Trends of Mansonia (Diptera, Culicidae, Mansoniini) in Porto Velho: Seasonal patterns and meteorological influences.

Entomological research is vital for shaping strategies to control mosquito vectors. Its significance also reaches into environmental management, aiming to prevent inconveniences caused by non-vector mosquitoes like the Mansonia Blanchard, 1901 mosquito. In this study, we carried out a five-year (2019-2023) monitoring of these mosquitoes at ten sites in Porto Velho, Rondônia, using SkeeterVac SV3100 automatic traps positioned between the two hydroelectric complexes on the Madeira River. Throughout this period, we sampled 153,125 mosquitoes, of which the Mansonia genus accounted for 54% of the total, indicating its prevalence in the region. ARIMA analysis revealed seasonal patterns of Mansonia spp., highlighting periods of peak density. Notably, a significant decreasing trend in local abundance was observed from July 2021 (25th epidemiological week) until the end of the study. Wind speed was observed to be the most relevant meteorological factor influencing the abundance of Mansonia spp. especially in the Joana D'Arc settlement, although additional investigation is needed to comprehensively analyze other local events and gain a deeper understanding of the ecological patterns of this genus in the Amazon region.

The first confirmed human case of rabies, Timor-Leste, 2024.

In March 2024, the first ever human case of rabies, following a dog bite, was detected in Timor-Leste. This paper briefly discusses the circumstances of transmission, clinical presentation, palliative care of the case and public health measures taken. Timor-Leste was previously considered rabies-free. Any person who is bitten or scratched by an animal that could potentially transmit rabies virus (especially dogs, bats, monkeys or cats) in Timor-Leste should be assessed for consideration of provision of rabies post-exposure prophylaxis.

Characterization and quantification of epilepsy patients with hospital episodes in Portugal: A multicenter retrospective study from Liga Portuguesa Contra a Epilepsia.

INTRODUCTION: Epilepsy affects around 50 million people worldwide and is associated with lower quality of life scores, an increased risk of premature death, and significant socio-economic implications. The lack of updated evidence on current epidemiology and patient characterization creates considerable uncertainty regarding the epilepsy burden in Portugal. The study aims to characterize and quantify the epilepsy patients who have been hospitalized, with medical or surgical procedures involved, and to analyze their associated comorbidities and mortality rates. METHODS: A multicenter retrospective study was conducted using hospital production data of epilepsy patients. The study included all patients diagnosed with epilepsy-related International Classification of Diseases-9/10 codes between 2015 and 2018 in 57 Portuguese National Health Service (NHS) hospitals (n = 57 institutions). Patient characterization and quantification were done for all patients with an epilepsy diagnosis, with specific analyses focusing on those whose primary diagnosis was epilepsy. Baseline, demographic, and clinical characteristics were analyzed using descriptive statistics. RESULTS: Between 2015 and 2018, a total of 80,494 hospital episodes (i.e., patient visit that generates hospitalization and procedures) were recorded, with 18 % to 19 % directly related to epilepsy. Among these epilepsy-related hospital episodes, 13.0 % led to short term hospitalizations (less than 24 h). Additionally, the average length of stay for all these epilepsy-related episodes was 8 days. A total of 49,481 patients were identified with epilepsy based on ICD-9/10 codes. The median age of patients was 64 years (min: 0; max: 104), with a distribution of 4.8 patients per 1,000 inhabitants. From the total of deaths (9,606) between 2015 and 2018, 14% were associated with patients whose primary diagnosis was epilepsy, with 545 of these being epilepsy-related deaths. Among patients with a primary diagnosis of epilepsy, the most common comorbidities were hypertension (24%) and psychiatric-related or similar comorbidities (15%), such as alcohol dependance, depressive and major depressive disorders, dementia and other convulsions. CONCLUSION: This study showed similar results to other European countries. However, due to methodological limitations, a prospective epidemiological study is needed to support this observation. Furthermore, the present study provides a comprehensive picture of hospitalized epilepsy patients in Portugal, their comorbidities, mortality, and hospital procedures.

Appropriateness and imaging outcomes of ultrasound, CT, and MR in the emergency department: a retrospective analysis from an urban academic center.

PURPOSE: To evaluate the appropriateness and outcomes of ultrasound (US), computed tomography (CT), and magnetic resonance (MR) orders in the ED. METHODS: We retrospectively reviewed consecutive US, CT, and MR orders for adult ED patients at a tertiary care urban academic center from January to March 2019. The American College of Radiology Appropriateness Criteria (ACRAC) guidelines were primarily used to classify imaging orders as "appropriate" or "inappropriate". Two radiologists in consensus judged specific clinical scenarios that were unavailable in the ACRAC. Final imaging reports were compared with the initial clinical suspicion for imaging and categorized into "normal", "compatible with initial diagnosis", "alternative diagnosis", or "inconclusive". The sample was powered to show a prevalence of inappropriate orders of 30% with a margin of error of 5%. RESULTS: The rate of inappropriate orders was 59.4% for US, 29.1% for CT, and 33.3% for MR. The most commonly imaged systems for each modality were neuro (130/330) and gastrointestinal (95/330) for CT, genitourinary (132/330) and gastrointestinal (121/330) for US, neuro (273/330) and gastrointestinal (37/330) for MR. Compared to inappropriately ordered tests, the final reports of appropriate orders were nearly three times more likely to demonstrate findings compatible with the initial diagnosis for all modalities: US (45.5 vs. 14.3%, p < 0.001), CT (46.6 vs. 14.6%, p < 0.001), and MR (56.3 vs. 21.8%, p < 0.001). Inappropriate orders were more likely to show no abnormalities compared to appropriate orders: US (65.8 vs. 38.8%, p < 0.001), CT (62.5 vs. 34.2%, p < 0.001), and MR (61.8 vs. 38.7%, p < 0.001). CONCLUSION: The prevalence of inappropriate imaging orders in the ED was 59.4% for US, 29.1% for CT, and 33.3% for MR. Appropriately ordered imaging was three times more likely to yield findings compatible with the initial diagnosis across all modalities.

A Performance Comparison between Different Industrial Real-Time Indoor Localization Systems for Mobile Platforms.

The flexibility and versatility associated with autonomous mobile robots (AMR) have facilitated their integration into different types of industries and tasks. However, as the main objective of their implementation on the factory floor is to optimize processes and, consequently, the time associated with them, it is necessary to take into account the environment and congestion to which they are subjected. Localization, on the shop floor and in real time, is an important requirement to optimize the AMRs' trajectory management, thus avoiding livelocks and deadlocks during their movements in partnership with manual forklift operators and logistic trains. Threeof the most commonly used localization techniques in indoor environments (time of flight, angle of arrival, and time difference of arrival), as well as two of the most commonly used indoor localization methods in the industry (ultra-wideband, and ultrasound), are presented and compared in this paper. Furthermore, it identifies and compares three industrial indoor localization solutions: Qorvo, Eliko Kio, and Marvelmind, implemented in an industrial mobile platform, which is the main contribution of this paper. These solutions can be applied to both AMRs and other mobile platforms, such as forklifts and logistic trains. In terms of results, the Marvelmind system, which uses an ultrasound method, was the best solution.

Effects of a cardiopulmonary rehabilitation protocol on functional capacity, dyspnea, fatigue, and body composition in individuals with post-COVID-19 syndrome: A randomized controlled trial.

BACKGROUND AND OBJECTIVE: Reduced functional capacity, dyspnea, fatigue, and changes in body composition are common in patients with post-COVID-19 syndrome (PCS), and cardiopulmonary rehabilitation may improve these parameters. Thus, the present study verified the effects of cardiopulmonary rehabilitation (respiratory, aerobic, and resistance muscle training) on submaximal exercise tolerance, dyspnea, fatigue, and body composition. METHODS: This controlled and randomized clinical trial applied a six-week outpatient intervention protocol in individuals over 18 years old (n = 33) with a diagnosis of COVID-19 confirmed by polymerase chain reaction. These individuals were allocated to cardiopulmonary rehabilitation (n = 17) or control groups (i.e., educational lectures; n = 16). The cardiopulmonary rehabilitation group performed respiratory, aerobic, and resistance muscle training. Submaximal exercise tolerance, dyspnea, fatigue, and body composition were assessed before and after the protocol. RESULTS: After 6 weeks, the cardiopulmonary rehabilitation group increased the tolerance to submaximal exercise, with a difference of 100.46 m (95% confidence interval [CI]: 7.40-193 m) in the distance walked on the six-minute walk test, reduced dyspnea (-1.45, 95% CI: -1.98--0.92) in the modified Medical Research Council, and increased 0.63 kg (95% CI: 0.09-1.18 kg) of muscle mass in the upper limbs compared with the control group. CONCLUSION: The six-week cardiopulmonary rehabilitation protocol improved functional capacity, reduced dyspnea, and increased muscle mass in the upper limbs in individuals with PCS. Thus, these results supported the protocol use in this population and encourage further studies to assess its effectiveness in a large sample.

Pheochromocytoma/Paraganglioma (PPGL): A Misdiagnosed Cause of Hypertension during Pregnancy.

Hypertension (HT) during pregnancy is not an infrequent obstetric problem, reaching a prevalence of 5-10%. This condition is highly associated with both maternal and fetal complications if not precisely diagnosed and managed. Even though primary HT, obesity, and preeclampsia are the main causes of HT in this period, other less familiar conditions must be considered during the investigation. Pheochromocytoma and paraganglioma (PPGL) are chromaffin cell tumors that produce, store, and secrete catecholamines, leading to HT and other adrenergic manifestations. Recognition of PPGL is crucial since misdiagnosis and improper management can lead to high morbidity and mortality, particularly during pregnancy. We report on two cases of PPGL diagnosed during pregnancy with different managements. Case 1 is a 25-year-old female at 31 weeks of first pregnancy, whose severe HT and life-threatening symptoms prompted an emergency delivery without previous confirmation or medical treatment of a suspected PPGL. After confirmation, a right adrenal PPGL was surgically resected 4 months later, following 15 days of medical therapy. Case 2 is a 22-year-old female at 18 weeks of pregnancy whose symptomatic PPGL was resected in the second trimester. A next-generation sequencing panel, including 23 PPGL-related genes, found no germline pathogenic variants (GPVs) in case 1 and an exon 1-4 germinative heterozygous deletion of the MAX gene in case 2. Despite the different medical approaches, both cases had satisfactory outcomes. Although uncommon, PPGL should be considered in the differential diagnosis of HT in pregnancy since missing the diagnosis and failing to introduce appropriate and timely treatment may lead to dramatic consequences for the mother and fetus. PPGL diagnosed during reproductive age is likely to result from GPV, prompting genetic investigation and counseling.

A genotyping array for the globally invasive vector mosquito, Aedes albopictus.

BACKGROUND: Although whole-genome sequencing (WGS) is the preferred genotyping method for most genomic analyses, limitations are often experienced when studying genomes characterized by a high percentage of repetitive elements, high linkage, and recombination deserts. The Asian tiger mosquito (Aedes albopictus), for example, has a genome comprising up to 72% repetitive elements, and therefore we set out to develop a single-nucleotide polymorphism (SNP) chip to be more cost-effective. Aedes albopictus is an invasive species originating from Southeast Asia that has recently spread around the world and is a vector for many human diseases. Developing an accessible genotyping platform is essential in advancing biological control methods and understanding the population dynamics of this pest species, with significant implications for public health. METHODS: We designed a SNP chip for Ae. albopictus (Aealbo chip) based on approximately 2.7 million SNPs identified using WGS data from 819 worldwide samples. We validated the chip using laboratory single-pair crosses, comparing technical replicates, and comparing genotypes of samples genotyped by WGS and the SNP chip. We then used the chip for a population genomic analysis of 237 samples from 28 sites in the native range to evaluate its usefulness in describing patterns of genomic variation and tracing the origins of invasions. RESULTS: Probes on the Aealbo chip targeted 175,396 SNPs in coding and non-coding regions across all three chromosomes, with a density of 102 SNPs per 1 Mb window, and at least one SNP in each of the 17,461 protein-coding genes. Overall, 70% of the probes captured the genetic variation. Segregation analysis found that 98% of the SNPs followed expectations of single-copy Mendelian genes. Comparisons with WGS indicated that sites with genotype disagreements were mostly heterozygotes at loci with WGS read depth < 20, while there was near complete agreement with WGS read depths > 20, indicating that the chip more accurately detects heterozygotes than low-coverage WGS. Sample sizes did not affect the accuracy of the SNP chip genotype calls. Ancestry analyses identified four to five genetic clusters in the native range with various levels of admixture. CONCLUSIONS: The Aealbo chip is highly accurate, is concordant with genotypes from WGS with high sequence coverage, and may be more accurate than low-coverage WGS.

Acute hepatic rupture causing hemoperitoneum in a dog with anaphylaxis.

A 2-year-old spayed female Siberian Husky was presented with a history of acute onset lethargy, collapse, haematochezia and vomiting. The patient was severely tachycardic and hypotensive. Point-of-care ultrasound revealed gallbladder wall thickening and peritoneal effusion consistent with haemorrhage on subsequent abdominocentesis. Despite attempted medical stabilization over the course of several hours, including blood products and multiple autotransfusions, the patient progressed to cardiopulmonary arrest. The dog was successfully resuscitated but was subsequently euthanized. Necropsy revealed a severe, acute hemoperitoneum secondary to rupture of the left lateral liver lobe. A tear in the hepatic capsule was identified along with a large hematoma. A single adult nematode, consistent with Dirofilaria immitis, was found in a pulmonary vessel in the right caudal lung lobe. The remaining necropsy findings were supportive of the clinical diagnosis of anaphylaxis. This report details a case, with necropsy findings, supporting a diagnosis of anaphylaxis and severe, refractory hemoperitoneum resulting from hepatic rupture. Acute hepatic rupture should be considered in cases of anaphylaxis-related hemoperitoneum.

Impact of SumiLarv® 2MR on Aedes aegypti larvae: a multicenter study in Brazil.

BACKGROUND: Aedes aegypti is associated with dengue, Zika, and chikungunya transmission. These arboviruses are responsible for national outbreaks with severe public health implications. Vector control is one of the tools used to prevent mosquito proliferation, and SumiLarv® 2MR is an alternative commercial product based on pyriproxyfen for larval/pupal control. In this study, the residual effectiveness of SumiLarv® 2MR in different regions of Brazil was evaluated in simulated field conditions. METHODS: We conducted a multicenter study across four Brazilian states-Amapá, Pernambuco, Rio de Janeiro, and São Paulo-given the importance to the country's climatic variances in the north, northeast, and southeast regions and their influence on product efficiency. The populations of Ae. aegypti from each location were held in an insectary. Third-instar larvae (L3) were added every 2 weeks to water containers with SumiLarv® 2MR discs in 250-, 500- and 1000-l containers in Amapá and Rio de Janeiro, and 100-l containers in Pernambuco and São Paulo, using concentrations of 0.04, 0.08, and 0.16 mg/l. RESULTS: Adult emergence inhibition over 420 days was observed in all tests conducted at a concentration of 0.16 mg/l; inhibition for 308-420 days was observed for 0.08 mg/l, and 224-420 days for 0.04 mg/l. CONCLUSIONS: Sumilarv® 2MR residual activity demonstrated in this study suggests that this new pyriproxyfen formulation is a promising alternative for Aedes control, regardless of climatic variations and ideal concentration, since the SumiLarv® 2MR showed adult emergence inhibition of over 80% and residual activity greater than 6 months, a period longer than that recommended by the Ministry of Health of Brazil between product re-application in larval breeding sites.

Fibroblasts and osteoblasts behavior after contact with different titanium surfaces used as implant abutment: An in vitro experimental study.

Background: The goal of this in vitro study was to compare three different surfaces: two types of implant surfaces commercially available ([a] smooth/machined and [b] acid-treated surface) versus (c) anodized surface. Discs were manufactured with commercially pure titanium (CP) grade IV, which were subsequently analyzed by scanning microscopy and fibroblastic and osteoblastic cell cultures. Methods: Ninety-nine discs (5 × 2 mm) were manufactured in titanium grade IV and received different surface treatments: (i) Mach group: machined; (ii) AA group: double acid etch; and (iii) AN group: anodizing treatment. Three discs from each group were analyzed by Scanning Electron Microscopy (SEM) to obtain surface topography images and qualitatively analyzed by EDS. Balb/c 3T3 fibroblasts and pre-osteoblastic cells (MC3T3-E1 lineage) were used to investigate each group's biological response (n = 10/cellular type). The data were compared statistically using the ANOVA one-way test, considered as a statistically significant difference p < 0.05. Results: The AA group had numerous micropores with diameters between 5 and 10 µm, while nanopores between 1 and 5 nm were measured in the AN group. The EDX spectrum showed a high titanium concentration in all the analyzed samples. The contact angle and wetting tension were higher in the AA, whereas similar results were observed for the other groups. A lower result was observed for base width in the AA, which was higher in the other two groups. The AN showed the best values in the fibroblast cells, followed by Mach and AA; whereas, in the culture of the MC3T3 cells, the result was precisely the opposite (AA > Mach > AN). There was similar behavior for cell adhesion for the test groups (Mach and AN), with greater adhesion of Balb/c 3T3 fibroblasts compared to MC3T3 cells; in the AA group, there was greater adherence for MC3T3 cells compared to Balb/c 3T3 fibroblasts. Conclusions: The findings suggest that different surface characteristics can produce different biological responses, possibly cell-line dependent. These findings have important implications for the design of implantable medical devices, where the surface characteristics can significantly impact its biocompatibility.

Angle Assessment for Upper Limb Rehabilitation: A Novel Light Detection and Ranging (LiDAR)-Based Approach.

The accurate measurement of joint angles during patient rehabilitation is crucial for informed decision making by physiotherapists. Presently, visual inspection stands as one of the prevalent methods for angle assessment. Although it could appear the most straightforward way to assess the angles, it presents a problem related to the high susceptibility to error in the angle estimation. In light of this, this study investigates the possibility of using a new approach to angle calculation: a hybrid approach leveraging both a camera and LiDAR technology, merging image data with point cloud information. This method employs AI-driven techniques to identify the individual and their joints, utilizing the cloud-point data for angle computation. The tests, considering different exercises with different perspectives and distances, showed a slight improvement compared to using YOLO v7 for angle calculation. However, the improvement comes with higher system costs when compared with other image-based approaches due to the necessity of equipment such as LiDAR and a loss of fluidity during the exercise performance. Therefore, the cost-benefit of the proposed approach could be questionable. Nonetheless, the results hint at a promising field for further exploration and the potential viability of using the proposed methodology.

The artificial intelligence-based model ANORAK improves histopathological grading of lung adenocarcinoma.

The introduction of the International Association for the Study of Lung Cancer grading system has furthered interest in histopathological grading for risk stratification in lung adenocarcinoma. Complex morphology and high intratumoral heterogeneity present challenges to pathologists, prompting the development of artificial intelligence (AI) methods. Here we developed ANORAK (pyrAmid pooliNg crOss stReam Attention networK), encoding multiresolution inputs with an attention mechanism, to delineate growth patterns from hematoxylin and eosin-stained slides. In 1,372 lung adenocarcinomas across four independent cohorts, AI-based grading was prognostic of disease-free survival, and further assisted pathologists by consistently improving prognostication in stage I tumors. Tumors with discrepant patterns between AI and pathologists had notably higher intratumoral heterogeneity. Furthermore, ANORAK facilitates the morphological and spatial assessment of the acinar pattern, capturing acinus variations with pattern transition. Collectively, our AI method enabled the precision quantification and morphology investigation of growth patterns, reflecting intratumoral histological transitions in lung adenocarcinoma.

Seasonal variations in botanical and nutritive composition, forage availability and ingestive behavior of grazing goats in the semiarid region.

The aim of this study was to assess how the different seasons of the year impact the botanical composition, availability, and quality of forage in the caatinga, as well as the frequency of ingestion and ingestive behavior of goats in a semi-arid region. The experiment used four crossbred castrated males, with an average weight of 30.2 ± 4.76 kg and an average age of 20 months. The experimental period lasted for 12 months, encompassing two rainy seasons and one dry season within this timeframe, with three replications (data collection) per season. All collected forage was categorized based on its stratum (herbaceous, woody, and litter), and a chemical composition analysis was conducted. The goats' behavior was assessed by observing variables such as feeding time, idleness, rumination, displacement, social interaction, and water intake. The findings revealed clear seasonality in both availability and quality of forage, consequently influencing the botanical composition of the goats' diet and their ingestive behavior. In addition, during the grazing period, the goats showed a shift grazing habit, in which idle and feeding peaks were alternated with increased displacement during the morning and rumination in the afternoon. The seasons of the year strongly impact the availability and nutritional quality of forage in the caatinga biome, consequently influencing the ingestive behavior and dietary composition of goats in this ecosystem.

Coronary Artery Disease Assessment and Cardiovascular Events in Middle-Aged Patients on Hemodialysis.

OBJECTIVE: To explore whether, in younger patients on dialysis with longer life expectancy, assessment of coronary artery disease (CAD) could identify individuals at higher risk of events and revascularization might improve outcomes in selected patients contrary to what had been observed in elderly patients. METHODS: From August 1997 to January 2019, 2265 patients with stage 5 chronic kidney disease were prospectively referred for cardiovascular assessment. For this study, we selected 1374 asymptomatic patients aged between 18 and 64 years. After clinical risk stratification and cardiac scintigraphy by single-photon emission computed tomography, 866 patients underwent coronary angiography. The primary end point was the composite incidence of nonfatal/fatal major adverse cardiovascular events during a follow-up period of 0.1 to 189.7 months (median, 26 months). The secondary end point was all-cause mortality. RESULTS: The primary end point occurred in 327 (23.8%) patients. Clinically stratified high-risk patients had a 3-fold increased risk of the primary end point. The prevalence of abnormal findings on perfusion scans was 29.2% (n=375), and significant CAD was found in 449 (51.8%) of 866 patients who underwent coronary angiography. An abnormal finding on myocardial perfusion scan and the presence of CAD were significantly associated with a 74% and 22% increased risk of cardiovascular events, respectively. In patients undergoing percutaneous coronary intervention or coronary artery bypass grafting (n=99), there was an 18% reduction in the risk of all-cause death relative to patients receiving medical treatment (P=.03). CONCLUSION: In this cohort of middle-aged, asymptomatic patients on dialysis, assessment of CAD identified individuals at higher risk of events, and coronary intervention was associated with reducing the risk of death in selected patients.

Preventing chronic malnutrition in children under 2 years in rural Angola (MuCCUA trial): protocol for the economic evaluation of a three-arm community cluster randomised controlled trial.

INTRODUCTION: Chronic malnutrition is a serious problem in southern Angola with a prevalence of 49.9% and 37.2% in the provinces of Huila and Cunene, respectively. The MuCCUA (Mother and Child Chronic Undernutrition in Angola) trial is a community-based randomised controlled trial (c-RCT) which aims to evaluate the effectiveness of a nutrition supplementation plus standard of care intervention and a cash transfer plus standard of care intervention in preventing stunting, and to compare them with a standard of care alone intervention in southern Angola. This protocol describes the planned economic evaluation associated with the c-RCT. METHODS AND ANALYSIS: We will conduct a cost-efficiency and cost-effectiveness analysis nested within the MuCCUA trial with a societal perspective, measuring programme, provider, participant and household costs. We will collect programme costs prospectively using a combined calculation method including quantitative and qualitative data. Financial costs will be estimated by applying activity-based costing methods to accounting records using time allocation sheets. We will estimate costs not included in accounting records by the ingredients approach, and indirect costs incurred by beneficiaries through interviews, household surveys and focus group discussions. Cost-efficiency will be estimated as cost per output achieved by combining activity-specific cost data with routine data on programme outputs. Cost-effectiveness will be assessed as cost per stunting case prevented. We will calculate incremental cost-effectiveness ratios comparing the additional cost per improved outcome of the different intervention arms and the standard of care. We will perform sensitivity analyses to assess robustness of results. ETHICS AND DISSEMINATION: This economic evaluation will provide useful information to the Angolan Government and other policymakers on the most cost-effective intervention to prevent stunting in this and other comparable contexts. The protocol was approved by the República de Angola Ministério da Saúde Comité de Ética (27C.E/MINSA.INIS/2022). The findings of this study will be disseminated within academia and the wider policy sphere. TRIAL REGISTRATION NUMBER: ClinicalTrials.gov Registry (NCT05571280).

Application of machine learning in dementia diagnosis: A systematic literature review.

According to the World Health Organization forecast, over 55 million people worldwide have dementia, and about 10 million new cases are detected yearly. Early diagnosis is essential for patients to plan for the future and deal with the disease. Machine Learning algorithms allow us to solve the problems associated with early disease detection. This work attempts to identify the current relevance of the application of machine learning in dementia prediction in the scientific world and suggests open fields for future research. The literature review was conducted by combining bibliometric and content analysis of articles originating in a period of 20 years in the Scopus database. Twenty-seven thousand five hundred twenty papers were identified firstly, of which a limited number focused on machine learning in dementia diagnosis. After the exclusion process, 202 were selected, and 25 were chosen for analysis. The recent increasing interest in the past five years in the theme of machine learning in dementia shows that it is a relevant field for research with still open questions. The methods used to identify dementia or what features are used to identify or predict this disease are explored in this study. The literature review revealed that most studies used magnetic resonance imaging (MRI) and its types as the main feature, accompanied by demographic data such as age, gender, and the mini-mental state examination score (MMSE). Data are usually acquired from the Alzheimer's Disease Neuroimaging Initiative (ADNI). Classification of Alzheimer's disease is more prevalent than prediction of Mild Cognitive Impairment (MCI) or their combination. The authors preferred machine learning algorithms such as SVM, Ensemble methods, and CNN because of their excellent performance and results in previous studies. However, most use not one machine-learning technique but a combination of techniques. Despite achieving good results in the studies considered, there are new concepts for future investigation declared by the authors and suggestions for improvements by employing promising methods with potentially significant results.

Prevalence of sarcopenia components and associated socioeconomic factors among older adults living in rural areas in the state of Ceará, Brazil. / Prevalência dos componentes da sarcopenia e fatores socioeconômicos associados em idosos de uma população rural do estado do Ceará, Brasil.

The aim is to determine the prevalence of sarcopenia components and associations with socioeconomic variables in older persons living in rural areas in the state of Ceará, Brazil. We conducted a cross-sectional study with 274 older adults. Muscle mass was assessed using muscle mass index (MMI), measured by bioelectrical impedance analysis and calf circumference. Muscle strength (MS) was assessed using the handgrip test. Physical performance was measured using the walk test to calculate gait speed (GS) and the timed up-and-go test. Probable sarcopenia was defined as the presence of low MS, while confirmed sarcopenia was defined as the presence of low MS and low MMI. Severe sarcopenia was defined as the presence of the latter two criteria and slow GS. We tested for associations between sociodemographic characteristics and lifestyle habits and the components of sarcopenia. The logistic regression produced the following results: i) prevalence of low MS was higher among men, individuals aged >69 years, and in those not working at the time of the study; ii) the prevalence of low MMI was higher in individuals aged >69 years, those not living with a spouse, and those with an inadequate level of physical activity; iii) the prevalence of slow GS was higher in individuals aged >69 years, those who had lived in rural areas for less than 30 years, and those not working at the time of the study.

O objetivo é estimar prevalência de componentes da sarcopenia e associações com variáveis socioeconômicas em idosos de população rural do Ceará. Estudo transversal com 274 idosos. Massa muscular foi determinada por Índice de Massa Muscular (IMM) por bioimpedância elétrica e por circunferência da panturrilha; força muscular (FM) por teste de preensão palmar; e desempenho físico por testes da caminhada (VC) e Timed-up-and-go. Provável sarcopenia foi caracterizada por diminuição da FM, sarcopenia quando associada a diminuição do IMM, e sarcopenia grave quando estes dois foram acompanhados de baixa VC. Foram estimadas associações entre condições sociodemográficas, hábitos de vida e componentes da sarcopenia. Na regressão logística, foi observada frequência mais elevada: i) no sexo masculino, idade>69 anos, e nos que não trabalham, entre os idosos com FM diminuída; ii) com idade>69 anos, nos que não moram com o cônjuge, e nos que não praticam atividade física num nível adequado, entre os idosos com IMM diminuído; iii) com idade>69 anos, nos que residem na zona rural há menos que 30 anos, e nos que não trabalham, entre os idosos com VC diminuída.

Respiratory Muscle Strength and Quality of Life in Patients With Heart Failure and Their Main Correlated Factors: A Cross-sectional Study.

BACKGROUND: Heart failure may cause peripheral and respiratory muscle alterations, dyspnea, fatigue, and exercise intolerance, worsening the quality of life of patients. OBJECTIVES: The aims of this study were to analyze respiratory muscle strength and quality of life of patients with heart failure and correlate them with clinical variables and functional classification. METHODS: This cross-sectional study involved patients with heart failure. A manovacuometer assessed maximum inspiratory and expiratory pressures, and quality of life was assessed using the Minnesota Living with Heart Failure Questionnaire. Functional classification was categorized according to the New York Heart Association (NYHA) class in I, II, III, or IV. RESULTS: We included 60 patients (66.7% male) with a mean age of 62.0 years and mean left ventricular ejection fraction of 42.0%. Maximum inspiratory pressure and maximum expiratory pressure were close to normal (>70% of predicted) in most patients; however, a subgroup composed mostly of patients with dilated heart failure and NYHA class III (n = 21) presented low maximum inspiratory pressure values (59.2%; 95% confidence interval, 55.7%-62.8%). The mean total score of the Minnesota Living with Heart Failure Questionnaire was 44.4 points, being negatively correlated with left ventricular ejection fraction (r = -0.29, P = .02). Patients with NYHA class III and disease duration longer than 120 months presented higher total (P < .01) and physical dimension scores. CONCLUSIONS: Most patients had respiratory muscle strength close to normal; however, those with dilated heart failure and NYHA class III presented low maximum inspiratory pressure values. Quality of life was moderately compromised, mainly because of long disease duration, NYHA class III, and low left ventricular ejection fraction.