Risk Factors Associated With Reoperative Surgery for Thyroid Malignancies: A Retrospective Cohort Study.

OBJECTIVE: To examine various factors associated with an increased risk of reoperation for persistent or recurrent malignant thyroid cancers. STUDY DESIGN: Retrospective cohort study. SETTING: Tertiary academic hospital centers. METHODS: Patients undergoing surgery for thyroid cancer at 2 tertiary academic institutions from 2006 to 2020 were included. Those who underwent a reoperative procedure were compared with patients only requiring 1 procedure. The Pearson chi-square and independent t test were used to compare group data accordingly. Furthermore, a binomial logistic regression was performed, while machine learning models were used to construct a predictive algorithm. RESULTS: This study included 2266 patients with surgically managed thyroid malignancy, of which 54 (2.4%) necessitated reoperations. Those requiring a second surgical procedure were more likely to be male (40.7% vs 20.9%, P < .001), undergo bilateral (24.1% vs 3.3%, P < .001) and lateral (16.7% vs 1.8%, P < .001) neck dissections, and have a greater number of metastatic lymph nodes (mean, 9.1 vs 3.5; P < .001) and a larger tumor size (mean, 3.0 vs 2.0 cm; P < .001). According to the binomial logistic regression model, lateral neck dissection, greater number of metastatic lymph nodes, and larger tumor size significantly increased the odds of necessitating a second procedure by 7.8 (95% CI, 2.523-24.083), 1.1 (95% CI, 1.032-1.152), and 1.3 (95% CI, 1.064-1.559), respectively. Last, machine learning models could not significantly predict the occurrence of reoperation. CONCLUSION: This study identified patient- and cancer-related characteristics associated with an increased risk of requiring reoperation for thyroid malignancies.

All-Atom Molecular Dynamics of Pure Water-Methane Gas Hydrate Systems under Pre-Nucleation Conditions: A Direct Comparison between Experiments and Simulations of Transport Properties for the Tip4p/Ice Water Model.

(1) Background: New technologies involving gas hydrates under pre-nucleation conditions such as gas separations and storage have become more prominent. This has necessitated the characterization and modeling of the transport properties of such systems. (2) Methodology: This work explored methane hydrate systems under pre-nucleation conditions. All-atom molecular dynamics simulations were used to quantify the performance of the TIP4P/2005 and TIP4P/Ice water models to predict the viscosity, diffusivity, and thermal conductivity using various formulations. (3) Results: Molecular simulation equilibrium was robustly demonstrated using various measures. The Green-Kubo estimation of viscosity outperformed other formulations when combined with TIP4P/Ice, and the same combination outperformed all TIP4P/2005 formulations. The Green-Kubo TIP4P/Ice estimation of viscosity overestimates (by 84% on average) the viscosity of methane hydrate systems under pre-nucleation conditions across all pressures considered (0-5 MPag). The presence of methane was found to increase the average number of hydrogen bonds over time (6.7-7.8%). TIP4P/Ice methane systems were also found to have 16-19% longer hydrogen bond lifetimes over pure water systems. (4) Conclusion: An inherent limitation in the current water force field for its application in the context of transport properties estimations for methane gas hydrate systems. A re-parametrization of the current force field is suggested as a starting point. Until then, this work may serve as a characterization of the deviance in viscosity prediction.

Renal function in children with a congenital solitary functioning kidney: A systematic review.

INTRODUCTION: Abnormal renal development that results in lack of function or development of one of two kidneys is known as congenital solitary functioning kidney (CSFK). Two well characterized sub-categories of CFSK are unilateral renal agenesis (URA) and multicystic dysplastic kidney (MCDK). This systematic review sought to evaluate the change in renal function in children ≤18 years old with a CSFK as a result of URA or MCDK. METHODS: A literature search in MEDLINE and Embase was conducted (1946 to July 13, 2020). All relevant articles were retrieved and evaluated based on pre-selected criteria by two independent researchers. Data was then extracted from variables of interest and conflicts were resolved by a third researcher. The primary outcome was renal function, and the secondary outcomes were proteinuria and hypertension. RESULTS: Forty-five studies were included, of which 49% (n = 22) were retrospective and/or 58% (n = 26) were cohort studies. A combined total of 2148 and 885 patients were diagnosed with MCDK or URA, respectively. The proportion of children with worsened renal function at follow-up was found to be 8.4% (95% CI: 5.2%-13.4%). Among the studies reporting renal function as a group mean or median at follow-up, 84% (21/25) had a GFR/CrCl above 90 (mL/min/1.73  m2/ml/min). In terms of secondary outcomes, the proportion of children with proteinuria and hypertension was found to be 10.1% (95% CI: 6.9%-14.6%) and 7.4% (95% CI: 5.0%-10.9%), respectively. CONCLUSION: The risk of developing proteinuria (10.1%), hypertension (7.4%), and/or worsened renal function (8.4%) for children with CFSK as a result of MCDK or URA is low. However, the level of evidence in the literature is weak. Further research is needed to identify the predisposing factors that may differentiate the small subset of children with CSFK at a higher risk of developing adverse renal outcomes.

Lactobacillus paracasei probiotic properties and survivability under stress-induced by processing and storage of ice cream bar or ice-lolly / Propriedades probióticas e sobrevivência de Lactobacillus paracasei sobre estresse induzido pelo processamento e armazenamento em picolé a base de leite ou água

ABSTRACT: Probiotics are live microorganisms which, when administered in adequate amounts, confer a health benefit on the host. The aim of this study was to identify genotypically lactobacilli strains isolated from newborn stools and selecting strain based on probiotic properties (gastrointestinal tolerance, antibiotic susceptibility, inhibition of pathogen biofilm formation, absence of alfa or gamma-blood hemolysis, and lysozyme sensibility) and technological properties of surviving either in ice cream bar or ice-lolly. Reduction of 1.2log cfu ml-1 of the Lactobacillus paracasei strain was observed after exposure through in vitro gastrointestinal conditions. It inhibited biofilms of Escherichia coli, Salmonella Typhimurium and Candida albicans by mechanisms of competition, exclusion and displacement, and was resistant up to 3000μg ml-1 of egg white lysozyme. It presented neither alfa nor gamma-hemolysis or was antibiotic resistant to usual antibiotics for human use. Microbial survivability in ice cream bar or ice-lolly was assessed up to 21 days of storage at -18°C. Viability was maintained in ice cream bar, but there was a reduction of almost 2.0logs in ice-lolly.

RESUMO: Probióticos são microrganismos vivos que, quando administrados em quantidade adequadas, conferem benefícios à saúde do hospedeiro. O objetivo desta pesquisa foi identificar genotipicamente lactobacilos isolados de material fecal de recém-nascidos, assim como selecionar uma cepa com base em suas propriedades probióticas (tolerância às condições gastrointestinais, susceptibilidade à antibióticos, inibição da formação de biofilmes por microrganismos patogênicos, ausência de hemólise alfa ou gama e sensibilidade à lisozima) e tecnológicas de sobrevivência em picolé à base de água ou leite. Houve redução de 1,2log ufc ml-1 do isolado identificado como Lactobacillus paracasei após passagem pelas condições gastrointestinais in vitro. Esta cepa inibiu a formação de biofilmes de Escherichia coli, Salmonella Typhimurium e Candida albicans pelos mecanismos de competição, exclusão e desacoplamento e apresentou resistência até 3000μg ml-1 frente a lisozima de ovo. Entre os aspectos de segurança, a cepa não apresentou hemólise alfa ou gama e não foi resistente a antibióticos comumente ministrados em humanos. A sobrevivência microbiana em picolé a base de água ou leite foi analisada ao longo de 21 dias de estocagem a -18°C. Houve manutenção da viabilidade no produto à base de leite, mas naquele à base de água, ocorreu redução de quase 2,0logs.

Sobre o "moralismo" dos comitês de ética / On "moralism" in ethics committees / Sobre el "moralismo" de los comités de ética / Sur le moralisme des comités de d'éthique

Este artigo problematiza a difícil função atribuída aos comitês de ética: a de institucionalizarem a ética, dimensão que é crítica por excelência, isto é, contraditória e movediça; arredia, portanto, a qualquer forma instituída e estanque de se manifestar. Afirma-se que a institucionalização empreendida nos comitês de ética sustenta-se em pressupostos que se chocam frontalmente com o próprio exercício ético, terminando por consolidar nesses espaços a cristalização daquilo que será nomeado aqui de "moral cientificista moderna", a qual se ergue como um critério supremo para atribuir ou negar o caráter "científico" às diversas propostas de pesquisa. Como consequência dessa moralização da ciência, vislumbra-se o empobrecimento da capacidade crítica e transformadora das propostas oriundas das universidades. A título de ilustração dessa problemática, será analisado o texto de um parecer consubstanciado acerca de uma proposta de pesquisa submetida pelos autores e que fora negada por um comitê de ética de uma universidade federal brasileira.

This article problematizes the difficult task attributed to ethics committees: the institutionalization of ethics, a critical dimension by excellence, with is itself contradictory and unstable; Therefore, too uncontainable to any established and manifest form of manifestation. It is stated that the institutionalization undertaken in the ethics committees is based on assumptions that clash headon with the ethical exercise itself, eventually consolidating in these spaces the crystallization of what will be called here "modern scientific morality", which stands as a supreme criterion for attributing or denying the "scientific" character to the various research proposals. As a consequence of this moralization of science, one can envisage the impoverishment of the critical and transforming capacity of proposals from universities. As an illustration of this problem, the text of a consolidated opinion about a research proposal submitted by the authors and denied by an ethics committee of a Brazilian federal university will be analyzed.

En este artículo se analiza la difícil tarea asignada a los comités de ética: la institucionalización de la ética, dimensión que es crítica por excelencia, es decir, contradictoria e movediza; distante, por tanto, de cualquier modo estabelecido y apretado de manifestación. La institucionalización llevada a cabo en los comités de ética mantiene supuestos que chocan frontalmente con el ejercicio ético, hacendo que en estos espacios haga una cristalización de lo que aquí se nombreará de "cientificismo moral moderno", la qual se erige como un criterio supremo para asignar o negar el carácter "científico" a las distintas propuestas de investigación. Como resultado de esta moralización de la ciencia, se vislumbra el empobrecimiento de la capacidad crítica y transformadora de las propuestas de las universidades. Como ejemplo de este problema, se analizó un dictamen sobre una propuesta de investigación presentada por los autores que fue negado por un comité de ética de una universidad federal de Brasil.

Cet article problématise la difficile tâche assignée aux comités d'éthique: celle d'institutionnaliser l'éthique, une dimension critique par excellence, c'est-à-dire contradictoire et incontrôlable à toute forme de manifestation établie et manifeste. On dit que l'institutionnalisation entrepris dans les comités d'éthique repose sur des hypothèses qui se heurtent de front à l'exercice éthique luimême et finissent par consolider dans ces espaces la cristallisation de ce que l'on appellera ici "la moralité scientifique moderne", critère suprême pour attribuer ou nier le caractère "scientifique" aux différentes propositions de recherche. Conséquence de cette moralisation de la science, on peut envisager l'appauvrissement de la capacité critique et transformatrice des propositions venant des universités. À titre d'illustration de ce problème, le texte d'un avis consolidé sur une proposition de recherche soumise par les auteurs et refusé par un comité de déontologie d'une université fédérale brésilienne sera analysé.

Amor e revolta: contribuições de Hannah Arendt e Albert Camus parauma ética absurda / Love and revolt: contributions of Hannah Arendt y Albert Camus toward absurd ethics / Amor e revuelta: aportes de Hannah Arendt y Albert Camus a una ética absurda

Este artigo traz as contribuições do literato e filósofo argelino Albert Camus para se problematizar a ética desde a perspectiva de uma filosofia existencial, mais especificamente, de uma Filosofia do Absurdo. Pretende-se com esse referencial retirar o problema ético de sua dimensão puramente intelectual para – a partir daquilo que será proposto como uma substancialização da ética – apontar as relações concretas dessa discussão com a vida, isto é, com a materialidade pressuposta nos modos de viver – ou estilos existenciais –, isto é, no modo como as pessoas relacionam-se consigo mesmas, com os outros e com o mundo. Depois de apresentadas as noções de “absurdo” e “revolta” cunhadas por Albert Camus, é feita uma aproximação destes com o conceito de Amor Mundi discutido por Hannah Arendt. Conclui-se, assim, que a ultrapassagem do absurdo em direção a novos estilos éticos pode se dar pela assunção do amor como um movimento de luta, constante e ininterrupto, responsável por valorizar a singularidade do viver.

This article brings the contributions of the Algerian writer and philosopher Albert Camus to discuss ethics from the perspective of an existential philosophy, more specifically, a Philosophy of the Absurd. It is intended with this referential to remove the ethical problem of its purely intellectual dimension to – on the basis of which will be proposed as a substantiation of ethics – pointing out the concrete relations of this discussion with life, i.e., with the presupposed materiality of ways of living – or existential styles –, i.e., in the way people relate with themselves, with others and with the world. After presented the notions of "absurd" and "revolt" presented by Albert Camus, it is made an approach of these to the concept of Amor Mundi discussed by Hannah Arendt. It follows, therefore, that the exceeding of the absurd toward new ethical styles can be given by the assumption of love as a constant and uninterrupted movement of struggle responsible for valuing the uniqueness of living.

Este artículo presenta aportes del escritor y filósofo argelino Albert Camus para discutir la ética desde la perspectiva de una filosofía existencial, más específicamente, una Filosofía del Absurdo. Se pretende con esta referencia retirar el problema ético de una dimensión puramente intelectual hacia – a partir de lo que se propone como una substancialización de la ética – apuntar las relaciones concretas de esta discusión con la vida, es decir, con la materialidad presupuesta en los modos de vivir – o estilos existenciales –, o sea, en los modos de relación consigo mismo, con los otros y con el mundo. Después de presentados las nociones de "absurdo" y "revuelta" acuñados por Albert Camus, se hace uma aproximación com el concepto de Amor Mundi discutido por Hannah Arendt. Concluye, que la superación de lo absurdo hacia nuevos estilos éticos se puede dar por la asunción del amor como un movimento de lucha, constante e ininterrumpido, responsable por valorar la singularidad del vivir.

Qualidade microbiológica da água consumida pela população do distrito de Sana, Macaé, Rio de Janeiro / Microbiological quality of water consumed by population of the district Sana, Macaé, Rio de Janeiro

A qualidade da água consumida pela população distrito de Sana, Macaé,RJ foi avaliada por meio de análises microbiológicas para pesquisa de coliformes termotolerantes e totais e bactérias heterotróficas baseando-se na portaria nº518/2004- Ministério da Saúde. A água consumida...

A determinaçäo e diferenciaçäo sexual normais: atualizaçäo / The normal sexual determination and differentiation: updating

Os portadores de distúrbios da diferenciaçäo sexual podem ser detectados ao nascimento pela presença de ambigüidade genital, ou na puberdade por hipogonadismo. Trata-se de questöes médico-psicológicas complexas e urgentes, necessitando de vários profissionais da áres da saúde para agilizaçäo e precisäo na conduta diagnóstica e terapêutica desses casos. Seu manejo exige muita sensibilidade, de modo que näo exista confusäo ao longo do tempo a respeito da identificaçäo sexual da criança. Conhecer a diferenciaçäo sexual normal é fundamental para a compreensäo de tais distúrbios, além de auxiliar nas informaçöes à família, bem como na caracterizaçäo dos achados da genitália externa. Nesta revisäo säo apresentados dados atualizados da determinaçäo e diferenciaçäo sexual normais, sob os aspectos anatômicos, embriológicos, fisiológicos e genéticos, além de propor um protocolo de avaliaçäo das características da genitália externa e sexuais secundárias de pacientes com distúrbios da diferenciaçäo sexual.