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Background Parkinson's disease (PD) is multi-symptom disease with variable progression. Objectives We performed a longitudinal study to address the evolution of motor symptoms (MS) and non-motor symptoms (NMS), predictors of motor-, cognitive-, disability-, and health-related quality of life (HRQL) status and the relative usefullness of a battery of separate NMS scales (BSS) versus the Non-Motor Symptom Scale (NMSS). Methods Seventy-two patients were assessed at baseline and 4 years later with the NMSS and BSS. We assessed the following outcomes: cognition (Montreal Cognitive Assessment scale [MoCA]), disability (Unified Parkinson's Disease Rating Scale Part II [UPDRS II], Schwab and England [S&E]), motor dysfunction (Unified Parkinson's Disease Rating Scale Part III [UPDRS III], Hoehn and Yahr [HY]), and HRQL (EuroQol [EQ] EQ-vertical visual analogue scale [VAS] and EQ-Index). Statistical analysis included a comparison between scales scores at both time points and multivariate regression analysis to calculate the impact of each baseline symptom in outcomes. NMSS and BSS were introduced in separate models. Results NMSS Domain 4: perception/hallucinations, Parkinson's Psychosis Questionnaire, Apathy Scale, NMSS Domain 7: urinary, S&E, UPDRS II, HY, and MoCA scores worsened significantly. Dementia increased to a 4-year prevalence of 39.8%. In the multivariate model using BSS, cognitive state variation was significantly predicted by baseline HY, EQ-Index, and S&E. Using the NMSS, MoCA change was significantly associated with NMSS Domain 4: perceptions/hallucination score, cognitive status with UPDRS III score, HRQL with NMSS Domain 4: perception/hallucinations score, and S&E. Conclusion Our study suggests that NMS progress heterogeneously, BSS approach being more sensitive to change than NMSS. The multivariate analysis has shown that S&E and NMSS Domain 4: perception/hallucinations scores are the stronger predictors of HRQL and cognitive dysfunction variation, favoring NMSS over the BSS approach.

Visualization can be a motivating way to teach students about molecules. Nowadays, the available experimental data and accurate computational results allow students to build realistic and accurate molecular models. These models include the representation of complex systems such as proteins, membranes, or nanotubes. However, the visualization of these three-dimensional (3D) structures can be challenging, complex, or even abstract for most people. To make the visualization easier and more motivating, BioSIM Augmented Reality (BioSIMAR) was developed as a free online software program to provide a new way to visualize and interact with 3D molecular models in a virtual environment. Using augmented reality (AR) and quick response code technologies, BioSIMAR provides tangible models of molecules to help illustrate chemical concepts. BioSIMAR runs on any electronic device, including mobile phones, tablets, laptops, or desktop computers with a camera and an internet connection, without requiring the installation of additional software. This software program helps people visualize and understand concepts about atoms and molecules, and their characteristics. BioSIMAR is freely available at https://ar.biosim.pt/.

The development of techniques that allow the efficient identification of residential loads (nonintrusive load monitoring) is a key factor for the practical implementation of demand response programs. Recently, in terms of nonintrusive load monitoring, the use of deep learning has gained attention, mainly the models based on convolutional neural networks. However, the efficient training of these models is strongly dependent on the quantity and balance of the data, i.e., characteristics that are not normally found in nonintrusive load monitoring datasets. To deal with these challenges, this paper proposes an approach based on three stages, that are: (i) time series transformation into 2D images; (ii) feature extraction using deep transfer learning; and (iii) classification/labelling of loads. Moreover, it was analyzed and defined the better window size per load in relation to the f1-score reached by the classifiers. In this sense, it was considered five loads present in the Reference Energy Disaggregation Dataset, where the proposed approach was able to obtain an average f1-score of 83.2%. From the results analysis, it was demonstrated the greater capacity of the proposed approach to infer and generalize its responses.

The use of fossil fuels represents a large part of the world’s energy availability. The burning of these fuels is related to several global problems. They are nonrenewable sources of energy, and th...

Oral dysfunctions are common in the elderly but the literature lacks a multidisciplinary approach on the relationship between polypharmacy, saliva flow, xerostomia, taste and swallowing complaints. This cross-sectional study included 204 non-institutionalized elderly (>60y; 123 women/81 men), free of severe disabilities and non-alcohol/tobacco consumers, from whom specific pharmacological therapies were evaluated, as well xerostomia (Xerostomia Inventory-XI) and swallowing complaints (EAT-10 questionnaire), salivary flow rate and gustatory sensitivity. Statistical analysis included Chi-square, Mann-Whitney, Two-way ANCOVA and linear multiple regression. Polypharmacy (≥5 drugs daily), hyposalivation and severe taste dysfunction were found in 18%, 46% and 10% of the participants, respectively. Polypharmacy was related with xerostomia (p=0.041) and swallowing complaints (p

Objectives We hypothesized that a time-controlled adaptive ventilation strategy would open and stabilize alveoli by controlling inspiratory and expiratory duration. Time-controlled adaptive ventilation was compared with volume-controlled ventilation at the same levels of mean airway pressure and positive end-release pressure (time-controlled adaptive ventilation)/positive end-expiratory pressure (volume-controlled ventilation) in a Pseudomonas aeruginosa-induced pneumonia model. Design Animal study. Setting Laboratory investigation. Subjects Twenty-one Wistar rats. Interventions Twenty-four hours after pneumonia induction, Wistar rats (n = 7) were ventilated with time-controlled adaptive ventilation (tidal volume = 8 mL/kg, airway pressure release ventilation for a Thigh = 0.75-0.85 s, release pressure (Plow) set at 0 cm H2O, and generating a positive end-release pressure = 1.6 cm H2O applied for Tlow = 0.11-0.14 s). The expiratory flow was terminated at 75% of the expiratory flow peak. An additional 14 animals were ventilated using volume-controlled ventilation, maintaining similar time-controlled adaptive ventilation levels of positive end-release pressure (positive end-expiratory pressure=1.6 cm H2O) and mean airway pressure = 10 cm H2O. Additional nonventilated animals (n = 7) were used for analysis of molecular biology markers. Measurements and main results After 1 hour of mechanical ventilation, the heterogeneity score, the expression of pro-inflammatory biomarkers interleukin-6 and cytokine-induced neutrophil chemoattractant-1 in lung tissue were significantly lower in the time-controlled adaptive ventilation than volume-controlled ventilation with similar mean airway pressure groups (p = 0.008, p = 0.011, and p = 0.011, respectively). Epithelial cell integrity, measured by E-cadherin tissue expression, was higher in time-controlled adaptive ventilation than volume-controlled ventilation with similar mean airway pressure (p = 0.004). Time-controlled adaptive ventilation animals had bacteremia counts lower than volume-controlled ventilation with similar mean airway pressure animals, while time-controlled adaptive ventilation and volume-controlled ventilation with similar positive end-release pressure animals had similar colony-forming unit counts. In addition, lung edema and cytokine-induced neutrophil chemoattractant-1 gene expression were more reduced in time-controlled adaptive ventilation than volume-controlled ventilation with similar positive end-release pressure groups. Conclusions In the model of pneumonia used herein, at the same tidal volume and mean airway pressure, time-controlled adaptive ventilation, compared with volume-controlled ventilation, was associated with less lung damage and bacteremia and reduced gene expression of mediators associated with inflammation.

Technological obsolescence and the lifecycle management of electrical equipment and automation systems are of fundamental importance to guarantee the operational continuity of power and industrial plants. This article presents a methodology to manage technological obsolescence and establishes requirements to classify equipment and systems into obsolescence grades. Moreover, it presents criteria to determine the impacts of each failure in production losses. Finally, it shows a prioritized ranking of the mitigation actions to minimize and even eliminate the risk of production losses. As a result, there is an increase in plant reliability and downtime avoidance as well as a rational budget destination.

Breast reconstruction (BR) has revealed significant benefits on physical and psychological well-being. Satisfaction is currently a key outcome on BR. This study aimed to assess the impact of timing and reconstructive technique on satisfaction, monitoring the influence of patient’s characteristics and complications. A single-center study of women undergoing primary BR over a 4.5-year period was conducted. Demographics, clinical features, procedural data, and postoperative complications were assessed. Patient satisfaction was evaluated with the BREAST-Q™. Influence of BR timing (immediate vs. delayed) and surgical technique (autologous vs. implant-based) on satisfaction was analyzed. Univariate and multivariate analyses were performed to identify independent predictors of satisfaction. Global response rate to BREAST-Q™ was 76.1% (216 from 284 patients). Responders underwent delayed BR in 67.6%, and autologous BR in 68.5%, with a 30.1% overall complication rate. Timing demonstrated significant impact on satisfaction (p = 0.001), with delayed reconstruction showing a higher mean BREAST-Q™ score. Autologous reconstruction also had a significantly higher BREAST-Q™ (p = 0.002). Transverse rectus abdominis myocutaneous flap presented the highest score, followed by latissimus dorsi with implant, and implant-based showed the lowest satisfaction (p = 0.004). Multivariate regression analysis identified timing, minor complications, and smoking status as independent impact factors of satisfaction (p = 0.001, p = 0.043, and p = 0.011, respectively). Timing significantly affected satisfaction (delayed reconstruction evidencing positive influence). Technique did not reach significance as independent predictor. Smoking and minor complications showed negative influence. Meaningful satisfaction with delayed reconstruction may encourage BR in the majority of patients, even those with medical or oncologic risks that precluded immediate reconstruction. Level of evidence: Not ratable.

Fossil fuels, which represent an important villain for the terrestrial ecosystem, are non-renewable sources of energy, which prompt many discussions about how long petroleum will remain available f...

Editor’s Perspective What We Already Know about This Topic What This Article Tells Us That Is New Background Pressure-support ventilation may worsen lung damage due to increased dynamic transpulmonary driving pressure. The authors hypothesized that, at the same tidal volume (VT) and dynamic transpulmonary driving pressure, pressure-support and pressure-controlled ventilation would yield comparable lung damage in mild lung injury. Methods Male Wistar rats received endotoxin intratracheally and, after 24 h, were ventilated in pressure-support mode. Rats were then randomized to 2 h of pressure-controlled ventilation with VT, dynamic transpulmonary driving pressure, dynamic transpulmonary driving pressure, and inspiratory time similar to those of pressure-support ventilation. The primary outcome was the difference in dynamic transpulmonary driving pressure between pressure-support and pressure-controlled ventilation at similar VT; secondary outcomes were lung and diaphragm damage. Results At VT = 6 ml/kg, dynamic transpulmonary driving pressure was higher in pressure-support than pressure-controlled ventilation (12.0 ± 2.2 vs. 8.0 ± 1.8 cm H2O), whereas static transpulmonary driving pressure did not differ (6.7 ± 0.6 vs. 7.0 ± 0.3 cm H2O). Diffuse alveolar damage score and gene expression of markers associated with lung inflammation (interleukin-6), alveolar-stretch (amphiregulin), epithelial cell damage (club cell protein 16), and fibrogenesis (metalloproteinase-9 and type III procollagen), as well as diaphragm inflammation (tumor necrosis factor-α) and proteolysis (muscle RING-finger-1) were comparable between groups. At similar dynamic transpulmonary driving pressure, as well as dynamic transpulmonary driving pressure and inspiratory time, pressure-controlled ventilation increased VT, static transpulmonary driving pressure, diffuse alveolar damage score, and gene expression of markers of lung inflammation, alveolar stretch, fibrogenesis, diaphragm inflammation, and proteolysis compared to pressure-support ventilation. Conclusions In the mild lung injury model use herein, at the same VT, pressure-support compared to pressure-controlled ventilation did not affect biologic markers. However, pressure-support ventilation was associated with a major difference between static and dynamic transpulmonary driving pressure; when the same dynamic transpulmonary driving pressure and inspiratory time were used for pressure-controlled ventilation, greater lung and diaphragm injury occurred compared to pressure-support ventilation.

Background Complete spinal cord injury (SCI) is characterized by permanent loss of nerve impulse propagation through the injury level leading to complete loss of voluntary muscle contraction. However, clinically undetectable top-down modulation of lower limbs might be present and can be evidenced using surface electromyography (sEMG). Case report A subject with complete chronic SCI and no spasticity presents voluntary modulation of sEMG signal during a task-specific activity associated with sensory input. Clinical rehabilitation impact We present for the first time the spectral characterization of sEMG signal in response to orthostatic training associated with voluntary movement attempts in complete SCI. Behavior of sEMG signal varied according to kinematic properties of movement, reinforcing the voluntary influence of efferent pathways on motor output. Our findings will contribute to elaborate evaluation protocols to investigate the preservation of corticospinal activities, and to evolve more accessible strategies in a clinical setting.

International audience

Introduction Much of the evidence on the relationship between stress, lifestyle, and other physical and mental health outcomes comes from studies conducted in high-income countries. There is therefore a need for research among populations in low and middle-income settings. Objectives To measure stress levels and identify factors associated with a high stress level and its consequences for health. Methods This was a population-based cross-sectional study carried out in 2016 with adults aged 18 years or older in a municipality in southern Brazil. A two-stage sampling strategy based on census tracts was used. Stress levels were measured with the Perceived Stress Scale (PSS-14) and classified into quartiles. The impact of the highest stress levelon each outcome was assessed with etiologic fractions (EF). Results The most stressed groups were: females (PR = 1.51, 95%CI 1.25-1.81), younger people (PR = 1.76, 95%CI 1.26-2.46), middle-aged individuals (PR = 1.60, 95%CI 1.17-2.19), those with lower schooling (PR = 1.56, 95%CI 1.20-2.02), the physically inactive (PR = 1.51, 95%CI 1.20-1.91), people who spent three or more hours watching television per day (PR = 1.29, 95%CI 1.12-1.50), and those with food insecurity (PR = 1.44, 95%CI 1.19-175). Possible consequences of high stress level were regular or poor self-perception of health (EF = 29.6%), poor or very poor sleep quality (EF = 17.3%), lower quality of life (EF = 45.6%), sadness (EF = 24.2%), and depressive symptoms (EF = 35.8%). Conclusions Stress plays an important role in several domains of health. Both public policies that target reduction of inequalities and specific stress-management interventions can reduce stress levels in populations, thereby decreasing the burden of other negative physical and mental health outcomes related to stress.

Introduction Cardiac computed tomography (CCT) is routinely performed for pulmonary vein isolation (PVI) planning in patients with paroxysmal or persistent atrial fibrillation (AF). This imaging method can also identify coronary artery calcium (CAC). Purpose To evaluate the prevalence of CAC in patients with paroxysmal and persistent AF undergoing catheter ablation. Methods Cross-sectional study including patients with AF/atrial flutter (AFL) undergoing CCT for ablation procedure planning from 2017 to 2019. Baseline clinical and demographic data were collected and CAC score was assessed using the Agatston method. Patients with paroxysmal and persistent AF/AFL (defined according to 2020 European Society of Cardiology guidelines for the diagnosis and management of AF) were compared. Results A total of 474 patients were included (441 with AF and 33 with AFL), with a mean age of 57±12 years, of which 295 (62%) were males. CHA2DS2-VASc score was ≥1 (male) or ≥2 (female) in 278 (64%) patients and most patients had a low to moderate cardiovascular risk (259, 80%). CAC was identified in 254 (54%) patients. AF/AFL was paroxysmal in 348 (75%) patients and persistent in 116 (25%). Baseline characteristics and cardiovascular risk factors were similar between groups except for diabetes mellitus (33 [10%] vs 22 [20%], p=0.012) and valvular heart disease (13 [4%] vs 18 [16%], p100 (58 [17%] vs 35 [30%], p=0.002). After multivariate analysis, CAC score>100 remained an independent predictor of persistent AF/AFL (OR 2.12, 95% CI 1.18–3.82, p=0.013) along with higher left atrial volume (OR 1.06, 95% CI 1.03–1.08, p Conclusion In this study, coronary artery calcium was present in more than half of AF/FLA patients undergoing catheter ablation. Patients with persistent AF/AFL showed higher calcium scores and this could derive from chronic, more advanced disease. Especially in those patients, opportunistic CV risk screening and CAC-guided clinical management might be clinically useful. Funding Acknowledgement Type of funding sources: None.

As a consequence of a short circuit in the power electrical system, there is a power quality disturbance occurring in the voltage/current signal that is propagated along the bars that compose the system with different characteristics and it is influenced by several factors, which makes it difficult to develop methods that can be used to locate the fault. Considering the advanced measurement infrastructure originating from the smart grid, these signals can be measured in real time and analyzed in a control and operation center improving the reliability of the system. This paper performs an exploratory data analysis on a database of voltage signals during the occurrence of a short circuit applied to the IEEE 34Bus system, aimed at the discovery of heuristics that can assist in decision making. The database includes information from voltage signals measured at each bar of the system and was assembled from simulations of three-phase, two-phase, and single-phase short circuits. Statistical metrics and data visualization are applied on the data subset to infer how the disturbance propagation occurs according to characteristics that are extracted from the measured signal during the presence of a fault in the power distribution system. This work shows that the combination of graphical, statistical modeling techniques is a powerful approach to explore these events. Multivariate data analysis has benefits over classical approaches that are based on raw data.

With the global pandemic of COVID-19 completing one year, this paper intends to analyse the perceptions of public transport users about the implementation of smart city technologies. Two aspects were analysed, namely: the perception of safety regarding the use of surveillance technologies in the containment of the virus; and the perception of safety of the same technologies regarding data protection and privacy. After the identification and choice of initiatives in smart cities to be addressed, a questionnaire was prepared and made available online, in which 414 replies were considered for the final analysis, respecting the proportionality of the percentage of replies in each region to the respective population percentage. In general, technologies provide a great sense of security regarding the use of public transportation. However, they cause concern regarding data protection and privacy. From this result and with analyses in relation to the regulation of personal data, international experiences and the Brazilian reality were contrasted.

BackgroundWe hypothesized that a decrease in frequency of controlled breaths during biphasic positive airway pressure (BIVENT), associated with an increase in spontaneous breaths, whether pressure support (PSV)-assisted or not, would mitigate lung and diaphragm damage in mild experimental acute respiratory distress syndrome (ARDS).Materials and methodsWistar rats receivedEscherichia colilipopolysaccharide intratracheally. After 24 hours, animals were randomly assigned to: 1) BIVENT-100+PSV0%: airway pressure (Phigh) adjusted to VT= 6 mL/kg and frequency of controlled breaths (f) = 100 bpm; 2) BIVENT-50+PSV0%: Phighadjusted to VT= 6 mL/kg andf= 50 bpm; 3) BIVENT-50+PSV50%(PSV set to half the Phighreference value, i.e., PSV50%); or 4) BIVENT-50+PSV100%(PSV equal to Phighreference value, i.e., PSV100%). Positive end-expiratory pressure (Plow) was equal to 5 cmH2O. Nonventilated animals were used for lung and diaphragm histology and molecular biology analysis.ResultsBIVENT-50+PSV0%, compared to BIVENT-100+PSV0%, reduced the diffuse alveolar damage (DAD) score, the expression of amphiregulin (marker of alveolar stretch) and muscle atrophy F-box (marker of diaphragm atrophy). In BIVENT-50 groups, the increase in PSV (BIVENT-50+PSV50%versusBIVENT-50+PSV100%) yielded better lung mechanics and less alveolar collapse, interstitial edema, cumulative DAD score, as well as gene expressions associated with lung inflammation, epithelial and endothelial cell damage in lung tissue, and muscle ring finger protein 1 (marker of muscle proteolysis) in diaphragm. Transpulmonary peak pressure (Ppeak,L) and pressure–time product per minute (PTPmin) at Phighwere associated with lung damage, while increased spontaneous breathing at Plowdid not promote lung injury.ConclusionIn the ARDS model used herein, during BIVENT, the level of PSV and the phase of the respiratory cycle in which the inspiratory effort occurs affected lung and diaphragm damage. Partitioning of inspiratory effort and transpulmonary pressure in spontaneous breaths at Plowand Phighis required to minimize VILI.

The application of organic crystals on nonlinear optical (NLO) materials has been increasing in recent years, and compounds like chalcones are interesting due to their significant third-order nonlinear properties. Hereof, we describe the synthesis, molecular structure, supramolecular arrangement, and theoretical calculations for a bromine-chalcone 3-(4-bromophenyl)-1-[3-(2-oxo-2-phenylethoxy)phenyl]-propenone (BC), which crystallized into noncentrosymmetric space group Pc. Also, a comprehensive topological analysis performed by QTAIM highlights the observed halogen bonds on solid state. In addition, the thermal stability was studied in temperatures smaller than 800 °C showing BC crystal as potential optical devices at temperatures up to 250 °C. Finally, the NLO properties indicate a photonic application based on strong third-order nonlinear response.

The coral snake genus Micrurus has non-aggressive behavior, being responsible for only 0.4% of the reports of snakebites in Brazil. However, although rare, accidents are potentially serious due to rapidly evolving respiratory paralysis. In the last few years, there was an abrupt reduction in the number of hospitals receiving antivenom support in Rio de Janeiro State, and currently the Health Ministry of Brazil distributes the antivenom only to 25 hospitals in 21 municipalities, even so with no data on specific serum provided by each hospital. This study aimed to determine the potential distribution of Micrurus species in Rio de Janeiro State in order to compare potential areas for risk of elapidic accidents with the localities assisted by hospitals with antivenom distribution. We performed ecological niche models to generate maps of potential distribution for all species through several niche algorithms. Based on these results we analyzed and discussed the consequences of this change in the number of hospitals receiving antivenom. Our results revealed the potential occurrence of the genus throughout the State territory and show a partially homogeneous distribution of health units, although the northern region represents an area with a deficiency in hospital coverage. According to our results and data from the Rio de Janeiro State Secretary of Health, it is highly desirable that at least some antivenom service centers in the regions “Metropolitana” and “Baixadas Litorâneas” receive antielapidic serum and that there be an increase in the number of units in “Norte Fluminense” and “Noroeste Fluminense” regions of Rio de Janeiro State.

Cloud computing has been envisioned as the main technology capable of integrating and managing many systems in a smart grid (SG). Thus, this research aims to develop a cloud computing infrastructure to store and manipulate smart distribution system data. To do this, extensible architecture with essential services was proposed to be integrated into an advanced metering infrastructure to host new applications in smart distribution systems. Based on this proposition, a cloud computing platform was developed using open source tools. A new application to reduce multiple estimation for fault location in radial distribution systems using data mining techniques over smart meter data was implemented. An optimised version of the data mining tool known as DAMICORE (DAta MIning of COde REpositories) was implemented as an extension to the proposed architecture basic services. The new cloud application was tested using hundreds of fault simulations on a test feeder and was able to reduce multiple estimation by more than 90% in the simulated fault cases. The results show that the proposed cloud computing architecture and infrastructure enable new smart distribution system applications, contributing to the development of SGs and diffusion of cloud computing in this context.

Painful peripheral neuropathy is the most dose-limiting side effect of paclitaxel (PTX), a widely used anti-cancer drug to treat solid tumours. The understanding of the mechanisms involved in this side effect is crucial to the development of new therapeutic approaches. CXCL1 chemokine and its receptor CXCR2 have been pointed as promising targets to treat chronic pain. Herein, we sought to evaluate the possible involvement of CXCL1 and CXCR2 in the pathogenesis of PTX-induced neuropathic pain in mice. PTX treatment led to increased levels of CXCL1 in both dorsal root ganglion and spinal cord samples. Systemic treatment with the anti-CXCL1 antibody (10 μg/kg, i.v.) or the selective CXCR2 antagonist (SB225002, 3 mg/kg, i.p.) had minor effect on PTX-induced mechanical hypersensitivity. On the other hand, the intrathecal (i.t.) treatment with anti-CXCL1 (1 ng/site) or SB225002 (10 μg/site) consistently inhibited the nociceptive responses of PTX-treated mice. Similar results were obtained by inhibiting the PI3Kγ enzyme a downstream pathway of CXCL1/CXCR2 signalling with either the selective AS605240 (5 μg/site, i.t.) or the non-selective wortmannin PI3K inhibitor (0.4 μg/site, i.t.). Overall, the data indicates that the up-regulation of CXCL1 is important for the development and maintenance of PTX-induced neuropathic pain in mice. Therefore, the spinal blockage of CXCL1/CXCR2 signalling might be a new innovative therapeutic approach to treat this clinical side effect of PTX.

Hydrogen peroxide (H2O2)-based products are effective in tooth whitening; however, their safety is controversial as they may harm patient tissues/cells. These effects are suggested to be concentration-dependent; nonetheless, to date, there are no reports on H2O2-mediated oxidative damage in the gingival tissue, and neither whether this can be detected in gingival crevicular fluid (GCF) samples. We hypothesize that H2O2 whitening products may cause collateral oxidative tissue damage following in office application. Therefore, H2O2 and nitric oxide (NO) levels were investigated in GCF samples obtained from patients undergoing dental bleaching with H2O2 at different concentrations, in a randomized, double-blind, split-mouth clinical trial. A proteomic analysis of these samples was also performed. H2O2-based whitening products promoted inflammation which was detected in GCF samples and lasted for longer following 35% H2O2 bleaching. This included time-dependent changes in NO levels and in the abundance of proteins associated with NO synthesis, oxidative stress, neutrophil regulation, nucleic acid damage, cell survival and/or tissue regeneration. Overall, H2O2-based products used in office promote inflammation irrespective of their concentration. As the inflammation caused by 35% H2O2 is longer, patients may benefit better from using lower concentrations of this bleaching product, as they may result in less tissue damage.

This research intends to contribute with improvements in the main steps usually implemented for an automatic monitoring of disturbances in the power quality (PQ) context. In a first step, this paper employs a wavelet transform (WT)-based method for disturbance segmentation with properties of temporal identification of signal discontinuities. Moreover, the WT was used to extract features as, for example, the duration and the root-mean-square values from PQ disturbance signals. The single disturbances analyzed were voltage sags (Sg), voltage swells (Sw), voltage interruptions (Int), oscillatory transients (Ot), impulse (Ip), harmonics (Hd), voltage fluctuations (Fl), and notching (Not). And the combined disturbances analyzed were Sg with Fl, Sw with Fl, Sg with Hd, Sw with Hd, Sg with Ot, and Sw with Ot. In the sequence, it was selected the most relevant features in order to better classify the PQ disturbances, which was done by using artificial neural networks. After the classification, the signals were compressed. Thus, the Non-dominated Sorting Genetic Algorithm II (NSGA-II) was employed to improve the performance of data compression methods (Huffman coding and Arithmetic coding), preserving the relevant information of signals with single and combined PQ disturbances. Initially, a database with 2800 synthetic disturbance signals was generated and used during the training and testing processes of the proposed approach. The testing process was also performed based on real disturbance signals. The results demonstrate the high performance of the segmentation, classification and the enhancements in PQ disturbance compression. The correct classification average rate is about 98.21%. The signals compression using NSGA-II achieves an average rate of 25:1. Such performance is 56% higher in comparison with the literature review of compression of PQ disturbance signals.

In this paper, a structured methodology is proposed to define the architecture for a communication framework with multiframe capability, which can be embedded in a residential smart meter hardware for smart grid applications. This framework is based on the Transmission Control Protocol/Internet protocol, and it is considered that the data are exchanged via wireless technologies. The architectural model was based upon the state-of-the-art in software engineering, making use of the design patterns and the principles of low coupling and high cohesion, which result in a solution that is both more reliable and maintainable. A security module is also provided and the framework performance is evaluated, in terms of packet throughput and computational effort of the security layer on the processing device, via practical experiments of some laboratory scenarios. Furthermore, errors on some frames are introduced in order to evaluate the feasibility of this framework in real field applications. Results show that this framework architecture supports acceptable transfer rates even with extra computational cost due to the use of data encryption and separated processing modules, making it a feasible proposal for the considered application context.

Bitcoin is the most accepted cryptocurrency in the world, which makes it attractive for investors and traders. However, the challenge in predicting the Bitcoin exchange rate is its high volatility. Therefore, the prediction of its behavior is of great importance for financial markets. In this way, recent studies have been carried out on what internal and/or external Bitcoin information is relevant to its prediction. The increased use of machine learning techniques to predict time series and the acceptance of cryptocurrencies as financial instruments motivated the present study to seek more accurate predictions for the Bitcoin exchange rate. In this way, in a first stage of the proposed methodology, different feature selection techniques were evaluated in order to obtain the most relevant attributes for the predictions. In the sequence, it was analyzed the behavior of Artificial Neural Networks (ANN), Support Vector Machines (SVM) and Ensemble algorithms (based on Recurrent Neural Networks and the k-Means clustering method) for price direction predictions. Likewise, the ANN and SVM were employed for regression of the maximum, minimum and closing prices of the Bitcoin. Moreover, the regression results were also used as inputs to try to improve the price direction predictions. The results showed that the selected attributes and the best machine learning model achieved an improvement of more than 10%, in accuracy, for the price direction predictions, with respect to the state-of-the-art papers, using the same period of information. In relation to the maximum, minimum and closing Bitcoin prices regressions, it was possible to obtain Mean Absolute Percentage Errors between 1% and 2%. Based on these results, it was possible to demonstrate the efficacy of the proposed methodology when compared to other studies.

Zinc oxide (ZnO) is a widely versatile semiconductor with major importance from the technological point of view, presenting the advantage of being grown by a large number of techniques and having one of the richest varieties of morphologies. Due to the special interest in this semiconductor, several approaches have been employed to control the production of its nanostructures. Herein, we report the development of a vapour-based method, designated as laser-assisted flow deposition (LAFD), capable of producing ZnO micro and nanocrystals with different morphologies and with a high crystalline and optical quality. This new process allows a high yield of ZnO production, showing great prospects for scalable applications. In the present work, we review in detail the main growth parameters and their relationship with the produced morphologies, in addition to their influence on the structural and optical properties. Furthermore, an assessment of the possible growth mechanisms that may be involved in this new method is reported. Some potential applications of the ZnO structures produced by LAFD were also evaluated, with focus on the photocatalysis and photovoltaic fields. Additionally, the possibility of synthesizing ZnO composite nanostructures as well as the growth of other metal oxides using this technique was explored.

The aims of this article are to discuss the rationale, design, and procedures of the Greater Houston Area Bipolar Registry (HBR), which aims at contributing to the effort involved in the investigation of neurobiological mechanisms underlying bipolar disorder (BD) as well as to identify clinical and neurobiological markers able to predict BD clinical course. The article will also briefly discuss examples of other initiatives that have made fundamental contributions to the field. This will be a longitudinal study with participants aged 6–17 at the time of enrollment. Participants will be required to meet diagnostic criteria for BD, or to be offspring of a parent with BD. We will also enroll healthy controls. Besides clinical information, which includes neurocognitive performance, participants will be asked to provide blood and saliva samples as well as to perform neuroimaging exams at baseline and follow-ups. Several studies point to the existence of genetic, inflammatory, and brain imaging alterations between individuals at higher genetic risk for BD compared with healthy controls. Longitudinal designs have shown high conversion rates to BD among high-risk offspring, with attempts to identify clinical predictors of disease onset, as well as clarifying the burden associated with environmental stressors. The HBR will help in the worldwide effort investigating the clinical course and neurobiological mechanisms of affected and high-risk children and adolescents with BD.

The purpose of this paper is to present an optimization model for planning the distribution of materials in earthmoving operations, considering possible interferences between cut-and-fill sections such as rivers, vegetation, topographical features, or expropriations. The earth allocation problem incorporating interferences was modeled as a linear programming problem, aiming to minimize the total earthmoving cost while considering the constraints related to volume balance, construction project duration, and time for the release of traffic. The proposed linear programming model was run by an integrated system, using Excel for data analysis and IBM CPLEX as the optimizer. The mathematical model was evaluated by a sensitivity analysis and validated by a real-world project of a dam access road in the state of Ceará, Brazil. The unit costs and productivity rates used in the fictional example and in the real-world application followed the referential cost system created by Ceará’s Secretariat of Infrastructure (SEINFRA-CE). The proposed optimization model achieved reasonable processing times for all tested applications, presenting itself as a viable and efficient option for planning earthmoving operations. Furthermore, the linear programming approach provided a 2.12% cost reduction for the real-world case study, when comparing the optimized solution and original budget. This study explored the problem of earth allocation with interferences using a linear programming approach, while avoiding complex modeling issues found in recent literature. As a result, this paper proposes a user-friendly optimization system that can be easily utilized by construction companies and departments.

Purpose: To review the effects of polysaccharides and their proposed mechanisms of action in breast cancer experimental models. Data sources, selection, and extraction: Articles were selected by using PubMed, ScienceDirect, Scopus, and Medline, assessed from 1 May 2019 to 1 July 2020. The systematic review was registered in the International Prospective Register of Systematic Reviews (Prospero) under the number CRD42020169103. Results: Most of the studies explore algae polysaccharides (43.2%), followed by mushrooms (13.5%), plants (13.5%), fruits (10.8%), fungus (2.7%), bacteria, (2.7%), and sea animals (2.7%). A total of 8.1% investigated only in vitro models, 62.1% evaluated only in vivo models, and 29.7% evaluated in vitro and in vivo models. The mechanism of action involves apoptosis, inhibition of cellular proliferation, angiogenesis, and antimetastatic effects through multiple pathways. Conclusions: Findings included here support further investigations on the anti-tumor effect of polysaccharides. Some polysaccharides, such as fucoidan and β-glucans, deserve detailed and structured studies aiming at translational research on breast tumors, since they are already used in the clinical practice of other proposals of human health.

Horizontal gated communities (HCGs) affect the dynamics of cities, as they are obstacles to mobility, integration and democratic use of public space. In this work, we investigate the negative impacts caused by these ventures and propose mitigation measures from the perspective of urban planning. This was based on bibliographic materials and a collection of interventions found in the literature, which led to a proposal of intervention on the walls of an HCG located in the Brazilian city of Engenheiro Coelho/SP. The focus of the proposed intervention was the outsourcing of part of the public green areas, visual permeability and improvement of access. The intervention proposals aimed at urban democratization and the resilience of communities impacted by this type of real estate development, in addition to restoring the right to enjoy the city and minimizing socio-spatial segregation, ensuring access to public areas and greater compliance with urban mobility policies.

We consider a comparative study of radiation effects (γ and electron) on fibre Bragg gratings (FBGs) that were inscribed using a femtosecond laser in single mode silica optical fibre. The FBGs were inscribed using the point-by-point and the plane-by-plane inscription methods. The FBGs were exposed to a total accumulated radiation dose of 15 kGy in both γ and electron cases. The gratings’ spectra were measured and analysed before and after the exposure to the radiation, while complementary characterisation was undertaken using Raman and Fourier transform infrared spectroscopy. In addition, the changes of the temperature coefficient of the FBGs were analysed comparatively prior to the irradiation to explain how material changes responded to the particular types of radiation. Finally, we consider which of the two inscription methods proves more robust in such harsh environments.

Introduction Point mutations in the Peripheral Myelin Protein 22 (PMP22) gene comprise less than 5% of the Charcot-Marie-Tooth (CMT) type 1 cases, and individualize either the CMT 1E subtype, or Hereditary Neuropathy with Liability to Pressure Palsy. The phenotype of CMT 1E presents with a severe early-onset polyneuropathy associated with deafness, although the clinical spectrum is broad. Case report We describe a novel PMP22 gene point mutation (c.84G>T;p.(Trp28Cys)) in three patients of a Portuguese family with variable phenotypes, ranging from asymptomatic to mild complaints of distal limb numbness and gait difficulties, with the age of onset of symptoms ranging from mid-twenties to late-sixties, and no associated disability. In all affected patients, there was evidence of diffuse demyelinating sensorimotor polyneuropathy. Hearing loss does not seem to be associated with this variant, albeit neuropathic pain was reported. Conclusions These findings suggest that this particular point mutation in the PMP22 gene is associated with a mild phenotype, further emphasizing that there are still unknown mechanisms (genetic and/or epigenetic) that may play a role in the clinical spectrum of CMT1E patients. Next generation sequencing panels including commonly mutated genes in CMT should be considered in CMT1 cases negative for PMP22 gene duplication.

Hepatic encephalopathy (HE) is a leading cause of hospita-lization and morbimortality in advanced cirrhosis with limited therapeutic options available. Given the paramount role of gut microbiota in HE, and the efficacy of fecal microbiota transplantation (FMT) in other diseases, this review intends to summarize the evidence supporting the safety, efficacy and future perspectives of FMT in HE. Current evidence, despite being scarce, points towards FMT being a safe, effective and tolerable procedure in HE. Some unanswered questions remain about the optimal dose, the administration route, the long term effects and the selection of the optimal donor. Future trials, some of which are already underway, will provide us additional evidence and hopefully the necessary answers.

[EN] In this study, a numerical methodology for the optimization of the combustion chamber in compression ignited engines using OME as fuel is presented. The objective is to obtain a dedicated combustion system for an engine that is fueled with this alternative fuel improving the efficiency and reducing the emissions of NOx. This article proposes the integration between the optimization algorithm and CFD codes to evaluate the behavior of an engine fuelled with the low sooting fuel OME. Based on a diesel model validated against experimental data, a further model for OME fuel was implemented for evaluating the performance of the engine. The particle swarm algorithm (PSO) was modified based on the Novelty Search concepts and used as optimization algorithm. Several tools are coupled in order to create each CFD case where all the tools and optimization algorithm are coupled in a routine that automates the entire process. The result is an optimized combustion system that provides an increase of the efficiency (about 2.2%) and a NOx reduction (35.7%) in comparison with the baseline engine with conventional fuel. In addition, a neuronal network was trained with all the results of all simulations performed during the optimization process, studying the influence of each parameter on the emissions and efficiency. From this analysis it was concluded that the EGR rate and injection pressure affects the NOx emissions with a range of variability of 63% and 38% respectively., The work has been partially supported by the Spanish Ministerio de Economia, Industria y Competitividad through Grant No TRA2017-89139-C2-1-R "Desarrollo de modelos de combustion y emisiones HPC para el analisis de sistemas de transporte sostenibles" The author C. S. Fernandes thanks the Universitat Politecnica de Valencia for his predoctoral contract (FPI-2019-S2-20-555) , which is included within the framework of Programa de Apoyo para la Investigacion y Desarrollo (PAID)

Automatic fingerprint identification systems (AFIS) are among the most used people identification solutions. As the size of fingerprint databases is continuously growing, studying fingerprint indexing mechanisms is desirable to facilitate the search process in a large-scale database. This work presents a method for fingerprint indexing, which uses both exact and approximation methods of nearest neighbors (ANNs), which are very efficient in terms of runtime, even if they sacrifice a little accuracy by presenting approximate solutions. In the presented approach, searches with ANN methods are made from deep embedding vectors extracted from image databases using a convolutional neural network (CNN). In this work, a CNN ResNet18 was used to extract the deep feature embeddings vectors, and the vectors vary in size between 64, 96, and 128. The ANNs methods tested for the query step were ANNOY, NGT, HNSW, and Nanoflann. The results were quite promising when using the FVC fingerprint databases (2000, 2002, and 2004), once we reached 100% hits in the searches with a penetration rate of 1%, with very low run times.

Rheumatoid arthritis (RA) is a painful inflammatory disease of the joints which affects a considerable proportion of the world population, mostly women. If not adequately treated, RA patients can become permanently disabled. Importantly, not all the patients respond to the available anti-rheumatic therapies, which also present diverse side effects. In this context, monitoring of treatment response is pivotal to avoid unnecessary side effects and costs towards an ineffective therapy. Herein, we performed a pilot study to investigate the potential use of flow cytometry and attenuated total reflection&ndash, Fourier transform infrared (ATR-FTIR) spectroscopy as measures to identify responders and non-responders to leflunomide, a disease-modifying drug used in the treatment of RA patients. The evaluation of peripheral blood CD62L+ polymorphonuclear cell numbers and ATR-FTIR vibrational modes in plasma were able to discriminate responders to leflunomide (LFN) three-months after therapy has started. Overall, the results indicate that both flow cytometry and ATR-FTIR can potentially be employed as additional measures to monitor early treatment response to LFN in RA patients.

Polycystic Ovary Syndrome is an endocrine abnormality that occurs in the female reproductive system and is considered a heterogeneous disorder because of the different criteria used for its diagnosis. Early detection and treatment are critical factors to reduce the risk of long-term complications, such as type 2 diabetes and heart disease. With the vast amount of data being collected daily in healthcare environments, it is possible to build Decision Support Systems using Data Mining and Machine Learning. Currently, healthcare systems have advanced skills like Artificial Intelligence, Machine Learning and Data Mining to offer intelligent and expert healthcare services. The use of efficient Data Mining techniques is able to reveal and extract hidden information from clinical and laboratory patient data, which can be helpful to assist doctors in maximizing the accuracy of the diagnosis. In this sense, this paper aims to predict, using the classification techniques and the CRISP-DM methodology, the presence of Polycystic Ovary Syndrome. This paper compares the performance of multiple algorithms, namely, Support Vector Machines, Multilayer Perceptron Neural Network, Random Forest, Logistic Regression and Gaussian Naive Bayes. In the end, it was found that Random Forest provides the best classification, and the use of data sampling techniques also improves the results, allowing to achieve a sensitivity of 0.94, an accuracy of 0.95, a precision of 0.96 and a specificity of 0.96.

Biopsychosocial aspects seem to influence the clinical condition of rotator cuff related shoulder pain (RCRSP). However, traditional bivariate and linear analyses may not be sufficiently robust to capture the complex relationships among these aspects. This study determined which biopsychosocial aspects would better classify individuals with acute and chronic RCRSP and described how these aspects interact to create biopsychosocial phenotypes in individuals with acute and chronic RCRSP. Individuals with acute (&lt, six months of pain, n = 15) and chronic (&ge, six months of pain, n = 38) RCRSP were included. Sociodemographic data, biological data related to general clinical health status, to shoulder clinical condition and to sensory function, and psychosocial data were collected. Outcomes were compared between groups and a decision tree was used to classify the individuals with acute and chronic RCRSP into different phenotypes hierarchically organized in nodes. Only conditioned pain modulation was different between the groups. However, the tree combined six biopsychosocial aspects to identify seven distinct phenotypes in individuals with RCRSP: three phenotypes of individuals with acute, and four with chronic RCRSP. While the majority of the individuals with chronic RCRSP have no other previous painful complaint besides the shoulder pain and low efficiency of endogenous pain modulation with no signs of biomechanical related pain, individuals with acute RCRSP are more likely to have preserved endogenous pain modulation and unilateral pain with signs of kinesiophobia.

A 26-year-old man noticed a facial asymmetry and double vision on awaking and went to the emergency room. There was left eye exotropia at rest and a total horizontal gaze palsy to the right. On attempting gaze to the left, there was limited right eye adduction and horizontal nystagmus of the abducted left eye. Vertical eye movements and convergence were normal. He had a right-sided lower motor neurone facial palsy, with decreased forehead wrinkling on the right, an asymmetric smile and Bell’s sign (figure 1 and video 1). There was also right sensorineural hearing loss (by Weber and Rinne testing) and right leg ataxia. Figure 1 (A) Internuclear ophthalmoplegia on left gaze (upper image), right gaze palsy (second image) and normal upward gaze (lower image). (B) Right lower motor neurone facial palsy. The patient has few wrinkles in his right forehead, a Bell’s sign, and an asymmetric smile. Video 1 ### Questions 1. What is probable site of the lesion? 2. What is its most likely cause? ### Question 1 This patient has the ‘eight-and-a-half syndrome’ (Eggenberger 1998), combining a one-and-a-half syndrome with an ipsilateral lower motor neurone facial (seventh) nerve palsy.1 The one-and-a-half syndrome combines …

Aims Finding the causative organism does not usually change the management of acute infective gastroenteritis, hence investigations such as stool culture should only be performed in selective cases. We intended to find if General Practitioners and Paediatricians were requesting stool cultures appropriately as recommended by the NICE guidelines for the diagnosis and management of diarrhoea and vomiting caused by gastroenteritis in children under 5. The guidelines recommend the performance or consideration of performance of stool microbiological investigations in specific cases, for instance in the presence of blood and/or mucous in stool. Methods Data was collected retrospectively from children under 5 years of age who had stool cultures performed over a period of 6 months (May 2018 to October 2018) in their local hospital or GP practice. The list of patients was provided by the laboratory and the information about the clinical indications and results was collected via the Information Technology system shared between primary and secondary care. The information about management was obtained from GP surgeries and hospital records. Results A total of 334 stool samples (GP practices=260 and Hospital=74) were sent for culture. The requests were inappropriate for the majority of patients with an overall of 58% (62% in community vs. 45% in hospital). Bacterial growths were observed in 7 samples (3 salmonella and 4 campylobacter). From all the appropriate requests (139), 4.3% were positive for bacterial growth and 0.7% were treated with antibiotic therapy. From the inappropriately requested samples (195), 0.5% were positive for bacterial growth with no patient receiving antibiotic treatment. Conclusion A significant number of stool culture requests by primary and secondary care did not follow the NICE recommendations. Inappropriate requests were more prevalent in primary than secondary care. There is a scope to investigate the reason for this difference. The probability of diagnosing a bacterial growth in a stool culture was significantly increased by approximately 8 times where recommendations were followed. Requesting investigations appropriately would also decrease unnecessary workload and reduce the burden on NHS finances.