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Polliana B Dos Santos,1 Rodrigo P Simões,1,2 Cássia da L Goulart,1 Meliza G Roscani,3 Renan S Marinho,1 Patrícia Faria Camargo,1 Renata F Arbex,1 Guilherme Casale,3 Cláudio R Oliveira,3 Renata G Mendes,1 Ross Arena,4 Audrey Borghi-Silva1 1Cardiopulmonary Physical Therapy Laboratory, Federal University of Sao Carlos, Sao Carlos, Brazil; 2Postgraduate Program in Rehabilitation Sciences, Federal University of Alfenas, Minas Gerais, Brazil; 3Department of Medicine, Federal University of Sao Carlos, Sao Carlos, Brazil; 4Department of Physical Therapy, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, USACorrespondence: Audrey Borghi-SilvaCardiopulmonary Physiotherapy Laboratory, Federal University of São Carlos, UFSCar, São Carlos, São Paulo, BrazilTel +551633066704Fax +551633612081Email audrey@ufscar.brAim: Our aim was to assess: 1) the impact of the eccentric left ventricular hypertrophy (ELVH) on exercise performance in patients diagnosed with chronic heart failure (CHF) alone and in patients with co-existing CHF and chronic obstructive pulmonary disease (COPD) and 2) the relationship between left and right cardiac function measurements obtained by doppler echocardiography, clinical characteristics and primary measures of cardiorespiratory fitness.Methods: The current study included 46 patients (CHF:23 and CHF+COPD:23) that performed advanced pulmonary function tests, echocardiography and symptom-limited, incremental cardiopulmonary exercise testing (CPET) on a cycle ergometer.Results: Patients with CHF+COPD demonstrated a lower work rate, peak oxygen uptake (VO2), oxygen pulse, rate pressure product (RPP), circulatory power (CP) and ventilatory power (VP) compared to those only diagnosed with CHF. In addition, significant correlations were observed between VP and relative wall thickness (r: 0.45 p: 0.03),VE/VCO2 intercept and Mitral E/e’ ratio (r: 0.70 p: 0.003) in the CHF group. Significant correlations were found between indexed left ventricle mass and RPP (r: − 0.47; p: 0.02) and relative VO2 and right ventricle diameter (r: − 0.62; p: 0.001) in the CHF+COPD group.Conclusion: Compared to a diagnosis of CHF alone, a combined diagnosis of CHF+COPD induced further impairments in cardiorespiratory fitness. Moreover, echocardiographic measures of cardiac function are related to cardiopulmonary exercise performance and therefore appear to be an important therapeutic target when attempting to improve exercise performance and functional capacity.Keywords: heart failure, chronic obstructive pulmonary disease, eccentric hypertrophy, ventricular dysfunction, cardiopulmonary exercise testing, echocardiography

Objectives: To evaluate respiratory muscle strength (RMS) in a sample composed exclusively of healthy sedentary individuals and to compare with predicted values, to investigate the relationship between maximal inspiratory pressure (MIP) and maximal expiratory pressure (MEP) and age, weight and height, and propose predictive equations of MIP and MEP for this population. Methods: Subjects were 140 healthy and sedentary individuals: 70 males (55±20 years) and 70 females (54±21 years), separated into groups according to age. The RMS was obtained with an aneroid vacuum manometer (±300 cmH2O). Results: There was a significant reduction in RMS with increasing age (ANOVA one-way, p<0.05). Moreover, the RMS values decreased significantly from age 40 compared to the predicted values (Student t test, p<0.05). There were also significant correlations of RMS with age, weight and height (Pearson correlation, p<0.05). The predictive equations using linear regression for maximal respiratory pressures according to sex showed that age in males and females and weight in females influenced the prediction of the MIP and MEP values. Conclusions: Our results showed that age anthropometric characteristics influence RMS values. In addition, the RMS values were lower compared to the predicted values age 40 because the sample was composed exclusively of sedentary individuals. In this context, we propose equations to predict MIP and MEP values exclusively for healthy, sedentary individuals from 20 to 89 years of age. Article registered in the Australian New Zealand Clinical Trials Registry (ANZCTR) under the number ACTRN12608000511336 [ABSTRACT FROM AUTHOR]

OBJECTIVE: To evaluate the autonomic modulation of heart rate (HR) at rest in the supine position and during a respiratory sinus arrhythmia maneuver (M-RSA) among participants with chronic obstructive pulmonary disease (COPD) or with chronic heart failure (CHF). METHODS: Twenty-eight men were divided into three groups: ten with COPD, aged 69±9 years; nine with CHF, aged 62±8 years; and nine healthy participants aged 64±5 years (controls). At rest, the R-R interval of the electrocardiographic signal was obtained in the following situations: 1) 15 min in the supine position; and 2) 4 min during M-RSA in the supine position. The data were analyzed in the time domain (RMSSD and SDNN indices) and the frequency domain (LFab and HFab). During M-RSA, the expiratory/inspiratory ratio (E/I) and the inspiratory/expiratory difference (delta IE) were calculated. RESULTS: The main findings showed that the CHF patients presented lower RMSSD (12.2±2.6 vs. 20.4±6.5), LFab (99.2±72.7 vs. 305.3±208.9) and HFab (53.4±29.9 vs. 178.9±113.1), compared with the controls. The LFab band was significantly lower in the COPD group than in the controls (133.8±145.5 vs. 305.3±208.9). Additionally, both CHF patients and COPD patients showed lower E/I ratios (1.1±0.06 vs. 1.2±0.1 and 1.1±0.03 vs. 1.2±0.1) and delta IE values (7.0±3.5 vs. 12.7±0.1 and 4.9±1.6 vs. 12.7±0.1), respectively, compared with the controls during M-RSA. CONCLUSION: The results from this study suggest that both COPD and CHF have a negative impact on the autonomic control of heart rate. Article registered on the Australian New Zealand Clinical Trials Registry (ANZCTR) under the number: ACTRN12609000467235 [ABSTRACT FROM AUTHOR]

Objective: To evaluate the autonomic activity of an adolescent with a single ventricle without surgical correction who participated in a physical therapy program. Methods: This was a 14-year-old female patient with a left-type single ventricle who had not undergone any surgical intervention. The autonomic activity was evaluated according to the heart rate variability in the supine and seated positions and by means of the respiratory sinus arrhythmia accentuation maneuver (RSA-M) in the beginning of the first, second and third years of outpatient cardiovascular physical therapy treatment. The RR intervals and beat-to-beat heart rate were calculated and stored for subsequent analysis. The heart rate variability was evaluated by means of the RMSSD and RMSM indexes and in the frequency domain with high and low frequency bands in normalized units (HFnu and LFnu, respectively) and using the LF/HF ratio. The cardiovascular physical therapy consisted of respiratory exercises associated with active and general resistance exercises, for two years. Results: From the first to the third year, the RMSM decreased (14.5%), LFnu band increased (42.2%), LF/HF ratio increased (117.0%) and HFnu decreased (35.2%). In all of the situations, the LFnu band was higher and HFnu was lower in the seated position. Additionally, the parasympathetic response to RSA-M increased from the first to the third years in 7.4% and 47.3%, respectively. Conclusions: We concluded that, for the patient studied, the reduction in heart rate variability seemed to be associated with the advance of the disease. Nevertheless, there was no damages related to postural change. In addition, the cardiovascular physical therapy proposed increased the parasympathetic response during RSA-M. [ABSTRACT FROM AUTHOR]

Background: The skin prick test (SPT) is used to diagnose sensitization to antigens. This study proposes a deep learning approach to infer wheal dimensions, aiming to reduce dependence on human interpretation., Methods: A dataset of SPT images (n = 5844) was used to infer a convolutional neural network for wheal segmentation ( ML model ). Three methods for inferring wheal dimensions were evaluated: the ML model ; the standard protocol ( MA1 ); and approximation of the area as an ellipse using diameters measured by an allergist ( MA2 ). The results were compared with assisted image segmentation ( AIS ), the most accurate method. Bland-Altman analysis, distribution analyses, and correlation tests were applied to compare the methods. This study also compared the percentage deviation among these methods in determining the area of wheals with regular geometric shapes (n = 150) and with irregular shapes (n = 150)., Results: The Bland-Altman analysis showed that the difference between methods was not correlated with the absolute area. The ML model achieved a segmentation accuracy of 85.88% and a strong correlation with the AIS method (ρ = 0.88), outperforming all other methods. Additionally, MA1 showed significant error (13.44 ± 13.95%) for pseudopods., Conclusions: The ML protocol can potentially automate the reading of SPT, offering greater accuracy than the standard protocol.

Chronic cadmium exposure is known to be associated with vascular changes and increased blood pressure, but its short-term effects on the cardiovascular system remain poorly understood. This study aimed to investigate the pressoric and vascular effects of a 7-day exposure to CdCl 2 in Wistar rats. The rats were divided in control group (Ct), which received tap water, and the Cd group, which received a 100 mg/L CdCl 2 solution via drinking water for 7 days. We analyzed body weight, plasma Cadmium concentration, systolic blood pressure (SBP), and vascular responses. Despite relatively low plasma Cadmium concentration, the Cd group exhibited elevated SBP and increased contractile response to phenylephrine. Endothelium removal and NOS inhibition increased contractions in both groups. In the Cd group's aorta, we observed enhanced levels of phospho-eNOS (Ser 1177) and basal NO release. Cd group showed reduced Catalase expression and increased basal release of H 2 O 2 , with catalase reducing the contractile response. In arteries pre-contracted with phenylephrine, Cd group showed impaired endothelium-dependent (Acetylcholine) and independent (sodium nitroprussiate-SNP) relaxation responses. However, responses to SNP were similar after pre-contraction with KCl in both groups. These data suggest early effects of Cadmium on blood pressure and aortic function, indicating impaired H 2 O 2 -scavenging by catalase. Increased H 2 O 2 due to Cadmium exposure might explain heightened responses to phenylephrine and weakened relaxation responses mediated by the NO-K + -channels pathway. Our findings shed light on Cadmium's short-term impact on the cardiovascular system, providing insights into potential mechanisms underlying its effects on blood pressure regulation and vascular function., (© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Background: The polymerase chain reaction of upper respiratory tract swab samples was established as the gold standard procedure for diagnosing SARS-CoV-2 during the COVID pandemic. However, saliva collection has attracted attention as an alternative diagnostic collection method. The goal of this study was to compare the use of saliva and nasopharyngeal swab (NPS) samples for the detection of SARS-CoV-2., Methods: Ninety-nine paired samples were evaluated for the detection of SARS-CoV-2 by saliva and swab for a qualitative diagnosis and quantitative comparison of viral particles. Furthermore, the detection limits for each sample collection technique were determined. The cycle threshold (C T ) values of the saliva samples, the vaccination status, and the financial costs associated with each collection technique were compared., Results: The results showed qualitative equivalence in diagnosis (96.96%) comparing saliva and swab collection, although there was low quantitative agreement. Furthermore, the detection limit test demonstrated equivalence for both collection methods. We did not observe a statistically significant association between C T values and vaccination status, indicating that the vaccine had no influence on viral load at diagnosis. Finally, we observed that the use of saliva incurs lower financial costs and requires less use of plastic materials, making it more sustainable., Conclusions: These findings support the adoption of saliva collection as a feasible and sustainable alternative to the diagnosis of COVID-19.

The potential emergence of zoonotic diseases has raised significant concerns, particularly in light of the recent pandemic, emphasizing the urgent need for scientific preparedness. The bioprospection and characterization of new molecules are strategically relevant to the research and development of innovative drugs for viral and bacterial treatment and disease management. Amphibian species possess a diverse array of compounds, including antimicrobial peptides. This study identified the first bioactive peptide from Salamandra salamandra in a transcriptome analysis. The synthetic peptide sequence, which belongs to the defensin family, was characterized through MALDI TOF/TOF mass spectrometry. Molecular docking assays hypothesized the interaction between the identified peptide and the active binding site of the spike WT RBD/hACE2 complex. Although additional studies are required, the preliminary evaluation of the antiviral potential of synthetic SS-I was conducted through an in vitro cell-based SARS-CoV-2 infection assay. Additionally, the cytotoxic and hemolytic effects of the synthesized peptide were assessed. These preliminary findings highlighted the potential of SS-I as a chemical scaffold for drug development against COVID-19, hindering viral infection. The peptide demonstrated hemolytic activity while not exhibiting cytotoxicity at the antiviral concentration.

In recent years, the scientific community has worked intensively in the search and development of new drugs to suppress viral infections, such as COVID-19. In fact, a number of active compounds have been tested; however, the absence of significant structure-activity relationships hinders the production of optimized drugs. In this study, molecular modeling techniques were employed to investigate the electronic, structural and chemical reactivity properties of a set α-ketoamides whose antiviral activities have been reported in the literature, aiming to propose new promising derivatives. The local reactivity of the compounds was evaluated via condensed-to-atoms Fukui indexes and molecular electrostatic potential. Multivariate data analysis and random forests machine learning techniques were employed to correlate the antiviral properties and electronic and structural descriptors and identify relevant variables. A series of new derivatives were then proposed and evaluated via density functional theory-based calculations, and docking/molecular dynamics with the target protein of the virus. The results suggest that active derivatives present reduced reactivity towards electrophilic agents on the central core of the molecules and high reactivity on R 1 ligands. Derivatives with higher predicted antiviral activities were proposed based on simple electronic descriptors, and their efficacies are reinforced by docking and molecular dynamics simulations.Communicated by Ramaswamy H. Sarma.

Cadmium is a heavy metal that is widespread in the environment and has been described as a metalloestrogen and a cardiovascular risk factor. Experimental studies conducted in male animals have shown that cadmium exposure induces vascular dysfunction, which could lead to vasculopathies caused by this metal. However, it is necessary to investigate the vascular effects of cadmium in female rats to understand its potential sex-dependent impact on the cardiovascular system. While its effects on male rats have been studied, cadmium may act differently in females due to its potential as a metalloestrogen. In vitro studies conducted in a controlled environment allow for a direct assessment of cadmium's impact on vascular function, and the use of female rats ensures that sex-dependent effects are evaluated. Therefore, the aim of this study was to investigate the in vitro effects of Cadmium Chloride (CdCl 2 , 5 µM) exposure on vascular reactivity in the isolated aorta of female Wistar rats. Exposure to CdCl 2 damaged the architecture of the vascular endothelium. CdCl 2 incubation increased the production and release of O 2 •- , reduced the participation of potassium (K + ) channels, and increased the participation of the angiotensin II pathway in response to phenylephrine. Moreover, estrogen receptors alpha (Erα) modulated vascular reactivity to phenylephrine in the presence of cadmium, supporting the hypothesis that cadmium could act as a metalloestrogen. Our results demonstrated that in vitro cadmium exposure induces damage to endothelial architecture and an increase in oxidative stress in the isolated aorta of female rats, which could precipitate vasculopathies. Graphical Abstract. Own source from Canva and Servier Medical Art servers., (© 2023. The Author(s), under exclusive licence to Springer Nature B.V.)

Introduction: Mercury (Hg) is a heavy metal that causes a variety of toxic effects in eukaryotic cells. Previous studies have reported detrimental effects of mercury toxicity in the cardiovascular system. Given the importance of understanding the relationship between Hg and cardiovascular disease, we sought to investigate if the Hg could worsen the myocardial repercussions following ischemic injury. We demonstrated that once mercury toxicity is established, it can influence the outcome of myocardial infarction (MI). Methods: Male Wistar rats received intramuscular injections of either saline (NaCl 0.9%) or mercuric chloride (HgCl 2 , first dose of 4.6 μg/kg, and subsequent doses of 0.07 μg/kg/day) for 4 weeks. Three weeks post-exposure, we induced transmural infarction in the left ventricle free wall through coronary artery occlusion surgery. Results: ECG recordings obtained from MI groups demonstrated alterations in the rhythm of the heartbeat/heart electrical activity, as expected, including ventricular extrasystoles and ventricular tachycardia. However, the MI group exposed to Hg (MI-Hg) exhibited augmented ventricular extrasystoles and ventricular tachycardia compared to the MI group. Also, Basckó coefficient revealed that the arrhythmic events-after MI-were aggravated by Hg exposure. Discussion: Our results indicate that the significantly increased mortality in MI-Hg groups when compared to MI (21%, MI vs 32%, MI-Hg) is correlated with greater occurrence of arrhythmias. In conclusion, this study further supports the idea that exposure to mercury (Hg) should be recognized as a significant risk factor that exacerbates the impact of cardiac ischemic injury, potentially leading to an increased mortality rate among patients experiencing acute MI., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Bello, Wilke, Simões, Landim-Vieira, Langa, Stefanon, Vassallo and Fernandes.)

Background: Fibromyalgia is a syndrome of chronic, generalized muscular pain, accompanied by sleep disturbances, fatigue and cardic autonomic dysfunction that will affect the quality of life. There is currently no gold standard treatment. There are limitations of studies with electroacupuncture in auricular acupuncture., Objectives: We evaluate the effects of systemic electroacupuncture (EA) with frequencies of 2/100 Hz associated of auricular acupuncture with a Nogier frequency (2.28, 4.56 and 9.12 Hz) for pain intensity, heart rate variability (HRV), and quality of life in fibromyalgia., Methods: Randomized clinical trial, a pilot study. Eighteen volunteers were randomized into a control group (CG, n = 9) and an experimental group (EG, n = 9). Six systemic EA sessions systemic and auricular were applied in the EG for 20 min, twice a week, for six weeks consecutive. The Numerical Pain Assessment Scale (NPRS), 2010 diagnostic criteria of the American College of Rheumatology (FDC 2010), Fibromyalgia Impact Questionnaire (FIQ) and analysis of HRV were the instruments used. The independent t-test compared to the groups was applied., Results: There was no statistically significant difference for the primary outcome for NPRS ( p > 0.05). In the secondary outcome there was a significant difference in the total score and in some FIQ domains ( p = 0.008) and some variables such as pain ( p = 0.02) and anxiety ( p = 0.006). There was no significant difference for the FDC 2010 and HRV variables ( p > 0.05)., Conclusion: 2/100 Hz systemic EA associated with the Nogier frequency positively influenced some quality of life variables; however, pain intensity, diagnostic criteria, and HRV variables did not change.

The rising popularity of herbal medicine as a weight loss remedy, fueled by misleading propaganda, raises concerns about the manufacturing processes and potential inclusion of controlled substances such as fluoxetine (FLU). The objective of this work is to develop and evaluate the performance of an electrochemical device by modifying a glassy carbon electrode (GC) with a nanocomposite based on reduced graphene oxide (rGO) and copper nanoparticles (CuNPs) for detecting FLU in manipulated herbal medicines. Scanning electron microscopy (FEG-SEM) and cyclic voltammetry (CV) were applied for morphological and electrochemical characterization and analysis of the composite's electrochemical behavior. Under optimized conditions, the proposed sensor successfully detected FLU within the range of 0.6 to 1.6 µmol L -1 , showing a limit of detection (LOD) of 0.14 µmol L -1 . To determine the presence of FLU in herbal samples, known amounts of the analytical standard were added to the sample, and the analyses were performed using the standard addition method, yielding recoveries between -2.13 and 2.0%.

Background: The aim of this study was to explore the effects of non-invasive positive pressure ventilation (NIPPV) associated with high-intensity exercise on heart rate (HR) and oxygen uptake (V̇O 2 ) recovery kinetics in in patients with coexistence of chronic obstructive pulmonary disease (COPD) and heart failure (HF)., Methods: This is a randomized, double blinded, sham-controlled study involving 14 HF-COPD patients, who underwent a lung function test and Doppler echocardiography. On two different days, patients performed incremental cardiopulmonary exercise testing (CPET) and two constant-work rate tests (80% of CPET peak) receiving Sham or NIPPV (bilevel mode - Astral 150) in a random order until the limit of tolerance (Tlim). During exercise, oxyhemoglobin and deoxyhemoglobin were assessed using near-infrared spectroscopy (Oxymon, Artinis Medical Systems, Einsteinweg, Netherland)., Results: The kinetic variables of both V̇O 2 and HR during the high-intensity constant workload protocol were significantly faster in the NIPPV protocol compared to Sham ventilation (P < 0.05). Also, there was a marked improvement in oxygenation and lower deoxygenation of both peripheral and respiratory musculature in TLim during NIPPV when contrasted with Sham ventilation., Conclusions: NIPPV applied during high-intensity dynamic exercise can effectively improve exercise tolerance, accelerate HR and V̇O 2 kinetics, improve respiratory and peripheral muscle oxygenation in COPD-HF patients. These beneficial results from the effects of NIPPV may provide evidence and a basis for high-intensity physical training for these patients in cardiopulmonary rehabilitation programs., Competing Interests: Declaration of Competing Interest No potential conflict of interest was reported by the authors., (Copyright © 2023 Southern Society for Clinical Investigation. Published by Elsevier Inc. All rights reserved.)

The main protease of SARS-CoV-2 (called M pro or 3CL pro ) is essential for processing polyproteins encoded by viral RNA. Several M pro mutations were found in SARS-CoV-2 variants, which are related to higher transmissibility, pathogenicity, and resistance to neutralization antibodies. Macromolecules adopt several favored conformations in solution depending on their structure and shape, determining their dynamics and function. In this study, we used a hybrid simulation method to generate intermediate structures along the six lowest frequency normal modes and sample the conformational space and characterize the structural dynamics and global motions of WT SARS-CoV-2 M pro and 48 mutations, including mutations found in P.1, B.1.1.7, B.1.351, B.1.525 and B.1.429+B.1.427 variants. We tried to contribute to the elucidation of the effects of mutation in the structural dynamics of SARS-CoV-2 M pro . A machine learning analysis was performed following the investigation regarding the influence of the K90R, P99L, P108S, and N151D mutations on the dimeric interface assembling of the SARS-CoV-2 M pro . The parameters allowed the selection of potential structurally stable dimers, which demonstrated that some single surface aa substitutions not located at the dimeric interface (K90R, P99L, P108S, and N151D) are able to induce significant quaternary changes. Furthermore, our results demonstrated, by a Quantum Mechanics method, the influence of SARS-CoV-2 M pro mutations on the catalytic mechanism, confirming that only one of the chains of the WT and mutant SARS-CoV-2 M pro s are prone to cleave substrates. Finally, it was also possible to identify the aa residue F140 as an important factor related to the increasing enzymatic reactivity of a significant number of SARS-CoV-2 M pro conformations generated by the normal modes-based simulations., Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Ana ligia Scott reports financial support was provided by National Council for Scientific and Technological Development., (Copyright © 2023 Elsevier Inc. All rights reserved.)

Introduction: Laser acupuncture (LA) is a medically approved treatment for chronic pain, especially fibromyalgia. It is widely known that all pain is related to autonomic modulation, which may influence heart rate variability (HRV). There are robust studies in the literature on the effect of LA with continuous frequency on musculoskeletal pain and autonomic modulation. However, little is known about the effect of pulsed frequency on fibromyalgia. Therefore, this study aimed to evaluate whether an individualized intervention protocol applying pulsed LA would provide benefits related to pain symptoms and cardiac autonomic modulation in patients with fibromyalgia. Methods: In this pilot randomized clinical controlled trial, the sample consisted of women with fibromyalgia between the ages of 40 and 80, randomized into two groups: a control group (CG; n=10) and an experimental group (EG; n=10). EG received the intervention twice per week for 3 weeks. Statistical analysis was conducted by delta (difference between post-intervention and pre-intervention) and the Shapiro-Wilk test (normality). For comparison between the groups, the Mann-Whitney test was used. Results: The results showed a significant reduction in pain intensity as reported via the pain numerical scale (PNS; P =0.00), generalized pain index (GPI; P =0.00), and symptom severity scale (SSS; P =0.00). There was no significant difference in any HRV variable ( P >0.05). Conclusion: Pulsed LA, when applied in an individualized protocol, can reduce pain intensity, as reported on the PNS, GPI, and SSS. However, no therapeutic effect was observed for HRV., Competing Interests: The authors declare that they have no conflict of interest, (Copyright © 2022 J Lasers Med Sci.)

Introduction: To understand the current practices in stroke evaluation, the main clinical decision support system and artificial intelligence (AI) technologies need to be understood to assist the therapist in obtaining better insights about impairments and level of activity and participation in persons with stroke during rehabilitation., Methods: This scoping review maps the use of AI for the functional evaluation of persons with stroke; the context involves any setting of rehabilitation. Data were extracted from CENTRAL, MEDLINE, EMBASE, LILACS, CINAHL, PEDRO Web of Science, IEEE Xplore, AAAI Publications, ACM Digital Library, MathSciNet, and arXiv up to January 2021. The data obtained from the literature review were summarized in a single dataset in which each reference paper was considered as an instance, and the study characteristics were considered as attributes. The attributes used for the multiple correspondence analysis were publication year, study type, sample size, age, stroke phase, stroke type, functional status, AI type, and AI function., Results: Forty-four studies were included. The analysis showed that spasticity analysis based on ML techniques was used for the cases of stroke with moderate functional status. The techniques of deep learning and pressure sensors were used for gait analysis. Machine learning techniques and algorithms were used for upper limb and reaching analyses. The inertial measurement unit technique was applied in studies where the functional status was between mild and severe. The fuzzy logic technique was used for activity classifiers., Conclusion: The prevailing research themes demonstrated the growing utility of AI algorithms for stroke evaluation.

Hepatitis C virus has infected over 71 million people worldwide, and it is the main cause of cirrhosis in the western world. Currently, the treatment involves direct-acting antiviral agents (DAAs) and its main goal is to achieve sustained virologic response (SVR). The aim of this study was to evaluate the impact of SVR using DAAs in the improvement of liver fibrosis using scores evaluation by indirect method, liver function, and inflammation indirect biomarkers. Patients with cirrhosis with SVR after treatment (n = 104) were evaluated using liver function scores, indirect fibrosis methods, alpha-fetoprotein, and ferritin at t-base and t-SVR. Statistically significant positive results in all parameters were observed: 54 patients were classified as 5 in the CP score in t-base, and 77 in t-SVR; a significant decrease was observed in MELD score, alpha-fetoprotein, ferritin, APRI, FIB-4 and liver stiffness in liver elastography. We did not observe difference in the liver function scores between regressors and non-regressors of liver stiffness, as well as in indirect inflammation biomarkers. The measurements of fibrosis using the indirect methods have significantly decreased in patients with cirrhosis treated who achieved SVR associated with decreased indirect inflammation biomarkers and improved liver function scores., (© 2021. The Author(s), under exclusive licence to Springer Nature Switzerland AG.)

Our aim was to evaluate: (1) the prevalence of coexistence of heart failure (HF) and chronic obstructive pulmonary disease (COPD) in the studied patients; (2) the impact of HF + COPD on exercise performance and contrasting exercise responses in patients with only a diagnosis of HF or COPD; and (3) the relationship between clinical characteristics and measures of cardiorespiratory fitness; (4) verify the occurrence of cardiopulmonary events in the follow-up period of up to 24 months years. The current study included 124 patients (HF: 46, COPD: 53 and HF + COPD: 25) that performed advanced pulmonary function tests, echocardiography, analysis of body composition by bioimpedance and symptom-limited incremental cardiopulmonary exercise testing (CPET) on a cycle ergometer. Key CPET variables were calculated for all patients as previously described. The [Formula: see text] E /[Formula: see text]CO 2 slope was obtained through linear regression analysis. Additionally, the linear relationship between oxygen uptake and the log transformation of [Formula: see text] E (OUES) was calculated using the following equation: [Formula: see text]O 2  = a log [Formula: see text] E  + b, with the constant 'a' referring to the rate of increase of [Formula: see text]O 2 . Circulatory power (CP) was obtained through the product of peak [Formula: see text]O 2 and peak systolic blood pressure and Ventilatory Power (VP) was calculated by dividing peak systolic blood pressure by the [Formula: see text] E /[Formula: see text]CO 2 slope. After the CPET, all patients were contacted by telephone every 6 months (6, 12, 18, 24) and questioned about exacerbations, hospitalizations for cardiopulmonary causes and death. We found a 20% prevalence of HF + COPD overlap in the studied patients. The COPD and HF + COPD groups were older (HF: 60 ± 8, COPD: 65 ± 7, HF + COPD: 68 ± 7). In relation to cardiac function, as expected, patients with COPD presented preserved ejection fraction (HF: 40 ± 7, COPD: 70 ± 8, HF + COPD: 38 ± 8) while in the HF and HF + COPD demonstrated similar levels of systolic dysfunction. The COPD and HF + COPD patients showed evidence of an obstructive ventilatory disorder confirmed by the value of %FEV 1 (HF: 84 ± 20, COPD: 54 ± 21, HF + COPD: 65 ± 25). Patients with HF + COPD demonstrated a lower work rate (WR), peak oxygen uptake ([Formula: see text]O 2 ), rate pressure product (RPP), CP and VP compared to those only diagnosed with HF and COPD. In addition, significant correlations were observed between lean mass and peak [Formula: see text]O 2 (r: 0.56 p < 0.001), OUES (r: 0.42 p < 0.001), and O 2 pulse (r: 0.58 p < 0.001), lung diffusing factor for carbon monoxide (D LCO ) and WR (r: 0.51 p < 0.001), D LCO and VP (r: 0.40 p: 0.002), forced expiratory volume in first second (FEV 1 ) and peak [Formula: see text]O 2 (r: 0.52; p < 0.001), and FEV 1 and WR (r: 0.62; p < 0.001). There were no significant differences in the occurrence of events and deaths contrasting both groups. The coexistence of HF + COPD induces greater impairment on exercise performance when compared to patients without overlapping diseases, however the overlap of the two diseases did not increase the probability of the occurrence of cardiopulmonary events and deaths when compared to groups with isolated diseases in the period studied. CPET provides important information to guide effective strategies for these patients with the goal of improving exercise performance and functional capacity. Moreover, given our findings related to pulmonary function, body composition and exercise responses, evidenced that the lean mass, FEV 1 and D LCO influence important responses to exercise., (© 2022. The Author(s).)

Healthy aging hemodynamics is known to exhibit a time-dependent loss of function. We aimed at verifying whether older men would have a slowed cardiac output and stroke volume dynamics in response to the onset ("on") and on recovery ("off") of exercise in comparison to young men. Twenty healthy active men (10 young and 10 older) were recruited. Participants performed an incremental cardiopulmonary exercise testing on a cycle ergometer, and on another day, 3 constant workload tests in different intensities. Compared to younger, older men exhibited a slower cardiac output and stroke volume dynamics in both on and off transients for all exercise intensities (all P < 0.05). During higher intensities, both younger and older men had slower hemodynamic kinetics compared to lower intensities (all P < 0.05). There was strong negative relationship between the time constant of cardiac output on-kinetics during high-intensity with maximal exercise performance in both groups (r = -0.88, P < 0.01). We interpret these findings to mean that healthy older men have slowed hemodynamic kinetics compared to younger, but this difference becomes less evident in higher intensities of exercise., Competing Interests: The authors certify that there is no conflict of interest with any financial organization regarding the material discussed in the manuscript., (Thieme. All rights reserved.)

Gene regulatory networks (GRNs) play key roles in development, phenotype plasticity, and evolution. Although graph theory has been used to explore GRNs, associations amongst topological features, transcription factors (TFs), and systems essentiality are poorly understood. Here we sought the relationship amongst the main GRN topological features that influence the control of essential and specific subsystems. We found that the K nn , page rank, and degree are the most relevant GRN features: the ones are conserved along the evolution and are also relevant in pluripotent cells. Interestingly, life-essential subsystems are governed mainly by TFs with intermediary K nn and high page rank or degree, whereas specialized subsystems are mainly regulated by TFs with low K nn . Hence, we suggest that the high probability of TFs be toured by a random signal, and the high probability of the signal propagation to target genes ensures the life-essential subsystems' robustness. Gene/genome duplication is the main evolutionary process to rise K nn as the most relevant feature. Herein, we shed light on unexplored topological GRN features to assess how they are related to subsystems and how the duplications shaped the regulatory systems along the evolution. The classification model generated can be found here: https://github.com/ivanrwolf/NoC/ ., (© 2021. The Author(s).)

Cirrhotic patients with chronic hepatitis C should be monitored for the evaluation of liver function and screening of hepatocellular carcinoma even after sustained virological response (SVR). The stage of inflammatory resolution and regression of fibrosis is likely to happen, once treatment and viral clearance are achieved. However, liver examinations by elastography show that 30-40% of patients do not exhibit a reduction of liver stiffness. This work was a cohort study in cirrhotic patients whose purpose was to identify immunological factors involved in the regression of liver stiffness in chronic hepatitis C and characterize possible serum biomarkers with prognostic value. The sample universe consisted of 31 cirrhotic patients who underwent leukocyte immunophenotyping, quantification of cytokines/chemokines and metalloproteinase inhibitors in the pretreatment (M1) and in the evaluation of SVR (M2). After exclusion criteria application, 16 patients included were once more evaluated in M3 (like M1) and classified into regressors (R) or non-regressors (NR), decrease or not ≥ 25% stiffness, respectively. The results from ROC curve, machine learning (ML) and linear discriminant analysis showed that TCD4 + lymphocytes (absolute) are the most important biomarkers for the prediction of the regression (AUC = 0.90). NR patients presented levels less than R of liver stiffness since baseline, whereas NK cells were increased in NR. Therefore, it was concluded that there is a difference in the profile of circulating immune cells in R and NR, thus allowing the development of a predictive model of regression of liver stiffness after SVR. These findings should be validated in greater numbers of patients., (© 2021. The Author(s), under exclusive licence to Springer Nature Switzerland AG.)

Purpose: Impairment of cardiac autonomic integrity is common in chronic obstructive pulmonary disease (COPD) patients. The influence of the interaction between clinical and severity status on brain-heart autonomic axis (BHAA) is not well known. We aimed to investigate the BHAA function across different clinical status and severity of COPD., Methods: Cross-sectional study involving 77 COPD patients allocated into four groups according to clinical status [acute exacerbation (GAE) or stable (GST)] and severity [less (-) or more (+)]: 1) GAE-, n = 13; 2) GAE+, n = 20; 3) GST-, n = 23; and 4) GST+, n = 21. Heart rate variability (HRV) at rest and heart rate recovery (HRR) after 6-min walk test were markers of BHAA. Mean R-R, STDRR, RMSSD, RRtri, HF, LF, SD1, SD2, ApEn and SampEn were the HRV indexes and, HRR was obtained as: HR at 1st min of recovery minus peak HR., Results: A main effect of clinical status (p < 0.001) was found to vagal modulation in GAE-vs. GST- (RMSSD: 25.0 ± 14.8 vs. 12.6 ± 5.5 ms; SD1: 18.0 ± 10.6 vs. 8.9 ± 3.9 ms) and to GAE + vs. GST+ (RMSSD: 26.4 ± 15.2 vs. 15.4 ± 6.3 ms; SD1: 18.3 ± 11.2 vs. 10.9 ± 4.5 ms). An effect of clinical status (p = 0.032) and severity (p = 0.030) were found to HF (vagal) in GAE + compared to GAE- and GST+ (264.7 ± 239.0 vs. 134.7 ± 169.7 and 135.8 ± 139.7 ms 2 ). Lower HRR was found in GAE-compared to GST- (8.0 ± 2.4 vs. 19.6 ± 2.4 bpm), p = 0.002., Conclusion: In COPD patients, clinical status (AECOPD or stable) was more dominant than the severity on BHAA function. A more pronounced parasympathetic modulation was found in AECOPD patients with a lower HRR to exercise., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

The literature has shown that there is no consensus regarding the best resin composite photoactivation protocol. This study evaluated the efficiency of the conventional, soft-start, pulse-delay and exponential protocols for photoactivation of resin composites in reducing the shrinkage stress and temperature variation during the photopolymerisation. The photoactivation processes were performed using a photocuring unit and a smartphone app developed to control the irradiance according each photoactivation protocol. These photoactivation methods were evaluated applying photoactivation energies recommended by the resins manufactures. Three brands of resin composites were analysed: Z-250, Charisma and Ultrafill. The cure effectiveness was evaluated through depth of cure experiments. All results were statistically evaluated using one-way and multi-factor analysis of variance (ANOVA). The use of exponential and pulse-delay methods resulted in a significant reduction of the shrinkage stress for all evaluated resins; however, the pulse-delay method required too long a photoactivation time. The increases on the temperature were lower when the exponential photoactivation was applied; however, the temperature variation for all photoactivation protocols was not enough to cause damage in the restoration area. The evaluation of the depth of cure showed that all photoactivation protocols resulted in cured resins with equivalent hardness, indicating that the choice of an alternative photoactivation protocol did not harm the polymerisation. In this way, the results showed the exponential protocol as the best photoactivation technique for practical applications.

The lack of consensus concerning the biological meaning of entropy and complexity of genomes and the different ways to assess these data hamper conclusions concerning what are the causes of genomic entropy variation among species. This study aims to evaluate the entropy and complexity of genomic sequences of several species without using homologies to assess relationships among these variables and non-molecular data (e.g., the number of individuals) to seek a trigger of interspecific genomic entropy variation. The results indicate a relationship among genomic entropy, genome size, genomic complexity, and the number of individuals: species with a small number of individuals harbors large genome, and hence, low entropy but a higher complexity. We defined that the complexity of a genome relies on the entropy of each DNA segment within genome. Then, the entropy and complexity of a genome reflects its organization solely. Exons of vertebrates harbor smaller entropies than non-exon regions (likely by the repeats that accumulated from duplications), whereas other taxonomic groups do not present this pattern. Our findings suggest that small initial population might have defined current genomic entropy and complexity: actual genomes are less complex than ancestral ones. Besides, our data disagree with the relationship between phenotype and genomic entropies previously established. Finally, by establishing the relationship between genomic entropy/complexity with the number of individuals and genome size, under an evolutive perspective, ideas concerning the genomic variability may emerge.

Objectives: To identify the clinical discriminative value and determinants of arterial stiffness in individuals with type 2 diabetes mellitus (T2DM)., Methods: This prospective cohort study included 51 individuals (53.57±9.35 years) diagnosed with T2DM (stage glucose≥126 mg/dL; diagnostic time: 87.4±69.8 months). All participants underwent an initial evaluation of personal habits, medications, and history; arterial stiffness assessment by carotid-femoral pulse wave velocity (cfPWV) using SphygmoCor; and blood laboratory analysis. A statistical analysis was performed using SPSS software, and values of p≤0.05 were considered significant., Results: A cut-off cfPWV value of 7.9 m/s was identified for T2DM [Sensitivity (SE): 90% and Specificity (SP): 80%]. A subgroup analysis revealed higher glycated hemoglobin (Hb1Ac) (p=0.006), obesity (p=0.036), and dyslipidemia (p=0.013) than those with cfPWV ≥7.9 m/s. Multivariate analysis identified higher stage glucose (p=0.04), Hb1Ac (p=0.04), hypertension (p=0.001), and dyslipidemia (p=0.01) as determinant factors of cfPWV; positive and significant correlation between cfPWV and glucose (r=0.62; p=0.0003) and Hb1Ac (r=0.55; p=0.0031)., Conclusions: In T2DM, an indicator of the discriminative value of arterial stiffness was cfPWV of 7.9 m/s. Clinical findings and comorbidities, such as hypertension, glucose, poor glycemic control, and dyslipidemia, were associated with and were determinants of arterial stiffness in T2DM. Reinforcement of monitoring risk factors, such as hypertension, dyslipidemia, and glycemic control, seems to be essential to the process of arterial stiffening. Confirmation of this discriminative value in larger populations is recommended.

The skin prick test is used to diagnose patients' sensitization to antigens through a mediated IgE response. It is a practical and quick exam, but its diagnosis depends on instruments for measuring the allergic response and observer's interpretation. The conventional method for inferring about the allergic reaction is performed from the dimensions of the wheals, which are measured using a ruler or a caliper. To make this diagnosis less dependent on human interpretation, the present study proposes two alternative methods to infer about the allergic reaction: computational determination of the wheal area and a study of the temperature variation of the patient's skin in the puncture region. For this purpose, prick test using histamine was performed on 20 patients randomly selected. The areas were determined by the conventional method using the dimensions of the wheals measured with a digital caliper 30 min after the puncture. The wheal areas were also determined by a Python algorithm using photographs of the puncture region obtained with a smartphone. A variable named circularity deviation was also determined for each analyzed wheal. The temperature variation was monitored using an infrared temperature sensor, which collected temperature data for 30 min. All results were statistically compared or correlated. The results showed that the computational method to infer the wheal areas did not differ significantly from the areas determined by the conventional method (p-value = 0.07585). Temperature monitoring revealed that there was a consistent temperature increase in the first minutes after the puncture, followed by stabilization, so that the data could be adjusted by a logistic equation (R 2  = 0.96). This adjustment showed that the optimal time to measure the temperature is 800 s after the puncture, when the temperature stabilization occurs. The results have also shown that this temperature stabilization has a significant positive correlation with wheal area (p-value = 0.0015). Thus, we concluded that the proposed computational method is more accurate to infer the wheal area when compared to the traditional method, and that the temperature may be used as an alternative parameter to infer about the allergic reaction., (Copyright © 2020 Elsevier B.V. All rights reserved.)

Background: Coronary artery disease (CAD) lead to cardiovascular autonomic control disfunctions that can worsen exercise and/or posture adjustments., Objectives: To verify the cardiovascular responses to low-intensity isometric handgrip exercise performed in different postures in CAD patients. This study tested the hypothesis that the posture influences the cardiovascular responses during isometric handgrip exercise and that the presence of CAD leads to greater cardiovascular stress during this type of exercise., Methods: We investigated cardiovascular responses to isometric handgrip exercise in 15 CAD patients (CADG) and 15 health matched-control (CG). The subjects performed isometric handgrip exercise at 30% of maximum voluntary contraction until exhaustion in SUPINE, SITTING and STANDING positions. Systolic arterial pressure, diastolic arterial pressure, mean blood pressure, heart rate, peripheral vascular resistance, cardiac output, stroke volume and double product were measured during rest (baseline), exercise (peak value) and recovery in the 1st minute (REC1). Delta PB (ΔPB, peak minus baseline) and PR1 (ΔPR1, peak minus REC1) were calculated., Results: Higher ΔPB and ΔPR1 of systolic and mean arterial pressure and double product were observed in STANDING when compared to SITTING and/or SUPINE. CADG showed higher ΔPB of systolic and mean arterial pressure in all postures and higher ΔPR1 of strove volume in the SITTING., Conclusion: We concluded that the posture during isometric handgrip exercise influences the cardiovascular responses with STANDING leading to higher cardiovascular stress. CAD promoted higher arterial pressure responses however these responses were physiological and expected due to the presence of disease and type of exercise., (Copyright © 2019 Associação Brasileira de Pesquisa e Pós-Graduação em Fisioterapia. Publicado por Elsevier Editora Ltda. All rights reserved.)

Mercury is a metal widely dispersed in nature that when in contact with human organism, it damages the cardiovascular system. Long-term mercury exposure for 30 days induces endothelial dysfunction without blood pressure changes in normotensive adult rats. However, it is not known whether exposure to mercury can exacerbate endothelial dysfunction and hypertension development in predisposed animals. Thus, we aimed to investigate the effects of long-term mercury exposure on the blood pressure (BP) and in the isolated aortas of young normotensive and prehypertensive spontaneously hypertensive rats (SHRs). Four-week-old male Wistar rats and SHRs were treated daily with mercury chloride (HgCl 2 ) (1st dose, 4.6 μg/kg; subsequent dose, 0.07 μg/kg/day, im, 30 days) or vehicle. BP was assessed weekly and the vascular reactivity to phenylephrine was evaluated in isolated aorta from rats exposed or not to mercury. Mercury exposure did not affect BP in young Wistar rats but accelerated the development of hypertension in young SHRs. Vascular reactivity to phenylephrine increased only in the aorta from mercury-exposed SHRs. While HgCl 2 exposure in SHRs did not alter nitric oxide production, we observed increased superoxide anion production and decreased superoxide dismutase-1 protein expression, and enhanced cyclooxygenase-2 (COX-2) participation with increased prostaglandin (PGE 2 ) production and decreased prostacyclin. In the Wistar group, mercury exposure did not alter superoxide anion production or the COX-2 pathway. Mercury exposure accelerated the natural course of hypertension in young SHRs and increased oxidative stress associated with reduced participation of antioxidant enzymes, an activated COX-2 pathway, thereby producing endothelial dysfunction, which is a risk factor in prehypertensive individuals.

Background: Circulatory (CP) and ventilatory power (VP) have been used to improve the prognostic accuracy of cardiopulmonary exercise tests in cardiovascular disease, such as coronary artery disease. However, the effects of combined resistance and aerobic exercise program on VP and CP, especially in type 2 diabetes patients, have not been adequately investigated. Thus, this new parameter can be useful to prescribe exercise programs more assertive for this population. The present study aimed to assess the effect of 3 months of combined resistance and aerobic exercise training (CET) on CP and VP in patients with type 2 diabetes., Methods: A randomized controlled trial was conducted involving 48 diabetic patients with an average age of 52.4 (±8.01) years old. The subjects were randomized into two groups: sedentary (SG, n = 15) and the CET group (n = 19). Cardiopulmonary exercise testing (symptom-limited incremental) was performed on a cycle ergometer, and the following parameters were measured: relative VO 2 , V E /VCO 2 slope, linear relationship between oxygen uptake and minute ventilation, and VCO 2 . CET was performed with 30-min aerobic and 30-min resistance exercises three times a week for 12 weeks., Results: Significant (p < .05) and clinical (d ≥ .80) differences were observed that favoured CET compared with SG for the following variables: heart rate, workload, VO 2 relative peak, circulatory power peak, and VCO 2 peak. Although no statistical difference was observed for ventilatory power, there was a clinical difference (p > .05 and d ≥ 0.80) that favoured CET., Conclusion: Three months of combined exercise training improved VP and CP indices in patients with type 2 diabetes when compared with a sedentary group., (© 2019 John Wiley & Sons, Ltd.)

Mercury is a heavy metal associated with cardiovascular diseases. Studies have reported increased vascular reactivity without changes in systolic blood pressure (SBP) after chronic mercury chloride (HgCl 2 ) exposure, an inorganic form of the metal, in normotensive rats. However, we do not know whether individuals in the prehypertensive phase, such as young spontaneously hypertensive rats (SHRs), are susceptible to increased arterial blood pressure. We investigated whether chronic HgCl 2 exposure in young SHRs accelerates hypertension development by studying the vascular function of mesenteric resistance arteries (MRAs) and SBP in young SHRs during the prehypertensive phase. Four-week-old male SHRs were divided into two groups: the SHR control group (vehicle) and the SHR HgCl 2 group (4 weeks of exposure). The results showed that HgCl 2 treatment accelerated the development of hypertension; reduced vascular reactivity to phenylephrine in MRAs; increased nitric oxide (NO) generation; promoted vascular dysfunction by increasing the production of reactive oxygen species (ROS), such as hydrogen peroxide (H 2 O 2 ); increased Gp91Phox protein levels and in situ levels of superoxide anion (O 2 ·- ); and reduced vasoconstrictor prostanoid production compared to vehicle treatment. Although HgCl 2 accelerated the development of hypertension, the HgCl 2 -exposed animals also exhibited a vasoprotective mechanism to counterbalance the rapid increase in SBP by decreasing vascular reactivity through H 2 O 2 and NO overproduction. Our results suggest that HgCl 2 exposure potentiates this vasoprotective mechanism against the early establishment of hypertension. Therefore, we are concluding that chronic exposure to HgCl 2 in prehypertensive animals could enhance the risk for cardiovascular diseases.

Introduction: Expiratory flow limitation (EFL) during moderate intensity exercise is present in patients with myocardial infarction (MI), whereas in healthy subjects it occurs only at a high intensity. However, it is unclear whether this limitation already manifests in those with stable coronary artery disease (CAD) (without MI)., Materials and Methods: Forty-one men aged 40-65 years were allocated into (1) recent MI (RMI) group ( n  = 8), (2) late MI (LMI) group ( n  = 12), (3) stable CAD group ( n  = 9), and (4) healthy control group (CG) ( n  = 12). All participants underwent two cardiopulmonary exercise tests at a constant workload (moderate and high intensity), and EFL was evaluated at the end of each exercise workload., Results: During moderate intensity exercise, the RMI and LMI groups presented with a significantly higher number of participants with EFL compared to the CG ( p < 0.05), while no significant difference was observed among groups at high intensity exercise ( p > 0.05). Moreover, EFL was only present in MI groups during moderate intensity exercise, whereas at high intensity all groups presented EFL. Regarding the degree of EFL, the RMI and LMI groups showed significantly higher values at moderate intensity exercise in relation to the CG. At high intensity exercise, significantly higher values for the degree of EFL were observed only in the LMI group., Conclusion: The ventilatory limitation at moderate intensity exercise may be linked to the pulmonary consequences of the MI, even subjects with preserved cardiac and pulmonary function at rest, and not to CAD per se., Competing Interests: The authors declare that there are no conflicts of interest regarding the publication of this article., (Copyright © 2020 Viviane Castello-Simões et al.)

Background: High intensity interval training (HIIT) has been used as a cardiovascular exercise strategy to promote greater adherence in cardiovascular rehabilitation. However, little is known about the effect of this training modality on cardiac autonomic control., Objective: To perform a systematic review to evaluate the effects of HIIT on cardiac autonomic responses in humans., Methods: PEDro, SCOPUS and PubMed were searched from the inception to March 29th, 2018. Moreover, the methodological quality and statistical reporting from all eligible clinical trials were assessed by the PEDro scale. The articles were eligible if: The primary objective was related to the effects of HIIT on the cardiac autonomic nervous system. Outcomes evaluated were indirect measures of cardiac autonomic control, represented by HRV indexes., Results: The search strategies resulted in 339 citations and 2 additional citations were identified through other sources. After deleting the duplicate articles and revising the full text, 6 articles were included. Overall, the results showed an improvement in parasympathetic and/or sympathetic modulation after HIIT, when evaluated by linear and non-linear indexes of HRV., Conclusions: HIIT is a promising tool to improve the cardiac autonomic control, with more recommendation in healthy individuals and patients with metabolic syndrome., (Copyright © 2018 Associação Brasileira de Pesquisa e Pós-Graduação em Fisioterapia. Publicado por Elsevier Editora Ltda. All rights reserved.)

Both deterioration of the mechanical vascular properties of barosensitive vessels and autonomic derangement lead to modification of baroreflex sensitivity (BRS) in coronary artery disease (CAD) individuals. Type 2 diabetes (T2D) reduces BRS as well even in absence of cardiac autonomic neuropathy. The aim of the study is to clarify whether, assigned the degree of mechanical vascular impairment and without cardiac autonomic neuropathy, the additional autonomic dysfunction imposed in CAD patients by T2D (CAD-T2D) decreases BRS further. We considered CAD (n = 18) and CAD-T2D (n = 19) males featuring similar increases of average carotid intima media thickness (ACIMT) and we compared them to age- and gender-matched healthy (H, n = 19) subjects. BRS was computed from spontaneous beat-to-beat variability of heart period (HP) and systolic arterial pressure (SAP) at supine resting (REST) and during active standing (STAND). BRS was estimated via methods including time domain, spectral, cross-spectral, and model-based techniques. We found that (i) at REST BRS was lower in CAD and CAD-T2D groups than in H subjects but no difference was detected between CAD and CAD-T2D individuals; (ii) STAND induced an additional decrease of BRS visible in all the groups but again BRS estimates of CAD and CAD-T2D patients were alike; (iii) even though with different statistical power, BRS markers reached similar conclusions with the notable exception of the BRS computed via model-based approach that did not detect the BRS decrease during STAND. In presence of a mechanical vascular impairment, indexes estimating BRS from spontaneous HP and SAP fluctuations might be useless to detect the additional derangement of the autonomic control in CAD-T2D without cardiac autonomic neuropathy compared to CAD, thus limiting the applications of cardiovascular variability analysis to typify CAD-T2D individuals. Graphical abstract Graphical representation of the baroreflex sensitivity (BRS) estimated from spontaneous fluctuations of heart period and systolic arterial pressure via transfer function (TF) in low frequency (LF) band (from 0.04 to 0.15 Hz). BRS was reported as a function of the group (i.e., healthy (H), coronary artery disease (CAD) and CAD with type 2 diabetes (CAD-T2D) groups) at REST (black bars) and during STAND (white bars). Values are shown as mean plus standard deviation. The symbol "*" indicates a significant difference between conditions within the same group (i.e., H, CAD, or CAD-T2D) and the symbol "§" indicates a significant difference between groups within the same experimental condition (i.e., REST or STAND). BRS cannot distinguish CAD and CAD-T2D groups both at REST and during STAND, while it is useful to distinguish experimental conditions and separate pathological groups from H subjects.

The HIV subtype B is the most frequent in Brazil. The HIV subtype B' codes the amino acids glicine-tryptophan-glicine (GWG) instead of glicine-proline-glicine on the tip of gp120 V3 loop. This variant was associated to a slower HIV progression in mono-infected patients; however, there is no information in coinfected patients. This study evaluated the infection progression of HIV variant B' on the hepatitis C virus presence. RNA isolated from plasma of the 601 infected patients were used to human immunodeficiency virus (HIV) subtyping and to classify the virus according their syncytium-inducing ability. The HIV infection progression was evaluated by clinical and laboratorial data. The results showed a significant association between HIV B' variant and CD4 count and time of AIDS in HIV mono-infected patients. Notwithstanding the fact that we did not find a direct association between GWG variant and AIDS and in HIV coinfected patients no mitigating effect due to GWG presence was found. We did observe that the association between GWG variant and CD4 counts is lost in coinfected patients. This is first work showing influence of the HIV GWG variant in coinfected patients. Nevertheless, the presence of the GWG variant can indicate a better prognostic in the mono-infected patients.

Introduction: High levels of shrinkage stress caused by volumetric variations during the activation process are one of the main problems in the practical application of composite resins., Objective: The aim of this study is to reduce the shrinkage stress and minimize the effects caused by composite resin volumetric variation due to the photopolymerization. In this way, this work proposes a systematic study to determine the optimal dimming function to be applied to light curing processes., Material and Methods: The study was performed by applying mathematical techniques to the optimization of nonlinear objective functions. The effectiveness of the dimming function was evaluated by monitoring the polymerization shrinkage stress during the curing process of five brands/models of composites. This monitoring was performed on a universal testing machine using two steel bases coupled in the arms of the machine where the resin was inserted and polymerized. The quality of the composites cured by the proposed method was analyzed and compared with the conventional photoactivation method by experiments to determine their degree of conversion (DC). Absorbance measurements were performed using Fourier-transform infrared spectroscopy (FT-IR). A T-test was performed on DC results to compare the photoactivation techniques. We also used scanning electron microscopy (SEM) to analyze in-vitro the adhesion interface of the resin in human teeth., Results: Our results showed that the use of the optimal dimming function, named as exponential, resulted in the significant reduction of the shrinkage stress (~36.88% ±6.56 when compared with the conventional method) without affecting the DC (t=0.86, p-value=0.44). The SEM analyses show that the proposed process can minimize or even eliminate adhesion failures between the tooth and the resin in dental restorations., Conclusion: The results from this study can promote the improvement of the composite resin light curing process by the minimization of polymerization shrinkage effects, given an operational standardization of the photoactivation process.

Despite the appeal of ultra-short-term heart rate variability (HRV) methods of analysis applied in the clinical and research settings, the number of studies that have investigated HRV by analyzing R-R interval (RRi) recordings shorter than 5 min is still limited. Moreover, ultra-short-term HRV analysis has not been extensively validated during exercise and, currently, no indications exist for its applicability during resistance exercise. The aim of the present study was to compare ultra-short-term HRV analysis with standard short-term HRV analysis during low-intensity, dynamic, lower limb resistance exercise in healthy elderly subjects. Heart rate (HR) and RRi signals were collected from 9 healthy elderly men during discontinuous incremental resistance exercise consisting of 4-min intervals at low intensities (10, 20, 30, and 35% of 1-repetition maximum). The original RRi signals were segmented into 1-, 2-, and 3-min sections. HRV was analyzed in the time domain (root mean square of the of differences between adjacent RRi, divided by the number of RRi, minus one [RMSSD]), RRi mean value and standard deviation [SDNN] (percentage of differences between adjacent NN intervals that are greater than 50 ms [pNN50]), and by non-linear analysis (short-term RRi standard deviation [SD1] and long-term RRi standard deviation [SD2]). No significant difference was found at any exercise intensity between the results of ultra-short-term HRV analysis and the results of standard short-term HRV analysis. Furthermore, we observed excellent (0.70 to 0.89) to near-perfect (0.90 to 1.00) concordance between linear and non-linear parameters calculated over 1- and 2-min signal sections and parameters calculated over 3-min signal sections. Ultra-short-term HRV analysis appears to be a reliable surrogate of standard short-term HRV analysis during resistance exercise in healthy elderly subjects.

Though hundreds to thousands of reports have described the distribution of B chromosomes among diverse eukaryote groups, a comprehensive theory of their biological role has not yet clearly emerged. B chromosomes are classically understood as a sea of repetitive DNA sequences that are poor in genes and are maintained by a parasitic-drive mechanism during cell division. Recent developments in high-throughput DNA/RNA analyses have increased the resolution of B chromosome biology beyond those of classical and molecular cytogenetic methods; B chromosomes contain many transcriptionally active sequences, including genes, and can modulate the activity of autosomal genes. Furthermore, the most recent knowledge obtained from omics analyses, which is associated with a systemic view, has demonstrated that B chromosomes can influence cell biology in a complex way, possibly favoring their own maintenance and perpetuation.

The aim of this study was to investigate whether it is possible to identify the first turn point of blood lactate (BL) concentration (1 st lactate threshold - LT1) during a discontinuous resistance exercise protocol in coronary artery disease (CAD) patients and verify if heart rate variability (HRV) responses are consistent with BL responses. A total of 22 elderly men, 12 with CAD and 10 apparently healthy (control group = CG), underwent one-repetition maximum (1RM) testing on an inclined leg press. Discontinuous resistance exercise testing (DRET) was initiated at 10% of the 1RM with subsequent increases of 10% until 30% and after this percentage, 5% increments of 1RM was carried out. The load corresponding to LT1 was approximately 30% 1RM in both groups; and the LT1 estimate by HRV was associated with BL responses. HRV indices representing parasympathetic modulation decreased with increasing loads until LT1 and stabilized thereafter in both groups, and HRV indices representing sympathetic and parasympathetic modulations only increased in the CAD group from 30% 1RM with higher values after this load in relation to the CG. We conclude HRV appears to be an effective tool to estimate the LT1 during discontinuous resistance exercise in patients with CAD. In addition, these results may have an impact on the prescription of endurance resistance exercise in the CAD population, as cardiac vagal modulation is an important indicator of cardiovascular protection and the over-activity of sympathetic modulation is related to cardiovascular risk.

Background: Recent studies have shown that the magnitude of the metabolic and autonomic responses during progressive resistance exercise (PRE) is associated with the determination of the anaerobic threshold (AT). AT is an important parameter to determine intensity in dynamic exercise., Objectives: To investigate the metabolic and cardiac autonomic responses during dynamic resistance exercise in patients with Coronary Artery Disease (CAD)., Method: Twenty men (age = 63±7 years) with CAD [Left Ventricular Ejection Fraction (LVEF) = 60±10%] underwent a PRE protocol on a leg press until maximal exertion. The protocol began at 10% of One Repetition Maximum Test (1-RM), with subsequent increases of 10% until maximal exhaustion. Heart Rate Variability (HRV) indices from Poincaré plots (SD1, SD2, SD1/SD2) and time domain (rMSSD and RMSM), and blood lactate were determined at rest and during PRE., Results: Significant alterations in HRV and blood lactate were observed starting at 30% of 1-RM (p<0.05). Bland-Altman plots revealed a consistent agreement between blood lactate threshold (LT) and rMSSD threshold (rMSSDT) and between LT and SD1 threshold (SD1T). Relative values of 1-RM in all LT, rMSSDT and SD1T did not differ (29%±5 vs 28%±5 vs 29%±5 Kg, respectively)., Conclusion: HRV during PRE could be a feasible noninvasive method of determining AT in CAD patients to plan intensities during cardiac rehabilitation.

Integration of cytogenetics and genomics has become essential to a better view of architecture and function of genomes. Although the advances on genomic sequencing have contributed to study genes and genomes, the repetitive DNA fraction of the genome is still enigmatic and poorly understood. Among repeated DNAs, transposable elements (TEs) are major components of eukaryotic chromatin and their investigation has been hindered even after the availability of whole sequenced genomes. The cytogenetic mapping of TEs in chromosomes has proved to be of high value to integrate information from the micro level of nucleotide sequence to a cytological view of chromosomes. Different TEs have been cytogenetically mapped in cichlids; however, neither details about their genomic arrangement nor appropriated copy number are well defined by these approaches. The current study integrates TEs distribution in Nile tilapia Oreochromis niloticus genome based on cytogenetic and genomics/bioinformatics approach. The results showed that some elements are not randomly distributed and that some are genomic dependent on each other. Moreover, we found extensive overlap between genomics and cytogenetics data and that tandem duplication may be the major mechanism responsible for the genomic dynamics of TEs here analyzed. This paper provides insights in the genomic organization of TEs under an integrated view based on cytogenetics and genomics.

Introduction: Indexes derived from spontaneous heart period (HP) and systolic arterial pressure (SAP) fluctuations can detect autonomic dysfunction in individuals with type 2 diabetes mellitus (DM) associated to cardiovascular autonomic neuropathy (CAN) or other neuropathies. It is unknown whether HP and SAP variability indexes are sensitive enough to detect the autonomic dysfunction in DM patients without CAN and other neuropathies., Methods: We evaluated 68 males aged between 40 and 65 years. The group was composed by DM type 2 DM with no manifest neuropathy (n = 34) and healthy (H) subjects (n = 34). The protocol consisted of 15 minutes of recording of HP and SAP variabilities at rest in supine position (REST) and after active standing (STAND). The HP power in the high frequency band (HF, from 0.15 to 0.5 Hz), the SAP power in the low frequency band (LF, from 0.04 to 0.15 Hz) and BRS estimated via spectral approach and sequence method were computed., Results: The HF power of HP was lower in DM patients than in H subjects, while the two groups exhibited comparable HF power of HP during STAND. The LF power of SAP was similar in DM and H groups at REST and increased during STAND in both groups. BRSs estimated in the HF band and via baroreflex sequence method were lower in DM than in H and they decreased further during STAND in both populations., Conclusion: Results suggest that vagal control of heart rate and cardiac baroreflex control was impaired in type 2 DM, while sympathetic control directed to vessels, sympathetic and baroreflex response to STAND were preserved. Cardiovascular variability indexes are sensitive enough to typify the early, peculiar signs of autonomic dysfunction in type-2 DM patients well before CAN becomes manifest.

The aim of this study was to determine the anaerobic threshold (AT) in a population of healthy and post-myocardial infarction men by applying Hinkley's mathematical method and comparing its performance to the ventilatory visual method. This mathematical model, in lieu of observer-dependent visual determination, can produce more reliable results due to the uniformity of the procedure. 17 middle-aged men (55±3 years) were studied in 2 groups: 9 healthy men (54±2 years); and 8 men with previous myocardial infarction (57±3 years). All subjects underwent an incremental ramp exercise test until physical exhaustion. Breath-by-breath ventilatory variables, heart rate (HR), and vastus lateralis surface electromyography (sEMG) signal were collected throughout the test. Carbon dioxide output (V˙CO2), HR, and sEMG were studied, and the AT determination methods were compared using correlation coefficients and Bland-Altman plots. Parametric statistical tests were applied with significance level set at 5%. No significant differences were found in the HR, sEMG, and ventilatory variables at AT between the different methods, such as the intensity of effort relative to AT. Moreover, important concordance and significant correlations were observed between the methods. We concluded that the mathematical model was suitable for detecting the AT in both healthy and myocardial infarction subjects., (© Georg Thieme Verlag KG Stuttgart · New York.)

Objective: To evaluate heart rate variability during an inspiratory muscle endurance protocol at three different load levels [30%, 60% and 80% of maximal inspiratory pressure], in patients who had previously undergone coronary artery bypass grafting., Methods: Nineteen late postoperative myocardial revascularization patients participating in a cardiovascular rehabilitation program were studied. Maximal inspiratory pressure maneuvers were performed. An inspiratory muscle endurance protocol at 30%, 60% and 80% of maximal inspiratory pressure was applied for four minutes each, in random order. Heart rate and RR intervals were recorded and heart rate variability was analyzed by time (RMSSD-the mean of the standard deviations for all R-R intervals, and RMSM-root-mean square differences of successive R-R intervals) and frequency domains indices (high and low frequency) in normalized units. ANOVA for repeated measurements was used to compare heart rate variability indices and Student t-test was used to compare the maximal inspiratory pressure and maximal expiratory pressure values., Results: Heart rate increased during performance of maximal respiratory pressures maneuvers, and the maximal inspiratory pressure and maximal expiratory pressure mean values were significantly lower than predicted values (P <0.05). RMSSD increased significantly at 80% in relation to rest and 30% of maximal inspiratory pressure and RMSM decreased at 30% and 60% of maximal inspiratory pressure in relation to rest (P <0.05). Additionally, there was significant and progressive decrease in low frequency and increase in high frequency at 30%, 60% and 80% of maximal inspiratory pressure in relation to the resting condition., Conclusion: These results suggest that respiratory muscle training at high intensities can promote greater parasympathetic activity and it may confer important benefits during a rehabilitation program in post-coronary artery bypass grafting.