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The aim of this study is to test the psychometric properties of the Spanish validation of the Fear of COVID-19 Scale (FCV-19S) in Paraguayan population.
Participants were recruited through an Internet-based survey. All participants whose scores in the Hospital Anxiety and Depression Scale (HADS) and The Fear Questionnaire (FQ) were greater than zero were included. 1245 subjects responded voluntarily: 1077 subjects, scoring >0, were considered.
To establish construct validity of the FCV-19S, an exploratory factor analysis was performed using the KMO test, which was adequate, and the Bartlett sphericity test, which was significant (p <.0001). The CFI, NFI, GFI, TLI and RMSEA indices were used to evaluate the model and showed good adjustment. Cronbach’s alpha showed valid internal consistency (α=0.86). This validation is supported by significant correlation (p <.001) with the HADS scale for anxiety and depression and with the FQ scale for specific phobia.
The Spanish version of the FCV-19S, validated in Paraguayan population, is a 7-item scale with two dimensions, psychological symptoms (items 1, 2, 4, and 5) and physiological symptoms (items 3, 6, and 7) with robust psychometric properties.
Based on the needs assessment of the medical and non-medical departments, the Investment Committee of the Hospital de Clínicas de Porto Alegre (HCPA), a teaching hospital in Brazil, recommends on which technologies the limited financial resources should be invested. Technology inclusion requests are evaluated by the hospital's technology assessment unit. For technology replacement, we have found models to assess the criticality of medical equipment, but they were insufficient to support the decision, which involves all departments of our hospital. This study aimed to develop an automated tool to support decision making regarding investments in equipment replacement in the hospital.
A working group was set up with professionals from healthcare administration, clinical engineering and research departments. From the hospital's inventory database, we developed the tool using Google SheetsR. We have defined three departments for pilot testing of the tool: hemodynamics, laundry, and basic research. These departments represent the areas of healthcare, support services, and teaching and research in the hospital.
The criticality of medical equipment is assessed based on the criteria of function, physical risk, impact, remaining equipment life cycle, intensity of use and number of corrective maintenance actions performed. For the equipment in the administrative, support and research areas, the function and physical risk criteria were replaced by the safety and by the risks to the quality of service criteria. The evaluation is carried out by a multidisciplinary team. The tool categorizes the equipment into low, medium and high criticality.
The tool prioritized the equipment based on objective criteria evaluated by the departments’ multidisciplinary team comprising experts who use the equipment in their activities, the department administrator and clinical engineers, and provided transparency regarding the decision-making of the hospital's Investment Committee. In 2019, the limited financial resources were invested only in the replacement of highly critical equipment. We believe the tool can be reproduced in hospitals in low and middle-income countries.
En este trabajo se describen las relaciones que las sociedades humanas establecieron con su entorno durante el período Formativo (3000-1000 aP) en la Pampa del Tamarugal, Desierto de Atacama, desde una perspectiva teórico-metodológica que pone el acento en el potencial del registro ecofactual. Éste, al mediar entre lo cultural y lo ambiental, proporciona información vital para una mejor comprensión de la relación entre naturaleza y cultura construida por estas sociedades. Queremos demostrar que este proceso forma parte de una larga historia de racionalización del desierto y de sus recursos silvestres, locales e introducidos, así como de la vivencia particular que tuvieron estas comunidades andinas. Por consiguiente, proponemos que la intervención humana en la Pampa del Tamarugal puede ser entendida como un cambio no sólo ecológico y económico, sino también cosmológico.
There is a lack of studies evaluating smoking cessation treatment protocols which include people with and without mental and substance use disorders (MSUD), and which allows for individuals with MSUD undergoing their psychiatric treatment.
We compared treatment success between participants with (n = 277) and without (n = 419) MSUD among patients in a 6-week treatment provided by a Brazilian Psychosocial Care Center (CAPS) from 2007 to 2013. Sociodemographic, medical and tobacco use characteristics were assessed at baseline. Tobacco treatment consisted of 1) group cognitive behavior therapy, which included people with and without MSUD in the same groups, and 2) pharmacotherapy, which could include either nicotine patches, nicotine gum, bupropion or nortriptyline. For participants with MSUD, tobacco treatment was integrated into their ongoing mental health treatment. The main outcome was 30-day point prevalence abstinence, measured at last day of treatment.
Abstinence rates did not differ significantly between participants with and without MSUD (31.1% and 34.4%, respectively). Variables that were significantly associated with treatment success included years smoking, the Heaviness of Smoking Index, and use of nicotine patch or bupropion.
The inclusion of individuals with and without MSUD in the same protocol, allowing for individuals with MSUD undergoing their psychiatric treatment, generates at least comparable success rates between the groups. Predictors of treatment success were similar to those found in the general population. Facilities that treat patients with MSUD should treat tobacco use in order to reduce the disparities in morbidity and mortality experienced by this population.
The low-temperature synthesis of bricks prepared from high-siliceous clays by the method of plastic molding of blanks was used. For the preparation of brick blanks, binary and ternary mixtures of high-siliceous clays, black sand, and bottle glass cullet were used. Gray-black low-porosity and high-porosity ceramics was obtained by sintering under conditions of oxygen deficiency. It has been established that to initiate plastic in mixtures containing high-siliceous clay, it is necessary to add montmorillonite/bentonite additives, carry out low-temperature sintering, and introduce low-melting glass additives with a melting point ranging from 750 to 800 °C. The performed investigations have shown that the sintering of mixtures with a total content of iron oxide of about 5 wt% under reducing conditions at Tsint. = 800°C for 8 h leads to the formation of glass ceramics consisting of quartz, feldspars, and a phase. The main sources of the appearance of a dark color is the formation of [Fe3+O4]4- and [Fe3+O6]9- anions in the composition of the glass phase and feldspars. By changing the contents of clay, sand, and glass in sintering, it is possible to obtain two types of ceramic materials: (a) in the form of building bricks and (b) in the form of porous fillers.
To determine whether (-)-epicatechin (Epi) could decrease visceral adipose tissue and improve the metabolic profile of male offspring rats, after maternal obesity was induced by a high-fat diet (HFD).
Maternal obesity in albino Wistar rats was induced with a HFD, whereas male offspring were fed with chow diet throughout the study. Eight male offspring per group, from different litters, were randomly assigned to the experimental or to the control groups. In the experimental group, Epi was administered at a dose of 1 mg/kg of body weight to the male offspring twice daily for two weeks, beginning at postnatal day (PND).
Weight of visceral adipose tissue, adipocyte size, and several metabolic parameters.
Epi administration in the male offspring induced a significant decrease in the amount of visceral fat (11.61 g less, P < 0.05) and in the size of adipose cells (28% smaller, P < 0.01). Besides, Epi was able to decrease insulin, leptin, and Homeostasis Model Assessment -Insulin Resistance (HOMA-IR) (P < 0.05), as well as triglycerides, when the experimental group was compared to the untreated male offspring of obese rats (P < 0.01).
Epi administration can reverse the negative effects that maternal obesity has on the male offspring. This could be because Epi reduces the amount of visceral fat and improves metabolic profile.
Organic/biodynamic agriculture has been reported worldwide as a suitable system to conserve or even regenerate natural resources. Due to the lack of long-term studies regarding the profitability of tropical organic vs conventional farming, the economic performance of biodynamic vs conventional soybean was studied using data from a consecutive 7-yr case study in a farm with 48.4 ha of biodynamic soybeans in Paraná State, Brazil. Analyses of production costs and financial indicators were adjusted at updated values according to inflation in the period. Effective operational costs were 4.4% higher in biodynamic than in conventional farming. The biodynamic yields were lower (3.6%) than those of conventional. Prices were 57% higher in biodynamic than in conventional, making biodynamic farming more profitable than conventional farming, as shown by financial indicators (gross revenue, gross margin, net margin, net income and capital income were 50.7, 99.9, 122.9, 150.4 and 166.9%, respectively, higher in biodynamic than in conventional). The price equilibrium point (PEP) was 3.4% higher for biodynamic farming; the leveling point was 36.9% higher for conventional farming. Manual weeding and plowing increased organic costs. Higher biodynamic trading prices than those of conventional triggered a PEP suitable for covering higher costs and thus boosting profitability. Further investigations and policies are suggested to further improve biodynamic farming efficiency and sustainability.
The fraction of organic matter present affects the fragmentation behavior of sialoliths; thus, pretherapeutic information on the degree of mineralization is relevant for a correct selection of lithotripsy procedures. This work proposes a methodology for in vivo characterization of salivary calculi in the pretherapeutic context. Sialoliths were characterized in detail by X-ray computed microtomography (μCT) in combination with atomic emission spectroscopy, Fourier transform infrared spectroscopy, X-ray diffraction, scanning electron microscopy, and transmission electron microscopy. Correlative analysis of the same specimens was performed by in vivo and ex vivo helical computed tomography (HCT) and ex vivo μCT. The mineral matter in the sialoliths consisted essentially of apatite (89 vol%) and whitlockite (11 vol%) with average density of 1.8 g/cm3. In hydrated conditions, the mineral mass prevailed with 53 ± 13 wt%, whereas the organic matter, with a density of 1.2 g/cm3, occupied 65 ± 10% of the sialoliths’ volume. A quantitative relation between sialoliths mineral density and X-ray attenuation is proposed for both HCT and μCT.
Recent open-label trials show that psychedelics, such as ayahuasca, hold promise as fast-onset antidepressants in treatment-resistant depression.
To test the antidepressant effects of ayahuasca, we conducted a parallel-arm, double-blind randomized placebo-controlled trial in 29 patients with treatment-resistant depression. Patients received a single dose of either ayahuasca or placebo. We assessed changes in depression severity with the Montgomery-Åsberg Depression Rating Scale (MADRS) and the Hamilton Depression Rating scale at baseline, and at 1 (D1), 2 (D2), and 7 (D7) days after dosing.
We observed significant antidepressant effects of ayahuasca when compared with placebo at all-time points. MADRS scores were significantly lower in the ayahuasca group compared with placebo at D1 and D2 (p = 0.04), and at D7 (p < 0.0001). Between-group effect sizes increased from D1 to D7 (D1: Cohen's d = 0.84; D2: Cohen's d = 0.84; D7: Cohen's d = 1.49). Response rates were high for both groups at D1 and D2, and significantly higher in the ayahuasca group at D7 (64% v. 27%; p = 0.04). Remission rate showed a trend toward significance at D7 (36% v. 7%, p = 0.054).
To our knowledge, this is the first controlled trial to test a psychedelic substance in treatment-resistant depression. Overall, this study brings new evidence supporting the safety and therapeutic value of ayahuasca, dosed within an appropriate setting, to help treat depression. This study is registered at http://clinicaltrials.gov (NCT02914769).
Coinfection with human visceral leishmaniasis (HVL) and human immunodeficiency virus (HIV) has become an emerging public health problem in several parts of the world, with high morbidity and mortality rates. A systematic review was carried out in the literature available in PubMed, Scielo and Lilacs related to HVL associated with HIV coinfection, seeking to analyze epidemiological, clinical and laboratory aspects. Of the 265 articles found, 15 articles were included in the qualitative analysis, which referred to the results of HVL treatment in patients coinfected with HIV. In the published articles between 2007 and 2015, 1171 cases of HVL/HIV coinfection were identified, 86% males, average age 34 years, liposomal amphotericin B was the most commonly used drug, cure rates 68 and 20% relapses and 19% deaths, five different countries, bone marrow was used in 10/15 manuscripts. HVL/HIV coinfection is a major challenge for public health, mainly due to the difficulty in establishing an accurate diagnosis, low response to treatment with high relapse rates and evolution to death. In addition, these two pathogens act concomitantly for the depletion of the immune system, contributing to worsening the clinical picture of these diseases, which requires effective surveillance and epidemiological control measures.
Litterfall is one of the most important pathways through which nutrients are recycled in the terrestrial biosphere. In tropical soils, which are generally low in essential nutrients such as phosphorus and cations, the flux of nutrients through litterfall is particularly important to sustaining CO2-uptake capacity; however, questions remain over the role of altitude in altering litter nutrient cycling rates among tropical forest ecosystems. Here we examine litterfall, carbon (C), nitrogen (N) and phosphorus (P) fluxes through litterfall over an altitudinal gradient in the coastal Atlantic Forest located on the northern coast of the State of São Paulo, Brazil. Litterfall was collected twice a month for 1 y (April 2007–March 2008) using 30 litter traps placed in four different forest types arrayed by altitude – coastal forest (sea level), lowland forest (50–200 m asl), submontane forest (300–500 m asl) and montane forest (1000 m asl). Litterfall mass-fluxes decreased with increasing altitude, from ~9 Mg ha−1 in lowland forests to 7 Mg ha−1 in higher-altitude ecosystems. Contribution of reproductive organs to litterfall was significantly greater in lower than in higher altitudes. Litterfall N and P fluxes were higher in the lowland forest vs. other forest types, pointing to strong altitudinal controls over nutrient cycling. Furthermore, nitrogen-use efficiency (NUE) was lower and litter δ15N was higher in the lowland site providing additional evidence for lack of N constraints to productivity in lowland of the south-eastern Atlantic Forest.
Lithotripsy methods show relatively low efficiency in the fragmentation of sialoliths compared with the success rates achieved in the destruction of renal calculi. However, the information available on the mechanical behavior of sialoliths is limited and their apparently tougher response is not fully understood. This work evaluates the hardness and Young’s modulus of sialoliths at different scales and analyzes specific damage patterns induced in these calcified structures by ultrasonic vibrations, pneumoballistic impacts, shock waves, and laser ablation. A clear correlation between local mechanical properties and ultrastructure/chemistry has been established: sialoliths are composite materials consisting of hard and soft components of mineralized and organic nature, respectively. Ultrasonic and pneumoballistic reverberations damage preferentially highly mineralized regions, leaving relatively unaffected the surrounding organic matter. In contrast, shock waves leach the organic component and lead to erosion of the overall structure. Laser ablation destroys homogeneously the irradiated zones regardless of the mineralized/organic nature of the underlying ultrastructure; however, damage is less extensive than with mechanical methods. Overall, the present results show that composition and internal structure are key features behind sialoliths’ comminution behavior and that the organic matter contributes to reduce the therapeutic efficiency of lithotripsy methods.
We demonstrate a compact tunable photonic modulator driven by surface acoustic waves (SAWs) in the low GHz frequency range. The device follows a well-known Mach-Zehnder interferometer (MZI) structure with three output channels, built upon multi-mode interference (MMI) couplers. The light continuously switches paths between the central and the side channels, avoiding losses and granting a 180◦-dephasing synchronization between them. The modulator was monolithically fabricated on (Al,Ga)As, and can be used as a building block for more complex photonic functionalities. It can also be implemented in other material platforms such as Silicon or (In,Ga)P. Light modulated at multiples of the fundamental acoustic frequency can be accomplished by adjusting the applied acoustic power. An excellent agreement between theory and experiment is achieved.
Theories have been put forward on the etiology of sialoliths; however, a comprehensive understanding of their growth mechanisms is lacking. In an attempt to fill this gap, the current study has evaluated the internal architecture and growth patterns of a set of 30 independent specimens of sialoliths characterized at different scales by computed microtomography and electron microscopy. Tomography reconstructions showed cores in most of the sialoliths. The cores were surrounded by concentric or irregular patterns with variable degrees of mineralization. Regardless of the patterns, at finer scales the sialoliths consisted of banded and globular structures. The distribution of precipitates in the banded structures is compatible with a Liesegang–Ostwald phenomenon. On the other hand, the globular structures appear to arise from surface tension effects and to develop self-similar features as a result of a viscous fingering process. Electron diffraction patterns demonstrated that Ca- and P-based electrolytes crystallize in a structure close to that of hydroxyapatite. The organic matter contained sulfur with apparent origin from sulfated components of secretory material. These results cast new light on the mechanisms involved in the formation of sialoliths.
Salt weathering is a major erosive process affecting porous materials in buildings. There have been attempts to relate erosive mass loss to physical characteristics of materials, but in the case of natural stone it is necessary to consider the effect of petrographic features that are a source of heterogeneity. In this paper, we use scanning electron microscopy before and after salt weathering tests in cubic specimens of three limestone types (two grainstones and a travertine) in an attempt to built conceptual models that relate petrographic features and salt weathering susceptibility (represented by mass loss). In the grainstones, the most relevant feature in controlling salt weathering processes is the interface between micrite aggregates and sparry cement that constitute weakness surfaces and barriers to fluid migration. Given the small size of the heterogeneities in relation to the test sample dimension and their spatial distribution, the macroscopic erosive patterns are globally homogeneously distributed, affecting edges and corners. In the travertine specimens, there are macroheterogeneities related to the presence of detritic-rich portions that cause heterogeneous erosive patterns in the specimens. Petrological modeling helps to understand results of salt weathering tests, supporting field studies for natural stone selection.
This article presents a detailed study of the microstructure of Iberian expanded clay lightweight aggregates (LWA). Other than more commonly used mercury porosimetry (MP) and water absorption methods, the experimental study involves optical microscopy, scanning electron microscopy (SEM), and microtomography (μ-CT). Pore connectivity and how it is deployed are shown to some degree, and the pore size spectrum is estimated. LWA are in general characterized by a dense outer shell up to 200 μm thick, encasing an inner cellular structure of 10–100 times bigger pore size. Aggregate pore sizes may span from some hundreds of nanometers up to over 1 mm, though the range of 1–25 μm is more typical. A noteworthy fraction of these pores is closed, and they are mainly up to 1 μm. It is also shown that macropore spatial arrangement is affected by the manufacturing process. A step forward is given to understanding how the outer shell and the inner pore network influence the mechanical and physical LWA properties, particularly the density and water absorption. The joint consideration of μ-CT and SEM seems to be the most appropriate methodology to study LWA microstructure. MP analysis is likely to distort LWA pore spectrum assessment.
In software development, we have to make choices and take decisions, and these depend on obtaining answers for critical questions, such as the following:
How should an important decision be made when conflicting strategic goals and stakeholders’ desires or quality attributes must be considered?
How can stakeholders be assured that the decision has been made in a sound, rational and fair process that withstands the rigour of an aspect-oriented analysis and design, or a software product line, for example?
In software product line (SPL) development, the answers to these questions are critical, because they require dealing with modelling and implementation of common and variable requirements that can be composed and interact in different ways. Furthermore, they also require decisions that can impact several products at the same time. For example, we may simply want to know which requirements are in conflict and which features are negatively affected – considering different configurations of the software product lines – to choose the best architecture to design and implement the product line and to be able to decide which mandatory or optional features should have implementation priority. Therefore, help is required to support software engineers in making better, informed decisions, by offering them a systematic process for ranking a set of alternatives based on a set of criteria. In requirements engineering, for instance, it is useful to identify conflicting requirements with respect to which negotiations must be carried out and to which trade-offs need to be established (Rashid et al., 2003). A concrete typical use is to offer a ranking of non-functional requirements (NFRs) based on stakeholders’ wishes. This helps to establish early trade-offs between requirements, hence providing support for negotiation and subsequent decision-making among stakeholders. As discussed in Moreira et al. (2005a), having performed a trade-off analysis on the requirements, we are better informed with respect to each important quality attribute the system should satisfy, before making any architectural choices.