Pontifícia Universidade Católica do Paraná (PUC-PR)
Recent publications
Diabetic kidney disease (DKD) remains the leading cause of chronic kidney disease (CKD) worldwide. The pathogenesis of DKD is influenced by functional, histopathological, and immune mechanisms, including NLRP3 inflammasome activity and oxidative stress. The sodium-glucose cotransporter 2 inhibitors (SGLT2i) have shown metabolic benefits and the ability to slow the progression of DKD in several clinical studies over the years. Recent studies suggest that the antidiabetic activity also extends to inhibition of the inflammatory response, including modulation of the NLRP3 inflammasome, reduction of pro-inflammatory markers and reduction of oxidative stress. Here we review the efficacy of SGLT2i in the treatment of CKD and discuss the role of the inflammatory response in the development of DKD, including its relationship to the NLRP3 inflammasome and oxidative stress.
The presence of moisture in buildings can lead to pathological manifestations, and the behavior of materials when exposed to various conditions can be predicted through computational simulations. For this purpose, the hygrothermal characteristics of building elements are paramount. In Brazil, there is a gap in studies on the hygrothermal properties of materials, compromising simulations. This article discusses the possibilities of using European data in simulating moisture transport in ceramic brick walls in the southern region of Rio Grande do Sul, Brazil. The results were generated by comparing hygrothermal simulations with WUFI Pro 6.5 using the simulation program database with data collected from laboratory tests on ceramic bricks from a southern Brazilian brickyard. Tests for water vapor diffusion resistance, water absorption, and hygroscopic curves were conducted. Although both situations led to the growth of filamentous fungi, experimental data led to3% lower values compared to database results. Regarding surface condensation, a likely higher occurrence was observed when using laboratory test data.
This study investigates the relationship between transportation modes and adolescent mental health, employing a natural experiment design to longitudinally track Brazilian high-school students amid the COVID-19 pandemic disruptions. We surveyed 213 students in the city of Curitiba during and after the COVID-19 lockdown period using the Depression, Anxiety, and Stress Scale (DASS-21) combined with a socioeconomic questionnaire. To analyze changes in DASS between these two times we used the paired-sample T-test, exploring association with school commuting modes through binomial logistic regression models. The use of public transportation emerges as a significant factor associated with a threefold odds of increasing depression levels among students (OR = 3.08). This likelihood nearly quadrupled (OR = 3.81) when considering students living 5 km or more from school. These findings unveil public transportation and home-school distance as critical factors in the development of depression among adolescents. For example, individuals who commute via individual motorized transportation demonstrate a markedly lower likelihood of experiencing depression, pointing to broader societal and environmental factors such as family income and access to opportunities. Despite appearing contradictory to the commonly understood impacts of car use on mental health, this observation may unveil overlapping layers of spatial inequality and underscore the nuanced dynamics between transportation modes and adolescent mental well-being.
  • Alexandre Camilotti Gasperin
    Alexandre Camilotti Gasperin
  • Bruna Timm Monteiro
    Bruna Timm Monteiro
  • Ellen Paula Schetz Zawierucha
    Ellen Paula Schetz Zawierucha
  • [...]
  • Pedro Henrique Vicari Passos
    Pedro Henrique Vicari Passos
We aimed to test the association between sleep-related polygenic scores (PGSs) and accelerometer-based sleep metrics among Brazilian adolescents, and to evaluate potential mechanisms underlying the association through the enrichment of obesity, and cortisol pathway-specific polygenic scores (PRSet). Utilizing data from The 2004 Pelotas (Brazil) Birth Cohort, sleep time window and sleep efficiency were measured at the 11-year-old follow-up using ActiGraph accelerometers. Three sleep-PGSs were developed based on the most recent genome-wide association study (GWAS) of accelerometer-based sleep measures. PRSet, calculated using variants linked to body mass index (BMI) and plasmatic cortisol concentration, aimed to assess pleiotropic effects. Linear regression models, adjusted for sex and the first 10 principal components of ancestry, were employed to explore the impact of sleep-PGS and specific-PRSet on sleep phenotypes. The number of nocturnal sleep episodes-PGS was positively associated with sleep time window (β =2.306, SE: 0.92, p=0.011). Nocturnal sleep episodes were also associated with sleep time window when restricted to BMI-PRSet (β=2.682, SE: 0.912, competitive-p=0.003). Both number of sleep episodes and sleep time window cortisol-PRSets were associated (β=0.002, SE: 0.001, p=0.013; β=0.003, SE: 0.001, p=0.003, respectively) and exhibited enrichment in molecular pathways (competitive-p=0.011; competitive-p=0.003, respectively) with sleep efficiency. Sleep polygenetic components observed in European adults may partially explain accelerometer-based sleep time window in Brazilian adolescents. Specific BMI molecular pathway strengthened the association between sleep-PGS and sleep time window, while cortisol concentration pathway had a significant impact on the genetic liability for sleep efficiency. Our results suggest genetic overlap as a potential etiological pathway for sleep-related comorbidities, emphasizing common genetic mechanisms.
Resumo Pacientes com doença arterial periférica e aterosclerose generalizada apresentam alto risco de complicações cardiovasculares e nos membros, o que afeta sua qualidade de vida e longevidade. A doença aterosclerótica das extremidades inferiores está associada à alta morbimortalidade cardiovascular, sendo necessário para sua adequada terapia realizar o tratamento dos fatores dependentes do paciente, como a modificação no estilo de vida, e dos fatores dependentes do médico, como o tratamento clínico, tratamento endovascular ou cirurgia convencional. A abordagem médica para a doença arterial periférica é multifacetada, e inclui como principais medidas a redução do nível do colesterol, a terapia antitrombótica, o controle da pressão arterial e do diabetes e a cessação do tabagismo. A adesão a esse regime pode reduzir as complicações relacionadas aos membros, como a isquemia crônica que ameaça o membro e pode levar à sua amputação, e as complicações sistêmicas da aterosclerose, como o acidente vascular cerebral e infarto do miocárdio.
Patients with peripheral artery disease and generalized atherosclerosis are at high risk of cardiovascular and limb complications, affecting both quality of life and longevity. Lower limb atherosclerotic disease is associated with high cardiovascular morbidity and mortality and adequate management is founded on treatments involving patient-dependent factors, such as lifestyle changes, and physician-dependent factors, such as clinical treatment, endovascular treatment, or conventional surgery. Medical management of peripheral artery disease is multifaceted, and its most important elements are reduction of cholesterol level, antithrombotic therapy, control of arterial blood pressure, control of diabetes, and smoking cessation. Adhesion to this regime can reduce complications related to the limbs, such as chronic limb-threatening ischemia, that can result in amputation, and the systemic complications of atherosclerosis, such as stroke and myocardial infarction.
Fewer donations are being made in Brazil to meet the growing organ demand. Organ donation in Brazil reached an average of 53% consent. However, hospitals in Paraná have reached a level of 94.2%. What reasons could be given for these levels? Accordingly, this study aimed to understand the causes involved in decision-making to donate organs. The methodology used was qualitative based on a case study. Data was collected at a hospital in Toledo, a city in Paraná, through documentary research and semi-structured interviews with two distinct groups: professionals responsible for the family approach to donation and five families consenting to donation. The search for data was restricted to the period between 2015 and 2023. Data analysis used Bardin's content analysis. The results were organized into four categories in the first group, and two categories in the second group, suggesting that aspects linked to bioethical references present in the interview, such as beneficence and autonomy, contribute to the emergence of high rates of family consent for organ donation in the hospital studied. It is recommended for future research to test successful interview models to reverse the current organ donation rates in Brazil.
Introduction This study explores how territorial variables and municipal fiscal capacity influence legislative initiatives and the allocation of distributive policies by City Councils in four selected cities within the Curitiba Metropolitan Region. We investigate whether there exists a correlation between distributive legislative initiatives introduced by city council members and the socioeconomic, demographic, and fiscal characteristics of these cities. Materials and methods We analyzed various types of legislative initiatives, including motions, requests, and bills introduced by city council members, categorizing them as either distributive or non-distributive. We also examined geographic, demographic, socioeconomic, and fiscal data for the cities of Mandirituba, São José dos Pinhais, Fazenda Rio Grande, and Campo Largo. Using a comparative case study approach, descriptive statistics, and correlation analysis, we assessed the relationship between municipal and legislative variables from 2012 to 2019. Results Our findings indicate that fiscal capacity and territorial characteristics can influence political behavior and municipal legislative output. Specifically, city councilors from Mandirituba - a less urbanized city with poorer socioeconomic indicators and lower fiscal capacity - proposed more distributive policies compared to the more urbanized cities of São José dos Pinhais, Fazenda Rio Grande, and Campo Largo, which have better indicators and greater fiscal capacity. Discussion Our findings offer complementing insights to the existing literature into why we find variations in distributive policy initiatives. Beyond electoral connections, the allocation of these policies appears related to socioeconomic and fiscal development, demographic characteristics, and the specific needs and demands of the municipalities. Our study reinforces the importance of including territorial factors in analyses of political behavior and public policy outcomes. Keywords public policies; distributive policies; pork barrel; legislative behavior; city councilors
Highly pathogenic Burkholderia pseudomallei is the causative agent of melioidosis, a neglected tropical disease endemic in Southeast Asian tropical region. This bacterium encompasses diverse virulence factors which further undergo dynamic gene-expression flux as it transits through distinct environmental niches within the host which may lead to manifestation of differential clinical symptoms. B. pseudomallei, is classified as a Tier 1 select agent in the United States and regarded as a risk group 3 organism in India with the potential to be used as bioweapon. Considering these facts, it is vital to uncover both physiological and genetic heterogeneity of B. pseudomallei, particularly to identify any novel virulence factors that may contribute to pathogenicity. B. pseudomallei strain CM000113 was isolated from a clinical case in India, characterized it for its physiological, biochemical, and prominently genetic traits through WGS. It has a type 2 morphotype with faster doubling time and high biofilm producing capacity as compared to Pseudomonas aeruginosa. The genome size is 7.3 Mbp and it is phylogenetically close to B. pseudomallei strain Mahidol 1106a and Burkholderia mallei Turkey 2. We observed genetic heterogeneity, as key virulence factors that were identified shows sequence dissimilarity with reference strains. Additionally, presence of genomic islands, harbouring two virulence factors, GmhA and GmhB2, associated with pathogenesis indicates possibility of horizontal gene transfer. These results emphasize the need for an extensive study focusing the genome of B. pseudomallei and its associated heterogeneity, to identify molecular biomarkers aiding to develop point-of-care diagnostic kits for early diagnosis of melioidosis.
Objective To evaluate vaccination coverage and delay in vaccine dose administration in infants in six municipalities in the Southern region of Brazil. Methodology National Vaccination Coverage Survey 2020, with infants born alive in 2017 and 2018, carried out from September 2020 to March 2022. Coverage of doses administered, doses administered on time and delay in dose administration were evaluated. Results For 4681 infants analyzed, coverage for vaccines recommended up to 24 months was 68.0% (95%CI 63.9;71.8%) for doses administered and 3.9% (95%CI 2.7%;5.7%) for doses administered on time. Delay time for the majority of late vaccinations was ≤ 3 months. For some boosters, 25% of vaccine administration was delayed by ≥ 6 months. Conclusion In addition to tracking vaccine defaulters, strategies are needed to encourage compliance with the vaccination schedule at the recommended ages. Keywords Vaccination Coverage; Vaccines; Health Surveys; Vaccination Hesitancy; Vaccination Delay
Despite significant investments in server infrastructure, spam continues to pose several challenges to the email ecosystem. These include ineffective detection and waste of computing resources. The constant need for periodic updates of spam detection model algorithms often contributes to these challenges. This paper proposes a reliable spam detection model that accounts for the dynamic nature of spam messages, which exhibit non-stationary behavior over time. The proposal is implemented in twofold. First, a shallow classifier selectively accepts only reliably classified spam messages to achieve a high detection rate. Second, unreliable classifications are forwarded to a deep-learning classifier. This ensures both reliability and high detection throughput. Experiments conducted on a novel dataset with 1.8 million real and valid spam messages collected over a decade demonstrate several key results: (i) the reliability of the model improves over time, (ii) autonomous identification of outdated models without human intervention, and (iii) the maintenance of high classification throughput.
Objective To evaluate vaccination coverage and delay in vaccine dose administration in infants in six municipalities in the Southern region of Brazil. Methodology National Vaccination Coverage Survey 2020, with infants born alive in 2017 and 2018, carried out from September 2020 to March 2022. Coverage of doses administered, doses administered on time and delay in dose administration were evaluated. Results For 4681 infants analyzed, coverage for vaccines recommended up to 24 months was 68.0% (95%CI 63.9;71.8%) for doses administered and 3.9% (95%CI 2.7%;5.7%) for doses administered on time. Delay time for the majority of late vaccinations was ≤ 3 months. For some boosters, 25% of vaccine administration was delayed by ≥ 6 months. Conclusion In addition to tracking vaccine defaulters, strategies are needed to encourage compliance with the vaccination schedule at the recommended ages. Keywords Vaccination Coverage; Vaccines; Health Surveys; Vaccination Hesitancy; Vaccination Delay
Background The Brazilian supplementary health market has undergone transformations in recent years due to constant mergers and acquisitions of by large corporations, contributing to the increase in market concentration, especially in the poorest and least developed regions of the country. Thus, given the care it provides and its economic relevance, understanding the fundamentals of these movements, the likely consequences and trends for the health market are relevant, important, and strategic. Objective To understand the general and specific context of Brazilian supplementary health, its scenarios, and trends, with emphasis on the analysis of market concentration and recent mergers and acquisitions. Methodology The research is applied, descriptive and exploratory and uses secondary data from various sources, submitted to quantitative data analysis methods. The data are organized into three groups: historical and regulatory documents; industry data; and market. Results The results show the growing concentration of the market promoted by large publicly traded corporations, the growing relevance of tech startups on the healthcare landscape, the predominant use of the relative valuation model, with implicit multiples for asset pricing and the prevalence of corporate health plans. Conclusion The growing concentration of the system projects a market with fewer options and less competitiveness, since the growth of large operators is evident, in addition to the relevant increase in the number of complaints from users of the system, which signals the growing gap between the expectations of users and the levels of quality care offered. The study also highlights the predominance of corporate health plans, revealing the direct relationship between access to supplementary health services and employability rates. The analysis of M&A operations, in addition to the increase in market concentration, reveals the prevalence of the use of the relative valuation model and implicit multiples for the pricing of traded assets. This denotes the future expectation of wealth generation, at least equivalent to the historical series of the sector, on the part of investors, whose frustration may signal the decreasing attractiveness of resources and M&A operations in the sector in the coming years.
Background Hyperphosphatemia is associated with poor outcome and is still very common in peritoneal dialysis (PD) patients. Since peritoneal phosphate clearance is closer to peritoneal creatinine clearance than urea clearance, we hypothesized that weekly creatinine clearance (CrCl) could be a better marker of serum phosphate in PD. Methods In a retrospective observational study, data from adult PD patients were collected across five institutions in North and South America: LATAM, RRI, Mount Sinai Hospital, Hospital Civil de Guadalajara, and the BRAZPD cohort. All centers analyzed routinely available laboratory data, with exclusions for missing data on serum phosphate, CrCl, or urea Kt/V. A unified statistical protocol was employed across centers. Linear mixed-effect models examined associations between longitudinal serum phosphate levels, CrCl, and Kt/V. Adjustments were made for age, gender, and baseline phosphate binder usage. Mixed-effects meta-analysis determined the pooled effect size of CrCl and Kt/V on serum phosphate trajectories, adjusted for confounders. Results There were 16,796 incident PD patients analyzed. Age, BMI, gender, PD modality, Kt/V and CrCl as well as serum phosphate varied significantly across the different cohorts, but >70% had residual renal function. For most cohorts, both CrCltotal and urea Kt/V associated negatively with serum phosphorus levels, and log-likelihood ratio tests demonstrate that models including CrCltotal have more predictive information than those including only urea Kt/V for the largest cohorts. Models including CrCltotal increase information predicting longitudinal serum phosphate levels irrespective of baseline urea Kt/V, age, use of phosphorus binder, and gender. Conclusions CrCl was not more accurate in predicting serum phosphate than urea Kt/V, but its inclusion in multivariable models predicting serum phosphate added accuracy. In conclusion, both creatinine clearance and Kt/V are associated with phosphate levels, and using both biomarkers, instead of just one, may better assist in the optimization of serum phosphate levels.
This study explores the potential of vancomycin-impregnated polylactic acid (V-PLA) as a novel biomaterial for orthopedic applications. V-PLA combines the biocompatibility of PLA with the antimicrobial properties of vancomycin, making it a promising candidate for managing orthopedic infections. We conducted a comprehensive assessment of V-PLA, including macroscopic characterization, biomechanical analysis, vancomycin release profiles, antimicrobial activity and antibiofilm effects on Staphylococcus aureus ATCCTM 25923. Filaments of V-PLA were manufactured by combining PLA pellets with vancomycin via extrusion and models produced by 3D printer. A biocompatibility test involved the insertion of PLA into a mouse calvaria model to evaluate the inflammatory response. Our results indicate that V-PLA exhibits a distinct macroscopic appearance and sustained vancomycin release over 28 days, surpassing minimal inhibitory concentrations for most Staphylococcus aureus strains. Moreover, V-PLA demonstrated the ability to prevent biofilm formation, a critical concern in orthopedic implant-related infections. While mechanical strength is identified as a limitation in certain applications, V-PLA's suitability varies depending on the clinical context. The V-PLA was biocompatible with a fibrous capsule similar to other prosthetic implants. This study sheds light on the potential of V-PLA for orthopedic spacers and implants, offering clinicians an innovative approach to infection management. Future research may explore its use in specific anatomical locations and clinical scenarios, advancing the field of orthopedic biomaterials. Keywords: Fused Deposition Modeling; impregnation; biomaterial; infection; antibiotics.
Introduction The long pathway that the canines take as they emerge into the maxillary arch makes them vulnerable to disruption during their natural emergence time. The process of planning treatment for impacted maxillary canine (IMC) presents significant challenges, underscoring the need for careful consideration and expertise. Objective The aim of this article was to shed light on these complexities by discussing clinical case studies involving IMC, providing insights into the intricacies of their management. Conclusions The management of IMC within orthodontics presents a multifaceted challenge that include the necessity for precise diagnostic processes, prudent use of cone beam computed tomography (CBCT), the strategic selection between open and closed exposure techniques, a in-depth understanding of the specific orthodontic biomechanics involved, and a keen awareness of potential adverse outcomes such as ankylosis, prolonged treatment times, root resorption, and additional complications. Keywords: Impacted maxillary canine; Diagnosis; Biomechanics
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2,845 members
Edvaldo Antonio Ribeiro Rosa
  • Xenobiotics Research Unit
Renata Ernlund Freitas Macedo
  • School of Life Sciences
Thiago Rocha da Cunha
  • Program in Bioethics
Gervasio Henrique Bechara
  • Graduate Program in Animal Science
Alex Antonio Ferraresi
  • Business School - PPGCOOP
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Curitiba, Brazil