LIM/05 - Laboratório de Poluição Atmosférica Experimental

URI Permanente desta comunidade

O Laboratório de Poluição Atmosférica Experimental é ligado ao Departamento de Patologia da Faculdade de Medicina da Universidade de São Paulo (FMUSP).

Linhas de pesquisa: patologia pulmonar; poluição atmosférica e seus efeitos sobre a saúde humana; toxicologia ambiental; fisiopatologia da lesão pulmonar aguda; mecânica pulmonar; imunopatologia e remodelamento da asma; patologia da doença pulmonar obstrutiva crônica; epidemiologia ambiental e educação ambiental; patologia pulmonar à autópsia.

Site oficial:http://limhc.fm.usp.br/portal/lim05-laboratorio-de-poluicao-atmosferica-experimental/

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Pulmões
(2022) SALDIVA, Paulo Hilário Nascimento; MAUAD, Thais; DOLHNIKOFF, Marisa; BERNARDI, Fabiola Del Carlo; SILVA, Luiz Fernando Ferraz da; NASCIMENTO, Ellen Caroline Toledo do; CURY, Patrícia Maluf
bookPart
Síndrome inflamatória multissistêmica pediátrica (SIM-P) associada à COVID-19
(2023) DELGADO, Artur Figueiredo; PEREIRA, Maria Fernanda Badue; DOLHNIKOFF, Marisa; DUARTE NETO, Amaro Nunes
bookPart
Doenças tropicais: Leishmaniose visceral
(2022) DUARTE, Maria Irma Seixas; DUARTE NETO, Amaro Nunes
bookPart
Infecção pelo HIV e AIDS
(2022) MILITO, Cristiane Bedran; MORAIS, José Carlos; BARROSO, Paulo Feijó; CHIMELLI, Leila; DUARTE, Maria Irma Seixas; CUZZI, Tullia; PANNAIN, Vera Lucia Nunes; PITTELLA, José Eymard Homem; DUARTE NETO, Amaro Nunes
bookPart
Doenças tropicais: paracoccidioidomicose
(2022) BENARD, Gil; CAVALCANTE, Ricardo de Souza; DUARTE NETO, Amaro Nunes; LOURES, Flávio Vieria; CALICH, Vera Lúcia Garcia
article
Shaping the future rural healthcare landscape: perspectives of young healthcare professionals
(2024) COUPER, Ian; LEDIGA, Manoko; TAKALANI, Ndivhuho; FLOSS, Mayara; YEOH, Alexandra; FERRARA, Alexandra; WHEATLEY, Amber; FEASBY, Lara; SANTANA, Marcela; WANJALA, Mercy; TUKUR, Mustapha; KOTIAN, Sneha; RASIC, Veronika; SHIRINDZA, Vuthlarhi; CHATER, Alan; KOLLER, Theadora
Introduction: Rural communities continue to struggle to access quality healthcare services. Even in countries where the majority of the population live in rural and remote areas, resources are concentrated in big cities, and this is continuing. As a result, countries with the highest proportion of rural residents correlate with the poorest access, which has negative implications for the health and wellbeing of people. Healthcare professionals (HCPs) have been identified as key informants in the construction and implementation of policies aimed at addressing rural health issues. We sought to understand the perspectives of young HCPs, representing the potential future rural workforce, regarding the future of rural health care.
Methods: An interpretivist paradigm was adopted for the study. Data were collected in two phases over Zoom using semi-structured individual interviews and focus group discussions (FGDs). Participants included selected HCPs who are members of Rural Seeds, which is a global movement for young HCPs. A total of 11 exploratory interviews and six FGDs were conducted. The 11 interviewees consisted of medical doctors and medical students from 10 countries classified at different levels of development by the WHO. The six FGDs ranged from three to nine participants, and they included medical doctors and medical students, nurses and rehabilitation therapists. Participants came from South Asia, Africa, Asia-Pacific, North America and Europe, and South America. Both interviews and FGDs were conducted in English, recorded, and transcribed verbatim. Data were analysed utilising thematic analysis.
Results: Similar themes were identified across both individual interviews and FGDs. The state of rural health care was perceived to be problematic by all the participants. Access to care, lack of equity and multiple socioeconomic challenges, particularly in relation to living conditions, human resources and infrastructure, were seen as the most significant issues in rural health care. Several ideas for addressing rural health issues, with examples, were proposed by the young HCPs from their perspectives as frontline healthcare providers. They particularly recognised the importance of addressing the local socioeconomic and developmental needs of rural communities, and the needs of present and future HCPs.
Conclusion: Young health professionals from across the world interested in a rural career have common concerns about the state of rural health in their countries and constructive insights into how these can be addressed. They suggest effective solutions that must include listening to their voices. This article is a step in that direction.
article 0 Citação(ões) na Scopus
Identifying Anterior Cruciate Ligament Injuries Through Automated Video Analysis of In-Game Motion Patterns
(2024) SCHULC, Attila; LEITE, Chilan B. G.; CSAKVARI, Mate; LATTERMANN, Luke; ZGODA, Molly F.; FARINA, Evan M.; LATTERMANN, Christian; TOSER, Zoltan; MERKELY, Gergo
Background: Failure to diagnose anterior cruciate ligament (ACL) injury during a game can delay adequate treatment and increase the risk of further injuries. Artificial intelligence (AI) has the potential to be an accurate, cost-efficient, and readily available diagnostic tool for ACL injury in in-game situations.Purpose: To develop an automated video analysis system that uses AI to identify biomechanical patterns associated with ACL injury and to evaluate whether the system can enhance the ability of orthopaedic and sports medicine specialists to identify ACL injuries on video.Study Design: Descriptive laboratory study.Methods: A total of 91 ACL injury and 38 control movement scenes from online available match recordings were analyzed. The videos were processed to identify and track athletes and to estimate their 3-dimensional (3D) poses. Geometric features, including knee flexion, knee and hip abduction, and foot and hip rotation, were extracted from the athletes' 3D poses. A recurrent neural network algorithm was trained to classify ACL injury, using these engineered features as its input. Analysis by 2 orthopaedic surgeons examined whether providing clinical experts with the reconstructed 3D poses and their derived signals could increase their diagnostic accuracy.Results: All AI models performed significantly better than chance. The best model, which used the long short-term memory network with engineered features, demonstrated decision interpretability and good performance (F1 score = 0.63 +/- 0.01, area under the receiver operating characteristic curve = 0.88 +/- 0.01). The analysis by the 2 orthopaedic surgeons demonstrated improved diagnostic accuracy for ACL injury recognition when provided with system data, resulting in a 0.08 increase in combined F1 scores.Conclusion: Our approach successfully reconstructed the 3D motion of athletes from a single-camera view and derived geometry-based biomechanical features from pose sequences. Our trained AI model was able to automatically detect ACL injuries with relatively good performance and prelabel and highlight regions of interest in video footage.Clinical Relevance: This study demonstrated the feasibility of using AI to automatically evaluate in-game video footage and identify dangerous motion patterns. Further research can explore the full potential of the biomechanical markers and use of the system by nonspecialists, potentially diminishing the rate of missed diagnosis and the detrimental outcomes that follow.
article 0 Citação(ões) na Scopus
Methotrexate for refractory adult atopic dermatitis leads to alterations in cutaneous IL-31 and IL-31RA expression
(2024) SAMORANO, Luciana Paula; MANFRERE, Kelly Cristina Gomes; PEREIRA, Naiura Vieira; TAKAOKA, Roberto; VALENTE, Neusa Yuriko Sakai; SOTTO, Mirian Nacagami; SILVA, Luiz Fernando Ferraz; SATO, Maria Notomi; AOKI, Valeria
Background: Methotrexate (MTX) is an alternative treatment for patients with moderate/severe atopic dermatitis (AD). Objective: The authors evaluated the effect of MTX on the cutaneous expression of cytokines and chemokines that are involved in the inflammatory response in adult AD patients who received treatment with methotrexate for 24 weeks. Methods: The authors conducted a prospective single-institution cohort study with 12 adults with moderate/severe AD who received oral MTX (15 mg/wk for 24 wks) and 10 non-atopic matched controls. The comparison was made of skin biopsies of lesional and non-lesional skin, pre- and post MTX treatment. The authors analyzed mean epidermal thickness and expression of IL-31, IL-31RA, OSMR, TSLP, Ki67, IL-4 mRNA, IL-6, IL-10, TNF-alpha, IFN-gamma, TARC, and CCL-22. Results: There was a reduction in mean epidermal thickness (p = 0.021), an increase in IL-31RA expression (immunohistochemistry) in the epidermis (p = 0.016) and a decrease in IL-31 gene expression (p = 0.019) on lesional AD skin post-MTX treatment. No significant changes in the cutaneous expression of the other evaluated markers were identified. Study limitations: Small sample size and limited length of follow-up. Conclusions: Treatment with MTX in adults with moderate/severe AD reduced epidermal hyperplasia and changed the cutaneous expression of inflammatory cytokines and receptors that are mainly related to pruritus, including IL-31 and IL-31RA. (c) 2023 Published by Elsevier Espana, S.L.U. on behalf of Sociedade Brasileira de Dermatologia. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
article 0 Citação(ões) na Scopus
Association of pulmonary black carbon accumulation with cardiac fibrosis in residents of Sao Paulo, Brazil
(2024) TAKANO, Ana Paula Cremasco; ANDRE, Carmen Diva Saldiva de; ALMEIDA, Raquel de; WAKED, Dunia; VERAS, Mariana Matera; SALDIVA, Paulo Hilario Nascimento
Evidence suggests that myocardial interstitial fibrosis, resulting from cardiac remodeling, may possibly be influenced by mechanisms activated through the inhalation of airborne pollutants. However, limited studies have explored the relationship between lifetime exposure to carbon-based particles and cardiac fibrosis, specially using post -mortem samples. This study examined whether long -term exposure to air pollution (estimated by black carbon accumulated in the lungs) is associated with myocardial fibrosis in urban dwellers of megacity of Sao Paulo. Data collection included epidemiological and autopsy-based approaches. Information was obtained by interviewing the next of kin and through the pathologist's report. The individual index of exposure to carbonbased particles, which we designed as the fraction of black carbon (FBC), was estimated through quantification of particles on the macroscopic lung surface. Myocardium samples were collected for histopathological analysis to evaluate the fraction of cardiac fibrosis. The association between cardiac fibrosis and FBC, age, sex, smoking status and hypertension was assessed by means of multiple linear regression models. Our study demonstrated that the association of FBC with cardiac fibrosis is influenced by smoking status and hypertension. Among hypertensive individuals, the cardiac fibrosis fraction tended to increase with the increase of the FBC in both groups of smokers and non-smokers. In non-hypertensive individuals, the association between cardiac fibrosis fraction and FBC was observed primarily in smokers. Long -term exposure to tobacco smoke and environmental particles may contribute to the cardiac remodeling response in individuals with pre-existing hypertension. This highlights the importance of considering hypertension as an additional risk factor for the health effects of air pollution on the cardiovascular system. Moreover, the study endorses the role of autopsy to investigate the effects of urban environment and personal habits in determining human disease.
article 1 Citação(ões) na Scopus
Maternal greenness exposure and preterm birth in Brazil: A nationwide birth cohort study*
(2024) YE, Tingting; XU, Rongbin; ABRAMSON, Michael J.; GUO, Yuming; ZHANG, Yiwen; SALDIVA, Paulo H. N.; COELHO, Micheline S. Z. S.; LI, Shanshan
In the dynamic landscape of maternal and child health, understanding the intricate interplay between environmental factors and pregnancy outcomes is of paramount importance. This study investigates the relationship between maternal greenness exposure and preterm births in Brazil using data spanning from 2010 to 2019. Satellite-derived indices, including the Normalized Difference Vegetation Index (NDVI) and Enhanced Vegetation Index (EVI), were employed to assess greenness exposure during whole pregnancy in maternal residential area. Employing Cox proportional hazard models, we calculated the hazard ratios (HRs) with 95% confidence intervals (CIs) for changes in NDVI, while adjusting for individual and area-level covariates. In total, 24,010,250 live births were included. Prevalence of preterm birth was 11.5%, with a modest but statistically significant decreasing trend (p = 0.013) observed across the nation over the study period. The findings reveal a significant association between greenness exposure and a reduced risk of preterm birth. Specifically, for every 0.1 increase in NDVI, there was a 2.0% decrease in the risk of preterm birth (95%CI: 1.9%-2.2%). Stratified analyses based on maternal education and ethnicity indicated potential effect modifications, with stronger protective effects observed among younger mothers and those with less years of education. Sensitivity analyses using EVI yielded consistent results. In conclusion, this study suggests that higher maternal greenness exposure is linked to a decreased risk of preterm birth in Brazil. These findings imply that enhancing residential greenspaces could be a valuable public health strategy to promote maternal and child health in Brazil.