High circulating dipeptidyl peptidase 3 predicts mortality and need for organ support in cardiogenic shock: An ancillary analysis of the ACCOST-HH trial.

BACKGROUND: Cardiogenic shock is burdened with high mortality. Efforts to improve outcome are hampered by the difficulty of individual risk stratification and the lack of targetable pathways. Previous studies demonstrated that elevated circulating dipeptidyl peptidase 3 (cDPP3) is an early predictor of short-term outcome in cardiogenic shock, mostly of ischemic origin. Our objective was to investigate the association between cDPP3 and short-terms outcomes in a diverse population of cardiogenic shock. METHODS: cDPP3 was measured at baseline and after 72 hours in the ACCOST-HH trial. The association of cDPP3 with 30-day mortality and need for organ support was assessed. RESULTS: Median cDPP3 concentration at baseline was 43.2 ng/mL [21.2-74] and 77 out of the 150 patients (52%) had high cDPP3 over the pre-defined cutoff of 40 ng/mL. Elevated cDPP3 was associated with higher 30-day mortality (adjusted (a) HR=1.7 [1.0-2.9]), fewer days alive without cardiovascular support (3 [0-24] vs 21 days [5-26], p<0.0001), a higher need for renal replacement therapy (56 vs 22%, p<0.0001) and mechanical ventilation (90 vs 74%, p=0.04). Patients with sustained high cDPP3 had poor prognosis (reference group). In contrast, patients with initially high but decreasing cDPP3 at 72 hours had markedly reduced 30-day mortality (aHR=0.17 [0.084-0.34]), comparable to patients with sustained low cDPP3 (aHR=0.23 [0.12-0.41]). Need for organ support was markedly reduced in subpopulations with sustained low or decreasing cDPP3. CONCLUSION: The present study confirms the prognostic value of cDPP3 in a contemporary population of cardiogenic shock.

Circulating Dipeptidyl Peptidase 3 Modulates Systemic and Renal Hemodynamics Through Cleavage of Angiotensin Peptides.

BACKGROUND: High circulating DPP3 (dipeptidyl peptidase 3) has been associated with poor prognosis in critically ill patients with circulatory failure. In such situation, DPP3 could play a pathological role, putatively via an excessive angiotensin peptides cleavage. Our objective was to investigate the hemodynamics changes induced by DPP3 in mice and the relation between the observed effects and renin-angiotensin system modulation. METHODS: Ten-week-old male C57Bl/6J mice were subjected to intravenous injection of purified human DPP3 or an anti-DPP3 antibody (procizumab). Invasive blood pressure and renal blood flow were monitored throughout the experiments. Circulating angiotensin peptides and catecholamines were measured and receptor blocking experiment performed to investigate the underlying mechanisms. RESULTS: DPP3 administration significantly increased renal blood flow, while blood pressure was minimally affected. Conversely, procizumab led to significantly decreased renal blood flow. Angiotensin peptides measurement and an AT1R (angiotensin II receptor type 1) blockade experiment using valsartan demonstrated that the renovascular effect induced by DPP3 is due to reduced AT1R activation via decreased concentrations of circulating angiotensin II, III, and IV. Measurements of circulating catecholamines and an adrenergic receptor blockade by labetalol demonstrated a concomitant catecholamines release that explains blood pressure maintenance upon DPP3 administration. CONCLUSIONS: High circulating DPP3 increases renal blood flow due to reduced AT1R activation via decreased concentrations of circulating angiotensin peptides while blood pressure is maintained by concomitant endogenous catecholamines release.

Dipeptidyl peptidase 3 plasma levels predict cardiogenic shock and mortality in acute coronary syndromes.

BACKGROUND AND AIMS: Dipeptidyl peptidase 3 (DPP3) is a protease involved in the degradation of angiotensin II which disturbs peripheral blood pressure regulation and compromises left ventricular function. This study examined the relationship of circulating DPP3 (cDPP3) with cardiogenic shock (CS) and mortality in patients presenting with acute coronary syndromes (ACS). METHODS: Plasma cDPP3 levels were assessed at baseline and 12-24 h after presentation in patients with ACS prospectively enrolled into the multi-centre SPUM-ACS study (n = 4787). RESULTS: Circulating DPP3 levels were associated with in-hospital CS when accounting for established risk factors including the ORBI risk score [per log-2 increase, hazard ratio (HR) 1.38, 95% confidence interval (CI) 1.05-1.82, P = .021]. High cDPP3 was an independent predictor of mortality at 30 days (HR 1.87, 95% CI 1.36-2.58, P < .001) and at one year (HR 1.61, 95% CI 1.28-2.02, P < .001) after adjustment for established risk factors and the GRACE 2.0 score. Compared to values within the normal range, persistently elevated cDPP3 levels at 12-24 h were associated with 13.4-fold increased 30-day mortality risk (HR 13.42, 95% CI 4.86-37.09, P < .001) and 5.8-fold increased 1-year mortality risk (HR 5.79, 95% CI 2.70-12.42, P < .001). Results were consistent across various patient subgroups. CONCLUSIONS: This study identifies cDPP3 as a novel marker of CS and increased mortality in patients with ACS. Circulating DPP3 offers prognostic information beyond established risk factors and improves early risk assessment.

Access to diabetes diagnosis in Brazil based on recent testing and consultation: The Brazilian national health survey, 2013 and 2019.

Background: Screening for undiagnosed diabetes using glucose testing is recommended globally to allow preventive action among those detected. Our aim was to evaluate the access to glucose testing to screen for diabetes in Brazil using self-reported information on recent testing and medical consultation from national surveys of Brazilian adults. Methods: The Pesquisa Nacional de Saúde (PNS) was conducted in 2013 and 2019 drawing probabilistic samples of Brazilians aged 18 years and above. To evaluate glucose testing among those undiagnosed, we excluded those self-reporting a previous diagnosis of diabetes. We then defined recent access to diabetes diagnosis by considering the previous two years and choosing the last blood glucose test and the proximal medical consultation reported. We used Poisson regression with robust variance to assess correlates of access, expressing them with adjusted prevalence ratios (PR) and their 95% confidence intervals. Results: Access to recent glucose testing documented that over 70% reported a recent glycemic test, 71% in 2013, and 77% in 2019. These findings are consistent with a wide recent access to medical consultation, 86% and 89% in 2013 and 2019, respectively. Reporting recent glucose testing and medical consultation may better reflect the actual access to medical diagnostic testing. When analyzing this joint outcome, diagnostic access was still wide, 67% and 74%, respectively. Greater access (p< 0.001) was seen for women (PR=1.16; 1.15-1.17), older individuals (PR=1.25; 1.22-1.28), and those with higher education (PR=1.17; 1.15-1.18), obesity (PR=1.06; 1.05-1.08), and hypertension (PR=1.12; 1.11-1.13). In contrast, lower access (p<0.001) was seen for those declaring being Black (PR=0.97; 0.95-0.99) or of mixed-race (PR=0.97; 0.96-0.98), those residing in rural areas (PR=0.89; 0.87-0.90), and not having a private health insurance plan (PR=0.85; 0.84-0.86). Conclusions: Although access to diagnostic testing for diabetes is high in Brazil, partly due to its universal health system, social inequities are still present, demanding specific actions, particularly in rural areas and among those self-declaring as being Black or mixed-race.

Molecular mechanism of topoisomerase poisoning by the peptide antibiotic albicidin.

The peptide antibiotic albicidin is a DNA topoisomerase inhibitor with low-nanomolar bactericidal activity towards fluoroquinolone-resistant Gram-negative pathogens. However, its mode of action is poorly understood. We determined a 2.6 Å resolution cryoelectron microscopy structure of a ternary complex between Escherichia coli topoisomerase DNA gyrase, a 217 bp double-stranded DNA fragment and albicidin. Albicidin employs a dual binding mechanism where one end of the molecule obstructs the crucial gyrase dimer interface, while the other intercalates between the fragments of cleaved DNA substrate. Thus, albicidin efficiently locks DNA gyrase, preventing it from religating DNA and completing its catalytic cycle. Two additional structures of this trapped state were determined using synthetic albicidin analogues that demonstrate improved solubility, and activity against a range of gyrase variants and E. coli topoisomerase IV. The extraordinary promiscuity of the DNA-intercalating region of albicidins and their excellent performance against fluoroquinolone-resistant bacteria holds great promise for the development of last-resort antibiotics.

Circulating dipeptidyl peptidase 3 and bio-adrenomedullin levels are associated with impaired outcomes in critically ill COVID-19 patients: a prospective international multicentre study.

Introduction: Dipeptidyl peptidase-3 (DPP3) is a protease involved in the degradation of several cardiovascular mediators. Adrenomedullin (bio-ADM) is a peptide essential for regulation of endothelial barrier function. In different shock-pathologies, both biomarkers are associated with disease severity, organ dysfunction and mortality. Associations with outcome in critically ill COVID-19 patients are unknown. The objectives of the present study were to investigate associations of bio-ADM and "circulating DPP3" (cDPP3) with short-term outcome in critically ill COVID-19 patients (n=80). Methods: A multicentre prospective cohort study was performed. The primary end-point was 28-day mortality. Secondary end-points included different severities of acute kidney injury (AKI). Results: cDPP3 levels were mainly associated with 28-day mortality; Area under the receiver operating characteristics (AUROCs) of 0.69 (0.56-0.82, p=0.023), 0.77 (0.64-0.90, p<0.001) and 0.81 (0.65-0.96, p<0.001) at admission, day 3 and day 7, respectively. In contrast, bio-ADM levels were mainly associated with AKI, with AUROCs of 0.64 (0.51-0.77, p=0.048), 0.75 (0.64-0.86, p<0.001) and 0.83 (0.74-0.93, p<0.001) for day 1, 3 and 7, respectively. Interestingly, patients with high levels of both cDPP3 and bio-ADM at day 7 had an additionally increased risk of 28-day mortality (hazard ratio 11.8; 95% CI 2.5-55.3, p<0.001). Conclusions: cDPP3 and bio-ADM responses were associated with short-term mortality and AKI in critically ill COVID-19 patients, respectively. These findings suggest that treatment with specific antibodies modulating cDPP3 or bio-ADM-related pathways may improve outcome of COVID-19.

The emerging role of dipeptidyl peptidase 3 in pathophysiology.

Dipeptidyl peptidase 3 (DPP3), a zinc-dependent aminopeptidase, is a highly conserved enzyme among higher animals. The enzyme cleaves dipeptides from the N-terminus of tetra- to decapeptides, thereby taking part in activation as well as degradation of signalling peptides critical in physiological and pathological processes such as blood pressure regulation, nociception, inflammation and cancer. Besides its catalytic activity, DPP3 moonlights as a regulator of the cellular oxidative stress response pathway, e.g., the Keap1-Nrf2 mediated antioxidative response. The enzyme is also recognized as a key modulator of the renin-angiotensin system. Recently, DPP3 has been attracting growing attention within the scientific community, which has significantly augmented our knowledge of its physiological relevance. Herein, we review recent advances in our understanding of the structure and catalytic activity of DPP3, with a focus on attributing its molecular architecture and catalytic mechanism to its wide-ranging biological functions. We further highlight recent intriguing reports that implicate a broader role for DPP3 as a valuable biomarker in cardiovascular and renal pathologies and furthermore discuss its potential as a promising drug target.

Chemical behavior of 20%-22% carbamide peroxide gels in at-home bleaching: Randomized crossover in situ trial.

OBJECTIVE: To evaluate if distinct 20%-22% carbamide peroxide bleaching gels present similar decomposition pattern and pH during the clinical use in both arches, as well as gels viscosity. METHODS: Participants randomly received treatments with carbamide peroxide gels (n = 10): OPF (OpalescencePF-20%); PNT (Polanight-22%); and WPC (Whiteness Perfect-22%) in three different days, with 2-day washout. Decomposition pattern was assessed by peroxide concentration. Both PC and pH of bleaching gels were measured in different time points in upper and lower trays during a total of 120 min of clinical use. Viscosity of bleaching gels was measured in triplicate. ANOVA and Tukey's test were applied (α = 0.05). RESULTS: Regarding decomposition pattern, no significant differences were observed for the interaction between gel, time, and tray position factors. The peroxide concentration progressively reduced until 120 min of trays use (p < 0.001), being overall more notable in lower trays (p < 0.001). Regarding pH, the lowest values were verified in WPC within time. At 120 min, an increase of pH was observed for both WPC and OPF (p < 0.001) compared to baseline means. PNT exhibited constant pH values over time. The values of viscosity were: OPF (1.682.000 ± 19 cP)a, WPC (1.388.667 ± 172.63 cP)ab, PNT (579.567 ± 0.98 cP)b. CONCLUSIONS: The bleaching gels presented overall decomposition pattern clinically equivalent, being more notable in lower trays over time. Nevertheless, distinct pH and viscosities were observed among the products. CLINICAL SIGNIFICANCE: Although the manufacturers recommend different times of use for bleaching gels with similar peroxide concentrations, the commercial products tested did not exhibit clinically relevant difference in the decomposition pattern during the 120 min of clinical procedure.

Effects of enrichment strategies on outcome of adrecizumab treatment in septic shock: Post-hoc analyses of the phase II adrenomedullin and outcome in septic shock 2 trial.

Purpose: Adrecizumab, a non-neutralizing antibody of adrenomedullin (ADM) was recently investigated regarding its potential to restore endothelial barrier function in septic shock patients with high plasma ADM levels. Circulating dipeptidyl peptidase 3 (cDPP3), a protease involved in the degradation of several cardiovascular mediators, represents another biological pathway strongly associated with outcome in septic shock, although unrelated to ADM. Therefore, the prognosis of patients with elevated cDPP3 may not be influenced by Adrecizumab. Also, time until initiation of treatment may influence efficacy. Objective: To evaluate effects of cDPP3-based enrichment on treatment efficacy of Adrecizumab. Materials and Methods: Post-hoc analysis of AdrenOSS-2, a phase-II, double-blind, randomized, placebo-controlled biomarker-guided trial of Adrecizumab. Results: Compared to the total study cohort [HR for 28-day mortality of 0.84 (95% CI 0.53;1.31), p = 0.439], therapeutic benefit of Adrecizumab tended to be more pronounced in the subgroup of 249 patients with low cDPP3 (<50 ng/mL); [HR of 0.61 (95% CI 0.34;1.08), p = 0.085]. Median duration to study drug infusion was 8.5 h. In the subgroup of 129 patients with cDPP3 <50 ng/mL and an early start of treatment (<8.5 h after septic shock diagnosis) HR for 28-day mortality vs. placebo was 0.49 (95% CI 0.21-1.18), p = 0.105. In multivariate interaction analyses corrected for baseline disease severity, both cDPP3, as well as the cDPP3 * treatment interaction term were associated with a reduced HR for 28-day mortality in the Adrecizumab treated group; p = 0.015 for cDPP3 in univariate analysis, p = 0.025 for the interaction term between cDPP3 and treatment group. In contrast, treatment timing was not significantly associated with 28-day mortality in multivariate interaction analyses. Discussion: In septic shock patients with high ADM levels, a further post-hoc enrichment strategy based on cDPP3 may indicate (with all the caveats to be considered for post-hoc subgroup analyses) that therapeutic efficacy is most pronounced in patients with lower cDPP3 levels.

Structural and functional investigation of the human snRNP assembly factor AAR2 in complex with the RNase H-like domain of PRPF8.

Small nuclear ribonucleoprotein complexes (snRNPs) represent the main subunits of the spliceosome. While the assembly of the snRNP core particles has been well characterized, comparably little is known of the incorporation of snRNP-specific proteins and the mechanisms of snRNP recycling. U5 snRNP assembly in yeast requires binding of the the Aar2 protein to Prp8p as a placeholder to preclude premature assembly of the SNRNP200 helicase, but the role of the human AAR2 homolog has not yet been investigated in detail. Here, a crystal structure of human AAR2 in complex with the RNase H-like domain of the U5-specific PRPF8 (PRP8F RH) is reported, revealing a significantly different interaction between the two proteins compared with that in yeast. Based on the structure of the AAR2-PRPF8 RH complex, the importance of the interacting regions and residues was probed and AAR2 variants were designed that failed to stably bind PRPF8 in vitro. Protein-interaction studies of AAR2 with U5 proteins using size-exclusion chromatography reveal similarities and marked differences in the interaction patterns compared with yeast Aar2p and imply phosphorylation-dependent regulation of AAR2 reminiscent of that in yeast. It is found that in vitro AAR2 seems to lock PRPF8 RH in a conformation that is only compatible with the first transesterification step of the splicing reaction and blocks a conformational switch to the step 2-like, Mg2+-coordinated conformation that is likely during U5 snRNP biogenesis. These findings extend the picture of AAR2 PRP8 interaction from yeast to humans and indicate a function for AAR2 in the spliceosomal assembly process beyond its role as an SNRNP200 placeholder in yeast.

Bullying escolar: com a palavra, o professor / School bullying: with the word, the teacher

Este estudo objetiva caracterizar o bullying pelo discurso de professores do Ensino Fundamental, verificando as causas, quem pratica, quem sofre e o que é necessário para combatê-lo. Participaram 24 docentes de oito escolas públicas da Grande Aracaju-SE. Os dados foram coletados por meio de uma entrevista semiestruturada, investigando o conhecimento, percepção, ocorrência, prática e estratégias quanto ao bullying nas escolas. A análise textual foi realizada pelo programa informático IRAMUTEQ (Classificação Hierárquica Descendente ­ CHD). Nos discursos dos participantes, percebeu-se a presença da naturalização desse tipo de violência no ambiente escolar, sendo sua prática passível a qualquer estudante, e os alvos geralmente são aqueles cujas características destoam do padrão social. As estratégias apontadas vão de encontro a ações de caráter multidisciplinar que envolvam professores, funcionários, familiares, estudantes e a sociedade

Relação da psoríase com doenças cardiovasculares: uma revisão integrativa / Relation between psoriasis and cardiovascular diseases: An integrative review

Psoriasis is an autoimmune disease that courses with chronic inflammation of the skin and exaggerated growth of keratinocytes, with a decrease in life expectancy mainly due to cardiovascular diseases. However, cardiometabolic conditions are poorly investigated. The objective of this study was to verify the relationship between psoriasis and cardiovascular diseases, seeking to answer: "What is the relationship between chronic inflammation present in psoriasis and cardiovascular diseases?" It is an integrative review using the PubMed platform and the descriptors "Psoriasis", "Cardiovascular diseases" and "Risk factors", with the boolean "AND." Was obtained 72 articles that, after analysis and exclusion, resulted in 12 publications. In conclusion, there was a relationship between several metabolic cytokines and those involved in the pathophysiology of psoriasis, directly associated with increased cardiovascular risks, due to chronic inflammation.

Psoríase é doença autoimune que cursa com inflamação crônica da pele e crescimento exagerado de queratinócitos, tendo a diminuição da expectativa de vida principalmente por doenças cardiovasculares. Contudo, as condições cardiometabólicas são pouco investigadas. O objetivo deste estudo foi verificar a relação entre a psoríase e as doenças cardiovasculares procurando responder: "Qual a relação da inflamação crônica presente na psoríase com as doenças cardiovasculares?". É revisão integrativa utilizando a plataforma PubMed e os descritores "Psoríase", "Doenças cardiovasculares" e "Fatores de risco", com o booleano "AND". Obteve-se 72 artigos que, após análise e exclusão, resultaram em 12 publicações. Em conclusão, observou-se relação entre várias citocinas metabólicas e envolvidas na fisiopatologia da psoríase, diretamente associadas ao aumento dos riscos cardiovasculares, devido a um quadro de inflamação crônica.

Sentido de vida e saúde mental em professores: uma revisão integrativa / Meaning in life and mental health at teachers: an integrative review / Sentido de vida y salud mental en docentes: una revisión integradora

RESUMO A presente revisão integrativa da literatura tem por objetivo investigar a relação entre sentido de vida (SV) e saúde mental em professores. As bases de dados acessadas para a busca das evidências foram: Web of Science - Coleção Principal, ERIC (ProQuest), PsycINFO, Scopus, SciELO e PePSIC. O período de publicação dos artigos abrangidos foi de janeiro de 2000 a dezembro de 2020 para responder à questão norteadora: Como a relação entre sentido de vida e a saúde mental em professores é abordada na literatura científica? Dos sete artigos recuperados, verificou-se que o sentido de vida está associado negativamente com síndrome de burnout e estresse percebido e proporciona melhores índices de funcionamento psicológico e de satisfação vital em docentes.

ABSTRACT This integrative literature review aimed to investigate the relationship between the meaning of life and mental health in teachers. The database accessed for the search for evidence was: Web of Science - Main Collection, ERIC (ProQuest), PsycINFO, SciELO, and PePSIC. The articles covered were from January 2000 to December 2020 to answer the following guiding question: How is the relationship between the meaning of life and mental health in teachers addressed in the scientific literature? Of the seven selected articles, we found that the meaning of life is negatively associated with burnout syndrome and perceived stress and provides better rates of psychological functioning and vital satisfaction at teachers.

RESUMEN La presente revisión de literatura integradora tuvo como objetivo investigar la relación entre el sentido de la vida y la salud mental en los docentes. Las bases de datos a los que se accedió para buscar evidencia fueron: Web of Science - Main Collection, ERIC (ProQuest), PsycINFO, Scopus, SciELO y PePSIC. El período de publicación de los artículos fue de enero de 2000 a diciembre de 2020 para dar respuesta a la pregunta orientadora: ¿Cómo se aborda en la literatura científica la relación entre el sentido de la vida y la salud mental en los docentes? De los siete artículos seleccionados, se encontró que el sentido de la vida está asociado negativamente con el síndrome de quemarse y el estrés percibido y proporciona mejores índices de funcionamiento psicológico y satisfacción vital en profesores.

Activity Against Musca domestica of Hypocrealean Fungi Isolated from Culicids in Central Brazil and Formulated in Vermiculite.

Musca domestica L. is a cosmopolitan nuisance of high sanitary importance. Entomopathogenic fungi are innovative and attractive tools for integrated control of the housefly to overcome insufficient levels of control caused by increasing resistance of this pest against chemical insecticides. High virulence of a fungal strain is a prerequisite to develop a mycoinsecticide, and the present study investigated the potential of hypocrealean fungi from the genera Beauveria, Clonostachys, Cordyceps, Akanthomyces, Metarhizium, and Tolypocladium, isolated from mosquitoes in Central Brazil against M. domestica. The highest mortalities (larvae, pupae, and adults) were caused by Metarhizium humberi IP 478 (98%) and IP 421 (90%), Metarhizium anisopliae IP 432 (85%), Beauveria bassiana IP 433 (82%), and Tolypocladium cylindrosporum IP 425 (68%) after a 23-day exposure of initially pre-pupating third instar larvae to conidia mixed with vermiculite. Lethal concentrations to kill 90% of adults of IP 433 and IP 478 were 5 × 107 and 108 conidia g-1 substrate, respectively. Fifty percent of adults were killed within 4 to 5 days of exposure initially as pupae close to emergence to substrate treated with conidia of IP 478 or IP 433 at 1.1 × 108 conidia g-1, respectively. The other fungal strains tested were less virulent. The results demonstrate high potentials for conidial preparations in vermiculite of IP 433 and IP 478 as candidates for the biological control of both pre-pupating larvae, pupae, and emerging adults of houseflies.

Ensino remoto emergencial em tempos de pandemia: Percepções de concluintes do curso de licenciatura em Educação Física da UFPR / Emergency remote education in times of pandemic: Perceptions of graduates of the Physical Education undergraduate course at UFPR / Educación remota de emergencia en tiempos de pandemia: Percepciones de los graduados del curso de licenciatura en Educación Física de la UFPR

O Ensino Remoto Emergencial (ERE) foi adotado por algumas instituições de ensino durante a pandemia da covid-19. Objetivou-se analisar a percepção de concluintes do curso de Licenciatura em Educação Física (EF) sobre o ERE. As participantes relataram ter bom ambiente para acompanhar as aulas remotas, não pensaram em trancar a matrícula/desistir do curso, mas se sentiram tristes por terem concluído pelo ERE. Foi detectada redução do interesse pelas aulas remotas e percepção que o ERE prejudicou a formação docente, além da falta de interação, distanciamento das aulas práticas e não poder estar presencialmente na escola nos estágios. A maior flexibilização de horário foi o aspecto positivo indicado (AU).

Emergency Remote Learning (ERE) was adopted by some educational institutions during the pandemic of COVID-19. We aimed to analyze the perception of graduates of the Physical Education (PE) degree course about the ERE. The participants reported having a good environment to follow the remote classes, did not think about locking the enrollment/dropping out of the course, and felt sad to have concluded by the ERE. A reduction in interest in remote classes and the perception that the distance learning program had detrimental effects on teacher education were indicated, as well as a lack of interaction, distance from practical classes, and not being able to be present in the school during internships. The positive aspect indicated was a more flexible schedule (AU).

El aprendizaje a distancia de emergencia (ERE) fue adoptado por algunas instituciones educativas durante la pandemia de COVID-19. El objetivo de este estudio fue analizar la percepción de los egresados de la carrera de Educación Física (EF) sobre el ERE. Los participantes manifestaron tener un buen ambiente para seguir las clases a distancia, no pensaron en cerrar la matrícula/abandonar el curso y se sintieron tristes por haber concluido por el ERE. Se indicó una reducción del interés por las clases a distancia y la percepción de que la ED había perjudicado su formación docente, así como la falta de interacción, el alejamiento de las clases prácticas y el no poder estar presente en la escuela durante las prácticas. La mayor flexibilidad de horarios fue el aspecto positivo indicado (AU).

Ensino remoto emergencial em tempos de pandemia: Percepções de concluintes do curso de licenciatura em Educação Física da UFPR / Emergency remote education in times of pandemic: Perceptions of graduates of the Physical Education undergraduate course at UFPR / Educación remota de emergencia en tiempos de pandemia: Percepciones de los graduados del curso de licenciatura en Educación Física de la UFPR

O Ensino Remoto Emergencial (ERE) foi adotado por algumas instituições de ensino durante a pandemia da covid-19. Objetivou-se analisar a percepção de concluintes do curso de Licenciatura em Educação Física (EF) sobre o ERE. As participantes relataram ter bom ambiente para acompanhar as aulas remotas, não pensaram em trancar a matrícula/desistir do curso, mas se sentiram tristes por terem concluído pelo ERE. Foi detectada redução do interesse pelas aulas remotas e percepção que o ERE prejudicou a formação docente, além da falta de interação, distanciamento das aulas práticas e não poder estar presencialmente na escola nos estágios. A maior flexibilização de horário foi o aspecto positivo indicado.

Emergency Remote Learning (ERE) was adopted by some educational institutions during the pandemic of COVID-19. We aimed to analyze the perception of graduates of the Physical Education (PE) degree course about the ERE. The participants reported having a good environment to follow the remote classes, did not think about locking the enrollment/dropping out of the course, and felt sad to have concluded by the ERE. A reduction in interest in remote classes and the perception that the distance learning program had detrimental effects on teacher education were indicated, as well as a lack of interaction, distance from practical classes, and not being able to be present in the school during internships. The positive aspect indicated was a more flexible schedule.

El aprendizaje a distancia de emergencia (ERE) fue adoptado por algunas instituciones educativas durante la pandemia de COVID-19. El objetivo de este estudio fue analizar la percepción de los egresados de la carrera de Educación Física (EF) sobre el ERE. Los participantes manifestaron tener un buen ambiente para seguir las clases a distancia, no pensaron en cerrar la matrícula/abandonar el curso y se sintieron tristes por haber concluido por el ERE. Se indicó una reducción del interés por las clases a distancia y la percepción de que la ED había perjudicado su formación docente, así como la falta de interacción, el alejamiento de las clases prácticas y el no poder estar presente en la escuela durante las prácticas. La mayor flexibilidad de horarios fue el aspecto positivo indicado.

Dipeptidyl peptidase-3 is associated with severity of liver disease and circulatory complications in patients with cirrhosis.

BACKGROUND: Patients with cirrhosis suffer from a complex multiorgan disturbance and their prognosis is influenced by the development of portal hypertension and systemic circulatory dysfunction. Although non-invasive techniques such as transient elastography aid in early detection, there is an unmet need for reliable markers of these clinically significant complications. METHODS: We conducted an exploratory single-center study investigating dipeptidyl peptidase-3 (DPP3) concentrations in various vascular beds in a cohort of 48 patients with cirrhosis and 16 healthy controls. Liver vein catheterisation with sampling from femoral artery and femoral, renal and hepatic veins as well as measurement of hepatic pressure and liver function via indocyanine green and galactose elimination tests were performed. RESULTS: DPP3 concentrations were higher in cirrhotic patients compared to controls (12.6 vs. 7.4 ng/mL, p = 0.006) and increased according to the severity of cirrhosis. DPP3 associated with MELD-Na score, Child class, indocyanine green clearance, increased DPP3 with the increased hepatic venous pressure gradient (p = 0.015) as well as increased heart rate and reduced systemic vascular resistance. DPP3 concentrations predicted the presence of clinically significant portal hypertension in cirrhotic patients (AUROC 0.78, 95% CI 0.65-0.9). CONCLUSION: DPP3 is a promising marker for portal hypertension and systemic hemodynamic changes in cirrhosis.

Experiência de mães após o diagnóstico de malformação congênita e as expectativas de cuidado / Experience of mothers after the diagnosis of congenital malformation and the expectations of care

RESUMO Objetivo compreender a experiência de mães após o diagnóstico de malformação congênita e as expectativas de cuidado da rede de saúde e social. Métodos pesquisa qualitativa com embasamento na Fenomenologia Social, com a participação de seis mães residentes em municípios de fronteira, por meio de entrevista semiestruturada. Resultados os relatos trouxeram informações sobre o diagnóstico de malformação congênita, a experiência da gravidez, o tornar-se mãe de criança com malformação e as expectativas de cuidado de saúde e social. Conclusão o grupo social estudado experienciou o diagnóstico de malformação com sofrimento, repercussões emocionais e com mudanças no cotidiano vivido. Contribuições para a prática: a comunicação por parte da equipe de saúde contribui para a compreensão e enfrentamento da malformação. Destacou-se a importância do apoio da rede familiar e social. É preciso desenvolver competências profissionais relacionadas à comunicação e a maiores investimentos para a formação e condições de trabalho que possibilitem maior tempo destinado ao atendimento deste público.

ABSTRACT Objective to understand the experience of mothers after the diagnosis of congenital malformation and the expectations of care from the health and social network. Methods qualitative research based on Social Phenomenology, with the participation of six mothers living in border towns, by means of semi-structured interviews. Results the reports brought information about the diagnosis of congenital malformation, the experience of pregnancy, becoming a mother of a child with malformation and the expectations of health and social care. Conclusion the social group studied experienced the diagnosis of malformation with suffering, emotional repercussions and changes in their daily lives. Contributions to practice: communication by the health team contributes to understanding and facing the malformation. The importance of the family and social network support was highlighted. It is necessary to develop professional skills related to communication and to make more investments in training and working conditions that allow more time for the care of this public.