The importance of simulation in team training on obstetric emergencies: results of the first phase of the national plan for continuous medical training

As emergências obstétricas são eventos raros e inesperados. O modelo tradicional para a formação médica nestes eventos críticos apresenta limitações óbvias. Dada a variedade de competências técnicas e o ambiente de alto risco em que são aplicadas, a obstetrícia é uma especialidade que se adequa totalmente ao treino através de técnicas ou tecnologias aplicadas à Medicina ou Obstetrícia. Este modelo de aprendizagem constitui uma oportunidade para aprender e treinar competências técnicas simples e complexas, bem como a oportunidade para ensaiar e aprender com os erros, sem riscos para os doentes. Assim, elaborámos um estudo com o objectivo de avaliar a percepção dos formandos relativamente a quais os factores associados à falibilidade humana antes e após a formação clínica com simulação; comparar o nível de confiança para a resolução de situações emergentes obstétricas entre internos e especialistas com mais de 5 anos de experiência, antes e após uma acção formativa em gestão de eventos críticos de Obstetrícia; determinar o valor atribuído pelos formandos à simulação como instrumento formativo em cuidados emergentes. Nesta fase do programa, correspondente às 3 primeiras sessões formativas em gestão de eventos críticos de Obstetrícia, participaram 31 médicos. Após a acção formativa, verificaram-se alterações na percepção dos formandos relativamente a quais os factores associados à falibilidade humana, no nível de confiança para a resolução de situações emergentes obstétricas e no valor atribuído pelos formandos à simulação como recurso pedagógico

Aerothermodynamic Analysis of a Reentry Brazilian Satellite

This work deals with a computational investigation on the small ballistic reentry Brazilian vehicle SARA (acronyms for SAt\'elite de Reentrada Atmosf\'erica). Hypersonic flows over the vehicle SARA at zero-degree angle of attack in a chemical equilibrium and thermal non-equilibrium are modeled by the Direct Simulation Monte Carlo (DSMC) method, which has become the main technique for studying complex multidimensional rarefied flows, and that properly accounts for the non-equilibrium aspects of the flows. The emphasis of this paper is to examine the behavior of the primary properties during the high altitude portion of SARA reentry. In this way, velocity, density, pressure and temperature field are investigated for altitudes of 100, 95, 90, 85 and 80 km. In addition, comparisons based on geometry are made between axisymmetric and planar two-dimensional configurations. Some significant differences between these configurations were noted on the flowfield structure in the reentry trajectory. The analysis showed that the flow disturbances have different influence on velocity, density, pressure and temperature along the stagnation streamline ahead of the capsule nose. It was found that the stagnation region is a thermally stressed zone. It was also found that the stagnation region is a zone of strong compression, high wall pressure. Wall pressure distributions are compared with those of available experimental data and good agreement is found along the spherical nose for the altitude range investigated.Comment: The paper will be published in Vol. 42 of the Brazilian Journal of Physic

Stir Casting Routes for Processing Metal Matrix Syntactic Foams: A Scoping Review

Metal matrix syntactic foams (MMSFs) are advanced lightweight materials constituted by a metallic matrix and a dispersion of hollow/porous fillers. Physical and mechanical properties can be fitted regarding matrix and filler properties and processing parameters. Their properties make them potential materials for sectors where density is a limiting parameter, such as transport, marine, defense, aerospace, and engineering applications. MMSFs are mainly manufactured by powder metallurgy, infiltration, and stir casting techniques. This study focuses on the current stir casting approaches and on the advances and deficiencies, providing processing parameters and comparative analyses on porosity and mechanical properties. PRISMA approaches were followed to favor traceability and reproducibility of the study. Stir casting techniques are low-cost, industrially scalable approaches, but they exhibit critical limitations: buoyancy of fillers, corrosion of processing equipment, premature solidification of molten metal during mixing, cracking of fillers, heterogeneous distribution, and limited incorporation of fillers. Six different approaches were identified; four focus on limiting buoyancy, cracking, heterogeneous distribution of fillers, and excessive oxidation of sensitive matrix alloys to oxygen. These improvements favor reaching the maximum porosity of 54%, increasing the fillers size from a few microns to 45 mm, reducing residual porosity by ±4%, synthesizing bimodal MMSFs, and reaching maximum incorporation of 74 vol%.</jats:p

The use of biomimetic surfaces to reduce single- and dual-species biofilms of Escherichia coli and Pseudomonas putida

The ability of bacteria to adhere to and form biofilms on food contact surfaces poses serious challenges, as these may lead to the cross-contamination of food products. Biomimetic topographic surface modifications have been explored to enhance the antifouling performance of materials. In this study, the topography of two plant leaves, Brassica oleracea var. botrytis (cauliflower, CF) and Brassica oleracea capitate (white cabbage, WC), was replicated through wax moulding, and their antibiofilm potential was tested against single- and dual-species biofilms of Escherichia coli and Pseudomonas putida. Biomimetic surfaces exhibited higher roughness values (SaWC = 4.0 ± 1.0 μm and SaCF = 3.3 ± 1.0 μm) than the flat control (SaF = 0.6 ± 0.2 μm), whilst the CF surface demonstrated a lower interfacial free energy (ΔGiwi) than the WC surface (−100.08 mJ m−2 and −71.98 mJ m−2, respectively). The CF and WC surfaces had similar antibiofilm effects against single-species biofilms, achieving cell reductions of approximately 50% and 60% for E. coli and P. putida, respectively, compared to the control. Additionally, the biomimetic surfaces led to reductions of up to 60% in biovolume, 45% in thickness, and 60% in the surface coverage of single-species biofilms. For dual-species biofilms, only the E. coli strain growing on the WC surface exhibited a significant decrease in the cell count. However, confocal microscopy analysis revealed a 60% reduction in the total biovolume and surface coverage of mixed biofilms developed on both biomimetic surfaces. Furthermore, dual-species biofilms were mainly composed of P. putida, which reduced E. coli growth. Altogether, these results demonstrate that the surface properties of CF and WC biomimetic surfaces have the potential for reducing biofilm formation

Intra and Inter-Population Morphological Variation of Shape and Size of the Chilean Magnificent Beetle, Ceroglossus chilensis in the Baker River Basin, Chilean Patagonia

The alteration of habitat generates different degrees of stress in insects. It has been suggested that the degrees of phenotypic disturbances reflect the ability of an individual to overcome the effects of stress. The Baker River Basin in the Aysén Region, Chilean Patagonia has a very fragmented landscape, due to the destruction of the native forest and the use of land for agriculture and animal husbandry. This alteration should generate different degrees of disturbances in the insect communities, whose effects may be quantified by geometric morphometric tools. We analyzed morphological differences in 244 males and 133 females of the the Chilean magnificent beetle, Ceroglossus chilensis (Eschscholtz) (Coleoptera: Carabidae) collected in January, 2007, in mixed forests of Nothofagus dombeyi Mirbel (Ørsted) (Fagales: Nothofagaceae) and N. nitida Hofmus and in Second-growth forest of N. pumilio (Poepp. & Endl.) Krasser. Males were generally wider in the pronotum, while females had wider abdominal sternites. Although there were significant differences in shape and size between mature forests and second-growth forest, these were less significant among the sites within each type of vegetal formation. Individuals had more shape variations in the mature forest. We suggest that differences in shape are due at least in part to the isolation of the habitat. The differences found between sexes raises the question of how morphological variations and sexual dimorphism may be affected spatially by natural selection

Migrations and habitat use of the smooth hammerhead shark (Sphyrna zygaena) in the Atlantic Ocean

The smooth hammerhead shark, Sphyrna zygaena, is a cosmopolitan semipelagic shark captured as bycatch in pelagic oceanic fisheries, especially pelagic longlines targeting swordfish and/or tunas. From 2012 to 2016, eight smooth hammerheads were tagged with Pop-up Satellite Archival Tags in the inter-tropical region of the Northeast Atlantic Ocean, with successful transmissions received from seven tags (total of 319 tracking days). Results confirmed the smooth hammerhead is a highly mobile species, as the longest migration ever documented for this species (> 6600 km) was recorded. An absence of a diel vertical movement behavior was noted, with the sharks spending most of their time at surface waters (0-50 m) above 23 degrees C. The operating depth of the pelagic long-line gear was measured with Minilog Temperature and Depth Recorders, and the overlap with the species vertical distribution was calculated. The overlap is taking place mainly during the night and is higher for juveniles (similar to 40% of overlap time). The novel information presented can now be used to contribute to the provision of sustainable management tools and serve as input for Ecological Risk Assessments for smooth hammerheads caught in Atlantic pelagic longline fisheries.Oceanario de Lisboa through Project "SHARK-TAG: Migrations and habitat use of the smooth hammerhead shark in the Atlantic Ocean"; Investigador-FCT from the Portuguese Foundation for Science and Technology (FCT, Fundacao para a Ciencia e Tecnologia) [Ref: IF/00253/2014]; EU European Social Fund; Programa Operacional Potencial Human

Study of radiactivity on Arctic marine seaweed from Kongsfjorden (Svalbard)

Levels of natural and anthropogenic radionuclides have been determined in six brown and red seaweed species from Arctic coasts (Kongsfjorden, Spitsbergen, Svalbard Islands) in order to characterize the radioactivity in this ecosystem. Samples were collected in September 2014, August 2017 and July 2019. Levels of 7Be, 40K, 208Tl, 210Pb, 226Ra and 228Ra were measured by high-resolution gamma spectrometry. While anthropogenic radionuclides (1 4 C and 1 2 9 I) were determined by low-energy accelerator mass spectrometry (LEAMS). The activities of 129I are two orders of magnitude higher than those found in algae collected on the Spanish Atlantic Coast and presents more variability than the 14C results, indicating their different affinity to this element depending on the species. Radionuclide tracers discharged from Sellafield and La Hague are transported into the Arctic Ocean where they circulate at different depth levels, marking water of Atlantic origin (Karcher et al., 2012).Universidad de Málaga. Campus de Excelencia Internacional Andalucía Tech. Proyecto CGL2015/67014

A New Chanidae (Ostariophysii: Gonorynchiformes) from the Cretaceous of Brazil with Affinities to Laurasian Gonorynchiforms from Spain

Based on specimens originally referred to as “Dastilbe minor”, a nomem-nudum, we describe a new genus of Chanidae †Nanaichthys longipinnus nov. gen. and sp. which exhibits several diagnostic characters such as the absence of orbitosphenoid and basisphenoid, anteriorly displaced quadrate-mandibular articulation, laterally expanded supraneurals, an acute angle between the preopercular limbs, expansion at the angle between the preopercular limbs, and a curved maxillary articular process. Its occurrence and supposed relationship within the Chanidae reinforce the influence of the Mediterranean Tethys over the Gondwanan main rift system prior to the Aptian/Albian highstands

Radiographers supporting radiologists in the interpretation of screening mammography: a viable strategy to meet the shortage in the number of radiologists.

BackgroundAn alternative approach to the traditional model of radiologists interpreting screening mammography is necessary due to the shortage of radiologists to interpret screening mammograms in many countries.MethodsWe evaluated the performance of 15 Mexican radiographers, also known as radiologic technologists, in the interpretation of screening mammography after a 6 months training period in a screening setting. Fifteen radiographers received 6 months standardized training with radiologists in the interpretation of screening mammography using the Breast Imaging Reporting and Data System (BI-RADS) system. A challenging test set of 110 cases developed by the Breast Cancer Surveillance Consortium was used to evaluate their performance. We estimated sensitivity, specificity, false positive rates, likelihood ratio of a positive test (LR+) and the area under the subject-specific Receiver Operating Characteristic (ROC) curve (AUC) for diagnostic accuracy. A mathematical model simulating the consequences in costs and performance of two hypothetical scenarios compared to the status quo in which a radiologist reads all screening mammograms was also performed.ResultsRadiographer's sensitivity was comparable to the sensitivity scores achieved by U.S. radiologists who took the test but their false-positive rate was higher. Median sensitivity was 73.3 % (Interquartile range, IQR: 46.7-86.7 %) and the median false positive rate was 49.5 % (IQR: 34.7-57.9 %). The median LR+ was 1.4 (IQR: 1.3-1.7 %) and the median AUC was 0.6 (IQR: 0.6-0.7). A scenario in which a radiographer reads all mammograms first, and a radiologist reads only those that were difficult for the radiographer, was more cost-effective than a scenario in which either the radiographer or radiologist reads all mammograms.ConclusionsGiven the comparable sensitivity achieved by Mexican radiographers and U.S. radiologists on a test set, screening mammography interpretation by radiographers appears to be a possible adjunct to radiologists in countries with shortages of radiologists. Further studies are required to assess the effectiveness of different training programs in order to obtain acceptable screening accuracy, as well as the best approaches for the use of non-physician readers to interpret screening mammography