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The objective of this study was to evaluate the reliability of Modified Vector Coding in assessing the coordination and coordination variability of the lower limbs and pelvis during running and to determine the Minimal Detectable Change (MDC). Twenty-five healthy runners participated in a biomechanical analysis of treadmill running using a motion capture system. Modified vector coding was applied to assess the three-dimensional coordination among various pelvis and lower limb segmental couplings. Reliability was assessed using the Intraclass Correlation Coefficient (ICC), Standard Error of Measurement (SEM), MDC, and Bland-Altman analysis to ascertain measurement consistency, agreement, and the smallest clinically meaningful change that exceeds measurement error. The test-retest reliability for 33 of 42 segmental couplings analyzed was good to excellent, with ICC values ranging from 0.613 to 0.928 (p <0.05), which substantiates the robustness of modified vector coding in running biomechanics. However, nine couplings, particularly femur-tibia in the sagittal plane during midstance and foot in the frontal plane-tibia in the transverse plane during late stance, exhibited poor to moderate reliability. These findings underscore the need for cautious interpretation due to significant proportional bias (p <0.05). SEM and MDC provided insights into the precision and minimal clinically significant changes for each coupling. The findings confirm the reliability of modified vector coding for biomechanical analysis in running, with most couplings demonstrating consistent high reliability. Nevertheless, specific couplings should be interpreted with caution due to potential measurement errors. The application of MDC highlights the precision of modified vector coding in biomechanical analyses and emphasizes the importance of careful interpretation to improve clinical and research outcomes in running-related injuries.
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Extremidad Inferior , Pelvis , Carrera , Humanos , Carrera/fisiología , Masculino , Extremidad Inferior/fisiología , Fenómenos Biomecánicos , Femenino , Pelvis/fisiología , Adulto , Reproducibilidad de los Resultados , Adulto JovenRESUMEN
Fomites might be responsible for virus introduction in swine farms, highlighting the importance of implementing practices to minimize the probability of virus introduction. The study's objective was to assess the efficacy of different combinations of temperatures and holding-times on detecting live PRRSV and PEDV on surfaces commonly found in supply entry rooms in swine farms. Two PRRSV isolates (MN 184 and 1-4-4 L1C variant) and one PEDV isolate (NC 49469/2013) were inoculated on cardboard and aluminum. An experimental study tested combinations of four temperatures (20°C, 30°C, 40°C, and 50°C) and six holding-times (15 minutes, 60 minutes, 6 hours, 12 hours, 24 hours, and 36 hours) for the presence of the viruses on each surface type. After virus titration, virus presence was assessed by assessing the cytopathic effects and immunofluorescence staining. The titers were expressed as log10 TCID50/ml, and regression models; half-lives equations were calculated to assess differences between treatments and time to not detect the live virus. The results suggest that the minimum time that surfaces should be held to not detect the virus at 30°C was 24 hours, 40°C required 12 hours, and 50°C required 6 hours; aluminum surfaces took longer to reach the desired temperature compared to cardboard. The results suggest that PRRSV 1-4-4 L1C variant had higher half-lives at higher temperatures than PRRSV MN 184. In conclusion, time and temperature combinations effectively decrease the concentration of PRRSV and PEDV on different surfaces found in supply entry rooms in swine farms.
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Síndrome Respiratorio y de la Reproducción Porcina , Virus de la Diarrea Epidémica Porcina , Virus del Síndrome Respiratorio y Reproductivo Porcino , Enfermedades de los Porcinos , Porcinos , Animales , Temperatura , AluminioRESUMEN
Evapotranspiration (ET) is a key process linking surface and atmospheric energy budgets, yet its drivers and patterns across wetlandscapes are poorly understood worldwide. Here we assess the ET dynamics in 12 wetland complexes across South America, revealing major differences under temperate, tropical, and equatorial climates. While net radiation is a dominant driver of ET seasonality in most environments, flooding also contributes strongly to ET in tropical and equatorial wetlands, especially in meeting the evaporative demand. Moreover, significant water losses through wetlands and ET differences between wetlands and uplands occur in temperate, more water-limited environments and in highly flooded areas such as the Pantanal, where slow river flood propagation drives the ET dynamics. Finally, floodplain forests produce the greatest ET in all environments except the Amazon River floodplains, where upland forests sustain high rates year round. Our findings highlight the unique hydrological functioning and ecosystem services provided by wetlands on a continental scale.
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Ecosistema , Humedales , Bosques , América del Sur , AguaRESUMEN
INTRODUCTION: colonoscopy is the best method for detecting polyps, with a reduction in colorectal cancer mortality of 29% and reaching 47% for distal tumors. However, it fails to demonstrate a significant reduction in proximal colon cancer mortality, and is the most common segment with interval neoplasm. The present study aimed to evaluate the impact on detection of polyps of a second sequential evaluation of cecum and ascending colon, with or without the use of indigo carmine chromoendoscopy. METHODS: prospective, non-randomized clinical trial. Patients were divided into two groups. The first (G1) underwent a routine colonoscopy, followed by a second endoscopy assessment of ascending colon and cecum. The second group (G2) underwent a routine colonoscopy, followed by a second assessment of the ascending colon and cecum with indigo carmine chromoendoscopy. RESULTS: In total, 203 patients were analyzed, 101 in the G1 and 102 in the G2. Newer polyps were identified in both groups after the second assessment with a significantly higher number of polyps detected in the patients in the G2 (p=0.0001). The number of patients who had at least one polyp in the two endoscopic assessments was significantly higher in the G2 (53 or 52% vs 27 or 26.7%, p=0.0002). In the second endoscopic assessment, the number of polyps found was also significantly higher in the G2 (50 or 76.9%) compared to the G1 (15 or 23.1%), p<0.0001. CONCLUSIONS: the second assessment with dye-based chromoendoscopy increases the detection of polyps in the ascending colon and cecum.
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Adenoma , Pólipos del Colon , Humanos , Colon Ascendente/patología , Pólipos del Colon/diagnóstico , Pólipos del Colon/patología , Carmin de Índigo , Estudios Prospectivos , Adenoma/diagnóstico , Adenoma/patología , Colonoscopía , Ciego/patologíaRESUMEN
Introduction: The porcine reproductive and respiratory syndrome virus (PRRSV) continues to challenge swine production in the US and most parts of the world. Effective PRRSV surveillance in swine herds can be challenging, especially because the virus can persist and sustain a very low prevalence. Although weaning-age pigs are a strategic subpopulation in the surveillance of PRRSV in breeding herds, very few sample types have been validated and characterized for surveillance of this subpopulation. The objectives of this study, therefore, were to compare PRRSV RNA detection rates in serum, oral swabs (OS), nasal swabs (NS), ear-vein blood swabs (ES), and family oral fluids (FOF) obtained from weaning-age pigs and to assess the effect of litter-level pooling on the reverse transcription-quantitative polymerase chain reaction (RT-qPCR) detection of PRRSV RNA. Methods: Three eligible PRRSV-positive herds in the Midwestern USA were selected for this study. 666 pigs across 55 litters were sampled for serum, NS, ES, OS, and FOF. RT-qPCR tests were done on these samples individually and on the litter-level pools of the swabs. Litter-level pools of each swab sample type were made by combining equal volumes of each swab taken from the pigs within a litter. Results: Ninety-six piglets distributed across 22 litters were positive by PRRSV RT-qPCR on serum, 80 piglets distributed across 15 litters were positive on ES, 80 piglets distributed across 17 litters were positive on OS, and 72 piglets distributed across 14 litters were positive on NS. Cohen's kappa analyses showed near-perfect agreement between all paired ES, OS, NS, and serum comparisons (). The serum RT-qPCR cycle threshold values (Ct) strongly predicted PRRSV detection in swab samples. There was a ≥ 95% probability of PRRSV detection in ES-, OS-, and NS pools when the proportion of positive swab samples was ≥ 23%, ≥ 27%, and ≥ 26%, respectively. Discussion: ES, NS, and OS can be used as surveillance samples for detecting PRRSV RNA by RT-qPCR in weaning-age pigs. The minimum number of piglets to be sampled by serum, ES, OS, and NS to be 95% confident of detecting ≥ 1 infected piglet when PRRSV prevalence is ≥ 10% is 30, 36, 36, and 40, respectively.
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A novel graphene antenna composed of a graphene dipole and four auxiliary graphene sheets oriented at 90∘ to each other is proposed and analyzed. The sheets play the role of reflectors. A detailed group-theoretical analysis of symmetry properties of the discussed antennas has been completed. Through electric field control of the chemical potentials of the graphene elements, the antenna can provide a quasi-omnidirectional diagram, a one- or two-directional beam regime, dynamic control of the beam width and, due to the vertical orientation of the dipole with respect to the base substrate, a 360∘ beam steering in the azimuth plane. An additional graphene layer on the base permits control of the radiation pattern in the θ-direction. Radiation patterns in different working states of the antenna are considered using symmetry arguments. We discuss the antenna parameters such as input reflection coefficient, total efficiency, front-to-back ratio, and gain. An equivalent circuit of the antenna is suggested. The proposed antenna operates at frequencies between 1.75 THz and 2.03 THz. Depending on the active regime defined by the chemical potentials set on the antenna graphene elements, the maximum gain varies from 0.86 to 1.63.
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OBJECTIVES: the purpose of this study was to evaluate the outcome of rectal cancer surgery, in a unit adopting the principles of total mesorectal excision (TME) with a high restorative procedure rate and with a low rate of abdominoperineal excision (APE). METHODS: we enrolles patients with extraperitoneal rectal cancer undergoing TME or TME+APE. Patients with mid rectal tumors underwent TME, and patients with tumors of the lower rectum and no criteria for APE underwent TME and intersphincteric resection. Those in which the intersphincteric space was invaded and in those with a free distal margin less than 1cm or a tumor free radial margin were unattainable underwent APE or extralevator abdominoperineal excision (ELAPE). We assessed local recurrence rates, overall survival and involvement of the radial margin. RESULTS: sixty (89.6%) patients underwent TME and seven (10.4%) TME + APE, of which five underwent ELAPE. The local recurrence, in pacientes undergoing TME+LAR, was 3.3% and in patients undergoing APE, 14.3%. The local recurrence rate (p=0.286) or the distant recurrence rate (p=1.000) was similar between groups. There was no involvement of radial margins. Survival after 120 months was similar (p=0.239). CONCLUSION: rectal malignancies, including those located in the low rectum, may be surgically treated with a low rate of APE without compromising oncological principles and with a low local recurrence rates.
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Procedimientos Quirúrgicos del Sistema Digestivo , Hominidae , Proctectomía , Neoplasias del Recto , Humanos , Animales , Recto/cirugía , Estudios Prospectivos , Procedimientos Quirúrgicos del Sistema Digestivo/métodos , Neoplasias del Recto/cirugía , Neoplasias del Recto/patología , Perineo/cirugía , Perineo/patología , Resultado del Tratamiento , Recurrencia Local de Neoplasia/epidemiologíaRESUMEN
Variants of concern (VOCs) of SARS-CoV-2 are viral strains that have mutations associated with increased transmissibility and/or increased virulence, and their main mutations are in the receptor binding domain (RBD) region of the viral spike. This study aimed to characterize SARS-CoV-2 VOCs via Sanger sequencing of the RBD region and compare the results with data obtained via whole genome sequencing (WGS). Clinical samples (oro/nasopharyngeal) with positive RT-qPCR results for SARS-CoV-2 were used in this study. The viral RNA from SARS-CoV-2 was extracted and a PCR fragment of 1006 base pairs was submitted for Sanger sequencing. The results of the Sanger sequencing were compared to the lineage assigned by WGS using next-generation sequencing (NGS) techniques. A total of 37 specimens were sequenced via WGS, and classified as: VOC gamma (8); delta (7); omicron (10), with 3 omicron specimens classified as the BQ.1 subvariant and 12 specimens classified as non-VOC variants. The results of the partial Sanger sequencing presented as 100% in agreement with the WGS. The Sanger protocol made it possible to characterize the main SARS-CoV-2 VOCs currently circulating in Brazil through partial Sanger sequencing of the RBD region of the viral spike. Therefore, the sequencing of the RBD region is a fast and cost-effective laboratory tool for clinical and epidemiological use in the genomic surveillance of SARS-CoV-2.
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OBJECTIVE: Peritoneal carcinomatosis (PC) indicates advanced stage cancer, which is generally associated with a poor outcome and a 6 to 12 months. Cytoreductive surgery (CRS) with hyperthermic intraperitoneal chemotherapy (HIPEC) is an option for treating patients with primary PC, such as mesothelioma, or secondary PC, such as colorectal cancer (CRC) or pseudomixoma. Until recently, such patients were deemed untreatable. The purpose of this study was to assess the results of CRS + HIPEC in patients with PC. Postoperative complications, mortality and survival rates were evaluated according to the diagnosis. RESULTS: Fifty-six patients with PC, undergoing full CRS + HIPEC between October 2004 and January 2020, were enrolled. The mortality rate was 3.8% and the morbidity rate was 61.5%. Complications were significantly higher in proportion to the duration of surgery (p<0.001). The overall survival rates, as shown in the Kaplan-Meyer curve, were respectively 81%, 74% and 53% at 12, 24 and 60 months. Survival rates according to each diagnosis for the same periods were 87%, 82% and 47% in patients with pseudomixoma, and 77%, 72% and 57% in patients with CRC (log-rank 0.371, p=0.543). CONCLUSION: CRS with HIPEC is an option for pacients with primary or secondary PC. Although complication rates are high, a longer survival rate may be attained compared to those seen in previously published results; in some cases, patients may even be cured.
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Neoplasias Colorrectales , Hipertermia Inducida , Mesotelioma Maligno , Neoplasias Peritoneales , Humanos , Neoplasias Peritoneales/cirugía , Quimioterapia Intraperitoneal Hipertérmica , Procedimientos Quirúrgicos de Citorreducción , Mesotelioma Maligno/tratamiento farmacológico , Tasa de Supervivencia , Terapia Combinada , Neoplasias Colorrectales/terapia , PronósticoRESUMEN
Sow mortality has significantly increased throughout the world over the past several years, and it is a growing concern to the global swine industry. Sow mortality increases economic losses, including higher replacement rates, affects employees' morale, and raises concerns about animal well-being and sustainability. This study aimed to assess herd-level risk factors associated with sow mortality in a large swine production system in the Midwestern United States. This retrospective observational study used available production, health, nutritional, and management information between July 2019 and December 2021. A Poisson mixed regression model was used to identify the risk factors and to build a multivariate model using the weekly mortality rate per 1000 sows as the outcome. Different models were used to identify the risk factors according to this study's main reasons for sow mortality (total death, sudden death, lameness, and prolapse). The main reported causes of sow mortality were sudden death (31.22 %), lameness (28.78 %), prolapse (28.02 %), and other causes (11.99 %). The median (25th-75th percentile) distribution of the crude sow mortality rate/1000 sows was 3.37 (2.19 - 4.16). Breeding herds classified as epidemic for porcine reproductive and respiratory syndrome virus (PRRSV) were associated with higher total death, sudden death, and lameness death. Open pen gestation was associated with a higher total death and lameness compared with stalls. Pulses of feed medication was associated with lower sow mortality rate for all outcomes. Farms not performing bump feeding were associated with higher sow mortality due to lameness and prolapses, while Senecavirus A (SVA)-positive herds were associated with a higher mortality rate for total deaths and deaths due to lameness. Disease interactions (herds Mycoplasma hyopneumoniae positive and epidemic for PRRSV; SVA positive herds and epidemic for PRRSV) were associated with higher mortality rates compared to farms with single disease status. This study identified and measured the major risk factors associated with total sow mortality rate, sudden deaths, lameness deaths, and prolapse deaths in breeding herds under field conditions.
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Virus del Síndrome Respiratorio y Reproductivo Porcino , Enfermedades de los Porcinos , Animales , Femenino , Cojera Animal , Medio Oeste de Estados Unidos/epidemiología , Factores de Riesgo , Porcinos , Enfermedades de los Porcinos/epidemiologíaRESUMEN
Climate change can affect all levels of society and the planet. Recent studies have shown its effects on sediment fluxes in several locations worldwide, which can impact ecosystems and infrastructure such as reservoirs. In this study, we focused on simulating sediment fluxes using projections of future climate change for South America (SA), a continent with a high sediment transport rate to the oceans. Here, we used four climate change data yielded by the Eta Regional Climate Model: Eta-BESM, Eta-CanESM2, Eta-HadGEM2-ES, and Eta-MIROC5. In addition, it was evaluated the RCP4.5 greenhouse gas emissions scenario from CMIP5, which represents a moderate scenario. Climate change data between 1961 and 1995 (past) and 2021 and 2055 (future) were used to simulate and compare changes that may occur in water and sediment fluxes using the hydrological-hydrodynamic and sediment model MGB-SED AS. The Eta climate projections provided input data to MGB-SED AS model, such as precipitation, air surface temperature, incident solar radiation, relative humidity, wind speed, and atmospheric pressure. Our results showed sediment fluxes are expected to reduce (increase) in north-central (south-central) SA. While a sediment transport (QST) increase >30 % might occur, a 28 % decrease is expected to occur in the water discharge for the main SA basins. The most significant QST reductions were estimated for the Doce (-54 %), Tocantins (-49 %), and Xingu (-34 %) rivers, while the most significant increases were estimated for the Upper Paraná (409 %), Juruá (46 %), and Uruguay (40 %) rivers. We also observed that different climate change signals over large basins can impact the river water composition, which could lead to a new composition of the Amazon basin waters in the future, accompanied by a significant increase in sediment concentration.
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BACKGROUND: With the progression of the Coronavirus disease pandemic, the number of mutations in the viral genome has increased, showing the adaptive evolution of severe acute respiratory syndrome coronavirus 2 in humans and intensification in transmissibility. Long-term infections also allow the development of viral diversity. In this study, we report the case of a child with severe combined immu presenting a prolonged severe acute respiratory syndrome coronavirus 2 infection. We aimed to analyze 3 naso-oropharyngeal swab samples collected between August and December 2021 to describe the amino acid changes present in the sequence reads that may have a role in the emergence of new viral variants. METHODS: The whole genome from clinical samples was sequenced through high throughput sequencing and analyzed using a workflow to map reads and then find variations/single-nucleotide polymorphisms. In addition, the samples were isolated in cell culture, and a plaque forming units assay was performed, which indicates the presence of viable viral particles. RESULTS: The results obtained showed that the virus present in all samples is infectious. Also, there were 20 common mutations among the 3 sequence reads, found in the ORF1ab and ORF10 proteins. As well, a considerable number of uncommon mutations were found. CONCLUSIONS: In conclusion, we emphasize that genomic surveillance can be a useful tool to assess possible evolution signals in long-term patients.
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COVID-19 , Humanos , Niño , COVID-19/genética , SARS-CoV-2/genética , Mutación , Genoma Viral , Secuenciación de Nucleótidos de Alto RendimientoRESUMEN
ABSTRACT Objectives: the purpose of this study was to evaluate the outcome of rectal cancer surgery, in a unit adopting the principles of total mesorectal excision (TME) with a high restorative procedure rate and with a low rate of abdominoperineal excision (APE). Methods: we enrolles patients with extraperitoneal rectal cancer undergoing TME or TME+APE. Patients with mid rectal tumors underwent TME, and patients with tumors of the lower rectum and no criteria for APE underwent TME and intersphincteric resection. Those in which the intersphincteric space was invaded and in those with a free distal margin less than 1cm or a tumor free radial margin were unattainable underwent APE or extralevator abdominoperineal excision (ELAPE). We assessed local recurrence rates, overall survival and involvement of the radial margin. Results: sixty (89.6%) patients underwent TME and seven (10.4%) TME + APE, of which five underwent ELAPE. The local recurrence, in pacientes undergoing TME+LAR, was 3.3% and in patients undergoing APE, 14.3%. The local recurrence rate (p=0.286) or the distant recurrence rate (p=1.000) was similar between groups. There was no involvement of radial margins. Survival after 120 months was similar (p=0.239). Conclusion: rectal malignancies, including those located in the low rectum, may be surgically treated with a low rate of APE without compromising oncological principles and with a low local recurrence rates.
RESUMO Objetivos: o objetivo deste estudo foi avaliar os resultados da cirurgia do câncer de reto, em uma unidade que adota os princípios da excisão total do mesorreto (ETM) com baixa taxa de amputação abdominoperineal (AAP). Métodos: os pacientes com câncer retal extraperitoneal foram submetidos a ETM ou ETM com amputação abdominoperianeal. Pacientes com tumores de reto médio foram submetidos a EMT e pacientes com tumores de reto inferior e sem critérios para AAP foram submetidos a EMT e ressecção interesfincteriana. Aqueles em que o espaço interesfincteriano foi invadido e naqueles com margem distal livre menor que 1cm ou margem radial livre de tumor foram inatingíveis foram submetidos a AAP ou excisão abdominoperineal extraelevadora (ELAPE). Avaliamos as taxas de recorrência local, sobrevida global e envolvimento da margem radial. Resultados: sessenta (89,6%) pacientes realizaram ETM e sete (10,4%) ETM + AAP, dos quais cinco realizaram ELAPE. A recidiva local, em pacientes submetidos a ETM com ressecção anterior baixa, foi de 3,3% e em pacientes submetidos a AAP, 14,3%. A taxa de recorrência local (p=0,286) ou a taxa de recorrência à distância (p=1,000) foi semelhante entre os grupos. Não houve envolvimento das margens radiais. A sobrevida após 120 meses foi semelhante (p=0,239). Conclusão: as neoplasias malignas retais, incluindo aquelas localizadas no reto baixo, podem ser tratadas cirurgicamente com baixo índice de AAP, sem comprometer os princípios oncológicos e com baixo índice de recorrência local.
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ABSTRACT Peritoneal carcinomatosis (PC) indicates advanced stage cancer, which is generally associated with a poor outcome and a 6 to 12 months. Cytoreductive surgery (CRS) with hyperthermic intraperitoneal chemotherapy (HIPEC) is an option for treating patients with primary PC, such as mesothelioma, or secondary PC, such as colorectal cancer (CRC) or pseudomixoma. Until recently, such patients were deemed untreatable. Objective: The purpose of this study was to assess the results of CRS + HIPEC in patients with PC. Postoperative complications, mortality and survival rates were evaluated according to the diagnosis. Results: Fifty-six patients with PC, undergoing full CRS + HIPEC between October 2004 and January 2020, were enrolled. The mortality rate was 3.8% and the morbidity rate was 61.5%. Complications were significantly higher in proportion to the duration of surgery (p<0.001). The overall survival rates, as shown in the Kaplan-Meyer curve, were respectively 81%, 74% and 53% at 12, 24 and 60 months. Survival rates according to each diagnosis for the same periods were 87%, 82% and 47% in patients with pseudomixoma, and 77%, 72% and 57% in patients with CRC (log-rank 0.371, p=0.543). Conclusion: CRS with HIPEC is an option for pacients with primary or secondary PC. Although complication rates are high, a longer survival rate may be attained compared to those seen in previously published results; in some cases, patients may even be cured.
RESUMO O diagnóstico de carcinomatose peritoneal (CP), indica um estágio avançado do câncer e em geral está associado a um mau prognóstico com sobrevida média variando de 6 a 12 meses. A cirurgia citorredutora (CRS) associada à quimioterapia intraperitoneal hipertérmica (HIPEC) tem sido descrita como uma opção de tratamento para os pacientes portadores de CP primária como nos portadores de mesotelioma, ou secundária como em portadores de cancer colorretal ou pseudomixoma, até recentemente considerados sem possibilidade terapêutica. Objetivo: Avaliar os resultados do tratamento de pacientes portadores de CP submetidos a CRS + HIPEC. Foram analisadas as taxas complicações pós-operatórias, mortalidade e a sobrevida desses pacientes. Resultados: Foram incluídos 56 pacientes com CP, submetidos a c CRS + HIPEC, no período de Outubro 2004 a Janeiro 2020. A taxa de mortalidade foi de 3,8% e taxa de morbidade de 61,5%, sendo a ocorrência de complicações significativamente maior quanto maior o tempo cirúrgico (p<0,001). A sobrevida global pela curva de Kaplan-Meyer foi de 81%, 74% e 53% em 12, 24 e 60 meses respectivamente. Já a sobrevida por diagnóstico nos mesmos períodos foi de 87%, 82%, 47% para os pacientes portadores de pseudomixoma e de 77%, 72% e 57% para pacientes portadores de câncer colorretal (Log -RANK 0,371, p=0,543). Conclusão: A CRS + HIPEC é uma opção de tratamento para pacientes portadores de CP primária ou secundária. Embora com taxa de complicações elevadas, pode proporcionar aumento da sobrevida quando comparado com resultados prévios da literatura e em alguns casos até a cura.
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ABSTRACT Introduction: colonoscopy is the best method for detecting polyps, with a reduction in colorectal cancer mortality of 29% and reaching 47% for distal tumors. However, it fails to demonstrate a significant reduction in proximal colon cancer mortality, and is the most common segment with interval neoplasm. The present study aimed to evaluate the impact on detection of polyps of a second sequential evaluation of cecum and ascending colon, with or without the use of indigo carmine chromoendoscopy. Methods: prospective, non-randomized clinical trial. Patients were divided into two groups. The first (G1) underwent a routine colonoscopy, followed by a second endoscopy assessment of ascending colon and cecum. The second group (G2) underwent a routine colonoscopy, followed by a second assessment of the ascending colon and cecum with indigo carmine chromoendoscopy. Results: In total, 203 patients were analyzed, 101 in the G1 and 102 in the G2. Newer polyps were identified in both groups after the second assessment with a significantly higher number of polyps detected in the patients in the G2 (p=0.0001). The number of patients who had at least one polyp in the two endoscopic assessments was significantly higher in the G2 (53 or 52% vs 27 or 26.7%, p=0.0002). In the second endoscopic assessment, the number of polyps found was also significantly higher in the G2 (50 or 76.9%) compared to the G1 (15 or 23.1%), p<0.0001. Conclusions: the second assessment with dye-based chromoendoscopy increases the detection of polyps in the ascending colon and cecum.
RESUMO Introdução: a colonoscopia é o melhor método para detecção de pólipos, com redução da mortalidade por câncer colorretal de 29% e chegando até 47% para tumores distais. No entanto, existe falha em demonstrar redução significativa na mortalidade no cólon proximal sendo o segmento mais comum de neoplasia de intervalo. O presente estudo avaliou o impacto na detecção de pólipos em uma segunda avaliação sequencial do ceco e cólon ascendente, com ou sem o uso de cromoendoscopia com Indigo carmim. Métodos: estudo prospectivo, não randomizado. Os pacientes foram divididos em dois grupos. O primeiro (G1) foi submetido à colonoscopia de rotina, seguida de segunda avaliação endoscópica do cólon ascendente e ceco. O segundo grupo (G2) foi submetido à colonoscopia de rotina, seguida de segunda avaliação do cólon ascendente e ceco com cromoendoscopia com índigo carmim. Resultados: no total, foram analisados 203 pacientes, sendo 101 do G1 e 102 do G2. Novos pólipos foram identificados em ambos os grupos após a segunda avaliação com número significativamente maior de pólipos detectados nos pacientes do G2 (p=0,0001). O número de pacientes que apresentaram pelo menos um pólipo nas duas avaliações endoscópicas foi significativamente maior no G2 (53 ou 52% vs 27 ou 26,7%, p=0,0002). Na segunda avaliação endoscópica, o número de pólipos encontrados também foi significativamente maior no G2 (50 ou 76,9%) em relação ao G1 (15 ou 23,1%), p<0,000. Conclusão: a segunda avaliação com cromoendoscopia com índigo carmim aumenta a detecção de pólipos no cólon ascendente e no ceco.
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The control of porcine reproductive and respiratory syndrome virus (PRRSV) hinges on monitoring and surveillance. The objective of this study was to assess PRRSV RNA detection by RT-PCR in tongue tips from dead suckling piglets compared to serum samples, processing fluids, and family oral fluids. Tongue tips and serum samples were collected from three PRRSV-positive breeding herd farms (farms A, B, and C) of three different age groups: newborns (<24 h), processing (2 to 7 days of age), and weaning (18 to 22 days of age). Additionally, processing fluids and family oral fluids were collected from 2-7 days of age and weaning age, respectively. In farms A and B, PRRSV RNA was detected in tongue tips from all age groups (100 and 95%, respectively). In addition, PRRSV RNA was detected in pooled serum samples (42 and 27%), processing fluids (100 and 50%), and family oral fluids (11 and 22%). Interestingly, the average Ct value from tongue tips was numerically lower than the average Ct value from serum samples in the newborn age. In farm C, PRRSV RNA was only detected in serum samples (60%) and family oral fluids (43%), both from the weaning age. Further, no PRRSV RNA was detected in tongue tips when pooled serum samples from the same age group tested PRRSV RNA-negative. Taken together, these results demonstrate the potential value of tongue tips for PRRSV monitoring and surveillance.
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Proposed hydropower dams at more than 350 sites throughout the Amazon require strategic evaluation of trade-offs between the numerous ecosystem services provided by Earth's largest and most biodiverse river basin. These services are spatially variable, hence collective impacts of newly built dams depend strongly on their configuration. We use multiobjective optimization to identify portfolios of sites that simultaneously minimize impacts on river flow, river connectivity, sediment transport, fish diversity, and greenhouse gas emissions while achieving energy production goals. We find that uncoordinated, dam-by-dam hydropower expansion has resulted in forgone ecosystem service benefits. Minimizing further damage from hydropower development requires considering diverse environmental impacts across the entire basin, as well as cooperation among Amazonian nations. Our findings offer a transferable model for the evaluation of hydropower expansion in transboundary basins.
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INTRODUCTION: The main laboratory test for the diagnosis of coronavirus disease 2019 (COVID-19) is the reverse transcription real-time polymerase chain reaction (RT-qPCR). However, RT-qPCR is expensive because of the number of tests required. This study aimed to evaluate an alternative to the RT-qPCR approach for the detection of sudden acute respiratory syndrome coronavirus 2 (SARS-CoV-2) that is half of the total volume currently recommended by the US Centers for Disease Control and Prevention. METHODS: The analytical limit of detection (LoD) and the reaction efficiency using half volumes of the RT-qPCR assay were evaluated for the N1 and N2 regions using a synthetic control RNA. A panel of 76 SARS-CoV-2-positive and 26 SARS-CoV-2-negative clinical samples was evaluated to establish clinical sensitivity and specificity. RESULTS: The RT-qPCR assay efficiency was 105% for the half and standard reactions considering the N2 target and 84% (standard) and 101% (half) for N1. The RT-qPCR half-reaction LoD for N1 and N2 were 20 and 80 copies/µL, respectively. The clinical sensitivity and specificity were 100%. The half reaction presented a decrease of up to 5.5 cycle thresholds compared with standard RT-qPCR. CONCLUSIONS: The use of the RT-qPCR half-reaction proved feasible and economic for the detection of SARS-CoV-2 RNA.
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COVID-19 , SARS-CoV-2 , Humanos , ARN Viral/genética , Reacción en Cadena en Tiempo Real de la Polimerasa , Sensibilidad y EspecificidadRESUMEN
Beer is one of the oldest and most consumed beverages worldwide, and recent trends point to increased consumption of functional beers. However, there is a lack in the scientific literature on the effects of adding functional adjuncts in distinct steps of the manufacturing process and its implications on the final physicochemical and sensorial profile. Therefore, the present review analyzes the ingredients used and their insertion stage to achieve a functional beer with bioactive compounds, higher antioxidant activity, and improved sensory characteristics. The addition of fruits, herbal extracts, plants, and mushrooms in beers was documented. Furthermore, adjuncts were successfully added in wort boiling, fermentation, maturation, and packaging. The wort boiling step stands out among these four due to the superior extraction of phenolic compounds from the added adjuncts. On the other hand, adjunct addition in the maturation step induced low increases in antioxidant and phenolic content of the respective enriched beers. Fruits represented the majority of adopted adjuncts among the studies evaluated. Furthermore, the addition of fruits represented a positive increment in the beer's volatile profile and an increase in sensory acceptability. A gap in the literature was found regarding the analysis of phenolic compounds with appropriate techniques such as HPLC-MS. Furthermore, there is a need to study the bioavailability of the incorporated bioactive compounds to prove the health claims inferred about these beers. In conclusion, functional beers are a little-explored relevant field, with potential for new studies.
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BACKGROUND: Enhanced Recovery Surgical Programs were initially applied to colorectal procedures and used as multimodal approach to relieve the response to surgical stress. An important factor that negatively impacts the success of these programs is the poor tolerance of these patients to certain items in the adopted protocol, especially with regard to post-operative measures. The identification of these factors may help to increase the success rate of such programs, ensuring that benefits reach a greater number of patients and that resources are better allocated. Thus, the aims of this study were to assess the results of the implementation of a Simplified Accelerated Recovery Protocol (SARP) and to identify possible factors associated with failure to implement postoperative protocol measures in patients submitted to laparoscopic colorectal surgery. METHODS: 161 patients were randomly divided into two groups. The SARP group (n = 84) was submitted to the accelerated recovery program and the CC group (n = 77), to conventional postoperative care. The SARP group was further divided into two subgroups: patients who tolerated the protocol (n = 51) and those who did not (n = 33), in order to analyze factors contributing to protocol nontolerance. RESULTS: The groups had similar sociodemographic and clinical characteristics. The SARP group had a shorter hospital stay, better elimination of flatus, was able to walk and to tolerate a diet sooner (p < 0.0001). Complications rates and readmissions to emergency room were similar between groups. Multivariate analysis revealed that prolonged operating time, stoma creation and rates of surgical complications were independently associated with poor adherence to SARP (p < 0.0001). CONCLUSIONS: The use of our SARP resulted in improved recovery from laparoscopic colorectal surgery and proved to be safe for patients. Extensive surgeries, occurrence of complications, and the need for ostomy were variables associated with poor program adhesion. Trial registration Trial Registry: RBR2b4fyr-Date of registration: 03 October 2017.