Identification of platelet refractoriness in oncohematologic patients

OBJECTIVES: To identify the occurrence and the causes of platelet refractoriness in oncohematologic patients. INTRODUCTION: Platelet refractoriness (unsatisfactory post-transfusion platelet increment) is a severe problem that impairs the treatment of oncohematologic patients and is not routinely investigated in most Brazilian services. METHODS: Forty-four episodes of platelet concentrate transfusion were evaluated in 16 patients according to the following parameters: corrected count increment, clinical conditions and detection of anti-platelet antibodies by the platelet immunofluorescence test (PIFT) and panel reactive antibodies against human leukocyte antigen class I (PRA-HLA). RESULTS: Of the 16 patients evaluated (median age: 53 years), nine (56%) were women, seven of them with a history of pregnancy. An unsatisfactory increment was observed in 43% of the transfusion events, being more frequent in transfusions of random platelet concentrates (54%). Platelet refractoriness was confirmed in three patients (19%), who presented immunologic and non-immunologic causes. Alloantibodies were identified in eight patients (50%) by the PIFT and in three (19%) by the PRA-HLA. Among alloimmunized patients, nine (64%) had a history of transfusion, and three as a result of pregnancy (43%). Of the former, two were refractory (29%). No significant differences were observed, probably as a result of the small sample size. CONCLUSION: The high rate of unsatisfactory platelet increment, refractoriness and alloimmunization observed support the need to set up protocols for the investigation of this complication in all chronically transfused patients, a fundamental requirement for the guarantee of adequate management

Bird checklist and contributions to conservation of the Atlantic forest-cerrado ecotone in Três Lagoas municipality, Brazil

Although Três Lagoas municipality is located in a rare and highly fragmented Atlantic Forest-Cerrado ecotone, there is scarcity of biodiversity data to guide conservation decisions. Therefore, this study aimed to compile the first bird checklist in 31 localities in this municipality to propose conservation strategies based on avian richness, conservation and migratory status. A total of 419 bird species were recorded, of which 412 were exclusive to the Atlantic Forest-Cerrado ecotone and seven to the Cerrado domain (C. minor, L. xenopterus, P. unicinctus, T. curucui, S. pileata, S. melanopis and S. luteola). According to the results, 12 species are included in the Near Threatened category, four are vulnerable (C. fasciolata, L. xenopterus, A. tricolor and S. hypoxantha) and one is endangered (U. coronata). Regarding migratory birds, 112 were recorded (95 intracontinental, 17 intercontinental). Since the majority of these species are recorded in grasslands, aquatic habitats and Seasonal Deciduous Alluvial Forest, they necessarily have highest priority for conservation and restoration. Thus, we recommend that: (1) areas 2, 11 and 24 be considered as both Important Bird Area and “Area de Proteção Ambiental”; (2) riparian forest restoration along the Paraná river act as a local ecological corridor among these areas, allowing the recolonization, genetic exchange and restoration of locally reduced populations of migratory and near/threatened bird species

Detecção de contaminação de solo por vinhaça através de análise de dados de eletrorresistividade

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)The vinasse, awaste produced in the proportion of 13 liters for each liter of alcohol. It has a high potential of polluting groundwater and superficial water resources, changes the soil behaviour and can also develop sanilization problems. This work aims to evaluate the efficiency of the DC-resistivity method in detecting and mapping anomalies caused by inappropriate disposal of vinasse in an inactive infiltration tank located at Sepé-Tiarajú settlement of landless agricultural laborers in the Ribeirão Preto region. Besides, as secondary goals, this work aims to characterize the type of anomaly residue as well as to diagnose its influence inside and outside of the limits of the tank. Eleven electrical resistivity tomography profiles were carried out with the dipole-dipole array, 10m of dipoles length and 5 leveis of investigation The geophysical survey enabled us to conclude that the DC-resistivity method is appropriate for mapping the contamination plume caused by intense vinasse disposal and its influence. It enabled also to conclude that the contamination exceeds the tank limits. The vinasse influence can be characterized by low resistivity values between 10 Ohm.m and 90 Ohm.m and its behavior can be compared with the one of the chorume, which is also conductive.A vinhaça, resíduo gerado na proporção de 13 litros para cada litro de álcool produzido, possui um alto potencial poluidor dos recursos hídricos subterrãneos e superficiais, causa alterações no comportamento do solo e pode gerar problemas de salinização. Este trabalho objetiva avaliar a eficiência do método da eletrorresistividade para a detecção e mapeamento das anomalias causadas pela disposição inadequada de grandes quantidades de vinhaça em um antigo tanque de infiltração localizado no Assentamento Sepé-Tiarajú, Região de Ribeirão Preto -SP. O trabalho objetiva também caracterizar o tipo de anomalia inerente ao resíduo no local estudado e diagnosticar sua influência dentro e fora dos limites do tanque. Foram executados onze perfis de tomografia elétrica, arranjo dipolo-dipolo radial e espaçamento entre eletrodos de 10 metros e 5 níveis de investigação. Os ensaios geofísicos mostraram que o método da eletrorresistividade é apropriado para mapear as anomalias decorrentes da disposição de grandes quantidades de vinhaça no solo, apontar suas áreas de influência e concluir que a contaminação extrapola os limites do tanque. A influência da vinhaça pode ser caracterizada por baixos valores de resistividade entre 10 Ohm.m e90 Ohm.m, podendo o seu comportamento ser comparado ao do chorume, que também é bastante condutivo.264481492Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)CNPq_Brasi

Caffeine supplementation can make runners run firther and improve pace strategy

A suplementação de cafeína pode fazer corredores correrem mais e melhorar estratégia de ritmoA cafeína pode estimular o sistema nervoso central e aumentar a tolerância ao exercício por meio de mudanças na percepção subjetiva de esforço (PSE), isso pode mudar a estratégia de ritmo (ER) durante uma corrida. Nosso objetivo foi verificar se a suplementação de cafeína promove mudanças na ER durante um teste de corrida de laboratório (TCL). De modo duplo-cego, cruzado, randomizado e contrabalançado, quinze homens saudáveis (idade: 24 ± 4,4 anos, VO2max. 53 ± 5 ml.Kg-1.min-1) ingeriram 6 mg/kg-1 de cafeína ou placebo, 60 minutos antes do TCL. O TCL consistiu de séries de três minutos (velocidade fixada à 1 km/h acima do “Onset Blood Lactate Accumulationâ€) até fadiga volicional; O Intervalo de Tempo de Descanso (ITD) entre as séries foi escolhido pelos participantes no primeiro teste (entre 30 a 60s). PSE, frequência cardíaca (FC) e lactato ([La]p) foram coletados em repouso, imediatamente após cada série e ao final do teste. O tempo de exaustão foi maior na situação cafeína (p= 0,014); o ITD foi significativamente menor na situação cafeína (p= 0,048), isso fez diminuir significativamente o tempo para realizar uma mesma distância (p= 0,034). A FC e [La]p foram semelhantes para ambas as condições (p= 0,252, p= 0,129, respectivamente). Apesar da semelhança da PSE ao longo do teste (p= 0,380), na situação cafeína não houve um aumento abrupto ao longo do teste como ocorreu na situação placebo. A suplementação de cafeína pode influenciar positivamente a ER durante uma corrida, além de aumentar a capacidade de correr mais (no mesmo evento). ABSTRACTCaffeine supplementation can make runners run firther and improve pace strategyCaffeine can stimulate the central nervous system and thus increase exercise tolerance throughout rating perceived exertion (RPE) changes and it can change the pace strategy (PS) during a physical task.  The aim of this study was to check if caffeine supplementation might promote changes in PS during a laboratory run test (LRT). In a double-blind, crossover, randomized and counterbalanced fashion, fifteen healthy-male (age: 24 ± 4.4 years; VO2max. 53 ± 5 ml.Kg-1.min-1) ingested 6 mg•kg-1 of CAF or placebo supplementation, 60 minutes before the LRT. The LRT was three-minutes sets (at fixed speed, 1 km/h above Onset Blood Lactate Accumulation) until volitional exhaustion; Rest Time Interval (RTI) between sets were chosen by the participants in the first test (ranging from 30 to 60s). RPE, Heart Rate (HR) and blood plasma lactate concentration ([La]p) were collected at rest, immediately after each set and at the end of test. Time to exhaustion was higher for CAF (p= 0.014).  RTI between sets was significantly lower in caffeine (p= 0.048) and this decreased significantly the time to perform a same distance (p= 0.034). Overall HR and [La]p was similar for both conditions (p= 0.252, p= 0.129, respectively). Despite similar overall RPE throughout test (p= 0.380), in caffeine, there was not a RPE abrupt increase similar to placebo.  Caffeine supplementation can positively influence running PS (to decrease the RTI required for recovery between moments of high-intensity exercise), as well as, can make an individual run further (in the same event)

Diretriz da Sociedade Brasileira de Cardiologia sobre Diagnóstico e Tratamento de Pacientes com Cardiomiopatia da Doença de Chagas

This guideline aimed to update the concepts and formulate the standards of conduct and scientific evidence that support them, regarding the diagnosis and treatment of the Cardiomyopathy of Chagas disease, with special emphasis on the rationality base that supported it.  Chagas disease in the 21st century maintains an epidemiological pattern of endemicity in 21 Latin American countries. Researchers and managers from endemic and non-endemic countries point to the need to adopt comprehensive public health policies to effectively control the interhuman transmission of T. cruzi infection, and to obtain an optimized level of care for already infected individuals, focusing on diagnostic and therapeutic opportunistic opportunities.   Pathogenic and pathophysiological mechanisms of the Cardiomyopathy of Chagas disease were revisited after in-depth updating and the notion that necrosis and fibrosis are stimulated by tissue parasitic persistence and adverse immune reaction, as fundamental mechanisms, assisted by autonomic and microvascular disorders, was well established. Some of them have recently formed potential targets of therapies.  The natural history of the acute and chronic phases was reviewed, with enhancement for oral transmission, indeterminate form and chronic syndromes. Recent meta-analyses of observational studies have estimated the risk of evolution from acute and indeterminate forms and mortality after chronic cardiomyopathy. Therapeutic approaches applicable to individuals with Indeterminate form of Chagas disease were specifically addressed. All methods to detect structural and/or functional alterations with various cardiac imaging techniques were also reviewed, with recommendations for use in various clinical scenarios. Mortality risk stratification based on the Rassi score, with recent studies of its application, was complemented by methods that detect myocardial fibrosis.  The current methodology for etiological diagnosis and the consequent implications of trypanonomic treatment deserved a comprehensive and in-depth approach. Also the treatment of patients at risk or with heart failure, arrhythmias and thromboembolic events, based on pharmacological and complementary resources, received special attention. Additional chapters supported the conducts applicable to several special contexts, including t. cruzi/HIV co-infection, risk during surgeries, in pregnant women, in the reactivation of infection after heart transplantation, and others.     Finally, two chapters of great social significance, addressing the structuring of specialized services to care for individuals with the Cardiomyopathy of Chagas disease, and reviewing the concepts of severe heart disease and its medical-labor implications completed this guideline.Esta diretriz teve como objetivo principal atualizar os conceitos e formular as normas de conduta e evidências científicas que as suportam, quanto ao diagnóstico e tratamento da CDC, com especial ênfase na base de racionalidade que a embasou. A DC no século XXI mantém padrão epidemiológico de endemicidade em 21 países da América Latina. Investigadores e gestores de países endêmicos e não endêmicos indigitam a necessidade de se adotarem políticas abrangentes, de saúde pública, para controle eficaz da transmissão inter-humanos da infecção pelo T. cruzi, e obter-se nível otimizado de atendimento aos indivíduos já infectados, com foco em oportunização diagnóstica e terapêutica. Mecanismos patogênicos e fisiopatológicos da CDC foram revisitados após atualização aprofundada e ficou bem consolidada a noção de que necrose e fibrose sejam estimuladas pela persistência parasitária tissular e reação imune adversa, como mecanismos fundamentais, coadjuvados por distúrbios autonômicos e microvasculares. Alguns deles recentemente constituíram alvos potenciais de terapêuticas. A história natural das fases aguda e crônica foi revista, com realce para a transmissão oral, a forma indeterminada e as síndromes crônicas. Metanálises recentes de estudos observacionais estimaram o risco de evolução a partir das formas aguda e indeterminada e de mortalidade após instalação da cardiomiopatia crônica. Condutas terapêuticas aplicáveis aos indivíduos com a FIDC foram abordadas especificamente. Todos os métodos para detectar alterações estruturais e/ou funcionais com variadas técnicas de imageamento cardíaco também foram revisados, com recomendações de uso nos vários cenários clínicos. Estratificação de risco de mortalidade fundamentada no escore de Rassi, com estudos recentes de sua aplicação, foi complementada por métodos que detectam fibrose miocárdica. A metodologia atual para diagnóstico etiológico e as consequentes implicações do tratamento tripanossomicida mereceram enfoque abrangente e aprofundado. Também o tratamento de pacientes em risco ou com insuficiência cardíaca, arritmias e eventos tromboembólicos, baseado em recursos farmacológicos e complementares, recebeu especial atenção. Capítulos suplementares subsidiaram as condutas aplicáveis a diversos contextos especiais, entre eles o da co-infecção por T. cruzi/HIV, risco durante cirurgias, em grávidas, na reativação da infecção após transplante cardíacos, e outros.    Por fim, dois capítulos de grande significado social, abordando a estruturação de serviços especializados para atendimento aos indivíduos com a CDC, e revisando os conceitos de cardiopatia grave e suas implicações médico-trabalhistas completaram esta diretriz.&nbsp

Multidifferential study of identified charged hadron distributions in ZZ-tagged jets in proton-proton collisions at s=\sqrt{s}=13 TeV

Jet fragmentation functions are measured for the first time in proton-proton collisions for charged pions, kaons, and protons within jets recoiling against a $Z$ boson. The charged-hadron distributions are studied longitudinally and transversely to the jet direction for jets with transverse momentum 20 $< p_{\textrm{T}} < 100$ GeV and in the pseudorapidity range $2.5 < \eta < 4$. The data sample was collected with the LHCb experiment at a center-of-mass energy of 13 TeV, corresponding to an integrated luminosity of 1.64 fb$^{-1}$. Triple differential distributions as a function of the hadron longitudinal momentum fraction, hadron transverse momentum, and jet transverse momentum are also measured for the first time. This helps constrain transverse-momentum-dependent fragmentation functions. Differences in the shapes and magnitudes of the measured distributions for the different hadron species provide insights into the hadronization process for jets predominantly initiated by light quarks.Comment: All figures and tables, along with machine-readable versions and any supplementary material and additional information, are available at https://cern.ch/lhcbproject/Publications/p/LHCb-PAPER-2022-013.html (LHCb public pages

Study of the B−→Λc+Λˉc−K−B^{-} \to \Lambda_{c}^{+} \bar{\Lambda}_{c}^{-} K^{-} decay

The decay $B^{-} \to \Lambda_{c}^{+} \bar{\Lambda}_{c}^{-} K^{-}$ is studied in proton-proton collisions at a center-of-mass energy of $\sqrt{s}=13$ TeV using data corresponding to an integrated luminosity of 5 $\mathrm{fb}^{-1}$ collected by the LHCb experiment. In the $\Lambda_{c}^+ K^{-}$ system, the $\Xi_{c}(2930)^{0}$ state observed at the BaBar and Belle experiments is resolved into two narrower states, $\Xi_{c}(2923)^{0}$ and $\Xi_{c}(2939)^{0}$, whose masses and widths are measured to be $$m(\Xi_{c}(2923)^{0}) = 2924.5 \pm 0.4 \pm 1.1 \,\mathrm{MeV}, \\ m(\Xi_{c}(2939)^{0}) = 2938.5 \pm 0.9 \pm 2.3 \,\mathrm{MeV}, \\ \Gamma(\Xi_{c}(2923)^{0}) = \phantom{000}4.8 \pm 0.9 \pm 1.5 \,\mathrm{MeV},\\ \Gamma(\Xi_{c}(2939)^{0}) = \phantom{00}11.0 \pm 1.9 \pm 7.5 \,\mathrm{MeV},$$ where the first uncertainties are statistical and the second systematic. The results are consistent with a previous LHCb measurement using a prompt $\Lambda_{c}^{+} K^{-}$ sample. Evidence of a new $\Xi_{c}(2880)^{0}$ state is found with a local significance of $3.8\,\sigma$, whose mass and width are measured to be $2881.8 \pm 3.1 \pm 8.5\,\mathrm{MeV}$ and $12.4 \pm 5.3 \pm 5.8 \,\mathrm{MeV}$, respectively. In addition, evidence of a new decay mode $\Xi_{c}(2790)^{0} \to \Lambda_{c}^{+} K^{-}$ is found with a significance of $3.7\,\sigma$. The relative branching fraction of $B^{-} \to \Lambda_{c}^{+} \bar{\Lambda}_{c}^{-} K^{-}$ with respect to the $B^{-} \to D^{+} D^{-} K^{-}$ decay is measured to be $2.36 \pm 0.11 \pm 0.22 \pm 0.25$, where the first uncertainty is statistical, the second systematic and the third originates from the branching fractions of charm hadron decays.Comment: All figures and tables, along with any supplementary material and additional information, are available at https://cern.ch/lhcbproject/Publications/p/LHCb-PAPER-2022-028.html (LHCb public pages

Measurement of the ratios of branching fractions R(D∗)\mathcal{R}(D^{*}) and R(D0)\mathcal{R}(D^{0})

The ratios of branching fractions $\mathcal{R}(D^{*})\equiv\mathcal{B}(\bar{B}\to D^{*}\tau^{-}\bar{\nu}_{\tau})/\mathcal{B}(\bar{B}\to D^{*}\mu^{-}\bar{\nu}_{\mu})$ and $\mathcal{R}(D^{0})\equiv\mathcal{B}(B^{-}\to D^{0}\tau^{-}\bar{\nu}_{\tau})/\mathcal{B}(B^{-}\to D^{0}\mu^{-}\bar{\nu}_{\mu})$ are measured, assuming isospin symmetry, using a sample of proton-proton collision data corresponding to 3.0 fb${ }^{-1}$ of integrated luminosity recorded by the LHCb experiment during 2011 and 2012. The tau lepton is identified in the decay mode $\tau^{-}\to\mu^{-}\nu_{\tau}\bar{\nu}_{\mu}$. The measured values are $\mathcal{R}(D^{*})=0.281\pm0.018\pm0.024$ and $\mathcal{R}(D^{0})=0.441\pm0.060\pm0.066$, where the first uncertainty is statistical and the second is systematic. The correlation between these measurements is $\rho=-0.43$. Results are consistent with the current average of these quantities and are at a combined 1.9 standard deviations from the predictions based on lepton flavor universality in the Standard Model.Comment: All figures and tables, along with any supplementary material and additional information, are available at https://cern.ch/lhcbproject/Publications/p/LHCb-PAPER-2022-039.html (LHCb public pages

Physics case for an LHCb Upgrade II - Opportunities in flavour physics, and beyond, in the HL-LHC era

The LHCb Upgrade II will fully exploit the flavour-physics opportunities of the HL-LHC, and study additional physics topics that take advantage of the forward acceptance of the LHCb spectrometer. The LHCb Upgrade I will begin operation in 2020. Consolidation will occur, and modest enhancements of the Upgrade I detector will be installed, in Long Shutdown 3 of the LHC (2025) and these are discussed here. The main Upgrade II detector will be installed in long shutdown 4 of the LHC (2030) and will build on the strengths of the current LHCb experiment and the Upgrade I. It will operate at a luminosity up to 2×1034 cm−2s−1, ten times that of the Upgrade I detector. New detector components will improve the intrinsic performance of the experiment in certain key areas. An Expression Of Interest proposing Upgrade II was submitted in February 2017. The physics case for the Upgrade II is presented here in more depth. CP-violating phases will be measured with precisions unattainable at any other envisaged facility. The experiment will probe b → sl+l−and b → dl+l− transitions in both muon and electron decays in modes not accessible at Upgrade I. Minimal flavour violation will be tested with a precision measurement of the ratio of B(B0 → μ+μ−)/B(Bs → μ+μ−). Probing charm CP violation at the 10−5 level may result in its long sought discovery. Major advances in hadron spectroscopy will be possible, which will be powerful probes of low energy QCD. Upgrade II potentially will have the highest sensitivity of all the LHC experiments on the Higgs to charm-quark couplings. Generically, the new physics mass scale probed, for fixed couplings, will almost double compared with the pre-HL-LHC era; this extended reach for flavour physics is similar to that which would be achieved by the HE-LHC proposal for the energy frontier