Mapping human pathogens in wastewater using a metatranscriptomic approach.

The monitoring of cities' wastewaters for the detection of potentially pathogenic viruses and bacteria has been considered a priority during the COVID-19 pandemic to monitor public health in urban environments. The methodological approaches frequently used for this purpose include deoxyribonucleic acid (DNA)/Ribonucleic acid (RNA) isolation followed by quantitative polymerase chain reaction (qPCR) and reverse transcription (RT)‒qPCR targeting pathogenic genes. More recently, the application of metatranscriptomic has opened opportunities to develop broad pathogenic monitoring workflows covering the entire pathogenic community within the sample. Nevertheless, the high amount of data generated in the process requires an appropriate analysis to detect the pathogenic community from the entire dataset. Here, an implementation of a bioinformatic workflow was developed to produce a map of the detected pathogenic bacteria and viruses in wastewater samples by analysing metatranscriptomic data. The main objectives of this work was the development of a computational methodology that can accurately detect both human pathogenic virus and bacteria in wastewater samples. This workflow can be easily reproducible with open-source software and uses efficient computational resources. The results showed that the used algorithms can predict potential human pathogens presence in the tested samples and that active forms of both bacteria and virus can be identified. By comparing the computational method implemented in this study to other state-of-the-art workflows, the implementation analysis was faster, while providing higher accuracy and sensitivity. Considering these results, the processes and methods to monitor wastewater for potential human pathogens can become faster and more accurate. The proposed workflow is available at https://github.com/waterpt/watermonitor and can be implemented in currently wastewater monitoring programs to ascertain the presence of potential human pathogenic species.

Decrease in CD8+CD45+CCR7+CD62L+ T cells in individuals vaccinated with Sinovac-CoronaVac following COVID-19 infection.

Vaccines induce antibodies, but T cell responses are also important for protection against Coronavirus disease 2019. Here, we analyzed the frequency of memory T cells in infected and/or vaccinated individuals and observed a decrease in central memory T cells in individuals who were vaccinated following COVID-19 infection.

Zarconia navalis gen. nov., sp. nov., Romeriopsis navalis gen. nov., sp. nov. and Romeriopsis marina sp. nov., isolated from inter- and subtidal environments from northern Portugal.

The morphology, 16S rRNA gene phylogeny and 16S-23S rRNA gene ITS secondary structures of three strains of marine Cyanobacteria, isolated from inter- and subtidal environments from north Portugal were studied, resulting in the description of Zarconia navalis gen. nov., sp. nov. (Oscillatoriales incertae sedis), Romeriopsis navalis gen. nov., sp. nov. (Leptolyngbyaceae) and Romeriopsis marina sp. nov., named under the International Code of Nomenclature for algae, fungi, and plants. No diacritical morphological characters were found for the new genera and species. The 16S rRNA gene maximum-likelihood and Bayesian phylogenies supported that the genus Zarconia is a member of the Oscillatoriales, morphologically similar to the genera Microcoleus and Phormidium, but distant from them. The genus Romeriopsis is positioned within the Leptolyngbyaceae (Synechococcales) and is closely related to Alkalinema. The secondary structures of the D1-D1', Box B, V2 and V3 helices corroborate the phylogenetic results. Furthermore, our study supports previous observations of polyphyletic Oscillatoriales families and reinforces the need for their taxonomic revision.

Translation, cross-cultural adaptation and validation of the Work Role Functioning Questionnaire 2.0 into Brazilian Portuguese in a general population.

BACKGROUND: The Work Role Functioning Questionnaire 2.0 (WRFQ 2.0) is an instrument that measures the difficulties perceived by workers in meeting work demands, given their physical or emotional health, but it has not yet been adapted for Brazil. Thus, this study aimed to translate, cross-culturally adapt and assess the psychometric properties of the WRFQ 2.0 into Brazilian Portuguese. METHODS: This is an observational study. Initially, translation and cross-cultural adaptation into Brazilian Portuguese was carried out. After that, this version was submitted to an evaluation of its internal structure. The internal consistency and test-retest reliability were assessed. To determine the construct validity, Spearman's correlation coefficient (rho) was used to determine the magnitude of correlation between the WRFQ 2.0 and the Work Ability Index (WAI), Numerical Pain Rating Scale (NPRS) and Self -Estimated Functional Inability because of Pain (SEFIP-work). RESULTS: The internal structure with five domains and 27 items presented adequate fit indices for the Brazilian version of the WRFQ 2.0. Adequate correlations of the five domains of the WRFQ 2.0 with the NPRS, WAI and SEFIP-work were found (rho ranged between 0.145 and 0.338). The test-retest reliability of the WRFQ 2.0 ranged from substantial to excellent (intraclass correlation coefficient ≥ 0.785) and internal consistency was adequate (Cronbach's alpha ≥ 0.852). CONCLUSION: The Brazilian Portuguese version of the WRFQ 2.0 presents valid internal structure with five domains and 27 items, adequate construct based on correlations with other instruments, and acceptable test-retest reliability and internal consistency.

Delirium in the intensive care unit: identifying difficulties in applying the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU).

BACKGROUND: Delirium is an underdiagnosed condition and this may be related, among other causes, to the incorrect use of assessment tools due to lack of knowledge about cognitive assessment and lack of training of the care team. The aim of this study was to investigate the difficulties encountered by the nursing team in the application of the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU) in patients on mechanical ventilation. METHODS: This is descriptive study with a qualitative approach in a private tertiary hospital located in northeast Brazil. Data collection took place from July 2018 to January 2019. We included 32 nurses and used face-to-face semi-structured interviews. The recorded data were analysed using content analysis. This study followed the recommendations of the Standards for Reporting Qualitative Research (SRQR). RESULTS: We identified three major categories: lack of knowledge of professionals, subdivided into deficit in academic formation, difficulty in the differential diagnosis of delirium and delusion, and lack of knowledge about the steps of the CAM-ICU; difficulty in patient cooperation; and lack of adequate training to apply the CAM-ICU. CONCLUSION: Nurses have a deficit in academic formation on delirium and need adequate training for the correct and frequent use of the CAM-ICU.

Distribution and diversity of dimetal-carboxylate halogenases in cyanobacteria.

BACKGROUND: Halogenation is a recurring feature in natural products, especially those from marine organisms. The selectivity with which halogenating enzymes act on their substrates renders halogenases interesting targets for biocatalyst development. Recently, CylC - the first predicted dimetal-carboxylate halogenase to be characterized - was shown to regio- and stereoselectively install a chlorine atom onto an unactivated carbon center during cylindrocyclophane biosynthesis. Homologs of CylC are also found in other characterized cyanobacterial secondary metabolite biosynthetic gene clusters. Due to its novelty in biological catalysis, selectivity and ability to perform C-H activation, this halogenase class is of considerable fundamental and applied interest. The study of CylC-like enzymes will provide insights into substrate scope, mechanism and catalytic partners, and will also enable engineering these biocatalysts for similar or additional C-H activating functions. Still, little is known regarding the diversity and distribution of these enzymes. RESULTS: In this study, we used both genome mining and PCR-based screening to explore the genetic diversity of CylC homologs and their distribution in bacteria. While we found non-cyanobacterial homologs of these enzymes to be rare, we identified a large number of genes encoding CylC-like enzymes in publicly available cyanobacterial genomes and in our in-house culture collection of cyanobacteria. Genes encoding CylC homologs are widely distributed throughout the cyanobacterial tree of life, within biosynthetic gene clusters of distinct architectures (combination of unique gene groups). These enzymes are found in a variety of biosynthetic contexts, which include fatty-acid activating enzymes, type I or type III polyketide synthases, dialkylresorcinol-generating enzymes, monooxygenases or Rieske proteins. Our study also reveals that dimetal-carboxylate halogenases are among the most abundant types of halogenating enzymes in the phylum Cyanobacteria. CONCLUSIONS: Our data show that dimetal-carboxylate halogenases are widely distributed throughout the Cyanobacteria phylum and that BGCs encoding CylC homologs are diverse and mostly uncharacterized. This work will help guide the search for new halogenating biocatalysts and natural product scaffolds.

Short-form quality care questionnaire-palliative care has acceptable measurement properties in Brazilian cancer patients.

BACKGROUND: Our objective was to perform the translation, cross-cultural adaptation, and validation of the Quality Care Questionnaire-Palliative Care (QCQ-PC) into Brazilian Portuguese for cancer patients in palliative care. The translation and cross-cultural adaptation comprised the following stages: translation, synthesis of translations, back-translation, analysis by a committee of experts, testing of the pre-final version, and definition of the final version. The evaluated measurement properties were: structural validity using factor analysis, test-retest reliability using the intraclass correlation coefficient (ICC), internal consistency using Cronbach's alpha, and construct validity using the correlations between the QCQ-PC and other questionnaires already validated in Brazil. RESULTS: Two hundred and twenty-five cancer patients were included for validity analyses, and a subsample of 30 patients was used for test-retest reliability. The most adequate fit indexes were for the short version of the QCQ-PC (SF-QCQ-PC), with two domains and 12 items. There was adequate reliability and internal consistency, with values of the ICC ≥ 0.83 and Cronbach's alpha ≥0.82. There were correlations > 0.30 between the SF-QCQ-PC and the Karnofsky Performance Scale, the Palliative Prognostic Index, the sadness domain of the Edmonton Symptom Assessment System, the Barthel Index, and all domains related to the McGill Quality of Life Questionnaire and the European Organization for Research in the Treatment of Cancer Questionnaire-core. CONCLUSION: The short version of the SF-QCQ-PC has acceptable psychometric properties for use in Brazil.

Reliability and Accuracy of 2-Minute Step Test in Active and Sedentary Lean Adults.

OBJECTIVE: The purpose of this study was to evaluate the intrarater and interrater reliability of the 2-minute step test (2MST) in active and sedentary lean adults and to identify the test cutoff point to differentiate active from sedentary individuals. METHODS: This observational study involved 4 mixed-sex groups (each with 50 lean participants): group 1, sedentary and aged 18 to 24 years; group 2, active and aged 18 to 24 years; group 3, sedentary and aged 25 to 44 years; and group 4, active and aged 25 to 44 years. The 2MST was administered independently by 2 examiners (with 3 months' training) at 2 different times, with a 7-day interval. Habitual physical activity was evaluated by means of the Baecke Questionnaire (BQ). In statistical analysis, the Pearson correlation coefficient was used to verify the correlation between the 2MST and BQ; intraclass correlation coefficients (ICC2,3) were used to determine the intrarater and interrater reliability of the 2MST; and the receiver operating characteristic curve was used to identify the accuracy of the 2MST. RESULTS: Excellent intrarater and interrater reliability were found for all 4 groups (intraclass correlation coefficients ≥ 0.83). Correlating the 2MST score with the BQ score, a significant, positive, weak correlation was observed (r = 0.344, P < .001). For differentiating active from sedentary individuals, the 2MST showed low accuracy (area under the curve = 0.671), with 61% sensitivity and 67% specificity. CONCLUSION: This study showed that the 2MST is a reliable test with a low amount of inherent error. There was a significant correlation between the 2MST and usual physical activity measured, and slight accuracy in differentiating active from sedentary individuals.

The Extremophile Endolithella mcmurdoensis gen. et sp. nov. (Trebouxiophyceae, Chlorellaceae), A New Chlorella-like Endolithic Alga From Antarctica.

The McMurdo Dry Valleys constitute the largest ice-free region of Antarctica and one of the most extreme deserts on Earth. Despite the low temperatures, dry and poor soils and katabatic winds, some microbes are able to take advantage of endolithic microenvironments, inhabiting the pore spaces of soil and constituting photosynthesis-based communities. We isolated a green microalga, Endolithella mcmurdoensis gen. et sp. nov, from an endolithic sandstone sample collected in the McMurdo Dry Valleys (Victoria Land, East Antarctica) during the K020 expedition, in January 2013. The single non-axenic isolate (E. mcmurdoensis LEGE Z-009) exhibits cup-shaped chloroplasts, electron-dense bodies, and polyphosphate granules but our analysis did not reveal any diagnostic morphological characters. On the basis of phylogenetic analysis of the 18S rRNA (SSU) gene, the isolate was found to represent a new genus within the family Chlorellaceae.

The Brazilian version of the work role functioning questionnaire 2.0 with 5 items (WRFQ-5) has adequate measurement properties.

BACKGROUND: The Work Role Functioning Questionnaire 2.0 (WRFQ 2.0) is an important instrument within the context of occupational health, consisting of 27 items and 5 domains. In addition, a short version of WRFQ 2.0 with 5 items (WRFQ-5) was proposed, showing agreement with the long version. Thus, we aimed to confirm the number of factors of the WRFQ-5 short version and to verify the structural, construct, and criterion validity, reliability, internal consistency, and analysis of ceiling and floor effects of the Brazilian version of the WRFQ-5 in a general workers population. METHODS: A questionnaire validation and measurement properties study. We evaluated the internal structure of the WRFQ-5 by means of confirmatory factor analysis. Construct validity was assessed by correlating the WRFQ-5 with the Numerical Pain Rating Scale (NPRS), Work Ability Index (WAI), and Self-Estimated Functional Inability because of Pain (SEFIP-work). Criterion validity was assessed by correlating the WRFQ-5 with the 5 domains of the WRFQ 2.0. Test-retest reliability and internal consistency were also evaluated. RESULTS: We observed positive correlations (p < .05) between the WRFQ-5 and the WAI (rho = 0.161 to 0.308) and negative correlations (p < .05) between the WRFQ-5 and the SEFIP-work (rho = -0.293). The WRFQ-5 significantly and positively correlates with the 5 domains of WRFQ 2.0 (rho = 0.742 to 0.830). The test-retest reliability of the WRFQ-5 was excellent (ICC2,1 = 0.935) and the internal consistency was adequate (Cronbach's alpha = 0.938). We did not observe ceiling and floor effects. CONCLUSION: The one-dimensional internal structure of the WRFQ-5 in Brazilian Portuguese has a valid internal structure and construct, as well as adequate reliability and internal consistency.

Clinical and Epidemiological Assessment of Children and Adolescents Hospitalized with SARS-CoV-2 in the Pre-Amazon Region.

INTRODUCTION: SARS-CoV-2 infection usually presents similarly to other respiratory viral pathogens. Children and adolescents do not present as a group that is highly affected by the disease, having low infection rates. However, limited publications are associated with the findings of pneumonia in pediatric patients with COVID-19. OBJECTIVE: To analyze the clinical and epidemiological aspects of children and adolescents hospitalized with SARS-CoV-2 in a pre-Amazon region. METHODS: A retrospective study, carried out in four public hospitals in São Luís, Brazil where medical records of children and adolescents aged from 0 to 13 years, of both sexes, with clinical diagnosis of community-acquired pneumonia were evaluated from March 2020 to March 2021. RESULTS: Almost 40.0% of children were aged between 1 year and 5 years. Of the 128 children who had SARS-CoV-2, 3 are of indigenous ethnicity. Additionally, 78.6% of the children had fever and there was no significant difference between COVID-19 patients and those of other respiratory viruses. Eighteen patients had chronic neurological disease, which is the most common comorbidity observed in patients with coronavirus infection. Ground glass opacity attenuation was observed in 24.8% of children and adolescents with COVID-19. Anemia and increased inflammatory response markers were related to SARS-CoV-2 infection. More than 90.0% of patients admitted to hospital, regardless of etiology, were treated with antibiotics. Eighteen patients died. Pediatric multisystem inflammatory syndrome (PMIS) was diagnosed in 17 patients. CONCLUSIONS: SARS-CoV-2 in children and adolescents is mild, but the condition of patients with PMIS is more serious, with an increase in inflammatory biomarkers which can lead to death. Therefore, rapid diagnosis and differentiation of agents causing respiratory diseases are necessary for better therapeutic decision making, since the results of this study make us question the excessive use of antibiotics without meeting well-defined clinical-epidemiological criteria.

Braden scale has low reliability in different patients under care in intensive care unit.

OBJECTIVE: The aim of this study was to assess the inter-reliability of the Braden scale and its subscales for different patients assisted in the intensive care unit. We hypothesized that the Braden scale has low reliability in different populations. METHODS: This reliability study involved the Braden scale in intensive care unit of a hospital. A total of 200 patients were admitted to the intensive care unit in four different groups: neurological patients, sepsis, elderly, and adults affected by trauma. The Braden scale is a tool composed of six subscales for patient assessment: sensory perception, humidity, activity, mobility, nutrition, and friction. The total score was also calculated. The Braden scale was applied by two different nurses with an interval of 20-30 min between applications. RESULTS: For all populations, kappa values considered unsuitable were observed for most categories of the Braden scale, ranging from 0.06-0.25. Only for the total Braden scale score was moderate reliability identified in all groups evaluated, with intraclass correlation coefficient values ranging from 0.48-0.75. CONCLUSIONS: Braden scale is not a reliable tool to be used in the intensive care unit, and we do not recommend the use of this scale to assess the risk of developing pressure injury.

The Baecke Habitual Physical Activity Questionnaire (BHPAQ): a valid internal structure of the instrument to assess healthy Brazilian adults.

OBJECTIVE: This study aimed to validate the internal structure of the Brazilian version of the Baecke Habitual Physical Activity Questionnaire. METHODS: A cross-sectional study was conducted with individuals over 18 years old of both sexes, with Brazilian Portuguese as their native language. The structure of the Baecke Habitual Physical Activity Questionnaire was tested by confirmatory factor analysis. The model fit was evaluated by the following indices: root mean square error of approximation, comparative fit index, Tucker-Lewis index, standardized root mean square residual, and χ²/degrees of freedom. We used the Akaike information criterion and Bayesian information criterion to compare different structures of the Baecke Habitual Physical Activity Questionnaire. RESULTS: A total of 241 individuals participated in this study. The original structure of the Baecke Habitual Physical Activity Questionnaire with 16 items and 3 domains was compared to a structure with 14 items and 3 domains. The internal structure of the Baecke Habitual Physical Activity Questionnaire with 14 items showed better fit indices and lower Akaike information criterion and Bayesian information criterion values. CONCLUSION: The best internal structure of the Brazilian version of the Baecke Habitual Physical Activity Questionnaire in adults presents 3 domains and 14 items.

Intra- and Interrater Reliability of Short-Term Measurement of Heart Rate Variability on Rest in Individuals Post-COVID-19.

Individuals affected by COVID-19 have an alteration in autonomic balance, associated with impaired cardiac parasympathetic modulation and, consequently, a decrease in heart rate variability (HRV). This study examines the inter- and intrarater reliability of HRV) parameters derived from short-term recordings in individuals post-COVID. Sixty-nine participants of both genders post-COVID were included. The RR interval, the time elapsed between two successive R-waves of the QRS signal on the electrocardiogram (RRi), were recorded during a 10 min period in a supine position using a portable heart rate monitor (Polar® V800 model). The data were transferred into Kubios® HRV standard analysis software and analyzed within the stable sessions containing 256 sequential RRi. The intraclass correlation coefficient (ICC) ranged from 0.920 to 1.000 according to the intrarater analysis by Researcher 01 and 0.959 to 0.999 according to the intrarater by Researcher 02. The interrater ICC ranged from 0.912 to 0.998. The coefficient of variation was up to 9.23 for Researcher 01 intrarater analysis, 6.96 for Researcher 02 intrarater analysis and 8.83 for interrater analysis. The measurement of HRV in post-COVID-19 individuals is reliable and presents a small amount of error inherent to the method, supporting its use in the clinical environment and in scientific research.

Ethyl Acetate Fraction of Bixa orellana and Its Component Ellagic Acid Exert Antibacterial and Anti-Inflammatory Properties against Mycobacterium abscessus subsp. massiliense.

Mycobacterium abscessus subsp. massiliense (Mabs) causes chronic infections, which has led to the need for new antimycobacterial agents. In this study, we investigated the antimycobacterial and anti-inflammatory activities of the ethyl acetate fraction of Bixa orellana leaves (BoEA) and ellagic acid (ElAc). In silico analysis predicted that ElAc had low toxicity, was not mutagenic or carcinogenic, and had antimicrobial and anti-inflammatory activities. Apparently, ElAc can interact with COX2 and Dihydrofolate reductase (DHFR) enzymes, which could explain both activities. In vitro analysis showed that BoEA and ElAc exerted antimicrobial activity against Mabs (minimum inhibitory concentration of 1.56, 1.56 mg/mL and bactericidal concentration of 6.25, 3.12 mg/mL, respectively. Clarithromycin showed MIC and MBC of 1 and 6 µg/mL). Treatment with BoEA or ElAc increased survival of Tenebrio molitor larvae after lethal infection with Mabs and reduced carrageenan-induced paw edema in mice, around 40% of edema volume after the fourth hour, similarly to diclofenac. In conclusion, BoEA and ElAc exert antimicrobial effects against Mabs and have anti-inflammatory effects, making them potential sources of antimycobacterial drugs. The biological activities of ElAc may be due to its high binding affinities predicted for COX2 and DHFR enzymes.

Unplanned Pregnancy and Depressive Symptoms during the COVID-19 Pandemic.

This is a cross-sectional study conducted with pregnant women who underwent prenatal care at basic health units in São Luís City, Maranhão State, Brazil. The authors used a semistructured questionnaire to assess the socioeconomic, demographic, and clinical characteristics of pregnant women as well as the Edinburgh Scale to investigate depressive symptoms. In order to assess the association between the explanatory variable and the outcome variable, Poisson logistic regression was performed with statistical significance at p < 0.05. A total of 205 women were interviewed, most aged between 18 and 29 years (66.83%). Of this total, 74.63% had not planned their pregnancy and 26.67% had depressive symptoms. The variables unplanned pregnancy (PR = 1.41; CI = 0.99−2.00; p = 0.05) and not undergoing psychological counseling (PR = 1.42; CI = 0.51−0.83; p ≤ 0.01) correlated with depressive symptoms during pregnancy. It is thus possible to link the variables unplanned pregnancy (p > 0.05) and not undergoing psychological counseling (p = 0.001) to depression. Therefore, it is important to monitor the mental health of pregnant women, especially in situations of vulnerability.

Secondary metabolite biosynthetic diversity in Arctic Ocean metagenomes.

Polyketide synthases (PKSs) and non-ribosomal peptide synthetases (NRPSs) are mega enzymes responsible for the biosynthesis of a large fraction of natural products (NPs). Molecular markers for biosynthetic genes, such as the ketosynthase (KS) domain of PKSs, have been used to assess the diversity and distribution of biosynthetic genes in complex microbial communities. More recently, metagenomic studies have complemented and enhanced this approach by allowing the recovery of complete biosynthetic gene clusters (BGCs) from environmental DNA. In this study, the distribution and diversity of biosynthetic genes and clusters from Arctic Ocean samples (NICE-2015 expedition), was assessed using PCR-based strategies coupled with high-throughput sequencing and metagenomic analysis. In total, 149 KS domain OTU sequences were recovered, 36 % of which could not be assigned to any known BGC. In addition, 74 bacterial metagenome-assembled genomes were recovered, from which 179 BGCs were extracted. A network analysis identified potential new NP families, including non-ribosomal peptides and polyketides. Complete or near-complete BGCs were recovered, which will enable future heterologous expression efforts to uncover the respective NPs. Our study represents the first report of biosynthetic diversity assessed for Arctic Ocean metagenomes and highlights the potential of Arctic Ocean planktonic microbiomes for the discovery of novel secondary metabolites. The strategy employed in this study will enable future bioprospection, by identifying promising samples for bacterial isolation efforts, while providing also full-length BGCs for heterologous expression.

Relationship between obstructive sleep apnea syndrome and functional capacity in patients with diabetes mellitus type 2: an observational transversal study.

OBJECTIVE: The aim of this study was to verify the association among obstructive sleep apnea, functional capacity, and metabolic control. METHODS: This was a cross-sectional study involving individuals of both sexes with clinical diagnosis of diabetes mellitus type 2 who were above 18 years of age. The assessment consisted of a volunteer identification form, a 2-minute step test, and the Stop-Bang questionnaire. In order to assess metabolic control, HbA1c and fasting glucose data were collected from medical records. RESULTS: A total of 100 individuals with diabetes mellitus type 2, of whom 61% were women, were included in this study. According to the Stop-Bang instrument, 26, 57, and 17% of patients had low, intermediate, and high risk of developing OSA, respectively. There was no association between the 2-minute step test and metabolic variables and diabetes mellitus type 2 chronicity with Stop-Bang. CONCLUSIONS: We concluded that there is no association among obstructive sleep apnea measured by means of Stop-Bang instrument, functional capacity measured by means of 2-minute step test, and metabolic variables in individuals with diabetes mellitus type 2.

Translation, cross-cultural adaptation, and validation of the Canadian Diabetes Risk Questionnaire for the Brazilian population.

OBJECTIVE: The aim of this study was to translate, cross-culturally adapt, and validate the Canadian Diabetes Risk Questionnaire for use in Brazilian Portuguese. METHODS: This is a Questionnaire validity study conducted at a private university. The Brazilian version of the Canadian Diabetes Risk Questionnaire was developed by means of the processes of translation, back-translation, committee review, and pretesting. Test-retest reliability was measured using the intraclass correlation coefficient and kappa coefficient. Internal consistency was measured using Cronbach's alpha. For construct validity, the total score of the Canadian Diabetes Risk Questionnaire was correlated with the Diabetes Knowledge Scale and the Diabetes Mellitus Risk Questionnaire. Ceiling and floor effects were also evaluated in the present study. RESULTS: For construct validity and floor and ceiling effect measurements, a total sample of 100 participants was used. For reliability, a subsample of 34 participants out of the total sample was used. We identified adequate values for reliability (kappa between 0.46-1.00 and ICC 0.96) and internal consistency (Cronbach's alpha 0.80). There were significant correlations between the Canadian Diabetes Risk Questionnaire and the Diabetes Mellitus Risk Questionnaire (rs=0.370, p<0.001), but not the Diabetes Knowledge Scale (rs= -0.162). No ceiling or floor effects were found. CONCLUSION: We concluded that in accordance with the best international recommendations, the Brazilian version of the Canadian Diabetes Risk Questionnaire has adequate psychometric properties.

Correlation between baropodometric variables, disability, and intensity of low back pain in pregnant women in the third trimester.

BACKGROUND: Growth of uterus, enlargement of breasts and weight gain result from the development and growth of the fetus during pregnancy. The posture and the displacement of the center of gravity change. OBJECTIVE: Correlate baropodometric variables with low back pain in pregnant women in the third trimester of pregnancy. METHODS: This is a cross-sectional analytical study conducted in São Luís (MA, Brazil). For data collection, we used a form containing sociodemographic and clinical data, Oswestry Disability Questionnaire for disability evaluation of the lumbar spine, Numerical Rating Scale to measure pain intensity, and baropodometric evaluation. RESULTS: Twenty-five pregnant women took part in the study. There was a significant and positive correlation (r = 0.404, p = 0.045) between functional disability and hindfoot pressure and a significant and negative correlation (r = -0.404, p = 0.045) between functional disability and plantar pressure in the forefoot of the right foot. In addition, there was a positive and significant correlation between the intensity of pain and the contact area on the left (r = 0.504, p = 0.010) and right (r = 0.509, p = 0.009) foot. CONCLUSION: There is a relation between disability and plantar pressure and between pain intensity and area of contact of feet in pregnant women.