Invisible beings: an overview of people with disabilities’ circumstances in Japan

Despite the fact that Japan ratified the Convention on the Rights of Persons with Disabilities in 2014 and that Tokyo will be the first city in the world to host the Paralympic Games more than once, people with disabilities are usually segregated from society and regarded as invisible. This separation process starts at childhood and lingers throughout their lives. This work aims to outline an overview of their living conditions, the main laws and recent events.Apesar de o Japão ter ratificado a Convenção sobre Direitos de Pessoas com Deficiências em 2014 e Tóquio ser a primeira cidade no mundo que sediará os Jogos Paralímpicos mais de uma vez, portadores de deficiência são geralmente segregados da sociedade e considerados invisíveis. Este processo de separação se inicia na infância e perdura durante suas vidas. Este trabalho objetiva traçar um panorama sobre suas condições de vida, principais leis e eventos recentes

Tradeoffs in the externalities of pig production are not inevitable

Farming externalities are believed to co-vary negatively, yet trade-offs have rarely been quantified systematically. Here we present data from UK and Brazilian pig production systems representative of most commercial systems across the world ranging from ‘intensive’ indoor systems through to extensive free range, Organic and woodland systems to explore co-variation among four major externality costs. We found that no specific farming type was consistently associated with good performance across all domains. Generally, systems with low land use have low greenhouse gas emissions but high antimicrobial use and poor animal welfare, and vice versa. Some individual systems performed well in all domains but were not exclusive to any particular type of farming system. Our findings suggest that trade-offs may be avoidable if mitigation focuses on lowering impacts within system types rather than simply changing types of farming

Anestesia intravenosa parcial (AIVP) em lobo-guará (Chrysocyon brachyurus) neonato

Background: The maned wolf (Chrysocyon brachyurus) is the largest canid in South America and the only representative of its genus. The scientific literature presents studies referring to the management and anaesthesia of the species but is scarce in case of emergency procedures, and to date, there are no reports of anaesthesia for emergency procedures in a neonatal maned wolf. Thus, this study aimed to report xenotransfusion and emergency anaesthesia for thoracic limb amputation in an approximately 8-days-old maned wolf pup.  Case: A maned wolf pup, approximately 8-days-old, with a history of an accident with an agricultural machine, was referred to the Veterinary Hospital of the Federal University of Paraná - Palotina Sector (HVP - UFPR) with a grade III open fracture of left radius and ulna. At the physical evaluation, bullous rales were observed in the right caudal lobe on pulmonary auscultation, hypoglycemia and severe dehydration, the latter being determined by the occurrence of enophthalmos, increased capillary refill time and skin turgor (3 s). The hemogram revealed regenerative hypochromic macrocytic anaemia, thrombocytopenia and leukopenia, and the chest radiograph showed alveolar pattern opacification, associated with the presence of air bronchograms in the caudal lobes, more evident on the right side, suggestive of pulmonary contusion. Considering the laboratory alterations and the need for amputation of the thoracic limb, xenotransfusion was chosen before the anaesthetic procedure. The animal was pre-medicated with methadone 0.2 mg/kg and anaesthetic induction was performed with propofol titrated to effect, requiring 10 mg/kg. This was followed by endotracheal intubation and anaesthetic maintenance using the partial intravenous technique with an infusion of 5 µg/kg/h of remifentanil and Isoflurane vaporised through a non-rebreathing system in oxygen at 0.6. Anaesthetic monitoring included heart rate and electrocardiogram tracing, respiratory rate, oxyhemoglobin saturation, end-tidal partial pressure of carbon dioxide, systemic blood pressure by the oscillometric method, and oesophageal body temperature. Although the blood tests after the transfusion showed an increase in hematocrit, changes suggestive of a delayed hemolytic reaction because of the transfusion were also noticed.  Discussion: Preanesthetic stabilisation is critical, as anaesthesia of unstable patients may result in a higher risk of anaesthetic complications. Critically ill patients may present systemic imbalances that can trigger pharmacokinetic and pharmacodynamic changes of anaesthetics and analgesics. Neonates have several marked physiological differences, since some organs are still immature, have a high body volume of water, and present a reduced amount of total fat and concentrations of circulating proteins, making it necessary to adjust protocols and doses used for these patients. Blood transfusion between the same species is always the best option, though xenotransfusion becomes an option when there is no homologous donor available. However, it can present a great risk to life, as there is a lack of studies regarding the blood typing of the species and blood compatibility tests. We concluded that there was an increase in hematocrit after 24 h of xenotransfusion and, even with signs of delayed hemolytic reaction observed in the blood test, the patient did not show specific clinical signs of transfusion reaction. The pup was sensitive to methadone but required a high dose of propofol for anaesthetic induction. The use of methadone as a pre-anaesthetic agent and the infusion of remifentanil provided adequate analgesia based on the parameters evaluated. Keywords: xenotransfusion, stabilisation, anaesthesia, neonatal. Título: Anestesia intravenosa parcial (AIVP) em uma lobo-guará(Chrysocyon brachyurus) neonata Descritores: xenotransfusão, estabilização, anestesia, neonato.Background: O lobo-guará (Chrysocyon brachyurus) é o maior canídeo da América do Sul e único representante do seu gênero. Atualmente, já existem estudos referentes ao manejo e anestesia da espécie, mas tratando-se de procedimentos de emergência, a literatura é escassa e, até o presente momento, não existem relatos de anestesia para procedimentos de emergência em lobo-guará neonato. Dessa forma, o objetivo do trabalho foi . Case: , com histórico de acidente com máquina agrícola, foi encaminhado ao Hospital Veterinário da Universidade Federal do Paraná, setor Palotina (HVP - UFPR) com fratura exposta grau III de rádio e ulna em membro torácico esquerdo. Na avaliação física observou-se presença estertor bolhoso em lobo caudal direito na ausculta pulmonar, hipoglicemia e grave desidratação, sendo a última determinada pela ocorrência de enoftalmia, No hemograma, identificou-se anemia macrocítica hipocrômica regenerativa, trombocitopenia e leucopenia, e na radiografia torácica observou-se opacificação de padrão alveolar, associado à presença de broncogramas aéreos em lobos caudais, mais evidentes do lado direito, sugestivo de contusão pulmonar. Considerando as alterações laboratoriais e a necessidade de amputação do membro torácico, optou-se pela xenotransfusão antes do procedimento anestésico. O animal foi pré-medicado com metadona 0,2 mg/kg e a indução anestésica foi realizada com propofol dose-efeito, sendo necessários 10 mg/kg. Seguiu-se intubação endotraqueal e manutenção anestésica utilizando a técnica parcial intravenosa com infusão de 5 µg/kg/h de remifentanil. O isoflurano foi vaporizado através de um sistema sem reinalação de gases em oxigênio a 0,6. Durante o procedimento foram avaliados frequência cardíaca e traçado de eletrocardiograma, frequência respiratória, saturação de oxihemoglobina, pressão parcial de dióxido de carbono ao final da expiração, pressão arterial sistêmica pelo método oscilométrico e temperatura corporal esofágica. A transfusão interespecífica terminou duas horas após o término da anestesia, sem a ocorrência de reações transfusionais imediatas. Embora os exames de sangue posteriores à transfusão evidenciaram aumento do hematócrito, notou-se também alterações sugestivas de reação hemolítica em decorrência da transfusão. Discussion: A estabilização pré-anestésica é fundamental, uma vez que a anestesia de pacientes instáveis pode resultar em maior risco de complicações anestésicas. Pacientes críticos podem apresentar desequilíbrio sistêmico que podem desencadear alterações farmacocinética e farmacodinâmica dos anestésicos e analgésicos. Neonatos apresentam diversas diferenças fisiológicas marcantes, visto que alguns órgãos ainda são imaturos, contam com um elevado volume corporal de água, uma quantidade de gordura total e concentrações de proteínas circulantes reduzidas, tornando necessário o ajuste de protocolos e doses utilizadas para esses pacientes. A transfusão de sangue entre a mesma espécie é sempre a melhor opção, no entanto, a xenotransfusão se torna uma opção quando não existe um doador homólogo disponível. Contudo, pode apresentar um grande risco à vida, pois faltam estudos referentes a tipagem sanguínea da espécie e testes de compatibilidade sanguínea. Concluiu-se que houve um aumento do hematócrito após 24 horas da xenotransfusão e mesmo com sinais de reação hemolítica tardia observadas no exame de sangue, o paciente não apresentou sinais clínicos específicos de reação transfusional. O filhote foi sensível a metadona, mas necessitou de alta dose de propofol para indução anestésica. A utilização de metadona como agente pré-anestésico e a infusão de remifentanil promoveram analgesia adequada baseado nos parâmetros avaliados. Keywords: xenotransfusion, stabilization, anesthesia, neonatal. Palavras-chave: xenotransfusão, estabilização, anestesia, neonato

Polineuropatia Desmielinizante Inflamatória Crônica: relato de caso

Chronic Inflammatory Demyelinating Polyneuropathy is a progressive, disabling, and rare disease, which requires greater understanding for a better propaedeutic and therapeutic approach, providing a better quality of life to the patient. The aim of this study is to report the case of a patient 48-year-old male patient seen in a Basic Health Unit with a complaint of loss of movement of the 4th and 5th fingers of both hands, associated with loss of upper limb strength for two months. The patient was diagnosed with Chronic Inflammatory Demyelinating Polyneuropathy by a specialized service and started treatment with immunoglobulin. He is currently clinically stable and on methylprednisolone. The current treatment is based on the reduction of the inflammatory process and consequent improvement of symptoms. However, there is no robust evidence indicating the better therapeutic regimen among the available options.A Polineuropatia Desmielinizante Inflamatória Crônica é uma doença de caráter progressivo,  incapacitante e rara, sendo necessário maior entendimento para melhor abordagem propedêutica e terapêutica, agregando maior qualidade de vida ao paciente. O objetivo deste estudo é relatar o caso de um paciente do sexo masculino, 48 anos com queixa de perda de movimentos de 4º e 5º quirodáctilo bilateral, associado a perda de força de membros superiores há dois meses atendido em Unidade Básica de Saúde. Realizado diagnóstico de Polineuropatia Desmielinizante Inflamatória Crônica em serviço especializado e iniciado tratamento com imunoglobulina. Atualmente encontra-se estável clinicamente com metilprednisolona. O tratamento atual baseia-se na diminuição do processo inflamatório e consequente melhora dos sintomas, entretanto não possui um esquema terapêutico com fortes evidências de superioridade entre as opções disponíveis

Search for new particles in events with energetic jets and large missing transverse momentum in proton-proton collisions at root s=13 TeV

A search is presented for new particles produced at the LHC in proton-proton collisions at root s = 13 TeV, using events with energetic jets and large missing transverse momentum. The analysis is based on a data sample corresponding to an integrated luminosity of 101 fb(-1), collected in 2017-2018 with the CMS detector. Machine learning techniques are used to define separate categories for events with narrow jets from initial-state radiation and events with large-radius jets consistent with a hadronic decay of a W or Z boson. A statistical combination is made with an earlier search based on a data sample of 36 fb(-1), collected in 2016. No significant excess of events is observed with respect to the standard model background expectation determined from control samples in data. The results are interpreted in terms of limits on the branching fraction of an invisible decay of the Higgs boson, as well as constraints on simplified models of dark matter, on first-generation scalar leptoquarks decaying to quarks and neutrinos, and on models with large extra dimensions. Several of the new limits, specifically for spin-1 dark matter mediators, pseudoscalar mediators, colored mediators, and leptoquarks, are the most restrictive to date.Peer reviewe

Combined searches for the production of supersymmetric top quark partners in proton-proton collisions at root s=13 TeV

A combination of searches for top squark pair production using proton-proton collision data at a center-of-mass energy of 13 TeV at the CERN LHC, corresponding to an integrated luminosity of 137 fb(-1) collected by the CMS experiment, is presented. Signatures with at least 2 jets and large missing transverse momentum are categorized into events with 0, 1, or 2 leptons. New results for regions of parameter space where the kinematical properties of top squark pair production and top quark pair production are very similar are presented. Depending on themodel, the combined result excludes a top squarkmass up to 1325 GeV for amassless neutralino, and a neutralinomass up to 700 GeV for a top squarkmass of 1150 GeV. Top squarks with masses from 145 to 295 GeV, for neutralino masses from 0 to 100 GeV, with a mass difference between the top squark and the neutralino in a window of 30 GeV around the mass of the top quark, are excluded for the first time with CMS data. The results of theses searches are also interpreted in an alternative signal model of dark matter production via a spin-0 mediator in association with a top quark pair. Upper limits are set on the cross section for mediator particle masses of up to 420 GeV

Probing effective field theory operators in the associated production of top quarks with a Z boson in multilepton final states at root s=13 TeV

Peer reviewe

Measurements of Higgs boson production cross sections and couplings in the diphoton decay channel at root s=13 TeV

Measurements of Higgs boson production cross sections and couplings in events where the Higgs boson decays into a pair of photons are reported. Events are selected from a sample of proton-proton collisions at root s = 13TeV collected by the CMS detector at the LHC from 2016 to 2018, corresponding to an integrated luminosity of 137 fb(-1). Analysis categories enriched in Higgs boson events produced via gluon fusion, vector boson fusion, vector boson associated production, and production associated with top quarks are constructed. The total Higgs boson signal strength, relative to the standard model (SM) prediction, is measured to be 1.12 +/- 0.09. Other properties of the Higgs boson are measured, including SM signal strength modifiers, production cross sections, and its couplings to other particles. These include the most precise measurements of gluon fusion and vector boson fusion Higgs boson production in several different kinematic regions, the first measurement of Higgs boson production in association with a top quark pair in five regions of the Higgs boson transverse momentum, and an upper limit on the rate of Higgs boson production in association with a single top quark. All results are found to be in agreement with the SM expectations.Peer reviewe

Observation of tW production in the single-lepton channel in pp collisions at root s=13 TeV

A measurement of the cross section of the associated production of a single top quark and a W boson in final states with a muon or electron and jets in proton-proton collisions at root s = 13 TeV is presented. The data correspond to an integrated luminosity of 36 fb(-1) collected with the CMS detector at the CERN LHC in 2016. A boosted decision tree is used to separate the tW signal from the dominant t (t) over bar background, whilst the subleading W+jets and multijet backgrounds are constrained using data-based estimates. This result is the first observation of the tW process in final states containing a muon or electron and jets, with a significance exceeding 5 standard deviations. The cross section is determined to be 89 +/- 4 (stat) +/- 12 (syst) pb, consistent with the standard model.Peer reviewe

Measurements of the Electroweak Diboson Production Cross Sections in Proton-Proton Collisions at root s=5.02 TeV Using Leptonic Decays

The first measurements of diboson production cross sections in proton-proton interactions at a center-of-mass energy of 5.02 TeV are reported. They are based on data collected with the CMS detector at the LHC, corresponding to an integrated luminosity of 302 pb(-1). Events with two, three, or four charged light leptons (electrons or muons) in the final state are analyzed. The WW, WZ, and ZZ total cross sections are measured as sigma(WW) = 37:0(-5.2)(+5.5) (stat)(-2.6)(+2.7) (syst) pb, sigma(WZ) = 6.4(-2.1)(+2.5) (stat)(-0.3)(+0.5)(syst) pb, and sigma(ZZ) = 5.3(-2.1)(+2.5)(stat)(-0.4)(+0.5) (syst) pb. All measurements are in good agreement with theoretical calculations at combined next-to-next-to-leading order quantum chromodynamics and next-to-leading order electroweak accuracy