Abstract

Purpose: To carry out a study of association between socioeconomic and demographic factors and homicides in general population, in the state of Bahia, in 2009. Methods: This is an ecological study. The data were collected from the database of the Information System about Mortality of the Ministry of Health, from the Brazilian Institute of Geography and Statistics and the Institute of Applied Economic Research. The Global Moran index was calculated for the detection of spatial autocorrelation, and the Local Moran index was calculated for the detection of spatial Clusters. The transformation in the variable answer (homicides rates) was performed and it was shaped using the Conditional Autoregressive Model. Results: The data showed spatial autocorrelation. Two clusters of municipalities with high rates of homicides were identified, one located predominantly in the Greater Metropolitan Region of Salvador and the other in the South Region of Bahia, especially Eunápolis and Lauro de Freitas, which had the highest rates. The Average Residents Variables, local GDP and the Percentage of Illiteracy presented an inverse association with homicide rates, and the variables Firjan's municipal development index of work and income. Enrolment in high school and the Average of Bolsa Família were directly associated. Conclusions: The urbanization process, in most cases, not controlled by the State, in most cases, made the cities bigger and with better socioeconomic conditions, attraction centers for people with different socioeconomic levels, increasing the social inequality among the residents of these regions, with parallel increase in homicide rates.

This research explored the integrated effect that several mobility scenarios had on traffic performance, conflicts, global and local pollutants, and emission-related costs on a University Campus. An emphasis was given to the campus parking areas. One of the main contributions of this study was the identification of hotspot in terms of emissions, costs and traffic conflict locations. A well-calibrated and validated modeling platform of traffic, emissions and safety was used to examine different traffic scenarios in the University of Aveiro, Portugal. These included the replacement of traffic lights by roundabouts, direct access to campus and some parking areas, increasing campus walkability and introduction of speed humps on main crosswalks. The analysis was performed both link-by-link and in the overall study area. Mobility scenarios with a new direct access to the campus yielded average reductions up to 9% in both costs and local pollutants (carbon monoxide, nitrogen oxides and hydrocarbons), and 36% and 32% for the number of stops and traffic conflicts, respectively. Nonetheless, additional traffic conflicts can be expected within campus after the implementation of those scenarios compared to the existing situation.

Context.-Almost all cervical cancers are related to the human papillomavirus (HPV). Future strategies for cervical cancer screening will be based on HPV detection. The Hybrid Capture 2 (HC2) test is currently the most widely used method to screen for HPV.Objective.-To test the performance of the Cervista HPV HR test for cervical screening.Design.-We examined 875 cervical samples by HC2 and Cervista. Of these, 64 were high-grade cervical intraepithelial neoplasia (CIN 2þ) cases and were used to test the sensitivity of the assay. The remaining 811 were non-CIN 2þ cases, which were used to compare specificity. The noninferiority score test was used, with at least 0.90 for sensitivity and 0.98 for specificity and with a j value of 0.7.Results.-Sensitivity and specificity were, respectively, 100% and 86.4% for the HC2 test, and 98.4% and 85.2% for the Cervista test. The agreement between the two assays was 91.7% (802 of 875; j ¼ 0.743; 95% confidence interval, 0.688-0.798). The noninferiority score test (relative sensitivity of 90%, T ¼ 2.85, P ¼ .002; and relative specificity of 98%, T ¼ 2.75, P ¼ .003) demonstrated that the Cervista results were not inferior to those of the HC2 test. Intralaboratory and interlaboratory reproducibility was determined by evaluating 513 and 507 samples, respectively. These reproducibilities showed j values of 0.886 (95% confidence interval, 0.845-0.927) and 0.907 (95% confidence interval, 0.886-0.948), respectively.Conclusions.-Our results demonstrate that the Cervista HPV HR test shows the same specificity as the HC2 assay. We therefore conclude that the Cervista HPV HR test is suitable for cervical cancer screening purposes. (Arch Pathol Lab Med. 2015;139:241-244; doi: 10.5858/ arpa.2014-0012-OA) N early all cervical cancers are related to the human papillomavirus (HPV). Persistent cervical infection with certain types of HPV is a prerequisite for the development of cervical cancer through precursor lesion, namely, cervical intraepithelial neoplasia (CIN) 3.1,2 The most important carcinogenic HPV genotypes are HPV16 and HPV18. The detection of high-risk HPV (HR HPV) in cervical samples, together with abnormal cytologic findings, is crucial in cervical cancer screening.3 It is essential to improve screening strategies to avoid unnecessary clinical follow-up, diagnostic procedures, and treatment of healthy women. 4 In Catalonia, the HPV test has been used in the cervical cancer screening protocol since 2006 as a complementary test to cytology in 3 circumstances: atypia on squamous cells of undetermined significance, monitoring after treatment for high-grade CIN (CIN 2þ), and screening of women older than 40 years who have not had a cytologic test in the previous 5 years.Hybrid Capture 2 (HC2; Qiagen, Hilden, Germany) is currently the most widely used HPV method to determine the presence of HR HPV in cytologic samples. It shows greater clinical sensitivity than other methods and acceptable specificity. 5,6 A group of experts in 2009 published recommendations for the validation of n...

Background and Objectives: One of the most frequently mutated oncogenes in cancer belongs to the Ras family of proto-oncogenes, which encode distinct key signaling events. RAS gain-of-function mutations are present in ~30% of all human cancers, with KRAS being the most frequently mutated isoform showing alterations in different cancer types including lung cancer. This study aimed to investigate the incidence of KRAS mutations, and concomitant mutations, in advanced non-small cell lung adenocarcinoma patients. Materials and Methods: This was a retrospective study, where genomic DNA extracted from paraffin-embedded tumor tissues from 121 Brazilian advanced non-small cell lung adenocarcinoma patients were analyzed to evaluate via Next Generation Sequencing (NGS) the incidence of KRAS mutations and co-occurring mutations and correlate, when possible, to clinicopathological characteristics. Statistical analyses were performed to calculate the prevalence of mutations and to investigate the association between mutational status, mutation type, and sex. Results: The results showed a prevalence of male (N = 63; 54.8%) compared to female patients (N = 52, 45.2%), and mutant KRAS was present in 20.86% (24/115) of all samples. Interestingly, 33.3% of the mutant KRAS samples showed other mutations simultaneously. Conclusions: This study revealed the presence of rare KRAS concomitant mutations in advanced lung adenocarcinoma patients. Further investigation on the importance of these genomic alterations in patient prognosis and treatment response is warranted.

This cross-sectional study aimed to analyze the cases of falls in urgent and

Our objective is to describe the differences in the sampling plans of the two editions of the Brazilian National Health Survey (PNS 2013 and 2019) and to evaluate how the changes affected the coefficient of variation (CV) and the design effect (Deff) of some estimated indicators. Variables from different parts of the questionnaire were analyzed to cover proportions with different magnitudes. The prevalence of obesity was included in the analysis since anthropometry measurement in the 2019 survey was performed in a subsample. The value of the point estimate, CV, and the Deff were calculated for each indicator, considering the stratification of the primary sampling units, the weighting of the sampling units, and the clustering effect. The CV and the Deff were lower in the 2019 estimates for most indicators. Concerning the questionnaire indicators of all household members, the Deffs were high and reached values greater than 18 for having a health insurance plan. Regarding the indicators of the individual questionnaire, for the prevalence of obesity, the Deff ranged from 2.7 to 4.2, in 2013, and from 2.7 to 10.2, in 2019. The prevalence of hypertension and diabetes per Federative Unit had a higher CV and lower Deff. Expanding the sample size to meet the diverse health objectives and the high Deff are significant challenges for developing probabilistic household-based national survey. New probabilistic sampling strategies should be considered to reduce costs and clustering effects.

Background: Triple negative breast cancer (TNBC) is characterized rapid tumor growth, and increased metastatic potential compared to other breast cancer subtypes. However, pathological complete response (pCR) to neoadjuvant chemotherapy (NACT) can predict patients with a better prognosis. Clinical predictors of pCR such as tumor size (TS) are controversial. This study aims to evaluate the influence of TS on achieving pCR, and the associated survival outcomes. Methods: Medical records from 310 TNBC patients treated with NACT between 2010 and 2013 in National Cancer Institute Brazil were screened. The aim study was to examine the impact of TS on pCR. We used descriptive statistics to organize and summarize TS data and all the other variables of interest. Logistic regression has done to assess if any of these variables were associated with pCR. Survival data were extrapolated using Kaplan-Meier analysis and log-rank tests. Results: Thirty-nine (21%) of 187 enrolled patients achieved pCR. Median age was 48 years, 50.27% were postmenopausal, 93.03% T3/T4 and 75.39% axillar clinical node-positive; 92.51% received an anthracycline regimen followed by a taxane. Age >40 years (P=0.04, OR 0.45, 95% CI, 0.20-0.95) and tumor infiltrating lymphocytes (TILs) presence (P<0.01, OR 3.71, 95% CI, 1.60-8.60) were factors significantly associated with increased rates of pCR. Neither the TS (IQR: 4; P=0.22, OR 0.93, 95% CI, 0.83-1.03) nor the other subgroups analysed demonstrated any association with achieving pCR. Median follow-up was 36 months. The 5-year OS and RFS of the study population was 71.20% and 61.10% respectively. Conclusions: Preoperative TS did not significantly impact pCR rate in our cohort of patients receiving NACT for TNBC. Characteristics associated with higher pCR rate included TILs and age >40 years. In addition, pCR, was indicative of better survival outcomes.