Exploring the interplay between miRNAs, apoptosis and viral load, in Dengue virus infection.

Dengue virus (DENV) is a major global health concern, causing millions of infections annually. Understanding the cellular response to DENV infection is crucial for developing effective therapies. This study provides an in-depth analysis of the cellular response to Dengue virus (DENV) infection, with a specific focus on the interplay between microRNAs (miRNAs), apoptosis, and viral load across different DENV serotypes. Utilizing a variety of cell lines infected with four DENV serotypes, the research methodically quantifies viral load, and the expression levels of miRNA-15, miRNA-16, and BCL2 protein, alongside measuring apoptosis markers. Methodologically, the study employs quantitative PCR for viral load and miRNA expression analysis, and Western blot for apoptosis and BCL2 detection, with a statistical framework that includes ANOVA and correlation analysis to discern significant differences and relationships. The findings reveal that despite similar viral loads across DENV serotypes, DENV-2 exhibits a marginally higher load. A notable upregulation of miRNA-15 and miRNA-16 correlates positively with increased viral load, suggesting their potential role in modulating viral replication. Concurrently, a marked activation of caspases 3 and 7, along with changes in BCL2 protein levels, underscores the role of apoptosis in the cellular response to DENV infection. Conclusively, the study enhances the understanding of miRNA involvement in DENV pathogenesis, highlighting miRNA-15 and miRNA-16 as potential regulatory agents in viral replication and apoptosis. These findings pave the way for further exploration into miRNA-based therapeutic strategies against DENV infection.

Perfil das pessoas com diabetes que utilizaram a telefarmácia na pandemia de covid-19: resultados da DIABETES / Profile of people with diabetes who used telepharmacy during the covid-19 pandemic: results from DIABETES / Perfil de personas con diabetes que usaron telefarmacia durante la pandemia de covid-19: resultados de DIABETES

O objetivo foi analisar o perfil das pessoas com diabetes que utilizaram a telefarmácia na pandemia de covid-19. Trata-se de um estudo transversal com dados oriundos da websurvey DIABETESvid que ocorreu nos meses de setembro e outubro de 2020. Verificou-se que 45 participantes recorreram à telefarmácia, sendo que 55,6% eram do sexo masculino, 42,2% tinham idade compreendida entre 18 e 34 anos e 46,7% estudaram 12 ou mais anos. Além disso, 48,9% autorreferiram diabetes mellitus tipo 1. A maioria usava insulina (55,6%) e obteve os medicamentos para o diabetes em farmácias do sistema público de saúde (60%). Ademais, as pessoas que tiveram o diagnóstico de covid-19 buscaram mais pela telefarmácia (RP=2,20; IC95% 1,23­3,94). Sabe-se que os medicamentos são essenciais para o tratamento do diabetes. Logo, no período estudado em que se preconizava o distanciamento físico, os participantes apropriaram-se da telefarmácia a fim de obter a integralidade do cuidado

The objective was to analyze the profile of people with diabetes who used telepharmacy during the covid-19 pandemic. This is a cross-sectional study with data from the DIABETESvid websurvey that took place in September and October 2020. It was found that 45 participants used telepharmacy, 55.6% of whom were male, 42.2% were between 18 and 34 years-old and 46.7% studied 12 or more years. In addition, 48.9% self-reported type 1 diabetes mellitus. Most used insulin (55.6%) and obtained their diabetes medication from pharmacies in the public health system (60%). Also, people diagnosed with covid-19 used telephar-macy more often (PR=2.20; 95%CI 1.23­3.94). It is known that drugs are essential for the treatment of diabetes. Therefore, in the period studied in which physical distancing was advocated, the participants used telepharmacy to obtain comprehensive care

El objetivo fue analizar el perfil de las personas con diabetes que utilizaron la telefarmacia durante la pandemia del covid-19. Estudio transversal con datos de la encuesta por internet DIABETESvid realizada en septiembre y octubre de 2020. Se encontró que 45 participantes recurrieron a la telefarmacia, de los cuales el 55,6% eran hombres, el 42,2% tenían entre 18 y 34 años y el 46,7% estudiaban 12 o más años. Además, el 48,9% se autorrefirió diabetes mellitus tipo 1. La mayoría utilizaba insulina (55,6%) y recibía su medicación antidiabética en farmacias del sistema público (60%). Además, las personas diagnosticadas con covid-19 buscaron telefarmacia con más frecuencia (RP = 2,20; IC 95% 1,23­3,94). Los medicamentos son esenciales para el tratamiento de la diabetes. Por lo tanto, en el período estudiado en el que se propugnaba el distanciamiento físico, los participantes se apropiaron de la telefarmacia para la atención integral

Experimental Dengue Virus Type 4 Infection Increases the Expression of MicroRNAs-15/16, Triggering a Caspase-Induced Apoptosis Pathway.

The World Health Organization has estimated the annual occurrence of approximately 392 million dengue virus (DENV) infections in more than 100 countries where the virus is endemic, which represents a serious threat to humanity. DENV is a serologic group with four distinct serotypes (DENV-1, DENV-2, DENV-3, and DENV-4) belonging to the genus Flavivirus, in the family Flaviviridae. Dengue is the most widespread mosquito-borne disease in the world. The ~10.7 kb DENV genome encodes three structural proteins (capsid (C), pre-membrane (prM), and envelope (E)) and seven non-structural (NS) proteins (NS1, NS2A, NS2B, NS3, NS4A, NS4B, and NS5). The NS1 protein is a membrane-associated dimer and a secreted, lipid-associated hexamer. Dimeric NS1 is found on membranes both in cellular compartments and cell surfaces. Secreted NS1 (sNS1) is often present in patient serum at very high levels, which correlates with severe dengue symptoms. This study was conducted to discover how the NS1 protein, microRNAs-15/16 (miRNAs-15/16), and apoptosis are related during DENV-4 infection in human liver cell lines. Huh 7.5 and HepG2 cells were infected with DENV-4, and miRNAs-15/16, viral load, NS1 protein, and caspases-3/7 were quantified after different durations of infection. This study demonstrated that miRNAs-15/16 were overexpressed during the infection of HepG2 and Huh 7.5 cells with DENV-4 and had a relationship with NS1 protein expression, viral load, and the activity of caspases-3/7, thus making these miRNAs potential injury markers during DENV infection in human hepatocytes.

Replication of Rocio virus in primary cultures of mouse neural cells.

OBJECTIVE: This study verified the replication efficiency of the Rocio virus in a primary culture of mouse neural cells. METHODS: Mixed primary cultures (neurons/glia) obtained from the brains of newborn isogenic BALB/c mice were inoculated with Rocio virus on the 7 th day of culture, and the development of cytopathogenic effects was monitored. The infection was confirmed via immunocytochemistry (anti-ROCV), while viral replication was quantified in infected primary cultures. The titration method used depended on the infection period. RESULTS: Rocio virus efficiently infected primary cultured neural cells, with the highest viral titer causing cytopathic changes was observed at 2 days post infection. The virus-infected primary culture survived for up to 7 days post infection, and viral load quantitation showed viral replication kinetics compatible with the cell death kinetics of cultures. CONCLUSION: The findings of this study suggest that mouse neural cell primary cultures support Rocio virus replication and could be used as an alternative system for studying Flavivirus infection in the central nervous system.

Experimental Yellow Fever in the Squirrel Monkey (Saimiri spp.): Hematological, Biochemical, and Immunological Findings.

Between 2016 and 2018, Brazil experienced the largest sylvatic epidemic of yellow fever virus (YFV). Despite to the magnitude and rapid spread of the epidemic, little is known about YFV dispersion. The study evaluated whether the squirrel monkey is a good model for yellow fever (YF) studies. Methods: Ten animals were infected with 1 × 106 PFU/mL of YFV, with one negative control. Blood samples were collected daily during the first 7 days and at 10, 20 and 30 days post infection (dpi) for detection of viral load and cytokines by RT-qPCR; measurements of AST, ALT, urea and creatinine were taken; IgM/IgG antibodies were detected by ELISA, and hemagglutination inhibition and neutralization tests were performed. The animals exhibited fever, flushed appearance, vomiting and petechiae, and one animal died. Viremia was detected between 1 and 10 dpi, and IgM/IgG antibodies appeared between 4 and 30 dpi. The levels of AST, ALT and urea increased. The immune responses were characterized by expression of S100 and CD11b cells; endothelial markers (VCAM-1, ICAM-1 and VLA-4), cell death and stress (Lysozyme and iNOS); and pro-inflammatory cytokines (IL-8, TNF-α, and IFN-γ) and anti-inflammatory cytokines (IL-10 and TGF-ß). The squirrel monkeys showed changes similar to those described in humans with YF, and are a good experimental model for the study of YF.

A homemade simulation model improves the impact of e-learning for the practical administration of dental anaesthesia.

INTRODUCTION: A simulation model improves the learning of dental anaesthesia in dental students. This study explored first, the making at home of a dental anaesthesia simulation model by dental students, and second, the impact of that simulation model on the learning of dental students following an online course. We compared the level of knowledge, the level of perception of confidence to perform the basic injection technique (BIT) of dental anaesthesia, and the level of attitude towards e-learning of the BIT between a group of dental students who had an online course with a home-made dental anaesthesia simulation model (HMDASM) and a group of dental students who did not use that model. MATERIALS AND METHODS: A group of participants (n = 28) used the HMDASM to learn the BIT with an e-learning course. Another group of participants (n = 28) followed the same e-learning course, but that group used a lemon to practise the BIT. The two groups answered questionnaires that explored the level of theoretical knowledge on the BIT, the level of perception of confidence to perform the BIT, and the level of attitude towards e-learning of the BIT. Questionnaire scores from each group were compared by a Student's t-test (p ≤ .05). RESULTS: The group that used the HMDASM had a level of knowledge similar to that of the other group (p > .05). The group that used the HMDASM had a level of perception of confidence to perform the BIT and a level of attitude towards online learning of the BIT higher than those of the group that did not use the simulation model (p < .05). CONCLUSION: The use of a HMDASM had a positive effect on dental students following an online course to learn the BIT.

Replication of Rocio virus in primary cultures of mouse neural cells

ABSTRACT Objective This study verified the replication efficiency of the Rocio virus in a primary culture of mouse neural cells. Methods Mixed primary cultures (neurons/glia) obtained from the brains of newborn isogenic BALB/c mice were inoculated with Rocio virus on the 7 th day of culture, and the development of cytopathogenic effects was monitored. The infection was confirmed via immunocytochemistry (anti-ROCV), while viral replication was quantified in infected primary cultures. The titration method used depended on the infection period. Results Rocio virus efficiently infected primary cultured neural cells, with the highest viral titer causing cytopathic changes was observed at 2 days post infection. The virus-infected primary culture survived for up to 7 days post infection, and viral load quantitation showed viral replication kinetics compatible with the cell death kinetics of cultures. Conclusion The findings of this study suggest that mouse neural cell primary cultures support Rocio virus replication and could be used as an alternative system for studying Flavivirus infection in the central nervous system.

Detraining period of the PILATES method on functional capacity of elderly women with type 2 diabetes: A randomized clinical trial.

INTRODUCTION: The aim of this study was to verify the effects of a 4-week detraining period on the functional capacity of elderly women with type-2 diabetes (T2D) after 12 weeks of a PILATES training program. METHODS: Twenty-two individuals with T2D were randomly allocated into two groups: CONTROL (n = 11; 67.5 ± 6.3 years; 154.7 ± 6.1 cm; 73.5 ± 6.1 kg; calorie intake: 1487.5 ± 360.6 kcal/day) and PILATES (n = 11; 65.5 ± 5.5 years; 155.0 ± 4.5 cm; 66.2 ± 5.4 kg; calorie intake: 1289.3 ± 385.0 kcal/day). The PILATES group participated at a 12-week PILATES program at moderate intensity, 3x/week with each session lasting 60-min. The functional capacity was evaluated in the baseline (PRE), after 12-weeks (POST) and 4-week detraining period (4W_DT). The general index of functional capacity (GIFC) was calculated for all participants. RESULTS: In the PILATES group there was a reduction in performance (increased test time) for the GIFC after 4W_DT in relation to POST (p < 0.05), however, GIFC showing maintenance of performance gain in relation to the PRE (p > 0.05) (PRE: 36.0 ± 5.5 s vs. POST: 27.2 ± 4.0 s vs. 4W_DT: 29.0 ± 4.2 s). The CONTROL group had worse performance than the GIFC POST (35.3 ± 4.6 s) and 4W_DT (35.4 ± 4.6 s) when compared to the PILATES group (F = 106.967; np2 = 0.842; p < 0.001). CONCLUSION: A period of 4W_DT was not able to reduce the functional gains of elderly women with T2D after 12 weeks of PILATES training. These results have a practical application for training professionals, enabling better control and planning of training interruptions on the PILATES method for elderly women with T2D.

Pilates training reduces blood pressure in older women with type 2 diabetes: A randomized controlled trial.

INTRODUCTION: The study investigated the effect of 12 weeks of pilates training on the hemodynamic responses of older women with type-2 diabetes (T2D). METHODS: 22 individuals with T2D were randomly allocated into two groups: CONTROL (n = 11; 67.5 ± 6.3 years; 154.7 ± 6.1 cm; 73.5 ± 6.1 kg; calorie intake: 1487.5 ± 360.6 kcal/day) and PILATES (n = 11; 65.5 ± 5.5 years; 155.0 ± 4.5 cm; 66.2 ± 5.4 kg; calorie intake: 1289.3 ± 385.0 kcal/day). The PILATES group executed a 12-week PILATES training program at moderate intensity, 3x/week with each session lasting 60-min. Systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HR), and postprandial blood glucose were assessed at four timepoints: i) baseline; ii) 4th week; iii) 8th week; and iv) 12th week (s) of intervention. Two-way ANOVA for repeated measures and the Pearson's correlation coefficient were adopted. The alpha level was set at 0.05. RESULTS: A time∗group interaction effect was found for SBP (F = 4.206; η2 = 0.17; p = 0.02) and DBP (F = 2.624; η2 = 0.12; p = 0.05) with significant reductions (mmHg) in the 4ths and 8ths in the PILATES (PILATES SBP baseline: 134.9 ± 27.6; 4ths: 112.4 ± 15.7; 8ths: 115.8 ± 18.3; 12ths: 124.3 ± 19.1 vs. CONTROL SBP baseline: 126.5 ± 15.7; 4ths: 126.3 ± 16.2; 8ths: 124.5 ± 13.1; 12ths: 126.3 ± 21.4 | PILATES DBP baseline: 72.9 ± 11.3; 4ths: 65.1 ± 12.2; 8ths: 65.8 ± 12.2; 12ths: 67.6 ± 7.5 vs. CONTROL DBP baseline: 74.6 ± 12.0; 4ths: 73.9 ± 11.5; 8ths: 75.3 ± 11.9; 12ths: 74.5 ± 9.2). CONCLUSION: Four and eight weeks of PILATES training promotes reduction in the SBP and DBP of older women with T2D. The exercises performed in this study were mainly body weight exercises and required a few auxiliary materials, which turns this method of training accessible.

Anal High-risk HPV and Liquid-based Cytology of Immunocompetent Brazilian Women with Genital High-risk HPV / HPV de alto risco e citologia em meio líquido de canal anal de mulheres brasileiras imunocompetentes com HPV genital de alto risco

Abstract Objective The purpose of this study was to compare the frequency of the occurrence of high-risk human papillomavirus (HPV) and abnormal anal cytology in immunocompetent women with and without HPV-induced genital lesions. Methods This analytical cross-sectional, observational study was conducted between July 2017 and December 2018 in a specialized outpatient clinic of a tertiary hospital in Fortaleza, CE. Fifty-seven immunocompetent women with and without genital intraepithelial lesions were assessed; they were divided into two groups: group 1 was comprised of women with HPV-associated genital lesions (n=26), and group 2 was comprised of those without HPV-associated genital lesions (n=31). Samples for liquidbased cytology and high-risk DNA-HPV polymerase chain reaction real-time tests were collected from the cervix and anus. All cases were evaluated using high-resolution anoscopy; biopsies were performed when required. The Fisher exact and chi-squared tests were applied for consolidated data in the contingency table, and the Student ttest and Mann-Whitney U-test for independent variables. Results Anal high-risk HPV infections were more frequent in group 1 (odds ratio [OR], 4.95; 95% confidence interval [CI], 1.34-18.3; p=0.012), along with concomitant highrisk HPV infections in the uterine cervix and the anus (OR 18.8; 95% CI, 2.20-160; p<0.001). The incidence of high-risk cervical HPV infection was associated with highrisk anal HPV infection (OR, 4.95; 95% CI, 1.34-18.3; p=0.012). There was no statistical difference concerning abnormal anal cytology or anoscopy between the groups, and no anal intraepithelial lesion was found in either group. Conclusion Immunocompetent women with HPV-associated genital lesions and high-risk cervical HPV were more likely to have high-risk anal HPV.

Resumo Objetivo O objetivo deste estudo foi comparar a frequência de papilomavírus humano (HPV) de alto risco e citologia anal anormal em mulheres imunocompetentes com e sem lesões genitais induzidas por HPV. Métodos Este estudo transversal analítico e observacional foi realizado entre julho de 2017 e dezembro de 2018 em um ambulatório especializado de um hospital terciário em Fortaleza, CE. Cinquenta e sete mulheres imunocompetentes com e sem lesões intraepiteliais genitais foram avaliadas. Foram divididas em dois grupos: grupo 1, composto por mulheres com lesões genitais associadas ao HPV (n=26) e grupo 2, composto pormulheres sem lesões genitais associadas ao HPV (n=31). Amostras para citologia em meio líquido e testes de reação em cadeia da polimerase em tempo real para DNA-HPV de alto risco foram coletadas do colo do útero e do ânus. Todos os casos foram avaliados por anuscopia de alta resolução; sendo realizada biópsia quando necessária. Os testes exatos de Fisher e qui-quadrado foram aplicados para dados consolidados na tabela de contingência; o teste t de Student e o teste U de Mann-Whitney foram aplicados para variáveis independentes. Resultados As infecções anais por HPV de alto risco forammais frequentes no grupo 1 (razão de chances [RC], 4,95; intervalo de confiança [IC] de 95%, 1,34-18,3; p=0,012), assim como infecções concomitantes por HPV de alto risco em colo uterino e ânus (RC 18,8; IC de 95%, 2,20-160; p<0,001). A incidência de infecção de HPV cervical de alto risco foi associada à infecção de HPV anal de alto risco (RC, 4,95; IC de 95%, 1,34-18,3; p=0,012). Não houve diferença estatística em relação à citologia anal anormal ou anuscopia entre os grupos, e não houve caso de lesão intraepitelial anal em nenhum dos grupos. Conclusão Mulheres imunocompetentes com lesões genitais associadas ao HPV e com HPV cervical de alto risco foram mais propensas a ter HPV anal de alto risco.

Anal High-risk HPV and Liquid-based Cytology of Immunocompetent Brazilian Women with Genital High-risk HPV.

OBJECTIVE: The purpose of this study was to compare the frequency of the occurrence of high-risk human papillomavirus (HPV) and abnormal anal cytology in immunocompetent women with and without HPV-induced genital lesions. METHODS: This analytical cross-sectional, observational study was conducted between July 2017 and December 2018 in a specialized outpatient clinic of a tertiary hospital in Fortaleza, CE. Fifty-seven immunocompetent women with and without genital intraepithelial lesions were assessed; they were divided into two groups: group 1 was comprised of women with HPV-associated genital lesions (n = 26), and group 2 was comprised of those without HPV-associated genital lesions (n = 31). Samples for liquid-based cytology and high-risk DNA-HPV polymerase chain reaction real-time tests were collected from the cervix and anus. All cases were evaluated using high-resolution anoscopy; biopsies were performed when required. The Fisher exact and chi-squared tests were applied for consolidated data in the contingency table, and the Student t-test and Mann-Whitney U-test for independent variables. RESULTS: Anal high-risk HPV infections were more frequent in group 1 (odds ratio [OR], 4.95; 95% confidence interval [CI], 1.34-18.3; p = 0.012), along with concomitant high-risk HPV infections in the uterine cervix and the anus (OR 18.8; 95% CI, 2.20-160; p < 0.001). The incidence of high-risk cervical HPV infection was associated with high-risk anal HPV infection (OR, 4.95; 95% CI, 1.34-18.3; p = 0.012). There was no statistical difference concerning abnormal anal cytology or anoscopy between the groups, and no anal intraepithelial lesion was found in either group. CONCLUSION: Immunocompetent women with HPV-associated genital lesions and high-risk cervical HPV were more likely to have high-risk anal HPV.

OBJETIVO: O objetivo deste estudo foi comparar a frequência de papilomavírus humano (HPV) de alto risco e citologia anal anormal em mulheres imunocompetentes com e sem lesões genitais induzidas por HPV. MéTODOS: Este estudo transversal analítico e observacional foi realizado entre julho de 2017 e dezembro de 2018 em um ambulatório especializado de um hospital terciário em Fortaleza, CE. Cinquenta e sete mulheres imunocompetentes com e sem lesões intraepiteliais genitais foram avaliadas. Foram divididas em dois grupos: grupo 1, composto por mulheres com lesões genitais associadas ao HPV (n = 26) e grupo 2, composto por mulheres sem lesões genitais associadas ao HPV (n = 31). Amostras para citologia em meio líquido e testes de reação em cadeia da polimerase em tempo real para DNA-HPV de alto risco foram coletadas do colo do útero e do ânus. Todos os casos foram avaliados por anuscopia de alta resolução; sendo realizada biópsia quando necessária. Os testes exatos de Fisher e qui-quadrado foram aplicados para dados consolidados na tabela de contingência; o teste t de Student e o teste U de Mann-Whitney foram aplicados para variáveis independentes. RESULTADOS: As infecções anais por HPV de alto risco foram mais frequentes no grupo 1 (razão de chances [RC], 4,95; intervalo de confiança [IC] de 95%, 1,34­18,3; p = 0,012), assim como infecções concomitantes por HPV de alto risco em colo uterino e ânus (RC 18,8; IC de 95%, 2,20­160; p < 0,001). A incidência de infecção de HPV cervical de alto risco foi associada à infecção de HPV anal de alto risco (RC, 4,95; IC de 95%, 1,34­18,3; p = 0,012). Não houve diferença estatística em relação à citologia anal anormal ou anuscopia entre os grupos, e não houve caso de lesão intraepitelial anal em nenhum dos grupos. CONCLUSãO: Mulheres imunocompetentes com lesões genitais associadas ao HPV e com HPV cervical de alto risco foram mais propensas a ter HPV anal de alto risco.

Onde os brasileiros obtiveram os medicamentos para o diabetes na pandemia de COVID-19? Resultados da DIABETESvid / Where did Brazilians get their diabetes drugs during the COVID-19 pandemic? DIABETESvid results

O acesso aos medicamentos para o diabetes é fundamental para o controle da doença. Contudo, o distanciamento social na pandemia de COVID-19 pode ter limitado a provisão de medicamentos e insumos. Assim, o objetivo deste estudo foi analisar as fontes de obtenção dos medicamentos para o diabetes na pandemia de COVID-19 no Brasil. Os dados são oriundos da pesquisa DIABETESvid e nesta análise considerou-se a amostra de conveniência de 1608 participantes que responderam ao questionário divulgado em mídias sociais de sociedades científicas relacionadas ao diabetes. Trata-se de um estudo transversal, conduzido na forma de websurvey, no período de 1 de setembro a 19 de outubro de 2020. O desfecho analisado foi as fontes de obtenção dos medicamentos para o diabetes categorizadas em farmácias do Sistema Único de Saúde, farmácias do programa "Aqui Tem Farmácia Popular", bem como, farmácias e drogarias privadas e outras fontes. A maioria dos participantes autorreferiu diagnóstico de diabetes mellitus tipo 1 (49,8%), usava insulina (61,9%) e possuía plano privado de saúde (68,7%). As farmácias e drogarias privadas e outras fontes foram os principais locais de provisão dos medicamentos para o diabetes (47,5%). Os participantes que residiam na região Centro-Oeste do país apresentaram menor frequência de provisão em farmácias do programa "Aqui tem Farmácia Popular" (0,57; IC95% 0,36-0,92). Verificou-se, na amostra estudada, maior frequência de provisão dos medicamentos para o diabetes em farmácias e drogarias privadas e outras fontes com redução na frequência em farmácias públicas na pandemia de COVID-19 no Brasil.

Access to diabetes medications is critical to disease control. However, social distancing in the COVID-19 pandemic may have limited the provision of medicines and supplies. Thus, the objective of this study was to analyze the sources of obtaining diabetes drugs in the COVID-19 pandemic in Brazil. The data came from the DIABETESvid survey, and this analysis considered a convenience sample of 1608 participants who responded to the questionnaire published on social media of scientific societies related to diabetes. This is a cross-sectional study, conducted in the form of a web survey, from September 1 to October 19, 2020. The outcome analyzed was the sources for obtaining diabetes drugs categorized in pharmacies of the "Sistema Único de Saúde", pharmacies of the "Aqui tem Farmácia Popular" program, as well as private pharmacies and drugstores and other sources. Most participants self-reported a diagnosis of type 1 diabetes mellitus (49.8%), used insulin (61.9%), and had a private health plan (68.7%). Private pharmacies and drugstores and other sources were the main places where medicines for diabetes were supplied (47.5%). Participants residing in the Midwest region of the country had a lower frequency of supply in pharmacies in the "Aqui tem Farmácia Popular" program (0.57; 95%CI 0.36-0.92). In the studied sample, there was a higher frequency of supply of diabetes drugs in private pharmacies and drugstores and other sources with a reduction in frequency in public pharmacies during the COVID-19 pandemic in Brazil.

Diabetes self-care practices and resilience in the Brazilian COVID-19 pandemic: results of a web survey: DIABETESvid.

BACKGROUND: The world guidance on the measures of social distancing for prevention of COVID-19 has changed the daily habits of great part of the population, and this could influence the care and resilience with diabetes during situations of adversity. This study aimed at assessing the characteristics of diabetic individuals and self-care practices and resilience with diabetes in the context of the COVID-19 pandemic in Brazil. METHODS: This is a cross-sectional web survey study carried out among adults with diabetes, in which a structured 43-item questionnaire was conducted on the REDCap plataform, including the Diabetes Self-Care Activities Questionnaire and Connor-Davidson Resilience Scale, to measure socio-demographic and clinical characteristics. The web survey was disseminated through the main social media and data were collected from September 1st to October 19th, 2020. Data analysis was performed according to type of diabetes mellitus (DM) and at a significance level of 5% (p < 0.05). RESULTS: Of the 1633 participants, 67.5% were women, 43.2% aged between 35 and 59 years old, 68.0% lived in the south-eastern region of Brazil, 57.1% had a high education level, 49% reported to have DM1 and 140 participants reported to have had COVID-19. Diabetes care mostly involved the use of medications (93%), whereas the least used ones were physical activity (24.6%) and examination of the shoes (35.7%). About 40% of the participants reported to be followed up by telemedicine, 61.5% monitored the glycaemic levels, 61.2% followed a healthy diet and 43.4% left home only to go to the supermarket and drugstore. The mean resilience was 25.4 (SD = 7.7). CONCLUSIONS: In Brazil, individuals with diabetes followed social distancing and maintained their medication treatment for DM. However, practice of physical activity and foot examination was little followed by the participants, who also had a low level of resilience. These findings showed the importance of patient follow-up in the healthcare services, meaning that telemedicine should be improved and support provided for adaptation in view of the therapeutic setbacks.

A new Brazilian regional scenario of Type 2 diabetes risk in the next ten years.

AIMS: According to a recent national diabetes screening performed by our group in 2018, 18.4% of the Brazilians were found to have high blood glucose. The objective of the present study was to estimate the risk of developing type 2 DM (T2DM) in the next ten years in Brazilian population. METHODS: A cross-sectional study was carried out in community pharmacies across Brazil, in 2018, where pharmacists applied the FINDRISC questionnaire to estimate the population's risk of developing T2DM within a ten-year period. RESULTS: The study included 977 pharmacists from 345 municipalities distributed across the five geographical regions of Brazil. Of the 17,580 people evaluated, the South region was found to have the highest frequency (59.6%) among people at very low and/or low risk of developing T2DM, while the North region, the most underserved, presented the highest and/or very highest T2DM risk (24.1%). The factors that mostly and importantly impacted these regional differences were body mass index; the highest daily consumption of vegetables and fruits; history of high blood glucose and family history of T1DM/T2DM. CONCLUSION: These results showed an impressive change of direction concerning diabetes numbers between the most underserved region in public health care and one of the most developed and best organized regions concerning health assistance, the North and the South, respectively.

Mechanisms for sperm mitochondrial removal in embryos.

BACKGROUND: Different animal species have different characteristics regarding the transmission of mitochondrial DNA. While some species have biparental mitochondrial inheritance, others have developed pathways to remove paternal mtDNA. These pathways guarantee the uniparental mitochondrial inheritance, so far well known in mammals, avoiding heteroplasmy, which may have the potential to cause certain mitochondrial diseases in the offspring. SCOPE OF REVIEW: This review aims to address the main mechanisms that involve mitochondrial degradation in different animal species, as well as to describe what is present in the literature on the mechanisms involved in mitochondrial inheritance. MAJOR CONCLUSIONS: Two theories are proposed to explain the uniparental inheritance of mtDNA: (i) active degradation, where mechanisms for paternal mitochondrial DNA elimination involve mitochondrial degradation pathway by autophagy and, in some species, may also involve the endocytic degradation pathway; and (ii) passive dilution, where the paternal mitochondria are diluted in the cells of the embryo according to cell division, until becoming undetectable. GENERAL SIGNIFICANCE: This work brings a wide review of the already published evidence on mitochondrial inheritance in the animal kingdom and the possible mechanisms to mtDNA transmission already described in literature.

Diversity of variant alleles encoding Kidd, Duffy, and Kell antigens in individuals with sickle cell disease using whole genome sequencing data from the NHLBI TOPMed Program.

BACKGROUND: Genetic variants in the SLC14A1, ACKR1, and KEL genes, which encode Kidd, Duffy, and Kell red blood cell antigens, respectively, may result in weakened expression of antigens or a null phenotype. These variants are of particular interest to individuals with sickle cell disease (SCD), who frequently undergo chronic transfusion therapy with antigen-matched units. The goal was to describe the diversity and the frequency of variants in SLC14A1, ACKR1, and KEL genes among individuals with SCD using whole genome sequencing (WGS) data. STUDY DESIGN AND METHODS: Two large SCD cohorts were studied: the Recipient Epidemiology and Donor Evaluation Study III (REDS-III) (n = 2634) and the Outcome Modifying Gene in SCD (OMG) (n = 640). Most of the studied individuals were of mixed origin. WGS was performed as part of the National Heart, Lung, and Blood Institute's Trans-Omics for Precision Medicine (TOPMed) program. RESULTS: In SLC14A1, variants included four encoding a weak Jka phenotype and five null alleles (JKnull ). JKA*01N.09 was the most common JKnull . One possible JKnull mutation was novel: c.812G>T. In ACKR1, identified variants included two that predicted Fyx (FY*X) and one corresponding to the c.-67T>C GATA mutation. The c.-67T>C mutation was associated with FY*A (FY*01N.01) in four participants. FY*X was identified in 49 individuals. In KEL, identified variants included three null alleles (KEL*02N.17, KEL*02N.26, and KEL*02N.04) and one allele predicting Kmod phenotype, all in heterozygosity. CONCLUSIONS: We described the diversity and distribution of SLC14A1, ACKR1, and KEL variants in two large SCD cohorts, comprising mostly individuals of mixed ancestry. This information may be useful for planning the transfusion support of patients with SCD.

Competency matrix related to Covid-19: contributions from students and residents / Matriz de competência relacionada à Covid-19: contribuições de estudantes e residentes

Abstract: Introduction: Competency-based education has been discussed under the new perspective of the COVID-19 pandemic. The need for social distancing had effects on student activities and educational institutions needed to reflect and redesign the teaching-learning process. It was necessary to incorporate contents related to COVID-19 into the medical training programs and to adapt the teaching tools. Therefore, it is necessary that training be mediated by a collective construction of the competency matrix with the participation of the subjects involved in the process. Objective: This project aims to present the reconstruction of the curriculum in cardiology by observing the collaboration of the students and residents. Method: Exploratory study, involving 13 undergraduate medical students and eight medical residents from the institution's cardiology program, who comprised the "Students and residents' panel". Consensus was reached among the panelists through the Delphi methodology. The first version of the matrix was prepared by the research team and sent, together with the FICF, containing 16 items aimed at COVID-19 content to be achieved at the cardiology internship and residency. The participants attributed their degree of agreement for each proposed item and after returning them, the data were tabulated, stored in an Excel spreadsheet and percentages for each item were calculated and presented in a descriptive manner. Result: The panel consisted of 19 participants. Of the 21 invited, 02 participants did not answer the online questionnaire and were excluded. The initial version of the matrix reached a consensus in the first round, with the lowest agreement rate being 71% in the internship matrix and 89.5% in the residency matrix. Both matrices showed high levels of agreement. There were no disagreements or suggestions for new items for the matrix. Conclusion: The students and residents' engagement in the pedagogical process may contribute to a better understanding of the competencies for their training and bring sustainable changes to the curriculum.

Resumo: Introdução: A educação baseada em competências vem sendo discutida sob a nova perspectiva da pandemia da Covid-19. A necessidade do distanciamento social trouxe repercussão nas atividades estudantis, e as instituições de ensino precisaram refletir e redesenhar o processo de ensino-aprendizagem. Houve a necessidade de inserção de conteúdos relacionados à Covid-19 nos programas de capacitação médica e a adaptação das ferramentas pedagógicas. Portanto, é necessário que a formação seja mediada por uma construção coletiva da matriz de competências com participação dos sujeitos envolvidos no processo. Objetivo: Este projeto visa apresentar a reconstrução da matriz de competências em cardiologia observando a colaboração do estudante e residente. Método: Trata-se de um estudo exploratório envolvendo 13 graduandos do curso de Medicina e oito residentes médicos do programa de cardiologia da instituição, os quais compuseram o "Painel de estudantes e residentes". Obteve-se o consenso entre os painelistas por meio da metodologia Delphi. A primeira versão da matriz foi elaborada pela equipe de pesquisa e enviada, com o TCLE, contendo 16 itens voltados para conteúdos sobre a Covid-19 a serem alcançados no internato e na residência em cardiologia. Os participantes atribuíram o grau de concordância a cada item proposto, sendo os dados apresentados de forma descritiva e com proporção de concordância. Resultados: O painel final foi formado por 19 integrantes. Dentre os 21 convidados, dois foram excluídos por não responderem ao questionário. A versão inicial da matriz obteve consenso na primeira rodada, sendo a menor taxa de concordância de 71% na matriz do internato e 89,5% na matriz da residência. Ambas as matrizes apresentaram índices elevados de concordância. Não houve discordâncias nem sugestões de novos itens para a matriz. Conclusão: O engajamento de estudantes e residentes no processo pedagógico pode contribuir para melhor compreensão sobre as competências para sua formação e promover mudanças sustentáveis no currículo.

Prevalence of people at risk of developing type 2 diabetes mellitus and the involvement of community pharmacies in a national screening campaign: a pioneer action in Brazil.

BACKGROUND: Brazil is one of top 10 countries with the highest number of people with diabetes mellitus (DM), affecting 16.8 million peoples. It is estimated that 7.7 million people (20-79 years) in the country have not yet been diagnosed, representing an under-diagnosis rate of 46.0%. Herein we aimed to screen people for high blood glucose or risk for developing type 2 DM (T2DM) through community pharmacies in Brazil. METHODS: A cross-sectional study was carried out in November 2018, involving 977 pharmacists from 345 municipalities in Brazil. The study evaluated people between 20 and 79 years old without a previous diagnosis of DM. Glycemia was considered high when its value was ≥ 100 mg/dL fasting and ≥ 140 mg/dL in a casual feeding state. The FINDRISC (Finnish Diabetes Risk Score) was used to estimate the risk for developing T2DM. The prevalence of high blood glucose was estimated and the associated factors were obtained using Poisson's multivariate analysis with robust variance. RESULTS: During the national screening campaign, 17,580 people were tested with the majority of the consultations (78.2%) being carried out in private pharmacies. The population was composed mainly of women (59.5%) and people aged between 20 and 45 years (47.9%). The frequency of participants with high blood glucose was 18.4% (95% CI 17.9-19.0). Considering the FINDRISC, 22.7% of people had a high or very high risk for T2DM. The risk factors associated with high blood glucose were: Body Mass Index > 25 kg/m2, abdominal circumference > 94 cm for men and > 80 cm for women; education level below 15 years of study, no daily intake of vegetables and fruits; previous diagnosis of arterial hypertension; history of high blood glucose and family history of DM. CONCLUSIONS: This is the largest screening study that evaluated the frequency of high blood glucose and its associated factors in a population without a previous diagnosis ever performed in community pharmacies in Brazil. These results may help to improve public health policies and reinforce the role of pharmacists in screening and education actions aimed at this undiagnosed population in a continent-size country such as Brazil.

Pilates Method Training: Functional and Blood Glucose Responses of Older Women With Type 2 Diabetes.

Melo, KCB, Araújo, FdS, Cordeiro Júnior, CCM, de Andrade, KTP, and Moreira, SR. Pilates method training: Functional and blood glucose responses of older women with type 2 diabetes. J Strength Cond Res 34(4): 1001-1007, 2020-The objective of this study was to investigate the effect of 12 weeks of the Pilates method on the functional capacity (FC) and glycemic control of older women with type 2 diabetes (T2D). Twenty-two women with T2D were randomized into control (CONTROL: 67.5 ± 6.3 years; 154.7 ± 6.1 cm; 73.5 ± 6.1 kg) and Pilates (PILATES: 65.5 ± 5.5 years; 155.0 ± 4.5 cm; 66.2 ± 5.4 kg) groups, which held sessions of 60 minutes at a frequency of 3 times per week during 12 weeks. Blood glucose was measured before and after sessions in PILATES, as well as in moments of pre, rest, 4, 8, and 12 weeks of the PILATES and CONTROL interventions. The glycated hemoglobin (HbA1c) level before and after 12 weeks of the intervention was evaluated. The general index of the FC (GIFC) was obtained through a battery of tests for older patients with T2D. Analysis of variance detected differences in the GIFC for PILATES vs. CONTROL, respectively, in 4 weeks (30.3 ± 4.6 vs. 34.8 ± 4.9 seconds; p < 0.05), 8 weeks (29.2 ± 4.5 vs. 34.6 ± 4.9 seconds; p < 0.05), and 12 weeks (27.2 ± 4.0 vs. 35.3 ± 4.6 seconds; p < 0.05). PILATES presented a difference in postprandial glycemia pre- vs. 4 and 12 weeks (246.1 ± 58.5 vs. 219.9 ± 59.9 and 207.6 ± 49.1 mg·dl, respectively; p < 0.05), as well as in HbA1c pre- vs. 12 weeks (7.8 ± 1.0 vs. 6.7 ± 0.6%, respectively; p < 0.05). Differences in postprandial glycemia (p < 0.05) were found in PILATES before vs. after sessions, respectively, of 1st-12th (217.1 ± 49.1 vs. 157.9 ± 55.7 mg·dl), 13th-24th (204.5 ± 44.7 vs. 146.3 ± 44.5 mg·dl), and 25th-36th (214.3 ± 40.4 vs. 152.7 ± 52.0 mg·dl). A correlation between postprandial glycemia and GIFC after 12 weeks was detected (r = 0.37; p = 0.04). It is concluded that 12 weeks of the Pilates method induces improvement and relationship in the FC and glycemic control in older women with T2D.