Although Brazil is considered a megadiverse country, its rich freshwater biodiversity is still poorly known. A general overview of to-date knowledge on Protozoa, Rotifera, Cladocera, and Copepoda ...species and distribution in Brazilian Hydrographic Regions is presented here, based on literature data since the 1890s. Ecological studies provided most of the occurrence records. The results show high richness for all studied biological groups and unequal distribution of the occurrence records, which are substantially influenced by research groups’ location. The data also revealed that Brazilian zooplankton biodiversity still needs to be better studied, taxonomically, although from the beginning of the last century until 1980 these kinds of studies were predominant.
Full text
Available for:
GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
The integrity of aquatic ecosystems is being challenged worldwide by invading species, which has been one of the frequent causes of biodiversity loss. The invader may cause extinctions of vulnerable ...native species through predation, grazing, competition and habitat alteration. Daphnia lumholtzi G. O. Sars, 1885, a native cladoceran from Australia, Southwestern Asia and North Africa, has recently been found in the Neotropical region. The D. lumholtzi records from the Upper Paraná River floodplain were restricted to the Pombas floodplain lake (22 degrees 47' 55.92" S and 53 degrees 21' 32.58" W) and Pau Véio Backwater (22 degrees 44' 50.76' S and 53 degrees 15' 11.16' W), in 2003 and 2008, respectively. This species can be distinguished from the other Daphnia species registered in Brazil by the conspicuous pointed fornix, the sizes of the tail spine and helmet, and a carapace ventral margin with strong spines. The high temperatures in the tropical region, as well as the increase in water transparency and the decrease in nutrient concentration observed in the environments of the Upper Paraná River floodplain due to the upstream retention by dams, may favor the development of D. lumholtzi populations. The development of populations of D. lumholtzi in natural environments of the Upper Paraná River floodplain may suggest that this species is establishing in the Neotropical region.
A growing body of evidence suggests that non-viral hepatocellular carcinoma (HCC) might benefit less from immunotherapy.
We carried out a retrospective analysis of prospectively collected data from ...consecutive patients with non-viral advanced HCC, treated with atezolizumab plus bevacizumab, lenvatinib, or sorafenib, in 36 centers in 4 countries (Italy, Japan, Republic of Korea, and UK). The primary endpoint was overall survival (OS) with atezolizumab plus bevacizumab versus lenvatinib. Secondary endpoints were progression-free survival (PFS) with atezolizumab plus bevacizumab versus lenvatinib, and OS and PFS with atezolizumab plus bevacizumab versus sorafenib. For the primary and secondary endpoints, we carried out the analysis on the whole population first, and then we divided the cohort into two groups: non-alcoholic fatty liver disease (NAFLD)/non-alcoholic steatohepatitis (NASH) population and non-NAFLD/NASH population.
One hundred and ninety patients received atezolizumab plus bevacizumab, 569 patients received lenvatinib, and 210 patients received sorafenib. In the whole population, multivariate analysis showed that treatment with lenvatinib was associated with a longer OS hazard ratio (HR) 0.65; 95% confidence interval (CI) 0.44-0.95; P = 0.0268 and PFS (HR 0.67; 95% CI 0.51-0.86; P = 0.002) compared to atezolizumab plus bevacizumab. In the NAFLD/NASH population, multivariate analysis confirmed that lenvatinib treatment was associated with a longer OS (HR 0.46; 95% CI 0.26-0.84; P = 0.0110) and PFS (HR 0.55; 95% CI 0.38-0.82; P = 0.031) compared to atezolizumab plus bevacizumab. In the subgroup of non-NAFLD/NASH patients, no difference in OS or PFS was observed between patients treated with lenvatinib and those treated with atezolizumab plus bevacizumab. All these results were confirmed following propensity score matching analysis. By comparing patients receiving atezolizumab plus bevacizumab versus sorafenib, no statistically significant difference in survival was observed.
The present analysis conducted on a large number of advanced non-viral HCC patients showed for the first time that treatment with lenvatinib is associated with a significant survival benefit compared to atezolizumab plus bevacizumab, in particular in patients with NAFLD/NASH-related HCC.
•Recent evidences suggest that non-viral HCCs could be less responsive to immunotherapy.•Lenvatinib performs better compared to atezolizumab plus bevacizumab in non-viral HCC.•Sorafenib performs similarly to atezolizumab plus bevacizumab in non-viral HCC.
Full text
Available for:
GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
Summary
Hepatitis B surface antigen (HBsAg) reduction during nucleoside/nucleotide analogue (NA) therapy is slow and an alternative strategy for patients receiving ongoing NA to facilitate HBsAg ...reduction is required. We investigated whether switching to pegylated interferon (PEG‐IFN) after long‐term NA administration enhances HBsAg reduction. Forty‐nine patients who switched from long‐term NA to 48 weeks of PEG‐IFN alfa‐2a were studied. The mean duration of previous NA was 48 months (sequential group). A total of 147 patients who continued NA and matched for baseline characteristics were analysed for comparison (NA continuation group). The treatment response was defined as HBsAg reduction ≥1.0 logIU/mL at the end of PEG‐IFN. HBsAg reduction at week 48 was 0.81±1.1 logIU/mL in the sequential group, which was significantly higher than that in the NA continuation group (0.11±0.3 logIU/mL, P < .001). The treatment response was achieved in 29% and 2% of the sequential group and NA continuation group (P < .001), and the odds ratio of sequential therapy for the treatment response was 19 compared with the NA continuation (P < .001). In patients tested positive for hepatitis B e antigen (HBeAg), HBeAg seroconversion was higher in the sequential group (44% vs 8%, P < .001). In HBeAg‐negative patients, only patients in the sequential group achieved HBsAg loss. No patient needed to resume NA administration because of HBV DNA increase accompanied by alanine aminotransferase flares. In summary, sequential therapy with PEG‐IFN after long‐term NA enhances the reduction of HBsAg and may represent a treatment option to promote HBsAg loss.
Full text
Available for:
BFBNIB, DOBA, FZAB, GIS, IJS, IZUM, KILJ, NLZOH, NUK, OILJ, PILJ, PNG, SAZU, SBCE, SBMB, SIK, UILJ, UKNU, UL, UM, UPUK
In Japan, intravitreal anti-vascular endothelial growth factor (anti-VEGF) dosing regimens for wet age-related macular degeneration (wAMD) include pro re nata, every 2 months, and treat-and-extend, ...resulting in different outcomes and patient burden. Although reflecting patient preferences in treatment decision-making is desirable, few studies have examined this in Japan. This study assessed the patients willingness to trade-off between different dosing regimens.
Patients with wAMD were recruited from four Japanese university hospitals to complete a face-to-face cross-sectional survey. In a discrete choice experiment, patients were asked to choose their preferred option from two anti-VEGF treatment profiles shown side-by-side across a series of choice tasks. The profiles varied on four attributes: number of injections in 12 months, number of physician consultations in 12 months, chance of 1-year visual acuity (VA) improvement, and chance of 2-year VA maintenance. Preference weights were estimated using hierarchical Bayes' models.
Overall, 120 patients (30 treatment naïve and 90 anti-VEGF experienced) completed the survey. Patients were willing to accept an increase from three to approximately eight injections in 12 months to increase the chance of 1-year VA improvement from 25% to 40%. They would be willing to accept 11 injections in 12 months if the chance of 2-year VA maintenance increased from 80% to 96%. The most valued attributes were increasing the chance of 2-year VA maintenance and reducing the number of injections in 12 months, which were each about twice as important as decreasing physician consultations in 12 months and increasing the chance of 1-year VA improvement (
<0.001). Among the dosing regimens, patients most preferred treat-and-extend because of its higher chance of 2-year VA maintenance.
Informing patients with wAMD about the likelihood of long-term VA maintenance when selecting treatment may increase the acceptance of an optimal treatment regimen and number of injections.
Full text
Available for:
IZUM, KILJ, NUK, PILJ, PNG, SAZU, UL, UM, UPUK
A review of the hospital charts for 788 patients treated in 19 public and private clinics in Cameroon showed that clinical follow-up visits, biologic follow-up visits, and drug supply were irregular ...and that many patients interrupted treatment. Virological and immunologic effectiveness of therapy was as expected in patients for whom results were available.
Full text
Available for:
BFBNIB, NUK, PNG, UL, UM, UPUK
Working as a first-line nurse manager requires high managerial competence as an essential component in the delivery of health care. Therefore, factors that influence managerial competence warrant ...examination. The aim of this study was to identify factors associated with managerial competence of the first-line nurse managers using the best-fit model of human resource management framework.
A cross-sectional study was conducted. A total of 247 first-line nurse managers from 18 public hospitals in Indonesia participated. Data on managerial competence and its related factors were collected via validated questionnaires.
The five factors of managerial competence were identified - performance appraisal (
= 0.476,
< 0.001), career advancement (
= 0.425,
< 0.001), recruitment and selection (
= 0.354,
< 0.001), larger hospitals (
= 0.165,
= 0.001), and management training attendance (
= 0.109,
= 0.029), which collectively explained 44.9% of the variance in managerial competence.
Human resource management factors, hospital types, and training attendance have significant roles to improve managerial competence of the first-line nurse managers. Nurse managers should provide routine performance appraisal, career advancement, and transparent recruitment and selection as well as to improve the attendance of management training and learn from larger hospitals for leadership and development of the first-line nurse managers.
We present a detailed study of waves with frequencies near the proton gyrofrequency in the high-altitude cusp for northward IMF as observed by the Cluster spacecraft. Waves in this regime can be ...important for energization of ions and electrons and for energy transfer between different plasma populations. These waves are present in the entire cusp with the highest amplitudes being associated with localized regions of downward precipitating ions, most probably originating from the reconnection site at the magnetopause. The Poynting flux carried by these waves is downward/upward at frequencies below/above the proton gyrofrequency, which is consistent with the waves being generated near the local proton gyrofrequency in an extended region along the flux tube. We suggest that the waves can be generated by the precipitating ions that show shell-like distributions. There is no clear polarization of the perpendicular wave components with respect to the background magnetic field, while the waves are polarized in a parallel-perpendicular plane. The coherence length is of the order of one ion-gyroradius in the direction perpendicular to the ambient magnetic field and a few times larger or more in the parallel direction. The perpendicular phase velocity was found to be of the order of 100km/s, an order of magnitude lower than the local Alfvén speed. The perpendicular wavelength is of the order of a few proton gyroradius or less. Based on our multi-spacecraft observations we conclude that the waves cannot be ion-whistlers, while we suggest that the waves can belong to the kinetic Alfvén branch below the proton gyrofrequency fcp and be described as non-potential ion-cyclotron waves (electromagnetic ion-Bernstein waves) above. Linear wave growth calculations using kinetic code show considerable wave growth of non-potential ion cyclotron waves at wavelengths agreeing with observations. Inhomogeneities in the plasma on the order of the ion-gyroradius suggests that inhomogeneous (drift) or nonlinear effects or both of these should be taken into account.
Triblock polymers, poly(ethylene oxide-b-propylene oxide-b-ethylene oxide) (PEO-b-PPO-b-PEO), are used as molecular templates in poly(methyl silsesquioxane) (MSQ) matrixes to fabricate nanoporous ...organosilicates for low dielectric constant applications. The results show that aggregation of block copolymers in the MSQ matrix can be prevented with the fast solvent evaporation which accompanies spin casting. Solid-state NMR shows that the triblock copolymer microphase-separates from the MSQ during a curing step, resulting in polymer domain size in the range of 3−15 nm, depending upon the polymer composition and loading percentage. When the films are heated to 500 °C, extremely small pores (2−6 nm) are generated, which are studied by small angle neutron scattering and positronium annihilation lifetime spectroscopy. These materials attain ultralow dielectric constants (k ≈ 1.5) with good electrical and mechanical properties.
Full text
Available for:
IJS, KILJ, NUK, PNG, UL, UM
This study assessed the prevalence and determinants of electrocardiographic abnormalities in a group of type 2 diabetes patients recruited from two referral centres in Cameroon.
A total of 420 ...patients (49% men) receiving chronic diabetes care at the Douala General and Yaoundé Central hospitals were included. Electrocardiographic abnormalities were investigated, identified and related to potential determinants, with logistic regressions.
The mean age and median duration of diagnosis were 56.7 years and four years, respectively. The main electrocardiographic aberrations (prevalence %) were: T-wave abnormalities (20.9%), Cornell product left ventricular hypertrophy (16.4%), arrhythmia (16.2%), ischaemic heart disease (13.6%), conduction defects (11.9%), QTc prolongation (10.2%) and ectopic beats (4.8%). Blood pressure variables were consistently associated with all electrocardiographic abnormalities. Diabetes-specific factors were associated with some abnormalities only.
Electrocardiographic aberrations in this population were dominated by repolarisation, conduction defects and left ventricular hypertrophy, and were more related to blood pressure than diabetes-specific factors.
PDF
