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ObjectiveThe Buffalo Concussion Physical Examination (BCPE) is a brief, but pertinent physical examination designed for the subacute, outpatient assessment of concussion. The purpose of this study was to perform the BCPE on a larger sample and derive a scoring system to identify children at risk for Persistent Post-Concussive Symptoms (PPCS, recovery ≥30 days).MethodsThis prospective, observational cohort study from September 2016 to March 2019 was performed at three university-affiliated concussion clinics. Male and female children (n=270, 14.92±1.86 years, range 8–18, 38% female) were diagnosed with a concussion within 14 days of injury and followed-up until recovery. Logistic regression was used with history and physical examination variables to predict PPCS and a weighted scoring metric was derived.ResultsOut of 15 predictor variables, the main effects of 1 preinjury variable (≥3 previous concussions), 2 injury characteristic variables (days-since-injury and type-of-injury), 3 physical examination variables (orthostatic intolerance (OI), vestibulo-ocular reflex (VOR) and tandem gait) and 2 interaction terms (OI/VOR and tandem gait/type-of-injury) produced a score that was 85% accurate for identifying children with low-risk, medium-risk and high-risk for PPCS on cross-validation.ConclusionThe Risk for Delayed Recovery (RDR)-Score allows physicians in an outpatient setting to more accurately predict which children are at greater risk for PPCS early after their injury, and who would benefit most from targeted therapies. The RDR-Score is intended to be used as part of a comprehensive assessment that should include validated symptom checklists, mental health history and adjunct testing (eg, cognitive or physical exertion) where clinically indicated.

Introducción: La utilización de los recursos digitales modernos para la enseñanza constituye una estrategia para atender las nuevas necesidades de aprendizaje. En el ámbito de enfermería puede facilitar la inserción de los estudiantes en la práctica clínica en modo virtual para que desarrollen sus habilidades y competencias. Objetivo: Analizar las evidencias sobre la utilización de tecnologías en la enseñanza de enfermería. Métodos: Revisión integrativa realizada en el portal de revistas SciELO y en las bases de datos IBECS, LILACS, BDENF, Web of Science, PubMed y CINAHL. Resultados: Se realizó la identificación inicial de 62 artículos, se aplicaron los criterios de exclusión hasta el establecimiento de la muestra de 26 artículos. Después de la lectura y análisis de los estudios, se constató que las tecnologías son más utilizadas junto con las clases teóricas en las aulas, o como plataformas online de enseñanza, o también como herramientas auxiliares para la práctica de simulaciones realísticas. Discusión: El uso de internet fue predominante en los estudios, pues favorece la actualización, la comunicación y la cualificación académica. En cuanto a las plataformas digitales de enseñanza, el espacio virtual permite reunir e integrar diversos medios con finalidades diferentes posibilitando la creación de actividades variadas. Para la enseñanza a través de simulaciones se presentaron diversos beneficios de inmersión a un ambiente profesional desde la universidad. Conclusiones: El estudio presenta una visión general de las tecnologías educativas utilizadas para la enseñanza de enfermería y provee conocimiento de nuevas metodologías, lo que beneficia a profesores y estudiantes.

Obstructive sleep apnea (OSA) is a common clinical condition associated with increased cardiovascular morbidity and mortality. Recent evidence from clinical studies and animal models suggest that OSA can promote cardiovascular disease by inducing autonomic, hemodynamic, inflammatory and metabolic dysregulation. However, most of the evidence addressing hard endpoints in humans is derived from observational studies. Several challenges have been noted in the pursuit of a comprehensive knowledge base about the impact of OSA including: 1) the precise mechanisms by which OSA causes metabolic and cardiovascular consequences are not clear, which limits our current ability to address potential targets in OSA; 2) several patients with OSA, even with severe forms, present with no or mild daytime symptoms. Beyond the obvious challenges for obtaining good adherence for conventional OSA treatments, there is evidence that symptomatic vs. asymptomatic patients with OSA do not necessarily have the same metabolic and cardiovascular outcomes; and 3) the cardiovascular response to OSA treatment may vary even in those patients with good adherence. In this scenario, there is an obvious need to develop biomarkers in the OSA research area. This review focuses on describing the advances that have occurred so far in exploring potential OSA biomarkers with clear emphasis for the cardiovascular risk. Particular attention will be devoted to discuss molecular biomarkers including the potential role of microRNAs, proteomics and metabolomics. We also discuss the major challenges and perspectives in this growing research field.

Background Intra-abdominal hypertension (IAH) is frequently encountered in critically ill surgical patients. We aimed to evaluate the incidence of IAH after orthotopic liver transplant (OLT) and its impact on organ function, hospital length-of-stay (LOS), and death. Methods This prospective, observational, cohort study evaluated consecutive adult patients admitted in the ICU after undergoing OLT. Intra-abdominal pressure (IAP) was measured every 4–6 h for 3 days. Worsening IAP was defined as a gradual increase in IAP over a period of time. Daily fluid balance was the daily sum of all intakes minus the output. Results IAH was observed in 48% of the patients within the first 3 days after ICU admission, while ACS was diagnosed in 15%. Patients with IAH had a higher positive fluid balance at day 1 (1764 mL [812–2733 mL] vs. 1301 mL [241–1904 mL], p = 0.025). Worsening IAH was associated with fewer days free of organ dysfunction. IAH within 72 h after ICU admission was independently associated with a composite outcome of death or a longer ICU LOS (odds ratio 2.9; CI 95% 1.02–8.25, p = 0.043). Conclusion After OLT, nearly half of the patients presented IAH, that was associated with unfavorable outcomes.

Nursing leaders play a pivotal role in managing the COVID-19 pandemic. Aiming to describe the challenges of nursing leaders and the solutions implemented to face the coronavirus pandemic in a Brazilian hospital we developed this qualitative study. Six tactical nursing leaders were recruited by convenience and responded via audio recordings to two open-ended questions: 1) What challenges have you experienced and what solutions have you implemented related to physical, human, and technological resources during the COVID-19 pandemic? and 2) What challenges have you experienced and what solutions have you implemented in relation to patient and staff safety during the COVID-19 pandemic? All audio files were transcribed, anonymized, and analyzed using inductive content analysis. We identified two main categories of challenges: the first, concerning the changes and challenges in the face of an unknown disease; the second category, consisting of an evaluation of the experiences lived by the nursing leaders. Numerous solutions were implemented in response to the challenging scenario. The technical competence and systemic view of nursing leaders were vital to face the challenges and develop solutions to ensure the quality of care provided and the safety of the workforce, patients, and families.

The adoption of innovative strategies for fertilization under pastures, unlike traditional fertilization, seeks to achieve specific objectives. In this regard, the mistaken argument that supports national livestock growth is due to the expansion of new frontiers can be substantially broken by taking into account the new soil fertilization strategies under pastures. Innovative strategies are based on flexible management and seek, among other ways, the use of agricultural and industrial waste, thus minimizing environmental impacts by reducing the emission of greenhouse gases and maximizing carbon fixation. Thus, the search for alternative sources to inorganic fertilizers and maximizing the efficiency of their use will continue to be the main objective of technological innovation of soils in pasture areas for the foreseeable future.

The TWIST (Testicular Work-up for Ischemia and Suspected Torsion) score was developed to allow for expedited diagnosis of testicular torsion (TT) in children based on clinical variables: edema (2 points), hard mass (2), absent cremasteric reflex (1), high-riding testis (1) and nausea/vomiting (1). We sought to validate the TWIST Score applied by non-expert physicians for the diagnosis of testicular torsion in an adult population. We prospectively analyzed all consecutive males presenting to a tertiary hospital with acute scrotum. Patients with previous scrotal pathology or trauma were excluded. Physical examination was performed by a general surgeon and variables of TWIST were recorded. All patients underwent Scrotal Doppler Ultrasound. Measures of accuracy of the TWIST score and ROC curves were generated to evaluate its performance in diagnosing TT in adults. Of 68 patients, 34 had TT (50%). Median age was 24.9 years. According to the original cutoffs of TWIST, 23 patients had a score ≤ 2 among which none had TT. Fifteen patients had a score of 3–4, among which seven had TT. Thirty patients had a score ≥ 5, among which 27 had TT. All 18 patients with a score of 6 or greater had TT (100% PPV). ROC curve revealed an AUC of 0.95. The TWIST Score is valid for the diagnosis of Testicular Torsion in adults, presenting a PPV of 90% for a cutoff of 5 points and 100% for six points. In all patients with a score of 2 or less, the disease could be safely excluded (100% NPV).

Aims Mesencephalic astrocyte‐derived neurotrophic factor (MANF) is a secretory neurotrophic factor protein that promotes repair after neuronal injury. The microglia cell surface receptor (triggering receptor expressed on myeloid cells‐2; TREM2) regulates the production of pro‐ and antiinflammatory mediators after stroke. Here, we study MANF and TREM2 expression after middle cerebral artery occlusion (MCAo) and explore if docosahexaenoic acid (DHA) treatment exerts a potentiating effect. Methods We used 2 hours of the MCAo model in rats and intravenously administered DHA or vehicle at 3 hours after the onset of MCAo. Neurobehavioral assessment was performed on days 1, 3, 7, and 14; MANF and TREM2 expression was measured by immunohistochemistry and Western blotting. Results MANF was upregulated in neurons and astrocytes on days 1, 7, and 14, and TREM2 was expressed on macrophages in the ischemic penumbra and dentate gyrus (DG) on days 7 and 14. DHA improved neurobehavioral recovery, attenuated infarct size on days 7 and 14, increased MANF and decreased TREM2 expression in ischemic core, penumbra, DG, and enhanced neurogenesis on Day 14. Conclusion MANF and TREM2 protein abundance is robustly increased after MCAo, and DHA treatment potentiated MANF abundance, decreased TREM2 expression, improved neurobehavioral recovery, reduced infarction, and provided enhanced neuroprotection., MANF and TREM2 were upregulated following focal cerebral ischemia. DHA treatment enhanced MANF abundance in neurons and astrocytes and suppressed TREM2 expression in activated microglia and astrocytes, which contributed to neurogenesis and neurological recovery.

This work shows a planar interdigital sensor for rapid measurement of oils. The kit is characterised by the impedance meter, a Raspberry Pi3 and a sample port where the planar capacitive interdigital multifinger (IDCM) sensor is stored. For validation of this IDCM sensor, the data was compared with measurements performed by impedance spectroscopy (IS). The measurements show that the measured values of the new and used oils are very close, validating the IDCM sensor for fast oil measurements of oils in transformers and other devices.

Sao Paulo State Foundation for Research (FAPESP)Fundacao de Amparo a Pesquisa do Estado de Sao Paulo (FAPESP) [2016/15603-0]

Buildings in urban environments offer large areas available for the deployment of solar energy technologies. Photovoltaic (PV) systems are often considered for installation on rooftops, with facades usually being disregarded due to their non-optimal inclination. However, PV facades not only convey a cleaner image to buildings but may also act as optimizers of distributed generation. The contribution of differently oriented and tilted PV surfaces varies seasonally and depends on the urban layout, therefore the aggregation of rooftop and facade PV potential in a neighbourhood or a city might satisfy a relevant fraction of its combined electricity consumption even at off-peak production hours. The optimization of PV systems towards load-matching is crucial for the success of future solar communities. This review aims to provide an overview on the rooftop versus facade PV paradigm in the context of future cities. The advantages of facades are highlighted along with methods to estimate their potential, and innovative technological approaches for their implementation are discussed.

Multiple coordinated views have often been used for visual analytics purposes over the last years. In this context, if the exploration of 2D visualizations is not an obstacle, adding an extra dimension can be an issue. The interaction with multiple 3D visualizations in 2D conventional displays lacks usability and does not guarantee the usefulness the extra dimension would provide. Immersive visualization techniques can potentially fulfill these gaps by providing 3D visualizations and novel 3D interactions simultaneously. In this paper, we propose a new approach for interacting with composite and multiple coordinated visualizations in immersive virtual environments. We use a 3D-WIMP-like concept, i.e., virtual cubes (Spaces), for encapsulating views, which the user can freely control in the virtual environment. Moreover, operations like “cloning” and “coordinated interactions” features provide a way for performing composed tasks. We compared our approach with a desktop version to evaluate its performance when dealing with composed tasks. A user study with 19 participants was conducted, and the results show that the immersive approach has advantages over the corresponding desktop version regarding interaction with multiple coordinated 3D views.

SummaryThe cryopreservation of murine ovarian tissue and its transplantation can be a promising technique for the preservation of fertility and an alternative for the future reconstitution of scientific valuable strains of mice. Accordingly, the aim of this study was to describe the entire surgical procedure for ovariectomy and dorsal subcutaneous autotransplantation in mice, and also some data about the efficiency of this procedure. Female C57Bl/6J mice (n = 18) were anaesthetised and bilaterally ovariectomized. After surgery, ovaries were autotransplanted in small subcutaneous pouches in the dorsal region of the forelimbs. The animals were inspected daily and, 23 days after transplantation, euthanasia and recovery of ovarian tissues were performed. Postoperative recovery, oestrous cyclicity, and folliculogenesis progression were evaluated. At 23 days after transplantation, the recovery of the ovaries was feasible, all classes (primordial to antral) of follicles were observed. Additionally, satisfactory efficiency rates were obtained, with 100% of anaesthesia survival rate, survival, graft recovery, folliculogenesis progression and oestrous cyclicity. In general, this short article describes ovarian ectopic autologous transplantation as an effective technique for maintaining rodent oogenesis and endocrine ovarian function. Even more broadly, we can still assume that the application of this technique may reduce the number of breeding matrices and experimental animals in the near future.

Introduction: Bioelectrical impedance vector analysis (BIVA) is a non-invasive and low-cost strategy. The methods used to assess malnutrition in patients undergoing HD are still a challenge. The aim of the present study was to compare BIVA to 7-Point Subjective Global Assessment (7-point SGA) to identify malnutrition. We also investigated the sensitivity and specificity of the previously proposed cutoffs point for BIVA parameters. Methods: Patients of both sexes, over 20 years of age, on HD treatment were included. Anthropometric parameters, laboratory data, and bioelectrical impedance analysis (BIA) were evaluated. Values of resistance (R) and reactance (Xc) obtained by mono-frequency BIA were normalized to body height (H) to generate a graph of the bioimpedance vector with the BIVA software. The analysis of the area under the receiver operating curve ROC (AUC) was performed. Results: Among the included 104 patients, the mean age was 51.70 (±15.10) years, and 52% were male. The BIVA had a sensitivity of 35% for diagnosing malnutrition. The specificity of BIVA for identifying the well-nourished patients was 85.7%. The diagnostic accuracy between the BIVA and 7-point SGA was AUC=0.604; 95%CI 0.490-0.726, higher than the previously established cutoff values (AUC=0.514; 95%CI: 0.369-0.631). The 95% confidence ellipses did not overlap (p

International audience; Visualization techniques are useful tools to explore data by enabling the discovery of meaningful patterns and causal relationships. The discovery process is often exploratory and requires multiple views to support analyzing different or complementary perspectives to the data. In this context, analytic provenance shows great potential to understand users’ reasoning process through the study of their interactions on multiple view systems. In this paper, we present an approach based on the concept of chained views to support the incremental exploration of large, multidimensional datasets. Our goal is to provide visual representation of provenance information to enable users to retrace their analytical actions and to discover alternative exploratory paths without loosing information on previous analyses. We demonstrate that our implementation of the approach, MGExplorer (Multidimensional Graph Explorer), allows users to explore different perspectives to a dataset by modifying the input graph topology, choosing visualization techniques, arranging the visualization space in meaningful ways to the ongoing analysis and retracing their analytical actions. MGExplorer combines multiple visualization techniques and visual querying while representing provenance information as segments connecting views, which each supports selection operations that help define subsets of the current dataset to be explored by a different view. We demonstrate the usage of the tool through a study case where we explore co-authorship data. We assess the approach through performance metrics, temporal ordering of tasks, number of physical actions, and amount of information to be recalled inbetween actions applied to the chosen visual exploration scenarios using chained views

Reference rules-of-thumb advise equator-facing orientations and slopes near the site's latitude as the optimal conditions for photovoltaic (PV) systems to maximize annual solar electricity production. However, if the electricity consumption profile is considered, this layout will most likely increase net load variance on the electricity grid at sunrise and sunset, which ought to be avoided. Making use of a variety of orientations and inclinations can help to minimize this impact, especially in cities where plentiful area of diversely oriented facades and rooftops is particularly relevant for broadening the peak of PV production throughout the day. Providing electricity not only around solar noon but also in the morning and late afternoon, when demand from residential buildings increases, helps to maximize self-consumption/-sufficiency and reduces costs for end-users and utilities. Until recently, due to high installation costs, there was little interest in this non-optimal PV systems configurations. In the last five years, however, the paradigm started to shift, triggered by the growing interest from municipalities that seek energy transition through currently more affordable PV systems and, on the other hand, by the duck-curve phenomena reported in pioneering “solar cities”. This paper reviews studies that address the use of non-optimal azimuths and tilts to better match utility- and distributed-scale demand and supply.

Treatment against visceral leishmaniasis (VL) is mainly hampered by drug toxicity, long treatment regimens and/or high costs. Thus, the identification of novel and low-cost antileishmanial agents is urgent. Acarbose (ACA) is a specific inhibitor of glucosidase-like proteins, which has been used for treating diabetes. In the present study, we show that this molecule also presents in vitro and in vivo specific antileishmanial activity against Leishmania infantum. Results showed an in vitro direct action against L. infantum promastigotes and amastigotes, and low toxicity to mammalian cells. In addition, in vivo experiments performed using free ACA or incorporated in a Pluronic ® F127-based polymeric micelle system called ACA/Mic proved effective for the treatment of L. infantum-infected BALB/c mice. Treated animals presented significant reductions in the parasite load in their spleens, livers, bone marrows and draining lymph nodes when compared to the controls, as well as the development of antileishmanial Th1-type humoral and cellular responses based on high levels of IFN-γ, IL-12, TNF-α, GM-CSF, nitrite and IgG2a isotype antibodies. In addition, ACA or ACA-treated animals suffered from low organ toxicity. Treatment with ACA/Mic outperformed treatments using either Miltefosine or free ACA based on parasitological and immunological evaluations performed one and 15 days post-therapy. In conclusion, data suggest that the ACA/Mic is a potential therapeutic agent against L. infantum and merits further consideration for VL treatment.

Objectives To systematically summarize the available evidence concerning the impact of pyeloplasty on symptoms and differential renal function (DRF) in adults with unilateral UPJO in poorly functioning kidneys (PFK), and to identify potential predictors of kidney function recovery that could help clinicians select candidates for pyeloplasty. Methods A literature search (MEDLINE, Embase, Google Scholar, Scopus, ClinicalTrials.gov, and the WHO Clinical Trials Registry) and systematic review were performed up to September 2020 according to the PRISMA guidelines. PFK were defined as a baseline DRF ≤30% on renal scintigraphy. The primary endpoints were symptom relief and postoperative scintigraphic DRF. Predictors of kidney function recovery were evaluated and compared among studies. Results Nine studies comprising 731 patients met the inclusion criteria and were included for evidence synthesis. A DRF increase >5% occurred in 13.3%-53.8% of 160 patients with a pre- and postoperative renal scan. Symptoms improved in 73.3%-93.3% of 141 adults after pyeloplasty. Neither patient's age, baseline DFR, comorbidities, degree of hydronephrosis, kidney parenchymal thickness, nor kidney biopsy findings consistently predicted a significant DRF increase among 375 patients undergoing pyeloplasty. Conclusion Based on a low level of evidence, pyeloplasty may relieve symptoms and stabilize kidney function in adults with UPJO in PFK. A significant number of patients showed a DRF increase >5%, yet no consistent predictor of kidney function recovery was identified. Until more evidence becomes available, pyeloplasty could be considered for selected cases after accounting for the risks of a failure requiring a future nephrectomy.

To compare symptom resolution and short-term renal function after pyeloplasty or nephrectomy in adults with ureteropelvic junction obstruction (UPJO) in poorly functioning renal units (PFRU).Retrospective analysis of adult patients with UPJO and differential renal function (DRF) ≤ 15% who underwent laparoscopic pyeloplasty or nephrectomy. Primary endpoints included symptom resolution and estimated glomerular filtration rate (eGFR) at 12 months. Surgical complications were compared between groups. A secondary analysis was performed comparing baseline and postoperative DRF to evaluate the PFRU recovery potential after pyeloplasty.Sixty-three patients were included; 19 underwent pyeloplasty and 44 underwent nephrectomy. The mean age of the cohort was 39.5 ± 13.8 years. Nephrectomy was associated with significantly higher intra-operative blood loss (Pyeloplasty can be considered for selected patients with UPJO in PFRU as an organ-sparing alternative to nephrectomy. Although there was no significant gain in mean DRF, pyeloplasty prevented further functional loss and relieved symptoms in most cases in the short-term with at least the same complication rates of nephrectomy.

Objective To present the clinical and radiological characteristics of women with severe structural deterioration of the bladder and upper urinary tract secondary to Primary Bladder Neck Obstruction (PBNO), and their outcomes after bladder neck incision (BNI). Methods Retrospective evaluation of adult women who underwent BNI for PBNO at one institution. Patients were assessed for symptoms, renal function, structural abnormalities of the urinary tract and video-urodynamics. PBNO diagnosis was confirmed with video-urodynamics in all patients. BNI was performed at the 4–5 and/or 7–8 o’clock positions. Postoperative symptoms, PVR, uroflowmetry and renal function were evaluated and compared to baseline. Results Median patient age was 56.5 years (range 40–80). All presented with urinary retention–four were on clean intermittent Catheterization (CIC) and two with a Foley catheter. All patients had bladder wall thickening and diverticula. Four women had elevated creatinine levels, bilateral hydronephrosis was present in five (83.3%). After BNI, all patients resumed spontaneous voiding without the need for CIC. Median Qmax significantly improved from 2.0 [1.0–4.0] mL/s to 15 [10–22.7] mL/s (p = 0.031). Median PVR decreased from 150 to 46 [22–76] mL (p = 0.031). There were no postoperative complications. Creatinine levels returned to normal in 3/4 (75%) patients. Conclusion PBNO in women may result in severe damage to the bladder and upper urinary tract. Despite severe structural abnormalities of the bladder, BNI was effective in reducing symptoms and improving structural and functional abnormalities of the lower and upper urinary tract.

Background To evaluate the impact of the use of face masks on oral hygiene habits; oral conditions self-perception; reasons to seek dental treatment; and esthetic concerns. Material and methods 1346 participants answered a web-based survey with questions related to the aims of the study. Descriptive statistic was performed and the responses were analyzed with chi-square test and regression analysis. Results With the use of masks, toothbrushing frequency decreased significantly, and people are significantly less concerned about oral hygiene. The number of subjects that reported to have halitosis increased significantly and this was associated with a decrease in toothbrushing frequency. The greatest complaints of subjects were teeth color and alignment. The prevalence of bruxism increased significantly. Overall, 94.1% considered that esthetics is important to seek dental care even with the use of masks, and 84.2% are maintaining usual periodic dental care. People are significantly less concerned with their smile and dental esthetics with the use of masks. Conclusions With the use of face mask, people must be motivated regarding maintaining oral hygiene habits. Some respondents will seek dental care only when masks were no longer necessary, therefore dentists must be aware of a reduction in the volume of patients. Key words:Dental health surveys, esthetics, oral hygiene, dental care, COVID-19, behavior.

Funding Information: Acknowledgments: Special thanks to Celso Matos, MD/PhD, for assistance with manuscrip preparation. The authors received no financial support for the publication of this article. Publisher Copyright: © 2021 Colloid carcinomas are rare pancreatic tumors characterized by the presence of mucin pools with scarce malignant cells. Most of these neoplasms arise from intestinal-type intraductal papillary mucinous neoplasms (IPMNs). We report a case of a 77-year-old male patient who presented with weight loss, asthenia, lumbar pain and diabetes. Imaging studies revealed a mixed-type IPMN with high-risk features and a possible invasive component. The patient underwent surgical resection and the histology confirmed an invasive colloid carcinoma of the pancreas associated with an intestinal-type IPMN. Although invasive ductal and colloid carcinomas may look similar on imaging studies, its distinction is important because the latter have a better prognosis. publishersversion published

Summary This randomized, double-blinded, placebo-controlled clinical trial evaluating outpatients with mild COVID-19 showed that viral clearance rates within 9-day period from enrollment did not change with HCQ/AZT treatment, although no major cardiovascular events were observed in participants without comorbidities. Registered at REBEC under the number 30413020.8.0000.0008 (http://www.ensaiosclinicos.gov.br/rg/RBR-95yjmq/), Background : Hydroxychloroquine showed potential to block viral replication of SARS-CoV-2 in in vitro studies. This randomized, double-blinded, placebo controlled clinical trial evaluated the efficacy of hydroxychloroquine plus azithromycin in reducing viral loads in patients with early and mild SARS-CoV-2 infection. Methods : A single-center randomized placebo-controlled clinical trial involving outpatients with early and mild SARS-CoV-2 infection was conducted. Inclusion criteria: patients aged between 18 to 65 years with symptoms suggestive of COVID-19 for fewer than five days, no significant comorbidities, and positive naso/oropharyngeal swab screening tests (POCT-PCR). Randomized patients received either hydroxychloroquine for seven days plus azithromycin for five days or placebo. The primary endpoint was viral clearance within a 9-day period. Secondary endpoints included viral load reduction, clinical evolution, hospitalization rates, chest computed tomography evolution and adverse effects. Results : From 107 potential trial participants, 84 were enrolled following pre-determined criteria. Statistical analyses were performed on an “intention-to-treat” (N=84) and “per-protocol” (PP) basis (N=70). On the PP analysis, the treatment group (N=36) and the placebo group (N=34) displayed similar demographic characteristics. At 95% CI, no statistically significant differences were found between groups in viral clearance rates within a 9-day following enrollment (p-value 0.26). Conclusions : Among outpatients with early and mild COVID-19, the use of HCQ/AZT did not impact the time to viral clearance compared to placebo. Secondary outcomes were also not significantly improved with HCQ/AZT treatment compared to placebo. These findings do not support use of HCQ/AZT in this setting.

Whenever accessing indoor spaces such as classrooms or auditoriums, people might attempt to analyze and choose an appropriate place to stay while attending an event. Several criteria may be accounted for, and most are not always self-evident or trivial. This work proposes the use of data visualization allied to an Augmented Reality (AR) user interface to help users defining the most convenient seats to take. We consider sets of arbitrary demands and project information directly atop the seats and all around the room. Users can also narrow down the search by switching and combining the attributes being displayed, e.g., temperature, wheelchair accessibility. The proposed approach was tested against a comparable 2D interactive visualization of the same data in usability assessments of seat-choosing tasks with a set of users (N = 16) to validate the solution. Qualitative and quantitative data indicated that the AR-based solution is promising, suggesting that AR may help users make more accurate decisions, even in an ordinary daily task. Regarding Augmented Situated Visualization, our results open new avenues for the exploration of context-aware data.

In Brazil, the Electricity Regulatory Agency defines that technical losses on distribution systems must be calculated via power flow simulation, with primary and secondary systems modeled in detail. However, as this approach requires a massive amount of data not always available in practice, the agency established assumptions to enable its implementation by all Brazilian utilities. These assumptions are currently under scrutiny by the utilities. In this context, this paper investigates the assumptions regarding load connection type, load power factor, line impedance, grounding resistance and load curve resolution, to identify whether they are indeed necessary, technically sound and what is the quantitative impact on technical losses. The study was conducted on a large database with 1,248 distribution feeders modeled in OpenDSS (over 4.5 million customers) to obtain truly realistic results. Moreover, analytical derivations are presented to assess the technical correctness of all assumptions. It is found that, for the studied feeders, the assumptions seem to be reasonable, but more studies are necessary to define the load power factor and how to model reactive power compensation equipment.

Infection by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been associated with leukopenia and uncontrolled inflammatory response in critically ill patients. A better comprehension of SARS-CoV-2-induced monocyte death is essential for the identification of therapies capable to control the hyper-inflammation and reduce viral replication in patients with COVID-19. Here, we show that SARS-CoV-2 induces inflammasome activation and cell death by pyroptosis in human monocytes, experimentally infected and from patients under intensive care. Pyroptosis was dependent on caspase-1 engagement, prior to IL-1s production and inflammatory cell death. Monocytes exposed to SARS-CoV-2 downregulate HLA-DR, suggesting a potential limitation to orchestrate the immune response. Our results originally describe mechanisms by which monocytes, a central cellular component recruited from peripheral blood to respiratory tract, succumb to control severe 2019 coronavirus disease (COVID-19). Author summary Since its emergence in China in late 2019, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has caused thousands of deaths worldwide. Currently, the number of individuals infected with SARS-CoV-2 and in need of antiviral, anti-inflammatory, anticoagulant and more invasive treatments has overwhelmed the health systems worldwide. In our study, we found that SARS-CoV-2 is capable of inducing inflammatory cell death in human monocytes, one of the main cell types responsible for anti-SARS-CoV-2 immune response. As a consequence of this intracellular inflammatory mechanism (inflammasome engagement), an exacerbated production of inflammatory mediators occurs. The infection also decreases the expression of HLA-DR in monocytes, a molecule related to the orchestration of the immune response in case of viral infections. We also demonstrated that the HIV-1 protease inhibitor, atazanavir (ATV), prevented the uncontrolled inflammatory response, cell death and reduction in HLA-DR expression in SARS-CoV-2-infected monocytes. Our study provides relevant information on the effects of SARS-CoV-2 infection on human monocytes, as well as on the effect of ATV in preventing these pathological effects on the host.

Langerhans cells (LCs) play important roles in cell-mediated immune reactions, as well as in the pathogenesis of periapical lesions. The aim of this study is to evaluate the role of LCs in the proliferative epithelium of radicular cysts (RCs) and the release of the proinflammatory cytokine tumor necrosis factor α (TNF-α) associated with epithelial thickness. Thirty cases of RCs and 30 cases of residual RCs were randomly selected. Morphologic analysis was performed to evaluate the association between the inflammatory infiltrate, cystic epithelial thickness and lesion size, in addition to immunohistochemical assessment of CD1a, CD68, and TNF-α. The highest macrophage percentages and TNF-α scores were found in RCs (P=0.038 and 0.017, respectively). The largest number of LCs was observed in RCs (P=0.021), especially those exhibiting atrophic epithelium (P=0.05). In addition, LCs were positively correlated with the number of macrophages in both RCs and residual RCs (P=0.033 and 0.002, respectively). In contrast to LCs, the largest number of macrophages was detected in cases with an intense inflammatory infiltrate (P=0.022). In addition, the highest TNF-α scores were associated with an intense inflammatory infiltrate (P=0.024) when analyzed in the capsule of RCs (P=0.017). In conclusion, LCs participate in defense mechanisms and were present in all cases evaluated. Along with macrophages, these cells release proinflammatory cytokines such as TNF-α, which is responsible for inducing the continued proliferation of cystic epithelium.

In orbital angular momentum (OAM) based free-space optical (FSO) communication systems, a CCD camera can be used at the reception side to capture images of the laser beam carrying the transmitted OAM modes. The tasks of extracting features from these images and identifying the transmitted modes are studied in this paper. The ability of machine learning algorithms to perform these tasks is explored. Laguerre-Gauss beams and turbulent channels are considered. Different modulation alphabets formed by using sets of superposed and multiplexed OAM modes are investigated. Appropriate choice of these alphabets can increase data rate transmission.

The present work proposes the use of data visualization techniques allied to an Augmented Reality (AR) user interface to provide information for users to define the most convenient location to sit down at an event. This accounts for different sets of arbitrary demands by projecting 3D information directly atop the seats. The users can also rearrange the data to narrow down the search and switch the attribute being displayed, e.g. temperature, stage visibility, exit access or Wi-Fi signal. The proposed approach was tested against a comparable 2D interactive visualization of the same data. Each user performed twelve location choosing tasks in an average sized classroom. Qualitative and quantitative data indicated that the augmented solution is promising in some senses, exposing that AR may help users to make better decisions.

Inflammation triggered by influenza A virus (IAV) infection is important for viral clearance, induction of adaptive responses, and return to lung homeostasis. However, an exaggerated immune response, characterized by the overproduction of chemokines, can lead to intense lung injury, contributing to mortality. Chemokine scavenger receptors, such as ACKR2, control the levels of CC chemokines influencing the immune responses. Among the chemokine targets of ACKR2, CCL5 is important to recruit and activate lymphocytes. We investigated the role of ACKR2 during IAV infection in mice. Pulmonary ACKR2 expression was increased acutely after IAV infection preceding the virus-induced lung dysfunction. ACKR2-knockout (ACKR2−/−) mice were protected from IAV, presenting decreased viral burden and lung dysfunction. Mechanistically, the absence of ACKR2 resulted in augmented airway CCL5 levels, secreted by mononuclear and plasma cells in the lung parenchyma. The higher chemokine gradient led to an augmented recruitment of T and B lymphocytes, formation of inducible bronchus-associated lymphoid tissue and production of IgA in the airways of ACKR2−/− mice post-IAV. CCL5 neutralization in ACKR2−/− mice prevented lymphocyte recruitment and increased bronchoalveolar lavage fluid protein levels and pulmonary dysfunction. Finally, CCR5−/− mice presented increased disease severity during IAV infection, displaying increased neutrophils, pulmonary injury and dysfunction, and accentuated lethality. Collectively, our data showed that ACKR2 dampens CCL5 levels and the consequent recruitment of CCR5+ T helper 1 (Th1), T regulatory cells (Tregs), and B lymphocytes during IAV infection, decreasing pathogen control and promoting lung dysfunction in wild type mice. Therefore, ACKR2 is detrimental and CCR5 is protective during IAV infection coordinating innate and adaptive immune responses in mice.

Importance The efficacy of factor XIa inhibition for thromboprophylaxis is unknown. Osocimab is a long-acting, fully human monoclonal antibody that inhibits factor XIa. Objective To compare different doses of osocimab with enoxaparin and apixaban for thromboprophylaxis in patients who have undergone knee arthroplasty. Design, Setting, and Participants Randomized, open-label, adjudicator-blinded, phase 2 noninferiority trial with observer blinding for osocimab doses, conducted at 54 hospitals in 13 countries. Adult patients undergoing unilateral knee arthroplasty were randomized from October 2017 through August 2018 and followed up until January 2019. Interventions Single intravenous osocimab postoperative doses of 0.3 mg/kg (n = 107), 0.6 mg/kg (n = 65), 1.2 mg/kg (n = 108), or 1.8 mg/kg (n = 106); preoperative doses of 0.3 mg/kg (n = 109) or 1.8 mg/kg (n = 108); or 40 mg of subcutaneous enoxaparin once daily (n = 105) or 2.5 mg of oral apixaban twice daily (n = 105) for at least 10 days or until venography. Main Outcomes and Measures The primary outcome was venous thromboembolism incidence between 10 and 13 days postoperatively (assessed by mandatory bilateral venography performed 10 to 13 days after surgery or confirmed symptomatic deep vein thrombosis or pulmonary embolism). A 5% noninferiority margin compared with enoxaparin was chosen. The primary safety outcome of major or clinically relevant nonmajor bleeding was assessed until 10 to 13 days postoperatively. Results Of 813 randomized participants (mean [SD] age, 66.5 years [8.2 years]; body mass index, 32.7 [5.7]; and 74.2% women), 600 were included in the per-protocol population used for the primary analysis. The primary outcome occurred in 18 patients (23.7%) receiving 0.3 mg/kg, 8 (15.7%) receiving 0.6 mg/kg, 13 (16.5%) receiving 1.2 mg/kg, and 14 (17.9%) receiving 1.8 mg/kg of osocimab postoperatively; 23 (29.9%) receiving 0.3 mg/kg and 9 (11.3%) receiving 1.8 mg/kg of osocimab preoperatively; 20 (26.3%) receiving enoxaparin; and 12 (14.5%) receiving apixaban. Osocimab given postoperatively met criteria for noninferiority compared with enoxaparin with risk differences (1-sided 95% CIs) of 10.6% (95% CI, –1.2% to ∞) at the 0.6-mg/kg dose; 9.9% (95% CI, –0.9% to ∞) at the 1.2-mg/kg dose, and 8.4% (95% CI, –2.6 to ∞) at the 1.8-mg/kg dose. The preoperative dose of 1.8 mg/kg of osocimab met criteria for superiority compared with enoxaparin with a risk difference of 15.1%; 2-sided 90% CI, 4.9% to 25.2%). Postoperative and preoperative doses of 0.3 mg/kg of osocimab did not meet the prespecified criteria for noninferiority, with risk differences (1-sided 95% CIs) of 2.6% (95% CI, –8.9% to ∞) and –3.6% (95% CI, –15.5% to ∞), respectively. Major or clinically relevant nonmajor bleeding was observed in up to 4.7% of those receiving osocimab, 5.9% receiving enoxaparin, and 2% receiving apixaban. Conclusions and Relevance Among patients undergoing knee arthroplasty, postoperative osocimab 0.6 mg/kg, 1.2 mg/kg, and 1.8 mg/kg met criteria for noninferiority compared with enoxaparin, and the preoperative 1.8-mg/kg dose of osocimab met criteria for superiority compared with enoxaparin for the primary outcome of incidence of venous thromboembolism at 10 to 13 days postoperatively. Further studies are needed to establish efficacy and safety of osocimab relative to standard thromboprophylaxis. Trial Registration ClinicalTrials.gov Identifier:NCT03276143

Background This study aimed to compare the facial profile attractiveness of Class III borderline patients after surgical or compensatory orthodontic treatment. Material and Methods The sample consisted of 60 borderline Class III malocclusion patients, divided into two groups: Group 1 (Surgical): 30 patients (16 male; 14 female) treated with orthodontic fixed appliances and bimaxillary orthognathic surgery. Mean initial age was 20.05 years (s.d.=2.40) and mean treatment time was 2.23 years (s.d.=0.82). Group 2 (Compensatory): 30 patients (13 male; 17 female) treated compensatorily with fixed appliances and Class III elastics. Mean initial age was 18.53 years (s.d.=4.35) and mean treatment time was 2.08 years (s.d.=0.67). Silhouettes of the facial profile were constructed obtained from the pretreatment and posttreatment lateral cephalograms and evaluated by orthodontists (N=41, 22 females and 19 males, mean age of 35.65 years), assigning scores from 1 (least attractive) to 10 (most attractive). Intergroup comparison of profile attractiveness was performed by Mann-Whitney test. For intragroup comparison of initial and final stages, the Wilcoxon test was used. Results At initial stage, the compensatory group presented a statistically significant greater attractiveness of the profile than the surgical group. With treatment, the surgical group presented significantly more improvement in facial profile than the compensatory group. At the final stage, profile attractiveness of surgical and compensatory groups was similar. Conclusions The facial profile attractiveness is similar in Class III patients after orthognathic surgery or compensatory orthodontic treatment. However, surgery provided more improvement in profile attractiveness than the compensatory treatment in Class III patients. Key words:Malocclusion, angle Class III, orthognathic surgery, corrective orthodontics.

This short review is aimed at presenting the most recent literature linking obstructive sleep apnea (OSA) with metabolic risk. In the last decades, substantial evidence derived from experimental, translational, and clinical studies has supported the possibility that OSA predisposes to cardiovascular diseases via activation and propagation of multiple pathophysiological pathways. While initial studies focused on the hemodynamic effects of OSA, further studies indicated that the components of OSA (especially intermittent hypoxia) also promote metabolic deregulation, including insulin resistance, impaired lipoprotein clearance, and dyslipidemia. This review indicates that the precise effects of chronic intermittent hypoxia and the relative impact of sleep fragmentation on glucose and lipid metabolism still require further studies as well as the impact of effective OSA treatment. Personalized medicine devoting to explore potential biomarkers that predicts metabolic risk may help to prevent cardiovascular disease in patients with OSA.

Fatela, P, Reis, JF, Mendonca, GV, Freitas, T, Valamatos, MJ, Avela, J, and Mil-Homens, P. Acute neuromuscular adaptations in response to low-intensity blood flow restricted exercise and high-intensity resistance exercise: are there any differences? J Strength Cond Res 32(4): 902-910, 2018-Numerous studies have reported similar neuromuscular adaptations between low-intensity (LI) blood-flow restricted exercise (BFRE) and high-intensity (HI) resistance training. Unfortunately, none of these experimental designs individualized blood flow restriction (BFR) levels to each participant. Thus, their findings are difficult to interpret. We aimed at comparing the acute effects of LI BFR (80% of absolute vascular occlusion pressure) with LI non-BFR and HI training on muscle torque, activation, and neuromuscular fatigue. Ten men (23.8 ± 5.4 years) exercised at 20 and 75% of 1 repetition maximum with and without BFR (for LI). Blood flow restriction pressure was determined individually using resting blood-flow measurements. Torque was determined during maximal voluntary contractions (MVCs) at pre-exercise and postexercise time points. Surface electromyographic activity (root mean square [RMS] and median frequency [MF]) was recorded for the rectus femoris (RF) and vastus medialis (VM) muscles, before and after each session of training, during isometric contractions at 20% MVC. Torque decreased post-HI and LI BFR (-9.5 and -7.8%, respectively; p < 0.01), but not after LI non-BFR. The MF was reduced following HI training in the VM and the RF muscles (-5.3 and -12.5%, respectively; p ≤ 0.05). Conversely, the impact of LI BFR on reducing MF was limited to the RF muscle (-10.7%, p ≤ 0.05). Finally, when compared to all other conditions, RMS values were consistently higher during submaximal contractions performed after HI training (p ≤ 0.05). Thus, we conclude that, despite enhancing the acute magnitude of muscular activation and fatigue, LI BFR exercise exerts a less profound impact on neuromuscular function than HI resistance training.

Laboratory diagnosis of leishmaniasis shows variable efficacy in detecting infected mammalian hosts and there is a need to identify suitable antigens to improve the accuracy of diagnostic tests. In the present study, a L. infantum hypothetical protein called LiHyQ was evaluated for the diagnosis of tegumentary (TL) and visceral (VL) leishmaniasis using canine and human samples. A collection of dog sera (n=155) were tested and contained samples from asymptomatic (n=20) and symptomatic (n=25) VL animals, from healthy dogs living in endemic (n=25) or non-endemic (n=25) areas of disease, from Leish-Tec® vaccinated dogs (n=20) or from dogs infected with Ehrlichia canis (n=15), Babesia canis (n=10) and Trypanosoma cruzi (n=15). Sensitivity (Se), Specificity (Sp), Positive Predictive Value (PPV) and Negative Predictive Value (NPV) of 100% were observed for rLiHyQ with these samples, whereas the Se, Sp, PPV and NPV values with L. infantum Soluble Leishmania Antigen (SLA) preparation were 60.0%, 99.0%, 96.0% and 86.0%, respectively. A collection of human sera (n=305) were tested and contained samples from TL (n=50) and VL (n=40) patients, from VL/HIV co-infected patients (n=35), from patients infected with HIV alone (n=30), Chagas Disease (n=30), malaria (n=10), tuberculosis (n=10), paracoccidioidomycosis (n=15), leprosy (n=30) or aspergillosis (n=15); and from healthy subjects (n=40). Se, Sp, PPV and NPV values of 100% were observed for rLiHyQ with these samples, whereas the Se, Sp, PPV and NPV values with SLA were 58.0%, 76.0%, 50.0% and 82.0%, respectively. The antibody reactivity against the protein was compared with commercial kits, and the kappa index varied from 0.95 to 1.00 for rLiHyQ, and of 0.55 to 0.82 for the kits. In addition, the serological follow-up of treated patients showed a significant reduction in rLiHyQ-specific IgG antibody levels. All canine and human samples were tested at the same time using the same reagents, in order to reduce experimental variation and interference in data interpretation. In conclusion, our preliminary data suggest a diagnostic and prognostic role for rLiHyQ against leishmaniasis.

Shadows exist in almost all aerial and outdoor images, and they can be useful for estimating Sun position estimation or measuring object size. On the other hand, they represent a problem in processes such as object detection/recognition, image matching, etc., because they may be confused with dark objects and change the image radiometric properties. We address this problem on aerial and outdoor color images in this work. We use a filter to find low intensities as a first step. For outdoor color images, we analyze spectrum ratio properties to refine the detection, and the results are assessed with a dataset containing ground truth. For the aerial case we validate the detections depending of the hue component of pixels. This stage takes into account that, in deep shadows, most pixels have blue or violet wavelengths because of an atmospheric scattering effect.

IntroductionPerinatal death includes losses such as ectopic pregnancies, miscarriages, stillbirths and neonatal deaths. Perinatal loss has well documented negative effects on the health of the bereaved parents. Early pregnancy loss (EPL) is the spontaneous death of a fetus within the first 20 weeks of gestation.ObjectivesTo describe a clinical case of disenfranchised grief following EPL and to review the literature.MethodsWe reviewed the clinical file of a patient presenting to the psychiatry outpatient clinic with disenfranchised grief. We conducted a non-systematic review on PubMed and Google Scholar.ResultsA 29-years-old female patient presents to the outpatient clinic with depressive symptoms and thoughts of death. The symptoms had begun 4 months earlier, following the loss of pregnancy at 14 weeks. She felt her grief was not accepted by her family and social network. Progressively, her relationships deteriorated, and she felt more and more isolated. She experienced marked difficulty in caring for her older child. Compared to other types of mourning, the loss of a child is associated with grief experience that is particularly severe and complicated. Despite the high prevalence of EPL, many women suffer in silence due to the common belief these losses are insignificant and may develop complicated grief.ConclusionsPerinatal loss of an infant has the potential to have a large impact on the mental health of the bereaved parents. Literature on the efficacy of different interventions is still scarce. Further studies are necessary on prevention strategies and interventions for parents already suffering from complicated grief or depressive disorders.DisclosureNo significant relationships.

In the last decades, obstructive sleep apnea (OSA) has gained substantial attention due to the high prevalence and multiple consequences not limited to sleep quality and quality of life (1).

Idiopathic pulmonary fibrosis (IPF) is a progressive and fatal lung disease that up to now has been associated with a poor prognosis. However, the results of the INPULSIS and ASCEND trials and the approval of nintedanib and pirfenidone have marked the beginning of a new era for IPF patients. Questions remain, however. Should these drugs be used earlier? What effect will they have on more severe disease? Will their effects last beyond the trial period? This manuscript is the outcome of a multidisciplinary meeting between pulmonology, radiology, and pathology clinicians on the use of antifibrotic agents in IPF. In our opinion, the existing data show that pirfenidone and nintedanib slow functional decline in early stages of disease. These drugs also appear to result in therapeutic benefits when administered to patients with advanced disease at diagnosis and maintain effective over time. The data also suggest that continuing antifibrotic therapy after disease progression may confer benefits, but more evidence is needed. Early diagnosis and treatment are crucial for reducing functional decline, slowing disease progression, and improving quality of life. Keywords: Idiopathic pulmonary fibrosis, Interstitial lung disease, Nintedanib, Pirfenidone

Hydropower turbine’s blades are constantly exposed to abrasion and cavitation phenomena, demanding regular maintenance for flow stability. Hard coating techniques by thermal aspersion are used to reduce the mechanical wear, thus increasing blade’s life cycle, and turbine efficiency. Currently, applying a new coating layer requires turbine disassembling and recalibration. EMMA is a robotic system to perform hard coating by thermal spray on hydraulic turbine blades within the turbine environment, i.e., hard coating application to an installed blade, significantly reducing the turbine downtime. This document is a study of the state of the art of in situ hydropower turbine robotic systems and describes the conceptual designs for EMMA. The results outlines the next steps for EMMA and future projects in the same area.

Obstructive sleep apnea (OSA) is associated with multiple comorbid conditions including cardiovascular diseases and cancer. There is a growing interest in exploring biomarkers to understand the related mechanisms and improve the risk stratification of OSA. Circulating microRNAs (miRNAs) are single noncoding strands of nearly 22 nucleotides that posttranscriptionally regulate target gene expression. Our aim was to identify miRNA profiles associated with OSA. We studied 48 male subjects, mostly Caucasian (63%) and overweight, divided by polysomnography into the no OSA control group (n = 6), mild OSA group (n = 12), moderate OSA group (n = 15), and severe OSA group (n = 15). The study groups were matched for age, body mass index (BMI), and body fat composition. miRNA profiles were measured from peripheral whole blood using two steps: (1) microarray analysis comprising more than 2500 miRNAs in a subsample of 12 subjects (three from each group); and (2) validation phase using real-time quantitative polymerase chain reaction (RTqPCR). The microarray assessment identified 21 differentially expressed miRNAs among the groups. The RT-qPCR assessment showed that miR-1254 and miR-320e presented a gradual increase in expression parallel to OSA severity. Linear regression analysis showed that severe OSA was independently associated with miR-1254 (s = 68.4; EP = 29.8; p = 0.02) and miR-320e (s = 76.1; EP = 31.3; p = 0.02). Severe OSA is independently associated with miRNAs that are involved in heart failure (miR-1254), myocardial ischemia/reperfusion (miR-320e), and cell proliferation in some cancer types (miR-1254 and miR-320e). Future investigations addressing whether these miRs may provide prognostic information in OSA are needed.

Energy-saving becomes an increasingly important point since the demand for energy increases, and the resources for production are limited. One way to help consumers to save is by providing them with more transparency on how they are consuming. Energy disaggregation seeks to distinguish the electrical energy consumption of distinct devices connected to a single channel, in a non-intrusive way from a single measuring point. Deep learning is very promising in this field since they present better results when compared to previous models such as the Factorial Hidden Markov Model and Graph Signal Processing. In this work, we propose a deep learning approach for energy disaggregation, focusing on its performance for embedded devices. Thus, we evaluate the scalability of our proposal for disaggregating multiple appliances considering an embedded device. The results show that our proposal is well-suited for this application and better than previous works.

Ascariasis is considered the most neglected tropical disease, and is a major problem for the public health system. However, idiopathic pulmonary fibrosis (IPF) is a result of chronic extracellular deposition of matrix in the pulmonary parenchyma, and thickening of the alveolar septa, which reduces alveolar gas exchange. Considering the high rates of ascariasis and pulmonary fibrosis, we believe that these two diseases may co-exist and possibly lead to comorbidities. We therefore investigated the mechanisms involved in comorbidity of Ascaris suum (A. suum) infection, which could interfere with the progression of pulmonary fibrosis. In addition, we evaluated whether a previous lung fibrosis could interfere with the pulmonary cycle of A. suum in mice. The most important findings related to comorbidity in which A. suum infection exacerbated pulmonary and liver injury, inflammation and dysfunction, but did not promote excessive fibrosis in mice during the investigated comorbidity period. Interestingly, we found that pulmonary fibrosis did not alter the parasite cycle that transmigrated preferentially through preserved but not fibrotic areas of the lungs. Collectively, our results demonstrate that A. suum infection leads to comorbidity, and contributes to the aggravation of pulmonary dysfunction during pulmonary fibrosis, which also leads to significant liver injury and inflammation, without changing the A. suum cycle in the lungs., Author summary Ascariasis is considered a major problem for the public health system, which has an estimated 800 million infected people worldwide. It occurs in the United States, Africa, Asia, and Latin America, and is generally associated with poverty and precarious health conditions. Pulmonary fibrosis affects 14–63 people per 100,000 habitants/year, and is characterized by collagen deposition and alveolar wall thickening. The comorbidities caused by infections are commonly associated with pulmonary fibrosis exacerbations, poor prognosis, and high mortality. Despite the comorbidities caused by helminth infections, which display a pulmonary parasitic cycle such as that of Ascaris, there is no evidence relating to pulmonary fibrosis progression, possibly because Ascariasis is considered a neglected disease. We evaluated the role of Ascaris during pulmonary fibrosis. We considered two simple questions: (1) Whether Ascaris infection could protect or aggravate fibrosis (comorbidities) and (2) whether pulmonary fibrosis could change the cycle of Ascaris as a result of increased alveolar thickening, larvae retention, and the limitation of influx into airways. We answered both questions as follows: (1) Ascaris infection exacerbates pulmonary and liver injury and inflammation, but not fibrosis; and (2) Pulmonary fibrosis did not alter the course of Ascaris cycle in lungs during transmigration into airways, because Ascaris preferentially seeks and penetrates into the lung areas, which are thought to be preserved, but not into fibrotic areas.

Artificial intelligence advances have an important role on self-driving cars development, such as assisting the recognition of traffic lights. However, when relying on images of the scene alone, little progress was observed on selecting the traffic lights defining guidance to the car. Common detection approaches rely on additional high-level decision-making process to select a relevant traffic light. This work address the problem by proposing a deep regression system with an outliers resilient loss to predict the coordinates of a relevant traffic light in the image plane. The prediction can be used as a high-level decision-maker or as an assistant to a cheaper classifier to work on a region of interest. Results for European scenes show success in about 88% of the cases.

The assessment of solar potential in the urban environment is an important instrument for policy decision regarding renewable energy deployment in the city. This paper presents an experimentally validated 3D solar potential model for rooftops and facades from LIDAR data considering anisotropic diffuse irradiation. The data visualization is rendered in the ArcGIS platform using CityEngine to automatically generate 3D models from 2D geometries. The model is validated against summer and winter measurements of photovoltaic performance on a facade. A case study for two densely packed urban areas in Lisbon, Portugal, are presented. Facades are shown to increase the solar potential by 10 to 15%.

This dissertation investigates the use of Virtual Reality for the exploration of multidimensional data represented as 3D scatterplots. After an initial user study indicated that an immersive environment required less effort to find information and less navigation, but resulted in inefficient times and frequent user discomfort, we proposed and evaluated an alternative data exploration approach based on the use of physical movements, direct interaction with data at arms reach and a virtual reproduction of the analysts work desk. Through a second study, we demonstrate that this setup, named VirtualDesk, presents excellent results regarding user comfort, and performs equally or better in all tasks, while adding minimal or no time overhead and amplifying data exploration.