OBJECTIVES: To describe the MORPHEOS (Morbidity in patients with uncontrolled HTN and OSA) trial, and describe the challenges imposed by the COVID-19 pandemic. METHODS: MORPHEOS is a multicenter (n=6) randomized controlled trial designed to evaluate the blood pressure (BP) lowering effects of treatment with continuous positive airway pressure (CPAP) or placebo (nasal strips) for 6 months in adult patients with uncontrolled hypertension (HTN) and moderate-to-severe obstructive sleep apnea (OSA). Patients using at least one antihypertensive medication were included. Uncontrolled HTN was confirmed by at least one abnormal parameter in the 24-hour ABPM and ≥80% medication adherence evaluated by pill counting after the run-in period. OSA was defined by an apnea-hypopnea index ≥15 events/hours. The co-primary endpoints are brachial BP (office and ambulatory BP monitoring, ABPM) and central BP. Secondary outcomes include hypertension-mediated organ damage (HMOD) to heart, aorta, eye, and kidney. We pre-specified several sub-studies from this investigation. Visits occur once a week in the first month and once a month thereafter. The programmed sample size was 176 patients but the pandemic prevented this final target. A post-hoc power analysis will be calculated from the final sample. ClinicalTrials.gov: NCT02270658. RESULTS: The first 100 patients are predominantly males (n=69), age: 52±10 years, body mass index: 32.7±3.9 kg/m2 with frequent co-morbidities. CONCLUSIONS: The MORPHEOS trial has a unique study design including a run-in period; pill counting, and detailed analysis of hypertension-mediated organ damage in patients with uncontrolled HTN that will allow clarification of the impact of OSA treatment with CPAP.

In early 2020, the World Health Organization (WHO) recognized the pandemic situation of the new coronavirus (severe acute respiratory syndrome coronavirus 2, SARS-CoV-2), which causes Coronavirus Disease-2019 (COVID-19). In Brazil by the end of April 2020, another 110 thousand cases and 5,000 deaths had been confirmed. The scarcity of laboratory resources and overload of the care network, added to the broad clinical spectrum of the disease, can make it difficult to capture all mortality from this disease through epidemiological surveillance based on individual notification of cases. The aim of this study was to evaluate the excess of deaths in Brazilian capitals with the highest incidence of COVID-19, as a way of validating the method, we also evaluated a capital with low incidence. We assessed weekly mortality from all causes during the year 2020, up to the epidemiological week 17, compared with the previous year. The data were obtained through the National Civil Registry Information Center (CNIRC, acronym in Portuguese). We estimate the expected mortality and the 95% confidence interval by projecting the observed mortality in 2019 for the population of 2020. In the five capitals with the highest incidences it was possible to identify excess deaths in the pandemic period, the age group most affected were those over 60 years old, 31% of the excess deaths occurred in the population between 20 and 59 years old. There was a strong correlation (r = 0.94) between the excess of deaths in each city and the number of deaths confirmed by epidemiological surveillance. There was no excess of deaths in the capital with the lowest incidence, nor among the population under 20 years old. We estimate that epidemiological surveillance managed to capture only 52% of all mortality associated with the COVID-19 pandemic in the cities studied. Considering the simplicity of the method, its low cost and reliability for assessing the real burden of the disease, we believe that the assessment of excess mortality associated with the COVID-19 pandemic should be widely used as a complementary tool to regular epidemiological surveillance and its use should be encouraged by WHO.

No início de 2020 a Organização Mundial da Saúde (OMS) reconheceu a situação de pandemia do novo coronavírus (severe acute respiratory syndrome coronavirus 2, SARS-CoV-2), causador da Coronavirus Disease-2019 (COVID-19). No Brasil até o final de abril de 2020 já tinham sido confirmados mais 110 mil casos e de 5 mil óbitos. A escassez de recursos laboratoriais e sobrecarga da rede assistencial, somados ao amplo espectro clínico da doença, pode dificultar a captação de toda a mortalidade por esta doença pela vigilância epidemiológica baseada na notificação individual dos casos. O objetivo deste estudo foi avaliar o excesso de mortes nas capitais brasileiras com maiores incidências de COVID-19, como forma de validação do método avaliamos, também, uma capital com baixa incidência. Nós avaliamos a mortalidade semanal por todas as causas durante o ano de 2020, até a semana epidemiológica 17, comparando com o ano anterior. Os dados foram obtidos através da Central Nacional de Informações do Registro Civil (CNIRC). Nós estimamos a mortalidade esperada e o intervalo de confiança de 95% projetando a mortalidade observada em 2019 para a população de 2020. Nas cinco capitais com maiores incidências foi possível identificar excesso de mortes no período da pandemia, a faixa etária mais afetada foram aqueles com mais de 60 anos, 31% do excesso de mortes ocorreu na população entre 20 e 59 anos. Houve uma forte correlação (r=0.94) entre o excesso de mortes em cada cidade e o número de mortes confirmados pela vigilância epidemiológica. Não houve excesso de mortes na capital com mais baixa incidência, nem entre a população com menos de 20 anos. Estimamos que a vigilância epidemiológica conseguiu captar apenas 52% de toda a mortalidade associada à pandemia de COVID-19 nas cidades estudadas. Considerando a simplicidade do método, seu baixo custo e confiabilidade para avaliação da carga real da doença, acreditamos que a avaliação do excesso de mortalidade associado à pandemia de COVID-19 deveria ser amplamente utilizada como ferramenta complementar à vigilância epidemiológica regular e ter seu uso incentivado pela OMS.

Abstract INTRODUCTION: In March 2020, the World Health Organization declared the coronavirus disease (COVID-19) outbreak a pandemic. In Brazil, 110 thousand cases and 5,901 deaths were confirmed by the end of April 2020. The scarcity of laboratory resources, the overload on the service network, and the broad clinical spectrum of the disease make it difficult to document all the deaths due to COVID-19. The aim of this study was to assess the mortality rate in Brazilian capitals with a high incidence of COVID-19. METHODS: We assessed the weekly mortality between epidemiological week 1 and 16 in 2020 and the corresponding period in 2019. We estimated the expected mortality at 95% confidence interval by projecting the mortality in 2019 to the population in 2020, using data from the National Association of Civil Registrars (ARPEN-Brasil). RESULTS: In the five capitals with the highest incidence of COVID-19, we identified excess deaths during the pandemic. The age group above 60 years was severely affected, while 31% of the excess deaths occurred in the age group of 20-59 years. There was a strong correlation (r = 0.94) between excess deaths and the number of deaths confirmed by epidemiological monitoring. The epidemiological surveillance captured only 52% of all mortality associated with the COVID-19 pandemic in the cities examined. CONCLUSIONS: Considering the simplicity of the method and its low cost, we believe that the assessment of excess mortality associated with the COVID-19 pandemic should be used as a complementary tool for regular epidemiological surveillance.

Resumo: O objetivo deste trabalho foi avaliar o desempenho de híbridos de milho (Zea mays) intervarietais, a partir de cruzamentos topcross entre populações crioulas, além de confirmar se a dissimilaridade genética entre as populações é correlacionada à heterose dos híbridos intervarietais no campo. Nove híbridos topcross foram avaliados com seu testador 'BRS Planalto', e as seguintes populações crioulas foram utilizadas como genitores: Argentino Branco, Dente de Ouro, Amarelão, Criolão, Caiano Rajado, Branco Oito Carreiras, Branco Roxo Índio, Cateto Branco e Argentino Amarelo. O testador 'BRS Planalto' e os híbridos topcross Branco Oito Carreiras x 'BRS Planalto' e Criolão x 'BRS Planalto' apresentaram maior potencial per se quanto ao rendimento de grãos. O topcross Branco Oito Carreiras x 'BRS Planalto' apresentou melhor desempenho quanto a número de grãos por fileira, massa de grãos da espiga e diâmetro de espiga, enquanto o Criolão x 'BRS Planalto' apresentou melhor desempenho quanto a número de grãos por fileira e comprimento de espiga. As maiores estimativas de distância genética não implicaram, necessariamente, altos valores de heterose, e tiveram correlação apenas com o comprimento da espiga. Portanto, não é possível predizer os efeitos de alta heterose sobre o rendimento de grãos, com base na distância genética entre as populações envolvidas nos cruzamentos.

Abstract: The objective of this work was to evaluate the performance of intervarietal corn (Zea mays) hybrids with topcross crosses between landrace populations, and to confirm whether genetic dissimilarity between populations is correlated with the heterosis of the intervarietal hybrids in the field. Nine topcross hybrids were evaluated with their tester 'BRS Planalto', and the following landrace populations were used as parents: Argentino Branco, Dente de Ouro, Amarelão, Criolão, Caiano Rajado, Branco Oito Carreiras, Branco Roxo Índio, Cateto Branco, and Argentino Amarelo. The tester 'BRS Planalto' and the topcross hybrids Branco Oito Carreiras x 'BRS Planalto' and Criolão x 'BRS Planalto' showed higher per se potential for grain yield. The topcross hybrid Branco Oito Carreiras x 'BRS Planalto' showed a better performance for number of grains per row, grain weight, and ear diameter, whereas Criolão x 'BRS Planalto' displayed a better performance for the number of grains per row and ear length. Greater estimates of genetic distance did not necessarily result in greater heterosis values and were exclusively correlated with grain ear length. Therefore, it is not possible to predict the effects of high heterosis on grain yield, based on the genetic distance between the populations involved in the crosses.

Resumo: O objetivo deste trabalho foi avaliar a consistência dos métodos de Annicchiarico, Lin & Binns, Wricke e de análise fatorial na identificação de clones de eucalipto com estabilidade, adaptabilidade e alto potencial produtivo. Foram utilizados 84 clones, com três anos de idade, provenientes do programa de melhoramento genético da empresa CMPC Celulose Riograndense. Três experimentos de campo foram realizados em delineamento de blocos ao acaso, em arranjo fatorial 84x3, com 20 repetições de uma planta por parcela. Os clones foram avaliados quanto a diâmetro à altura do peito, altura da planta e volume de madeira. Os métodos de Annicchiarico e Lin & Binns são altamente correlacionados entre si, e seu uso em conjunto com o método de Wricke é uma estratégia apropriada para avaliação de clones de eucalipto. A análise fatorial identificou clones amplamente adaptáveis, e alguns deles foram os mesmos identificados pelos métodos de Annicchiarico e Lin & Binns. O uso da classificação média dos clones, juntamente com a análise fatorial, é eficiente para identificar os mais adaptados, estáveis e produtivos, entre um elevado número de genótipos.

Abstract: The objective of this work was to evaluate the consistency of the methods of Annicchiarico, Lin & Binns, Wricke, and factor analysis in identifying eucalyptus clones with stability, adaptability, and high productive potential. Eight-four clones, with three years of age, from the genetic breeding program of the company CMPC Celulose Riograndense were used. Three field experiments were carried out in a randomized complete block design, in an 84x3 factorial arragement, with 20 replicates of one plant per plot. The clones were evaluated as to diameter at breast height, plant height, and volume of wood. The methods of Annicchiarico and Lin & Binns are highly correlated with each other, and their use together with the method of Wricke is a sound strategy for the evaluation of eucalyptus clones. The factor analysis identified broadly adaptable clones, and some of them were the same ones identified by the methods of Annicchiarico and Lin & Binns. The use of the mean classification of the clones, along with the factor analysis, is efficient to identify the most adapted, stable, and productive ones among a high number of genotypes.

Tandem repeats (microsatellites or SSRs) are molecular markers with great potential for plant genetic studies. Modern strategies include the transfer of these markers among widely studied and orphan species. In silico analyses allow for studying distribution patterns of microsatellites and predicting which motifs would be more amenable to interspecies transfer. Transcribed sequences (Unigene) from ten species of three plant families were surveyed for the occurrence of micro and minisatellites. Transcripts from different species displayed different rates of tandem repeat occurrence, ranging from 1.47% to 11.28%. Both similar and different patterns were found within and among plant families. The results also indicate a lack of association between genome size and tandem repeat fractions in expressed regions. The conservation of motifs among species and its implication on genome evolution and dynamics are discussed.

Os autores relatam o caso de uma paciente de 19 anos de idade, com quadro característico de esclerose tuberosa, que evoluiu com hemorragia maciça em astrocitoma subependimário de células gigantes e óbito súbito. Aspectos da fisiopatologia do sangramento são discutidos.

The authors report the case of 19 year-old patient with features of tuberous sclerosis that developed a massive hemorrhage in a subependymal giant-cell astrocytoma causing sudden death. Aspects of the pathophysiological bleeding are discussed.