Resonant couplings in U shaped fibers for biosensing

U-shaped tight curvatures in optical fibers lead to resonant couplings between the fundamental and higher order modes that are sensible to different parameters, such as strain or temperature, for example. The optical response of the sensor consists on the shift of the resonant wavelength of the coupling. In the case of singlemode fibers, the coupling involves a so-called 'cladding mode' and, due to its evanescent field, the curved region will be sensible to changes in the external medium, as well. In this paper, we present the fabrication and characterization of a robust, easy-to-make, U-shaped fiber sensor based on singlemode telecom fiber and its application for biosensing. The resonant nature of the sensingmechanism presents the advantage of large dynamic ranges for RI variations without the ambiguity of other techniques such as interferometry. We studied the performance of the U-shaped fiber sensor for different bending radii, to optimize its sensitivity and detection limit at 1550 nm operation wavelength, as well as the effect of temperature on its response. The shift of the resonant wavelength was measured in detail as a function of the external RI within the range [1.33-1,37]; the detection limit was established in (2.88 ± 0.03) × 10−5 RIU. Furthermore, the device was successfully tested as a proof of concept biosensor, using a system model antigen-antibody (BSA-aBSA)

Anthropometric Features and Third-Fourth Degree Perineal Tears

The main objective of this study was to evaluate the association between maternal and fetal anthropometric characteristics and third- and fourth-degree perineal tears. This retrospective cohort study considered all consecutive pregnancies from 2011 to 2017 at a single Institution. The inclusion criteria were: singletons who delivered vaginally during the study period, the presence of information on maternal pre-pregnancy weight, maternal height, and weight of the newborn. The feto-maternal body-mass index (BMI) was calculated as neonatal weight in kg on maternal height in squared meters (kg/m(2)). In total, 5397 singleton-term pregnancies were included; the prevalence of third-fourth-degree perineal tears was 0.47%. The most predictive factors were: nulliparity, feto-maternal BMI, neonatal weight, gestational age at delivery, and neonatal head circumference. After adjustment in multivariate analysis, the only independent predictors were nulliparity and fetomaternal BMI. The AUC of the final multivariate model was 73.54% (95% CI 65.65-81.42). Furthermore, feto-maternal BMI and gestational age had a significant direct correlation. Nulliparity and feto-maternal BMI are the two best predictors for third and fourth-degree perineal tears in our setting. Confirming this association in future research and integrating it into a decision algorithm on delivery timing could reduce obstetric damage to the anal sphincter

Adaptação parental ao filho com deficiência: revisão sistemática da literatura

Quando nasce uma criança com deficiência é necessária uma reidealização do filho para que os pais possam lidar com suas incapacidades e atender suas demandas, o que resultará em uma adaptação parental adequada ao filho real. O presente artigo objetivou realizar uma revisão sistemática sobre a adaptação parental. Para tanto, investigou as bases de dados, Pubmed, BVS, Scopus e Cochrane, utilizando os termos: Family adaptation, family impact, disabled children, no período de agosto a setembro de 2017. Foram analisados 21 artigos completos. Os resultados apontam que as famílias com um filho(a) com alguma incapacidade enfrentam inúmeros desafios, afetando diretamente a adaptação familiar e as estratégias de enfrentamento. Foram elaboradas três categorias para apresentar os resultados: impacto familiar ante o diagnóstico da deficiência; estados emocionais parentais e consequências sociais; fatores que interferem na adaptação familiar e nas estratégias de enfrentamento. Foi possível concluir que são aspectos centrais na adaptação parental a identificação precoce de fatores positivos e negativos que impactam no processo de reidealização do filho; a abordagem terapêutica precoce, centrada na família, que considere esses fatores objetivando a busca de um enfrentamento focado na resolução de problemas; a criação de condições sociais de apoio as famílias

Efeito do pisoteio animal acumulativo e da fenação nos parâmetros físicos do solo em área com sobressemeadura de misturas forrageiras de estação fria em pastagem de Tifton.

Os sistemas de manejo do solo e de pastagem implicam em mudanças nas propriedades físicas do solo a curto, médio e longo prazo, as quais podem ou não ser restritivas ao desenvolvimento do sistema radicular. Objetivou-se, a avaliação de parâmetros físicos do solo em pastagens de tifton 85 sobressemeado com espécies forrageiras de estação fria, em área pastejada no inverno e na primavera e destinadas a produção de feno no verão. O experimento foi conduzido no Instituto Regional de Desenvolvimento Rural (IRDeR). O experimento foi disposto na forma de blocos ao acaso, com arranjo fatorial triplo (2x3x4) constituído de 2 sistemas de manejo (com e sem pastejo), 3 consórcios (aveia preta + ervilhaca, aveia preta + trevo vesiculoso e aveia preta) e quatro camadas de profundidade, com três repetições. Foram coletadas amostras de solo em quatro camadas de profundidade do solo (0-0,05, 0,05- 0,10, 0,10-0,15, 0,15-0,20 m), em todos os tratamentos, para determinação da umidade gravimétrica, densidade de partícula e densidade do solo. A umidade volumétrica, porosidade total, espaço aéreo e o grau de saturação foram calculados. Não ocorreu diferença na porosidade total nas áreas com e sem pastejo, já para o espaço aéreo, houve diferença entre as mesmas. A área com pastejo apresentou maior espaço aéreo. A densidade de partícula foi menor na camada superficial do solo. A aveia preta proporcionou uma maior umidade gravimétrica na área de exclusão de pastejo. Os valores de densidade do solo e de espaço aéreo não são restritivos ao crescimento radicular em ambas as áreas

Impact of social determinants on antiretroviral therapy access and outcomes entering the era of universal treatment for people living with HIV in Italy

Background: Social determinants are known to be a driving force of health inequalities, even in high income countries. Aim of our study was to determine if these factors can limit antiretroviral therapy (ART) access, outcome and retention in care of people living with HIV (PLHIV) in Italy. Methods: All ART naïve HIV+ patients (pts) of Italian nationality enrolled in the ICONA Cohort from 2002 to 2016 were included. The association of socio-demographic characteristics (age, sex, risk factor for HIV infection, educational level, occupational status and residency area) with time to: ART initiation (from the first positive anti-HIV test), ART regimen discontinuation, and first HIV-RNA < 50 cp/mL, were evaluated by Cox regression analysis, Kaplan Meier method and log-rank test. Results: A total of 8023 HIV+ pts (82% males, median age at first pos anti-HIV test 36 years, IQR: 29-44) were included: 6214 (77.5%) started ART during the study period. Women, people who inject drugs (PWID) and residents in Southern Italy presented the lowest levels of education and the highest rate of unemployment compared to other groups. Females, pts aged > 50 yrs., unemployed vs employed, and people with lower educational levels presented the lowest CD4 count at ART initiation compared to other groups. The overall median time to ART initiation was 0.6 years (yrs) (IQR 0.1-3.7), with a significant decrease over time [2002-2006 = 3.3 yrs. (0.2-9.4); 2007-2011 = 1.0 yrs. (0.1-3.9); 2012-2016 = 0.2 yrs. (0.1-2.1), p < 0.001]. By multivariate analysis, females (p < 0.01) and PWID (p < 0.001), presented a longer time to ART initiation, while older people (p < 0.001), people with higher educational levels (p < 0.001), unemployed (p = 0.02) and students (p < 0.001) were more likely to initiate ART. Moreover, PWID, unemployed vs stable employed, and pts. with lower educational levels showed a lower 1-year probability of achieving HIV-RNA suppression, while females, older patients, men who have sex with men (MSM), unemployed had higher 1-year risk of first-line ART discontinuation. Conclusions: Despite median time to ART start decreased from 2002 to 2016, socio-demographic factors still contribute to disparities in ART initiation, outcome and durability

Ductal carcinoma in situ and sentinel lymph node metastasis in breast cancer

<p>Abstract</p> <p>Background</p> <p>The impact of sentinel lymph node biopsy on breast cancer mimicking ductal carcinoma in situ (DCIS) is a matter of debate.</p> <p>Methods</p> <p>We studied the rate of occurrence of sentinel lymph node metastasis in 255 breast cancer patients with pure DCIS showing no invasive components on routine pathological examination. We compared this to the rate of occurrence in 177 patients with predominant intraductal-component (IDC) breast cancers containing invasive foci equal to or less than 0.5 cm in size.</p> <p>Results</p> <p>Most of the clinical and pathological baseline characteristics were the same between the two groups. However, peritumoral lymphatic permeation occurred less often in the pure DCIS group than in the IDC-predominant invasive-lesion group (1.2% vs. 6.8%, p = 0.002). One patient (0.39%) with pure DCIS had two sentinel lymph nodes positive for metastasis. This rate was significantly lower than that in patients with IDC-predominant invasive lesions (6.2%; p < 0.001).</p> <p>Conclusions</p> <p>Because the rate of sentinel lymph node metastasis in pure DCIS is very low, sentinel lymph node biopsy can safely be omitted.</p

Impact of episiotomy on pelvic floor disorders and their influence on women's wellness after the sixth month postpartum: a retrospective study

<p>Abstract</p> <p>Background</p> <p>The role of episiotomy as a protective factor against pelvic floor disorders postpartum has been debated for many years, but its routine use has been hitherto discouraged in the literature. Comparisons between restrictive and routine use of episiotomy in existent literature, however, fail to include any consideration relating to quality of life. The aim of this study, therefore, is to state the role of episiotomy in preserving the perineum from damage, in order to prevent the influence of pelvic floor disorders on women's psycho-physical wellness after the sixth month postpartum.</p> <p>Methods</p> <p>A follow-up telephone interview was performed among 377 primiparous and secondiparous Caucasian women who had a child by spontaneous or operative vaginal delivery in 2006 using a self-created questionnaire and King's Health Questionnaire (KHQ).</p> <p>Results</p> <p>The mean age at delivery was 35.26 (±4.68) years and episiotomy was performed in 59.2% of women. Multivariate linear regression shows episiotomy associated to higher quality of life after the sixth month postpartum by correlating with inferior values of King's Health Questionnaire (p < 0.05).</p> <p>Conclusions</p> <p>Episiotomy appears to be a protective factor for women's wellness. Women who had episiotomy and who experienced perineal symptoms have a better psycho-physical health status in the 12.79 months (±3.3) follow-up.</p