Análise da Mortalidade Materna em uma Região do Interior do Ceará / Analysis of Maternal Mortality in an Interior Region of Ceará

Resumo: A mortalidade materna é um fator de relevância mundial, definido pela CID 10 como todo óbito que ocorreu no período gestacional ou até 42 dias após o término da mesma, independente da duração ou localização da gravidez. A presente pesquisa tem como objetivo identificar o número de casos de morte materna na 21ª CRES. Trata-se de um estudo epidemiológico descritivo, com abordagem quantitativa, com dados obtidos das bases do SIM, SINASC E DATASUS. A coleta de dados ocorreu no mês de janeiro de 2018 e foi realizada na 21ª CRES. A população estudada foi mulheres de 10 a 49 anos que vieram a óbito por causas obstétricas no período de 2007 a 2016. Foram notificados 34 casos de morte materna e a maior Razão de Mortalidade Materna (RMM) foi registrada no ano de 2016 (133,43) e a menor em 2008 (1,48) por 100.000 nascidos vivos. A morte materna obstétrica direta representou 56% dos casos e as indiretas 44% dos óbitos. Nota-se que duas faixas etárias representam a maior incidência do número de óbitos, sendo elas de 20 a 29 anos com 41% dos casos e de 30 a 39 anos representa 32%. Os óbitos investigados com informação de ficha síntese equivalem a 62%, os sem ficha síntese correspondem a 26% e os óbitos maternos não investigados correspondem a 11%. O enfrentamento da problemática da morte materna implica no envolvimento de diferentes atores sociais, de forma a garantir que as políticas públicas sejam, de fato, executadas e respondam às reais necessidades locais da população.

Nrf2 regulates collective cancer migration by modulating the hybrid epithelial/mesenchymal phenotype

Hybrid epithelial/mesenchymal cells (E/M) are key players in aggressive cancer metastasis. A challenge is to understand how these cells, which are mostly non-existent in healthy tissue, become stable phenotypes participating collective cancer migration. The transcription factor Nrf2, which is associated with tumor progression and resistance to therapy, appears to be central to this process. Here, using a combined experimental-computational approach, we show that Nrf2 functions as a phenotypic stability factor for hybrid E/M cells by inhibiting a complete epithelial-mesenchymal transition (EMT) during collective cancer migration. We demonstrate that Nrf2 and EMT signaling are spatially coordinated near the migrating front. Computational analysis of Nrf2-EMT-Notch network and experimental modulation of Nrf2 by pharmacological treatment and CRISPR/Cas9 gene editing reveal that Nrf2 stabilizes a hybrid E/M phenotype maximally observed in the interior region immediately behind the leading edge. We further demonstrate that the Nrf2-EMT-Notch network enhances Dll4 and Jagged1 expression near the leading edge, which correlates with the formation of protruding tips and leader cells. Together, Nrf2 acts as a phenotypic stability factor in restricting complete EMT and coordinating collective cancer migration.

Cold-triggered induction of ROS- and raffinose-related metabolism in freezing-sensitive taproot tissue of sugar beet

Sugar beet (Beta vulgaris subsp. vulgaris) is the exclusive source of sugar in the form of sucrose in temperate climate zones. There, sugar beet is grown as an annual crop from spring to autumn because of the damaging effect of freezing temperatures to taproot tissue. Natural and breeded varieties display variance in the degree of tolerance to freezing temperatures and genotypes with elevated tolerance to freezing have been isolated. Here we compare initial responses to frost between genotypes with either low and high winter survival rates. The selected genotypes differed in the severity of frost injury. We combined transcriptomic and metabolite analyses of leaf- and taproot tissues from such genotypes to elucidate mechanisms of the early freezing response and to dissect genotype- and tissue-dependent responses. Freezing temperatures induced drastic downregulation of photosynthesis-related genes in leaves but upregulation of genes related to minor carbohydrate metabolism, particularly of genes involved in raffinose metabolism in both, leaf and taproot tissue. In agreement with this, it has been revealed that raffinose and the corresponding intermediates, inositol and galactinol, increased markedly in these tissues. We found that genotypes with improved tolerance to freezing, showed higher accumulation of raffinose in a defined interior region within the upper part of the taproot, the pith, representing the tissue most susceptible to freeze damages. This accumulation was accompanied by specific upregulation of raffinose synthesizing enzymes in taproots, suggesting a protective role for raffinose and its precursors for freezing damage in sugar beet.

Aspects of the Hydrogeology of southern Campeche and Quintana Roo, Mexico

This paper explores strong indirect evidence for existence of a previously unrecognized deep groundwater aquifer in southern Quintana Roo, adjacent parts of Campeche, and (probably) northern Belize. The region contains rocks of Cretaceous-to-Holocene age, including: 1) an up-thrust block of the late Cretaceous carbonate known in Belize as the Barton Creek Formation, which is the oldest formation exposed in the Mexican Yucatán Peninsula, 2) the Cretaceous/Paleogene Albion Formation consisting of weakly consolidated Chicxulub impact air-fall deposits, 3) the Paleocene-Eocene Icaiche Formation, containing a massive 25-35 m thick gypsum member that crops out over an estimated area of more than 10,000 km2 in the elevated interior region of the northern lowlands, and 4) younger rocks of relatively low permeability that flank the region on the east. Hydrogeology is dominated by groundwater and surface flow in and adjacent to the Rio Hondo Fault Zone (RHFZ) and by recharge in the elevated interior region. Groundwater in the elevated region has a high sulfate concentration and is approximately saturated with gypsum dissolved from the Icaiche Formation. High-sulfate groundwater and river water with a slightly lower gypsum saturation index than in the elevated region also occurs in the RHFZ, but no water of comparably high sulfate content is present elsewhere in the study area. This suggests that the elevated region is a recharge zone for high-sulfate groundwater carried eastward beneath a 50 km gap by a deep, previously unrecognized aquifer and then discharged into the RHFZ. Based on chemistry of chloride, sulfate and other ions it is proposed here that a deep aquifer comprising the strongly weathered upper surface of the Barton Creek Formation plus the overlying weakly consolidated Albion Formation connects the elevated recharge area with the RHFZ discharge area. If this composite permeable zone does extend westward beneath the elevated recharge zone, it is probably an excellent aquifer.

Unitarity of entanglement and islands in two-sided Janus black holes

We explore the entanglement evolution of boundary intervals in eternal Janus black holes that can be embedded consistently into string theory in the low-energy limit. By studying the geodesics we show that there is a transition in the entanglement characteristic around the Page time, which manifests the unitarity of the evolution. We reproduce and reinterpret these bulk results from two different lower-dimensional perspectives: first as an interface CFT in the usual AdS/CFT correspondence and second as an effective gravity theory in one lower dimension coupled to a radiation background. In the limit where the number of interface degrees of freedom becomes large, we obtain an effective theory on appropriate branes that replace the deep interior region in the bulk, coined the shadow region. In this effective theory, we also identify the island of the radiation entanglement wedge and verify the newly proposed quantum extremization method. Our model clarifies that double holography with gravity in two higher dimensions can be realized in a concrete and consistent way and that the occurrence of islands is natural in one higher dimension. Furthermore, our model reveals that there can be a transitional behavior of the Page curve before the Page time, which is related to the emergence of new matter degrees of freedom on the branes.

Analytical Survival Analysis of the Ornstein–Uhlenbeck Process

We use asymptotic methods from the theory of differential equations to obtain an analytical expression for the survival probability of an Ornstein–Uhlenbeck process with a potential defined over a broad domain. We form a uniformly continuous analytical solution covering the entire domain by asymptotically matching approximate solutions in an interior region, centered around the origin, to those in boundary layers, near the lateral boundaries of the domain. The analytic solution agrees extremely well with the numerical solution and takes into account the non-negligible leakage of probability that occurs at short times when the stochastic process begins close to one of the boundaries. Given the range of applications of Ornstein–Uhlenbeck processes, the analytic solution is of broad relevance across many fields of natural and engineering science.