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Brazil has historically invested few resources in its transport infrastructure, leaving gaps and reducing its efficiency. The country presents a high dependence on road transport, which results in increased operational costs and higher greenhouse gas (GHG) emissions. Consequently, the performance of cargo transportation in Brazil has been deteriorating, accompanied by a rise in the consumption of fossil fuels and noteworthy levels of GHG emissions. This article assesses the carbon intensity of soybean transport operations within Brazil. Utilizing a network equilibrium model, this study estimated the soybean transportation flows that minimize the total cost of transporting this product across the origins and destinations within the grain handling system. The modeling also calculated the GHG emissions in transportation. The results show that the transportation of soybeans produced 2.74 million tonnes of CO2 equivalent annually, with road transport accounting for 81.7% of these emissions. The state of Mato Grosso, responsible for 44.08 kg CO2 equivalent per tonne of soybeans transported, contributed almost 49% of the total emissions due to the extensive distances involved. In contrast, states like Paraná and Rio Grande do Sul, located closer to southern ports, exhibited the lowest emissions, with rates of 11.55 kg CO2 eq/t and 12.52 kg CO2 eq/t, respectively. The analysis highlights the significant potential for reducing GHG emissions by increasing the use of rail and barge transport, particularly in high-emission regions such as Mato Grosso.

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Background: Small bowel bleeding (SB) comprises 5%-10% of gastrointestinal (GI) bleeding cases. This article describes the staged retrograde intraoperative enteroscopy (SRIE) surgical technique for the etiological diagnosis and treatment of small bowel bleeding. Methods: SRIE was performed on patients with persistent SB at a quaternary university hospital in Brazil from 2020 to 2023. The technique is described in 5 steps, alongside visual aids, including images and a depicting a portion of the procedure. Patients presenting with confirmed coagulopathies, pregnancy, or unwillingness for surgery were excluded. Surgical procedures were performed after informed consent. Case Series: Four participants were submitted to SRIE, including 2 females (64 and 83 years old), and 2 males (46 and 57 years old). Three out of four (75%) of the patients received a confirmed diagnosis of GI bleeding, attributed to angioectasia, acquired von Willebrand disease, and vitamin K deficiency. SRIE was conducted via enterotomy, involving a subsequent insufflation-inspection-deflation of 10 to 10 cm segments of the small bowel (Steps 1 to 5). The procedure was successfully executed in all four patients without complications, allowing confirmation of the etiological diagnosis of SB or exclusion of anatomical causes of hemorrhage. Conclusions: SRIE is a valuable but invasive tool for assessing SB hemorrhage when conventional imaging falls short. When performed systematically and standardized, it allows accurate visualization of SB using a standard endoscope.

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CLINICAL DATA: A nine-month-old female infant diagnosed with transposition of the great arteries with symptoms of heart failure associated with cyanosis and difficulty in gaining weight was referred to our center with late diagnosis (at nine months of age). CHEST RADIOGRAPHY: Cardiomegaly; attenuated peripheral vascular markings.Electrocardiography: Sinus rhythm with biventricular overload and aberrantly conducted supraventricular extra systoles. ECHOCARDIOGRAPHY: Wide atrial septal defect, ventricular axis torsion with concordant atrioventricular connection and discordant ventriculoarterial connection. COMPUTED TOMOGRAPHY ANGIOGRAPHY: Concordant atrioventricular connection, right ventricle positioned superiorly and left ventricle positioned inferiorly; discordant ventriculoarterial connection with right ventricle connected to the aorta and left ventricle connected to pulmonary artery. DIAGNOSIS: Crisscross heart is a rare congenital heart defect, accounting for 0.1% of congenital heart diseases. It consists of the 90º rotation of ventricles' axis in relation to their normal position; therefore, ventricles are positioned in the superior-inferior direction rather than anterior-posterior. Most cases have associated cardiac anomalies, and in this case, it is associated with transposition of the great arteries. The complexity and rarity of its occurrence make diagnosis and surgical treatment challenging. OPERATION: Modified Senning procedure using the pericardial sac in the construction of a tunnel from pulmonary veins to the right atrium. Cardiopulmonary bypass time of 147 minutes with nine minutes of total circulatory arrest.

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The Ordered Weighted Averaging (OWA) operator is a multicriteria method that has conquered space among researchers in the composite indicators field. Typically, OWA operator weights are defined by the decision maker. This type of weighting is highly criticized, as decision-makers are susceptible to errors and bias in judgment. Some methods have been used to define OWA operator weights objectively. However, none of them is concerned about the quality of the composite indicator. This paper introduces a method that defines the weights of the OWA operator based on two quality parameters of the composite indicator: the ability to capture the concept of the multidimensional phenomenon and the informational loss. The method can be implemented in Microsoft Excel Solver and has a high degree of flexibility and applicability in problems of a multidimensional nature and a high degree of appropriation by researchers and practitioners in the area.•Defines weights that maximize the ability of the composite indicator to capture the concept of the multidimensional phenomenon.•Considers restrictions to limit the informational loss of the composite indicator or emphasize positive or negative aspects of the multidimensional phenomenon.•Offers flexibility in setting the objective and constraints of the optimization algorithm.

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Behavioral momentum theory (BMT) provides a theoretical and methodological framework for understanding how differentially maintained operant responding resists disruption. A common way to test operant resistance involves contingencies with suppressive effects, such as extinction or prefeeding. Other contingencies with known suppressive effects, such as response-cost procedures arranged as point-loss or increases in response force, remain untested as disruptive events within the BMT framework. In the present set of three experiments, responding of humans was maintained by point accumulation programmed according to a multiple variable-interval (VI) VI schedule with different reinforcement rates in either of two components. Subsequently, subtracting a point following each response (Experiment 1) or increasing the force required for the response to be registered (Experiments 2 and 3 decreased response rates, but responding was less disrupted in the component associated with the higher reinforcement rate. The point-loss contingency and increased response force similarly affected response rates by suppressing responding and human persistence, replicating previous findings with humans and nonhuman animals when other types of disruptive events (e.g., extinction and prefeeding) were investigated. The present findings moreover extend the generality of the effects of reinforcement rate on persistence, and thus BMT, extending the analysis of resistance to two well-known manipulations used to reduce responding in the experimental analysis of behavior.

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This work aimed to evaluate the influence of the mechanical defibrillation technique on the pinhão nanosuspensions production obtained from the whole pinhão, its coat, and almond. The nanosuspensions were characterized concerning their composition, morphology, thermal stability, rheological behavior, compound profiling, and cytotoxicity. The results revealed a significant fiber content in pinhão coat nanosuspension (63.12 ± 0.52 %) and non-fiber carbohydrates in whole pinhão (59.00 ± 0.13 %) and almond (74.39 ± 0.23 %) nanosuspensions. The defibrillation process led to micro/nano-sized fibers in pinhão coat nanosuspensions and small-size starch granules in almond nanosuspensions. The nanosuspensions containing pinhão coat exhibited a gel-like behavior, while almond nanosuspensions displayed liquid-like characteristics. Pinhão coat nanosuspensions presented a significant content of flavonoids and phytosterols, whereas almond-based nanosuspensions contained substantial sugar amounts. No cytotoxicity was observed at the concentrations evaluated. These findings demonstrated that the defibrillation technique impacted the properties of pinhão constituents, allowing their application in new product development.

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Abstract CHIVA (Cure Conservatrice et Hemodynamique de l'Insuffisance Veineuse en Ambulatoire) is a surgical technique for varicose veins that avoids destroying the saphenous vein and collaterals. In some patients, the flush ligation of saphenous collaterals performed in the CHIVA technique may require more dissection than is desirable. This is especially valid for obese patients and thigh ligations. We report an innovative technique that uses duplex-guided puncture to bring the collateral closer to the skin and reduce the need for dissection and incision. The technique does not change any of the CHIVA principles. While the long-term results are not yet known, we expect them to be similar to normal CHIVA procedures.

Resumo CHIVA (Cure Conservatrice et Hemodynamique de l'Insuffisance Veineuse en Ambulatoire) é uma técnica de cirurgia de varizes que evita a destruição da safena e das colaterais. A ligadura rasante de colaterais da safena usando a técnica CHIVA pode requerer mais dissecção do que o desejado em alguns subgrupos de pacientes, principalmente os obesos. Este estudo descreve uma técnica inovadora de ligadura das colaterais com mini-incisões guiadas por eco-Doppler. A técnica consiste em puncionar com eco e passar um fio ao redor da colateral para puxá-la para cima. Uma pequena incisão é feita exatamente onde a colateral está situada sob a pele. A veia é tracionada e ligada em sua junção com a safena. A técnica é factível e pode diminuir a incisão e o trauma cirúrgico. Os resultados a longo prazo são desconhecidos, mas esperamos que sejam semelhantes aos da técnica CHIVA, já que nenhum dos preceitos é modificado.

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ABSTRACT Clinical data: A nine-month-old female infant diagnosed with transposition of the great arteries with symptoms of heart failure associated with cyanosis and difficulty in gaining weight was referred to our center with late diagnosis (at nine months of age). Chest radiography: Cardiomegaly; attenuated peripheral vascular markings. Electrocardiography: Sinus rhythm with biventricular overload and aberrantly conducted supraventricular extra systoles. Echocardiography: Wide atrial septal defect, ventricular axis torsion with concordant atrioventricular connection and discordant ventriculoarterial connection. Computed tomography angiography: Concordant atrioventricular connection, right ventricle positioned superiorly and left ventricle positioned inferiorly; discordant ventriculoarterial connection with right ventricle connected to the aorta and left ventricle connected to pulmonary artery. Diagnosis: Crisscross heart is a rare congenital heart defect, accounting for 0.1% of congenital heart diseases. It consists of the 90º rotation of ventricles' axis in relation to their normal position; therefore, ventricles are positioned in the superior-inferior direction rather than anterior-posterior. Most cases have associated cardiac anomalies, and in this case, it is associated with transposition of the great arteries. The complexity and rarity of its occurrence make diagnosis and surgical treatment challenging. Operation: Modified Senning procedure using the pericardial sac in the construction of a tunnel from pulmonary veins to the right atrium. Cardiopulmonary bypass time of 147 minutes with nine minutes of total circulatory arrest.

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El informe operatorio es un documento oficial que forma parte indispensable de la historia clínica. A pesar de que se le atribuyen funciones médicas (asistencial, docente e investigativa), legal y administrativas, con frecuencia no cumple las especificidades requeridas en la redacción. El permanente y continuo mejoramiento del desempeño profesional de los cirujanos demanda el rescate de las especificidades para la confección de tan importante documento. Es considerada una habilidad profesional específica de los médicos de las especialidades quirúrgicas, al ser parte de la práctica quirúrgica habitual e incluye aspectos cuantitativos (formales y sustanciales) y cualitativos (contenido informativo), de obligatorio cumplimiento por especialistas y residentes en formación. Constituye una responsabilidad individual que debe ser controlada por directivos y docentes de cada servicio quirúrgico. Este trabajo expresa la posición de la autora sobre el necesario rescate de la calidad de la confección del informe operatorio como parte indispensable de la seguridad del enfermo quirúrgico(AU)

The operation note is an official document that is an indispensable part of the clinical history. Despite the fact that medical (care, teaching and investigative), legal and administrative functions are attributed to it, it frequently does not meet the specificities required in the wording. The permanent and continuous improvement of the professional performance of surgeons demands the rescue of the specificities for the preparation of such an important document. It is considered a specific professional skill for physicians in surgical specialties, as it is part of routine surgical practice and includes quantitative (formal and substantial) and qualitative (informational content) aspects, of mandatory compliance by specialists and residents in training. It constitutes an individual responsibility that must be controlled by directors and teachers of each surgical service. This work expresses the author's position on the necessary rescue of the quality of the preparation of the operation note as an essential part of the safety of the surgical patient(AU)

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The objective of this study was to assess the effectiveness of functionalized bionanocompounds with ice nucleation protein (INP) as a novel approach for freezing applications in terms of how much energy is used during each step of freezing when water bionanocompound solutions were compared with pure water. According to the results of the manufacturing analysis, water required 28 times less energy than the silica + INA bionanocompound and 14 times less than the magnetite + INA bionanocompound. These findings showed that water used the least energy during the manufacturing process. In order to determine the associated environmental implications, an analysis of the operating stage was also conducted, taking the defrosting time of each bionanocompound during a 4 h work cycle into account. Our results showed that bionanocompounds may substantially reduce the environmental effects by achieving a 91% reduction in the impact after their use during all four work cycles in the operation stage. Additionally, given the energy and raw materials needed in this process, this improvement was more significant than at the manufacturing stage. The results from both stages indicated that, when compared with water, the magnetite + INA bionanocompound and the silica + INA bionanocompound would save an estimated 7% and 47% of total energy, respectively. The study's findings also demonstrated the great potential for using bionanocompounds in freezing applications to reduce the effects on the environment and human health.

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The Fresnel transform (FrT) is commonly used to describe the free-space propagation of optical waves. In this work, we present new definitions for the convolution, correlation and generalized shift operations based on the FrT. The generalized shift operation is defined by using simultaneous space and phase shifts. The generalized shift operation is useful for centred optical systems in the Fresnel domain (FrD) when the data distributions at the input plane of the optical system are shifted. The new convolution and correlation operations defined in terms of the FrT, the wavelength and the propagation distance, can be considered as a generalization of the usual convolution and correlation operations. The sampling theorem for distributions, whose resulting FrT has finite support, is formulated by using the new convolution operation introduced in this work and a new definition of the Dirac comb function. These new definitions and results could be applied to describe, design and implement optical processing systems related to the FrT. Finally, we present a centred optical systems used in holography and optical security systems that can be described or modelled by the new definitions of the operations proposed in this paper.

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Nowadays, in Mexico, most of the installed electricity generation capacity corresponds to combined cycles, representing 37.1%. For this reason, it is important to maintain these cycles in good operating conditions, with the least environmental impacts. An exergoeconomic and environmental analysis is realized to compare the operation of the combined cycle, with and without postcombustion, with the comparison of exergoeconomic and environmental indicators. With the productive structure of the energy system, the process of formation of the final products and the residues are identified, and an allocation criterion is also used to impute the formation cost of residue to the productive components related to its formation. This criterion considers the irreversibilities generated in each productive component that participates in the formation of a residue. The compositions of pollutant gases emitted are obtained, and their environmental impact is determined. The unit exergoeconomic cost of the power output in the gas turbine is lower in the combined cycle with postcombustion, indicating greater efficiency in the process of obtaining this energy stream, and the environmental indicators of global warming, smog formation and acid rain formation are higher in the combined cycle with postcombustion, these differences being 5.22%, 5.53% and 5.30%, respectively.

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RESUMO O objetivo do trabalho foi avaliar a operação e manutenção de um sistema de esgotamento sanitário centralizado, composto de três subsistemas, que atende 367 mil habitantes no Nordeste do Brasil. A avaliação do ciclo de vida considerou um inventário amplo de operação e manutenção do sistema de esgotamento sanitário com as redes de coleta, estações de tratamento de esgoto, disposição do esgoto tratado no corpo hídrico e gestão do lodo. O arranjo tecnológico das estações de tratamento de esgoto avaliadas incluiu o reator do tipo upflow anaerobic sludge blanket, seguido de lagoa aerada e lagoa de polimento em um subsistema, e upflow anaerobic sludge blanket seguido de reator de lodo ativado por aeração prolongada em dois subsistemas. O desempenho energético utilizou o método de demanda de energia acumulada e a pegada de carbono empregou o método de potencial de aquecimento global de 100 anos do Painel Intergovernamental sobre Mudanças Climáticas. O sistema de esgotamento sanitário avaliado demandou 5,12 MJ·m−3 e emitiu 4,08 kg CO2eq·m−3. As maiores contribuições do sistema de esgotamento sanitário avaliado foram a eletricidade, com 62% da demanda energética, e as emissões diretas para o ar, com 94% da pegada de carbono, sendo as emissões dos reatores upflow anaerobic sludge blanket com 76% da pegada de carbono. A identificação dos aspectos e impactos ambientais do sistema de esgotamento sanitário avaliado apoia a inovação tecnológica e gerencial para otimizar o desempenho energético e mitigar as emissões de gases de efeito estufa.

ABSTRACT This aim of this work was to evaluate the operation and maintenance of a centralized wastewater treatment system, composed of three subsystems, which serves 367 thousand inhabitants in northeastern Brazil. The life cycle assessment considered a comprehensive inventory of the wastewater treatment system operation and maintenance with the collection networks, wastewater treatment plants, disposal of the treated wastewater in the water body and sludge management. The technological arrangement of the evaluated wastewater treatment plants included the Upflow Anaerobic Sludge Blanket reactor, followed by aerated and polishing ponds in one subsystem, and Upflow Anaerobic Sludge Blanket followed by extended aeration activated sludge in two subsystems. The energy performance used the cumulative energy demand method and the carbon footprint used the global warming potential method for 100 years of the Intergovernmental Panel on Climate Change. The evaluated wastewater treatment system presented 5.12 MJ·m−3 and 4.08 kg CO2eq·m−3. The largest contribution of the evaluated wastewater treatment system was the electricity use with 62% of the energy demand and direct emissions to the air with 94% of the carbon footprint, being direct emissions from Upflow Anaerobic Sludge Blanket reactors with 76% of the carbon footprint. The identification of environmental aspects and impacts of the evaluated wastewater treatment system supports technological and management innovations to optimize its energy performance and mitigate greenhouse gases emission.

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Maternal obesity increases the risk of nonalcoholic fatty liver disease (NAFLD) in offspring. The Roux-en-Y gastric bypass (RYBG) is effective for achieving weight loss and ameliorates NAFLD. To determine whether these benefits are maintained after pregnancy and/or lactation, and whether they modulate hepatic morphofunction in the next generation, we evaluated hepatic lipid metabolism in Western diet (WD)-obese female rats that underwent RYGB and in their F1 offspring at adulthood. Female Wistar rats consumed a WD from 21 to 130 days of age, before being submitted to RYGB (WD-RYGB-F0) or SHAM (WD-SHAM-F0) operations. After 5 weeks, these females were mated with control male breeders, and the male and female F1 offspring were identified as WD-RYGB-F1 and WD-SHAM-F1. WD-RYGB-F0 dams exhibited lower serum lipids levels, but severe hepatic steatosis and pathological features of advanced liver injury. The hepatic proteins involved in lipogenesis were reduced in WD-RYGB-F0, as were the genes related to ß-oxidation and bile acids (BAs). Although the female and male WD-RYGB-F1 groups did not exhibit hepatic steatosis, the livers of female WD-RYGB-F1 demonstrated higher amounts of lipogenic genes and proteins, while male WD-RYGB-F1 presented a similar downregulation of lipogenic factors to that seen in WD-RYGB-F0 dams. In contrast, maternal and offspring groups of both sexes displayed reductions in the expressions of genes involved in BAs physiology and gluconeogenesis. As such, RYGB aggravates NAFLD after pregnancy and lactation and induces a gender-dependent differential expression of the hepatic lipogenesis pathway in offspring, indicating that female WD-RYGB-F1 may be an increased risk of developing NAFLD.

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AIMS: In this study, we will describe a comprehensive haemodynamic analysis and its relationship to the dilation of the aorta in transposition of the great artery (TGA) patients post-arterial switch operation (ASO) and controls using 4D-flow magnetic resonance imaging (MRI) data. METHODS AND RESULTS: Using 4D-flow MRI data of 14 TGA young patients and 8 age-matched normal controls obtained with 1.5 T GE-MR scanner, we evaluate 3D maps of 15 different haemodynamics parameters in six regions; three of them in the aortic root and three of them in the ascending aorta (anterior-left, -right, and posterior for both cases) to find its relationship with the aortic arch curvature and root dilation. Differences between controls and patients were evaluated using Mann-Whitney U test, and the relationship with the curvature was accessed by unpaired t-test. For statistical significance, we consider a P-value of 0.05. The aortic arch curvature was significantly different between patients 46.238 ± 5.581 m-1 and controls 41.066 ± 5.323 m-1. Haemodynamic parameters as wall shear stress circumferential (WSS-C), and eccentricity (ECC), were significantly different between TGA patients and controls in both the root and ascending aorta regions. The distribution of forces along the ascending aorta is highly inhomogeneous in TGA patients. We found that the backward velocity (B-VEL), WSS-C, velocity angle (VEL-A), regurgitation fraction (RF), and ECC are highly correlated with the aortic arch curvature and root dilatation. CONCLUSION: We have identified six potential biomarkers (B-VEL, WSS-C, VEL-A, RF, and ECC), which may be helpful for follow-up evaluation and early prediction of aortic root dilatation in this patient population.

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Maintaining accurate and complete operation notes is an essential metric of the quality of surgical care. While developed countries have implemented electronic health records to improve documentation, financial constraints prevent this realisation in the Caribbean. Somewhat paradoxically, previous studies in this area have focussed on 'process' while neglecting the key role of the surgeon. We conducted a 25-item Knowledge, Attitudes and Practices survey of orthopaedic doctors to identify any culturally unique health-related behaviours. Our results indicate that while most doctors understand the importance of operation notes, many are unaware of international note-keeping recommendations. Legibility was identified as a significant issue by 92% of doctors. A disturbing and previously unreported finding from the study revealed that 72% of surgeons would occasionally write the operation notes, although they were not scrubbed in for the procedure. We suggest that future studies examine this peculiar behaviour in greater detail.

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A bioeconomic model was developed to calculate the economic value (ev) of reproductive and growth performance, feed efficiency and carcass traits of a seedstock Nellore herd. Data from a full-cycle cattle operation (1,436 dams) located in the Brazilian Cerrado were assessed. The ev was calculated by the difference in profit before and after one-unit improvement in the trait, with others remaining unchanged. The ev was standardized by the phenotypic standard deviation of each trait. Preweaning average daily gain (ADG) was the most economically important trait evaluated (R$ 58.04/animal/year), followed by age at first calving (R$ 44.35), postweaning ADG (R$ 31.43), weight at 450 days (R$ 25.36), accumulated productivity (R$ 21.43), ribeye area (R$ 21.35), calving interval (R$ 19.97), feed efficiency (R$ 15.24), carcass dressing per cent (R$ 8.27), weight at 120 days (R$ 6.22), weight at 365 days (R$ 6.06), weight at weaning (210 days, R$ 5.82), stayability (R$ 5.70) and the probability of early calving (R$ 0.32). The effects of all traits on profits are evidence that their selection may result in the economic and genetic progress of the herd if there is genetic variability.

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The Chilean workforce has over 200,000 people that are intermittently exposed to altitudes over 4,000 m. In 2012, the Ministry of Health provided a technical guide for high-altitude workers that included a series of actions to mitigate the effects of hypoxia. Previous studies have shown the positive effect of oxygen enrichment at high altitudes. The Atacama Large Millimeter/submillimeter Array (ALMA) radiotelescope operates at 5,050 m [Array Operations Site (AOS)] and is the only place in the world where pressure swing adsorption (PSA) and liquid oxygen technologies have been installed at a large scale. These technologies reduce the equivalent altitude by increasing oxygen availability. This study aims to perform a retrospective comparison between the use of both technologies during operation in ALMA at 5,050 m. In each condition, variables such as oxygen (O2), temperature, and humidity were continuously recorded in each AOS rooms, and cardiorespiratory variables were registered. In addition, we compared portable O2 by using continuous or demand flow during outdoor activities at very high altitudes. The outcomes showed no differences between production procedures (PSA or liquid oxygen) in regulating oxygen availability at AOS facilities. As a result, big-scale installations have difficulties reaching the appropriate O2 concentration due to leaks in high mobility areas. In addition, the PSA plant requires adequacy and maintenance to operate at a very high altitude. A continuous flow of 2-3 l/min of portable O2 is recommended at 5,050 m.

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Resumen: El artículo analiza el libro "Comuna 13 de Medellín. El Drama del Conflicto Armado" publicado por Yoni Alexander Rendón Rendón, en 2007 cuando el autor era patrullero de la Policía Nacional, en una las zonas más violentas de Colombia: los barrios populares de Medellín. El libro se analizó en sus dimensiones textuales y extratextuales lo que permitió clasificarlo en el género testimonial y en algunos de los universos discursivos sobre el conflicto urbano, lo que explica su inserción exitosa en las disputas sobre la verdad de lo ocurrido en la Comuna 13 en octubre de 2002 en la operación Orión.

Abstract The article analyzes the book "Comuna 13 de Medellín. El Drama del Conflicto Armado" published by Yoni Alexander Rendón Rendón Rendón, in 2007 when the author was a patrolman of the National Police, in one of the most violent areas of Colombia: the popular neighborhoods of Medellín. The book was analyzed in its textual and extratextual dimensions, which allowed it to be classified in the testimonial genre and in some of the discursive universes on the urban conflict, which explains its successful insertion in the disputes about the truth of what happened in Comuna 13 in October 2002 in the Orion Operation.