Low bone turnover is associated with plain X-ray vascular calcification in predialysis patients

Background Vascular calcification (VC) is a common finding in chronic kidney disease (CKD) patients and predicts subsequent cardiovascular morbidity and mortality in this population. Vascular calcification is linked to disordered mineral metabolism and has been associated with bone histomorphometry changes in CKD. However, data on predialysis patients is scarce. Methods A cross-sectional study was conducted on a cohort of 56 CKD patients not yet on dialysis, who underwent a transiliac bone biopsy for histomorphometric evaluation after double tetracycline labeling. Patients had no previous exposure to calcium salts, vitamin D agents, steroids or bisphosphonates. Vascular calcification was assessed at the time of biopsy, using Kauppila (plain X-ray of the lateral lumbar spine) and Adragão (plain X-ray of the pelvis and hands) scores. Results Vascular calcification was seen in two-thirds of the cohort. Subjects with VC were more likely to be male and have diabetes, and had significantly higher sclerostin and osteoprotegerin circulating levels than those without VC. The histomorphometric analysis showed that bone formation rate was significantly lower in VC compared to non-VC patients. In the multivariable logistic regression analysis, bone formation rate was independently associated with the presence of VC. Conclusions Vascular calcification is highly prevalent in predialysis patients, especially in those with diabetes. The independent association between bone formation rate and VC provides evidence of an important interaction between bone and vessel in CKD. Our results suggest that low bone turnover is a non-traditional risk factor for cardiovascular disease in predialysis patients

The COVID-19 pandemic and the growing need to train engineers aligned to the sustainable development goals

© 2020, Emerald Publishing Limited. Purpose: Considering the requirements of sustainable development regarding professionals training and the challenges evidenced during Coronavirus disease (COVID-19) pandemic, this study aims to contribute to the debates regarding the need to insert sustainability into engineering education in the current context. Design/methodology/approach: For this, the literature about sustainability in engineering education was considered, and the need for sustainability insertion in the context of the COVID-19 pandemic was debated. It is important to emphasize that this debate was based on the authors’ experience regarding sustainability research and teaching. Findings: The current moment unveiled companies’ financial management problems, constantly evidenced by media. In this sense, the interest of engineering students in business management may lead them to believe that companies’ survival depends only on financial aspects, neglecting environmental and social aspects. This study is characterized as a reminder to academic staff in the field of engineering to continue valuing the principles of sustainable development with their students during the COVID-19 pandemic. Originality/value: The need to make engineering students understand the importance of social projects in the current period is emphasized. The training of professionals to consider all the sustainability aspects even during crisis moments is evidenced now and should be used as a learning lesson for the future

Optical Flow on Evolving Surfaces with an Application to the Analysis of 4D Microscopy Data

We extend the concept of optical flow to a dynamic non-Euclidean setting. Optical flow is traditionally computed from a sequence of flat images. It is the purpose of this paper to introduce variational motion estimation for images that are defined on an evolving surface. Volumetric microscopy images depicting a live zebrafish embryo serve as both biological motivation and test data.Comment: The final publication is available at link.springer.co

Evaluation of lean practices in warehouses: an analysis of Brazilian reality

© 2020, Emerald Publishing Limited. Purpose: This article aims to investigate the most applied lean warehouse practices in Brazilian warehouses. Design/methodology/approach: To perform this research, three phases were conducted: a literature review, a multiple case study, and an analysis of lean warehouses practices implementation by an engineering committee. Thus, both qualitative and quantitative approaches were used. Additionally, the study has an applied nature, with an exploratory and descriptive character. Findings: Results showed that regardless of the type of criterion used, the most implanted practices are those that do not involve investments in technology. On the other hand, practices like RFID and Cross Docking systems were not found in any of the operations, which shows numerous possibilities for improvement. Originality/value: The main contribution of this article is to initiate a debate about the management and productivity of Brazilian warehouses, a theme still little explored by the academic community despite the importance that the logistic scenario represents for Brazil as an emerging country and leader in Latin America, participating actively in several global supply chains

Sclerostin and DKK1 circulating levels associate with low bone turnover in patients with chronic kidney disease Stages 3 and 4

Background: Disordered mineral and bone metabolism is a common complication of chronic kidney disease (CKD). Bone biopsy remains the gold standard tool for evaluating renal osteodystrophy (ROD), but it is an invasive procedure. Despite a growing interest in the ability of newer bone biomarkers to discriminate between different forms of ROD, data on pre-dialysis patients are scarce. Methods: A cross-sectional study was conducted in a cohort of 56 patients with CKD Stages 3 and 4. Participants underwent a transiliac bone biopsy after a course of double tetracycline labelling. Circulating levels of Wnt signalling inhibitors sclerostin and Dickkopf-1 (DKK1), soluble receptor activator of nuclear factor-¿B ligand (sRANKL) and osteoprotegerin were measured and correlated with histomorphometric analysis results. Results: Most patients had abnormal bone histology and low-turnover bone disease was the predominant form of ROD. Characteristics associated with high bone turnover were worse renal function, lower serum calcium and higher intact parathyroid hormone and fibroblast growth factor-23 levels. Patients with low bone turnover, on the other hand, presented with higher sclerostin along with lower DKK1 and sRANKL levels. In the multivariable logistic regression analysis, sclerostin and DKK1 levels were independently associated with low-turnover bone disease. Conclusions: Our results suggest that circulating levels of Wnt signalling inhibitors sclerostin and DKK1 are predictive of low-turnover bone disease in patients not yet on dialysis. Further research is needed to assess the performance of these bone turnover biomarkers, compared with histomorphometric analysis, in the diagnosis and treatment monitoring of ROD

Critical analysis of organizational change process: evidences from a steel company

© 2020, Emerald Publishing Limited. Purpose: The purpose of this paper is to evaluate the main factors that influence the organizational change in a steel company. Design/methodology/approach: The methodological procedures used were literature review and survey. The literature review allowed the listing of 24 factors and these factors were grouped into three constructs (Behavioral Aspects, Cultural Aspects and Management Aspects). The survey allowed the quantification of each factor based on information provided by employees who work in the mentioned company. The data collected were analyzed using the Partial Least Squares-Structural Equation Modeling technique. Findings: For the Behavioral Aspects, the following factors were validated: fear of the unknown; insecurity and anxiety; stress and feeling of suffering. For the Cultural Aspects the following factors were validated: multiculturalism in the company; low degree of risk acceptance and low performance acceptance; excessive concerns about consensus. Finally, for the Management Aspects, the following factors were validated: lack of clarity in communications; lack of alignment of goals; lack of leadership engagement. Originality/value: The results are valuable for the company studied and for other managers interested in subject. The findings presented here can broaden the debate about this topic and contribute with professionals that wish to evaluate the mentioned factors

Vascular Training Does Matter in the Outcomes of Saphenous High Ligation and Stripping

Objective: Varicose vein (VV) surgery is frequently performed by surgeons without formal vascular training. We aimed to compare the outcomes of the procedure based on the background of the surgeon. Methods: All patients registered with VV surgery between 2004 and 2016 in Portuguese public hospitals were included in the study. Intrahospital outcomes were assessed from this administrative database. A random multicenter sample of 315 patients submitted to saphenous high ligation and stripping (175 patients from six vascular surgery departments and 140 patients from five general surgery divisions) were further queried over the phone, whereby additional nonregistered outcomes were evaluated: preoperative venous ultrasound, impact on quality of life by the 14-item Chronic Venous Insufficiency Quality of Life Questionnaire, visual analogue scale evaluation (score of 1 to 5) of the aesthetic results and general satisfaction, work absence days, and time to return to physical activities. Results: In 13 years, there were 153,382 patients submitted to VV surgery. Of these, 49% were operated on by general surgeons and 40% by vascular surgeons; in 11%, it was not possible to identify the specialty performing the operation. Twenty-three deaths were registered (no differences between groups). In the general surgery group, 14% of patients were hospitalized for more than one night compared with 3% in the vascular group (P < .001). Reintervention rate during the period analyzed was significantly higher in the general surgery group (13.5% vs 8.2%; P < .001). Rate of outpatient surgery was higher in the vascular surgery group (60% vs 36%; P < .001). Phone query revealed similar overall satisfaction and improvement in quality of life in both groups (4.2 vs 4.0 [P = .275] and 35% vs 36% [P = .745], respectively). However, patients operated on by general surgeons reported worse surgical scars (2.8 vs 2.1; P = .007), higher number of residual VVs (2.4 vs 1.7; P = .006), and higher number of days absent from work (40 vs 27 days; P = .005) and took longer to resume physical activities (60 vs 41 days; P = .001). Conclusions: Despite that the majority of VV surgery in Portugal is executed by general surgeons, this study highlights important advantages when it is performed by surgeons with vascular training.info:eu-repo/semantics/publishedVersio

Business models towards SDGs: the barriers for operationalizing Product-Service System (PSS) in Brazil

© 2020 Informa UK Limited, trading as Taylor & Francis Group. Sustainable development requires the creation and development of new business models. Sharing economy will maximize the use of a product by several people, while it enables the reduction of natural resource consumption. In this sense, Product-Service Systems (PSS) can greatly contribute to achieving the Sustainable Development Goals, published by the United Nations. In this context, the present study aims to analyse the barriers associated with the operationalization of PSS business models in Brazil. Nineteen barriers listed in the literature supported a questionnaire used in a survey of Brazilian researchers. Data analysis was performed through Hierarchical Cluster Analysis, descriptive statistics and TOPSIS (Technique for Order of Preference by Similarity to Ideal Solution). TOPSIS is used for comparative ordering of barriers in terms of intensity. The results showed that there are many barriers observed in the Brazilian scenario for the operationalization of PSS; those related to the resistance to change to the mentioned business models and the lack of necessary skills to manage them stood out. These findings can be used to enhance the debates about PSS in the Brazilian context