Dehydration, Rehydration and Thermal Treatment: Effect on Bioactive Compounds of Red Seaweeds Porphyra umbilicalis and Porphyra linearis.

The nutritional and bioactive value of seaweeds is widely recognized, making them a valuable food source. To use seaweeds as food, drying and thermal treatments are required, but these treatments may have a negative impact on valuable bioactive compounds. In this study, the effects of dehydration, rehydration, and thermal treatment on the bioactive compounds (carotenoids, phycobiliproteins, total phenolic content (TPC), total flavonoids content (TFC)), antioxidant (ABTS and DPPH radical scavenging activities) and anti-Alzheimer's (Acetylcholinesterase (AchE) inhibitory activities, and color properties of Porphyra umbilicalis and Porphyra linearis seaweeds were evaluated. The results revealed significant reductions in carotenoids, TPC, TFC, and antioxidant activities after the seaweeds' processing, with differences observed between species. Thermal treatment led to the most pronounced reductions in bioactive compound contents and antioxidant activity. AchE inhibitory activity remained relatively high in all samples, with P. umbilicalis showing higher activity than P. linearis. Changes in color (ΔE) were significant after seaweeds' dehydration, rehydration and thermal treatment, especially in P. umbilicalis. Overall, optimizing processing methods is crucial for preserving the bioactive compounds and biological activities of seaweeds, thus maximizing their potential as sustainable and nutritious food sources or as nutraceutical ingredients.

The impact of time-of-day reperfusion on remote ischemic conditioning in ST-elevation myocardial infarction: a RIC-STEMI substudy.

Daytime variation affects the tolerance of cardiomyocytes to ischemia-reperfusion injury (IRI). This study aims to evaluate the impact of time-of-day reperfusion on clinical outcomes of remote ischemic conditioning (RIC) as an adjuvant to primary percutaneous coronary intervention(PPCI) in ST-elevation myocardial infarction(STEMI) patients. A post-hoc analysis of a prospective, single-center parallel 1:1 randomized trial (RIC-STEMI) was performed. This analysis included 448 STEMI patients previously randomized to either PPCI alone (PPCI group) (n = 217) or RIC as an adjuvant to PPCI (RIC + PPCI group) (n = 231). Moreover, the sample was divided according to the time of PPCI: night-morning (22 h-11h59min) (n = 216) or afternoon (12 h-21h59min) (n = 232) groups. The primary follow-up endpoint was a composite of cardiac death and hospitalization due to heart failure. There were no significant differences in the clinical characteristics and the follow-up outcomes between groups. The afternoon period (HR = 0.474; 95% CI 0.230-0.977; p = 0.043) and RIC (HR = 0.423; 95% CI 0.195-0.917; p = 0.029) were independent predictors of the primary follow-up endpoint. An univariate analysis showed a lower frequency of primary follow-up endpoint, just in the afternoon period (10.3%vs0.9%; p = 0.002), in the RIC + PPCI group. A multivariate analysis revealed that RIC was an independent predictor of the primary follow-up endpoint in the afternoon group (HR = 0.098; 95% CI 0.012-0.785; p = 0.029), but not in the night-morning group. In addition, the afternoon period was not an independent predictor of the primary follow-up endpoint when the multivariate analysis was performed in the PPCI group. In conclusion, this study showed an important cardioprotective effect of RIC, namely in the afternoon period, suggesting that the afternoon period enhances the cardioprotection induced by RIC.

Effect of Deployment and Harvest Date on Growth and High-Value Compounds of Farmed Alaria esculenta.

Alaria esculenta is a brown seaweed farmed in many European countries for its biomass rich in useful bio compounds. This study aimed to identify the optimal growing season to maximise biomass production and quality. The seeded longlines of the brown seaweed were deployed in the southwest of Ireland in October and November 2019 and samples of the biomass were harvested in different dates, between March and June 2020. Biomass gain and composition, phenolic and flavonoid content (TPC and TFC) and biological activities (antioxidant and anti-hypertensive activities) of seaweed extracts prepared with Alcalase were evaluated. The biomass production was significantly higher for the line deployed in October (>20 kg·m-1). In May and June, an increasing amount of epiphytes was observed on the surface of A. esculenta. The protein content of A. esculenta varied between 11.2 and 11.76% and fat content was relatively low (1.8-2.3%). Regarding the fatty acids profile, A. esculenta was rich in polyunsaturated fatty acids (PUFA), especially in eicosapentaenoic acid (EPA). The samples analysed were very rich in Na, K, Mg, Fe, Mn, Cr and Ni. The content of Cd, Pb Hg was relatively low and below the maximum levels allowed. The highest TPC and TFC were obtained in extracts prepared with A. esculenta collected in March and levels of these compounds decreased with time. In general, the highest radical scavenging activities (ABTS and DPPH), as well as chelating activities (Fe2+ and Cu2+) were observed in early spring. Extracts from A. esculenta collected in March and April presented higher ACE inhibitory activity. The extracts from seaweeds harvested in March exhibited higher biological activity. It was concluded that an earlier deployment allows for maximising growth and harvest of biomass earlier when its quality is at the highest levels. The study also confirms the high content of useful bio compounds that can be extracted from A. esculenta and used in the nutraceutical and pharmaceutical industry.

Superfoods for Type 2 Diabetes: A Narrative Review and Proposal for New International Recommendations.

Background and Objectives: Type 2 diabetes mellitus (T2DM) is a chronic metabolic disease affecting an estimated 537 million individuals worldwide. 'Superfoods' can be integrated into the diet of T2DM patients due to their health benefits. Study Objectives: (i) To carry out a narrative review of 'superfoods' with the potential to reduce glycaemic levels in T2DM patients (2019 to 2022), (ii) to identify 'superfoods' with the potential to reduce HbA1c and (iii) to propose new guidance on the use of 'superfoods'. Materials and Methods: A narrative review was carried out using the databases PubMed, SciELO, DOAJ and Google Scholar. The keywords were ["type 2 diabetes" and ("food" or "diet" or "nutrition") and ("glycaemia" or "glycemia")]. Only review studies were included. Results: Thirty reviews were selected. The 'superfoods' identified as having a potential impact on glycaemic control were foods with polyphenols (e.g., berries), fermented dairy products, whole cereals/grains, nuts and proteins, among others. The possibility of an extensive reduction in Hb1Ac was reported for fermented dairy products, especially yoghurts enriched with vitamin D or probiotics (HbA1c reduction of around 1%) or by increasing the fibre intake by 15 g (or up to 35 g) (HbA1c reduction of around 2%). Conclusion: It is recommended that the identified 'superfoods' are included in the diet of T2DM patients, although this should not substitute an appropriate diet and exercise plan. In particular, yoghurts and an increased fibre intake (by 15 g or up to 35 g) can be used as nutraceuticals. New recommendations on the introduction of 'superfoods' in the diet of T2DM patients have been proposed.

Atrial cardiopathy predicts detection of atrial fibrillation in embolic stroke of undetermined source: real-life data.

OBJECTIVES: Atrial cardiopathy (AC) is more frequent in patients with embolic stroke of undetermined source (ESUS) than in patients with non-cardioembolic stroke. The aim of this work was to describe AC in patients with ESUS and to study its impact on detection of atrial fibrillation (AF) during follow-up. METHODS: This is an observational study of 123 consecutive ESUS patients and 55 ESUS patients from a previous cohort. AC was defined according to the presence of one or more of the following criteria: severe left atrial enlargement, p-wave terminal force in lead V1 > 5000 µVxms, and excessive premature atrial complexes. Unadjusted and adjusted survival analyses for the occurrence of AF and stroke or transient ischemic attack (TIA) were performed. Diagnostic performance of AC for the detection of AF was analyzed. RESULTS: Among 178 patients with ESUS, those with AC (42.7%) were older (p < 0.001), and more frequently had hypertension (p = 0.001) and lower total cholesterol levels (p = 0.001) than patients without AC. The detection of AF during follow-up (median 34 months, interquartile range = 12.8-64) was higher in patients with AC (hazard ratio = 7.00, 95% confidence interval = 2.01-24.39, p = 0.002). This association persisted after adjusting for age, arterial hypertension, and other vascular risk factors. The c-statistic for detection of AF during follow-up for AC was 0.719. There were no differences in stroke or TIA recurrence between groups with and without AC. DISCUSSION: ESUS patients with AC have different baseline clinical characteristics than patients without AC and have a higher detection of AF during follow-up.

A pre-systematic review on the use of masks as a protection material for SARS-COV-2 during the COVID-19 pandemic.

BACKGROUND: Coronavirus disease 2019 (COVID-19) was first reported in Wuhan, China on 31 December 2019. AIMS: to review, analyse and discuss all works about the wearing and development of facemasks as potential protection against SARS-COV-2 during the COVID-19 pandemic. METHODS: PubMed, SciELO, Google Scholar and DOAJ were browsed. KEYWORDS: "mask and (SARS or Cov)" (1 August 2019 to 12 April 2020). INCLUSION CRITERIA: original research. PRISMA criteria were followed. RESULTS: Twenty-one works were selected. Identified topics: effectiveness of protective equipment/devices (PE) (n = 3), universal wearing of facemasks plus other protective measures in the community (n = 3), impact of infection control measures on hospitals and epidemiological tracing (n = 3), development of new PE (n = 2), sanitisation of facemasks (n = 4), clinical guidance (n = 4) and questionnaires (n = 2). DISCUSSION: It seems that the effectiveness of PE, namely facemasks, is not fully known. Universal wearing of facemasks may be simultaneously recommended with other protective measures. Nosocomial and community infections seem to be preventable. New PE, methods of facemask sanitisation and clinical guidance are emerging, but caution is recommended regarding their adoption, revision and monitoring by international boards and institutions. Questionnaires are useful tools for collecting citizens' opinions on implementing public health measures, and thus contribute to mitigating the COVID-19 pandemic. CONCLUSIONS: Universal wearing of facemasks in the community is likely to be recommended during the COVID-19pandemic. Since SARS-COV-2 is highly contagious, a set of measures should be considered. Facemask sanitisation is possible, but standardised procedures are lacking. New PE is emerging and requires detailed regulatory approval. It is advisable to monitor public opinion.

Characterization of Protein Hydrolysates from Fish Discards and By-Products from the North-West Spain Fishing Fleet as Potential Sources of Bioactive Peptides.

Fish discards and by-products can be transformed into high value-added products such as fish protein hydrolysates (FPH) containing bioactive peptides. Protein hydrolysates were prepared from different parts (whole fish, skin and head) of several discarded species of the North-West Spain fishing fleet using Alcalase. All hydrolysates had moisture and ash contents lower than 10% and 15%, respectively. The fat content of FPH varied between 1.5% and 9.4% and had high protein content (69.8-76.6%). The amino acids profiles of FPH are quite similar and the most abundant amino acids were glutamic and aspartic acids. All FPH exhibited antioxidant activity and those obtained from Atlantic horse mackerel heads presented the highest 2,2-diphenyl-1-picrylhydrazyl (DPPH) radical scavenging activity, reducing power and Cu2+ chelating activity. On the other hand, hydrolysates from gurnard heads showed the highest ABTS radical scavenging activity and Fe2+ chelating activity. In what concerns the α-amylase inhibitory activity, the IC50 values recorded for FPH ranged between 5.70 and 84.37 mg/mL for blue whiting heads and whole Atlantic horse mackerel, respectively. α-Glucosidase inhibitory activity of FPH was relatively low but all FPH had high Angiotensin Converting Enzyme (ACE) inhibitory activity. Considering the biological activities, these FPH are potential natural additives for functional foods or nutraceuticals.

Emergence and Transmission of Drug-/Multidrug-resistant Mycobacterium leprae in a Former Leprosy Colony in the Brazilian Amazon.

BACKGROUND: Leprosy has been treated with multidrug therapy, which has been distributed for free across the globe and regarded as highly efficient. However, the impossibility of growing Mycobacterium leprae in axenic media has historically impaired assessments of M. leprae resistance, a parameter only recently detectable through molecular methods. METHODS: A systematic, population-based search for M. leprae resistance in suspected leprosy relapse cases and contacts was performed in Prata Village, an isolated, hyperendemic, former leprosy colony located in the Brazilian Amazon. Results led to an extended active search involving the entire Prata population. Confirmed leprosy cases were investigated for bacterial resistance using a combination of in vivo testing and direct sequencing of resistance genes folP1, rpoB, and gyrA. A molecular epidemiology analysis was performed using data from 17 variable number tandem repeats (VNTR). RESULTS: Mycobacterium leprae was obtained from biopsies of 37 leprosy cases (18 relapses and 19 new cases): 16 (43.24%) displayed drug-resistance variants. Multidrug resistance to rifampicin and dapsone was observed in 8 relapses and 4 new cases. Single resistance to rifampicin was detected in 1 new case. Resistance to dapsone was present in 2 relapses and 1 new case. Combined molecular resistance and VNTR data revealed evidence of intra-familial primary transmission of resistant M. leprae. CONCLUSIONS: A comprehensive, population-based systematic approach to investigate M. leprae resistance in a unique population revealed an alarming scenario of the emergence and transmission of resistant strains. These findings may be used for the development of new strategies for surveillance of drug resistance in other populations.

Membrane Proteome-Wide Response to the Antifungal Drug Clotrimazole in Candida glabrata: Role of the Transcription Factor CgPdr1 and the Drug:H+ Antiporters CgTpo1_1 and CgTpo1_2.

Azoles are widely used antifungal drugs. This family of compounds includes triazoles, mostly used in the treatment of systemic infections, and imidazoles, such as clotrimazole, often used in the case of superficial infections. Candida glabrata is the second most common cause of candidemia worldwide and presents higher levels of intrinsic azole resistance when compared with Candida albicans, thus being an interesting subject for the study of azole resistance mechanisms in fungal pathogens.Since resistance often relies on the action of membrane transporters, including drug efflux pumps from the ATP-binding cassette family or from the Drug:H(+) antiporter (DHA)(1) family, an iTRAQ-based membrane proteomics analysis was performed to identify all the membrane-associated proteins whose abundance changes in C. glabrata cells exposed to the azole drug clotrimazole. Proteins found to have significant expression changes in this context were clustered into functional groups, namely: glucose metabolism, oxidative phosphorylation, mitochondrial import, ribosome components and translation machinery, lipid metabolism, multidrug resistance transporters, cell wall assembly, and stress response, comprising a total of 37 proteins. Among these, the DHA transporter CgTpo1_2 (ORF CAGL0E03674g) was identified as overexpressed in the C. glabrata membrane in response to clotrimazole. Functional characterization of this putative drug:H(+) antiporter, and of its homolog CgTpo1_1 (ORF CAGL0G03927g), allowed the identification of these proteins as localized to the plasma membrane and conferring azole drug resistance in this fungal pathogen by actively extruding the drug to the external medium. The cell wall protein CgGas1 was also shown to confer azole drug resistance through cell wall remodeling. Finally, the transcription factor CgPdr1 in the clotrimazole response was observed to control the expression of 20 of the identified proteins, thus highlighting the existence of additional unforeseen targets of this transcription factor, recognized as a major regulator of azole drug resistance in clinical isolates.

Nerve Damage in Young Patients with Leprosy Diagnosed in an Endemic Area of the Brazilian Amazon: A Cross-Sectional Study.

OBJECTIVE: To describe nerve damage and its association with clinical and epidemiologic characteristics in young patients with leprosy diagnosed in an endemic area of the Brazilian Amazon. STUDY DESIGN: All 45 patients with leprosy younger than 15 years of age and diagnosed at a health referral unit in northern Brazil were invited to participate in a cross-sectional, descriptive, analytical study. Subjects were submitted to a templated simple neurologic examination of the peripheral nerves and answered a structured questionnaire. RESULTS: Of 41 cases, referral was the mode of detection in 33 participants (80.5%); 19 (46.3%) had been seen by 3 or more physicians to obtain a diagnosis, and 26 (63.4%) had received other diagnoses. The interval between the onset of symptoms and diagnosis was more than 1 year in 30 cases (73.2%). Borderline leprosy was the predominant clinical form (48.8%); 63.4% of the participants had multibacillary leprosy, 31.7% had nerve damage, and 17.1% exhibited disabilities. The following variables showed a statistically significant association (P???.05) with nerve damage at diagnosis: home visit by the community health worker, number of doctors seen, number of skin lesions (>5), and lesions along the path of nerve trunks. CONCLUSION: Centralized healthcare, a low frequency of home visits by community health workers, and the difficulty in diagnosing leprosy in children are factors that contribute to late treatment initiation and an increased risk of peripheral nerve damage. In addition, multiple skin lesions and lesions along the path of nerve trunks require rigorous monitoring.

Graphical content of medicinal package inserts: an exploratory study to evaluate potential legibility issues.

BACKGROUND: The graphical content of the Medicines Package Inserts (MPIs), such as illustrations and typographic features should be legible and appropriate, as required by international pharmaceutical regulations. OBJECTIVES: To study: (1) the frequency and type of MPIs' key graphic elements, (2) their compliance with regulations and (3) how educated people understand them. METHODS: Descriptive study: characterisation of the graphical content of 651 MPIs. Usability study: illustrations and tables (purposively selected) were evaluated with questionnaires in three groups of humanities undergraduates (illustrations only, illustrations plus text and text only). RESULTS: Descriptive study: illustrations and tables were respectively identified in 6.3% and 11.8% of the MPIs. The illustrations were mainly related to how to take/use the medicine. Non-recommended graphical representations were found (e.g. italic or underline). Usability test: legibility issues were identified, especially for the group of isolated illustrations. DISCUSSION & CONCLUSIONS: The scarce use of illustrations and tables possibly affected the legibility of the MPIs. Compulsory legibility tests are needed to guarantee the MPIs' proper use, thus contributing to a safe use of medicines. Overall, this study highlighted the need to carefully revise/assess the MPIs' design and probably increase health information experts' awareness on this issue.

Protein gels and emulsions from mixtures of Cape hake and pea proteins.

BACKGROUND: Portioning of frozen fish generates by-products such as fish 'sawdust' and cut-offs which can be further processed into protein concentrates and isolates. The objective of the present work was to produce gels and emulsions using recovered Cape hake protein powder (HPP). In previous works, the structures of the gels produced by HPP were found to be strong, with a high rubbery character. In this work, the addition of commercial pea proteins (PPC) to HPP gels and emulsions was studied. RESULTS: Physical properties of gels and emulsions prepared with different proportions of mixtures of PPC and HPP were evaluated. In general, gels and emulsions showed high values for whiteness and, as expected, the higher content of HPP in the protein mixtures led to higher firmness values of the gels. The gel network was rapidly formed upon heating due to the fish protein macromolecules and further reinforced by the pea protein macromolecules when cooled to 5 °C. Both visco-elastic parameters, storage and loss moduli, of the produced gels increased with the HPP proportion in the protein mixtures, corresponding to more structured systems. For the emulsions, two different pH environments were studied: 3.8 and 7.0. At neutral pH a synergy was found between the vegetable and fish protein, which is not so strong when pH is lowered to 3.8, near the isoelectric point of pea proteins (pI = 4.5). This evidence was supported by the results from the texture measurements, viscosity and visco-elastic parameters. CONCLUSIONS: Gels made from Cape hake proteins showed a softer texture and were less rubbery with the addition of pea proteins. Emulsions stabilised by these mixtures showed slightly different behaviour when produced at pH 7.0 or pH 3.8.

Exploring the perspectives of potential consumers and healthcare professionals on the readability of a package insert: a case study of an over-the-counter medicine.

PURPOSE: To explore and compare the opinions of physicians, pharmacists and potential users on the readability of a package insert of an over-the-counter medicine. METHODS: Exploratory study based on the administration of a semi-open questionnaire. This instrument was developed according to the readability guideline of the European Medicine Agency (EMA) and used to evaluate participants' accessibility to, and comprehensibility of, the package insert for diclofenac 12.5 mg tablets. Sixty-three participants were recruited from the Lisbon region and enrolled in three groups: physicians (Dg), pharmacists (Pg) and potential consumers (PCg), with a minimum of 20 participants each. RESULTS: Almost all (85 %) of the 20 PCg participants were educated above the 9th grade, although the majority of them (95 %) referred to, at least, one package insert interpretation issue, mainly related to the comprehension of technical terms. Amongst other differences between the groups, the Pg participants (n = 22) obtained a significantly less favourable opinion regarding the layout of the titles. Furthermore, the Pg and Dg (n = 21) participants proposed technical enhancements, such as the use of a table to explain the posology, precautions in case of renal failure, or the recommendation to take the tablets with meals. CONCLUSIONS: Differences in the way of using the diclofenac tablets are expected, considering the comprehension dissimilarities between health professionals and potential consumers. The package insert of diclofenac 12.5 mg could be enhanced for safer use. Regarding the readability assessment of this package insert, the method proposed in the EMA guidelines might not be as effective as expected. Future research is advisable.

Candida glabrata drug:H+ antiporter CgQdr2 confers imidazole drug resistance, being activated by transcription factor CgPdr1.

The widespread emergence of antifungal drug resistance poses a severe clinical problem. Though predicted to play a role in this phenomenon, the drug:H(+) antiporters (DHA) of the major facilitator superfamily have largely escaped characterization in pathogenic yeasts. This work describes the first DHA from the pathogenic yeast Candida glabrata reported to be involved in antifungal drug resistance, the C. glabrata QDR2 (CgQDR2) gene (ORF CAGL0G08624g). The expression of CgQDR2 in C. glabrata was found to confer resistance to the antifungal drugs miconazole, tioconazole, clotrimazole, and ketoconazole. By use of a green fluorescent protein (GFP) fusion, the CgQdr2 protein was found to be targeted to the plasma membrane in C. glabrata. In agreement with these observations, CgQDR2 expression was found to decrease the intracellular accumulation of radiolabeled clotrimazole in C. glabrata and to play a role in the extrusion of this antifungal from preloaded cells. Interestingly, the functional heterologous expression of CgQDR2 in the model yeast Saccharomyces cerevisiae further confirmed the role of this gene as a multidrug resistance determinant: its expression was able to complement the susceptibility phenotype exhibited by its S. cerevisiae homologue, QDR2, in the presence of imidazoles and of the antimalarial and antiarrhythmic drug quinidine. In contrast to the findings reported for Qdr2, CgQdr2 expression does not contribute to the ability of yeast to grow under K(+)-limiting conditions. Interestingly, CgQDR2 transcript levels were seen to be upregulated in C. glabrata cells challenged with clotrimazole or quinidine. This upregulation was found to depend directly on the transcription factor CgPdr1, the major regulator of multidrug resistance in this pathogenic yeast, which has also been found to be a determinant of quinidine and clotrimazole resistance in C. glabrata.

Functional and antioxidative properties of protein hydrolysates from Cape hake by-products prepared by three different methodologies.

BACKGROUND: The production of fish protein hydrolysates (FPH) is a convenient technology for upgrading fish by-products. The aim of this work was to study three different methods of FPH preparation from Cape hake by-products to improve yield and quality. Functional and antioxidative properties of all FPHs were determined. RESULTS: The protein content of hake FPH was in the range 807-860 g kg(-1) and the degree of hydrolysis was between 19% and 22%. The maximum yield (71.9%) was achieved by methodology B but the hydrolysate was darker. The peptide profile of all FPHs was very similar. FPH prepared by methodology C had significantly higher emulsifying activity index and hydrolysate prepared by methodology B had the highest foaming capacity. The solubility of FPH was in the range 71-76% and increased the water-holding capacity of minced fish by about 9%. The fractionation of FPH obtained by methodologies A and B allowed concentrating peptides with higher radical scavenging activity and reducing power. CONCLUSION: The properties of the FPH prepared indicated that they can be used in food systems as natural additives, particularly to improve their water-holding capacity.

A SWOT Analysis of Pharmacy Students' Perspectives on e-Learning Based on a Narrative Review.

BACKGROUND: Online education became the new normal during the COVID-19 pandemic. However, the number of studies exploring the potential advantages/disadvantages of e-learning in pharmacy courses is limited. STUDY AIM: to propose a strengths, weaknesses, opportunities, and threats (SWOT) analysis of e-learning according to pharmacy students' perspectives. METHODS: A narrative review was conducted to examine student pharmacist perspectives on e-learning. RESULTS: Diverse strengths and weaknesses (internal environment) and opportunities and threats (external environment) were identified, which were grouped into categories, such as (1) students' well-being (e.g., access to classes anywhere vs. students' psychological or physical disorders); (2) teachers and materials (e.g., more diverse/interesting audiovisual materials vs. too challenging materials); (3) technologies (e.g., new education strategies, such as gamification vs. barriers in the access to the internet); (4) classes/training (e.g., more versatile/immediate classes vs. eventual presence of other persons during online classes); and (5) faculty/school of pharmacy (e.g., availability of technical support). CONCLUSION: Overall, online education seems to be suitable for pharmacy students, although diverse challenges should be addressed, such as the well-being of students or lack of standards. Pharmacy schools should regularly identify/define and implement measures to reinforce opportunities and strengths as well as to solve threats and weaknesses.

Atrial cardiopathy in young adults with embolic stroke of undetermined source: a myocardial deformation imaging analysis.

BACKGROUND: Atrial cardiopathy (AC) has emerged as a potential pathological thrombogenic atrial substract of embolic stroke of undetermined source (ESUS), even in the absence of atrial fibrillation. Left atrium (LA) myocardial deformation analysis may be of value as a subclinical marker of AC and a predictor of ESUS. AIMS: To compare LA mechanical function between ESUS cases and age and sex-matched controls. METHODS: A single-center analytical study with case-control design was performed. Case group was composed by young patients admitted in the Neurology department from January 2017 to June 2021. Control group was composed by age and sex matched controls recruited from the community. All participants performed echocardiogram and a smaller sample underwent cardiac magnetic resonance. RESULTS: We recruited 31 ESUS patients aged between 18 and 65 years and 31 age and sex matched controls. ESUS patients had a significantly higher prevalence of cardiovascular risk factors and patent foramen ovale (PFO). The prevalence of AC was not different between groups. Echocardiogram parameters, including strain analysis, were similar between groups, except for LA appendage (LAA) ostium variation which was significantly lower in ESUS patients (absolute: 6.5vs8.7mm, p<0.001; relative: 44.5%vs53.4%, p=0.002). After exclusion of patients with PFO, all the results were statistically similar. Regarding cardiac magnetic resonance analysis, there were no statistically significant differences between groups. CONCLUSION: This study shows that in our population atria cardiopathy and atrial function was not associated with ESUS.LAA structural and functional abnormalities may play a major role. The role of LAA in ESUS warrants further studies.

Perceptions of Pharmacy Students on the E-Learning Strategies Adopted during the COVID-19 Pandemic: A Systematic Review.

BACKGROUND: E-learning strategies were globally adopted by academies because of the COVID-19 pandemic. The characterization of students' perception of online learning is fundamental to design appropriate models for pharmacy curricula. The study aim was to carry out a systematic review about the perception of pharmacy students on the e-learning strategies adopted during the COVID-19 pandemic. METHODS: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist was followed. PICOS criteria were applied. Five databases were screened: PubMed, Cochrane Library, DOAJ-Directory of Open Access Journals, SciELO-Scientific Electronic Library Online and b-on-Online Library of knowledge (Biblioteca do conhecimento online). KEYWORDS: "pharmacy and (distant or remote or e-learning or online or zoom or education or training or digital) and (COVID or SARS and (student or undergraduate) and (opinion or satisfaction or perception or attitude)". RESULTS: 23 out of 176 papers were selected (28 duplicated and 125 excluded). Selected papers were classified, as follows: studies exclusively involving pharmacy students (n = 8); studies simultaneously involving pharmacy students and other healthcare students (n = 6); and studies related to the involvement of pharmacy students in specific courses (n = 9). CONCLUSIONS: In general, the perception of pharmacy students on e-learning strategies adopted during the COVID-19 pandemic was positive. However, an expressive proportion of undergraduates reported negative issues about online education, which seems to support the necessity of optimizing e-learning strategies in the future.

Global Predictors of COVID-19 Vaccine Hesitancy: A Systematic Review.

BACKGROUND: vaccine hesitancy is defined as a delay in the acceptance or refusal of vaccination, even though immunisation is a determinant in reducing the mortality and morbidity associated with Coronavirus Disease 2019 (COVID-19). AIM: to identify and analyse the predictors of COVID-19 vaccine acceptance and/or hesitancy. METHODS: a systematic review according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) criteria. KEYWORDS: vaccine and (COVID or SARS) and (acceptance or acceptability or willingness or hesitancy or refusal) and (multivariate or regression) and (questionnaire or survey) and national. Databases/resources: PubMed, DOAJ, SciELO and b-on. Timeframe: March 2020-2022. INCLUSION CRITERIA: general population, questionnaire-based, calculation of a multivariate regression model and national studies. QUALITY ASSESSMENT: application of the National Heart, Lung, and Blood institute (NHLBI) tool. RESULTS: a total of 37 studies were selected, whose overall rate was fair. The most predominant predictors of vaccine hesitancy were a lower perceived risk of getting infected, a lower level of institutional trust, not being vaccinated against influenza, lower levels of perceived severity of COVID-19, or stronger beliefs that the vaccination would cause side effects or be unsafe. DISCUSSION AND CONCLUSION: the identified predictors can be used to design tailored health policies and/or public health interventions, or to evaluate subjects' vaccine hesitancy.

A Systematic Review on the Contribution of Artificial Intelligence in the Development of Medicines for COVID-2019.

BACKGROUND: COVID-2019 pandemic lead to a raised interest on the development of new treatments through Artificial Intelligence (AI). AIM: to carry out a systematic review on the development of repurposed drugs against COVID-2019 through the application of AI. METHODS: The Systematic Reviews and Meta-Analyses (PRISMA) checklist was applied. KEYWORDS: ["Artificial intelligence" and (COVID or SARS) and (medicine or drug)]. Databases: PubMed®, DOAJ and SciELO. Cochrane Library was additionally screened to identify previous published reviews on the same topic. RESULTS: From the 277 identified records [PubMed® (n = 157); DOAJ (n = 119) and SciELO (n = 1)], 27 studies were included. Among other, the selected studies on new treatments against COVID-2019 were classified, as follows: studies with in-vitro and/or clinical data; association of known drugs; and other studies related to repurposing of drugs. CONCLUSION: Diverse potentially repurposed drugs against COVID-2019 were identified. The repurposed drugs were mainly from antivirals, antibiotics, anticancer, anti-inflammatory, and Angiotensin-converting enzyme 2 (ACE2) groups, although diverse other pharmacologic groups were covered. AI was a suitable tool to quickly analyze large amounts of data or to estimate drug repurposing against COVID-2019.