RESUMEN

INTRODUCTION: The scientific community highlighted the relevance of 3D physical models since the beginning of the XXI century, complementary to three-dimensional(3D) digital volume by computer tomography, to support court discussions on medico-legal issues. The recreation of 3D evidence can be an important tool for investigators and experts, providing a better understanding of the causes and circumstances of the events involved in a crime. OBJECTIVE: The present study aims to assess the reproducibility of 3D printed and 3D tomographic volumes generated from mandibles following simulated forensic injuries, highlighting the recreation of crime tools. MATERIAL AND METHODS: Concerning the study design presented, data collection was performed in three phases. Nine simulated injuries of forensic interest were selected (phase1) and all the mandibles were scanned tomographically, individually, by Cone Beam Computed Tomography CBCT (phase 2). Then, in phase 3, the DICOM images were used for 3D printing with the Ender 3® printer by the Fused Deposition Modeling (FDM) technique. The data analysis followed two procedures: the comparison between the artificial mandible and 3D tomographic volume (AT) and the comparison between the artificial mandible and 3D printed volume, or the copy (AC). Data were analyzed using T-Student and ICC tests and presented in Bland-Altman plots. CONCLUSION: The analogic technique applied in 3D printed volume, when compared with computerized technique, using 3D digital images and measurement, showed to be accurate and reproducible. Further studies are needed in search of standardization for three-dimensional measurements in digitized and printed volumes.

Asunto(s)

RESUMEN

BACKGROUND: Social isolation and loneliness are pervasive issues among older adults in the United States, carrying significant health risks. Low-income older adults are particularly vulnerable to these challenges compared with their higher-income counterparts due to their limited access to resources and social networks. Many low-income older adults live in subsidized housing, which has the potential to offer unique support tailored to their needs. The intersection of aging and the unique social circumstances faced by low-income older adults significantly influences how they navigate crises. METHODS: We conducted semi-structured interviews with 24 older adults aged 63-86 residing in subsidized housing communities in the United States. The data were collected from August 2021 to November 2022 and subsequently analyzed using a thematic constant comparison analysis approach. RESULTS: Many participants felt connected to their housing community. Participants reported that their lives changed substantially due to the pandemic: communal activities ceased leading to isolation and feelings of loneliness. Amid this challenge, participants were resourceful and found creative ways to manage. Many emphasized the crucial role of technology in maintaining emotional support despite physical separation. CONCLUSIONS: Participants in subsidized housing shared their experiences before and during this unique crisis highlighting the challenges they face, as well as their resilience and adaptability when facing challenges. Our findings underscore the significance of community activation, demonstrating that activities motivated older adults to improve their well-being. Additionally, the role of technology in maintaining connections proved to be crucial.

RESUMEN

The economic advantages of H2SO4 make it the acid of choice for the hydrometallurgical treatment of waste lithium-ion batteries (LIBs). However, to facilitate the full dissolution of the higher valency metal oxides present in the cathode black mass, a suitable reducing agent is required. Herein, the application of industrial black liquor (BL) obtained from the Kraft pulping for papermaking is investigated as a renewable reducing agent for the enhanced leaching of transition metals from LIB powder with H2SO4. The addition of acidified BL to H2SO4 significantly improved the leaching efficiency for a range of LIB cathode chemistries, with the strongest effect observed for manganese-rich active material. Focusing on NMC111 (LiMnxCoyNizO2) material, a linear correlation between the BL concentration and the leaching yield of Mn was obtained, with the best overall leaching efficiencies being achieved for 2.0 mol L-1 H2SO4 and 50 vol % of BL at 353 K. A quasi-total degradation of oxygenated and aromatic groups from the BL during NMC111 dissolution was observed after leaching, suggesting that these chemical groups are essential for LIB reduction. Finally, the leached transition metals could be easily recovered by pH adjustment and oxalic acid addition, closing the resource loop and fostering resource efficiency.

RESUMEN

Resumo O artigo explora como as doenças eram pensadas e enfrentadas na América portuguesa no início da década de 1820, pouco antes da consolidação da ruptura política com Portugal que tornou o Brasil um país independente. Analisa quem foram os indivíduos chamados para tratar as doenças da população sofredora, seus saberes e terapêuticas. Para tanto, inicia-se com um recuo no tempo, enfatizando as influências das reformas do Império português sobre o saber médico na segunda metade do século XVIII. A primeira parte do artigo se dedica a explorar as complexas e multifacetadas práticas de cura na América portuguesa, resultantes das misturas entre as concepções tradicionais sobre o corpo e a doença que faziam parte das referências culturais da população local. Em seguida, analisa alguns dos embates institucionais e políticos envolvidos na consolidação da medicina científica no Brasil, especialmente após a transferência da Corte portuguesa para o Rio de Janeiro. Apesar do prestígio político dos médicos acadêmicos, os praticantes das artes da cura contavam com amplo apoio da população, além de encontrarem mobilidade social nas brechas das relações clientelistas que marcavam a cultura política do período.

Abstract This article explores how diseases were contemplated and faced in Portuguese America in the early 1820s, shortly before the consolidation of the political rupture with Portugal that made Brazil an independent country. It analyzes who the individuals called to treat the diseases of the suffering population were, along with their knowledge and their therapies. To achieve this, we must begin by taking a step back in time, emphasizing the influences of the reforms of the Portuguese Empire on medical knowledge in the second half of the eighteenth century. The first section of the article is dedicated to exploring the complex and multifaceted healing practices in Portuguese America, resulting from the mixtures between traditional concepts about the body and the diseases that were part of the cultural references of the local population. The article then moves on to analyze some of the institutional and political conflicts involved in the consolidation of scientific medicine in Brazil, especially after the transfer of the Portuguese Court to Rio de Janeiro. Despite the political prestige of academic doctors, practitioners of the healing arts had broad support from the population, in addition to finding social mobility in the breaches of clientelistic relationships that marked the political culture of the period.

RESUMEN

This article explores how diseases were contemplated and faced in Portuguese America in the early 1820s, shortly before the consolidation of the political rupture with Portugal that made Brazil an independent country. It analyzes who the individuals called to treat the diseases of the suffering population were, along with their knowledge and their therapies. To achieve this, we must begin by taking a step back in time, emphasizing the influences of the reforms of the Portuguese Empire on medical knowledge in the second half of the eighteenth century. The first section of the article is dedicated to exploring the complex and multifaceted healing practices in Portuguese America, resulting from the mixtures between traditional concepts about the body and the diseases that were part of the cultural references of the local population. The article then moves on to analyze some of the institutional and political conflicts involved in the consolidation of scientific medicine in Brazil, especially after the transfer of the Portuguese Court to Rio de Janeiro. Despite the political prestige of academic doctors, practitioners of the healing arts had broad support from the population, in addition to finding social mobility in the breaches of clientelistic relationships that marked the political culture of the period.

O artigo explora como as doenças eram pensadas e enfrentadas na América portuguesa no início da década de 1820, pouco antes da consolidação da ruptura política com Portugal que tornou o Brasil um país independente. Analisa quem foram os indivíduos chamados para tratar as doenças da população sofredora, seus saberes e terapêuticas. Para tanto, inicia-se com um recuo no tempo, enfatizando as influências das reformas do Império português sobre o saber médico na segunda metade do século XVIII. A primeira parte do artigo se dedica a explorar as complexas e multifacetadas práticas de cura na América portuguesa, resultantes das misturas entre as concepções tradicionais sobre o corpo e a doença que faziam parte das referências culturais da população local. Em seguida, analisa alguns dos embates institucionais e políticos envolvidos na consolidação da medicina científica no Brasil, especialmente após a transferência da Corte portuguesa para o Rio de Janeiro. Apesar do prestígio político dos médicos acadêmicos, os praticantes das artes da cura contavam com amplo apoio da população, além de encontrarem mobilidade social nas brechas das relações clientelistas que marcavam a cultura política do período.

Asunto(s)

RESUMEN

Introducción y objetivo: La corrección de la ginecomastia se encuentra entre las cirugías estéticas más solicitadas por los pacientes masculinos. La principal complicación de este procedimiento es el hematoma postoperatorio. Describimos nuestra experiencia con el uso de la red hemostática percutánea para reducir la incidencia de hematoma postoperatorio, sin el uso de drenajes. Material y método: Evaluamos 13 pacientes operados de ginecomastia con edades compreendidas entre los 15 y los 59 años; un total de 25 mamas. Realizamos la red hemostática en los segmentos superior, inferior y areolar, con hilo de Prolene 2.0 o 3.0 y aguja cilíndrica, después de la hemostasia y antes de cerrar la incisión de la adenectomía, por lo tanto, bajo observación directa. No utilizamos drenajes en ninguno de los pacientes de esta serie y retiramos la malla entre 48 y 96 horas de postoperatorio. Resultados: Del total de 25 mamas operadas, solo 1 presentó hematoma limitado a la región retroareolar, siendo el primer caso de esta serie en el que no habíamos realizado la malla en el segmento areolar. La red no causó ninguna secuela cicatricial (marcas em la piel) ni pigmentación em los punto de transfixión de la aguja. Conclusiones: En nuestra experiencia, el uso de la red hemostática fue un procedimiento adicional al tratamiento de la ginecomastia y resultó eficaz en la prevención del hematoma postoperatorio. (AU)

Background and objective: Correction of gynecomastia is among the most requested cosmetic surgeries by male patients. The main complication of this procedure is postoperative hematoma. We describe the use of a percutaneous hemostatic network to reduce the incidence of postoperative hematoma, without the use of drains. Methods: Thirteen patients were evaluated, aged between 15 and 59 years, in a total of 25 breasts. The hemostatic net was performed in the upper, lower and areolar segments, with 2.0 or 3.0 Prolene with a cylindrical needle, after hemostasis, before closing the adenectomy incision, therefore under direct vision. Drains were not used in any of the patients in this series. The mesh was removed between 48 and 96 hours. Results: Of the total of 25 breasts, only 1 had a hematoma, limited to the retro-areolar region, which was the first case in this series in which the mesh was not performed in the areolar segment. Net did not produced any sequel scar (skin marks) not pigmentation at the needle transfixation sites. Conclusions: In our experience, the use of the hemostatic net was an additional procedure to the treatment of gynecomastia, having been efficient in the prevention of postoperative hematoma. (AU)

Asunto(s)

RESUMEN

Anti-Black racism embedded in contemporary health systems harms Black and Indigenous People of Color (BIPoC) in concert with various diseases. Seemingly unrelated at first, the COVID-19 pandemic is a recent example that reveals how the combined manifestations of anti-Black racism in disease governance, course, and burden exacerbate the historic and still present subjugation of Black people. Thus, such conditions highlight a biosocial network that intricately propagates and consolidates systems of oppression since the birth of the United States of America. In this article, we show how anti-Black racism in conjunction with past and ongoing epidemics exemplify intertwined conditions embodying and perpetuating racial inequities in the North American country. Through schematic visualizations and techniques of progressive disclosure, we situate disease governance, course, and burden as action spaces within a design model that alternates views of organizational strategies, operations, offerings, and people's experiences, supporting an action-oriented discussion in each of these spaces. We utilize insights from this analysis to recommend that public health moves forward, considering more holistic, solution-oriented questions that embrace systemic complexity and people-centered perspectives when seeking to improve health outcomes for all.

Asunto(s)

RESUMEN

Francisco Antônio de Sampaio worked as a surgeon for over two decades in Cachoeira, in the captaincy of Bahia, Brazil. In this village, he produced writings on natural history, which he sent to the Lisbon Academy of Science, although he had no specific training in this area. This article analyzes his scientific output and healing practices, especially the uses and descriptions of local plants and his relationships with different agents, such as the "local commoners" and the naturalist and magistrate Joaquim de Amorim e Castro. His production of knowledge is interpreted here both from the perspective of the construction of scientific authority and through his interactions with local and metropolitan agents.

Francisco Antônio de Sampaio atuou como cirurgião por mais de duas décadas em Cachoeira (BA). Nessa vila, produziu e enviou à Academia das Ciências de Lisboa escritos de história natural, embora não tivesse formação específica para esses estudos. Neste artigo analisamos sua produção científica e suas práticas de cura, em particular os usos e descrições das plantas locais e sua relação com diferentes agentes, a exemplo das pessoas do "vulgo local" e do naturalista e juiz de fora Amorim e Castro. Buscamos interpretar sua produção de conhecimento, tanto do ponto de vista da construção de autoridade científica quanto de sua interação com os agentes locais e metropolitanos.

Asunto(s)

RESUMEN

Resumo Francisco Antônio de Sampaio atuou como cirurgião por mais de duas décadas em Cachoeira (BA). Nessa vila, produziu e enviou à Academia das Ciências de Lisboa escritos de história natural, embora não tivesse formação específica para esses estudos. Neste artigo analisamos sua produção científica e suas práticas de cura, em particular os usos e descrições das plantas locais e sua relação com diferentes agentes, a exemplo das pessoas do "vulgo local" e do naturalista e juiz de fora Amorim e Castro. Buscamos interpretar sua produção de conhecimento, tanto do ponto de vista da construção de autoridade científica quanto de sua interação com os agentes locais e metropolitanos.

Abstract Francisco Antônio de Sampaio worked as a surgeon for over two decades in Cachoeira, in the captaincy of Bahia, Brazil. In this village, he produced writings on natural history, which he sent to the Lisbon Academy of Science, although he had no specific training in this area. This article analyzes his scientific output and healing practices, especially the uses and descriptions of local plants and his relationships with different agents, such as the "local commoners" and the naturalist and magistrate Joaquim de Amorim e Castro. His production of knowledge is interpreted here both from the perspective of the construction of scientific authority and through his interactions with local and metropolitan agents.

Asunto(s)

RESUMEN

Bodybuilding is a sport in which competitors' physiques are judged on their muscular size, symmetry, and leanness, as displayed in a number of different poses. In the pre-competitive period, bodybuilders attempt to reduce body fat stores as much as possible while maintaining fat-free mass (FFM). This is achieved via a sustained negative energy balance, generally induced by a combination of decreased energy intake and increased energy expenditure. This study aimed to assess the ability of bodybuilders to resist fatigue during resistance exercise based German Volume Training (GVT), as well as the affective response after carbohydrate refeed following four weeks of moderate or severe energy restriction. Eleven male bodybuilders (28.4 ± 2.3 years old) with experience in competitions were randomized into two groups: Moderate Energy Restriction (MER; n = 6) or Severe Energy Restriction (SER; n = 5). On the 2nd day (during energy restriction) and 7th day (during refeed) of the fourth week, both groups completed two leg press protocols involving the GVT method. After the first and last workout protocol subjects were assessed for muscle soreness using the visual-analog scale (VAS), rating of perceived exertion (RPE), affective response, lactate, and creatine kinase. Anthropometric analysis indicated that a reduction of 3.7 and 3.2% in body mass corresponded to a loss of 16.0 and 17.6% of fat mass for the MER and SER groups, respectively, with both groups maintaining FFM. Blood CK and VAS values were reduced only in SER. Our results suggest that a carbohydrate refeed may help to attenuate the perception of muscle soreness and maintain exercise performance, especially when severe energy restriction is combined with an intense training protocol such as GVT.

Asunto(s)

RESUMEN

Abstract: The Mid-Domain Effect (MDE) and the Rapoport (RE) effect are two biogeographical theories that make predictions about biogeogaphic patterns. MDE predicts higher richness in the central portions of a gradient if it is within a bounded domain. RE predicts a positive relation between altitude and species range size along an altitudinal gradient. Our aim was to document the distribution of spider species richness along an altitudinal gradient in the Brazilian Amazon, and to test the influence of MDE and RE on the diversity patterns. Our study was conducted at the Pico da Neblina (Amazonas state, Brazil), and we sampled spiders at six different altitudes using two methods: nocturnal hand sampling and a beating tray. We obtained 3,140 adult spiders from 39 families, sorted to 529 species/morphospecies. Richness declined continuously with an altitude increase, but the fit with the MDE richness estimates was very weak and was not significant. Range size was not related to altitude, i. e., no RE. Finally, the abundance distribution within each species range varied more specifically, which prevented the occurrence of a RE at the community level. The influence of MDE was extremely low, a consequence of our community characteristics, formed mostly by small range size species. Short and medium range species were located at all altitudes, preventing a significant relation between range size and altitude. The distribution of abundance within a species range varied specifically and do not support a RE hypothesis.

Resumo: O Efeito do Domínio Central (MDE) e o Efeito Rapoport (ER) são duas teorias biogeografias que fazem previsões sobre a distribuição da diversidade ao longo de gradientes. O MDE prevê maior riqueza nas porções centrais de um gradiente, se este estiver dentro de um domínio fechado. O ER prevê uma relação positiva entre altitude e tamanho da distribuição ao longo do gradiente altitudinal. Nosso objetivo foi o de registrar a distribuição de uma comunidade de aranhas ao longo de um gradiente altitudinal na Amazônia Brasileira, e testar se há uma influência do EDC e do ER sobre os padrões de diversidade da comunidade. Nosso estudo foi feito no Parque Nacional do Pico da Neblina (AM, Brasil), e nós amostramos aranhas em seis altitudes diferentes. Nós coletamos 3.140 exemplares adultos de 39 famílias, que foram divididos em 529 espécies/morfoespécies. A riqueza declinou com o aumento de altitude, mas o padrão não mostrou ajuste com as previsões feitas pelo EDC. O tamanho da distribuição altitudinal também não esteve relacionado ao previsto pelo ER. Por fim, a distribuição de abundância ao longo da distribuição altitudinal das espécies variou de maneira específica, o que impediu a ocorrência de um ER nos padrões da comunidade. A influência do EDC sobre os padrões observados foi baixíssima, uma consequência de características de nossa comunidade, já que esta é formada por espécies com pequena distribuição altitudinal. Espécies de distribuição altitudinal médias e grandes ocorreram em todas as partes do gradiente o que impediu a ocorrência de um ER. Por fim, o ER também não foi observado na distribuição de abundância das espécies ao longo do gradiente, já que essa variou de maneira específica.

RESUMEN

Beta diversity is usually high along elevational gradients. We studied a spider community at the Pico da Neblina (Brazil), an Amazonian mountain which is one of the southern components of the Guayana region. We sampled six elevations and investigated if beta diversity patterns correspond to the elevational division proposed for the region, between lowlands (up to 500 m), uplands (500 m to 1500 m), and highlands (>1500 m). Patterns of dominance increased with elevation along the gradient, especially at the two highest elevations, indicating that changes in composition may be accompanied by changes in species abundance distribution. Beta diversity recorded was very high, but the pattern observed was not in accordance with the elevationaldivision proposed for the region. While the highlands indeed harbored different fauna, the three lowest elevationshad similar species compositions, indicating that the lowlands spider community extends into the uplands zone. Other measures of compositional change, such as similarity indices and species indicator analysis, also support this pattern. Our results, in addition to a revision of the literature, confirm the high diversity and endemism rates of montane spider communities, and we stress the importance of protecting those environments, especially considering the climate crisis.

RESUMEN

The Mid-Domain Effect (MDE) and the Rapoport (RE) effect are two biogeographical theories that make predictions about biogeogaphic patterns. MDE predicts higher richness in the central portions of a gradient if it is within a bounded domain. RE predicts a positive relation between altitude and species range size along an altitudinal gradient. Our aim was to document the distribution of spider species richness along an altitudinal gradient in the Brazilian Amazon, and to test the influence of MDE and RE on the diversity patterns. Our study was conducted at the Pico da Neblina (Amazonas state, Brazil), and we sampled spiders at six different altitudes using two methods: nocturnal hand sampling and a beating tray. We obtained 3,140 adult spiders from 39 families, sorted to 529 species/morphospecies. Richness declined continuously with an altitude increase, but the fit with the MDE richness estimates was very weak and was not significant. Range size was not related to altitude, i. e., no RE. Finally, the abundance distribution within each species range varied more specifically, which prevented the occurrence of a RE at the community level. The influence of MDE was extremely low, a consequence of our community characteristics, formed mostly by small range size species. Short and medium range species were located at all altitudes, preventing a significant relation between range size and altitude. The distribution of abundance within a species range varied specifically and do not support a RE hypothesis.

O Efeito do Domínio Central (MDE) e o Efeito Rapoport (ER) são duas teorias biogeografias que fazem previsões sobre a distribuição da diversidade ao longo de gradientes. O MDE prevê maior riqueza nas porções centrais de um gradiente, se este estiver dentro de um domínio fechado. O ER prevê uma relação positiva entre altitude e tamanho da distribuição ao longo do gradiente altitudinal. Nosso objetivo foi o de registrar a distribuição de uma comunidade de aranhas ao longo de um gradiente altitudinal na Amazônia Brasileira, e testar se há uma influência do EDC e do ER sobre os padrões de diversidade da comunidade. Nosso estudo foi feito no Parque Nacional do Pico da Neblina (AM, Brasil), e nós amostramos aranhas em seis altitudes diferentes. Nós coletamos 3.140 exemplares adultos de 39 famílias, que foram divididos em 529 espécies/morfoespécies. A riqueza declinou com o aumento de altitude, mas o padrão não mostrou ajuste com as previsões feitas pelo EDC. O tamanho da distribuição altitudinal também não esteve relacionado ao previsto pelo ER. Por fim, a distribuição de abundância ao longo da distribuição altitudinal das espécies variou de maneira específica, o que impediu a ocorrência de um ER nos padrões da comunidade. A influência do EDC sobre os padrões observados foi baixíssima, uma consequência de características de nossa comunidade, já que esta é formada por espécies com pequena distribuição altitudinal. Espécies de distribuição altitudinal médias e grandes ocorreram em todas as partes do gradiente o que impediu a ocorrência de um ER. Por fim, o ER também não foi observado na distribuição de abundância das espécies ao longo do gradiente, já que essa variou de maneira específica.

RESUMEN

Habitat destruction is the single greatest anthropogenic threat to biodiversity. Decades of research on this issue have led to the accumulation of hundreds of data sets comparing species assemblages in larger, intact, habitats to smaller, more fragmented, habitats. Despite this, little synthesis or consensus has been achieved, primarily because of non-standardized sampling methodology and analyses of notoriously scale-dependent response variables (i.e., species richness). To be able to compare and contrast the results of habitat fragmentation on species' assemblages, it is necessary to have the underlying data on species abundances and sampling intensity, so that standardization can be achieved. To accomplish this, we systematically searched the literature for studies where abundances of species in assemblages (of any taxa) were sampled from many habitat patches that varied in size. From these, we extracted data from several studies, and contacted authors of studies where appropriate data were collected but not published, giving us 117 studies that compared species assemblages among habitat fragments that varied in area. Less than one-half (41) of studies came from tropical forests of Central and South America, but there were many studies from temperate forests and grasslands from all continents except Antarctica. Fifty-four of the studies were on invertebrates (mostly insects), but there were several studies on plants (15), birds (16), mammals (19), and reptiles and amphibians (13). We also collected qualitative information on the length of time since fragmentation. With data on total and relative abundances (and identities) of species, sampling effort, and affiliated meta-data about the study sites, these data can be used to more definitively test hypotheses about the role of habitat fragmentation in altering patterns of biodiversity. There are no copyright restrictions. Please cite this data paper and the associated Dryad data set if the data are used in publications.

RESUMEN

BACKGROUND: The demand for total hip arthroplasty (THA) is rising. In the face of rapidly increasing health care costs, ensuring widespread, cost-effective rehabilitation is a priority. Technologies allowing independent home-based rehabilitation may be the key to facilitate access, improve effectiveness, and lower costs of care. OBJECTIVE: The aim of this study was to assess the feasibility of a novel artificial intelligence-powered digital biofeedback system following THA and compare the clinical outcomes against supervised conventional rehabilitation. METHODS: This was a single-center, parallel-group pilot study, with an 8-week intervention program. Patients were assessed at baseline, during the program (at 4 and 8 weeks), and 3 and 6 months after surgery. The primary outcome was the Timed Up and Go (TUG) score and secondary outcomes were the Hip dysfunction and Osteoarthritis Outcome Scale (HOOS; a patient-reported outcome) and hip range of motion (ROM). RESULTS: A total of 66 patients were included: 35 digital physiotherapy (PT) versus 31 conventional. There were no differences at baseline between groups except for lower HOOS quality of life (QoL) subscale scores in the digital PT group. Clinically relevant improvements were noted in both groups at all time points. The digital PT group showed a retention rate of 86% (30/35). Per-protocol analysis revealed a superiority of the digital PT group for all outcome measures. Intention-to-treat analysis revealed the superiority of the digital PT group at all time points for TUG (change between baseline and 4 and 8 weeks: P<.001; change between baseline and 3 and 6 months: P=.001 and P=.005, respectively), with a difference between median changes of -4.79 seconds (95% CI -7.24 to -1.71) at 6 months post-THA. Between baseline and month 6, results were also superior in the digital PT group for the HOOS sports and QoL subscales and all ROM except for standing flexion. CONCLUSIONS: This study demonstrates this novel solution holds promise in rehabilitation after THA, ensuring better clinical outcomes than conventional rehabilitation while reducing dependence on human resources. TRIAL REGISTRATION: ClinicalTrials.gov NCT03045549; https://clinicaltrials.gov/ct2/show/NCT03045549.

RESUMEN

BACKGROUND: Physical rehabilitation is recommended after total knee arthroplasty (TKA). With the expected increase in TKA over the next few decades, it is important to find new ways of delivering cost-effective interventions. Technological interventions have been developed with this intent, but only preliminary evidence exists regarding their validity, with short follow-up times. OBJECTIVE: This study aimed to present the follow-up results of a feasibility study comparing two different home-based programs after TKA: conventional face-to-face sessions and a digital intervention performed through the use of an artificial intelligence-powered biofeedback system under remote clinical monitoring. METHODS: The digital intervention uses a motion tracker allowing 3D movement quantification, a mobile app and a Web portal. This study presents the results of the previous single-center, prospective, parallel-group, feasibility study including an 8-week active treatment stage and further assessments at 3 and 6 months post-TKA. Primary outcome was the Timed Up and Go score, and secondary outcomes were the Knee Osteoarthritis Outcome Scale (KOOS) score and knee range of motion. RESULTS: A total of 59 patients completed the study (30 in the digital intervention group and 29 in the conventional rehabilitation group) and follow-up assessments. During the active treatment stage, patients in the digital intervention group demonstrated high engagement and satisfaction levels, with an 82% retention rate. Both groups attained clinically relevant improvements from baseline to 6 months post-TKA. At the end of the 8-week program, clinical outcomes were superior in the digital intervention group. At the 3- and 6-month assessments, the outcomes remained superior for the Timed Up and Go score (P<.001) and all KOOS subscale scores (at 3 months, P<.001 overall; at 6 months, KOOS Symptoms: P=.006, Pain: P=.002, Activities of Daily Living: P=.001, Sports: P=.003, and Quality of Life: P=.001). There was progressive convergence between both groups in terms of the knee range of motion, which remained higher for standing flexion in the digital intervention group than the conventional group at 6 months (P=.01). For the primary outcome, at 6 months, the median difference between groups was 4.87 seconds (95% CI 1.85-7.47), in favor of the digital intervention group. CONCLUSIONS: The present study demonstrates that this novel digital intervention for independent home-based rehabilitation after TKA is feasible, engaging, and capable of maximizing clinical outcomes in comparison to conventional rehabilitation in the short and medium term; in addition, this intervention is far less demanding in terms of human resources. TRIAL REGISTRATION: ClinicalTrials.gov NCT03047252; https://clinicaltrials.gov/ct2/show/NCT03047252.

RESUMEN

The CO2 photoreduction process to produce light hydrocarbons is known to be influenced by the presence of CuO nanoparticles, but the actual role of this material, whether as a catalyst or a reactant, has not yet been revealed. In this work, we investigate the role of CuO nanoparticles produced by a solvothermal method as a catalyst in CO2-saturated water reaction media under UV light, considering the effects of different electrolytes (Na2C2O4, KBrO3, and NaOH) and temperatures on nanoparticle phase and activity. The electrolyte strongly influenced product selectivity (NaOH led to evolution of CH4, Na2C2O4 to CO, and KBrO3 to O2) and induced CuO phase change. A long-term analysis of these processes indicated that during the initial steps, CuO acted as a reactant, rather than as a catalyst, and was converted to CuCO3.Cu(OH)2, while the as-converted material acted as a catalyst in CO2 photoreduction, with conversion values comparable to those reported in the literature.

RESUMEN

In-person home-based rehabilitation and telerehabilitation can be as effective as clinic-based rehabilitation after total knee arthroplasty (TKA), but require heavy logistics and are highly dependent on human supervision. New technologies that allow independent home-based rehabilitation without constant human supervision may help solve this problem. This was a single-center, feasibility study comparing a digital biofeedback system that meets these needs against conventional in-person home-based rehabilitation after TKA over an 8-week program. Primary outcome was the change in the Timed Up and Go score between the end of the program and baseline. Fifty-nine patients completed the study (30 experimental group; 29 conventional rehabilitation). The study demonstrated a superiority of the experimental group for all outcomes. Adverse events were similar in both groups. This is the first study to demonstrate that a digital rehabilitation solution can achieve better outcomes than conventional in-person rehabilitation, while less demanding in terms of human resources.

Asunto(s)

RESUMEN

Partindo de um diálogo com a historiografia, este capítulo aponta alguns elementos para a compreensão do universo das práticas de cura e do saber médico na América Portuguesa. Para tanto, destaca temas que têm suscitado diversas abordagens - das mais tradicionais às inovadoras - sobre o assunto. Trata sobre doença e cura no contexto luso-brasileiro, saberes e práticas de cura, doenças e expansão colonial, doenças, clima e higiene e estratégias de profilaxia.

Asunto(s)