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The need to transition to more sustainable agriculture that is adaptable to environmental challenges, reducing dependence on chemical fertilizers and minimizing environmental impact, represents the new paradigm of the moment. In this scenario, studies with the adoption of bioinputs in corn cultivation emerge as a viable option for the sustainability of agricultural activity. Therefore, the objective was to evaluate the effect of doses of neem vegetable cake on the yield components of corn crops. An experimental design was used of randomized blocks was used, consisting of four doses of neem vegetable rendering (3 kg ha-1, 6 kg ha-1, 9 kg ha-1 and 12 kg ha-1) and a treatment control without the presence of organic fertilizer. The result indicates the presence of a significant effect of treatments with the application of neem cake on the main components of corn yield, including grain productivity, suggesting that the high carbon content present in the organic product can induce phytochemical effects and biological changes. in the soil, making it more productive. It was found that, when administering the maximum experimental dose, compared to the control group, there was a significant effect (p≤0.01) of 21.3% on grain productivity, jumping from 2,140 kg ha -1, when did not apply organic fertilizer, to 2,596 kg ha-1 with the application of 12 kg of neem cake per hectare. It is noted that the increase in grain productivity was in the proportion of 38 kg ha-1 of corn for each kilo of neem cake applied. To facilitate interpretation and decision-making, an analysis of the economic viability of neem cake for rainfed corn was also determined, also identifying the maximum experimental dose of 12 kg ha-1, as the most economically viable, providing an increase in profit of around R$ 119.92 per hectare, in relation to the control.
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Azadirachta , Fertilizantes , Zea mays , Zea mays/crecimiento & desarrollo , Azadirachta/química , Fertilizantes/análisis , Agricultura/métodos , Distribución Aleatoria , Suelo/químicaRESUMEN
As urban areas grow with the increase in population, so do the problems associated with these areas, such as an increase in atmospheric emissions. Since urban morphology has an effect on the environment, it is necessary to design future urban morphologies to accommodate the expected growth and mitigate the associated problems. By employing an emission distribution methodology based on the relationship between land use and emission activity sectors, including transport and road traffic emissions modelling (with PTV-VISUM and TREM, respectively), this study aims to identify urban morphologies that have the potential to minimize atmospheric emissions for future multi-core regions. This study assesses three urban morphology scenarios, focused on Aveiro, Portugal, where two represent urban compaction - Focused City scenario and Independent City scenario -, and one represents an extreme version of the current urban dispersion. The impact of urban scenarios was compared against the current urban morphology. Results indicate that, for the compact urban morphologies, the Focused City scenario showed a small increase in emissions, and the Independent City scenario led to a decrease in emissions, especially for NOx (-16 %), as it is the pollutant most affected by road traffic emissions. As for the Disperse City scenario, it showed the highest overall increase, as it greatly increased the vehicle volume and total distance travelled. These results highlight the need for policy and behavioral changes to accompany the changes to urban morphology, and for special attention to be paid to the location of activity sectors when designing the different urban morphologies. This study contributes novel insights by applying a comprehensive methodology that integrates land use, activity sectors, and road traffic emissions modelling. By assessing the urban morphology's impact on air pollutant emissions, it is possible to inform urban planners of future urban planning strategies.
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Intervertebral Disc (IVD) degeneration has been associated with a chronic inflammatory response, but knowledge on the contribution of distinct IVD cells, namely CD44, to the progression of IVD degeneration remains elusive. Here, bovine nucleus pulposus (NP) CD44 cells were sorted and compared by gene expression and proteomics with the negative counterpart. NP cells were then stimulated with IL-1b (10 ng/ml) and dynamics of CD44 gene and protein expression was analyzed upon pro-inflammatory treatment. The results emphasize that CD44 has a multidimensional functional role in IVD metabolism, ECM synthesis and production of neuropermissive factors. CD44 widespread expression in NP was partially associated with CD14 and CD45, resulting in the identification of distinct cell subsets. In conclusion, this study points out CD44 and CD44-based cell subsets as relevant targets in the modulation of the IVD pro-inflammatory/degenerative cascade.
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Receptores de Hialuranos , Inflamación , Degeneración del Disco Intervertebral , Núcleo Pulposo , Animales , Bovinos , Núcleo Pulposo/metabolismo , Núcleo Pulposo/patología , Receptores de Hialuranos/metabolismo , Receptores de Hialuranos/genética , Inflamación/metabolismo , Inflamación/patología , Degeneración del Disco Intervertebral/metabolismo , Degeneración del Disco Intervertebral/patología , Células Cultivadas , Interleucina-1beta/metabolismo , Proteómica/métodosRESUMEN
Cutaneous pythiosis is a life-threatening infectious disease. Low-level laser therapy (LLLT) and ozone (O3) have been used individually in the treatment of infected wounds. The goals of the study were a) to characterize the antimicrobial action of the photo-ozone therapy (LLLT-O3) against equine Pythium insidiosum, and b) to assess the cytotoxic potential of the LLLT-O3 in keratinocytes. Specimens of pathogen were isolated from 10 horses. After culturing, 120 hyphae plugs were distributed among four groups (n=30 hyphae plugs/group): LLLT (laser irradiation for 160 sec;), O3 (exposition to O3 for 15 min;), LLLT-O3 (LLLT and O3 treatments in sequence) and control (untreated plugs). The hyphae growth was measured during the first 14 days post-treatment. Where there was an absence of hyphae growth, the plug was recultured for an additional 7 days. The cytotoxic potential of the treatments against HaCaT keratinocytes was assessed by colorimetric assays. The LLLT-O3 and O3 treatments inactivated, respectively, 92.3% (28/30) and 30% (9/30) of the samples. No growth was detected after 7 days reculture of inactivated hyphae plugs on new media. Hyphae growth was visualized in 100% of the control and LLLT hyphae plugs. The viability of HaCaT cells was not affected by the isolated treatments (LLLT and O3), while the LLLT-O3 showed slight cytotoxic effect (20%) when compared to the control group (P<0.05). Photo-ozone therapy inactivated equine P. insidiosum hyphae with minimal cytotoxicity in skin cells in vitro.
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Enfermedades de los Caballos , Pitiosis , Pythium , Animales , Caballos , Pitiosis/tratamiento farmacológico , Enfermedades de los Caballos/tratamiento farmacológicoAsunto(s)
Conservadores de la Densidad Ósea , Fracturas del Fémur , Osteoporosis , Fracturas Osteoporóticas , Humanos , Portugal/epidemiología , Fracturas del Fémur/diagnóstico por imagen , Fracturas Osteoporóticas/etiología , Fracturas Osteoporóticas/prevención & control , Conservadores de la Densidad Ósea/uso terapéuticoRESUMEN
Screener, a board game supplemented with online resources, was introduced and distributed by the Brazilian Society of Pharmacology and Experimental Therapeutics to postgraduate programs as an instructional tool for the process of drug discovery and development (DDD). In this study, we provided a comprehensive analysis of five critical aspects for evaluating the quality of educational games, namely: 1) description of the intervention; 2) underlying pedagogical theory; 3) identification of local educational gaps; 4) impact on diverse stakeholders; and 5) elucidation of iterative quality enhancement processes. We also present qualitative and quantitative assessments of the effectiveness of this game in 11 postgraduate courses. We employed the MEEGA+ online survey, comprising thirty-three close-ended unipolar items with 5-point Likert-type response scales, to assess student perceptions of the quality and utility of Screener. Based on 115 responses, the results indicated a highly positive outlook among students. In addition, we performed a preliminary evaluation of learning outcomes in two courses involving 28 students. Pre- and post-quizzes were applied, each consisting of 20 True/False questions directly aligned with the game's content. The analysis revealed significant improvement in students' performance following engagement with the game, with scores rising from 8.4 to 13.3 (P<0.0001, paired t-test) and 9.7 to 12.7 (P<0.0001, paired t-test). These findings underscore the utility of Screener as an enjoyable and effective tool for facilitating a positive learning experience in the DDD process. Notably, the game can also reduce the educational disparities across different regions of our continental country.
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Descubrimiento de Drogas , Aprendizaje , Humanos , Escolaridad , Brasil , Suplementos DietéticosRESUMEN
Screener, a board game supplemented with online resources, was introduced and distributed by the Brazilian Society of Pharmacology and Experimental Therapeutics to postgraduate programs as an instructional tool for the process of drug discovery and development (DDD). In this study, we provided a comprehensive analysis of five critical aspects for evaluating the quality of educational games, namely: 1) description of the intervention; 2) underlying pedagogical theory; 3) identification of local educational gaps; 4) impact on diverse stakeholders; and 5) elucidation of iterative quality enhancement processes. We also present qualitative and quantitative assessments of the effectiveness of this game in 11 postgraduate courses. We employed the MEEGA+ online survey, comprising thirty-three close-ended unipolar items with 5-point Likert-type response scales, to assess student perceptions of the quality and utility of Screener. Based on 115 responses, the results indicated a highly positive outlook among students. In addition, we performed a preliminary evaluation of learning outcomes in two courses involving 28 students. Pre- and post-quizzes were applied, each consisting of 20 True/False questions directly aligned with the game's content. The analysis revealed significant improvement in students' performance following engagement with the game, with scores rising from 8.4 to 13.3 (P<0.0001, paired t-test) and 9.7 to 12.7 (P<0.0001, paired t-test). These findings underscore the utility of Screener as an enjoyable and effective tool for facilitating a positive learning experience in the DDD process. Notably, the game can also reduce the educational disparities across different regions of our continental country.
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INTRODUCTION: We investigated the burden of microembolic signals (MES) in patients with acute ischaemic stroke (AIS) and atrial fibrillation (AF), assessing their impact on functional outcomes. PATIENTS AND METHODS: This multicentre international prospective cohort study involved patients with AIS and either a known or newly diagnosed anticoagulant-naïve AF. All centres utilised the same transcranial Doppler machine for 1-h monitoring with bilateral 2 MHz probes within 24 h of symptom onset. Recordings underwent MES analysis by a blinded central reader. The primary objectives were to ascertain the MES proportion and its association with functional outcomes assessed by the modified Rankin scale (mRS) score at 90 days. RESULTS: Between September 2019 and May 2021, we enrolled 61 patients, with a median age of 78 years (interquartile range 73-83) and a median stroke severity score of 11 (interquartile range 4-18). MES were observed in 14 patients (23%), predominantly unilateral (12/14, 86%), with a median rate of 6 counts/hour (interquartile range 4-18). MES occurrence was higher post-thrombectomy and among those with elevated brain natriuretic peptide levels (p < 0.05). A worse mRS score of 3-6 was more frequent in patients with MES, occurring in 11/14 (79%), compared to those without MES, 20/47 (43%), with an adjusted odds ratio of 5.04 (95% CI, 1.15-39.4), p = 0.04. CONCLUSIONS: Nearly a quarter of patients with AIS and AF exhibited silent microembolization after the index event. Detecting MES within 24 h post-stroke (using transcranial Doppler) could signify a marker of poor functional outcomes. Subsequent trials will assess if very early antithrombotic treatment might enhance outcomes in this highly selective group of cardioembolic stroke patients. (Clinicaltrials.gov ID: NCT06018090).
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Fibrilación Atrial , Accidente Cerebrovascular Isquémico , Ultrasonografía Doppler Transcraneal , Humanos , Anciano , Fibrilación Atrial/complicaciones , Femenino , Masculino , Accidente Cerebrovascular Isquémico/diagnóstico por imagen , Accidente Cerebrovascular Isquémico/terapia , Anciano de 80 o más Años , Estudios Prospectivos , Ultrasonografía Doppler Transcraneal/métodos , Embolia Intracraneal/diagnóstico por imagen , TrombectomíaRESUMEN
The mallard duck or wild duck (Anas platyrhynchos) is the world's most widespread and numerous dabbling duck, being traditionally hunted across many countries in Europe and North America. This study aims to provide a detailed characterization of mallard duck's meat lipid fraction obtained from farmed specimens, reared for hunting purposes, under semiextensive conditions. The mallard's duck meat total lipid content averaged 2.0 and 4.26 g/100 g of fresh meat in breast and leg meat portions, and its meat comprised 23 individual fatty acids (FA) and 3 dimethylacetals (DMA), independently of the sex or meat portion. The oleic (C18:1 cis-9), palmitic (C16:0), stearic (C18:0), linoleic (C18:2n-6), arachidonic (C20:4n-6), palmitoleic (C16:1 cis-9), and cis-vaccenic (C18:1 cis-11) acids were the predominant FA (representing >1% of total fatty acids in both breast and leg meat portions and independently of the sex), and together, these 7 fatty acids were accountable for 92.4 to 96.5% of total FA plus DMA in mallard duck meat. The monounsaturated, saturated and polyunsaturated fatty acids were accountable for 40.4, 35.0, and 21.0% of total FA plus DMA in breast and 54.6, 38.7, and 5.7% of total fatty acids in leg, while total DMA were liable for 3.6 and 0.9% of total FA plus DMA in breast and leg, respectively. The mallard duck meat total cholesterol content averaged 49.8 and 57.1 mg/100 g of fresh meat for breast and leg meat portions. Five tocochromanols were quantified in mallard duck meat, affording it with a total vitamin E content of 5.48 and 3.63 µg/g of fresh meat in breast and leg portions. The sex had no influence (P > 0.05) on mallard's duck meat lipid composition, but meat portion had a strong influence on mallard's duck meat lipid composition, influencing total lipid, total cholesterol, total vitamin E contents, FA partial sums, FA ratios (exception made for the n-6/n-3 ratio), and all nutritional lipid indices. The breast meat presented lower total lipid and total cholesterol contents, better FA ratios and nutritional quality indices and higher vitamin E content, being regarded as a healthier meat than leg. The study presented herein shows that mallard duck production in semiextensive conditions, similar to those used herein, could be used for the production of mallard duck beyond hunting. A production of duck's meat under natural or organic production practices, oriented to a market niche within the gourmet/organic markets.
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Patos , Caza , Animales , Pollos , Ácidos Grasos/análisis , Lípidos , Carne/análisis , Valor Nutritivo , Vitamina E , ColesterolRESUMEN
Abstract Visceral leishmaniosis is a neglected tropical disease. We evaluated the spatial distribution of cases of visceral leishmaniosis in the state of Alagoas, Brazil. All cases of VL, registered by the health department, were analyzed and georeferenced. Results: Between 2008 and 2017, 97.1% of the municipalities presented sporadic classification of transmission. With temporal evolution, the incidence of cases of visceral leishmaniosis was concentrated in most municipalities in the microregion of Santana do Ipanema-AL. Space-time analysis, if considered, may promote the improvement of surveillance and control actions of visceral leishmaniosis.
Resumo A leishmaniose visceral é uma doença tropical negligenciada. Foram avaliadas a distribuição espacial dos casos de leishmaniose visceral no estado de Alagoas. Todos os casos de LV, registrados pela secretaria de saúde, foram analisados e georreferenciados. Entre 2008 e 2017, 97,1% dos municípios apresentaram classificação esporádica de transmissão. Com a evolução temporal, a incidência de casos de leishmaniose visceral se concentrou na maioria dos municípios da microrregião de Santana do Ipanema-AL. A análise espaço-tempo, se considerada, pode promover o aprimoramento das ações de vigilância e controle da leishmaniose visceral.
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Visceral leishmaniosis is a neglected tropical disease. We evaluated the spatial distribution of cases of visceral leishmaniosis in the state of Alagoas, Brazil. All cases of VL, registered by the health department, were analyzed and georeferenced. Results: Between 2008 and 2017, 97.1% of the municipalities presented sporadic classification of transmission. With temporal evolution, the incidence of cases of visceral leishmaniosis was concentrated in most municipalities in the microregion of Santana do Ipanema-AL. Space-time analysis, if considered, may promote the improvement of surveillance and control actions of visceral leishmaniosis.
A leishmaniose visceral é uma doença tropical negligenciada. Foram avaliadas a distribuição espacial dos casos de leishmaniose visceral no estado de Alagoas. Todos os casos de LV, registrados pela secretaria de saúde, foram analisados e georreferenciados. Entre 2008 e 2017, 97,1% dos municípios apresentaram classificação esporádica de transmissão. Com a evolução temporal, a incidência de casos de leishmaniose visceral se concentrou na maioria dos municípios da microrregião de Santana do Ipanema-AL. A análise espaço-tempo, se considerada, pode promover o aprimoramento das ações de vigilância e controle da leishmaniose visceral.
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Humanos , Medicina Tropical , Análisis Espacio-Temporal , Leishmaniasis Visceral , BrasilRESUMEN
Although ivermectin (IVM) has a wide spectrum and long half-life, its frequent use as an anthelmintic for the last 42 years led to its worldwide tolerance by Haemonchus contortus. We evaluated the combination of limonene (LIM), a P-glycoprotein (Pgp) modulator, with IVM in lambs infected with a multidrug-resistant H. contortus. Twenty-four male Dorper lambs were artificially infected with two doses (seven days apart) of 8000 infective larvae of a multidrug-resistant isolate of H. contortus. The infection was patent 25 days later. Fifteen days before treatment with IVM (DAY -15), animals were divided into 4 groups: Infected-untreated control (CTL), IVM, LIM, and LIM+IVM. From DAY -15 to DAY + 14, groups LIM and LIM+IVM received 200 mg/kg of body weight/day of LIM via oral. On DAY 0, a single dose of IVM at 200 µg/kg of body weight was administered orally to groups IVM and LIM+IVM. On DAY + 7 and DAY + 14, fecal egg counts (FEC) were performed and on DAY + 14 animals were euthanized for total worm count (TWC), worm length, fecundity of females, and Pgp-9 gene expression. On DAY + 7, group LIM+IVM had 96.29% efficacy based on Fecal Egg Count Reduction TEST (FECRT) and a highly significant reduction in FEC (P = 0.0005) when compared to CTL. On DAY + 14, the efficacy of LIM+IVM was 82.87% on FECRT, although no differences were found among groups for FEC, TWC, worm length, or Pgp-9 gene expression. Female worms from the CTL group had higher egg counts in their uterus when compared to LIM. No differences were found for hematological or biochemical parameters, body weight, or weight gain among groups. Thus, LIM given daily at 200 mg/kg was safe for animals and, when combined with IVM, decreased egg shedding and could reduce pasture contamination, although it was unable to kill multidrug-resistant H. contortus.
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Antihelmínticos , Hemoncosis , Haemonchus , Enfermedades de las Ovejas , Ovinos , Animales , Femenino , Masculino , Ivermectina/farmacología , Ivermectina/uso terapéutico , Haemonchus/genética , Limoneno/farmacología , Óvulo , Antihelmínticos/farmacología , Antihelmínticos/uso terapéutico , Oveja Doméstica , Peso Corporal , Subfamilia B de Transportador de Casetes de Unión a ATP/genética , Expresión Génica , Hemoncosis/tratamiento farmacológico , Hemoncosis/veterinaria , Enfermedades de las Ovejas/tratamiento farmacológico , Heces , Recuento de Huevos de Parásitos/veterinariaRESUMEN
INTRODUCTION AND OBJECTIVES: This study aimed to examine the clinical utility of the radiographic evaluation of the bicipital groove in predicting long head of biceps tendon (LHBT) pathology. MATERIAL AND METHODS: A prospective study was conducted, and sixty consecutive patients proposed to shoulder arthroscopic surgery were selected. Before surgery, a radiographic evaluation was performed with a supine and a Fisk radiograph. Most supine radiographs (>75%) were non-interpretable and were excluded from the study. As some Fisk radiographs (26.7%) were also non-interpretable, that left 44 interpretable radiographs in the study. These were measured for medial opening angle, total opening angle, width and depth of the bicipital groove. The radiographic measurements and the presence of LHBT pathology, as assessed at arthroscopy, were correlated. RESULTS: Radiographic evaluation of the bicipital groove showed a mean medial opening angle of 53⯱â¯15° (23-90), a mean total opening angle of 80⯱â¯26° (30-135), a mean width of 10.3⯱â¯2.5â¯mm (6-19) and a mean depth of 4.1⯱â¯1.5â¯mm (1-8). Men had higher medial opening angle (60 vs 50°, pâ¯=â¯0.044) and wider grooves (11.9 vs 9.7â¯mm, pâ¯=â¯0.019). Twenty-five patients (56.8%) were found to have an abnormal LHBT. No correlation was found between the radiographic measurements and LHBT pathology. Only age was correlated with a LHBT lesion (61.8 vs 46.3 years, pâ¯<â¯0.001). CONCLUSIONS: Our results show that there is no correlation between radiographic morphologic evaluation of the bicipital groove and LHBT pathology.
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Hombro , Tendones , Masculino , Humanos , Persona de Mediana Edad , Estudios Prospectivos , Tendones/diagnóstico por imagen , Tendones/patología , Tendones/cirugía , Músculo Esquelético/patología , RadiografíaRESUMEN
PURPOSE: To investigate the prevalence of negative behaviour in preschool children attending dental clinics and its association with sociodemographic, oral health-related and parental psychosocial factors. METHODS: A cross-sectional study was carried out with 145 parents/guardians and their children aged 4-6 years attending paediatric dentistry training programmes in a capital city of Midwest Brazil. Data were obtained from children's dental records, interviews, and questionnaires for parents/guardians. The outcome was negative child behaviour, based on the dentists' use or indication of behavioural control measures during the dental appointments, as registered in the children's dental records. Covariates were sociodemographic, clinical and parent/guardian psychosocial factors religiosity (DUREL index) and Sense of Coherence (SOC-13 scale). Bivariate analyses and Poisson regression with robust variance were performed. RESULTS: The prevalence of negative behaviour was 24.1% (95% CI = 17.9-31.7). In the bivariate analyses, the variables initially selected for the regression models (p < 0.25) were the parent/guardians' number of children and religiosity, and the children's dental pain and caries status in deciduous teeth. After adjustment, the prevalence of negative behaviour was 2.12 higher in children with teeth extracted due to caries. CONCLUSION: The prevalence of negative behaviour was high and associated with the presence of missing teeth due to caries, regardless of sociodemographic, psychosocial, and other oral health factors.
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Caries Dental , Salud Bucal , Humanos , Preescolar , Brasil/epidemiología , Prevalencia , Estudios Transversales , Caries Dental/epidemiologíaRESUMEN
The extracts of medicinal plants are used for the treatment of seeds in order to reduce the action of phytopathogens and increase the vigor of the seeds. Currently, computerized image analysis has been used to assess the physiological quality of seed lots. The objective was to evaluate the efficiency of the Vigor-S® software in the evaluation of the physiological quality of cowpea seeds treated with essential oils, comparing with a traditional test and the principal component analysis. Two cowpea cultivars were analyzed, BRS Tumucumaque and BRS Guariba, treated with doses of natural extracts of Alfavaca, garlic, horsetail, citronella and pyroligneous acid. The traditional method consisted of evaluations for germination, first germination count, seedling emergence, emergence speed index, accelerated aging, fresh matter and dry matter of seedling and the image analysis for: seedling length, growth index, uniformity index, vigor index, and germination. A Principal component analysis was applied to reduce the number of variables. Horsetail, Alfavaca and citronella extracts were efficient in increasing the physiological quality of the seeds of at least one cultivar. The Vigor-S® software proved to be efficient compared to traditional tests to assess the physiological quality of seeds. Principal Component Analysis is an ally to identify the best extracts and doses to be used. The image analysis method proved to be effective when compared to the traditional method and can therefore be used.
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Aceites Volátiles , Vigna , Aceites Volátiles/farmacología , Plantones/fisiología , Semillas/fisiología , Germinación , Análisis Multivariante , Extractos VegetalesRESUMEN
The present study aimed to evaluate concentrations and forms of application of salicylic acid used for water stress mitigation on the gas exchange and growth of yellow passion fruit. The experimental design was arranged in randomized blocks in a 4 × 4 × 2 factorial scheme, with four concentrations of salicylic acid (SA) via foliar application (0.0, 0.7, 1.4, and 2.1 mM), four SA concentrations via fertigation (0.0, 0.7, 1.4, and 2.1 mM), and two irrigation depths estimated based on the actual evapotranspiration - ETr (50 and 100% of ETr), with three replications. Water stress negatively affected the physiology and growth of yellow passion fruit seedlings at 75 days after sowing (DAS). The application of salicylic acid, regardless of the form of application, attenuates the effects of water stress on gas exchange and growth of yellow passion fruit, with the best results obtained when applying a concentration of 1.30 mM via leaf or 0.90 mM via fertirrigation. The combination of foliar application of AS and fertigation contributed to improve photosynthetic and growth parameters under water conditions of 50 and 100% of ETr. The foliar application of AS presents superior responses to the application via fertigation. These results reinforce the hypothesis that the attenuation of water stress by salicylic acid is related to the maintenance of gas exchange, which depends on the concentration and form of application, and studies testing combinations throughout the crop cycle become promising for advances in knowledge from the action of this phytohormone on abiotic stress.
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Passiflora , Deshidratación , Frutas , Plantones , Ácido SalicílicoRESUMEN
BACKGROUND: Between 2015 and 2018 The Netherlands experienced increases of invasive meningococcal disease (IMD) serogroup W (MenW). Therefore in 2018 the MenACWY vaccination was introduced in the National Immunisation Programme (NIP) and a catch-up campaign was initiated targeting adolescents. This study aimed to gain insight into what factors played a role in the decision-making process regarding the MenACWY vaccination. The focus was on the differences in the decision-making of parents and adolescents in order to assess what factors influence the decisions made. METHODS: An online questionnaire was offered to adolescents and one of their parents. We used random forest analyses to determine which factors best predict the outcome of the MenACWY vaccination decision. We carried out ROC (receiver-operator characteristics) analyses to confirm the predictive value of the variables. RESULTS: Among parents several factors stand out, centring on the process of the decision, their attitude about the MenACWY vaccination, trust in the vaccination, and ideas of important people around them. Among adolescents the three stand-out predictors are the ideas of important people around them, the process of the decision and trust in the vaccination. Parents have prominent influence in the decision-making, while the adolescent's influence in the household decision-making is more limited. Adolescents tend to be less engaged and spend less time thinking about the decision compared to parents. Opinions of parents and adolescents from the same households concerning the factors that are influential do not differ a lot in the final decision-making. CONCLUSIONS: Information about MenACWY vaccination might be mainly addressed to the parents of the adolescents and whereby the dialogue about MenACWY vaccination between parents and adolescents will be stimulated. With regard to the predictor trust in vaccination, raising the frequency of use of certain sources, especially those deemed very reliable among households such as conversations with a GP or the provider of the vaccination (GGD/JGZ), might prove a useful strategy to solidify vaccination uptake numbers.
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Infecciones Meningocócicas , Vacunas Meningococicas , Humanos , Adolescente , Países Bajos , Vacunación , Padres , Vacunas ConjugadasRESUMEN
OBJECTIVE: Patients with rheumatoid arthritis (RA) have different presentations and prognoses. Cluster analysis based on proteomic signatures creates independent phenogroups of patients with different pathophysiological backgrounds. We aimed to identify distinct pathophysiological clusters of RA patients based on circulating proteomic biomarkers. METHOD: This was a cohort study including 399 RA patients. Clustering was performed on 94 circulating proteins (92 CVDII Olink®, high-sensitivity troponin T, and C-reactive protein). Unsupervised clustering was performed using a partitioning cluster algorithm. RESULTS: The clustering algorithm identified two distinct clusters: cluster 1 (n = 223) and cluster 2 (n = 176). Compared with cluster 1, cluster 2 included older patients with a higher burden of comorbidities (cardiovascular and RA related), more erosive and longer RA duration, more dyspnoea and fatigue, walking a shorter distance in the Six-Minute Walk Test, with more severe diastolic dysfunction, and a 4.5-fold higher risk of death or hospitalization for cardiovascular reasons. Tumour necrosis factor (TNF) receptor superfamily-related pathways were mainly responsible for the model's discriminative ability. CONCLUSION: Using unsupervised cluster analysis based on proteomic phenotypes, we identified two clusters of RA patients with distinct biomarkers profiles, clinical characteristics, and different outcomes that could reflect different pathophysiological backgrounds. TNF receptor superfamily-related proteins may be used to distinguish subgroups.
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Artritis Reumatoide , Proteómica , Humanos , Estudios de Cohortes , Artritis Reumatoide/diagnóstico , Biomarcadores/metabolismo , Análisis por ConglomeradosRESUMEN
Air pollution and climate change are the most important environmental issues for European citizens. Despite the air quality improvements achieved in recent years, with most pollutants' concentrations below the European Union legislated values, it is necessary to understand whether this will continue in the future due to expected climate changes impacts. In this context, this work tries to answer two main questions: (i) What is the relative contribution of emission source regions/activities to air quality, now and in the future, considering a climate change scenario?; and (ii) What additional policies are needed to support win-win strategies for air quality and climate mitigation and/or adaptation, at urban scale? For that, a climate and air quality modelling system, with source apportionment tools, was applied to the Aveiro Region, in Portugal. Main results show that in the future, due to the implementation of carbon neutrality measures, air quality in the Aveiro Region may improve, with reduction up to 4 µg.m-3 for particulate matter (PM) concentrations and 22 µg.m-3 for nitrogen dioxide (NO2), and consequently, the premature deaths due to air pollution exposure will also decrease. The expected air quality improvement will ensure that, in the future, the limit values of the European Union (EU) Air Quality Directive will not be exceeded, but the same will not happen if the proposed revision of the EU Air Quality Directive is approved. Results also shown that, in the future, industrial sector will be the one with higher relative contribution for PM concentrations and the second one for NO2. For that sector, additional emission abatement measures were tested, showing that, in the future, it is possible to comply with all the new limit values proposed by the EU.