3.178 AMICOR (26)

 3.178 AMICOR (26)  

#Com Dra. Valderês A. Robinson Achutti (*13/06/1931+15/06/2021)

Le Lac de Côme em 10 de maio de 1999

#Re-Publicando artigos antigos meus

ESTENDENDO A OPINIÃO (escrito em 2007)

Nos anos 80, quando a saudosa jornalista Eunice Jacques era editora de OPINIÃO da Zero Hora, comecei a enviar artigos para publicação, inicialmente a propósito de uma reunião nacional da SBPC que se realizava em Porto Alegre, e eu coordenava temas de Saúde Pública e Epidemiologia. A receptividade da editora e seu exemplo me empolgaram, resultando na continuidade das crônicas a propósito de temas de atualidade e, obviamente, na dependência da inspiração.

Bem no início, durante uma viagem de avião, conversando sobre o assunto com Moacyr Scliar, ele (com sua maestria) deu-me um conselho muito importante: “procurar ser conciso, e colocar o que pensas numa só lauda, porque espaço em jornal é muito importante (é dinheiro), e a aceitação de um artigo depende também de seu tamanho”. 

Penso que não somente para publicação em jornal, para qualquer exposição de idéias, a concisão é uma virtude essencial para não perder a atenção do leitor ou do ouvinte. O que não se consegue colocar numa lauda, precisa de um livro inteiro e de um interesse muito especial do leitor para consultá-lo.

Também aprendi que quando se transmite qualquer mensagem (seja escrita, verbal ou musical) o cérebro do interlocutor continua trabalhando e, estimulado pelo que vai captando, mobiliza sua memória e capacidade de criação. O prazer de ouvir depende da compatibilidade do que chega com o conteúdo já existente. Como dizia Thomas K. Simpson (americano, filósofo da ciência), o ouvinte antecipa em sua mente a próxima nota quando ouve o intérprete, e o acerto lhe dá prazer. Dizer tudo pressupõe um ouvinte passivo, mas é preferível dar partida ao assunto e estimular sua criatividade comprometendo-o com a ideia apresentada.

É impossível separar a origem da inspiração após 55 anos (em 2006) de convívio com minha esposa, Valderês A. Robinson Achutti, além de sua eficiente função de revisora e conselheira. Também nossos filhos (Luiz Eduardo, Ana Lúcia e Lúcia Helena), em muitas ocasiões, contribuíram para vários textos, seja a partir de acaloradas discussões em família, seja na opinião pessoal com o texto quase concluído.   

Pretendo aproveitar muitos dos artigos publicados e outros que não foram aproveitados, ou foram publicados em outros veículos. Como cada vez mais a comunicação e a leitura estão trocando o papel pelos meios eletrônicos, presumimos que o interesse do leitor possa se estender, e tolere mais algumas linhas, à guisa de atualização, e comentário da releitura. 

#Novo Livro de Dr. Aristóteles Alencar publicado

A obra não é somente o retrato local da propaganda profissional. A partir desse pretexto, o autor revisa a história da medicina, seus recursos técnico-científicos disponíveis, bem como a evolução de implicações ético-profissionais universais

A obra “Reclames Médicos na Manaus Antiga”, do acadêmico Aristóteles Alencar, reúne a história de anúncios de propagandas médicas sob o ponto de vista da ética médica, um trabalho de pesquisa dos mais interessantes, sob nova temática, através de pesquisas realizadas no objetivo de familiarizar o leitor com os profissionais assim como eram as propagandas de medicamentos e alguns produtos destinados à saúde humana no final do Século XIX e começo do Século XX no estado do Amazonas.  (do Portal Amazonense A Crítica)

#

QUANTUM PHYSICS | ALL TOPICS   Eternal Quantum Stability Runs Into Trouble By CHARLIE WOOD A series of advances seemed to promise the impossible: the existence of quantum states that would never, ever fall into disarray. But physicists are now discovering that the pull of disorder may not be so easily overcome. Read the article DYNAMICAL SYSTEMS   ‘Entropy Bagels’ and Other Complex Structures Emerge From Simple Rules By JORDANA CEPELEWICZ Simple rules in simple settings continue to puzzle mathematicians, even as they devise intricate tools to analyze them. Read the blog Related:  The Quest to Decode the Mandelbrot Set By Jordana Cepelewicz THE JOY OF WHY   What Is the Nature of Time? Podcast hosted by STEVEN STROGATZ Time is all around us: in the language we use, in the memories we revisit and in our predictions of the future. But what exactly is it? The physicist and Nobel laureate Frank Wilczek joins Steve Strogatz to discuss the fundamental hallmarks of time. Listen to the podcast Read the transcript   NATURAL LANGUAGE PROCESSING   How Selective Forgetting Can Help AI Learn Better By AMOS ZEEBERG Erasing key information during training results in machine learning models that can learn new languages faster and more easily. Read the blog Related:  Tiny Language Models Come of Age By Ben Brubaker (2023) EVOLUTION   Mollusk Eyes Reveal How Future Evolution Depends on the Past By VIVIANE CALLIER The visual systems of an obscure group of mollusks provide a rare natural example of path-dependent evolution, in which a critical fork in the creatures’ past determined their evolutionary futures. Read the blog

Each week Quanta Magazine explains one of the most important ideas driving modern research. This week, senior math writer Jordana Cepelewicz describes the mathematical utility of studying how shapes “tile” the plane.   The Deep Math of Tiling By JORDANA CEPELEWICZ     Tilings are all around us. These geometric patterns — arrangements of interlocking shapes that cover a flat surface — appear in ancient mosaics and M.C. Escher drawings, in decorative wallpaper and bathroom floor designs. They also crop up in nature, in the structure of honeycombs, of snakes’ skin, of rock formations.     Mathematicians have been captivated by such patterns, which they also call tessellations, for millennia. The central question they want to answer is a simple one: Can a given set of shapes “tile” the infinite 2D plane, filling the entire space without gaps or overlaps? Squares can; regular pentagons cannot. It turns out that the general version of this problem is maddeningly difficult — what theoretical computer scientists call “undecidable.” It’s impossible to write an algorithm to determine the answer for all possible sets of tiles.     And so rather than trying to study tiling problems this way, mathematicians have set their sights on individual patterns, testing — often through trial and error — what might happen when they play with different shapes and different rules. To do so, they’ve had to wander through the mathematical kingdom, from geometry and topology to algebra and number theory. They’ve had to reckon with the infinite, and with surprising kinds of symmetry. And they’ve had to push up against the limits of human intuition. (As a mathematician once remarked to me, “You want to understand the structure of tilings. How crazy can they get?”)     These are only some of the reasons mathematicians find tilings so compelling. Here’s another: It’s one of those rare areas of mathematical study where there is room for amateurs and hobbyists. Many nonprofessionals have made major advances, including Robert Ammann, a mail sorter; David Smith, a retired print technician; and Marjorie Rice, a California housewife. In a field known for its technical jargon and high barrier to entry, the study of tilings is an important exception, reminiscent of an older era of mathematics. Which is not to say that it’s easy.     Recently, though, there’s been a flurry of exciting progress by mathematicians and nonmathematicians alike — culminating in the unexpected discovery of a very special tile.  What’s New and Noteworthy     Mathematicians have historically sought answers to several questions about tilings. First: What’s possible, and what’s not? Some shapes simply cannot tile the plane, no matter how hard you try to wedge them together. But stretch or squish them a little, making the shape’s outline just a bit more irregular, and you might succeed.     Similarly, there are lots of different ways you might try to tile the plane using a given set of shapes. You can cover a surface with squares, for instance, by simply placing copies of a square tile next to one another in rows and columns. But if you’re using triangles, this won’t work; you’ll also have to rotate some of the tiles.     Both squares and triangles can form periodic tilings — tessellations built from a repeating pattern. But mathematicians are also interested in aperiodic tilings, which lack a globally repeating pattern (and can never be rearranged into something periodic). Those are much harder to find. The first aperiodic tiling, discovered in the 1960s, relied on an arrangement of a whopping 20,426 different tiles. Mathematicians immediately wanted to knock that number down. In the mid-1970s, Roger Penrose found two tiles that create an aperiodic pattern. (His aperiodic tilings have figured in research on naturally occurring “quasicrystal” structures, and in recent work by physicists on quantum error-correcting codes.)     But for decades, mathematicians couldn’t find a single-tile solution. They found some workarounds. In 2010, Joshua Socolar, a physics professor at Duke University, and Joan Taylor, an amateur mathematician in Tasmania, designed a single disconnected tile that could be shifted, rotated and flipped to cover the 2D plane aperiodically. In 2022, I wrote about the similar discovery of an immensely complicated tile that tiles higher-dimensional space aperiodically without having to be rotated or reflected.     Then, last year, an eclectic team — Smith, the retired print technician, along with a mathematician, a computer scientist and a software engineer — announced that they had finally found an “einstein,” a single connected shape capable of aperiodically tiling the 2D plane. (In German, ein stein means “one brick” or “block.”) The group discovered a whole family of such tiles. Where once mathematicians wondered if an einstein could exist at all, now they know of infinitely many such shapes.     This finding will not put an end to the search for novel tiles and tilings. There are still new patterns to uncover, new questions to answer — whether there are broader properties that all einstein tiles share, for instance — and new geometric boundaries to probe.      AROUND THE WEB Scientific American published a first-person account of the discovery of the einstein tile earlier this year. The Guardian ran a puzzle column that featured tiling-related problems in February 2019. The Numberphile channel on YouTube detailed the importance of Penrose tilings in a 2012 video.

#IHME As the world ages, unpaid caregiving demand will grow As the global population ages, the prevalence of dementia is rising, leading to an increased demand for caregiving, write IHME Managing Research Scientist Amy Lastuka and Researcher Michael Breshock in the new Acting on Data insights blog. With a declining birth rate in the US, future caregivers will likely face greater demands on their time. Providing unpaid care has tangible costs, such as out-of-pocket expenses and forgone wages, alongside intangible impacts like stress and depression. Current estimates of forgone wages for dementia caregivers often oversimplify, assuming uniform impacts across all caregivers, masking important differences among subgroups. A study found that only 12% of caregivers in their dataset reduced work hours or quit their jobs due to caregiving responsibilities, emphasizing the need for nuanced understanding and measurement of caregiving impacts. Read the story Top Stories US Indigenous populations face highest liver cancer mortality rates A new study examines liver cancer rates, which varied among racial and ethnic groups in the US from 2000 to 2019, with American Indian and Alaska Native populations experiencing the highest mortality. Despite recent stabilization, disparities persist, especially for minorities, highlighting issues with access to health care. Read the research→ “Expose yourself to a lot of quantitative things and learn to code if you can” IHME Research Assistant Professor Angela Apeagyei shares her experience working in global health economics focused on tracking financial resources and gives advice for both life and career in academia. Read the interview→ IHME in the News South Korea’s fertility rate sinks to record low despite $270bn in incentives (The Guardian) » If the low fertility rate persists, the population of Asia’s fifth-biggest economy is projected to almost halve to 26.8 million by 2100, according to the Institute for Health Metrics and Evaluation at the University of Washington in Seattle. Global Challenge: Underreporting and Misclassification of Suicide Deaths (BNN Breaking) » Efforts by the WHO and IHME to reclassify misreported deaths aim to shed light on this global health crisis. Is alcohol good for your heart? It’s complicated, despite new insights (Seattle Times) » The Global Burden of Disease Study 2016, coordinated by the University of Washington’s Institute for Health Metrics and Evaluation, used 694 sources of individual and population-level alcohol consumption, along with 592 studies on the risk of alcohol to estimate that nearly 3 million deaths globally in 2016 were attributed to alcohol use. LinkedIn post of the week  This up-to-date, high-resolution population map has enormous value for civil government applications, from planning and undertaking a census, estimating budgets for service delivery, citing infrastructure like roads, schools, hospitals and sanitation facilities, and much more. Always inspired by the work our team is doing with Microsoft's AI for Good Lab and the Institute for Health Metrics and Evaluation! “In an age of seemingly ubiquitous realtime information, it’s perhaps surprising that many of the world’s most climate-vulnerable populations simply aren’t on any map. They are excluded largely as a consequence of unplanned growth, economic and climate precarity, and migration.” Planet, Microsoft, and the Institute for Health Metrics and Evaluation collaborated to map climate-vulnerable populations in unprecedented detail. Read how artificial intelligence and satellite data are making it possible to enable anticipatory action – helping to protect populations before climate disruptions strike: https://lnkd.in/gVCcWtP5 — Will Marshall Co-Founder & CEO, Planet Labs What We’re Reading There's a cheap and effective way to treat childhood diarrhea. So why is it underused? » Every year, nearly 500,000 children die from an easily curable condition: diarrhea. There's a simple and effective treatment: mixing oral rehydration salts. (NPR) Why South Korean women aren't having babies » Globally, developed countries are seeing birth rates fall, but none in such an extreme way as South Korea. Its projections are grim. (BBC)  Featured Datasets Effects of Education on Adult Mortality Systematic Review and Meta-Analysis Estimates Development Assistance for Health on COVID-19 Database 2020-2022 #OUR WORLD IN DATA Tracking global data on electric vehicles Explore data on electric car sales and stocks worldwide. Recent articles, updates, and announcements The world’s nuclear powers have more than 12,000 nuclear warheads The global fight against polio — how far have we come? We’re hiring a Junior Data Scientist! What were the death tolls from pandemics in history? Period versus cohort measures: what’s the difference? The mission of Our World in Data is to make data and research on the world’s largest problems understandable and accessible. We are a nonprofit, building Our World in Data as a public good that’s freely available to everyone. Help us do more by supporting us with a donation.

#AMB

#MEDSCAPE

New Marker of Cardiovascular Risk Discovered in T2D

Anne-Gaëlle Moulun February 19, 2024

    A significant quantity of dysfunctional monocytes appears to indicate poor
cardiovascular prognosis in patients with type 2 diabetes, according to a new
publication. Nicolas Venteclef, PhD, director of an Inserm institute for diabetes
research at Necker Enfants Malades Hospital in Paris, France, led the research.

Quantifying Inflammation

    Patients with type 2 diabetes have about twice the risk for a cardiovascular
event associated with atherosclerosis, such as a heart attack or stroke, during
their lifetimes. "Predicting these complications in diabetic patients is usually very
difficult," Venteclef told the Medscape French edition.
    "They are strongly associated with inflammation in these patients. Therefore,
we sought to quantify this inflammation in the blood." To do this, his team focused
 on monocytes, a category of white blood cells circulating in the blood. They
measured the blood concentration of monocytes and the subtypes present in
patients with type 2 diabetes.

    The results were published in Circulation Research./.../

Exercícios físicos ajudam no tratamento do transtorno depressivo — novos dados Dr. Mauricio Wajngarten 

23 de fevereiro de 2024

    O transtorno depressivo é uma das principais causas de incapacidade, e exercícios são frequentemente recomendados juntamente com medicamentos e psicoterapia, que são os tratamentos de primeira linha. Porém, não há um consenso de diretrizes e pesquisas científicas sobre como prescrever exercícios para melhor tratar a doença. Na verdade, questões importantes sobre o papel da atividade física no tratamento do transtorno depressivo ainda não foram respondidas, como a modalidade que funciona melhor, em que intensidade e frequência, qual o melhor formato (individual ou em grupo) e para quais pacientes é indicada.

    Noetel et al. apresentaram recentemente uma metanálise em rede de ensaios clínicos randomizados que responde a algumas dessas dúvidas. ^[1]/.../

Is Metformin a 'Drug for All Diseases'?

Marilynn Larkin February 27, 2024

    As a front-line treatment for type 2 diabetes, metformin is among the most
widely prescribed drugs in the United States. In 2021 alone, clinicians wrote more
 than 91 million orders for the medication — up from 40 million 2004.

    But is metformin just getting started? Emerging evidence suggests the drug
may be effective for a much broader range of conditions beyond managing high
blood glucose, including various cancers, obesity, liver disease, cardiovascular,
neurodegenerative, and renal diseases. As the evidence for diverse uses
accumulates, many trials have launched, with researchers looking to expand
metformin's indications and validate or explore new directions.

    Metformin's long history as a pharmaceutical includes an herbal ancestry,
recognition in 1918 for its ability to lower blood glucose, being cast aside because
of toxicity fears in the 1930s, rediscovery and synthesis in Europe in the 1940s,
the first reported use for diabetes in 1957, and approval in the United States in
1994.

    The drug has maintained its place as the preferred first-line treatment for type 2
diabetes since 2011, when it was first included in the World Health Organization's
essential medicines list.

Akshay Jain, MD

"The focus hitherto has been primarily on its insulin
sensitization effects," Akshay Jain, MD, a clinical and research
endocrinologist at TLC Diabetes and Endocrinology, in Surrey,
British Columbia, Canada, told Medscape Medical News.

"The recent surge of renewed interest is in part related to its
postulated effects on multiple other receptors," he said. "In my
mind, the metformin data on coronary artery disease reduction
and cancer-protective effects have come farther along than
other disease states."

Cardiovascular Outcomes

    Gregory G. Schwartz, MD, PhD, chief of the cardiology section at Rocky Mountain
Regional VA Medical Center and professor of medicine at the University of
Colorado School of Medicine in Aurora, Colorado, is leading the VA-IMPACT trial.
Despite metformin's long history and widespread use, he said his study is the first
placebo-controlled cardiovascular outcomes trial of the drug.

Gregory G. Schwartz, MD, PhD

Launched in 2023, the study tests the hypothesis that
metformin reduces the risk for death or nonfatal
ischemic cardiovascular events in patients with
prediabetes and established coronary, cerebrovascular,
 or peripheral artery disease, Schwartz said. The trial
is being conducted at roughly 40 VA medical centers,
with a planned enrollment of 7410 patients. The
estimated completion date is March 2029.

"The principal mechanism of action of metformin is
through activation of AMP [adenosine monophosphate]–activated protein kinase,
a central pathway in metabolic regulation, cell protection, and survival," Schwartz
explained. "Experimental data have demonstrated attenuated development of
atherosclerosis, reduced myocardial infarct size, improved endothelial function,
and antiarrhythmic actions — none of those dependent on the presence of
diabetes." 
    Schwartz and his colleagues decided to test their hypothesis in people with
prediabetes, rather than diabetes, to create a "true placebo-controlled comparison"
he said.

    "If patients with type 2 diabetes had been chosen, there would be potential for
confounding because a placebo group would require more treatment with other
active antihyperglycemic medications to achieve the same degree of glycemic
control as a metformin group," Schwartz said.

    "If proven efficacious in the VA-IMPACT trial, metformin could provide an
inexpensive, generally safe, and well-tolerated approach to reduce cardiovascular
morbidity and mortality in a large segment of the population," Schwartz added.
"Perhaps the old dog can learn some new tricks."

    Other recruiting trials looking at cardiovascular-related outcomes include 
Met-PEF,  LIMIT, and Metformin as an Adjunctive Therapy to Catheter Ablation
in Atrial Fibrillation./.../

Read on blog or Reader # Neuroscience News Early Words Shape Future Brain: Genetic Link Between ADHD and Language March 1 A new study delves into the genetic underpinnings of language development in early childhood and  its implications for later cognitive abilities and neurodevelopmental disorders like ADHD and ASD. By analyzing vocabulary data from over 17,000 children across different languages, the study uncovers how genetics influences word production and comprehension from infancy to toddlerhood, revealing that vocabulary size is not only a marker of early language skills but also predictive of future literacy, cognition, and potential neurodevelopmental challenges. Read more of this post