Conversion of chemical scrubbers to biotrickling filters for VOCs and H2S treatment at low contact times.

The purpose of this work was to evaluate the technical and economical feasibility of converting three chemical scrubbers in series to biotrickling filters (BTFs) for the simultaneous removal of H2S and volatile organic compounds (VOCs). The conversion of the full-scale scrubbers was based on previous conversion protocols. Conversion mainly required replacing the original carrier material and recycle pumps as well as modifying the controls and operation of the reactors. Complete removal of H2S and VOCs on a routine basis was reached at neutral pH in a longer period of time compared to previous conversions reported. Biotrickling filters operated at a gas contact time of about 1.4 s per reactor and at pH controlled between 6.5 and 6.8. Inlet average concentrations below 10 ppmv of H2S and below 5 ppmv for VOCs were often completely removed. The first and second bioreactors played a primary role in H2S removal. Year-round operation of the biotrickling filters proved the ability of the system to handle progressive load increases of H2S and VOCs. However, fast, sudden load changes often lead to reduced removal efficiencies. Odor analyses showed average removal efficiencies above 80%. Gas chromatography-mass spectrometry of selected samples showed that outlet odor concentration was due to limited removal of VOCs. The conversion showed was economically viable taking into account the theoretical consumption of chemicals needed for the absorption and oxidation of both H2S and VOCs.

DO OLDER PATIENTS "WARN" THAT THEY WILL SUFFER A NEW FRACTURE?

Objective: To evaluate whether patients older than 60 years admitted for fracture treatment had a history of previous fracture, a diagnosis of osteoporosis, or were under treatment for bone fragility. Methods: Retrospective study including 100 patients older than 60 years with fracture. Fracture location, bone densitometry within the past two years, previous diagnosis and osteoporosis treatment, and previous fracture within the past five years were assessed. Using Fisher's test, it was evaluated whether there was an association between previous fracture and osteoporosis treatment. Results: The most prevalent fracture was in the proximal femur (48%). Of the patients, 18% had fracture in the last five years, with 22% of them diagnosed with osteoporosis, and 22% under treatment. Previous fracture in the last five years was not associated with having a diagnosis of osteoporosis, having had bone densitometry, or being under treatment for osteoporosis. Conclusion: Among patients with previous fracture, only 22% were aware of their diagnosis of osteoporosis, and less than 25% of them were under bone fragility treatment. Previous fracture in the past five years had no association with having a diagnosis of osteoporosis, having had bone densitometry, or being on osteoporosis treatment. Level of Evidence III, Retrospective Study.

Objetivo: Avaliar se os pacientes com mais de 60 anos internados para tratamento de fraturas têm história de fratura prévia, diagnóstico de osteoporose ou se estão em tratamento para fragilidade óssea. Métodos: Estudo retrospectivo que inclui 100 pacientes maiores de 60 anos com fratura. Avaliamos a localização da fratura, a densitometria óssea nos últimos dois anos, o diagnóstico e os tratamentos anteriores de osteoporose, assim como a presença de fratura prévia nos últimos cinco anos. Através de testes de Fisher avaliamos se houve associação entre fratura prévia e tratamento de osteoporose. Resultados: A fratura mais prevalente foi na extremidade proximal do fêmur (48%). Do total de pacientes, 18% tiveram fratura nos últimos cinco anos, sendo que 22% deles tinham diagnóstico de osteoporose e 22% estavam em tratamento. Fratura prévia nos últimos cinco anos não teve associação com diagnóstico de osteoporose, realização de densitometria óssea ou tratamento para osteoporose. Conclusão: Entre os pacientes com fratura prévia, apenas 22% estavam cientes do diagnóstico de osteoporose, e menos de 25% deles estavam em tratamento para fragilidade óssea. Não houve associação de fratura prévia nos últimos cinco anos com diagnóstico de osteoporose, realização de densitometria óssea ou tratamento para osteoporose. Nível de Evidência III, Estudo Retrospectivo.

Exploring the Phase-Locking Mechanisms Yielding Delayed and Anticipated Synchronization in Neuronal Circuits.

Synchronization is one of the brain mechanisms allowing the coordination of neuronal activity required in many cognitive tasks. Anticipated Synchronization (AS) is a specific type of out-of-phase synchronization that occurs when two systems are unidirectionally coupled and, consequently, the information is transmitted from the sender to the receiver, but the receiver leads the sender in time. It has been shown that the primate cortex could operate in a regime of AS as part of normal neurocognitive function. However it is still unclear what is the mechanism that gives rise to anticipated synchronization in neuronal motifs. Here, we investigate the synchronization properties of cortical motifs on multiple scales and show that the internal dynamics of the receiver, which is related to its free running frequency in the uncoupled situation, is the main ingredient for AS to occur. For biologically plausible parameters, including excitation/inhibition balance, we found that the phase difference between the sender and the receiver decreases when the free running frequency of the receiver increases. As a consequence, the system switches from the usual delayed synchronization (DS) regime to an AS regime. We show that at three different scales, neuronal microcircuits, spiking neuronal populations and neural mass models, both the inhibitory loop and the external current acting on the receiver mediate the DS-AS transition for the sender-receiver configuration by changing the free running frequency of the receiver. Therefore, we propose that a faster internal dynamics of the receiver system is the main mechanism underlying anticipated synchronization in brain circuits.

Integrated community case management: planning for sustainability in five African countries.

BACKGROUND: The World Health Organization (WHO) launched an initiative to plan for the sustainability of integrated community case management (iCCM) programmes supported by the Rapid Access Expansion (RAcE) Programme in five African countries in 2016. WHO contracted experts to facilitate sustainability planning among Ministries of Health, WHO, nongovernmental organisation grantees, and other stakeholders. METHODS: We designed an iterative and unique process for each RAcE project area which involved creating a sustainability framework to guide planning; convening meetings to identify and prioritise elements of the framework; forming technical working groups to build country ownership; and, ultimately, creating roadmaps to guide efforts to fully transfer ownership of the iCCM programmes to host countries. For this analysis, we compared priorities identified in roadmaps across RAcE project sites, examined progress against roadmaps via transition plans, and produced recommendations for short-term actions based on roadmap priorities that were unaddressed or needed further attention. RESULTS: This article describes the sustainability planning process, roadmap priorities, progress against roadmaps, and recommendations made for each project area. We found a few patterns among the prioritised roadmap elements. Overall, every project area identified priorities related to policy and coordination of external stakeholders including funders; supply chain management; service delivery and referral system; and communication and social mobilisation, indicating that these factors have persisted despite iCCM programme maturity, and are also of concern to new programmes. We also found that a facilitated process to identify and document programme priorities in roadmaps, along with deliberately planning for transition from an external implementer to a national system could support the sustainability of iCCM programmes by facilitating teams of stakeholders to accomplish explicit tasks related to transitioning the programme. CONCLUSIONS: Certain common elements are of concern for sustaining iCCM programmes across countries, among them political leadership, supply chain management, data processes, human resources, and community engagement. Adapting and using a sustainability planning approach created an inclusive and comprehensive dialogue about systemic factors that influence the sustainability of iCCM services and facilitated changes to health systems in each country.

Cerebral toxoplasmosis in patients with acquired immune deficiency syndrome in the neurological emergency department of a tertiary hospital.

INTRODUCTION: Cerebral toxoplasmosis is the most common cause of space occupying brain lesion in patients with HIV/AIDS in Brazil. In the post-HAART era, it is responsible for high rates of morbidity and mortality worldwide. MATERIALS AND METHODS: This study consists of a case series of 56 patients diagnosed with cerebral toxoplasmosis whose clinical features, brain imaging and cerebrospinal fluid aspects were analyzed. RESULTS: Cerebral toxoplasmosis led to the diagnosis of infection by the human immunodeficiency virus (HIV) in 27 (48.2%) of the patients, while 29 (51.2%) others already knew to be HIV seropositive. However, at the time of diagnosis of cerebral toxoplasmosis, only 9 (16.6%) reported being under antiretroviral therapy and 5 (8.9%) were receiving primary prophylaxis for toxoplasmosis. Headache, strength deficit and fever were the most frequent signs and symptoms throughout the study. Fifty-three patients showed changes consistent with toxoplasmosis in CT or MRI. Thirty-four (60.7%) CSF samples were positive in the indirect haemagglutination test and for the reaction of Toxoplasma gondii IgG ELISA, while 31 (55.4%) were positive in the direct haemagglutination test. Fifty (89.3%) patients underwent first-line treatment for toxoplasmosis. CONCLUSION: Cerebral toxoplasmosis is still a very relevant neurological disease in individuals with AIDS admitted to neurology emergency departments. Early diagnosis and initiation of empiric treatment and antiretroviral therapy are important for good prognosis.

Estructura y composición arbórea en un gradiente altitudinal del Área Natural Protegida Metzabok, Chiapas, México / Tree structure and composition in an altitude gradient of the Metzabok Protected Natural Area, Chiapas, Mexico

Introducción: Las selvas albergan más de la mitad de las especies del planeta, a pesar de la biodiversidad que poseen son los ambientes más amenazados, principalmente por actividades antrópicas, y su complejidad con relación a la altitud alberga vacíos de información a pesar de los valores que representa. Objetivo: Describir la estructura y diversidad de árboles en un gradiente altitudinal. Métodos: En cinco estratos altitudinales (EA) se establecieron 21 unidades de muestreo (UM) de 20 x 50 m: seis en el EA1, cinco en EA2, cuatro en EA3, tres en EA4 y 5. La estructura se caracterizó mediante las categorías diamétricas y de altura, y de los índices de valor de importancia (IVI) y forestal (IVF). La diversidad se analizó con los índices de Shannon-Wiener (H´) y Simpson (S), mientras la semejanza florística con el coeficiente de Sørensen (IS). Resultados: Se registraron 209 especies, ocho registradas en la Norma Oficial Mexicana-059-Secretaría de Medio Ambiente y Recursos Naturales-2010 (NOM-059-SEMARNAT-2019). Las especies con los mayores IVI e IVF fueron: Haematoxylum campechianum y Manilkara zapota en EA1; Rinorea guatemalensis y Pouteria reticulata en EA2; M. zapota y Brosimum alicastrum en EA3; Guatteria anomala y Pseudolmedia spuria en EA4; y Terminalia amazonia y Pouteria durlandii en EA5. En los cinco EA se identificaron tres rangos de altura y seis de diámetro, el mayor número de individuos se encontró en la primera categoria diamétrica. La diversidad de las especies fue menor a mayor altitud. En los EA 2 y 3 se presentó la mayor semejanza (IS = 58.7 %). Conclusión: La estructura y diversidad de las especies arbóreas, presentan mayores cambios en intervalos altitudinales más amplios, relacionados con la necesidad ambiental de cada especie.

Introduction: The forests are home to more than half of the planet's species, despite of their biodiversity, they are the ecosystems most threatened mainly by anthropic activities, but their complexity in relation to altitude has information gaps despite of the values it represents. Objective: Describe the structure and diversity of trees on an altitudinal gradient. Methods: In five altitudinal strata (EA) 21 sampling plots (UM) of 20 x 50 m were established: six in EA1, five in EA2, four in EA3, three in EA4 and 5. The structure was characterized by the categories diametric and height, and the importance value indexes (IVI) and forestry (IVF). Diversity was analyzed with the Shannon-Wiener (H´) and Simpson (S) indices, while the floristic similarity with the Sørensen coefficient (IS). Results: It was registered 209 tree species, eight are listed in the Official Mexican Standard-059-Secretariat of the Environment and Natural Resources-2010 (NOM-059-SEMARNAT-2019) as vulnerable species. The species with the highest IVI and IVF were Haematoxylum campechianum and Manilkara zapota in EA1; Rinorea guatemalensis and Pouteria reticulata in EA2; M. zapota and Brosimum alicastrum at EA3; Guatteria anomala and Pseudolmedia spuria in EA4; and Terminalia amazonia and Pouteria durlandii at EA5. In the five EAs, three ranges of height and six of diameter were identified, the largest number of individuals was found in the first diametric range. Species diversity was lower at higher altitudes. In EA 2 and 3 the greatest similarity was presented (IS= 58.7 %). Conclusion: The structure and diversity of the tree species present greater changes in wider altitude ranges, related to the environmental need of each species.

A new species of Leposternon Wagler, 1824 (Squamata, Amphisbaenia) from northeastern Argentina.

A new species of Leposternon is described from the Humid Chaco biome in Argentina. The species is known only from its type locality, at El Bagual Ecological Reserve, a conservation unit located in the province of Formosa. The new species can be distinguished from all its congeners by the presence of rostral processes in the maxillae and nasals that contact each other on the facial portion of the skull. Additionally, we present a key for the species of Leposternon.

Envenomation caused by Rhopalurus amazonicus Lourenço, 1986 (Scorpiones, Buthidae) in Pará State, Brazil.

Scorpions, mainly those belonging to the genus Tityus cause many deaths and injuries in Brazil, with tens of thousands of envenomations notified every year. However, injuries involving other scorpion species are scarcely registered. Among the sixteen species of the genus Rhopalurus, Thorell, 1876, described up to date, nine are found in this country, with only a confirmed case of human envenomation provoked by R. agamemnon Koch, 1839. The present case reports, for the first time, a case of scorpion sting in a human victim involving Rhopalurus amazonicus, endemic species of the west region of the Pará state, Amazon, Brazil. The symptoms of envenomation were local pain and paresthesia. This study contributes to develop the knowledge on venomous scorpions, particularly those that may cause envenomations in this region.

A introdução do Karate-Do Shotokan no Rio Grande do Sul_ memórias do sensei Watanabe / The introduction of Karate-Do Shotokan in Rio Grande do Sul: memories of sensei Watanabe

Este estudo objetivou investigar como ocorreu a introdução do Karate-Do Shotokan no estado do Rio Grande do Sul, por meio da reconstrução das memórias do sensei Luiz Tasuke Watanabe. Tendo como perspectiva teórico-metodológica a História Oral recuperou-se as memórias deste sensei, que foi um dos precursores do estilo Shotokan de Karate-Do no estado. Para tanto, foi gravada e transcrita uma entrevista com o sensei Watanabe. Além desta fonte oral, também foram analisadas fontes documentais, bem como, realizada a revisão bibliográfica sobre o assunto. As análises empreendidas nas fontes acessadas revelaram que Watanabe, ainda criança, emigrou do Japão para o Brasil com sua família e teve sua iniciação no Karate-Do por intermédio de seu irmão, que havia sido praticante no Japão. A prática do Karate-Do intensificou-se quando prestou o serviço militar ao ser aluno do sensei Yasutaka Tanaka, que ministrava aulas no exército. Posteriormente, em 1970, a convite do sensei Teruo Obata, Watanabe foi designado para dar aulas em Porto Alegre, onde atuou em diversas localidades, colaborando mais tarde para a criação do Departamento de Karate da Federação de Pugilismo do Rio Grande do Sul. Watanabe, na época, atuava como professor, mas também participou de competições. No ano de 1972, conquistou o primeiro lugar no Campeonato Mundial de Karate e alcançou destaque a nível nacional, contribuindo para a divulgação desta prática. Após uma década na cidade, em 1981, Watanabe partiu de Porto Alegre por designação do exército, retornando a cidade somente 30 anos depois para ministrar um curso...(AU)

This study aimed to investigate how occurred the introduction of Karate-Do Shotokan in Rio Grande do Sul state, through the reconstruction of memories of Luiz Tasuke Watanabe sensei. Having as theoretical and methodological perspective of the Oral History recovered the memories of this sensei, one of Shotokan karate style precursors in the state. For that was was recorded and transcribed an interview with Watanabe sensei. In addition to this oral source were analyzed documentary sources and was performed a bibliographic review about the subject. The analyzes undertaken in the accessed sources revealed that Watanabe, as a child, along with his family migrated from Japan to Brazil and had its initiation in karate, through his brother, who had been practicing in Japan. The practice of Karate-Do was intensified when paid military service and was a student of sensei Yasutaka Tanaka, who ministered classes in the army. After, in 1970 at the invitation of sensei Teruo Obata, Watanabe was appointed to teach in Porto Alegre, where he served in several places and also colaborated to creation of Karate Department of Pugilism Federation of Rio Grande Sul. Watanabe worked as a teacher and participated in competitions, and in 1972 won first place at the World Karate Championships. So, gained prominence in national level and contributes to the dissemination of Karate. After a decade in the city in 1981, Watanabe left Porto Alegre, by appointment of the army, returning the city only 30 years later to minister a course...(AU)

Anastrozole versus tamoxifen as first-line therapy in postmenopausal patients with hormone-dependent advanced breast cancer: a prospective, randomized, phase III study.

A prospective phase III trial comparing anastrozole with tamoxifen as first-line therapy in postmenopausal, hormone-dependent, advanced breast cancer (ABC). Patients were randomized to anastrozole 1 mg daily (n = 121) or tamoxifen 40 mg daily (n = 117). Efficacy and tolerability were evaluated after 3 months' therapy, and survival was evaluated at median time of follow-up. At a median follow-up of 13.3 months, clinical benefit (CB) was achieved in 83% and 56% of anastrozole and tamoxifen patients, respectively (p < 0.001); median time to disease progression (TTP) in patients achieving CB was 18.0 months and 7.0 months, respectively, (hazard ratio [HR] = 0.13, 95% CI = 0.08-0.20, p < 0.01). At data cutoff, 89% of tamoxifen patients had died, compared with 60% of anastrozole patients; median time to death was 17.4 months and 16.0 months, respectively (HR = 0.64, 95% CI = 0.47-0.86, p = 0.003). Therapy was well tolerated in both groups. Anastrozole showed significant advantages over tamoxifen for CB, median TTP in patients gaining CB, and survival. These data further support routine use of anastrozole as first-line treatment for postmenopausal hormone-dependent ABC.