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Stefanie De Jesus,1 Lyndsay Fitzgeorge,2 Karen Unsworth,3 David Massel,4,5 Neville Suskin,4,5 Harry Prapavessis,1 Michael Sanatani6 1Department of Kinesiology, The University of Western Ontario, 2School of Health Sciences, Fanshawe College, 3Cardiac Rehabilitation & Secondary Prevention Program, St. Joseph’s Hospital, 4Division of Cardiology & Program of Experimental Medicine, Schulich School of Medicine and Dentistry, University of Western Ontario, 5Lawson Health Research Institute, 6Department of Medical Oncology, Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON, Canada Purpose: Exercise is beneficial to quality of life after cancer treatment, yet few cancer survivors meet exercise guidelines. Our study sought to determine the feasibility of an oncology rehabilitation exercise program embedded within a cardiac rehabilitation program. Methods: Patients who rated their fatigue >4/10 after completion of adjuvant chemotherapy for breast cancer were screened for eligibility and the outcomes were assessed (Piper Fatigue Scale, Functional Assessment of Cancer Therapy-Breast [FACT-B], Edmonton Symptom Assessment System, body composition, stress test, and physical activity measurement [accelerometer]). Participants received individualized exercise prescription. Following the 16-week program, repeat assessment plus patient acceptance and satisfaction survey was completed. The primary end point was the composite of accrual rate >25%, program adherence >80%, and mean compliance with accelerometer use >80%. Results: Twenty of 24 screened patients consented to the study and completed the baseline assessment. Adherence was 30.3%. Mean accelerometer use was 3.88/7 days (78%). Fatigue at baseline was rated at 4.82/10, and at 3.59 (p = 0.09) after the intervention. Overall well-being (FACT-B) score changed from 92.7 to 98.3 (p = 0.05). There were no significant changes in body composition (except for bone mineral content), aerobic exercise capacity, or activity patterns. Conclusion: Although the primary outcome was not met, our study indicates that an oncology exercise rehabilitation program can be incorporated into an existing cardiac rehabilitation program. Based on feedback received, we propose that in order to achieve exercise goals, frequent, encouraging, and tailored feedback and group sessions to foster a sense of community may additionally be needed to strengthen adherence to a prescribed exercise program. Keywords: breast cancer rehabilitation, fatigue, exercise, community setting

FUNDAMENTOS: A eliminação transepidérmica de parasitas (ETEP) tem sido pouco estudada na doença de Jorge Lobo. OBJETIVOS: Identificar aspectos morfológicos da ETEP na doença de Jorge Lobo. MÉTODOS: Recortes de biópsias de doença de Jorge Lobo emblocados em parafina foram corados pela hematoxilina-eosina e examinados. Considerou-se como ETEP, exclusivamente, a presença de parasitas em estruturas epidérmicas. RESULTADOS: Foram incluídas no estudo 40 biópsias de 37 pacientes (31 homens e seis mulheres, média de idade 51,03 anos, variação 29-80 anos) realizadas em um período de 37 anos (1967-2003), das quais foram obtidos 511 cortes (média de 12,77 cortes por caso, variação 2-39 cortes por caso). Observou-se ETEP em 110/511 (21,52%) e não se observou em 401/511 cortes (78,48%) (p < 0,0001). Em relação aos pacientes (37), em 15 se verificaram aspectos consistentes com ETEP (40,5%), ao passo que, em 22 deles (59,5%), isso não foi observado (p > 0,05). Os parasitas dispunham-se em infundíbulos hiperplásicos, formando catênulas, ou como unidades isoladas, associados ou não a células inflamatórias. CONCLUSÕES: Aspectos consistentes com ETEP, embora observados em número estatisticamente não significante de pacientes da amostra (p > 0,05), sugerem que, na doença de Jorge Lobo, o fenômeno, invariavelmente, ocorra através do epitélio infundibular. Estudos futuros serão necessários para avaliar sua eventual importância na epidemiologia da micose.BACKGROUND: Few studies have focussed on the transepidermal elimination of parasites in Jorge Lobo's disease (lobomycosis). OBJECTIVE: To identify the morphological features of the transepidermal elimination of parasites in lobomycosis. METHODS: Sections were obtained from paraffin-embedded biopsy specimens of patients with lobomycosis and stained with hematoxylin-eosin for microscopic examination. Only the presence of parasites in epidermal structures was considered to constitute transepidermal elimination. RESULTS: Forty biopsies from 37 patients were included in the study (31 males and 6 females). The mean age of patients was 51.03 years (range 29-80 years). Biopsies performed over a period of 37 years (1967-2003) were used, from which 511 sections were obtained (a mean of 12.77 sections per case; range 2-39 sections per case). Transepidermal elimination of parasites was found in 110/511 (21.52%) and was absent in 401/511 sections (78.48%) (p0.05). Parasites in the epidermis were detected within hyperplastic infundibula, either connected in chains or as isolated units, associated or not with inflammatory cells. CONCLUSION: Features consistent with transepidermal elimination of parasites were found in a statistically nonsignificant number of patients in the sample (p>0.05), suggesting that in Jorge Lobo's disease, this phenomenon invariably occurs through the infundibular epithelium. Future studies are required to evaluate the significance of this finding in the epidemiology of mycosis.

Estudo bibliográfico que buscou identificar a produção científica sobre humanização e assistência de enfermagem ao parto normal. As fontes foram artigos científicos da base de dados da SCIELO-Brasil, período 2000 a 2007. Obtivemos como resultado da busca 13 artigos que foram agrupados nas seguintes áreas temáticas: medicalização do parto, humanização da assistência ao parto, acompanhante no parto e atuação da enfermeira obstétrica. A análise apontou que o paradigma atual é centralizado na intervenção do parto, apesar do movimento da humanização defender o parto natural e fisiológico realizado por enfermeira.. Conclui-se que assistência de qualidade e humanizada ao parto e nascimento privilegia o respeito, dignidade e autonomia das mulheres, com resgate do papel ativo da mulher no processo parturitivo.Estudio bibliográfico que buscó identificar la producción científica sobre humanización y asistencia de enfermería al parto normal. Las fuentes fueron artículos científicos de la base de datos de SCIELO-Brasil, de 2000 a 2007. Obtuvimos 13 artículos como resultado de la búsqueda, que fueron agrupados en las siguientes categorías: medicalización del parto, humanización de la asistencia al parto, acompañante en el parto y actuación de la enfermera obstétrica. El análisis apuntó que el paradigma actual es centralizado en la intervención del parto, a pesar de movimientos de la humanización defender el parto natural y fisiológico realizado por enfermera. Concluimos que asistencia de calidad y humanizada al parto y nacimiento privilegia el respecto, dignidad y autonomía de las mujeres, y también el papel activo de la mujer en el proceso de parto.Bibliographical study that sought to identify the scientific production about humanization and nursing assistance to normal childbirth. The sources were scientific articles from SCIELO-Brasil's database, from 2000 to 2007. We obtained 13 articles as result from the search, which were grouped in the following categories: childbirth medicalization, humanization of assistance to childbirth, companion during childbirth and performance of the obstetric nurse. The analysis pointed out that the current paradigm is centralized on childbirth intervention, despite of humanization movements defending the natural and physiological childbirth made by the nurse. We concluded that qualified and humanized assistance to childbirth and birth privileges women's respect, dignity and autonomy, regarding women's active role in the birth process.

Researchers have hypothesized that wild stingless bee colonies are a repository of genes for managed populations via the mating of managed virgin queens with males from wild colonies. We tested this hypothesis with the stingless bee, Scaptotrigona mexicana, a culturally important species in the study region. Each of ten colonies were split into two colonies and placed in a meliponary, which resulted in ten queen-right mother colonies and ten queenless daughter colonies. We allowed daughter colonies to produce gynes, which then naturally mated with males of unknown origins. Six months later, five third-instar larvae from each colony were genotyped at six microsatellite loci. Four new alleles (12% of 33 alleles) were found in daughter colonies that were not present in any other mother colony. The Fst index showed no overall significant differences between mother and daughter colonies, indicating that they belonged to the same population despite the new alleles. Interestingly, nine queens were estimated to be polyandrous, with an average mating frequency of 1.3, unlike previous reports for this species. These results have implications for the fitness of managed stingless bee colonies and suggest that a better understanding of how gene flow is affected by human management practices would be beneficial.

Tegumentary Leishmaniasis (TL) in the Brazilian Amazon region is associated with several Leishmania species. In this report, we describe two cases of TL related to Leishmania lindenbergi occurring in different locations of Rondônia state. After clinical diagnosis, lesion samples were collected for parasitological diagnoses via direct microscopic visualization, parasite isolation, and PCR. PCR reactions were positive in both clinical samples. Parasite isolation was possible for both patients, and isolates were submitted to species identification by isoenzyme electrophoresis and DNA sequencing. This report is the first to describe human infections caused by L. lindenbergi since the initial description and record of human infection by this species in 2002.

Ameboma is a rare complication of invasive amebiases caused by the intestinal protozoan Entamoeba histolytica . The disease is characterized by tumorous, exophytic, inflammatory masses in the lower-right quadrant of the abdomen. Symptoms are nonspecific but may include intestinal obstruction and gastrointestinal bleeding. Although computed tomography and ultrasound can identify colonic masses, biopsy is the most accurate diagnostic method for ameboma. Differential diagnosis includes Crohn's disease and colon carcinoma. Treatment involves killing the trophozoites in most cases and surgical intervention in patients with intestinal obstruction or perforation, phlegmon, or toxic megacolon. This study reports a case of intestinal obstruction caused by ameboma within the ascending colon of a bariatric surgery patient., Competing Interests: None declared., (Published by Oxford University Press and JSCR Publishing Ltd. © The Author(s) 2024.)

Introduction: Teaching learners the benefits and challenges of interprofessional collaborative practice (IPCP) in acute care is best done in the context of authentic patient care rather than classroom settings. Yet differing clinical schedules of students and faculty as well as structured, controlled environments of intensive care units are not conducive to bringing multiple interprofessional learners to the bedside., Methods: We developed a 2.5-hour interprofessional education (IPE) activity based around neurology intensive care unit patients that was implemented using team-based learning (TBL) methodologies, including individual/team readiness assessments (iRAT/tRAT) and application activities comprising interprofessional student-led care conferences in which authentic patients and their unique, deidentified clinical parameters were discussed. Students represented medicine, nursing, chaplain, physician assistant, social work, respiratory therapy, pharmacy, physical therapy, and law programs., Results: Two hundred ninety-three students participated online during the first year. Mean tRAT scores were 14.9 points higher than iRAT scores (39.5 vs. 24.6 of 44 possible). There was strong agreement from students that the session met educational objectives (all >4.0 on a 5-point Likert scale). Individualized feedback was provided to learners using a rubric; 276 students shared personal reflections of knowledge learned through interactions with other health professional students/faculty., Discussion: IPE activities that use authentic patient chart data as the basis for student application exercises are useful learning tools since students must teach and learn from each other, interpret data, and propose care plans based upon their collaborations. This enables students to experience acute care IPCP in a low-stakes environment., (© 2024 Gross et al.)

Background: Cardiac surgery with cardiopulmonary bypass (CPB) triggers pulmonary injury. In this trial we assessed the feasibility, safety, and efficacy of low frequency ventilation (LFV) during CPB in patients undergoing valvular surgery., Methods and Results: Patients with severe mitral or aortic valve disease were randomized to either LFV or usual care. Primary outcomes included release of generic inflammatory and vascular biomarkers and the lung-specific biomarker sRAGE (soluble receptor for advance glycation end products) up to 24 hours postsurgery. Secondary outcomes included pulmonary function tests and 6-minute walking test up to 8 weeks postdischarge. Sixty-three patients were randomized (33 LFV versus 30 usual care). Mean age was 66.8 years and 30% were female. LFV was associated with changes of sRAGE (soluble receptor for advance glycation end products) levels (geometric mean ratio, 3.05; [95% CI, 1.13-8.24] 10 minutes post CPB, and 1.07 [95% CI, 0.64-1.79], 0.84 [95% CI, 0.55-1.27], 0.67 [95% CI, 0.42-1.07], and 0.62 [95% CI, 0.45-0.85] at 2, 6, 12, and 24 hours post CPB respectively). No changes were observed for any of the generic biomarkers. Respiratory index soon after surgery (mean difference, -0.61 [95% CI, -1.24 to 0.015] 10 minutes post end of CPB), forced expiratory volume after 1 second/forced vital capacity ratio (0.050 [95% CI, 0.007-0.093] at 6 to 8 weeks pos-surgery), Forced vital capacity alone (95% CI, -0.191 L [-0.394 to 0.012]) and 6-minute walking test score at discharge (63.2 m [95% CI, 12.9-113.6]) were better preserved in the LFV group. No other differences were noted., Conclusions: The use of LFV during CPB in patients undergoing valvular surgery was feasible and safe and was associated with changes in sRAGE levels along with better preserved lung function and walking performance. These observations warrant further investigation in larger future studies., Registration: URL: https://www.isrctn.com; Unique Identifier: ISRCTN75795633.

Background: Identifying species, particularly small metazoans, remains a daunting challenge and the phylum Nematoda is no exception. Typically, nematode species are differentiated based on morphometry and the presence or absence of certain characters. However, recent advances in artificial intelligence, particularly machine learning (ML) algorithms, offer promising solutions for automating species identification, mostly in taxonomically complex groups. By training ML models with extensive datasets of accurately identified specimens, the models can learn to recognize patterns in nematodes' morphological and morphometric features. This enables them to make precise identifications of newly encountered individuals. Implementing ML algorithms can improve the speed and accuracy of species identification and allow researchers to efficiently process vast amounts of data. Furthermore, it empowers non-taxonomists to make reliable identifications. The objective of this study is to evaluate the performance of ML algorithms in identifying species of free-living marine nematodes, focusing on two well-known genera: Acantholaimus Allgén, 1933 and Sabatieria Rouville, 1903., Methods: A total of 40 species of Acantholaimus and 60 species of Sabatieria were considered. The measurements and identifications were obtained from the original publications of species for both genera, this compilation included information regarding the presence or absence of specific characters, as well as morphometric data. To assess the performance of the species identification four ML algorithms were employed: Random Forest (RF), Stochastic Gradient Boosting (SGBoost), Support Vector Machine (SVM) with both linear and radial kernels, and K-nearest neighbor (KNN) algorithms., Results: For both genera, the random forest (RF) algorithm demonstrated the highest accuracy in correctly classifying specimens into their respective species, achieving an accuracy rate of 93% for Acantholaimus and 100% for Sabatieria , only a single individual from Acantholaimus of the test data was misclassified., Conclusion: These results highlight the overall effectiveness of ML algorithms in species identification. Moreover, it demonstrates that the identification of marine nematodes can be automated, optimizing biodiversity and ecological studies, as well as turning species identification more accessible, efficient, and scalable. Ultimately it will contribute to our understanding and conservation of biodiversity., Competing Interests: The authors declare that they have no competing interests., (© 2023 Brito de Jesus et al.)

Cerebrotendinous xanthomatosis (CTX) is a rare autosomal recessive disorder caused by a deficiency of the sterol 27-hydroxylase enzyme. This deficiency results in excess production and accumulation of cholestanol, which can lead to many clinical findings within the first three decades of life, including progressive neurological dysfunction. This is a treatable condition with improvements in neurological and non-neurological symptoms upon the early initiation of replacement therapy. This case report details a 42 years-old left-handed male in whom deep brain stimulation (DBS) intervention was pursued due to a limiting tremor related to delayed diagnosis and treatment of CTX at 22 years old. The application of DBS in treating tremors in a CTX patient has not previously been reported. For our patient, application of DBS led to meaningful and longstanding tremor control benefits that have required minimal changes to stimulation parameters post-DBS. These improvements to tremor were achieved without negative impact to his other CTX related comorbidities., Competing Interests: SDJ has received support unrelated to this research for her role as an Educational Consultant for Medtronic Inc. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Rich, Karakoleva, McInerney, Farace and De Jesus.)

Current pharmacotherapy has limited efficacy and/or intolerable side effects in late-stage Parkinson's disease (LsPD) patients whose daily life depends primarily on caregivers and palliative care. Clinical metrics inadequately gauge efficacy in LsPD patients. We explored if a D 1/5 dopamine agonist would have efficacy in LsPD using a double-blind placebo-controlled crossover phase Ia/b study comparing the D 1/5 agonist PF-06412562 to levodopa/carbidopa in six LsPD patients. Caregiver assessment was the primary efficacy measure because caregivers were with patients throughout the study, and standard clinical metrics inadequately gauge efficacy in LsPD. Assessments included standard quantitative scales of motor function (MDS-UPDRS-III), alertness (Glasgow Coma and Stanford Sleepiness Scales), and cognition (Severe Impairment and Frontal Assessment Batteries) at baseline (Day 1) and thrice daily during drug testing (Days 2-3). Clinicians and caregivers completed the clinical impression of change questionnaires, and caregivers participated in a qualitative exit interview. Blinded triangulation of quantitative and qualitative data was used to integrate findings. Neither traditional scales nor clinician impression of change detected consistent differences between treatments in the five participants who completed the study. Conversely, the overall caregiver data strongly favored PF-06412562 over levodopa in four of five patients. The most meaningful improvements converged on motor, alertness, and functional engagement. These data suggest for the first time that there can be useful pharmacological intervention in LsPD patients using D 1/5 agonists and also that caregiver perspectives with mixed method analyses may overcome limitations using methods common in early-stage patients. The results encourage future clinical studies and understanding of the most efficacious signaling properties of a D 1 agonist for this population.

Background: Obsessive-Compulsive Disorder (OCD) is a common and chronic psychiatric disorder with significant morbidity characterized by intrusive, uncontrollable and reoccurring thoughts (i.e., obsessions) and/or ritualistic behaviours (i.e., compulsions). Conradi-Hünerman-Happle Syndrome (CHHS) is a rare inherited X-linked dominant variant of chondrodysplasia punctata, a heterogeneous group of rare bone dysplasias characterized by punctate epiphyseal calcifications of complex etiology and pathophysiology that remain to be defined. Available literature reveals a lacuna in regards to the coexistence of the entities with no clinical reports described., Case Presentation: A 12 year old female patient with diagnosis of CHHS, presents to psychiatric consultation due to aggravation of her OCD clinical picture, with aggravation of hand-washing frequency during the Covid-19 pandemic with significant functional impact. Psychopharmacological treatment aimed at OCD with Selective Serotonin Reuptake Inhibitor (SSRI) and antipsychotic was instituted with favourable, albeit partial response., Conclusions: The authors aim to describe a clinical case in which the patient presents with Conradi-Hünerman-Happle Syndrome and Obsessive-Compulsive Disorder. Clinical descriptions of CHHS and OCD are not available in the literature. Through this case description the authors aim to present a rare case as well as discuss an eventual association between etiology and/or pathophysiology of the two disorders., (© 2023. The Author(s).)

Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) is responsible for causing Coronavirus Disease-2019 (COVID-19), a heterogeneous clinical condition that manifests varying symptom severity according to the demographic profile of the studied population. While many studies have focused on the spread of COVID-19 in large urban centers in Brazil, few have evaluated medium or small cities in the Northeast region. The aims of this study were: (i) to identify risk factors for mortality from SARS-CoV-2 infection, (ii) to evaluate the gene expression patterns of key immune response pathways using nasopharyngeal swabs of COVID-19 patients, and (iii) to identify the circulating SARS-CoV-2 variants in the residents of a medium-sized city in Northeast Brazil. A total of 783 patients infected with SARS-CoV-2 between May 2020 and August 2021 were included in this study. Clinical-epidemiological data from patients who died and those who survived were compared. Patients were also retrospectively divided into three groups based on disease severity: asymptomatic, mild, and moderate/severe. Samples were added to a qPCR array for analyses of 84 genes involved with immune response pathways and sequenced using the Oxford Nanopore MinION technology. Having pre-existing comorbidity; being male; having cardiovascular disease, diabetes, and/or chronic obstructive pulmonary disease; and PCR cycle threshold (Ct) values under 22 were identified as risk factors for mortality. Analysis of the expression profiles of inflammatory pathway genes showed that the greater the infection severity, the greater the activation of inflammatory pathways, triggering the cytokine storm and downregulating anti-inflammatory pathways. Viral genome analysis revealed the circulation of multiple lineages, such as B.1, B.1.1.28, Alpha, and Gamma, suggesting that multiple introduction events had occurred over time. This study's findings help identify the specific strains and increase our understanding of the true state of local health. In addition, our data demonstrate that epidemiological and genomic surveillance together can help formulate public health strategies to guide governmental actions.

In 2010 the US-Affiliated Pacific Islands (USAPI) declared a regional state of health emergency due to the epidemic of non-communicable disease (NCD) and an NCD monitoring and surveillance framework was developed that includes adult NCD risk factor and disease prevalence indicators to be collected every 5 years using a population-based survey. On evaluation of existing data from adult population-based NCD surveys, it was found that there was a lack of valid, available and consistently collected data. Therefore, a new model was developed to combine various indicators and survey tools from different partner agencies into one survey. After the report was endorsed by local health leadership, a dissemination workshop was conducted. In 2015 (baseline for Hybrid Survey implementation), three out of nine jurisdictions (33.3%) had completed a population-based survey in the past 5 years. Four (44.4%) had no adult prevalence data at all, two (22.2%) had data sets from their surveys and four (44.4%) had at least two surveys ever collected that could be used for comparison. As of 2020, all nine jurisdictions have, or are in the process of completing an adult population-based survey. Eight (88.9%) have data sets from their surveys, and five (55.6%) have at least two surveys collected that can be used for comparison. This Hybrid Survey model has helped to improve adult NCD surveillance in the USAPI by more efficiently using limited resources. This model could be considered in other small island nations, or rural areas where adult NCD surveillance is challenging., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Depending on the magnitude and nature of a disaster, identifying the victims can be a complex task that requires coordinated work by disaster victim identification (DVI) teams based on pre-established protocols. Thus, the analysis of fingerprints has been presented as a method to establish, when possible, the identity of the victims during the DVI process. This study discusses the importance of this primary method of identification and the results obtained in four different disasters in which Brazilian DVI teams were involved: the Air France Flight AF447 plane crash in the Atlantic Ocean, floods and mudslides in the State of Rio de Janeiro, Brazil, the LaMia Flight 2933 plane crash in Colombia, and the tailings dam collapse in Brumadinho, Brazil. Here, we also report the use of the automatic fingerprint capture and identification system, called Alethia, developed by the Federal Police of Brazil and used in the victim identification process in the two latter events mentioned above.Key pointsThis article presents four different disasters that occurred in Brazil and overseas and involved Brazilian DVI teams in the identification process, focusing on fingerprint identification (Air France Flight AF447, floods and mudslides in the State of Rio de Janeiro, Brazil, LaMia Flight 2933, and the Brumadinho tailings dam collapse).This article also describes the evolution of the DVI process in Brazil, including a description of the technology currently used by Brazilian fingerprint experts (Alethia).This article reports how the Alethia System was used in the disasters and how it optimized the human identification process when compared to traditional methods., Competing Interests: The authors declare that they have no affiliations with or involvement in any organization or entity with any financial interest or non-financial interest in the subject matter or materials discussed in this manuscript., (© 2021 The Author(s). Published by Taylor & Francis Group on behalf of the Academy of Forensic Science.)

Background: Brazil is a violent society and police officers play a fundamental role in this scenario. Police work is a stressful occupation. Dealing with routine violence, police officers must have high standards of physical and mental health. Patrolling the streets involves several risks and stressful situations that may hamper military policemen's quality of life. The identification of factors associated with health-related quality of life may help in planning and providing adequate care to military policemen. This study aimed to identify factors associated with health-related quality of life of military policemen in Salvador, Brazil., Methods: A cross-sectional design study investigated a random sample of 329 male military police officers, engaged in patrolling the streets of Salvador, Brazil. A structured questionnaire applied to the policemen collected information about age, education, marital status, income, house ownership, car ownership, police rank, working day, alcohol consumption, smoking, frequency of vigorous physical activity, obesity (body mass index ≥ 30.0), and work ability. Health-related quality of life was evaluated through the 36-Item Short Form Health Survey Questionnaire (SF-36). Work ability was assessed through the Work Ability Index questionnaire. Poor work ability was defined by a 7-27 points score. Multiple linear regression models were used to measure the impact of police officers characteristics on the variation in the Physical Component and Mental Component Summary scores., Results: Normalised scores were below 50.0% for seven out of the eight SF-36 domains and for the two component summaries. The SF-36 Physical Component Summary was significantly (P < 0.05) associated with poor work ability, while the Mental Component Summary was associated with poor work ability, excessive alcohol consumption, and younger age (24-34 years). Multivariate analysis estimated that the Physical Component Summary was 7.386 units (%) lower among policemen with poor work ability compared to those with moderate/good/excellent work ability. The Mental Component Summary was 12.755 units lower among those with poor work ability, 5.354 units lower among those with excessive alcohol consumption, and 5.532 units higher among those with younger age., Conclusions: The military police officers investigated presented low health-related quality of life, associated with younger age, excessive alcohol consumption, and poor work ability.

Background: Conventional Parkinson's disease (PD) deep brain stimulation (DBS) utilizes a pulse with an active phase and a passive charge-balancing phase. A pulse-shaping strategy that eliminates the passive phase may be a promising approach to addressing movement disorders., Objectives: The current study assessed the safety and tolerability of square biphasic pulse shaping (sqBIP) DBS for use in PD., Methods: This small pilot safety and tolerability study compared sqBiP versus conventional DBS. Nine were enrolled. The safety and tolerability were assessed over a 3-h period on sqBiP. Friedman's test compared blinded assessments at baseline, washout, and 30 min, 1 h, 2 h, and 3 h post sqBIP., Results: Biphasic pulses were safe and well tolerated by all participants. SqBiP performed as well as conventional DBS without significant differences in motor scores nor accelerometer or gait measures., Conclusion: Biphasic pulses were well-tolerated and provided similar benefit to conventional DBS. Further studies should address effectiveness of sqBIP in select PD patients., (Copyright © 2019 De Jesus, Okun, Foote, Martinez-Ramirez, Roper, Hass, Shahgholi, Akbar, Wagle Shukla, Raike and Almeida.)

Objective: The purpose of this study is to evaluate the association between psychosocial aspects at work and dissatisfaction among health workers in five cities in Bahia, Brazil., Methods: The evaluation was based on different models proposed to measuring occupational stress and possible combinations between them: demand-control model (DCM) and effort-reward imbalance (ERI). We conducted a cross-sectional epidemiological study including 3084 health workers. The analysis considered the association between partial/full/partial (combined) occupational stress models (the variable "exposure") and job dissatisfaction (the variable "outcome")., Results: Dissatisfaction rate was 26%. Full DCM and ERI models were better than partial ones to investigate job dissatisfaction. After adjustments, the combined models presented more robust measures of prevalence ratio than models evaluated separately (PR 2.93; CI 2.26-3.80)., Conclusions: The combination of models has shown greater capacity to identify situations of job dissatisfaction and provided more potential information to support actions for workers' health.