Trends on Novel Targets and Nanotechnology-Based Drug Delivery System in the Treatment of Parkinson's disease: Recent Advancement in Drug Development.

Parkinson's disease (PD) is a neurodegenerative disease (ND) that affects many people. However, there remains no cure for PD and difficulties exist with conventional medicines. There has been a lot of discussion about using nanotechnology to increase the bioavailability of smallmolecule drugs to target cells in recent years. It is possible that PD treatment might become far more effective and have fewer side effects if medication delivery mechanisms were to be improved. Potential alternatives to pharmacological therapy for molecular imaging and treatment of PD may lie in abnormal proteins such as parkin, α-synuclein, leucine-rich repeat serine and threonine protein kinase 2. Published research has demonstrated encouraging outcomes when nanomedicine-based approaches are used to address the challenges of PD therapy. So, to address the present difficulties of antiparkinsonian treatment, this review outlines the key issues and limitations of antiparkinsonian medications, new therapeutic strategies, and the breadth of delivery based on nanomedicine. This review covers a wide range of subjects, including drug distribution in the brain, the efficacy of drug-loaded nano-carriers in crossing the blood-brain barrier, and their release profiles. In PD, the nano-carriers are also used. Novel techniques of pharmaceutical delivery are currently made possible by vesicular carriers, which eliminate the requirement to cross the blood-brain barrier (BBB).

Comparison between Motor Performance of People with Multiple Sclerosis during a Virtual Reality Task Practiced on Concrete and Abstract Devices: A Cross-Sectional Randomized Study.

Multiple sclerosis (MS) is an autoimmune demyelinating disease of the central nervous system with unknown etiology, resulting in various impairments that necessitate continuous rehabilitation to enhance functionality, quality of life, and motor function, including through Virtual Reality (VR) therapy. Comparing tasks in virtual environments and their potential skill transfer to real-world settings could aid in optimizing treatment programs to improve motor performance in individuals with MS. This study aimed to determine whether practicing acquisition and retention phases using two distinct interfaces (concrete-Touch Screen or abstract-Kinect system) affects performance in a subsequent task using a different interface (transfer phase). A randomized clinical trial was conducted with 56 volunteers with MS and 41 controls. Participants engaged in a computer game where they burst as many bubbles as possible within 10 s per attempt. After the acquisition and retention phases, all participants switched interfaces (e.g., those using Kinect switched to Touchscreen and vice versa). Significant performance improvements were observed in both groups during the acquisition phase, which were maintained in the retention phase. Although the abstract interface was more challenging for both groups, only the MS group that practiced with the abstract interface successfully transferred their improvements to the concrete interface. Thus, despite the increased difficulty of the abstract task during practice, it led to better performance transfer when required to complete a subsequent concrete task, suggesting that abstract devices may be beneficial in clinical practice for improving motor function in people with MS.

Fine Motor Impairment and its Impact on Social Outcomes in Survivors of Pediatric Acute Lymphoblastic Leukemia: St Jude Lifetime Cohort Study.

OBJECTIVE: The impact of fine motor impairment among adult survivors of childhood acute lymphoblastic leukemia on life after treatment is unknown. METHODS: This study evaluated prevalence and utilized multivariate logistic regression to identify risk factors for fine motor impairment among survivors of acute lymphoblastic leukemia, and associations with educational attainment and social independence. Latent class analysis defined social independence (independent, moderately independent, dependent), using employment, independent living, personal care assistance, routine need assistance, driver's license status, and marital status inputs. RESULTS: Among 875 survivors who were ≥ 25 years old (age when most adults achieve independence) and ≥ 5 years from diagnosis (mean = 28.97 years), 33.6% had fine motor impairment, with scores at or below the 10th percentile of the scores of community controls (n = 460) on fine motor components of the Physical Performance Test and the Grooved Peg-Board Test. Survivors exposed to cranial radiation had more fine motor impairment than those without (45.8% vs 20.2%). Male sex (exposed: odds ratio [OR] = 2.55, 95.0% CI = 1.65-3.92; unexposed: OR = 3.02, 95.0% CI = 1.69-5.38), and lower scores on the Wechsler Abbreviated Scale of Intelligence (exposed: OR = 0.46, 95.0% CI = 0.36-0.58; unexposed: OR = 0.43, 95.0% CI = 0.31-0.58) were risk factors for neuropathy. A 1-point-higher total neuropathy score was associated with 8% (95.0% CI = 1%-17%) increased odds of fine motor impairment. Fine motor impairment was associated with less than a college education (less than high school: OR = 2.23, 95.0% CI = 1.20-4.14; high school diploma/general equivalency diploma: OR = 2.66, 95.0% CI = 1.65-4.30; vocational education: OR = 2.07, 95.0% CI = 1.38-3.13), and less social independence (moderately independent: OR = 1.80, 95.0% CI = 1.15-2.83; dependent: OR = 2.65, 95.0% CI = 1.25-5.64). CONCLUSION: Fine motor impairment in survivors of childhood acute lymphoblastic leukemia may interfere with optimal educational attainment and social independence. IMPACT: Early identification of survivors at risk for fine motor impairment, with timely intervention, may improve long-term outcomes.

Associations Between Substitution of Sedentary Behavior Patterns With Physical Activity and Cardiovascular Risk Factors in Adolescents: A 3-Year Longitudinal Study.

BACKGROUND: Little is known on how the substitution of time spent in sedentary behavior (SB) patterns with time spent in physical activity impacts cardiovascular risk factors during adolescence. The study aimed to investigate how the substitution of time spent in SB and sedentary bouts with time spent in different physical activity intensities was associated with longitudinal changes in cardiovascular risk factors in analyses stratified by sex. METHODS: This is a prospective cohort study with a mean follow-up period of 3.2 (±0.34) years, involving 109 (60 girls and 49 boys) Brazilian adolescents. Body mass index, waist circumference, and cardiorespiratory fitness were the cardiovascular risk factors considered. A cardiovascular risk score was calculated. Sedentary bouts, light physical activity (LPA), and moderate to vigorous physical activity (MVPA) were measured by accelerometers. Multivariate linear regression models adopting the isotemporal substitution were used to analyze the association between substitution of 10 minutes per day of sedentary bouts with LPA and MVPA and risk factors. All analyses considered 5% significance levels. RESULTS: Substitutions of SB, short and long bouts, with MVPA were associated with higher cardiorespiratory fitness in boys (ß = 0.077; 95% confidence interval, 0.001 to 0.55; ß = 0.076; 95% confidence interval, 0.003 to 0.154; and ß = 0.084; 95% confidence interval, 0.001 to 0.167, respectively). No associations were observed when analyses involved substitution of sedentary bouts with LPA, adiposity, cardiovascular risk score, and girls. CONCLUSIONS: Substituting SB bouts with MVPA appears to favorably influence changes of cardiorespiratory fitness in boys during adolescence. Greater benefits appear to occur when longer sedentary bouts are substituted by MVPA.

17ß-Trenbolone Exposure Enhances Muscle Activity and Exacerbates Parkinson's Disease Progression in Male Mice.

Parkinson's disease (PD) ranks as the second most prevalent neurodegenerative disorder, and while the neuroprotective effects of estrogen are well-documented, the impact of androgens on neurological disorders remains understudied. The consequences of exposure to 17-trenbolone (17-TB), an environmental endocrine disruptor with androgen-like properties, on the mammalian nervous system have received limited attention. Therefore, in this study, we aimed to investigate the biological effects of 17-TB exposure on PD. In our investigation using the 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP)-induced PD mouse model, we discovered that 17-TB exposure elevated testosterone hormone levels prevented androgen receptor (AR) reduction, upregulated the expression of muscular dystrophic factors (Atrogin1, MuRF1, Musa1, and Myostatin), improved muscle strength, and enhanced locomotor activity in the open field test. However, it is noteworthy that exposure to 17-TB also led to an upregulation of neuroinflammatory cytokines (NLRP3, IL-6, IL-1α, and IL-1ß) in PD mice. Crucially, 17-TB exposure induced downregulation of nigral apoptotic proteins DJ-1 and Bcl-2 while upregulating Bax and Caspase-3 in PD mice. This exacerbated neuronal apoptosis, ultimately intensifying dopaminergic neuronal degeneration and death in the substantia nigra and striatum of PD mice. In conclusion, our findings indicate that while 17-TB mitigates muscle atrophy and enhances motor activity in PD mice, it concurrently exacerbates neuroinflammation, induces neuronal apoptosis, and worsens dopaminergic neuronal death, thereby aggravating the progression of MPTP-induced Parkinsonism. This underscores the importance of considering potential environmental risks in neurodegeneration associated with Parkinson's disease, providing a cautionary tale for our daily exposure to environmental endocrine chemical disruptors.

Physical activity as part of the surveillance, monitoring, and evaluation of Primary Health Care in Brazil: a scoping review / La actividad física en la vigilancia, seguimiento y evaluación de la Atención Primaria en Brasil: revisión del alcance / Atividade física na vigilância, monitoramento e avaliação da Atenção Primária à Saúde do Brasil: uma revisão de escopo: Revisão da atividade física na APS do Brasil

OBJECTIVE: Mapping how physical activity (PA) is considered in Primary Health Care (PHC) is essential for aiding planning and management of policies and programs within the Brazilian Unified Health System (SUS). The aim of this study was to map PA-related measures and indicators that are considered in the surveillance, monitoring and evaluation of services and users from the PHC/SUS. METHOD: This is a scoping review with searches conducted in January 2024 on electronic portals related to PHC/SUS. A "snowball" strategy was used to access government documents/reports and their complementary references. Documents were eligible whether they: 1) were government materials; 2) aimed at health surveillance, monitoring/evaluation of services or users from PHC/SUS, and 3) reported PA-related measures or indicators (the behavior and their psychosocial and/or contextual correlates). The selection and extraction process were performed in pairs. A thematic synthesis (evidence map) was applied. RESULTS: Of the 239 potentially eligible documents, 95 were included and summarized according to four groups: health surveillance (n=39), indicators of health plans/policies (n=7), monitoring/evaluation of users (n=34) and services (n =15) from PHC/SUS. A total of 69 measures and 38 different indicators were addressed in health surveillance. The monitoring/evaluation of services includes general- and specific PA programs in PHC/SUS (17 and 13 indicators, respectively). User monitoring/evaluation included indicators aimed at people from different groups (e.g., people with chronic diseases) and their application, primarily in initial examinations and therapeutic planning. CONCLUSIONS: These findings reinforce a call for government actions aiming to qualify the acquisition and implementation of PA-related health information; this may be one the main pathways of strengthening PA promotion on the SUS agenda.

OBJETIVO: Compreender como a atividade física (AF) é contemplada em vigilância, monitoramento e avaliação de serviços e de usuários da Atenção Primária à Saúde (APS) é necessário para auxiliar nas decisões de planejamento e gestão do Sistema Único de Saúde (SUS). O objetivo deste estudo é mapear medidas e indicadores relacionados à AF que são considerados nas estratégias de vigilância, monitoramento e avaliação de serviços e usuários da APS/SUS. MÉTODO: Revisão de escopo com buscas realizadas em janeiro de 2024 em portais eletrônicos relacionados à APS/SUS, usando a estratégia de "bola de neve" e a leitura das referências complementares. Documentos foram elegíveis quando representavam materiais governamentais que eram direcionados para vigilância em saúde, monitoramento/avaliação de serviços e monitoramento/avaliação de usuários na APS/SUS e que continham medidas ou indicadores relacionados à AF (o comportamento em si, global ou por domínios, e seus correlatos psicossociais e/ou contextuais). O processo de seleção e extração foi realizado por pares e uma síntese com representações temáticas das evidências foi realizada. RESULTADOS: Dos 239 documentos potencialmente elegíveis, 95 foram incluídos, abordando vigilância em saúde (n=39), indicadores de planos/políticas de saúde (n=7), monitoramento/avaliação de usuários (n=34) e de serviços (n=15) da APS/SUS. Um total de 69 medidas e 38 indicadores foram contemplados na vigilância. O monitoramento/avaliação de serviços contemplou programas gerais e específicos da AF na APS/SUS (17 e 13 indicadores, respectivamente). O monitoramento/avaliação de usuários incluiu indicadores voltados aos diferentes grupos populacionais (ex., pessoas com doenças crônicas) e sua aplicação, principalmente, em exames iniciais e planejamento terapêutico. CONCLUSÕES: Estes achados reforçam uma chamada para ações governamentais que qualifiquem a aquisição e a implementação das informações em saúde relacionadas à AF, como forma de fortalecer a AF na agenda do SUS.

GAP43 Located on Corticostriatal Terminals Restrains Novelty-Induced Hyperactivity in Mice.

Growth-associated protein of 43 kDa (GAP43) is a key cytoskeleton-associated component of the presynaptic terminal that facilitates neuroplasticity. Downregulation of GAP43 expression has been associated to various psychiatric conditions in humans and evokes hippocampus-dependent memory impairments in mice. Despite the extensive studies conducted on hippocampal GAP43 in past decades, however, very little is known about its roles in modulating the excitatory versus inhibitory balance in other brain regions. We recently generated conditional knock-out mice in which the Gap43 gene was selectively inactivated in either telencephalic glutamatergic neurons (Gap43fl/fl ;Nex1Cre mice, hereafter Glu-GAP43-/- mice) or forebrain GABAergic neurons (Gap43fl/fl ;Dlx5/6Cre mice, hereafter GABA-GAP43-/- mice). Here, we show that Glu-GAP43-/- but not GABA-GAP43-/- mice of either sex show a striking hyperactive phenotype when exposed to a novel environment. This behavioral alteration of Glu-GAP43-/- mice was linked to a selective activation of dorsal-striatum neurons, as well as to an enhanced corticostriatal glutamatergic transmission and an abrogation of corticostriatal endocannabinoid-mediated long-term depression. In line with these observations, GAP43 was abundantly expressed in corticostriatal glutamatergic terminals of wild-type mice. The novelty-induced hyperactive phenotype of Glu-GAP43-/- mice was abrogated by chemogenetically inhibiting corticostriatal afferences with a Gi-coupled "designer receptor exclusively activated by designer drugs" (DREADDs), thus further supporting that novelty-induced activity is controlled by GAP43 at corticostriatal excitatory projections. Taken together, these findings show an unprecedented regulatory role of GAP43 in the corticostriatal circuitry and provide a new mouse model with a delimited neuronal-circuit alteration for studying novelty-induced hyperactivity, a phenotypic shortfall that occurs in diverse psychiatric diseases.

Jaw-neck motor function 2 years after whiplash trauma.

BACKGROUND: There is limited knowledge about the possible long-term effects on jaw motor function after whiplash trauma. OBJECTIVES: The primary aim was to evaluate integrated jaw and head-neck movement amplitudes during jaw function in individuals 2 years after whiplash trauma, compared to controls. The secondary aim was to evaluate changes between the acute stage and a 2-year follow-up in terms of jaw and head-neck movement amplitudes during jaw function. METHODS: This study included 28 cases exposed to a whiplash trauma 2 years earlier (13 women) and 28 controls (13 women) without previous neck trauma. Head and jaw movement amplitudes were recorded during maximal jaw opening-closing movements using an optoelectronic 3D recording system. For a subpopulation of 12 cases and 15 controls, recordings had also been performed in the acute stage after the whiplash trauma. Jaw and head movement amplitudes were analysed using linear regression with group and sex as independent variables. The subpopulation longitudinal analysis was adjusted for movement amplitudes at baseline. RESULTS: Jaw movement amplitudes were significantly associated with group (coefficient: -0.359: 95% CI: -10.70 to -1.93, p = .006) with smaller amplitudes of jaw movements for whiplash cases. Head movement amplitudes were not associated with group (coefficient: -0.051, 95% CI: -4.81 to 3.20, p = .687). In the longitudinal analysis, both jaw and head movement amplitudes showed significant associations between baseline and the 2-year follow-up. CONCLUSION: The present findings indicate that the effects on jaw function in terms of jaw opening capacity in the acute stage after whiplash trauma do not spontaneously recover.

The use of digital platforms and physical activity practice in a population from southern Brazil: Findings from the PAMPA Cohort.

Objective: We aimed to identify the factors associated with using digital platforms for physical activity during the COVID-19 pandemic among adults living in Southern Brazil. We also compared the trajectory of physical activity between users and non-users and by type of digital platform used. Methods: We analyzed data from the PAMPA (Prospective Study About Mental and Physical Health in Adults) cohort. The study started in June 2020, and tracked participants through three waves (December 2020, June 2021, and June 2022). The exposure variable was usingf digital platforms for physical activity. The outcome measure was minutes per week of physical activity. We employed a generalized linear model with robust variance to explore the interaction between time and the use of digital platforms, adjusting for sociodemographic covariates and the presence of chronic diseases. Results: The proportion of participants using digital platforms for physical activity declined from 36.8% in 2020 to 25.6% in 2021 and further to 13.5% in 2022. Using digital platforms for physical activity was associated with a higher mean daily physical activity during the COVID-19 pandemic. Participants who used digital platforms were more likely to be physically active when compared to their inactive contemparts throughout the entire study period. Notably, social media emerged with greater influence in the physical activity practice among digital platforms. Conclusion: Using these platforms had a positive impact on increasing the level of physical activity among the participants.

Health-improving effect of running for students of technical specialties.

OBJECTIVE: Aim: To study the dynamics of indicators of the functional state and health of technical specialties students during their long-term running engagement. PATIENTS AND METHODS: Materials and Methods: The research involved 112 students (59 men and 53 women) aged 17-20 years. Two groups of students were formed: group 1 included students who, in addition to compulsory academic physical education training sessions, were not engaged in any type of motor activity on their own; group 2 included students who independently were engaged in recreational running 3 times a week in extracurricular time. RESULTS: Results: It was found that during the research period, both male and female students who were independently engaged in recreational running in extracurricular time showed a significant improvement of such indicators as resting heart rate, vital capacity of the lungs, duration of breath holding during inhalation and exhalation, duration of heart rate recovery after standard exercise, level of endurance development, level of physical health. CONCLUSION: Conclusions: The positive influence of independent running with moderate intensity on the functional state and health of students of technical specialties has been proved. The low efficiency of the physical education system in Ukraine and, accordingly, the insufficient level of motor activity, indicators of functional status, and health of students who, in addition to academic physical education training sessions, did not exercise on their own, were also confirmed.

Motivational and value-based attitude of law enforcement officers to motor activity as a factor of a healthy lifestyle.

OBJECTIVE: Aim: To study the attitude of law enforcement officers to motor activity and investigate its impact on their health. PATIENTS AND METHODS: Materials and Methods: The research, which was conducted in 2022-2024, involved 163 law enforcement officers under the age of 30. Research methods: bibliosemantic, questionnaire, testing, medical and biological methods, methods of mathematical statistics. RESULTS: Results: It has been found that the vast majority of law enforcement officers (85.3 %) understand the importance of motor activity as a factor of a healthy lifestyle, its impact on physical and mental health, and quality of their professional activities. At the same time, only 27.6 % of law enforcement officers systematically engage in motor activity, 52.8 % do it sporadically, and 25.8 % do not engage in it at all. Among the reasons that prevent them from exercising are lack of time (65.6 %), lack of desire (31.3 %), and fatigue after a service day (28.1 %). It has been found that law enforcement officers who systematically engage in motor activity have a significantly better level of health (7.31 points) compared to those who engage in occasional motor activity (5.07 points) and do not engage at all (2.19 points). CONCLUSION: Conclusions: The positive impact of motor activity on the level of health of law enforcement officers has been proved. Good health is a guarantee of high resistance of law enforcement officers to negative factors of professional activities, professional longevity, and quality of their professional tasks.

Physical activity levels in patients with chronic venous insufficiency.

BACKGROUND: Increasing the levels of physical activity (PA) is widely recommended for people with chronic venous insufficiency (CVI). However, studies investigating the patterns of PA and adherence to PA guidelines using objective measures are lacking. OBJECTIVE: The primary aim was to examine the patterns of PA and adherence to PA guidelines among patients with CVI. A secondary aim was to identify whether adherence to PA recommendations differed according to patients' sociodemographic and clinical characteristics. METHODS: This cross-sectional study included 96 patients with CVI with Clinical-Etiology-Anatomy-Pathology (CEAP) C3 to C6 (69.1% women 59 ± 11 years; 51.5% C5-C6 on CEAP classification). Objective time spent in PA was measured by a triaxial accelerometer. To examine adherence to PA guidelines, patients were grouped as meeting (or) the recommendations if they had at least 150 min/week of moderate to vigorous PA. Sociodemographic and clinic characteristics were obtained by self-report. Binary logistic regression was employed to examine whether sociodemographic and clinical characteristics were associated with adherence to PA guidelines. T-tests were employed to compare PA levels at different intensities according to patients' age. RESULTS: Patients spent an average of 311.4 ± 91.5 min/week, 42.1 ± 28.0 min/week, and 19.8 ± 17.8 min/week in low-light PA, high-light PA, and moderate-to-vigorous PA, respectively. The proportion of patients meeting PA recommendations was 36.2%, and older patients had lower odds (OR = 0.94; 95%CI: 0.89 to 0.99). Additional analysis reinforced that by showing lower time in high-light PA (51.2 ± 30.0 min/day vs. 31.9 ± 21.8 min/day; p = .001) and moderate-to-vigorous PA (24.3 ± 15.8 min/day vs. 14.8 ± 18.8 min/day; p = .012) among older patients than their peers younger. CONCLUSION: Our findings showed that 36,2% of CVI patients met PA recommendations, with lower odds found among older patients. Public health interventions to enhance PA engagement among CVI patients should prioritize those who are older.

Polydatin attenuated neuropathic pain and motor dysfunction following spinal cord injury in rats by employing its anti-inflammatory and antioxidant effects.

Background: Considering the complex pathological mechanisms behind spinal cord injury (SCI) and the adverse effects of present non-approved drugs against SCI, new studies are needed to introduce novel multi-target active ingredients with higher efficacy and lower side effects. Polydatin (PLD) is a naturally occurring stilbenoid glucoside recognized for its antioxidative and anti-inflammatory properties. This study aimed to assess the effects of PLD on sensory-motor function following SCI in rats. Methods: Following laminectomy and clip compression injury at the thoracic 8 (T8)-T9 level of the spinal cord, rats were randomly assigned to five groups: Sham, SCI, and three groups receiving different doses of PLD treatment (1, 2, and 3 mg/kg). Over 4 weeks, behavioral tests were done such as von Frey, acetone drop, hot plate, Basso-Beattie-Bresnahan, and inclined plane test. At the end of the study, changes in catalase and glutathione activity, nitrite level, activity of matrix metalloproteinase 2 (MMP2) and MMP9 as well as spinal tissue remyelination/neurogenesis, were evaluated. Results: The results revealed that PLD treatment significantly improved the behavioral performance of the animals starting from the first week after SCI. Additionally, PLD increased catalase, and glutathione levels, and MMP2 activity while reduced serum nitrite levels and MMP9. These positive effects were accompanied by a reduction in the size of the lesion and preservation of neuronal count. Conclusion: In conclusion, PLD showed neuroprotective effects in SCI rats by employing anti-inflammatory and antioxidant effects, through which improve sensory and motor function.

Expression of exploratory activity of rat offspring depends on the expression of exploratory activity of their parents at the moment of mating.

The aim of this work was to study the, so far, unexplored possibility that non-genetic inheritance of animal behavioral characteristics could depend on the state of the parents at the time of conception. In this study, we measured the levels of motor and exploratory activity in rats at the ages of 2 and 5 months. Male and female rats were mated at the age of 5 months. The following groups were used: male and female rats with high motor activity at ages of 2 and 5 months (ACT+); male and female rats with high activity at the age of 2 months, but low activity at the age of 5 months (ACT-); male and female rats with low activity at the ages of 2 and 5 months (PAS-); male and female rats with low activity at the age of 2 months, but high activity at the age of 5 months (PAS+). It was found that both males and females ACT+ had significantly higher motor activity, which was observed in the first 10 minutes, in the next 20-60 minutes, in the center of the cage and more rearings as compared with PAS- rats. Significant differences in the severity of exploratory activity were found between the male offspring of ACT+ and ACT- rats. Differences between the offspring of PAS+ and PAS- rats were observed in both the male and female rats. The motor activity of animals in the period from 20 minutes after the start of registration did not differ between groups. Thus, it can be considered that individual characteristics of general motor activity are due to genetically inherited factors, while differences in the level of exploratory activity, apparently, are formed due to non-genetic influences from parents during mating.

Global Physical Activity, Active Commuting to School, and Sedentary Behavior Among Latin American Adolescents: Global School-Based Student Health Survey and the National School Health Survey.

BACKGROUND: This study aimed to compare the overall prevalence, stratified by sex and age group of global physical activity (GPA), active commuting to school (ACS), and sedentary behavior (SB) among adolescents from ten Latin American countries, and to assess the correlation of Development Index with the indicators. METHODS: This research is grounded on data from the Global School-Based Student Health Survey (2009-2015) and the 2015 Brazilian National School Health Survey. The prevalence and 95% confidence intervals for GPA (≥5 d/wk), ACS (≥1 d/wk), and SB (>2 h/d) were calculated using the chi-square test to compare the sexes (male; female) and age group (≤13 y; 14 y; 15 y; ≥16 y). We also performed Pearson correlation analysis with the Human Development Index. RESULTS: The prevalence of indicators ranged from 16.1% to 28.2% for GPA, from 56.7% to 71.2% for ACS, and from 20.7% to 62.6% for SB. Boys generally had a higher prevalence of GPA and ACS, and girls had a higher prevalence of SB. The prevalence of the indicators by age group varied between countries, with significant differences observed in some, depending on each indicator. A positive correlation was observed between Human Development Index, GPA, and SB. CONCLUSION: Health promotion policies must include guidelines that encourage and promote a more active and less sedentary lifestyle among young people in Latin America, considering specific groups, the local socioeconomic context, and differences between countries.

Neurorehabilitation with vagus nerve stimulation: a systematic review.

Objective: To systematically review vagus nerve stimulation (VNS) studies to present data on the safety and efficacy on motor recovery following stroke, traumatic brain injury (TBI), and spinal cord injury (SCI). Methods: Data sources: PubMed, EMBASE, SCOPUS, and Cochrane. Study selection: Clinical trials of VNS in animal models and humans with TBI and SCI were included to evaluate the effects of pairing VNS with rehabilitation therapy on motor recovery. Data extraction: Two reviewers independently assessed articles according to the evaluation criteria and extracted relevant data electronically. Data synthesis: Twenty-nine studies were included; 11 were animal models of stroke, TBI, and SCI, and eight involved humans with stroke. While there was heterogeneity in methods of delivering VNS with respect to rehabilitation therapy in animal studies and human non-invasive studies, a similar methodology was used in all human-invasive VNS studies. In animal studies, pairing VNS with rehabilitation therapy consistently improved motor outcomes compared to controls. Except for one study, all human invasive and non-invasive studies with controls demonstrated a trend toward improvement in motor outcomes compared to sham controls post-intervention. However, compared to non-invasive, invasive VNS, studies reported severe adverse events such as vocal cord palsy, dysphagia, surgical site infection, and hoarseness of voice, which were found to be related to surgery. Conclusion: Our review suggests that VNS (non-invasive or invasive) paired with rehabilitation can improve motor outcomes after stroke in humans. Hence, VNS human studies are needed in people with TBI and SCI. There are risks related to device implantation to deliver invasive VNS compared to non-invasive VNS. Future human comparison studies are required to study and quantify the efficacy vs. risks of paired VNS delivered via different methods with rehabilitation, which would allow patients to make an informed decision. Systematic review registration: https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=330653.

Obstructive sleep apnea may induce sleep-wake cycle dysregulation: An actigraphic study.

Obstructive sleep apnea (OSA) causes sleep fragmentation and excessive daytime sleepiness (EDS). OSA has been hypothesised to impair the circadian sleep-wake rhythm, and this dysregulation may in turn exacerbate OSA-related diurnal symptoms. Hence, this study aimed to assess the sleep-wake rhythm through actigraphy, and its relationship with EDS in patients with untreated OSA. Patients with moderate-severe OSA (apnea-hypopnea index ≥15/h) and healthy controls (HC) underwent a 7-day actigraphic recording to evaluate the sleep-wake rhythm. Participants underwent a sleep medicine visit and completed the self-report questionnaires assessing EDS (Epworth sleepiness scale, ESS), sleep quality (Pittsburgh sleep quality index, PSQI), and chronotype (morningness-eveningness questionnaire, MEQ). This study included 48 OSA patients (72.9% males; mean age 56.48 ± 9.53 years), and 22 HC (45.5% males; mean age 53.73 ± 18.20 years). After controlling for MEQ scores, actigraphic recording showed that the OSA patients present a lower sleep time (p = 0.011) and sleep efficiency (p = 0.013), as well as a higher sleep latency (p = 0.047), and sleep fragmentation (p = 0.029) than the HC. Regarding the sleep-wake rhythm actigraphic parameters, the OSA patients showed a lower average activity during the most active 10-hour period (p = 0.036) and a lower day/night activity ratio (p = 0.007) than the HC. Patients with OSA also reported higher ESS (p = 0.005) and PSQI scores (p < 0.001), and a chronotype less of morning type (p = 0.027) than the HC. In conclusion, this study documented a reduced diurnal motor activity and lower day/night activity ratio in OSA patients than in controls. These findings suggest a dysregulation of the circadian sleep-wake rhythm in OSA, possibly related to both EDS and reduced daytime motor activity.

Effects of Therapies Involving Plyometric-Jump Training on Physical Fitness of Youth with Cerebral Palsy: A Systematic Review with Meta-Analysis.

The aim of this systematic review was to assess the effects of plyometric-jump training (PJT) on the physical fitness of youth with cerebral palsy (CP) compared with controls (i.e., standard therapy). The PRISMA 2020 guidelines were followed. Eligibility was assessed using the PICOS approach. Literature searches were conducted using the PubMed, Web of Science, and SCOPUS databases. Methodological study quality was assessed using the PEDro scale. Data were meta-analyzed by applying a random-effects model to calculate Hedges' g effect sizes (ES), along with 95% confidence intervals (95% CI). The impact of heterogeneity was assessed (I2 statistic), and the certainty of evidence was determined using the GRADE approach. Eight randomized-controlled studies with low-to-moderate methodological quality were included, involving male (n = 225) and female (n = 138) youth aged 9.5 to 14.6 years. PJT interventions lasted between 8 and 12 weeks with 2-4 weekly sessions. Compared with controls, PJT improved the muscle strength (ES = 0.66 [moderate], 95% CI = 0.36-0.96, p < 0.001, I2 = 5.4%), static (ES = 0.69 [moderate], 95% CI= 0.33-1.04, p < 0.001, I2 = 0.0%) and dynamic balance (ES = 0.85 [moderate], 95% CI = 0.12-1.58, p = 0.023, I2 = 81.6%) of youth with CP. Therefore, PJT improves muscle strength and static and dynamic balance in youth with CP compared with controls. However, more high-quality randomized-controlled trials with larger sample sizes are needed to provide a more definitive recommendation regarding the use and safety of PJT to improve measures of physical fitness.

Measuring Active Transportation on National Health Surveys in Canada From 1994 to 2020.

BACKGROUND: Active transportation (AT), described as self-powered modes of travel (eg, walking and cycling), is an important source of health-promoting physical activity. While AT behaviors have been measured on national health surveys in Canada for over 2 decades, historic prevalence has not been previously reported. We aimed to document the measures of AT on Canada's various national health surveys, examine AT over time, and interpret them within the context of evolving methods of assessment. METHODS: We compiled and summarized the questions used to measure AT among Canadians on 4 national health surveys: National Population Health Survey (1994-1998), Canadian Community Health Survey (2000-2020), Canadian Health Measures Survey (2007-2019), and the Health Behaviour in School-aged Children Study (2010-2018). Among youth and adults (12+ y), we summarized over time: (1) the prevalence of AT participation and (2) time spent in AT (in hours per week) among those who report any AT participation. Where possible, we reported separate estimates of walking and cycling and produced an aggregate estimate of total AT. We stratified results by age group and sex. RESULTS: Changes in AT survey questions over time and between surveys limit the interpretation and comparability of temporal trends. Nevertheless, a consistently higher proportion of females report walking, while a higher proportion of males report cycling. Irrespective of mode, males report spending more total time in AT. Participation in AT tends to decrease with age, with youth reporting the highest rates of AT and young adults often spending the most time in AT. CONCLUSIONS: Monitoring trends in AT can help assess patterns of behavior and identify whether promotion strategies are needed or whether population interventions are effective. Our evaluation of AT over time is limited by questions surveyed; however, consistent differences in AT by age and sex are evident over time. Moving forward, ensuring consistency of AT measurement over time is essential to monitoring this important behavior.

Translation, validity and reliability of the persian version of the rapid assessment of physical activity questionnaire.

PURPOSE: The purpose of this study was to produce a valid and reliable Persian version of the Rapid Assessment of Physical Activity (RAPA) questionnaire, which previously has been shown to be valid and reliable for assessing physical activity among older adults. METHODS: Permission was obtained from the scale developer, who provided a copy of the the Linguistic Validation of the RAPA Qestionnaire, which utilizes a forward-backward translation methodology. Content validity, face validity, and construct validity of the questionnaire were then determined. Comparison of known groups (older adults with more or less than 50% balance confidence) was used to assess construct validity and the Leiden-Padua (LEIPAD) quality of life questionnaire were used to assess convergent validity. Three hundred older adults, who were members of the Qom retirement centers, participated in the study. Thirty participants completed the RAPA twice with a one-week interval to determine test-retest reliability. RESULTS: Results of comparisons of known groups showed that the mean RAPA score of the older people with greater balance confidence was significantly higher. Significant correlations between most of the scores obtained from both RAPA and the LEIPAD questionnaires confirmed the convergent validity of the questionnaire. Intraclass Correlation Coefficient (ICC) was as high as 0.94 showing that the test-retest reliability was good. CONCLUSION: This study showed the Persian RAPA is a reliable and valid instrument for measuring physical activity among older individuals in both research and clinical contexts.