Altered functional brain connectivity in a non-clinical sample of young adults with attention-deficit/hyperactivity disorder

Attention-deficit/hyperactivity disorder (ADHD) is characterized by symptoms of inattention and hyperactivity/impulsivity that often persist in adulthood. There is a growing consensus that ADHD is associated with abnormal function of diffuse brain networks, but such alterations remain poorly characterized. Using resting-state functional magnetic resonance imaging, we characterized multivariate (complex network measures), bivariate (network-based statistic), and univariate (regional homogeneity) properties of brain networks in a non-clinical, drug-naive sample of high-functioning young men and women with ADHD (nine males, seven females) and a group of matched healthy controls. Data from our sample allowed the isolation of intrinsic functional connectivity alterations specific to ADHD diagnosis and symptoms that are not related to developmental delays, general cognitive dysfunction, or history of medication use. Multivariate results suggested that frontal, temporal, and occipital cortices were abnormally connected locally as well as with the rest of the brain in individuals with ADHD. Results from the network-based statistic support and extend multivariate results by isolating two brain networks comprising regions between which inter-regional connectivity was significantly altered in the ADHD group; namely, a frontal amygdala-occipital network and a frontal temporal-occipital network. Brain behavior correlations further highlighted the key role of altered orbitofrontal-temporal and frontal-amygdala connectivity for symptoms of inattention and hyperactivity/impulsivity. All univariate properties were similar between groups. Taken together, results from this study show that the diagnosis and the two main symptom dimensions of ADHD are related to altered intrinsic connectivity in orbitofrontal-temporal-occipital and fronto-amygdala-occipital networks. Accordingly, our findings highlight the importance of extending the conceptualization of ADHD beyond segregated fronto-striatal alterations

Papanicolaou test in Brazil: analysis of the National Health Survey of 2013 and 2019

OBJETIVOS: Comparar a cobertura do rastreamento do câncer de colo do útero no Brasil em 2013 e 2019, investigar os fatores associados à realização do exame e os motivos informados para não ter realizado, além de comparar o tempo do recebimento do resultado do exame no SUS e na rede privada. MÉTODOS: A partir de dados da Pesquisa Nacional de Saúde (PNS) foram calculadas as prevalências e os respectivos intervalos de confiança de realização do exame preventivo do câncer do colo do útero há menos de três anos, em mulheres de 25 a 64 anos, em 2013 e 2019. Modelos de regressão de Poisson foram utilizados para comparar as prevalências do desfecho segundo características sociodemográficas. Também foram analisados os motivos para não ter feito o exame e o tempo entre a realização e o recebimento do laudo. RESULTADOS: Houve aumento na cobertura do exame preventivo no Brasil entre 2013 (78,7%) e 2019 (81,3%) e redução na proporção de mulheres que nunca fizeram o exame de 9,7% para 6,1%. A prevalência de realização do exame foi maior em mulheres brancas, melhor escolaridade e renda mais alta, residentes nas regiões Sul e Sudeste. Os motivos mais frequentes para não realizar o exame foram achar desnecessário (45% em 2013 e em 2019) e nunca ter sido orientada a fazê-lo (20,6% em 2013 e 14,8% em 2019). CONCLUSÕES: Apesar das elevadas coberturas de rastreamento alcançadas pelo país, há grande desigualdade no acesso ao exame, e uma parcela não desprezível de mulheres está sob maior risco de morrer por uma doença que pode ser evitada. Esforços devem ser feitos para a estruturação de um programa de rastreamento organizado que identifique e capte as mulheres mais vulneráveis.OBJECTIVES: To compare the coverage of cervical cancer screening in Brazil in 2013 and 2019, investigating the factors associated with having the test performed and the reasons given for not doing it. Additionally, a comparison is made concerning the time taken to receive the test result in SUS (Sistema Único de Saúde) and in the private health services. METHODS: Using data from the National Health Survey (Pesquisa Nacional de Saúde - PNS), prevalence rates and corresponding confidence intervals were calculated to determine the frequency of recent cervical cancer screenings among women aged between 25 and 64 years old in Brazil, for both 2013 and 2019. Poisson regression models were employed to compare the prevalence of the outcome according to sociodemographic characteristics. The reasons for not having the test and the time between performing and receiving the result were also analyzed. RESULTS: The findings revealed an increase in the coverage of preventive cervical cancer exams in Brazil from 78.7% in 2013 to 81.3% in 2019. Additionally, there was a decline in the proportion of women who had never undergone the exam, from 9.7% to 6.1%. Prevalence of test uptake was higher among white women, those with higher levels of education and income, and those residing in the South and Southeast regions of the country. The most commonly cited reasons for not taking the test were the impression it was unnecessary (45% in both 2013 and 2019) and never having been asked to undergo the test (20.6% in 2013 and 14.8% in 2019). CONCLUSIONS: Despite the high coverage of screening achieved in the country, there is great inequality in access to the test, and a non-negligible number of women are at greater risk of dying from a preventable disease. Efforts must be made to structure an organized screening program that identifies and captures the most vulnerable women

Environmental Exposure to Pesticides and Breast Cancer in a Region of Intensive Agribusiness Activity in Brazil: A Case-Control Study.

Background: Breast cancer is a serious public health problem and is the second most prevalent cancer type in the world. The purpose of this article is to evaluate the association between pesticide use and breast cancer in a region of intense agribusiness activity in the state of Mato Grosso, Brazil. Methods: A case-control study was conducted on women living in the city of Rondonópolis, in the south of Mato Grosso state. There were 85 cases of women with confirmed breast cancer and 266 controls who were randomly selected from primary health care users. Bivariate and stratified analyses were performed. Multiple logistic regression was then performed, keeping in the final model the factors with a significance level lower than or equal to 0.05 or considered important according to apriori biological criteria. Results: In the final model, living near cropland with pesticides (OR: 2.37; CI: 95% 1.78-3.16) and women aged over 50 years who experienced early menarche (OR: 2.08; CI: 95% 1.06-4.12) had a higher risk of developing breast cancer compared to control subjects. Conclusion: This study highlights the importance of exposure to pesticides as an environmental risk factor for the development of breast cancer among women

Abnormal Striatal BOLD Responses to Reward Anticipation and Reward Delivery in ADHD

Altered reward processing has been proposed to contribute to the symptoms of attention deficit hyperactivity disorder (ADHD). The neurobiological mechanism underlying this alteration remains unclear. We hypothesize that the transfer of dopamine release from reward to reward-predicting cues, as normally observed in animal studies, may be deficient in ADHD. Functional magnetic resonance imaging (fMRI) was used to investigate striatal responses to reward-predicting cues and reward delivery in a classical conditioning paradigm. Data from 14 high-functioning and stimulant-naïve young adults with elevated lifetime symptoms of ADHD (8 males, 6 females) and 15 well-matched controls (8 males, 7 females) were included in the analyses. During reward anticipation, increased blood-oxygen-level-dependent (BOLD) responses in the right ventral and left dorsal striatum were observed in controls, but not in the ADHD group. The opposite pattern was observed in response to reward delivery; the ADHD group demonstrated significantly greater BOLD responses in the ventral striatum bilaterally and the left dorsal striatum relative to controls. In the ADHD group, the number of current hyperactivity/impulsivity symptoms was inversely related to ventral striatal responses during reward anticipation and positively associated with responses to reward. The BOLD response patterns observed in the striatum are consistent with impaired predictive dopamine signaling in ADHD, which may explain altered reward-contingent behaviors and symptoms of ADHD

Elimination of Metastatic Melanoma Using Gold Nanoshell-Enabled Photothermal Therapy and Adoptive T Cell Transfer

Ablative treatments such as photothermal therapy (PTT) are attractive anticancer strategies because they debulk accessible tumor sites while simultaneously priming antitumor immune responses. However, the immune response following thermal ablation is often insufficient to treat metastatic disease. Here we demonstrate that PTT induces the expression of proinflammatory cytokines and chemokines and promotes the maturation of dendritic cells within tumor-draining lymph nodes, thereby priming antitumor T cell responses. Unexpectedly, however, these immunomodulatory effects were not beneficial to overall antitumor immunity. We found that PTT promoted the infiltration of secondary tumor sites by CD11b+Ly-6G/C+ myeloid-derived suppressor cells, consequently failing to slow the growth of poorly immunogenic B16-F10 tumors and enhancing the growth of distant lung metastases. To exploit the beneficial effects of PTT activity against local tumors and on antitumor immunity whilst avoiding the adverse consequences, we adoptively transferred gp100-specific pmel T cells following PTT. The combination of local control by PTT and systemic antitumor immune reactivity provided by adoptively transferred T cells prevented primary tumor recurrence post-ablation, inhibited tumor growth at distant sites, and abrogated the outgrowth of lung metastases. Hence, the combination of PTT and systemic immunotherapy prevented the adverse effects of PTT on metastatic tumor growth and optimized overall tumor control

Time-series forecasting of pollutant concentration levels using particle swarm optimization and artificial neural networks

This study evaluates the application of an intelligent hybrid system for time-series forecasting of atmospheric pollutant concentration levels. The proposed method consists of an artificial neural network combined with a particle swarm optimization algorithm. The method not only searches relevant time lags for the correct characterization of the time series, but also determines the best neural network architecture. An experimental analysis is performed using four real time series and the results are shown in terms of six performance measures. The experimental results demonstrate that the proposed methodology achieves a fair prediction of the presented pollutant time series by using compact networks

Nursing care to clients with arteriovenous fistula: an integrative review of the literature / Cuidados de enfermagem a clientes com fistula arteriovenosa: uma revisão integrativa da literatura

Objetivo: descrever os cuidados da equipe de enfermagem aos clientes portadores de Fistula Arteriovenosa (FAV). Método: revisão integrativa de literatura, que utilizou como questão de busca: quais são os cuidados da equipe de enfermagem aos clientes portadores de fístula arteriovenosa? A busca foi realizada na Biblioteca Virtual de Saúde, nas bases de dados: MEDLINE, LILACS e BDENF; PubMed; Portal de Periódicos da Capes, nas bases SCOPUS e CINAHL, em agosto de 2018. Resultados: foram encontrados três artigos indexados na LILACS e dois na CINAHL. Emergiu a categoria analítica do estudo intitulada: Cuidados de enfermagem aos clientes portadores de FAV, e duas unidades de decodificação: “Incorporação de evidências sobre a FAV, para se pensar os cuidados de enfermagem” e “Atuação da equipe de enfermagem na preservação da FAV: pensando o autocuidado”. Conclusões: os cuidados de enfermagem aos clientes portadores de FAV perpassaram pela durabilidade e a manutenção do seu funcionamento