Evaluating social protection mitigation effects on HIV/AIDS and Tuberculosis through a mathematical modelling study.

The global economic downturn due to the COVID-19 pandemic, war in Ukraine, and worldwide inflation surge may have a profound impact on poverty-related infectious diseases, especially in low-and middle-income countries (LMICs). In this work, we developed mathematical models for HIV/AIDS and Tuberculosis (TB) in Brazil, one of the largest and most unequal LMICs, incorporating poverty rates and temporal dynamics to evaluate and forecast the impact of the increase in poverty due to the economic crisis, and estimate the mitigation effects of alternative poverty-reduction policies on the incidence and mortality from AIDS and TB up to 2030. Three main intervention scenarios were simulated-an economic crisis followed by the implementation of social protection policies with none, moderate, or strong coverage-evaluating the incidence and mortality from AIDS and TB. Without social protection policies to mitigate the impact of the economic crisis, the burden of HIV/AIDS and TB would be significantly larger over the next decade, being responsible in 2030 for an incidence 13% (95% CI 4-31%) and mortality 21% (95% CI 12-34%) higher for HIV/AIDS, and an incidence 16% (95% CI 10-25%) and mortality 22% (95% CI 15-31%) higher for TB, if compared with a scenario of moderate social protection. These differences would be significantly larger if compared with a scenario of strong social protection, resulting in more than 230,000 cases and 34,000 deaths from AIDS and TB averted over the next decade in Brazil. Using a comprehensive approach, that integrated economic forecasting with mathematical and epidemiological models, we were able to show the importance of implementing robust social protection policies to avert a significant increase in incidence and mortality from AIDS and TB during the current global economic downturn.

Combining Digital and Molecular Approaches Using Health and Alternate Data Sources in a Next-Generation Surveillance System for Anticipating Outbreaks of Pandemic Potential.

Globally, millions of lives are impacted every year by infectious diseases outbreaks. Comprehensive and innovative surveillance strategies aiming at early alert and timely containment of emerging and reemerging pathogens are a pressing priority. Shortcomings and delays in current pathogen surveillance practices further disturbed informing responses, interventions, and mitigation of recent pandemics, including H1N1 influenza and SARS-CoV-2. We present the design principles of the architecture for an early-alert surveillance system that leverages the vast available data landscape, including syndromic data from primary health care, drug sales, and rumors from the lay media and social media to identify areas with an increased number of cases of respiratory disease. In these potentially affected areas, an intensive and fast sample collection and advanced high-throughput genome sequencing analyses would inform on circulating known or novel pathogens by metagenomics-enabled pathogen characterization. Concurrently, the integration of bioclimatic and socioeconomic data, as well as transportation and mobility network data, into a data analytics platform, coupled with advanced mathematical modeling using artificial intelligence or machine learning, will enable more accurate estimation of outbreak spread risk. Such an approach aims to readily identify and characterize regions in the early stages of an outbreak development, as well as model risk and patterns of spread, informing targeted mitigation and control measures. A fully operational system must integrate diverse and robust data streams to translate data into actionable intelligence and actions, ultimately paving the way toward constructing next-generation surveillance systems.

Subsidised housing and diabetes mortality: a retrospective cohort study of 10 million low-income adults in Brazil.

INTRODUCTION: Housing-related factors can be predictors of health, including of diabetes outcomes. We analysed the association between subsidised housing residency and diabetes mortality among a large cohort of low-income adults in Brazil. RESEARCH DESIGN AND METHODS: A cohort of 9 961 271 low-income adults, observed from January 2010 to December 2015, was created from Brazilian administrative records of social programmes and death certificates. We analysed the association between subsidised housing residency and time to diabetes mortality using a Cox model with inverse probability of treatment weighting and regression adjustment. We assessed inequalities in this association by groups of municipality Human Development Index. Diabetes mortality included diabetes both as the underlying or a contributory cause of death. RESULTS: At baseline, the mean age of the cohort was 40.3 years (SD 15.6 years), with a majority of women (58.4%). During 29 238 920 person-years of follow-up, there were 18 775 deaths with diabetes as the underlying or a contributory cause. 340 683 participants (3.4% of the cohort) received subsidised housing. Subsidised housing residents had a higher hazard of diabetes mortality compared with non-residents (HR 1.17; 95% CI 1.05 to 1.31). The magnitude of this association was more pronounced among participants living in municipalities with lower Human Development Index (HR 1.30; 95% CI 1.04 to 1.62). CONCLUSIONS: Subsidised housing residents had a greater risk of diabetes mortality, particularly those living in low socioeconomic status municipalities. This finding suggests the need to intensify diabetes prevention and control actions and prompt treatment of the diabetes complications among subsidised housing residents, particularly among those living in low socioeconomic status municipalities.

Sensory Integration for Postural Control in Rheumatoid Arthritis Revealed by Computerized Dynamic Posturography.

Rheumatoid arthritis (RA) is a systemic autoimmune disease that impairs mobility. How does sensory information influence postural responses in people with RA? The aim of this study was to evaluate the postural control of people with RA during a sensory organization test, comparing how sensory information influences postural responses in people with rheumatoid arthritis compared with healthy people. Participants were 28 women with rheumatoid arthritis (RA group) and 16 women without any rheumatoid disease (Control group CG). The Sensory Organization Test (SOT) was performed on a Smart Balance Master® (NeuroCom International, Inc., Clackamas, OR, USA) and center of pressure (COP) was measured. SOT conditions: SOT1 (eyes open, fixed support surface and surround; SOT2) eyes closed, fixed support surface and surround; and SOT5) eyes closed, sway-referenced support surface, and fixed surround. To compare the demographic and clinical aspects between groups, independent t-test or Mann-Whitney's U-test were used. Differences were found between groups. Between SOT conditions, for CG and RA, COP was faster for SOT-5 than SOT-1, while SOT-1 and SOT-2 presented similar COP velocity. For SOT-2 and SOT-5, COP was larger for the RA group. For both groups, SOT-1 presented the smallest COP, and SOT-5 showed the largest COP.

Profile of COVID-19 in Brazil-risk factors and socioeconomic vulnerability associated with disease outcome: retrospective analysis of population-based registers.

OBJECTIVES: To classify the most up-to-date factors associated with COVID-19 disease outcomes in Brazil. DESIGN: Retrospective study. SETTING: Nationwide Brazilian COVID-19 healthcare registers. PARTICIPANTS: We used healthcare data of individuals diagnosed with mild/moderate (n=70 056 602) or severe (n=2801 380) COVID-19 disease in Brazil between 26 February 2020 and 15 November 2021. MAIN OUTCOME MEASURES: Risk of hospitalisation and mortality affected by demographic, clinical and socioeconomic variables were estimated. The impacts of socioeconomic inequalities on vaccination rates, cases and deaths were also evaluated. RESULTS: 15.6 million SARS-CoV-2 infection cases and 584 761 COVID-19-related deaths occurred in Brazil between 26 February 2020 and 15 November 2021. Overall, men presented a higher odds of death than women (OR=1.14, 95% CI 1.13 to 1.15), but postpartum patients admitted to hospital wards were at increased odds of dying (OR=1.23, 95% CI 1.13 to 1.34) compared with individuals without reported comorbidities. Death in younger age groups was notably higher in most deprived municipalities and also among individuals <40 years belonging to indigenous backgrounds compared with white patients, as shown by descriptive analysis. Ethnic/racial backgrounds exhibited a continuum of decreasing survival chances of mixed-race (OR=1.11, 95% CI 1.10 to 1.12), black (OR=1.34, 95% CI 1.32 to 1.36) and indigenous (OR=1.42, 95% CI 1.31 to 1.54) individuals, while those in most deprived municipalities also presented an increased odds of death (OR=1.38, 95% CI 1.36 to 1.40). Deprivation levels also affect the prompt referral of patients to adequate care. Our results show that the odds of death of individuals hospitalised for less than 4 days is more than double that of patients with close-to-average hospital stays (OR=2.07, 95% CI 2.05 to 2.10). Finally, negative vaccination status also increased the odds of dying from the disease (OR=1.29, 95% CI 1.28 to 1.31). CONCLUSIONS: The data provide evidence that the patterns of COVID-19 mortality in Brazil are influenced by both individual-level health and social risk factors, as well as municipality-level deprivation. In addition, these data suggest that there may be inequalities in the timely provision of appropriate healthcare that are related to municipality-level deprivation.

An IoT-Based System for Monitoring the Health of Guyed Towers in Overhead Power Lines.

The collapse of overhead power line guyed towers is one of the leading causes of power grid failures, subjecting electricity companies to pay considerable, high-value fines. In this way, the current work proposes a novel and complete framework for the remote monitoring of mechanical stresses in guyed towers. The framework method comprises a mesh network for data forwarding and neural networks to improve the performance of Low-Power and Lossy Networks. The method also considers the use of multiple sensors in the sensor fusion technique. As a result, the risk of collapse of guyed cable towers reduces, due to the remote monitoring and preventive actions promoted by the framework. Furthermore, the proposed method uses multiple input variable fusions, such as accelerometers and tension sensors, to estimate the tower's displacement. These estimations help address the structural health of the tower against failures (i.e., loosening of the stay cables, displacement, and vibrations) that can cause catastrophic events, such as tower collapse or even cable rupture.

Scaling effect in COVID-19 spreading: The role of heterogeneity in a hybrid ODE-network model with restrictions on the inter-cities flow.

The new Covid-19 pandemic has left traces of suffering and devastation to individuals of almost all countries worldwide and severe impact on the global economy. Understanding the clinical characteristics, interactions with the environment, and the variables that favor or hinder its dissemination help the public authorities in the fight and prevention, leading for a rapid response in society. Using models to estimate contamination scenarios in real time plays an important role. Population compartments models based on ordinary differential equations (ODE) for a given region assume two homogeneous premises, the contact mechanisms and diffusion rates, disregarding heterogeneous factors as different contact rates for each municipality and the flow of contaminated people among them. This work considers a hybrid model for covid-19, based on local SIR models and the population flow network among municipalities, responsible for a complex lag dynamic in their contagion curves. Based on actual infection data, local contact rates ( ß ) are evaluated. The epidemic evolution at each municipality depends on the local SIR parameters and on the inter-municipality transport flow. When heterogeneity of ß values and flow network are included, forecasts differ from those of the homogeneous ODE model. This effect is more relevant when more municipalities are considered, hinting that the latter overestimates new cases. In addition, mitigation scenarios are assessed to evaluate the effect of earlier interventions reducing the inter-municipality flux. Restricting the flow between municipalities in the initial stage of the epidemic is fundamental for flattening the contamination curve, highlighting advantages of a contamination lag between the capital curve and those of other municipalities in the territories.

Processing methods with heat increases bioactive phenolic compounds and antioxidant activity in grape juices.

In this work, the influence of the method of processing on phenolic composition and the in vitro antioxidant activity (AOX) of grape juices was studied. The classic methods of producing "Hot Press" (HP), "Hot Break" (HB), and "Cold Press" (CP), and an artisanal method using steam were compared. Among the methods of elaboration of evaluated grape juices, those that heated the grape showed higher content of bioactive phenolics and AOX. The artisanal method using steam presented acceptable bioactive content and could be simple alternative for grape juice production. The main bioactive compounds quantified in the studied juices were procyanidin B1, quercetin-3-pyranoside, chlorogenic acid, malvidin-3-glucoside, cyanidin-3-glucoside, and petunidin-3-glucoside. These were correlated by principal component analysis (PCA) with the antioxidant activity. The characteristics obtained from the different juice elaboration methods demonstrate that the HB method was responsible for the greatest extraction of bioactive compounds from the grapes. PRACTICAL APPLICATIONS: Worldwide consumption of grape juice has been increasing. The factors that have contributed to this growth include the good sensory acceptance and the nutritional appeal related to bioactive compounds. The bioactive compounds of grape juice are mainly flavonoids and phenolic acids, and several factors exert influence on the phenolic composition of this beverage, among them, the method of elaboration. The present work presents new information on the influence of grape juice processing methods on the profile of bioactive compounds of nutritional interest and contributes to improvements in the production processes of this beverage.

Climate effects on physicochemical composition of Syrah grapes at low and high altitude sites from tropical grown regions of Brazil.

The major areas of the world where viticulture is practiced enjoy temperate or cool temperature climates. When wine grapes are grown in tropical regions, edaphoclimatic factors result in distinct grape quality attributes, and production techniques also require significant adjustment. The objective of this study was to characterize the chemical compositions, in particular of phenolic compounds, of Syrah grapes grown in two location in northeast Brazil - these are also at widely different altitudes. A range of methods of phenolic extraction were used, along with classical chemical analyses including for organic acids, sugars, monomeric anthocyanins, flavonols, stilbene, condensed tannins and some of the monomeric and small oligomeric procyanidins. The regions and their diverse environments had a larger influence than harvest year. The grapes at higher altitude (Bahia, 1.100 m asl (metres above sea level) were characterized by higher levels of malic acid, anthocyanins and condensed tannins in the skins. The low-altitude grapes (Pernambuco, 350 m asl (metres above sea level) had higher levels of glucose, fructose, 3-O-acetylglucoside anthocyanins and condensed tannins in the seeds. Fruit composition was highly influenced by the region. In the low-altitude region, the grapes were characterized by higher tartaric and citric acid in the must, also of flavonols in skins and of tannins in the seeds. Meanwhile, the fruit from the high altitude, contained higher levels of malic and succinic acid in the must, and of anthocyanins and condensed tannins in the skins.

Chemical characteristics of grapes cv. Syrah (Vitis vinifera L.) grown in the tropical semiarid region of Brazil (Pernambuco state): influence of rootstock and harvest season.

BACKGROUND: Obtaining two or more successive annual vintages from the same vineyard is characteristic of regions with a tropical climate, such as the Submédio of the São Francisco Valley, Brazil. The present study aimed to characterize the chemical composition of grapes in four production cycles (i.e. two calendar years) when considering the interaction between cv. Syrah and two rootstocks. For a broad characterization, two methodologies for the extraction of phenolic compounds were used, as well as different methods of analysis. RESULTS: The results obtained showed that there was an influence of rootstock and harvest season. Grapes from vines grafted onto IAC 313 contained higher concentrations of total condensed tannins (skins) and flavanols than grapes from vines grafted onto 1103P. However, the grape samples from the vines grafted onto 1103P contained higher levels of monomeric anthocyanins than the grape samples from the vines grafted onto IAC 313. The first harvest season was characterized by higher concentrations of most phenolic compounds than the second harvest season. CONCLUSION: In the present study, it was possible to confirm that, in the semiarid region of Brazil, the interaction between the cultivar Syrah and the different rootstocks, as well as the climatic conditions in each harvest season, influenced the composition of the grapes, mainly in relation to phenolic compounds. © 2019 Society of Chemical Industry.

Quercetin protects the impairment of memory and anxiogenic-like behavior in rats exposed to cadmium: Possible involvement of the acetylcholinesterase and Na(+),K(+)-ATPase activities.

The present study investigated the effects of quercetin in the impairment of memory and anxiogenic-like behavior induced by cadmium (Cd) exposure. We also investigated possible alterations in acetylcholinesterase (AChE), Na(+),K(+)-ATPase and δ-aminolevulinate dehydratase (δ-ALA-D) activities as well as in oxidative stress parameters in the CNS. Rats were exposed to Cd (2.5mg/kg) and quercetin (5, 25 or 50mg/kg) by gavage for 45days. Animals were divided into eight groups (n=10-14): saline/control, saline/Querc 5mg/kg, saline/Querc 25mg/kg, saline/Querc 50mg/kg, Cd/ethanol, Cd/Querc 5mg/kg, Cd/Querc 25mg/kg and Cd/Querc 50mg/kg. Results demonstrated that Cd impaired memory has an anxiogenic effect. Quercetin prevented these harmful effects induced by Cd. AChE activity decreased in the cerebral cortex and hippocampus and increased in the hypothalamus of Cd-exposed rats. The Na(+),K(+)-ATPase activity decreased in the cerebral cortex, hippocampus and hypothalamus of Cd-exposed rats. Quercetin prevented these effects in AChE and Na(+),K(+)-ATPase activities. Reactive oxygen species production, thiobarbituric acid reactive substance levels, protein carbonyl content and double-stranded DNA fractions increased in the cerebral cortex, hippocampus and hypothalamus of Cd-exposed rats. Quercetin totally or partially prevents these effects caused by Cd. Total thiols (T-SHs), reduced glutathione (GSH), and reductase glutathione (GR) activities decreased and glutathione S-transferase (GST) activity increased in Cd exposed rats. Co-treatment with quercetin prevented reduction in T-SH, GSH, and GR activities and the rise of GST activity. The present findings show that quercetin prevents alterations in oxidative stress parameters as well as AChE and Na(+),K(+)-ATPase activities, consequently preventing memory impairment and anxiogenic-like behavior displayed by Cd exposure. These results may contribute to a better understanding of the neuroprotective role of quercetin, emphasizing the influence of this flavonoid in the diet for human health, possibly preventing brain injury associated with Cd intoxication.