Contribution of energy services to the Millennium Development Goals and to poverty alleviation in Latin America and the Caribbean: executive summary

Includes bibliography

Contribution of energy services to the millennium development goals and to poverty alleviation in Latin America and the Caribbean

Includes bibliography

Prepubertal exposure to bisphenol-A induces ERα upregulation and hyperplasia in adult gerbil female prostate

Prostate physiology is highly dependent on oestrogenic and androgenic homeostasis. Interferences in this equilibrium, especially in early periods of life, may disrupt the prostate and increase the susceptibility to the development of diseases with ageing. Taking this into account, and considering the increase of environmental chemicals with endocrine-disrupting potential such as bisphenol-A (BPA), this study aimed to evaluate the prostates of adult female gerbils exposed to BPA and BPA plus testosterone from pubertal to adult periods. Morphological, stereological and chemical analyses revealed that long-term BPA exposure, even in environmental dosages, increases the proliferative status of the prostate, increases the number of ERα-positive stromal cells and elicits the development of prostatic hyperplasia in adult female gerbils. Moreover, we also observed that the association with testosterone did not increase the proliferative status of the gland, which shows that low levels of BPA are enough to cause an oestrogenic disruption of the prostate in young adults. This evidence suggests that this oestrogenic endocrine disruptor may increase the susceptibility to prostatic disorders with ageing.

Prevalence of excessive daytime sleepiness and associated factors in women aged 35-49 years from the "Pindamonhangaba Health Project" (PROSAPIN)

OBJETIVO: Estimar a prevalência da sonolência diurna excessiva (SDE) e identificar os fatores associados em mulheres de 35 a 49 anos de idade do "Projeto de Saúde de Pindamonhangaba" (PROSAPIN). MÉTODOS: O estudo foi observacional transversal com 372 mulheres com idade entre 35 e 49 anos selecionadas aleatoriamente da Estratégia Saúde da Família (ESF) do município de Pindamonhangaba, São Paulo, onde é desenvolvido o "Projeto de Saúde de Pindamonhangaba" (PROSAPIN). A SDE foi avaliada por entrevista utilizando a Escala de Sonolência de Epworth e os fatores associados por meio de questões que investigaram as características sócio-demográficas, a história ginecológica, a presença de comorbidades, o estilo de vida, a rotina de sono e o uso de medicamentos capazes de alterar o estado de alerta, além de mensuradas as variáveis antropométricas. Estimou-se a prevalência da SDE com intervalo de confiança de 95% (IC 95%) e foram identificados os fatores associados por meio de um modelo de regressão logística múltipla realizado no Programa Stata, versão 10.0. RESULTADOS: A prevalência da SDE foi de 18,5% (IC 95%: 14,7- 22,9) e os fatores associados foram: profissão relacionada a serviços domésticos (OR = 2,2; IC 95%: 1,1-4,3), nível de atividade física acima da média da população estudada (OR = 1,9; IC 95%: 1,1-3,4); e a presença de características sugestivas de ansiedade (OR = 1,9; IC 95%: 1,1-3,4). CONCLUSÃO: A prevalência da SDE em mulheres de 35 a 49 anos do PROSAPIN foi elevada e associada à característica sociodemográfica, à presença de comorbidades e ao estilo de vida.

A Transcriptomic View of the Proteome Variability of Newborn and Adult Bothrops jararaca Snake Venoms

Background: Snake bite is a neglected public health problem in communities in rural areas of several countries. Bothrops jararaca causes many snake bites in Brazil and previous studies have demonstrated that the pharmacological activities displayed by its venom undergo a significant ontogenetic shift. Similarly, the venom proteome of B. jararaca exhibits a considerable variation upon neonate to adult transition, which is associated with changes in diet from ectothermic prey in early life to endothermic prey in adulthood. Moreover, it has been shown that the Brazilian commercial antibothropic antivenom, which is produced by immunization with adult venom, is less effective in neutralizing newborn venom effects. On the other hand, venom gland transcripts of newborn snakes are poorly known since all transcriptomic studies have been carried out using mRNA from adult specimens. Methods/Principal Findings: Here we analyzed venom gland cDNA libraries of newborn and adult B. jararaca in order to evaluate whether the variability demonstrated for its venom proteome and pharmacological activities was correlated with differences in the structure of toxin transcripts. The analysis revealed that the variability in B. jararaca venom gland transcriptomes is quantitative, as illustrated by the very high content of metalloproteinases in the newborn venom glands. Moreover, the variability is also characterized by the structural diversity of SVMP precursors found in newborn and adult transcriptomes. In the adult transcriptome, however, the content of metalloproteinase precursors considerably diminishes and the number of transcripts of serine proteinases, C-type lectins and bradykinin-potentiating peptides increase. Moreover, the comparison of the content of ESTs encoding toxins in adult male and female venom glands showed some genderrelated differences. Conclusions/Significance: We demonstrate a substantial shift in toxin transcripts upon snake development and a marked decrease in the metalloproteinase P-III/P-I class ratio which are correlated with changes in the venom proteome complexity and pharmacological activities.

Congenital Adrenal Hyperplasia Due to 21 Hydroxylase Deficiency: From Birth to Adulthood

The most frequent form of congenital adrenal hyperplasia (CAH) is steroid 21-hydroxylase deficiency, accounting for more than 90% of cases. Affected patients cannot synthesize cortisol efficiently. Thus the adrenal cortex is stimulated by corticotropin (ACTH) and overproduces cortisol precursors. Some precursors are diverted to sex hormone biosynthesis, causing signs of androgen excess including ambiguous genitalia in newborn females and rapid postnatal growth in both sexes. In the most severe "salt wasting" form of CAH (similar to 75% of severe or "classic" cases), concomitant aldosterone deficiency may lead to salt wasting with consequent failure to thrive, hypovolemia, and shock. Newborn screening minimizes delays in diagnosis, especially in males, and reduces morbidity and mortality from adrenal crises. CAH is a recessive disorder caused by mutations in the CYP21 (CYP21A2) gene, most of which arise from recombination between CYP21 and a nearby pseudogene, CYP21P (CYP21A1P). Phenotype is generally correlated with genotype. Classic CAH patients require chronic glucocorticoid treatment at the lowest dose that adequately suppresses adrenal androgens and maintains normal growth and weight gain, and most require mineralocorticoid (fludrocortisone). Transition of care of older patients to adult physicians should be planned in advance as a structured, ongoing process.

Computer simulations of microstructures related to the olivine spinel transition

Tiefherd-Beben, die im oberen Erdmantel in einer Tiefe von ca. 400 km auftreten, werden gewöhnlich mit dem in gleicher Tiefe auftretenden druckabhängigen, polymorphen Phasenübergang von Olivine (α-Phase) zu Spinel (β-Phase) in Verbindung gebracht. Es ist jedoch nach wie vor unklar, wie der Phasenübergang mit dem mechanischen Versagen des Mantelmaterials zusammenhängt. Zur Zeit werden im Wesentlichen zwei Modelle diskutiert, die entweder Mikrostrukturen, die durch den Phasenübergang entstehen, oder aber die rheologischen Veränderungen des Mantelgesteins durch den Phasenübergang dafür verantwortlich machen. Dabei sind Untersuchungen der Olivin→Spinel Umwandlung durch die Unzugänglichkeit des natürlichen Materials vollständig auf theoretische Überlegungen sowie Hochdruck-Experimente und Numerische Simulationen beschränkt. Das zentrale Thema dieser Dissertation war es, ein funktionierendes Computermodell zur Simulation der Mikrostrukturen zu entwickeln, die durch den Phasenübergang entstehen. Des Weiteren wurde das Computer Modell angewandt um die mikrostrukturelle Entwicklung von Spinelkörnern und die Kontrollparameter zu untersuchen. Die Arbeit ist daher in zwei Teile unterteilt: Der erste Teil (Kap. 2 und 3) behandelt die physikalischen Gesetzmäßigkeiten und die prinzipielle Funktionsweise des Computer Modells, das auf der Kombination von Gleichungen zur Errechnung der kinetischen Reaktionsgeschwindigkeit mit Gesetzen der Nichtgleichgewichtsthermodynamik unter nicht-hydostatischen Bedingungen beruht. Das Computermodell erweitert ein Federnetzwerk der Software latte aus dem Programmpaket elle. Der wichtigste Parameter ist dabei die Normalspannung auf der Kornoberfläche von Spinel. Darüber hinaus berücksichtigt das Programm die Latenzwärme der Reaktion, die Oberflächenenergie und die geringe Viskosität von Mantelmaterial als weitere wesentliche Parameter in der Berechnung der Reaktionskinetic. Das Wachstumsverhalten und die fraktale Dimension von errechneten Spinelkörnern ist dabei in guter Übereinstimmung mit Spinelstrukturen aus Hochdruckexperimenten. Im zweiten Teil der Arbeit wird das Computermodell angewandt, um die Entwicklung der Oberflächenstruktur von Spinelkörnern unter verschiedenen Bedigungen zu eruieren. Die sogenannte ’anticrack theory of faulting’, die den katastrophalen Verlauf der Olivine→Spinel Umwandlung in olivinhaltigem Material unter differentieller Spannung durch Spannungskonzentrationen erklärt, wurde anhand des Computermodells untersucht. Der entsprechende Mechanismus konnte dabei nicht bestätigt werden. Stattdessen können Oberflächenstrukturen, die Ähnlichkeiten zu Anticracks aufweisen, durch Unreinheiten des Materials erklärt werden (Kap. 4). Eine Reihe von Simulationen wurde der Herleitung der wichtigsten Kontrollparameter der Reaktion in monomineralischem Olivin gewidmet (Kap. 5 and Kap. 6). Als wichtigste Einflüsse auf die Kornform von Spinel stellten sich dabei die Hauptnormalspannungen auf dem System sowie Heterogenitäten im Wirtsminerals und die Viskosität heraus. Im weiteren Verlauf wurden die Nukleierung und das Wachstum von Spinel in polymineralischen Mineralparagenesen untersucht (Kap. 7). Die Reaktionsgeschwindigkeit der Olivine→Spinel Umwandlung und die Entwicklung von Spinelnetzwerken und Clustern wird durch die Gegenwart nicht-reaktiver Minerale wie Granat oder Pyroxen erheblich beschleunigt. Die Bildung von Spinelnetzwerken hat das Potential, die mechanischen Eigenschaften von Mantelgestein erheblich zu beeinflussen, sei es durch die Bildung potentieller Scherzonen oder durch Gerüstbildung. Dieser Lokalisierungprozess des Spinelwachstums in Mantelgesteinen kann daher ein neues Erklärungsmuster für Tiefbeben darstellen.

Absence of the calcium-binding protein calretinin, not of calbindin D-28k, causes a permanent impairment of murine adult hippocampal neurogenesis

Calretinin (CR) and calbindin D-28k (CB) are cytosolic EF-hand Ca(2+)-binding proteins and function as Ca(2+) buffers affecting the spatiotemporal aspects of Ca(2+) transients and possibly also as Ca(2+) sensors modulating signaling cascades. In the adult hippocampal circuitry, CR and CB are expressed in specific principal neurons and subsets of interneurons. In addition, CR is transiently expressed within the neurogenic dentate gyrus (DG) niche. CR and CB expression during adult neurogenesis mark critical transition stages, onset of differentiation for CR, and the switch to adult-like connectivity for CB. Absence of either protein during these stages in null-mutant mice may have functional consequences and contribute to some aspects of the identified phenotypes. We report the impact of CR- and CB-deficiency on the proliferation and differentiation of progenitor cells within the subgranular zone (SGZ) neurogenic niche of the DG. Effects were evaluated (1) two and four weeks postnatally, during the transition period of the proliferative matrix to the adult state, and (2) in adult animals (3 months) to trace possible permanent changes in adult neurogenesis. The absence of CB from differentiated DG granule cells has no retrograde effect on the proliferative activity of progenitor cells, nor affects survival or migration/differentiation of newborn neurons in the adult DG including the SGZ. On the contrary, lack of CR from immature early postmitotic granule cells causes an early loss in proliferative capacity of the SGZ that is maintained into adult age, when it has a further impact on the migration/survival of newborn granule cells. The transient CR expression at the onset of adult neurogenesis differentiation may thus have two functions: (1) to serve as a self-maintenance signal for the pool of cells at the same stage of neurogenesis contributing to their survival/differentiation, and (2) it may contribute to retrograde signaling required for maintenance of the progenitor pool.

Insular volume abnormalities associated with different transition probabilities to psychosis

Background Although individuals vulnerable to psychosis show brain volumetric abnormalities, structural alterations underlying different probabilities for later transition are unknown. The present study addresses this issue by means of voxel-based morphometry (VBM). Method We investigated grey matter volume (GMV) abnormalities by comparing four neuroleptic-free groups: individuals with first episode of psychosis (FEP) and with at-risk mental state (ARMS), with either long-term (ARMS-LT) or short-term ARMS (ARMS-ST), compared to the healthy control (HC) group. Using three-dimensional (3D) magnetic resonance imaging (MRI), we examined 16 FEP, 31 ARMS, clinically followed up for on average 3 months (ARMS-ST, n=18) and 4.5 years (ARMS-LT, n=13), and 19 HC. Results The ARMS-ST group showed less GMV in the right and left insula compared to the ARMS-LT (Cohen's d 1.67) and FEP groups (Cohen's d 1.81) respectively. These GMV differences were correlated positively with global functioning in the whole ARMS group. Insular alterations were associated with negative symptomatology in the whole ARMS group, and also with hallucinations in the ARMS-ST and ARMS-LT subgroups. We found a significant effect of previous antipsychotic medication use on GMV abnormalities in the FEP group. Conclusions GMV abnormalities in subjects at high clinical risk for psychosis are associated with negative and positive psychotic symptoms, and global functioning. Alterations in the right insula are associated with a higher risk for transition to psychosis, and thus may be related to different transition probabilities.

Follow-up care of adolescent survivors of childhood cancer: The role of health beliefs

BACKGROUND Little is known about follow-up care attendance of adolescent survivors of childhood cancer, and which factors foster or hinder attendance. Attending follow-up care is especially important for adolescent survivors to allow for a successful transition into adult care. We aimed to (i) describe the proportion of adolescent survivors attending follow-up care; (ii) describe adolescents' health beliefs; and (iii) identify the association of health beliefs, demographic, and medical factors with follow-up care attendance. PROCEDURE Of 696 contacted adolescent survivors diagnosed with cancer at ≤16 years of age, ≥5 years after diagnosis, and aged 16-21 years at study, 465 (66.8%) completed the Swiss Childhood Cancer Survivor Study questionnaire. We assessed follow-up care attendance and health beliefs, and extracted demographic and medical information from the Swiss Childhood Cancer Registry. Cross-sectional data were analyzed using descriptive statistics and logistic regression models. RESULTS Overall, 56% of survivors reported attending follow-up care. Most survivors (80%) rated their susceptibility for late effects as low and believed that follow-up care may detect and prevent late effects (92%). Few (13%) believed that follow-up care is not necessary. Two health beliefs were associated with follow-up care attendance (perceived benefits: odds ratio [OR]: 1.56; 95% confidence interval [CI]: 1.07-2.27; perceived barriers: OR: 0.70; 95%CI: 0.50-1.00). CONCLUSIONS We show that health beliefs are associated with actual follow-up care attendance of adolescent survivors of childhood cancer. A successful model of health promotion in adolescent survivors should, therefore, highlight the benefits and address the barriers to keep adolescent survivors in follow-up care. Pediatr Blood Cancer © 2015 Wiley Periodicals, Inc.

[Transition in kidney transplantation]

Transition from pediatric to adult care in renal transplantation has emerged as a critical step in the life of a young kidney recipient. During this phase, young patients are faced with the physiological and psychological changes associated with adolescence that can lead to non-compliance and potentially graft loss. To date, there is not a unique accepted model of transition, however it has been proved that the presence of a multidisciplinary team including specialists in adolescent management and in the transition from pediatric to adult transplant care is beneficial during this at-risk phase. The goal of this team is to ensure a progressive transition of the patients according to a precise plan and time line.

The Ryan White CARE Act : 20 years of transition

The Ryan White CARE Act has undergone substantial changes in the past 20 years. Today it serves over 500,000 persons living with HIV/AIDS in the United States. The purpose of this project was to update the history and content Ryan White CARE Act and to consider how changes since the 2006 CARE Act reauthorization have affected the Ryan White Planning Council in Harris County. The results of the 2008 Houston Area HIV/AIDS Needs Assessment were reviewed and compared to responses to access of service questions of the 2005 Houston Area HIV/AIDS Needs Assessment. The results of the comparison show that informational barriers continue to be the leading barriers in persons living with HIV/AIDS to accessing services. In conclusion the strength of the Ryan White CARE Act is its ability to respond to a changing epidemic and its weakness lies in its vulnerability to shifting political sentiments. ^

Access to oral care --- A systematic review of a continuing public health issue among older adults

Oral health is essential for the general well being of the individual and collectively for the health of the population. Oral health can be maintained by routine dental care and visits to dental professionals, but accessing professional dental care may be a continuing difficulty in vulnerable older adult population. Many older adults are not frequent users of dental care, though oral health is crucial to their well-being and overall health. Access to care is the timely use of personal health services to achieve the best possible health outcomes. ^ Objectives: The aims of this review are to (i) to analyze and elucidate the relationship between socio-economic disparities in gender, ethnicity, poverty status, education and the continuing public issue of access to oral care, (ii) to identify the underlying causes through which these factors can affect access to oral care. This review will provide a knowledgeable basis for development of interventions to provide adequate access to oral care in older adults and implementing policies to ensure access to oral care; through highlighting the various socio economic factors that affect access to oral care among older adults. ^ Methods: This paper used a purposeful review of literature on socioeconomic disparities in access to oral care among older adults. The references considered in this review included all the relevant articles, surveys and reports published in English language, since the year 1985 to 2010, in the United States. The articles selected were scrutinized for relevancy to the topic of access to oral care and which included discussions of the effects of gender, ethnicity, poverty status, educational status in accessing oral care. ^ Results: Evidence confirmed the continuing disparity in access to oral care among older adults. The possible links identified were gender inequality, ethnic differences, income levels and educational differences affecting access to oral care. The underlying causes linking these factors with access to oral care were established. ^ Conclusion: The analysis of the literature review findings supported the prevalence of disparities in gender, ethnicity, income and education with its possible links affecting access to oral care. The underlying causes helped to understand the reasons behind this growing issue of inaccessible oral care. Further research is needed to develop policies and target dental public health efforts towards specific problem areas ensuring equitable access to oral services and consequently, improve the health of older adults.^

The attention/support to students in the socio-labor transition

In the present paper I intend to put forward some inquiries regarding the socio-labor guidance and transition of the young people in the co-ordinates of contemporary society. The outstanding paradox in which some young people are immersed when trying to get a first, second, third employment is also analyzed: "The job of looking for a job". This is a common experience shared by many young people when they try to find a place in the complex labor panorama. Looking for a job is a recurrent situation in contemporary society, given the high dose of precarious employment in which the productive world moves. Life-long jobs belong to the past and what is normal is that people strive to enter the competitive labor market repeatedly. Moreover, the paper offers the partial results of a larger research project that approaches tutorship, decision taking and expectations before the academic-labor future of the studentship in the last years of secondary school. Finally, I suggest some insights in the line that it is not longer feasible to work with old-fashioned guidance, trying to channel people's vocation and offering them information so that they get a job that provides them with the happiness of "doing what you like". Behind these ideas lay the normal biographies, the predictable itineraries. Labor market complexity makes the transition to working life very difficult. Once immersed in it, biographies and labor itineraries are constructed and reconstructed at the rhythm of the changing fortunes of times.