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Several countries maintain universal health coverage, which implies responsibility to organize delivery formats of healthcare services and products for citizens. In Brazil, the health system has a principle of universal access for more than 30 years, but many deficiencies remain and the country observes a day practice for those seeking judicial decisions to determine provision of healthcare.
Primordial germ cells transplantation is a unique approach for conservation and reconstitution of endangered fish species. This study aimed to establish techniques to culture dechorionated embryos in different incubation systems and also to determine anaesthetic concentration for fish recipients in the larval stage for subsequent primordial germ cell transplantation. Intact and dechorionated embryos were divided into three incubation systems: (1) a control group with manual replacement of the solution; (2) a closed environment with high oxygen with manual replacement of the solution; and (3) constant solution recirculation. This combination resulted in six treatments. For the evaluation of anaesthetics for larvae, the concentrations evaluated were 19.5 mM, 24.4 mM, 29.3 mM, and 34.2 mM of 2-phenoxyethanol. Anaesthesia concentration and recovery at different stages were evaluated. For transplantation, primordial germ cells of Astyanax altiparanae were transplanted into anaesthetised larvae (1 dph) of Prochilodus lineatus. Better results were obtained in the recirculation system for dechorionated embryos of P. lineatus for hatching (54.18%) and normal morphology (50.06%). The 2-phenoxyethanol anaesthetic with a dose of 29.3 mM resulted in shorter induction times, in addition to the recovery time between 5 and 10 min. By using this anaesthetic concentration at transplantation, GFP-positive cells were seen in two recipients, but the cells did not proliferate. This study established an effective incubation system for the development of the dechorionated embryo and determined an effective anaesthetic concentration for P. lineatus larvae. In addition, micromanipulation and transplantation of primordial germ cells in neotropical species were conducted for the first time.
Portugal has high fish/seafood consumption, which may have both risks and benefits. This study aims to quantify the net health impact of hypothetical scenarios of fish/seafood consumption in the Portuguese population using a risk–benefit assessment methodology. Consumption data from the National Food, Nutrition and Physical Activity Survey 2015–2016 (n 5811) were used to estimate the mean exposure to methylmercury and EPA + DHA in the current and the alternative scenarios considered. Alternative scenarios (alt) were modelled using probabilistic approaches to reflect substitutions from the current consumption in the type of fish/seafood (alt1: excluding predatory fishes; alt2: including only methylmercury low-level fishes) or in the frequency of weekly fish/seafood consumption (alt3 to alt6: 1, 3, 5 or 7 times a week, replacing fish/seafood meals with meat or others). The overall health impact of these scenarios was quantified using disability-adjusted life years (DALY). In the Portuguese population, about 11 450 DALY could be prevented each year if the fish/seafood consumption increased to a daily basis. However, such a scenario would result in 1398 extra DALY considering the consumption by pregnant women and the respective risk on fetal neurodevelopment. Our findings support a recommendation to increase fish/seafood consumption up to 7 times/week. However, for pregnant women and children, special considerations must be proposed to avoid potential risks on fetal neurodevelopment due to methylmercury exposure.
Fossil fuels are of utmost importance to the world we live in today. However, their use can cause major impacts on the environment, especially on water resources. In this regard, algae have been intensively used as a strategy for remediation and monitoring of environmental pollution due to its efficient absorption of contaminants. In this work, samples of seaweed collected in Niterói/RJ—contaminated with kerosene and diesel—were analyzed by radiocarbon (14C) accelerator mass spectrometry (AMS) and by n-alkane quantification with gas chromatography to evaluate bioaccumulation in function of the dosage of contaminants. The biogenic content measured by radiocarbon analysis resulted in 95.6% for algae contaminated with 10 mL of kerosene and 67.6% for algae contaminated with 10 mL of diesel. The maximum intensity of n-C17 n-alkane in algae with 5 mL, 10 mL, and 15 mL of diesel was 768.2, 1878.1, and 5699.2 ng.g-1, respectively. While the maximum concentration of n-C27 in algae with 5 mL, 10 mL and 15 mL of kerosene was 3.3, 35.9, and 150.3 ng.g-1. We concluded that, for both contaminants, their incorporation into algae increases as the contamination dosage increases, making this methodology an effective technique for monitoring and remediation of urban aquatic ecosystems.
The Radiocarbon Laboratory of the Fluminense Federal University was installed in 2009, and its NEC Single Stage Accelerator Mass Spectrometry system has been operational since 2012. As the first 14C-AMS facility in Latin America, the LAC-UFF became a reference center for radiocarbon (14C) dating in Brazil. Over the years we have implemented pretreatment protocols for several kinds of materials, such as cellulose, soil, bone, and biofuels. In the present paper we describe our current protocols for the preparation of these types of samples. Moreover, after 10 years of operation, with the aim of expanding the range of materials we are able to analyze, we report the results of several tests to improve accuracy, precision and background levels. For example, here we discuss how isotopic fractionation during the graphitization and measurement steps has been controlled. Concerning results interpretation, our research group has been using OxCal chronological models to analyze different contexts such as stromatolite growth, tree rings, soil deposition and marine reservoir effect (MRE) determination.
The Brazilian health system has not been able to enforce the constitutional Right to Health for the entire population, leaving litigation as the last alternative for the fulfillment of the right. In order to harmonize and underpin the decision making of federal judges, an Academic Detailing (AD) program with concepts of evidence-based medicine and health policies for federal judges will be conducted nationwide in Brazil. AD is a strategy to provide information, combining an interactive outreach approach with the best evidence. This study reports the method used to define key messages to be used during visits.
Government, federal judges and academy representatives were invited to a workshop on health litigation in Brazil. They were divided into six groups to discuss five hypothetical scenarios. In each scenario, groups listed two possible key messages to disseminate during AD, addressing the legal, scientific, economic or ethical dimensions. After the definition, a vote was taken, according to the importance that each participant attributed to them (1 to 10), and then a score was generated.
Of the thirty-one participants, five were from the judiciary, three prosecutors, one health insurance representative, nine managers and thirteen from the academy. From the case study presented, fifty-five key messages were suggested. After removing duplicates, twenty-five were selected to assign importance values by each participant. The key messages were sorted from highest to lowest score, the most important being “Explain what evidence-based medicine means and what scientific evidence means”.
Knowledge of theoretical concepts of evidence-based medicine, health policies and the technology incorporation process seem to be of fundamental importance to federal judges. This information will serve as a basis for decision making regarding litigious proceedings involving the constitutional Right to Health in Brazil. From the selected key messages, bulletins to the academic detailing program to federal judges shall be produced.
Denture-related stomatitis caused by Candida spp. affects elderly individuals using partial/total prosthesis, provoking several discomforts including burning sensation and altered taste. Herein, we have studied 52 denture-wearing individuals (>60 years-old), attended at the dentistry clinic of UNIVALE, aiming to isolate Candida spp. directly from the stomatitis lesions and to evaluate their potential to produce virulence attributes. A low prevalence of denture-related stomatitis was reported in these patients (4/52; 7.7%). Candida albicans was isolated in the 4 selected patients, with the ability to form biofilm over a polystyrene surface and to produce aspartic protease, esterase and hemolysin. However, neither phospholipase nor caseinase activities were detected. Planktonic-growing yeasts were susceptible to amphotericin B and caspofungin, while the susceptibility to azoles (fluconazol, itraconazole and voriconazole) varied depending on either the isolate or antifungal. Relevantly, biofilm-forming C. albicans cells exhibited resistance to all studied antifungals. So, new effective drugs against resistant C. albicans isolates causing denture-related stomatitis are urgently required.
Observational studies provide evidence for an association between potassium intake and BP levels. However, uncertainties still exist about the size and the shape of this relation. Conversely, experimental studies have not been used to estimate dose-response curves, since standard methods can only be applied in trials including at least three exposure groups.
Materials and Methods:
We carried out a systematic review of the evidence concerning the effect of potassium supplementation on blood pressure in epidemiologic experimental studies. Following a PubMed search up to June 20, 2019, we included randomized controlled trials (RCTs) encompassing potassium supplementation as the only intervention for at least four weeks. We used a restricted cubic spline model and the ‘one-stage’ approach to perform a dose-response meta-analysis, a newly-developed statistical procedure which allows inclusion of studies with as few as two categories of exposure (Stat Methods Med Res. 2019;28:1579–1596). Finally, we repeated the analyses stratifying for hypertensive status and use of anti-hypertensive medication.
Overall, we included 33 studies carried out in adult population, with potassium supplementation ranging from 30 to 140 mmol/day. RCTs’ duration ranged from 4 up to 26 weeks. Most of the studies have a cross-over design (N = 24), include hypertensive individuals (N = 27) and subjects not under anti-hypertensive medication (N = 27). Overall, an increase of 40, 80 and 120 mmol/day of potassium resulted in reductions of SBP by -5.64 (95% CI - 8.78, -2.50), -4.62 (-6.41, -2.84) and -2.54 mmHg (95% CI -5.14, + 0.06), respectively. Higher potassium intakes also resulted in reduced DBP levels by -3.57 (95% CI -5.55, -1.59), -3.07 (95% CI -5.07, -1.08), and -1.92 mmHg (95% CI -5.65, 1.81). The effect of increasing potassium intake on BP was larger among hypertensives than normotensives, and among pharmacologically untreated hypertensives compared to their treated counterparts. Subgroup analyses according to study design (parallel vs. crossover) yielded similar results.
With the application of advanced dose-response modeling on RCT results, we found a U-shaped relation between potassium intake and blood pressure. A low to moderate increase in potassium intake resulted in a progressive reduction in blood pressure, which was reversed at higher levels of potassium supplementation. The effect was stronger among untreated hypertensives.
Supported by grant GP-EFSA-AFSCO-2017-01 GA09 of the European Food Safety Authority - EFSA. The text reflects only the authors' view; and EFSA is not responsible for any use that may be made of the information it contains.
This study aimed to assess the effects of the inhibition of nitric oxide synthase (NOS) on events that modulate bovine in vitro oocyte maturation. Cumulus–oocyte complexes (COCs) were cultured with hemisections (HSs) of the follicular walls in a maturation medium supplemented with different concentrations (0.1–10.0 mM) of Nω-nitro-l-arginine methyl ester hydrochloride (l-NAME). Controls consisted of COCs cultured in the presence (+HSs) or absence of HSs (–HSs) with no additional l-NAME supplementation. The following parameters were assessed: oocyte nuclear maturation stage; cumulus cell (CC) membrane integrity; nitrate/nitrite, progesterone, and estradiol concentrations in the culture medium at 22 h of cultivation; and the concentrations of cGMP and cAMP in COCs during the first hour of maturation. The addition of 1.0 mM l-NAME increased the percentage of oocytes that reached metaphase II (MII) and the percentage of intact CCs (P < 0.05). All l-NAME concentrations reduced the nitrate/nitrite concentrations (P < 0.05), but none affected steroid concentrations compared with control +HSs (P > 0.05). The addition of 1.0 mM l-NAME reduced cGMP concentrations at 3 h and increased cAMP concentrations in the first hour of culture (P < 0.05). Our findings suggest that the NOS/NO/cGMP pathway participates in meiosis progression (MI to MII) of the bovine oocytes matured in vitro in the presence of hemisections of the follicular walls. Lastly, the mechanisms that lead to the progression of meiosis after NOS inhibition do not involve changes in steroid production.
The Abrolhos bank, in southern Bahia State (BA), is the largest coral reef system in the southwestern Atlantic. It is highly influenced by the Brazil Current (BC), since it is located in the continental shelf. By contrast, Todos os Santos Bay (TSB), in Salvador, capital of Bahia State (BA) has an important coral biodiversity, located in a bay inlet with restricted water circulation. Coral cores were collected in those sites and were analyzed for density band counting and by Th/U dating to estimate growth rates and age. In this work, we present 14C ages of some of these bands in order to evaluate the marine reservoir effect (MRE) to which the colonies were subjected during growth. It is the first study making use of coral skeleton samples for MRE determination for the Brazilian coast. ΔR was calculated to be –151±23 14C yr, while that for the TSB was –107±51 14C yr.
The fraction of organic matter present affects the fragmentation behavior of sialoliths; thus, pretherapeutic information on the degree of mineralization is relevant for a correct selection of lithotripsy procedures. This work proposes a methodology for in vivo characterization of salivary calculi in the pretherapeutic context. Sialoliths were characterized in detail by X-ray computed microtomography (μCT) in combination with atomic emission spectroscopy, Fourier transform infrared spectroscopy, X-ray diffraction, scanning electron microscopy, and transmission electron microscopy. Correlative analysis of the same specimens was performed by in vivo and ex vivo helical computed tomography (HCT) and ex vivo μCT. The mineral matter in the sialoliths consisted essentially of apatite (89 vol%) and whitlockite (11 vol%) with average density of 1.8 g/cm3. In hydrated conditions, the mineral mass prevailed with 53 ± 13 wt%, whereas the organic matter, with a density of 1.2 g/cm3, occupied 65 ± 10% of the sialoliths’ volume. A quantitative relation between sialoliths mineral density and X-ray attenuation is proposed for both HCT and μCT.
The radiocarbon (14C) chronology of hunter-fisher-gatherers’ archaeological settlements along the Brazilian coast is usually based on mollusk shells, charcoal from hearths, and eventually human bones. However, fish otoliths are found in several archaeological contexts and may represent a reliable option as a chronological record. In this work, we compare the 14C dates of whitemouth croakers (Micropogonias furnieri) otoliths with dates obtained from other materials (shell and charcoal), collected from shellmounds on the coast of Rio de Janeiro, with the aim of improving the accuracy in the 14C dating of Brazilian shellmounds, strengthening the comprehension of the native populations’ occupational trends and the coeval palaeoceanographic context. Based on x-ray diffraction results for archaeological otoliths, their geochemical composition indicates minimal diagenesis effect over time even under burial conditions in the studied sites. The comparison between otolith dates and dates obtained from other proxies revealed similar results but with decreased deviations in otolith dates in all of the studied sites.
In Brazil, health is a constitutional right and the government is responsible for its guarantee. The Brazilian health system is characterized by universality, equality, and integrality, but citizens still strive to guarantee their rights through litigation. This work aimed to develop an evidence brief to support the decision-making process of judges with respect to health technologies, based on scientific evidence.
Support tools from the Evidence-Informed Policy Network (EVIPNet) were used to develop the evidence brief. After defining and describing the problem, a comprehensive search was conducted in PubMed, Health Systems Evidence, The Campbell Library, The Cochrane Library, Rx for Change, and PDQ-Evidence for systematic reviews published from 2010 to 2016. Nine systematic reviews were found. Review selection and quality appraisal were conducted independently by two reviewers. Three strategies for addressing the health litigation were defined. Evidence was summarized on benefits, harms, resource use, cost-effectiveness, uncertainties, and implementation. Implementation barriers and facilitators were also described.
Three strategies were found: (i) Rapid response services to support evidence-informed decision making in health technology decisions—educational activities and materials were described as an effective way to involve different stakeholders and inform decision making, even when financial reallocation is needed; (ii) Continuing education programs focused on developing health technology assessment knowledge among law workers—continued education and educational outreach may be effective in knowledge and ability acquisition and retention, changing professional practices. Eventual lack of interest from or availability of the professionals can be addressed by involving leaders and opinion makers, as well as offering multimedia educational materials and activities adapted for the public; and (iii) Restorative justice conferencing (RJC) focused on the litigation of health technologies—the use of RJC through face-to-face meetings or social councils involves citizens in the decision-making process, including resource management. There are multiple barriers to this option (e.g. a lack of understanding among the public, conflicts of interest, a lack of professionals capable of conducting RJCs, and the need for legal reformulation) because of its unprecedented use in the healthcare setting. Opinion leaders should be invited to facilitate communication and the decision-making process among citizens, government, and the law.
This evidence brief will be debated among interested parties and presented to the health minister and state secretaries in order to implement the strategy options, once regional specificities are taken into account.
Considering the impact of coastal dynamics on the radiocarbon (14C) marine reservoir effect (MRE), upwelling has the potential of enhancing marine influence, usually 14C depleted. Freshwater input can contribute either to increased reservoir offsets, when dead carbon from rock weathering is available, but also towards an atmospheric 14C signal, when the presence of terrestrial organic matter from catchment prevails. An overview of the MRE studies based on shellmounds on the coast of Rio de Janeiro reveals a pattern of negative local corrections for Saquarema and Rio das Ostras but positive values for Cabo Frio island, suggesting the presence of cold upwelling waters in Cabo Frio at 1.6–1.2 cal kBP. New results for a shellmound on the Ilha Grande island, in the western portion of the Rio de Janeiro coast, revealed a negative value at about 3 ka. We discuss distribution of MRE values and temporal variability in the region and their relation to ocean dynamics, continental input and the choice of marine organisms used for ∆R determination. A comparison of local reservoir offsets for the Saquarema region obtained from fish otolith and mollusk shells revealed similar ΔR distributions, showing that both materials can be equally used.
Among the oldest remains of living beings to have inhabited the Earth’s surface, there are the stromatolites—laminated sedimentary rocks associated with lithified mats of layered phototrophic microbial communities—which grow in specific environmental conditions. In the present work, we study a recent carbonatic stromatolite from Lagoa Vermelha (Rio de Janeiro, Brazil), a shallow coastal hypersaline lagoon. X-ray diffraction was associated to a depth chronological model defining three different sections based on changes in mineral composition of the stromatolite with increased dolomite content. Although a mean growth rate of 0.19±0.03 mm/yr is observed, the model discloses decreasing growth rates among the sections. Since dolomite formation can be related to high availability of Mg+2, confirmed by an expressive presence of (Ca, Mg)CO3, the lower growth rates were associated to a more arid environment, until approximately 1440 cal AD, with higher temperatures and consequently promoting water evaporation and salinity enhancement.
Jaguariaíva 1 is a sandstone rockshelter located in Jaguariaíva, Paraná State, Brazil, with rock art on the surface of the walls and ceiling. A stratigraphic analysis of the soil within the shelter showed six occupational layers and a superficial disturbed layer with evidence from the end of the 19th century. The establishment of a rock-art chronology became possible using fallen painted rock sections incorporated into three sedimentary levels underlying this rock shelter. These show superimpositions of several pictures of differently sized animals, such as deer, and lattice motifs, which are generally associated with the Planalto rock art tradition. The chronological study was performed based on radiocarbon (14C) analysis of charcoal collected from six excavated subsurface archaeological contexts. The two oldest layers, associated with hunters and gatherers of the Umbu tradition, were dated to 7680–7516 cal BP and 6913–6656 cal BP. There are four occupational layers from ceramists and farmers related to the south Jê linguistic family, and linked to the Itararé-Taquara archaeological tradition: layer 3 linked to the oldest of such occupation, dated to 3058–2796 cal BP, followed by layer 4, dated to 2080–1701 cal BP. Layers 5 and 6, dated to 1995–1526 cal BP and 540–152 cal BP, respectively.
Among other zooarchaeological remains, terrestrial snails’ shells from the Thaumastus and Megalobulimus genera are found in some Brazilian shellmounds, presenting a potential substitute for charcoal in radiocarbon dating analyses, as reliable representatives of the atmospheric carbon isotopic ratio. In this paper, we present statistically similar results of both charcoal and land snails samples from the same archaeological contexts in three settlements on the coast of Rio de Janeiro. The Manitiba I shellmound results range from 4.2 to 3.7 ka cal BP (95.4%), contemporary with the Saquarema shellmound, occupied during the period from 4.3 to 3.6 ka cal BP (95.4%). For the Usiminas shellmound, two groups of samples revealed different periods of time for two occupational layers from 2.3 to 2.1 ka cal BP (95.4%) and from 1.6 and 1.3 ka cal BP (95.4%). A model constraining each group of samples to within a single phase has a general agreement of 97% with only two outliers out of 22 dates, yielding minimum individual agreement of 74% and 7% posterior outlier probability for Saquarema shells. These are good examples of sites in which the occupation chronology can be successfully obtained by the radiocarbon dating of land snails.
Lithotripsy methods show relatively low efficiency in the fragmentation of sialoliths compared with the success rates achieved in the destruction of renal calculi. However, the information available on the mechanical behavior of sialoliths is limited and their apparently tougher response is not fully understood. This work evaluates the hardness and Young’s modulus of sialoliths at different scales and analyzes specific damage patterns induced in these calcified structures by ultrasonic vibrations, pneumoballistic impacts, shock waves, and laser ablation. A clear correlation between local mechanical properties and ultrastructure/chemistry has been established: sialoliths are composite materials consisting of hard and soft components of mineralized and organic nature, respectively. Ultrasonic and pneumoballistic reverberations damage preferentially highly mineralized regions, leaving relatively unaffected the surrounding organic matter. In contrast, shock waves leach the organic component and lead to erosion of the overall structure. Laser ablation destroys homogeneously the irradiated zones regardless of the mineralized/organic nature of the underlying ultrastructure; however, damage is less extensive than with mechanical methods. Overall, the present results show that composition and internal structure are key features behind sialoliths’ comminution behavior and that the organic matter contributes to reduce the therapeutic efficiency of lithotripsy methods.
The Radiocarbon Laboratory of the Universidade Federal Fluminense, in Brazil, has been successfully applying the zinc reduction method for graphitization of carbon samples since the development of its early protocols in 2009. Successive methodological research aiming to improve and, ultimately, optimize the precision and accuracy of our results indicates that graphitization temperatures as low as 460°C promote erratic 13C isotopic fractionation, but an approximately constant fractionation of about –5‰ is achieved at 520°C. In this work, we present isotope ratio mass spectrometry (IRMS) δ13C results for 14C reference materials graphitized at 550°C with variable amounts of zinc. Based on the results obtained from the addition of 20, 35, and 50 mg of zinc, we conclude that a slightly lower variation in 13C isotope fractionation during graphitization is obtained with less zinc. Moreover, the average isotopic fractionation is not altered by increasing the graphitization temperature from 520°C to 550°C.
Studies have demonstrated a decreased platelet ADAM10 expression in patients with Alzheimer's Disease (AD), classifying this protein as a blood-based AD biomarker. About 50% of the patients with AD are diagnosed with depression, which is commonly treated with tricyclic and tetracyclic antidepressants, monoaminoxidade (MAO) inhibitors and, more preferably, with selective serotonin reuptake inhibitors (SSRIs). Considering that a large proportion of patients with AD takes antidepressant medications during the course of the disease we investigated the influence of this medication on the expression of platelet ADAM10, which is considered the main α-secretase preventing beta-amyloid (βA) formation.
Blood was collected for protein extraction from platelets. ADAM10 was analyzed by using western blotting and reactive bands were measured using β-actin as endogenous control.
Platelet ADAM10 protein expression in patients with AD was positively influenced by serotoninergic medication.
More studies on the positive effects of serotonergic antidepressants on ADAM10 platelet expression should be performed in order to understand its biological mechanisms and to verify whether these effects are reflected in the central nervous system. This work represents an important advance for the study of AD biomarkers, as well as for more effective pharmacological treatment of patients with AD and associated depression.