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Abstract Background Maternal mortality is a global public health problem. Statistics show that in 2013, 289,000 women died from complications during pregnancy, childbirth or the postpartum period worldwide. Between 2010 and 2015, there were 10,075 maternal deaths in Brazil, 3,522of which occurred in the Northeast region. The aim of this study was to investigate the actions taken by primary health care (PHC) professionals to reduce maternal mortality. Method This was a cross-sectional, descriptive field study with a qualitative approach. The sample comprised 81 graduate-level professionals working in PHC in the state of Ceará, Brazil. Data were collected from January to March 2016 using structured interviews, which were digitally audio recorded and transcribed. The results were organized using collective subject discourse and analyzed according with the relevant literature. Results The PHC professionals took both individual and joint measures to reduce maternal mortality. These activities included home visits, health education, active searches, prenatal care consultations, referrals to specialized care and outreach. The challenges that must be overcome to prevent maternal mortality include poor care and ineffective public policies that are associated with a lack of managerial support. Conclusion Interaction among professionals in the health care network is critical to the development of cross-sectoral projects that improve the quality of women’s health care. Prenatal care is a key factor in reducing maternal death and enables the identification and classification of the risks to which pregnant women may be exposed and the implementation of early actions that can ensure a safe and uncomplicated delivery. However, all of these actions require effective public policies and managerial support.

This research highlights the aspects of resiliency among business establishments in the Visayas regions that were directly affected by super typhoon Yolanda in 2013. This study employs a descriptive method to characterize resiliency factors among various businesses. A survey questionnaire was utilized to gather relevant data from the 106 business proprietors and managers. Multivariate analysis via exploratory factor analysis (EFA) was used to determine the underlying factors. In the context of the post-disaster recovery of businesses in the Visayas regions, the exploratory analysis yielded five dimensions. Based on the finding, five causal factors are significant in developing a post-disaster resiliency and recovery framework among various business types. Any business is considered resilient against any form of disaster if it has complete control of its institutional affairs and plans ahead guided by its philosophy. Futuristic planning is also necessary as it imbibes in its operational philosophy the value of foresight. Besides, every business needs to strengthen its linkages outside its operations. Hence, a resilient business considers the value of information exchange and dissemination. Thus, a business is said to be sustainable if it maintains a sound and working framework to improve an adaptive capacity for any calamity or disaster. [ABSTRACT FROM AUTHOR]

Antecedentes: Durante la primera oleada de la pandemia de COVID-19 se llevaron a cabo extensos estudios de población en los que se detallaron las características de aquellos que contrajeron la enfermedad. Fue en este momento cuando se observó que una considerable proporción de los afectados presentaban, tanto al ingreso como durante el curso de la enfermedad, lesión renal aguda (LRA). La incidencia de esta condición se informó en varias series de casos, llegando hasta un 56.9%. Este estudio surge ante la necesidad de enfrentar la enfermedad y se basa en el conocimiento de estas investigaciones para demostrar si estas características se cumplen también en la población mexicana. Objetivo: Asociar la relación de la LRA como factor pronóstico y el incremento de la tasa de mortalidad en pacientes que presentaron infección por SARS-CoV-2 en pacientes del Área de Urgencias del Hospital Juárez de México. Método: Se realizó un estudio observacional, analítico, retrospectivo, transversal, incluyendo 606 expedientes de pacientes, los cuales cumplieron con la definición para caso sospechoso o confirmado para infección por SARS-CoV-2, ingresados al Hospital Juárez de México en el periodo de abril de 2020 a marzo de 2021. Resultados: Respecto a la prevalencia en relación con el sexo, se observó un total de 402 pacientes (66%) de sexo masculino y 206 pacientes de sexo femenino (34%). Se observó en el presente trabajo de investigación que la presencia de comorbilidades asociada a LRA presentó un incremento en la tasa de mortalidad de la población del Hospital Juárez de México. Conclusión: En nuestra población la presencia de comorbilidades como la hipertensión arterial sistémica (HAS) y la obesidad demostraron tener un impacto en el desarrollo de LRA en pacientes con infección por SARS-CoV-2. El desarrollo de LRA en pacientes con comorbilidades como HAS u obesidad tuvo una relación directa con el incremento en la tasa de mortalidad.

Delayed gastric emptying is common following severe large cutaneous burns; however, the mechanisms of burn-induced delayed gastric emptying remain unknown. The aim of this study was to explore the possible involvement of hyperglycemia and cyclooxygenase-2 receptors in the burn-induced gastric dysrhythmias. Gastric slow waves and gastric emptying were assessed in rats 6 h following sham or burn injury. Animals were randomized to one sham-burn and seven burn groups: untreated; two groups of saline treated (control); insulin treated (5 IU/kg); cyclooxygenase-2 inhibitor treated (10 mg/kg); ghrelin treated (2 nmol/rat); and gastric electrical stimulation treated. It was found that 1) severe burn injury impaired gastric slow waves postprandially and delayed gastric emptying; 2) the impairment in gastric slow waves included a decrease in the slow-wave frequency and in the percentage of normal slow waves, and an increase in the percentage of bradygastria (P = 0.001, 0.01, and 0.01, respectively vs. preburn values). None of the gastric slow-wave parameters was significantly correlated with gastric emptying; 3) cyclooxygenase-2 inhibitor normalized burn-induced delayed gastric emptying (P = 0.3 vs. sham-burn), but not gastric dysrhythmias (P < 0.002 vs. sham), whereas insulin normalized both gastric emptying (P = 0.4 vs. sham-burn) and gastric dysrhythmias (P = 0.3 vs. sham-burn); 4) both gastric electrical stimulation and ghrelin accelerated burn-induced delayed gastric emptying (P = 0.002 and 0.04, respectively, vs. untreated burn). In conclusion, hyperglycemia alters gastric slow-wave activity and delayed gastric emptying, while cyclooxygenase-2 inhibition delays gastric emptying without altering gastric slow-wave activity. cyclooxygenase inhibitor; gastric electrical stimulation; ghrelin; insulin doi: 10.1152/ajpregu.00135.2010.

Summary: Most surgical and anaesthetic mortality and morbidity occurs postoperatively, disproportionately affecting low‐ and middle‐income countries. Various short courses have been developed to improve patient outcomes in low‐ and middle‐income countries, but none specifically to address postoperative care and complications. We aimed to identify key features of a proposed short‐course addressing this topic using a Delphi process with low‐ and middle‐income country anaesthesia providers trained as short‐course facilitators. An initial questionnaire was co‐developed from literature review and exploratory workshops to include 108 potential course features. Features included content; teaching method; appropriate participants; and appropriate faculty. Over three Delphi rounds (panellists numbered 86, 64 and 35 in successive cycles), panellists indicated which features they considered most important. Responses were analysed by geographical regions: Africa, the Americas, south‐east Asia and Western Pacific. Ultimately, panellists identified 60, 40 and 54 core features for the proposed course in each region, respectively. There were high levels of consensus within regions on what constituted core course content, but not between regions. All panellists preferred the small group workshop teaching method irrespective of region. All regions considered anaesthetists to be key facilitators, while all agreed that both anaesthetists and operating theatre nurses were key participants. The African and Americas regional panels recommended more multidisciplinary healthcare professionals for participant roles. Faculty from high‐income countries were not considered high priority. Our study highlights variability between geographical regions as to which course features were perceived as most locally relevant, supporting regional adaptation of short‐course design rather than a one‐size‐fits‐all model. [ABSTRACT FROM AUTHOR]

Homocysteine is a precursor of S-adenosylmethionine (AdoMet) and a metabolite of S-adenosylhomocysteine (AdoHcy). The ratio of AdoMet to AdoHcy, defined as the methylation potential (MP), indicates the flow of methyl groups within the cells. Chronic elevations of total homocysteine (tHcy) in plasma correlate with increased AdoHcy concentrations, decreased MP, and impaired DNA methylation. However, the influence of acute hyperhomocysteinemia on MP is unknown. We induced acute hyperhomocysteinemia in 14 healthy volunteers by oral administration of L-homocysteine (65.1 [micro]mol/kg body wt) in an open, randomized, placebo-controlled two-period crossover study. The kinetics of tHcy in blood and urine, MP in blood, and global DNA methylation in lymphocytes were studied systematically during 48 h. Plasma tHcy concentrations reached a peak at 34 [+ or -] 11 min after an oral load with L-homocysteine and decreased with a half-life of 257 [+ or -] 41 min (means [+ or -] SD). Only 2.3% of the homocysteine dose were recovered in urine. AdoHcy concentrations and MP in whole blood and erythrocytes were not affected by the oral homocysteine load. Furthermore, global DNA methylation in lymphocytes did not change under these conditions. We found no difference between the genotypes of 5,10-methylenetetrahydrofolate reductase in response to the homocysteine load. However, AdoMet content in erythrocytes was significantly higher in the C677T carriers (CT; n = 7) compared with the CC genotype (n = 7). Although chronic elevation of tHcy has been shown to affect MP and DNA methylation, acute elevation of plasma tHcy above 20 [micro]mol/l for 8 h is not sufficient to change MP and to induce DNA hypomethylation in lymphocytes.

Small carbon particles have excellent absorption properties for concentrated solar radiation. Oxidation rates of micron and submicron sized carbon black particles have been investigated under high flux solar conditions. These oxidation rates are required for a thermal model of direct absorbing particle receivers as well as for the development of solar chemical technologies to treat toxic wastes. An experimental set-up has been developed for kinetic measurements in the solar furnace of the DLR. In the temperature range 600-900 [degrees] C no significant acceleration of the oxidation could be observed due to insolation up to irradiances 1 [less than or equal to] 700 kW [m.sup.-2] as compared to thermal oxidation of carbon particles (Derussol C[C]).