Abstract Introduction An accurate assessment of balance problems is critical for decreasing the risk of falling in patients with Parkinson's Disease (PD). Reliable diagnostic tools such as Computerized Dynamic Posturography (CDP) are not feasible for the clinical setting. Therefore, the present study's aim was to assess the correlation between the clinical Balance Evaluation Systems Test (BESTest) and CDP. Methods 20 male older adults with Parkinson's Disease (PD) were included in this study. Participants first executed the Sit-To-Stand (STS), Step/Quick turn (SQT), and Step Up and Over (SUO) tests on a Balance Master® force platform, followed by a clinical balance evaluation using the BESTest. Results Four outcomes of the CDP were negatively correlated with one or more BESTest domains or total BESTest score: STS sway velocity was negatively correlated with the anticipatory postural adjustment (p = 0.02) and sensory orientation (p = 0.01) domains. SQT turn time was negatively correlated with biomechanical restriction (for turns to the left, p = 0.01, and right, p = 0.03, respectively), postural response (p = 0.01, p = 0.01), dynamic balance during gait (p = 0.007, p = 0.001), and total score (p = 0.02, p = 0.01). Step over time to the right in SUP was negatively correlated with the limits of the stability domain (p = 0.002) and total BESTest score (p = 0.020). SUO impact index was negatively correlated with the anticipatory postural adjustment domain (p = 0.01). Conclusion This study shows that several BESTest domains are significantly correlated with CDP outcomes, demonstrating that the BESTest can be used as a more clinically feasible alternative for computerized posturography, without loss of information. Parkinsons Parkinson s PD. PD . (CDP setting Therefore studys (BESTest 2 (PD SitToStand Sit To Stand STS, , (STS) StepQuick Quick SQT, (SQT) (SUO Master platform 0.02 002 0 02 0.01 001 01 left 003 03 0.03 respectively, respectively respectively) 0007 007 0.007 0.001, 0001 0.001 0.001) 0.01. 0.002 0002 0.020. 0020 0.020 020 0.020) posturography information (STS (SQT 0.0 00 000 0.00 0.

Abstract Objective The present study aimed to investigate FOXO3a deregulation in Uterine Smooth Muscle Tumors (USMT) and its potential association with cancer development and prognosis. Methods The authors analyzed gene and protein expression profiles of FOXO3a in 56 uterine Leiomyosarcomas (LMS), 119 leiomyomas (comprising conventional and unusual leiomyomas), and 20 Myometrium (MM) samples. The authors used techniques such as Immunohistochemistry (IHC), FISH/CISH, and qRT-PCR for the present analyses. Additionally, the authors conducted an in-silico analysis to understand the interaction network involving FOXO3a and its correlated genes. Results This investigation revealed distinct expression patterns of the FOXO3a gene and protein, including both normal and phosphorylated forms. Expression levels were notably elevated in LMS, and Unusual Leiomyomas (ULM) compared to conventional Leiomyomas (LM) and Myometrium (MM) samples. This upregulation was significantly associated with metastasis and Overall Survival (OS) in LMS patients. Intriguingly, FOXO3a deregulation did not seem to be influenced by EGF/HER-2 signaling, as there were minimal levels of EGF and VEGF expression detected, and HER-2 and EGFR were negative in the analyzed samples. In the examination of miRNAs, the authors observed upregulation of miR-96-5p and miR-155-5p, which are known negative regulators of FOXO3a, in LMS samples. Conversely, the tumor suppressor miR-let7c-5p was downregulated. Conclusions In summary, the outcomes of the present study suggest that the imbalance in FOXO3a within Uterine Smooth Muscle Tumors might arise from both protein phosphorylation and miRNA activity. FOXO3a could emerge as a promising therapeutic target for individuals with Unusual Leiomyomas and Leiomyosarcomas (ULM and LMS), offering novel directions for treatment strategies. FOXOa FOXO USMT (USMT prognosis 5 , (LMS) 11 comprising leiomyomas, leiomyomas) 2 MM (MM samples IHC, IHC (IHC) FISHCISH FISH CISH FISH/CISH qRTPCR qRT PCR analyses Additionally insilico silico genes forms ULM LM (LM OS (OS patients Intriguingly EGF/HER2 EGFHER2 EGFHER EGF/HER HER EGF/HER- signaling detected HER2 HER- miRNAs miR965p miRp miR 96 5p p miR1555p, miR1555p 155 5p, miR-155-5p Conversely miRlet7c5p miRletcp let7c let c downregulated summary activity LMS) strategies (LMS 1 (IHC 9 15 miRlet letc

Abstract Context: Vehicle driving depends on the integration of motor, visual, and cognitive skills to respond appropriately to different situations that occur in traffic. Objectives: To analyze a model of performance predictor for braking time in the driving simulator, using a battery of tests divided by gender. Methods: Selected were 100 male drivers with a mean age of 72.6 ± 5.7 years. Sociode-mographic variables, braking time in the driving simulator, and motor, visual, and cognitive skills were evaluated. Results: Comparing genders, men were older than women (p = 0.002) and had longer driving times (p = 0.001). Men had more strength in hand grip (p ≤ 0.001). In the linear regression analysis, the model explained 68 % of the braking time in men and 50.8 % in women. In the stepwise multiple linear regression analysis, the variable that remained in the model was the strength of the right plantar flexors, which explained 13 % of the braking time in women and men, and the cognitive variables explained 38.9 %. Conclusion: Sociodemographic, motor, visual, and cognitive variables, explained a substantial portion of the variability in braking time for both older women and men, the specific variables driving this performance differed between the sexes. For older women, factors such as muscle strength emerged as critical determinants of braking ability, highlighting the importance of physical health in maintaining driving skills. On the other hand, cognitive conditions emerged as the primary predictor of braking performance in older men, underscoring the role of mental acuity and decision-making processes in safe driving. Context motor visual traffic Objectives simulator gender Methods 10 726 72 6 72. 57 5 7 5. years Sociodemographic Sociode mographic evaluated Results genders p 0.002 0002 0 002 0.001. 0001 0.001 . 001 0.001) analysis 508 50 8 50. flexors 1 389 38 9 38. Conclusion sexes ability decisionmaking decision making 0.00 000 00 3 0.0 0.

Abstract Background: Melatonin is a hormone produced by the pineal gland and it has antioxidant properties. Aim: This study aimed to evaluate the effects of melatonin on assisted reproductive technologies through a systematic review and a meta-analysis. Materials and methods: Search strategies were used in PubMed and in other databases covering the last 15 years. After screening for eligibility, 17 articles were selected for the systematic review. For the meta-analysis statistics, two groups were formed, the treatment group (with melatonin) and the control group (without melatonin) for various assisted reproduction outcomes. Results: The main results were that no statistical differences were found concerning the clinical pregnancy outcome (p = 0.64), but there was a statistical difference with respect to Mature Oocytes (MII) (p = 0.001), antral follicle count (p = 0.0002), and the fertilization rate (p ≤ 0.0001). Conclusions: Melatonin had beneficial effects such as the improvement in the fertilization rate, although the authors did not obtain significance in the clinical pregnancy rate. Background properties Aim metaanalysis. metaanalysis meta analysis. analysis methods 1 years eligibility statistics formed without outcomes Results p 0.64, 064 0.64 , 0 64 0.64) MII (MII 0.001, 0001 0.001 001 0.001) 0.0002, 00002 0.0002 0002 0.0002) 0.0001. 00001 0.0001 . 0.0001) Conclusions 06 0.6 6 000 0.00 00 0000 0.000 0. 0.0

Abstract Introduction Advanced Glycation End-Products (AGEs) are a diverse group of highly reactive molecules that play a vital role in the development of neurodegenerative disorders, such as Parkinson's Disease (PD), leading to a decline in functional and cognitive capacity. The objective of this study was to assess the intake and quantification of AGEs in individuals with PD and to correlate them with their functional and cognitive abilities. Methods This was a cross-sectional study involving 20 PD patients and 20 non-PD individuals as the Control group (C). The autofluorescence reader was used to evaluate skin AGEs, while food recall was used to quantify AGEs consumed for three different days. The Montreal Cognitive Assessment, Short Physical Performance Battery, and handgrip tests were used. PD patients demonstrated greater impairment in functional capacity compared to the control group. Results Dominant Handgrip (p = 0.02) and motor performance, in the sit and stand test (p = 0.01) and Short Physical Performance Battery (SPPB) (p = 0.01) were inferior in PD patients than the control group. Although PD patients tended to consume less AGEs than the control group, AGE intake was negatively correlated with handgrip strength in individuals with PD (r = -0.59; p < 0.05). Conclusion PD patients had lower strength and functional capacity, suggesting that the effects of AGEs might be exacerbated during chronic diseases like Parkinson's. EndProducts End Products (AGEs disorders Parkinsons Parkinson s PD, , (PD) abilities crosssectional cross sectional 2 nonPD non C. C . (C) days Assessment 0.02 002 0 02 performance 0.01 001 01 SPPB (SPPB r 0.59 059 59 -0.59 0.05. 005 0.05 05 0.05) Parkinsons. s. (PD (C 0.0 00 0.5 5 -0.5 0. -0. -0 -

Abstract Background Acknowledging the relationship between postural control and muscle strength in lower limbs is important to find persons with high fall risk and to design fall prevention exercise programs. Objective To investigate the connection between knee muscle strength, semi-static postural balance, and functional mobility in irregularly active older women. Methods One hundred and ten older women aged 60 to 85 years underwent a semi-static postural balance test in a force and functional mobility measured by Timed Up & Go (TUG) with and without Cognitive Tasks (CT). Muscle strength of the knee was assessed by isokinetic dynamometry at 60°/s. Results A negative correlation between the functional mobility (TUG with and without CT) and the muscular strength of the knee was observed. Regarding semi-static balance, there was a low negative correlation with peak torque corrected for body weight of the extensors with the following variables with eyes open: Mean Velocity Dominant limb (D) (r = -0.19; p = 0.03); and anteroposterior range Non-Dominant limb (ND) (r = -0.19; p = 0.04); with eyes closed: mediolateral range ND limb (r = -0.21; p = 0.02) and Mean Velocity ND limb (r = -0.18; p = 0.05). Conclusions This study found that better functional mobility was associated with greater muscle strength in the knee in elderly women. There were weak negative correlations between knee extensor strength and some measures of semi-static postural balance, suggesting that different motor control actions are required to maintain semi-static balance and mobility. In the case of semi-static balance, a lower level of muscle response is required than in functional mobility. programs semistatic semi static 6 8 TUG CT. CT . (CT) 60s s 60°/s observed open D (D r 0.19 019 0 19 -0.19 0.03 003 03 0.03) NonDominant Non (ND 0.04 004 04 0.04) closed 0.21 021 21 -0.21 0.02 002 02 0.18 018 18 -0.18 0.05. 005 0.05 05 0.05) (CT 0.1 01 1 -0.1 0.0 00 0.2 2 -0.2 0. -0. -0 -

Abstract Context: Transtibial Amputation (TA) predisposes to a sedentary lifestyle. Objectives: To evaluate the efficiency of a short-term (8-week) Concurrent Training (CT) program in Unilateral Transtibial Amputees (UTA) and to compare it with the physical condition of a group of Paralympic athletes in preparation for the Rio de Janeiro Paralympics. Design: This was a longitudinal, prospective and controlled trial study. Methods: Thirty-four male subjects with UTA and using prostheses for six months or more were selected for this study. They were divided into two groups: Group 1 (G1) – 17 non-athlete and untrained UTA and Group 2 (G2) – 17 paralympic athletes with active UTA in the training phase. G1 was evaluated before and after eight weeks of CT and G2 made a single evaluation for control. All were submitted to anamnesis, clinical evaluation (blood pressure, electrocardiogram, and heart rate) and cardiopulmonary exercise testing on a lower limb cycle ergometer, and isokinetic knee dynamometry. The CT of G1 included resistance exercise and aerobic interval training on a stationary bicycle and G2 followed the training of the Paralympic teams. Results: Patients were retested by the same methods after CT. The two most important central dependent variables (maximal oxygen uptake and muscular strength) increased by 22% and knee extensor and flexor strength by 106% and 97%, respectively. Conclusion: After eight weeks of CT, there was an improvement in general functional condition, muscle strength, and cardiorespiratory performance improving protection against chronic diseases and quality of life. Context TA (TA lifestyle Objectives shortterm short term 8week week 8 (8-week (CT (UTA Paralympics Design longitudinal study Methods Thirtyfour Thirty four groups G (G1 nonathlete non athlete (G2 phase control anamnesis blood pressure electrocardiogram rate ergometer dynamometry teams Results maximal 22 106 97 97% respectively Conclusion life (G 10 9

Abstract Context: Many studies show the importance of evaluating the adaptation time of subjects in a virtual driving environment, looking forwards to a response as closest as a possible real vehicle. Objectives: This study aimed to identify and analyze the adaptation to the driving simulator in older adults and middle-aged adults with and without a distraction, and a secondary aim was to identify predictors of safe performance for older adults’ drives. Design: Male and female middle-aged adults (n = 62, age = 30.3 ± 7.1 years) and older adults (n = 102, age = 70.4 ± 5.8 years) were evaluated for braking time performance in a driving simulator; cognition performance assessment included the Mini-Mental State Examination; motor evaluation included ankle flexor muscle strength with the isokinetic dynamometer and handgrip strength; the postural balance was evaluated with Timed Up and Go test, with and without a cognitive distraction task. Results: Older adults (men and women) and middle-aged adult women require more time to adapt to the driving simulator. The distractor increases the adaptation time for all groups. The main predictors of braking time for older women are age, muscle strength, and postural balance associated with distraction, and for older men, muscle strength. Conclusions: Age, sex, and distractor interfere in the adaptation of the virtual task of driving in a simulator. The evaluation model developed with multi-domains demonstrated the ability to predict which skills are related to braking time with and without the presence of the distractor. Context environment vehicle Objectives middleaged middle aged drives Design n 62 303 30 3 30. 71 7 1 7. years 102 704 70 4 70. 58 5 8 5. MiniMental Mini Mental Examination test Results men groups Conclusions Age sex multidomains multi domains 6 10

Abstract Introduction The CA1 region of the hippocampus has an important role in learning and memory. It has been shown that estrogen deficiency may reduce the synaptic density in the region and that hormone replacement therapy may attenuate the reduction. Objectives This study aimed to evaluate the effects of estrogen and raloxifene on the synaptic density profile in the CA1 region of the hippocampus in ovariectomized rats. Methods Sixty ovariectomized three-month-old virgin rats were randomized into six groups (n = 10). Treatments started either three days (early treatment) or sixty days (late treatment) after ovariectomy. The groups received propylene glycol vehicle (0.5 mL/animal/day), equine conjugated estrogens (50 μg/animal/day), or raloxifene (3 mg/kg/day) either early or late after ovariectomy. The drugs were administered orally by gavage for 30 days. At the end of the treatments, the animals were anesthetized and transcardially perfused with ether and saline solution. The brains were removed and prepared for analysis under transmission electron microscopy and later fixed. Results Results showed a significant increase in the synaptic density profile of the hippocampal CA1 region in both the early estrogen (0.534 ± 0.026 µ/m2) and the early raloxifene (0.437 ± 0.012 µ/m2) treatment groups compared to the early or late vehicle-treated control groups (0.338 ± 0.038 µ/m2 and 0.277 ± 0.015 µ/m2 respectively). Conclusions The present data suggest that the raloxifene effect may be lower than that of estrogen, even early or late treatment, on synaptic density in the hippocampus. CA memory reduction threemonthold month old n 10. 10 . 10) ovariectomy 0.5 05 0 5 (0. mL/animal/day, mLanimalday mL/animal/day , mL animal day mL/animal/day) 50 (5 μg/animal/day, μganimalday μg/animal/day μg μg/animal/day) 3 ( mg/kg/day mgkgday mg kg treatments solution fixed 0.534 0534 534 (0.53 0026 026 0.02 µm2 µm µ m2 m 0.437 0437 437 (0.43 0012 012 0.01 vehicletreated treated 0.338 0338 338 (0.33 0038 038 0.03 µ/m 0277 277 0.27 0015 015 respectively. respectively respectively) 1 0. (0 0.53 053 53 002 02 0.0 0.43 043 43 (0.4 001 01 0.33 033 33 (0.3 003 03 027 27 0.2 00 0.4 04 4 0.3 2

Abstract Context In the elderly, weak lower limb muscles impair functional tasks' performance. Objective To evaluate the healthy elderly's ankle dorsiflexion and plantarflexion maximum torque and its variability in two sets of 5 RM isokinetics evaluation. Method 50 women (68.0 ± 4.6 years old) and 50 men (72.7 ± 8.5 years old) did two sets of ankle plantar flexor and dorsiflexor isokinetic tests at 30°/s. Peak torque, total work, and coefficient of variation were analyzed. Results Men did the strongest plantarflexion torque (p < 0.05) and dorsiflexion torque (p < 0.05); their highest peak torque occurred at set 2 (p < 0.05), while the largest plantarflexion torque variability (p < 0.05), dorsiflexion torque variability (p < 0.05), and the largest plantarflexion torque variability occurred at set 1 (p < 0.05). Men did the highest plantarflexion and dorsiflexion total work (p < 0.05) at set 2 (p < 0.05). Conclusion Older men are stronger than older women. The torque variability, in men, was higher during the first set, suggesting an adaptation to the isokinetics evaluation. Clinicians and researchers should consider that different muscles might need different numbers of sets and trials to measure their maximal muscle strength.

Abstract Context: Anterior Cruciate Ligament (ACL) injury is disabling in several sports because it causes knee instability and functional deficit. Usually, surgical treatments produce the best functional outcomes, however, sometimes they are not always able to fully restore stability and function. Objective: The objective of this study was to evaluate postural balance, muscle strength, and functional performance of young athletes with an ACL injury before and after ACL reconstruction. Design: This was a longitudinal observational prospective study. Method: 74 athletes, 60 men, and 14 women, aged between 16 and 45, divided into two groups: the Group-Lesion of ACL with 34 athletes (24.1 years) and the Group-Control with 40 athletes without ACL lesion (27.7 years old). All volunteers performed posturography, isokinetic dynamometry, and the Hop-Test. The ACL-Group was evaluated before and 12 months after the reconstruction and the control group was evaluated once. Results: The Postoperative ACL Group presented greater limb symmetry, 0.96 (± 0.12), than the preoperative ACL Group, 0.87 (± 0.17), p < 0.01 in the Hop-Test. In the posturography, the displacement area was smaller in the postoperative ACL Group, 19.85 (± 5.74), compared to the preoperative ACL Group, 24.20 (± 8.97), p < 0.01. In isokinetic dynamometry the torque peak was greater in the postoperative ACL Group, 0.91 (± 0.14), than in the preoperative ACL Group, 0.74 (± 0.15), p < 0.01. Conclusion: The functional outcomes increased in ACL reconstruction athletes after 12 months, but not at the same level as in the Control Group. The result indicates an incomplete functional recovery, adaptive changes in postural control after injury, reconstruction, and return to sport.

Abstract Purpose To assess the knowledge of students from public high schools in poor communities about HPV and Sexually Transmitted Infections and their attitude towards and prevention of such diseases. Patients and methods Cross-sectional study with adolescents from public schools of São Paulo - Brazil. Participants were selected for an interview by a randomization program. A questionnaire about knowledge, attitudes, and preventive practices regarding STIs, including HPV, according to sex was administered and answers were analyzed by the Poisson regression model with robust variance. Results Median age of the 269 participants was 16 years. The majority was of African descent (68.8%, n = 185), most (74%, n = 199) were religious and the vast majority (90.7%, n = 244) lived with their parents. The Poisson regression revealed statistically significant sex-related differences regarding the following questions: “Do you know how it is prevented?” (PR = 1.12 [1.03‒1.23], p = 0.007); “Have you ever been concerned with HPV?” (PR = 1.10 [1.02‒1.19], p = 0.011); “Have you ever sought health care due to concerns about HPV?” (PR = 1.09 [1.04‒1.14], p < 0.001); “Do you know what a Pap Smear is?” (PR = 1.24 [1.13‒1.36], p < 0.001); “Do you know what the cervix is?” (PR = 1.23 [1.13‒1.34], p < 0.001); “Do you know what cervical cancer is?” (PR = 1.13 [1.04‒1.22], p = 0.004). Conclusions The present results show that adolescents from public schools in poor communities in São Paulo City know little about HPV and cervical cancer. Male adolescents know less than female adolescents and are less concerned with health care. diseases Crosssectional Cross sectional Brazil program attitudes STIs variance 26 1 years 68.8%, 688 68 8 (68.8% 185, 185 , 185) 74%, 74 (74% 199 90.7%, 907 90 7 (90.7% 244 parents sexrelated related questions Do prevented prevented? PR 112 12 1.1 1.03‒1.23, 103123 1.03‒1.23 03 23 [1.03‒1.23] 0.007 0007 0 007 0.007) Have HPV? 110 10 1.02‒1.19, 102119 1.02‒1.19 02 19 [1.02‒1.19] 0.011 0011 011 0.011) 109 09 1.0 1.04‒1.14, 104114 1.04‒1.14 04 14 [1.04‒1.14] 0.001 0001 001 0.001) is? 124 24 1.2 1.13‒1.36, 113136 1.13‒1.36 13 36 [1.13‒1.36] 123 1.13‒1.34, 113134 1.13‒1.34 34 [1.13‒1.34] 113 1.04‒1.22, 104122 1.04‒1.22 22 [1.04‒1.22] 0.004. 0004 0.004 . 004 0.004) 2 68.8% 6 (68.8 18 74% (74 90.7% 9 (90.7 11 1. 10312 1.03‒1.2 [1.03‒1.23 0.00 000 00 10211 1.02‒1.1 [1.02‒1.19 0.01 01 10411 1.04‒1.1 [1.04‒1.14 11313 1.13‒1.3 3 [1.13‒1.36 [1.13‒1.34 10412 1.04‒1.2 [1.04‒1.22 68.8 (68. (7 90.7 (90. 1031 1.03‒1. [1.03‒1.2 0.0 1021 1.02‒1. [1.02‒1.1 1041 1.04‒1. [1.04‒1.1 1131 1.13‒1. [1.13‒1.3 [1.04‒1.2 68. (68 ( 90. (90 103 1.03‒1 [1.03‒1. 0. 102 1.02‒1 [1.02‒1. 104 1.04‒1 [1.04‒1. 1.13‒1 [1.13‒1. (6 (9 1.03‒ [1.03‒1 1.02‒ [1.02‒1 1.04‒ [1.04‒1 1.13‒ [1.13‒1 1.03 [1.03‒ 1.02 [1.02‒ 1.04 [1.04‒ [1.13‒ [1.03 [1.02 [1.04 [1.13 [1.0 [1.1 [1. [1 [

ABSTRACT Objective: Fatigue of the ankle’s stabilizing muscles may influence the performance of functional activities and postural control. The purpose of this study was to evaluate the performance of healthy young adults using functional jump tests and static posturography control under pre- and post-fatigue conditions of the ankle invertor and evertor muscles. Methods: Thirty physically active healthy male and female (15 male and 15 female) volunteers (24.3 years) were enrolled in this prospective cross-sectional study. Participants performed tests on one day under a non-fatigued state of invertor and evertor muscles and on the second day in a fatigued state. Tests included static posturography on a force platform in a bipedal stance with eyes open and closed and in one-legged support with eyes open and functional jump tests (figure-of-8, side hop, 6-m crossover hop, and square hop). Fatigue of the ankle invertor and evertor muscles was induced using isokinetic dynamometry with 30 repetitions at 120°/s. Results: Participants had an average age of 24.3 years (SD ± 2.08), the height of 1.73 m (SD ± 0.08), and a weight of 68.63 kg (SD ± 10.29). The average Body Mass Index (BMI) was 22.88 (SD ± 2.46). A decrease in performance was observed in functional activities and postural control under all conditions after the induction of muscle fatigue, except for the speed at a bipedal stance with eyes open. Conclusions: Functional jump tests are low cost and useful for clinical practice and evaluation of the effects of muscle fatigue and could be used in clinical practice.