Association between area-level walkability and glycated haemoglobin: a Portuguese population-based study.

Diabetes poses a substantial disease burden, prompting preventive interventions. Physical inactivity, a major risk factor for type 2 diabetes, can potentially be mitigated by enhancing area-level walkability. Despite this, limited population-based studies have investigated the link between walkability and objective diabetes measures. Our study aims to estimate the association between area-level walkability and individual glycated haemoglobin levels in the Portuguese adult population without the diagnosis of diabetes. Data from the 2011 census and an updated street map were obtained to construct a walkability index based on residential density, land-use mix, and street connectivity. Individual health data were sourced from The National Health Examination Survey (INSEF) 2015, a representative survey of the Portuguese adult population. Gamma regression was employed for estimation of the main associations, revealing that residing in moderately walkable areas significantly reduced average glycated haemoglobin levels (Exp(ß) = 0.906; 95% CI: 0.821, 0.999) compared to the least walkable areas. The association was less pronounced and not statistically significant for the third tertile of walkability (Exp(ß) = 0.919; 95% CI: 0.822, 1.028). Our findings highlight a nonlinear protective association between walkability and glycated haemoglobin, emphasizing the potential policy implications for urban planning, diabetes prevention, and health promotion.

Comparative Effectiveness of COVID-19 Vaccines in Preventing Infections and Disease Progression from SARS-CoV-2 Omicron BA.5 and BA.2, Portugal.

We estimated comparative primary and booster vaccine effectiveness (VE) of SARS-CoV-2 Omicron BA.5 and BA.2 lineages against infection and disease progression. During April-June 2022, we implemented a case-case and cohort study and classified lineages using whole-genome sequencing or spike gene target failure. For the case-case study, we estimated the adjusted odds ratios (aORs) of vaccination using a logistic regression. For the cohort study, we estimated VE against disease progression using a penalized logistic regression. We observed no reduced VE for primary (aOR 1.07 [95% CI 0.93-1.23]) or booster (aOR 0.96 [95% CI 0.84-1.09]) vaccination against BA.5 infection. Among BA.5 case-patients, booster VE against progression to hospitalization was lower than that among BA.2 case-patients (VE 77% [95% CI 49%-90%] vs. VE 93% [95% CI 86%-97%]). Although booster vaccination is less effective against BA.5 than against BA.2, it offers substantial protection against progression from BA.5 infection to severe disease.

Effect of thickness of CAD/CAM materials on light transmission and resin cement polymerization using a blue light-emitting diode light-curing unit.

OBJECTIVE: Evaluate the effect of thickness of high-translucency (HT) CAD/CAM materials on irradiance and beam profile from a blue light-emitting diode light-curing unit (LCU) and on the degree of conversion (DC) and maximum polymerization rate (Rpmax ) of a light-cured resin cement (LCC). MATERIAL AND METHODS: The direct output from the LCU, the light transmission and irradiance ratio (IR) through one conventional composite and nine HT CAD/CAM materials (0.5, 1.0, 1.5, or 2.0-mm thick; n = 5) were measured with a integrating sphere coupled to a spectrometer. The light beam was assessed with a beam profiler camera. The DC at 600 s and the Rpmax of one LCC was determined using a Fourier transform infrared spectrometer (n = 5). Data were analyzed by ANOVA followed by Tukey's tests, and Dunnett's test was also used for irradiance data (α = 0.05). RESULTS: A significant decrease in irradiance through all materials occurred as thickness increased. Thin CAD/CAM materials improved light homogeneity, which decreased with the increase in thickness. The DC of the LCC directly exposed to light was the same as when exposed to 45%, 25%, 15%, or 5% IRs. Rpmax decreased with the decrease in IR. CONCLUSIONS: Although the HT CAD/CAM materials reduced the irradiance from the LCU, minor effects were observed in the LCC's DC. CLINICAL SIGNIFICANCE: Despite the light attenuation of blue light through different CAD/CAM materials that were up to 2-mm thick, the degree of conversion of one brand of light-cured resin cement was clinically acceptable when the LCU was used for 30 s.

Characterization of Systemic Disease Development and Paw Inflammation in a Susceptible Mouse Model of Mayaro Virus Infection and Validation Using X-ray Synchrotron Microtomography.

Mayaro virus (MAYV) is an emerging arthropod-borne virus endemic in Latin America and the causative agent of arthritogenic febrile disease. Mayaro fever is poorly understood; thus, we established an in vivo model of infection in susceptible type-I interferon receptor-deficient mice (IFNAR-/-) to characterize the disease. MAYV inoculations in the hind paws of IFNAR-/- mice result in visible paw inflammation, evolve into a disseminated infection and involve the activation of immune responses and inflammation. The histological analysis of inflamed paws indicated edema at the dermis and between muscle fibers and ligaments. Paw edema affected multiple tissues and was associated with MAYV replication, the local production of CXCL1 and the recruitment of granulocytes and mononuclear leukocytes to muscle. We developed a semi-automated X-ray microtomography method to visualize both soft tissue and bone, allowing for the quantification of MAYV-induced paw edema in 3D with a voxel size of 69 µm3. The results confirmed early edema onset and spreading through multiple tissues in inoculated paws. In conclusion, we detailed features of MAYV-induced systemic disease and the manifestation of paw edema in a mouse model extensively used to study infection with alphaviruses. The participation of lymphocytes and neutrophils and expression of CXCL1 are key features in both systemic and local manifestations of MAYV disease.

Thermoregulatory capacity of goat kids from birth to weaning in a dry hot climate.

This study aimed to evaluate the thermoregulatory capacity and performance of Saanen goat kids from birth to weaning in a hot climate. Twelve newborn males and female goat kids with an initial body weight of 4.17 ± 0.81 kg were used. Physiological responses, climatic variables, and biometric traits data were collected. Univariate and multivariate analysis techniques were used. Heart rate (HR) was high up to the 6th week of life, with a reduction from the 7th week on (P < 0.001). Rectal temperature (RT) was lower in the first 2 weeks (P < 0.001), with an increase and stabilization occurring in the 7th and 8th weeks. Coat surface temperature (ST) was more activated from the 5th week onwards (P < 0.001). Body weight (BW) and withers height (WH) were higher in later weeks of the calving phase with a linear effect (P < 0.001). The first principal component demonstrated the relationship of sensible heat dissipation × body area of the goat kids; the second component shows the relationship of meteorological data with RT, having a positive relationship between RT with RH and negative with AT, and the third component points to the association of RR and HR. Of the animals, 81.3% were correctly classified in their group of origin in discriminant canonical analysis, with emphasis on the classification of the kids in the 1st-2nd and 3rd-4th weeks (classification percentage Æ© = 95.8%). It is concluded that (i) newborn kids activate latent mechanisms to maintain their homoeothermic during the first 2 weeks of life, and as they grow, they use sensitive heat loss processes, especially from the 5th week of life onwards and (ii) male and female goats do not show sexual dimorphism effect on body performance and body morphometric measurements up to 60 days of life.

Phenotypes of mutations related to voltage-dependent sodium channels on children and adolescents.

Cardiac channelopathies are a heterogeneous group of inherited cardiac diseases that are associated with mutations in the genes that encode the expression of cardiac ion channels. In view of this, it can be mentioned that the main hereditary arrhythmias in children and adolescents, caused by dysfunction of the ion channels, are Brugada Syndrome (BrS) and Long QT Syndrome (LQTS). However, few studies address the physiological effects of these conditions on children and adolescents. Thus, the aim of this study is to describe the mutation phenotype related to voltage-gated sodium channels in children and adolescents. A search was performed in the literature of PubMed, Scielo, and Google scholar. The search was limited to articles written in the last 5 years, so articles published between 2014 and 2019 were included. Among 2196 studies identified through a systematic literature review, 30 studies related to the theme were identified for a complete review and after applying exclusion criteria, 4 articles were included in the results of this study. As the most frequently observed channelopathy, BrS was also more identified in children and adolescents, characterized by episodes of syncope or sudden cardiac death. LQTS shows clinical manifestations with a mild phenotype and good prognosis, although it is necessary to monitor and correct serum electrolyte disturbances to prevent ventricular arrhythmias and, consequently, sudden death in patients with the pathology. The aim of this study is to find the general phenotypes related to genetic mutations of voltage-gated sodium channels, in a population aged from 7- to 14-year-old.

PM10 exposure interacts with abdominal obesity to increase blood triglycerides: a cross-sectional linkage study.

BACKGROUND: Blood lipids and glucose levels dysregulation represent potential mechanisms intermediating the adverse cardiovascular effects of ambient particulate matter (PM) exposure. This study aims to estimate the effect of long-term PM10 exposure on blood lipids and glucose levels and to assess the potential mediation and/or modification action of abdominal obesity (AO) (waist-to-height ratio). METHODS: Our study was based on 2,390 participants of the first Portuguese Health Examination Survey (INSEF, 2015) with available data on blood lipids and glucose parameters and living within a 30-km radius of an air quality monitoring station with available PM10 measurements. PM10 concentrations were acquired from the air quality monitoring network of the Portuguese Environment Agency. Generalized linear models were used to assess the effect of 1-year PM10 exposure on blood lipids and glucose levels. An interaction term was introduced in the models to test the modification action of AO. RESULTS: We found an association between PM10 and non-fasting blood triglycerides (TG) after adjustment for age, sex, education, occupation, lifestyles-related variables and temperature but only in participants with AO. Per each 1 µg/m3 PM10 increment, there was a 1.84% (95% confidence interval: 0.02-3.69) increase in TG. For the remaining blood lipid and glucose parameters, no associations were found. CONCLUSIONS: Our study demonstrates that even at low levels of exposure, long-term PM10 exposure interacts with AO to increase blood TG. Our findings suggest that reducing both AO prevalence and PM10 below current standards would result in additional health benefits for the population.

Information needs of parents of children with congenital anomalies across Europe: a EUROlinkCAT survey.

BACKGROUND: Parents of children who have a congenital anomaly can experience significant worry about their child's health. Access to clear, helpful, and trustworthy information can provide a valuable source of support. In this study the aim was to explore the information needs of parents/carers of children with congenital anomalies across Europe. METHOD: A cross-sectional online survey was developed in nine languages to measure parents' information needs, including: (1) the 'helpfulness'/'trustworthiness' of information received from eight relevant sources, and (2) overall satisfaction with information received. Parents/carers of children (0-10 years) with cleft lip, spina bifida, congenital heart defect [CHD] requiring surgery, and/or Down syndrome were recruited online via relevant organisations in 10 European countries from March-July 2021. Quantitative analyses using multivariable logistic regressions were performed. RESULTS: One thousand seventy parents/carers of children with a cleft lip (n = 247), spina bifida (n = 118), CHD (n = 366), Down syndrome (n = 281), and Down syndrome with CHD (n = 58) were recruited in Poland (n = 476), the UK (n = 120), Germany (n = 97), the Netherlands/Belgium (n = 74), Croatia (n = 68), Italy (n = 59), other European countries (n = 92), and not specified/non-European countries (n = 84). Most participants were mothers (92%) and aged 31-40 years (71%). Participants were most likely to rate support groups (63%), patient organisations (60%), specialist doctors/nurses (58%), and social media (57%) as 'very helpful' information sources. 'Very trustworthy' ratings remained high for specialist doctors/nurses (61%), however, they declined for support groups (47%), patient organisations (48%), and social media (35%). Germany had the highest proportion of participants who were 'very satisfied' (44%, 95% CI = 34%-54%) with information, whereas this percentage was lowest in Croatia (11%, 95% CI = 3%-19%) and Poland (15%, 95% CI = 11%-18%). Parents of children with Down syndrome had significantly lower satisfaction ratings than parents of children with CHD; 13% (95% CI = 8%-18%) reported being 'very satisfied' compared to 28% (95% CI = 23%-33%) in the CHD group. CONCLUSIONS: Findings suggest that informal sources of information (e.g. support groups) are of value to parents, however, they are not deemed as trustworthy as specialist medical sources. Satisfaction ratings differed across countries and by anomaly, and were particularly low in Croatia and Poland, as well as for parents of children with Down syndrome, which warrants further investigation.

Impact of stringent non-pharmaceutical interventions applied during the second and third COVID-19 epidemic waves in Portugal, 9 November 2020 to 10 February 2021: an ecological study.

BackgroundNon-pharmaceutical interventions (NPIs) were implemented worldwide to control the spread of SARS-CoV-2.AimTo evaluate the impact of tiered NPIs and a nationwide lockdown on reduction of COVID-19 incidence during the second and third epidemic waves in Portugal.MethodsSurveillance data on laboratory-confirmed COVID-19 cases were used to conduct an interrupted time series analysis to estimate changes in daily incidence during a second wave tiered NPI period (9 November-18 December 2020), and a third wave lockdown period without (15-21 January 2021) and with school closure (22 January-10 February 2021).ResultsSignificant changes in trends were observed for the overall incidence rate; declining trends were observed for tiered NPIs (-1.9% per day; incidence rate ratio (IRR): 0.981; 95% confidence interval (CI): 0.973-0.989) and a lockdown period without (-3.4% per day; IRR: 0.966; 95% CI: 0.935-0.998) and with school closure (-10.3% per day, IRR: 0.897; 95% CI: 0.846-0.951). Absolute effects associated with tiered NPIs and a lockdown on a subsequent 14-day period yielded 137 cases and 437 cases per 100,000 population potentially averted, respectively.ConclusionOur results indicate that tiered NPIs implemented during the second wave caused a decline in COVID-19 incidence, although modest. Moreover, a third wave lockdown without school closure was effective in reducing COVID-19 incidence, but the addition of school closure provided the strongest effect. These findings emphasise the importance of early and assertive decision-making to control the pandemic.

COVID-19 mRNA vaccine effectiveness (second and first booster dose) against hospitalisation and death during Omicron BA.5 circulation: cohort study based on electronic health records, Portugal, May to July 2022.

We measured vaccine effectiveness (VE) against COVID-19-related severe outcomes in elderly people in Portugal between May and July 2022. In ≥ 80 year-olds, the second booster dose VE was 81% (95% CI: 75-85) and 82% (95% CI: 77-85), respectively, against COVID-19-related hospitalisation and death. The first booster dose VE was 63% (95% CI: 55-70) in ≥ 80 year-olds and 74% (95% CI: 66-80) in 60-79 year-olds against hospitalisation, and 63% (95% CI: 57-69) and 65% (95% CI: 54-74) against death.

Candida species biotypes and polyclonality of potentially virulent Candida albicans isolated from oral cavity of patients with orofacial clefts.

OBJECTIVES: This study evaluated the incidence of Candida species, and the genetic diversity and virulence of C. albicans of the oral cavity from patients with cleft lip and palate (CLP). MATERIALS AND METHODS: Oral samples were investigated by microbiological and species-specific PCR methods. The genetic diversity of C. albicans was established using isoenzyme markers, Nei's statistics, and clustering analysis. Hydrolytic enzymes (SAPs and PLs) were analyzed in vitro. RESULTS: Oral colonization by Candida species was observed in 29 patients with CLP (65.9%), and C. albicans was highly prevalent. SAP and PL activities were observed in 100% and 51.9% of isolates, respectively. High genetic diversity and patterns of monoclonal and polyclonal oral colonization by C. albicans were observed among patients with CLP. Two major polymorphic taxa (A and B) and other minor polymorphic taxa (C to J) were identified. Only one of the 16 clusters (taxon A) harbored strains from patients with and without CLP, whereas other clusters harbored strains exclusively from CLP patients. CONCLUSIONS: The anatomical conditions of the oral cavity of patients with CLP contribute to the high incidence of Candida species (C. albicans, C. krusei, C. tropicalis, and/or Candida spp.). Data suggest high genetic diversity of potentially virulent C. albicans strains in the oral cavity of CLP patients. CLINICAL RELEVANCE: Microbiological niches in orofacial clefts can contribute to the emergence of a relative clinical genotypic identity of C. albicans. However, orofacial rehabilitation centers can contribute to the direct and indirect sources of transmission and propagation of Candida species.

Effect of at-home bleaching gels with different thickeners on the physical properties of a composite resin without bisphenol A.

OBJECTIVE: To investigate, in vitro, the influence of at-home bleaching with 16% carbamide peroxide (CP) gels containing different thickeners on the color, gloss, roughness, and microhardness of a composite resin with bisphenol A (BPA) and without bisphenol A (BPA-free). MATERIAL AND METHODS: Cylindrical samples (7 × 2 mm) of a composite resin with BPA (Filtek Z350 XT®; 3M/ESPE) and composite resin BPA-free (Vittra APS®; FGM) were subdivided into six subgroups (n = 12), according to the bleaching gel used: no bleaching (control), commercial gel with 16% CP and carbopol, experimental gel with 16% CP and carbopol, experimental gel with 16% CP and natrosol, experimental gel with carbopol and experimental gel with natrosol. At the end of the experimental phase, the specimens were analyzed for color (ΔE*ab and ΔE00 ), surface roughness (Ra), gloss (GU), and surface microhardness (SMH). The data for all analyzes were submitted to Levene's test, Shapiro-Wilk's test and ANOVA. RESULTS: For ΔE*ab and ΔE00 no statistically significant differences were found between all groups evaluated. Bleaching with experimental 16% CP gel with carbopol resulted in the lowest GU values for both composite resins evaluated. 16% CP experimental gel with natrosol resulted in higher Ra for the BPA composite resin and the bleaching with natrosol resulted in higher Ra for BPA-free. About 16% CP experimental gel with carbopol and 16% CP experimental gel with natrosol resulted in the lowest final SMH for composite resin with BPA. For the BPA-free composite resin, no differences were found between the groups in SMH for the same resin, however they presented the lowest values compared with all others groups. CONCLUSION: The effects on physical properties are dependent on the composition of the composite resin and the thickener/bleaching gel used. The BPA-free composite resin showed less changes after exposure to bleaching agent, although its initial physical properties were worse compared to a bleached BPA. CLINICAL RELEVANCE: The hydrogen peroxide and thickener of the at-home bleaching gel does impact the properties of composites with BPA or BPA-free such as gloss, roughness and surface microhardness, extremely important factors for maintaining an aesthetically and physically satisfactory restoration. BPA-free composite resins have inferior properties after at-home bleaching with different thickeners.

Association between area- and individual-level socio-economic factors with glycated haemoglobin-Evidence from a Portuguese population-based study.

AIMS: This study aims to estimate the associations between area-level deprivation and individual-level socio-economic factors, as well as their interaction, with glycated haemoglobin (HbA1c ) levels. METHODS: We conducted a gamma multilevel regression analysis using individual-level data from the Portuguese National Health Examination Survey and a deprivation index built through factor analysis, at municipality level, with census variables. RESULTS: Living in a municipality with high material deprivation and having a low level of education were independently associated with an increase of 2.3% (95% confidence interval [CI] 0.6, 4.0) and of 1.6% (95% CI 0.6, 2.7) in the mean levels of HbA1c , respectively. The interaction between area material deprivation and individual-level education was not associated with the levels of HbA1c (0.5%, 95% CI -1.3, 2.3). CONCLUSIONS: Our findings support the collective resources model that argues that people in less deprived areas have better health because there are more collective resources. The results suggest that to reduce socio-economic inequalities associated with the levels of HbA1c and, consequently, with diabetes, will require attention to the area material deprivation and individual-level education. Upstream social determinants of health are thus highlighted.

Effect of treatment with carvacrol and aerobic training on cardiovascular function in spontaneously hypertensive rats.

NEW FINDINGS: What is the central question of this study? Can two non-drug therapies, carvacrol and aerobic physical training, together have additive effects on the reduction of cardiovascular risks and control of arterial hypertension? What is the main finding and its importance? The oral use of carvacrol (20 mg/kg/day) can control sustained hypertension in spontaneously hypertensive rats, and when this use is associated with aerobic physical training, there is a more pronounced effect on the reduction of blood pressure values, making these therapies an adjunct option in the drug treatment of hypertension. ABSTRACT: Systemic arterial hypertension is considered the foremost cardiovascular risk factor, and it is important to examine different therapies that help prevent and treat it, especially when associated with other cardiovascular risk factors. In this context, it is known that both carvacrol and aerobic physical training benefit the cardiovascular system. This study investigated the effects of treatment with carvacrol combined with aerobic exercise on hypertensive rats with cardiovascular risk parameters. We used an experimental design with six groups: normotensive control (Wistar rats); hypertensive control (spontaneously hypertensive rats, SHR); positive control rats treated with amlodipine (Aml-20 mg); rats treated with carvacrol (Carv-20 mg); rats trained with exercise (Exer); and rats treated with carvacrol and exercise (ExerCarv). The treatment lasted for 4 weeks, monitoring heart rate and systolic blood pressure (SBP). At the end of the treatment, vascular reactivity tests were performed in addition to biochemical measurements of urea, creatinine, aspartate aminotransferase, alanine aminotransferase, triglycerides, total cholesterol, high density lipoprotein cholesterol, low density lipoprotein cholesterol, very low density lipoprotein cholesterol, atherogenic indexes, relative heart weight and histopathological analysis of cardiac perivascular tissue. Significant reductions in SBP were observed after the training period, with the ExerCarv group showing a greater magnitude of reduction (∆SBP = 88 ± 10.0 mmHg, 42%). This group also experienced reductions in atherogenic indices and improvement in all analysed lipid parameters, with no differences observed in the Exer group. The findings indicated that the interaction between aerobic exercise and carvacrol offers a greater BP reduction. Exercise is particularly effective for controlling biochemical parameters of cardiovascular risk, regardless of carvacrol use.

The effect of family history of hypertension and polymorphism of the ACE gene (rs1799752) on cardiac autonomic modulation in adolescents.

This study aims to analyze the behaviour of cardiac autonomic modulation in adolescents with a family history of hypertension along with polymorphism of the ACE gene (rs1799752). The study involved 141 adolescents, with a mean age of 14.89, divided into the following six groups: offspring of normotensive parents (ONP): DD, DI and II; and offspring of hypertensive parents (OHP): DD, DI and II. Blood pressure, body composition, family history of hypertension, sleep disorder, and sexual maturation were assessed for the groups' characterization. Afterwards, an electrocardiogram was performed, and oral mucosal cells were collected to analyze heart rate variability and genotypic research of angiotensin-converting enzyme. The main finding of this study was the decrease of vagal action in group OHP (genotype DD) relative to group ONP (genotype II): LF (%), 54.25 ± 3.14 vs 39.33 ± 3.80; HF (%), 45.74 ± 3.14 vs 60.66 ± 3.80; LF/HF, 1.48 ± 0.23 vs 0.68 ± 0.19. The results also showed changes in the variable diastolic blood pressure (DBP) in OHP (genotype DI) to ONP (genotype II) groups: 72.99 ± 2.33 vs 63.27 ± 1.72; and OHP (genotype DI) to ONP (genotype DD) groups. Adolescents with genotype DD and a family history of arterial hypertension present chances in cardiac autonomic modulation, the cardiac parasympathetic modulation is lower in these adolescents in comparison to participants of ONP + II group.

Bioprospection: in vitro antimicrobial potential of the leaf extract of mycorrhizal guava infected by Meloidogyne enterolobii on Klebsiella pneumoniae.

Guava (Psidium guajava L.), is adapted to tropical and subtropical climates, and, in addition to its nutritional value, has great medicinal potential. One of the medicinal effects is antibacterial, and this can be identified from the phytochemicals present in its various parts, especially the leaf, which contains flavonoids, phenols, and tannins, as well as phytocomposites with antibacterial action. Therefore, the interaction of this plant with arbuscular mycorrhizal fungi and Meloidogyne enterolobii is a biotechnological resource that can increase the production of secondary metabolites so that the guava ethanolic extract is effective against multidrug-resistant bacterial strains. Therefore, the objective of this study was to test the inhibitory action of mycorrhizal guava leaf extract and Meloidogyne enterolobii on strains of Klebsiella pneumoniae carbapenemase. Guava seedlings from cuttings were inoculated with Acaulospora longula, and later with Meloidogyne enterolobii; the leaves were harvested at two maturation times of the plant and placed in an oven. Next, a leaf extract was prepared using ethanol as a solvent. The extract was tested in multidrug-resistant strains of K. pneumoniae carbapenemase from operative wounds using disc diffusion methodology. The plant-AMF-phytonematode interaction positively potentialize the inhibitory action of guava leaf ethanolic extract on multidrug-resistant bacterial strains.

mRNA vaccine effectiveness against COVID-19-related hospitalisations and deaths in older adults: a cohort study based on data linkage of national health registries in Portugal, February to August 2021.

Through deterministic data linkage of health registries, mRNA vaccine effectiveness (VE) against COVID-19-related hospitalisations and deaths was measured in 1,880,351 older adults. VE against hospitalisations was 94% (95% confidence interval (CI): 88-97) and 82% (95% CI: 72-89) for those 65-79 and ≥ 80 years old, with no evidence of waning 98 days after dose two. VE against mortality was 96% (95% CI: 92-98) and 81% (95% CI: 74-87) in these two age groups.

Identification of trailer heat zones and associated heat stress in weaner pigs transported by road in tropical climates.

Heat stress is major welfare concern during transport of pigs in tropical climates, which can also lead to direct production costs. This study evaluated the dynamics of heat zones through the load and their relationship with heat stress of weaner pigs during road transport in a tropical climate. Both environmental (e.g. temperature and relative humidity) and physiological (e.g. respiratory frequency and lactate) measures were recorded from four vehicle journeys (70 km distance, 216 weaner pigs within each trailer load) within Ceará, northeastern Brazil. Geostatistics and fluid dynamics simulation techniques were applied to understand the dynamics of heat zones and ventilation patterns the truckload. Statistics based on canonical discriminant analysis and ANOVA were performed to verify the relationship between heat zones and heat stress in pigs. The results showed that, during transport, the generation of heat zones occurred with different magnitudes along the load (P < 0.05), which was harmonized by the ventilation dynamics. There was a heat core with high energy content, in the front region of the lower deck (LD) of the trailer. In this zone, weaners pigs had higher rectal temperature (+1.8 °C temperature difference), respiratory frequency (LD = 94 ± 1.3 breaths/min; UD = 86 ± 1.3 breaths/min), and blood cortisol concentration (LD = 32.9 ± 0.8 ng/mL; UD = 30.18 ± 0.6 ng/mL) (all P < 0.05). Weaners pigs transported in the upper deck (UD) compartments had the highest skin temperature (LD = 38.13 ± 0.3 °C; UD = 38.9 ± 0.22 °C) and the highest mean values of blood lactate (LD = 65.5 ± 1.11 m/M; UD = 71.60 ± 1.19 m/M) and Creatine kinase (LD = 3891.23 ± 69U/L; UD = 4107.43 ± 62U/L) (P < 0.05). Weaners transported in compartments of the LD of trailer were more susceptible to heat stress, while weaners in the UD compartments were more susceptible to physical stress and muscle exhaustion. These results provide additional evidence of heat zones within trailer compartments and highlight the requirement for the planning of pig transport operations in tropical climates to mitigate risks of heat stress.

Acute Effects of Resistance Exercise With Blood Flow Restriction in Elderly Women: A Pilot Study.

AIM: To compare the acute effects of two resistance exercise sessions with different partial blood flow restrictions (BFR) on hemodynamic parameters and cardiac autonomic modulation in older women with metabolic syndrome. METHODS: Thirty-nine older women (64.4 ± 4.5 years) were allocated into three groups: BFR0 = resistance exercise (20%, 1 maximum repetition [MR]) + 0% BFR; BFR60 = 20% 1 MR resistance exercise + 60% BFR; and BFR80 = 20% 1MR resistance exercise + 80% BFR. RESULTS: A reduction of 14 mmHg (BFR60 group) and 13 mmHg (BRF80 group) was observed 48 hr after the first exercise session, while vagal modulation was increased in the BRF60 group after 24 and 48 hr. CONCLUSION: A low-intensity resistance exercise session with 60% and 80% of BFR resulted in blood pressure (systolic, diastolic, and mean) reduction and positive changes on heart rate variability after 24 h of a RE session.

Spectrum of congenital anomalies among VACTERL cases: a EUROCAT population-based study.

BACKGROUND: The VACTERL (Vertebral anomalies, Anal atresia, Cardiac malformations, Tracheo-Esophageal fistula, Renal anomalies, Limb abnormalities) association is the non-random occurrence of at least three of these congenital anomalies: vertebral, anal, cardiac, tracheo-esophageal, renal, and limb anomalies. Diagnosing VACTERL patients is difficult, as many disorders have multiple features in common with VACTERL. The aims of this study were to clearly outline component features, describe the phenotypic spectrum among the largest group of VACTERL patients thus far reported, and to identify phenotypically similar subtypes. METHODS: A case-only study was performed assessing data on 501 cases recorded with VACTERL in the JRC-EUROCAT (Joint Research Centre-European Surveillance of Congenital Anomalies) central database (birth years: 1980-2015). We differentiated between major and minor VACTERL features and anomalies outside the VACTERL spectrum to create a clear definition of VACTERL. RESULTS: In total, 397 cases (79%) fulfilled our VACTERL diagnostic criteria. The most commonly observed major VACTERL features were anorectal malformations and esophageal atresia/tracheo-esophageal fistula (both occurring in 62% of VACTERL cases), followed by cardiac (57%), renal (51%), vertebral (33%), and limb anomalies (25%), in every possible combination. Three VACTERL subtypes were defined: STRICT-VACTERL, VACTERL-LIKE, and VACTERL-PLUS, based on severity and presence of additional congenital anomalies. CONCLUSION: The clearly defined VACTERL component features and the VACTERL subtypes introduced will improve both clinical practice and etiologic research.