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  1. Article ; Online: Taking the inner route: spatial and demographic factors affecting vulnerability to COVID-19 among 604 cities from inner São Paulo State, Brazil.

    Fortaleza, C M C B / Guimarães, R B / de Almeida, G B / Pronunciate, M / Ferreira, C P

    Epidemiology and infection

    2020  Volume 148, Page(s) e118

    Abstract: Even though the impact of COVID-19 in metropolitan areas has been extensively studied, the geographic spread to smaller cities is also of great concern. We conducted an ecological study aimed at identifying predictors of early introduction, incidence ... ...

    Abstract Even though the impact of COVID-19 in metropolitan areas has been extensively studied, the geographic spread to smaller cities is also of great concern. We conducted an ecological study aimed at identifying predictors of early introduction, incidence rates of COVID-19 and mortality (up to 8 May 2020) among 604 municipalities in inner São Paulo State, Brazil. Socio-demographic indexes, road distance to the state capital and a classification of regional relevance were included in predictive models for time to COVID-19 introduction (Cox regression), incidence and mortality rates (zero-inflated binomial negative regression). In multivariable analyses, greater demographic density and higher classification of regional relevance were associated with both early introduction and increased rates of COVID-19 incidence and mortality. Other predictive factors varied, but distance from the State Capital (São Paulo City) was negatively associated with time-to-introduction and with incidence rates of COVID-19. Our results reinforce the hypothesis of two patterns of geographical spread of SARS-Cov-2 infection: one that is spatial (from the metropolitan area into the inner state) and another which is hierarchical (from urban centres of regional relevance to smaller and less connected municipalities). Those findings may apply to other settings, especially in developing and highly heterogeneous countries, and point to a potential benefit from strengthening non-pharmaceutical control strategies in areas of greater risk.
    MeSH term(s) Brazil/epidemiology ; COVID-19 ; Cities/epidemiology ; Communicable Disease Control ; Coronavirus Infections/epidemiology ; Coronavirus Infections/mortality ; Coronavirus Infections/prevention & control ; Humans ; Incidence ; Pandemics/prevention & control ; Pneumonia, Viral/epidemiology ; Pneumonia, Viral/mortality ; Pneumonia, Viral/prevention & control ; Regression Analysis ; Urban Population ; Vulnerable Populations
    Keywords covid19
    Language English
    Publishing date 2020-06-19
    Publishing country England
    Document type Journal Article
    ZDB-ID 632982-2
    ISSN 1469-4409 ; 0950-2688
    ISSN (online) 1469-4409
    ISSN 0950-2688
    DOI 10.1017/S095026882000134X
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  2. Article: Taking the inner route: spatial and demographic factors affecting vulnerability to COVID-19 among 604 cities from inner São Paulo State, Brazil

    Fortaleza, C M C B / Guimarães, R B / de Almeida, G B / Pronunciate, M / Ferreira, C P

    Epidemiol Infect

    Abstract: Even though the impact of COVID-19 in metropolitan areas has been extensively studied, the geographic spread to smaller cities is also of great concern. We conducted an ecological study aimed at identifying predictors of early introduction, incidence ... ...

    Abstract Even though the impact of COVID-19 in metropolitan areas has been extensively studied, the geographic spread to smaller cities is also of great concern. We conducted an ecological study aimed at identifying predictors of early introduction, incidence rates of COVID-19 and mortality (up to 8 May 2020) among 604 municipalities in inner São Paulo State, Brazil. Socio-demographic indexes, road distance to the state capital and a classification of regional relevance were included in predictive models for time to COVID-19 introduction (Cox regression), incidence and mortality rates (zero-inflated binomial negative regression). In multivariable analyses, greater demographic density and higher classification of regional relevance were associated with both early introduction and increased rates of COVID-19 incidence and mortality. Other predictive factors varied, but distance from the State Capital (São Paulo City) was negatively associated with time-to-introduction and with incidence rates of COVID-19. Our results reinforce the hypothesis of two patterns of geographical spread of SARS-Cov-2 infection: one that is spatial (from the metropolitan area into the inner state) and another which is hierarchical (from urban centres of regional relevance to smaller and less connected municipalities). Those findings may apply to other settings, especially in developing and highly heterogeneous countries, and point to a potential benefit from strengthening non-pharmaceutical control strategies in areas of greater risk.
    Keywords covid19
    Publisher WHO
    Document type Article
    Note WHO #Covidence: #606044
    Database COVID19

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  3. Article ; Online: Taking the inner route

    Fortaleza, C. M. C. B. / Guimarães, R. B. / de Almeida, G. B. / Pronunciate, M. / Ferreira, C. P.

    Epidemiology and Infection

    spatial and demographic factors affecting vulnerability to COVID-19 among 604 cities from inner São Paulo State, Brazil

    2020  Volume 148

    Abstract: Abstract Even though the impact of COVID-19 in metropolitan areas has been extensively studied, the geographic spread to smaller cities is also of great concern. We conducted an ecological study aimed at identifying predictors of early introduction, ... ...

    Abstract Abstract Even though the impact of COVID-19 in metropolitan areas has been extensively studied, the geographic spread to smaller cities is also of great concern. We conducted an ecological study aimed at identifying predictors of early introduction, incidence rates of COVID-19 and mortality (up to 8 May 2020) among 604 municipalities in inner São Paulo State, Brazil. Socio-demographic indexes, road distance to the state capital and a classification of regional relevance were included in predictive models for time to COVID-19 introduction (Cox regression), incidence and mortality rates (zero-inflated binomial negative regression). In multivariable analyses, greater demographic density and higher classification of regional relevance were associated with both early introduction and increased rates of COVID-19 incidence and mortality. Other predictive factors varied, but distance from the State Capital (São Paulo City) was negatively associated with time-to-introduction and with incidence rates of COVID-19. Our results reinforce the hypothesis of two patterns of geographical spread of SARS-Cov-2 infection: one that is spatial (from the metropolitan area into the inner state) and another which is hierarchical (from urban centres of regional relevance to smaller and less connected municipalities). Those findings may apply to other settings, especially in developing and highly heterogeneous countries, and point to a potential benefit from strengthening non-pharmaceutical control strategies in areas of greater risk.
    Keywords Epidemiology ; Infectious Diseases ; covid19
    Language English
    Publisher Cambridge University Press (CUP)
    Publishing country uk
    Document type Article ; Online
    ZDB-ID 632982-2
    ISSN 1469-4409 ; 0950-2688
    ISSN (online) 1469-4409
    ISSN 0950-2688
    DOI 10.1017/s095026882000134x
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  4. Article ; Online: Elementary spatial structures and dispersion of COVID-19: health geography directing responses to public health emergency in Sao Paulo State, Brazil

    Fortaleza, C. M. C. B. / Guimaraes, R. B. / Catao, R. d. C. / Ferreira, C. P. / de Almeida, G. B. / Pugliesi, E.

    Abstract: Public health policies to contain the spread of COVID-19 rely mainly on non-pharmacological measures. Those measures, especially social distancing, are a challenge for developing countries, such as Brazil. In Sao Paulo, the most populous state in Brazil ( ...

    Abstract Public health policies to contain the spread of COVID-19 rely mainly on non-pharmacological measures. Those measures, especially social distancing, are a challenge for developing countries, such as Brazil. In Sao Paulo, the most populous state in Brazil (45 million inhabitants), most COVID-19 cases up to April 18th were reported in the Capital and metropolitan area. However, the inner municipalities, where 20 million people live, are also at risk. As governmental authorities discuss the loosening of measures for restricting population mobility, it is urgent to analyze the routes of dispersion of COVID-19 in those municipalities. In this ecological study, we use geographical models of population mobility as patterns for spread of SARS-Cov-2 infection. Based on surveillance data, we identify two patterns: one by contiguous diffusion from the capital metropolitan area and other that is hierarchical, with long-distance spread through major highways to cities of regional relevance. We also modelled the impact of social distancing strategies in the most relevant cities, and estimated a beneficial effect in each and every setting studied. This acknowledgement can provide real-time responses to support public health strategies.
    Keywords covid19
    Publisher MedRxiv; WHO
    Document type Article ; Online
    DOI 10.1101/2020.04.26.20080895
    Database COVID19

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  5. Article ; Online: Structural heart disease as the cause of syncope.

    Guimarães, R B / Essebag, V / Furlanetto, M / Yanez, J P G / Farina, M G / Garcia, D / Almeida, E D / Stephan, L / Lima, G G / Leiria, T L L

    Brazilian journal of medical and biological research = Revista brasileira de pesquisas medicas e biologicas

    2018  Volume 51, Issue 4, Page(s) e6989

    Abstract: We described the clinical evolution of patients with structural heart disease presenting at the emergency room with syncope. Patients were stratified according to their syncope etiology and available scores for syncope prognostication. Cox proportional ... ...

    Abstract We described the clinical evolution of patients with structural heart disease presenting at the emergency room with syncope. Patients were stratified according to their syncope etiology and available scores for syncope prognostication. Cox proportional hazard models were used to investigate the relationship between etiology of the syncope and event-free survival. Of the 82,678 emergency visits during the study period, 160 (0.16%) patients were there due to syncope, having a previous diagnosis of structural heart disease. During the median follow-up of 33.8±13.8 months, mean age at the qualifying syncope event was 68.3 years and 40.6% of patients were male. Syncope was vasovagal in 32%, cardiogenic in 57%, orthostatic hypotension in 6%, and of unknown causes in 5% of patients. The primary composite endpoint death, readmission, and emergency visit in 30 days was 39.4% in vasovagal syncope and 60.6% cardiogenic syncope (P<0.001). Primary endpoint-free survival was lower for patients with cardiogenic syncope (HR=2.97, 95%CI=1.94-4.55; P<0.001). The scores were analyzed for diagnostic performance with area under the curve (AUC) and did not help differentiate patients with an increased risk of adverse events. The differential diagnosis of syncope causes in patients with structural heart disease is important, because vasovagal and postural hypotension have better survival and less probability of emergency room or hospital readmission. The available scores are not reliable tools for prognosis in this specific patient population.
    MeSH term(s) Aged ; Brazil/epidemiology ; Cardiomyopathies/complications ; Cohort Studies ; Disease-Free Survival ; Emergency Medical Services/statistics & numerical data ; Female ; Heart Diseases/complications ; Heart Diseases/epidemiology ; Humans ; Male ; Proportional Hazards Models ; Risk Factors ; Survival Analysis ; Syncope/etiology ; Syncope/mortality
    Language English
    Publishing date 2018-03-01
    Publishing country Brazil
    Document type Journal Article
    ZDB-ID 786234-9
    ISSN 1414-431X ; 0100-879X
    ISSN (online) 1414-431X
    ISSN 0100-879X
    DOI 10.1590/1414-431X20176989
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  6. Article ; Online: The bone degenerative processes in senile fishes from Holocene Brazilian shell mounds.

    Aguilera, O / Rocha, I / Lopes, M S / Lima, I / Lopes, R T / Machado, A S / Guimarães, R B / Crapez, M A C / Tenório, M C / Nepomuceno, A

    Journal of fish diseases

    2017  Volume 40, Issue 12, Page(s) 1869–1881

    Abstract: Zooarchaeological collections from shell mounds in Rio de Janeiro (2,470-4,632 cal BP) contain a high prevalence of swollen fish bones belonging to the Atlantic spadefish (Chaetodipterus faber), crevalle jack (Caranx hippos) and fat snook (Centropomus ... ...

    Abstract Zooarchaeological collections from shell mounds in Rio de Janeiro (2,470-4,632 cal BP) contain a high prevalence of swollen fish bones belonging to the Atlantic spadefish (Chaetodipterus faber), crevalle jack (Caranx hippos) and fat snook (Centropomus parallelus). Given the lack of knowledge of the bone degenerative process in senile fishes, this study analysed hyperostotic bone in zooarchaeological and modern specimens to obtain high-resolution morphology and microstructure reconstruction. We used microCT as well as X-ray diffraction to characterize the crystallographic changes associated with fish senility. Our results showed that trabecular microstructures in hyperostotic bones were consistent with estimated values of the per cent bone volume-to-total volume ratio (BV/TV) and were greater than 60% in cortical bone. Hyperostotic bones indicated a high radiograph density, and X-ray diffractograms showed a decrease in hydroxyapatite [Ca
    MeSH term(s) Aging ; Animals ; Archaeology ; Bone and Bones/anatomy & histology ; Bone and Bones/ultrastructure ; Brazil ; Calcium Carbonate/chemistry ; Durapatite/chemistry ; Fishes/anatomy & histology ; History, Ancient ; X-Ray Diffraction ; X-Ray Microtomography
    Chemical Substances Durapatite (91D9GV0Z28) ; Calcium Carbonate (H0G9379FGK)
    Language English
    Publishing date 2017-07-14
    Publishing country England
    Document type Historical Article ; Journal Article
    ZDB-ID 432109-1
    ISSN 1365-2761 ; 0140-7775
    ISSN (online) 1365-2761
    ISSN 0140-7775
    DOI 10.1111/jfd.12662
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  7. Article ; Online: Expression of Concern: Selective impairment of insulin signalling in the hypothalamus of obese Zucker rats.

    Carvalheira, J B C / Ribeiro, E B / Araújo, E P / Guimarães, R B / Telles, M M / Torsoni, M / Gontijo, J A R / Velloso, L A / Saad, M J A

    Diabetologia

    2017  

    Language English
    Publishing date 2017-09-14
    Publishing country Germany
    Document type Journal Article ; Expression of Concern
    ZDB-ID 1694-9
    ISSN 1432-0428 ; 0012-186X
    ISSN (online) 1432-0428
    ISSN 0012-186X
    DOI 10.1007/s00125-017-4358-4
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  8. Article: Lateral hypothalamic serotonergic responsiveness to food intake in rat obesity as measured by microdialysis.

    Mori, R C / Guimarães, R B / Nascimento, C M / Ribeiro, E B

    Canadian journal of physiology and pharmacology

    1999  Volume 77, Issue 4, Page(s) 286–292

    Abstract: The hypothalamic serotonergic system is involved in the regulation of food ingestion and energy metabolism. Since disturbances of both energy intake and expenditure can contribute to obesity, the objective of the present study was to evaluate the ... ...

    Abstract The hypothalamic serotonergic system is involved in the regulation of food ingestion and energy metabolism. Since disturbances of both energy intake and expenditure can contribute to obesity, the objective of the present study was to evaluate the serotonergic response stimulated by food ingestion in two different models of obesity: the hyperphagic Zucker and the hypophagic and hypometabolic, monosodium glutamate (MSG) obese Wistar rat. For this we used microdialysis to examine the release of 5-hydroxytryptamine (serotonin, 5HT) and 5-hydroxyindoleacetic acid (5HIAA) in the lateral hypothalamus. Daily intake of MSG-obese rats was 40% lower while that of Zucker obese rats was 60% higher than that of the respective lean controls. In overnight-fasted animals, 20-min microdialysate samples were collected before (basal release) and during a 2-h period of access to a balanced palatable food mash. The animals began to eat during the first 20 min of food access, and food consumption was similar among the four groups in all six individual 20-min periods recorded. Ingestion of food increased 5HT release in all groups. In MSG-obese and lean Wistar rats, 5HT levels were similarly elevated during the whole experimental period. In the Zucker strain, 5HT increments of basal release tended to be higher in obese than in lean rats at 20 and 40 min, and a significantly higher increment was observed at 60 min after food access (40 and 135% for lean and obese, respectively). The area under the curve relating serotonin levels to the 120 min of food availability was significantly higher in Zucker obese (246.7 +/- 23.3) than MSG-obese (152.7 +/- 13.4), lean Wistar (151.9 +/- 11.1), and lean Zucker (173.5 +/- 24.0) rats. The present observation, of a food-induced serotonin release in the lateral hypothalamus of lean Wistar and Zucker rats, evidences that 5HT in the lateral hypothalamus is important in the normal response to feeding. In obese animals, the serotonin response was similar to (in the hypophagic-hypometabolic MSG model) or even higher than (in the hyperphagic Zucker model) that seen in the respective lean controls. This result indicates that the energy homeostasis disturbances of both these obesity models may not be ascribed to an impairment of the acute lateral hypothalamic serotonin response to a dietary stimulus.
    MeSH term(s) Animals ; Eating ; Hydroxyindoleacetic Acid/metabolism ; Hypothalamic Area, Lateral/secretion ; Male ; Microdialysis ; Obesity/metabolism ; Rats ; Rats, Wistar ; Rats, Zucker ; Serotonin/secretion ; Sodium Glutamate
    Chemical Substances Serotonin (333DO1RDJY) ; Hydroxyindoleacetic Acid (54-16-0) ; Sodium Glutamate (W81N5U6R6U)
    Language English
    Publishing date 1999-04
    Publishing country Canada
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 127527-6
    ISSN 1205-7541 ; 0008-4212
    ISSN (online) 1205-7541
    ISSN 0008-4212
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    Zs.A 589: Show issues Location:
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  9. Book ; Online: Nanostructured Europium Oxide thin films deposited by pulsed laser ablation of a metallic target in a He buffer atmosphere

    Luna, H. / Franceschini, D. F. / Prioli, R. / Guimarães, R. B. / Sanchez, C. M. / Canal, G. P. / Barbosa, M. D. L. / Galvão, R. M. O.

    2009  

    Abstract: Nanostrucured Europium oxide and hydroxide films were obtained by pulsed Nd:Yag (532 nm) laser ablation of an Europium metallic target, in the presence of a 1 mbar Helium buffer atmosphere. Both the produced film and the ambient plasma were characterized. ...

    Abstract Nanostrucured Europium oxide and hydroxide films were obtained by pulsed Nd:Yag (532 nm) laser ablation of an Europium metallic target, in the presence of a 1 mbar Helium buffer atmosphere. Both the produced film and the ambient plasma were characterized. The plasma was monitored by an electrostatic probe, for plume expansion in vacuum or in the presence of the buffer atmosphere. The time evolution of the ion saturation current was obtained for several probe to substrate distances. The results show the splitting of the plume into two velocity groups, being the lower velocity profile associated with metal cluster formation within the plume. The films were obtained in the presence of helium atmosphere, for several target to substrate distances. They were analyzed by Rutherford backscattering spectrometry (RBS), X-Ray Diffraction (XRD) and Atomic Force Microscopy, for samples as-deposited and treated at 600 degrees C in air. The results show that the as-deposited samples are amorphous and have chemical composition compatible with Europium hydroxide. The thermally treated samples show X-Ray diffraction peaks of Eu_2O_3, with chemical composition showing excess oxygen. Film nanostructuring was shown to be strongly correlated to cluster formation, as shown by velocity splitting in probe current versus time plots.

    Comment: 7 pages, 11 figures, 31 references
    Keywords Condensed Matter - Materials Science
    Subject code 620
    Publishing date 2009-11-14
    Publishing country us
    Document type Book ; Online
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  10. Article: Selective impairment of insulin signalling in the hypothalamus of obese Zucker rats.

    Carvalheira, J B C / Ribeiro, E B / Araújo, E P / Guimarães, R B / Telles, M M / Torsoni, M / Gontijo, J A R / Velloso, L A / Saad, M J A

    Diabetologia

    2003  Volume 46, Issue 12, Page(s) 1629–1640

    Abstract: Aim/hypothesis: By acting in the brain, insulin suppresses food intake. However, little is known with regard to insulin signalling in the hypothalamus in insulin-resistant states.: Methods: Western blotting, immunohistochemistry and polymerase chain ... ...

    Abstract Aim/hypothesis: By acting in the brain, insulin suppresses food intake. However, little is known with regard to insulin signalling in the hypothalamus in insulin-resistant states.
    Methods: Western blotting, immunohistochemistry and polymerase chain reaction assays were combined to compare in vivo hypothalamic insulin signalling through the PI3-kinase and MAP kinase pathways between lean and obese Zucker rats.
    Results: Intracerebroventricular insulin infusion reduced food intake in lean rats to a greater extent than that observed in obese rats, and pre-treatment with PI3-kinase inhibitors prevented insulin-induced anorexia. The relative abundance of IRS-2 was considerably higher than that of IRS-1 in hypothalamus of both lean and obese rats. Insulin-stimulated phosphorylation of IR, IRS-1/2, the associations of PI 3-kinase to IRS-1/2 and phosphorylation of Akt in hypothalamus were decreased in obese rats compared to lean rats. These effects seem to be mediated by increased phosphoserine content of IR, IRS-1/2 and decreased protein levels of IRS-1/2 in obese rats. In contrast, insulin stimulated the phosphorylation of MAP kinase equally in lean and obese rats.
    Conclusion/interpretation: This study provides direct measurements of insulin signalling in hypothalamus, and documents selective resistance to insulin signalling in hypothalamus of Zucker rats. These findings provide support for the hypothesis that insulin could have anti-obesity actions mediated by the PI3-kinase pathway, and that impaired insulin signalling in hypothalamus could play a role in the development of obesity in this animal model of insulin-resistance.
    MeSH term(s) Animals ; Blood Glucose/metabolism ; Body Weight ; Hypothalamus/physiopathology ; Injections, Intraventricular ; Insulin/administration & dosage ; Insulin/pharmacology ; Insulin Receptor Substrate Proteins ; Intracellular Signaling Peptides and Proteins ; Male ; Obesity/genetics ; Obesity/physiopathology ; Phosphoproteins/metabolism ; Phosphorylation ; Phosphoserine/metabolism ; Rats ; Rats, Zucker ; Reference Values ; Signal Transduction/physiology
    Chemical Substances Blood Glucose ; Insulin ; Insulin Receptor Substrate Proteins ; Intracellular Signaling Peptides and Proteins ; Irs1 protein, rat ; Irs2 protein, rat ; Phosphoproteins ; Phosphoserine (17885-08-4)
    Language English
    Publishing date 2003-11-05
    Publishing country Germany
    Document type Journal Article
    ZDB-ID 1694-9
    ISSN 1432-0428 ; 0012-186X
    ISSN (online) 1432-0428
    ISSN 0012-186X
    DOI 10.1007/s00125-003-1246-x
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