1
|
Noorbakhsh S, Roshan VD. Influence of 8 Weeks of Tabata High-Intensity Interval Training and Nanocurcumin Supplementation on Inflammation and Cardiorespiratory Health among Overweight Elderly Women. Prev Nutr Food Sci 2023; 28:224-234. [PMID: 37842247 PMCID: PMC10567597 DOI: 10.3746/pnf.2023.28.3.224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 07/19/2023] [Accepted: 07/24/2023] [Indexed: 10/17/2023] Open
Abstract
Nanocurcumin (NaC) and high-intensity interval training (HIIT) play crucial role in weight and inflammation control. The purpose of the current study was to evaluate the separate and combined effects of 8 weeks of Tabata-HIIT and NaC supplementation on the NOD-like receptor family pyrin domain-containing 3 (NLRP3) inflammasome, long non-coding RNA myocardial infarction associated transcript (lncRNA MIAT) expression, body composition, and cardiorespiratory health in elderly overweight women. A total of 48 healthy overweight elderly women were randomly divided into four groups: NaC, Tabata-HIIT+Pla, Tabata-HIIT+NaC, and placebo. Participants underwent a Tabata HIIT program (2 days per week, at 80∼0% of maximal HR) and NaC supplementation (daily 80 mg in two 40 mg capsules) for 8 weeks. Blood sampling, cardiorespiratory hemodynamic responses, and body composition evaluations were obtained before and after treadmill stress testing at the baseline timepoint and following 8 weeks of intervention. The mRNA of lncRNA-MIAT and NLRP3 were measured by real-time polymerase chain reaction. After 8 weeks, a significant improvement was observed in body composition and cardiorespiratory hemodynamics in the Tabata-HIIT groups compared to the NaC alone and placebo groups (P<0.05). Tabata training, both with and without the addition of nano curcumin supplementation, did not result significant effect on the resting levels of lncRNA-MIAT expression (P>0.05). Nevertheless, NaC supplementation along with Tabata training led to a significant reduction in NLRP3 inflammasome. In addition, NaC supplementation in overweight/preobese women improved systemic inflammation during treadmill stress testing. These findings indicating the suppressive effects of non-pharmacologic interventions on the sympathetic system and downregulation of the inflammasome.
Collapse
Affiliation(s)
- Sepideh Noorbakhsh
- Department of Exercise Physiology, Faculty of Sport Science, University of Mazandaran, Babolsar 416, Iran
| | - Valiollah Dabidi Roshan
- Department of Exercise Physiology, Faculty of Sport Science, University of Mazandaran, Babolsar 416, Iran
- Athletic Performance and Health Research Center, Department of Exercise Physiology, Faculty of Sport Science, University of Mazandaran, Babolsar 416, Iran
| |
Collapse
|
2
|
Gentil P, Silva LRBE, Antunes DE, Carneiro LB, de Lira CAB, Batista G, de Oliveira JCM, Cardoso JS, Souza DC, Rebelo ACS. The effects of three different low-volume aerobic training protocols on cardiometabolic parameters of type 2 diabetes patients: A randomized clinical trial. Front Endocrinol (Lausanne) 2023; 14:985404. [PMID: 36755928 PMCID: PMC9900112 DOI: 10.3389/fendo.2023.985404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2022] [Accepted: 01/03/2023] [Indexed: 01/24/2023] Open
Abstract
Objective To compare the effects of different aerobic training protocols on cardiometabolic variables in patients with type 2 diabetes mellitus (T2DM). Methods This study was a parallel clinical trial. Fifty-two men and women with T2DM (>40 years) were randomly allocated into three groups, and 44 (22 males/22 females) were included in the final analysis. Exercise intensity was based on the speed corresponding to the maximum oxygen consumption (v V ˙ O2max). Moderate intensity continuous training (MICT) involved 14 minutes at 70% of v V ˙ O2max; short interval high-intensity interval training (S-HIIT) consisted of 20 bouts of 30 seconds at 100% of V˙O2max with 30 seconds passive recovery; long interval high-intensity training (L-HIIT) consisted of 5 bouts of 2 minutes at 100% of v V ˙ O2max with 2 minutes passive recovery. Training protocols were performed on a motorized treadmill two times per week for eight weeks. Glycated hemoglobin (Hb1Ac), total cholesterol, triglycerides, resting systolic blood pressure (SBP), resting diastolic blood pressure (DBP), resting heart rate (resting HR) and maximum oxygen consumption (V˙O2max) were measured before and after the exercise intervention. The study was registered on the Brazilian clinical trial records (ID: RBR45 4RJGC3). Results There was a significant difference between groups for changes on V ˙ O2max. Greater increases on V ˙ O2max were achieved for L-HIIT (p = 0.04) and S-HIIT (p = 0.01) in comparison to MICT group, with no significant difference between L-HIIT and S-HIIT (p = 0.9). Regarding comparison within groups, there were significant reductions on HbA1c and triglycerides levels only for L-HIIT (p< 0.05). V ˙ O2max significantly increased for both L-HIIT (MD = 3.2 ± 1.7 ml/kg/min, p< 0.001) and S-HIIT (MD = 3.4 ± 1.7, p< 0.001). There was a significant reduction on resting SBP for L-HIIT group (MD = -12.07 ± 15.3 mmHg, p< 0.01), but not for S-HIIT and MICT. There were no significant changes from pre- to post-training on fasting glycemia, total cholesterol, HDL, LDL, resting HR and resting DBP for any group (p > 0.05). Conclusion Low-volume HIIT promoted greater improvements in cardiorespiratory capacity in comparison with low-volume MICT, independent of the protocols used. There were no other differences between groups. All protocols improved at least one of the variables analyzed; however, the most evident benefits were after the high-intensity protocols, especially L-HIIT.
Collapse
Affiliation(s)
- Paulo Gentil
- College of Physical Education and Dance, Federal University of Goiás, Goiânia, Brazil
- Hypertension League, Federal University of Goiás, Goiânia, Brazil
- Instituto VIDA, Brasilia, Brazil
| | - Lucas Raphael Bento e Silva
- College of Physical Education and Dance, Federal University of Goiás, Goiânia, Brazil
- Faculty of Medicine, Federal University of Goiás, Goiânia, Brazil
- Hospital das Clínicas, Federal University of Goiás, Goiânia, Brazil
| | | | | | - Claudio Andre Barbosa de Lira
- College of Physical Education and Dance, Federal University of Goiás, Goiânia, Brazil
- Faculty of Medicine, Federal University of Goiás, Goiânia, Brazil
| | - Gislene Batista
- Faculty of Nutrition, Federal University of Goiás, Goiânia, Brazil
| | | | | | | | - Ana Cristina Silva Rebelo
- College of Physical Education and Dance, Federal University of Goiás, Goiânia, Brazil
- Faculty of Medicine, Federal University of Goiás, Goiânia, Brazil
- Hospital das Clínicas, Federal University of Goiás, Goiânia, Brazil
| |
Collapse
|
3
|
Superior cardiometabolic and cellular adaptive responses to multiple versus single daily sessions of high-intensity interval training in Wistar rats. Sci Rep 2022; 12:21187. [PMID: 36476806 PMCID: PMC9729616 DOI: 10.1038/s41598-022-24906-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Accepted: 11/22/2022] [Indexed: 12/12/2022] Open
Abstract
This study aimed to compare in rats the cardiometabolic and cellular adaptative responses to 8 weeks of high-intensity interval training (HIIT) performed in a single (1xHIIT) or three shorter daily sessions (3xHIIT). Male Wistar rats were assigned to untrained (n = 10), 1xHIIT (n = 10), and 3xHIIT (n = 10) groups. Both HIIT groups performed 15 min of a treadmill run five times per week for 8 weeks. The 1xHIIT performed single daily sessions of 15 min, and the 3xHIIT performed three daily sessions of 5 min with an interval of 4 h between sessions. Resting VO2 and VO2max were measured using a metabolic chamber; blood pressure and heart rate were measured by plethysmography; body composition was estimated by DEXA; Glucose and insulin tolerance tests were performed; after euthanasia, hearts, gastrocnemius, and visceral fat were harvested for analysis of cardiac function, histology, and morphology. Mitochondrial densities of the gastrocnemius and left ventricle muscles were determined by electron microscopy. 3xHIIT induced similar positive adaptative responses to 1xHIIT on resting VO2 and VO2max, cardiac function, and mitochondria density. 3xHIIT was superior to 1xHIIT in reducing visceral fat weight and adipocyte size and improving insulin tolerance. Multiple short daily bouts of HIIT may be superior to single HIIT daily sessions in improving cardiometabolic and cellular adaptations in rats.
Collapse
|
4
|
Impact of High-Intensity Interval Training on Body Composition and Depressive Symptoms in Adults under Home Confinement. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19106145. [PMID: 35627681 PMCID: PMC9140689 DOI: 10.3390/ijerph19106145] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Revised: 05/11/2022] [Accepted: 05/17/2022] [Indexed: 12/21/2022]
Abstract
The home confinement derived from the COVID-19 pandemic has led to drastic changes in people’s habits. This situation has influenced their eating, rest, physical activity and socialization patterns, triggering changes in their mental stability. It was demonstrated that physical activity is beneficial for people’s physical and mental health. By its moderate volume and requiring little space or material, high-intensity interval training (HIIT) could prove to be a valid alternative in a situation of confinement. The aim of the present study was to observe the impact of an 8-week HIIT protocol on the body composition and the depressive symptoms of adults in strict home confinement. A total of 21 healthy adults, both male and female, (35.4 ± 5.6 years old; 70.50 ± 12.1 kg; 171 ± 10 cm) were divided into an experimental group (EG, n = 11) who carried out an 8-week Tabata protocol, based upon calisthenic exercises with their own weight in their homes, and a control group (CG, n = 10) who did not carry out any systematic physical activity over the same period. Following the intervention, the EG experienced a significant reduction in percentage (t = 3.86, d = 0.57, p < 0.05) and in kg (t = 4.62, d = 0.29, p < 0.05) of body fat mass (BFM) and body fat mass index (BFMI) (t = 4.61, d = 0.31, p < 0.05), as well as a reduction in depressive symptoms (t = 6.48, d = 1.3, p < 0.05). These results indicate that HIIT is a potential public health tool that could possibly be prescribed to the population in case of future situations of home confinement.
Collapse
|
5
|
Liu Y, Li Y, Cheng B, Feng S, Zhu X, Chen W, Zhang H. Comparison of visceral fat lipolysis adaptation to high-intensity interval training in obesity-prone and obesity-resistant rats. Diabetol Metab Syndr 2022; 14:62. [PMID: 35501906 PMCID: PMC9063201 DOI: 10.1186/s13098-022-00834-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Accepted: 04/13/2022] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND/OBJECTIVES Visceral obesity is one of the key features of metabolic syndrome. High-intensity interval training (HIIT) could effectively reduce visceral fat, but its effects show strong heterogeneity in populations with different degrees of obesity. The mechanism may be related to the differential adaptation to training between obesity phenotypes, namely obesity prone (OP) and obesity resistant (OR). The aim of the present study was to compare adaptive changes of visceral adipose lipolysis adaptation to HIIT between OP and OR animals and further explore the upstream pathway. METHODS OP and OR Sprague Dawley rats were established after feeding a high-fat diet for 6 weeks; they were then divided into HIIT (H-OP and H-OR) and control (C-OP and C-OR) groups. After 12 weeks of HIIT or a sedentary lifestyle, animals were fasted for 12 h and then sacrificed for histology as well as gene and protein analysis. Visceral adipocytes were isolated without fasting for catecholamine stimulation and β3-adrenergic receptor (β3-AR) blockade in vitro to evaluate the role of upstream pathways. RESULTS After training, there were no differences in weight loss or food intake between OP and OR rats (P > 0.05). However, the visceral fat mass, adipocyte volume, serum triglycerides and liver lipids of OP rats decreased by more than those of OR rats (P < 0.05). Meanwhile, the cell lipolytic capacity and the increase in the expression of β3-AR were higher in the OP compared with OR groups (P < 0.05). Although training did not increase sympathetic nervous system activity (P > 0.05), the cell sensitivity to catecholamine increased significantly in the OP compared with OR groups (P < 0.05). Following blocking β3-AR, the increased sensitivity disappeared. CONCLUSION With HIIT, OP rats lost more visceral fat than OR rats, which was related to stronger adaptive changes in lipolysis. Increased β3-AR expression mediated this adaptation.
Collapse
Affiliation(s)
- Yang Liu
- Physical Education College, Hebei Normal University, Shijiazhuang, China
- Hebei Provincial Key Laboratory of Measurement and Evaluation in Human Movement and Bio-Information, Hebei Normal University, Shijiazhuang, China
| | - Yu Li
- Physical Education College, Hebei Normal University, Shijiazhuang, China
| | - Baishuo Cheng
- Physical Education College, Hebei Normal University, Shijiazhuang, China
| | - Shige Feng
- Physical Education College, Hebei Normal University, Shijiazhuang, China
| | - Xiangui Zhu
- Physical Education College, Hebei Normal University, Shijiazhuang, China
| | - Wei Chen
- Physical Education College, Hebei Normal University, Shijiazhuang, China
- Hebei Provincial Key Laboratory of Measurement and Evaluation in Human Movement and Bio-Information, Hebei Normal University, Shijiazhuang, China
| | - Haifeng Zhang
- Physical Education College, Hebei Normal University, Shijiazhuang, China
- Hebei Provincial Key Laboratory of Measurement and Evaluation in Human Movement and Bio-Information, Hebei Normal University, Shijiazhuang, China
| |
Collapse
|
6
|
Timmons JF, Beatty A, Stout C, Ivory A, Carroll C, Egan B. Increased Lean Body Mass After Bodyweight-Based High Intensity Interval Training in Overweight and Obese Men. RESEARCH QUARTERLY FOR EXERCISE AND SPORT 2022:1-9. [PMID: 35363598 DOI: 10.1080/02701367.2021.2002247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Accepted: 10/26/2021] [Indexed: 06/14/2023]
Abstract
Purpose: The effects of 8 weeks of bodyweight exercise-based, high-intensity interval training (BWHIIT) on body composition and blood-based markers of metabolic health were investigated in overweight and obese, sedentary young men. Methods: In a parallel group, PRE-POST design, n = 30 men (age, 25.7 ± 4.3 y; body mass index, 27.7 ± 2.1 kg m-2; 26.1 ± 5.2% body fat) were randomized to BWHIIT (n = 20) or a control group (CON; n = 10). BWHIIT consisted of supervised, group-based training sessions (~30 minutes) performed 3 times weekly. Each session consisted of 6 high-intensity bodyweight-based exercises, with each exercise being performed for 4 minutes in the manner of 8 sets of 20 seconds of exercise, 10 seconds of rest. Prior to commencing training (PRE), and 36 h after the final training session (POST), an overnight fasted blood sample was drawn, and body composition was assessed by dual-energy X-ray absorptiometry. Eighteen participants completed the intervention (CON, n = 9; BWHIIT, n = 9). Results: Lean body mass (LBM) was increased at POST in BWHIIT compared to CON (P = .011, η2p = .359), with the mean (95% confidence limits) increase in LBM from PRE to POST within BWHIIT being 1.23 (0.55, 1.92) kg. Body mass and fat mass were unchanged in both groups from PRE to POST. BWHIIT had no effect on serum concentrations of total cholesterol, HDL-C, LDL-C, triglycerides, NEFA, hsCRP, or glucose. Conclusion: Eight weeks of bodyweight exercise-based high intensity interval training by overweight and obese sedentary young men increased LBM by ~2%, but fat mass and blood-based markers of metabolic health were unchanged.
Collapse
Affiliation(s)
| | | | | | | | | | - Brendan Egan
- Dublin City University
- Florida Institute for Human and Machine Cognition
| |
Collapse
|
7
|
Silva LRB, Gentil P, Seguro CS, de Oliveira JCM, Silva MS, Marques VA, Beltrame T, Rebelo ACS. High-Intensity Interval Training Improves Cardiac Autonomic Function in Patients with Type 2 Diabetes: A Randomized Controlled Trial. BIOLOGY 2022; 11:biology11010066. [PMID: 35053064 PMCID: PMC8773290 DOI: 10.3390/biology11010066] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 12/23/2021] [Accepted: 12/28/2021] [Indexed: 02/04/2023]
Abstract
Different exercise models have been used in patients with type 2 diabetes mellitus (T2D), like moderate intensity continuous training (MICT) and high intensity interval training (HIIT); however, their effects on autonomic modulation are unknown. The present study aimed to compare the effects of different exercise modes on autonomic modulation in patients with T2D. In total, 44 adults with >5 years of T2D diagnosis were recruited and stratified into three groups: HIIT-30:30 (n = 15, age 59.13 ± 5.57 years) that performed 20 repetitions of 30 s at 100% of VO2peak with passive recovery, HIIT-2:2 (n = 14, age 61.20 ± 2.88) that performed 5 repetitions of 2 min at 100% of VO2peak with passive recovery, and MICT (n = 15, age 58.50 ± 5.26) that performed 14 min of continuous exercise at 70% of VO2peak. All participants underwent anamnesis and evaluation of cardiorespiratory fitness and cardiac autonomic modulation. All protocols were equated by total distance and were performed two times per week for 8 weeks. Group × time interactions were observed for resting heart rate (HRrest) [F(2.82) = 3.641; p = 0.031] and SDNN [F(2.82) = 3.462; p = 0.036]. Only the HIIT-30:30 group significantly reduced SDNN (p = 0.002 and 0.025, respectively). HRrest reduced more in the HIIT-30:30 group compared with the MICT group (p = 0.038). Group × time interactions were also observed for offTAU [F(2.82) = 3.146; p = 0.048] and offTMR [F(2.82) = 4.424; p = 0.015]. The MICT group presented increased values of offTAU compared with the HIIT-30:30 and HIIT-2:2 groups (p = 0.001 and 0.013, respectively), representing a slower HR response after eight weeks of intervention. HIIT, specially HIIT-30:30, represents a promising measure for improving autonomic modulation in patients with T2D.
Collapse
Affiliation(s)
- Lucas Raphael Bento Silva
- Department of Physical Education, Araguaia University Center, Goiania 74223-060, Brazil;
- Post-Graduate Program in Health Sciences, Faculty of Medicine, Federal University of Goias, Goiania 74605-050, Brazil; (P.G.); (V.A.M.); (A.C.S.R.)
- Correspondence:
| | - Paulo Gentil
- Post-Graduate Program in Health Sciences, Faculty of Medicine, Federal University of Goias, Goiania 74605-050, Brazil; (P.G.); (V.A.M.); (A.C.S.R.)
- Faculty of Physical Education and Dance, Federal University of Goiás, Goiania 74690-900, Brazil;
- Hypertension League, Federal University of Goias, Goiania 74605-020, Brazil
| | - Camila Simões Seguro
- Post-Graduate Program in Nutrition and Health, Faculty of Nutrition, Federal University of Goias, Goiania 74605-080, Brazil;
| | - Jordana Campos Martins de Oliveira
- Department of Physical Education, Araguaia University Center, Goiania 74223-060, Brazil;
- Post-Graduate Program in Health Sciences, Faculty of Medicine, Federal University of Goias, Goiania 74605-050, Brazil; (P.G.); (V.A.M.); (A.C.S.R.)
| | - Maria Sebastiana Silva
- Faculty of Physical Education and Dance, Federal University of Goiás, Goiania 74690-900, Brazil;
| | - Vitor Alves Marques
- Post-Graduate Program in Health Sciences, Faculty of Medicine, Federal University of Goias, Goiania 74605-050, Brazil; (P.G.); (V.A.M.); (A.C.S.R.)
| | - Thomas Beltrame
- Institute of Computing, University of Campinas, Campinas 13083-852, Brazil;
- Department of Physiotherapy, Federal University of Sao Carlos, Sao Carlos 13565-905, Brazil
| | - Ana Cristina Silva Rebelo
- Post-Graduate Program in Health Sciences, Faculty of Medicine, Federal University of Goias, Goiania 74605-050, Brazil; (P.G.); (V.A.M.); (A.C.S.R.)
- Faculty of Physical Education and Dance, Federal University of Goiás, Goiania 74690-900, Brazil;
- Department of Morphology, Institute of Biological Sciences, Federal University of Goiás, Goiania 74690-900, Brazil
| |
Collapse
|
8
|
Togni G, Puccinelli PJ, Costa T, Seffrin A, de Lira CAB, Vancini RL, Santos DDAT, Nikolaidis PT, Knechtle B, Andrade MS. Factors Associated with Reduction in Physical Activity during the COVID-19 Pandemic in São Paulo, Brazil: An Internet-Based Survey Conducted in June 2020. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:11397. [PMID: 34769910 PMCID: PMC8583209 DOI: 10.3390/ijerph182111397] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Revised: 10/23/2021] [Accepted: 10/24/2021] [Indexed: 12/15/2022]
Abstract
BACKGROUND The COVID-19 pandemic negatively affected physical activity levels. This study investigated the factors associated with the change in physical activity level in Brazilians residing in the city of São Paulo. METHODS A self-administered questionnaire, addressing personal data, restriction level, education level, family income, daily working hours, and physical activity level, was answered by 2140 volunteers, of which 1179 were excluded because the answers were either incomplete or the respondents were not from São Paulo. The total number of participants selected was 961 (581 female and 380 male). RESULTS The physical activity level adopted prior to the pandemic period (p < 0.001) and family income (p = 0.001) correlated significantly with physical activity level reduction during the pandemic. The proportion of people who reduced their physical activity was greater among those who were very active than those who were active (adjusted prevalence ratio [aPR]: 0.65 [confidence interval (CI): 0.52-0.80]) or insufficiently active [aPR: 0.39 (0.18-0.82)]. The proportion of people who reduced their physical activity was greater among those who received a salary less than minimum wage (MW) than those who received a salary between three to six times minimum wage [(aPR: 0.50 (CI 0.35-0.70)] or more than 6 MW [(aPR: 0.56 (CI 0.40-0.79)]. CONCLUSIONS A higher prevalence of Brazilians residing in the city of São Paulo reduced their physical activity who had a vigorous level of physical activity prior to the pandemic and who received less than a MW.
Collapse
Affiliation(s)
- Gabriela Togni
- Department of Physiology, Federal University of São Paulo, São Paulo 04021-001, Brazil; (G.T.); (P.J.P.); (T.C.); (A.S.); (M.S.A.)
| | - Paulo José Puccinelli
- Department of Physiology, Federal University of São Paulo, São Paulo 04021-001, Brazil; (G.T.); (P.J.P.); (T.C.); (A.S.); (M.S.A.)
| | - Taline Costa
- Department of Physiology, Federal University of São Paulo, São Paulo 04021-001, Brazil; (G.T.); (P.J.P.); (T.C.); (A.S.); (M.S.A.)
| | - Aldo Seffrin
- Department of Physiology, Federal University of São Paulo, São Paulo 04021-001, Brazil; (G.T.); (P.J.P.); (T.C.); (A.S.); (M.S.A.)
| | - Claudio Andre Barbosa de Lira
- Human and Exercise Physiology Division, Faculty of Physical Education and Dance, Federal University of Goiás, Goiânia 74690-900, Brazil
| | - Rodrigo Luiz Vancini
- Center for Physical Education and Sports, Federal University of Espírito Santo, Vitória 29075-910, Brazil;
| | | | | | - Beat Knechtle
- Institute of Primary Care, University of Zurich, 8091 Zurich, Switzerland;
| | - Marilia Santos Andrade
- Department of Physiology, Federal University of São Paulo, São Paulo 04021-001, Brazil; (G.T.); (P.J.P.); (T.C.); (A.S.); (M.S.A.)
| |
Collapse
|
9
|
Souza D, Vale AF, Silva A, Araújo MAS, de Paula Júnior CA, de Lira CAB, Ramirez-Campillo R, Martins W, Gentil P. Acute and Chronic Effects of Interval Training on the Immune System: A Systematic Review with Meta-Analysis. BIOLOGY 2021; 10:biology10090868. [PMID: 34571745 PMCID: PMC8465842 DOI: 10.3390/biology10090868] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 08/24/2021] [Accepted: 08/30/2021] [Indexed: 12/20/2022]
Abstract
Simple Summary Interval training (IT) is a popular training strategy recognized by its positive effects on metabolic and cardiovascular system. However, there seems no consensus regarding the effects of IT on immune system parameters. Therefore, we aimed to summarize the evidence regarding the effects of IT on the immune system. As our many findings, an IT acutely promote a transitory change on immune cell count followed by reduced function. The magnitude of these changes seems to vary in accordance with IT type. On the other hand, the regular practice of IT might contribute to improve immune function without apparent change on immune cell count. Abstract Purpose: To summarize the evidence regarding the acute and chronic effects of interval training (IT) in the immune system through a systematic review with meta-analysis. Design: Systematic review with meta-analysis. Data source: English, Portuguese and Spanish languages search of the electronic databases Pubmed/Medline, Scopus, and SciELO. Eligibility criteria: Studies such as clinical trials, randomized cross-over trials and randomized clinical trials, investigating the acute and chronic effects of IT on the immune outcomes in humans. Results: Of the 175 studies retrieved, 35 were included in the qualitative analysis and 18 in a meta-analysis. Within-group analysis detected significant acute decrease after IT on immunoglobulin A (IgA) secretory rate (n = 115; MD = −15.46 µg·min−1; 95%CI, −28.3 to 2.66; p = 0.02), total leucocyte count increase (n = 137; MD = 2.58 × 103 µL−1; 95%CI, 1.79 to 3.38; p < 0.001), increase in lymphocyte count immediately after exercise (n = 125; MD = 1.3 × 103 µL−1; 95%CI, 0.86 to 1.75; p < 0.001), and decrease during recovery (30 to 180 min post-exercise) (n = 125; MD = −0.36 × 103 µL−1;−0.57 to −0.15; p < 0.001). No effect was detected on absolute IgA (n = 127; MD = 47.5 µg·mL−1; 95%CI, −10.6 to 105.6; p = 0.11). Overall, IT might acutely reduce leucocyte function. Regarding chronic effects IT improved immune function without change leucocyte count. Conclusion: IT might provide a transient disturbance on the immune system, followed by reduced immune function. However, regular IT performance induces favorable adaptations on immune function.
Collapse
Affiliation(s)
- Daniel Souza
- Faculdade de Educação Física e Dança, Universidade Federal de Goiás, Goiânia 74690-900, Brazil; (D.S.); (A.F.V.); (A.S.); (M.A.S.A.); (C.A.B.d.L.)
| | - Arthur F. Vale
- Faculdade de Educação Física e Dança, Universidade Federal de Goiás, Goiânia 74690-900, Brazil; (D.S.); (A.F.V.); (A.S.); (M.A.S.A.); (C.A.B.d.L.)
| | - Anderson Silva
- Faculdade de Educação Física e Dança, Universidade Federal de Goiás, Goiânia 74690-900, Brazil; (D.S.); (A.F.V.); (A.S.); (M.A.S.A.); (C.A.B.d.L.)
| | - Murilo A. S. Araújo
- Faculdade de Educação Física e Dança, Universidade Federal de Goiás, Goiânia 74690-900, Brazil; (D.S.); (A.F.V.); (A.S.); (M.A.S.A.); (C.A.B.d.L.)
| | | | - Claudio A. B. de Lira
- Faculdade de Educação Física e Dança, Universidade Federal de Goiás, Goiânia 74690-900, Brazil; (D.S.); (A.F.V.); (A.S.); (M.A.S.A.); (C.A.B.d.L.)
| | | | - Wagner Martins
- Faculdade de Fisioterapia, Universidade de Brasília, Distrito Federal, Brasilia 70910-900, Brazil;
| | - Paulo Gentil
- Faculdade de Educação Física e Dança, Universidade Federal de Goiás, Goiânia 74690-900, Brazil; (D.S.); (A.F.V.); (A.S.); (M.A.S.A.); (C.A.B.d.L.)
- Correspondence: ; Tel.: +55-62-3521-1021
| |
Collapse
|
10
|
Mental health during the COVID-19 pandemic and beyond: The importance of the vagus nerve for biopsychosocial resilience. Neurosci Biobehav Rev 2021; 125:1-10. [PMID: 33582230 PMCID: PMC8106638 DOI: 10.1016/j.neubiorev.2021.02.010] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2020] [Revised: 01/27/2021] [Accepted: 02/04/2021] [Indexed: 12/22/2022]
Abstract
The COVID-19 pandemic has led to widespread increases in mental health problems, including anxiety and depression. The development of these and other psychiatric disorders may be related to changes in immune, endocrine, autonomic, cognitive, and affective processes induced by a SARS-CoV-2 infection. Interestingly, many of these same changes can be triggered by psychosocial stressors such as social isolation and rejection, which have become increasingly common due to public policies aimed at reducing the spread of SARS-CoV-2. The present review aims to shed light on these issues by describing how viral infections and stress affect mental health. First, we describe the multi-level mechanisms linking viral infection and life stress exposure with risk for psychopathology. Then, we summarize how resilience can be enhanced by targeting vagus nerve function by, for example, applying transcutaneous vagus nerve stimulation and targeting lifestyle factors, such as exercise. With these biopsychosocial insights in mind, researchers and healthcare professionals will be better equipped to reduce risk for psychopathology and increase resilience during this challenging pandemic period and beyond.
Collapse
|
11
|
Sonza A, da Cunha de Sá-Caputo D, Sartorio A, Tamini S, Seixas A, Sanudo B, Süßenbach J, Provenza MM, Xavier VL, Taiar R, Bernardo-Filho M. COVID-19 Lockdown and the Behavior Change on Physical Exercise, Pain and Psychological Well-Being: An International Multicentric Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18073810. [PMID: 33917363 PMCID: PMC8038730 DOI: 10.3390/ijerph18073810] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Revised: 03/20/2021] [Accepted: 03/25/2021] [Indexed: 12/11/2022]
Abstract
Objective: To evaluate the impact of the COVID-19 pandemic and the following lockdown on physical exercise (PEx) practice, pain, and psychological well-being. Methods: A cross-sectional multicentric study was performed using a nonrandom convenience sampling from the general population (≥18 years-old) of 6 countries (Brazil, Italy, France, Portugal, Germany, and Spain) adopting social isolation (SI). The validated self-administered online survey (PEF-COVID19) was used. The tests T-test and Chi-square with Bonferroni correction were used for statistical analysis and a multivariate logistic regression model (p ˂ 0.05). Results: We included 3194 replies and ~80% of the respondents were in SI. Brazilian sample was highly influenced by the pandemic considering PEx practice and habits, pain, anxiety, and stress (p ˂ 0.05). Among the European countries, Italy presented the major changes. The model to predict the non-practice of PEx during SI showed that the variables countries, smoking, SI, and PEx level were significant predictors (p ˂ 0.001). Conclusion: The pandemic changed the PEx practice and habits, and the psychological well-being of populations in different manners. Countries, smoking, SI, and PEx level were predictors for the non-practice of PEx. Public health strategies are suggested to avoid sedentary lifestyles and quality of life decrease.
Collapse
Affiliation(s)
- Anelise Sonza
- Programa de Pós-Graduação em Fisioterapia e Programa de Pós-Graduação em Ciências do Movimento Humano, Centro de Ciências da Saúde e do Esporte, Universidade do Estado de Santa Catarina, 88085-350 Florianópolis, Brazil;
| | - Danúbia da Cunha de Sá-Caputo
- Laboratório de Vibrações Mecânicas, Policlínica Piquet Carneiro, Instituto de Biologia Roberto Alcantara Gomes, Universidade do Estado do Rio de Janeiro, 20550-900 Rio de Janeiro, Brazil; (D.d.C.d.S.-C.); (M.B.-F.)
- Faculdade Bezerra de Araújo, 23052-090 Rio de Janeiro, Brazil
| | - Alessandro Sartorio
- Istituto Auxologico Italiano, IRCCS, Experimental Laboratory for Auxo-endocrinological Research & Division of Auxology and Metabolic Diseases, 28824 Piancavallo (VB), Italy; (A.S.); (S.T.)
| | - Sofia Tamini
- Istituto Auxologico Italiano, IRCCS, Experimental Laboratory for Auxo-endocrinological Research & Division of Auxology and Metabolic Diseases, 28824 Piancavallo (VB), Italy; (A.S.); (S.T.)
| | - Adérito Seixas
- Escola Superior de Saúde, Universidade Fernando Pessoa, 4200-253 Porto, Portugal;
| | - Borja Sanudo
- Departamento de Educación Física y Deporte, Universidad de Sevilla, 41013 Seville, Spain;
| | - Jessica Süßenbach
- Institut für Bewegung, Sport und Gesundheit, Leuphana Universität Lüneburg, 78120 Lüneburg, Germany;
| | - Marcello Montillo Provenza
- Instituto de Matematica e Estatistica, Universidade do Estado do Rio de Janeiro, 20550-900 Rio de Janeiro, Brazil; (M.M.P.); (V.L.X.)
| | - Vinicius Layter Xavier
- Instituto de Matematica e Estatistica, Universidade do Estado do Rio de Janeiro, 20550-900 Rio de Janeiro, Brazil; (M.M.P.); (V.L.X.)
| | - Redha Taiar
- MATIM, Université de Reims Champagne Ardenne, 51100 Reims, France
- Correspondence:
| | - Mario Bernardo-Filho
- Laboratório de Vibrações Mecânicas, Policlínica Piquet Carneiro, Instituto de Biologia Roberto Alcantara Gomes, Universidade do Estado do Rio de Janeiro, 20550-900 Rio de Janeiro, Brazil; (D.d.C.d.S.-C.); (M.B.-F.)
| |
Collapse
|
12
|
Fiorillo L, Meto A, Cicciù F, De Stefano R. An Eventual Sars-CoV-2 Infection Prevention Protocol in the Medical Setting and Dental Office. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:2593. [PMID: 33807646 PMCID: PMC7967356 DOI: 10.3390/ijerph18052593] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Accepted: 03/03/2021] [Indexed: 12/12/2022]
Abstract
The current Coronavirus disease 2019 (COVID-19) pandemic has affected the entire world population, and in particular the medical-health field, especially dentistry [...].
Collapse
Affiliation(s)
- Luca Fiorillo
- Department of Biomedical and Dental Sciences, Morphological and Functional Images, School of Dentistry, University of Messina, Policlinico G. Martino, Via Consolare Valeria, 98100 Messina, Italy
- Multidisciplinary Department of Medical-Surgical and Odontostomatological Specialties, University of Campania “Luigi Vanvitelli”, 80121 Naples, Italy
| | - Aida Meto
- Department of Dental Therapy, Faculty of Dental Medicine, University of Medicine, 1005 Tirana, Albania;
| | - Francesca Cicciù
- Unità Operativa di Patologia Clinica, ARNAS Garibaldi Centro, 95123 Catania, Italy;
| | - Rosa De Stefano
- Department of Biomedical and Dental Sciences, Morphological and Functional Images, University of Messina, 98100 Messina, Italy;
| |
Collapse
|
13
|
Puccinelli PJ, da Costa TS, Seffrin A, de Lira CAB, Vancini RL, Nikolaidis PT, Knechtle B, Rosemann T, Hill L, Andrade MS. Reduced level of physical activity during COVID-19 pandemic is associated with depression and anxiety levels: an internet-based survey. BMC Public Health 2021; 21:425. [PMID: 33648487 PMCID: PMC7919983 DOI: 10.1186/s12889-021-10470-z] [Citation(s) in RCA: 103] [Impact Index Per Article: 34.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2020] [Accepted: 02/05/2021] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND The coronavirus disease 2019 (COVID-19) pandemic has resulted in a strong negative impact on economic and social life worldwide. It has also negatively influenced people's general health and quality of life. The aim of the present study was to study the impact of social distancing on physical activity level, and the association between mood state (depression and anxiety level) or sex with actual physical activity levels, the change in physical activity caused by social distancing period, the adhesion level to social distancing, the adoption time of social distancing, family income and age. METHODS A self-administered questionnaire with personal, quarantine, physical activity, and mood state disorders information's was answered by 2140 Brazilians of both sex who were recruited through online advertising. RESULTS The physical activity level adopted during the period of social distancing (3.5 ± 0.8) was lower than that the adopted prior to the pandemic period (2.9 ± 1.1, p < 0.001). Thirty percent of the participants presented symptoms of moderate/severe depression and 23.3% displayed moderate/severe anxiety symptoms. A greater presence of symptoms related to anxiety and depression were associated with low physical activity levels, low family monthly income, and younger age. A higher percentage of men who had no mood disorders was observed among those who were very active than among those less active. CONCLUSION The COVID-19 pandemic has a negative impact on physical activity. Those who reduced their level of physical activity had the highest levels of mood disorders. Therefore, physical activity programs should be encouraged, while respecting the necessary social distancing to prevent the spread of Severe Acute Respiratory Syndrome Coronavirus 2.
Collapse
Affiliation(s)
| | | | - Aldo Seffrin
- Department of Physiology, Federal University of São Paulo, São Paulo, Brazil
| | - Claudio Andre Barbosa de Lira
- Human and Exercise Physiology Division, Faculty of Physical Education and Dance, Federal University of Goiás, Goiânia, Brazil
| | - Rodrigo Luiz Vancini
- Center for Physical Education and Sports, Federal University of Espírito Santo, Victoria, Brazil
| | | | - Beat Knechtle
- Medbase St. Gallen Am Vadianplatz, St. Gallen, Switzerland
- Institute of Primary Care, University of Zurich, Zurich, Switzerland
| | - Thomas Rosemann
- Institute of Primary Care, University of Zurich, Zurich, Switzerland
| | - Lee Hill
- Divison of Gastroenterology and Nutrition, Department of Pediatrics, McMaster University, Hamilton, Canada
| | | |
Collapse
|
14
|
Puccinelli PJ, da Costa TS, Seffrin A, de Lira CAB, Vancini RL, Nikolaidis PT, Knechtle B, Rosemann T, Hill L, Andrade MS. Reduced level of physical activity during COVID-19 pandemic is associated with depression and anxiety levels: an internet-based survey. BMC Public Health 2021. [PMID: 33648487 DOI: 10.1186/s12889-021-10,470-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/01/2023] Open
Abstract
BACKGROUND The coronavirus disease 2019 (COVID-19) pandemic has resulted in a strong negative impact on economic and social life worldwide. It has also negatively influenced people's general health and quality of life. The aim of the present study was to study the impact of social distancing on physical activity level, and the association between mood state (depression and anxiety level) or sex with actual physical activity levels, the change in physical activity caused by social distancing period, the adhesion level to social distancing, the adoption time of social distancing, family income and age. METHODS A self-administered questionnaire with personal, quarantine, physical activity, and mood state disorders information's was answered by 2140 Brazilians of both sex who were recruited through online advertising. RESULTS The physical activity level adopted during the period of social distancing (3.5 ± 0.8) was lower than that the adopted prior to the pandemic period (2.9 ± 1.1, p < 0.001). Thirty percent of the participants presented symptoms of moderate/severe depression and 23.3% displayed moderate/severe anxiety symptoms. A greater presence of symptoms related to anxiety and depression were associated with low physical activity levels, low family monthly income, and younger age. A higher percentage of men who had no mood disorders was observed among those who were very active than among those less active. CONCLUSION The COVID-19 pandemic has a negative impact on physical activity. Those who reduced their level of physical activity had the highest levels of mood disorders. Therefore, physical activity programs should be encouraged, while respecting the necessary social distancing to prevent the spread of Severe Acute Respiratory Syndrome Coronavirus 2.
Collapse
Affiliation(s)
| | | | - Aldo Seffrin
- Department of Physiology, Federal University of São Paulo, São Paulo, Brazil
| | - Claudio Andre Barbosa de Lira
- Human and Exercise Physiology Division, Faculty of Physical Education and Dance, Federal University of Goiás, Goiânia, Brazil
| | - Rodrigo Luiz Vancini
- Center for Physical Education and Sports, Federal University of Espírito Santo, Victoria, Brazil
| | | | - Beat Knechtle
- Medbase St. Gallen Am Vadianplatz, St. Gallen, Switzerland
- Institute of Primary Care, University of Zurich, Zurich, Switzerland
| | - Thomas Rosemann
- Institute of Primary Care, University of Zurich, Zurich, Switzerland
| | - Lee Hill
- Divison of Gastroenterology and Nutrition, Department of Pediatrics, McMaster University, Hamilton, Canada
| | | |
Collapse
|
15
|
Vancini RL, Camargo-Neto L, de Lira CAB, Andrade MS, Viana RB, Nikolaidis PT, Knechtle B, Gentil P, Piacezzi LHV, Lopes MCBT, Batista REA, Vancini-Campanharo CR. Physical Activity and Sociodemographic Profile of Brazilian People during COVID-19 Outbreak: An Online and Cross-Sectional Survey. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17217964. [PMID: 33138270 PMCID: PMC7663508 DOI: 10.3390/ijerph17217964] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/10/2020] [Revised: 10/26/2020] [Accepted: 10/28/2020] [Indexed: 01/08/2023]
Abstract
The Coronavirus Disease 2019 (COVID-19) outbreak has created an unprecedented impact on global health and further aggravated the physical inactivity pandemic. For this reason, the understanding of sociodemographic variables in the context of physical activity levels are important for the field of public health in order to assist in relevant public health decisions. Our main aim was to characterize sociodemographic variables and physical activity levels and their association with COVID-19 aspects. We applied an online Google survey with closed questions in Brazilian people of different age and regions, both sexes and physical activity levels (n = 1.726). Our main results were that participants who had symptoms of COVID-19 had the highest percentage of level 1 of physical activity (the lowest level according to the classification used) and those who showed no symptoms had the highest percentage of levels 2 and 3 of physical activity; that is, close to the light/moderate levels of physical activity. This cross-sectional study in the Brazilian population provided important sociodemographic data and COVID-19 aspects regarding the level of physical activity. It is possible to assume that the regular practice of physical activity could positively impact health status and quality of life and be a tool in the field of public health to cope (from a physical and mental point of view) with disease scenarios that require quarantine.
Collapse
Affiliation(s)
- Rodrigo L. Vancini
- Centro de Educação Física e Desportos (CEFD), Universidade Federal do Espírito Santo (UFES), Espírito Santo (ES) 29075-910, Brazil;
| | - Luiz Camargo-Neto
- Escola Paulista de Enfermagem (EPE), Universidade Federal de São Paulo (UNIFESP), São Paulo (SP) 04023-062, Brazil; (L.C.-N.); (L.H.V.P.); (M.C.B.T.L.); (R.E.A.B.); (C.R.V.-C.)
| | - Claudio A. B. de Lira
- Setor de Fisiologia Humana e do Exercício, Faculdade de Educação Física e Dança, Universidade Federal de Goiás (UFG), Goiânia, Goiás (GO) 74.690-900, Brazil; (C.A.B.d.L.); (R.B.V.); (P.G.)
| | - Marília S. Andrade
- Departamento de Fisiologia, Universidade Federal de São Paulo (UNIFESP), São Paulo (SP) 04023-910, Brazil;
| | - Ricardo B. Viana
- Setor de Fisiologia Humana e do Exercício, Faculdade de Educação Física e Dança, Universidade Federal de Goiás (UFG), Goiânia, Goiás (GO) 74.690-900, Brazil; (C.A.B.d.L.); (R.B.V.); (P.G.)
| | - Pantelis T. Nikolaidis
- School of Health and Caring Sciences, University of West Attica, Athens, 11521 Attica, Greece
- Correspondence:
| | - Beat Knechtle
- Medbase St. Gallen Am Vadianplatz, St. Gallen and Institute of Primary Care, University of Zurich, 8091 Zurich, Switzerland;
| | - Paulo Gentil
- Setor de Fisiologia Humana e do Exercício, Faculdade de Educação Física e Dança, Universidade Federal de Goiás (UFG), Goiânia, Goiás (GO) 74.690-900, Brazil; (C.A.B.d.L.); (R.B.V.); (P.G.)
- Liga de Hipertensão Arterial, Universidade Federal de Goiás (UFG), Goiânia, Goiás (GO) 74.690-900, Brazil
| | - Luiz H. V. Piacezzi
- Escola Paulista de Enfermagem (EPE), Universidade Federal de São Paulo (UNIFESP), São Paulo (SP) 04023-062, Brazil; (L.C.-N.); (L.H.V.P.); (M.C.B.T.L.); (R.E.A.B.); (C.R.V.-C.)
| | - Maria C. B. Teixeira Lopes
- Escola Paulista de Enfermagem (EPE), Universidade Federal de São Paulo (UNIFESP), São Paulo (SP) 04023-062, Brazil; (L.C.-N.); (L.H.V.P.); (M.C.B.T.L.); (R.E.A.B.); (C.R.V.-C.)
| | - Ruth E. Assayag Batista
- Escola Paulista de Enfermagem (EPE), Universidade Federal de São Paulo (UNIFESP), São Paulo (SP) 04023-062, Brazil; (L.C.-N.); (L.H.V.P.); (M.C.B.T.L.); (R.E.A.B.); (C.R.V.-C.)
| | - Cássia R. Vancini-Campanharo
- Escola Paulista de Enfermagem (EPE), Universidade Federal de São Paulo (UNIFESP), São Paulo (SP) 04023-062, Brazil; (L.C.-N.); (L.H.V.P.); (M.C.B.T.L.); (R.E.A.B.); (C.R.V.-C.)
| |
Collapse
|