Trayectoria del compromiso académico en estudiantes secundarios de la provincia de Entre Ríos, Argentina

El objetivo del presente trabajo fue conocer la trayectoria del compromiso académico en estudiantes secundarios de Entre Ríos, Argentina, en tres tiempos de su recorrido escolar. El diseño fue cuantitativo, siendo un estudio de tipo longitudinal. El muestreo utilizado fue no probabilístico intencional. La muestra se constituyó por adolescentes escolarizados de Entre Ríos, consistió en 105 sujetos para el primer tiempo, 101 para el segundo y 97 para el tercero. Las edades abarcaron desde los 13 hasta los 15 años. En cuanto al instrumento, se utilizó la adaptación argentina de la Utrecht-Work Engagement Scale en su versión para estudiantes. Se realizaron análisis de estadística descriptiva básica y análisis de modelos de curva de crecimiento latente. Los resultados evidencian bajos niveles de compromiso de los estudiantes con sus actividades escolares. Además, en relación a la trayectoria del engagement, los hallazgos indican que el compromiso se mantuvo constante en el tiempo en la dimensión vigor y disminuyó en los componentes dedicación y absorción hacia el tercer tiempo de evaluación. Se reflexiona sobre la importancia de la promoción del compromiso académico en población adolescente, por ejemplo, a través de la ejecución de intervenciones.

The objective of the work was to know the trajectory of academic engagement in secondary students from Entre Ríos, Argentina, in three stages of their school journey. The design was quantitative, being a longitudinal study. The sampling used was intentional non-probabilistic. The sample was made up of school adolescents from Entre Ríos. It consisted of 105 subjects for the first time, 101 for the second and 97 for the third. The ages ranged from 13 to 15 years. Regarding the instrument, the Argentine adaptation of the Utrecht-Work Engagement Scale in its version for students was used. Analysis of basic descriptive statistics and Analysis of Latent Growth Curve Models were performed; The results show low levels of student engagement to their school activities. In addition, in relation to the trajectory of engagement over time, the findings indicate that the commitment remained constant over time in the vigor dimension and decreased in the dedication and absorption components towards the third evaluation period.

Virus aerosol transmission, dispersion, and infection probability simulation: A case study in subway carriages / 环境与职业医学

Background Subways are typical congregate settings and may facilitate aerosol transmission of viruses. However, quantified transmission probability estimates are lacking. Purpose To model spread and diffusion of respiratory aerosols in subways by simulation and calculation of infection probabilities. Methods The internal environment of carriages of Shanghai Metro Line 10 was used to establish a study scene. The movement of tiny particles was simulated using the turbulent model. Trend analysis of infection probabilities and viral quantum doses was conducted in a closed subway carriage scene by a quantum emission-infection probability model. Results Under a typical twelve-vent air conditioning configuration, respiratory droplet aerosols within a subway carriage dispersed rapidly throughout various regions due to airflow, with limited short-term diffusion to other carriages. Concurrently, owing to the uncertainty of airflow patterns, the airflow might circulate and converge within carriages, causing delayed outward dispersion or hindered dispersion of droplet aerosols upon entry into these zones. Passengers boarding the carriage could exacerbate the formation of these zones. When the air conditioning system functioned adequately (air exchange rate=23.21 h−1), the probability of a virus carrier transmitting the virus to other passengers within the same carriage via aerosol transmission was approximately 3.8%. However, in the event of air conditioning system failure (air exchange rate=0.5 h−1), this probability escalated dramatically to 30%. Furthermore, a super-spreader (with virus spreading exceeding 90% of the average) elevated the infection probability to 14.9%. Additionally, due to the complexity of turbulence within the carriage, if local diffusion occurred in 1/2 zones of a carriage, the anticipated infection probability would increase to 8.9%, or during the morning or evening rush hours leading to elevated aerosol concentrations, the infection probability would rise to 4.7%. The subway transmission probability for common coronaviruses diminished to as low as 0.9%. Conclusion Combined computational fluid dynamics and infection probability analysis reveals that in the prevalent twelve-vent air conditioning configurations, despite being a major transportation hub with substantial spatial-temporal overlap, the internal space of subway carriages exhibits a certain level of resistance to virus aerosol transmission owing to built-in ventilation capabilities. However, turbulence and passenger positioning may lead to localized hovering of droplet aerosols, thereby increase the risk of virus transmission. Furthermore, super-spreaders, poor operational status of built-in air conditioning system, and high passenger volume at morning or evening peak hours exert profound effects on virus transmission and infection probability.

Biomechanical Comparison of Internal Fixation by Traditional and Cortical Bone Trajectory Pedicle Screw / 医用生物力学

Objective To compare the effects of cortical bone trajectory ( CBT) and traditional trajectory ( TT)pedicle screw internal fixation on the range of motion (ROM) and rod system stress of normal and osteoporotic(OP) spines. Methods The L3-S1 finite element models of normal and OP spines were established. The screwrod system with two kinds of trajectory was used for internal fixation of the L4-5 segment, so as to simulate sixphysiological loads, namely, flexion, extension, left / right bending, left / right rotation. The effects of two internalfixation methods on ROMs and maximum equivalent stress of screws in normal and OP spines were compared.Results For both bone conditions, CBT and TT significantly reduced ROM of the fixed segment (L4-5) and theentire segment of lower lumbar spine ( L3-S1). However, the ROM decline of CBT group was slightly smaller than that of TT group, and their ROMs were similar under flexion and extension, but the ROM differences were significant under lateral bending and axial rotation. In addition, for both the normal and OP spine models, themaximum equivalent stress of screws in CBT group was significantly higher than that in TT group. Compared withTT group, the screw stress of CBT group in normal spine model under flexion and extension, lateral bending,axial rotation was increased by 27% , 268% and 58% , respectively. However, when CBT technique was used atthe same time, the OP spine model had a smaller screw stress distribution than the normal spine model.Conclusions Compared with TT technique, CBT technique can achieve higher screw stress under OP conditionand reduce screw stress concentration under normal bone condition. In addition, CBT slightly increases ROMs of each segment, which is conducive to recovery of spinal physiological function after surgery. Lateral bending and axial rotation can produce negative mechanical effects, and these two physiological loads should be avoided.

Trajectory of the development of caries in the permanent dentition of 12- to 16-year-old students based on a latent class growth model analysis in Liuyang / 口腔疾病防治

Objective@# To explore the trajectory of the development of permanent caries in 12- to 16-year-old students in Liuyang and to provide a reference for the prevention and management of caries.@*Methods@#Primary and secondary school students who were registered within the Liuyang jurisdiction were screened for caries from September to November by the Liuyang Center for Disease Control and Prevention. A total of 7 297 students between the ages of 12 and 16 years with complete permanent dentition caries monitoring records and traceable deciduous dentition caries monitoring records were selected from 2013 to 2019, and a zero-inflated negative binomial-latent class growth model (ZINB-LCGM) was established to describe the trajectory of the development of individual caries using the decayed missing filled teeth (DMFT) indicators. @*Results@# DMFT of 12- to 16-year-old students in Liuyang were mainly decayed teeth (DT), with the majority occurring in the first permanent molar. According to the ZINB-LCGM model, the students were classified into three latent categories, "slow growth pattern" (28.55%), "rapid growth pattern" (6.59%), and "stable pattern" (64.86%), which followed different nonlinear caries growth trajectories. Females with deciduous teeth caries were more likely to have trajectories showing a “rapid growth pattern” and a “slow growth pattern”. There were significant differences in the trajectories between men and women, as well as between those with and without primary dentition caries. @*Conclusion @# The trajectory of the development of caries in 12-16-year-old students shows heterogeneity in terms of different developmental patterns of latent categories, suggesting that females with deciduous dental caries should receive more attention.

Correlation between the changing trajectories of serum uric acid and new onset nonalcoholic fatty liver disease / 中华健康管理学杂志

Objective:To explore the correlation between changing trajectories of serum uric acid and the onset of nonalcoholic fatty liver disease (NAFLD).Methods:A longitudinal cohort study. Total of 3 353 subjects who had routine health examination every year from January 2017 to December 2019 in the Health Management Center of the Second Affiliated Hospital of Dalian Medical University and met the inclusion criteria were selected as the research subjects. Four different serum uric acid trajectory groups were determined by using the group-based trajectory model: the low stability group, medium stability group, medium-high stability group and high stability group. During the follow-up to December 2021, the differences in cumulative incidence of NAFLD in different serum uric acid trajectory groups were calculated and compared. Cox proportional hazard regression model was used to evaluate the hazard ratio ( HR) and 95% confidence interval ( CI) of the NAFLD onset in different serum uric acid trajectory groups. The dose-response relationship between baseline serum uric acid and NAFLD was evaluated by a restricted cubic spline regression model. Results:The cumulative incidence of NAFLD in two years was 10.77%, and the cumulative incidence increased with the rising trajectory of serum uric acid, it was the highestin the high stability group ( P<0.05). Compared that in the low stability group, the risk of NAFLD in the other three groups was as follows: 2.24 (95% CI: 1.59-3.14) in the medium stability group, 2.89 (95% CI: 1.92-4.33) in the medium-high stability group and 4.55 (95% CI:2.83-7.31) in the high stability group (all P<0.05). The risk of NAFLD gradually increased with the rising of serum uric acid level, and the cut-off value of serum uric acid for women and men was 260.32 μmol/L and 365.09 μmol/L, respectively. Conclusions:Long-term moderate and high levels of serum uric acid are independent risk factors for the occurrence of NAFLD. With the rising of serum uric acid trajectory, the risk of NAFLD increases. Attention should be paid to the longitudinal change trend of serum uric acid level in the prevention of NAFLD, and it should be controlled within lower level of the normal range.

Association between the trajectory of waist-to-height ratio from childhood to adulthood and the risk of adult hypertension / 中华健康管理学杂志

Objective:To analyze the trajectory of waist-to-height ratio (WHtR) from childhood to adulthood and its association with the risk of hypertension in adulthood.Methods:In this retrospective cohort study, based on the data of China Health and Nutrition Survey (CHNS) from 1991 to 2015, the group-based trajectory model was applied to identify the trajectory of WHtR in 1 794 subjects aged from 7 to 40 years living in 15 provinces, autonomous regions and municipalities in China. The subjects aged 18 years and above with a systolic blood pressure≥140 mmHg (1 mmHg=0.133 kPa) or diastolic blood pressure ≥90 mmHg or those currently taking antihypertensive drugs were defined as having adult hypertension. And further, the Poisson regression model was used to assess the effect of WHtR trajectory from childhood to adulthood on adult hypertension, and the “E-value” approach was employed to evaluate the potential impact of unobserved confounders on the robustness of the results.Results:Of all the subjects surveyed, 3 trajectory groups were identified, and 750 (41.8%), 958 (53.4%) and 86 (4.8%) subjects were identified as having persistent normal, slow-growing and fast-growing WHtR trajectory, respectively; the incidence of adulthood hypertension in the up-mentioned 3 trajectory groups was 2.1%, 4.7% and 14.0%, respectively ( P<0.001). The risk of adult hypertension in the slow-growing trajectory group ( RR=1.94, 95% CI: 1.12-3.36) and the fast-growing trajectory group ( RR=5.70, 95% CI: 2.65-12.24) were both significantly higher than that in the persistent normal group (both P<0.05). The results of sensitivity analysis showed that the results were relatively robust (E-value was 3.29 and 10.88, respectively). Conclusion:Different trajectories of WHtR from childhood to adulthood exist in the surveyed population, and the increase of WHtR would be positively correlated with the risk of adulthood hypertension.

Feasibility of using cortical bone trajectory screws in osteoporotic thoracolumbar fixation based on evaluation of bone CT values at bone-screw interface / 中华创伤骨科杂志

Objective:To evaluate the feasibility of using cortical bone trajectory (CBT) screws in the osteoporotic thoracolumbar fixation by comparing the bone CT values at the bone-screw interface between traditional trajectory (TT) screws and CBT screws in patients with different bone densities.Methods:The high-resolution CT imaging data of thoracolumbar segments following thoracic or lumbar spine fractures from April 2020 to October 2022 were collected at The Second Hospital Affiliated to Wenzhou Medical University for retrospective analysis. They were divided into 3 groups: a normal bone mass group, an osteopenia group and an osteoporosis group. From each group 30 cases were chosen (90 cases in total, 36 males and 54 females). All the data were imported into Mimics 18.0 for three-dimensional bone reconstruction in which placement of TT and CBT screws was simulated on the vertebrae from T10 to L2 (non-fractured vertebrae). Regions of interest (ROI) where each simulated screw intersected the bone were segmented to measure their CT bone values. For each vertebra in each group, the relative difference percentage in average CT value of ROI between TT and CBT screws was calculated. The CT values of ROI were compared in the same group between TT and CBT screws from T10 to L2; the CT values of ROI were compared in the same screws among the 3 groups from T10 to L2; the CT values of ROI were compared between the CBT screws in the osteopenia and osteoporosis groups and the TT screws in the normal bone mass group; the relative difference percentages in average CT value of ROI between CBT and TT screws were compared between the 3 groups from T10 to L2.Results:The average CT value of ROI for CBT screws was significantly higher than that for TT screws from T10 to L2 in every group ( P< 0.001); as for the CT values of ROI for CBT and TT screws from T10 to L2, the osteoporosis group<the osteopenia group<the normal bone mass group ( P<0.001); from T10 to L2, the CT value of ROI for CBT screws in the osteopenia group was significantly higher than that for TT screws in the normal bone mass group ( P<0.001); the CT value of ROI for CBT screws in the osteoporosis group was not significantly different from that for TT screws in the normal bone mass group ( P>0.05). At T10, T12, and L1, the relative difference percentage in average CT value of ROI between CBT and TT screws was significantly higher in the osteopenia and osteoporosis groups than that in the normal bone mass group ( P<0.05), but there was no such a difference between the osteopenia and the osteoporosis groups ( P>0.05). At T11 and L2, there was no significant difference between the 3 groups in the relative difference percentage in average CT value of ROI between CBT and TT screws ( P>0.05). Conclusions:As bone mass decreases, both CBT and TT screws lead to a significant decrease in the bone density at the bone-screw interface. In patients with osteoporosis, CBT screws can still lead to a higher bone density at the bone-screw interface than TT screws, thus providing a higher strength at the bone-screw interface.

Development trajectory and influencing factors of pediatric medical traumatic stress in parents with children undergoing surgery: a latent growth mixture model / 中国实用护理杂志

Objective:To explore the development trajectory and influencing factors of pediatric medical traumatic stress in parents of children undergoing surgery, so as to provide reference for targeted intervention measures in the later stage.Methods:Adopting prospective research design, from January 2022 to August 2022, convenience sampling was used to recruit 199 parents of children undergoing surgery in the pediatric surgery ward of the First Affiliated Hospital of University of Science and Technology of China as subjects. The level of medical traumatic stress symptoms in parents was investigated by the PTSD Checklist for DSM-5 at one day before surgery, during postoperative recovery, after discharge and 3 months after discharge. The general data questionnaire, Parents′ Perception of Uncertainty Scale, Hospital Anxiety and Depression Scale, Simplified Coping Style Questionnaire and Perceived Social Support Scale were used to investigate the influencing factors of medical traumatic stress symptoms in parents one day before the operation.Latent growth mixture model and binary Logistic regression were used to analyze the data.Results:The development trajectory of pediatric medical traumatic stress in parents of children undergoing surgery was divided into two categories: the first was low-level decline (90.5%, 180/199) and the second was high-level stability (9.5%, 19/199). Binary Logistic regression analysis showed that postoperative complications, surgical type and negative coping styles of parents were the main influencing factors of pediatric medical traumatic stress trajectory in parents of surgical children(all P<0.05). Conclusions:The pediatric medical traumatic stress in parents of children undergoing surgery have group heterogeneity trajectory, medical staff can formulate targeted and individualized intervention programs according to their trajectories and influencing factors.

Latent class growth model-based study of demoralization syndrome among maintenance hemodialysis patients in young and middle-aged adults / 中国实用护理杂志

Objective:To investigate distinct trahectories of demoralization of maintenance hemodialysis patients in young and middle-aged adults, and analyze the factors that affect the trajectory category, so as to provides reference for formulating individualized intervention strategies.Methods:This study was a cross-sectional survey. From April 2020 to April 2021, young and middle-aged maintenance hemodialysis patients fromShangyu People′s Hospital were collected by convenience sampling method and conducted 4-time follow-up investigation. The survey tools included general information questionnaire, Demoralization Scale Mandarin Version (DS-MV) and Experiences in Close Relationship Scale-Short Form (ECR-S). Latent class growth model was used to identify trajectory patterns of demoralization, Logistic regression was used to identify predictors of demoralization trajectories.Results:Totally, 105 patients were enrolled in the present study. Three distinct trajectories were identified and named as "table high level group" 24 cases, "slow reduction group" 39 cases and "continuous reduction group" 42 cases. Univariate analysis showed that age, occupational status, average income per person in family, number of comorbidities, attachment anxiety scores were related to the category of demoralization trajectories ( F = 15.92, χ2 values were 9.16-15.95, all P<0.05). Multivariate Logistic regression analysis showed that age, occupational status, average income per person in family, number of comorbidities, and attachment anxiety scores were important predictors of patterns of demoralization trajectories in young and middle-aged maintenance hemodialysis patients. Conclusions:This study identified three distinct demoralization trajectories in young and middle-aged maintenance hemodialysis patients, clinical nursing should formulate individualized intervention strategies according to the types of patients′ delirium trajectories.

A cohort study on the correlation between serum uric acid trajectory and the progression of renal function in patients with Type 2 diabetes mellitus / 中南大学学报(医学版)

OBJECTIVES@#Diabetic kidney disease is one of the most serious complications of diabetes mellitus (DM), and it is a main cause for chronic kidney disease and end-stage kidney disease (ESRD). It is important to find out the factors that cause the progression of renal function. The study aims to explore the relationship between serum uric acid (SUA) trajectory and the progression of renal function in patients with Type 2 diabetes mellitus (T2DM).@*METHODS@#A total of 846 patients with T2DM, who were admitted to the Department of Nephrology and Endocrinology, the Third Xiangya Hospital of Central South University, from January 2009 to December 2021 and met the criteria of baseline estimated glomerular filtration rate (eGFR)≥60 mL/(min·1.73 m2), were selected as the research subjects. The SUA data of multiple measurements were collected and identified as different SUA trajectories by group-based trajectory modeling (GBTM). According to the SUA trajectories, the patients were divided into a low trajectory group (105 cases), a middle trajectory group (396 cases), a middle high trajectory group (278 cases), and a high trajectory group (67 cases). Cox regression analysis was used to examine the effect of SUA trajectory on the progression of renal function in patients with T2DM. Subgroup analysis was performed by sex, age, course of disease, body mass index (BMI) and hemoglobin A1c (HbA1c).@*RESULTS@#The median follow-up was 4.8 years. At the end of follow-up, 158 patients had different degrees of decline in renal function. After adjusting for multiple confounding factors by Cox regression analysis, the risks of eGFR<60 mL/(min·1.73 m2), eGFR reduction rate≥50%, serum creatinine (Scr) doubling and composite endpoint (eGFR reduction rate≥50%, Scr doubling or ESRD) in the high trajectory group were significantly higher than those in the low trajectory group, with HR of 3.84 (95% CI 1.83 to 8.05), 6.90 (95% CI 2.27 to 20.96), 6.29 (95% CI 2.03 to 19.52), and 8.04 (95% CI 2.68 to 24.18), respectively. There was no significant difference in the risk of ESRD among the above 4 groups (all P>0.05). Subgroup analysis showed that: compared with the low trajectory group, the risks of eGFR<60 mL/(min·1.73 m2) in patients with high trajectory in the subgroup of male, female, age<65 years, course of disease<10 years, BMI≥24 kg/m2 and HbA1c≥7% were increased (all P<0.05). The SUA trajectory had no interaction with sex, age, course of disease, BMI and HbA1c (all interactive P>0.05).@*CONCLUSIONS@#The high SUA trajectory increases the risk for progression of renal function in patients with T2DM. Long-term longitudinal changes of SUA should be paid attention to.

Dual trajectory of sleep and frail in elderly people / 中南大学学报(医学版)

The high incidence of dual sleep and frail disorders in the elderly people, often occurring together, seriously affects the physical and mental health of the older people, effective research on the dynamics of dual sleep and frail disorders is important for improving the quality of life for the older people and responding to global ageing trend. While trajectory studies provide a unique practical scientific perspective to grasp the dynamics of development, dual trajectories unite dual barriers provide an opportunity to study the dynamic dependence of both sleep and frailty simultaneously sleep trajectories and frailty trajectories in older people are interrelated and interacted through deeper mechanisms. Therefore, it is necessary for the study not only focus on the ongoing development of health problems, but also needs to consider multiple aspects and propose targeted intervention program.

Trajetórias e determinantes do alto risco cardiovascular de 30 anos entre participantes de uma coorte brasileira (Estudo CUME) / Trajectories and determinants of 30-year high cardiovascular risk among participants in a Brazilian cohort (CUME Study)

Introdução: As doenças cardiovasculares são o principal problema de saúde pública em todo o mundo. Portanto, a avaliação do risco cardiovascular, com a identificação de seus fatores de risco e de proteção e de suas trajetórias ao longo do tempo são importantes para a proposição, a consolidação e a implementação de medidas de prevenção da ocorrência de doenças cardiovasculares. Objetivo geral: Analisar a trajetória e os determinantes do alto risco cardiovascular de 30 anos em participantes da Coorte de Universidades Mineiras (Estudo CUME). Métodos: Inicialmente, foi realizada uma revisão integrativa da literatura e, em seguida, dois estudos de coorte prospectiva. A) Artigo 1 ­ revisão integrativa da literatura sobre a estimação do alto risco cardiovascular e seus fatores associados, realizada nas bases Medical Literature Analysis and Retrievel System Online, Web of Science, Excerpta Medica Database, Cumulative Index to Nursing and Allied Health Literature e no portal Biblioteca Virtual de Saúde; B) Artigo 2 ­ Coorte aberta prospectiva desenvolvida com 2.854 participantes do Estudo CUME, que é uma pesquisa multicêntrica conduzida com egressos de sete instituições públicas federais de ensino superior do Estado de Minas Gerais desde 2016. A incidência do alto risco cardiovascular de 30 anos foi calculada usando o escore de Framingham e seus determinantes foram estimados usando análise multivariada hierárquica pela técnica de regressão de Cox; C) Artigo 3 ­ Estudo prospectivo fechado desenvolvido com 1.286 participantes da CUME, que responderam ao questionário da linha de base em 2016, aos questionários de seguimento de dois anos (2018) e de quatro anos (2020). O risco cardiovascular foi avaliado com o escore de Framingham de 30 anos. A identificação das trajetórias do risco cardiovascular foi realizada com a técnica de modelagem de crescimento de classe latente com o uso do modelo normal censurado. A análise dos fatores independentemente associados a cada uma das trajetórias foi conduzida com a técnica de regressão logística multinominal. Resultados: Artigo 1 ­ foram selecionados 13 artigos com um ou mais fatores associados ao alto risco cardiovascular, segundo o escore de Framingham de 10 anos. Nenhum artigo investigou os fatores associados ao alto risco cardiovascular de 30 anos. Artigo 2 ­ após média de 2,62 anos de seguimento, a incidência do alto risco cardiovascular de 30 anos foi 8,1 casos/1.000 pessoas-ano no sexo feminino e 20,2 casos/1.000 pessoas-ano no sexo masculino. Sexo masculino (Hazard Ratio ­ HR: 2,34; IC 95%: 1,58 - 3,46), trabalhar (HR: 2,13; IC 95%: 1,13 - 3,99), alto consumo de alimentos processados (HR: 2,44; 95% CI: 1,21 - 4,90) e ser ativo fisicamente (HR: 0,63; IC 95%: 0,41 - 0,98) se associaram independentemente ao alto risco cardiovascular de 30 anos; Artigo 3 - Três trajetórias de risco cardiovascular de 30 anos foram identificadas: Baixo-Baixo (68,3%), Médio-Médio (26,2%) e Alto-Alto (5,5%). Ao longo do tempo, o risco cardiovascular apresentou discreto aumento para a trajetória Baixo-Baixo (2,9%), moderado aumento para a trajetória Médio-Médio (7,6%) e elevado aumento para a trajetória Alto-Alto (13%). O sexo masculino, viver em união estável, ter consumos moderado e alto de alimentos ultraprocessados se associaram positivamente às trajetórias de risco cardiovascular Médio-Médio e Alto-Alto. Ainda, ter formação profissional fora da área da saúde e estar trabalhando se associaram positivamente à trajetória de risco cardiovascular Médio-Médio, enquanto ser ativo fisicamente se associou negativamente à trajetória de risco cardiovascular Alto-Alto. Conclusão: Poucos estudos foram conduzidos para avaliar o alto risco cardiovascular de 30 anos, sendo que em nenhum deles foram estimados fatores associados ao desfecho. Nossos achados científicos indicaram que praticar atividade física reduz a incidência do alto risco cardiovascular de 30 anos. Homens, pessoas que trabalham e com consumo elevado de alimentos processados devem ser monitorados com maior cautela, pois apresentaram maior susceptibilidade de ocorrência do alto risco cardiovascular de 30 anos. Adultos jovens e com melhor situação socioeconômica possuem uma trajetória de baixo risco cardiovascular de 30 anos, entretanto, há uma tendência de piora desta trajetória ao longo do tempo devido aos maus hábitos de vida. Dessa forma, é essencial a implementação de estratégias de prevenção para evitar o adoecimento cardiovascular.

Introduction: Cardiovascular diseases are the main public health problem worldwide. Therefore, the assessment of cardiovascular risk, with the identification of its risk and protection factors and their trajectories over time, are important for proposing, consolidating and implementing measures to prevent the occurrence of cardiovascular diseases. General objective: To analyze the 30-year trajectory and determinants of high cardiovascular risk in participants of the Cohort of Universities of Minas Gerais (CUME Study). Methods: Initially, an integrative literature review was performed, followed by two prospective cohort studies. A) Article 1 ­ integrative review of the literature on the estimation of high cardiovascular risk and its associated factors, carried out in the databases Medical Literature Analysis and Retrievel System Online, Web of Science, Excerpta Medica Database, Cumulative Index to Nursing and Allied Health Literature and the Virtual Health Library portal; B) Article 2 ­ Prospective open cohort developed with 2,854 participants of the CUME Study, which is a multicenter research conducted with graduates from seven federal public institutions of higher education in the State of Minas Gerais since 2016. The incidence of high cardiovascular risk at 30 years was calculated using the Framingham score and its determinants were estimated using hierarchical multivariate analysis by the Cox regression technique; C) Article 3 ­ Prospective closed study developed with 1,286 participants from CUME, who answered the baseline questionnaire in 2016, the two-year follow-up questionnaire in 2018 and the four-year follow-up questionnaire in 2020. The risk Cardiovascular was assessed using the 30-year Framingham score. The identification of cardiovascular risk trajectories was performed using the latent class growth modeling technique using the normal censored model. The analysis of the factors independently associated with each of the trajectories was conducted using the multinomial logistic regression technique. Results: Article 1 ­ 13 articles were selected with one or more factors associated with high cardiovascular risk, according to the Framingham score over 10 years. No article investigated the factors associated with 30-year high cardiovascular risk. Article 2 ­ After an average of 2.62 years of follow-up, the incidence of high cardiovascular risk at 30 years was 8.1 cases/1,000 person-years in females and 20.2 cases/1,000 person-years in males. Male sex (Hazard Ratio ­ HR: 2.34; 95% CI: 1.58 - 3.46), work (HR: 2.13; 95% CI: 1.13 - 3.99), high food intake processed foods (HR: 2.44; 95% CI: 1.21 - 4.90) and being physically active (HR: 0.63; 95% CI: 0.41 - 0.98) were independently associated with high cardiovascular risk 30 years old; Article 3 - Three 30-year cardiovascular risk trajectories were identified: Low-Low (68.3%), Medium-Medium (26.2%) and High-High (5.5%). Over time, cardiovascular risk showed a slight increase for the Low-Low trajectory (2.9%), a moderate increase for the Medium-Medium trajectory (7.6%) and a high increase for the High-High trajectory (13%). Being male, living in a stable relationship, having moderate and high consumption of ultra-processed foods were positively associated with Medium-Medium and High-High cardiovascular risk trajectories. Also, having professional training outside the health area and being working were positively associated with the Medium-Medium cardiovascular risk trajectory, while being physically active was negatively associated with the High-High cardiovascular risk trajectory. Conclusion: Few studies were conducted to assess the 30-year high cardiovascular risk, and none of them estimated factors associated with the outcome. Our scientific findings indicated that practicing physical activity reduces the incidence of 30-year high cardiovascular risk. Men, people who work and with a high consumption of processed foods should be monitored with greater caution, as they were more susceptible to the occurrence of the high cardiovascular risk of 30 years. Young adults with better socioeconomic status have a 30-year trajectory of low cardiovascular risk, however, there is a tendency for this trajectory to worsen over time due to bad lifestyle habits. Thus, it is essential to implement prevention strategies to avoid cardiovascular disease.

Nada, pedala e corre: análise qualitativa das motivações para a prática esportiva de triatletas amadores e profissionais / Nadar, pedalear y correr: análisis cualitativo de las motivaciones para la práctica deportiva de triatletas aficionados y profesionales / Swim, pedals and run: qualitative analysis of motivations for the practice of sports by amateur and professional triathletes

Resumo O Triathlon, composto por natação, ciclismo e corrida, evidenciou um crescimento da sua prática nos últimos anos. Atualmente enfrentamos uma das maiores pandemias mundiais devido ao novo coronavírus, o que afetou diretamente a rotina de treinos e preparação para competições de triatletas. O objetivo desta investigação, sob uma metodologia qualitativa, é compreender quais são os fatores motivacionais para a prática do Triathlon por atletas brasileiros. Os resultados mostram três categorias emergentes: planilhas de treinos, provas e competições e impactos da pandemia de COVID-19. O artigo conclui que triatletas são motivados por razões distintas e traçam íntima relação à prática do Triathlon com suas respectivas trajetórias esportivas.

Resumen El triatlón, compuesto por natación, ciclismo y carrera a pie, ha mostrado un incremento en su práctica en los últimos años. Actualmente nos enfrentamos a una de las pandemias más grandes del mundo debido al nuevo coronavirus, que afectó directamente a la rutina de entrenamiento y preparación para las competencias de los triatletas. El objetivo de esta investigación, bajo una metodología cualitativa, es comprender cuáles son los factores motivacionales para la práctica del Triatlón por parte de los atletas brasileños. Los resultados muestran tres categorías emergentes: hojas de entrenamiento, pruebas y competencias e impactos de la pandemia de COVID-19. El artículo concluye que los triatletas se motivan por diferentes motivos y trazan una íntima relación entre la práctica del Triatlón y sus respectivas trayectorias deportivas.

Abstract Triathlon, composed of swimming, cycling and running, has shown an increase in its practice in the last few years. We are currently facing one of the biggest pandemics in the world due to the new coronavirus, which directly affected the training routine and preparation for triathlon competitions. The objective of this investigation, under a qualitative methodology, is to understand what are the motivational factors for the practice of Triathlon by Brazilian athletes. The results show three emerging categories: workout schedules, tests and competitions and the impacts of the COVID-19 pandemic. The article concludes that triathletes are motivated by different reasons and trace an intimate relationship between the practice of Triathlon and their respective sports trajectories.

Os limites do financiamento de bolsistas da Fundação Rockefeller: Maria Palmira Macedo Tito de Morais e a enfermagem internacional, 1936-1966 / Limits of the Rockefeller Foundation fellowship funding: Maria Palmira Macedo Tito de Morais and international nursing, 1936-1966

Resumo Este artigo analisa a formação internacional de Maria Palmira Macedo Tito de Morais, como bolsista da Fundação Rockefeller no campo da enfermagem, durante o Estado Novo português. Compreende-se de que forma os contextos locais influenciaram as ações da agência filantrópica internacional, o que culminou em disputas com a Organização Mundial da Saúde pela presença da enfermeira portuguesa em seus quadros. São utilizados como fonte dois dossiês sobre Maria Tito de Morais e seus dois cartões de bolsista, coletados no Rockefeller Archive Center, um relatório da Direção Geral de Saúde de Portugal e o periódico A Tribuna, consultado na Hemeroteca Digital brasileira. Conclui-se que as estratégias utilizadas pela Fundação Rockefeller, ao financiar a formação de Maria Tito de Morais com o intuito de cooptá-la para seu staff, não garantiram o controle sobre sua trajetória profissional.

Abstract The article analyses Maria Palmira Macedo Tito de Morais' international nursing education as a Rockefeller Foundation fellow, during the Portuguese Estado Novo. It studies the local contexts influence on the international philanthropic agency's actions, culminating in disputes with World Health Organization over the Portuguese nurse as staff. The sources are two dossiers on Maria Tito de Morais and her two fellowship cards collected at the Rockefeller Archive Center, a report of the Directorate-General of Health of Portugal and the journal A Tribuna, consulted at the Brazilian Digital Library. In conclusion, the Rockefeller Foundation's strategies, when funding Maria Tito de Morais' education aiming to hire her did not guarantee control over her professional trajectory.

Cadaveric study of anatomical measurement of isthmus parameters of lumbar spine to guide cortical bone screw placement

SUMMARY OBJECTIVE: To reduce surgical exposure and improve accuracy, this study evaluated the anatomical distance parameter D (including D1, D2, and D3) of the lumbar isthmus for cortical bone screw insertion. METHODS: A total of 25 structurally complete lumbar dry specimens were used for lumbar anatomy measurements. The six cadaver specimens were divided into upper and lower parts on the plane of the T11-T12 vertebrae, and we use the lower parts. Therefore, six lumbar wet specimens and another four complete lumbar dry specimens were selected. The lumbar isthmus tangent point was considered a coordinate origin, and the insertion point was determined through translating the distance of D1 value to the midline of the vertebral body horizontally and then vertically moved toward inferior board of the transverse process with the distance of D3 value. RESULTS: In four dry and six wet intact lumbar specimens, cortical bone screws were placed according to the average value of the isthmus parameter D. A total of 100 trajectories were verified in specimens by X-ray and computed topography scan to evaluate the safety, accuracy, and feasibility of the surgical use of isthmus parameter D. Using this parameter, the rates of excellent screw placement were 95% (38/40) in four dry specimens and 88.7% (53/60) in six wet specimens. CONCLUSION: The isthmus parameter D is easier to use by the operator, which can improve surgical accuracy and reduce operation time. LEVEL OF EVIDENCE: Level IV, prospective study.

Diferencias biomecánicas en la patada chigo-Chagüi con pierna delantera entre taekwondocas principiantes y avanzados

El análisis de la técnica deportiva entre diferentes niveles de rendimiento sirve para establecer comparaciones metodológicas que tributan al perfeccionamiento del rendimiento motriz especializado, incluidos los deportes eminentemente técnico-tácticos. En tal sentido, el objetivo de la investigación es analizar las diferencias biomecánicas entre deportistas profesionales y amateurs de taekwondo en la realización de la patada Chigo-Chagüi con pierna delantera. Se estudiaron dos grupos independientes, Deportistas Principiantes (DPRI) 15 principiantes y Deportistas Profesionales (DPRO): 15 avanzados o profesionales), se estudiaron indicadores de Velocidad, Ángulo de Flexión y Centro de Gravedad y se estableció una comparación. Se determinó un ángulo inicial de DPRO =28,4° y DPRI: 27,34° (p=0.309) y un ángulo de impacto de DPRI= 117,93º y DPRO=129,2º (p=0.001) y un ángulo final de DPRI=31,34º y DPRO=26,34º (p=0.057), con un tiempo de ejecución de la patada de DPRO=1312ms y DPRI=1462 ms (p=0.009), una velocidad máxima de DPRO=6,86 m/s y DPRI=5,47 m/s (p=0.003) y una aceleración promedio de DPRO=48,35 m/s2 y DPRI=36,55 m/s2 (p=0.029), siendo el centro de gravedad para el punto de impacto en Eje X sin diferencias significativas (p=0.506) y en el Eje y con diferencias significativas entre grupos independientes (p=0.029). Las diferencias entre deportistas avanzados y principiantes en la patada chigo-chagüi con pierna delantera suelen ser notables en la mayoría de los indicadores analizados, siendo el nivel del atleta un indicador que permite describir las deficiencias técnicas.

A análise da técnica desportiva entre diversos níveis de desempenho serve para estabelecer comparações metodológicas que contribuirão para a melhoria do desempenho motor especializado, nomeadamente dos desportos eminentemente técnico-tácticos. Neste sentido, o propósito da investigação é analisar as diferenças biomecânicas entre os atletas profissionais e os iniciantes de taekwondo no desempenho do pontapé Chigo-Chagüi com a perna dianteira. Foram estudados dois grupos independentes, Atletas Principiantes (DPRI) 15 principiantes e Atletas Profissionais (DPRO): 15 avançados ou profissionais), foram estudados indicadores de Velocidade, Ângulo de Flexibilidade e Centro de Gravidade e foi estabelecida uma comparação. Um ângulo inicial do DPRO=28,4° e DPRI: 27,34° (p=0,309) e um ângulo de impacto do DPRI= 117,93º e DPRO=129,2º (p=0,001) e um ângulo final do DPRI=31,34º e DPRO=26,34º (p=0,057), com um tempo de pontapé de execução do DPRO=1312ms e DPRI=1462 ms (p=0,009), um tempo máximo de pontapé de execução do DPRO=1312ms e DPRI=1462 ms (p=0 009), uma velocidade máxima de DPRO=6,86 m/s e DPRI=5,47 m/s (p=0,003) e uma aceleração média de DPRO=48,35 m/s2 e DPRI=36,55 m/s2 (p=0,029), sendo o centro de gravidade para o ponto de colisão no Eixo X sem diferenças significativas (p=0,506) e no Eixo y com diferenças significativas entre grupos independentes (p=0,029). As diferenças entre atletas avançados e iniciantes no pontapé de chigo-Chagüi com a perna dianteira são geralmente notáveis na maioria dos indicadores analisados, sendo o nível do atleta um indicador que permite descrever as deficiências técnicas.

The analysis of sports technique between different performance levels serves to establish methodological comparisons that contribute to the improvement of specialized motor performance, including eminently technical-tactical sports. In this sense, the objective of the research is to analyze the biomechanical differences between professional and amateur taekwondo athletes in the performance of the Chigo-Chagüi kick with front leg. Two independent groups were studied, 15 Beginner Athletes (DPRI in Spanish) and15 Professional or advanced Athletes (DPRO in Spanish); indicators of Speed, Flexion Angle and Center of Gravity were studied and a comparison was established. An initial angle of DPRO=28.4° and DPRI: 27.34° (p=0.309) and an impact angle of DPRI= 117.93º and DPRO=129.2º (p=0.001) and a final angle of DPRI=31.34º and DPRO=26.34º (p=0.057) were determined, with a kick execution time of DPRO=1312ms and DPRI=1462 ms (p=0.009), a maximum velocity of DPRO=6.86 m/s and DPRI=5.47 m/s (p=0.003) and an average acceleration of DPRO=48.35 m/s2 and DPRI=36.55 m/s2 (p=0.029), being the center of gravity for the impact point in Axis X with no significant differences (p=0.506) and in Axis Y with significant differences between independent groups (p=0.029). The differences between advanced and beginner athletes in the chigo-chagüi kick with front leg are usually remarkable in most of the indicators analyzed, being the level of the athlete an indicator that allows describing the technical deficiencies.

A cohort study on the correlation between fasting plasma glucose trajectories and new-onset carotid plaque / 中华健康管理学杂志

Objective:To investigate the correlation between fasting plasma glucose (FPG) and new-onset carotid plaque through latent class trajectory models.Methods:A total of 953 observation objects came from the first affiliated hospital of Zhengzhou University in accordance with the inclusion criteria. According to the FPG values of the observed subjects during the annual physical examination from January 2017 to December 2019, the following four different FPG trajectories groups were determined by latent class trajectory modelling tools: the low-stable group, the medium stable group, the medium-high stable group, and the high stable group. Carotid plaque incidence in each group was followed up in 2020 to compare the differences of the cumulative incidences of the four groups. The Cox proportional risk regression model was used to analyze the correlation between different FPG trajectories and new-onset carotid plaque.Results:The incidence of carotid plaque increased with the increase of FPG trajectories by 11.13%, 19.70%, 23.44%, 23.81%, respectively, with significance ( P<0.001). After adjusting gender, age, BMI and other confounding factors with the cox proportional risk regression model, the risk of carotid plaque in the FPG medium stable group, medium and high stable group, high-stable group was still 1.895 (95% CI: 1.296-2.769), 2.273 (95% CI: 1.241-4.161), 2.527 (95% CI: 1.219-5.241) times of the low stable group (all P<0.05). Conclusion:The long-term high FPG levels are independent risk factors for the incidence of carotid plaque, and controlling FPG at a low level steadily can reduce the risk of carotid plaque.

A grounded theory study of primary caregiver coping trajectories in patients with permanent enterostomy / 中国实用护理杂志

Objective:To explore the coping trajectory of primary caregivers in patients with permanent enterostomy, and to provide theoretical basis for clinical intervention.Methods:A semi-structured interview was conducted among 20 primary caregivers of patients with permanent enterostomy hospitalized in Qilu Hospital of Shandong University from May to July 2021. The data were analyzed by three-level coding and continuous comparison.Results:The coping trajectory of primary caregivers of permanent enterostomy patients experienced confusion and fatigue period, coping exploration period, acceptance and coexistence period, transformation and transcendence period.Conclusions:Medical staff should give corresponding health education and timely formulate effective intervention measures according to different stages. At the same time, we should effectively integrate external resources to promote the construction of "Hospital-Family-Community" tripartite care model to relieve the care pressure of caregivers.

Longitudinal study on the trajectory and influencing factors of cancer-related fatigue in breast cancer patients during chemotherapy / 中国实用护理杂志

Objective:To investigate the longitudinal trajectory and influencing factors of cancer-related fatigue (CRF) in breast cancer patients during chemotherapy.Methods:From March 2019 to January 2020, breast cancer patients in Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine Affiliated to Shanghai University of Traditional Chinese Medicine and Peking Union Medical College Hospital were selected as the research objects to conduct follow-up investigation. The survey tools included general information questionnaire, Cancer-related Fatigue Assessment Scale, International Physical Activity Questionnaire, and the Pittsburgh Sleep Quality Index Scale.Results:A total of 91 patients were included in the study. The incidence of severe CRF at each time point before chemotherapy, 3 weeks after chemotherapy and 6 weeks after chemotherapy were 1.1% (1/91), 8.8% (5/57) and 2.1% (1/48), respectively. The results of the generalized estimation equation showed that the trajectory of the total score CRF firstly increased and then decreased, reaching a peak at 3 weeks after chemotherapy (35.45±13.07), and mild CRF change showed statistical difference ( P<0.05). In addition, BMI and sleep and daytime dysfunction were the influencing factors of the total score of CRF. Disease stage, sleep disturbance and daytime dysfunction were the influencing factors of CRF with different severity. Conclusions:CRF is a prominent problem in breast cancer patients during chemotherapy. Attention should be paid to high-risk individuals with abnormal BMI and daytime function by medical staff.

A method of lung puncture path planning based on multi-level constraint / 生物医学工程学杂志

Percutaneous pulmonary puncture guided by computed tomography (CT) is one of the most effective tools for obtaining lung tissue and diagnosing lung cancer. Path planning is an important procedure to avoid puncture complications and reduce patient pain and puncture mortality. In this work, a path planning method for lung puncture is proposed based on multi-level constraints. A digital model of the chest is firstly established using patient's CT image. A Fibonacci lattice sampling is secondly conducted on an ideal sphere centered on the tumor lesion in order to obtain a set of candidate paths. Finally, by considering clinical puncture guidelines, an optimal path can be obtained by a proposed multi-level constraint strategy, which is combined with oriented bounding box tree (OBBTree) algorithm and Pareto optimization algorithm. Results of simulation experiments demonstrated the effectiveness of the proposed method, which has good performance for avoiding physical and physiological barriers. Hence, the method could be used as an aid for physicians to select the puncture path.