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The global transition towards electromobility presents unique challenges, particularly in regions with limited infrastructure. In Northern Chile, the sparse distribution of charging stations, with distances often exceeding 100 km, complicates the widespread adoption of electric vehicles (EVs). This study investigates the feasibility of enhancing the autonomy of the "Takai Urban", a solar-assisted battery EV through the integration of Zebra IBC solar cells, leveraging the region's high solar irradiance. Initially, the Takai urban EV had a maximum range of 70 km per charge. Through virtual modelling and simulations, which incorporated GPS and meteorological data along a typical 43.3 km route in Antofagasta city, we examined the impact of solar integration on vehicle performance. The simulations indicated that with the strategic placement of high-efficiency solar cells, the vehicle's range could be extended by approximately 48%, achieving a new maximum of 104 km per charge. This approach not only demonstrates the potential for solar-assisted EVs in regions like Northern Chile but also underscores the broader implications for sustainable mobility in similar environments globally. The results highlight the potential for practical enhancements in EV designs using solar technologies, focusing on efficiency improvements and sustainable mobility solutions.

ABSTRACT Introduction Patients undergoing evaluation for a heart transplant are frequently on inotropic medications or mechanical circulatory support (MCS) devices, which places them at a higher risk for anesthesia‐related complications. These patients often require colonoscopies for bleeding or screening purposes, but there are limited data on the safety and outcomes of colonoscopy in this setting. Methods This is a retrospective, two‐center study between the years 2015 and 2021 of patients with heart failure who subsequently underwent a heart transplant. To be included in the study, patients were required to be on advanced heart failure therapies at the time of colonoscopy. Advanced heart failure therapies were defined as requiring inotropes (milrinone or dobutamine), vasopressors (norepinephrine or vasopressin), or MCS such as an impella, left ventricular assist device (LVAD), intra‐aortic balloon pump (IABP), or extra‐corporeal membrane oxygenation (ECMO). Indications for colonoscopy, adequacy of bowel preparation, and complications were reported. Results A total of 92 patients were included in the study. The most common indication was colon cancer screening (67%), and the remainder were performed due to gastrointestinal bleeding. An inadequate bowel preparation was reported on 20% of patients, but the cecum was reached in all of them. There was no association between the inadequacy of bowel preparation and the presence of MCS (20% vs. 17%, p value 0.67). In colonoscopies performed for screening, 8% (5/62) of patients were found to have an advanced adenoma. In colonoscopies performed for bleeding, 17% (5/30) had a source that required therapeutic intervention and use of hemostatic clips was the preferred modality. Only four patients had a complication of bleeding requiring clips after polypectomy during the index procedure, with no anesthesia‐related adverse events (such as hypotension, arrhythmias, or cardiac arrest) or addition of inotropes, vasopressors, or MCS. Discussion Colonoscopy in patients on advanced heart failure therapies is acceptable with not only a low rate of complications but also a high rate of inadequate bowel preparation.

Background: Historically, rural regions of Mexico have been characterized by a lack of communication infrastructure and social isolation, which contributes to difficulties in digital health and education services. Objective: to determine the need for digital health services for health information and education in the rural population of San Felipe, in the municipality of Mexicali, Mexico. Methods: qualitative research was developed in San Felipe, rural population of the municipality of Mexicali, Mexico, in the period 2021 to 2023. Theoretical methods were used: analysis-synthesis, inductive-deductive and historical-logical; empirical methods: questionnaire to residents; and mathematical-statistical methods for the analysis of the data obtained. Results: within the sample chosen for the research, the predominant sex was male (56.25 %) and with a high school diploma (37.50 %); 71.87 % said that Internet connectivity was not acceptable, 81.09 % connected through cellular phones and only 6.25 % used it for health advice. 71.87% of the users say that the health service in their community is bad and they believe that it would improve in terms of health promotion, disease prevention and even assistance if connectivity had greater coverage. Conclusions: the need for digital services for health information and education was determined in a rural population in the municipality of Mexicali, Mexico. Given that medical care is rated as deficient, the use of information and communication technologies could be a viable and prudent alternative to make up for the shortcomings diagnosed.

Accurate simulation techniques are indispensable to efficiently propose new memory or architectural organizations. As implementing new hardware concepts in real systems is often not feasible, cycle-accurate simulators employed together with certain benchmarks are commonly used. However, detailed simulators may take too much time to execute these programs until completion. Therefore, several techniques aimed at reducing this time are usually employed. These schemes select fragments of the source code considered as representative of the entire application’s behaviour–mainly in terms of performance, but not plenty considering the behaviour of cache memory levels–and only these intervals are simulated. Our hypothesis is that the different simulation windows currently employed when evaluating microarchitectural proposals, especially those involving the last level cache (LLC), do not reproduce the overall cache behaviour during the entire execution, potentially leading to wrong conclusions on the real performance of the proposals assessed. In this work, we first demonstrate this hypothesis by evaluating different cache replacement policies using various typical simulation approaches. Consequently, we also propose a simulation strategy, based on the applications’ LLC activity, which mimics the overall behaviour of the cache much closer than conventional simulation intervals. Our proposal allows a fairer comparison between cache-related approaches as it reports, on average, a number of changes in the relative order among the policies assessed – with respect to the full simulation – more than 30% lower than that of conventional strategies, maintaining the simulation time largely unchanged and without losing accuracy on performance terms, especially for memory-intensive applications.

This article explores the challenges that arise when human rights come into conflict with cultural, political, and ethical values in diverse societies. Eight areas of discord related to human rights are identified, and four criteria are proposed to assess how human rights relate to these values. These criteria include universality and cultural relativism, contextualization, ethical pluralism, and equity and social justice. The evaluation is based on neutrosophic selection criteria, employing the COPRAS multicriteria method. This analytical and decision-making approach is applied to eight specific cases of conflicts between human rights and values, such as women's rights, freedom of expression, and others. The results obtained provide a solid foundation for understanding how human rights relate to cultural, political, and ethical values in diverse societies. The article highlights the importance of finding a balance between protecting fundamental rights and respecting cultural and ethical diversity in resolving these conflicts. The promotion and protection of human rights remain a fundamental goal of the international community, regardless of cultural, political, or ethical differences.

White striping (WS) is a myopathy characterized by the appearance of white stripes parallel to the muscle fibers in the breast of broiler chickens, composed of adipose and connective tissues. This condition causes economic losses and, although common, its etiology remains poorly understood. Hence, the objective was to identify genes and biological mechanisms involved in the early stages of WS using a paternal broiler line that grows slightly slower than commercial ones, at 35 days of age, through the RNA sequencing of the pectoralis major muscle. Thirty genes were differentially expressed between normal and WS-affected chickens, with 23 upregulated and 7 downregulated in the affected broilers. Of these, 14 genes are novel candidates for WS and are implicated in biological processes related to muscle development (CEPBD, DUSP8, METTL21EP, NELL2, and UBE3D), lipid metabolism (PDK4, DDIT4, FKBP5, DGAT2, LIPG, TDH, and RGCC), and collagen (COL4A5 and COL4A6). Genes related to changes in muscle fiber type and the processes of apoptosis, autophagy, proliferation, and differentiation are possibly involved with the initial stage of WS development. In contrast, the genes linked to lipid metabolism and collagen may have their expression altered due to the progression of the myopathy.

Background: Snake envenomation is a medical condition with high morbidity and mortality in southwestern Colombia. Objectives: To describe the characteristics of the envenomation caused by Viperidae snakes view in a highly complex hospital in Southwestern Colombia. Methods: A cross-sectional study was carried out. Patients treated for Viperidae snake envenomation from 2001 to 2020 in a Hospital Fundación Valle del Lili, Cali, Colombia, were studied. Results: Twenty-eight patients were included. Envenomation was caused by the genera Bothrops, Bothriechis, Porthidium, and Bothrocophias. The median age was 37.7 (±20.6), and they were predominantly male (19, 68%). Bites occurred on the upper extremities in 16 (57%) patients. Pain (23, 81%) and edema (22, 78%) were the most common clinical symptoms. Thirteen (46%) patients presented coagulopathy. Prolonged prothrombin and activated partial thromboplastin times were common: (22, 78% and 15, 53%, respectively). Twenty (71%) patients were treated with polyvalent antivenom (median dose of 6 (2–15) vials). The median time between the accident and antivenom administration was 9 h (5.5–17). Door-to-needle time was 37.5 (0–62) min. Eighteen (64%) patients were admitted to the intensive care unit. Three (11%) patients had serum sickness. Seven (25%) developed infectious complications, four (14%) had surgery, one (3%) had compartment syndrome, one (3%) underwent amputation of the affected limb, and one (3%) patient died. Conclusions: Local manifestations and coagulopathy were common clinical features. Polyvalent antivenom was an effective treatment for disease control. Significant complications were associated with delays in seeking medical care.

Ca and P homeostasis across the egg-laying cycle is a complex process involving absorption in the small intestine, reabsorption/excretion in the kidneys, and eggshell gland secretion. Diets with inadequate calcium and phosphorus can interfere with their absorption and digestibility, resulting in eggshell quality losses and reduced productive life, affecting egg production and welfare. A better understanding of gene expression profiles in the kidneys of laying hens during the late egg-laying period could clarify the renal role in mineral metabolism at this late stage. Therefore, the performance, egg quality and bone integrity-related traits, and expression profiles of kidney candidate genes were evaluated in 73-week-old laying hens receiving different Ca and P ratios in their diet: a high Ca/P ratio (HR, 22.43), a low ratio (LR, 6.71), and a medium ratio (MR, 11.43). The laying hens receiving the HR diet had improved egg production and eggshell quality traits compared to the other two groups. Humerus length was shorter in the HR than in the other groups. The CYP24A1 and TRPC3 genes were differentially expressed (p.adj ≤ 0.05) among the groups. Therefore, their expression profiles could be involved in calcium and phosphate transcellular transport in 73-week-old laying hens as a way to keep mineral absorption at adequate levels.

Introducción. El compostaje transforma materiales orgánicos residuales en un producto con potencial para restituir materia orgánica y nutrientes para la agricultura, mientras se reduce el volumen y peso de estos materiales y su disposición en rellenos sanitarios o como contaminantes de ríos y mantos acuíferos. Objetivo. Optimizar la producción comercial de compost, con la mejora de las condiciones del proceso y la adición de inóculos microbianos. Materiales y métodos. Sobre un sustrato agroindustrial se optimizaron condiciones del proceso de compostaje, tales como aeración, temperatura, altura de la pila y humedad, y se evaluó la adición de 3 inóculos microbianos degradadores de materia orgánica, para compararlos con un testigo comercial y un testigo absoluto. Se realizaron análisis químicos y microbiológicos, así como de inocuidad, estabilidad y madurez. En total se evaluaron 17 variables químicas, 7 microbiológicas, 2 de inocuidad y 13 de madurez. Para el análisis y comparación de los tratamientos se empleó un método multicriterio y de esa forma resumir el resultado de las 39 variables estudiadas en un solo valor representativo. Resultados. Se establecieron 2 intervalos de confianza, el primero (a) incluye al testigo comercial y al testigo absoluto, con las menores calificaciones de calidad. El segundo (b) abarca a los tratamientos microbiológicos Degradabiol, Bacilos y Agrecicla, con los mayores índices ponderados y las mejores características de calidad. Conclusión. La adición de inóculos, así como el manejo de la humedad, temperatura, volteos frecuentes y altura de hileras, permitió obtener mejores características de calidad, en comparación con el compost producido convencionalmente. La relación C/N deficiente de las materias primas iniciales fue un factor que no pudo ser corregido debido al tipo de residuos usualmente procesados. Es necesario implementar medidas viables para mejorar esta relación, que generalmente es deficiente en las producciones comerciales de compost.

Introduction: The most frequently used office-based procedures in hemorrhoidal disease (HD) are rubber band ligation (RBL) and sclerotherapy. Few studies have been published comparing the various types of instrumental therapy. The aim of this systematic review and meta-analysis was to compare the efficacy and safety of sclerotherapy and RBL. Methods: Three online databases were searched. Efficacy (control of symptoms, prolapse, bleeding and pain, patients’ satisfaction, and disease recurrence) and safety (complications, such as pain and bleeding) were the assessed outcomes. Pooled relative risks (RR) were computed for each outcome using a random-effects model, and heterogeneity was assessed by Cochran’s Q test and I2. Results: Six RCTs and three cohort studies were included. Control of prolapse and bleeding was significantly higher with RBL (93.1% RBL vs. 66.4% sclerotherapy, RR 1.34, 95% CI 1.12–1.60 and 89.1% RBL vs. 78.7% SCL, RR 1.17, 95% CI 1.02–1.34, respectively). Both techniques had similar results in terms of pain relief, overall control of symptoms, and risk of recurrence at 3 months. Although patient satisfaction was significantly higher with RBL (77.8% RBL vs. 46.7% sclerotherapy, RR 1.59, 95% CI 1.01–2.50), post-procedural pain was significantly higher with this technique (24% RBL vs. 14% sclerotherapy, RR 1.74, 95% CI 1.32–2.28). There was no significant difference regarding post-procedure bleeding (11.1% RBL vs. 8.7% sclerotherapy, RR 1.29, 95% CI 0.86–1.94). In the subgroup analysis, according to the HD grade, post-procedure pain was higher with RBL only in HD grade II (vs. HD grade I–III). Conclusions: RBL performs better than sclerotherapy in controlling HD symptoms, specifically prolapse and bleeding, although post-procedural pain is a frequent complication. Recurrence is similar with both procedures. While waiting for the publication of results with sclerotherapy with new sclerosants, RBL remains the office-based treatment of choice in HD.

In recent years, autonomous vehicles have attracted the attention of many research groups, both in academia and business, including researchers from leading com- panies such as Google, Uber and Tesla. This type of vehicles are equipped with systems that are subject to very strict requirements, essentially aimed at per- forming safe operations –both for potential passengers and pedestrians– as well as carrying out the process- ing needed for decision making in real time. In many instances, general-purpose processors alone cannot ensure that these safety, reliability and real-time re- quirements are met, so it is common to implement heterogeneous systems by including accelerators. This paper explores the acceleration of a line detection ap- plication in the autonomous car environment using a heterogeneous system consisting of a general-purpose RISC-V core and a domain-specific accelerator. In par- ticular, the application is analyzed to identify the most computationally intensive parts of the code and it is adapted accordingly for more efficient processing. Fur- thermore, the code is executed on the aforementioned hardware platform to verify that the execution effec- tively meets the existing requirements in autonomous vehicles, experiencing a 3.7x speedup with respect to running without accelerator.

Education in the history of humanity briefly establishes the general characteristics of education over time. Throughout life, the student goes through more than 18 years in the classrooms, because education has rigorously changed throughout history, as a result of the evolution of some universities during the processes carried out until changing categories and an improvement in the evaluated indicators. On the other hand, governments and leading entities of education speak of the application of standards of educational quality, the efficiency of the educational system, and sustainability of financing and quality of spending to ensure that students develop knowledge, skills, and attitudes in specific situations, in different contexts for solving problems and interacting with the main dimensions, with their factors or sub-dimensions, limitations or critical nodes and challenges of education. This study analyzes the effects that affect educational development through the neutrosophic statistical study with the application of plithogenic sets.

Objetivou-se avaliar diferentes épocas, formas de aplicação e doses de nitrogênio nas características agronômicas, componentes de produção, produtividade de grãos, bem como a eficiência de utilização do nutriente na cultura do milho. O delineamento experimental de blocos casualizados, em esquema fatorial (2 x 2 x 4) e quatro repetições, foi utilizado para o experimento. Os tratamentos foram duas épocas de aplicação, na semeadura do milho e em cobertura no estádio V7; duas formas de aplicação, superficial e incorporada ao solo a 8 cm de profundidade; e quatro doses de nitrogênio, 0, 60, 120, 180 kg ha-1. As características agronômicas do milho, altura da planta, altura da inserção da espiga, diâmetro do colmo e nitrogênio foliar não diferenciaram em função das épocas ou formas de aplicação, apenas das doses de nitrogênio. Os componentes da produção, comprimento e número de fileiras por espiga, número de grãos por fileira, massa de 100 grãos e produtividade de grãos apresentaram melhores resultados com aplicação do nitrogênio incorporado ao solo e doses de 120 a 180 kg ha-1 de nitrogênio. A prática de incorporação e a dose de 60 kg ha-1 propiciaram maior eficiência agronômica no uso do nitrogênio.

The northeast area of the Bogotá Savannah (Cundinamarca, Colombia) is a region where biodiversity requires research because of few records in the current literature. We present a list of birds from the northeast area of the Bogotá Savannah. A systematic sample was conducted in the Ecoparque Sabana Nature Reserve (Tocancipá) to record the frequency of occurrence of bird species, while opportunistic observations were made at Parque Jaime Duque Nature Reserve (Tocancipá) and Aguablanca wetland (Sesquilé). A total of 820 h of sampling was done between February 2016 and June 2019. We provide a list with 128 species belonging to 37 families. Of these species, eight are newly recorded from the Bogotá Savannah; one species is considered Endangered and three are Near Threatened according to the Red List of the International Union for Conservation of Nature. The species richness found in our study supports the importance of protected areas in the northeast area of the Bogotá Savannah. Protected areas here help conserve the biodiversity of birds of the Andean region.

This investigation aims to model experts’ selection for neutrosophic Delphi method. The phase of selecting experts is essential to obtain adequate results in Delphi method, thus this phase deserves a major attention. The proposed method considers the complexity of the subject, according to experts’ criteria to fix the number of experts necessary to apply the neutrosophic Delphi method. Single-valued triangular neutrosophic numbers are used to measure experts’ self-evaluations and the weights of expertise criteria. Neutrosophy allows us to include indeterminacy, which is typical in any decision-making problem, as well as the calculation based on linguistic terms. Hotel activity serves as a case study for illustrating the applicability of the method in a real life situation.

Resumo: A escolha pela carreira médica é determinada por vários fatores e vem sendo pesquisada e discutida em muitas escolas médicas. Já em 1951, iniciou-se a abordagem sobre vocação médica e até hoje são diversas e controversas as opiniões dos estudiosos. Ana Mercês Bock afirma que a ideia de vocação é exatamente não ter vocação nenhuma. Entretanto, o jornalista Alexandre Garcia descreve que a carreira médica é uma vocação para super-homem. “Quem tiver vocação para super-homem, vira médico”. Existem fatores determinantes antes de ingressar na faculdade e os fatores que orientam o estudante durante o curso médico a decidir-se por ser médico. Assim, uma família de médicos; círculo de amizades; matérias preferenciais no colégio, como biologia; fatores psicológicos, por exemplo, ter enfrentado problemas e situações infantis. Direcionam o adolescente pela escolha da Medicina.

There are more than 100 autoimmune diseases (AD), which have a high prevalence that ranges between 5% and 8% of the general population. Type I diabetes mellitus, multiple sclerosis, systemic lupus erythematosus and rheumatoid arthritis remain the health problem of highest concern among people worldwide due to its high morbidity and mortality. The development of new treatment strategies has become a research hotspot. In recent years, the study of the ion channels presents in the cells of the immune system, regarding their functional role, the consequences of mutations in their genes and the different ways of blocking them are the subject of intense research. Pharmacological blockade of KV1.3 channel inhibits Ca2+ signaling, T cell proliferation, and pro-inflammatory interleukins production in human CD4+ effector memory T cells. These cells mediated most of the AD and their inhibition is a promising therapeutic target. In this review, we will highlight the biological function of KV1.3 channel in T cells, consequence of the pharmacological inhibition (through anemone and scorpion toxins, synthetic peptides, nanoparticles, or monoclonal antibodies) as well as the possible therapeutical application in AD.

Introduction and objectives: Immune Checkpoint Inhibitors (ICI) have shifted the paradigm of cancer therapy treatment. Despite their efficacy, ICIs may induce immune-related adverse events (irAE), which can affect various organs, namely the liver. This study intends to perform a comprehensive clinical description of the hepatic irAEs associated with ICI in a Portuguese population of a tertiary hospital centre. Materials and methods: A retrospective analysis of patients who developed immune-mediated liver injury (IMLI), among a cohort of patients treated with ICIs between March 15th of 2015 and December 15th of 2019 in a tertiary hospital. We used both Common Terminology Criteria for Adverse Events (CTCAE) and Drug‐Induced Liver Injury Network (DILIN) criteria to define liver injury. Results: Among 151 patients, eight (5.3%) patients developed liver injury grade ≥3, of which five had hepatic metastasis. As such, only 3 cases were classified as IMLI. All IMLI presented with cholestasis pattern; the median duration from ICI initiation to IMLI was 84 days and/or 4 ICI cycles; one patient registered IMLI one month after nivolumab suspension; all were treated with steroids and one was successfully submitted to ICI re-challenge; a favourable outcome was seen in all patients; the median time to hepatic biochemistries normalization was 150 days. Among 10 patients with previous hepatic conditions, only one developed liver injury grade 2. Conclusions: Clinically significant ICI-related hepatotoxicity was uncommon; Immune-mediated liver injury may present a cholestatic pattern predominance. There was a low rate of liver injury of any kind in patients with previous hepatic disease while on ICI.

Abstract Background Breast cancer (BrC) remains the leading cause of cancer-related death in women, mainly due to recurrent and/or metastatic events, entailing the need for biomarkers predictive of progression to advanced disease. MicroRNAs hold promise as noninvasive cancer biomarkers due to their inherent stability and resilience in tissues and bodily fluids. There is increasing evidence that specific microRNAs play a functional role at different steps of the metastatic cascade, behaving as signaling mediators to enable the colonization of a specific organ. Herein, we aimed to evaluate the biomarker performance of microRNAs previously reported as associated with prognosis for predicting BrC progression in liquid biopsies. Methods Selected microRNAs were assessed using a quantitative reverse transcription-polymerase chain reaction in a testing cohort of formalin-fixed paraffin-embedded primary (n = 16) and metastatic BrC tissues (n = 22). Then, miR-30b-5p and miR-200b-3p were assessed in a validation cohort #1 of formalin-fixed paraffin-embedded primary (n = 82) and metastatic BrC tissues (n = 93), whereas only miR-30b-5p was validated on a validation cohort #2 of liquid biopsies from BrC patients with localized (n = 20) and advanced (n = 25) disease. ROC curve was constructed to evaluate prognostic performance. Results MiR-30b-5p was differentially expressed in primary tumors and paired metastatic lesions, with bone metastases displaying significantly higher miR-30b-5p expression levels, paralleling the corresponding primary tumors. Interestingly, patients with advanced disease disclosed increased circulating miR-30b-5p expression compared to patients with localized BrC. Conclusions MiR-30b-5p might identify BrC patients at higher risk of disease progression, thus, providing a useful clinical tool for patients’ monitoring, entailing earlier and more effective treatment. Nonetheless, validation in larger multicentric cohorts is mandatory to confirm these findings.

La familia Rallidae, ampliamente distribuida, tiene una alta proporción de especies amenazadas e in-formación limitada sobre su biología reproductiva. La subespecie endémica y amenazada de la tingua moteada, Porphyriops melanops bogotensis, constituye un grupo aislado de Colombia con poca infor-mación sobre su reproducción y desarrollo. Describimos la biología reproductiva y el desarrollo de los pollos de P. m. bogotensis, aportando información novedosa y útil para su conservación. El estudio se hizo en la sabana de Bogotá, Colombia entre 2016 y 2019. Semanalmente hicimos recorridos en busca de nidos para su descripción y seguimiento. Se incubaron artificialmente catorce huevos; los pollue-los fueron criados en cautiverio, haciendo seguimiento de su crecimiento y cambio de plumaje hasta terminar su desarrollo. Las aves anidaron durante todo el año; el número de huevos varió entre tres y seis, con un período de incubación de 18-20 días. Se alcanzó el tamaño definitivo alrededor de los 55 días, con diferencias significativas entre sexos. El color definitivo del pico se adquiere a los 75 días mientras que el color del iris y plumaje adulto se alcanza entre los días 150 y 165. En términos generales la reproducción y desarrollo de P. m. bogotensis concuerda con lo descrito para otros miembros de la familia Rallidae. Los detalles del cambio en coloración de la subespecie durante su desarrollo permiten determinar la edad de individuos silvestres.

Irritable bowel syndrome (IBS) is a functional gastrointestinal (GI) disorder, which can affect all members of a society, regardless of age, sex, race or socioeconomic status. Because of its high prevalence and chronic nature, it represents a significant economic burden. In fact, these patients have a relevant impairment of their quality of life, which limits their work productivity and daily social activities, especially when it is associated with other disorders, such as anxiety and depression. The diagnosis of IBS relies on symptom-based diagnostic criteria with normal results on a limited number of complementary tests that rule out other possible diagnoses. The aetiology of this condition is incompletely established. However, evidence suggests that it is a multifactorial disorder with several different mechanisms that have been implicated as responsible for the symptoms. Since the treatment strategy is usually based on predominant symptoms and their severity, it is important to recognise the underlying mechanisms in order to successfully relief the visceral pain and altered bowel habits. The aim of this non-systematic review of the literature was to explore the pathophysiology and treatment options of IBS, highlighting the most recent evidence, from the new Rome IV criteria to the new drug armamentarium.

Hemorrhoidal disease (HD) is a frequent health problem with considerable repercussions on patients’ quality of life. However, much of the clinical practice related to HD is based on knowledge without scientific evidence and supported largely by empirical experience of the physician who deals with this pathology. As in other countries, the goal of this consensus is to establish statements supported by solid scientific evidence and whose purpose will be to standardize and guide the diagnosis and management of HD both in the general population and in some particular groups of patients.

Raw coffee beans are seen as valuable sources of bioactive compounds, such as alkaloids and chlorogenic acids. In this study, an efficient and eco-friendly method for the simultaneous extraction of caffeine, trigonelline, and chlorogenic acids from raw beans of two coffee species was developed, using green solvents and an unconventional method of extraction (assisted by ultrafast rotary disintegrator/homogenizer (UT-AE)). The experimental extraction conditions were optimized according to a completely randomized design (CRD), considering the following variables: solvent type (four deep eutectic solvents (DESs), water, and aqueous choline chloride solution (50 wt.%); temperature (25, 45, and 65 °C); and extraction technique (solid-liquid extraction with agitated heating and assisted by ultrafast rotary disintegrator/homogenizer). The extract obtained with choline chloride solution (50 wt.%) exhibited high total phenolic compounds and the highest antioxidant capacity. An analysis using high-performance liquid chromatography with a diode array detector (HPLC-DAD) indicated the presence of chlorogenic acids, caffeine, and trigonelline in all the extracts, in different amounts. The results obtained by the analysis of phenolic compounds and HPLC indicated that the aqueous solution of choline chloride (50% wt.%) was the most suitable solvent for the extraction of chlorogenic acids, while the water-based extracts showed high values of caffeine and trigonelline. DESs, in turn, seems to promote a protective effect on the antioxidant activity of biomolecules.

Fluorspar is considered a critical raw material for the European Union, due to its industrial uses and lack of sufficient extraction in European countries. It is a source for hydrofluoric acid manufacture, this latter chemical being employed, among other uses, in the pickling of stainless steels. From this latter activity, sludge is generated due to the need for used water treatment. In this article, we report a full characterization of this residue, obtained in an industrial plant in Vieira de Leiria, Portugal. Its chemical and mineralogical characteristics were determined, showing that it is mostly a mixture of calcium fluoride and calcium sulfate with some heavy metals content. Thermal behavior allowed us to determine that the material melts at around 950 °C. The influence of calcining operation on the residue was determined, especially concerned with the leachability of some elements. Taking into account the results of the characterization of this residue, some considerations are presented about the potential for the valorization of this industrial residue.

Snake venoms have components with diverse biological actions that are extensively studied to identify elements that may be useful in biomedical sciences. In the field of autoimmunity and rheumatology, various findings useful for the study of diseases and potential drug development have been reported. The study of disintegrins, proteins that block the action of integrins, has been useful for the development of antiplatelet agents and principles for the development of immunosuppressants and antineoplastics. Several proteins in snake venoms act on the coagulation cascade, activating factors that have allowed the development of tests for the study of coagulation, including Russell’s viper venom time, which is useful in the diagnosis of antiphospholipid syndrome. Neurotoxins with either pre- or postsynaptic effects have been used to study neurogenic synapses and neuromuscular plaques and the development of analgesics, muscle relaxants and drugs for neurodegenerative diseases. Various components act by inhibiting cells and proteins of the immune system, which will allow the development of anti-inflammatory and immunosuppressive drugs. This review summarizes the usefulness of the components of snake venoms in the fields of autoimmunity and rheumatology, which can serve as a basis for diverse translational research.

Objective and study aims Patients with left-ventricular assist devices (LVADs) have an increased risk of gastrointestinal bleeding, especially from the small bowel, often necessitating evaluation with balloon-assisted enteroscopy (BAE). Our study aimed to assess the periprocedural safety and utility of BAE for gastrointestinal bleeding in patients with LVADs. Patients and methods This was a multicenter retrospective cohort study of adults with LVADs who underwent BAE between January 2007 to December 2018. Results Thirty-four patients underwent a total of 46 BAEs (9 were single-balloon enteroscopies [SBEs] and 37 were double-balloon enteroscopies [DBEs]). Mean age of patients was 66.4 ± 8.3 years. Patients tolerated anesthesia well, without complications. There were no complications from the BAE itself. One patient required repeat BAE due to a progressive drop in hemoglobin and another patient developed paroxysmal supraventricular tachycardia. One patient died within 72 hours of the procedure due to worsening of LVAD thrombosis. Diagnostic yields were 69.6 % for all procedures, 73.0 % for DBE and 55.6 % for SBE (P = 0.309). Therapeutic yields were 67.4 % overall: 73.0 % for DBE and 44.4 % for SBE (P = 0.102). In those that presented with overt gastrointestinal bleeding, DBE had a higher diagnostic yield compared to SBE (84.2 % vs. 42.9 %; P = 0.057) and a significantly higher therapeutic yield (84.2 % vs. 28.6 %; p = 0.014). Conclusions This is the largest multicenter study of patients with LVADs who underwent DBE. BAE appears to be a safe and useful modality for the evaluation of gastrointestinal bleeding in these patients.

In the analyzes carried out in the plenary session of the National Accreditation Board on the processes of external evaluation of the Institutions of Higher Education in Cuba, a group of difficulties was identified that recommended the incorporation of a member of the same as an observer of these. From the analysis of the reports presented by each evaluator and the analyzes in the plenary session of the National Accreditation Board, this work was proposed to systematize the experiences reached from the year 2016 to date and to propose a procedure that guides the work of future observers. The practice demonstrated the utility of the observer in terms of ensuring compliance with the regulations and procedures established by all the evaluators, while also leaving important recommendations for future processes.

Background: The objective of this pilot study was to assess the safety and efficacy of VitalFlow stimulation in aneurysmal subarachnoid hemorrhage (aSAH) patients with vasospasm for the purpose of guiding the design of larger, controlled studies in vasospasm patients, a largely untreated condition [1]. Methods: Six patients with angiographic vasospasm developing post-aSAH were treated with VitalFlow stimulation. Digital subtraction angiograms were obtained at the time of diagnosis (baseline) and then 30 minutes post-stimulation. A single 2-minute period of stimulation was delivered to the patients using parameters previously shown to be safe, tolerable, and effective at increasing cerebral blood flow (CBF) in healthy volunteers. Results: VitalFlow stimulation improved tissue perfusion as assessed by parenchymography and reversed the constriction of vasospastic arteries. Two patients had only partial improvement and so were treated with intraarterial nimodipine after VitalFlow stimulation, whereas four patients had complete resolution of the vasospasm after VitalFlow stimulation per the treating neuroendovascular surgeon’s evaluation. Clinical examination showed improvement in Hunt and Hess Scale scores assessed post-stimulation. Conclusions: Non-invasive magnetic stimulation of the facial nerve with the VitalFlow stimulator appears to be a safe and effective means to reverse angiographic vasospasm in aSAH patients. Clinical Impact: This study provides Class IV evidence that non-invasive magnetic stimulation of the facial nerves reduce angiographic vasospasm in aSAH patients.

Background and Aim: Enteral nutrition (EN) is applicable to adult Crohn’s disease (CD) in treating malnutrition and in inducing remission – here as a less effective alternative than corticosteroids. The purpose of this review is to determine whether preoperative EN impacts postoperative complications of adult CD, either by means of nutritional or therapeutic effects. Summary: A systematic review of English written full-text research articles published between January 1990 and November 2017, including adult patients undergoing abdominal surgery for complicated CD after EN, was performed. Four studies out of 22 were selected, all of which institutional, retrospective, case-control cohorts, one classified as “good quality” and three as “poor quality,” as rated by the Newcastle-Ottawa Scale. The application of inclusion and exclusion criteria resulted in a non-intentional absence of studies referring to supplemental EN among those reviewed. The reduced number of heterogeneous eligible studies impeded meta-analysis. In all studies, exclusive EN (EEN) was used and well tolerated, allowing to defer or even avoid surgery altogether, improving patients’ global state. The two studies with the greatest number of patients found preoperative EEN to be an independent factor against infectious and non-infectious complications in 219 patients and against anastomotic leaks or abscesses in 38 patients. Also, in univariate analysis, EEN was found to increase preop­erative immunosuppressant-free intervals and to protect against anastomotic dehiscences, intra-abdominal abscesses, surgical wound infections, ileus, stomas, and reoperations in the largest study; in another study it was related to fewer intra-abdominal septic complications. Key Messages: All reviewed studies are retrospective and, consequently, of limited relevance. Nonetheless, all of them call the attention of the scientific community to the potential benefits of preoperative EEN on postoperative outcomes in adult CD, calling for prospective multi-institutional studies and randomized controlled trials.

Para enfrentar el desarrollo sostenible en la sociedad del conocimiento se hace cada vez más necesario el perfeccionamiento de la investigación como generadora de conocimientos y tecnología; en esto, las universidades poseen un papel crucial, que exige mejorar la gestión de la misma. Este trabajo persigue como objetivo describir diferentes criterios y apreciaciones acerca de la gestión universitaria y en particular de la gestión de la función investigativa en esas instituciones para fundamentar su significación y necesidad en la actualidad. Partiendo del método de análisis documental y del analítico-sintético se muestran las diversas aristas y temáticas en discusión alrededor de la gestión universitaria y de la gestión de la investigación en ellas, concluyendo que la relevancia creciente de la educación superior y de la investigación científica allí generada como ingrediente indispensable para la promoción y alcance del desarrollo sostenible apunta y exige la atención y perfeccionamiento de la gestión de esta inalienable función sustantiva de las instituciones de educación superior ante las complejidades y retos de la sociedad actual.

Abstract Background Magnetic stimulation of the facial nerve has been tested in preclinical studies as a new, non-invasive emergency treatment of ischemic stroke that acts by increasing cerebral blood flow (CBF). The objective of the studies reported herein was to identify minimal stimulation parameters that increase CBF in large animals and then test those stimulation parameters in healthy volunteers for safety, tolerability, and effectiveness at increasing CBF. This translational research is necessary preparation for clinical studies in ischemic stroke patients. Methods Initial experiments in anesthetized Yorkshire pigs were undertaken in order to identify the lowest stimulus power and duration that increase CBF. A full 3 × 3 factorial design was used to evaluate magnetic stimulation of the facial nerve at various stimulation powers (1.3, 1.6, and 1.9 Tesla field strength at coil surface) and for various durations (2, 3.5, and 5 min). CBF was measured with contrast MRI perfusion imaging and the internal carotid arteries were assessed with MR angiography. Magnetic facial nerve stimulation with parameters identified in the pig study was then applied to 35 healthy volunteers. Safety was assessed with adverse event reports and by medical examination. Tolerability was defined as each volunteer’s ability to withstand at least 2 min of stimulation. Volunteers could determine the maximum power of stimulation they received during a ramp-up period. Results In pigs, unilateral facial nerve stimulation increased CBF by as much as 77% over pre-stimulation baseline when administered across a range of 1.3–1.9 Tesla power and for 2- to 5-min duration. No clear dose–response relationship could be observed across this range, but lower powers and durations than these were markedly less effective. The effect of a single stimulation lasted 90 min. A second stimulation delivered 100 min after the first stimulation sustained the increased CBF without evidence of tachyphylaxis. In human, bilateral facial nerve stimulation caused only non-serious adverse events that were limited to the 2-min stimulation period. Tolerability was greatly improved by gentle encouragement from the study staff, which enabled most volunteers to tolerate 1.6–1.8 Tesla of stimulation power. CBF measures taken approximately 10 min after stimulation demonstrated on average a 32 ± 6% increase in CBF, with ≥ 25% increases in CBF occurring in 10 of the 31 volunteers who had adequate CBF measurements. Conclusions The minimal effective stimulation parameters defined by increased CBF, as identified in the pig study, translated into safe, tolerable, and effective stimulation of healthy volunteers. These results support the future development and evaluation of non-invasive facial nerve stimulation for the emergency treatment of ischemic stroke. Trial Registration retrospectively registered with clinicaltrials.gov NRV_P1_01_15 on June 6, 2017

A soja é uma das culturas mais importantes do mundo, porém, quando cultivada em solos com deficiências de nutrientes pode influenciar negativamente no potencial fisiológico das sementes. O objetivo desta pesquisa é avaliar o efeito de doses e épocas de aplicação de zinco no potencial fisiológico de sementes de soja, cultivada em solo da região do Cerrado. O experimento foi instalado no município de Ipameri – Goiás, utilizou-se o delineamento inteiramente casualizado, em esquema fatorial 2 (épocas V9 e R1) x 5 (doses 0, 3, 6, 9 e 12 kg ha-1 de zinco), com quatro repetições. Para avaliar o potencial fisiológico das sementes foi realizado o teste de germinação, os testes tradicionais de vigor para espécie e o teste de tetrazólio. Os resultados foram submetidos à análise de variância e as médias comparadas pelo teste de Tukey a 5% de probabilidade e para analisar as doses de Zn utilizou-se a análise de regressão. As diferentes doses de Zn e épocas de aplicação não influenciaram no potencial fisiológico das sementes de soja, porém influenciou positivamente para a massa de 100 sementes e o teste de envelhecimento acelerado.

A soja é uma das culturas mais importantes do mundo sendo sua produtividade afetada pela deficiência do micronutriente zinco. O presente trabalho teve como objetivo avaliar o efeito de doses e épocas de aplicação de zinco nas características agronômicas da soja, cultivada em solo da região do Cerrado. O delineamento experimental utilizado foi o de blocos casualizados em esquema fatorial 2 x 5, sendo, duas épocas de aplicação (estádio V9 e R1) e cinco doses (0, 3, 6, 9 e 12 kg ha-1 de zinco), com quatro repetições. Avaliou-se teor de zinco foliar, teor relativo de clorofila, altura de planta, diâmetro do caule, altura de inserção da primeira vagem, número de vagens por planta, número de grãos por vagem, número de nós reprodutivos por planta, massa de 100 grãos e produtividade de grãos. A adubação com Zn influenciou positivamente o teor foliar de Zn, altura de plantas, diâmetro do caule, altura de inserção da primeira vagem, número de vagens por planta, número de nós reprodutivos por planta, massa de 100 grãos e produtividade de grãos. A massa de 100 grãos e a produtividade de grãos apresentaram diferença significativa entre as épocas de aplicação, com resultados superiores para as médias de V9. De acordo com estes resultados recomenda-se a adubação com Zn na cultura da soja.

Os métodos e as ferramentas da qualidade oferecem controles simples de aplicação que podem otimizar e potencializar resultados. Este artigo aplica a metodologia da pesquisa bibliográfica, pesquisa documental e pesquisa-ação em conjunto com métodos e ferramentas da qualidade para estudo e avaliação dos dados de uma empresa de facção industrial da região de Maringá. A facção industrial está inserida no macro sistema da cadeia têxtil, que no ramo dos confeccionados delegando a etapa de montagem das peças, a partir da função costurar, à terceiros. Em uma primeira avaliação, na empresa estudo de caso, foi possível identificar que a mesma já apresenta o uso de uma ferramenta da qualidade, a inspeção. O objetivo é aprofundar os conhecimentos a respeito do processo da empresa, identificando oportunidades de melhorias com potencial de redução de custos e otimização de ganhos causados por problemas qualitativos, bem como melhorar a satisfação dos clientes que poderá ser percebida após a implantação dos controles de qualidade. A problemática inicial foi a partir da redução do volume de produção, medidos em peças, e o lead time de produção, medidos em dias corridos, que não atendem ao desejado. Para tanto foi aplicada a metodologia do Ciclo PDCA (Plan, Do, Check and Act/ Planejar, Fazer, Verificar e Agir) com base nas fases do método gerencial MASP (Método de Solução e Análise de Problemas).A fase Planejar foi cumprida com a realização do diagrama SIPOC, mapeamento do processo, FMEA, Gráfico de Pareto e método dos 5 Porquês, em conjunto.

Os mercados de pequeno porte vêm tendo destaque no senário brasileiro, pela forma de atendimento ao cliente, de forma diferenciada e personalizado, e por ser tratar de um nicho especificos de pessoas que buscam estes mercados. Neste sentido, o objetivo desse estudo é analisara influencia da ruptura nas gôndolas de um mercado de pequeno porte e propor melhorias com aplicação de ferramentas de gestão. Deste modo, foram classificados 41 produtos vendidos por esse mercado, de acordo com seus maiores giros de vendas por categorias e realizado coletas de dados a fim de medir e controlar o índice de ruptura. Por meio dos dados e informações obtidas durante essa coleta de dados no período estimado, verificou grandes melhorias com a aplicação dos conceitos de gestão, obtendo uma diminuição de ruptura de gôndola, de 31% de ruptura no inicio da coleta para 6% de média ao final do plano de ação implantado. Isso demonstrou-se uma evolução muito grande na aplicação dos conceitos de gestão e controle do processo de compra, abastecimento e reposição de produtos. Com isso, as melhorias trouxeram satisfação dos clientes em poder atendê-lo com maior eficiência e eficácia. Além disso, favoreceu a possibilidade de aumentar as vendas uma vez que o índice de ruptura foi minimizado, ou seja, mantendo o produto disponível na gôndola para que o cliente possa comprar.

Alkaline activation of fly ashes is a procedure that enables an alternative binder which has been receiving much interest by several research groups particularly on the manufacturing of mortars and concretes. The properties of the materials that are developed during the alkaline activation are influenced by the curing conditions (temperature and relative humidity). Another relevant facet related to the curing procedures is the possibility of carbonation occur, which may have an impact on the mechanical strength of the alkaline cements. In this research, several sets of curing conditions were tested to understand which one results in a higher strength and reveals carbonation. Uniaxial compressive strength tests were conducted to assess mechanical behavior. The outcome suggests that higher temperature and low relative humidity yields higher mechanical strength.

Resumo Objetivo do estudo foi analisar e comparar os padrões cinemáticos do joelho e as velocidades lineares da coxa e perna no chute com o dorso do pé no futsal em relação aos chutes com diferentes aproveitamentos, sendo estes os que acertaram (CA) ou não o alvo (CNA). Participaram do estudo 18 universitários homens. Utilizou-se uma câmera filmadora com a frequência de amostragem de 30Hz. Foram colocados marcadores passivos nos pontos anatômicos do membro inferior dominante. Cada participante realizou 10 chutes. Foram analisados três momentos T1 (fase de preparação), T2 (metade do movimento) e T3 (fase de execução). Na comparação entre o setor T1-T2 com o T2-T3 foram encontradas diferenças significativas (p

Este artigo objetiva debater o processo de pesquisa científica alinhavada ao processo de educação no ensino superior. Desta forma, procura explanar sobre a atividade de iniciação científica que ocorre nas universidades, dentro da perspectiva constitucional do tripé acadêmico de ensino, pesquisa e extensão. Será discutida a utilidade da história da ciência como forma de apresentar os feitos científicos aos alunos. A caracterização dos tipos de conhecimentos e as categorias de pesquisa e de procedimentos científicos são outros itens apresentados, didaticamente por meio de exemplos reforçadores, para favorecer a compreensão dos conceitos envolvidos na realização dos processos de pesquisa

INTRODUÇÃO: Este artigo consiste na utilização de uma ferramenta de marketing o Net Promoter Score (NPS), associadas com técnicas de engenharia na busca de melhorias de pro dutos, processos e serviços. O objetivo deste trabalho é de investigar possíveis problemas tanto de produtos, processo e serviço, e aplicar técnicas de engenharia para solucioná-los dentro da unidade de negócio do ramo de varejo de uma empresa cooperativa agroindústria. A metodologia adotada foi o uso do NPS para levantamentos de dados. Os clientes pesquisados foram selecionados via amostragem probabilística de uma população de 7302 clientes, com 95,5% de confiabilidade e erro amostral máxima de 5%. No decorrer dos anos de pesquisa e aplicação de melhorias, houve um aumento da média da nota final da satisfação dos clientes com os produtos de varejo e os serviços de atendimento de 8,26% para 8,54 %. Como destaque é apresentado produtos da categoria Café, que o nível de clientes aumentou próximo de 600 %. O método NPS se demonstrou imensamente eficaz para a geração de indicadores, e através dos resultados obtidos nas pesquisas de satisfação dos clientes, a equipe de gestão da qualidade pode extrair informações para melhorar produto e processo, melhorando a satisfação e conquistando novos clientes.

Objetivo do estudo foi analisar e comparar os padrões cinemáticos do joelho e as velocidades lineares da coxa e perna no chute com o dorso do pé no futsal em relação aos chutes com diferentes aproveitamentos, sendo estes os que acertaram (CA) ou não o alvo (CNA). Participaram do estudo 18 universitários homens. Utilizou-se uma câmera filmadora com a frequência de amostragem de 30Hz. Foram colocados marcadores passivos nos pontos anatômicos do membro inferior dominante. Cada participante realizou 10 chutes. Foram analisados três momentos T1 (fase de preparação), T2 (metade do movimento) e T3 (fase de execução). Na comparação entre o setor T1-T2 com o T2-T3 foram encontradas diferenças significativas (p

El objetivo fue cuantificar el valor de las especies del género Anolis como indicadores ecológicos del estado de conservación de los hábitats usados por estas especies en una zona de bosque tropical en el departamento del Chocó. El método de relevamiento por encuentro visual, fue empleado para establecer especies con mayor abundancia relativa en determinado sitio con distintos grados de cobertura vegetal, el patrón “A” son especies indicadoras de altos niveles de intervención donde se destacó Anolis chloris con el 88.2% de abundancia relativa, patrón “B” se referencia a las especies indicadoras de niveles medios de intervención, donde A. latifrons con el 75% de los individuos fueron registrados en este nivel de tolerancia y el patrón “C”, hace referencia a especies que se encuentran en áreas boscosas con un alto nivel de conservación de su estado natural, donde las especies A. anchicayae (92.8%) y A. notopholis (exclusiva) fueron las más importantes., en cuanto al indice de Valor Indicador Ecológico “IndVal”, se reportaron cuatro especies indicadoras, con una diferencia estadísticamente significativa entre especies; A. anchicayae (IndVal: 92.9%), para áreas de bosque con muchos años de regeneración natural, A. chloris (IndVal: 88.2%), A. maculiventris (IndVal: 65.2%) y A. granuliceps (IndVal: 50.8%). Además, se realizo un análisis de similitud y complementariedad entres las diferentes coberturas, indicando el recambio y la exclusividad de especies entre las mismas y posteriormente se graficaron curvas de rango- abundancia. Los resultados sugerir a los Anolis como grupo indicador del estado de conservación de los bosques tropicales del Chocó.

The influence of suction on the mechanical behaviour of unsaturated chemically stabilised soils is still mostly unknown and unquantified. This is also motivated by the difficulties associated with the experimental procedure required to fully characterise the unsaturated response of the soil, including its direct influence on traditional strength tests. The present paper presents the soil water retention curves obtained for a Portuguese soil before and after being stabilised with Portland cement (OPC) and an alkali-activated cement (AAC). Saturated undrained triaxial tests were also performed for the same curing conditions (0, 28, and 90 days). Previous attempts to characterise the retention curve of soils stabilised with AAC are unknown, and the results showed that the pore volume structure is already formed after 28 days, prior to the full development of the gel matrix responsible for the strength increase between 28 and 90 days. The curve changed after stabilisation, and with each binder, as the OPC presented a higher air-entry value and a narrower suction range compared to the AAC solution. The significant differences between the curves obtained from each binder suggest the future development of a methodology to assess the quality of the AAC stabilisation.

Expediente - v. 6, n. 1, 2016