Human adenovirus in municipal solid waste leachate and quantitative risk assessment of gastrointestinal illness to waste collectors

Leachate is a variable effluent from waste management systems generated during waste collection and on landfills. Twenty-two leachate samples from waste collection trucks and a landfill were collected from March to December 2019 in the municipality of Rio de Janeiro (Brazil) and were analyzed for Human Adenovirus (HAdV), bacterial indicators and physico-chemical parameters. For viral analysis, samples were concentrated by ultra centrifugation and processed for molecular analysis using QIAamp Fast DNA Stool mini kit (R) for DNA extraction followed by nested-PCR and qPCR/PMA-qPCR TaqMan (R) system. HAdV was detected by nested-PCR in 100% (9/ 9) and 83.33% (12/13) of the truck and landfill leachate samples, respectively. Viral concentrations ranged from 8.31 x 10(1) to 6.68 x 107 genomic copies per 100 ml by qPCR and PMA-qPCR. HAdV species A, B, C, and F were characterized using nucleotide sequencing. HAdV were isolated in A549 culture cells in 100% (9/9) and 46.2% (6/13) from truck and landfill leachate samples, respectively. Regardless of the detection methods, HAdV concentration was predicted by the quantity of total suspended solids. A quantitative microbial risk assessment was performed to measure the probability of gastrointestinal (GI) illness attributable to inadvertent oral ingestion of truck leachate, revealing the higher probability of disease for the direct splashing into the oral cavity (58%) than for the gloved hand-to-mouth (33%). In a scenario where waste collectors do not wear gloves as protective personal equipment, the risk increases to 67%. This is the first study revealing infectious HAdV in solid waste leachate and indicates a potential health risk for waste collectors

Pancreatite crônica - uma revisão abrangente sobre a etiologia, patogênese, manifestações clínicas, diagnóstico, abordagens terapêuticas, indicações e modalidades cirúrgicas

A pancreatite crônica (PC) se configura como uma condição desafiadora do pâncreas, caracterizada por uma inflamação persistente associada a diversas causas, como o consumo excessivo de álcool e distúrbios metabólicos, como a hipertrigliceridemia. Essa enfermidade acarreta alterações irreversíveis na estrutura e função pancreáticas devido a processos inflamatórios recorrentes, resultando em fibrose e perda progressiva de função. Os sintomas abrangem dor abdominal persistente, má absorção de nutrientes, perda de peso e diabetes, tornando o diagnóstico uma combinação crucial de critérios clínicos, exames laboratoriais e de imagem, como a tomografia computadorizada abdominal. As estratégias terapêuticas buscam aliviar a dor, melhorar a função pancreática e prevenir complicações. Modificações no estilo de vida, controle do consumo de álcool, uso de enzimas pancreáticas e, em casos específicos, intervenções cirúrgicas compõem o leque de opções terapêuticas. No âmbito cirúrgico, as indicações para procedimentos muitas vezes se relacionam com complicações estruturais do pâncreas. A obstrução do ducto pancreático, a formação de pseudocistos ou a suspeita de neoplasia são situações que podem demandar intervenção cirúrgica. A escolha entre diferentes modalidades cirúrgicas varia de acordo com a gravidade e a natureza específica da condição do paciente. A ressecção pancreática, embora eficaz em casos selecionados, apresenta desafios consideráveis devido à complexidade anatômica e à função vital do pâncreas. Além disso, é essencial considerar os potenciais riscos e benefícios, levando em conta as condições gerais de saúde do paciente. Por fim, a PC é uma realidade complexa, demandando uma abordagem integrada para um diagnóstico precoce e tratamento eficaz. A ênfase na melhoria da qualidade de vida e na prevenção de complicações graves destaca-se como um elemento central na gestão dessa condição desafiadora

Qualificando jovens produtores rurais : o uso de software de gerenciamento rural em pequenas unidades produtoras de leite no Distrito Federal

O agronegócio do leite é bastante representativo no Brasil, tendo resultados expressivos em diversas regiões do país. No Distrito Federal, a produção é proveniente essencialmente da agricultura familiar e a área média dedicada à atividade é reduzida, o que impede sua expansão. Ações que objetivam o aprimoramento de diversas atividades relacionadas à agropecuária são desenvolvidas por meio da extensão rural, tendo em vista que esta possibilita troca de experiências e conhecimentos entre os atores. Este artigo é resultado direto de um projeto de extensão universitária realizado por discentes do curso de graduação em Gestão de Agronegócios da Universidade de Brasília. Em parceria com a Emater/DF, tal projeto é desenvolvido com o intuito de habilitar produtores rurais de leite no Distrito Federal e seus filhos ao uso do software de gerenciamento rural, Rural-Pró 2010, visando maior controle gerencial da propriedade, e se caracteriza essencialmente por sua ação contínua, estando apenas em uma fase inicial de execução. ______________________________________________________________________________ ABSTRACTThe production of milk is very representative in Brazil, with expressive results in many regions of the country. In the Federal District, the production comes essentially from family farming and the average area dedicated to the activity is reduced, which prevents its expansion. Actions that aim at the improvement of various activities related to agriculture and cattle are developed through the extension in order that enables the exchange of experiences and knowledge between the actors. This article is a direct result of a university extension project carried out by students of the undergraduate course in Agribusiness from the Universidade de Brasília.. In partnership with Emater/DF, this project is developed in order to enable dairy family farmers in the Federal District and their children to use the software management, Rural-Pró 2010, seeking greater management control of the property, and is essentially characterized by its continuous action and is only in a initial stage of execution

Prevalence and determinants of unintended pregnancies amongst women attending antenatal clinics in Pakistan

Background: Unintended pregnancies are a global public health concern and contribute significantly to adverse maternal and neonatal health, social and economic outcomes and increase the risks of maternal deaths and neonatal mortality. In countries like Pakistan where data for the unintended pregnancies is scarce, studies are required to estimate its accurate prevalence and predictors using more specific tools such as the London Measure of Unplanned Pregnancies (LMUP). Methods: We conducted a hospital based cross sectional survey in two tertiary care hospitals in Pakistan. We used a pre tested structured questionnaire to collect the data on socio-demographic characteristics, reproductive history, awareness and past experience with contraceptives and unintended pregnancies using six item the LMUP. We used Univariate and multivariate analysis to explore the association between unintended pregnancies and predictor variables and presented the association as adjusted odds ratios. We also evaluated the psychometric properties of the Urdu version of the LMUP. Results: Amongst 3010 pregnant women, 1150 (38.2%) pregnancies were reported as unintended. In the multivariate analysis age \u3c 20 years (AOR 3.5 1.1-6.5), being illiterate (AOR 1.9 1.1-3.4), living in a rural setting (1.7 1.2-2.3), having a pregnancy interval of = \u3c 12 months (AOR 1.7 1.4-2.2), having a parity of \u3e2 (AOR 1.4 1.2-1.8), having no knowledge about contraceptive methods (AOR 3.0 1.7-5.4) and never use of contraceptive methods (AOR 2.3 1.4-5.1) remained significantly associated with unintended pregnancy. The Urdu version of the LMUP scale was found to be acceptable, valid and reliable with the Cronbach\u27s alpha of 0.85. Conclusions: This study explores a high prevalence of unintended pregnancies and important factors especially those related to family planning. Integrated national family program that provides contraceptive services especially the modern methods to women during pre-conception and post-partum would be beneficial in averting unintended pregnancies and their related adverse outcomes in Pakistan

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Intraoperative Comparison of Measured Resection and Gap Balancing Using a Force Sensor: A Prospective, Randomized Controlled Trial.

BACKGROUND: For establishing femoral component position, gap-balancing (GB) and measured resection (MR) techniques were compared using a force sensor. METHODS: Ninety-one patients were randomized to undergo primary total knee arthroplasty using either MR (n = 43) or GB (n = 48) technique using a single total knee arthroplasty design. GB was performed with an instrumented tensioner. Force sensor data were obtained before the final implantation. RESULTS: GB resulted in greater range of femoral component rotation vs MR (1.5° ± 2.9° vs 3.1° ± 0.5°, P \u3c .05) and posterior condylar cut thickness medially (10.2 ± 2.0 mm vs 9.0 ± 1.3 mm) and laterally (8.5 ± 1.9 mm vs 6.4 ± 1.0 mm). Force sensor data showed a decreased intercompartmental force difference at full flexion in GB (.8 ± 2.3 vs 2.0 ± 3.3u, 1u ≈ 15 N, P \u3c .05). CONCLUSION: GB resulted in a greater range of femoral component rotation and thicker posterior condylar cuts resulting in an increased flexion space relative to MR. Intercompartmental force difference trended toward a more uniform distribution between full extension and full flexion in the GB vs MR group