Search

No prior studies have evaluated the efficacy and safety of zolpidem and zopiclone to treat insomnia of demented patients. This randomized, triple-blind, placebo-controlled clinical trial used these drugs to treat patients with probable, late onset Alzheimer's dementia (AD) (DSM V and NINCDS-ADRDA criteria) exhibiting insomnia (DSM V criteria and nocturnal NPI scores ≥ 2). Actigraphic records were performed for 7 days at baseline and for 14 days during the treatment period in 62 patients aged 80.5 years in average and randomized at a 1:1:1 ratio for administration of zolpidem 10 mg/day, zopiclone 7.5 mg/day or placebo. Primary endpoint was the main nocturnal sleep duration (MNSD), whereas secondary outcomes were the proportion of the night time slept, awake time after sleep onset (WASO), nocturnal awakenings, total daytime sleep time and daytime naps. Cognitive and functional domains were tested before and after drug/placebo use. Three participants under zopiclone use had intervention interrupted due to intense daytime sedation and worsened agitation with wandering. Zopiclone produced an 81 min increase in MNSD (95% confidence interval (CI): -0.8, 163.2), a 26 min reduction in WASO (95% CI: -56.2, 4.8) and a 2-episode decrease in awakening per night (95% CI: -4.0, 0.4) in average compared to placebo. Zolpidem yielded no significant difference in MNSD despite a significant 22 min reduction in WASO (95% CI: -52.5, 8.3) and a reduction of 1 awakening each night (95% CI: -3.4, 1.2) in relation to placebo. There was a 1-point reduction in mean performance in the symbols search test among zolpidem users (95% CI: -4.1, 1.5) and an almost eight-point reduction in average scores in the digit-symbol coding test among zopiclone users (95% CI: -21.7, 6.2). In summary, short-term use of zolpidem or zopiclone by older insomniacs with AD appears to be clinically helpful, even though safety and tolerance remain issues to be personalized in healthcare settings and further investigated in subsequent trials. This trial was registered in ClinicalTrials.gov Identifier: NCT03075241.

Simulations of human body motion involve different fields of study such as robotics, from nano to macroscale, and biomechanics. The simulation of human motion is a challenging problem from the physical and computational perspectives and several models have been proposed in literature. Using a methodology named predictive dynamics, this work aims to propose a 2D spatial model of human walking during the single stance phase (SSP), using a flat foot adaptation. The model is based on inverse dynamics in which the angular displacements are interpolated by 5th degree B-splines. The equation of motion is developed by the recursive Lagrangian formulation due to its computational efficiency. An optimization problem is set up to obtain the control points of the B-splines using as the objective function the dynamic effort, which is a limited power supply. The constraints imposed on the motion are time-dependent, such as the torque/angle limits, and the dynamic stability criterion defined by the zero moment point (ZMP), or time-independent, such the equation of motion and step length. All the steps are explained in detail to find the dynamics of the body using the smallest number of laboratory results. The solution from the model is favorably compared to Winter’s data, in particular the ground reaction forces, which is important in many engineering applications.

Background The proximal fascia lata (FL) graft construct used for arthroscopic superior capsule reconstruction (ASCR) is openly harvested, whereas the mid-thigh FL graft construct is minimally invasively harvested. The purpose of the current study was to compare the biomechanical properties of proximal thigh and mid-thigh-harvested FL graft constructs used for ASCR. The hypothesis was that, despite the different morphological characteristics of the proximal thigh and mid-thigh FL graft constructs used for ASCR, their biomechanical properties would not significantly differ. This information may assist orthopedic surgeons in the choice of the harvest location, technique, and type of graft construct for ASCR. Methods Forty FL specimens, 20 proximal thigh and 20 mid-thigh, were harvested from the lateral thighs of 10 fresh human cadavers (6 male, 4 female; average age, 58.60 ± 17.20 years). The thickness of each 2-layered proximal thigh and 6-layered mid-thigh FL graft construct was measured. Each construct was mechanically tested in the longitudinal direction, and the stiffness and Young’s modulus were computed. Data were compared by Welch’s independent t-test and analysis of variance, and statistical significance was set at P Results The average thickness of the proximal thigh FL graft construct (7.17 ± 1.97 mm) was significantly higher than that of the mid-thigh (5.54 ± 1.37 mm) [F (1,32) = 7.333, P = .011]. The average Young’s modulus of the proximal thigh and mid-thigh graft constructs was 32.85 ± 19.54 MPa (range, 7.94 – 75.14 MPa; 95% confidence interval [CI], 23.71 – 42.99) and 44.02 ± 31.29 MPa (range, 12.53 –120.33 MPa; 95% CI, 29.38 – 58.66), respectively. The average stiffness of the proximal thigh and mid-thigh graft constructs was 488.96 ± 267.80 N/mm (range, 152.96 – 1086.49 N/mm; 95% CI, 363.63 – 614.30) and 562.39 ± 294.76 N/mm (range, 77.46 – 1229.68 N/mm; 95% CI, 424.44 – 700.34), respectively. There was no significant difference in the average Young’s modulus or stiffness between the proximal thigh and mid-thigh graft constructs (P = .185 and P = .415, respectively). Conclusion Despite the different morphological characteristics of the proximal thigh and mid-thigh FL graft constructs used for ASCR, their Young’s modulus and stiffness did not significantly differ.

Background and Aims: There are increasing reports on case series on spontaneous isolated mesenteric artery dissection, that is, dissections of the superior mesenteric artery and celiac artery, mainly due to improved diagnostic capacity of high-resolution computed tomography angiography performed around the clock. A few case–control studies are now available, while randomized controlled trials are awaited. Material and Methods: The present systematic review based on 97 original studies offers a comprehensive overview on risk factors, management, conservative therapy, morphological modeling of dissection, and prognosis. Results and Conclusions: Male gender, hypertension, and smoking are risk factors for isolated mesenteric artery dissection, while the frequency of diabetes mellitus is reported to be low. Large aortomesenteric angle has also been considered to be a factor for superior mesenteric artery dissection. The overwhelming majority of patients can be conservatively treated without the need of endovascular or open operations. Conservative therapy consists of blood pressure lowering therapy, analgesics, and initial bowel rest, whereas there is no support for antithrombotic agents. Complete remodeling of the dissection after conservative therapy was found in 43% at mid-term follow-up. One absolute indication for surgery and endovascular stenting of the superior mesenteric artery is development of peritonitis due to bowel infarction, which occurs in 2.1% of superior mesenteric artery dissections and none in celiac artery dissections. The most documented end-organ infarction in celiac artery dissections is splenic infarctions, which occurs in 11.2%, and is a condition that should be treated conservatively. The frequency of ruptured pseudoaneurysm in the superior mesenteric artery and celiac artery dissection is very rare, 0.4%, and none of these patients were in shock at presentation. Endovascular therapy with covered stents should be considered in these patients.

INTRODUCTION Autologous fat grafting (AFG) for the purpose of breast reconstruction presents difficulties during follow-up radiological exams and the oncological potential of grafted fat is uncertain. Coleman et al in 2007 confirmed that, provided a rigorous protocol is respected, the fatty tissue could be transferred under good conditions and would not interfere with mammographic follow-up, although the issue remains controversial about the oncological safety. This study aims to analyze the oncological safety of lipofilling through a meta-analysis of the current literature. METHODS We conducted a meta-analysis to evaluate the oncological safety of AFG after breast cancer (BC) surgery. We reviewed the literature published until 07/05/2020. The outcomes were overall survival (OS), disease free-survival (DFS) and local recurrence (LR). We included RCTs, cohort studies, case-control studies that evaluated women with BC diagnosis who undergone surgery followed by reconstruction with AFG. This review was performed in accordance with the PRISMA guidelines and we searched the electronic databases of Medline, EMBASE and LILACS, using the MeSH terms for AFG and BC. There was no language restriction. Methodological quality was assessed using the Downs and Black instrument and evidence quality by GRADE. We synthesized data using the inverse variance method on the log-HR scale for time-to-event outcomes using RevMan. We assessed the presence of statistical heterogeneity using the Chi2 statistic and we investigated its extension by the use of I2 statistic. RESULTS We identified 624 references. Of these, 16 studies fulfilled our eligibility criteria and were included. Funnel plot analysis revealed no publication bias. There were 8667 patients included and their mean age was 49 years. The breast surgery indications were invasive breast carcinoma (66.1%), carcinoma in situ (18.4%) and prophylactic reasons (15,5%). Ten out of 16 studies described the technique used to perform the AFG as Coleman’s. In 9 out 16 studies there was no difference in adjuvant treatment between groups, two studies do not mention if there was any difference and in 4 studies there were different adjuvant treatments in control and intervention arms. Quality assessment resulted in 11 studies being considered ‘good’, 4 studies were considered ‘fair’ and 1 study was considered poor. The HR could be extracted from four studies and an increase of OS for lipofilling group was detected with high heterogeneity (HR 0.47, 95% CI 0.32 to 0.7, p=0.0002, 2331 patients, I2= 84%, high certainty evidence). Funnel plot analysis indicated a high risk of publication bias from one study, Krastev et al, which included 587 patients. The analysis excluding this article found no difference in OS between lipofilling group and control and publication bias was not detected (HR 0.9, 95% CI 0.53 to 1.54, p=0.71, 1744 patients, I2= 58%, high certainty evidence). The HR for DFS could be extracted from six studies and no difference was found between lipofilling group and control (HR 1.01, 95% CI 0.73 to 1.38, p=0.96, 2755 patients, I2= 0%, high certainty evidence). The HR for LR could be extracted from ten studies and no difference was found between lipofilling group and control (HR 0.86, 95% CI 0.66 to 1.12, p=0.43,6839 patients, I2= 1%, moderate certainty evidence). Funnel plot analysis indicated a publication bias from one study (Petit et al) that included only DCIS tumors. The analysis excluding this article did not demonstrate difference in results. (HR 0.8, 95% CI 0.61 to 1.05, p=0.94, 6662 patients, I2= 0%, moderate certainty evidence) CONCLUSION Based on published data, AFG is a safe technique of breast reconstruction for patients that undergone BC surgery. According to our findings, AFG did not affect OS, DFS or LR. These data have moderate to high certainty and additional studies probably will not change the current evidence. Citation Format: Rodrigo Goncalves, Bruna S Mota, Bruno Sobreiro-Lima, Marcos D Ricci, José M Soares, Jr, Edmund C Baracat, José R Filassi. The oncological safety of lipofilling after breast cancer surgery: A meta-analysis [abstract]. In: Proceedings of the 2020 San Antonio Breast Cancer Virtual Symposium; 2020 Dec 8-11; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2021;81(4 Suppl):Abstract nr PS1-22.

The severe acute respiratory syndrome caused by the new coronavirus (SARS-CoV-2), termed COVID-19, has been highlighted as the most important infectious disease of our time, without a vaccine and treatment available until this moment, with a big impact on health systems worldwide, and with high mortality rates associated with respiratory viral disease. The medical and scientific communities have also been confronted by an urgent need to better understand the mechanism of host-virus interaction aimed at developing therapies and vaccines. Since this viral disease can trigger a strong innate immune response, causing severe damage to the pulmonary tract, immunotherapies have also been explored as a means to verify the immunomodulatory effect and improve clinical outcomes, whilst the comprehensive COVID-19 immunology still remains under investigation. In this review, both cellular and molecular immunopathology as well as hemostatic disorders induced by SARS-CoV-2 are summarized. The immunotherapeutic approaches based on the most recent clinical and nonclinical studies, emphasizing their effects for the treatment of COVID-19, are also addressed. The information presented elucidates helpful insights aiming at filling the knowledge gaps around promising immunotherapies that attempt to control the dysfunction of host factors during the course of this infectious viral disease.

We aimed to evaluate the influence of shift work rotation, circadian misalignment and being overweight/obese on psychomotor performance throughout a complete shift rotation schedule. The study was conducted with 30 males working rotating shifts from a mining company under real life conditions. Individuals were evaluated over seven days in a shift schedule carried out as follow: two shifts in the morning (D1 and D2), two shifts in the afternoon (D3 and D4), 24 hour free day (D5) and two shifts at night (D6 and D7). Work performance was evaluated by psychomotor vigilance task tests (PVT), and actigraphy was used to characterise the rest-activity rhythm based on intradaily variability (IV) and interdaily stability (IS) of nonparametric functions. We found a significant effect of the shift, body mass index (BMI), IS and IV on lapses in attention. More lapses occurred on D7 than D1, D2, D3 and D4 of the schedule shift. The obese group presented a higher number of lapses in attention than eutrophic. The interaction between day and IS showed that less synchronised individuals presented a higher number of lapses in attention on D7 than D1 and, for the interaction between day and IV, more fragmented individuals presented a higher number of lapses in attention on D7 than D6. We conclude that higher BMI, lower synchronisation and higher fragmentation of the rest-activity pattern influenced lapses in attention throughout the shift rotation.

AimsTo correlate the ‘Residual Cancer Burden’ (RCB) index with overall survival (OS) and disease-free survival (DFS) in women undergoing neoadjuvant chemotherapy at the Cancer Institute of the State of São Paulo.MethodsWe analysed the medical records of patients with breast cancer who underwent neoadjuvant chemotherapy and breast surgery, from 2011 to December 2017. Variables analysed were age, clinical and pathological staging, molecular subtype, number of recurrences or metastases, number of deaths, value and class of the RCB index. We used the Kaplan-Meier and the log-rank statistics to evaluate the possible association between RCB and OS and DFS. A regression model was used to determine the independent association of the RCB with the outcomes controlling for confounding factors.Results347 patients were included in the analysis with a mean age of 49.39 years. Initial clinical staging was T3 in 57.9% of patients and 43.8% of patients had N1 axillary status. Survival analysis showed a statistically significant better prognosis for the RCB 0 (pCR) subgroup compared with RCB 1, 2 and 3 (log rank p=0.01). In a multivariate analysis, only the RCB classification showed a statistically significant correlation with DFS (RCB 1, HR 6.9, CI 1.9 to 25.4, p=0.004; RCB 2, HR 4.2, CI 1.6 to 10.8, p=0.03; and RCB 3, HR 7.6, CI 2.76 to 20.8, p=0.00).ConclusionWe demonstrated a positive and significant relationship between the RCB index and the risk of relapse and death.

Breast cancer is a disease that affects many women throughout the world. It is the second most common type of cancer. The early diagnosis of the disease is relevant for increasing the chances of the patient recovering. Thermography is a promising technique that might be used to help the early diagnosis of breast cancer. In this work, we use three state of the art CNNs (VGG-16, Densenet201, and Resnet50) combined with transfer learning to classify static thermography images (sick and healthy). In our experiments, the best results have an F1-score of 0.92, 91.67% for accuracy, 100% for sensitivity, and 83.3% for specificity obtained with the Densenet using 38 static images for each class.

PURPOSE Pellucid marginal degeneration (PMD) is a bilateral corneal ectatic disorder, characterized by thinning of the inferior cornea. Numerous surgical procedures have been described in the literature, and there is a lack of consensus regarding the best available surgical management. Recently, full-thickness intrastromal lamellar keratoplasty (ILK) was described as an option for treating PMD and emerged as a promising technique. However, ILK results in an irregular surface, leading to a significant residual against-therule (ATR) astigmatism. METHODS This study describes a variation of the ILK technique, using a partial-thickness graft to treat 2 cases of PMD. RESULTS At the final follow-up, both patients improved visual acuity and had their mean simulated keratometry flattened, although a residual ATR astigmatism remained. CONCLUSIONS The ILK technique modification might lead to a more regular thickness pattern, although it did not seem efficient in reducing the ATR astigmatism.

The 3D deployable frames studied in this work are structures composed of elastic beam elements connected by complex joints. During transformation a controlled snap-through allows the instantaneous stabilization of the structure in an open and in a closed, compact configuration. The mechanics of the transformation is highly nonlinear, since it relies on finite rotations of the structural elements. It is also strongly influenced by geometrical features required for a manufacturing-ready design, such as the finite size of structural elements and sufficient spacing between the beams. These features are generally disregarded in the usual wireframe-based design, but they are taken into account in this work by applying a tailor-made corotational 3D joint finite element, developed to incorporate naturally finite joint size, finite nonlinear joint stiffness and friction effects. The formulation of the proposed joint FE is presented and the performance of the numerical implementation is verified using computational benchmarks. The joint FE is then applied to the numerical investigation of the transformation response of bistable deployable structures from a single module case to large, complex structures. Among other findings, it is shown that the incorporation of finite joint size and beam spacing in the numerical model leads to a different snap-through mechanism that significantly reduces the peak force required for transformation, which could be a basis for future design strategies. Additionally the performance of structures applying the bistable structural pattern on the whole structure or following an entirely modular design (interconnected single modules) is also compared, as a function of the structural size., info:eu-repo/semantics/published

The incidence and mortality of breast cancer are rising in the whole world in the past few decades, adding up to a total of around two million new cases and 620,000 deaths in 2018. Unlike what occurs in developed countries, most of the cases diagnosed in the developing world are already in advanced stages and also in women younger than 50 years old. As most screening programs suggest annual mammograms starting at the age of 50, we can infer that a considerable portion of the new breast cancer cases is missed with this strategy. Here, we will propose the adoption of an alternative hierarchical patient flow, with the creation of a diagnostic fast track with referral to timely treatment, promoting better resources reallocation favoring the least advantaged strata of the population, which is not only ethically acceptable but also a way of promoting social justice.

Studying communities at different stages of urbanisation and industrialisation can teach us how timing and intensity of light affect the circadian clock under real-life conditions. We have previously described a strong tendency towards morningness in the Baependi Heart Study, located in a small rural town in Brazil. Here, we tested the hypothesis that this morningness tendency is associated with early circadian phase based on objective measurements (as determined by dim light melatonin onset, DLMO, and activity) and light exposure. We also analysed how well the previously collected chronotype questionnaire data were able to predict these DLMO values. The average DLMO observed in 73 participants (40 female) was 20:03 ± 01:21, SD, with an earlier average onset in men (19:38 ± 01:16) than in women (20:24 ± 01:21; P ≤ .01). However, men presented larger phase angle between DLMO and sleep onset time as measured by actigraphy (4.11 hours vs 3.16 hours; P ≤ .01). Correlational analysis indicated associations between light exposure, activity rhythms and DLMO, such that early DLMO was observed in participants with higher exposure to light, higher activity and earlier light exposure. The strongest significant predictor of DLMO was morningness-eveningness questionnaire (MEQ) (beta=-0.35, P ≤ .05), followed by age (beta = -0.47, P ≤ .01). Sex, light exposure and variables derived from the Munich chronotype questionnaire were not significant predictors. Our observations demonstrate that both early sleep patterns and earlier circadian phase have been retained in this small rural town in spite of availability of electrification, in contrast to metropolitan postindustrial areas.

Uraemic encephalopathy (UE) is rarely associated with acute kidney injury or chronic kidney disease in domestic animals, and we now report the first case in a cat. The animal presented with hypothermia, apathy, lethargy, depression, severe dehydration, uraemic breath, elevated serum urea nitrogen and creatine concentrations, and eventual seizures and coma prior to death. Gross necropsy findings included severe bilateral renal scarring, ulcerative stomatitis and glossitis, and uraemic gastropathy. Microscopic lesions of diffuse interstitial fibrosis, multifocal mineralization and lymphoplasmacytic interstitial nephritis were seen in the kidneys. There was symmetrical, bilateral spongy vacuolation of the white matter of the basal nuclei and cerebellum and Alzheimer type II astrocytes in the cerebral cortex and hippocampus. Glial fibrillary acid protein immunolabelling was absent or faint in astrocytes of the cerebral grey matter. UE should be included in the differential diagnosis in animals with chronic kidney disease and neurological signs.

Neutron/gamma discrimination techniques are widely applied in scintillator-based neutron diagnostics for present nuclear fusion tokamak experiments (e.g. JET – Neutron Camera and compact neutron spectrometer) and will also be necessary for neutron diagnostics of up-coming machines (e.g. ITER Radial Neutron Camera). Neutron/gamma discrimination in scintillators relies on the fact that the detectors output pulses have different shapes depending on the impinging particle; several discrimination techniques are described in literature such as the charge-integration, curve-fitting and pattern recognition [1]. This paper aims at describing a new technique for neutron/gamma discrimination in scintillators based on trapezoidal filtering, which targets Field Programmable Gate Array (FPGA) implementation due to its recursive nature. Furthermore its capability to restore the baseline of each detected pulse and the fact that the output signals are shorter than the correspondent incoming pulses, points this technique as a promising solution for applications in high count rate conditions. First results coming from the application of a real-time FPGA implementation of the trapezoidal filter to simulated neutron/gamma data including pile-up events and to real scintillator data will be presented.

Marker-based motion tracking systems are the golden standard for human motion analysis, however such systems are expensive, non-portable and require long time subject preparation. The Kinect One se...

BACKGROUND: The aim of this study was to assess the oncological efficacy of breast conserving surgery (BCS) after neoadjuvant chemotherapy in patients with local advanced breast cancer. PATIENTS AND METHODS: A retrospective cohort study was conducted with locally advanced breast cancer invasive (Stage IIb to III) treated at ICESP, an oncologic referral center between 2008 and 2016. Endpoints were disease free survival (DFS), local disease free survival (LDFS) and overall survival (OS). Multivariable analyses were performed using Cox proportional hazards models. RESULTS: 530 patients were included, 26% (138) were stage IIB, 41.9% (222) IIIA, 29.6% (157) IIIB and 2.5% (13) IIIA. 88.8% (470) were invasive ductal carcinoma. The mean age was 51.5(23-95). 95.5% and 4.5% were submitted Neoadjuvant Chemotherapy and Hormone therapy, respectively. The BCS were performed in 24.5% (130) patients versus 75.5% (400) of mastectomies. The mean follow up was 36.4(0.16-80.2) months. There were no differences in local disease free-survival 59 (95%CI 58-61) versus 60 (95%CI 57-60); p=0.4 and overall survival 56.2 (95%CI 52-60) versus 59.3(95%CI 53-65); p= 0.24 for mastectomy and BCS. The disease free survival was lower at mastectomy group 51.4 (95%CI 49-53) versus 56,8 (95%CI 53-59); p=0.01. Logistic regression models were significant only for cancer stage both patterns, although the results were better for masses, particularly when kinetic assessments were included (LR 12.8; p = 0.005) CONCLUSION: In our population, the BCS does not affect the overall and local disease-free survival rates, which seems to be safe to perform in patients who desire to conserve the breast after neoadjuvant treatment. Citation Format: Boufelli G, Mota BS, Franca FC, Doria MT, Maesaka JY, Ricci MD, Piato JRM, Rocha FBC, Giribela AHG, Gonçalves R, Masili-Oku S, Mano MS, Chala LF, Thompson BM, Baracat EC, Filassi JR. Does conservative surgery treatment for locally advanced breast cancer safe after neoadjuvant treatment? [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P2-12-11.

The Radial Neutron Camera (RNC) diagnostic is a neutron detection system with multiple collimators aiming at characterizing the neutron emission that will be produced by the ITER tokamak. The RNC plays a primary role for basic and advanced plasma control measurements and acts as backup for system machine protection measurements. During the RNC system level design phase the following real-time data processing algorithms were developed to assess RNC data throughput needs and measurement performances: (i) real-time data compression block (ii) real-time calculation of the neutron emissivity radial profile, based on Tikhonov regularization, starting from the line-integrated measurements, the line-of-sight geometry and using the magnetic flux information [1] (iii) real-time calculation of the neutron emissivity profile using a-priori trained neural networks, the line-integrated measurements and the magnetic flux information (the best output from different neural networks being evaluated by a figure of merit that maps the neutron emissivity profile to the original line-integrated measurements) [2] . This paper presents results for the processing times of the various algorithms and their minimum control cycle for different conditions, such as number of lines of sight, number of magnetic flux surfaces and measurement error on the line integrated RNC measurements.

The new multichannel X-mode reflectometer installed on ASDEX Upgrade measures the plasma density profile evolution at different positions in front of the ICRF antenna. The reflectometer operates in the extended U-band (40–68 GHz) microwave region, measuring density profiles up to 2 × 1019 m−3 with magnetic fields between 1.5 T and 2.7 T. In this heterodyne reflectometer architecture, the signal reflected by the plasma is down-shifted and quadrature detectors demodulate its in-phase and quadrature (IQ) components. In this work we analysed the acquired IQ signals from the different reflectometer antennas, and describe the waveguide dispersion calibration and filtering of the raw signal. The effect of spurious reflections, such as the multiple reflections from the ICRF antenna metal straps, are analysed and taken into account on the data processing software. In high plasma density and high magnetic field scenarios, both the lower and upper X-mode cut off frequencies are detected in the probing range. The first fringe (FF) reflection of the upper cut off indicates the start of the plasma signal and must be determined robustly to reduce density profile errors. Existing FF estimation algorithms based on signal amplitude and spectral information may still fail in the presence of both upper and lower cut off reflections.

In this work, the development of rational explicit equations for distortional buckling critical stress of lipped channel columns subject to uniform compression is presented. An energy-based approach is adopted along with two different assumed buckled shapes (models) to obtain the analytical expressions. In Model 1, stiffened flange is assumed rigid, i.e., transverse wall bending is neglected, whereas in Model 2 the flange plate flexibility is taken into account. An analytical procedure to determine warping stresses based on cross-section displacements and considering that flange-stiffener assembly rotation center does not coincide with web-flange fold-line is described. To validate proposed equations, a parametric analysis is carried out for lipped channels with flange-to-web width ratio, bf/bw, ranging from 0.2 to 1.0 and lip-to-web width ratio, bs/bw, from 0.1 to 0.4. Results are compared to those obtained with a generalized beam theory (GBT) software for ‘pure’ distortional mode and it is shown that, within the range of typical geometries used in industry, average differences are approximately 1.062 ± 0.073 and 0.998 ± 0.001 for Models 1 and 2, respectively. The linear (natural) coupling of pure distortion and local/global deformation modes is also briefly described and its influence on the critical loads is discussed. Finally, comparison is made to benchmark methodologies currently used in design standard and specifications. The obtained results indicate that proposed equations are reliable and valuable for practical design applications.

The concept of geodiversity, which refers to the diversity of abiotic elements of nature, is passing through a period of methodological development. The concept has a great potential of becoming an efficient territorial management tool as the physical environment is the basis in which biodiversity and human societies develop. However, this potential has not yet been achieved because the methodologies of practical application are not consistent enough. This work aimed to contribute to this issue by applying a method of quantitative mapping of geodiversity at a landscape scale and integrating it to an urban growth map in Armacao dos Buzios municipality, located in Rio de Janeiro State, Brazil. On the basis of some of the most important previous proposals, a Geodiversity Index Map of Armacao dos Buzios was created, which shows the richness and distribution of the elements of geodiversity (geology, geomorphology, soils, and hydrology) throughout the territory. With this product, it was possible to identify the most geodiverse areas of the municipality. After that, an Urban Growth Map of Armacao dos Buzios was created by the photointerpretation of aerial photographs from 1976 to 2006, in which the urban areas in both dates were mapped, allowing the observation of how much the urban area grew during this time. By integrating these two maps, we were able to quantify the impacted areas in relation to the geodiversity. The results showed that urbanization impacted a significant portion of the areas classified with high and very high geodiversity indices, highlighting that the physical environment, and consequently the biodiversity, are under serious threat, and it must be taken into account in public policies and territorial management. In addition, this work aimed to contribute to the methodological development of the concept of geodiversity, which still needs more tests and discussions to be improved and widely applied, especially in nature conservation issues.

Duponchelia fovealis Zeller is a polyphagous insect that has been recently reported attacking strawberry plants (Fragaria x ananassa Duchesne). Despite its economic importance there are few studies on this pest because it is difficult to rear it in the laboratory. With a constant supply of insects, studies on alternative methods of pest control can be conducted. This study aimed at developing an artificial diet for rearing D. fovealis with biological characteristics similar to those reared on their natural diet. This study was carried out in a climate-controlled room (25°C ± 2°C, RH 70% ± 10%, and 14L : 10D). The natural diet consisted of 'San Andreas' strawberry leaves (D1), while the artificial diet (D2) was developed in which beans, casein, soy protein, yeast and wheat germ are used as sources of protein. Five instars were identified. D. fovealis completed its life cycle in 38 and 40 days when fed D1 and D2, respectively. Survival was highest for the larvae fed the artificial diet. Females fed D1 lay a mean of 300.2 ± 62.3 eggs, while those fed D2, 220.3 ± 41.8 eggs. The artificial diet is suitable for the continuous rearing of D. fovealis in the laboratory.

This study aims to assess the prevalence, distribution, and etiological profile of intestinal parasitism in children living in periurban areas in Cachoeiras de Macacu, Rio de Janeiro, Brazil. A community-based cross-sectional survey (n = 479) was carried out. Prevalence of infection with G. duodenalis and E. histolytica/E. dispar was 8.6% (n = 41) and 13.4% (n = 64), respectively. Infection with G. duodenalis was significantly more frequent among children living in poor families (24/187 (12.8%) vs. 16/272 (5.9%); prevalence ratio (PR) = 2.18; 95% confidence interval (CI) = 1.19–3.99; p=0.011). This difference was also significant for infection with any pathogenic parasite (43/187 (23%) vs. 40/272 (14/7%); PR = 1.56; 95% CI = 1.06–2.30; p=0.026). In addition, people residing in houses with more than four inhabitants showed significantly higher positivity for infections with G. duodenalis and with E. histolytica/E. dispar (22/138 (15.9%) vs. 16/311 (5.1%); PR = 3.09; 95% CI = 1.68–5.71; p<0.001 for G. duodenalis and 32/138 (23.2%) vs. 30/311 (9.6%); PR = 2.40; 95% CI = 1.52–3.79; p<0.001 for E. histolytica/E. dispar). Laboratory diagnosis of protozoan enteric infections and effective drugs for their treatment are unmet goals in the primary health care system. Therefore, giardiasis and amebiasis are neglected conditions.

Educational assessment usually considers a contextual questionnaire to extract relevant information from the applicants. This may include items related to socio-economical profile as well as items to extract other characteristics potentially related to applicant’s performance in the test. A careful analysis of the questionnaires jointly with the test’s results may evidence important relations between profiles and test performance. The most coherent way to perform this task in a statistical context is to use the information from the questionnaire to help explain the variability of the abilities in a joint model-based approach. Nevertheless, the responses to the questionnaire typically present missing values which, in some cases, may be missing not at random. This paper proposes a statistical methodology to model the abilities in dichotomous IRT models using the information of the contextual questionnaires via linear regression. The proposed methodology models the missing data jointly with the all the observed data, which allows for the estimation of the former. The missing data modelling is flexible enough to allow the specification of missing not at random structures. Furthermore, even if those structures are not assumed a priori, they can be estimated from the posterior results when assuming missing (completely) at random structures a priori. Statistical inference is performed under the Bayesian paradigm via an efficient MCMC algorithm. Simulated and real examples are presented to investigate the efficiency and applicability of the proposed methodology.

Breast cancer kills a large number of women around the world. Infrared thermography is a promising screening technique which does not involve harmful radiation for the patient and has a relatively low cost. This work proposes an approach for classifying patients into three different classes using infrared images: healthy patients, patients with benign changes and patients with cancer (malignant changes). A set of features is extracted from each image and two approaches are used in the classification process. The first is based on Artificial Neural Networks while the second is based on Support Vector Machines. The proposed approach shows a great potential to be used as a screening diagnosis technique for early breast cancer detection.

Background It is well-established that sleep regulates immune functions. Immunological functions are dependent on circadian rhythms and regular sleep as both have an impact on the magnitude of immune responses following antigenic challenge (eg, in vaccination). Here we investigated whether nocturnal shift work can influence post-vaccination response. Methods Thirty-four healthy workers (23 females) working either nocturnal or diurnal shifts (17 in each group) received the meningococcal C meningitis vaccine. Sleep was recorded polysomnographically (PSG) and with actigraphy. Humoral and cellular responses were assessed after vaccination. Results Night workers showed decreased N3 stage and REM sleep duration, increased inflammatory mediators (TNF-α and IL-6 levels), and a weak specific humoral response to vaccination associated with reduced CD4 T lymphocytes, reduced plasmacytoid dendritic cells, reduced prolactin levels, increased TReg and increased IL-10 levels. In addition, the decrease in total sleep time and circadian rhythm alterations were associated with a reduced humoral response post-vaccination. Conclusions Our findings provide novel evidence concerning immune alterations of shift work on workers' health based on real-life circumstances. In association with circadian components, sufficient sleep time and rhythm synchronization were important for the development of the Ag-specific immune response, suggesting that the humoral response to vaccination may be impaired in individuals with chronic sleep restriction and circadian misalignment.

The ITER project demanding operating conditions, as well as other enabling experiments in relevant fusion projects, present new challenges to the diagnostics, control and instrumentation. The most critical requirements relate to the high acquisition rates (up to some gigasample per second), high physical event rate (up to several megaevents per second), need to handle enormous quantities of data in long experimental pulses (up to 30 minutes) and highly complex control and diagnostic algorithms. Radiation hardness of all equipment involved must also be taken into account for high magnetic fields as well as neutron irradiation in the fusion devices port cells. The implementation of state-of-the-art designs were tested both with in-house built prototypes and complete systems installed in the major international fusion experiments. The main technologies used include Advanced Telecommunications Computing Architecture (ATCA), high speed electronic devices for signal digitization, complex real-time algorithms for physics analysis, control and data compression implemented in high-performance computing using field-programmable gate arrays and multicore processor architectures. The control and data acquisition group at Instituto de Plasmas e Fusao Nuclear (Instituto Superior Tecnico - Lisboa) has conducted several projects and studies for the development of reliable high-performance processing tools and instrumentation for the diagnostics and control of fusion devices capable of complying with the most demanding requirements.

Online Learning of non-stationary data streams is a challenging task. This work presents an online training method for a Single hidden Layer Feedforward neural Network (SLFN) that learns sample-by-sample, using an adjustable sliding window to adapt the network when data has changed. The method presents a fast training procedure, estimating hidden and output layer parameters independently. Tests with four synthetic datasets showed a good accuracy and quick recovery after drift occurrences. The proposed method is also applied to a real dataset from an industrial process in order to address the anomaly detection task, with the network acting as a classifier. Results show that the method is able to detect drifts prior to anomalies in the pre-fault periods, in the real situation that appeared in the industrial dataset.

The elastic von Mises truss model is a prototype for bi-stable structures. It allows a deep understanding of the static and dynamic buckling of several planar and spatial truss systems and shallow lattice shell structures, including the geodesic dome, and has a theoretical and practical interest. This structure has a highly nonlinear response in the presence of static and dynamic loads. The geometric nonlinearity is particularly significant even at low load levels when this structure is shallow. This paper presents an exact nonlinear formulation, which is used to investigate the mechanics of erosion and escape from the safe pre-buckling well. As the static pre-load increases, the probability of escape increases in a nonlinear manner. Permanent and transient escapes, as well as the influence of random noise, on the dynamic buckling load are investigated. To increase the load carrying capacity, a method for controlling the global nonlinear dynamics for the elastic von Mises truss is employed. The control method consists of the (optimal) elimination of homoclinic intersection by properly adding superharmonic terms to a given harmonic excitation. Permanent and transient basins of attraction are obtained. The results highlight the complex nonlinear dynamics of this class of structures and the effectiveness of the control method in increasing the integrity of the basins of attraction of the system and its practical safety.

Summary We propose a hidden Markov mixture model for the analysis of gene expression measurements mapped to chromosome locations. These expression values represent preprocessed light intensities observed in each probe of Affymetrix oligonucleotide arrays. Here, the algorithm BLAT is used to align thousands of probe sequences to each chromosome. The main goal is to identify genome regions associated with high expression values which define clusters composed of consecutive observations. The model proposed assumes a mixture distribution in which one of the components (the one with the highest expected value) is supposed to accommodate the overexpressed clusters. The model takes advantage of the serial structure of the data and uses the distance information between neighbours to infer about the existence of a Markov dependence. This dependence is crucially important in the detection of overexpressed regions. We propose and discuss a Markov chain Monte Carlo algorithm to fit the model. Finally, the methodology proposed is used to analyse five data sets representing three types of cancer (breast, ovarian and brain).

The aim of this paper is to analyse the influence of the nonlinear modal coupling on the nonlinear vibrations of a simply supported cylindrical panel excited by a time dependent transversal load. The cylindrical panel is modeled by the Donnell nonlinear shallow shell theory and the lateral displacement field is based on a perturbation procedure. The axial and circumferential displacement are described in terms of the obtained lateral displacement, generating a precise low-dimensional model that satisfies all transversal boundary conditions. The discretized equations of motion in time domain are determined by applying the standard Galerkin method. Various numerical techniques are employed to obtain the cylindrical panel resonance curves, bifurcation scenario and basins of attraction. The results show the influence of geometry and the nonlinear modal coupling on the nonlinear response of the cylindrical panel.

This paper investigates the nonlinear dynamics and stability of the shallow von Mises truss, which is a prototype for buckling analysis of several planar and spatial truss systems and shallow lattice shell structures, including the geodesic dome, and which has a theoretical and practical interest in many engineering fields. These structural systems are liable to limit point instability and may fail at load levels well below the theoretical limit point load due to complex nonlinear phenomena that reduce the safety and the dynamic integrity of the structure; this often occurs as a consequence of the erosion of the basins of attraction of the safe pre-buckling solutions. So, it is vital to increase the safety of the structure in a dynamic environment. In this paper a method for controlling the global nonlinear dynamics of mechanical systems is applied to the shallow von Mises truss. The method consists of the (optimal) elimination of homoclinic intersection by properly adding superharmonic terms to a given harmonic excitation. By means of the solution of an appropriate optimization problem, it is possible to select the amplitudes and the phases of the added superharmonics in such a way that the manifolds distance is as large as possible. This methodology is here applied to increase the integrity of the basins of attraction of the system and consequently its practical safety.

Repurposing of drugs to treat tuberculosis (TB) has been considered an alternative to overcome the global TB epidemic, especially to combat drug-resistant forms of the disease. Mefloquine has been reported as a potent drug to kill drug-resistant strains of Mycobacterium tuberculosis. In addition, mefloquine-derived molecules have been synthesised and their effectiveness against mycobacteria has been assessed. In this work, we demonstrate for the first time the activities of mefloquine and its oxazolidine derivative compound 1E in a murine model of TB infection following administration of both drugs by the oral route. The effects of associations between mefloquine or 1E with the clinically used antituberculosis drugs isoniazid, rifampicin, ethambutol, moxifloxacin and streptomycin were also investigated. Importantly, combination of mefloquine with isoniazid and of 1E with streptomycin showed a two-fold decrease in their minimum inhibitory concentrations (MICs). Moreover, no tested combinations demonstrated antagonist interactions. Here we describe novel evidence on the activity of mefloquine and 1E against a series of quinolone-resistant M. tuberculosis strains. These data show MICs against quinolone-resistant strains (0.5–8 µg/mL) similar to or lower than those previously reported for multidrug-resistant strains. Taking these results together, we can suggest the use of mefloquine or 1E in combination with clinically available drugs, especially in the case of resistant forms of TB.

The authors regret there were mistakes in Table 12 concerning adjusted risk estimation for surgical site infections of the lower limbs. The authors would like to thank Dr Tresson and colleagues for their careful reading and to apologise for any inconvenience. Table 12 should be read as below

Context Metabolic syndrome (MetS) is a complex condition comprising a ‘clustering’ of components representing cardiometabolic risk factors for heart disease and diabetes; its prevalence rate is high and consequences serious. Evidence suggests that light exposure patterns and misalignment of circadian rhythms might contribute to MetS etiology by impacting energy metabolism and glucose regulation. Objective We hypothesised that individuals with MetS would show disrupted circadian and sleep parameters alongside differences in light exposure profiles. We investigated this using data from a cohort study in Brazil. Methods Data from 103 individuals from the Baependi Heart Cohort Study aged between 50 and 70 were analysed. Motor activity and light exposure were measured using wrist-worn actigraphy devices. Cardiometabolic data were used to calculate the number of MetS components present in each participant, and participants grouped as MetS/non-MetS according to standard guidelines. Between-group comparisons were made for the actigraphy measures; additionally, correlation analyses were conducted. Results Motor activity and circadian profiles showed no differences between groups. However, the MetS group presented lower light exposure during the day and higher light exposure at night. Correlation analyses, including all participants, showed that greater daytime light exposure and greater light exposure difference between day and night were associated with reduced MetS risk (a lower number of MetS components). Also, the light exposure difference between day and night correlated with body mass index across all participants. Conclusions The observed results suggest a direct association between light exposure and MetS which appears to not be attributable to disruptions in circadian activity rhythm nor to sleep parameters. This link between light exposure patterns and MetS risk could inform possible prevention strategies.

Background: Appropriate dietary recommendations represent a key part of secondary prevention in cardiovascular disease (CVD). We evaluated the effectiveness of the implementation of a nutritional program on quality of diet, cardiovascular events, and death in patients with established CVD. Methods: In this open-label, multicenter trial conducted in 35 sites in Brazil, we randomly assigned (1:1) patients aged 45 years or older to receive either the BALANCE Program (experimental group) or conventional nutrition advice (control group). The BALANCE Program included a unique nutritional education strategy to implement recommendations from guidelines, adapted to the use of affordable and regional foods. Adherence to diet was evaluated by the modified Alternative Healthy Eating Index. The primary end point was a composite of all-cause mortality, cardiovascular death, cardiac arrest, myocardial infarction, stroke, myocardial revascularization, amputation, or hospitalization for unstable angina. Secondary end points included biochemical and anthropometric data, and blood pressure levels. Results: From March 5, 2013, to Abril 7, 2015, a total of 2534 eligible patients were randomly assigned to either the BALANCE Program group (n = 1,266) or the control group (n = 1,268) and were followed up for a median of 3.5 years. In total, 235 (9.3%) participants had been lost to follow-up. After 3 years of follow-up, mean modified Alternative Healthy Eating Index (scale 0-70) was only slightly higher in the BALANCE group versus the control group (26.2 ± 8.4 vs 24.7 ± 8.6, P

The ITER Radial Neutron Camera (RNC) Data Acquisition (DAQ) prototype is based on the PCIe protocol as the interface to be used between the I/O unit and the host computer, allowing the scalability of the final RNC DAQ system. The prototype architecture comprises two digitizer modules with two channels in each, installed in the host computer and the maximum produced data throughput is up to 1.6 GB/s per board, allowing a sustainable 2 MHz peak event to cope with the long plasma discharges, up to half an hour. The Linux Device Driver provides the interface between the hardware and the host applications running on a high-performance computer, which receives the acquired data through the Direct Memory Access (DMA) channels. The preliminary tests show that the Linux kernel miss some hardware interrupts when the time between interrupts is in the microsecond scale, which implies data loss if a traditional read technique based on interrupt handling is implemented. The direct usage of the polling mechanisms to retrieve the data is not suitable as the variable event rate over the same discharge does not allow to define an optimal fixed-time to retrieve data and identify missing data packets. This contribution presents the architecture, implementation and test of a different device driver approach using the polling mechanism which improves the performance and reliability. This allows the device driver to automatically check and transfer missing data blocks, recovering the data losses transparently for the host applications. The performance results for tests with different event data rates and duration up to an hour are also presented.

The combination of computational methods with 3D printing allows for the control of scaffolds microstructure. Lately, triply periodic minimal surfaces (TPMS) have been used to design porosity-controlled scaffolds for bone tissue engineering (TE). The goal of this work was to assess the mechanical properties of TPMS Gyroid structures with two porosity levels (50 and 70%). The scaffold stiffness function of porosity was determined by the asymptotic homogenisation method and confirmed by mechanical testing. Additionally, microCT analysis confirmed the quality of the printed parts. Thus, the potential of both design and manufacturing processes for bone TE applications is here demonstrated. info:eu-repo/semantics/publishedVersion

Objective: The aim of the present study was to evaluate the peripheral temperature rhythmicity and control in individuals with type 1 diabetes mellitus. Methods: Twelve non-obese adults (20-40 years old) with type 1 diabetes mellitus (T1D) and eight control individuals, matched for age and BMI, wore a wrist temperature recorder for 10 consecutive days. Recorded data were aggregated to calculate M10 (ten hours of highest temperature) and L5 (five hours of lowest temperature) of wrist temperature values for both groups. Results: Mean wrist temperature and M10 were not different when comparing the groups. The wrist temperature amplitude was reduced in the T1D group (p=0.039), due to a higher L5 (p=0.038). Discussion: While the higher L5 observed in T1D could be explained by less efficient heat dissipation, the amplitude flattening coincides with that observed in elderly.

We assessed the impact of a common sleep disturbance, the social jetlag, on postural control during a period involving workdays and free days. The sleep habits of 30 healthy subjects were registered with a wrist actimeter for nine days (starting on Friday) and they participated in a set of four postural control tests carried out on Friday and on Monday. In addition, the subjects filled questionnaires about their sleep conditions and preferences. Actimetry measurements were used to calculate the Mid Sleep Phase (MSP). The difference between the MSP values on the workdays and free days measures the social jetlag. There were significant differences in sleep variables between workdays and free days. Postural control performance improved on Monday, after free sleep over the weekend, when compared with the tests performed on Friday. It seems that social jetlag affects brain areas involved in the control of posture, such as thalamus and the prefrontal cortex as well as the cerebellum, resulting in a worse performance in postural control. The performance improvement in the posture tests after the free days could be attributed to a lower sleep debt.

Myotonic dystrophy (MD) is a neuromuscular disease with myotonia, progressive weakness, and involvement of CNS, heart, and gastrointestinal system. Excessive daytime sleepiness (EDS) in myotonic dystrophy type 1 (MD1) is related to sleep breathing diseases, restless leg syndrome, periodic limb movements during sleep and narcoleptic-like phenotype. However, authors highlight a central dysfunction of sleep regulation. We describe a 26-year-old, female, MD1 patient with EDS. Sleep diary/actigraphy evidenced two different circadian periods with values of 1442 and 1522 min. Agomelatine, 50 mg at night, was prescribed with improvement of the circadian rhythm and complaints of sleepiness. The identification of unanticipated causes of EDS, such as circadian rhythm disorders permits an appropriated treatment. As we know, it is the first relate of non-24-h sleep-wake disorder in patient with MD1. Sleep diary and actigraphy could be good options to investigate sleep-wake cycle disorder in patients with MD and EDS.

This paper presents the fundamentals for prediction of a more realistic behavior of planar steel frames with semi-rigid connections under dynamic loading. The majority of the research in this area concentrates on the nonlinear static analysis of frames with semi-rigid connections. Indeed, few studies have contributed to the nonlinear dynamic and vibration analyses of frames. Therefore, this article first describes the frames’ semi-rigid connection behavior under monotonic and cyclic loads, and presents the independent hardening technique adopted to simulate the joint behavior under cyclic excitation. In a finite element context, this paper presents an efficient numerical methodology that is proposed in algorithmic form to obtain the nonlinear transient response of the structural system. The paper also presents, in algorithmic form, a complete description of the adopted connection hysteretic model. Satisfying the equilibrium and compatibility conditions, and assuming only the connection’s rotational deformation due to bending as variable, this work obtains the tangent stiffness and mass matrices of the beam-column element with semi-rigid connections at the ends. The study concludes by verifying and validating the proposed numerical approach using four structural steel systems: a L-frame, a two-story frame, a six-story frame, and a four-bay five-story frame. The analyses show that the hysteresis of the semi-rigid connection has a strong effect on the frames’ responses and is an important source of damping during the structural vibration.

A circadian rhythm is a cycle of approximately 24 h, responsible for many physiological adjustments, and ageing of the circadian clock contributes to cognitive decline. Rhythmicity is severely impaired in Alzheimer disease (AD) and few therapeutic attempts succeeded in improving sleep disorders in such context. This study evaluated sleep parameters by actigraphy in 30 AD patients before and after trazodone use for 2 weeks, and we show a significant improvement in relative rhythm amplitude (RRA), compatible with a more stable daytime behavioral pattern. So, trazodone appears to produce a stabilization of the circadian rhythms in individuals with AD.

The aim of this study was to compare the areas of stress concentration in a three-dimensional (3D) premolar tooth model with anisotropic or isotropic enamel using the finite element method. A computed tomography was imported to an image processing program to create the tooth model which was exported to a 3D modeling program. The mechanical properties and loading conditions were prescribed in Abaqus. In order to evaluate stresses, axial and oblique loads were applied simulating realistic conditions. Compression stress was observed on the side of load application, and tensile stress was observed on the opposite side. Tensile stress was concentrated mainly in the cervical region and in the alveolar insertion bone. Although stress concentration analyses of the isotropic 3D models produced similar stress distribution results when compared to the anisotropic models, tensile stress values shown by anisotropic models were smaller than the isotropic models. Oblique loads resulted in higher values of tensile stresses, which concentrate mainly in the cervical area of the tooth and in the alveolar bone insertion. Anisotropic properties must be utilized in enamel stress evaluation in non-carious cervical lesions.