ABSTRACT Objective: This study aimed to verify the association between childhood anthropometric indicators and areal bone mineral density (aBMD) in adulthood. Methods: Repeated measures of 137 subjects (68 females) were obtained in childhood (9.2±1.5 years of age) and adulthood (22.3±1.7 years of age). aBMD (g/cm2) was assessed for whole body, lumbar spine, upper and lower limbs, and femoral neck in adulthood using dual-energy X-ray absorptiometry. Anthropometric measurements of body weight (BW), height, triceps and subscapular skinfolds were obtained in childhood. The anthropometric indicators used were BW, body mass index (BMI), and sum of skinfolds (ΣSF). Simple linear regression was used to assess the association between childhood anthropometric indicators and aBMD in adulthood, controlled by chronological age and stratified by sex, with 5% statistical significance. Results: In females, multiple associations were observed between anthropometric indicators and aBMD, with higher coefficients for BMI (β=0.020; R2=0.20; p<0.01 for right femoral neck to β=0.008; R2=0.16; p<0.01 for upper limbs), followed by BW (β=0.003; R2=0.21; p<0.01 for upper limbs to β=0.008; R2=0.20; p<0.01 for right femoral neck) and ΣSF (β=0.001; R2=0.06; p<0.01 for upper limbs to β=0.005; R2=0.12; p<0.01 for right femoral neck). In males, associations were observed only for the lumbar spine region (β=0.016; R2=0.09 for BMI to β=0.004; R2=0.06; p<0.01 for ΣSF). Conclusions: Anthropometric indicators of childhood proved to be sensitive predictors of aBMD in adulthood, especially in females. BMI indicated a greater association with aBMD in both sexes.

RESUMO Objetivo: O objetivo do estudo foi verificar a associação entre os indicadores antropométricos da infância com a área da densidade mineral óssea (aDMO) na idade adulta. Métodos: Medidas repetidas de 137 sujeitos (68 do sexo feminino) foram obtidos na infância (9,2±1,5 anos de idade) e idade adulta (22,3±1,7 anos de idade). A aDMO (g/cm2) foi avaliada para todo o corpo, coluna lombar, membros superiores e inferiores e colo do fêmur na idade adulta usando a absorciometria radiológica de dupla energia (DXA). Medidas antropométricas de peso corporal, estatura e dobras cutâneas das regiões tricipital e subescapular foram obtidas na infância. Os indicadores antropométricos utilizados para as análises foram o peso corporal (PC), o índice de massa corporal (IMC) e o somatório de dobras cutâneas (ΣDC). Regressão linear simples controlada pela idade e estratificada por sexo foi empregada para avaliar a associação entre os indicadores antropométricos do período da infância na aDMO na idade adulta, com significância estatística de 5%. Resultados: No sexo feminino, múltiplas associações foram observadas entre os indicadores antropométricos e a aDMO, com maiores coeficientes para IMC (β=0,020; R2=0,20; p<0.01 para colo do fêmur direito a β=0,008; R2=0,16; p<0,01 para membros superiores), seguido da PC (β=0,003; r2=0,21; p<0,01 para membros superiores a β=0,008; r2=0,20; p<0,01 para colo do fêmur direito) e ΣDC (β=0,001; R2=0,06; p<0,01 para membros superiores a β=0,005; R2=0,12; p<0,01 para colo do fêmur direito). No sexo masculino, associações ocorreram apenas na região da coluna (β=0,016; R2=0,09 para IMC a β=0,004; R2=0,06; p<0,01 para ΣDC). Conclusões: Indicadores antropométricos da infância mostraram ser sensíveis preditores da aDMO na idade adulta, especialmente no sexo feminino. O IMC indicou maior associação com a aDMO em ambos os sexos.

Abstract The use of biopolymers and platelet-rich fibrin (PRF) is currently investigated as an excellent application biomaterial in the tissue engineering field. Natural biomaterials with application potential in tissue engineering and regenerative medicine are due to their characteristics in biocompatibility, biodegradability, and mechanical characteristic. Though, the basic knowledge of three‐dimensional fibrin scaffold and chitosan/alginate processing technology combined with an understanding of the physical-chemical properties of this natural biomaterial is necessary for proper application in regenerative medicine and tissue engineering. This mini review summarizes the information on the composition of chitosan/alginate and PRF in medical area and discusses recent developments with a special focus on its use for the application of drug delivery. The most important advances and stimulating applications are studies in regenerative medicine and tissue engineering, for wound healing to treat burns, tumor treatment, nanoparticle carriers, and drug delivery systems.

Abstract The use of Wharton's Jelly (WJ) as a biomaterial is currently undergoing an appearance in the regenerative medicine field. The biomaterials applications focus on the aspects of cellular growth or delivery of proteins capable of stimulating cellular response. However, the basic knowledge about Wharton jelly and decellularization processing technology combined with understanding the physical-chemical properties of this biomaterial is necessary for proper application in regenerative medicine. This mini-review article summarizes information on the composition of WJ, application of drug delivery, in medicine and discusses recent developments with a special focus on its use for regenerative medicine. The most successful and stimulating applications are studies in regenerative medicine and tissue engineering, for wound healing to treat burns, tumor treatment, nanoparticle carriers, and drug delivery systems.

ABSTRACT: In the last decades, the high incidence of viruses transmitted by whiteflies has become a problem in the tomato fields, threatening, more recently, the potato crops. The present study carried out a survey of begomoviruses and criniviruses in tomato and potato crops, from 2015 to 2018, in the municipalities of Araucária, Campo do Tenente, Campo Largo, Contenda, Lapa, Faxinal, Morretes, Reserva, Castro, Palmeira and São Mateus do Sul, in Paraná State, Brazil. Total DNA and RNA from leaves were extracted and used as templates to detect, respectively, begomoviruses by PCR and criniviruses by RT-PCR. Out of 215 tomato samples, 14 from Faxinal were infected by crinivirus. The other tomato samples and 243 potato samples showed negative results for begomovirus and crinivirus. Results indicated a low incidence (6.5%) of crinivirus infecting tomato crops in Paraná State, and the nucleotide sequence of one amplified fragment shared 99.71% identity with tomato chlorotic virus (ToCV).

RESUMO: Nas últimas décadas, a alta incidência de vírus transmitidos por mosca-branca tornou-se um problema nos campos de tomateiros, ameaçando, mais recentemente, a cultura da batateira. O presente trabalho teve como objetivo realizar um levantamento de begomovírus e crinivírus em lavouras de tomateiro e batateira nos municípios de Araucária, Campo do Tenente, Campo Largo, Contenda, Lapa, Faxinal, Morretes, Reserva, Castro, Palmeira e São Mateus do Sul, no Estado do Paraná, Brasil, de 2015 à 2018. DNA e RNA totais de folhas foram extraídos e utilizados como molde para detectar begomovírus por PCR e crinivírus por RT-PCR. Das 215 amostras de tomateiros coletadas, 14 provenientes de Faxinal estavam infectadas por crinivírus. As demais amostras de tomateiro e as 243 amostras de batateira analisadas apresentaram resultados negativo para begomovírus e crinivírus. Os resultados indicaram baixa incidência (6,5%) de crinivírus infectando lavouras de tomateiros no Estado do Paraná e a sequência de nucleotídeos de um amplicon apresentou 99,71% de identidade com o crinivírus tomato chlorotic virus (ToCV).

ABSTRACT. Cohesive Oxisols are widely used for cultivating eucalyptus in the Coastal Tablelands of the northeastern region of Brazil. However, mechanization and plant cultivation in these soils are difficult because of their cohesive layers. Therefore, the objective of this study was to identify better combinations between tillage systems and types of fertilization to improve the physical attributes of cohesive soil, with the aim of improving eucalyptus growth. The experimental design was completely randomized in a 4 × 2 factorial scheme (soil preparation × fertilization). The tillage systems tested were: i) conventional tillage (CT) - one plowing combined with two harrowings, ii) minimum tillage (MT) - subsoiling down until 0.57 m depths in the planting line, iii) no-tillage type 1 (NT1) - planting in 0.3 m-deep pits, and iv) no-tillage type 2 (NT2) - planting in 0.6 m-deep pits. The types of fertilization tested were mineral (MF) and organic fertilization (OF). The diameter of the soil aggregates was reduced after being subjected to any combination of cohesive soils. Furthermore, OF provided the best levels of plant-available water, attenuating the adverse conditions of the cohesive layer. MT, NT1, and NT2 improved the soil physical attributes when compared to CT. Therefore, the combination of either NT1 or NT2 with OF, followed by the combination of either NT1 or NT2 with MF, was determined to be the best way to cultivate eucalyptus on cohesive soils.

ABSTRACT The objective of this study was to evaluate the relationships between preovulatory follicle (POF) and corpus luteum (CL) diameters, and POF and CL vascular perfusion with progesterone production, ovulation, and pregnancy in Nellore cows subjected to timed artificial insemination (TAI). Nellore cows (n = 201) were subjected to ovulation synchronization and later to ultrasound evaluation of POF and CL at the time of insemination (D0) and seven days later (D7), respectively. Females were divided into three categories according to the POF diameter assessed at the time of insemination: small (SF), medium (MF), and large (LF) follicles. The LF group had a greater number and intensity of pixels in the POF ultrasound exam compared with the SF group. The CL flow intensity and progesterone concentration were also higher in the LF group. The SF group showed lower flow intensity and lower ovulation rate compared with the others. When non-pregnant females were compared to pregnant ones, no difference was observed in any of the analyzed variables. The results show for the first time in Nellore cattle the relationship between the size of ovarian structures and blood flow (quantity and intensity) as well as the ability of the CL to produce progesterone. The intensity of the POF pixels proved to be relevant, demonstrating correlations with the size and flow of the CL, which were not found when evaluating only the number of pixels, thus revealing the importance of evaluating complementary characteristics of the flow.

RESUMO A metástase ocular é uma patologia incomum, principalmente quando se considera a íris como sítio da metástase. Apesar de incomum, a metástase ocular possui o câncer de mama como um de seus principais sítios primários. Ocasionalmente, a manifestação oftalmológica pode ser primária a qualquer outra clínica. Este artigo relata o caso de uma paciente com carcinoma de mama ductal invasivo com presumida metástase em corpo ciliar e íris em olho direito. O diagnóstico precoce interfere de forma significativa na evolução do quadro, sendo necessário o acompanhamento oftalmológico. incomum primários Ocasionalmente clínica direito quadro oftalmológico

ABSTRACT Ocular metastasis is an uncommon pathology, especially when considering the iris as the site of metastasis. Although uncommon, eye metastasis has breast cancer as one of its main primary sites. Occasionally, the ophthalmologic manifestation may be primary to any other clinical manifestation. This article reports the case of a patient with invasive ductal breast carcinoma with presumed metastasis in the ciliary body and iris in the right eye. Early diagnosis significantly affects the evolution of the condition, requiring ophthalmologic follow-up. pathology sites Occasionally condition followup. followup follow up. up follow-up

RESUMO A maioria dos estudos sobre mudanças no estoque de carbono orgânico do solo no bioma Cerrado está relacionada a dados coletados em Latossolos argilosos ou sob diferentes usos da terra, como se estivessem em equilíbrio. Objetivou-se avaliar os efeitos de tipos de preparo do solo e de sequência de culturas sobre o estoque de carbono orgânico do solo e a produtividade das culturas, em Latossolo arenoso, na Bahia. O delineamento experimental foi o de blocos casualizados, com quatro repetições. Amostras de solo foram coletadas após cinco anos de monocultivo de algodão, soja e milho e de uso de grade de discos pesada e grade niveladora (preparo convencional), e de rotação das culturas do algodão, soja e milho com adubo verde ou planta de cobertura (plantio direto). Amostras adicionais foram coletadas em área não cultivada (Cerrado sensu stricto). Práticas de conservação do solo como o não revolvimento e rotação de culturas com planta de cobertura e adubo verde favoreceram o estoque de carbono orgânico do solo na camada de 0-40 cm, com os maiores valores atingindo 36,03 Mg ha−1. O acúmulo de carbono no solo sob preparo convencional e monocultivo de algodão, milho e soja foi menor do que sob plantio direto, que variou de 30,9 a 54,9 %, com o estoque no plantio direto aumentando à taxa anual de 2,36 Mg ha−1 durante cinco anos. O plantio direto, com a rotação soja-milho-algodão, combinada com planta de cobertura e adubo verde, aumentou a produtividade do algodão e da soja e acumulou carbono orgânico no solo arenoso.

ABSTRACT Most studies about soil organic carbon stock changes in the Cerrado (Brazilian Savanna) biome are either related to field data collected in clayey Ferralsols or different land uses, as if they were in equilibrium. This study aimed to evaluate the effect of tillage systems and crop sequences on the soil organic carbon stock and crop yield, in a sandy Ferralsol from Bahia, Brazil. The experimental design was randomized blocks, with four replicates. Soil samples were collected after fve years of cotton, soybean and maize monocropping under heavy disk harrow and leveling harrow (conventional tillage), and of crop rotation of cotton, soybean and maize with green manure or cover crop (no-tillage). Additional samples were collected from a non-cultivated site (Neotropical Savanna, Cerrado sensu stricto). Soil conservation practices such as no-tillage and crop rotation with cover crop and green manure favored the soil organic carbon stock at the 0-40 cm layer, with the highest values reaching 36.03 Mg ha−1. The accrued soil carbon stock under conventional tillage and monoculture of cotton, maize and soybean was lower than under no-tillage, which ranged from 30.9 to 54.9 %, with the soil organic carbon stock increasing at the annual rate of 2.36 Mg ha−1 during fve years. The no-tillage, with the soybean-maize-cotton rotation, in combination with cover crop and green manure, increased the cotton and soybean yields, with a simultaneous organic carbon accumulation in the sandy soil.

Resumo O tratamento da doença venosa crônica dos membros inferiores evoluiu de forma exponencial nas últimas décadas. Tais avanços permitiram o desenvolvimento de uma proposta de execução técnica sistematizada para o tratamento de ablação endovenosa com laser, a ablação térmica total assistida (ATTA). A técnica propõe um método padronizado de abordagem das veias axiais ou tributárias, varicosas ou inestéticas, de membros inferiores ou outros territórios, em regime ambulatorial ou de hospital-dia. Foram descritos os processos de preparo pré-operatório, marcação detalhada, materiais necessários, acessos venosos, anestesia, cálculo de potência e energia, a técnica de ablação, seguimento e eventos adversos. A ATTA é proposta como uma ferramenta para o tratamento da doença venosa crônica e das veias inestéticas, sugerindo possíveis expansões para as aplicações do laser, além dos troncos venosos, para toda veia passível de ser puncionada.

Abstract Treatment of lower limb chronic venous disease has progressed exponentially over recent decades. The advances achieved have made it possible to develop a proposal for a systematized intravenous laser ablation technique — assisted total thermal ablation (ATTA). The technique constitutes a standardized method for management of axial or tributary veins that are varicosed or esthetically unappealing, whether in the lower limbs or other areas, that can be performed on an outpatient or day-hospital basis. This article describes the processes for preoperative preparation and detailed marking, the materials needed, venous access, anesthesia, calculation of power and energy, the ablation technique itself, follow-up, and adverse events. The ATTA technique is proposed as a tool for treatment of chronic venous disease and of esthetically unappealing veins, suggesting possible extension of the applications for lasers beyond trunk veins to any vein that can be punctured.

ABSTRACT Microalgae hold great potential for producing purified high-value products (e.g. pigments and polyunsaturated fatty acids) and represent a source of bioavailable nutrients in aquaculture feeds; however, its production is limited by the high costs of harvesting. Recently, microalgae autoflocculation has been considered a useful solution due to the easy recovery of cell aggregates and natural increase in pH that prevents cell lysis. This work evaluates some cultivation conditions that could contribute to autoflocculation, such as natural pH increase and precipitate formation over the productivity and flocculation of 16 microalgae consortia. Results showed a biomass production of 1.4 to 4.4 dry weight (g L-1) and high flocculation of 81 to ~100%, probably due to Ca3(PO4)2 formation. Moreover, the alkaline pH could have facilitated the assimilation of CO2 and explained the increase of inorganic carbon in the solution obtained. Likewise, results showed a marked descent in electrical conductivity (EC) in solution and high mineral content in the biomass (21.4-35.9%). Finally, this study suggests that the studied culture conditions facilitated microalgae harvest, and the resulting biomass could be a source of bioavailable dietary minerals. Therefore, some of these results might be addressed in future studies with individual microalgae species.

resumo O objetivo do estudo foi verificar a correlação entre a variabilidade da frequência cardíaca de repouso (VFCRepouso) e o desempenho de resistência em jogadoras de futsal, bem como avaliar a confiabilidade do marcador parassimpático. No total, 16 jogadoras de futsal (idade: 22 ± 3 anos; VO2max: 42.3 ± 2.0 ml.kg-1.min-1) foram avaliadas durante a primeira semana de treinamento da pré-temporada. A modulação vagal foi avaliada a partir da VFC de repouso (isto é, raiz quadrada da média das diferenças sucessivas ao quadrado dos intervalos R-R adjacentes - Ln-RMSSD) por dois dias consecutivos, enquanto o desempenho da resistência foi avaliado pelo Yo-Yo Intermittent Recovery Test, Level 1 (Yo-Yo IR1). A correlação de Pearson foi utilizada para analisar a relação entre as variáveis. A confiabilidade foi testada através do coeficiente de correlação intraclasse, coeficiente de variação e análise de concordância de Bland-Altman. Observou-se uma forte correlação entre o índice de VFCrepouso e o desempenho de endurance (r = 0,643; p = 0,007). Por outro lado, repetibilidade aceitável dos índices de repouso vagal, mas com grande variabilidade interindividual (ICC = 0,670, IC = 0,056-0,885, CV = 15,8%). O presente estudo apresentou forte correlação entre Ln-RMSSD e desempenho de endurance, e mesmo com valores aceitáveis de confiabilidade intrasujeito, a VFC em repouso apresentou alta variabilidade interindividual em jogadoras de futsal.

abstract The study aimed to verify the correlation between resting heart rate variability (HRVrest) and endurance performance in female futsal players, as well as to evaluate the reliability of this parasympathetic autonomic marker. A total of 16 female futsal players (age: 22 ± 3 years; VO2max: 42.3 ± 2.0 ml.kg-1.min-1) were evaluated during the first week of preseason training. Vagal modulation was evaluated from the HRVrest (i.e., log-transformed root mean square of successive R-R interval differences - Ln-RMSSD) for two consecutive days, while endurance performance was evaluated by the Yo-Yo Intermittent Recovery Test, Level 1 (Yo-Yo IR1). Pearson correlation was used to analyze the relationship between the variables. Strong correlation between the HRVrest index and endurance performance (r = 0.643; p = 0.007). Reliability was tested through the intraclass correlation coefficient, coefficient of variation (CV), and Bland-Altman analysis of the agreement. Furthermore, acceptable repeatability of HRVrest, but with great inter-subject variability (ICC = 0.670, 95%CI = 0.056-0.885, CV = 15.8%). The current study demonstrated a strong correlation between Ln-RMSSD and endurance performance, and despite the acceptable values of intrasubject reliability, HRVrest presented high inter-individual variability in female futsal players.

Resumo Objetivo Determinar a composição corporal média (porcentagem de gordura corporal), os marcadores antropométricos, e a intensidade de dor clínica em mulheres com diagnóstico clínico de dor pélvica crônica (DPC) secundária a endometriose. Métodos Um estudo de caso-controle realizado com 91 mulheres, 46 das quais com DPC secundária a endometriose, e 45 das quais com DPC secundária a outras causas. As pacientes foram submetidas à avaliação dos parâmetros antropométricos por meio do índice de massa corporal (IMC), dos perímetros (cintura, abdômen, quadril), e do percentual de gordura corporal (%GC), que foram avaliados emmonitor de composição corporal por bioimpedância; a intensidade clínica da dor foi avaliada usando-se a escala visual analógica (EVA), e os sintomas de ansiedade e depressão, usando a escala de ansiedade e depressão do hospital (EADH). Resultados Os grupos não diferiram quanto à idade média, ao IMC, ao %GC, nem quanto à relação da cintura-quadril (RCQ) disponível. Amédia da intensidade clínica da dor pela EVA foi de 7,2 ± 2,06 no grupo com DPC secundária a endometriose, e de 5,93 ± 2,64 no grupo com DPC secundária a outras causas (p = 0,03), revelando diferenças significativas entre os grupos. Emrelação à EADH, ambos os grupos estavam acima da média de corte. Conclusão Concluímos que, apesar da diferença no escore de dor avaliado entre os dois grupos, não houve diferença com relação à composição corporal e à antropometria.

Abstract Objective To determine the average body composition (percentage of body fat), the anthropometric markers, and the intensity of clinical pain in women with a clinical diagnosis of chronic pelvic pain (CPP) secondary to endometriosis. Methods A case-control study performed with 91 women, 46 of whom with CPP secondary to endometriosis and 45 of whom with CPP secondary to other causes. They underwent an evaluation of the anthropometric parameters by means of the body mass index (BMI), the perimeters (waist, abdomen, hip), and the percentage of body fat (%BF), which were assessed on a body composition monitor by bioimpedance; the intensity of the clinical pain was evaluated using the visual analog scale (VAS), and the symptoms of anxiety and depression, using the hospital’s anxiety and depression scale (HAD). Results The groups did not differ in terms of mean age, BMI, %BF or regarding the available waist-to-hip ratio (WHR). The mean intensity of the clinical pain by the VAS was of 7.2 ± 2.06 in the group with CPP secondary to endometriosis, and of 5.93 ± 2.64 in the group with CPP secondary to other causes (p = 0.03), revealing significant differences between the groups. Conclusion We concluded that, despite the difference in the pain score assessed between the two groups, there was no difference regarding body composition and anthropometry.

Abstract: Recent research has shown that the use of biological extracts, which contain a wide variety of nutrients and phytohormones are potentially useful in the production of plants of agricultural importance. Seaweed extracts are particularly rich in minerals and micronutrients necessary for the growth of microalgae. The effect of three commercial extracts of Ascophyllum nodosum as plant growth inducers (Stimplex®, Acadian Soils® and Liquid Seaweed Concentrate®), provided by Acadian Sea Plants Ltd., were evaluated in relation to the growth and production of biomass and carotenoids in Haematococcus pluvialis. The results were evaluated by one-way ANOVA and post-hoc analysis utilizing Tukey's test with a significance level of 95% (α= 0.05). The reference medium used was the Bold basal medium, to which 250 ppm of each extract was added. The Stimplex® extract had an increase of 22.79% in cell density and 17% in dry matter, higher than the control culture. The content of carotenoids and antioxidant capacity, respectively, with Stimplex® was 30.05% and 141.76% higher than the control culture.

RESUMO Objetivo Investigar a prevalência de sonolência diurna excessiva (SDE) e os fatores associados em adolescentes de escolas militares. Métodos Participaram 466 adolescentes do ensino médio (15 a 17 anos) de ambos os sexos (230 homens). Os participantes foram entrevistados sobre as características sociodemográficas e sobre a duração de sono (semana e final de semana), adotando-se valores < 8 horas de sono como tempo insuficiente de sono. A SDE foi avaliada com a escala de sonolência de Epworth, na qual os adolescentes que obtivessem escores ≥ 10 apresentavam SDE. Resultados A prevalência geral de SDE foi de 34,1%. A média de horas de sono foi de 6,9 h (±1,85) em dias da semana e de 8,5 h (±1,96) nos fins de semana. Identificou-se que 60% dos adolescentes apresentaram baixa duração do sono semanal (p = 0,05). Observaram-se, no modelo final de regressão, maiores riscos de SDE nos indivíduos com baixa duração de sono (OR: 1,55; IC de 95%: 1,04-2,31) e que utilizavam o celular antes de dormir (OR: 4,30; IC de 95%: 2,00-9,23). Conclusão A SDE foi fortemente associada ao uso de celular antes de dormir. Outros fatores associados são sono insuficiente e estudar em tempo integral. Medidas educacionais, administrativas e de saúde são necessárias para melhorar o sono em adolescentes.

ABSTRACT Objective To investigate the prevalence of excessive daytime sleepiness (EDS) and associated factors in adolescents attending military schools. Methods 466 high school students (15-17 years old) of both sexes (230 men) participated. Participants were interviewed about sociodemographic characteristics and sleep duration (week and weekend), adopting values < 8 hours of sleep as insufficient sleep time. EDS was assessed with the Epworth Sleepiness Scale; where students with scores ≥ 10 had EDS. Results The overall prevalence of EDS was 34.1%. The mean for sleep hours was 6.9 h (±1,85) on weekdays and 8.5 h (±1.96) on weekends. It was identified that 60% of the adolescents presented short weekly sleep duration (p = 0.05). In the final regression model, higher EDS risks were observed in those subjects that had a short sleep duration (OR: 1.55; 95% CI: 1.04-2.31) and those that used the cell phone before bedtime (OR: 4.30; 95% CI: 2.00-9.23). Conclusion EDS was strongly associated with cell phone use before bedtime. Other associated factors are insufficient sleep and studying full-time. Educational, administrative and health measures are needed to improve sleep in adolescents.