RESUMEN
Reinfection and multiple viral strains are among the latest challenges in the current COVID-19 pandemic. In contrast, epidemic models often consider a single strain and perennial immunity. To bridge this gap, we present a new epidemic model that simultaneously considers multiple viral strains and reinfection due to waning immunity. The model is general, applies to any viral disease and includes an optimal control formulation to seek a trade-off between the societal and economic costs of mitigation. We validate the model, with and without mitigation, in the light of the COVID-19 epidemic in England and in the state of Amazonas, Brazil. The model can derive optimal mitigation strategies for any number of viral strains, whilst also evaluating the effect of distinct mitigation costs on the infection levels. The results show that relaxations in the mitigation measures cause a rapid increase in the number of cases, and therefore demand more restrictive measures in the future.
Asunto(s)
Algoritmos , COVID-19/prevención & control , Modelos Teóricos , Virosis/prevención & control , Brasil/epidemiología , COVID-19/epidemiología , COVID-19/virología , Simulación por Computador , Inglaterra/epidemiología , Epidemias/prevención & control , Humanos , SARS-CoV-2/fisiología , Virosis/epidemiología , Virosis/virologíaRESUMEN
BACKGROUND: The use of point-of-care testing (POCT) in different clinical applications is justified by the fact that the time to release the result is shortened, allowing the physician to define the diagnosis and most appropriate therapy in a shorter time. However, the negative aspects must also be highlighted and studied so that we can move forward with the use of these devices. These negative aspects include greater analytical imprecision compared to laboratory automation, the variability between different equipment from different manufacturers, the risk of inappropriate use, a low level of global regulation, higher costs compared with laboratory testing and cost ineffectiveness in terms of health care. Methods and. RESULTS: This review presents some clinical applications of POCT in different scenarios, such as for diabetes mellitus, infectious diseases, pediatrics, and chronic kidney disease, among others. CONCLUSIONS: We hope to see a global consensus on an acceptable quality standard for performing POCT that is adaptable, practical, and cost effective in primary care settings, ensuring patient safety, and minimizing the risk of harm.
Asunto(s)
Sistemas de Atención de Punto/normas , Pruebas en el Punto de Atención/normas , Enfermedades Transmisibles/diagnóstico , Enfermedades Transmisibles/terapia , Análisis Costo-Beneficio , Diabetes Mellitus/diagnóstico , Diabetes Mellitus/terapia , Humanos , Sistemas de Atención de Punto/economía , Sistemas de Atención de Punto/estadística & datos numéricos , Pruebas en el Punto de Atención/economía , Pruebas en el Punto de Atención/estadística & datos numéricos , Insuficiencia Renal Crónica/diagnóstico , Insuficiencia Renal Crónica/terapiaRESUMEN
Point-of-Care Testing (POCT) has been highlighted in the health care sector in recent decades. On the other hand, due to its low demand, POCT is at a disadvantage compared to conventional equipment, since its cost is inversely proportional to the volume of use. In addition, for the implementation of POCT to succeed, it is essential to rely on the work of a multidisciplinary team. The awareness of health professionals of the importance of each step is perhaps the critical success factor. The trend towards the continuous advancement of the use of POCT and the great potential of its contributions reinforce the need to implement quality management tools, including performance indicators, to ensure their results. This review presents some advantages and disadvantages concerning POCT and the real need to use it. A worldwide call for the availability of easy-to-use health technologies that are increasingly closer to the final user is one of the main reasons for this focus.
Asunto(s)
Técnicas de Laboratorio Clínico/normas , Guías como Asunto/normas , Sistemas de Atención de Punto/normas , Pruebas en el Punto de Atención/normas , Técnicas de Laboratorio Clínico/economía , Técnicas de Laboratorio Clínico/métodos , Análisis Costo-Beneficio , Humanos , Sistemas de Atención de Punto/economía , Pruebas en el Punto de Atención/economía , Reproducibilidad de los ResultadosRESUMEN
This paper shows the use of exhaled air as a biomonitoring method to assess perchloroethylene (PERC) environmental and occupational exposure. A sensitive, fast, and solvent free analytical method was developed to determine PERC in ambient and exhaled air of individuals occupationally exposed. The developed method used cold fiber solid phase microextraction (CF-SPME) as the sampling technique, and a standard permeation method to simulation of air matrix. The analysis were conducted by gas chromatography coupled to mass spectrometry (GC/MS). The methods were validated and were found to be precise, linear and sensitive for environmental and biological monitoring. The developed methods were applied to twenty-seven sampling points spread across Belo Horizonte city, Brazil, twenty four dry cleaners, an electroplating industry, a research laboratory, and an automotive paint preparation shop. The results of ambient air analyses ranging from 14.0 to 3205.0µgm-3 with median concentration of 599.0µgm-3. Furthermore, sampling of exhaled air of individuals occupationally exposed presented results ranging from 6.0 to 2635.0µgm-3 with median concentration of 325.0µgm-3. The strong correlation observed between ambient and exhaled air (r =0.930) demonstrates that exhaled air is a suitable biomarker for evaluating occupational exposure to PERC.
Asunto(s)
Contaminantes Ocupacionales del Aire/análisis , Contaminación del Aire Interior/análisis , Monitoreo del Ambiente/métodos , Espiración , Exposición Profesional , Tetracloroetileno/análisis , Adulto , Anciano , Biomarcadores/análisis , Brasil , Pruebas Respiratorias , Femenino , Cromatografía de Gases y Espectrometría de Masas , Humanos , Masculino , Persona de Mediana Edad , Microextracción en Fase Sólida , Adulto JovenRESUMEN
Acrolein is a pollutant released daily to the indoor environment from different sources. The present study reports the development of a simple and sensitive cold fiber solid phase microextraction sampling method for the determination of acrolein in exhaled air and indoor air by gas chromatography mass spectrometry. O-(2,3,4,5,6-pentafluorobenzyl) hydroxylamine was used as derivatizing agent supported on a 65-µm polydimethylsiloxane-divinylbenzene SPME fiber. An acrolein permeation tube at 326.25 ng min-1 rate was used to generate gaseous standards. The method shows good results for main validation parameters. The limits of detection and quantification were 2.88 and 5.08 µg m-3, respectively, for indoor analysis; and 2.40 and 3.79 µg m-3, respectively, for exhaled air analysis. The precision showed standard deviation ranges from 6.00 to 8.00% for intra-assay analyses and from 8.00 to 10.00% for inter-assay analyses. After optimizing the conditions, analyses of real samples were performed on indoor environments contaminated by cigarette smoke, or heated oil, including pastry shops, restaurants, churros stands, and closed parking cars located in the city of Belo Horizonte, Brazil. Acrolein breaths of exposed people were also determined. A good Pearson correlation coefficient (r = 0.901) was observed between the concentration of acrolein in indoor air and exhaled air, allowing to propose acrolein breath as environmental exposure biomarker. Graphical Abstract Cold fiber solid phase microextraction gas chromatography/mass spectrometry.
Asunto(s)
Acroleína/análisis , Contaminación del Aire Interior/análisis , Pruebas Respiratorias/métodos , Monitoreo del Ambiente/métodos , Cromatografía de Gases y Espectrometría de Masas/métodos , Microextracción en Fase Sólida/métodos , Acroleína/química , Humanos , Metales/química , Reproducibilidad de los Resultados , Sensibilidad y EspecificidadRESUMEN
Humane education and the debate on alternatives to harmful animal use for training is a relatively recent issue in Brazil. While animal use in secondary education has been illegal since the late 1970s, animal use in higher science education is widespread. However, alternatives to animal experiments in research and testing have recently received attention from the Government, especially after the first legislation on animal experiments was passed, in 2008. This article proposes that higher science education should be based on a critical and humane approach. It outlines the recent establishment of the Brazilian Network for Humane Education (RedEH), as a result of the project, Mapping Animal Use for Undergraduate Education in Brazil, which was recognised by the 2014 Lush Prize. The network aims to create a platform to promote change in science education in Brazil, starting by quantitatively and qualitatively understanding animal use, developing new approaches adapted to the current needs in Brazil and Latin America, and communicating these initiatives nationally. This paper explores the trajectory of alternatives and replacement methods to harmful animal use in training and education, as well as the status of humane education in Brazil, from the point of view of educators and researchers engaged with the network.
Asunto(s)
Alternativas a las Pruebas en Animales/educación , Animales , Brasil , Humanismo , HumanosRESUMEN
Coffee is a major tropical agricultural commodity and represents a significant fraction of the economy of many countries. However, certain plant and animal species can damage coffee crops, affecting trade. A solution to this issue is the use of pesticides, some of which are harmful to human health and the environment. This work consisted of the development of a multi-residue method for the analysis of pesticides in coffee by using LC-MS/MS. The QuEChERS extraction procedure was used. The following analytical parameters were optimised: selectivity, analytical range, linearity, LOD, LOQ, precision (RSD%) and recovery of the method. The results showed that the method is selective, as they were linear in the range of 10.0-100.0 µg kg(-1). The sensitivity, recovery and precision were adequate for the multi-residue analysis of pesticides in coffee. The method was applied to the analyses of 15 Brazilian coffee samples.