Interactive web visualization tools to the results interpretation of a seismic risk study aimed at the emergency levels definition

Results of a seismic risk assessment study are often applied and interpreted by users unspecialised on the topic or lacking a scientific background. In this context, the availability of tools that help translating essentially scientific contents to broader audiences (such as decision makers or civil defence officials) as well as representing and managing results in a user-friendly fashion, are on indubitable value. On of such tools is the visualization tool VISOR-RISNA, a web tool developed within the RISNA project (financed by the Emergency Agency of Navarre, Spain) for regional seismic risk assessment of Navarre and the subsequent development of emergency plans. The RISNA study included seismic hazard evaluation, geotechnical characterization of soils, incorporation of site effects to expected ground motions, vulnerability distribution assessment and estimation of expected damage distributions for a 10% probability of exceedance in 50 years. The main goal of RISNA was the identification of higher risk area where focusing detailed, local-scale risk studies in the future and the corresponding urban emergency plans. A geographic information system was used to combine different information layers, generate tables of results and represent maps with partial and final results. The visualization tool VISOR-RISNA is intended to facilitate the interpretation and representation of the collection of results, with the ultimate purpose of defining actuation plans. A number of criteria for defining actuation priorities are proposed in this work. They are based on combinations of risk parameters resulting from the risk study (such as expected ground motion and damage and exposed population), as determined by risk assessment specialists. Although the values that these parameters take are a result of the risk study, their distribution in several classes depends on the intervals defined by decision takers or civil defense officials. These criteria provide a ranking of municipalities according to the expected actuation level and eventually, to alert levels. In this regard, the visualization tool constitutes an intuitive and useful tool that the end-user of the risk study may use to optimize and guide its application on emergency planning. The use of this type of tools can be adapted to other scenarios with different boundary conditions (seismicity level, vulnerability distribution) and user profiles (policy makers, stakeholders, students, general public) maintaining the same final goal: to improve the adaptation of the results of a scientific-technical work to the needs of other users with different backgrounds

USO de Adjuvantes (caf 09, Caf 01 e Mpl) Mucosa-compatíveis na Formulação de Vacinas Contra a Leishmaniose Viceral.

A leishmaniose visceral é umas das doenças infecto-parasitária endêmica em diversos países dentre deles o Brasil, que atinge os seres humanos e outros vertebrados. Seu tratamento é feito com fármacos específicos (pentavelentes antimonais, anfoterecina B, pentamidinas e miltefosina) de alta toxicidade, causando efeitos colaterais nos pacientes, sendo assim é necessária um busca por alternativas para controlar a doença. Nesse contexto, as vacinas de mucosa tem sido promissoras devido à sua especificidade na ativação do sistema imunológico associado ao baixo custo e simples administração. A vacinação por via mucosa contra leishmaniose visceral, proposto por este estudo, utiliza uma vacina composta por antígenos totais de L. amazonensis (LaAg) em associação com adjuvantes, como CAF01, CAF09 e MPL, os quais são eficazes em gerar uma forte resposta imunológica mediante ao estimulo de TLR1, 2, 4 e/ou TLR9. Nesse contexto, avaliamos os efeitos imunogênicos e protetores da administração intranasal de nossa vacina em camundongos BALB/c desafiados por L. infantum chagasi. Nossos resultados mostraram uma resposta promissora da vacina em conjunto com dois adjuvantes, CAF01 e MPL, levando a uma diminuição da carga parasitaria 60 veze menos no caso do baço e 30 vezes menos no fígado dos animais, assim como um aumento na expressão de óxido nítrico (80μM) baço e (150 μM ) fígado e também a presença de citocinas inflamatórias ex-vivo IL-4 e IFN-γ. Observamos também um aumento na linfoproliferação de células CD8+ em cultura de esplenócitos. Dessa forma, podemos determinar a efetividade de nossa vacina de estudo de base em camundongos BALB/c, podendo, a partir de próximos estudos

Stroke care in Italy: An overview of strategies to manage acute stroke in COVID-19 time

Purpose: To analyse structural and non-structural modifications of acute stroke care pathways undertaken at healthcare institutions across the regions of Italy due to the coronavirus disease 2019 (COVID-19) pandemic. Methods: Research on National decrees specific for the pandemic was carried out. The stroke pathways of four Italian regions from North to South, such as Lombardy, Veneto, Lazio and Campania, were analysed before and after the pandemic outbreak. Findings: On 29 February 2020, the Italian Minister of Health issued national guidelines on how to address the COVID-19 emergency. Stroke management was affected and required changes, basically resulting in the need to prioritise the ongoing COVID-19 emergency. In the most affected regions, the closure of departments and hospitals led to a complete reorganisation of previously functioning stroke networks. With the closure of several Stroke Units and Stroke Centres, the transportation time to hospital lengthened significantly, especially for the outlying populations. Discussion: The COVID-19 pandemic outbreak has been spreading rapidly in Italy and placing an overwhelming burden on healthcare systems. In response to this, political and healthcare decision-makers worked together to develop and implement efforts to sustain the national healthcare system while fighting the pandemic. Stroke care pathways changed during the pandemic and different organisational models were applied in the most affected regions. Conclusions: Stroke treatment pathways will need to be redesigned so to guarantee that severe and acute disease patients do not lose their rights to the access and delivery of care during the COVID-19 pandemics

Dietary polyphenols and non-alcoholic fatty liver disease

Non-alcoholic fatty liver disease (NAFLD), which is emerging as a major public health issue worldwide, is characterized by a wide spectrum of liver disorders, ranging from simple fat accumulation in hepatocytes, also known as steatosis, to non-alcoholic steatohepatitis (NASH) and cirrhosis. At present, the pharmacological treatment of NAFLD is still debated and dietary strategies for the prevention and the treatment of this condition are strongly considered. Polyphenols are a group of plant-derived compounds whose anti-inflammatory and antioxidant properties are associated with a low prevalence of metabolic diseases, including obesity, hypertension, and insulin resistance. Since inflammation and oxidative stress are the main risk factors involved in the pathogenesis of NAFLD, recent studies suggest that the consumption of polyphenol-rich diets is involved in the prevention and treatment of NAFLD. However, few clinical trials are available on human subjects with NAFLD. Here, we reviewed the emerging existing evidence on the potential use of polyphenols to treat NAFLD. After introducing the physiopathology of NAFLD, we focused on the most investigated phenolic compounds in the setting of NAFLD and described their potential benefits, starting from basic science studies to animal models and human trials

Neurology training around the world

Lancet Neurol. 2003 Sep;2(9):572-9. Neurology training around the world. Hooker J, Eccher M, Lakshminarayan K, Souza-Lima FC, Rejdak K, Kwiecinski H, Corea F, Lima JM. The National Hospital for Neurology and Neurosurgery, Queen Square, WC1N 3BG, London, UK. Comment in: Lancet Neurol. 2003 Oct;2(10):594; discussion 594

Whole-genome sequences of eight clinical isolates of Burkholderia pseudomallei from melioidosis patients in Eastern Sri Lanka

Here, we report whole-genome sequences (WGS) of eight clinical isolates of Burkholderia pseudomallei obtained from melioidosis patients with sepsis in eastern Sri Lanka

Influencia de la cultura empresarial en el éxito o fracaso de los talleres de hamacas y de calzado de cuero para mujer de la ciudad de Masaya

ESTE TRABAJO EXPLORA LAS OPORTUNIDADES Y OBSTACULOS que enfrentan dos sectores productivos de la ciudad de Masaya, la artesanía de hamacas y el calzado de cuero para mujeres, a partir de su cultura empresarial. Los éxitos y los fracasos de uno y otro sector se explican y fundamentan en el estilo empresarial característico de los talleres productores. Para realizar la investigación, se eligieron 15 talleres de cada especialidad y se estudió la cultura empresarial y el estilo de dirección. Este enfoque empresarial raramente se ha aplicado a los estudios de las diferentes empresas nicaragüenses y menos aún, de los talleres artesanales. Con este trabajo se espera abrir un ámbito a la exploración y la investigación

An Evaluation of the Responsiveness and Discriminant Validity of Shoulder Questionnaires among Patients Receiving Surgical Correction of Shoulder Instability

Health-related quality-of-life (HRQL) measures must detect clinically important changes over time and between different patient subgroups. Forty-three patients (32 M, 13 F; mean age  =  26.00  ±  8.19 years) undergoing arthroscopic Bankart repair completed three validated shoulder questionnaires (Western Ontario Shoulder Instability index (WOSI), American Shoulder and Elbow Surgeons Standardized Shoulder Assessment form (ASES), Constant score) preoperatively, and at 6, 12, and 24 months postoperatively. Responsiveness and discriminant validity was assessed between those with a satisfactory outcome and those with (1) a major recurrence of instability, (2) a single episode of subluxation, (3) any postoperative episode of instability. Eight (20%) patients reported recurrent instability. Compared to baseline, the WOSI detected improvement at the 6- (P<0.001) and 12-month (P=0.011) evaluations. The ASES showed improvement at 6 months (P=0.003), while the Constant score did not report significant improvement until 12 months postoperatively (P=0.001). Only the WOSI detected differential shoulder function related to shoulder instability. Those experiencing even a single episode of subluxation reported a 10% drop in their WOSI score, attaining the previously established minimal clinically important difference (MCID). Those experiencing a frank dislocation or multiple episodes of subluxation reported a 20% decline. The WOSI allows better discrimination of the severity of postoperative instability symptoms following arthroscopic Bankart repair

Frequency and patterns of early recanalization after vasectomy

BACKGROUND: Our understanding of early post-vasectomy recanalization is limited to histopathological studies. The objective of this study was to estimate the frequency and to describe semen analysis patterns of early recanalization after vasectomy. METHODS: Charts displaying serial post-vasectomy semen analyses were created using the semen analysis results from 826 and 389 men participating in a randomized trial of fascial interposition (FI) and an observational study of cautery, respectively. In the FI trial, participants were randomly allocated to vas occlusion by ligation and excision with or without FI. In the cautery study, sites used their usual cautery occlusion technique, two with and two without FI. Presumed early recanalization was based on the assessment of individual semen analysis charts by three independent reviewers. Discrepancies were resolved by consensus. RESULTS: Presumed early recanalization was characterized by a very low sperm concentration within two weeks after vasectomy followed by return to large numbers of sperm over the next few weeks. The overall proportion of men with presumed early recanalization was 13% (95% CI 12%–15%). The risk was highest with ligation and excision without FI (25%) and lowest for thermal cautery with FI (0%). The highest proportion of presumed early recanalization was observed among men classified as vasectomy failures. CONCLUSION: Early recanalization, occurring within the first weeks after vasectomy, is more common than generally recognized. Its frequency depends on the occlusion technique performed