Custos de procedimentos de saúde e associação com nível de atividade física e estado nutricional de idosos hipertensos e diabéticos: análise do Estudo SABE - Saúde, Bem-estar e Envelhecimento, 2010

Introdução O nível de atividade física (NAF) insuficiente e estado nutricional (EN) inadequado conferem risco de desenvolvimento de hipertensão arterial e diabete, bem como dificultam o controle destas doenças. Assim, infere-se que os custos despendidos pelo SUS com medicamentos, internações e consultas de hipertensos e diabéticos apresentem relação inversa com NAF, incluindo a prática de caminhada e EN. Entretanto, estudos epidemiológicos que descrevam estes custos e analisem essas associações na população idosa são inexistentes no Brasil, o que dificulta a fundamentação para a implementação de políticas publicas para a economia de recursos. Objetivo Descrever os custos com procedimentos de saúde de idosos hipertensos e diabéticos e verificar qual a sua associação com NAF e EN, segundo sexo e grupos etários. Métodos A amostra foi constituída por 806 idosos com autorreferência à hipertensão e/ou diabete ( 60 anos) residentes no município de São PauloSP, participantes das três coortes do Estudo Saúde, Bem-estar e Envelhecimento SABE - em 2010. A variável dependente custo total anual (em Reais), foi estimada com base nos dados autorreferidos sobre uso de medicamentos, uso dos serviços ambulatoriais e internações hospitalares, retroativos a um ano da coleta de dados. A variáveis explanatórias: i) NAF foi estimada a partir de entrevista utilizando o International Physical Activity Questionnaire (IPAQ, versão curta), classificando os idosos segundo duração da realização de atividades físicas moderada, em ativos ( 150 minutos/semana) e insuficientemente ativos (< 150 minutos/semana); ii) Prática de caminhada, categorizada segundo frequência semanal: a) 4 dias/ semana; b) 1 a 3 dias/semana; c) não caminha. iii) EN, identificado pelo índice de massa corporal (IMC), classificando os idosos em dois grupos: a) IMC < 28 kg/ m²; b) IMC 28 kg/ m² (excesso de peso); as variáveis de controle foram o sexo, grupos etários (a. 70 anos; b. 65 a 69 anos; c. 60 a 64 anos); estado civil (a. casado; b. outros) e, escolaridade (a. sem escolaridade; b. 1 ano). A descrição dos custos segundo as NAF e EN foi representada pelos valores de média e IC95 por cento , mediana e P25 P75, valores mínimos e máximos. Modelos de regressão logística múltipla foram empregados para analisar as associações entre variáveis dependentes e explanatórias. O nível de significância foi estabelecido em 5 por cento e todas as análises foram realizadas considerando amostras complexas, por meio do software Stata, 13.0. 9 Resultados: A média de custo total anual por pessoa foi de R$ 732,54 e a soma dos custos relativa a 12 meses para os 806 idosos foi de R$ 609.587,20, sempre superiores para idosos em excesso de peso, com NAF insuficiente e para idosos que não caminham. Idosos em excesso de peso apresentaram chance 50 por cento superior de estarem no grupo de maior custo total anual (OR 1.49, IC95 por cento 1.01 2.18) e mais de 70 por cento superior de maior custo com medicamentos (OR 1.71, IC95 por cento 1.18 2.47). A ausência de caminhada significou a chance superior para maiores custos anuais com medicamentos (OR 1.63, IC95 por cento 1.06 2.51) e custos totais (OR 1.82, IC95 por cento 1.17 2.81). Todas as análises ajustadas por sexo e idade. O NAF não se associou aos custos totais e custo com medicamentos (p>0.05). Conclusão: Os custos para o controle de HAS e DM em idosos são altos e se associam inversamente à prática de caminhada e ao estado nutricional, especialmente em relação ao custo com o uso de medicamentos antihipertensivos e hipoglicemiantes.

Paleointensity of various DSDP sites (Table 3)

The existing database for paleointensity estimates of the ancient geomagnetic field contains more than 1500 data points collected through decades of effort. Despite the huge amount of work put into obtaining these data, there remains a strong bias in the age and global distribution of the data toward very young results from a few locations. Also, few of the data meet strict criteria for reliability and most are of unknown quality. In order to improve the age and spatial distribution of the paleointensity database, we have carried out paleointensity experiments on submarine basaltic glasses from a number of DSDP sites. Of particular interest are the sites that provide paleointensity data spanning the time period 0.3-5 Ma, a time of relatively few high quality published data points. Our new data are concordant with contemporaneous data from the published literature that meet minimum acceptance criteria, and the combined data set yields an average dipole moment of 5.49 +/- 2.36*10**22 Am**2. This average value is comparable to the average paleofield for the period 5-160 Ma (4.2 +/- 2.3*10**22 Am**2) (Juarez et al., 1998, doi:10.1038/29746) and is substantially less than the value of approximately 8*10**22 Am**2 often quoted for the last 5 Myr (e.g. McFadden and McElhinny (1982) J. Geomagn. Geoelectr. 34, 163-189; Goguitchaichvili et al., 1999, doi:10.1016/S0012-821X(99)00010-2).

Analysis of Mn nodules from cruise GH72-2

The GH72-2 shipborne survey was carried out in the northwest Pacific during 31 days under the 'Basic investigations for exploration of deep sea mineral resources' program. The sediments encountered could be classified as follows: 1) Most of the brown clays occur on the abyssal plain of the basins at depth over 4500m. 2) Calcareous oozes are predominant at the top, slope and foot of seamounts and guyots. 3) Terrigeneous sediments are distributed near islands. The concentrated zone of ferromanganese nodules was located in the Magellan seamounts area. However, the metal contents in Mn, Cu, Ni and Co for these nodules are relatively poor, and these ferromanganese deposits occur at a depth over 5000m. It is interesting to note that the shape of the nodules is sometimes nearly spherical, and that the chemical composition of the nodules is characterized by the low ratio Mn/Fe and Co/Ni.

Factors associated with pregnant women's participation in a mHealth intervention in Timor-Leste

Thesis (Master's)--University of Washington, 2016-06

Nedd4-2 functionally interacts with ClC-5 - Involvement in constitutive albumin endocytosis in proximal tubule cells

Constitutive albumin uptake by the proximal tubule is achieved by a receptor-mediated process in which the Cl- channel, ClC-5, plays an obligate role. Here we investigated the functional interaction between ClC-5 and ubiquitin ligases Nedd4 and Nedd4-2 and their role in albumin uptake in opossum kidney proximal tubule (OK) cells. In vivo immunoprecipitation using an anti-HECT antibody demonstrated that ClC-5 bound to ubiquitin ligases, whereas glutathione S-transferase pull-downs confirmed that the C terminus of ClC-5 bound both Nedd4 and Nedd4-2. Nedd4-2 alone was able to alter ClC-5 currents in Xenopus oocytes by decreasing cell surface expression of ClC-5. In OK cells, a physiological concentration of albumin (10 mug/ml) rapidly increased cell surface expression of ClC-5, which was also accompanied by the ubiquitination of ClC-5. Albumin uptake was reduced by inhibiting either the lysosome or proteasome. Total levels of Nedd4-2 and proteasome activity also increased rapidly in response to albumin. Overexpression of ligase defective Nedd4-2 or knockdown of endogenous Nedd4-2 with small interfering RNA resulted in significant decreases in albumin uptake. In contrast, pathophysiological concentrations of albumin (100 and 1000 mug/ml) reduced the levels of ClC-5 and Nedd4-2 and the activity of the proteasome to the levels seen in the absence of albumin. These data demonstrate that normal constitutive uptake of albumin by the proximal tubule requires Nedd4-2, which may act via ubiquitination to shunt ClC-5 into the endocytic pathway.

Heparanase and COX-2 expression as predictors of lymph node metastasis in large, high-grade breast tumors

Background/Aim: Heparanase (HPA) contributes to breast cancer metastasis by facilitating the breakdown of the basement membrane and extracellular matrix. High expression of HPA is thought to be associated with increased nodal involvement and poor survival in patients with breast cancer. Overexpression of cyclooxygenase-2 (COX-2) in breast cancer is associated with indicators of poor prognosis such as lymph node metastasis, poor differentiation, and large tumor size. The underlying mechanism by which HPA and COX-2 overexpression increases the metastatic potential of breast cancer is not fully-understood. To enhance our understanding over these mechanisms, we aimed to investigate the relationship between the size of the tumor and HPA expression, tumor grade as well as lymph node status in patients with breast cancer. Materials and Methods: Immunohistochemical analysis of HPA and COX-2 expression was performed on 246 breast tumor samples. The expression of HPA was correlated with COX-2 expression, tumor grade, lymph node status, oestrogen receptor status. Results: The overexpression of HPA and COX-2 was associated with increased likelihood of lymph node positivity in large, high-grade tumors. High-grade tumors with size greater than 20 mm, that overexpressed HPA, were 4-times more likely to be associated with lymph node involvement (OR 4.71, CI 1.21-18.25). Whereas, tumors greater than 20 mm in size were 5-times more likely to metastasize to the regional lymph nodes, if associated with overexpression of COX-2 (OR 5.5, CI 1.2-24.8). Conclusion: Expression of HPA appears to be a key mechanism by which large, highgrade breast tumors metastasize to regional lymph nodes, while COX-2 overexpression may be an independent predictor of lymph node positivity.

Compilation of downward flux observations from sediment trap deployments in the Atlantic Ocean - Contribution to EURO-BASIN's Data integration

We provide a compilation of downward fluxes (total mass, POC, PON, BSiO2, CaCO3, PIC and lithogenic/terrigenous fluxes) from over 6000 sediment trap measurements distributed in the Atlantic Ocean, from 30 degree North to 49 degree South, and covering the period 1982-2011. Data from the Mediterranean Sea are also included. Data were compiled from different sources: data repositories (BCO-DMO, PANGAEA), time series sites (BATS, CARIACO), published scientific papers and/or personal communications from PI's. All sources are specifed in the data set. Data from the World Ocean Atlas 2009 were extracted to provide each flux observation with contextual environmental data, such as temperature, salinity, oxygen (concentration, AOU and percentage saturation), nitrate, phosphate and silicate.

Data compilation on the biological response to ocean acidification: environmental and experimental context of data sets and related literature

The exponential growth of studies on the biological response to ocean acidification over the last few decades has generated a large amount of data. To facilitate data comparison, a data compilation hosted at the data publisher PANGAEA was initiated in 2008 and is updated on a regular basis (doi:10.1594/PANGAEA.149999). By January 2015, a total of 581 data sets (over 4 000 000 data points) from 539 papers had been archived. Here we present the developments of this data compilation five years since its first description by Nisumaa et al. (2010). Most of study sites from which data archived are still in the Northern Hemisphere and the number of archived data from studies from the Southern Hemisphere and polar oceans are still relatively low. Data from 60 studies that investigated the response of a mix of organisms or natural communities were all added after 2010, indicating a welcomed shift from the study of individual organisms to communities and ecosystems. The initial imbalance of considerably more data archived on calcification and primary production than on other processes has improved. There is also a clear tendency towards more data archived from multifactorial studies after 2010. For easier and more effective access to ocean acidification data, the ocean acidification community is strongly encouraged to contribute to the data archiving effort, and help develop standard vocabularies describing the variables and define best practices for archiving ocean acidification data.

Diatom abundance in surface sediments of the Southern Ocean

Based on the quantitative analysis of diatom assemblages preserved in 274 surface sediment samples recovered in the Pacific, Atlantic and western Indian sectors of the Southern Ocean we have defined a new reference database for quantitative estimation of late-middle Pleistocene Antarctic sea ice fields using the transfer function technique. The Detrended Canonical Analysis (DCA) of the diatom data set points to a unimodal distribution of the diatom assemblages. Canonical Correspondence Analysis (CCA) indicates that winter sea ice (WSI) but also summer sea surface temperature (SSST) represent the most prominent environmental variables that control the spatial species distribution. To test the applicability of transfer functions for sea ice reconstruction in terms of concentration and occurrence probability we applied four different methods, the Imbrie and Kipp Method (IKM), the Modern Analog Technique (MAT), Weighted Averaging (WA), and Weighted Averaging Partial Least Squares (WAPLS), using logarithm-transformed diatom data and satellite-derived (1981-2010) sea ice data as a reference. The best performance for IKM results was obtained using a subset of 172 samples with 28 diatom taxa/taxa groups, quadratic regression and a three-factor model (IKM-D172/28/3q) resulting in root mean square errors of prediction (RMSEP) of 7.27% and 11.4% for WSI and summer sea ice (SSI) concentration, respectively. MAT estimates were calculated with different numbers of analogs (4, 6) using a 274-sample/28-taxa reference data set (MAT-D274/28/4an, -6an) resulting in RMSEP's ranging from 5.52% (4an) to 5.91% (6an) for WSI as well as 8.93% (4an) to 9.05% (6an) for SSI. WA and WAPLS performed less well with the D274 data set, compared to MAT, achieving WSI concentration RMSEP's of 9.91% with WA and 11.29% with WAPLS, recommending the use of IKM and MAT. The application of IKM and MAT to surface sediment data revealed strong relations to the satellite-derived winter and summer sea ice field. Sea ice reconstructions performed on an Atlantic- and a Pacific Southern Ocean sediment core, both documenting sea ice variability over the past 150,000 years (MIS 1 - MIS 6), resulted in similar glacial/interglacial trends of IKM and MAT-based sea-ice estimates. On the average, however, IKM estimates display smaller WSI and slightly higher SSI concentration and probability at lower variability in comparison with MAT. This pattern is a result of different estimation techniques with integration of WSI and SSI signals in one single factor assemblage by applying IKM and selecting specific single samples, thus keeping close to the original diatom database and included variability, by MAT. In contrast to the estimation of WSI, reconstructions of past SSI variability remains weaker. Combined with diatom-based estimates, the abundance and flux pattern of biogenic opal represents an additional indication for the WSI and SSI extent.

Table 1: Station list with macrobenthos biomass results from the ocean floor

Among the Siberian shelf seas the Kara Sea is most strongly influenced by riverine runoff with nearly 1500 km fresh water discharge per year. This fresh water, discharged mainly by Ob and Yenisei, contains about 3.1 * 106 and 4.6 * 106 tons of total organic carbon per year, respectively (Gordeev et al. 1996). Little is known about the relevance of this organic material for biological communities, neither for the Kara Sea nor for the adjacent deep basins of the central Arctic Ocean. Aiming at elucidating the fate of fluvial matter transported from the rivers via estuaries into the central Arctic Ocean and the relative importance of marine organic matter being produced such information is crucial. Here we present calculations on the organic carbon demand of the Kara Sea macrozoobenthos based on measured biomass (total wet weight [ww] per 0.25 m ) from quantitative box corer samples and empirical relationships between biomass, annual production, annual respiration, and carbon remineralisation. This bottom-up approach may serve as a first estimate of the carbon remineralization potential of a given zoobenthos community (or area) as long as no data on in situ respiration rates are available. Our data basis comprises 54 stations sampled in summer seasons 1997, 1999 and 2000 in the Kara Sea at water depths between 10 and 68 m. The geographical area represented by stations analysed covers roughly 178 000 km**2, which is about one fifth of the total Kara Sea area. In this area, 290 species of invertebrate macrozoobenthos were identified with polychaeta, Crustacea, mollusca and echinodermata being the most abundant. For all stations analysed, mean biomass values ranged between 4.3 and 778.1 g ww/m**2 with organic carbon demands between 3.5 and 43.2 mg C/m**2/d. For the area of 178 000 km2 a preliminary total consumption of 1.4 * 10**6t Corg/y (equivalent to 21.5 mg C/m**2/d) was calculated for the macrozoobenthos. An extrapolation of our data would lead to an annual carbon demand of about 5-7 * 106 t for the whole Kara Sea macrozoobenthos (or 15.5-21.7 mg C/m2/d).

First Triassic tetrapod (Sauropterygia, Nothosauridae) from Castilla y León: evidence of an unknown taxon for the Spanish record

Several vertebrae of a sauropterygian specimen have been recovered in Fuencaliente de Medinaceli (Soria Province, Castilla y León, Spain). The remains come from Middle–Upper Triassic Muschelkalk Facies. This finding represents the first documented evidence of a Triassic tetrapod in Castilla y León. The vertebrae belong to Nothosaurus, a sauropterygian genus found in Europe, Middle East, North of Africa and China. This genus is poorly-known in the Iberian record. The new remains constitute the first evidence of the species Nothosaurus giganteus, or a related taxon, in the Iberian Peninsula. This study reveals the occurrence of at least two species of the sauropterygian Nothosaurus in the Spanish record.