Extracellular vesicles: structure, function, and potential clinical uses in renal diseases

Interest in the role of extracellular vesicles in various diseases including cancer has been increasing. Extracellular vesicles include microvesicles, exosomes, apoptotic bodies, and argosomes, and are classified by size, content, synthesis, and function. Currently, the best characterized are exosomes and microvesicles. Exosomes are small vesicles (40-100 nm) involved in intercellular communication regardless of the distance between them. They are found in various biological fluids such as plasma, serum, and breast milk, and are formed from multivesicular bodies through the inward budding of the endosome membrane. Microvesicles are 100-1000 nm vesicles released from the cell by the outward budding of the plasma membrane. The therapeutic potential of extracellular vesicles is very broad, with applications including a route of drug delivery and as biomarkers for diagnosis. Extracellular vesicles extracted from stem cells may be used for treatment of many diseases including kidney diseases. This review highlights mechanisms of synthesis and function, and the potential uses of well-characterized extracellular vesicles, mainly exosomes, with a special focus on renal functions and diseases.

Form(s)-of-life: agamben's reading of Wittgenstein and the potential uses of a notion

Giorgio Agamben and Ludwig Wittgenstein seem to have very little in common: the former is concerned with traditional ontological issues while the latter was interested in logics and ordinary language, avoiding metaphysical issues as something we cannot speak about. However, both share a crucial notion for their philosophical projects: form of life. In this paper, I try to show that, despite their different approaches and goals, form of life is for both a crucial notion for thinking ethics and life in-common. Addressing human existence in its constitutive relation to language, this notion deconstructs traditional dichotomies like bios and zoé, the cultural and the biological, enabling both authors to think of a life which cannot be separated from its forms, recognizing the commonality of logos as the specific trait of human existence. Through an analogical reading between both theoretical frameworks, I suggest that the notion of form-of-life, elaborated by Wittgenstein to address human production of meaning, becomes the key notion in Agamben's affirmative thinking since it enables us to consider the common ontologically in its relation to Human potentialities and to foresee a new, common use of the world and ourselves.

Brazil and the nuclear issues in the years of the Luiz Inácio Lula da Silva government (2003-2010)

The present article is an analysis of Brazilian nuclear diplomacy and of the international relevance of the national nuclear program adopted during the two Presidential terms of Luiz Inácio Lula da Silva. Particular attention will be given to the Brazilian position in the agreement on nuclear non-proliferation, to the role of mediation between Iran and the nuclear powers, and finally to the national ambitions concerning the industrial and military uses of the nuclear technologies.

The essential role of democracy in the Bush Doctrine: the invasions of Iraq and Afghanistan

Everyone knows that democracy played a role in the Bush Doctrine. What not everyone knows is that this role was essential for the doctrine to be put into operation under which the Iraq invasion was prepared and launched. We argue moreover that, even if aggressive, the Bush doctrine is compatible with the American Liberal Tradition. To demonstrate these arguments we analyze the links between democracy, security, and the US national interests as expressed in the pillars of the American foreign policy since the end of Cold War. The consequential belief of the Bush Administration on the positive effect of exporting democracy by the use of force to Afghanistan and Iraq to fight terrorism will be remarked. It will be shown, however, that in the first years of the Bush Administration, among the justifications for the military interventions in the two countries, security reasons prevailed over democratic concerns, although the latter was significantly present since the early hours after September 11. It was only when it became clear that WMDs did not exist in Iraq that the exporting of democracy as the ultimate weapon to fight terrorism grew remarkably and prevailed over security reasons to invade those rogue states. The paper uses quantitative and qualitative content analysis of the speeches of President Bush and his Secretaries of State and Defense.

Discourses of cyberspace securitization in Brazil and in the United States

Abstract This paper uses the framework of the Copenhagen School to understand the process of securitization of cyberspace, exploring how something in such sphere becomes a threat. Seeking to contribute to the debate, this study analyses the securitization discourses of Brazil and of the United States from Hansen and Nissenbaum's (2009) theorization about the existence of a specific sector for cybersecurity. To comprehend the securitization of cyberspace in these terms allows not only to identify distinct levels of securitization, but also to capture the dynamics of cyber threats, distinguishing them from those existent in other sectors, as well as to trace distinctions between tendencies of securitization and militarization.

Morphological, physical and pedogenetic attributes related to water yield in small watersheds in Guarapari/ES, Brazil

Soil characteristics related to the genesis, land use and management are important factors in water dynamics in watersheds. This study evaluated physical, morphological and pedogenetic attributes related to water yield potential in small watersheds in Guarapari, ES, Brazil. The following representative profiles were selected, morphologically described and sampled in area of Atlantic Forest domain: Lithic Udifolists, Oxyaquic Udifluventes, Typic Paleudults, Typic Hapludults, Typic Hapludox, Oxic Dystrudepts and Typic Endoaquents. Samples were collected in the soil profiles for physical analysis. Measurements of field-saturated hydraulic conductivity and soil penetration resistance were perfomed in some profiles, which were under different uses. The Endoaquents of Limão Creek can be considered efficient as temporary water reservoirs. However, the use of artificial drainage tends to reduce this effect. Differential erosion was detected by the sand texture on the surface of the Typic Paleudults due to the low degree of clay flocculation, slope, high resistance to the penetration and low hydraulic conductivity of the Bt horizon, making it necessary to adopt soil management practices to increase the water infiltration. Under pasture, mainly in the cattle trails where the trampling is more intense, there was high resistance to penetration in the superficial layers of the Typic Hapludults. The Typic Hapludox have the greatest potential for water yield in the small watersheds because of its greater extent in the headwaters and their morphological and physical characteristics, which can result in increased aquifer recharge.

Identification of 'Ubá' mango tree zygotic and nucellar seedlings using ISSR markers

Polyembryonic seeds are characterized by the development of over one embryo in the same seed, which can be zygotic and nucellar. The objective of this work was to identify the genetic origin, whether zygotic or nucellar, of seedlings of polyembryonic seeds of 'Ubá' mango tree using ISSR markers, and relating them with the vigor of the seedlings. Thus, mangos were harvested in Visconde do Rio Branco (accession 102) and Ubá (accessions 112, 138, 152 and 159), whose seeds were germinated in plastic trays filled with washed sand. Fifty days after sowing, seedlings from five seeds of each one of the accessions 102, 112, 138, 159 and from 10 seeds of the accession 152, were analyzed. These sseedlings were characterized and evaluated for plant height, stem circumference and mass of fresh aerial part and the most vigorous seedling was the one displaying at least two of these traits higher than the other seedlings from seed. Leaves were collected for genomic DNA extraction, which was amplified using seven ISSR primers previously selected based on the amplification profile and considering the number and resolution of fragments. Zygotic seedlings were found in 18 seeds, which were the most vigorous in six seeds. The results evidenced the existence of genetic variability in orchards using seedlings grown from seeds, because the farmer usually uses the most vigorous ones, assuming that this is of nucellar origin. These results also indicate that the most vigorous seedling are not always nucellar, inasmuch as of 20% of the total seeds evaluated, the zygotic seedling was the most vigorous.

Antecedents of the importance of price in purchase decisions

This paper analyses the commercial and socio-demographic antecedents of the importance of price in buyers' decisions. The study uses ordinal regression in order to analyze the data obtained from a random sample of consumers of frequently purchased products; these consumers were surveyed in different stores. The results demonstrate that shopping enjoyment and brand loyalty have an influence over the importance of price. However, responsibility for shopping (purchase frequency) does not show a significant relationship. Furthermore, some interesting socio-demographic characteristics were found in the context of the study that can be analyzed in future research.

USE AND CONSEQUENCES OF PARTICIPATORY GIS IN A MEXICAN MUNICIPALITY: APPLYING A MULTILEVEL FRAMEWORK

This paper seeks to understand the use and the consequences of Participatory Geographic Information System (PGIS) in a Mexican local community. A multilevel framework was applied, mainly influenced by two theoretical lenses – structurationist view and social shaping of technology – structured in three dimensions – context, process and content – according to contextualist logic. The results of our study have brought two main contributions. The first is the refinement of the theoretical framework in order to better investigate the implementation and use of Information and Communication Technology (ICT) artifacts by local communities for social and environmental purposes. The second contribution is the extension of existing IS (Information Systems) literature on participatory practices through identification of important conditions for helping the mobilization of ICT as a tool for empowering local communities.

On the economic analysis of response to preventive measures

There are many circumstances in which the effectiveness of preventive measures depends to a large extent on the compliance of the patient in changing his or her behavior or lifestyle. It is shown how economic techniques can be used (i) to describe the rationale of individuals and predict their behavior (Section 2); and (ii) to assess preventive measures that, by requiring a change of conduct, imply "costs" to the individual due to a decline in the quality of life (Appendix). Cigarette smoking and coronary heart disease are used as an illustration. While the analysis of Section 2 uses graphical techniques, a simple textbook-type of lifetime utility model with a mathematical emphasis is used in the Appendix. It is also shown that techniques often used to assess health care programs such as the QALYs (Quality-Adjusted Life Years) are inappropriate to the evaluation of preventive programs aiming at behavioral changes. Finally, topics that call for further research are indicated.

Convergent validity between SF-36 and WHOQOL-BREF in older adults

OBJECTIVE : To compare the reliability and convergent validity of instruments assessing quality of life in Brazilian older adults. METHODS : Cross-sectional study of 278 literate, community-dwelling older adults attending a municipal university for the elderly in Sao Carlos, SP, Southeastern Brazil between 2006 and 2008. The Brazilian versions of the SF-36 and WHOQOL-BREF instruments to assess quality of life were compared. Cronbach’s alpha coefficient was used to estimate reliability and Pearson’s correlation for comparison between the two scales. RESULTS : Most of participants were women (87.8%) with a mean age of 63.83±7.22 years. Both scales showed an acceptable internal consistency – WHOQOL-BREF Cronbach’s alpha was 0.832 and SF-36 was 0.868. There was a weak (r ≤ 0.6) correlation between the related fields in the two questionnaires. CONCLUSIONS : The SF-36 and WHOQOL-BREF are reliable instruments for clinical and research uses in Brazilian older women. To select one, researchers should consider which aspects of quality of life they aim to capture because of weak convergent validity signs. This study’s results indicate that WHOQOL-BREF may be more relevant to evaluate changes in the quality of life of older women because it prioritizes responses to the aging process and avoids focusing on impairment.

Trends in public health policies addressing violence against women

OBJECTIVE To analyze the content of policies and action plans within the public healthcare system that addresses the issue of violence against women.METHODS A descriptive and comparative study was conducted on the health policies and plans in Catalonia and Costa Rica from 2005 to 2011. It uses a qualitative methodology with documentary analysis. It is classified by topics that describe and interpret the contents. We considered dimensions, such as principles, strategies, concepts concerning violence against women, health trends, and evaluations.RESULTS Thirteen public policy documents were analyzed. In both countries’ contexts, we have provided an overview of violence against women as a problem whose roots are in gender inequality. The strategies of gender policies that address violence against women are cultural exchange and institutional action within the public healthcare system. The actions of the healthcare sector are expanded into specific plans. The priorities and specificity of actions in healthcare plans were the distinguishing features between the two countries.CONCLUSIONS The common features of the healthcare plans in both the counties include violence against women, use of protocols, detection tasks, care and recovery for women, and professional self-care. Catalonia does not consider healthcare actions with aggressors. Costa Rica has a lower specificity in conceptualization and protocol patterns, as well as a lack of updates concerning health standards in Catalonia.

Hospitalization due to drug use did not change after a decade of the Psychiatric Reform

ABSTRACT OBJECTIVE To investigate whether the psychiatric hospitalization rates due to use of psychoactive substances and average time of hospitalization suffered any changes after the first decade of effective implementation of the psychiatric reform in Brazil. METHODS This article examines the evolution of hospitalizations due to disorders arising from the use of alcohol or other substances in the state of Santa Catarina, Southern Brazil, from 2000 to 2012. This is an ecological, time-series study, which uses data from admissions obtained by the Informatics Service of the Brazilian Unified Health System. Hospitalization rates by 100,000 inhabitants and average time of occupancy of beds were estimated. Coefficients of variation of these rates were estimated by Poisson Regression. RESULTS The total and male hospitalization rates did not vary (p = 0.056 and p = 0.244, respectively). We observed an increase of 3.0% for the female sex (p = 0.049). We did not observe any significant variation for occupancy time of beds. CONCLUSIONS The deployment of services triggered by the Brazilian psychiatric reform was not accompanied by a reduction of hospitalization rates or mean occupancy time of hospitalized patients during this first decade of implementation of the reform.

Difficulties in access and estimates of public beds in intensive care units in the state of Rio de Janeiro

ABSTRACT OBJECTIVE To estimate the required number of public beds for adults in intensive care units in the state of Rio de Janeiro to meet the existing demand and compare results with recommendations by the Brazilian Ministry of Health. METHODS The study uses a hybrid model combining time series and queuing theory to predict the demand and estimate the number of required beds. Four patient flow scenarios were considered according to bed requests, percentage of abandonments and average length of stay in intensive care unit beds. The results were plotted against Ministry of Health parameters. Data were obtained from the State Regulation Center from 2010 to 2011. RESULTS There were 33,101 medical requests for 268 regulated intensive care unit beds in Rio de Janeiro. With an average length of stay in regulated ICUs of 11.3 days, there would be a need for 595 active beds to ensure system stability and 628 beds to ensure a maximum waiting time of six hours. Deducting current abandonment rates due to clinical improvement (25.8%), these figures fall to 441 and 417. With an average length of stay of 6.5 days, the number of required beds would be 342 and 366, respectively; deducting abandonment rates, 254 and 275. The Brazilian Ministry of Health establishes a parameter of 118 to 353 beds. Although the number of regulated beds is within the recommended range, an increase in beds of 122.0% is required to guarantee system stability and of 134.0% for a maximum waiting time of six hours. CONCLUSIONS Adequate bed estimation must consider reasons for limited timely access and patient flow management in a scenario that associates prioritization of requests with the lowest average length of stay.