Adverse events associated with individual statin treatments for cardiovascular disease: an indirect comparison meta-analysis

Background: Statins are the most widely prescribed drug available. Due to this reason, it is important to understand the risks involved with the drug class and individual statins. Aim: We conducted a meta-analysis and employed indirect comparisons to identify differing risk effects across statins. Design: We included any randomized clinical trial (RCT) of atorvastatin, fluvastatin, lovastatin, pitavastatin, pravastatin, rosuvastatin and simvastatin used for cardiovascular disease event prevention. The main outcome was adverse events [all-cause mortality, cancers, rhabdomylosis, diabetes, aspartate and alanine aminotransferase (AST/ALT), and creatinine kinase (CK) increases beyond the upper limit of normal]. In order to evaluate the relative effects of each drug on adverse events, we calculated adjusted indirect comparisons of the adverse-event outcomes. Results: Seventy-two trials involving 159 458 patients met our inclusion criteria. Overall, statin treatments significantly increased the rate of diabetes when compared to controls (OR: 1.09; 95% CI: 1.02-1.16) and elevated AST (OR: 1.31; 95% CI: 1.04-1.66) and ALT (OR: 1.28; 95% CI: 1.11-1.48) levels when compared to controls. Using indirect comparisons, we also found that atorvastatin significantly elevated AST levels compared to pravastatin (OR: 2.21; 95% CI: 1.13-4.29) and simvastatin significantly increased CK levels when compared to rosuvastatin (OR: 4.39; 95% CI: 1.01-19.07). Higher dose studies had increased risk of AST elevations. Discussion: Although statins are generally well tolerated, there are risks associated with almost all drugs. With few exceptions, statins appear to exert a similar risk across individual drug

Uso de índices RGB para o Bioma Caatinga associados a dados meteorológicos e índices de vegetação: estudos iniciais.

O presente estudo teve como objetivo monitorar a cobertura vegetal em uma área de Caatinga preservada por meio de imagens digitais, bem como sua correlação com dados meteorológicos e índices de vegetação obtidos em imagens MODIS

Linking plant phenology to conservation biology

Phenology has achieved a prominent position in current scenarios of global change research given its role inmonitoring and predicting the timing of recurrent life cycle events. However, the implications of phenology to environmental conservation and management remain poorly explored. Here,we present the first explicit appraisal of howphenology-amultidisciplinary science encompassing biometeorology, ecology, and evolutionary biology- can make a key contribution to contemporary conservation biology. We focus on shifts in plant phenology induced by global change, their impacts on species diversity and plant-animal interactions in the tropics, and how conservation efforts could be enhanced in relation to plant resource organization. We identify the effects of phenological changes and mismatches in the maintenance and conservation of mutualistic interactions, and examine how phenological research can contribute to evaluate, manage and mitigate the consequences of land-use change and other natural and anthropogenic disturbances, such as fire, exotic and invasive species. Wealso identify cutting-edge tools that can improve the spatial and temporal coverage of phenological monitoring, from satellites to drones and digital cameras. We highlight the role of historical information in recovering long-term phenological time series, and track climate-related shifts in tropical systems. Finally, we propose a set of measures to boost the contribution of phenology to conservation science.Weadvocate the inclusion of phenology into predictive models integrating evolutionary history to identify species groups that are either resilient or sensitive to future climate-change scenarios, and understand how phenological m ismatches can affect community dynamics, ecosystem services, and conservation over time

A leap forward in geographic scale for forest ectomycorrhizal fungi

Published versio

Experimental benchmarking of Monte Carlo simulations for radiotherapy dosimetry using monochromatic X-ray beams in the presence of metal-based compounds

The local dose deposition obtained in X-ray radiotherapy can be increased by the presence of metal-based compounds in the irradiated tissues. This finding is strongly enhanced if the radiation energy is chosen in the kiloelectronvolt energy range, due to the proximity to the absorption edge. In this study, we present a MC application developed with the toolkit Geant4 to investigate the dosimetric distribution of a uniform monochromatic X-ray beam, and benchmark it against experimental measurements. Two validation studies were performed, using a commercial PTW RW3 water-equivalent slab phantom for radiotherapy, and a custom-made PMMA phantom conceived to assess the influence of high atomic number compounds on the dose profile, such as iodine and gadolinium at different concentrations. An agreement within 9% among simulations and experimental data was found for the monochromatic energies considered, which were in the range of 30–140 keV; the agreement was better than 5% for depths <60 mm. A dose enhancement was observed in the calculations, corresponding to the regions containing the contrast agents. Dose enhancement factors (DEFs) were calculated, and the highest values were found for energies higher than the corresponding K-edges of iodine and gadolinium. The in-silico results are in line with the empirical findings, which suggest that Geant4 can be satisfactorily used as a tool for the calculation of the percentage depth dose (PDD) at the energies considered in this study in the presence of contrast agents

O enfermeiro psiquiátrico na assistência ao doente mental

Comentários sobre o papel do enfermeiro psiquiátrico especializado dentro da instituição hospitalar e a importância da orientação dinâmica ao pessoal de Enfermagem que assiste ao doente mental.Coments about functions of psychiatric nurse in the hospital and, also focuse the importance of dinamic orienta-tion to the nursing personal who assist the pacient's mental desease

O Enfermeiro psiquiátrico na assistência ao doente mental

Comentários sobre o papel do enfermeiro psiquiátrico especializado dentro da instituição hospitalar e a importância da orientação dinâmica ao pessoal de Enfermagem que assiste ao doente mental

The Coexistence of Trees, Shrubs, and Grasses Creates a Complex Picture of Land Surface Phenology in Dry Tropical Ecosystems

The use of digital cameras to monitor vegetation phenology (phenocams) has become increasingly common as a means of ground truthing estimates of land surface phenology from Earth observation data. Whilst the relationship between phenocam and Earth Observation-derived indices of land surface phenology has been examined across many temperate land cover types, our understanding of these relationships across the seasonally dry tropics is limited. Here we examined phenological time series derived from coarse-scale MODIS and fine-scale phenocam data across four seasonally dry tropical sites in Brazil to determine their correlation and how phenological metrics derived from these time series differed. While MODIS-derived vegetation indices showed seasonal patterns, we found a poor correlation with vegetation indices from phenocams at sites with a high proportion of evergreen vegetation and a poor correlation of MODIS indices with specific vegetation components. The high spatial and temporal resolution of phenocams allowed us to demonstrate differences in phenological metrics among different components of the vegetation which were obscured in the coarser MODIS data. This study highlights the potential of phenocam data to improve our understanding of complex vegetation leaf phenology and its drivers within mixed tree–shrub–grass systems in the seasonally dry tropics. This could help improve the representation of the savanna, grass, and shrubland biomes within terrestrial biosphere models, and lead to better predictions of the impact of climate change on carbon dynamics via shifting vegetation phenology

Accountability democrática: proposta de índice para órgãos deliberativos locais

As crescentes demandas pelo alargamento da participação social e legitimação das escolhas públicas trouxeram ao debate a maneira como instituições públicas se comunicam com a sociedade por meio de seus canais oficiais. Este estudo trata das iniciativas de accountability democrática nos portais eletrônicos dos órgãos deliberativos locais (no Brasil, as câmaras municipais) e propõe um instrumento de aferição denomidado Índice de Accountability Democrática Local (IADL). Com abordagem qualitativa, empregouse métodos de Análise de Conteúdo para compreender as dimensões envoltas neste processo e o papel da Ciência da Informação na implementação destes portais. A aplicação do IADL revela que embora as câmaras municipais estejam dispostas a prestar contas de forma transparente e façam uso das ferramentas de Tecnologia da Informação Comunicação, há um importante déficit de participação, acessibilidade e inteligibilidade da informação, o que acentua a distância entre governos e governados.info:eu-repo/semantics/publishedVersio

The importance of the user in the construction of the electronic p0ortals of the local deliberative bodies

Os portais eletrônicos têm se apresentado como uma importante via de comunicação e de prestação de serviços para os órgãos da Administração Pública à nivel global. Embora grande parte dos estudos foquem as esferas executivas, esta tecnologia também é amplamente empregada nos parlamentos, onde atuam como importante ferramenta de informação e participação. O objetivo deste paper foi verificar com que frequência as ferramentas de Tecnologia de Informação e Comunicação, consideradas facilitadoras de uso pela literatura internacional, estão sendo implementadas nestes portais. Um formulário de observação, elaborado por meio de pesquisa bibliográfica e técnicas de análise de conteúdo foi o guia para a observação dos portais eletrônicos dos órgãos deliberativos locais das principais cidades brasileiras e portuguesas. Além de evidenciarem alguns pontos para melhoria de desempenho e satisfação do usuário final, os resultados apontam para uma importante falha nos instrumentos de acessibilidade nestes sítios eletrônicos em ambos os países, fator visto como potencializador da exclusão digital.Electronic portals have been presented as an important means of communication and provision of services for Public Administration bodies around the world. Although most of the studies focus on the executive spheres, this technology is also widely used in parliaments, where it acts as an important tool for information and participation. The objective of this paper was to verify how often the Information and Communication Technology tools considered as facilitators of use by the international literature are being implemented in these portals. An observation form, developed through bibliographic research and content analysis techniques, was the guide for observing the electronic portals of local deliberative bodies in the main Brazilian and Portuguese cities. In addition to highlighting some points for improving performance and end-user satisfaction, the results point to a considerable failure in the accessibility instruments on these electronic sites in both countries, a factor seen as a potential booster of the digital divide.info:eu-repo/semantics/publishedVersio