Hours of sleep and associated factors in college students during the COVID-19 pandemic.

BACKGROUND: Sleep alterations are common in college students, particularly during the COVID-19 pandemic. Sociodemographic factors may predict these alterations in this population. OBJECTIVE: To identify the sociodemographic factors and health characteristics associated with the number of hours of sleep of college students during the COVID-19 pandemic. METHODS: This was a cross-sectional study carried out with 244 university students from a multicampi public university in the State of Bahia, Northeast Brazil. Data collection was performed online and participants answered a specific questionnaire to assess sleep hours, sociodemographic and health variables. RESULTS: Significant associations were observed between hours of sleep and older students (odds ratio adjusted -ORaj: 3.75; 95% Confidence Interval -CI: 1.81-7.75; p <  0.01), attending the final semesters (ORaj: 1.85; 95% CI: 1.05-3.25; p <  0.03), and who reported having some disease (ORaj: 2.18; 95% CI: 1.05-4.50; p <  0.03) with greater chances of getting less sleep. However, those who used tobacco (ORaj: 0.08; 95% CI: 0.01-0.45; p <  0.001) were likely to have more hours of sleep per night. CONCLUSION: Sleep restriction was common among participating college students, which has likely intensified due to the COVID-19 pandemic and its restrictions. This encourages specific public health actions, contemplating the health and hours of sleep of this population.

Habilidades de comunicação clínica: análise da autoavaliação dos residentes de medicina de família e comunidade / Clinical communication skills: analysis of the self-assessment of family medicine residents

Resumo Introdução: O conhecimento das habilidades de comunicação clínica é primordial para o adequado exercício da medicina de família e comunidade (MFC), visto que um dos princípios da especialidade advém da relação médico-pessoa. A comunicação assertiva é uma competência clínica básica que deve ser aprendida, sobretudo, durante a residência médica. Não se trata de uma característica inata, perpassa um processo de conhecer, aplicar e dominar, necessitando, portanto, de avaliações. Objetivo: Este estudo teve como objetivo avaliar a percepção dos médicos residentes de MFC em relação às suas habilidades de comunicação. Método: Trata-se de um estudo quantitativo, descritivo e transversal. O cenário de estudo foi o conjunto de programas de residência de MFC do município de João Pessoa, na Paraíba. A coleta de dados foi feita a partir de um questionário on-line, disponível para preenchimento de setembro a novembro de 2022. Utilizamos para a construção do questionário o instrumento A Consulta em 7 Passos. Desenvolvemos escores denominados índice de desempenho geral (IDg), índice de desempenho por passo da consulta (IDp) e índice de desempenho por item (IDitem). Na análise estatística, utilizamos o teste t para amostras independentes. Resultado: O IDg médio foi de 72,0%. Os residentes tiveram o maior índice de IDp no passo 5 da consulta (81,7%), seguido pelos passos 2 (77,6%), 3 (76,1%) e 6 (75,9%). Os menores desempenhos foram nos passos 4 (68,9%), 7 (63,7%) e 1 (63,3%). Não houve significância estatística quanto ao desempenho quando se compararam sexo, ano de residência e programa. Conclusão: Os residentes de MFC avaliam positivamente suas habilidades de comunicação. Entretanto, ainda há o que aprimorar, como fomentar momentos crítico-reflexivos sobre os fenômenos subjetivos que ocorrem na consulta. Destarte, a utilização do instrumento A Consulta em 7 Passos se revelou, no presente estudo, como uma ferramenta importante no processo de formação e avaliação da comunicação clínica durante a residência.

Abstract Introduction: Knowledge of clinical communication skills is essential for the proper practice of Family Medicine, since one of the principles of the specialty treats the doctor-person relationship as fundamental. Good communication is a basic clinical competence and must be learned, above all, during medical residency. Communication is not an innate characteristic, but a process of self-knowledge, therefore requiring self-assessments. Objective: This study aimed to evaluate the perception of Family Medicine residents doctors in relation to their communication skills. Method: This is a quantitative, descriptive and cross-sectional study. The study setting was the set of Family Medicine Residency Programs in the city of João Pessoa, Paraíba. Data collection was performed using an online questionnaire, available to be completed from September to November 2022. We used the instrument A consulta em 7 passos (7-step consultation) to construct the questionnaire. We developed scores called overall performance index (IDg), query step performance index (IDp) and item performance index (IDitem). In the statistical analysis, we used the t test for independent samples. Result: The average overall performance index (IDg) was 72.0%. Residents had the highest IDp rate in step 5 of the consultation (81.7%), followed by step 2 (77.6%), step 3 (76.1%) and step 6 (75.9% ). While residents had the lowest performances in descending order in steps 4 (68.9%), 7 (63.7%) and 1 (63.3%). There was no statistical significance between sexes, year of residency and residency program. Conclusion: MFC residents positively evaluate their communication skills. However, there is still room forto improvement in how to encourage critical-reflective moments about the subjective phenomena that occur in the consultation. Furthermore, the use of a consulta em 7 passos is an important tool in the training and evaluation process in residency.

Rare Association of Autoimmune Limbic Encephalitis and Stiff Person Syndrome.

Antibodies to Glutamic Acid Decarboxylase (GAD) have been implicated in the pathogenesis of both autoimmune Limbic Encephalitis (LE) and Stiff Person Syndrome (SPS). However, their association is quite rare. We present a case of a 48-year-old Caucasian female who presented with symptoms of recurrent severe headaches, behavioral and cognitive dysfunction, and an episode of seizure. She was found to have high titers of anti-GAD65 antibodies in both cerebrospinal fluid and serum. She was diagnosed with LE and SPS, and was started on immunosuppressive therapy with steroids and intravenous immunoglobulins (IVIG). The patient responded well to treatment with improvement in her symptoms.

Factors Associated with the Lifestyle of Pediatric Healthcare Professionals during the COVID-19 Pandemic.

The objective of this study was to analyze the association between sociodemographic and occupational variables with the lifestyle of health professionals in pediatric units during the COVID-19 pandemic. A cross-sectional study was conducted with 407 health professionals working in four pediatric health units in the State of Bahia, northeast Brazil. The Fantastic Lifestyle Questionnaire and a questionnaire with sociodemographic and employment variables self-applied via Google Forms were used. The final binary logistic regression models revealed significant associations between those who received 3 to 5 minimum wages, without a marital relationship and with more than one employment relationship. Data suggest that these sociodemographic and occupational profiles are more exposed to risky lifestyle behaviors. The findings of this study demonstrated the need for greater attention to the health of health professionals in the pediatric field, as well as the promotion of initiatives that seek to value the work of these professionals and reduce the damage caused to their lifestyle, especially in a pandemic scenario.

Comprehensive analysis of the GALACTINOL SYNTHASE (GolS) gene family in citrus and the function of CsGolS6 in stress tolerance.

Galactinol synthase (GolS) catalyzes the first and rate-limiting step in the synthesis of raffinose family of oligosaccharides (RFOs), which serve as storage and transport sugars, signal transducers, compatible solutes and antioxidants in higher plants. The present work aimed to assess the potential functions of citrus GolS in mechanisms of stress response and tolerance. By homology searches, eight GolS genes were found in the genomes of Citrus sinensis and C. clementina. Phylogenetic analysis showed that there is a GolS ortholog in C. clementina for each C. sinensis GolS, which have evolved differently from those of Arabidopsis thaliana. Transcriptional analysis indicated that most C. sinensis GolS (CsGolS) genes show a low-level tissue-specific and stress-inducible expression in response to drought and salt stress treatments, as well as to 'Candidatus Liberibacter asiaticus' infection. CsGolS6 overexpression resulted in improved tobacco tolerance to drought and salt stresses, contributing to an increased mesophyll cell expansion, photosynthesis and plant growth. Primary metabolite profiling revealed no significant changes in endogenous galactinol, but different extents of reduction of raffinose in the transgenic plants. On the other hand, a significant increase in the levels of metabolites with antioxidant properties, such as ascorbate, dehydroascorbate, alfa-tocopherol and spermidine, was observed in the transgenic plants. These results bring evidence that CsGolS6 is a potential candidate for improving stress tolerance in citrus and other plants.

Olhares do Internato Médico sob os Registros dos Atendimentos às Pessoas para além da Área Adstrita

Objetivos: pesquisa que se propõe a organizar os prontuários em saúde de moradores não adscritos à Unidade de Saúde da Família (USF) Saúde e Vida Integrada em João Pessoa-PB. A urbanização vertical adicionou usuários às equipes, pois uma morada se tornou várias, e as pessoas que passam a viver no território buscam a USF referência da comunidade. Existe inadequação do termo cotidiano "usuário fora de área", visto que ele habita o epicentro do território. Métodos: Trata-se de um relato de experiência que buscou narrar o cuidado ofertado para além do cadastro formal. Resultados e Discussão: Os registros dos atendimentos se deram através do Registro em Saúde Orientado por Problemas (ReSOAP), acompanhados de maio a setembro de 2019, sob os olhares dos internos de medicina da Universidade Federal da Paraíba (UFPB). A pesquisa teve como mote o esboço criativo-organizacional de fichas de atendimento organizadas cronologicamente, orientadas por problemas e separadas por famílias. Buscou-se, através dessa tecnologia leve, fornecer cuidado longitudinal, garantia de acompanhamento e seguimento. Ao desenvolver o Prontuário de Saúde da Família dessas pessoas consideradas "fora de área", procurou-se trabalhar com o postulado da coerência, transformando o atendimento individual, o motivo de consulta em um compilado de registros dos indivíduos adequado às necessidades da pessoa no seio da família. Conclusões: a idealização desse prontuário não formal propiciou organização e entusiasmo estudantil e foi utilizado como fonte para cuidados longitudinais, trazendo benefícios para a formação acadêmica e para a comunidade.

Effectiveness of "run-ins" at predicting adherence in a behavioral weight loss efficacy trial.

There is limited research on whether run-in procedures predict participant adherence during behavioral efficacy trials. This study examined whether information from behavioral run-ins (food diary completion, questionnaire completion, and staff interview) predict intervention adherence, trial retention, and trial outcomes in a behavioral weight loss trial. Using run-in data, trial staff predicted which participants would have high, moderate, or low trial adherence. Participants with predicted high or moderate adherence were randomized. Results showed that predicted high adherers had better intervention adherence (session attendance and completion of self-monitoring records) and superior trial outcomes (i.e. weight loss). Run-in data did not predict trial retention. Results suggest that run-ins may be effective at identifying participants adherent to intervention protocols, thereby enhancing internal validity of behavioral efficacy trials.

Acute Nephrotic Syndrome and Otosyphilis.

Syphilis, also known as the "the great masquerader," is a re-emerging infectious disease in the Western world, and may present with various signs and symptoms, making it difficult to distinguish from other diseases. Nephrotic syndrome due to syphilis has been rarely reported in modern times. Here, we describe a young male with acute hearing loss and peripheral edema, found to have acute nephrotic syndrome in the setting of otosyphilis. Given increasing incidence of syphilis, physicians must remain alert to syphilis as a possible cause of nephrotic syndrome.

Effect of the execution order from concurrent exercise session on blood pressure responses in hypertensive older men

Abstract Aim: To compare blood pressure (BP) responses among the different orders of execution of concurrent exercise (CE) sessions in controlled hypertensive older men. Methods: Fifteen older men (64 ± 5 years) participated in three randomized crossover sessions: control session (C), CE in aerobic-resistance order (AR), and resistance-aerobic order (RA). The CE was performed for 1 h, in which 30 min were for the resistance exercise with 5 exercises at 70% of 1RM and 30 min for the aerobic exercise on a treadmill with intensity corresponding to the first ventilatory threshold. Clinical systolic blood pressure (SBP), diastolic blood pressure (DBP), and mean blood pressure (MBP) were measured at rest and over 2 h and 24 h after the session. For analysis, the Generalized Estimating Equations (GEE) test was used with Bonferroni's complimentary test (α = 0.05). Results: The SBP decreased by 30 min after AR, while after RA we obtained reductions during 1 h after a session concerning rest. Between sessions, we found lower values in both CE compared to the C at 30 min, 45 min, and 90 min. In the RA there was a lower pressure in relation to the C at minute 60. The DBP reduced 30 min after the AR regarding the pre-session, however with no difference between sessions. The MBP was lower in relation to 30 min rest after AR. Among sessions, a pressure drop was observed in the AR compared to the C at 30 min and 45 min. Conclusion: We can conclude that the CE was effective in generating post-exercise hypotension regardless of the order in controlled hypertensive older men.

Fecaloma - A Common Problem, Uncommon Dimensions.

Chronic constipation and fecal impaction are common in older individuals but can also be found in younger patients with cognitive and psychiatric illnesses. The diagnosis of fecal impaction and, the assessment of severity are best performed clinically. Here, we present a case of a 30-year-old autistic individual where limited history was obtainable and further imaging helped to urgently diagnose a 47 x 15.6 x 12 cm stool ball, causing significant mass effect of surrounding intra-abdominal structures. Fecal disimpaction and aggressive bowel regimen prevented the pathological effects of severe fecal retention.

Metastatic Melanoma Progression Is Associated with Endothelial Nitric Oxide Synthase Uncoupling Induced by Loss of eNOS:BH4 Stoichiometry.

Melanoma is the most aggressive type of skin cancer due to its high capability of developing metastasis and acquiring chemoresistance. Altered redox homeostasis induced by increased reactive oxygen species is associated with melanomagenesis through modulation of redox signaling pathways. Dysfunctional endothelial nitric oxide synthase (eNOS) produces superoxide anion (O2-•) and contributes to the establishment of a pro-oxidant environment in melanoma. Although decreased tetrahydrobiopterin (BH4) bioavailability is associated with eNOS uncoupling in endothelial and human melanoma cells, in the present work we show that eNOS uncoupling in metastatic melanoma cells expressing the genes from de novo biopterin synthesis pathway Gch1, Pts, and Spr, and high BH4 concentration and BH4:BH2 ratio. Western blot analysis showed increased expression of Nos3, altering the stoichiometry balance between eNOS and BH4, contributing to NOS uncoupling. Both treatment with L-sepiapterin and eNOS downregulation induced increased nitric oxide (NO) and decreased O2• levels, triggering NOS coupling and reducing cell growth and resistance to anoikis and dacarbazine chemotherapy. Moreover, restoration of eNOS activity impaired tumor growth in vivo. Finally, NOS3 expression was found to be increased in human metastatic melanoma samples compared with the primary site. eNOS dysfunction may be an important mechanism supporting metastatic melanoma growth and hence a potential target for therapy.

Aerobic Exercise During Advance Stage of Uncontrolled Arterial Hypertension.

AIM: To evaluate the influence of physical training on myocardial function, oxidative stress, energy metabolism, and MAPKs and NF-κB signaling pathways in spontaneously hypertensive rats (SHR), at advanced stage of arterial hypertension, which precedes heart failure development. METHODS: We studied four experimental groups: normotensive Wistar rats (W, n = 27), trained W (W-EX, n = 31), SHR (n = 27), and exercised SHR (SHR-EX, n = 32). At 13 months old, the exercise groups underwent treadmill exercise 5 days a week for 4 months. In vitro myocardial function was analyzed in left ventricular (LV) papillary muscle preparations. Antioxidant enzyme activity and energy metabolism were assessed by spectrophotometry. Nicotinamide adenine dinucleotide phosphate (NADPH) oxidase activity was analyzed by lucigenin reduction and protein expression by Western blot. Statistical analyzes: ANOVA and Tukey or Kruskal-Wallis and Dunn tests. RESULTS: SHR-EX had a lower frequency of heart failure features than SHR. Myocardial function and antioxidant enzyme activity were better in SHR-EX than SHR. Lipid hydroperoxide concentration, and phosphorylated JNK and total IkB protein expression were higher in hypertensive than control groups. Malondialdehyde, NADPH oxidase activity, total JNK, phosphorylated p38, phosphorylated and total p65 NF-κB, and phosphorylated IkB did not differ between groups. Protein expression from total p38, and total and phosphorylated ERK were higher in SHR than W. Lactate dehydrogenase and phosphorylated ERK were lower and citrate synthase and ß-hydroxyacyldehydrogenase were higher in SHR-EX than SHR. CONCLUSION: Exercise improves physical capacity, myocardial function, and antioxidant enzyme activity; reduces the frequency of heart failure features and ERK phosphorylation; and normalizes energy metabolism in SHR.

Physical exercise is effective for neuropsychiatric symptoms in Alzheimer's disease: a systematic review.

BACKGROUND: Neuropsychiatric symptoms are disorders frequently seen in Alzheimer's disease. These symptoms contribute to reduction of brain reserve capacity and, in addition, they present unfavorable implications, such as: poor prognosis for the disease, increased functional decline, increased burden on the caregiver and institutionalization. This scenario makes neuropsychiatric symptoms one of the biggest problems in Alzheimer's disease, and gives rise to a need for treatments focused on improving these symptoms. Sow progress in drug trials has led to interest in exploring non-pharmacological measures for improving the neuropsychiatric symptoms of Alzheimer's disease, such as physical exercise. OBJECTIVE: To ascertain the effect of exercise on the neuropsychiatric symptoms of Alzheimer's disease and its implications. METHODS: This was a systematic review of effective longitudinal research, conducted by searching for articles in the PubMed, Web of Science, CINAHL and Scopus electronic databases, from 2009 to 2019. Studies in which the sample consisted of elderly people aged 65 years old or over with a diagnosis of Alzheimer's disease were included. Initially 334 articles were identified. After exclusions, 21 articles remained to be read in full. From these, five articles fitted the eligibility criteria, and a further two articles were added through manual searches in the references of the articles found. RESULTS: Out of the seven articles analyzed in this review, five studies revealed that physical exercise had a positive effect on the neuropsychiatric symptoms of Alzheimer's disease. CONCLUSION: This systematic review indicated that physical exercise is a favorable non-pharmacological means for attenuating the neuropsychiatric symptoms of elderly people with Alzheimer's disease, with special attention to aerobic exercises.

Physical exercise is effective for neuropsychiatric symptoms in Alzheimer's disease: a systematic review / Exercício físico é efetivo para sintomas neuropsiquiátricos na doença de Alzheimer: uma revisão sistemática

ABSTRACT Background: Neuropsychiatric symptoms are disorders frequently seen in Alzheimer's disease. These symptoms contribute to reduction of brain reserve capacity and, in addition, they present unfavorable implications, such as: poor prognosis for the disease, increased functional decline, increased burden on the caregiver and institutionalization. This scenario makes neuropsychiatric symptoms one of the biggest problems in Alzheimer's disease, and gives rise to a need for treatments focused on improving these symptoms. Sow progress in drug trials has led to interest in exploring non-pharmacological measures for improving the neuropsychiatric symptoms of Alzheimer's disease, such as physical exercise. Objective: To ascertain the effect of exercise on the neuropsychiatric symptoms of Alzheimer's disease and its implications. Methods: This was a systematic review of effective longitudinal research, conducted by searching for articles in the PubMed, Web of Science, CINAHL and Scopus electronic databases, from 2009 to 2019. Studies in which the sample consisted of elderly people aged 65 years old or over with a diagnosis of Alzheimer's disease were included. Initially 334 articles were identified. After exclusions, 21 articles remained to be read in full. From these, five articles fitted the eligibility criteria, and a further two articles were added through manual searches in the references of the articles found. Results: Out of the seven articles analyzed in this review, five studies revealed that physical exercise had a positive effect on the neuropsychiatric symptoms of Alzheimer's disease. Conclusion: This systematic review indicated that physical exercise is a favorable non-pharmacological means for attenuating the neuropsychiatric symptoms of elderly people with Alzheimer's disease, with special attention to aerobic exercises.

RESUMO Introdução: Sintomas neuropsiquiátricos são desordens frequentemente observadas na Doença de Alzheimer, os quais contribuem para a diminuição da capacidade de reserva cerebral e ocasiona implicações ruins, como mau prognóstico da doença, aumento do declínio funcional, aumento da sobrecarga do cuidador e institucionalização. Esse cenário faz com que os sintomas neuropsiquiátricos se tornem um dos maiores problemas da Doença de Alzheimer, incitando, assim, o interesse em explorar medidas não-farmacológicas nos sintomas neuropsiquiátricos na Doença de Alzheimer, como o exercício físico. Objetivo: Verificar o efeito do exercício físico em sintomas neuropsiquiátricos da Doença de Alzheimer e suas implicações. Métodos: Trata-se de uma revisão sistemática com pesquisas longitudinais efetivadas por meio da busca de artigos nas bases de dados eletrônicas: PubMed, Web of Science, CINAHL e Scopus, de 2009 a 2019. Foram incluídos estudos cuja amostra foi constituída por idosos com diagnóstico de Doença de Alzheimer com idade igual ou acima de 65 anos. Inicialmente, foram identificados 334 artigos; após as exclusões, restaram 21 artigos para leitura na íntegra. Destes, cinco artigos se enquadraram nos critérios de elegibilidade, assim como dois artigos adicionados por meio de busca manual nas referências dos artigos encontrados. Resultados: Dos sete artigos analisados na presente revisão, cinco estudos revelaram um efeito positivo do exercício físico em sintomas neuropsiquiátricos na Doença de Alzheimer. Conclusão: Esta revisão sistemática indica que o exercício físico é um meio não-farmacológico favorável à atenuação dos sintomas neuropsiquiátricos de idosos com Doença de Alzheimer, com especial atenção na modalidade aeróbia.

PDIA1 acts as master organizer of NOX1/NOX4 balance and phenotype response in vascular smooth muscle.

Changes in vascular smooth muscle cell (VSMC) phenotype underlie disease pathophysiology and are strongly regulated by NOX NADPH oxidases, with NOX1 favoring synthetic proliferative phenotype and NOX4 supporting differentiation. Growth factor-triggered NOX1 expression/activity strictly depends on the chaperone oxidoreductase protein disulfide isomerase-A1 (PDIA1). Intracellular PDIA1 is required for VSMC migration and cytoskeleton organization, while extracellular PDIA1 fine-tunes cytoskeletal mechanoadaptation and vascular remodeling. We hypothesized that PDIA1 orchestrates NOX1/NOX4 balance and VSMC phenotype. Using an inducible PDIA1 overexpression model in VSMC, we showed that early PDIA1 overexpression (for 24-48 h) increased NOX1 expression, hydrogen peroxide steady-state levels and spontaneous VSMC migration distances. Sustained PDIA1 overexpression for 72 h and 96 h supported high NOX1 levels while also increasing NOX4 expression and, remarkably, switched VSMC phenotype to differentiation. Differentiation was preceded by increased nuclear myocardin and serum response factor-response element activation, with no change in cell viability. Both NOX1 and hydrogen peroxide were necessary for later PDIA1-induced VSMC differentiation. In primary VSMC, PDIA1 knockdown decreased nuclear myocardin and increased the proliferating cell nuclear antigen expression. Newly-developed PDIA1-overexpressing mice (TgPDIA1) exhibited normal general and cardiovascular baseline phenotypes. However, in TgPDIA1 carotids, NOX1 was decreased while NOX4 and calponin expressions were enhanced, indicating overdifferentiation vs. normal carotids. Moreover, in a rabbit overdistension injury model during late vascular repair, PDIA1 silencing impaired VSMC redifferentiation and NOX1/NOX4 balance. Our results suggest a model in which PDIA1 acts as an upstream organizer of NOX1/NOX4 balance and related VSMC phenotype, accounting for baseline differentiation setpoint.

Patient-provided e-support in reduced intensity obesity treatment: The INSPIRE randomized controlled trial.

OBJECTIVE: There are two types of patient supporters, peers (two individuals initiating health behavior change who support one another) and mentors (a previously successful patient who supports incoming patients). Social comparison theory suggests that peers and mentors may elicit social comparison processes (patients may compare their progress to that of their peer/mentor), and these social comparisons could impact treatment outcomes. This randomized controlled trial is the first to examine the differential impact of peers and mentors on obesity treatment outcomes and social comparison processes when added to reduced intensity treatment. METHOD: Participants (N = 278) were randomly assigned to reduced intensity behavioral weight loss treatment alone (rBWL), rBWL plus peer e-support (rBWL + Peer), or rBWL plus mentor e-support (rBWL + Mentor). rBWL involved periodic group sessions that decreased over time; when group sessions decreased, intensity of peer/mentor e-support increased. Weight and social comparison processes were assessed throughout the 12-month intervention. RESULTS: There was a significant treatment effect; when group sessions became less frequent and peer/mentor e-support became more frequent, rBWL + Peer had significantly greater weight loss than rBWL alone, and rBWL + Mentor was not significantly different from the other two. Social comparison processes differed by treatment arm; rBWL + Peer participants tended to report more lateral social comparisons ("my weight loss progress is 'similar' to my peer's"), whereas rBWL + Mentor participants reported more upward comparisons ("my weight loss progress is 'worse than' my mentor's"). Upward comparisons were associated with poorer weight loss outcomes. CONCLUSIONS: Peer e-support may be an effective, low-cost, sustainable method for improving longer-term weight loss outcomes in reduced intensity obesity treatment. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

ADAM17 cytoplasmic domain modulates Thioredoxin-1 conformation and activity.

The activity of Thioredoxin-1 (Trx-1) is adjusted by the balance of its monomeric, active and its dimeric, inactive state. The regulation of this balance is not completely understood. We have previously shown that the cytoplasmic domain of the transmembrane protein A Disintegrin And Metalloprotease 17 (ADAM17cyto) binds to Thioredoxin-1 (Trx-1) and the destabilization of this interaction favors the dimeric state of Trx-1. Here, we investigate whether ADAM17 plays a role in the conformation and activation of Trx-1. We found that disrupting the interacting interface with Trx-1 by a site-directed mutagenesis in ADAM17 (ADAM17cytoF730A) caused a decrease of Trx-1 reductive capacity and activity. Moreover, we observed that ADAM17 overexpressing cells favor the monomeric state of Trx-1 while knockdown cells do not. As a result, there is a decrease of cell oxidant levels and ADAM17 sheddase activity and an increase in the reduced cysteine-containing peptides in intracellular proteins in ADAM17cyto overexpressing cells. A mechanistic explanation that ADAM17cyto favors the monomeric, active state of Trx-1 is the formation of a disulfide bond between Cys824 at the C-terminal of ADAM17cyto with the Cys73 of Trx-1, which is involved in the dimerization site of Trx-1. In summary, we propose that ADAM17 is able to modulate Trx-1 conformation affecting its activity and intracellular redox state, bringing up a novel possibility for positive regulation of thiol isomerase activity in the cell by mammalian metalloproteinases.

Avaliação do autocuidado na adesão do tratamento em pacientes usuários de insulinas / Evaluation of self-care in adherence to treatment in patients using insulin

O tratamento do diabetes constituí em alterações no estilo de vida, através de atividades físicas, hábitos alimentares e quando necessário uso de medicamentos. O objetivo deste trabalho foi avaliar o autocuidado de pacientes com diabetes mellitus em uso de insulina. O estudo teve uma abordagem exploratória, descritiva, quantitativa, realizada através do Questionário de Atividades de Autocuidado com o Diabetes (QAD). A maioria dos entrevistados (40) foram mulheres, entre 50 a 59 anos, casadas, aposentadas e autodeclaradas brancos. O item que apresentou menor aderência foi a realização de atividade física e o de maior aderência foi a utilização dos medicamentos. Concluímos que a aderência ao autocuidado ainda é baixa, por ser pouco entendida pelos pacientes. A educação em saúde é uma ferramenta importante para compreender a doença e entender a importância de realizar um tratamento completo. A realização do acompanhamento por uma equipe multiprofissional, traz uma abordagem mais abrangente e efetiva.

The treatment of diabetes constitutes changes in lifestyle, through physical activities, eating habits and use of medications when necessary. The objective of this work was to evaluate self-care of patients with diabetes mellitus in insulin use. The study had an exploratory, descriptive, quantitative approach, carried out through the Diabetes Self-Care Activity Questionnaire. Most of the interviewees were women, 50-59 years, married, retired and self-declared white. The item that presented less adhesion was the physical activity and the one of greater adhesion was the use of the medications. We conclude that adherence to self-care is still low, because it is still poorly understood by patients. Health education is an important tool for understanding the disease and understanding the importance of completing treatment. The realization of this, by the multiprofessional team, brings a more comprehensive and effective approach.

Imbalance between nitric oxide and superoxide anion induced by uncoupled nitric oxide synthase contributes to human melanoma development.

Melanoma is the most aggressive type of cutaneous tumors due to its metastatic potential and high mortality. Increased levels of reactive oxygen species, including superoxide anion (O2-), and the consequent installation of a pro-oxidant environment are associated with melanoma development. The enzyme nitric oxide synthase (NOS), responsible for the production of nitric oxide (NO), when uncoupled is as a source of O2-, for example by the absence of its cofactor tetrahydrobiopterin (BH4). Western blot analysis showed increased expression of endothelial and inducible NOS in human melanoma cells, altering the stoichiometry between NOS levels and BH4 concentration and together with decreased BH4:BH2 ratio are contributing to NOS uncoupling. The treatment of melanoma cells with exogenous BH4 increased NO concentration and decreased O2- levels, leading to NOS coupling, which in turn reduced cell viability, cell proliferation and the ability of melanoma cells to form melanoma spheroids. Moreover, BH4 level restoration rendered melanoma cells more sensitive to apoptosis, demonstrating the role of dysfunctional NOS in melanoma genesis.

Assessing the impact of waste water effluents on native fish species from a semi-arid region, NE Spain.

Mediterranean rivers are strongly affected by pollution and water scarcity. Over the summer period, urban and industrial effluents arrive into the rivers with little dilution. In order to assess the water quality, two native fish species, Barbus meridionalis and Squalius laietanus, were collected from six sites along the Ripoll River (Spain). PAH metabolites, alkylphenols (nonylphenol and octylphenol) and the musk galaxolide levels were determined in bile. 7-Ethoxyresorufin-O-deethylase (EROD) and 7-benzyloxy-4-trifluoromethyl-coumarin O-debenzyloxylase (BFCOD) were measured as metabolic biomarkers, and the activity of CYP19 aromatase was determined in the ovaries of B. meridionalis as a biomarker of endocrine disruption. The analysis of bile indicated that fish from the lower course of the river were highly exposed to different pollutants. Accordingly, a significant induction of EROD (9 to 10-fold) and BFCOD (3 to 5-fold) activities were detected in both fish species together with an increased aromatase activity in females of B. meridionalis from the most polluted sites. Considering that sewage treatment plant (STP) effluents are essential for maintaining environmental flows in small Mediterranean rivers, this study highlights the need to improve the efficiency of STPs to protect fish health.