This study aimed to compare blood pressure and vascular responses during isometric handgrip exercise and muscle metaboreflex activation in the offspring of parents with type 2 diabetes and individuals without a family history of diabetes. The sample consisted of a family history of type 2 diabetes parents (n = 12; 30.92 ± 4.87 years) and those without a family history of diabetes (n = 12; 28.42 ± 5.43 years). Blood pressure (Dixtal®), heart rate (ECG-Dixtal®) and muscle blood flow (Hokanson®) were recorded for 3 min at baseline and 3 min during isometric handgrip exercise (Saehan®). Immediately after the exercise, circulatory occlusion was performed for 2 min to assess muscle metaboreflex activation. Additionally, the vascular conductance was calculated. A two-factor repeated measures analysis of variance was conducted to test for possible differences between the groups for all variables under baseline conditions and during isometric handgrip exercise and to analyse the muscle metaboreflex activation. A significance level of p < 0.05 was adopted. Blood pressure, heart rate, muscle blood flow and vascular conductance showed similar baseline values in both groups, with significant and similar increases during the isometric handgrip exercise. Furthermore, for muscle metaboreflex activation, the systolic, diastolic and mean blood pressure values were significantly and similarly increased compared with baseline in both groups. The blood pressure and vascular responses during isometric handgrip exercise, as well as the muscle metaboreflex activation of blood pressure, are preserved in the offspring of parents with type 2 diabetes compared to those without a family history of diabetes.

Background/Objectives: Manual preparation of semisolid formulations (creams, ointments, gels) is prone to variability in mixing energy and time, which may compromise uniform API distribution. This study aimed to evaluate an Electronic Mortar and Pestle (EMP; Unguator™) as a standardized compounding tool, with objectives to: (i) validate stability-indicating UHPLC methods; (ii) assess content uniformity across jar strata; (iii) quantify the impact of mixing time and rotation speed via design of experiments (DOE); and (iv) verify cleaning effectiveness and cross-contamination risk. Methods: Five representative formulations were compounded: urea 40%, clobetasol 0.05%, diclofenac 2.5% in hyaluronic acid 3% gel, urea 10% + salicylic acid 1%, and hydroquinone 5%. UHPLC methods were validated per ICH Q2(R2) and stress-tested under acid, base, oxidative, thermal, and UV conditions. Homogeneity was assessed by stratified sampling (top/middle/bottom). A 32 factorial DOE (time: 2/6/10 min; speed: 600/1500/2400 rpm) modeled effects on % label claim and RSD. Cleaning validation employed hydroquinone as a tracer, with swab sampling pre-/post-use and post-sanitization analyzed by HPLC. Results: All UHPLC methods met specificity, linearity, precision, accuracy, and sensitivity criteria and were stability-indicating (Rs ≥ 1.5). Formulations achieved 90-110% label claim with strata CV ≤ 5%. DOE revealed speed as the dominant factor for clobetasol, urea, and diclofenac, while time was more influential for salicylic acid; gels exhibited curvature, indicating diminishing returns at high rpm. Model-predicted optima were implementable on the Unguator™ with minor rounding of rpm/time. Cleaning validation confirmed post-sanitization residues below LOQ and <10 ppm acceptance. Conclusions: The Unguator™ provides a practical, parameter-controlled route for compounding pharmacies to standardize semisolid preparations, achieving reproducible layer-to-layer content uniformity within predefined criteria under the evaluated conditions through programmable set-points and validated cycles. DOE-derived rpm-time relationships define an operational design space within the studied ranges and support selection of implementable device settings and set-points. Importantly, the DOE-derived "optima" in this study are optimized for assay-based content uniformity (mean % label claim and strata variability). Cleaning validation supports a closed, low-cross-contamination workflow, facilitating consistent routines for both routine and complex formulations. Overall, the work implements selected QbD elements (QTPP-Quality Target Product Profile; CQA-Critical Quality Attribute definition; CPP-Critical Process Parameter identification; operational design space; and a proposed control strategy) and should be viewed as a step toward broader lifecycle QbD implementation in compounding.

BackgroundFear of falling can be present in the daily lives of patients with Parkinson's disease (PD) due to their predisposition to falls.ObjectiveThe main objective of this study was to translate the Fear of Falls Scale (FFS) into Brazilian Portuguese, adapt it cross-culturally, and validate it.MethodsA multicenter, cross-sectional study was conducted with PD patients fluent in Brazilian Portuguese, recruited from five research centers in Brazil. Descriptive analysis characterized the sample and compared the data. Cronbach's α and McDonald's ω coefficients were used to assess the internal consistency of the scale.ResultsNo significant differences were observed between the translated versions T1 and T2. The B1 and B2 versions did not present significant divergences in the back-translation from the original scale. The Movement Disorder Society – Unified Parkinson Disease Rating Scale (MDS-UPDRS) part III significantly correlated with motor skills (rho = 0.56, 0.43–0.67;p≤ 0.001) and fear of falling (rho = 0.48, 0.34–0.60;p≤ 0.001). Higher stages on the modified Hoehn & Yahr scale were associated with a greater decline in motor skills and a greater fear of falling (p < 0.001). The total internal consistency of balance-related motor skills and fear of falling was considered sufficiently reliable. Cronbach's α values were 0.96, 0.91, and 0.90; while McDonald's ω values were 0.96, 0.92, and 0.91, respectively.ConclusionThe Brazilian version of the FFS proved to be valid and reliable for assessing fear of falling in people with PD.

The objective of this scoping review was to map the range of methodologies and methods used to undertake evidence synthesis aimed at determining barriers and/or enablers in health care, and to inform further research relevant to synthesis methodology in this area. Questions related to identifying and exploring barriers and/or enablers within health care are becoming increasingly popular. Currently, there are multiple approaches to synthesizing this evidence, and it is unclear whether a more consistent approach is warranted. Evidence synthesis on barriers and/or enablers (facilitators) that included interest-holders at different levels of the health system were considered. Evidence synthesis projects had to include primary research studies and were published from 2010 to 2021. Literature reviews, narrative reviews, and umbrella reviews were excluded, as were reviews published in languages other than English. This scoping review followed JBI methodology and was based on a published a priori protocol and reported in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). A 3-step search strategy using a combination of key terms and index headings was undertaken in October 2021 via the following databases/resources: PubMed, Embase, CINAHL (EBSCOhost), PsycINFO (Ovid), Cochrane Database of Systematic Reviews, JBI Evidence Synthesis, and EPPI-Centre Systematic Reviews. An extensive piloting process for screening and selection, and data extraction was undertaken due to the large number of reviewers involved. All records were screened independently by 2 reviewers, and any disagreements were resolved through either a third reviewer or discussion with a panel of reviewers. Extraction was undertaken using a customized form, and data were analyzed using descriptive statistics. Data are presented via tables, figures, a word cloud, and an infographic, supplemented with a narrative synthesis. Following completion of the search, 22,308 records were screened and 774 reviews were included in the scoping review. Systematic reviews were the most commonly used methodology (68%) to synthesize barrier and/or enabler questions. Reviews often included diverse types of evidence and involved an assessment of methodological quality (70%). Findings related to barriers and/or enablers were usually grouped and organized into categories, often by thematic methods (33%) or a narrative approach (20%). Incongruencies related to nomenclature, missing information, and methods used were evident across the large dataset. A variety of methodological approaches are being followed to undertake reviews focused on barriers and/or enablers in health care. The current state of the literature indicates that most authors answer these questions via the conduct of a systematic review and include diverse types of evidence. Further work is needed to determine whether authors are unclear when deciding on methodology and whether guidance is required.

Light-emitting diodes (LEDs) are light sources that can be used for photobiomodulation to treat various diseases and clinical conditions. Growing evidence suggests that photobiomodulation is a promising treatment for rheumatoid arthritis (RA) and osteoarthritis (OA) because of its analgesic and anti-inflammatory effects. However, such evidence is primarily based on studies evaluating low-power laser-based photobiomodulation, and few studies have assessed the efficacy of LED photobiomodulation in the treatment of RA and OA. Thus, this study aimed to review studies on LED photobiomodulation for the treatment of RA and OA, summarizing the irradiation parameters and conditions, and reporting the study types and main results. Studies on the effects of LED photobiomodulation on RA and OA were accessed via PubMed. Data from accessed studies show that LED photobiomodulation has been carried out with red and infrared LEDs based on invitro and invivo experimental models. This therapy may decrease arthritic markers, including edema, hyperalgesia, inflammation, cartilage degradation, extracellular matrix alterations, and proinflammatory cytokine levels. LED photobiomodulation could be as effective a therapy as laser photobiomodulation, but further clinical studies are necessary to verify its therapeutic benefits in both RA and OA.

Mental fatigue (MF) has been widely investigated in resistance exercise (RE). However, the results remain inconsistent, likely due to variability in the cognitive load across studies and, most importantly, the lack of individualized assessments of self-reported MF levels among participants before initiating the RE session. Therefore, the present study aimed to analyze the acute effect of different levels of MF induced by prior cognitive effort on the subsequent number of repetitions performed during an RE session. In a crossover trial, 20 participants were randomly assigned to three experimental conditions: a control and two mentally fatiguing conditions. In the MF conditions, the participants performed a computerized Stroop word-color (ST) task until reaching 40mm (moderate MF) and 80mm (high MF) on the visual analog scale for MF. Following all three conditions, participants completed an RE session consisting of six sets of half back-squat performed to muscle failure with a fixed load of ∼45% 1RM (1.0m.s-1). Physical and perceptual parameters-including total repetitions, repetitions per set, repetitions per velocity loss, and rating of perceived exertion (RPE)-were measured during the RE session. Participants exhibited a lower number of repetitions and a higher RPE during RE in the high MF condition compared to the moderate MF and control conditions, with a significant difference also observed between the moderate MF and control conditions (p<0.05). In summary, these findings suggest that a high level of subjective MF results in a greater magnitude of impairment in physical performance during an RE session.