Remote and Proximal Sensors Data Fusion: Digital Twins in Irrigation Management Zoning.

The scientific field of precision agriculture employs increasingly innovative techniques to optimize inputs, maximize profitability, and reduce environmental impact. However, obtaining a high number of soil samples is challenging in order to make precision agriculture viable. There is a trade-off between the amount of data needed and the time and resources spent to obtain these data compared to the accuracy of the maps produced with more or fewer points. In the present study, the research was based on an exhaustive dataset of apparent electrical conductivity (aEC) containing 3906 points distributed along 26 transects with spacing between each of up to 40 m, measured by the proximal soil sensor EM38-MK2, for a grain-producing area of 72 ha in São Paulo, Brazil. A second sparse dataset was simulated, showing only four transects with a 400 m distance and, in the end, only 162 aEC points. The aEC map via ordinary kriging (OK) from the grid with 26 transects was considered the reference, and two other mapping approaches were used to map aEC via sparse grid: kriging with external drift (KED) and geographically weighted regression (GWR). These last two methods allow the increment of auxiliary variables, such as those obtained by remote sensors that present spatial resolution compatible with the pivot scale, such as data from the Landsat-8, Aster, and Sentinel-2 satellites, as well as ten terrain covariates derived from the Alos Palsar digital elevation model. The KED method, when used with the sparse dataset, showed a relatively good fit to the aEC data (R2 = 0.78), with moderate prediction accuracy (MAE = 1.26, RMSE = 1.62) and reasonable predictability (RPD = 1.76), outperforming the GWR method, which had the weakest performance (R2 = 0.57, MAE = 1.78, RMSE = 2.30, RPD = 0.81). The reference aEC map using the exhaustive dataset and OK showed the highest accuracy with an R2 of 0.97, no systematic bias (ME = 0), and excellent precision (RMSE = 0.56, RPD = 5.86). Management zones (MZs) derived from these maps were validated using soil texture data from clay samples measured at 0-10 cm depth in a grid of 72 points. The KED method demonstrated the highest potential for accurately defining MZs for irrigation, producing a map that closely resembled the reference MZ map, thereby providing reliable guidance for irrigation management.

A cellulose monolithic stir bar for sorptive extraction of glycerol from biodiesel.

This work presents an eco-friendly approach for determining free glycerol in biodiesel samples, using a cellulose monolith stir bar in the sorptive extraction method with analysis by high-performance liquid chromatography and a refractive index detector. The cellulose monolith was produced from cellulose acetate by non-solvent-induced phase separation and subsequent alkaline deacetylation. The cellulose monolith presented a hierarchically porous structure, with 68% porosity and almost total deacetylation, with morphological and polarity characteristics that favor an efficient extraction of free glycerol from biodiesel. The sorptive extraction method using a cellulose monolith stir bar was optimized, obtaining a total extraction time of 30 min at 70 °C, using ultrapure water as the desorption solvent, and extraction of free glycerol of 93.6 ± 2.3%. The proposed method showed selectivity in free glycerol extraction, with limits of detection and quantification of 6.60 × 10-5% w/w and 2.18 × 10-4% w/w, respectively. Compared with the official reference method, the proposed one presented similar precision and accuracy, with few manipulations and any reagent/solvents. Furthermore, it is compatible with the principles of green chemistry and can be considered an eco-friendly method for determining free glycerol in biodiesel.

[Reconstructive surgery of the large intrathoracic veins, four case reports]. / Cirurgia Reconstrutiva das Grandes Veias Intratorácicas, a Propósito de Quatro Casos Clínicos.

The resection and reconstruction of the large venous vessels of the chest is a procedure intended to treat the symptoms of venous hypertension caused by the Superior Vena Cava Syndrome and to allow resection of mediastinal tumors that invade the superior vena cava (SVC) and the left and right innominate veins. We report four clinical cases of mediastinal tumors involving the large intrathoracic venous vessels, submitted to surgery between 2010 and 2013. In all cases our purpose was to completely resect the tumor. We intended to evaluate the surgical results in terms of improvement of symptoms, complications of the procedures, permeability of the bypasses in the short and medium term and mortality rates. We used ringed ePTFE grafts to perform the following vascular reconstructions: - Y configuration bypass from the left subclavian vein and the left internal jugular vein to the left inominate vein; - two bypasses from the top of the left innominate vein to the right atrial appendage; - bypass from the left innominate vein to the right atrial appendage and a bypass from the right innominate vein to the SVC. All patients were discharged, and all the bypasses were patent at discharge and after 30 days . There were two cases of late thrombosis, but patients remained asymptomatic. Our series shows the feasibility of these technically complex surgeries, which are an excellent example of the benefits of multidisciplinary collaboration between vascular and thoracic surgeons.

Post-earthquake damage classification and assessment: case study of the residential buildings after the M w = 5 earthquake in Mila city, Northeast Algeria on August 7, 2020.

On August 7th, 2020, a magnitude Mw = 5.0 earthquake shook 5 km north of Mila city center, northeast of Algeria, causing substantial damage directly to structures, and indirectly from induced impacts of landslides and rock falls, ultimately disrupt to everyday civilian life. Given the recent significant seismic occurrences in the region, a detailed and comprehensive examination and assessment of post-earthquake damage is critical to Algeria. This is primarily because masonry, concrete, and colonial-era structures are sensitive to horizontal motions caused by seismic waves, and because masonry and concrete structures constitute a substantial portion of today's Algeria's build environment. We present a post-earthquake investigation of the Mila earthquake, starting from the earthquake source, and a catalogue of buildings type, damage categorization, and failure patterns of residential structures in Mila's historic old town, where colonial-era brick buildings prevail. We find that structures that represent notable architectural achievements were severely damaged as a result of the earthquake. Data acquired during the immediate post-earthquake analysis was also evaluated and discussed. The graphical representations of the damages are detailed and complemented by photos. This seismic event has shown the fragility of Algeria's building stock, which must be addressed properly in future years. This study reports on an overall estimate of residential buildings in Mila's lower city, as well as an evaluation of the seismic vulnerability of three neighborhood towns (El-Kherba, Grareme-Gouga, and Azzeba). A generic database for graphical surveys and geometric research was developed and implemented making it possible to evaluate the shear strength on-site. The broad observations, collated data, and consequences were then loaded into the 3Muri structural verification program. Nonlinear static analysis was conducted to analyze probable failure paths and compare the real damage to the software results.

IMPLEMENTATION OF OTTAWA ANKLE RULES IN UNIVERSITY HOSPITAL EMERGENCY ROOM: PILOT STUDY.

Ankle injuries are the most common musculoskeletal injuries in emergency rooms and are associated with a great social and economic impact. The need to request additional tests for ankle sprains is based on suspicion of fracture. The Ottawa Ankle Rules (OAR) establish criteria for ordering radiographs to avoid performing unnecessary examinations. OBJECTIVE: To evaluate the implementation of the Ottawa Rules as a protocol for treating ankle sprains in the emergency department of a university hospital. METHODS: This is a retrospective observational study, conducted over a period of three months before and three months after implementation of the protocol. RESULTS: In the first phase, all patients complaining of ankle sprain underwent radiographs. In the second phase, after the application of the OAR, out of 85 patients evaluated, only 58 underwent complementary exams, showing a reduction of 31.8% in the request for imaging exams. There was no significant difference in fracture detection between the two groups (p=0.476). CONCLUSION: The OAR can be used as a tool in diagnosing ankle sprains, and their implementation reduced the request for imaging exams. Level of Evidence III, Retrospective Comparative Study.

Os traumatismos de tornozelo são as lesões musculoesqueléticas mais comuns nas salas de emergência e estão associadas a um grande impacto social e econômico. A solicitação de exames complementares para a entorse de tornozelo baseia-se na suspeita de fratura. As Regras de Ottawa para Tornozelo (ROT) estabelecem critérios para a solicitação de radiografias com o intuito de evitar a realização de exames desnecessários. Objetivo: Avaliar a implementação das ROT como protocolo de atendimento das entorses de tornozelo no pronto-socorro de um hospital universitário. Métodos: Estudo observacional retrospectivo que visou comparar a solicitação de radiografias e a presença de fraturas três meses antes e três meses após a implantação do protocolo. Resultados: Na primeira fase, todos os pacientes com queixa de entorse de tornozelo realizaram radiografias. Na segunda fase, após aplicação das ROT, de 85 pacientes avaliados, apenas 58 realizaram exames complementares, apresentando uma redução de 31,8% na solicitação dos exames de imagem. Não houve diferença na detecção de fraturas entre os dois grupos (p=0,476). Conclusão: As ROT podem ser utilizadas como ferramenta no atendimento das entorses de tornozelo e sua implantação reduziu a solicitação de exames de imagem. Nível de Evidência III, Estudo Comparativo Retrospectivo.

High-resolution assessment of coal mining methane emissions by satellite in Shanxi, China.

Accurate assessment of coal mine methane (CMM) emissions is a prerequisite for defining baselines and assessing the effectiveness of mitigation measures. Such an endeavor is jeopardized, however, by large uncertainties in current CMM estimates. Here, we assimilated atmospheric methane column concentrations observed by the TROPOMI space borne instrument in a high-resolution regional inversion to estimate CMM emissions in Shanxi, a province representing 15% of the global coal production. The emissions are estimated to be 8.5 ± 0.6 and 8.6 ± 0.6 Tg CH4 yr-1 in 2019 and 2020, respectively, close to upper bound of current bottom-up estimates. Data from more than a thousand of individual mines indicate that our estimated emission factors increase significantly with coal mining depth at prefecture level, suggesting that ongoing deeper mining will increase CMM emission intensity. Our results show robustness of estimating CMM emissions utilizing TROPOMI images and highlight potential of monitoring methane leakages and emissions from satellites.

Study protocol of a prospective single-arm multicenter clinical study to assess the safety and performance of the aXess hemodialysis graft: The pivotal study.

BACKGROUND: Arteriovenous grafts (AVGs) are used for patients deemed unsuitable for the creation of an autogenous arteriovenous fistula (AVF) or unable to await maturation of the AVF before starting hemodialysis. However, AVGs are prone to infection and thrombosis resulting in low long-term patency rates. The novel aXess Hemodialysis Graft consists of porous polymeric biomaterial allowing the infiltration by cells and the growth of neotissue, while the graft itself is gradually absorbed, ultimately resulting in a fully functional natural blood vessel. The Pivotal Study will examine the long-term effectiveness and safety of the aXess Hemodialysis Graft. METHODS: The Pivotal Study is a prospective, single-arm, multicenter study that will be conducted in 110 subjects with end-stage renal disease who are not deemed suitable for the creation of an autogenous vascular access. The primary efficacy endpoint will be the primary patency rate at 6 months. The primary safety endpoint will be the freedom from device-related serious adverse events at 6 months. The secondary endpoints will include the procedural success rate, time to first cannulation, patency rates, the rate of access-related interventions to maintain patency, the freedom from device-related serious adverse events and the rate of access site infections. Patients will be followed for 60 months. An exploratory Health Economic and Outcomes Research sub-study will determine potential additional benefits of the aXess graft to patients, health care institutions, and reimbursement programs. DISCUSSION: The Pivotal study will examine the long-term performance and safety of the aXess Hemodialysis Graft and compare the outcome measures with historical data obtained with other graft types and autogenous AVFs. Potential advantages may include superior long-term patency rates and lower infection rates versus currently available AVGs and a shorter time to first cannulation compared to an autologous AVF. As such, the aXess Hemodialysis Graft may fulfill an unmet clinical need in the field of hemodialysis access.

Dynamic Structural Health Monitoring of slender structures using optical sensors.

In this paper we summarize the research activities at the Instituto de Telecomunicações--Pólo de Aveiro and University of Aveiro, in the field of fiber Bragg grating based sensors and their applications in dynamic measurements for Structural Health Monitoring of slender structures such as towers. In this work we describe the implementation of an optical biaxial accelerometer based on fiber Bragg gratings inscribed on optical fibers. The proof-of-concept was done with the dynamic monitoring of a reinforced concrete structure and a slender metallic telecommunication tower. Those structures were found to be suitable to demonstrate the feasibility of FBG accelerometers to obtain the structures' natural frequencies, which are the key parameters in Structural Health Monitoring and in the calibration of numerical models used to simulate the structure behavior.

[Hybrid repair of the aortic arch. Santa Marta Hospital initial experience]. / Reparação híbrida do arco aórtico: experiência inicial do Hospital de Santa Marta.

OBJECTIVES: To retrospectively review the hybrid treatment of the aortic arch with supra-aortic debranching and endo- vascular stent-graft repair in a single institution. METHODS: From 2007 to 2010, all patients submitted to aortic debranching procedures were entered into a prospective database analysis. For the present study, only patients with sealing zones 0 and 1, according to the Ishimaru classification, were included. Procedure-related morbimortality was analysed for the open and endovascular procedures. RESULTS: During the study period, we electively performed 6 total aortic debranching and 4 partial aortic debranching procedures in 10 patients. According to the etiology the indications were: 6 aortic arch aneurysms, 2 post-dissection aneurysms, 1 false aneurysm and 1 type I endoleak following TEVAR. The proximal sealing zone was Ishimaru zone 0 in six patients and zone 1 in four patients. The TEVAR procedure was delayed in all patients with a completion success of 80% (1 patient died from ruptured aortic aneurysm; 1 patient denied the second procedure and was lost to follow-up). The 30d mortality rate was 10% (patient mentioned above). The main morbidity was: 1 axillar venous thrombosis, 1 case of subclinical myocardial infarction, 1 case of terminal renal insufficiency and 1 case of prolonged ventilation. No permanent cerebral or peripheral neurologic deficit was noted. CONCLUSIONS: The hybrid repair of the aortic arch is a feasible and reproducible procedure, and our results are similar to the previously published series. Medium and long-term results are necessary to confirm whether the technique can be regarded as a safe alternative to open surgery in high-risk patients.

A simple and fast method for the production and characterization of methylic and ethylic biodiesels from tucum oil via an alkaline route.

A simple, fast, and complete route for the production of methylic and ethylic biodiesel from tucum oil is described. Aliquots of the oil obtained directly from pressed tucum (pulp and almonds) were treated with potassium methoxide or ethoxide at 40°C for 40 min. The biodiesel form was removed from the reactor and washed with 0.1 M HCl aqueous solution. A simple distillation at 100°C was carried out in order to remove water and alcohol species from the biodiesel. The oxidative stability index was obtained for the tucum oil as well as the methylic and ethylic biodiesel at 6.13, 2.90, and 2.80 h, for storage times higher than 8 days. Quality control of the original oil and of the methylic and ethylic biodiesels, such as the amount of glycerin produced during the transesterification process, was accomplished by the TLC, GC-MS, and FT-IR techniques. The results obtained in this study indicate a potential biofuel production by simple treatment of tucum, an important Amazonian fruit.

[Endovascular aortic procedures]. / Prodecimentos endovasculares aórticos.

The authors report a retrospective analysis of all the aortic endovascular procedures performed in the Department until November 2009. The series includes a total of 302 patients, 246 of them having an elective treatment of an abdominal aortic aneurysm; 33 underwent an emergency treatment of an abdominal aortic aneurysm; and the remainder 23 patients had an endovascular procedure of the thoracic aorta. The aim of the study was dedicated at the evaluation of the epidemiologic characteristics of the patients, including associated and co-morbid entities, as well as the evaluation of the results, especially the early 30 days post-operative mortality and major morbidity.

Risk management in water supply networks: Aveiro case study.

Water supply networks are critical infrastructures essentials to health, safety, economic and social well-being which have to be maintained and preserved to ensure their proper functioning. Considering the importance of these critical infrastructures, the risks to which they are exposed and the consequences of such risks must be analysed. Thus, it is important that companies responsible for the management of these assets incorporate risk management in their activities. In the scope of risk management, this paper intends to identify the vulnerabilities of water supply infrastructures, by analysing the risks they are exposed and identifying the measures that need to be implemented or reinforced. Risk assessment methodologies were analysed to identify the advantages and disadvantages of each one. As a case study, the water supply network of the Aveiro municipality in mainland Portugal was used. This network was analysed resourcing ArcMap, ArcGIS desktop software, which allows a better understanding of the water supply network. Risk management was applied and the probability and possible consequences of six distinct categories of threats were determined in eight scenarios, allowing the development of risk maps concluding that all these scenarios are in a low or medium level of risk. To decrease the vulnerability of the water network, a set of plans and specific measures have to be developed.

Experimental Study of Rubberized Concrete Stress-Strain Behavior for Improving Constitutive Models.

Inclusion of rubber into concrete changes its behavior and the established shape of its stress-strain curve. Existing constitutive stress-strain models for concrete are not valid in case of rubberized concrete, and currently available modified models require additional validation on a larger database of experimental results, with a wider set of influential parameters. By executing uniaxial compressive tests on concrete with rubber substituting 10%, 20%, 30%, and 40% of aggregate, it was possible to study and evaluate the influence of rubber content on its mechanical behavior. The stress-strain curve was investigated in its entirety, including compressive strength, elastic modulus, strains at significant levels of stress, and failure patterns. Experimental results indicated that increase of rubber content linearly decreases compressive strength and elastic modulus, but increases ductility. By comparing experimental stress-strain curves with those plotted using available constitutive stress-strain models it was concluded that they are inadequate for rubberized concrete with high rubber content. Based on determined deviations an improvement of an existing model was proposed, which provides better agreement with experimental curves. Obtained research results enabled important insights into correlations between rubber content and changes of the stress-strain curve required when utilizing nonlinear material properties.

Burnout syndrome among medical residents: A systematic review and meta-analysis.

BACKGROUND: Burnout is a psychological syndrome that is very common among medical residents. It consists of emotional exhaustion (EE), depersonalization (DP) and reduced personal accomplishment (PA). OBJECTIVE: To estimate burnout among different medical residency specialties. METHODS: A systematic review with meta-analysis was performed following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A search of bibliographic databases and grey literature was conducted, from inception to March 2018. The following databases were accessed: Embase, PubMed, Web of Science, Google Scholar and Scopus, and 3,575 studies were found. Methodological quality was evaluated by Agency for Healthcare Research and Quality Methodology Checklist for Cross-Sectional/Prevalence Study. In the final analysis, 26 papers were included. Their references were checked for additional studies, but none were included. RESULTS: 4,664 medical residents were included. High DP, EE and low PA proportions were compared. Specialties were distributed into three groups of different levels of burnout prevalence: general surgery, anesthesiology, obstetrics/gynecology and orthopedics (40.8%); internal medicine, plastic surgery and pediatrics (30.0%); and otolaryngology and neurology (15.4%). Overall burnout prevalence found for all specialties was 35.7%. CONCLUSION: The prevalence of burnout syndrome was significantly higher among surgical/urgency residencies than in clinical specialties. PROSPERO REGISTRATION: CRD42018090270.

Implementation of ottawa ankle rules in university hospital emergency room: pilot study / Implementação das regras de ottawa para tornozelo em pronto-socorro de hospital universitário: estudo piloto

ABSTRACT Ankle injuries are the most common musculoskeletal injuries in emergency rooms and are associated with a great social and economic impact. The need to request additional tests for ankle sprains is based on suspicion of fracture. The Ottawa Ankle Rules (OAR) establish criteria for ordering radiographs to avoid performing unnecessary examinations. Objective: To evaluate the implementation of the Ottawa Rules as a protocol for treating ankle sprains in the emergency department of a university hospital. Methods: This is a retrospective observational study, conducted over a period of three months before and three months after implementation of the protocol. Results: In the first phase, all patients complaining of ankle sprain underwent radiographs. In the second phase, after the application of the OAR, out of 85 patients evaluated, only 58 underwent complementary exams, showing a reduction of 31.8% in the request for imaging exams. There was no significant difference in fracture detection between the two groups (p=0.476). Conclusion: The OAR can be used as a tool in diagnosing ankle sprains, and their implementation reduced the request for imaging exams. Level of Evidence III, Retrospective Comparative Study.

RESUMO Os traumatismos de tornozelo são as lesões musculoesqueléticas mais comuns nas salas de emergência e estão associadas a um grande impacto social e econômico. A solicitação de exames complementares para a entorse de tornozelo baseia-se na suspeita de fratura. As Regras de Ottawa para Tornozelo (ROT) estabelecem critérios para a solicitação de radiografias com o intuito de evitar a realização de exames desnecessários. Objetivo: Avaliar a implementação das ROT como protocolo de atendimento das entorses de tornozelo no pronto-socorro de um hospital universitário. Métodos: Estudo observacional retrospectivo que visou comparar a solicitação de radiografias e a presença de fraturas três meses antes e três meses após a implantação do protocolo. Resultados: Na primeira fase, todos os pacientes com queixa de entorse de tornozelo realizaram radiografias. Na segunda fase, após aplicação das ROT, de 85 pacientes avaliados, apenas 58 realizaram exames complementares, apresentando uma redução de 31,8% na solicitação dos exames de imagem. Não houve diferença na detecção de fraturas entre os dois grupos (p=0,476). Conclusão: As ROT podem ser utilizadas como ferramenta no atendimento das entorses de tornozelo e sua implantação reduziu a solicitação de exames de imagem. Nível de Evidência III, Estudo Comparativo Retrospectivo.

Acute upper limb ischemia, a rare presentation of giant cell arteritis.

Giant cell arteritis (GCA) is a systemic large vessel vasculitis, with extracranial arterial involvement described in 10-15% of cases, usually affecting the aorta and its branches. Patients with GCA are more likely to develop aortic aneurysms, but these are rarely present at the time of the diagnosis. We report the case of an 80-year-old Caucasian woman, who reported proximal muscle pain in the arms with morning stiffness of the shoulders for eight months. In the previous two months, she had developed worsening bilateral arm claudication, severe pain, cold extremities and digital necrosis. She had no palpable radial pulses and no measurable blood pressure. The patient had normochromic anemia, erythrocyte sedimentation rate of 120 mm/h, and a negative infectious and autoimmune workup. Computed tomography angiography revealed concentric wall thickening of the aorta extending to the aortic arch branches, particularly the subclavian and axillary arteries, which were severely stenotic, with areas of bilateral occlusion and an aneurysm of the ascending aorta (47 mm). Despite corticosteroid therapy there was progression to acute critical ischemia. She accordingly underwent surgical revascularization using a bilateral carotid-humeral bypass. After surgery, corticosteroid therapy was maintained and at six-month follow-up she was clinically stable with reduced inflammatory markers. GCA, usually a chronic benign vasculitis, presented exceptionally in this case as acute critical upper limb ischemia, resulting from a massive inflammatory process of the subclavian and axillary arteries, treated with salvage surgical revascularization.