Situations difficiles quotidiennes des proches aidants de personnes atteintes de démence vivant à domicile: une étude qualitative

Les proches aidants jouent un rôle important dans la prise en charge à domicile des personnes atteintes de démence dont 50% vivent à domicile avec le soutien d’un proche aidant. Avec le temps, ce rôle peut devenir pénible pour le proche aidant qui risque de s’épuiser

Treatment And Follow-Up Guidelines For Multiple Brain Metastases: A Systematic Review

Brain metastases are a complication of primary cancer, representing the most common type of brain tumor in adults. The management of multiple brain metastases represents a clinical challenge worldwide in finding the optimal treatment for patients considering various individual aspects. Managing multiple metastases with stereotactic radiosurgery (SRS) is being increasingly used because of quality of life and neurocognitive preservation, which do not present such good outcomes when dealt with whole brain radiation therapy (WBRT). After treatment, analyzing the progression of the disease still represents a clinical issue, since it is difficult to determine a standard schedule for image acquisition. A solution could be the applying artificial intelligence, namely predictive models to forecast the incidence of new metastases in post-treatment images. Although there aren't many works on this subject, this could potentially bennefit medical professionals in early decision of the best treatment approache

Multilingual Natural Language Processing Model for Radiology Reports -- The Summary is all you need!

The impression section of a radiology report summarizes important radiology findings and plays a critical role in communicating these findings to physicians. However, the preparation of these summaries is time-consuming and error-prone for radiologists. Recently, numerous models for radiology report summarization have been developed. Nevertheless, there is currently no model that can summarize these reports in multiple languages. Such a model could greatly improve future research and the development of Deep Learning models that incorporate data from patients with different ethnic backgrounds. In this study, the generation of radiology impressions in different languages was automated by fine-tuning a model, publicly available, based on a multilingual text-to-text Transformer to summarize findings available in English, Portuguese, and German radiology reports. In a blind test, two board-certified radiologists indicated that for at least 70% of the system-generated summaries, the quality matched or exceeded the corresponding human-written summaries, suggesting substantial clinical reliability. Furthermore, this study showed that the multilingual model outperformed other models that specialized in summarizing radiology reports in only one language, as well as models that were not specifically designed for summarizing radiology reports, such as ChatGPT.Comment: Problems with the mode

QUALIDADE DE VIDA E DOENÇA DE CHAGAS: DESAFIOS E PERSPECTIVAS PARA OS ACOMETIDOS

Introdução: A Doença de Chagas (DC) é uma doença tropical causada pelo agente etiológico Trypanosoma cruzi. A infecção ocorre silenciosamente, propiciando o desenvolvimento da fase crônica da doença. Dessa forma, os acometidos precisam se ajustar às condições da enfermidade, o que pode impactar em sua qualidade de vida. Objetivo: Analisar como a Doença de Chagas afeta a qualidade de vida dos indivíduos acometidos por essa patologia. Metodologia: É um estudo descritivo, utilizando a revisão integrativa da literatura como método de pesquisa. A busca por artigos foi realizada nas bases de dados eletrônicas PubMed, BVS e SciELO, utilizando os seguintes descritores: "Doença de Chagas", "Qualidade de Vida", "Doentes" e termos relacionados. Resultado: A análise dos artigos evidenciou que os principais afetados pela DC foram os grupos de baixa renda, da zona rural, mulheres e idosos. Maus hábitos de vida como o sedentarismo e o tabagismo influenciam na qualidade de vida. Da mesma forma, as esferas sociais e psicológicas também foram afetadas. Conclusão: a DC impacta a qualidade de vida de seus portadores nas esferas física, social e psicológica. Assim, é necessária a busca pela visibilidade dessa condição, expondo a falta de informação e detalhamento sobre os danos causados por essa comorbidade.&nbsp

LOCUS (LOng Covid-Understanding Symptoms, events and use of services in Portugal): A three-component study protocol

Study ProtocolApproximately 10% of patients experience symptoms of Post COVID-19 Condition (PCC) after a SARS-CoV-2 infection. Akin acute COVID-19, PCC may impact a multitude of organs and systems, such as the cardiovascular, respiratory, musculoskeletal, and neurological systems. The frequency and associated risk factors of PCC are still unclear among both community and hospital settings in individuals with a history of COVID-19. The LOCUS study was designed to clarify the PCC’s burden and associated risk factors. LOCUS is a multi-component study that encompasses three complementary building blocks. The “Cardiovascular and respiratory events following COVID-19” component is set to estimate the incidence of cardiovascular and respiratory events after COVID-19 in eight Portuguese hospitals via electronic health records consultation. The “Physical and mental symptoms following COVID-19” component aims to address the community prevalence of self-reported PCC symptoms through a questionnaire-based approach. Finally, the "Treating and living with Post COVID-19 Condition" component will employ semi-structured interviews and focus groups to characterise reported experiences of using or working in healthcare and community services for the treatment of PCC symptoms. This multi-component study represents an innovative approach to exploring the health consequences of PCC. Its results are expected to provide a key contribution to the optimisation of healthcare services design.This study is sponsored by Pfizer (grant code #68639655).info:eu-repo/semantics/publishedVersio

COMPARATIVE EVALUATION OF SKIN SUTURE IN RATS WITH POLYGLYCAPRONE 25 AND NYLON

ABSTRACT Currently, the market offers a wide variety of suture threads, made of materials with different structural and chemical properties. Among many other characteristics, they vary in origin, absorption or degradation, and structure. From this variety, the clinical doubt arises as to which material provides the patient with the best healing quality. Objective: This study aims to comparatively evaluate two different types of suture threads-Monocryl® (polyglycaprone 25) and Ethilon® (nylon)-regarding their ability to aid in tissue regeneration by a histological and immunohistochemical analysis of the skin of rats sutured with the aforementioned materials. Methods: This basic experimental study used 12 adult Wistar rats, randomly divided into three groups with four animals each and subjected to four longitudinal incisions under anesthesia. Each group corresponded to a postsurgical evaluation date (one, seven, and 14 days). Results: At 14 postoperative days, the studied groups had no histological difference. However, the use of nylon thread showed greater evidence of earlier fibrotic union. Conclusion: This study found no histological difference in healing 14 days after surgery among the techniques and the types of suture threads. Level of Evidence II, Therapeutic Studies

Wellbore integrity in a saline aquifer : experimental steel-cement interface degradation under supercritical CO2 conditions representative of Brazil’s Parana basin

From our work, significant progress has been made in understanding the degradation of cement-casing systems. The CO2 degradation process was evaluated in specimens with a large interfacial defect, such as large annular spaces, voids and/or channels, which may be the result of a poor cementing job. From the experiments showing no interfacial defect, no signs of degradation were observed, while from experiments showing interfacial defect, both the cement and steel undergo significant degradation. In the well casing, the CO2-rich brine affects the steel phase, leaching Fe2+ ions into solution and promoting FeCO3 precipitation on the material surface, while on the cement sheath, two processes are occurring: (i) the portlandite dissolution and (ii) the cement carbonation process. Then, iron (Fe2+) starts to migrate into the cement structure, compromising the material’s self-healing and pore-blocking features, while calcium (Ca2+) starts to compose the corrosion film from the formation of mixed carbonates (FexCayCO3) so reducing the corrosion layer’s protection. Finally, both ions (Ca2+ and Fe2+) become so abundant in the material vicinity that they may form calcium carbonate (CaCO3) on the corrosion layer and iron carbonate (FeCO3) in the cement matrix. Thus, from our results, the degradation mechanisms of the cement-casing system in CO2-rich brine was revised

DILEMAS DA EPISTEMOLOGIA AMBIENTAL

The perception crisis as part of the scientific knowledge crisis is expanded by inversions caused by merchandise development. They are interdependent dimensions of the environmental epistemology dilemmas which have been analyzed in this study, such as the customization of goods and the reification of people. These and other inversions obstruct the understanding of essential aspects relating to the current environmental issues, arising from a particular development model driven by production and consumption. Environmental epistemology is part of a science driven by the permanent conflict due to the inversion that maintains the inverted reality since the development of merchandise. Such science constitutes itself through interdisciplinary exercise, having in knowledge dialogue its own dynamism.A crise de percepção como parte da crise do conhecimento científico é expandida pelas inversões provocadas pelo desenvolvimento da mercadoria. São dimensões interdependentes dos dilemas da epistemologia ambiental analisadas por este texto, tais como a personalização das mercadorias e a coisificação das pessoas. Essas e outras inversões obstaculizam a compreensão de aspectos imprescindíveis, referentes à questão ambiental atual, advindos de um determinado modelo de desenvolvimento impulsionado pela produção e pelo consumo. A epistemologia ambiental é parte de uma ciência impulsionada pela conflituosidade permanente devido à inversão que mantém a realidade invertida desde o desenvolvimento da mercadoria. Tal ciência se constitui por intermédio do exercício interdisciplinar tendo no diálogo dos saberes o seu dinamismo

PERSPECTIVAS TECNOLÓGICAS PARA O ENVELHECIMENTO POPULACIONAL: O BENEFÍCIO DA INTELIGÊNCIA ARTIFICIAL EM IDOSOS

The increase in global life expectancy brings with it the growing challenge of population aging, marked by the increase in chronic diseases such as dementia and cancer, demanding personalized medical care. At the same time, there is a worrying trend towards a reduction in physical activity levels and an increase in sedentary lifestyle, influenced by public policies, social support and individual, cultural and environmental factors. The social and psychological impact of aging, including loneliness in old age, highlights the need for innovative interventions such as the use of educational robotic technologies, such as "RoboLS", which aim to improve the physical and mental health of the elderly. Advances in clinical artificial intelligence and socially assistive robotics are also explored as promising tools to support healthy aging and improve social interaction among older. OBJECTIVE: Analyze and highlight technological perspectives to promote healthy aging in the population. METHODOLOGY: This study reviewed articles published between 2018 and 2023, obtained from the PubMed database using descriptors such as Artificial Intelligence, Aging and technology. 16 articles were selected from a total of 63 initially found, after applying inclusion criteria that considered complete studies in Portuguese, English, Spanish or French, including reviews and meta-analyses relevant to the research. RESULTS: The studies highlight significant advances in the application of technologies such as Social Assistance Robots (SARs) and artificial intelligence (AI) programs to improve the quality of life of the elderly. Telemonitoring and the use of advanced sensors have proven effective in managing chronic diseases and early detection of adverse events. SARs equipped with tactile and light sensors promoted beneficial social interactions, reducing the burden on caregivers. However, challenges such as cultural adaptation and patient safety remain critical to the widespread acceptance of these technologies. Personalization of care and ethical algorithm development are essential to maximizing the potential of AI and robotics-based solutions in elderly care. CONCLUSION: Recent advances in AI for elderly care are highlighted by the implementation of SARs, which improve health and quality of life, although they face technical and ethical challenges in their continued acceptance and effectiveness.O aumento da expectativa de vida global traz consigo o desafio crescente do envelhecimento populacional, marcado pelo aumento das doenças crônicas como demência e câncer, demandando cuidados médicos personalizados. Paralelamente, observa-se uma tendência preocupante de redução nos níveis de atividade física e aumento do sedentarismo, influenciados por políticas públicas, apoio social e fatores individuais, culturais e ambientais. O impacto social e psicológico do envelhecimento, incluindo a solidão na terceira idade, ressalta a necessidade de intervenções inovadoras como o uso de tecnologias robóticas educativas, como o "RoboLS", que visam melhorar a saúde física e mental dos idosos. Avanços na inteligência artificial clínica e robótica socialmente assistencial também são explorados como ferramentas promissoras para apoiar o envelhecimento saudável e melhorar a interação social entre os idosos. OBJETIVO: Analisar e destacar as perspectivas tecnológicas para promover um envelhecimento saudável na população. METODOLOGIA: Este estudo revisou artigos publicados entre 2018 e 2023, obtidos da base de dados PubMed usando descritores como Inteligência Artificial, Envelhecimento e tecnologia. Foram selecionados 16 artigos de um total de 63 inicialmente encontrados, após aplicação de critérios de inclusão que consideraram estudos completos em português, inglês, espanhol ou francês, incluindo revisões e meta-análises relevantes para a pesquisa. RESULTADOS: Os estudos destacam avanços significativos na aplicação de tecnologias como os Robôs de Assistência Social (SARs) e programas de inteligência artificial (IA) para melhorar a qualidade de vida dos idosos. O telemonitoramento e o uso de sensores avançados mostraram-se eficazes na gestão de doenças crônicas e na detecção precoce de eventos adversos. SARs equipados com sensores táteis e de luz promoveram interações sociais benéficas, reduzindo o fardo dos cuidadores. No entanto, desafios como a adaptação cultural e a segurança dos pacientes continuam a ser críticos para a aceitação generalizada dessas tecnologias. A personalização dos cuidados e o desenvolvimento ético de algoritmos são essenciais para maximizar o potencial das soluções baseadas em IA e robótica no cuidado aos idosos. CONCLUSÃO: Recentes avanços na IA para cuidados com idosos destacam-se pela implementação de SARs, que melhoram saúde e qualidade de vida, embora enfrentem desafios técnicos e éticos em sua aceitação e eficácia contínuas

Practical Science and Environmental Education Workshop in Manaus, Brazil

It is an unequivocal fact that Amazonian tropical forest is the largest remaining primary forest in the world. The ecosystem in the region is e tremely comple with high biodiversity (Peres et al. 2010). Conservation and protection of the dynamic forest and river regions is e tremely important not only for the natural environments, but also for the economy and social dependence of benefits from such abundant natural environments. Important natural parameters that affect status of the natural environments include light (natural sunlight), soil, and water, which abundantly e ist in the Amazon region. Solar energy is the primary energy source for the majority of living organisms in both terrestrial and aquatic ecosystems, and drives the diurnal and seasonal cycles of biogeochemical processes (Monteith & Unsworth 2013). In particular, in situ light data remains one of the most underappreciated data measurements although having a significant impact on the physical, chemical and biological processes in the ecosystem (Johnsen 2012). Soil provides the fundamental basis for all terrestrial living organisms including the Amazonian forests as well as life-sustaining infrastructure for human society. Water is the most essential single entity to constitute all organisms from a single cell to the earth. Understanding of importance and roles of each factor and interaction of such comple dynamics in the natural environments can serve as fundamental platform for natural scientists, particularly for young scientists such as university students. The objective of this workshop was to provide hand- on scientific and environmental education for university students in Manaus, Amazonas, Brazil through practical field measurements using the three most important parameters in the natural ecosystem composed of natural sunlight, soil, and water. The workshop was divided into a series of lectures, in situ field sampling, and data processing, analysis and interpretation with the ultimate goal of empowering the undergraduate students with research-centered environmental education and e perience of developing international collaboration.departmental bulletin pape