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1.
Artigo em Inglês | MEDLINE | ID: mdl-38478310

RESUMO

The Net-zero, Resilience, and Agile Closed-Loop Supply Chain Network (NZRACLSCND) concept integrates net-zero, resiliency, and agility in a circular economy. Regarding net-zero, this research embeds renewable energy like solar energy and hybrid trucks to supply energy for facilities and transportation of goods and products between components. Applying redundancy, multi-source, and flexible capacity as resiliency strategies is suggested to cope with the demand disruption. Satisfaction demand level is utilized for the agile approach. This research proposes Robust Stochastic Optimization (RSO), including the weighted expected value and maximum CO2 for NZRACLSCND. This study locates and determines the flow of CLSC in the home appliance industry by considering NZRA, robustness, and risk against demand disruption. CO2 emission using the NZRA concept is 233.33% less than without considering NZRA concepts. In addition, the conservative coefficient, agile coefficient, decreased CO2 coefficient, and the model scale are analyzed. The results show that when the conservative coefficient increases, the risks of CO2 emission increase. In addition, when the agile coefficient increases, as a result, CO2 emission increases. Finally, when the decreased CO2 coefficient and the model scale increase, we can see that CO2 emission and cost are increased.

2.
J Am Coll Surg ; 2024 Feb 26.
Artigo em Inglês | MEDLINE | ID: mdl-38407302

RESUMO

BACKGROUND: Thoracic endovascular aortic repair (TEVAR) is the standard of care for the treatment of blunt thoracic aortic injuries (BTAI) requiring intervention. Data suggests that low grade BTAI (Grade 1 [intimal tears] or Grade 2 [intramural hematoma]) will resolve spontaneously if treated with non operative management (NOM) alone. There has been no comparison specifically between the use of NOM vs. TEVAR for low grade BTAI. We hypothesize that these low-grade injuries can be safely managed with NOM alone. STUDY DESIGN: Retrospective analysis of all patients with a low grade BTAI in the Aortic Trauma Foundation Registry from 2016 to 2021 was performed. The study population was 1primary outcome was mortality. Secondary outcomes included complications, ICU length of stay, and ventilatory days. RESULTS: 880 patients with BTAI were enrolled. Of the 269 patients with low grade BTAI, 218 (81%) were treated with NOM alone (81% Grade I, 19% Grade II), while 51 (19%) underwent a TEVAR (20% Grade I, 80% Grade II). There was no difference in demographics or mechanism of injury in low grade BTAI patients who underwent NOM vs. TEVAR. There was a difference in mortality between NOM alone and TEVAR (8% vs. 18%, p=0.009). Aortic-related mortality was 0.5% in the NOM group and 4% in the TEVAR group (p=0.06). Hospital and ICU length of stay, and ventilator days were not different between the two groups. CONCLUSIONS: NOM alone is safe and appropriate management for low grade BTAIs, with lower mortality and decreased rates of complications when compared to routine initial TEVAR.

3.
J Surg Educ ; 81(4): 551-555, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38388308

RESUMO

OBJECTIVE: Breastfeeding is a highly demanding experience, especially for surgical residents who pump after returning to work. We believe that there are obstacles to pumping and opportunities exist to improve support for this group. The objective of this study was to understand the experience of breastfeeding surgery residents and find opportunities for increased support. DESIGN: Surveys were sent out through the Association of Program Directors in Surgery for distribution among current residents. A survey was also conducted in a private group of surgeon mothers to identify those who had previously been breastfeeding during residency. SETTING: All surveys were performed online with results collected in a REDCap web-based application. PARTICIPANTS: Participants were those who gave birth during their surgical residency. RESULTS: 67% of the 246 survey respondents stated that they did not have adequate time for pumping and 56% rarely had access to a lactation room. 69% of mothers reported a reduction in milk supply and 64% stated that the time constraints of residency shortened the total duration they breastfed. 59% of women did not feel comfortable asking to pump. CONCLUSIONS: Surgical residents reported a lack of space, resources, and dedicated time for pumping. These deficiencies contribute to shorter breastfeeding duration. It is crucial to provide lactation rooms and to foster a supportive culture.


Assuntos
Aleitamento Materno , Internato e Residência , Feminino , Humanos , Mães , Inquéritos e Questionários , Fatores de Tempo
4.
Acad Emerg Med ; 31(1): 36-41, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-37828864

RESUMO

OBJECTIVE: This study aims to assess the change in cervical spine (C-spine) immobilization frequency in trauma patients over time. We hypothesize that the frequency of unnecessary C-spine immobilization has decreased. METHODS: A retrospective chart review of adult trauma patients transported to our American College of Surgeons-verified Level I trauma center from January 1, 2014, to December 31, 2021, was performed. Emergency medical services documentation was manually reviewed to record prehospital physiology and the application of a prehospital cervical collar (c-collar). C-spine injuries were defined as cervical vertebral fractures and/or spinal cord injuries. Univariate and year-by-year trend analyses were used to assess changes in C-spine injury and immobilization frequency. RESULTS: Among 2906 patients meeting inclusion criteria, 12% sustained C-spine injuries, while 88% did not. Patients with C-spine injuries were more likely to experience blunt trauma (95% vs. 68%, p < 0.001), were older (46 years vs. 41 years, p < 0.001), and had higher Injury Severity Scores (31 vs. 18, p < 0.001). They also exhibited lower initial systolic blood pressures (108 mm Hg vs. 119 mm Hg, p < 0.001), lower heart rates (92 beats/min vs. 97 beats/min, p < 0.05), and lower Glasgow Coma Scale scores (9 vs. 11, p < 0.001). In blunt trauma, c-collars were applied to 83% of patients with C-spine injuries and 75% without; for penetrating trauma, c-collars were applied to 50% of patients with C-spine injuries and only 8% without. Among penetrating trauma patients with C-spine injury, all patients either arrived quadriplegic or did not require emergent neurosurgical intervention. The proportion of patients receiving a c-collar decreased in both blunt and penetrating traumas from 2014 to 2021 (blunt-82% in 2014 to 68% in 2021; penetrating-24% in 2014 to 6% in 2021). CONCLUSIONS: Unnecessary C-spine stabilization has decreased from 2014 to 2021. However, c-collars are still being applied to patients who do not need them, both in blunt and in penetrating trauma cases, while not being applied to patients who would benefit from them.


Assuntos
Serviços Médicos de Emergência , Lesões do Pescoço , Traumatismos da Medula Espinal , Traumatismos da Coluna Vertebral , Ferimentos não Penetrantes , Ferimentos Penetrantes , Adulto , Humanos , Estudos Retrospectivos , Traumatismos da Coluna Vertebral/terapia , Traumatismos da Medula Espinal/terapia , Lesões do Pescoço/terapia , Vértebras Cervicais/lesões
5.
Am J Surg ; 228: 88-93, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-37567816

RESUMO

INTRODUCTION: Aggressive prehospital interventions (PHI) in trauma may not improve outcomes compared to prioritizing rapid transport. The aim of this study was to quantify temporal changes in the frequency of PHI performed by EMS. METHODS: Retrospective chart review of adult patients transported by EMS to our trauma center from January 1, 2014 to 12/31/2021. PHI were recorded and annual changes in their frequency were assessed via year-by-year trend analysis and multivariate regression. RESULTS: Between the first and last year of the study period, the frequency of thoracostomy (6% vs. 9%, p â€‹= â€‹0.001), TXA administration (0.3% vs. 33%, p â€‹< â€‹0.001), and whole blood administration (0% vs. 20%, p â€‹< â€‹0.001) increased. Advanced airway procedures (21% vs. 12%, p â€‹< â€‹0.001) and IV fluid administration (57% vs. 36%, p â€‹< â€‹0.001) decreased. ED mortality decreased from 8% to 5% (p â€‹= â€‹0.001) over the study period. On multivariate regression, no PHI were independently associated with increased or decreased ED mortality. CONCLUSION: PHI have changed significantly over the past eight years. However, no PHI were independently associated with increased or decreased ED mortality.


Assuntos
Serviços Médicos de Emergência , Adulto , Humanos , Serviços Médicos de Emergência/métodos , Estudos Retrospectivos , Centros de Traumatologia , Toracostomia
6.
Viruses ; 15(12): 1-15, dez 4, 2023. tab, mapa
Artigo em Inglês | RDSM | ID: biblio-1531383

RESUMO

Emerging zoonotic diseases are an increasing threat to public health. There is little data on the seroprevalence of zoonotic diseases among pastoralists in the country. We aim to carry out a cross-sectional study on the prevalence of major zoonotic diseases among pastoral communities in the Caia and Búzi districts. Methods: Between January and December 2018, a questionnaire was used to solicit socio-demographic data from consenting pastoralists with the collection of blood samples in the Caia and Búzi districts of the Sofala province. All samples were tested using ELISA commercial reagents for the detection of IgM antibodies against Brucella and Leptospira. Likewise, IgM and IgG antibodies against Rickettsia and CCHFV were determined using ELISA kits. Results: A total of 218 samples were tested, of which 43.5% (95/218) were from the district of Caia and 56.4% (123/218) from the Búzi district. Results from both districts showed that the seroprevalence of IgM antibodies against Brucella and Leptospira was 2.7% (6/218) and 30.3% (67/218), respectively. Positivity rates for IgM and IgG anti-Rickettsia and CCHFV were 8.7% (19/218), 2.7% (6/218), 4.1% (9/218), and 0.9% (2/218), respectively. Conclusions: Results from our study showed evidence of antibodies due to exposure to Brucella, Leptospira, Rickettsia, and CCHFV with antibodies against Leptospira and Rickettsia being the most prevalent. Hence, laboratory diagnosis of zoonotic diseases is essential in the early detection of outbreaks, the identification of silent transmission, and the etiology of non-febrile illness in a pastoral community. There is a need to develop public health interventions that will reduce the risk of transmission.


Assuntos
Humanos , Masculino , Feminino , Brucella/virologia , Febre Hemorrágica da Crimeia/virologia , Anticorpos Antivirais/imunologia , Rickettsia/crescimento & desenvolvimento , Vírus Hantaan/imunologia , Febre Hemorrágica da Crimeia/prevenção & controle , Leptospira/virologia , Moçambique
7.
Artigo em Inglês | MEDLINE | ID: mdl-38112632

RESUMO

OBJECTIVE: Acute trauma care has significantly reduced mortality over the last two decades. The last study to examine the epidemiology of traumatic amputees predates these gains. The majority of those who sustain traumatic amputation are male; therefore, limited data exist on female amputees. This study aimed to (1) provide a current epidemiological analysis of traumatic amputees, and (2) compare male and female amputees. DESIGN: All patients sustaining a major limb amputation in the National Trauma Data Bank (NTDB) from 2013 to 2017 were identified. First, descriptive analyses of patient demographics and injury characteristics were performed and compared with a prior 2000-2004 NTDB study. Second, female and male traumatic amputees were compared in this study. RESULTS: From 2013 to 2017 we identified 7,016 patients who underwent major limb amputation. Compared to prior years, the current amputees were older and more severely injured. Mortality was 6.3% in the current years compared to 13.4% in the prior years (odds ratio [OR] 0.44, 95% CI = 0.37 to 0.51, p < 0.001). After multivariable analysis, mortality remained significantly decreased, with no difference in hospital length of stay. CONCLUSIONS: Contemporary NTDB analysis demonstrated that patients with traumatic amputations, regardless of sex, often survive until hospital discharge, despite more severe injuries.

8.
Viruses ; 15(12)2023 Dec 04.
Artigo em Inglês | MEDLINE | ID: mdl-38140620

RESUMO

BACKGROUND: Emerging zoonotic diseases are an increasing threat to public health. There is little data on the seroprevalence of zoonotic diseases among pastoralists in the country. We aim to carry out a cross-sectional study on the prevalence of major zoonotic diseases among pastoral communities in the Caia and Búzi districts. METHODS: Between January and December 2018, a questionnaire was used to solicit socio-demographic data from consenting pastoralists with the collection of blood samples in the Caia and Búzi districts of the Sofala province. All samples were tested using ELISA commercial reagents for the detection of IgM antibodies against Brucella and Leptospira. Likewise, IgM and IgG antibodies against Rickettsia and CCHFV were determined using ELISA kits. RESULTS: A total of 218 samples were tested, of which 43.5% (95/218) were from the district of Caia and 56.4% (123/218) from the Búzi district. Results from both districts showed that the seroprevalence of IgM antibodies against Brucella and Leptospira was 2.7% (6/218) and 30.3% (67/218), respectively. Positivity rates for IgM and IgG anti-Rickettsia and CCHFV were 8.7% (19/218), 2.7% (6/218), 4.1% (9/218), and 0.9% (2/218), respectively. CONCLUSIONS: Results from our study showed evidence of antibodies due to exposure to Brucella, Leptospira, Rickettsia, and CCHFV with antibodies against Leptospira and Rickettsia being the most prevalent. Hence, laboratory diagnosis of zoonotic diseases is essential in the early detection of outbreaks, the identification of silent transmission, and the etiology of non-febrile illness in a pastoral community. There is a need to develop public health interventions that will reduce the risk of transmission.


Assuntos
Brucella , Vírus da Febre Hemorrágica da Crimeia-Congo , Febre Hemorrágica da Crimeia , Leptospira , Rickettsia , Animais , Humanos , Estudos Soroepidemiológicos , Moçambique , Estudos Transversais , Anticorpos Antivirais , Zoonoses , Imunoglobulina G , Imunoglobulina M
9.
Sci Rep ; 13(1): 18730, 2023 Oct 31.
Artigo em Inglês | MEDLINE | ID: mdl-37907496

RESUMO

Requirement elicitation stands as a pivotal activity within requirement engineering, gaining even greater significance in the context of global software development. Effective communication among stakeholders assumes paramount importance in this arena. Factors such as time zone disparities, cultural variations, and language differences exert a formidable impact on communication within the sphere of global software development. These dynamics inevitably impinge upon timely coordination, potentially compromising the software's quality. In response, researchers have proffered communication models tailored for requirement elicitation within the ambit of global software development. The purpose of this study is to conduct an in-depth critical review of existing communication models for demand elicitation in global software development. Through this comprehensive review, we aim to discern prevailing publication trends, provide an introductory overview, and illuminate the strengths and limitations inherent in the existing communication models. By identifying these limitations, we seek to advance a novel, low-cost communication approach designed primarily for demand elicitation in global software development. To culminate our endeavor, we will undertake a case study-based experiment, meticulously designed to assess the efficacy and practical utility of the proposed techniques.

10.
Injury ; 54(4): 1102-1105, 2023 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-36801130

RESUMO

INTRODUCTION: Sarcopenia is a clinically relevant loss of muscle mass with implications of increased morbidity and mortality in adult trauma populations.  Our study aimed to evaluate loss of muscle mass change in adult trauma patients with prolonged hospital stays. METHODS: Retrospective analysis using institutional trauma registry to identify all adult trauma patients with hospital length of stay >14 days admitted to our Level 1 center between 2010 and 2017. All CT images were reviewed, and cross-sectional area (cm2) of the left psoas muscle was measured at the level of the third lumbar vertebral body to determine total psoas area (TPA) and Total Psoas Index (TPI) normalized for patient stature.  Sarcopenia was defined as a TPI on admission below gender specific thresholds of 5.45(cm2/m2) in men and 3.85(cm2/m2) in women.  TPA, TPI, and rates of change in TPI were then evaluated and compared between sarcopenic and non-sarcopenic adult trauma patients. RESULTS: There were 81 adult trauma patients who met inclusion criteria. The average change in TPA was -3.8 cm2 and TPI was -1.3 cm2. On admission, 23% (n = 19) of patients were sarcopenic while 77% (n = 62) were not. Non-sarcopenic patients had a significantly greater change in TPA (-4.9 vs. -0.31, p<0.0001), TPI (-1.7 vs. -0.13, p<0.0001), and rate of decrease in muscle mass (p = 0.0002). 37% of patients who were admitted with normal muscle mass developed sarcopenia during admission.  Older age was the only risk factor independently associated with developing sarcopenia (OR: 1.04, 95%CI 1.00-1.08, p = 0.045). CONCLUSION: Over a third of patients with normal muscle mass at admission subsequently developed sarcopenia with older age as the primary risk factor. Patients with normal muscle mass at admission had greater decreases in TPA and TPI, and accelerated rates of muscle mass loss compared to sarcopenic patients.


Assuntos
Sarcopenia , Masculino , Adulto , Humanos , Feminino , Sarcopenia/diagnóstico por imagem , Estudos Retrospectivos , Músculos Psoas/diagnóstico por imagem , Músculos Psoas/patologia , Fatores de Risco , Tempo de Internação
11.
Environ Sci Pollut Res Int ; 30(15): 43267-43278, 2023 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-36652074

RESUMO

Regarding hard situations like war, the increasing cost of extraction and exploration of fossil fuels make governments move toward green and clear renewable energy (RE). As a result, we propose a novel multi-criteria decision-making (MCDM) method for RE location (REL) for the first time. This model suggests a Robust, Resilience MCDM with Risk approach (RRMCDMR) for REL. We propose a risk approach by adding a risk function in MCDM. A robust convex approach is used to tackle the uncertainty of the model for the real world. We compare the RRMCDMR problem in a wind farm location in Iran with different risk coefficient functions. As defined, Khaf, Nehbandan, and Esfarayan are in locations one to three in all modes. We changed the normalized risk function and suggested two other risk functions that can help risk-averse and risk-neutral decision-makers. We varied the robust convex coefficient and considered that by increasing the robust convex coefficient, the alternative score increased.


Assuntos
Tomada de Decisões , Energia Renovável , Combustíveis Fósseis , Irã (Geográfico) , Incerteza
12.
J Am Coll Surg ; 236(3): 461-467, 2023 03 01.
Artigo em Inglês | MEDLINE | ID: mdl-36408977

RESUMO

BACKGROUND: Although evidence suggests that racial and ethnic minority (REM) patients receive inadequate pain management in the acute care setting, it remains unclear whether these disparities also occur during the prehospital period. The aim of this study is to assess the impact of race and ethnicity on prehospital analgesic use by emergency medical services (EMS) in trauma patients. STUDY DESIGN: Retrospective chart review of adult trauma patients aged 18 to 89 years old transported by EMS to our American College of Surgeons-verified level 1 trauma center from 2014 to 2020. Patients who identified as Black, Asian, Native American, or Other for race and/or Hispanic or Latino or Unknown for ethnicity were considered REM. Patients who identified as White, non-Hispanic were considered White. Groups were compared in univariate and multivariate analysis. The primary outcome was prehospital analgesic administration. RESULTS: A total of 2,476 patients were transported by EMS (47% White and 53% REM). White patients were older on average (46 years vs 38 years; p < 0.001) and had higher rates of blunt trauma (76% vs 60%; p < 0.001). There were no differences in Injury Severity Score (21 vs 20; p = 0.22). Although REM patients reported higher subjective pain rating (7.2 vs 6.6; p = 0.002), they were less likely to get prehospital pain medication (24% vs 35%; p < 0.001), and that difference remained significant after controlling for baseline characteristics, transport method, pain rating, prehospital hypotension, and payor status (adjusted odds ratio [95% CI], 0.67 [0.47 to 0.96]; p = 0.03). CONCLUSIONS: Patients from racial and ethnic minority groups were less likely to receive prehospital pain medication after traumatic injury than White patients. Forms of conscious and unconscious bias contributing to this inequity need to be identified and addressed.


Assuntos
Serviços Médicos de Emergência , Etnicidade , Adulto , Humanos , Adolescente , Adulto Jovem , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Manejo da Dor , Estudos Retrospectivos , Grupos Minoritários , Analgésicos/uso terapêutico , Dor/tratamento farmacológico
13.
J Surg Res ; 283: 586-593, 2023 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-36442258

RESUMO

INTRODUCTION: Agitation on arrival in trauma patients is known as a sign of impending demise. The aim of this study is to determine outcomes for trauma patients who present in an agitated state. We hypothesized that agitation in the trauma bay is an early indicator for hemorrhage in trauma patients. METHODS: We performed a single-institution prospective observational study from September 2018 to December 2020 that included any trauma patient who arrived agitated, defined as a Richmond Agitation-Sedation Scale of +1 to +4. Variables collected included demographics, mechanism of injury, admission physiology, blood alcohol level, toxicity screen, and injury severity. The primary outcomes were need for massive transfusion (≥ 10 units) and need for emergent therapeutic intervention for hemorrhage control (laparotomy, preperitoneal pelvic packing, sternotomy, thoracotomy, or angioembolization). RESULTS: Of 4657 trauma admissions, 77 (2%) patients arrived agitated. Agitated patients were younger (40 versus 46, P = 0.03), predominantly male (94% versus 66%, P < 0.0001) sustained more penetrating trauma (31% versus 12%, P < 0.0001), had a lower systolic blood pressure (127 versus 137, P < 0.0001), and a higher Injury Severity Score (17 versus 9, P < 0.0001). On multivariable logistic regression, agitation was independently associated with massive transfusion (odds ratio: 2.63 [1.20-5.77], P = 0.02) and emergent therapeutic intervention for hemorrhage control (odds ratio: 2.60 [1.35-5.03], P = 0.005). CONCLUSIONS: Agitation in trauma patients may serve as an early indicator of hemorrhagic shock, as agitation is independently associated with a two-fold increase in the need for massive transfusion and emergent therapeutic intervention for hemorrhage control.


Assuntos
Hipotensão , Choque Hemorrágico , Humanos , Masculino , Feminino , Choque Hemorrágico/terapia , Hemorragia , Escala de Gravidade do Ferimento , Pelve , Estudos Retrospectivos , Centros de Traumatologia
14.
J Surg Res ; 283: 778-782, 2023 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-36470203

RESUMO

INTRODUCTION: Failed extubation in critically ill patients is associated with poor outcomes. In critically ill trauma patients who have failed extubation, providers must decide whether to proceed with tracheostomy or attempt extubation again. The aim of this study was to describe the natural history of failed extubation in trauma patients and determine whether tracheostomy or a second attempt at extubation is more appropriate. METHODS: Trauma patients admitted to our level I trauma center from 2013 to 2019 were identified. Patients who failed extubation, defined as an unplanned reintubation within 48 h of extubation, were included. Patients who immediately underwent tracheostomy were compared with those who had subsequent attempts at extubation. The primary outcome was mortality, and the secondary outcomes were intensive care unit (ICU) length of stay (LOS), ventilator days, and hospital LOS. RESULTS: The population included 93 patients who failed extubation and met inclusion criteria. A total of 53 patients were ultimately successfully extubated, whereas 40 patients underwent a tracheostomy. There was no statistically significant difference in demographics or injury patterns. Patients who underwent tracheostomy had a longer ICU LOS and more ventilator days. There was no difference in mortality or hospital LOS between the two groups. CONCLUSIONS: In trauma patients, those who underwent subsequent attempts at extubation did not experience higher rates of mortality than those who received a tracheostomy. Tracheostomy was associated with longer ICU LOS and ventilator days. In certain situations, it is appropriate to consider subsequent attempts at extubation in trauma patients who fail extubation rather than proceeding directly to tracheostomy.


Assuntos
Estado Terminal , Unidades de Terapia Intensiva , Humanos , Traqueostomia , Intubação Intratraqueal/efeitos adversos , Centros de Traumatologia , Tempo de Internação , Extubação , Respiração Artificial , Estudos Retrospectivos
15.
Comput Biol Med ; 152: 106443, 2023 01.
Artigo em Inglês | MEDLINE | ID: mdl-36563539

RESUMO

The Global Cancer Statistics 2020 reported breast cancer (BC) as the most common diagnosis of cancer type. Therefore, early detection of such type of cancer would reduce the risk of death from it. Breast imaging techniques are one of the most frequently used techniques to detect the position of cancerous cells or suspicious lesions. Computer-aided diagnosis (CAD) is a particular generation of computer systems that assist experts in detecting medical image abnormalities. In the last decades, CAD has applied deep learning (DL) and machine learning approaches to perform complex medical tasks in the computer vision area and improve the ability to make decisions for doctors and radiologists. The most popular and widely used technique of image processing in CAD systems is segmentation which consists of extracting the region of interest (ROI) through various techniques. This research provides a detailed description of the main categories of segmentation procedures which are classified into three classes: supervised, unsupervised, and DL. The main aim of this work is to provide an overview of each of these techniques and discuss their pros and cons. This will help researchers better understand these techniques and assist them in choosing the appropriate method for a given use case.


Assuntos
Neoplasias da Mama , Aprendizado Profundo , Neoplasias Mamárias Animais , Humanos , Animais , Feminino , Mamografia/métodos , Aprendizado de Máquina , Neoplasias da Mama/patologia , Diagnóstico por Computador/métodos , Processamento de Imagem Assistida por Computador/métodos
16.
Sci Rep ; 12(1): 21787, 2022 12 16.
Artigo em Inglês | MEDLINE | ID: mdl-36526681

RESUMO

This research proposes a new framework for agri-food capacity production by considering resiliency and robustness and paying attention to disruption and risk for the first time. It is applied robust stochastic optimization by adding robustness to the constraint's objective function and resiliency situation. This research minimizes the mean absolute deviation and coefficient of standard deviation errors by linear function in the agri-food capacity production. This study suggests agri-food managers and decision-makers use this mathematical method to forecast and improve production management. The results of this research lead to better decision-making and are compared with other sine functions. The main model's Robust and Resiliency Mean Absolute Deviation (RRMAD) value is 1.28% lower than other sine-type functions. The conservativity coefficient, confidence level, weight factor, resiliency coefficient, and probability of the scenario vary. The main model's RRMAD value is 1.28% lower than other sine-type functions. Growing the weight factor will result in an increase in RRMAD and a smooth decline in R-squared. Additionally, as the resilience coefficient rises, the RRMAD function increases while the R-squared declines. By altering the probability of the scenario, the RRMAD function drops, and the R-squared goes up.


Assuntos
Alimentos , Aprendizado de Máquina , Previsões , Coleta de Dados
17.
PLoS One ; 17(9): e0274492, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36099282

RESUMO

Regular physical activity reduces the progression of several cancers and offers physical and mental health benefits for cancer survivors. However, many cancer survivors are not sufficiently active to achieve these health benefits. Possible biological mechanisms through which physical activity could affect cancer progression include reduced systemic inflammation and positive changes in metabolic markers. Chronic and acute hyperglycemia could have downstream effects on cell proliferation and tumorigenesis. One novel strategy to motivate cancer survivors to be more active is to provide personalized biological-based feedback that demonstrates the immediate positive impact of physical activity. Continuous glucose monitors (CGMs) have been used to demonstrate the acute beneficial effects of physical activity on insulin sensitivity and glucose metabolisms in controlled lab settings. Using personal data from CGMs to illustrate the immediate impact of physical activity on glucose patterns could be particularly relevant for cancer survivors because they are at a higher risk for developing type 2 diabetes (T2D). As a pilot project, this study aims to (1) test the preliminary effect of a remotely delivered physical activity intervention that incorporates personalized biological-based feedback on daily physical activity levels, and (2) explore the association between daily glucose patterns and cancer-related insulin pathway and inflammatory biomarkers in cancer survivors who are at high risk for T2D. We will recruit 50 insufficiently active, post-treatment cancer survivors who are at elevated risk for T2D. Participants will be randomly assigned into (1) a group that receives personalized biological feedback related to physical activity behaviors; and (2) a control group that receives standard educational material. The feasibility and preliminary efficacy of this wearable sensor-based, biofeedback-enhanced 12-week physical activity intervention will be evaluated. Data from this study will support the further refinement and enhancement of a more comprehensive remotely delivered physical activity intervention that targets cancer survivors. Trial registration: ClinicalTrials.gov Identifier: NCT05490641.


Assuntos
Sobreviventes de Câncer , Diabetes Mellitus Tipo 2 , Neoplasias , Dispositivos Eletrônicos Vestíveis , Exercício Físico/psicologia , Retroalimentação , Glucose , Humanos , Neoplasias/terapia , Projetos Piloto , Ensaios Clínicos Controlados Aleatórios como Assunto
18.
Biomed Pharmacother ; 152: 113235, 2022 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-35696944

RESUMO

L-lysine (L-lys) had long been comprehended as an essential amino acid for humans. There were reports that the absence or inadequate availability of L-lys in the diet may lead to mental and physical impairments. The present study was designed to explore the effects of L-lys on body weight changes, cumulative food intake, anxiety-like behavior and pain perception in rats. 5-Hydroxytryptamine (5-HT, serotonin) metabolism, and tryptophan (Trp) levels in the midbrain (MB), hippocampus (HP), and prefrontal cortex (PFC) were also determined. Animals were treated with L-lys in doses of 0.5 g/kg and 1 g/kg for 20 days and behavioral studies were performed on day 1st and day 20th. After monitoring behaviors on day 20th, animals were killed to collect the serum and brain regions MB, HP and PFC. 5-HT metabolism and Trp levels were determined by HPLC-EC. The treatment produce no effect on food intakes but body weights were reduced. 20 days administration of L-lys produced an anxiolytic effect and increased exploratory activity on day 1st. Repeated administration of L-lys increased 5-HT levels in the PFC and HP. 5-Hydroxyindoleacetic acid (5-HIAA), the metabolite of 5-HT, decreased in the HP. Trp, the precourser of 5-HT, decreased in the PFC. Results suggested a decrease in 5-HT degredation in enhancing 5-HT levels. Results of in-silico analysis showed that lysine had a potential binding affinity for MAO (monoamine oxidase) A and B with an energy of (-4.8 kcal/mol and -5.3 kcal/mol) respectively. The molecular dynamic simulation study revealed the stability of L-lys after 10 ns for each protein. Conclusively, the present study showed that L-lys produced an anxiolytic effect and reduced body weight. These beneficial effects were associated with an increase in 5-HT levels in the PFC and HP. In-silico analysis suggested that 5-HT increase were due to the binding of L-lys with MAOs resulting in an inhibition of the degradation of monoamine.


Assuntos
Ansiolíticos , Serotonina , Animais , Ansiolíticos/farmacologia , Peso Corporal , Encéfalo , Ácido Hidroxi-Indolacético/metabolismo , Ácido Hidroxi-Indolacético/farmacologia , Lisina/metabolismo , Lisina/farmacologia , Monoaminoxidase/metabolismo , Ratos , Serotonina/metabolismo , Triptofano/metabolismo , Triptofano/farmacologia
19.
Int J Tryptophan Res ; 15: 11786469221104729, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35757086

RESUMO

To determine the effect of long-term restricted feeding schedules on behavior, serotonergic responses, and neuro-endocrine functions, metabolism of serotonin (5-HT) in the striatum, expression of serotonin-1A (5-HT1A) auto-receptor in the raphe nuclei and circulating levels of leptin and corticosterone were determined in female Wistar rats kept on excessive food restriction schedule. Due to a role of dietary deficiency of tryptophan (Trp) in influencing serotonergic neurotransmission, circulating levels of Trp were also determined. Estimations were done in 2 different restricted feeding models: time-restricted feeding (TRF) and diet restricted (DR). TRF animals were given access to food ad libitum only for 2 hours/day. The DR animals were given a small calculated amount of food each day. We found that chronic food restriction for 5 weeks cause a significant decrease in the body weight and produced hyperactivity in both, TRF and DR animals. Levels of Trp were declined in circulation and in the striatum. Similarly, the levels of 5-HT and its metabolite 5-hydroxyindoleacetic acid (5-HIAA) were decreased in the striatum. Also, the expression of 5-HT1A auto-receptor was declined in the raphe nuclei. These changes in 5-HT metabolism and 5-HT1A auto-receptor expression were more profound in DR animals as compare to TRF animals. Similarly, hypoleptinemia and increased corticosterone found in both models was higher in DR animals. Effect of dietary deficiency of Trp in the modulation of striatal 5-HT metabolism and its consequences on circulating leptin and corticosterone are discussed.

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