Aceh in Indonesia is rich inmarine resources and abundant fishery products such as oyster.Traditionally,fishermen only harvest oysters and discard the shells,which can cause pollution and environmental contamination.W...Aceh in Indonesia is rich inmarine resources and abundant fishery products such as oyster.Traditionally,fishermen only harvest oysters and discard the shells,which can cause pollution and environmental contamination.Waste Oyster Shells(WOS)contain a high percentage of calcium carbonate(CaCO_(3))that experiences thermal decomposition at high temperature,following the reaction CaCO_(3)→CaO+CO_(2)(ΔT=825℃).At temperature>900℃,dead-burned lime is formed,which severely influences CaO reactivity.However,the optimum temperature for producing high CaO content is still uncertain.Therefore,this study aimed to determine the optimum calcination temperature to produce high CaO content,assess initial setting time of WOS paste,and identify the best compressive strength of paste.For the experiment,WOS was used as a partial cement replacement(with a size of 0.075 mm)in paste at a proportion of 5%and calcined at temperature of 700℃,800℃,900℃,and 1000℃.The specimens used were an ebonite ring(dimensions:70 mm bottom diameter,60 mm top diameter,and 40 mm height)and a cube(dimensions:5 cm×5 cm×5 cm).The experiment was conducted following the ASTM(American Society for Testing andMaterials)standards and optimumcompressive strength values were analyzed using ANOVA(Analysis of Variance)and Response Surface Methodology(RSM)through the Design Expert software.The results showed that WOS calcined at 1000℃ increased CaO content by approximately 57.40%.Furthermore,the initial setting time test of 5%WOS paste at 1000℃ showed a more uniform binding performance compared to conventional cement paste,with an initial setting time of 75 min and a penetration depth of 15 mm.In line with the analysis,optimum compressive strength of 71.028 MPa with a desirability value of 0.986 was achieved at 5%cement replacement and calcination temperature of 786.44℃.展开更多
In the immediate postpartum period, women need to be observed by the obstetric nurse so that measures can be taken to prevent hemorrhages and reduce its complications. Most maternal deaths from hemorrhage are preventa...In the immediate postpartum period, women need to be observed by the obstetric nurse so that measures can be taken to prevent hemorrhages and reduce its complications. Most maternal deaths from hemorrhage are preventable with support measures for clinical practice, such as: guiding protocols, training of professionals, organization and management of health services and provision of adequate conditions for the parturition process. Objective: To validate Rangel’s instrument with its application in the Maternity Ward of the General Hospital of Huambo, Angola. Methodology: This is a descriptive study with a quantitative approach. This is the sixth stage, called pre-test, of the Translation and Cultural Adaptation process. This instrument was sent for evaluation by the validators using the electronic data collection form named Google forms, with a seven-point Likert-type scale (from 7—totally agree to 1—totally disagree). The analysis was performed with the Cronbach’s Alpha coefficient index (>0.91) and the Content Validity Index (CVI > 0.98). Results: Of the 10 items of evaluation criteria of the instrument analyzed by the 20 validators, 100% of them obtained a Cronbach’s Alpha index rating of 0.91: clarity;coherence;scientific writing;relevance;sequence;uniqueness and updating. Coverage, item criticality and objectivity reached a Cronbach’s Alpha of 0.95. The Content Validity Index was 0.95 for coverage, coherence, item criticality, scientific writing, relevance and updating. Conclusion: Rangel’s instrument for nursing care aimed at preventing and controlling hemorrhage in the third period of birth, translated into Angolan Portuguese and validated by nurses, through the statistical results obtained in the validation, was considered reliable and necessary for clinical nursing practice in Huambo, Angola. .展开更多
Background: Postpartum hemorrhage is one of the main causes of maternal mortality, mainly in underdeveloped countries. Deaths are mostly preventable, and are related to socioeconomic development, organization of healt...Background: Postpartum hemorrhage is one of the main causes of maternal mortality, mainly in underdeveloped countries. Deaths are mostly preventable, and are related to socioeconomic development, organization of health services and professional training. Objective: To systematize alerts for the prevention of postpartum hemorrhage. Method: This is a technical essay developed from reflections on previously produced and published texts about maternal mortality and has hemorrhage as the focus of this study. Results: It presents the concept, classification of hemorrhage, risk factors and their classification, prevention strategies, universal recommendations, pharmacological and non-pharmacological interventions when hemorrhage already exists, bleeding assessment techniques;clinical evaluation, by laboratory examination and by shock index. Conclusions: Hemorrhage is a preventable cause of maternal death through the accomplishment of multiple care. Hospital care must be conducted by qualified professionals and in adequate numbers. The risk diagnosis must be carried out during prenatal care with the recording of clinical data accessible in the health care network. All references studied are not specific to nursing, as hemorrhage prevention requires multidisciplinary action.展开更多
BACKGROUND Helicobacter pylori(H.pylori)infects over half the global population,causing gastrointestinal diseases like dyspepsia,gastritis,duodenitis,peptic ulcers,GMALT lymphoma,and gastric adenocarcinoma.Eradicating...BACKGROUND Helicobacter pylori(H.pylori)infects over half the global population,causing gastrointestinal diseases like dyspepsia,gastritis,duodenitis,peptic ulcers,GMALT lymphoma,and gastric adenocarcinoma.Eradicating H.pylori is crucial for treating and preventing these conditions.While conventional proton pump inhibitor(PPI)-based triple therapy is effective,there’s growing interest in longer acid suppression therapies.Potassium competitive acid blocker(P-CAB)triple and dual therapy are new regimens for H.pylori eradication.Initially used in Asian populations,vonoprazan(VPZ)has been recently Food and Drug Administration-approved for H.pylori eradication.AIM To assess the efficacy of regimens containing P-CABs in eradicating H.pylori infection.METHODS This study,following PRISMA 2020 guidelines,conducted a systematic review and meta-analysis by searching MEDLINE and Scopus libraries for randomized clinical trials(RCTs)or observational studies with the following command:[("Helicobacter pylori"OR"H pylori")AND("Treatment"OR"Therapy"OR"Eradication")AND("Vonaprazan"OR"Potassium-Competitive Acid Blocker"OR"P-CAB"OR"PCAB"OR"Revaprazan"OR"Linaprazan"OR"Soraprazan"OR"Tegoprazan")].Studies comparing the efficacy of P-CABs-based treatment to classical PPIs in eradicating H.pylori were included.Exclusion criteria included case reports,case series,unpublished trials,or conference abstracts.Data variables encompassed age,diagnosis method,sample sizes,study duration,intervention and control,and H.pylori eradication method were gathered by two independent reviewers.Meta-analysis was performed in R software,and forest plots were generated.RESULTS A total of 256 references were initially retrieved through the search command.Ultimately,fifteen studies(7 RCTs,7 retrospective observational studies,and 1 comparative unique study)were included,comparing P-CAB triple therapy to PPI triple therapy.The intention-to-treat analysis involved 8049 patients,with 4471 in the P-CAB intervention group and 3578 in the PPI control group across these studies.The analysis revealed a significant difference in H.pylori eradication between VPZ triple therapy and PPI triple therapy in both RCTs and observational studies[risk ratio(RR)=1.17,95%confidence interval(CI):1.11-1.22,P<0.0001]and(RR=1.13,95%CI:1.09-1.17,P<0.0001],respectively.However,no significant difference was found between tegoprazan(TPZ)triple therapy and PPI triple therapy in both RCTs and observational studies(RR=1.04,95%CI:0.93-1.16,P=0.5)and(RR=1.03,95%CI:0.97-1.10,P=0.3),respectively.CONCLUSION VPZ-based triple therapy outperformed conventional PPI-based triple therapy in eradicating H.pylori,positioning it as a highly effective first-line regimen.Additionally,TPZ-based triple therapy was non-inferior to classical PPI triple therapy.展开更多
BACKGROUND Liver transplant(LT)patients have become older and sicker.The rate of post-LT major adverse cardiovascular events(MACE)has increased,and this in turn raises 30-d post-LT mortality.Noninvasive cardiac stress...BACKGROUND Liver transplant(LT)patients have become older and sicker.The rate of post-LT major adverse cardiovascular events(MACE)has increased,and this in turn raises 30-d post-LT mortality.Noninvasive cardiac stress testing loses accuracy when applied to pre-LT cirrhotic patients.AIM To assess the feasibility and accuracy of a machine learning model used to predict post-LT MACE in a regional cohort.METHODS This retrospective cohort study involved 575 LT patients from a Southern Brazilian academic center.We developed a predictive model for post-LT MACE(defined as a composite outcome of stroke,new-onset heart failure,severe arrhythmia,and myocardial infarction)using the extreme gradient boosting(XGBoost)machine learning model.We addressed missing data(below 20%)for relevant variables using the k-nearest neighbor imputation method,calculating the mean from the ten nearest neighbors for each case.The modeling dataset included 83 features,encompassing patient and laboratory data,cirrhosis complications,and pre-LT cardiac assessments.Model performance was assessed using the area under the receiver operating characteristic curve(AUROC).We also employed Shapley additive explanations(SHAP)to interpret feature impacts.The dataset was split into training(75%)and testing(25%)sets.Calibration was evaluated using the Brier score.We followed Transparent Reporting of a Multivariable Prediction Model for Individual Prognosis or Diagnosis guidelines for reporting.Scikit-learn and SHAP in Python 3 were used for all analyses.The supplementary material includes code for model development and a user-friendly online MACE prediction calculator.RESULTS Of the 537 included patients,23(4.46%)developed in-hospital MACE,with a mean age at transplantation of 52.9 years.The majority,66.1%,were male.The XGBoost model achieved an impressive AUROC of 0.89 during the training stage.This model exhibited accuracy,precision,recall,and F1-score values of 0.84,0.85,0.80,and 0.79,respectively.Calibration,as assessed by the Brier score,indicated excellent model calibration with a score of 0.07.Furthermore,SHAP values highlighted the significance of certain variables in predicting postoperative MACE,with negative noninvasive cardiac stress testing,use of nonselective beta-blockers,direct bilirubin levels,blood type O,and dynamic alterations on myocardial perfusion scintigraphy being the most influential factors at the cohort-wide level.These results highlight the predictive capability of our XGBoost model in assessing the risk of post-LT MACE,making it a valuable tool for clinical practice.CONCLUSION Our study successfully assessed the feasibility and accuracy of the XGBoost machine learning model in predicting post-LT MACE,using both cardiovascular and hepatic variables.The model demonstrated impressive performance,aligning with literature findings,and exhibited excellent calibration.Notably,our cautious approach to prevent overfitting and data leakage suggests the stability of results when applied to prospective data,reinforcing the model’s value as a reliable tool for predicting post-LT MACE in clinical practice.展开更多
This editorial addresses the growing concern of herb-induced liver injury(HILI),focusing on a unique case of Skullcap-induced HILI report.This editorial underscore the significant mortality rate linked to Skullcap-ind...This editorial addresses the growing concern of herb-induced liver injury(HILI),focusing on a unique case of Skullcap-induced HILI report.This editorial underscore the significant mortality rate linked to Skullcap-induced HILI,emphasizing the importance of vigilant monitoring and intervention.As herbal supplement usage rises,collaboration among clinicians and researchers is crucial to comprehend and address the complexities of HILI,particularly those involving Skullcap.展开更多
Protein-calorie malnutrition (PCM) is a common condition in cirrhotic patients, leading to a worse prognosis, complications, poor quality of life and lower survival rates. Among ways of assessing nutritional status, t...Protein-calorie malnutrition (PCM) is a common condition in cirrhotic patients, leading to a worse prognosis, complications, poor quality of life and lower survival rates. Among ways of assessing nutritional status, there are anthropometric methods such as the evaluation of the triceps skinfold, the arm circumference, the arm muscle circumference and the body mass index, and non-anthropometric methods such as the subjective global assessment, the handgrip strength of non-dominant hand, and the bioelectrical impedance analysis (BIA). PCM is frequently under-diagnosed in clinical settings in patients with cirrhosis due to the limitations of nutritional evaluation methods in this population. BIA is a useful method, but cannot be indicated in patients with abnormal body composition. In these situations, the phase angle (PA) has been used, and can become an important tool in assessing nutritional status in any situation. The PA is superior to anthropometric methods and might be considered as a nutritional indicator in cirrhosis. The early characterization of the nutritional status in patients with cirrhosis means an early nutritional intervention, with a positive impact on patients’ overall prognosis. Among the usually accepted methods for nutritional diagnosis, the PA provides information in a quick and objective manner.展开更多
AIM To perform a systematic review to evaluate the incidence and prevalence of non-alcoholic fatty liver disease(NAFLD) in adult patients with sarcopenia.METHODS Randomized clinical trials,cross-sectional or cohort st...AIM To perform a systematic review to evaluate the incidence and prevalence of non-alcoholic fatty liver disease(NAFLD) in adult patients with sarcopenia.METHODS Randomized clinical trials,cross-sectional or cohort studies including adult patients(over 18 years) with sarcopenia were selected.The primary outcomes of interest were the prevalence or incidence of NAFLD in sarcopenic patients.In the screening process,44 fulltext articles were included in the review and 41 studies were excluded.RESULTS Three cross-sectional studies were included.The authors attempted to perform a systematic review,but due to the differences between the studies,a qualitative synthesis was provided.The diagnosis of NAFLD was made by non-invasive methods(image methods or any surrogate markers) in all three evaluated studies.All the studies suggested that there was an independent association between sarcopenia and NAFLD.CONCLUSION Sarcopenia is independently associated with NAFLD and possibly to an advanced fibrosis.展开更多
Apple consumption is related to the prevention of chronic diseases due to the presence of phenolic acids and flavonoids that have antioxidant capacity. However, phenolic profile and antioxidant capacity can vary betwe...Apple consumption is related to the prevention of chronic diseases due to the presence of phenolic acids and flavonoids that have antioxidant capacity. However, phenolic profile and antioxidant capacity can vary between varieties. The aim of this study was to analyze the total phenolic content (TPC) and antioxidant capacity (AC) of thirty-six apple varieties to establish a classification of these fruits. The TPC was analyzed according to the Folin-Ciocalteau method and AC was analyzed using the ferric reducing antioxidant power (FRAP) method. Hierarchical cluster analysis was used for the classification of the fruit. The TPC ranged from 456 to 1583 mg/kg of fresh fruit (catechin equivalents) and the AC ranged from 5606 to 23,719 mmol/kg (fresh fruit). The Pearson linear correlation showed significant differences in the association between TPC and AC (r: 0.79, p < 0.001). The apples were classified into the following five groups according to their AC: very high (8%), high (17%), medium (47%), low (11%) and very low (17%). The varieties classified in the group with very high AC were Carícia, Mollies and Imperatriz. The Gala varieties showed a great variability in AC, with values classified as high and low, while the Fuji, with less variability, was classified as low AC. The classification of apples based on TPC and AC using hierarchical cluster analysis was performed and the results can be of great value to geneticists, producers and consumers.展开更多
Exergames can be considered a dual task because the games are performed by a man-videogame interface, requiring cognitive and motor functions simultaneously. Although the literature has shown improvements of cognitive...Exergames can be considered a dual task because the games are performed by a man-videogame interface, requiring cognitive and motor functions simultaneously. Although the literature has shown improvements of cognitive and physical functions due to exergames, the intrinsic mechanisms involved in these functional changes have still not been elucidated. The aims of the present study were（1） to demonstrate the known biological mechanisms of physical exercise regarding muscle adaptation and establish a relationship with exergames; and（2） to present a neurobiological hypothesis about the neuroplastic effects of exergames on the cognitive function of institutionalized older persons. These hypotheses are discussed.展开更多
Petrological characterization,U-Pb geochronology,Lu-Hf analyses and major and trace element data from mafic intrusions in the Central Espinhaco(central portion of the Brazilian shield)are used here to investigate the ...Petrological characterization,U-Pb geochronology,Lu-Hf analyses and major and trace element data from mafic intrusions in the Central Espinhaco(central portion of the Brazilian shield)are used here to investigate the geological significance of the Early Neoproterozoic magmatism in the context of the Sao Francisco-Congo paleocontinent.These mafic bodies are represented by medium to coarse-grained metagabbros with plagioclase,amphibole and clinopyroxene.Zircon U-Pb isotopic data from two samples yielded weighted mean 206pb/238U ages of 895±3.4 Ma(MSWD=1.7)and 896±2.4 Ma(MSWD=0.64),regarded as the best estimates for the crystallization age of these mafic rocks.Major and trace element data(including REEs)show that the gabbros originated from a subalkaline tholeiitic magma,typical of intraplate magmatism.Such rocks are slightly enriched in LREEs and LILEs and depleted in HFSEs.Our new isotope and geochemical data,along with regional knowledge,indicate that these metagabbros mark the beginning of an important Tonian-age extensional tectonic event of the landmass of which the Sao Francisco-Congo paleocontinent was part(Rodinia supercontinent or Central African block?).We furthermore suggest that these rocks belong to a prominent suite of Tonian-age mafic rocks that mark a diachronic breakup attempt of this landmass which may have occurred from south to north along the Espinhaco mountain range.展开更多
The challenge of keeping and getting new customers drives the development of new practices to meet the consumption needs of increasingly tends to micro-segmentation of product and consumer market. The new consumption ...The challenge of keeping and getting new customers drives the development of new practices to meet the consumption needs of increasingly tends to micro-segmentation of product and consumer market. The new consumption habits of brazilians brought new prospects for market. The objective of this paper is to develop of a dynamic vehicle routing system supported by the behavior of urban traffic in the city ofSao Paulo using Neuro Fuzzy Network. The methodology of this paper consists in the capture of relevant events that interfere with the flow of traffic of the city of Sao Paulo and implementation of a Fuzzy Neural Network trained with these events in order to foresee the traffic behavior. The system offers three labels of hierarchical routing, thus is possible to consider not only the basic factors of routing, but too external factors that directly influence on the flow of traffic and the disruption which may be avoided in large cities, through alternative routes （dynamic vehicle routing）. Predicting the behavior of traffic represents the strategic level routing, dynamic vehicle routing is the tactical level, and routing algorithms to the operational level. This paper will not be discussed the operational level.展开更多
Objective:To describe the prognostic and clinical profile of hospitalized patients with chikungunya virus(CHIKV)infection focusing on renal outcomes.Methods:This is a cross-sectional study including all patients with ...Objective:To describe the prognostic and clinical profile of hospitalized patients with chikungunya virus(CHIKV)infection focusing on renal outcomes.Methods:This is a cross-sectional study including all patients with confirmed chikungunya fever(CHIKF)admitted to 3 different highcomplexity hospitals in Fortaleza,Brazil between January 2016 and June 2017.Data analysis was carried out to evaluate correlation between clinical profile and outcomes.Results:Fifty-five patients were included,with a median age of 77(IQR=21)years,and 23(41.82%)were male.Twenty-five patients(45.45%,25/55)developed acute kidney injury(AKI),and 15(60.00%,15/25)were classified as KDIGO 1,1(4.00%)as KDIGO 2,and 9(36.00%)as KDIGO 3.The overall mortality was 34.54%whilst AKI-related mortality was 64.00%(16/25).Both AKI and encephalitis were associated with higher mortality.Patients who died were significantly older[82(IQR=12)years vs.70(IQR=28.75)years,P<0.001].In the multivariate analysis,abdominal pain was associated with an increased risk of severe AKI(OR=5.33,95%CI=1.11–25.64,P=0.037)and AKI was an independent risk factor of death(OR=12.06,95%CI=2.55–57.15,P=0.002).Recovery of renal function was similar among the different age groups.Conclusions:AKI is present in half of the study population and is an independent risk factor of death.Thus,renal function should be carefully monitored in hospitalized patients with CHIKV infection.展开更多
Height limitations are not uncommon in multi-storey buildings due to economic requirements and esthetical considerations. Substantial spaces are normally required to enable the passage of large pipes and ducts beneath...Height limitations are not uncommon in multi-storey buildings due to economic requirements and esthetical considerations. Substantial spaces are normally required to enable the passage of large pipes and ducts beneath steel beams leading to uneconomic floor heights. The most adopted solution for this issue is the use of steel beam web openings to provide the required space for services. These openings could lead to a significant decrease of the beam load carrying capacity depending on the adopted openings shape, size and location. These aspects motivated the present study based on FE simulations calibrated against numerical and test results. The results accuracy enabled a comprehensive parametric analysis of beams with web openings to be made focused on the profile size, web opening location, among others. The study also investigated the efficiency of longitudinal stiffeners welded at the opening region and benefits of using an adequate edge concordance radius in beams with rectangular and square openings. The obtained results showed the need of using welded longitudinal stiffeners in order to increase the beams ultimate load carrying capacity. This adoption can double or even triple the ultimate load of beams with rectangular and square opening heights equal to 0.75 H, respectively.展开更多
Objective: To examine the anti-angiogenic potential of Artocarpus heterophyllus(A. heterophyllus) seed extract in chicken chorioallantoic membrane(CAM).Methods: This study used chicken CAM ex ovo culture to examine th...Objective: To examine the anti-angiogenic potential of Artocarpus heterophyllus(A. heterophyllus) seed extract in chicken chorioallantoic membrane(CAM).Methods: This study used chicken CAM ex ovo culture to examine the potential antiangiogenic activity of A. heterophyllus seed methanolic extract. Basic fibroblast growth factor was used to induce the ectopic formation of blood vessels on CAM treated with extract. Blood vessel number was assessed by macroscopic and microscopic observation,and compared and analyzed for all treatments and controls.Results: Macroscopic observation revealed that a dose of 35 mg/m L of methanolic extract of A. heterophyllus seeds could inhibit basic fibroblast growth factor-induced angiogenesis by 61% in chicken CAM ex ovo culture. This concurred with microscopic observations on the histological structure of blood vessels, which indicated that extract treatment repressed the formation of new blood vessels.Conclusions: This is the first study to report the anti-angiogenic effect of methanolic extract derived from A. heterophyllus seeds and its potential as a candidate for future anticancer therapy.展开更多
The aim of this paper was to report on factors contributing to the deterioration of the mental health of Indigenous populations(IP)in Brazil.Five factors seem to have a direct impact on the mental health of IP in Braz...The aim of this paper was to report on factors contributing to the deterioration of the mental health of Indigenous populations(IP)in Brazil.Five factors seem to have a direct impact on the mental health of IP in Brazil:(1)The absence of public policies;(2)Intellectual production;(3)Psychiatric medical care for remote areas(e.g.,telemedicine)aimed at promoting the mental health of Brazil’s IP,which causes a huge gap in the process of assistance and social,psychological,economic and cultural valorization of native peoples;(4)The dissemination of fake news,which exposed,above all,older IP to risk behaviors in the pandemic,such as refusal of vaccination;and(5)The violence carried out on IP lands due to economic interests with mining/agribusiness.展开更多
For decades the ecologists are using the same methods in order to determine the environmental health of a community,however,the crescent need on defining how these processes act,triggered the development of new method...For decades the ecologists are using the same methods in order to determine the environmental health of a community,however,the crescent need on defining how these processes act,triggered the development of new methods that could classify the organisms and their function at the habitats.Here we used the anuran larvae to understand the effects of an environmental gradient on the structure and organization of the anuran assemblages along it,and to access in a realistic form,the actual state of preservation of the la rgest remnant of Atlantic Rainforest on the Southernmost portion of Brazil.We found that despite the higher diversity of species and the conservation unit status of the place,the ecosystem itself is still in danger,given the low number of functional groups and thus a higher number of ecosystem services that can be lost.展开更多
In 2009, based on a multicenter study conducted in Asia and Latin Americaand subsidized by the Dengue Control (DENCO) Research Program, the World Health Organization (WHO) proposed a new classification for dengue case...In 2009, based on a multicenter study conducted in Asia and Latin Americaand subsidized by the Dengue Control (DENCO) Research Program, the World Health Organization (WHO) proposed a new classification for dengue cases. The purpose of the present study was to evaluate the applicability of the new classification, relative to its previous version [1]. The evaluation, conducted in Campo Grande county, Mato Grosso do Sul state, Brazil, drew on secondary data from referral healthcare centers that assist high-severity dengue patients. A total of 156 medical records of patients with laboratory diagnosis of dengue were investigated. The records covered two epidemic periods: summer of 2006-2007 and summer of 2009-2010. The results showed that 64.6% of cases classified as dengue fever under the 1997 criteria presented manifestations of severity, warranting their reclassification as dengue with warning signs (49) or severe dengue (15) under the 2009 revised criteria. Bleeding, persistent vomiting, and severe, continuous abdominal pain were the most prevalent warning signs, indicative of risk of progression to severe disease. The revised classification was proved less complex than the current version, facilitating the identification of cases and the clinical management of patients.展开更多
The paper was monitored the conductivity （g.L＂l of NaCI）, the absorbances values （Abs） and the amount of TOC （total organic carbon）, before and after five consecutive dyeings made with reuse water, obtained fro...The paper was monitored the conductivity （g.L＂l of NaCI）, the absorbances values （Abs） and the amount of TOC （total organic carbon）, before and after five consecutive dyeings made with reuse water, obtained from treated effluent by UV/H202 photocatalysis. All rates of decolorization were above 92%, the removal of total organic carbon was above 89% in all treatments and the economy of NaCI was from 3.10 in the first recipe, 3.17 in the second, 3.49 in the third, 3.79 in the fourth and 4.05 in the fifth recipe. The five dyeings compared with same dyeings made with deionized water presented a color deviation （AE＊） below 1. The conventional dyeings would consume 80 L/kg against 40 L/kg used in the dyeing process proposed in this study, representing a great economy of water, with no discharge of effluents.展开更多
文摘Aceh in Indonesia is rich inmarine resources and abundant fishery products such as oyster.Traditionally,fishermen only harvest oysters and discard the shells,which can cause pollution and environmental contamination.Waste Oyster Shells(WOS)contain a high percentage of calcium carbonate(CaCO_(3))that experiences thermal decomposition at high temperature,following the reaction CaCO_(3)→CaO+CO_(2)(ΔT=825℃).At temperature>900℃,dead-burned lime is formed,which severely influences CaO reactivity.However,the optimum temperature for producing high CaO content is still uncertain.Therefore,this study aimed to determine the optimum calcination temperature to produce high CaO content,assess initial setting time of WOS paste,and identify the best compressive strength of paste.For the experiment,WOS was used as a partial cement replacement(with a size of 0.075 mm)in paste at a proportion of 5%and calcined at temperature of 700℃,800℃,900℃,and 1000℃.The specimens used were an ebonite ring(dimensions:70 mm bottom diameter,60 mm top diameter,and 40 mm height)and a cube(dimensions:5 cm×5 cm×5 cm).The experiment was conducted following the ASTM(American Society for Testing andMaterials)standards and optimumcompressive strength values were analyzed using ANOVA(Analysis of Variance)and Response Surface Methodology(RSM)through the Design Expert software.The results showed that WOS calcined at 1000℃ increased CaO content by approximately 57.40%.Furthermore,the initial setting time test of 5%WOS paste at 1000℃ showed a more uniform binding performance compared to conventional cement paste,with an initial setting time of 75 min and a penetration depth of 15 mm.In line with the analysis,optimum compressive strength of 71.028 MPa with a desirability value of 0.986 was achieved at 5%cement replacement and calcination temperature of 786.44℃.
文摘In the immediate postpartum period, women need to be observed by the obstetric nurse so that measures can be taken to prevent hemorrhages and reduce its complications. Most maternal deaths from hemorrhage are preventable with support measures for clinical practice, such as: guiding protocols, training of professionals, organization and management of health services and provision of adequate conditions for the parturition process. Objective: To validate Rangel’s instrument with its application in the Maternity Ward of the General Hospital of Huambo, Angola. Methodology: This is a descriptive study with a quantitative approach. This is the sixth stage, called pre-test, of the Translation and Cultural Adaptation process. This instrument was sent for evaluation by the validators using the electronic data collection form named Google forms, with a seven-point Likert-type scale (from 7—totally agree to 1—totally disagree). The analysis was performed with the Cronbach’s Alpha coefficient index (>0.91) and the Content Validity Index (CVI > 0.98). Results: Of the 10 items of evaluation criteria of the instrument analyzed by the 20 validators, 100% of them obtained a Cronbach’s Alpha index rating of 0.91: clarity;coherence;scientific writing;relevance;sequence;uniqueness and updating. Coverage, item criticality and objectivity reached a Cronbach’s Alpha of 0.95. The Content Validity Index was 0.95 for coverage, coherence, item criticality, scientific writing, relevance and updating. Conclusion: Rangel’s instrument for nursing care aimed at preventing and controlling hemorrhage in the third period of birth, translated into Angolan Portuguese and validated by nurses, through the statistical results obtained in the validation, was considered reliable and necessary for clinical nursing practice in Huambo, Angola. .
文摘Background: Postpartum hemorrhage is one of the main causes of maternal mortality, mainly in underdeveloped countries. Deaths are mostly preventable, and are related to socioeconomic development, organization of health services and professional training. Objective: To systematize alerts for the prevention of postpartum hemorrhage. Method: This is a technical essay developed from reflections on previously produced and published texts about maternal mortality and has hemorrhage as the focus of this study. Results: It presents the concept, classification of hemorrhage, risk factors and their classification, prevention strategies, universal recommendations, pharmacological and non-pharmacological interventions when hemorrhage already exists, bleeding assessment techniques;clinical evaluation, by laboratory examination and by shock index. Conclusions: Hemorrhage is a preventable cause of maternal death through the accomplishment of multiple care. Hospital care must be conducted by qualified professionals and in adequate numbers. The risk diagnosis must be carried out during prenatal care with the recording of clinical data accessible in the health care network. All references studied are not specific to nursing, as hemorrhage prevention requires multidisciplinary action.
文摘BACKGROUND Helicobacter pylori(H.pylori)infects over half the global population,causing gastrointestinal diseases like dyspepsia,gastritis,duodenitis,peptic ulcers,GMALT lymphoma,and gastric adenocarcinoma.Eradicating H.pylori is crucial for treating and preventing these conditions.While conventional proton pump inhibitor(PPI)-based triple therapy is effective,there’s growing interest in longer acid suppression therapies.Potassium competitive acid blocker(P-CAB)triple and dual therapy are new regimens for H.pylori eradication.Initially used in Asian populations,vonoprazan(VPZ)has been recently Food and Drug Administration-approved for H.pylori eradication.AIM To assess the efficacy of regimens containing P-CABs in eradicating H.pylori infection.METHODS This study,following PRISMA 2020 guidelines,conducted a systematic review and meta-analysis by searching MEDLINE and Scopus libraries for randomized clinical trials(RCTs)or observational studies with the following command:[("Helicobacter pylori"OR"H pylori")AND("Treatment"OR"Therapy"OR"Eradication")AND("Vonaprazan"OR"Potassium-Competitive Acid Blocker"OR"P-CAB"OR"PCAB"OR"Revaprazan"OR"Linaprazan"OR"Soraprazan"OR"Tegoprazan")].Studies comparing the efficacy of P-CABs-based treatment to classical PPIs in eradicating H.pylori were included.Exclusion criteria included case reports,case series,unpublished trials,or conference abstracts.Data variables encompassed age,diagnosis method,sample sizes,study duration,intervention and control,and H.pylori eradication method were gathered by two independent reviewers.Meta-analysis was performed in R software,and forest plots were generated.RESULTS A total of 256 references were initially retrieved through the search command.Ultimately,fifteen studies(7 RCTs,7 retrospective observational studies,and 1 comparative unique study)were included,comparing P-CAB triple therapy to PPI triple therapy.The intention-to-treat analysis involved 8049 patients,with 4471 in the P-CAB intervention group and 3578 in the PPI control group across these studies.The analysis revealed a significant difference in H.pylori eradication between VPZ triple therapy and PPI triple therapy in both RCTs and observational studies[risk ratio(RR)=1.17,95%confidence interval(CI):1.11-1.22,P<0.0001]and(RR=1.13,95%CI:1.09-1.17,P<0.0001],respectively.However,no significant difference was found between tegoprazan(TPZ)triple therapy and PPI triple therapy in both RCTs and observational studies(RR=1.04,95%CI:0.93-1.16,P=0.5)and(RR=1.03,95%CI:0.97-1.10,P=0.3),respectively.CONCLUSION VPZ-based triple therapy outperformed conventional PPI-based triple therapy in eradicating H.pylori,positioning it as a highly effective first-line regimen.Additionally,TPZ-based triple therapy was non-inferior to classical PPI triple therapy.
文摘BACKGROUND Liver transplant(LT)patients have become older and sicker.The rate of post-LT major adverse cardiovascular events(MACE)has increased,and this in turn raises 30-d post-LT mortality.Noninvasive cardiac stress testing loses accuracy when applied to pre-LT cirrhotic patients.AIM To assess the feasibility and accuracy of a machine learning model used to predict post-LT MACE in a regional cohort.METHODS This retrospective cohort study involved 575 LT patients from a Southern Brazilian academic center.We developed a predictive model for post-LT MACE(defined as a composite outcome of stroke,new-onset heart failure,severe arrhythmia,and myocardial infarction)using the extreme gradient boosting(XGBoost)machine learning model.We addressed missing data(below 20%)for relevant variables using the k-nearest neighbor imputation method,calculating the mean from the ten nearest neighbors for each case.The modeling dataset included 83 features,encompassing patient and laboratory data,cirrhosis complications,and pre-LT cardiac assessments.Model performance was assessed using the area under the receiver operating characteristic curve(AUROC).We also employed Shapley additive explanations(SHAP)to interpret feature impacts.The dataset was split into training(75%)and testing(25%)sets.Calibration was evaluated using the Brier score.We followed Transparent Reporting of a Multivariable Prediction Model for Individual Prognosis or Diagnosis guidelines for reporting.Scikit-learn and SHAP in Python 3 were used for all analyses.The supplementary material includes code for model development and a user-friendly online MACE prediction calculator.RESULTS Of the 537 included patients,23(4.46%)developed in-hospital MACE,with a mean age at transplantation of 52.9 years.The majority,66.1%,were male.The XGBoost model achieved an impressive AUROC of 0.89 during the training stage.This model exhibited accuracy,precision,recall,and F1-score values of 0.84,0.85,0.80,and 0.79,respectively.Calibration,as assessed by the Brier score,indicated excellent model calibration with a score of 0.07.Furthermore,SHAP values highlighted the significance of certain variables in predicting postoperative MACE,with negative noninvasive cardiac stress testing,use of nonselective beta-blockers,direct bilirubin levels,blood type O,and dynamic alterations on myocardial perfusion scintigraphy being the most influential factors at the cohort-wide level.These results highlight the predictive capability of our XGBoost model in assessing the risk of post-LT MACE,making it a valuable tool for clinical practice.CONCLUSION Our study successfully assessed the feasibility and accuracy of the XGBoost machine learning model in predicting post-LT MACE,using both cardiovascular and hepatic variables.The model demonstrated impressive performance,aligning with literature findings,and exhibited excellent calibration.Notably,our cautious approach to prevent overfitting and data leakage suggests the stability of results when applied to prospective data,reinforcing the model’s value as a reliable tool for predicting post-LT MACE in clinical practice.
文摘This editorial addresses the growing concern of herb-induced liver injury(HILI),focusing on a unique case of Skullcap-induced HILI report.This editorial underscore the significant mortality rate linked to Skullcap-induced HILI,emphasizing the importance of vigilant monitoring and intervention.As herbal supplement usage rises,collaboration among clinicians and researchers is crucial to comprehend and address the complexities of HILI,particularly those involving Skullcap.
文摘Protein-calorie malnutrition (PCM) is a common condition in cirrhotic patients, leading to a worse prognosis, complications, poor quality of life and lower survival rates. Among ways of assessing nutritional status, there are anthropometric methods such as the evaluation of the triceps skinfold, the arm circumference, the arm muscle circumference and the body mass index, and non-anthropometric methods such as the subjective global assessment, the handgrip strength of non-dominant hand, and the bioelectrical impedance analysis (BIA). PCM is frequently under-diagnosed in clinical settings in patients with cirrhosis due to the limitations of nutritional evaluation methods in this population. BIA is a useful method, but cannot be indicated in patients with abnormal body composition. In these situations, the phase angle (PA) has been used, and can become an important tool in assessing nutritional status in any situation. The PA is superior to anthropometric methods and might be considered as a nutritional indicator in cirrhosis. The early characterization of the nutritional status in patients with cirrhosis means an early nutritional intervention, with a positive impact on patients’ overall prognosis. Among the usually accepted methods for nutritional diagnosis, the PA provides information in a quick and objective manner.
文摘AIM To perform a systematic review to evaluate the incidence and prevalence of non-alcoholic fatty liver disease(NAFLD) in adult patients with sarcopenia.METHODS Randomized clinical trials,cross-sectional or cohort studies including adult patients(over 18 years) with sarcopenia were selected.The primary outcomes of interest were the prevalence or incidence of NAFLD in sarcopenic patients.In the screening process,44 fulltext articles were included in the review and 41 studies were excluded.RESULTS Three cross-sectional studies were included.The authors attempted to perform a systematic review,but due to the differences between the studies,a qualitative synthesis was provided.The diagnosis of NAFLD was made by non-invasive methods(image methods or any surrogate markers) in all three evaluated studies.All the studies suggested that there was an independent association between sarcopenia and NAFLD.CONCLUSION Sarcopenia is independently associated with NAFLD and possibly to an advanced fibrosis.
文摘Apple consumption is related to the prevention of chronic diseases due to the presence of phenolic acids and flavonoids that have antioxidant capacity. However, phenolic profile and antioxidant capacity can vary between varieties. The aim of this study was to analyze the total phenolic content (TPC) and antioxidant capacity (AC) of thirty-six apple varieties to establish a classification of these fruits. The TPC was analyzed according to the Folin-Ciocalteau method and AC was analyzed using the ferric reducing antioxidant power (FRAP) method. Hierarchical cluster analysis was used for the classification of the fruit. The TPC ranged from 456 to 1583 mg/kg of fresh fruit (catechin equivalents) and the AC ranged from 5606 to 23,719 mmol/kg (fresh fruit). The Pearson linear correlation showed significant differences in the association between TPC and AC (r: 0.79, p < 0.001). The apples were classified into the following five groups according to their AC: very high (8%), high (17%), medium (47%), low (11%) and very low (17%). The varieties classified in the group with very high AC were Carícia, Mollies and Imperatriz. The Gala varieties showed a great variability in AC, with values classified as high and low, while the Fuji, with less variability, was classified as low AC. The classification of apples based on TPC and AC using hierarchical cluster analysis was performed and the results can be of great value to geneticists, producers and consumers.
基金support by Conselho Nacional de Desenvolvimento Científico e Tecnologico(CNPq)Fundacao de AmparoàPesquisa do Estado do Rio de Janeiro(FAPERJ)+1 种基金Coordenacao de Aperfeicoamento de Pessoal de Nivel Superior(CAPES)Financiadora de Estudos e Projetos(Finep)
文摘Exergames can be considered a dual task because the games are performed by a man-videogame interface, requiring cognitive and motor functions simultaneously. Although the literature has shown improvements of cognitive and physical functions due to exergames, the intrinsic mechanisms involved in these functional changes have still not been elucidated. The aims of the present study were（1） to demonstrate the known biological mechanisms of physical exercise regarding muscle adaptation and establish a relationship with exergames; and（2） to present a neurobiological hypothesis about the neuroplastic effects of exergames on the cognitive function of institutionalized older persons. These hypotheses are discussed.
基金CAPES,FAPEMIG(APQ-00125-12)and Petrobras(Geotectonic Studies Network)for financial supportthe Universidade Federal de Ouro Preto and CDTN(Centro de Desenvolvimento da Tecnologia Nuclear)for institutional support。
文摘Petrological characterization,U-Pb geochronology,Lu-Hf analyses and major and trace element data from mafic intrusions in the Central Espinhaco(central portion of the Brazilian shield)are used here to investigate the geological significance of the Early Neoproterozoic magmatism in the context of the Sao Francisco-Congo paleocontinent.These mafic bodies are represented by medium to coarse-grained metagabbros with plagioclase,amphibole and clinopyroxene.Zircon U-Pb isotopic data from two samples yielded weighted mean 206pb/238U ages of 895±3.4 Ma(MSWD=1.7)and 896±2.4 Ma(MSWD=0.64),regarded as the best estimates for the crystallization age of these mafic rocks.Major and trace element data(including REEs)show that the gabbros originated from a subalkaline tholeiitic magma,typical of intraplate magmatism.Such rocks are slightly enriched in LREEs and LILEs and depleted in HFSEs.Our new isotope and geochemical data,along with regional knowledge,indicate that these metagabbros mark the beginning of an important Tonian-age extensional tectonic event of the landmass of which the Sao Francisco-Congo paleocontinent was part(Rodinia supercontinent or Central African block?).We furthermore suggest that these rocks belong to a prominent suite of Tonian-age mafic rocks that mark a diachronic breakup attempt of this landmass which may have occurred from south to north along the Espinhaco mountain range.
文摘The challenge of keeping and getting new customers drives the development of new practices to meet the consumption needs of increasingly tends to micro-segmentation of product and consumer market. The new consumption habits of brazilians brought new prospects for market. The objective of this paper is to develop of a dynamic vehicle routing system supported by the behavior of urban traffic in the city ofSao Paulo using Neuro Fuzzy Network. The methodology of this paper consists in the capture of relevant events that interfere with the flow of traffic of the city of Sao Paulo and implementation of a Fuzzy Neural Network trained with these events in order to foresee the traffic behavior. The system offers three labels of hierarchical routing, thus is possible to consider not only the basic factors of routing, but too external factors that directly influence on the flow of traffic and the disruption which may be avoided in large cities, through alternative routes （dynamic vehicle routing）. Predicting the behavior of traffic represents the strategic level routing, dynamic vehicle routing is the tactical level, and routing algorithms to the operational level. This paper will not be discussed the operational level.
文摘Objective:To describe the prognostic and clinical profile of hospitalized patients with chikungunya virus(CHIKV)infection focusing on renal outcomes.Methods:This is a cross-sectional study including all patients with confirmed chikungunya fever(CHIKF)admitted to 3 different highcomplexity hospitals in Fortaleza,Brazil between January 2016 and June 2017.Data analysis was carried out to evaluate correlation between clinical profile and outcomes.Results:Fifty-five patients were included,with a median age of 77(IQR=21)years,and 23(41.82%)were male.Twenty-five patients(45.45%,25/55)developed acute kidney injury(AKI),and 15(60.00%,15/25)were classified as KDIGO 1,1(4.00%)as KDIGO 2,and 9(36.00%)as KDIGO 3.The overall mortality was 34.54%whilst AKI-related mortality was 64.00%(16/25).Both AKI and encephalitis were associated with higher mortality.Patients who died were significantly older[82(IQR=12)years vs.70(IQR=28.75)years,P<0.001].In the multivariate analysis,abdominal pain was associated with an increased risk of severe AKI(OR=5.33,95%CI=1.11–25.64,P=0.037)and AKI was an independent risk factor of death(OR=12.06,95%CI=2.55–57.15,P=0.002).Recovery of renal function was similar among the different age groups.Conclusions:AKI is present in half of the study population and is an independent risk factor of death.Thus,renal function should be carefully monitored in hospitalized patients with CHIKV infection.
文摘Height limitations are not uncommon in multi-storey buildings due to economic requirements and esthetical considerations. Substantial spaces are normally required to enable the passage of large pipes and ducts beneath steel beams leading to uneconomic floor heights. The most adopted solution for this issue is the use of steel beam web openings to provide the required space for services. These openings could lead to a significant decrease of the beam load carrying capacity depending on the adopted openings shape, size and location. These aspects motivated the present study based on FE simulations calibrated against numerical and test results. The results accuracy enabled a comprehensive parametric analysis of beams with web openings to be made focused on the profile size, web opening location, among others. The study also investigated the efficiency of longitudinal stiffeners welded at the opening region and benefits of using an adequate edge concordance radius in beams with rectangular and square openings. The obtained results showed the need of using welded longitudinal stiffeners in order to increase the beams ultimate load carrying capacity. This adoption can double or even triple the ultimate load of beams with rectangular and square opening heights equal to 0.75 H, respectively.
基金Supported by Beasiswa Unggulan Directorate General of Higher Education 2012,and BOPTN-WUR,Universitas Gadjah Mada(Grant No.578A/KJM/XI/2015)
文摘Objective: To examine the anti-angiogenic potential of Artocarpus heterophyllus(A. heterophyllus) seed extract in chicken chorioallantoic membrane(CAM).Methods: This study used chicken CAM ex ovo culture to examine the potential antiangiogenic activity of A. heterophyllus seed methanolic extract. Basic fibroblast growth factor was used to induce the ectopic formation of blood vessels on CAM treated with extract. Blood vessel number was assessed by macroscopic and microscopic observation,and compared and analyzed for all treatments and controls.Results: Macroscopic observation revealed that a dose of 35 mg/m L of methanolic extract of A. heterophyllus seeds could inhibit basic fibroblast growth factor-induced angiogenesis by 61% in chicken CAM ex ovo culture. This concurred with microscopic observations on the histological structure of blood vessels, which indicated that extract treatment repressed the formation of new blood vessels.Conclusions: This is the first study to report the anti-angiogenic effect of methanolic extract derived from A. heterophyllus seeds and its potential as a candidate for future anticancer therapy.
文摘The aim of this paper was to report on factors contributing to the deterioration of the mental health of Indigenous populations(IP)in Brazil.Five factors seem to have a direct impact on the mental health of IP in Brazil:(1)The absence of public policies;(2)Intellectual production;(3)Psychiatric medical care for remote areas(e.g.,telemedicine)aimed at promoting the mental health of Brazil’s IP,which causes a huge gap in the process of assistance and social,psychological,economic and cultural valorization of native peoples;(4)The dissemination of fake news,which exposed,above all,older IP to risk behaviors in the pandemic,such as refusal of vaccination;and(5)The violence carried out on IP lands due to economic interests with mining/agribusiness.
基金VML and APS wish to thank CAPES(Brasilia,Brazil)and FAPERGS(Porto Alegre,Brazil)for the financial support,and TGS and APS are grateful to CNPq(Brasilia,Brazil)for the research fellowship and financial support(proc.307352/2013-7 and proc.441407/2014-5,respectively).We are also thankful the local people from Derrubadas municipality(Rio Grande do Sul state,Brazil).This work was performed by following the licenses provided by the Secretaria Estadual do Meio Ambiente,RS,Brazil(SEMA,#144/2013),ICMBIO/MMA(#39772-1),and the Ethics Committee on Animal Use of the Federal University of Santa Maria(#060/2013).
文摘For decades the ecologists are using the same methods in order to determine the environmental health of a community,however,the crescent need on defining how these processes act,triggered the development of new methods that could classify the organisms and their function at the habitats.Here we used the anuran larvae to understand the effects of an environmental gradient on the structure and organization of the anuran assemblages along it,and to access in a realistic form,the actual state of preservation of the la rgest remnant of Atlantic Rainforest on the Southernmost portion of Brazil.We found that despite the higher diversity of species and the conservation unit status of the place,the ecosystem itself is still in danger,given the low number of functional groups and thus a higher number of ecosystem services that can be lost.
文摘In 2009, based on a multicenter study conducted in Asia and Latin Americaand subsidized by the Dengue Control (DENCO) Research Program, the World Health Organization (WHO) proposed a new classification for dengue cases. The purpose of the present study was to evaluate the applicability of the new classification, relative to its previous version [1]. The evaluation, conducted in Campo Grande county, Mato Grosso do Sul state, Brazil, drew on secondary data from referral healthcare centers that assist high-severity dengue patients. A total of 156 medical records of patients with laboratory diagnosis of dengue were investigated. The records covered two epidemic periods: summer of 2006-2007 and summer of 2009-2010. The results showed that 64.6% of cases classified as dengue fever under the 1997 criteria presented manifestations of severity, warranting their reclassification as dengue with warning signs (49) or severe dengue (15) under the 2009 revised criteria. Bleeding, persistent vomiting, and severe, continuous abdominal pain were the most prevalent warning signs, indicative of risk of progression to severe disease. The revised classification was proved less complex than the current version, facilitating the identification of cases and the clinical management of patients.
文摘The paper was monitored the conductivity （g.L＂l of NaCI）, the absorbances values （Abs） and the amount of TOC （total organic carbon）, before and after five consecutive dyeings made with reuse water, obtained from treated effluent by UV/H202 photocatalysis. All rates of decolorization were above 92%, the removal of total organic carbon was above 89% in all treatments and the economy of NaCI was from 3.10 in the first recipe, 3.17 in the second, 3.49 in the third, 3.79 in the fourth and 4.05 in the fifth recipe. The five dyeings compared with same dyeings made with deionized water presented a color deviation （AE＊） below 1. The conventional dyeings would consume 80 L/kg against 40 L/kg used in the dyeing process proposed in this study, representing a great economy of water, with no discharge of effluents.
