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1.
MedUNAB ; 26(1): 9-11, 20230731.
Artigo em Inglês | LILACS | ID: biblio-1525482

RESUMO

A key global health objective is to promote the advancement of scientific production in disciplines with low publication volume, as opposed to specialties addressing pathologies that represent the greatest global disease burden (1). Dermatology is one such discipline, which has experienced substantial growth in research on immunopathogenic, pathophysiological, diagnostic, and therapeutic aspects (2-4). The extent to which Latin American authors and institutions have been involved in publishing scientific articles in the dermatology journals with highest impact worldwide remains unknown.


Un objetivo clave de salud mundial es promover el avance de la producción científica en disciplinas con bajo volumen de publicación, a diferencia de especialidades que abordan las patologías que representan la mayor carga de enfermedad a nivel mundial (1). La Dermatología es una de esas disciplinas que ha experimentado un crecimiento sustancial en investigación en aspectos inmunopatogénicos, fisiopatológicos, diagnósticos y terapéuticos (2-4). El alcance en el cual los autores e instituciones latinoamericanas han participado en la publicación de artículos científicos en revistas de dermatología con mayor impacto mundial permanece incierto.


Um objetivo fundamental da saúde global é promover o avanço da produção científica em disciplinas com baixo volume de publicações, em oposição às especialidades que abordam patologias que representam a maior carga de doenças em todo o mundo (1). A Dermatologia é uma das disciplinas que tem experimentado um crescimento substancial nas pesquisas em aspectos imunopatogênicos, fisiopatológicos, diagnósticos e terapêuticos (2-4). A extensão da participação de autores e instituições latino-americanas na publicação de artigos científicos em revistas de dermatologia de maior impacto global permanece incerta.


Assuntos
Dermatologia , Hispânico ou Latino , Bibliometria , Autoria na Publicação Científica , Comunicação Acadêmica
2.
Crit Care ; 25(1): 347, 2021 09 25.
Artigo em Inglês | MEDLINE | ID: mdl-34563234

RESUMO

BACKGROUND: Restricted visitation policies in acute care settings because of the COVID-19 pandemic have negative consequences. The objective of this scoping review is to identify impacts of restricted visitation policies in acute care settings, and describe perspectives and mitigation approaches among patients, families, and healthcare professionals. METHODS: We searched Medline, Embase, PsycINFO, Healthstar, CINAHL, Cochrane Central Register of Controlled Trials on January 01/2021, unrestricted, for published primary research records reporting any study design. We included secondary (e.g., reviews) and non-research records (e.g., commentaries), and performed manual searches in web-based resources. We excluded records that did not report primary data. Two reviewers independently abstracted data in duplicate. RESULTS: Of 7810 citations, we included 155 records. Sixty-six records (43%) were primary research; 29 (44%) case reports or case series, and 26 (39%) cohort studies; 21 (14%) were literature reviews and 8 (5%) were expert recommendations; 54 (35%) were commentary, editorial, or opinion pieces. Restricted visitation policies impacted coping and daily function (n = 31, 20%) and mental health outcomes (n = 29, 19%) of patients, families, and healthcare professionals. Participants described a need for coping and support (n = 107, 69%), connection and communication (n = 107, 69%), and awareness of state of well-being (n = 101, 65%). Eighty-seven approaches to mitigate impact of restricted visitation were identified, targeting families (n = 61, 70%), patients (n = 51, 59%), and healthcare professionals (n = 40, 46%). CONCLUSIONS: Patients, families, and healthcare professionals were impacted by restricted visitation polices in acute care settings during COVID-19. The consequences of this approach on patients and families are understudied and warrant evaluation of approaches to mitigate their impact. Future pandemic policy development should include the perspectives of patients, families, and healthcare professionals. TRIAL REGISTRATION: The review was registered on PROSPERO (CRD42020221662) and a protocol peer-reviewed prior to data extraction.


Assuntos
COVID-19/prevenção & controle , Cuidados Críticos , Família , Política de Saúde , Pacientes Internados , Distanciamento Físico , Visitas a Pacientes , COVID-19/psicologia , COVID-19/transmissão , Comunicação , Família/psicologia , Pessoal de Saúde/psicologia , Humanos , Pacientes Internados/psicologia , Serviços de Saúde Mental , Pandemias , Angústia Psicológica , SARS-CoV-2 , Telefone , Visitas a Pacientes/psicologia
3.
Sci Rep ; 10(1): 13825, 2020 Aug 14.
Artigo em Inglês | MEDLINE | ID: mdl-32796892

RESUMO

We study the dynamics of opinion formation in the situation where changing opinion involves a cost for the agents. To do so we couple the dynamics of a heterogeneous bounded confidence Hegselmann-Krause model with that of the resources that the agents invest on each opinion change. The outcomes of the dynamics are non-trivial and strongly depend on the different regions of the confidence parameter space. In particular, a second order phase transition, for which we determine the corresponding critical exponents, is found in the region where a re-entrant consensus phase is observed in the heterogeneous Hegselmann-Krause model. For regions where consensus always exist in the heterogeneous Hegselmann-Krause model, the introduction of cost does not lead to a phase transition but just to a continuous decrease of the size of the largest opinion cluster. Finally in the region where fragmentation is expected in the heterogeneous HK model, the introduction of a very small cost surprisingly increases the size of the largest opinion cluster.

4.
Sleep Health ; 6(5): 550-562, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32335039

RESUMO

BACKGROUND: The objective of this systematic review and meta-analysis was to investigate the associations between neighborhood socioeconomic status (nSES) and sleep duration in children aged 0-18 years. METHODS: Three electronic databases were searched for relevant articles that assessed nSES and sleep duration (either subjectively or objectively). Inclusion criteria included peer-reviewed scholarly articles on the topic area that reported an association between nSES and sleep in children and adolescents. RESULTS: The database searched identified 6080 potentially eligible studies, of which 1210 were selected for full-text review, and 8 met the inclusion criteria. Data included 67,677 unique participants. Studies were conducted in either the United States of America or Australia. Pooled estimates suggested that poorer nSES was associated with shorter child sleep duration (odds ratio: 1.262; 95% confidence interval: 1.086-1.467). This relationship between nSES and sleep was moderated by sleep assessment type (self-report versus actigraphy), child sex/gender, and child race/ethnicity. CONCLUSIONS: Across studies, there is an association between nSES and child sleep duration. This study adds child sleep to the growing number of child health disparities associated with nSES.


Assuntos
Características de Residência/estatística & dados numéricos , Sono , Classe Social , Criança , Humanos , Fatores de Tempo
5.
Rev. salud bosque ; 10(1): 1-14, 2020. Graf, tab, Ilus
Artigo em Espanhol | LILACS, COLNAL | ID: biblio-1104435

RESUMO

Introducción. Según el Ministerio de Salud y Protección Social, las enfer-medades del sistema circulatorio fueron la primera causa de mortalidad en Colombia entre 2005 y 2014, dentro de las cuales la enfermedad isquémica cardiaca (EIC) representó el 49,30 % de los casos. Respecto a esta última, el Instituto Nacional de Salud indicó que ocupó el primer lugar en 2010 entre las causas de muertes en el país.Objetivo. Caracterizar la mortalidad por EIC en Bogotá, Colombia, en el periodo 2008-2015 bajo la perspectiva de las principales variables sociodemográficas.Materiales y métodos. Estudio descriptivo basado en fuentes secundarias. Se analizaron los casos de muerte por EIC en Bogotá para el periodo 2008-2015. Los datos demográficos se obtuvieron de las proyecciones poblacionales del Departamento Administrativo Nacional de Estadística (DANE) del censo del 2005. La caracterización de la mortalidad por EIC se hizo a partir del grupo 303 de la lista 6/67 de la Organización Panamericana de la Salud (OPS). Se tomaron las muertes codificadas como EIC con el código 3.03 y los códigos CIE-10: I20, I21, I22, I23, I24, I25. Las variables sociodemográficas estudiadas fueron sexo, edad, nivel educativo, afiliación al sistema de seguridad social y estado civil.Resultados. Entre 2008 y 2015 se registró un aumento del 14,56 % en la tasa de mortalidad por EIC en Bogotá, situación que coincidió con lo reportado por el DANE, quien indicó que para el 2015 esta enfermedad representó el 15 % de la mortalidad por todas las causas registradas en Bogotá.Conclusiones. Las variables sociodemográficas juegan un papel importante en la frecuencia de aparición de las enfermedades del sistema circulatorio, por lo cual se debe buscar intervención por parte del Estado para generar un mayor impacto en términos de mortalidad.


Introduction: According to the Colombian healthcare authority, cardiovascular diseases were the leading cause of mortality from 2005 to 2014. Among these, the cardiac ischemic disease (CID) represented 49.3% of the total reported cases and in 2010, it became the leading cause of death nationwide. Objectives: To characterize CID mortality in Bogota, Colombia, during 2008 ­ 2015, according to sociodemographic variables Materials & Methods: This is a descriptive study based on secondary sources. CID related deaths in Bogota were analyzed during the 2008-2015. Demographic data were collected from the 2005 National Population Census population projections The support for CID mortality characterization is found in Pan American Health Organization ́s Group 303, list 6/67, including ICD-10 codes I20, I21, I22, I23, I24, I25. The analyzed sociodemographic variables were: gender, age, education level, social security system affiliation, and civil status. Results: CID mortality rate in Bogota increased 14.56% during 2008-2015. According to the Colombian National Administrative Department of Statistics, CID represented 15% of all deaths causes in Bogota in 2015, supporting the findings of this study. Conclusion: Sociodemographic variables play an important role in the incidence of circulatory system diseases. The Colombian state should seek appropriate interventions at this level, to achieve a greater impact on mortality rate.


Introdução. Segundo o Ministério da Saúde e Proteção Social, as doenças do sistema circulatório foram as principais causas de mortalidade na Colômbia entre 2005 e 2014, as doenças cardíacas isquêmicas (CID) representaram 49,30% dos casos do total. Quanto a este último, o Instituto Nacional de Saúde indicou que ficou em primeiro lugar em 2010 entre as causas de morte no país. Objetivo. Caracterizar a mortalidade por EIC em Bogotá, Colômbia, no período de 2008 a 2015, sob a perspectiva das principais variáveis sociodemográficas. Materiais e métodos. Estudo descritivo, baseado em fontes secundárias. Foram analisados casos de morte por EIC em Bogotá no período de 2008 a 2015. Os dados demográficos foram obtidos das projeções populacionais do Departamento Administrativo Nacional de Estatística (DANE) do censo de 2005. A caracterização da mortalidade por EIC foi feita a partir do grupo 303 da lista 6/67 da Organização PanAmericana da Saúde (OPS). Foram registados óbitos codificados como EIC com os códigos 3.03 e CID-10: I20, I21, I22, I23, I24, I25. As variáveis sociodemográficas estudadas foram sexo, idade, escolaridade, afiliação ao sistema previdenciário e estado civil. Resultados. Entre 2008 e 2015, houve um aumento de 14,56% na taxa de mortalidade por EIC em Bogotá. Situação confirmada pelo DANE, que indicou que em 2015 esta doença representava 15% da mortalidade por todas as causas em Bogotá.Conclusões. As variáveis sociodemográficas desempenham papel importante na frequência do aparecimento de doenças do aparelho circulatório, motivo pelo qual a intervenção do Estado deve ser procurada


Assuntos
Humanos , Doenças Cardiovasculares , Isquemia Miocárdica , Sistema Cardiovascular , Incidência , Morbidade , Mortalidade , Causas de Morte , Previsões Demográficas , Colômbia , Morte
6.
PLoS One ; 13(5): e0196206, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29734331

RESUMO

Centralized markets are often considered more efficient than bilateral exchanges because information is public and the same for all the agents. On decentralized markets, where the information is private, the influence of trust on the market outcome has been underlined by many authors. We present an empirical study of the distinctive Boulogne-sur-Mer Fish Market (where both buyers and sellers can choose to trade by either bidding or bargaining), focused on the interactions between agents. Our approach is inspired by studies of mutualistic ecosystems, where the agents are of two different types (as in plant-pollinator networks) and the interactions only take place between agents of different kinds, naturally providing benefits to both. In our context, where the two kinds of agents are buyers and sellers, our study shows that not only do their interactions bring economic benefits for the agents directly involved, but they also contribute to the stability of the market. Our results help to explain the surprising coexistence of the two forms of market in the distinctive Boulogne sur Mer Fish Market.


Assuntos
Comércio , Confiança , Modelos Econômicos
7.
Sci Total Environ ; 599-600: 1171-1180, 2017 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-28511362

RESUMO

Accurate carbon-balance accounting in forest soils is necessary for the development of climate change policy. However, changes in soil organic carbon (SOC) occur slowly and these changes may not be captured through repeated soil inventories. Simulation models may be used as alternatives to SOC measurement. The Yasso07 model presents a suitable alternative because most of the data required for the application are readily available in countries with common forest surveys. In this study, we test the suitability of Yasso07 for simulating SOC stocks and stock changes in a variety of European forests affected by different climatic, land use and forest management conditions and we address country-specific cases with differing resources and data availability. The simulated SOC stocks differed only slightly from measured data, providing realistic, reasonable mean SOC estimations per region or forest type. The change in the soil carbon pool over time, which is the target parameter for SOC reporting, was generally found to be plausible although not in the case of Mediterranean forest soils. As expected under stable forest management conditions, both land cover and climate play major roles in determining the SOC stock in forest soils. Greater mean SOC stocks were observed in northern latitudes (or at higher altitude) than in southern latitudes (or plains) and conifer forests were found to store a notably higher amount of SOC than broadleaf forests. Furthermore, as regards change in SOC, an inter-annual sink effect was identified for most of the European forest types studied. Our findings corroborate the suitability of Yasso07 to assess the impact of forest management and land use change on the SOC balance of forests soils, as well as to accurately simulate SOC in dead organic matter (DOM) and mineral soil pools separately. The obstacles encountered when applying the Yasso07 model reflect a lack of available input data. Future research should focus on improving our knowledge of C inputs from compartments such as shrubs, herbs, coarse woody debris and fine roots. This should include turnover rates and quality of the litter in all forest compartments from a wider variety of tree species and sites. Despite the limitations identified, the SOC balance estimations provided by the Yasso07 model are sufficiently complete, accurate and transparent to make it suitable for reporting purposes such as those required under the UNFCCC (United Nations Framework Convention on Climate Change) and KP (Kyoto Protocol) for a wide range of forest conditions in Europe.

8.
Vaccine ; 33 Suppl 1: A126-34, 2015 May 07.
Artigo em Inglês | MEDLINE | ID: mdl-25919152

RESUMO

BACKGROUND: Rotavirus is a leading cause of severe diarrhea in children under 5. In Argentina, the most affected regions are the Northeast and Northwest, where hospitalizations and deaths are more frequent. This study estimated the cost-effectiveness of adding either of the two licensed rotavirus vaccines to the routine immunization schedule. METHODS: The integrated TRIVAC vaccine cost-effectiveness model from the Pan American Health Organization's ProVac Initiative (Version 2.0) was used to assess health benefits, costs savings, life-years gained (LYGs), DALYs averted, and cost/DALY averted of vaccinating 10 successive cohorts, from the health care system and societal perspectives. Two doses of monovalent (RV1) rotavirus vaccine and three doses of pentavalent (RV5) rotavirus vaccine were each compared to a scenario assuming no vaccination. The price/dose was US$ 7.50 and US$ 5.15 for RV1 and RV5, respectively. We ran both a national and sub-national analysis, discounting all costs and benefits 3% annually. Our base case results were compared to a range of alternative univariate and multivariate scenarios. RESULTS: The number of LYGs was 5962 and 6440 for RV1 and RV5, respectively. The cost/DALY averted when compared to no vaccination from the health care system and societal perspective was: US$ 3870 and US$ 1802 for RV1, and US$ 2414 and US$ 358 for RV5, respectively. Equivalent figures for the Northeast were US$ 1470 and US$ 636 for RV1, and US$ 913 and US$ 80 for RV5. Therefore, rotavirus vaccination was more cost-effective in the Northeast compared to the whole country; and, in the Northwest, health service's costs saved outweighed the cost of introducing the vaccine. Vaccination with either vaccine compared to no vaccination was highly cost-effective based on WHO guidelines and Argentina's 2011 per capita GDP of US$ 9090. Key variables influencing results were vaccine efficacy, annual loss of efficacy, relative coverage of deaths, vaccine price, and discount rate. CONCLUSION: Compared to no vaccination, routine vaccination against rotavirus in Argentina would be highly cost-effective with either vaccine. Health and economic benefits would be higher in the Northeast and Northwest regions, where the intervention would even be cost-saving.


Assuntos
Infecções por Rotavirus/economia , Infecções por Rotavirus/prevenção & controle , Vacinas contra Rotavirus/economia , Vacinas contra Rotavirus/imunologia , Vacinação/economia , Argentina/epidemiologia , Pré-Escolar , Análise Custo-Benefício , Diarreia/economia , Diarreia/epidemiologia , Diarreia/mortalidade , Diarreia/prevenção & controle , Política de Saúde , Humanos , Programas de Imunização , Lactente , Recém-Nascido , Modelos Estatísticos , Infecções por Rotavirus/epidemiologia , Infecções por Rotavirus/mortalidade , Vacinas contra Rotavirus/administração & dosagem , Vacinação/métodos , Vacinas Atenuadas/administração & dosagem , Vacinas Atenuadas/economia , Vacinas Atenuadas/imunologia
9.
Biomed Res Int ; 2015: 570243, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-25667924

RESUMO

We report the isolation of a bacterium from Galleria mellonella larva and its identification using genome sequencing and phylogenomic analysis. This bacterium was named Alcaligenes faecalis strain MOR02. Microscopic analyses revealed that the bacteria are located in the esophagus and intestine of the nematodes Steinernema feltiae, S. carpocapsae, and H. bacteriophora. Using G. mellonella larvae as a model, when the larvae were injected with 24,000 CFU in their hemocoel, more than 96% mortality was achieved after 24 h. Additionally, toxicity assays determined that 1 µg of supernatant extract from A. faecalis MOR02 killed more than 70% G. mellonella larvae 96 h after injection. A correlation of experimental data with sequence genome analyses was also performed. We discovered genes that encode proteins and enzymes that are related to pathogenicity, toxicity, and host/environment interactions that may be responsible for the observed phenotypic characteristics. Our data demonstrates that the bacteria are able to use different strategies to colonize nematodes and kill insects to their own benefit. However, there remains an extensive group of unidentified microorganisms that could be participating in the infection process. Additionally, a nematode-bacterium association could be established probably as a strategy of dispersion and colonization.


Assuntos
Alcaligenes faecalis/genética , Alcaligenes faecalis/patogenicidade , Larva/microbiologia , Mariposas/microbiologia , Controle Biológico de Vetores/métodos , Alcaligenes faecalis/isolamento & purificação , Animais , Produtos Biológicos/farmacologia , Larva/efeitos dos fármacos , Mariposas/efeitos dos fármacos
10.
Hepatology ; 61(4): 1239-50, 2015 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-25482832

RESUMO

UNLABELLED: Ezetimibe inhibits intestinal cholesterol absorption and lowers low-density lipoprotein cholesterol. Uncontrolled studies have suggested that it reduces liver fat as estimated by ultrasound in nonalcoholic steatohepatitis (NASH). Therefore, we aimed to examine the efficacy of ezetimibe versus placebo in reducing liver fat by the magnetic resonance imaging-derived proton density-fat fraction (MRI-PDFF) and liver histology in patients with biopsy-proven NASH. In this randomized, double-blind, placebo-controlled trial, 50 patients with biopsy-proven NASH were randomized to either ezetimibe 10 mg orally daily or placebo for 24 weeks. The primary outcome was a change in liver fat as measured by MRI-PDFF in colocalized regions of interest within each of the nine liver segments. Novel assessment by two-dimensional and three-dimensional magnetic resonance elastography was also performed. Ezetimibe was not significantly better than placebo at reducing liver fat as measured by MRI-PDFF (mean difference between the ezetimibe and placebo arms -1.3%, P = 0.4). Compared to baseline, however, end-of-treatment MRI-PDFF was significantly lower in the ezetimibe arm (15%-11.6%, P < 0.016) but not in the placebo arm (18.5%-16.4%, P = 0.15). There were no significant differences in histologic response rates, serum alanine aminotransferase and aspartate aminotransferase levels, or longitudinal changes in two-dimensional and three-dimensional magnetic resonance elastography-derived liver stiffness between the ezetimibe and placebo arms. Compared to histologic nonresponders (25/35), histologic responders (10/35) had a significantly greater reduction in MRI-PDFF (-4.35 ± 4.9% versus -0.30 ± 4.1%, P < 0.019). CONCLUSIONS: Ezetimibe did not significantly reduce liver fat in NASH. This trial demonstrates the application of colocalization of MRI-PDFF-derived fat maps and magnetic resonance elastography-derived stiffness maps of the liver before and after treatment to noninvasively assess treatment response in NASH.


Assuntos
Anticolesterolemiantes/uso terapêutico , Azetidinas/uso terapêutico , Técnicas de Imagem por Elasticidade , Imageamento por Ressonância Magnética , Hepatopatia Gordurosa não Alcoólica/tratamento farmacológico , Método Duplo-Cego , Ezetimiba , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
11.
J Endourol ; 28(7): 854-60, 2014 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-24579820

RESUMO

PURPOSE: We present our experience in the design and development of a training program in laparoscopic radical prostatectomy (LRP), and the validation of the first steps of the program by objective measurement of the attendants' skills improvement and subjective evaluation of its contents. MATERIALS AND METHODS: Our training model on LRP has a total duration of 42 hours, divided in two modules of 21 hours each, performed 1 month apart. Data included in the present study were obtained from the first module of our course. It begins with acquisition of basic knowledge in ergonomics and instrument concepts, after which the attendants develop essential laparoscopic dexterities through the performance of hands-on physical simulator tasks. During the second and third day, urologists performed urethrovesical anastomosis also in the physical simulator. Attendants' skills improvement was measured during the first module by registering surgical times and suturing quality of the anastomosis, the latter by means of a leak test. At the end of the training program, a subjective evaluation questionnaire on the different didactic and organizational aspects was handed out to the attendants. RESULTS: By comparing first and last anastomosis, we observed a significant decrease in surgical times (minutes) (T1 40.1±4.6 vs T6 24.01±3.34; P≤0.005) and an increase in intraluminal leak pressure (mm Hg) (T1 8.27±7.33 vs T6 21.09±6.72; P≤0.005). We obtained a highly positive score on all questions concerning the different topics and techniques included in the training program (≥9 points over 10). Regarding the attendants' self-assessment of acquired abilities, 78.3% considered themselves capacitated to perform the trained procedures on patients. CONCLUSIONS: Training obtained during the first module of our training model significantly decreased performance times for ex vivo urethrovesical anastomosis, simultaneously increasing its quality. In addition, validation of the training model was also demonstrated by the highly scored evaluation resulting from the attendants' assessment.


Assuntos
Laparoscopia/educação , Desenvolvimento de Programas , Prostatectomia/educação , Uretra/cirurgia , Bexiga Urinária/cirurgia , Adulto , Anastomose Cirúrgica/métodos , Fístula Anastomótica , Ergonomia , Humanos , Laparoscopia/métodos , Masculino , Duração da Cirurgia , Avaliação de Programas e Projetos de Saúde , Prostatectomia/métodos , Inquéritos e Questionários , Urologia/educação
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