Efficacy of Transcranial Direct Current Stimulation (tDCS) on Cognition, Anxiety, and Mobility in Community-Dwelling Older Individuals: A Controlled Clinical Trial.

Transcranial direct current stimulation (tDCS) has gained popularity as a method of modulating cortical excitability in people with physical and mental disabilities. However, there is a lack of consensus on its effectiveness in older individuals. This study aimed to assess the efficacy of a 2-month tDCS program for improving physical and mental performance in community-dwelling older individuals. In this single-blinded, controlled clinical trial, forty-two participants were allocated to one of three groups: (1) the tDCS group, which received, twice a week, 20 min sessions of 2 mA electric current through electrodes placed on the dorsolateral prefrontal cortex; (2) the tDCS-placebo group, which underwent the same electrode placement as the tDCS group but without actual electric stimulation; and (3) the cognitive-control group, which completed crossword puzzles. Main outcome measures were cognition, mobility, and anxiety. Multivariate analyses of variance were employed. Significance was set at 5% (p < 0.05). Regarding the results, no significant benefits were observed in the tDCS group compared with the tDCS-placebo or cognitive-control groups for cognition (p = 0.557), mobility (p = 0.871), or anxiety (p = 0.356). Cognition exhibited positive oscillations during the assessments (main effect of time: p = 0.001). However, given that all groups showed similar variations in cognitive scores (main effect of group: p = 0.101; group × time effect: p = 0.557), it is more likely that the improvement reflects the learning response of the participants to the cognitive tests rather than the effect of tDCS. In conclusion, a 2-month tDCS program with two sessions per week appears to be ineffective in improving physical and mental performance in community-dwelling older individuals. Further studies are necessary to establish whether or not tDCS is effective in healthy older individuals.

Associated Factors with Congenital Heart Disease in the Most Populated State of Brazil Between 2010 and 2018

Abstract Background Cardiac anomalies are the most prevalent congenital malformations among live births in the world. In Brazil, it is estimated that nearly 25,757 new cases occur each year, and the Southeast region presents the highest prevalence, with 10 new cases/1,000 live births. Objective The aim of this study is to evaluate the epidemiology of congenital heart disease (CHD) in the state of São Paulo. Methods This is a cross-sectional and time-series observational study with data from the Brazilian Information System on Live Births. Heart-related cardiac malformation cases — International Classification of Diseases (ICD) 10th revision Q20.0 to Q24.9 — were selected from January 2010 to December 2018, in the state of São Paulo, Brazil. This study analyzed rates of malformations per year and investigated associated factors, using single and multiple logistic regression models. The significance level adopted in this study was 5%. Results The highest cardiac malformation rate was in the São Paulo metropolitan region (2.84:1000), while the lowest was found in the region of Franca (0.3:1000). The most frequent defect was interatrial communication (38.2%). The main associated factors observed in this study were prematurity of 22 to 27 weeks (OR=4,401 95% CI: 3,796-5,104) — CI: Confidence Interval; OR: Odds ratio —, mother's age between 35 and 49 years of age (OR=1,602 95% CI: 1,525-1,682), yellow race (OR=1,481 95% CI: 1,235-1,775), triple or more pregnancy (OR=1,438 95% CI: 1,004-2,060), and history of a dead child (OR=1,213 95% CI: 1,152-1,277). Conclusion The main factors associated with this outcome, which are part of the obstetric history of mothers, should be addressed and considered when pregnancy is a planned event.

Atitudes e Autoeficácia dos Professores de Educação Física em Relação à Inclusão: Estudo Centrado na Região de Lisboa - Portugal / Attitudes and Self-Efficacy of Physical Education Teachers Towards The Inclusion: Study Focused on the Lisbon Region - Portugal

RESUMO: Os objetivos deste estudo foram analisar a atitude e a autoeficácia de professores de Educação física (EF) portugueses, determinar a relação entre as atitudes e a autoeficácia dos professores de EF em relação à inclusão de alunos com deficiência e avaliar o efeito das variáveis independentes (género, tempo de serviço docente, formação complementar em EF Inclusiva e docência ao aluno com deficiência nas aulas de EF e no Desporto Escolar) sobre as dimensões das atitudes e nas dimensões da autoeficácia. Participaram do estudo 115 professores de EF portugueses. Para analisar as atitudes, foram utilizadas a versão portuguesa do Multidimentional Attitudes toward Inclusive Education e a versão portuguesa do Self-Efficacy Scale for Physical Education Teacher Education Majors towards Children with Disabilities. Os resultados indicaram que, de uma forma geral, os professores de EF revelam atitudes mais positivas na dimensão comportamental e são mais confantes para ensinar alunos com deficiência intelectual. Identificaram-se relações positivas entre as diferentes dimensões das atitudes e da autoeficácia. Na análise comparativa das atitudes e da autoeficácia, observaram-se diferenças estatisticamente significativas nas dimensões cognitiva e de deficiência intelectual na variável "formação complementar em EF Inclusiva" e nas dimensões deficiência intelectual e visual na variável "Docência a alunos com deficiência". De um modo geral, os participantes reportaram atitudes positivas e são confantes em relação à inclusão de alunos com deficiência. A investigação futura deverá comparar as atitudes e a autoeficácia antes e após um programa prático de intervenção ao nível da EF inclusiva.

ABSTRACT: The objectives of this study were to analyze the attitude and self-efficacy of Portuguese Physical Education (PE) teachers, to determine the relationship between PE teachers' attitudes and self-efficacy regarding the inclusion of students with disabilities, and to evaluate the effect of independent variables (gender, length of teaching service, additional training in Inclusive PE and teaching students with disabilities in PE classes and School Sports) on the dimensions of attitudes and in the dimensions of self-efficacy. One hundred and fifteen Portuguese PE teachers participated in the study. To analyze the attitudes, the Portuguese version of the Multidimensional Attitudes to Inclusive Education was used, and the Portuguese version of the Self-Efficacy Scale for Physical Education Teacher Education Majors towards Children with Disabilities was used. The results indicated that, in general, PE teachers show more positive attitudes in the behavioral dimension and are more confident in teaching students with intellectual disabilities. Positive relationships were identified between the different dimensions of attitudes and self-efficacy. In the comparative analysis of attitudes and self-efficacy, statistically, differences were observed in the cognitive and intellectual disability dimensions in the variable "additional training in inclusive PE" and the intellectual and visual disability dimensions in the variable "Teaching students with disabilities". Overall, participants reported positive attitudes and are confident about the inclusion of students with disabilities in PE classes. Future research should compare attitudes and self-efficacy before and after a practical intervention program at the level of inclusive PE.

Hepatitis B virus infection among institutionalized mentally ill patients in Brazil.

OBJECTIVES: The main objective was to evaluate HBV infection and occult HBV infection (OBI) cases in mentally ill patients based on serological and molecular profiles. MATERIAL AND METHODS: Serum samples of 333 long-stay mentally ill patients were tested for the prevalence of HBV markers by serological (ELISA) and molecular (PCR) assays. The PCR products were sequenced to determine viral genotypes. RESULTS: It was observed a global prevalence of 12.9% (43/333) for HBV infection markers, considering HBsAg and/or anti-HBc positivity. Fourteen samples tested positive for anti-HBs alone. All samples positive (n=57) for any HBV serological markers were tested for HBV-DNA and six were positive: HBsAg/anti-HBc (n=1), anti-HBc/anti-HBs (n=1), anti-HBs alone (n=1), and anti-HBc alone (n=3). The rate of OBI was 9.2% (5/54) from samples that were anti-HBc and/or anti-HBs positive. All sequenced samples were characterized as genotype A. CONCLUSION: The high rate of HBV infections found in this study suggests the possibility of HBV transmission due to risk factors displayed by some patients, and highlights the importance of vaccination of susceptible patients and the staff of that institution.

Simvastatin does not reduce chemokine production in obesity without comorbidities.

Obesity is considered a subchronic inflammatory disease with high risk of comorbidity development. Obesity-associated inflammation originates from adipose tissue itself, which secretes a panel of inflammatory chemokines and cytokines. Therefore, we enrolled 23 obese women without comorbidity and evaluated if simvastatin 20 mg/day dose therapy for 6 weeks (n=15) may modulate plasma levels of inflammatory CXCL-10, CCL-2, CXCL-9, CXCL-8, and CCL-5. A significant decrease of cholesterol and its fractions, triglycerides, and high-sensitivity C-reactive protein (hsCRP) after simvastatin treatment was observed when compared to placebo (n=8). Chemokine plasma levels were unchanged by statin intake when compared to placebo. Although dyslipidemia biomarkers and hsCRP have been diminished by simvastatin, low chemokine amounts produced by healthy obese women do not seem to be altered by simvastatin anti-inflammatory activity.

Thermodynamic stability of hydrogen-bonded systems in polar and nonpolar environments.

The thermodynamic properties of a selected set of benchmark hydrogen-bonded systems (acetic acid dimer and the complexes of acetic acid with acetamide and methanol) was studied with the goal of obtaining detailed information on solvent effects on the hydrogen-bonded interactions using water, chloroform, and n-heptane as representatives for a wide range in the dielectric constant. Solvent effects were investigated using both explicit and implicit solvation models. For the explicit description of the solvent, molecular dynamics and Monte Carlo simulations in the isothermal-isobaric (NpT) ensemble combined with the free energy perturbation technique were performed to determine solvation free energies. Within the implicit solvation approach, the polarizable continuum model and the conductor-like screening model were applied. Combination of gas phase results with the results obtained from the different solvation models through an appropriate thermodynamic cycle allows estimation of complexation free energies, enthalpies, and the respective entropic contributions in solution. Owing to the strong solvation effects of water the cyclic acetic acid dimer is not stable in aqueous solution. In less polar solvents the double hydrogen bond structure of the acetic acid dimer remains stable. This finding is in agreement with previous theoretical and experimental results. A similar trend as for the acetic acid dimer is also observed for the acetamide complex. The methanol complex was found to be thermodynamically unstable in gas phase as well as in any of the three solvents.

A certeza incerta da morte e suas metáforas na situação de acometimento de AIDS - Tuberculose / Death uncertain certainty and its metaphores in AIDS - tuberculosis situations

Trata a proposta de um estudo qualitativo do sistema de produção e reprodução de saúde, privilegiando o componente organização tecnológica do trabalho, com o objetivo de compreender o conteúdo metafórico e nexos referentes ao significado da morte, presente na rede de relações que se estabelece no trabalho, na especificidade da assistência aos indivíduos com AIDS e acometidos de tuberculose. Diante da certeza incerta da morte, agem e reagem os sujeitos envolvidos, sujeitos clientes e sujeitos trabalhadores, buscando adequação ao enfrentamento humano de viver e estar doente, processando a morte por meio da condição biossocial de AIDS...

It is about the study proposal quality of production and reproduction health system, giving privilege to work technologycal organizational component, with the purpose of understanding the metaphorical content and branches, referring to the meaning of death, present in work relationships network, in how specific the support to individuals with AIDS and tuberculosis in. Facing the uncertain certainty of death, the agents which are involved - client agents and worker agents - searching for an adequacy to human fight in order to live and having sick, processing deatd through AIDS biosocial condition...

La propuesta trata del estudio cualitativo del sistema de producción y reproducción de la salud, privilegiando el componente de la organizción tecnológica del trabajo, com el objetivo de comprender el contenido metafórico y relaciones referentes a la significativa muerte, presentes em la red de relaciones que se estabelecen em el trabajo, em lo específico de la asistencia a los individuos com SIDA y atacados de tuberculosis. Delante de la certeza incierta de la muerte, proceden y reaccionan los sujetos envueltos, sujetos clientes y trabajadores, buscando adecuarse al enfrentamiento humano de vivir y estar enfermo, procesando la muerte por medio de la condición biosocial del SIDA...