Cellular and Molecular Aspects of Human Disease

This research area is characterized by the fundamental investigation of pathophysiology and susceptibility to infectious, inflammatory, and degenerative diseases. The projects linked to this line focus on investigating infectious, periodontal, renal, metabolic, cardiovascular, and neurological diseases using cellular, molecular, and genetic biology tools.

This research area has the Multi-User Experimental Laboratory (LEM) of the Nucleus for Advanced Molecular Research (NIMA) structure, laboratories of pathology and experimental surgery. Additionally, the research area diagnostic and therapeutic methods in pathology that enables intense scientific production in basic science, capacity for training human resources, and seeking encouragement from faculty members. This nucleus — which supports the research line, Cellular and Molecular Aspects of Human Disease — is composed of a group of researchers responsible for much of the scientific production and training of human resources of the PPGCS, not only for master’s and doctorate but also more recently for the post-doctorate.

Faculty

• Dr. Andréa Novaes Moreno Amaral | Email: [email protected]
• Dr. Felipe Francisco Bondan Tuon | Email: [email protected]
• Dr. Lucia de Noronha | Email: [email protected]
• Dr. Marcelo Távora Mira | Email: [email protected]
• Dr. Paula Cristina Trevilatto | Email: [email protected]
• Dr. Paulo Roberto Slud Brofman | Email: [email protected]
• Dr. Ricardo Aurino de Pinho| Email: [email protected]
• Dr. Roberto Hirochi Herai | Email: [email protected]
• Dr. Selene Elifio Esposito | Email: [email protected]
• Dr. Vanessa Santos Sotomaior | Email: [email protected]

Human Disease Prevention and Therapy

Concerned with stimulating clinical research within outpatient and hospital care environments, PPGCS aims to develop a working model shared between the infrastructure and qualified personnel with the Clinical Research Center, traditionally responsible for observational studies and conducting trials.

Within this model, the infrastructure and portions of time allocated to research coordinators are currently dedicated to the support and training of master’s and doctoral students with projects in the Basic and Applied Clinical and Epidemiological Research area of research. In this way, a highly qualified structure and human resources for the development of competitive clinical research were instituted in this research area. As such, financial resources were attracted, and high impact intellectual production emerged.

The research projects in this area use a wide range of common pathologies found in our environment. The area is based on quality clinical research, using information generated at PUCPR clinics and hospitals, and on collaborative networks in infectious, cardiovascular, renal, and diabetes diseases. These clinical research activities return to the discussion with the necessary research groups in course interaction environments, especially in the regular seminars, causing a translational character to PPGCS investigation when seen as a whole.

The researchers in this area also investigate cell engineering methods, with an experimental focus, applied to the transplantation of cells and tissues in humans. This area’s applications extend to cell therapy in diseases of the cardiovascular and gastrointestinal systems and diabetes treatment. As an example of the research area’s translational profile, one of the laboratories in this area — where pioneering studies are carried out on people— as a part of the Ministry of Health’s network for the application of stem cell therapy in heart disease.

Faculty

• Dr. Adriano Akira Ferreira Hino | Email: [email protected]
• Dr. Cristina Pellegrino Baena | Email: [email protected]
• Dr. José Rocha Faria Neto | Email: [email protected]
• Dr. Luiz César Guarita Souza | Email: [email protected]
• Dr. Paulo Gustavo Kotze | Email: [email protected]
• Dr. Roberto Flávio Pecoits Filho | Email: [email protected]
• Dr. Thyago Proença de Moraes | Email: [email protected]

• 1. Basic laboratories for PPGCS research areas:

1.1 Laboratory of Operation Techniques and Experimental Surgery

The Laboratory of Operation Techniques and Experimental Surgery is equipped with nine sets: a trough operating table, surgical lamp, instrument table, compressed air point, and vacuum point. Equipment: Biomonitor 7 (BESE) with three (3) pressure channels and one (1) ECG; CAT2 monitor (BESE) with hemodynamic parameters; laser flow meter (Vasamedics); inhalation anesthesia set; complete video-surgery equipment (Storz); two (2) microcomputers; Optimas 6.0 image analyzer and quantifier, coupled with an optical microscope and image acquisition system; 10 surgery kits for mice; four (4) sets of surgical instruments, two (2) mono/bipolar electrocautery, surgical microscope with 12 complete instrument kits, one (1) digital ultrasound system, a respirator for small animals, and a video endoscope (Karl Storz). The laboratory also has a classroom for teaching small animal surgery, a professors’ room, and a locker room for students.

1.2 Tissue Engineering Laboratory

1.2.1 Clinical Laboratory

The Clinical Laboratory occupies 856 m2, containing several clean area environments with positive pressure, a genetics laboratory, cold room, and equipment designed to work with tissue engineering. The State Government of Paraná, the State Department of Science, Technology, and Higher Education (Paraná Technology Program), PUCPR, and federal agencies funded this laboratory’s implementation.

1.2.2 Experimental Laboratories

1.2.2.1 Cell Culture Experimental Laboratory

The 170 m2 Experimental Cell Culture Laboratory, composed of two (2) cell culture rooms, a fluorescence microscopy room, a standard room, and a warehouse, contains infrastructure that allows the cultivation of various cell types. The cultivation rooms are separated from the others to avoid contamination of the cultures carried out in aseptic conditions. Each cell culture room has a cabin with vertical laminar flow, a peristaltic pump, a vacuum pump, an inversion microscope with a camera, a CO2 oven with thermostat and 180L capacity, Neubauer chambers, and micropipettes. The standard room is composed of full benches and sinks, which allows the preparation of solutions and material for the cultures. In this room, there are refrigerators for the storage of culture media, freezers for storing serums and growth factors, cabinets for glassware and other consumables, traditional optical microscope, strobe magnifying glass for dissection, autoclave, distiller, water bath, liquid nitrogen storage units, centrifuge, bacteriological oven, drying oven, analytical balance, and precision balance.

1.2.2.2 Laboratory of Surgery and Diagnostic Methods

Laboratory of Surgery and Diagnostic Methods, 82.56 m², with four (4) environments. The first — a room equipped for surgery on small animals — has three (3) artificial respirators (Harvard), a heart rate monitor, and an operating table. Another area is designated for doppler-echocardiogram diagnosis, which allows the identification of cardiac lesions, great vessels, measuring hemodynamic parameters, and cardiac function. This equipment has software developed for small animals. The radioscopy room is equipped with a radioscopy device with an image intensifier and aims to assess the anatomy and dynamic function of the repercussions determined by experimentally caused injuries. The last room — one for testing heart valves — is equipped with devices for evaluating fatigue by accelerating cycles and determining spinal hydrodynamics by flow simulation.

1.3 Multiplying Experimental Laboratory (LEM) of the Nucleus for Advanced Molecular Research (NIMA)

The Multiuser Experimental Laboratory (LEM) is installed in approximately 750 m2 on PUCPR’s main campus. The structure hosts eight (8) research groups formed by the leading investigator and his teams of permanent researchers, researchers and visiting professors, graduate students, scientific initiation students, interns, technicians, and support staff, with a daily flow of over 100 people. LEM acts as a reference and support laboratory for all institutional research projects based on fundamental, preclinical, and translational scientific research. It provides unrestricted support to other research institutions through scientific collaboration (universities, public, and private research institutions) that need the competencies installed in the LEM. In this way, LEM has maintained its objectives to reach a vast universe of direct and indirect users, thus playing an essential role in scientific research with a global impact. The diverse research carried out at LEM is associated with the following themes: analysis and interpretation of genetic sequencing data on a large scale; software development and availability in the area of bioinformatics and computational biology; genetic modifications in neurological disorders of the autism spectrum; leprosy molecular genetics, detection of genetic and molecular biomarkers in cancer tumors; immunological mechanisms associated with renal diseases, biochemical modulation; and energy metabolism associated with physical exercise; and diseases of the immune system. The current scientific production of LEM and the representativeness of researchers in their areas of activity demonstrate and justify the high impact of research produced in the laboratory. It also has a sealer for sterilization packaging (Thermo-Plus III); two (2) vacuum pumps and air compressors; wireless all-in-one computers with Intel Pentium E5400/4GB/750GB/screen 21.5; a massive next-generation “Ion PMG” sequencing platform (Life Technologies); a Veriti 96 wells automatic cycler (Thermal Cycler) and an –80 °C Freezer (Revco, model ULT-1786-4-D); a Temperature Indication System with a visual and audible alarm; a Bioanalyzer 2,100 Agilent; and an Epmotion-Robot pipetting (Eppendorf, mod M5073). Three higher-level technicians hired by PUCPR manage the integration of these units with the research groups. Extending the analysis of soluble biomarkers, LEM has an ELISA Reader or Spectrophotometic Reader (Molecular Devices); a Luminex Platform (mon Magipix), installed in an environment with an air conditioning unit (Springer) and UPS (sea NHS), always in the form of structuring a multiuser laboratory.

1.3.1 Multi-Experimental Laboratory II (LEM II)

This new 50m² room is available to PPGCS students and professors, providing a computer, printer, shaker, two precision scales, microcentrifuge, laminar flow, water purification system, and tube shaker. LEM II represents an expansion of the PPGCS infrastructure, within the multiuser system, which occurred in 2017.

1.4 Multi-Experimental Pathology Laboratory

This laboratory occupies an area of approximately 110 m² and has seven rooms:

a) a room for pathologists with a small thematic library;

(b) a large meeting room with a 12-seat discussion table and multi-head microscopes for joint observation, as well as television projection systems, a computer screen, and a slide scanner (Scanner Zeiss capable of working with WSI or Whole Scan Image obtaining images of 12 slides in just one hour in various increments and generating more than 5,000 images per slide);

(c) a secretariat for receiving samples;

(d) a sample processing room with (d1) a macroscopy area, (d2) a processing area for paraffin samples containing Leica auto technician and Leica auto inclusive, (d3) sample microtomy area with Leica microtome, (d4) area for conventional stains (hematoxylin-eosin) and special stains (PAS, trichrome, among others), and (d5) a processing area for frozen samples with a chrysotile table;

(e) area for immunohistochemistry and immunofluorescence with numerous kits and antibodies available for these techniques;

(f) area for extracting DNA from paraffined material with centrifuges, among other necessary materials for the technique;

(g) processing area for biological samples for the scanning and transmission of electron microscopy with ultramicrotome, critical point, razor maker, and other necessary materials for the technique.

The Multi-Path Experimental Pathology Laboratory has a team of five pathologists (four medical pathologists and one oral pathologist) and three biologists (two of whom have graduated from our Master’s in Health Sciences); all are fully qualified to carry out the most varied research procedures. The team also assists the other researchers in choosing the methods of collecting, fixing, cutting, and coloring the samples, in addition to methods of reading the slides with image scanning and applying morphometry methods.

1.5 Epicenter

The Epicenter is in the Clinical Simulation Center building in the Nossa Senhora da Luz Hospital complex. It is a wing composed of four rooms equipped with eight computers connected to the network and statistical analysis software packages such as SPSS 22 and Stata 14, video conference equipment, teleconference, and furniture for team meetings. There is also a structure for collecting, processing, and storing biological material and a space for the storage of clinical research documents. In this space, students, professors, research coordinators, and multidisciplinary care teams can discuss research questions, design projects, and perform statistical analysis. During the period, multicentric clinical research projects developed and coordinated at PUCPR EPICENTER and linked to PPGCS doctoral dissertations were initiated under PUCPR coordination (Salted, HDFit, and STARCH Studies). Additionally, PPGCS professors coordinate national observational multicenter studies (CKDOPPS, EPICUREAN, ERICA, and BRAZPD).

 

• 2. Support Units

2.1 Immunogenetics Laboratory

This laboratory has expanded and now has the following dimensions:

The Immunogenetics Laboratory occupies 400 m², distributed among eight rooms: secretariat, reports room, serology/receipt of biological material, reagent preparation, DNA extraction, pre-PCR, post-PCR, MO, and LUMINEX dark room. This laboratory is equipped to develop service provision activities related to the a) histocompatibility procedures necessary for organ and tissue transplantation; b) pre- and post-transplant follow-up; c) monitoring of desensitization therapies and post-transplant immune rescue; and d) aid to diagnosis and prognosis of diseases associated with HLA system (Human Leucocytes Antigens), including HLA typing of voluntary bone marrow donors (DVMO) for REDOME enrollment and HLA typing of the 1st, 2^nd, and 3rd stages of DVMO selection for valid donation. In the academic area, it contributes to the training and professional development of technicians specialized in histocompatibility and immunology of solid organ transplants, as well as providing and guiding the development of research work in undergraduate and graduate courses. In the clinical area, it is a national reference for training and updating professionals to work in clinical laboratories of histocompatibility for organ and tissue transplantation, offering tutoring programs through agreements with the National Transplant System and SINCOV. Internationally, it participates in validation works on the HLA matchmaker algorithm for clinical application for kidney, pancreas, kidney-pancreas, kidney-livers, and heart transplants.

2.2 Cajuru University Hospital (HUC)

In its 21,100 m2, HUC is a general hospital with tradition and emphasis on trauma and emergency care. It stands out as one of the best and most extensive in the southern region of Brazil. HUC is a private philanthropic hospital maintained by the Marist Group and accredited by the Unified Health System (SUS) as a health service provider, allocating 70% of its care.

It has 300 beds, 20 beds in intensive care (ICU), and nine beds in intermediate care beds. One thousand five hundred forty-three professionals work at the hospital, including professors from courses in PUCPR’s health area, clinical staff, health professionals, administrative, and support staff. As a teaching hospital, it has 109 resident physicians in training and students from health courses such as medicine, nursing, physiotherapy, pharmacy, dentistry, occupational therapy, speech therapy, and psychology, among others in related areas, featuring multidisciplinary performance and a training health team.

Every year, 32 vacancies are offered for medical residency in clinical medicine, general surgery, cardiovascular surgery, plastic surgery, thoracic surgery, peripheral vascular surgery, community medicine, neurosurgery, and neurology ophthalmology, orthopedics and traumatology, and radiology.

2.3 Irmandade da Santa Casa de Misericórdia Charity Hospital (ISCMC)

In 1869, Emperor Dom Pedro II began the construction of the ISCMC Hospital in Curitiba. On May 22, 1880, initially — with 160 beds — it was considered a large hospital and was the only hospital in Curitiba for many years. In 1912, the University of Paraná — later Federal University of Paraná — promoted the Charity Hospital to a teaching hospital that housed students from the Medical School Sciences, starting in 1956. The cooperation and joint action between ISCMC, the Medical School Sciences of the Catholic University, and the Madre Léonie Nursing School started in 1957. From that date on, the Charity Hospital welcomed, and still does today, PUCPR students. This is one of the places of residency offered to doctors trained at PUCPR, for whom there is a specific pedagogical project aiming to transform the process into a technical learning stage and profoundly humanistic training.

The alliance signed with PUCPR, approved on August 27, 1999, strengthened the bond between the two institutions and implemented necessary changes to expand its mission as a teaching hospital, consolidating teaching-research-assistance trinomial. The Charity Hospital offers an excellent team of doctors in various specializations. The technical and structural support services complement attendance with dedication.

The Charity Hospital — with an area of 17,416.99 m², 278 total beds (37 in the ICU) and 9 operating rooms — performs between 600 and 800 surgeries and admit an average of 1350 patients per month, establishing a gradual image of a center of excellence in Cardiology, Nephrology, and Gastroenterology.

2.4 PUCTrials

The PUCTrials sector manages the sponsored clinical research in the context of assistance from the group’s hospitals. Human resources is comprised of three research coordinators, an administrative coordinator, and a financial manager collaborate. This sector is in permanent contact with the Research Ethics Committee, CONEP and the legal sector to manage research projects aligned with ethics and to protect the individuals studied. This structure has dedicated cabinets, freezers for sample storage, manuals of good practices under ANVISA, and CONEP standards. This nucleus, created in 2005, was reformulated in 2014 and is linked to the School of Medicine. It aims to improve the clinical research potential of the hospital and outpatient network linked to PUCPR. The nucleus includes clinical researchers, monitors, study coordinators, and the graduate degree program’s primary research structure.

 

PUC Trials operates in three locations, all linked to the Marist Group’s hospital structure: Cajuru University Hospital, located at Av. São José, 300 – Cristo Rei; Irmandade da Santa Casa de Misericórdia de Curitiba Hospital, located at Praça Rui Barbosa, 694, Epicenter – Area for outpatient care for Santa Casa; and Cajuru Hospital patients, located at Av. Mal. Floriano Peixoto, 2509. Each location has a specialized team to coordinate the patient recruitment and conduct research composed of doctors, nurses, and pharmaceutical biochemists with experience in the field. Thus, the team performs the submission to regulatory bodies, statistical assistance (database preparation and analysis), and follow-up to adapt data collection to Good Clinical Practices (BPC). The leading researchers are medical professors linked to the School of Medicine and with extensive trial experience. The spaces have a structure for collecting material, ways to prepare it for analysis and storage, as well as the structure for coordinating research and specific offices for adequate care for the research patient, establishing a new pillar where research is closest to the patient.

In this physical structure and these human resources, translational research projects are created in which ideas generated in basic research can be similarly tested in clinical studies to clarify questions raised by clinical observation.

2.5 Research Ethics Committee (CEP)

PUCPR Research Ethics Committee (CEP) is composed of effective representation from all sectors that research with human beings and the processes tend to be agile.

CEP’s objectives are: to promote and improve the ethical aspects of research involving human beings; promote, protect, and value research subjects (person or groups researched), ensuring that research can always “treat them with dignity, respect their autonomy, and defend their vulnerability” (Res. 196/96 ll, 1.a); support researchers, ensuring that their projects meet “the fundamental ethical and scientific requirements” (Res 196/96 lll).

PPGCS maintains a program professor at the local CEP. As of 2015, Dr. Roberto Herai joined the committee as a PPGCS representative.

2.6 Computer Labs – NIAA

The purpose of using the laboratories is to apply practical classes for undergraduate, technologist, technical, and graduate courses (non-degree and degree), and the students and professors use it to conduct academic research and work.

The university has 1,377 computers, distributed among 38 laboratories and a library. All laboratories are accessible to PPGCS students and have internet and intranet access.

Minimum configuration: Intel Core 2 Duo processor, 4GB of memory, 250GB HD, 512MB offboard graphics card, and 17 ″ LCD monitor.

Maximum configuration: Intel Core i5 processor, 8GB of memory, 1TB HD, 1GB offboard graphics card, and 19 ″ LCD monitor.

All computers have intranet and internet access. The laboratories have proper ventilation, lighting, upholstered chairs, whiteboard, projection screen, multimedia projector, and fans. Some have air conditioning.

Periodically, software needs are checked (acquisitions, version updates, or increased number of licenses) and equipment (memory/disk upgrade or replacement). With the definitions, planning is carried out, and the needs are met or included in the budget projection for the following year.

 

Administrative employees carry out a weekly verification of physical facilities. A checklist of the following items is performed: projection screen, picture, benches, chairs, floor, lighting, curtain, fans/air conditioning, doors, windows, logical and electrical installations, painting, and cleaning. For items that are not up to the established standard, the responsible sector is requested to provide due repairs.

The computer lab equipment is checked weekly by the sector technical. A checklist is completed, and — in the case of problems — procedures for solving them are adopted.

The technical team sends a request to a sector employee reporting the problem. If the equipment is under warranty, the employee who receives the request asks the company to correct it. If not, orders the part from the institution’s warehouse department, receives it, and forwards it to the technical team for replacement. Generally, the computer equipment fully meets the courses’ needs, in terms of quantity, quality, as well as updating policies.

2.7 Clinical Simulation Center

PUCPR Clinical Simulation Center allows medical students to train their skills on mannequins and complete operating rooms before practicing with patients.

The Center, a general hospital, contains an area of 1200m², has state-of-the-art mannequins that simulate real situations such as bleeding, crying, vomiting, and even a normal birth. In addition to mannequins, the complex has two complete surgical centers, two wards that can be converted into ICUs or emergency care units, two offices, six skill rooms, four meeting rooms, two auditoriums, and a pre-hospital area, which it has an ambulance and a car, where students can simulate emergency calls such as traffic events.

The construction of the Clinical Simulation Center meets a worldwide trend of learning through simulation. The use of mannequins for simulating complications is not new in the Medicine course at PUCPR. Since the 1990s, cardiology and trauma specialties have trained their students in models. However, mannequins with such fidelity to human reactions — and available in realistic scenarios — are new in Brazilian higher education.

PUCPR Clinical Simulation Center also allows the simulation of surgical procedures by video and exams such as endoscopy, which will reduce the use of animals in these practical classes.

2.8 Marcelino Champagnat Hospital

The School of Medicine, through PPGCS, advanced the synergy with the Marist Group hospitals. Following the institutional vision and mission, CEPI – Center for Teaching, Research, and Innovation was created at Marcelino Champagnat Hospital. This center makes the connection between students and professors of PPGCS and the structure of the hospital. PPGCS now has one more service for data collection, and the hospital aims to train medical staff for research and teaching. The Teaching, Research, and Innovation Center – CEPI was created to promote and develop research, extension courses, and innovations in the health areas of Hospital Marcelino Champagnat and Cajurú University Hospital. The objective is to provide knowledge to the medical and scientific community based on high ethical principles, always searching for better clinical practices. The main result of this mission is the achievement of innovative ways to care for, treat, and recover patients. In addition to CEPI coordination (Professor Cristina Pellegrino Baena), Professors Thyago Proença de Moraes and Roberto Pecoits Filho are also part of the Scientific Committee. Through this interface, some doctors from the clinical staff at Marcelino Champagnat Hospital started their master’s and doctoral programs at PPGCS in 2017. All courses and events promoted by CEPI in partnership with the university are free and widely disseminated to the clinical staff and University students.

Internationalizing higher education is no longer an option but a necessity for every university committed to the quality of teaching, research, and extension. Although having a local impact, the significant modern challenges of society are global in scope — energy, sustainability, cities, health, human rights, among others-. Therefore, their solutions depend on the formation of leaders with global vision and presence.

PUCPR decided to take on this task when it chose internationalization as an institutional priority. In this scenario, the University Administration, through the Research Office, Graduate Studies (PRPPI) and Innovation and the Internationalization Board (DI), has the role of (i) indicating the direction; (ii) facilitate processes; and (iii) offer the means and encourage talents in its community, at all levels, to become the real protagonists of internationalization. This document describes the PUCPR President’s proposal for the internationalization of the University for the 2016-2022 period. The plan is organized in two pathways, named InPUC (campus internationalization) and OutPUC — external internationalization activities — each with three guidelines, described in this document, accompanied by an activity plan, an in-progress portion, and others planned for the future.

The proposal aims to include the entire academic community to make PUCPR a truly borderless university.

In a scenario of intense and unforeseen transformations as we are currently experiencing, a higher education institution fails when it does not seek the training of professionals and citizens inserted in the global community and capable of acting in different contexts and cultures. Moreover, the internationalization of a higher education institution is a powerful tool that adds to the available arsenal in the pursuit of excellence in teaching, research, and extension.

DEFINITION OF INTERNATIONALIZATION

At PUCPR, internationalization is a strategy to improve the quality of teaching and research and increase the reach of its social impact. It can be defined as integrating international, intercultural, and global dimensions in the purposes, functions, and higher education deliveries. (J. Knight, International Higher Education, 2015).

Internationalization is a priority in PPGCS actions, and with the mobilization of institutional resources, it enabled a more significant number of international trips for all professors of the program in 2018. The current Normative Act regulates aid to trips for research presentation with students when the researcher has current funding, qualified publication in the previous year, and the research approved at the event is related to the graduate project. In cases where the criteria of the normative act are not met, the professor will receive travel assistance from the School of Medicine with the student for research presentation approved at an international event. In this sense, all professors had the opportunity to attend international events in 2018, with one student each.

Additionally, some professors have international exposure in their respective areas and are invited to give lectures and courses abroad, including Dr. Thyago Proença with the “Outcomes of PD Patients in a Developing Country” class at the World Society of Peritoneal Dialysis in 2018. Additional examples include Dr. José Rocha Faria Neto’s class “Applications and Limitations of Recent Discoveries for Prevention of Cardiovascular Diseases” at the 6th Annual Conquering Healthcare Challenges in the Emerging Worlds Symposium; Dr. Selene Esposito with the class, “Neuroblastoma, chromosome 11q, and tick saliva” at the University of Burgundy, France; Professor Marcelo Mira with the class, “Genetic susceptibility to leprosy” at Kent State University (USA); Prof. Roberto Pecoits Filho with classes on Nephrology: Renal Research Institute Seminars (NYC, USA), Fresenius Medical Care Scientific Meetings (Boston, USA), Advances in Kidney Disease (Orlando, USA), Arbor Research Brown Bag Series (Ann Arbor, USA ), the George Institute Renal Seminars (Sydney, Australia), Cardiovascular Metabolic Diseases Health Forum (Abu Dhabi, United Arab Emirates), ISN ESKD Summit (Sharja, United Arab Emirates), ISPD Congress (Vancouver, Canada), Arbor Research Seminars (Ann Arbor, USA), ERA/EDTA Congress (Copenhagen, Denmark), ISN Excom Retreat (Frankfurt, Germany), ISMA Course and Mohamed Elamin Memorial Lecture (Khartoum, Sudan), KDIGO Controversies Conferences on Potassium Management (Miami (USA), and Nephrocure Meeting (Washington, USA).

Regarding doctoral internships, two students left with a PDSE resource: Claudia Caroline Veloso da Silva, supervised by Dr. Vanessa Santos Sotomaior (Georgetown University), and doctoral student for the University of Burgundy in France, Nilton de França Junior, where the advisor — Prof. Selene Esposito —signed a co-tutelage agreement for the student’s doctorate. With funds from the Institutional Research Fund, two students received assistance for shorter internships: Murilo Guedes (University of Michigan), with his supervisor Prof. Roberto Pecoits Filho, for work meetings; and postdoctoral student, Ana Paula Martins Sebastião (Memorial Cancer Sloan Institute). Because she is a civil servant and is ineligible for assistance, she requested paid leave for the internship.

Currently, the biggest internationalization project at PPGCS is the ISN Sister Renal Centers Program (Sudan – Brazil), where a team of Brazilian doctors and nurses led by Dr. Roberto Pecoits Filho makes annual visits to Sudan (Soba University Hospital – Khartoum) to train health professionals for the detection, treatment, and research in acute and chronic kidney disease. The program is sponsored by the International Society of Nephrology, which chooses a receiving center in developing countries and an enabling center (usually from developed countries, except for Brazil, which, despite being considered a developing country, has this team made up of PUCPR, URGS, and led by Prof. Pecoits, competence, and expertise to run the program as a training center). The third visit took place in September 2018. Due to the efforts and training of local professionals, Sudan is now classified as an integral unit with its training and dissemination of management techniques and acute and chronic kidney disease, with direct funding from the International Society of Nephrology. Through this project, two graduates of the program have already been to Sudan (Dr. Viviane Calice and Dr. Cristina Von Glehn). After the first two years, the training progressed to immunogenetic techniques for kidney transplantation. The program foresees the beginning of the bidirectionality of efforts when the PPGCS Immunogenetics Laboratory will receive a health professional from Soba University to train immunogenetics exams for kidney transplantation. Due to this effort’s positive impact, the International Society of Nephrology increased the funding of this Brazil-Sudan partnership. Professor Pecoits, in international multicenter projects such as DONG Initiative, HDFit, CKDOPPS, produces opportunities for exchange and contact of students, graduates, and professors of the program with researchers and international scenarios.

The program website https://www.pucpr.br/en/escola-de-medicina/mestre-d Doutorado/ciencias-da-saude/ is fully mirrored in English and Spanish, indicating the area of concentration, the lines of research, professor profile, projects, and dissertation bank. These efforts, coupled with the adaptation of the program’s subjects to English, make it effectively international.