A Standardized Classification for Subdural Hematomas- I

Subdural hematomas are a frequent and highly heterogeneous traumatic disorder, with significant clinical and socioeconomic consequences. In clinical and medicolegal practice, subdural hematomas are classified according to its apparent age, which significantly influences its intrinsic pathogenic behavior, forensic implications, clinical management, and outcome. Although practical, this empirical classification is somewhat arbitrary and scarcely informative, considering the remarkable heterogeneity of this entity. The current research project aims at implementing a comprehensive multifactorial classification of subdural hematomas, allowing a more standardized and coherent assessment and management of this condition. This new method of classification of subdural hematomas takes into account its intrinsic and extrinsic features, using imaging data and histopathological elements, to provide an easily apprehensible and intuitive nomenclature. The proposed classification unifies and organizes all relevant details concerning subdural hematomas, hopefully improving surgical care and forensic systematization

Chemical trends in the Galactic halo from APOGEE data

Indexación: Web of Science; Scopus.The galaxy formation process in the A cold dark matter scenario can be constrained from the analysis of stars in the Milky Way's halo system. We examine the variation of chemical abundances in distant halo stars observed by the Apache Point Observatory Galactic Evolution Experiment ( APOGEE), as a function of distance from the Galactic Centre ( r) and iron abundance ([M/H]), in the range 5 less than or similar to r less than or similar to 30 kpc and - 2.5 15 kpc and [M/H] > - 1.1 (larger in the case of O, Mg, and S) with respect to the nearest halo stars. This result confirms previous claims for low-alpha stars found at larger distances. Chemical differences in elements with other nucleosynthetic origins (Ni, K, Na, and Al) are also detected. C and N do not provide reliable information about the interstellar medium from which stars formed because our sample comprises red giant branch and asymptotic giant branch stars and can experience mixing of material to their surfaces.https://academic.oup.com/mnras/article-lookup/doi/10.1093/mnras/stw286

Myocardial Perfusion in Rheumatoid Arthritis Patients: Associations with Traditional Risk Factors and Novel Biomarkers

Introduction. Cardiovascular (CV) diseases are a major cause of death in rheumatoid arthritis (RA) patients. Novel biomarkers [B-type natriuretic peptide (BNP); osteoprotegerin (OPG)/receptor activator of nuclear factor-kappa B ligand (RANKL) ratio; and dickkopf-1 (DKK-1)] have been used in CV risk assessment. We analysed, in established RA patients, the presence of silent myocardial ischemia and its association with clinical variables, BNP, and bone and atheroma biomarkers. Methods. From a single-center tertiary referral hospital, RA patients asymptomatic for CV disease were submitted to myocardial perfusion scintigraphy (MPS) under adenosine stress and biomarkers measurements. Logistic regression was used to estimate crude odds ratios (OR) and 95% confidence intervals (CI). Results. In 189 patients, perfusion defects were frequent (25%) and associated with BNP ≥ 100 pg/mL (OR = 5.68; 95% CI: 2.038–15.830), fourth log OPG/RANKL ratio quartile (OR = 2.88; 95% CI: 1.091–7.622), and DKK-1 ≥ 133 pmol/L (OR = 2.69; 95% CI: 1.058–6.840). Similar associations were confirmed in those with C-reactive protein > or ≤ 3 mg/L. No relationship was found with the majority of traditional CV factors nor with disease variables. Conclusions. Our results corroborated the hypothesis that MPS could reveal subclinical CV dysfunction, supported the utility of BNP measurements as a screening tool, and put in perspective the potential usefulness of complementary approaches in CV risk assessment in RA patients

Intrahepatic Colangiocarcinoma

Introdução: o colangiocarcinoma intra-hepático (CCIhp) é um tumor maligno raro, normalmente diagnosticado num estadio avançado. São objectivos deste estudo avaliar os resultados da terapêutica do CCIhp e os factores prognósticos com significado estatístico na sobrevida de doentes com esta entidade nosológica tratados no nosso Serviço. Material e métodos: Vinte e um doentes submetidos a tratamento por CCIhp nos últimos anos, dos quais onze foram operados com intuitos curativos: quatro hepatectomias esquerdas, duas hepatectomias esquerdas alargadas aos segmentos V e VIII, duas hepatectomias direitas, duas bissegmentectomias e uma trissegmentectomia. Resultados: a mortalidade per-operatória foi de 0% e a pós-operatória (três meses) de 6%. As sobrevidas cumulativas aos 5 anos foram de 14% no total da população, 26% nos doentes submetidos a cirurgia com intuitos curativos e 26% para a sobrevida cumulativa livre de doença. Observou-se recidiva tumoral hepática em cinco doentes, a qual ocorreu aos 1,09 ± 0,82 anos (limites: 0,24-2,08). Os factores que influenciaram a sobrevida da globalidade dos doentes foram o tratamento cirúrgico com intuitos curativos (p=0,028), a presença de invasão vascular (p=0,002) e o valor da fosfatase alcalina no momento do diagnóstico (p=0,044). Entre os doentes operados com intuitos curativos, a presença de invasão vascular influenciou a sobrevida global (p=0,025) e a sobrevida livre de doença (p=0,002). Conclusões: A ressecção cirúrgica com intuitos curativos aumentou, de forma estatisticamente significativa, a sobrevida dos doentes com CCIhp. No entanto, sendo o diagnóstico geralmente tardio, apenas uma pequena percentagem destes doentes pode beneficiar deste tratamento.info:eu-repo/semantics/publishedVersio

Hyperbaric oxygen therapy as a complementary treatment in neuroblastoma — a narrative review

info:eu-repo/semantics/publishedVersio

Trade-offs during the COVID-19 pandemic: A discrete choice experiment about policy preferences in Portugal

The need to control the sanitary situation during the COVID-19 pandemic has led governments to implement several restrictions with substantial social and economic impacts. We explored people’s trade-offs in terms of their income, life restrictions, education, and poverty in the society, compared to their willingness to avoid deaths. We applied a web-based discrete choice experiment to elicit preferences of the Portuguese citizens for these attributes and computed the marginal rate of substitution in terms of avoided deaths. We recorded 2,191 responses that faced the possibility of having 250 COVID-19 related deaths per day as the worst possible outcome from the choice levels presented. Estimates suggested that individuals would be willing to sacrifice 30% instead of 10% of their income to avoid approximately 47 deaths per day during the first six months of 2021. For the same period, they would also accept 30% of the students’ population to become educationally impaired, instead of 10%, to avoid approximately 25 deaths; a strict lockdown, instead of mild life restrictions, to avoid approximately 24 deaths; and 45% of the population to be in risk of poverty, instead of 25%, to avoid approximately 101 deaths. Our paper shows that avoiding deaths was strongly preferred to the remaining societal impacts; and that being a female, as well as working on site, led individuals to be more averse to such health hazards. Furthermore, we show how a DCE can be used to assess the societal support to decision-making during times of crisis

Ultrasonic Flaw Detection Using Neural Network Models and Statistical Analysis: Simulation Studies

Flaw detection problems in ultrasonic NDE can be considered as two-class classification problems, i.e., determining whether a flaw is present or not present. To be practical, a flaw classification method must be able to handle the uncertainties associated with interference from grain noise which leads to poor signal-to-noise ratios (SNR). In this work, the use of neural network models and statistical correlation is demonstrated for one such detection/classification problem. In particular, based on simulation studies, we wish to establish practical strategies in detecting weak volumetric flaw signals corrupted by high grain noise. An example of this type that is of recent interest is the detection of “hard-alpha” inclusions in aircraft titanium components [1]. Both the feasibility and reliability of using these classifiers are assessed. This effort was carried out in parallel with another study [2] where more traditional signal processing approaches were taken

ANÁLISE DO CONHECIMENTO DOS ACADÊMICOS DA UNIEVANGÉLICA SOBRE O FLÚOR

O  flúor  é  utilizado  na  prevenção  e  controle  da  doença  cárie, pois interfere no processo de desmineralização e remineralização dos dentes. O  conhecimento  sobre  os  métodos  de  utilização  do  flúor  e  seus  efeitos  é importante  para  toda  a  população  para  que  o  flúor  seja  utilizado  de  maneira adequada.