An evaluation of Multiple Endmember Spectral Mixture Analysis applied to Landsat 8 OLI images for mapping land cover in southern Africa\u27s Savanna.

Mapping land cover in southern Africa’s savannas using traditional pixel based remote sensing techniques can be very challenging due to the heterogeneity of its vegetation structure and the spectral difficulty in separating similar land covers across various land uses. In order to overcome these complications, a Multiple Endmember Spectral Mixture Analysis (MESMA) provides a potential remote sensing approach to quantify spectral variation in the physical environment at a subpixel level. The MESMA approach was applied in the study area of the Mayuni Conservancy, in Namibia. Results show that 32.3% of the study area is covered by photosynthetic vegetation (PV), 32.0% by non-photosynthetic vegetation (NPV), 25.2% by bare soil (B) and 10.6% by shade. Post-classification validation shows that MESMA presented a moderate performance in estimating the proportions of land cover types in the study area. However the validation process is limited to the available resources and carries great subjectivity. It is concluded that future research on the matter should include a more consistent investigation on the endmember selection methodology and expand the study area inside of the same ecosystem

A IMPORTÂNCIA DA SELAGEM IMEDIATA DA DENTINA: uma revisão narrativa da literatura

The Dentin Immediate Sealing (IDS) technique provides a better quality in direct and indirect restorations, seeking an improvement in the resistance of the adhesion forces between the restoration and the dentin structure, also decreasing the sensitivity and risks of contamination. A narrative and exploratory literature review was carried out on adherence to direct and indirect restorations, as the contamination occurs during the procedure and the Adhesive System materials, seeking to promote benefits to the patient and the dental structure. The keywords used were: Hybrid Layer, Adhesive Systems and Immediate dentin sealing, in Portuguese and English, from 2010 to 2020. IDS provides numerous advantages: protection against infiltration, reduction of risk for post-cementation sensitivity, decrease of the necessary anesthesia and better resistance to dental structure. The immediate sealing of the dentin is performed on freshly cut dentin, after removal of the caries, after removal of the restoration and after making preparations. It is indicated due to its reduction in dentin contamination, in cases of freshly cut dentins as this is the best time for good adhesion of the material and prevents bacterial, saliva and material contamination.La técnica de Inmediate Dentin Sealing (IDS) proporciona una mejor calidad en las restauraciones directas e indirectas, buscando una mejora en la resistencia de las fuerzas de unión entre la restauración y la estructura dentinaria, reduciendo también la sensibilidad y los riesgos de contaminación. Se realizó una revisión narrativa y exploratoria de la literatura sobre la adhesión en restauraciones directas e indirectas, cómo se produce la contaminación durante el procedimiento y los materiales del Sistema Adhesivo, buscando promover beneficios para el paciente y la estructura dental. Las palabras clave utilizadas fueron: Capa híbrida, Sistemas adhesivos y Sellado dentinario inmediato, en portugués e inglés, en el período de 2010 a 2020. El IDS ofrece numerosas ventajas: protección contra la infiltración, reducción del riesgo de sensibilidad post cementación, reducción de la anestesia necesaria y mejor resistencia de la estructura del diente. El sellado inmediato de la dentina se realiza en la dentina recién cortada, después de la eliminación de la caries, después de la eliminación de la restauración y después de las preparaciones. Está indicado por su reducción de la contaminación dentinaria, en casos de dentina recién cortada, ya que es el mejor momento para una buena adherencia del material y evita la contaminación bacteriana, saliva y del material.A técnica da Selagem Imediata da Dentina (IDS) proporciona uma qualidade melhor nas restaurações diretas e indiretas, buscando uma melhoria na resistência das forças de adesão entre a restauração e a estrutura dentinária, diminuindo também a sensibilidade e os riscos de contaminação. Foi realizada uma revisão de literatura narrativa e exploratória, sobre adesão nas restaurações diretas e indiretas, como ocorrem as contaminações durante o procedimento e os materiais de Sistema Adesivo, buscando promover benefícios ao paciente e a estrutura dentária. As palavras-chave utilizadas foram: Camada Híbrida, Sistemas adesivos e Selagem imediata da dentina, na língua portuguesa e inglesa, no período de 2010 a 2020. A IDS fornece inúmeras vantagens: proteção contra infiltração redução do risco para a sensibilidade pós cimentação, diminuição da anestesia necessária e melhor resistência estrutura dental. O selamento imediato da dentina é realizado em dentina recém cortada, após remoção da cárie, após remoção de restauração e após realização de preparos. Ela é indicada devido a sua redução da contaminação de dentina, em casos de dentinas recém cortada pois este é o melhor momento para uma boa adesão do material e evita a contaminação bacteriana, de saliva e de materiais.   Palavras chave: Restauração, Adesivos Dentinários, Camada Híbrida

Pessoas vivendo com HIV/Aids no Sudoeste Goiano: caracterização sociodemográfica, clínica e laboratorial no ano de 2018

Introdução: É significativo o número de pessoas vivendo com HIV (PVHIV) no Brasil, não se restringindo aos grandes centros, o que torna necessário entender as características clinicoepidemiológicas de cada região para que políticas públicas sejam estabelecidas de forma realística, prática e aplicável às suas peculiaridades. Objetivo: Caracterizar o perfil sociodemográfico, clínico e laboratorial das PVHIV que tiveram seu primeiro atendimento em um ambulatório do município de Jataí, Goiás, no ano de 2018. Método: Coletaram-se dados sociodemográficos, clínicos e laboratoriais de uma amostra de 80 prontuários de PVHIV atendidas em um ambulatório de Jataí, Goiás, no ano de 2018. Os dados foram analisados por estatística descritiva e inferencial. Resultados: Houve predomínio de homens (71,3%), idade de 16-35 anos (61,3%), solteiros (68,8%), heterossexuais (43,8%), com vínculo empregatício (70,0%) e o meio de exposição ao HIV foi pela relação sexual (97,5%). A herpes zoster se destacou como infecção oportunista (27,8%), a sífilis (76,9%) como outras infecções e o transtorno de ansiedade (30,0%) como comorbidade. Os homens, em relação às mulheres, associaram-se positivamente com o diagnóstico de outras infecções (p=0,0250) e com valores alterados para aspartato aminotransferase (p=0,0410). Já as PVHIV com atendimento por diagnóstico, em relação as por transferência/abandono, apresentaram associação positiva com a presença de carga viral detectável (p=0,0001) e circunferência abdominal adequada (p=0,0304). Conclusão: Em 2018, o atendimento para o recém diagnóstico predominou, bem como de adultos, homens, solteiros, heterossexuais e com vínculo empregatício. A herpes zoster e a sífilis foram as infecções mais presentes, o tipo de exposição ao HIV foi a relação sexual e os homens apresentaram alteração para a aspartato aminotransferase e maior presença de outras infecções. A carga viral detectável e a circunferência abdominal adequada estiveram mais presentes nos recém diagnosticados..Introduction: The number of people living with HIV (PLHIV) in Brazil is significant, and not restricted to large centers, which makes it necessary to understand the clinical and epidemiological characteristics of each region so that public policies can be established in a realistic, practical, and applicable way to the peculiarities of this disease. Objective: To characterize the sociodemographic, clinical, and laboratory profile of PLHIV who had their first consultation at an outpatient clinic in the city of Jataí, Goiás, in 2018. Methods: Sociodemographic, clinical, and laboratory data were collected from the medical records of a sample of 80 PLHIV attended at an outpatient clinic in Jataí, Goiás, in 2018. Data were analyzed using descriptive and inferential statistics. Results: There was a predominance of men (71.3%), aged 16-35 years (61.3%), single (68.8%), heterosexual (43.8%), employed (70.0%), and the route of exposure to HIV was through sexual intercourse (97.5%). Herpes zoster stood out as an opportunistic infection (27.8%), and syphilis (76.9%) as well as other infections and anxiety disorder (30.0%) as comorbidities. Men, compared to women, were positively associated with the diagnosis of other infections (p=0.0250) and with altered values for aspartate aminotransferase (p=0.0410). On the other hand, the PLHIV attended due to diagnosis, in relation to those due to transfer/abandonment, showed a positive association with the presence of detectable viral load (p=0.0001) and adequate abdominal circumference (p=0.0304). Conclusion: In 2018, consultations for newly diagnosed patients predominated, as well as for adults, men, single people, heterosexuals, and employed individuals. Herpes zoster and syphilis were the most common infections, the route of exposure to HIV was sexual intercourse, and men showed alterations in aspartate aminotransferase and a greater presence of other infections. Detectable viral load and adequate abdominal circumference were more present in newly diagnosed PLHIV

Medidas de mitigação ao atropelamento de fauna em rodovias federais concedidas no Brasil

O desenvolvimento socioeconômico de diversos paí­ses está relacionado   expansão e manutenção da infraestrutura rodoviária. No Brasil, o modo rodoviário é o mais utilizado, todavia, as rodovias podem causar impactos negativos   biodiversidade, pois contribuem para a fragmentação de hábitats e a redução de fluxos biológicos. Dentre os principais impactos causados pelas rodovias, destaca-se o atropelamento da fauna, de forma que medidas de mitigação para esse impacto se tornam necessárias. Com base nos dados coletados até o ano de 2017, o presente estudo tem por objetivo apresentar informações quanto  s medidas mitigadoras ao atropelamento de fauna silvestre presentes nas rodovias federais concedidas do Brasil. Foram cadastradas 461 medidas de mitigação, mais 627 dispositivos de engenharia que podem ser utilizados como passagens, sendo que, desse total, 334 encontram-se nas proximidades de áreas legalmente protegidas. Existem 158 medidas em fase de planejamento para serem implementadas

Rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART): Study protocol for a randomized controlled trial

Background: Acute respiratory distress syndrome (ARDS) is associated with high in-hospital mortality. Alveolar recruitment followed by ventilation at optimal titrated PEEP may reduce ventilator-induced lung injury and improve oxygenation in patients with ARDS, but the effects on mortality and other clinical outcomes remain unknown. This article reports the rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART). Methods/Design: ART is a pragmatic, multicenter, randomized (concealed), controlled trial, which aims to determine if maximum stepwise alveolar recruitment associated with PEEP titration is able to increase 28-day survival in patients with ARDS compared to conventional treatment (ARDSNet strategy). We will enroll adult patients with ARDS of less than 72 h duration. The intervention group will receive an alveolar recruitment maneuver, with stepwise increases of PEEP achieving 45 cmH(2)O and peak pressure of 60 cmH2O, followed by ventilation with optimal PEEP titrated according to the static compliance of the respiratory system. In the control group, mechanical ventilation will follow a conventional protocol (ARDSNet). In both groups, we will use controlled volume mode with low tidal volumes (4 to 6 mL/kg of predicted body weight) and targeting plateau pressure <= 30 cmH2O. The primary outcome is 28-day survival, and the secondary outcomes are: length of ICU stay; length of hospital stay; pneumothorax requiring chest tube during first 7 days; barotrauma during first 7 days; mechanical ventilation-free days from days 1 to 28; ICU, in-hospital, and 6-month survival. ART is an event-guided trial planned to last until 520 events (deaths within 28 days) are observed. These events allow detection of a hazard ratio of 0.75, with 90% power and two-tailed type I error of 5%. All analysis will follow the intention-to-treat principle. Discussion: If the ART strategy with maximum recruitment and PEEP titration improves 28-day survival, this will represent a notable advance to the care of ARDS patients. Conversely, if the ART strategy is similar or inferior to the current evidence-based strategy (ARDSNet), this should also change current practice as many institutions routinely employ recruitment maneuvers and set PEEP levels according to some titration method.Hospital do Coracao (HCor) as part of the Program 'Hospitais de Excelencia a Servico do SUS (PROADI-SUS)'Brazilian Ministry of Healt

Global variations in diabetes mellitus based on fasting glucose and haemogloblin A1c

Fasting plasma glucose (FPG) and haemoglobin A1c (HbA1c) are both used to diagnose diabetes, but may identify different people as having diabetes. We used data from 117 population-based studies and quantified, in different world regions, the prevalence of diagnosed diabetes, and whether those who were previously undiagnosed and detected as having diabetes in survey screening had elevated FPG, HbA1c, or both. We developed prediction equations for estimating the probability that a person without previously diagnosed diabetes, and at a specific level of FPG, had elevated HbA1c, and vice versa. The age-standardised proportion of diabetes that was previously undiagnosed, and detected in survey screening, ranged from 30% in the high-income western region to 66% in south Asia. Among those with screen-detected diabetes with either test, the agestandardised proportion who had elevated levels of both FPG and HbA1c was 29-39% across regions; the remainder had discordant elevation of FPG or HbA1c. In most low- and middle-income regions, isolated elevated HbA1c more common than isolated elevated FPG. In these regions, the use of FPG alone may delay diabetes diagnosis and underestimate diabetes prevalence. Our prediction equations help allocate finite resources for measuring HbA1c to reduce the global gap in diabetes diagnosis and surveillance.peer-reviewe