Exfoliating B. mori silk into high aspect ratio nanofibrils facilitated by response surface methodology.

Silk fiber is formed by an assembly of fibrils. The fibrils can be isolated by a top-down mechanical process called microfibrillation and the fibrils are known as microfibrillated silk (MFS). The process involves chopping, milling, enzyme treatment and high-pressure homogenization. The milling is an important manufacturing step and to optimize the milling step, a response surface methodology was used in this work where the influence of fiber content in milled suspension, milling time and alkaline concentration were investigated. Output responses for the optimization were diameter distribution of fibrils, size and percentage of different diameter fractions, and the aspect ratio. The main and interaction effects of the milling parameters on these responses were statistically analysed. Milling time was the most significant factor for producing finer fibrils while the fiber content in milling had the maximum impact in reducing the number of large fibrils. Milling time had a positive correlation with the aspect ratio. The optimized milling resulted in MFS with an average diameter of 55.35 nm and 90% of MFS less than 100 nm based on high-magnification SEM image analysis. The aspect ratio of the MFS was 137. The MFS suspension was stable over the pH range 3-11.

Perfil clínico e epidemiológico dos pacientes em uso de terapia biológica em uma policlínica universitária do Rio de Janeiro: um estudo descritivo / Clinical and epidemiological profile of patients using biological therapy in a university polyclinic in Rio de Janeiro: a descriptive study / Perfil clínico y epidemiológico de los pacientes que utilizan terapia biológica en un policlínico universitário de Rio de Janeiro: un estudio descriptivo

OBJETIVO: descrever o perfil socioeconômico, demográfico e as condições clínicas dos pacientes em uso de terapia biológica em uma unidade de saúde de atenção secundária do município do Rio de Janeiro. MÉTODO: estudo descritivo, transversal com abordagem quantitativa. RESULTADOS: A maioria dos pacientes eram do sexo feminino, com idade ≥50 anos, pardos, casados ou convivendo com parceiro, sem filhos e com ensino médio completo. Declararam-se 28,75% inválidos e possuírem como principal fonte de renda, o beneficio de seguridade social a pensão do Instituto Nacional do Seguro Social com valor entre 1-2 salários mínimos e contribuírem permanentemente com a renda da família com a qual residem. Quanto às características clínicas, 54% relataram realizar acompanhamento no ambulatório de gastroenterologia, 55% fazerem uso de Infleximabe e estarem em tratamento a mais de 24 meses. CONCLUSÃO: A partir do conhecimento das características dessa clientela podemos proporcionar um apoio organizacional de prestação de cuidados que influenciará diretamente a qualidade e a satisfação dos pacientes e profissionais.

OBJECTIVE: to describe the socioeconomic, demographic and clinical conditions of patients on biological therapy in a secondary health care unit in the city of Rio de Janeiro. METHOD: a descriptive, cross-sectional study with a quantitative approach. RESULTS: Most patients were female, aged ≥50 years, brown-skinned, married or living with a partner, without children and having concluded high school. 28.75% were declared disabled and had as their main source of income the social security pension from the National Institute of Social Security, amounting between 1 and 2 minimum wages, all of them contributing permanently to the total income of the families they were living with. As for clinical characteristics, 54% reported being followed up at the gastroenterology clinic, 55% of them taking Infleximab and having been on treatment for more than 24 months. CONCLUSION: Based on the knowledge of the characteristics of this clientele, we can provide an organizational support to the provision of care that may have direct influence on the quality of life and well-being of patients and professionals.

OBJETIVO: describir el perfil socioeconómico, demográfico y las condiciones clínicas de los pacientes que utilizan terapia biológica en una unidad de salud de atención secundária en la municipalidad de Rio de Janeiro. MÉTODO: estudio descriptivo, transversal con abordage cuantitativo. RESULTADOS: La mayoría de los pacientes era del sexo femenino, con edad ≥50 AÑOS, morenos, casados o viviendo con pareja, sin hijos y con escuela secundaria completa. 28,75% declaran que son discapacitados y que su principal fuente de ingreso es la pensión que reciben del Instituto Nacional de Seguridad Social con valor entre 1 y 2 salarios mínimos, contribuyendo de manera permanente al ingreso de la família con la cual viven. En cuanto a las características clínicas, 54% reportaron usar Infleximabe y estar en tratamiento hace más de 24 meses. CONCLUSIÓN: A partir del conococimiento de las caracteristicas de esa clientela se puede aportar un apoyo organizativo a la prestación de cuidados, que impactará directamente la calidad de vida y la satisfacción de pacientes y profesionales.

Efficient Bayesian Function Optimization of Evolving Material Manufacturing Processes.

The scale-up of laboratory procedures to industrial production is the main challenge standing between ideation and the successful introduction of novel materials into commercial products. Retaining quality while ensuring high per-batch production yields is the main challenge. Batch processing and other dynamic strategies that preserve product quality can be applied, but they typically involve a variety of experimental parameters and functions that are difficult to optimize because of interdependencies that are often antagonistic. Adaptive Bayesian optimization is demonstrated here as a valuable support tool in increasing both the per-batch yield and quality of short polymer fibers, produced by wet spinning and shear dispersion methods. Through this approach, it is shown that short fiber dispersions with high yield and a specified, targeted fiber length distribution can be obtained with minimal cost of optimization, starting from sub-optimal processing conditions and minimal prior knowledge. The Bayesian function optimization demonstrated here for batch processing could be applied to other dynamic scale-up methods as well as to cases presenting higher dimensional challenges such as shape and structure optimization. This work shows the great potential of synergies between industrial processing, material engineering, and machine learning perspectives.

Coeficiente de difusión aparente en tejido encefálico: valores de normalidad en población colombiana clínicamente sana / Apparent diffusion coefficient in brain tissue: values of normality in clinically healthy colombian population

Resumen Introducción: Las secuencias de difusión en resonancia magnética, incluido el coeficiente de difusión aparente (ADC), representan una herramienta fundamental para el radiólogo en el diagnóstico clínico. Sin embargo, no existe estandarización para las medidas entre los límites normales o un rango de valores normales del ADC. Objetivo: Determinar valores normales del ADC en el tejido encefálico para la población clínica y radiológicamente sana. Métodos: Estudio de corte transversal sobre datos retrospectivos, se midieron valores del ADC para 21 regiones encefálicas (sustancia gris frontal, parietal y temporal, sustancia blanca frontal y parietal, núcleo caudado, putamen, tálamo, cápsula interna, hemisferios cerebelosos bilateralmente y puente del tallo cerebral) en 90 sujetos clínica y radiológicamente sanos, en dos clínicas privadas de Bogotá. Resultados: Valores normales del ADC, en población clínica y radiológicamente sana, en 21 territorios encefálicos, análisis comparativo de los resultados según el sexo y edad de los pacientes, y correlación entre las mediciones realizadas por dos investigadores. Conclusiones: Los hallazgos sirven como referencia para la población colombiana y latinoamericana normal, establecen un punto de comparación para la evaluación de patologías intracraneanas, y abre la posibilidad a desarrollar nuevos proyectos de investigación que busquen determinar valores de ADC en población enferma.

Abstract Introduction: The diffusion sequences in magnetic resonance, including the apparent diffusion coefficient (ADC), represent a fundamental tool for the radiologist in the clinical diagnosis. However, there is no standardization for measurements between normal limits or a range of normal ADC values. Objective: To determine normal ADC values ​​in the brain tissue for the clinical and radiologically healthy population. Methods: Cross-sectional study on retrospective data, ADC values ​​were measured for 21 encephalic regions (frontal gray, parietal and temporal substance, frontal and parietal white matter, caudate nucleus, putamen, thalamus, internal capsule, cerebellar hemispheres bilaterally and bridge of the brainstem) in 90 clinically and radiologically healthy subjects, in two private clinics in Bogotá. Results: Normal ADC values, in a clinical and radiologically healthy population, in 21 encephalic territories, comparative analysis of the results according to the sex and age of the patients, and correlation between the measurements made by two researchers. Conclusions: The findings serve as a reference for the Colombian and normal Latin American population, establish a point of comparison for the evaluation of intracranial pathologies, and open the possibility to develop new research projects that seek to determine ADC values ​​in sick population.

Optimizing a High-Entropy System: Software-Assisted Development of Highly Hydrophobic Surfaces using an Amphiphilic Polymer.

In materials science, the investigation of a large and complex experimental space is time-consuming and thus may induce bias to exclude potential solutions where little to no knowledge is available. This work presents the development of a highly hydrophobic material from an amphiphilic polymer through a novel, adaptive artificial intelligence approach. The hydrophobicity arises from the random packing of short polymer fibers into paper, a highly entropic, multistep process. Using Bayesian optimization, the algorithm is able to efficiently navigate the parameter space without bias, including areas which a human experimenter would not address. This resulted in additional knowledge gain, which can then be applied to the fabrication process, resulting in a highly hydrophobic material (static water contact angle 135°) from an amphiphilic polymer (contact angle of 90°) through a simple and scalable filtration-based method. This presents a potential pathway for surface modification using the short polymer fibers to create fluorine-free hydrophobic surfaces on a larger scale.

Crisis, austeridad e impactos para las enfermeras de Atención Primaria en España y Brasil / Crisis, austherity and impacts on Primary Care Nursing working in Spain and Brazil

Las crisis económico-políticas afectan sobremanera a los sistemas sanitarios, y amenazan los principios de universalidad de acceso y la integralidad del cuidado de salud. Situaciones de crisis económica y política fueron vividas en Europa en la última década y más recientemente en países latinoamericanos, con impactos severos en las condiciones de vida y salud de la población, y en los sistemas sanitarios. Se presentan los principales impactos sociales y de salud de la crisis en España y en Brasil, así como los elementos comunes y comparables de la práctica enfermera que actúan en Atención Primaria en ambos países. A partir de los elementos destacados, se puede concluir que las enfermeras de Atención Primaria son imprescindibles para el mantenimiento y ampliación de servicios y acciones derivados de los principios de equidad y de salud como derecho y, por lo tanto, deben organizarse para hacer frente a las situaciones de crisis actuales y futuras

Economic-political crises greatly affect health systems, and threaten the principles of universal access and the integrality of health care. Situations of economic and political crisis were experienced in Europe in the last decade and more recently in Latin American countries, with severe impacts on the living conditions and health of the population, and health systems. The main social and health impacts of the crisis in Spain and Brazil are presented, as well as the common and comparable elements of the nurse practice that act in Primary Care in both countries. Based on the highlighted elements, it can be concluded that primary care nurses are essential for the maintenance and expansion of services and actions derived from the principles of equity and health as a right and, therefore, must be organized to face the current and future crisis situations

Clinical and financial evaluation of carbetocin as postpartum haemorrhage prophylaxis at caesarean section: A retrospective cohort study.

BACKGROUND: The long-acting oxytocic agent; carbetocin, has been consistently shown to reduce the need for additional uterotonics at caesarean section, but not postpartum haemorrhage (PPH). While promising, current evidence is limited by heterogenicity in study design and findings. AIMS: To examine whether carbetocin confers clinical or economic benefit compared to oxytocin at caesarean section in an all-risk Australian population. MATERIALS AND METHODS: A retrospective cohort study was undertaken of all singleton caesarean sections at a public tertiary hospital from 2008 to 2010 (n = 2499). From 1 January 2008 to 24 March 2009 all women received prophylactic oxytocin 5-10 units slow push intravenously at delivery, after which all patients received 100 µg intravenous carbetocin. Outcomes were PPH (≥1000 mL) and the requirement of secondary uterotonics. A post hoc cost analysis was also performed. RESULTS: A total of 1467 and 1024 patients received carbetocin and oxytocin, respectively. Incidence of PPH ≥1000 mL was 7.8% for carbetocin compared to and 9.7% for oxytocin (odds ratio (OR) 0.79, 95% CI 0.59-1.05). Moderate blood loss >500 mL was significantly reduced with carbetocin; occurring in 27.3% versus 39.4% (OR 0.57, 95% CI 0.49-0.68). There was a 20.0% reduction in secondary uterotonic treatment with carbetocin (OR 0.42, 95% CI 0.35-0.49). Average drug costs were lower with oxytocin at $4.74 versus $36.42/patient. However, the 1.9% reduction in PPH with carbetocin resulted in a $63.46 reduction in cost per patient, with a cost-effectiveness ratio of $1667 to prevent one case of PPH ≥1000 mL. CONCLUSIONS: Carbetocin reduced moderate blood loss >500 mL, but not PPH ≥1000 mL. Carbetocin conferred a 20% reduction in secondary uterotonic treatment, as well as lowering direct medical costs.

Rapid Bayesian optimisation for synthesis of short polymer fiber materials.

The discovery of processes for the synthesis of new materials involves many decisions about process design, operation, and material properties. Experimentation is crucial but as complexity increases, exploration of variables can become impractical using traditional combinatorial approaches. We describe an iterative method which uses machine learning to optimise process development, incorporating multiple qualitative and quantitative objectives. We demonstrate the method with a novel fluid processing platform for synthesis of short polymer fibers, and show how the synthesis process can be efficiently directed to achieve material and process objectives.

Deporting social capital: Implications for immigrant communities in the United States.

The United States currently removes approximately 400,000 individual migrants each year, which represents close to an eightfold increase since the mid-1990s. While scholars have studied the consequences of such policies for children and families, this article posits broader effects on communities through the reduction of immigrant social and human capital. Using findings from three studies of immigrant communities and Salvadoran deportees, we show that current deportation practices remove individuals with a wide range of socio-economic resources and ties to local communities. When they are removed from economic, family, social, and civic networks, the individuals and communities left behind are impoverished in important ways. This is particularly consequential for low-resource immigrant communities, which under the best of circumstances encounter obstacles to economic advancement, social integration, and political engagement. In addition, we consider the potential harm to the institutions in which immigrants participate, such as businesses and churches, which has implications for the economy and society more generally.

Preparation and characterization of hydrogels based on homopolymeric fractions of sodium alginate and PNIPAAm.

Graft copolymers were prepared by formation of an amide bond between poly-α-L-guluronic acid (MW 24,000), isolated from sodium alginate and the free amino group of PNIPAAm-NH(2). SEM micrographs revealed the formation of a macroscopic network on the surface of the grafted hydrogels with a porosity diameter of 10-20 µm. Semi-IPN hydrogels were prepared using different proportions of sodium poly-ß-D-mannuronate (MW 21,000), isolated from sodium alginate and cross-linked PNIPAAm-NH(2) polymers. SEM micrographs showed porosities of minor size (∼5 µm). Though both types of hydrogels are good water containers, the water retention capacity of graft copolymers is more than 50% higher than that of semi-IPN hydrogels. Both hydrogel types showed significant changes in swelling ratios between 20 and 45 °C: the swelling ratio decreases near the LCST of PNIPAAm. The water absorption and retention capacity of graft hydrogels increases with pH, reaching a maximum value at pH 7.0.

Nursing in Brazil a critical-holistic perspective

Global and local insecurities influence the Brazilian health care system and the complexities of the healthcare workforce. Nursing in Brazil is shaped by socio-political and historical factors. This paper conceptualizes nursing as a social practice and uses Wright's (2000) “Critical-Holistic Paradigm for an Interdependent World” as a guide framework to analyze how nursing education and professional practice exist within the country's socio-economic and political reality while being constructed within the domains of science and technology (AU)

Los problemas globales y locales de seguridad, influyen sobre el sistema brasileño de asistencia sanitaria y las complejidades del personal de asistencia sanitaria de este país. La práctica de la Enfermería en Brasil está modelada por factores históricos y sociopolíticos. Este modelo concibe el ejercicio de la Enfermería como una práctica social y utiliza el trabajo de Wright (2000) «Critical-Holistic Paradigm for an Independent World» (Paradigma crítico y holístico para un mundo independiente) como marco para analizar la formación y la práctica profesional de la Enfermería en la realidad socioeconómica y política del país, a la par que basadas en los fundamentos de la ciencia y la tecnología (AU)

FT-IR spectra of alginic acid block fractions in three species of brown seaweeds.

Sodium alginates obtained by alkaline extraction of Lessonia flavicans, Desmarestia ligulata and Desmarestia distans (Phaeophyta) from southern Chile were partially hydrolyzed with HCl. Each alginate gave three fractions that were characterized using FT-IR spectroscopy. The fractions soluble in 0.3M HCl presented in the fingerprint region four vibrations at around 960, 911, 890 and 815 cm(-1) that were assigned to heteropolymeric blocks. The fractions soluble at pH 2.85 showed bands at around 948, 888 and 820 cm(-1) attributed to homopolymannuronic acid blocks, the first band is resolved in the second-derivative spectra into two bands at 951 and 936 cm(-1). The fractions insoluble at pH 2.85 presented four bands at around 947, 903, 812 and 781 cm(-1), which were assigned to homopolyguluronic acid blocks. For some samples, the second derivative FT-IR spectra showed new bands indicating the presence of other structures, in low proportions. Structures deduced by FT-IR spectroscopy were corroborated by solution (1)H and (13)C NMR spectroscopy. Two-dimensional spectra were collected to confirm the fine structure of the hetero- and homopolymeric fractions. A geometrically optimized model for the disaccharide alpha-l-gulopyranuronosyl-(1-->4)-alpha-l-gulopyranuronic acid was calculated using density functional theory; good agreement was obtained between its corresponding calculated vibrations and the experimental bands assigned to homopolyguluronic acid blocks.