Uma análise comparativa de sistemas de gerenciamento de bancos de dados NoSQL multimodelo

TCC(graduação) - Universidade Federal de Santa Catarina. Centro Tecnológico. Sistemas de Informação.O aumento crescente do número de aplicações na Web, ou que utilizam dados da Web, como redes sociais e aplicações voltadas à Internet das coisas, teve um papel importante para o aumento exponencial de dados. Esses dados são obtidos das mais diversas fontes e assim se tornam mais complexos, possuem maior variedade e tem uma alta taxa de crescimento. Nesse sentido, é necessário desenvolver tecnologias de gerenciamento de dados que consigam suportar as distintas características de cada grupo de dados e ainda possuir um bom desempenho. Para obter esses resultados foram criados os sistemas de gerenciamento de banco de dados (SGBDs) chamados de NoSQL multimodelo. Eles oferecem mais funcionalidades e flexibilidade, podendo suportar vários modelos de dados em um único SGBD. Para os desenvolvedores que necessitam utilizar tais sistemas ainda não é claro qual solução combina e se adapta melhor ao seu projeto, pois essas tecnologias são consideradas novas no mercado. Na literatura é possível encontrar trabalhos comparando SGBDs, entretanto os que comparam SGBDs NoSQL multimodelo são escassos e não abrangem muitos sistemas. Sendo assim, esse trabalho de conclusão de curso tem como objetivo apresentar uma análise comparativa de SGBDs NoSQL multimodelo populares no mercado e não abordados por trabalhos relacionados.The increasing number of web applications, or those using web data, such as social networks and IoT applications, has played an important role in exponentially increasing data. These data are obtained from various sources and thus become more complex, have greater variety and have a high growth rate. In this sense, it is necessary to develop data management technologies that can support the distinct characteristics of each data group and still have a good performance. To achieve these results, database management systems (DBMSs) called multi-model NoSQL have been created. They offer more functionality and flexibility and may support multiple data models in a single DBMS. For developers who need to use such systems it is not yet clear which solution best fits their project as these technologies are considered new to the market. In the literature it is possible to find out works comparing DBMSs, however those comparing multimodel NoSQL DBMSs are scarce and do not cover many systems. Thus, this undergraduate conclusion paper aims to present a comparative analysis of the most used multimodel NoSQL DBMS in the market that were not covered by the related work

Measuring progress and projecting attainment on the basis of past trends of the health-related Sustainable Development Goals in 188 countries: an analysis from the Global Burden of Disease Study 2016

The UN’s Sustainable Development Goals (SDGs) are grounded in the global ambition of “leaving no one behind”. Understanding today’s gains and gaps for the health-related SDGs is essential for decision makers as they aim to improve the health of populations. As part of the Global Burden of Diseases, Injuries, and Risk Factors Study 2016 (GBD 2016), we measured 37 of the 50 health-related SDG indicators over the period 1990–2016 for 188 countries, and then on the basis of these past trends, we projected indicators to 2030

Measuring performance on the Healthcare Access and Quality Index for 195 countries and territories and selected subnational locations: A systematic analysis from the Global Burden of Disease Study 2016

Background: A key component of achieving universal health coverage is ensuring that all populations have access to quality health care. Examining where gains have occurred or progress has faltered across and within countries is crucial to guiding decisions and strategies for future improvement. We used the Global Burden of Diseases, Injuries, and Risk Factors Study 2016 (GBD 2016) to assess personal health-care access and quality with the Healthcare Access and Quality (HAQ) Index for 195 countries and territories, as well as subnational locations in seven countries, from 1990 to 2016. Methods Drawing from established methods and updated estimates from GBD 2016, we used 32 causes from which death should not occur in the presence of effective care to approximate personal health-care access and quality by location and over time. To better isolate potential effects of personal health-care access and quality from underlying risk factor patterns, we risk-standardised cause-specific deaths due to non-cancers by location-year, replacing the local joint exposure of environmental and behavioural risks with the global level of exposure. Supported by the expansion of cancer registry data in GBD 2016, we used mortality-to-incidence ratios for cancers instead of risk-standardised death rates to provide a stronger signal of the effects of personal health care and access on cancer survival. We transformed each cause to a scale of 0-100, with 0 as the first percentile (worst) observed between 1990 and 2016, and 100 as the 99th percentile (best); we set these thresholds at the country level, and then applied them to subnational locations. We applied a principal components analysis to construct the HAQ Index using all scaled cause values, providing an overall score of 0-100 of personal health-care access and quality by location over time. We then compared HAQ Index levels and trends by quintiles on the Socio-demographic Index (SDI), a summary measure of overall development. As derived from the broader GBD study and other data sources, we examined relationships between national HAQ Index scores and potential correlates of performance, such as total health spending per capita. Findings In 2016, HAQ Index performance spanned from a high of 97\ub71 (95% UI 95\ub78-98\ub71) in Iceland, followed by 96\ub76 (94\ub79-97\ub79) in Norway and 96\ub71 (94\ub75-97\ub73) in the Netherlands, to values as low as 18\ub76 (13\ub71-24\ub74) in the Central African Republic, 19\ub70 (14\ub73-23\ub77) in Somalia, and 23\ub74 (20\ub72-26\ub78) in Guinea-Bissau. The pace of progress achieved between 1990 and 2016 varied, with markedly faster improvements occurring between 2000 and 2016 for many countries in sub-Saharan Africa and southeast Asia, whereas several countries in Latin America and elsewhere saw progress stagnate after experiencing considerable advances in the HAQ Index between 1990 and 2000. Striking subnational disparities emerged in personal health-care access and quality, with China and India having particularly large gaps between locations with the highest and lowest scores in 2016. In China, performance ranged from 91\ub75 (89\ub71-93\ub76) in Beijing to 48\ub70 (43\ub74-53\ub72) in Tibet (a 43\ub75-point difference), while India saw a 30\ub78-point disparity, from 64\ub78 (59\ub76-68\ub78) in Goa to 34\ub70 (30\ub73-38\ub71) in Assam. Japan recorded the smallest range in subnational HAQ performance in 2016 (a 4\ub78-point difference), whereas differences between subnational locations with the highest and lowest HAQ Index values were more than two times as high for the USA and three times as high for England. State-level gaps in the HAQ Index in Mexico somewhat narrowed from 1990 to 2016 (from a 20\ub79-point to 17\ub70-point difference), whereas in Brazil, disparities slightly increased across states during this time (a 17\ub72-point to 20\ub74-point difference). Performance on the HAQ Index showed strong linkages to overall development, with high and high-middle SDI countries generally having higher scores and faster gains for non-communicable diseases. Nonetheless, countries across the development spectrum saw substantial gains in some key health service areas from 2000 to 2016, most notably vaccine-preventable diseases. Overall, national performance on the HAQ Index was positively associated with higher levels of total health spending per capita, as well as health systems inputs, but these relationships were quite heterogeneous, particularly among low-to-middle SDI countries. Interpretation GBD 2016 provides a more detailed understanding of past success and current challenges in improving personal health-care access and quality worldwide. Despite substantial gains since 2000, many low-SDI and middle- SDI countries face considerable challenges unless heightened policy action and investments focus on advancing access to and quality of health care across key health services, especially non-communicable diseases. Stagnating or minimal improvements experienced by several low-middle to high-middle SDI countries could reflect the complexities of re-orienting both primary and secondary health-care services beyond the more limited foci of the Millennium Development Goals. Alongside initiatives to strengthen public health programmes, the pursuit of universal health coverage hinges upon improving both access and quality worldwide, and thus requires adopting a more comprehensive view-and subsequent provision-of quality health care for all populations

Measuring performance on the Healthcare Access and Quality Index for 195 countries and territories and selected subnational locations: A systematic analysis from the Global Burden of Disease Study 2016

Copyright © 2018 The Author(s). Published by Elsevier Ltd. Background A key component of achieving universal health coverage is ensuring that all populations have access to quality health care. Examining where gains have occurred or progress has faltered across and within countries is crucial to guiding decisions and strategies for future improvement. We used the Global Burden of Diseases, Injuries, and Risk Factors Study 2016 (GBD 2016) to assess personal health-care access and quality with the Healthcare Access and Quality (HAQ) Index for 195 countries and territories, as well as subnational locations in seven countries, from 1990 to 2016. Methods Drawing from established methods and updated estimates from GBD 2016, we used 32 causes from which death should not occur in the presence of effective care to approximate personal health-care access and quality by location and over time. To better isolate potential effects of personal health-care access and quality from underlying risk factor patterns, we risk-standardised cause-specific deaths due to non-cancers by location-year, replacing the local joint exposure of environmental and behavioural risks with the global level of exposure. Supported by the expansion of cancer registry data in GBD 2016, we used mortality-to-incidence ratios for cancers instead of risk-standardised death rates to provide a stronger signal of the effects of personal health care and access on cancer survival. We transformed each cause to a scale of 0-100, with 0 as the first percentile (worst) observed between 1990 and 2016, and 100 as the 99th percentile (best); we set these thresholds at the country level, and then applied them to subnational locations. We applied a principal components analysis to construct the HAQ Index using all scaled cause values, providing an overall score of 0-100 of personal health-care access and quality by location over time. We then compared HAQ Index levels and trends by quintiles on the Socio-demographic Index (SDI), a summary measure of overall development. As derived from the broader GBD study and other data sources, we examined relationships between national HAQ Index scores and potential correlates of performance, such as total health spending per capita. Findings In 2016, HAQ Index performance spanned from a high of 97·1 (95% UI 95·8-98·1) in Iceland, followed by 96·6 (94·9-97·9) in Norway and 96·1 (94·5-97·3) in the Netherlands, to values as low as 18·6 (13·1-24·4) in the Central African Republic, 19·0 (14·3-23·7) in Somalia, and 23·4 (20·2-26·8) in Guinea-Bissau. The pace of progress achieved between 1990 and 2016 varied, with markedly faster improvements occurring between 2000 and 2016 for many countries in sub-Saharan Africa and southeast Asia, whereas several countries in Latin America and elsewhere saw progress stagnate after experiencing considerable advances in the HAQ Index between 1990 and 2000. Striking subnational disparities emerged in personal health-care access and quality, with China and India having particularly large gaps between locations with the highest and lowest scores in 2016. In China, performance ranged from 91·5 (89·1-93·6) in Beijing to 48·0 (43·4-53·2) in Tibet (a 43·5-point difference), while India saw a 30·8-point disparity, from 64·8 (59·6-68·8) in Goa to 34·0 (30·3-38·1) in Assam. Japan recorded the smallest range in subnational HAQ performance in 2016 (a 4·8-point difference), whereas differences between subnational locations with the highest and lowest HAQ Index values were more than two times as high for the USA and three times as high for England. State-level gaps in the HAQ Index in Mexico somewhat narrowed from 1990 to 2016 (from a 20·9-point to 17·0-point difference), whereas in Brazil, disparities slightly increased across states during this time (a 17·2-point to 20·4-point difference). Performance on the HAQ Index showed strong linkages to overall development, with high and high-middle SDI countries generally having higher scores and faster gains for non-communicable diseases. Nonetheless, countries across the development spectrum saw substantial gains in some key health service areas from 2000 to 2016, most notably vaccine-preventable diseases. Overall, national performance on the HAQ Index was positively associated with higher levels of total health spending per capita, as well as health systems inputs, but these relationships were quite heterogeneous, particularly among low-to-middle SDI countries. Interpretation GBD 2016 provides a more detailed understanding of past success and current challenges in improving personal health-care access and quality worldwide. Despite substantial gains since 2000, many low-SDI and middle- SDI countries face considerable challenges unless heightened policy action and investments focus on advancing access to and quality of health care across key health services, especially non-communicable diseases. Stagnating or minimal improvements experienced by several low-middle to high-middle SDI countries could reflect the complexities of re-orienting both primary and secondary health-care services beyond the more limited foci of the Millennium Development Goals. Alongside initiatives to strengthen public health programmes, the pursuit of universal health coverage hinges upon improving both access and quality worldwide, and thus requires adopting a more comprehensive view - and subsequent provision - of quality health care for all populations

Global, regional, and national life expectancy, all-cause mortality, and cause-specific mortality for 249 causes of death, 1980-2015 : a systematic analysis for the Global Burden of Disease Study 2015

Background Improving survival and extending the longevity of life for all populations requires timely, robust evidence on local mortality levels and trends. The Global Burden of Disease 2015 Study (GBD 2015) provides a comprehensive assessment of all-cause and cause-specific mortality for 249 causes in 195 countries and territories from 1980 to 2015. These results informed an in-depth investigation of observed and expected mortality patterns based on sociodemographic measures. Methods We estimated all-cause mortality by age, sex, geography, and year using an improved analytical approach originally developed for GBD 2013 and GBD 2010. Improvements included refinements to the estimation of child and adult mortality and corresponding uncertainty, parameter selection for under-5 mortality synthesis by spatiotemporal Gaussian process regression, and sibling history data processing. We also expanded the database of vital registration, survey, and census data to 14 294 geography-year datapoints. For GBD 2015, eight causes, including Ebola virus disease, were added to the previous GBD cause list for mortality. We used six modelling approaches to assess cause-specific mortality, with the Cause of Death Ensemble Model (CODEm) generating estimates for most causes. We used a series of novel analyses to systematically quantify the drivers of trends in mortality across geographies. First, we assessed observed and expected levels and trends of cause-specific mortality as they relate to the Socio-demographic Index (SDI), a summary indicator derived from measures of income per capita, educational attainment, and fertility. Second, we examined factors affecting total mortality patterns through a series of counterfactual scenarios, testing the magnitude by which population growth, population age structures, and epidemiological changes contributed to shifts in mortality. Finally, we attributed changes in life expectancy to changes in cause of death. We documented each step of the GBD 2015 estimation processes, as well as data sources, in accordance with Guidelines for Accurate and Transparent Health Estimates Reporting (GATHER). Findings Globally, life expectancy from birth increased from 61.7 years (95% uncertainty interval 61.4-61.9) in 1980 to 71.8 years (71.5-72.2) in 2015. Several countries in sub-Saharan Africa had very large gains in life expectancy from 2005 to 2015, rebounding from an era of exceedingly high loss of life due to HIV/AIDS. At the same time, many geographies saw life expectancy stagnate or decline, particularly for men and in countries with rising mortality from war or interpersonal violence. From 2005 to 2015, male life expectancy in Syria dropped by 11.3 years (3.7-17.4), to 62.6 years (56.5-70.2). Total deaths increased by 4.1% (2.6-5.6) from 2005 to 2015, rising to 55.8 million (54.9 million to 56.6 million) in 2015, but age-standardised death rates fell by 17.0% (15.8-18.1) during this time, underscoring changes in population growth and shifts in global age structures. The result was similar for non-communicable diseases (NCDs), with total deaths from these causes increasing by 14.1% (12.6-16.0) to 39.8 million (39.2 million to 40.5 million) in 2015, whereas age-standardised rates decreased by 13.1% (11.9-14.3). Globally, this mortality pattern emerged for several NCDs, including several types of cancer, ischaemic heart disease, cirrhosis, and Alzheimer's disease and other dementias. By contrast, both total deaths and age-standardised death rates due to communicable, maternal, neonatal, and nutritional conditions significantly declined from 2005 to 2015, gains largely attributable to decreases in mortality rates due to HIV/AIDS (42.1%, 39.1-44.6), malaria (43.1%, 34.7-51.8), neonatal preterm birth complications (29.8%, 24.8-34.9), and maternal disorders (29.1%, 19.3-37.1). Progress was slower for several causes, such as lower respiratory infections and nutritional deficiencies, whereas deaths increased for others, including dengue and drug use disorders. Age-standardised death rates due to injuries significantly declined from 2005 to 2015, yet interpersonal violence and war claimed increasingly more lives in some regions, particularly in the Middle East. In 2015, rotaviral enteritis (rotavirus) was the leading cause of under-5 deaths due to diarrhoea (146 000 deaths, 118 000-183 000) and pneumococcal pneumonia was the leading cause of under-5 deaths due to lower respiratory infections (393 000 deaths, 228 000-532 000), although pathogen-specific mortality varied by region. Globally, the effects of population growth, ageing, and changes in age-standardised death rates substantially differed by cause. Our analyses on the expected associations between cause-specific mortality and SDI show the regular shifts in cause of death composition and population age structure with rising SDI. Country patterns of premature mortality (measured as years of life lost [YLLs]) and how they differ from the level expected on the basis of SDI alone revealed distinct but highly heterogeneous patterns by region and country or territory. Ischaemic heart disease, stroke, and diabetes were among the leading causes of YLLs in most regions, but in many cases, intraregional results sharply diverged for ratios of observed and expected YLLs based on SDI. Communicable, maternal, neonatal, and nutritional diseases caused the most YLLs throughout sub-Saharan Africa, with observed YLLs far exceeding expected YLLs for countries in which malaria or HIV/AIDS remained the leading causes of early death. Interpretation At the global scale, age-specific mortality has steadily improved over the past 35 years; this pattern of general progress continued in the past decade. Progress has been faster in most countries than expected on the basis of development measured by the SDI. Against this background of progress, some countries have seen falls in life expectancy, and age-standardised death rates for some causes are increasing. Despite progress in reducing age-standardised death rates, population growth and ageing mean that the number of deaths from most non-communicable causes are increasing in most countries, putting increased demands on health systems. Copyright (C) The Author(s). Published by Elsevier Ltd.Peer reviewe

Global, regional, and national comparative risk assessment of 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks, 1990-2015: a systematic analysis for the Global Burden of Disease Study 2015

Forouzanfar MH, Afshin A, Alexander LT, et al. Global, regional, and national comparative risk assessment of 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks, 1990-2015: a systematic analysis for the Global Burden of Disease Study 2015. LANCET. 2016;388(10053):1659-1724.Background The Global Burden of Diseases, Injuries, and Risk Factors Study 2015 provides an up-to-date synthesis of the evidence for risk factor exposure and the attributable burden of disease. By providing national and subnational assessments spanning the past 25 years, this study can inform debates on the importance of addressing risks in context. Methods We used the comparative risk assessment framework developed for previous iterations of the Global Burden of Disease Study to estimate attributable deaths, disability-adjusted life-years (DALYs), and trends in exposure by age group, sex, year, and geography for 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks from 1990 to 2015. This study included 388 risk-outcome pairs that met World Cancer Research Fund-defined criteria for convincing or probable evidence. We extracted relative risk and exposure estimates from randomised controlled trials, cohorts, pooled cohorts, household surveys, census data, satellite data, and other sources. We used statistical models to pool data, adjust for bias, and incorporate covariates. We developed a metric that allows comparisons of exposure across risk factors-the summary exposure value. Using the counterfactual scenario of theoretical minimum risk level, we estimated the portion of deaths and DALYs that could be attributed to a given risk. We decomposed trends in attributable burden into contributions from population growth, population age structure, risk exposure, and risk-deleted cause-specific DALY rates. We characterised risk exposure in relation to a Socio-demographic Index (SDI). Findings Between 1990 and 2015, global exposure to unsafe sanitation, household air pollution, childhood underweight, childhood stunting, and smoking each decreased by more than 25%. Global exposure for several occupational risks, high body-mass index (BMI), and drug use increased by more than 25% over the same period. All risks jointly evaluated in 2015 accounted for 57.8% (95% CI 56.6-58.8) of global deaths and 41.2% (39.8-42.8) of DALYs. In 2015, the ten largest contributors to global DALYs among Level 3 risks were high systolic blood pressure (211.8 million [192.7 million to 231.1 million] global DALYs), smoking (148.6 million [134.2 million to 163.1 million]), high fasting plasma glucose (143.1 million [125.1 million to 163.5 million]), high BMI (120.1 million [83.8 million to 158.4 million]), childhood undernutrition (113.3 million [103.9 million to 123.4 million]), ambient particulate matter (103.1 million [90.8 million to 115.1 million]), high total cholesterol (88.7 million [74.6 million to 105.7 million]), household air pollution (85.6 million [66.7 million to 106.1 million]), alcohol use (85.0 million [77.2 million to 93.0 million]), and diets high in sodium (83.0 million [49.3 million to 127.5 million]). From 1990 to 2015, attributable DALYs declined for micronutrient deficiencies, childhood undernutrition, unsafe sanitation and water, and household air pollution; reductions in risk-deleted DALY rates rather than reductions in exposure drove these declines. Rising exposure contributed to notable increases in attributable DALYs from high BMI, high fasting plasma glucose, occupational carcinogens, and drug use. Environmental risks and childhood undernutrition declined steadily with SDI; low physical activity, high BMI, and high fasting plasma glucose increased with SDI. In 119 countries, metabolic risks, such as high BMI and fasting plasma glucose, contributed the most attributable DALYs in 2015. Regionally, smoking still ranked among the leading five risk factors for attributable DALYs in 109 countries; childhood underweight and unsafe sex remained primary drivers of early death and disability in much of sub-Saharan Africa. Interpretation Declines in some key environmental risks have contributed to declines in critical infectious diseases. Some risks appear to be invariant to SDI. Increasing risks, including high BMI, high fasting plasma glucose, drug use, and some occupational exposures, contribute to rising burden from some conditions, but also provide opportunities for intervention. Some highly preventable risks, such as smoking, remain major causes of attributable DALYs, even as exposure is declining. Public policy makers need to pay attention to the risks that are increasingly major contributors to global burden. Copyright (C) The Author(s). Published by Elsevier Ltd

31st Annual Meeting and Associated Programs of the Society for Immunotherapy of Cancer (SITC 2016) : part two

Background The immunological escape of tumors represents one of the main ob- stacles to the treatment of malignancies. The blockade of PD-1 or CTLA-4 receptors represented a milestone in the history of immunotherapy. However, immune checkpoint inhibitors seem to be effective in specific cohorts of patients. It has been proposed that their efficacy relies on the presence of an immunological response. Thus, we hypothesized that disruption of the PD-L1/PD-1 axis would synergize with our oncolytic vaccine platform PeptiCRAd. Methods We used murine B16OVA in vivo tumor models and flow cytometry analysis to investigate the immunological background. Results First, we found that high-burden B16OVA tumors were refractory to combination immunotherapy. However, with a more aggressive schedule, tumors with a lower burden were more susceptible to the combination of PeptiCRAd and PD-L1 blockade. The therapy signifi- cantly increased the median survival of mice (Fig. 7). Interestingly, the reduced growth of contralaterally injected B16F10 cells sug- gested the presence of a long lasting immunological memory also against non-targeted antigens. Concerning the functional state of tumor infiltrating lymphocytes (TILs), we found that all the immune therapies would enhance the percentage of activated (PD-1pos TIM- 3neg) T lymphocytes and reduce the amount of exhausted (PD-1pos TIM-3pos) cells compared to placebo. As expected, we found that PeptiCRAd monotherapy could increase the number of antigen spe- cific CD8+ T cells compared to other treatments. However, only the combination with PD-L1 blockade could significantly increase the ra- tio between activated and exhausted pentamer positive cells (p= 0.0058), suggesting that by disrupting the PD-1/PD-L1 axis we could decrease the amount of dysfunctional antigen specific T cells. We ob- served that the anatomical location deeply influenced the state of CD4+ and CD8+ T lymphocytes. In fact, TIM-3 expression was in- creased by 2 fold on TILs compared to splenic and lymphoid T cells. In the CD8+ compartment, the expression of PD-1 on the surface seemed to be restricted to the tumor micro-environment, while CD4 + T cells had a high expression of PD-1 also in lymphoid organs. Interestingly, we found that the levels of PD-1 were significantly higher on CD8+ T cells than on CD4+ T cells into the tumor micro- environment (p < 0.0001). Conclusions In conclusion, we demonstrated that the efficacy of immune check- point inhibitors might be strongly enhanced by their combination with cancer vaccines. PeptiCRAd was able to increase the number of antigen-specific T cells and PD-L1 blockade prevented their exhaus- tion, resulting in long-lasting immunological memory and increased median survival

Measuring performance on the Healthcare Access and Quality Index for 195 countries and territories and selected subnational locations: a systematic analysis from the Global Burden of Disease Study 2016.

BACKGROUND: A key component of achieving universal health coverage is ensuring that all populations have access to quality health care. Examining where gains have occurred or progress has faltered across and within countries is crucial to guiding decisions and strategies for future improvement. We used the Global Burden of Diseases, Injuries, and Risk Factors Study 2016 (GBD 2016) to assess personal health-care access and quality with the Healthcare Access and Quality (HAQ) Index for 195 countries and territories, as well as subnational locations in seven countries, from 1990 to 2016. METHODS: Drawing from established methods and updated estimates from GBD 2016, we used 32 causes from which death should not occur in the presence of effective care to approximate personal health-care access and quality by location and over time. To better isolate potential effects of personal health-care access and quality from underlying risk factor patterns, we risk-standardised cause-specific deaths due to non-cancers by location-year, replacing the local joint exposure of environmental and behavioural risks with the global level of exposure. Supported by the expansion of cancer registry data in GBD 2016, we used mortality-to-incidence ratios for cancers instead of risk-standardised death rates to provide a stronger signal of the effects of personal health care and access on cancer survival. We transformed each cause to a scale of 0-100, with 0 as the first percentile (worst) observed between 1990 and 2016, and 100 as the 99th percentile (best); we set these thresholds at the country level, and then applied them to subnational locations. We applied a principal components analysis to construct the HAQ Index using all scaled cause values, providing an overall score of 0-100 of personal health-care access and quality by location over time. We then compared HAQ Index levels and trends by quintiles on the Socio-demographic Index (SDI), a summary measure of overall development. As derived from the broader GBD study and other data sources, we examined relationships between national HAQ Index scores and potential correlates of performance, such as total health spending per capita

Avaliação da atividade antibacteriana dos extratos metanólico e hexânico do caule folhado de Melissa Officinalis

Introducción: Melissa Officinalis L., de la familia Lamiaceae, es una hierba utilizada en la medicina popular. Es conocido en Brasil como erva cidreira, melisa, y melitéia cidrilha. Teniendo en cuenta que M. Officinalis L. se utiliza ampliamente en la medicina popular, entre ellos para uso antibacteriano, este trabajo tuvo como objetivo evaluar la actividad antibacteriana y modulador de extracto de metanol y hexano rodar el tallo de M. officinalis L. frente a las cepas de bacterias normas y las bacterias multirresistentes. Materiales y métodos: se analizó el extracto de metanol y hexano del tallo rodadura M. Officinalis L. para la actividad antibacteriana por una prueba de microdilución para la determinación de la Concentración Mínima Inhibitoria (mic) y la modulación de aminoglucósidos (gentamicina y amikacina). Resultados: en la evaluación de la mic los resultados obtenidos fueron ≥1024μg/ml con contra las bacterias (Escherichia coli y Staphylococcus aureus) en ambos extractos. El extracto de metanol mostró resultados significativos en combinación con efecto potenciador gentamicina contra E. coli y s. Aureus cuando se combina con amikacina, esta bacteria era antagonismo. Ya extracto de hexano dio lugar a una reducción de la mic de amikacina y gentamicina contra cepas de E. coli, que muestra el efecto antagónico con cepas de la cuenta de amikacina de S. Aureus. Conclusión: se concluye que el material vegetal influye en el comportamiento de los antimicrobianos, lo que hace este trabajo importante como parámetro para futuros estudios que puedan combatir la creciente resistencia de las bacterias.Introdução: Melissa officinalis, da família Lamiaceae, é uma erva comumente utilizada na medicina popular. É conhecida no Brasil como Melissa, erva cidreira, cidrilha e melitéia. Tendo em vista que M.officinalis L é largamente utilizada na medicina popular, dentre elas para uso antibacteriano, este trabalho teve como principal objetivo avaliar a atividade antibacteriana e modulatória de extratos metanólico e hexânico do caule folhado de M. officinalis L frente a cepas de bactérias padrões e multirresistentes. Materiais e métodos: Os extratosmetanólico e hexânico do caule folhado de M. officinalis L foram analisados para a atividade antibacteriana por meio de teste de microdiluição para determinação de concentração inibitória mínima (cim) e modulação de aminoglicosídeos (gentamicina e amicacina). Resultados: Na avaliação dacim foram obtidos resultados ≥1024μg/mLcontra as bactérias (Escherichia coli e Staphylococcus aureus) em ambos extratos. O extrato metanólico mostrou resultados relevantes em associação com gentamicina potencializando o efeito contra E. coli e S. aureus quando associado à amicacina, nesta bactéria houve antagonismo. Já o extrato hexânico, resultou em uma redução da cim de amicacina e gentamicina frente a linhagens de E. coli, mostrando efeito antagonista com a amicacina conta cepas de S. aureus. Conclusão: Conclui-se que o material vegetal influencia no comportamento dos antimicrobianos, tornando este trabalho importante como parâmetro para estudos mais aprofundados que possam combater a crescente resistência de bactérias patogênicas.Introduction: Melissa officinalis L., of the Lamiaceae family, is a herb commonly used on folkmedicine. In Brazil it is known as Melissa, erva cidreira, cidrilha and meliteia. Considering thatthe M. Officinalis L is widely used in folk medicine, as for antibacterial use, among others, themain objective of this work was to evaluate the antibacterial and modulating activity of methanolic and hexanic extracts of M. officinalis L against pattern and multidrug resistant bacterial strains. Materials and methods: The methanolic and hexanic extracts of the stem of puff pastry of M. officinalis L were analized to determine antibacterial activity by using the microdiluition for establishing the minimal inibitory concentration (MIC) and aminoglycosides (gentamicin and amikacin) modulation. Results: In the MIC evaluation, the results obtained were ≥1024μg/mL against bacteria (Escherichia coli and Staphylococcus aureus) in both extracts. The methanolic extract showed important results when associated with gentamicin, since it potentiates its effect against E. coli and S. aureus when associated with amikacin, where antagonism was found. As to the hexanic extract, it showed a MIC reduction of amikacin and gentamicin against S. aureus strains. Conclusion: It was concluded that the plant material influences the antimicrobial behavior, a fact that makes this study an important parameter to deeper studies to combat the increase of pathogenic multidrug-resistant bacteria

Avaliação da atividade antibacteriana dos extratos metanólico e hexânico do caule folhado de Melissa Officinalis

Introduction: Melissa officinalis L., of the Lamiaceae family, is a herb commonly used on folkmedicine. In Brazil it is known as Melissa, erva cidreira, cidrilha and meliteia. Considering thatthe M. Officinalis L is widely used in folk medicine, as for antibacterial use, among others, themain objective of this work was to evaluate the antibacterial and modulating activity of methanolic and hexanic extracts of M. officinalis L against pattern and multidrug resistant bacterial strains. Materials and methods: The methanolic and hexanic extracts of the stem of puff pastry of M. officinalis L were analized to determine antibacterial activity by using the microdiluition for establishing the minimal inibitory concentration (MIC) and aminoglycosides (gentamicin and amikacin) modulation. Results: In the MIC evaluation, the results obtained were ≥1024μg/mL against bacteria (Escherichia coli and Staphylococcus aureus) in both extracts. The methanolic extract showed important results when associated with gentamicin, since it potentiates its effect against E. coli and S. aureus when associated with amikacin, where antagonism was found. As to the hexanic extract, it showed a MIC reduction of amikacin and gentamicin against S. aureus strains. Conclusion: It was concluded that the plant material influences the antimicrobial behavior, a fact that makes this study an important parameter to deeper studies to combat the increase of pathogenic multidrug-resistant bacteria.Introdução: Melissa officinalis, da família Lamiaceae, é uma erva comumente utilizada na medicina popular. É conhecida no Brasil como Melissa, erva cidreira, cidrilha e melitéia. Tendo em vista que M.officinalis L é largamente utilizada na medicina popular, dentre elas para uso antibacteriano, este trabalho teve como principal objetivo avaliar a atividade antibacteriana e modulatória de extratos metanólico e hexânico do caule folhado de M. officinalis L frente a cepas de bactérias padrões e multirresistentes. Materiais e métodos: Os extratosmetanólico e hexânico do caule folhado de M. officinalis L foram analisados para a atividade antibacteriana por meio de teste de microdiluição para determinação de concentração inibitória mínima (cim) e modulação de aminoglicosídeos (gentamicina e amicacina). Resultados: Na avaliação dacim foram obtidos resultados ≥1024μg/mLcontra as bactérias (Escherichia coli e Staphylococcus aureus) em ambos extratos. O extrato metanólico mostrou resultados relevantes em associação com gentamicina potencializando o efeito contra E. coli e S. aureus quando associado à amicacina, nesta bactéria houve antagonismo. Já o extrato hexânico, resultou em uma redução da cim de amicacina e gentamicina frente a linhagens de E. coli, mostrando efeito antagonista com a amicacina conta cepas de S. aureus. Conclusão: Conclui-se que o material vegetal influencia no comportamento dos antimicrobianos, tornando este trabalho importante como parâmetro para estudos mais aprofundados que possam combater a crescente resistência de bactérias patogênicas.Introducción: Melissa Officinalis L., de la familia Lamiaceae, es una hierba utilizada en la medicina popular. Es conocido en Brasil como erva cidreira, melisa, y melitéia cidrilha. Teniendo en cuenta que M. Officinalis L. se utiliza ampliamente en la medicina popular, entre ellos para uso antibacteriano, este trabajo tuvo como objetivo evaluar la actividad antibacteriana y modulador de extracto de metanol y hexano rodar el tallo de M. officinalis L. frente a las cepas de bacterias normas y las bacterias multirresistentes. Materiales y métodos: se analizó el extracto de metanol y hexano del tallo rodadura M. Officinalis L. para la actividad antibacteriana por una prueba de microdilución para la determinación de la Concentración Mínima Inhibitoria (mic) y la modulación de aminoglucósidos (gentamicina y amikacina). Resultados: en la evaluación de la mic los resultados obtenidos fueron ≥1024μg/ml con contra las bacterias (Escherichia coli y Staphylococcus aureus) en ambos extractos. El extracto de metanol mostró resultados significativos en combinación con efecto potenciador gentamicina contra E. coli y s. Aureus cuando se combina con amikacina, esta bacteria era antagonismo. Ya extracto de hexano dio lugar a una reducción de la mic de amikacina y gentamicina contra cepas de E. coli, que muestra el efecto antagónico con cepas de la cuenta de amikacina de S. Aureus. Conclusión: se concluye que el material vegetal influye en el comportamiento de los antimicrobianos, lo que hace este trabajo importante como parámetro para futuros estudios que puedan combatir la creciente resistencia de las bacterias