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Author Harling, G.; Lima Neto, A.S.; Sousa, G.S.; Machado, M.M.T.; Castro, M.C.
Title Determinants of tuberculosis transmission and treatment abandonment in Fortaleza, Brazil Type Journal Article
Year 2017 Publication BMC Public Health Abbreviated Journal BMC Public Health
Volume 17 Issue 1 Pages 508
Keywords Brazil; Epidemiology; Fortaleza; Social determinants; Spatial analysis; Treatment; Treatment failure; Tuberculosis
Abstract BACKGROUND: Tuberculosis (TB) remains a public health problem, despite recent achievements in reducing incidence and mortality rates. In Brazil, these achievements were above the worldwide average, but marked by large regional heterogeneities. In Fortaleza (5th largest city in Brazil), the tuberculosis cure rate has been declining and treatment abandonment has been increasing in the past decade, despite a reduction in incidence and an increase in directly observed therapy (DOT). These trends put efforts to eliminate tuberculosis at risk. We therefore sought to determine social and programmatic determinants of tuberculosis incidence and treatment abandonment in Fortaleza. METHODS: We analyzed sociodemographic and clinical data for all new tuberculosis cases notified in the Notifiable Diseases Information System (SINAN) from Fortaleza between 2007 and 2014. We calculated incidence rates for 117 neighborhoods in Fortaleza, assessed their spatial clustering, and used spatial regression models to quantify associations between neighborhood-level covariates and incidence rates. We used hierarchical logistic regression models to evaluate how individual- and neighborhood-level covariates predicted tuberculosis treatment abandonment. RESULTS: There were 12,338 new cases reported during the study period. Case rates across neighborhoods were significantly positively clustered in two low-income areas close to the city center. In an adjusted model, tuberculosis rates were significantly higher in neighborhoods with lower literacy, higher sewerage access and homicide rates, and a greater proportion of self-reported black residents. Treatment was abandoned in 1901 cases (15.4%), a rate that rose by 71% between 2007 and 2014. Abandonment was significantly associated with many individual sociodemographic and clinical factors. Notably, being recommended for DOT was protective for those who completed DOT, but associated with abandonment for those who did not. CONCLUSION: Low socioeconomic status areas have higher tuberculosis rates, and low socioeconomic individuals have higher risk of treatment abandonment, in Fortaleza. Treatment abandonment rates are growing despite the advent of universal DOT recommendations in Brazil. Proactive social policies, and active contact tracing to find missed cases, may help reduce the tuberculosis burden in this setting.
Address Department of Global Health and Population, Harvard T.H. Chan School of Public Health, 665 Huntington Avenue, Building I, Room 1113, Boston, MA, 02115, USA. mcastro@hsph.harvard.edu
Corporate Author Thesis
Publisher Place of Publication Editor
Language English Summary Language Original Title
Series Editor Series Title Abbreviated Series Title
Series Volume Series Issue Edition
ISSN 1471-2458 ISBN Medium
Area Expedition Conference
Notes (down) PMID:28545423 Approved no
Call Number ref @ user @ Serial 97635
Permanent link to this record
 

 
Author Florindo, A.A.; Barrozo, L.V.; Cabral-Miranda, W.; Rodrigues, E.Q.; Turrell, G.; Goldbaum, M.; Cesar, C.L.G.; Giles-Corti, B.
Title Public Open Spaces and Leisure-Time Walking in Brazilian Adults Type Journal Article
Year 2017 Publication International Journal of Environmental Research and Public Health Abbreviated Journal Int J Environ Res Public Health
Volume 14 Issue 6 Pages
Keywords Adolescent; Adult; Bicycling; Brazil; Child; Cities; City Planning; Cluster Analysis; Demography; Environment Design; Family Characteristics; Female; Geographic Information Systems; Health Surveys; Humans; Logistic Models; Male; Middle Aged; Parks, Recreational; Residence Characteristics/*statistics & numerical data; Surveys and Questionnaires; Walking/*statistics & numerical data; Young Adult; Brazil; adults; built environment; leisure-time walking; public open spaces
Abstract Access to public open space is important to increase leisure-time walking (LTW) in high-income countries, but there is little evidence in middle-income countries. We conducted a cross-sectional analysis to examine the relationship between LTW and the presence of different public open spaces (parks, bike paths, and squares) and the mix of these recreational destinations near the homes of adults participating in the Sao Paulo Health Survey (n = 3145). LTW was evaluated by a questionnaire. We delineated buffers (500, 1000, and 1500 m) from the geographic coordinates of the adults' residential addresses using a geographic information system. We used multilevel logistic regression taking account of clustering by census tracts and households, and with adjustment for social, demographics, and health characteristics. The main results showed that the presence of at least two recreational destinations within a 500-m buffer of participants' homes were associated with an increased odds of LTW compared with no destinations present (OR = 1.65; 95% CI 1.09-2.55). No associations were found for destinations further away. These results support actions outlined in the new urban plan for Sao Paulo city and could be used to highlight the importance access to a mix of public open spaces to promote physical activity in megacities of middle-income countries.
Address Adjunct, School of Population and Global Health, University of Melbourne, Melbourne 3010, Australia. billie.giles-corti@rmit.edu.au
Corporate Author Thesis
Publisher Place of Publication Editor
Language English Summary Language Original Title
Series Editor Series Title Abbreviated Series Title
Series Volume Series Issue Edition
ISSN 1660-4601 ISBN Medium
Area Expedition Conference
Notes (down) PMID:28545242 Approved no
Call Number ref @ user @ Serial 97447
Permanent link to this record
 

 
Author Florindo, A.A.; Barrozo, L.V.; Cabral-Miranda, W.; Rodrigues, E.Q.; Turrell, G.; Goldbaum, M.; Cesar, C.L.G.; Giles-Corti, B.
Title Public Open Spaces and Leisure-Time Walking in Brazilian Adults Type Journal Article
Year 2017 Publication International Journal of Environmental Research and Public Health Abbreviated Journal Int J Environ Res Public Health
Volume 14 Issue 6 Pages
Keywords Adolescent; Adult; Bicycling; Brazil; Child; Cities; City Planning; Cluster Analysis; Demography; Environment Design; Family Characteristics; Female; Geographic Information Systems; Health Surveys; Humans; Logistic Models; Male; Middle Aged; Parks, Recreational; Residence Characteristics/*statistics & numerical data; Surveys and Questionnaires; Walking/*statistics & numerical data; Young Adult; Brazil; adults; built environment; leisure-time walking; public open spaces
Abstract Access to public open space is important to increase leisure-time walking (LTW) in high-income countries, but there is little evidence in middle-income countries. We conducted a cross-sectional analysis to examine the relationship between LTW and the presence of different public open spaces (parks, bike paths, and squares) and the mix of these recreational destinations near the homes of adults participating in the Sao Paulo Health Survey (n = 3145). LTW was evaluated by a questionnaire. We delineated buffers (500, 1000, and 1500 m) from the geographic coordinates of the adults' residential addresses using a geographic information system. We used multilevel logistic regression taking account of clustering by census tracts and households, and with adjustment for social, demographics, and health characteristics. The main results showed that the presence of at least two recreational destinations within a 500-m buffer of participants' homes were associated with an increased odds of LTW compared with no destinations present (OR = 1.65; 95% CI 1.09-2.55). No associations were found for destinations further away. These results support actions outlined in the new urban plan for Sao Paulo city and could be used to highlight the importance access to a mix of public open spaces to promote physical activity in megacities of middle-income countries.
Address Adjunct, School of Population and Global Health, University of Melbourne, Melbourne 3010, Australia. billie.giles-corti@rmit.edu.au
Corporate Author Thesis
Publisher Place of Publication Editor
Language English Summary Language Original Title
Series Editor Series Title Abbreviated Series Title
Series Volume Series Issue Edition
ISSN 1660-4601 ISBN Medium
Area Expedition Conference
Notes (down) PMID:28545242 Approved no
Call Number ref @ user @ Serial 97636
Permanent link to this record
 

 
Author Florindo, A.A.; Barrozo, L.V.; Cabral-Miranda, W.; Rodrigues, E.Q.; Turrell, G.; Goldbaum, M.; Cesar, C.L.G.; Giles-Corti, B.
Title Public Open Spaces and Leisure-Time Walking in Brazilian Adults Type Journal Article
Year 2017 Publication International Journal of Environmental Research and Public Health Abbreviated Journal Int J Environ Res Public Health
Volume 14 Issue 6 Pages
Keywords Adolescent; Adult; Bicycling; Brazil; Child; Cities; City Planning; Cluster Analysis; Demography; Environment Design; Family Characteristics; Female; Geographic Information Systems; Health Surveys; Humans; Logistic Models; Male; Middle Aged; Parks, Recreational; Residence Characteristics/*statistics & numerical data; Surveys and Questionnaires; Walking/*statistics & numerical data; Young Adult; Brazil; adults; built environment; leisure-time walking; public open spaces
Abstract Access to public open space is important to increase leisure-time walking (LTW) in high-income countries, but there is little evidence in middle-income countries. We conducted a cross-sectional analysis to examine the relationship between LTW and the presence of different public open spaces (parks, bike paths, and squares) and the mix of these recreational destinations near the homes of adults participating in the Sao Paulo Health Survey (n = 3145). LTW was evaluated by a questionnaire. We delineated buffers (500, 1000, and 1500 m) from the geographic coordinates of the adults' residential addresses using a geographic information system. We used multilevel logistic regression taking account of clustering by census tracts and households, and with adjustment for social, demographics, and health characteristics. The main results showed that the presence of at least two recreational destinations within a 500-m buffer of participants' homes were associated with an increased odds of LTW compared with no destinations present (OR = 1.65; 95% CI 1.09-2.55). No associations were found for destinations further away. These results support actions outlined in the new urban plan for Sao Paulo city and could be used to highlight the importance access to a mix of public open spaces to promote physical activity in megacities of middle-income countries.
Address Adjunct, School of Population and Global Health, University of Melbourne, Melbourne 3010, Australia. billie.giles-corti@rmit.edu.au
Corporate Author Thesis
Publisher Place of Publication Editor
Language English Summary Language Original Title
Series Editor Series Title Abbreviated Series Title
Series Volume Series Issue Edition
ISSN 1660-4601 ISBN Medium
Area Expedition Conference
Notes (down) PMID:28545242 Approved no
Call Number ref @ user @ Serial 98023
Permanent link to this record
 

 
Author Yan, H.; Romero-Lopez, M.; Benitez, L.I.; Di, K.; Frieboes, H.B.; Hughes, C.C.W.; Bota, D.A.; Lowengrub, J.S.
Title 3D Mathematical Modeling of Glioblastoma Suggests That Transdifferentiated Vascular Endothelial Cells Mediate Resistance to Current Standard-of-Care Therapy Type Journal Article
Year 2017 Publication Cancer Research Abbreviated Journal Cancer Res
Volume 77 Issue 15 Pages 4171-4184
Keywords Brain Neoplasms/*pathology; Cell Transdifferentiation/physiology; Endothelial Cells/*pathology; Glioblastoma/*pathology; Humans; *Models, Theoretical; Neoplastic Stem Cells/*pathology
Abstract Glioblastoma (GBM), the most aggressive brain tumor in human patients, is decidedly heterogeneous and highly vascularized. Glioma stem/initiating cells (GSC) are found to play a crucial role by increasing cancer aggressiveness and promoting resistance to therapy. Recently, cross-talk between GSC and vascular endothelial cells has been shown to significantly promote GSC self-renewal and tumor progression. Furthermore, GSC also transdifferentiate into bona fide vascular endothelial cells (GEC), which inherit mutations present in GSC and are resistant to traditional antiangiogenic therapies. Here we use three-dimensional mathematical modeling to investigate GBM progression and response to therapy. The model predicted that GSCs drive invasive fingering and that GEC spontaneously form a network within the hypoxic core, consistent with published experimental findings. Standard-of-care treatments using DNA-targeted therapy (radiation/chemo) together with antiangiogenic therapies reduced GBM tumor size but increased invasiveness. Anti-GEC treatments blocked the GEC support of GSCs and reduced tumor size but led to increased invasiveness. Anti-GSC therapies that promote differentiation or disturb the stem cell niche effectively reduced tumor invasiveness and size, but were ultimately limited in reducing tumor size because GECs maintain GSCs. Our study suggests that a combinatorial regimen targeting the vasculature, GSCs, and GECs, using drugs already approved by the FDA, can reduce both tumor size and invasiveness and could lead to tumor eradication. Cancer Res; 77(15); 4171-84. (c)2017 AACR.
Address Center for Complex Biological Systems, University of California, Irvine, California
Corporate Author Thesis
Publisher Place of Publication Editor
Language English Summary Language Original Title
Series Editor Series Title Abbreviated Series Title
Series Volume Series Issue Edition
ISSN 0008-5472 ISBN Medium
Area Expedition Conference
Notes (down) PMID:28536277 Approved no
Call Number ref @ user @ Serial 96585
Permanent link to this record