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Herbert Klein and Francisco Luna present a sweeping narrative of social change in Brazil that documents its transition from a predominantly rural and illiterate society in 1950, to an overwhelmingly urban, modern, and literate society in the twenty-first century. Tracing this radical evolution reveals how industrialization created a new labor force, how demographic shifts reorganized the family and social attitudes, and how urban life emerged in what is now one of the most important industrial economies in the world. A paradigm for modern social histories, the book also examines changes in social stratification and mobility, the decline of regional disparities, education, social welfare, race, and gender. By analyzing Brazil's unprecedented Brazilian political, economic, and social changes in the late twentieth and twenty-first century, the authors address an under-explored area in current scholarship and offer an invaluable resource for scholars of Latin American and Brazil.
Kinetoplastid parasites are responsible for serious diseases in humans and livestock such as Chagas disease and sleeping sickness (caused by Trypanosoma cruzi and Trypanosoma brucei, respectively), and the different forms of cutaneous, mucocutaneous and visceral leishmaniasis (produced by Leishmania spp). The limited number of antiparasitic drugs available together with the emergence of resistance underscores the need for new therapeutic agents with novel mechanisms of action. The use of agents binding to surface glycans has been recently suggested as a new approach to antitrypanosomal design and a series of peptidic and non-peptidic carbohydrate-binding agents have been identified as antiparasitics showing efficacy in animal models of sleeping sickness. Here we provide an overview of the nature of surface glycans in three kinetoplastid parasites, T. cruzi, T. brucei and Leishmania. Their role in virulence and host cell invasion is highlighted with the aim of identifying specific glycan–lectin interactions and carbohydrate functions that may be the target of novel carbohydrate-binding agents with therapeutic applications.
A common feature in Answer Set Programming is the use of a second negation, stronger than default negation and sometimes called explicit, strong or classical negation. This explicit negation is normally used in front of atoms, rather than allowing its use as a regular operator. In this paper we consider the arbitrary combination of explicit negation with nested expressions, as those defined by Lifschitz, Tang and Turner. We extend the concept of reduct for this new syntax and then prove that it can be captured by an extension of Equilibrium Logic with this second negation. We study some properties of this variant and compare to the already known combination of Equilibrium Logic with Nelson’s strong negation.
To evaluate the impact of message framing on attitudes towards messages aimed at promoting the use of nutritional warnings, behavioural intention and actual behaviour, evaluated through visual attention to nutritional warnings and the choice of a snack product during a real choice task.
Following a between-subjects design, participants were exposed to loss-framed nutrition messages, gain-framed nutrition messages or non-nutrition-related messages (control group). After evaluating the messages, participants were asked to select a snack product as a compensation for their participation. The experiment was conducted using an eye tracker.
Convenience sample of 201 people (18–51 years old, 58 % female).
The average percentage of participants who fixated their gaze on the nutritional warnings during the choice task was slightly but significantly higher for participants who attended to nutrition messages (regardless of their framing) compared with the control group. Participants who attended to loss-framed messages fixated their gaze on the warnings for the longest period of time. In addition, the healthfulness of the snack choices was higher for participants exposed to nutrition-related messages compared with the control group.
Results from the present work suggest that nutrition messages aimed at increasing awareness of nutritional warnings may increase consumers’ visual attention and encourage more heathful choices. The framing of the messages only had a minor effect on their efficacy.
Maternal physical activity induces brain functional changes and neuroplasticity, leading to an improvement of cognitive functions, such as learning and memory in the offspring. This study investigated the effects of voluntary maternal physical activity on the gene expression of the neurotrophic factors (NTFs): BDNF, NTF4, NTRK2, IGF-1 and IGF-1r in the different areas of mother’s brain, placenta and foetus brain of rats. Female Wistar rats (n = 15) were individually housed in voluntary physical activity cages, containing a running wheel, for 4 weeks (period of adaptation) before gestation. Rats were classified as inactive (I, n = 6); active (A, n = 4) and very active (VA, n = 5) according to daily distance spontaneously travelled. During gestation, the dams continued to have access to the running wheel. At the 20th day of gestation, gene expression of NTFs was analysed in different areas of mother’s brain (cerebellum, hypothalamus, hippocampus and cortex), placenta and the offspring’s brain. NTFs gene expression was evaluated using quantitative PCR. Very active mothers showed upregulation of IGF-1 mRNA in the cerebellum (36.8%) and NTF4 mRNA expression in the placenta (24.3%). In the cortex, there was a tendency of up-regulation of NTRK2 mRNA (p = 0.06) in the A and VA groups when compared to I group. There were no noticeable changes in the gene expression of NTFs in the offspring’s brain. Our findings suggest the existence of a developmental plasticity induced by maternal physical activity in specific areas of the brain and placenta representing the first investment for offspring during development.
Trypanosoma cruzi is the causative agent of Chagas disease, a vector-borne disease. The parasite molecules involved in vector interaction have been little investigated. Metallopeptidases and gp63 molecules have been implicated in parasite adhesion of several trypanosomatids to the insect midgut. Although gp63 homologues are highly expanded in the T. cruzi genome, and are implicated in parasite–mammalian host interaction, its role in the insect vector has never been explored. Here, we showed that divalent metal chelators or anti-Tcgp63-I antibodies impaired T. cruzi adhesion to Rhodnius prolixus midgut. Parasites isolated after insect colonization presented a drastic enhancement in the expression of Tcgp63-I. These data highlight, for the first time, that Tcgp63-I and Zn-dependent enzymes contribute to the interaction of T. cruzi with the insect vector.
We examine whether early acquisition of a second language (L2) leads to native-like neural processing of phonemic contrasts that are absent in the L1. Four groups (adult and child monolingual speakers of English; adult and child early bilingual speakers of English and Spanish, exposed to both languages before 5 years of age) participated in a study comparing the English /ɪ/ - /ε/ contrast. Neural measures of automatic change detection (Mismatch Negativity, MMN) and attention (Processing Negativity, PN and Late Negativity, LN) were measured by varying whether participants tracked the stimulus stream or not. We observed no effect of bilingualism on the MMN, but adult bilinguals differed significantly from adult monolinguals on neural indices of attention. The child bilinguals were indistinguishable from their monolingual peers. This suggest that learning a L2 before five years of age leads to native-like phoneme discrimination, but bilinguals develop increased attentional sensitivity to speech sounds.
We present here the results from a full polarisation study, an important VLBI capability, of a selected set of bright Active Galactic Nuclei (AGNs), along with the steps required to fully calibrate the Australian Long Baseline Array. We compare strategies for high-precision polarisation measurements using two polarisation correction methods: (1) Linear model and (2) Ellipticity-Orientation model and two data-recording techniques: recording (1) nominally circular polarisation at all stations and (2) mixed polarisation, where all but one station record circular polarisation and the other recorded linear polarisation. The latter is corrected post-correlation. We explored these possible solution to discover which will best accommodate the heterogeneous nature of the Australian Long Baseline Array without impacting on the science results. The targets, all compact and of low polarisation fraction, allow us to compare multiple independent solutions for polarisation characteristics. The results show that the agreement between the two polarisation correction models is excellent. However, the values from Mopra with nominally circular polarisation are larger than would be acceptable. However, we also demonstrate that recording mixed polarisation modes and correcting post-correlation provide a high quality polarisation product. We report on the detailed tests of these strategies and assess that the array is ready for full polarisation operation.
Rate of treatment non-compliance in schizophrenia, like in other chronic diseases. Long-acting injectable (LAI) antipsychotics have proven to be more effective than orals in reducing the number of recurrences. Although the perception of LAIs has changed over the last few years with the introduction of new molecules, there might be prejudices regarding these formulations within the mental health professionals community. The exercise of imagining how and with which antipsychotic you would like to treat yourself or a close relative in case of suffering from schizophrenia, can help to emerge true prescription preferences.
The objective of the present work is to assess the psychiatrists antipsychotics prescribing preferences for schizophrenia, in the hypothetical case they were patients suffering a 2nd/3rd relapse. With this purpose, we performed an on-line survey in a sample of psychiatrists and trainees fromSpain.
Results showed that election of LAIs were less frequent for in Self-prescription scenario, both for the 2nd and 3rd hypothetical recurrence. Also, psychiatrist who chose LAIs for their patients are more likely to choose orals for themselves (p=0.039; p<0.001 for 2nd and 3rd recurrence respectively). The most preferred LAI for both patients and self-prescription was aripiprazole once-monthly (60% and 87% respectively).
Interestingly, nearly 70% of psychiatrist choosing a LAI different form Aripiprazole, would change the prescription for themselves; and those choosing aripiprazole once-monthly for their patients were more likely to maintain it for themselves (p<0.001). Practitioners changing from LAIs to orals in the self-treatment scenario perceive LAIs as a more coercive measure (p<0.01), being the degree of coercitivity perceived the only variable associated with a change in prescription's decisions (p=0.002). Curiously, LAIs associated coercitivity was significantly lower for oncologist vs psychiatrists (p<0.001). The level of weight gain, metabolic problems, extrapyramidal symptomatology, sexual dysfunction, sedation and cognitive problems perceived by psychiatrists is significantly lower for Aripiprazole than for the rest of LAIs (p <0.01 for all comparisons), with a comparable perceived efficacy (mean=3.95 and 4 out of possible 5, p=0.7). In light of our results, this is partially explained by a perception of LAIs as coercive measures, in contrast with perception of similar treatments for the control of somatic diseases. The fact of imagining a scene where oneself is the one suffering from a disease, shows preferences in the use of psychotropic drugs for the management of schizophrenia where the profile of side-effects and efficacy has a more equitable balance: starting from comparable effectiveness, we prefer treatments associated with a perception of fewer side-effects
The use of drugs for clinical conditions that differ from those approved in prescribing information (product labels) is known as off-label use. In Brazil, the Brazilian Health Regulatory Agency (ANVISA) is the official organization that regulates the use of health technologies. For technologies to be incorporated into the Brazilian public health system, registration with ANVISA is mandatory. However, occasionally, it is necessary to evaluate technologies for off-label use in the interests of public health. This study aimed to identify the health technologies recommended by the National Committee for Health Technology Incorporation (CONITEC) with an off-label indication between January 2012 and October 2017.
A descriptive study was undertaken using data available on the CONITEC website.
The study identified seven drugs with a favorable recommendation for off-label use: everolimus, sirolimus, and tacrolimus as immunosuppressants in transplant recipients; clozapine for bipolar affective disorder; pentoxifylline for cutaneous leishmaniosis mucosa; risperidone for adults with autism spectrum disorder, and bevacizumab for age-related macular degeneration and diabetic macular edema. For these decisions the Committee considered the scientific evidence available for the indication proposed, the severity of the disease, and the existence or absence of alternative treatments. This was possible because Brazilian legislation allows ANVISA to authorize the off-label use of health technologies provided that the analysis is supported by scientific evidence regarding effectiveness, accuracy, and safety for the intended purpose.
The off-label use of health technologies is a worldwide practice that can favor vulnerable populations and neglected diseases. This practice should be seen as positive when there is evidence supporting off-label use, and such decisions should not be influenced by political, economic, or marketing considerations.
For patients with bifascicular block and syncope of unknown origin, different American Heart Association guidelines give Class 2A recommendations for two treatments: the implantable loop recorder (ILR) and empiric pacemaker insertion (PM). Equipoise reflected in guidelines may contribute to uncertainty in management and inefficient resource use. The objective of this analysis is to determine the cost-effectiveness of ILR compared to PM in the management of older adults (age>50 years) with bifascicular block and syncope over two years, from the perspective of a Canadian publicly funded health care system, in the Syncope: Pacing or Recording In ThE Later Years (SPRITELY) trial.
Resource utilization data was collected throughout the trial, and unit costs were assigned (2017 Canadian dollars). Utility was measured at baseline and annually with the EQ-5D-3L. Quality adjusted life years (QALYs) were calculated as area-under-the-curve, and adjusted for baseline imbalances in utility. Confidence intervals for the incremental cost effectiveness ratio were generated with non-parametric bootstrapping.
Mean cost in participants randomized to PM was CAD 9,759 (USD 7,400), compared to CAD 13,453 (USD 10,200) in participants randomized to ILR. The ILR strategy resulted in 0.020 QALYs more than the PM strategy. The incremental cost effectiveness ratio was CAD 186,553 (95% CI: −831,950–1,191,816) (USD 141,900, 95% CI: −632,740–906,440) per additional QALY. In 1,000 bootstrapped replicates, the cost of the ILR strategy was always greater than that of the PM strategy. At the threshold of CAD 50,000 (USD 38,000) per additional QALY, the probability that the ILR strategy is the cost effective option is 0.504.
ILR costs were greater than PM costs, with little difference in QALY outcomes over two-years. Findings are generalizable to patients similar to SPRITELY participants, from the perspective of the Canadian health care system. However, practice pattern variation and payment systems inhibit generalizability to other countries. Future analysis will explore cost and QALY outcomes in countries that participated in the SPRITELY trial.