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Objetivos: Analisar as solicitações, distribuição e descarte de Concentrado de Hemácia (CH) através do estoque estratégico do Hemocentro do HCFMB, para atender a demanda das Agências Transfusionais da região de abrangência. Material e métodos: Os dados foram obtidos nos registros do Laboratório de Componentes Lábeis do Hemocentro do HCFMB no período de 2021 a 2023. Foram analisadas as solicitações para estoque das Agências transfusionais identificadas como X, Y, Z, W, A, B, C e o índice de descarte de CH dos anos 2022 e 2023. Resultados: Somando os três anos, o Hemocentro distribuiu 14.102 bolsas de CH, sendo em 2021 enviados 4.830, em 2022 enviados 4.397 e em 2023 enviados 4.875. Em relação às Agências, somando a quantidade de CH solicitados e enviados, dos últimos três anos, 21,43% do que foi pedido não foi enviado, sendo 24,08% em 2021, 23,87% em 2022 e 16,36% em 2023. Entretanto, mesmo não sendo enviados em suas totalidades, em 2022 a média de bolsas enviadas que foram descartadas foi de 15% e em 2023 de 14,28%. Em 2022, a cidade X registrou uma média de 22,75% não enviadas e 6,81% de descartadas. Na cidade Y, as médias foram de 29,39% e 9,80%, respectivamente. Já a cidade Z apresentou uma média de 9,24% de não enviadas e 11,20% de descartadas. A cidade W teve uma média de 18,74% de não enviadas e 8,28% de descartadas, enquanto a cidade B registrou 29,38% de não enviadas e 36,32% de descartadas. A cidade A teve uma média de 26,27% de não enviadas e 21,30% de descartadas, e a cidade C apresentou 16,98% de não enviadas e 14,67% de descartadas. Já em 2023 a cidade X reduziu suas taxas para 13,25% de não enviadas e teve um aumento na porcentagem de descartadas, sendo 9,55%. A cidade Y também teve uma queda, com 20,3% de não enviadas e o mesmo padrão de aumento de descartadas, sendo 11,75%. A cidade Z obteve melhorias consideráveis, com apenas 5,41% de não enviadas e 9,97% de descartadas. Na cidade W, as taxas foram de 17,1% de não enviadas e 8,48% de descartadas. A cidade B, demonstrou uma queda na quantidade de não enviadas e descartadas, sendo respectivamente 20,29% e 31,81%. A cidade A apresentou 20,87% de não enviadas e 15,43% de descartadas. Por fim, a cidade C teve 11,11% de não enviadas e 13,01% de descartadas. Discussão: Nota-se que houve em vários pedidos a solicitação das cidades sem o uso do estoque estratégico, e verificamos a distribuição sem seguir o estoque pré-estabelecido. Essa análise justifica algumas situações de descarte que poderiam ser evitadas, se houvesse o emprego dos valores estabelecidos pelo cálculo de estoque estratégico. Conclusão: Identificamos fragilidades no manejo do estoque estratégico, problema enfrentado globalmente devido à natureza perecível do sangue e a sazonalidade das demandas. Sugerimos o uso habitual do estoque estratégico na distribuição mediante as solicitações de CH evitando o descarte de sangue. Além da implementação de um manejo eficiente na utilização de sangue, com a adoção dos protocolos de PBM (Patient Blood Management).

Objetivo: Avaliar os fatores pré-operatórios e intraoperatórios associados à utilização de concentrado de hemácias em cirurgias cardíacas eletivas realizadas no Hospital das Clínicas da Faculdade de Medicina de Botucatu. Material e métodos: Um estudo retrospectivo observacional com coleta de dados foi realizado, entre 2018 e 2021, o qual se obteve 741 indivíduos. Os dados alcançados foram avaliados por meio de análise descritiva, teste Qui-quadrado e Regressão Logística (stepwase), considerando o nível de significância de 5%. Resultados: Parâmetros pré-operatórios, como feminino biológico feminino (OR 9,074; IC95% 5,218; p < 0,0001), seguido do hematócrito baixo (OR 7,498; IC95% 4,362; p = 0,0034), presença de diabete mellitus (DM) (OR 1,779; IC95% 1,052; p = 0,0318) e intraoperatório, como tempo de circulação extracorpórea acima de 90 minutos (OR 1,68; IC95% 1,013; p = 0,0442) mostraram-se de riscos para o sangramento excessivo e/ou indispensabilidade do uso de concentrados de hemácias durante a cirurgia. Discussão: Sabe-se que as mulheres, em sua maioria, apresentam maior prevalência de anemia, principalmente associados a fatores como menstruação, gravidez e lactação. Sob a mesma perspectiva, a anemia pré-operatória possui associação a comorbidades, idade avançada e o sexo feminino, sendo todos eles destacados pela literatura como fatores de risco para resultados adversos após cirúrgicas cardíacas. Em relação ao tempo de circulação extracorpórea (CEC) acima de 90 minutos, sabe-se que a técnica de CEC, é potencialmente categorizada como uma das principais causas de sangramento em todo o período perioperatório, tendo em vista os distúrbios de coagulação e ativação de fibrinólise, fatores esses que são reforçados com a presença do enorme tempo de uso e, o último, considerado um dos principais fatores de sangramento em cirurgias cardíacas com uso de CEC. Somado a esses fatores, ressalta-se que um paciente que apresenta hematócrito abaixo de 40% e necessidade do uso de CEC, tem maior chance de usar sangue em cirurgias de revascularização do miocárdio, concernindo ao uso de hemocomponentes encontrado no presente trabalho. Embora a literatura apresente grandes estudos sobre DM, ainda não é possível comprovar a relação entre a presença dessa comorbidade e a necessidade transfusional na literatura, levantando-se três possíveis fatores envolvidos nessa relação para os resultados encontrados no presente estudo: complicações vasculares devido a resistência à insulina, a prevalente presença de anemia em pacientes com DM e, por conseguinte, necessidade transfusional, e o fato do sexo feminino estar mais associado a complicações vasculares na DM, todos achados correlacionados entre si e com os resultados do presente trabalho. Conclusão: Os fatores de risco pré-operatórios, como sexo biológico feminino, hematócrito diminuído e presença de diabetes mellitus, e intraoperatórios, como o uso de circulação extracorpórea acima de 90 minutos, demonstraram-se estar associados à utilização de concentrados de hemácias em cirurgias cardíacas eletivas realizadas entre 2018 e 2021.

Objetivos: Analisar os principais motivos de descartes de concentrado de hemácias do Hemocentro do HCFMB. Material e métodos: Foi realizado um levantamento dos relatórios do sistema informatizado SBS no laboratório de Componentes Lábeis do Hemocentro do HCFMB durante o período de 2021 a 2023. Os dados utilizados foram a quantidade de bolsas de concentrado de hemácias (CH) processadas e quantidade de bolsas de CH descartadas. Resultados: No período estudado, o Hemocentro do HCFMB, processou 25.683 bolsas de CH, destas 1800 (7%) foram descartadas, sendo 715 (2,78%) em 2021, 577 (2,24%) em 2022 e 508 (1,97%) em 2023. A sorologia positiva, apresentou uma média dentro do total dos motivos de descartes de 19,16% em 2021, aumentando para 28,94% em 2022 e diminuindo levemente para 25,98% em 2023. O descarte devido à sistema aberto teve uma média de 2,93% em 2021, 2,77% em 2022 e 1,77% em 2023. Lipemia foi responsável por 2,51% dos descartes em 2021, subindo para 2,94% em 2022 e caindo para 1,37% em 2023. O volume coletado inadequado (baixo) teve médias de 2,51% em 2021, 0,69% em 2022 e 0,78% em 2023. O vencimento dos CH registrou uma média de descarte de 22,51% em 2021, diminuindo para 15,77% em 2022 e 16,53% em 2023. Os casos de bolsas com PAI (Pesquisa de anticorpos irregulares) positiva tiveram uma média de 2,93% em 2021, aumentando significativamente para 12,13% em 2022 e diminuindo para 9,05% em 2023. As bolsas de teste e controle de qualidade interno apresentaram uma média de descarte de 26,01% em 2021, 21,14% em 2022 e 25% em 2023. Já o motivo de descarte por teste de Hemoglobina alterada (Itano) verificou-se 4,19% em 2021, 4,33% em 2022 e aumentou para 7,08% em 2023. Problemas técnicos foram responsáveis por 7,13% dos descartes em 2021, diminuindo em 2022 para 0,69% e de 3,36% em 2023. A recusa subjetiva teve médias de 8,81% em 2021, 9,70% em 2022 e 8,07% em 2023. Discussão: Os principais motivos de descarte de bolsas foram sorologia positiva, seguida por bolsa teste e controle de qualidade, vencimento, recusa subjetiva, PAI positiva, sistema aberto, volume coletado inadequado, itano e problemas técnicos. Estudos indicam que o vencimento é a principal causa não sorológica de descarte, mas no Hemocentro analisado, bolsas próximas ao vencimento são usadas em testes de controle de qualidade, aumentando o descarte por controle de qualidade e reduzindo o por vencimento. Já a elevação nos casos de PAI positiva associamos com a vacinação em massa da população local contra a COVID-19 decorrente de uma pesquisa de imunização realizada pelo Ministério da Saúde. Conclusão: Considerando a importância do gerenciamento eficiente do estoque de hemocomponentes, é essencial evitar tanto o descarte quanto a falta desse produto raro, que resulta de doações altruístas e não possui substituto sintético. Sugere-se a utilização do estoque estratégico para evitar descartes por vencimento, além da implementação de programas contínuos de capacitação para a equipe técnica. Esses programas visam aprimorar e otimizar a utilização do sangue, bem como reduzir as perdas decorrentes de problemas internos.

Knowing where, when, and how much rice is planted and harvested is crucial information for understanding the effects of policy, trade, and global and technological change on food security. We developed RiceAtlas, a spatial database on the seasonal distribution of the world's rice production. It consists of data on rice planting and harvesting dates by growing season and estimates of monthly production for all rice-producing countries. Sources used for planting and harvesting dates include global and regional databases, national publications, online reports, and expert knowledge. Monthly production data were estimated based on annual or seasonal production statistics, and planting and harvesting dates. RiceAtlas has 2,725 spatial units. Compared with available global crop calendars, RiceAtlas is nearly ten times more spatially detailed and has nearly seven times more spatial units, with at least two seasons of calendar data, making RiceAtlas the most comprehensive and detailed spatial database on rice calendar and production.

We evaluate temperature and humidity profiles retrieved from an INSAT-3DR sounder against radiosonde measurements for one year during 2017–2018. This evaluation is carried out in terms of slope, intercept, bias, Root Mean Square Error (RMSE), and correlation coefficient in temperature and relative humidity profiles. This comparison provided first-hand information about the performance of INSAT-3DR sounder retrievals. This validation exercise is unique in terms of comparing with the high resolution (1 Hz) radiosonde measurements performed in the afternoon time when there is maximum convection driven by solar radiation. 276 pairs of co-located temperatures have been compared. INSAT-3DR temperature retrievals are strongly linearly correlated to radiosonde measurements, with the slope as 1.001 and correlation coefficient of 0.99, while the mean temperature bias between INSAT-3DR and radiosonde is -0.23°C with RMSE of 1.9°C. Comparison of Relative humidity retrieved from INSAT-3DR to the radiosonde data results in RMSE of 9.8% with a slope of 0.99 with a correlation coefficient of 0.77. The collocation of data points for validation is done matching in space [Latitude, Longitude, Pressure level (height)] and time (±30 minutes). The effect of relaxing the space and time window on the validation statistics is also studied for the first time.

BackgroundDelirium in hospitalized patients is a syndrome of acute brain dysfunction. Diagnostic (International Classification of Diseases [ICD]) codes are often used in studies using electronic health records (EHRs), but they are inaccurate. ObjectiveWe sought to develop a more accurate method using natural language processing (NLP) to detect delirium episodes on the basis of unstructured clinical notes. MethodsWe collected 1.5 million notes from >10,000 patients from among 9 hospitals. Seven experts iteratively labeled 200,471 sentences. Using these, we trained three NLP classifiers: Support Vector Machine, Recurrent Neural Networks, and Transformer. Testing was performed using an external data set. We also evaluated associations with delirium billing (ICD) codes, medications, orders for restraints and sitters, direct assessments (Confusion Assessment Method [CAM] scores), and in-hospital mortality. F1 scores, confusion matrices, and areas under the receiver operating characteristic curve (AUCs) were used to compare NLP models. We used the φ coefficient to measure associations with other delirium indicators. ResultsThe transformer NLP performed best on the following parameters: micro F1=0.978, macro F1=0.918, positive AUC=0.984, and negative AUC=0.992. NLP detections exhibited higher correlations (φ) than ICD codes with deliriogenic medications (0.194 vs 0.073 for ICD codes), restraints and sitter orders (0.358 vs 0.177), mortality (0.216 vs 0.000), and CAM scores (0.256 vs –0.028). ConclusionsClinical notes are an attractive alternative to ICD codes for EHR delirium studies but require automated methods. Our NLP model detects delirium with high accuracy, similar to manual chart review. Our NLP approach can provide more accurate determination of delirium for large-scale EHR-based studies regarding delirium, quality improvement, and clinical trails.

CONTEXT AND AIM: AIDS is an acronym for acquired immunodeficiency syndrome caused by a retrovirus known as human immunodeficiency virus (HIV) which breaks down the body's immune system, leaving the patient vulnerable to a host of life-threatening opportunistic infections, neurological disorders, or unusual malignancies. According to estimates by the WHO and UNAIDS, 35 million people were living with HIV globally at the end of the year 2013. The first AIDS case in India was detected in the year 1986. Seldom studies have been conducted correlating CD4 cell counts and complete blood picture including platelet counts in HIV infected and AIDS patients in the Indian population. The present study was carried-out with the same intent to evaluate the CD4 cell counts and complete blood picture in the HIV infected and AIDS patients and correlate them with the sero-negative controls. MATERIALS AND METHODS: The present study was a cross-sectional, hospital-based study on patients that were divided into three groups: Group A consisting of 500 patients who were healthy controls without any systemic illness, Group B consisting of 500 patients who were diagnosed as HIV infected, and Group C consisting of 500 patients diagnosed as AIDS patients depending on their CD4 cell counts. Evaluation of complete blood picture was done using Sysmex XP 100, a fully automated analyzer, while CD4 cell counts were evaluated using Partec Cyflow Cell Counter. STATISTICAL ANALYSIS USED: The data was analyzed using SPSS version 15.0 (SPSS Inc., Chicago, IL, USA). Comparison of the said parameters was done using Analysis of Variance (ANOVA) and post-hoc Games-Howell test. P-value of

The richly forested Indian state of Uttarakhand experienced widespread forest fires in April to May 2016. The current study examines dispersion of carbon monoxide (CO) from the source regions of forest fire to distant places, using the Lagrangian particle dispersion model, FLEXPART. Atmospheric Infrared Sounder (AIRS) observations revealed that CO columnar concentrations had increased by almost 28 percentage during 24 April to 02 May 2016 with respect to the previous non-burning period of April 2016 at Uttarakhand. It is also seen that there is considerable enhancement of 45 percentage in average columnar concentration of CO during the burning period, compared to that in the previous 5 years as observed by AIRS. In the present study, concentrations of CO at different pressure levels and columnar CO over Uttarakhand during the forest fire event have been simulated using FLEXPART. The area averaged profile of model derived CO has been compared with the profile from AIRS onboard Aqua. Comparison between model derived columnar CO and satellite observations shows good agreement with coefficient of correlation (r) approximately 0.91 over the burnt areas. Further analysis using FLEXPART reveals that the transport of pollutants is towards north-eastern and eastern regions from the locations of forest fire events. Model derived vertical distribution of CO over Tibet, which is situated at the north-east of Uttarakhand, shows significant increase of CO concentration at higher altitudes around 3 km from the mean sea level during the fire event. FLEXPART results show that the emissions from the Uttarakhand fires were transported to Tibet during the study period.

Context AIDS is caused by a retrovirus known as HIV which breaks down the body’s immune system leaving the patient vulnerable to a host of life-threatening opportunistic infections, neurological disorders, or unusual malignancies. According to estimates by WHO and UNAIDS, 35 million people were living with HIV globally at the end of the year 2013. The first AIDS case in India was detected in the year 1986. Seldom studies have been conducted correlating these parameters in the Indian population. Aim The present study was carried out to evaluate the CD4 cell counts, complete blood picture, and lipid profile in HIV-infected patients and those with AIDS and correlate these parameters with those obtained in the sero-negative controls. Materials and methods This was a cross-sectional, hospital-based study. The included participants were divided into three groups: group A consisted of 500 patients who were without any systemic illness as healthy controls, group B consisted of 500 patients who were diagnosed as having HIV infection, and group C consisted of 500 patients diagnosed as having AIDS depending on their CD4 cell counts. Permission from the Ethical Committee of the Institution as well as Superintendent of Government Hospital was taken to conduct the study. Evaluation of CD4 cell counts in patients with HIV infection and AIDS was done using CyFlow counter, whereas complete blood picture, hemoglobin (Hb), packed cell volume, red blood cell and white blood cells (WBCs) and platelet counts, were analyzed using Sysmex XP 100, a compact, fully automated analyzer. Lipid profile was evaluated using an automated analyzer, Erba EM 360 powered by a diffraction grating photometer. Results The results were found to be statistically significant, with the P-value being less than 0.001, for the CD4 cell counts, Hb, WBCs, and platelet counts. The levels of total cholesterol and low-density lipoproteins (LDLs) were significantly decreased whereas triglycerides and very LDLs were significantly increased in patients with AIDS when compared with the control group and patients with HIV infection. Conclusion CD4 cell counts, Hb, WBCs and platelet counts as well as total cholesterol, LDLs, triglycerides and very LDLs were significantly altered in patients with HIV infection and those with AIDS when compared with the controls.

ABSTRACT The incidence of the psittacine beak and feather disease virus (BFDV) was investigated in Brazilian native parrots with normal feathering arriving at rescue and triage centers for wild animals (CETAS, IBAMA) in the state of Minas Gerais, Brazil. BFDV DNA was investigated by previously described PCR technique for the partial amplification of BFDV ORF-1 in DNA extracts from blood, cloacal swab or liver of psittacines. Some birds provided more than one sample. Nine species of psittacines were sampled between January 2009 and October 2010. Blood (n=46) or cloacal swab (n=128) samples were obtained from psittacines immediately upon arrival at the triage centers. Liver samples were collected from necropsied birds dead on arrival (n=167). All swab samples were negative, except for one Ara ararauna individual (n=3) which blood presented the BFDV DNA. On the other hand, 11 liver samples were positive for BFDV DNA, with a prevalence of 7.8% in Amazona aestiva (n=140). No BFDV DNA was detected in the liver of Amazona amazonica (n=11), A. vinacea (n=5), A. rhodochorytha (n=4), Anodorhynchus hyacinthinus (n=3), Ara ararauna, (n=3), Aratinga leucophtalma (n=2), Guarouba guarouba (n=1) and Pionus maximiliani (n=1). In most cases, alopecia was not associated with BFDV detection in liver, and liver histopathology was inconclusive. Although all cloacal swab samples were negative, a few psittacines (n=19) that died at CETAS-Belo Horizonte were retested, and 21% were detected as positive in liver. A group of psittacines (n=16) was clinically evaluated, and despite showing feather dystrophy, all birds were negative in the cloacal swabs, except for one, which blood sample was positive (A. ararauna). The obtained sequences of the BFDV strains BH 215 and BH 732 were deposited in the GenBank (JQ649409 and JQ649410). A 98% similarity with strain sequences described in Australia, Japan, and New Zealand was observed. It is possible that these strains arrived in Brazil through the legal and illegal trade of parrots. However, it was not possible to associate BFDV infection with the geographical origin of birds and no local marker was detected. The rates of detection, although similar to other studies, indicate the tendency of a high incidence of the disease, possibly associated with stress, and high bird density and wide transmission in captivity conditions.

In the present study, shortwave angle slope index (SASI) was derived from near-infrared (NIR), shortwave infrared 1 (SWIR1) and shortwave infrared 2 (SWIR2) bands of Moderate Resolution Imaging Spectroradiometer (MODIS) 500-m 8-day composite images in three meteorological sub-divisions of India. The SASI, sensitive to surface wetness, was found to be strongly correlated with rainfall and its seasonal profiles were able to distinguish the early season drought incidents. Comparison between normalized difference vegetation index (NDVI) and SASI showed that during the beginning of the crop season, SASI was relatively better in discriminating the surface dryness conditions prevailing in different years. The SASI, integrated over the period of June to August, better captured the changing dryness/wetness patterns in different years. A normal SASI profile was developed by averaging the SASI values of two normal years. Integrated SASI (InSASI) was computed for the normal SASI profile. Week-wise area under a SASI curve was computed. Based on deviations from the area under the normal SASI curve, dryness/wetness patterns in terms of normal, moderate dry and severe dry were mapped for June, July and August, separately. These patterns are in good agreement with India Meteorological Department rainfall deviations. The study concludes that the early season/sowing-period agricultural drought assessment based on SASI and InSASI could complement the existing vegetation index-based agricultural drought monitoring mechanism.

Background: Genetic factors cause about 15% of male infertility. Azoospermia factors (AZFa, AZFb, and AZFc) present on Yq are most important for spermatogenesis. We have made an attempt to evaluate the frequencies of microdeletions of AZFa, AZFb, AZFc in idiopathic cases of azoospermia and oligozoospermia from central Indian population. Materials and Methods: We have analyzed a total of 156 subjects (95 oligozoospermia and 61 azoospermia) & 50 control subjects. DNA samples were analyzed for microdeletions of Y chromosome by PCR-screening of 18 sequences-tagged-site (STS) markers from different region of the AZF on Yq and SRY on Yp. Results: Out of 156 cases analyzed, 13 (8.33%) subjects (8 azoospermia and 5 oligozoospermia) showed partial deletion of AZF regions, of which deletion in AZFc region was the most common (84.6%) followed by AZFb (15.4%) and AZFa (15.4%). The sites and sizes of deletions varied among patients. Histological study of the testicular tissue of the available subjects, who showed microdeletions of Y chromosome, showed spermatogenic arrest at different stages. The frequency of Y chromosome microdeletion in our subjects was 8.33%. Conclusion: Some Indian studies reported low frequencies of microdeletions than that of our result. We suggest that the frequency of deletions may be affected by the involvement of different genetic factors, ethnic population and different geographical regions. PCR based Y chromosome screening for microdeletions will be useful and great help to infertility clinics for genetic counselling and assisted reproduction.

Falconiformes (n=82), Strigiformes (n=84) and Cathartiformes (n=14) at a triage center (CETAS-Belo Horizonte, IBAMA, Brazil) were examined between 2008 and 2010 . No bird was reactive at hemagglutination-inhibition (HI) for antibodies against Mycoplasma gallisepticum (Mg). Two Caracara plancus (2/68) had HI titers (16-32) against Newcastle disease virus. No Chlamydophila psittaci DNA was detected in the liver (PCR; n=95). Blood smears (Giemsa; n=89) and spleen fragments (PCR; n=82) were 13.5% and 8.5% positive, respectively, for Haemoproteus only. Necropsy of Cathartiformes (n=10), Falconiformes (n=42) and Strigiformes (n=57) showed that trauma injuries were the main cause (63.3%) of admission and death, being fractures (38.5%) of the thoracic limbs (57.1%) the most frequent. Nematode (12.8%), cestode (1.8%), trematode (0.9%), and acanthocephalan (2.7%) parasite infections were relevant. Mites (Acari) were the most frequent (17.4%) external parasites, particularly Ornithonyssus sylviarum in Asio clamator and Amblyomma cajennense in Tyto alba. Chewing lice (10.1%) and Pseudolynchia spp. (9.2%) were also found. Histomonas spp. (6.4%) was found in the ceca of Bubo virginianus, Athene cunicularia, Tyto alba, and Asio clamator, but not in Falconiformes or Cathartiformes. Trichomonas spp. (oral cavity, pharynx and upper esophagus; 9.1%) was detected in Falconiformes and Strigiformes, but not in Cathartiformes. Trichomonas spp. were found in A. cunicularia, Asio clamator, Glaucidium brasilianum and Tyto alba (Strigiformes), and in Rupornis magnirostris, Milvago chimachima, Falco femoralis, Falco sparverius and Caracara plancus (Falconiformes). Coccidia (9.1%) (Sarcocystis spp., 6.4%) and mycosis were observed in most Tyto alba (70%). The evaluated Orders may not pose risks for commercial poultry production. Habitat loss and urban adaptation may be increasingly affecting raptors.

Sunil K Singh1, Kalyan Goswami2, Richa D Sharma2, Maryada VR Reddy2, Debabrata Dash11Department of Biochemistry, Institute of Medical Sciences, Banaras Hindu University, Varanasi, 2Department of Biochemistry, Mahatma Gandhi Institute of Medical Sciences, Sevagram, IndiaPurpose: The currently available drug repertoire against lymphatic filariasis, a major health hazard in the developing world, is inadequate and is fraught with serious limitations. Thus, the development of an effective antifilarial strategy has become a global research thrust mandated by the World Health Organization. Nanoparticles of silver endowed with antibacterial potency are known to induce apoptosis in eukaryotic cells. The present study was designed to investigate the possible microfilaricidal efficacy of silver nanoparticles and to establish the validity of apoptotic rationale in antifilarial drug designing.Methods: This report analyzed the effect of nanoparticles of silver as well as gold (size range: 10–15 nm) on the microfilariae of Brugia malayi obtained from the lavage of peritoneal cavities of infected jirds (Meriones unguiculatus). The study included a microfilarial motility assay, a trypan blue exclusion test, a poly(adenosine diphosphate-ribose) polymerase activity study, ethidium bromide/acridine orange differential staining, and transmission, as well as scanning electron microscopic evaluation of ultrastructural changes in microfilariae.Results: The study demonstrates that nanoparticles of silver, but not of gold, elicited significant loss in microfilarial motility. Differential staining of parasites with ethidium bromide and acridine orange, poly(adenosine diphosphate-ribose) polymerase activity in microfilarial lysate, and electron microscopic findings underscored apoptotic death of parasites attributable to nanosilver. In a trypan blue exclusion test, the 50% lethal dose of nanosilver was measured to be 101.2 µM, which was higher than the recorded complete inhibitory concentration value (50.6 µM), thus supporting nanosilver as a potential drug candidate against lymphatic filariasis.Conclusion: The present report provides the first ever conclusive proof in support of apoptosis as a novel stratagem in antifilarial drug designing and nanoscale silver as a valid lead in research on antifilarial therapeutics. The main embargo about the current drug diethylcarbamazine citrate is its empirical use without rationale. Effective microfilaricidal activity of nanosilver at relatively low concentrations as reported in this study, with evidence of the induction of apoptosis in microfilariae, projects nanosilver as a potential drug adjuvant against lymphatic filariasis. The much higher 50% lethal dose value of nanosilver compared to the complete inhibitory concentration value reported in this study argues in favor of a safe therapeutic window of this agent in its antifilarial efficacy.Keywords: silver nanoparticles, apoptosis, lymphatic filariasis, microfilaricidal agent, parasitic diseases

The mortality of passerines native of Southern Minas Gerais, Brazil, in August 2006 and the examination of sentinel free-range chicken eggs in August 2007 in an area surrounding a car battery lead smelter plant is described. The high levels of lead, as detected in the passerines (4.80-12.74 mg/kg) at the onset of mortality and at the follow-up sampling of the free-range chicken eggs (25.02-35.21 mg/kg in shells, 0.41-1.36 mg/kg in yolks and 0.40-0.75 mg/kg in the albumins), used as environmental sentinels, indicated the continuing lead pollution.

Mycoplasma gallisepticum (Mg) infection of wild native Brazilian psittacines (Psittaciformes) which died of any cause during sorting, rehabilitation, or conservation, was investigated by PCR. Two previously described PCR methodologies using Mg specific primers were employed for the analyses of 140 swab samples (cloaca, trachea, or palatine cleft). Average positive Mg detection in cloacal swabs was 51.9%, with 80.0% (n=5) of Blue-and-yellow Macaws (Ara ararauna), 60.0% (n=3) Dusky Parrots (Pionus fuscus), 52.5% (n=59) Amazon Parrots (Amazona aestiva), 50.0% (n=2) Orange-winged Parrots (Amazona amazonica), 50.0% (n=2) Jandaya Parakeetsor Jandaya Conures (Aratinga jandaya), 0% (n=2) Golden Conures or Golden Parakeets (Guarouba guarouba), and 0% (n=2) Hyacinth Macaws (Anodorhynchus hyacinthinus). Palatine cleft swab sampling was more sensitive to detect Mg, with 85.4% (n=17) detection rate, as compared to 67.4% (n=46) obtained with tracheal samples, and 53.5% (n=77) with cloacal swabs. The surprisingly high Mg incidence in psittacines kept in conservation or triage environments is possibly due to the proximity or cohabitation with several bird species during confinement and housing psittacines of different origins together. The implementation of biosecurity measures and species-specific facilities is recommended.

OBJETIVO: Aplicar a metodologia de Análise Envoltória de Dados na avaliação do desempenho de hospitais públicos em termos das internações em suas clínicas médicas. MÉTODOS: A eficiência dos hospitais foi medida a partir do desempenho de unidades de decisão nas variáveis estudadas para cada hospital, no ano 2000. Foram analisados dados referentes às internações em clínica médica dos hospitais SUS das capitais estaduais do Brasil e Distrito Federal (taxas de mortalidade e tempo médio de internação, valor médio da internação e perfil de doenças). A técnica de análise de correlação canônica foi introduzida na restrição do intervalo de variação das variáveis. O modelo Constant Returns to Scale foi utilizado para gerar escores que permitissem avaliar a eficiência das unidades. A partir dos escores obtidos, os municípios foram classificados de acordo com seu desempenho relativo nas variáveis analisadas. Procurou-se correlação entre os escores de classificação com variáveis exógenas: despesas com programas de saúde básica por habitante e índice de desenvolvimento humano das capitais. RESULTADOS: Nos hospitais estudados se destacaram as doenças do aparelho circulatório (23,6% das internações); e a taxa de mortalidade foi de 10,3% das internações. Das 27 capitais, quatro alcançaram 100% de eficiência (Palmas, Macapá, Teresina e Goiânia), sete ficaram entre 85% e 100%, dez entre 70% e 85% e dez com menos de 70%. CONCLUSÕES: A ferramenta utilizada mostrou ser aplicável para a avaliação de desempenho de hospitais públicos, revelando a grande variabilidade entre as capitais brasileiras, no que se refere às internações em clínica médica.OBJECTIVE: To apply the Data Envelopment Analysis (DEA) methodology for evaluating the performance of public hospitals, in terms of clinical medical admissions. METHODS: The efficiency of the hospitals was measured according to the performance of decision-making units in relation to the variables studied for each hospital, in the year 2000. Data relating to clinical medical admissions in hospitals within the public system in Brazilian state capitals and Federal District (mortality rate, mean length of stay, mean cost of stay and disease profile) were analyzed. The canonical correlation analysis technique was introduced to restrict the variation range of the variables used. The constant returns to scale model was used to generate scores that would enable assessment of the efficiency of the units. From the scores obtained, these cities were classified according to their relative performance in the variables analyzed. It was sought to correlate between the classification scores and the exogenous variables of the expenditure on primary care programs per inhabitant and the human development index for each state capital. RESULTS: In the hospitals studied, circulatory diseases were the most prevalent (23.6% of admissions), and the mortality rate was 10.3% of admissions. Among the 27 state capitals, four reached 100% efficiency (Palmas, Macapá, Teresina and Goiânia), seven were between 85 and 100%, ten were between 70 and 85% and ten had efficiency of less than 70%. CONCLUSIONS: The tool utilized was shown to be applicable for evaluating the performance of public hospitals. It revealed large variations among the Brazilian state capitals in relation to clinical medical admissions.

Tissue microenvironment functions as an important determinant of the inflammatory response elicited by the resident cells. Yet, the underlying molecular mechanisms remain obscure. Our systems-level analyses identified a duration code that instructs stimulus specific crosstalk between TLR4-activated canonical NF-κB pathway and lymphotoxin-β receptor (LTβR) induced non-canonical NF-κB signaling. Indeed, LTβR costimulation synergistically enhanced the late RelA/NF-κB response to TLR4 prolonging NF-κB target gene-expressions. Concomitant LTβR signal targeted TLR4-induced newly synthesized p100, encoded by Nfkb2, for processing into p52 that not only neutralized p100 mediated inhibitions, but potently generated RelA:p52/NF-κB activity in a positive feedback loop. Finally, Nfkb2 connected lymphotoxin signal within the intestinal niche in reinforcing epithelial innate inflammatory RelA/NF-κB response to Citrobacter rodentium infection, while Nfkb2−/− mice succumbed to gut infections owing to stromal defects. In sum, our results suggest that signal integration via the pleiotropic NF-κB system enables tissue microenvironment derived cues in calibrating physiological responses.