ASSOCIAÇÃO ENTRE DECLÍNIO COGNITIVO, SINTOMAS DEPRESSIVOS E DO MEDO DE CAIR COM A VELOCIDADE DA MARCHA CONFORTÁVEL EM IDOSOS COMUNITÁRIOS

Diminuições na velocidade da marcha (VM) estão associadas a desfechos adversos na saúde física e mental em idosos. Assim, torna-se relevante identificar fatores que podem associar-se com a VMconfortável em idosos, de forma a propor estratégias para prevenção de alterações na mobilidade. Objetivo: verificar a associação entre declínio cognitivo, sintomas depressivos e do medo de cair com a VM confortável em idosos comunitários. Métodos: tratou-se de um estudo transversal, com amostra probabilística, incluindo 308 idosos comunitários. O desfecho do estudo foi a VM confortável, sendo considerado como baixo desempenho VM < 0,8m/s. As variáveis preditoras foram 1) declínio cognitivo avaliado pelo Mini Exame do Estado Mental, 2) sintomas depressivos avaliados com a Escala de Depressão Geriátrica Abreviada e 3) medo de cair avaliado pela FallsEfficacy Scale – Brasil. Para analisar a associação entre as variáveis foi utilizada a Regressão Logística Multivariada. Resultados: idosos tiveram chances significativamente maiores de apresentar baixodesempenho na VM confortável quando apresentaram declínio cognitivo (OR: 4,67; IC95%: 1,68; 12,94), sintomas depressivos (OR: 2,90; IC95%: 1,42; 5,92) e medo de cair (OR: 4,08; IC95%: 1,72;9,71) quando comparados aos que não tiveram essas condições. Conclusão: o declínio cognitivo, sintomas depressivos e medo de cair foram associados ao baixo desempenho na VM confortável nos idosos amostrados. Esses achados podem servir para identificação precoce dos fatores que estão associados a alterações na VM confortável, contribuindo para a proposição de estratégias públicas em saúde e no direcionamento de atividades de promoção em saúde para idosos comunitários

Pervasive gaps in Amazonian ecological research

Biodiversity loss is one of the main challenges of our time,1,2 and attempts to address it require a clear un derstanding of how ecological communities respond to environmental change across time and space.3,4 While the increasing availability of global databases on ecological communities has advanced our knowledge of biodiversity sensitivity to environmental changes,5–7 vast areas of the tropics remain understudied.8–11 In the American tropics, Amazonia stands out as the world’s most diverse rainforest and the primary source of Neotropical biodiversity,12 but it remains among the least known forests in America and is often underrepre sented in biodiversity databases.13–15 To worsen this situation, human-induced modifications16,17 may elim inate pieces of the Amazon’s biodiversity puzzle before we can use them to understand how ecological com munities are responding. To increase generalization and applicability of biodiversity knowledge,18,19 it is thus crucial to reduce biases in ecological research, particularly in regions projected to face the most pronounced environmental changes. We integrate ecological community metadata of 7,694 sampling sites for multiple or ganism groups in a machine learning model framework to map the research probability across the Brazilian Amazonia, while identifying the region’s vulnerability to environmental change. 15%–18% of the most ne glected areas in ecological research are expected to experience severe climate or land use changes by 2050. This means that unless we take immediate action, we will not be able to establish their current status, much less monitor how it is changing and what is being lostinfo:eu-repo/semantics/publishedVersio

Pervasive gaps in Amazonian ecological research

Biodiversity loss is one of the main challenges of our time,1,2 and attempts to address it require a clear understanding of how ecological communities respond to environmental change across time and space.3,4 While the increasing availability of global databases on ecological communities has advanced our knowledge of biodiversity sensitivity to environmental changes,5,6,7 vast areas of the tropics remain understudied.8,9,10,11 In the American tropics, Amazonia stands out as the world's most diverse rainforest and the primary source of Neotropical biodiversity,12 but it remains among the least known forests in America and is often underrepresented in biodiversity databases.13,14,15 To worsen this situation, human-induced modifications16,17 may eliminate pieces of the Amazon's biodiversity puzzle before we can use them to understand how ecological communities are responding. To increase generalization and applicability of biodiversity knowledge,18,19 it is thus crucial to reduce biases in ecological research, particularly in regions projected to face the most pronounced environmental changes. We integrate ecological community metadata of 7,694 sampling sites for multiple organism groups in a machine learning model framework to map the research probability across the Brazilian Amazonia, while identifying the region's vulnerability to environmental change. 15%–18% of the most neglected areas in ecological research are expected to experience severe climate or land use changes by 2050. This means that unless we take immediate action, we will not be able to establish their current status, much less monitor how it is changing and what is being lost

The Anxiety Inventory for Respiratory Disease (AIR): adaptação transcultural e investigação das propriedades psicométricas para o Brasil para uso em pacientes com Doença Pulmonar Obstrutiva Crônica

Seminário de Iniciação Científica e Tecnológica Universidade Federal de Santa Catarina Centro de Ciências, Tecnologias e Saúde (CTS) FisioterapiaIntrodução: A doença pulmonar obstrutiva crônica (DPOC) gera efeitos extrapulmonares importantes, incluindo a ansiedade, condição subdiagnosticada nesta população. Assim, instrumentos específicos para a avaliação da ansiedade tornam-se importantes. Objetivo: Investigar a validade de constructo convergente e divergente do Inventário de Ansiedade para Doenças Respiratórias (IAR) no formato de entrevista telefônica em pacientes com DPOC. Métodos: Após leitura do TCLE e anuência para participação, os participantes responderam a ficha de anamnese, o COPD Assessment Test (CAT) e a escala do Medical Research Council modificada (mMRC) para fins de caracterização. Em seguida, foram aplicados o IAR, a Hospital Anxiety and Depression Scale (HADS) e a escala London Chest Activity of Daily Living (LCADL), em ordem aleatorizada. A correlação entre os escores das escalas foi determinada pelo coeficiente de correlação de Spearman, com nível de significância de 5%. Resultados: Foram avaliados até o momento 34 indivíduos [mediana de idade 65 (P25-75 61-66,5) anos; 18 do sexo masculino]. As correlações entre o IAR e os escores da HADS total (rho=0,86, p=0,0007), domínio depressão (rho=0,83, p=0,0001) e ansiedade (rho=0,82,p=0,0004) foram de magnitude alta. A correlação entre o IAR e a LCADL foi de magnitude fraca (rho=0,39, p=0,0007). Conclusão: O IAR apresentou excelentes índices de validade convergente quando correlacionado a HADS e o coeficiente de correlação com a LCADL foi baixo, atestando adequada validade divergente. Em decorrência da pandemia pela COVID-19, houve necessidade de ajuste do objetivo do estudo, que a princípio seria a investigação das propriedades do IAR na forma de entrevista presencial. Destaca-se que, em virtude da pandemia, a investigação das propriedades de medida de diferentes formas de aplicação das escalas tornou-se importante devido ao crescimento da telereabilitação e a necessidade de instrumentos de avaliação validados para aplicação a distância

ASSOCIAÇÃO ENTRE DECLÍNIO COGNITIVO, SINTOMAS DEPRESSIVOS E DO MEDO DE CAIR COM A VELOCIDADE DA MARCHA CONFORTÁVEL EM IDOSOS COMUNITÁRIOS

Diminuições na velocidade da marcha (VM) estão associadas a desfechos adversos na saúde física e mental em idosos. Assim, torna-se relevante identificar fatores que podem associar-se com a VMconfortável em idosos, de forma a propor estratégias para prevenção de alterações na mobilidade. Objetivo: verificar a associação entre declínio cognitivo, sintomas depressivos e do medo de cair com a VM confortável em idosos comunitários. Métodos: tratou-se de um estudo transversal, com amostra probabilística, incluindo 308 idosos comunitários. O desfecho do estudo foi a VM confortável, sendo considerado como baixo desempenho VM < 0,8m/s. As variáveis preditoras foram 1) declínio cognitivo avaliado pelo Mini Exame do Estado Mental, 2) sintomas depressivos avaliados com a Escala de Depressão Geriátrica Abreviada e 3) medo de cair avaliado pela FallsEfficacy Scale – Brasil. Para analisar a associação entre as variáveis foi utilizada a Regressão Logística Multivariada. Resultados: idosos tiveram chances significativamente maiores de apresentar baixodesempenho na VM confortável quando apresentaram declínio cognitivo (OR: 4,67; IC95%: 1,68; 12,94), sintomas depressivos (OR: 2,90; IC95%: 1,42; 5,92) e medo de cair (OR: 4,08; IC95%: 1,72;9,71) quando comparados aos que não tiveram essas condições. Conclusão: o declínio cognitivo, sintomas depressivos e medo de cair foram associados ao baixo desempenho na VM confortável nos idosos amostrados. Esses achados podem servir para identificação precoce dos fatores que estão associados a alterações na VM confortável, contribuindo para a proposição de estratégias públicas em saúde e no direcionamento de atividades de promoção em saúde para idosos comunitários

Arboviruses in Free-Ranging Birds and Hematophagous Arthropods (Diptera, Nematocera) from Forest Remnants and Urbanized Areas of an Environmental Protection Area in the Amazon Biome

The rapid and disorderly urbanization in the Amazon has resulted in the insertion of forest fragments into cities, causing the circulation of arboviruses, which can involve hematophagous arthropods and free-ranging birds in the transmission cycles in urban environments. This study aimed to evaluate the circulation of arboviruses in free-ranging birds and hematophagous arthropods captured in an Environmental Protection Area in the Belem metropolitan area, Brazil. Birds were captured using mist nets, and hematophagous arthropods were collected using a human protected attraction technique and light traps. The birds’ sera were subjected to a hemagglutination inhibition test to detect antibodies against 29 arbovirus antigens. Arthropod macerates were inoculated into C6/36 and VERO cell cultures to attempt viral isolation and were tested using indirect immunofluorescence, subsequent genetic sequencing and submitted for phylogenetic analysis. Four bird sera were positive for arbovirus, and one batch of Psorophora ferox was positive for Flavivirus on viral isolation and indirect immunofluorescence. In addition, the Ilheus virus was detected in the sequencing and phylogenetic analysis. The presence of antibodies in sera from free-ranging birds and the isolation of Ilheus virus in Psorophora ferox indicate the circulation of arboviruses in forest remnants in the urban center of Belem

Clinical manifestations of intermediate allele carriers in Huntington disease

Objective: There is controversy about the clinical consequences of intermediate alleles (IAs) in Huntington disease (HD). The main objective of this study was to establish the clinical manifestations of IA carriers for a prospective, international, European HD registry. Methods: We assessed a cohort of participants at risk with <36 CAG repeats of the huntingtin (HTT) gene. Outcome measures were the Unified Huntington's Disease Rating Scale (UHDRS) motor, cognitive, and behavior domains, Total Functional Capacity (TFC), and quality of life (Short Form-36 [SF-36]). This cohort was subdivided into IA carriers (27-35 CAG) and controls (<27 CAG) and younger vs older participants. IA carriers and controls were compared for sociodemographic, environmental, and outcome measures. We used regression analysis to estimate the association of age and CAG repeats on the UHDRS scores. Results: Of 12,190 participants, 657 (5.38%) with <36 CAG repeats were identified: 76 IA carriers (11.56%) and 581 controls (88.44%). After correcting for multiple comparisons, at baseline, we found no significant differences between IA carriers and controls for total UHDRS motor, SF-36, behavioral, cognitive, or TFC scores. However, older participants with IAs had higher chorea scores compared to controls (p 0.001). Linear regression analysis showed that aging was the most contributing factor to increased UHDRS motor scores (p 0.002). On the other hand, 1-year follow-up data analysis showed IA carriers had greater cognitive decline compared to controls (p 0.002). Conclusions: Although aging worsened the UHDRS scores independently of the genetic status, IAs might confer a late-onset abnormal motor and cognitive phenotype. These results might have important implications for genetic counseling. ClinicalTrials.gov identifier: NCT01590589

Clinical and genetic characteristics of late-onset Huntington's disease

Background: The frequency of late-onset Huntington's disease (&gt;59 years) is assumed to be low and the clinical course milder. However, previous literature on late-onset disease is scarce and inconclusive. Objective: Our aim is to study clinical characteristics of late-onset compared to common-onset HD patients in a large cohort of HD patients from the Registry database. Methods: Participants with late- and common-onset (30–50 years)were compared for first clinical symptoms, disease progression, CAG repeat size and family history. Participants with a missing CAG repeat size, a repeat size of ≤35 or a UHDRS motor score of ≤5 were excluded. Results: Of 6007 eligible participants, 687 had late-onset (11.4%) and 3216 (53.5%) common-onset HD. Late-onset (n = 577) had significantly more gait and balance problems as first symptom compared to common-onset (n = 2408) (P &lt;.001). Overall motor and cognitive performance (P &lt;.001) were worse, however only disease motor progression was slower (coefficient, −0.58; SE 0.16; P &lt;.001) compared to the common-onset group. Repeat size was significantly lower in the late-onset (n = 40.8; SD 1.6) compared to common-onset (n = 44.4; SD 2.8) (P &lt;.001). Fewer late-onset patients (n = 451) had a positive family history compared to common-onset (n = 2940) (P &lt;.001). Conclusions: Late-onset patients present more frequently with gait and balance problems as first symptom, and disease progression is not milder compared to common-onset HD patients apart from motor progression. The family history is likely to be negative, which might make diagnosing HD more difficult in this population. However, the balance and gait problems might be helpful in diagnosing HD in elderly patients