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1.
Rev. bras. cir. plást ; 39(3): 1-9, jul.set.2024. ilus
Artigo em Inglês, Português | LILACS-Express | LILACS | ID: biblio-1572488

RESUMO

Introdução: As queimaduras são um desafio da saúde pública devido à alta morbimortalidade e prejuízo na qualidade de vida da vítima. Elas afetam desproporcionalmente as populações de menor nível socioeconômico, resultando em elevados custos para saúde. Método: Estudo ecológico, retrospectivo, observacional, com abordagem quantitativa e análise de tendência temporal da morbimortalidade por queimadura em Santa Catarina, com dados obtidos dos Sistemas de Informações Hospitalar e de mortalidade disponibilizados pelo Departamento de Informática do Sistema Único de Saúde. Análise temporal pelo Teste de Correlação de Spearman. Resultados: Verificada tendência de crescimento na taxa geral de internação (Spearman=0,806; p<0,005) por queimaduras no estado no período analisado. Maior prevalência no sexo masculino (RP 1,68), na população de 0 a 4 anos (RP 3,08) e na região da Grande Florianópolis (taxa média 23,22%). Predominou o grupo classificado como médio queimado (taxa média 25,67%) e as internações de 0 a 3 dias (taxa média 50,25%). Queimaduras em cabeça, pescoço e tronco (taxa média 32,25%) foram as mais prevalentes. Conclusão: Identificada tendência de crescimento na taxa de internação por queimaduras em crianças no estado. Maior prevalência de internação no sexo masculino, em crianças de 0 a 4 anos e na região da Grande Florianópolis. Predomínio de médio queimados e de queimaduras em cabeça, pescoço e tronco, com maior taxa de internações de curta duração.


Introduction: Burns is a public health challenge due to high morbidity and mortality and impairment of the victim's quality of life. They disproportionately affect populations of lower socioeconomic status, resulting in high health costs. Method: Ecological, retrospective, observational study, with a quantitative approach and temporal trend analysis of morbidity and mortality due to burns in Santa Catarina, with data obtained from the Hospital and Mortality Information Systems made available by the Information Technology Department of the Unified Health System. Temporal analysis by Spearman Correlation Test. Results: There was a growing trend in the general hospitalization rate (Spearman=0.806; p<0.005) for burns in the state in the period analyzed. Higher prevalence in males (RP 1.68), in the population aged 0 to 4 years (RP 3.08), and in the Greater Florianópolis region (mean rate 23.22%). The group classified as medium burn predominated (mean rate 25.67%) and hospitalizations of 0 to 3 days (mean rate 50.25%). Burns to the head, neck, and trunk (mean rate 32.25%) were the most prevalent. Conclusion: A growth trend was identified in the hospitalization rate for burns in children in the state. Higher prevalence of hospitalization in males, in children aged 0 to 4 years, and in the Greater Florianópolis region. Predominance of moderate burns and burns to the head, neck, and trunk, with a higher rate of short-term hospitalizations.

3.
Rural Remote Health ; 24(3): 8387, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-39034488

RESUMO

INTRODUCTION: Guatemalan lay midwives are well-respected community leaders in a country that lacks the institutional capacity to meet healthcare needs related to pregnancy, newborns, and COVID-19. Thus, Guatemalan lay midwives, who attend the majority of births in their country and who attend most births at home, are in an optimal position to offer frontline support to pregnant women and newborns regarding the global pandemic. The primary objective of this program of study was to dispel myths about COVID-19 and to provide culturally relevant educational activities to low-literacy Guatemalan lay midwives about issues related to the virus, such as signs and symptoms, risks to the mother and fetus, which patients are most vulnerable, appropriate responses, benefits and side-effects of the vaccine, timing of the vaccine, how the virus interacts with breastfeeding, and breastfeeding recommendations. METHODS: In a partnership among the Guatemalan Ministry of Health, expert faculty at the University of Utah College of Nursing, and Madre y Niño, a non-profit organization from the US, evidence-based educational activities about COVID-19 were offered orally in the native language of participants. Two hundred and ten lay midwives attended educational sessions at 11 locations throughout the remote Peten department. Educational activities included repetition, storytelling, and role plays. A pretest-post-test evaluation of 10 questions with 24 correct answers was used to determine if the educational activities changed lay midwife knowledge about COVID-19. Participants were given essential birth supplies and laminated COVID Reminder Cards, which were designed to increase visual literacy, to encourage knowledge retention after the educational sessions. RESULTS: Participants showed a significant increase in knowledge scores (possible 0-24) from prescores 7.09 (standard deviation (SD)=3.06) to 15.20 (SD=4.61), Student's t-test p<0.001. In addition, a significantly higher proportion of participants mistakenly thought COVID-19 passed through breast milk on the pretest (70.1%) compared to post-test (8.4%) (McNemar test, p<0.001). Regarding breastfeeding, 12.6% of participants knew on the pretest that women with COVID-19 who breastfeed should wear a mask and wash their hands compared to 74.3% of participants who knew these recommendations on the post-test (Wilcoxon signed-rank test, p<0.001). Finally, 2% of participants knew on the pretest that pregnant women with COVID-19 should take a low-dose aspirin compared to 67% of participants on the post-test (χ² (1)=194.7, p<0.001). CONCLUSION: These essential primary care providers misunderstood many critical issues related to COVID-19, pregnancy, and newborns. Culturally relevant educational activities provided orally in the native language of participants dispelled myths about the virus and significantly improved lay midwife knowledge. Providing evidence-based educational activities in a culturally relevant format is critical to protecting remote, vulnerable populations, such as pregnant Guatemalan women and newborns, during a global pandemic.


Assuntos
COVID-19 , Tocologia , SARS-CoV-2 , Humanos , COVID-19/prevenção & controle , COVID-19/epidemiologia , Guatemala , Feminino , Tocologia/educação , Gravidez , Adulto , Pandemias , Conhecimentos, Atitudes e Prática em Saúde
4.
Ecol Evol ; 14(7): e11664, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38952659

RESUMO

The bluntnose sixgill shark (Hexanchus griseus) is a wide-ranged deep-water shark species found off continental and insular shelves. Despite its global distribution, little is known about the reproductive ecology of the species, particularly with regard to the location and timing of important phenological events such as mating and pupping. In this study, we report the landing of a neonate H. griseus individual from an artisanal fishing camp in Baja California Sur, Mexico. This represents only the ninth confirmed record of the species from the Mexican Pacific and the first to report a neonate specimen in Mexican waters. We discuss this specimen in the context of the environmental conditions in which it was found, ultimately suggesting that these shallow coastal waters may be an important pupping ground for H. griseus in the region. Furthermore, the specimen was found during the winter months (whereas all previous reports have suggested H. griseus pups during the summer), implying regional variation in reproductive periodicity, or the presence of multiple reproductive events per year. This study provides novel insight into the reproductive biology of H. griseus and the ecological characteristics of the species in the Northern Mexican Pacific.

5.
Foods ; 13(13)2024 Jun 24.
Artigo em Inglês | MEDLINE | ID: mdl-38998497

RESUMO

The influence of the geographical location on the chemical composition of commercial Sauvignon Blanc wines was investigated. The assay was carried out on Sauvignon Blanc wines from three cold-climate valleys in Central Chile, Casablanca, Leyda, and San Antonio. The analyses revealed clear variations in some chemical parameters, especially in titratable acidity, which was higher in the geographical areas closest to the Pacific Ocean, such as the Leyda and San Antonio valleys. Regarding the composition of low-molecular-weight phenolic compounds, 17 compounds were found, and the results show that the Casablanca valley exhibits a greater abundance of monomeric flavanols, such as (+)-catechin, whereas the Leyda valley shows a higher abundance in flavonols and phenolic acids esterified with tartaric acid. Concerning the aromatic compound profile, the wines from the Casablanca valley showed a greater abundance of esters, C13 norisoprenoids, and some terpenes. The PLS-DA analysis revealed some differences, especially between wines from Casablanca and Leyda, demonstrating that the difference in the chemical composition of the wines was influenced by the geographical area.

6.
Molecules ; 29(13)2024 Jun 28.
Artigo em Inglês | MEDLINE | ID: mdl-38999037

RESUMO

The performance of catalysts prepared from hierarchical Y zeolites has been studied during the conversion of vacuum gas oil (VGO) into higher-value products. Two different catalysts have been studied: CatY.0.00 was obtained from the standard zeolite (Y-0.00-M: without alkaline treatment) and CatY.0.20 was prepared from the desilicated zeolite (Y-0-20-M: treated with 0.20 M NaOH). The cracking tests were carried out in a microactivity test (MAT) unit with a fixed-bed reactor at 550 °C in the 20-50 s reaction time range, with a catalyst mass of 3 g and a mass flow rate of VGO of 2.0 g/min. The products obtained were grouped according to their boiling point range in dry gas (DG), liquefied petroleum gas (LPG), naphtha, and coke. The results showed a greater conversion and selectivity to gasoline with the CatY.0.20 catalyst, along with improved quality (RON) of the C5-C12 cut. Conversely, the CatY.0.00 catalyst (obtained from the Y-0.00-M zeolite) showed greater selectivity to gases (DG and LPG), attributable to the electronic confinement effect within the microporous channels of the zeolite. The nature of coke has been studied using different analysis techniques and the impact on the catalysts by comparing the properties of the fresh and deactivated catalysts. The coke deposited on the catalyst surfaces was responsible for the loss of activity; however, the CatY.0.20 catalyst showed greater resistance to deactivation by coke, despite showing the highest selectivity. Given that the reaction occurs in the acid sites of the zeolite and not in the matrix, the increased degree of mesoporosity of the zeolite in the CatY.0.20 catalyst facilitated the outward diffusion of products from the zeolitic channels to the matrix, thereby preserving greater activity.

7.
Plants (Basel) ; 13(13)2024 Jul 02.
Artigo em Inglês | MEDLINE | ID: mdl-38999661

RESUMO

Plant density is increasing in modern olive orchards to improve yields and facilitate mechanical harvesting. However, greater density can reduce light quantity and modify its quality. The objective was to evaluate plant morphology, biomass, and photosynthetic pigments under different red/far-red ratios and photosynthetically active radiation (PAR) combinations in an olive cultivar common to super-high-density orchards. In a greenhouse, young olive trees (cv. Arbequina) were exposed to low (L) or high (H) PAR with or without lateral FR supplementation (L+FR, L-FR, H+FR, H-FR) using neutral-density shade cloth and FR light-emitting diode (LED) modules. Total plant and individual organ biomass were much lower in plants under low PAR than under high PAR, with no response to +FR supplementation. In contrast, several plant morphological traits, such as main stem elongation, individual leaf area, and leaf angle, did respond to both low PAR and +FR. Total chlorophyll content decreased with +FR when PAR was low, but not when PAR was high (i.e., a significant FR*PAR interaction). When evaluating numerous plant traits together, a greater response to +FR under low PAR than under high PAR appeared to occur. These findings suggest that consideration of light quality in addition to quantity facilitates a fuller understanding of olive tree responses to a light environment. The +FR responses found here could lead to changes in hedgerow architecture and light distribution within the hedgerow.

8.
Forensic Sci Int Synerg ; 9: 100484, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-39041044

RESUMO

This study aimed to evaluate the reliability of an age estimation method based on the pulp/tooth area ratio by assessing intra- and inter-examiner agreement across five observers at different intervals. Using the same X-ray device and technical parameters, 96 digital periapical X-ray images of upper and lower canines were obtained from 28 deceased people in Central America, whose age at death ranged from 19 to 49 years. Excellent and good agreement of results were achieved, and there were no statistically significant differences. The R2 value for upper teeth (54.0%) was higher than the R2 value for lower teeth (45.7%). The highest intraclass correlation coefficient value was 0.995 (0.993-0.997) and the lowest 0.798 (0.545-0.895). Inter-examiner agreement was high with values of 0.975 (0.965-0.983) and 0.927 (0.879-0.955). This method is adequate for assessing age in missing and unidentified people, including victims of mass disasters.

9.
Ecol Appl ; 34(6): e3008, 2024 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-39034303

RESUMO

Wildfires and climate change increasingly are transforming vegetation composition and structure, and postfire management may have long-lasting effects on ecosystem reorganization. Postfire aerial seeding treatments are commonly used to reduce runoff and soil erosion, but little is known about how seeding treatments affect native vegetation recovery over long periods of time, particularly in type-converted forests that have been dramatically transformed by the effects of repeated, high-severity fire. In this study, we analyze and report on a rare long-term (23-year) dataset that documents vegetation dynamics following a 1996 post-fire aerial seeding treatment and a subsequent 2011 high-severity reburn in a dry conifer landscape of northern New Mexico, USA. Repeated surveys between 1997 and 2019 of 49 permanent transects were analyzed for differences in vegetation cover, richness, and diversity between seeded and unseeded areas, and to characterize the development of seeded and unseeded vegetation communities through time and across gradients of burn severity, elevation, and soil-available water capacity. Seeded plots showed no significant difference in bare ground cover during the initial years postfire relative to unseeded plots. Postfire seeding led to a clear and sustained divergence in herbaceous community composition. Seeded plots had a much higher cover of non-native graminoids, primarily Bromus inermis, a likely contaminant in the seed mix. High-severity reburning of all plots in 2011 reduced native graminoid cover by half at seeded plots compared with both prefire levels and with plots that were unseeded following the initial 1996 fire. In addition, higher fire severity was associated with increased non-native graminoid cover and reduced native graminoid cover. This study documents fire-driven ecosystem transformation from conifer forest into a shrub-and-grass-dominated system, reinforced by aerial seeding of grasses and high-severity reburning. This unique long-term dataset illustrates that post-fire seeding carries significant risks of unwanted non-native species invasions that persist through subsequent fires-thus alternative postfire management actions merit consideration to better support native ecosystem resilience given emergent climate change and increasing disturbance. This study also highlights the importance of long-term monitoring of postfire vegetation dynamics, as short-term assessments miss key elements of complex ecosystem responses to fire and postfire management actions.


Assuntos
Pinus ponderosa , Incêndios Florestais , New Mexico , Incêndios , Mudança Climática , Florestas , Conservação dos Recursos Naturais
10.
Rev Cient Odontol (Lima) ; 12(1): e186, 2024.
Artigo em Espanhol | MEDLINE | ID: mdl-39015309

RESUMO

Introduction: Periodontal disease is a multifactorial chronic inflammatory disease, so knowledge about this disease is important for health professionals for an assertive and early diagnosis. Objective: Determine the level of knowledge about periodontal health in Health Sciences students at a private university in Lima-Perú. Materials and Methods: Through a descriptive and cross-sectional study, 200 students from the Faculty of Health Sciences were evaluated. The sample size was obtained using a proportion estimation formula. The level of knowledge about periodontal health was measured using a specific virtual and self-applicable questionnaire, which was fully validated. University students of legal age and who signed the informed consent were included. This consisted of 16 questions about the causes, signs, prevention habits and relationship with systemic diseases related to periodontal disease. The data were analyzed using descriptive statistics (absolute and relative frequencies) and means and averages for age. Results: The level of knowledge was medium in 38%, high in 32.5% and low in 29.5% of the students surveyed. 96.5% knew that periodontal disease is preventable; However, 91.5% do not know what its main clinical sign is. Conclusions: The use of a self-applicable and specific questionnaire is beneficial to evaluate and measure knowledge about periodontal health, and the Health Sciences students evaluated have a medium level of knowledge about periodontal health.

11.
Ecol Evol ; 14(6): e11436, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38826175

RESUMO

Costa Rica emerged from the seas as a new geological territory during the Miocene as an insular archipelago. It later became part of a continental area once it became a segment of Central America. Two dung beetle genera that colonized this new territory from South and North America, Canthidium and Onthophagus (Coleoptera: Scarabaeidae: Scarabaeinae), are here studied, in the first analysis of a volcanic paleo-archipelago, colonized from its emergence, and then later becoming terra firma. To assess their biodiversity distribution patterns, we analyzed the effect of biogeography, ecosystem origins, and body size on their altitudinal distribution patterns in three geographic basins of Costa Rica. Based on 32 years of collecting representing more than 158,000 specimens from 1017 localities, we undertook Generalized Linear Models of the two dung beetle genera to assess the effects of biodiversity and biogeographical distribution patterns. Canthidium and Onthophagus species ranged from 0 to 3000 m a.s.l., with an abrupt diversity decline at altitudes above 1500 m. Endemic species tended to show a higher altitudinal mean with a narrow altitudinal band distribution than non-endemic dung beetle species. Although there was a trend of decreasing species body size with the increase in altitude, such a trend depended on the distribution pattern of the species group. This possible insular-mediated endemicity mechanism has generated baffling biodiversity levels, considered the highest worldwide per unit area. Costa Rica is an expanse represented by a geographic overlap of two or more temporally disjunct areas and is not part of a natural transition zone. The effect of the insular Miocene origin of Costa Rica still pervades today, reflected by different insular syndromes shown by the dung beetle fauna. The importance of geological origins in generating biodiversity seems to have been an underrated criterion for conservation biology practices and should be considered ex officio.

12.
Aesthetic Plast Surg ; 2024 Jun 05.
Artigo em Inglês | MEDLINE | ID: mdl-38839611

RESUMO

BACKGROUND: The prerequisite of a well-shaped dorsum with proper dorsal aesthetic lines that needs no modifications in its width and symmetry is key to letdown and push-down techniques as classically described. The common current concept is that total preservation of the middle vault is obligatory. This, however, obviously limits the indications, since nasal dorsum with natural aesthetic dorsal lines per se is relatively few. The recent, impressive, revival of letdown and push-down procedures has progressively generated numerous technical variations, but all those essentially still left the middle vault unmodified. The concept of splitting the middle vault and modifying its width and symmetry, while leaving the crucial dorsal (central) and lateral Keystone area intact, represents a new hybrid approach to the nasal dorsum. The structural benefits of classical component separation are combined with the major advantage of preserving the flexible chondro-osseous joint at the keystone junction. Osteotomies and/or osteoplasty can be done as necessary to modify the bony dorsum and at the same time any type of septal deformity can be addressed according to the time-tested L-strut principle, a Cottle septoplasty included. This hybrid approach expands indications beyond those of the conventional push-down/letdown technique, including moderate asymmetries of the bony and cartilaginous dorsum. Although splitting the middle vault along the septal T will also facilitate middle vault reshaping in cases where a full letdown procedure is indicated, this paper will clarity address only those instances where no circumferential osteotomy is done. METHODS AND MATERIALS: The dorsal bony nasal pyramid is always addressed first by rhinosculpture (osteoplasty) with piezoelectric inserts and/or burrs, in combination with different types of osteotomies as needed. This will allow narrowing of the bridge and correction of bony asymmetries. The osseous-cartilaginous connection of the central dorsal keystone area (DKA) is totally preserved. At this point, three main variations are possible: Type 1) preservation of the septal T and push-down by a high-middle septal strip resection, two different variations (1A and 1B) are possible here, Type 2) reduction in width of the septal T-segment and middle vault restoration by spreader flaps without any push-down of the septal T and Type 3) preservation of the septal T and letdown by low strip resection. CONCLUSION: Hybrid Dorsal Preservation involves concepts of Structure and Preservation Rhinoplasty. Dorsal and lateral keystone area are preserved, and the middle vault could be modified splitting the septal T in the anatomical plane, expanding patient indications and improve outcomes. LEVEL OF EVIDENCE V: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

13.
PeerJ ; 12: e17298, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38903885

RESUMO

Background: A scale is used to establish performance ranges in different sciences, it being necessary to design specialized biological and pedagogical indicators in physical activity, sport and health. Objective: To design a scale for the pedagogical control of the vertical jumping ability in untrained adolescents (13-16 years), stratifying the sample by age range, ethnicity, urban and rural area, socioeconomic level, and gender. Methods: A representative sample of the Ecuadorian population (n = 3,705) is studied, classifying it into the aforementioned strata, controlling the vertical jump by ISAK I and II level experts, applying the Sargent Test to measure vertical jumps on a multi-force wall, establishing scales with seven percentile levels, and making comparisons related to chronological age, gender, socioeconomic, and genetic indicators. Results: Significant differences in the vertical jumping performance were determined according to the category or age range (13-14 ≠ 15-16 years) and by gender (w = 0.000). Various levels of performance were determined, classifying the maximum level as talented in the female gender (≥40 cm; and ≥42 cm) and male gender (≥47 cm; and ≥57 cm) in the 13‒14 and 15‒16 years categories, respectively. Sampling comparisons by geographical area only determined significant differences in the male gender, with the jumping ability being higher in urban areas (13‒14 years: w = 0.046; 15‒16 years: w = 0.013). The comparison by ethnic groups showed significant differences (k = 0.030), favoring the Afro-Ecuadorian ethnic group in both genders, while there are significant differences by socioeconomic level, especially between the middle and lower classes. Conclusions: The present research solves the lack of a tool for making correct didactic decisions related to the vertical jumping ability, taking into account various important stratified indicators. The complementary conclusions show significant differences according to the category stratum or age range, the gender stratum, and the ethnic stratum in females and males, where the best average rank favored the Afro-Ecuadorian ethnic group in both genders. There are significant differences in the geographical area stratum in the male gender, and differences in the socioeconomic stratum in favor of the upper and middle classes.


Assuntos
Desempenho Atlético , Humanos , Adolescente , Masculino , Feminino , Equador , Desempenho Atlético/fisiologia , Fatores Sexuais , Exercício Físico/fisiologia , População Rural
14.
Front Psychiatry ; 15: 1354762, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38895036

RESUMO

Borderline Personality Disorder (BPD) symptoms include inappropriate control of anger and severe emotional dysregulation after rejection in daily life. Nevertheless, when using the Cyberball paradigm, a tossing game to simulate social exclusion, the seven basic emotions (happiness, sadness, anger, surprise, fear, disgust, and contempt) have not been exhaustively tracked out. It was hypothesized that these patients would show anger, contempt, and disgust during the condition of exclusion versus the condition of inclusion. When facial emotions are automatically detected by Artificial Intelligence, "blending", -or a mixture of at least two emotions- and "masking", -or showing happiness while expressing negative emotions- may be most easily traced expecting higher percentages during exclusion rather than inclusion. Therefore, face videos of fourteen patients diagnosed with BPD (26 ± 6 years old), recorded while playing the tossing game, were analyzed by the FaceReader software. The comparison of conditions highlighted an interaction for anger: it increased during inclusion and decreased during exclusion. During exclusion, the masking of surprise; i.e., displaying happiness while feeling surprised, was significantly more expressed. Furthermore, disgust and contempt were inversely correlated with greater difficulties in emotion regulation and symptomatology, respectively. Therefore, the automatic detection of emotional expressions during both conditions could be useful in rendering diagnostic guidelines in clinical scenarios.

15.
J Pediatr ; 274: 114170, 2024 Jun 27.
Artigo em Inglês | MEDLINE | ID: mdl-38944189

RESUMO

OBJECTIVE: To assess recent temporal trends in guideline-compliant pediatric lipid testing, and to examine the influence of social determinants of health (SDoH) and provider characteristics on the likelihood of testing in youth. STUDY DESIGN: In this observational, multiyear cross-sectional study, we calculated lipid testing prevalence by year among 268 627 12-year olds from 2015 through 2019 who were enrolled in Florida Medicaid and eligible for universal lipid screening during age 9 to 11, and 11 437 22-year olds (2017-2019) who were eligible for screening during age 17-21. We compared trends in testing prevalence by SDoH and health risk factors at two recommended ages and modeled the associations between patient characteristics and provider type on lipid testing using generalized estimating equations. RESULTS: Testing among 12-year olds remained low between 2015 through 2019 with the highest prevalence in 2015 (8.0%) and lowest in 2017 (6.7%). Screening compliance among 22-year olds was highest in 2017 (21.1%) and fell to 17.8% in 2019. Hispanics and non-Hispanic Blacks in both age groups had about 2%-3% lower testing prevalence than non-Hispanic Whites. Testing in 12-year olds was 12.3% vs 7.7% with and without obesity, and 14.4% vs 7.6% with and without antipsychotic use. Participants who saw providers who were more likely to prescribe lipid testing were more likely to receive testing (OR = 2.3, 95% CI 2.0-2.8, P < .001). CONCLUSIONS: Although lipid testing prevalence was greatest among high-risk children, overall prevalence of lipid testing in youth remains very low. Provider specialty and choices by individual providers play important roles in improving guideline-compliant pediatric lipid testing.

16.
Artigo em Inglês | MEDLINE | ID: mdl-38791823

RESUMO

In the Americas, wild yellow fever (WYF) is an infectious disease that is highly lethal for some non-human primate species and non-vaccinated people. Specifically, in the Brazilian Atlantic Forest, Haemagogus leucocelaenus and Haemagogus janthinomys mosquitoes act as the major vectors. Despite transmission risk being related to vector densities, little is known about how landscape structure affects vector abundance and movement. To fill these gaps, we used vector abundance data and a model-selection approach to assess how landscape structure affects vector abundance, aiming to identify connecting elements for virus dispersion in the state of São Paulo, Brazil. Our findings show that Hg. leucocelaenus and Hg. janthinomys abundances, in highly degraded and fragmented landscapes, are mainly affected by increases in forest cover at scales of 2.0 and 2.5 km, respectively. Fragmented landscapes provide ecological corridors for vector dispersion, which, along with high vector abundance, promotes the creation of risk areas for WYF virus spread, especially along the border with Minas Gerais state, the upper edges of the Serra do Mar, in the Serra da Cantareira, and in areas of the metropolitan regions of São Paulo and Campinas.


Assuntos
Mosquitos Vetores , Febre Amarela , Brasil , Animais , Febre Amarela/transmissão , Mosquitos Vetores/virologia , Ecossistema , Clima Tropical , Vírus da Febre Amarela , Densidade Demográfica , Culicidae/virologia , Culicidae/fisiologia
17.
Popul Health Metr ; 22(1): 9, 2024 May 27.
Artigo em Inglês | MEDLINE | ID: mdl-38802870

RESUMO

BACKGROUND: Mortality rate estimation in small areas can be difficult due the low number of events/exposure (i.e. stochastic error). If the death records are not completed, it adds a systematic uncertainty on the mortality estimates. Previous studies in Brazil have combined demographic and statistical methods to partially overcome these issues. We estimated age- and sex-specific mortality rates for all 5,565 Brazilian municipalities in 2010 and forecasted probabilistic mortality rates and life expectancy between 2010 and 2030. METHODS: We used a combination of the Tool for Projecting Age-Specific Rates Using Linear Splines (TOPALS), Bayesian Model, Spatial Smoothing Model and an ad-hoc procedure to estimate age- and sex-specific mortality rates for all Brazilian municipalities for 2010. Then we adapted the Lee-Carter model to forecast mortality rates by age and sex in all municipalities between 2010 and 2030. RESULTS: The adjusted sex- and age-specific mortality rates for all Brazilian municipalities in 2010 reveal a distinct regional pattern, showcasing a decrease in life expectancy in less socioeconomically developed municipalities when compared to estimates without adjustments. The forecasted mortality rates indicate varying regional improvements, leading to a convergence in life expectancy at birth among small areas in Brazil. Consequently, a reduction in the variability of age at death across Brazil's municipalities was observed, with a persistent sex differential. CONCLUSION: Mortality rates at a small-area level were successfully estimated and forecasted, with associated uncertainty estimates also generated for future life tables. Our approach could be applied across countries with data quality issues to improve public policy planning.


Assuntos
Teorema de Bayes , Cidades , Expectativa de Vida , Mortalidade , Humanos , Brasil/epidemiologia , Masculino , Feminino , Mortalidade/tendências , Lactente , Pré-Escolar , Idoso , Pessoa de Meia-Idade , Adolescente , Adulto , Criança , Adulto Jovem , Recém-Nascido , Idoso de 80 Anos ou mais , Fatores Sexuais , Distribuição por Idade , Fatores Etários , Distribuição por Sexo , Previsões
18.
Med Eng Phys ; 127: 104165, 2024 05.
Artigo em Inglês | MEDLINE | ID: mdl-38692768

RESUMO

Laparoscopic instrument handles design and dimensions are crucial to determine the configuration of surgeons' hand grip and, therefore, can have a deleterious effect on overall surgical efficiency and surgeons' comfort. The aim of this study is to investigate the impact of laparoscopic handle size and hand surface area on surgical task performance. A single-blind, randomized crossover trial was carried out with 29 novice medical students. Participants performed three simulated tasks in "black box" simulators using two scissor-type handles of different sizes. Surgical performance was assessed by the number of errors and time required to complete each task. Hand anthropometric data were measured using a 3D scanner. Execution time was significantly higher when cutting and suturing tasks were performed with the smaller handle. In addition, hand surface area was positively correlated with peg transfer task time when performed with the standard handle and was correlated with cutting task time in small and standard handle groups. We also found positive correlations between execution time and the number of errors executed by larger-handed participants. Our findings indicate that laparoscopic handle size and hand area influence surgical performance, highlighting the importance of considering hand anthropometry variances in surgical instrument design.


Assuntos
Estudos Cross-Over , Laparoscopia , Humanos , Masculino , Feminino , Adulto Jovem , Desenho de Equipamento , Adulto , Análise e Desempenho de Tarefas , Mãos/cirurgia
19.
Ying Yong Sheng Tai Xue Bao ; 35(3): 797-805, 2024 Mar 18.
Artigo em Inglês | MEDLINE | ID: mdl-38646768

RESUMO

Phthorimaea operculella is a major potato pest of global importance, early warning and detection of which are of significance. In this study, we analyzed the climate niche conservation of P. operculella during its invasion by comparing the overall climate niche from three dimensions, including the differences between native range (South America) and entire invaded region (excluding South America), the differences bwtween native range (South America) and five invaded continents (North America, Oceania, Asia, Africa, and Europe), as well as the differences between native region (South America) and an invaded region (China). We constructed ecological niche models for its native range (South America) and invaded region (China). The results showed that the climatic niche of the pest has expanded to varying degrees in different regions, indicating that the pest could well adapt to new environments during the invasion. Almost all areas of South America are suitable for P. operculella. In China, its suitable area is mainly concentrated in Shandong, Hebei, Tianjin, Beijing, Henan, Hubei, Yunnan, Guizhou, Sichuan, Hainan, northern Guangxi, southern Hunan, Anhui, Guangdong, Jiangsu, southern Shanxi, and southern Shaanxi. With increasing greenhouse gas emissions and global temperature, its suitable area will decrease at low latitude and increase gradually at high latitude. Specifically, the northern boundary will extend to Liaoning, Jilin, and the southeastern region of Inner Mongolia, while the western boundary extends to Sichuan and the southeast Qinghai-Tibet Plateau. The suitable area in the southeast Yunnan-Guizhou Plateau, Hainan Island, and the south of Yangtze River, will gradually decrease. The total suitable habitat area for P. operculella in China is projected to increase under future climate condition. From 2081 to 2100, under the three greenhouse gas emissions scenarios of ssp126, ssp370, and ssp585, the suitable area is expected to increase by 27.78, 165.54, and 140.41 hm2, respectively. Therefore, it is crucial to strengtehen vigilance and implement strict measures to prevent the further expansion of P. operculella.


Assuntos
Ecossistema , Espécies Introduzidas , China , Animais , América do Sul , Clima
20.
Environ Monit Assess ; 196(5): 452, 2024 Apr 13.
Artigo em Inglês | MEDLINE | ID: mdl-38613696

RESUMO

The Metropolitan Area of Lima-Callao (MALC) is a South American megacity that has suffered a serious deterioration in air quality due to high levels of particulate matter (PM2.5 and PM10). Studies on the behavior of the PM2.5/PM10 ratio and its temporal variability in relation to meteorological parameters are still very limited. The objective of this study was to analyze the temporal trends of the PM2.5/PM10 ratio, its temporal variability, and its association with meteorological variables over a period of 5 years (2015-2019). For this, the Theil-Sen estimator, bivariate polar plots, and correlation analysis were used. The regions of highest mean concentrations of PM2.5 and PM10 were identified at eastern Lima (ATE station-41.2 µg/m3) and southern Lima (VMT station-126.7 µg/m3), respectively. The lowest concentrations were recorded in downtown Lima (CDM station-16.8 µg/m3 and 34.0 µg/m3, respectively). The highest average PM2.5/PM10 ratio was found at the CDM station (0.55) and the lowest at the VMT station (0.27), indicating a predominance of emissions from the vehicular fleet within central Lima and a greater emission of coarse particles by resuspension in southern Lima. The temporal progression of the ratio of PM2.5/PM10 showed positive and highly significant trends in northern and central Lima with values of 0.03 and 0.1 units of PM2.5/PM10 per year, respectively. In the southern region of Lima, the trend was also significant, showcasing a value of 0.02 units of PM2.5/PM10 per year. At the hourly and monthly level, the PM2.5/PM10 ratio presented a negative and significant correlation with wind speed and air temperature, and a positive and significant correlation with relative humidity. These findings offer insights into identifying the sources of PM pollution and are useful for implementing regulations to reduce air emissions considering both anthropogenic sources and meteorological dispersion patterns.


Assuntos
Bivalves , Monitoramento Ambiental , Animais , Peru , Conceitos Meteorológicos , Material Particulado
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