Management Of Infection By The Zika Virus

A panel of national experts was convened by the Brazilian Infectious Diseases Society in order to organize the national recommendations for the management of zika virus infection. The focus of this document is the diagnosis, both clinical and laboratorial, and appropriate treatment of the diverse manifestations of this infection, ranging from acute mild disease to Guillain-Barre syndrome and also microcephaly and congenital malformations.1

Decision support visualization approach in textile manufacturing a case study from operational control in textile industry

Decision support visualization tools provide insights for solving problems by displaying data in an interactive, graphical format. Such tools can be effective for supporting decision-makers in finding new opportunities and in measuring decision outcomes. In this study, was used a visualization tool capable of handling multivariate time series for studying a problem of operational control in a textile manufacturing plant; the main goal was to identify sources of inefficiency in the daily production data of three machines. A concise rule-based model of the inefficiency measures (i.e. quantitative measures were transformed into categorical variables) was developed and then performed an in-depth visual analysis using a particular technique, the categorical time series plots stacked vertically. With this approach were identified a wide array of production inefficiency patterns, which were difficult to identify using standard quantitative reporting - temporal pattern of best and worst performing machines - and critically, along with most important sources of inefficiency and some interactions between them were revealed. The case study underlying this work was further contextualized within the state of the art, and demonstrates the effectiveness of adequate visual analysis as a decision support tool for operational control in manufacturing.This study was partially conducted at the Psychology Research Centre (UID/PSI/01662/2013), University of Minho, and supported by the Portuguese Foundation for Science and Technology and the Portuguese Ministry of Science, Technology and Higher Education through national funds and co-financed by FEDER through COMPETE2020 under the PT2020 Partnership Agreement (POCI-010145-FEDER-007653). This work was also supported by the following grants: FCT project PTDC/MHC/PCN/1530; FEDER Funds through the "Programa Operacional Factores de Competitividade - COMPETE" program and by National Funds through FCT "Fundacao para a Ciencia e a Tecnologia" under the project: FCOMP-010124-FEDER-PEst-OE/EEI/UI0760/2011, PEst-OE/EEI/UI0760/2014, PEst2015-2020 and UID/CEC/00319/2019

a preliminary report

© European Association of Hospital Pharmacists 2021. No commercial re-use. See rights and permissions. Published by BMJ.OBJECTIVES: Since the outbreak of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), the pressure to minimise its impact on public health has led to the implementation of different therapeutic strategies, the efficacy of which for the treatment of coronavirus disease 2019 (COVID-19) was unknown at the time. Remdesivir (REM) was granted its first conditional marketing authorisation in the EU in June 2020. The European Medicines Agency (EMA) and local health authorities all across the EU have since strongly recommended the implementation of pharmacovigilance activities aimed at further evaluating the safety of this new drug. The objective of this study was to evaluate adverse drug reactions (ADRs) attributed to either REM or hydroxychloroquine (HCQ) in patients hospitalised for COVID-19 in Centro Hospitalar de Lisboa Ocidental, a Portuguese hospital centre based in Lisbon. We present the preliminary results reporting plausible adverse effects of either HCQ or REM. METHODS: An observational cohort study was carried out between 16 March and 15 August 2020. Participants were divided into two cohorts: those prescribed an HCQ regimen, and those prescribed REM. Suspected ADRs were identified using an active monitoring model and reported to the Portuguese Pharmacovigilance System through its online notification tool. The ADR cumulative incidence was compared between the two cohorts. RESULTS: The study included 149 patients, of whom 101 were treated with HCQ and the remaining 48 with REM. The baseline characteristics were similar between the two cohorts. A total of 102 ADRs were identified during the study period, with a greater incidence in the HCQ cohort compared with the REM cohort (47.5% vs 12.5%; p<0.001). Causality was assessed in 81 ADRs, all of which were considered possible. CONCLUSIONS: Real-world data are crucial to further establish the safety profile for REM. HCQ is no longer recommended for the treatment of COVID-19.publishersversionpublishe

Livros e Leituras para Instrução Económica do Povo (1746-1820

Entre 1746 e 1820 surgem diversos textos de marcados pela preocupação de instruir o povo. Entre eles sobressaem os catecismos de agricultura, corolários práticos e almanaques. As pesquisas, no âmbito da história do livro e da leitura, levaram-nos a olhar para este acervo com interesse redobrado e a extrair da sua leitura novos elementos de análise e reflexão. É neste sentido que inscrevemos este trabalho. Com efeito, pretendemos fazer uma sistematização de alguns desses textos populares, e tentaremos responder ás seguintes questões: quais eram os objectivos dos autores? Que leituras eram recomendadas para instrução popular? Eram esses textos lidos pelo povo? Os obstáculos a uma análise deste tipo foram já inventariados por Roger Chartier, a começar pela definição de povo, passando pela grande dificuldade em determinar as práticas de leitura, e são também conhecidos os dilemas de uma história popular, quer porque os textos são, normalmente, produzidos por eclesiásticos, magistrados e outros membros das elites, que tem relativamente ao povo uma atitude de superioridade intelectual e até de distanciamento; quer porque se torna difícil, ou muitas vezes impossível, dada a falta de suporte documental, descrever o impacto dessas obras nas comunidades para que foram dirigidas. Mesmo assim, pensamos que se pode traçar um quadro para nos apercebermos das ideias que animavam os autores que escreviam obras com um nítido objectivo de instruir o povo nas novas técnicas agrícolas e na indústria popular

Maternal Moderate Physical Training during Pregnancy Attenuates the Effects of a Low-Protein Diet on the Impaired Secretion of Insulin in Rats: Potential Role for Compensation of Insulin Resistance and Preventing Gestational Diabetes Mellitus

The effects of pregestational and gestational low-to-moderate physical training on insulin secretion in undernourished mothers were evaluated. Virgin female Wistar rats were divided into four groups as follows: control (C, n = 5); trained (T, n = 5); low-protein diet (LP, n = 5); trained with a low-protein diet (T + LP, n = 5). Trained rats ran on a treadmill over a period of 4 weeks before mate (5 days week(-1) and 60 min day(-1), at 65% of VO2max). At pregnancy, the intensity and duration of the exercise were reduced. Low-protein groups were provided with an 8% casein diet, and controls were provided with a 17% casein diet. At third day after delivery, mothers and pups were killed and islets were isolated by collagenase digestion of pancreas and incubated for a further 1 h with medium containing 5.6 or 16.7 mM glucose. T mothers showed increased insulin secretion by isolated islets incubated with 16.7 mM glucose, whereas LP group showed reduced secretion of insulin by isolated islets when compared with both C and LP + T groups. Physical training before and during pregnancy attenuated the effects of a low-protein diet on the secretion of insulin, suggesting a potential role for compensation of insulin resistance and preventing gestational diabetes mellitus.National Council for Scientific and Technological Development (CNPq)National Council for Scientific and Technological Development (CNPq)Foundation to Support Science and Research from Pernambuco State (FACEPE)Foundation to Support Science and Research from Pernambuco State (FACEPE)Sao Paulo Research Foundation (FAPESP)Sao Paulo Research Foundation (FAPESP)Coordination for the Improvement of Higher Level Personnel (CAPES)Coordination for the Improvement of Higher Level Personnel (CAPES)Deans Office for Research/University of Sao PauloDean's Office for Research/University of Sao Paul

Impact on the Quality of Life of an Educational Program for the Prevention of Work-Related Musculoskeletal Disorders: a randomized controlled trial

<p>Abstract</p> <p>Background</p> <p>Work-related musculoskeletal disorders (WMSD) are a major cause for concern in public health and the main causes of sick leave. Treatments for WMSD have given disappointing results; prevention is the best strategy, but results of preventive measures have not been consistent. To the best of our knowledge there are few studies in literature that evaluated the impact of a specific program aimed at preventing WMSD on the quality of life of employed persons.</p> <p>Methods</p> <p>One hundred and one clerical and production workers in a steel trading company were enrolled in an open-label randomized controlled clinical trial (parallel groups) to compare the efficacy of an educational program for primary prevention of WMSD with control intervention. The primary outcome was a change in the physical functioning domain of the quality of life (QL) measured by Medical Outcomes Study Short Form 36 Health Survey (SF-36). The intervention group underwent six consecutive weekly sessions concerning specific orientations for the prevention of WMSD, while the control group received general health education in an identical schedule. The SF-36 and theses Work Limitation Questionnaire (WLQ) were evaluated at weeks zero, five and 26.</p> <p>Results</p> <p>Baseline characteristics of the interventions groups were comparable, and both groups comprised predominantly young healthy individuals. No significant differences in the variation of the SF-36 and WLQ between the groups were observed at weeks five and 26. However, both groups demonstrated improvement in some aspects of SF-36, suggesting that both educational interventions have beneficial impacts on QL.</p> <p>Conclusions</p> <p>A specific educational program aimed at the preventing of WMSD was comparable with general health orientation for the improvement of QL and work capacity in a sample of healthy workers during a six month period.</p> <p>Trial Registration</p> <p>ClinicalTrials.gov: <a href="http://www.clinicaltrials.gov/ct2/show/NCT00981877">NCT00874718</a></p> <p>Trial Registration</p

Geoeconomic variations in epidemiology, ventilation management, and outcomes in invasively ventilated intensive care unit patients without acute respiratory distress syndrome: a pooled analysis of four observational studies

Background: Geoeconomic variations in epidemiology, the practice of ventilation, and outcome in invasively ventilated intensive care unit (ICU) patients without acute respiratory distress syndrome (ARDS) remain unexplored. In this analysis we aim to address these gaps using individual patient data of four large observational studies. Methods: In this pooled analysis we harmonised individual patient data from the ERICC, LUNG SAFE, PRoVENT, and PRoVENT-iMiC prospective observational studies, which were conducted from June, 2011, to December, 2018, in 534 ICUs in 54 countries. We used the 2016 World Bank classification to define two geoeconomic regions: middle-income countries (MICs) and high-income countries (HICs). ARDS was defined according to the Berlin criteria. Descriptive statistics were used to compare patients in MICs versus HICs. The primary outcome was the use of low tidal volume ventilation (LTVV) for the first 3 days of mechanical ventilation. Secondary outcomes were key ventilation parameters (tidal volume size, positive end-expiratory pressure, fraction of inspired oxygen, peak pressure, plateau pressure, driving pressure, and respiratory rate), patient characteristics, the risk for and actual development of acute respiratory distress syndrome after the first day of ventilation, duration of ventilation, ICU length of stay, and ICU mortality. Findings: Of the 7608 patients included in the original studies, this analysis included 3852 patients without ARDS, of whom 2345 were from MICs and 1507 were from HICs. Patients in MICs were younger, shorter and with a slightly lower body-mass index, more often had diabetes and active cancer, but less often chronic obstructive pulmonary disease and heart failure than patients from HICs. Sequential organ failure assessment scores were similar in MICs and HICs. Use of LTVV in MICs and HICs was comparable (42\ub74% vs 44\ub72%; absolute difference \u20131\ub769 [\u20139\ub758 to 6\ub711] p=0\ub767; data available in 3174 [82%] of 3852 patients). The median applied positive end expiratory pressure was lower in MICs than in HICs (5 [IQR 5\u20138] vs 6 [5\u20138] cm H2O; p=0\ub70011). ICU mortality was higher in MICs than in HICs (30\ub75% vs 19\ub79%; p=0\ub70004; adjusted effect 16\ub741% [95% CI 9\ub752\u201323\ub752]; p&lt;0\ub70001) and was inversely associated with gross domestic product (adjusted odds ratio for a US$10 000 increase per capita 0\ub780 [95% CI 0\ub775\u20130\ub786]; p&lt;0\ub70001). Interpretation: Despite similar disease severity and ventilation management, ICU mortality in patients without ARDS is higher in MICs than in HICs, with a strong association with country-level economic status. Funding: No funding