Análise da Judicialização do Direito à Saúde, Subfinanciamento do setor e Políticas Públicas: Estudo de Caso no Estado de Alagoas

The judicial demands related to the requirement of the compliance of the Universal Right to Health in accordance with the Federal Constitution of 1988 have increased in recent years. It also accounts that the public financing for the sector is insufficient to cover the scope of the Constitution due to the budget limits for the implementation of health policies. This article aims to analyze the process of judicialization of health, noting the implications and impacts on public administration, and specifically for the management of public policy. Therefore, a qualitative research was organized through case study, analyzing the data regarding to the judicialization and the expenses of the Health Department in the State of Alagoas (SESAU). An evolution of judicial requests has mainly been related to the access to medications through actions from the Public Defender´s Office and the Public Prosecutor's Office with expenditures exceeding $ 100 million between 2009 and 2014. Thus, despite attempts to minimize the impact generated with the creation of an interinstitutional core aiming to mitigate the effects of judicialization, it is necessary to implement health public policy for the community and evaluate the efficiency and effectiveness of existing ones. However, the underfunding and ineffective management of the Unified Health System (SUS) are highlighted as main causes that block the implementation of alternative solutions.As demandas judiciais referentes à exigência do cumprimento do Direito Universal à Saúde, conforme prevê a Constituição Federal de 1988, aumentaram nos últimos anos. Também se registra que o financiamento público do setor é insuficiente para abarcar a abrangência do texto constitucional, decorrente de limites orçamentários para a implementação das políticas de saúde. Este artigo objetivou analisar o processo de judicialização da saúde, observando as implicações e impactos para a Administração Pública e, especificamente, para a gestão de políticas públicas. Para tanto, organizou-se uma pesquisa qualitativa, por meio de estudo de caso, analisando os dados referentes à judicialização e aos gastos da Secretaria Estadual de Saúde de Alagoas (SESAU). Contatou-se uma evolução das solicitações judiciais, principalmente buscando acesso a medicamentos, mediante ações da Defensoria Pública e Ministério Público, e que os gastos ultrapassaram 100 milhões de reais, entre 2009 e 2014. Desta forma, apesar das tentativas de minimização do impacto gerado, com a criação de um Núcleo Interinstitucional objetivando mitigar os efeitos da judicialização, é necessário implementar políticas públicas de saúde para a coletividade e avaliar a eficiência e efetividade das existentes. Contudo, ilustrou-se o subfinanciamento e a gestão ineficaz do Sistema Único de Saúde (SUS), dificultando a operacionalização das alternativas de soluções

Flavonoid-enriched plant-extract-loaded emulsion: a novel phytocosmetic sunscreen formulation with antioxidant properties

The aim of this study was to develop a phytocosmetic sunscreen emulsion with antioxidant effect, containing a blend of flavonoid-enriched plant extracts. In vitro sun protection factor, antioxidant activity, skin irritation, photostability, cutaneous permeation, and retention of flavonoids were evaluated. Thermodynamically stable emulsions were obtained and tested for sensorial analysis after loading the blend of extracts. The selected emulsion was stable when stored at low temperatures (5 C), for which after 120 days the concentration of quercetin and rutin were above their limit of quantification, i.e., 2.8 ± 0.39 µg/mL and 30.39 ± 0.39 µg/mL, respectively. Spreadability, low rupture strength and adhesiveness were shown to be similar to a conventional topical product. Higher brittleness, pseudo-plastic, and viscoelastic behaviors were also recorded for the developed phytocosmetic sunscreen. The product presented a critical wavelength of 387.0 nm and ultraviolet rays A and B (UVA/UVB) rate of 0.78, confirming that the developed formulation shows capacity for UVA/UVB protection, protecting skin against damages caused by Ultraviolet (UV) radiation. Rutin was shown to permeate the skin barrier and was also quantified in the stratum corneum (3.27 ± 1.92 µg/mL) by tape stripping and retention test (114.68 ± 8.70 µg/mL). The developed flavonoid-enriched phytocosmetic was shown to be non-irritant to skin by an in vitro assay. Our results confirm the antioxidant activity, sun protection, and physical properties of the developed phytocosmetic for topical application.This research was funded by FAPESP (grant number 2015/25533‐7 and 2017/14757‐7), CAPES and CNPq. The authors also received support from the Portuguese Science and Technology Foundation (FCT/MCT) and from European Funds (PRODER/COMPETE) under the project reference M‐ERA‐NET/0004/2015‐PAIRED, co‐financed by FEDER, under the Partnership Agreement PT2020, and PhD scholarship (SFRH/BD/130555/2017).info:eu-repo/semantics/publishedVersio

Gender Differences in COVID-19 Among Liver Transplant Recipients: Results from a Multicenter Brazilian Cohort

Introduction: Existing literature presents varying perspectives on the impact of COVID-19 on liver transplant recipients.However, no research has specifically investigated the role of gender differences in the manifestation of COVID-19 among liver transplant recipients. This study aims to examine the effects of COVID-19 on liver transplant recipients, with a focus on gender differences in disease presentation and progression. Methods: Conducted as a multicenter historical cohort study, this research collected patient records through an online questionnaire. Assessing COVID-related mortality was the main objective. Additionally, demographic, clinical, and laboratory data pertaining to disease presentation and progression werecollected. Results: The study included a total of 283 patients, of whom 76 were female and 206 were male. The median follow-up period for males was 99 days (IQR 38-283), while for females, it was 126 days (IQR 44-291). A higher prevalence of cardiovascular disease was observed in males (p=0.002). Females frequently experienced a loss of smell (p=0.021), whereas males commonly exhibited fever (p=0.031). Levels of ALT and gamma-glutamyl transferase were significantly elevated in males (p=0.008 and 0.004, respectively). Although there was a trend towards increased mortality in males, it did not reach statistical significance. Conclusion: This study is the first attempt to investigate gender differences in COVID-19 among liver transplant recipients. Our findings highlight the need for a comprehensive and personalised approach to treating this patient population and underscore the importance of further elucidating the disease presentation in these individuals

Optimisation studies for the pion-induced Drell-Yan measurement at the AMBER experiment

The AMBER experiment is a future fixed-target experiment at SPS, CERN. It was recently approved, and one of the first phase physics goals is to study the pion-induced Drell-Yan process. The Drell-Yan process is a hard process where a quark-antiquark annihilation originates a virtual photon that decays in the final state to a pair of oppositely charged leptons. This process allows privileged access to the pion structure. At AMBER the valence, sea, and gluon contributions in the pion will be characterised with unprecedented accuracy, using high-intensity pion beams of both charges impinging in different nuclear targets. The AMBER setup is based on the COMPASS one but introduces significant upgrades to the existing spectrometer. Thus, the optimisation of the AMBER Drell-Yan detector is currently being studied and is a goal of this work. We introduce the AMBER Monte Carlo simulation chain. We start by simulating the physics process, followed by the simulation of the spectrometer and the response of the detector, and finally by allowing the reconstruction of the data. We will study the impact of the introduction of a vertex detector and how different positions, geometry, and segmentation affect the results. In our study, the silicon microstrips detector FVTX seems to be the most solid option. The choice is based on the values obtained for the dimuon mass and vertex position resolutions, as well as on the global acceptance for dimuons

Time Resolution Study using Garfield++

In this project, different silicon sensors are simulated. The goal is to study how different parameters affect the time resolution considering different geometries of silicon detectors and front-ends. This will be important for the Vertex Locator Detector in LHCb, in future upgrades of the LHCb experiment. This study was made using the simulation tool Garfield++. For thicker pad sensors, it has been shown that the time resolution is better. High noise is shown to worsen time resolution. When varying the temperature, the low temperature sensors show an improved time resolution caused by a higher mobility of the electrons and holes. When comparing the pixel detector with the pad, the time resolution obtained was worse. The uncorrected resolution obtained for different thicknesses in a pixel detector is similar, due to a similar weighting field

Análise da Judicialização do Direito à Saúde, Subfinanciamento do setor e Políticas Públicas: Estudo de Caso no Estado de Alagoas

The judicial demands related to the requirement of the compliance of the Universal Right to Health in accordance with the Federal Constitution of 1988 have increased in recent years. It also accounts that the public financing for the sector is insufficient to cover the scope of the Constitution due to the budget limits for the implementation of health policies. This article aims to analyze the process of judicialization of health, noting the implications and impacts on public administration, and specifically for the management of public policy. Therefore, a qualitative research was organized through case study, analyzing the data regarding to the judicialization and the expenses of the Health Department in the State of Alagoas (SESAU). An evolution of judicial requests has mainly been related to the access to medications through actions from the Public Defender´s Office and the Public Prosecutor's Office with expenditures exceeding $ 100 million between 2009 and 2014. Thus, despite attempts to minimize the impact generated with the creation of an interinstitutional core aiming to mitigate the effects of judicialization, it is necessary to implement health public policy for the community and evaluate the efficiency and effectiveness of existing ones. However, the underfunding and ineffective management of the Unified Health System (SUS) are highlighted as main causes that block the implementation of alternative solutions.As demandas judiciais referentes à exigência do cumprimento do Direito Universal à Saúde, conforme prevê a Constituição Federal de 1988, aumentaram nos últimos anos. Também se registra que o financiamento público do setor é insuficiente para abarcar a abrangência do texto constitucional, decorrente de limites orçamentários para a implementação das políticas de saúde. Este artigo objetivou analisar o processo de judicialização da saúde, observando as implicações e impactos para a Administração Pública e, especificamente, para a gestão de políticas públicas. Para tanto, organizou-se uma pesquisa qualitativa, por meio de estudo de caso, analisando os dados referentes à judicialização e aos gastos da Secretaria Estadual de Saúde de Alagoas (SESAU). Contatou-se uma evolução das solicitações judiciais, principalmente buscando acesso a medicamentos, mediante ações da Defensoria Pública e Ministério Público, e que os gastos ultrapassaram 100 milhões de reais, entre 2009 e 2014. Desta forma, apesar das tentativas de minimização do impacto gerado, com a criação de um Núcleo Interinstitucional objetivando mitigar os efeitos da judicialização, é necessário implementar políticas públicas de saúde para a coletividade e avaliar a eficiência e efetividade das existentes. Contudo, ilustrou-se o subfinanciamento e a gestão ineficaz do Sistema Único de Saúde (SUS), dificultando a operacionalização das alternativas de soluções

In vitro SPF and photostability assays of emulsion containing nanoparticles with vegetable extracts rich in flavonoids

The aim of study was to determine the in vitro sun protection factor (SPF) and the photostability profile of a topical formulation composed of nanoparticles loaded with vegetable extracts and to assess its physicochemical properties. Chitosan/tripolyphosphate (TPP) nanoparticles loaded with flavonoids-enriched vegetable extracts (Ginkgo biloba L., Dimorphandra mollis Benth, Ruta graveolens, and Vitis vinifera L.) were produced and characterized for their morphology, mean particle size, zeta potential, and encapsulation efficiency. A final topical formulation was obtained by dispersing chitosan/TPP nanoparticles in an o/w emulsion. Results showed that nanoparticles dispersion exhibited yellowish color, spherical shape, and uniform appearance. Extract-loaded chitosan/TPP nanoparticles showed a mean particle size of 557.11±3.1 nm, polydispersity index of 0.39±0.27, zeta potential of +11.54±2.1 mV, and encapsulation efficiency of 75.89% of rutin. The recorded texture parameters confirm that the developed formulation is appropriate for skin application. The SPF obtained was 2.3±0.4, with a critical wavelength of 387.0 nm and 0.69 UVA/UVB ratio. The developed formulation exhibited photostability, allowing the release of flavonoids from nanoparticles while retaining rutin into the skin in a higher extension.The authors acknowledge FAPESP (grant number 2015/25533-7 and 2017/14757-7), CAPES, and CNPq agencies for the financial support of this study. The authors also acknowledge the financial support received from the Portuguese Science and Technology Foundation (FCT/MCT) and from the European Funds (PRODER/COMPETE) under the project reference M-ERA-NET/0004/2015-PAIRED, co-financed by FEDER, under the Partnership Agreement PT2020.info:eu-repo/semantics/publishedVersio

Transverse polarisation measurement of Λ\Lambda hyperons in ppNe collisions at sNN\sqrt{s_{NN}}=68.4 GeV with the LHCb detector

A measurement of the transverse polarization of the $\Lambda$ and $\bar{\Lambda}$hyperons in $p$Ne fixed-target collisions at $\sqrt{s_{NN}}$=68.4 GeV is presented using data collected by the LHCb detector. The polarization is studied using the decay $\Lambda \rightarrow p \pi^-$ together with its charge conjugated process, the integrated values measured are $$P_{\Lambda} = 0.029 \pm 0.019 \, (\rm{stat}) \pm 0.012 \, (\rm{syst}) \, ,$$ $$P_{\bar{\Lambda}} = 0.003 \pm 0.023 \, (\rm{stat}) \pm 0.014 \,(\rm{syst}) \,$$ Furthermore, the results are shown as a function of the Feynman $x$ variable, transverse momentum, pseudorapidity and rapidity of the hyperons, and are compared with previous measurements.A measurement of the transverse polarization of the $\Lambda$ and $\bar{\Lambda}$ hyperons in $p$Ne fixed-target collisions at $\sqrt{s_{NN}}$ = 68.4 GeV is presented using data collected by the LHCb detector. The polarization is studied using the decay $\Lambda \rightarrow p \pi^-$ together with its charge conjugated process, the integrated values measured are $$P_{\Lambda} = 0.029 \pm 0.019 \, (\rm{stat}) \pm 0.012 \, (\rm{syst}) \, ,$$ $$P_{\bar{\Lambda}} = 0.003 \pm 0.023 \, (\rm{stat}) \pm 0.014 \,(\rm{syst}) \,.$$ Furthermore, the results are shown as a function of the Feynman~$x$~variable, transverse momentum, pseudorapidity and rapidity of the hyperons, and are compared with previous measurements

Comprehensive analysis of local and nonlocal amplitudes in the B0→K∗0μ+μ−B^0 \to K^{*0} \mu^+\mu^- decay

A comprehensive study of the local and nonlocal amplitudes contributing to the decay $B^0\rightarrow K^{*0}(\to K^+\pi^-) \mu^+\mu^-$ is performed by analysing the phase-space distribution of the decay products. The analysis is based on $pp$ collision data corresponding to an integrated luminosity of 8.4fb$^{-1}$ collected by the LHCb experiment. This measurement employs for the first time a model of both one-particle and two-particle nonlocal amplitudes, and utilises the complete dimuon mass spectrum without any veto regions around the narrow charmonium resonances. In this way it is possible to explicitly isolate the local and nonlocal contributions and capture the interference between them. The results show that interference with nonlocal contributions, although larger than predicted, only has a minor impact on the Wilson Coefficients determined from the fit to the data. For the local contributions, the Wilson Coefficient $C_9$, responsible for vector dimuon currents, exhibits a $2.1\sigma$ deviation from the Standard Model expectation. The Wilson Coefficients $C_{10}$, $C_{9}'$ and $C_{10}'$ are all in better agreement than $C_{9}$ with the Standard Model and the global significance is at the level of $1.5\sigma$. The model used also accounts for nonlocal contributions from $B^{0}\to K^{*0}\left[\tau^+\tau^-\to \mu^+\mu^-\right]$ rescattering, resulting in the first direct measurement of the $b s\tau\tau$ vector effective-coupling $C_{9\tau}$.A comprehensive study of the local and nonlocal amplitudes contributing to the decay $B^0\rightarrow K^{*0}(\to K^+\pi^-) \mu^+\mu^-$ is performed by analysing the phase-space distribution of the decay products. The analysis is based on \proton\proton collision data corresponding to an integrated luminosity of 8.4fb$^{-1}$ collected by the LHCb experiment. This measurement employs for the first time a model of both one-particle and two-particle nonlocal amplitudes, and utilises the complete dimuon mass spectrum without any veto regions around the narrow charmonium resonances. In this way it is possible to explicitly isolate the local and nonlocal contributions and capture the interference between them. The results show that interference with nonlocal contributions, although larger than predicted, only has a minor impact on the Wilson Coefficients determined from the fit to the data. For the local contributions, the Wilson Coefficient $C_9$, responsible for vector dimuon currents, exhibits a $2.1\sigma$ deviation from the Standard Model expectation. The Wilson Coefficients $C_{10}$, $C_{9}'$ and $C_{10}'$ are all in better agreement than $C_{9}$ with the Standard Model and the global significance is at the level of $1.5\sigma$. The model used also accounts for nonlocal contributions from $B^{0}\to K^{*0}\left[\tau^+\tau^-\to \mu^+\mu^-\right]$ rescattering, resulting in the first direct measurement of the $b s\tau\tau$ vector effective-coupling $C_{9\tau}$