Reatividade linfonodal e densidade microvascular nas metástases cervicais de carcinoma epidermóide com tumor primário oculto

INTRODUÇÃO: A neoangiogênese e a resposta imunológica são mecanismos importantes no desenvolvimento das metástases. OBJETIVO: Avaliar a reatividade linfonodal e a densidade microvascular nas metástases cervicais de carcinoma epidermóide com tumor primário oculto, considerando a sua relação com outras variáveis histológicas e clínicas. TIPO DE ESTUDO: Série de casos, retrospectiva. CASUÍSTICA E MÉTODO: 19 pacientes submetidos a esvaziamento cervical entre 1983 e 2000. Os linfonodos foram reavaliados quanto ao tipo de reatividade, considerando a área cortical e paracortical. Nas metástases foi avaliado o grau de diferenciação, desmoplasia, necrose, e densidade microvascular (CD34). Foi estabelecida a relação entre as diferentes variáveis histológicas e clínicas, incluindo o estadiamento e a evolução dos pacientes. RESULTADOS: A densidade microvascular apresentou mediana de 91 vasos/mm2, variando de 28 a 145. A reatividade paracortical foi mais freqüente nos pacientes com menos de 55 anos (90% x 44%, p= 0,05). A sobrevida livre de doença foi de 52% em 3 anos, sendo similar entre os pacientes com maior ou menor densidade microvascular tumoral. CONCLUSÕES: A densidade microvascular nas metástases de tumor primário oculto apresenta grande variação individual. Não foi possível estabelecer relação entre a densidade microvascular e as variáveis clínicas e histológicas estudadas.

A network society communicative model for optimizing the Refugee Status Determination (RSD) procedures

This article recommends a new way to improve Refugee Status Determination (RSD) procedures by proposing a network society communicative model based on active involvement and dialogue among all implementing partners. This model, named after proposals from Castells, Habermas, Apel, Chimni, and Betts, would be mediated by the United Nations High Commissioner for Refugees (UNHCR), whose role would be modeled after that of the International Committee of the Red Cross (ICRC) practice.

The international implications of the Chinese model of development in the Global South: Asian Consensus as a network power

This paper analyzes People's Republic of China (PRC) economic and political ascendance in the 21st century focusing on the evolution of the sui generis economic development model and its significances of the evolution of relationship between China and the developing countries in the peripheral "Global South." The objective of this article is to analyze the relationship between China and the Global South (Africa and South America) in the 21st century, characterized as a new Center-periphery global network power based on trade and investment that we call as "Asian Consensus."

Network dynamics in scientific knowledge acquisition: an analysis in three public universities in the state of Bahia

This paper aims to cast some light on the dynamics of knowledge networks in developing countries by analyzing the scientific production of the largest university in the Northeast of Brazil and its influence on some of the remaining regional research institutions in the state of Bahia. Using a methodology test to be employed in a larger project, the Universidade Federal da Bahia (UFBA) (Federal University of Bahia), the Universidade do Estado da Bahia (Uneb) (State of Bahia University) and the Universidade Estadual de Santa Cruz (Uesc)'s (Santa Cruz State University) scientific productions are discussed in one of their most traditionally expressive sectors in academic production - namely, the field of chemistry, using social network analysis of co-authorship networks to investigate the existence of small world phenomena and the importance of these phenomena in research performance in these three universities. The results already obtained through this research bring to light data of considerable interest concerning the scientific production in unconsolidated research universities. It shows the important participation of the UFBA network in the composition of the other two public universities research networks, indicating a possible occurrence of small world phenomena in the UFBA and Uesc networks, as well as the importance of individual researchers in consolidating research networks in peripheral universities. The article also hints that the methodology employed appears to be adequate insofar as scientific production may be used as a proxy for scientific knowledge.

Ensuring dynamic strategic fit of firms that compete globally in alliances and networks: proposing the Global SNA - Strategic Network Analysis - framework

In order to sustain their competitive advantage in the current increasingly globalized and turbulent context, more and more firms are competing globally in alliances and networks that oblige them to adopt new managerial paradigms and tools. However, their strategic analyses rarely take into account the strategic implications of these alliances and networks, considering their global relational characteristics, admittedly because of a lack of adequate tools to do so. This paper contributes to research that seeks to fill this gap by proposing the Global Strategic Network Analysis - SNA - framework. Its purpose is to help firms that compete globally in alliances and networks to carry out their strategic assessments and decision-making with a view to ensuring dynamic strategic fit from both a global and relational perspective.

Dynamic network data envelopment analysis for university hospitals evaluation

ABSTRACT OBJECTIVE To develop an assessment tool to evaluate the efficiency of federal university general hospitals. METHODS Data envelopment analysis, a linear programming technique, creates a best practice frontier by comparing observed production given the amount of resources used. The model is output-oriented and considers variable returns to scale. Network data envelopment analysis considers link variables belonging to more than one dimension (in the model, medical residents, adjusted admissions, and research projects). Dynamic network data envelopment analysis uses carry-over variables (in the model, financing budget) to analyze frontier shift in subsequent years. Data were gathered from the information system of the Brazilian Ministry of Education (MEC), 2010-2013. RESULTS The mean scores for health care, teaching and research over the period were 58.0%, 86.0%, and 61.0%, respectively. In 2012, the best performance year, for all units to reach the frontier it would be necessary to have a mean increase of 65.0% in outpatient visits; 34.0% in admissions; 12.0% in undergraduate students; 13.0% in multi-professional residents; 48.0% in graduate students; 7.0% in research projects; besides a decrease of 9.0% in medical residents. In the same year, an increase of 0.9% in financing budget would be necessary to improve the care output frontier. In the dynamic evaluation, there was progress in teaching efficiency, oscillation in medical care and no variation in research. CONCLUSIONS The proposed model generates public health planning and programming parameters by estimating efficiency scores and making projections to reach the best practice frontier.

Scientific authorships and collaboration network analysis on Chagas disease: papers indexed in PubMed (1940-2009)

Chagas disease is a chronic, tropical, parasitic disease, endemic throughout Latin America. The large-scale migration of populations has increased the geographic distribution of the disease and cases have been observed in many other countries around the world. To strengthen the critical mass of knowledge generated in different countries, it is essential to promote cooperative and translational research initiatives. We analyzed authorship of scientific documents on Chagas disease indexed in the Medline database from 1940 to 2009. Bibliometrics was used to analyze the evolution of collaboration patterns. A Social Network Analysis was carried out to identify the main research groups in the area by applying clustering methods. We then analyzed 13,989 papers produced by 21,350 authors. Collaboration among authors dramatically increased over the study period, reaching an average of 6.2 authors per paper in the last five-year period. Applying a threshold of collaboration of five or more papers signed in co-authorship, we identified 148 consolidated research groups made up of 1,750 authors. The Chagas disease network identified constitutes a "small world," characterized by a high degree of clustering and a notably high number of Brazilian researchers.

Pathogenesis of chronic Chagas cardiomyopathy: the role of coronary microvascular derangements

There is ample experimental and clinical evidence of functional and structural microvascular abnormalities occurring in patients with Chagas cardiomyopathy, possibly due to the inflammatory process and/or autonomic disturbances caused by Trypanosoma cruzi infection. Those microvascular derangements are likely to constitute at least an ancillary factor that potentiates and amplifies the chronic inflammation in myocardial tissue. It is possible to devise appropriate therapeutic interventions aimed at reverting or slowing the progression of the microvascular abnormalities to positively affect the natural history of Chagas cardiomyopathy.

Network Meta-analysis to Synthesize Evidence for Decision Making in Cardiovascular Research

Abstract Clinical decision-making requires synthesis of evidence from literature reviews focused on a specific theme. Evidence synthesis is performed with qualitative assessments and systematic reviews of randomized clinical trials, typically covering statistical pooling with pairwise meta-analyses. These methods include adjusted indirect comparison meta-analysis, network meta-analysis, and mixed-treatment comparison. These tools allow synthesis of evidence and comparison of effectiveness in cardiovascular research.

Human chronic chagasic cardiopathy: participation of parasite antigens, subsets of lymphocytes, cytokines and microvascular abnormalities

This article tries to demonstrate by new pathological findings (with the use of immunohistochemical technique and confocal laser microscopy) that chronic chagasic cardiomyopathy is a result of multiple factors involving myocarditis, immunodepression, severe fibrosis and microvessels dilatation and that all of these alterations are probably directly related with the presence of Trypanosoma cruzi parasites in the host associated with inadequate immunological response of the host.

Distinction of males of the Lutzomyia intermedia (Lutz & Neiva, 1912) species complex by ratios between dimensions and by an artificial neural network (Diptera: Psychodidae, Phlebotominae)

The females of the two species of the Lutzomyia intermedia complex can be easily distinguished, but the males of each species are quite similar. The ratios between the extra-genital and the genital structures of L. neivai are larger than those of L. intermedia s. s., according to ANOVA. An artificial neural network was trained with a set of 300 examples, randomly taken from a sample of 358 individuals. The input vectors consisted of several ratios between some structures of each insect. The model was tested on the remaining 58 insects, 56 of which (96.6%) were correctly identified. This ratio of success can be considered remarkable if one takes into account the difficulty of attaining comparable results using traditional statistical techniques.

Toxoplasma gondii: further studies on the subpellicular network

The association of the pellicle with cytoskeletal elements in Toxoplasma gondii allows this parasite to maintain its mechanical integrity and makes possible its gliding motility and cell invasion. The inner membrane complex (IMC) resembles the flattened membrane sacs observed in free-living protozoa and these sacs have been found to associate with cytoskeletal proteins such as articulins. We used immunofluorescence microscopy to characterise the presence and distribution of plateins, a sub-family of articulins, in T. gondii tachyzoites. A dispersed labelling of the whole protozoan body was observed. Electron microscopy of detergent-extracted cells revealed the presence of a network of 10 nm filaments distributed throughout the parasite. These filaments were labelled with anti-platein antibodies. Screening the sequenced T. gondii genome, we obtained the sequence of an IMC predicted protein with 25% identity and 42% similarity to the platein isoform alpha 1 present in Euplotes aediculatus, but with 42% identity and 55% similarity to that found in Euglena gracilis, suggesting strong resemblance to articulins.

Sentinel network for monitoring in vitro susceptibility of Plasmodium falciparum to antimalarial drugs in Colombia: a proof of concept

Drug resistance is one of the principal obstacles blocking worldwide malaria control. In Colombia, malaria remains a major public health concern and drug-resistant parasites have been reported. In vitro drug susceptibility assays are a useful tool for monitoring the emergence and spread of drug-resistant Plasmodium falciparum. The present study was conducted as a proof of concept for an antimalarial drug resistance surveillance network based on in vitro susceptibility testing in Colombia. Sentinel laboratories were set up in three malaria endemic areas. The enzyme linked immunosorbent assay-histidine rich protein 2 and schizont maturation methods were used to assess the susceptibility of fresh P. falciparum isolates to six antimalarial drugs. This study demonstrates that an antimalarial drug resistance surveillance network based on in vitro methods is feasible in the field with the participation of a research institute, local health institutions and universities. It could also serve as a model for a regional surveillance network. Preliminary susceptibility results showed widespread chloroquine resistance, which was consistent with previous reports for the Pacific region. However, high susceptibility to dihydroartemisinin and lumefantrine compounds, currently used for treatment in the country, was also reported. The implementation process identified critical points and opportunities for the improvement of network sustainability strategies.

The infection of microvascular endothelial cells with ExoU-producing Pseudomonas aeruginosa triggers the release of von Willebrand factor and platelet adhesion

An increased plasma concentration of von Willebrand factor (vWF) is detected in individuals with many infectious diseases and is accepted as a marker of endothelium activation and prothrombotic condition. To determine whether ExoU, a Pseudomonas aeruginosa cytotoxin with proinflammatory activity, enhances the release of vWF, microvascular endothelial cells were infected with the ExoU-producing PA103 P. aeruginosa strain or an exoU-deficient mutant. Significantly increased vWF concentrations were detected in conditioned medium and subendothelial extracellular matrix from cultures infected with the wild-type bacteria, as determined by enzyme-linked immunoassays. PA103-infected cells also released higher concentrations of procoagulant microparticles containing increased amounts of membrane-associated vWF, as determined by flow cytometric analyses of cell culture supernatants. Both flow cytometry and confocal microscopy showed that increased amounts of vWF were associated with cytoplasmic membranes from cells infected with the ExoU-producing bacteria. PA103-infected cultures exposed to platelet suspensions exhibited increased percentages of cells with platelet adhesion. Because no modulation of the vWF mRNA levels was detected by reverse transcription-polymerase chain reaction assays in PA103-infected cells, ExoU is likely to have induced the release of vWF from cytoplasmic stores rather than vWF gene transcription. Such release is likely to modify the thromboresistance of microvascular endothelial cells.

The network social support experience of people involved in home care

Objective: To build a theoretical model to configure the network social support experience of people involved in home care. Method: A quantitative approach research, utilizing the Grounded Theory method. The simultaneous data collection and analysis allowed the interpretation of the phenomenon meaning The network social support of people involved in home care. Results: The population passive posture in building their well-being was highlighted. The need of a shared responsibility between the involved parts, population and State is recognized. Conclusion: It is suggested for nurses to be stimulated to amplify home care to attend the demands of caregivers; and to elaborate new studies with different populations, to validate or complement the proposed theoretical model.