Body image dissatisfaction and experimental pressure pain sensitivity in a cohort of 13-year-old adolescents

Objective: We aimed to quantify the associations between body image (dis)satisfaction and pressure pain thresholds in adolescents, using data from Generation XXI, a population-based cohort study in Portugal. Methods: We assessed 1785 13-year old adolescents cross-sectionally. Body image satisfaction was measured using the Children's Figure Rating Scale. Pain detection and tolerance thresholds were assessed using cuff pressure algometry. We quantified the associations between body image categories (satisfied, prefers slightly thinner, prefers much thinner, and prefers heavier) and pain detection and tolerance thresholds using linear and logistic regression for continuous and binary (odds of achieving the highest distribution quarter) outcomes, respectively. Models were adjusted to pubertal stage and body mass index. Results: Adolescents who desired a heavier silhouette had lower pressure pain tolerance thresholds when compared to those who were satisfied (linear regression coefficient: −3.95; 95% confidence interval: −6.68, −1.21), which was more precise in boys (−3.51; −7.17, −0.08). Those adolescents also had lower odds of achieving the highest quarter of pressure pain tolerance threshold (odds ratio: 0.66; 0.48, 0.90), especially girls (0.58; 0.35, 0.98). Adolescents who desired much thinner silhouettes had lower odds of achieving the highest quarter of pressure pain tolerance (0.68; 0.46, 1.00), and this was clearer in girls (0.66; 0.48, 0.90). Pain detection thresholds did not show robust associations with body image dissatisfaction. Conclusion: Our study suggests an association between satisfaction with one's silhouette and pain tolerance in adolescents from the general population, arguing for an integrated approach to the assessment of body image and pain sensitivity. © 2022 The AuthorsThis study was funded by the European Regional Development Fund (ERDF) , through COMPETE 2020 Operational Programme ‘Competitiveness and Internationalization’ together with national funding from the Foundation for Science and Technology (FCT) - Portuguese Ministry of Science, Technology and Higher Education - through the projects “ STEPACHE - The pediatric roots of amplified pain: from contextual influences to risk stratification ” ( POCI-01-0145-FEDER-029087 , PTDC/SAU-EPI/29087/2017 ), “ Appetite regulation and obesity in childhood: a comprehensive approach towards understanding genetic and behavioural influences ” ( PTDC/SAU-EPI/30334/2017/ POCI-01-0145- FEDER-030334) , and by the Epidemiology Research Unit - Instituto de Saúde Pública, Universidade do Porto (EPIUnit) ( POCI-01-0145-FEDER-006862 ; UID/DTP/04750/2019 ; LA/P/0064/2020 ), Administração Regional de Saúde Norte (Regional Department of the Portuguese Ministry of Health) and Calouste Gulbenkian Foundation . This work was also supported by a research grant from FOREUM Foundation for Research in Rheumatology (Career Research Grant). Funding sources were not involved in the design, conduct, analysis or writing of the present results

Serum serotonin levels and bone in rheumatoid arthritis patients

In rheumatoid arthritis (RA), a disease characterized by bone loss, increased levels of serotonin have been reported. Recent studies have demonstrated a role for circulating serotonin as a regulator of osteoblastogenesis, inhibiting bone formation. Thus, we measured serum serotonin levels (SSL) in a Portuguese sample of 205 RA patients and related these to anthropometric variables, disease parameters, serum bone biomarkers, and bone mineral density (BMD) assessed by dual-energy X-ray absorptiometry at several sites (total proximal femur, lumbar spine, left hand, and left second proximal phalange). SSL were inversely associated with body mass index (BMI) in RA women (r = − 0.218; p = 0.005), independent of exposure to biologics and/or bisphosphonates. Among biologic naïves, there was an inverse association between SSL and osteoprotegerin in RA women (r = − 0.260; p = 0.022). Serum β-CTX and dickkopf-1 were strongly associated with SSL in RA men not treated with bisphosphonates (r = 0.590; p < 0.001/r = 0.387; p = 0.031, respectively). There was also an inverse association between SSL and sclerostin in RA men (r = − 0.374; p < 0.05), stronger among biologic naïve or bisphosphonates-unexposed RA men. In crude models, SSL presented as a significant negative predictor of total proximal femur BMD in RA women as well as in postmenopausal RA women. After adjustment for BMI, disease duration, and years of menopause, SSL remained a significant negative predictor of total proximal femur BMD only in postmenopausal RA women. Our data reinforce a role, despite weak, for circulating serotonin in regulating bone mass in RA patients, with some differences in terms of gender and anatomical sites.Associação Nacional de Reumatologia, the study sponsor, had no role in the study design; in the collection, analysis, and interpretation of the data; in the writing of the report; and in the decision to submit the paper for publication

Myocardial Perfusion in Rheumatoid Arthritis Patients: Associations with Traditional Risk Factors and Novel Biomarkers

Introduction. Cardiovascular (CV) diseases are a major cause of death in rheumatoid arthritis (RA) patients. Novel biomarkers [B-type natriuretic peptide (BNP); osteoprotegerin (OPG)/receptor activator of nuclear factor-kappa B ligand (RANKL) ratio; and dickkopf-1 (DKK-1)] have been used in CV risk assessment. We analysed, in established RA patients, the presence of silent myocardial ischemia and its association with clinical variables, BNP, and bone and atheroma biomarkers. Methods. From a single-center tertiary referral hospital, RA patients asymptomatic for CV disease were submitted to myocardial perfusion scintigraphy (MPS) under adenosine stress and biomarkers measurements. Logistic regression was used to estimate crude odds ratios (OR) and 95% confidence intervals (CI). Results. In 189 patients, perfusion defects were frequent (25%) and associated with BNP ≥ 100 pg/mL (OR = 5.68; 95% CI: 2.038–15.830), fourth log OPG/RANKL ratio quartile (OR = 2.88; 95% CI: 1.091–7.622), and DKK-1 ≥ 133 pmol/L (OR = 2.69; 95% CI: 1.058–6.840). Similar associations were confirmed in those with C-reactive protein > or ≤ 3 mg/L. No relationship was found with the majority of traditional CV factors nor with disease variables. Conclusions. Our results corroborated the hypothesis that MPS could reveal subclinical CV dysfunction, supported the utility of BNP measurements as a screening tool, and put in perspective the potential usefulness of complementary approaches in CV risk assessment in RA patients

A voltage-based approach for series high impedance fault detection and location in distribution systems using smart meters

High impedance faults (HIFs) have been a major concern for protecting distribution systems and public safety hazards when involving downed conductors. The deployment of smarter grids brings new technologies for smart monitoring, automation, and protection of distribution networks. This paper presents a new method for a series of HIF detection and location in primary distribution feeders, using voltage unbalance measurements collected from smart meters (SMs) installed at low-voltage end-users. The methodology was tested in MATLAB and Simulink through steady-state simulations of a typical 13.8 kV distribution system, under load unbalance and di erent fault scenarios. Results show that the proposed method is robust and accurate for the detection of blown fuses and broken conductors, with or without ground faults, located either at the source or the load-side. The ease of implementation in SM design, formulation of parameters, and reliable simulation results show potential real-life applications

Development of forest structure and leaf area in secondary forests regenerating on abandoned pastures in Central Amazonia

The area of secondary forest (SF) regenerating from pastures is increasing in the Amazon basin; however, the return of forest and canopy structure following abandonment is not well understood. This study examined the development of leaf area index (LAI), canopy cover, aboveground biomass, stem density, diameter at breast height (DBH), and basal area ( BA) by growth form and diameter class for 10 SFs regenerating from abandoned pastures. Biomass accrual was tree dominated, constituting >= 94% of the total measured biomass in all forests abandoned >= 4 to 6 yr. Vine biomass increased with forest age, but its relative contribution to total biomass decreased with time. The forests were dominated by the tree Vismia spp. (> 50%). Tree stem density peaked after 6 to 8 yr ( 10 320 stems per hectare) before declining by 42% in the 12- to 14-yr-old SFs. Small-diameter tree stems in the 1-5-cm size class composed > 58% of the total stems for all forests. After 12 to 14 yr, there was no significant leaf area below 150-cm height. Leaf area return (LAI = 3.2 after 12 to 14 yr) relative to biomass was slower than literature-reported recovery following slash-and-burn, where LAI can reach primary forest levels ( LAI = 4 - 6) in 5 yr. After 12 to 14 yr, the colonizing vegetation returned some components of forest structure to values reported for primary forest. Basal area and LAI were 50% - 60%, canopy cover and stem density were nearly 100%, and the rapid tree-dominated biomass accrual was 25% - 50% of values reported for primary forest. Biomass accumulation may reach an asymptote earlier than expected because of even-aged, monospecific, untiered stand structure. The very slow leaf area accumulation relative to biomass and to reported values for recovery following slash-and-burn indicates a different canopy development pathway that warrants further investigation of causes ( e. g., nutrient limitations, competition) and effects on processes such as evapotranspiration and soil water uptake, which would influence long-term recovery rates and have regional implications

Development and validation of psoriatic arthritis switch quality assessment tool (PASQAL)-an outcomes measurement tool to assess the quality of biologic switch decisions in psoriatic arthritis

Background: Switching between biologic therapies is a recommended strategy for Psoriatic Arthritis (PsA) patients that show an insufficient response or adverse events. Although the choice of the subsequent biologic may be dependent on many factors, assessing the quality of the switch decision is of utmost relevance. Objectives: To develop and validate two outcomes measurement tools (for patients with peripheral and axial PsA phenotypes) that address the quality of treatment decisions in PsA regarding the switch of biologic therapies in clinical practice. Methods: A Task Force and an Expert Panel were specifically assembled for this purpose. The Psoriatic Arthritis Switch Quality Assessment tool (PASQAL) de-velopment comprised a modified-Delphi method in a four-step procedure: 1) literature search and experts' opinion collection about quality indicators for PsA management; 2) Delphi design to address the development of the measurement tool; 3) three Delphi questionnaire rounds; 4) final consensus meeting. This phase resulted in the definition of two measurement tools, one to evaluate the quality of biologic switch in peripheral (pPASQAL) and another one in axial PsA (axPASQAL). For the validation of PASQAL, 12 experienced rheumatologists were asked to evaluate and classify the biologic switch of 80 clinical cases (40 with predominant peripheral and 40 with predominant axial PsA). Clinical judgement was defined to be the "gold standard" against which the performance of PASQAL was assessed. The results were used to assess tools' performance (sensitivity/specificity analysis) and the agreement between the tools and the gold standard (Cohen's kappa). Results: PASQAL consists of 6 domains (joint disease activity, dactylitis, enthesis, physical function, quality of life, and skin and nail manifestations), respective instruments and thresholds. The classification of the biologic switch was divided into three quality levels: "Good", based on treat-to-target thresholds; "Mode-rate", based on improvement from baseline; and the remaining as "Insufficient". pPASQAL was found to be highly sensitive (92%) with the "Good" quality level and specific (97%) with the "Insufficient" quality le vel. Whilst axPASQAL showed overall higher sensitivity and specificity for all quality levels, as well as a higher level of agreement between the tool and the gold standard than pPASQAL (k=0.87 vs k=0.71). Conclusion: PASQAL was developed and showed good criterion validity for the evaluation of the quality of switch in both peripheral and axial PsA phenotypes. These tools may be used in research as well as in clinical practice, to support rheumatologists in making more informed therapeutic decisions.publishersversionpublishe

DESENVOLVIMENTO E ANÁLISE SENSORIAL DE BARRA DE CEREAIS FORMULADAS COM INGREDIENTES REGIONAIS (MILHO E ERVA-MATE)

Nas últimas décadas, com a mudança no estilo de vida das pessoas, alimentos saudáveis e convenientes estão ganhando cada vez mais espaço no mercado, sendo as barras de cereais um bom exemplo desse tipo de produto. Considerando que 90% do consumo da erva-mate estão focados na forma de bebidas tradicionais como o tererê e o chimarrão e que a demanda de milho é ainda destinada principalmente à alimentação animal este trabalho visou agregar valor a estas matérias-primas regionais, buscando a inovação com o desenvolvimento de produtos diferenciados e que atendam a consumidores cada vez mais exigentes. Dentro deste contexto e considerando o crescimento do segmento de barras de cereais no setor de alimentos, este projeto desenvolveu barras de cereais aproveitando e valorizando matérias-primas regionais, para viabilizar o aumento da competitividade por meio da inovação tecnológica