Background
High-frequency repetitive transcranial magnetic stimulation of the left dorsolateral prefrontal cortex (rTMS-DLPFC) is an effective treatment for depression. Preliminary studies indicated ...beneficial effects of rTMS-DLPFC on pain relief in patients treated for depression, and in patients with chronic migraine.
Methods
In this randomized, double-blind, parallel-group, single-center, proof-of-principle clinical trial, we tested the hypothesis that 23 sessions of active rTMS-DLPFC delivered over eight weeks would be feasible, safe and superior to sham rTMS to decrease the number of headache days in 18 patients with chronic migraine without severe depression. Per-protocol analysis was performed.
Results
rTMS-DLPFC applied over eight weeks was feasible and safe in patients with chronic migraine. Contrary to our primary hypothesis, the number of headache days decreased significantly more in the sham group than in the group treated with active rTMS-DLPFC at eight weeks. Average decrease in headache days was >50% in the sham group, indicating a powerful placebo response. Pain intensity improved in both groups to a similar extent.
Conclusions
Positive results of M1 stimulation in other studies, and the absence of significant benefits of active high-frequency rTMS of the DLPFC in the present study, point to M1 as a more promising target than the DLPFC, for larger trials of noninvasive brain stimulation in patients with chronic migraine.
Individuals infected with
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may present different asymptomatic and symptomatic stages of infection, which vary in the clinical-immunological profiles that can be classified as asymptomatic ...infection (AI), subclinical resistant infection (SRI), indeterminate initial infection (III), subclinical oligosymptomatic infection (SOI), and symptomatic infection (SI) (=American visceral leishmaniasis, AVL). However, little is known about the molecular differences between individuals having each profile. Here, we performed whole-blood transcriptomic analyses of 56 infected individuals from Pará State (Brazilian Amazon), covering all five profiles. We then identified the gene signatures of each profile by comparing their transcriptome with those of 11 healthy individuals from the same area. Symptomatic individuals with SI (=AVL) and SOI profiles showed higher transcriptome perturbation when compared to those asymptomatic III, AI and SRI profiles, suggesting that disease severity may be associated with greater transcriptomic changes. Although the expression of many genes was altered on each profile, very few genes were shared among the profiles. This indicated that each profile has a unique gene signature. The innate immune system pathway was strongly activated only in asymptomatic AI and SRI profiles, suggesting the control of infection. In turn, pathways such as MHC Class II antigen presentation and NF-kB activation in B cells seemed to be specifically induced in symptomatic SI (=AVL) and SOI profiles. Moreover, cellular response to starvation was down-regulated in those symptomatic profiles. Overall, this study revealed five distinct transcriptional patterns associated to the clinical-immunological (symptomatic and asymptomatic) profiles of human
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-infection in the Brazilian Amazon.
The daily optimization of oil production systems relies on models to simulate phenomena of interest, such as fluid flow in wells and risers. Keeping models up to date is no easy task, due to the ...complex nature of the processes, and the need of human intervention to tune simulators. This work contributes by taking advantage of real-time measurements, to adjust process parameters that play a key role in steady-state simulators, e.g. the basic sediment and water and gas-oil ratio, and thereby optimize production for the prevailing conditions. The methodology consists of: (i) a strategy to identify steady-state of process variables (i.e., flows and pressures); (ii) an optimization formulation to adjust the key parameters such that the predicted total flows from the wells match the measured platform streams, while honoring pressure and flow measurements at critical points.
Climate change induced by global warming will produce more frequent heatwaves and intensify urban heat islands, thereby increasing heating related risks. Given this scenario, it is important to ...mitigate heat on urban ecosystems to promote their resilience. This study aims to develop a method to identify heat vulnerable urban areas by considering the land surface temperature (LST) distribution and landscape patterns. Methods included the creation of a cellular space to represent a given urban environment and integrate multidisciplinary databases; the use of Landsat-8 satellite images to estimate fraction vegetation cover, normalized difference moisture indices emissivity, and albedo; and exploratory spatial analyses using Moran's global and local indices to identify landscape patterns associated with Local Climate Zones (LCZ). Analyses revealed that the estimated variables are suitable for explaining LST, which is autocorrelated in space, despite seasonal variations. The methods made it possible to identify heat vulnerable areas, which should be considered when developing adaptation policies, and that heating is associated with areas composed of both compact low rise (LCZ3) and large low rise buildings (LCZ8), whereas cooling is associated with dense trees (LCZA), and when vegetation is associated with both open high rise (LCZ4) and open low rise buildings (LCZ6).
•Land surface temperature mapping allows us to identify landscape patterns.•Spatial analyses are useful to evaluate the urban surface's thermal performance.•Autocorrelation spatial indices can be used to identify vulnerable heat areas.•Local indicators of spatial associations can indicate areas for adaptation policies.
Resumo O artigo reflete resultados de duas pesquisas de iniciação científica que tiveram o escopo basilar da teoria psicossocial proposta pelo professor Ciampa, que concebe a identidade enquanto ...metamorfose humana em busca de emancipação. Esse enfoque teórico metodológico possibilitou um entendimento conceitual crítico sobre aspectos relevantes da política nacional de assistência social e a inserção da psicologia nessa produção. Para o intento foi pesquisada a construção identitária de psicólogos e cidadãos usuários dos Centros de Referência de Assistência Social (CRAS), utilizando-se métodos qualitativos com ênfase nas entrevistas de história de vida. Dentre os fragmentos analisados destaca-se a percepção do psicólogo sobre sua identidade profissional (angústias e dificuldades sistêmicas que entravam suas práticas emancipatórias); em relação aos cidadãos usuários, percebe-se a falta de compreensão sobre o ideário da política, o não reconhecimento da psicologia enquanto prática comunitária e o conformismo e a resignação diante das precariedades vividas.
Abstract The article reflects results of two pieces of scientific initiation research that had the basic scope of the psychosocial theory proposed by professor Ciampa, which conceives identity while human metamorphosis in search for emancipation. This theoretical methodological approach enabled a critical conceptual understanding of relevant aspects of the national policy on social assistance and the insertion of psychology in this production. For this purpose, the identity construction of psychologists and user citizens of the Social Assistance Reference Centers (CRAS) was researched with the use of qualitative methods with emphasis on life story interviews. Among the analyzed fragments, the perception of the psychologist of his/her professional identity (the anguish and systemic problems that hinder his/her emancipatory practices) stands out; as for the user citizens, the observed fragments are lack of comprehension of the policy ideas, the non-recognition of psychology as a community practice, and the conformity and resignation towards the experienced precariousness.
Resumen Este artículo analiza los resultados de dos investigaciones que se apoyaron en la teoría psicosocial propuesta por Ciampa, que concibe la identidad como metamorfosis humana en la búsqueda de emancipación. Este enfoque permitió una comprensión conceptual crítica sobre aspectos relevantes de la Política Nacional de Asistencia Social y la inserción de la Psicología en esta producción. Se investigó la construcción de la identidad de psicólogos y de ciudadanos usuarios de los Centros de Referencia y Asistencia Social (CRAS), utilizando métodos cualitativos, con énfasis en las entrevistas de Historia de Vida. Entre los fragmentos analizados, se destaca la percepción del psicólogo acerca de su identidad profesional (la angustia y las dificultades sistémicas que obstaculizan sus prácticas emancipatorias). Con relación a los ciudadanos usuarios, se perciben la falta de comprensión sobre el ideario de la política, el no reconocimiento de la Psicología como práctica comunitaria y la conformidad y resignación ante las precariedades que han experimentado.
•Intact skin, blood, bone marrow and internal organs proved efficient for diagnosing CL by PCR and its variant.•Leishmania braziliensis can spread to other sites: such as peripheral blood and ...internal organs.•Dogs can play an important role as reservoir in CL.•Asymptomatic dogs should be surveyed in areas where CL human cases have been reported.
Environmental changes have occurred over the years, altering the eco-epidemiological pattern of leishmaniosis in the State of Paraná, Brazil, involving the pillars of the cycle (parasite, vectors, reservoir, and environment) and their interaction. Much has been discussed about the dog’s role as a reservoir of the Leishmania (Viannia) braziliensis Vianna, 1911 transmission cycle. However, this question remains unanswered. The purpose of this study was to investigate, using parasitological and molecular methods, different samples in eight naturally infected dogs from an endemic rural locality where only L. (V.) braziliensis is present, and where human cases have been previously notified. Blood and biopsied organ samples from naturally infected dogs were analyzed by culture media, PCR, random amplified polymorphic DNA and sequencing methodologies. Only skin lesions from all dogs yielded positive cultures and when PCR was performed, L. (V.) braziliensis DNA was amplified from intact skin, peripheral blood, bone marrow, spleen, liver and lymph nodes. RAPD was also applied to isolates from the skin lesions, exhibiting the genetic variability of the parasite identified. To confirm which species of Leishmania was amplified in PCR, the sequencing method was performed, verifying 100% similarity with the Viannia subgenus. This study showed that L. (V.) braziliensis can spread to other sites besides the ulcerous lesions, such as intact skin, peripheral blood and internal organs, making it possibility for dogs to serve as active sources of parasite transmission. For definitive proof, xenodiagnostic test on intact skin of infected dogs, should be done.
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•Direct/indirect sample methods combined gave best occupancy/detection estimates.•Detection probability was high and positively related with macrophyte coverage.•Final occupancy ...estimate can be baseline to Purus River long-term monitoring studies.•Hierarchical model potential to know aquatic mammals distribution.•Our data support the selection of priority areas for the species’ conservation.
Understanding the distribution and abundance of threatened species is crucial to elaborate effective management plans for wild populations; however, elusive species prove difficult to detect. To support conservation strategies for the Vulnerable Amazonian manatee (Trichechus inunguis), the only freshwater sirenian, we analyzed presence/absence data with hierarchical models based on imperfect detection to assess T. inunguis occupancy in a Sustainable Development Reserve, Brazilian Central Amazon. In parallel, we compared the effectiveness of direct and indirect sampling methods to provide occupancy (ψ) and detection (p) estimates. Combining both sampling methods’ presence datasets provided higher accuracy estimates. The Amazonian manatee’s detection probability had never been estimated before: surprisingly, it was high (p = 0.50, SD = 0.05) and positively related with macrophyte coverage. Results suggest that the studied communities resident impact is not affecting the manatee occupancy, with greatest probabilities closer to human settlements. The final occupancy estimate obtained (ψ = 0.85, SD = 0.12) can be a baseline to Amazonian manatee long-term monitoring studies, and provide support for decision makers and local communities to establish effective protection zones for the species. Our approach highlights the potential of hierarchical models to understand the distribution not only of T. inunguis in different habitats, but also of other threatened Amazonian aquatic mammals.
Melatonin has been studied in headache disorders. Amitriptyline is efficacious for migraine prevention, but its unfavourable side effect profile limits its use.
A randomised, double-blind, ...placebo-controlled study was carried out. Men and women, aged 18-65 years, with migraine with or without aura, experiencing 2-8 attacks per month, were enrolled. After a 4-week baseline phase, 196 participants were randomised to placebo, amitriptyline 25 mg or melatonin 3 mg, and 178 took a study medication and were followed for 3 months (12 weeks). The primary outcome was the number of migraine headache days per month at baseline versus last month. Secondary end points were responder rate, migraine intensity, duration and analgesic use. Tolerability was also compared between groups.
Mean headache frequency reduction was 2.7 migraine headache days in the melatonin group, 2.2 for amitriptyline and 1.1 for placebo. Melatonin significantly reduced headache frequency compared with placebo (p=0.009), but not to amitriptyline (p=0.19). Melatonin was superior to amitriptyline in the percentage of patients with a greater than 50% reduction in migraine frequency. Melatonin was better tolerated than amitriptyline. Weight loss was found in the melatonin group, a slight weight gain in placebo and significantly for amitriptyline users.
Melatonin 3 mg is better than placebo for migraine prevention, more tolerable than amitriptyline and as effective as amitriptyline 25 mg.
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