Search

Background: Diverticulitis is experiencing a significant increase in prevalence and its widespread in-hospital management results in a high burden on healthcare systems worldwide. This study compared inpatient and outpatient approach of acute non-complicated diverticulitis using a non-selected population in a real-world setting. Methods: This observational retrospective study included all consecutive patients from two Portuguese institutions diagnosed between January 2017 and December 2021 with non-complicated diverticulitis according to the modified Hinchey Classification. The primary endpoints were to identify criteria for inpatient treatment and compare the outcomes on the basis of the treatment regimen. The secondary endpoints were to determine the predictive factors for clinical outcomes, focusing on treatment failure, pain recurrence, and the need for elective surgery following the initial episode. Results: A total of 688 patients were included in this study, 437 treated as outpatients and 251 hospitalized. Inpatient management was significantly associated with higher preadmission American society of anesthesiologists (ASA) score (p = 0.004), fever (p = 0.030), leukocytosis (p < 0.001), and elevated C-reactive protein (CRP) (p < 0.001). No significant association was found between failure of conservative treatment and patient's age, ASA score, baseline CRP, presence of systemic inflammatory response syndrome (SIRS), and inpatient or outpatient treatment regimen. Pain recurrence was significantly associated with higher CRP levels (p = 0.049), inpatient treatment regime (p = 0.009) and post index episode mesalazine prescription (p = 0.006). Moreover, the need for elective surgery was significantly associated with the presence of previous episodes (p = 0.004) and pain recurrence (p < 0.001). Conclusions: The majority of patients with uncomplicated diverticulitis of the left colon experience successful conservative approach and can be safely managed in an ambulatory setting. Neither treatment failure, recurrence of pain, or need for posterior elective surgery are associated with outpatient treatment regimen. [ABSTRACT FROM AUTHOR]

This work focuses on panel flutter and active control in supersonic variable stiffness composite laminates, making progress on the analytical modeling and combined exploration of curvilinear fiber composites tailoring and piezoelectric sensors/actuators, as promising structural design technologies, for aeroelastic control. The Classical Laminated Plate Theory and the First-Order Piston Theory are used as structural and aerodynamic models, respectively. Flutter analyses are carried out for simply supported plates, either purely elastic laminates or piezoelectric composite laminates. The tailor-ability of curvilinear fiber composites and the effect of proportional control are discussed. Ultimately, the presented results provide a comprehensive benchmark for future assessments. [ABSTRACT FROM AUTHOR]

The Skyrmion Hall Effect (SkHE) observed in ferromagnetic and ferrimagnetic (FI) skyrmions traveling due to a spin-polarized current can be a problematic issue when it comes to technological applications. By investigating the properties of FI skyrmions in racetracks through computational simulations, we have described the nature of their movement based on the relative values of the exchange, Dzyaloshinskii–Moriya, and anisotropy coupling constants. Beyond that, using a design strategy, a magnetic channel-like nano-device is proposed in which a spin-polarized current protocol is created to successfully control the channel on which the skyrmion will travel without the adverse SkHE. Additionally, a simple adjustment in the current strength can modify the skyrmion position sideways between different parallel channels in the nanostripe. [ABSTRACT FROM AUTHOR]

In light of the limited number of available literature on Abaqus user-elements implementation, this work presents two layerwise electro-elastic user-elements for static and free vibration analysis of piezoelectric composite plates. Three discrete layers are considered, each one described by a first-order shear deformation displacement field along with a linear or quadratic z-expansion of the electric potential. The models predictive capabilities are assessed by a comparison with three-dimensional exact solutions for simply supported plates. Numerical results demonstrate an advantage of the electric potential quadratic z-expansion for static analysis, with negligible improvements on the evaluation of the first 12 natural frequencies. [ABSTRACT FROM AUTHOR]

Nanoparticle mediated hyperthermia has been explored as a method to increase cancer treatment efficacy by heating tumours inside-out. With that purpose, nanoparticles have been designed and their properties tailored to respond to external stimuli and convert the supplied energy into heat, therefore inducing damage to tumour cells. Moreover, the combination of hyperthermia with chemotherapy has been described as a more effective strategy due to the synergy between the high temperature and the drug's effects, also associated with a remote controlled and on-demand drug release. In this review, the methods behind nanoparticle mediated hyperthermia, namely material design, external stimuli response and energy conversion will be discussed and critically analysed. We will address the most relevant studies on hyperthermia and temperature triggered drug release for cancer treatment. Finally, the advantages, difficulties and challenges of this therapeutic strategy will be discussed, while giving insight for future developments. [Display omitted] • Nanoparticles correct the non-specific mode of action of chemotherapy. • Hyperthermia works as an adjuvant in cancer therapy • Hyperthermia sensitizes cancer cells to chemotherapy. • Hyperthermia can be induced through several external stimuli. • Stimuli responsive nanomaterials allow for a remote-controlled drug release. [ABSTRACT FROM AUTHOR]

Eu0.8Y0.2MnO3 has been widely studied due to its very distinctive phase diagram, where it is still poorly understood the actual ferroelectric character of the low temperature magnetic phases. In order to figure out what is the origin of the microscopic mechanisms that drive its behavior, we carried out a detailed study of the displacement currents for both different starting conditions and polarizing electric fields, and of the field dependent magnetodielectric effect in Eu0.8Y0.2MnO3 ceramics. The experimental results provide clear evidence for the existence of two dipolar systems, one stemming from an electric field-induced process, likely associated with the isovalent substitution of Eu3+ by the smaller off-center Y3+ ions at A-lattice sites, which is independent of any cooperative phenomena occurring in the system. The other dipolar system, strongly dependent on the existence of the first one, drives the polar behavior of the nonmodulated magnetic phase AFM-2, stable in the temperature range of 23–30 K, and is associated with the ferroelectric character of this phase. The magnetic field dependence of the complex dielectric constant clearly shows that the magnetodielectric effect is strongly dependent on the phase it is being considered, and provides further evidence for the ferroelectric character of the AFM-2 phase referred to above. [ABSTRACT FROM AUTHOR]

The initial electrocardiogram (ECG) revealed an irregular broad complex tachycardia (Fig. A second ECG showed sinus rhythm and positive delta waves in the anterolateral leads and negative delta waves in the inferior leads (Fig. Further ECGs showed no delta waves and negative T waves in the inferior leads indicating successful ablation (Fig. [Extracted from the article]

Abstract Biofouling represents a major economic, environmental and health concern for which new eco-friendly solutions are needed. International legislation has restricted the use of biocidal-based antifouling coatings, and increasing efforts have been applied in the search for environmentally friendly antifouling agents. This research work deals with the assessment of the interest of a series of synthetic chalcone derivatives for antifouling applications. Sixteen chalcone derivatives were synthesized with moderate yields (38–85%). Antifouling bioactivity of these compounds was assessed at different levels of biological organization using both anti-macrofouling and anti-microfouling bioassays, namely an anti-settlement assay using mussel ( Mytilus galloprovincialis ) larvae, as well as marine bacteria and microalgal biofilms growth inhibition bioassays. Results showed that three compounds ( 11 , 12 , and 16 ) were particularly active against the settlement of mussel larvae (EC 50 7.24–34.63 μM), being compounds 12 and 16 also able to inhibit the growth of microfouling species (EC 50 4.09–20.31 μM). Moreover, the most potent compounds 12 and 16 were found to be non-toxic to the non-target species Artemia salina (<10% mortality at 25 μM). A quantitative structure-activity relationship model predicted that descriptors describing the ability of molecules to form hydrogen bonds and encoding the shape, branching ratio and constitutional diversity of the molecule were implied in the antifouling activity against the settlement of mussel larvae. This work elucidates for the first time the relevance of synthesizing chalcone derivatives to generate new non-toxic products to prevent marine biofouling. Graphical abstract Unlabelled Image Highlights • Marine biofouling impacts atmosphere, hydrosphere, and biosphere negatively. • Antifouling paints in use release toxic and persistent organic pollutants. • Synthesis of new nontoxic antifoulants was achieved in this work. • These compounds are able to be obtained in short time and in suitable amounts. [ABSTRACT FROM AUTHOR]

Background The causes of acute febrile illness (AFI) in Latin America are diverse and their complexity increases as the proportion of fever due to malaria decreases, as malaria control measures and new pathogens emerge in the region. In this context, it is important to shed light on the gaps in the epidemiological characteristics and the geographic range for many AFI aetiologies. Objectives To review studies on community-acquired fever aetiology other than malaria in Latin America, and to highlight knowledge gaps and challenges needing further investigation. Sources PubMed from 2012 to April 2018. Content We found 17 eligible studies describing 13 539 patients. The median number of pathogens tested per individual was 3.5 (range 2–17). A causative pathogen could be determined for 6661 (49.2%) individuals. The most frequently reported pathogen during the study periods was dengue virus (DENV) (14 studies), followed by chikungunya virus (nine studies) and Zika virus (seven studies). Among the studies reporting concurrent infections, 296 individuals (2.2%) were found to have co-infections. In-hospital mortality was reported in eight (47%) studies, ranging between 0% and 18%. Implications DENV fever is the febrile illness most frequently reported, reflecting its importance, while chikungunya and zika viruses present increasing trends since their emergence in the region. Studies with systematic and harmonized approaches for detection of multiple pathogens are needed and would probably reveal a higher burden of neglected pathogens such as Rickettsia spp. and arenaviruses. The lack of point-of-care tests and harmonized approach limits the care provided by health professionals and the efficacy of surveillance for AFI in the region. [ABSTRACT FROM AUTHOR]

In this work we developed and evaluated an ecological stove for food cooking, using hydrogen as the fuel. The operation of the device consists mainly of a renewable energy source, such as a photovoltaic system, which produces the electricity needed to power a bipolar alkaline electrolyzer from 1 kW to 1.9 kW, consisting of 85 stainless steel electrodes, which generates hydrogen for combustion in the cooking system. The prototype evaluation consisted of two main stages. In the first phase the operating parameters of the electrolyzer were obtained, achieving an efficiency of 60 to 77%, gas production from 3 to 6 L/min, with a maximum operating time of 395 minutes. The second phase focused on the cooking system, where the thermal efficiency of the device was determined, as 61.5%. [ABSTRACT FROM AUTHOR]

BACKGROUND Butantan-Dengue Vaccine (Butantan-DV) is an investigational, single-dose, live, attenuated, tetravalent vaccine against dengue disease, but data on its overall efficacy are needed. METHODS In an ongoing phase 3, double-blind trial in Brazil, we randomly assigned participants to receive Butantan-DV or placebo, with stratification according to age (2 to 6 years, 7 to 17 years, and 18 to 59 years); 5 years of follow-up is planned. The objectives of the trial were to evaluate overall vaccine efficacy against symptomatic, virologically confirmed dengue of any serotype occurring more than 28 days after vaccination (the primary efficacy end point), regardless of serostatus at baseline, and to describe safety up to day 21 (the primary safety end point). Here, vaccine efficacy was assessed on the basis of 2 years of follow-up for each participant, and safety as solicited vaccine-related adverse events reported up to day 21 after injection. Key secondary objectives were to assess vaccine efficacy among participants according to dengue serostatus at baseline and according to the dengue viral serotype; efficacy according to age was also assessed. RESULTS Over a 3-year enrollment period, 16,235 participants received either Butantan-DV (10,259 participants) or placebo (5976 participants). The overall 2-year vaccine efficacy was 79.6% (95% confidence interval [CI], 70.0 to 86.3) -- 73.6% (95% CI, 57.6 to 83.7) among participants with no evidence of previous dengue exposure and 89.2% (95% CI, 77.6 to 95.6) among those with a history of exposure. Vaccine efficacy was 80.1% (95% CI, 66.0 to 88.4) among participants 2 to 6 years of age, 77.8% (95% CI, 55.6 to 89.6) among those 7 to 17 years of age, and 90.0% (95% CI, 68.2 to 97.5) among those 18 to 59 years of age. Efficacy against DENV-1 was 89.5% (95% CI, 78.7 to 95.0) and against DENV-2 was 69.6% (95% CI, 50.8 to 81.5). DENV-3 and DENV-4 were not detected during the follow-up period. Solicited systemic vaccine- or placebo-related adverse events within 21 days after injection were more common with Butantan-DV than with placebo (58.3% of participants, vs. 45.6%). CONCLUSIONS A single dose of Butantan-DV prevented symptomatic DENV-1 and DENV-2, regardless of dengue serostatus at baseline, through 2 years of follow-up. (Funded by Instituto Butantan and others; DEN-03-IB ClinicalTrials.gov number, NCT02406729, and WHO ICTRP number, U1111-1168-8679.) [ABSTRACT FROM AUTHOR]

Background Zika virus (ZIKV) is transmitted to humans primarily by Aedes mosquito bites. However, circumstantial evidence points to a sexual transmission route. Objectives To assess the sexually acquired ZIKV cases and to investigate the shedding of ZIKV in genital fluids. Data sources PubMed, Scopus, Pro-MED-mail and WHO ZIKV notification databases from inception to December 2016. Selection criteria Reports describing ZIKV acquisition through sex and studies reporting the detection or isolation of ZIKV in the genital fluids were included. Risk-of-bias assessment The risk of bias was assessed using the National Institute of Health Tool. Results Eighteen studies reporting on sex-acquired ZIKV and 21 describing the presence of ZIKV in genital fluids were included. The overall risk of bias was moderate. Sexual transmission was male–female (92.5%), female–male (3.7%) and male–male (3.7%). Modes of sexual transmission were unprotected vaginal (96.2%), oral (18.5%) and anal (7.4%) intercourse. The median time between onset of symptoms in the index partner and presumed sexual transmission was 13 days (range 4–44 days). ZIKV RNA was detected in semen as late as 188 days (range 3–188 days) following symptom onset, and infectious virus was isolated in semen up to 69 days after symptom onset. No study reported ZIKV isolation from female genital samples, but detection did occur up to 13 days after symptom onset. Conclusions ZIKV is potentially sexually transmitted and persists in male genital secretions for a prolonged period after symptom onset. PROSPERO systematic review registration number CRD42016041475. [ABSTRACT FROM AUTHOR]

Long period fiber gratings (LPFGs) were used to monitor the characteristics of copper (Cu) thin films when annealed in air atmosphere up to ∼680 °C. The wavelength and the optical power shift of the resonant bands of the LPFGs when coated with the Cu thin films, were measured as a function of the annealing temperature, and were found to exhibit a different evolution comparing to a bare LPFGs. Thin films of Cu deposited on quartz (SiO 2 ) substrates were annealed and analyzed by XRD, SEM/EDS and Raman spectroscopy, allowing to identify the formation of two distinct oxide phases at different temperatures, cuprous (Cu 2 O-cuprite) and cupric (CuO-tenorite) oxides, respectively. The observed features of the resonant bands of the LPFGs were found to be associated with the Cu oxide phase transitions, indicating the possibility of using LPFGs to monitor, in real time, the oxidation states of Cu thin films by following specific characteristics of the attenuation bands. In addition, LPFGs over coated with the two distinct oxidation phases of Cu were characterized for refractive index sensing in the range between 1.300 to 1.600, leading to the conclusion that the sensitivity to the refractive index of the surrounding medium of Cu coated LPFGs sensing systems can be temperature tuned. [ABSTRACT FROM AUTHOR]

The biointeractions of graphene-based materials depend on their physico-chemical properties. These properties can be manipulated by polymer adsorption. Graphene nanoplatelets (GNP-C) were modified with PVA, HEC, PEG, PVP, chondroitin, glucosamine, and hyaluronic acid. These materials were characterized by SEM, DLS, XPS, Raman spectroscopy, and TGA. Surface adsorption was confirmed for all polymers. Biocompatibility evaluation showed that all of these materials induced low haemolysis (<1.7%) at concentrations up to 500 μg mL −1 . GNP-C-PVA and GNP-C-HEC presented the lowest haemolysis percentages and were therefore more thoroughly studied. The morphology of HFF-1 cells was investigated by microscopy (optical, fluorescence, TEM) in order to evaluate interactions with GNP materials. Small GNP-C nanoplatelets were observed to enter cells independently of the surface treatment. For pristine GNP-C at a concentration of 50 μg mL −1 , ROS production increased 4.4-fold. This effect is lower for GNP-C-PVA (3.3-fold) and higher for GNP-C-HEC (5.1-fold). Resazurin assays showed that GNP-C caused toxicity in HFF-1 cells at concentrations above 20 μg mL −1 at 24 h, which decreased at 48 and 72 h. PVA surface adsorption rendered GNP-C non-toxic at concentrations up to 50 μg mL −1 . LIVE/DEAD assays showed that at 20 and 50 μg mL −1 cell death is significantly lower for GNP-C-PVA compared to pristine GNP-C. Modification of nanoplatelets with HEC resulted in no benefit in terms of biocompatibility, whereas PVA considerably improved the biocompatibility. [ABSTRACT FROM AUTHOR]

The region of the Midwest of Santa Catarina deserves highlight in swine production by the large installed cold stores. The Italian immigration also brought to this region small industries in order to add value and produce meat products, such as salami. Small industrializers cold stores located in the region of Alto Vale do Rio do Peixe do not have their own laboratories to monitor neither the quality of the raw materials used in the manufacture of salami nor of the product to be sent to the consumer; because of that, the samples are sent to third laboratories where the product is evaluated, proving its quality and the compliance with legal requirements. In this context, the aim of this study was to evaluate the microbiological quality of salamis produced by three companies of the region of Alto Vale do Rio do Peixe, as well as determining the levels of nitrites and compare them to the values established by the current Legislation in the Country. The analyses were performed between August and September 2016 using official methodology determined by the Ministry of Agriculture, Livestock and Supply (MAPA). It was concluded that all the samples met the microbiological standards required by the Legislation. The results for nitrite analysis show that 100% of the samples of the three brands analyzed contained nitrite levels within the current Legislation, ie below 150 mg/kg, what proves that the salami production in small agro-industries in this region of the State of Santa Catarina is in safe condition for consumption. [ABSTRACT FROM AUTHOR]

YMnO3thin films were prepared based on a chemical solution deposition route. Their structure was studied as a function of the annealing temperature using X-ray diffraction, Raman spectroscopy, and electron backscatter diffraction. For annealing temperatures above 850°C the films, though crystallizing predominantly in aP63cmhexagonal structure, exhibit a thin Pnma orthorhombic phase close to the film-substrate interface. It is shown that the residual orthorhombic structure is associated with a substrate induced strain state, characterized by an expansion in the in-planeadirection, and a compression in the out of plaincdirection. [ABSTRACT FROM PUBLISHER]

Introduction. Sickle cell disease (SCD) is characterized by hemoglobin S homozygosity, leading to hemolysis and vasoocclusion. The hemolysis releases arginase I, an enzyme that decreases the bioavailability of nitric oxide, worsening the symptoms. The different SCD haplotypes are related to clinical symptoms and varied hemoglobin F (HbF) concentration. The aim of this study was to evaluate the impact of the βS gene haplotypes and HbF concentration on arginase I levels in SCD patients. Methods. Fifty SCD adult patients were enrolled in the study and 20 blood donors composed the control group. Arginase I was measured by ELISA. The βS haplotypes were identified by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). Statistical analyses were performed with GraphPad Prism program and the significance level was p<0.05. Results. Significant increase was observed in the arginase I levels in SCD patients compared to the control group (p<0.0001). The comparison between the levels of arginase I in three haplotypes groups showed a difference between the Bantu/Bantu × Bantu/Benin groups; Bantu/Bantu × Benin/Benin, independent of HU dosage. An inverse correlation with the arginase I levels and HbF concentration was observed. Conclusion. The results support the hypothesis that arginase I is associated with HbF concentration, also measured indirectly by the association with haplotypes. [ABSTRACT FROM AUTHOR]

In industrial processes, particularly in the food sector, sustainability is increasingly important. Consumers demand safer food and this is often associated with elevated cleaning costs and high environmental impacts in order to reduce contaminations on equipment and products. Modified surfaces are seen as a promising strategy for biofouling mitigation and contamination prevention. In this work, the performance of a modified Diamond-Like Carbon (DLC) surface designated by SICON® (a-C:H:Si:0) was compared with stainless steel (316L) regarding bacterial adhesion, biofilm formation and cleanability. Assays were performed at different temperatures using Escherichia coli, one of the most persistent foodbome microorganisms and also the natural flora present in the water from an industrial salad washing line. Bacterial adhesion on SICON® and stainless steel were similar and favored at a higher temperature (30 C). Biofilm formation was reduced on SICON® (1-2 Log) and this may be explained by the lower ratio between the Lifshitz-van der Waals apolar component and the electron donor component (γLW/γ-) of this surface. It was also shown that after performing a cleaning treatment with chlorine, reduction of viability counts was much higher in SICON® (about 3.5 Log reduction and 15% removal) when compared to stainless steel (1.6 Log reduction and 6% removal). Additionally, it was observed that 18h after treatment, biofilm values in SICON® were similar to those obtained with stainless steel. Results indicate that for industries with cleaning frequencies of up to 6 h, the use of SICON® on critical areas enables operation at a much higher hygienic level. [ABSTRACT FROM AUTHOR]

Study Objective: The study objective is to determine the incidence of oral soft tissue trauma during classic direct laryngoscopy for tracheal intubation and the risk factors associated with it.Design: This is a prospective observational study.Setting: The setting is at a ward.Patients: The patients are adults submitted to elective interventions in general surgery requiring tracheal intubation by classic direct laryngoscopy.Interventions: During 6 months, all patients were interviewed 12-24 hours before anesthesia and after surgery and underwent a detailed oral examination performed by an anesthesiology blind to anesthetic management details and preoperative patient care.Measurements: Evaluation of oral soft tissue injuries includes oral mucosa including the gums; the alveolar mucosa in the edentulous patient, palate, and the buccal mucosa; lips (mucosa and skin); and the tongue. Injury severity was assessed using the severity scale presented routinely in Portuguese legal medicine research: grade 0, no injuries had; grade 1, mild severity injuries; grade 2, medium severity injuries; and grade 3, major severity injuries.Main Results: Soft tissue trauma was observed in 278 (52.1%) patients. Soft tissue injury occurred once in 204 (38.2%) patients, 2 in 64 (38.2%) patients, and 3 times in 10 (1.9%) patients. Tongue injury was the most common type of soft tissue trauma (36.3%) followed by lower lip injury (22.3%), upper lip injury (7.1%), and oral mucosa injury (2.1%). All the lesions were grade 1 or 2. Only oral mucosa injury was found to be associated with age group (P = .021).Conclusions: Our study reveals a high incidence of lesions grade 1 or 2 in soft tissue. [ABSTRACT FROM AUTHOR]

In the food industry, biofilm formation in pipes, equipment and cooling systems increases maintenance costs, decreases operational efficiencies and is a source of contamination. Shear stress, nutrient load and surface material are important variables affecting the biofilm onset in industry. In this work, the combined impacts of these variables were assessed using three different materials (glass, copper and stainless steel), two nutrient loads (high and low nutrient medium) and two hydrodynamic conditions (static and dynamic). Initial adhesion and biofilm formation were studied in microplates using Escherichia coli as a model organism. Surface material was the factor with the strongest impact and adhesion/biofilm formation were correlated with surface hydrophobicity. However, the impact of this variable was dependent on the nutrient load and imposed shear stress. It was also found that, for the majority of the situations tested, initial attachment performance is a good predictor of biofilm formation behaviour and that the effects observed during attachment are amplified during biofilm maturation. Since shear stress is a major determinant in cell adhesion, the results of this study may find application in industrial systems operating at flow rates between 0.001 and 600 m³ h-1 depending on tube material and diameter. [ABSTRACT FROM AUTHOR]

In this work, we analyzed GdMnO3 magnetoelectric thin films prepared by a general sol-gel method. The film formation temperature is analyzed by a thermogravimetric analysis, while the lattice parameters of the Pbnm orthorhombic films are determined from the analysis of the X-ray spectra. The X-ray results also reveal that GdMnO3 films are under compression along the b axis. The lattice dynamic analysis carried out by a Raman spectroscopy confirms the formation of films with a Pbnm orthorhombic structure. Moreover, the analysis of the Raman spectra suggests that besides film-substrate interaction, texture and grain size influence can alter lattice dynamics relative to the bulk ones. Magnetic measurements show that the film response is different from that observed in ceramic and single crystal; mainly, in the shape and temperature where the transitions are taking place. The magnetic study also reveals that GdMnO3 films are paramagnetic above 80K, showing a ferromagnetic-like response at low temperatures (T≤15K). The dielectric analysis carried out on the 850°C annealed film shows the formation of a relaxation process at low temperature, which is associated with a polaronic process. Moreover, it is also observed a small anomaly at T~27K that might be related to the magnetic transition taking place in this temperature range. [ABSTRACT FROM AUTHOR]