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1.
Adv Parasitol ; 114: 27-73, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34696844

RESUMO

Lymphatic filariasis (LF) is a major public health problem globally and in the Pacific Region. The Global Programme to Eliminate LF has made great progress but LF is persistent and resurgent in some Pacific countries and territories. Samoa remains endemic for LF despite elimination efforts through multiple two-drug mass drug administrations (MDA) since 1965, including renewed elimination efforts started in 1999 under the Pacific Programme for Elimination of LF (PacELF). Despite eight rounds of national and two rounds of subnational MDA under PacELF, Samoa failed transmission assessment surveys (TAS) in all three evaluation units in 2017. In 2018, Samoa was the first to distribute countrywide triple-drug MDA using ivermectin, diethylcarbamazine (DEC), and albendazole. This paper provides a review of MDAs and historical survey results from 1998 to 2017 in Samoa and highlights lessons learnt from LF elimination efforts, including challenges and potential ways to overcome them to successfully achieve elimination.


Assuntos
Filariose Linfática , Filaricidas , Animais , Filariose Linfática/tratamento farmacológico , Filariose Linfática/epidemiologia , Filariose Linfática/prevenção & controle , Filaricidas/uso terapêutico , Administração Massiva de Medicamentos , Oceania/epidemiologia , Prevalência , Samoa , Wuchereria bancrofti
3.
BMC Ecol Evol ; 21(1): 179, 2021 09 22.
Artigo em Inglês | MEDLINE | ID: mdl-34551727

RESUMO

BACKGROUND: Homo sapiens have experienced admixture many times in the last few thousand years. To examine how admixture affects local adaptation, we investigated genomes of modern Polynesians, who are shaped through admixture between Austronesian-speaking people from Southeast Asia (Asian-related ancestors) and indigenous people in Near Oceania (Papuan-related ancestors). METHODS: In this study local ancestry was estimated across the genome in Polynesians (23 Tongan subjects) to find the candidate regions of admixture-enabled selection contributed by Papuan-related ancestors. RESULTS: The mean proportion of Papuan-related ancestry across the Polynesian genome was estimated as 24.6% (SD = 8.63%), and two genomic regions, the extended major histocompatibility complex (xMHC) region on chromosome 6 and the ATP-binding cassette transporter sub-family C member 11 (ABCC11) gene on chromosome 16, showed proportions of Papuan-related ancestry more than 5 SD greater than the mean (> 67.8%). The coalescent simulation under the assumption of selective neutrality suggested that such signals of Papuan-related ancestry enrichment were caused by positive selection after admixture (false discovery rate = 0.045). The ABCC11 harbors a nonsynonymous SNP, rs17822931, which affects apocrine secretory cell function. The approximate Bayesian computation indicated that, in Polynesian ancestors, a strong positive selection (s = 0.0217) acted on the ancestral allele of rs17822931 derived from Papuan-related ancestors. CONCLUSIONS: Our results suggest that admixture with Papuan-related ancestors contributed to the rapid local adaptation of Polynesian ancestors. Considering frequent admixture events in human evolution history, the acceleration of local adaptation through admixture should be a common event in humans.


Assuntos
Adaptação Fisiológica , Grupo com Ancestrais Oceânicos , Transportadores de Cassetes de Ligação de ATP , Teorema de Bayes , Humanos , Povos Indígenas , Oceania , Grupo com Ancestrais Oceânicos/genética
4.
Virus Res ; 305: 198579, 2021 11.
Artigo em Inglês | MEDLINE | ID: mdl-34560183

RESUMO

The SARS-CoV2 mediated Covid-19 pandemic has impacted humankind at an unprecedented scale. While substantial research efforts have focused towards understanding the mechanisms of viral infection and developing vaccines/ therapeutics, factors affecting the susceptibility to SARS-CoV2 infection and manifestation of Covid-19 remain less explored. Given that the Human Leukocyte Antigen (HLA) system is known to vary among ethnic populations, it is likely to affect the recognition of the virus, and in turn, the susceptibility to Covid-19. To understand this, we used bioinformatic tools to probe all SARS-CoV2 peptides which could elicit T-cell response in humans. We also tried to answer the intriguing question of whether these potential epitopes were equally immunogenic across ethnicities, by studying the distribution of HLA alleles among different populations and their share of cognate epitopes. Results indicate that the immune recognition potential of SARS-CoV2 epitopes tend to vary between different ethnic groups. While the South Asians are likely to recognize higher number of CD8-specific epitopes, Europeans are likely to identify higher number of CD4-specific epitopes. We also hypothesize and provide clues that the newer mutations in SARS-CoV2 are unlikely to alter the T-cell mediated immunogenic responses among the studied ethnic populations. The work presented herein is expected to bolster our understanding of the pandemic, by providing insights into differential immunological response of ethnic populations to the virus as well as by gaging the possible effects of mutations in SARS-CoV2 on efficacy of potential epitope-based vaccines through evaluating ∼40,000 viral genomes.


Assuntos
COVID-19/imunologia , Epitopos de Linfócito B/imunologia , Epitopos de Linfócito T/imunologia , Grupos Étnicos , Genoma Viral , Antígenos HLA/imunologia , SARS-CoV-2/imunologia , África/epidemiologia , Alelos , Sequência de Aminoácidos , Ásia/epidemiologia , Linfócitos T CD4-Positivos/imunologia , Linfócitos T CD4-Positivos/virologia , Linfócitos T CD8-Positivos/imunologia , Linfócitos T CD8-Positivos/virologia , COVID-19/epidemiologia , COVID-19/genética , COVID-19/patologia , Biologia Computacional/métodos , Suscetibilidade a Doenças , Epitopos de Linfócito B/classificação , Epitopos de Linfócito B/genética , Epitopos de Linfócito T/classificação , Epitopos de Linfócito T/genética , Europa (Continente)/epidemiologia , Antígenos HLA/classificação , Antígenos HLA/genética , Humanos , Oriente Médio/epidemiologia , Oceania/epidemiologia , Análise de Componente Principal , RNA Viral/genética , RNA Viral/imunologia , SARS-CoV-2/genética , SARS-CoV-2/patogenicidade
5.
Mult Scler Relat Disord ; 54: 103119, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34247103

RESUMO

BACKGROUND: Multiple sclerosis (MS) is an inflammatory demyelinating CNS disease and the most common neurological immune-mediated disorder. Due to its progressive format, it affects patients' quality of life (QoL) significantly. This study aimed to evaluate epidemiologic parameters of MS in the Asia and Oceania continents. METHODS: A comprehensive literature search on October 1st, 2020, was performed in PubMed, Scopus, and Web of Science to retrieve original population-based studies on MS epidemiology in the Asian and Oceanian countries, published between January 1st, 1985 and October 1st, 2020. The designed search strategy was repeated for each country, and the relevant referenced articles were added to our database. A random-effect model was used to combine the epidemiological estimates, and subgroup analysis was also performed by continent, region, and country, when possible. Meta-regression analysis was done to evaluate the effects of Human Developmental Index (HDI), latitude, and study period on the epidemiologic parameters. RESULTS: A total of 3,109 publications were found, of which 89 articles met the eligibility criteria and were included for data extraction. These articles provided data on prevalence, incidence, and mean age at disease onset in 18 countries in Asia and Oceania, including Iran, Turkey, Cyprus, Kuwait, Saudi Arabia, Qatar, UAE, Jordan, Israel, India, Malaysia, China, Hong Kong, Taiwan, Republic of Korea, Japan, Australia, and New Zealand. The pooled total prevalence, incidence, and mean age of onset in Asia and Oceania were 37.89/100000 (95% CI: 35.65 - 40.142), 2.40/100000 (95% CI: 2.22 - 2.58), and 28.21 (95% CI: 27.55 - 28.88), respectively. MS prevalence and incidence in the female gender (68.7/100000 and 4.42/100000, respectively) were infinitely higher than in the male gender (24.52/100000 and 2.06/100000, respectively). Our subgroup analysis showed that MS was much more prevalent in Australia and West Asia among the studied area. The meta-regression showed that the total incidence decreased with an increase in the HDI, and the total prevalence in Asia increased with increasing latitude gradients. Also, the study period had a positive effect on the total prevalence and incidence in Asia and Oceania. CONCLUSION: MS prevalence and incidence have increased in recent decades. This study highlights the need for further studies to elucidate MS's geographical and temporal variations' exact etiologies.


Assuntos
Esclerose Múltipla , Qualidade de Vida , Ásia/epidemiologia , Feminino , Humanos , Incidência , Masculino , Esclerose Múltipla/epidemiologia , Oceania/epidemiologia
6.
Sci Total Environ ; 796: 148958, 2021 Nov 20.
Artigo em Inglês | MEDLINE | ID: mdl-34280621

RESUMO

The Himawari-8 aerosol algorithm was updated to version 3 (V30). However, no study has evaluated its performance. The purpose of this study is to verify and to compare version 2.1 (V21) and V30 aerosol products, to explain which factor dominates the aerosol optical depth (AOD) error, and to provide recommendations for aerosol product usage. The AOD accuracy of V30 was better than that of V21, with a higher correlation coefficient (R) and a higher expected error (EE_DT). The V30 AOD metrics (including R, EE_DT, and the root mean square error) exceeded those of V21 on more than 69% of the AERONET sites and its bias from MODIS AOD was smaller than that of V21 AOD. However, the V30 AOD does not meet the metric of EE_DT > 0.66. The analysis results suggest that aerosol type parameters (primarily the Ångström exponent (AE)) may be the dominant factor determining the AOD error. This reveals the direction of H8 algorithm improvement. More than 59% of the H8 AE value meets the expected error but they do not capture the variety (R < 0.3). The FMF and SSA retrieved by H8 performed poorly. The V30 AOD performs best in Japan and South Korea (83.3% of AERONET sites meet the EE_DT > 0.66 requirement) and has better data accuracy in the morning. Therefore, we recommend V30 AOD morning data to users in Japan and South Korea regions.


Assuntos
Monitoramento Ambiental , Aerossóis/análise , Ásia , Oceania , República da Coreia
7.
Phys Eng Sci Med ; 44(2): 357-364, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-33646476

RESUMO

Medical physicists are health professionals recognized by the International Labour Organization (ILO) and hence medical physicists working in a clinical environment should have the required competency and undergo a structured training program and residency under an experienced medical physicist in a recognized institution. Furthermore, medical physics is a rapidly growing area needing a high degree of knowledge and professional competency due to the rise in complexity of treatment procedures, increasing access to medical technology, and the requirement of coordination between the disciplines of medicine, physics and biomedical engineering. The unprecedented surge in medical physics competency in the last 2-3 decades is due to the implementation of specialized physics intensive procedures such as particle therapy, image-guided & intra-operative radiotherapy, advanced imaging and nuclear medicine techniques. In this scenario to handle this new technology era the quantity of qualified medical physicists needs to be in consonance with the competency needed. There is a special requirement for education and training of medical physicists which led to the opening of numerous educational programs around the world. The Asia-Oceania Federation of Organizations for Medical Physics (AFOMP) was founded in 2000 and today 19 countries national medical physicist associations (NMPO) are member of AFOMP. The AFOMP region is populated by over 4.5 billion people and socioeconomically is very diverse with GDP per capita as high as around US $60,000 [Australia] to as low as around US $750 [Nepal]. We conducted a survey by sending questionnaires to AFOMP NMPOs to assess the status of medical physics education and training in the region. We have received responses from 20 countries in the AFOMP region to the questionnaire. It was observed that 16 [80%] countries from AFOMP have well organized master program in medical physics, however only 8 [50%] programs were accredited and in only 9 [45%] countries are medical physicists registered as health professionals.


Assuntos
Educação Médica , Física Médica , Ásia , Escolaridade , Humanos , Oceania
8.
Asian Pac J Cancer Prev ; 22(3): 801-809, 2021 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-33773544

RESUMO

OBJECTIVE: To evaluate the potential radiological impact of atmospheric nuclear weapons tests conducted in 1966-1974 at Mururoa and Fangataufa atolls on populations in Oceania, South America and Africa. METHODS: Results of measurements of total beta(ß)-concentrations in filtered air and 131I activity concentrations in locally produced cow's milk in Oceania, South America and Africa after the tests were compared with those in French Polynesia. Radiation doses due to external irradiation and thyroid doses due to 131I intake with milk by local populations were also compared. RESULTS: Higher total ß-concentrations in filtered air, 131I activity concentrations in locally produced milk and radiation doses to local population were, in general, observed in French Polynesia than in other countries in the southern hemisphere. However, for specific years during the testing period, the radiological impact to South America was found to be similar or slightly higher than that to Tahiti. The resulting thyroid doses in the considered countries were lower than those in French Polynesia with two exceptions: thyroid doses due to 131I intake with cow's milk for 1-y old child in 1968 were higher in Peru (0.35 mGy) and in Madagascar (0.30 mGy) than in Tahiti (0.25 mGy). However, the populations outside French Polynesia received doses lower than those from the natural sources of radiation. CONCLUSION: According to the current knowledge in radiation epidemiology, it is very unlikely that nuclear fallout due to French nuclear tests had a measurable radiological and health impact outside French Polynesia.
.


Assuntos
Armas Nucleares , Doses de Radiação , Exposição à Radiação/estatística & dados numéricos , África , Animais , Partículas beta , França , Humanos , Radioisótopos do Iodo/análise , Madagáscar , Leite/química , Oceania , Peru , Polinésia , Monitoramento de Radiação , América do Sul
9.
Orphanet J Rare Dis ; 16(1): 119, 2021 03 05.
Artigo em Inglês | MEDLINE | ID: mdl-33673852

RESUMO

BACKGROUND: This study assesses the areas and extent of impact of the Coronavirus Disease of 2019 (COVID-19) pandemic on rare disease (RD) organisations in the Asia Pacific region. There is no existing literature that focuses on such impact on RD organisations in any jurisdictions, nor RD populations across multiple jurisdictions in the Asia Pacific region. A cross-sectional survey was distributed to RD organisations between April and May 2020. Quantitative and qualitative data on the impact of COVID-19 on RD organisations and patients were collected from the organisation representative's perspective. Qualitative data was analysed using thematic analysis. A follow-up focus group meeting was conducted in August 2020 to validate the survey findings and to discuss specific needs, support and recommendations for sustainable healthcare systems during the pandemic. RESULTS: A total of 80 RD organisations from Australia, Hong Kong Special Administrative Region of China, India, Japan, mainland China, Malaysia, New Zealand, the Philippines, Singapore and Taiwan participated in the study. Of all, 89% were concerned about the impact of pandemic on their organisations. Results indicate that 63% of the organisations functioned at a reduced capacity and 42% stated a decrease in funding as their biggest challenge. Overall, 95% believed their patients were impacted, particularly in healthcare access, social lives, physical health, psychological health and financial impact. Specifically, 43% identified the reduced healthcare access as their top impact, followed by 26% about the impact on daily living and social life. Focus group meeting discussed differential impact across jurisdictions and point towards telemedicine and digitalisation as potential solutions. CONCLUSIONS: This serves as the first study to assess the impact of COVID-19 on RD patients and organisations across multiple jurisdictions in the Asia Pacific region, identifying major themes on the impact on both RD patients and organisations. By including 80 organisations from ten jurisdictions, our study presents the most comprehensive assessment of the pandemic's impact to date. It highlights the need for mental health support and sheds light on moving towards telemedicine and digitalisation of organisation operation, which constitutes a sustainable model in times of pandemics and beyond.


Assuntos
COVID-19/complicações , COVID-19/epidemiologia , Pandemias , Doenças Raras/complicações , Sociedades/organização & administração , Ásia/epidemiologia , COVID-19/virologia , Estudos Transversais , Humanos , Oceania/epidemiologia , SARS-CoV-2/isolamento & purificação
10.
J Obstet Gynaecol Res ; 47(5): 1643-1650, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-33650217

RESUMO

Since the outbreak of COVID-19, there have already been over 26 million people being infected and it is expected that the pandemic will not end in near future. Not only the daily activities and lifestyles of individuals have been affected, the medical practice has also been modified to cope with this emergency catastrophe. In particular, the cancer services have faced an unprecedented challenge. While the services may have been cut by the national authorities or hospitals due to shortage of manpower and resources, the medical need of cancer patients has increased. Cancer patients who are receiving active treatment may develop various kinds of complications especially immunosuppression from chemotherapy, and they and their carers will need additional protection against COVID-19. Besides, there is also evidence that cancer patients are more prone to deteriorate from COVID-19 if they contract the viral infection. Therefore, it is crucial to establish guidelines so that healthcare providers can triage their resources to take care of the most needed patients, reduce less important hospitalization and visit, and to avoid potential complications from treatment. The Asia and Oceania Federation of Obstetrics and Gynecology (AOFOG) hereby issued this opinion statement on the management of gynecological cancer patients during the COVID-19.


Assuntos
COVID-19 , Neoplasias dos Genitais Femininos , Ginecologia , Obstetrícia , Ásia/epidemiologia , Feminino , Neoplasias dos Genitais Femininos/epidemiologia , Neoplasias dos Genitais Femininos/terapia , Humanos , Oceania , Gravidez , SARS-CoV-2
11.
J Physiol Biochem ; 77(1): 175-189, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-33704694

RESUMO

Despite the general relationship between obesity and its co-morbidities, there are both obese individuals who scarcely present the associated pathologies (metabolically healthy obese; MHO) and individuals who present obesity alterations despite having normal weight (metabolically obese normal weight; MONW). It is still difficult to define metabolically MHO and MONW individuals because different classifications have been used in the studies reported. Indeed, different inclusion criteria have been used to discriminate between metabolically healthy and metabolically unhealthy subjects. Due to this and other reasons, such as differences in ethnicity, genetics, and lifestyle of the populations, data concerning the prevalence of MHO and MONW are very variable. The main determinants of MHO are type of growth (hypertrophy or hyperplasia), anatomical location, inflammation of adipose tissue, ectopic fat accumulation, genetic factors, and lifestyles factors. In the case of MONW, the main determinants are genetic background and lifestyle factors. With regard to treatment, it is not clear whether MHO subjects would benefit from traditional lifestyle interventions, based on diet energy restriction and increased physical activity. For MONW subjects, there is still no specialized treatment, and the therapies are the same as those used in obese subjects.


Assuntos
Peso Corporal , Obesidade Metabolicamente Benigna/epidemiologia , Tecido Adiposo/patologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , América , Ásia , Índice de Massa Corporal , Europa (Continente) , Humanos , Estilo de Vida , Pessoa de Meia-Idade , Oceania , Prevalência , Fatores de Risco , Adulto Jovem
12.
Artigo em Inglês | MEDLINE | ID: mdl-33561945

RESUMO

Favorable testicular cancer mortality-to-incidence ratios (MIRs) are associated with health care disparities, including health care expenditures, but the trends of testicular MIR and health care disparity remain unclear. We evaluated changes in MIR as the difference between 2012 and 2018, termed delta MIR (δMIR). Health care expenditures and the human development index (HDI) were obtained from the World Health Organization and the Human Development Report Office of the United Nations Development Programme. The association between the variables was analyzed by Spearman's rank correlation coefficient. A total of 54 countries were included in the criteria of data quality reports and missing data. By continent, the most favorable MIR was in Oceania (0.03) while it was 0.36 in Africa. In these areas, the incidence rates were positively correlated to health care expenditure, but the mortality rates showed a reversed correlation. The MIR ranged from 0.01 to 0.34 and the δMIR ranged from -0.05 to 0.34. The favorable MIRs are correlated to high health care expenditure and HDI (all p < 0.001). Interestingly, favorable δMIRs tend to be seen in countries with relatively low health care expenditure and HDI (all p < 0.001). In conclusion, favorable testicular cancer MIRs are associated with high HDI and health care expenditure, but the improvement in MIR between 2012 and 2018 (δMIR) is negatively correlated with HDI and health care expenditure.


Assuntos
Gastos em Saúde , Neoplasias Testiculares , África , Saúde Global , Humanos , Incidência , Masculino , Oceania , Neoplasias Testiculares/epidemiologia
13.
CA Cancer J Clin ; 71(3): 209-249, 2021 05.
Artigo em Inglês | MEDLINE | ID: mdl-33538338

RESUMO

This article provides an update on the global cancer burden using the GLOBOCAN 2020 estimates of cancer incidence and mortality produced by the International Agency for Research on Cancer. Worldwide, an estimated 19.3 million new cancer cases (18.1 million excluding nonmelanoma skin cancer) and almost 10.0 million cancer deaths (9.9 million excluding nonmelanoma skin cancer) occurred in 2020. Female breast cancer has surpassed lung cancer as the most commonly diagnosed cancer, with an estimated 2.3 million new cases (11.7%), followed by lung (11.4%), colorectal (10.0 %), prostate (7.3%), and stomach (5.6%) cancers. Lung cancer remained the leading cause of cancer death, with an estimated 1.8 million deaths (18%), followed by colorectal (9.4%), liver (8.3%), stomach (7.7%), and female breast (6.9%) cancers. Overall incidence was from 2-fold to 3-fold higher in transitioned versus transitioning countries for both sexes, whereas mortality varied <2-fold for men and little for women. Death rates for female breast and cervical cancers, however, were considerably higher in transitioning versus transitioned countries (15.0 vs 12.8 per 100,000 and 12.4 vs 5.2 per 100,000, respectively). The global cancer burden is expected to be 28.4 million cases in 2040, a 47% rise from 2020, with a larger increase in transitioning (64% to 95%) versus transitioned (32% to 56%) countries due to demographic changes, although this may be further exacerbated by increasing risk factors associated with globalization and a growing economy. Efforts to build a sustainable infrastructure for the dissemination of cancer prevention measures and provision of cancer care in transitioning countries is critical for global cancer control.


Assuntos
Países Desenvolvidos/estatística & dados numéricos , Países em Desenvolvimento/estatística & dados numéricos , Saúde Global/estatística & dados numéricos , Neoplasias/epidemiologia , Dinâmica Populacional , África/epidemiologia , América/epidemiologia , Ásia/epidemiologia , Bases de Dados Factuais , Europa (Continente) , Feminino , Humanos , Incidência , Internacionalidade , Masculino , Neoplasias/mortalidade , Oceania/epidemiologia , Fatores de Risco , Distribuição por Sexo
14.
Virology ; 555: 71-77, 2021 03.
Artigo em Inglês | MEDLINE | ID: mdl-33454559

RESUMO

This review summarizes the presentations given at the 22nd International conference on Emerging Infectious Diseases in the Pacific Rim. The purpose of this annual meeting is to foster international collaborations and address important public health issues in the Asia-Pacific region. This meeting was held in Bangkok in February 2020 and focused on emerging virus infections. Unexpectedly, the SARS-CoV-2 pandemic was in the initial stages leading to a special session on COVID-19 in addition to talks on dengue, influenza, hepatitis, AIDS, Zika, chikungunya, rabies, cervical cancer and nasopharyngeal carcinoma.


Assuntos
Doenças Transmissíveis Emergentes , Saúde Global , Cooperação Internacional , Ásia , COVID-19 , Humanos , Japão , Oceania , Estados Unidos
15.
Pediatr Rheumatol Online J ; 19(1): 11, 2021 Jan 23.
Artigo em Inglês | MEDLINE | ID: mdl-33485337

RESUMO

BACKGROUND: Paediatric rheumatic diseases are a leading cause of acquired disability in Southeast Asia and Asia-Pacific Countries (SE ASIA/ASIAPAC). The aims of this study were to identify and describe the challenges to the delivery of patient care and identify solutions to raise awareness about paediatric rheumatic diseases. METHODS: The anonymised online survey included 27 items about paediatric rheumatology (PR) clinical care and training programmes. The survey was piloted and then distributed via Survey-Monkey™ between March and July 2019. It was sent to existing group lists of physicians and allied health professionals (AHPs), who were involved in the care pathways and management of children with rheumatic diseases in SE ASIA/ASIAPAC. RESULTS: Of 340 participants from 14 countries, 261 participants had been involved in PR care. The majority of the participants were general paediatricians. The main reported barriers to providing specialised multidisciplinary service were the absence or inadequacy of the provision of specialists and AHPs in addition to financial issues. Access to medicines was variable and financial constraints cited as the major obstacle to accessing biological drugs within clinical settings. The lack of a critical mass of specialist paediatric rheumatologists was the main perceived barrier to PR training. CONCLUSIONS: There are multiple challenges to PR services in SE ASIA/ASIAPAC countries. There is need for more specialist multidisciplinary services and greater access to medicines and biological therapies. The lack of specialist paediatric rheumatologists is the main barrier for greater access to PR training.


Assuntos
Pediatria/estatística & dados numéricos , Reumatologia/estatística & dados numéricos , Ásia , Ásia Sudeste , Criança , Humanos , Oceania , Padrões de Prática Médica/estatística & dados numéricos , Doenças Reumáticas/terapia , Inquéritos e Questionários
16.
Anat Rec (Hoboken) ; 304(8): 1776-1791, 2021 08.
Artigo em Inglês | MEDLINE | ID: mdl-33159494

RESUMO

Our goal is to describe the global distribution of the "rocker jaw" variant in human populations. Rocker jaw refers to mandibles that lack the antegonial notch, making them unstable on a flat surface. Data were collected by C.G. Turner II on 9,207 individuals from Asia, Europe, the Pacific, and the Americas, and by J.D. Irish on 3,526 individuals from North and South Africa. With a focus on Polynesia, where the trait is most common, frequencies are presented for subdivisions of Oceania, Australasia, Eurasia, the Americas, and Africa. While the rocker jaw is a Polynesian characteristic, the trait is found throughout the world. Within major geographic regions, there are interesting contrasts, for example, (a) the similarity of Jomon and Ainu and their difference from modern Japanese; (b) Aleuts and Northwest Coast Indians are similar and both are distinct from the Inuit and other Native Americans; and (c) North and Sub-Saharan Africans show a regional difference that parallels genetic and dental distinctions. Skeletons in South America that exhibit the rocker jaw have been interpreted as Polynesian voyagers who ventured to the west coast of South America. The rarity of rocker jaw in South American natives supports this view. The rocker jaw can be attributed to the unique basicranium morphology and large upper facial height of Polynesians, which highlights the integrated growth of a functional module (i.e., mastication) of the craniofacial complex. The unusually high frequency of the trait in Polynesians is a product of both function and founder effect/genetic drift.


Assuntos
Mandíbula/anatomia & histologia , América , Ásia , Cefalometria , Europa (Continente) , Humanos , Oceania , Polinésia
17.
Cancer Epidemiol ; 71(Pt B): 101662, 2021 04.
Artigo em Inglês | MEDLINE | ID: mdl-31924557

RESUMO

BACKGROUND: Most of the world's population is not covered by cancer surveillance systems or vital registration, and worldwide/UN-regional cancer incidence is estimated using a variety of methods. Quantifying the cancer burden in children (<15 years) is more challenging than in adults; childhood cancer is rare and often presents with non-specific symptoms that mimic those of more prevalent infectious and nutritional conditions. METHODS: A Baseline Model (BM) was constructed comprising a set of quality assured sex- and age-specific cancer rates derived from the US Surveillance, Epidemiology and End Results (SEER) program, for diagnostic groups of the International Classification of Childhood Cancers (ICCC-3) 3rd edition, and information on a known risk factor for endemic Burkitt lymphoma and Kaposi's sarcoma. These rates were applied to global country-level population data for 2015 to estimate the global and regional incidence of childhood cancer. Results were compared to GLOBOCAN 2018, extrapolations from the International Incidence of Childhood Cancer (IICC-3) and estimates from the Global Childhood Cancer (GCC) model (based on IICC-3 data combined with information on health care systems and other parameters). RESULTS: The BM estimated 360,114 total childhood cancers occurring worldwide in 2015; 54% in Asia and 28% in Africa. BM estimated standardised rates ranged from ∼178 cases per million in Europe and North America, through to ∼218 cases per million in West and Middle Africa. Totals from GLOBOCAN and extrapolations from the IICC-3 study were lower (44.6% and 34.7% respectively), but the estimate from the GCC model was 10.2% higher. In all models, agreement was good in countries with very high human development index (HDI), but more variable in countries with medium and low HDIs; the discrepancies correlating with registration coverage across these settings. CONCLUSION: Disagreements between the BM estimates and other sources occur in areas where health systems are insufficiently equipped to provide adequate access to diagnosis, treatment, and supportive care. Incorporating aetiological evidence into the BM enabled the estimation of the additional burden of Burkitt lymphoma and Kaposi sarcoma; similar adjustments could be applied to other cancers, as and when information becomes available.


Assuntos
Saúde Global/estatística & dados numéricos , Neoplasias/epidemiologia , África/epidemiologia , América/epidemiologia , Ásia/epidemiologia , Criança , Europa (Continente)/epidemiologia , Feminino , Humanos , Incidência , Masculino , Oceania/epidemiologia , Sistema de Registros
18.
J Antimicrob Chemother ; 76(2): 396-412, 2021 01 19.
Artigo em Inglês | MEDLINE | ID: mdl-33254234

RESUMO

OBJECTIVES: To define key genetic elements, single or in clusters, underlying SARS-CoV-2 (severe acute respiratory syndrome coronavirus-2) evolutionary diversification across continents, and their impact on drug-binding affinity and viral antigenicity. METHODS: A total of 12 150 SARS-CoV-2 sequences (publicly available) from 69 countries were analysed. Mutational clusters were assessed by hierarchical clustering. Structure-based virtual screening (SBVS) was used to select the best inhibitors of 3-chymotrypsin-like protease (3CL-Pr) and RNA-dependent RNA polymerase (RdRp) among the FDA-approved drugs and to evaluate the impact of mutations on binding affinity of these drugs. The impact of mutations on epitope recognition was predicted following Grifoni et al. (Cell Host Microbe 2020. 27: 671-80.). RESULTS: Thirty-five key mutations were identified (prevalence: ≥0.5%), residing in different viral proteins. Sixteen out of 35 formed tight clusters involving multiple SARS-CoV-2 proteins, highlighting intergenic co-evolution. Some clusters (including D614GSpike + P323LRdRp + R203KN + G204RN) occurred in all continents, while others showed a geographically restricted circulation (T1198KPL-Pr + P13LN + A97VRdRp in Asia, L84SORF-8 + S197LN in Europe, Y541CHel + H504CHel + L84SORF-8 in America and Oceania). SBVS identified 20 best RdRp inhibitors and 21 best 3CL-Pr inhibitors belonging to different drug classes. Notably, mutations in RdRp or 3CL-Pr modulate, positively or negatively, the binding affinity of these drugs. Among them, P323LRdRp (prevalence: 61.9%) reduced the binding affinity of specific compounds including remdesivir while it increased the binding affinity of the purine analogues penciclovir and tenofovir, suggesting potential hypersusceptibility. Finally, specific mutations (including Y541CHel + H504CHel) strongly hampered recognition of Class I/II epitopes, while D614GSpike profoundly altered the structural stability of a recently identified B cell epitope target of neutralizing antibodies (amino acids 592-620). CONCLUSIONS: Key genetic elements reflect geographically dependent SARS-CoV-2 genetic adaptation, and may play a potential role in modulating drug susceptibility and hampering viral antigenicity. Thus, a close monitoring of SARS-CoV-2 mutational patterns is crucial to ensure the effectiveness of treatments and vaccines worldwide.


Assuntos
Adaptação Biológica/genética , Antivirais/metabolismo , COVID-19/imunologia , Proteases 3C de Coronavírus/genética , Inibidores de Protease de Coronavírus/metabolismo , RNA-Polimerase RNA-Dependente de Coronavírus/genética , SARS-CoV-2/genética , América , Sequência de Aminoácidos , Antígenos Virais/sangue , Antivirais/uso terapêutico , Ásia , COVID-19/tratamento farmacológico , COVID-19/epidemiologia , Simulação por Computador , Proteases 3C de Coronavírus/metabolismo , Inibidores de Protease de Coronavírus/uso terapêutico , RNA-Polimerase RNA-Dependente de Coronavírus/metabolismo , Europa (Continente) , Evolução Molecular , Humanos , Simulação de Acoplamento Molecular , Família Multigênica , Mutação/genética , Taxa de Mutação , Oceania , Ligação Proteica , SARS-CoV-2/enzimologia , Topografia Médica
19.
Food Chem ; 334: 127555, 2021 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-32711268

RESUMO

Conjugated linoleic acid (CLA) content of ruminant milk reported in published research papers (n = 65) from January 1995 to March 2020 around the world were analyzed to estimate the overall mean CLA value. The CLA content of ruminant milk samples was grouped according to geographical regions (Europe, South America, North America, Oceania, Asia, and Africa). The total CLA content of milk samples from cows, sheep, goats, yaks, and llama retrieved from the collected data ranged between 0.06 and 2.96% of total fatty acids. There is a wide variation of pooled estimated mean content of CLA in milk among the study regions and were highest in Oceania with 1.33% (95% confidence interval (CI): 1.16 - 1.49%) of total fatty acids. Though several factors have been reported to influence the CLA content of milk, the effect of the "geographical origin" was only considered in the present manuscript as one of the main factors in this respect.


Assuntos
Ácidos Linoleicos Conjugados/análise , Leite/química , África , Animais , Ásia , Bovinos , Europa (Continente) , Ácidos Graxos/análise , Cabras , América do Norte , Oceania , Ruminantes , Ovinos , América do Sul
20.
Artigo em Inglês | MEDLINE | ID: mdl-33261090

RESUMO

Indigenous Peoples in high-income countries experience higher burdens of food insecurity, obesity, and diet-related health conditions compared to national averages. The objective of this systematic scoping review is to synthesize information from the published literature on the methods/approaches, findings, and scope for research and interventions on the retail food sector servicing Indigenous Peoples in high-income countries. A structured literature search in two major international databases yielded 139 relevant peer-reviewed articles from nine countries. Most research was conducted in Oceania and North America, and in rural and remote regions. Several convergent issues were identified across global regions including limited grocery store availability/access, heightened exposure to unhealthy food environments, inadequate market food supplies (i.e., high prices, limited availability, and poor quality), and common underlying structural factors including socio-economic inequality and colonialism. A list of actions that can modify the nature and structure of retailing systems to enhance the availability, accessibility, and quality of healthful foods is identified. While continuing to (re)align research with community priorities, international collaboration may foster enhanced opportunities to strengthen the evidence base for policy and practice and contribute to the amelioration of diet quality and health at the population level.


Assuntos
Abastecimento de Alimentos , Grupos Populacionais , Estudos Transversais , Países Desenvolvidos , Humanos , Povos Indígenas , Estudos Longitudinais , América do Norte , Oceania , Projetos Piloto
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