Spatio-temporal variability of potentially toxic elements' pollution in road-deposited sediments according to health risk thresholds: a meta-analysis.

Road deposited sediments (RDS) are important sinks of potentially toxic elements (PTEs), which may have a significant impact on human health. A systematic review of published papers on the PTEs occurrence in RDS was carried out. The main goal was to assess the global RDS contamination by PTEs and human health risks linked with anthropogenic activities. A systematic search was made to collect information about the most cited PTEs in the published literature and perform a statistical analysis. Subsequently, health risks were assessed for 35 different areas worldwide. PTE concentrations showed high variability, and means were multiple times higher than the corresponding consensus-based threshold effect concentrations (5.2-, 10.3-, 5.3-, 3-, 7.3-, and 3.6-fold higher for Zn, Pb, Ni, Cr, Cu, and Cd, respectively). PTEs concentrations were ranked as Zn > Pb > Cu > Mn > Cr > Ni > Cd. Non carcinogenic risks followed the trend Pb > Cu > Zn > Cd. Lead is responsible for the highest significant non carcinogenic risk to human health. Unacceptable exposition to carcinogenic risks is present in most areas. The top carcinogenic risk areas were Singapore > Beijing > Yixing > Shanghai > Zhuzhou for adult male, Dresden > Singapore > Ulsan > Huludao for adult females, and Dresden > Singapore > Ulsan > Huludao for children. Highest chromium and nickel carcinogenic risks occurred in Singapore, Cd in Dresden, and Cu in Huludao. Highest RDS contamination was seen in industrial areas due to pollutants deposition. Highest Zn, Cu, Cd, and Pb concentrations occur in densely urbanized areas due to heavy-duty vehicular exhausts.

Air Medical Transportation Provided by Norte Novo Regional Urgency Mobile Service: What Is the Current Scenario?

OBJECTIVE: The aim of this study was to investigate, describe, and analyze the Norte Novo regional air medical service provided by the Brazilian Emergency Medical Rescue Service. METHODS: This was a retrospective and descriptive study with a quantitative approach of the incidents registered from November 2016 to December 2019. For general patient classification, descriptive statistics of the following variables were performed: sex, age/age group, type of diagnosis, city where the incident took place, city of destination, length of patient care, ventilatory support, use of sedation, and use of vasoactive drugs. All analyses were performed using the XLSTAT program (Version 19.4; Addinsoft, New York, NY), considering a significance level of 5%. RESULTS: There were 1,677 responses divided into clinical (60.8%), traumatic (37.8%), organ transport (1.2%), and interhospital transference (0.2%). The most frequent diagnoses were acute myocardial infarction and stroke (clinical care) and polytrauma (trauma care). The average waiting time until the helicopter arrived at the scene was 25 minutes. CONCLUSION: This study shows the importance and relevance of this air medical service for the area it covers. Further research is needed to address the profile of this service in our country, which will allow us to elucidate scenarios and develop strategies to assist the population and, thus, design training and simulation exercises for emergency service teams based on local realities.

Influence of SARS-CoV-2 during pregnancy: a placental view.

Since the beginning of the current coronavirus outbreak (COVID-19), there has been great concern over a disease that has spread rapidly in several countries worldwide, with the result of several deaths, including deaths of pregnant women. Therefore, the aim of this study was to conduct a literature review on placental changes in infected pregnant women and/or asymptomatic carriers of COVID-19 during pregnancy, aiming at the possible vertical transmission. A systematic collection was carried out on the effects of that COVID-19 can cause directly and/or indirectly to pregnancy and the placenta in the following databases: Pubmed, Science Direct, Scielo, Lilacs, and Web of Science. For search, the following descriptors were used: placenta, pregnant woman, COVID-19, maternal-fetal. The results indicate transplacental transmission in some cases reviewed in many reports from this study. The presence of the virus was seen in the amniotic fluid, umbilical cord, and peripheral blood. Finally, pathological studies suggest that there are morphological changes related to infection in the placentas. We can conclude that, based on the researched material, there is little evidence of transplacental vertical viral transmission and its respective morphological changes related to viral infection in the placenta.

Social Participation and Associated Factors in Individuals with Chronic Obstructive Pulmonary Disease on Long-Term Oxygen Therapy.

Long-term oxygen therapy (LTOT) reduces hypoxaemia and mitigate systemic alterations in chronic obstructive pulmonary disease (COPD), however, it is related to inactivity and social isolation. Social participation and its related factors remain underexplored in individuals on LTOT. This study investigated social participation in individuals with COPD on LTOT and its association with dyspnoea, exercise capacity, muscle strength, symptoms of anxiety and depression, and quality of life. The Assessment of Life Habits (LIFE-H) assessed social participation. The modified Medical Research Council dyspnoea scale, the 6-Minute Step test (6MST) and handgrip dynamometry were used for assessments. In addition, participants responded to the Hospital Anxiety and Depression Scale (HADS) and the Chronic Respiratory Questionnaire (CRQ). Correlation coefficients and multivariate linear regression analyses were applied. Fifty-seven participants with moderate to very severe COPD on LTOT were included (71 ± 8 years, FEV1: 40 ± 17%predicted). Social participation was associated with dyspnoea (rs=-0.46, p < 0.01), exercise capacity (r = 0.32, p = 0.03) and muscle strength (r = 0.25, p = 0.05). Better participation was also associated with fewer depression symptoms (rs=-0.40, p < 0.01) and a better quality of life (r = 0.32, p = 0.01). Dyspnoea was an independent predictor of social participation (p < 0.01) on regression models. Restricted social participation is associated with increased dyspnoea, reduced muscle strength and exercise capacity. Better participation is associated with fewer depression symptoms and better quality of life in individuals with COPD on LTOT.

Proteomic analyses unraveling water stress response in two Eucalyptus species originating from contrasting environments for aridity.

Eucalyptus are widely cultivated in several regions of the world due to their adaptability to different climatic conditions and amenable to tree breeding programs. With changes in environmental conditions pointing to an increase in aridity in many areas of the globe, the demand for genetic materials that adapt to this situation is required. Therefore, the aim of this work was to identify contrasting differences between two Eucalyptus species under water stress through the identification of differentially abundant proteins. For this, total protein extraction was proceeded from leaves of both species maintained at 40 and 80% of field capacity (FC). The 80% FC water regime was considered as the control and the 40% FC, severe water stress. The proteins were separated by 2-DE with subsequent identification of those differentially abundant by liquid nanocromatography coupled to high resolution MS (Q-Exactive). Comparative proteomics allowed to identify four proteins (ATP synthase gamma and alpha, glutamine synthetase and a vacuolar protein) that were more abundant in drought-tolerant species and simultaneously less abundant or unchanged in the drought- sensitive species, an uncharacterized protein found exclusively in plants under drought stress and also 10 proteins (plastid-lipid, ruBisCO activase, ruBisCO, protease ClpA, transketolase, isoflavone reductase, ferredoxin-NADP reductase, malate dehydrogenase, aminobutyrate transaminase and sedoheptulose-1-bisphosphatase) induced exclusively in the drought-tolerant species in response to water stress. These results suggest that such proteins may play a crucial role as potential markers of water stress tolerance through the identification of species-specific proteins, and future targets for genetic engineering.

Quality of Life Questionnaire-Bronchiectasis: a study of the psychometric properties of the Brazilian Portuguese version.

OBJECTIVE: To evaluate the psychometric properties of the Brazilian Portuguese version of the Quality of Life Questionnaire-Bronchiectasis. DESIGN: Cross-sectional study. SETTING: Outpatient clinic. SUBJECTS: Clinically stable individuals with a diagnosis of bronchiectasis. MEASURES: The evaluations performed were spirometry, incremental shuttle walk test, Saint George's Respiratory Questionnaire, and the modified Medical Research Council dyspnea scale. The Quality of Life Questionnaire-Bronchiectasis was administered twice (seven to 14 days apart). Psychometric analyses were performed as follows: reliability, construct validity, criterion validity, and interpretability. RESULTS: In total, 108 individuals (48 ± 14 years, 61 women) participated in the study. Internal consistency was considered adequate (Cronbach's alpha ⩾ 0.70) for the majority of scales (from 0.58 to 0.93). Test-retest coefficients were moderate to excellent (intraclass correlation coefficients from 0.70 to 0.93). In the construct validity, 35 of 37 items correlated more strongly with their assigned scale than a competing scale. The convergent validity showed significant correlations between scales of the Quality of Life Questionnaire-Bronchiectasis with modified Medical Research Council dyspnea scale, and incremental shuttle walk test (r from 0.20 to 0.59). A low to moderate correlations was revealed between all scales of the Quality of Life Questionnaire-Bronchiectasis and the Saint George's Respiratory Questionnaire domains (r from 0.26 to 0.70). The standard error of measurement was acceptable. Ceiling effects were found for the Social Functioning and Treatment Burden scales. CONCLUSIONS: The Quality of Life Questionnaire-Bronchiectasis is a reliable, valid instrument with adequate internal consistency for the evaluation of the impact of bronchiectasis on the health-related quality of life of Brazilian adults.

30 years later: Social Representations about AIDS and sexual practices of rural towns residents.

In the 30 years of the AIDS pandemic in Brazil, it is recognized the HIV virus internalization of the phenomenon as a challenge to care and current health policies. In this sense, it aimed to verify sex practices and social representations that rural towns residents have about the disease. Attended by 789 people, men and women, between 18 and 90 years old, residents in 41 towns with fewer than 11,000 inhabitants in the state of Paraiba / Brazil. Data were collected by a questionnaire and the free association of words test. The results showed low concern about disease, perception of invulnerability to HIV infection and not using condoms during sexual intercourse, and confidence in the major reason related partner. Also showed endure derogatory and stereotypical representations, revealing that still persist in rural areas, beliefs and representations concerning the beginning of the epidemic. From these findings, it is possible to point out deficiencies in the care provided by the health services in these localities, which may result in increased vulnerability of this population to diseases, so there is the need to intensify information campaigns and intervention. The results reveal the existence of three different types of modes of learning health literacy skills in informal context: : i) learning that takes place in action, in achieving daily tasks; ii) learning processes that result from problem solving; iii) learning that occurs in an unplanned manner, resulting from accidental circumstances and, in some cases, devoid of intentionality. Nos 30 anos da pandemia da Aids no Brasil, reconhece-se o fenômeno da interiorização do vírus HIV como um desafio ao cuidado e às politicas de saúde atuais. Neste sentido, objetivou-se conhecer práticas sexuais e as representações sociais que residentes de cidades rurais têm acerca da doença. Participaram 789 pessoas, homens e mulheres, entre 18 e 90 anos de idade, residentes em 41 cidades com menos de 11.000 habitantes no estado da Paraíba/Brasil. Os dados foram coletados por um meio de um questionário e o teste de associação livre de palavras. Os resultados mostraram baixa preocupação com doença, percepção de invulnerabilidade à contaminação pelo HIV e o não uso do preservativo nas relações sexuais, sendo a confiança no parceiro o principal motivo relacionado. Também mostraram perdurar representações de natureza pejorativa e estereotipada, revelando que ainda perduram, no meio rural, crenças e representações referentes ao início da epidemia. A partir de tais achados, é possível apontar deficiências em termos de cuidados oferecidos pelos serviços de saúde nestas localidades, o que pode resultar em maiores vulnerabilidades dessa população ao adoecimento, havendo assim a necessidade da intensificação de campanhas de informação e intervenção.

Real-time telerehabilitation for chronic respiratory disease and post-COVID-19: A systematic review and meta-analysis.

INTRODUCTION: Telerehabilitation may facilitate access and adherence to pulmonary rehabilitation. Given the heterogeneity in existing telerehabilitation studies, it is still necessary to identify the most effective, safe, and cost-efficient strategy for clinical implementation, as well as the necessary level of supervision during telerehabilitation. The aim of this review was to determine the effectiveness and safety of real-time telerehabilitation for chronic respiratory diseases and post-COVID-19 compared to no-rehabilitation, center-based rehabilitation or asynchronous telerehabilitation. METHODS: A comprehensive search was conducted in six databases until 30 April 2023. Clinical trials of real-time telerehabilitation supervised via videoconference in adults with diagnosis of any chronic respiratory disease or post-COVID-19 were included. RESULTS: Twelve studies with 1540 participants were included. Very-low to moderate certainty evidence showed no difference between real-time telerehabilitation and center-based pulmonary rehabilitation. Studies included in this review reported high adherence rates to real-time telerehabilitation and completion rate, with no difference compared to center-based pulmonary rehabilitation. When compared to no-rehabilitation, the results of this review provide low-certainty evidence that real-time telerehabilitation may have a potential effect on exercise capacity at the end of the intervention, with no better results in others outcomes. No studies comparing real-time telerehabilitation with asynchronous telerehabilitation were found. CONCLUSION: Real-time telerehabilitation is safe and it seems to promote similar effects to center-based pulmonary rehabilitation. However, the certainty of this evidence ranged from very-low to moderate. Therefore, real-time telerehabilitation offers an alternative to center-based pulmonary rehabilitation models. This review provides a clear definition of real-time telerehabilitation, facilitating results interpretation and clinical applicability.

Normative values and prediction equations for the modified incremental step test in healthy adults aged 18-83 years.

OBJECTIVE: To establish normative values and reference equations for predicting the number of steps and oxygen consumption (VO2) from the modified incremental step test (MIST) in healthy adults aged 18-83 years. DESIGN: Prospective observational study. PARTICIPANTS: One hundred and ninety-four healthy adults aged 18-83 years with normal spirometry. SETTINGS: Exercise physiology laboratory of a university. METHODS: Participants underwent two MISTs (30 minutes apart). The MIST was performed on a 20-cm-high step using an externally paced rhythm imposed by audible signals, starting with 10 steps per minute and with constant increments of 1 step every 30 seconds. MAIN OUTCOMES: Number of steps and VO2 obtained from MIST. RESULTS: Normative values were provided for males and females for each age group. The following equations were determined: number of steps = 675.113 + (66.165*sex, 0 female and 1 male) - (5.353*age) - (6.593*body mass index) (R² =0.44, P < 0.001); VO2 = 0.106 + (0.216*sex, 0 female and 1 male) - (0.008*age [years]) + (0.021*weight [kilograms]) + (0.001*number of steps) (R² =0.80, P < 0.001). CONCLUSION: Normative values and prediction equations are proposed for the number of steps and VO2 which can be used to interpret performance on the MIST in individuals with different health conditions. These equations now need validation in other samples.

Exploring the impact of the environment on physical activity in patients with chronic obstructive pulmonary disease (EPCOT)-A comparative analysis between suggested and free walking: Protocol study.

BACKGROUND: Individuals with chronic obstructive pulmonary disease (COPD) exhibit reduced levels of physical activity, which are associated with poorer outcomes. The number of clinical trials aiming to promote behavioral changes to increase physical activity in this population has grown; therefore, these trials have yet to produce satisfactory results. An ecological model encompassing individual, social, environmental, and political factors represent a potentially more effective approach to promoting physical activity. While favorable urban environments can positively impact physical activity, specifically tailored environmental interventions for individuals with COPD could enhance their engagement in physical activity. Therefore, the aim of this randomized controlled trial (RCT) study was to analyze the effects of walking in a suggested environment and free walking on physical activity levels in individuals with COPD. METHODS: The environment on physical activity for chronic obstructive disease (EPCOT) is a randomized controlled clinical trial protocol approved by our institution's Ethics Committee and registered with The Brazilian Registry of Clinical Trials (ReBEC) (https://ensaiosclinicos.gov.br, number RBR-4tfwdhp). This protocol will involve 38 volunteers diagnosed with COPD recruited from the pulmonary physiotherapy and rehabilitation service. The volunteers were randomly divided into two walking groups: an experimental group (ERG) with guidance for walking in a suggested environment and an active control group (ACG) instructed to choose their own routes. The intervention consisted of eight consecutive weeks, with progressive walks carried out 3 to 5 times weekly. The primary outcome will be assessing participants' physical activity levels. Secondary outcomes will include exercise capacity, quality of life, dyspnea levels, motivation, anxiety, depression, and perceptions of the environment. All assessments will occur before and after the intervention period, aiming to fill a literature gap by investigating the impact of urban environments on COPD-related physical activity. The results may shed light on the importance of environmental factors in promoting physical activity among individuals with COPD, helping to develop more effective interventions.

The Bed Bridge Test: a new functional test for hospital inpatients - a feasibility and measurement study.

PURPOSE: To develop and assess the Bed Bridge Test's (BBT) feasibility, safety, and clinimetric properties and evaluate functional capacity in hospitalised patients. MATERIALS AND METHODS: This feasibility and measurement study examined four BBT versions, including the timed-limited at 30 and 60 s and repetition-limited at 5 and 10 times, in hospitalised patients in a university hospital in Brazil. Ninety-two functionally stable patients with respiratory, gastrointestinal, or post-surgical conditions participated. Participants completed the BBT versions in a random order. BBT concurrent criterion validity was evaluated using the Short Physical Performance Battery (SPPB), Sit-to-Stand (STS) test, and Functional Status Score (FSS). RESULTS: The participants were 51 ± 17 years old, 60% female, and 66% with clinical conditions. All participants completed the BBT versions without adverse events. Test-retest reliability was good-excellent (intraclass correlation coefficient >0.87) for all BBT versions, with acceptable agreement parameters and minimal detectable changes. The time-limited versions of the BBT might be affected by a ceiling effect. Floor effects were minimal for all BBT versions. BBT showed moderate associations with SPPB and STS and weak associations with FSS. CONCLUSIONS: The BBT is feasible and has promising measurement properties.

The Bed Bridge Test (BBT) offers a valuable solution for healthcare professionals by addressing the limitations of existing functional tests, providing a straightforward assessment of functional capacity for both the patient and the assessor.The BBT has demonstrated excellent feasibility and safety, as all eligible participants completed its various versions without adverse events, indicating its potential utility across diverse patient populations.The BBT exhibits good to excellent reliability, indicating its reproducibility in clinical settings.The BBT has validated its effectiveness by exhibiting robust correlations with established functional tests such as the Short Physical Performance Battery (SPPB) and Sit-to-Stand (STS) test.

Paricalcitol prevents renal tubular injury induced by ischemia-reperfusion: Role of oxidative stress, inflammation and AT1R.

The vitamin D receptor (VDR) is associated with antioxidative and anti-inflammatory effects and modulation of the renin-angiotensin-aldosterone system. This study evaluated whether VDR agonist paricalcitol protects renal ischemia-reperfusion (IR) induced tubular injury in rats by evaluating: 1) ATP-dependent tubular Na+ transport; 2) renal redox signaling; 3) renal content of proinflammatory cytokines TNF-α and IL-6; and 4) renal content of renin and angiotensin II receptor type 1 (AT1R). Paricalcitol prevented IR-induced tubular injury, evidenced by the prevention of histopathological changes and renal fibrosis with preservation of the activity of ATP-dependent Na+ transporters in the renal cortex. Paricalcitol decreased renal oxidative stress by reducing NADPH oxidase activity and increasing catalase. Paricalcitol also decreased the renal content of TNF-α, IL-6, and AT1R. The NADPH oxidase inhibitor apocynin did not present additive protection to paricalcitol-induced effects. The protective effects of paricalcitol on tubular injury induced by renal IR may dependent on the modulation of redox and proinflammatory signaling and renal angiotensin II/AT1R signaling.

Pulmonary expansion manoeuvres compared to usual care on ventilatory mechanics, oxygenation, length of mechanical ventilation and hospital stay, extubation, atelectasis, and mortality of patients in mechanical ventilation: A randomized clinical trial.

Pulmonary expansion manoeuvres are therapeutic techniques used to prevent and reverse atelectasis; however, no randomized controlled trials have provided evidence supporting the use of this intervention among individuals on mechanical ventilation. OBJECTIVE: To evaluate the effects of chest compression-decompression and chest block manoeuvres compared to usual care among patients on mechanical ventilation. METHODS: The current study was a randomized clinical trial of adult subjects on mechanical ventilation for 12 to 48 hours. The control group received usual care (passive or active mobilization, manoeuvres for airway clearance and tracheal aspiration). The intervention group received usual care plus two lung expansion manoeuvres, i.e., chest decompression and chest block, while remaining on mechanical ventilation. Assessments were performed before and after usual care, immediately after the intervention and 30 minutes after the intervention. The primary outcome was static compliance. The secondary outcomes were the incidence of atelectasis, dynamic compliance, airway resistance, driving pressure, oxygenation, duration of mechanical ventilation, extubation success, length of hospital and ICU stay, and mortality. RESULTS: Fifty-one participants (67±15 years old, 53% men, 26 in the control group and 25 in the intervention group) were evaluated. No differences in static compliance were observed between groups (intervention minus control) before and after expansion manoeuvres [3.64 ml/cmH2O (95% CI: -0.36-7.65, p = 0.074)]. Peripheral oxygen saturation differed between groups before and after expansion manoeuvres, with more favourable outcome observed in the control group [-1.04% (95% CI: -1.94 --0.14), p = 0.027]. No differences were found in other outcomes. CONCLUSION: Chest compression-decompression and chest block manoeuvres did not improve ventilatory mechanics, the incidence of atelectasis, oxygenation, the duration of mechanical ventilation, the length of stay in the ICU and hospital, or mortality in individuals on mechanical ventilation. The findings of this study can be valuable for guiding evidence-based clinical practice and developing a therapeutic approach that provides real benefits for this population.

Upper limb function of individuals hospitalized in intensive care: A 6-month cohort study.

BACKGROUND: Impaired physical function is a common complication in intensive care unit (ICU) patients. However, specific upper limb (UL) function is still poorly studied in this population. OBJECTIVE: To evaluate UL function at discharge and after a 6-month follow-up of individuals hospitalized in the ICU. METHODS: This was a longitudinal prospective 6-month multicentre cohort study with forty-six individuals hospitalized in the ICU undergoing mechanical ventilation for ≥ 48 h (ICU Group) and forty-six healthy individuals matched by sex, age, and socioeconomic status (control Group). The primary outcomes were measurements of UL disability using the Jebsen-Taylor Hand Function Test (JTT) and the Nine Hole Peg Test (NHPT). Secondary outcomes were physical function (Barthel index), muscle strength (Medical Research Council scale and hand grip strength), and quality of life (EuroQol-5 Dimension). All measurements were assessed after ICU discharge and at a 6-month follow-up. RESULTS: The JTT performance time in the ICU group after discharge was worse than that in the control group [121 s (86-165) vs. 54 s (49-61), median (IQR), p<0,001] and was reduced after 6 months [62 s (54-81), p<0,01]. The NHPT performance time at discharge in the ICU group was worse than that in the controls [39 s (33-59) vs. 21 s (20-23), p<0,001] and was reduced after 6 months of follow-up [24 s (21-27), p<0,01]. Physical function, muscle strength and quality of life were reduced after ICU discharge. CONCLUSION: Individuals hospitalized in the ICU presented with reduced UL function at discharge and at the 6-month follow-up.

Perceptions of individuals regarding barriers to participation in a pulmonary rehabilitation program after hospitalization due to COVID-19: A qualitative study.

INTRODUCTION: Several individuals with post-COVID-19 syndrome referred for pulmonary rehabilitation did not participate. This study aimed to explore individuals' barriers to participating in posthospitalization COVID-19 rehabilitation. MATERIALS AND METHODS: This was a qualitative, multicenter study performed using semistructured interviews. This study included 20 individuals hospitalized for COVID-19 who refused to participate in a pulmonary rehabilitation program at a university hospital. RESULTS: Individuals reported difficulties accessing the rehabilitation center, mainly due to distance, transport costs and conditions, and lack of companions. Health problems (e.g., surgeries, pain, and mobility difficulties) and lack of time due to work, commuting, and household work were also reported. Another reported theme was not perceiving the need for rehabilitation due to feeling well. Minor themes included the need for more information about rehabilitation and a lack of interest, motivation, and medical encouragement. CONCLUSION: Individuals hospitalized for COVID-19 faced several barriers to participating in a pulmonary rehabilitation program. These barriers included difficulties in accessing the rehabilitation center, health problems, lack of time, and the perception that rehabilitation was unnecessary. There is a need for actions to overcome these barriers to make the program available to a larger number of individuals.

The Brazilian version of the telehealth usability questionnaire (telehealth usability questionnaire Brazil): translation, cross-cultural adaptation, and psychometric properties.

OBJECTIVE: The objectives of this study were to translate and cross-culturally adapt the telehealth usability questionnaire into Brazilian Portuguese and to evaluate its psychometric properties. METHODS: This was a methodological validation study carried out in two phases. In phase 1, the telehealth usability questionnaire was cross-culturally adapted with 10 participants comprising the expert committee members, including 5 healthcare professionals with theoretical and practical knowledge of telehealth, 1 methodologist, and 4 translators. This phase was performed at Universidade Federal de Juiz de Fora Physiotherapy Clinic School. In phase 2, the psychometric properties of telehealth usability questionnaire Brazil were analyzed. This phase included in-person assessments at Márcio Cunha Hospital, Minas Gerais. The recruitment period for both phases was from April 2020 to February 2021. Content validity, reliability, internal consistency, and criterion validity were analyzed. The criterion validity was evaluated using correlation with a validated instrument: the system usability scale. RESULTS: The telehealth usability questionnaire was adequately translated and cross-culturally adapted. The telehealth usability questionnaire Brazil presented an excellent content validity index of 0.96 with percentages of understanding higher than 90%. The telehealth usability questionnaire Brazil demonstrated great internal consistency (α=0.94 and ω=0.94), excellent intra-rater reliability (intraclass correlation coefficient=0.85, 95%CI 0.75-0.91), no difference between the test and retest [T (0.425), p>0.673], and no proportional bias (p=0.205). There was a moderate correlation between telehealth usability questionnaire Brazil and the system usability scale (r=0.52, p<0.0001). CONCLUSION: The telehealth usability questionnaire was adequately translated and cross-culturally adapted into Brazilian Portuguese and showed adequate psychometric properties for use in telehealth clinical practice and research in Brazilian-Portuguese-speaking individuals.

Pulmonary Telerehabilitation for People With Chronic Obstructive Pulmonary Disease in Brazil: A Mixed-Methods Feasibility Study.

This study assessed the feasibility of pulmonary telerehabilitation‧s (PTR) acceptability, implementation, practicality, and adaptation for people with Chronic Obstructive Pulmonary Disease (COPD) in Brazil. It also explored associations with clinical and socioeconomic features of Brazilians with COPD. This mixed-method study included thirty-one participants with COPD (age 62±10 years; FEV1= 72±14% predicted). Most participants (74.2%) reported good PTR session acceptability on the System Usability Scale and scores of 4.6±0.3 and 4.5±0.6 on a 1-5 Likert-type scale of implementation and practicality, respectively. Participants suggested adaptations for better comfort on the exercise bike and varying exercise modalities. PTR acceptability was associated with participants' younger age (rs=-0.57, p<0.01) and higher education (rs=0.51, p<0.01). PTR is feasible for people with COPD in Brazil regarding acceptability, implementation, practicality, and adaptation. Younger age and higher educational level are associated with greater PTR acceptability.

Validation and reproducibility of the Glittre activities of the daily living test for evaluation of functional capacity after a stroke.

METHODS: Thirty patients with hemiparesis stemming from a stroke and 20 healthy peers were evaluated. Reproducibility was determined using the intraclass correlation coefficient (ICC), standard measurement error (SME), minimum detectable change (MDC), and Bland-Altman analysis. For construct validity, the Glittre ADL test was correlated with the Six-Minute Walk Test (6MWT), Timed Up and Go Test (TUG), and Functional Independence Measure (FIM), and analyzed based on convergent validity and the comparison of known groups (stroke survivors and healthy peers). RESULTS: Intra- and inter-observer reliability were excellent (ICC3,1 = 0.98; 0.96, respectively). Intra-observer SME ranged from 0.27 to 0.31 minutes and inter-observer SME was 0.45 minutes. Intra-observer MDC ranged from 1.44 to 1.54 minutes and inter-observer MDC was 1.86 minutes. Strong statistically significant correlations were found between time on the Glittre ADL test and time on the 6MWT (rh = -0.91; p < .001) and TUG test (rh = 0.82; p < .001), whereas a moderate correlation was found with the FIM (rh = -0.47; p < .008). CONCLUSIONS: The Glittre ADL test is valid for assessing functional capacity in stroke patients. It demonstrated good convergent and construct validity and excellent intra- and inter-observer reproducibility.

Protective effect of exogenous melatonin on testicular histopathology and histomorphometry of adult rats with domperidone-induced hyperprolactinemia.

Hyperprolactinemia is a pathological condition resulting from increased prolactin that directly affects reproduction, as this condition inhibits the release of LH, FSH and gonadal steroidogenesis, bringing several negative clinical associations in reproduction. In contrast, melatonin (MEL) plays an important role in the regulation of steroidogenesis and modulates damages to the process of spermatogenesis. The objective was to analyze the protective effects of exogenous melatonin on the testis of hyperprolactinemic adult rats. Forty-eight male rats were used, divided into two treatment periods: 30 and 60 days, each treatment was subdivided into three groups: Control, Hyper (hyperprolactinemia), and Hyper+MEL (hyperprolactinemia and melatonin). Treatment with melatonin was 200 µg/100 g, subcutaneously. Induction of hyperprolactinemia was obtained with a dose of 4 mg/kg of domperidone, subcutaneously. The results of the histopathology demonstrated that the animals in the Hyper group presented degeneration of germ cells when compared to the control. In addition, the degenerations were presented in smaller quantities in the Hyper+MEL, in both treatment periods, evidencing the benefits of the melatonin in gonadal regeneration. The Hyper group of both treatment periods showed a decrease in tubular diameter, epithelium height, and tubular area, in addition to a decrease in Sertoli cells, when compared to the control and the Hyper+MEL group. In conclusion, the hyperprolactinemia can affect the germinal epithelium and testicular microstructure; the exogenous melatonin has a protective effect against hyperprolactinemia, reducing testicular damage.

Mechanism and control of Genipa americana seed germination.

Genipa americana (Rubiaceae) is important for restoration of riparian forest in the Brazilian Cerrado. The objective was to characterize the mechanism and control of germination of G. americana to support uniform seedling production. Morphology and morphometrics of seeds, embryo and endosperm were assessed by light and scanning electron microscopy during germination. Imbibition and germination curves were generated and over the same time interval endosperm digestion and resistance were measured by puncture force analysis and activity assay of endo-ß-mannanase (EBM) in water and in abscisic acid (ABA). The gene encoding for EBM was partially cloned and its expression monitored by quantitative real-time-polymerase chain reaction. Embryos displayed growth prior to radicle protrusion. A two-phase increase in EBM activity coincided with the two stages of weakening of the micropylar endosperm. The second stage also coincided with growth of the embryo prior to radicle protrusion. Enzyme activity was initiated in the micropylar endosperm but spread to the lateral endosperm. ABA completely inhibited germination by inhibiting embryo growth, the second stage of weakening and expression of the EBM gene, but EBM activity was not significantly inhibited. This suggests that a specific isoform of the enzyme is involved in endosperm weakening. EBM may cause a general 'softening' of micropylar endosperm cell walls, allowing the embryo to puncture the endosperm as the driving force of the decrease in puncture force.