Effects of age and fatigue on human gait

When healthy humans walk in a real-life environment, there could be many distractions that can perturb walking. The ability to adjust walking to such perturbations can prevent a loss of balance, trips, and falls. Aging affects the ability to adjust gait to perturbations. One type of perturbation is fatigability that limits the capacity to allocate internal resources and may require age-specific adjustments in gait. This thesis has examined whether and how healthy older adults who do not otherwise report being tired, adjust their gait to fatigability. Firstly, we reviewed studies and concluded that the underlying mechanism of fatigability’s effect on older adults’ gait remains unclear. Therefore, we developed an experimental model in which older and younger adults walked on a treadmill before and after induced mental (demanding mental tasks) and muscle fatigability (repetitive sit-to-stand – rSTS). We measured the strides outcomes and its variability, dynamics features of gait, and neuromuscular control during walking. We also examined the muscle activation during rSTS and maximal voluntary isometric force (MVIF) before and after rSTS to verify the suitability of rSTS in inducing muscle fatigability. Surprisingly, we found minimal effects of muscle and mental fatigability on stride outcomes and gait variability. Mental performance fatigability appears to affect gait only during dual-task walking. Such minimal effects generated by muscle fatigability were accompanied by only subtle changes induced by rSTS on muscle activation and MVIF. However, rSTS induced age-specific changes in the neuromuscular control, which might have compensated for fatigue to maintain older adults’ gait performance

Association of Social Data

According to the ILO International Labour Organisation about 218 million children between 5 and 17 years working in the world of which 50 have jobs at risk On the basis of this information arising questions on how to understand and find the factors that comprise the ratings of child labour and which properties are important to analyze these cases With the use of data mining techniques to find valid patterns on Brazilian social databases were evaluated data of child labour in the State of Tocantins located north of Brazil with a territory of 277 thousand and composed of 139 cities This work aims to identify factors that are deterministic to the practice of child labour and their relationships with financial indicators educational social and regional generating information that are not explicit in the Government database thus enabling a better monitoring and updating policies to that en

Significance of interactions between microplastics and POPs in the marine environment: a critical overview

The presence of plastic debris in the ocean is increasing and several effects in the marine environment have been reported. A great number of studies have demonstrated that microplastics (MPs) adsorb organic compounds concentrating them several orders of magnitude than the levels found in their surrounding environment, therefore they could be potential vectors of these contaminants to biota. However, a consensus on MPs as vectors of persistent organic pollutants (POPs) has not been reached since are opposing views among different researchers on this topic. However, all agree that more extensive studies are needed to clarify this relationship. This review reunites information reporting the factors that drive the sorption dynamics between MPs and POPs, which essentially corresponds to polymer properties and surrounding environmental variables. Furthermore, this review highlights several supporting and rebuttal arguments in the direction to clear up the real hazard enforced by the presence of MPs in marine environments.publishe

Predictive Response Value of Pre- and Postchemoradiotherapy Variables in Rectal Cancer: An Analysis of Histological Data

Background. Neoadjuvant chemoradiotherapy (nCRT) followed by curative surgery in locally advanced rectal cancer (LARC) improves pelvic disease control. Survival improvement is achieved only if pathological response occurs. Mandard tumor regression grade (TRG) proved to be a valid system to measure nCRT response. Potential predictive factors for Mandard response are analyzed. Materials and Methods. 167 patients with LARC were treated with nCRT and curative surgery. Tumor biopsies and surgical specimens were reviewed and analyzed regarding mitotic count, necrosis, desmoplastic reaction, and inflammatory infiltration grade. Surgical specimens were classified according to Mandard TRG. The patients were divided as "good responders" (Mandard TRG1-2) and "bad responders" (Mandard TRG3-5). According to results from our previous data, good responders have better prognosis than bad responders. We examined predictive factors for Mandard response and performed statistical analysis. Results. In univariate analysis, distance from anal verge and ten other postoperative variables related with nCRT tumor response had predictive value for Mandard response. In multivariable analysis only mitotic count, necrosis, and differentiation grade in surgical specimen had predictive value. Conclusions. There is a lack of clinical and pathological preoperative variables able to predict Mandard response. Only postoperative pathological parameters related with nCRT response have predictive value.info:eu-repo/semantics/publishedVersio

Tumor regression grades: can they influence rectal cancer therapy decision tree?

BACKGROUND: Evaluating impact of tumor regression grade in prognosis of patients with locally advanced rectal cancer (LARC). MATERIALS AND METHODS: We identified from our colorectal cancer database 168 patients with LARC who received neoadjuvant therapy followed by complete mesorectum excision surgery between 2003 and 2011: 157 received 5-FU-based chemoradiation (CRT) and 11 short course RT. We excluded 29 patients, the remaining 139 were reassessed for disease recurrence and survival; the slides of surgical specimens were reviewed and classified according to Mandard tumor regression grades (TRG). We compared patients with good response (Mandard TRG1 or TRG2) versus patients with bad response (Mandard TRG3, TRG4, or TRG5). Outcomes evaluated were 5-year overall survival (OS), disease-free survival (DFS), local, distant and mixed recurrence. RESULTS: Mean age was 64.2 years, and median followup was 56 months. No statistically significant survival difference was found when comparing patients with Mandard TRG1 versus Mandard TRG2 (p = .77). Mandard good responders (TRG1 + 2) have significantly better OS and DFS than Mandard bad responders (TRG3 + 4 + 5) (OS p = .013; DFS p = .007). CONCLUSIONS: Mandard good responders had a favorable prognosis. Tumor response (TRG) to neoadjuvant chemoradiation should be taken into account when defining the optimal adjuvant chemotherapy regimen for patients with LAR

Attention deficit and hyperactivity disorder: case series of a secondary center

Introdução: A Perturbação de Hiperatividade e Défice de Atenção (PHDA) é o distúrbio neuro comportamental mais frequente em crianças em idade escolar e caracteriza-se pela dificuldade em controlar a atividade motora, a impulsividade e dificuldade em controlar a atenção. Objetivos: Caracterização das crianças com PHDA seguidas num hospital distrital. Material e Métodos: Estudo retrospetivo de crianças com o diagnóstico de PHDA. Analisadas as variáveis: idade, sexo, antecedentes familiares e pessoais, sintomatologia, co morbilidades, tratamento e resposta terapêutica. Resultados: Analisadas 45 crianças, 75,5 % do sexo masculino. À data do diagnóstico, 62,2 % das crianças apresentavam entre cinco e oito anos. Antecedentes familiares relacionados com PHDA foram identificados em 40% dos casos. Em 44,5%, a referenciação foi efetuada pela consulta de Pediatria Geral, sendo os motivos mais frequentes as dificuldades da aprendizagem (37,8%) e as alterações do comportamento (35,5%). A maioria das crianças (55,5%) apresentava associação de hiperatividade e défice de atenção. Realizada avaliação cognitiva em 90%, sendo que 39% apresentaram coeficiente intelectual inferior ao normal. As co morbilidades mais frequentes foram: alterações da linguagem, ansiedade, distúrbios de oposição/desafio. O tratamento com metilfenidato foi iniciado em 95%, com efeitos laterais em 16,3 %. Em 80% a resposta ao tratamento foi favorável. Conclusão: A PHDA apresenta elevada incidência em rapazes com idades entre os cinco e os oito anos, com predomínio do tipo misto. As dificuldades da aprendizagem e as alterações do comportamento são habitualmente o motivo de consulta. A intervenção com abordagem multidisciplinar e farmacológica demonstrou resultados favoráveis

Heart Rate Variability during Plateau Waves of Intracranial Pressure: a pilot descriptive study

This study aims to describe heart rate variability during the first episode of plateau waves of intracranial pressure (ICP) in Traumatic Brain Injury (TBI) in order to characterize and identify at bedside this cerebrovascular phenomenon. The general behavior of the heart rate variability (HRV) spectral measures expressed in the medians across patients is concordant with an increased HRV in the latter part of the baseline and plateau wave, followed by a decrease after the event and a new increase during the recovery. In low and high frequency bands the same increase is more marked in the parametric analysis. Interpretation of HRV may help clinicians to better identify the plateau waves and allow earlier management

Gut immune dysfunction through impaired innate pattern recognition receptor expression and gut microbiota dysbiosis in chronic SIV infection.

HIV targets the gut mucosa early in infection, causing immune and epithelial barrier dysfunction and disease progression. However, gut mucosal sensing and innate immune signaling through mucosal pattern recognition receptors (PRRs) during HIV infection and disease progression are not well defined. Using the simian immunodeficiency virus (SIV)-infected rhesus macaque model of AIDS, we found a robust increase in PRRs and inflammatory cytokine gene expression during the acute SIV infection in both peripheral blood and gut mucosa, coinciding with viral replication. PRR expression remained elevated in peripheral blood following the transition to chronic SIV infection. In contrast, massive dampening of PRR expression was detected in the gut mucosa, despite the presence of detectable viral loads. Exceptionally, expression of Toll-like receptor 4 (TLR4) and TLR8 was downmodulated and diverged from expression patterns for most other TLRs in the gut. Decreased mucosal PRR expression was associated with increased abundance of several pathogenic bacterial taxa, including Pasteurellaceae members, Aggregatibacter and Actinobacillus, and Mycoplasmataceae family. Early antiretroviral therapy led to viral suppression but only partial maintenance of gut PRRs and cytokine gene expression. In summary, SIV infection dampens mucosal innate immunity through PRR dysregulation and may promote immune activation, gut microbiota changes, and ineffective viral clearance