Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 168
Filtrar
1.
Am J Gastroenterol ; 119(7): 1272-1284, 2024 07 01.
Artigo em Inglês | MEDLINE | ID: mdl-38595149

RESUMO

Irritable bowel syndrome (IBS) is responsive to treatments using central neuromodulators. Central neuromodulators work by enhancing the synaptic transmission of 5-hydroxytryptamine, noradrenalin, and dopamine, achieving a slower regulation or desensitization of their postsynaptic receptors. Central neuromodulators act on receptors along the brain-gut axis, so they are useful in treating psychiatric comorbidities, modifying gut motility, improving central downregulation of visceral signals, and enhancing neurogenesis in patients with IBS. Choosing a central neuromodulator for treating IBS should be according to the pharmacological properties and predominant symptoms. The first-line treatment for pain management in IBS is using tricyclic antidepressants. An alternative for pain management is the serotonin and noradrenaline reuptake inhibitors. Selective serotonin reuptake inhibitors are useful when symptoms of anxiety and hypervigilance are dominant but are not helpful for treating abdominal pain. The predominant bowel habit is helpful when choosing a neuromodulator to treat IBS; selective serotonin reuptake inhibitors help constipation, not pain, but may cause diarrhea; tricyclic antidepressants help diarrhea but may cause constipation. A clinical response may occur in 6-8 weeks, but long-term treatment (usually 6-12 months) is required after the initial response to prevent relapse. Augmentation therapy may be beneficial when the therapeutic effect of the first agent is incomplete or associated with side effects. It is recommended to reduce the dose of the first agent and add a second complementary treatment. This may include an atypical antipsychotic or brain-gut behavioral treatment. When tapering central neuromodulators, the dose should be reduced slowly over 4 weeks but may take longer when discontinuation effects occur.


Assuntos
Síndrome do Intestino Irritável , Neurotransmissores , Humanos , Síndrome do Intestino Irritável/tratamento farmacológico , Síndrome do Intestino Irritável/fisiopatologia , Neurotransmissores/uso terapêutico , Antidepressivos Tricíclicos/uso terapêutico , Inibidores Seletivos de Recaptação de Serotonina/uso terapêutico , Eixo Encéfalo-Intestino/fisiologia , Inibidores da Recaptação de Serotonina e Norepinefrina/uso terapêutico
2.
Ann Emerg Med ; 84(3): 234-243, 2024 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-38661620

RESUMO

STUDY OBJECTIVE: Identification of HIV remains a critical health priority for which emergency departments (EDs) are a central focus. The comparative cost-effectiveness of various HIV screening strategies in EDs remains largely unknown. The goal of this study was to compare programmatic costs and cost-effectiveness of nontargeted and 2 forms of targeted opt-out HIV screening in EDs using results from a multicenter, pragmatic randomized clinical trial. METHODS: This economic evaluation was nested in the HIV Testing Using Enhanced Screening Techniques in Emergency Departments (TESTED) trial, a multicenter pragmatic clinical trial of different ED-based HIV screening strategies conducted from April 2014 through January 2016. Patients aged 16 years or older, with normal mental status and not critically ill, or not known to be living with HIV were randomized to 1 of 3 HIV opt-out screening approaches, including nontargeted, enhanced targeted, or traditional targeted, across 4 urban EDs in the United States. Each screening method was fully integrated into routine emergency care. Direct programmatic costs were determined using actual trial results, and time-motion assessment was used to estimate personnel activity costs. The primary outcome was newly diagnosed HIV. Total annualized ED programmatic costs by screening approach were calculated using dollars adjusted to 2023 as were costs per patient newly diagnosed with HIV. One-way and multiway sensitivity analyses were performed. RESULTS: The trial randomized 76,561 patient visits, resulting in 14,405 completed HIV tests, and 24 (0.2%) new diagnoses. Total annualized new diagnoses were 12.9, and total annualized costs for nontargeted, enhanced targeted, and traditional targeted screening were $111,861, $88,629, and $70,599, respectively. Within screening methods, costs per new HIV diagnoses were $20,809, $23,554, and $18,762, respectively. Enhanced targeted screening incurred higher costs but with similar annualized new cases detected compared with traditional targeted screening. Nontargeted screening yielded an incremental cost-effectiveness ratio of $25,586 when compared with traditional targeted screening. Results were most sensitive to HIV prevalence and costs of HIV tests. CONCLUSION: Nontargeted HIV screening was more costly than targeted screening largely due to an increased number of HIV tests performed. Each HIV screening strategy had similar within-strategy costs per new HIV diagnosis with traditional targeted screening yielding the lowest cost per new diagnosis. For settings with budget constraints or very low HIV prevalences, the traditional targeted approach may be preferred; however, given only a slightly higher cost per new HIV diagnosis, ED settings looking to detect the most new cases may prefer nontargeted screening.


Assuntos
Análise Custo-Benefício , Serviço Hospitalar de Emergência , Infecções por HIV , Programas de Rastreamento , Humanos , Serviço Hospitalar de Emergência/economia , Infecções por HIV/diagnóstico , Infecções por HIV/economia , Programas de Rastreamento/economia , Programas de Rastreamento/métodos , Feminino , Adulto , Masculino , Estados Unidos , Pessoa de Meia-Idade , Teste de HIV/economia , Teste de HIV/métodos , Adulto Jovem
3.
J Bodyw Mov Ther ; 36: 5-13, 2023 10.
Artigo em Inglês | MEDLINE | ID: mdl-37949598

RESUMO

BACKGROUND AND PURPOSE: Exercise-based interventions can be a safe alternative to improve and maintain physical and mental health during the aging process. The aim of the present study was to evaluate the effects of a 12-week training program with Dance Exergames on the mood and functional fitness profile of elderly women. METHODS: The sample (n = 22) was divided into Exergames (EG, n = 9, 70.6 ± 1.6 years) and Control Groups (CG, n = 13, 73.6 ± 2.2 years). Evaluations were carried out before and after the interventions. Each participant played, in pairs, the electronic game Dance Central 3, with the XBOX 360 Kinect console (Slim, Microsoft, USA). The EG trained for 12 weeks (24 sessions), with two weekly sessions of 50 min and the CG performed manual activities workshops. RESULTS: In functional fitness, both exercise training with exergame (EG) and the intervention model for the CG did not produce significant effects regarding interaction (group*time). Mood state presented significant effect of time intervention regarding tension (p = <0.001), depression (p = 0.001), anger (p = 0.030), fatigue (p = 0.001), and mental confusion (p = 0.004). CONCLUSION: Twelve weeks of training with a dance exergame (for, EG) and manual activities (for, CG) is enough to promote improvements in the mood state of healthy elderly women. This is an interesting result, as it shows that social interaction is as important a component as improving functional capacity.


Assuntos
Dança , Jogos Eletrônicos de Movimento , Humanos , Feminino , Idoso , Brasil , Exercício Físico/psicologia , Qualidade de Vida
4.
Front Oncol ; 13: 1207578, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37886167

RESUMO

Background: High-quality clinical care requires excellent interdisciplinary communication, especially during emergencies, and no tools exist to evaluate communication in critical care. We describe the development of a pragmatic tool focusing on interdisciplinary communication during patient deterioration (CritCom). Methods: The preliminary CritCom tool was developed after a literature review and consultation with a multidisciplinary panel of global experts in communication, pediatric oncology, and critical care to review the domains and establish content validity iteratively. Face and linguistic validity were established through cognitive interviews, translation, and linguistic synthesis. We conducted a pilot study among an international group of clinicians to establish reliability and usability. Results: After reviewing 105 potential survey items, we identified 52 items across seven domains. These were refined through cognitive interviews with 36 clinicians from 15 countries. CritCom was piloted with 433 clinicians (58% nurses, 36% physicians, and 6% other) from 42 hospitals in 22 countries. Psychometric testing guided the refinement of the items for the final tool. CritCom comprised six domains with five items each (30 total). The final tool has excellent reliability (Cronbach's alpha 0.81-0.86), usability (93% agree or strongly agree that the tool is easy to use), and similar performance between English and Spanish tools. Confirmatory factor analysis was used to establish the final 6-domain structure. Conclusions: CritCom is a reliable and pragmatic bilingual tool to assess the quality of interdisciplinary communication around patient deterioration for children in diverse resource levels globally. Critcom results can be used to design and evaluate interventions to improve team communication.

5.
JHEP Rep ; 5(8): 100727, 2023 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-37456675

RESUMO

Background & Aims: Model for End-Stage Liver Disease (MELD) score better predicts mortality in alcohol-associated hepatitis (AH) but could underestimate severity in women and malnourished patients. Using a global cohort, we assessed the ability of the MELD 3.0 score to predict short-term mortality in AH. Methods: This was a retrospective cohort study of patients admitted to hospital with AH from 2009 to 2019. The main outcome was all-cause 30-day mortality. We compared the AUC using DeLong's method and also performed a time-dependent AUC with competing risks analysis. Results: A total of 2,124 patients were included from 28 centres from 10 countries on three continents (median age 47.2 ± 11.2 years, 29.9% women, 71.3% with underlying cirrhosis). The median MELD 3.0 score at admission was 25 (20-33), with an estimated survival of 73.7% at 30 days. The MELD 3.0 score had a better performance in predicting 30-day mortality (AUC:0.761, 95%CI:0.732-0.791) compared with MELD sodium (MELD-Na; AUC: 0.744, 95% CI: 0.713-0.775; p = 0.042) and Maddrey's discriminant function (mDF) (AUC: 0.724, 95% CI: 0.691-0.757; p = 0.013). However, MELD 3.0 did not perform better than traditional MELD (AUC: 0.753, 95% CI: 0.723-0.783; p = 0.300) and Age-Bilirubin-International Normalised Ratio-Creatinine (ABIC) (AUC:0.757, 95% CI: 0.727-0.788; p = 0.765). These results were consistent in competing-risk analysis, where MELD 3.0 (AUC: 0.757, 95% CI: 0.724-0.790) predicted better 30-day mortality compared with MELD-Na (AUC: 0.739, 95% CI: 0.708-0.770; p = 0.028) and mDF (AUC:0.717, 95% CI: 0.687-0.748; p = 0.042). The MELD 3.0 score was significantly better in predicting renal replacement therapy requirements during admission compared with the other scores (AUC: 0.844, 95% CI: 0.805-0.883). Conclusions: MELD 3.0 demonstrated better performance compared with MELD-Na and mDF in predicting 30-day and 90-day mortality, and was the best predictor of renal replacement therapy requirements during admission for AH. However, further prospective studies are needed to validate its extensive use in AH. Impact and implications: Severe AH has high short-term mortality. The establishment of treatments and liver transplantation depends on mortality prediction. We evaluated the performance of the new MELD 3.0 score to predict short-term mortality in AH in a large global cohort. MELD 3.0 performed better in predicting 30- and 90-day mortality compared with MELD-Na and mDF, but was similar to MELD and ABIC scores. MELD 3.0 was the best predictor of renal replacement therapy requirements. Thus, further prospective studies are needed to support the wide use of MELD 3.0 in AH.

6.
Spectrochim Acta A Mol Biomol Spectrosc ; 300: 122841, 2023 Nov 05.
Artigo em Inglês | MEDLINE | ID: mdl-37269658

RESUMO

Automating infrared spectra interpretation in microplastic identification is of interest since most current methodologies are conducted manually or semi-automatically, which requires substantial processing time and presents a higher accuracy limited to single-polymer materials. Furthermore, when it comes to multicomponent or weathered polymeric materials commonly found in aquatic environments, identification usually becomes considerably depreciated as peaks shift and new signals are frequently observed, representing a significant deviation from reference spectral signatures. Therefore, this study aimed to develop a reference modeling framework for polymer identification through infrared spectra processing, addressing the limitations above. The case study selected for model development was polypropylene (PP) identification, as it is the second most abundant material in microplastics. Therefore, the database comprises 579 spectra with 52.3% containing PP to some degree. Different pretreatment and model parameters were evaluated for a more robust investigation, totaling 308 models, including multilayer perceptron and long-short-term memory architectures. The best model presented a test accuracy of 94.8% within the cross-validation standard deviation interval. Overall, the results achieved in this study indicate an opportunity to investigate the identification of other polymers following the same framework.


Assuntos
Plásticos , Polímeros , Redes Neurais de Computação , Polipropilenos
7.
Am J Dermatopathol ; 45(6): 423-424, 2023 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-37073986

RESUMO

ABSTRACT: Dysplastic nevi are an important subset of melanocytic nevi with atypical clinical, histopathologic, as well as genomic features compared with common acquired nevi. Dysplastic nevi are characterized histologically by both cytologic atypia and architectural disorder. The established criteria for cytologic atypia used to distinguish between low-grade and high-grade dysplastic nevi are often subjective, although there is a dearth of more objective, reproducible features of architectural disorder (eg, pagetoid scatter) that have been validated to differentiate between low-grade and high-grade dysplastic nevi. In this study, we sought to determine whether the presence and degree of follicular extension differ between low-grade and high-grade dysplastic nevi. We retrospectively examined the histopathologic features of 90 dysplastic nevi: 60 cases of low-grade dysplastic nevi (average age of 47.2 ± 18.1 years; 62.7% female) and 30 cases of high-grade dysplastic nevi (average age of 47.4 ± 19.8 years; 60.0% female). After examination, 50% of the cases of dysplastic nevi (n = 45) had hair follicles within the lesion, for which the presence and degree of follicular extension was then determined. Low-grade and high-grade dysplastic nevi do not differ significantly regarding the presence of follicular extension, average depth of follicular extension, and confluence of nevus cells along the follicular epithelium. Both low-grade and high-grade dysplastic nevi in our study demonstrated follicular extension that was superficial, that is, above the level of isthmus of hair follicles (insertion of sebaceous gland into hair follicle). Future studies are warranted to confirm these preliminary findings.


Assuntos
Síndrome do Nevo Displásico , Nevo Pigmentado , Nevo , Neoplasias Cutâneas , Humanos , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Masculino , Síndrome do Nevo Displásico/patologia , Neoplasias Cutâneas/patologia , Estudos Retrospectivos , Nevo Pigmentado/patologia , Hiperplasia
8.
J Vasc Surg Cases Innov Tech ; 8(4): 674-677, 2022 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-36325315

RESUMO

We have presented the case of a symptomatic, primarily infected aortic pseudoaneurysm treated with endovascular stent graft exclusion and adjunctive use of a long-acting biocomposite antibiotic material injected directly into the pseudoaneurysm sac. We have described preparation of the biocomposite antibiotic material and the catheter-directed delivery technique in detail. Although the use of long-acting antibiotic materials such as antibiotic beads has been well described when performing open surgery in an infected field, the application of these materials in endovascular procedures has been less certain. The techniques we have described have the potential to promote field sterilization in a minimally invasive manner for patients with aortic infections who could be poor candidates for open surgery.

9.
Front Plant Sci ; 13: 995307, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36247585

RESUMO

In this work, we report a successful protocol to obtain in vitro peach palm (Bactris gasipaes Kunth) "Diamantes 10" plants through somatic embryogenesis from transverse thin cell layer (TCL) explants, dissected from three sections (basal, medial, and apical) of lateral offshoots of adult plants cultured on different concentrations of 4-amino-3,5,6-trichloropicolonic acid (picloram). After swelling and development of primary callus in all treatments, without any strong effect of explant origin or picloram concentration, it was possible to observe the formation of embryogenic structures and the exact point from where they developed. Browning was also observed and correlated to the induction treatments, although it was not an impairment for the production of embryogenic structures. Subsequent maturation and conversion of somatic embryos into plantlets allowed their acclimatization 17 months after culture initiation (ACI), which was quicker than previous reports with juvenile tissues (from embryos or seed-germinated plantlets). To the best of our knowledge, this is the first report on peach palm regeneration through somatic embryogenesis from TCL explants from adult plants and could constitute, after fine-tuning the acclimatization stage, a tool for mass clonal propagation of elite genotypes of this open-pollinated crop, as well as for the establishment of conservation strategies of in situ gene bank plant accessions endangered due to aging and other threats.

10.
Sci Data ; 9(1): 489, 2022 08 10.
Artigo em Inglês | MEDLINE | ID: mdl-35948576

RESUMO

The lack of georeferencing in geospatial datasets hinders the accomplishment of scientific studies that rely on accurate data. This is particularly concerning in the field of health sciences, where georeferenced data could lead to scientific results of great relevance to society. The Brazilian health systems, especially those for Notifiable Diseases, in practice do not register georeferenced data; instead, the records indicate merely the municipality in which the event occurred. Typically in data-driven modeling, accurate disease prediction models based on occurrence requires socioenvironmental characteristics of the exact location of each event, which is often unavailable. To enrich the expressiveness of data-driven models when the municipality of the event is the best available information, we produced datasets with statistical characterization of all 5,570 Brazilian municipalities in 642 layers of thematic data that represent the natural and artificial characteristics of the municipalities' landscapes over time. This resulted in a collection of datasets comprising a total of 11,556 descriptive statistics attributes for each municipality.

11.
Zootaxa ; 5116(2): 253-266, 2022 Mar 18.
Artigo em Inglês | MEDLINE | ID: mdl-35391336

RESUMO

A new species of Hyphessobrycon presenting dimorphic males is described from the western Amazon basin in Brazil, Colombia, Ecuador, and Peru. The new species has been mistakenly identified in the literature with the non-congener Hemigrammus marginatus, with which shares a similar color pattern by presenting dark patches of dark pigmentation on caudal-fin lobes. It can be distinguished from the latter species, as well as from Hemigrammus durbinae, and two similar congeners, Hyphessobrycon diancistrus and Hy. otrynus, all of which sharing the same caudal fin color pattern, by the combination of presenting a dark patch of pigmentation on the dorsal fin, a single large anal-fin hook at the last unbranched anal-fin ray in mature males, and a moderately high body depth (22.432.5 % SL, mean 28.4 %). The new species is more similar to Hyphessobrycon diancistrus, which is putatively its closely related taxon. A putative close relationship with Hyphessobrycon otrynus, and with a non-congener presenting a distinct color pattern but sharing a similar sexual dimorphism on anal-fin hook morphology, Hemigrammus boesemani, is suggested.


Assuntos
Characidae , Caraciformes , Animais , Characidae/anatomia & histologia , Masculino , Pigmentação , Rios , Caracteres Sexuais
12.
Nat Commun ; 13(1): 629, 2022 02 02.
Artigo em Inglês | MEDLINE | ID: mdl-35110564

RESUMO

The largest living rodent, capybara, can efficiently depolymerize and utilize lignocellulosic biomass through microbial symbiotic mechanisms yet elusive. Herein, we elucidate the microbial community composition, enzymatic systems and metabolic pathways involved in the conversion of dietary fibers into short-chain fatty acids, a main energy source for the host. In this microbiota, the unconventional enzymatic machinery from Fibrobacteres seems to drive cellulose degradation, whereas a diverse set of carbohydrate-active enzymes from Bacteroidetes, organized in polysaccharide utilization loci, are accounted to tackle complex hemicelluloses typically found in gramineous and aquatic plants. Exploring the genetic potential of this community, we discover a glycoside hydrolase family of ß-galactosidases (named as GH173), and a carbohydrate-binding module family (named as CBM89) involved in xylan binding that establishes an unprecedented three-dimensional fold among associated modules to carbohydrate-active enzymes. Together, these results demonstrate how the capybara gut microbiota orchestrates the depolymerization and utilization of plant fibers, representing an untapped reservoir of enzymatic mechanisms to overcome the lignocellulose recalcitrance, a central challenge toward a sustainable and bio-based economy.


Assuntos
Microbioma Gastrointestinal , Plantas/metabolismo , Polissacarídeos/metabolismo , Roedores/microbiologia , Animais , Bactérias/classificação , Bactérias/enzimologia , Bactérias/metabolismo , Bacteroidetes/enzimologia , Bacteroidetes/genética , Bacteroidetes/metabolismo , Metabolismo dos Carboidratos , Cristalografia por Raios X , Fibras na Dieta/metabolismo , Glicosídeo Hidrolases/metabolismo , Lignina , Filogenia , Simbiose , Xilanos/metabolismo
13.
J Arthroplasty ; 37(6S): S70-S75, 2022 06.
Artigo em Inglês | MEDLINE | ID: mdl-35210145

RESUMO

BACKGROUND: Postoperative orthostatic intolerance can limit mobilization after hip and knee arthroplasty. The literature is lacking on the incidence and risk factors associated with orthostatic intolerance after elective arthroplasty. METHODS: A retrospective case-control study of primary total hip, total knee, and unicompartmental knee arthroplasty patients was conducted. Patients with orthostatic events were identified, and potential demographic and perioperative risk factors were recorded. Orthostatic intolerance was defined as postoperative syncope, lightheadedness, or dizziness, limiting ambulation and/or requiring medical treatment. Statistical analysis was completed using Pearson's chi-square test for categorical data and t-tests for continuous data. Binary logistic regression was performed. RESULTS: A total of 500 consecutive patients were included. The overall incidence of orthostatic intolerance was 18%; 25% in total hip arthroplasty (THA) and 11% in total knee arthroplasty. On univariate analysis, significant risk factors for developing postoperative orthostatic intolerance include older age, female gender, THA surgery, lower American Society of Anesthesiologists class, absence of recreational drug use, lower estimated blood volume, lower preoperative diastolic blood pressure, spinal with monitored anesthesia care (MAC), posterior approach for THA, bupivacaine use in spinal, percent of blood loss, postoperative oxycodone or tramadol use, higher postoperative intravenous fluid volume, and lower postoperative hemoglobin. Multivariate analysis demonstrated persistent significance of female gender, THA surgery, spinal with MAC, bupivacaine use in spinal, and more intravenous fluid administered postoperatively. CONCLUSION: Orthostatic intolerance affects a significant number of arthroplasty patients. Awareness of risk factors and modification of perioperative variables linked to orthostatic intolerance may assist the surgeon in choosing the appropriate surgical setting, educating patients, and improving early postoperative recovery.


Assuntos
Artroplastia de Quadril , Artroplastia do Joelho , Intolerância Ortostática , Artroplastia de Quadril/efeitos adversos , Artroplastia do Joelho/efeitos adversos , Bupivacaína , Estudos de Casos e Controles , Tontura/complicações , Feminino , Humanos , Incidência , Intolerância Ortostática/complicações , Intolerância Ortostática/epidemiologia , Complicações Pós-Operatórias/epidemiologia , Complicações Pós-Operatórias/etiologia , Estudos Retrospectivos , Fatores de Risco
14.
J Environ Qual ; 51(2): 193-204, 2022 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-35098536

RESUMO

Cover cropping is used to improve soil quality and increase N inputs in agricultural systems, but it also may enhance greenhouse gases (GHG) emissions. Here, a 47-d incubation study was conducted to track the decomposition process and evaluate GHG emissions and its drivers and to calculate the C costs of residue-derived N released following the addition of residues from cover crops (pigeon pea, cowpea, lablab bean, vetch, and black oat) and maize under two water-filled pore space (WFPS) levels (40 and 70%). For both WFPS levels, the increase in cumulative CO2 fluxes in plots that received residues is mainly related with the increment of potentially mineralizable C. Crop residues increased the global warming potential (GWP) under both WFPS levels, with CO2 emissions accounting for ≥98% of the GWP at 40% WFPS. At 70% WFPS, the GPW increment was driven by a notable increase in N2 O emissions. The contribution of CH4 in the GWP emissions was negligible for all the crop residues evaluated. Principal component analysis highlighted that the optimal conditions for production and release are specific for each GHG. The cleaner N source was cowpea at 40% WFPS, which produced only 17.7 kg CO2 -eq kg-1 N mineralized, compared with vetch residues, which produced 233 kg CO2 -eq kg-1 N mineralized. To integrate agronomic and climate change mitigation perspectives, we suggest considering the C costs of the residue-N released when choosing a cover crop.


Assuntos
Gases de Efeito Estufa , Agricultura , Dióxido de Carbono/análise , Produtos Agrícolas , Gases de Efeito Estufa/análise , Metano/análise , Óxido Nitroso/análise , Solo/química
15.
Lancet Reg Health Am ; 13: 100298, 2022 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-36777324

RESUMO

Background: Population-based data on epidemiology of Inflammatory Bowel Diseases (IBD) in Brazil are scarce. This study aims to define temporal trends of incidence and prevalence rates of Crohn's disease (CD) and ulcerative colitis (UC) in Brazil. Methods: All IBD patients from the public healthcare national system were included from January 2012 to December 2020. Average Annual Percent Change (AAPC) and 95% confidence intervals (CI) were calculated using log-linear regression for incidence and binomial regression for prevalence. Moran's I autocorrelation index was used to analyse clustering of cities by level of prevalence. Findings: A total of 212,026 IBD patients were included. Incidence of IBD rose from 9.4 in 2012 to 9.6 per 100,000 in 2020 (AAPC=0.8%; 95% CI -0.37, 1.99); for UC, incidence increased from 5.7 to 6.9 per 100,000 (AAPC=3.0%; 95% CI 1.51, 4.58) and for CD incidence decreased from 3.7 to 2.7 per 100,000 (AAPC=-3.2%; 95% CI -4.45, -2.02). Prevalence of IBD increased from 30.0 in 2012 to 100.1 per 100,000 in 2020 (AAPC=14.8%; CI 14.78-14.95); for UC, from 15.7 to 56.5 per 100,000 (AAPC=16.0%; CI 15.94, 16.17); for CD from 12.6 to 33.7 per 100,000 (AAPC=12.1% CI 11.95, 12.02). A south-north gradient was observed in 2020 prevalence rates of IBD [I=0.40 (p<0.0001)], CD [I=0.22 (p<0.0001)] and UC [I=0.42 (p<0.0001)]. Interpretation: Incidence of CD is decreasing whereas of UC is increasing, leading to stabilization in the incidence of IBD from 2012 to 2020 in Brazil. Prevalence of IBD has been climbing with 0.1% of Brazilians living with IBD in 2020. Funding: None.

16.
J Sports Med Phys Fitness ; 62(4): 560-567, 2022 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33721985

RESUMO

BACKGROUND: Anxiety disorders affect many people around the world and women are more affected than men. Physical exercise might be an important nonpharmacological tool to ameliorate these disorders. The aim of this study was to compare state anxiety level and enjoyment between a dance exergame session and a traditional aerobic exercise. METHODS: Twenty healthy young women completed 3 visits, on separate days. At the first visit, participants performed a graded exercise testing and familiarization procedures. In other two visits, participants completed two exercise sessions (dance exergame and traditional aerobic exercise), with similar intensities and duration. Each session lasted approximately 45 minutes. State anxiety level was evaluated before, immediately post- and 10 minutes post-sessions. Enjoyment was evaluated immediately post-sessions. RESULTS: There was a significant interaction between session and time (P<0.001), a main effect of time (P=0.007) but no significant main effect of session (P=0.057) on state anxiety level. State anxiety level immediately post (P<0.001) and 10 minutes postsession (P<0.001) were significantly lower than predance exergame session. There were no significant changes between pre-, immediately post and 10 minutes post-traditional aerobic exercise session (P>0.05). State anxiety level at immediately post dance exergame session was significantly lower than immediately post traditional aerobic exercise session (P=0.026). Dance exergame session was significantly more enjoyable than traditional aerobic exercise session (P<0.0001). CONCLUSIONS: Dance exergames might be used as a tool to reduce anxiety level in young women.


Assuntos
Dança , Ansiedade/prevenção & controle , Transtornos de Ansiedade , Exercício Físico , Jogos Eletrônicos de Movimento , Feminino , Humanos , Masculino , Prazer
17.
Sci Rep ; 11(1): 18159, 2021 09 13.
Artigo em Inglês | MEDLINE | ID: mdl-34518574

RESUMO

Ichthyological surveys have traditionally been conducted using whole-specimen, capture-based sampling with varied but conventional fishing gear. Recently, environmental DNA (eDNA) metabarcoding has emerged as a complementary, and possible alternative, approach to whole-specimen methodologies. In the tropics, where much of the diversity remains undescribed, vast reaches continue unexplored, and anthropogenic activities are constant threats; there have been few eDNA attempts for ichthyological inventories. We tested the discriminatory power of eDNA using MiFish primers with existing public reference libraries and compared this with capture-based methods in two distinct ecosystems in the megadiverse Amazon basin. In our study, eDNA provided an accurate snapshot of the fishes at higher taxonomic levels and corroborated its effectiveness to detect specialized fish assemblages. Some flaws in fish metabarcoding studies are routine issues addressed in natural history museums. Thus, by expanding their archives and adopting a series of initiatives linking collection-based research, training and outreach, natural history museums can enable the effective use of eDNA to survey Earth's hotspots of biodiversity before taxa go extinct. Our project surveying poorly explored rivers and using DNA vouchered archives to build metabarcoding libraries for Neotropical fishes can serve as a model of this protocol.


Assuntos
Biodiversidade , DNA Ambiental/análise , Peixes/genética , Museus , Animais , Código de Barras de DNA Taxonômico , Análise de Dados , Bases de Dados Genéticas , Peixes/classificação , Filogenia , Rios , América do Sul , Especificidade da Espécie , Inquéritos e Questionários
18.
Artigo em Inglês | MEDLINE | ID: mdl-34300057

RESUMO

BACKGROUND: It is well known that athletes originating from a specific region or country can master specific sports disciplines (e.g., East-African runners in long-distance running). In addition, physical and athletic performance are the result of an interaction between genetic, environmental and epigenetic factors. However, little is known about on what determines sports success and performance for long-distance master swimmers such as origin. The aim of the study was to investigate the participation and performance trends of elite master open-water swimmers competing in the World Championships (WC) in 3000 m open-water swimming between 1986 and 2019. METHODS: A total of 9247 valid participants were analyzed using generalized linear models (GLMs) with a gamma probability distribution and log link function. Resultsː Most of the starters were from Italy (1646 participations), followed by the United States of America (USA) (1128 participations) and Germany (959 participations). Swimmers from Italy were significantly faster than swimmers from Canada, Germany, USA, Great Britain and also from all other countries grouped (p < 0.005). The age group from 35-39 years old was significantly faster than athletes from age groups of 25-29 years old, 30-34 years old, 40-44 years old, 45-49 years old and 50-54 years old (p < 0.005). The percentage of local athletes in WC was 36% and varied from 36% (Italy, 2004) to 43 % (Germany), 53% (Italy, 2012) and up to 68 % (USA, 1992). CONCLUSIONS: Swimmers from Italy were the faster and the most numerous starters during this period of 27 years and 15 editions all over the world in 3000 m master open-water swimming.


Assuntos
Natação , Água , Adulto , Canadá , Alemanha , Humanos , Itália , Pessoa de Meia-Idade , Reino Unido , Estados Unidos
19.
Nat Commun ; 12(1): 4049, 2021 06 30.
Artigo em Inglês | MEDLINE | ID: mdl-34193873

RESUMO

Xyloglucans are highly substituted and recalcitrant polysaccharides found in the primary cell walls of vascular plants, acting as a barrier against pathogens. Here, we reveal that the diverse and economically relevant Xanthomonas bacteria are endowed with a xyloglucan depolymerization machinery that is linked to pathogenesis. Using the citrus canker pathogen as a model organism, we show that this system encompasses distinctive glycoside hydrolases, a modular xyloglucan acetylesterase and specific membrane transporters, demonstrating that plant-associated bacteria employ distinct molecular strategies from commensal gut bacteria to cope with xyloglucans. Notably, the sugars released by this system elicit the expression of several key virulence factors, including the type III secretion system, a membrane-embedded apparatus to deliver effector proteins into the host cells. Together, these findings shed light on the molecular mechanisms underpinning the intricate enzymatic machinery of Xanthomonas to depolymerize xyloglucans and uncover a role for this system in signaling pathways driving pathogenesis.


Assuntos
Parede Celular/metabolismo , Citrus/microbiologia , Glucanos/metabolismo , Glicosídeo Hidrolases/metabolismo , Fatores de Virulência/genética , Xanthomonas/metabolismo , Xilanos/metabolismo , Proteínas de Bactérias/metabolismo , Doenças das Plantas/genética , Doenças das Plantas/microbiologia , Ativação Transcricional , Sistemas de Secreção Tipo III/metabolismo , Fatores de Virulência/metabolismo , Xanthomonas/genética , Xanthomonas/patogenicidade
20.
Nat Commun ; 12(1): 2980, 2021 05 20.
Artigo em Inglês | MEDLINE | ID: mdl-34016995

RESUMO

Near field scanning Microwave Impedance Microscopy can resolve structures as small as 1 nm using radiation with wavelengths of 0.1 m. Combining liquid immersion microscopy concepts with exquisite force control exerted on nanoscale water menisci, concentration of electromagnetic fields in nanometer-size regions was achieved. As a test material we use twisted bilayer graphene, because it provides a sample where the modulation of the moiré superstructure pattern can be systematically tuned from Ångstroms up to tens of nanometers. Here we demonstrate that a probe-to-pattern resolution of 108 can be obtained by analyzing and adjusting the tip-sample distance influence on the dynamics of water meniscus formation and stability.

SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA