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The medicinal plant Bredemeyera floribunda Willd. is used to treat cardiovascular disease, chronic fatigue, low libido, as well as increased diuresis. However, studies considering the toxicity of this plant are scarce. Develop an aqueous extract of B. floribunda considering traditional use and determine the average lethality (LD50), signs, and symptoms of toxicity. The B. floribunda extract was obtained by immersing the root bark in ultrapure water for 18 hours at 4°C, under constant stirring. The test extract was administered in a single dose of 2.000 mg/kg by gavage to rats. Signs and symptoms of toxicity were determined according to the Hippocratic screening test and compared with the control group. In addition, a necropsy was performed for macroscopic evaluation of the organs in the abdominal cavity. A powder was obtained from aqueous extracts that showed the same organoleptic characteristics and emulsification capacity as those presented by the fresh root when prepared according to popular tradition. The LD50 was greater than the test dose with three animals surviving. On the other hand, necropsy of dead rats showed necrosis and reduction in lung mass, in addition to the presence of foam and excessive distension of the stomach and intestines. The main symptoms of toxicity were anesthesia, ataxia, sedation, loss of muscle strength, and excessive drowsiness in the first 24 hours. There was no difference between the control and extract groups with regard to body mass, food, and water intake, as well as in macroscopy of the heart, liver, lungs, intestines, spleen, pancreas, and kidneys. The aqueous extract of the B. floribunda was considered nontoxic or of very low toxicity. However, it is capable of altering the activity of the central nervous system and causing disorders in the respiratory and digestive systems.

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BACKGROUND: Yoga practice can increase blood flow in the genital area, increase muscular strength, and improve body perception, which is related to sexual function. This study aimed to summarize the available evidence about the effects of yoga on sexual function in adults. METHODS: Systematic searches of five databases were conducted from inception to April 28, with the last update on September 28, 2023. Randomized clinical trials (RCTs) that compared yoga with nonintervention control groups on sexual function in adults. Risk of bias and certainty of evidence were assessed by the Cochrane risk of bias tool 2, and the GRADE approach, respectively. Summary effect size measures were calculated using a random-effects model estimation and are reported as standardized mean differences and 95% confidence intervals. Reporting followed the PRISMA guidelines. RESULTS: Ten RCTs that comprised 730 adults (range mean age, 26.64-68.2 years; 680 [93.2 %] women) were included. For the primary outcome, yoga intervention was associated with a significant small improvement in sexual function (-0.31; -0.47 to -0.15, p = 0.0002), with some concerns about risk of bias in nine RCTs (90%) and low-certainty evidence. Subgroup analyses revealed that yoga interventions performed by women (-0.36; -0.52 to -0.21, p < 0.00001), healthy individuals (-0.38; -0.59 to -0.16, p = 0.0006), or middle-aged individuals (-0.44; -0.63 to -0.25, p < 00001) significantly improved sexual function compared with control groups. CONCLUSION: Yoga was associated with a small improvement in sexual function compared with nonintervention control groups in adults. However, high-quality, larger RCTs are required to draw more definitive conclusions.

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There is a recent and growing interest in assessing differential responders to resistance training (RT) for diverse outcomes. Thus, the individual ability to respond to an intervention for a specific measurement, called responsiveness, remains to be better understood. Thus, the current study aimed to summarize the available information about the effects of RT on functional performance and muscle strength, power, and size in healthy adults, through the prevalence rate in different responsiveness classifications models. A systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and was registered at the International Prospective Register of Systematic Reviews (PROSPERO, CRD42021265378). PubMed/MEDLINE, Scopus, and Embase databases were systematically searched in October 2023. A total of 13 studies were included, totaling 921 subjects. Only two studies presented a low risk of bias. Regarding the effectiveness of RT, the prevalence rate for non-responders ranged from 0% to 44% for muscle strength, from 0% to 84% for muscle size, and from 0% to 42% for functional performance, while for muscle power, the only study found showed a responsiveness rate of 37%. In conclusion, a wide range of differential responders is described for all variables investigated. However, the evidence summarized in this systematic review suggested some caution while interpreting the findings, since the body of evidence found seems to be incipient, and widely heterogeneous in methodological and statistical aspects.

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The advection of passive scalars in time-independent two-dimensional incompressible fluid flows is an integrable Hamiltonian system. It becomes non-integrable if the corresponding stream function depends explicitly on time, allowing the possibility of chaotic advection of particles. We consider for a specific model (double gyre flow), a given number of exits through which advected particles can leak, without disturbing the flow itself. We investigate fractal escape basins in this problem and characterize fractality by computing the uncertainty exponent and basin entropy. Furthermore, we observe the presence of basin boundaries with points exhibiting the Wada property, i.e., boundary points that separate three or more escape basins.

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This study evaluated the acute effect of the exergame Kinect Sports® beach volleyball on state anxiety level in adult women. Thirty healthy adult women (age: 21 [4] years, body mass: 54.70 [19.50] kg, height: 1.61 ± 0.05 m, and body mass index: 21.87 [5.76] kg/m2, data are expressed as median [interquartile range] and as the mean ± standard deviation) were assigned to play an exergame of beach volleyball in singleplayer mode session (intervention session) for ~ 30 min using the Xbox 360 Kinect® or remained seated (control session). State anxiety was evaluated before and after the intervention and control sessions through the State-Trait Anxiety Inventory. State anxiety obtained in both sessions (exergame and control) was classified as intermediate before (median: 36.00 [IQR: 4.75] and mean = 38.73 ± 7.23, respectively) and after (mean: 34.86 ± 6.81 and mean: 37.66 ± 8.44, respectively). Friedman test found no time significant effect on state anxiety of the sessions (χ2 [3] = 6.45, p-value = 0.092, Kendall's W = 0.07 "trivial"). In conclusion, the present study showed that there were no significant differences in the state anxiety level after an acute session of the exergame beach volleyball.

KEY POINTS: • Exergame beach volleyball presented high enjoyment and a moderate to strong future engagement possibility. • A session of the volleyball exergame did not improve affectivity and state anxiety level compared with control condition. • A session of the volleyball exergame elicited moderate physical exercise intensity.

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In this work, we study the dynamics of a susceptible-exposed-infectious-recovered-susceptible epidemic model with a periodic time-dependent transmission rate. Emphasizing the influence of the seasonality frequency on the system dynamics, we analyze the largest Lyapunov exponent along parameter planes finding large chaotic regions. Furthermore, in some ranges, there are shrimp-like periodic structures. We highlight the system multistability, identifying the coexistence of periodic orbits for the same parameter values, with the infections maximum distinguishing by up one order of magnitude, depending only on the initial conditions. In this case, the basins of attraction have self-similarity. Parametric configurations, for which both periodic and non-periodic orbits occur, cover 13.20% of the evaluated range. We also identified the coexistence of periodic and chaotic attractors with different maxima of infectious cases, where the periodic scenario peak reaches approximately 50% higher than the chaotic one.

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For tokamaks with uniform magnetic shear, Martin and Taylor have proposed a symplectic map which has been used to describe the magnetic field lines at the plasma edge perturbed by an ergodic magnetic limiter. We propose an analytical magnetic field line map, based on the Martin-Taylor map, for a tokamak with arbitrary safety factor profile. With the inclusion of a nonmonotonic profile, we obtain a nontwist map which presents the characteristic properties of degenerate systems, such as the twin islands scenario, shearless curve, and separatrix reconnection. We estimate the width of the islands and describe their changes of shape for large values of the limiter current. From our numerical simulations about the shearless curve, we show that its position and aspect depend on the control parameters.

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We examined the effect of amount of muscle mass involved in moderate-intensity continuous physical exercise on executive function. To this end, fifty-five participants completed two acute physical exercise sessions on an airbike ergometer using the upper and lower limbs simultaneously and only the upper limbs, and a resting control session in a randomized order. The physical exercise session lasted 30 min and was performed at moderate intensity (between 64 %-76 % of maximal heart rate evaluated in graded maximal exercise testing). Participants took the Stroop test (congruent and incongruent trials) before and after the sessions to assess executive performance. For the congruent trial, both physical exercise interventions improved executive function performance (pre vs. post, p-value = 0.002 and 0.003 for physical exercise with upper limbs and physical exercise with upper and lower limbs, respectively). Furthermore, executive function performance was higher after the physical exercise interventions than after the control session (p-value = 0.002 and 0.004 for physical exercise with upper limbs and physical exercise with upper and lower limbs, respectively). For the incongruent trial, both physical exercise interventions also improved executive function performance (pre vs. post, p-value < 0.001 for physical exercise with upper limbs and physical exercise with upper and lower limbs, respectively). However, there were no significant differences after both physical exercise interventions and resting control session (p-value = 0.175). Executive function (congruent trial) was positively impacted by acute aerobic physical exercise regardless of the amount of muscle mass involved (upper limbs or upper plus lower limbs). Therefore, we recommend aerobic physical exercise with less or more muscle mass involved to improve cognitive function.

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We consider open non-twist Hamiltonian systems represented by an area-preserving two-dimensional map describing incompressible planar flows in the reference frame of a propagating wave, and possessing exits through which map orbits can escape. The corresponding escape basins have a fractal nature that can be revealed by the so-called basin entropy, a novel concept developed to quantify final-state uncertainty in dynamical systems. Since the map considered violates locally the twist condition, there is a shearless barrier that prevents global chaotic transport. In this paper, we show that it is possible to determine the shearless barrier breakup by considering the variation in the escape basin entropy with a tunable parameter.

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Mobility applications are rapidly growing in cities worldwide due to their convenience and low cost. Mobility applications drivers experience vast flexibility in work hours, often work longer than in fixed-hours jobs, and can constantly transport passengers in their vehicles for up to 12 h; after this, they must go offline for eight consecutive hours before driving again. Nonetheless, drivers have found an easy way around this limitation by switching to other apps and continuing driving. This burden of prolonged work can increase sedentary behavior among mobility applications drivers. Sedentary behavior is any waking activity in which the individual expends 1.5 metabolic equivalents (METs) or less while sitting or reclining. This behavior can increase the risk of detrimental effects on health. In this opinion article, we aim to discuss the possible effects of the burden of prolonged work on the sedentary behavior of mobility applications drivers and propose possible strategies to face this concerning situation.

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The stickiness effect is a fundamental feature of quasi-integrable Hamiltonian systems. We propose the use of an entropy-based measure of the recurrence plots (RPs), namely, the entropy of the distribution of the recurrence times (estimated from the RP), to characterize the dynamics of a typical quasi-integrable Hamiltonian system with coexisting regular and chaotic regions. We show that the recurrence time entropy (RTE) is positively correlated to the largest Lyapunov exponent, with a high correlation coefficient. We obtain a multi-modal distribution of the finite-time RTE and find that each mode corresponds to the motion around islands of different hierarchical levels.

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BACKGROUND & AIMS: It is well known that dietary fiber positively impacts the microbiome and health as a whole. However, the health effects of ß-glucan, a dietary fiber extracted from oats, have been questioned when administered alone or incorporated into other foods. The purpose of this systematic review and meta-analysis was to evaluate the impact of oats or ß-glucan supplements on the lipid profile. METHODS: Randomized controlled trials with parallel-arm or crossover blinded interventions at least two weeks in duration, for hyperlipidemic or non-hyperlipidemic men and women ≥18 years of age were selected. Only single (participants blinded) or double-blinded studies that compared oat or isolated ß-glucan with a placebo/control group were considered for this review. The databases EMBASE, PubMed, Web of science and CINHAL were searched, from the earliest indexed year available online to the end of January 2022. Random-effects models were used to combine the estimated effects extracted from individual studies, and data were summarized as standardized mean difference (SMD) and 95% confidence interval (95%CI). RESULTS: A total of 811 articles were screened for eligibility, and relevant data were extracted from 28 studies, totaling 1494 subjects. Oat interventions TC (-0.61, 95%CI: -0.84;-0.39, p < 0.00001, and -0.70, 95%CI: -1.07;-0.34, p = 0.0002, respectively) and LDL (-0.51, 95%CI: -0.71;-0.31, p < 0.00001, and -0.38, 95%CI: -0.60;-0.15, p = 0.001, respectively). Moreover, isolated ß-glucan interventions from parallel-arm studies decreased TC (-0.73, 95%CI: -1.01;-0.45, p < 0.00001), LDL (-0.58, 95%CI: -0.85;-0.32, p < 0.0001) and triglycerides (-0.30, 95%CI: -0.49;-0.12, p = 0.001). HDL was not altered by either oat or isolated ß-glucan (p > 0.05). CONCLUSION: Overall, this review showed that both oat and isolated ß-glucan interventions improved lipid profiles. Furthermore, the ingestion of oats or isolated ß-glucan supplements are effective tools to combat dyslipidemia and should be considered in cardiovascular disease prevention.

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Introducción. La innovación ha marcado el progreso de la cirugía por medio del desarrollo y aplicación de procedimientos seguros y rentables enfocados en solucionar los problemas del profesional. Además, ofrece a los usuarios nuevas técnicas y alternativas accesibles y seguras para elegir. División de temas tratados. La innovación en cirugía se basa en: 1) técnicas; 2) mejora en la logística de la práctica; 3) e introducción, diseño de dispositivos y herramientas. El Innovar debe estructurarse basado en marcos propuestos como el Idea, Development, Exploration, Assessment, Long term study (IDEAL). Hay que comprender la necesidad de innovar en cirugía y proponer puntos clave para tener en cuenta durante la implementación del marco IDEAL, herramienta valiosa como propuesta innovadora de cirugía en Latinoamérica. Conclusiones. La innovación es un camino al progreso y avance de la medicina en general. Se propone que para lograr un impacto innovador se centre en la aplicación del algoritmo propuesto, relacionándolo con la realidad que afronta nuestra sociedad Latinoamericana.

Introduction. Innovation has driven progress in surgery through the development and application of safe and profitable procedures that focus on solving the professional's problems. It also offers users new choices of safe and accessible techniques and alternatives. Division of Covered Topics. Innovation in surgery is based on 1) techniques; 2) improved logistics in the practice, and 3) the design and introduction of devices and tools. Innovation should be structured in frameworks such as those proposed by IDEAL (Idea, Development, Exploration, Assessment, Long term study). It is necessary to understand the need to innovate in surgery and to propose key aspects to take into consideration during the implementation of the IDEAL framework, which represents a valuable tool for the development of innovative proposals in Latin America. Conclusions. Innovation is a path towards progress and the advancement of medicine in general. It is suggested that innovative impact can be achieved by using the proposed algorithm, associating it with the realities we face in Latin America.

Introdução. A inovação tem marcado o avanço da cirurgia através do desenvolvimento e aplicação de procedimentos seguros e rentáveis com foco na solução dos problemas do profissional. Além disso, ofrece aos usuários novas técnicas e alternativas acessíveis e seguras para escolher. Divisão dos tópicos abordados. A inovação em cirurgia baseia-se em: 1) técnicas; 2) melhoria na logística da prática; e 3) introdução, design de dispositivos e ferramentas. Inovar deve ser estruturado com base em estruturas propostas, tais como Idea, Development, Exploration, Assessment, Long term study (IDEAL). É preciso entender a necessidade de inovar na cirurgia e propor pontos-chave a serem considerados na implantação da estrutura IDEAL, uma ferramenta valiosa como proposta inovadora da cirurgia na América Latina. Conclusões. A inovação é um caminho para o progresso e avanço da medicina em geral. Propõe-se que, para alcançar um impacto inovador, se concentre na aplicação do algoritmo proposto, relacionando-o com a realidade que enfrenta nossa sociedade Latino-americana.

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We propose a one-dimensional dynamical system, the sine-circle nontwist map, that can be considered a local approximation of the standard nontwist map and an extension of the paradigmatic sine-circle map. The map depends on three parameters, exhibiting a simple mathematical form but with a rich dynamical behavior. We identify periodic, quasiperiodic, and chaotic solutions for different parameter sets with the Lyapunov exponent and Slater's theorem. From the bifurcation analysis, we determine two bifurcation lines, those that depend on just two of the control parameters, for which the bifurcation that occurs is of the saddle-node type. In order to investigate multistability, we analyze the bifurcation diagrams in the two directions of parameter variation and we observe some regions of hysteresis, representing the coexistence of different attractors. We also analyze different multistable scenarios, as single attractor, coexistence of periodic attractors, coexistence of chaotic and periodic attractors, chaotic behavior, and coexistence of different chaotic bands, by the Lyapunov exponent and the analysis of the domain occupied by the solutions. From the parameter spaces constructed, we observe the prevalence of single attractor and only chaotic behavior scenarios. The multistable scenario is, mostly, formed by different periodic attractors. Lastly, we analyze the crisis in chaotic attractors and we identify the interior and the boundary crisis. From our results, the boundary crisis plays a key role for the extinction of multistability.

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To evaluate the heart rate response, emotion and changes in anxiety and anger levels after exposure to unpleasant pictures from the International Assessment Pictures System (IAPS) compared with neutral picture exposure in healthy individuals. Forty participants (23 women) visited the laboratory on two occasions. State anger and state anxiety levels were evaluated pre- and post-visualization of a set of IAPS pictures and heart rate was monitored during exposure. Two different picture sets were utilized-one with neutral pictures (that served as the control) and the other with unpleasant pictures. State anxiety and state anger were higher in post-unpleasant session for women than before (p < 0.001). For men, only state anxiety was higher in the post-unpleasant session (p < 0.001). State anxiety (p = 0.004) and state anger (p < 0.001) post-unpleasant session was higher for women than in men. The pleasure and dominance domains were lower in the unpleasant session for both men and women (p < 0.001), and the arousal domain was higher for both men and women (p < 0.001) than in the neutral session. In the unpleasant session, arousal was higher (p = 0.004), and dominance was lower (p < 0.001) among women than among men, but no difference in pleasure was found (p > 0.05). For women, average heart rate was higher on unpleasant session, compared to neutral (p = 0.01), but not for men (p > 0.05). Women are more sensitive and react strongly to unpleasant picture exposure. The IAPS unpleasant session was not able to induce anger levels in men.

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BACKGROUND: Anxiety disorders affect many people around the world and women are more affected than men. Physical exercise might be an important nonpharmacological tool to ameliorate these disorders. The aim of this study was to compare state anxiety level and enjoyment between a dance exergame session and a traditional aerobic exercise. METHODS: Twenty healthy young women completed 3 visits, on separate days. At the first visit, participants performed a graded exercise testing and familiarization procedures. In other two visits, participants completed two exercise sessions (dance exergame and traditional aerobic exercise), with similar intensities and duration. Each session lasted approximately 45 minutes. State anxiety level was evaluated before, immediately post- and 10 minutes post-sessions. Enjoyment was evaluated immediately post-sessions. RESULTS: There was a significant interaction between session and time (P<0.001), a main effect of time (P=0.007) but no significant main effect of session (P=0.057) on state anxiety level. State anxiety level immediately post (P<0.001) and 10 minutes postsession (P<0.001) were significantly lower than predance exergame session. There were no significant changes between pre-, immediately post and 10 minutes post-traditional aerobic exercise session (P>0.05). State anxiety level at immediately post dance exergame session was significantly lower than immediately post traditional aerobic exercise session (P=0.026). Dance exergame session was significantly more enjoyable than traditional aerobic exercise session (P<0.0001). CONCLUSIONS: Dance exergames might be used as a tool to reduce anxiety level in young women.

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BACKGROUND: Complications after endoscopic retrograde cholangiopancreatography (ERCP) are rare, approximately 0.09% to 1.8% are duodenal perforation. This type of injury requires early diagnosis and proper management since the outcomes can be catastrophic, leading to death in 20% of cases. OBJECTIVE: To show our experience in the management of these injuries in order to establish if there is benefit from minimally invasive management versus conventional management. METHOD: Observational, retrospective and descriptive study comparing patients who required surgical management after post-ERCP duodenal perforation in three centers in Bogotá, Colombia, between January 2013 and December 2018. RESULTS: 13 patients were taken to surgical management after duodenal perforation post ERCP, 7 laparoscopically (53.8%), with an average hospital stay of 10.7 days and mortality of 0% and 6 by open route (46.1%), with an average hospital stay of 33 days and mortality of 50%, with a minimum follow-up of 6 months. CONCLUSIONS: Post ERCP duodenal perforation, despite its low incidence, should be suspected due to its high mortality. Laparoscopic surgery is a good tool to address duodenal perforations after ERCP, because it presents a lower rate of complications and mortality.

ANTECEDENTES: Las complicaciones tras la colangiopancreatografía retrógrada endoscópica (CPRE) que necesitan manejo quirúrgico son limitadas y aproximadamente el 0.09-1.8% corresponden a perforación duodenal. Este tipo de lesiones requieren un diagnóstico temprano y un manejo adecuado, ya que los desenlaces pueden ser catastróficos, con una mortalidad reportada de hasta el 20%. OBJETIVO: Presentar nuestra experiencia en el manejo quirúrgico de estas lesiones. MÉTODO: Estudio observacional, retrospectivo y descriptivo, de pacientes que requirieron manejo quirúrgico por perforación duodenal tras CPRE en tres centros de Bogotá, Colombia, entre enero de 2013 y diciembre de 2018. RESULTADOS: Fueron llevados a manejo quirúrgico 13 pacientes, 7 (53.8%) por vía laparoscópica, con una estancia hospitalaria promedio de 10.7 días y una mortalidad del 0%, y 6 (46.1%) por vía abierta, con una estancia hospitalaria promedio de 33 días y una mortalidad del 50%, con seguimiento mínimo a 6 meses. CONCLUSIONES: La perforación duodenal tras una CPRE, pese a su baja incidencia, se debe sospechar por su alta morbimortalidad. La decisión del abordaje quirúrgico está condicionada por el estado clínico del paciente, y por ende está ligada al pronóstico de este.

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This study compared the exergame beach volleyball's acute effects on state anxiety level in single vs. multiplayer mode in adult men. Sixty adult men (age: 21.98 [4.58] years, body mass: 75.40 [15.70] kg, height: 1.77 [0.09] m, and body mass index: 24.19 [5.44] kg/m2; data are expressed as median [interquartile range]) were assigned to play exergame of beach volleyball in single- or multiplayer mode for approximately 30 min using the Xbox 360 Kinect®. The state anxiety level was evaluated before and after the intervention. There was no significant difference in the state anxiety levels after an exergame session between the single and multiplayer modes (p-value = 0.407, effect size (rB) = -0.12, defined as small). Furthermore, there was no significant difference in the state anxiety levels before and after an exergame session in single-player mode (p-value = 0.516, effect size (d) = 0.14, defined as trivial) and multiplayer mode (p-value = 0.053, rB = 0.43, defined as medium). In conclusion, state anxiety level after exergame beach volleyball did not differ between the single and multiplayer modes in adult men.

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Oscillatory activities in the brain, detected by electroencephalograms, have identified synchronization patterns. These synchronized activities in neurons are related to cognitive processes. Additionally, experimental research studies on neuronal rhythms have shown synchronous oscillations in brain disorders. Mathematical modeling of networks has been used to mimic these neuronal synchronizations. Actually, networks with scale-free properties were identified in some regions of the cortex. In this work, to investigate these brain synchronizations, we focus on neuronal synchronization in a network with coupled scale-free networks. The networks are connected according to a topological organization in the structural cortical regions of the human brain. The neuronal dynamic is given by the Rulkov model, which is a two-dimensional iterated map. The Rulkov neuron can generate quiescence, tonic spiking, and bursting. Depending on the parameters, we identify synchronous behavior among the neurons in the clustered networks. In this work, we aim to suppress the neuronal burst synchronization by the application of an external perturbation as a function of the mean-field of membrane potential. We found that the method we used to suppress synchronization presents better results when compared to the time-delayed feedback method when applied to the same model of the neuronal network.

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