Body Weight Satisfaction, Comments, Nutrition and Injury Risk in 489 Adolescent Elite Athletes.

Exposure to critical body weight comments in youth athletes could lead to decreased self-esteem, affect body image, and increase the risk of eating disorders and cause depressive symptoms. The aim was to explore differences between sex, body mass index, sports type, with regards to body weight satisfaction, exposure to critical body weight comments from their coach and nutrition status in adolescent elite athletes. A questionnaire about body weight, critical body weight comments and nutrition was distributed to 489 adolescent elite athletes and injury prevalence was monitored across 20 weeks. The results showed that almost one in four athletes (n=116, 24%) was not satisfied with their weight and 12% (n=59) had received critical body weight comments from their coach. Of the athletes who were unsatisfied with their body weight (n=116), 47% wanted to lose weight (n=55). A significant (p<0.05) higher proportion of ice hockey players and swimmers used nutritional supplements, were unsatisfied with their body weight, and were more exposed to critical body weight comments compared to athletes from other sports. Adolescent elite athletes as young as 15-16 years old are exposed to critical body weight comments from their coach and experience challenges with body weight satisfaction that is partly dependent on the sport-specific context.

Nutrition Status of Female Winter Sports Athletes.

Eating disorders, especially restrictive eating, are common among female athletes. There are two main types of winter sports: those that are practiced outdoors on snow (-25 to +5 °C and 2500 m), such as alpine skiing and snowboarding, and those that are practiced indoors on ice (5-10 °C at low altitude), such as figure skating and ice hockey. The aim of this research was to identify the nutritional status and potential risk of female athletes practicing winter sports, considering the altitude of training. The sample was composed of 58 women (aged 19.81 years (SD: 12.61)) who were competitors in some winter sports. Anthropometrics and nutritional variables were taken. Statistically significant differences were found between HA and LA groups for all the characteristics except thigh skinfold, and neither group had an energy intake (EI) that matched their total energy expenditure (TEE). Both groups met at least two-thirds of the RDI for all minerals and vitamins except iodine, fluorine, vitamin D, vitamin E, and retinol. This study suggests that female winter sports athletes have insufficient energy, vitamin, and mineral intake, which can be worsened with altitude.

Capturing the Complex Relationship Between Internal and External Training Load: A Data-Driven Approach.

BACKGROUND: Training load is typically described in terms of internal and external load. Investigating the coupling of internal and external training load is relevant to many sports. Here, continuous kernel-density estimation (KDE) may be a valuable tool to capture and visualize this coupling. AIM: Using training load data in speed skating, we evaluated how well bivariate KDE plots describe the coupling of internal and external load and differentiate between specific training sessions, compared to training impulse scores or intensity distribution into training zones. METHODS: On-ice training sessions of 18 young (sub)elite speed skaters were monitored for velocity and heart rate during 2 consecutive seasons. Training session types were obtained from the coach's training scheme, including endurance, interval, tempo, and sprint sessions. Differences in training load between session types were assessed using Kruskal-Wallis or Kolmogorov-Smirnov tests for training impulse and KDE scores, respectively. RESULTS: Training impulse scores were not different between training session types, except for extensive endurance sessions. However, all training session types differed when comparing KDEs for heart rate and velocity (both P < .001). In addition, 2D KDE plots of heart rate and velocity provide detailed insights into the (subtle differences in) coupling of internal and external training load that could not be obtained by 2D plots using training zones. CONCLUSION: 2D KDE plots provide a valuable tool to visualize and inform coaches on the (subtle differences in) coupling of internal and external training load for training sessions. This will help coaches design better training schemes aiming at desired training adaptations.

Muscular and kinematic features in speed skaters indicate a task-specific dystonia.

OBJECTIVE: Skater's cramp is a movement disorder in speed skaters. We investigated whether affected skaters matched the disease profile of task-specific dystonia, specifically whether there was evidence of maladaptive muscle activity occurring simultaneously with aberrant movements (jerking). We further examined different skating intensities, positing no change would be more indicative of task-specific dystonia. METHODS: We analyzed video, kinematic and muscle activity in 14 affected skaters. We measured the angular velocity and electromyographic activity of normalized speed skating strokes using one dimensional statistical non-parametric mapping. Skaters were matched with comparably skilled controls, and filled out a bespoke clinical questionnaire. RESULTS: Skaters' impacted leg showed over-activation in the peroneus longus, tibialis anterior and gastrocnemius that coincided with higher foot movement compared to their healthy leg and controls. This pattern persisted regardless of skating intensity. Clinical features indicated it was task-specific and painless with common trigger factors including stress, equipment change, and falling. CONCLUSIONS: We showed aberrant muscular and kinematic activity in a movement disorder in speed skaters indicative of task-specific dystonia. SIGNIFICANCE: Understanding skater's cramp as a task-specific dystonia could reduce the damage that misdiagnosis and unsuccessful invasive operations have caused. Our quantitative method has value in testing future treatment efficacy.

Confinement dependence of protein-associated solvent dynamics around different classes of proteins, from the EPR spin probe perspective.

Protein function is modulated by coupled solvent fluctuations, subject to the degree of confinement from the surroundings. To identify universal features of the external confinement effect, the temperature dependence of the dynamics of protein-associated solvent over 200-265 K for proteins representative of different classes and sizes is characterized by using the rotational correlation time (detection bandwidth, 10-10-10-7 s) of the electron paramagnetic resonance (EPR, X-band) spin probe, TEMPOL, which is restricted to regions vicinal to protein in frozen aqueous solution. Weak (protein surrounded by aqueous-dimethylsulfoxide cryosolvent mesodomain) and strong (no added crysolvent) conditions of ice boundary confinement are imposed. The panel of soluble proteins represents large and small oligomeric (ethanolamine ammonia-lyase, 488 kDa; streptavidin, 52.8 kDa) and monomeric (myoglobin, 16.7 kDa) globular proteins, an intrinsically disordered protein (IDP, ß-casein, 24.0 kDa), an unstructured peptide (protamine, 4.38 kDa) and a small peptide with partial backbone order (amyloid-ß residues 1-16, 1.96 kDa). Expanded and condensate structures of ß-casein and protamine are resolved by the spin probe under weak and strong confinement, respectively. At each confinement condition, the soluble globular proteins display common T-dependences of rotational correlation times and normalized weights, for two mobility components, protein-associated domain, PAD, and surrounding mesodomain. Strong confinement induces a detectable PAD component and emulation of globular protein T-dependence by the amyloid-ß peptide. Confinement uniformly impacts soluble globular protein PAD dynamics, and is therefore a generic control parameter for modulation of soluble globular protein function.

Injury incidence and patterns in rink hockey: A systematic review

This systematic review aims to analyze studies on the extent of injuries in rink hockey athletes. Quality of the reported information was also analyzed. A literature search was performed from January 1992 until August 2020 using the main databases The search terms were: “rink hockey” or the synonym “roller hockey” and “injur*”.A total of 11 studies were considered eligible and included. Of these, nine were cross-sectional or descriptive. All samples were non-random, and only one study used a standardized consensus classification of injuries.Muscle strains were the most frequent injuries and lower limbs the most affected body regions. Moreover, overuse was the most common cause, and injury severity was primarily moderate. Injury burden was not reported, and the incidence rate ranged from 3.23–9.7 injuries/1000 h.We conclude that the quality of the reports has room for improvement in terms of study design, outcome, epidemiology measures, and investigation of injury characteristics. (AU)

Female Pacific walruses (Odobenus rosmarus divergens) show greater partitioning of sea ice organic carbon than males: Evidence from ice algae trophic markers.

The expected reduction of ice algae with declining sea ice may prove to be detrimental to the Pacific Arctic ecosystem. Benthic organisms that rely on sea ice organic carbon (iPOC) sustain benthic predators such as the Pacific walrus (Odobenus rosmarus divergens). The ability to track the trophic transfer of iPOC is critical to understanding its value in the food web, but prior methods have lacked the required source specificity. We analyzed the H-Print index, based on biomarkers of ice algae versus phytoplankton contributions to organic carbon in marine predators, in Pacific walrus livers collected in 2012, 2014 and 2016 from the Northern Bering Sea (NBS) and Chukchi Sea. We paired these measurements with stable nitrogen isotopes (δ15N) to estimate trophic position. We observed differences in the contribution of iPOC in Pacific walrus diet between regions, sexes, and age classes. Specifically, the contribution of iPOC to the diet of Pacific walruses was higher in the Chukchi Sea (52%) compared to the NBS (30%). This regional difference is consistent with longer annual sea ice persistence in the Chukchi Sea. Within the NBS, the contribution of iPOC to walrus spring diet was higher in females (~45%) compared to males (~30%) for each year (p < 0.001), likely due to specific foraging behavior of females to support energetic demands associated with pregnancy and lactation. Within the Chukchi Sea, the iPOC contribution was similar between males and females, yet higher in juveniles than in adults. Despite differences in the origin of organic carbon fueling the system (sea ice versus pelagic derived carbon), the trophic position of adult female Pacific walruses was similar between the NBS and Chukchi Sea (3.2 and 3.5, respectively), supporting similar diets (i.e. clams). Given the higher quality of organic carbon from ice algae, the retreat of seasonal sea ice in recent decades may create an additional vulnerability for female and juvenile Pacific walruses and should be considered in management of the species.

The burden of injury in field hockey: A secondary analysis of prospective cohort data.

Most studies report injuries based upon their incidence rate, or the number of injuries which occur in a sport per unit of time. While this is recommended across numerous consensus statements on reporting injury data in sport, it may be of benefit to consider injury burden also. Reporting injuries as the duration of injury per 1000 exposure hours highlights those injuries which will likely cause greater disruption within a team. Therefore, the primary aim of this study was to report the burden of injury in field hockey. This secondary analysis of epidemiological data employed two methods of data collection: self-reported through an online reporting software, and through contact with the team physiotherapist. Athletes reported injury-related symptoms for 4170 days in total, giving rise to an injury burden of 121.0/1000 h, of which 61.4/1000 h were days lost through injury. Injuries to the hamstring, as well as muscle strain injuries, caused the most significant injury burden in athletes (22.6 and 35.8/1000 h respectively). Reporting injuries as the duration of injuries per 1000 hours highlights those injuries which cause the most significant disruption within a squad. Future injury prevention strategies in field hockey should prioritize the injuries which are most burdensome.

Preseason Vestibular Ocular Motor Screening in Children and Adolescents.

OBJECTIVES: The primary purpose of this study was to examine vestibular/ocular motor screening (VOMS) test performance in a sample of healthy youth ice hockey players. A particular focus was to investigate the potential effects of age and pre-existing health conditions, including concussion history, attention-deficit/hyperactivity disorder (ADHD), learning disability (LD), headaches/migraines, and depression/anxiety on preseason baseline VOMS performance, including the near point of convergence (NPC) distance. DESIGN: Cross-sectional cohort. SETTING: Outpatient physiotherapy clinic. PARTICIPANTS: Three hundred eighty-seven male youth hockey players, with an average age of 11.9 years (SD = 2.2, range = 8-17), completed the VOMS and responded to self- or parent-reported demographic and medical history questionnaires during preseason baseline assessments. INDEPENDENT VARIABLES ASSESSED: Age, sex, and mental and physical health history including ADHD, headaches, depression, anxiety, migraine, and LD. OUTCOME MEASURE: Vestibular/ocular motor screening. RESULTS: The large majority of boys scored within normal limits on the VOMS, ie, they reported no symptom provocation of more than 2 points on any VOMS subset (89%) and had a normal NPC distance, ie, <5 cm (78%). The individual VOMS subtests had low abnormality rates, and demographic and pre-existing health conditions, such as age, headache or migraine history, previous neurodevelopmental conditions, or mental health problems, were not associated with clinically meaningful symptom provocation during the VOMS. CONCLUSIONS: There was a low rate of abnormal findings for the individual VOMS subtests, with the exception of NPC distance, among male youth hockey players during preseason assessment.

Epidemiology of injuries in senior men's field hockey: A two-season prospective observational injury surveillance study.

Determining the rate and severity of injuries incurred through sport is accepted as the primary step towards designing, implementing and evaluating injury prevention programmes. The aim of this study was to determine the injury incidence rate and characteristics of male field hockey athletes participating in the Irish Hockey League. Athletes from eight field hockey teams were assigned to an online reporting system, where they logged injuries as they were incurred. Injuries were defined as any physical complaint. Coaches and physiotherapists were contacted weekly to corroborateinjuries. Overall 323 injuries were reported across 34,449 exposure hours, giving rise to an incidence rate of 9.4/1000 h. On average, athletes sustained one injury over the course of two seasons. Muscle strains, pain and contusions were the most common types of injury, while the hamstring, knee and hip/groin were the most frequently reported locations. While 66.9% of injuries occurred through non-contact mechanisms, contact injuries were also common. Injury recurrences accounted for 16.1% of injuries. In conclusion, the incidence of injury in field hockey is high, occurring from a variety of mechanisms. Future injury prevention strategies should prioritise injuries to the hamstring, knee and ankle, and be specific to particular playing positions.

[Estimation of the diet and metabolic status of hokkey players with different body mass].

Intense physical activity can lead to endogenous intoxication of the organism of athletes. Metabolic stress occurs due to the acceleration of plastic and energy exchanges and the accumulation of products of incomplete metabolism, lipid peroxidation processes are activated, changes occur in the hypothalamic-pituitary-adrenal system of the organism. One of the first and most powerful means of recovery is nutrition. The aim of the work is to evaluate biochemical blood parameters characterizing the metabolic processes in athletes with different body weight under organized nutrition. Material and methods. Three groups of hockey players aged 26.4±0.8 years old were examined, playing in the Continental Hockey League, with different body mass (BM): below the 25th quartile - 1st (n=7), above 75th quartile - 3rd (n=9) and in the zone of 25- 75 quartile - 2nd (n=17). For the assessment of the consumption of nutrients and energy per day, menu layouts have been analyzed. Blood biochemical parameters (total protein, urea, creatinine, glucose, total cholesterol, high and low density lipoprotein cholesterol, triglycerides', creatine kinase-MB, alanine aminotransferase, aspartate aminotransferase (AST), testosterone and cortisol), characterizing the metabolic status of the organism, have been determined through 2.5 and 4 months of games. The anabolism index, atherogenic index and De Ritis Ratio have been calculated. Results and discussion. The energy value of the diet (6693.5 kcal/day), in general, corresponded to the daily needs of athletes (from 5953.2 to 6494.4 kcal/day). Daily calorie intake in the individuals of group 1st was higher than recommended by 13.5%, 2nd - by 3.1%, 3rd - corresponded to the need per 1 kg of BM. Protein level exceeded the norm for individuals of groups 1-3 by 51.4-27.0%; fats - by 34.0-12.4%. The amount of carbohydrates complied with the norm only for persons of group 1st. Athletes of groups 2nd and 3rd received less carbohydrates, respectively by 6.7 and 13.8%. Testosterone level was within the normal range, while cortisol level was significantly higher than norm. The anabolism index indicated that individuals from groups 1st and 2nd were overtraining at all stages of observation, and group 3rd - after 4 months of games. Urea level in the re-examination significantly increased and exceeded the norm by 30.4, 27.4 and 25.3%, respectively, creatinine level also elevated. After 2.5 months of games, total cholesterol in individuals of groups 2nd and 3rd was higher than in group 1st, but did not go beyond the reference limit; after 4 months it exceeded the norm. High-density lipoproteins were lower or within low norm limit; low-density lipoproteins in group 1st slightly increased, and in group 2nd and 3rd exceeded the norm. Atherogenic index increased, exceeding the age norm in all groups. Creatine kinase-MB went beyond the normal range in hockey players of all groups. AST increased in groups 2nd and 3rd, exceeding the norm. De Ritis Ratio in athletes of all groups in each study was above the norm. Conclusion. In hockey players, signs of catabolism were more pronounced in group 1st, less than in 3rd (cortisol level). The systemic metabolic shift towards an increase in protein catabolism in the same sequence was indicated by the level of urea and creatinine and De Ritis Ratio. Lipid metabolism disorders were more pronounced in individuals of groups 2nd and 3rd. Biochemical indicators showed the presence of overtraining, hypoxia in the heart muscle cells and the activation of biochemical processes in the direction of gluconeogenesis, which was confirmed by the data on insufficient consumption of diet carbohydrates.

"Weathering the storm:" Mothers' and fathers' experiences of parenting a preterm infant.

Parenting preterm infants is a unique experience distinct from parenting full-term infants, characterized by a delayed transition to parenthood and limited caregiving opportunities. This study explored mothers' and fathers' lived experiences of parenting during infancy in the context of preterm birth. Semistructured qualitative interviews were conducted with 13 parents (6 fathers, 7 mothers) of preterm infants. Data were analyzed using interpretative phenomenological analysis. Four superordinate themes emerged: (a) An unnatural disaster: The traumatic nature of preterm birth, (b) The immediate aftermath: Disconnected and displaced, (c) Breaking the ice: Moving from frozen to melted, and (d) Aftershocks: Transitioning home. Both parents experienced preterm birth as traumatic. Similarities and differences in mothers' and fathers' experiences were identified. Preterm birth posed challenges for nurturant and social caregiving and resulted in anxiety, hypervigilance, and overprotective parenting behavior. The results highlight the need for trauma-informed care and further research developing and testing empirically based interventions.

Criar a infantes nacidos prematuramente es una experiencia única, distinta de criar a infantes nacidos a los nueve meses, caracterizada por una transición retrasada al hecho de ser padres y por oportunidades limitadas de prestación de cuidados. Este estudio exploró las experiencias de crianza vividas por las mamás y los papás durante la infancia dentro del contexto del nacimiento prematuro. Se llevaron a cabo entrevistas cualitativas semiestructuradas con 13 progenitores (6 papás, 7 mamás) de infantes nacidos prematuramente. Se analizó la información usando el Análisis Fenomenológico Interpretativo. Surgieron cuatro temas superiores: (i) Un desastre no natural: La naturaleza traumática del nacimiento prematuro; (ii) Las consecuencias inmediatas: Desconectados y desplazados; (iii) El rompimiento del hielo: Pasar de estar congelado a derretirse; y (iv) La conmoción posterior: En transición a casa. Ambos padres experimentaron el nacimiento prematuro como traumático. Se identificaron las similitudes y las diferencias en las experiencias de las mamás y de los papás. El nacimiento prematuro presentó retos para el cuidado de crianza y social y resultó en ansiedad, excesiva vigilancia y conducta de crianza sobreprotectora. Los resultados subrayan la necesidad de un cuidado fundamentado en la comprensión del trauma y de una investigación futura que desarrolle y examine las intervenciones con base empírica.

Le parentage de nourrissons prématurés est une expérience unique distincte du parentage de nourrissons à terme, caractérisée par une transition retardée au parentage et par des opportunités de prendre soin du bébé limitées. Cette étude a exploré les expériences vécues de parentage des mères et des pères durant la petite enfance dans le contexte d'une naissance prématurée. Des entretiens qualitatifs semi-structurés ont été faits avec 13 parents (6 pères, 7 mères) de nourrissons prématurés. Les données ont été analysées en utilisant l'Analyse Interprétative Phénoménologique. Quatre thèmes sur-ordonnés ont émergé : (i) Un désastre contre nature : la nature traumatique de la naissance prématurée, (ii) Le lendemain immédiat : déconnecté et déplacés, (iii) La glace brisée : de l'état de glace au dégel, et (iv) Les secousses secondaires : la transition au domicile. Les deux parents ont fait l'expérience de la naissance prématurée comme étant traumatique. Les similarités et les différences dans les expériences des mères et des pères ont été identifiées. La naissance prématurée s'est avérée difficile pour les soins nourriciers et sociaux et a résulté en anxiété, hypervigilance et en comportement de parentage surprotecteur. Les résultats de l'étude mettent en valeur le besoin de soin tenant en compte le trauma et de procéder à des recherches plus approfondies sur le développement et le test d'interventions basées sur des faits empiriques.

Concussion and National Hockey League Player Performance: An Advanced Hockey Metrics Analysis.

CONTEXT: Postconcussion deficits in neurocognitive performance and postural control may persist at the time of return to sport participation. How these deficits, if present, affect athletic performance is largely unknown, with prior studies showing mixed results. OBJECTIVE: To evaluate postconcussion National Hockey League player performance using advanced hockey metrics over short- (5 games), medium- (10 games), and long-term (remainder of the season) seasonal performance. DESIGN: Retrospective cohort study. PATIENTS OR OTHER PARTICIPANTS: National Hockey League players who sustained a sport-related concussion (SRC; n = 93) and returned during the same season and players (n = 51) who missed time for non-injury-related reasons. MAIN OUTCOME MEASURE(S): Six performance metrics were used: (1) points per 60 minutes, (2) Corsi percentage, (3) personal Fenwick shooting percentage, (4) scoring chances per 60 minutes, (5) penalty difference, and (6) PDO (not an acronym but sometimes referred to as SVSP% [save percentage shooting percentage]). Performance was compared using 2 (group) × 2 (time) repeated-measures analyses of variance for 3 time windows: (1) ±5 games, (2) ±10 games, and (3) the remainder of the season postconcussion. Alpha values were set at a conservative .01 to account for the lack of independence among dependent variables. RESULTS: No significant interactions were present for any of the 6 dependent variables at any of the 3 time windows. Overall, none of the secondary variables differed. CONCLUSIONS: Using advanced, sport-specific metrics, we found that National Hockey League players did not display worse seasonal performance during 3 postinjury time frames after they sustained an SRC. Whereas laboratory studies have identified lingering neurologic deficits after concussion, our results suggest that these deficits, if present, either do not translate to worse athletic performance or were not captured by these 44 metrics. Further, prospective efforts are needed to accurately quantify performance after SRC among professional hockey players.

A Bayesian Network risk model for assessing oil spill recovery effectiveness in the ice-covered Northern Baltic Sea.

The Northern Baltic Sea, as one of the few areas with busy ship traffic in ice-covered waters, is a typical sea area exposed to risk of ship accidents and oil spills in ice conditions. Therefore, oil spill capability for response and recovery in this area is required to reduce potential oil spill effects. Currently, there are no integrated, scenario-based models for oil spill response and recovery in ice conditions. This paper presents a Bayesian Network (BN) model for assessing oil spill recovery effectiveness, focusing on mechanical recovery. It aims to generate holistic understanding and insights about the oil spill-to-recovery phase, and to estimate oil recovery effectiveness in representative winter conditions. A number of test scenarios are shown and compared to get insight into the impact resulting from different oil types, spill sizes and winter conditions. The strength of evidence of the model is assessed in line with the adopted risk perspective.

Possible evidence for care and treatment in the Tyrolean Iceman.

The Tyrolean Iceman is the world's oldest glacier mummy. He was found in September 1991 in the Italian part of the Ötztal Alps. Since his discovery a variety of morphological, radiological and molecular analyses have been performed that revealed detailed insights into his state of health. Despite the various pathological conditions found in the Iceman, little is known about possible forms of care and treatment during the Copper Age in Northern Italy. A possible approach to this topic is the presence of tattoos on the mummified body. In previous work, it was already believed that the tattoos were administered as a kind of treatment for his lower back pain and degenerative joint disease of his knees, hip and wrist. In other studies, the tattoos of the Iceman have been related to an early form of acupuncture. We carefully re-evaluated the various health issues of the Iceman, including joint diseases, gastrointestinal problems and arterial calcifications and compared them to the location and number of tattoos. Together with the finding of medically effective fungi and plants, such as the birch polypore or fern in his equipment and intestines, we suggest that care and treatment was already common during the Iceman's time.

Prevalence of Pica in Patients on Dialysis and its Association With Nutritional Status.

OBJECTIVE: Pica could be strongly implicated in nutritional status of patients on dialysis; however, very scarce data are currently available. The objective of this study was to evaluate the prevalence of pica and its association with nutritional status in dialysis patients. DESIGN AND METHODS: This is a cross-sectional study in a tertiary care teaching hospital. Four-hundred patients on dialysis, without previous pica diagnosis or transplant, pregnancy, mental illness, or infection, were included in the study. Pica, according to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, was classified as no pica, ice pica, or hard pica. Dialysis Malnutrition Score, 24-hour dietary recall, and biochemical measurements were obtained from patients. As part of statistical analysis, point prevalence and 95% confidence interval of pica were calculated. Comparisons between groups were performed by means of analysis of variance, Kruskal-Wallis test, χ2, or Fisher exact tests, as appropriate. A multivariate analysis was performed by multinomial logistic regression. RESULTS: Prevalence of pica was 42% (ice pica, 46%; soil, 29%; two substances, 14%; red brick, 5%; paper, 3%; soap, 2%; and cattle pasture, 1%). Comparing patients with pica (hard pica and ice pica) versus no pica, subjects with pica were of younger age (25 ± 7, 27 ± 9, 30 ± 11 years, respectively), were more frequently educated <9 years (57%, 46%, 30%, respectively), and had longer dialysis duration (36 ± 19, 32 ± 18, 27 ± 16 months, respectively). Patients with pica achieved the recommended calorie and macronutrients intake target less frequently than those without pica (40-64% vs. 66-77%, P <.05). Malnutrition was present in 74% of the whole sample: (1) 67% in no pica group, (2) 80% in ice pica group, and (3) 89% in hard pica group (P = .001). In the multivariate analysis (R2, 0.27; P < .0001), malnutrition, C-reactive protein, and lower educational level significantly predicted both ice and hard pica. CONCLUSIONS: A worse nutritional status was observed in patients with pica, who additionally were younger, had lower educational level, longer dialysis duration, and worse macronutrient intake routine than patients without pica. Malnutrition, C-reactive protein, and lower educational level significantly predicted both ice and hard pica.

Gross and histopathological pitfalls found in the examination of 3338 cattle brains submitted to the BSE surveillance program in Brazil / Ciladas macroscópicas e histopatológicas encontradas no exame de 3338 encéfalos de bovinos submetidos ao programa de vigilância da EEB no Brasil

This study stems from the findings during the gross and histopathological exam of 3,338 cattle brains as part of the bovine spongiform encephalopathy (BSE) active surveillance program of the Brazilian Ministry of Agriculture, Livestock, and Supply from 2001 to 2005. The work was carried out in the Veterinary Pathology Laboratory of the Federal University of Santa Maria which at the time (2001-2007) was the national reference laboratory for the diagnosis of BSE and other transmissible spongiform encephalopathies. Both gross and histopathological aspects are described. Several gross aspects were annotated: anatomic normal structures not commonly recognized (non-lesions), lesions of no clinical significance, postmortem changes and artifacts; all these can amount to important pitfalls that distract the pathologist during the routine gross examination of the central nervous system (CNS). Accordingly, equivalent pitfalls were described in the histological examination. Non-lesions observed were the pineal body, embryo remnants such as the external germinal layer of the cerebellum, subependymal plates, and clusters of neuroblasts in the basal ganglia; or circumventricular structures such as area postrema, subcomisural organ, and melanosis in the leptomeninges and vessel walls. Lesions with little or no clinical importance included age-related changes as lipofuscin, hemosiderin, mineralization and hyalinization of vessel walls within the brain and meninges. Corpora amylacea and corpora arenacea were detected respectively in astrocyte processes and the pineal body. Cytoplasmic neuronal vacuolization was observed in the red nucleus and habenular nucleus. Sarcocystis sp. without a correspondent inflammatory reaction was rarely observed. Included within findings with no clinical manifestation were axonal spheroids and perivascular mononuclear cuffings. Changes in the CNS due to killing, sampling and fixation methods can obscure or distract from the more critical lesions. The ones related to the process of killing included hemorrhages caused in cattle destroyed by a captive bolt. Artifacts related to sampling and handling of CNS tissue consisted of inclusion of bone sand in the neural tissue from sawing the calvarium; dark neurons produced by excessive handling of the brain, and micro-organisms that contaminated the tissues during sampling or histological processing. Postmortem autolytic or putrefactive changes observed included vacuolar changes in the myelin sheath, clear halos surrounding neurons and oligodendrocytes, clusters of putrefaction bacilli within vessels or dispersed throughout the brain tissue associated or not to clear halos. One interesting, and somewhat frequent, postmortem autolytic change found in the bovine brain was the partial dissolution of the granule cell layer (GCL) of the cerebellum, also referred to as conglutination of the GCL or as the French denomination "état glace". Due to the shortage of comprehensive publications in the subject, this review is intended to address the main pitfalls that can be observed in the brain of cattle hoping to help other pathologists avoiding misinterpret them.(AU)

Os resultados deste estudo foram obtidos pelo exame macroscópico e histopatológico de 3.338 cérebros de bovinos examinados durante o programa de vigilância ativa da encefalopatia espongiforme bovina (BSE) do Ministério da Agricultura, Pecuária e Abastecimento (MAPA), de 2001 a 2005. O trabalho foi realizado no Laboratório de Patologia Veterinária (LPV) da Universidade Federal de Santa Maria (UFSM) que, de 2001 a 2007, foi o laboratório nacional de referência para o diagnóstico da BSE e de outras encefalopatias espongiformes transmissíveis. Macroscopicamente, foram descritas estruturas anatômicas normais (não-lesões), mas que são, com frequência, interpretadas como lesões; lesões sem significado clínico; alterações pós-mortais e artefatos. Esses achados podem confundir e desviar a atenção do patologista durante o exame de rotina do sistema nervoso central (SNC). Da mesma forma, estruturas equivalentes foram descritas no exame histológico. As não-lesões observadas foram corpo pineal, remanescentes embrionários, como a camada germinativa externa do cerebelo, placas subependimárias e aglomerados de neuroblastos nos gânglios da base; ou estruturas circunventriculares, como área de postrema, órgão subcomissural e melanose em leptomeninges e paredes dos vasos. Lesões com pouca ou nenhuma importância relacionadas ao envelhecimento incluíram lipofuscina, hemossiderina, mineralização, hialinização das paredes dos vasos do encéfalo e das meninges. Corpora amylacea foram detectados em processos astrocíticos e corpora arenacea, no corpo pineal. Adicionalmente, foi observada vacuolização no citoplasma de neurônios do núcleo vermelho e do núcleo habenular. Sarcocystis sp. sem reação inflamatória correspondente foi raramente observado. Incluídos nos achados sem manifestação clínica estavam esferóides axonais e manguitos mononucleares perivasculares. Alterações no SNC causadas pelo método de abate, amostragem e fixação podem simular ou obscurecer lesões mais importantes. Aquelas relacionadas ao método de abate incluíram hemorragias causadas em bovinos dessensibilizados pelo dardo cativo ou por punção por faca da medula na articulação atlanto-occipital. Artefatos relacionados à amostragem e manuseio de tecido do SNC consistiram na inclusão de pó de osso no tecido neural em consequência do uso de serra para abrir a caixa craniana; neurônios escuros produzidos pelo manuseio excessivo do cérebro e micro-organismos que contaminaram os tecidos durante a amostragem ou processamento histológico. Alterações autolíticas pós-mortais ou de putrefação incluíram vacuolizações na bainha de mielina, halos claros em torno dos neurônios e oligodendrócitos, aglomerados de bacilos de putrefação dentro dos vasos ou dispersos em todo o tecido cerebral, relacionados ou não a halos claros. Uma alteração autolítica pós-mortal intrigante e relativamente frequente encontrada foi a dissolução parcial da camada de células granulares (CCG) do cerebelo, também referida como conglutinação da CCG ou "état glacé". Devido à escassez de publicações abrangentes neste assunto, esta revisão pretende abordar as principais ciladas que possam aparecer no cérebro de bovinos, na esperança de ajudar outros patologistas a evitar interpretá-las erroneamente.(AU)

Glacier protection laws: Potential conflicts in managing glacial hazards and adapting to climate change.

The environmental, socioeconomic and cultural significance of glaciers has motivated several countries to regulate activities on glaciers and glacierized surroundings. However, laws written to specifically protect mountain glaciers have only recently been considered within national political agendas. Glacier Protection Laws (GPLs) originate in countries where mining has damaged glaciers and have been adopted with the aim of protecting the cryosphere from harmful activities. Here, we analyze GPLs in Argentina (approved) and Chile (under discussion) to identify potential environmental conflicts arising from law restrictions and omissions. We conclude that GPLs overlook the dynamics of glaciers and could prevent or delay actions needed to mitigate glacial hazards (e.g. artificial drainage of glacial lakes) thus placing populations at risk. Furthermore, GPL restrictions could hinder strategies (e.g. use of glacial lakes as reservoirs) to mitigate adverse impacts of climate change. Arguably, more flexible GPLs are needed to protect us from the changing cryosphere.