Enhanced Elastocaloric Effects in γ-Graphyne.

The global emphasis on sustainable technologies has become a paramount concern for nations worldwide. Specifically, numerous sustainable methods are being explored as promising alternatives to the well-established vapor-compression technologies in cooling and heating devices. One such avenue gaining traction within the scientific community is the elastocaloric (eC) effect. This phenomenon holds promise for efficient cooling and heating processes without causing environmental harm. Studies carried out at the nanoscale have demonstrated the efficiency of the eC effect, proving to be comparable to that of state-of-the-art macroscopic systems. In this study, we used classical molecular dynamics simulations to investigate the elastocaloric effect for the recently synthesized γ-graphyne. Our analysis goes beyond obtaining changes in eC temperature and the coefficient of performance (COP) for two species of γ-graphyne nanoribbons (armchair and zigzag). We also explore their dependence on various conditions, including whether they are deposited on a substrate or prestrained. Our findings reveal a substantial enhancement in the elastocaloric effect for γ-graphyne nanoribbons when subjected to prestrain, amplifying it by at least 1 order of magnitude. Under certain conditions, the changes in the eC temperature and the COP of the structures reach expressive values as high as 224 K and 14, respectively. We discuss the implications of these results by examining the shape and behavior of the carbon-carbon bond lengths within the structures.

Development of an image-based fluorometer with smartphone control for paper analytical devices.

This work describes the construction and evaluation of a fluorometer for use in paper analytical devices, using a smartphone to operate the instrument and to perform real-time image-based detection. In this approach, a circular PAD containing twenty analytical plates is rotated at 18° increments under a UV LED source, providing a sequential irradiation of plates and the detection of the luminescence with a lab-made application, capable of automatically identifying the analytical zones and collecting the RGB intensities from the selected pixels. As a proof of concept, the fluorometer performance was evaluated for the determination of quinine in beverages and riboflavin (B2 vitamin) in supplements. Quinine, which is less photoreactive, provided steady-state signals, while riboflavin, which rapidly degrades under UV photons, presented transient responses for RGB detection. For both analytes, linear calibration ranges (R2 > 0.99) were observed from 2.0 mg L-1 to 10.0 mg L-1 with limits of detection estimated at approximately 1.0 mg L-1. Nevertheless, it was demonstrated that successive additions of standard solutions to a single analytical plate of PAD could enhance the signal-to-noise ratios for less concentrated samples, acting as a pre-concentration step. In addition, suitable deviations for the signals (ca. 4.0%) and the absence of systematic errors for most samples (9 out of 11), when compared with a reference method at 95% confidence level, indicates that the proposed strategy is precise and accurate enough to be used as analytical tool for fluorescence detection in PAD.

Elastocaloric Effect in Graphene Kirigami.

Kirigami, a traditional Japanese art of paper cutting, has recently been explored for its elastocaloric effect (ECE) in kirigami-based materials (KMs), where an applied strain induces temperature changes. Importantly, the feasibility of a nanoscale graphene kirigami monolayer was experimentally demonstrated. Here, we investigate the ECE in GK representing the thinnest possible KM to better understand this phenomenon. Through molecular dynamics simulations, we analyze the temperature change and coefficient of performance (COP) of GK. Our findings reveal that while GKs lack the intricate temperature changes observed in macroscopic KMs, they exhibit a substantial temperature change of approximately 9.32 K (23 times higher than that of macroscopic KMs, which is about 0.4 K) for heating and -3.50 K for cooling. Furthermore, they demonstrate reasonable COP values of approximately 1.57 and 0.62, respectively. It is noteworthy that the one-atom-thick graphene configuration prevents the occurrence of the complex temperature distribution observed in macroscopic KMs.

Purple passion fruit (Passiflora edulis f. edulis): A comprehensive review on the nutritional value, phytochemical profile and associated health effects.

Passiflora is a highly diverse genus where taxonomic lack of consensus remains. This may be the reason why numerous studies do not specify to the infraspecific level the plant material used or lack consistency in the nomenclature of botanical formae of Passiflora edulis. Ultimately, this may contribute to inaccurate chemical composition and health effects attributed to different Passiflora edulis species and formae. Hence, this review aims to overcome these challenges by exploring the phytochemical profile, specific nutritional value and potential health benefits of purple passion fruit (PPF). PPF is often consumed fresh for its pulp (including seeds) or juice, either directly or added to food dishes. It is also used industrially to produce a wide range of products, where peels and seeds are abundant by-products, most often discarded or used in low-value applications. Herein, in a perspective of integral valorisation of the fruit, the potential use of all PPF fractions (peel, pulp and seeds) is discussed as a source of important macro and micronutrients, adequate to integrate a balanced and healthy diet. In addition, the phytochemical profile of such fractions is also discussed along with the associated in vitro biological activities (antioxidant, anti-inflammatory, antibacterial and antifungal) and in vivo beneficial effects in the management of several diseases (asthma, hypertension, osteoarthritis, diabetes and pulmonary fibrosis). In summary, this review gathers the current knowledge on the nutritional and phytochemical composition of PPF and highlights the potential of using all fractions as a source of ingredients in food formulations that promote health and well-being. At the same time, it also contributes to defining sustainable strategies for an integrated valorisation of this natural product.

Abdominal esophagocardiectomy with esophagogastric anastomosis, with vagal preservation and construction of a spiral anti reflux valve in the treatment of advanced megaesophagus.

OBJECTIVE: present a new operative technique characterized by abdominal esophagocardiectomy, with esophagogastrus anastomosis, vagal preservation and spiral anti-reflux valve construction in the treatment of advanced megaesophagus in patients with severe systemic diseases, as well as its result in an initial group of 17 patients. METHOD: We selected 17 patients with advanced megaesophagus and comorbidities submitted to new technique. The following parameters were analyzed: age, sex, length of hospital stay, early and late complications, mortality, radiological/endoscopic aspects. RESULTS: twelve male patients (70%) and five (30%) were operated on, with mean age of 51.5 years and mean hospital stay of 14.8 days. There was no mortality in the immediate intraoperative or postoperative period and there were no cases of postoperative fistula. During hospitalization there was one case of pulmonary atelectasis (5.8%), one of pleural effusion (5.8%), two of wall infection (11.7%) and one of urinary retention (5.8%). Discussion: We believe it to be an easy technique, made exclusively by the abdominal route, that is, without violating the thoracic cavity. Such a procedure would be beneficial in patients with advanced megaesophagus and important comorbidities, as well as in those with a history of previous surgeries. CONCLUSION: the technique described was easy to perform and safe, when performed by an experienced team, with low morbidity and mortality in patients with advanced megaesophagus and important comorbidities, which could increase your complications with more invasive and complex surgeries.

Scalable Synthesis and Characterization of Multilayer γ-Graphyne, New Carbon Crystals with a Small Direct Band Gap.

γ-Graphyne is the most symmetric sp2/sp1 allotrope of carbon, which can be viewed as graphene uniformly expanded through the insertion of two-carbon acetylenic units between all the aromatic rings. To date, synthesis of bulk γ-graphyne has remained a challenge. We here report the synthesis of multilayer γ-graphyne through crystallization-assisted irreversible cross-coupling polymerization. A comprehensive characterization of this new carbon phase is described, including synchrotron powder X-ray diffraction, electron diffraction, lateral force microscopy, Raman spectroscopy, infrared spectroscopy, and cyclic voltammetry. Experiments indicate that γ-graphyne is a 0.48 eV band gap semiconductor, with a hexagonal a-axis spacing of 6.88 Å and an interlayer spacing of 3.48 Å, which is consistent with theoretical predictions. The observed crystal structure has an aperiodic sheet stacking. The material is thermally stable up to 240 °C but undergoes transformation at higher temperatures. While conventional 2D polymerization and reticular chemistry rely on error correction through reversibility, we demonstrate that a periodic covalent lattice can be synthesized under purely kinetic control. The reported methodology is scalable and inspires extension to other allotropes of the graphyne family.

Managing tube thoracostomy with thoracic ultrasound: results from a randomized pilot study.

PURPOSE: Tube thoracostomy (TT) is a simple and a life-saving procedure; nevertheless, it carries morbidity, even after its removal. Currently, TT is managed and removed by chest X-ray (CXR) evaluation. There are limitations and these are directly linked to complications. The use of thoracic ultrasound (US) has already been established in the diagnosis of pneumothorax (PTX) and hemothorax (HTX); its use, in substitution of CXR can lead to improvement in care. Our aim is to evaluate the efficiency and safety of US in the management of TT. METHODS: Prospective and randomized study with patients requiring TT. They were divided in groups according to their thoracic injuries (PTX and HTX) and randomized into two groups according to TT management: US and CXR. Data collected included gender, age, mechanism of injury, days to TT removal, complications after TT removal and presence of mechanical ventilation. RESULTS: Sixty-one patients were randomized, of which 68.8% were male. The most frequent diagnosis was PTX, present in 37 cases. Median time for TT removal was 2.5 days in the US group and 4.9 in the control group (p = 0.009). The complication rate was 6.6%, with no morbidity in the US group. TT removal in patients with mechanical ventilation did not increase the incidence of complications. CONCLUSIONS: The use of US in the management is efficient and safe. It allows early TT removal regardless the cause of the thoracic injury.

Abdominal esophagocardiectomy with esophagogastric anastomosis, with vagal preservation and construction of a spiral anti reflux valve in the treatment of advanced megaesophagus / Esofagocardiectomia abdominal com esofagogastro anastomose, com preservação vagal e construção de válvula antirrefluxo em espiral no tratamento do megaesôfago avançado

ABSTRACT Objective: present a new operative technique characterized by abdominal esophagocardiectomy, with esophagogastrus anastomosis, vagal preservation and spiral anti-reflux valve construction in the treatment of advanced megaesophagus in patients with severe systemic diseases, as well as its result in an initial group of 17 patients. Method: We selected 17 patients with advanced megaesophagus and comorbidities submitted to new technique. The following parameters were analyzed: age, sex, length of hospital stay, early and late complications, mortality, radiological/endoscopic aspects. Results: twelve male patients (70%) and five (30%) were operated on, with mean age of 51.5 years and mean hospital stay of 14.8 days. There was no mortality in the immediate intraoperative or postoperative period and there were no cases of postoperative fistula. During hospitalization there was one case of pulmonary atelectasis (5.8%), one of pleural effusion (5.8%), two of wall infection (11.7%) and one of urinary retention (5.8%). Discussion: We believe it to be an easy technique, made exclusively by the abdominal route, that is, without violating the thoracic cavity. Such a procedure would be beneficial in patients with advanced megaesophagus and important comorbidities, as well as in those with a history of previous surgeries. Conclusion: the technique described was easy to perform and safe, when performed by an experienced team, with low morbidity and mortality in patients with advanced megaesophagus and important comorbidities, which could increase your complications with more invasive and complex surgeries.

RESUMO Objetivo: apresentar uma nova técnica caracterizada por esofagocardiectomia abdominal com esofagogastro anastomose, preservação vagal e construção de válvula antirrefluxo em espiral no tratamento do megaesôfago avançado de pacientes com doenças sistêmicas graves, assim como seu resultado em grupo inicial de 17 pacientes. Método: foram selecionados 17 pacientes com megaesôfago avançado e comorbidades submetidos a nova técnica. Os seguintes parâmetros analisados foram: idade, sexo, tempo de permanência hospitalar, complicações precoces e tardias, mortalidade, aspectos radiológicos/endoscópicos. Resultados: foram operados 12 (70%) pacientes do sexo masculino e 5 (30%) do sexo feminino, com idade média foi de 51,5 anos e tempo de permanência hospitalar médio de 14,8 dias. Não houve mortalidade no intraoperatório ou pós-operatório imediato e não houve casos de fìstula. Durante a internação houve um caso de atelectasia pulmonar (5,8%), um de derrame pleural (5,8%), dois de infecção de parede (11,7%) e um de retenção urinária (5,8%). Discussão: acreditamos ser uma técnica de fácil realização, feita exclusivamente por via abdominal, ou seja, sem violar a cavidade torácica. Tal procedimento seria benéfico em pacientes com megaesôfago avançado e comorbidades importantes, assim como naqueles com história de cirurgias prévias. Conclusão: a técnica descrita mostrou-se de fácil execução e segura, quando realizada por equipe experiente, com baixa morbimortalidade em pacientes com megaesôfago avançado e comorbidades importantes, o que poderia aumentar suas complicações com cirurgias mais invasivas e complexas.

A new quantitative gel electrophoresis method with image-based detection for the determination of food dyes and metallic ions.

This work describes an alternative application of gel electrophoresis for the separation and quantification of analytes with low molecular weights using an innovative and low-cost apparatus that enables the acquisition of image-based electropherograms with a webcam. As a proof of concept, the determination of Cu and Ni content in metallic alloys was evaluated by means of the separation and detection of the metallic ions, previously complexed with Eriochrome Black T. Furthermore, the determination of the food colouring agents Sunset Yellow FCF, Tartrazine, Brilliant Blue FCF and Amaranth Red in powder refreshment samples was investigated as alternative to well-stablished methods used for this purpose. For all investigated analytes, the corresponding electrophoretic peaks showed signal to noise ratios ranging from 10 to 180, suitable precision on areas (RSD < 3.5%) and linear relationships (R > 0.99) between RGB detected signals and concentrations of the standard solutions. Application of the method to the determination of Cu and Ni contents in metallic alloys provided results with no significant differences, at 95% confidence level, when compared to the results obtained with a FAAS based method. Apparent recoveries estimated for powder refreshment samples fortified with the food dyes ranged from 93% to 108% for added and found contents, suggesting the absence of matrix effects. The studies prove the feasibility of separation and quantification of coloured analytes by gel electrophoresis and image-based detection that can be useful for different samples.

Laparoscopic resection of primary retroperitoneal schwannoma: A case report.

BACKGROUND: Schwannomas are rare, often benign, tumors deriving from Schwann cells that have low incidence in the retroperitoneal region (0.5% to 5%). Their diagnosis is hardly confirmed at early stage due to lack of specific features in signs, symptoms and imaging tests. Thus, it is necessary performing guided punch biopsy in order to identify it. Tumor removal is the treatment of choice due to its low sensitivity to radiation and chemotherapy. CASE SUMMARY: Forty-seven years old female patient who was hospitalized for elective orthopedic procedure, without complications, evolved with severe pain in the lower limbs, thigh and gluteal region associated with neurogenic claudication. Persistent pain required magnetic resonance imaging (MRI) of the lumbar spine, which showed epidural collection with dural compression and massive heterogeneous perihepatic nodular lesion. The surgical team opted for draining the collection, as well as requested an MRI of the abdomen and pelvis, whose analysis showed expansive lesion in the retroperitoneum, in close contact with the inferior vena cava and with the right renal vein. A guided puncture was performed for diagnostic clarification, which showed immunohistochemical profile compatible with schwannoma. The selected treatment comprised retroperitoneum tumor resection in association with laparoscopic cholecystectomy. The patient was discharged and remained stable after 4-mo follow-up; she remains under follow-up to check the need of cancer investigations. CONCLUSION: Schwannoma features requires surgical treatment based on laparoscopic resection, which often presents low relapse rates and optimistic prognosis.

The Impact of Plant-Based Coatings in "ROCHA" Pear Preservation during Cold Storage: A Metabolomic Approach.

Although new storage technologies have been emerging in recent years, preservation of pear (Pyrus communis L.) remains a challenge for suppliers. Maintenance of desired organoleptic properties throughout cold storage using non-chemical strategies has been investigated and the use of edible coatings has shown potential to delay fruit quality deterioration during cold storage. Thus, the objective of this study is to evaluate the impact of pectin coatings including plant extracts, in "Rocha" pear (Pyrus communis L. cv. Rocha) preservation. A four-month pilot scale assay was performed in both dynamic controlled atmosphere (DCA) (-0.5 °C, 0.5% O2, and 0.4% CO2) and normal atmospheric (NA) conditions (2 °C). For each storage condition, the following three coatings were tested: pectin (3% w/v) (PCT), pectin (3% w/v) + strawberry tree leaves extract (9.5 mg/mL) (CT1), and pectin (3% w/v) + apple pomace extract (16 mg/mL) (CT2). Volatile compounds, potentially related to aroma or ripening status of "Rocha" pear, were monitored alongside with conjugated trienols (CTs) and maturity parameters. The combination of DCA conditions and the application of pectin coatings were able to reduce the release of Rocha pear volatiles associated with ripening status, (particularly esters and sesquiterpenes), as well as reduce CTs, which could contribute to the preservation of Rocha pear for longer periods.

Natural-Based Antioxidant Extracts as Potential Mitigators of Fruit Browning.

Fruit enzymatic browning (EB) inhibition continues to be a challenge in the Food Industry. This physiological disorder results mainly from the oxidation of natural phenolic compounds by polyphenoloxidase (PPO) and peroxidase (POX) leading to the formation of brown pigments. EB can be controlled with the application of antioxidants, reducing/inhibiting the activity of these oxidative enzymes. In this study, strawberry tree (leaves and branches) and apple byproduct were the natural-based extracts (NES) selected, as potential tissue browning inhibitors, within a first screening of fifteen natural-based extracts with antioxidant properties. Phenolic profile, total phenolic content and antioxidant activity of the selected extracts were also performed as well as their depletion effect on the oxidative enzyme's activity and browning inhibiton in fresh-cut pears. Strawberry tree extracts (leaves and branches) revealed higher total phenolic content (207.97 ± 0.01 mg GAE.gNES-1 and 104.07 ± 16.38 mg GAE.gNES-1, respectively), confirmed by the plethora of phenolic compounds identified by LC-ESI-UHR-QqTOF-HRMS and quantified by HPLC. This phytochemical composition was reflected in the low IC50 against PPO and POX obtained. Despite the lower phenolic content (6.76 ± 0.11 mg GAE.gNES-1) and antioxidant activity (IC50 = 45.59 ± 1.34 mg mL-1), apple byproduct extract showed potential in delaying browning. This study highlights the opportunity of byproducts and agricultural wastes extracts as novel anti-browning agents.

Expression of MMR system genes is correlated to NF-kB in patients with oral squamous cell carcinoma.

AIMS: The aim of this study was to evaluate the mismatch repair gene expression and their correlation with NF-kB in patients with oral squamous cell carcinoma (SCC). METHODS: Total RNA was isolated from 28 biopsy samples. A control group was composed of 20 volunteers. Differential expression of hMSH2, hMSH6 and NF-kB genes was accessed by quantitative PCR. RESULTS: There is increased expression of all the analysed genes when the patients were smokers and alcoholics. In addition, there is increased expression of hMSH2 when SCC was removed from the base of the tongue. There was a correlation between NF-kB and hMSH2 and hMSH6 as well as between repair genes hMSH2 and hMSH6 expression levels. There is increased expression of the hMSH2 gene in patients with SCC, especially in the alcoholics. CONCLUSIONS: There is a strong indication that NF-kB gene was expressed along with the studied repair genes, evidencing the possibility that this system can be activated by the inflammatory pathway.

Abordagem de segurança alimentar nutricional nos currículos das universidades federais brasileiras: principais enfoques / Food and nutrition security approach in Brazilian federal universities curricula: core aspects

Resumo O nutricionista é um profissional importante para a promoção da saúde individual e coletiva, tendo em vista a realização da segurança alimentar e nutricional (SAN), que focaliza o direito humano à alimentação adequada (DHAA) e se constitui estratégia de ações e políticas que pautam o próprio DHAA, a soberania alimentar e o enfoque sistêmico. Nesse sentido, a formação do nutricionista deve incluir conteúdos que subsidiem a sua tarefa de promoção da alimentação adequada e saudável, comprometida com os princípios do Sistema Único de Saúde, na perspectiva da SAN. Este estudo analisou 27 projetos pedagógicos do curso de nutrição de universidades federais das cinco regiões do país, visando identificar como a SAN aparece nos currículos e se constitui elemento para a construção do perfil profissional. A análise evidenciou que, apesar de a maioria estar em consonância com as orientações das Diretrizes Curriculares Nacionais em relação ao perfil esperado para o egresso, o tema é abordado por um número restrito de disciplinas, apontando baixa representatividade dos conteúdos de SAN em relação a outros conteúdos disciplinares. Conclui-se que o fortalecimento do tema na formação refletirá na atuação do profissional engajado e comprometido com a sua realização no cotidiano.

Abstract Nutritionists are key for individual and collective health promotion focused on achieving Food and Nutrition Security (FNS) policies, which in Brazil focuses on the human right to adequate food (HRAF) and includes guidelines for itself, for food sovereignty, and its systemic approach. The nutritionist's training must include content that promotes adequate and healthy food, following SUS principles from the perspective of FNS. This study analyzes 27 pedagogical projects of the Nutrition course from federal universities in the five regions of Brazil to identify how the FNS appears in Nutrition curricula and functions as an element for constructing a professional profile. The results showed that, although most curricula comply with the national curriculum guidelines regarding the expected profile for graduates, the subject is addressed by a restricted number of disciplines, indicating a low representativeness of FNS content regarding interdisciplinary content. Strengthening the subject during training thus reflects on these professionals' performance in daily life.

Concepções e práticas de educação e saúde da população negra: uma revisão integrativa da literatura brasileira / Conceptions and practices of education and black population health: an integrative review of Brazilian literature / Concepciones y prácticas de educación y salud de la población negra: una revisión integrativa de la literatura brasileña

A Política de Saúde Integral da População Negra reiterou a urgência de qualificação dos processos educativos no Sistema Único de Saúde (SUS) em prol da superação do racismo institucional. A revisão integrativa, apresentada neste artigo, analisou as concepções teóricas e as práticas educativas em estudos dirigidos à saúde da população negra. Foram utilizadas as bases de dados da Biblioteca Virtual em Saúde (BVS); a Scientific Eletronic Library Online (SciELO); a ferramenta de pesquisa na web Google Scholar e o acervo darevista da Associação Brasileira de Pesquisadores/as Negros/as, a Revista da ABPN. A produção na temática é heterogênea, dispersa entre periódicos das áreas da educação, educação em saúde e interdisciplinar. Há vanguardismo da enfermagem e forte presença de estudos com povos e comunidades tradicionais. Nota-se dificuldade de interpenetração de referenciais teóricos e pedagógicos do campo da educação na sustentação das práticas educativas de saúde. Sugerem-se a cooperação e a integração científica entre esses campos visando ao protagonismo do sujeito negro nos processos de cuidado.

The Política de Saúde Integral da População Negra (Integral Health Policy of the Black Population) reiterated the urgency of qualifying educational processes in the Unified Health System (SUS ­ Sistema Único de Saúde) in order to overcome institutional racism. The integrative review presented in this article analyzed the theoretical conceptions and the educational practices in studies directed to the health of the black population. The databases of the Virtual Health Library (VHL); the Scientific Electronic Library Online (SciELO); the web search engine Google Scholar and the collection of the Revista da ABPN that is the magazine of the Associação Brasileira de Pesquisadores/as Negros/as (Brazilian Association of Black Researchers) were examined. The production in this thematic is heterogeneous, dispersed in periodicals of the areas of education, health education and interdisciplinary. When the matter is the health of black population, the nursing is an avantgarde profession carrying out a number of studies with traditional peoples and communities. It was noted the difficulty of interpenetration of theoretical and pedagogical references of the field of education in support of educational health practices. We suggest the cooperation and the scientific integration between these fields aiming at the protagonism of the black population in the process of care.

La Política de Saúde Integral da População Negra (Política de Salud Integral de la Población Negra) reiteró la urgencia de calificación de los procesos educativos en el Sistema Único de Salud (SUS ­ Sistema Único de Saúde) en pro de la superación del racismo institucional. La revisión integrativa, presentada en este artículo, analizó las concepciones teóricas y las prácticas educativas en estudios dirigidos a la salud de la población negra. Se utilizaron las bases de datos de la Biblioteca Virtual en Salud (BVS); la Scientific Eletronic Library Online (SciELO); el motor de búsqueda web Google Scholar y el acervo de la Revista da ABPN, la cual es la revista de la Associação Brasileira de Pesquisadores/as Negros/as (Asociación Brasileña de Investigadores/ as Negros/as. La producción en la temática es heterogénea, dispersa entre periódicos del área de la educación, educación en salud y interdisciplinaria. La enfermería se destaca en la literatura acerca de la salud de la población negra en la cual hay fuerte presencia de estudios con pueblos y comunidades tradicionales. Se observa dificultad de interpenetración de referenciales teóricos y pedagógicos del campo de la educación en la sustentación de las prácticas educativas de salud. Proponemos la cooperación y la integración científica entre esos campos visando el protagonismo del sujeto negro en los procesos de cuidado.

Caring for the surgical patient with limited ICU resources.

PURPOSE OF REVIEW: The current review aims to discuss the management of surgical patients in an ICU in countries where resources are limited. RECENT FINDINGS: ICU beds in low-income and middle-income countries (LMICs) are limited and also have limited human and structural resources. The working force has been described to be the costliest factor. Nevertheless, costs for intensive care in LMICs are one third from the cost reported from high-income countries. Alternative options have been described, so intensive care can be delivered outside ICU. Examples are Rapid-Response Systems and Medical Emergency Teams. SUMMARY: The care of the surgical patients in an intensive care setting in countries with resource limitations should be optimized, protocols for standardized care implemented and Better research and resource allocation, as well as investment in healthcare training are essential for the development of intensive care in LMICs is necessary.

Torsional refrigeration by twisted, coiled, and supercoiled fibers.

Higher-efficiency, lower-cost refrigeration is needed for both large- and small-scale cooling. Refrigerators using entropy changes during cycles of stretching or hydrostatic compression of a solid are possible alternatives to the vapor-compression fridges found in homes. We show that high cooling results from twist changes for twisted, coiled, or supercoiled fibers, including those of natural rubber, nickel titanium, and polyethylene fishing line. Using opposite chiralities of twist and coiling produces supercoiled natural rubber fibers and coiled fishing line fibers that cool when stretched. A demonstrated twist-based device for cooling flowing water provides high cooling energy and device efficiency. Mechanical calculations describe the axial and spring-index dependencies of twist-enhanced cooling and its origin in a phase transformation for polyethylene fibers.

The structure of graphene on graphene/C60/Cu interfaces: a molecular dynamics study.

Two experimental studies reported the spontaneous formation of amorphous and crystalline structures of C60 molecules intercalated between graphene and a surface. The findings observed included interesting phenomena ranging from reaction between fullerene C60s ('C60s' stands for plural of C60) under graphene to graphene sheets sagging between C60s and control of strain in these sheets. Motivated by this work, we performed fully atomistic reactive molecular dynamics simulations to investigate the formation and thermal stability of graphene sheet wrinkles as well as graphene attachment to and detachment from a surface when the sheet is laid over a previously distributed array of C60 molecules on a copper surface at different temperatures. As graphene compresses the C60s against the surface, and graphene attachment to the surface in between C60s depends on the height of the wrinkles in the graphene sheet, configurations with both frozen and non-frozen fullerenes were investigated in the simulations in order to examine the experimental result of stable, sagged graphene sheets when the distance between C60s is about 4 nm and the height of the wrinkles in the sheet is about 0.8 nm. Below a distance of 4 nm between fullerenes, the graphene is predicted to become locally suspended and less strained. The simulations predict that this happens when the fullerenes can deform under the compressive action of the graphene sheet. If the fullerenes are kept frozen, spontaneous 'blanketing' of graphene is predicted only when the distance between neighbouring C60s is equal to or great than about 7 nm. These predictions agree with a mechanical model relating the rigidity of a graphene sheet to the energy of graphene-surface adhesion. This work further reveals the structure of intercalated molecules and the role of stability and sheet wrinkling on the preferred configuration of graphene. This study thus might assist in the development of two-dimensional confined nanoreactors for chemical reactions.

Involvement of repair genes in oral cancer: A systematic review.

Among the types of cancers that may occur in the oral cavity, squamous cell carcinomas (SCC) of the mouth have a higher incidence and are associated with increased rates of morbidity and mortality. Among steps from the beginning to the progression of the tumour, DNA Repair System is highlighted. The present study aims to conduct a systematic review of the literature on the expression of the repair genes hMSH2 and hMSH6 in patients with SCC in the mouth and oropharyngeal region. The search was performed in databases such as PubMed, Lilacs, and Scielo and included articles published in English from 1999 until 2015. The search in the above-mentioned databases initially yielded 15 scientific articles related to the proposed objective. After a detailed analysis of each of them, only 8 were included in the present review, precisely because they met the inclusion criteria determined in the method. All the reviewed works were unanimous in recognizing the veracity and complexity of the Genomic Repair System, also called Mismatch Repair System, confirming the participation of repair gene proteins (such as hMSH2 and hMSH6) in patients with oral cancer and even of lesions that are susceptible to malignization. SIGNIFICANCE OF THE STUDY: Worldwide, there are an estimated 300 thousand new cases of oral cancer per year. Studies have shown a greater risk in individuals who are smokers and alcohol consumers in developing mouth cancer. Many steps are observed from the beginning to the progression of the tumour, highlighted among them is the moment in which genetic, and epigenetic alterations will interfere in the functioning of the DNA Repair System. This work presents a survey of current knowledge about the involvement of repair genes, especially those of the MutSα system, in the development and progression of oral cancer.

Influence of vascularized lymph node transfer (VLNT) flap positioning on the response to breast cancer-related lymphedema treatment. / Influência do posicionamento do retalho linfonodal vascularizado na resposta ao tratamento cirúrgico do linfedema secundário ao câncer de mama.

OBJECTIVE: to evaluate the initial therapeutic experience of transplantation of vascularized lymph nodes in patients with lymphedema of the upper limbs secondary to the treatment of breast cancer, and to verify if the positioning of the transplant influences the surgical result. METHODS: we conducted a prospective, comparative test of two therapeutic modalities, with 24 patients with lymphedema of the upper limb after breast cancer treatment, classified as grades 2 and 3, according to the International Lymphedema Society. The two types of procedures performed were: 1) total breast reconstruction with - deep inferior epigastric perforator (DIEP) flap associated with lymph node flap, in patients with no previous breast reconstruction or loss of previous reconstruction (axillary positioning); 2) isolated inguinal lymph node flap performed in patients with completed breast reconstruction or without the desire to perform the breast reconstruction (wrist positioning). RESULTS: the reduction percentage of the affected limb volume was 20.1% (p=0.0370). The number of infectious episodes (cellulites) also decreased significantly, from 41% in the preoperative period to 12.5% in the postoperative one (p=0.004). There were no differences between the proximal and distal groups. CONCLUSION: the transplantation of lymph nodes positively affected the postoperative evolution of patients with lymphedema secondary to breast cancer. We observed no differences in relation to flap positioning.

OBJETIVO: analisar a experiência terapêutica inicial do transplante de linfonodos vascularizados em pacientes portadoras de linfedema de membros superiores secundário ao tratamento do câncer de mama e verificar se o posicionamento do transplante influencia o resultado cirúrgico. MÉTODOS: ensaio prospectivo, comparativo, de duas modalidades terapêuticas em 24 pacientes portadoras de linfedema de membro superior após tratamento de câncer mamário, classificados como graus 2 e 3, segundo a Sociedade Internacional de Linfedema. Os dois tipos de procedimentos realizados foram: 1) reconstrução total da mama com retalho de perfurante da artéria epigástrica inferior (DIEP- deep inferior epigastric perforator flap) associado ao retalho linfonodal, em pacientes sem reconstrução mamária prévia ou com histórico de perda da reconstrução (posicionamento axilar); 2) retalho linfonodal inguinal isolado foi realizado em pacientes com reconstrução mamária finalizada ou sem o desejo de realizar a reconstrução da mama (posicionamento no punho). RESULTADOS: a porcentagem de redução do volume do membro afetado foi de 20,1% (p=0,0370). O número de episódios infecciosos (celulites) também sofreu redução significativa, de 41% no período pré-operatório para 12,5% no pós-operatório (p=0,004). Não foram observadas diferenças entre os grupos proximal e distal. CONCLUSÃO: o transplante de linfonodos afetou positivamente a evolução pós-operatória de pacientes portadoras de linfedema secundário ao câncer de mama. Não foram observadas diferenças em relação ao posicionamento do retalho.