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Stages of care for patients with chronic hepatitis C at a hospital in southern Brazil

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World Journal of Hepatology 2023年第8期15卷 973-984页

作者： Manoela Badinelli Vaucher Camila Ubirajara Silva Ivana Rosângela Santos Varella Arthur Yu-Shin Kim Dimas Alexandre Kliemann Department of Hepatology Universidade Federal de Ciências da Saúde de Porto AlegrePorto Alegre 90050-170Rio Grande do SulBrazil Department of Medicine Universidade do Vale do TaquariLajeado 95914-014RSBrazil Department of Application and Monitoring of Injectable Drugs Hospital Sanatório PartenonPorto Alegre 90650-000RSBrazil Department of Epidemiology Hospital Nossa Senhora da ConceiçãoPorto Alegre 91350-200Rio Grande do SulBrazil Department of Infectious Diseases Massachusetts General HospitalBostonMA 02114United States Department of Medicine Harvard Medical SchoolBostonMA 02114United States Departament of Infectious Diseases Hospital Nossa Senhora da ConceiçãoPorto Alegre 91350-200Rio Grande do SulBrazil

BACKGROUND Hepatitis C virus(HCV)is defined as a public health problem by the World Health Organization(WHO)and since then has defined targets through the HCV *** HCV cascade of care highlights the progress towards these goals and essential interventions that need to be delivered along this continuum *** To document the treatment cascade for patients with HCV infection at the Hospital Nossa Senhora da Conceição(HNSC),defining the percentage of antibody-positive patients who collected molecular biology tests(polymerase chain reaction),attended outpatient clinic assistance,underwent treatment,and achieved a virologic cure termed sustained virologic response(SVR).METHODS With the retrospective cohort design,patients diagnosed with HCV infection in the period between January 1,2015 and December 31,2020 were *** from HCV notification forms,electronic medical records,Computerized Laboratory Environment Manager System,and Medicine Administration System(evaluation of special medications)were collected in 2022 and all information up to that period was *** data were analyzed with IBM SPSS version 25,and Poisson regression with robust simple variance was performed for analysis of variables in relation to each step of the *** with P<0.20 were included in the multivariate analysis with P<0.05 considered ***’s chi-square test was applied to compare the groups of patients who persisted in follow-up at the HNSC and who underwent follow-up at other *** Results were lower than expected by the WHO with only 49%of candidates receiving HCV treatment and only 29%achieving SVR,despite the 98%response rate to direct acting antivirals documented by follow-up *** city of origin and the place of follow-up were the variables associated with SVR and all other *** comparing the cascade of patients who remained assisted by the HNSC vs external patients,we observed superior data for HNSC patien

关键词： Cascade of care Elimination Hepatitis C virus Sustained virologic response

Effectiveness of Acupuncture on Pain, Physical Function and Health-Related Quality of Life in Patients with Rheumatoid Arthritis: A Systematic Review of Quantitative Evidence

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Chinese Journal of Integrative Medicine 2019年第9期25卷 704-709页

作者： Susana Seca Diana miranda Daniela Cardoso Bernice Nogueira Henry J.Greten Antonio Cabrita Manuel Alves Rodrigues Faculty of Medicine University of CoimbraInstitute of Science Biomedicine Abel Salazar University of Porto Porto PortugalHeidelberg School of Chinese Medicine Heidelberg Germany Institute of Science Biomedicine Abel Salazar University of Porto Porto Portugal Health Sciences Research Unit:Nursing (UICISA: E) Nursing School of Coimbra (ESEnfC) Portugal Centre for Evidenee Based Practice: A Joanna Briggs Institute Centre of Excellence Coimbra Portugal School of Health Sciences Macao Polytechnic Institute Macao SAR China Institute of Science Biomedicine Abel Salazar University of PortoHeidelberg School of Chinese Medicine Heidelberg Germany Faculty of Medicine University of Coimbra Portugal Health Sciences Research Unit: Nursing (UICISA:E) Nursing School of Coimbra (ESEnfC)Portugal Centre for Evidence Based Practice: A Joanna Briggs Institute Centre of Excellence Portugal

Objective: To identify and synthesize the most recent available evidence of effectiveness of acupuncture on pain, physical function and health-related quality of life(HRQoL) in patients with rheumatoid arthritis(RA). Methods: A comprehensive search of 12 Western and Chinese databases was undertaken from their inception up to end of 2016. Randomized controlled trials(RCTs), concerning patients with RA treated with needle acupuncture, written in English, Portuguese, German or Chinese were included. Primary outcomes included pain, physical function and HRQoL. Secondary outcomes included morning stiffness, functional impairment, number of tender and swollen joints and serum concentrations of inflamatory markers. Methodological quality was assessed by three independent reviewers using the standardized critical appraisal instrument from the Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument. Results: Twenty-two studies met the inclusion criteria. Of those, 9 studies were excluded after assessment of their methodological quality. The remaining 13 original RCTs included 974 patients. Ten of these studies published in China, showed favorable statistical significant effects of acupuncture in relieving symptoms of RA compared with controls. Conclusions: Evidence suggests that acupuncture interventions may have a positive effect in pain relief, physical function and HRQo L in RA patients. However, due to the heterogeneity and methodologic limitations of the studies included in this systematic review, evidence is not strong enough to produce a best practice guideline.

关键词： acupuncture rheumatoid arthritis quality of life pain physical function randomized clinical trial

Modelling potential distribution of a pine bark beetle in Mexican temperate forests using forecast data and spatial analysis tools

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Journal of Forestry Research 2020年第2期31卷 649-659页

作者： Antonio Gonzalez-Hernandez Rene Morales-Villafana Martin Enrique Romero-Sanchez Brenda Islas-Trejo Ramiro Perez-miranda Conservation and Enhancement of Forest Ecosystems National Institute of ForestryAgriculture and Livestock ResearchProgreso 504010 Coyoacan Mexico CityMexico Geography Department The National Autonomous University of MexicoUniversidad 300004010 Coyoacan Mexico CityMexico

Accurate and reliable predictions of pest species distributions in forest ecosystems are urgently needed by forest managers to develop management plans and monitor new areas of potential ***-only species distribution models are commonly used in these *** maximum entropy algorithm(MaxEnt)has gained popularity for modelling species ***,MaxEnt was used to model the spatial distribution of the Mexican pine bark beetle(Dendroctonus mexicanus)in a daily fashion by using forecast data from the Weather Research and Forecasting *** study aimed to exploit freely available geographic and environmental data and software and thus provide a pathway to overcome the lack of costly data and technical guidance that are a challenge to implementing national monitoring and management strategies in developing *** results showed overall agreement values between 60 and 87%.The results of this research can be used for *** monitoring and management and may aid as a model to monitor similar species.

关键词： Spatial analysis Dendroctonus mexicanus Geodatabases MaxEnt Forest modelling

High-resolution multi-scale air pollution system:Evaluation of modelling performance and emission control strategies

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Journal of Environmental Sciences 2024年第3期137卷 65-81页

作者： Diogo Lopes Joana Ferreira Sandra Rafael Ka In Hoi Xin Li Yuan Liu Ka-Veng Yuen Kai Meng Mok Ana Isabel miranda Department of Environment and Planning&CESAM University of AveiroAveiroPortugal Department of Civil&Environmental Engineering Faculty of Science and TechnologyUniversity of MacaoMacao SARChina

A high percentage of the world's population lives in areas where air pollutant concentrations exceed the World Health Organization *** work aims to develop and test,a high-resolution multi-scale air pollution modelling system by integrating a set of adequate *** system is able to provide detailed air pollutant concentrations in urban areas and support air quality management strategies through a better identification of different atmospheric *** also allows furthering the design and assessment of air pollution control measures for a specific *** evaluate its performance and suitability,the system was applied to the Macao Special Administrative Region(SAR),China,one of the most densely populated areas on earth,during a winter period when this area is affected by high levels of Particulate Matter(PM).Although the developed system tends to underestimate the PM concentrations,it revealed a good performance in reproducing the temporal and spatial air pollution *** exceedances of the Chinese air quality standards were calculated and high population exposure to PM pollution was *** tested urban atmospheric emission reduction scenarios have shown air quality improvements,indicating that emission reduction measures at urban level should focus on the domestic ***,it is crucial to implement joint pollution prevention strategies with neighbouring regions to improve the air quality in Macao *** approach developed in this work can support policymakers in defining new strategies to reduce atmospheric pollution in urban areas.

关键词： Urban areas High-resolution emission inventory Particulate matter Population exposure

glbase:a framework for combining,analyzing and displaying heterogeneous genomic and high-throughput sequencing data

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Cell Regeneration 2014年第1期3卷 1-20页

作者： Andrew Paul Hutchins Ralf Jauch Mateusz Dyla Diego miranda-Saavedra Key Laboratory of Regenerative Biology South China Institute for Stem Cell Biology and Regenerative MedicineGuangzhou Institutes of Biomedicine and HealthChinese Academy of SciencesGuangzhou 510530China Genome Regulation Laboratory South China Institute for Stem Cell Biology and Regenerative MedicineGuangzhou Institutes of Biomedicine and HealthChinese Academy of SciencesGuangzhou 510530China Laboratory for Structural Biochemistry Genome Institute of Singapore60 Biopolis StreetSingapore 138672Singapore Department of Molecular Biology and Genetics Aarhus UniversityAarhusDenmark Fibrosis Laboratories Institute of Cellular MedicineNewcastle University Medical SchoolFramlington PlaceNewcastle upon Tyne NE24HHUK

Genomic datasets and the tools to analyze them have proliferated at an astonishing ***,such tools are often poorly integrated with each other:each program typically produces its own custom output in a variety of non-standard file *** we present glbase,a framework that uses a flexible set of descriptors that can quickly parse non-binary data *** includes many functions to intersect two lists of data,including operations on genomic interval data and support for the efficient random access to huge genomic data *** glbase functions can produce graphical outputs,including scatter plots,heatmaps,boxplots and other common analytical displays of high-throughput data such as RNA-seq,ChIP-seq and microarray expression *** is designed to rapidly bring biological data into a Python-based analytical environment to facilitate analysis and data *** summary,glbase is a flexible and multifunctional toolkit that allows the combination and analysis of high-throughput data(especially next-generation sequencing and genome-wide data),and which has been instrumental in the analysis of complex data *** is freely available at http://***/oaxiom/glbase/.

关键词： ChIP-seq RNA-seq Genomics Microarray Motifs Transcription factor Bioinformatics

Nanoparticles with high payloads of pipemidic acid, a poorly soluble crystalline drug: drug-initiated polymerization and self-assembly approach

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Acta Pharmaceutica Sinica B 2018年第3期8卷 420-431页

作者： Elisabetta Pancani Mario Menendez-miranda Alexandra Pastor Francois Brisset Marie-Francoise Bernet-Camard Didier Desmaele Ruxandra Gref Institut de Sciences Moléculaires d'Orsay(ISMO) Univ.of Paris-SudUniversitéParis-Saclay Institut Galien UMR8612 Univ.of Paris-SudUniversitéParis-Saclay Institut de Chimie Moléculaire et des Matériaux d'Orsay(ICMMO) Univ.of Paris-SudUniversitéParis-Saclay EA4043" UnitéBactéries Pathogènes et Santé"(UBaPS) Univ.of Paris-SudUniversitéParis-Saclay

Nowadays, biodegradable polymers such as poly(lactic acid)(PLA), poly(D,L-lactic-coglycolic acid)(PLGA) and poly(ε-caprolactone)(PCL) remain the most common biomaterials to produce drug-loaded nanoparticles(NPs). Pipemidic acid(PIP) is a poorly soluble antibiotic with a strong tendency to crystallize. PIP incorporation in PLA/PLGA NPs was challenging because of PIP crystals formation and burst release. As PIP had a poor affinity for the NPs, an alternative approach to encapsulation was used, consisting in coupling PIP to PCL. Thus, a PCL–PIP conjugate was successfully synthesized by an original drug-initiated polymerization in a single step without the need of ***–PIP was characterized by NMR, IR, SEC and mass spectrometry. PCL–PIP was used to prepare selfassembled NPs with PIP contents as high as 27%(w/w). The NPs were characterized by microscopy,DLS, NTA and TRPS. This study paves the way towards the production of NPs with high antibiotic payloads by drug-initiated polymerization. Further studies will deal with the synthesis of novel polymer–PIP conjugates with ester bonds between the drug and PCL. PIP can be considered as a model drug and the strategy developed here could be extended to other challenging antibiotics or anticancer drugs and employed to efficiently incorporate them in NPs.

关键词： Pipemidic acid Nanoparticle Antibiotic Nanoprecipitation Crystalline drug Drug-initiated polymerization

Diagnostic criteria for autoimmune hepatitis in children: A challenge for pediatric hepatologists

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World Journal of Gastroenterology 2012年第33期18卷 4470-4473页

作者： Priscila Menezes Ferri Alexandre Rodrigues Ferreira Débora Marques miranda Ana Cristina Sim■es e Silva Division of Pediatric Gastroenterology and Hepatology Department of Pediatrics School Medicine Federal University of Minas Gerais Minas Gerais 30130-100 Brazil National Institute of Science and Technology of Molecular Medicine Faculty of Medicine Federal University of Minas Gerais Minas Gerais 30130-100 Brazil

Autoimmune hepatitis (AIH) is a progressive inflammatory liver disorder that is rare in children and adolescents. AIH has a broad clinical spectrum and a quick response to treatment with corticosteroids and immunosuppressive medication. The available diagnosis criteria have limitations and should be evaluated in pediatric populations. Recently, some studies reported that the 2008 simplified diagnostic criteria for AIH could be used in children with high sensibility and specificity. In addition, the authors reported that globulin and immunoglobulin G levels can be used interchangeably for diagnostic purposes. They also demonstrated that the 2008 simplified criteria fail in identifying patients with fulminant hepatic failure. Here, we discuss the limitations of the use of these criteria in pediatric patients and the requirement of more studies to improve the diagnosis of AIH in children.

关键词： Child Autoimmune hepatitis Liver diseases Diagnosis Autoimmunity

Adaptive immunity in the liver

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Cellular & Molecular Immunology 2016年第3期13卷 354-368页

作者： Zongwen Shuai miranda WY Leung Xiaosong He Weici Zhang Guoxiang Yang Patrick SC Leung M Eric Gershwin Division of Rheumatology Allergy and Clinical Immunology University of California Davis School of Medicine Davis CA 95616 USA Department of Rheumatology and Immunology The First Affiliated Hospital of Anhui Medical University Hefei 230022 China.

The anatomical architecture of the human liver and the diversity of its immune components endow the liver with its physiological function of immune competence. Adaptive immunity is a major arm of the immune system that is organized in a highly specialized and systematic manner, thus providing long-lasting protection with immunological memory. Adaptive immunity consists of humoral immunity and cellular immunity. Cellular immunity is known to have a crucial role in controlling infection, cancer and autoimmune disorders in the liver. In this article, we will focus on hepatic virus infections, hepatocellular carcinoma and autoimmune disorders as examples to illustrate the current understanding of the contribution of T cells to cellular immunity in these maladies. Cellular immune suppression is primarily responsible for chronic viral infections and cancer. However, an uncontrolled auto-reactive immune response accounts for autoimmunity. Consequently, these immune abnormalities are ascribed to the quantitative and functional changes in adaptive immune cells and their subsets, innate immunocytes, chemokines, cytokines and various surface receptors on immune cells. A greater understanding of the complex orchestration of the hepatic adaptive immune regulators during homeostasis and immune competence are much needed to identify relevant targets for clinical intervention to treat immunological disorders in the liver.

关键词： adaptive immunity T cells immunopathogenesis antiviral immunity

Silymarin Attenuates Hepatic and Pancreatic Redox Imbalance Independent of Glycemic Regulation in the Alloxan-induced Diabetic Rat Model

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Biomedical and Environmental Sciences 2020年第9期33卷 690-700页

作者： miranda Laise Mara Oliveira Agostini Livia da Cunha Lima Wanderson Geraldo de Camini Fernanda Caetano Costa Daniela Caldeira Programa de Pos-graduagao em Saude e Nutricao Escola de NutricaoUniversidade Federal de Ouro PretoOuro PretoMinas Gerais 35400-000Brazil Escola de Farmacia Universidade Federal de Ouro Preto.Ouro PretoMinas Gerais 35400-000Brazil Laboratorio de Morfopatologia Departamento de Ciencias BioldgicasUniversidade Federal de Ouro PretoOuro Preto 35400-000Brazil Programa de Pos-graduaqao em Ciencias Bioldgicas Nucleo de Pesquisas em Ciencias BiologicasUniversidade Federal de Ouro Preto.Ouro Preto 35400-000Brazil Laboratorio de Bioquimica Metabolica Departamento de Ciencias BiologicasUniversidade Federal de Ouro PretoOuro Preto 35400-000Brazil

Objective To evaluate the efficiency of silymarin(SMN) in modulating metabolic parameters and redox status in rats with type 1 diabetes mellitus(T1 DM).Methods Diabetes was induced by intraperitoneal injection of alloxan. The diabetic rats were administered with SMN at doses of 50 and 100 mg/kg body weight/d for 30 consecutive days. The rats were divided into the following four groups: vehicle control, diabetic(alloxan-treated), DS50(alloxan +50 mg/kg body weight/d of SMN), and DS100(alloxan + 100 mg/kg body weight/d of SMN) groups. The bodyweight and food and water intake were evaluated. After 30 d, the animals were euthanized and the blood was collected for measuring the serum levels of glucose, triacylglycerol(TAG), urea, and creatinine. The liver and pancreas were collected for measuring the activities of superoxide dismutase(SOD) and catalase(CAT), and the levels of carbonylated protein(PC). The pancreas sample was also used for histological *** SMN reduced hepatic(P < 0.001) and pancreatic(P < 0.001) protein damage and creatinine levels(P = 0.0141) in addition to decreasing food(P < 0.001) and water intake(P < 0.001). However,treatment with SMN did not improve beta-cell function or decrease blood glucose levels in diabetic *** SMN improved polyphagia and polydipsia, renal function, and protected the liver and pancreas against protein damage without affecting hyperglycemia in diabetic animals.

关键词： Silymarin Silybum marianum Type 1 diabetes Oxidative stress