Reduced genetic diversity and the success of the invasive peacock bass (Cichliformes: Cichlidae) / Diversidade genética reduzida e o sucesso da espécie invasora tucunaré (Cichliformes: Cichlidae)

Abstract Several species of Cichla successfully colonized lakes and reservoirs of Brazil, since the 1960's, causing serious damage to local wildlife. In this study, 135 peacock bass were collected in a reservoir complex in order to identify if they represented a single dominant species or multiple ones, as several Cichla species have been reported in the basin. Specimens were identified by color pattern, morphometric and meristic data, and using mitochondrial markers COI, 16S rDNA and Control Region (CR). Overlapping morphological data and similar coloration patterns prevented their identification using the taxonomic keys to species identification available in the literature. However, Bayesian and maximum likelihood from sequencing data demonstrated the occurrence of a single species, Cichla kelberi. A single haplotype was observed for the 16S and CR, while three were detected for COI, with a dominant haplotype present in 98.5% of the samples. The extreme low diversity of the transplanted C. kelberi evidenced a limited number of founding maternal lineages. The success of this colonization seems to rely mainly on abiotic factors, such as increased water transparency of lentic environments that favor visual predators that along with the absence of predators, have made C. kelberi a successful invader of these reservoirs.

Resumo Muitas espécies de Cichla colonizaram com sucesso lagos e reservatórios do Brasil desde os anos 1960, causando graves prejuízos à vida selvagem nesses locais. Neste estudo, 135 tucunarés foram coletados em um complexo de reservatórios a fim de identificar se representavam uma espécie dominante ou múltiplas espécies, uma vez que diversas espécies de Cichla foram registradas na bacia. Os espécimes foram identificados com base na coloração, dados morfométricos e merísticos, e por marcadores mitocondriais COI, 16S rDNA e Região Controle (RC). A sobreposição dos dados morfométricos e o padrão similar de coloração impediram a identificação utilizando as chaves de identificação disponíveis na literatura. Entretanto, as análises bayesiana e de máxima verossimilhança de dados moleculares demonstraram a ocorrência de uma única espécie, Cichla kelberi. Um único haplótipo foi observado para o 16S e RC, enquanto três foram detectados para o COI, com um haplótipo dominante presente em 98,5% das amostras. A baixa diversidade nos exemplares introduzidos de C. kelberi evidenciou um número limitado de linhagens maternas fundadoras. O sucesso da invasão parece depender de fatores abióticos, como a maior transparência da água de ambientes lênticos que favorece predadores visuais que, atrelado à ausência de predadores, fez do C. kelberi um invasor bem-sucedido nesses reservatórios.

Mathematical models to describe the growth curves of Vietnamese Ri chicken / Modelos matemáticos para descrever as curvas de crescimento do frango Ri vietnamita

Abstract Ri chicken is the most popular backyard chicken breed in Vietnam, but little is known about the growth curve of this breed. This study compared the performances of models with three parameters (Gompertz, Brody, and Logistic) and models containing four parameters (Richards, Bridges, and Janoschek) for describing the growth of Ri chicken. The bodyweight of Ri chicken was recorded weekly from week 1 to week 19. Growth models were fitted using minpack.lm package in R software and Akaike's information criterion (AIC), Bayesian information criterion (BIC), and root mean square error (RMSE) were used for model comparison. Based on these criteria, the models having four parameters showed better performance than the ones with three parameters, and the Richards model was the best one for males and females. The lowest and highest value of asymmetric weights (α) were obtained by Bridges and Brody models for each of sexes, respectively. Age and weight estimated by the Richard model were 8.46 and 7.51 weeks and 696.88 and 487.58 g for males and for females, respectively. Differences in the growth curves were observed between males and female chicken. Overall, the results suggested using the Richards model for describing the growth curve of Ri chickens. Further studies on the genetics and genomics of the obtained growth parameters are required before using them for the genetic improvement of Ri chickens.

Resumo O frango Ri é a raça de frango de quintal mais popular do Vietnã, mas pouco se sabe sobre a curva de crescimento dessa raça. Este estudo comparou o desempenho de modelos com três parâmetros (Gompertz, Brody e Logistic) e modelos contendo quatro parâmetros (Richards, Bridges e Janoschek) para descrever o crescimento do frango Ri. O peso corporal do frango Ri foi registrado semanalmente da semana 1 à semana 19. Os modelos de crescimento foram ajustados usando o pacote minpack.lm no software R e o critério de informação de Akaike (AIC); critério de informação bayesiano (BIC) e erro quadrático médio (RMSE) foram usados ​​para comparação de modelos. Com base nesses critérios, os modelos com quatro parâmetros apresentaram melhor desempenho do que os com três parâmetros, sendo o modelo de Richards o melhor para homens e mulheres. O menor e o maior valor dos pesos assimétricos (α) foram obtidos pelos modelos Bridges e Brody para cada um dos sexos, respectivamente. A idade e o peso estimados pelo modelo de Richard foram de 8,46 e 7,51 semanas e 696,88 e 487,58 g para homens e mulheres, respectivamente. Diferenças nas curvas de crescimento foram observadas entre frangos machos e fêmeas. No geral, os resultados sugeriram o uso do modelo de Richards para descrever a curva de crescimento de frangos Ri. Mais estudos sobre a genética e genômica dos parâmetros de crescimento obtidos são necessários antes de usá-los para o melhoramento genético de frangos Ri.

The molecular investigations on the subgenus Artemisia Less. of the genus Artemisia L. (Asteraceae) in Turkey / Investigações moleculares sobre o subgênero Artemisia Less. do gênero Artemisia L. (Asteraceae) na Turquia

Abstract The genus Artemisia L. of the family Asteraceae is systematically very complex. The aim of this study was to evaluate taxonomic positions of taxa of the subgenus Artemisia belonging to the genus Artemisia in Turkey using some molecular techniques. In this molecular study, 44 individuals belong to 14 species of the subgenus Artemisia were examined. Analyses were performed on the combined dataset using maximum parsimony, maximum likelihood and Bayesian inference and Molecular parameters obtained from co-evaluations of sequences of the psbA-trnH, ITS and ETS regions of examined individuals were used in the phylogenetic tree drawing. According to the results of this study, two molecular groups have been formed based on the DNA sequence similarity of the species, but there are no obvious morphological characters corresponding to two molecular groups. There is no also agreement between the two molecular groups and the two morphological groups formed according to the hairiness condition of the receptacle of species. Due to the lack of molecular significance of their receptacles with or without hair, dividing of the subgenus Artemisia species into new subgenera or sections was not considered appropriate. Likewise, it has been found that with or without hair on the corolla lobes of the central hermaphrodite disc flowers have no molecular significance. It was found that there were no gene flow and hybridization between the 14 species of the subgenus Artemisia and these 14 species were found completed their speciation. This study is important as it is the first molecular based study relating with belong to subgenus Artemisia species growing naturally in Turkey. In addition, new haplotypes related to the populations of Turkey belonging to the subgenus Artemisia taxa were reported by us for the first time and added to the GenBank database.

Resumo O gênero Artemisia L. da família Asteraceae é sistematicamente muito complexo. O objetivo deste estudo foi avaliar as posições taxonômicas de táxons do subgênero Artemisia pertencentes ao gênero Artemisia na Turquia usando algumas técnicas moleculares. Neste estudo molecular, 44 indivíduos pertencentes a 14 espécies do subgênero Artemisia foram examinados. As análises foram realizadas no conjunto de dados combinado usando máxima parcimônia, máxima verossimilhança e inferência bayesiana e parâmetros moleculares obtidos a partir de coavaliações de sequências das regiões psbA-trnH, ITS e ETS de indivíduos examinados foram usados ​​no desenho da árvore filogenética. De acordo com os resultados deste estudo, dois grupos moleculares foram formados com base na similaridade da sequência de DNA das espécies, mas não há caracteres morfológicos óbvios correspondentes a dois grupos moleculares. Também não há concordância entre os dois grupos moleculares e os dois grupos morfológicos formados de acordo com a condição de pilosidade do receptáculo da espécie. Devido à falta de significado molecular de seus receptáculos com ou sem cabelo, a divisão das espécies do subgênero Artemisia em novos subgêneros ou seções não foi considerada apropriada. Da mesma forma, verificou-se que com ou sem cabelo nos lobos da corola das flores do disco hermafrodita central não tem significado molecular. Constatou-se que não houve fluxo gênico e hibridização entre as 14 espécies do subgênero Artemisia e essas 14 espécies concluíram sua especiação. Este estudo é importante porque é o primeiro estudo de base molecular relacionado com espécies pertencentes ao subgênero Artemisia crescendo naturalmente na Turquia. Além disso, novos haplótipos relacionados às populações da Turquia pertencentes ao subgênero Artemisia taxa foram relatados por nós pela primeira vez e adicionados ao banco de dados do GenBank.

Método de captura y recaptura: una experiencia de su aplicación para determinar la incidencia de diabetes gestacional / Capture and recapture method: anexperience of itsapplication to estimatetheincidence of gestational diabetes

Los métodos de captura y recaptura (MCR) se emplean en la estimación de poblaciones mediante la utilización de diferentes fuentes de datos, disponibles e incompletas, que registran por separado un mismo evento. En esta metodología, las fuentes son utilizadas para extrapolar el número de individuos no registrados, usando la información recopilada sobre los individuos sí registrados. Este artículo describe todos los pasos de su aplicación práctica, a partir de un ejemplo de estimación de la incidencia de diabetes gestacional en una institución, a partir de cinco fuentes documentales. (AU)

Capture-recapture (CRM) methods are widely used to estimate populations by using different data sources, available and incomplete, that record the same event separately. In these methods, the available sources are used to extrapolate the number of unregistered individuals, using the information collected on the individuals that are registered. This article describes all the steps of its practical application, based on an example of estimating the incidence of gestational diabetes in an institution based on five documentary sources. (AU)

Distribuição Espacial de Mortalidade por Insuficiência Cardíaca no Brasil, 1996-2017 / Spatial Distribution of Mortality for Heart Failure in Brazil, 1996 - 2017

Resumo Fundamento Insuficiência cardíaca (IC) é uma das principais causas de mortalidade e morbidade no mundo, e está associada ao alto uso de recursos e custos com saúde. No Brasil, a prevalência de IC é de aproximadamente 2 milhões de pacientes, e sua incidência é de aproximadamente 240.000 novos casos por ano. Objetivo A investigação objetivou analisar a tendência espaço-temporal da mortalidade causada por IC no Brasil, de 1996 a 2017. Métodos Este é um estudo ecológico desenvolvido com dados secundários sobre mortalidade por IC no Brasil. Durante o período, 1.242.014 casos de morte causada por IC foram analisados. A existência da autocorrelação espacial de casos foi calculada utilizando o Índice de Moran Global (IMG) e, quando significativo, o Índice de Moran Local, considerando p <0,05. O risco relativo dos grupos foi calculado. Resultados A taxa de mortalidade causada por IC foi diversificada em regiões brasileiras, com ênfase no sul, sudeste e nordeste. O IMG indicou autocorrelação espacial positiva (p=0,01) em todos os períodos. Cidades localizadas no sul, sudeste, nordeste e centro-oeste mostraram maior risco relativo para mortalidade causada por IC, e a maioria das cidades do norte foi classificada como um fator protetivo contra esta causa de morte. Conclusões O estudo demonstrou declínio nas taxas de mortalidade no território nacional. A maior concentração de taxas de mortalidade está nas regiões norte e nordeste, enfatizando as áreas prioritárias de vulnerabilidade no planejamento e estratégias de controle de serviços de saúde.

Abstract Background Heart failure (HF) is a leading cause of mortality and morbidity worldwide, and is associated with the high use of resources and healthcare costs. In Brazil, the HF prevalence is around 2 million patients, and its incidence is of approximately 240,000 new cases per year. Objective The present investigation aimed to analyze the spatiotemporal trend of mortality caused by HF in Brazil, from 1996 to 2017. Methods This is an ecological study developed with secondary data on HF mortality in Brazil. During the period, 1,242,014 cases of death caused by heart failure were analyzed. The existence of spatial autocorrelation of cases was calculated using the Global Moran Index (GMI) and, when significant, the Local Moran Index, considering p<0.05. The relative risk of the clusters was calculated. Results The mortality rate due to HF was diversified in all Brazilian regions, with an emphasis in the South, Southeast, and Northeast. The GMI indicated positive spatial autocorrelation (p=0.01) in all periods. Municipalities located in the South, Southeast, Northeast, and Midwest showed a higher Relative Risk for mortality from HF, and most municipalities in the North were classified as a protective factor against this cause of death. Conclusions The study showed a decline in mortality rates across the national territory. The highest concentration of mortality rates is in the North and Northeast regions, highlighting priority vulnerable areas in the planning and controlling strategies of health services.

El Enfoque Bayesiano en las Ciencias de la Salud / The Bayesian Approach in the Health Sciences

En estadística existen dos enfoques básicos, la estadística frecuentista que es la corriente principal y la estadística bayesiana. La mayoría de los principales métodos estadísticos son frecuentistas siendo el enfoque bayesiano más desconocido entre los investigadores. En el presente artículo se exponen los fundamentos lógicos del enfoque bayesiano y su uso mediante un ejemplo de aplicación. En este contexto, más que presentar un debate entre la lógica clásica y la bayesiana, se pretende mostrar de manera introductoria las enormes posibilidades que el enfoque bayesiano puede aportar a la investigación en las Ciencias de la Salud.

In the stadistic field there are two basic approaches, the Frequentist Statistics which is the primary one, and the Bayesian Statistics. The most used statistical methods are the Frequentist methods, being the Bayesian approach the most popular among researchers. In this article, the logical basis of the Bayendian approach and its use are exposed through an application example. In this context, rather than presenting a debate between the classic and the Bayensian logic, it is intended to demonstrate in an introductory method the considerable possibilities how Bayesian approach can contribute to Health and Sciences research.

A spatio-temporal analysis of cause-specific mortality in São Paulo State, Brazil / Uma análise espaço-temporal da mortalidade por causas específicas no estado de São Paulo, Brasil

Abstract Using five cause-specific mortality data sourced by the Brazilian Ministry of Health, and over 17 years period, we applied Bayesian spatio-temporal models on 644 municipalities of the state of São Paulo, using logistic model to the binary outcome that specifies whether or not the death was from a specific cause. We modeled the temporal mortality effects using B-splines, while the spatial components were considered through Gaussian and Markov random field, and inference was based on Markov chain Monte Carlo simulation. The results demonstrate consistent downward trend in mortality from infectious and parasitic diseases and external causes, while those from neoplasms and respiratory are rising. Cardiovascular is the only cause-specific death that is kept constant in time. All the causes of death considered show heterogeneous spatial and temporal variations among the municipalities, which sometimes change considerably within successive years. Mortality from infectious diseases clustered around the Northwestern municipalities in 2000, but changes to the Southeastern part in 2016, a similar development as external death causes. The study identifies areas with increased and decreased odds mortality and could be useful in disease monitoring, especially if we consider small spatial units.

Resumo Usando dados do Ministério da Saúde do Brasil para cinco causa de mortes, e num período de 17 anos, aplicamos modelos espaço-temporais Bayesianos em 644 municípios do estado de São Paulo, utilizando um modelo logístico binário que especifica se o óbito foi (ou não) de uma determinada causa. Modelamos os efeitos temporais da mortalidade com B-splines, e os componentes espaciais foram estimados através de campos aleatórios de Gaussiano e Markov. Simulamos a inferência estatística com Monte Carlo via cadeias de Markov. Os resultados demonstraram tendência consistente de queda nas mortes por doenças infecciosas e causas externas, enquanto mortes por neoplasias e doenças respiratórias aumentaram no tempo. Cardiovascular foi a única causa de morte constante no tempo. As causas de morte apresentaram variações espaciais e temporais entre os municípios, com consideráveis mudanças em anos sucessivos. A mortalidade por doenças infecciosas se concentrou nos municípios do noroeste do estado em 2000, mas mudou para a parte sudeste em 2016, um desenvolvimento semelhante as causas externas de morte. Este estudo identificou áreas com maior e menor chances de morte entre diferentes causas, e pode ser útil no monitoramento de doenças, especialmente se considerarmos pequenas unidades espaciais.

Frequentist and Bayesian Hypothesis Testing: An Intuitive Guide for Urologists and Clinicians / Pruebas de hipótesis frecuentista y bayesiana: Una Guía intuitiva para urólogos y clínicos

Given the limitations of frequentist method for null hypothesis significance testing, different authors recommend alternatives such as Bayesian inference. A poor understanding of both statistical frameworks is common among clinicians. The present is a gentle narrative review of the frequentist and Bayesian methods intended for physicians not familiar with mathematics. The frequentist p-value is the probability of finding a value equal to or higher than that observed in a study, assuming that the null hypothesis (H0) is true. The H0 is rejected or not based on a p threshold of 0.05, and this dichotomous approach does not express the probability that the alternative hypothesis (H1) is true. The Bayesian method calculates the probability of H1 and H0 considering prior odds and the Bayes factor (Bf). Prior odds are the researcher's belief about the probability of H1, and the Bf quantifies how consistent the data is concerning H1 and H0. The Bayesian prediction is not dichotomous but is expressed in continuous scales of the Bf and of the posterior odds. The JASP software enables the performance of both frequentist and Bayesian analyses in a friendly and intuitive way, and its application is displayed at the end of the paper. In conclusion, the frequentist method expresses how consistent the data is with H0 in terms of p-values, with no consideration of the probability of H1. The Bayesian model is a more comprehensive prediction because it quantifies in continuous scales the evidence for H1 versus H0 in terms of the Bf and the

Dadas las limitaciones del método de significancia frecuentista basado en la hipótesis nula, diferentes autores recomiendan alternativas como la inferencia bayesiana. Es común entre los médicos una comprensión deficiente de ambos marcos estadísticos. Esta es una revisión narrativa amigable de los métodos frecuentista y bayesiano dirigida quienes no están familiarizados con las matemáticas. El valor de p frecuentista es la probabilidad de encontrar un valor igual o superior al observado en un estudio, asumiendo que la hipótesis nula (H0) es cierta. La H0 se rechaza o no con base en un umbral p de 0.05, y este enfoque dicotómico no expresa la probabilidad de que la hipótesis alternativa (H1) sea verdadera. El método bayesiano calcula la probabilidad de H1 y H0 considerando las probabilidades a priori y el factor de Bayes (fB). Las probabilidades a priori son la creencia del investigador sobre la probabilidad de H1, y el fB cuantifica cuán consistentes son los datos con respecto a H1 y H0. La predicción bayesiana no es dicotómica, sino que se expresa en escalas continuas del fB y de las probabilidades a posteriori. El programa JASP permite realizar análisis frecuentista y bayesiano de una forma simple e intuitiva, y su aplicación se muestra al final del documento. En conclusión, el método frecuentista expresa cuán consistentes son los datos con H0 en términos de valores p, sin considerar la probabilidad de H1. El modelo bayesiano es una predicción más completa porque cuantifica en escalas continuas la evidencia de H1 versus H0 en términos del fB y de las probabilidades a posteriori.

Análise espacial da leishmaniose tegumentar americana entre 2007 e 2017 / Spatial analysis of american cutaneous leishmaniasis between 2007 and 2017 / Análisis espacial de la leishmaniosis tegumentaria americana entre 2007 y 2017

Objetivo: analisar o perfil epidemiológico da leishmaniose tegumentar americana entre 2007 e 2017 na Paraíba, Nordeste Brasileiro. Método: Estudo ecológico dos casos de leishmaniose tegumentar americana registrados no Sistema de Informação de Agravos de Notificação. Utilizou-se o Risco Relativo, Método Scan Espacial e Método Bayesiano Empírico Local para a análise dos conglomerados. Resultados: Foram registrados 671 casos de leishmaniose tegumentar americana na Paraíba entre 2007 e 2017 com maior ocorrência em 2009 e 2010, com 121 e 91 notificações, respectivamente e no sexo masculino (341). A maioria apresentou a forma clínica cutânea e residentes na zona rural. Identificaram-se conglomerados espaciais significativos da leishmaniose tegumentar americana na Paraíba, no Litoral Norte, microrregião do Agreste e no município de Poço Dantas no Alto Sertão. Conclusões: os conglomerados espaciais de risco para a infecção demonstram a importância de ações imediatas de educação em saúde para prevenção do agravo

Objective: to analyze the epidemiological profile of american cutaneous leishmaniasis between 2007 and 2017 in Paraíba, Northeast Brazil. Method: Ecological study of cases of american cutaneous leishmaniasis registered in the Notifiable Diseases Information System. Relative Risk, Spatial Scan Method and Local Empirical Bayesian Method were used for the analysis of conglomerates.Results: 671 cases of american cutaneous leishmaniasis were registered in Paraíba between 2007 and 2017, with the highest occurrence in 2009 and 2010, with 121 and 91 notifications, respectively and among males (341). Most presented the clinical cutaneous form and lived in the rural area. Significant spatial conglomerates of american cutaneous leishmaniasis were identified in Paraíba, on the North Coast, the Agreste micro-region and in the municipality of Poço Dantas in Alto Sertão. Conclusions: thespatial conglomerates at risk for infection demonstrate the importance of immediate health education actions to prevent the disease

Objetivo: analizar el perfil epidemiológico de la leishmniosis cutánea entre 2007 y 2017 en Paraíba, noreste de Brasil. Método: Estudio ecológico de casos de leishmniosis cutánea registrados en el Sistema de Información de Enfermedades de Notificación. El riesgo relativo, el método de exploración espacial y el método bayesiano empírico local se utilizaron para el análisis del conglomerados. Resultados: se registraron 671 casos de leishmaniasis cutánea en Paraíba entre 2007 y 2017, con la mayor incidencia en 2009 y 2010, con 121 y 91 notificaciones, respectivamente, y entre hombres (341). La mayoría presentaba la forma cutánea clínica y vivía en el área rural. Se identificaron importantes conglomerados espaciales de leishmaniasis cutánea en Paraíba, en la costa norte, en la microrregión de Agreste y en el municipio de Poço Dantas en Alto Sertão. Conclusiones: los conglomerados espaciales en riesgo de infección demuestran la importancia de las acciones inmediatas de educación sanitaria para prevenir la enfermedad

Impacts of the 2017 Brazilian National Primary Care Policy on public primary health care in Rio de Janeiro, Brazil / Os impactos da Política Nacional de Atenção Básica de 2017 sobre a atenção primária pública no Rio de Janeiro, Brasil / Impactos de la Política Nacional de Atención Primaria 2017 en la atención primaria pública en Río de Janeiro, Brasil

In 2017, in a scenario of financial restrictions caused by an economic crisis in Brazil, a new primary health care policy promoted changes in the way different primary health care models were prioritized and implemented, with possible negative effects on the access to primary health care. This study aims to investigate if the 2017 Brazilian National Primary Care Policy (PNAB) negatively affected the primary care organization based on the Family Health Strategy (FHS) model and on the access to public primary care services in the city of Rio de Janeiro. The annual averages and the pre- and post-2017 averages of 15 variables were analyzed to identify possible trend breaks in 2017. A Bayesian structural time series model was used to determine the differences between actual and predicted post-2017 averages of each variable. The data were obtained via the Brazilian Health Informatics Department (DATASUS), the Department of Informatics of the Brazilian Unified National Health System. The annual average of family health teams was 1,179.9 teams, in 2017, and 788.8 teams in 2020, while the annual average of equivalent family health teams was 163.6, in 2017, and 125.4, in 2020. The actual post-2017 average of 989.3 family health teams (p = 0.004) was 16.7% lower than the predicted post-2017 average of 1,187.4 teams. In total, 62.6% and 40.5% of the population in Rio de Janeiro were covered by the FHS in 2017, and 2020, respectively. The provision of public primary care services decreased after 2017. Results show a deterioration of the FHS in Rio de Janeiro after 2017 and no increase in the traditional primary care model. Access to public primary care services reduced in the same period.

Em 2017, dentro de um cenário de restrições financeiras provocadas por uma crise econômica no Brasil, uma nova política de atenção primária em saúde introduziu mudanças na maneira que diferentes modelos de atenção primária eram priorizados e implementados, com possíveis efeitos negativos no acesso à atenção primária. O estudo teve como objetivo investigar se a Política Nacional de Atenção Básica de 2017 teve impacto negativo sobre a organização da atenção primária baseada no modelo da Estratégia Saúde da Família (ESF) e no acesso aos serviços de atenção primária no Município do Rio de Janeiro. Foram analisadas as médias anuais e as médias pré- e pós-2017 de 15 variáveis para identificar possíveis quebras de tendência em 2017. Foi usado um modelo bayesiano de séries temporais estruturais para determinar as diferenças entre as médias pós-2017 reais e previstas para cada variável. Os dados foram obtidos do Departamento de Informática do SUS (DATASUS). O número anual médio de equipes de saúde da família foi 1.179,9 em 2017 e 788,8 em 2020, enquanto a média anual de equivalentes de equipes de saúde da família foi 163,6 em 2017 e 125,4 em 2020. A média pós-2017 real de 989,3 equipes de saúde da família (p = 0,004) foi 16,7% mais baixa que a média pós-2017 prevista, de 1.187,4 equipes. A cobertura da população do Rio de Janeiro pela ESF era 62,6% em 2017, caindo para 40,5% em 2020. A prestação de serviços públicos de atenção primária caiu depois de 2017. Os resultados demonstram a deterioração da ESF no Rio de Janeiro depois de 2017, sem nenhum aumento no modelo tradicional de atenção primária. O acesso aos serviços públicos de atenção primário diminuiu durante o mesmo período.

En 2017, en un escenario de restricciones financieras causadas por una crisis económica en Brasil, la nueva política nacional de atención primaria promovió cambios, con el fin de que se priorizaran e implementaran diferentes modelos de atención primaria, con posibles efectos negativos en el acceso a la atención primaria en salud. El objetivo de este estudio fue investigar si la Política Nacional de Atención Primária de 2017 tuvo un impacto negativo en la organización de la atención primaria, basada en el modelo de Estrategia de Salud Familiar (ESF), y en el acceso a los servicios públicos de atención primaria en la ciudad de Río de Janeiro. Se analizaron los promedios anuales y los pre- y post-2017 promedios de 15 variables para identificar posibles rupturas de tendencia en 2017. Se usó uno modelo Bayesiano estructural de series temporales para determinar las diferencias entre los promedios actuales y previstos post-2017 de cada variable. Los datos se obtuvieron mediante el Departamento de Informática del Sistema Único de Salud (DATASUS). El promedio anual de equipos de salud familiar fue 1.179,9 equipos en 2017 y 788,8 equipos en 2020, mientras que el promedio anual de los equipos equivalentes familiares fue 163,6 en 2017 y 125,4 en 2020. El promedio actual post-2017 de 989,3 equipos de salud familiares (p = 0,004) fue un 16,7% más bajo que el promedio previsto post-2017 de 1.187,4 equipos. El porcentaje de población en Río de Janeiro cubierto por la ESF fue 62,6% en 2017 y 40,5% en 2020. La provisión de servicios públicos de atención primaria se redujo después de 2017. Los resultados demostraron el deterioro de la ESF en Río de Janeiro después 2017 y no hubo incrementos en el modelo de atención primaria tradicional. El acceso a los servicios de atención primaria pública decayó en el mismo periodo.

Identification of multi-target anti-cancer agents from TCM formula by in silico prediction and in vitro validation / 中国天然药物

Cancer is a complex disease associated with multiple gene mutations and malignant phenotypes, and multi-target drugs provide a promising therapy idea for the treatment of cancer. Natural products with abundant chemical structure types and rich pharmacological characteristics could be ideal sources for screening multi-target antineoplastic drugs. In this paper, 50 tumor-related targets were collected by searching the Therapeutic Target Database and Thomson Reuters Integrity database, and a multi-target anti-cancer prediction system based on mt-QSAR models was constructed by using naïve Bayesian and recursive partitioning algorithm for the first time. Through the multi-target anti-cancer prediction system, some dominant fragments that act on multiple tumor-related targets were analyzed, which could be helpful in designing multi-target anti-cancer drugs. Anti-cancer traditional Chinese medicine (TCM) and its natural products were collected to form a TCM formula-based natural products library, and the potential targets of the natural products in the library were predicted by multi-target anti-cancer prediction system. As a result, alkaloids, flavonoids and terpenoids were predicted to act on multiple tumor-related targets. The predicted targets of some representative compounds were verified according to literature review and most of the selected natural compounds were found to exert certain anti-cancer activity in vitro biological experiments. In conclusion, the multi-target anti-cancer prediction system is very effective and reliable, and it could be further used for elucidating the functional mechanism of anti-cancer TCM formula and screening for multi-target anti-cancer drugs. The anti-cancer natural compounds found in this paper will lay important information for further study.

Impact of adjuvant chemotherapy on prognosis in intrahepatic cholangiocarcinoma patients underwent radical resection / 中华外科杂志

Objectives: To investigate the clinical value of adjuvant chemotherapy(ACT) in patients with intrahepatic cholangiocarcinoma(ICC) who underwent radical resection and to explore the optimal population that can benefit from ACT. Methods: A retrospective cohort study method was adopted. The clinical and pathological data of 685 patients with ICC who underwent curative intent resection in 10 Chinese hepatobiliary surgery centers from January 2010 to December 2018 were collected;There were 355 males and 330 females. The age(M(IQR)) was 58(14) years (range: 22 to 83 years). Propensity score matching(PSM) was applied to balance the differences between the adjuvant and non-adjuvant chemotherapy groups. Log-rank test was used to compare the prognosis of the two groups of patients. A Bayesian network recurrence-free survival(RFS) prediction model was constructed using the median RFS time (14 months) as the target variable, and the importance of the relevant prognostic factors was ranked according to the multistate Birnbaum importance calculation. A survival prognostic prediction table was established to analyze the population benefiting from adjuvant chemotherapy. Results: Among 685 patients,214 received ACT and 471 did not receive ACT. A total of 124 pairs of patients were included after PSM, and patients in the ACT group had better overall survival (OS) and RFS than those in the non-ACT group(OS: 32.2 months vs. 18.0 months,P=0.003;RFS:18.0 months vs. 10.0 months,P=0.001). The area under the curve of the Bayesian network RFS prediction model was 0.7124. The results of the prognostic factors in order of importance were microvascular invasion (0.158 2),perineural invasion (0.158 2),N stage (0.155 8),T stage (0.120 9), hepatic envelope invasion (0.090 3),adjuvant chemotherapy (0.072 1), tumor location (0.057 5), age (0.042 3), pathological differentiation (0.034 0), sex (0.029 3), alpha-fetoprotein (0.028 9) and preoperative jaundice (0.008 5). A survival prediction table based on the variables with importance greater than 0.1 (microvascular invasion,perineural invasion,N stage,T staging) and ACT showed that all patients benefited from ACT (increase in the probability of RFS≥14 months from 2.21% to 7.68%), with a more significant increase in the probability of RFS≥14 months after ACT in early-stage patients. Conclusion: ACT after radical resection in patients with ICC significantly prolongs the OS and RFS of patients, and the benefit of ACT is greater in early patients.

Application of phylogenetic analysis in the molecular epidemiological study of infectious diseases / 中华流行病学杂志

The rapid development of sequencing technology brings the explosive growth of pathogen genetic data. The combination of genomic data and phylogenetic method is being used to elaborate the origin and evolution of pathogens, the time and space distribution and parameter changes in the prevalence process, and how phenotypes like antigen, virulence, and resistance change over time. This method is also being used to predict pathogen transmission trends. In this study, we described the aim of phylogeny and the process of the phylogenetic construction method. We elaborated the advantages and disadvantages and scope of application of tree-building methods including distance-based, maximum parsimony, maximum likelihood and bayesian methods. We have reviewed the application and the estimation methods of major epidemiological parameters of phylodynamics and phylogeography in domestic and foreign studies. We concluded that the time- and location-scaled phylogenetic trees are increasingly used for outbreak investigation and routine surveillance of infectious diseases.

Association between short-term exposure to ambient nitrogen dioxide and the risk of heart failure hospitalization / 中华预防医学杂志

Objective: To assess the association between short-term exposure level of nitrogen dioxide and the hospitalization risk of heart failure. Methods: Based on China-PEACE Retrospective Heart Failure Study, 117 364 hospitalized patients with heart failure were recruited from 92 hospitals in 62 cities throughout China between January 1, 2015 and December 31, 2015. The daily exposure level of nitrogen dioxide, temperature, and humidity in the same cities during the same period were also collected. We applied the generalized additive model and Bayesian hierarchical model to quantify the lagged effect and cumulative effect of short-term (0-3 days) exposure to ambient nitrogen dioxide on the hospitalization risk of heart failure. We further conducted stratified analyses by age, region, and season to identify any difference in the associations between short-term nitrogen dioxide exposure and heart failure among subgroups. Results: The mean age for participants in the analysis was (70.32±12.22) years. The median, minimum and maximum of daily nitrogen dioxide concentration in 62 cities from January 1, 2015 to December 31, 2015 was 26.4 μg/m3, 2.33 μg/m3 and 150.25 μg/m3, respectively. The exposure level of nitrogen dioxide at the same day was associated with the hospitalization risk of heart failure (OR=1.022, 95%CI: 1.012, 1.031). Significant effects were also observed in the moving average concentrations from lag 0-1 to lag 0-3 day (OR=1.020, 95%CI: 1.009, 1.030; OR=1.016, 95%CI: 1.004, 1.028; OR=1.013, 95%CI: 1.001, 1.026). Moreover, all of the associations between short-term exposure to nitrogen dioxide and the risk of heart failure hospitalization were statistically significant, with no significant difference in all subgroups stratified by age, region, and season. Conclusion: A higher level of short-term exposure to nitrogen dioxide could trigger more hospitalizations with heart failure.

Prediction of trends for fine-scale spread of Oncomelania hupensis in Shanghai Municipality based on supervised machine learning models / 中国血吸虫病防治杂志

OBJECTIVE@#To predict the trends for fine-scale spread of Oncomelania hupensis based on supervised machine learning models in Shanghai Municipality, so as to provide insights into precision O. hupensis snail control.@*METHODS@#Based on 2016 O. hupensis snail survey data in Shanghai Municipality and climatic, geographical, vegetation and socioeconomic data relating to O. hupensis snail distribution, seven supervised machine learning models were created to predict the risk of snail spread in Shanghai, including decision tree, random forest, generalized boosted model, support vector machine, naive Bayes, k-nearest neighbor and C5.0. The performance of seven models for predicting snail spread was evaluated with the area under the receiver operating characteristic curve (AUC), F1-score and accuracy, and optimal models were selected to identify the environmental variables affecting snail spread and predict the areas at risk of snail spread in Shanghai Municipality.@*RESULTS@#Seven supervised machine learning models were successfully created to predict the risk of snail spread in Shanghai Municipality, and random forest (AUC = 0.901, F1-score = 0.840, ACC = 0.797) and generalized boosted model (AUC= 0.889, F1-score = 0.869, ACC = 0.835) showed higher predictive performance than other models. Random forest analysis showed that the three most important climatic variables contributing to snail spread in Shanghai included aridity (11.87%), ≥ 0 °C annual accumulated temperature (10.19%), moisture index (10.18%) and average annual precipitation (9.86%), the two most important vegetation variables included the vegetation index of the first quarter (8.30%) and vegetation index of the second quarter (7.69%). Snails were more likely to spread at aridity of < 0.87, ≥ 0 °C annual accumulated temperature of 5 550 to 5 675 °C, moisture index of > 39% and average annual precipitation of > 1 180 mm, and with the vegetation index of the first quarter of > 0.4 and the vegetation index of the first quarter of > 0.6. According to the water resource developments and township administrative maps, the areas at risk of snail spread were mainly predicted in 10 townships/subdistricts, covering the Xipian, Dongpian and Tainan sections of southern Shanghai.@*CONCLUSIONS@#Supervised machine learning models are effective to predict the risk of fine-scale O. hupensis snail spread and identify the environmental determinants relating to snail spread. The areas at risk of O. hupensis snail spread are mainly located in southwestern Songjiang District, northwestern Jinshan District and southeastern Qingpu District of Shanghai Municipality.

Translation and cultural validation of the Revised Illness Perception Questionnaire for Healthcare Professionals for Brazilian Portuguese / Tradução e validação cultural do Questionário de Percepção de Doença Revisado para Profissionais de Saúde em português brasileiro

ABSTRACT Background: Multiple sclerosis progression and disability can be rated differently by healthcare professionals. Therefore, how physicians perceive the disease can impact treatment decisions. There are no previous studies on this matter. Objective: To translate and transculturally validate the Revised Illness Perception Questionnaire for Healthcare Professionals (IPQ-R HP), for use in Brazilian Portuguese. Methods: The process used to validate the IPQ-R HP was based on the steps presented in the guide proposed by Dorcas Beaton. The final version of the IPQ-R HP had 38 questions, divided into seven different dimensions to assess the patient's disease. Also, two clinical cases that were representative of real-life patients with multiple sclerosis (MS) were assembled to consider the two main profiles of the disease. We applied the questionnaire to neurologists at the Federal University of São Paulo (UNIFESP) to assess their perception of MS. These doctors also answered a brief survey to establish the profile of the interviewees. For statistical analysis, we used Bayesian CFA models and kappa statistics. Conclusions: The kappa statistics showed a general agreement of 0.4. For the Bayesian CFAs with seven-factor correlation solution, we had a poor fit for case 1 with a 95% confidence interval ranging from -52.893 to 273.797 and a PPP of 0.107. Regarding case 2, the model did not converge even after 50,000 iterations, which indicated that the specified model (i.e. seven-factor correlation solution) for case 2 was inadmissible. Thus, the IPQ-R HP questionnaire in Brazilian Portuguese has not been validated.

RESUMO Antecedentes: A progressão da esclerose múltipla e a incapacidade podem ser avaliadas de formas diferentes por médicos. Portanto, a forma como estes percebem a doença pode afetar as decisões de tratamento. Não há estudos anteriores sobre o assunto. Procuramos traduzir e validar o Revised Illness Perception Questionnaire-Revised Healthcare Professionals (IPQ-R HP). Objetivos: Validação transcultural da versão IPQ-R HP para português. Métodos: O processo de validação do IPQ-R HP foi baseado nas etapas apresentadas no guia proposto por Dorcas Beaton. A versão final do IPQ-R HP continha 38 questões, divididas em sete dimensões diferentes para avaliar a doença do paciente. Além disso, dois casos clínicos representativos de esclerose múltipla (EM) foram criados para contemplar os dois perfis principais da doença. Aplicamos o questionário a neurologistas da UNIFESP para avaliar sua percepção sobre a EM, além de uma pesquisa para estabelecer o perfil dos entrevistados. Para a análise estatística, usamos modelos CFA Bayesianos e estatísticas kappa. Conclusões: A estatística kappa mostrou concordância geral de 0,4. Para os CFAs bayesianos com solução de sete fatores correlacionados, tivemos um ajuste ruim para o caso 1 com um intervalo de confiança de 95% variando de -52,893 a 273,797 e o PPP de 0,107. Em relação ao Caso 2, o modelo não convergiu mesmo após 50000 iterações, indicando que o modelo especificado (ou seja, solução de sete fatores correlacionados) para o caso 2 é inadmissível. Assim, o questionário IPQ-R HP em português não é validado.

Análisis bayesiano de la ideación suicida en adultos peruanos / Bayesian analysis of the suicidal idea in Peruvian adults

Introducción: La ideación suicida es un término amplio para describir una variedad de contemplaciones, deseos y preocupaciones sobre la muerte. Es uno de los principales factores de riesgo de muerte por suicidio, aunque se refieren diferencias en cuanto al sexo. Objetivo: Analizar las diferencias según el sexo respecto a la ideación suicida en adultos peruanos. Métodos: Se efectuó un estudio comparativo, transversal y no experimental, durante abril del 2021, de 366 adultos peruanos de la población general, seleccionados mediante muestreo por conveniencia a través de criterios de inclusión y exclusión. A tal efecto, se utilizaron el inventario de frecuencia de ideación suicida y, en el análisis estadístico, la prueba de la U de Mann-Whitney de muestras independientes bayesianas. Resultados: El promedio de edad fue de 29,64 años y existió una mayor participación del sexo femenino (55,5 %). El análisis bayesiano demostró que los datos observados eran más probables bajo la hipótesis alternativa (BF10=53,477; δ=0,411; IC 95 %: 0,181-0,635), con una evidencia muy fuerte. Esta diferencia fue superior en las mujeres (M=6,46) en comparación con los hombres (M=5,83). Conclusiones: Los hallazgos demostraron que la ideación suicida se presenta principalmente en las mujeres, de manera que resulta el grupo más vulnerable y, por ende, necesita una mayor atención por parte de los profesionales de la salud. Al respecto, los psicólogos y psiquiatras desempeñan un papel importante en identificar a las personas en riesgo y proporcionar anticipadamente la ayuda necesaria para su intervención.

Introduction: The suicidal idea is a wide term to describe a variety of views, desires and concerns about death. It is one of the main risk factors of suicidal death, although they refer differences as for sex. Objective: To analyze the differences according to sex regarding the suicidal ideation in Peruvian adults. Methods: A comparative, cross-sectional and non-experimental study was carried out, in April, 2021, of 366 Peruvian adults from the general population, selected by means of sampling by convenience with inclusion and exclusion criteria. To such an effect, the frequency inventory of suicidal ideation, and in the statistical analysis, the Mann-Whitney U-test of independent bayesian samples were used. Results: The average age was 29.64 and there a higher participation of the female sex (55.5 %). The bayesian analysis demonstrated that the observed data were more probable under the alternative hypothesis (BF10=53.477; δ=0.411; IC 95 %: 0.181-0.635), with a very strong evidence. This difference was higher in women (M=6.46) in comparison with men (M=5.83). Conclusions: The findings demonstrated that suicidal ideation is mainly presented in women, so that it is the most vulnerable group, reason why it needs a higher care of health professionals. In this respect, psychologists and psychiatrists play an important role to identify people at risk and provide the necessary help in advance for their intervention.

Desigualdades socioeconómicas en la mortalidad por enfermedades cardiovasculares: Región Pacifico de Colombia, 2002-2015 / Socioeconomic inequalities in mortality due to cardiovascular diseases: Pacific Region of Colombia, 2002-2015

Resumen Las enfermedades cardiovasculares (ECV) son la principal causa de muerte en el mundo y en Colombia siendo consideradas un serio problema de salud pública. El objetivo de este estudio fue analizar espacial y temporalmente la mortalidad por ECV en la región Pacifico de Colombia durante el periodo 2002-2015 y su asociación con algunos indicadores socioeconómicos municipales usando técnicas estadísticas de análisis espacial. Fue un estudio descriptivo-ecológico en los 177 municipios de la región Pacifico que usó datos de mortalidad por ECV, bajo los códigos I00-I99 de la Clasificación Internacional de Enfermedades (CIE-10), y siete indicadores socioeconómicos municipales. El análisis incluyó cálculo de tasas de mortalidad crudas y estandarizadas, según sexo, para las ECV y sus principales causas, y la modelación del conteo de defunciones usando modelos jerárquicos Bayesianos. Durante el periodo 2002-2015 las tasas estandarizadas de mortalidad por ECV mostraron una tendencia descendente en hombres (129,0 a 119,3) y en mujeres (129,0 a 110,0) siendo las principales causas de muerte las enfermedades isquémicas del corazón, seguidas de las cerebrovasculares. En general, el riesgo de mortalidad por ECV fue mayor en los municipios menos favorecidos económica y socialmente.

Abstract Cardiovascular diseases (CVD) are the leading cause of death in the world, and they are considered a serious public health problem in Colombia. The main goal of this study was to analyze CVD mortality spatially and temporarily in the Pacific region of Colombia during the 2002-2015 period, and its association with some municipal socio-economic indicators using spatial statistical analysis techniques. It involved a descriptive-ecological study in the 177 municipalities of the Pacific region that used CVD mortality data, under codes I00-I99 of the International Classification of Diseases (ICD-10), and seven municipal socio-economic indicators. The analysis included the calculation of crude and standardized mortality rates, according to sex, for CVD and its main causes, and modeling of CVD death counts using Bayesian hierarchical models. During the 2002-2015 period, standardized rates of CVD mortality showed a downward trend in men (129.0 to 119.3) and in women (129.0 to 110.0), the main causes of death being ischemic heart diseases, followed by cerebrovascular diseases. In general, the risk of CVD mortality was higher in the less economically and socially privileged municipalities.