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This Systematic Review assesses the economic impact of Respiratory Syncytial Virus (RSV) in Latin America and the Caribbean (LAC) in relation to healthcare resource utilization and associated costs. We searched online databases from January 2012 to November 2022 to identify eligible publications. We identified 12 publications that reported direct costs, indirect costs, and resources associated with RSV and its complications. The primary direct medical resources reported were medical services, diagnostics tests and procedures, and length of stay (LOS). Direct total costs per patient ranged widely from $563 to $19,076. Direct costs are, on average, 98% higher than indirect costs. Brazil reported a higher total cost per patient than Colombia, El Salvador, México, Panamá, and Puerto Rico, while for indirect costs per patient, El Salvador and Panamá had higher costs than Brazil, Colombia, and Mexico. The mean LOS in the general ward due to RSV was 6.9 days (range 4 to 20 days) and the mean Intensive Care Unit LOS was 9.1 days (range 4 to 16 days). In many countries of the LAC region, RSV represents a considerable economic burden on health systems, but significant evidence gaps were identified in the region. More rigorous health economic studies are essential to better understand this burden and to promote effective healthcare through an informed decision-making process. Vaccination against RSV plays a critical role in mitigating this burden and should be a priority in public health strategies.
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Efeitos Psicossociais da Doença , Custos de Cuidados de Saúde , Infecções por Vírus Respiratório Sincicial , Humanos , Infecções por Vírus Respiratório Sincicial/economia , Infecções por Vírus Respiratório Sincicial/epidemiologia , América Latina/epidemiologia , Custos de Cuidados de Saúde/estatística & dados numéricos , Tempo de Internação/economia , Tempo de Internação/estatística & dados numéricos , Região do Caribe/epidemiologia , Vírus Sincicial Respiratório HumanoRESUMO
The nervous system is rich in miRNAs, indicating an important role of these molecules in regulating processes associated with cognition, memory, and others. Therefore, qualitative and quantitative imbalances involving such miRNAs may be involved in dementia contexts, including Late-Onset Alzheimer's Disease (LOAD). To test the viability of circulating miRNAs (c-miRNAs) as biomarkers for LOAD, we proceed accordingly to the following reasoning. The first stage was to discover and identify profile of c-miRNAs by RNA sequencing (RNA-Seq). For this purpose, blood serum samples were used from LOAD patients (n = 5) and cognitively healthy elderly control group (CTRL_CH) (n = 5), all over 70 years old. We identified seven c-miRNAs differentially expressed (p ≤ 0.05) in the serum of LOAD patients compared to CTRL_CH (miR-10a-5p; miR-29b-2-5p; miR-125a-5p; miR-342-3p, miR-708-5p, miR-380-5p and miR-340-3p). Of these, five (p ≤ 0.01) were selected for in silico analysis (miR-10a-5p; miR-29b-2-5p; miR-125a-5p; miR-342-3p, miR-708-5p), for which 44 relevant target genes were found regulated by these c-miRNAs and related to LOAD. Through the analysis of these target genes in databases, it was possible to observe that they have functions related to the development and progress of LOAD, directly or indirectly connecting the different Alzheimer's pathways. Thus, this work found five promising serum c-miRNAs as options for biomarkers contributing to LOAD diagnosis. Our study shows the complex network between these molecules and LOAD, supporting the relevance of studies using c-miRNAs in dementia contexts.
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Doença de Alzheimer , Biomarcadores , MicroRNAs , Humanos , Doença de Alzheimer/sangue , Doença de Alzheimer/genética , Doença de Alzheimer/diagnóstico , MicroRNAs/sangue , MicroRNAs/genética , Masculino , Idoso , Biomarcadores/sangue , Feminino , Idoso de 80 Anos ou maisRESUMO
The search for increased performance and physical performance are linked to the use of ergogenic resources. The vertical jump is one of the measures commonly used to evaluate the performance of lower limbs in athletes. Transcranial direct current stimulation (tDCS) is a non-invasive, safe, economically viable technique that can modulate cortical excitability, which can influence the increase in the performance of athletes in general. This study aimed to investigate whether the use of tDCS on the primary motor cortex (M1) improves the performance of soccer players. A cross-sectional study was conducted. Twenty-seven players were randomized into three groups: Active tDCS group (n = 9), Sham group (n = 9), and control group (n = 9). Stimulation was applied at 2â mA for 15â min using a cephalic mount. Visual Pain Scale (VAS) and Subjective Recovery Scale (SRS) were monitored before and after tDCS. In addition, the participants performed the Countermovement Jump (CMJ) before and after the stimulation intercalated with Heart Rate (HR) and Rating of Perceived Exertion (RPE CR-10). No differences were found in any of the performance variables analyzed (p > 0.05) nor in the responses of HR (p > 0.05), RPE (p > 0.05), VAS (p > 0.05), and SRS (p > 0.05) between groups. The tDCS in M1 did not change the performance of the vertical jump, and there was no improvement in the subjective scales. New studies should also be developed with different stimulus intensities in different cortical areas and sports modalities.
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The aims of this study were to estimate the genetic parameters for fat-to-protein ratio (F:P) within the first 90 days of lactation and to examine their genetic associations with daily milk yield (MY), somatic cell score (SCS), and calving interval between the first and second calving (IFSC) and between the second and third calving (ISTC) during the first three lactations of Holstein cows. We utilized 200,626 production-related data officially recorded from 77,436 cows milked two or three times a day from 2012 to 2022, sourced from the Holstein Cattle Breeders Association of Paraná State, Brazil. The (co)variance components were estimated using animal models, adopting the restricted maximum likelihood (REML) method with single-trait analysis (for heritability and repeatability) and two-trait analysis (for genetic and phenotypic correlations), per lactation. Regardless of lactation number, heritability estimates were relatively low, ranging from 0.08 ± 0.005 to 0.10 ± 0.003 for F:P; 0.08 ± 0.01 to 0.18 ± 0.005 for MY; 0.04 ± 0.01 to 0.07 ± 0.004 for SCS; and 0.03 ± 0.01 for both IFSC and ISTC. Repeatability estimates within the same lactation were low for F:P (ranging from 0.17 ± 0.002 to 0.19 ± 0.03), high for MY (between 0.50 ± 0.003 and 0.53 ± 0.002), and moderate to high for SCS (between 0.39 ± 0.003 and 0.44 ± 0.004). Genetic correlations between F:P and MY ranged from -0.26 ± 0.03 to -0.15 ± 0.02; F:P and SCS, from -0.06 ± 0.03 to -0.03 ± 0.08; F:P and IFSC, 0.31 ± 0.01; F:P and ISTC, 0.20 ± 0.01; MY and IFSC, 0.24 ± 0.05; and MY and ISTC, 0.13 ± 0.08. The fat-to-protein ratio during early lactation showed low genetic variability, regardless of lactation number. Furthermore, it was genetically correlated with MY, IFSC, and ISTC, although there is an antagonistic and unfavorable correlation between traits that can limit genetic progress.
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Lactação , Leite , Feminino , Bovinos/genética , Animais , Brasil , Lactação/genética , FenótipoRESUMO
Background: Electroencephalography (EEG) has identified neural activity in specific brain regions as a potential indicator of the neural signature of chronic pain. This study compared the lagged coherence connectivity between regions of interest (ROIs) associated with the pain connectome in women with fibromyalgia (FM) and healthy women (HC). Methods: We evaluated 64 participants (49 FM and 15 HC) during resting-state EEG sessions under both eyes open (EO) and eyes closed (EC) conditions. In addition to EEG measurements, we assessed clinical and psychological symptoms and serum levels of brain-derived neurotrophic factor (BDNF). The connectivity between eight ROIs was computed across eight different EEG frequencies. Results: The FM group demonstrated increased connectivity between the left dorsolateral prefrontal cortex (DLPFC) and right anterior cingulate cortex (ACC), specifically in the beta-3 frequency band (t = 3.441, p = 0.044). When comparing the EO and EC conditions, FM patients exhibited heightened interhemispheric connectivity between insular areas (t = 3.372, p = 0.024) and between the left insula (INS) and right DLPFC (t = 3.695, p = 0.024) within the beta-3 frequency band. In the EC condition, there was a negative correlation between pain disability and connectivity in the beta-3 frequency band between the left ACC and the left primary somatosensory cortex (SI; r = -0.442, p = 0.043). In the EO condition, there was a negative correlation between central sensitization severity and lagged coherence connectivity in the alpha-2 frequency band between the right ACC and left SI (r = 0.428, p = 0.014). Moreover, in the EO-EC comparison, the lagged coherence connection between the left DLPFC and right INS, indexed by the gamma frequency band, showed a negative correlation with serum BDNF levels (r = -0.506, p = 0.012). Conclusion: These findings indicate that increased connectivity between different pain processing circuits, particularly in the beta-3 frequency band during rest, may serve as neural biomarkers for the chronic pain brain signature associated with neuroplasticity and the severity of FM symptoms.
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Corn grain particle size has the potential to influence the performance of lactating dairy cows and the overall profitability of a dairy farm. The objective of this study was to evaluate the productive performance of lactating cows fed diets containing finely or coarsely ground corn grain. Fifty lactating Holstein cows (n = 50; 10 primiparous and 40 multiparous), averaging (mean ± standard deviation, SD) 658 ± 64 kg of BW, 38.8 ± 7.3 kg of milk/d, and 155 ± 80 DIM, were fed diets with finely ground corn grain (FGC) or coarsely ground corn grain (CGC) in a randomized block design with a 28-d treatment period. Finely and coarsely ground corn grain had an average particle size of 660 and 915 µm, respectively. Dry matter intake (DMI) was reduced (p < 0.01) for cows fed FGC (22.1 vs. 21.2 kg d-1). Milk yield and efficiency were not affected by treatments (37.9 vs. 36.8 kg d-1; p = 0.12 and 1.78 vs. 1.79; p = 0.15). Concentrations of milk protein and fat, as well as other milk solids, were unaffected (p > 0.05) by treatments. Fecal starch (FS) concentrations were greater (p < 0.01) for cows fed CGC (7.0 vs. 4.9%), whereas plasma concentrations of D-lactate were greater (p < 0.05) for cows fed FGC (98.5 vs. 79.7 µM). Overall, feeding finely ground corn grain increased total-tract starch digestibility and reduced DMI while maintaining milk yield.
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Lactação , Zea mays , Animais , Bovinos , Feminino , Ração Animal/análise , Fenômenos Fisiológicos da Nutrição Animal , Dieta/veterinária , Digestão , Tamanho da Partícula , Rúmen/metabolismo , Silagem , Amido/metabolismo , Zea mays/metabolismoRESUMO
BACKGROUND: Oral anticoagulation is the cornerstone treatment of several diseases. Its management is often challenging, and different telemedicine strategies have been implemented to support it. OBJECTIVE: The aim of the study is to systematically review the evidence on the impact of telemedicine-based oral anticoagulation management compared to usual care on thromboembolic and bleeding events. METHODS: Randomized controlled trials were searched in 5 databases from inception to September 2021. Two independent reviewers performed study selection and data extraction. Total thromboembolic events, major bleeding, mortality, and time in therapeutic range were assessed. Results were pooled using random effect models. RESULTS: In total, 25 randomized controlled trials were included (n=25,746 patients) and classified as moderate to high risk of bias by the Cochrane tool. Telemedicine resulted in lower rates of thromboembolic events, though not statistically significant (n=13 studies, relative risk [RR] 0.75, 95% CI 0.53-1.07; I2=42%), comparable rates of major bleeding (n=11 studies, RR 0.94, 95% CI 0.82-1.07; I2=0%) and mortality (n=12 studies, RR 0.96, 95% CI 0.78-1.20; I2=11%), and an improved time in therapeutic range (n=16 studies, mean difference 3.38, 95% CI 1.12-5.65; I2=90%). In the subgroup of the multitasking intervention, telemedicine resulted in an important reduction of thromboembolic events (RR 0.20, 95% CI 0.08-0.48). CONCLUSIONS: Telemedicine-based oral anticoagulation management resulted in similar rates of major bleeding and mortality, a trend for fewer thromboembolic events, and better anticoagulation quality compared to standard care. Given the potential benefits of telemedicine-based care, such as greater access to remote populations or people with ambulatory restrictions, these findings may encourage further implementation of eHealth strategies for anticoagulation management, particularly as part of multifaceted interventions for integrated care of chronic diseases. Meanwhile, researchers should develop higher-quality evidence focusing on hard clinical outcomes, cost-effectiveness, and quality of life. TRIAL REGISTRATION: PROSPERO International Prospective Register of Systematic Reviews CRD42020159208; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=159208.
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Telemedicina , Tromboembolia , Humanos , Anticoagulantes/uso terapêutico , Qualidade de Vida , Hemorragia/induzido quimicamente , Hemorragia/tratamento farmacológico , Tromboembolia/tratamento farmacológico , Tromboembolia/prevenção & controle , Tromboembolia/induzido quimicamenteRESUMO
Soccer is a team sport that requires players to process a significant amount of information quickly and respond with both speed and accuracy to the ever-changing demands of the game. As such, success in soccer depends not only on physical attributes but also on cognitive abilities such as perception and decision-making. The aim of the current study was to investigate the acute effects of caffeine ingestion on Stroop test performance before and after repeated small-sided games (SSG) in professional soccer players. Twelve professional male soccer players (29 ± 4.1 years; 78.1 ± 7.7 kg body mass) participated in this study. A randomized crossover double-blind placebo-controlled trial was used. Caffeine (5 mg.kg-1) or a placebo was ingested 45 min before a protocol consisting of five 5 min SSG with 1 min rest intervals. A computerized version of the colour Stroop test was completed immediately before and after the exercise protocol. During the Stroop test, words appeared on the computer screen in three different ways: (i) neutral words (neutral condition); (ii) correspondent colour (i.e., "red" painted in red; congruent condition), or; (iii) different colour (i.e., "red" painted in green; incongruent condition). The incongruent condition aimed to cause the interference effect, as the colour and the word did not match. Ratings of perceived exertion (RPE) were assessed after each SSG. RPE increased during the five sets of the SSG protocol (p < 0.001), without differences between the caffeine and placebo trials. The soccer-specific exercise protocol promoted a faster response during the Stroop test (two-way ANOVA main effect for SSG protocol: p < 0.05), with no differences in accuracy (p > 0.05). Caffeine ingestion resulted in slower reaction time during the Stroop test during the congruent and neutral trials but not during the incongruent trial (two-way ANOVA main effect for supplementation: p = 0.009, p = 0.045, and p = 0.071, respectively). Accuracy was lower in the caffeine trial in congruent and incongruent trials (p < 0.05 caffeine vs. placebo both on the pre- and post-SSG protocol). In conclusion, a soccer-specific exercise protocol improved the Stroop test performance in professional soccer players, but acute caffeine ingestion (5 mg.kg-1) was detrimental.
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Desempenho Atlético , Futebol , Humanos , Masculino , Cafeína/farmacologia , Futebol/fisiologia , Estudos Cross-Over , Desempenho Atlético/fisiologia , Cognição , Ingestão de AlimentosRESUMO
Since its initial detection in Brazil in February 2020, SARS-CoV-2 and the associated COVID-19 pandemic have continued to devastate Latin America. Specific comorbidities, as well as sociodemographic and lifestyle factors that may be more prevalent in underserved areas, have been identified as risk factors for COVID-19 infection or associated adverse outcomes. Dynamics of infections and deaths in Latin America have varied by country and temporally, as has SARS-CoV-2 variant prevalence; however, more recently, the Delta and subsequent Omicron variants have become ubiquitous. Successful pandemic responses have involved robust infection mitigation measures, testing, and smart deployment of healthcare resourcing. While in some Latin American countries up to 90% of the population is fully vaccinated (i.e., 2 doses) against COVID-19, other countries have failed to reach the World Health Organization's 70% target. Continued focus on comprehensive surveillance, strategies to maximize vaccine availability and uptake, and mitigation of collateral damage on other aspects of public health and social services are critical for managing the COVID-19 pandemic. This review summarizes the COVID-19 experience in Latin America, including epidemiology and vaccination. Key learnings and future considerations for the ongoing pandemic response are also discussed.
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In soccer, physical, tactical, and decision-making processes are highly important facets of successful performance. Caffeine has well established effects for promoting both physical and cognitive performance, but the translation of such benefits specifically for soccer match play is not well established. This study examined the effects of acute caffeine ingestion on tactical performance during small-sided games (SSG) in professional soccer players. Nineteen soccer players (22 ± 4 years) underwent a randomized, counterbalanced, crossover, double-blind placebo-controlled trial. The protocol consisted of 5 bouts of 5-min SSG with 3 players plus a goalkeeper in each team (3 + GK × 3 + GK) with each SSG separated by 1 min rest intervals. Tactical performance was assessed using the system of tactical assessment in soccer (FUT-SAT). Prior to each experimental trial, participants ingested caffeine (5 mg·kg-1) or a placebo 60 min before the protocol. Overall, caffeine ingestion resulted in an increased ball possession time when compared to the placebo. When the offensive and defensive core principles were analyzed, the results were equivocal. Caffeine resulted in positive effects on some tactical decisions during the protocol, but it was deleterious or promoted no observed effect on other of the core tactical principles. Caffeine ingestion resulted in less offensive (during SSG3) and defensive (SSG 2, SSG3, and SSG4) errors. Caffeine ingestion also resulted in higher total offensive success during SSG 1 and SSG2, but it was detrimental during SSG3. Additionally, total defensive success was lower for the caffeine conditions during SSG 2 and SSG5 when compared to the placebo. In conclusion, caffeine influenced aspects of tactical decisions in soccer, resulting in fewer offensive and defensive errors, although it may be deleterious considering other tactical parameters. Future studies may clarify the effects of caffeine ingestion on specific decision-making parameters in soccer.
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Desempenho Atlético , Futebol , Desempenho Atlético/psicologia , Cafeína/farmacologia , Método Duplo-Cego , Ingestão de Alimentos , Humanos , Futebol/psicologiaRESUMO
OBJECTIVES: To determine the incidence, aetiology and pneumococcal serotype distribution of community-acquired pneumonia (CAP) in Brazilian adults during a 2-year period. DESIGN: Prospective population-based surveillance study. SETTING: Patients from two emergency hospitals in Brazil were consecutively included in this study. PARTICIPANTS: A total of 111 adults aged 50 years and older with radiographically-confirmed CAP requiring an emergency department visit were prospectively enrolled between January 2018 and January 2020. MAIN OUTCOME MEASURES: Incidence rates of CAP were calculated according to age and pathogen. Pathogens were identified by conventional microbiological methods. Additionally, a novel, Luminex-based serotype specific urinary antigen detection assay was used to detect serotypes included in pneumococcal vaccines. RESULTS: Mean age of participants was 64 years and 31% were aged ≥70 years. Aetiology was established in 61 (57%) patients; among identified cases, the most common pathogens were Streptococcus pneumoniae (42/61, 69%) and influenza (4/61, 7%). Among serotypes identified from the 42 cases of pneumococcal CAP, estimated coverage ranged by pneumococcal vaccine formulations from 47.6% (13-valent), 59.5% (20-valent, licenced in the USA only) and 71.4% (23-valent). In patients with CAP, 20-valent pneumococcal vaccine serotypes were identified 2.5 times more frequently than 10-valent pneumococcal vaccine serotypes (22.5% vs 9.0%). The incidence rate for CAP in adults aged ≥50 years was 20.1 per 10 000 person-years. In general, the incidence of CAP increased consistently with age, reaching 54.4 (95% CI 36.8 to -76.6) per 10 000 in adults 80 years or older. CONCLUSIONS: We observed a high burden of pneumococcal CAP among adults in Brazil. Despite the routine immunisation of children and high-risk adults against pneumococcal disease in the Brazilian national vaccination programme, a persistent burden of pneumococcal CAP caused by vaccine serotypes remains in this population.
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Infecções Comunitárias Adquiridas , Infecções Pneumocócicas , Pneumonia Pneumocócica , Adulto , Idoso , Idoso de 80 Anos ou mais , Brasil/epidemiologia , Criança , Infecções Comunitárias Adquiridas/epidemiologia , Infecções Comunitárias Adquiridas/microbiologia , Infecções Comunitárias Adquiridas/prevenção & controle , Humanos , Incidência , Pessoa de Meia-Idade , Infecções Pneumocócicas/prevenção & controle , Vacinas Pneumocócicas , Pneumonia Pneumocócica/epidemiologia , Pneumonia Pneumocócica/prevenção & controle , Estudos Prospectivos , Sorogrupo , Streptococcus pneumoniae , Vacinas Conjugadas , Conduta ExpectanteRESUMO
Recent theoretical studies demonstrate the advantages of using decentralized architectures over traditional centralized architectures for real-time Power Distribution Systems (PDSs) operation. These advantages include the reduction of the amount of data to be transmitted and processed when performing state estimation in PDSs. The main contribution of this paper is to provide lab validation of the advantages and feasibility of decentralized monitoring of PDSs. Therefore, this paper presents an advanced trial emulating realistic conditions and hardware setup. More specifically, the paper proposes: (i) The laboratory development and implementation of an Advanced Measurement Infrastructure (AMI) prototype to enable the simulation of a smart grid. To emulate the information traffic between smart meters and distribution operation centers, communication modules, that enable the use of wireless networks for sending messages in real-time, are used, bridging concepts from both IoT and Edge Computing. (ii) The laboratory development and implementation of a decentralized architecture based on Embedded State Estimator Modules (ESEMs) are carried out. ESEMs manage information from smart meters at lower voltage networks, performing real-time state estimation in PDSs. Simulations performed on a real PDS with 208 buses (considering both medium and low voltage buses) have met the aims of this paper. The results show that by using ESEMs in a decentralized architecture, both the data transit through the communication network, as well as the computational requirements involved in monitoring PDSs in real-time, are reduced considerably without any loss of accuracy.
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Sistemas Computacionais , Simulação por Computador , Meios de CulturaRESUMO
Few studies have been published on the body growth of replacement dairy heifers from Jersey (JER) and Holstein × Gyr (H × G) breeds, as most of them have focused on Holstein (HOL) heifers. In addition, HOL genetics vary significantly across countries. Our goal was to study the body growth curves of 3 distinct genetic groups of heifers (HOL, H × G, and JER) using data from Brazilian commercial dairy herds. Heart girth [to estimate body weight (BW)], hip height (HH), and withers height (WH) were measured. Weights (heifers and cows) and heights (only heifers) were collected from animals in several herds for each genetic group to model and describe the growth rates, mature body weight (MBW), weights, and heights for the recommended age at first breeding (RAFB) and first calving (RAFC). The RAFB values for HOL, H × G, and JER cattle were 15, 18, and 13 mo, respectively. The RAFC values for HOL, H × G, and JER cattle were 24, 27, and 22 mo, respectively. Data were obtained from 18 dairy farms located in 4 Brazilian states and analyzed using nonlinear modeling. Data were collected from 2,266 animals: 878 HOL, 610 H × G, and 778 JER cattle. We observed different body growth patterns in each genetic group. Jersey cattle matured earlier than HOL and H × G, especially for BW and HH. Mature BW of the HOL, H × G, and JER cattle was 681, 607, and 440 kg, respectively. All genetic groups reached the recommended BW at RAFB. However, the genetic groups did not reach the recommended BW at RAFC. Average daily weight gain from weaning to RAFB was 0.84, 0.53, and 0.54 kg/d for HOL, H × G, and JER cattle, respectively. Average daily gain from RAFB to RAFC was 0.53, 0.42, and 0.48 kg/d for HOL, H × G, and JER cattle, respectively. The HH at RAFB and RAFC were 130 and 139 cm for HOL, 130 and 137 cm for H × G, and 114 and 124 cm for JER. Withers height at RAFB and RAFC were 125 and 134 cm, 125 and 134 cm, and 110 and 121 cm for HOL, H × G, and JER cattle, respectively. In general, the rearing practices were adequate to reach the recommended BW at RAFB but below the recommended BW at RAFC for all genetic groups. In addition, each genetic group demonstrated different body growth patterns, especially for BW.
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Ingestão de Alimentos , Aumento de Peso , Animais , Peso Corporal , Brasil , Bovinos/genética , FemininoRESUMO
The Brazilian population is a product of asymmetric admixture among European men and Amerindian and African women. However, Brazilian subcontinental ancestry is scarcely documented, especially regarding its African roots. Here, we aimed to unveil the uniparental continental and subcontinental contributions from distinct Brazilian regions, including South (n = 43), Southeast (n = 71), the poorly genetically characterized Central-Western region (n = 323), and a subset of unique Brazilian Amerindians (n = 24), in the context of their genome-wide ancestral contributions. The overwhelming majority of European Y haplogroups (85%) contrast sharply with the predominant African and Amerindian mtDNA haplogroups (73.2%) in admixed populations, whereas in Amerindians, non-Native haplogroups could only be detected through the paternal line. Our in-depth investigation of uniparental markers showed signals of an Andean and Central-Brazilian Amerindian maternal contribution to Southeastern and Central-Western Brazil (83.1 ± 2.1% and 56.9 ± 0.2%, respectively), the last having the highest paternal Amerindian ancestry yet described for an admixed Brazilian region (9.7%) and contrasting with higher Southern-Brazilian Amerindian contribution to Southern Brazil (59.6 ± 1%). Unlike the higher African Bantu contribution previously reported for the South and Southeast, a relevant Western African non-Bantu contribution was detected in those regions (85.7 ± 5% and 71.8 ± 10.8% respectively). In contrast, a higher Bantu contribution was described for the first time in the Central-West (64.8 ± 1.3% maternal and 86.9 ± 9.6% paternal). We observed sex-biased signatures consistent with the historically recorded Brazilian colonization and added new insights in the subcontinental maternal ancestry of Brazilians from regions never studied at this level.
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População Negra , DNA Mitocondrial , População Negra/genética , Brasil , DNA Mitocondrial/genética , Feminino , Genética Populacional , Haplótipos/genética , Humanos , MasculinoRESUMO
This communication seeks to address the questions and criticisms issued by Gomez and colleagues in their letter on our original study "Cost-effectiveness analysis of replacing the 10-valent pneumococcal conjugate vaccine (PCV10) with the 13-valent pneumococcal conjugate vaccine (PCV13) in Brazil infants." Gomez and colleagues are concerned that the assumptions used in our model may have unintended negative impacts for Brazil decision-making and we intend to clarify any potential misinterpretation of our assessment.
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Infecções Pneumocócicas , Brasil , Análise Custo-Benefício , Humanos , Lactente , Infecções Pneumocócicas/prevenção & controle , Vacinas Pneumocócicas , Vacinas ConjugadasRESUMO
Glioblastoma (GBM) is the most lethal and frequent type of brain tumor, leading patients to death in approximately 14 months after diagnosis. GBM treatment consists in surgical removal followed by radio and chemotherapy. However, tumors commonly relapse and the treatment promotes only a slight increase in patient survival. Thus, uncovering the cellular mechanisms involved in GBM resistance is of utmost interest, and the use of cell lines has been shown to be an extremely important tool. In this work, the exploration of RNAseq data from different GBM cell lines revealed different expression signatures, distinctly correlated with the behavior of GBM cell lines regarding proliferation indexes and radio-resistance. U87MG and U138MG cells, which presented expressively reduced proliferation and increased radio-resistance, showed a particular expression signature encompassing enrichment in many extracellular matrix (ECM) and receptor genes. Contrasting, U251MG and T98G cells, that presented higher proliferation and sensibility to radiation, exhibited distinct signatures revealing consistent enrichments for DNA repair processes and although several genes from the ECM-receptor pathway showed up-regulation, enrichments for this pathway were not detected. The ECM-receptor is a master regulatory pathway that is known to impact several cellular processes including: survival, proliferation, migration, invasion, and DNA damage signaling and repair, corroborating the associations we found. Furthermore, searches to The Cancer Genome Atlas (TCGA) repository revealed prognostic correlations with glioma patients for the majority of genes highlighted in the signatures and led to the identification of 31 ECM-receptor genes individually correlated with radiation responsiveness. Interestingly, we observed an association between the number of upregulated genes and survivability greater than 5 years after diagnosis, where almost all the patients that presented 21 or more upregulated genes were deceased before 5 years. Altogether our findings suggest the clinical relevance of ECM-receptor genes signature found here for radiotherapy decision and as biomarkers of glioma prognosis.
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Pemphigus foliaceus (PF) is an autoimmune blistering disease of the skin, clinically characterized by erosions and, histopathologically, by acantholysis. PF is endemic in the Brazilian Central-Western region. Numerous single nucleotide polymorphisms (SNPs) have been shown to affect the susceptibility for PF, including SNPs at long non-coding RNA (lncRNA) genes, which are known to participate in many physiological and pathogenic processes, such as autoimmunity. Here, we investigated whether the genetic variation of immune-related lncRNA genes affects the risk for endemic and sporadic forms of PF. We analysed 692 novel SNPs for PF from 135 immune-related lncRNA genes in 227 endemic PF patients and 194 controls. The SNPs were genotyped by Illumina microarray and analysed by applying logistic regression at additive model, with correction for sex and population structure. Six associated SNPs were also evaluated in an independent German cohort of 76 sporadic PF patients and 150 controls. Further, we measured the expression levels of two associated lncRNA genes (LINC-PINT and LY86-AS1) by quantitative PCR, stratified by genotypes, in peripheral blood mononuclear cells of healthy subjects. We found 27 SNPs in 11 lncRNA genes associated with endemic PF (p < .05 without overlapping with protein-coding genes). Among them, the LINC-PINT SNP rs10228040*A (OR = 1.47, p = .012) was also associated with increased susceptibility for sporadic PF (OR = 2.28, p = .002). Moreover, the A+ carriers of LY86-AS1*rs12192707 mark lowest LY86-AS1 RNA levels, which might be associated with a decreasing autoimmune response. Our results suggest a critical role of lncRNA variants in immunopathogenesis of both PF endemic and sporadic forms.
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Antígenos de Superfície/genética , Pênfigo/genética , Polimorfismo de Nucleotídeo Único/genética , RNA Longo não Codificante/genética , Antígenos de Superfície/imunologia , Predisposição Genética para Doença , Humanos , Pênfigo/imunologia , Polimorfismo de Nucleotídeo Único/imunologia , RNA Longo não Codificante/imunologiaRESUMO
Brazil currently has a 10-valent pneumococcal conjugate vaccine (PCV10) pediatric national immunization program (NIP). However, in recent years, there has been significant progressive increases in pneumococcal disease attributed to serotypes 3, 6A, and 19A, which are covered by the 13-valent PCV (PCV13). We sought to evaluate the cost-effectiveness and budget impact of switching from PCV10 to PCV13 for Brazilian infants from a payer perspective. A decision-analytic model was adapted to evaluate the clinical and economic outcomes of continuing PCV10 or switching to PCV13. The analysis estimated future costs ($BRL), quality-adjusted life-years (QALYs), and health outcomes for PCV10 and PCV13 over 5 y. Input parameters were from published sources. Future serotype dynamics were predicted using Brazilian and global historical trends. Over 5 y, PCV13 could prevent 12,342 bacteremia, 15,330 meningitis, 170,191 hospitalized pneumonia, and 25,872 otitis media cases, avert 13,709 pneumococcal disease deaths, gain 20,317 QALYs, and save 172 million direct costs compared with PCV10. The use of PCV13 in the Brazilian NIP could reduce pneumococcal disease, improve population health, and save substantial health-care costs. Results are reliable even when considering uncertainty for possible serotype dynamics with different underlying assumptions.
Assuntos
Infecções Pneumocócicas , Vacinas Pneumocócicas , Brasil , Criança , Análise Custo-Benefício , Humanos , Lactente , Vacinas ConjugadasRESUMO
INTRODUCTION: Increased excitability of the motor cortex through transcranial direct current stimulation (tDCS) has been described as a non-pharmacological strategy for the treatment of Spinal Cord Injury neuropathic pain (SCINP). It is also believed that the ability to enhance motor cortex excitability (MCE) could be impaired within chronic SCINP individuals. The following case reports describe the MCE behavior in individuals with chronic SCINP submitted to electrical non-invasive neuromodulation. CASE PRESENTATIONS: This article reports 11 cases with chronic SCINP in which each individual was submitted to a 5-day pre-post MCE analysis in order to evaluate its behavior after the anodal tDCS sessions. All cases maintained ongoing pharmacological treatment. Four individuals have shown negative variation of the MCE, two of which reported pain intensity reduction. Three other individuals had MCE-positive variation along 5 days, from which only one reported a VAS 0.5 pain reduction after the 5th day of observation. The other four individuals did not present significant variation of the MCE. DISCUSSION: The positive variation of MCE was significantly altered by adjunctive tDCS only in three individuals, though no clinically relevant reduction in pain intensity was reported among these participants. Key factors such as pain and injury duration, age, chronic medication use and underlying maladaptive neuroplasticity may influence responsiveness to brain stimulation within this population. These case reports try to add evidence for cautious recommendation of tDCS in chronic SCINP individuals and to the necessity of identifying groups of individuals that are most susceptible to neuromodulation.