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As turbinas hidráulicas são uma das principais componentes na geração da energia hidrelétrica, porém, o alto valor de aquisição e manutenção desses dispositivos constitui a maior limitação para uso nos países em via de desenvolvimento. É neste contexto que se realizou uma pesquisa experimental com objetivo de construir uma turbina hidráulica do tipo Francis, utilizando materiais alternativos, capaz de gerar energia elétrica para uso residencial. A turbina foi testada no laboratório de Física da Universidade Rovuma – Nampula e instalada num trecho do rio Muatala, na cidade de Nampula, gerando a potência hídrica de 147W e potência do eixo da turbina de 132W, que conectado a um gerador elétrico, registou-se uma tensão de 133V e corrente elétrica de 34mA. Os parâmetros elétricos obtidos podem ser usados no acionamento de eletrodomésticos de baixa potência. Conclui-se que a turbina hidráulica do tipo Francis construída a partir de materiais alternativos apresenta sustentabilidade social, ambiental e econômica para geração de eletricidade para uso residencial.

Enzymatic hydrolysis is considered as one of the most promiser approaches to improving algae protein digestibility and to obtain several protein products. In the work reported here, we have been interested in investigating the influence of biomass treatment and the nature of proteolytic enzymes on the hydrolysis of cell proteins in the microalga Chlorella vulgaris growth under autotrophic conditions in the Solar Energy Research Center. The enzymatic digestion took place more efficiently in biomass previously extracted with ethanol and with the exception of pepsin, the other enzymes yielded hydrolysates in which the amino nitrogen content and the degree of hydrolysis were higher than 3 and 30 % respectively. These results suggest that a wide spectrum of proteolytic enzymes could be used for the production of protein hydrolysates from the extracted alga. [ABSTRACT FROM AUTHOR]

In the work reported here the biochemical composition of a protein hydrolysate obtained from the microalga Chlorella vulgaris with a comercial preparation of pancreatin is studied. The biostimulant properties of this product were also evaluated in a model of protein-energy malnutrition (PEM).The free amino acid content in hydrolysate went up to 5,7 % and three polypeptides were the main peptide fractions. The amino acid pattern contains the eight essential amino acids and the balanced mineral profile reenforce the intrinsic hydrolysate value. The intraperitoneal administration to Balb/c mice (at a dose of the 500 mg/Kg) at PEM condition led to the recovery of the integrity and the stimulation of the liver and jejunal mucosa functionality. The proliferation of lymphocytes and cells of the mononuclear phagocytic system, were findings of the inmunostimulant effects of the algal hydrolysate. [ABSTRACT FROM AUTHOR]

Background/Objectives : This study presents a novel approach, based on a combination of radiomic feature extraction, data resampling techniques, and machine learning algorithms, for the detection of degraded bone structures in Dual X-ray Absorptiometry (DXA) images. This comprehensive approach, which addresses the critical aspects of the problem, distinguishes this work from previous studies, improving the performance achieved by the most similar studies. The primary aim is to provide clinicians with an accessible tool for quality bone assessment, which is currently limited. Methods : A dataset of 1531 spine DXA images was automatically segmented and labelled based on Trabecular Bone Score (TBS) values. Radiomic features were extracted using Pyradiomics, and various resampling techniques were employed to address class imbalance. Three machine learning classifiers (Logistic Regression, Support Vector Machine (SVM), and XGBoost) were trained and evaluated using standard performance metrics. Results : The SVM classifier outperformed the other classifiers. The highest F-score of 97.5% was achieved using the Grey Level Dependence Matrix and Grey Level Run Length Matrix feature combination with SMOTEENN resampling, which proved to be the most effective resampling technique, while the undersampling method yielded the lowest performance. Conclusions : This research demonstrates the potential of radiomic texture features, resampling techniques, and machine learning methods for classifying DXA images into healthy or degraded bone structures, which potentially leads to improved clinical diagnosis and treatment.

Aims: Research in diabetes-related foot conditions (DRFC) often focuses on ulcer-related care, whilst the patient experience and influence of sociodemographic factors are under-researched. This systematic review investigated patient-reported outcomes and experience in people with DRFC., Methods: Multiple databases were searched from inception to 16 August 2023. All original articles that assessed any patient-reported outcome or experience in DRFC and reported participant ethnicity were included. Data were synthesized using a sequential contingent approach. Study quality was assessed using study design-specific tools., Results: Twenty-three studies were included (11 qualitative, 11 quantitative and one mixed-methods). DRFC had a largely negative impact on various life dimensions, including social and daily life, work, emotional and psychological well-being, necessitating dependence on others in the form of emotional, social and/or religious support, which were experienced differently by different groups. Patient DRFC knowledge and self-care habits were typically suboptimal, and levels of hope and feeling of control over their condition varied between groups. Outcomes varied slightly between ethnicities across studies, with some ethnicity-specific themes identified such as beliefs about disease cause and footwear habits. Quantitative and qualitative findings were mostly congruent., Conclusions: DRFC profoundly and negatively impacts patient-reported outcomes and experience, with limited evidence suggesting an influence of ethnicity., (© 2024 The Author(s). Diabetic Medicine published by John Wiley & Sons Ltd on behalf of Diabetes UK.)

Data on long-term treatment regimens for preventing bone mineral density (BMD) loss that occurs after denosumab (Dmab) withdrawal are scarce. Our aim was to evaluate the long-term changes (12-36 months) in BMD and bone turnover markers in a group of postmenopausal women who had been treated with Dmab and received subsequent treatment with bisphosphonates. Secondary objectives were to evaluate factors associated with BMD loss, to compare the BMD change in patients who received oral vs intravenous bisphosphonates, and to assess the frequency of fragility fractures after Dmab discontinuation. The clinical data of 54 patients, 26 of whom had clinical and DXA assessments at 36 months, were analyzed. After 12 months, the mean LS BMD had decreased by 2.8% (±5.0), FN BMD by 1.9% (±5.8), and TH BMD by 1.9% (±3.7). After 36 months, LS BMD had decreased by 3.7% (±6.7), FN BMD by 2.5% (±7.1), and TH BMD by 3.6% (±5.2). C-terminal cross-linked telopeptide of type I collagen significantly increased during the first 12 months after Dmab withdrawal but then decreased at 36 months. BMD loss at 12 months was higher in patients with more than 30 months of Dmab treatment, but this difference was only statistically significant at FN (-3.3% vs -0.3%, P  = .252 at LS, -3.3% vs 0.3%, P  = .033 at FN, and -2.1% vs 0.9, P  = .091 at TH). There were no statistically significant differences regarding the change in BMD at 12 and 36 months between oral and intravenous treatment. Seven patients suffered incidental vertebral fractures (clinical vertebral fractures: n  = 6, morphometric fractures: n  = 1) three of which were multiple. None of these patients were treated following international or institutional guidelines or recommendations. In summary, our study suggests that bisphosphonates can help maintain BMD for 36 months after Dmab discontinuation., Competing Interests: M.B.Z. had received speaker honoraria from Amgen. The other authors declare no potential conflicts of interest regarding this work., (© The Author(s) 2024. Published by Oxford University Press on behalf of the American Society for Bone and Mineral Research.)

Aims: Amongst elderly people with type 2 diabetes (T2D) over prescribing can result in emergency ambulance call-outs, falls and fractures and increased mortality, particularly in frail patients. Current clinical guidelines, however, remain focused on medication intensification rather than deintensification where appropriate. This study aims to evaluate the effectiveness of an electronic decision-support system and training for the deintensification of potentially inappropriate medications amongst older frail people with T2D, when compared to 'usual' care at 12-months., Methods: This study is an open-label, multi-site, two-armed pragmatic cluster-randomised trial. GP practices randomised to the 'enhanced care' group have an electronic decision support system installed and receive training on the tool and de-intensification of diabetes medications. The system flags eligible patients for possible deintensification of diabetes medications, linking the health care professional to a clinical algorithm. The primary outcome will be the number of patients at 12-months who have had potentially inappropriate diabetes medications de-intensified., Results: Study recruitment commenced in June 2022. Data collection commenced in January 2023. Baseline data have been extracted from 40 practices (3145 patients)., Conclusions: Digital technology, involving computer decision systems, may have the potential to reduce inappropriate medications and aid the process of de-intensification., Trial Registration: International Standard Randomised Controlled Trial Number: ISRCTN53221378. Available at: https://www.isrctn.com/ISRCTN53221378., Competing Interests: Declaration of Competing Interest KK has acted as a consultant and speaker for Novartis, Novo Nordisk, Sanofi-Aventis, Lilly, and Merck Sharp & Dohme. He has received grants in support of investigator and investigator-initiated trials from Novartis, Novo Nordisk, Sanofi-Aventis, Lilly, Pfizer, Boehringer Ingelheim, and Merck Sharp & Dohme. SS has received funds for research, consultancy to or honoraria from Boehringer Ingelheim, Lilly, Merck Sharp & Dohme Limited, Novartis Pharmaceuticals UK Ltd, Novo Nordisk Limited, Sanofi-Aventis, Amgen, Astra Zeneca, Abbott Janssen-Cilag Ltd, NAPP, and Takeda UK Ltd. JPS receives funding from the Wellcome Trust/Royal Society via a Sir Henry Dale Fellowship (ref: 211182/Z/18/Z), the National Institute for Health and Care Research (NIHR) and from the British Heart Foundation (refs: PG/21/10341; FS/19/13/34235). This research was funded in part, by the Wellcome Trust [211182/Z/18/Z]. For the purpose of open access, the author has applied a CC BY public copyright licence to any Author Accepted Manuscript version arising from this submission. All other authors: none declared., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

In this report, we present the case of a woman with clinical characteristics of hypercalcemia due to ectopic production of 1,25(OH)2D. She reported a history of aesthetic surgery with gluteal fillers. The formation of granulomas after these interventions were previously described. In this case, surgical removal of the foreign formations was attempted with clinical stability during 3 years.

The Argentine Osteoporosis Society convened renowned specialists in the care of transgender people to prepare the first local position on the evaluation of bone health in this population. Law 26.743 on "Gender Identity" recognize all identities and guarantees free care throughout the health system. The impact of different gender affirmation treatments on bone mass has been topic of international debate. To date the evidence remains limited and different societies have issued suggestions and recommendations. For this reason, we believe it is relevant to mention our experience, capturing through this document a series of suggestions to be used in medical care.

Objective: The aim of this study was to provide an evidence-based framework to guide health care professionals treating patients under glucocorticoid (GC) therapy and develop guidelines for the prevention and treatment of glucocorticoid-induced osteoporosis (GIO) in postmenopausal women and men aged ≥50 years., Methods: An expert panel on bone diseases designed a series of clinically meaningful questions following the PICO (Population, Intervention, Comparator, and Outcome) structure. Using GRADE (Grading of Recommendations Assessment, Development, and Evaluation) methodology, we made a systematic literature review, extracted and summarized the effect estimates, and graded the quality of the evidence. The expert panel voted each PICO question and made recommendations after reaching an agreement of at least 70%., Results: Seventeen recommendations (9 strong and 8 conditional) and 8 general principles were developed for postmenopausal women and men aged ≥50 years under GC treatment. Bone mineral density (BMD), occurrence of fragility fractures, probability of fracture at 10 years by Fracture Risk Assessment Tool, and other screening factors for low BMD are recommended for patient evaluation and stratification according to fragility fracture risk. The treatment of patients under GC therapy should include counseling on lifestyle habits and strict control of comorbidities. The goal of GIO treatment is the nonoccurrence of new fragility fractures as well as to increase or maintain BMD in certain clinical situations. This was considered for the therapeutic approach in different clinical scenarios., Conclusions: This GIO guideline provides evidence-based guidance for health care providers treating patients., Competing Interests: The authors declare no conflict of interest., (Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.)

Introduction: Complex regional pain syndrome (CRPS), also known as Sudeck syndrome, is a chronic painful condition usually affecting the limbs after trauma or surgery. Its presentation is heterogeneous and its physiopathology, diagnosis and treatment remain controversial. The objective of this study was to analyze a group of patients with this rare syndrome, describing in detail the results of the dual energy X-ray absorptiometry (DXA) and the response to bisphosphonate treatment., Method: We retrospectively analyzed 54 patients with CRPS, taking into account their demographic features, inciting events and diagnostic tests. As regards treatment, we analyzed the results and adverse events of the use of bisphosphonates Results: We found a female predominance (74%), with 55 ± 13 years. The most common inciting event was trauma (59%), followed by surgery. The difference in bone mineral density between the affected limb and the healthy one was 12 to 15%. Forty-four patients were treated with bisphosphonates (pamidronate, ibandronate, zoledronic acid) and showed a clinical improvement, mainly in terms of pain intensity. Only six patients presented with adverse events, like pseudoflu syndrome and acute phase symptoms., Conclusion: In our cohort, lower limbs CRPS predominantly affects middle aged women. DXA scans are tests used to quantify bone loss and the response to treatment. The use of bisphosphonates is an interesting therapeutic option to improve clinical symptoms in most patients. Future prospective randomized studies will be needed to confirm our results.

Trans man is a biological female person with male gender identity, who can choose to receive a genderaffirming hormone treatment with testosterone. So far, the effects of this treatment on reproduction are unclear. Anti-müllerian hormone levels were evaluated in trans men during short-term testosterone treatment. A prospective study was conducted on 16 individuals who met the requirements to be included. The levels of gonadotrophins, estradiol, testosterone and antimüllerian hormone in the early follicular phase were measured prior to the start of the hormonal firming treatment, by means of a chemiluminescent method. The testosterone and antimüllerian hormone levels were determinedafter 6 to 12 months of treatment. The median age was 22.5 years.Basal testosterone and antimüllerian hormone levels of 0.58 ng/ml and 2.89 ng/ml respectively were obtained, values within the range corresponding to biological women. By the time of the semi-ünnual or annual control of the hormonal firming treatment, all the individuals managed to reach testosterone levels within the reference range of the male population (3-9 ng/ml). However, no significant differences were observed in antimüllerian hormone levels(p 0.7630) before and after 6 to 12 months of starting treatment with testosterone. Our study revealed that, despite the high biological variability of the antimüllerian hormone, no significant changes in its levels were observed during the firming hormone treatment in trans men.

Objectives: Sarcopenia is the loss of skeletal muscle mass and function that occurs with aging that can lead to greater morbidity and mortality. Chronic kidney disease and hemodialysis (HD) favors the development of sarcopenia. We studied the prevalence of sarcopenia and its components using European Working Group on Sarcopenia in Elderly People 2 proposed criteria and risk factors for its development in HD patients., Methods: In 100 adult HD patients, we evaluated: hand grip strength (HGS), muscle mass by dual energy X-ray absorptiometry and physical performance (gait-speed and sit-stand test)., Results: Sixty patients were male and 40 were female; mean age 55.6 years. Prevalence of sarcopenia was 16% (11.1% in males and 25% in females; P = 0.05); 7% had severe sarcopenia. Prevalence of low HGS was 33% in males and 28% in females; low muscle mass was 30% in males but 70% in females and low physical performance 23% in males and 45% in females. Falls were reported by 23 patients. Patients with lower HGS had a higher prevalence of falls in the last year (40% two or more falls; P = 0.03). Only females with sarcopenia had lower bone mineral content. Neither age, body mass index, time on dialysis, or prevalence of diabetes predicted sarcopenia., Conclusions: A significant proportion of dialysis patients had sarcopenia, more frequent in females. Low HGS was associated with a higher prevalence of falls. Only females with sarcopenia had lower bone mineral content., Competing Interests: The authors declare no competing interests., (© 2021 The Korean Society of Osteoporosis. Publishing services by Elsevier B.V.)

Recently, a new consensus of the European Working Group on Sarcopenia in Older People (EWSOP2) recommended new cut-off points for the diagnosis of sarcopenia. The aim of the present manuscript was to assess the prevalence of sarcopenia in postmenopausal women and its relationship with bone mineral density, falls and fragility fractures according to EWGSOP2. In this cross-sectional study, 250 ambulatory postmenopausal women over 60 years of age were included. Lumbar spine and hip bone mineral density (BMD) and whole-body composition were assessed by dual-energy X-ray absorptiometry (DXA). Muscle strength was evaluated by handgrip dynamometry and physical performance by a 4-m walk gait speed and five-repetition sit-to-stand test. Sarcopenia was defined according to EWGSOP2 as low muscle strength (handgrip) and low muscle mass (appendicular skeletal muscle mass index by DXA). A sarcopenia prevalence of 4% was found in the whole group increasing with age being 12.5% in = 80- year-old. A higher percentage of falls, prevalence of osteoporosis and vertebral fractures were found in the sarcopenic group. Sarcopenia increased 6.0-fold the likelihood of having a fragility fracture. Women with sarcopenia had significantly lower femoral neck BMD and higher frequency of falls and vertebral fractures. According to our results, identifying patients with sarcopenia might be a useful tool to detect adults at higher risk of falls and fractures.

We present the case of a 65-year-old man with brown tumors due to secondary hyperparathyroidism. Magnetic resonance imaging of the pelvis showed multiple lesions with expansive bone appearance. Additionally, prostate cancer was diagnosed during this time. For this reason, differential diagnosis was performed through biopsy of the right iliac bone lesion. Brown tumors are caused by osteoclastic activity and fibroblast proliferation; the differential diagnosis of these bone lesions includes giant tumors, metastases, Paget's disease, and paraneoplastic syndrome with high levels of parathyroid hormone-related peptide (PTHrP). This case report describes the coexistence of two pathologies that could explain these images. In this report, we present a case of a 65-year-old man with brown tumors due to secondary hyperparathyroidism and prostate cancer. In this setting, histologic confirmation is recommended.

The traditional ethnobotanic and pharmacologic use of Spondias mombin L. samples includes a wide range of applications. In the present study, new antiangiogenic and antitumor effects of two types of extracts from Spondias mombin L. leaves have been demonstrated by using a number of in vitro assays in both endothelial and human cancer and non cancer cells., (Copyright © 2020 The Authors. Published by Elsevier Masson SAS.. All rights reserved.)

Objectives: This was a systematic review of studies on the use of diffusion-weighted imaging (DWI) for paranasal sinus diseases. The applications of DWI were analyzed along with the main results, and conclusions were obtained by the investigators., Study Design: Databases were searched using the keyword "diffusion" combined with "sinonasal," "paranasal sinus," "maxillary sinus," "frontal sinus," "ethmoid sinus," and "sphenoid sinus," including only articles that were published from 2008 to 2018. Only original English language studies with sinonasal disease samples were selected., Results: Sixteen studies about various sinonasal diseases were included. The main objectives of most of the studies were related to the use of the apparent diffusion coefficient (ADC) in the differentiation of benign lesions and malignant neoplasms. We concluded that the ADC for malignant neoplasms is lower. Histologic features of samples evaluated in the studies were heterogeneous., Conclusions: The ADC may improve the quality of the diagnostic hypothesis, particularly in differentiating benign and malignant diseases. Furthermore, the differences between certain types of lesions could be determined by using the ADC. However, further studies focusing on inflammatory diseases should be performed. Overall, DWI and the ADC are promising methods that can be incorporated into routine evaluations., (Copyright © 2018 Elsevier Inc. All rights reserved.)

Background: Magnetic resonance imaging is considered a preferable imaging examination in the diagnosis of inflammatory maxillary sinus disease and can provide precise sinonasal characterization. Diffusion-weighted magnetic resonance imaging and apparent diffusion coefficient are complementary magnetic resonance imaging tools that can be applied to the differentiation of sinus diseases. In this report, 3 cases of inflammatory maxillary sinus diseases imaging findings considering diffusion-weighted magnetic resonance imaging features were described. Additionally, a literature review considering the use of diffusion-weighted magnetic resonance imaging in inflammatory lesions is provided., Methods: The cases reported were: presence of air-fluid levels, mucosal thickening and a mucous retention cyst. Conventional magnetic resonance imaging and apparent diffusion coefficient (ADC) maps, with ADC values were demonstrated. In the literature review, the studies considering inflammatory lesions were detailed, as well as ADC values established by investigators., Results: ADC values for presence of air-fluid levels, mucosal thickening and mucous retention cyst were respectively: 1.99 x 10 -3 mm 2 /s; 1.83 x 10 -3 mm 2 /s; 2.05 x 10 -3 mm 2 /s., Conclusions: It was observed that apparent diffusion coefficient values from the inflammatory lesions described in this report were different and apparent diffusion coefficient may be useful in the differentiation of these maxillary sinus alterations. Further larger sample investigations considering apparent diffusion coefficient values focusing in inflammatory lesions are recommended. The lack of studies considering the use of diffusion-weighted magnetic resonance imaging on inflammatory diseases diagnostic was the major limitation to the literature review.

A trans-male (TM) is a biologically female person with male gender identity who wishes to acquire male sexual characteristics and fulfil a male social role. To achieve that purpose, both cross-hormonal therapy (CHT) and surgical phalloplasty can be used. We evaluated the short term (12 months) safety profile of CHT using different forms of testosterone available for prescription in Argentina. In this retrospective study, we analyzed the medical history of 30 trans-male patients fitting the inclusion criteria. The mean age of the population was 27 years. The mean basal serum level of testosterone was 0.43 ng/ml, which increased to 6.36 ng/ml (male hormonal levels). The hematocrit increased from a baseline of 40.0 to 45.2% (p < 0.01) and hemoglobin increased from 13.6 to 15.2 g/dl (p < 0.01). Total cholesterol remained stable with values of 175 and 185 mg/dl (p = 0.81). There were no significant changes in serum triglycerides: 88.3 and 102 mg/dl (p = 0.08). LDL increased in the first 6 to 12 months of CHT from 101.2 to 112.5 mg/dl (p = 0.17). At 12 months HDL levels increased from 50.1 to 52 mg/dl (p < 0.01). Hepatic enzymes remained stable. There is no available data regarding safety of testosterone use in TM in our country. In no case did we need to suspend the medication due to unwanted effects.

The biofiltration capacity, biomass-yield and accumulation of N- and C-compounds of Hydropuntia cornea were analyzed. Algae were grown in different conditions for 28 d: outdoor and indoor, with or without fishpond effluents. N-uptake efficiency of these effluents was higher than 95% after 7 d both outdoors and indoors. N-enriched conditions reduced the extent of photoinhibition and increased the maximal quantum yield in H. cornea. The biomass-yield was higher in outdoor grown-algae after 7 d and decreased independently of the treatment after 28 d. N, acid polysaccharide (AP) and mycosporine-like amino acid (MAA)-yields decreased throughout the experiment in all conditions. The highest MAA-yield was observed in fishpond effluent outdoor-grown algae, indicating a positive effect of increased radiation on MAA accumulation. However, APs were higher under N-depleted conditions. The use of MAAs as UV-screening and antioxidants, and the use of AP as immunostimulants are discussed., (Copyright © 2011 Elsevier Ltd. All rights reserved.)

Trans-urocanic acid is a major chromophore for ultraviolet (UV) radiation in human epidermis. The UV induces photoisomerization of trans-urocanic acid (tUCA) form to cis-urocanic acid (cUCA) and has been reported as an important mediator in the immunosuppression induced by UV. This immunomodulation has been recognized as an important factor related to skin cancer development. This is the first time that UCA isomers have been measured in epidermis of skin biopsies from patients with squamous cell carcinoma (SCC) and with basal cell carcinoma (BCC) and compared with the tumor periphery and biopsies of healthy photoexposed and non-photoexposed skin as controls. The UCA isomers were separated and quantified by high performance liquid chromatography. Analysis of UCA in healthy skin showed significant increase in total UCA content in non-photoexposed body sites compared with highly exposed skins. In contrast, the percentage of cUCA was higher in photoexposed body sites. Maximal levels of cUCA were found in cheek, forehead and forearm and lower levels in abdomen and thigh. No differences were found in total UCA concentration between the tumor samples and healthy photoexposed skin. However, differences were found in relation between isomers. Higher levels of cUCA were detected in SCC biopsies (44% of total UCA) compared with samples of BCC and that of healthy photoexposed skin (30%). These results suggest that the UV radiation exposure, a main factor in development of SCC can be mediated, apart from direct effect to cells (DNA damage), by immunosuppression pathways mediated by high production of cUCA.