High-resolution mapping of linear epitopes from LiNTPDase2: Advancing leishmaniasis detection using optimized protein and peptide antigens.

Visceral Leishmaniasis, caused by Leishmania infantum, is a tropical neglected disease and the most dangerous form of Leishmaniasis. It occurs zoonotically, with domestic transmission posing risks to humans as dogs have high susceptibility and are natural reservoirs of the parasite. Given their epidemiological role, improvements are needed in diagnosing Canine Visceral Leishmaniasis (CVL). Thus, we mapped linear epitopes from the rLiNTPDase2 antigen through peptide microarray and identified six positive epitopes. Validation through peptide ELISA revealed three promising peptides with accuracies of 78.6%, 85.92%, and 79.59%. Their combination yielded 97.58% accuracy. Negative epitopes were also found, which interacted with CVL-negative and Chagas Disease positive samples. Their removal from the rLiNTPDase2 sequence resulted in the rNT2.neg, which obtained enhanced specificity over rLiNTPDase2. The rNT2.neg validation achieved 87.50% sensitivity, 90.55% specificity, and 93.5% accuracy within 127 CVL-positive and 96 CVL-negative samples. Therefore, three peptides and rNT2.neg show significant promise for CVL diagnosis.

Quality of sleep and excessive daytime sleepiness among medical students in a Brazilian private university.

OBJECTIVE: The aim of this study was to assess medical students' quality of sleep and excessive daytime sleepiness in different graduation cycles. METHODS: A cross-sectional study was carried out at a private university in Maceió, Brazil, from August 2021 to March 2022. The sample was composed of medical students aged 18 years and above from years 1-2 (basic cycle), 3-4 (clinical cycle), and 5-6 (internship) of Medical School who were invited to answer two validated questionnaires: the Pittsburgh Sleeping Quality Index and the Epworth Sleepiness Scale. RESULTS: A total of 179 students participated; most of them were female (78.2%), aged 19-25 years (73.7%), and with a body mass index<25 kg/m2 (73.7%), with smaller participation from students from the basic cycle (21.2%). Analyzing the Pittsburgh Sleeping Quality Index, 55.9% of the students were classified as having poor sleep quality, with no difference in sleep category between gender, age, body mass index, and graduation cycle. Students with a body mass index of ≥25 kg/m2 had longer sleep latency (p=0.016) and shorter sleep duration (p=0.027). The Epworth Sleepiness Scale assessment showed that 44.1% of the students exhibit daytime sleepiness. Women had more daytime sleepiness than men (p=0.017), with no difference between age, body mass index, and graduation cycle. CONCLUSION: About half of the medical students experience poor sleep quality and daytime sleepiness, regardless of the graduation cycle. This should trigger a targeted institutional intervention to promote better mental and physical health, as well as sleep hygiene, to reduce future health issues.

Transdermal Opioids and the Quality of Life of the Cancer Patient: A Systematic Literature Review.

OBJECTIVE: This systematic literature review aims to evaluate the effectiveness of transdermal opioids in managing cancer pain and their impact on the quality of life (QoL) of patients. DATA SOURCES: A systematic literature review conducted following the PRISMA protocol, focusing on randomized clinical trials found in the Lilacs, Embase, PubMed, and SciELO databases over the last 20 years. STUDY SELECTION AND DATA EXTRACTION: We included randomized clinical trials, published in English, Portuguese, or Spanish, which assessed the impact of transdermal opioids on the QoL. Data extraction was facilitated using the Rayyan app. DATA SYNTHESIS: Six articles meeting the inclusion and exclusion criteria were analyzed. These studies covered a population ranging from 24 to 422 cancer patients experiencing moderate to severe pain. The risk of bias was assessed in each study, generally being categorized as uncertain or high. RELEVANCE TO PATIENT CARE AND CLINICAL PRACTICE: The findings indicate that the analgesic effectiveness and side effects of transdermal formulations (specifically buprenorphine and fentanyl) for managing moderate to severe cancer pain are comparable to, or in some cases superior to, those of oral opioids traditionally employed. CONCLUSIONS: Transdermal therapy was suggested to have several advantages over oral opioid therapy in enhancing cancer patients' QoL. These benefits span various dimensions, including pain management, physical functioning, mental health, vitality, overall patient improvement, anger/aversion, strength/activity, general QoL, cognitive and emotional functions, fatigue, and insomnia.

Mitophagy induction improves salivary gland stem/progenitor cell function by reducing senescence after irradiation.

BACKGROUND AND PURPOSE: Patients undergoing radiotherapy for head and neck cancer often experience a decline in their quality of life due to the co-irradiation of salivary glands. Radiation-induced cellular senescence is a key factor contributing to salivary gland dysfunction. Interestingly, mitochondrial dysfunction and cellular senescence have been reported to be strongly interconnected and thus implicated in several aging-related diseases. This study aims to investigate the role of mitochondrial dysfunction in senescence induction in salivary gland stem/progenitor cells after irradiation. MATERIALS AND METHODS: A dose of 7 Gy photons was used to irradiate mouse salivary gland organoids. Senescent markers and mitochondrial function were assessed using rt-qPCR, western blot analysis, SA-ß-Gal staining and flow cytometry analysis. Mitochondrial dynamics-related proteins were detected by western blot analysis while Mdivi-1 and MFI8 were used to modulate the mitochondrial fission process. To induce mitophagy, organoids were treated with Urolithin A and PMI and subsequently stem/progenitor cell self-renewal capacity was assessed as organoid forming efficiency. RESULTS: Irradiation led to increased senescence and accumulation of dysfunctional mitochondria. This was accompanied by a strong downregulation of mitochondrial fission-related proteins and mitophagy-related genes. After irradiation, treatment with the mitophagy inducer Urolithin A attenuated the senescent phenotype and improved organoid growth and stem/progenitor cell self-renewal capacity. CONCLUSION: This study shows the important interplay between senescence and mitochondrial dysfunction after irradiation. Importantly, activation of mitophagy improved salivary gland stem/progenitor cell function thereby providing a novel therapeutic strategy to restore the regenerative capacity of salivary glands following irradiation.

Quality of sleep and excessive daytime sleepiness among medical students in a Brazilian private university

SUMMARY OBJECTIVE: The aim of this study was to assess medical students' quality of sleep and excessive daytime sleepiness in different graduation cycles. METHODS: A cross-sectional study was carried out at a private university in Maceió, Brazil, from August 2021 to March 2022. The sample was composed of medical students aged 18 years and above from years 1-2 (basic cycle), 3-4 (clinical cycle), and 5-6 (internship) of Medical School who were invited to answer two validated questionnaires: the Pittsburgh Sleeping Quality Index and the Epworth Sleepiness Scale. RESULTS: A total of 179 students participated; most of them were female (78.2%), aged 19-25 years (73.7%), and with a body mass index<25 kg/m2 (73.7%), with smaller participation from students from the basic cycle (21.2%). Analyzing the Pittsburgh Sleeping Quality Index, 55.9% of the students were classified as having poor sleep quality, with no difference in sleep category between gender, age, body mass index, and graduation cycle. Students with a body mass index of ≥25 kg/m2 had longer sleep latency (p=0.016) and shorter sleep duration (p=0.027). The Epworth Sleepiness Scale assessment showed that 44.1% of the students exhibit daytime sleepiness. Women had more daytime sleepiness than men (p=0.017), with no difference between age, body mass index, and graduation cycle. CONCLUSION: About half of the medical students experience poor sleep quality and daytime sleepiness, regardless of the graduation cycle. This should trigger a targeted institutional intervention to promote better mental and physical health, as well as sleep hygiene, to reduce future health issues.

Heterologous expression and biochemical characterization of the recombinant nucleoside triphosphate diphosphohydrolase 2 (LbNTPDase2) from Leishmania (Viannia) braziliensis.

Leishmania braziliensis is a pathogenic protozoan parasite that causes American Tegumentary Leishmaniasis (ATL), an important tropical neglected disease. ENTPDases are nucleotidases that hydrolyze intracellular and/or extracellular nucleotides. ENTPDases are known as regulators of purinergic signalling induced by extracellular nucleotides. Leishmania species have two isoforms of ENTPDase, and, particularly, ENTPDase2 seems to be involved in infectivity and virulence. In this study, we conducted the heterologous expression and biochemical characterization of the recombinant ENTPDase2 of L. braziliensis (rLbNTPDase2). Our results show that this enzyme is a canonical ENTPDase with apyrase activity, capable of hydrolysing triphosphate and diphosphate nucleotides, and it is dependent on divalent cations (calcium or magnesium). Substrate specificity was characterized as UDP>GDP>ADP>GTP>ATP=UTP. The enzyme showed optimal activity at a neutral to basic pH and was partially inhibited by suramin and DIDS. Furthermore, the low apparent Km for ADP suggests that the enzyme may play a role in adenosine-mediated signalling. The biochemical characterization of this enzyme can open new avenues for using LbNTPDase2 as a drug target.

Protein-caloric restriction induced HPA axis activation and altered the milk composition imprint metabolism of weaned rat offspring.

OBJECTIVES: Maternal protein-caloric restriction during lactation can malprogram offspring into having a lean phenotype associated with metabolic dysfunction in early life and adulthood. The aim of this study was to investigate the relationships between nutritional stress, maternal behavior and metabolism, milk composition, and offspring parameters. Additionally, we focused on the role of hypothalamus-pituitary-adrenal axis hyperactivation during lactation. METHODS: Dams were fed a low-protein diet (4% protein) during the first 2 wk of lactation or a normal-protein diet (20% protein) during all lactation. Analyses of dams, milk, and offspring were conducted on postnatal days (PD) 7, 14, and 21. RESULTS: Body weight and food intake decreased in dams, which was associated with reduced fat pad stores and increased corticosterone levels at PD 14. The stressed low-protein diet dams demonstrated alterations in behavior and offspring care. Despite nutritional deprivation, dams adapted their metabolism to provide adequate energy supply through milk; however, we demonstrated elevated corticosterone and total fat levels in milk at PD 14. Male offspring also showed increased corticosterone at PD 7, associated with a lean phenotype and alterations in white and brown adipose tissue morphology at PD 21. CONCLUSION: Exposure to protein-caloric restriction diet of dams during lactation increased the glucocorticoid levels in dams, milk, and offspring, which is associated with alterations in maternal behavior and milk composition. Thus, glucocorticoids and milk composition may play an important role in metabolic programming induced by maternal undernutrition.

Avaliação dos efeitos do curativo compressivo após procedimentos intervencionistas por via radial / Evaluation of the effects of compressive dressing after interventional procedures via radial approach

Introdução: Dispositivos externos compressivos após a punção radial para cateterismo cardíaco e intervenção coronária percutânea visam à hemostasia, ao conforto para o paciente e à segurança. O estudo objetivou avaliar pacientes submetidos a procedimentos coronários invasivos por via radial, nos quais se utilizou um curativo compressivo e de baixo custo, desenvolvido no serviço, avaliando a segurança dele e a ocorrência de complicações. Métodos: Indivíduos submetidos à coronariografia e à intervenção coronária percutânea, avaliados no momento de retirada do curativo compressivo e após 7 dias, por meio de questionário abrangendo comorbidades, quadro clínico, tempo do procedimento e de compressão, avaliação física de hematoma e dor, e Doppler vascular sonoro para avaliação de oclusão da artéria radial. Resultados: Foram avaliados 144 pacientes, sendo 138 com seguimento em 7 dias. Os eventos não diferiram entre procedimentos diagnósticos e terapêuticos. Na avaliação imediata à retirada do curativo, revelou-se incidência de 4,2% de oclusão da artéria radial, com dor referida em 23,6% dos pacientes, graduada em 2,9±1,7 pela Escala Visual Analógica (intensidade de zero a dez) e sem sangramentos graves. Hematoma ocorreu em um paciente (0,9%), com classificação III pelo critério EASY. Na avaliação de 7 dias, a incidência de oclusão da artéria radial foi de 2,2%, a dor foi referida em 11,1% da amostra (intensidade 1,8±0,8), e o hematoma foi evidenciado em 3,5%. Conclusão: O curativo compressivo mostrou-se um procedimento seguro, com baixa taxa de complicações e baixa taxa de dor local nos pacientes submetidos a procedimentos coronários invasivos pela via radial.

Background: External compressive devices after radial puncture for cardiac catheterization and percutaneous coronary intervention aim at hemostasis, patient comfort, and safety. The objective of the study was to evaluate patients undergoing invasive coronary procedures by radial approach, in which a low-cost compressive dressing developed at the service was used, assessing its safety and the occurrence of complications. Methods: Patients undergoing coronary angiography and percutaneous coronary intervention, evaluated at the time of removal of compressive dressing and after 7 days, by means of a questionnaire addressing comorbidities, clinical picture, procedure and compression time, physical assessment of hematoma and pain, and a vascular Doppler ultrasound to evaluate radial artery occlusion. Results: A total of 144 patients were evaluated, 138 of whom were followed up within 7 days. Events did not differ among diagnostic and therapeutic procedures. In the immediate evaluation after removal of dressing, an incidence of 4.2% of radial artery occlusion was observed, with pain reported by 23.6% of patients, graded at 2.9±1.7 points in the Visual Analogue Scale (intensity of zero to ten), and no major bleeding. Hematoma occurred in one patient (0.9%), classified as type III according to the EASY criteria. In the 7-day evaluation, the incidence of radial artery occlusion was 2.2%, pain was reported in 11.1% of sample (intensity 1.8±0.8), and hematoma was evident in 3.5%. Conclusion: The compressive dressing proved to be a safe procedure, with a low rate of complications and a low rate of local pain in patients undergoing invasive coronary procedures via radial approach.

Educação física cultural: o currículo em ação pela ótica docente / Cultural physical education: the curriculum in action from a docent perspective / Educación física cultural: el curriculum en acción a través de la mirada del docente

O currículo cultural se apresenta enquanto proposta que busca superar as práticas hegemônicas e eurocêntricas, reconhecer e valorizar as diferenças e problematizar as desigualdades e injustiças com vistas a contribuir com a formação de sujeitos solidários. Para tanto, os professores que afirmam colocá-lo em ação são agenciados por determinados princípios ético-políticos, o que os leva a tematizar determinadas práticas corporais mediante encaminhamentos pedagógicos singulares. A fim de identificar as percepções acerca dessa proposta, o presente artigo submete ao confronto com a teoria curricular cultural, os dados gerados a partir de entrevistas narrativas feitas com professores que atuam numa instituição pública cujo projeto político pedagógico se alinha a essa vertente de ensino. A investigação reconhece que, de acordo com as falas docentes, houve mudança da percepção estudantil sobre as práticas corporais. Os estudantes puderam encontrar nesse espaço educacional o reconhecimento de suas identidades, tendo maior possibilidade de vivenciar experiências inéditas e diversificadas que promoveram maior representatividade, o que gerou provável identificação com as práticas corporais tematizadas. (AU)

The cultural curriculum is a proposal that seeks to overcome hegemonic and Eurocentric practices, recognize and value differences, and problematize inequalities and injustice with the goal of contributing to the education of caring individuals. To this end, teachers who state that they put it into action are guided by certain political-ethical principles, which leads them to focus on certain body practices through singular pedagogical pathways. In order to identify the perceptions that exist regarding this proposal, the present article compares cultural curricular theory with the data obtained through narrative interviews conducted with teachers who work at a public institution that has a political pedagogical project aligned with this dimension of teaching. The investigation recognizes that, according to the teachers' responses, student perception of body practices was changed. The students were able to recognize their identities in this educational space and had a better chance of undergoing novel and diversified experiences that promoted increased representativity, which probably caused them to identify with the body practices in question. (AU)

El currículo cultural presenta una propuesta que busca superar las prácticas hegemónicas y eurocéntricas, reconocer y valorar las diferencias, problematizar las desigualdades e injusticias y contribuir a la formación de un sujeto solidario. Para esto, los profesores que la implementan se comprometen con determinados principios éticos-políticos, lo que los lleva a abordar algunas prácticas corporales a través de enfoques pedagógicos singulares. Con el fin de identificar las percepciones sobre esta propuesta, este artículo confronta los datos generados a partir de entrevistas narrativas realizadas con los profesores que trabajan en una institución pública cuyo proyecto pedagógico se alinea con esta corriente educativa con la teoría curricular cultural. La investigación reconoce que, según las conversaciones con los docentes, ha habido un cambio en la percepción de los estudiantes sobre las prácticas corporales. Los estudiantes pudieron encontrar en este entorno educativo el reconocimiento de sus identidades, lo que les brindó una mayor posibilidad de vivir experiencias inéditas y diversas que promovieron una mayor representatividad. Esto generó una posible identificación con las prácticas corporales abordadas. (AU)

Knowledge of medical students about breastfeeding / Conhecimento dos estudantes de medicina sobre aleitamento materno

Breastfeeding (BF) is essential for the development of the child and the promotion of a bond between mother and child. Therefore, it is essential that medical students know how to advise on the subject, to stimulate BF, so this study aimed to identify their knowledge in relation to BF knowledge, guidance, orientation, and management. Cross-sectional study with 252 medical students from a private university, carried out in the second semester of 2021 and first semester of 2022. The students answered a questionnaire that investigated seven domains that evaluated the knowledge and experience about BF. The Stata Program, version 16.0, was used in the statistical analyses. Chi-square test was applied to verify differences between students with no prior knowledge about AM (<7th period) and those with prior knowledge (>7th period). It was observed that students with prior knowledge obtained 65% (95%CI 56.2% - 73.0%) of performance in the general knowledge item about AM, while students without knowledge had 13.2% (95%CI 8.3 % - 20.2%). The subject with the best performance in both groups, with no statistically significant difference, was on the effectiveness of BF (96.0%; 95%CI 92.8 - 97.8). The content with the worst performance was the expression of breast milk, where 10.8% (95%CI 6.5 - 17.5) of students with no prior knowledge and 16.3% (95%CI 10.7 - 23.9) with knowledge got a better score. In view of the results obtained, it was concluded that students from the 7th to 12th period have more knowledge about the subject compared to students from the initial periods, even with poor performance in the domain expression of breast milk.

O aleitamento materno (AM) é fundamental para o desenvolvimento da criança e da promoção de vínculo entre mãe e filho. Diante disso, é primordial que os estudantes de medicina oriente sobre a temática, a fim de estimular o AM, por isso, tal estudo teve por objetivo identificar o conhecimento em relação ao conhecimento, orientações e manejo do AM. Estudo transversal com 22 estudantes de medicina de uma universidade, no 2º semestre de 20 e 1º semestre de 2022. Os estudantes responderam22. O Programa Stata, versão 16.0, foi avaliado nas estimativas estatísticas. Teste quiquadrado foi aplicado para diferenças entre os estudantes sem conhecimento prévio sobre AM (<7º) e os com conhecimento prévio ( > 7º período).Observou-se que os alunos com conhecimento prévio obtiveram 65% (IC95% 56,2% - 73,0%) de desempenho no quesito conhecimento geral sobre AM, enquanto os alunos sem conheceram 13,2% (IC95% 8,3) % - 20,2%). O desempenho em diferença significativa foi sobre o melhor significado do AM (96% 92,8,8) - IC95% 92,8,8. O conteúdo com melhor desempenho foi a expressão do leite materno, onde 10,8% (IC95% 6,5 - 17,5) dos estudantes sem conhecimento prévio e 16,3% (IC95% 10,7 - 23,9) com conhecimentoram o melhor escore obtido. Resultados maternos, concluídos-se que os alunos do 7º ao 12º período possuem mais conhecimento sobre o tema com os alunos dos períodos iniciais, mesmo apresentando desempenho ruim no domínio.

Galactooligosaccharides: Physiological benefits, production strategies, and industrial application.

The concern for better life quality has been encouraging the bioprocess industries to develop technological strategies to obtain new biomolecules. Galactooligosaccharides (GOS) are an important class of food-grade oligosaccharides, being classified as non-digestible, and which present prebiotic potential, promoting better conditions of health and well-being. The main benefits include the selective stimulation of beneficial microorganisms, the decrease in the formation of toxic compounds, the increase in the absorption of minerals, improvement of an immune response, and a reduction in the severity of obesity and diabetes. This review approaches the recent methodologies and strategies to obtain GOS, their health benefits, purification, and technological properties for industrial application. Improvements in the process are continuously being investigated, with the technique of enzyme immobilization representing a potentially promising strategy. Sustainable GOS productions have been reported by the use of agro-industrial residues, such as cheese whey. Despite these advances, the main concern of the process consists in the low yield, which implies high investments in the purification of the bioproducts. Technological and nutritional approaches to the GOS application in different industrial sectors are also reported.

O efeito do tipo de mulher na categorização social inicial e na atribuição de características estereotípicas / The Effect of Woman's Type on Initial Social Categorization and the Attribution of Stereotypical Characteristics

Resumo Introdução: Os estereótipos de género dizem respeito a crenças partilhadas sobre os atributos físicos, psicológicos e comportamentais de homens e mulheres. De acordo com a literatura, observa-se alguma variabilidade nos estereótipos para a categoria mulher, em função de serem associadas a uma de três subcategorias: mulher tradicional, mulher independente e mulher sexy. Este estudo pretendeu observar os estereótipos predominantes e diferenciadores de cada tipo de mulher e a formação de impressões numa amostra portuguesa. Método: Os participantes (N = 78), distribuídos em 6 condições de acordo com o design experimental 3 (tipo de mulher: tradicional, independente vs. sexy) x 2 (sexo do participante: homem vs. mulher), deveriam, com base numa descrição prévia, indicar a área profissional, aparência física e modo de vestir da mulher alvo e formar uma impressão em termos dos atributos calorosa e competente. Resultados: Os resultados indicam maiores avaliações de calor para a mulher tradicional, pouca variabilidade nas avaliações de competência e as respostas obtidas através da análise semântica conferem diferentes imagens para os três subgrupos de mulher. Conclusões: Os resultados confirmam parcialmente as hipóteses e são discutidos com base nas implicações para a literatura dos estereótipos de género.

Abstract Introduction: Gender stereotypes are beliefs about the physical, psychological, and behavioral attributes of men and women. According to the literature, there is some variability in stereotypes for the woman category, as they are associated with one of three subcategories: traditional woman, independent woman, and sexy woman. This study aimed to observe the predominant and differentiating stereotypes of each type of woman and the formation of impressions in a Portuguese sample. Method: Participants (N = 78), distributed in 6 conditions according to the experimental design 3 (woman type: traditional, independent vs. sexy) x 2 (participant's gender: male vs. female), should base on a previous description indicate the professional field, physical appearance and dress of the target woman and form an impression in terms of warm and competent attributes. Results: The results indicate higher warmth ratings for traditional women, little variability in competency ratings, and the responses obtained through semantic analysis provide different images for the three subgroups of women. Conclusions: The results partially confirm the hypotheses and are discussed based on the implications for the gender stereotypes` literature.

Urea, salts, and Tween 20 influence on adsorption of IgG and Leishmania rNTPDase2 to nitrocellulose.

Lateral flow immunochromatography is a widely used technique for immunological assays. Construction of test and control lines is mostly done by antigen adsorption to nitrocellulose membranes, a process not fully understood. This study aimed to evaluate the influence of urea, salts, and Tween 20, on adsorption. The performance of canine IgG in water and in buffer containing urea and salts (pH 8.3) were compared to observe if the interferents would lead to protein stripping when challenged with increasing concentrations of Tween 20 in the lateral flow buffer. Immobilization of the rLiNTPDase2, an antigen for Canine Leishmaniasis diagnosis, was evaluated and compared to the rLbNTPDase2 by the same method. There were no differences between adsorption coefficients of IgG in water and in buffer, but high salt and urea concentrations seems to stabilize and enhance IgG immobilization. Adsorption performance between canine IgG and rNTPDases had different patterns, but was highly similar between rNTPDases, indicating that protein identity may have an important role. Also, low concentrations of Tween 20 in the flow solution may aid the maintenance of rNTPDase2 on the strips. Our results bring insights about protein adsorption and perspectives about the influence of urea, salts and Tween 20 on this process.

In loco provision of physical therapy services to military firefighters involved in Brumadinho dam disaster.

OBJECTIVE: To investigate the impact of in loco physical therapy interventions on military firefighters involved in search and rescue operations following the collapse of the Brumadinho dam, in Minas Gerais. To describe the clinical and demographic profile of military firefighters receiving physical therapy care. METHODS: Physical therapy assessment and care protocols were designed. Protocols were based on manual physical therapy approaches, and aimed primarily to alleviate musculoskeletal pain. Physical therapists involved were duly trained prior to interventions to level technical skills. Physical therapy was provided upon request (i.e., military workers sought the service after work shift completion). RESULTS: A total of 318 military firefighters, most of whom were males (92.5%) mean age 32.9 years, received physical therapy care (575 sessions spread out over 48 days). In this sample, 43.4% of military workers had a history of musculoskeletal complaints. Military workers seeking physical therapy after completion of their work shifts reported mean pain intensity of 5.4 in a numerical scale. Spinal pain was reported in 61.7% of cases, followed by generalized muscle and myofascial pain (16.7%), lower and upper limb pain (14.4% and 6.8%, respectively). At the end of sessions, mean pain intensity reported dropped down to 1.3. Differences were statistically significant (non-parametric Wilcoxon test; p=0.001). CONCLUSION: The unprecedented physical therapy intervention described had a positive impact on relief of musculoskeletal pain among military firefighters involved in search and rescue operations during the Brumadinho dam disaster, and seen at the end of their work shifts.

Protein restriction during lactation causes transgenerational metabolic dysfunction in adult rat offspring.

Introduction: Protein restriction during lactation can induce metabolic dysfunctions and has a huge impact on the offspring's phenotype later in its life. We tested whether the effects of a maternal low-protein diet (LP) in rats can be transmitted to the F2 generation and increase their vulnerability to dietary insults in adulthood. Methods: Female Wistar rats (F0) were fed either a low-protein diet (LP; 4% protein) during the first 2 weeks of lactation or a normal-protein diet (NP; 23% protein). The female offspring (F1 generation) were maintained on a standard diet throughout the experiment. Once adulthood was reached, female F1 offspring from both groups (i.e., NP-F1 and LP-F1) were bred to proven males, outside the experiment, to produce the F2 generation. Male F2 offspring from both groups (NP-F2 and LP-F2 groups) received a standard diet until 60 days old, at which point they received either a normal fat (NF; 4.5% fat) or a high fat diet (HF; 35% fat) for 30 days. Results: At 90 days old, LPNF-F2 offspring had increased lipogenesis and fasting insulinemia compared to NPNF-F2, without alteration in insulin sensitivity. HF diet caused increased gluconeogenesis and displayed glucose intolerance in LPHF-F2 offspring compared to LPNF-F2 offspring. Additionally, the HF diet led to damage to lipid metabolism (such as steatosis grade 3), higher body weight, fat pad stores, and hepatic lipid content. Discussion: We concluded that an F0 maternal protein restricted diet during lactation can induce a transgenerational effect on glucose and liver metabolism in the F2 generation, making the offspring's liver more vulnerable to nutritional injury later in life.

In loco provision of physical therapy services to military firefighters involved in Brumadinho dam disaster

ABSTRACT Objective To investigate the impact of in loco physical therapy interventions on military firefighters involved in search and rescue operations following the collapse of the Brumadinho dam, in Minas Gerais. To describe the clinical and demographic profile of military firefighters receiving physical therapy care. Methods Physical therapy assessment and care protocols were designed. Protocols were based on manual physical therapy approaches, and aimed primarily to alleviate musculoskeletal pain. Physical therapists involved were duly trained prior to interventions to level technical skills. Physical therapy was provided upon request (i.e., military workers sought the service after work shift completion). Results A total of 318 military firefighters, most of whom were males (92.5%) mean age 32.9 years, received physical therapy care (575 sessions spread out over 48 days). In this sample, 43.4% of military workers had a history of musculoskeletal complaints. Military workers seeking physical therapy after completion of their work shifts reported mean pain intensity of 5.4 in a numerical scale. Spinal pain was reported in 61.7% of cases, followed by generalized muscle and myofascial pain (16.7%), lower and upper limb pain (14.4% and 6.8%, respectively). At the end of sessions, mean pain intensity reported dropped down to 1.3. Differences were statistically significant (non-parametric Wilcoxon test; p=0.001). Conclusion The unprecedented physical therapy intervention described had a positive impact on relief of musculoskeletal pain among military firefighters involved in search and rescue operations during the Brumadinho dam disaster, and seen at the end of their work shifts.

Are Semi-Quantitative Clinical Cultures Inadequate? Comparison to Quantitative Analysis of 1053 Bacterial Isolates from 350 Wounds.

Early awareness and management of bacterial burden and biofilm is essential to wound healing. Semi-quantitative analysis of swab or biopsy samples is a relatively simple method for measuring wound microbial load. The accuracy of semi-quantitative culture analysis was compared to 'gold standard' quantitative culture analysis using 428 tissue biopsies from 350 chronic wounds. Semi-quantitative results, obtained by serial dilution of biopsy homogenates streaked onto culture plates divided into 4 quadrants representing occasional, light, moderate, and heavy growth, were compared to total bacterial load quantified as colony-forming units per gram (CFU/g). Light growth, typically considered an insignificant finding, averaged a clinically significant 2.5 × 105 CFU/g (SE = 6.3 × 104 CFU/g). Occasional growth (range: 102-106 CFU/g) and light growth (103-107 CFU/g) corresponded to quantitative values that spanned a 5-log range; moderate and heavy growth corresponded to a range of 4-log and 6-log, respectively, with a high degree of overlap in range of CFU/g per category. Since tissue biopsy and quantitative culture cannot be widely practiced and semi-quantitative analysis is unreliable, other clinically relevant approaches are required to determine wound bioburden and guide best management practices. Fluorescence imaging is a point-of-care technology that offers great potential in this field.

Diabetes in the COVID-19 pandemic era.

OBJECTIVE: To analyze the association between patients with diabetes mellitus and the increased severity and its complications that arise with a severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. METHODS: This is a complementary review of literature in which 14 articles published in 2020 were selected. These reviewed articles were written in both Portuguese and English available in the SciELO and PubMed databases. This review also involved searching on websites of international and national organizations in order to gather information published by these bodies about diabetic population and coronavirus disease (COVID-19)-infected individuals. DISCUSSION: The presence of comorbidities in SARS-CoV-2-infected individuals causes an increase in the expression level of angiotensin-converting enzyme 2, facilitating the entry of the virus into the cell. Diabetes causes metabolic and vascular changes, thus weakening the immune system through the inhibition of the innate immune system and the secretion of various inflammatory cytokines. This hyperinflammation can lead to multiple organ failure. The interaction between this comorbidity and COVID-19 can worsen pre-existing diabetes or predispose the onset of diabetes in non-diabetic individuals. CONCLUSIONS: Diabetes mellitus is related to the increased severity and complications of COVID-19. The association between diabetes and COVID-19 creates a devastating double pandemic, as it worsens the prognosis of COVID-19.