Analysis and ergonomics of houses for elderly people

This paper presents an analysis and application of ergonomics in the kitchen and bathrooms of elderly people. The purpose is to enable them to execute their daily activities more comfortably, safely and without help. First, an analysis was made of routine activities of elders, pointing out their needs and difficulties in these rooms; Later an analysis of these rooms was performed. With this data and a bibliographical research on ergonomics of kitchens and bathrooms, problems were identified showing possible accidents in the forth-mentioned places that old people may be exposed to, due to their vulnerability in a routine tasks performance. It was noticed that most of them have visual and postural instability and also a decrease in other senses that increase accident risks. According to all this information changes and adaptations of layout are proposed to make kitchens and bathrooms safer and more comfortable to this population

INVENTÁRIO DE PEQUENOS MAMÍFEROS (RODENTIA E DIDELPHIMORPHIA) DA SERRA DE OURO BRANCO: PORÇÃO SUL DA CADEIA DO ESPINHAÇO, MINAS GERAIS, BRASIL

Serra do Ouro Branco is located at the south portion of Espinhaço Range, at a transition area between Cerrado and Atlantic Forest biomes, in Minas Gerais state, Brazil. Here, we surveyed small mammals communities from Parque Estadual Serra do Ouro Branco and Monumento Natural Estadual do Itatiaia, two protected areas, and compared them with the diversity recorded in the remaining Espinhaço mountain range. Sampling occurred over 24 months (2009-2010) using pitfall traps. Nineteen species, 13 rodents and six marsupials, were recorded in 6,664 traps /night. The study area has low similarity with other areas of Espinhaço Range; high dissimilarity was the main pattern found, as revealed by the large number of singletons (40%) and few species found at least in half of the areas (17%). Thus, the elevated richness and diversity registered allied to the singularity in composition of species in each area and the scarcity of data for the north and mainly for the central region of Espinhaço, reinforce the importance and urgency of more studies and inventories of small mammals in all mountain range extension.Serra do Ouro Branco is located at the south portion of Espinhaço Range, at a transition area between Cerrado and Atlantic Forest biomes, in Minas Gerais state, Brazil. Here, we surveyed small mammals communities from Parque Estadual Serra do Ouro Branco and Monumento Natural Estadual do Itatiaia, two protected areas, and compared them with the diversity recorded in the remaining Espinhaço mountain range. Sampling occurred over 24 months (2009-2010) using pitfall traps. Nineteen species, 13 rodents and six marsupials, were recorded in 6,664 traps /night. The study area has low similarity with other areas of Espinhaço Range; high dissimilarity was the main pattern found, as revealed by the large number of singletons (40%) and few species found at least in half of the areas (17%). Thus, the elevated richness and diversity registered allied to the singularity in composition of species in each area and the scarcity of data for the north and mainly for the central region of Espinhaço, reinforce the importance and urgency of more studies and inventories of small mammals in all mountain range extension.Serra do Ouro Branco is located at the south portion of Espinhaço Range, at a transition area between Cerrado and Atlantic Forest biomes, in Minas Gerais state, Brazil. Here, we surveyed small mammals communities from Parque Estadual Serra do Ouro Branco and Monumento Natural Estadual do Itatiaia, two protected areas, and compared them with the diversity recorded in the remaining Espinhaço mountain range. Sampling occurred over 24 months (2009-2010) using pitfall traps. Nineteen species, 13 rodents and six marsupials, were recorded in 6,664 traps /night. The study area has low similarity with other areas of Espinhaço Range; high dissimilarity was the main pattern found, as revealed by the large number of singletons (40%) and few species found at least in half of the areas (17%). Thus, the elevated richness and diversity registered allied to the singularity in composition of species in each area and the scarcity of data for the north and mainly for the central region of Espinhaço, reinforce the importance and urgency of more studies and inventories of small mammals in all mountain range extension

Laryngomalacia surgery: a series from a tertiary pediatric hospital

AbstractLaryngomalacia is the condition responsible for 75% of the cases of stridor in children aged up to 30 months, in which there is supraglottic collapse during inhalation. Inspiratory stridor is a characteristic telltale. As many as 20% of the patients are severely affected and require surgery. Supraglottoplasty is the procedure of choice and the presence of comorbidities is the most relevant prognostic factor for surgery success.ObjectiveTo describe a series in a tertiary pediatric hospital, its success rates, and surgery prognostic factors.MethodThis retrospective cohort study enrolled 20 patients submitted to supraglottoplasty between July 2007 and May 2011.ResultsThirteen (65%) patients were males; mean age at the time of the procedure was 6.32 months. Endoscopic examination showed that 12 subjects had combined forms of laryngomalacia, 40% had associated pharyngomalacia, and three also had tracheomalacia. Thirteen subjects had isolated laryngomalacia and seven had gastroesophageal reflux disease. Fifteen (75%) patients underwent aryepiglottic fold resection. After the procedure, eleven patients were asymptomatic and two required tracheostomy. Presence of comorbidities was the strongest predictor of unfavorable postoperative outcome (p = 0.034).ConclusionSupraglottoplasty is a safe therapeutical procedure for select patients with laryngomalacia

Does the use of health technology assessment have an impact on the utilisation of health care resources? Evidence from two European countries

Objectives: A centralised approach to health technology assessment (HTA) may facilitate optimal use of HTA resources. A regional approach may increase the chances of local implementation of recommendations. This study aimed to compare assessment procedures in England (centralised HTA approach) with Spain (regional HTA approach) discussing key challenges and opportunities from both approaches. Methods: We compared technology assessments of anticancer medicines in the two jurisdictions from 2008 to 2015. In order to assess the implementation of HTA recommendations, we assessed trends in medicine usage using regression methods. We used IQVIA data, from 2011 to 2016, for a sample of 11 medicines. We used CatSalut data from Catalonia to assess the implementation of local recommendations. Results: In England 66 assessments were undertaken by the National Institute for Health and Care Excellence (NICE), using a standardised methodology. In Spain there were 79 reports undertaken by a range of bodies using a shared process and coordinated through the GENESIS collaboration; the assessment methods used varied substantially. Overall, the recommendations in the two jurisdictions were similar. Regression analyses indicate that where there is a positive recommendation by HTA bodies, the usage of the medicine responds most strongly (p<0.001) in Catalonia (=4.892), followed by England ( =3.120) and Spain ( =1.693). Conclusions: This study suggests that medicine utilisation does respond to the positive recommendations of HTA bodies. However, if HTA capacity is organised primarily regionally, considerable effort may be required in coordination, in order to ensure consistent and rigorous assessments and adequate implementation of HTA findings

A total transcriptome profiling method for plasma-derived extracellular vesicles: applications for liquid biopsies

Extracellular vesicles (EVs) are key mediators of intercellular communication. Part of their biological effects can be attributed to the transfer of cargos of diverse types of RNAs, which are promising diagnostic and prognostic biomarkers. EVs found in human biofluids are a valuable source for the development of minimally invasive assays. However, the total transcriptional landscape of EVs is still largely unknown. Here we develop a new method for total transcriptome profiling of plasma-derived EVs by next generation sequencing (NGS) from limited quantities of patient-derived clinical samples, which enables the unbiased characterization of the complete RNA cargo, including both small- and long-RNAs, in a single library preparation step. This approach was applied to RNA extracted from EVs isolated by ultracentrifugation from the plasma of five healthy volunteers. Among the most abundant RNAs identified we found small RNAs such as tRNAs, miRNAs and miscellaneous RNAs, which have largely unknown functions. We also identified protein-coding and long noncoding transcripts, as well as circular RNA species that were also experimentally validated. This method enables, for the first time, the full spectrum of transcriptome data to be obtained from minute patient-derived samples, and will therefore potentially allow the identification of cell-to-cell communication mechanisms and biomarkers.Fundacao de Amparo a Pesquisa do Estado de Sao Paulo (FAPESP)Gillson-Longenbaugh FoundationNational Institutes of Health (NIH/NCATS) through the NIH Common Fund, Office of Strategic Coordination (OSC)AC Camargo Canc Ctr, Lab Med Genom, Sao Paulo, SP, BrazilAC Camargo Canc Ctr, Lab Computat Biol, Sao Paulo, SP, BrazilUniv Sao Paulo, Inst Biomed Sci, Dept Cell & Dev Biol, Sao Paulo, SP, BrazilUniv Fed Sao Paulo, Electron Microscopy Ctr, Sao Paulo, SP, BrazilUniv Texas MD Anderson Canc Ctr, Dept Expt Therapeut, Houston, TX 77030 USAUniv Texas MD Anderson Canc Ctr, Ctr RNA Interference & Non Coding RNAs, Houston, TX 77030 USAUniv New Mexico, Comprehens Canc Ctr, Albuquerque, NM 87131 USAUniv New Mexico, Sch Med, Div Hematol Oncol, Dept Internal Med, Albuquerque, NM 87131 USAUniv New Mexico, Sch Med, Div Mol Med, Dept Internal Med, Albuquerque, NM 87131 USARockefeller Univ, Lab Mol Immunol, 1230 York Ave, New York, NY 10021 USAFMUSP, Lab Neurociencias Alzira Denise Hertzog Silva LIM, Inst Psiquiatria, Sao Paulo, SP, BrazilUniv Fed Sao Paulo, Electron Microscopy Ctr, Sao Paulo, SP, BrazilFAPESP: 2011/09172-3FAPESP: 2014/26897-0Web of Scienc

Uso dos coprodutos da indústria do biodiesel para produção de bioquerosene de aviação / Use of biodiesel industry co-products for the aviation biokerosene production

Antes da pandemia do COVID 19, que assola o mundo desde dezembro 2019, o setor de aviação era responsável por 2% das emissões antropogênicas de CO2 no planeta. Com a pandemia, houve uma redução de 75% nas emissões no setor de aviação em abril de 2020, em comparação com abril de 2019. Porém, em alguns casos isolados como na ilha de Fernando de Noronha, em Pernambuco, as emissões aéreas, em tempos normais, sem pandemia, 53% das emissões aéreas eram provenientes da aviação civil.    Por esses motivos, algumas empresas aéreas estão investindo em ações sustentáveis como o uso de biocombustíveis para aviação, como forma de reduzir as emissões de GEE em 50% até 2050. Estas ações focam principalmente no desenvolvimento de alternativas para o fornecimento de similar ao JetA1 (combustível drop-in) baseado em matérias-primas biogênicas, ou seja, bioquerosene de aviação. Cinco rotas para produção do bioquerosene de aviação (BioQAV) foram aprovadas pelo American Society for Testing and Materials (ASTM) até 2018, sendo a maior parte derivada de óleos vegetais, gorduras animais e óleo de cozinha residual. Portanto, este trabalho contribui para a visualização das rotas tecnológicas para produção do BIOQAV, utilizando os coprodutos (resíduos) da produção do biodiesel no Brasil. 

Ampullary cancers harbor ELF3 tumor suppressor gene mutations and exhibit frequent WNT dysregulation

The ampulla of Vater is a complex cellular environment from which adenocarcinomas arise to form a group of histopathologically heterogenous tumors. To evaluate the molecular features of these tumors, 98 ampullary adenocarcinomas were evaluated and compared to 44 distal bile duct and 18 duodenal adenocarcinomas. Genomic analyses revealed mutations in the WNT signaling pathway among half of the patients and in all three adenocarcinomas irrespective of their origin and histological morphology. These tumors were characterized by a high frequency of inactivating mutations of ELF3, a high rate of microsatellite instability, and common focal deletions and amplifications, suggesting common attributes in the molecular pathogenesis are at play in these tumors. The high frequency of WNT pathway activating mutation, coupled with small-molecule inhibitors of β-catenin in clinical trials, suggests future treatment decisions for these patients may be guided by genomic analysis

Arginine or Hypertonic Saline-Stimulated Copeptin to Diagnose AVP Deficiency

BACKGROUND Distinguishing between arginine vasopressin (AVP) deficiency and primary polydipsia is challenging. Hypertonic saline-stimulated copeptin has been used to diagnose AVP deficiency with high accuracy but requires close sodium monitoring. Arginine-stimulated copeptin has shown similar diagnostic accuracy but with a simpler test protocol. However, data are lacking from a head-to-head comparison between arginine-stimulated copeptin and hypertonic saline-stimulated copeptin in the diagnosis of AVP deficiency. METHODS In this international, noninferiority trial, we assigned adult patients with polydipsia and hypotonic polyuria or a known diagnosis of AVP deficiency to undergo diagnostic evaluation with hypertonic-saline stimulation on one day and with arginine stimulation on another day. Two endocrinologists independently made the final diagnosis of AVP deficiency or primary polydipsia with use of clinical information, treatment response, and the hypertonic-saline test results. The primary outcome was the overall diagnostic accuracy according to prespecified copeptin cutoff values of 3.8 pmol per liter after 60 minutes for arginine and 4.9 pmol per liter once the sodium level was more than 149 mmol per liter for hypertonic saline. RESULTS Of the 158 patients who underwent the two tests, 69 (44%) received the diagnosis of AVP deficiency and 89 (56%) received the diagnosis of primary polydipsia. The diagnostic accuracy was 74.4% (95% confidence interval [CI], 67.0 to 80.6) for arginine-stimulated copeptin and 95.6% (95% CI, 91.1 to 97.8) for hypertonic saline-stimulated copeptin (estimated difference, -21.2 percentage points; 95% CI, -28.7 to -14.3). Adverse events were generally mild with the two tests. A total of 72% of the patients preferred testing with arginine as compared with hypertonic saline. Arginine-stimulated copeptin at a value of 3.0 pmol per liter or less led to a diagnosis of AVP deficiency with a specificity of 90.9% (95% CI, 81.7 to 95.7), whereas levels of more than 5.2 pmol per liter led to a diagnosis of primary polydipsia with a specificity of 91.4% (95% CI, 83.7 to 95.6). CONCLUSIONS Among adult patients with polyuria polydipsia syndrome, AVP deficiency was more accurately diagnosed with hypertonic saline-stimulated copeptin than with arginine-stimulated copeptin. (Funded by the Swiss National Science Foundation; CARGOx ClinicalTrials.gov number, NCT03572166.)

Implementation of coverage with evidence development schemes for medical devices : a decision tool for late technology adopter countries

Experiences with coverage with evidence development (CED) schemes are fairly limited in Central and Eastern European (CEE) countries, which are usually late adopters of new health technologies. Our aim was to put forward recommendations on how CEE health technology assessment bodies and payer organizations can apply CED to reduce decision uncertainty on reimbursement of medical devices, with a particular focus on transferring the structure and data from CED schemes in early technology adopter countries in Western Europe. Structured interviews on the practices and feasibility of transferring CED schemes were conducted and subsequently, a draft tool for the systematic classification of decision alternatives and recommendations was developed. The decision tool was reviewed in a focus group discussion and validated within a wider group of CEE experts in a virtual workshop. Transferability assessment is needed in case of (1) joint implementation of a CED scheme; (2) transferring the structure of an existing CED scheme to a CEE country; (3) reimbursement decisions that are linked to outcomes of an ongoing CED scheme in another country and (4) real-world evidence transferred from completed CED schemes. Efficient use of available resources may be improved by adequately transferring evidence and policy tools from early technology adopter countries

Potencial energético do biocarvão de pirólise a partir da borra de café / Energetic potential of the pyrolysis biochar from coffee grounds

O consumo de café, que é umas das bebidas mais ingeridas no Brasil e no mundo, gera grandes quantidades de borra de café, que é considerado como um resíduo, tanto no processo industrial quanto no consumo residencial. Essa quantidade só pode ser mensurada quando são considerados os processos de industrialização do café. Pode-se acumular 480 kg de resíduos (borra) para cada uma tonelada de café que foi industrializado. Essa biomassa mesmo após o processo de extração do óleo da borra, pode ser utilizado na indústria de alimentos, cosméticos e biocombustíveis, pois, possui componentes lignocelulósicos com um alto poder calorífico que o torna atraente como fonte energética sustentável. Através do processo de pirólise lenta foi produzido o biocarvão que pode ser utilizado como combustível para geração de energia térmica e elétrica. Neste trabalho foram utilizadas temperaturas de pirólise que variaram de 200 a 500 ºC com intervalos de 50 ºC. Os estudos calorimétricos determinaram que o poder calorifico superior (PCS) e o poder calorífico inferior (PCI) da borra de café forma de 21,92 MJ.kg-1 e 21,72 MJ.kg-1, respectivamente. Os poderes caloríficos mais elevados foram obtidos na pirólise a       350 ºC com 29,61 MJ.kg-1 para o PCS e 29,39 MJ.kg-1 para o PCI, sendo assim 35% superiores aos PC da borra.  Assim sendo a borra de café e o biocarvão da borra do café podem ser utilizados como combustíveis sólidos sustentáveis para fornos, fornalhas e caldeiras, evitando o seu destaque em aterros.