The urogenital microbiome in chronic kidney disease patients on peritoneal dialysis / El microbioma urogenital en pacientes con enfermedad renal crónica en diálisis peritoneal

Introduction and objectives: Diabetes, dyslipidemia, older age, gender, urinary tract infections, and recent antibiotic intake have been associated with a decrease in the urobiome richness and other fluctuations in this microbiome. Gut and blood microbiome have been reported to be altered in patients with chronic kidney disease (CKD), and specifically in peritoneal dialysis (PD) patients. Still, there are currently no studies describing the urogenital microbiome in CKD-PD patients. In this study we characterized the urobiome profile in 46 PD patients and analyzed its clinical and inflammatory parameters. Materials and methods: Mid-stream urine, fecal and blood samples were collected from 46 patients undergoing PD at Centro Hospitalar Universitário de São João (CHUSJ) in Porto, Portugal. Exclusion criteria were age under 18 years old, inability to give informed consent, history of infection in the last three months, and antibiotic intake in the last three months. The microbiome communities were analyzed by amplification and sequencing of the V3–V4 region of the bacterial 16S rRNA gene. Correlations with the patients’ clinical data and inflammatory profile were performed. Results: CKD-PD patients presented a unique urobiome profile dominated by Bacillota, Actinomycetota and Pseudomonadota and characterized by a lower Shannon diversity than fecal and blood microbiome. The taxonomic profiles of urogenital samples were organized in multiple subtypes dominated by populations of Lactobacillus, Staphylococcus, Streptococcus, Gardnerella, Prevotella, Escherichia-Shigella, being similar to other non-PD-CKD patients. Gender, sCD14, residual diuresis and history of peritonitis were significantly associated to variations in the urobiome. Although not reaching statistical significance, diabetes and the time on PD also showed association with particular taxonomic groups... (AU)

Introducción y objetivos: Diabetes, dislipemia, edad avanzada, género, infecciones del tracto urinario y toma reciente de antibióticos, entre otras, se han asociado a una disminución en la riqueza del urobioma y a otras fluctuaciones de dicho microbioma.Recientemente, se han descrito alteraciones en losmicrobiomas intestinal y en sangreen pacientes con enfermedad renal crónica (ERC) y, específicamente, en pacientes en diálisis peritoneal (DP).A pesar de ello, aún no existen estudios que describan el microbioma urogenital en pacientes en DP. En el presente trabajo, caracterizamos el urobioma en 46 pacientes en DP. Pacientes y métodos: Se recogieron muestras de orina (micción espontánea), heces y sangre de 46 pacientes en DP del Centro HospitalarUniversitário de São João en Oporto, Portugal. Los criterios de exclusión fueron edad menor a 18 años, incapacidad para entenderel consentimiento informado, e historia de infección y toma de antibióticos en los últimos 3 meses. Las comunidades microbiológicas fueron analizadas por amplificación y secuenciación de las regiones V3-V4 del 16S rRNA bacteriano. Se realizaron correlaciones con los datos clínicos y el perfil inflamatorio de los pacientes. Resultados: Los pacientes en DP presentaron un urobioma único dominado por Bacillota, Actinomycetota yPseudomonadota, y caracterizado por una menor diversidad de Shannon que los microbiomas en sangre e intestinal. Los perfiles taxonómicos de las muestras urogenitales se organizaron en múltiples subtipos dominados por poblaciones de Lactobacillus, Staphylococcus, Streptococcus, Gardnerella, Prevotella, Escherichia-Shigella, siendo similar al descrito para otros pacientes con ERC no en DP.Género, factor sCD14, diuresis residual yantecedentes de peritonitis se asociaron de forma significativa a cambios en el urobioma... (AU)

Reprogramming iPSCs to study age-related diseases: Models, therapeutics, and clinical trials.

The unprecedented rise in life expectancy observed in the last decades is leading to a global increase in the ageing population, and age-associated diseases became an increasing societal, economic, and medical burden. This has boosted major efforts in the scientific and medical research communities to develop and improve therapies to delay ageing and age-associated functional decline and diseases, and to expand health span. The establishment of induced pluripotent stem cells (iPSCs) by reprogramming human somatic cells has revolutionised the modelling and understanding of human diseases. iPSCs have a major advantage relative to other human pluripotent stem cells as their obtention does not require the destruction of embryos like embryonic stem cells do, and do not have a limited proliferation or differentiation potential as adult stem cells. Besides, iPSCs can be generated from somatic cells from healthy individuals or patients, which makes iPSC technology a promising approach to model and decipher the mechanisms underlying the ageing process and age-associated diseases, study drug effects, and develop new therapeutic approaches. This review discusses the advances made in the last decade using iPSC technology to study the most common age-associated diseases, including age-related macular degeneration (AMD), neurodegenerative and cardiovascular diseases, brain stroke, cancer, diabetes, and osteoarthritis.

Measuring healthy ageing: current and future tools.

Human ageing is a complex, multifactorial process characterised by physiological damage, increased risk of age-related diseases and inevitable functional deterioration. As the population of the world grows older, placing significant strain on social and healthcare resources, there is a growing need to identify reliable and easy-to-employ markers of healthy ageing for early detection of ageing trajectories and disease risk. Such markers would allow for the targeted implementation of strategies or treatments that can lessen suffering, disability, and dependence in old age. In this review, we summarise the healthy ageing scores reported in the literature, with a focus on the past 5 years, and compare and contrast the variables employed. The use of approaches to determine biological age, molecular biomarkers, ageing trajectories, and multi-omics ageing scores are reviewed. We conclude that the ideal healthy ageing score is multisystemic and able to encompass all of the potential alterations associated with ageing. It should also be longitudinal and able to accurately predict ageing complications at an early stage in order to maximize the chances of successful early intervention.

Corrigendum: In a zebrafish biomedical model of human Allan-Herndon-Dudley syndrome impaired MTH signaling leads to decreased neural cell diversity.

[This corrects the article DOI: 10.3389/fendo.2023.1157685.].

Automatic acoustic recognition of pollinating bee species can be highly improved by Deep Learning models accompanied by pre-training and strong data augmentation.

Introduction: Bees capable of performing floral sonication (or buzz-pollination) are among the most effective pollinators of blueberries. However, the quality of pollination provided varies greatly among species visiting the flowers. Consequently, the correct identification of flower visitors becomes indispensable to distinguishing the most efficient pollinators of blueberry. However, taxonomic identification normally depends on microscopic characteristics and the active participation of experts in the decision-making process. Moreover, the many species of bees (20,507 worldwide) and other insects are a challenge for a decreasing number of insect taxonomists. To overcome the limitations of traditional taxonomy, automatic classification systems of insects based on Machine-Learning (ML) have been raised for detecting and distinguishing a wide variety of bioacoustic signals, including bee buzzing sounds. Despite that, classical ML algorithms fed by spectrogram-type data only reached marginal performance for bee ID recognition. On the other hand, emerging systems from Deep Learning (DL), especially Convolutional Neural Networks (CNNs), have provided a substantial boost to classification performance in other audio domains, but have yet to be tested for acoustic bee species recognition tasks. Therefore, we aimed to automatically identify blueberry pollinating bee species based on characteristics of their buzzing sounds using DL algorithms. Methods: We designed CNN models combined with Log Mel-Spectrogram representations and strong data augmentation and compared their performance at recognizing blueberry pollinating bee species with the current state-of-the-art models for automatic recognition of bee species. Results and Discussion: We found that CNN models performed better at assigning bee buzzing sounds to their respective taxa than expected by chance. However, CNN models were highly dependent on acoustic data pre-training and data augmentation to outperform classical ML classifiers in recognizing bee buzzing sounds. Under these conditions, the CNN models could lead to automating the taxonomic recognition of flower-visiting bees of blueberry crops. However, there is still room to improve the performance of CNN models by focusing on recording samples for poorly represented bee species. Automatic acoustic recognition associated with the degree of efficiency of a bee species to pollinate a particular crop would result in a comprehensive and powerful tool for recognizing those that best pollinate and increase fruit yields.

In a zebrafish biomedical model of human Allan-Herndon-Dudley syndrome impaired MTH signaling leads to decreased neural cell diversity.

Background: Maternally derived thyroid hormone (T3) is a fundamental factor for vertebrate neurodevelopment. In humans, mutations on the thyroid hormones (TH) exclusive transporter monocarboxylic acid transporter 8 (MCT8) lead to the Allan-Herndon-Dudley syndrome (AHDS). Patients with AHDS present severe underdevelopment of the central nervous system, with profound cognitive and locomotor consequences. Functional impairment of zebrafish T3 exclusive membrane transporter Mct8 phenocopies many symptoms observed in patients with AHDS, thus providing an outstanding animal model to study this human condition. In addition, it was previously shown in the zebrafish mct8 KD model that maternal T3 (MTH) acts as an integrator of different key developmental pathways during zebrafish development. Methods: Using a zebrafish Mct8 knockdown model, with consequent inhibition of maternal thyroid hormones (MTH) uptake to the target cells, we analyzed genes modulated by MTH by qPCR in a temporal series from the start of segmentation through hatching. Survival (TUNEL) and proliferation (PH3) of neural progenitor cells (dla, her2) were determined, and the cellular distribution of neural MTH-target genes in the spinal cord during development was characterized. In addition, in-vivo live imaging was performed to access NOTCH overexpression action on cell division in this AHDS model. We determined the developmental time window when MTH is required for appropriate CNS development in the zebrafish; MTH is not involved in neuroectoderm specification but is fundamental in the early stages of neurogenesis by promoting the maintenance of specific neural progenitor populations. MTH signaling is required for developing different neural cell types and maintaining spinal cord cytoarchitecture, and modulation of NOTCH signaling in a non-autonomous cell manner is involved in this process. Discussion: The findings show that MTH allows the enrichment of neural progenitor pools, regulating the cell diversity output observed by the end of embryogenesis and that Mct8 impairment restricts CNS development. This work contributes to the understanding of the cellular mechanisms underlying human AHDS.

Development of a Novel Phagomagnetic-Assisted Isothermal DNA Amplification System for Endpoint Electrochemical Detection of Listeria monocytogenes.

The hitherto implemented Listeria monocytogenes detection techniques are cumbersome or require expensive non-portable instrumentation, hindering their transposition into on-time surveillance systems. The current work proposes a novel integrated system resorting to loop-mediated isothermal amplification (LAMP), assisted by a bacteriophage P100-magnetic platform, coupled to an endpoint electrochemical technique, towards L. monocytogenes expeditious detection. Molybdophosphate-based optimization of the bacterial phagomagnetic separation protocol allowed the determination of the optimal parameters for its execution (pH 7, 25 °C, 32 µg of magnetic particles; 60.6% of specific capture efficiency). The novel LAMP method targeting prfA was highly specific, accomplishing 100% inclusivity (for 61 L. monocytogenes strains) and 100% exclusivity (towards 42 non-target Gram-positive and Gram-negative bacteria). As a proof-of-concept, the developed scheme was successfully validated in pasteurized milk spiked with L. monocytogenes. The phagomagnetic-based approach succeeded in the selective bacterial capture and ensuing lysis, triggering Listeria DNA leakage, which was efficiently LAMP amplified. Methylene blue-based electrochemical detection of LAMP amplicons was accomplished in 20 min with remarkable analytical sensitivity (1 CFU mL-1). Hence, the combined system presented an outstanding performance and robustness, providing a 2.5 h-swift, portable, cost-efficient detection scheme for decentralized on-field application.

How can we modulate aging through nutrition and physical exercise? An epigenetic approach.

The World Health Organization predicts that by 2050, 2.1 billion people worldwide will be over 60 years old, a drastic increase from only 1 billion in 2019. Considering these numbers, strategies to ensure an extended "healthspan" or healthy longevity are urgently needed. The present study approaches the promotion of healthspan from an epigenetic perspective. Epigenetic phenomena are modifiable in response to an individual's environmental exposures, and therefore link an individual's environment to their gene expression pattern. Epigenetic studies demonstrate that aging is associated with decondensation of the chromatin, leading to an altered heterochromatin structure, which promotes the accumulation of errors. In this review, we describe how aging impacts epigenetics and how nutrition and physical exercise can positively impact the aging process, from an epigenetic point of view. Canonical histones are replaced by histone variants, concomitant with an increase in histone post-translational modifications. A slight increase in DNA methylation at promoters has been observed, which represses transcription of previously active genes, in parallel with global genome hypomethylation. Aging is also associated with deregulation of gene expression - usually provided by non-coding RNAs - leading to both the repression of previously transcribed genes and to the transcription of previously repressed genes. Age-associated epigenetic events are less common in individuals with a healthy lifestyle, including balanced nutrition, caloric restriction and physical exercise. Healthy aging is associated with more tightly condensed chromatin, fewer PTMs and greater regulation by ncRNAs.

Mixed circuit training acutely reduces arterial stiffness in patients with chronic stroke: a crossover randomized controlled trial.

PURPOSE: Investigate whether a single bout of mixed circuit training (MCT) can elicit changes in arterial stiffness in patients with chronic stroke. Second, to assess the between-day reproducibility of post-MCT arterial stiffness measurements. METHODS: Seven participants (58 ± 12 years) performed a non-exercise control session (CTL) and two bouts of MCT on separate days in a randomized counterbalanced order. The MCT involved 3 sets of 15 repetition maximum for 10 exercises, with each set separated by 45-s of walking. Brachial-radial pulse wave velocity (br-PWV), radial artery compliance (AC) and reflection index (RI1,2) were assessed 10 min before and 60 min after CTL and MCT. Ambulatory arterial stiffness index (AASI) was calculated from 24-h recovery ambulatory blood pressure monitoring. RESULTS: Compared to CTL, after 60 min of recovery from the 1st and 2nd bouts of MCT, lower values were observed for br-PWV (mean diff = - 3.9 and - 3.7 m/s, respectively, P < 0.01; ICC2,1 = 0.75) and RI1,2 (mean diff = - 16.1 and - 16.0%, respectively, P < 0.05; ICC2,1 = 0.83) concomitant with higher AC (mean diff = 1.2 and 1.0 × 10-6 cm5/dyna, respectively, P < 0.01; ICC2,1 = 0.40). The 24-h AASI was reduced after bouts of MCT vs. CTL (1st and 2nd bouts of MCT vs. CTL: mean diff = - 0.32 and - 0.29 units, respectively, P < 0.001; ICC2,1 = 0.64). CONCLUSION: A single bout of MCT reduces arterial stiffness during laboratory (60 min) and ambulatory (24 h) recovery phases in patients with chronic stroke with moderate-to-high reproducibility. TRIAL REGISTRATION: Ensaiosclinicos.gov.br identifier RBR-5dn5zd.

Searching for biomarkers candidates of autism spectrum disorder with metabolic disorders evidences for a possible role of proteins and amino acids content in urine

Background: Autism Spectrum Disorder (ASD) is characterized by conditions involving areas of social interaction, communication and behavior, as well as sensory sensitivity. Studies have reported an association of ASD with al terations in protein and amino acid metabolism. The aim of this study was to identify the profile of proteins and amino acids in the urine of children with ASD. Methods: Prospective cross-sectional study with case-control design. The cases were male children (n=22) with ASD, aged 3 to 10 years, and the control group was formed by neuro-typical children (n=22), matched for sex and age. The determination of the amount and composition of proteins was performed by the Bradford method and the determination of the amount and composition of amino acids by ultra-efficient liquid chromatography (CLUE). Results: Alterations in protein and amino acid concentrations of arginine, glycine, leucine, threonine, aspartic acid, alanine, histidine, and tyrosine were identified in the urine of children with ASD. The abnormal levels of proteins and amino acids may be related to several symptoms observed in people with ASD. Conclusion: The concentration of total protein and amino acid profile in urine are good candidates as biomarkers for individuals with ASD.

Nutritional aspects related with casein and gluten comsumption in autism spectrum disorder ASD

The etyology of Autism Spectrum Disorder (ASD) is unknown, involves a complex interaction between multiple and varied susceptible genes, epygenetic and environmental factors. The diagnosis is made through clinical evaluation First-line therapies are psychosocial treatments and educational interventions. On average 30% of people and with ASD consumes some drug or supplement. The options and effectiveness of the treatments are limited and therefore several lines of alternative treatment have emerged. The use of dietary restriction to reduce behavioral symptoms is widespread, with the most popular being the "theory of excess opioid peptides which postulates that the consumption of gluten and casein contributes to the worsening of symptoms and a diet free of these proteins improves the clinical picture. Despite many data presented in the literature, there are still doubts about the mechanisms involved as well as about dietary efficacy For all of the above, the topical review will address the opioid system, opioid peptides derived from gluten and casein, changes in the digestive tract of individuals with ASD, history of the onset of the theory, physiological mechanisms involved, brief description of the scientific literature, on the subject and the perspectives as a therapeutic instrument.

Vascular Calcification and the Gut and Blood Microbiome in Chronic Kidney Disease Patients on Peritoneal Dialysis: A Pilot Study.

Vascular calcification (VC) is a frequent condition in chronic kidney disease (CKD) and a well-established risk factor for the development of cardiovascular disease (CVD). Gut dysbiosis may contribute to CVD and inflammation in CKD patients. Nonetheless, the role of gut and blood microbiomes in CKD-associated VC remains unknown. Therefore, this pilot study aimed to explore the link between gut and blood microbiomes and VC in CKD patients on peritoneal dialysis (CKD-PD). Our results showed relative changes in specific taxa between CKD-PD patients with and without VC, namely Coprobacter, Coprococcus 3, Lactobacillus, and Eubacterium eligens group in the gut, and Cutibacterium, Pajaroellobacter, Devosia, Hyphomicrobium, and Pelomonas in the blood. An association between VC and all-cause mortality risk in CKD-PD patients was also observed, and patients with higher mortality risk corroborate the changes of Eubacterium eligens in the gut and Devosia genus in the blood. Although we did not find differences in uremic toxins, intestinal translocation markers, and inflammatory parameters among CKD-PD patients with and without VC, soluble CD14 (sCD14), a nonspecific marker of monocyte activation, positively correlated with VC severity. Therefore, gut Eubacterium eligens group, blood Devosia, and circulating sCD14 should be further explored as biomarkers for VC, CVD, and mortality risk in CKD.

Effects of pristine or contaminated polyethylene microplastics on zebrafish development.

The presence of microplastics in the aquatic ecosystem represents a major issue for the environment and human health. The capacity of organic pollutants to adsorb onto microplastic particles raises additional concerns, as it creates a new route for toxic compounds to enter the food web. Current knowledge on the impact of pristine and/or contaminated microplastics on aquatic organisms remains insufficient, and we provide here new insights by evaluating their biological effects in zebrafish (Danio rerio). Zebrafish larvae were raised in ZEB316 stand-alone housing systems and chronically exposed throughout their development to polyethylene particles of 20-27 µm, pristine (MP) or spiked with benzo[α]pyrene (MP-BaP), supplemented at 1% w/w in the fish diet. While they had no effect at 30 days post-fertilization (dpf), MP and MP-BaP affected growth parameters at 90 and 360 dpf. Relative fecundity, egg morphology, and yolk area were also impaired in zebrafish fed MP-BaP. Zebrafish exposed to experimental diets exhibited an increased incidence of skeletal deformities at 30 dpf as well as an impaired development of caudal fin/scales, and a decreased bone quality at 90 dpf. An intergenerational bone formation impairment was also observed in the offspring of parents exposed to MP or MP-BaP through a reduction of the opercular bone in 6 dpf larvae. Beside a clear effect on bone development, histological analysis of the gut revealed a reduced number of goblet cells in zebrafish fed MP-BaP diet, a sign of intestinal inflammation. Finally, exposure of larvae to MP-BaP up-regulated the expression of genes associated with the BaP response pathway, while negatively impacting the expression of genes involved in oxidative stress. Altogether, these data suggest that long-term exposure to pristine/contaminated microplastics not only jeopardizes fish growth, reproduction performance, and skeletal health, but also causes intergenerational effects.

Biocontamination and diversity of epilithic bacteria and fungi colonising outdoor stone and mortar sculptures.

Microbial communities colonising outdoor sculptures form intricate and dynamic ecosystems, which can accelerate the deterioration processes of the artworks and pose challenges to their conservation. In this study, the bacterial and fungal communities colonising the surfaces of five contemporary outdoor sculptures were characterised by high-throughput sequencing. The sculptures, made of marble, granite, Ançã limestone and mortar, are in urban parks and squares in the district of Porto, Portugal. The analysis of the microbial populations revealed great taxonomic diversity and species richness, including in well-preserved sculptures showing few visible traces of contamination. Proteobacteria, namely the genera Pseudomonas and Sphingomonas, were the core taxa common to all the sculptures, while Massilia and Aureobasidium were dominant only in granite. An abundance of pigment-producing microorganisms, such as Deinococcus, Methylobacterium, Rhodotorula and Sporobolomyces, was also found in granite. These are relevant taxonomic groups that can negatively impact stone and mortar artworks. The study was complemented with colourimetric analyses and bioluminescence assays to measure the adenosine triphosphate (ATP) content of samples collected from specific contaminated areas of the sculptures. The characterisation of the microbiomes of sculptures can provide further knowledge on the deterioration risks of this type of artwork in the region and help outline future targeted conservation strategies. KEY POINTS: • Rich and abundant microbiomes expose sculptures' vulnerability to deterioration. • Well-preserved sculptures are at risk of deterioration by pigment-producing taxa. • ATP and colourimetry quickly identified the most relevant contaminated areas.

Comparative performance of fully-automated and semi-automated artificial intelligence methods for the detection of clinically significant prostate cancer on MRI: a systematic review.

OBJECTIVES: We systematically reviewed the current literature evaluating the ability of fully-automated deep learning (DL) and semi-automated traditional machine learning (TML) MRI-based artificial intelligence (AI) methods to differentiate clinically significant prostate cancer (csPCa) from indolent PCa (iPCa) and benign conditions. METHODS: We performed a computerised bibliographic search of studies indexed in MEDLINE/PubMed, arXiv, medRxiv, and bioRxiv between 1 January 2016 and 31 July 2021. Two reviewers performed the title/abstract and full-text screening. The remaining papers were screened by four reviewers using the Checklist for Artificial Intelligence in Medical Imaging (CLAIM) for DL studies and Radiomics Quality Score (RQS) for TML studies. Papers that fulfilled the pre-defined screening requirements underwent full CLAIM/RQS evaluation alongside the risk of bias assessment using QUADAS-2, both conducted by the same four reviewers. Standard measures of discrimination were extracted for the developed predictive models. RESULTS: 17/28 papers (five DL and twelve TML) passed the quality screening and were subject to a full CLAIM/RQS/QUADAS-2 assessment, which revealed a substantial study heterogeneity that precluded us from performing quantitative analysis as part of this review. The mean RQS of TML papers was 11/36, and a total of five papers had a high risk of bias. AUCs of DL and TML papers with low risk of bias ranged between 0.80-0.89 and 0.75-0.88, respectively. CONCLUSION: We observed comparable performance of the two classes of AI methods and identified a number of common methodological limitations and biases that future studies will need to address to ensure the generalisability of the developed models.

Performance analysis of women over 55 years on abdominaltests: impact of anthropometry and flexibility

The objective of the present study was to evaluate the effect of anthropometric variables and flexibility on the performance of women aged 55+ years on abdominal test protocols. The sample was composed by 20 physically active volunteers, aged 55 years (median 61), who were participants in gymnastic activities program. Each volunteer performed two abdominal tests: partial trunk flexion with a 7.6 cm sliding of the hands (P1) and partial flexion of the trunk with the hands on the thighs (P2), both executed with the feet resting on the ground. For analysis, the number of correct executions (final position) was considered in each test, as recommended by the authors. Measurements of body mass, flexibility, height, waist and hip perimeters, subjective perception of exertion, and calculations of body mass index and waist-hip ratio were performed. The perception of abdominal effort, and discomfort or pain in the cervical and lumbar region were also evaluated. The results showed that there were no statistically significant associations between the analyzed indicators (Age: P1: rs = -0.024, p = 0.916; P2: rs = -0.194, p = 0.407; BMI: P1: rs =-0.064, p = 0.792; P2: rs = -0.235, p= 0.327; Waist Circumference: P1: rs = -0.143, p = 0.563; P2: rs = 0.027, p = 0.908; Flexibility: r s= -0.327, p = 0.169; P2: rs = 0.0009, p = 0.991; Hip waist ratio: P1: rs = -0.209, p = 0.371; P2: rs = 0.217, p = 0.353) and the performance on the tests. In addition, 35% of the participants made valid attempts on P1 while 45% produced at least one valid attempt on P2. It was concluded that both abdominal tests were adequate for the studied sample and they can be applied to adult and elderly women to assess their abdominal musculature.(AU)

El objetivo del presente estudio fue evaluar el efecto de las variables las antropométricas y la flexibilidad sobre el desempeño de mujeres mayores de 55 años en protocolos de testes abdominales. La muestra, seleccionada por criterio de accesibilidad, estuvo formada por 20 voluntarias físicamente activas, mayores de 55 años (mediana 61), que participaban en actividades gimnásticas para personas mayores. Cada voluntaria realizó dos pruebas abdominales: flexión parcial del tronco con deslizamiento de las manos de 7,6 cm (P1) y flexión parcial del tronco con las manos en los muslos (P2), ambas ejecutadas con los pies apoyados en el suelo. Para el análisis, se consideró el número de ejecuciones correctas (posición final) en cada prueba, según lo recomendado por los autores. Se realizaron mediciones de masa corporal, flexibilidad, altura, perímetro de cintura y cadera, percepción subjetiva del esfuerzo y cálculos del índice de masa corporal y la relación cintura-cadera. También se evaluó la percepción de esfuerzo abdominal y de malestar o dolor en la región cervical y lumbar. Los resultados mostraron que no hubo asociaciones estadísticamente significativas entre las variables analizadas (Edad: P1: rs = -0,024, p = 0,916; P2: rs = -0,194, p = 0,407; IMC: P1: rs =-0,064, p = 0,792; P2: rs = -0,235, p = 0,327; Perímetro de cintura: P1: rs = -0,143, p = 0,563; P2: rs = 0,027, p = 0,908; Flexibilidad: rs = -0,327, p = 0,169; P2: rs = 0,0009, p = 0,991; Relación cintura/cadera: P1: rs = -0,209, p = 0,371; P2: rs = 0,217, p = 0,353) y el desempeño en las pruebas, y el 35% de las participantes hicieron intentos válidos en P1 mientras que el 45% produjo al menos un intento válido en P2. Se concluyó que ambas pruebas abdominales fueron adecuadas para la muestra estudiada y se pueden aplicar a mujeres adultas y mayores para evaluar su musculatura abdominal.(AU)

Knowledge of HIV/AIDS and the clinical and sexual practices of dental students / Conhecimento sobre HIV/AIDS e práticas clínicas e sexuais de estudantes de Odontologia

The aim of the study was to assess knowledge of HIV/AIDS and the clinical and sexual practices of dental students. This was a cross-sectional study in which a self-administered questionnaire about age, gender, and dental program term; knowledge of HIV/AIDStransmission and prevention; use of personal protective equipment; prevention and occurrence of accidental exposure to biological material; post-exposure conduct; and sexual behavior was answered by dental students (n = 148, answer rate of 91.9%). Descriptive and inferential statistical analyses (chi-square and Fisher's exact tests) were performed, at a significance level of 5%. Students correctly recognized the routes of HIV transmission, including "blood" (100%), "sexual.3%). Regarding frequency of condom use during sexual intercourse, 37% of dental students said "always," 55.5% "sometimes" and 7.6% "never". Regarding clinical practices, 99.3% of dental students said they used personal protective equipment, 28.4% had intercourse" (99.3%), "vertical transmission" (58.1%) and "sharing contaminated material" (94.6%), and ways of prevention, including "condom use" (100%) and "not sharing needles and syringes" (99suffered percutaneous injuries, the needle was the most cited exposure agent (32.5%) and in most cases (54.8%), no providences were taken after the accident. In conclusion, the students had good knowledge of HIV / AIDS and appropriate preventive attitudes in clinical care and handling of sharp instruments; however, they still need to be motivated with regard to condom use and oriented about care after accidental exposure to biological material (AU).

O objetivo do estudo foi avaliar o conhecimento de HIV/AIDS e as práticas clínicas e sexuais de estudantes de Odontologia. Este foi um estudo transversal, no qual um questionário autoadministrado abordando: idade, gênero, período do curso; conhecimento sobre transmissão e prevenção de HIV/AIDS; uso de equipamentos de proteção individual; prevenção e ocorrência de exposição acidental a material biológico; conduta pós-exposição e comportamento sexual foi respondido por alunos de Odontologia (n = 148, taxa deresposta de 91.9%). Foram realizadas análises estatísticas descritiva e inferencial (testes qui-quadrado e exato de Fisher), comnível de significância de 5%. Os estudantes reconheceram corretamente as rotas de transmissão de HIV, incluindo "sangue" (100%), "relação sexual" (99,3%), "transmissão vertical" (58,1%) e "compartilhamento de material contaminado" (94,6%) e os meios de prevenção, incluindo "uso de preservativo" (100%) e "não compartilhar agulhas e seringas" (99,3%). Quanto à frequência do uso de preservativo nas relações sexuais, 37% dos estudantes responderam "sempre", 55,5% "às vezes" e 7,6% "nunca". Com relação a práticas clínicas, 99,3% dos estudantes de Odontologia afirmaram utilizar equipamentos de proteção individual, 28,4% já sofreram acidente perfurocortante, sendo agulha o agente de exposição mais citado (32,5%) e na maioria dos casos (54,8%) nenhuma medida foi tomada após o acidente. Em conclusão, os estudantes exibiram bom conhecimento acerca de HIV/AIDS e atitudes preventivas adequadasno atendimento clínico e manejo de instrumentais perfurocortantes, entretanto ainda precisam ser motivados quanto ao uso de preservativo e orientados sobre os cuidados pós-exposição acidental a material biológico (AU).

The effectiveness of community-based upper body exercise programs in persons with chronic paraplegia and manual wheelchair users: A systematic review.

Context: Physical activity has been beneficial to health, functional independence and quality of life in individuals with spinal cord injury. However, there is no consensus concerning the effects of community-based upper-body exercise for people with paraplegia who use a manual wheelchair.Objective: Conduct a systematic review of evidence of upper-body exercise effects able to be developed in a community-setting, on both functional independence and quality of life, for individuals with chronic paraplegia who use a manual wheelchair.Methods: PubMed, Scopus, Ebsco, SportDiscus and Web of Science databases were browsed, searching for studies that combined words as paraplegia, exercise, functional independence and quality of life and their synonyms, published from January/1998 to December/2018 in English. PEDro scale and the Cochrane tool analyzed methodological quality and risk of bias, respectively.Results: Four studies were selected out of 4004. Studies conducted aerobic arm-ergometer and resistance training predominantly at home. Upper-limb functionality and wheelchair propulsion assessed functional independence, but only the first presented positive effects after resistance training. Resistance and aerobic arm-ergometer training seemed to improve health-related and subjective quality of life.Conclusion: Studies have shown low methodological quality and high risk of bias. Aerobic arm-ergometer and resistance training were the most upper-body exercises used. Resistance training improved functional independence while both types of exercise induced positive effects on quality of life. Future studies with uniform and high-quality methodology should be conducted with exercise in community-dwelling people with paraplegia who use a manual wheelchair.

Characterization of Oral Enterobacteriaceae Prevalence and Resistance Profile in Chronic Kidney Disease Patients Undergoing Peritoneal Dialysis.

Chronic Kidney Disease (CKD) is a growing public-health concern worldwide. Patients exhibit compromised immunity and are more prone to infection than other populations. Therefore, oral colonization by clinically relevant members of the Enterobacteriaceae family, major agents of both nosocomial and dialysis-associated infections with frequent prevalence of antibiotic resistances, may constitute a serious risk. Thus, this study aimed to assess the occurrence of clinically relevant enterobacteria and their antibiotic resistance profiles in the oral cavity of CKD patients undergoing peritoneal dialysis (CKD-PD) and compare it to healthy controls. Saliva samples from all the participants were cultured on MacConkey Agar and evaluated regarding the levels of urea, ammonia, and pH. Bacterial isolates were identified and characterized for antibiotic resistance phenotype and genotype. The results showed that CKD-PD patients exhibited significantly higher salivary pH, urea, and ammonia levels than controls, that was accompanied by higher prevalence and diversity of oral enterobacteria. Out of all the species isolated, only the prevalence of Raoultella ornithinolytica varied significantly between groups, colonizing the oral cavity of approximately 30% of CKD-PD patients while absent from controls. Antibiotic resistance phenotyping revealed mostly putative intrinsic resistance phenotypes (to amoxicillin, ticarcillin, and cephalothin), and resistance to sulfamethoxazole (~43% of isolates) and streptomycin (~17%). However, all isolates were resistant to at least one of the antibiotics tested and multidrug resistance isolates were only found in CKD-PD group (31,6%). Mobile genetic elements and resistance genes were detected in isolates of the species Raoultella ornithinolytica, Klebsiella pneumoniae, Klebsiella oxytoca, Escherichia coli, and Enterobacter asburiae, mostly originated from CKD-PD patients. PD-related infection history revealed that Enterobacteriaceae were responsible for ~8% of peritonitis and ~ 16% of exit-site infections episodes in CKD-PD patients, although no association was found to oral enterobacteria colonization at the time of sampling. The results suggest that the CKD-induced alterations of the oral milieu might promote a dysbiosis of the commensal oral microbiome, namely the proliferation of clinically relevant Enterobacteriaceae potentially harboring acquired antibiotic resistance genes. This study highlights the importance of the oral cavity as a reservoir for pathobionts and antibiotic resistances in CKD patients undergoing peritoneal dialysis.