Survival of patients with AIDS and association with level of education level and race/skin color in South and Southeast Brazil: a cohort study, 1998-1999

Analisar a sobrevida de pessoas com aids e sua associação com escolaridade e raça/cor da pele. Coorte de diagnosticados entre 1998 e 1999, nas regiões Sul e Sudeste do Brasil, com análise de sobrevida (método de Kaplan--Meier), estratificada por escolaridade e raça/cor da pele; a análise multivariada foi realizada mediante regressão de Cox. Foram incluídas 2.091 pessoas com sobrevida em 60 meses, a percentuais de 65% entre brancos e 62% entre pretos/pardos; o uso irregular de antirretrovirais (HR=11,2 - IC95%8,8;14,2) e a idade ≥60 anos (HR=2,5 - IC95%1,4;4,4) foram relacionados com menor sobrevida; escolaridade >8 anos (HR=0,4 - IC95%0,3;0,6) e sexo feminino (HR=0,6 - IC95%0,5;0,8) relacionaram-se positivamente com sobrevida; os menos escolarizados tiveram sobrevida menor. Menor escolaridade sobrepôs-se às diferenças de raça/cor da pele, quando relacionada à sobrevida; tais desigualdades explicaram as diferenças observadas, mesmo com políticas de acesso universal aos antirretrovirais. Síndrome da Imunodeficiência Adquirida; Sobrevivência (Saúde Pública); Análise de Sobrevida; Escolaridade; Origem Étnica e Saúde281To analyze the survival of people with AIDS and association with schooling and race/skin color. METHODS: this was a retrospective cohort study of people diagnosed with AIDS between 1998 and 1999, in the South and Southeast regions of Brazil. We used survival analysis (Kaplan-Meier method), stratified by schooling and race/skin color and multivariate analysis was performed using Cox regression. RESULTS: the study included 2,091 people who had survived at 60 months, with 65% survival among White participants and 62% among Black/brown participants. Irregular use of antiretroviral (HR=11.2 - 95%CI8.8;14.2), and age ≥60 years (HR=2.5 - 95%CI1.4;4.4) were related to lower survival; schooling >8 years (HR=0.4 - 95%CI0.3;0.6) and being female (HR=0.6 - 95%CI0.5;0.8) were positively related to survival; those with less schooling had lower survival. CONCLUSION: lower schooling levels overlap race/skin color differences in relation to survival; these inequalities explain the differences found, despite the policies on universal access to antiretroviral.OBJETIVO: analisar a sobrevida de pessoas com aids e sua associação com escolaridade e raça/cor da pele. MÉTODOS: coorte de diagnosticados entre 1998 e 1999, nas regiões Sul e Sudeste do Brasil, com análise de sobrevida (método de Kaplan--Meier), estratificada por escolaridade e raça/cor da pele; a análise multivariada foi realizada mediante regressão de Cox. RESULTADOS: foram incluídas 2.091 pessoas com sobrevida em 60 meses, a percentuais de 65% entre brancos e 62% entre pretos/pardos; o uso irregular de antirretrovirais (HR=11,2 - IC95%8,8;14,2) e a idade ≥60 anos (HR=2,5 - IC95%1,4;4,4) foram relacionados com menor sobrevida; escolaridade >8 anos (HR=0,4 - IC95%0,3;0,6) e sexo feminino (HR=0,6 - IC95%0,5;0,8) relacionaram-se positivamente com sobrevida; os menos escolarizados tiveram sobrevida menor. CONCLUSÃO: menor escolaridade sobrepôs-se às diferenças de raça/cor da pele, quando relacionada à sobrevida; tais desigualdades explicaram as diferenças observadas, mesmo com políticas de acesso universal aos antirretrovirais.OBJETIVO: analizar la sobrevida de personas con sida y su asociación con escolaridad y raza/color de la piel. MÉTODOS: cohorte de diagnosticados entre 1998 y 1999, en las regiones Sur y Sudeste de Brasil, con análisis de supervivencia (Kaplan-Meier), estratificados por educación y raza/color de la piel; el análisis multivariante se realizó con regresión de Cox. RESULTADOS: fueron incluidas 2.091 personas con sobrevida de 60 meses, a porcentuales de 65% entre blancos y 62% entre negros/pardos; el uso irregular de antirretrovirales (HR=11,2 - IC95%8,8;14,2) y la edad ≥60 años (HR=2,5 - IC95%1,4;4,4) se relacionaron con una menor sobrevida; escolaridad >8 años (HR=0,4 - IC95%0,3;0,6) y sexo femenino (HR=0,6 - IC95%0,5;0,8) se relacionaron positivamente con sobrevida; los menos escolarizados tuvieron sobrevida menor. CONCLUSIÓN: menor escolaridad se superpuso a las diferencias de raza/color de la piel referida, cuando relacionada a la supervivencia; tales desigualdades explicaron las diferencias observadas, aún con políticas de acceso universal a antirretrovirales

Response surface for biodiesel production from soybean oil by ethylic route

Petroleum has been the most consumed energy source in the world, but it tends to run out due its non-renewable character. Among biofuels, biodiesel has emerged as the main candidate to substitute petroleum diesel. The present study aimed to identify the maximum yield point of biodiesel production by generating a response surface using molar ratio, temperature and agitation time as independent variables, and yield as a dependent variable. From the response surface, it is observed that the increase in temperature and reaction time leads to reduced yield. The configuration that resulted in maximum yield of 93.30% was 12:1 molar ratio, 30 °C temperature and 30-minute reaction time. From the chromatographic analysis it was possible to identify five different fatty acids in the composition of the biodiesels. Total saturated fatty acids (palmitic and stearic acids) ranged from 41.53% to 42.09% and total unsaturated fatty acids including monounsaturated and polyunsaturated fatty acids (oleic, linoleic and linolenic acids) ranged from 57.92% to 58.48%. According to the results of the physicochemical analyses, the specific mass at 68°F is in agreement with Brazilian, American and European specifications, ranging from 877.46 kg m-3 to 879.64 kg m-3 . The kinematic viscosity at 104 °F ranged from 4.49 mm² s -1 to 4.82 mm² s -1 . The acid value obtained did not vary within the limits established by the norms, and values between 0.54 and 2.74 mg KOH g -1 were observed

Productive efficiency and density and viscosity studies of biodiesels from vegetable oil mixtures

Received: January 31st, 2021 ; Accepted: April 10th, 2021 ; Published: April 29th, 2021 ; Correspondence: [email protected] in Brazil the minimum content of biodiesel in mixtures is 11% and, according to Brazilian laws, the goal is to reach 15% in volume in diesel fuel available for final consumers by 2023. Therefore, studies about different matrices of biodiesel and distinct mixtures are essential. The present work had two goals, the first one was to analyse physico-chemical properties of 16 biofuels produced from soybean and cotton oils, using S10 diesel, in mixtures B8, B10, B20 and B30. The second goal was to verify the vantages and disadvantages of biodiesel production through prior mixing of the oils, before and after the transesterification process. All biofuels produced presented results of specific mass values at 20 °C and kinematic viscosity at 40 °C within the limits established by ANP Resolution no 30/2016 and International Resolutions. The soybean B20 biofuel showed the best overall results, with the second highest production yield of 65.36%, the fifth lowest kinematic viscosity with 3.48 mm s -1 . The mixture of soybean and cotton oils before the transesterification process presented the highest production yield when compared with the production from a single oil or biodiesel mixtures. The results found proved to be satisfactory and corroborate to continue with the increase of biodiesel in the mixture with diesel to B15 until 2023 and support the possibility of planning for a gradual increase of this mixture in the following years

Missed opportunities in full immunization coverage:findings from low- and lower-middle-income countries

Background: An estimated 23 million infants are still not being benefitted from routine immunization services. We assessed how many children failed to be fully immunized even though they or their mothers were in contact with health services to receive other interventions. Design: Fourteen countries with Demographic and Health Surveys and Multiple Indicator Cluster Surveys carried out after 2000 and with coverage for DPT (Diphtheria-tetanus-pertussis) vaccine below 70% were selected. We defined full immunization coverage (FIC) as having received one dose of BCG (bacille Calmette-Guérin), one dose of measles, three doses of polio, and three doses of DPT vaccines. We tabulated FIC against: antenatal care (ANC), skilled birth attendance (SBA), postnatal care for the mother (PNC), vitamin A supplementation (VitA) for the child, and sleeping under an insecticide-treated bed-net (ITN). Missed opportunities were defined as the percentage of children who failed to be fully immunized among those receiving one or more other interventions. Results: Children who received other health interventions were also more likely to be fully immunized. In nearly all countries, FIC was lowest among children born to mothers who failed to attend ANC, and highest when the mother had four or more ANC visits Côte d'Ivoire presented the largest difference in FIC: 54 percentage points (pp) between having four or more ANC visits and lack of ANC. SBA was also related with higher FIC. For instance, the coverage in children without SBA was 36 pp lower than for those with SBA in Nigeria. The largest absolute difference on FIC in relation to PNC was observed for Ethiopia: 31 pp between those without and with PNC. FIC was also positively related with having received VitA. The largest absolute difference was observed in DR Congo: 41 pp. The differences in FIC among whether or not children slept under ITN were much smaller than for other interventions. Haiti presented the largest absolute difference: 16 pp. Conclusions: Our results show the need to develop and implement strategies to vaccinate all children who contact health services in order to receive other interventions

Altered glucose homeostasis and hepatic function in obese mice deficient for both kinin receptor genes

The Kallikrein-Kinin System (KKS) has been implicated in several aspects of metabolism, including the regulation of glucose homeostasis and adiposity. Kinins and des-Arg-kinins are the major effectors of this system and promote their effects by binding to two different receptors, the kinin B2 and B1 receptors, respectively. To understand the influence of the KKS on the pathophysiology of obesity and type 2 diabetes (T2DM), we generated an animal model deficient for both kinin receptor genes and leptin (obB1B2KO). Six-month-old obB1B2KO mice showed increased blood glucose levels. Isolated islets of the transgenic animals were more responsive to glucose stimulation releasing greater amounts of insulin, mainly in 3-month-old mice, which was corroborated by elevated serum C-peptide concentrations. Furthermore, they presented hepatomegaly, pronounced steatosis, and increased levels of circulating transaminases. This mouse also demonstrated exacerbated gluconeogenesis during the pyruvate challenge test. The hepatic abnormalities were accompanied by changes in the gene expression of factors linked to glucose and lipid metabolisms in the liver. Thus, we conclude that kinin receptors are important for modulation of insulin secretion and for the preservation of normal glucose levels and hepatic functions in obese mice, suggesting a protective role of the KKS regarding complications associated with obesity and T2DM

Neurolysin knockout mice generation and initial phenotype characterization

The oligopeptidase neurolysin (EC 3.4.24.16; Nln) was first identified in rat brain synaptic membranes and shown to ubiquitously participate in the catabolism of bioactive peptides such as neurotensin and bradykinin. Recently, it was suggested that Nln reduction could improve insulin sensitivity. Here, we have shown that Nln knockout mice (KO) have increased glucose tolerance, insulin sensitivity and gluconeogenesis. KO mice have increased liver mRNA for several genes related to gluconeogenesis. Isotopic label semi-quantitative peptidomic analysis suggests increase in specific intracellular peptides in gastrocnemius and epididymal adipose tissue, which likely is involved with the increased glucose tolerance and insulin sensitivity in the KO mice. These results suggest the exciting new possibility that Nln is a key enzyme for energy metabolism and could be a novel therapeutic target to improve glucose uptake and insulin sensitivity

Inequalities in full immunization coverage:Trends in low-and middle-income countries

OBJECTIVE: To investigate disparities in full immunization coverage across and within 86 low- and middle-income countries. METHODS: In May 2015, using data from the most recent Demographic and Health Surveys and Multiple Indicator Cluster Surveys, we investigated inequalities in full immunization coverage – i.e. one dose of bacille Calmette-Guérin vaccine, one dose of measles vaccine, three doses of vaccine against diphtheria, pertussis and tetanus and three doses of polio vaccine – in 86 low- or middle-income countries. We then investigated temporal trends in the level and inequality of such coverage in eight of the countries. FINDINGS: In each of the World Health Organization’s regions, it appeared that about 56–69% of eligible children in the low- and middle-income countries had received full immunization. However, within each region, the mean recorded level of such coverage varied greatly. In the African Region, for example, it varied from 11.4% in Chad to 90.3% in Rwanda. We detected pro-rich inequality in such coverage in 45 of the 83 countries for which the relevant data were available and pro-urban inequality in 35 of the 86 study countries. Among the countries in which we investigated coverage trends, Madagascar and Mozambique appeared to have made the greatest progress in improving levels of full immunization coverage over the last two decades, particularly among the poorest quintiles of their populations. CONCLUSION: Most low- and middle-income countries are affected by pro-rich and pro-urban inequalities in full immunization coverage that are not apparent when only national mean values of such coverage are reported