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1.
Nature ; 626(7998): 327-334, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-38109939

RESUMO

The pulp and paper industry is an important contributor to global greenhouse gas emissions1,2. Country-specific strategies are essential for the industry to achieve net-zero emissions by 2050, given its vast heterogeneities across countries3,4. Here we develop a comprehensive bottom-up assessment of net greenhouse gas emissions of the domestic paper-related sectors for 30 major countries from 1961 to 2019-about 3.2% of global anthropogenic greenhouse gas emissions from the same period5-and explore mitigation strategies through 2,160 scenarios covering key factors. Our results show substantial differences across countries in terms of historical emissions evolution trends and structure. All countries can achieve net-zero emissions for their pulp and paper industry by 2050, with a single measure for most developed countries and several measures for most developing countries. Except for energy-efficiency improvement and energy-system decarbonization, tropical developing countries with abundant forest resources should give priority to sustainable forest management, whereas other developing countries should pay more attention to enhancing methane capture rate and reducing recycling. These insights are crucial for developing net-zero strategies tailored to each country and achieving net-zero emissions by 2050 for the pulp and paper industry.


Assuntos
Agricultura Florestal , Efeito Estufa , Gases de Efeito Estufa , Indústrias , Internacionalidade , Papel , Desenvolvimento Sustentável , Madeira , Efeito Estufa/prevenção & controle , Efeito Estufa/estatística & dados numéricos , Gases de Efeito Estufa/análise , Gases de Efeito Estufa/isolamento & purificação , Indústrias/legislação & jurisprudência , Indústrias/estatística & dados numéricos , Metano/análise , Metano/isolamento & purificação , Reciclagem/estatística & dados numéricos , Reciclagem/tendências , Países Desenvolvidos , Países em Desenvolvimento , Florestas , Agricultura Florestal/métodos , Agricultura Florestal/tendências , Desenvolvimento Sustentável/tendências , Clima Tropical
2.
J Neuroinflammation ; 20(1): 61, 2023 Mar 08.
Artigo em Inglês | MEDLINE | ID: mdl-36882750

RESUMO

Zika virus (ZIKV) infection is a global public health concern linked to adult neurological disorders and congenital diseases in newborns. Host lipid metabolism, including lipid droplet (LD) biogenesis, has been associated with viral replication and pathogenesis of different viruses. However, the mechanisms of LD formation and their roles in ZIKV infection in neural cells are still unclear. Here, we demonstrate that ZIKV regulates the expression of pathways associated with lipid metabolism, including the upregulation and activation of lipogenesis-associated transcription factors and decreased expression of lipolysis-associated proteins, leading to significant LD accumulation in human neuroblastoma SH-SY5Y cells and in neural stem cells (NSCs). Pharmacological inhibition of DGAT-1 decreased LD accumulation and ZIKV replication in vitro in human cells and in an in vivo mouse model of infection. In accordance with the role of LDs in the regulation of inflammation and innate immunity, we show that blocking LD formation has major roles in inflammatory cytokine production in the brain. Moreover, we observed that inhibition of DGAT-1 inhibited the weight loss and mortality induced by ZIKV infection in vivo. Our results reveal that LD biogenesis triggered by ZIKV infection is a crucial step for ZIKV replication and pathogenesis in neural cells. Therefore, targeting lipid metabolism and LD biogenesis may represent potential strategies for anti-ZIKV treatment development.


Assuntos
Neuroblastoma , Infecção por Zika virus , Zika virus , Animais , Humanos , Camundongos , Gotículas Lipídicas , Replicação Viral
3.
Mem Inst Oswaldo Cruz ; 118: e230044, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37820117

RESUMO

Lipid droplets (LD) are evolutionarily conserved lipid-enriched organelles with a diverse array of cell- and stimulus-regulated proteins. Accumulating evidence demonstrates that intracellular pathogens exploit LD as energy sources, replication sites, and part of the mechanisms of immune evasion. Nevertheless, LD can also favor the host as part of the immune and inflammatory response to pathogens. The functions of LD in the central nervous system have gained great interest due to their presence in various cell types in the brain and for their suggested involvement in neurodevelopment and neurodegenerative diseases. Only recently have the roles of LD in neuroinfections begun to be explored. Recent findings reveal that lipid remodelling and increased LD biogenesis play important roles for Zika virus (ZIKV) replication and pathogenesis in neural cells. Moreover, blocking LD formation by targeting DGAT-1 in vivo inhibited virus replication and inflammation in the brain. Therefore, targeting lipid metabolism and LD biogenesis may represent potential strategies for anti-ZIKV treatment development. Here, we review the progress in understanding LD functions in the central nervous system in the context of the host response to Zika infection.


Assuntos
Infecções do Sistema Nervoso Central , Gotículas Lipídicas , Infecção por Zika virus , Zika virus , Humanos , Gotículas Lipídicas/metabolismo , Gotículas Lipídicas/fisiologia , Gotículas Lipídicas/virologia , Lipídeos/fisiologia , Replicação Viral/fisiologia , Zika virus/fisiologia , Infecção por Zika virus/fisiopatologia , Infecção por Zika virus/virologia , Infecções do Sistema Nervoso Central/fisiopatologia , Infecções do Sistema Nervoso Central/virologia
4.
J Environ Manage ; 342: 118317, 2023 Sep 15.
Artigo em Inglês | MEDLINE | ID: mdl-37320926

RESUMO

The debate about the negative impacts that production and consumption cause on the environment is in vogue. Strategies that point to a sustainable, healthy, and resilient path are being sought. One of these paths is the Circular Economy, which emerges as an alternative to reduce the socio-environmental impacts caused by the linear model of production-use-disposal, presenting opportunities to generate revenue, income, and wealth with circular processes. However, despite the circular economy being considered an essential strategy to improve overall performance toward sustainability in its three dimensions, recent research has shown that the predominant focus of circular approaches is on the economic and environmental dimensions. At the same time, the social aspects still need to be explored. This article addresses this problem, aiming to explore circular economy environmental, economic, and social elements in three economic blocs from 2000 to 2020 using the Five Sector Sustainability Model, establishing a baseline to co-create an equitable and regenerative future. The results showed that ASEAN in 2000 occupied the first position in the general ranking. The European Union had the best classification in the economic sector, and Mercosur was the best regarding social benefits. In 2020, while the European bloc was better positioned in the general ranking, the South American bloc occupied the last post in almost all sectors. Comparatively, the highest-ranked bloc in 2020 in overall sustainability is more in line with the UN SDG due to circular actions oriented towards the three fundamental pillars of sustainability.


Assuntos
Meio Ambiente , Renda , União Europeia
5.
J Environ Manage ; 345: 118849, 2023 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-37657293

RESUMO

Current energy, water, and land (EWL) nexus research treats all resources equally, causing bias in complicated nexus studies. To make the analysis robust, we consider resource endowment and significance. Here, we provide a methodological framework where the urban industrial resource nexus strength is constructed and assign weights to resources according to policies, describing resource efficiency and representing it in ternary diagrams to assess the urban industrial nexus innovatively. Results showed that energy drives urban development under all weights, with energy resource efficiency exceeding 60%. From consumption-based accounting, energy continues to dominate most industries under physical weightings but emphasizes the significance of water and land. While, under economic weightings, land supplants energy's dominance in specific sectors. Setting weights helps understand resource interaction, establish synergy based on urban development objectives, and minimize robustness. Our findings provide quantitative evidence for assessing urban resource efficiency to highlight priority sectors for intervention in urban decision-making.


Assuntos
Indústrias , Narração , Políticas , Reforma Urbana , Água
6.
Clin Rehabil ; 36(6): 813-821, 2022 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-35313751

RESUMO

OBJECTIVE: To analyze (1) the effect of an aerobic training program on functional exercise tolerance in decompensated heart failure (DHF) patients; (2) to assess the effects of an aerobic training program on functional independence; and (3) dyspnea during activities of daily living. DESIGN: A randomized controlled clinical trial with follow-up at discharge. SETTINGS: Eight hospitals. Recruitment took place between 9/ 2017 and 3/2019. GROUP ASSIGNMENTS: Patients with DHF who were admitted to the hospital, were randomly assigned to usual rehabilitation care guideline recommended (control group) or aerobic training program (exercise group). MAIN OUTCOME: Functional exercise tolerance was measured with a 6-min walking test at discharge. RESULTS: In total 257 patients with DHF were included, with a mean age of 67 ± 11 years, 84% (n = 205) had a reduced ejection fraction and the hospital stay was 16 ± 10 days. At discharge, patients in the intervention group walked further compared to the control group (278 ± 117m vs 219 ± 115m, p < 0.01) and this difference stayed significant after correcting for confounders (p < 0.01). A significant difference was found favoring the exercise group in functional independence (96 ± 7 vs 93 ± 12, p = 0.02) and dyspnea associated to ADL (13 ± 5 vs 17 ± 7, p < 0.01) and these differences persisted after correcting for baseline values and confounders (functional independence p < 0.01; dyspnea associated with ADL p = 0.02). CONCLUSION: The ERIC-HF program is safe, feasible, and effective in increasing functional exercise tolerance and functional independence in hospitalized patients admitted due to DHF.


Assuntos
Tolerância ao Exercício , Insuficiência Cardíaca , Atividades Cotidianas , Idoso , Dispneia/etiologia , Terapia por Exercício/métodos , Humanos , Pessoa de Meia-Idade , Qualidade de Vida
7.
Int J Mol Sci ; 23(9)2022 Apr 20.
Artigo em Inglês | MEDLINE | ID: mdl-35562967

RESUMO

This review aims to describe and discuss the different functions of the endolysosomal system, from homeostasis to its vital role during viral infections. We will initially describe endolysosomal system's main functions, presenting recent data on how its compartments are essential for host defense to explore later how SARS-CoV-2 (Severe Acute Respiratory Syndrome Coronavirus 2) and other coronaviruses subvert these organelles for their benefit. It is clear that to succeed, pathogens' evolution favored the establishment of ways to avoid, escape, or manipulate lysosomal function. The unavoidable coexistence with such an unfriendly milieu imposed on viruses the establishment of a vast array of strategies to make the most out of the invaded cell's machinery to produce new viruses and maneuvers to escape the host's defense system.


Assuntos
COVID-19 , SARS-CoV-2 , Endossomos , Humanos , Lisossomos
8.
Odontology ; 109(1): 184-192, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-32274674

RESUMO

PURPOSE: To compare direct clinical and indirect digital photographic assessment of resin composite restorations. Ninety-two posterior resin composite restorations were classified using World Dental Federation (FDI) criteria by two different clinical examiners (C1 and C2). In the same appointment of clinical assessment, intraoral high-quality digital photographs were taken and posteriorly two different digital examiners (D1 and D2) classified the images of each restoration. Restorations of each patient were assessed once by C1 and C2 independently. D1 and D2 assessed the digital images from different locations and in different time. Data were analyzed using the Cohen's kappa coefficient, Kruskal-Wallis non-parametric test and Dunn's multiple shared test, with 95% confidence. Agreement levels varied from very good (0.81-1.00) to fair (0.21-0.40). Statistically significant differences (p < 0.05) between assessments were found for surface lustre, staining, color match and translucency, esthetic anatomical form, fracture of material and retention and marginal adaptation. The classification of the resin composite restorations varied significantly according to clinical or high-quality digital photographic assessments. Overall, clinical assessment detected more demand for repair or replacement.


Assuntos
Adaptação Marginal Dentária , Restauração Dentária Permanente , Cor , Resinas Compostas , Falha de Restauração Dentária , Seguimentos , Humanos , Fotografação , Propriedades de Superfície
9.
Clin Oral Investig ; 23(4): 1855-1864, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30218228

RESUMO

OBJECTIVE: To evaluate the clinical performance of posterior resin composite restorations regarding experimental and regular adhesive protocols in caries affected-dentin (CAD). MATERIAL AND METHODS: A total of 92 class I and class II cavities with carious lesions were selected and randomly assigned to the following groups: (1) bioactive glass-ceramic powder/two-step etch and rinse system, (2) control/two-step etch and rinse system, (3) bioactive glass-ceramic powder/two-step self-etching system, and (4) control/two-step self-etching system. Two operators carried out the adhesive protocols and restored the cavities with a nano-hybrid resin composite. Participants were followed up at 1 week and 6, 12, and 18 months for clinical evaluation performed by two blinded examiners and calibrated according to FDI criteria. Data were analyzed using Kruskal-Wallis and Dunn tests with a confidence of 95%. RESULTS: The clinical performance of resin composite restoration was not affected by the experimental use of an adhesive protocol including a bioactive glass-ceramic powder for 18 months post-procedure. However, there was a significant difference between group 2 and group 4 (p < 0.05) for marginal adaptation (18 months). Group 2 was significantly different from group 3 (p < 0.05) for fracture of material/retention (18 months) and marginal adaptation (1 week); group 2 showed a better performance. CONCLUSION: Adhesive protocols can alter the clinical performance of posterior restorations in terms of marginal adaptation and the fracture of material/retention in CAD. CLINICAL SIGNIFICANCE: Adhesive protocols may influence the success of resin composite restorations in CAD; this is important because failure can lead to caries, re-incidence, and/or clinical re-work.


Assuntos
Colagem Dentária , Cárie Dentária/terapia , Restauração Dentária Permanente , Dentina , Condicionamento Ácido do Dente , Adolescente , Adulto , Cerâmica , Resinas Compostas , Cimentos Dentários , Corrosão Dentária , Adaptação Marginal Dentária , Adesivos Dentinários , Método Duplo-Cego , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pós , Cimentos de Resina , Adulto Jovem
10.
J Esthet Restor Dent ; 31(2): 160-165, 2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-30367714

RESUMO

OBJECTIVE: The use of electronic cigarettes (ECIGs) has recently increased as an alternative to conventional smoking tobacco products. The literature is scarce on the effects of ECIGs on dental and oral structures. Therefore, the objective of this study was to observe whether ECIG aerosol could alter the color of dental enamel. MATERIALS AND METHODS: Sixty-three bovine enamel specimens were randomly separated into groups (n = 7) and treated with aerosols with different e-liquid flavors (neutral, menthol, and tobacco) and nicotine content (0, 12, and 18 mg). The initial color assessment was performed using a spectrophotometer (Easy Shade-Vita). Dental enamel was exposed to 20 cycles of ECIG aerosol in a smoking machine, and the final color was measured. The color change was evaluated using ΔEab, ΔE00, and Whiteness Index (WID ) formulae. Differences in L* a* b* coordinates were calculated, and data were analyzed (two-way ANOVA, uncorrected Fisher's LSD post hoc test, α = 0.05). RESULTS: Luminosity (ΔL) was reduced by aerosols with almost all levels of nicotine content and neutral and menthol flavors. Flavored e-liquids caused more color change (P < .05) according to ΔEab and ΔE00. ΔE values from both formulae exceeded the thresholds for perceptible visual alterations of color. WID increased after ECIGs exposure for menthol and tobacco and decreased for neutral flavors. CONCLUSIONS: ECIG aerosol from e-liquids with different nicotine contents and flavors altered enamel color. Menthol and tobacco e-liquids may alter the enamel color decreasing the yellowness of the enamel compared to neutral e-liquid. CLINICAL SIGNIFICANCE: Electronic cigarettes can cause perceptible changes in tooth color, altering dental esthetics.


Assuntos
Sistemas Eletrônicos de Liberação de Nicotina , Aerossóis , Animais , Bovinos , Cor , Esmalte Dentário , Nicotina
11.
Strahlenther Onkol ; 192(4): 216-22, 2016 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-26809652

RESUMO

BACKGROUND: Concurrent chemoradiotherapy (CRT) is considered standard for inoperable stage III non-small cell lung cancer (NSCLC). Consolidation chemotherapy (CC) following CRT is intended to further improve outcomes, yet studies have shown discordant results. This phase III study assessed CRT followed by best supportive care (BSC) or consolidation with oral vinorelbine and cisplatin. METHODS: Patients received two cycles of oral vinorelbine (50 mg/m(2) days 1, 8 and 15) + cisplatin (20 mg/m(2) days 1-4) q4w + radiotherapy (RT; 66 Gy). Patients with at least stable disease (SD) were randomised to either two cycles oral vinorelbine (60-80 mg/m(2) days 1 and 8) + cisplatin (80 mg/m(2) day 1) q3w + BSC or BSC alone. Primary endpoint was progression-free survival (PFS). RESULTS: A total of 279 patients were enrolled for CRT and 201 patients were randomised to CC or BSC. Both CRT and CC were well tolerated, with limited radiation-mediated grade 3/4 toxicities (CRT/CC/BSC: oesophagitis-related events 12.9 %/3.1 %/0 %; grade 3 pneumonitis 0 %/0 %/2 %) and chemotherapy-mediated grade 3/4 toxicities (CRT/CC: neutropenia 11.2 %/22.1 %; leukopenia 18.3 %/26.7 %; grade 3 nausea 5.0 %/2.3 %, grade 3 vomiting 3.2 %/3.5 %). Median PFS from randomisation was 6.4 (5.0-8.7) and 5.5 (3.8-7.4) months in the CC and BSC arms (hazard ratio, HR = 0.93 [0.69-1.26]; p = 0.63), respectively; median overall survival (OS) 20.8 (13.5-25.3) and 18.5 (13.6-24.7) months, respectively. DISCUSSION: Consolidation chemotherapy after concurrent CRT did not prolong PFS or OS. Concurrent RT with oral vinorelbine and cisplatin demonstrated a favourable safety profile and represents a suitable treatment regimen for inoperable stage III NSCLC.


Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Carcinoma Pulmonar de Células não Pequenas/terapia , Quimiorradioterapia , Quimioterapia de Consolidação , Neoplasias Pulmonares/terapia , Administração Oral , Adulto , Idoso , Carcinoma Pulmonar de Células não Pequenas/mortalidade , Carcinoma Pulmonar de Células não Pequenas/patologia , Cisplatino/administração & dosagem , Terapia Combinada , Intervalo Livre de Doença , Relação Dose-Resposta a Droga , Esquema de Medicação , Feminino , Humanos , Neoplasias Pulmonares/mortalidade , Neoplasias Pulmonares/patologia , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Vimblastina/administração & dosagem , Vimblastina/análogos & derivados , Vinorelbina
12.
Biochim Biophys Acta ; 1841(1): 97-107, 2014 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-24120921

RESUMO

The nuclear receptor PPARγ acts as a key modulator of lipid metabolism, inflammation and pathogenesis in BCG-infected macrophages. However, the molecular mechanisms involved in PPARγ expression and functions during infection are not completely understood. Here, we investigate signaling pathways triggered by TLR2, the involvement of co-receptors and lipid rafts in the mechanism of PPARγ expression, lipid body formation and cytokine synthesis in macrophages during BCG infection. BCG induces NF-κB activation and increased PPARγ expression in a TLR2-dependent manner. Furthermore, BCG-triggered increase of lipid body biogenesis was inhibited by the PPARγ antagonist GW9662, but not by the NF-κB inhibitor JSH-23. In contrast, KC/CXCL1 production was largely dependent on NF-κB but not on PPARγ. BCG infection induced increased expression of CD36 in macrophages in vitro. Moreover, CD36 co-immunoprecipitates with TLR2 in BCG-infected macrophages, suggesting its interaction with TLR2 in BCG signaling. Pretreatment with CD36 neutralizing antibodies significantly inhibited PPARγ expression, lipid body formation and PGE2 production induced by BCG. Involvement of CD36 in lipid body formation was further confirmed by decreased BCG-induced lipid body formation in CD36 deficient macrophages. Similarly, CD14 and CD11b/CD18 blockage also inhibited BCG-induced lipid body formation, whereas TNF-α synthesis was not affected. Disruption of rafts recapitulates the latter result, inhibiting lipid body formation, but not TNF-α synthesis in BCG-infected macrophages. In conclusion, our results suggest that CD36-TLR2 cooperation and signaling compartmentalization within rafts, divert host response signaling through PPARγ-dependent and NF-κB-independent pathways, leading to increased macrophage lipid accumulation and down-modulation of macrophage response.


Assuntos
Quimiocina CXCL1/biossíntese , Metabolismo dos Lipídeos , Mycobacterium bovis , Transdução de Sinais , Receptor 2 Toll-Like/metabolismo , Tuberculose , Fator de Necrose Tumoral alfa/biossíntese , Anilidas/farmacologia , Animais , Antígeno CD11b/biossíntese , Antígeno CD11b/genética , Antígenos CD18/biossíntese , Antígenos CD18/genética , Antígenos CD36/biossíntese , Antígenos CD36/genética , Quimiocina CXCL1/genética , Regulação da Expressão Gênica/efeitos dos fármacos , Regulação da Expressão Gênica/genética , Receptores de Lipopolissacarídeos/biossíntese , Receptores de Lipopolissacarídeos/genética , Macrófagos/metabolismo , Macrófagos/microbiologia , Macrófagos/patologia , Microdomínios da Membrana/genética , Microdomínios da Membrana/metabolismo , Microdomínios da Membrana/patologia , Camundongos , Camundongos Knockout , NF-kappa B/antagonistas & inibidores , NF-kappa B/genética , NF-kappa B/metabolismo , PPAR gama/antagonistas & inibidores , PPAR gama/biossíntese , PPAR gama/genética , Fenilenodiaminas/farmacologia , Receptor 2 Toll-Like/genética , Tuberculose/metabolismo , Tuberculose/patologia , Tuberculose/veterinária , Fator de Necrose Tumoral alfa/genética
13.
Ambio ; 2024 Jun 13.
Artigo em Inglês | MEDLINE | ID: mdl-38871927

RESUMO

Escalating global human activities elicit diverse ecosystem service responses, yet understanding remains limited. This study establishes a framework to clarify these responses, focusing on the Yangtze River Economic Belt in China. Analyzing 2000-2020 data, it calculates ecosystem service economic value and human footprint index. It introduces the ecosystem services response index and comprehensive responsiveness index to assess response characteristics and intensity to anthropogenic pressures. Results show a fluctuating decline in ecosystem services and an increase in anthropogenic pressures. There is a nonlinear relationship: ecosystem services decline with rising pressures, following a U-shaped trend. Notably, nonurban agglomerations experience more significant ecosystem service evolution than urban agglomerations due to differing environmental conditions. This highlights regional disparities in human activity impacts on ecosystems, crucial for planning.

14.
J Clin Pharmacol ; 64(5): 514-528, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38098162

RESUMO

The US Food and Drug Administration (FDA) encourages the use of enrollment practices that will lead to clinical trials that reflect the population most likely to use the therapeutic product (drug or biologic), if approved. In doing so, the benefit-risk profile of the product may be assessed more completely and offer patients and their health care providers a better understanding of the drug profile and greater confidence in clinical trial results. The objective of this systematic review was to assess recent literature on the demographic diversity of clinical trial participants, describe the methods used in defining clinical trial diversity, and address knowledge gaps to enhance clinical trial diversity. Our literature search initially yielded 246 articles. After applying our eligibility criteria, we conducted a full-text review and analyzed the contents of the 28 remaining articles in our systematic review. Eleven (39%) of the 28 articles used a reference standard to compare the participation of populations in clinical trials to assess diversity. The majority of the 28 articles reported on adult participants; only 5 included pediatric populations. Most articles found that women and minority populations were underrepresented in clinical trials. Some articles proposed solutions to improve clinical trial diversity; however, several did not comment on clinical trial diversity. Despite a growing emphasis on demographic diversity in research, certain populations continue to be underrepresented in clinical trials. There is a need to standardize the definition of diversity in clinical trials. Future research into effective enrollment approaches and appropriate reference standards could improve demographic diversity.


Assuntos
Ensaios Clínicos como Assunto , Humanos , Estados Unidos , United States Food and Drug Administration , Feminino , Seleção de Pacientes , Masculino
15.
Breast ; 74: 103681, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38377732

RESUMO

INTRODUCTION: Single-agent oral vinorelbine is a standard of care for hormone receptor (HR)-positive/human epidermal growth factor receptor 2 (HER2)-negative advanced breast cancer (ABC) that has progressed on endocrine therapy. Metronomic administration may offer a better balance of efficacy and safety than standard regimens, but data from previous trials are scarce. METHODS: In this open-label, multicenter, phase II trial, patients were randomized to oral vinorelbine administered on a metronomic (50 mg three times weekly) or weekly (60 mg/m2 in cycle 1, increasing to 80 mg/m2 if well tolerated) schedule. Treatment was continued until disease progression or intolerance. The primary endpoint was disease control rate (DCR, the proportion of patients with a best overall confirmed response of CR, PR, or stable disease lasting 6 months or more). RESULTS: One-hundred sixty-three patients were randomized and treated. The DCR was 63.4% (95% confidence interval [CI]: 52.0-73.8) with metronomic vinorelbine and 72.8% (95% CI: 61.8-82.1) with weekly vinorelbine. Weekly vinorelbine was also associated with longer progression-free survival (5.6 vs 4.0 months) and overall survival (26.7 vs 22.3 months) than metronomic vinorelbine, but was associated with more adverse events. CONCLUSIONS: In this randomized phase II trial, single-agent metronomic oral vinorelbine was effective and well tolerated as first-line chemotherapy for patients with HR-positive/HER2-negative ABC. Formal comparisons are not done in this phase II study and one can simply observe that confidence intervals of all endpoints overlap. When deciding for a chemotherapy after failure of endocrine therapy and CDK 4/6 inhibitors, oral vinorelbine might be an option to be given with either schedule. CLINICAL TRIAL REGISTRATION NUMBER: EudraCT 2014-003860-19.


Assuntos
Neoplasias da Mama , Humanos , Feminino , Vinorelbina , Mama/metabolismo , Receptor ErbB-2/metabolismo , Intervalo Livre de Progressão , Administração Metronômica , Protocolos de Quimioterapia Combinada Antineoplásica , Resultado do Tratamento , Vimblastina
16.
Healthcare (Basel) ; 11(9)2023 Apr 26.
Artigo em Inglês | MEDLINE | ID: mdl-37174776

RESUMO

BACKGROUND: This study aimed to evaluate burnout in intensive care unit nurses and describe the relationship between burnout dimensions and sociodemographic and professional variables. METHODS: A pilot study was carried out with 29 intensive care nurses during the COVID-19 pandemic. The data were collected using an online questionnaire consisting of a sociodemographic characterization and the Maslach Burnout Inventory Human Services Survey. In the comparative statistical analysis, the nonparametric Mann-Whitney and Kruskal-Wallis tests were used (p < 0.05). RESULTS: The Emotional Exhaustion dimension represented an average of 27.9 ± 10.4, and the Personal Fulfillment of 30.8 ± 7.0 was considered high. Regarding Depersonalization, medium-level results (8.1 ± 6.0) were found. There was a prevalence of 41.3% of high levels of burnout. There was no statistically significant difference in the comparison between the three dimensions and sociodemographic and professional variables (p > 0.05). CONCLUSIONS: The global results point to high levels of burnout in nurses, with greater expression in the Emotional Exhaustion and Professional Fulfillment domains. There were no differences between groups, demonstrating homogeneity in the team's level of burnout. The incidence of burnout in this study was higher than that identified in other studies carried out in Portugal with health professionals. This pilot study will allow the defining of strategies for reducing burnout and, consequently, a proposed extension of the study to other organization wards.

17.
iScience ; 26(11): 108045, 2023 Nov 17.
Artigo em Inglês | MEDLINE | ID: mdl-37867959

RESUMO

This paper proposes a process for updating monthly input-output tables with monthly macroeconomic statistics and published input-output tables. Reasonable assumptions are set up and 48 monthly input-output tables are prepared from 2018 to 2021 with the combination of the row range series method and nonlinear mathematical planning. The Weaver-Thomas composite index is used to analyze the role of the sector in the economic network, and the sectoral correlation indicators are used to analyze the correlation change of the sector's monthly electricity emissions to show an environmental application effect of the monthly input-output table. The results show that the monthly input-output tables can be prepared with acceptable accuracy, and they can reveal the sectoral network structure changes and sectoral carbon emissions changes in continuous monthly time series. The proposed approach contributes for the compilation of high-time-frequency input-output tables, so as to support high-frequency industrial environmental impact analysis.

18.
Front Immunol ; 14: 1268854, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-38106410

RESUMO

Lipids perform a series of cellular functions, establishing cell and organelles' boundaries, organizing signaling platforms, and creating compartments where specific reactions occur. Moreover, lipids store energy and act as secondary messengers whose distribution is tightly regulated. Disruption of lipid metabolism is associated with many diseases, including those caused by viruses. In this scenario, lipids can favor virus replication and are not solely used as pathogens' energy source. In contrast, cells can counteract viruses using lipids as weapons. In this review, we discuss the available data on how coronaviruses profit from cellular lipid compartments and why targeting lipid metabolism may be a powerful strategy to fight these cellular parasites. We also provide a formidable collection of data on the pharmacological approaches targeting lipid metabolism to impair and treat coronavirus infection.


Assuntos
Infecções por Coronavirus , Coronavirus , Humanos , Metabolismo dos Lipídeos , Infecções por Coronavirus/tratamento farmacológico , Replicação Viral , Lipídeos
19.
Braz Dent J ; 34(3): 82-93, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37466529

RESUMO

The objective of this study was to observe patients' satisfaction with their in-service direct anterior dental restorations and to compare it with clinical evaluation using FDI (Federation Dental International) criteria. Patients scored their own anterior dental restorations regarding satisfaction (satisfactory /dissatisfactory). If dissatisfaction was mentioned, then, they would be interviewed about the complaint. In the same session, the dental restorations were clinically evaluated by two dentists using FDI criteria (1-5 score) concerning esthetic, functional, and biological domains. Descriptive statistics were used for frequencies of scores attributed by patients and clinicians. In order to compare patients' to clinicians' frequencies, the Chi-square test was applied (p ≤ 0.05). A total of 106 restorations were evaluated by patients and clinicians. Patients reported 52.8% of restorations satisfactory and 47.8% dissatisfactory. Overall, clinicians reported the same restorations as 82,3% satisfactory and 17,6% dissatisfactory. Patients' most frequent complaints referred to color, followed by anatomical form, fracture of material and retention, and approximal anatomical form. Comparing patients' satisfaction and dissatisfaction rates to clinicians' evaluation per criteria, there was no difference regarding esthetics. The frequency of dissatisfactory restorations by clinicians was significantly lower when functional and biological properties were compared with patients' opinions. Direct anterior dental restorations were more frequently reported as satisfactory by patients and clinicians, being the main complaints related to esthetic issues. When clinicians and patients' evaluations were compared, it was observed that the frequencies of satisfactory restoration by patients and clinicians were similar regarding esthetic properties, and significantly different regarding functional and biological properties.


Assuntos
Estética Dentária , Satisfação do Paciente , Humanos , Restauração Dentária Permanente , Falha de Restauração Dentária , Resinas Compostas
20.
Artigo em Inglês | MEDLINE | ID: mdl-21977054

RESUMO

Wade Davis's study of Haitian "zombification" in the 1980s was a landmark in ethnobiological research. His research was an attempt to trace the origins of reports of "undead" Haitians, focusing on the preparation of the zombification poison. Starting with this influential ethnopharmacological research, this study examines advances in the pharmacology of natural products, focusing especially on those of animal-derived products. Ethnopharmacological, pharmacological, and chemical aspects are considered. We also update information on the animal species that reportedly constitute the zombie poison. Several components of the zombie powder are not unique to Haiti and are used as remedies in traditional medicine worldwide. This paper emphasizes the medicinal potential of products from zootherapy. These biological products are promising sources for the development of new drugs.

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