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Medical imaging is a multidisciplinary specialty, combining clinical expertise from medical physics, radiography, and radiology, and plays a key role in patient care. Research is vital to ensure the care delivered to patients is evidence-based, and is a core component of clinical governance; however, there are pressures on the imaging workforce, which are significantly impeding imaging research. This commentary presents a research gap analysis pertaining to the multidisciplinary imaging workforce on behalf of the National Institute for Health Research (NIHR) Imaging Workforce Group. Data were summarised from membership surveys of the Royal College of Radiologists, Society and College of Radiographers, and Institute of Physics and Engineering in Medicine; national reports; and feedback from NIHR Clinical Research Network Imaging Champions meeting in 2020/2021. Common barriers to delivering research were found across the multidisciplinary workforce. The key issues were lack of staff, lack of time, and lack of funding to backfill clinical services. Given the ongoing workforce shortages and increasing clinical demands on radiologists, diagnostic radiographers, and medical physicists, these issues must be tackled with a high priority to ensure the future of clinical research within the NHS.

Background COVID-19 infection is known to cause a wide array of clinical chronic sequelae, but little is known regarding the long-term cardiac complications. We aim to report echocardiographic follow-up findings and describe the changes in left (LV) and right ventricular (RV) function that occur following acute infection. Methods Patients enrolled in the World Alliance Societies of Echocardiography-COVID study with acute COVID-19 infection were asked to return for a follow-up transthoracic echocardiogram. Overall, 198 returned at a mean of 129 days of follow-up, of which 153 had paired baseline and follow-up images that were analyzable, including LV volumes, ejection fraction (LVEF), and longitudinal strain (LVLS). Right-sided echocardiographic parameters included RV global longitudinal strain, RV free wall strain, and RV basal diameter. Paired echocardiographic parameters at baseline and follow-up were compared for the entire cohort and for subgroups based on the baseline LV and RV function. Results For the entire cohort, echocardiographic markers of LV and RV function at follow-up were not significantly different from baseline (all P > .05). Patients with hyperdynamic LVEF at baseline (>70%), had a significant reduction of LVEF at follow-up (74.3% ± 3.1% vs 64.4% ± 8.1%, P < .001), while patients with reduced LVEF at baseline (−20%) at baseline had significant improvement at follow-up (−15.2% ± 3.4% vs −17.4% ± 4.9%, P = .004). Patients with abnormal RV basal diameter (>4.5 cm) at baseline had significant improvement at follow-up (4.9 ± 0.7 cm vs 4.6 ± 0.6 cm, P = .019). Conclusions Overall, there were no significant changes over time in the LV and RV function of patients recovering from COVID-19 infection. However, differences were observed according to baseline LV and RV function, which may reflect recovery from the acute myocardial injury occurring in the acutely ill. Left ventricular and RV function tends to improve in those with impaired baseline function, while it tends to decrease in those with hyperdynamic LV or normal RV function.

Background The novel severe acute respiratory syndrome coronavirus-2 virus, which has led to the global coronavirus disease-2019 (COVID-19) pandemic is known to adversely affect the cardiovascular system through multiple mechanisms. In this international, multicenter study conducted by the World Alliance Societies of Echocardiography, we aim to determine the clinical and echocardiographic phenotype of acute cardiac disease in COVID-19 patients, to explore phenotypic differences in different geographic regions across the world, and to identify parameters associated with in-hospital mortality. Methods We studied 870 patients with acute COVID-19 infection from 13 medical centers in four world regions (Asia, Europe, United States, Latin America) who had undergone transthoracic echocardiograms. Clinical and laboratory data were collected, including patient outcomes. Anonymized echocardiograms were analyzed with automated, machine learning–derived algorithms to calculate left ventricular (LV) volumes, ejection fraction, and LV longitudinal strain (LS). Right-sided echocardiographic parameters that were measured included right ventricular (RV) LS, RV free-wall strain (FWS), and RV basal diameter. Multivariate regression analysis was performed to identify clinical and echocardiographic parameters associated with in-hospital mortality. Results Significant regional differences were noted in terms of patient comorbidities, severity of illness, clinical biomarkers, and LV and RV echocardiographic metrics. Overall in-hospital mortality was 21.6%. Parameters associated with mortality in a multivariate analysis were age (odds ratio [OR] = 1.12 [1.05, 1.22], P = .003), previous lung disease (OR = 7.32 [1.56, 42.2], P = .015), LVLS (OR = 1.18 [1.05, 1.36], P = .012), lactic dehydrogenase (OR = 6.17 [1.74, 28.7], P = .009), and RVFWS (OR = 1.14 [1.04, 1.26], P = .007). Conclusions Left ventricular dysfunction is noted in approximately 20% and RV dysfunction in approximately 30% of patients with acute COVID-19 illness and portend a poor prognosis. Age at presentation, previous lung disease, lactic dehydrogenase, LVLS, and RVFWS were independently associated with in-hospital mortality. Regional differences in cardiac phenotype highlight the significant differences in patient acuity as well as echocardiographic utilization in different parts of the world.

Rutherford Backscattering Spectrometry (RBS) is an important technique providing elemental information of the near surface region of samples with high accuracy and robustness. However, this technique lacks throughput by the limited rate of data processing and is hardly routinely applied in research with a massive number of samples (i.e. hundreds or even thousands of samples). The situation is even worse for complex samples. If roughness or porosity is present in those samples the simulation of such structures is computationally demanding. Fortunately, Artificial Neural Networks (ANN) show to be a great ally for massive data processing of ion beam data. In this paper, we report the performance comparison of ANN against human evaluation and an automatic fit routine running on batch mode. 500 spectra of marker layers from the stellarator W7-X were used as study case. The results showed ANN as more accurate than humans and more efficient than automatic fits., Comment: 15 pages, 8 figures

Summary Background Little is known about the economic burden of healthcare-associated infections (HAIs) in Brazil. Aim To analyse the costs of hospitalization by reimbursement from the Brazilian government, via the Brazilian Unified Health System (SUS) affiliation, and direct costs in the adult Intensive Care Unit (ICU). Methods The matched-pairs case–control study (83 patients with HAIs and 83 without HAIs) was performed at a referral tertiary-care teaching hospital in Brazil in January 2018. In order to calculate the HAI costs from the perspective of the payer, the total cost for each hospitalization was obtained through the Hospital's Billing Sector. Direct costs were calculated annually for 949 critical patients during 2018. Findings The reimbursement cost per hospitalization of patients with HAIs was 75% (US$2721) higher than patients without HAIs (US$1553). When a patient has an HAI, in addition to a longer length of stay (15 days), there was an extra increase (US$996) in the reimbursement cost per hospitalization. An HAI in the ICU was associated with a total direct cost eight times higher compared with patients who did not develop infections in this unit, US$11,776 × US$1329, respectively. The direct cost of hospitalization in the ICU without HAI was 56.5% less than the reimbursement (US$1329 × US$3052, respectively), whereas for the patient with an HAI, the direct cost was 111.5% above the reimbursement (US$11,776 × US$5569, respectively). Conclusion HAIs contribute to a longer stay and an eight-fold increase in direct costs. It is necessary to reinforce programmes that prevent HAIs in Brazilian hospitals.

Transthoracic echocardiography is the leading cardiac imaging modality for patients admitted with COVID-19, a condition of high short-term mortality. The aim of this study was to test the hypothesis that artificial intelligence (AI)-based analysis of echocardiographic images could predict mortality more accurately than conventional analysis by a human expert.Patients admitted to 13 hospitals for acute COVID-19 who underwent transthoracic echocardiography were included. Left ventricular ejection fraction (LVEF) and left ventricular longitudinal strain (LVLS) were obtained manually by multiple expert readers and by automated AI software. The ability of the manual and AI analyses to predict all-cause mortality was compared.In total, 870 patients were enrolled. The mortality rate was 27.4% after a mean follow-up period of 230 ± 115 days. AI analysis had lower variability than manual analysis for both LVEF (P = .003) and LVLS (P = .005). AI-derived LVEF and LVLS were predictors of mortality in univariable and multivariable regression analysis (odds ratio, 0.974 [95% CI, 0.956-0.991; P = .003] for LVEF; odds ratio, 1.060 [95% CI, 1.019-1.105; P = .004] for LVLS), but LVEF and LVLS obtained by manual analysis were not. Direct comparison of the predictive value of AI versus manual measurements of LVEF and LVLS showed that AI was significantly better (P = .005 and P = .003, respectively). In addition, AI-derived LVEF and LVLS had more significant and stronger correlations to other objective biomarkers of acute disease than manual reads.AI-based analysis of LVEF and LVLS had similar feasibility as manual analysis, minimized variability, and consequently increased the statistical power to predict mortality. AI-based, but not manual, analyses were a significant predictor of in-hospital and follow-up mortality.

Pulmonary veno-occlusive disease (PVOD) is a rare subtype of pulmonary arterial hypertension (PAH) characterised by preferential remodelling of the pulmonary venules. Differentiation from other subtypes of PAH is essential as the management can differ significantly; for example, initiation of vasodilator therapy may cause fatal pulmonary oedema in a patient with PVOD misdiagnosed with idiopathic PAH. PVOD also carries a substantially worse prognosis. Lung biopsy is required for definitive diagnosis, but this is hazardous, and ideally, should be avoided in pulmonary hypertension. Computed tomography (CT) may suggest the diagnosis, directing the patient towards specialist review. Potential distinguishing CT features between PVOD and other subtypes of PAH include interlobular septal thickening, mediastinal lymphadenopathy, and centrilobular ground-glass opacities. No evidence-based medical therapy exists for PVOD at present and lung transplantation remains the definitive treatment for eligible patients. Therefore, early radiological identification of this challenging diagnosis facilitates timely referral for transplant.

Two-terminal memristor devices were developed by growing ZnO/ZnO-Al thin films on ITO substrates using a magnetron sputtering system. The films demonstrate resistance modulation as electric voltage history is modified. A dependence on the excitation frequency (f) was found while for f

Objective Adrenocortical carcinoma (ACC) is an aggressive cancer that originates from steroidogenic cells within the adrenal cortex. The most common alteration in ACC patients is inactivation of the transmembrane E3 ubiquitin-ligase Zinc and Ring Finger 3 (ZNRF3), which is responsible for inhibiting the canonical WNT/Beta-catenin pathway. We show that inactivation of Znrf3 (ZKO) in the adrenal cortex results in an initial hyperplasia by 6-weeks, after which sexually dimorphic phenotypes arise. Materials & methods Adrenal cortex specific ablation of Znrf3 & Trp53 was achieved by Cre/LoxP recombination technology. Results In males, but not females, Znrf3 inactivation induces senescence and release of senescence associated secretory phenotype (SASP) factors. This is associated with recruitment of macrophages (Mφ) that phagocytose neoplastic cells, which is associated with regression of hyperplasia. In ACC patients, ZNRF3 inactivation is frequently associated with mutations of TP53, a key inducer of senescence, suggesting that inhibition of senescence may be required for tumorigenesis to proceed. Preliminary data suggests that combined inactivation of Trp53 and Znrf3 (DKO) results in blunted senescence, reduced Mφ recruitment and acceleration of tumorigenesis, ultimately culminating with metastatic ACC development at 6 months. Discussion Our current aim is to use this metastatic ACC mouse model to highlight the role of Mφ in immunosurveillance and tumor inhibition within the adrenal cortex.

AIM To understand the impact of COVID-19 on radiology trainee experience and well-being. MATERIALS AND METHODS A questionnaire designed to capture the impact of COVID-19 on radiology training, working patterns, and well-being was sent to all speciality trainees in a regional UK radiology school. The survey was distributed at the beginning of May 2020 and responses collected over 2 weeks. Trainees were questioned about changes that had occurred over a time period starting at the beginning of the COVID-19 pandemic. All survey responses (n=29) were anonymised and the results were subsequently analysed. RESULTS Sixty-two percent (29 of 47) of trainees within the deanery, who were spread across seven different hospital sites, responded to the questionnaire. All trainees felt that overall radiology workload had decreased in response to COVID-19. Seventy-two percent (21/29) stated that their workload had significantly decreased. Seventy percent (19/27) reported decreased subspecialty experience, and 19% (5/27) reported a complete lack of subspecialty training. Twenty-four percent (7/29) of trainees were redeployed from radiology to clinical ward-based work. Forty-eight percent reported experiencing a worsening in their well-being compared to before the pandemic. CONCLUSION The first wave of the COVID-19 pandemic had a significant impact on training and well-being. Lessons learnt from this report should help prepare for a second-wave of COVID-19 or future pandemics., Highlights • Radiology workload had significantly decreased during COVID-19 pandemic. • Covid-19 had a significant impact on radiology trainee reporting and experience. • Overall trainee well-being has significantly worsened during the pandemic. • Our results could help prepare for second-wave of COVID-19 or future pandemics.

In accordance with guidance from the Chief Medical Officer's office and the Royal College of Radiologists, the British Society of Thoracic Imaging (BSTI) recognises that based on the available evidence computed tomography (CT) currently has no upfront role in the diagnostic work-up of 2019 novel coronavirus (COVID-19) infection (https://www.rcr.ac.uk/college/coronavirus-covid-19-what-rcr-doing/rcr-position-role-ct-patients-suspected-covid-19). Nevertheless, a number of reports have been published highlighting CT appearances in COVID-19, raising the possibility of a role for CT in patient management.1, 2, 3, 4, 5 In response to these reports, the BSTI published a preliminary consensus statement on 6 March 2020.6 We discuss below what role, if any, CT would play in the detection and management of COVID-19 infection in the UK, and the logistics of imaging delivery. This role is heavily predicated on the clinical context as well as the timing of its intended use within the diagnostic pathway, especially relative to the current reference standard diagnostic test, real-time reverse transcriptase polymerase chain reaction (RT-PCR) of a pharyngeal swab,7 and other clinical and laboratory investigations. Although it may not be feasible or desirable for isolation purposes to perform a chest radiograph (CXR), we should acknowledge that pragmatically patients with a respiratory complaint are likely to present via any number of routes (primary care, emergency departments [EDs] or outpatient clinics) having already had a CXR, other than to isolation pods outside a hospital, and work-up of a respiratory complaint would usually include a CXR in such settings. Cognizant of this fact, in the following discussion we have considered how a CXR would also fit into diagnostic algorithms, and in particular, how the use of CT would alter management in settings where a CXR was or was not available. As such, we deliberate the following questions: (1) would a CT thorax contribute to management of symptomatic cases after a rapidly available RT-PCR result? (2) Would a CT thorax contribute to symptomatic cases if an RT-PCR test was not available or had to be rationed, and (a) a chest radiograph had been performed and was abnormal? (b) A chest radiograph had been performed and was normal, or was not/could not be performed? (3) Would a CT thorax contribute to the detection and management of COVID-19 in asymptomatic high-risk cases? (4) How should imaging (CT thorax or CXR) be provided? (5) What would a COVID-19 diagnostic algorithm look like? In the following discussion, a high pre-test probability is assumed for symptomatic cases, based on one or more of: clinical presentation (Pyrexia of 37.8); acute onset persistent cough, hoarseness, nasal discharge or congestion, shortness of breath, sore throat, wheezing, sneezing; and compatible laboratory abnormalities (relative lymphopenia, elevated C-reactive protein [CRP]).8

Liquid film migration is of great practical importance in materials engineering. The phenomenon depends on thermal gradients and coherency strain, but no single driving mechanism seems capable of justifying all experimental observations. On the other hand, the inevitable capillarity effects are often indeterminable due to the unknown three-dimensional geometry of the system. Here, we present evidence of liquid film migration governed primarily by the Gibbs-Thomson effect through a microstructural setup of cylindrical interfaces designed to allow clear interpretation and modeling. The experiment relies on the strong oxygen-gettering ability of tantalum fibers dispersed in a tungsten matrix and on field-enhanced diffusivity provided by pulse plasma compaction. Tantalum scavenges residual oxygen present in the W powder and, as a result, oxide films grow around the fibers. These oxide tubes, in liquid state during sintering, migrate toward the fiber axis and become surrounded by external rims of metallic Ta. An analytical description of the film evolution is implemented by combining the incoming O flux with capillarity driven migration. P ossible contributions from other mechanisms are examined and the r elevance of the Gibbs-Thomson effect to liquid film migration is established .

This study investigated the effect of resistive switching on Pt/Al2O3/Cu/Al2O3/ITO multilayer structures grown by RF/DC magnetron sputtering. A reproducible unipolar switching free forming was found only for the negative voltage. The SET and RESET processes occurred at very low voltage values, which may be advantageous for practical applications. The ON/OFF ratio was approximately five orders of magnitude for more than 103 s, which is desirable for nonvolatile memories such as resistive random-access memories (RRAMs). We explain the unipolar behavior of the characteristic (I–V) curves in terms of the formation and rupture of conductive filaments, connected via a Cu metal layer.

Hurricanes Irma and Maria hit Puerto Rico in September 2017. According to initial estimates, 90% of coffee plants were destroyed. We surveyed damage to coffee plants in 81 plots throughout the coffee-growing area of west-central Puerto Rico; we used the change in the Landsat derived Normalized Difference Vegetation Index (ΔNDVI) to estimate damage to vegetation in coffee farms. ΔNDVI values ranged from 0 to 0.36. Almost half of all plots had ΔNDVI ≤ 0.17 and had less than 20% damaged plants, whereas twelve plots in six municipalities were severely hit and had ≥80% plants damaged. Damage varied greatly among plots and even within plots. Probability of damage was significantly higher in sites with north- and south-facing slopes than in sites with east- and west-facing slopes. Neither minimum distance from the center of Hurricane Maria, altitude, precipitation nor maximum wind speeds were related to extent of damage. Coffee berry borer (Hypothenemus hampei) populations decreased after the hurricanes but recovered quickly. Understanding patterns of damage and their causes may help suggest ways to protect the coffee industry from future natural disasters.

The elemental mapping of large areas using ion beam techniques is a desired capability for several scientific communities, involved on topics ranging from geoscience to cultural heritage. Usually, the constraints for large-area mapping are not met in setups employing micro- and nano-probes implemented all over the world. A novel setup for mapping large sized samples in an external beam was recently built at the University of Sao Paulo employing a broad MeV-proton probe with sub-millimeter dimension, coupled to a high-precision large range XYZ robotic stage (60 cm range in all axis and precision of 5 μ m ensured by optical sensors). An important issue on large area mapping is how to deal with the irregularities of the sample’s surface, that may introduce artifacts in the images due to the variation of the measuring conditions. In our setup, we implemented an automatic system based on machine vision to correct the position of the sample to compensate for its surface irregularities. As an additional benefit, a 3D digital reconstruction of the scanned surface can also be obtained. Using this new and unique setup, we have produced large-area elemental maps of ceramics, stones, fossils, and other sort of samples.

Atrazine (ATZ) is a herbicide worldwide used. That can cause oxidative damage in non-target organisms, such as fish. Furthermore, the threat of exposure to pesticides together with poor nutrition is hazardous to the normal development of fish, and supplementation of the fish diet with antioxidants compounds is an alternative approach to prevent the hazardous effects of pesticide exposure. Here we aimed to investigate the capacity of diphenyl diselenide (PhSe)2 diet supplementation to improve the antioxidant defense of Cyprinus carpio (carp) exposed to environmental concentrations of ATZ. To prove the efficiency of (PhSe)2, we used the Integrated Biomarkers Response (IBR) methodology. Therefore, carp were fed for 8 weeks diets either with or without (PhSe)2 and exposed to 2 or 10µg/L of ATZ for 96h, euthanized, and their liver, gills, and muscle tissues were removed for biochemical assays. ATZ was able to cause oxidative damage from reactive species production in all tissues of carp, as observed by the increase of lipid peroxidation and protein damage. The activity of some antioxidant enzymes was inhibited in carp exposed to ATZ. However, (PhSe)2 supplementation was able to prevent this ATZ-induced damage by improving the activities of antioxidant enzymes and through antioxidant competence of (PhSe)2per se. Furthermore, IBR was shown to be a useful tool to compare treatments, even at different concentrations, and identify the efficiently antioxidant behavior of the organoselenium compound.

Melatonin is an essential human hormone produced mainly by the pineal gland from the amino acid tryptophan; it has several types of bioactivity, such as regulation of circadian rhythm, antioxidant, and DNA protection. Despite the importance of melatonin in the human body, studies on the interaction of melatonin with water molecules, considered explicitly, are quite limited in the literature. Thus, the present work reports a study on the effects of aqueous solvation on the geometric and electronic parameters of melatonin using Car-Parrinello Molecular Dynamics (CPMD). The CPMD results show that the aqueous solvation of melatonin affects mainly C14-O2 (2.176%), N17-C14 (2.169%), and N16-H21 (1.079%) bond lengths as well as O1-C3-C4 (4.37%) and O1-C3-C8 (4.241%) bond angles. These effects are attributed mainly to the H-bond formation between O1, O2, H21, and H30 melatonin sites and water molecules. The topological analysis of the H-bond electron density shows that the H-bond strength varies from weak to intermediate intensities, except for the O2 site – where it varies from weak to strong. The energetic aspect of the H-bonds was investigated using Helmholtz free energy, and the radial distribution function was employed to assess the mean residence time of the water atoms inside the first shell. The supramolecular arrangement of melatonin in the solid-state was investigated using the Hirshfeld surface technique. These findings deepen the knowledge of melatonin chemistry in the human body and help develop explanations for its biological activities.

Background Endurance training prevents cardiac dysfunction induced by menopause, but to date, no studies compared the effects of endurance training prior to menopause versus estrogen replacement therapy during menopause on heart function of rats. Methods Female Wistar rats aged three months were randomly assigned into three groups: Untrained ovariectomized rats (UN-OVX), untrained ovariectomized rats treated with estradiol (UN-OVX-E2), and ovariectomized rats previously exercised (EX-OVX). The endurance training protocol consisted of running on a treadmill at 60-70% of maximal aerobic capacity, 60 min per day, five days per week, for eight weeks. Estradiol replacement therapy consisted of silastic capsules containing the hormone for twelve days. After euthanasia, hearts were harvested, weighed and cardiac function was evaluated by the Langendorff technique. Results Both cardiac contractility and relaxation indexes improved similarly in the EX-OVX and UN-OVX-E2 rats compared to UN-OVX. Conclusion Our findings reveal similar beneficial effects between endurance training previously to menopause and estradiol replacement therapy during menopause on cardiac function of rats.

Objectives The aim of this study was to define the dynamic in vivo morphology of post-infarct ventricular septal defect (PIVSD), which has not been previously described in living patients. Background PIVSD is a devastating complication of acute myocardial infarction. Methods The anatomic features of PIVSD, as demonstrated by computed tomography or magnetic resonance imaging, were retrospectively reviewed. Results Thirty-two PIVSDs were assessed, 16 left coronary artery and 16 right coronary artery PIVSDs. PIVSDs were large (mean maximum dimension 26.5 ± 11.5 mm, mean area 5.2 ± 4.2 cm 2 ) and oval (mean eccentricity index 1.7 ± 0.5), with thin margins (diastolic mean thickness 5 mm from the edge of the PIVSD 6.4 ± 3.0mm), and only 22% of PIVSDs were entirely confined to the septum. The defects could be larger in diastole or systole. The stem of the largest available Amplatzer occluder stem (St. Jude Medical, St. Paul, Minnesota) filled only 50% of defects. Patients with small defects may survive without closure. Without closure, those with large defects die. If accepted for closure, PIVSD size and coronary territory did not predict survival >1 year (overall 60%). Conclusions This is the first detailed anatomic description of PIVSD in living patients. Defects may be larger in systole or diastole, meaning that single-phase measurement is unsuitable. Its complex nature means that the most commonly available occluder device is frequently unsuitable. Successful closure leads to prolonged survival and should be attempted where possible. This study may lead to improved patient selection, closure techniques, and device design.

Background: Recent data from the Health Brazilian Ministry indicate that in the last 10 years there has been a greater increase in the HIV prevalence among adolescents. The objective of the study is to analyze the trend of the HIV / AIDS epidemic in adolescents in the city of Rio de Janeiro. Methods: Retrospective longitudinal study with secondary data from the National System of Notifiable Diseases database of HIV-AIDS cases among adolescents aged 13 to 19 years in the city of Rio de Janeiro, Brazil. For each case analyzed, from the beginning of the epidemic until June 2017, we assessed sociodemographic information, type of transmission and if the case advanced to death. Multilevel logistic models were used to estimate the mortality AIDS odds in adolescents. Findings: There were 885 AIDS cases in adolescents from 1978 to 2017 and 445 HIV cases from 2014 to 2017. The more recent the period, the higher the number of AIDS cases. In all periods, there were more nonwhite race AIDS cases than white ones. The percentage of AIDS cases in pregnant increased in the last two periods. Over the time, the percentage of AIDS cases transmitted through sexual route increases, while the cases transmitted through blood route decreases. Adjusted analyses indicated that the odds to die by AIDS was 63% higher in male, 66% lower for those who completed elementary school, about 3 times higher for those infected by injected drugs. Interpretation: The increase in AIDS rates in adolescents in and the high incidence of HIV in the last 4 years reveal that the epidemic is not controlled. There have been advances in secondary and tertiary prevention of AIDS and setbacks in primary prevention. Funding Statement: The authors state: "This study did not receive funding." Declaration of Interest: None. Ethics Approval Statement: The Ethical Committee of Municipal Health Secretary of Rio de Janeiro approved the project, with the CAAE no 84670817.4.3001.5279 in April 16th 2018.

Pyrochlore is a common accessory in carbonatite rocks and its composition can provide useful insights on petrogenetic and post-magmatic metal-enrichment processes, especially those which favour its occurrence and concentration. Comprehensive compositional and textural characterization of a large set of pyrochlores from the Bailundo Carbonatite Complex (SW Angola) and associated surface rocks was the basis to (i) evaluate the main effects of metasomatism and weathering as causes of metal leaching or concentration; and (ii) assess pyrochlore compositions as potential petrogenetic or metallogenetic tools, with particular emphasis on pyrochlore enrichment in economic components, such as Ta, REE , U, Th and Pb, during weathering processes. Unweathered fluor- and hydroxyl-calciopyrochlores from deep-seated carbonatitic rocks (provided by a 600 m-deep drill-core) often present high Ta/Nb ratios, as well as high U and Th contents, and comparatively low overall REE concentrations. Metasomatic effects are not easy to assess, given the extreme compositional variability of these pyrochlores. On the other hand, some systematic trends can be established in pyrochlores from weathered surface rocks: these pyrochlores usually show strong depletion in most A-site cations (e.g., Na, Ca, U), and clear enrichment in Nb and in large-ion metals (e.g., Ba, Sr, Pb) usually absent in unweathered pyrochlores. REE seem to be relatively immobile and to become concentrated during weathering. Along with some REE phosphates and oxides, pyrochlore is often present in several domains of the weathering profile , occurring in the outcropping weathered carbonatite as well as in the regolith immediately overlying the intrusion. Thus, both the Bailundo carbonatite intrusion and its weathering products, concentrated inside the ridge formed by differential erosion of the fenitic aureole , constitute good exploration targets for Nb (±Ta ± REE). However, future exploration work should also include a 3-D understanding of the chemical and geological processes at work in both geological environments.

Brazilian freshwater ecosystems are continuously exposed to pesticides and domestic sewage. The Uruguay River was chosen for this study because of its international importance, as it flows through Brazil, Argentina, and Uruguay. It receives contaminants such as pesticides and domestic residues. Thus, the aim of this study to assess the accumulation of pesticides in muscle of the fish Astyanax jacuhiensis, its biochemical responses, and the presence of pesticides in water. In total, seven pesticides were registered in water from both river sites. Eight pesticides were detected in fish muscle. The biochemical responses showed that brain lipid peroxidation (LPO) and protein carbonyl (PC) in A. jacuhiensis were higher in the summer. Muscle showed the highest LPO levels in the spring and the highest PC in the summer. Liver LPO and PC levels were higher in the spring and summer. In the gills, the PC was higher in the spring and the LPO in the spring and winter. In the brain and in the gills, glutathione-S-transferase activity was high in the summer and autumn. Catalase activity was lower during the winter and spring. Non-protein thiol (NPSH) levels were lower in the brain in the winter and spring. Muscle tissue showed lower NPSH in the winter (site 1). Liver NPSH showed increased levels in liver in the spring and winter (site 2). The biochemical results clearly is related to pesticides and/or to the presence of other contaminants in the water such as metals or domestic sewage. The accumulation of pesticides in fish muscle added evidence that pesticides have been used in the area surrounding the Uruguay River. In conclusion, the biomarkers assayed in the present study could be used in future investigations considering other sampling sites along Uruguay River.

The microscopic agglutination test (MAT) is considered the “golden standard” leptospirosis serodiagnostic test, but there is little information about it as it pertains to snakes. To fill this information gap, we provide data on serovars and titers of fifty-six Crotalus durissus collilineatus sera samples that tested positive by MAT (10.1016/j.actatropica.2016.02.006 (Rodrigues et al., 2016) [5]). These data are presented in a table, along with a description of the methodology used for sample collection and serologic testing.

This study evaluated the effect of different doses of eCG (control, 300 or 400 IU) administered at progesterone (P4) device removal in suckled Bos taurus beef cows undergoing a timed artificial insemination (TAI) protocol. A total of 966 cows received a P4 insert and 2.0 mg intramuscular estradiol benzoate at the onset of the synchronization. After 9 days, P4 insert was removed, and 12.5 mg of dinoprost tromethamine and 1 mg of estradiol cypionate were administered, followed by TAI 48 hours later. Then, the cows received one of three treatments as follows: control (n = 323), 300 (n = 326), or 400 IU of eCG (n = 317). A subset (n = 435) of cows in anestrus had their ovaries evaluated using ultrasound at the time of P4 removal and at TAI. Data were analyzed by orthogonal contrasts (C): C1 (eCG effect) and C2 (eCG dose effect). Estrous occurrence (control = 53.7%, 300 IU = 70.6%, and 400 IU = 77.0%) and pregnancy per artificial insemination (control = 29.7%, 300 IU = 44.8%, and 400 IU = 47.6%) were improved by eCG treatment (C1; P = 0.0004 and P0.0001, respectively). Furthermore, the cows receiving eCG presented larger follicles at TAI (control = 13.5 ± 0.3 mm, 300 IU = 14.0 ± 0.2 mm, and 400 IU = 15.1 ± 0.3 mm; P0.0001; C1). However, there was no effect of eCG dose on any response variables studied (C2; P0.15). In conclusion, the eCG treatment administered at the time of P4 removal increased the occurrence of estrus, the larger follicles at TAI, and pregnancy per artificial insemination of suckled B taurus beef cows. Despite the greater occurrence of estrus in noncyclic cows receiving 400 IU of eCG, both eCG doses (300 and 400 IU) were equally efficient to improve pregnancy to artificial insemination.

Seven to 15% of patients with acute coronary syndrome (ACS) have nonobstructed coronary arteries, an entity that is known as myocardial infarction with nonobstructed coronary arteries (MINOCA) [(1)][1]. In these patients, cardiac magnetic resonance (CMR) can identify different underlying etiologies

Elemental composition of the steel of two ancient swords (Japanese and Damascus from a private collection) was characterized using in air IBA techniques. Our results contribute for the understanding the processes of manufacturing (hammering and quenching) and surface treatments applied in these swords. The Particle Induced X-ray Emission (PIXE) measurements along the Damascus blade allowed to identify and to trace a superficial concentration profile for the elements such Cr, Mn, Fe, Ni, Cu, Zn and As, while results for the Japanese blade showed only the presence of iron. The carbon content on the surface was also investigated using a resonant region in the Elastic Backscattering Spectrometry (EBS) measurements and the results have shown a slightly difference between the surfaces under investigation. In order to investigate the nitrogen content on surface, that could explain the hardening process, we used Nuclear Reaction Analysis (NRA) and the results shown that nitrogen content was under our detection limit for the technique (0.3% in mass). The measurements of PIXE, NRA and EBS were taken using the external beam setup installed at Lamfi – Sao Paulo/Brazil, the latter being successfully implemented for the first time in this facility.

Bryophyllum pinnatum (Lam.) Oken (Crassulaceae), popularly known in Brazil as "folha-da-fortuna", is a plant species used in folk medicine for the external and internal treatment of inflammation, infection, wound, burn, boil, ulcers and gastritis, and several other diseases. The present study aimed to perform the chemical characterization and the evaluation of the topical anti-inflammatory effect of the ethanol extract of Bryophyllum pinnatum leaves (EEBP) in acute and chronic mice ear edema models induced by different irritant agents.The EEBP chemical characterization was performed by HPLC-UV DAD. Ear edema on Swiss mice was induced by the topical application of Croton oil (single and multiple applications), arachidonic acid, phenol, capsaicin and ethyl phenylpropiolate (EPP). The topical anti-inflammatory effect of EEBP was evaluated by measuring the ear weight (acute inflammation models) and thickness (chronic inflammation model). Histopathological analyses of ear tissue samples sensitized with Croton oil (single and multiple applications) were also performed.The flavonoids rutin, quercetin, luteolin and luteolin7-O-β-d-glucoside were detected in EEBP. Topical application of EEBP significantly (P0.001) inhibited the ear edema induced by Croton oil single application (inhibition of 57%), arachidonic acid (inhibition of 67%), phenol (inhibition of 80%), capsaicin (inhibition of 72%), EPP (inhibition of 75%) and Croton oil multiple application (55% after 9 days). Histopathological analyses confirmed the topical anti-inflammatory effect of EEBP since it was observed reduction of edema, epidermal hyperplasia, inflammatory cells infiltration and vasodilation.The results suggest that EEBP is effective as a topical anti-inflammatory agent in acute and chronic inflammatory processes possibly due to inhibition of arachidonic acid pathway, which justify the traditional use of Bryophyllum pinnatum as a remedy for skin disorders.

Introduction: the standard treatment for locally advanced extra-peritoneal rectal adenocar- cinoma, consists of neoadjuvant treatment with radiotherapy and chemotherapy followed by total mesorectal excision.Objective: evaluate, retrospectively, the patients submitted to neoadjuvant therapy and surgery that presents with total remission of the lesion in the anatomopathological examination.Methods: between 2000 and 2010, 212 patients underwent surgery at the Coloproctology Unit at DMAD at FCM–UNICAMP. They were grouped as: rectosigmoidectomy and colorectal anastomosis (n = 54), rectosigmoidectomy with coloanal anastomosis (n = 41), 114 abdomi- noperineal resection of the rectum (n = 114) and other (n = 3).Results: thirty (14.2%) patients (mean age 57.6 years; 60% males) showed complete remis- sion of the rectal lesion. 4 (13.3%) had compromised lymph nodes and/or lymphatic inva- sionAt follow-up (mean 51.9 months), 4 (13.3%) presented with local recurrence (one patient) or distant metastases (two patients had liver metastasis, one had liver and lung, and one had bone metastasis). The mean survival was 86.7%.Conclusion: patients with a complete tumor response show ed an increased survival rate, however, the same patients without evidence of residual tumors could develop local recur- rence or distant metastases on a later follow-up. Resumo: Introdução: o tratamento padrão do adenocarcinoma de reto extra-peritoneal localmente avançado consiste de neoadjuvância com radio e quimioterapia, seguida de cirurgia com excisão total do mesorreto.Objetivo: avaliar, retrospectivamente, os pacientes submetidos à neoadjuvância e cirurgia, que apresentaram remissão completa da lesão no reto no exame anatomopatológico.Métodos: foram avaliados 212 doentes, operados no Serviço de Coloproctologia da DMAD da FCM-Unicamp, entre 2000 e 2010. As cirurgias realizadas foram: retossigmoidectomia e anastomose colorretal (n = 54), retossigmoidectomia com anastomose coloanal (n = 41), amputação abdominoperineal do reto (n = 114) e outras (n = 3).Resultados: trinta (14,2%) pacientes (média de idade de 57,6 anos; 60% do sexo masculino) apresentaram remissão tumoral completa no reto; destes, 4 (13,3%) tinham acometimento linfonodal e/ou invasão linfática. No seguimento pós-operatório (médio de 51,9 meses), 4 (13,3%) apresentaram recidiva local (um doente) ou metástases à distância (dois doentes com metástases hepáticas, uma hepática e pulmonar, e um outro metástase óssea). A so- brevida média do grupo foi de 86,7%.Conclusão: os pacientes com resposta tumoral completa no reto apresentaram elevada taxa de sobrevida, mas mesmo doentes sem evidência de tumor residual, podem apresentar recidiva local ou metástases à distância no seguimento tardio. Keywords: Rectal cancer Neoadjuvant therapy Surgery, Palavras-chave: Câncer retal, Terapia neoadjuvante Cirurgia

To investigate the effect of incorporating a lateral scan projection radiograph (topogram) in addition to the standard frontal topogram on excess scan length in computed tomography pulmonary angiography (CTPA) and to quantify the impact on effective dose.Fifty consecutive patients referred for exclusion of pulmonary embolism who had undergone a CTPA examination with conventional frontal topogram to plan scan length (protocol A) were compared with 50 consecutive patients who had undergone a CTPA study with frontal and additional lateral topogram for planning (protocol B) in a retrospective audit. Optimal scan length was defined from lung apex to lung base. Mean excess scan length beyond these landmarks was determined. The mean organ doses to the thyroid, liver, and stomach, as well as mean effective dose, were estimated using standard conversion factors.The mean excess scan length was significantly lower in protocol B compared to the protocol A cohort (19.5 ± 17.4 mm [mean ± standard deviation] versus 39.1 ± 20.4 mm, p0.0001). The mean excess scan length below the lung bases was significantly lower in the protocol B cohort compared to the protocol A group (7.5 ± 12.7 mm versus 23 ± 16.6 mm, p0.0001), as were the mean organ doses to the stomach (4.24 ± 0.81 mGy versus 5.22 ± 1.06 mGy, p0.0001) and liver (5.60 ± 0.64 mGy versus 6.38 ± 0.81 mGy, p0.0001). A non-significant reduction in over-scanning above the apices in protocol B was observed compared with protocol A (12 ± 8.8 mm versus 16.2 ± 13.6 mm, p = 0.07), which equated to lower mean thyroid organ dose in (3.28 ± 1.76 mGy versus 4.11 ± 3.11 mGy, p = 0.104).The present audit indicates that incorporation of a lateral topogram into the CTPA protocol, together with radiographer education, reduces excess scan length, which significantly reduces the dose to the liver and stomach, and potentially lowers the dose to the thyroid. This simple dose-saving technique can be applied to all CT investigations of the chest on all CT systems with immediate effect.

To investigate the effects of a test bolus protocol contrast medium administration on diagnostic image quality in computed tomography pulmonary angiography (CTPA).Fifty patients referred for exclusion of pulmonary embolism underwent CTPA using a test bolus protocol CTPA at 120 kVp and were compared with 50 patients undergoing CTPA using a standard bolus-tracking protocol at 120 kVp, via assessment of attenuation, signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR) seen in the pulmonary arteries (PAs). An additional group of 10 non-obese patients who underwent CTPA using a test bolus protocol performed at 100 kVp were also analysed. Mean effective dose was calculated from the dose-length product, using standard conversion factors.The test bolus protocol showed significantly higher attenuation, SNR, and CNR in the pulmonary vasculature down to the segmental level compared to bolus-tracking CTPA (p0.0001). There was no significant difference in effective dose between the test bolus and bolus tracking cohorts. The additional group of test bolus CTPA examinations performed at 100 kVp had a significantly reduced effective dose in comparison to both test bolus CTPA at 120 kVp and bolus-tracking CTPA at 120 kVp (p0.005) yet maintained mean PA attenuation to segmental level significantly better than bolus-tracking CTPA performed at 120 kVp and comparable to the test bolus cohort performed at 120 kVp.Test bolus contrast administration should be used as an optimal protocol. Performing test bolus CTPA at 100 kVp, as opposed to 120 kVp, significantly reduces dose without compromising PA attenuation in non-obese subjects.

We report on a numerical and experimental study of two-column versions of streamlined, multicolumn, semi-continuous chromatography for binary separation. The systems combine a flexible node design, cyclic flow-rate modulation, and relayed operation of the inlet/outlet ports to extend the mass-transfer zone over the largest possible length, while keeping it inside the system at all times. One advantage of these streamlined designs is the simplicity of their physical realization: regardless of the number of columns, they only require two pumps to supply feed and desorbent into the system, while the flow rates of liquid withdrawn from the system are controlled by material balance using simple two-way valves. In one case, an extra pump is needed to recirculate the fluid in closed-loop. A rigorous model-based optimization approach is employed in the optimal design of the cycles to generate solutions that are physically realizable in the experimental set-ups. The optimized schemes for two-column operation supply fresh feed into the middle of the system where the composition of the circulating fluid is closest to that of the feedstock fluid, and recover the purified products, extract and raffinate, alternately at the downstream end of the unit, while desorbent is continuously supplied into the upstream end of the system. By internally recycling part of the non-pure cut fraction, the scheme with a step of closed-loop recycling significantly reduces its solvent consumption. The feasibility and effectiveness of the reported two-column processes have been verified experimentally on the linear separation of nucleosides by reversed phase subject to 99% purity constraints on both products. It is shown that our processes compare favorably against single-column batch chromatography, steady-state recycling, and four-column, open-loop SMB, for the same amount of adsorbent; they are also better than the four-column, closed-loop SMB at high feed throughputs.