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OBJECTIVE: The COVID-19 pandemic has raised numerous concerns regarding its effects on individuals' health and lifestyle. We aim to analyze potential changes in adolescent sleep patterns from before and during the pandemic and identify specific predictors of changes. METHODS: A subgroup of adolescents from a population-based birth cohort from Pelotas, Brazil, was assessed pre-pandemic (T1, November-2019 to March-2020) and peri-pandemic (T2, August-2021 to December-2021) in in-person interviews (n = 1,949). Sleep parameters, including sleep duration and latency time on workdays and free days, as well as social jetlag (SJL), were assessed using the Munich ChronoType Questionnaire (MCTQ). Socio-demographic, pre-pandemic, and pandemic-related predictors were analyzed. Changes in sleep parameters from T1 to T2 were estimated by multivariate latent change score modeling. RESULTS: The latent change factor shows a significant mean increase in workday sleep duration (M = 0.334, p < 0.001), workday sleep latency (M = 0.029, p = 0.002), and free day sleep latency (M = 0.021, p = 0.034), and a decreased in SJL (M = -0.758, p < 0.001) during the pandemic. Female adolescents presented higher increases in workday sleep duration. Adolescents who adopted a stricter social distancing level during the pandemic presented greater increases in workday sleep duration and smaller reductions in SJL. Self-evaluated insomnia during the pandemic predicted lower increases in workday and free day sleep duration and higher increases in workday and free day sleep latency. CONCLUSION: The COVID-19 outbreak brought certain advantages regarding increased sleep duration and reduced SJL. However, the observed increase in sleep latency and the influence of self-reported insomnia could be related to psychological distress inherent to the pandemic.

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Background: The impact of previous SARS-CoV-2 infection on the systemic immune response during tuberculosis (TB) disease has not been explored. Methods: An observational, cross-sectional cohort was established to evaluate the systemic immune response in persons with pulmonary tuberculosis with or without previous SARS-CoV-2 infection. Those participants were recruited in an outpatient referral clinic in Rio de Janeiro, Brazil. TB was defined as a positive Xpert-MTB/RIF Ultra and/or a positive culture of Mycobacterium tuberculosis from sputum. Stored plasma was used to perform specific serology to identify previous SARS-CoV-2 infection (TB/Prex-SCoV-2 group) and confirm the non- infection of the tuberculosis group (TB group). Plasmatic cytokine/chemokine/growth factor profiling was performed using Luminex technology. Tuberculosis severity was assessed by clinical and laboratory parameters. Participants from TB group (4.55%) and TB/Prex-SCoV-2 (0.00%) received the complete COVID-19 vaccination. Results: Among 35 participants with pulmonary TB, 22 were classified as TB/Prex-SCoV-2. The parameters associated with TB severity, together with hematologic and biochemical data were similar between the TB and TB/Prex-SCoV-2 groups. Among the signs and symptoms, fever and dyspnea were significantly more frequent in the TB group than the TB/Prex-SCoV-2 group (p < 0,05). A signature based on lower amount of plasma EGF, G-CSF, GM-CSF, IFN-α2, IL-12(p70), IL-13, IL-15, IL-17, IL-1ß, IL-5, IL-7, and TNF-ß was observed in the TB/Prex-SCoV-2 group. In contrast, MIP-1ß was significantly higher in the TB/Prex-SCoV-2 group than the TB group. Conclusion: TB patients previously infected with SARS-CoV-2 had an immunomodulation that was associated with lower plasma concentrations of soluble factors associated with systemic inflammation. This signature was associated with a lower frequency of symptoms such as fever and dyspnea but did not reflect significant differences in TB severity parameters observed at baseline.

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Glucose-6 phosphate dehydrogenase deficiency (G6PDd) was suggested as a risk factor for severe disease in patients with COVID-19. We evaluated clinical outcomes and glucose-6 phosphate dehydrogenase (G6PD) activity during and after illness in patients with COVID-19. This prospective cohort study included adult participants (≥ 18 years old) who had clinical and/or radiological COVID-19 findings or positive reverse transcription-polymerase chain reaction results. Epidemiological and clinical data were extracted from electronic medical records. Glucose-6 phosphate dehydrogenase activity was measured using SD Biosensor STANDARD G6PD® equipment on admission and 1 year after discharge. Samples were genotyped for the three most common single nucleotide polymorphisms for G6PDd in the Brazilian Amazon. Seven hundred fifty-three patients were included, of whom 123 (16.3%) were G6PD deficient. There was no difference between groups regarding the risks of hospitalization (P = 0.740) or invasive mechanical ventilation (P = 0.31), but the risk of death was greater in patients with normal G6PD levels (P = 0.022). Only 29 of 116 participants (25%) carried the African G6PDd genotype. Of 30 participants tested as G6PD deficient during disease, only 11 (36.7%) results agreed 1 year after discharge. In conclusion, this study does not demonstrate an association of G6PDd with severity of COVID-19. Limitations of the test for detecting enzyme levels during COVID-19 illness were demonstrated by genotyping and retesting after the disease period. Care must be taken when screening for G6PDd in patients with acute COVID-19.

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Features of threatening cues and the associated context influence the perceived imminence of threat and the defensive responses evoked. To provide additional knowledge about how the directionality of a threat (i.e. directed-towards or away from the viewer) might impact defensive responses in humans, participants were shown pictures of a man carrying a gun (threat) or nonlethal object (neutral) directed-away from or towards the participant. Cardiac and electrodermal responses were collected. Compared to neutral images, threatening images depicting a gun directed-towards the participant induced sustained bradycardia and an increased electrodermal response, interpreted as immobility under attack. This defensive immobility reaction is evoked by high perceived threat and inescapable situations and indicates intense action preparation. Pictures of guns directed-away from the participant induced shorter bradycardia and no significant modulation of the electrodermal response compared to neutral pictures, which might be consistent with the perception of a less threatening situation. The results show that the directionality of threat stimuli is a key factor that prompts different patterns of defensive responses.

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ABSTRACT OBJECTIVE The COVID-19 pandemic has raised numerous concerns regarding its effects on individuals' health and lifestyle. We aim to analyze potential changes in adolescent sleep patterns from before and during the pandemic and identify specific predictors of changes. METHODS A subgroup of adolescents from a population-based birth cohort from Pelotas, Brazil, was assessed pre-pandemic (T1, November-2019 to March-2020) and peri-pandemic (T2, August-2021 to December-2021) in in-person interviews (n = 1,949). Sleep parameters, including sleep duration and latency time on workdays and free days, as well as social jetlag (SJL), were assessed using the Munich ChronoType Questionnaire (MCTQ). Socio-demographic, pre-pandemic, and pandemic-related predictors were analyzed. Changes in sleep parameters from T1 to T2 were estimated by multivariate latent change score modeling. RESULTS The latent change factor shows a significant mean increase in workday sleep duration (M = 0.334, p < 0.001), workday sleep latency (M = 0.029, p = 0.002), and free day sleep latency (M = 0.021, p = 0.034), and a decreased in SJL (M = −0.758, p < 0.001) during the pandemic. Female adolescents presented higher increases in workday sleep duration. Adolescents who adopted a stricter social distancing level during the pandemic presented greater increases in workday sleep duration and smaller reductions in SJL. Self-evaluated insomnia during the pandemic predicted lower increases in workday and free day sleep duration and higher increases in workday and free day sleep latency. CONCLUSION The COVID-19 outbreak brought certain advantages regarding increased sleep duration and reduced SJL. However, the observed increase in sleep latency and the influence of self-reported insomnia could be related to psychological distress inherent to the pandemic.

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The present systematic review aimed to evaluate the effect of probiotic supplementation on gut microbiota and sport performance in athletes and physically active individuals. This review followed the recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (P RISMA). The search had no time limits and included the following databases: MEDLINE, LILACS, Scopus, Web of Science, Cochrane, and SP ORT Discus. The risk of bias was assessed through the updated version of the Cochrane tool for assessing the risk of bias in randomized trials (RoB 2). Nine randomized clinical trials (RCTs) were included, accounting for 216 participants. Of these, seven studies found positive results on sport performance. Additionally, some studies showed significant decrease in biochemical parameters linked to inflammation. It was also observed direct results in the microbiota composition of the participants, such as an increase in the abundance of probiotics and a decrease in certain pathogenic bacteria. Therefore, the use of probiotics showed improvement in inflammatory biomarkers and oxidative stress, which indirectly may contribute to the improvement of sport performance. However, the majority of the studies presented a high risk of bias, which impair the reproducibility of the results. While the field of probiotic supplementation and sport performance is emerging, the promising results from this systematic review suggest that further investigation through larger and more robust randomized clinical trials can provide valuable insights for athletes and their performance.

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The freshwater/brackish amphipod Quadrivisio lutzi inhabits coastal lagoons, highly unstable environments subject to sudden inflow of marine water. Our aim was to evaluate how the genetic composition varies in these populations. Brazilian populations were compared by 16S rRNA and COI gene sequences. The genetic structure of four Rio de Janeiro amphipod populations was evaluated during the period of 2011-2019 by COI. Rio de Janeiro population was compared with Alagoas and São Paulo populations, which was genetically distinct, at species level (16S, d > 7%; COI, d >14%). The genetic structure in Rio de Janeiro showed the Imboassica subpopulation as the most divergent (Imboassica & Carapebus, F ST = 0.238), followed by Lagamar population (Lagamar & Carapebus, F ST = 0.049). The geographic distance and urbanization around these lagoons explain the degree of genetic isolation of these amphipod subpopulations. Paulista and Carapebus populations were not structured. Temporal variation in haplotype number and frequency were evident in both populations that were evaluated (Carapebus and Imboassica). Changes in salinity and water volume variation at these lagoons may be responsible for the observed changes in genetic composition, which may be the results of genetic drift effects over temporally fluctuating size subpopulations, without loss of genetic diversity.

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Background: Despite the proliferation of studies on the impact of the coronavirus disease 2019 (COVID-19) pandemic, there is less evidence on the indirect death toll compared to the health system and service provision disruptions. We assessed the impact of the COVID-19 pandemic on national and regional trends and differences in stillbirths, under-5 and maternal deaths in Brazil. Methods: We used the nationwide routine health information system data from January 2017 to December 2021, to which we applied descriptive and advanced mixed effects ordinary least squared regression models to measure the percent change in mortality levels during the COVID-19 pandemic (March 2020 to December 2021). We carried out counterfactual analyses comparing the observed and expected mortality levels for each type of mortality at national and regional levels. Results: Stillbirths increased 4.8% (3.1% in 2020 and 6.2% in 2021) and most noticeably maternal deaths increased 71.6% (35.3% in 2020 and 103.3% in 2021) over the COVID-19 period. An opposite pattern was observed in under-5 mortality, which dropped -10.2% (-12.5% in 2020 and -8.1% in 2021). We identified regional disparities, with a higher percent increase in stillbirths observed in the Central-West region and in maternal deaths in the South region. Discussion: Based on pre-pandemic trends and expected number of deaths in the absence of the COVID-19, we observed increases in stillbirths and maternal deaths and reductions in under-5 deaths during the pandemic. The months with the highest number of deaths (stillbirths and maternal deaths) coincided with the months with the highest mortality from COVID-19. The increase in deaths may also have resulted from indirect effects of the pandemic, such as unavailability of health services or even reluctance to go to the hospital when necessary due to fear of contagion. Conclusions: In Brazil, the COVID-19 outbreak and subsequent restrictions had a detrimental impact on stillbirths and maternal deaths. Even before the pandemic, mortality trends highlighted pre-existing regional inequalities in the country's health care system. Although there were some variations, increases were observed in all regions, indicating potential weaknesses in the health system and inadequate management during the pandemic, particularly concerning pregnant and postpartum women.

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BACKGROUND AND AIMS: Dysphagia is a swallowing disorder that affects mainly the older adults and can compromise quality of life, and increase the risk for malnutrition and aspiration. Early diagnosis is, therefore, essential to prevent adversities. We aimed to evaluate the validity of self-perceived dysphagia in community-dwelling older adults (60 years or older) from Pelotas, Brazil, participants in the "COMO VAI?" METHODS: The Eating Assessment Tool (EAT-10) was used as the reference tool to identify the risk for dysphagia and the self-perception of dysphagia was assessed using the following question: "Do you have swallowing difficulties?" (Yes/No). The parameters of sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy were described with 95% confidence intervals (95% CI) and according to independent variables (sex, age, economic level, and education). RESULTS: The prevalence of dysphagia risk according to EAT-10 and self-perception was 12.9% (95% CI 10.2-16.1) and 8.8% (95% CI 6.6-11.6), respectively. Sensitivity was 34.8% (95% CI 23.5-47.6) and the highest values were observed in women and the older individuals (80 years or older). Specificity was 95.1% (95% CI 92.6-96.9). PPV was 51.1% (95% CI 35.8-66.3), NPV 90.8% (95% CI 87.8-93.2) and accuracy 87.3%. CONCLUSIONS: Considering the low sensitivity and PPV, the self-perception of dysphagia analyzed with a single question should be used with caution, as an individual at risk for dysphagia may not realize their condition.

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Objective To investigate sleep duration and its associated factors in adolescents aged 11 years from the 2004 Pelotas (Brazil) Birth Cohort Study. Methods Sleep duration was assessed using a self-report sleep habits. Independent variables included perinatal, sociodemographic, behavioral, and health characteristics. The associations were estimated using multiple linear regression. Results The mean sleep duration of 3,179 adolescents was 9.3 hour (SD =1.7 hour). Longer sleep duration was associated with lower socioeconomic status at birth (ß: 0.37, 95% CI: 0.12; 0.61), lower mother's education level ( p < 0.001), and being female (ß: 0.19, 95% CI: 0.06; 0.33). Shorter sleep duration was associated with cesarean section delivery (ß: -0.16, 95% CI: -0.31; -0.02); having classes in the morning shift (ß: -1.38, 95% CI: -1.51; -1.26), and lower terciles of physical activity ( p = 0.04). Conclusions The mean sleep duration observed in this study was consistent with the international recommendations for this age range. Adolescents from lower income families, who are more active, study in shifts other than morning, girls, and those born through vaginal delivery presented higher sleep duration than their counterparts.