Complementary approaches to dissect late leaf rust resistance in an interspecific raspberry population.

Over the last 10 years, global raspberry production has increased by 47.89%, based mainly on the red raspberry species (Rubus idaeus). However, the black raspberry (Rubus occidentalis), although less consumed, is resistant to one of the most important diseases for the crop, the late leaf rust caused by Acculeastrum americanum fungus. In this context, genetic resistance is the most sustainable way to control the disease, mainly because there are no registered fungicides for late leaf rust in Brazil. Therefore, the aim was to understand the genetic architecture that controls resistance to late leaf rust in raspberries. For that, we used an interspecific multiparental population using the species mentioned above as parents, 2 different statistical approaches to associate the phenotypes with markers [GWAS (genome-wide association studies) and copula graphical models], and 2 phenotyping methodologies from the first to the 17th day after inoculation (high-throughput phenotyping with a multispectral camera and traditional phenotyping by disease severity scores). Our findings indicate that a locus of higher effect, at position 13.3 Mb on chromosome 5, possibly controls late leaf rust resistance, as both GWAS and the network suggested the same marker. Of the 12 genes flanking its region, 4 were possible receptors, 3 were likely defense executors, 1 gene was likely part of signaling cascades, and 4 were classified as nondefense related. Although the network and GWAS indicated the same higher effect genomic region, the network identified other different candidate regions, potentially complementing the genetic control comprehension.

Construction and genetic characterization of an interspecific raspberry hybrids panel aiming resistance to late leaf rust and adaptation to tropical regions.

Raspberries (Rubus spp) are temperate climate fruits with profitable high returns and have the potential for diversification of fruit growing in mid to low-latitude regions. However, there are still no cultivars adapted to climatic conditions and high pressure of diseases that occurs in tropical areas. In this context, our objective was to evaluate the genetic diversity from a 116 raspberry genotypes panel obtained from interspecific crosses in a testcross scheme with four cultivars already introduced in Brazil. The panel was genotyped via genotyping-by-sequencing. 28,373 and 27,281 SNPs were obtained, using the species R. occidentalis and R. idaeus genomes as references, respectively. A third marker dataset was constructed consisting of 41,292 non-coincident markers. Overall, there were no differences in the results when using the different marker sets for the subsequent analyses. The mean heterozygosity was 0.54. The average effective population size was 174, indicating great genetic variability. The other analyses revealed that the half-sibling families were structured in three groups. It is concluded that the studied panel has great potential for breeding and further genetic studies. Moreover, only one of the three marker matrices is sufficient for diversity studies.

Prognosing the risk of COVID-19 death through a machine learning-based routine blood panel: A retrospective study in Brazil.

BACKGROUND: Despite an extensive network of primary care availability, Brazil has suffered profoundly during the COVID-19 pandemic, experiencing the greatest sanitary collapse in its history. Thus, it is important to understand phenotype risk factors for SARS-CoV-2 infection severity in the Brazilian population in order to provide novel insights into the pathogenesis of the disease. OBJECTIVE: This study proposes to predict the risk of COVID-19 death through machine learning, using blood biomarkers data from patients admitted to two large hospitals in Brazil. METHODS: We retrospectively collected blood biomarkers data in a 24-h time window from 6,979 patients with COVID-19 confirmed by positive RT-PCR admitted to two large hospitals in Brazil, of whom 291 (4.2%) died and 6,688 (95.8%) were discharged. We then developed a large-scale exploration of risk models to predict the probability of COVID-19 severity, finally choosing the best performing model regarding the average AUROC. To improve generalizability, for each model five different testing scenarios were conducted, including two external validations. RESULTS: We developed a machine learning-based panel composed of parameters extracted from the complete blood count (lymphocytes, MCV, platelets and RDW), in addition to C-Reactive Protein, which yielded an average AUROC of 0.91 ± 0.01 to predict death by COVID-19 confirmed by positive RT-PCR within a 24-h window. CONCLUSION: Our study suggests that routine laboratory variables could be useful to identify COVID-19 patients under higher risk of death using machine learning. Further studies are needed for validating the model in other populations and contexts, since the natural history of SARS-CoV-2 infection and its consequences on the hematopoietic system and other organs is still quite recent.

Optimizing Genomic-Enabled Prediction in Small-Scale Maize Hybrid Breeding Programs: A Roadmap Review.

The usefulness of genomic prediction (GP) for many animal and plant breeding programs has been highlighted for many studies in the last 20 years. In maize breeding programs, mostly dedicated to delivering more highly adapted and productive hybrids, this approach has been proved successful for both large- and small-scale breeding programs worldwide. Here, we present some of the strategies developed to improve the accuracy of GP in tropical maize, focusing on its use under low budget and small-scale conditions achieved for most of the hybrid breeding programs in developing countries. We highlight the most important outcomes obtained by the University of São Paulo (USP, Brazil) and how they can improve the accuracy of prediction in tropical maize hybrids. Our roadmap starts with the efforts for germplasm characterization, moving on to the practices for mating design, and the selection of the genotypes that are used to compose the training population in field phenotyping trials. Factors including population structure and the importance of non-additive effects (dominance and epistasis) controlling the desired trait are also outlined. Finally, we explain how the source of the molecular markers, environmental, and the modeling of genotype-environment interaction can affect the accuracy of GP. Results of 7 years of research in a public maize hybrid breeding program under tropical conditions are discussed, and with the great advances that have been made, we find that what is yet to come is exciting. The use of open-source software for the quality control of molecular markers, implementing GP, and envirotyping pipelines may reduce costs in an efficient computational manner. We conclude that exploring new models/tools using high-throughput phenotyping data along with large-scale envirotyping may bring more resolution and realism when predicting genotype performances. Despite the initial costs, mostly for genotyping, the GP platforms in combination with these other data sources can be a cost-effective approach for predicting the performance of maize hybrids for a large set of growing conditions.

Tolerance of tomato to cadmium-induced stress: analyzing cultivars with different fruit colors.

The objective of the present study was to assess the response of tomato cultivars with different fruit colors to exposure to increasing Cd levels in the substrate by measuring the impacts of Cd on the oxidative stress indicators and physicochemical features of fruits, as well as plant development and yield components. A completely randomized experiment in a 3 × 3 factorial design [tomato cultivar (which produces purple, red, or white fruits) vs Cd level in the substrate (0, 3.6, or 12 mg kg-1)] was performed. The cultivation of plants in substrate containing 3.6 mg kg-1 Cd did not affect yield, but fruits exhibited nonpermissive Cd concentrations in both peel and mesocarp across all cultivars. By contrast, yield was decreased in plants with red and white fruits after their cultivation in substrate containing 12 mg kg-1 Cd, while the productivity of plants with purple fruits was maintained under such conditions. The hydrogen peroxide content in the fruit mesocarp depended only on cultivar. However, an increased lipid peroxidation level was detected in the mesocarp of purple fruits at the highest Cd concentration. No parameters of fruit quality [i.e., diameter, length, °Brix, pH, titratable acidity, color (L*, a*, and b*), and concentrations of lycopene and ß-carotene in mesocarp] were affected by long-term exposure to Cd at 12 mg kg-1. In conclusion, the results of this study suggested that the potential Cd side effects on diverse tomato quality features can be buffered at the fruit level because these features were maintained at the usual values despite high Cd concentrations in tomato peel and pulp. Moreover, these buffering mechanisms are independent of lycopene and ß-carotene concentrations in fruit peel, since the three tomato cultivars that were evaluated in the present study (white fruits, possessing no or negligible concentrations of these carotenoids, and red and purple tomato, possessing high lycopene and ß-carotene concentrations) were able to sustain several fruit quality parameters after long-term exposure to high Cd concentrations in the substrate.

Quantitative proteomic analysis of tomato genotypes with differential cadmium tolerance.

This is a report on comprehensive characterization of cadmium (Cd)-exposed root proteomes in tomato using label-free quantitative proteomic approach. Two genotypes differing in Cd tolerance, Pusa Ruby (Cd-tolerant) and Calabash Rouge (Cd-sensitive), were exposed during 4 days to assess the Cd-induced effects on root proteome. The overall changes in both genotypes in terms of differentially accumulated proteins (DAPs) were mainly associated to cell wall, redox, and stress responses. The proteome of the sensitive genotype was more responsive to Cd excess, once it presented higher number of DAPs. Contrasting protein accumulation in cellular component was observed: Cd-sensitive enhanced intracellular components, while the Cd-tolerant increased proteins of extracellular and envelope regions. Protective and regulatory mechanisms were different between genotypes, once the tolerant showed alterations of various protein groups that lead to a more efficient system to cope with Cd challenge. These findings could shed some light on the molecular basis underlying the Cd stress response in tomato, providing fundamental insights for the development of Cd-safe cultivars. Graphical abstract.

Alzheimer's disease: risk factors and potentially protective measures.

Alzheimer's disease (AD) is the most common type of dementia and typically manifests through a progressive loss of episodic memory and cognitive function, subsequently causing language and visuospatial skills deficiencies, which are often accompanied by behavioral disorders such as apathy, aggressiveness and depression. The presence of extracellular plaques of insoluble ß-amyloid peptide (Aß) and neurofibrillary tangles (NFT) containing hyperphosphorylated tau protein (P-tau) in the neuronal cytoplasm is a remarkable pathophysiological cause in patients' brains. Approximately 70% of the risk of developing AD can be attributed to genetics. However, acquired factors such as cerebrovascular diseases, diabetes, hypertension, obesity and dyslipidemia increase the risk of AD development. The aim of the present minireview was to summarize the pathophysiological mechanism and the main risk factors for AD. As a complement, some protective factors associated with a lower risk of disease incidence, such as cognitive reserve, physical activity and diet will also be addressed.

Hemostatic Abnormalities in Dementia: A Systematic Review and Meta-Analysis.

Alzheimer's disease (AD) is considered the most frequent cause of dementia. It is known that vascular risk factors play an important role in the development and progression of this condition. Alterations in vascular walls represent documented findings in patients with AD and other dementias affecting elderly people. The authors performed a systematic review and meta-analysis, aiming to synthesize observational studies that evaluated how the hemostatic system may contribute to cognitive decline in the elderly, using papers published until April 2018 and as indexed in Medline (PubMed), Scopus, Web of Science, ScienceDirect, Lilacs, Cinahl, PsycINFO, Cochrane Central Register of Controlled Trials, and Cochrane Database of Systematic Reviews. Among 5,278 studies identified, 32 were included in the final synthesis, and these included 485 patients with mild cognitive impairment, 568 with vascular dementia (VD), 1,781 with AD, and 2,855 participants without dementia. AD patients had increased plasma von Willebrand factor (VWF) (standardized mean difference [SMD]: 2.53; 95% confidence interval [CI]: 0.10-4.95), D-dimer (SMD: 0.50; 95% CI: 0.35-0.66), plasminogen activator inhibitor-1 (SMD: 3.34; 95% CI: 1.01-5.67), thrombomodulin (SMD: 1.08; 95% CI: 0.53-1.62), and homocysteine levels (SMD: 0.65; 95% CI: 0.15-1.15). In contrast, the VD group showed increased fibrinogen levels (SMD: 0.77; 95% CI: 0.13-1.41), activated factor VII (SMD: 0.36; 95% CI: 0.05-0.67), factor VIII (SMD: 0.57; 95% CI: 0.22-0.91), VWF (SMD: 2.34; 95% CI: 0.38-4.29), D-dimer (SMD: 1.14; 95% CI: 0.51-1.78), and homocysteine (SMD: 2.17; 95% CI: 1.67-2.68). AD showed an elevation in some markers of endothelial dysfunction, whereas VD presented mostly an involvement of coagulation cascade components.

Arterial Stiffness Use for Early Monitoring of Cardiovascular Adverse Events due to Anthracycline Chemotherapy in Breast Cancer Patients. A Pilot Study / Uso da Rigidez Arterial para Monitoramento Precoce de Eventos Adversos Cardiovasculares por Antracíclicos em Pacientes com Câncer de Mama. Um Estudo Piloto

Abstract Background: Chemotherapy with doxorubicin and cyclophosphamide, although efficient for treating breast cancer, is associated with cardiovascular complications. Recent studies seek to identify methods that can early detect cardiological and vascular changes as a strategy to decrease the incidence of cardiovascular comorbidities. Objective: To evaluate the role of arterial stiffness measurement in the monitoring of doxorubicin and cyclophosphamide-induced cardiotoxicity in breast cancer patients. Methods: Prospective longitudinal study in 24 breast cancer patients undergoing treatment with doxorubicin and cyclophosphamide. Patients underwent an indirect evaluation of arterial stiffness through non-invasive measurement of hemodynamic parameters such as pulse wave velocity with the Mobil-O-Graph® 24H PWA device at three different times of the chemotherapy treatment (pre-chemotherapy, after the first and the fourth cycle). The left ventricular ejection fraction was also evaluated by Doppler echocardiography (pre-chemotherapy and after the fourth chemotherapy cycle). Data were considered significant when p ≤ 0.05. Results: Patients had a mean age of 52.33 ± 8.85 years and body mass index of 31 ± 5.87 kg/m2. There was no significant difference between the hemodynamic parameters evaluated by the oscillometric method or in the left ventricular ejection fraction in the different evaluated periods. Conclusion: Evaluations of arterial stiffness by oscillometry and measurement of left ventricular ejection fraction by Doppler echocardiography showed equivalence in the values found, suggesting that the evaluation method of arterial stiffness studied could be used as a marker for cardiovascular adverse events associated with doxorrubicin-based chemotherapy drugs.

Resumo Fundamento: O tratamento quimioterápico com doxorrubicina e ciclofosfamida, apesar de eficiente no combate ao câncer de mama, está associado a complicações cardiovasculares. Trabalhos recentes identificam métodos que possam detectar alterações cardiológicas e vasculares precocemente, visando a uma estratégia para diminuição na incidência de comorbidades cardiovasculares. Objetivo: Avaliar o papel da medida da rigidez arterial no acompanhamento da ocorrência de eventos adversos cardiovasculares induzidos por doxorrubicina e ciclofosfamida em pacientes com câncer de mama. Métodos: Estudo longitudinal prospectivo realizado com 24 pacientes com câncer de mama em tratamento com doxorrubicina e ciclofosfamida. As pacientes foram submetidas à avaliação indireta da rigidez arterial, por mensuração não invasiva de parâmetros hemodinâmicos, como a velocidade de onda de pulso, pelo equipamento Mobil-O-Graph® 24H PWA em três diferentes momentos do tratamento quimioterápico (pré-quimioterapia, após o primeiro e após o quarto ciclos). Foi avaliada também a fração de ejeção do ventrículo esquerdo pelo ecoDopplercardiograma (pré-quimioterapia e após o quarto ciclo quimioterápico). Os valores de p ≤ 0,05 foram considerados significativos. Resultados: As pacientes apresentaram média de idade de 52,33 ± 8,85 anos e índice de massa corporal de 31 ± 5,87 kg/m2. Não houve diferença significativa entre os parâmetros hemodinâmicos avaliados pelo método oscilométrico ou na fração de ejeção do ventrículo esquerdo, nos diferentes períodos avaliados. Conclusão: As avaliações de rigidez arterial por oscilometria e medida da fração de ejeção do ventrículo esquerdo por ecoDopplercardiograma mostraram equivalência nos valores encontrados, sugerindo que o método de avaliação da rigidez arterial estudado possa ser utilizado como mais um marcador para eventos adversos cardiovasculares associados aos medicamentos quimioterápicos baseados em doxorrubicina.

Arterial Stiffness Use for Early Monitoring of Cardiovascular Adverse Events due to Anthracycline Chemotherapy in Breast Cancer Patients. A Pilot Study.

BACKGROUND: Chemotherapy with doxorubicin and cyclophosphamide, although efficient for treating breast cancer, is associated with cardiovascular complications. Recent studies seek to identify methods that can early detect cardiological and vascular changes as a strategy to decrease the incidence of cardiovascular comorbidities. OBJECTIVE: To evaluate the role of arterial stiffness measurement in the monitoring of doxorubicin and cyclophosphamide-induced cardiotoxicity in breast cancer patients. METHODS: Prospective longitudinal study in 24 breast cancer patients undergoing treatment with doxorubicin and cyclophosphamide. Patients underwent an indirect evaluation of arterial stiffness through non-invasive measurement of hemodynamic parameters such as pulse wave velocity with the Mobil-O-Graph® 24H PWA device at three different times of the chemotherapy treatment (pre-chemotherapy, after the first and the fourth cycle). The left ventricular ejection fraction was also evaluated by Doppler echocardiography (pre-chemotherapy and after the fourth chemotherapy cycle). Data were considered significant when p ≤ 0.05. RESULTS: Patients had a mean age of 52.33 ± 8.85 years and body mass index of 31 ± 5.87 kg/m2. There was no significant difference between the hemodynamic parameters evaluated by the oscillometric method or in the left ventricular ejection fraction in the different evaluated periods. CONCLUSION: Evaluations of arterial stiffness by oscillometry and measurement of left ventricular ejection fraction by Doppler echocardiography showed equivalence in the values found, suggesting that the evaluation method of arterial stiffness studied could be used as a marker for cardiovascular adverse events associated with doxorrubicin-based chemotherapy drugs.

Cadmium toxicity degree on tomato development is associated with disbalances in B and Mn status at early stages of plant exposure.

Cadmium (Cd) toxicity is frequently coupled to its accumulation in plants, but not always the highest Cd concentration triggers the worst damages, indicating that additional events influence the magnitude of Cd side-effects. We investigated the early mechanisms behind the differential Cd-induced impacts on plant development of four tomato accessions with contrasting tolerance to Cd toxicity. At organ level, the highest Cd concentration was not associated with the largest biomass losses. In leaves, changes in superoxide dismutase and catalase activities were not related to differences in Cd concentration, which was unable to provoke H2O2 overproduction on the sixth day of plant exposure to this metal. Further investigation in the mineral profile revealed that magnitude of Cd toxicity depends probably on synergic effects from increased B status, in addition to the own Cd accumulation. Furthermore, disbalances in Mn status (i.e., excess in leaves and deficiency in roots) may enhance Cd toxicity degree. According to data, however, the low magnesium (Mg) status can be linked to tomato tolerance against Cd toxicity. In conclusion, the tomato tolerance degree under short-Cd exposure depends on actively, finely regulation of mineral homeostasis that results in different development of plant organs. The better understanding on the mode of action of Cd toxicity in plants can help in the establishment of strategies to mitigate its impacts on crop yield.

Toxicological study of a new doxorubicin-loaded pH-sensitive liposome: A preclinical approach.

Doxorubicin (DOX) is widely used in cancer treatment, however, the use of this drug is often limited due to its cardiotoxic side effects. In order to avoid these adverse effects, the encapsulation of DOX into nanosystems has been used in the last decades. In this context, pH-sensitive liposomes have been shown promising for delivering cytotoxic agents into tumor cells, however, the lack of information about in vivo toxicity of this nanocarrier has impaired translational studies. Therefore, the aim of this work was to investigate the acute toxicity and cardiotoxicity of DOX-loading pH-sensitive liposomes (SpHL-DOX). To achieve this, female BALB/c mice, after intravenous administration, were monitored by means of clinical, laboratory, histopathological and electrocardiographic (ECG) analyses. Results indicate that SpHL was able to prevent renal toxicity and the hepatic injury was less extensive than free DOX. In addition, lower body weight loss was associated with less ECG QT interval prolongation to animals receiving SpHL-DOX (14.6 ±â€¯5.2%) compared to animals receiving free DOX (35.7 ±â€¯4.0%) or non-pH-sensitive liposomes (nSpHL-DOX) (47.0 ±â€¯9.8%). These results corroborate with SpHL-DOX biodistribution studies published by our group. In conclusion, the SpHL-DOX showed less toxic effects on mice compared to free DOX or nSpHL-DOX indicating that SpHL-DOX is a promising strategy to reduce the serious cardiotoxic effects of DOX.

Temporal dynamic responses of roots in contrasting tomato genotypes to cadmium tolerance.

Despite numerous studies on cadmium (Cd) uptake and accumulation in crops, relatively little is available considering the temporal dynamic of Cd uptake and responses to stress focused on the root system. Here we highlighted the responses to Cd-induced stress in roots of two tomato genotypes contrasting in Cd-tolerance: the tolerant Pusa Ruby and the sensitive Calabash Rouge. Tomato genotypes growing in the presence of 35 µM CdCl2 exhibited a similar trend of Cd accumulation in tissues, mainly in the root system and overall plants exhibited reduction in the dry matter weight. Both genotypes showed similar trends for malondialdehyde and hydrogen peroxide accumulation with increases when exposed to Cd, being this response more pronounced in the sensitive genotype. When the antioxidant machinery is concerned, in the presence of Cd the reduced glutathione content was decreased in roots while ascorbate peroxidase (APX), glutathione reductase (GR) and glutathione S-transferase (GST) activities were increased in the presence of Cd in the tolerant genotype. Altogether these results suggest APX, GR and GST as the main players of the antioxidant machinery against Cd-induced oxidative stress.

Síndrome do comer noturno e estados emocionais em estudantes universitários / Night eating syndrome and emotional states in university students

INTRODUCTION: University students are exposed to many factors related to Night Eating Syndrome (NES), an eating disorder that may be associated with obesity. OBJECTIVE: To determine the prevalence of NES among students from a Brazilian university and evaluate the association of the syndrome behaviours with emotional. biological and environmental factors. METHODS: Cross-sectional study with 200 students from a private higher education institution located in the city of Juazeiro do Norte. Ceará. Brazil. NES was evaluated using the Night Eating Questionnaire (NEQ). considering the NEQ score ≥ 25 as the cut-off value for indication of the syndrome. Depression. anxiety. and stress symptoms were assessed using the Depression Anxiety Stress Scales (DASS-21) questionnaire. Additional information was collected about the participants (gender. age. weight and height). the academic status (enrolled course. study period and year) and the employment status (whether the participant worked at least 4h daily in addition to studying. RESULTS: 30 participants (15%) presented NEQ score ≥ 25. indicative of NES. There was no association between the NEQ score and the variables: gender, nutritional status, work, enrolled course. study period and academic year. There was an association between NEQ score and severity of depression (p=0.0001). anxiety (p=0.0001) and stress (p=0.0218). CONCLUSION: Evidence of a high prevalence of NES was found among Brazilian university students and an association between the behaviours of the syndrome with depressive. anxiety and stress symptoms was found.

INTRODUÇÃO: Estudantes universitários estão expostos a muitos fatores relacionados à Síndrome do Comer Noturno (SCN), um transtorno alimentar que pode estar associado à obesidade. OBJETIVO: Determinar a prevalência da SCN entre estudantes de uma universidade brasileira e avaliar a associação de comportamentos da síndrome a fatores emocionais, biológicos e ambientais. MÉTODO: Estudo transversal realizado com 200 estudantes de instituição de ensino superior privada localizada na cidade de Juazeiro do Norte, Ceará, Brasil. A SCN foi avaliada por meio do Night Eating Questionnaire (NEQ), considerando-se o escore NEQ ≥ 25 como valor de corte para indicação da síndrome. Sintomas depressivos, de ansiedade e de estresse foram avaliados por meio do questionário Depression Anxiety Stress Scales (DASS-21). Informações adicionais foram coletadas sobre os participais (sexo, idade, peso, altura); seu status acadêmico (tipo de curso, período, série); e seu status empregatício (se o participante trabalha ao menos 4h diárias além de estudar. RESULTADOS: 30 participantes (15%) apresentaram o escore NEQ ≥ 25, indicativo da SCN. Não houve associação entre o escore NEQ e as variáveis: sexo, estado nutricional, trabalho, curso matriculado, período de estudo e série cursada. Foi observada associação entre o escore NEQ e a severidade de depressão (p=0,0001), de ansiedade (p=0,0001) e de estresse (p=0,0218). CONCLUSÃO: Foram encontradas evidências de alta prevalência da SCN entre estudantes universitários brasileiros e verificou-se associação dos comportamentos da síndrome com sintomas depressivos, de ansiedade e de estresse.

A new index to discriminate between iron deficiency anemia and thalassemia trait.

BACKGROUND: The most common microcytic and hypochromic anemias are iron deficiency anemia and thalassemia trait. Several indices to discriminate iron deficiency anemia from thalassemia trait have been proposed as simple diagnostic tools. However, some of the best discriminative indices use parameters in the formulas that are only measured in modern counters and are not always available in small laboratories. The development of an index with good diagnostic accuracy based only on parameters derived from the blood cell count obtained using simple counters would be useful in the clinical routine. Thus, the aim of this study was to develop and validate a discriminative index to differentiate iron deficiency anemia from thalassemia trait. METHODS: To develop and to validate the new formula, blood count data from 106 (thalassemia trait: 23 and iron deficiency: 83) and 185 patients (thalassemia trait: 30 and iron deficiency: 155) were used, respectively. Iron deficiency, ß-thalassemia trait and α-thalassemia trait were confirmed by gold standard tests (low serum ferritin for iron deficiency anemia, HbA2>3.5% for ß-thalassemia trait and using molecular biology for the α-thalassemia trait). RESULTS: The sensitivity, specificity, efficiency, Youden's Index, area under receiver operating characteristic curve and Kappa coefficient of the new formula, called the Matos & Carvalho Index were 99.3%, 76.7%, 95.7%, 76.0, 0.95 and 0.83, respectively. CONCLUSION: The performance of this index was excellent with the advantage of being solely dependent on the mean corpuscular hemoglobin concentration and red blood cell count obtained from simple automatic counters and thus may be of great value in underdeveloped and developing countries.

Validity and reliability evidence of the questionnaire for illness representation, the impact of epilepsy, and stigma (QIRIS) / Evidências de validade e confiabilidade do questionário de representação da doença, impacto da epilepsia e estigma (QIRIS)

ABSTRACT The objective of this study was to obtain reliability and validity evidence for the questionnaire of illness representation, the impact of epilepsy, and stigma (QIRIS) for use with adolescents and adults in Brazil. QIRIS consists of 14 questions grouped in three domains (attribution of meaning, impact of disease, and stigma) and was applied to 57 adults with epilepsy. QIRIS internal consistency was satisfactory (Cronbach’s α = 0. 866). Significant and strong correlation was found between issues belonging to the same domain, as expected. Three domains have highly significant and positive correlations with the instrument’s total score, indicating evidence of content validity. We conclude that QIRIS has psychometric properties and can facilitate a systematic evaluation of the patient’s representation according to a biopsychosocial approach that may contribute to clinical practice based on scientific evidence.

RESUMO Este estudo buscou evidências de confiabilidade e validade para o questionário de representação da doença, impacto da epilepsia e estigma (QIRIS), para uso em adolescentes e adultos no Brasil. O QIRIS consiste de 14 questões agrupadas em 3 domínios (atribuição de significados, impacto da doença e estigma) e foi aplicado em 57 adultos com epilepsia. A consistência interna do QIRIS foi satisfatória (α de Cronbach = 0,866). Foi encontrada forte e significante correlação entre as questões com o mesmo domínio.Os três domínios têm correlações altamente significativas e positivas com a pontuação total do instrumento, indicando evidências de validade de conteúdo. Concluímos que o QIRIS tem propriedades psicométricas que facilitam uma avaliação sistemática de representação do paciente de acordo com uma abordagem biopsicossocial, além de contribuir para uma prática clínica baseada em evidências científicas.

Validity and reliability evidence of the questionnaire for illness representation, the impact of epilepsy, and stigma (QIRIS).

The objective of this study was to obtain reliability and validity evidence for the questionnaire of illness representation, the impact of epilepsy, and stigma (QIRIS) for use with adolescents and adults in Brazil. QIRIS consists of 14 questions grouped in three domains (attribution of meaning, impact of disease, and stigma) and was applied to 57 adults with epilepsy. QIRIS internal consistency was satisfactory (Cronbach's α = 0. 866). Significant and strong correlation was found between issues belonging to the same domain, as expected. Three domains have highly significant and positive correlations with the instrument's total score, indicating evidence of content validity. We conclude that QIRIS has psychometric properties and can facilitate a systematic evaluation of the patient's representation according to a biopsychosocial approach that may contribute to clinical practice based on scientific evidence.