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1.
Nature ; 618(7964): 252-256, 2023 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-37286648

RESUMO

The fast solar wind that fills the heliosphere originates from deep within regions of open magnetic field on the Sun called 'coronal holes'. The energy source responsible for accelerating the plasma is widely debated; however, there is evidence that it is ultimately magnetic in nature, with candidate mechanisms including wave heating1,2 and interchange reconnection3-5. The coronal magnetic field near the solar surface is structured on scales associated with 'supergranulation' convection cells, whereby descending flows create intense fields. The energy density in these 'network' magnetic field bundles is a candidate energy source for the wind. Here we report measurements of fast solar wind streams from the Parker Solar Probe (PSP) spacecraft6 that provide strong evidence for the interchange reconnection mechanism. We show that the supergranulation structure at the coronal base remains imprinted in the near-Sun solar wind, resulting in asymmetric patches of magnetic 'switchbacks'7,8 and bursty wind streams with power-law-like energetic ion spectra to beyond 100 keV. Computer simulations of interchange reconnection support key features of the observations, including the ion spectra. Important characteristics of interchange reconnection in the low corona are inferred from the data, including that the reconnection is collisionless and that the energy release rate is sufficient to power the fast wind. In this scenario, magnetic reconnection is continuous and the wind is driven by both the resulting plasma pressure and the radial Alfvénic flow bursts.

2.
Nature ; 569(7757): E9, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-31073227

RESUMO

Change history: In this Letter, the y-axis values in Fig. 3f should go from 4 to -8 (rather than from 4 to -4), the y-axis values in Fig. 3h should appear next to the major tick marks (rather than the minor ticks), and in Fig. 1b, the arrows at the top and bottom of the electron-scale current sheet were going in the wrong direction; these errors have been corrected online.

3.
Nature ; 576(7786): 237-242, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31802007

RESUMO

During the solar minimum, when the Sun is at its least active, the solar wind1,2 is observed at high latitudes as a predominantly fast (more than 500 kilometres per second), highly Alfvénic rarefied stream of plasma originating from deep within coronal holes. Closer to the ecliptic plane, the solar wind is interspersed with a more variable slow wind3 of less than 500 kilometres per second. The precise origins of the slow wind streams are less certain4; theories and observations suggest that they may originate at the tips of helmet streamers5,6, from interchange reconnection near coronal hole boundaries7,8, or within coronal holes with highly diverging magnetic fields9,10. The heating mechanism required to drive the solar wind is also unresolved, although candidate mechanisms include Alfvén-wave turbulence11,12, heating by reconnection in nanoflares13, ion cyclotron wave heating14 and acceleration by thermal gradients1. At a distance of one astronomical unit, the wind is mixed and evolved, and therefore much of the diagnostic structure of these sources and processes has been lost. Here we present observations from the Parker Solar Probe15 at 36 to 54 solar radii that show evidence of slow Alfvénic solar wind emerging from a small equatorial coronal hole. The measured magnetic field exhibits patches of large, intermittent reversals that are associated with jets of plasma and enhanced Poynting flux and that are interspersed in a smoother and less turbulent flow with a near-radial magnetic field. Furthermore, plasma-wave measurements suggest the existence of electron and ion velocity-space micro-instabilities10,16 that are associated with plasma heating and thermalization processes. Our measurements suggest that there is an impulsive mechanism associated with solar-wind energization and that micro-instabilities play a part in heating, and we provide evidence that low-latitude coronal holes are a key source of the slow solar wind.

4.
Emerg Infect Dis ; 30(3): 499-509, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38407176

RESUMO

We characterized the spatial distribution of drug-susceptible (DS) and multidrug-resistant (MDR) tuberculosis (TB) cases in Ho Chi Minh City, Vietnam, a major metropolis in southeastern Asia, and explored demographic and socioeconomic factors associated with local TB burden. Hot spots of DS and MDR TB incidence were observed in the central parts of Ho Chi Minh City, and substantial heterogeneity was observed across wards. Positive spatial autocorrelation was observed for both DS TB and MDR TB. Ward-level TB incidence was associated with HIV prevalence and the male proportion of the population. No ward-level demographic and socioeconomic indicators were associated with MDR TB case count relative to total TB case count. Our findings might inform spatially targeted TB control strategies and provide insights for generating hypotheses about the nature of the relationship between DS and MDR TB in Ho Chi Minh City and the wider southeastern region of Asia.


Assuntos
Tuberculose Resistente a Múltiplos Medicamentos , Tuberculose , Masculino , Humanos , Vietnã/epidemiologia , Tuberculose Resistente a Múltiplos Medicamentos/epidemiologia , Ásia , Análise Espacial
5.
Nature ; 557(7704): 202-206, 2018 05.
Artigo em Inglês | MEDLINE | ID: mdl-29743689

RESUMO

Magnetic reconnection in current sheets is a magnetic-to-particle energy conversion process that is fundamental to many space and laboratory plasma systems. In the standard model of reconnection, this process occurs in a minuscule electron-scale diffusion region1,2. On larger scales, ions couple to the newly reconnected magnetic-field lines and are ejected away from the diffusion region in the form of bi-directional ion jets at the ion Alfvén speed3-5. Much of the energy conversion occurs in spatially extended ion exhausts downstream of the diffusion region 6 . In turbulent plasmas, which contain a large number of small-scale current sheets, reconnection has long been suggested to have a major role in the dissipation of turbulent energy at kinetic scales7-11. However, evidence for reconnection plasma jetting in small-scale turbulent plasmas has so far been lacking. Here we report observations made in Earth's turbulent magnetosheath region (downstream of the bow shock) of an electron-scale current sheet in which diverging bi-directional super-ion-Alfvénic electron jets, parallel electric fields and enhanced magnetic-to-particle energy conversion were detected. Contrary to the standard model of reconnection, the thin reconnecting current sheet was not embedded in a wider ion-scale current layer and no ion jets were detected. Observations of this and other similar, but unidirectional, electron jet events without signatures of ion reconnection reveal a form of reconnection that can drive turbulent energy transfer and dissipation in electron-scale current sheets without ion coupling.

6.
Ann Ig ; 35(6): 641-659, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37313797

RESUMO

Background: In Vietnam, cervical cancer is a significant public health concern for women. Unfortunately, despite the availability of the HPV vaccine, low vaccination rates persist. Objectives: This study investigates the discrepancy between urban and rural areas in the willingness to receive HPV vaccination with or without fees. Methods: A cross-sectional study was conducted on a sample of 648 women aged between 15 and 49, living in two urban and two rural Vietnamese districts of Can Tho, between May and December 2021. Results: The overall vaccination rate was 4%, with urban women having a higher rate of 4.9% compared to rural women at 3.1%. Among unvaccinated women, those from rural areas expressed a significantly higher desire to receive the free vaccine (91.4%) than urban women (84.4%). However, the intention to vaccinate declined when rural women and urban women were advised to pay the cost (63.4% and 57.1%, respectively). A strong correlation was found between a positive attitude and intention for vaccination, irrespective of its price or free availability. Education and access to information about the HPV vaccine were also identified as the most significant factors influencing the intention to vaccination among urban and rural women. Conclusion: The low HPV vaccination rates among women aged 15-49 living in both urban and rural regions of Vietnam are a notable public health concern. These outcomes emphasize the critical need for effective programs of vaccine laterization, as an introduction to the offer of affordable and accessible HPV vaccines for women in Can Tho, Vietnam.


Assuntos
Infecções por Papillomavirus , Vacinas contra Papillomavirus , Neoplasias do Colo do Útero , Humanos , Feminino , Adolescente , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Infecções por Papillomavirus/prevenção & controle , Papillomavirus Humano , Vietnã , Estudos Transversais , Vacinação , Neoplasias do Colo do Útero/prevenção & controle , Conhecimentos, Atitudes e Prática em Saúde , Aceitação pelo Paciente de Cuidados de Saúde
7.
Geophys Res Lett ; 49(9): e2021GL096986, 2022 May 16.
Artigo em Inglês | MEDLINE | ID: mdl-35864893

RESUMO

We report observations of reconnection exhausts in the Heliospheric Current Sheet (HCS) during Parker Solar Probe Encounters 08 and 07, at 16 R s and 20 R s , respectively. Heliospheric current sheet (HCS) reconnection accelerated protons to almost twice the solar wind speed and increased the proton core energy by a factor of ∼3, due to the Alfvén speed being comparable to the solar wind flow speed at these near-Sun distances. Furthermore, protons were energized to super-thermal energies. During E08, energized protons were found to have leaked out of the exhaust along separatrix field lines, appearing as field-aligned energetic proton beams in a broad region outside the HCS. Concurrent dropouts of strahl electrons, indicating disconnection from the Sun, provide further evidence for the HCS being the source of the beams. Around the HCS in E07, there were also proton beams but without electron strahl dropouts, indicating that their origin was not the local HCS reconnection exhaust.

8.
Arch Pharm (Weinheim) ; 355(1): e2100216, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34674294

RESUMO

In our continuing search for novel small-molecule anticancer agents, we designed and synthesized a series of novel (E)-N'-(3-allyl-2-hydroxy)benzylidene-2-(4-oxoquinazolin-3(4H)-yl)acetohydrazides (5), focusing on the modification of substitution in the quinazolin-4(3H)-one moiety. The biological evaluation showed that all 13 designed and synthesized compounds displayed significant cytotoxicity against three human cancer cell lines (SW620, colon cancer; PC-3, prostate cancer; NCI-H23, lung cancer). The most potent compound 5l displayed cytotoxicity up to 213-fold more potent than 5-fluorouracil and 87-fold more potent than PAC-1, the first procaspase-activating compound. Structure-activity relationship analysis revealed that substitution of either electron-withdrawing or electron-releasing groups at positions 6 or 7 on the quinazolin-4(3H)-4-one moiety increased the cytotoxicity of the compounds, but substitution at position 6 seemed to be more favorable. In the caspase activation assay, compound 5l was found to activate the caspase activity by 291% in comparison to PAC-1, which was used as a control. Further docking simulation also revealed that this compound may be a potent allosteric inhibitor of procaspase-3 through chelation of the inhibitory zinc ion. Physicochemical and ADMET calculations for 5l provided useful information of its suitable absorption profile and some toxicological effects that need further optimization to be developed as a promising anticancer agent.


Assuntos
Antineoplásicos/farmacologia , Compostos de Benzilideno/farmacologia , Hidrazinas/farmacologia , Quinolonas/farmacologia , Antineoplásicos/síntese química , Antineoplásicos/química , Compostos de Benzilideno/síntese química , Compostos de Benzilideno/química , Linhagem Celular Tumoral , Neoplasias do Colo/tratamento farmacológico , Fluoruracila/farmacologia , Humanos , Hidrazinas/síntese química , Hidrazinas/química , Neoplasias Pulmonares/tratamento farmacológico , Masculino , Simulação de Acoplamento Molecular , Células PC-3 , Neoplasias da Próstata/tratamento farmacológico , Quinolonas/síntese química , Quinolonas/química , Relação Estrutura-Atividade
9.
N Engl J Med ; 378(3): 221-229, 2018 Jan 18.
Artigo em Inglês | MEDLINE | ID: mdl-29342390

RESUMO

BACKGROUND: Active case finding is a top priority for the global control of tuberculosis, but robust evidence for its effectiveness in high-prevalence settings is lacking. We sought to evaluate the effectiveness of household-contact investigation, as compared with standard, passive measures alone, in Vietnam. METHODS: We performed a cluster-randomized, controlled trial at clinics in 70 districts (local government areas with an average population of approximately 500,000 in urban areas and 100,000 in rural areas) in eight provinces of Vietnam. Health workers at each district clinic or hospital were assigned to perform either household-contact intervention plus standard passive case finding (intervention group) or passive case finding alone (control group). In the intervention districts, household contacts of patients with positive results for tuberculosis on sputum smear microscopy (smear-positive tuberculosis) were invited for clinical assessment and chest radiography at baseline and at 6, 12, and 24 months. The primary outcome was the cumulative incidence of registered cases of tuberculosis among household contacts of patients with tuberculosis during a 2-year period. RESULTS: In 70 selected districts, we enrolled 25,707 household contacts of 10,964 patients who had smear-positive pulmonary tuberculosis. In the 36 districts that were included in the intervention group, 180 of 10,069 contacts were registered as having tuberculosis (1788 cases per 100,000 population), as compared with 110 of 15,638 contacts (703 per 100,000) in the control group (relative risk of the primary outcome in the intervention group, 2.5; 95% confidence interval [CI], 2.0 to 3.2; P<0.001); the relative risk of smear-positive disease among household contacts in the intervention group was 6.4 (95% CI, 4.5 to 9.0; P<0.001). CONCLUSIONS: Household-contact investigation plus standard passive case finding was more effective than standard passive case finding alone for the detection of tuberculosis in a high-prevalence setting at 2 years. (Funded by the Australian National Health and Medical Research Council; ACT2 Australian New Zealand Clinical Trials Registry number, ACTRN12610000600044 .).


Assuntos
Busca de Comunicante/métodos , Tuberculose Pulmonar/epidemiologia , Adolescente , Adulto , Idoso , Características da Família , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Mycobacterium tuberculosis/isolamento & purificação , Prevalência , Escarro/microbiologia , Inquéritos e Questionários , Tuberculose Pulmonar/diagnóstico , Vietnã/epidemiologia , Adulto Jovem
10.
Phys Rev Lett ; 127(15): 155101, 2021 Oct 08.
Artigo em Inglês | MEDLINE | ID: mdl-34677989

RESUMO

Observations in Earth's turbulent magnetosheath downstream of a quasiparallel bow shock reveal a prevalence of electron-scale current sheets favorable for electron-only reconnection where ions are not coupled to the reconnecting magnetic fields. In small-scale turbulence, magnetic structures associated with intense current sheets are limited in all dimensions. And since the coupling of ions are constrained by a minimum length scale, the dynamics of electron reconnection is likely to be 3D. Here, both 2D and 3D kinetic particle-in-cell simulations are used to investigate electron-only reconnection, focusing on the reconnection rate and associated electron flows. A new form of 3D electron-only reconnection spontaneously develops where the magnetic X-line is localized in the out-of-plane (z) direction. The consequence is an enhancement of the reconnection rate compared with two dimensions, which results from differential mass flux out of the diffusion region along z, enabling a faster inflow velocity and thus a larger reconnection rate. This outflow along z is due to the magnetic tension force in z just as the conventional exhaust tension force, allowing particles to leave the diffusion region efficiently along z unlike the 2D configuration.

11.
Phys Rev Lett ; 126(13): 135101, 2021 Apr 02.
Artigo em Inglês | MEDLINE | ID: mdl-33861105

RESUMO

The first self-consistent simulations of electron acceleration during magnetic reconnection in a macroscale system are presented. Consistent with solar flare observations, the spectra of energetic electrons take the form of power laws that extend more than two decades in energy. The drive mechanism for these nonthermal electrons is Fermi reflection in growing and merging magnetic flux ropes. A strong guide field suppresses the production of nonthermal electrons by weakening the Fermi drive mechanism. For a weak guide field the total energy content of nonthermal electrons dominates that of the hot thermal electrons even though their number density remains small. Our results are benchmarked with the hard x-ray, radio, and extreme ultraviolet observations of the X8.2-class solar flare on September 10, 2017.

12.
Chemistry ; 27(60): 14800-14815, 2021 Oct 25.
Artigo em Inglês | MEDLINE | ID: mdl-34347912

RESUMO

The kinetic isotope effect (KIE) is key to understanding reaction mechanisms in many areas of chemistry and chemical biology, including organometallic chemistry. This ratio of rate constants, kH /kD , typically falls between 1-7. However, KIEs up to 105 have been reported, and can even be so large that reactivity with deuterium is unobserved. We collect here examples of large KIEs across organometallic chemistry, in catalytic and stoichiometric reactions, along with their mechanistic interpretations. Large KIEs occur in proton transfer reactions such as protonation of organometallic complexes and clusters, protonolysis of metal-carbon bonds, and dihydrogen reactivity. C-H activation reactions with large KIEs occur with late and early transition metals, photogenerated intermediates, and abstraction by metal-oxo complexes. We categorize the mechanistic interpretations of large KIEs into the following three types: (a) proton tunneling, (b) compound effects from multiple steps, and (c) semi-classical effects on a single step. This comprehensive collection of large KIEs in organometallics provides context for future mechanistic interpretation.


Assuntos
Isótopos , Prótons , Carbono , Catálise , Cinética
13.
Anaesthesia ; 76(2): 182-188, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-33047327

RESUMO

Aerosol-generating procedures such as tracheal intubation and extubation pose a potential risk to healthcare workers because of the possibility of airborne transmission of infection. Detailed characterisation of aerosol quantities, particle size and generating activities has been undertaken in a number of simulations but not in actual clinical practice. The aim of this study was to determine whether the processes of facemask ventilation, tracheal intubation and extubation generate aerosols in clinical practice, and to characterise any aerosols produced. In this observational study, patients scheduled to undergo elective endonasal pituitary surgery without symptoms of COVID-19 were recruited. Airway management including tracheal intubation and extubation was performed in a standard positive pressure operating room with aerosols detected using laser-based particle image velocimetry to detect larger particles, and spectrometry with continuous air sampling to detect smaller particles. A total of 482,960 data points were assessed for complete procedures in three patients. Facemask ventilation, tracheal tube insertion and cuff inflation generated small particles 30-300 times above background noise that remained suspended in airflows and spread from the patient's facial region throughout the confines of the operating theatre. Safe clinical practice of these procedures should reflect these particle profiles. This adds to data that inform decisions regarding the appropriate precautions to take in a real-world setting.


Assuntos
Aerossóis , Extubação , Intubação Intratraqueal , Salas Cirúrgicas , Manuseio das Vias Aéreas , Anestesia por Inalação , Monitoramento Ambiental , Humanos , Tamanho da Partícula , Equipamento de Proteção Individual , Respiração Artificial
14.
J Antimicrob Chemother ; 75(9): 2594-2598, 2020 09 01.
Artigo em Inglês | MEDLINE | ID: mdl-32585694

RESUMO

OBJECTIVES: Implementation of EUCAST susceptibility testing in an Australian hospital laboratory demonstrated higher rates of aminopenicillin and amoxicillin/clavulanate resistance in Haemophilus influenzae than previously recognized. This study aimed to better define the variability in the detection of ß-lactam resistance based on EUCAST and CLSI disc diffusion (DD) methodology, by comparison with the recommended reference method, broth microdilution (BMD), and by concordance with genomic analysis. METHODS: A total of 100 random H. influenzae isolates were assessed for ampicillin and amoxicillin/clavulanate susceptibility by EUCAST and CLSI DD and BMD. WGS was used to analyse the ftsI gene of a subset of isolates with ß-lactam resistance, other than that due to isolated ß-lactamase production. RESULTS: Of the 100 isolates, 32 were categorized as either ß-lactamase negative, ampicillin resistant (BLNAR) (n = 18) or ß-lactamase positive, amoxicillin/clavulanate resistant (BLPACR) (n = 14) by EUCAST DD. All 18 EUCAST BLNAR isolates were genotypically confirmed by WGS. Five of 18 BLNAR isolates were concordant by CLSI DD, 12 by EUCAST BMD and 4 by CLSI BMD. Nine of 14 EUCAST BLPACR isolates were confirmed by WGS; the remaining 5 were 1 mm below the EUCAST DD breakpoint. Only one isolate was detected as BLPACR by CLSI DD. Group III mutations associated with high-level ampicillin resistance were identified in 10/32 isolates. CONCLUSIONS: The EUCAST DD susceptibility method is more reliable than either CLSI or BMD for the detection of genotypically defined BLNAR resistance. However, accurate categorization of amoxicillin/clavulanate resistance remains problematic. Continuous and reproducible surveillance of resistance is needed; for this to be possible, robust susceptibility methods are required.


Assuntos
Infecções por Haemophilus , Haemophilus influenzae , Combinação Amoxicilina e Clavulanato de Potássio/farmacologia , Antibacterianos/farmacologia , Austrália , Haemophilus influenzae/genética , Humanos , Testes de Sensibilidade Microbiana , beta-Lactamases/genética
15.
J Exp Bot ; 71(6): 1763-1773, 2020 03 25.
Artigo em Inglês | MEDLINE | ID: mdl-32109278

RESUMO

Seeds are the typical dispersal and propagation units of angiosperms and gymnosperms. Water movement into and out of seeds plays a crucial role from the point of fertilization through to imbibition and seed germination. A class of membrane intrinsic proteins called aquaporins (AQPs) assist with the movement of water and other solutes within seeds. These highly diverse and abundant proteins are associated with different processes in the development, longevity, imbibition, and germination of seed. However, there are many AQPs encoded in a plant's genome and it is not yet clear how, when, or which AQPs are involved in critical stages of seed biology. Here we review the literature to examine the evidence for AQP involvement in seeds and analyse Arabidopsis seed-related transcriptomic data to assess which AQPs are likely to be important in seed water relations and explore additional roles for AQPs in seed biology.


Assuntos
Aquaporinas , Regulação da Expressão Gênica de Plantas , Aquaporinas/genética , Aquaporinas/metabolismo , Biologia , Germinação , Sementes/genética , Sementes/metabolismo
16.
Phys Rev Lett ; 125(26): 265102, 2020 Dec 31.
Artigo em Inglês | MEDLINE | ID: mdl-33449730

RESUMO

Magnetic reconnection is of fundamental importance to plasmas because of its role in releasing and repartitioning stored magnetic energy. Previous results suggest that this energy is predominantly released as ion enthalpy flux along the reconnection outflow. Using Magnetospheric Multiscale data we find the existence of very significant electron energy flux densities in the vicinity of the magnetopause electron dissipation region, orthogonal to the ion energy outflow. These may significantly impact models of electron transport, wave generation, and particle acceleration.

17.
J Appl Microbiol ; 129(1): 51-62, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32027769

RESUMO

AIMS: We investigated the potential cooperative effects of carotenoid-producing Bacillus aquimaris SH6 and nonpigmented Bacillus subtilis SH23 on white-leg shrimp growth and health. METHODS AND RESULTS: SH6, SH23 and a combination of both spores (1 × 106  CFU per g pellet) were administered in shrimp. The growth rate (2·36% day-1 ), red-colour score (25) and astaxanthin concentration (3·5 µg g-1 shrimp) were maximum in two-spore-administered shrimp. Immune-related Rho mRNA expression level and phenoloxidase and superoxidase dismutase activities were higher in two-spore-administered shrimp than in control shrimp, with Rho mRNA expression level being 55-fold higher in two-spore-administered shrimp than in SH6-administered shrimp and phenoloxidase activity being 1·2-fold higher in two-spore-administered shrimp than in SH23-administered shrimp. Although live SH6 count was 2·7-fold lower, SH6 germination level was 3·5-fold higher in the combination group than in SH6 group. CONCLUSIONS: When both SH6 and SH23 spores were administered, SH6 spore germination was enhanced and cooperative improvement was seen in growth, astaxanthin level and red-colour score of white-leg shrimp; however, immune-related parameters were induced in a noncooperative manner. SIGNIFICANCE AND IMPACT OF THE STUDY: This is the first report showing the cooperative probiotic activities of Bacillus strains and their possible mechanisms in a shrimp model.


Assuntos
Bacillus/fisiologia , Microbioma Gastrointestinal , Penaeidae/química , Penaeidae/crescimento & desenvolvimento , Probióticos , Animais , Bacillus/metabolismo , Carotenoides/metabolismo , Penaeidae/microbiologia , Pigmentação , Frutos do Mar/análise , Frutos do Mar/microbiologia , Esporos Bacterianos/metabolismo , Esporos Bacterianos/fisiologia , Xantofilas/análise
18.
Respirology ; 25(7): 703-708, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32403194

RESUMO

The SARS-CoV-2 pandemic is unprecedented in our professional lives and much effort and resources will be devoted to care of patients (and HCW) affected by this illness. We must also continue to aim for the same standard of care for our non-COVID respiratory patients, while minimizing risks of infection transmission to our colleagues. This commentary addresses the key paired issues of minimizing performance of diagnostic/staging bronchoscopy in patients with suspected/known lung cancer while maximizing the safety of the procedure with respect to HCW transmission of COVID-19.


Assuntos
Broncoscopia/métodos , Infecções por Coronavirus/epidemiologia , Transmissão de Doença Infecciosa/prevenção & controle , Endossonografia/métodos , Neoplasias Pulmonares , Pneumonia Viral/epidemiologia , Gestão da Segurança/tendências , Betacoronavirus/isolamento & purificação , COVID-19 , Comorbidade , Humanos , Controle de Infecções/métodos , Controle de Infecções/organização & administração , Neoplasias Pulmonares/diagnóstico , Neoplasias Pulmonares/epidemiologia , Pandemias , SARS-CoV-2
19.
Rev Epidemiol Sante Publique ; 68(4): 215-225, 2020 Aug.
Artigo em Francês | MEDLINE | ID: mdl-32653261

RESUMO

BACKGROUND: The screening of patients who are at-risk drinkers, which means exceeding the thresholds defined by health authorities or associated with a specific situation (taking psychotropic drugs, having an organic pathology, driving a vehicle, drinking during pregnancy), represents a major issue in primary care. Few studies have offered perspective from the patients' standpoint. The main purpose of this study was to describe general practitioners at-risk drinking screening from their patients point of view. The secondary objective was to identify the factors associated with perception of satisfactory general practitioner knowledge about alcohol consumption. METHODS: A quantitative cross-sectional study was launched in 9 general practitioner offices over 6 months. Patients older than 18 were recruited to answer a questionnaire blinded from their general practitioner, indicating the level of their alcohol consumption and their perception regarding their general practitioner's screening methods. Descriptive, univariate and multivariate logistic regression analyses were performed. RESULTS: All in all, 445 patients were analyzed. Sixty-two at-risk drinkers were screened (13.9 %). Most of the patients declared they had not been interviewed about their alcohol consumption by their general practitioner either during initial consultations (86.1 %) or over time (83.3 %). Only 4.2 % of patients had previously initiated discussion about their consumption. Patients were not ashamed to talk about alcohol (99.2 %) and found their general practitioner to be competent on this topic (100 %). In multivariate analysis, independent factors associated with a good general practitioner knowledge about their patients' current consumption were the questions put forward by their general practitioner about alcohol consumption during their first visit (P<0.001) and during subsequent visits (P<0.001). CONCLUSION: This study showed a low general practitioner screening rate of their patients' at-risk drinking. Only a minority of patients, including at-risk drinkers, declared that their general practitioner was aware of their level of alcohol consumption. Screening could be improved by being systematized during initial consultations and regularly scheduled during subsequent visits, especially in at-risk situations.


Assuntos
Consumo de Bebidas Alcoólicas , Alcoolismo/diagnóstico , Clínicos Gerais , Programas de Rastreamento , Adulto , Idoso , Consumo de Bebidas Alcoólicas/epidemiologia , Alcoolismo/epidemiologia , Alcoolismo/etiologia , Alcoolismo/prevenção & controle , Estudos Transversais , Diagnóstico Precoce , Feminino , Clínicos Gerais/estatística & dados numéricos , Comportamentos de Risco à Saúde , Humanos , Masculino , Programas de Rastreamento/métodos , Programas de Rastreamento/normas , Programas de Rastreamento/estatística & dados numéricos , Pessoa de Meia-Idade , Padrões de Prática Médica/estatística & dados numéricos , Atenção Primária à Saúde/métodos , Atenção Primária à Saúde/normas , Atenção Primária à Saúde/estatística & dados numéricos , Fatores de Risco , Inquéritos e Questionários
20.
Exp Mech ; 60(7)2020.
Artigo em Inglês | MEDLINE | ID: mdl-36619901

RESUMO

Insufficient data are available to fully understand the effects of metal additive manufacturing (AM) defects for widespread adoption of the emerging technology. Characterization of failure processes of complex internal geometries and defects in metal AM can significantly enhance this understanding. We aim to demonstrate a complete experimental measurement process and failure analysis method to study the effects of AM defects. We utilized simultaneous implementation of tensile tests with high-resolution X-ray computed tomography (XCT) measurements on 17-4 stainless steel dog-bone samples with an intentional octahedron-shaped internal cavity included in the gauge length and also containing much smaller lack-of-fusion (LOF) defects, all generated by a Laser Powder Bed Fusion (LPBF) additive manufacturing process. The LOF defects were introduced by intentionally changing the LPBF default processing parameters. XCT image-based linear elastic finite element (FE) simulations were used to interpret the data. The in-situ tensile tests combined with simultaneous XCT measurements revealed the details of the failure process initiated by additively manufactured rough internal surfaces and porous defect structures, which experienced high stress concentrations. Progressive collapse of ligaments leading to larger pores was clearly observed, and the resulting porosity evolution until failure was quantitatively analyzed. The high stress concentrations were also directly confirmed by the FE simulations. The experimental methods described in this paper enable the quantitative study of the complex failure mechanisms of additively manufactured metal parts, and the image-based FE simulation method is effective for identifying and/or confirming possible failure locations and features.

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