Diabetes immersion training as teaching method to medical practitioners

Este estudo avaliou a eficácia do método de ensino teórico e prático sobre diabetes e a atitude de profissionais médicos quanto à realização de controle glicêmico intensivo. Participaram de um curso de imersão em diabetes, com dois dias de duração, 48 médicos-residentes de clínica médica ou endocrinologia. Os participantes receberam treinamento de monitorização de glicemia capilar, técnicas de aplicação de insulina e contagem de carboidratos, sendo orientados a se portarem como diabéticos e a seguir prescrição médica individual. Foram avaliados através de questionários. No questionário de conhecimentos, observou-se um aumento significante de 12% no índice de acertos entre o início e o final do curso (61,2% e 73,2%, respectivamente, com p < 0,0001). Antes do curso, 70,8% dos participantes diziam ter dificuldades na contagem de carboidratos e 89,6%, na automonitorização glicêmica. Após a experiência prática, 82,9% dos participantes encontraram dificuldades na realização de contagem de carboidratos e 80,8%, na automonitorização; 40,4% fizeram uso de todas as medicações prescritas e 36,1% monitorizaram todas as glicemias. Os resultados deste estudo mostram que esse tipo de curso é eficaz para a aquisição de conhecimentos e contribui com a sensibilização do profissional médico quanto às dificuldades cotidianas enfrentadas pelo portador de diabetes melito na aderência às recomendações.This study evaluated the effectiveness of theoretical and practical teaching method in diabetes and doctors' position about feasibility of intensive blood glucose control. Forty-eight internal medicine or endocrinology residents participated in a two-day diabetes immersion course. The participants received training on self-blood glucose monitoring, techniques of insulin administration and carbohydrate counting. They were also instructed to behave as patients with diabetes and to follow individual medical prescription. They were assessed through questionnaires. In knowledge assessment, a significant increase of 12% was observed between the beginning and the end of the course (61.2% and 73.2%, respectively, with p < 0.0001). Before the course, 70.8% and 89.6% of the participants believed there were complications in performing carbohydrate counting and blood glucose monitoring, respectively. After the experience, 82.9% of them had difficulties in carbohydrate counting and 80.8% in self-monitoring; 40.4% took all medications prescribed and 36.1% monitored blood glucose correctly. These results show that the methodology of this course is an effective way to disseminate knowledge and that it contributes to doctors becoming more sensitive to daily problems faced by patients with diabetes melito concerning the acceptance of medical recommendations

Crystal Reorientation and Amorphization Induced by Stressing Efficient and Stable P-I-N Vacuum-Processed MAPbI3 Perovskite Solar Cells

Herein, the long‐term stability of vacuum‐deposited methylammonium lead iodide (MAPbI3) perovskite solar cells (PSCs) with power conversion efficiencies (PCEs) of around 19% is evaluated. A low‐temperature atomic layer deposition (ALD) Al2O3 coating is developed and used to protect the MAPbI3 layers and the solar cells from environmental agents. The ALD encapsulation enables the MAPbI3 to be exposed to temperatures as high as 150 °C for several hours without change in color. It also improves the thermal stability of the solar cells, which maintain 80% of the initial PCEs after aging for ≈40 and 37 days at 65 and 85 °C, respectively. However, room‐temperature operation of the solar cells under 1 sun illumination leads to a loss of 20% of their initial PCE in 230 h. Due to the very thin ALD Al2O3 encapsulation, X‐ray diffraction can be performed on the MAPbI3 films and completed solar cells before and after the different stress conditions. Surprisingly, it is found that the main effect of light soaking and thermal stress is a crystal reorientation with respect to the substrate from (002) to (202) of the perovskite layer, and that this reorientation is accelerated under illumination

Sinonasal mucosal melanoma: Molecular profile and therapeutic implications from a series of 32 cases

BACKGROUND: Primary sinonasal mucosal melanomas are aggressive tumors with a poor clinical control by current treatments, raising the urgent need of novel strategies. METHODS: By fluorescence in situ hybridization (FISH), direct sequencing, and immunohistochemistry, we investigate the spectrum of molecular abnormalities in a cohort of 32 cases of primary sinonasal mucosal melanomas. RESULTS: We found that all primary sinonasal mucosal melanomas lack BRAF V600E mutation; in addition, they are characterized by somatic mutations of NRAS (22%) and KIT (12.5%), together with amplification of RREB1 (100%) and loss of MYB (76%). The large majority of cases showed KIT protein expression (96.9%). Among tumor suppressor genes, primary sinonasal mucosal melanomas showed loss of PTEN (48.1%) and p16/INK4a (55.2%). All tested cases showed expression of pAkt and pErk, suggesting a combined activation of PI3K/Akt and RAS-mitogen-activated protein kinase (MAPK) pathways. CONCLUSIONS: This molecular fingerprint strongly argues against the clinical efficacy of BRAF-inhibitors, but could candidate primary sinonasal mucosal melanomas to therapeutic strategies targeting RAS and KIT mutations or inhibiting PI3K-Akt-mTOR pathway

Enzymatic hydrolysis of raw and pre-treated Eucalyptus.

Ethanol from lignocellulosic biomass (LCB), such as agricultural and forest residues, is known as the second generation (2G) ethanol. Carbohydrate fractions in LCB (cellulose and hemicellulose) are not readily available for microbial fermentation and they need to be released by additional pre-treatment and hydrolysis operations. This process is intrinsically more difficult and costly. In this study the efficiency of enzymatic hydrolysis of the species Eucalyptus urophylla and the hybrid E. urophylla x E. grandis, submitted or not to alkaline pre-treatment with green liquor, has been evaluated. The hydrolysis was carried out with a enzymatic cocktail containing aggressive cellulases, high level of ?-glucosidases and hemicellulase at 6% (g enzyme/g solid), pH 5.0, 50 g.L-1 solids for 72 h, 45 °C and 250 rpm. The pre-treatment promoted disruption of the cellular structure of the samples, allowing easier accessibility for the enzymes and demonstrating higher effectiveness of enzymatic hydrolysis. The maximum efficiency of hydrolysis (81.3%) was observed for pretreated E. urophylla.SOLABIAA

Fatty Acid Characterization from Flowers of Tulipa Systola Stapf. Using Gas Chromatography-Mass Spectrometry (GC-MS)

The structural analysis of fatty acid mixtures by gas chromatography-mass spectrometry (GC-MS) has been characterized from Tulipa systola Stapf. Flowers, wild plant growing in Kurdistan region-Iraq. The fatty acids of the lipid fraction were mainly saturated fatty acids, the highest value recorded for isopropyl palmitic acid methyl ester (47.02%), glycerol α-palmitic acid methyl ester (19.66%) and stearic acid methyl ester (8.64%). In addition, two unsaturated fatty acids that characterized were oleic acid methyl ester (6.95%) and undecylenic acid methyl ester (2.22%)

Rainfall Erosivity: Gap-Filling Method Differences in the Brazilian Pantanal and Cerrado Biomes

To improve the use of soil and its conservation, precipitation data are necessary. With the Universal Soil Loss Equation (USLE), the study of historical precipitation series is a main factor, but in these series, there are gaps that need to be filled. This study had, as a basis, the methods of weighted likelihood, multiple regression, and weighted likelihood based on multiple regression to fill the gaps of the rainfall data for the rainfall gauges in the Brazilian biomes (Cerrado and Pantanal, municipalities of Campo Grande, Bandeirantes, Sidrolândia, Miranda, Fazenda Ponte, and Ribas do Rio Pardo). With this, it became possible to calculate the rainfall erosivity (R factor in the USLE). Therefore, the consistency of the filled rainfall data was analyzed by the double mass method. The value of the rainfall erosivity calculated varies from 2304.80 to 13562.10 MJ mm ha−1 h−1 year. With this data, it was possible to identify particular results that differed from the rainfall erosivity. Comparing all the gap-filling methods, numbers varying from 0–12% at the same rainfall gauge were obtained

Design and Vertical Tests of SPS-series Double-Quarter Wave (DQW) Cavity Prototypes for the HL-LHC Crab Cavity System

Crab crossing is essential for high-luminosity colliders. The High Luminosity Large Hadron Collider (HL-LHC) will equip one of its Interaction Points (IP1) with Double-Quarter Wave (DQW) crab cavities. A DQW cavity is a new generation of deflecting RF cavities that stands out for its compactness and broad frequency separation between fundamental and first high-order modes. The deflecting kick is provided by its fundamental mode. Each HL-LHC DQW cavity shall provide a nominal deflecting voltage of 3.4 MV, although up to 5.0 MV may be required. A Proof-of-Principle (PoP) DQW cavity was limited by quench at 4.6 MV. This paper describes a new, highly optimized cavity, designated DQW SPS-series, which satisfies dimensional, cryogenic, manufacturing and impedance requirements for beam tests at SPS and operation in LHC. Two prototypes of this DQW SPS-series were fabricated by US industry and cold tested after following conventional SRF surface treatment. Both units outperformed the PoP cavity, reaching a deflecting voltage of 5.3-5.9 MV. This voltage - the highest reached by a DQW cavity - is well beyond the nominal voltage of 3.4 MV and may even operate at the ultimate voltage of 5.0MVwith sufficient margin. This paper covers fabrication, surface preparation and cryogenic RF test results and implications

Filtro de tecnología sencilla y bajo costo para remoción de arsénico y flúor en agua

La exposición crónica al arsénico (As) favorece el desarrollo de enfermedades como hidroarsenicismo o HACRE, hipertensión y cáncer, especialmente de piel, pulmón y vejiga. Asimismo, el flúor (F) produce fluorosis esquelética y dental.Desde 2006 la Organización Mundial de la Salud (OMS) recomienda una concentración máxima de As en agua potable de 0,01 mg/L; mientras en Argentina el valor continúa en estudio, aceptando 0,05 mg/L (si bien el Código Alimentario Argentino (CAA) indica 0,01 mg/L). La concentración máxima de F recomendada por la OMS es 1,5 mg/L; mientras CAA la regula según la temperatura media de la región.Este trabajo se localiza en caseríos dispersos en el monte a los alrededores de San José de Boquerón (Santiago del Estero). La zona carece de servicios básicos como energía eléctrica o agua potable. Sus pobladores consumen agua de pozo contaminada con As y F.Se busca proveer una solución, mediante el desarrollo e implementación de un filtro sustentable, con materiales económicos, que permita disminuir el contenido de As y F en agua para consumo.El filtro propuesto consiste en 4 baldes plásticos de 20 L, 1 Kg de clavos, arena, carbón de hueso-leña y granza. Tras el filtrado del agua contaminada con este sistema, se cuantificaron concentraciones de: As entre 0,025-0,05 mg/L y F entre 0,73-0,98 mg/L, conteniendo inicialmente 0,25 y 3,1 mg/L, respectivamente. Así, se lograron tratar 140 L (en 7 batches) de agua apta para consumo. Se evidenció la necesidad de acompañamiento durante la implementación del dispositivo en la zona

Engineering Design and Prototype Fabrication of HOM Couplers for HL-LHC Crab Cavities

The High-Luminosity upgrade for the LHC relies on a set of RF Crab Cavities for reaching its goals. Two parallel concepts, the Double Quarter Wave (DQW) and the RF Dipole (RFD), are going through a comprehensive design process along with preparation of fabrication in view of extensive tests with beam in SPS. High Order Modes (HOM) couplers are critical in providing damping in RF cavities for operation in accelerators. HOM prototyping and fabrication have recently started at CERN. In this paper, an overview of the final shape is provided along with an insight in the mechanical and thermal analyses performed to validate the design of these critical components. Emphasis is also given to test campaigns, material selection, prototyping and initial fabrication that are aimed at fulfilling the highly demanding tolerances of the couplers