Reduction in blood pressure and metabolic profile in overweight hypertensive boys participating in a 12-week aerobic exercise program.

Strategies for controlling hypertension include reducing excess fat and increasing muscle mass. However, the effects of exercise interventions on hypertension in adolescents have been little investigated. The purpose was to evaluate the effect of 12 weeks of aerobic exercise on systolic blood pressure (SBP) and diastolic blood pressure (DBP) and the cardiometabolic profile of overweight hypertensive and non-hypertensive boys. The sample included 107 boys diagnosed as overweight, aged between 12 and 17, divided into two non-hypertension groups, one control (GCN, n = 14) and one with exercise (GEN, n = 55), as well as two groups of hypertensives, one control (GCH, n = 12) and one with exercise (GEH, n = 26). The boys were assessed at the study baseline and after 12 weeks in terms of anthropometric parameters, biological maturation, SBP, DBP and mean blood pressure (MBP), lipid, and metabolic profile. The aerobic training programs lasted 12 weeks and were carried out in three weekly sessions at different intensities. The high-intensity interval training session lasted around 35 min at an intensity of 80-100% of the reserve heart rate, and the moderate-intensity of continuous training session lasted 60 min at an intensity of 35-75% of the reserve heart rate. Caloric expenditure was equivalent between the exercises (p = 0.388). CGN and CGH participated only in school physical activities. Repeated measures analysis of variance and clinical effect analysis using Cohen's effect size were used, with a significance level established at p < 0.05. After 12 weeks, all groups increased their height (p < 0.05), but only the exercise groups showed a reduction in anthropometric variables (p < 0.05), with a possibly beneficial effect in GEN (d = - 0.203; p = 0.003). No differences were found in the variables for the GCN. The GCH and GEH groups reduced SBP (p < 0.05), but only GEH showed a reduction in DBP (p = 0.005) and MBP (p = 0.001). In relation to the lipid profile, GEH maintained HDL-c close to baseline values, while GCH showed a reduction in HDL-c (p = 0.021). Regarding the clinical effect of exercise on hypertension, GEH showed a large and very beneficial effect size on DBP (d = - 0.916; p = 0.006) and MBP (d = - 0.926; p = 0.005).Conclusion: Hypertensive boys who practiced physical exercise showed greater effects in reducing blood pressure, indicating the importance of non-drug therapeutic management in overweight adolescents.Trial registration:Brazilian Registry of Clinical Trials RBR-4v6h7b / RBR-6343y7.

Biological maturation, fat mass and cardiorespiratory fitness in prepubescent girls: A mediation analysis.

BACKGROUND: The association between indicators of maturation and measures of physical fitness are not well correlated and vary according to chronological age, sex, body size, and motor characteristics. It is known that chronological age, maturation, and fat mass are significant predictors of cardiorespiratory fitness in girls, however, the contributions of fat mass to the relationship between maturation and endurance performance are still unclear. OBJECTIVE: The current study aimed to examine whether the association between somatic maturation and running performance in the 20-m shuttle-run in girls is mediated by estimated fat mass. METHODS: The sample comprised 67 girls, aged 8.00-8.99 years. Stature, body mass, and skinfolds were measured. Estimates of body composition and predicted mature stature (PMS) were then calculated. Current stature was expressed as a percentage of PMS and somatic maturation was given by z-scores of the percentage of PMS. Mediation analysis was performed using the bias-corrected bootstrap approach with 5000 resamples in order to obtain estimates of total, direct, and indirect effects of z-scores of the percentage of PMS on 20-m shuttle-run performance mediated by fat mass. RESULTS: The results show that fat mass mediated the negative effect of biological maturation on 20-m shuttle-run performance in the observed sample of prepubescent girls (Indirect effect: ß = -0.177, 95%CI: -0.291 to -0.059). CONCLUSION: Although the participants were prepubescent girls, poorer aerobic running performance appeared to be partly due to increased levels of fat mass.

Examining the mediating role of muscle quantity in adolescents: associations with adiposity, cardiorespiratory fitness, muscular fitness, and cardiometabolic risk factors.

The aim of this study was to evaluate the mediation role of muscle quantity in the relationship between physical fitness and cardiometabolic risk factors (CMRF) in adolescents. This cross-sectional study conducted with 120 adolescents of both sexes, aged between 10 and 17 years. Body mass, height, fat mass (FM), lean mass, blood pressure, high-density lipoprotein, low-density lipoprotein, triglycerides, glucose, insulin, cardiorespiratory fitness (CRF) and 1 repetition maximum strength (1-RM) with evaluation of the leg press 45° (RM-leg), bench press (RM-bench) and arm curl (RM-arm). Body mass index z-score, appendicular skeletal muscle mass, appendicular skeletal muscle mass index, lean mass index (LMI), muscle-to-fat ratio (MFR), age at peak height velocity, and CMRF z-score were calculated. The direct relation between FM and CMRF was mediated by the LMI (26%) and inverse relation between CRF and CMRF was mediated by the LMI (26%). For girls, the direct relation between FM and CMRF was mediated by the LMI (32%); the inverse relation between CRF, RM-leg, RM-arm and CMRF was mediated by the LMI (32%, 33%, and 32%, respective). For boys, the indirect effect was not significant, indicating that LMI is not a mediator in the relation between FM, CRF, 1-RM with CMRF. The direct relation between RM-leg and CMRF was mediated by the MRF (16%). This finding evidenced the importance of promoting a healthy lifestyle to improve physical fitness levels and the quantity of muscle mass in adolescents.

Resistance training presents beneficial effects on bone development of adolescents engaged in swimming but not in impact sports: ABCD Growth Study.

BACKGROUND: Sports practice during adolescence is important to enhance bone development, although it may provide different effects depending on the mechanical impact present in the sport. Besides, resistance training (RT) may also induce bone changes directly (via muscle contractions) and indirectly (via myokines). However, there have been no studies analyzing the longitudinal influence of engaging in sport with and without added mechanical load. Thus, this study aims to analyze the combined effects of sports participation and resistance training on areal bone mineral density (aBMD) accrual in adolescent athletes participating in swimming and impact sports for 12-months. METHODS: This was a 12-month longitudinal study. The sample comprised 91 adolescents (21 females) aged 10 to 18 years, engaged in impact sports (basketball, tennis, track & field, baseball and gymnastics, n = 66) and non-impact sport (swimming, n = 25). The sample was divided according to resistance training participation: impact sports only (n = 45), impact sports + resistance training (n = 21), swimming-only (n = 17) and swimming + resistance training (n = 8). aBMD and soft tissues were measured using dual-energy X-ray absorptiometry. Generalized linear models analysis was used for the resistance training (RT) x type of sport interaction in predicting aBMD changes overtime, adjusting for maturation, sex and baseline aBMD. RESULTS: After 12-months, all groups showed a significant increase in aBMD, except for the swimming groups (regardless of resistant training), which showed a significant loss in spine aBMD (-0.045 [-0.085 to -0.004] g/cm2 in swimming-only and - 0.047 [-0.073 to -0.021] g/cm2 in swimming + RT). In comparisons between groups, only swimming + RT group, compared with swimming-only group presented higher upper limbs aBMD (0.096 g/cm2 [0.074 to 0.118] in swimming + RT vs. 0.046 [0.032 to 0.060] g/cm2 in swimming only; p < 0.05) and whole body less head (WBLH) aBMD (0.039 [0.024 to 0.054] g/cm2 in swimming + RT vs. 0.017 [0.007 to 0.027] g/cm2 swimming-only; p < 0.05). CONCLUSION: Despite the significant gain in aBMD in all groups and body sites after 12-months, except for the spine site of swimmers, the results indicate that participation in RT seems to improve aBMD accrual in swimmers at the upper limbs and WBLH.

Escoliosis idiopática del adolescente / Adolescent idiopathic scoliosis

La escoliosis idiopática del Adolescente (EIA) es una deformidad tridimensional de la columna vertebral que aqueja de diversas formas la condición de vida de quien la padece, afectando el desarrollo físico y psicológico del paciente. Proponemos evaluar el resultado clínico, radiológico y el componente de calidad de vida de pacientes tratados quirúrgicamente con EIA, en el servicio de Neurocirugía, Hospital Jesús Yerena del Lídice. Se evaluó patrón de la curva, clasificación según Lenke, ángulo de Cobb pre y postquirúrgico, edad de tratamiento quirúrgico, gradode corrección, calidad de vida según cuestionario SRS-22 pre y postquirúrgica, valoración funcional mediante la escala de discapacidad de Oswestry (ODI) y complicaciones postoperatorias. Se estudiaron 22 casos (95 % femenino), el principal grupo etario fue de 11-14 años (55 %), la escoliosis tipo 1 fue la predominante (60 %), el ángulo de Cobb inicial fue mayor a 50° (50 %) y la madurez esquelética principal fue Risser 3 (55 %). La edad de resolución quirúrgica predominante fue entre 15-18 años (60 %), el grado de corrección postoperatorio fue de 75-100 % (73 %) y la densidad de los tornillos pediculares fue de 1.4-1.7 (64 %). En el cuestionario SRS-22, hubo mayor afectación en las dimensiones de autoimagen con una media de 1.8 y la valoración por ODI mostró un índice de incapacidad mínima, que fue mejorando en los controles sucesivos. Nuestra principal complicación fueron las infecciones (36 %). Concluimos que la cirugía correctiva temprana en la EIA ofrece a una mejoría clínica, radiológica y de la calidadde vida de estos paciente(AU)

Adolescent idiopathic scoliosis (AIS) is a three-dimensional deformity of the spine that affects the living condition of those who suffer from it in various ways, affecting the physical and psychological development of the patient. We propose to evaluate the clinical and radiological outcome and the quality-of-life component of patients treated surgically with EIA, in the Neurosurgery Service, Hospital Jesús Yerena del Lídice. Curve pattern, Lenke classification, pre-and post-surgical Cobb angle, age at surgical treatment, degree of correction, quality of life according to pre-and post-surgical SRS-22 questionnaire, functional assessment using the Oswestry Disability Scale (ODI) and postoperative complications were evaluated. 22 cases were studied (95% female), the main age group was 11-14 years (55%), type 1 scoliosis was predominant (60%), the initial Cobb angle was greater than 50° (50%) and the main skeletal maturity was Risser 3 (55%). The predominant age of surgical resolution was between 15-18 years (60%), the degree of postoperative correction was 75-100% (73%) and the density of pedicle screws was 1.4-1.7 (64%). In the SRS-22 questionnaire, there was greater impairment in the self-image dimensions with a mean of 1.8 and the ODI assessment showed aminimal disability index, which improved in successive controls. Our main complication was infections (36%). We conclude that early corrective surgery in AIS offers clinical, radiological and quality of life improvement for these patient(AU)

Biocultural correlates of gross motor coordination in prepubescent children: A cross-sectional study.

AIM: This study aimed to explore the association of gross motor coordination (GMC) with a matrix of biocultural factors in prepubescent children, taking into account weight status, somatic maturation, sociodemographic variables, and type of school. METHODS: One hundred twenty-nine prepubescent children, of both sexes, aged between 8.00 and 8.99, were assessed for GMC (Körperkoordinationstest Für Kinder - KTK), weight status, biological maturation (predicted mature stature), sex, mother's education level and type of school. Binary logistic regression was used to examine the relationship between higher values of KTK and associated biocultural factors. RESULTS: Normoponderal children are more likely to attain better total KTK scores than those with overweight or obesity (OR: 2.942; LC 95%: 1.189, 7.280). In addition, children who are more advanced in terms of biological maturation exhibited significantly lower odds of being in the high KTK category than their less advanced peers (OR: 0.670; LC 95%: 0.474,0.946). Sex, mother's education level and the type of school are not associated with higher performance on KTK. CONCLUSION: Weight status and biological maturation are associated with motor competence in prepubescent children. Future studies should consider additional correlates to better understand the complex interactions between biological, psychosocial and behavioral factors in the prediction of motor competence.

A saúde e a medicina portuguesas no primeiro quartel do século XX pelas lentes de Jorge Marçal da Silva / Portuguese health and medicine during the first quarter of the twentieth century through the lenses of Jorge Marçal da Silva

Resumo Este trabalho pretende ilustrar o panorama da saúde e da medicina em Portugal no primeiro quartel do século XX a partir do espólio fotográfico de Jorge Marçal da Silva, médico e fotógrafo amador, que tem sido preservado pela família. Da sua coleção, escolhemos uma seleção de fotografias que ilustram o modus vivendi da população portuguesa, no interior rural, no litoral piscatório e na vida citadina, bem como algumas das que retratam os ambientes hospitalares e a assistência médica na capital, no sentido de reflectir sobre a sua importância como fonte de reflexão historiográfica para a história da medicina portuguesa de Novecentos.

Abstract This paper aims at illustrating the panorama of health and medicine in Portugal in the first quarter of the twentieth century using the photographic collection of Jorge Marçal da Silva, a doctor and amateur photographer, which has been preserved by his family. From his collection, we have chosen a selection of photographs that illustrate the modus vivendi of the Portuguese population, in the rural interior, on the fishing coast and in city life, as well as some that depict hospital environments and medical care in the capital, in order to reflect on their importance as a source for the historiographical reflection on the history of Portuguese medicine in the 1900s.

Laparoscopic-assisted Resection of a Retroperitoneal Lumbar Nerve Root Neurofibroma: A Case Report / Ressecção assistida por laparoscopia de neurofibroma retroperitoneal da raiz nervosa lombar: Relato de caso

Abstract We present a case of a 59-year-old patient with chronic low back pain, caused by a retroperitoneal intraneural tumour. Laparoscopic excision was performed and histology revealed a spinal nerve root neurofibroma. Post-operatively, the patient developed partial motor and sensitive deficits due to tumoral nerve entrapment, with progressive recovery with rehabilitation. This report reviews the literature on this sparsely reported condition, highlighting the utility of laparoscopy in its management.

Resumo Apresentamos o caso de uma paciente de 59 anos com lombalgia crônica causada por tumor intraneural retroperitoneal. A excisão laparoscópica foi realizada e a histologia revelou um neurofibroma da raiz do nervo espinhal. No período pós-operatório, a paciente desenvolveu déficits motores e sensitivos parciais devido ao encarceramento do nervo tumoral, com recuperação progressiva à reabilitação. Este relato revisa a literatura sobre essa doença pouco descrita, destacando a utilidade da laparoscopia em seu tratamento.

Mild to moderate post-COVID-19 alters markers of lymphocyte activation, exhaustion, and immunometabolic responses that can be partially associated by physical activity level- an observational sub-analysis fit- COVID study.

Aim: This study aimed to evaluate if physical activity is associated with systemic and cellular immunometabolic responses, in young adults after mild-to-moderate COVID-19 infection. Methods: Mild- to- moderate post-COVID-19 patients (70.50 ± 43.10 days of diagnosis; age: 29.4 (21.9- 34.9) years; BMI: 25.5 ± 4.3 kg m2 n = 20) and healthy age-matched controls (age: 29.3 (21.2 - 32.6) years; BMI: 25.4 ± 4.7 kg m2; n = 20) were evaluated. Physical activity levels (PAL), body composition, dietary habits, muscular and pulmonary function, mental health, sleep quality, metabolic parameters, immune phenotypic characterization, stimulated whole blood and PBMC culture (cytokine production), mRNA, and mitochondrial respiration in PBMCs were evaluated. Results: The post-COVID-19 group exhibited lower levels of moderate to vigorous physical activity (MVPA) (p = 0.038); therefore, all study comparisons were performed with adjustment for MVPA. Post-COVID-19 impacted the pulmonary function (FEV1, FEV1%pred, FVC, and FVC %pred) compared with the control (p adjusted by MVPA (p adj) <0.05). Post-COVID-19 exhibited lower levels of serum IL-6 (p adj <0.01), whereas it showed higher serum IL-10, triglyceride, leptin, IgG, ACE activity, TNFRSF1A, and PGE2 (p adj <0.05) levels compared with controls. Post-COVID-19 presented a lower percentage of Treg cells (p adj = 0.03) and altered markers of lymphocyte activation and exhaustion (lower CD28 expression in CD8+ T cells (p adj = 0.014), whereas CD4+T cells showed higher PD1 expression (p adj = 0.037)) compared with the control group. Finally, post- COVID-19 presented an increased LPS-stimulated whole- blood IL-10 concentration (p adj <0.01). When exploring mitochondrial respiration and gene expression in PBMCs, we observed a higher LEAK state value (p adj <0.01), lower OXPHOS activity (complex I) (p adj = 0.04), and expression of the Rev-Erb-α clock mRNA after LPS stimulation in the post-COVID-19 patients than in the control (p adj <0.01). Mainly, PAL was associated with changes in IL-10, triglyceride, and leptin levels in the plasma of post-COVID-19 patients. PAL was also associated with modulation of the peripheral frequency of Treg cells and the expression of PD-1 in CD8+ T cells, although it abrogated the statistical effect in the analysis of TNF-α and IL-6 production by LPS- and PMA-stimulated PBMC of post-COVID-19 patients. Conclusion: Young adults after mild-to-moderate SARS-CoV-2 infection appeared to have lower physical activity levels, which can be associated with clinical and immunometabolic responses in a complex manner.

Interrelationship between muscle fitness in childhood and bone mineral density in adulthood: mediation analysis of muscle fitness in adulthood.

BACKGROUND: This study was aimed to examine the relationship between muscular fitness indicators in childhood and areal bone mineral density (aBMD) in adulthood and to verify whether the relationship is mediated by performance on muscular fitness indicators in adulthood. METHODS: A sample of 138 healthy adults (69 males; 22.3 years) were followed after a previous assessment at the age of 7-10 years. Stature, body mass and muscular fitness indicators (handgrip strength, standing long jump and sit-ups tests) were assessed in childhood and adulthood. Additionally, total body, upper limbs, lower limbs, right femoral neck and lumbar spine aBMD was assessed in adulthood using dual X-ray absorptiometry. Analysis included descriptive statistics; t-test or Mann-Whitney U-test for comparison between males and females, multiple linear regression for the prediction aBMD from muscular fitness indicators in childhood, mediation analysis of the respective muscular fitness indicators in adulthood and the relationship between muscular fitness indicators in childhood and aBMD. RESULTS: Males were stronger compared to females regarding muscular fitness indicators in childhood and adulthood, and presented higher mean values for aBMD in adulthood, except for lumbar spine (p < 0.05). Regression analysis revealed that some muscular fitness indicators in childhood showed significant positive relationship with bone health indicators in adulthood, such as: handgrip strength and total body aBMD (ß = 0.005; R2 = 0.35; p = 0.040) and upper limbs aBMD (ß = 0.005; R2 = 0.55; p = 0.019); and sit-ups test was a significant predictors of lumbar spine BMD (ß = 0.003; R2 = 0.06; p = 0.039). Mediation analysis pointed out the following: adulthood handgrip strength mediated relationships between childhood handgrip strength and total aBMD (indirect effect (IE) = 0.0025; 95%CI = 0.0005-0.0048), and upper limbs aBMD (IE = 0.0040; 95%CI = 0.0017-0.0069). CONCLUSIONS: Muscular fitness indicators in childhood showed significant relationship with bone health indicators in adulthood and the sit-ups test in childhood had direct effect on lumbar spine aBMD in adulthood. Adulthood handgrip strength mediated the relationship between childhood handgrip strength and total body and upper limb aBMD, pointing out that muscular fitness in childhood may be a aBMD determinant in adulthood, especially when higher muscle fitness performance is maintained in adulthood.

Modelling anaerobic peak power assessed by the force-velocity test among late adolescents.

OBJECTIVES: The aim of this study was to examine the concurrent contributions of body size, estimates of whole-body composition, and appendicular volume in addition to participation in competitive basketball to explain inter-individual variance in anaerobic peak power output during late adolescence. The study also tested non-participation versus participation in basketball as an independent predictor of peak power output. METHODS: The sample of this cross-sectional study was composed of 63 male participants (basketball: n=32, 17.0±0.9 years; school: n=31, 17.4±1.0 years). Anthropometry included stature, body mass, circumferences, lengths, and skinfolds. Fat-free mass was estimated from skinfolds and lower limbs volume predicted from circumferences and lengths. Participants completed the force-velocity test using a cycle ergometer to determine peak power output. RESULTS: For the total sample, optimal peak power was correlated to body size (body mass: r=0.634; fat-free mass: r=0.719, lower limbs volume: r=0.577). The best model was given by fat-free mass and explained 51% of the inter-individual variance in force-velocity test. The preceding was independent of participating in sports (i.e., the dummy variable basketball vs. school did not add significant explained variance). CONCLUSION: Adolescent basketball players were taller and heavier than school boys. The groups also differed in fat-free mass (school: 53.8±4.8 kg; basketball: 60.4±6.7 kg), which was the most prominent predictor of inter-individual variance in peak power output. Briefly, compared to school boys, participation in basketball was not associated with optimal differential braking force. Higher values in peak power output for basketball players were explained by a larger amount of fat-free mass.

Modelling anaerobic peak power assessed by the force-velocity test among late adolescents

SUMMARY OBJECTIVES: The aim of this study was to examine the concurrent contributions of body size, estimates of whole-body composition, and appendicular volume in addition to participation in competitive basketball to explain inter-individual variance in anaerobic peak power output during late adolescence. The study also tested non-participation versus participation in basketball as an independent predictor of peak power output. METHODS: The sample of this cross-sectional study was composed of 63 male participants (basketball: n=32, 17.0±0.9 years; school: n=31, 17.4±1.0 years). Anthropometry included stature, body mass, circumferences, lengths, and skinfolds. Fat-free mass was estimated from skinfolds and lower limbs volume predicted from circumferences and lengths. Participants completed the force-velocity test using a cycle ergometer to determine peak power output. RESULTS: For the total sample, optimal peak power was correlated to body size (body mass: r=0.634; fat-free mass: r=0.719, lower limbs volume: r=0.577). The best model was given by fat-free mass and explained 51% of the inter-individual variance in force-velocity test. The preceding was independent of participating in sports (i.e., the dummy variable basketball vs. school did not add significant explained variance). CONCLUSION: Adolescent basketball players were taller and heavier than school boys. The groups also differed in fat-free mass (school: 53.8±4.8 kg; basketball: 60.4±6.7 kg), which was the most prominent predictor of inter-individual variance in peak power output. Briefly, compared to school boys, participation in basketball was not associated with optimal differential braking force. Higher values in peak power output for basketball players were explained by a larger amount of fat-free mass.

Exercise as a Peripheral Circadian Clock Resynchronizer in Vascular and Skeletal Muscle Aging.

Aging is characterized by several progressive physiological changes, including changes in the circadian rhythm. Circadian rhythms influence behavior, physiology, and metabolic processes in order to maintain homeostasis; they also influence the function of endothelial cells, smooth muscle cells, and immune cells in the vessel wall. A clock misalignment could favor vascular damage and indirectly also affect skeletal muscle function. In this review, we focus on the dysregulation of circadian rhythm due to aging and its relationship with skeletal muscle changes and vascular health as possible risk factors for the development of sarcopenia, as well as the role of physical exercise as a potential modulator of these processes.

Modulatory Effects of Physical Activity Levels on Immune Responses and General Clinical Functions in Adult Patients with Mild to Moderate SARS-CoV-2 Infections-A Protocol for an Observational Prospective Follow-Up Investigation: Fit-COVID-19 Study.

Background: This proposal aims to explain some of the gaps in scientific knowledge on the natural history of coronavirus disease (COVID-19), with a specific focus on immune, inflammatory, and metabolic markers, in parallel with temporal assessment of clinical and mental health in patients with COVID-19. The study will explore the temporal modulatory effects of physical activity and body composition on individual trajectories. This approach will provide a better understanding of the survival mechanisms provided by the immunomodulatory role of physical fitness. Methods: We will conduct a prospective observational cohort study including adult patients previously infected with the SARS-CoV-2 virus who have expressed a mild to moderate COVID-19 infection. Procedures will be conducted for all participants at baseline, six weeks after vaccination, and again at 12 months. At each visit, a venous blood sample will be collected for immune phenotypic characterization and biochemistry assays (inflammatory and metabolic parameters). Also, body composition, physical activity level, cardiovascular and pulmonary function, peripheral and respiratory muscle strength, functional exercise capacity, and mental health will be evaluated. Using the baseline information, participants will be grouped based on physical activity levels (sedentary versus active), body composition (normal weight versus overweight or obese), and SARS-CoV-2 status (positive versus negative). A sub-study will provide mechanistic evidence using an in-vitro assay based on well-trained individuals and age-matched sedentary controls who are negative for SARS-CoV-2 infection. Whole blood will be stimulated using recombinant human coronavirus to determine the cytokine profile. Peripheral blood mononuclear cells (PBMCs) from healthy well-trained participants will be collected and treated with homologous serum (from the main study; samples collected before and after the vaccine) and recombinant coronavirus (inactive virus). The metabolism of PBMCs will be analyzed using Respirometry (Seahorse). Data will be analyzed using multilevel repeated-measures ANOVA. Conclusions: The data generated will help us answer three main questions: (1) Does the innate immune system of physically active individuals respond better to viral infections compared with that of sedentary people? (2) which functional and metabolic mechanisms explain the differences in responses in participants with different physical fitness levels? and (3) do these mechanisms have long-term positive modulatory effects on mental and cardiovascular health? Trial registration number: Brazilian Registry of Clinical Trials: RBR-5dqvkv3. Registered on 21 September 2021.

Excess adiposity and low physical fitness hamper Supine-to-Stand test performance among sedentary adolescents

Abstract Objective: The aim of this study was to analyze the relationship between body adiposity and physical fitness with performance in the Supine-to-Stand test (STS-test) in sedentary adolescents. Methods: Sixty-two adolescents, of both sexes, between 10 and 16 years old, participated in the study. Body mass (BM), height, waist circumference (WC), fat mass (FM), fat-free mass (FFM), right and left handgrip strength (HGS-right, HGS-left), abdominal resistance (ABDO), flexibility (FLEX), and cardiorespiratory fitness (VO2peak) were measured. Body mass index (BMI), z-score BMI (BMI-z), tri-ponderal mass index (TMI) and waist-to-height ratio (WHtR) were calculated. The STS-test was applied to evaluate the STS-MC by the movement patterns in the execution of the test. The STS-time in seconds (s) was categorized into terciles: fast (FG < 2.0 s), intermediate (IG = 2.0-2.6 s) and slow (SG > 2.6 s). One-way ANOVA, Chi-square, Spearman's correlation coefficient as well as non-parametric tests were used, with significance p 0.05. Results: The SG presented higher BMI, BMI-z, TMI, WHtR, FM, %FM, as well as lower averages for %FFM, HGS-right, HGS-left, FLEX, ABDO, VO2peak, VO2peak relative to BM (VO2peakBM) in relation to GF. The BMI, BMI-z, TMI, WC, WHtR and FM showed moderate and direct correlations with STS-time and inverse with STS-MC (p < 0.01). HGS-right, HGS-left, ABDO, and VO2peakBM showed moderate and an inverse correlation with STS-time (p < 0.05). The VO2peakBM was moderate and with direct correlations to STS-MC (p < 0.01). Conclusion: It is concluded that excess fat and low physical fitness hamper STS-test performance. Therefore, the STS-test can be used for screening students to assess MC.

Effects of air pollution on health: A mapping review of systematic reviews and meta-analyses.

BACKGROUND: There has been a notable increase in knowledge production on air pollution and human health. OBJECTIVE: To analyze the state of the art on the effects of air pollution on human health through a mapping review of existing systematic reviews and meta-analyses (SRs and MAs). METHODS: The systematic mapping review was based on the recommendations for this type of scientific approach in environmental sciences. The search was performed using PubMed, Web of Science, Scopus, Cinahl, and Cochrane Library databases, from their inception through June 2020. RESULTS: Among 3401 studies screened, 240 SRs and MAs satisfied the inclusion criteria. Five research questions were answered. There has been an overall progressive increase in publications since 2014. The majority of the SRs and MAs were carried out by researchers from institutions in China, the US, the UK, and Italy. Most studies performed a meta-analysis (161). In general, the reviews support the association of air pollution and health outcomes, and analyzed the effects of outdoor air pollution. The most commonly investigated health outcome type was the respiratory (mainly asthma and COPD), followed by cardiovascular outcomes (mainly stroke). Particulate matter (with a diameter of 2.5 µm (PM2.5) and 10 µm (PM10) or less) and nitrogen dioxide (NO2) were the most widely investigated pollutants in the reviews. The general population was the most common sample in the reviews, followed by children, and adults. The majority of the reviews investigated health outcomes of respiratory diseases in children, as well as cardiovascular diseases in all ages. Combining health outcomes and air pollutants, PM2.5 was included in a higher number of reviews in eight health outcomes, mainly cardiovascular diseases. DISCUSSION: The majority of SRs and MAs showed that air pollution has harmful effects on health, with a focus on respiratory and cardiovascular outcomes. Future studies should extend the analysis to psychological and social aspects influenced by air pollution.

Excess adiposity and low physical fitness hamper Supine-to-Stand test performance among sedentary adolescents.

OBJECTIVE: The aim of this study was to analyze the relationship between body adiposity and physical fitness with performance in the Supine-to-Stand test (STS-test) in sedentary adolescents. METHODS: Sixty-two adolescents, of both sexes, between 10 and 16 years old, participated in the study. Body mass (BM), height, waist circumference (WC), fat mass (FM), fat-free mass (FFM), right and left handgrip strength (HGS-right, HGS-left), abdominal resistance (ABDO), flexibility (FLEX), and cardiorespiratory fitness (VO2peak) were measured. Body mass index (BMI), z-score BMI (BMI-z), tri-ponderal mass index (TMI) and waist-to-height ratio (WHtR) were calculated. The STS-test was applied to evaluate the STS-MC by the movement patterns in the execution of the test. The STS-time in seconds (s) was categorized into terciles: fast (FG < 2.0 s), intermediate (IG = 2.0-2.6 s) and slow (SG > 2.6 s). One-way ANOVA, Chi-square, Spearman's correlation coefficient as well as non-parametric tests were used, with significance p ≤ 0.05. RESULTS: The SG presented higher BMI, BMI-z, TMI, WHtR, FM, %FM, as well as lower averages for %FFM, HGS-right, HGS-left, FLEX, ABDO, VO2peak, VO2peak relative to BM (VO2peakBM) in relation to GF. The BMI, BMI-z, TMI, WC, WHtR and FM showed moderate and direct correlations with STS-time and inverse with STS-MC (p < 0.01). HGS-right, HGS-left, ABDO, and VO2peakBM showed moderate and an inverse correlation with STS-time (p < 0.05). The VO2peakBM was moderate and with direct correlations to STS-MC (p < 0.01). CONCLUSION: It is concluded that excess fat and low physical fitness hamper STS-test performance. Therefore, the STS-test can be used for screening students to assess MC.

Effects of adding an automated monitoring device to the health screening of postpartum Holstein cows on survival and productive and reproductive performances.

Automated monitoring devices (AMD) have become more affordable, and consequently more popular among dairy producers. We hypothesized that the addition of AMD-generated health alerts to a health-screening program improves survival, milk production, and reproductive success. In addition, we hypothesized that cows diagnosed with clinical disease that have AMD alerts are at greater risk of culling, lower milk production, and decreased risk of pregnancy than cows without AMD alerts. Holstein cows (nulliparous = 282, parous = 328) were enrolled at -60 ± 3 d (d 0 = calving), when they were fitted with an AMD and assigned randomly to 1 of 2 health-screening strategies: (1) control: AMD alerts not provided to farm personnel; and (2) automated device: AMD alerts provided to farm personnel. Twice daily, study personnel determined which cows had AMD alerts (health index ≤79, rumination <200 min/d, or difference between current rumination and the average of the 3 preceding days <0) and provided the information to farm personnel. Farm personnel examined cows at 3, 5, and 9 d in milk (DIM) and when daily milk yield decreased ≥25% on consecutive days. We detected no differences between health-screening strategies regarding morbidity (control = 49.7 ± 3.3%, automated device = 52.8 ± 3.2%), but the interaction between health-screening strategy and parity tended to be associated with the number of clinical diseases per cow (primiparous: control = 0.46 ± 0.06, automated device = 0.65 ± 0.07 cases/cow; multiparous: 0.88 ± 0.08, automated device = 0.86 ± 0.08 cases/cow). Cows enrolled in the automated device strategy were more likely to be treated with supportive therapy (64.4 ± 3.1 vs. 55.0 ± 3.2%), whereas primiparous cows in the automated device strategy were more likely to be treated with anti-inflammatory drugs than those in the control strategy (41.6 ± 4.7 vs. 23.8 ± 4.0%). Health-screening strategy did not affect survival or total milk yield up to 22 wk postpartum, but cows in the automated device strategy had reduced risk of pregnancy after the first 2 services (54.5 ± 3.0 vs. 46.2 ± 3.2%). Cows diagnosed with a clinical disease without AMD alerts had reduced risk of removal from the herd by 150 DIM (5.7 ± 2.0 vs. 19.0 ± 3.3%), greater risk of pregnancy after the first 2 services (49.6 ± 4.5 vs. 33.6 ± 3.9%), and greater milk by 22 wk postpartum (6.7 ± 0.2 vs. 5.3 ± 0.2 × 103 kg) than cows diagnosed with a clinical disease that had an AMD alert. Adding AMD-generated health alerts to the health screening of postpartum cows in a herd with an existing screening program did not improve survival, milk yield, or reproductive success. In addition, AMD alerts in cows diagnosed with a clinical disease may be indicative of the future success of such cows.

Reproducibility and inter-observer agreement of Greulich-Pyle protocol to estimate skeletal age among female adolescent soccer players.

BACKGROUND: Skeletal age (SA) is considered the best method of assessing biological maturation. The aim of this study was to determine intra-observer (reproducibility) and inter-observer agreement of SA values obtained via the Greulich-Pyle (GP) method. In addition, the variation in calculated SAs by alternative GP protocols was examined. METHODS: The sample was composed of 100 Portuguese female soccer players aged 12.0-16.7 years. SAs were determined using the GP method by two observers (OB1: experience < 100 exams using GP; OB2: experience > 2000 exams using several methods). The radiographs were examined using alternative GP protocols: (wholeGP) the plate was matched to the atlas as an overall approach; (30-boneGP) bone-by-bone inspections of 30-bones; (GPpmb) bone-by-bone inspections of the pre-mature bones only. For the 30-boneGP and GPpmb approaches, SA was calculated via the mean (M) and the median (Md). RESULTS: Reproducibility ranged 82-100% and 88-100% for OB1 and OB2, respectively. Inter-observer agreement (100 participants multiplied by 30 bones) was 92.1%. For specific bones, agreement rates less than 90% were found for scaphoid (81%), medial phalange V (83%), trapezium (84%) and metacarpal V (87%). Differences in wholeGP SAs obtained by the two observers were moderate (d-cohen was 0.79). Mean differences between observers when using bone-by bone SAs were trivial (30-boneGP: d-cohen less than 0.05; GPpmb: d-cohen less than 0.10). The impact of using the mean or the median was negligible, particularly when analyses did not include bones scored as mature. CONCLUSION: The GP appeared to be a reasonably reproducible method to assess SA and inter-observer agreement was acceptable. There is evidence to support a recommendation of only scoring pre-mature bones during later adolescence. Further research is required to examine whether these findings are consistent in younger girls and in boys.

Reactive hyperemia correlates with the presence of sepsis and glycocalyx degradation in the intensive care unit: a prospective cohort study. / A hiperemia reativa correlaciona-se com presença de sepse e degradação de glicocálix na unidade de terapia intensiva: um estudo de coorte prospectiva.

OBJECTIVE: To investigate whether reactive hyperemia measured by peripheral arterial tonometry correlates with markers of endothelial dysfunction and may be used to identify sepsis in critical illness. METHODS: A prospective study was performed using a cohort of critically ill patients. Endothelial dysfunction was assessed on admission by quantifying reactive hyperemia-peripheral arterial tonometry and plasma levels of endothelin-1, soluble E-selectin, endocan and syndecan-1. Septic patients were compared to patients without evidence of infection. RESULTS: Fifty-eight septic patients were compared to 28 controls. The natural logarithm of reactive hyperemia-peripheral arterial tonometry was negatively correlated with cardiovascular comorbidities, disease severity and plasma levels of soluble E-selectin (p = 0.024) and syndecan-1 (p < 0.001). The natural logarithm of reactive hyperemia-peripheral arterial tonometry was lower in septic patients than in controls (0.53 ± 0.48 versus 0.69 ± 0.42, respectively). When adjusted for age, the multivariable model predicted that each 0.1-unit decrease in natural logarithm of reactive hyperemia-peripheral arterial tonometry increased the odds for infection by 14.6%. m. CONCLUSION: Reactive hyperemia-peripheral arterial tonometry is closely related to soluble E-selectin and syndecan-1, suggesting an association between endothelial activation, glycocalyx degradation and vascular reactivity. Reactive hyperemia-peripheral arterial tonometry appears to be compromised in critically ill patients, especially those with sepsis.

OBJETIVO: Investigar se a hiperemia reativa correlaciona-se com marcadores de disfunção endotelial e pode ser utilizada para identificar sepse na doença crítica. MÉTODOS: Trata-se de estudo prospectivo em uma coorte de pacientes críticos. A disfunção endotelial foi avaliada quando da admissão, por meio da quantificação de hiperemia por tonometria arterial periférica e níveis plasmáticos de endotelina 1, E-selectina solúvel, endocana e sindecano 1. Os pacientes sépticos foram comparados com pacientes sem evidência de infecção. RESULTADOS: Cinquenta e oito pacientes sépticos foram comparados com 28 controle. O logaritmo natural da tonometria arterial periférica teve correlação negativa com comorbidades cardiovasculares, severidade da doença e níveis plasmáticos de E-selectina solúvel (p = 0,024) e sindecano 1 (p < 0,001). O logaritmo natural da tonometria arterial periférica foi mais baixo nos pacientes sépticos quando comparado com os de pacientes controle (0,53 ± 0,48 versus 0,69 ± 0,42, respectivamente) e, quando ajustado à idade, o modelo multivariado predisse que cada 0,1 de diminuição em unidades de logaritmo natural da tonometria arterial periférica levou a aumento de 14,6% na probabilidade de infecção. CONCLUSÃO: A hiperemia reativa avaliada por tonometria arterial periférica tem estreita relação com E-selectina solúvel e sindecano 1, o que sugere associação entre ativação endotelial, degradação de glicocálix e reatividade vascular. A hiperemia reativa por tonometria arterial periférica parece estar comprometida em pacientes críticos, especialmente os com sepse.