Update on the approach of urinary tract infection in childhood

AbstractObjectiveUrinary tract infection (UTI) is the most common bacterial infection in childhood. UTI may be the sentinel event for underlying renal abnormality. There are still many controversies regarding proper management of UTI. In this review article, the authors discuss recent recommendations for the diagnosis, treatment, prophylaxis, and imaging of UTI in childhood based on evidence, and when this is lacking, based on expert consensus.SourcesData were obtained after a review of the literature and a search of Pubmed, Embase, Scopus, and Scielo.Summary of the findingsIn the first year of life, UTIs are more common in boys (3.7%) than in girls (2%). Signs and symptoms of UTI are very nonspecific, especially in neonates and during childhood; in many cases, fever is the only symptom.ConclusionsClinical history and physical examination may suggest UTI, but confirmation should be made by urine culture, which must be performed before any antimicrobial agent is given. During childhood, the proper collection of urine is essential to avoid false‐positive results. Prompt diagnosis and initiation of treatment is important to prevent long‐term renal scarring. Febrile infants with UTIs should undergo renal and bladder ultrasonography. Intravenous antibacterial agents are recommended for neonates and young infants. The authors also advise exclusion of obstructive uropathies as soon as possible and later vesicoureteral reflux, if indicated. Prophylaxis should be considered for cases of high susceptibility to UTI and high risk of renal damage.ResumoObjetivoA infecção do trato urinário (ITU) é a infecção bacteriana mais comum na infância. A ITU pode ser o evento sentinela para alteração renal subjacente. Ainda há muitas controvérsias com relação ao tratamento adequado da ITU. Neste artigo de revisão, discutimos as últimas recomendações para diagnóstico, tratamento, profilaxia e imagiologia da ITU na infância, com base em comprovação e, na sua ausência, no consenso de especialistas.Fonte de dadosOs dados foram coletados após uma revisão da literatura e pesquisa no Pubmed, Embase, Scopus e Scielo.Resumo dos dadosNo primeiro ano de vida, as ITUs são mais comuns em meninos (3,7%) do que em meninas (2%). Os sinais e sintomas da ITU são muito inespecíficos, principalmente em neonatos e durante a infância. A febre é o único sintoma em muitos casos.ConclusõesO histórico clínico e exame físico podem sugerir ITU, porém a confirmação deve ser feita por urocultura. Antes da administração de qualquer agente antimicrobiano, deve ser feita coleta de urina. Durante a infância, a coleta de urina adequada é essencial para evitar resultados falso‐positivos. O diagnóstico e o início do tratamento imediatos são importantes na prevenção de cicatriz renal de longo prazo. Neonatos febris com ITUs devem ser submetidos a ultrassonografia renal e da bexiga, Agentes antibacterianos intravenosos são recomendados para neonatos e neonatos jovens. Recomendamos também a exclusão de uropatias obstrutivas o mais rapidamente possível e posterior refluxo vesico‐ureteral, caso indicado. A profilaxia deve ser considerada em casos de elevada susceptibilidade a ITU e risco elevado de danos renais

How can customer experience improve retail operations sustainability?

Trabalho apresentado em 3rd International Conference on Quality Innovation and Sustainability – ICQIS2022, 3-4 maio 2022, Aveiro, Portugal.Consumer needs drive supply chains, so they are arguably the main actors in the process. Nonetheless, consumers are unaware of their ability to con tribute to stock management and the sustainability of retail operations, from the reduction of stockouts and waste to the minimization of energy-environmental impacts, through the centralization of stock in distribution and consolidation of last mile delivery in pooling systems. For this to happen, companies must provide channels that allow consumers to actively participate in the process and negotiate delivery times and prices through sustainable purchase options, through a crowdsourcing strategy in phygital stores. This paper explores two alternative strategies, maintaining or changing the current physical retail business model, based on the increase in online commerce and the use of mobile devices and ap plications in the purchase process. The first is applied in physical stores in a gam ing context through a consumer-facing augmented reality mobile application that rewards users for identifying stockouts and informing the need to replace prod ucts in the shelves. The second involves the transformation of physical stores into a showroom format, where desired products are read through a QR Code or using artificial intelligence through a mobile application, in which virtual shopping carts are created and deliveries can be fulfilled via home distribution centers, col lection points or drive-inN/

Perceived ethical reputation: Scale development and validation

Ethical reputation reflects organizations’ commitment to ethics (Jaramillo, Grisaffe, Chonko, & Roberts, 2009; Mulki & Jaramillo, 2011), based on perceived occurrences of ethical problems (Armstrong, 1996) and ways organizations treat their employees and customers (Dawkins & Lewis, 2003). Having a favorable reputation may lead to favorable consequences, such as attracting higher-quality applicants, enhanced job attitudes, and increased employee ethical conduct (Fombrun & Shanley, 1990; Turban & Cable, 2003). However, a comprehensive measure to assess employees’ perceptions of the ethical reputation of their organizations is still missing. Therefore, the present study attempts to develop and validate such a measure. A pool of items reflecting the different dimensions of the construct was drawn from the existing literature on business ethics and organizational reputation. The relevance and clarity of those items was assessed by experts to assure content validity. In order to assess the psychometric characteristics of the scale, data are being collected via convenience sampling. The target sample comprises employees from organizations of different business sectors. Subsequently, analyses to determine construct validity and reliability will be performed. Results will be presented at the conference. The present research is expected to provide a new and useful tool for measuring ethical reputation of organizations, to be used in future research on the issue.info:eu-repo/semantics/publishedVersio

Comparison of solar radio and EUV synoptic limb charts during the present solar maximum

The present solar cycle is particular in many aspects: it had a delayed rising phase, it is the weakest of the last 100 years, and it presents two peaks separated by more than one year. To understand the impact of these characteristics on the solar chromosphere and coronal dynamics, images from a wide wavelength range are needed. In this work we use the 17~GHz radio continuum, formed in the upper chromosphere and the EUV lines 304 and 171~{\AA}, that come from the transition region (He II) and the corona (Fe IX, X), respectively. We analyze daily images at 304 and 171~{\AA} obtained by the Atmospheric Imaging Assembly (AIA). The 17~GHz maps were obtained by the Nobeyama Radioheliograph (NoRH). To construct synoptic limb charts, we calculated the mean emission of delimited limb areas with 100" wide and angular separation of $5^\circ$. At the equatorial region, the results show an hemispheric asymmetry of the solar activity. The northern hemisphere dominance is coincident with the first sunspot number peak, whereas the second peak occurs concurrently with the increase in the activity at the south. The polar emission reflects the presence of coronal holes at both EUV wavelengths, moreover, the 17~GHz polar brightenings can be associated with the coronal holes. Until 2013, both EUV coronal holes and radio polar brightenings were more predominant at the south pole. Since then they have not been apparent in the north, but thus appear in the beginning of 2015 in the south as observed in the synoptic charts. This work strengthens the association between coronal holes and the 17~GHz polar brightenings as it is evident in the synoptic limb charts, in agreement with previous case study papers. The enhancement of the radio brightness in coronal holes is explained by the presence of bright patches closely associated with the presence of intense unipolar magnetic fields.Comment: 6 pages, 5 figures. Acccepted for publication in Astronomy & Astrophysic

Piezoelectric actuators for bone mechanical stimulation: exploring the concept.

Arthroplasty is liable to cause intense changes on strain levels and distribution in the boné surrounding the implant, namely stress shielding. Several solutions have been proposed for this, namely design variations and development of controlled-stiffness implants. A new approach to this problem, with potential application to other orthopaedic problems and other medical fields, would be the development of smart implants integrating systems for bone mechanical stimulation. Ideally, the implant should presente sensing capability and the ability to maintain physiological levels of strain at the implant interface. Piezoelectric materials’ huge potential as a mean to produce direct mechanical stimulation lies on the possibility of producing stimuli at a high range of frequencies and in multiple combinations. The present in vitro and preliminary in vivo studies were a first step towards the validation of the concept

Angiotensin Converting Enzyme 2, Angiotensin-(1-7), and Receptor Mas Axis in the Kidney

In the past few years the understanding of the renin-angiotensin system (RAS) has improved, helping to better define the role of this system in physiological conditions and in human diseases. Besides Angiotensin (Ang) II, the biological importance of other Ang fragments was progressively evidenced. In this regard, Angiotensin- (Ang-) (1-7) was recognized as a biologically active product of the RAS cascade with a specific receptor, the G-protein-coupled receptor Mas, and that is mainly formed by the action of the angiotensin-converting enzyme (ACE) homolog enzyme, ACE2, which converts Ang II into Ang-(1-7). Taking into account the biological effects of these two mediators, Ang II and Ang-(1-7), the RAS can be envisioned as a dual function system in which the vasoconstrictor/proliferative or vasodilator/antiproliferative actions are primarily driven by the balance between Ang II and Ang-(1-7), respectively. In this paper, we will discuss our current understanding of the ACE2/Ang-(1-7)/Mas axis of the RAS in renal physiology and in the pathogenesis of primary hypertension and chronic kidney disease

Bone mechanical stimulation with piezoelectric materials

This chapter summarized explores in vivo use of a piezoelectric polymer for bone mechanical stimulatio

Water productivity and crop yield in five chickpea varieties – how important is supplemental irrigation?

Chickpea (Cicer arietinum L.) is one of the most important pulse crops in the world as a source of protein for human consumption. In Mediterranean regions, chickpea is traditionally grown as a rainfed crop, thus highly dependent on rainfall. In this situation, supplemental irrigation may be applied. The objective of our study was to evaluate the improvement in crop yield and water productivity with supplemental irrigation in five chickpea varieties (three kabuli type and two desi type) from the Portuguese breeding selection program. Field tests were carried out over two cropping seasons (2009, dry year and 2010, wet year), in Southern Portugal, using four irrigation treatments, full (100%) crop irrigation requirements(IR), 50 % of IR, 25 % of IR and rainfed. A significant increase in grain and shoot biomass yields was observed especially in dry years. Elixir (kabuli type) variety showed the highest grain and biomass yield, harvest index and water productivity. In the dry year, the highest water productivity for grain and biomass production was attained at the 50% and in the wet year in the rainfed treatment

Contextual determinants of HR professionals’ self-perceptions of unethical HRM practices

This study examined human resources (HR) professionals’ self-perceptions of ethically questionable human resource management (HRM) practices (i.e., a disregard for the individual, favoring those in power, and discrimination). The research sought specifically to determine how these perceptions are influenced by their organizations’ ethical infrastructure and corporate social responsibility (CSR) practices. Data were collected from 134 HR professionals using an anonymous structured questionnaire. The scope of organizations’ ethics programs and the degree of importance given to developing an ethical infrastructure were found to predict the level of acceptance of unethical HRM practices related to discrimination. These practices are also less acceptable to professionals from organizations that are perceived as more socially responsible regarding their employees. Additional studies with larger samples are needed to determine more clearly not only the influence of contextual determinants but also the practical consequences of high levels of acceptance of unethical practices in HRM. Organizations can decrease their HR professionals’ acceptance of ethically questionable HRM practices by developing and emphasizing a strong ethical infrastructure and CSR practices, especially those affecting employees. HR professionals’ perceptions of ethical issues have rarely been analyzed using empirically tested methods. By surveying HR professionals, this study contributes to a fuller understanding of their perceptions regarding the ethics of their own practices. The results show that contextual determinants play an important role in predicting the level of acceptance of unethical HRM practices, especially those leading to discrimination.info:eu-repo/semantics/publishedVersio

Nevo de Spitz e nevo de Reed

Spitz and Reed nevi, also called spindle and/or epithelioid cell nevi, are a special group of melanocytic lesions due to their peculiar clinical, dermoscopic and histopathological features. The study of these nevi is of great interest because both their nomenclature and classification are still a matter of discussion. Most importantly, the difficulty to differentiate them from melanoma can lead to inadequate therapies. In this context, dermoscopy, a link between clinical and anatomopathological examinations, appears as a helpful diagnostic tool whose accuracy can reach 93%. Borderline lesions are still a great challenge and object of research, including molecular studies. The present study explores the relevant characteristics of these nevi, with emphasis on dermoscopic findings, aiming at understanding their natural history, as well as discussing treatment and patient follow-up.Os nevos de Spitz e de Reed, ou também chamados nevos de células fusiformes e/ou epitelióides, formam um grupo especial de lesões melanocíticas, por suas características peculiares, tanto clínicas como dermatoscópicas e histopatológicas. Torna-se grande o interesse no estudo desses nevos, pois tanto a nomenclatura como a classificação ainda são motivos de debate e, sobretudo, a dificuldade de diferenciação com o melanoma pode gerar condutas terapêuticas inadequadas. Neste contexto, surge a dermatoscopia, elo entre o exame clínico e o anatomopatológico, como método diagnóstico auxiliar importante cuja acurácia pode chegar a 93%. A grande dificuldade ainda são as lesões borderline, motivo de pesquisas, incluindo estudos moleculares. O presente estudo aborda os aspectos relevantes das características destes nevos, com ênfase nos achados dermatoscópicos, buscando o entendimento da sua história natural, além da discussão quanto ao tratamento e seguimento dos pacientes.ABC School of MedicineUniversidade Federal de São Paulo (UNIFESP) Department of Pathology and DermatologyUNIFESP, Department of Pathology and DermatologySciEL