Instrumentos de avaliação multidimensional de fragilidade para uso no cuidado de idosos com doença cardiovascular / Multidimensional frailty assessment tools for use in the care of older adults with cardiovascular disease / Instrumentos de evaluación multidimensional de la fragilidad en la atención de adultos mayores con enfermedad cardiovascular

Objetivo: identificar quais os instrumentos disponíveis para avaliação multidimensional da fragilidade em idosos com doença cardiovascular, potencialmente aplicáveis durante a realização do Processo de Enfermagem. Método: revisão sistemática conduzida em oito bases de dados/portais, para identificação de estudos que apresentassem instrumentos multidimensionais de avaliação de fragilidade em idosos com doença cardiovascular e que fossem aplicáveis ao processo de enfermagem. Resultados: foram incluídos 19 instrumentos multidimensionais. O Brief Frailty Index for Coronary Artery Disease foi desenvolvido para uso no cuidado cardiovascular de idosos. O Frailty Index for Adults e o Maastricht Frailty Screening Tool for Hospitalized Patients foram desenvolvidos para uso no Processo de Enfermagem. Conclusão: apesar de apenas um instrumento ter sido desenvolvido para o idosos com doença cardiovascular e apenas dois serem aplicáveis ao processo de enfermagem, a maioria deles tem potencial de adaptação e validação para uso nesta população durante a avaliação de enfermagem.

Objective: to identify which tools are available for multidimensional frailty assessment of older adult with cardiovascular disease and which are potentially applicable during the Nursing Process. Method: a systematic review conducted in eight databases/portals to identify studies that presented multidimensional frailty assessment tools for older adult with cardiovascular disease and that were applicable to the nursing process. Results: a total of 19 multidimensional tools were included. The Brief Frailty Index for Coronary Artery Disease was developed for use in the cardiovascular care of older adult. The Frailty Index for Adults and the Maastricht Frailty Screening Tool for Hospitalized Patients were developed for use in the Nursing Process. Conclusion: although only one tool was developed for older adults with cardiovascular disease and only two are applicable to the nursing process, most of them have the potential to be adapted and validated for use in this population during nursing assessment.

Objetivo: identificar qué instrumentos están disponibles para la evaluación multidimensional de la fragilidad en personas mayores con enfermedad cardiovascular, que se puedan aplicar en el Proceso de Enfermería. Método: revisión sistemática realizada en ocho bases de datos/portales, para identificar estudios que presentaran instrumentos multidimensionales para la evaluación de la fragilidad en adultos mayores con enfermedad cardiovascular y que fueran aplicables al proceso de enfermería. Resultados: se incluyeron 19 instrumentos multidimensionales. El Brief Frailty Index for Coronary Artery Disease se desarrolló para usarlo en el cuidado cardiovascular de las personas mayores. El Frailty Index for Adults y la Maastricht Frailty Screening Tool for Hospitalized Patients se elaboraron para ser usados en el Proceso de Enfermería. Conclusión: aunque sólo se elaboró un instrumento para adultos mayores con enfermedad cardiovascular y sólo dos son aplicables al proceso de enfermería, la mayoría de ellos tienen el potencial para ser adaptados y validados para ser usados en esa población en la evaluación de enfermería.

Estudio sobre la calidad del proceso de formación del futuro profesional en la Universidad de Ciencias Médicas de Camagüey

Introducción: Una educación de calidad para los estudiantes universitarios de las ciencias médicas es parte de la política establecida por el Estado cubano para el nivel superior. En correspondencia se desarrolla un proyecto de investigación dirigido a la elevación de la calidad en el proceso formativo de los estudiantes de la Universidad de Ciencias Médicas de Camagüey; por ello el presente texto tiene como objetivo exponer los resultados del proceso de caracterización de la situación problémica asumida, atendiendo a las dimensiones lingüística y tecnológica, a partir de la aplicación de los instrumentos de investigación durante la etapa del diagnóstico inicial a profesionales y estudiantes que conforman la muestra. Método: La investigación clasifica como I+D, de carácter observacional explicativo causal, que produce sistemas de acciones para elevar la calidad de la formación del futuro profesional de la Universidad de Ciencias Médicas de Camagüey y se desarrolla entre enero de 2023 y diciembre de 2024. El muestreo no probabilístico por cuota está constituido por estudiantes de las diferentes facultades, docentes, profesionales y trabajadores no docentes. Resultados: Se constataron insuficiencias en el desarrollo de las habilidades informáticas para complementar sus estudios mediante la búsqueda de información en los entornos virtuales de aprendizaje, a lo que se suman las dificultades que presentan los alumnos dela muestra para expresarse y comprender textos, valiéndose del empleo del inglés con fines profesionales. Discusión: Se confrontaron los resultados con los de otros estudiosos que, a nivel nacional y mundial, han investigado sobre la temática acerca del logro de la calidad en los procesos de formación en la universidad y con ello se corroboró la utilidad del estudio.

Introduction: A quality education for university students of medical sciences is part of the policy established by the Cuban State for Higher Education. Correspondingly, a research project is being developed aimed at raising the quality in the training process of the students of the University of Medical Sciences of Camagüey; For this reason, the objective of this text is to present the results of the process of characterization of the assumed problematic situation, taking into account the linguistic and technological dimensions, based on the application of research instruments during the initial diagnosis stage to professionals and students who make up the sample. Method: The research is classified as R&D, of a causal explanatory observational nature, which produces systems of actions to raise the quality of the training of future professionals at the University of Medical Sciences of Camagüey and is developed between January 2023 and December 2024. The non-probabilistic sampling by quota is made up of students from different faculties, teachers, professionals and non-teaching workers. Results: Insufficiencies were found in the development of computer skills to complement their studies through the search for information in virtual learning environments, to which are added the difficulties that the students in the sample present in expressing themselves and understanding texts, using the use of English for professional purposes. Discussion: The results were compared with those of con scholars who, at a national and global level, have investigated the topic of achieving quality in training processes at the university, and with this the usefulness of the study was corroborated.

Sistema de acciones para perfeccionar la escala valorativa de la evaluación, en la Educación Física inclusiva

Los procesos formativos, complejos por su propia naturaleza social, parten de los contextos en que se desarrollan y de las características psicopedagógicas, sociológicas, culturales y fisiológicas de los que intervienen como componentes personales. El ámbito educativo ecuatoriano, consciente de lo anterior, evidenció en los últimos años el desarrollo de estrategias encaminadas a cumplir estándares básicos de inclusión, reconocidos por organismos internacionales y materializados en acciones pedagógicas y curriculares en todos los niveles formativos. La investigación propuesta estuvo dirigida a perfeccionar la escala evaluativa para la inclusión, en la asignatura Educación física, de los estudiantes con necesidades educativas especiales asociados a una discapacidad, en Ecuador. Se utilizaron los métodos de análisis-síntesis y modelación; además, el análisis documental y una encuesta a docentes del área para profundizar en las características fenomenológicas del objeto de investigación. La estadística descriptiva facilitó el procesamiento de la información y la determinación de regularidades, lo que sustentó la propuesta del sistema de acciones, para el perfeccionamiento de la escala evaluativa inclusiva para la Educación Física.

Os processos de formação, complexos pela sua natureza muito social, partem dos contextos em que se desenvolvem e das características psicopedagógicas, sociológicas, culturais e fisiológicas de quem intervém como componentes pessoais do processo. O contexto educacional equatoriano, consciente do exposto, tem evidenciado, nos últimos anos, o desenvolvimento de estratégias que visam atender aos padrões básicos de inclusão reconhecidos pelos organismos internacionais e materializados em ações pedagógicas e curriculares em todos os níveis educacionais. A pesquisa proposta teve como objetivo aperfeiçoar a escala de avaliação para a inclusão, na disciplina de Educação Física, de alunos com necessidades educacionais especiais associadas à deficiência, a partir de uma visão holística, no contexto equatoriano. Métodos de análise-síntese e modelagem foram utilizados para o estudo teórico prático do processo avaliativo em Educação Física. Além disso, a análise documental e um levantamento de professores da área, para a análise das características fenomenológicas do objeto de pesquisa, que subsidiaram a proposta do sistema de ações para o aprimoramento da escala de avaliação inclusiva para a Educação Física.

The training processes, complex due to their very social nature, start from the contexts in which they develop and the psycho-pedagogical, sociological, cultural and physiological characteristics of those who intervene as personal components. The Ecuadorian educational field, aware of the above, has demonstrated in recent years the development of strategies aimed at meeting basic inclusion standards, recognized by international organizations and materialized in pedagogical and curricular actions at all educational levels. The proposed research was aimed at perfecting the evaluation scale for the inclusion, in the Physical Education subject, of students with special educational needs associated with a disability, in Ecuador. Analysis-synthesis and modeling methods were used; in addition, documentary analysis and a survey of teachers in the area to delve into the phenomenological characteristics of the research object. Descriptive statistics facilitated the processing of information and the determination of regularities, which supported the proposal of the system of actions, for the improvement of the inclusive evaluation scale for Physical Education.

An enzymatic hydrolysis-based platform technology for the efficient high-yield production of cellulose nanospheres.

This study evaluates the feasibility of using enzymatic technology to produce novel nanostructures of cellulose nanomaterials, specifically cellulose nanospheres (CNS), through enzymatic hydrolysis with endoglucanase and xylanase of pre-treated cellulose fibers. A statistical experimental design facilitated a comprehensive understanding of the process parameters, which enabled high yields of up to 82.7 %, while maintaining a uniform diameter of 54 nm and slightly improved crystallinity and thermal stability. Atomic force microscopy analyses revealed a distinct CNS formation mechanism, where initial fragmentation of rod-like nanoparticles and subsequent self-assembly of shorter rod-shaped nanoparticles led to CNS formation. Additionally, adjustments in process parameters allowed precise control over the CNS diameter, ranging from 20 to 100 nm, highlighting the potential for customization in high-performance applications. Furthermore, this study demonstrates how the process framework, originally developed for cellulose nanocrystals (CNC) production, was successfully adapted and optimized for CNS production, ensuring scalability and efficiency. In conclusion, this study emphasizes the versatility and efficiency of the enzyme-based platform for producing high-quality CNS, providing valuable insights into energy consumption for large-scale economic and environmental assessments.

Steady and transient state behavior of a gasification process under fixed-bed downdraft configuration.

Gasification is a thermochemical process that has gained significant interest in the field of biomass energy conversion. Despite the level of technological maturity of the process, the dynamic variation of the process as a result of changes in both the properties of the gasifying agent and biomass has not been analysed in sufficient depth. Therefore, the present study characterizes the process dynamically as a function of step-type changes in rice husk biomass moisture content and gasifying airflow. To identify stability conditions and the range for inducing disturbances, steady-state tests were carried out using a 32-factorial design. The experimental results demonstrate that within the tested range of airflow, the gasification process operates in the oxygen-limited zone. Despite increasing the airflow from 20 to 40 standard liters per minute (SLPM) and driving the reaction towards the combustion zone, the high temperatures achieved resulted in the gas reaching a peak Lower Heating Value (LHV) of 2.6 MJ/Nm3 and a gas power of 2.6 kW, with a Cold Gas Efficiency (CGE) of 62%. In contrast, the effect of biomass moisture content was negligible due to the thermal inertia of the reactor and the natural variation of the process. Dynamic evaluation revealed that the oxidation temperature and gas concentration were the variables that took the longest to return to stability after air disturbances. It took approximately 1200 s for the hydrogen (H2) concentration to stabilize, while the gas power required about 300 s. No clear results were observed regarding the impact of the dynamic disturbance in moisture content, which varied between 12.3% w.t and 21.5% w.t.

Oven-drying and decontamination effects on crude protein concentration and in vitro crude protein digestibility of yellow mealworm (Tenebrio molitor) (Coleoptera: Tenebrionidae).

The study aims to assess the impact of oven-drying and decontamination on crude protein concentration and in vitro crude protein digestibility of yellow mealworms. Two kilograms of 12-wk-old mealworm larvae were subjected to freezing prior to the drying process. Approximately 1.5 kg of mealworm larvae were divided into 3 groups and exposed to oven-drying at temperatures of 50 °C for 36 h, 60 °C, and 70 °C for 24 h each. At intervals of 2 h, sets of 3 replicates were withdrawn to record water loss. Consistent weight stabilization was observed at 36 h for 50 °C (T50), 18 h for 60 °C (T60), and 14 h for 70 °C (T70). The remaining 0.5 kg of mealworm larvae was divided and dried under treatments T50, T60, and T70. Each treatment was then split into 2 portions, with one portion subjected to 90 °C for 15 min (denoted as T50-90, T60-90, T70-90) to eliminate microbial contamination. The 6 treatments were then used to determine concentrations of dry matter, crude ash, crude protein, pre-caecal protein digestibility, and dry matter residues after neutral detergent fiber, acid detergent fiber, and acid detergent lignin treatments. No interaction was observed between drying and decontamination treatments (P > 0.17). Pre-caecal crude protein digestibility increased with decreasing temperature (T50: 58% crude protein; T60: 51% crude protein; T70: 50% crude protein). Therefore, lower temperatures for longer times preserve crude protein digestibility. These findings are crucial for understanding how drying temperature and time impact protein bioavailability.

Management of Infections in Palliative Care Patients at the End-of-Life and Active Process of Death: A Brazilian Retrospective Study.

Background: There is a lack of specific studies on the management of infections in patients receiving palliative care (PC) in the final stages of life and during the active process of death, related to specific nursing care. There is clinical and social importance as patients in PC represent a vulnerable population, and adequate management of infections is crucial to improve quality of life and the experience of comfort. Objective: This study analyzed how infections are managed in patients undergoing PC at the end-of-life and in the active process of death in two hospital health services. Design: This is an observational, analytical, and retrospective study. Settings: Data collection took place in two hospitals that assist individuals who are hospitalized under PC, located in Brazil, in a city in the interior of the state of São Paulo. Measurements and Results: The sample consisted of 113 medical records, in which the oncological diagnosis was the most prevalent. There was a predominance of infection diagnoses based on the patient's clinical symptoms, the main focus being the pulmonary, in individuals at the end-of-life. The management of infection in the study sample occurred through care and procedures that generate physical discomfort, however aiming at relieving symptoms. Such findings must be documented, as they invite us to reflect on our practical attitudes and what it means to be comfortable for these people, making it possible to incorporate this information into the design of interventions focused on enhancing the experience of comfort.

Andean Crops Germination: Changes in the Nutritional Profile, Physical and Sensory Characteristics. A Review.

Andean crops such as quinoa, amaranth, cañihua, beans, maize, and tarwi have gained interest in recent years for being gluten-free and their high nutritional values; they have high protein content with a well-balanced essential amino acids profile, minerals, vitamins, dietary fiber, and antioxidant compounds. During the germination bioprocess, the seed metabolism is reactivated resulting in the catabolism and degradation of macronutrients and some anti-nutritional compounds. Therefore, germination is frequently used to improve nutritional quality, protein digestibility, and availability of certain minerals and vitamins; furthermore, in specific cases, biosynthesis of new bioactive compounds could occur through the activation of secondary metabolic pathways. These changes could alter the technological and sensory properties, such as the hardness, consistency and viscosity of the formulations prepared with them. In addition, the flavor profile may undergo improvement or alteration, a critical factor to consider when integrating sprouted grains into food formulations. This review summarizes recent research on the nutritional, technological, functional, and sensory changes occur during the germination of Andean grains and analyze their potential applications in various food products.

Intake Characteristics as Predictors of Psychotherapy Outcome in a Practice Research Network in Argentina.

There are few studies exploring intake diagnostic characteristics as predictors of change in integrative naturalistic settings. The aim of this study is to explore baseline variables at the intake process and establish the predictive value of the individual trajectories of the patients. We recruited 259 patients undergoing an integrative psychotherapy network of psychotherapists from Buenos Aires, Argentina. Every therapist completed the intake form of each patient involved in the routine outcome monitoring. Thereafter step-wise regressions based on forward selection strategies were used, in order to identify meaningful baseline predictors of patients' clinical evolution, derived from the intake process. The selected predictors were social support network, subjective distress, the initial measure of clinical distress, unemployment, sociocultural status and reactance. When including those six variables in a multilevel model, the results indicate that social support network, subjective distress, and the initial measure of clinical distress were significant predictors of the trajectories of OQ-30, whereas unemployment, sociocultural status and reactance were not significant. The results regarding social support network are in line with the literature, while results of socioeconomic status (unemployment and sociocultural level) move in an opposite direction in comparison to the available evidence. Moreover, the mental health findings (initial OQ-30 and subjective distress) confirm the contradictory body of literature produced in this domain. Finally, reactance seems to be a significant predictor in previous study in contradiction of our results. Overall, this endeavor constitutes important but preliminary evidence to enhance the production of bottom-up science within practice research networks in the global south.

Tuning Energetics of 2 e-/2H+ PCET Properties with Model Ru-bisamido Complexes.

Most redox processes that break/form bonds involve net 2e- changes, and many are coupled to protons. Yet most proton-coupled electron transfer (PCET) studies focus on 1e-/1H+ reactions. Reported here is a family of molecular models that undergo tunable 2e-/2H+ redox changes. Complexes [(X2bpy)RuII(en*)2](PF6)2 and [(X2bpy)RuIV(en*-H)2](PF6)2 have been synthesized with bpy=2,2'-bipyridine with 4,4'-subtitutions X=-NMe2, -OMe, -Me, -H, -CF3; and en*=2,3-dimethyl-2,3-butanediamine. They have been characterized by IR, UV-vis, and NMR spectroscopies, XRD, electrochemistry, mass spectrometry, DFT and (TD)DFT computations. The introduction of electron-withdrawing and donating groups at the 4,4'-position of the bpy ligand affects the complexes' redox potentials, pKa's, and Bond Dissociation Free Energies (BDFEs) of the N-H bonds in the en* ligands. The average BDFEs for the overall 2e-/2H+ PCET span over 5 kcal/mol. Notably, these complexes all show marked potential inversion over an extended range, ΔpKa>25 units and ΔE0>1.4 V. Potential inversion remains despite the electronic influence of bpy's substitutions which regulate N-H properties several bonds apart by trans-effect over dπ-molecular orbitals at the Ru center. The experimental and computational results presented in this work support the presence of strong coupling between electrons and protons, for modelling insights of 2e-/2H+ transfer reactivity.

The Effect of an Educational Intervention Based on the Health Action Process Approach on Nurses' Communication Skills.

Objective: This study aimed to the effects of the Health Action Process Approach (HAPA) in promoting the quality of nurses' communication skills among nurses. Methods: The present quasi-experimental research was conducted on 148 nurses (76 in the intervention and 72 in the control group) in Yazd province (Iran). In this study, the total number of nurses in one hospital was selected as the intervention group, while the nurses from another hospital were chosen as the control group. The participants were recruited from public hospitals in Ardakan and Meibod cities. The data collection instrument was a questionnaire based on the Health Action Process Approach (HAPA) Constructs and a communicative skill questionnaire. The data were collected from the two groups before, one month after, and four months after the intervention. The control group did not receive any educational training during the course of the study. Results: In the pretest, no statistically significant difference was found between the intervention and control groups regarding the behavioral stages of effective communication with patients. In the posttest, the mean task self-efficacy score was significantly increased in the intervention group compared to the control (p<0.001). The mean coping self-efficacy score was also significantly higher in the intervention group than the control in the posttest (p<0.001). Moreover, the mean coping planning score was significantly increased in the post-test intervention group(p < 0.001). The mean communicative skill score was also significantly increased in the intervention group compared to the post-test control (p=0.03). Conclusion: The intervention used in the present study based on the target model (HAPA) significantly affected nurses' self-efficacy and communicative skills in the experimental group.

Intensifying the sonochemical degradation of hydrophilic organic contaminants by organic and inorganic additives.

The sonochemical system is highly effective at degrading hydrophobic substances but has limitations when it comes to eliminating hydrophilic compounds. This study examines the impact of organic and inorganic additives on improving the sonochemical degradation of hydrophilic pollutants in water. The effects of adding an organic substance (CCl4) and two inorganic ions (Fe2+ and HCO3-) were tested. The treatment was focused on a representative hydrophilic antibiotic, cefadroxil (CDX). Initially, the sonodegradation of CDX without additives was assessed and compared with two reference pollutants more hydrophobic than CDX: dicloxacillin (DCX) and methyl orange (MO). The results highlighted the limitations of ultrasound alone in degrading CDX. Subsequently, the impact of the additives on enhancing the removal of this recalcitrant pollutant was evaluated at two frequencies (375 and 990 kHz). A significant improvement in the CDX degradation was observed with the presence of CCl4 and Fe2+ at both frequencies. Increasing CCl4 concentration led to greater CDX elimination, whereas a high Fe2+ concentration had detrimental effects. To identify the reactive sites on CDX towards the species generated with the additives, theoretical calculations (i.e. Fukui indices and HOMO-LUMO gaps) were performed. These analyses indicated that the ß-lactam and dihydrothiazine rings on CDX are highly reactive towards oxidizing species. This research enhances our understanding of the relationship between the structural characteristics of contaminants and the sonochemical frequency in the action of additives having diverse nature.

You can't nudge into vaccination: Comparing the effects of nudge types and Covid-19 vaccination attitudes on vaccine willingness.

Nudges can be an effective strategy to promote vaccination. However, it is necessary to better identify the characteristics of nudges that produce the strongest effects and how they interact with individuals' attitudes. Here we sequentially test the effectiveness of three nudge characteristics (framing, nudge type, and presentation modality) and the role of participants' attitudes toward Covid-19 vaccination, social solidarity and authoritarianism in vaccination decisions. In studies 1-4, participants were presented with a nudge manipulating a target characteristic (e.g. positive/negative framing, nudge type) and measuring willingness to vaccinate and related variables compared a control nudge. Study 5 used a single combined nudge reflecting the combination of successful nudges in previous studies. Results over all studies show that nudging has unreliable effects while vaccine attitudes are more reliably linked to all measures of vaccines willingness. These results suggest that attitudes play a more reliable role on effective adoption of vaccinations.

Model Predictive Control (MPC) of a Countercurrent Flow Plate Heat Exchanger in a Virtual Environment.

This research proposes advanced model-based control strategies for a countercurrent flow plate heat exchanger in a virtual environment. A virtual environment with visual and auditory effects is designed, which requires a mathematical model describing the real dynamics of the process; this allows parallel fluid movement in different directions with hot and cold temperatures at the outlet, incorporating control monitoring interfaces as communication links between the virtual heat exchanger and control applications. A multivariable and non-linear process like the plate and countercurrent flow heat exchanger requires analysis in the controller design; therefore, this work proposes and compares two control strategies to identify the best-performing one. The first controller is based on the inverse model of the plant, with linear algebra techniques and numerical methods; the second controller is a model predictive control (MPC), which presents optimal control actions that minimize the steady-state errors and aggressive variations in the actuators, respecting the temperature constraints and the operating limits, incorporating a predictive model of the plant. The controllers are tested for different setpoint changes and disturbances, determining that they are not overshot and that the MPC controller has the shortest settling time and lowest steady-state error.

Role of the Surgical Approach in the Treatment of Eagle Syndrome.

Introduction Eagle syndrome is a rare and an often misdiagnosed entity in otorhinolaryngology. Objective To determine the efficacy of the surgical treatment for Eagle syndrome. Methods The present prospective study included 25 patients who presented with complaints of pain in the throat, ear, and neck, as well as difficulty and/or pain while swallowing; they were assessed for Eagle syndrome. As per patient profile, we performed a clinical assessments along with orthopantomograms (OPGs), three-dimensional computed tomography (3D CT) scans, and cone beam computed tomography (CBCT). Pain was assessed pre- and postoperatively through the Numerical Rating Scale-11 (NRS-11), whose score ranges from 0 to 10. Microscopic tonsillo-styloidectomy was performed in cases in which the conservative treatment failed to relieve pain. Results The mean age of the entire study population was of 36.08 ± 7.19 years, and the male-to-female ratio was of 1.08:1. Referred otalgia was the commonest (44%) complaint. Radiologically, out of 25 patients, 20 patients presented elongated styloid processes. The longest symptomatic styloid process measured radiographically was of 64.7 mm while the shortest was of 28.2 mm. Out of 20 patients, 12 underwent surgery. The postoperative pain assessment through the NRS-11 was performed on day 0 (3.83 ± 0.83), day 7 (1.5 ± 0.52), week 4 (0.5 ± 0.52), and week 12 (0.41 ± 0.51). By 12 weeks, 7 patients were symptom-free, while 5 patients still reported mild pain. Conclusion Eagle syndrome associated with an elongated styloid process is not a rarity, but it often goes undiagnosed. Microscopic tonsillo-styloidectomy shows excellent results in the management of patients with Eagle syndrome.

Atrazine degradation through a heterogeneous dual-effect process using Fe-TiO2-allophane catalysts under sunlight.

This study investigated the novel application of Fe-TiO2-allophane catalysts with 6.0 % w/w of iron oxide and two TiO2 proportions (10 % and 30 % w/w) for degrading atrazine (ATZ) using the heterogeneous dual-effect (HDE) process under sunlight. Comparative analyses with Fe-allophane and TiO2-allophane catalysts were conducted in both photocatalysis (PC) and HDE processes. FTIR spectra reveal the unique hydrous feldspathoids structure of allophane, showing evidence of new bond formation between Si-O groups of allophane clays and iron hydroxyl species, as well as Si-O-Ti bonds that intensified with higher TiO2 content. The catalysts exhibited an anatase structure. In Fe-TiO2-allophane catalysts, iron oxide was incorporated through the substitution of Ti4+ by Fe3+ in the anatase crystal lattice and precipitation on the surface of allophane clays, forming small iron oxide particles. Allophane clays reduced the agglomeration and particle size of TiO2, resulting in an enhanced specific surface area and pore volume for all catalysts. Iron oxide incorporation decreased the band gap, broadening the photoresponse to visible light. In the PC process, TiO2-allophane achieves 90 % ATZ degradation, attributed to radical species from the UV component of sunlight. In the HDE process, Fe-TiO2-allophane catalysts exhibit synergistic effects, particularly with 30 % w/w TiO2, achieving 100 % ATZ degradation and 85 % COD removal, with shorter reaction time as TiO2 percentage increased. The HDE process was performed under less acidic conditions, achieving complete ATZ degradation after 6 h without iron leaching. Consequently, Fe-TiO2-allophane catalysts are proposed as a promising alternative for degrading emerging pollutants under environmentally friendly conditions.

Graph Theory to Map Nursing Knowledge of Diagnosis and Interventions in Women's Health.

OBJECTIVE: Apply Graph Theory to analyze and map knowledge about nursing diagnoses and interventions, based on records of consultations carried out by nurses, in women's health, in primary health care. METHODS: Secondary data from a cross-sectional study were used. Records of nursing consultations carried out during the month of October 2016, in 21 health units, in a Brazilian municipality were analyzed. Network analysis was carried out using Graphs from 61 nursing consultations. RESULTS: 175 diagnoses were recorded, an average of three per consultation; and 380 interventions, an average of six per consultation. In the analysis, four diagnostic and four intervention network groupings were identified. CONCLUSIONS: The mapping allowed reflection on phenomena of interest to Nursing and fostering critical thinking in decision making. The findings are useful for teaching and training nurses, as well as strengthening the use of standardized language systems.

Long chikungunya? An overview to immunopathology of persistent arthralgia.

Chikungunya fever (CF) is caused by an arbovirus whose manifestations are extremely diverse, and it has evolved with significant severity in recent years. The clinical signs triggered by the Chikungunya virus are similar to those of other arboviruses. Generally, fever starts abruptly and reaches high levels, followed by severe polyarthralgia and myalgia, as well as an erythematous or petechial maculopapular rash, varying in severity and extent. Around 40% to 60% of affected individuals report persistent arthralgia, which can last from months to years. The symptoms of CF mainly represent the tissue tropism of the virus rather than the immunopathogenesis triggered by the host's immune system. The main mechanisms associated with arthralgia have been linked to an increase in T helper type 17 cells and a consequent increase in receptor activator of nuclear factor kappa-Β ligand and bone resorption. This review suggests that persistent arthralgia results from the presence of viral antigens post-infection and the constant activation of signaling lymphocytic activation molecule family member 7 in synovial macrophages, leading to local infiltration of CD4+ T cells, which sustains the inflammatory process in the joints through the secretion of pro-inflammatory cytokines. The term "long chikungunya" was used in this review to refer to persistent arthralgia since, due to its manifestation over long periods after the end of the viral infection, this clinical condition seems to be characterized more as a sequel than as a symptom, given that there is no active infection involved.

Effects of cherries Sanitization methods and fermentation times on quality parameters of coffee beans.

For the first time, the dual effect of coffee cherry sanitization methods to control the microbial load in processing and the influence of fermentation time on coffee quality parameters was evaluated. Two assays were carried out by wet processing: I) Sanitization of the coffee cherry (ST1: Unclassified processed cherries; ST2: Classified and sanitized cherries with drinking water; ST3: Classified and sanitized cherries with a chemical agents and II) Fermentation times (FT1: 12 h; FT2: 24 h; FT3: 48 h; FT4: 72 h and FT5: 96 h). pH, temperature, and dissolved oxygen were monitored during fermentation. Counts of Lactic Acid Bacteria - LAB, mesophiles, and yeasts were carried out on the coffee mass before and after fermentation. Caffeine and chlorogenic acid contents were determined by HPLC-DAD and the sensory profile by methodology for specialty coffees (SCA). The main findings showed that: sanitization with Timsen® did not significantly influence the evolution of pH during fermentation (p > 0.05), but it can reduce to a small extent the action of LAB at the end of the process. It was observed that the temperature of the coffee mass tends to balance with the ambient temperature, with significant effects (p < 0.05) of sanitization (ST2 and ST3) on the stability of this variable during fermentation. Timsen® as a disinfectant affected microbial populations and improved the sensory profile in the cup. In prolonged coffee fermentations (FT3, FT4 and FT5), the pH of the coffee mass tended to stabilize after 36 h, regardless of the process time. Likewise, a correlation was evident between a higher microbial load correlated with better sensory profiles in FT4 and FT5. Neither the sanitization process nor the fermentation time significantly affected the caffeine and chlorogenic acid contents of the coffee, both in its green and roasted states. Consequently, the sanitization of cherry coffee with Timsen® and prolonged fermentation times favor the safety and coffee final quality in the cup.

Effects of different anesthesia methods on labor process and postpartum serum estrogen and progesterone levels in primiparas with painless labor.

OBJECTIVE: To look into the effects of different anesthesia methods on the labor process and the expression of serum estrogen and progesterone in primiparas with painless labor. METHODS: 60 primiparas receiving painless labor were selected as the research objects, and they were divided into either a Spinal & Continuous epidural anesthesia group (n = 30) or a continuous epidural anesthesia group (n = 30), anesthesia is administered using the corresponding anesthesia method. The authors compared serum estrogen and progesterone, inflammatory index expression, pain degree and neonatal health status in different periods. RESULTS: At T2 and T3, serum P, LH, FSH and E2 levels in the Spinal & Continuous epidural anesthesia group were signally lower than those in the Spinal & Continuous epidural anesthesia group (p < 0.05). Spinal & Continuous epidural anesthesia group harbored faster onset and longer duration of sensory block and motor block than the Continuous epidural anesthesia group (p < 0.05). SAS and SDS scores of the Spinal & Continuous epidural anesthesia group were clearly lower than those of the Continuous epidural anesthesia group (p < 0.05). VAS score and serum TNF-α, IL-6 levels of pregnant women in the Spinal & Continuous epidural anesthesia group were memorably lower than those in the Continuous epidural anesthesia group at T2 and T3 (p < 0.05). The total incidence of postoperative complications in the Spinal & Continuous epidural anesthesia group was distinctively lower than that in the Continuous epidural anesthesia group (p < 0.05). CONCLUSION: Spinal anesthesia combined with continuous epidural anesthesia has a better anesthesia effect in the painless labor of primiparas, which can effectually ameliorate the labor process and the expression of serum estrogen and progesterone.