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1.
Int J Biol Macromol ; 265(Pt 2): 130933, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38508554

RESUMO

Glucans, a polysaccharide naturally present in the yeast cell wall that can be obtained from side streams generated during the fermentation process, have gained increasing attention for their potential as a skin ingredient. Therefore, this study focused on the extraction method to isolate and purify water-insoluble glucans from two different Saccharomyces cerevisiae strains: an engineered strain obtained from spent yeast in an industrial fermentation process and a wild strain produced through lab-scale fermentation. Two water-insoluble extracts with a high glucose content (> 90 %) were achieved and further subjected to a chemical modification using carboxymethylation to improve their water solubility. All the glucans' extracts, water-insoluble and carboxymethylated, were structurally and chemically characterized, showing almost no differences between both yeast-type strains. To ensure their safety for skin application, a broad safety assessment was undertaken, and no cytotoxic effect, immunomodulatory capacity (IL-6 and IL-8 regulation), genotoxicity, skin sensitization, and impact on the skin microbiota were observed. These findings highlight the potential of glucans derived from spent yeast as a sustainable and safe ingredient for cosmetic and skincare formulations, contributing to the sustainability and circular economy.


Assuntos
Glucanos , Saccharomyces cerevisiae , Glucanos/química , Saccharomyces cerevisiae/química , Polissacarídeos/química , Água
2.
Cureus ; 16(3): e55999, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38476508

RESUMO

Introduction Our department conducted a retrospective cohort study to compare the efficacy of continuous glucose monitoring devices versus capillary blood glucose in the glycemic control of inpatient type 2 diabetes on intensive insulin therapy in a Portuguese hospital. The use of continuous glucose monitoring devices was associated with improved glycemic control, including an increased number of glucose readings within target range and reduced hyperglycemic events, being safe concerning hypoglycemias. This is the cost-effectiveness analysis associated with these results. Aim The primary objective was to compare the cost-effectiveness of achieving glycemic control, defined as the number of patients within glycemic goals, between groups. Secondary endpoints included cost-effectiveness analyses of each time in range goal, and each percentual increment in time in range. Methods We defined each glycemic goal as: "readings within range (70-180 mg/dL) >70%", "readings below range (below 70 mg/dL) <4%", "severe hypoglycemia (below 54 mg/dL) <1%", "readings above range (above 180 mg/dL) <25%", "very high glycemic readings (above 250 mg/dL) <5%". Results Continuous glucose monitoring showed lower median cost per effect for the primary outcome (€11.1 vs. €34.9/patient), with lower cost for readings in range (€7.8 vs. €11.6/patient) and for both readings above range goals ("above 180mg/dL": €7.4 vs. €9.9/patient, and "above 250mg/dL": €6.9 vs. €17.4/patient). Conclusions There are no published data regarding the cost-effectiveness of continuous glucose monitoring devices in inpatient settings. Our results show that continuous glucose monitoring devices were associated with an improved glycemic control, at a lower cost, and endorse the feasibility of incorporating these devices into hospital settings, presenting a favorable cost-effective option compared to capillary blood glucose.

3.
J Thorac Dis ; 15(9): 5239-5247, 2023 Sep 28.
Artigo em Inglês | MEDLINE | ID: mdl-37868846

RESUMO

Background and Objective: In thoracic surgery, different modalities of extracorporeal life support (ECLS) can be used for cardiorespiratory support in complex scenarios. Decades of learning in clinical practice and physiology associated with technological development led to a great variety of ECLS technologies available. Thoracic surgery procedures with difficult or impossible single lung ventilation may still be performed using different ECLS modalities. The aim of this review is to describe the use of ECLS, with its different modalities, as a solution to perform complex surgeries in a patient with difficult or impossible single lung ventilation. Methods: A literature review was conducted using the terms "extracorporeal life support pulmonary resection" and "extracorporeal life support thoracic surgery", and articles were selected according to defined criteria. Key Content and Findings: To support lung function during thoracic surgery, the most efficient and popular variety of ECLS is venovenous extracorporeal membrane oxygenation. Lung resection on a single lung after pneumonectomy, surgery in a patient with severe hypercapnia and/or low respiratory reserve, carinal and airway surgery, and severe thoracic trauma are the main examples of situations where ECLS may be the solution to provide a safe surgical environment in patients who cannot tolerate single lung ventilation. Multidisciplinarity, selection of patients and careful surgical planning are cornerstones in defining the situations that may benefit from ECLS support. Conclusions: Knowledge on techniques of ECLS are essential for every thoracic surgeon. Although rarely used, these techniques of cardiorespiratory support should be considered when planning complex cases with difficulties in ventilation and emergent situations.

4.
Carbohydr Polym ; 322: 121329, 2023 Dec 15.
Artigo em Inglês | MEDLINE | ID: mdl-37839841

RESUMO

ß-Glucans, which are naturally present in cereals, yeast, and mushrooms, have gained attention as a potential natural source for functional foods and pharmaceuticals. Due to the availability of ß-glucans from several sources, different extraction methods can be employed to obtain high purity extracts that can be further modified to enhance their solubility or other biological properties. Apart from their known ability to interact with the immune system, ß-glucans possess specific properties that could benefit overall skin health and prevent age-related signs, including soothing and antioxidant activities. As a result, the use of ß-glucans to mitigate damage caused by environmental stressors or skin-related issues that accelerate skin aging or trigger chronic inflammation may represent a promising, natural, eco-friendly, and cost-effective approach to maintaining skin homeostasis balance. This review outlines ß-glucan extraction methodologies, molecular structure, functionalization approaches, and explores skin-related benefits of ß-glucans, along with an overview of related products in the market.


Assuntos
Agaricales , beta-Glucanas , beta-Glucanas/uso terapêutico , beta-Glucanas/química , Agaricales/química , Pele , Antioxidantes/farmacologia , Antioxidantes/uso terapêutico , Solubilidade
5.
Chemosphere ; 341: 140028, 2023 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-37660783

RESUMO

The knowledge of the lithological context is necessary to interpret trace elements concentrations in the soil. Soil magnetic signature (χ) and soil X-ray fluorescence (XRF) are promising approaches in the study of the spatial variability of trace elements and the environmental monitoring of soil quality. This research aimed to assess the efficiency of measurements of χ and XRF sensors for spatial characterization of zinc (Zn), manganese (Mn), and copper (Cu) contents in soils of a sandstone-basalt transitional environment, using machine learning modeling. The studied area consisted of the Western Plateau of São Paulo (WPSP), with soils originating from sandstone and basalt. A total of 253 soil samples were collected at a depth of 0.0-0.2 m. The soils were characterized by particle size and chemical analysis: organic matter (OM), cation exchange capacity (CEC), ammonium oxalate-extracted iron (Feo), sodium dithionite-citrate-bicarbonate-extracted iron (Fed), and sulfuric acid-extracted iron (Fet). Hematite (Hm), goethite (Gt), kaolinite (Kt), and gibbsite (Gb) contents were obtained by X-ray diffraction (XRD). Magnetite (Mt) and maghemite (Mh) contents were obtained by soil χ, while trace elements contents were obtained by XRF and predicted by χ. Descriptive analysis, the test of means, and correlation were performed between attributes. Zn, Mn, and Cu contents were predicted using the machine learning algorithm random forest, and the spatial variability was obtained using the ordinary kriging interpolation technique. Landscape dissections influenced iron oxides, which had the highest contents in slightly dissected environments. Trace elements contents were not influenced by landscape dissections, demonstrating that lithological knowledge is necessary to characterize trace elements in soils. The prediction models developed through the machine learning algorithm random forest showed that χ can be used to characterize trace elements. The similar spatial pattern of trace elements obtained by XRF and χ measurements confirm the applicability of these sensors for mapping it under lithological and landscape transition, aiming for sustainable strategic planning of land use and occupation.


Assuntos
Oligoelementos , Raios X , Fluorescência , Brasil , Zinco , Ferro , Manganês
6.
Catheter Cardiovasc Interv ; 102(4): 631-640, 2023 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-37579212

RESUMO

BACKGROUND: Visual assessment of the percentage diameter stenosis (%DSVE ) of lesions is essential in coronary angiography (CAG) interpretation. We have previously developed an artificial intelligence (AI) model capable of accurate CAG segmentation. We aim to compare operators' %DSVE in angiography versus AI-segmented images. METHODS: Quantitative coronary analysis (QCA) %DS (%DSQCA ) was previously performed in our published validation dataset. Operators were asked to estimate %DSVE of lesions in angiography versus AI-segmented images in separate sessions and differences were assessed using angiography %DSQCA as reference. RESULTS: A total of 123 lesions were included. %DSVE was significantly higher in both the angiography (77% ± 20% vs. 56% ± 13%, p < 0.001) and segmentation groups (59% ± 20% vs. 56% ± 13%, p < 0.001), with a much smaller absolute %DS difference in the latter. For lesions with %DSQCA of 50%-70% (60% ± 5%), an even higher discrepancy was found (angiography: 83% ± 13% vs. 60% ± 5%, p < 0.001; segmentation: 63% ± 15% vs. 60% ± 5%, p < 0.001). Similar, less pronounced, findings were observed for %DSQCA < 50% lesions, but not %DSQCA > 70% lesions. Agreement between %DSQCA /%DSVE across %DSQCA strata (<50%, 50%-70%, >70%) was approximately twice in the segmentation group (60.4% vs. 30.1%; p < 0.001). %DSVE inter-operator differences were smaller with segmentation. CONCLUSION: %DSVE was much less discrepant with segmentation versus angiography. Overestimation of %DSQCA < 70% lesions with angiography was especially common. Segmentation may reduce %DSVE overestimation and thus unwarranted revascularization.

7.
Artigo em Português | PAHO-IRIS | ID: phr-57875

RESUMO

[RESUMO]. No Brasil, 67,7% dos municípios têm menos de 20 mil habitantes, sendo caracterizados como de pequeno porte. O objetivo do presente artigo é sistematizar a experiência e identificar os desafios e as lições aprendidas na implantação do modelo de fortalecimento da governança regional e da organização da rede de atenção à saúde (RAS) em uma região do Brasil composta por esses municípios, que apresentam baixa capacidade técnica e orçamentária, além de fragilidades diversas relacionadas à organização da RAS. Na perspectiva do fortalecimento da governança regional e da organização do processo de trabalho da atenção primária em saúde (APS) e, por consequência, dos fluxos com os outros níveis de atenção, foi proposta a estratégia intitulada Mais Cuidado Mais Saúde, desenvolvida em parceria com a Organização Pan-Americana da Saúde/Organização Mundial da Saúde (OPAS/OMS) e o Ministério da Saúde. O projeto foi executado por meio de processos de educação permanente em saúde e fortalecimento de capacidades institucionais na região de Ivaiporã/Paraná, com oficinas descentralizadas, contemplando três eixos prioritários: integração da RAS, formação de capacidades e gestão da informação. O público-alvo foram as equipes de APS ampliada. O projeto permitiu desenvolver capacidades locais e de governança regional por meio de reflexões conjuntas a respeito do modelo de atenção à saúde, de seus componentes e das mudanças necessárias nos processos de trabalho para a promoção de saúde com foco na qualidade de vida dos usuários. Por se tratar de uma experiência que considera as fragilidades, necessidades e autonomia dos atores locais, o projeto tem alto poder de replicação e customização para outras regiões com características similares dentro e fora do Brasil.


[ABSTRACT]. In Brazil, 67.7% of the municipalities are characterized as small, with a population of less than 20 thousand. The objective of this article is to systematize the experience and identify the challenges and lessons learned in the implementation of the model for strengthening regional governance and organizing the health care network (HCN) in a region of Brazil composed of these municipalities, which present low technical and budgetary capacity, in addition to various fragilities related to the organization of the HCN. With a view to strengthening regional governance and the organization of the primary health care (PHC) work process and, consequently, the workflow with other levels of care, a strategy entitled More Care More Health (Mais Cuidado Mais Saúde) was proposed, developed in partnership with the Pan American Health Organization/World Health Organization (PAHO/WHO) and the Ministry of Health. The project was developed through permanent health education and institutional capacity building in the region of Ivaiporã, state of Paraná, based on workshops and addres- sing three priority axes: HCN integration, capacity building and information management. The target audience were the extended PHC teams. The project made it possible to develop local and governance capacities through joint reflections on the health care model, its components and the necessary changes in work proces- ses for health promotion with a focus on the quality of life of users. Because it is an experience that considers the weaknesses, needs and autonomy of local actors, the project has a high potential for replication and cus- tomization for other regions with similar characteristics inside and outside Brazil.


[RESUMEN]. En Brasil, 67,7% de los municipios se clasifican como pequeños, puesto que tienen menos de 20 000 habitantes. El objetivo de este artículo es sistematizar la experiencia adquirida y determinar cuáles son los desafíos y las enseñanzas extraídas en la implementación del modelo de fortalecimiento de la gobernanza regional y de la organización de la red de atención de salud en una región de Brasil compuesta por municipios de este tipo, que tienen poca capacidad técnica y presupuestaria y diversas debilidades relacionadas con la organización de dicha red. Desde la perspectiva del fortalecimiento de la gobernanza regional y de la organización del proceso de trabajo en el campo de la atención primaria de salud y, por consiguiente, de los flujos asistenciales con los demás niveles de atención, se propuso la estrategia Más cuidado, más salud, formulada junto con la Organización Panamericana de la Salud/Organización Mundial de la Salud (OPS/OMS) y el Ministerio de Salud. El proyecto se ejecutó por medio de procesos de educación permanente en salud y fortalecimiento de las capacidades institucionales en la región de Ivaiporã, Estado de Paraná, con talleres descentralizados, dentro de tres ejes prioritarios, a saber, integración de red de atención de salud, capacitación y gestión de la información. El público destinatario fueron los equipos de atención primaria de salud ampliada. El proyecto permitió el desarrollo de las capacidades locales y la gobernanza regional por medio de reflexiones conjuntas sobre el modelo de atención de salud, sus elementos constitutivos y los cambios necesarios en los procesos de trabajo para impulsar la promoción de la salud centrada en la calidad de vida de los usuarios. Por tratarse de una experiencia en la cual se tienen en cuenta las debilidades, las necesidades y la autonomía de los acto- res locales, el proyecto tiene un alto poder de repetición y adaptación en otras regiones con características similares dentro y fuera de Brasil.


Assuntos
Regionalização da Saúde , Educação Continuada , Governança em Saúde , Atenção Primária à Saúde , Brasil , Regionalização da Saúde , Educação Continuada , Governança em Saúde , Atenção Primária à Saúde , Brasil , Regionalização da Saúde , Educação Continuada , Governança em Saúde , Atenção Primária à Saúde
8.
Rev Saude Publica ; 57: 34, 2023.
Artigo em Inglês, Português | MEDLINE | ID: mdl-37377330

RESUMO

The article analyzes aspects of the change in the legal nature of private healthcare from "for-profit" to "non-profit" entities. It is an exploratory research, supported by the policy analysis framework, focusing on secondary data from the Cadastro Nacional de Estabelecimentos de Saúde (National Registry of Health Facilities - CNES) from 2012 to 2020 and a case study. The results show an increase in these entities in all regions of the country and evidence that they behave like profit-oriented entities. The change in legal nature hides a broader process of implicit commodification of healthcare services, encouraged by state policies and related to exemptions provided by law.


Assuntos
Obtenção de Fundos , Humanos , Brasil , Atenção à Saúde , Serviços de Saúde , Hospitais Privados
9.
Rev. enferm. Cent.-Oeste Min ; 13: 4754, jun. 2023.
Artigo em Português | LILACS, BDENF - Enfermagem | ID: biblio-1436955

RESUMO

Objetivo: compreender a maneira como a residência em saúde da família e comunidade atua como instrumento para o fortalecimento e a defesa do Sistema Único de Saúde sob a ótica da enfermagem. Método: estudo do tipo exploratório-descritivo com abordagem qualitativa, desenvolvido com 13 enfermeiros residentes. Neste estudo, os dados foram coletados de modo remoto por meio de entrevista semiestruturada, processados pelo software IRaMuTeQ e interpretados conforme análise de conteúdo de Bardin. Resultados: os resultados apontam que as residências na área da saúde se expressam com força política, conhecimento teórico e formação na prática, essenciais para fortalecer o controle social. Conclusão: faz-se necessário que a formação dos profissionais seja orientada a partir dos princípios/objetivos do SUS e que ocorra o combate aos ataques iminentes, exemplificados pelo baixo financiamento e má gestão.


Objective: to understand the way in which residency in family and community health acts as an instrument for strengthening and defending the Unified Health System from the perspective of nursing. Method: exploratory-descriptive study with a qualitative approach, developed with 13 resident nurses.In this study, data were collected remotely with semi-structured interviews, processed by the IRAMUTEQ software, and interpreted according to Bardin's content analysis. Results: the results indicate that residencies in the health area express themselves with political force, theoretical knowledge, and training in practice, essential to strengthen social control. Conclusion: the training of professionals must be guided from the principles/objectives of the SUS and the fight against imminent attacks, exemplified by low funding and poor management, must occur.


Objetivo: comprender el modo en que la residencia en salud familiar y comunitaria actúa como instrumento de fortalecimiento y defensa del Sistema Único de Salud (SUS) desde la perspectiva de la enfermería. Método: estudio exploratório descriptivo, con enfoque cualitativo, desarrollado con 13 enfermeras residentes. En este estudio, los datos se recolectaron de forma remota mediante entrevistas semiestructuradas, que, posteriormente, fueron procesadas por el software IRaMuTeQ e interpretadas de acuerdo con el análisis de contenido de Bardin. Resultados: las residencias en el área de la salud se desarrollan con fuerza política, conocimiento teórico y formación práctica, lo que es esencial para fortalecer el control social. Conclusión: es necesario que la formación de los profesionales se base en los principios/objetivos del SUS y que ocurra la lucha contra los inminentes ataques, ejemplificados por una baja financiación y mala gestión.


Assuntos
Humanos , Masculino , Feminino , Política Pública , Sistema Único de Saúde , Enfermagem , Capacitação de Recursos Humanos em Saúde , Internato e Residência
10.
Colloids Surf B Biointerfaces ; 226: 113305, 2023 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-37084526

RESUMO

The demand for sustainable products is increasing worldwide and cosmetic industry is not an exception. Besides exploring nature as source of new ingredients, their production must be sustainable and should use environmentally friendly processes. In this work, biogenic silica microparticles were synthesized from sugarcane ash, and their potential application as cosmetic and skincare ingredient was evaluated. For such application, several properties were validated, including cytotoxicity in skin keratinocytes, potential sensitization effect on skin peptides, stimulation of pro-collagen I alpha 1, wound healing capacity, as well as the ingredient stability along a storage period. Biogenic silica showed to be non-cytotoxic on skin keratinocytes, at concentrations up to 5 wt%, and non-skin sensitizer. A positive effect on the stimulation of pro-collagen I alpha 1 suggests a potential anti-ageing activity, while the migration of fibroblasts to a wounded area suggests a regenerative capacity. Under an accelerated stability study, biogenic silica showed an increase on the loss on drying, but no changes were observed on its functional properties, mainly oil absorption capacity, as well the microbiological quality, which was maintained. Overall, novel biogenic silica microparticles produced from a sustainable source are safe, stable over time and have potential to be used as a cosmetic and skincare ingredient.


Assuntos
Cosméticos , Testes de Toxicidade , Qualidade de Produtos para o Consumidor , Fenômenos Químicos , Colágeno
11.
ABC., imagem cardiovasc ; 36(1): e366, abr. 2023. ilus, tab
Artigo em Português | LILACS | ID: biblio-1515911

RESUMO

A pericardite constritiva (PC) é uma condição na qual a cicatrização e perda de elasticidade do pericárdio resultam em enchimento ventricular prejudicado, disfunção diastólica e insuficiência cardíaca direita. O diagnóstico dessa patologia é desafiador, sendo frequente a necessidade de técnicas de imagem multimodal, dentre as quais a ecocardiografia representa a modalidade de imagem inicial para a avaliação diagnóstica, além de permitir a diferenciação da PC da cardiomiopatia restritiva (CMR) e outras condições que mimetizam constrição. (AU)


Constrictive pericarditis (CP) is a condition in which scarring and loss of elasticity of the pericardium result in impaired ventricular filling, diastolic dysfunction, and right heart failure. The diagnosis of this pathology is challenging, with frequent need for multimodal imaging techniques, among which echocardiography represents the initial imaging modality for the diagnostic evaluation, in addition to allowing the differentiation of CP from restrictive cardiomyopathy (RCM) and other conditions that mimic constriction. (AU)


Assuntos
Humanos , Adolescente , Idoso , Idoso de 80 Anos ou mais , Adulto Jovem , Pericardite Constritiva/fisiopatologia , Pericardite Constritiva/diagnóstico por imagem , Pericárdio/anormalidades , Insuficiência Cardíaca/etiologia , Pericárdio/anatomia & histologia , Tuberculose/complicações , Cardiomiopatia Restritiva/diagnóstico , Ecocardiografia/métodos , Espectroscopia de Ressonância Magnética/métodos , Tomografia Computadorizada por Raios X/métodos
12.
Rev Bras Enferm ; 76(2): e20220396, 2023.
Artigo em Inglês, Português | MEDLINE | ID: mdl-36753258

RESUMO

OBJECTIVE: To develop and validate the content of the Nurses' Work Methods Assessment Scale. METHODS: Methodological study conducted between January and February 2022, based on the Quality Standards for Nursing Care and Imogene King's framework. A literature review was previously undertaken to design the scale. The content validation was carried out by 23 experts. RESULTS: The initial version consisted of 40 items organized in four work methods identified in the literature. In the first dimension, from ten items, seven were considered, and one was reformulated. Seven of the initial ten items were considered in the second version. The third dimension consisted of seven items. In the fourth dimension, three items were reformulated, and three were excluded, leaving seven items. The final version ended with 28 items, whose Content Validity Index ranged between 0.83 and 1. CONCLUSIONS: The involvement of experts has become pivotal in the development and validation of the items, providing confidence to the continuity of psychometric procedures.


Assuntos
Enfermeiras e Enfermeiros , Cuidados de Enfermagem , Humanos , Inquéritos e Questionários , Reprodutibilidade dos Testes , Psicometria/métodos
13.
Rev. saúde pública (Online) ; 57: 34, 2023. graf
Artigo em Inglês, Português | LILACS | ID: biblio-1442133

RESUMO

ABSTRACT The article analyzes aspects of the change in the legal nature of private healthcare from "for-profit" to "non-profit" entities. It is an exploratory research, supported by the policy analysis framework, focusing on secondary data from the Cadastro Nacional de Estabelecimentos de Saúde (National Registry of Health Facilities - CNES) from 2012 to 2020 and a case study. The results show an increase in these entities in all regions of the country and evidence that they behave like profit-oriented entities. The change in legal nature hides a broader process of implicit commodification of healthcare services, encouraged by state policies and related to exemptions provided by law.


RESUMO O artigo analisa aspectos da mudança da natureza jurídica de instituições privadas de assistência à saúde, de estabelecimentos "com" para "sem" fins lucrativos. Trata-se de uma pesquisa exploratória, apoiada no referencial de análise de políticas, com foco em dados secundários, provenientes do Sistema de Cadastro Nacional de Estabelecimentos de Saúde (SCNES), de 2012 a 2020, e estudo de caso. Os resultados apresentam aumento dessas entidades em todas as regiões do país e evidências de que se comportam como estabelecimentos com fins lucrativos. A mudança de natureza jurídica oculta um processo mais amplo de mercantilização implícita dos serviços de saúde, incentivado por políticas estatais e relacionado às isenções previstas em lei.


Assuntos
Política Pública , Instituições Filantrópicas de Saúde/legislação & jurisprudência , Sistema Único de Saúde , Hospitais Privados , Gestão em Saúde , Obtenção de Fundos
14.
Rev. bras. enferm ; 76(2): e20220396, 2023. tab
Artigo em Inglês | LILACS-Express | LILACS, BDENF - Enfermagem | ID: biblio-1423188

RESUMO

ABSTRACT Objective: To develop and validate the content of the Nurses' Work Methods Assessment Scale. Methods: Methodological study conducted between January and February 2022, based on the Quality Standards for Nursing Care and Imogene King's framework. A literature review was previously undertaken to design the scale. The content validation was carried out by 23 experts. Results: The initial version consisted of 40 items organized in four work methods identified in the literature. In the first dimension, from ten items, seven were considered, and one was reformulated. Seven of the initial ten items were considered in the second version. The third dimension consisted of seven items. In the fourth dimension, three items were reformulated, and three were excluded, leaving seven items. The final version ended with 28 items, whose Content Validity Index ranged between 0.83 and 1. Conclusions: The involvement of experts has become pivotal in the development and validation of the items, providing confidence to the continuity of psychometric procedures.


RESUMEN Objetivo: Construir y validar contenido de Escala de Evaluación de Métodos de Trabajo de Enfermeros. Métodos: Estudio metodológico realizado entre enero y febrero de 2022, basado en Estándares de Calidad de Atención de Enfermeríay referencial de Imogene King. Para construcción de Escala, realizado previamente revisión de literatura. La validez de contenido contó con 23 peritos. Resultados: La versión inicial contenía 40 items, organizados en cuatro métodos de trabajo identificados en la literatura. La primera dimensión, de diez items, fueron considerados siete y uno fue reformulado. La segunda, de diez iniciales, fueron considerados siete. La tercera dimensión constituída por siete ítems. La cuarta dimensión, reformulados tres y excluidos tres, quedando siete. La versión final quedó con 28 items, cuyo Índice de Validez de Contenido osciló entre 0,83 y 1. Conclusiones: Recorrer a peritos volvió fundamental en la construcción y validez de los items, confiriendo seguridad a continuidad de procedimientos psicométricos.


RESUMO Objetivo: Construir e validar o conteúdo da Escala de Avaliação dos Métodos de Trabalho dos Enfermeiros. Métodos: Estudo metodológico realizado entre janeiro e fevereiro de 2022, baseado nos Padrões de Qualidade dos Cuidados de Enfermagem e no referencial de Imogene King. Para construção da Escala, realizou-se previamente revisão de literatura. A validação de conteúdo contou com 23 peritos. Resultados: A versão inicial continha 40 itens, organizados nos quatro métodos de trabalho identificados na literatura. Na primeira dimensão, dos dez itens, foram considerados sete e um foi reformulado. Na segunda, dos dez iniciais, foram considerados sete. A terceira dimensão constituiu-se por sete itens. Na quarta dimensão, reformularam-se três e excluíram-se três, ficando sete. A versão final ficou com 28 itens, cujo Índice de Validade de Conteúdo oscilou entre 0,83 e 1. Conclusões: Recorrer aos peritos tornou-se fundamental na construção e validação dos itens, conferindo segurança à continuidade dos procedimentos psicométricos.

15.
Rev Port Cardiol ; 41(12): 1011-1021, 2022 12.
Artigo em Inglês, Português | MEDLINE | ID: mdl-36511271

RESUMO

INTRODUCTION AND OBJECTIVES: Although automatic artificial intelligence (AI) coronary angiography (CAG) segmentation is arguably the first step toward future clinical application, it is underexplored. We aimed to (1) develop AI models for CAG segmentation and (2) assess the results using similarity scores and a set of criteria defined by expert physicians. METHODS: Patients undergoing CAG were randomly selected in a retrospective study at a single center. Per incidence, an ideal frame was segmented, forming a baseline human dataset (BH), used for training a baseline AI model (BAI). Enhanced human segmentation (EH) was created by combining the best of both. An enhanced AI model (EAI) was trained using the EH. Results were assessed by experts using 11 weighted criteria, combined into a Global Segmentation Score (GSS: 0-100 points). Generalized Dice Score (GDS) and Dice Similarity Coefficient (DSC) were also used for AI models assessment. RESULTS: 1664 processed images were generated. GSS for BH, EH, BAI and EAI were 96.9+/-5.7; 98.9+/-3.1; 86.1+/-10.1 and 90+/-7.6, respectively (95% confidence interval, p<0.001 for both paired and global differences). The GDS for the BAI and EAI was 0.9234±0.0361 and 0.9348±0.0284, respectively. The DSC for the coronary tree was 0.8904±0.0464 and 0.9134±0.0410 for the BAI and EAI, respectively. The EAI outperformed the BAI in all coronary segmentation tasks, but performed less well in some catheter segmentation tasks. CONCLUSIONS: We successfully developed AI models capable of CAG segmentation, with good performance as assessed by all scores.


Assuntos
Aprendizado Profundo , Humanos , Tomografia Computadorizada por Raios X , Inteligência Artificial , Estudos Retrospectivos , Raios X , Angiografia Coronária
16.
Front Plant Sci ; 13: 973087, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36426150

RESUMO

Selection on plant functional traits may occur through their direct effects on fitness (or a fitness component), or may be mediated by attributes of plant performance which have a direct impact on fitness. Understanding this link is particularly challenging for long-lived organisms, such as forest trees, where lifetime fitness assessments are rarely achievable, and performance features and fitness components are usually quantified from early-life history stages. Accordingly, we studied a cohort of trees from multiple populations of Eucalyptus pauciflora grown in a common-garden field trial established at the hot and dry end of the species distribution on the island of Tasmania, Australia. We related the within-population variation in leaf economic (leaf thickness, leaf area and leaf density) and hydraulic (stomatal density, stomatal length and vein density) traits, measured from two-year-old plants, to two-year growth performance (height and stem diameter) and to a fitness component (seven-year survival). When performance-trait relationships were modelled for all traits simultaneously, statistical support for direct effects on growth performance was only observed for leaf thickness and leaf density. Performance-based estimators of directional selection indicated that individuals with reduced leaf thickness and increased leaf density were favoured. Survival-performance relationships were consistent with size-dependent mortality, with fitness-based selection gradients estimated for performance measures providing evidence for directional selection favouring individuals with faster growth. There was no statistical support for an effect associated with the fitness-based quadratic selection gradient estimated for growth performance. Conditional on a performance measure, fitness-based directional selection gradients estimated for the leaf traits did not provide statistical support for direct effects of the focal traits on tree survival. This suggested that, under the environmental conditions of the trial site and time period covered in the current study, early-stage selection on the studied leaf traits may be mediated by their effects on growth performance, which in turn has a positive direct influence on later-age survival. We discuss the potential mechanistic basis of the direct effects of the focal leaf traits on tree growth, and the relevance of a putative causal pathway of trait effects on fitness through mediation by growth performance in the studied hot and dry environment.

17.
Environ Sci Pollut Res Int ; 29(49): 73599-73621, 2022 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-36071358

RESUMO

Improper disposal of animal waste is responsible for several environmental problems, causing eutrophication of lakes and rivers, nutrient overload in the soil, and the spread of pathogenic organisms. Despite the potential to cause adverse ecological damage, animal waste can be a valuable source of resources if incorporated into a circular concept. In this sense, new approaches focused on recovery and reuse as substitutes for traditional processes based on removing contaminants in animal manure have gained attention from the scientific community. Based on this, the present work reviewed the literature on the subject, performing a bibliometric and scientometric analysis of articles published in peer-reviewed journals between 1991 and 2021. Of the articles analyzed, the main issues addressed were nitrogen and phosphorus recovery, energy generation, high-value-added products, and water reuse. The energy use of livestock waste stands out since it is characterized as a consolidated solution, unlike other routes still being developed, presenting the economic barrier as the main limiting factor. Analyzing the trend of technological development through the S curve, it was possible to verify that the circular economy in the management of animal waste will enter the maturation phase as of 2036 and decline in 2056, which demonstrates opportunities for the sector's development, where animal waste can be an economic agent, promoting a cleaner and more viable product for a sustainable future.


Assuntos
Esterco , Gerenciamento de Resíduos , Animais , Bibliometria , Nitrogênio/metabolismo , Fósforo/metabolismo , Solo , Água
18.
Plants (Basel) ; 11(14)2022 Jul 14.
Artigo em Inglês | MEDLINE | ID: mdl-35890479

RESUMO

With climate change impacting trees worldwide, enhancing adaptation capacity has become an important goal of provenance translocation strategies for forestry, ecological renovation, and biodiversity conservation. Given that not every species can be studied in detail, it is important to understand the extent to which climate adaptation patterns can be generalised across species, in terms of the selective agents and traits involved. We here compare patterns of genetic-based population (co)variation in leaf economic and hydraulic traits, climate-trait associations, and genomic differentiation of two widespread tree species (Eucalyptus pauciflora and E. ovata). We studied 2-year-old trees growing in a common-garden trial established with progeny from populations of both species, pair-sampled from 22 localities across their overlapping native distribution in Tasmania, Australia. Despite originating from the same climatic gradients, the species differed in their levels of population variance and trait covariance, patterns of population variation within each species were uncorrelated, and the species had different climate-trait associations. Further, the pattern of genomic differentiation among populations was uncorrelated between species, and population differentiation in leaf traits was mostly uncorrelated with genomic differentiation. We discuss hypotheses to explain this decoupling of patterns and propose that the choice of seed provenances for climate-based plantings needs to account for multiple dimensions of climate change unless species-specific information is available.

20.
Front Physiol ; 13: 829920, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35620602

RESUMO

In recent decades, the high incidence of infectious and parasitic diseases has been replaced by a high prevalence of chronic and degenerative diseases. Concomitantly, there have been profound changes in the behavior and eating habits of families around the world, characterizing a "nutritional transition" phenomenon, which refers to a shift in diet in response to modernization, urbanization, or economic development from undernutrition to the excessive consumption of hypercaloric and ultra-processed foods. Protein malnutrition that was a health problem in the first half of the 20th century has now been replaced by high-fat diets, especially diets high in saturated fat, predisposing consumers to overweight and obesity. This panorama points us to the alarming coexistence of both malnutrition and obesity in the same population. In this way, individuals whose mothers were undernourished early in pregnancy and then exposed to postnatal hyperlipidic nutrition have increased risk factors for developing metabolic dysfunction and cardiovascular diseases in adulthood. Thus, our major aim was to review the cardiometabolic effects resulting from postnatal hyperlipidic diets in protein-restricted subjects, as well as to examine the epigenetic repercussions occasioned by the nutritional transition.

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