The professional perception of the International Caries Classification and Management System (ICCMS): a pragmatic randomised clinical trial.

Introduction The International Caries Classification and Management System (ICCMS) was developed to standardise caries diagnosis, risk assessment and treatment decisions based on overall evidence. To evaluate its criteria in practice, a clinical trial assessed professionals' perceptions of two caries management systems.Methods A perception questionnaire was administered to two groups: one using ICCMS criteria and the other based on professional experience criteria (non-ICCMS group). The online questionnaire included quantitative scale questions to measure effort and satisfaction and two open-ended questions to collect the positive and negative perceptions of dentists by using either criteria system. The questionnaires were administered six months after the study's implementation.Results Both groups showed high levels of effort and satisfaction. Professionals using ICCMS reported more positive perceptions by citing improved diagnosis (71.4%) and standardised patient care (43%). However, they also noted negative aspects, such as increased number of questionnaires and records (58%), longer clinical sessions (43%) and higher rates of patient absenteeism (29%).Conclusion Professionals who used the ICCMS had a positive outlook on the system, with benefits seen in diagnosis and patient monitoring. However, there is room for improvement in terms of automation and simplification to enhance the professional use of the system in the clinical setting.

One Health approach for Brucella canis: Serological and molecular detection in animal-hoarding individuals and their dogs.

Animal hoarding disorder (AHD) is classified as a psychiatric obsessive-compulsive condition characterized by animal accumulation and often accompanied by unsanitary conditions and animal cruelty. Although AHD may increase pathogen transmission and spread, particularly for zoonotic diseases, human and dog exposure in such cases has yet to be fully established. Accordingly, this study aimed to assess Brucella canis in 19 individuals with AHD (11 households) and their 264 dogs (21 households) in Curitiba, the eighth largest city in Brazil, with approximately 1.8 million habitants. Anti-B. canis antibodies were detected by the 2-mercaptoethanol microplate agglutination test (2ME-MAT) and by a commercial lateral flow immunoassay (LFIA), while molecular detection of previously positive seropositive samples was performed by conventional PCR. Although all the human samples were 2ME-MAT negative, 12/264 (4.5%, 95% Confidence Interval: 2.0-7.0%) dog samples were 2ME-MAT and LFIA positive, with 2ME-MAT titers ranging from 20 to 640. At least one dog in 4/21 (19.0%, 95% CI: 2.0-46.0%) households was seropositive. Despite the absence of seropositivity in individuals with AHD and the comparatively low seroprevalence in dogs, B. canis circulation and outbreaks should be considered in such human populations due to the high burden and recurrent character of B. canis exposure in high-density dog populations and the constant introduction of susceptible animals.

Serological and Molecular Survey of Brucella Species in Owners and Their Dogs Living on Island and Mainland Seashore Areas of Brazil.

Background: Although Brucella abortus, Brucella suis, and Brucella canis may infect humans and dogs worldwide, no study to date has assessed and compared owners and their dogs between island and mainland seashore areas. Materials and Methods: Accordingly, the study herein has applied serological tests, including Microplate Agglutination Test with 2-Mercaptoethanol, immunochromatographic assay, and Rose Bengal Test, and a Brucella genus-specific PCR assay to 195 owners and their 148 dogs living on 1 mainland seashore area and three nearby oceanic islands of southern Brazil. Results: No seropositivity to B. abortus and B. suis was detected in owner or dog sera. Anti-B. canis seropositivity was observed in 3/148 (2.0%) dogs, but no owner sample was seropositive to B. canis. In addition, all blood samples from both owners and dogs were negative on Brucella genus-specific PCR assay. Conclusions: The seropositive dogs were not related and lived on the seashore mainland area of Guaraqueçaba city. The absence of seropositivity on the islands and the low seropositivity on the seashore mainland could be attributed to geographic isolation, and suggest the low impact of the disease in the region. Despite being a zoonotic disease, brucellosis by B. canis is not included in the National Program for Control and Eradication of Brucellosis, and its diagnosis and notification are not mandatory. The presence of seropositive dogs highlights the risk to human health and the importance of epidemiological surveillance actions in the region, as well as the need for the implantation of preventive measures to avoid the transmission of the pathogen.

Climate change and carnivores: shifts in the distribution and effectiveness of protected areas in the Amazon.

Background: Carnivore mammals are animals vulnerable to human interference, such as climate change and deforestation. Their distribution and persistence are affected by such impacts, mainly in tropical regions such as the Amazon. Due to the importance of carnivores in the maintenance and functioning of the ecosystem, they are extremely important animals for conservation. We evaluated the impact of climate change on the geographic distribution of carnivores in the Amazon using Species Distribution Models (SDMs). Do we seek to answer the following questions: (1) What is the effect of climate change on the distribution of carnivores in the Amazon? (2) Will carnivore species lose or gain representation within the Protected Areas (PAs) of the Amazon in the future? Methods: We evaluated the distribution area of 16 species of carnivores mammals in the Amazon, based on two future climate scenarios (RCP 4.5 and RCP 8.5) for the year 2070. For the construction of the SDMs we used bioclimatic and vegetation cover variables (land type). Based on these models, we calculated the area loss and climate suitability of the species, as well as the effectiveness of the protected areas inserted in the Amazon. We estimated the effectiveness of PAs on the individual persistence of carnivores in the future, for this, we used the SDMs to perform the gap analysis. Finally, we analyze the effectiveness of PAs in protecting taxonomic richness in future scenarios. Results: The SDMs showed satisfactory predictive performance, with Jaccard values above 0.85 and AUC above 0.91 for all species. In the present and for the future climate scenarios, we observe a reduction of potencial distribution in both future scenarios (RCP4.5 and RCP8.5), where five species will be negatively affected by climate change in the RCP 4.5 future scenario and eight in the RCP 8.5 scenario. The remaining species stay stable in terms of total area. All species in the study showed a loss of climatic suitability. Some species lost almost all climatic suitability in the RCP 8.5 scenario. According to the GAP analysis, all species are protected within the PAs both in the current scenario and in both future climate scenarios. From the null models, we found that in all climate scenarios, the PAs are not efficient in protecting species richness.

Decoding Electroencephalography Signal Response by Stacking Ensemble Learning and Adaptive Differential Evolution.

Electroencephalography (EEG) is an exam widely adopted to monitor cerebral activities regarding external stimuli, and its signals compose a nonlinear dynamical system. There are many difficulties associated with EEG analysis. For example, noise can originate from different disorders, such as muscle or physiological activity. There are also artifacts that are related to undesirable signals during EEG recordings, and finally, nonlinearities can occur due to brain activity and its relationship with different brain regions. All these characteristics make data modeling a difficult task. Therefore, using a combined approach can be the best solution to obtain an efficient model for identifying neural data and developing reliable predictions. This paper proposes a new hybrid framework combining stacked generalization (STACK) ensemble learning and a differential-evolution-based algorithm called Adaptive Differential Evolution with an Optional External Archive (JADE) to perform nonlinear system identification. In the proposed framework, five base learners, namely, eXtreme Gradient Boosting, a Gaussian Process, Least Absolute Shrinkage and Selection Operator, a Multilayer Perceptron Neural Network, and Support Vector Regression with a radial basis function kernel, are trained. The predictions from all these base learners compose STACK's layer-0 and are adopted as inputs of the Cubist model, whose hyperparameters were obtained by JADE. The model was evaluated for decoding the electroencephalography signal response to wrist joint perturbations. The variance accounted for (VAF), root-mean-squared error (RMSE), and Friedman statistical test were used to validate the performance of the proposed model and compare its results with other methods in the literature, including the base learners. The JADE-STACK model outperforms the other models in terms of accuracy, being able to explain around, as an average of all participants, 94.50% and 67.50% (standard deviations of 1.53 and 7.44, respectively) of the data variability for one step ahead and three steps ahead, which makes it a suitable approach to dealing with nonlinear system identification. Also, the improvement over state-of-the-art methods ranges from 0.6% to 161% and 43.34% for one step ahead and three steps ahead, respectively. Therefore, the developed model can be viewed as an alternative and additional approach to well-established techniques for nonlinear system identification once it can achieve satisfactory results regarding the data variability explanation.

Characterization of Thermo-Mechanical and Chemical Properties of Polypropylene/Hemp Fiber Biocomposites: Impact of Maleic Anhydride Compatibilizer and Fiber Content.

This article presents a comprehensive study on the physical, mechanical, thermal, and chemical properties of polypropylene (PP) composites reinforced with hemp fibers (HF) and compatibilized with maleic anhydride (MAPP). The composites were processed using a twin-screw extruder, followed by hot compression at 190 °C. Subsequently, the composites were analyzed using Izod impact and Shore D hardness tests to evaluate their mechanical properties. Thermal properties were investigated through differential scanning calorimetry (DSC) and thermogravimetric analysis (TGA), while X-ray diffraction (XRD) and Fourier-transform infrared spectroscopy (FTIR) were employed to study their chemical properties. Additionally, a statistical analysis was conducted to compare the average results of the impact and hardness tests. XRD analysis revealed that the addition of HF and MAPP led to the disappearance of peaks corresponding to the beta phase in pure PP. Hemp fibers exhibited an impressive crystallinity of 82.10%, surpassing other natural fibers, and had a significant molecular orientation angle (MFA) of 6.06°, making them highly desirable for engineering applications. The crystallite size was observed to be relatively large, at 32.49 nm. FTIR analysis demonstrated strong interactions between the fiber, compatibilizing agent, and polymer matrix. TGA tests showed that the addition of 5 and 10 wt.% MAPP resulted in complete degradation of the composites, similar to pure PP. DSC analyses indicated a reduction in crystallinity (Xc) due to the incorporation of HF and MAPP. Shore D hardness tests revealed an increase in hardness with the addition of 5 wt.% MAPP, while a steep decline in this property was observed with 10 wt.% MAPP. In terms of impact resistance, fractions of 3 and 5 wt.% MAPP in the composites exhibited improved performance compared to the pure polymer. Analysis of variance (ANOVA) was employed to ensure the statistical reliability of the mechanical test results. This comprehensive study sheds light on the diverse properties of PP composites reinforced with hemp fibers and compatibilized with MAPP, emphasizing their potential as sustainable materials for engineering applications. The results contribute to the understanding of the structural and functional aspects of these composites, guiding future research and developments in the field.

Myocardial microstructure assessed by T1 mapping after on-pump and off-pump coronary artery bypass grafting.

Background: The correlation between the release of cardiac biomarkers after revascularization, in the absence of late gadolinium enhancement (LGE) or myocardial edema, and the development of myocardial tissue damage remains unclear. This study sought to identify whether the release of biomarkers is associated with cardiac damage by assessing myocardial microstructure on T1 mapping after on-pump (ONCAB) and off-pump coronary artery bypass grafting (OPCAB). Methods: Seventy-six patients with stable multivessel coronary artery disease (CAD) and preserved systolic ventricular function were included. T1 mapping, high-sensitive cardiac troponin I (cTnI), creatine kinase myocardial band (CK-MB) mass, and ventricular dimensions and function were measured before and after procedures. Results: Of the 76 patients, 44 underwent OPCAB, and 32 ONCAB; 52 were men (68.4%), and the mean age was 63±8.5 years. In both OPCAB and ONCAB the native T1 values were similar before and after surgeries. An increase in extracellular volume (ECV) values after the procedures was observed, due to the decrease in hematocrit levels during the second cardiac resonance. However, the lambda partition coefficient showed no significant difference after the surgeries. The median peak release of cTnI and CK-MB were higher after ONCAB than after OPCAB [3.55 (2.12-4.9) vs. 2.19 (0.69-3.4) ng/mL, P=0.009 and 28.7 (18.2-55.4) vs. 14.3 (9.3-29.2) ng/mL, P=0.009, respectively]. Left ventricular ejection fraction (LVEF) was similar in both groups before and after surgery. Conclusions: In the absence of documented myocardial infarction, T1 mapping did not identify structural tissue damage after surgical revascularization with or without cardiopulmonary bypass (CPB), despite the excessive release of cardiac biomarkers.

Abnormal release of cardiac biomarkers in the presence of myocardial oedema evaluated by cardiac magnetic resonance after uncomplicated revascularization procedures.

AIMS: To analyse the association of myocardial oedema (ME), observed as high T2 signal intensity (HT2) in cardiac magnetic resonance imaging, with the release of cardiac biomarkers, ventricular ejection, and clinical outcomes after revascularization. METHODS AND RESULTS: Patients with stable coronary artery disease with the indication for revascularization were included. Biomarker levels [troponin I (cTnI) and creatine kinase MB (CK-MB)] and T2-weighted and late gadolinium enhancement (LGE) images were obtained before and after the percutaneous or surgical revascularization procedures. The association of HT2 with the levels of biomarkers, with and without LGE, evolution of left ventricular ejection fraction (LVEF), and 5-year clinical outcomes were assessed. A total of 196 patients were divided into 2 groups: Group 1 (HT2, 40) and Group 2 (no HT2, 156). Both peak cTnI (8.9 and 1.6 ng/mL) and peak CK-MB values (44.7 and 12.1 ng/mL) were significantly higher in Group 1. Based on the presence of new LGE, patients were stratified into Groups A (no HT2/LGE, 149), B (HT2, 9), C (LGE, 7), and D (both HT2/LGE, 31). The peak cTnI and CK-MB values were 1.5 and 12.0, 5.4 and 44.7, 5.0 and 18.3, and 9.8 and 42.8 ng/mL in Groups A, B, C, and D, respectively, and were significantly different. The average LVEF decreased by 4.4% in Group 1 and increased by 2.2% in Group 2 (P = 0.057). CONCLUSION: ME after revascularization procedures was associated with increased release of cardiac necrosis biomarkers, and a trend towards a difference in LVEF, indicating a role of ME in cardiac injury after interventions.

Myocardial tissue microstructure with and without stress-induced ischemia assessed by T1 mapping in patients with stable coronary artery disease.

BACKGROUND: Stress-induced myocardial ischemia seems not to be associated with cardiovascular events. However, its effects on myocardial tissue characteristics remain under debate. Thus, we sought to assess whether documented stress-induced ischemia is associated with changes in myocardial microstructure evaluated by magnetic resonance native T1 map and extracellular volume fraction (ECV). METHODS: This is a single-center, analysis of the previously published MASS V Trial. Multivessel patients with a formal indication for myocardial revascularization and with documented stress-induced ischemia were included in this study. Native T1 and ECV values evaluated by cardiac magnetic resonance imaging of ischemic and nonischemic myocardial segments at rest and after stress were compared. Myocardial ischemia was detected by either nuclear scintigraphy or stress magnetic cardiac resonance protocol. RESULTS: Between May 2012 and March 2014, 326 prospective patients were eligible for isolated CABG or PCI and 219 were included in the MASS V trial. All patients underwent resting cardiac magnetic resonance imaging. Of a total of 840 myocardial segments, 654 were nonischemic segments and 186 were ischemic segments. Native T1 and ECV values of ischemic segments were not significantly different from nonischemic segments, both at rest and after stress induction. In addition, native T1 and ECV values of myocardial segments supplied by vessels with obstructive lesions were similar to those supplied by nonobstructive ones. CONCLUSION AND RELEVANCE: In this study, cardiac magnetic resonance identified similar T1 mapping values between ischemic and nonischemic myocardial segments. This finding suggests integrity and stability of myocardial tissue in the presence of stress-induced ischemia.

Evolving Diagnostic and Management Advances in Coronary Heart Disease.

Despite considerable improvement in diagnostic modalities and therapeutic options over the last few decades, the global burden of ischemic heart disease is steadily rising, remaining a major cause of death worldwide. Thus, new strategies are needed to lessen cardiovascular events. Researchers in different areas such as biotechnology and tissue engineering have developed novel therapeutic strategies such as stem cells, nanotechnology, and robotic surgery, among others (3D printing and drugs). In addition, advances in bioengineering have led to the emergence of new diagnostic and prognostic techniques, such as quantitative flow ratio (QFR), and biomarkers for atherosclerosis. In this review, we explore novel diagnostic invasive and noninvasive modalities that allow a more detailed characterization of coronary disease. We delve into new technological revascularization procedures and pharmacological agents that target several residual cardiovascular risks, including inflammatory, thrombotic, and metabolic pathways.

Left ventricle segmentation combining deep learning and deformable models with anatomical constraints.

Segmentation of the left ventricle is a key approach in Cardiac Magnetic Resonance Imaging for calculating biomarkers in diagnosis. Since there is substantial effort required from the expert, many automatic segmentation methods have been proposed, in which deep learning networks have obtained remarkable performance. However, one of the main limitations of these approaches is the production of segmentations that contain anatomical errors. To avoid this limitation, we propose a new fully-automatic left ventricle segmentation method combining deep learning and deformable models. We propose a new level set energy formulation that includes exam-specific information estimated from the deep learning segmentation and shape constraints. The method is part of a pipeline containing pre-processing steps and a failure correction post-processing step. Experiments were conducted with the Sunnybrook and ACDC public datasets, and a private dataset. Results suggest that the method is competitive, that it can produce anatomically consistent segmentations, has good generalization ability, and is often able to estimate biomarkers close to the expert.

Bromelain does not provide significant analgesic and anti-inflammatory benefits over placebo in cats undergoing ovariohysterectomy.

OBJECTIVE: To evaluate the efficacy and safety of bromelain to control pain and inflammation in cats undergoing ovariohysterectomy. ANIMALS: 30 client-owned cats undergoing ovariohysterectomy. PROCEDURES: In a randomized, blinded clinical study, cats were assigned to receive either oral bromelain suspension (40 mg/kg [18 mg/lb]; BG, n = 15) or placebo solution (0.1 mL/kg [0.045 mL/lb]; PG, 15), which were administered 90 minutes before and 12 hours after surgery. The anesthetic protocol included acepromazine, meperidine, propofol, and isoflurane. Pain and sedation were assessed at various time points up to 24 hours post-extubation using the UNESP-Botucatu multidimensional composite pain scale, the Glasgow feline composite measure pain scale, and a descriptive numerical scale. Surgical wound inflammation was measured at the same time points, using a numeric rating scale. Morphine was administered as rescue analgesia. Laboratory data (urea, creatinine, gamma-glutamyl transferase, alkaline phosphatase, the prothrombin time, and the fecal occult blood) were analyzed preoperatively and 24 hours after surgery. RESULTS: Pain/inflammation scores, and analgesic requirements did not differ between groups. Shorter recovery time and lower sedation scores were recorded during the first hour post-extubation in the BG than the PG. Postoperatively, serum creatinine and gamma-glutamyl transferase were lower in the BG compared to PG. Compared to baseline values, all biochemistry variables decreased at 24 hours in the BG. The prothrombin time and fecal occult blood did not differ between groups or over time. CLINICAL RELEVANCE: Bromelain did not provide significant analgesic and anti-inflammatory benefits over placebo in cats undergoing ovariohysterectomy.

Kill site database: A unified dataset on human-megafauna interactions across time and space.

The database presented in this data article is related to the paper "Megafauna kill sites in South America: a critical review" [1]. It includes a list of 134 publications on human-megafauna interaction, with 69 archaeological sites showing human-megafauna interaction. From these sites, 44 present a minimum human-megafauna association, from which up to 17 megafauna kill sites were classified, with up to 15 exploited extinct megafauna taxa. It also provides a list of current taxonomic classifications of extinct megafauna that humans have exploited according to empirical evidence presented in the related paper. The megafauna kill sites were classified based on five restrictive criteria according to Grayson and Meltzer's (2015, 2002), Borrero's (2009) and Mothé et al.'s (2020) protocol. The kill sites database reflects the empirical evidence on megafauna exploitation by humans available in scientific literature and is useful to understand the human-megafauna interactions in the late Quaternary. Finally, we also provide our online repository (www.killsitedatabase.com), an initiative to unify the evidence on megafauna kill sites (and their related data) worldwide, starting in South America.

4-Nerolidylcatechol (4-NC) and Docetaxel Synergize in Controlling Androgen- independent Prostate Cancer Cells.

BACKGROUND: Effective cancer treatment still challenges medicine since the strategies employed so far are not sufficiently safe and capable of specifically eliminating tumor cells. Prostate cancer (PCa) is a highly incident malignant neoplasm, and the outcome of patients, especially those with advanced castration-resistant PCa (CRPC), depends directly on the efficacy of the therapeutic agents, such as docetaxel (DOC). OBJECTIVES: This study investigated the synergistic potentiation of 4-nerolidylcatechol (4-NC) with DOC in inhibiting androgen-independent PCa cells. METHODS: The cytotoxic effect of 4-NC was evaluated against non-tumorigenic (RWPE-01) and PCa cell lines (LNCaP and PC-3), and the antiproliferative potential of 4-NC was assessed by flow cytometry and colony formation. The Chou-Talalay method was applied to detect the synergistic effect of 4-NC and DOC, and the mechanism of anticancer activities of this combination was investigated by analyzing players in epithelial-mesenchymal transition (EMT). RESULTS: 4-NC significantly reduced the viability of PC-3 cells in a dose-dependent manner, decreasing colony formation and proliferation. The combination of 4-NC and DOC was synergistic in the androgen-independent cells and allowed the reduction of DOC concentration, with increased cytotoxicity and induction of apoptosis when compared to compounds alone. Furthermore, when 4- NC was co-administered with DOC, higher expression levels of proteins associated with the epithelial phenotype were observed, controlling EMT in PC-3 cells. CONCLUSION: Collectively, these data demonstrated, for the first time, that the combination of 4-NC with reduced doses of DOC could be especially valuable in the suppression of oncogenic mechanisms of androgen-independent PCa cells.

The herpetofauna of priority highland areas for conservation of the Caatinga in the state of Rio Grande do Norte, northeastern Brazil / A herpetofauna de áreas serranas prioritárias para conservação da Caatinga no estado do Rio Grande do Norte, nordeste do Brasil

Abstract The Brazilian Caatinga has already lost extensive areas of original vegetation, thus it becomes imperative to perform fauna inventories within this region to fill geographical sampling gaps. Herein, we present a taxonomic list of the herpetofauna of a mountain chain located in the central zone of Rio Grande do Norte (RN) state whose region includes two priority areas for conservation of the Caatinga: "CA087 - Serra de Santana" in the west, and "CA078 - Nascente do Potengi" in the east. The sampling was carried out using methods of visual searching, pitfall traps with drift fences, specimens rescued during vegetation suppression activities in wind energy projects, occasional encounters, and third-party records. We recorded 19 amphibian species and 53 reptile species (23 lizards, 24 snakes, five amphisbaenians and one chelonian). About half of the recorded species have distributions entirely or mostly in the Caatinga. The mountain range sampled in this study harbors virtually all species found in nearby lowlands of the "sertaneja" depression of RN state, plus some relevant species with relictual distributions in the Caatinga, highlighting the importance of these highland areas for conservation of the Caatinga herpetofauna.

Resumo A Caatinga brasileira já perdeu extensas áreas de vegetação original, por isso torna-se importante realizar inventários de fauna nesta região para preencher lacunas geográficas de amostragem. Aqui, apresentamos uma lista taxonômica da herpetofauna de uma cadeia serrana localizada na zona central do estado do Rio Grande do Norte (RN) e cuja região inclui duas áreas prioritárias para conservação da Caatinga: "CA087 - Serra de Santana" a oeste, e "CA078 - Nascente do Potengi" a leste. A amostragem foi realizada por meio de métodos de busca visual, armadilhas de interceptação e queda, espécimes resgatados durante atividades de supressão vegetal em projetos de energia eólica, encontros ocasionais e registros de terceiros. Registramos 19 espécies de anfíbios e 53 espécies de répteis (23 lagartos, 24 serpentes, cinco anfisbênias e um quelônio). Cerca de metade das espécies registradas tem distribuição inteiramente ou predominantemente na Caatinga. A cadeia serrana amostrada neste estudo abriga praticamente todas as espécies encontradas nas planícies próximas da depressão sertaneja do RN, além de algumas espécies relevantes com distribuição relictual na Caatinga, destacando a importância dessas áreas de altitude para a conservação da herpetofauna da Caatinga.

O parto vaginal e o corpo feminino no puerpério: Contribuições para a enfermagem obstétrica / El parto vaginal y el cuerpo femenino en la puerperia: Aportes a la enfermería obstétrica / Vaginal birth and the female body in the puerperum: Contributions to obstetric nursing

Objetivo: descrever os significados e os sentimentos da mulher após o parto vaginal e identificar como a atuação da enfermagem obstétrica pode contribuir para melhores experiências no puerpério. Método: Pesquisa fenomenológica heideggeriana com 14 mulheres que passaram pelo parto vaginal. Realizada entrevista aberta audiogravada, para a constituição da Unidade de Significação e da compreensão vaga e mediana. Resultado: O vivido e os sentimentos da mulher após o parto vaginal significaram: ter medo de fazer sexo, sentir dor na relação sexual, achar que não ia voltar a ser normal, sentir o corpo diferente de antes, achar que a relação sexual mudou, perder o desejo sexual. Conclusão: A atuação da enfermagem obstétrica é necessária para melhores desfechos frente ao medo e à adaptação da puérpera ao retorno da atividade sexual, pontuando ações simples para a sexualidade da puérpera/casal, como: cuidados de higiene, uso de lubrificantes e estímulo à retomada da intimidade sexual.(AU)

Objective: to describe the meanings and feelings of women after vaginal delivery and to identify how the performance of obstetric nursing can contribute to better experiences in the puerperium. Method: Heideggerian phenomenological research with 14 women who underwent vaginal delivery. An open audio-recorded interview was carried out, for the constitution of the Meaning Unit and vague and median understanding. Result: The experience and feelings of the woman after vaginal delivery meant: being afraid of having sex, feeling pain in sexual intercourse, thinking that it would not go back to being normal, feeling the body different from before, thinking that the sexual relationship has changed, lose sexual desire. Conclusion: The performance of obstetric nursing is necessary for better outcomes in the face of fear and the adaptation of the puerperal woman to the return of sexual activity, punctuating simple actions for the sexuality of the puerperal woman/couple, such as: hygiene care, use of lubricants and encouragement to resume of sexual intimacy.(AU)

Objetivo: describir los significados y sentimientos de las mujeres después del parto vaginal e identificar cómo la actuación de la enfermería obstétrica puede contribuir para mejores experiencias en el puerperio. Método: Investigación fenomenológica heideggeriana con 14 mujeres que tuvieron parto vaginal. Se realizó una entrevista abierta grabada en audio, para la constitución de la Unidad de Significado y comprensión vaga y mediana. Resultado: La experiencia y sentimientos de la mujer después del parto vaginal significó: tener miedo de tener relaciones sexuales, sentir dolor en las relaciones sexuales, pensar que no volvería a ser normal, sentir el cuerpo diferente al anterior, pensar que la relación sexual ha cambia, pierde el deseo sexual. Conclusión: La actuación de enfermería obstétrica es necesaria para mejores resultados frente al miedo y la adaptación de la puérpera al retorno de la actividad sexual, puntuando acciones simples para la sexualidad de la puérpera/pareja, tales como: cuidado de la higiene, uso de lubricantes y estímulo a la reanudación de la intimidad sexual.(AU)

Superficial femoral vein transposition as a solution for hemodialysis vascular access.

The significant growth in the number of individuals dependent on hemodialysis for renal replacement therapy and unrestricted use of short and long-term catheters have challenged vascular surgeons in search of solutions for patients whose options for access via the upper limbs have been exhausted and for the increasing rates of central venous stenosis in these patients. When access via the upper limbs is impossible, exceptional techniques can be used and the lower limbs offer feasible alternative vascular access sites for hemodialysis. This article reports a case of superficial femoral vein transposition to make a loop arteriovenous fistula in a patient with no possibility of access via the upper limbs and presents a literature review on this technique that remains little used.

Fabric Impregnation with Shear Thickening Fluid for Ballistic Armor Polymer Composites: An Updated Overview.

As destructive power of firearms raises over the years, ballistic armors are in continuous need of enhancement. For soft armors, this improvement is invariably related to the increase of stacked layers of high-strength fiber fabrics, which potentially restrains wearer mobility. A different solution was created in the early 2000s, when a research work proposed a new treatment of the ballistic panels with non-Newtonian colloidal shear thickening fluid (STF), in view of weight decreasing with strength reinforcement and cost-effective production. Since then, databases reveal a surge in publications generally pointing to acceptable features under ballistic impact by exploring different conditions of the materials adopted. As a result, several works have not been covered in recent reviews for a wider discussion of their methodologies and results, which could be a barrier to a deeper understanding of the behavior of STF-impregnated fabrics. Therefore, the present work aims to overview the unexplored state-of-art on the effectiveness of STF addition to high-strength fabrics for ballistic applications to compile achievements regarding the ballistic strength of this novel material through different parameters. From the screened papers, SiO2, Polyethylene glycol (PEG) 200 and 400, and Aramid are extensively being incorporated into the STF/Fabric composites. Besides, parameters such as initial and residual velocity, energy absorbed, ballistic limit, and back face signature are common metrics for a comprehensive analysis of the ballistic performance of the material. The overview also points to a promising application of natural fiber fabrics and auxetic fabrics with STF fluids, as well as the demand for the adoption of new materials and more homogeneous ballistic test parameters. Finally, the work emphasizes that the ballistic application for STF-impregnated fabric based on NIJ standards is feasible for several conditions.

Aspergillus welwitschiae: A Potential amylases Producer.

Amylases, glycoside hydrolases widely used in several industrial processes, can be produced by many animals, plants, bacteria, and fungi. Fungal amylases from Aspergillus sp. hold remarkable importance in biotechnological applications for presenting a great catalysis efficiency in a wide range of pH and temperature. The production of amylases is mainly dependent on the genetic background of the species, i.e., Aspergillus strains, and abiotic factors. Among the major producers of amylases are the species of Aspergillus section Nigri, including Aspergillus welwitschiae. In this study, Aspergillus welwitschiae strains were evaluated for their ability to produce extracellular amylases. Among the 24 strains, wild Aspergillus welwitschiae UELAs 15.262 and mutant A. welwitschiae UELAs 15.262/35 strains showed greater potential for amylases production. The A. welwitschiae UELAs 15.262 produced more amylases (8645 U/mg) when compared to A. welwitschiae UELAs 15.262/35 (6666 U/mg). The amylases activity from partially purified crude enzymatic extract of A. welwitschiae UELAs 15.262 strain obtained at pH 5.5, 60 °C, resulted in 1.98-fold (3837 U/mg) increase in enzymatic activity. Likewise, the amylases activity from partially purified crude extract of A. welwitschiae UELAs 15.262/35 obtained at pH 5.0, 60 °C resulted in 2.2-fold (9077 U/mg) increase in amylases activity. The presence of metallic ions (Cu2+ and Fe3+) also provided an increase of amylases activity for both strains. To our knowledge, this is the first study reporting the ability of Aspergillus welwitschiae strains in order to produce amylases.

Dynamic Mechanical Analysis and Ballistic Performance of Kenaf Fiber-Reinforced Epoxy Composites.

Several industry sectors have sought to develop materials that combine lightness, strength and cost-effectiveness. Natural lignocellulosic natural fibers have demonstrated to be efficient in replacing synthetic fibers, owing to several advantages such as costs 50% lower than that of synthetic fibers and promising mechanical specific properties. Polymeric matrix composites that use kenaf fibers as reinforcement have shown strength increases of over 600%. This work aims to evaluate the performance of epoxy matrix composites reinforced with kenaf fibers, by means of dynamic-mechanical analysis (DMA) and ballistic test. Through DMA, it was possible to obtain the curves of storage modulus (E'), loss modulus (E″) and damping factor, Tan δ, of the composites. The variation of E' displayed an increase from 1540 MPa for the plain epoxy to 6550 MPa for the 30 vol.% kenaf fiber composites, which evidences the increase in viscoelastic stiffness of the composite. The increase in kenaf fiber content induced greater internal friction, resulting in superior E″. The Tan δ was considerably reduced with increasing reinforcement fraction, indicating better interfacial adhesion between the fiber and the matrix. Ballistic tests against 0.22 caliber ammunition revealed similar performance in terms of both residual and limit velocities for plain epoxy and 30 vol.% kenaf fiber composites. These results confirm the use of kenaf fiber as a promising reinforcement of polymer composites for automotive parts and encourage its possible application as a ballistic armor component.