Is a short-stage protocol during an incremental exercise test reliable for heart rate variability threshold analysis?

Aim: Heart rate variability threshold (HRVT) is a valid method to determine parasympathetic depression during an incremental exercise test (IET). However, HRVT is usually assessed using the last 60s of each 180s stage of an IET, resulting in longer and demotivating tests. This study aimed to evaluate the agreement of HRVT analysis adopting the first and second minute of R-R interval (iRR) segment comparatively to a standard third-minute segment obtained at each 3-min stage on IET. Methods: Seventeen young male subjects (22.2 ± 3.1 years; 23.4 ± 2.3 kg/m2) underwent IET on a cycle ergometer. HRVT was considered the load corresponding to the point of stabilization of the SD1 index (HRVTV), or the first load with SD1 value < 3ms (HRVT<3), both assessed by the 1st (HRVT1V, HRVT1<3), 2nd (HRVT2V, HRVT2<3) and standard 3rd (HRVT3V, HRVT3<3) 60s iRR segment analyzed at each stage of IET. Agreement and reliability were assessed by the Bland-Altman analysis and the intraclass correlation coefficient (ICC), respectively. Results: High reliability and non-significant bias were observed considering HRVT1V vs HRVT3V (ICC = 0.92; p = 0.18) or HRVT2V vs HRVT3V (ICC = 0.94; p = 0.99). However, lower reliability was observed for HRVT1<3 vs HRVT3<3 (ICC = 0.79; p = 0.75) and for HRVT2<3 vs HRVT3<3 (ICC = 0.91; p = 0.33). Conclusion: HRVT can be similarly assessed by the 1st, 2nd or 3rd 60 seconds iRR segment, mainly when assessed by a visual method

The interactions between hemostasis and resistance training: a review

Physical inactivity is considered a risk factor for cardiovascular disease and is strongly associated with changes in arterial structure. Regular physical activity and exercise contributes to the prevention of coronary artery disease. Therefore, cardiovascular and resistance training improve hemostatic parameters and promote a less thrombotic blood profile. This review highlights the studies, mechanisms, and outcomes relating to the effectiveness of resistance training on the process of hemostasis. The Pubmed, Scopus, Medline, Scielo, Lilacs, Ibecs, and Cochrane databases were used to locate the original articles. Seventeen studies were found during the research process. Of these, ten articles were excluded. Those protocols using a high volume of training for young adults showed a greater fibrinolytic response, and training protocols with intensities above 80% of 1 maximum repetition showed an increased platelet activity. In subjects with coronary artery disease, just one session of resistance training resulted in improvement in the fibrinolytic system (tissue plasminogen activator) without raising potential thrombotic markers

Descarte de pilha e baterias no contexto da educação ambiental / Disposal of batteries and batteries in the context of environmental education

Embora haja legislação específica acerca do descarte de pilhas e baterias ainda hoje, no Brasil, esse material é descartado como lixo comum oferecendo desse modo, riscos eminentes contra o meio ambiente e a saúde humana. A legislação brasileira vigente classifica esse material como “resíduos especiais”, no entanto, por falta de conhecimento ou consciência ambiental é lançado diariamente no lixo comum, uma grande quantidade de metais pesados que contaminam o solo e podem  causar doenças graves não somente ao homem como a todos os animais. Esse projeto foi desenvolvido de forma interdisciplinar com o objetivo de promover a sensibilização nos alunos de uma turma de sexto ano do ensino fundamental de uma escola estadual da rede pública do município de Rorainópolis no Estado de Roraima sobre a necessidade da prática da logística reversa e da participação de todos nesse processo. De caráter qualitativo, descritivo e participante a pesquisa alcançou êxito em seus resultando em uma campanha de coletas desse material com três pontos de coleta os quais objetiva-se torná-los permanente e alcançar o apoio da comunidade escolar e da sociedade

Assessing the best time interval between doses in a two-dose vaccination regimen to reduce the number of deaths in an ongoing epidemic of SARS-CoV-2

Funding: This work was supported by the Coordination of Superior Level Staff Improvement (CAPES), Brazil (Finance Code 001 to LSF and FMDM), National Council for Scientific and Technological Development (CNPq), Brazil (grant number: 315854/2020-0 to MEB, 141698/2018-7 to RLPS, 312559/2020-8 to MASMV and 311832/2017-2 to RAK), São Paulo Research Foundation (FAPESP), Brazil (grant #2019/26310-2 and #2017/26770-8 to CF, #2018/26512-1 to OC, #2018/24037-4 to SP, #2018/23984-0 to VS and contract #2016/01343-7 to RAK) and Swiss National Science Foundation (grant PCEFP3_181243 to VS). The Sound Foundation (Massachusetts, USA) provided financial support for the open-source publication of this work via a grant to The University of Oxford (UK) to support the work of members of the COVID-19 International Modeling (CoMo) Consortium. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.Peer reviewedPublisher PD

AVALIAÇÃO PRÉ ANESTÉSICA E SEUS FATORES PRECISOS DENTRO DO BLOCO CIRÚRGICO

The preoperative consultation performed by an anesthetist is a formal evaluation, performed days or weeks before the surgical act. Its function is to identify possible risk factors for complications or to reduce the therapeutic success of the procedure. Nowadays, they are already highly recommended for patients who will undergo elective procedures under anesthetic induction. Objectives: This study aims at a review of the literature on Preoperative Anesthetic Consultation and its effects in the in and postoperative period, highlighting methods of evaluation, practical application, influence on the prognosis of patients and whether there is a direct cost-benefit relationship. Methods: Review articles, case reports and clinical trials were selected based on the use of indexed descriptors in DECS, the inclusion criteria of the research were "Revision", "Human Studies" and "last 10 years". Discussion And Results: In Brazil, the Federal Council of Medicine (CFM), through Resolution No. 802 / 06.1, made pre- anesthetic assessment (APA) indispensable and recommended that it be done before hospital admission. Information should be obtained in this evaluation so that the anesthetist can trace their preoperative conducts, such as medication introduction, and intraoperative through anesthetic and adjuvant therapies, thereby reducing postoperative complications and risks. Some studies have emphasized the importance of requesting complementary tests, showing that in many cases there were unnecessary exams that did not aggregate information pertinent to the pathologies in question. Other studies have demonstrated the direct relationship of a good pre-anesthetic evaluation with good results in the patient's survival, as well as failures in this evaluation, resulting in worse prognosis and greater number of complications.A consulta pré operatória realizada por anestesista é uma avaliação formal, realizada dias ou semanas antes do ato cirurgico. Sua função é de identificar possíveis fatores de risco para complicações ou que possam reduzir o sucesso terapêutico do procedimento. Hoje em dia, já são altamente recomendadas para pacientes que irão se submeter a procedimentos eletivos sob indução anestésica. Objetivos: O estudo visa uma revisão da literatura sobre a Consulta Pré-Operatória Anestésica e os seus efeitos no período peri e pós operatório, destacando métodos de avaliação, aplicação prática, influencia no prognóstico dos pacientes e se há direta relação custo-benefício. Métodos: Foram selecionados artigos de revisão, relato de caso e ensaios clínicos, com base na utilização dos descritores indexados no DECS, os critérios de inclusão da pesquisa foram “Revisão”, “Estudos em Humanos” e “últimos 10 anos”. Discussão e resultados: No Brasil, Conselho Federal de Medicina (CFM), por meio da Resolução n◦1.802/06.1, tornou indispensável a avaliação pré-anestésica (APA) e recomendou que seja feita antes da admissão hospitalar. Deve se obter informações nessa avaliação para que o anestesista possa traçar suas condutas pré operatórias, como introdução de medicamentos, e intra-operatórios por meio de cuidados no plano anestésico e terapias adjuvantes, desse modo, reduzindo complicações e riscos no período pós operatório. Alguns estudos foram destacaram a importância na solicitação de exames complementares, mostrando que em muitos casos haviam exames desnecessários que não agregavam informações pertinentes às patologias em questão. Outros estudos já demonstraram a relação direta de uma boa avaliação pré-anestésica com bons resultados na sobrevida do paciente, assim como falhas nessa avaliação resultando em pior prognóstico e maior número de complicações

Brazil in the face of new SARS-CoV-2 variantsemergencies and challenges in public health

Peer reviewedPublisher PD

Transcriptional profiles of the human pathogenic fungus paracoccidioides brasiliensis in mycelium and yeast cells

This work was supported by MCT, CNPq, CAPES, FUB, UFG, and FUNDECT-MS. PbGenome Network: Alda Maria T. Ferreira, Alessandra Dantas, Alessandra J. Baptista, Alexandre M. Bailão, Ana Lídia Bonato, André C. Amaral, Bruno S. Daher, Camila M. Silva, Christiane S. Costa, Clayton L. Borges, Cléber O. Soares, Cristina M. Junta, Daniel A. S. Anjos, Edans F. O. Sandes, Eduardo A. Donadi, Elza T. Sakamoto-Hojo, Flábio R. Araújo, Flávia C. Albuquerque, Gina C. Oliveira, João Ricardo M. Almeida, Juliana C. Oliveira, Kláudia G. Jorge, Larissa Fernandes, Lorena S. Derengowski, Luís Artur M. Bataus, Marcus A. M. Araújo, Marcus K. Inoue, Marlene T. De-Souza, Mauro F. Almeida, Nádia S. Parachin, Nadya S. Castro, Odair P. Martins, Patrícia L. N. Costa, Paula Sandrin-Garcia, Renata B. A. Soares, Stephano S. Mello, and Viviane C. B. ReisParacoccidioides brasiliensis is the causative agent of paracoccidioidomycosis, a disease that affects 10 million individuals in Latin America. This report depicts the results of the analysis of 6,022 assembled groups from mycelium and yeast phase expressed sequence tags, covering about 80% of the estimated genome of this dimorphic, thermo-regulated fungus. The data provide a comprehensive view of the fungal metabolism, including overexpressed transcripts, stage-specific genes, and also those that are up- or down-regulated as assessed by in silico electronic subtraction and cDNA microarrays. Also, a significant differential expression pattern in mycelium and yeast cells was detected, which was confirmed by Northern blot analysis, providing insights into differential metabolic adaptations. The overall transcriptome analysis provided information about sequences related to the cell cycle, stress response, drug resistance, and signal transduction pathways of the pathogen. Novel P. brasiliensis genes have been identified, probably corresponding to proteins that should be addressed as virulence factor candidates and potential new drug targets

Pervasive gaps in Amazonian ecological research

Biodiversity loss is one of the main challenges of our time,1,2 and attempts to address it require a clear un derstanding of how ecological communities respond to environmental change across time and space.3,4 While the increasing availability of global databases on ecological communities has advanced our knowledge of biodiversity sensitivity to environmental changes,5–7 vast areas of the tropics remain understudied.8–11 In the American tropics, Amazonia stands out as the world’s most diverse rainforest and the primary source of Neotropical biodiversity,12 but it remains among the least known forests in America and is often underrepre sented in biodiversity databases.13–15 To worsen this situation, human-induced modifications16,17 may elim inate pieces of the Amazon’s biodiversity puzzle before we can use them to understand how ecological com munities are responding. To increase generalization and applicability of biodiversity knowledge,18,19 it is thus crucial to reduce biases in ecological research, particularly in regions projected to face the most pronounced environmental changes. We integrate ecological community metadata of 7,694 sampling sites for multiple or ganism groups in a machine learning model framework to map the research probability across the Brazilian Amazonia, while identifying the region’s vulnerability to environmental change. 15%–18% of the most ne glected areas in ecological research are expected to experience severe climate or land use changes by 2050. This means that unless we take immediate action, we will not be able to establish their current status, much less monitor how it is changing and what is being lostinfo:eu-repo/semantics/publishedVersio

Análise da eficácia do uso terapêutico da trimetazidina nas principais síndromes coronarianas agudas

A injúria de reperfusão, ou isquemia, é um mecanismo fisiopatológico que ocorre nas etiopatogenias do miocárdio, como na angina instável. Assim, são utilizados fármacos adjuvantes citoprotetores, como a trimetazidina (TMZ), que visam à diminuição do tempo de hospitalização e melhora na função cardíaca com ação profilática contra essa lesão. No entanto, apesar dos seus potenciais benefícios no tratamento da síndrome coronariana aguda, ainda não está clara a sua eficácia em relação a outras terapias disponíveis. Nesse sentido, o objetivo do estudo é analisar a eficácia do uso terapêutico da trimetazidina nas principais síndromes coronarianas agudas. Foi realizada uma revisão sistemática usando as bases de dados PubMed, Cochrane Library e Embase. Um total de 3 estudos foi incluído na análise. Os resultados mostraram que a terapia com trimetazidina reduziu significativamente a incidência de eventos cardíacos adversos maiores (ECAM) (OR = 0,33, IC 95% 0,15-0,75, p = 0,007), menor dano miocárdico (p &lt; 0,05) e fração de ejeção ventricular esquerda mais elevada e menos eventos adversos em comparação com o grupo placebo (p &lt; 0,05). Não foram observadas diferenças significativas entre os grupos de trimetazidina e controle em termos de mortalidade por todas as causas, mortalidade cardiovascular ou incidência de eventos adversos. Os resultados deste estudo sugerem que a terapia adjuvante com trimetazidina pode melhorar os resultados clínicos e a função cardíaca em pacientes com IAM sem aumentar o risco de eventos adversos. No entanto, são necessários mais ensaios clínicos randomizados em larga escala para confirmar esses resultados e determinar a duração e dose ideais da terapia com trimetazidina nessa população de pacientes