Crescimento, diversidade e sobrevivência: o conceito de vitalidade aplicado em um estudo cientométrico

The paper addresses the structure and dynamics of scientific activities in the Health Sciences in Brazil. It starts with the assumption that vitality in science can be identified by characteristics related to productivity of authors, longevity of institutions, thematic diversity and publication channels. It points out specific features that represent different degrees of vitality in science. Analyzing 117,521 articles by Brazilian authors published between 1987 and 2011 in journals indexed by MEDLINE, vitality characteristics have been identified in each of the 27 states of the country. The results reveal that, in the area of Health Sciences in Brazil, there is much disparity between the states and that the higher levels of scientific vitality are located in the states of São Paulo, Rio de Janeiro and Rio Grande do SulAborda a estrutura e a dinâmica das atividades de produção científica na área das Ciências da Saúde no Brasil. Partiu-se do pressuposto de que a vitalidade da ciência pode ser identificada através de características sobre produtividade de autores, longevidade de instituições, diversidade temática e canais de divulgação. Por meio da identificação dessas características específicas, foram apontados indícios que representam diferentes graus de vitalidade. Analisando 117.521 artigos de autores brasileiros publicados entre 1987 e 2011 em periódicos indexados pela base de dados bibliográfica Medline, foram identificadas características de vitalidade em cada um dos 27 estados da federação. Os resultados revelaram que, na área das Ciências da Saúde no Brasil, há muita disparidade entre os estados e que os maiores graus de vitalidade científica estão localizados nos estados de São Paulo, Rio de Janeiro e Rio Grande do Sul

Crescimento, diversidade e sobrevivência: o conceito de vitalidade aplicado em um estudo cientométrico

The paper addresses the structure and dynamics of scientific activities in the Health Sciences in Brazil. It starts with the assumption that vitality in science can be identified by characteristics related to productivity of authors, longevity of institutions, thematic diversity and publication channels. It points out specific features that represent different degrees of vitality in science. Analyzing 117,521 articles by Brazilian authors published between 1987 and 2011 in journals indexed by MEDLINE, vitality characteristics have been identified in each of the 27 states of the country. The results reveal that, in the area of Health Sciences in Brazil, there is much disparity between the states and that the higher levels of scientific vitality are located in the states of São Paulo, Rio de Janeiro and Rio Grande do SulAborda a estrutura e a dinâmica das atividades de produção científica na área das Ciências da Saúde no Brasil. Partiu-se do pressuposto de que a vitalidade da ciência pode ser identificada através de características sobre produtividade de autores, longevidade de instituições, diversidade temática e canais de divulgação. Por meio da identificação dessas características específicas, foram apontados indícios que representam diferentes graus de vitalidade. Analisando 117.521 artigos de autores brasileiros publicados entre 1987 e 2011 em periódicos indexados pela base de dados bibliográfica Medline, foram identificadas características de vitalidade em cada um dos 27 estados da federação. Os resultados revelaram que, na área das Ciências da Saúde no Brasil, há muita disparidade entre os estados e que os maiores graus de vitalidade científica estão localizados nos estados de São Paulo, Rio de Janeiro e Rio Grande do Sul

Propriedades Psicométricas do Instrumento Youth Risk Behavior Survey (YRBS) entre Universitários do Brasil

Teniendo en cuenta la importancia de las conductas de riesgo para la salud (CRS) y la necesidad de instrumentos confiables para evaluarlas, este estudio tuvo como objetivo evaluar las propiedades psicométricas de los ítems de la Youth Risk Behavior Survey (YRBS) en una muestra de 902 estudiantes universitarios. Se evaluaron la validez convergente, el criterio, la consistencia interna y la estabilidad temporal. Se observaron correlaciones más altas para: uso de otras drogas y uso de marihuana (ρ = 0.537), consumo de alcohol y uso de tabaco (ρ = 0.418). Se verificó la validez del criterio, con diferencias significativas entre las puntuaciones de dominio según el género. Consistencia interna adecuada, alfa de Cronbach = 0.770 para la escala general. La mayoría de los dominios (82%) presentó un coeficiente de correlación intraclase ≥ 0.75 y el 64.1% de los ítems presentaron kappa ≥ 0.60. El instrumento parece presentar indicadores de validez de criterio, consistencia interna y estabilidad temporal con niveles satisfactorios. Se recomienda que la evaluación de CRS a través de YRBS sea realizada por dominios por separado.Considerando-se a importância dos comportamentos de risco à saúde (CRS) e a necessidade de instrumentos confiáveis para avaliá-los, este estudo teve como objetivo avaliar as propriedades psicométricas dos itens do Youth Risk Behavior Survey (YRBS) em uma amostra de 902 universitários. Foram avaliadas validade convergente, critério, consistência interna e estabilidade temporal. Observaramse maiores correlações: uso de outras drogas e uso de maconha (ρ = 0,537), consumo de bebida alcóolica e uso de tabaco (ρ = 0,418). Constatou-se validade de critério, com diferenças significativas entre escores dos domínios segundo o sexo. Consistência interna adequada, alfa de Cronbach = 0,770 para escala geral. A maioria dos domínios (82%) apresentou coeficiente de correlação intraclasse ≥ 0,75 e 64,1% dos itens apresentaram kappa ≥ 0,60. O instrumento parece apresentar indicadores de validade de critério, consistência interna e estabilidade temporal com níveis satisfatórios. Recomenda-se que avaliação dos CRS, por meio do YRBS, seja realizada por domínios separadamente.Considering the importance of health risk behaviors (HRB) and the need for reliable instruments to evaluate them, this study was designed to evaluate the psychometric properties of the items of the Youth Risk Behavior Survey (YRBS) in a sample of 902 college students. Convergent validity, criterion, internal consistency, and temporal stability were evaluated. Higher correlations were observed between use of other drugs and use of marijuana (ρ = 0.537), and alcohol consumption and tobacco use (ρ = 0.418). Criterion validity was observed, with significant differences between domain scores according to gender. Adequate internal consistency, Cronbach’s alpha = 0.770 for overall scale. Most of the domains (82%) showed intraclass correlation coefficient ≥ 0.75 and 64.1% of the items showed kappa ≥ 0.60. The instrument seems to have indicators of criterion validity, internal consistency and temporal stability with satisfactory levels. We recommend that HRB assessment using YRBS should be performed separately on each domain

Model to estimate the leaf area of combretum leprosum mart

Combretum leprosum Mart. -Combretaceae is a shrub used in popular medicine in Northeast Brazil as antiulcer, antihemorragica and antinociceptive. Estimating the leaf area is an important remark to be made biometric to compare the growth of plants. In this study, a model for calculating leaf area was developed for Combretum leprosum using linear measurements of leaf length (C) and maximum width (L), in order to obtain an equation by the linear dimensions of the leaf. It was collected 200 leaf blades of a population of C. leprosum native in a conservation area of Caatinga in the campus of the Federal Rural University of the Semi Arid in Natal, Rio Grande do Norte. The leaves were obtained from adults and leaf area was measured using an integrator leaf area (LI-3100, LI-COR). The analysis of variance of the regression was made in the program SAEG. The linear and geometric equations can be used to estimate leaf area of C. leprosum. From a practical standpoint, it is suggested to opt for the simple linear equation involving the C x L, using the regression equation A = 0.7103 x (C x L), which is equivalent to taking 71.03% of product of the length along the midrib and the maximum width, with a coefficient of determination of 0.952617.Combretum leprosum Mart. –Combretaceae é um arbusto usado na medicina popular do nordeste brasileiro como antiúlcerogênica, antihemorragica e antinociceptiva. Estimativa da área foliar é uma importante observação biométrica a ser feita para comparar o crescimento das plantas. Neste estudo, um modelo de cálculo da área foliar foi desenvolvido para Combretum leprosum, utilizando medidas lineares de comprimento de folha (C) e a largura máxima (L), com o objetivo de obter uma equação através de parâmetros lineares dimensionais das folhas. Foram coletados 200 limbos foliares de uma população de C. leprosus nativa em uma área conservada de Caatinga dentro do campus da Universidade Federal Rural do Semi Árido em Mossoró, Rio Grande do Norte. As folhas foram obtidas de indivíduos adultos e a área das folhas foi determinada através de um integrador de área foliar (LI-3100, LI-COR). A analise de variância da regressão foi feita no programa SAEG. As equações lineares simples, exponenciais e geométricas obtidas podem ser usadas para estimação da área foliar de C. leprosum. Do ponto de vista prático, sugere-se optar pela equação linear simples que envolve o produto C x L, usando-se a equação de regressão A = 0.7103 x (C x L), que equivale a tomar 71.03% do produto entre o comprimento ao longo da nervura principal e a largura máxima, com um coeficiente de determinação (R2) de 0.952617.Combretum leprosum Mart. – Combretaceae, conocido como mofumbo, es un arbusto utilizado en medicina popular como antiulcerosa, y antihemorragica antinociceptivo. Los métodos para determinar el área foliar son importantes los estudios ecológicos y agronómicos. Con el fin de obtener una ecuación que, a través de las dimensiones lineales de las hojas, permiten estimar el área foliar de C. leprosum se analizaron las relaciones entre el área foliar real (A) y los parámetros como la longitud a lo largo de la vena principal (C) y la anchura máxima (L) perpendicular a la nervadura central. Las hojas fueron obtenidos de los adultos y el área de las hojas se determinó mediante un modelo integrador de área foliar LI 3100 de licor. El análisis de regresión de la varianza se realizó en el SAEG programa. El lineal, exponencial y geométrica obtenida puede ser utilizada para estimar el área foliar de C. leprosum. Desde un punto de vista práctico, se sugiere optar por simples ecuaciones lineales que implican la L * C, utilizando la ecuación de regresión A = 0,7103 x (L x C), que es equivalente a tomar 71,03% de producto de la longitud a lo largo de la nervadura central y el ancho máximo, con un coeficiente de determinación de 0,952617

Post-intervention Status in Patients With Refractory Myasthenia Gravis Treated With Eculizumab During REGAIN and Its Open-Label Extension

OBJECTIVE: To evaluate whether eculizumab helps patients with anti-acetylcholine receptor-positive (AChR+) refractory generalized myasthenia gravis (gMG) achieve the Myasthenia Gravis Foundation of America (MGFA) post-intervention status of minimal manifestations (MM), we assessed patients' status throughout REGAIN (Safety and Efficacy of Eculizumab in AChR+ Refractory Generalized Myasthenia Gravis) and its open-label extension. METHODS: Patients who completed the REGAIN randomized controlled trial and continued into the open-label extension were included in this tertiary endpoint analysis. Patients were assessed for the MGFA post-intervention status of improved, unchanged, worse, MM, and pharmacologic remission at defined time points during REGAIN and through week 130 of the open-label study. RESULTS: A total of 117 patients completed REGAIN and continued into the open-label study (eculizumab/eculizumab: 56; placebo/eculizumab: 61). At week 26 of REGAIN, more eculizumab-treated patients than placebo-treated patients achieved a status of improved (60.7% vs 41.7%) or MM (25.0% vs 13.3%; common OR: 2.3; 95% CI: 1.1-4.5). After 130 weeks of eculizumab treatment, 88.0% of patients achieved improved status and 57.3% of patients achieved MM status. The safety profile of eculizumab was consistent with its known profile and no new safety signals were detected. CONCLUSION: Eculizumab led to rapid and sustained achievement of MM in patients with AChR+ refractory gMG. These findings support the use of eculizumab in this previously difficult-to-treat patient population. CLINICALTRIALSGOV IDENTIFIER: REGAIN, NCT01997229; REGAIN open-label extension, NCT02301624. CLASSIFICATION OF EVIDENCE: This study provides Class II evidence that, after 26 weeks of eculizumab treatment, 25.0% of adults with AChR+ refractory gMG achieved MM, compared with 13.3% who received placebo

Minimal Symptom Expression' in Patients With Acetylcholine Receptor Antibody-Positive Refractory Generalized Myasthenia Gravis Treated With Eculizumab

The efficacy and tolerability of eculizumab were assessed in REGAIN, a 26-week, phase 3, randomized, double-blind, placebo-controlled study in anti-acetylcholine receptor antibody-positive (AChR+) refractory generalized myasthenia gravis (gMG), and its open-label extension

Mapping local patterns of childhood overweight and wasting in low- and middle-income countries between 2000 and 2017

A double burden of malnutrition occurs when individuals, household members or communities experience both undernutrition and overweight. Here, we show geospatial estimates of overweight and wasting prevalence among children under 5 years of age in 105 low- and middle-income countries (LMICs) from 2000 to 2017 and aggregate these to policy-relevant administrative units. Wasting decreased overall across LMICs between 2000 and 2017, from 8.4% (62.3 (55.1–70.8) million) to 6.4% (58.3 (47.6–70.7) million), but is predicted to remain above the World Health Organization’s Global Nutrition Target of <5% in over half of LMICs by 2025. Prevalence of overweight increased from 5.2% (30 (22.8–38.5) million) in 2000 to 6.0% (55.5 (44.8–67.9) million) children aged under 5 years in 2017. Areas most affected by double burden of malnutrition were located in Indonesia, Thailand, southeastern China, Botswana, Cameroon and central Nigeria. Our estimates provide a new perspective to researchers, policy makers and public health agencies in their efforts to address this global childhood syndemic

Global burden and strength of evidence for 88 risk factors in 204 countries and 811 subnational locations, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021

Background: Understanding the health consequences associated with exposure to risk factors is necessary to inform public health policy and practice. To systematically quantify the contributions of risk factor exposures to specific health outcomes, the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 aims to provide comprehensive estimates of exposure levels, relative health risks, and attributable burden of disease for 88 risk factors in 204 countries and territories and 811 subnational locations, from 1990 to 2021. Methods: The GBD 2021 risk factor analysis used data from 54 561 total distinct sources to produce epidemiological estimates for 88 risk factors and their associated health outcomes for a total of 631 risk–outcome pairs. Pairs were included on the basis of data-driven determination of a risk–outcome association. Age-sex-location-year-specific estimates were generated at global, regional, and national levels. Our approach followed the comparative risk assessment framework predicated on a causal web of hierarchically organised, potentially combinative, modifiable risks. Relative risks (RRs) of a given outcome occurring as a function of risk factor exposure were estimated separately for each risk–outcome pair, and summary exposure values (SEVs), representing risk-weighted exposure prevalence, and theoretical minimum risk exposure levels (TMRELs) were estimated for each risk factor. These estimates were used to calculate the population attributable fraction (PAF; ie, the proportional change in health risk that would occur if exposure to a risk factor were reduced to the TMREL). The product of PAFs and disease burden associated with a given outcome, measured in disability-adjusted life-years (DALYs), yielded measures of attributable burden (ie, the proportion of total disease burden attributable to a particular risk factor or combination of risk factors). Adjustments for mediation were applied to account for relationships involving risk factors that act indirectly on outcomes via intermediate risks. Attributable burden estimates were stratified by Socio-demographic Index (SDI) quintile and presented as counts, age-standardised rates, and rankings. To complement estimates of RR and attributable burden, newly developed burden of proof risk function (BPRF) methods were applied to yield supplementary, conservative interpretations of risk–outcome associations based on the consistency of underlying evidence, accounting for unexplained heterogeneity between input data from different studies. Estimates reported represent the mean value across 500 draws from the estimate's distribution, with 95% uncertainty intervals (UIs) calculated as the 2·5th and 97·5th percentile values across the draws. Findings: Among the specific risk factors analysed for this study, particulate matter air pollution was the leading contributor to the global disease burden in 2021, contributing 8·0% (95% UI 6·7–9·4) of total DALYs, followed by high systolic blood pressure (SBP; 7·8% [6·4–9·2]), smoking (5·7% [4·7–6·8]), low birthweight and short gestation (5·6% [4·8–6·3]), and high fasting plasma glucose (FPG; 5·4% [4·8–6·0]). For younger demographics (ie, those aged 0–4 years and 5–14 years), risks such as low birthweight and short gestation and unsafe water, sanitation, and handwashing (WaSH) were among the leading risk factors, while for older age groups, metabolic risks such as high SBP, high body-mass index (BMI), high FPG, and high LDL cholesterol had a greater impact. From 2000 to 2021, there was an observable shift in global health challenges, marked by a decline in the number of all-age DALYs broadly attributable to behavioural risks (decrease of 20·7% [13·9–27·7]) and environmental and occupational risks (decrease of 22·0% [15·5–28·8]), coupled with a 49·4% (42·3–56·9) increase in DALYs attributable to metabolic risks, all reflecting ageing populations and changing lifestyles on a global scale. Age-standardised global DALY rates attributable to high BMI and high FPG rose considerably (15·7% [9·9–21·7] for high BMI and 7·9% [3·3–12·9] for high FPG) over this period, with exposure to these risks increasing annually at rates of 1·8% (1·6–1·9) for high BMI and 1·3% (1·1–1·5) for high FPG. By contrast, the global risk-attributable burden and exposure to many other risk factors declined, notably for risks such as child growth failure and unsafe water source, with age-standardised attributable DALYs decreasing by 71·5% (64·4–78·8) for child growth failure and 66·3% (60·2–72·0) for unsafe water source. We separated risk factors into three groups according to trajectory over time: those with a decreasing attributable burden, due largely to declining risk exposure (eg, diet high in trans-fat and household air pollution) but also to proportionally smaller child and youth populations (eg, child and maternal malnutrition); those for which the burden increased moderately in spite of declining risk exposure, due largely to population ageing (eg, smoking); and those for which the burden increased considerably due to both increasing risk exposure and population ageing (eg, ambient particulate matter air pollution, high BMI, high FPG, and high SBP). Interpretation: Substantial progress has been made in reducing the global disease burden attributable to a range of risk factors, particularly those related to maternal and child health, WaSH, and household air pollution. Maintaining efforts to minimise the impact of these risk factors, especially in low SDI locations, is necessary to sustain progress. Successes in moderating the smoking-related burden by reducing risk exposure highlight the need to advance policies that reduce exposure to other leading risk factors such as ambient particulate matter air pollution and high SBP. Troubling increases in high FPG, high BMI, and other risk factors related to obesity and metabolic syndrome indicate an urgent need to identify and implement interventions