The Role of the p38 MAPK Signaling Pathway in High Glucose-Induced Epithelial-Mesenchymal Transition of Cultured Human Renal Tubular Epithelial Cells

Epithelial-mesenchymal transition of tubular epithelial cells, which is characterized by a loss of epithelial cell characteristics and a gain of ECM-producing myofibroblast characteristics, is an essential mechanism that is involved in tubulointerstitial fibrosis, an important component of the renal injury that is associated with diabetic nephropathy. Under diabetic conditions, p38 MAPK activation has been reported in glomeruli and mesangial cells; however, studies on p38 MAPK in TECs are lacking. In this study, the role of p38 MAPK in AP-1 activation and in the EMT in the human proximal tubular epithelial cell line (HK-2) under high glucose concentration conditions is investigated.A vector for small interfering RNA that targets p38 MAPK was constructed; the cells were then either transfected with p38 siRNA or pretreated with a chemical inhibitor of AP-1 and incubated with low glucose plus TGF-β1 or high glucose for 48 h. Cells that were not transfected or pretreated and were exposed to low glucose with or without TGF-β1 or high glucose for 48 h were considered to be the controls. We found that high glucose induced an increase in TGF-β1. And high glucose-induced p38 MAPK activation was inhibited by p38 siRNA (P<0.05). A significant decline in E-cadherin and CK expression and a notable increase in vimentin and α-SMA were detected when exposed to low glucose with TGF-β1 or high glucose, and a significant raise of secreted fibronectin were detected when exposed to high glucose; whereas these changes were reversed when the cells were treated with p38 siRNA or AP-1 inhibitor (P<0.05). AP-1 activity levels and Snail expression were up-regulated under high glucose conditions but were markedly down-regulated through knockdown of p38 MAPK with p38 siRNA or pretreatment with AP-1 inhibitor (P<0.05).This study suggests that p38 MAPK may play an important role in the high glucose-induced EMT by activating AP-1 in tubular epithelial cells

A global experiment on motivating social distancing during the COVID-19 pandemic

Significance Communicating in ways that motivate engagement in social distancing remains a critical global public health priority during the COVID-19 pandemic. This study tested motivational qualities of messages about social distancing (those that promoted choice and agency vs. those that were forceful and shaming) in 25,718 people in 89 countries. The autonomy-supportive message decreased feelings of defying social distancing recommendations relative to the controlling message, and the controlling message increased controlled motivation, a less effective form of motivation, relative to no message. Message type did not impact intentions to socially distance, but people’s existing motivations were related to intentions. Findings were generalizable across a geographically diverse sample and may inform public health communication strategies in this and future global health emergencies. Abstract Finding communication strategies that effectively motivate social distancing continues to be a global public health priority during the COVID-19 pandemic. This cross-country, preregistered experiment (n = 25,718 from 89 countries) tested hypotheses concerning generalizable positive and negative outcomes of social distancing messages that promoted personal agency and reflective choices (i.e., an autonomy-supportive message) or were restrictive and shaming (i.e., a controlling message) compared with no message at all. Results partially supported experimental hypotheses in that the controlling message increased controlled motivation (a poorly internalized form of motivation relying on shame, guilt, and fear of social consequences) relative to no message. On the other hand, the autonomy-supportive message lowered feelings of defiance compared with the controlling message, but the controlling message did not differ from receiving no message at all. Unexpectedly, messages did not influence autonomous motivation (a highly internalized form of motivation relying on one’s core values) or behavioral intentions. Results supported hypothesized associations between people’s existing autonomous and controlled motivations and self-reported behavioral intentions to engage in social distancing. Controlled motivation was associated with more defiance and less long-term behavioral intention to engage in social distancing, whereas autonomous motivation was associated with less defiance and more short- and long-term intentions to social distance. Overall, this work highlights the potential harm of using shaming and pressuring language in public health communication, with implications for the current and future global health challenges

Óbito neonatal precoce e tardio: perfil das mães e dos recém-nascidos

O objetivo do estudo foi analisar o perfil das mães e dos recém-nascidos que foram a óbito no período neonatal precocee tardio. Estudo descritivo-exploratório de corte transversal, que utilizou dados secundários obtidos dos sistemas deinformação de mortalidade, de nascidos vivos e prontuários hospitalares de mães residentes em Cuiabá (MT), quederam à luz no ano de 2010. Foram estudados 77 óbitos, sendo que 72,7% ocorreram no período neonatal precoce.Os coeficientes de mortalidade neonatal, precoce e tardio foram, respectivamente, 8,2, 6,0 e 2,2/1.000 nascidos vivos.Não se constatou diferença no perfil materno e dos recém-nascidos que foram a óbito no período neonatal precoceou tardio. Características que prevaleceram entre os óbitos neonatais foram: realização de menos de 7 consultaspré-natais, prematuridade, baixo peso e Apgar menor que 7 no 1º minuto. Tais resultados indicam a necessidade deinvestimentos, especialmente na melhoria da qualidade da assistência pré-natal no município

A prática baseada em evidência no contexto da Atenção Primária à Saúde

A prática baseada em evidência agrega o melhor conhecimento científico, com a experiência clínica do profissional e a escolha do paciente, resultando em uma maior resolutividade na assistência em saúde. O objetivo do estudo foi analisar a prática baseada em evidência dos profissionais das equipes com Estratégia Saúde da Família em um município de Santa Catarina. Trata-se de um estudo quantitativo, realizado por meio de questionários com 112 profissionais de saúde. Os resultados apontaram que eles consideram a prática baseada em evidência fundamental, contudo, em suas ações, ela está mais centrada na experiência clínica. Outrossim, não se sentem plenamente capacitados para realizar a busca de evidências científicas, destacando o pouco conhecimento e habilidades em pesquisa. Além disso, ressaltam a alta demanda de atendimentos, escasso domínio de língua estrangeira e falta de apoio da gestão como dificultadores. Conclui-se que os profissionais da atenção primária precisam se aprimorar para o desenvolvimento da prática baseada em evidência, sendo que isso ultrapassa a sua vontade individual, ficando também ao encargo das instituições formadoras e dos serviços de saúde.Evidence-based practice brings together the best scientific knowledge with the professional’s clinical experience and the patient’s choice, resulting in a higher resoluteness in health care. The research was carried out aiming at analyzing the evidence-based practice of professionals from Family Health Strategy teams, in a city in the state of Santa Catarina. It was a quantitative study, developed through questionnaires with 112 health professionals. The results showed that professionals consider evidence-based practice essential; however, such practice is more focused on clinical experience in their actions. Moreover, they do not feel completely qualified to search for scientific evidence, highlighting their little knowledge and abilities on research. In addition, they emphasized that applying evidence-based practice is even more difficult because of high demand for care, lack of foreign language skills and lack of management support. As a conclusion, primary care professionals need some improvement for the development of evidencebased practice, which doesn´t only depend on their individual willingness, but it is also a responsibility of educational institutions and health services.info:eu-repo/semantics/publishedVersio