| 11. |
- Dias-Neto, Marina, et al.
(författare)
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Nationwide Analysis of Intact Abdominal Aortic Aneurysm Repair in Portugal from 2000 to 2015
- 2020
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Ingår i: Annals of Vascular Surgery. - : ELSEVIER SCIENCE INC. - 0890-5096 .- 1615-5947. ; 66:July, s. 54-64
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Tidskriftsartikel (refereegranskat)abstract
- Background: Results on the management of infrarenal abdominal aortic aneurysm (AAA) from Mediterranean countries are scarce. The aim of this study was to evaluate trends in rate of and mortality after repair of intact AAA (iAAA) in Portugal. Methods: iAAA repairs registered in the hospitals' administrative database of the National Health Service from 2000 to 2015 were retrospectively analyzed regarding demographics (age and gender) and type of repair (open surgery [OS] or endovascular repair [EVAR]). Rate and mortality were compared among three time periods: 2000-2004, 2005-2009, and 2010-2015. Results: Age-standardized rate of iAAA repair increased consistently across the time periods under analysis from 3.6 +/- 0.6/100,000/year in 2000-2004, to 5.6 +/- 0.4/100,000/year in 2005-2009 and to 7.1 +/- 0.9/100,000/year in 2010-2015 (P < 0.001). The percentage of EVAR among all iAAA repairs rose steeply from 0 to 21 +/- 19% and then to 58 +/- 7% (P < 0.001). The rate of OS also increased from the first to the second period, but there was a decrease in the third period (P < 0.001). The in-hospital mortality after iAAA repair decreased from 7.5 +/- 1.3% to 6.6 +/- 1.6% and then to 5.1 +/- 1.9% (P < 0.001). This variation corresponded to a decrease in in-hospital mortality after EVAR (from 4.0 +/- 3.5% to 2.8 +/- 0.9%, P < 0.001) and increased in-hospital mortality after OS (7.5 +/- 1.3% to 7.4 +/- 1.1% to 8.3 +/- 3.7%, P < 0.001). Low-volume centers (< 15 repairs/year) did not present higher mortality rates. The number of EVARs per year in a center presented a positive association with EVAR mortality (Spearman correlation of 0.696, P = 0.004). Conclusions: The rate of repair of iAAA continues to grow, especially in patients aged >= 75 years and did not reach an inflection point yet. This is happening along with decreased repair mortality mainly because of the increased use of EVAR. Hospital mortality for iAAA repair is still a matter of concern, warranting further investigation and planning of vascular surgical services.
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| 12. |
- Dias-Neto, Marina, et al.
(författare)
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Nationwide Analysis of Ruptured Abdominal Aortic Aneurysm in Portugal (2000-2015)
- 2020
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Ingår i: European Journal of Vascular and Endovascular Surgery. - : Elsevier BV. - 1078-5884 .- 1532-2165. ; 60:1, s. 27-35
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Tidskriftsartikel (refereegranskat)abstract
- Objective: Ruptured abdominal aortic aneurysm (rAAA) is a lethal condition that requires acute repair to prevent death. This analysis aims to assess the nationwide trends in rAAA admission, repair and mortality in a country, Portugal, without national screening for AAA. Methods: rAAA registered in the hospital administrative database of the National Health Service and all nationally registered deaths due to rAAA based on death certificate data were analysed. Three time periods (2000-2004, 2005-2009, and 2010-2015) were compared in patients >= 50 years old to assess the variations over time. Results: A total of 2 275 patients >= 50 years old with rAAA were identified in the two databases from 2000 to 2015. The age standardised incidence of rAAA was 2.78 +/- 0.24/100 000/year in 2000-2004, 3.17 +/- 0.39/100 000/year in 2005-2009 and 3.21 +/- 0.28/100 000/year in 2010-2015 (p < .001). When comparing the time periods 2000-2004 to 2005-2009, the age standardised rate of admission (n = 1460) increased from 1.57 +/- 0.25/100 000/year to 2.24 +/- 0.32/100 000/year (p < .001). The operative mortality rates decreased during this time period (from 55.3 +/- 4.7% to 48.8 +/- 4.7%, p < .001). In 2010-2015, the age standardised rate of admissions due to rAAA decreased (1.98 +/- 0.22/100 000/year). Operative mortality remained stable (48.9 +/- 6.2%). The rate of patient deaths outside the hospital decreased from the first to the second period (1.21 +/- 0.10/100 000/year and 0.93 +/- 0.29/100 000/year, respectively) but later increased (1.14 +/- 0.22/100 000/year). This resulted in a higher overall rAAA related mortality in Portugal in the third period (2.20 +/- 0.18/100 000/year, 2.21 +/- 0.27/100 000/year and 2.26 +/- 0.26/100 000/year in 2000-2004, 2005-2009, and 2010-2015, respectively, p < .001). Conclusion: Overall, the incidence of rAAA in Portugal has been stable over the past 10 years. The rates of admission, repair, and death due to rAAA repair seem to have reached an inflection point and are now decreasing. Mortality outside the hospital remains a matter of concern, warranting further planning of streamlined transfer networks and vascular surgical departments.
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| 13. |
- Egeskog, Andrea, 1981, et al.
(författare)
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Actions and opinions of Brazilian farmers who shift to sugarcane : an interview-based assessment with discussion of implications for land-use change
- 2016
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Ingår i: Land use policy. - Kidlington : Elsevier. - 0264-8377 .- 1873-5754. ; 57, s. 594-604
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Tidskriftsartikel (refereegranskat)abstract
- Sugarcane ethanol systems can deliver large greenhouse gas emissions savings if emissions associated with land-use change are kept low. This qualitative study documents and analyzes actions and opinions among Brazilian farmers who shift to sugarcane production. Semi-structured interviews were held with 28 actors associated with sugarcane production in three different regions: one traditional sugarcane region and two regions where sugarcane is currently expanding. Most farmers considered sugarcane a land diversification option with relatively low economic risk, although higher risk than their previous land use. Beef production was considered a low-risk option, but less profitable than sugarcane. In conjunction with converting part of their land to sugarcane, most farmers maintained and further intensified their previous agricultural activity, often beef production. Several farmers invested in expanded production in other regions with relatively low land prices. Very few farmers in the expansion regions shifted all their land from the former, less profitable, use to sugarcane. Very few farmers in this study had deforested any land in connection with changes made when shifting to sugarcane. The respondents understand "environmental friendliness" as compliance with the relevant legislation, especially the Brazilian Forest Act, which is also a requirement for delivering sugarcane to the mills. Indirect land-use change is not a concern for the interviewed farmers, and conversion of forests and other native vegetation into sugarcane plantations is uncontroversial if legal. We derive hypotheses regarding farmers' actions and opinions from our results. These hypotheses aim to contribute to better understanding of what takes place in conjunction with expansion of sugarcane and can, when tested further, be of use in developing, e.g., policies for iLUC-free biofuel production.
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| 14. |
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| 15. |
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| 16. |
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| 17. |
- Gorasso, Vanessa, et al.
(författare)
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Burden of disease attributable to risk factors in European countries: a scoping literature review
- 2023
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Ingår i: Archives of Public Health. - 0778-7367 .- 2049-3258. ; 81:1
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Forskningsöversikt (refereegranskat)abstract
- Objectives: Within the framework of the burden of disease (BoD) approach, disease and injury burden estimates attributable to risk factors are a useful guide for policy formulation and priority setting in disease prevention. Considering the important differences in methods, and their impact on burden estimates, we conducted a scoping literature review to: (1) map the BoD assessments including risk factors performed across Europe; and (2) identify the methodological choices in comparative risk assessment (CRA) and risk assessment methods. Methods: We searched multiple literature databases, including grey literature websites and targeted public health agencies websites. Results: A total of 113 studies were included in the synthesis and further divided into independent BoD assessments (54 studies) and studies linked to the Global Burden of Disease (59 papers). Our results showed that the methods used to perform CRA varied substantially across independent European BoD studies. While there were some methodological choices that were more common than others, we did not observe patterns in terms of country, year or risk factor. Each methodological choice can affect the comparability of estimates between and within countries and/or risk factors, since they might significantly influence the quantification of the attributable burden. From our analysis we observed that the use of CRA was less common for some types of risk factors and outcomes. These included environmental and occupational risk factors, which are more likely to use bottom-up approaches for health outcomes where disease envelopes may not be available. Conclusions: Our review also highlighted misreporting, the lack of uncertainty analysis and the under-investigation of causal relationships in BoD studies. Development and use of guidelines for performing and reporting BoD studies will help understand differences, avoid misinterpretations thus improving comparability among estimates.
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| 18. |
- Hoshino, Ayuko, et al.
(författare)
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Extracellular Vesicle and Particle Biomarkers Define Multiple Human Cancers
- 2020
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Ingår i: Cell. - : CELL PRESS. - 0092-8674 .- 1097-4172. ; 182:4, s. 1044-
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Tidskriftsartikel (refereegranskat)abstract
- There is an unmet clinical need for improved tissue and liquid biopsy tools for cancer detection. We investigated the proteomic profile of extracellular vesicles and particles (EVPs) in 426 human samples from tissue explants (TEs), plasma, and other bodily fluids. Among traditional exosome markers, CD9, HSPA8, ALIX, and HSP90AB1 represent pan-EVP markers, while ACTB, MSN, and RAP1B are novel pan-EVP markers. To confirm that EVPs are ideal diagnostic tools, we analyzed proteomes of TE- (n =151) and plasma-derived (n =120) EVPs. Comparison of TE EVPs identified proteins (e.g., VCAN, TNC, and THBS2) that distinguish tumors from normal tissues with 90% sensitivity/94% specificity. Machine-learning classification of plasma-derived EVP cargo, including immunoglobulins, revealed 95% sensitivity/90% specificity in detecting cancer Finally, we defined a panel of tumor-type-specific EVP proteins in TEs and plasma, which can classify tumors of unknown primary origin. Thus, EVP proteins can serve as reliable biomarkers for cancer detection and determining cancer type.
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| 19. |
- Kehoe, Laura, et al.
(författare)
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Make EU trade with Brazil sustainable
- 2019
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Ingår i: Science. - : American Association for the Advancement of Science (AAAS). - 0036-8075 .- 1095-9203. ; 364:6438, s. 341-
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
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| 20. |
- Martins, Leila Droprinchinski, et al.
(författare)
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Extreme value analysis of air pollution data and their comparison between two large urban regions of South America
- 2017
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Ingår i: Weather and Climate Extremes. - : Elsevier BV. - 2212-0947. ; 18, s. 44-54
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Tidskriftsartikel (refereegranskat)abstract
- Sixteen years of hourly atmospheric pollutant data (1996-2011) in the Metropolitan Area of São Paulo (MASP), and seven years (2005-2011) of data measured in the Metropolitan Area of Rio de Janeiro (MARJ), were analyzed in order to study the extreme pollution events and their return period. In addition, the objective was to compare the air quality between the two largest Brazilian urban areas and provide information for decision makers, government agencies and civil society. Generalized Extreme Value (GEV) and Generalized Pareto Distribution (GPD) were applied to investigate the behavior of pollutants in these two regions. Although GEV and GPD are different approaches, they presented similar results. The probability of higher concentrations for CO, NO, NO2, PM10 and PM2.5 was more frequent during the winter, and O3 episodes occur most frequently during summer in the MASP. On the other hand, there is no seasonally defined behavior in MARJ for pollutants, with O3 presenting the shortest return period for high concentrations. In general, Ibirapuera and Campos Elísios stations present the highest probabilities of extreme events with high concentrations in MASP and MARJ, respectively. When the regions are compared, MASP presented higher probabilities of extreme events for all analyzed pollutants, except for NO; while O3 and PM2.5 are those with most frequent probabilities of presenting extreme episodes, in comparison other pollutants.
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