ANÁLISE ESTATÍSTICA ESPACIAL APLICADA A CONSTRUÇÃO DE SUPERFÍCIES BATIMÉTRICAS

Nas ultimas décadas os Sistemas de Informações Geográficas (SIG) tem sido incorporados no gerenciamento de zonas costeiras e oceânicas. Esses sistemas permitem a criar mapas e cenas de visualização tridimensional, de forma a obter uma produção mais realista da morfologia do fundo do mar. Face às inúmeras possibilidades de aplicação de modelos de interpoladores em amostras pontuais resultantes de levantamentos batimétricos, torna-se difícil escolher qual interpolador irá gerar a superfície que mais se aproxime da superfície real. Nesse trabalho, é apresentado um estudo estatístico que procurou estabelecer qual interpolador reproduz mais fidedignamente à morfologia da plataforma continental interna, adjacente aos municípios de Paulista, Olinda e Recife. Foram implementadas as interpolações Inverso da Distância Ponderada, Polinomial Local, Funções de Base Radial, Polinomial Global e Krigagem. Os resultados das análises estatísticas indicaram que não existem diferenças significativas entre o Polinomial Local, Funções de Base Radial e Krigagem. Portanto, qualquer um desses três métodos pode ser recomendado. Entretanto, por ser o único interpolador capaz de minimizar tendências e espacialisar a distribuição da variância dos pontos interpolados sobre uma superfície, optou-se por selecionar a Krigagem como o interpolador mais indicado na representação tridimensional da área em estudo

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

Análise espacial do índice de desenvolvimento humano municipal na região semiárida brasileira

A região Semiárida Brasileira é um espaço geográfico com área de 980.133,079km², caracterizada por uma precipitação média anual inferior a 800 milímetros, índice de aridez de até 0,5 e risco de seca maior que 60%. Abrange 9 estados, 1135 municípios e sua população é de 22.598.318 habitantes. O Índice de Desenvolvimento Humano dos Municípios (IDHM) é um indicador que permite conhecer as oportunidades de crescimento e de escolhas que estão disponíveis no nível municipal para que as pessoas tenham vida que desejam. O Atlas do Desenvolvimento Humano no Brasil 2013 disponibiliza o IDHM e suas três componentes: IDHM Renda, IDHM Educação e IDHM Longevidade, calculados a partir de dados do Censo Demográfico do Brasil do ano de 2010. O objetivo do trabalho foi descrever e visualizar distribuições espaciais, descobrir padrões de associação, identificar aglomerados e situações atípicas nos dados do IDHM da região Semiárida Brasileira através da Análise Exploratória de Dados Espaciais (AEDE). Os resultados mostram a existência de autocorrelação espacial no IDHM. Foram identificados clusters de altos e baixos valores com diferentes padrões de agregação. Tais resultados podem provocar a realização de estudos mais aprofundados para entender os fatores de agregação, bem como sugerir regiões prioritárias para atuação por parte dos governos estaduais

Effects of melatonin on ovarian follicles

Objective: To evaluate the histomorphometry and expression of Ki-67 and c-kit in ovarian follicles of pinealectomized or melatonin-treated pinealectomized rats.Study design: Forty adult rats were randomly divided into four groups of 10 animals: Group I - control; Group II - sham-pinealectomized; Group III - pinealectomized (Px), and Group IV - Px treated with melatonin (10 mu g/night, per animal). After two months' treatment, on the night of proestrous, the animals were placed in metabolic cages for night urine collection and subsequent measurement of 6-sulfatoxymelatonin (6-SMT). the rats were anesthetized, blood samples were taken for estrogen and progesterone determinations, and they were then euthanized. the ovaries were dissected out for further histological and immunohistochemical analyses. Data were first submitted to analysis of variance (ANOVA) complemented with the Tukey-Kramer test for multiple comparisons (P < 0.05).Results: the urinary levels of 6-SMT and serum progesterone were lower in the Px group (GIII). Exogenous melatonin treatment restored both blood melatonin and 6-SMT urinary levels. the histomorphometric data in Group III revealed a significant increase of degenerating antral and nonantral follicles with regard to the other groups. in addition no corpora lutea were observed in this group. No significant differences were noticed regarding the number of corpora lutea among the other groups (I, II and IV), but the number of cells and the thickness of the theca interna of Px animals (Group III) were higher than in the other groups. Conversely, the density of progesterone receptors (fmol/g) in the ovaries of Group III was significantly lower than in the other groups.Conclusion: Our data indicate that melatonin exerts a role on the maintenance of a proper follicular function, and is thus important for ovulation and progesterone production. (C) 2012 Elsevier Ireland Ltd. All rights reserved.Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)São Paulo Fed Univ UNIFESP, Dept Gynecol, BR-04038031 São Paulo, BrazilUniv São Paulo, Fac Med, Gynecol Div, Dept Obstet & Gynecol, BR-05403000 São Paulo, BrazilUniv São Paulo, Inst Biomed Sci, Dept Pharmacol, BR-05508900 São Paulo, BrazilSão Paulo Fed Univ EPM UNIFESP, Dept Morphol & Genet, BR-04023009 São Paulo, BrazilSão Paulo Fed Univ UNIFESP, Dept Gynecol, BR-04038031 São Paulo, BrazilSão Paulo Fed Univ EPM UNIFESP, Dept Morphol & Genet, BR-04023009 São Paulo, BrazilFAPESP: 2006/60412-7FAPESP: 2007/54398-4Web of Scienc

Epidemiological assessment of liver disease in northeastern Brazil by means of a standardized liver biopsy protocol

Submitted by Ana Maria Fiscina Sampaio ([email protected]) on 2016-09-02T12:17:35Z No. of bitstreams: 1 Lembrança L Epidemiological assessment....pdf: 68854 bytes, checksum: ab46220b6e2af3c2c5618b5c4ed55442 (MD5)Approved for entry into archive by Ana Maria Fiscina Sampaio ([email protected]) on 2016-09-02T13:06:26Z (GMT) No. of bitstreams: 1 Lembrança L Epidemiological assessment....pdf: 68854 bytes, checksum: ab46220b6e2af3c2c5618b5c4ed55442 (MD5)Made available in DSpace on 2016-09-02T13:06:26Z (GMT). No. of bitstreams: 1 Lembrança L Epidemiological assessment....pdf: 68854 bytes, checksum: ab46220b6e2af3c2c5618b5c4ed55442 (MD5) Previous issue date: 2011Federal University of Bahia. University Hospital. Scientific Initiation Program of the Hepatology Unit. Salvador, BA, BrasilFederal University of Bahia. University Hospital. Scientific Initiation Program of the Hepatology Unit. Salvador, BA, BrasilFederal University of Bahia. Bahia State Health Department. Salvador, BA, BrasilFederal University of Bahia. Bahia State Health Department. Salvador, BA, BrasilBahia State Health Department. Salvador, BA, BrasilMinistry of Health. National Viral Hepatitis Program. Salvador, BA, BrasilFundação Oswaldo Cruz. Centro de Pesquisas Gonçalo Moniz. Salvador, BA, BrasilFederal University of Bahia. Teaching Hospital. Hepatology Unit. Salvador, BA, BrasilThe main objective of this study was to describe the profile of patients who were benefitted in a collective effort to perform liver biopsies in Bahia, Brazil. METHOD: A cross-sectional study was conducted with a sample composed of all the patients who were submitted to liver biopsy during a collective effort carried out in Bahia between July 2007 and November 2009. At the time of the procedure, date on the age and gender of patients and the reason for performing the biopsy were recorded. Data on the degree of fibrosis and the presence of co-morbidities. Following statistical analysis, the frequency of the liver diseases that led to the biopsy procedure was described, and the profile of the patients was stratified into groups according to the most prevalent etiologies. RESULTS: Of the 550 patients evaluated, 55.3% were men and 44.7% women. Mean age was 46.63 ± 11.59 years and there was no statistically significant difference in age between males and females. Of the 550 patients, 72% had hepatitis C and the mean age of these patients was 48.49 ± 10.1 years, significantly higher than the mean age of the patients with hepatitis B (40.41 ± 12.43 years). Furthermore, 70.7% of the patients with hepatitis C were between 41 and 60 years of age. The most frequent fibrosis grade was F2 (44%) and the prevalence of advanced fibrosis was 27.7%. Overall, 85 patients, most of them men, had some degree of iron overload. With respect to the safety of the biopsy procedure, severe complications occurred in only two patients. CONCLUSION: Hepatitis C is the predominant liver disease that demanded liver biopsy. The profile of the patients who benefitted from this collective effort is similar to that of patients in the rest of the country. Moreover, non-Ultrasonography guided liver biopsy is safe and the collective effort to carry out liver biopsies in Bahia was found to be a viable venture

Ambient levels of concentrated PM2.5 affects cell kinetics in adrenal glands: an experimental study in mice

We evaluated the effects of air pollution on the adrenal cortex using 30 female mice divided into two groups of fifteen animals each. One group was conditioned daily in a chamber with exposure to particulate matter (PM) 2.5 mu m (GExp). Animals were exposed on daily basis in an ambient particles concentrator during the period of time enough to reach an accumulated dose of 600 mu g/m(3), which corresponds to a 24-h exposure of 25 mu g/m(3) that approximates to the annual mean of PM2.5 in Sao Paulo. The other group was allocated to another chamber with filtered air (GCrt). After euthanasia, the adrenals underwent histological processing and immunohistochemistry staining for Ki-67 and cleaved caspase-3. Histomorphometry of the adrenal glands in GExp showed increased thickness of the zona glomerulosa, while in GCrtthe adrenal glands from GExp had higher Ki-67 immunostaining scores in the zona reticularis than those from GCrt. The adrenal from GExp showed higher cleaved caspase-3 immunoreactivity in the zona fasciculata than the unexposed group (GCrt). The homeostasis index indicated higher cell proliferation in the zona glomerulosa and zona reticularis in GExp than in GCrt. Our data indicate that PM2.5 air pollution induces alterations on cell kinetics in mouse adrenal glands.Univ Sao Paulo FMUSP, Dept Obstet & Ginecol, Lab Invest Med LIM 58, Disciplina Ginecol,Hosp Clin,Fac Med, Sao Paulo, BrazilUniv Sao Paulo FMUSP, Dept Patol, Lab Invest Med LIM 05, Fac Med, Sao Paulo, BrazilUniv Fed Sao Paulo, Escola Paulista Med, Disciplina Histol & Biol Estrutural, Dept Morfol & Genet, Sao Paulo, BrazilUniv Fed Sao Paulo, Escola Paulista Med, Disciplina Histol & Biol Estrutural, Dept Morfol & Genet, Sao Paulo, BrazilWeb of Scienc

Melatonin effects on the female genital system: A brief review

Melatonin is secreted by the pineal gland and this is linked to the day/night cycle. It is an antioxidant and plays a fundamental role in the regulation of the jet-lag stage, in several physiological reactions and in control of the biologic rhythm, Human melatonin has an Important influence on the female genital system. in fact, melatonin may influence production and action of steroids, modifying cellular signalization on the target tissue. There are many evidences that the melatonin therapy may be interfering with neoplasia development, mainly of the estrogen-dependent tumor. This paper aims to analyze the actions of melatonin on the neuroendocrine, immunological and cardiovascular systems, as well as on the reproductive function.A melatonina é um hormônio produzido pela glândula pineal, cuja secreção está diretamente relacionada ao ciclo claro-escuro. É um poderoso antioxidante e tem papel fundamental na regulação do estado sono/vigília, do ritmo de vários processos fisiológicos, participando do controle do relógio biológico, inclusive nos seres humanos. Ressalta-se que há evidências da sua ação no sistema genital feminino, influenciando a função ovariana e a fertilidade. De fato, este hormônio interage com esteróides sexuais, como o estrogênio, modificando a sinalização celular e a resposta no tecido alvo. Estudos clínicos sugerem que o tratamento com a melatonina interviria com a evolução de neoplasia-dependente do estrogênio. O objetivo dessa revisão é analisar as principais ações da melatonina no sistema neuroendócrino, no ciclo sono-vigília, no sistema imunológico, no sistema cardiovascular, bem como no sistema reprodutor.Trabalho Realizado UNIFESP EPM, São Paulo, BrazilTrabalho Realizado UNIFESP EPM, São Paulo, BrazilWeb of Scienc

Delayed colorectal cancer care during covid-19 pandemic (decor-19). Global perspective from an international survey

Background The widespread nature of coronavirus disease 2019 (COVID-19) has been unprecedented. We sought to analyze its global impact with a survey on colorectal cancer (CRC) care during the pandemic. Methods The impact of COVID-19 on preoperative assessment, elective surgery, and postoperative management of CRC patients was explored by a 35-item survey, which was distributed worldwide to members of surgical societies with an interest in CRC care. Respondents were divided into two comparator groups: 1) ‘delay’ group: CRC care affected by the pandemic; 2) ‘no delay’ group: unaltered CRC practice. Results A total of 1,051 respondents from 84 countries completed the survey. No substantial differences in demographics were found between the ‘delay’ (745, 70.9%) and ‘no delay’ (306, 29.1%) groups. Suspension of multidisciplinary team meetings, staff members quarantined or relocated to COVID-19 units, units fully dedicated to COVID-19 care, personal protective equipment not readily available were factors significantly associated to delays in endoscopy, radiology, surgery, histopathology and prolonged chemoradiation therapy-to-surgery intervals. In the ‘delay’ group, 48.9% of respondents reported a change in the initial surgical plan and 26.3% reported a shift from elective to urgent operations. Recovery of CRC care was associated with the status of the outbreak. Practicing in COVID-free units, no change in operative slots and staff members not relocated to COVID-19 units were statistically associated with unaltered CRC care in the ‘no delay’ group, while the geographical distribution was not. Conclusions Global changes in diagnostic and therapeutic CRC practices were evident. Changes were associated with differences in health-care delivery systems, hospital’s preparedness, resources availability, and local COVID-19 prevalence rather than geographical factors. Strategic planning is required to optimize CRC care

Management of coronary disease in patients with advanced kidney disease

BACKGROUND Clinical trials that have assessed the effect of revascularization in patients with stable coronary disease have routinely excluded those with advanced chronic kidney disease. METHODS We randomly assigned 777 patients with advanced kidney disease and moderate or severe ischemia on stress testing to be treated with an initial invasive strategy consisting of coronary angiography and revascularization (if appropriate) added to medical therapy or an initial conservative strategy consisting of medical therapy alone and angiography reserved for those in whom medical therapy had failed. The primary outcome was a composite of death or nonfatal myocardial infarction. A key secondary outcome was a composite of death, nonfatal myocardial infarction, or hospitalization for unstable angina, heart failure, or resuscitated cardiac arrest. RESULTS At a median follow-up of 2.2 years, a primary outcome event had occurred in 123 patients in the invasive-strategy group and in 129 patients in the conservative-strategy group (estimated 3-year event rate, 36.4% vs. 36.7%; adjusted hazard ratio, 1.01; 95% confidence interval [CI], 0.79 to 1.29; P=0.95). Results for the key secondary outcome were similar (38.5% vs. 39.7%; hazard ratio, 1.01; 95% CI, 0.79 to 1.29). The invasive strategy was associated with a higher incidence of stroke than the conservative strategy (hazard ratio, 3.76; 95% CI, 1.52 to 9.32; P=0.004) and with a higher incidence of death or initiation of dialysis (hazard ratio, 1.48; 95% CI, 1.04 to 2.11; P=0.03). CONCLUSIONS Among patients with stable coronary disease, advanced chronic kidney disease, and moderate or severe ischemia, we did not find evidence that an initial invasive strategy, as compared with an initial conservative strategy, reduced the risk of death or nonfatal myocardial infarction