancer deaths, and chronic obstructive pulmonary disease (COPD) can increase LC risk. Metallomics may provide insights into both of these tobacco-related diseases and their shared etiology. We conducted an observational study of 191 human serum samples, including those of healthy controls, LC patients, COPD patients, and patients with both COPD and LC. We found 18 elements (V, Al, As, Mn, Co, Cu, Zn, Cd, Se, W, Mo, Sb, Pb, Tl, Cr, Mg, Ni, and U) in these samples. In addition, we evaluated the elemental profiles of COPD cases of varying severity. The ratios and associations between the elements were also studied as possible signatures of the diseases. COPD severity and LC have a significant impact on the elemental composition of human serum. The severity of COPD was found to reduce the serum concentrations of As, Cd, and Tl and increased the serum concentrations of Mn and Sb compared with healthy control samples, while LC was found to increase Al, As, Mn, and Pb concentrations. This study provides new insights into the effects of LC and COPD on the human serum elemental profile that will pave the way for the potential use of elements as biomarkers for diagnosis and prognosis. It also sheds light on the potential link between the two diseases, i.e., the evolution of COPD to LC.

Telerehabilitation for the treatment in chronic low back pain: A randomized controlled trial.

INTRODUCTION: Although there is growth in the approach to telerehabilitation (TLRH) in different pathologies, research on TLRH for the management of low back pain is scarce and controversial. Thus, the purpose of this study was to analyze whether a TLRH program is as effective as a clinical exercise program in improving pain and different functional variables in patients with nonspecific low back pain (NLBP). METHOD: A single-blind, two-armed randomized controlled trial was carried out with 68 individuals with chronic NLBP. Participants were randomly allocated to either the TLRH group (TG) (n = 34) or the clinic group (CG) (n = 34). The TG received an exercise-based TLRH video and an educational program on the neurophysiology of pain. The CG received the same pain education and exercise program at the clinic facility supervised by a clinician. Both groups performed 2 weekly sessions for 8 weeks. Active movements of the lumbar spine, pain and range of motion, and kinesiophobia were assessed at baseline, at the end of 8 weeks of treatment, and at 3 months. RESULTS: Statistically significant differences for time-by-group interaction were identified in range of motion of right (F = 11.668; p = 0.001) and left (F = 4.219; p = 0.042) legs when knee extended test is performed; as well as in pain intensity when the same test (F = 5.176; p = 0.043). Moreover, higher pain level during flexion (F = 5.133; p = 0.009) and extension movements (F = 6.335; p = 0.003) in patients with bilateral pain location than those with unilateral or central pain location has been appreciated. CONCLUSION: A TLRH rehabilitation program via mobile app is as effective as the same exercise program supervised in a clinic.

Sperm morphology and comparison morphometry measurements of two species of bats, Molossus molossus and Molossops temminckii (Chiroptera: Molossidae).

Sperm morphology is considered a species-specific character and has been used as a tool in the classification of numerous mammalian taxa. Neotropical bats have been poorly studied, and important aspects on sperm morphology have not been elucidated. The aim of the present study was to describe and compare the sperm morphology and morphometry of Molossus molossus and Molossops temminckii. A total of 14 adults specimens were analyzed from the Colección Mamíferos Lillo, Universidad Nacional de Tucumán: five M. molossus and nine M. temminckii. The epididymis were extracted and macerated in Farmer's solution, followed by a coloration with different stains. To carry out the description and morphometric analysis, microphotographs were taken under an optical, epifluorescence, and scanning electron microscope (SEM). A total of 50 sperm from each individual were measured for morphometric analysis. The length and width of the head, midpiece and tail were taken as variables. Sperm from M. molossus and M. temminckii were practically identical, both morphologically and morphometrically. In both species, a distal bulge was observed at the end of the intermediate piece in a percentage greater than 85%. The main characteristics shared between the species were: presence of acrosomal blebs in the upper half of the head of the spermatozoa; cephalic equatorial segment with filiform ornamentations; intermembrane space of head apex wedge-shaped; helical middle piece and annulus at the end of middle piece. In the present study, SEM allowed us to visualize structures, such as acrosomal vesicles, that were not detected with other types of microscopy. RESEARCH HIGHLIGHTS: The similarities in the sperm morphology between M. molossus and M. temminckii were observed with three types of microscopy: optical, epifluorescence and scanning electron, and supported by morphometric and statistical analyses.

International Pediatric COVID-19 Severity Over the Course of the Pandemic.

Importance: Multiple SARS-CoV-2 variants have emerged over the COVID-19 pandemic. The implications for COVID-19 severity in children worldwide are unclear. Objective: To determine whether the dominant circulating SARS-CoV-2 variants of concern (VOCs) were associated with differences in COVID-19 severity among hospitalized children. Design, Setting, and Participants: Clinical data from hospitalized children and adolescents (younger than 18 years) who were SARS-CoV-2 positive were obtained from 9 countries (Australia, Brazil, Italy, Portugal, South Africa, Switzerland, Thailand, UK, and the US) during 3 different time frames. Time frames 1 (T1), 2 (T2), and 3 (T3) were defined to represent periods of dominance by the ancestral virus, pre-Omicron VOCs, and Omicron, respectively. Age groups for analysis were younger than 6 months, 6 months to younger than 5 years, and 5 to younger than 18 years. Children with an incidental positive test result for SARS-CoV-2 were excluded. Exposures: SARS-CoV-2 hospitalization during the stipulated time frame. Main Outcomes and Measures: The severity of disease was assessed by admission to intensive care unit (ICU), the need for ventilatory support, or oxygen therapy. Results: Among 31 785 hospitalized children and adolescents, the median age was 4 (IQR 1-12) years and 16 639 were male (52.3%). In children younger than 5 years, across successive SARS-CoV-2 waves, there was a reduction in ICU admission (T3 vs T1: risk ratio [RR], 0.56; 95% CI, 0.42-0.75 [younger than 6 months]; RR, 0.61, 95% CI; 0.47-0.79 [6 months to younger than 5 years]), but not ventilatory support or oxygen therapy. In contrast, ICU admission (T3 vs T1: RR, 0.39, 95% CI, 0.32-0.48), ventilatory support (T3 vs T1: RR, 0.37; 95% CI, 0.27-0.51), and oxygen therapy (T3 vs T1: RR, 0.47; 95% CI, 0.32-0.70) decreased across SARS-CoV-2 waves in children 5 years to younger than 18 years old. The results were consistent when data were restricted to unvaccinated children. Conclusions and Relevance: This study provides valuable insights into the impact of SARS-CoV-2 VOCs on the severity of COVID-19 in hospitalized children across different age groups and countries, suggesting that while ICU admissions decreased across the pandemic in all age groups, ventilatory and oxygen support generally did not decrease over time in children aged younger than 5 years. These findings highlight the importance of considering different pediatric age groups when assessing disease severity in COVID-19.

Persistent pain management in an oncology population through pain neuroscience education, a multimodal program: PaiNEd randomized clinical trial protocol.

INTRODUCTION: Pain is one of the most persistent symptoms after cancer treatment. The central nervous system can erroneously stay in its alarm phase, altering the pain experience of patients who have cancer. Pain neuroscience education (PNE) with multimodal approaches may benefit these patients. OBJECTIVE: This protocol aims to determine the effectiveness of a PNE tool on pain, physical function and quality of life, as a supplement to a multimodal rehabilitation (MR) program in patients who had breast cancer (BC). METHODS: An 8-week double-blinded randomized controlled trial will be conducted, including 72 participants who had BC and who have persistent pain, randomized into three groups: PNE program + MR program, traditional biomedical information + MR program and control group. The PNE program will include educational content that participants will learn through a mobile app and the MR program will include a concurrent exercise program and manual therapy. The primary outcome will be the perceived pain assessed using the Visual Analogue Scale and secondary outcomes are others related to pain, physical function and quality of life. All outcomes will be evaluated at baseline, at the end of the intervention and 6 months after the end of intervention. DISCUSSION: The proposed study may help BC patients with persistent pain improve their pain experience, quality of life and provide for more adaptive pain-coping strategies. This protocol could propose an action guide to implement different integral approaches for the treatment of sequelae. This treatment option could be offered to this patient profile and it could be easily implemented in the healthcare systems due to its low costs. TRIAL REGISTRATION: ClinicalTrials.gov, NCT04877860. (February18, 2022).

Validity, Reliability, and Sensitivity of Mobile Applications to Assess Change of Direction Speed.

This study aimed to assess the validity, reliability, and sensitivity of mobile applications for assessing change-of-direction speed (CODS) performance. Thirty college athletes performed two Illinois CODS tests during one session. Assessments were carried out simultaneously using six devices (the CODTimer app, Seconds Count app, StopwatchCamera app, two analog stopwatches, and timing gates). Validity analyses included Pearson's product-moment correlation analysis, a linear regression model, and Bland-Altman plots. Reliability analyses included the intraclass correlation coefficient (ICC), the coefficient of variation (CV%), and the paired-sample t test. Sensitivity analyses included the typical error and smallest worthwhile change (SWC). The results showed that validity, reliability, and sensitivity values were higher for the CODTimer app (r = 0.99, R2 = 0.99, mean bias = -0.03 ± 0.10, CV% = 3.21, ICC = 0.89, SWC rating: good, p = 0.84) and the Seconds Count app (r = 0.99, R2 = 0.99, mean bias = -0.03 ± 0.08, CV% = 3.28, ICC = 0.88, SWC rating: good, p = 0.84) relative to the StopwatchCamera app (r = 0.98, R2 = 0.97, mean bias = -0.11 ± 0.22, CV% = 3.43, ICC = 0.86, SWC rating: marginal, p = 0.10), Analog Stopwatch 1 (r = 0.98, R2 = 0.96, mean bias = -0.09 ± 0.42, CV% = 2.95, ICC = 0.90, SWC rating: good, p = 0.91), and Analog Stopwatch 2 (r = 0.99, R2 = 0.97, mean bias = -0.12 ± 0.88, CV% = 3.51, ICC = 0.87, SWC rating: marginal, p = 0.96). In conclusion, compared to timing gates, the CODTimer app and Seconds Count app provided lower measurement bias and higher sensitivity for assessing CODS performance.

A dietary polyphenol metabolite alters CA1 excitability ex vivo and mildly affects cortico-hippocampal field potential generators in anesthetized animals.

Dietary polyphenols have beneficial effects in situations of impaired cognition in acute models of neurodegeneration. The possibility that they may have a direct effect on the electrical activity of neuronal populations has not been tested. We explored the electrophysiological action of protocatechuic acid (PCA) on CA1 pyramidal cells ex vivo and network activity in anesthetized female rats using pathway-specific field potential (FP) generators obtained from laminar FPs in cortex and hippocampus. Whole-cell recordings from CA1 pyramidal cells revealed increased synaptic potentials, particularly in response to basal dendritic excitation, while the associated evoked firing was significantly reduced. This counterintuitive result was attributed to a marked increase of the rheobase and voltage threshold, indicating a decreased ability to generate spikes in response to depolarizing current. Systemic administration of PCA only slightly altered the ongoing activity of some FP generators, although it produced a striking disengagement of infraslow activities between the cortex and hippocampus on a scale of minutes. To our knowledge, this is the first report showing the direct action of a dietary polyphenol on electrical activity, performing neuromodulatory roles at both the cellular and network levels.

A spatial threshold for astrocyte calcium surge.

Astrocytes are active cells involved in brain function through the bidirectional communication with neurons, in which the astrocyte calcium signal plays a crucial role. Synaptically-evoked calcium increases can be localized to independent subcellular domains or expand to the entire cell, i.e., calcium surge. In turn, astrocytes may regulate individual synapses by calcium-dependent release of gliotransmitters. Because a single astrocyte may contact ~100,000 synapses, the control of the intracellular calcium signal propagation may have relevant consequences on brain function by regulating the spatial range of astrocyte neuromodulation of synapses. Yet, the properties governing the spatial dynamics of the astrocyte calcium signal remains poorly defined. Imaging subcellular responses of cortical astrocytes to sensory stimulation in mice, we show that sensory-evoked astrocyte calcium responses originated and remained localized in domains of the astrocytic arborization, but eventually propagated to the entire cell if a spatial threshold of >23% of the arborization being activated was surpassed. Using transgenic IP3R2-/- mice, we found that type-2 IP3 receptors were necessary for the generation of the astrocyte calcium surge. We finally show using in situ electrophysiological recordings that the spatial threshold of the astrocyte calcium signal consequently determined the gliotransmitter release. Present results reveal a fundamental property of astrocyte calcium physiology, i.e., a spatial threshold for the astrocyte intracellular calcium signal propagation, which depends on astrocyte intrinsic properties and governs the astrocyte integration of local synaptic activity and the subsequent neuromodulation.

Implicit Motor Imagery for Chronic Pelvic Pain: A Cross-Sectional Case-Control Study.

Implicit motor imagery (IMI), with an image laterality discrimination (LD) task, has been proposed as a useful therapeutic tool to restore body schema in patients with chronic pelvic pain (CPP). The aim of this study was to analyse the existence of differences between patients with CPP and healthy individuals in order to justify the use of IMI. An observational, cross-sectional study with non-probabilistic sampling was designed as a one-to-one matched case-control study. Through a web link designed for this purpose, a total of 40 abdominoperineal images were shown to 130 participants during the laterality task. Outcome measures were pain intensity (visual analogue scale, VAS), accuracy, response time (RT), and CPPQ-Mohedo score (Chronic Pelvic Pain Questionnaire-Mohedo). This was an observational, cross-sectional study with a total of 64 CPP patients and 66 healthy individuals. The comparative analysis between groups revealed significant differences in accuracy, CPPQ-Mohedo and VAS (p < 0.001), but not in RT; in patients with CPP, accuracy was correlated with a lower CPPQ-Mohedo score and RT and, the greater the pain intensity, the higher the CPPQ-Mohedo score and RT, and the lower the accuracy. In the LD task, the patients with CPP made more mistakes than the healthy individuals. IMI could be a useful and complementary tool in the therapeutic approach for patients with CPP.

A Systematic Review with Meta-Analysis on the Effects of Plyometric-Jump Training on the Physical Fitness of Combat Sport Athletes.

We aimed to assess the athletic performance changes in combat sport athletes (CoSAs) after plyometric-jump training (PJT), compared to control conditions, through a systematic review with meta-analysis. Following PRISMA guidelines, three electronic databases were searched for includable articles, according to a PICOS approach. Using a random-effects model, Hedges' g effects sizes (ES) were calculated. Heterogeneity was assessed using the I2 statistic, with values of <25%, 25-75%, and >75% representing low, moderate, and high levels of heterogeneity, respectively. Statistical significance was set at p ≤ 0.05. The certainty of evidence was assessed using the GRADE approach. Twelve eligible articles were identified for systematic review, seven of high quality and five of moderate quality, according to the PEDro scale. The studies recruited taekwondo, silat, wrestling, judo, fencing, and karate athletes (292 total participants), including specific-active and active controls. Most participants had a mean age of <18 years and were males (n = 225). Compared to the control, PJT programmes, involving 4-12 weeks and 2-3 sessions per week, induced small to moderate improvements (ES = 0.47 to 1.04) in athletes' maximal strength (e.g., 1RM squat), vertical jump height, change-of-direction speed, and specific performance (e.g., fencing movement velocity), although without meaningful effects on body mass, fat mass, and muscle mass (ES = 0.02 to -0.06). Most (7 of 8) outcomes attained low heterogeneity. The outcome-level GRADE analysis indicated a certainty of evidence from low to moderate. In conclusion, PJT, when compared to control conditions, may improve CoSA athletic performance.

Piezoelectric and Magnetically Responsive Biodegradable Composites with Tailored Porous Morphology for Biotechnological Applications.

The biomedical area in the scope of tissue regeneration pursues the development of advanced materials that can target biomimetic approaches and, ideally, have an active role in the environment they are placed in. This active role can be related to or driven by morphological, mechanical, electrical, or magnetic stimuli, among others. This work reports on the development of active biomaterials based on poly(3-hydroxybutyric acid-co-3-hydroxyvaleric acid), PHBV, a piezoelectric and biodegradable polymer, for tissue regeneration application by tailoring its morphology and functional response. PHBV films with different porosities were obtained using the solvent casting method, resorting to high-boiling-point solvents, as N,N-dimethylformamide (DMF) and dimethylsulfoxide (DMSO), and the combination of chloroform (CF) and DMF for polymer dissolution. Furthermore, magnetoelectric biomaterials were obtained through the combination of the piezoelectric PHBV with magnetostrictive iron oxide (Fe3O4) nanoparticles. Independently of the morphology or filler content, all biomaterials proved to be suitable for biomedical applications.

The effects of myofascial induction therapy in survivors of head and neck cancer: a randomized, controlled clinical trial.

PURPOSE: We aim to evaluate the effects of myofascial induction therapy (MIT) on the sequelae suffered by the survivors of HNC (sHNC). METHODS: We enrolled 46 sHNC in a randomized controlled trial (RCT), of whom 20 received a MIT protocol and 23 were placed on a waitlist while receiving the recommended treatment for 6 weeks. The MIT protocol included a total of 18 sessions, 3 days a week on alternate days for 6 weeks. Maximal mouth opening, the presence of temporomandibular dysfunction, cervical endurance, active range of motion (AROM), shoulder AROM, handgrip strength, and perceived physical fitness were assessed. RESULTS: Maximal mouth opening, temporomandibular dysfunction, cervical endurance, and AROM, affected shoulder abduction and unaffected shoulder flexion and external rotation significantly improved (p < .05) after an MIT protocol, but only cervical AROM and affected shoulder abduction changes were clinically meaningful. No statistically significant changes were observed in the other shoulder AROM, handgrip strength, or physical fitness perception (p > .05). CONCLUSION: A 6-week MIT protocol improves mouth opening, TMD, cervical function (endurance and AROM), affected shoulder abduction and unaffected shoulder flexion, and external rotation AROM in the sHNC. However, no changes were observed in most of the shoulder AROM, muscular strength, or perceived physical fitness. Future studies should perform longer follow-up designs, increase the sample size, and include multimodal treatments to address these sequelae in the sHNC.

Effects of plyometric training on softer vs. Harder surfaces on jump-related performance in rugby sevens players.

This study aimed to compare jump-related performance after plyometric training on harder vs. softer surfaces in rugby sevens players. Fourteen players were randomly assigned to the harder surface group (H-G, n = 7) and softer surface group (S-G, n = 7). Three times per week, in the morning, the players performed plyometric training on different surfaces and strength training. Before and after the 4-week intervention period, squat jump (SJ), countermovement jump (CMJ), and CMJ with arms (CMJA) tests were performed to measure vertical jump displacement (d), rate of force development (r), and power (p). The main results indicated a significant improvement in S-G for CMJd (∆% = +8.2%; p = 0.029; ES = 0.59) and for CMJAp (∆% = +8.7%; p = 0.035; ES = 0.44). These improvements were significant compared to H-G for CMJAd (F1,12 = 8.50; p = 0.013; η p 2 = 0.41; ES = 0.83) and CMJAp (F1,12 = 7.69; p = 0.017; η p 2 = 0.39; ES = 0.79). This study reveals that performance related to the counter movement jump with arms on softer surfaces after 4-week plyometric training improved vertical jump displacement and lower body power in rugby sevens players.