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New Trauma and Injury Severity Score (TRISS) adjustments for survival prediction
No full textAbstract\ud
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Background\ud
The objective of this study is to propose three new adjustments to the Trauma and Injury Severity Score (TRISS) equation and compare their performances with the original TRISS as well as this index with coefficients adjusted for the study population.\ud
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Methods\ud
This multicenter, retrospective study evaluated trauma victims admitted to two hospitals in São Paulo-Brazil and San Diego-EUA between January 1st, 2006, and December 31st, 2010. The proposed models included a New Trauma and Injury Severity Score (NTRISS)-like model that included Best Motor Response (BMR), systolic blood pressure (SBP), New Injury Severity Score (NISS), and age variables; a TRISS peripheral oxygen saturation (SpO2) model that included Glasgow Coma Scale (GCS), SBP, SpO2, Injury Severity Score, and age variables; and a NTRISS-like SpO2 model that included BMR, SBP, SpO2, NISS, and age variables. All equations were adjusted for blunt and penetrating trauma coefficients. The model coefficients were established by logistic regression analysis. Receiver operating characteristic (ROC) curve analysis was used to evaluate the performance of the models.\ud
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Results\ud
The original TRISS (area under the curve (AUC) = 0.90), TRISS with adjusted coefficients (AUC = 0.89), and the new proposals (NTRISS-like, TRISS SpO2, and NTRISS-like SpO2) showed no difference in performance (AUC = 0.89, 0.89, and 0.90, respectively).\ud
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Conclusions\ud
The new models demonstrated good accuracy and similar performance to the original TRISS and TRISS adjusted for coefficients in the study population; therefore, the new proposals may be useful for the assessments of quality of care in trauma patients using variables that are routinely measured and recorded.Cristiane de Alencar Domingues has received scholarship funds from\ud
Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)
Diary of Smells: Glass Ceiling
No full textFolder da exposição "Diário de cheiros Teto de vidro", de Josely Carvalho, realizada no MAC USP entre 3 de março e 6 de maio de 2018. Texto em português (páginas 2 e 3) e em inglês (páginas 7 e 8)
Behavior and illusions: a model to study superstition in a participant replacement experiment
No full textAbstract\ud
The notion of superstitious behavior can provide a basic background for understanding such notions as illusions and beliefs. The present study investigated the social mechanism of the transmission of superstitious behavior in an experiment that utilized participant replacement. The sample was composed of a total of 38 participants. Participants performed a task on a computer: they could click a colored rectangle using the mouse. When the rectangle was in a particular color, the participants received points independently of their behavior (variable time schedule). When the color of the rectangle was changed, no points were presented (extinction). Under an Individual Exposure condition, ten participants worked alone on the task. Other participants were exposed to the same experimental task under a Social Exposure condition, in which each participant first learned by observation and then worked on the task in a participant replacement (chain) procedure. The first participant in each chain in the Social Exposure condition was a confederate who worked on the task “superstitiously,” clicking the rectangle when points were presented. Superstitious responding was transmitted because of the behavior of the confederate. This also influenced estimates of personal control. These findings suggest that social learning can facilitate the acquisition and maintenance of superstitious behavior and the illusion of control. Our data also suggest that superstitious behavior and the illusion of control may involve similar learning principles.Marcelo Frota Lobato Benvenuti is a member of the Instituto Nacional de\ud
Ciência e Tecnologia sobre Comportamento, Cognição e Ensino [National\ud
Institute of Science and Technology on Behavior, Cognition, and Teaching],\ud
supported by FAPESP (grant no. 08/57705-8) and CNPq (grant no. 573972/\ud
2008-7). Support for this research was provided by FAPESP (grant no. 2011/\ud
22216-0 to Marcelo Benvenuti), FAPEMAT (doctoral scholarship grant no.\ud
392421/2012 to Thais de Toledo), and Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES), master scholarship to Flavia Duarte
Contribution of SLC26A4 to the molecular diagnosis of nonsyndromic prelingual sensorineural hearing loss in a Brazilian cohort
No full textAbstract\ud
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Objective\ud
Hereditary hearing loss (HL) is the most common sensorineural disorder in humans. Besides mutations in GJB2 and GJB6 genes, pathogenic variants in the SLC26A4 gene have been reported as a cause of hereditary HL due to its role in the physiology of the inner ear. In this research we wanted to investigate the prevalence of mutations in SLC26A4 in Brazilian patients with nonsyndromic prelingual sensorineural HL. We applied the high-resolution melting technique to screen 88 DNA samples from unrelated deaf individuals that were previously screened for GJB2, GJB6 and MT-RNR1 mutations.\ud
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Results\ud
The frequency of mutations in the SLC26A4 gene was 28.4%. Two novel mutations were found: p.Ile254Val and p.Asn382Lys. The mutation c.-66C>G (rs17154282) in the promoter region of SLC26A4, was the most frequent mutation found and was significantly associated with nonsyndromic prelingual sensorineural HL. After mutations in the GJB2, GJB6 and mitochondrial genes, SLC26A4 mutations are considered the next most common cause of hereditary HL in Brazilian as well as in other populations, which corroborates with our data. Furthermore, we suggest the inclusion of the SCL26A4 gene in the investigation of hereditary HL since there was an increase in the frequency of the mutations found, up to 22.7%.This study was supported by the Molecular Genetics and Bioinformatics Labo‑\ud
ratory, the Foundation for Education, Research and Assistance Support (FAEPA)\ud
of the University Hospital of the Ribeirão Preto Medical School—USP, and\ud
the National Council for Scientifc and Technological Development (CNPq),\ud
which supported the Master’s scholarship of the frst author (process number\ud
141974/2015-0)
Diapause in a tropical oil-collecting bee: molecular basis unveiled by RNA-Seq
No full textAbstract\ud
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Background\ud
Diapause is a natural phenomenon characterized by an arrest in development that ensures the survival of organisms under extreme environmental conditions. The process has been well documented in arthropods. However, its molecular basis has been mainly studied in species from temperate zones, leaving a knowledge gap of this phenomenon in tropical species. In the present study, the Neotropical and solitary bee Tetrapedia diversipes was employed as a model for investigating diapause in species from tropical zones. Being a bivoltine insect, Tetrapedia diversipes produce two generations of offspring per year. The first generation, normally born during the wet season, develops faster than individuals from the second generation, born after the dry season. Furthermore, it has been shown that the development of the progeny, of the second generation, is halted at the 5th larval instar, and remains in larval diapause during the dry season. Towards the goal of gaining a better understanding of the diapause phenomenon we compared the global gene expression pattern, in larvae, from both reproductive generations and during diapause. The results demonstrate that there are similarities in the observed gene expression patterns to those already described for temperate climate models, and also identify diapause-related genes that have not been previously reported in the literature.\ud
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Results\ud
The RNA-Seq analysis identified 2275 differentially expressed transcripts, of which 1167 were annotated. Of these genes, during diapause, 352 were upregulated and 815 were downregulated. According to their biological functions, these genes were categorized into the following groups: cellular detoxification, cytoskeleton, cuticle, sterol and lipid metabolism, cell cycle, heat shock proteins, immune response, circadian clock, and epigenetic control.\ud
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Conclusion\ud
Many of the identified genes have already been described as being related to diapause; however, new genes were discovered, for the first time, in this study. Among those, we highlight: Niemann-Pick type C1, NPC2 and Acyl-CoA binding protein homolog (all involved in ecdysteroid synthesis); RhoBTB2 and SASH1 (associated with cell cycle regulation) and Histone acetyltransferase KAT7 (related to epigenetic transcriptional regulation). The results presented here add important findings to the understanding of diapause in tropical species, thus increasing the comprehension of diapause-related molecular mechanisms.This work was supported by Coordenação de Aperfeiçoamento de Pessoal\ud
de Nível Superior (CAPES) as a scholarship to PKFS, by Conselho Nacional de\ud
Desenvolvimento Científico e Tecnológico (CNPq) as a research fellowship to\ud
MCA, by Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)\ud
as a scholarship to NSA (2012/18531–0) and research grants to MCA (2010/\ud
50597–5 and 2013/12530–4). This work was developed in the Centro de\ud
Pesquisa em Biodiversidade e Computação (BioComp) of the Universidade\ud
de São Paulo (USP), supported by the USP Provost’s Office for Research. The\ud
funding agencies had no role in the study design, sample collection, analysis\ud
and interpretation of the data, and in writing the manuscript
Challenges to decision-making processes in the national HTA agency in Brazil: operational procedures, evidence use and recommendations
No full textAbstract\ud
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Background\ud
The quality of the evidence used in health technology assessment (HTA) agency reports has been considered essential for decision-making processes and their legitimacy. In Brazil, CONITEC is the agency responsible for defining data mandatory for the submission of proposals for the incorporation of new technologies. The objective of this study was to analyse CONITEC recommendation reports, the type of scientific evidence used in them and their compliance with operational procedures.\ud
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Methods\ud
This is a descriptive study based on CONITEC official reports from July 2012 through December 2016. Data were collected with a specific extraction form and analysed using descriptive statistics.\ud
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Results\ud
We evaluated 199 CONITEC recommendation reports. The annual number of reports increased during the study period. The absolute annual number of new technologies incorporated in 2013 (n = 24) was similar to that observed for 2014 (n = 24) and 2015 (n = 22), decreasing in 2016 (n = 13). The type of technology most frequently evaluated was ‘drugs’ (68.3%), followed by ‘procedures’ (20.1%). Overall, 117 (58.8%) reports were internal demands, 75 (37.7%) were external demands and 7 (3.5%) were mixed demands. There were differences between internal and external demands in terms of the evidence used in the reports and the decision regarding the recommendation to incorporate the technologies. Among the internal demands, the recommendation to incorporate the new technology was made for 70.9% of the reports, only 9.6% of which included full HTAs. Among the external demands, the incorporation of the new technology was recommended for 17.3% of the reports, 76.9% of which included full HTAs. Of the 101 reports in which incorporation of the new technology was recommended, 88 (87.1%) did not include a full health economic evaluation and ICER calculation. There are compliance difficulties with the recommendations in the CONITEC internal regulations regarding the type and quality of evidence considered in the analysis of recommendation reports.\ud
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Conclusions\ud
The characteristics of the evidence used in recommendation reports and those considered to be mandatory were very different, indicating problems in decision-making processes. There is a need to study, with a broader perspective, the factors that influence the type of evidence used in decision-making processes in order to contribute to the development of better practices and policies.No direct funding was received for this study. However, PCS is the recipient\ud
of grants from the Fundação de Amparo à Pesquisa do Estado de São Paulo\ud
(FAPESP, São Paulo Research Foundation; Research Grant no. 2012/22126–3)\ud
and from the Conselho Nacional de Desenvolvimento Cientifico e Tecnológico\ud
(CNPq, National Council for Technological and Scientific Development;\ud
Research Grant no. 304580/2016–3); HMDN is the recipient of a grant from\ud
the CNPq (Research Grant no. 306536/2015–3); and TYY is the recipient of a\ud
grant from FAPESP (Research Grant no. 2015/02713–0). PCS, HMDN and TYY\ud
are researchers from the IATS, National Institute of Science and Technology\ud
for Health Technology Assessment (IATS) – CNPq/Brazil
A hybrid protein containing MSP1a repeats and Omp7, Omp8 and Omp9 epitopes protect immunized BALB/c mice against anaplasmosis
No full textAbstract\ud
Anaplasma marginale (A. marginale) has a remarkable impact on livestock production, and an effective vaccine is not currently available due to the inexistence of a small animal model. Recently, BALB/c mice were successfully infected with A. marginale, resulting in an acute and persistent anaplasmosis infection. Here, we designed a hybrid protein containing repeats of polypeptide 1a from major surface protein-1 complex (MSP1a) repeats and common epitopes of outer membrane proteins (OMPs) OMP7, OMP8 and OMP9 expressed in Escherichia coli. Our proof-of-concept assessed vaccinal effectiveness against a challenge with live bacteria. The MSP1a/OMP7/8/9 immunized BALB/C mice exhibited a strong reduction in rickettsemia and had no signs of anaplasmosis or hepatic lesions. In contrast, the non-immunized mice exhibited signs of anaplasmosis and a body weight loss associated with increases in monocyte and neutrophil counts. Furthermore, the non-immunized mice displayed atrophies with chronic inflammatory infiltrates in the spleen and increased binucleation and hydropic degeneration in the hepatocytes. Our findings demonstrated that immunization with our hybrid protein induced a strong reduction in rickettsemia and conferred protection against anaplasmosis. Therefore, given the strong evidence of the protective effect against anaplasmosis, hybrid protein designs are potential candidates for the rational design of vaccinal subunits.This study has no granted, and it was performed with help of authors. We had\ud
not fnancial support to provide this study, but we acknowledge the FAPEAM\ud
for Keila Pereira’s fellowship through the Graduate Biotechnology Program
Natural vertical transmission of dengue virus in Aedes aegypti and Aedes albopictus: a systematic review
No full textAbstract\ud
Dengue is of great concern in various parts of the world, especially in tropical and subtropical countries where the mosquito vectors Aedes aegypti and Aedes albopictus are present. The transmission of this virus to humans, by what is known as horizontal transmission, occurs through the bite of infected females of one or other of the two mosquito species. Furthermore, an infected female or male parent, by what is known as vertical transmission, can transfer this arbovirus to some part of their offspring. Considering that vertical transmission may represent an important strategy for maintaining the circulation of arboviruses in nature, the verification of this phenomenon worldwide is extremely important and necessary to better understand its dynamic. In the present study, we conducted a literature review of the presence of natural vertical transmission of dengue virus in Ae. aegypti and Ae. albopictus worldwide. Searches were conducted in MEDLINE, sciELO and Lilacs and all the studies published in Portuguese, English and Spanish were read, evaluated and organized by mosquito species, serotype and the location at which the samples were collected. Forty-two studies were included in accordance with the exclusion criteria and methodology. The presence of natural vertical transmission in Ae. aegypti and Ae. albopictus was most clearly evidenced by dengue virus in endemic countries, especially in those in South America and Asia. Despite several African countries being considered endemic for dengue, there is a lack of publications on this subject on that continent, which highlights the importance of conducting studies there. Furthermore, the finding of natural vertical transmission in Ae. albopictus in countries where this species is not yet incriminated as a vector is of great concern as it demonstrates the circulation of this virus in populations of Ae. albopictus and alerts to the possibility of some other mosquito species playing a role in the transmission dynamics of this arbovirus. Parallel to this, the small number of studies of natural vertical transmission of chikungunya and Zika virus in the world may be explained by the recent entry of these arboviruses into most of the countries concerned.This research was financially supported by: Grant No. 2016/12140–0, São Paulo Research Foundation (FAPESP); Grant No. 2017/12434–6, São Paulo Research Foundation (FAPESP)
Quality of life scores differs between genotypic groups of patients with suspected hereditary hemochromatosis
No full textAbstract\ud
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Background\ud
Hereditary hemochromatosis (HH) encompasses a group of autosomal recessive disorders mainly characterized by enhanced intestinal absorption of iron and its accumulation in parenchymal organs. HH diagnosis is based on iron biochemical and magnetic resonance imaging (MRI) assessment, and genetic testing. Questionnaires, such as SF-36 (short form health survey), have been increasingly used to assess the impact of diseases on the patient’s quality of life (QL). In addition, different genotypes are identified as results of genetic tests in patients with suspected primary iron overload. In the present study, our aim was to evaluate whether domains of QL are different according to genotypic groups in patients suspected of HH.\ud
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Methods\ud
Seventy-nine patients with primary iron overload were included and two genotypic groups were formed (group 1: homozygous genotype for the HFE p.Cys282Tyr mutation; group 2: other genotypes).\ud
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Results\ud
Group 1 had higher means of plasma transferrin saturation (86 ± 19%) and serum ferritin (1669 ± 1209 ng/mL) compared to group 2 (71 ± 12%, 1252 ± 750 ng/mL, respectively; p = 0.001). Four domains were significantly different among groups 1 and 2: physical functioning (p = 0.03), bodily pain (p = 0.03), vitality (p = 0.02) and social functioning (p = 0.01).\ud
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Conclusions\ud
Our main finding was that patients with p.Cys282Tyr homozygosity had a worse QL scenario assessed by SF-36, compared with patients with iron overload without the same genotype. Being aware of this relationship between genotypes and QL might be helpful in the overall management of patients suspected of hereditary hemochromatosis.PFS Fonseca and PCJL Santos are recipients of fellowships from\ud
Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) and\ud
Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP), Brazil\ud
(Proc. 2013/09295–3 and Proc. 2013/20614–3, respectively)
Spontaneous prematurity in fetuses with congenital diaphragmatic hernia: a retrospective cohort study about prenatal predictive factors
No full textAbstract\ud
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Background\ud
To evaluate possible predictive factors of spontaneous prematurity in fetuses with congenital diaphragmatic hernia (CDH).\ud
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Methods\ud
A retrospective cohort study was performed. Inclusion criteria were presence of CDH; absence of fetoscopy; absence of karyotype abnormality; maximum of one major malformation associated with diaphragmatic hernia; ultrasound monitoring at the Obstetrics Clinic of Clinicas Hospital at the University of São Paulo School of Medicine, from January 2001 to October 2014. The data were obtained through the electronic records and ultrasound system of our fetal medicine service. The following variables were analyzed: maternal age, primiparity, associated maternal diseases, smoking, previous spontaneous preterm birth, fetal malformation associated with hernia, polyhydramnios, fetal growth restriction, presence of intrathoracic liver, invasive procedures performed, side of hernia and observed-to- expected lung to head ratio (o/e LHR). On individual analysis, variables were assessed using the Chi-square test and the Mann-Whitney test. A multiple logistic regression model was applied to select variables independently influencing the prediction of preterm delivery. A ROC curve was constructed with the significant variable, identifying the values with best sensitivity and specificity to be suggested for use in clinical practice.\ud
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Results\ud
Eighty fetuses were evaluated, of which, 21 (26.25%) were premature. O/e LHR was the only factor associated with prematurity (p = 0.020). The ROC curve showed 93% sensitivity with 48.4% specificity for the cutoff of 40%.\ud
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Conclusion\ud
O/e LHR was the only predictor of prematurity in this sample