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Abstract In this work, we study the evolution of an evaporating black hole, described by the Kerr–Taub–NUT metric, which emits scalar particles. We found that allowing the black hole to radiate massless scalar particles increases the angular momentum loss rate while decreasing the loss rate of the NUT parameter and black hole mass. In fact, it means that angular momentum will disappear faster than the other black hole parameters (mass and NUT parameter) during the evaporation process. We also calculate the time evolution of the mass, angular momentum, and NUT parameter in order to get the evolution of the Von Neumann entropy of the black hole. We found that the entropy follows approximately the so-called Page curve, where the $$\beta $$ β parameter, which quantifies the amount of radiation, affects the evaporation process. Implying that high $$\beta $$ β values accelerate the evaporation process of a Kerr–Taub–NUT black hole.

Abstract Background National palliative care plans depend upon stakeholder engagement to succeed. Assessing the capability, interest, and knowledge of stakeholders is a crucial step in the implementation of public health initiatives, as recommended by the World Health Organisation. However, utilising stakeholder analysis is a strategy underused in public palliative care. Objective To conduct a stakeholder analysis characterising a diverse group of stakeholders involved in implementing a national palliative care plan in three rural regions of an upper-middle-income country. Methods A descriptive cross-sectional study design, complemented by a quantitative stakeholder analysis approach, was executed through a survey designed to gauge stakeholders’ levels of interest and capability in relation to five fundamental dimensions of public palliative care: provision of services, accessibility of essential medicines, palliative care education, financial support, and palliative care vitality. Stakeholders were categorised as promoters (high-power, high-interest), latent (high-power, low-interest), advocates (low-power, high-interest), and indifferent (low-power and low-interest). Stakeholder self-perceived category and knowledge level were also assessed. Results Among the 65 surveyed stakeholders, 19 were categorised as promoters, 34 as advocates, 9 as latent, and 3 as indifferent. Stakeholders’ self-perception of their category did not align with the results of the quantitative analysis. When evaluated by region and palliative care dimensions the distribution of stakeholders was nonuniform. Palliative care funding was the dimension with the highest number of stakeholders categorised as indifferent, and the lowest percentage of promoters. Stakeholders categorised as promoters consistently reported a low level of knowledge, regardless of the dimension, region, or their level of interest. Conclusions Assessing the capability, interest, and knowledge of stakeholders is a crucial step when implementing public health initiatives in palliative care. It allows for a data-driven decision-making process on how to delegate responsibilities, administer financial resources, and establish governance boards that remain engaged and work efficiently.

Abstract Background The number of people suffering from chronic diseases requiring palliative care (PC) is increasing rapidly. Therefore, PC teaching in undergraduate health science programs is necessary to improve primary PC based on international recommendations and available scientific evidence. Methods A descriptive cross-sectional study was conducted. Active undergraduate medical and nursing programs that were approved by the Colombian Ministry of Education and integrated PC teaching into their curricula were included in the study. The total sample consisted of 48 programs: 31 nursing and 17 medical programs. Results PC competencies are distributed throughout the curriculum in 41.67% of programs, in elective courses in 31.25%, and in mandatory courses in 27.08% of the programs. The average PC teaching hours is 81 for nursing and 57.6 for medicine. PC clinical rotations are not offered in 75% of the programs. For undergraduate nursing programs, the most frequent competencies taught are the definition and history of PC and identifying common symptoms associated with advanced disease. In undergraduate medicine, the most common competencies are pharmacological and non-pharmacological pain management and identification of PC needs. Conclusions PC teaching in undergraduate health science programs mainly addresses the conceptual and theoretical aspects of PC, which are part of the competencies present throughout the programs’ curricula. Low availability of PC clinical rotations was identified. Future studies should assess whether the low availability of clinical rotations in PC limits the ability of students to develop the practical competencies necessary to provide quality PC. Trial registration Not applicable.

Introduction: Living kidney donation is currently low in Colombia, and this is associated with the lack of knowledge of the risks and renal function outcomes of potential donors; there are no studies that evaluate these outcomes. The objective of this study is to evaluate the outcomes of renal function, the incidence of metabolic diseases, arterial hypertension, as well as the finding of albuminuria and/or proteinuria in living kidney donors with a 2-year follow-up post donation. Methods: Observational study in living kidney donor patients, in which renal function outcomes were evaluated between the predonation period and up to 24 months postdonation. Results: Ninety-one patients were included, with a median predonation glomerular filtration rate of 98 ml/min/1.73 m 2 , interquartile range (90.5–109), and 24-month postdonation of 66.3 ml/min/1.73 m 2 interquartile range (57.9–75). A total of 60.26% of the population was in stage 2 at the end of follow-up and no patient had a glomerular filtration rate less than 30 ml/min/1.73 m 2 or required renal support therapy. Conclusion: A living donor evaluation process based on risk factor stratification and adequate assessment of renal function was found to generate safe renal function outcomes both in the perioperative period and in medium- and long-term follow-up.

A pesquisa tem como objetivo analisar como as competências e habilidades da Matriz de Referência das Ciências da Natureza e suas Tecnologias (MRCNT) do Exame Nacional para Certificação de Competências de Jovens e Adultos (ENCCEJA) mobilizam os conhecimentos dos jovens e adultos que não tiveram acesso à escolaridade na idade própria. Entendemos que a MRCNT delimita quais conteúdos, habilidades e conhecimentos são importantes para o ENNCEJA e para a Educação de Jovens e Adultos (EJA). Sendo uma política pública, destacamos quais são os objetivos do ENCCEJA e como se caracterizam os seus sujeitos. Como referencial teórico, destacamos as perspectivas do currículo pré-ativo e do vivido acompanhadas de discussões sobre o conhecimento a partir das noções do conhecimento em si e do conhecimento para fazer algo. O referencial metodológico para abordarmos a MRCNT foi a análise de conteúdos de Laurence Bardin. Concluímos que os conhecimentos destacados nas habilidades e competências presentes na MRCNT são todos relacionados a conhecimentos disciplinares e sobre a natureza das ciências, abrindo-se pouco espaços para os conhecimentos e culturas locais. Na medida em que os conhecimentos presentes na Matriz são pretensamente objetivos e universais, eles se adequam aos sistemas de avalições em larga escala que favorecem a cristalização dos conhecimentos, a generalização das formas de preparo dos estudantes e a arrecadação de dados de performance.

Introducción: El cáncer infantil es una enfermedad compleja que requiere intervenciones interdisciplinarias. Este estudio busca describir la calidad de vida y el agotamiento en niños diagnosticados con cáncer, utilizando instrumentos validados que reflejan las peculiaridades de esta enfermedad. Método: Se llevó a cabo un estudio observacional analítico en niños y adolescentes de 2 a 18 años con cáncer. Se emplearon el PedsQL Cancer Module y el FACIT-F para evaluar calidad de vida y fatiga, respectivamente, analizando estadísticamente para identificar correlaciones y desarrollar un modelo explicativo. Resultados: Se identificaron síntomas físicos y psicológicos notables como náuseas, fatiga, hiporexia, irritabilidad y tristeza. Los instrumentos PedsQL Cancer Module y FACIT-F indicaron una calidad de vida disminuida. Hubo una alta concordancia entre las percepciones de niños y padres, excepto en la ansiedad por procedimientos, donde los niños reportaron mayores niveles. Estos síntomas reflejan el impacto del tratamiento oncológico, en el bienestar de los niños. La concordancia en las evaluaciones sugiere que los padres comprenden bien estas experiencias, destacando la pertinencia de intervenciones psicosociales que mejoren la calidad de vida a partir de una adecuada red de apoyo. Conclusiones: Es crucial que el tratamiento del cáncer pediátrico aborde no solo aspectos médicos, sino también el apoyo integral al bienestar emocional y psicosocial de los pacientes y sus familias.

Introduction: The response to vaccination against the virus that causes severe acute respiratory infection syndrome coronavirus 2 is lower in renal transplant recipients than in the general population. The data obtained from Latin America showed reduced immunogenicity under inactivated virus vaccination schedules and messenger ribonucleic acid platforms. Methods: A retrospective cohort study including renal transplant recipients from Colombia with a two-dose vaccination schedule against severe acute respiratory infection syndrome coronavirus 2 with Pfizer, AstraZeneca, Moderna, Jansen, and Sinovac vaccines between March 1, 2021 and December 1, 2021, was carried out with a follow-up period to evaluate outcomes until May 2022. The outcomes correspond to the titers of immunoglobulin G antibodies against the receptor binding domain of the severe acute respiratory infection syndrome coronavirus 2 spike and a composite outcome of mortality, general, and intensive care unit hospitalization. Results: In total, 215 renal transplant recipients with two doses of vaccination for severe acute respiratory infection syndrome coronavirus 2 during the predominance of the Omicron variant in Colombia were included, with the measurement of immunoglobulin G antibody titers against the receptor binding domain of the severe acute respiratory infection syndrome coronavirus 2 spike at 8 weeks of vaccination. The mean age was 52.1 years, and the standard deviation was ± 14.2; severe acute respiratory infection syndrome coronavirus 2 infection occurred in 20% of the population, of which 23.26% required hospitalization, 13.95% were under intensive care unit management, and four cases of mortality (9.3%) were reported. Of the total population, 52.5% had antibody titers higher than 0.8 IU/mL (median 0.77 IU/mL, interquartile range 0.4–131). Patients with severe acute respiratory infection syndrome coronavirus 2 infection had a median antibody titer of 0.4 IU/mL (interquartile range 0.4–3.45), and those without infection had a median antibody titer of 1.8 IU/mL (interquartile range 0.4–202) ( p = 0.015). Conclusion: Anti-severe acute respiratory infection syndrome coronavirus 2 antibody titers with a cutoff point less than 0.8 IU/mL are associated with increased risk of severe acute respiratory infection syndrome coronavirus 2 infection.

PURPOSEThe present article aims to present the data of a Breast Cancer Team Short-Term Surgical Mission in Guinea-Bissau in the setting of the National Bissau Hospital, Hospital Nacional Simão Mendes, level A referral health structure.PATIENTS AND METHODSPatients with breast disease have been presented to our team for in loco consultation during the total of three missions in 1 year. We have observed a total of 97 female patients with age ranging from 12 to 70 years. We performed 21 excisional biopsies, five radical surgeries, and 28 needle biopsies.RESULTSThere have been diagnosed 19 invasive breast cancer cases in stage IV, and in seven patients, the biopsy resulted in malignancy. On the recall consultation of the needle biopsied patients, just two returned and accepted the proposed treatment. Major issue has been the lack of trained pathology technicians for adequate sampling conditioning, a fact that led to a poor quality of 18 samples.CONCLUSIONAccess to surgical care is disparate across the world, and short-term surgical missions are often call-in action to deliver not only patient care but also local staff training. Complex disease management, such as cancer, may create several problems being conditioned by the lack of basic resources required. In Guinea-Bissau, a poor country with very few inhabitants, the need to implement an anticancer national strategy is urgent but seems feasible. Any action should prioritize local team training and enhance specialization. No external intervention can provide any long-term benefit for patients if they are detached from local health workers.

Purpose: Stroke is the leading cause of disability in adults worldwide, with hemiparesis being the most prevalent consequence. The use of video games and movement sensors could contribute to improving patients’ chances of recovery. We performed a supervised pilot study to validate the safety, feasibility, and acceptability of a new virtual rehabilitation platform in patients with chronic post-stroke upper limb hemiparesis. Methods: The participants (n = 9) participated in 40 rehabilitation sessions, twice a week, for a period of 20 weeks. Their experiences with the platform were documented using a Likert-scale survey. Changes in motor function were evaluated using the Chedoke Arm and Hand Activity Inventory (CAHAI) and the Wolf Motor Function Test (WMFT). Results and conclusions: All participants expressed that they enjoyed the experience and felt comfortable using the platform. Preliminary results showed significant motor recovery ( P = .0039) according to the WMFT scores. Patients with significant impairment showed no improvement in upper limb task-oriented motor function after therapy. The new platform is safe and well-accepted by patients. The improvement in motor function observed in some of the participants should be attributed to the therapy since spontaneous functional recovery is not expected in chronic stroke patients.

El presente artículo presenta el diseño e implementación de antenas planas, mejor conocidas como Antenas de Microlínea para aplicaciones de Radio Frecuencia y Microonda, utilizando materiales de fácil acceso en el mercado nacional.

OBJECTIVES: Oral health in Down syndrome children has some peculiar aspects that must be considered in the follow-up of these patients. This study focuses on characterizing the environmental and host factors associated with dental caries in Portuguese children with and without Down syndrome. METHODS: A sibling-matched, population-based, cross-sectional survey was performed. RESULTS: Down syndrome children presented a significantly greater percentage of children without caries, 78% vs. 58% of non-Down syndrome siblings. This difference in the DMFT index (number of decayed, missing and filled teeth) essentially reflects data obtained from treated teeth, for which 91% of children with Down syndrome had never had a tooth treated vs. 67% of siblings. This result was statistically significant, whereas results for decayed and lost teeth did not differ between Down syndrome children and their unaffected siblings. Additionally, in Down syndrome children, a delayed eruption of the second molar occurs. Down syndrome children and their siblings have similar oral hygiene habits, but a higher percentage of Down syndrome children visit a dentist before the age of three years, in comparison to their siblings. Bruxism was also more common in Down syndrome children compared to their siblings. CONCLUSIONS: Our results show that Portuguese children with Down syndrome have lower caries rates than children without Down syndrome. This reduced prevalence may be associated with the parents' greater concern about oral health care in Down syndrome children, resulting in their taking them sooner to visit a dentist, as well as to a higher bruxism prevalence and delayed tooth eruption.

This article is concerned with the non-linear interaction of homogeneous random ocean surface waves. Under this umbrella, numerous kinetic equations have been derived to study the evolution of the spectral action density, each employing slightly different assumptions. Using analytical and numerical tools, and providing exact formulas, we demonstrate that the recently derived generalized kinetic equation exhibits blow up in finite time for certain degenerate quartets of waves. This is discussed in light of the assumptions made in the derivation, and this equation is contrasted with other kinetic equations for the spectral action density.

A pneumatose intestinal, caracterizada pela presença de gás na parede do cólon, é uma condição incomum com um espectro de apresentação variável. Pode ser idiopática ou secundária a outras doenças. A tomografia computorizada é o método de diagnóstico com maior sensibilidade. Na ausência de sinais e sintomas sugestivos de complicações, como a perfuração e a peritonite, a pneumatose intestinal pode ser tratada de forma conservadora. Apresenta-se o caso de uma mulher de 59 anos com pneumatose cólica secundária a teratoma ovárico benigno. Após a cirurgia, manteve-se sintomática e foi tratada com sucesso com metronidazol e oxigenoterapia hiperbárica.

Child Abuse is a frequent problem worldwide that surpasses ethnicity, religion, culture, economic and social classes. In the United States of America child protective services account, per year, over one million cases of child abuse or neglect. In Portugal, the incidence of the problem is unknown but each year thousands of abused children are accompanied by the Commissions for the Protection of Children and Youth at Risk. This abuse threatens children's physical, emotional and intellectual development, as well as their dignity, security, well-being and even their own lives. The body regions most frequently affected in physical abuse, are the cranium, neck and orofacial region, in fact, about 50% of the injuries arising from child abuse occur in the orofacial region. These data place the dentist in a privileged position to make the detection, diagnosis and report of child abuse. Therefore, these professionals must be prepared to recognize, diagnose and report their suspicions to the appropriate authorities, which play a key role in victims protection and criminal investigation. This review intends to stress the important role of the dentist in the detection, diagnosis and report of child abuse, systematizing child abuse risk factors and indicators essential to the intervention of these professionals. This problem's approach is multidisciplinary, involving particularly dentists, who must obtain continuing education and training in this area.

Background: The cassava starch industry is recognized as a source of negative externalities caused by the agroindustrial waste ‘cassava bagasse’. Even though options for bioconversion of cassava bagasse have been introduced, it is also true that hundreds of tons of this waste are produced annually with the consequent negative environmental impact. This agroindustrial context highlights the need for further research in technological proposals aimed at lowering the water contained in cassava bagasse. Methods: We report a scoping review of studies from 2010–2021 that mention the uses of cassava bagasse, as well as the technological options that have become effective for drying fruits and vegetables. The method used for selecting articles was based on the Preferred Reporting Items for Systematic Review and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) method. Articles selected were taken from the databases of ScienceDirect, Google Scholar, Scopus and Springer. Results : This review highlights fruit and vegetable osmotic dehydration and drying studies assisted by the combination of emerging technologies of osmotic pressure, ultrasound, and electrical pulses. Studies that take advantage of cassava bagasse have focused on biotechnological products, animal and human food industry, and development of biofilms and biomaterials. Conclusions: In this review, we found 60 studies out of 124 that show the advantages of the residual components of cassava bagasse for the development of new products. These studies do not mention any potential use of bagasse fiber for post-industrial purposes, leaving this end products’ final use/disposal unaddressed. A viable solution is osmotic dehydration and drying assisted with electrical pulse and ultrasound that have been shown to improve the drying efficiency of fruits, vegetables and tubers. This greatly improves the drying efficiency of agro-industrial residues such as husks and bagasse, which in turn, directly impacts its post-industrial use.

Background: The number of people suffering from chronic diseases requiring palliative care (PC) is increasing rapidly. Therefore, PC teaching in undergraduate health science programs is necessary to improve primary PC based on international recommendations and available scientific evidence. Methods: A descriptive cross-sectional study was conducted. Active undergraduate medical and nursing programs that were approved by the Colombian Ministry of Education and integrated PC teaching into their curricula were included in the study. The total sample consisted of 48 programs: 31 nursing and 17 medical programs. Results: PC competencies are distributed throughout the curriculum in 41.67% of programs, in elective courses in 31.25%, and in mandatory courses in 27.08% of the programs. The average PC teaching hours is 81 for nursing and 57.6 for medicine. PC clinical rotations are not offered in 75% of the programs. For undergraduate nursing programs, the most frequent competencies taught are the definition and history of PC and identifying common symptoms associated with advanced disease. In undergraduate medicine, the most common competencies are pharmacological and non-pharmacological pain management and identification of PC needs. Conclusions: PC teaching in undergraduate health science programs mainly addresses the conceptual and theoretical aspects of PC, which are part of the competencies present throughout the programs' curricula. Low availability of PC clinical rotations was identified. Future studies should assess whether the low availability of clinical rotations in PC limits the ability of students to develop the practical competencies necessary to provide quality PC. Trial registration: Not applicable. [ABSTRACT FROM AUTHOR]