The number of published systematic reviews has increased over the last years, with a non-negligible proportion displaying methodological concerns. We aimed to develop and evaluate a tool to assess the reported methodological quality of medical systematic reviews. The developed tool (ReMarQ) consists of 26 dichotomous items. We applied an item response theory model to assess the difficulty and discrimination of the items and decision tree models to identify those items more capable of identifying systematic reviews with higher reported methodological quality. ReMarQ was applied to a representative sample of medical systematic reviews (excluding those published in the Cochrane Database of Systematic Reviews) to describe their methodological quality and identify associated factors. We assessed 400 systematic reviews published between 2010 and 2020, of which 196 (49.0%) included meta-analysis. The most discriminative items were (i) conducting a risk of bias assessment, (ii) having a published protocol and (iii) reporting methods for solving disagreements. More recent systematic reviews (adjusted yearly RR=1.03; 95%CI=1.02 −1.04, p<0.001) and those with meta-analysis (adjusted RR=1.34; 95%CI=1.25 −1.43, p<0.001) were associated with higher reported methodological quality. Such an association was not observed with the journal impact factor. The items most frequently fulfilled were (i) reporting search dates, (ii) reporting bibliographic sources and (iii) searching multiple electronic bibliographic databases. ReMarQ, consisting of dichotomous items and whose application does not require subject content expertise, may be important (i) in supporting an efficient quality assessment of systematic reviews and (ii) as the basis of automated processes to support that assessment.

Aplectana membranosa is a cosmocercid nematode that shows affinity with various amphibian and reptile hosts, being considered a generalist species. To date, no studies have investigated the influence of host and locality in the morphological variation of this species. Thus, we analysed morphological and morphometric characters of 260 specimens of A. membranosa collected from 9 host species and 7 different localities. To complement the metric studies, we conducted phylogenetic analyses using the ribosomal genes 28S and internal transcript spacer 1 (ITS1) to determine the phylogenetic position of the species and its divergence. In the present study, it was possible to observe the cloacal papillae pattern of the species through scanning electron microscopy, and we found no morphological variation in the specimens of A. membranosa from various hosts in different localities in Brazil. The study showed low variation in all data. However, despite the low variation, we found that external environmental conditions, such as climate and latitude, influence its variation. Molecular analyses highlighted that the separation of Cosmocercidae members may be related to geographic distribution and population genetic divergence. Thus, the results illustrated in this study reiterate the importance of using integrative data to better elucidate the family’s taxonomic and evolutionary history.

This study aimed to identify patterns of anthropometric trajectories throughout life and to analyse their association with the occurrence of sarcopenia in people from the Longitudinal Study of Adult Health (ELSA-Brasil). It is a cross-sectional study involving 9670 public servants, aged 38–79 years, who answered the call for new data collection and exams, conducted approximately 4 years after the study baseline (2012–2014). Data sequence analysis was used to identify patterns of anthropometric trajectory. A theoretical model was elaborated based on the directed acyclic graph (DAG) to select the variables of minimum adjustment in the analysis of the causal effect between trajectory and sarcopenia. Poisson regression with robust variance was adopted for data analysis. The patterns of change in the anthropometric trajectory were classified in stable weight (T1); change to normal weight (T2); change to excess weight (T3); weight fluctuation (T4) and change to low weight (T5). The prevalence of sarcopenia in men and women who changed the anthropometric path for the low weight was twice as large when compared to participants with a stable weight trajectory. A protective effect of the excess weight trajectory was observed for the occurrence of sarcopenia in them. The results pointed to the need for health policies that encourage the proper management of body components in order to prevent and control obesity, as well as to preserve the quantity and quality of skeletal muscle mass throughout life, especially in older adults.

Early weaning can lead to changes in the morphology of organs in adulthood, and the consumption of functional foods during lactation and postnatal life is believed to prevent these changes. However, it is not known if early weaning affects testicular morphology and if the use of cocoa can prevent that. We studied the effects of maternal and postnatal supplementation of cocoa powder on the testicular morphology of early weaned adult rats. The animals were divided into four groups (n = 6 each), control group, cocoa control group, early weaning (EW) group, and cocoa early weaning (EWCa) group, and were analyzed for 90 d, after which they were euthanized. The animals from the EW group showed a reduction in the tubular diameter and height of the seminiferous epithelium, a decrease in epithelial surface density (Sv), and an increase in the lumen and proper tunic. However, the animals from the EWCa group showed an increase in the diameter and height of the epithelium, an increase in the epithelium Sv, and a decrease in the lumen and the proper tunic. The early weaning promotes morphological changes in the testicles; however, supplementation with cocoa powder can preserve the testicular histoarchitecture.

The study of the Bom Santo Cave (central Portugal), a Neolithic cemetery, indicates a complex social, palaeoeconomic, and population scenario. With isotope, aDNA, and provenance analyses of raw materials coupled with stylistic variability of material culture items and palaeogeographical data, light is shed on the territory and social organization of a population dated to 3800–3400 cal BC, i.e. the Middle Neolithic. Results indicate an itinerant farming, segmentary society, where exogamic practices were the norm. Its lifeway may be that of the earliest megalithic builders of the region, but further research is needed to correctly evaluate the degree of this community's participation in such a phenomenon.

Objective: To assess the frequency of suicidal ideation and suicide attempts in patients with Parkinson's disease.

Methods: The Mini International Neuropsychiatric Interview (MINI), Beck Depression Inventory (BDI), and Hamilton Rating Scale for Depression (HAM-D) were administered to 90 consecutive, non-demented Parkinson's disease patients. They were also submitted to a complete neurologic examination which included brief cognitive batteries, the Mini Mental Status Exam, and Frontal Assessment Battery. We analyzed the scores of the section of the MINI related to the risk of suicide as well as the specific questions of BDI and HAM-D concerning suicidal ideation.

Results: No patient had ever attempted suicide. According to MINI, suicidal ideation was present in 13 patients (14.4%) with Parkinson's disease. All instruments assessed the risk of suicide in a similar way. Suicidal ideation was associated only with lower age (P=.022), lower age of Parkinson's disease onset (P=.021), panic disorder (P=.004), social anxiety disorder (P=.007), and major depression (P<.001). Logistic regression analysis indicated that major depression was the main predictor of suicidal ideation.

Conclusion: Suicide attempts seem to be uncommon in Parkinson's disease, despite the fact that the rates of suicidal ideation are possibly elevated. Depression seems to be the most important predictor of suicidal ideation in Parkinson's disease.

Kumbira Forest is the best representative area of Angola's Central Escarpment and the only site known to hold significant populations of four of the five threatened endemic bird species of this habitat. However, the forest is disappearing as a result of human activities. Remote-sensing techniques were used to assess changes in forest cover, and bird and habitat surveys were performed to assess the effect of land-use changes on endemic species and the bird community. No relationships could be established between the presence of endemics and habitat and landscape variables. This lack of effect may be attributable to the low number of records and compounded by the mosaic structure of the landscape. Although forest cover has been maintained in Kumbira, old-growth forest has been replaced by secondary growth in many areas. Nevertheless these secondary-growth forest patches can maintain a bird community similar to that found in old-growth forest.

Dias FM, Doyle F, Kummer A, Cardoso F, Fontenelle LF, Teixeira AL. Frequency of psychiatric disorders in blepharospasm does not differ from hemifacial spasm.