Neurophobia in Brazil: Detecting and Preventing a Global Issue

<div><p>ABSTRACT Neurophobia is a global issue known as a fear of Neurology and Neurosciences by medical students and physicians, and it may contribute to a reduced number of trained neurologists and a global misunderstanding of neurological diseases among physicians. To date, there are no studies that address the issue of Neurophobia in Brazil. The present study aimed to evaluate the perception of Neurology and Neurosciences among Brazilian medical students. Students from four medical schools in the state of Pará, in the second (pre-clinical phase), fourth (clinical phase) and sixth (internship) years of the course, were submitted to a self-administered and written questionnaire divided into two sections: the first section included questions assessing their perceived level of interest, level of knowledge, degree of difficulty, confidence in examining patients, quality of teaching in medical school and likelihood of pursuing the career, concerning different clinical specialties (Cardiology, Endocrinology, Gastroenterology, Nephrology, Neurology, Respiratory Medicine and Rheumatology). In the second section, there were questions about possible reasons why Neurology was perceived as a difficult subject and possible ways to improve neurological education. A total of 486 questionnaires were completed. Neurology was perceived as the most difficult clinical specialty (mean score 4.00; p < 0.001), in which students feel least confident about conducting physical examinations (mean score 2.97; p < 0.001), and with the worst quality of teaching (mean score 3.12; p < 0.001). The main cause of Neurophobia was the need to know neuroanatomy and neurophysiology (very important reason for 39.4% of students), and the most frequently suggested method to improve neurological education was through more and better bedside tutorials (very important factor — 53.3%). Students developing extracurricular activities, women and older students had more unfavorable opinions about Neurology. Neurophobia is also present in Brazil, and new educational approaches must be proposed to improve the misperception of Neurology by medical students. The Medical Education Commission of the Brazilian Academy of Neurology should propose guidelines on Neurology teaching at undergraduate level.</p></div

Norovirus RNA in serum associated with increased fecal viral load in children: Detection, quantification and molecular analysis - Fig 6

<p>Simplot analysis of the ORF1-ORF2 overlap sequence (530 bp) of the strains VIR613F (MG023180)/ VIR699F (MG023186)/ VIR715F (MG023183) (a), VIR554F (MG023188) /VIR693F (MG023184) (b), VIR 138F (MG023190) (c), VIR 560 (MG023187) (d). The assay was performed using standards parameters of the program with a window size of 200 bp, a step size of 20 bp and with the Kimura (2-parameter) model. The accession numbers of the prototypes used in the analyses were the following: GII.P13/GII.13 (EU921354.2), GII.17/GII.17 (AY502009.1), GII.P22/GII.22 (AB233471), GII.P5/GII.5 (AF397156), GII.P7/GII.7 (JQ751043), GII.P6/GII.6 (AB039778), GI.Pb/GI.6 (AB081723), GI.6/GI.6 (AF093797), GI.Pb/GI.6 (AB354289). The y-axis indicates the nucleotide sequence similarity between the recombinant sequence and reference strains. The y-axis indicates nucleotide position.</p

Distribution by age group of norovirus-positive patients in serum/stool samples collected from children hospitalized for acute gastroenteritis in the city of Belém, Pará, Brazil, from March/2012 to June/2015.

<p>Distribution by age group of norovirus-positive patients in serum/stool samples collected from children hospitalized for acute gastroenteritis in the city of Belém, Pará, Brazil, from March/2012 to June/2015.</p

Phylogenetic cladogram generated by the maximum likelihood test using partial nucleotide sequences (360 bp) from the C region of norovirus strains from 10 paired samples of sera and feces from children hospitalized for acute gastroenteritis at two clinics in the city of Belém, Brazil, from March/2012 to June/2015.

<p>Phylogenetic cladogram generated by the maximum likelihood test using partial nucleotide sequences (360 bp) from the C region of norovirus strains from 10 paired samples of sera and feces from children hospitalized for acute gastroenteritis at two clinics in the city of Belém, Brazil, from March/2012 to June/2015.</p

Phylogenetic cladogram generated by the maximum likelihood test using partial nucleotide sequences (360 bp) of the C region of the capsid of norovirus strains obtained from 47 stools of children hospitalized for acute gastroenteritis at two clinics in the city of Belém, Brazil, from March / 2012 to June / 2015.

<p>Phylogenetic cladogram generated by the maximum likelihood test using partial nucleotide sequences (360 bp) of the C region of the capsid of norovirus strains obtained from 47 stools of children hospitalized for acute gastroenteritis at two clinics in the city of Belém, Brazil, from March / 2012 to June / 2015.</p

Viral load quantification by RT-qPCR in serum and stool samples from cases of norovirus infection in children hospitalized for acute gastroenteritis in the city of Belém, Pará, Brazil, from March/2012 to June/2015.

<p>Dots in red represent positive serum samples, blue dots indicate positive stool samples without RNAemia, and green dots represent positive stool samples with presence of RNA in serum.</p

Monthly frequency of norovirus-positivity and temporal distribution of genotypes in stool samples from children hospitalized for acute gastroenteritis in the city of Belém, Brazil, from March/2012 to June/2015.

<p>Monthly frequency of norovirus-positivity and temporal distribution of genotypes in stool samples from children hospitalized for acute gastroenteritis in the city of Belém, Brazil, from March/2012 to June/2015.</p