Strategic Insight and Age-Related Goal-Neglect Influence Risky Decision-Making

Maximizing long-run gains often requires taking on some degree of risk, yet decision-makers often exhibit risk aversion (RA), rejecting risky prospects even when these have higher expected value (EV) than safer alternatives. We investigated whether explicit strategy instruction and practice can decrease prepotent RA, and whether aging impacts the efficacy of such an intervention. Participants performed a paired lottery task with options varying in risk and magnitude, both before and after practice with a similar task that encouraged maximization of EV and instruction to use this strategy in risky decisions. In both younger and older adults (OAs), strategy training reduced RA. Although RA was age-equivalent at baseline, larger training effects were observed in younger adults (YAs). These effects were not explained by risk-related (i.e., affective) interference effects or computation ability, but were consistent with a progressive, age-related neglect of the strategy across trials. Our findings suggest that strategy training can diminish RA, but that training efficacy is reduced among OAs, potentially due to goal neglect. We discuss implications for neural mechanisms that may distinguish older and YAs’ risky decision-making

Virtual reality gaming in rehabilitation after musculoskeletal injur: user experience pilot study

The purposes of this study were twofold: (1) to describe a new technological solution for the rehabilitation of musculoskeletal injuries based on virtual reality (VR) gaming, and (2) to analyze the variation in rated perceived exertion (RPE) and heart rate (HR) of the participants when undergoing a rehabilitation session based on different VR games. Thirty-seven participants aged 23.7 ± 7.0 years tested during five customized VR games to provide a complete rehabilitation session after a musculoskeletal injury. The results of the Friedman test indicated a statistically significant difference in RPE scale and HR across the five VR games throughout a complete rehabilitation session (χ2 (4, n = 35) = 75.59; p < 0.001 and χ2 (4, n = 35) = 27.75, p < 0.001, respectively). RPE and HR increased significantly from Game 1 to Game 2 (z = –5.16, p < 0.001), from Game 1 to Game 3 (z = – 5.05, p < 0.001), from Game 1 to Game 4 (z = –4.87, p < 0.001), and from Game 1 to Game 5 (z = –3.61, p < 0.001). Moreover, the results showed a high perceived usability of the system, greater intrinsic motivation to perform the rehabilitation exercises, a high level of immersion, and a good experience in the VR gaming environment. Our study stimulates extended intervention programs following up on this immersive virtual reality rehabilitation system to support soccer players recovering from musculoskeletal injuries.info:eu-repo/semantics/publishedVersio

Evaluation of medications prescribed to in a geriatric outpatient clinic

O estudo teve como objetivo analisar e descrever o perfil das prescrições de medicamentos realizadas aos idosos atendidos no ambulatório de geriatria de um hospital universitário. Trata-se de pesquisa descritiva e transversal, realizada com 194 prontuários de usuários atendidos no período de 2006 a 2012. Verificou-se prevalência do sexo feminino, faixa etária entre 71 e 80 anos e idosos casados. Observou-se o número médio de três comorbidades (dp=1,7), com prevalência no aparelho circulató- rio. O consumo médio de medicamentos foi de 4,78 (dp=2,63), porém 49% dos idosos estavam em polifarmácia, considerando a segunda consulta ambulatorial. Além disso, o consumo de cinco ou mais medicamentos esteve mais relacionado aos idosos de 71 a 80 anos. Observou-se discreta readequação com elevação no número médio de medicamentos prescritos, coerentes com o número de doenças e faixa etária, além de possível condição do idoso no encaminhamento. O referido estudo aponta a necessidade de maior monitoramento daqueles em uso de mais de cinco medicamentos, bem como maior integração com a atenção primária à saúde na prescrição de medicamentos aos idosos, com vistas a reduzir a polifarmácia, eventos adversos, interação medicamentosa e alterações fisiológicas no geronteThe study aimed to analyze and describe the profile of the prescriptions of medicines carried out the elderly in geriatric outpatient clinic of a university hospital. It is a descriptive and transversal research, conducted with 194 charts of patients attended between 2006 and 2012. There was a verified female prevalence, the patients were mostly aged between 71 to 80 years and most of them were married. The average number of comorbidities was three (dp=1.7), most of them of the circulatory system. The average consumption of medicines was 4.78 (dp=2.63), but 49% of seniors were on polypharmacy as of the second ambulatory consultation. In addition, the consumption of five or more medicines were especially associated with the elderly of 71 to 80 years. A discrete elevation in the average number of prescribed medicines was observed, adequate to the number of illnesses and age group, besides the possible condition of the senior at the moment of his or her referral. This study points out the need for a greater monitoring of those using more than five medications, as well as for a better integration with primary health care when prescribing drugs for the elderly, in order to reduce polypharmacy, adverse events, drug interaction and physiological changes in elderly patient

Is intrauterine exposure to acetaminophen associated with emotional and hyperactivity problems during childhood? : findings from the 2004 Pelotas birth cohort

Background: Longitudinal studies have consistently reported that prenatal exposure to acetaminophen can to lead to an increased risk of attention deficit-hyperactivity disorder during childhood. This study aimed to investigate the association between intrauterine exposure to acetaminophen and the presence of emotional and behavioral problems at the ages of 6 and 11 years in a low-middle income country. Methods: We performed a prospective longitudinal population-based study using data from the 2004 Pelotas birth cohort. From the 4231 initial cohort participants, 3722 and 3566 children were assessed at 6 and 11 years of age, respectively. The outcomes were assessed using the parent version of Strengths and Difficulties Questionnaire (SDQ). The cut-off points established for the Brazilian population were used to categorize the outcomes. Crude and adjusted odds ratio were obtained through logistic regression. Results: Acetaminophen was used by 27.5% (95% confidence interval [CI]: 26.1–28.9) of the mothers at least once during pregnancy. The prevalence of emotional problems at 6 and 11 years was 13.6 and 19.9%, respectively. For hyperactivity problems, prevalence was 13.9 and 16.1%, respectively. Intrauterine exposure to acetaminophen increased the odds of having emotional (odds ratio [OR] = 1.47; 95% CI: 1.07–2.02) and hyperactivity/inattention (OR = 1.42; 95% CI: 1.06–1.92) problems in 6-year-old boys. At the age of 11, a small decrease in the effect was observed for both outcomes after adjustment: OR = 1.31 (95% CI: 0.99–1.73) for emotional problems and OR = 1.25 (95% CI: 0.95–1.65) for hyperactivity/inattention in boys. No association for any phenotypes at both ages was observed for girls. Conclusion: The effect of intrauterine exposure to acetaminophen in emotional and hyperactivity symptoms was dependent on sex in a Brazilian cohort. While it seemed to be important for boys, mainly at 6 years of age, for girls, no association was observed

Conhecendo Unidades de Conservação

Unidades de Conservação (UC) são espaços utilizados mundialmente como parte de estratégias para a proteção de paisagens naturais, ecossistemas, recursos naturais e sua biodiversidade associada. No Brasil, essas áreas são regidas por lei e categorizadas conforme as restrições de uso para atividades humanas. Em função da implementação, gestão e monitoramento da UC, surgem conflitos entre setores da sociedade com distintos interesses de natureza social, ambiental, política e econômica. Tais conflitos muitas vezes resultam do desconhecimento por parte da sociedade a respeito das Unidades de Conservação

Synergism/complementarity of recombinant adenoviral vectors and other vaccination platforms during induction of protective immunity against malaria

The lack of immunogenicity of most malaria antigens and the complex immune responses required for achieving protective immunity against this infectious disease have traditionally hampered the development of an efficient human malaria vaccine. The current boom in development of recombinant viral vectors and their use in prime-boost protocols that result in enhanced immune outcomes have increased the number of malaria vaccine candidates that access pre-clinical and clinical trials. In the frontline, adenoviruses and poxviruses seem to be giving the best immunization results in experimental animals and their mutual combination, or their combination with recombinant proteins (formulated in adjuvants and given in sequence or being given as protein/virus admixtures), has been shown to reach unprecedented levels of anti-malaria immunity that predictably will be somehow reproduced in the human setting. However, all this optimism was previously seen in the malaria vaccine development field without many real applicable results to date. We describe here the current state-of-the-art in the field of recombinant adenovirus research for malaria vaccine development, in particular referring to their use in combination with other immunogens in heterologous prime-boost protocols, while trying to simultaneously show our contributions and point of view on this subject

Impaired Innate Immunity in Tlr4−/− Mice but Preserved CD8+ T Cell Responses against Trypanosoma cruzi in Tlr4-, Tlr2-, Tlr9- or Myd88-Deficient Mice

The murine model of T. cruzi infection has provided compelling evidence that development of host resistance against intracellular protozoans critically depends on the activation of members of the Toll-like receptor (TLR) family via the MyD88 adaptor molecule. However, the possibility that TLR/MyD88 signaling pathways also control the induction of immunoprotective CD8+ T cell-mediated effector functions has not been investigated to date. We addressed this question by measuring the frequencies of IFN-γ secreting CD8+ T cells specific for H-2Kb-restricted immunodominant peptides as well as the in vivo Ag-specific cytotoxic response in infected animals that are deficient either in TLR2, TLR4, TLR9 or MyD88 signaling pathways. Strikingly, we found that T. cruzi-infected Tlr2−/−, Tlr4−/−, Tlr9−/− or Myd88−/− mice generated both specific cytotoxic responses and IFN-γ secreting CD8+ T cells at levels comparable to WT mice, although the frequency of IFN-γ+CD4+ cells was diminished in infected Myd88−/− mice. We also analyzed the efficiency of TLR4-driven immune responses against T. cruzi using TLR4-deficient mice on the C57BL genetic background (B6 and B10). Our studies demonstrated that TLR4 signaling is required for optimal production of IFN-γ, TNF-α and nitric oxide (NO) in the spleen of infected animals and, as a consequence, Tlr4−/− mice display higher parasitemia levels. Collectively, our results indicate that TLR4, as well as previously shown for TLR2, TLR9 and MyD88, contributes to the innate immune response and, consequently, resistance in the acute phase of infection, although each of these pathways is not individually essential for the generation of class I-restricted responses against T. cruzi

Vaccine Platforms Combining Circumsporozoite Protein and Potent Immune Modulators, rEA or EAT-2, Paradoxically Result in Opposing Immune Responses

Malaria greatly impacts the health and wellbeing of over half of the world's population. Promising malaria vaccine candidates have attempted to induce adaptive immune responses to Circumsporozoite (CS) protein. Despite the inclusion of potent adjuvants, these vaccines have limited protective efficacy. Conventional recombinant adenovirus (rAd) based vaccines expressing CS protein can induce CS protein specific immune responses, but these are essentially equivalent to those generated after use of the CS protein subunit based vaccines. In this study we combined the use of rAds expressing CS protein along with rAds expressing novel innate immune response modulating proteins in an attempt to significantly improve the induction of CS protein specific cell mediated immune (CMI) responses.BALB/cJ mice were co-vaccinated with a rAd vectors expressing CS protein simultaneous with a rAd expressing either TLR agonist (rEA) or SLAM receptors adaptor protein (EAT-2). Paradoxically, expression of the TLR agonist uncovered a potent immunosuppressive activity inherent to the combined expression of the CS protein and rEA. Fortunately, use of the rAd vaccine expressing EAT-2 circumvented CS protein's suppressive activity, and generated a fivefold increase in the number of CS protein responsive, IFNγ secreting splenocytes, as well as increased the breadth of T cells responsive to peptides present in the CS protein. These improvements were positively correlated with the induction of a fourfold improvement in CS protein specific CTL functional activity in vivo.Our results emphasize the need for caution when incorporating CS protein into malaria vaccine platforms expressing or containing other immunostimulatory compounds, as the immunological outcomes may be unanticipated and/or counter-productive. However, expressing the SLAM receptors derived signaling adaptor EAT-2 at the same time of vaccination with CS protein can overcome these concerns, as well as significantly improve the induction of malaria antigen specific adaptive immune responses in vivo