Perception of learning by anatomy teachers in the COVID-19.

The discipline of anatomy is one of the pillars of training in higher education courses in health area. Since its origin, this discipline has used the traditional method as an educational strategy. Since then, the discipline has undergone changes, including other teaching methods, such as active methodologies. With the COVID-19 pandemic, declared in March 2020 and the closure of higher education institutions, the teaching of anatomy was impacted, since it was necessary to adapt the modality of face-to-face teaching to remote teaching. The present study aims to evaluate the perception of teachers regarding students' anatomy learning in relation to the types of methodologies applied in remote teaching during the pandemic. For such, a cross-sectional study was carried out, which analyzed the answers of 101 anatomy teachers. The results showed that there was no statistically significant difference regarding teachers' perception of learning in relation to the type of methodology used in remote teaching during the pandemic. There was also no difference in comparing perceptions regarding the type of methodology used before and during the pandemic. Given this, these data encourage the need for reflection in the academic community and new studies with educators and students, in order to identify factors that may improve the quality of anatomy learning.

Chest computed tomography findings of patients infected with Covid-19 and their association with disease evolution stages.

INTRODUCTION: To describe CT findings in patients with confirmed Covid-19 infection and correlate them with the disease evolution stages. METHODS: This is a historical cohort observational analytical study carried out with outpatients, inpatients, and emergency patients from a private hospital in Maceió/AL, Brazil. The final sample consisted of 390 patients with positive RT-PCR for Covid-19 with available laboratory tests and chest CT results. RESULTS: The most frequent initial symptoms were cough, fever, dyspnea and headache. The most commonly found comorbidities were hypertension, diabetes mellitus and obesity. A total of 22% of the CT scans showed no alterations; ground-glass opacity was the most frequently found one. There was a significant association between age, comorbidities, pulmonary involvement, ground-glass opacity, mosaic attenuation and percentage of pulmonary involvement with death. The analysis of the disease stages showed a significant association with laboratory data (CRP and platelet levels), ground-glass opacity and mosaic attenuation with the disease evolution stages in relation to the days since symptom onset. CONCLUSION: The disease evolution of Covid-19 occurs in stages, and this study describes tomographic findings in patients with confirmed Covid-19 infection and shows they vary depending on the disease evolution stages. IMPLICATIONS FOR PRACTICE: This paper provides important addition to the various records that have been accumulated through the Covid-19 pandemic.

The introduction of Physa acuta (Gastropoda: Physidae) on Ilha Grande, Southeast Brazil, from initial stages to an established population / A introdução de Physa acuta Draparnaud, 1805 (Gastropoda: Physidae) na Ilha Grande, Sudeste do Brasil, desde os estágios iniciais até uma população estabelecida

This study presents a four-year follow-up of an introduced population of Physa acuta Draparnaud, 1805, from initial stages to an established population. This introduction occurred on a small impacted stream of Vila do Abraão, the main village of Ilha Grande (Angra dos Reis, Rio de Janeiro, Brazil). The population size increased during the study, and presented a relationship to environmental factors, especially with rainfall. On the initial stages of introduction prevailed the smaller specimens, but on the overall, predominated the intermediate size classes. After less than a year, P. acuta becomes established on this stream and was possibly affecting the other species found on the stream. The information presented here is useful to understand the invasion process of invasive snails, as well as directing conservation efforts.

Neste estudo é apresentado um acompanhamento de quatro anos de uma população de Physa acuta Draparnaud, 1805, desde os estágios iniciais da introdução até seu pleno estabelecimento. Esta introdução ocorreu em um pequeno riacho impactado da Vila do Abraão, o principal vilarejo da Ilha Grande (Angra dos Reis, Rio de Janeiro, Brasil). A população cresceu durante o estudo, e apresentou uma relação com os fatores ambientais, especialmente a pluviosidade. Nos estágios iniciais de introdução prevaleceram os exemplares menores, contudo no panorama geral, predominaram as classes de tamanho intermediárias. Em menos de um ano de introdução, P. acuta se estabeleceu neste riacho, e possivelmente está afetando as demais espécies encontradas no rio. A informação apresentada aqui é importante para a compreensão do processo de invasão de moluscos invasores no Brasil, assim como no direcionamento de esforços de conservação.

The introduction of Physa acuta (Gastropoda: Physidae) on Ilha Grande, Southeast Brazil, from initial stages to an established population

Abstract This study presents a four-year follow-up of an introduced population of Physa acuta Draparnaud, 1805, from initial stages to an established population. This introduction occurred on a small impacted stream of Vila do Abraão, the main village of Ilha Grande (Angra dos Reis, Rio de Janeiro, Brazil). The population size increased during the study, and presented a relationship to environmental factors, especially with rainfall. On the initial stages of introduction prevailed the smaller specimens, but on the overall, predominated the intermediate size classes. After less than a year, P. acuta becomes established on this stream and was possibly affecting the other species found on the stream. The information presented here is useful to understand the invasion process of invasive snails, as well as directing conservation efforts.

Resumo Neste estudo é apresentado um acompanhamento de quatro anos de uma população de Physa acuta Draparnaud, 1805, desde os estágios iniciais da introdução até seu pleno estabelecimento. Esta introdução ocorreu em um pequeno riacho impactado da Vila do Abraão, o principal vilarejo da Ilha Grande (Angra dos Reis, Rio de Janeiro, Brasil). A população cresceu durante o estudo, e apresentou uma relação com os fatores ambientais, especialmente a pluviosidade. Nos estágios iniciais de introdução prevaleceram os exemplares menores, contudo no panorama geral, predominaram as classes de tamanho intermediárias. Em menos de um ano de introdução, P. acuta se estabeleceu neste riacho, e possivelmente está afetando as demais espécies encontradas no rio. A informação apresentada aqui é importante para a compreensão do processo de invasão de moluscos invasores no Brasil, assim como no direcionamento de esforços de conservação.

The introduction of Physa acuta (Gastropoda: Physidae) on Ilha Grande, Southeast Brazil, from initial stages to an established population / A introdução de Physa acuta Draparnaud, 1805 (Gastropoda: Physidae) na Ilha Grande, Sudeste do Brasil, desde os estágios iniciais até uma população estabelecida

Abstract This study presents a four-year follow-up of an introduced population of Physa acuta Draparnaud, 1805, from initial stages to an established population. This introduction occurred on a small impacted stream of Vila do Abraão, the main village of Ilha Grande (Angra dos Reis, Rio de Janeiro, Brazil). The population size increased during the study, and presented a relationship to environmental factors, especially with rainfall. On the initial stages of introduction prevailed the smaller specimens, but on the overall, predominated the intermediate size classes. After less than a year, P. acuta becomes established on this stream and was possibly affecting the other species found on the stream. The information presented here is useful to understand the invasion process of invasive snails, as well as directing conservation efforts.

Resumo Neste estudo é apresentado um acompanhamento de quatro anos de uma população de Physa acuta Draparnaud, 1805, desde os estágios iniciais da introdução até seu pleno estabelecimento. Esta introdução ocorreu em um pequeno riacho impactado da Vila do Abraão, o principal vilarejo da Ilha Grande (Angra dos Reis, Rio de Janeiro, Brasil). A população cresceu durante o estudo, e apresentou uma relação com os fatores ambientais, especialmente a pluviosidade. Nos estágios iniciais de introdução prevaleceram os exemplares menores, contudo no panorama geral, predominaram as classes de tamanho intermediárias. Em menos de um ano de introdução, P. acuta se estabeleceu neste riacho, e possivelmente está afetando as demais espécies encontradas no rio. A informação apresentada aqui é importante para a compreensão do processo de invasão de moluscos invasores no Brasil, assim como no direcionamento de esforços de conservação.

74 Ge( n , γ ) cross section below 70 keV measured at n_TOF CERN.

Neutron capture reaction cross sections on 74 Ge are of importance to determine 74 Ge production during the astrophysical slow neutron capture process. We present new resonance data on 74 Ge( n , γ ) reactions below 70 keV neutron energy. We calculate Maxwellian averaged cross sections, combining our data below 70 keV with evaluated cross sections at higher neutron energies. Our stellar cross sections are in agreement with a previous activation measurement performed at Forschungszentrum Karlsruhe by Marganiec et al., once their data has been re-normalised to account for an update in the reference cross section used in that experiment.

Allergen sensitization associates with worse lung function parameters.

Summary: Objective. To assess the association between the number of allergen sensitizations and lung function variables in individuals with airway symptoms. Methods. Retrospective study with all individuals who performed lung function and skin-prick tests at CUF-Porto (01/2011-06/2016). Six allergen groups were considered. % predicted Pre-Bronchodilator test (BD) and % change after BD were analysed for spirometry and plethysmography parameters. Results. A total of 1293 individuals were included, 54% (n = 698) adults and 69% (n = 891) with sensitization to ≥ 1 allergen group. % FEV1 was significantly higher and % change in FEV1 significantly lower in non-sensitized individuals. % sRaw was higher in polysensitized (vs non-sensitized). Conclusions. The presence of allergen sensitizations was significantly associated with worse key lung function parameters.

An overview on the current available treatment for COVID-19 and the impact of antibiotic administration during the pandemic

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has caused several problems in healthcare systems around the world, as to date, there is no effective and specific treatment against all forms of COVID-19. Currently, drugs with therapeutic potential are being tested, including antiviral, anti-inflammatory, anti-malarial, immunotherapy, and antibiotics. Although antibiotics have no direct effect on viral infections, they are often used against secondary bacterial infections, or even as empiric treatment to reduce viral load, infection, and replication of coronaviruses. However, there are many concerns about this therapeutic approach as it may accelerate and/or increase the long-term rates of antimicrobial resistance (AMR). We focused this overview on exploring candidate drugs for COVID-19 therapy, including antibiotics, considering the lack of specific treatment and that it is unclear whether the widespread use of antibiotics in the treatment of COVID-19 has implications for the emergence and transmission of multidrug-resistant bacteria.

An overview on the current available treatment for COVID-19 and the impact of antibiotic administration during the pandemic.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has caused several problems in healthcare systems around the world, as to date, there is no effective and specific treatment against all forms of COVID-19. Currently, drugs with therapeutic potential are being tested, including antiviral, anti-inflammatory, anti-malarial, immunotherapy, and antibiotics. Although antibiotics have no direct effect on viral infections, they are often used against secondary bacterial infections, or even as empiric treatment to reduce viral load, infection, and replication of coronaviruses. However, there are many concerns about this therapeutic approach as it may accelerate and/or increase the long-term rates of antimicrobial resistance (AMR). We focused this overview on exploring candidate drugs for COVID-19 therapy, including antibiotics, considering the lack of specific treatment and that it is unclear whether the widespread use of antibiotics in the treatment of COVID-19 has implications for the emergence and transmission of multidrug-resistant bacteria.

The introduction of Physa acuta (Gastropoda: Physidae) on Ilha Grande, Southeast Brazil, from initial stages to an established population.

This study presents a four-year follow-up of an introduced population of Physa acuta Draparnaud, 1805, from initial stages to an established population. This introduction occurred on a small impacted stream of Vila do Abraão, the main village of Ilha Grande (Angra dos Reis, Rio de Janeiro, Brazil). The population size increased during the study, and presented a relationship to environmental factors, especially with rainfall. On the initial stages of introduction prevailed the smaller specimens, but on the overall, predominated the intermediate size classes. After less than a year, P. acuta becomes established on this stream and was possibly affecting the other species found on the stream. The information presented here is useful to understand the invasion process of invasive snails, as well as directing conservation efforts.

The novel collagen matrikine, endotrophin, is associated with mortality and cardiovascular events in patients with atherosclerosis.

BACKGROUND: Rupture of atherosclerotic plaques is the major cause of acute cardiovascular events. The biomarker PRO-C6 measuring Endotrophin, a matrikine of collagen type VI, may provide valuable information detecting subjects in need of intensified strategies for secondary prevention. OBJECTIVE: In this study, we evaluate endotrophin in human atherosclerotic plaques and circulating levels of PRO-C6 in patients with atherosclerosis, to determine the predictive potential of the biomarker. METHODS: Sections from the stenotic human carotid plaques were stained with the PRO-C6 antibody. PRO-C6 was measured in serum of patients enrolled in the Carotid Plaque Imagining Project (CPIP) (discovery cohort, n = 577) and the innovative medicines initiative surrogate markers for micro- and macrovascular hard end-points for innovative diabetes tools (IMI-SUMMIT, validation cohort, n = 1,378). Median follow-up was 43 months. Kaplan-Meier curves and log-rank tests were performed in the discovery cohort. Cox proportional hazard regression analysis (HR with 95% CI) was used in the discovery cohort and binary logistic regression (OR with 95% CI) in the validation cohort. RESULTS: PRO-C6 was localized in the core and shoulder of the atherosclerotic plaque. In the discovery cohort, PRO-C6 independently predicted future cardiovascular events (HR 1.089 [95% CI 1.019 -1.164], p = 0.01), cardiovascular death (HR 1.118 [95% CI 1.008 -1.241], p = 0.04) and all-cause death (HR 1.087 [95% CI 1.008 -1.172], p = 0.03). In the validation cohort, PRO-C6 predicted future cardiovascular events (OR 1.063 [95% CI 1.011 -1.117], p = 0.017). CONCLUSION: PRO-C6 is present in the atherosclerotic plaque and associated with future cardiovascular events, cardiovascular death and all-cause mortality in two large prospective cohorts.

Cadaverine and Spermine Elicit Ca2+ Uptake in Human CP Cells via a Trace Amine-Associated Receptor 1 Dependent Pathway.

The choroid plexus (CP) constitutes a barrier between the blood and the cerebrospinal fluid (CSF) which regulates the exchange of substances between these two fluids through mechanisms that are not completely understood. Polyamines as spermine, spermidine and putrescine are produced by all cells and are present in the CSF. Interestingly, their levels are altered in some neuronal disorders as Alzheimer's and Parkinson's diseases, thus increasing the interest in their signalling in the central nervous system (CNS). Cadaverine, on the other hand, is synthetized by the intestinal microbiome, suggesting that the presence of this bacterial metabolite in the CSF requires that it is up taken to the CNS across brain barriers. We knew that polyamines are detected by the olfactory signalling cascade operating at the CP, but the receptor involved had not been identified. The zebrafish TAAR13c was the only receptor known to bind a polyamine-cadaverine. Thus, we searched for a human receptor with homology to TAAR13c and found that some human TAARs including TAAR1 showed great homology. Then, we confirmed the expression of TAAR1 mRNA and protein in a human cell line of the CP, and in human CP samples. Calcium imaging assays after TAAR1 knockdown in these cells with a specific siRNA against TAAR1 showed a consistent reduction in the responses of these cells to cadaverine and spermidine, but not to spermine, suggesting that TAAR1 is activated by cadaverine and spermidine, but not spermine.

Exploring the role of extracellular matrix proteins to develop biomarkers of plaque vulnerability and outcome.

Cardiovascular disease (CVD) is the most common cause of death in industrialized countries. One underlying cause is atherosclerosis, which is a systemic disease characterized by plaques of retained lipids, inflammatory cells, apoptotic cells, calcium and extracellular matrix (ECM) proteins in the arterial wall. The biologic composition of an atherosclerotic plaque determines whether the plaque is more or less vulnerable, that is prone to rupture or erosion. Here, the ECM and tissue repair play an important role in plaque stability, vulnerability and progression. This review will focus on ECM remodelling in atherosclerotic plaques, with focus on how ECM biomarkers might predict plaque vulnerability and outcome.

The senses of the choroid plexus.

The composition of cerebrospinal and brain interstitial fluids is ensured by barriers between the blood and the brain parenchyma (the blood-brain barrier) and between the blood and the cerebrospinal fluid (the blood-cerebrospinal fluid barrier). Barrier function results from the combination of tight junctions between cells that impair solute flux via the paracellular pathway, cell membrane transporters that enable selective transcellular solute passage, and intracellular metabolizing enzymes that transform molecules in transit. Collectively, they comprise a chemical surveillance system, essential to protect the brain from toxicants, microorganisms, and other harmful compounds. Conversely, this chemical surveillance system compromises the brain delivery of many pharmacologic agents against brain cancer and brain metastasis, neurodegenerative diseases, and brain infections. Despite their importance, the mechanisms underlying the regulation of the components of this chemical surveillance system in response to alterations in the composition of blood and brain fluids are still poorly understood. We propose that odorant receptors, vomeronasal receptors and taste receptors, recently identified at brain barriers might be upstream components of this surveillance system. These chemosensory receptors are strategically placed to monitor the composition of blood, cerebrospinal and brain interstitial fluids. Upon ligand-binding, they may deploy the action of transporters and detoxifying enzymes or other unprecedented functions in brain barrier cells, to cope with alterations in the composition of blood and brain cerebrospinal and interstitial fluids, working as guardians of the central nervous system.

Subclinical atherosclerosis and its progression are modulated by PLIN2 through a feed-forward loop between LXR and autophagy.

BACKGROUND: Hyperlipidaemia is a major risk factor for cardiovascular disease, and atherosclerosis is the underlying cause of both myocardial infarction and stroke. We have previously shown that the Pro251 variant of perilipin-2 reduces plasma triglycerides and may therefore be beneficial to reduce atherosclerosis development. OBJECTIVE: We sought to delineate putative beneficial effects of the Pro251 variant of perlipin-2 on subclinical atherosclerosis and the mechanism by which it acts. METHODS: A pan-European cohort of high-risk individuals where carotid intima-media thickness has been assessed was adopted. Human primary monocyte-derived macrophages were prepared from whole blood from individuals recruited by perilipin-2 genotype or from buffy coats from the Karolinska University hospital blood central. RESULTS: The Pro251 variant of perilipin-2 is associated with decreased intima-media thickness at baseline and over 30 months of follow-up. Using human primary monocyte-derived macrophages from carriers of the beneficial Pro251 variant, we show that this variant increases autophagy activity, cholesterol efflux and a controlled inflammatory response. Through extensive mechanistic studies, we demonstrate that increase in autophagy activity is accompanied with an increase in liver-X-receptor (LXR) activity and that LXR and autophagy reciprocally activate each other in a feed-forward loop, regulated by CYP27A1 and 27OH-cholesterol. CONCLUSIONS: For the first time, we show that perilipin-2 affects susceptibility to human atherosclerosis through activation of autophagy and stimulation of cholesterol efflux. We demonstrate that perilipin-2 modulates levels of the LXR ligand 27OH-cholesterol and initiates a feed-forward loop where LXR and autophagy reciprocally activate each other; the mechanism by which perilipin-2 exerts its beneficial effects on subclinical atherosclerosis.

Activation of immune responses against the basement membrane component collagen type IV does not affect the development of atherosclerosis in ApoE-deficient mice.

Oxidation of low-density lipoprotein (LDL) in the arterial extracellular matrix results in malondialdehyde (MDA)-modifications of surrounding matrix proteins. We have recently demonstrated an association between high levels of autoantibodies against MDA-modified collagen type IV and risk for development of myocardial infarction. Collagen type IV is an important component of the endothelial basement membrane and influences smooth muscle cell function. We hypothesized that immune responses against collagen type IV could contribute to vascular injury affecting the development of atherosclerosis. To investigate this possibility, we induced an antibody-response against collagen type IV in apolipoprotein E (Apo E)-deficient mice. Female ApoE-/- mice on C57BL/6 background were immunized with α1α2 type IV collagen chain peptides linked to the immune-enhancer PADRE, PADRE alone or PBS at 12 weeks of age with three subsequent booster injections before the mice were killed at 23 weeks of age. Immunization of PADRE alone induced autoantibodies against PADRE, increased IL-4 secretion from splenocytes and reduced SMC content in the subvalvular plaques. Immunization with peptides of α1α2 type IV collagen chains induced a strong IgG1antibody response against collagen type IV peptides without affecting the distribution of T cell populations, plasma cytokine or lipid levels. There were no differences in atherosclerotic plaque development between collagen α1α2(IV)-PADRE immunized mice and control mice. Our findings demonstrate that the presence of antibodies against the basement membrane component collagen type IV does not affect atherosclerosis development in ApoE-/- mice. This suggests that the association between autoantibodies against collagen type IV and risk for myocardial infarction found in humans does not reflect a pathogenic role of these autoantibodies.

Bothrops alternatus snake venom induces apoptosis of skeletal muscle cells in a rabbit model / O veneno da serpente Bothrops alternatus induz apoptose nas células musculares de coelhos

Este estudo objetiva reportar a ocorrência de apoptose in vivo induzida pelo veneno da serpente Bothrops alternatus em células musculares esqueléticas. Cinco coelhos machos, adultos, receberam 150µg/kg de veneno no músculo vasto lateral, enquanto outros cinco animais receberam 0,1% de BSA diluído em PBS no mesmo local. Após 12 horas, os animais foram eutanasiados, e amostras do local de inoculação foram coletadas para análise histopatológica. Foram evidenciadas necrose e hemorragia nas células musculares. Além disso, a análise imuno-histoquímica para identificação de caspase-3 ativada revelou marcações granulares e agregadas no citoplasma das células musculares, compatíveis com o processo de apoptose. Este é o primeiro relato que confirma o veneno de B. alternatus como causador de apoptose in vivo em células musculares esqueléticas.(AU)

A biomarker of collagen type I degradation is associated with cardiovascular events and mortality in patients with atherosclerosis.

OBJECTIVE: Atherosclerosis is characterized by accumulation of lipids, cells and extracellular matrix (ECM) proteins in the arterial wall. Collagen type I (COL1), a component of the arterial ECM, is cleaved by matrix metalloproteinases (MMPs) and known to be remodelled in atherosclerosis. We explored whether the MMP-mediated COL1 biomarker, C1M, was associated with cardiovascular events, cardiovascular mortality and all-cause mortality in a large prospective cohort of patients with known atherosclerosis. METHODS: Serum from 787 patients who underwent a carotid endarterectomy was included. Circulating levels of C1M were measured in serum. A total of 473 patients were followed for 6 years after surgery. Associations between C1M and incidence of cardiovascular events, cardiovascular mortality and all-cause mortality were assessed by Kaplan-Meier curves and Cox regression analysis. RESULTS: A total of 101 (21.4%) patients suffered from nonfatal cardiovascular events during the follow-up period, and 64 (13.5%) patients died. Of these, 39 (60.9%) died from cardiovascular diseases. Patients with C1M levels above the median were significantly associated with cardiovascular events, cardiovascular mortality and all-cause mortality (P < 0.001, P = 0.004 and P < 0.001, respectively). C1M was included in the final model for prediction of cardiovascular events (HR 2.15, 95% CI 1.40-3.32, P = 0.001), cardiovascular mortality (HR 2.20, 95% CI 1.07-4.51, P = 0.031) and all-cause mortality (HR 2.98 95% CI 1.67-5.33, P = < 0.001). CONCLUSIONS: In patients with atherosclerotic carotid lesions, high levels of C1M predicted cardiovascular events, cardiovascular mortality and all-cause mortality. These findings emphasize the importance of remodelling mechanisms in atherosclerosis that are now becoming more and more explored.

Clinical and molecular markers in COPD.

Chronic obstructive pulmonary disease (COPD) is a complex and heterogeneous disease, and there is a clinical need for validated markers and biomarkers that can contribute to the assessment of patients, risk prediction, treatment guidance, and assessment of response. Although according to the 2018 GOLD guidelines clinically useful biomarkers for COPD patients in stable condition have yet to be identified, several clinical markers and biomarkers have been proposed for COPD. These include isolated clinical markers, such as symptoms and Health Status assessment, exercise tests, function tests and imaging, and also composite scores and molecular markers. However, and despite strong efforts to identify useful markers in an attempt to improve prognostic and therapeutic approaches, results have not been consistent and expectations of relying on these markers in near future are faint. Current approaches to COPD have shifted from treating the disease to treating the individual patient. There is a clear need to identify treatable traits, focusing more on the patient and not on the disease, in order to implement an increasingly personalized treatment of COPD in the clinic, leading to true precision medicine. There is a need to identify combinations of clinical markers and biomarkers, genetic markers, and phenotypes that can guide the personalized therapy of COPD patients. This critical review will therefore focus not only on currently established markers and biomarkers in COPD but also on possible future approaches toward precision medicine.