O uso do medicamento na percepção do usuário do Programa Hiperdia The use of medication in the perception of users Hiperdia Program

O presente artigo discute a questão do acesso aos medicamentos como direito social, a partir da investigação de como o usuário do Hiperdia percebe seu acesso aos medicamentos. Para tanto, aborda o processo de medicalização vivenciado pela sociedade brasileira contemporânea, ressaltando a influência que esse processo exerce sobre o acesso aos medicamentos, comprometendo a concretização do acesso universal e igualitário. Utilizando técnica preconizada pela pesquisa qualitativa, foram realizados grupos focais com os usuários do Hiperdia nas unidades básicas de saúde de Juiz de Fora, Minas Gerais. O estudo enfatiza a percepção que esses usuários têm de seus direitos em relação ao acesso aos medicamentos essenciais. Nesse processo, investigam-se suas crenças, saberes, atitudes, dificuldades, medos, dúvidas, anseios com relação ao uso dos medicamentos essenciais, bem como a visão sobre a(s) doença(s) que os acomete(m). Entre os resultados alcançados, evidenciou-se que a maioria dos usuários das unidades básicas de saúde não se considera portador de direitos e que o acesso aos medicamentos como direito social garantido constitucionalmente está longe de ser efetivado no cotidiano do serviço público de saúde brasileiro.<br>This article discusses the question of access to medication as a social right, investigating how users registered in the Hiperdia program perceive their access to medication. To achieve this, the process of "medicalization" experienced by Brazilian society today was assessed, highlighting the influence that this process has on access to medication, prejudicing the achievement of universal and equalitarian access. Using a technique recommended by qualitative research, focal groups with Hiperdia users in the basic health service of Juiz de Fora, Minas Gerais, Brazil, were set up. The survey emphasizes the perception that these users have with respect to their rights related to essential medication. In this process, their beliefs, knowledge, attitudes, difficulties, fears, doubts and anxieties concerning the use of essential medication are investigated, as well as their viewpoints on the disease(s) they suffer from. Among the results obtained, it was revealed that the majority of the users of basic health units do not consider that they have rights and that access to medication as a constitutionally-assured social right is far from being implemented in the Brazilian public health service today

A DEFINED AMINO-ACID EXCHANGE CLOSE TO THE PUTATIVE NUCLEOTIDE BINDING-SITE IS RESPONSIBLE FOR AN OXYGEN-TOLERANT VARIANT OF THE RHIZOBIUM-MELILOTI NIFA PROTEIN

KREY R, Pühler A, KLIPP W. A DEFINED AMINO-ACID EXCHANGE CLOSE TO THE PUTATIVE NUCLEOTIDE BINDING-SITE IS RESPONSIBLE FOR AN OXYGEN-TOLERANT VARIANT OF THE RHIZOBIUM-MELILOTI NIFA PROTEIN. MOLECULAR &amp; GENERAL GENETICS. 1992;234(3):433-441.In Rhizobium meliloti the NifA protein plays a central role in the expression of genes involved in nitrogen fixation. The R. meliloti NifA protein has been found to be oxygen sensitive and therefore acts as a transcriptional activator only under microaerobic conditions. In order to generate oxygen-tolerant variants of the NifA protein a plasmid carrying the R. meliloti nifA gene was mutagenized in vitro with hydroxylamine. About 70 mutated nifA genes were isolated which mediated up to 12-fold increased NifA activity at high oxygen concentrations. A cloning procedure involving the combination of DNA fragments from mutated and wild-type nifA genes allowed mapping of the mutation sites within the central part of the nifA gene. For 17 mutated nifA genes the exact mutation sites were determined by DNA sequence analysis. It was found that all 17 mutated nifA genes carried identical guanosine adenosine mutations resulting in a methionine - isoleucine exchange (M217I) near the putative nucleotide binding site within the central domain. Secondary structure predictions indicated that the conformation of the putative nucleotide binding site may be altered in the oxygen-tolerant NifA proteins. A model is proposed which assumes that at high oxygen concentrations the loss of activity of the R. meliloti NifA protein is due to a conformational change in the nucleotide binding site that may abolish binding or hydrolysis of the nucleotide. Such a conformational change may be blocked in the oxygen-tolerant NifA protein, thus allowing interaction with the nucleotide at high oxygen concentrations

Swarm Learning for decentralized and confidential clinical machine learning

Fast and reliable detection of patients with severe and heterogeneous illnesses is a major goal of precision medicine1,2. Patients with leukaemia can be identified using machine learning on the basis of their blood transcriptomes3. However, there is an increasing divide between what is technically possible and what is allowed, because of privacy legislation4,5. Here, to facilitate the integration of any medical data from any data owner worldwide without violating privacy laws, we introduce Swarm Learning—a decentralized machine-learning approach that unites edge computing, blockchain-based peer-to-peer networking and coordination while maintaining confidentiality without the need for a central coordinator, thereby going beyond federated learning. To illustrate the feasibility of using Swarm Learning to develop disease classifiers using distributed data, we chose four use cases of heterogeneous diseases (COVID-19, tuberculosis, leukaemia and lung pathologies). With more than 16,400 blood transcriptomes derived from 127 clinical studies with non-uniform distributions of cases and controls and substantial study biases, as well as more than 95,000 chest X-ray images, we show that Swarm Learning classifiers outperform those developed at individual sites. In addition, Swarm Learning completely fulfils local confidentiality regulations by design. We believe that this approach will notably accelerate the introduction of precision medicine. © 2021, The Author(s)