Integration models for SDC-capable medical devices into an existing OR network : a case study for a high-frequency surgical device

The interconnection of medical devices in an operating room (OR) represents a major step in optimizing clinical processes and increasing the quality of treatment. The IEEE 11073 Service-oriented Device Connectivity (SDC) standard family constitutes the foundation for manufacturerindependent information exchange and remote control of medical devices. However, integrating new SDC-capable devices into an existing OR network poses a major challenge for medical device manufacturers. Thus, suitable integration models are required. This work focuses on the definition of three possible integration models and their comparison according to architectural design patterns. Thereby, the use case of integrating a high-frequency (HF) surgical device to interconnect with existing SDC-capable devices is pursued. One of the models, which focuses on high expandability and low coupling, was successfully applied to interconnect an HF surgical device with an OR light in the research OR of Reutlingen University. The results indicate transferability to other integration scenarios and are intended to further promote manufacturer-independent integrated ORs

Séries de procedimentos odontológicos realizadas nos serviços públicos brasileiros, 1994-2007

Os objetivos foram descrever o padrão temporal de taxas mensais de cinco procedimentos odontológicos dos serviços públicos do Brasil e avaliar mudanças nas tendências das taxas entre 1994 e 2007. Os dados foram obtidos no Sistema de Informação Ambulatorial (SIA-SUS). Foram calculadas as taxas mensais de procedimentos odontológicos coletivos, procedimentos preventivos, restauradores, exodontias e total de procedimentos odontológicos para o Brasil, e a taxa total de procedimentos odontológicos para cada macrorregião. As séries foram analisadas por médias móveis e modelos Sarima. Observou-se decréscimo nas tendências das taxas de restaurações e exodontias. As principais alterações foram observadas entre janeiro de 1998 e janeiro de 2000. Em outubro de 1999, a taxa total de procedimentos por mil habitantes aumentou em 30,5 procedimentos ou 55%, e após a inclusão das Equipes de Saúde Bucal (ESB) o aumento foi de 5,9 procedimentos ou 6,9%. Encontrou-se um forte padrão sazonal. Conclui-se que as principais alterações nas séries coincidem com o período tardio de municipalização da saúde, mas houve um aumento na taxa total de procedimentos com o incentivo a inclusão da ESB-PSF (Programa Saúde da Família).</jats:p

Bullying escolar: um fenômeno multifacetado

School bullying can involve children in different ways, making them play different roles, among them, victims, bullies and bully-victims. The aim of this study was to describe how bullying occurs in high social vulnerability schools of Florianópolis metropolitan area and the roles played by students in this phenomenon. Overall, 409 children and adolescents from the 3rd to 5th grades and of two public elementary schools aged 8-16 years (X = 11.14) participated in this study. As a tool, the Olweus Questionnaire adapted to the Brazilian population was used. For data analysis, descriptive statistics and inferential statistics were applied by the Mann Whitney and Kruskal Wallis tests. As for results, 29.8% of boys and 40.5% of girls reported being victims; 32.3% of boys and 24.6% of girls reported being bullies. Victims were the most willing to help a colleague who is suffering from bullying (X = 1.54; p> 0.001), even if they do not know the victims (X = 1.57; p> 0.004). Bullies are differentiated from the group that does not participate (X = 1.73) and the group of victims (X = 2.34), being those who felt less alone (x = 1.47; p> 0.001). It was concluded that the information obtained in this study is indispensable in the search for alternatives to reduce school bullying. The strengthening of relations between school and students and a better preparation of teachers and school staff are extremely necessary to try to minimize the effects of risk factors to which these children are exposed and consequently violence at school.O bullying escolar pode envolver crianças de diferentes maneiras, fazendo com que essas assumam papéis diferenciados. Dentre estes, têm-se vítimas, agressores e vítimas-agressoras. O objetivo deste estudo foi descrever como ocorre o bullying em escolas de alta vulnerabilidade social da Grande Florianópolis e os papéis assumidos pelos alunos nesse fenômeno. Quanto ao método, participaram 409 crianças e adolescentes do terceiro ao quinto ano e da quarta à sexta série do ensino fundamental, de duas escolas públicas municipais, com idades entre 8 e 16 anos (X=11,14). Como instrumento, utilizou-se o Questionário de Olweus adaptado à população brasileira. Para a análise dos dados, empregaram-se a estatística descritiva e estatística inferencial por meio dos testes Mann Whitney e Kruskal Wallis. Quanto aos resultados, 29,8% dos meninos e 40,5% das meninas relataram terem sido vítimas; já 32,3% dos meninos e 24,6% das meninas relataram terem sido agressores. As vítimas foram as que se mostraram mais dispostas a ajudar como podem um colega que esteja sofrendo agressão (X=1,54; p>0,001), mesmo que não o conheçam (X=1,57; p>0,004). Em contrapartida, os agressores se diferenciaram do grupo que não participa (X=1,73) e do grupo das vítimas (X=2,34), sendo aqueles que menos se sentiram sozinhos (X=1,47; p>0,001). Concluiu-se que as informações obtidas neste estudo são indispensáveis na busca de alternativas para redução do bullying escolar. O fortalecimento das relações entre escola e alunos, e um maior preparo dos professores e funcionários são extremamente necessários para tentar minimizar os efeitos dos fatores de risco a que essas crianças estão expostas e consequentemente a violência na escola.CAPES - Proc. nº 0815/14-4CIEC - Centro de Investigação em Estudos da Criança, IE, UMinho (UI 317 da FCT)Projeto Estratégico da FCT: UID/CED/00317/201

Dating violence perpetration and victimization among high schoolers from public and private schools in Rio de Janeiro, Brazil

Dating violence during adolescence is a global public health issue due to its widespread occurrence and negative health consequences. Unfortunately, research addressing this topic in Latin American countries remains limited. Seeking to bridge this gap, the present study estimated the prevalence of both dating violence victimization and perpetration among high schoolers considering sociodemographic factors, exposure to other forms of violence, and school-related characteristics. A total of 539 students participated in the study selected by means of probabilistic sampling from private and public schools in Rio de Janeiro, Brazil. Dating violence was identified using the Conflict in Adolescent Dating Relationships Inventory. Victimization prevalence ranged from 16.7% (sexual) to 94.6% (emotional), whereas perpetration prevalence varied between 9.9% (sexual) and 94.6% (emotional). Boys were more physically victimized (37.2% vs. 24.5%) and perpetrated more sexual abuse (13.7% vs. 6.9%) than girls. Adolescents reporting child abuse, living in violent areas, and those who consumed alcoholic beverages more frequently had greater dating violence prevalence overall. However, some differences between male and female vulnerability characteristics merit debate. These heterogeneous profiles of victimization/perpetration between boys and girls indicate the need for specific dating violence prevention interventions

Successful auxiliary two-staged partial resection liver transplantation (ASPIRE-LTx) for end-stage liver disease to avoid small-for-size situations

Background Risks for living-liver donors are lower in case of a left liver donation, however, due to lower graft volume, the risk for small-for-size situations in the recipients increases. This study aims to prevent small-for-size situations in recipients using an auxiliary two-staged partial resection liver transplantation (LTX) of living-donated left liver lobes. Case presentation Two patients received a two-stage auxiliary LTX using living-donated left liver lobes after left lateral liver resection. The native extended right liver was removed in a second operation after sufficient hypertrophy of the left liver graft had occurred. Neither donor developed postoperative complications. In both recipients, the graft volume increased by an average of 105% (329 ml to 641 ml), from a graft-to-body-weight ratio of 0.54 to 1.08 within 11 days after LTX, so that the remnant native right liver could be removed. No recipient developed small-for-size syndrome; graft function and overall condition is good in both recipients after a follow-up time of 25 months. Conclusions Auxiliary two-staged partial resection LTX using living-donor left lobes is technically feasible and can prevent small-for-size situation. This new technique can expand the potential living-donor pool and contributes to increase donor safety

Biological abdominal wall expansion in pediatric liver recipients after transplantation with large‐for‐size organs

Background After pediatric split liver transplantation, intra-abdominal loss of domain due to large-for-size left lateral grafts is a frequent problem for fascial closure and potentially leads to reduced liver perfusion and abdominal compartment syndrome. Therefore, delayed fascial closure with the use of temporary silastic meshes and reoperation or alternative fascial bridging procedures are necessary. Methods Between March 2019 and October 2021, biologic meshes were used for abdominal wall expansion in 6 cases of pediatric split liver transplantation. These cases were analyzed retrospectively. Results One male and 5 female children with median age of 6 months (range: 0–57 months) and weight of 6 kg (range: 3.5–22 kg) received a large-for-size left lateral graft. Graft-to-recipient weight ratio (GRWR) was 4.8% (range: 1.5%–8.5%) in median. Biologic mesh implantation for abdominal wall expansion was done in median 7 days (range: 3–11 days) after transplantation when signs of abdominal compartment syndrome with portal vein thrombosis in 3 and of the liver artery in 1 case occurred. In 2 cases, bovine acellular collagen matrix and 4 cases ovine reinforced tissue matrix was used. Median follow-up was 12.5 months (range: 4–28 months) and showed good liver perfusion by sonography and normal corporal development without signs of ventral hernia. One patient died because of fulminant graft rejection and emergency re-transplantation 11 months after the initial transplantation. Conclusions Biologic meshes can be used as safe method for abdominal wall expansion to achieve fascial closure in large-for-size liver transplant recipients. Usage for primary fascial closure can be considered in selected patients

Self-Control and Adverse “Drinking” Consequences

Most research on adverse alcohol consequences such as problems with health, work, and relationships focuses only on alcohol use itself as a cause of these outcomes. However, Gottfredson and Hirschi’s (1990) self-control theory holds that alcohol use and these negative outcomes are likely to have a common cause–low self-control. Tests of hypotheses derived from self-control theory show that self-control predicts negative drinking consequences better than combined measures of alcohol dependence and frequency and quantity of drinking. This suggests that various forms of risk–taking behavior and negative outcomes can be conceptualized as indicators of underlying levels of self-control

Good outcomes after repeated pediatric liver retransplantations: A justified procedure even in times of organ shortage

Background Pediatric liver transplantations generally represent advanced surgery for selected patients. In case of acute or chronic graft failure, biliary or vessel complications, a retransplantation (reLT) can be necessary. In these situations massive adhesions, critical patient condition or lack of good vessels for anastomosis often are problematic. Methods Between 2008 and 2021, 208 pediatric patients received a liver transplantation at our center. Retrospectively, all cases with at least one retransplantation were identified and stored in a database. Indication, intra- and postoperative course and overall survival (OS) were analyzed. Results Altogether 31 patients (14.9%) received a reLT. In 22 cases only one reLT was done, 8 patients received 2 reLTs and 1 patient needed a fourth graft. Median age for primary transplantation, first, second and third reLT was 14 (range: 1–192 months), 60.5 (range: 1–215 months), 58.5 (range: 14–131 months) and 67 months, respectively. Although biliary atresia (42%) and acute liver failure (23%) represented the main indications for the primary liver transplantation, acute and chronic graft failure (1st reLT: 36%, 2nd reLT: 38%), hepatic artery thrombosis (1st reLT: 29%, 2nd reLT: 25%, 3rd reLT: 100%) and biliary complications (1st reLT: 26%, 2nd reLT: 37%) were the most frequent indications for reLT. OS was 81.8% for patients with 1 reLT, 87.5% with 2 reLTs and 100% with 3 reLTs. Conclusion Pediatric liver retransplantation is possible with a good outcome even after multiple retransplantations in specialized centers. Nevertheless, careful patient and graft selection, as well as good preoperative conditioning, are essential