First-mile logistics parcel pickup: Vehicle routing with packing constraints under disruption

peer reviewedFirst-mile logistics tackles the movement of products from retailers to a warehouse or distribution centre. This first step towards the end customer has been pushed by large e-commerce platforms forming extensive networks of partners and is critical for fast deliveries. First-mile pickup requires efficient methods different from those developed for last-mile delivery, among other reasons due to the complexity of cargo features and volume — increasing the relevance of advanced packing methods. More importantly, the problem is essentially dynamic and the pickup process, in which the vehicle is initially empty, is much more flexible to react to disruptions arising when the vehicles are en route. We model the static first-mile pickup problem as a vehicle routing problem for a heterogeneous fleet, with time windows and three-dimensional packing constraints. Moreover, we propose an approach to tackle the dynamic problem, in which the routes can be modified to accommodate disruptions — new customers’ demands and modified requests of known customers that are arriving while the initially established routes are being covered. We propose three reactive strategies for addressing the disruptions depending on the number of vehicles available, and study their results on a newly generated benchmark for dynamic problems. The results allow quantifying the impact of disruptions depending on the strategy used and can help the logistics companies to define their own strategy, considering the characteristics of their customers and products and the available fleet

Gastroenterite aguda em crianças internadas na área de Lisboa

Introdução: A Gastroenterite Aguda (GEA) é uma patologia com importante morbilidade sendo a segunda causa de internamento na idade pediátrica. Objetivo: Caracterizar a GEA, em crianças internadas em dois hospitais da área de Lisboa com diferentes características demográficas. Métodos: Estudo prospetivo de Maio 2011 a Junho 2012. Pesquisados potenciais agentes etiológicos por técnicas convencionais e de biologia molecular em amostras de fezes e analisados dados epidemiológicos e clínicos. Resultados: Total de 140 amostras de crianças com GEA com identificação do agente em 83,6%: 64,3% vírus, 27,9% parasitas e 21,4% bactérias. Os agentes mais frequentes foram rotavírus (26,4%), norovírus II (13,6%), enterovírus (12,1%), Microsporidia (11,4%), Escherichia coli (9,3%), Campylobacter jejuni (7,9%), Giardia sp. (5,7%), Cryptosporidium sp. (5%) e Salmonella sp. (4,3%). Coinfecções (2 ou mais agentes) em 40 doentes (28,6%). Mediana de idade de 1,4 anos (min-5 dias; max-17 anos) sendo a etiologia viral mais frequente abaixo dos 5 anos (p<0.01), com o rotavírus identificado em crianças mais jovens (média=1,7 anos). Dois picos sazonais: o rotavírus entre Janeiro e Março e norovírus entre Agosto e Outubro. Apenas 10 (7,1%) doentes estavam vacinados para rotavírus, mas nenhum com o esquema completo. A presença de sangue nas fezes (p=0.02) e a febre (p=0.039) foram mais frequentes na infeção bacteriana, os vómitos (p<0.01) e os sintomas respiratórios (p=0.046) na infeção por rotavírus. Registaram-se complicações clínicas em 50 doentes (35,7%): desidratação (47), invaginação íleo-cecal (1), adenite mesentérica (1) e apendicite fleimonosa (1). Conclusão: Os vírus são os agentes mais frequentes de GEA sobretudo na criança pequena (idade <5 anos), sendo o rotavírus e norovírus os principais agentes. O número de coinfecções foi significativo mas não se associou a maior morbilidade. A ausência de identificação de agente em alguns casos pode refletir a necessidade de outros meios diagnósticos ou a existência de agentes ainda desconhecidos

CARACTERÍSTICAS CLÍNICAS E EPIDEMIOLÓGICAS DE HOMENS COM LESÕES GENITAIS ATENDIDOS EM AMBULATÓRIOS ESPECIALIZADOS EM SÃO LUÍS–MA

Introdução: As políticas públicas reconhecem que os agravos do sexo masculino constituem verdadeiros problemas de saúdecoletiva, e nisso, compreende sua singularidade social buscando fortalecer a promoção de ações que impactam na expectativade vida e redução dos índices de morbimortalidade por causas preveníeis. Objetivo: Analisar os tipos de lesões genitais e característicasepidemiológicas em pacientes atendidos em ambulatórios especializados no município de São Luís (MA). Métodos:Estudo transversal e descritivo realizado com 96 homens assistidos em ambulatório especializados no município de São Luís(MA). As variáveis investigadas foram questões socioeconômicas, hábitos de vida, história sexual e clínica. Resultados: A médiade idade dos pacientes foi de 57 anos, com desvio-padrão de 14,9 anos, cor parda (41,7%), união consensual (75,0%) e 58,3%naturais do município de São Luís (MA); 36,5% eram ex-etilistas e 41,7% ex-tabagistas. Realizavam higiene da região genital(88,5%), com exposição total da glande (64,6%), utilizavam sempre preservativos (14,6%) e mais que 10 parceiros (60,4%).Lesões urológicas como feridas e caroços (34,8%); presença de verrugas genitais em 38,5%, com mais de 5 anos de aparecimento(46%); 39,6% com Infecções Sexualmente Transmissíveis (IST), destes, 71% gonorreia, 13,2% condiloma acuminado e 6,25%câncer de pênis. Conclusões: Os pacientes relataram múltiplos parceiros sexuais ao longo da vida, negligência no uso de preservativos,hábitos de higiene genital precários, história de (IST) prévia, sendo a mais prevalente a gonorreia seguida pelo condilomaacuminado. Os casos diagnosticados como câncer de pênis foram na maioria localizados no prepúcio.Palavras-chave: Saúde do Homem. Fatores de Risco. Epidemiologia

Analysis of the biological effect of Carica papaya leaf extracts on the viability and proliferation of K562 cells

Os autores reconhecem o apoio do H&TRC – Centro de Investigação em Saúde e Tecnologia, ESTeSL – Escola Superior de Tecnologia da Saúde de Lisboa, Instituto Politécnico de Lisboa (apoio FCT/MCTES, UIDB/05608/2020 e UIDP/05608/2020).Introdução – A anemia falciforme é uma doença monogénica causada por mutações no gene da β-globina que afeta a estrutura da hemoglobina, sendo associada a diversas complicações clínicas com elevadas taxas de morbilidade e mortalidade. A reativação farmacológica da hemoglobina fetal (HbF) por compostos como a hidroxiureia (HU) é um dos tratamentos atualmente disponíveis; contudo, o seu perfil de segurança e o elevado custo em países subdesenvolvidos limitam a sua utilização. Nesse contexto é essencial estudar novos compostos indutores da HbF com baixa citotoxicidade e que possam estar amplamente disponíveis, como é o caso de extratos de folhas da Carica papaya (CP), uma planta medicinal com propriedades antioxidantes e anti-inflamatórias. Objetivos – Este estudo pretende avaliar o efeito do extrato metanólico das folhas de CP (EMFCP) em parâmetros biológicos como a proliferação e a viabilidade celular em células K562. Método – As células K562 foram expostas durante 72h ao EMFCP a 500 µg/mL e durante 24 horas ao EMFCP (0,5; 50; 100 µg/mL) e à HU (25 μg/mL). A proliferação e viabilidade celular foram analisadas através da quantificação celular pelo método de exclusão do azul de tripano. Resultados – Os resultados demonstram que a proliferação e a viabilidade celular foram afetadas pelo EMFCP apenas na concentração de 500 µg/mL, não se tendo verificado alteração nestes parâmetros nas restantes concentrações utilizadas. Conclusão – Os resultados mostraram que os EMFCP não são citotóxicos quando incubados em células K562 em concentrações inferiores ou iguais a 100 μg/mL, permitindo assim explorar este composto na avaliação do seu potencial terapêutico no contexto da anemia falciforme.ABSTRACT: Background – Sickle cell disease (SCD) is a genetic blood disorder caused by mutations in the β-globin gene that affects the shape and transport of red blood cells in blood vessels, leading to various clinical complications. The pharmacological reactivation of fetal hemoglobin (HbF) through compounds such as hydroxyurea (HU), is one of the currently available treatments, however, their safety concerns and expensive cost in low- and middle-Income countries limit their use. In this context, it is essential to study novel HbF-inducing compounds that have scarcer adverse effects and can be widely available, such as Carica papaya leaf (CP) extracts, a medicinal plant with anti-oxidant and anti-inflammatory properties. Aim of the study – Evaluate the effect of CP methanolic leaf extracts (CPMLE) on biological parameters such as cell proliferation and viability on the K562 cell line. Methods – K562 cells were exposed for 72 hours to CPMLE at 500 µg/mL and for 24 hours to CPMLE (0.5; 50; 100 µg/mL) and HU (25 μg/mL). Cell proliferation and viability after CPMLE exposure were analyzed by cell counting. Results – The results demonstrate that cell proliferation and viability were affected by CPMLE only at the concentration of 500 µg/mL, with no effects being observed at the lower concentrations analysed. Conclusion – Our results showed that CPMLE is not cytotoxic when incubated at concentrations equal to or below 100 μg/mL thus allowing us to explore this compound in the evaluation of its therapeutic potential, in the context of sickle cell anemia treatment.Este estudo foi financiado pelo projeto IDI&CA-IPL/2021/EpiCa/ESTeSL.info:eu-repo/semantics/publishedVersio

Effects of environmental exposure to tobacco on modulation of color vision

The chronic use of cigarettes causes toxic and oxidative effects on the visual system, which can cause changes in color vision. Although there are studies on the harmful effects of tobacco in active smokers, the literature on secondhand/passive smokers (or environmental tobacco smoke) is still scarce. Therefore, the aim of this study was to investigate the ability of color vision in active and passive smokers. This is a cross-sectional observational study in which 103 individuals were divided pseudorandomly into 3 groups: control group (CG) n = 44 individuals (72 eyes), with a mean age of 28.65 ± 7.90; group of passive smokers (GPS) n = 28 (56 eyes), mean age 28.74 ± 9.42; group of active smokers (GAS) n = 31 (60 eyes), mean age 34.91 ± 11.30. The psychophysical evaluation of color vision was performed using the Ishihara pseudoisochromatic plates, the computer program of the Freiburg Visual Acuity &amp; Contrast Test, version 3.7, and the desaturated Lanthony D15 ordering test. The results indicate that there was no correlation in GAS and GPS with age, time of exposure to tobacco and daily consumption. It was observed that both GAS and GPS showed changes in visual acuity (P &lt;0.05), and only GPS showed changes in color vision (P &lt;0.05); GFP showed a deficit in visual acuity and worse color vision when compared to GAS (P &lt;0.05). These results are discussed in relation to the biochemical and pathophysiological effects that exposure to cigarettes may have on the visual system, which would explain the functional changes observed. We conclude that passive and active smokers have impaired color vision and that the psychophysical methods used in this study are effective for the subclinical tracking of changes in color vision

Low Density Lipoproteins at 2% Concentration Can Replace Whole Egg Yolk in TES-Tris-Milk Extender for Freezing Buffalo Sperm Cells

Background: Over the years, the most commonly used extenders for semen cryopreservation contain egg yolk as cryoprotectant. However, more recent studies have used the low density lipoproteins, extract of hen egg yolk which is responsible for the cryoprotective effect. Nevertheless, little was known about its required minimum concentration as well as its interaction with other extra cellular cryoprotectants, like skimmed milk. The present study aimed at investigating the effect of replacing whole egg yolk by adding low density lipoproteins at low concentrations, in TES-Tris-skim milk based extender, on the post-thaw quality of buffalo bull sperm.Materials, Methods & Results: Eighteen ejaculates were collected from six buffalo bulls and diluted with TES-Tris-skim milk based extender containing LDL, extracted from hen egg yolks, at the concentrations of 2%, 4%, 8% and 14%, against a control extender containing 20% fresh egg yolk. After semen collection, analyses of subjective motility, vigor, force tourbillon, sperm concentration (Neubauer chamber) and sperm morphology (phase contrast microscopy) were performed. The diluted semen was packaged in 0.25 mL straws, and cooling was performed on computerized machine (TK 4000®), using a cooling rate of -0.25°C/min to 5°C. Semen was kept in balance at 5°C for 4 h. The straws were frozen in an ice chest, kept at 5 cm from the surface of liquid nitrogen for 20 min and then immersed in liquid nitrogen. The samples were kept in cryogenic container until thawing. Post-thaw kinetic parameters during incubation at 37°C (CASA), sperm membrane integrity (SYBR-14/PI), membrane functionality (hypo-osmotic swelling test) and DNA fragmentation (%DFI - SCSA) were evaluated after thawing. Immediately post-thaw, total motility was higher in the control (56.53 ± 9.73) than in the tested extenders; however, after 30 min the difference was no longer detected. All other kinetic parameters presented significantly better results in extenders containing 2%, 4% and 8% LDL, compared with the control. There was no difference between treatments regarding the integrity of membranes or fragmentation of the DNA after freezing/thawing procedures.Discussion: The molecules of low density lipoproteins of egg yolk have the known action of sequestering BSP ( binder of sperm proteins) protein, due to the chemical affinity of their main components, phosphatidylcholine and phosphatidylethanolamine. The BSP are responsible for removing cholesterol from the plasma membrane of the sperm, preparing it for the sperm capacitation phase. Low density lipoproteins by inhibiting the action of the BSP increase the stability of the plasma membrane during the freeze-thaw process. The milk caseins micelles have a similar ability to bind the BSP, but with lower affinity. The present study has shown that the use of purified low density lipoproteins has an advantage over the use of whole egg yolk, especially with regard to the kinetic parameters of the spermatozoa after thawing. Furthermore, it was observed that low concentrations of low density lipoproteins, such as 2%, in extenders containing skim milk, could preserve the sperm cell during the freeze-thawing process like that higher LDL concentrations and whole egg yolk. Further studies are needed to determine if the cryoprotectant action found in this study was a result of the synergistic action of skim milk with lipoproteins or even at low concentrations like 2% the lipoproteins can provide protection to the buffalo spermatozoa during freezing, as it has been reproduced in other domestic species. In conclusion, our results indicated that the extender TES-Tris-skim milk containing 2% LDL extracted from egg yolk could be used successfully in the cryopreservation of buffalo sperm cells

Prevalência e fatores associados à fragilidade em idosos atendidos na Atenção Primária à Saúde

Objetivo: identificar a prevalência e os fatores associados à fragilidade em idosos atendidos na atenção primária à saúde. Método: estudo transversal e analítico, realizado entre março de 2018 e abril de 2019, com 184 idosos cadastrados em equipe de Estratégia Saúde da Família de uma cidade do norte de Minas Gerais. Foram coletadas variáveis sociodemográficas e clínicas, sendo a fragilidade identificada pelo Índice de Vulnerabilidade Clínico Funcional-20. Realizou-se estatística descritiva, análise bivariada e multivariada por meio da regressão logística com os respectivos intervalos de confiança de 95% e nível de significância de p?0,05. Resultado: entre os 184 idosos, a prevalência de fragilidade foi de 9,8%. As variáveis associadas ao desfecho foram: escolaridade (analfabeto) (p=0,007) e idade (?80 anos) (p=0,002). Conclusão: o estudo evidencia que a fragilidade é um achado comum entre idosos da atenção primária e medidas de promoção, proteção, prevenção e recuperação da saúde precisam ser implementadas

Aetiology of Acute Gastroenteritis in Hospitalized Children from Lisbon Area

Gastroenteritis is a major cause of morbidity and mortality worlwide. Aim: Determine the etiology of gastroenteritis in a cohort of children hospitalized Methods: From May 2011 to January 2012, stool samples were collected from children (4.2 ± 4.8 years). Viral agents (enteric and enterovirus) were detected by RT-PCR. Stool specimens were also tested for bacteria and parasites, by conventional methods. Results: From the 82 stool samples, 42(51.2%) were positive for virus, 22 (26.8%) for bacteria and 35.6% (26/73) for parasites. An association between viral infection and age<3 years (OR=4.92, p<0.01) was observed. Distribution of viral agents was NorovirusII (33.3%), Enterovirus (31%), Rotavirus (23.8%), Adenovirus (9.5%), NorovirusI (2.4%). Simultaneous detection of two viral agents was observed in seven cases (16.7%) - NorovirusII and Enterovirus was the most frequent (57.1%); association with another agent was detected in 33.3% samples. Eight of 22 samples (36.4%) were positive for Campylobacter jejuni, 5 (22.7%) for Salmonella spp, 7 (31.8%) for E. coli, although always in co-infection with another agent, and 1 (4.5%) for Shigella spp. 38.5% of the samples were positive for Cryptosporidium spp., 23.1% for Giardia sp. and 3.8% for Entamoeba histolytica. 69.2% of the parasites were co-detected with other agents. Conclusion: Results suggest that viral agents are the most common among children with acute gastroenteritis, although co-infections with bacteria and parasites are frequent. The most common viral agent associated with acute diarrhea was NorovirusII. An important percentage of cases with no infectious aetiology identified, suggesting that other emergent agents are probably implicated