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Introduction Colchicine, commonly used in gout flare, is contraindicated in severe chronic kidney disease (CKD) (estimated glomerular filtration rate

Machine learning (ML) and artificial intelligence (AI) methods are emerging as promising technologies for enhancing the performance of low‐cost photovoltaic (PV) cells in miniaturized electronic devices. Indeed, ML is set to significantly contribute to the development of more efficient and cost‐effective solar cells. This systematic review offers an extensive analysis of recent ML techniques in designing novel solar cell materials and structures, highlighting their potential to transform the low‐cost solar cell research and development landscape. The review encompasses a variety of ML approaches, such as Gaussian process regression (GPR), Bayesian optimization (BO), and deep neural networks (DNNs), which have proven effective in boosting the efficiency, stability, and affordability of solar cells. The findings of this review indicate that GPR combined with BO is the most promising method for developing low‐cost solar cells. These techniques can significantly speed up the discovery of new PV materials and structures while enhancing the efficiency and stability of low‐cost solar cells. The review concludes with insights on the challenges, prospects, and future directions of ML in low‐cost solar cell research and development.

Introducción: Indecisión a las vacunas es “la demora en la aceptación o rechazo de la vacunación a pesar de la disponibilidad de los servicios. Objetivo: Relacionar la indecisión a las vacunas de la madre y el esquema de vacunación del menor de 5 años. Materiales y métodos: Estudio transversal, correlacional, no experimental. Se aplicó el cuestionario Actitudes de los Padres ante las Vacunas de los Niños para medir Indecisión a las Vacunas en madres de niños menores de cinco años, se registró el esquema de vacunación. Se realizó análisis descriptivo e inferencial para comparar, asociar y relacionar variables. Resultados: En madres de niños con esquema de vacunación completo 21% presentan nivel intermedio y 1,75% nivel alto de indecisión a las vacunas, madres de hijos con esquema incompleto 26% presenta nivel intermedio y 5% nivel alto. No se encontró relación entre indecisión a vacunas y esquema de vacunación (p=0,265). Se encontraron asociaciones entre ocupación e indecisión a las vacunas (p=0,034); entre esquema de vacunación con escolaridad (p=0,013), ocupación (p=0,034) y motivos de no vacunación (p=0,000), correlaciones negativas entre esquema de vacunación, escolaridad (p=0,003) edad del hijo (p=0,037). Conclusión: No se encontró correlación entre indecisión a las vacunas y esquema de vacunación.

IntroductionGut microbiota can significantly affect the effectiveness of immune checkpoint inhibitors (ICIs) in cancer patients. Recently, antibiotics were shown to decrease survival rate of patients treated by ICIs. Proton pump inhibitors (PPIs) can indeed modulate microbiota’s diversity, therefore altering ICIs response. A meta-analysis was performed based on published data to verify this hypothesis.MethodsIn this study, over 41 publications, exploring the impact of concomitant PPI treatment on outcomes of ICI-treated patients, were analyzed. Evaluated endpoints were overall survival (OS) and progression-free survival (PFS). Pooled hazard ratios (HRs) with a 95% confidence interval (CI) were reported in ICIs in PPI users versus non-PPI users. Subgroup analyses were performed to minimize the impact of study heterogeneity and to investigate the influence of PPI on the different groups of interest. There was no evidence of publication bias for OS and PFS analysis in subgroup analysis.ResultsForty-one studies were included in the meta-analysis, including a total of 20,042 patients. OS of patients receiving ICIs was negatively correlated in patients concomitantly treated with PPI (HR=1.37; 95%CI, 1.23–1.52). PFS of cancer patients receiving ICIs was also negatively correlated with PPI treatment (HR=1.28; 95%CI, 1.15–1.42). PPI and ICI use was associated with worst OS and PFS not only for non-small-cell lung cancer (NSCLC) or urothelial cancer patients but also for patients treated with anti PD-1 (OS) and anti PD-L1 (OS and PFS) immunotherapies when administered in non-first line and when PPI was received as baseline treatment or in 60 days before ICI initiation. PPI and ICI use also showed the worst OS and PFS for patients from Europe and Asia.ConclusionThis meta-analysis suggests that PPI treatment leads to significantly worse outcomes in advanced cancer patients treated by ICIs in terms of PFS and OS.

O presente artigo propõe se a apresentar uma síntese dos resultados apresentados na dissertação Integração do Ensino Técnico ao Médio na Habilitação Profissional de Agropecuária do Centro Paula Souza, defendida junto ao Programa de Pós – Graduação em Educação da Faculdade de Filosofia e Ciências da Unesp. A pesquisa buscou avaliar como ocorre a integração na referida habilitação profissional, após 10 anos de implantação. Tendo como métodos investigativos aplicados, a pesquisa documental, pesquisa bibliográfica; com relação a pesquisa empírica, foram realizadas observações assistemáticas e entrevistas semiestruturadas com docentes de duas unidades agrícolas do Centro Paula Souza. Conclui-se que a Proposta Pedagógica desenvolvida pela instituição está alicerçada em uma abordagem da Pedagogia das Competências que privilegia o desenvolvimento das competências voltadas ao mercado de trabalho, alerta-se para os potenciais desperdiçados ao se negligenciar as demais dimensões da existência humana; além das percepções dos docentes entrevistados com relação ao processo de integração.

Background and Objectives: Remote patient monitoring (RPM) of vital signs and symptoms for lung transplant recipients (LTRs) has become increasingly relevant in many situations. Nevertheless, RPM research integrating multisensory home monitoring in LTRs is scarce. We developed a novel multisensory home monitoring device and tested it in the context of COVID-19 vaccinations. We hypothesize that multisensory RPM and smartphone-based questionnaire feedback on signs and symptoms will be well accepted among LTRs. To assess the usability and acceptability of a remote monitoring system consisting of wearable devices, including home spirometry and a smartphone-based questionnaire application for symptom and vital sign monitoring using wearable devices, during the first and second SARS-CoV-2 vaccination. Materials and Methods: Observational usability pilot study for six weeks of home monitoring with the COVIDA Desk for LTRs. During the first week after the vaccination, intensive monitoring was performed by recording data on physical activity, spirometry, temperature, pulse oximetry and self-reported symptoms, signs and additional measurements. During the subsequent days, the number of monitoring assessments was reduced. LTRs reported on their perceptions of the usability of the monitoring device through a purpose-designed questionnaire. Results: Ten LTRs planning to receive the first COVID-19 vaccinations were recruited. For the intensive monitoring study phase, LTRs recorded symptoms, signs and additional measurements. The most frequent adverse events reported were local pain, fatigue, sleep disturbance and headache. The duration of these symptoms was 5–8 days post-vaccination. Adherence to the main monitoring devices was high. LTRs rated usability as high. The majority were willing to continue monitoring. Conclusions: The COVIDA Desk showed favorable technical performance and was well accepted by the LTRs during the vaccination phase of the pandemic. The feasibility of the RPM system deployment was proven by the rapid recruitment uptake, technical performance (i.e., low number of errors), favorable user experience questionnaires and detailed individual user feedback.

Introducción: En los últimos años se han desarrollado movimientos de personas, generalmente padres, que rechazan o están indecisas en cuanto al uso de las vacunas por la falta de conciencia de riesgos y la gravedad de las enfermedades prevenibles por vacunación, así como, por la difusión en las redes sociales de noticias falsas sobre la inocuidad y la eficacia de las vacunas. Investigaciones en países de Europa y América del Norte han descrito un término para estudiar este fenómeno el cual es Indecisión a las Vacunas, estas investigaciones son escasas en Latinoamérica. Objetivo: identificar instrumentos potencialmente válidos y confiables que puedan ser adaptados y modificados tanto al idioma español como al contexto de América Latina relacionados a la indecisión a las vacunas entre padres. Metodología: Se realizó una búsqueda en tres bases de datos PubMed, EBSCOhost y Biblioteca Virtual en Salud; con los términos descriptores de ciencias de la salud: “vaccine hesitancy”, “parents” y “vaccine refutation”. Resultados: Los resultados arrojaron 394 artículos de los cuales 19 fueron elegidos para el análisis. Los principales instrumentos identificados para medir la indecisión a las vacunas fueron los cuestionarios “Parental Attitudes About Childhood Vaccines” y “Vaccine Hesitancy Scale”. Conclusiones: El cuestionario “Parental Attitudes About Childhood Vaccines” es el instrumento más usado y validado en diferentes idiomas para medir la indecisión a las vacunas.

Introdução: A pneumonia associada à ventilação mecânica (PAV) é definida como aquela que se desenvolve 48h após o início da ventilação mecânica. O mecanismo comumente envolvido é a aspiração para as vias aéreas inferiores de secreções colonizadas. O diagnóstico de PAV pode ser clínico ou microbiológico. A PAV prolonga o tempo de internação e aumenta custos. Seu tratamento precoce e adequado está associado à redução da mortalidade. Objetivos: Traçar o perfil epidemiológico e realizar a análise clínica de pacientes diagnosticados com PAV, comparando o grupo de pacientes com diagnóstico clínico e os com diagnóstico microbiológico. Métodos: Foram avaliados 62 prontuários eletrônicos de pacientes diagnosticados com PAV no período de janeiro de 2015 a janeiro de 2017 no Hospital Escola de Itajubá (MG), de acordo com o banco de dados da Comissão de Controle de Infecção Hospitalar. Os dados coletados incluíram: idade; sexo; presença de febre; resultado da cultura; desfecho; causa do óbito; uso de antibiótico; tempo de internação; valores de leucócitos e proteína C-reativa (PCR). Resultados: Foram analisados 49 pacientes através de prontuários eletrônicos, com idade média de 60,5 anos, sendo 71,4% do sexo masculino. Quase 70,0% do total de casos de PAV teve diagnóstico microbiológico definido. O agente mais envolvido foi o Acinetobacter baumannii. A mortalidade foi de 55,0%. PCR estava elevada em quase 100,0% dos casos; febre esteve presente em 45,0% dos casos e leucocitose, em 70,0%. Conclusão: A PAV é frequente em unidades de terapia intensiva. Os agentes mais prevalentes são os gram-negativos e multirresistentes. Palavras-Chave: Pneumonia associada à ventilação mecânica; Infecção hospitalar; Intubação intratraqueal ABSTRACT Introduction: Ventilation associated pneumonia (VAP) is defined as one which takes place 48 hours after the onset of mechanical ventilation. The mechanism commonly involved in the etiology is the aspiration of contaminated secretions into the lower airways. VAP diagnosis may be clinical or microbiological. VAP extends the hospitalization period and therefore its cost; early and appropriate treatment of VAP is associated with an expressive decrease of mortality. Aims: To identify the epidemiological profile, to perform clinical analysis of VAP diagnosed by comparing the group of patients with clinical diagnosis and those with a microbiological diagnosis. Methods: Sixty-two electronic medical records of patients diagnosed with VAP were evaluated from January 2015 to January 2017 at a Teaching Hospital, according to the Hospital Infection Control Committee database. Data collected included: age; sex; presence of fever; culture result; outcome; cause of death; use of antibiotic; leukocyte values and C-reactive protein (CRP). Results: Forty-nine patients were analyzed using electronic medical records, with a mean age of 60.5 years, of which 71.4% were male. Almost 70.0% of the total VAP had a definite microbiological diagnosis. The most involved agent was Acinetobacter Baumannii. Mortality was 55.0%. CRP was elevated in almost 100.0% of cases; fever was present in 45.0% of cases and leukocytosis in 70.0%. Conclusion: VAP is frequent in intensive care units. The most prevalent are the gram-negative and the multiresistant agents. Keywords: Ventilation associated pneumonia; Hospital infection; Endotracheal intubation

Introdução: As infecções do trato urinário (ITU), de origem comunitária, são diagnósticos muito prevalentes a nível ambulatorial, sendo uma grande causa de uso de antibioticoterapia. Seus agentes etiológicos mais prevalentes são os bacilos gram-negativos da família Enterobacteriaceae, em especial a Escherichia coli (E. coli). Visando este agente, as terapias antimicrobianas empíricas mais utilizadas no Brasil são o sulfametoxazol-trimetoprim, quinolonas, cefalosporinas de 1º e 2º geração, amoxicilina e nitrofurantoína. Objetivos: Tendo em vista o aumento da antibioticorresistência a estes medicamentos, demonstrado na literatura médica mundial, e a importância do conhecimento deste dado pela comunidade médica local, este artigo pretende traçar o perfil de resistência às quinolonas e ao sulfametoxazol-trimetoprim pelas cepas de E. coli isoladas de uroculturas de ITU comunitária, encaminhadas para um laboratório de análises clínicas, de uma cidade do sul de Minas Gerais, no período de 2010 a 2014. Métodos: Estudo descritivo e retrospectivo por meio de pesquisa em banco de dados, no período de 2010 a 2014. Foram realizadas análises de urocultura e antibiograma, com cálculo estatístico utilizando-se o teste qui-quadrado. Resultados: Foram obtidas 14870 uroculturas, tendo crescimento bacteriano maior que 105 unidades formadoras de colônia (UFC) em 3073 amostras, das quais 2203 foram cepas de E. coli e 870 de outras bactérias. A taxa global de resistência nos 5 anos de todos os antibióticos foi de 24,46%, sendo que a de sulfametoxazol-trimetoprim em específico foi de 19,65% e a do grupo quinolonas, 19,2%. Observou-se aumento da resistência ao longo dos 5 anos (p

Artificial Intelligence in combination with the Internet of Medical Things enables remote healthcare services through networks of environmental and/or personal sensors. We present a remote healthcare service system which collects real-life data through an environmental sensor package, including binary motion, contact, pressure, and proximity sensors, installed at households of elderly people. Its aim is to keep the caregivers informed of subjects’ health-status progressive trajectory, and alert them of health-related anomalies to enable objective on-demand healthcare service delivery at scale. The system was deployed in 19 households inhabited by an elderly person with post-stroke condition in the Emilia–Romagna region in Italy, with maximal and median observation durations of 98 and 55 weeks. Among these households, 17 were multi-occupancy residences, while the other 2 housed elderly patients living alone. Subjects’ daily behavioral diaries were extracted and registered from raw sensor signals, using rule-based data pre-processing and unsupervised algorithms. Personal behavioral habits were identified and compared to typical patterns reported in behavioral science, as a quality-of-life indicator. We consider the activity patterns extracted across all users as a dictionary, and represent each patient’s behavior as a ‘Bag of Words’, based on which patients can be categorized into sub-groups for precision cohort treatment. Longitudinal trends of the behavioral progressive trajectory and sudden abnormalities of a patient were detected and reported to care providers. Due to the sparse sensor setting and the multi-occupancy living condition, the sleep profile was used as the main indicator in our system. Experimental results demonstrate the ability to report on subjects’ daily activity pattern in terms of sleep, outing, visiting, and health-status trajectories, as well as predicting/detecting 75% hospitalization sessions up to 11 days in advance. 65% of the alerts were confirmed to be semantically meaningful by the users. Furthermore, reduced social interaction (outing and visiting), and lower sleep quality could be observed during the COVID-19 lockdown period across the cohort.

The genus Dorsomitus Tjeder, 1992, is considered a nomen nudum. Dorsomitus gen. nov. is described and validated here. A new combination, Dorsomitus neavei (Kimmins, 1949) gen. et comb. nov. is proposed, Dorsomitus tjederi gen. et sp. nov. is described, and Disparomitus neavei Kimmins, 1949, is designated as type species of the genus Dorsomitus gen. nov.

A ISO 26000, publicada em 2010, trata sobre o tema de Responsabilidade Social das Organizações. Esse estudo apresenta uma revisão sistemática nas bases de dados ISI Web of Science e Scopus sobre a questão: "quais são as barreiras e motivadores da adoção da ISO 26000 para as organizações?". Os artigos foram selecionados por filtros baseados em dois critérios de inclusão. Os dados foram sumarizados em uma tabela abrangendo os conceitos de ISO 26000, os motivadores e as barreiras. Os motivadores encontrados foram: globalização - competição em mercados internacionais; congruência com sistemas de gestão; reputação (imagem) da empresa; relação com os funcionários e melhora do ambiente organizacional; melhora na relação com stakeholders externos; vantagem competitiva/estratégias; guia para a Responsabilidade Social Corporativa (RSC); e diminuição dos riscos do negócio. As barreiras encontradas foram: falta de alinhamento da RSC com a estratégia organizacional; comercial (nacional e internacional); falta de compreensão da ISO 26000; falta de comunicação; falta de ferramentas; falta de sensibilidade ao tema; foco no curto prazo; gestão do conhecimento; receio em não cumprir a norma; recursos financeiros. Por fim, uma agenda para estudos futuros foi elaborada.

This paper introduces technical solutions devised to support the Deployment Site - Regione Emilia Romagna (DS-RER) of the ACTIVAGE project. The ACTIVAGE project aims at promoting IoT (Internet of Things)-based solutions for Active and Healthy ageing. DS-RER focuses on improving continuity of care for older adults (65+) suffering from aftereffects of a stroke event. A Wireless Sensor Kit based on Wi-Fi connectivity was suitably engineered and realized to monitor behavioral aspects, possibly relevant to health and wellbeing assessment. This includes bed/rests patterns, toilet usage, room presence and many others. Besides hardware design and validation, cloud-based analytics services are introduced, suitable for automatic extraction of relevant information (trends and anomalies) from raw sensor data streams. The approach is general and applicable to a wider range of use cases; however, for readability’s sake, two simple cases are analyzed, related to bed and toilet usage patterns. In particular, a regression framework is introduced, suitable for detecting trends (long and short-term) and labeling anomalies. A methodology for assessing multi-modal daily behavioral profiles is introduced, based on unsupervised clustering techniques. The proposed framework has been successfully deployed at several real-users’ homes, allowing for its functional validation. Clinical effectiveness will be assessed instead through a Randomized Control Trial study, currently being carried out.

Aripiprazole is reported to be a good clinical safety profile antipsychotic. However, recent data suggest that the risk of tardive dyskinesia could be higher than initially thought. We report the case of aripiprazole-induced tardive dyskinesia with dramatic evolution in a patient with several risk factors, including older age and exposure to antipsychotic over a period longer than six months. This case and its dramatic evolution, associated with other cases recently published, suggest reconsidering the real risk of tardive dyskinesia associated with aripiprazole, particularly in the elderly.

Long-term use of benzodiazepines (BZDs) is known to induce tolerance and dependence, and increase the risk of falls-related injuries in older adults. We present a study carried out in a French nursing home that concerns the implementation of a BZD withdrawal program reassessed at one year. BZD deprescription was achieved by gradual cessation of doses. A secondary benefit of this program was assessed by comparing the number of falls among residents before and after withdrawal. The number of falls was recorded over a six-month period prior to the onset of withdrawal (T1) and then over a six-month period after reassessment at one year (T2). At the beginning, 31 (28.7%) of the patients were under BZD. Total deprescription was obtained for 11 patients. The number of falls per patient over the T1 period was not different between the two groups (future non-withdrawn and withdrawn patients in BZD): 2.1 ± 1.3 and 2.3 ± 0.6 falls per resident, respectively. Conversely, the number of falls per patient was significantly decreased in the population completely withdrawn in BZD between the T1 and T2 periods (2.3 ± 0.6 vs. 0.5 ± 0.2 falls, p = 0.01). The results show that BZD deprescription, through a gradual reduction of doses, is possible to achieve.

We are developing a high-resolution printing technique based on transferring a pattern from an elastomeric stamp to a solid substrate by conformal contact. This is an attempt to enhance the accuracy of classical printing to a precision comparable with optical lithography, creating a low-cost, large-area, high-resolution patterning process. First, we introduce the components of this technique, called soft lithography, and review its evolution. Topics described in detail are the stamp material, stamp architecture, pattern design rules, and printing tools. The accuracy of the prints made by thin patterned elastomeric layers supported on a stiff and flexible backplane is then assessed, and defects are characterized using a new electrical metrology approach. This is followed by a discussion of various printing processes used in our laboratory: (1) thiol printing for high-resolution patterns of noble metals that may also be used as sacrificial masks; (2) confined contact processing with liquids in cavities or channels to chemically convert a substrate or deposit layers of materials or biomolecules; (3) printing of catalysts to mediate patterned deposition of metals; and (4) structured, light-guiding stamps for transferring high-resolution patterns into photoresists. Finally, we compare classical and high-resolution printing approaches, and describe their potential for emerging micro- and nanoscale patterning technologies.