Prevalence, under-reporting, and epidemiological surveillance of COVID-19 in the Araguaína City of Brazil.

Asymptomatic and underreported individuals remain a source of coronafig disease 2019 (COVID-19) transmission to others. Data on the prevalence and epidemiological factors influencing transmission are fundamental for establishing control measures, especially in vulnerable regions such as the Amazon. This study aimed to determine the point prevalence and active infection of COVID-19 among the population in Araguaína, a Brazilian city located in the Amazon region, analyzed the socioeconomic and behavioral variables of a statistically representative sample of this population using an epidemiological survey, and identify the viral genomic diversity in the region. During the sixth epidemiological week of 2021 (February 8 to 12), samples of 497 inhabitants of the municipality asymptomatic for respiratory syndromes underwent reverse transcription-quantitative polymerase chain reaction and serological tests (immunoglobulin M and immunoglobulin G). A questionnaire collated data on socioeconomic factors, prevention measures, and health status history. The active infection rate was 6.2%, and the prevalence was 13.5% of the study population. Active infection cases were under-reported; each reported positive case represented 14-28 under-reported cases. Lineages P.2, P.1, and B.1.1 were detected. Working from home was a protective factor against the infection, and clinical signs of fever, dry cough, and loss of taste or smell were associated with testing positive (p <0.05). A descriptive analysis of the indicators revealed that the entire population was susceptible to the disease. Intensified vaccination strategies are required regardless of socioeconomic factors, health conditions, and preventive measures. Implementation of objective, comprehensive, and efficient management tools to minimize the spread of COVID-19 in this municipality can serve as a model for other regions of Brazil.

Gold nanoparticles for surface-enhanced Raman scattering detection of benzyldimethyldodecylammonium chloride at low concentration.

The oil and gas industry plays a vital role in the global economy. The production process has several critical conditions and can expose metals to corrosion. Surfactants like the quaternary ammonium salt Benzyldimethyldodecylammonium Bromide (BDAC) are currently used to prevent corrosions; classical methods for determining these surfactants have problems in saline samples and usually present high costs. In this context, spectroscopic techniques become an excellent alternative for quaternary ammonium salts detection. Here, a SERS (surface-enhanced Raman scattering) sensor based on gold nanoparticles (AuNPs) synthesized through chemical reduction was used as an alternative method for BDAC detection. We detected BDAC at low concentrations in water solutions: at 5 to 30 ppm (1.47 × 10-5 mol L-1 to 8.82 × 10-5 mol L-1); and had the vibration attempt attribute analyzed. A new study of quaternary ammonium compounds using AuNPs and SERS with a different, easy, and repeatable approach to spectra acquisition is presented and shows to be a promising method applied in quaternary ammonium salt compounds detection for the oil and gas industry.

Analysis of naphthenic acids in produced water samples by capillary electrophoresis-mass spectrometry.

A capillary electrophoresis-mass spectrometry method was used to analyze naphthenic acids in produced water samples. It was possible to detect cyclopentanecarboxylic, benzoic, cyclohexanebutyric, 1-naphthoic, decanoic, 3,5-dimethyladamantane-1-carboxylic, 9-anthracenecarboxylic, and pentadecanoic acids within ca. 13 min using a buffer composed of 40 mmol/L ammonium hydroxide, 32 mmol/L acetic acid and 20% v/v isopropyl alcohol, pH 8.6. The proposed method showed good repeatability, with relative standard deviation (RSD) values of 6.6% for the sum of the peak areas and less than 2% for the analysis time. In the interday analysis, the RSD values for the sum of the peak areas and migration time were 10.3% and 10%, respectively. The developed method demonstrated linear behavior in the concentration range between 5 and 50 mg/L for benzoic, decanoic, 3,5-dimethyladamantane-1-carboxylic and 9-anthracenecarboxylic acids, and between 10 and 50 mg/L for cyclopentanecarboxylic, cyclohexanebutyric, 1- naphthoic, and pentadecanoic acids. The detection limits values ranged from 0.31 to 1.64 mg/L. Six produced water samples were analyzed and it was possible to identify and quantify cyclopentanecarboxylic, benzoic, cyclohexanebutyric, and decanoic acids. The concentrations varied between 4.8 and 98.9 mg/L, proving effective in the application of complex samples.

Development of Synthetic Aqueous Oil and Grease Standards for Determination of TOG in Produced Water: Evaluation of Alternative Methods for Application in an Offshore Environment.

Produced water is present in oil and natural gas reservoirs and is transported to the surface along with the oil. Total oil and grease content (TOG) is the main parameter evaluated in this waste disposal category. Today, the validation of methods in the laboratory is not done using petroleum. The objective of this work was to develop synthetic oily water standards that can be applied for internalization and validation in the laboratory. Oil weighing protocols, the influence of volatile compounds, and a procedure for preparing oily water with high reproducibility were studied. Synthetic oily water standards were prepared for TOG determination by gravimetric and infrared methods. Repeatability of 3.8 and 11% and accuracy of 85 and 105% were obtained using gravimetric and infrared methods. These results indicate that with the development of these standards, it is possible to validate methodologies for TOG determination using petroleum.

CRYPTOCHROME 1a-mediated blue light perception regulates tomato seed germination via changes in hormonal balance and endosperm-degrading hydrolase dynamics.

MAIN CONCLUSION: Blue light exposure delays tomato seed germination by decreasing endosperm-degrading hydrolase activities, a process regulated by CRY1a-dependent signaling and the hormonal balance between ABA and GA. The germination of tomato seeds (Solanum lycopersicum L.) is tightly controlled by an internal hormonal balance, which is also influenced by environmental factors such as light. In this study, we investigated the blue light (BL)-mediated impacts on physiological, biochemical, and molecular processes during the germination of the blue light photoreceptor CRYPTOCHROME 1a loss-of-function mutant (cry1a) and of the hormonal tomato mutants notabilis (not, deficient in ABA) and procera (pro, displaying a GA-constitutive response). Seeds were germinated in a controlled chamber in the dark and under different intensities of continuous BL (ranging from 1 to 25 µmol m-2 s-1). In general, exposure to BL delayed tomato seed germination in a fluency rate-dependent way due to negative impacts on the activities of endosperm-degrading hydrolases, such as endo-ß-mannanase, ß-mannosidase, and α-galactosidase. However, not and pro mutants presented higher germination speed index (GSI) compared to WT despite the BL influence, associated with higher hydrolase activities, especially evident in pro, indicating that the ABA/GA hormonal balance is important to diminish BL inhibition over tomato germination. The cry1a germination percentage was higher than in WT in the dark but its GSI was lower under BL exposure, suggesting that functional CRY1a is required for BL-dependent germination. BL inhibits the expression of GA-biosynthetic genes, and induces GA-deactivating and ABA-biosynthetic genes. The magnitude of the BL influence over the hormone-related transcriptional profile is also dependent upon CRY1a, highlighting the complex interplay between light and hormonal pathways. These results contribute to a better understanding of BL-induced events behind the photoregulation of tomato seed germination.

Automated method using direct-immersion solid-phase microextraction and on-fiber derivatization coupled with comprehensive two-dimensional gas chromatography high-resolution mass spectrometry for profiling naphthenic acids in produced water.

Naphthenic acids (NAs) are naturally occurring organic acids in petroleum and are found in waste waters generated during oil production (produced water, PW). Profiling this class of compounds is important due to flow assurance during oil exploration. Compositional analysis of PW is also relevant for waste treatment to reduce negative impacts on the environment. Here, comprehensive two-dimensional gas chromatography coupled with high-resolution mass spectrometry (GC×GC-HRMS) was applied as an ideal platform for qualitative analysis of NAs by combining the high peak capacity of the composite system with automated scripts for group-type identification based on accurate mass measurements and fragmentation patterns. To achieve high-throughput profiling of NAs in PW samples, direct-immersion solid phase microextraction (DI-SPME) was selected for extraction, derivatization and preconcentration. A fully automated DI-SPME method was developed to combine extraction, fiber rinsing and drying, and on-fiber derivatization with N-methyl-N­tert-butyldimethylsilyltrifluoroacetamide (MTBSTFA). Data processing was based on filtering scripts using the Computer Language for Identifying Chemicals (CLIC). The method successfully identified up to 94 NAs comprising carbon numbers between 6 and 18 and hydrogen deficiency values ranging from 0 to -4. The proposed method demonstrated wider extraction coverage compared to traditional liquid-liquid extraction (LLE) - a critical factor for petroleomic investigations. The method developed also enabled quantitative analysis, exhibiting detection limits of 0.5 ng L-1 and relative standard deviation (RSD) at a concentration of NAs of 30 µg L-1 ranging from 4.5 to 25.0%.

Effect of Indole-3-Acetic Acid on Tomato Plant Growth.

Plant growth-promoting bacteria have several abilities to promote plant growth and development. One of these skills is the synthesis of indole-3-acetic acid (IAA), which mainly promotes root and shoot development. The bacteria Bacillus subtilis and Azospirillum brasilense have been widely used in agriculture with this function. However, little is known about whether the joint inoculation of these bacteria can reduce plant development by the excess of IAA produced as a result of the joint inoculation. The objective of the present study was to verify the effect of IAA on the inoculation of B. subtilis and A. brasilense in three tomato genotypes. The Micro-Tom genotype without mutation for IAA synthesis, Entire, has high sensitivity to IAA, and the diageotropic genotype (dgt) has low sensitivity to IAA. The results show that the plant parameter most sensitive to microbial inoculation is the number of roots. No treatment increased the shoot dry mass parameters for the Micro-Tom genotype and dgt, root dry mass for the Micro-Tom genotype, plant height for the Micro-Tom and Entire genotypes, root area and root volume for the genotype dgt. The Azm treatment reduced plant height compared to the control in the dgt, the BS + Azw and BS + Azm treatments in the Micro-Tom genotype and the Azw + Azm treatment in the dgt genotype reduced the plant diameter compared to the control. BS and BS + Azw reduced the number of roots in the Micro-Tom. The results strongly support that the mixture of B. subtilis and A. brasilense can reduce some parameters of plant development; however, this effect is possibly an interference in the mode of action of growth promotion of each isolate and is not related to an excess of IAA produced by the bacteria.

Electromembrane Extraction of Naphthenic Acids in Produced Water Followed by Ultra-High-Resolution Mass Spectrometry Analysis.

Naphthenic acids comprise one of the most toxic compounds of the produced water released from offshore oil platforms. Therefore, developing and applying faster, simpler, and more efficient analytical methods for analyzing naphthenic acids are urgently needed. Electromembrane extraction (EME) uses the electrokinetic migration of target ions through a porous membrane. Herein, the EME method was applied to extract naphthenic acids from produced water. The EME method was optimized, and the optimal conditions encompassed decanol as the organic solvent, the sample with pH 10.0, 5 min of extraction at 200 V, and the ratio 4:1 (borate buffer/matrix, v/v). Electrochemical impedance spectroscopy confirmed charged species' migration from produced water through the EME. Subsequently, all extracts were analyzed by ultra-high-resolution mass spectrometry. The EME efficiency was assessed by comparing the extraction results to the liquid-liquid extraction (LLE) method results. Analytical results showed good linearity for both solvent and matrix curves (R2 > 0.98). Low detection limits ranged from 0.10 to 0.13 µg mL-1 and quantification limits from 0.36 to 0.45 µg mL-1. Precision and accuracy values ranged from -13.3% to 16.5%. These values fit the proposed method, demonstrating that the EME was more efficient than LLE in naphthenic acid extraction. The EME method preferably extracted aromatic compounds with double-bond equivalence from 6 to 8. The EME coupled with ultra-high-resolution mass spectrometry was demonstrated as a promising analytical approach to naphthenic acid extraction as an efficient and more environmentally friendly alternative to conventional extraction methods.

Determination of naphthenic acids in produced water by using microchip electrophoresis with integrated contactless conductivity detection.

This study reports for the first time the use of a microchip electrophoresis (ME) device with integrated capacitively coupled contactless conductivity detection (C4D) to analyze naphthenic acids in produced water. A mixture containing 9-anthracenecarboxylic, 1-naphthoic, and benzoic acids was separated and detected using a running buffer composed of 10 mmol L-1 carbonate buffer (pH = 10.2). The separation was achieved within ca. 140 s with baseline resolution greater than 2 and efficiency values ranging from 1.9 × 105 to 2.4 × 105 plates m-1. The developed methodology provided linear correlation with determination coefficients greater than 0.992 for the concentration ranges between 50 and 250 µmol L-1 for benzoic and 9-anthracenecarboxylic acids, and between 50 and 200 µmol L-1 for 1-naphthoic acid. The achieved limit of detection values varied between 4.7 and 7.7 µmol L-1. The proposed methodology revealed satisfactory repeatability with RSD values for a sequence of eight injections between 5.5 and 7.7% for peak areas and lower than 1% for migration times. In addition, inter-day precision was evaluated for sixteen injections (a sequence of four injections performed during four days), and the RSD values were lower than 11.5 and 4.9% for peak areas and migration time, respectively. Five produced water samples were analyzed, and it was possible to detect and quantify 9-anthracenecarboxylic acid. The concentrations ranged from 1.05 to 2.24 mmol L-1 with recovery values between 90.8 and 96.0%. ME-C4D demonstrated satisfactory analytical performance for determining naphthenic acids in produced water for the first time, which is useful for petroleum or oil industry investigation.

Genomic Epidemiology of SARS-CoV-2 in Tocantins State and the Diffusion of P.1.7 and AY.99.2 Lineages in Brazil.

Tocantins is a state in the cross-section between the Central-West, North and Northeast regions of Brazilian territory; it is a gathering point for travelers and transportation from the whole country. In this study, 9493 genome sequences, including 241 local SARS-CoV-2 samples (collected from 21 December 2020, to 16 December 2021, and sequenced in the MinION platform) were analyzed with the following aims: (i) identify the relative prevalence of SARS-CoV-2 lineages in the state of Tocantins; (ii) analyze them phylogenetically against global SARS-CoV-2 sequences; and (iii) hypothesize the viral dispersal routes of the two most abundant lineages found in our study using phylogenetic and phylogeographic approaches. The performed analysis demonstrated that the majority of the strains sequenced during the period belong to the Gamma P.1.7 (32.4%) lineage, followed by Delta AY.99.2 (27.8%), with the first detection of VOC Omicron. As expected, there was mainly a dispersion of P.1.7 from the state of São Paulo to Tocantins, with evidence of secondary spreads from Tocantins to Goiás, Mato Grosso, Amapá, and Pará. Rio de Janeiro was found to be the source of AY.99.2 and from then, multiple cluster transmission was observed across Brazilian states, especially São Paulo, Paraiba, Federal District, and Tocantins. These data show the importance of trade routes as pathways for the transportation of the virus from Southeast to Northern Brazil.

Proposta de utilização da Classificação Internacional de Funcionalidade, Incapacidade e Saúde na avaliação fisioterapêutica no câncer mamário / Proposal for the use of the International Classification of Functioning, Disability and Health in the physical therapy evaluation in breast cancer

INTRODUÇÃO: O câncer de mama é uma doença comum entre as mulheres e o tratamento está sujeito a apresentar limitações nas atividades diárias e sociais. A Classificação Internacional de Funcionalidade, Incapacidade e Saúde (CIF) pode ser uma ferramenta útil para apontar a alteração da funcionalidade dessas mulheres. OBJETIVO: Verificar em que medida o conteúdo de uma ficha de avaliação fisioterapêutica para mulheres com câncer de mama engloba os componentes de saúde da CIF e comparar com o core set específico para o câncer de mama. MATERIAL E MÉTODO: Estudo descritivo realizando-se a vinculação entre os itens da ficha de avaliação com as categorias da CIF. Dois pesquisadores avaliaram independentes quais as categorias mais adequadas para cada item da ficha de avaliação fisioterapêutica utilizada para mulheres com câncer mamário em um hospital de referência no interior de Minas Gerais, considerando o contexto, opções de resposta e as perspectivas adotadas nos instrumentos utilizados. RESULTADOS: 70 categorias da CIF foram elencadas a partir da ficha de avaliação fisioterapêutica utilizada no hospital, envolvendo todos os seus componentes de saúde. Das 80 categorias do core set específico para câncer de mama, apenas 21 foram equivalentes com a ficha de avaliação. CONCLUSÃO: A vinculação das categorias da CIF com a ficha de avaliação para mulheres com câncer de mama engloba todos os seus componentes de saúde, entretanto com baixa equivalência quando comparada com o core set específico para o câncer de mama.

INTRODUCTION: Breast cancer is a common disease among women and the treatment is subject to present limitations in daily and social activities. The International Classification of Functioning, Disability and Health (ICF) can be a useful tool to point out the alteration in the functionality of these women. OBJECTIVE: To verify the extent to which the content of a physical therapy assessment form for women with breast cancer encompasses the ICF health components and compare with the breast cancer-specific core set. MATERIAL AND METHOD: A descriptive study was carried out linking the items of the evaluation form with the ICF categories. Two researchers independently evaluated which categories were more appropriate for each item on the physical therapy evaluation form used for women with breast cancer in a reference hospital in the interior of Minas Gerais, considering the context, response options, and the perspectives adopted in the instruments used. RESULTS: 70 ICF categories were listed from the physical therapy evaluation form used in the hospital, involving all its health components. Of the 80 categories of the specific core set for breast cancer, only 21 were equivalent to the evaluation form. CONCLUSION: The link between the ICF categories and the assessment form for women with breast cancer encompasses all its health components, but with low equivalence when compared to the breast cancer-specific core set.

Naphthenic Acids: Formation, Role in Emulsion Stability, and Recent Advances in Mass Spectrometry-Based Analytical Methods.

Naphthenic acids (NAs) are compounds naturally present in most petroleum sources comprised of complex mixtures with a highly variable composition depending on their origin. Their occurrence in crude oil can cause severe corrosion problems and catalysts deactivation, decreasing oil quality and consequently impacting its productivity and economic value. NAs structures also allow them to behave as surfactants, causing the formation and stabilization of emulsions. In face of the ongoing challenge of treatment of water-in-oil (W/O) or oil-in-water (O/W) emulsions in the oil and gas industry, it is important to understand how NAs act in emulsified systems and which acids are present in the interface. Considering that, this review describes the properties of NAs, their role in the formation and stability of oil emulsions, and the modern analytical methods used for the qualitative analysis of such acids.

Direct analysis of naphthenic acids in produced water and crude oil by NH2-surface-modified wooden-tip electrospray ionization mass spectrometry.

This work describes the surface coating of wooden toothpicks with amino groups (NH2) for electrospray ionization mass spectrometry (MS) analysis of naphthenic acids (NAs) in produced water samples and crude oil fractions. NH2 was introduced into the cellulosic material through a silanization reaction using aminopropyltriethoxysilane. An NH2-modified toothpick was inserted into the analyte extraction sample and was subsequently used as an electrospray emitter for MS analysis. The extraction conditions were optimized by analyzing NAs (benzoic acid, 1-naphthoic acid, decanoic acid, 3,5-dimethyladamantane-1-carboxylic acid, and 3,5-dimethyladamantane-1-acetic acid) in pure water, and the best condition was using 5 min of extraction time with the samples under agitation. Modified and unmodified wooden toothpicks were compared, and the intensities of all NAs were higher when using the modified substrates than when using the unmodified ones. Limit of detection (LOD), limit of quantification (LOQ), linearity, precision, and recovery were determined by analyzing decanoic acid in seawater samples. The LOD and LOQ were 2 and 5 µg mL-1, respectively, and a linear correlation (R2 = 0.9927) was obtained with concentrations ranging from 5 to 250 µg mL-1. Precision values ranged from 6 to 13% and recoveries from 89 to 106%. The technique was also employed to analyze three produced water samples, in which decanoic acid was semi-quantified, and the concentrations ranged from 10 to 13 µg mL-1. High abundances of acidic compounds of class O2 with DBEs (double bond equivalents) ranging from 1 to 3 and carbon numbers going from 8 to 12 were detected in the produced water samples. The results suggest that the modification of wooden toothpicks with NH2 might offer a significant advancement in the knowledge of cheap substrates that can improve the sensitivity of analysis of NAs in water samples.

Tomato phytochromes B1 and B2 are part of the responses to the nutritional stress induced by NPK deficiency.

Phytochromes are red-light photoreceptors that play an important role in regulating many responses of plants, including its nutritional control. Nutrient deficiency in plants has become a constraint for agricultural production; thus, we investigated the role of phytochromes B1 and B2 in the nutritional, physiological, and growth changes of the control genotype (WT) and both phyB1 and phyB2 tomato mutants (deficient in phyB1 and phyB2) under nutritional sufficiency and individual deficiency of N, P, and K. Under complete solution, the plants of phyB1 and phyB2 had a decreased N, P, and K accumulation compared with WT and consequently a reduced content of chlorophyll and carotenoids, and dry weight production. In the condition of N deficiency, phyB1 had decreased N absorption, pigments concentration, and plant dry weight, while increased oxidative stress of membranes (MDA content). Similarly, phyB2 also had reduced N absorption. The deficiency of phyB1 mitigated the effects of P deficiency as phyB1 mutant had improved nutritional and physiological responses, increasing plant dry weight production. In contrast, phyB2 reduced N accumulation, quantum efficiency of photosystem II (Fv/Fm), and the concentration of pigments, while it increased MDA. Under K deficiency, phyB1 displayed a reduced P accumulation, as well as the total concentration of chlorophylls and carotenoids and K use efficiency. An increased concentration of MDA was found in phyB2 plants, as well as a reduction in chlorophylls concentration and in the use efficiency of K. Together, these results indicate a new perspective on the control of phytochromes in the nutrition of tomato plants under nutritional stress.

Validation of conventional PCR-like alternative to SARS-CoV-2 detection with target nucleocapsid protein gene in naso-oropharyngeal samples.

SARS-CoV-2 has spread worldwide and has become a global health problem. As a result, the demand for inputs for diagnostic tests rose dramatically, as did the cost. Countries with inadequate infrastructure experience difficulties in expanding their qPCR testing capacity. Therefore, the development of sensitive and specific alternative methods is essential. This study aimed to develop, standardize, optimize, and validate conventional RT-PCR targeting the N gene of SARS-CoV-2 in naso-oropharyngeal swab samples compared to qPCR. Using bioinformatics tools, specific primers were determined, with a product expected to be 519 bp. The reaction conditions were optimized using a commercial positive control, and the detection limit was determined to be 100 fragments. To validate conventional RT-PCR, we determined a representative sampling of 346 samples from patients with suspected infection whose diagnosis was made in parallel with qPCR. A sensitivity of 92.1% and specificity of 100% were verified, with an accuracy of 95.66% and correlation coefficient of 0.913. Under current Brazilian conditions, this method generates approximately 60% savings compared to qPCR costs. Conventional RT-PCR, validated herein, showed sufficient results for the detection of SARS-CoV-2 and can be used as an alternative for epidemiological studies and interspecies correlations.

Profiling naphthenic acids in produced water using hollow fiber liquid-phase microextraction combined with gas chromatography coupled to Fourier transform Orbitrap mass spectrometry.

In this study, we describe the development of an analytical method to profile naphthenic acids (NAs) from produced water (PW). The NAs were isolated by hollow fiber liquid-phase microextraction (HF-LPME). A microwave-assisted methylation method was used to convert the free acids into its corresponding naphthenic methyl esters (NAMEs). The best reaction conditions were ascertained using central composite design. The optimized sample preparation method exhibited an improved analytical eco-scale value (80 vs. 61) compared to conventional liquid-liquid extraction. Although the primary goal was qualitative analysis of NAMEs (e.g., group-type separation) in produced water, the quantitative performance was also evaluated for future investigations. The instrumental detection and quantification limits were 0.10 ng mL-1 and 0.16 ng mL-1, respectively, using full spectrum data acquisition. The accuracy and precision of the proposed method ranged from 90.4 to 96.6 % and 3.3 to 13.1 %, respectively, using matrix-matched working solutions (0.1, 0.5, and 1.0 µg mL-1). The monoisotopic masses of the adduct ions ([M+H]+) and its corresponding fine isotopic patterns were used to determine the elemental composition of the NAMEs in the PW samples. Qualitative analysis indicated the O2 class as the predominant class in all samples with carbon numbers ranging from C5 to C19 and double bond equivalent (DBE) values of 1 to 8. Additional classes of polar compounds, i.e., O3, O4 and nitrogen-containing classes, are reported for the first time by gas chromatography coupled to Fourier transform Orbitrap mass spectrometry and chemical ionization.

Return to Sports After High Tibial Osteotomy Using the Opening Wedge Technique.

Objective The present paper evaluates the resuming of physical activities by young, active patients who practiced some sport modality and underwent a high tibial osteotomy (HTO) using the opening wedge technique. Methods A total of 12 patients submitted to HTO using the opening wedge technique were prospectively analyzed. All patients were not playing sports at that time. Pre- and postoperative Lysholm and International Knee Documentation Committee (IKDC) scores, visual analog scale for pain and performance level were compared. The average follow-up time was of 12 months. Results One patient resumed sporting activities at a performance level significantly lower compared to the preoperative level, while eight patients returned at a slightly below level, two returned at the same level and one patient returned at a higher level in comparison with the preoperative period. Conclusion For isolated medial osteoarthrosis treatment, HTO using the opening wedge technique has favorable clinical and functional results, allowing patients to resume their sporting activities.

A Framework for a Statistical Characterization of Epidemic Cycles: COVID-19 Case Study.

BACKGROUND: Since the beginning of the COVID-19 pandemic, researchers and health authorities have sought to identify the different parameters that drive its local transmission cycles to make better decisions regarding prevention and control measures. Different modeling approaches have been proposed in an attempt to predict the behavior of these local cycles. OBJECTIVE: This paper presents a framework to characterize the different variables that drive the local, or epidemic, cycles of the COVID-19 pandemic, in order to provide a set of relatively simple, yet efficient, statistical tools to be used by local health authorities to support decision making. METHODS: Virtually closed cycles were compared to cycles in progress from different locations that present similar patterns in the figures that describe them. With the aim to compare populations of different sizes at different periods of time and locations, the cycles were normalized, allowing an analysis based on the core behavior of the numerical series. A model for the reproduction number was derived from the experimental data, and its performance was presented, including the effect of subnotification (ie, underreporting). A variation of the logistic model was used together with an innovative inventory model to calculate the actual number of infected persons, analyze the incubation period, and determine the actual onset of local epidemic cycles. RESULTS: The similarities among cycles were demonstrated. A pattern between the cycles studied, which took on a triangular shape, was identified and used to make predictions about the duration of future cycles. Analyses on effective reproduction number (Rt) and subnotification effects for Germany, Italy, and Sweden were presented to show the performance of the framework introduced here. After comparing data from the three countries, it was possible to determine the probable dates of the actual onset of the epidemic cycles for each country, the typical duration of the incubation period for the disease, and the total number of infected persons during each cycle. In general terms, a probable average incubation time of 5 days was found, and the method used here was able to estimate the end of the cycles up to 34 days in advance, while demonstrating that the impact of the subnotification level (ie, error) on the effective reproduction number was <5%. CONCLUSIONS: It was demonstrated that, with relatively simple mathematical tools, it is possible to obtain a reliable understanding of the behavior of COVID-19 local epidemic cycles, by introducing an integrated framework for identifying cycle patterns and calculating the variables that drive it, namely: the Rt, the subnotification effects on estimations, the most probable actual cycles start dates, the total number of infected, and the most likely incubation period for SARS-CoV-2.

Return to Sports After High Tibial Osteotomy Using the Opening Wedge Technique / Retorno ao esporte após osteotomia tibial alta com método de cunha de abertura

Abstract Objective The present paper evaluates the resuming of physical activities by young, active patients who practiced some sport modality and underwent a high tibial osteotomy (HTO) using the opening wedge technique. Methods A total of 12 patients submitted to HTO using the opening wedge technique were prospectively analyzed. All patients were not playing sports at that time. Pre- and postoperative Lysholm and International Knee Documentation Committee (IKDC) scores, visual analog scale for pain and performance level were compared. The average follow-up time was of 12 months. Results One patient resumed sporting activities at a performance level significantly lower compared to the preoperative level, while eight patients returned at a slightly below level, two returned at the same level and one patient returned at a higher level in comparison with the preoperative period. Conclusion For isolated medial osteoarthrosis treatment, HTO using the opening wedge technique has favorable clinical and functional results, allowing patients to resume their sporting activities.

Resumo Objetivo Avaliar o retorno ao esporte em pacientes jovens e ativos praticantes de alguma modalidade esportiva submetidos a osteotomia tibial alta (OTA) com o método de cunha de abertura. Métodos Foram analisados prospectivamente 12 pacientes submetidos ao procedimento de OTA utilizando-se método de cunha de abertura. Todos os pacientes estavam afastados do esporte. Foram utilizados os escores Lysholm, questionário International Knee Documentation Committee (IKDC, na sigla em inglês), escala analógica de dor e nível de retorno em comparação ao período pré-operatório. O tempo médio de seguimento foi de 12 meses. Resultados Um paciente retornou ao esporte em nível muito abaixo do pré-operatório, oito pacientes retornaram em nível pouco abaixo, dois pacientes retornaram no mesmo nível e um paciente retornou em nível acima. Conclusão A OTA com uso do método de cunha de adição como forma de tratamento para osteoartrose medial isolada demonstra resultados clínicos e funcionais favoráveis e permite o retorno ao esporte.