PERFIL EPIDEMIOLÓGICO DA HANSENÍASE NO ESTADO DO TOCANTINS NO PERÍODO DE 2018 A 2021

INTRODUÇÃO: Apesar dos avanços referentes à hanseníase conquistados ao longo de décadas, a partir de 2020 o Brasil sofreu os impactos da pandemia da COVID-19, de modo que a rotina dos indivíduos e a gestão do sistema de saúde foram alteradas. OBJETIVO: Nesse contexto, objetivando ampliar a compreensão da distribuição da doença de Hansen nos anos adjacentes ao período pandêmico, o presente estudo descreve o perfil epidemiológico da hanseníase no Tocantins de 2018 a 2021. METODOLOGIA: Trata-se de um estudo epidemiológico retrospectivo e descritivo, com abordagem quantitativa. Os dados foram obtidos por meio do Sistema de Informação de Agravos de Notificação. Foram pesquisados os parâmetros: sexo, faixa etária, cor/raça, microrregião de residência segundo IBGE, modo de entrada, classificação operacional diagnosticada, forma clínica notificada, avaliação da capacidade física notificada, contatos registrados e contatos examinados. RESULTADOS: Observou-se queda da taxa de detecção anual de casos de hanseníase, mas o Tocantins ainda foi classificado como hiperendêmico. De 2018 a 2021, foram notificados 6.401 casos de hanseníase, sendo a microrregião de Porto Nacional responsável por 3.139 (49,04%). Foram acometidos principalmente indivíduos homens, pardos e com idade entre 30 e 59 anos. Houve predomínio de diagnósticos da classe operacional multibacilar (90,17%) e da forma clínica dimorfa (72,38%). Em 2020 e 2021, anos iniciais da pandemia, a proporção entre contatos examinados e rastreados diminuiu, enquanto a porcentagem de diagnósticos tardios, em fase avançada da doença, aumentou. CONCLUSÃO: Tendo em vista a importância dessa descrição, o presente estudo poderá contribuir para a elaboração de ações mais efetivas para o controle da hanseníase no Tocantins. Palavras-chave: : Hanseníase; Epidemiologia; Saúde Pública

Avaliação do letramento em saúde e conhecimento sobre Terapia Renal Substitutiva de pacientes em um ambulatório multiprofissional de Doença Renal Crônica pré-dialítica

Introduction: Health Literacy (HL) is associated with morbidity and mortality in chronic kidney disease (CKD). Objective: To evaluate HL and knowledge of renal replacement therapy (RRT) of the patients from a multidisciplinary outpatient CKD predialysis. Material and Methods: Cross-sectional study in HIPERDIA Minas clinic from March to April/2015. Assessed sociodemographic variables, HL through SAHLPA 18 (Short Assessment of Health Literacy for English-Speaking Adults), and applied a semi-structured questionnaire. Patients were divided into two groups according to HL and the variables were compared; carried out a comparative analysis between the stage and the answers to the semi-structured questionnaire and compared the SAHLPA and type of RRT. Finally, we performed a logistic regression with the dependent variable "having knowledge of RRT." Results: We evaluated 100 consecutive patients, mean age was 68.2 ± 10.7 years. The majority were men, whites, had only elementary school, the most common category of CKD was 3b, 68% had inadequate HL. When asked if had already been informed of dialysis 37.7% in stage 3b, 60.6% in the 4 and 66.7% in 5 said yes; about the modalities 68.9% in stage 3b, 60.6% in the 4 and 16.7% in 5 said they did not know about RRT. The variable related to "having knowledge of RRT" in a logistic regression model was just age. Conclusion: There was a low percentage of appropriate HL and knowledge of RRT. The most reported method was hemodialysis. Our results suggest that strategies to improve health literacy and provide appropriate information on RRT should be part of multidisciplinary care.  Introdução: O letramento em saúde (LS) inadequado está associado a morbi-mortalidade em doença renal crônica (DRC). Objetivo: Avaliar o LS e conhecimento sobre terapia renal substitutiva (TRS) de pacientes de um ambulatório multiprofissional de DRC pré-dialítica. Material e Métodos: Estudo transversal no ambulatório HIPERDIA Minas de março a abril/2015. Avaliadas variáveis sóciodemográficas, LS através do SAHLPA 18 (Short Assessment of Health Literacy for Portuguese-Speaking Adults), e aplicado um questionário semiestruturado. As variáveis foram comparadas entre os pacientes que foram separados em dois grupos de acordo com o letramento e as variáveis foram comparadas. Além disto, foi realizada uma análise comparativa entre o estágio da DRC e as respostas ao questionário semiestruturado e o SAHLPA. Ao final, realizamos uma regressão logística, tendo como variável dependente “ter conhecimento sobre TRS”. Resultados: Foram abordados e avaliados 100 pacientes consecutivos, média de idade foi 68,2±10,7 anos. A maioria era homem, branco, apenas ensino fundamental. A categoria da DRC mais frequente foi 3b. 68% apresentaram letramento inadequado. Comparando os dados sócio demográficos e letramento, podemos observar que maior idade, menor escolaridade, menor renda familiar foram estatisticamente significativos para letramento inadequado. Quando perguntados sobre já ter sido informado sobre diálise; 37,7% no estágio 3b, 60,6% no 4 e 66,7% nos 5 disseram que sim; quanto às modalidades de TRS, 68,9% em estágio 3b, 60,6% no 4 e 16,7% no 5 responderam que não sabiam os tipos existentes. A variável relacionada a “ter conhecimento sobre TRS” em um modelo de regressão logística foi apenas idade. Conclusão: Houve um baixo percentual de LS adequado e de conhecimento sobre TRS. A modalidade mais referida foi hemodiálise. Nossos resultados sugerem que estratégias que melhorem o letramento em saúde e forneçam informações adequadas sobre TRS devem fazer parte do atendimento multiprofissional

Pervasive gaps in Amazonian ecological research

Biodiversity loss is one of the main challenges of our time,1,2 and attempts to address it require a clear un derstanding of how ecological communities respond to environmental change across time and space.3,4 While the increasing availability of global databases on ecological communities has advanced our knowledge of biodiversity sensitivity to environmental changes,5–7 vast areas of the tropics remain understudied.8–11 In the American tropics, Amazonia stands out as the world’s most diverse rainforest and the primary source of Neotropical biodiversity,12 but it remains among the least known forests in America and is often underrepre sented in biodiversity databases.13–15 To worsen this situation, human-induced modifications16,17 may elim inate pieces of the Amazon’s biodiversity puzzle before we can use them to understand how ecological com munities are responding. To increase generalization and applicability of biodiversity knowledge,18,19 it is thus crucial to reduce biases in ecological research, particularly in regions projected to face the most pronounced environmental changes. We integrate ecological community metadata of 7,694 sampling sites for multiple or ganism groups in a machine learning model framework to map the research probability across the Brazilian Amazonia, while identifying the region’s vulnerability to environmental change. 15%–18% of the most ne glected areas in ecological research are expected to experience severe climate or land use changes by 2050. This means that unless we take immediate action, we will not be able to establish their current status, much less monitor how it is changing and what is being lostinfo:eu-repo/semantics/publishedVersio

La lección del Nunca Más. Una aproximación interdisciplinar al contenido y alcance jurídico internacional de la obligación estatal de garantizar la no repetición a través de la educación en memoria. Informe Final

Conceptualmente, el proyecto giró en torno a las garantías de no repetición, es decir: medidas orientadas a evitar futuros incumplimientos del Derecho internacional, de muy diversa naturaleza, pues virtualmente pueden consistir en cualquier cosa (siempre que no resulte abusiva), aunque las más habituales en la práctica internacional son la adopción/derogación/reforma de legislación o de medidas administrativas y las medidas de carácter institucional (relativas a la existencia, organización o funcionamiento de órganos del Estado). Cuando un Estado incumple una obligación internacional –y, por tanto, comete un hecho internacionalmente ilícito–, la principal consecuencia que surge para él es la obligación de reparar, en cualquier de sus tres formas –restitución (o, en su caso, compensación por equivalencia), indemnización o satisfacción (reparación moral)–. Además, en circunstancias excepcionales, tendría también la obligación de ofrecer garantías de no repetición1. Esas “circunstancias excepcionales” vienen en esencia delimitadas por la existencia de violaciones graves de normas imperativas de Derecho internacional, como ocurre cuando se lesionan de manera flagrante o sistemática derechos humanos fundamentales, prácticas que a su vez están tipificadas como crímenes internacionales (genocidio o crímenes contra la humanidad). Por tanto, cuando en el interior de un Estado se cometen atrocidades de esa naturaleza, bien por parte de las propias autoridades estatales, bien por parte de actores no estatales cuyo comportamiento no ha sido prevenido o reprimido por el Estado, surgiría para este la obligación de ofrecer garantías de no repetición

<i>In vitro</i> antiviral activity of the anti-HCV drugs daclatasvir and sofosbuvir against SARS-CoV-2, the aetiological agent of COVID-19

BackgroundCurrent approaches of drug repurposing against COVID-19 have not proven overwhelmingly successful and the SARS-CoV-2 pandemic continues to cause major global mortality. SARS-CoV-2 nsp12, its RNA polymerase, shares homology in the nucleotide uptake channel with the HCV orthologue enzyme NS5B. Besides, HCV enzyme NS5A has pleiotropic activities, such as RNA binding, that are shared with various SARS-CoV-2 proteins. Thus, anti-HCV NS5B and NS5A inhibitors, like sofosbuvir and daclatasvir, respectively, could be endowed with anti-SARS-CoV-2 activity.MethodsSARS-CoV-2-infected Vero cells, HuH-7 cells, Calu-3 cells, neural stem cells and monocytes were used to investigate the effects of daclatasvir and sofosbuvir. In silico and cell-free based assays were performed with SARS-CoV-2 RNA and nsp12 to better comprehend the mechanism of inhibition of the investigated compounds. A physiologically based pharmacokinetic model was generated to estimate daclatasvir's dose and schedule to maximize the probability of success for COVID-19.ResultsDaclatasvir inhibited SARS-CoV-2 replication in Vero, HuH-7 and Calu-3 cells, with potencies of 0.8, 0.6 and 1.1 μM, respectively. Although less potent than daclatasvir, sofosbuvir alone and combined with daclatasvir inhibited replication in Calu-3 cells. Sofosbuvir and daclatasvir prevented virus-induced neuronal apoptosis and release of cytokine storm-related inflammatory mediators, respectively. Sofosbuvir inhibited RNA synthesis by chain termination and daclatasvir targeted the folding of secondary RNA structures in the SARS-CoV-2 genome. Concentrations required for partial daclatasvir in vitro activity are achieved in plasma at Cmax after administration of the approved dose to humans.ConclusionsDaclatasvir, alone or in combination with sofosbuvir, at higher doses than used against HCV, may be further fostered as an anti-COVID-19 therapy

Measurement of the top quark forward-backward production asymmetry and the anomalous chromoelectric and chromomagnetic moments in pp collisions at √s = 13 TeV

Abstract The parton-level top quark (t) forward-backward asymmetry and the anomalous chromoelectric (d̂ t) and chromomagnetic (μ̂ t) moments have been measured using LHC pp collisions at a center-of-mass energy of 13 TeV, collected in the CMS detector in a data sample corresponding to an integrated luminosity of 35.9 fb−1. The linearized variable AFB(1) is used to approximate the asymmetry. Candidate t t ¯ events decaying to a muon or electron and jets in final states with low and high Lorentz boosts are selected and reconstructed using a fit of the kinematic distributions of the decay products to those expected for t t ¯ final states. The values found for the parameters are AFB(1)=0.048−0.087+0.095(stat)−0.029+0.020(syst),μ̂t=−0.024−0.009+0.013(stat)−0.011+0.016(syst), and a limit is placed on the magnitude of | d̂ t| &lt; 0.03 at 95% confidence level. [Figure not available: see fulltext.

Measurement of the azimuthal anisotropy of Y(1S) and Y(2S) mesons in PbPb collisions at root s(NN)=5.02 TeV

The second-order Fourier coefficients (v(2)) characterizing the azimuthal distributions of Y(1S) and Y(2S) mesons produced in PbPb collisions at root s(NN) = 5.02 TeV are studied. The Y mesons are reconstructed in their dimuon decay channel, as measured by the CMS detector. The collected data set corresponds to an integrated luminosity of 1.7 nb(-1). The scalar product method is used to extract the v2 coefficients of the azimuthal distributions. Results are reported for the rapidity range vertical bar y vertical bar < 2.4, in the transverse momentum interval 0 < pT < 50 GeV/c, and in three centrality ranges of 10-30%, 30-50% and 50-90%. In contrast to the J/psi mesons, the measured v(2) values for the Y mesons are found to be consistent with zero. (C) 2021 The Author(s). Published by Elsevier B.V.Peer reviewe

Worldwide trends in underweight and obesity from 1990 to 2022: a pooled analysis of 3663 population-representative studies with 222 million children, adolescents, and adults

Background Underweight and obesity are associated with adverse health outcomes throughout the life course. We estimated the individual and combined prevalence of underweight or thinness and obesity, and their changes, from 1990 to 2022 for adults and school-aged children and adolescents in 200 countries and territories. Methods We used data from 3663 population-based studies with 222 million participants that measured height and weight in representative samples of the general population. We used a Bayesian hierarchical model to estimate trends in the prevalence of different BMI categories, separately for adults (age ≥20 years) and school-aged children and adolescents (age 5–19 years), from 1990 to 2022 for 200 countries and territories. For adults, we report the individual and combined prevalence of underweight (BMI &lt;18·5 kg/m2) and obesity (BMI ≥30 kg/m2). For school&#x2;aged children and adolescents, we report thinness (BMI &lt;2 SD below the median of the WHO growth reference) and obesity (BMI &gt;2 SD above the median). Findings From 1990 to 2022, the combined prevalence of underweight and obesity in adults decreased in 11 countries (6%) for women and 17 (9%) for men with a posterior probability of at least 0·80 that the observed changes were true decreases. The combined prevalence increased in 162 countries (81%) for women and 140 countries (70%) for men with a posterior probability of at least 0·80. In 2022, the combined prevalence of underweight and obesity was highest in island nations in the Caribbean and Polynesia and Micronesia, and countries in the Middle East and north Africa. Obesity prevalence was higher than underweight with posterior probability of at least 0·80 in 177 countries (89%) for women and 145 (73%) for men in 2022, whereas the converse was true in 16 countries (8%) for women, and 39 (20%) for men. From 1990 to 2022, the combined prevalence of thinness and obesity decreased among girls in five countries (3%) and among boys in 15 countries (8%) with a posterior probability of at least 0·80, and increased among girls in 140 countries (70%) and boys in 137 countries (69%) with a posterior probability of at least 0·80. The countries with highest combined prevalence of thinness and obesity in school-aged children and adolescents in 2022 were in Polynesia and Micronesia and the Caribbean for both sexes, and Chile and Qatar for boys. Combined prevalence was also high in some countries in south Asia, such as India and Pakistan, where thinness remained prevalent despite having declined. In 2022, obesity in school-aged children and adolescents was more prevalent than thinness with a posterior probability of at least 0·80 among girls in 133 countries (67%) and boys in 125 countries (63%), whereas the converse was true in 35 countries (18%) and 42 countries (21%), respectively. In almost all countries for both adults and school-aged children and adolescents, the increases in double burden were driven by increases in obesity, and decreases in double burden by declining underweight or thinness. Interpretation The combined burden of underweight and obesity has increased in most countries, driven by an increase in obesity, while underweight and thinness remain prevalent in south Asia and parts of Africa. A healthy nutrition transition that enhances access to nutritious foods is needed to address the remaining burden of underweight while curbing and reversing the increase in obesit