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This paper aims to introduce GIS, its definition, principle, application in any discipline particularly maritime, its process, data sets and features and its benefits to maritime and universities. Specifically, the paper intends to provide an overview of its wide applications in maritime including but not limited to marine transportation, marine environment, port management and operation, maritime education and training (MET) and maritime research. GIS simplest task is in mapping and visualization. But its most important function is in spatial analysis. Spatial analysis takes into account the location, geometry, topology, and relationships of geographic data, which lend itself to intelligent decision making. GIS is not just for researchers and students. GIS is especially useful for decision makers such as: managers, administrators, and directors of large and small projects. Scenarios are “seen” and analyzed even before events happen. To planners and decision makers, this is very important because they can assess the impact of events or scenario and may save a lot of time, effort, and money before implementing the actual project. An additional skill on GIS when learned or thought would certainly result to a technically competent maritime global workforce. The paper would provide ideas on possible areas for collaborations among TransNav member institutions for data sharing which may be processed and analyzed by a GIS specialist.

ABSTRACT Introduction: Endoscopic Combined Intrarenal Surgery (ECIRS) has emerged as a promising technique for the management of large and complex kidney stones, potentially offering advantages over traditional Percutaneous Nephrolithotomy (PCNL). This study aims to evaluate best practices, outcomes, and future perspectives associated with ECIRS. Materials and Methods: A comprehensive PubMed search was conducted from 2008 to 2024, using MESH terms and the following key words: "ECIRS" and "Endoscopic Combined Intrarenal Surgery" The search yielded 157 articles, including retrospective cohort studies, two randomized controlled trials (RCTs), and four meta-analyses comparing ECIRS with PCNL. Most important findings were summarized regarding indications, patient positioning, kidney access, tract size, surgical outcomes, and complications. Results: ECIRS demonstrated higher stone-free rate, lower complication rate, and a reduced need for multiple procedures compared to traditional PCNL. Additionally, ECIRS has the potential to integrate new technologies to further enhance outcomes. Conclusion: ECIRS demonstrates significant advantages in the management of large kidney stones. Future research should focus on well-designed RCTs to provide robust evidence of its efficacy, safety, and cost-effectiveness, potentially establishing ECIRS as the first option treatment for complex kidney stones.

ABSTRACT Introduction: The ureteral access sheath (UAS) is a medical device that enables repeated entrance into the ureter and collecting system during retrograde intrarenal surgery (RIRS). Its impact on stone-free rates, ureteral injuries, operative time, and postoperative complications remains controversial. Therefore, we performed a systematic review and meta-analysis comparing RIRS with versus without UAS for urolithiasis management. Purpose: To compare outcomes from retrograde intrarenal surgery (RIRS) for stone extraction with or without ureteral access sheath (UAS); evaluating stone-free rate (SFR), ureteral injuries, operative time, and postoperative complications. Materials and Methods: We systematically searched PubMed, Embase, and Cochrane Library in June 2024 for randomized controlled trials (RCTs) evaluating the efficacy and safety outcomes of UAS use in RIRS for urolithiasis treatment. Articles published between 2014 and 2024 were included. Pooled risk ratios (RRs) and mean differences (MDs) were calculated for binary and continuous outcomes, respectively. Results: Five RCTs comprising 466 procedures were included. Of these, 246 (52.7%) utilized UAS. The follow-up ranged from 1 week to 1 month. UAS reduced the incidence of postoperative fever (RR 0.49; 95% confidence interval [CI] 0.29–0.84; p=0.009), and postoperative infection (RR 0.50; 95% CI 0.30–0.83; p=0.008). There were no significant differences between groups in terms of SFR (RR 1.05; 95% CI 0.99–1.11; p=0.10), ureteral injuries (RR 1.29; 95% CI 0.95–1.75; p=0.11), operative time (MD 3.56 minutes; 95% CI −4.15 to 11.27 minutes; p=0.36), or length of stay (MD 0.32 days; 95% CI −0.42 to 1.07 days; p=0.40). Conclusion: UAS leads to a lower rate of post-operative fever and infection. However, UAS did not significantly reduce or increase the SFR or the rate of ureteral injuries during RIRS for patients with urolithiasis. The use of UAS should be considered to decrease the risk of infectious complications, particularly in those who may be at higher risk for such complications.

Abstract To investigate whether and how Social Innovation (SI) can contribute to transformative change, we explored nine Native Seed Collectors Networks (NSCNs) in Brazil. Employing Social Network Analysis, we delved into the organisational structure of four NSCNs. Additionally, we identified five instances of social innovations (SIs) using the guiding questions of the Social Innovation—Forest and Landscape Restoration (SI‐FLR) framework. These networks, which received a total of US$ 12 million in investments from 2018 to 2021, have not only contributed to the production of 180 tonnes of native seeds but also had a significant socioeconomic impact. They have generated a total income of US$ 1.01 million for 997 seed collectors, 46% of whom are from traditional communities and marginalised groups. Furthermore, 55% of these collectors are women, and 23% rely solely on seed collection as their only source of income. While the NSCNs represent a fledgling economy, they have effectively activated local agency capacity. With the support of the NSCNs' social capital, a favourable context and clear motivations, this agency capacity can trigger SIs. By generating positive impacts, these SIs are changing values and empowering local agents (scaling deep), inspiring agents in other geographies (scaling out) and even influencing policies favourable to socially inclusive landscape restoration (scaling up). This three‐dimensional scaling underscores the catalysing power of SI in NSCNs and their potential contribution to transformative change. We also emphasise the role of public bodies in promoting enabling conditions, the vital role of local experimentation and the rarely evidenced local agency capacity to leverage SIs in FLR. Read the free Plain Language Summary for this article on the Journal blog.

Abstract We describe the geographical variation in tree species composition across Amazonian forests and show how environmental conditions are associated with species turnover. Our analyses are based on 2023 forest inventory plots (1 ha) that provide abundance data for a total of 5188 tree species. Within-plot species composition reflected both local environmental conditions (especially soil nutrients and hydrology) and geographical regions. A broader-scale view of species turnover was obtained by interpolating the relative tree species abundances over Amazonia into 47,441 0.1-degree grid cells. Two main dimensions of spatial change in tree species composition were identified. The first was a gradient between western Amazonia at the Andean forelands (with young geology and relatively nutrient-rich soils) and central–eastern Amazonia associated with the Guiana and Brazilian Shields (with more ancient geology and poor soils). The second gradient was between the wet forests of the northwest and the drier forests in southern Amazonia. Isolines linking cells of similar composition crossed major Amazonian rivers, suggesting that tree species distributions are not limited by rivers. Even though some areas of relatively sharp species turnover were identified, mostly the tree species composition changed gradually over large extents, which does not support delimiting clear discrete biogeographic regions within Amazonia.

Improvements in clinical assessment have occurred since the last published recommendations on the diagnosis and treatment of acute promyelocytic leukemia in 2013. Here, a committee of specialists of the Brazilian Association of Hematology, Hemotherapy and Cellular Therapy presents a comprehensive review on the current knowledge, focusing on the advances in diagnosis, risk assessment, and frontline and salvage therapy. The concept of urgent diagnosis is explored as well as the management of critical situations such as coagulopathy and differentiation syndrome. Recent adjustments in risk stratification based on white blood cell counts only are presented together with the incorporation of chemo-free regimens for non-high-risk patients. Special conditions such as acute promyelocytic leukemia in children, the elderly and pregnant women are discussed. Finally, acute promyelocytic leukemia is presented as a highly curable disease because of the real possibility of targeted therapy towards differentiation, and, paradoxically, as a serious and urgent condition that deserves prompt recognition and management to avoid early mortality.

ABSTRACT Purpose: to identify risk factors for urinary septic shock in patients who underwent percutaneous nephrolithotomy (PCNL). Materials and Methods: Data from PCNL procedures performed between January 2009 and February 2020 were retrospectively analyzed. The study included all patients over 18 years old with kidney stones larger than 15 mm who underwent PCNL. Patients who underwent mini-PCNL or combined surgeries, such as ureteroscopy or bilateral procedures, were not included in the study. Logistic regression was conducted to determine the risk factors for urinary septic shock within 30 days post-operation in patients who underwent PCNL. Results: Urinary septic shock was observed in 8 out of the 1,424 patients analyzed (0.56%). The presence of comorbidities, evaluated using the Charlson Comorbidity Index (CCI) (OR 1.46 [CI 95% 1.15-1.86], p=0.01), larger stones (41.0 mm [IQR 30.0-47.5 mm] vs. 24.0 mm [IQR 17.0-35.0 mm], OR 1.03 [CI 95% 1.01-1.06], p=0.04), and a positive preoperative urine culture (OR 8.53 [CI 95% 1.71-42.45], p 2, larger stones (≥ 35 mm), and a positive preoperative urine culture were at even higher risk of urinary septic shock (OR 15.40 [CI 95% 1.77-134.21], p=0.01). Conclusion: Patients with larger stones, positive preoperative urine culture, and a higher CCI are at risk for urinary septic shock after PCNL. These findings are of utmost importance for optimizing the perioperative care of these patients to prevent life-threatening complications.

Abstract The proposition of a minimal dose of resistance training (RT) to elicit health benefits, encompassing physiological and psychological aspects, has garnered attention. While empirical investigations have demonstrated the efficacy of low-volume RT protocols in inducing adaptations such as enhanced strength and functional capacity, further exploration of the effects of this paradigm across a broader spectrum of variables is warranted. Thus, this study aimed to investigate the effects of minimal dose RT on strength and functional capacity, cardiac autonomic modulation, and hemodynamic parameters in menopausal women. Twenty-six women were randomly assigned to the training (TG: 63.2 ± 9.3 years) or control group (CG: 59.3 ± 7.6 years). Anthropometric measurements, strength and functional performance tests, cardiac autonomic assessment, and hemodynamic parameters were performed before and after four weeks of intervention. The TG performed the minimum dose RT twice weekly for four weeks (2 sets of 8–12 repetitions in three dynamic exercises, plus three 1-min isometric planks), and the CG had a weekly meeting with lectures and stretching. Two-way ANOVA with repeated measures was applied to each variable. Regarding time comparisons, there was a significant increase for LniRR (F = 4.78; ω2 = 0.046; p = 0.04), one repetition maximum (1RM) bench press (F = 8.06; ω2 = 0,013; p = 0.01), and 1RM leg press (F = 17.3; ω2 = 0,098; p

Abstract Brain damage triggers diverse cellular and molecular events, with astrocytes playing a crucial role in activating local neuroprotective and reparative signaling within damaged neuronal circuits. Here, we investigated reactive astrocytes using a multidimensional approach to categorize their responses into different subtypes based on morphology. This approach utilized the StarTrack lineage tracer, single-cell imaging reconstruction and multivariate data analysis. Our findings identified three profiles of reactive astrocyte responses, categorized by their effects on cell size- and shape- related morphological parameters: “moderate”, “strong,” and “very strong”. We also examined the heterogeneity of astrocyte reactivity, focusing on spatial and clonal distribution. Our research revealed a notable enrichment of protoplasmic and fibrous astrocytes within the “strong” and “very strong” response subtypes. Overall, our study contributes to a better understanding of astrocyte heterogeneity in response to an injury. By characterizing the diverse reactive responses among astrocyte subpopulations, we provide insights that could guide future research aimed at identifying novel therapeutic targets to mitigate brain damage and promote neural repair. Graphical Abstract

Abstract We aimed to assess high-density surface electromyography (HDsEMG)-torque relationships in the presence of delayed onset trunk muscle soreness (DOMS) and the effect of these relationships on torque steadiness (TS) and lumbar movement during concentric/eccentric submaximal trunk extension contractions. Twenty healthy individuals attended three laboratory sessions (24 h apart). HDsEMG signals were recorded unilaterally from the thoracolumbar erector spinae with two 64-electrode grids. HDsEMG-torque signal relationships were explored via coherence (0–5 Hz) and cross-correlation analyses. Principal component analysis was used for HDsEMG-data dimensionality reduction and improvement of HDsEMG-torque-based estimations. DOMS did not reduce either concentric or eccentric trunk extensor muscle strength. However, in the presence of DOMS, improved TS, alongside an altered HDsEMG-torque relationship and kinematic changes were observed, in a contraction-dependent manner. For eccentric trunk extension, improved TS was observed, with greater lumbar flexion movement and a reduction in δ-band HDsEMG-torque coherence and cross-correlation. For concentric trunk extensions, TS improvements were observed alongside reduced thoracolumbar sagittal movement. DOMS does not seem to impair the ability to control trunk muscle force, however, perceived soreness induced changes in lumbar movement and muscle recruitment strategies, which could alter motor performance if the exposure to pain is maintained in the long term.

In this paper we examine several definitions of vaccine efficacy (VE) that we found in the literature, for diseases that express themselves in outbreaks, that is, when the force of infection grows in time, reaches a maximum and then vanishes. The fact that the disease occurs in outbreaks results in several problems that we analyse. We propose a mathematical model that allows the calculation of VE for several scenarios. Vaccine trials usually needs a large number of volunteers that must be enrolled. Ideally, all volunteers should be enrolled in approximately the same time, but this is generally impossible for logistic reasons and they are enrolled in a fashion that can be replaced by a continuous density function (for example, a Gaussian function). The outbreak can also be replaced by a continuous density function, and the use of these density functions simplifies the calculations. Assuming, for example Gaussian functions, one of the problems one can immediately notice is that the peak of the two curves do not occur at the same time. The model allows us to conclude: First, the calculated vaccine efficacy decreases when the force of infection increases; Second, the calculated vaccine efficacy decreases when the gap between the peak in the force of infection and the peak in the enrollment rate increases; Third, different trial protocols can be simulated with this model; different vaccine efficacy definitions can be calculated and in our simulations, all result are approximately the same. The final, and perhaps most important conclusion of our model, is that vaccine efficacy calculated during outbreaks must be carefully examined and the best way we can suggest to overcome this problem is to stratify the enrolled volunteer's in a cohort-by-cohort basis and do the survival analysis for each cohort, or apply the Cox proportional hazards model for each cohort.

Anti-CD19 CAR-T cell therapy represents a breakthrough in the treatment of B-cell malignancies, and it is expected that this therapy modality will soon cover a range of solid tumors as well. Therefore, a universal cheap and sensitive method to detect CAR expression is of foremost importance. One possibility is the use of epitope tags such as c-Myc, HA or FLAG tags attached to the CAR extracellular domain, however, it is important to determine whether these tags can influence binding of the CAR with its target molecule. Here, we conducted in-silico structural modelling of an FMC63-based anti-CD19 single-chain variable fragment (scFv) with and without a c-Myc peptide tag added to the N-terminus portion and performed molecular dynamics simulation of the scFv with the CD19 target. We show that the c-Myc tag presence in the N-terminus portion does not affect the scFv’s structural equilibrium and grants more stability to the scFv. However, intermolecular interaction potential (IIP) analysis reveals that the tag can approximate the complementarity-determining regions (CDRs) present in the scFv and cause steric impediment, potentially disturbing interaction with the CD19 protein. We then tested this possibility with CAR-T cells generated from human donors in a Nalm-6 leukemia model, showing that CAR-T cells with the c-Myc tag have overall worse antitumor activity, which was also observed when the tag was added to the C-terminus position. Ultimately, our results suggest that tag addition is an important aspect of CAR design and can influence CAR-T cell function, therefore its use should be carefully considered.

Polycyclic aromatic systems (PASs) are pervasive compounds that have a substantial impact in chemistry and materials science. Although their specific structure–property relationships hold the key to the design of new functional molecules, a detailed understanding of these relationships remains elusive. To elucidate these relationships, we performed a data-driven investigation of the newly generated COMPAS-2 dataset, which contains ~500k molecules consisting of 11 types of aromatic and antiaromatic rings and ranging in size from one to ten rings. Our analysis explores the effects of electron count, geometry, atomic composition, and heterocyclic composition on a range of electronic molecular properties of PASs.

Abstract Background Glucagon-like peptide-1 agonist receptors (GLP-1RAs), medications used for glycemic control and weight loss, are increasing worldwide. In the perioperative period, the major concern related to GLP-1RA is gastric emptying delay and risk of aspiration. This meta-analysis and systematic review compared the risks and benefits of using GLP-1 agonist receptors and control in surgical and nonsurgical procedures under anesthesia or sedation. Methods We systematically searched MEDLINE, Embase, and Cochrane for randomized controlled trials and observational studies involving patients > 18 years undergoing elective surgeries or procedures. Outcomes of interest were pre-procedural gastrointestinal (GI) symptoms, residual gastric content assessed by endoscopy, pulmonary aspiration during anesthesia/sedation, perioperative glycemic control, postoperative inotropic support, nausea/vomiting (PONV), atrial fibrillation, and 30-day mortality rate. We used a random effects model, with odds ratio and mean difference computed for binary and continuous outcomes, respectively. Results Fourteen randomized and observational studies with 2143 adult patients undergoing elective surgeries and procedures were included. GLP-1RA resulted in increased pre-procedural GI symptoms (OR 7.66; 95% CI 3.42, 17.17; p

Abstract Background HIV remains a critical global public health challenge. In 2022, it was estimated that approximately 39.0 million people worldwide were living with HIV, and of these, around 29.8 million were receiving antiretroviral therapy (ART). The objective was to evaluate the clinical and epidemiological profile and factors associated with viral load (VL) non-suppression in people living with HIV/AIDS at the Maputo Military Hospital (CITRA/MMH). Methods A retrospective cross-sectional analytical study was conducted on 9105 people aged 15 years and over. We use secondary data from participants on ART for at least 2 years being followed up between the years 2019–2020 at CITRA/MMH. Those recently enrolled (on ART

Abstract Background Despite extensive studies on the neurobiological correlates of traumatic brain injury (TBI), little is known about its molecular determinants on long-term consequences, such as dementia and Alzheimer’s disease (AD). Methods Here, we carried out behavioural studies and an extensive biomolecular analysis, including inflammatory cytokines, gene expression and the combination of LC-HRMS and MALDI-MS Imaging to elucidate the targeted metabolomics and lipidomics spatiotemporal alterations of brains from wild-type and APP-SWE mice, a genetic model of AD, at the presymptomatic stage, subjected to mild TBI. Results We found that brain injury does not affect cognitive performance in APP-SWE mice. However, we detected an increase of key hallmarks of AD, including Aβ1-42 levels and BACE1 expression, in the cortices of traumatized transgenic mice. Moreover, significant changes in the expanded endocannabinoid (eCB) system, or endocannabinoidome (eCBome), occurred, including increased levels of the endocannabinoid 2-AG in APP-SWE mice in both the cortex and hippocampus, and N-acylserotonins, detected for the first time in the brain. The gene expression of enzymes for the biosynthesis and inactivation of eCBs and eCB-like mediators, and some of their main molecular targets, also underwent significant changes. We also identified the formation of heteromers between cannabinoid 1 (CB1) and serotonergic 2A (5HT2A) receptors, whose levels increased in the cortex of APP-SWE mTBI mice, possibly contributing to the exacerbated pathophysiology of AD induced by the trauma. Conclusions Mild TBI induces biochemical changes in AD genetically predisposed mice and the eCBome may play a role in the pathogenetic link between brain injury and neurodegenerative disorders also by interacting with the serotonergic system.

RESUMO diante de uma inflação muito elevada, a partir do segundo semestre de 1984, os sindicatos vêm pressionando pelo aumento da frequência dos reajustes salariais. Esta nota explora o atual sistema de ajustes semestrais e propõe um ajuste mensal.

Abstract We analyze how the presence of closed timelike curves (CTCs) characterizing a time machine can be discerned by placing a local particle detector in a region of spacetime which is causally disconnected from the CTCs. Our study shows that not only can the detector tell if there are CTCs, but also that the detector can separate topological from geometrical information and distinguish periodic spacetimes without CTCs (like the Einstein cylinder), curvature, and spacetimes with topological identifications that enable time-machines.

Abstract Clade 2.3.4.4b highly pathogenic avian influenza (HPAI) H5N1 virus was detected in the South American sea lions found dead in Santa Catarina, Brazil, in October 2023. Whole genome sequencing and comparative phylogenetic analysis were conducted to investigate the origin, genetic diversity, and zoonotic potentials of the H5N1 viruses. The H5N1 viruses belonged to the genotype B3.2 of clade 2.3.4.4b H5N1 virus, which was identified in North America and disseminated to South America. They have acquired new amino acid substitutions related to mammalian host affinity. Our study provides insights into the genetic landscape of HPAI H5N1 viruses in Brazil, highlighting the continuous evolutionary processes contributing to their possible adaptation to mammalian hosts.

Myeloid neoplasms result from molecular alterations in hematopoietic stem cells, with acute myeloid leukemia (AML) being one of the most aggressive and with a poor prognosis. Hematopoietic cell kinase (HCK) is a proto-oncogene that encodes a protein-tyrosine kinase of the Scr family, and it is highly expressed in AML. The present study investigated HCK expression in normal hematopoietic cells across myeloid differentiation stages and myeloid neoplasm patients. Within the AML cohort, we explored the impact of HCK expression on clinical outcomes and its correlation with clinical, genetic, and laboratory characteristics. Furthermore, we evaluated the association between HCK expression and the response to antineoplastic agents using ex vivo assay data from AML patients. HCK expression is higher in differentiated subpopulations of myeloid cells. High HCK expression was observed in patients with chronic myelomonocytic leukemia, chronic myeloid leukemia, and AML. In patients with AML, high levels of HCK negatively impacted overall and disease-free survival. High HCK expression was also associated with worse molecular risk groups and white blood cell count; however, it was not an independent prognostic factor. In functional genomic analyses, high HCK expression was associated with several biological and molecular processes relevant to leukemogenesis. HCK expression was also associated with sensitivity and resistance to several drugs currently used in the clinic. In conclusion, our analysis confirmed the differential expression of HCK in myeloid neoplasms and its potential association with unfavorable molecular risks in AML. We also provide new insights into HCK biological functions, prognosis, and response to antineoplastic agents.

Several factors contribute to the increase in irrigation demand: population growth, demand for higher value-added products, and the impacts of climate change, among others. High-quality water is essential for irrigation, so knowledge of water quality is critical. Additionally, water use in agriculture has been increasing in the last decades. Lack of water quality can cause drip clog, a lack of application uniformity, cross-contamination, and direct and indirect impacts on plants and soil. Currently, there is a need for more automated methods for evaluating and monitoring water quality for irrigation purposes, considering different aspects, from impacts on soil to impacts on irrigation systems. This work proposes a data-driven method to address this gap and implemented it in a case study in the PCJ river basin in Brazil. The methodology contains nine components and considers the main steps of the data lifecycle and the traditional machine learning workflow, allowing for automated knowledge extraction and providing important information for improving decision making. The case study illustrates the use of the methodology, highlighting its main advantages and challenges. Clustering different scenarios in three hydrological years (high, average, and lower streamflows) and considering different inputs (soil-related metrics, irrigation system-related metrics, and all metrics) helped generate new insights into the area that would not be easily obtained using traditional methods.

The reaction of lithium hexamethyldisilylamide, [Li{N(Si(CH3)3)2}] (LiHMDS), with 4,4-dimethyl-2-phenyl-2-oxazoline (Phox, C11H13NO) in hexane produced colourless crystals of bis(4,4-dimethyl-2-phenyl-2-oxazoline-κN)(hexamethyldisilylamido-κN)lithium, [Li(C6H18NSi2)(C11H13NO)2] or [Li{N(Si(CH3)3)2}(Phox)2] in high yield (89%). Despite the 1:1 proportion of the starting materials in the reaction mixture, the product formed with a 1:2 amide:oxazoline ratio. In the unit cell of the C2/c space group, the neutral molecules lie on twofold rotation axes coinciding with the Li—N(amide) bonds. The lithium(I) centre adopts a trigonal–planar coordination geometry with three nitrogen donor atoms, one from the HMDS anion and two from the oxazolines. All ligands are monodentate. In the phenyloxazoline units, the dihedral angle defined by the five-membered heterocyclic rings is 35.81 (5)°, while the phenyl substituents are approximately face-to-face, separated by 3.908 (5) Å. In the amide, the methyl groups assume a nearly eclipsed arrangement to minimize steric repulsion with the analogous substituents on the oxazoline rings. The non-covalent interactions in the solid-state structure of [Li{N(Si(CH3)3)2}(Phox)2] were assessed by Hirshfeld surface analysis and fingerprint plots. This new compound is attractive for catalysis due to its unique structural features.

There is a recent and growing interest in assessing differential responders to resistance training (RT) for diverse outcomes. Thus, the individual ability to respond to an intervention for a specific measurement, called responsiveness, remains to be better understood. Thus, the current study aimed to summarize the available information about the effects of RT on functional performance and muscle strength, power, and size in healthy adults, through the prevalence rate in different responsiveness classifications models. A systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and was registered at the International Prospective Register of Systematic Reviews (PROSPERO, CRD42021265378). PubMed/MEDLINE, Scopus, and Embase databases were systematically searched in October 2023. A total of 13 studies were included, totaling 921 subjects. Only two studies presented a low risk of bias. Regarding the effectiveness of RT, the prevalence rate for non-responders ranged from 0% to 44% for muscle strength, from 0% to 84% for muscle size, and from 0% to 42% for functional performance, while for muscle power, the only study found showed a responsiveness rate of 37%. In conclusion, a wide range of differential responders is described for all variables investigated. However, the evidence summarized in this systematic review suggested some caution while interpreting the findings, since the body of evidence found seems to be incipient, and widely heterogeneous in methodological and statistical aspects.

ABSTRACT Background: Success rates in endourological procedures, notably percutaneous nephrolithotomy (PCNL) and ureteroscopy (URS), have demonstrated suboptimal outcomes, leading to more reinterventions and radiation exposure. Recently, the use of intraoperative computed tomography (ICT) scans has been hypothesized as a promising solution for improving outcomes in endourology procedures. With this considered, we conducted a comprehensive systematic review and meta-analysis encompassing all available studies that evaluate the impact of the use of intraoperative CT scans on surgical outcomes compared to conventional fluoroscopic-guided procedures. Methods: This systematic review was conducted in accordance with PRISMA guidelines. Multiple databases were systematically searched up to December of 2023. This study aimed to directly compare the use of an ICT scan with the standard non-ICT-guided procedure. The primary endpoint of interest was success rate, and the secondary endpoints were complications and reintervention rates, while radiation exposure was also evaluated. Data extraction and quality assessment were performed following Cochrane recommendations. Data was presented as an Odds ratio with 95%CI across trials and a random-effects model was selected for pooling of data. Results: A comprehensive search yielded 533 studies, resulting in the selection of 3 cohorts including 327 patients (103 ICT vs 224 in non-ICT). Primary outcome was significantly higher in the experimental group versus the control group (84.5% vs 41.4% respectively, 307 patients; 95% CI [3.61, 12.72]; p

Abstract Aiming to study the performance, carcass characteristics, nutrient digestibility, blood parameters, salivary cortisol levels, and economic viability of pigs administered aspartic protease, a total of 135 pigs were housed in pens in a randomized block design, divided into five treatments with nine replications. The experimental diets were positive control (PC), basic diet with a 5.0% reduction in protein and amino acid requirements; negative control (NC) with a 7.5% reduction in protein and amino acid requirements; NC + 100 g/mT of aspartic protease (NC100); NC + 150 g/mT of aspartic protease (NC150); and NC + 200 g/mT of neutral serine protease (NC200). The inclusion of protease, independently of the source and amount, increased the average daily weight gain (P 0.05) in the blood parameters or salivary cortisol levels were found. Regarding economic viability, proteases increased the profitability, with NC150 leading to the best results. Thus, the use of aspartic proteases is recommended to improve performance and further facilitate pork production.

Abstract Background Due to population aging, healthcare expenditure is projected to increase substantially in developed countries like Spain. However, prior research indicates that health status, not merely age, is a key driver of healthcare costs. This study analyzed data from over 1.25 million residents of Spain's Murcia region to develop a capitation-based healthcare financing model incorporating health status via Adjusted Morbidity Groups (AMGs). The goal was to simulate an equitable area-based healthcare budget allocation reflecting population needs. Methods Using 2017 data on residents' age, sex, AMG designation, and individual healthcare costs, generalized linear models were built to predict healthcare expenditure based on health status indicators. Multiple link functions and distribution families were tested, with model selection guided by information criteria, residual analysis, and goodness-of-fit statistics. The selected model was used to estimate adjusted populations and simulate capitated budgets for the 9 healthcare districts in Murcia. Results The gamma distribution with logarithmic link function provided the best model fit. Comparisons of predicted and actual average costs revealed underfunded and overfunded areas within Murcia. If implemented, the capitation model would decrease funding for most districts (up to 15.5%) while increasing it for two high-need areas, emphasizing allocation based on health status and standardized utilization rather than historical spending alone. Conclusions AMG-based capitated budgeting could improve equity in healthcare financing across regions in Spain. By explicitly incorporating multimorbidity burden into allocation formulas, resources can be reallocated towards areas with poorer overall population health. Further policy analysis and adjustment is needed before full-scale implementation of such need-based global budgets.

Argentinean economic reforms introduced in the 1990s were characterized by structural adjustments which increased both job insecurity and barriers to health care. In Córdoba, some individuals found themselves without health coverage. Conversely, many private practices, also in crisis, were forced to close with a resultant loss of heath care jobs. Rather than accepting layoffs, the employees of the private Junin Clinic took over the facility and reorganized it as a cooperative. They wanted both to keep their jobs and to provide affordable health services primarily to the uninsured. We hypothesized that the quality of their clinical jobs would impact on the care they provided. We undertook to examine how changes in the organization of the clinic affected working relations and working conditions . We undertook a descriptive, correlative survey of 25 employees chosen via a multi-stage process to be representative of the clinic. Four percent worked under contract; eighty percent were professionals who split their earning 50/50 with the cooperative. The remaining workers were cooperative members. Fifty percent of those interviewed earned less than the basic minimum wage. Forty-four percent worked alone; the remaining workers were part of teams. Eighty-eight percent felt that their job was appropriate for their level of training. No one reported any occupational accidents. Eighty percent reported satisfactory hygienic conditions in their workplace. While the division of labor at the clinic had not changed since the take over, administrative structures were different. Cooperative decisions are made in large meetings. Since most professionals are not members of the cooperative, they do not participate in these meetings. However, we observed that relations and exchanges among the workers were less hierarchical. This work was undertaken to inform the debate on the relationship between working conditions and the provision of health care. We found that the work environment impacts on health care workers as they try to provide a more equitable form of health care.

It is estimated that workplace harassment has a high incidence rate within the workforce. It generates negative health consequences and an array of psychosocial problems. The knowledge gaps on the issue make it difficult to evaluate, and create a situation of impotence for the affected workers, perpetuating a silence on the part of those subjected to these attacks. Without being identified as victims of workplace harassment, they are dealt with using non-specific approaches. The scientific evaluation of harassment is an area lacking today in Argentina. The objective is to present a process for the construction of a technique to evaluate psychological workplace harassment within our current socio-cultural context. The stages of this process are: literature review, interviews with key informants and worker-victims, creation and adaptation of an item list, review by expert judges, filtering of item list and use in pilot sample, and an analysis of the validity of items. A reliable instrument was constructed for the evaluation of the phenomenon in our context: the Inventory of Workplace Harassment (Inventario de Hostigamiento Laboral) (IWH, Bustos Villar, Caputo and Aranda Coria, 2011) composed of four scales that identify situations of harassment, those being communication, work, private life, and facilitating environment. In a second component it reveals information about characteristics of the perpetrator and the perceived consequences. KEY WORDS: workplace harassment, inventory, Argentina

Abstract The settlement is a critical factor in foundation selection. To ensure the safety and stability of a structure, engineers must accurately predict settlement and design the foundation accordingly. However, in cases where the soil stratigraphy is complex, a more detailed analysis is necessary to determine safe and cost-effective solutions for a building's foundation. This paper presents a case study in which settlement monitoring was performed on a 23-story building with spread footings laid on a stiff rock layer of limited thickness overlying more compressible layers of clay and sand. The building was monitored through four construction stages, during which data on vertical displacements and stress distribution on the soil were obtained. To improve the accuracy of the results, a methodology for calibrating the thicknesses of the soil strata was applied, based on the measured settlements, soil-structure interaction, and estimates from semi-empirical methods. Furthermore, a numerical analysis was performed using the finite element method, where more conservative displacements were observed. Finally, the safety of the building was evaluated by verifying angular distortions.

ObjectiveDry eye disease (DED) is a condition associated with a myriad of systemic disorders. According to recent preliminary data, axial spondylarthritis (axial-SpA) could represent a new entity associated with DED. Therefore, this study aimed to assess DED in patients with axial SpA by performing quantitative and qualitative specific tests to investigate the potential association between DED and ocular surface damage in patients with axial-SpA and to identify potential variables associated with DED.MethodsA total of 71 patients with axial-SpA who fulfilled the Assessment of SpondyloArthritis International Society (ASAS) classification criteria and 19 healthy controls were enrolled in this study. Both the patients and the controls underwent a complete ocular assessment aimed at evaluating the tear film and ocular surface, which included the Schirmer test, tear break-up time (TBUT), fluorescein staining, and lissamine green staining. The Ocular Surface Disease Index (OSDI) questionnaire was administered to all patients.ResultsDED symptoms were reported in 46 (64.8%) patients and three (15.8%) healthy controls (p = 0.0004). The odds ratio for receiving a diagnosis of axial-SpA based on the presence of dry-eye-related symptoms was 9.2 (95% C.I. 2.72–42.52, p = 0.001). The Schirmer test values of < 6 mm/5 min were observed in 31 (43.7%) patients with axial-SpA and two (10.5%) healthy controls (p = 0.013); a TBUT of

Abstract The aim of this study was to assess the effect of adding arginine at different concentrations to commercial and experimental orthodontic resins on shear bond strength (SBS), as well as on the antimicrobial activity of arginine against S. mutans. Metal brackets were bonded onto the surface of 120 bovine incisors using Transbond, OrthoCem, and an experimental resin (ER), adding 0, 2.5, 5, and 7 wt.% of arginine. The SBS test was performed in deionized water at 37 ºC for 24 h, at 0.5 mm/min. SBS test results were subjected to two-way ANOVA and Tukey’s test (α = 0.05). CFU/mL data (antimicrobial assessment) were assessed by Kruskal-Wallis and Dunn’s tests (α = 0.05). No statistical difference between the resins was observed in untreated groups (p > 0.05). The addition of arginine at 2.5% (27.7 MPa) and 5% (29.0 MPa) increased the SBS of Transbond when compared (p < 0.05) to OrthoCem (18.5 and 15.6 MPa, respectively) and ER (16.3 and 18.1 MPa, respectively). Arginine at 7% improved the SBS of Transbond (24.1 MPa) and ER (21.0 MPa), which was statistically higher (p < 0.05) than OrthoCem (12.6 MPa). OrthoCem did not show a statistically significant difference at the three concentrations of arginine (p > 0.05). The addition of arginine to resins reduced the count of S. mutans (p < 0.05). As for ER, all concentrations of arginine significantly decreased CFU/mL (p < 0.05). Among commercial resins, only 7% of arginine significantly reduced CFU/mL. The addition of arginine did not interfere with the bond strength and demonstrated antibacterial activity against S. mutans.

ContextThis study proposes a Bayesian network model to aid mental health specialists making data-driven decisions on suitable treatments. The aim is to create a probabilistic machine learning model to assist psychologists in selecting the most suitable treatment for individuals for four potential mental disorders: Depression, Panic Disorder, Social Phobia, or Specific Phobia.MethodsThis study utilized a dataset from 1,094 individuals in Denmark containing socio-demographic details and mental health information. A Bayesian network was initially employed in a purely data-driven approach and was later refined with expert knowledge, referred to as a hybrid model. The model outputted probabilities for each disorder, with the highest probability indicating the most suitable disorder for treatment.ResultsBy incorporating expert knowledge, the model demonstrated enhanced performance compared to a strictly data-driven approach. Specifically, it achieved an AUC score of 0.85 vs 0.80 on the test data. Furthermore, we evaluated some cases where the predictions of the model did not match the actual treatment. The symptom questionnaires indicated that these participants likely had comorbid disorders, with the actual treatment being proposed by the model with the second highest probability.ConclusionsIn 90.1% of cases, the hybrid model ranked the actual disorder treated as either the highest (67.3%) or second-highest (22.8%) on the test data. This emphasizes that instead of suggesting a single disorder to be treated, the model can offer the probabilities for multiple disorders. This allows individuals seeking treatment or their therapists to incorporate this information as an additional data-driven factor when collectively deciding on which treatment to prioritize.

The purpose of this work is to present an analytical method that allows to estimate in an approximate and fast way the presence of the non-resonant and ultra-fast multipactor effect in RF accelerating structures in the presence of high gradient electromagnetic fields. This single-surface multipactor regime, which has been little studied in the scientific literature, is characterised by appearing only under conditions of very strong RF electric fields (of the order of tens or hundreds of MV/m), where it is predominant over other types of single- or dual-surface resonance described in classical multipactor theory. This type of multipactor causes a rapid growth of the electron population and poses a serious drawback in the operation of RF accelerator components operating under high gradient conditions. Specifically, in dielectric-assist accelerating structures (DAA) it has been experimentally found that the presence of multipactor limits the maximum operating gradient of these components due to a significant increase in the reflected power due to the discharge, being this phenomenon the main problem to overcome. In a previous work, we found and described in detail by means of numerical simulations the presence of this non-resonant and ultra-fast multipactor regime in a DAA structure design for hadrontherapy. Here we aim to present a simple and fast method to predict the presence of this non-resonant and ultra-fast multipactor regime in RF accelerator structures with cylindrical revolution symmetry around the acceleration axis. This method is especially useful in the design stages of accelerating structures as it provides much faster results than numerical simulations of the multipactor, with quite good accuracy in a wide range of cases as shown in this paper.

Resumen: Introducción: la simulación como herramienta docente está en expansión en la educación de grado. El objetivo de este estudio es describir esta metodología aplicada al paciente pediátrico y descubrir las opiniones de los alumnos. Material y métodos: se realizaron 14 sesiones de simulación clínica avanzada (SCA) de pediatría a 168 alumnos de 6.° curso del grado de Medicina, con los escenarios de bronquiolitis, RCP, taquicardia supraventricular, crisis convulsiva y exploración de centro salud, durante los cursos 2020-2021 y 2021-2022. Tras la SCA tuvieron la oportunidad de responder a una encuesta de satisfacción de 29 preguntas. Resultados: 103/168 (61,3%) alumnos contestaron la encuesta de satisfacción. Las puntuaciones medias ± SD (sobre un máximo de 5) de los ítems principales fueron: aprendizaje de habilidades técnicas 4,58 ± 0,59; comunicación y motivación del alumno en la simulación clínica 4,94 ± 0,24. Sobre la estructura de la sesión de simulación, la puntuación media mejor valorada fue el profesorado 4,95 ± 0,26 y la duración del caso 4,75 ± 0,64. La valoración del alumno sobre el incremento de los conocimientos prácticos en pediatría fue elevada. Conclusiones: la SCA con práctica deliberada que sigue el método de aprendizaje por repetición, es considerada por los alumnos útil y motivadora para su formación. Al terminar la SCA, 87,4% de los participantes consideraron que se sentían capaces de enfrentarse a una urgencia pediátrica; 96% se sentía capaz de identificar a un enfermo inestable aplicando el triángulo de evaluación pediátrica; 94% sabría informar a los padres de forma clara y comprensible. Abstract: Introduction: Simulation as a teaching tool is expanding in healthcare disciplines and is being implemented in pediatric undergraduate education. This study describes this teaching methodology applied to pediatric patient knowledge and considers student opinions in order to tailor it to their educational needs. Methods: Fourteen sessions of advanced clinical simulation (ACS) in Pediatrics were conducted with 168 sixth-year medical students, featuring scenarios of bronchiolitis, CPR, supraventricular tachycardia, seizure, and primary care examination, during the academic years 2020-2021 and 2021-2022. After the ACS, the students were given the opportunity to respond to a satisfaction survey. Results: 103 out of 168 (61,3%) students completed the survey. The average scores ± SD (on a maximum of 5) for the main items were as follows: learning technical skills 4,58 ± 0,59; communication and student motivation in ACS 4,94 ± 0,24. Regarding the structure ACS session, the highest rated average score was for the faculty 4,95 ± 0,26, and the case duration 4,75 ± 0,64. The student assessment of increased practical knowledge in pediatrics was high. Conclusions: ACS with deliberate practice that follows a learning by repetition method is considered useful and motivational learning amongs students. Upon completion of the ACS, 87.4% of the participants felt capable of initially managing a pediatric emergency; 96% felt capable of identifying an unstable patient using the pediatric assessment triangle; and 94% stated that they would be able to provide clear and understandable information to parents.

Background: Midazolam is routinely used as preanesthetic medication in pediatric patients. Recently, dexmedetomidine has emerged as an alternative as a premedicant. We aimed to add more evidence about the efficacy and safety of two common routes of administration for pediatric premedication: oral midazolam versus intranasal dexmedetomidine. Methods: We systematically searched Randomized Controlled Trials (RCTs) involving patients ≤ 18 years old undergoing preanesthetic medication and comparing intranasal dexmedetomidine with oral midazolam. Risk Ratio (RR) and Mean Difference (MD) with 95% Confidence Intervals (95% CI) were computed using a random effects model. Trial-sequential analyses were performed to assess inconsistency. Results: Sixteen RCTs (1,239 patients) were included. Mean age was 5.5 years old, and most procedures were elective. There was no difference in satisfactory induction or mask acceptance (RR = 1.15, 95% CI 0.97–1.37; p = 0.11). There was a higher incidence of satisfactory separation from parents in the dexmedetomidine group (RR = 1.40; 95% CI 1.13–1.74; p = 0.002). Dexmedetomidine was also associated with a reduction in the incidence of emergence agitation (RR = 0.35; 95% CI 0.14–0.88; p = 0.02). Heart rate and mean arterial pressure were marginally lower in the dexmedetomidine group but without clinical repercussions. Conclusion: Compared with oral midazolam, intranasal dexmedetomidine demonstrated better separation from parents and lower incidence of emergence agitation in pediatric premedication, without a difference in satisfactory induction. Intranasal dexmedetomidine may be a safe and effective alternative to oral midazolam for premedication in pediatric patients.

El objetivo del artículo es describir el estado del desarrollo tecnológico y la cadena de valor eólica en México. Los resultados muestran que este país se ha enfocado en acumular capacidad instalada, mediante la importación de tecnología, desestimando el desarrollo de capacidades tecnológicas nacionales. Los hallazgos indican que esta política ha favorecido que las patentes sean desarrolladas por extranjeros y empresas privadas, siendo testimonial las patentes registradas en universidades nacionales. Su originalidad consiste en proponer una reconfiguración de la cadena de valor, que incluye actores para un desarrollo bajo el modelo de las cinco hélices.

Este artigo objetiva compreender de que modo as ferramentas de comunicação analógicas e digitais têm sido usadas na rádio comunitária Oeste FM para proporcionar a participação da comunidade, objetivando alcançar os princípios de uma rádio comunitária. O serviço de radiodifusão comunitária foi legalizado no Brasil em 1998 por meio da lei 9.612/98, que estabelece as diretrizes do referido serviço. Esta investigação foi realizada a partir de um Estudo de Caso, com apoio da pesquisa bibliográfica, documental, entrevista semiestruturada, estudo da usabilidade e design da homepage e estudo da programação da rádio. A principal hipótese deste trabalho, é que as ferramentas analógicas e digitais aproximam a comunidade nas ações da rádio e criam novas relações, intensificando a participação na gestão. Contudo, os resultados da pesquisa mostram que, apesar da disposição de ferramentas analógicas e digitais, a participação da comunidade é extremamente limitada e se resume em boa parte ao entretenimento, com ênfase no pedido musical. Portanto, não atende completamente aos objetivos de uma rádio comunitária.

Summary: Background: Household transmission studies seek to understand the transmission dynamics of a pathogen by estimating the risk of infection from household contacts and community exposures. We estimated within/extra-household SARS-CoV-2 infection risk and associated factors in a household cohort study in one of the most vulnerable neighbourhoods in Rio de Janeiro city. Methods: Individuals ≥1 years-old with suspected or confirmed COVID-19 in the past 30 days (index cases) and household members aged ≥1 year were enrolled and followed at 14 and 28 days (study period November/2020–December/2021). RT-PCR testing, COVID-19 symptoms, and SARS-CoV-2 serologies were ascertained in all visits. Chain binomial household transmission models were fitted using data from 2024 individuals (593 households). Findings: Extra-household infection risk was 74.2% (95% credible interval [CrI] 70.3–77.8), while within-household infection risk was 11.4% (95% CrI 5.7–17.2). Participants reporting having received two doses of a COVID-19 vaccine had lower extra-household (68.9%, 95% CrI 57.3–77.6) and within-household (4.1%, 95% CrI 0.4–16.6) infection risk. Within-household infection risk was higher among participants aged 10–19 years, from overcrowded households, and with low family income. Contrastingly, extra-household infection risk was higher among participants aged 20–29 years, unemployed, and public transportation users. Interpretation: Our study provides important insights into COVID-19 household/community transmission in a vulnerable population that resided in overcrowded households and who struggled to adhere to lockdown policies and social distancing measures. The high extra-household infection risk highlights the extreme social vulnerability of this population. Prioritising vaccination of the most socially vulnerable could protect these individuals and reduce widespread community transmission. Funding: Fundação Oswaldo Cruz, CNPq, FAPERJ, Royal Society, Instituto Serrapilheira, FAPESP.

Background: The capsule formulation of CDK4/6 inhibitor palbociclib has reduced solubility at gastric pH > 4.5 and may have decreased activity when used with proton-pump inhibitors (PPI). Herein, we report the effect of PPI on palbociclib capsule activity and safety in the PARSIFAL study. Methods: First-line endocrine-sensitive, hormone receptor-positive (HR+)/human epidermal growth factor receptor 2-negative (HER2-) advanced breast cancer (ABC) patients received palbociclib capsules plus fulvestrant or letrozole. The primary endpoint was progression-free survival (PFS). This post-hoc analysis compared PPI use. Patients were PPI-naïve (N-PPI) if not on PPI during the study, and either early (E-PPI) or long-term PPI (LT-PPI) if on PPI at study entry or for at least ≥⅔ of treatment, respectively. PPI groups were not mutually exclusive. Results: Among 486 patients, 66.9 % were N-PPI, 13.2 % E-PPI, 18.7 % LT-PPI, and 11.5 % of the PPI users were defined as neither. Median PFS (mPFS) was 29.6 months in the study population, 28.7 months in N-PPI, 23.0 months in E-PPI (Hazard Ratio [HR] 1.5; 95%Confidence Interval [CI] 1.1–2.2; p = 0.024), and 23.0 months in LT-PPI (HR 1.4; 95%CI 1.0–1.9; p = 0.035). By landmark analysis, PPI use was associated with poorer mPFS at 3 and 12 months. Grade ≥3 hematological adverse events occurred in 71.7 % of N-PPI, 57.8 % of E-PPI (p = 0.021), and 54.9 % of LT-PPI (p = 0.003). Dose reductions and dosing delays due to hematological toxicity occurred in 70.8 % of N-PPI, 56.3 % of E-PPI (p = 0.018), and 52.7 % of LT-PPI (p = 0.002). Conclusions: PPI use may reduce palbociclib capsule toxicity, dose modifications, and clinical activity in HR+/HER2- ABC.

This study explores a nanoemulsion formulated with açaí seed oil, known for its rich fatty acid composition and diverse biological activities. This study aimed to characterise a nanoemulsion formulated with açaí seed oil and explore its cytotoxic effects on HeLa and SiHa cervical cancer cell lines, alongside assessing its antioxidant and toxicity properties both in vitro and in vivo. Extracted from fruits sourced in Brazil, the oil underwent thorough chemical characterization using gas chromatography–mass spectrometry. The resulting nanoemulsion was prepared and evaluated for stability, particle size, and antioxidant properties. The nanoemulsion exhibited translucency, fluidity, and stability post centrifugation and temperature tests, with a droplet size of 238.37, PDI -9.59, pH 7, and turbidity 0.267. In vitro assessments on cervical cancer cell lines revealed antitumour effects, including inhibition of cell proliferation, migration, and colony formation. Toxicity tests conducted in cell cultures and female Swiss mice demonstrated no adverse effects of both açaí seed oil and nanoemulsion. Overall, açaí seed oil, particularly when formulated into a nanoemulsion, presents potential for cancer treatment due to its bioactive properties and safety profile.