Search

Background Pan-intestinal capsule endoscopy (PCE) evaluates the small bowel and colon noninvasively. This study evaluated diagnostic accuracy and safety of PCE vs. colonoscopy as first-line examination in suspected mid–lower gastrointestinal bleeding (MLGIB). Methods In this prospective, single-center, single-blinded cohort study, consecutive patients with suspected MLGIB underwent PCE followed by same-day colonoscopy. Diagnostic accuracy for potentially hemorrhagic lesions (PHLs; combined diagnosis by PCE + colonoscopy) and incidence of adverse events were assessed. Results 100 patients were included (median age 70 [range 18–92] years; 65% female). PHLs were diagnosed in 46 patients, including small-bowel and/or colon angioectasias in 32. PCE correctly identified 54 individuals without PHLs, and 95.7% (44/46) of those with PHLs vs. 50.0% (23/46) for colonoscopy (P<0.01). PHLs were detected by PCE alone in 65.2% (30/46), both examinations in 28.3% (13/46), and colonoscopy alone in 6.5% (3/46). PHLs were diagnosed at the ileocolonic region in 28% of patients, with PCE diagnosing 25/28 cases (89.3%) and colonoscopy diagnosing 23/28 (82.1%; P=0.13). Interventional procedures were performed at colonoscopy in 13/81 patients with iron-deficiency anemia (16.0%) vs. 6/19 patients with overt bleeding (31.6%; P<0.01). No significant adverse events occurred with PCE vs. 2% with colonoscopy. Conclusions In patients with MLGIB, PCE avoided further invasive procedures in >50% of patients. PCE was safe and more effective than colonoscopy in identifying PHL both in the small bowel and colon. These results support the potential use of PCE as first-line examination in patients with suspected MLGIB. [ABSTRACT FROM AUTHOR]

This study contributes to the unconsolidated cryptocurrency literature, with a systematic literature review focused on cryptocurrency market microstructure. We searched Web of Science database and focused only on journals listed on 2021 ABS list. Our final sample comprises 138 research papers. We employed a quantitative and an integrative analysis, and revealed complex network associations, and a detailed research trending analysis. Our study provides a robust and systematic contribution to cryptocurrency literature by making use of a powerful and accurate methodology—the bibliographic coupling, also by only considering ABS academic journals, using a wider keyword scope, and not enforcing any restrictions regarding areas of knowledge, thus enhancing the contribution of extant literature by allowing the insights of more high-quality peripheral studies on the subject. The conclusions of this study are of extreme importance for researchers, investors, regulators, and the academic community in general. Our study provides high structured networking and clear information for research outlets and literature strands, for future studies on cryptocurrency investment, it also presents valuable insights to better understand the cryptocurrency market microstructure and deliver helpful information for regulators to effectively regulate cryptocurrencies. [ABSTRACT FROM AUTHOR]

This study uses the memories of people of African descent as a way of understanding the narratives that cover work relationships between white masters and descendants of former slaves in the post-abolition period in Garopaba-SC, more specifically in the first decades of the 20th century, in the neighborhoods Campo D'una and Encantada. The work is methodologically developed from oral history, in this sense it seeks to investigate, through reports obtained through semi-structured interviews, what these individuals worked with and how they were remunerated in addition to understanding how they understood concepts such as: slavery, freedom and free labor. [ABSTRACT FROM AUTHOR]

This work presents the "Dossiê de Mortes e Violências contra LGBTI+ no Brasil em 2021", highlighting its spatial distribution. The data used in the Dossier were produced through news published in the media and, when necessary, supplemented by alternative sources. An effort was made to map the deaths, expressed on three scales of analysis (municipal, state/district and macroregional). The main challenge for the preparation of the Dossier was the absence of government information, so this study highlights the difficulties encountered in the production and dissemination of the elaborated data to guarantee greater consistency and reliability to the analyses of violent deaths of LGBTI+ in Brazil. [ABSTRACT FROM AUTHOR]

Currently, radiologists face an excessive workload, which leads to high levels of fatigue, and consequently, to undesired diagnosis mistakes. Decision support systems can be used to prioritize and help radiologists making quicker decisions. In this sense, medical content-based image retrieval systems can be of extreme utility by providing well-curated similar examples. Nonetheless, most medical content-based image retrieval systems work by finding the most similar image, which is not equivalent to finding the most similar image in terms of disease and its severity. Here, we propose an interpretability-driven and an attention-driven medical image retrieval system. We conducted experiments in a large and publicly available dataset of chest radiographs with structured labels derived from free-text radiology reports (MIMIC-CXR-JPG). We evaluated the methods on two common conditions: pleural effusion and (potential) pneumonia. As ground-truth to perform the evaluation, query/test and catalogue images were classified and ordered by an experienced board-certified radiologist. For a profound and complete evaluation, additional radiologists also provided their rankings, which allowed us to infer inter-rater variability, and yield qualitative performance levels. Based on our ground-truth ranking, we also quantitatively evaluated the proposed approaches by computing the normalized Discounted Cumulative Gain (nDCG). We found that the Interpretability-guided approach outperforms the other state-of-the-art approaches and shows the best agreement with the most experienced radiologist. Furthermore, its performance lies within the observed inter-rater variability. [ABSTRACT FROM AUTHOR]

This letter is a response to a previous article on the optimal timing of endoscopy in patients taking anticoagulants with upper gastrointestinal bleeding (NVUGIB). The authors of the response analyzed data from adult patients using anticoagulants and found that early endoscopy (≤ 24 hours) was associated with more endoscopic therapy, a shorter hospital stay, and more frequent admission to intermediate/intensive care units compared to delayed endoscopy (> 24 hours). However, there were no differences in outcomes such as the need for surgery, recurrent bleeding, and 30-day mortality between the two groups. The authors suggest that early endoscopy should be the preferred strategy for patients with NVUGIB taking anticoagulants. They also discuss other studies that have different findings and highlight the importance of considering factors such as age and anticoagulant use when interpreting the results. Overall, the research supports early endoscopy as the optimal approach for managing NVUGIB, regardless of anticoagulant use. [Extracted from the article]

The article discusses the role and focus of young endoscopists in the field of digestive endoscopy. It highlights the importance of education, training, and access to career development opportunities for young endoscopists. The article also emphasizes the need for standardized, high-quality training and credentialing in order to ensure uniformity in the field. It suggests that young endoscopists can contribute to the future of digestive endoscopy by providing input on various key issues, such as training, mobility, education, social media, sub-specialties, artificial intelligence, and ethical values. The article concludes by expressing optimism about the growth and development of the ESGE Young Endoscopists Committee. [Extracted from the article]

Knowledge hiding and knowledge hoarding define two organizational behaviors that integrate knowledge withholding related phenomena in organizations. Although recent literature presents efforts to conceptually differentiate knowledge hiding and knowledge hoarding, evidence shows that there are emerging gaps resulting from conceptual and empirical inconsistencies between the constructs. This paper addresses the need for theoretical and empirical clarification by developing on the use of Grounded Theory (GT) as a systematic methodology to expand knowledge on both phenomena. This work explores core characteristics and procedures related to GT that can support the pursuit of theoretical refinement behind knowledge hiding and knowledge hoarding as dimensions of knowledge withholding. It presents three philosophical rationales that can support knowledge hiding and knowledge hoarding conceptualization using Classic, Interpretivist and Constructivist GT. Specifically, it provides a conceptual framework that discusses concerns of the researcher, literature review processes, data collection methods, and data coding and analysis strategies that should be considered to ensure quality in GT research. Lastly, it discusses an integration of research using mixed methods GT to address quantitative concerns surrounding GT. This paper contributes to the theoretical and empirical development of knowledge hiding and knowledge hoarding related phenomena by suggesting research conducts and designs to support the usage of GT approaches in the study of both phenomena. [ABSTRACT FROM AUTHOR]

10.1055/a-2270-4601In the above-mentioned article Figure 2 has been corrected. Correct ist that the two diagrams on the right are summarised as "Overt bleeding (n=19)". This was corrected in the online version on April 8, 2024.By Bruno Rosa; Tiago Cúrdia Gonçalves; Maria J. Moreira; Francisca Dias de Castro; Bernardo Sousa-Pinto; Mário Dinis-Ribeiro and José CotterReported by Author; Author; Author; Author; Author; Author; Author [Extracted from the article]

In this work, we study the possibility of finite-time future cosmological singularities appearing in f(R, T) gravity, where R is the Ricci scalar and T is the trace of the stress-energy tensor. We present the theory in both the geometrical and the dynamically equivalent scalar–tensor representation and obtain the respective equations of motion. In a background Friedmann–Lemaître–Robertson–Walker (FLRW) universe with an arbitrary curvature and for a generic C ∞ function f(R, T), we prove that the conservation of the stress-energy tensor prevents the appearance of sudden singularities in the cosmological context at any order in the time-derivatives of the scale factor. However, if this assumption is dropped, the theory allows for sudden singularities to appear at the level of the third time-derivative of the scale factor a(t), which are compensated by divergences in either the first time-derivatives of the energy density ρ (t) or the isotropic pressure p(t). For these cases, we introduce a cosmological model featuring a sudden singularity that is consistent with the current measurements for the cosmological parameters, namely, the Hubble constant, deceleration parameter, and age of the universe, and provide predictions for the still unmeasured jerk and snap parameters. Finally, we analyse the constraints on a particular model of the function f(R, T) that guarantees that the system evolves in a direction favorable to the energy conditions at the divergence time. [ABSTRACT FROM AUTHOR]

This paper presents an incentivized experiment analyzing the role of demographic characteristics in individual decision-making under uncertainty. Reactions to a natural source of uncertainty, payoffs in a TV game show, were measured using Fuzzy-set Qualitative Comparative Analysis (fsQCA), allowing us to identify multiple configurations of causal conditions that are sufficient for individuals to prefer an uncertain payoff to a sure gain, and, thus, lower risk aversion. This paper found evidence of preference for uncertainty, measured as willingness to play for an uncertain payoff, in individuals with characteristics most commonly present in the literature: being male; young; childless; with studies in finance or similar areas. This paper also shows that conditions that would not justify the preference for uncertainty according to the literature (an older individual or having children), when combined with other conditions, change contestants' behavior regarding preference for uncertainty. Individuals that are both older and single, and individuals that have children combined with education in finance, show an inverse effect on preference for uncertainty. [ABSTRACT FROM AUTHOR]

Biometric recognition and presentation attack detection (PAD) methods strongly rely on deep learning algorithms. Though often more accurate, these models operate as complex black boxes. Interpretability tools are now being used to delve deeper into the operation of these methods, which is why this work advocates their integration in the PAD scenario. Building upon previous work, a face PAD model based on convolutional neural networks was implemented and evaluated both through traditional PAD metrics and with interpretability tools. An evaluation on the stability of the explanations obtained from testing models with attacks known and unknown in the learning step is made. To overcome the limitations of direct comparison, a suitable representation of the explanations is constructed to quantify how much two explanations differ from each other. From the point of view of interpretability, the results obtained in intra and inter class comparisons led to the conclusion that the presence of more attacks during training has a positive effect in the generalisation and robustness of the models. This is an exploratory study that confirms the urge to establish new approaches in biometrics that incorporate interpretability tools. Moreover, there is a need for methodologies to assess and compare the quality of explanations. [ABSTRACT FROM AUTHOR]

The retail assumed a role of highlight in the socio-spatial reorganization of cities. In this context, observing the importance of the city Canindé in the economic and cultural scope of the state Ceara, then this article aims to grasp the lower circuit of the urban economy in the period of the St. Francis of Assisi and their consequences in the socio-spatial dynamics of Canindé. The study was based on the theory of circuits in urban economics. Thus, we did interviews with and street vendors. The temporal frame from 2018 to 2019 (in the periods of September and October). In the Canindé, it is perceived that the lower circuit is productive and responsible for generating employment and income, which enabling the survival of several families. [ABSTRACT FROM AUTHOR]

Lipids govern vital cellular processes and drive physiological changes in response to different pathological or environmental cues. Lipid species can be roughly divided into structural and signalling lipids. The former is essential for membrane composition, while the latter are usually oxidized lipids. These mediators provide beneficial effects against cardiometabolic diseases (CMDs), including fatty-liver diseases, atherosclerosis, thrombosis, obesity, and Type 2 diabetes. For instance, several oxylipins were recently found to improve glucose homeostasis, increase insulin secretion, and inhibit platelet aggregation, while specialized pro-resolving mediators (SPMs) are able to ameliorate CMD by shaping the immune system. These lipids act mainly by stimulating GPCRs. In this review, we provide an updated and comprehensive overview of the current state of the literature on signalling lipids in the context of CMD. We also highlight the network encompassing the lipid-modifying enzymes and the lipid-binding GPCRs, as well as their interactions in health and disease. [ABSTRACT FROM AUTHOR]

Introduction: Percutaneous Endoscopic Gastrostomy (PEG) is accepted as an efficient method to provide long-term enteral nutrition. PEG accidental dislodgement (device exteriorization confirmed by expert evaluation) rate is high and can lead to major morbidity. Objective: To identify independent risk factors for PEG accidental dislodgement. Methods: Retrospective, single-center study, including consecutive patients submitted to PEG procedure, for 38 consecutive months. Every patient had 12 months minimum follow-up after PEG placement. Univariate analysis selected variables with at least marginal association (p <.15) with the outcome variable, PEG dislodgement, which were included in a logistic regression multivariate model. Discriminative power was assessed using area under curve (AUC) of the receiver operating curve (ROC). Results: We included 164 patients, 67.7% (111) were female, mean age was 81 years. We report 59 (36%) PEG dislodgements, of which 13 (7.9%) corresponded to early dislodgements. The variables with marginal association were hypoalbuminemia (p =.095); living at home (p =.049); living in a nursing home (p =.074); cerebrovascular disease (CVD) (p =.028); weight change of more than 5 kg, either increase or decrease (p =.001); psychomotor agitation (p <.001); distance inner bumper-abdominal wall (p =.034) and irregular appointment follow-up (p =.149). At logistic multivariate regression, the significant variables after model adjustment were CVD OR 4.8 (CI 95% 2.0–11.8), weight change OR 4.7 (CI 95%1.6–13.9) and psychomotor agitation OR 18.5 (CI 95% 5.2–65.6), with excellent discriminative power (AUC ROC 0.797 [CI95% 0.719–0.875]). Conclusion: PEG is a common procedure and accidental dislodgement is a frequent complication. CVD, psychomotor agitation and weight change >5 kg increase the risk of this complication and should be seriously considered when establishing patients' individual care requirements. [ABSTRACT FROM AUTHOR]

[Display omitted] Enterobacteriaceae species are part of the 2017 World Health Organization antibiotic-resistant priority pathogens list for development of novel medicines. Multidrug-resistant Klebsiella pneumoniae is an increasing threat to public health and has become a relevant human pathogen involved in life-threatening infections. Phage therapy involves the use of phages or their lytic endolysins as bioagents for the treatment of bacterial infectious diseases. Gram-negative bacteria have an outer membrane, making difficult the access of endolysins to the peptidoglycan. Here, three endolysins from prophages infecting three distinct Enterobacterales species, Kp2948-Lys from K. pneumoniae , Ps3418-Lys from Providencia stuartii , and Kaer26608-Lys from Klebsiella aerogenes , were purified and exhibited antibacterial activity against their specific bacterium species verified by zymogram assays. These three endolysins were successfully associated to liposomes composed of dimyristoyl phosphatidyl choline (DMPC), dioleoyl phosphatidyl ethanolamine (DOPE) and cholesteryl hemisuccinate (CHEMS) at a molar ratio (4:4:2), with an encapsulation efficiency ranging from 24 to 27%. Endolysins encapsulated in liposomes resulted in higher antibacterial activity compared to the respective endolysin in the free form, suggesting that the liposome-mediated delivery system enhances fusion with outer membrane and delivery of endolysins to the target peptidoglycan. Obtained results suggest that Kp2948-Lys appears to be specific for K. pneumoniae , while Ps3418-Lys and Kaer26608-Lys appear to have a broader antibacterial spectrum. Endolysins incorporated in liposomes constitute a promising weapon, applicable in the several dimensions (human, animals and environment) of the One Health approach, against multidrug-resistant Enterobacteriaceae. [ABSTRACT FROM AUTHOR]

In a context marked by technical, economic and political ferocity, the return to the study of concepts and categories proposes to enable the individual to reconstruct pillars that contribute to the subject's knowledge of the object, being essential mediations for understanding the world. Thus, this study discusses the concept of region as an explanatory possibility in spatial analysis and its relation in the planning and development process. The methodology of the work is based on a bibliographical research about the dialectical relation present in the following conceptual triad: region, planning and development. To do so, a survey of national and foreign studies was undertaken on the articulation of said concepts and categories within the scope of geographic science. The present analysis, when dialoguing with a wide range of authors, presents interpretations about the organization of regional thinking, as well as its possibilities of understanding its meaning in the space dimension contained therein, going from the development of regional superintendencies to regional development policies of tourism in the country. Faced with the contemporary crisis of the globalization process, which failed to suppress spatial diversity, as well as the search for the strengthening of regional boundaries and blocks of power, we can see the return of the region at the center of the political-economic debates, evoking the resumption of studies on the epistemological basis of the geographic community. [ABSTRACT FROM AUTHOR]

Objectives: Perianal Crohn’s disease (CD) prevalence varies according to the disease location, being particularly frequent in patients with colonic involvement. We aimed to evaluate small bowel involvement and compare small bowel capsule endoscopy findings and inflammatory activity between patients with and without perianal disease. Materials and methods: Retrospective single-center study including 71 patients - all patients with perianal CD (17 patients) who performed a small bowel capsule endoscopy were included, and non-perianal CD patients were randomly selected (54 patients). Clinical and analytical variables at diagnosis were reviewed. Statistical analysis was performed with SPSS v21.0 and a two-tailed p value <.05 was defined as indicating statistical significance. Results: Patients had a median age of 30 ± 16 years with 52.1% females. Perianal disease was present in 23.9%. Patients with perianal disease had significantly more relevant findings (94.1% vs 66.6%, p = .03) and erosions (70.6% vs 42.6%, p = .04), however, no differences were found between the two groups regarding ulcer, villous edema and stenosis detection. Overall, patients with perianal disease had more frequently significant small bowel inflammatory activity, defined as a Lewis Score ≥135 (94.1% vs 64.8%, p = .03), and higher Lewis scores in the first and second tertiles (450 ± 1129 vs 0 ± 169, p = .02 and 675 ± 1941 vs 0 ± 478, p = .04, respectively). No differences were found between the two groups regarding third tertile inflammatory activity assessed with the Lewis Score. Conclusion: Patients with perianal CD have significantly higher inflammatory activity in the small bowel, particularly in proximal small bowel segments, when compared with patients without perianal disease. [ABSTRACT FROM AUTHOR]

Background and study aims:Available scoring systems to assess the risk for major bleeding in patients on chronic anticoagulation seem inadequate in predicting higher diagnostic yields of small bowel capsule endoscopy (SBCE) or higher rebleeding rates in patients with suspected small bowel bleeding. The aim of this study was to evaluate the ability of the new ORBIT score in predicting positive findings of SBCE or higher rebleeding rates in chronically anticoagulated patients with suspected small bowel bleeding. Patients and methods:Retrospective analysis of 570 patients who consecutively underwent SBCE for the study of suspected small bowel bleeding. For each of the 67 patients who were on chronic anticoagulation, ORBIT score (Older age, Reduced hemoglobin/hematocrit, Bleeding history,Insufficient kidney function and Treatment with antiplatelets) was calculated. Patients were classified as high-risk (ORBIT score ≥4) or low/intermediate-risk (ORBIT score <4). Data on SBCE findings, diagnostic yield and rebleeding were compared between groups. Results:When ORBIT score was calculated, 41 and 26 patients were classified as low/intermediate-risk and high-risk, respectively. When low/intermediate-risk and high-risk groups were compared, no differences were found in the diagnostic yield of SBCE (39.0% vs. 23.1%;p = .176). However, in high-risk patients, rebleeding was significantly more common than in low/intermediate-risk patients (80.0% vs. 36.6%;p = .003). Conclusions:In patients presenting with suspected small bowel bleeding and on chronic anticoagulation, the new ORBIT score seems promising in identifying those with a higher risk of rebleeding, in whom a closer follow-up and a more aggressive diagnostic and therapeutic strategy is advisable. [ABSTRACT FROM PUBLISHER]

This article aims to discuss the theoretical and methodological approaches of environmental management tools, focusing on environmental assessment and environmental valuation methods with a bias of environmental economics and ecological economics. It was considered that the theme is of interest to Geography, Economics and Ecology, as well as to other professionals involved in research on the environment. Part of the ecological premises in the management of the environment, as well as its applicability becomes an instrument for the treatment of the questions related to the environmental degradation. The imminence of measures that allow to protect ecosystems is recognized, an objective that can be reached through paths that introduce new paradigms and readings about the relations between nature and economy. In this way, studies on the mechanisms that contribute to a significant environmental management need to move forward and gain new foundations. Thus, the incorporation of economic and ecological contents contribute to the work related to Environmental Management. [ABSTRACT FROM AUTHOR]

Morphine use in acute cardiogenic pulmonary oedema: is MIMO trial enough to change practice? Patients randomized to morphine received intravenously 2-4 mg and a further additional bolus of 1 mg every 5 min until achieving desired effects, secondary effects, or a maximum total dose of 8 mg. Letter regarding the article 'Midazolam versus morphine in acute cardiogenic pulmonary oedema: results of a multicentre, open-label, randomized controlled trial'. [Extracted from the article]

The theme of the shopping centres inserts in the midst of the transformations occurred in the in trade associated with the real estate and financial dynamics. The article proposed here aims to analyze the shopping centres of the current stage of the metropolis Fortaleza. It starts with the relationship between the metropolis, shopping centre, space production and consumption that are quite narrow, is linked to the new dynamics of internationalization of the world economy. The article has as reflective instrumental the categories, the dynamic and the spatial processes related to real estate-tertiary. [ABSTRACT FROM AUTHOR]

"This work was partially funded by the Project TAMI - Transparent Artificial Medical Intelligence (NORTE-01-0247-FEDER-045905) financed by ERDF - European Regional Fund through the North Portugal Regional Operational Program - NORTE 2020 and by the Portuguese Foundation for Science and Technology - FCT under the CMU - Portugal International Partnership, and also by the Portuguese Foundation for Science and Technology - FCT within PhD grants SFRH/BD/139468/2018 and 2020.06434.BD. The authors thank the Swiss National Science Foundation grant number 198388, as well as the Lindenhof foundation for their grant support." now reads: "This work was supported by National Funds through the Portuguese Funding Agency, FCT-Foundation for Science and Technology Portugal, under Project LA/P/0063/2020, and also by the Portuguese Foundation for Science and Technology - FCT within PhD grants SFRH/BD/139468/2018 and 2020.06434.BD. The authors thank the Swiss National Science Foundation grant number 198388, as well as the Lindenhof foundation for their grant support.". [Extracted from the article]

This paper presenting as contribution a model for the evaluation, control, and improvement of airport safety by analyzing different operational events. This model is based on multicriteria methods, in particular, the entropy and TOPSIS methods. It allows to operationalize the evaluation of the airport ramp safety performance in contexts of scarce information about the weights of each criterion, and where the absence of personal judgments in the weighting process is considered important. Operational events were used to develop the criteria. In addition, an application was conducted and the data from airport ramp safety events were used to identify trends, diagnose problems, support the planning of actions, and provide a basis for allocating resources for prevention of catastrophic accidents and improvement of safety. This application was used to validate the model. It was concluded that the airport ramp safety did not maintain a trend of continuous improvement and the proposed model allowed the identification of trends, of criteria with low performance, and the realization of recommendations for improvinge airport safety. [ABSTRACT FROM AUTHOR]

Teaching Engineering students some theoretical concepts of Control Theory is a quite a challenge. Practical and theoretical skills must be taught in parallel because those students are being prepared for working at industry, developing added value for the economy of the country where they belong. In Portugal, the domain of control and automation is quite important due to the fact that economy grows based on knowledge and development of high added value products. This ideas are being invoked by government institutions and accepted by industry and universities. So, this work has been developed on the context of Triple Helix of university-industry-government relationships. Hand-on experiments related to those concepts may be a significant help. This paper presents two aero-stabilizer workbenches that were designed in order to help the teaching of Proportional-Integral-Derivative (PID) controllers. Each workbench has a bar which is free to rotate about one of its extremities. A motor propeller assembly at the other end of the bar raises it. The desired bar orientation is obtained by controlling the rotation speed of the motor. Bar orientation is measured with an optical encoder that sends a feedback signal to a PID controller. The two workbenches differ only on the electronic system that performs the PID control. One of them uses an industrial Programmable Logic Controller (PLC) for that purpose. The other uses an Arduino platform. Having both workbenches will allow students to work with two widely used microcontroller technologies and to compare them. Some fundamental concepts and the main components required to build the workbenches are described. [ABSTRACT FROM AUTHOR]

Background: The rate of adequate cleansing (ACR) and complete examinations (CR) are key quality indicators in capsule colonoscopy (CC) and pan-intestinal capsule endoscopy (PCE). Aims: To evaluate the efficacy of bowel preparation protocols regarding ACR and CR. Methods: We conducted a systematic review and meta-analysis, search terms regarding colon capsule preparation, publication date from 2006/01, and date of search 2021/12, in six bibliographic databases. Multiple steps of the cleansing protocol were assessed: diet, adjunctive laxatives, purgative solution, use of prokinetic agents, and "booster". The meta-analytical frequency of ACR and CR was estimated, and subgroup analyses performed. Strategies associated with higher ACR and CR were explored using meta-analytical univariable and multivariable regression models. Results: Twenty-six observational studies and five RCTs included (n = 4072 patients). The pooled rate of ACR was 72.5% (95% C.I. 67.8–77.5%; I2 = 92.4%), and the pooled rate of CR was 83.0% (95% C.I. 78.7–87.7%; I2 = 96.5%). The highest ACR were obtained using a low-fibre diet [78.5% (95% C.I. 72.0–85.6%); I2 = 57.0%], adjunctive laxatives [74.7% (95% C.I. 69.8–80.1%); I2 = 85.3%], and split dose < 4L polyethylene glycol (PEG) as purgative [77.5% (95% C.I. 68.4–87.8%); I2 = 47.3%]. The highest CR were observed using routine prokinetics prior to capsule ingestion [84.4% (95% C.I. 79.9–89.2%); I2 = 89.8%], and sodium phosphate (NaP) as "booster" [86.2% (95% C.I. 82.3–90.2%); I2 = 86.8%]. In univariable models, adjunctive laxatives were associated with higher ACR [OR 1.81 (95% C.I. 1.13; 2.90); p = 0.014]. CR was higher with routine prokinetics [OR 1.86 (95% C.I. 1.13; 3.05); p = 0.015] and split-dose PEG purgative [OR 2.03 (95% C.I. 1.01; 4.09), p = 0.048]. Conclusions: Main quality outcomes (ACR, CR) remain suboptimal for CC and PCE. Despite considerable heterogeneity, our results support low-fibre diet, use of adjunctive sennosides, split dose < 4L PEG, and routine prokinetics, while NaP remains the most consistent option as booster. [ABSTRACT FROM AUTHOR]

This paper proposes an approach to obtain a global index of safety in airport runways, with criteria based on safety events. Events were weighted based on the cardinal data extracted from the perception of an expert on safety risks, using the Swing Weights method. The multi-attribute value theory to group the different criteria in a global index was employed to analyze the evolution of the safety levels. This approach was applied to the operations of the São Paulo-Guarulhos International Airport. Trend analyses were done to highlight the most urgent indicators to carry out actions to increase the safety levels. The results were considered to be consistent, contributing to the continuity of its practical application in the management of airport safety. [ABSTRACT FROM AUTHOR]

With the prevalence of mobile computing systems and location based services, large amounts of spatio-temporal data are nowadays being collected, representing the mobility of people performing various activities. However, despite the increasing interest in the exploration of these data, there are still open challenges in various application contexts, e.g. related to visualisation and human–computer interaction. In order to support the extraction of useful and relevant information from the spatio-temporal and the thematic properties associated with human trajectories, it is crucial to develop and study adequate interactive visualisation techniques. In addition to the properties of the visualisations themselves, it is important to take into consideration the types of information present within the data and, more importantly, the types of tasks that a user might need to consider in order to achieve a given goal. The understanding of these factors may, in turn, simplify the development and the assessment of a given interactive visualisation. In this paper, we present and analyse the most relevant concepts associated to these topics. In particular, our analysis addresses the main properties associated with (human) trajectory data, the main types of visualisation tasks/objectives that the users may require in order to analyse that data and the high-level classes of techniques for visualising trajectory data. In addition, this paper also presents an overview on a user study, conducted in function of this analysis, to compare two classes of visualisation techniques, namely static maps and space-time cubes, regarding their adequacy in helping users completing basic visualisation tasks. [ABSTRACT FROM PUBLISHER]

Aim This study evaluated the effects of scaling and root planing ( SRP) on gingival crevicular fluid ( GCF) and serum levels of adipokines in patients with chronic periodontitis ( CP) with or without obesity. Methods Twenty patients with obesity and 20 patients without obesity, all with CP, received SRP. Serum and GCF levels of resistin, adiponectin, leptin, tumour necrosis factor [ TNF]- α and interleukin [ IL]-6 were evaluated by enzyme-linked immunosorbent assay at baseline, 3, 6 and 12 months post-therapy. Results SRP reduced the amounts of TNF- α in deep sites and increased the concentration of adiponectin in shallow sites of non-obese patients ( p < 0.05). SRP increased the concentrations of TNF- α and leptin in patients with obesity ( p < 0.05). GCF levels of TNF- α were higher in patients with obesity than in patients without obesity at all time-points ( p < 0.05). There were no changes in serum levels of any adipokines for any group after therapy ( p > 0.05). Patients with obesity exhibited higher serum levels of leptin at all time-points and IL-6 at 3 months post-therapy ( p < 0.05). Conclusions Obesity may modulate systemic and periodontal levels of adipokines in favour of pro-inflammation, independently of periodontal therapy. SRP did not affect the circulating levels of adipokines in patients with or without obesity. [ABSTRACT FROM AUTHOR]

Background and Aim. Angioectasias are the most common vascular anomalies found in the gastrointestinal tract. In small bowel (SB), they can cause obscure gastrointestinal bleeding (OGIB) and in this setting, small bowel capsule endoscopy (SBCE) is an important diagnostic tool. This study aimed to identify predictive factors for the presence of SB angioectasias, detected by SBCE. Methods. We retrospectively analyzed the results of 284 consecutive SBCE procedures between April 2006 and December 2012, whose indication was OGIB, of which 47 cases with SB angioectasias and 53 controls without vascular lesions were selected to enter the study. Demographic and clinical data were collected. Results. The mean age of subjects with angioectasias (70.9 ± 14.7) was significantly higher than in controls (53.1 ± 18.6; P < 0.001). The presence of SB angioectasias was significantly higher when the indication for the examwas overtOGIB versus occultOGIB (13/19 versus 34/81,P = 0.044).Hypertension and hypercholesterolemia were significantly associated with the presence of SB angioectasias (38/62 versus 9/38, P < 0.001 and 28/47 versus 19/53, P = 0.027, resp.).Other studied factorswere not associated with small bowel angioectasias. Conclusions. In patients withOGIB, overt bleeding, older age, hypercholesterolemia, and hypertension are predictive of the presence of SB angioectasias detected by SBCE, which may be used to increase the diagnostic yield of the SBCE procedure and to reduce the proportion of nondiagnostic examinations. [ABSTRACT FROM AUTHOR]

This article analyzes the fieldwork as a methodology of teaching-learning in the Regional Geography discipline. This study shows like assumption the understanding of how to drive the geographic knowledge and its repercussions in cognitive development of students of Geography, in the Federal University of Ceará. This work points to the educator and the students of this scientific field a rethink about the importance of field class, its construction process of knowledge about the lived space and designed to be observed. This activity field presents a dialogue between the studied concepts in the classroom and the phenomena seen in the field. [ABSTRACT FROM AUTHOR]

This study investigates the effect on nonprofessional investors' judgements and decisions of discretionary measurement choices. Using a paper-and-pencil experience, we collect and analyze information regarding investment amounts as well as past and future financial performance judgements of firms' earnings by manipulating fair value (mark-to-market and mark-to-model) criteria and benchmarking it with historical cost-based financial statements. We proxy nonprofessional investors with graduate students from a business school. Our results show evidence that nonprofessional investors view fair value changes as permanent. We argue for a cashflow volatility factor. Contrary to previous research, we do not find evidence of any effect on investors' willingness to invest (average budget amounts invested) or performance judgments (past and future). We corroborate previous evidence that investors rank measurement concepts' relevance differently for different classes, although, on average, mark-to-market fair values and historical cost are rated more relevant and reliable than mark-to-model fair values. [ABSTRACT FROM AUTHOR]

Aflatoxin B1 (AFB1) and ochratoxin A (OTA) naturally co-occur in several foods, but no studies have followed the fate of mycotoxins' interactions along the gastrointestinal tract using in vitro digestion models. This study used a novel semi-dynamic model that mimics gradual acidification and gastric emptying, coupled with a static colonic fermentation phase, in order to monitor mycotoxins' bioaccessibility by the oral route. AFB1 and OTA bioaccessibility patterns differed in single or co-exposed scenarios. When co-exposed (MIX meal), AFB1 bioaccessibility at the intestinal level increased by ~16%, while OTA bioaccessibility decreased by ~20%. Additionally, a significant increase was observed in both intestinal cell viability and NO production. With regard to mycotoxin–probiotic interactions, the MIX meal showed a null effect on Lactobacillus and Bifidobacterium strain growth, while isolated AFB1 reduced bacterial growth parameters. These results were confirmed at phylum and family levels using a gut microbiota approach. After colonic fermentation, the fecal supernatant did not trigger the NF-kB activation pathway, indicating reduced toxicity of mycotoxins. In conclusion, if single exposed, AFB1 will have a significant impact on intestinal viability and probiotic growth, while OTA will mostly trigger NO production; in a co-exposure situation, both intestinal viability and inflammation will be affected, but the impact on probiotic growth will be neglected. [ABSTRACT FROM AUTHOR]

Semantic segmentation consists of classifying each pixel according to a set of classes. Conventional models spend as much effort classifying easy-to-segment pixels as they do classifying hard-to-segment pixels. This is inefficient, especially when deploying to situations with computational constraints. In this work, we propose a framework wherein the model first produces a rough segmentation of the image, and then patches of the image estimated as hard to segment are refined. The framework is evaluated in four datasets (autonomous driving and biomedical), across four state-of-the-art architectures. Our method accelerates inference time by four, with additional gains for training time, at the cost of some output quality. [ABSTRACT FROM AUTHOR]

ABSTRACT Background and Aim Methods Results Conclusion We aimed to develop and validate a simple capsule endoscopy (CE) training assessment tool, the Capsule Endoscopy Training Assessment (CETA), and prospectively use it to analyze the learning progression achieved by participants in our CE training program.Over a 3‐year period, all participants in our CE training program completed pre‐training and post‐training CETA, ranging between 0% and 100%, and encompassing theoretical questions and interpretation of segmented CE videos. We compared the mean differences in overall, theoretical, and practical pre‐training and post‐training CETA, and assessed the influence of previous endoscopic experience (upper gastrointestinal endoscopy [UGE], colonoscopy, device‐assisted enteroscopy [DAE] and CE) using generalized linear models.Fifty‐seven participants were included. After training, there was a significant increase in participants' overall (mean difference, 26.3; 95% confidence interval [CI], 20.70 to 31.83), theoretical (mean difference, 27.2; 95% CI, 19.81 to 34.57), and practical (mean difference, 25.9; 95% CI, 20.09 to 31.63) CETA components. Compared to those without experience, participants with previous endoscopic experience demonstrated a smaller increase in overall CETA after training (UGE, rate ratio, 0.76; 95% CI, 0.63 to 0.91; colonoscopy (rate ratio, 0.80; 95% CI, 0.67 to 0.95; DAE (rate ratio, 0.84; 95% CI, 0.73 to 0.97; CE, rate ratio, 0.81; 95% CI, 0.72 to 0.92, respectively).CETA is a valid and useful tool in assessing the learning progression achieved by participants following the CE training program. We demonstrated a significant improvement in participants' CETA after training, being the least experienced participants in endoscopic procedures who benefited the most from CE training. [ABSTRACT FROM AUTHOR]

We present a dense and metric 3D mapping pipeline designed for embedded operation on-board UAVs, by loosely coupling deep neural networks trained to infer dense depth single images with a SLAM system that restores metric scale from sparse depth. In contrast to computationally restrictive approaches that leverage multiple views, we propose a highly efficient, single-view approach without sacrificing 3D mapping performance. This enables real-time construction of a global 3D voxel map by iterative fusion of the rescaled dense depth maps obtained via raycasting from the estimated camera poses. Quantitative and qualitative experimentations of our framework in challenging environmental conditions show comparable or superior performance with respect to state-of-the-art approaches via a better effectiveness-efficiency trade-off. [ABSTRACT FROM AUTHOR]

• Paspalum species have different DNA content and reproductive mode • DNA content ranged from 1.50 pg to 4.27 pg. • Three accessions had low DNA content and were sexual. • Other 132 accessions had high DNA content and were apomictic. This study aims the reproductive and DNA content characterization of ten different Paspalum species from the Plicatula group (P. atratum, P. compressifolium, P. guenoarum, P. lenticulare, P. lepton, P. oteroi, P. plicatulum, P. rhodopedum, P. rojasii and P. wrightii), contributing to the determination of the best breeding and conservation method to be used. The DNA content of 150 accessions was estimated by flow cytometry using foliar tissues. The reproductive mode of 135 accessions was characterized by flow cytometric seed screening, and five accessions were determined by cytoembryological ovary analysis. DNA content ranged from 1.50 pg (BGP 380) to 4.27 pg (BGP 193), both from P. compressifolium species. Most of the accessions were compatible to the tetraploid level, except for BGP 281 (P. lenticulare), BGP 272 (P. rojasii), and BGP 380 (P. compressifolium), which were diploids. Accessions with tetraploid DNA content presented apomictic reproduction, whereas the three diploid accessions were sexual. These results contribute to the reproductive knowledge of species of the Plicatula group. The diploid sexual accessions identified represent important material to overcome the apomictic barrier in crosses and can be used after polyploidization as female parents in crosses with apomictic accessions in Paspalum breeding programs. [ABSTRACT FROM AUTHOR]

The use of combination therapy of anti-TNFα and thiopurines in inflammatory bowel disease (IBD) is associated with greater efficacy and lower immunogenicity. However, the dose of thiopurine in this setting remains to be elucidated. To compare the trough levels, anti-TNFα antibodies and the inflammatory biomarkers between three groups in combotherapy: group 1 (dose of azathioprine <1 mg/kg); group 2 (dose of azathioprine ≥1 and <2 mg/kg), and group 3 (dose of azathioprine ≥2 mg/kg). A retrospective study was performed, selecting all patients with established diagnosis of IBD who were on combined maintenance treatment. We included 99 patients, 52.5% female with median age 33 (17–61) years. Eighty patients (80.8%) were diagnosed with Crohn's disease and 19 (19.2%) with ulcerative colitis. Seventy-one (71.8%) patients were on infliximab (IFX) and 28 (28.3%) were on adalimumab (ADA). In patients treated with IFX, there were no differences in trough levels (p=.976) or formation of antibodies anti-IFX (p=.478) between groups. Moreover, there were no differences in inflammatory biomarkers: CRP (p=.385) and fecal calprotectin (p=.576) among the three groups. Regarding patients treated with ADA, there were no differences in trough levels of ADA (p=.249), formation of antibodies anti-ADA (p=.706) or in inflammatory biomarkers: CRP (p=.738) and fecal calprotectin (p=.269) among the three groups. In our cohort, there were no differences between anti-TNFα trough levels, formation of anti-TNFα antibodies or inflammatory biomarkers among patients in combotherapy with azathioprine, irrespective of its dosage. In conclusion, our study suggests that maintaining therapeutic levels of anti-TNFα drugs without antibodies formation is feasible with lower doses of azathioprine, minimizing its side effects. [ABSTRACT FROM AUTHOR]

There is scarce data focused on recurrence neoplasia rate (RR) after piecemeal endoscopic mucosal resection (pEMR) of 10–19 mm non-pedunculated colorectal lesions (NPL). We aimed to analyze the RR after pEMR of 10–19 mm NPL, identify risk factors for its development and compare it with RR after pEMR of ≥ 20 mm NPL. Retrospective cohort-study including all ≥10 mm NPL resected by pEMR in our center between 2018–2022 with an early repeat colonoscopy (ERC). RR was defined as recurrence neoplasia identified in the ERC EMR scar with virtual chromoendoscopy or histological confirmation. A total of 444 NPL were assessed, 124 (27.9%) with 10–19 mm. In the ERC, performed a median of 6 months after pEMR, RR was significantly lower for 10–19 mm NPL compared to ≥ 20 mm NPL (13/124 vs 68/320, p = 0.005). In subgroup analysis, RR after pEMR of 15–19 mm NPL was significantly higher compared to 10–14 mm NPL (13/98 vs 0, p = 0.041) but not significantly different compared to ≥ 20 mm NPL (13/98 vs 68/320, p = 0.073). In multivariable analysis, size of NPL (HR 1.501, 95% CI 1.012–2.227, p = 0.044) was the only independent risk factor identified for RR for 10–19 mm NPL. Although the early RR after pEMR of 10–19 mm NPL is significantly lower compared to ≥ 20 mm NPL, it is non-negligible (10.5%) and appears to be the highest among 15–19 mm NPL. The size of the lesion was the only independent risk factor for RR. Our findings should be accounted in the selection of the most appropriate post-polypectomy endoscopic surveillance. [ABSTRACT FROM AUTHOR]

Background: In patients with acute nonvariceal upper gastrointestinal bleeding (NVUGIB), early (≤ 24 h) endoscopy is recommended following hemodynamic resuscitation. Nevertheless, scarce data exist on the optimal timing of endoscopy in patients with NVUGIB receiving anticoagulants. Objective: To analyze how the timing of endoscopy may influence outcomes in anticoagulants users admitted with NVUGIB. Methods: Retrospective cohort study which consecutively included all adult patients using anticoagulants presenting with NVUGIB between January 2011 and June 2020. Time from presentation to endoscopy was assessed and defined as early (≤ 24 h) and delayed (> 24 h). The outcomes considered were endoscopic or surgical treatment, length of hospital stay, intermediate/intensive care unit admission, recurrent bleeding, and 30-day mortality. Results: From 636 patients presenting with NVUGIB, 138 (21.7%) were taking anticoagulants. Vitamin K antagonists were the most frequent anticoagulants used (63.8%, n = 88). After adjusting for confounders, patients who underwent early endoscopy (59.4%, n = 82) received endoscopic therapy more frequently (OR 2.4; 95% CI 1.1–5.4; P = 0.034), had shorter length of hospital stay [7 (IQR 6) vs 9 (IQR 7) days, P = 0.042] and higher rate of intermediate/intensive care unit admission (OR 2.7; 95% CI 1.3 – 5.9; P = 0.010) than patients having delayed endoscopy. Surgical treatment, recurrent bleeding, and 30-day mortality did not differ significantly between groups. Conclusion: Early endoscopy (≤ 24 h) in anticoagulant users admitted with acute nonvariceal upper gastrointestinal bleeding is associated with higher rate of endoscopic treatment, shorter hospital stay, and higher intermediate/intensive care unit admission. The timing of endoscopy did not influence the need for surgical intervention, recurrent bleeding, and 30-day mortality. [ABSTRACT FROM AUTHOR]

Main Statements: This ESGE Position Statement provides structured and evidence-based guidance on the essential requirements and processes involved in training in basic gastrointestinal (GI) endoscopic procedures. The document outlines definitions; competencies required, and means to their assessment and maintenance; the structure and requirements of training programs; patient safety and medicolegal issues. 1 ESGE and ESGENA define basic endoscopic procedures as those procedures that are commonly indicated, generally accessible, and expected to be mastered (technically and cognitively) by the end of any core training program in gastrointestinal endoscopy. 2 ESGE and ESGENA consider the following as basic endoscopic procedures: diagnostic upper and lower GI endoscopy, as well as a limited range of interventions such as: tissue acquisition via cold biopsy forceps, polypectomy for lesions ≤ 10 mm, hemostasis techniques, enteral feeding tube placement, foreign body retrieval, dilation of simple esophageal strictures, and India ink tattooing of lesion location. 3 ESGE and ESGENA recommend that training in GI endoscopy should be subject to stringent formal requirements that ensure all ESGE key performance indicators (KPIs) are met. 4 Training in basic endoscopic procedures is a complex process and includes the development and acquisition of cognitive, technical/motor, and integrative skills. Therefore, ESGE and ESGENA recommend the use of validated tools to track the development of skills and assess competence. 5 ESGE and ESGENA recommend incorporating a multimodal approach to evaluating competence in basic GI endoscopic procedures, including procedural thresholds and the measurement and documentation of established ESGE KPIs. 7 ESGE and ESGENA recommend the continuous monitoring of ESGE KPIs during GI endoscopy training to ensure the trainee's maintenance of competence. 9 ESGE and ESGENA recommend that GI endoscopy training units fulfil the ESGE KPIs for endoscopy units and, furthermore, be capable of providing the dedicated personnel, infrastructure, and sufficient case volume required for successful training within a structured training program. 10 ESGE and ESGENA recommend that trainers in basic GI endoscopic procedures should be endoscopists with formal educational training in the teaching of endoscopy, which allows them to successfully and safely teach trainees. [ABSTRACT FROM AUTHOR]

Background: Inflammatory bowel disease (IBD) patients have a higher risk of metabolic dysfunction-associated fatty liver disease (MAFLD) compared with the general population. However, it is not known whether available non-invasive hepatic steatosis scores are useful in predicting MAFLD in IBD patients. We aimed to analyze the performances of MAFLD screening score (MAFLD-S), Fatty Liver Index (FLI), Hepatic Steatosis Index (HSI) and Clinical Prediction Tool for NAFLD in Crohn's Disease (CPN-CD), in identifying MAFLD in IBD patients. Methods: A cross-sectional study was carried out including consecutive adult IBD outpatients submitted to transient elastography (TE). MAFLD criteria were assessed, and hepatic steatosis (HS) was defined by a controlled attenuation parameter (CAP) >248 dB/m using TE. MAFLD-S, FLI, HSI, and CPN-CD were calculated and their accuracy for the prediction of MAFLD was evaluated through their areas under the receiver-operating characteristic (AUROC) curves. Results: Of 168 patients, body mass index ≥25, type 2 diabetes mellitus, dyslipidemia and arterial hypertension were present in 76 (45.2%), 10 (6.0%), 53 (31.5%), 20 (11.9%), respectively. HS was identified in 77 (45.8%) patients, of which 65 (84.4%) fulfilled MAFLD criteria. MAFLD-S (AUROC, 0.929 [95% CI, 0.888-0.971]) had outstanding and FLI (AUROC, 0.882 [95% CI, 0.830–0.934]), HSI (AUROC, 0.803 [95% CI, 0.736–0.871]), and CPN-CD (AUROC, 0.822 [95% CI, 0.753–0.890) had excellent discrimination in predicting MAFLD. Conclusions: MAFLD-S, FLI, HSI and CPN-CD scores can accurately identify MAFLD in IBD patients, allowing the selection of those in whom hepatic steatosis and metabolic risk factors assessment may be particularly beneficial. [ABSTRACT FROM AUTHOR]

Background: Breast cancer therapy improved significantly, allowing for different surgical approaches for the same disease stage, therefore offering patients different aesthetic outcomes with similar locoregional control. The purpose of the CINDERELLA trial is to evaluate an artificial-intelligence (AI) cloud-based platform (CINDERELLA platform) vs the standard approach for patient education prior to therapy. Methods: A prospective randomized international multicentre trial comparing two methods for patient education prior to therapy. After institutional ethics approval and a written informed consent, patients planned for locoregional treatment will be randomized to the intervention (CINDERELLA platform) or controls. The patients in the intervention arm will use the newly designed web-application (CINDERELLA platform, CINDERELLA APProach) to access the information related to surgery and/or radiotherapy. Using an AI system, the platform will provide the patient with a picture of her own aesthetic outcome resulting from the surgical procedure she chooses, and an objective evaluation of this aesthetic outcome (e.g., good/fair). The control group will have access to the standard approach. The primary objectives of the trial will be i) to examine the differences between the treatment arms with regards to patients' pre-treatment expectations and the final aesthetic outcomes and ii) in the experimental arm only, the agreement of the pre-treatment AI-evaluation (output) and patient's post-therapy self-evaluation. Discussion: The project aims to develop an easy-to-use cost-effective AI-powered tool that improves shared decision-making processes. We assume that the CINDERELLA APProach will lead to higher satisfaction, better psychosocial status, and wellbeing of breast cancer patients, and reduce the need for additional surgeries to improve aesthetic outcome. [ABSTRACT FROM AUTHOR]