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Purpose Hypertensive patients with access to telemedicine can receive telemonitoring of blood pressure and cardiovascular risk factors such as sedentary lifestyle, diet, and remote supervision of treatment compliance. Faced with this challenge, electronic devices for telemonitoring of BP have gained space. They have shown to be effective in the follow-up of hypertensive patients and assist in the adherence and control of associated risk factors such as physical inactivity and obesity. Materials and methods Narrative Review. Results The use of advanced smartwatches, smartphone apps, and online software for monitoring physical activity is increasingly common. Electronic equipment is briefly presented here as a support for better addressing some cardiovascular variables. Using various automated feedback services with a follow-up multidisciplinary clinical team is the ideal strategy. Conclusion Mobile health can improve risk factors and health status, particularly for hypertensive patients, improving access to cardiac rehabilitation and reducing the cost.

Objective: To evaluate the inter-rater reliability and intra-class correlation coefficients (ICC) of Böhler’s angle and the critical angle of Gissane in calcaneal fractures, stratified by severity and by the Essex-Lopresti and Sanders classifications. Methods: Retrospective study of radiographs obtained from 97 patients: 67 with calcaneal fractures and 30 with normal lateral radiographs (used as a control group). Böhler’s angle and the angle of Gissane were measured by six raters: two orthopedic surgery residents, two musculoskeletal radiologists, a foot and ankle surgery fellow, and a senior consultant in foot surgery. Statistical analysis of inter-rater reliability was performed for the two angles, in the sample overall and stratified by the different radiographic and CT subtypes of calcaneal fractures. Results: For the angle of Gissane, the ICC was at best 0.400 (95% CI: 0.250 to 0.581) for normal radiographs, with poor agreement across all classifications and severity stratifications. For Böhler’s angle, the ICC values indicated weak to moderate agreement, with the best reproducibility obtained for the overall sample (0.740; 95% CI: 0.673 to 0.801). In Sanders type 1 fractures, the ICC was 0.704 (95% CI: 0.397 to 0.940), and in Sanders type 2 fractures, 0.762 (95% CI: 0.634 to 0.870). Conclusion: Böhler’s angle is more reproducible than the critical angle of Gissane, with greater inter-rater reliability among fractures deemed less severe on the Sanders classification, although the overall ICC ranged from weak to moderate at best. Level of Evidence III; Case Control Study; Diagnostic Studies.

Objetivo: revisar artigos disponí­veis em periódicos cientí­ficos que exemplificassem o papel do profissional de odontologia no atendimento de manifestações bucais em pacientes com Leucemia. Metódo: tratou-se de uma revisão bibliográfica narrativa utilizando artigos selecionados datados dos anos de 2008 a 2018. Resultados: As manifestações bucais das leucemias são mais frequentes nas formas agudas, do que nas formas crônicas. O profissional da saúde deve estar sempre atento a qualquer tipo de sinal ou sintoma, assim como í constante atualização da história médica. Com o surgimento de novas técnicas que propiciem a manutenção da saúde bucal nos pacientes com algum tipo de neoplasia, hoje é possí­vel prevenir uma doença sem que ela já esteja instalada. Conclusão: Conclui-se que a presença do profissional de odontologia na equipe oncológica pode diminuir a morbidade e a mortalidade relacionadas a complicações bucais, assim como aumentar o conforto e qualidade de vida dos pacientes durante a terapia.

Objetivo: Revisar artigos disponí­veis em periódicos cientí­ficos que retratassem os aspectos odontológicos de pacientes com Sí­ndrome de Down. Métodos: Trata-se de um estudo de revisão bibliográfica realizado em 2020, o limite temporal estabelecido para a pesquisa foi entre 2008 a 2018, elegí­veis as bases da Biblioteca Digital Brasileira de Teses e Dissertações (BDTD), Coordenação de Aperfeiçoamento de Pessoal de Ní­vel Superior (CAPES) e Google Acadêmico. Conclusão: A partir das informações obtidas podemos concluir que A higiene bucal supervisionada é fundamental nesses indiví­duos, devido í s limitações motoras e í alta prevalência de doenças periodontais. O cirurgião-dentista deve estar preparado para o atendimento de pacientes com necessidades especiais por meio da capacitação técnica e cultivo de valores humanos, minimizando os diversos problemas que esses pacientes já estão condicionados a enfrentar devido ao seu estado de deficiência.

Made available in DSpace on 2021-06-25T10:27:04Z (GMT). No. of bitstreams: 0 Previous issue date: 2021-01-01 Inflammation has been described as a prominent mechanism involved in dysfunctions and diseases evoked by chronic stress. Notably, the spleen is an immune organ controlled by sympathetic and glucocorticoid mechanisms, but the impact of chronic stress in the spleen is not entirely understood. Besides, the impact of aerobic exercise training on the effects of chronic stress in the spleen has never been reported. Therefore, this study aimed to assess the changes caused in the spleen by repeated restraint stress and the effect of aerobic exercise training performed after a period of chronic restraint stress in rats. We identified that daily exposure to restraint stress (120 min per session, for 14 consecutive days) increased corticosterone and noradrenaline content, gene expression of glucocorticoid and β2-adrenergic receptors, TNF-α and IL-6 levels, and increased pro-oxidant substances in the spleen. Circulating levels of corticosterone were also increased in chronically stressed animals. Exercise training (1 h a day/5 days per week, for 60 days) increased glucocorticoid receptor gene expression, interleukin (IL)-10 and antioxidant mechanisms in the spleen. Exercise also decreased splenic noradrenaline, tumoral necrosis factor (TNF)-α, and IL-6 contents. Lastly, the effects of repeated restraint stress in the spleen were mitigated in animals subjected to aerobic training. Taken together, the results reported in the present study indicate that aerobic exercise training is a relevant non-pharmacological therapeutic approach to dysfunctions in the spleen caused by a period of stress. Laboratory of Cardiovascular Investigation and Exercise (LICE) School of Physical Education University of Campinas (UNICAMP) Department of Structural and Functional Biology Institute of Biology University of Campinas (UNICAMP) Department of Drugs and Pharmaceutics School of Pharmaceutical Sciences São Paulo State University (UNESP) Department of Drugs and Pharmaceutics School of Pharmaceutical Sciences São Paulo State University (UNESP)

Purpose: Transcranial direct current stimulation (tDCS) seems to positively modulate the autonomic nervous system in different clinical conditions and healthy subjects; however, its effects on hype...

Inflammatory bowel diseases (IBD) comprise two major forms: Crohn's disease and ulcerative colitis. The diagnosis of IBD is based on clinical symptoms combined with results found in endoscopic and radiological examinations. In addition, the discovery of biomarkers has significantly improved the diagnosis and management of IBD. Several potential genetic, serological, fecal, microbial, histological and immunological biomarkers have been proposed for IBD, and they have been evaluated for clinical routine and clinical trials. Ileocolonoscopy, especially with biopsy collection, has been considered the standard method to diagnose IBD and to assess clinical activity of the disease, but it is limited to the colon and terminal ileum and is considered invasive. For this reason, non-invasive biomarkers are necessary for this type of chronic inflammatory disease, which affects mostly young individuals, as they are expected to have a long follow-up.

In general, postmenopausal women present higher mortality, and worse prognosis after myocardial infarction (MI) compared to men, due to estrogen deficiency. After MI, cardiovascular alterations occur such as the autonomic imbalance and the pro-inflammatory cytokines increase. In this sense, therapies that aim to minimize deleterious effects caused by myocardial ischemia are important. Aerobic training has been proposed as a promising intervention in the prevention of cardiovascular diseases. On the other hand, some studies have attempted to identify potential biomarkers for cardiovascular diseases or specifically for MI. For this purpose, metabolomics has been used as a tool in the discovery of cardiovascular biomarkers. Therefore, the objective of this work is to discuss the changes involved in ovariectomy, myocardial infarction, and aerobic training, with emphasis on inflammation and metabolism.

Resumo Objetivo Avaliar a prevalência de queixas álgicas no pé e tornozelo, parâmetros radiográficos e o desempenho funcional de indivíduos com obesidade grave, Índice de Massa Corpórea (IMC) com valor > 40 e indicação de cirurgia bariátrica. Métodos Foram avaliados 40 pacientes com obesidade grave acompanhados em ambulatório de cirurgia bariátrica. Este grupo de obesos graves (IMC > 40) foi subdividido em dois subgrupos: obesos com IMC 50 (n = 16). Foi realizada comparação com grupo controle de 42 indivíduo voluntários com IMC médio de 24. Foram avaliados a presença de dor no pé pela escala visual (EVA), o desempenho funcional pela escala da Associação Americana de Cirurgia do Pé e Tornozelo (AOFAS, na sigla em inglês) (domínios antepé, mediopé e retropé), idade, gênero, ângulo (âng) metatarso-falangeano do hálux, âng intermetatarsal do hálux , âng talocalcaneano, “pitch” calcaneano e âng de Meary. Resultados Foi observada maior incidência de dor no pé no grupo de obesos graves em relação ao controle (p Conclusão Houve maior incidência de dor no pé no grupo de obesos graves em relação ao controle. Houve pior desempenho funcional pela escala AOFAS nas regiões do antepé, mediopé e retropé no grupo de obesos graves.

Background. Studies investigating resistance training (RT) effects on cardiovascular autonomic modulation (CAM) have shown controversial results. Objective. To address the effect of RT on CAM in humans, in healthy and unhealthy individuals by analysing the findings of previous studies. Methods. An updated search (MEDLINE on January 18, 2016) found 19 studies testing the basal heart rate variability (HRV) before and after a RT intervention in humans. Results. Although, some individual studies showed significant effects from RT on HRV in both directions, the overall effect (standard difference in means) was not significantly on all HRV parameters analysed (time and frequency domains). No RT subgroup (samples and protocols features) presented significant effect on sympathovagal balance, limiting the comprehension about these variations. Conclusion. We conclude RT does not change humans CAM.

Introduction Throwing is considered the most important technical skill in Handball. However, it requires the athlete to perform this movement with maximum speed and accuracy, as it can define the final score of the game. Objective The aim of this study was to evaluate the effect of Proprioceptive Neuromuscular Facilitation, known as the Kabat method, on the throwing performance of handball athletes. Methods An experimental study of 18 male handball athletes with a mean age of 14 ± 1.13 years. The athletes were divided into two groups: control group (CG) and Kabat method group (KG). The athletes performed 16 training sessions, with analyses at the beginning and end of each session. Range of motion (ROM) of internal and external shoulder rotation, strength, muscle imbalance, throwing speed and accuracy were measured. The results were compared by the Student t-test of repeated measures. Results KG significantly increased external shoulder rotation and muscle strength in all the analyzed shoulder complex muscles. CG also increased strength, but not in all muscles. KG significantly increased the speed and accuracy of the pitch. Conclusion The Kabat method, through proprioceptive neuromuscular facilitation, significantly increased throwing performance, speed and accuracy in handball athletes when compared to the control group. Level of evidence III; Randomized Experimental Study. RESUMO Introdução O arremesso é considerado a habilidade técnica mais importante do handebol. Porém, exige que o atleta realize esse movimento com máxima velocidade e precisão, visto que ele pode definir a pontuação final do jogo. Objetivo O objetivo deste estudo foi avaliar o efeito da facilitação neuromuscular proprioceptiva, conhecida como método Kabat, no desempenho de arremesso em atletas de handebol. Métodos Estudo experimental com 18 atletas de handebol masculino, com média de idade de 14 ± 1,13 anos. Os atletas foram divididos em dois grupos: grupo controle (GC) e grupo método Kabat (GK). Os atletas realizaram 16 sessões de treinamento com análise inicial e final. A amplitude de movimento (ADM) da rotação interna e externa do ombro, a força, o desequilíbrio muscular, a velocidade e precisão do arremesso foram medidos. Os resultados foram comparados com o teste t de Student de medidas repetidas. Resultados O GK teve aumento significativo da rotação externa do ombro e da força muscular em todos os músculos do complexo do ombro analisados. O GC também teve aumento da força, mas não em todos os músculos. O GK teve elevação significativa da velocidade e da precisão do arremesso. Conclusão O método Kabat, com a técnica de facilitação neuromuscular proprioceptiva, aumentou significativamente o desempenho, a velocidade e a precisão do arremesso nos atletas de handebol quando comparado com o grupo controle. Nível de evidência III; Estudo Experimental Randomizado. RESUMEN Introducción El lanzamiento se considera la habilidad técnica más importante del balonmano. Sin embargo, requiere que el atleta realice este movimiento con la máxima velocidad y precisión, ya que puede establecer el puntaje final del juego. Objetivo El objetivo de este estudio fue evaluar el efecto de la facilitación neuromuscular propioceptiva, conocida como el método Kabat, en el rendimiento del lanzamiento de atletas de balonmano. Métodos Estudio experimental de 18 atletas de balonmano masculino con edad promedio de 14 ± 1,13 años. Los atletas se dividieron en dos grupos: grupo control (CG) y grupo método Kabat (GK). Los atletas realizaron 16 sesiones de entrenamiento con análisis inicial y final. Se midió el rango de movimiento (RDM) de la rotación interna y externa del hombro, la fuerza, el desequilibrio muscular, la velocidad y la precisión de lanzamiento. Los resultados se compararon con la prueba t de Student de medidas repetidas. Resultados El GK tuvo un aumento significativo en la rotación externa del hombro y la fuerza muscular en todos los músculos del complejo del hombro analizados. El CG también tuvo aumento en la fuerza, pero no en todos los músculos. El GK tuvo un aumento significativo en la velocidad y precisión del lanzamiento. Conclusión El método Kabat, con la facilitación neuromuscular propioceptiva, aumentó significativamente el rendimiento, la velocidad y la precisión del lanzamiento en los atletas de balonmano en comparación con el grupo control. Nivel de evidencia III; Estudio experimental aleatorizado.

Objetivo: Verificar nos portais eletrônicos dos municípios do Crato, Juazeiro do Norte e Barbalha (CRAJUBAR), as informações divulgadas acerca da gestão pública em atendimento à lei de responsabilidade fiscal, lei complementar 131/2009 e ao Decreto nº 7185/2010. Metodologia: Estudo descritivo com abordagem qualitativa. Foram analisados os municípios da Região CRAJUBAR, localizados no sul do Ceará. Os dados utilizados para análise desta pesquisa correspondem ao período de 2012 a 2015 no que se refere aos instrumentos de transparência da gestão fiscal da LRF 101/2000 e o mês de janeiro de 2017 no que se refere à LC 131/2009 e ao Decreto nº 7.185/ 2010. A coleta destes ocorreu por meio dos portais eletrônicos de cada prefeitura. Para análise dos dados coletados, utilizou-se como ferramentas de apoio, a planilha eletrônica Excel versão 2013. Resultados: Concluiu-se que os gestores municipais das prefeituras pesquisadas não obedecem, na integralidade, à publicação em meio eletrônico dos instrumentos referente à transparência da gestão fiscal, no tocante à divulgação de informações pormenorizadas e em tempo real. Contribuições do Estudo: Constatou-se a desobediência aos normativos analisados, implicando em uma verificação da eficiência da aplicação da legislação em análise. A evidenciação da transparência é essencial no processo de gestão. Aborda a discussão sobre a transparência dos recursos públicos constante na LRF e na Lei Complementar nº 131/2009, além de demonstrar a discussão sobre a gestão dos recursos em municípios do estado do Ceará.

The association of ipsilateral talar and calcaneal fractures is an uncommon combination and is typically the result of a high-energy trauma. It is often associated with comminution, marked fracture displacement, and soft-tissue compromise. Obtaining satisfactory clinical and radiographic results is very challenging. Residual deformities, multiple procedures, and limitations are usually the norm. Therefore, studies have suggested that primary arthrodesis may represent the best option of surgical treatment. In this study, we report a case of a 30-year-old male patient with a rare combination of a highly comminuted transcalcaneal fracture-dislocation associated with a talar neck fracture successfully treated with open reduction and internal fixation (ORIF) with an 18-month follow-up. This case demonstrates that even when there are associated fractures of the talus and calcaneus with severe bone loss, ORIF may provide satisfactory outcomes in the short-term postoperative period. Levels of Evidence: Level V: Case report

Objetivo Descrever e explorar determinantes da promoção de Atividade Física (AF) por parte dos oncologistas, analisar a perceção de capacidade, oportunidade e motivação dos médicos quanto à promoção de AF, e analisar as preocupações relacionadas com a prática de exercício físico dos doentes oncológicos. Método Um total de 76 oncologistas preencheram um questionário constituído por demografia, questões sobre a promoção da AF ligadas às perceções de capacidade, oportunidade, motivação, comportamento, e necessidades. Foram realizadas análises de correlação de Pearson e Spearman, regressão linear múltipla, teste-t paramétrico e não paramétrico. Resultados Foram detetadas perceções de capacidade e oportunidade baixas e uma motivação elevada. A grande maioria promove atividade física, mas não promove exercício físico estruturado, contudo, reconhecem a sua importância. A capacidade é a variável mais preponderante no comportamento, mas as restantes variáveis estão associadas ao mesmo. É reportada uma necessidade de melhoria de condições para a promoção de AF. Conclusão Os resultados devem ser analisados com cautela devido à amostra reduzida, no entanto, sugerem que os médicos valorizam a prática de AF dos seus doentes mas não se sentem capazes para promovê-la, o que legitima a presença de fisiologistas do exercício nos serviços de saúde. A presença do fisiologista do exercício pode ser um fator desencadeador da promoção de AF e exercício físico.

Category: Bunion; Midfoot/Forefoot Introduction/Purpose: Lapidus procedure (LP) for hallux valgus (HV) requires an adequate control of first metatarsal (M1) sagittal alignment to avoid dorsiflexion. Otherwise, clinical and functional impairment, including transfer metatarsalgia may occur. This study aimed to evaluate the effects of pre- and postoperative measurements of M1 sagittal alignment on clinical and functional outcomes, and whether these variations would lead to transfer metatarsalgia or not. Methods: 29 patients (36 feet) with a mean follow-up of 20 months after LP were reviewed. Clinical and functional data were assessed with the VAS for pain, AOFAS, LEFS and SF-12. SF-12 comprises physical and mental health scales (PCS-12 and MCS-12, respectively). Transfer metatarsalgia diagnosis was based on the clinical exam. M1 sagittal alignment analysis was based on the first metatarsal declination angle (FMDA) and Meary Angle (MA). Decrease of FMDA means that the M1 dorsiflected (Figure 1). Intermetatarsal angle (IMA) and hallux valgus angle (HVA) were assessed. Radiographic, clinical and functional measurements were compared. Intraclass Correlation Coefficients (ICC) were calculated for FMDA and MA. Linear regression was used to assess the association of Δ-FMDA and Δ-MA with clinical and functional questionnaires. Based on that, we assessed our sample at different cut-off points to evaluate whether a given Δ-FMDA and/or Δ-MA measurement was significantly related to the Δ-Questionnaires. Results: Pre- and postoperative ICC of FMDA was 0.90 and 0.91 and MA was 0.94 and 0.88, respectively. FMDA showed significant variation after the LP, but MA did not. IMA and HVA improved significantly. Significant clinical and functional improvement were observed, except in MCS-12. No patient developed transfer metatarsalgia. A direct correlation was found between ΔFMDA with Δ-PCS-12 and Δ-LEFS (p=.028 and p=.02, respectively), meaning that excessive dorsiflexion of M1 as measured by FMDA led to a decrease in PCS-12 and LEFS. We found that at the cut-off point of quartile 50%, in which our sample was divided equally, patients with Δ-FMDA below 3.2 degrees of dorsiflexion had significantly improved results on Δ-PCS-12 compared to those with greater values (p=.029) (Figure 2). Conclusion: The present study showed that excessive dorsiflexion of M1 led to decreased outcome scores as measured by PCS- 12 and LEFS. It supports that M1 dorsiflexion should be avoided after the LP. However, slight dorsal deviation can occur and, even so, satisfactory outcomes can be obtained. Further prospective and comparative studies with larger populations are required to evaluate the effects of M1 inclination on clinical and functional outcomes.

Geotechnical data is often produced and managed by several producers in isolation, in their own formats and standards, which aim to meet the unique needs of specific users, because there is not a defined geospatial geotechnical data storage standard. This article presents the physical implementation of a three-dimensional geotechnical database, based on a data model generated using the Object Modeling Technique for Geographic Applications, composed of information produced by the academy and various administrative institutions of the Federal District Government. More than four thousand quantitative e qualitative geotechnical investigations are available in this structured database that can be accessed by anyone with some geographic information system knowledge using QGIS. Considering that the compiled information was stored by their producers in distinct formats and most of them in a non-digital and without locational information, this work reinforces the need to adoption a standardization of geospatial geotechnical data storage on a unified basis compatible with the National Spatial Data Bank to disseminate this information.

As the number of blockchain (BC) platforms providing specific features increases, selecting a platform that fits all requirements needed for a specific case becomes a cumbersome task. For example, not only are BCs' technical details relevant, but also their intrinsic characteristics (e.g., cryptocurrency price) must be considered in selecting a BC for a given case. Hence, the management of data stored in multiple BCs and the selection process are not straightforward due to the myriad platforms and both technical and economic details (e.g., BC throughput and the underlying price fluctuation). This article defines a novel refinement flow (based on the policy continuum) of high-level BC selection policies to low-level BC transactions. Experiments with the BC selection framework developed applying policy-based management (PBM) in the BC context do show that such synergy simplifies data management in multiple BCs driven by user requirements (e.g., based on costs or performance policies). The performance analysis of the framework demonstrates the successful employment of PBM for BC selections with minimal overhead.

ResumoO poroma écrino e o hidradenoma poroide são neoplasias poroides benignas raras, derivadas das glândulas sudoríparas écrinas. Existem quatro tipos de neoplasias poroides, conforme a posição na camada da pele, sendo denominadas hidroacantoma simples, poroma écrino, tumor do ducto dérmico e hidradenoma poroide. As neoplasias poroides geralmente surgem como uma lesão solitária, com crescimento lento, podendo apresentar diferentes apresentações clínicas, como massa sobre o pé, lesão ulcerada, cisto sólido, lesão hemorrágica ou suspeita de melanoma. As extremidades são os sítios mais comuns, especialmente as mãos e os pés. No entanto, a coexistência desses dois tumores em uma única lesão é extremamente rara. A excisão cirúrgica representa o principal tratamento, podendo ser curativa, prevenindo assim as alterações malignas e as recidivas. Descrevemos um raro tumor solitário no pé com características clínicas e histopatológicas de uma associação de poroma écrino e hidradenoma poroide tratado cirurgicamente sem recidiva no acompanhamento de médio prazo. Nível de Evidência IV, Relato de Caso.

For the protection of people and society against harm and health threats — especially in case of the COVID-19 pandemic — a variety of different disciplines needs to be involved. The data collection of basic and health-related data of individuals in today’s highly mobile society does help to plan, protect, and identify next steps health authorities and governments can, shall, or need to plan for or even implement. Thus, every individual, human, and inhabi- tant of the world is the key player — very different from many past crises’. And since all individuals are involved his/her (a) health and (b) privacy shall be considered in a very carefully crafted balance, not overruling one aspect with another one. Privacy remains key. The solution of the current pandemic’s data collection can be based on a fully privacy-preserving application, which can be used by individuals on their mobile devices, such as smartphones, while maintaining at the same time their privacy. Additionally, respective data collected in such a fully distributed setting does help to confine the pandemic and can be achieved in a democratic and very open, but still and especially privacy-protecting manner. Therefore, the WeTrace approach and application designed uti- lizes the Bluetooth low energy (BLE) communication channel, many modern mobile devices offer, where public-key cryptography is being applied to allow for deciphering of messages for that desti- nation it had been intended for. Since literally every other potential participant only listens to random data, even a brute force attack will not succeed. WeTrace and its Open Source implementation en- sure that any receiver of a message knows that this is for him/her, without being able to identify the original sender.

Made available in DSpace on 2022-04-28T19:41:32Z (GMT). No. of bitstreams: 0 Previous issue date: 2021-10-01 Growth and production models can help to simulate the growth of tree dimensions to predict forest productivity at different levels. In this context, the following questions arise: (i) is it possible to recognize the growth pattern of eucalyptus species based on spectral features using machine learning (ML) for data modeling? (ii) what spectral features provides better accuracy? and (iii) what ML algorithms are most accurate for performing this modeling? To answer these questions, the present study evaluated the use of ML techniques using breast height and total plant height to classify the growth of five species of eucalyptus and Corymbria citriodora in an unsupervised learning, and the obtained classes for induce ML algorithms to recognize the species with relation to their growth using vegetation indices (VIs) and spectral bands (SBs). It were evaluated five eucalyptus species (E. camaldulensis, E. uroplylla, E. saligna, E. grandis e E. urograndis) and C. citriodora in experimental design of randomized blocks with four replicates, with 20 plants inside each experimental plot. The diameter at breast height and total plant height at stand level were obtained by measuring five trees in each experimental unit in seven measurements. During this same period, a flight was carried out using a remotely piloted aircraft for the acquisition of spectral variables (SBs and VIs). For recognition of eucalyptus species in relation to their growth two machine learning approaches were employed: supervised and unsupervised. The average accuracy obtained from 10-fold cross-validation, employing Random Forest algorithm and 24 features, was 0.76. This result shows that the proposed approach is appropriate to recognize different eucalyptus species based on their growth. Universidade Federal de Mato Grosso do Sul (UFMS), Rodovia MS 306, Km. 305 Universidade Estadual Paulista (UNESP), Av. Brasil Sul, 56 – Centro Department of Geography Universidade Estadual de Mato Grosso (UNEMAT), Av. dos Ingas, 3001, Jardim Imperial Universidade Tecnológica Federal do Paraná (UTFPR), Via do Conhecimento – Km 01 Universidade Estadual Paulista (UNESP), Av. Brasil Sul, 56 – Centro

To correlate first metatarsal (M1) shortening with transfer metatarsalgia, and clinical and functional outcomes in patients who underwent the Lapidus procedure (LP). A retrospective review of 29 patients who were submitted to the LP for HV correction. The average follow-up was 20 months. M1 length was analyzed using the Relative First Metatarsal Length (RML) measurement. Intermetatarsal angle (IMA) and hallux valgus angle (HVA) were also measured. Clinical and functional analyses were based on the visual analogue scale (VAS), Lower Extremity Functional Scale (LEFS), and Short-form 12 (SF-12) health survey. SF-12 is divided into physical (PCS-12) and mental health (MCS-12) composite scales. Transfer metatarsalgia was diagnosed by the clinical exam. Radiographic, clinical, and functional outcomes were compared using paired Wilcoxon’s and Student’s t tests. Inter-observer reliability of RML measures was calculated using Intraclass Correlation Coefficients (ICC). The correlation between RML and the clinical and functional questionnaires was assessed with the Spearman’s Rho test. There was a significant M1 shortening of 2.3 mm (p

Introduction: In Brazil, in recent years, an effort has been verified to incorporate interprofessional education into policies that induce professional reorientation in health. In this context, the Program of Education through Work for Health stands out, based on the triad of teaching-service-community. Objectives: To describe experiences and knowledge collectively constructed in the implementation of PET-I in the context of interprofessional education practices in the municipality of Jatai, Goias. Methods: Descriptive exploratory study, with a qualitative approach, based on the theoretical-conceptual and methodological bases of interprofessional education, carried out between August 2019 and November 2020.Results: All participants of each stage of the research presented a positive and receptive attitude towards interprofessional work, mentioning that it promotes beneficial results, especially for the resolution of attention and safety of users. At times, however, there were stereotyped views about the professions. It was remarkable the thought that IPE is something very good, which has advantages, but it is very difficult to do it and be able to disseminate it to all professionals or actually work as a team. Conclusions: When analyzing the participants' perceptions, we realized that the skills and knowledge proposed by PET-I for interprofessional training can overcome mechanization and fragmented views of health care, resulting in a humanized, integrated training that can generate new responses to current needs.

Este estudo objetivou conhecer o perfil epidemiológico de puérperas e neonatos atendidos em um hospital de referência. Trata-se de um estudo transversal quantitativo realizado em um hospital público, onde foram analisados o cartão de gestante e os prontuários das puérperas e do recém-nascido. Participaram 457 puérperas, destas, 51,4% tinham idade entre 17 e 26 anos, 85,4% eram casadas/ união estável, 39,6% eram primigestas e 64,6% tiveram parto normal; e 461 neonatos, destes, 84,2% eram a termo e tiveram Índice de Apgar maior que 7 e 8 no 1º (92,2%) e no 5º (94,8%) minuto de vida. Baixo peso ao nascer e prematuridade foram constatados em 11,3% e 9,1% dos neonatos, respectivamente. A pesquisa permitiu traçar o perfil epidemiológico de puérperas e de seus neonatos, possibilitando a compreensão da interação dos fatores de risco e a reorganização de estratégias de serviços mais efetiva.AbstractThis study had the objective of to trace the epidemiological profile of puerperae and neonates treated in a referral hospital. A quantitative cross-sectional study was carried out in a public hospital, where the pregnant woman’s card, the medical records of the puerperae and the newborn were analyzed. 457 postpartum women participated, 51.4% were between 17 and 26 years of age, 85.4% were married / stable, 39,6% were primigravidae and 64.6% had normal births; and 461 neonates, of whom 84.2% were at term and had an Apgar score greater than 7 and 8 in the 1st (92.2%) and in the 5th (94.8%) minute of life. Low birth weight and prematurity were found in 11.3% and 9.1% of neonates, respectively. The research allowed us to trace the epidemiological profile of puerperal women and their newborns, enabling the understanding of the interaction of risk factors and the reorganization of more effective service strategies.

Checkrein deformity is characterized by flexible plantar flexion contracture of the interphalangeal joint and flexible extension contracture of the metatarsophalangeal joint of the hallux. It occurs due to entrapment of the flexor hallucis longus in the callus formation at the fracture site or within scar tissue on lower limb. Currently, there is still no consensus about the best surgical treatment for this deformity. The aim of this study is to report a case of a patient that was treated with a novel approach for the treatment of checkrein deformity of the hallux located in the forefoot, with satisfactory functional outcomes. Level of Evidence V; Therapeutics Studies; Expert Opinion.

Background and purpose Cutoff points for physical function tests are commonly used in clinical practice for the evaluation, monitoring, and treatment of older adults. Previous studies have shown that, while age-related patterns of muscle strength change are similar between ethnic groups, strength values differ significantly independent of age. Whether the same applies to other physical function tests is presently unclear. This study investigated age- and gender-related changes of performance on a battery of physical function tests in Brazilian community dwellers. Methods The study followed a cross-sectional design. Participants were community-dwelling adults. Candidates were considered eligible if they were 18 years or older, lived independently, and possessed sufficient physical and cognitive abilities to perform all of the measurements required by the protocol. Physical function tests included isometric handgrip (IHG), 5 times sit-to-stand (5×STS) test, Timed Up and Go, 1-leg stance, and walking speed (WS) at usual and fast pace. Results Two-thousand eight-hundred and four people were enrolled. Mean age was 68.0 (7.0) years (range 50-102 years), and 2262 (80.7%) were women. Men displayed better IHG and balance, while women showed higher performance on the 5×STS and WS tests. A gender-specific pattern of decline in physical performance was observed. Specifically, women showed a linear age-dependent decline in all tests. In men, only in the IHG, 1-leg stance, and WS test at a fast pace was there a linear decline with age. In both genders, the lowest mean values of physical function tests were higher than the proposed cutoffs for sarcopenia. Discussion and conclusions Our findings indicate that the performance on different physical function tests decreases with advancing age in Brazilian adults, following a gender-specific pattern. In none of the tests did the lowest mean values reach the cutoffs for sarcopenia. This suggests that region-specific cutoffs might be necessary to identify older people at risk of adverse events.

Crohn's disease is a chronic inflammatory disease consisting of alternated periods of relapse and remission. The disease is associated with altered body composition and micronutrient deficiencies. This study aimed to evaluate the nutritional status of Crohn's disease outpatients in remission and activity of the disease.Patients were classified according to Crohn's Disease Endoscopic Index of Severity or Magnetic Resonance Imaging scan. Anthropometric and biochemical analysis was performed for nutritional status evaluation.A total of 60 patients were evaluated of which 31 were in endoscopic remission (mean Crohn's Disease Endoscopic Index of Severity: 1.76) and 29 in activity (mean Crohn's Disease Endoscopic Index of Severity: 7.88). Regarding markers of fat and lean mass, lower values were observed in the activity group when compared to the remission group (p 0.05). There was a positive correlation regarding the duration of the disease and the anthropometric parameters in patients with active disease. Interestingly, the prevalence of overweight/obese patients was 55% in remission group and 28% in activity group according to the Body Mass Index classification. In addition, lower levels of iron, folic acid and albumin were also observed in Crohn's disease activity group.We observed important differences in nutritional markers between patients in remission and activity phases, with higher prevalence of overweight/obese in patients with remission of the disease.

Objective: To analyze the interobserver agreement among physicians in an orthopedy and traumatology service with knowledge and training in adult ankle fracture classifications through radiographic evaluation. Methods: A cross-sectional study was carried out in which the records of 20 patients with a diagnosis of ankle fracture in 2016 (uni-, bi- or trimalleolar), aged older than 18 years or with a closed physis, were studied. The radiographs that met the criteria were analyzed and classified according to the Danis Weber (DW), Lauge-Hansen (LH) and Arbeitsgemeinschaft für Osteosynthesefragen/Orthopaedic Trauma Association (AO/OTA) classifications by two first-year residents, two second-year residents, two third-year residents and two preceptors of the service. The conditions were identical for the observers and were performed individually once. The Kappa coefficient (K) was used to assess agreement. Results: The results showed great interobserver agreement in the DW and LH classifications, with K values equal to 0.69 and 0.64, respectively. The AO/OTA classification showed moderate agreement, with K = 0.47. Conclusion: The DW classification was the most reliable among the three classifications. The AO/OTA classification showed the lowest agreement and was the least reliable, and the LH classification was in between the others. Level of Evidence III, Diagnostic Studies; Study of non consecutive patients; without consistently applied reference “gold” standard.

Nowadays, getting data remotely in a secure way, becomes critical and of utmost importance. The simple task of data transfer can be a problem in remote environments, where the network connectivity is unstable and can be unavailable for some period of times. In this paper is proposed a secure remote monitoring system with data encryption, which collects data from diverse sensors and display them to authenticated users, through charts in a website, with the option of exporting data using an Excel file format. The system created was tested with a hydraulic laboratory setup, where data is collected by a remote Data Logger, transmitted to a server and stored in a non-relational database by an encrypted data transmission that protects its integrity. The results obtained with the developed tests, regarding the success in data transmission, give good perspectives for its usability at a larger scale.

Objective to evaluate the effectiveness of the 3D virtual anatomical table as a complementary resource to the learning of the hepatobiliary anatomy by undergraduate medical students. Method A randomized controlled study comparing the anatomical learning of hepatobiliary structures, supported by a real model versus a virtual model, both three-dimensional (3D), by undergraduate medical students. The students’ perception of the resources used to teach anatomy was also evaluated. The students were submitted to a pre-test and to two evaluations after the interventions were applied. Results Overall, both the 3D virtual anatomical table and the real liver increased students’ knowledge of the hepatobiliary anatomy in relation to their previous knowledge (p = 0.001 and p = 0.01, respectively for second and third evaluations). In the longitudinal comparison between the pre-test and the second evaluation (hepatobiliary anatomy and Couinaud’s segmentation), this increase was significantly higher in the group allocated to the real liver (p = 0.002); in the comparison of the pre-test with the third evaluation (inclusion of adjacent organs in the anatomical table or in the real liver), the increase in knowledge was significantly higher in the group allocated to the anatomical table (p = 0.04). The perception of participants’ satisfaction regarding the learning resources was considered very good, with a minimum percentage of satisfaction of 80%. Conclusion the 3D virtual anatomical table provided more hepatobiliary anatomy knowledge than a real liver for undergraduate medical students, in comparison to their previous knowledge about these structures. In the cross-sectional comparison of the post-instruction evaluations, there was no difference between the two interventions. Moreover, the 3D platform had a positive impact on the level of satisfaction of study participants. This study shows that the 3D virtual anatomical table has the potential to improve both medical students’ understanding and interest in anatomy. It is recommended, however, that future protocols such as this be carried out with larger samples and exploring other anatomical structures.

The integration of Blockchains (BC) and Internet-of-Things (IoT) brings several benefits, such as data immutability and traceability, to a myriad of use-cases. The use of intermediary nodes, e.g., an edge node, provides benefits, but opens the possibility for attacks, especially when considering nodes handling the signing of transactions for devices. If the private key of a device is leaked, the data coming from that device cannot be trusted anymore, thus, rendering transactions signed with that private key unreliable. To tackle this concern, this paper presents Edge2BC, a practical approach to sign automatically BC transactions in an IoT device without revealing its private key to intermediary nodes, thus, increasing trust in the edge-to-BC data transit. The device relies on an edge node to communicate with a BC interoperability API to retrieve dynamic information (e.g., transaction nonce and gas price) and to send the signed raw transaction to the correct BC node. Power measurements (i.e., required current for different method steps) were performed in the prototype implemented to verify Edge2BC’s feasibility. Such evaluations indicate that it is possible to have such a method in place, but the high power consumption required during the signing phase should be taken into consideration when deploying Edge2BC in a dedicated scenario.

Background Lipoprotein-associated phospholipase A2 (Lp-PLA2), which is involved in the inflammatory atherosclerotic process, has emerged as an independent risk factor for atheromatous vascular events. Its impact on coronary disease has already been demonstrated, however, its influence in cerebrovascular etiology is still unknown. We aimed to observe and describe the potential association between Lp-PLA2 levels and the etiologic subtype of ischemic stroke. Methods Unicentric, observational, and prospective cohort study of consecutive patients with acute ischemic stroke, admitted in a comprehensive stroke center. Patients with incomplete investigation or coexisting causes were excluded. Lp-PLA2 was dosed in peripheral blood between day 3 and 14 postevent with "Lp-PLA2-SNIBE" kit. Statistical significance was set for P Results A total of 96 patients were enrolled, with mean age of 75.31±11.88 years, 41 males (42.7%); 12.5% with lacunar stroke, 16.7% atherothrombotic, 46.9% cardioembolic, and 24% embolic stroke of undetermined source (ESUS). The level of Lp-PLA2 was different between etiologies (F=2.982, P=0.035), being lower in ESUS (143.3±42.8 ng/mL). There were no significant associations with previous vascular risk factors, history of ischemic stroke and modified-Rankin scale (mRS) score 3 months postevent. In ESUS patients, Lp-PLA2 was not associated with cervical ultrasound findings or frequent supraventricular extrasystoles. Conclusions Lp-PLA2 levels are different between etiologic subtypes of ischemic stroke, being lower in ESUS patients. The results of this study reinforce the existence of distinct pathophysiological mechanisms in patients with ESUS. Multicenter clinical trials with larger sample sizes are needed to clarify the role Lp-PLA2 on the etiology of stroke.

The aim of this study was to report the prevalence of adequate sleep and the correlates of sleep duration in Portuguese adolescents aged 12-18 years.Cross-sectional analysis with 1017 adolescents (471 girls) aged 14.6 ± 1.8 years. Adolescents self-reported their sleep duration.The percentage of adolescents meeting the guidelines was 72.7%, 60.7% and 51.3%, during a whole week, on weekdays and on weekends, respectively. Boys were always more compliant with the guidelines than girls, for all week categories. A significant difference was found on sleep duration on weekends, between boys and girls (p 0.001). During weekdays, more adolescents were classified as short sleepers when compared to long sleepers. Younger adolescents were more likely to meet the guidelines over the whole week and on weekdays (OR = 2.23, OR = 2.13, respectively; p 0.05) and being long sleepers on weekends (OR = 1.49, p 0.05). Those of medium and low SES were less likely to meet the sleep guidelines for all week categories (pDuring weekends, the percentage of girls sleeping more than recommended is high, indicating a clear compensation of low sleep duration during weekdays. Those of low SES and older adolescents were less likely to meet the sleep guidelines. Policy makers and researchers should consider the potential effects that SES, gender and age might have on sleep duration, when designing targeted interventions to promote adequate sleep duration.

A ocorrência da ingesta de substâncias cáusticas é considerada emergência médica que pode ocorrer em adultos e crianças e acarretar sequelas e agravos como a estenose cáustica de esfôfago. O diagnóstico e o manejo adequados são de extrema importância para a diminuição da mortalidade e para traçar o prognóstico desses pacientes. A diagnose se dará pela somatória de características clínicas, laboratoriais, radiológicas e endoscópicas, sendo fundamental e necessário a endoscopia digestiva alta somada à radiografia contrastada de esôfago, estomago e duodeno, para avaliar o grau da lesão e a estenose esofágica. A terapêutica inicial será realizada de acordo com grau estabelecido e posteriormente pode necessitar de condutas especificas para a dilatação esofágica, sendo o método mais indicado através de expansores endoscópicos associados a fármacos, principalmente a mitomicina C. Em casos recidivantes, ou não responsivos à terapêutica precoce, pode ser realizada, tardiamente, a intervenção cirúrgica que possui a sua eficiência bem descrita.

Background: Coronavirus disease 2019 (Covid-19) pandemic is a global health crisis that has culminated in thousands of deaths. In order to reduce the spread of Sars-CoV-2 virus, governments of several countries have adopted social isolation as a strategy. However, social isolation has culminated in deleterious effects for the population’s health, including increased physical inactivity, stress and, consequently, adverse changes in body composition, cardiorespiratory capacity, muscle strength, physical functionality, and vascular events, which are increasingly pointed out as the main determinants of cardiovascular health. Staying physically active during lockdown is a challenge, especially for the population with a higher risk of mortality from COVID-19 who are still encouraged to maintain social distance until there is a vaccine available. Strategies to avoid physical inactivity, and reduce stress levels can promote cardiovascular protection, and must be considered during COVID-19 time. Objectives: The aim of this paper is to discuss the risks of physical inactivity and stress for the cardiovascular system during the COVID-19 pandemic and propose strategies to protect cardiovascular health. Conclusion: A home-based training protocol could be an interesting and effective strategy for the population who need to remain physically active and safe at home.

Due to the increasing number of cyberattacks and respective predictions for the upcoming years with even larger numbers of occurrences, companies are becoming aware not only that the digitization of their businesses is essential, but also that the adoption of efficient cybersecurity strategies is crucial. Therefore, approaches for a better understanding and analysis of cybersecurity are essential.Thus, SecGrid, a Machine Learning (ML) empowered platform for analyzing, classification, and visualization of cyberattacks is introduced. SecGrid implements an extensible set of miners to analyze information from network traces to provide insightful visualizations of malicious traffic given and to classify automatically different types of cyberattacks by using supervised ML. Experiments conducted show high overall usability, scalability in terms of the capacity of the platform to extract information from large files, and high performance and accuracy during the classification of cyberattacks.

&nbsp, Rapid worldwide decreases in physical activity (PA), an increase in sedentary behaviour (SB) and poorer dietary patterns have been reported during COVID-19 confinement periods. However, as national variability has been observed, this study sought to describe PA, SB and eating patterns, and to explore their gender as well as other socio-demographic correlates and how they interrelate in a representative sample of Portuguese adults during the COVID-19 first mandatory social confinement. The survey was applied online and by telephone to 5856 adults (mean age = 45.8 years, 42.6% women). The majority reported high (46.0%) or moderate (20.5%) PA levels. Men, younger participants, those with higher education levels and a favourable perception of their financial situation reported higher PA levels, with the opposite pattern for SB. Physical fitness activities and household chores were more reported by women, with more strength training and running activities reported by men. Regarding eating behaviours, 45.1% reported changes, positive (58%) and negative (42%), with 18.2% reporting increases in consumption of fruit, vegetables, and fish and other seafood consumption, while 10.8% (most with lower educational level and less comfortable with their income) reported an increase in consumption of ready-to-eat meals, soft drinks, savoury snacks, and take-away and delivered meals. Two clusters—a health-enhancing vs. risky pattern—emerged through multiple correspondence analysis characterized by co-occurrence of high vs. low PA levels, positive vs. negative eating changes, awareness or not of the COVID-19 PA and dietary recommendations, perceived financial situation, higher vs. lower educational level and time in social confinement. In conclusion, while in social confinement, both positive and negative PA and eating behaviours and trends were displayed, highlighting the role of key sociodemographic correlates contributing to healthy vs. risky patterns. Results may inform future health interventions and policies to be more targeted to those at risk, and also advocate the promotion of PA and healthy eating in an integrated fashion.&nbsp

The present study was designed to compare the body composition and indicators of chronic inflammatory grade, such as leptin, adiponectin, and resistin concentrations in irregularly active and active SCI subjects. Thirty-two male subjects participated in this study. They were divided into three groups: able-bodied control irregularly active (control, n = 11 ), irregularly active with SCI (SCI-IA, n = 8 ), and physically active with SCI (SCI-PA, n = 13 ). The enzyme-linked immunosorbent assay (ELISA) assessed serum concentrations of leptin, adiponectin, and resistin. All volunteers performed the maximum oxygen uptake (VO2max) test, 24 h total energy expenditure (TEE), and body composition by skinfold thicknesses. Leptin concentrations were higher in the SCI-IA group when compared to the other groups, while no significant differences were found between the SCI-PA and control cohorts. In addition, no significant differences were found among groups for serum adiponectin and resistin concentrations either. The SCI-PA group showed significantly higher values for TEE and VO2max when compared to the other groups. Percentages of body fat and circumference were decreased in the control and SCI-PA groups when compared to the SCI-IA cohort. Associations between leptin and cardiorespiratory capacity and anthropometric markers were also observed. Our findings highlight that the lack of physical activity in the SCI subjects leads to poor general physical fitness and higher levels of body adiposity, which may induce hyperleptinemia, an essential marker for cardiometabolic disorders.

Mobile devices expose information about their hardware and manufacturer while searching for available WiFi networks via a Media Access Control (MAC) protocol. Thus, to protect the users' privacy and prevent MAC address tracking, manufacturers typically provide anonymity through MAC randomization techniques by randomly and periodically modifying the MAC address. This paper presents the ASIMOV tracking approach, which shows through the correlation of randomized information concerning the displacement of devices in space-time dimensions that it is possible to gain insights into identifiable device information. The proposed system is entirely passive and uses a combined Received Signal Strength Indicator (RSSI) value-based localization and the Information Elements (IE) transmitted in every IEEE 802.11 probe request frame.

Background and PurposeMobilization of critical patients should be precocious and the inclusion of nursing in this task can be decisive in paradigm shift. The purpose of this study was to validate the Portuguese version of the intensive care unit Mobility Scale for nursing use.MethodsProspective multicenter observational study. Patients' mobility was evaluated by rehabilitation nurses in order to determine interobserver agreement. The validation criteria was tested by determining the correlation between the evaluation results of mobility, strength, and functionality levels at discharge.ResultsGood interobserver agreement (R = 0.98; K = 0.76). Positive correlation with muscle strength (R = 0.77) and functionality (R = 0.85) levels at discharge.ConclusionsBased on the correlations observed the scale is a valid instrument for nurses and could be a useful tool for routine use. More research is recommended to make the results more robust.

Background APOE e4 is independently associated with lobar intracranial hemorrhages (ICH). Although the e4 allele enhances amyloid deposition in blood vessels, the e2 allele predisposes to vasculopathic changes leading to rupture of amyloid laden vessels. Thus, e4 and e2 carriers might have increased susceptibility to ICH. We aimed to study the impact of the apolipoprotein E alleles in the development of symptomatic ICH (sICH). Methods We included 384 consecutive ischemic anterior circulation stroke patients submitted to thrombolysis between January 2014 and March 2016. Admission CT-scans were reviewed to calculate the ASPECTS. Patients were followed for up to at least 6 months post-stroke or until death. Outcome was development of sICH, defined according to the ECASS III. Results Considering APOE genotyping, three patients had e2/e2, four had e2/e4, 38 had e2/e3, 284 had e3/e3, 51 had e3/e4 and four had e4/e4. sICH was associated with sex and diabetes. In multivariate analysis, sICH was not associated with carrying one or more e4 alleles (OR: 0.483, 95%CI = [0.059, 3.939], p = 0.497) nor with carrying one or more e2 alleles (OR: 1.369, 95%CI = [0.278, 6.734], p = 0.699). Conclusion No association was found between APOE genotype and the development of symptomatic intracranial hemorrhage.

Aim The present study investigated whether hypertension, blood pressure, and antihypertensive therapy were associated with frailty status in community-dwelling older adults. In addition, we tested whether such associations were consistent across different frailty instruments. Material and methods Two-hundred older adults were enrolled in the study. Participant frailty status was determined according to a modified physical frailty phenotype (mFP), the FRAIL scale, and the Study of Osteoporotic Fracture (SOF) index. Blood pressure was assessed three times, in three different days, and mean values were used in the final analysis. Information pertaining to disease conditions and antihypertensive therapy were collected by two researchers through self-report and careful review of medical charts. Results No significant differences in hemodynamic parameters, hypertension diagnosis, and antihypertensive therapy were observed across frailty statuses, regardless of the frailty assessment tool used. Conclusion Findings of the present study indicate that hypertension, blood pressure levels and antihypertensive medication were not cross-sectionally associated with frailty status in cognitively preserved community-dwelling older adults with low prevalence of comorbidities, regardless of the tool used for frailty identification.

Orthobiologics continue to gain popularity in many areas of medical science, especially in the field of regenerative medicine. Platelet-rich plasma derivatives are orthobiologic tools of particular interest. These biologic products can be obtained via centrifugation of a patient's whole blood and the components can then be subsequently isolated, concentrated and ultimately administered into injured tissues, particularly in areas where standard healing is disrupted. The elevated concentration of platelets above the basal value enables accelerated growth of various tissues with minimal side effects. The application of autologous orthobiologics is a relatively new biotechnology undergoing expansion which continues to reveal optimistic results in the stimulation and enhanced healing of various sorts of tissue injuries. The local release of growth factors and cytokines contained in platelet alpha granules accelerates and ameliorates tissue repair processes, mimicking and supporting standard wound healing. This effect is greatly enhanced upon combination with the fibrinolytic system, which are essential for complete regeneration. Fibrinolytic reactions can dictate proper cellular recruitment of certain cell populations such as mesenchymal stem cells and other immunomodulatory agents. Additionally, these reactions also control proteolytic activity in areas of wound healing and regenerative processes of mesodermal tissues including bone, cartilage, and muscle, which makes it particularly valuable for musculoskeletal health, for instance. Although many investigations have demonstrated significant results with platelet-rich plasma derivatives, further studies are still warranted.

While the existence of Public Bulletin Boards (PBB) is often formulated as an assumption in related work on Remote Electronic Voting (REV) systems, this work here on Provotum focuses on the practical design and architecture of such a PBB, including its distributed execution. Further, Provotum leverages a public permissioned Blockchain (BC) as a PBB, where only authorized entities can sign blocks, while the general public can verify all BC data.Therefore, Provotum defines a new and fully decentralized BC-based REV system, which deploys a permissioned BC as a PBB and allows for the explicit distribution of trust across different permissioned BC nodes. Provotum is operated in a fully distributed fashion by using Smart Contracts (SC), Distributed Key Generation (DKG), Homomorphic Encryption (HE), and Cooperative Decryption (CD), as well as employing client-side encryption, which enables ballot secrecy, while the BC forms an audit trail, enabling public and End-to-end Verifiability (E2E-V).