Aims
The aim of this study was to validate and update the risk score originally developed at Hospital de Clínicas de Porto Alegre, verifying its performance in an infectious disease population.
...Methods
This is an observational study with consecutive selection of admission in a ward of participants with infectious diseases. Predictors were age, number of medications, intravenous drugs, potentially dangerous drugs, renal dysfunction, liver dysfunction, use of nasoenteral tube, nasogastric tube, gastrostomy feeding, jejunostomy feeding, oral enteral tube, total parenteral nutrition, cardiac or pulmonary dysfunction and immunosuppression. Outcome was defined as preventable prescription incidents by a clinical pharmacist. A GEE model was fit to make predictions each week.
Results
A total of 219 patients participated in the study, 79.25% of whom had prescription incidents in the first week of admission. Predictors of the updated model were number of drugs prescribed, number of intravenous drugs, use of tubes, truncated age at 36 years and week of hospitalization. The performance of the original model was poor. The updated model's discrimination and calibration were moderate (overall AUC 0.74). A calculator to apply the model is available at https://pedrobrasil.shinyapps.io/INDWELL/.
Conclusion
The updated risk score enabled the user to make predictions at admission and throughout the weeks, allowing for a prioritized weekly update for clinical pharmacy intervention. The updated model has a moderate and satisfactory performance for infectious disease patients.
This study identified spatial clusters of type 2 diabetes mellitus among participants of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) residing in two cities and verified individual ...and neighborhood socioeconomic environmental characteristics associated with the spatial clusters. A cross-sectional study was conducted with 4,335 participants. Type 2 diabetes mellitus was defined as fasting blood glucose ≥ 126mg/dL (7.0mmol/L), oral glucose tolerance test ≥ 200mg/dL (11.1mmol/L), or glycated hemoglobin ≥ 6.5% (48mmol/L); by antidiabetic drug use; or by the self-reported medical diagnosis of type 2 diabetes mellitus. Neighborhood socioeconomic characteristics were obtained from the 2011 Brazilian census. A spatial data analysis was conducted with the SaTScan method to detect spatial clusters. Logistic regression models were fitted to estimate the magnitude of associations. In total, 336 and 343 participants had type 2 diabetes mellitus in Belo Horizonte, Minas Gerais State (13.5%) and Salvador, Bahia State (18.5%), respectively. Two cluster areas showing a high chance of type 2 diabetes mellitus were identified in Belo Horizonte and Salvador. In both cities, participants living in the high type 2 diabetes mellitus cluster area were more likely to be mixed-race or black and have a low schooling level and manual work; these were also considered low-income areas. On the other hand, participants in the low type 2 diabetes mellitus cluster area of Salvador were less likely to be black and have low schooling level (university degree) and live in a low-income area. More vulnerable individual and neighborhood socioeconomic characteristics were associated with living in clusters of higher type 2 diabetes mellitus occurrence , whereas better contextual profiles were associated with clusters of lower prevalence.
Many native species of the Brazilian flora are still little explored economically in the country. An example is Acrocomia intumescens, a palm tree that in recent studies has shown some industrial ...potential still unexplored. The present study evaluates the proximate composition, including minerals, and total carotenoid content of A. intumescens fruits from three different locations in Pernambuco State, north‐east Brazil, with distinct climatic characteristics. A. intumescens fruits showed that nutritional composition, mineral profile and total carotenoid content varied between fruit parts and between locations. A. intumescens pulp is rich in moisture (35.96%–40.97%), lipids (31.88%–43.22%), ashes (3.63%–4.95%) and total carotenoids (106.69–265.23 µg/g), while the kernel stands out for its high content of lipids (52.08%–56.67%) and proteins (16.49%–21.88%). The main A. intumescens minerals present in the pulp were K (max. 241 mg/100 g) and Mg (max. 153.38 mg/100 g), while P (max. 92.51 mg/100 g) predominated in the kernel. Multivariate analysis (PCA) indicates that location with higher rainfall and temperature produces fruits with higher macro‐ and micronutrient contents.
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•Inga vera trypsin inhibitor (IVTI) is a Kunitz-type inhibitor composed of a single 20kDa polypeptide chain.•IVTI inhibits the trypsin-like enzymes from several lepidopteran ...pests.•IVTI impairs the weight gain, survival and larval cycle of Anagasta kuehniella.•IVTI is a fungicidal to Candida buinensis.•IVTI prevents the proliferation of colorectal adenocarcinoma cells (CACO-2).
Here, the purification, biochemical and biological properties of a trypsin inhibitor from Inga vera seeds (IVTI) are described. Partial amino acid sequence of IVTI showed that it belongs to the MEROPS I03 Kunitz inhibitor family. Moreover, it is composed of a single 20kDa polypeptide chain with one disulfide bridge and was capable of inhibiting bovine trypsin at a 1:1 molar ratio with a 1.15nM inhibition constant. IVTI was stable over a wide range of temperature, pH and concentration of a reducing agent. IVTI also inhibited the trypsin-like enzymes from the midgut of lepidopteran pests, such as Anagasta kuehniella (89%), Spodoptera frugiperda (83%), Corcyra cephalonica (80%), Heliothis virescens (70%) and Helicoverpa zea (64%). Furthermore, bioinsecticidal assays against A. kuehniella demonstrated that IVTI affected larval development by impairing weight gain and survival, as well as altering the duration of the larval cycle. IVTI was also fungicidal to Candida buinensis and bacteriostatic agent to Escherichia coli. Further assays revealed that IVTI is a chemopreventive agent against human epithelial colorectal adenocarcinoma cells (CACO-2), reducing cell viability by 70% at 200μgmL−1. In summary, these results demonstrate the multifaceted potential of IVTI as a biotechnological tool for agriculture and healthcare.
We examined the effect of acute and chronic sprint interval training (SIT), with or without prior caffeine intake, on levels of exercise-induced inflammatory plasma cytokines interleukin (IL)-6, ...IL-10, tumor necrosis factor (TNF)-α. Twenty physically-active men ingested either a placebo (
= 10) or caffeine (
= 10) 1 h before each SIT session(13-s × 30-s sprint/15 s of rest) during six training sessions (2 weeks). The early (before, immediately after, and 45 min after the exercise) and late (24 and 48 h after the exercise) cytokine and creatine kinase (CK) responses were analyzed for the first and last training sessions. Plasma IL-6 and IL-10 peaked 45 min after the exercise, and then returned to basal values within 24 h (
< 0.05) in both groups on both occasions (
> 0.05). On both occasions, and for both groups, plasma TNF-α increased from rest to immediately after the exercise and then decreased at 45 min before reaching values at or below basal levels 48 h after the exercise (
< 0.05). Serum CK increased from rest to 24 and 48 h post-exercise in the first training session (
< 0.05), but did not alter in the last training session for the PLA group (
> 0.05). Serum CK was unchanged in both the first and last training sessions for the CAF group (
> 0.05). Two weeks of SIT induced a late decrease in the IL-6/IL-10 ratio (
< 0.05) regardless of caffeine intake, suggesting an improved overall inflammatory status after training. In conclusion, a single session of SIT induces muscle damage that seems to be mitigated by caffeine intake. Two weeks of SIT improves the late SIT-induced muscle damage and inflammatory status, which seems to be independent of caffeine intake.
Abstract This study aimed to evaluate the effect of the first and last stocking strategies combined with a partial substitution of the protein from the supplement for urea nitrogen on nutrient intake ...and digestibility, milk composition, and nitrogen balance of primiparous Girolando cows. The cows were allocated to a double 4 × 4 Latin square composed of four animals and four treatments in a 2 × 2 factorial arrangement. Supplements were formulated to provide an intake of 0.6% body weight, with and without the inclusion of 21% urea nitrogen in their composition. The first stocking management method improved nutrient intake and digestibility. Supplementation with urea led to a 47% higher excretion of urine N (g/day) than the urea treatment. The combination of the supplement without urea and the first stocking provided higher intake and retention of nitrogen and higher retained-N levels (%digested N). The combination of a supplement containing 21% urea nitrogen and the first stocking can be used without compromising the nutritional and productive parameters of the cows.
Resumo Objetivou-se avaliar os efeitos dos manejos do pastejo ponta e repasse combinados a substituição parcial da proteína do suplemento por nitrogênio ureico sobre o consumo e digestibilidade dos nutrientes, composição do leite e balanço de nitrogênio de vacas primíparas da raça Girolanda. As vacas foram alocadas em dois quadrados latinos 4 x 4 compostos de quatro animais cada e quatro tratamentos em um esquema fatorial 2 x 2. Os suplementos foram formulados para um consumo de 0,6% do peso corporal: sem utilização de nitrogênio ureico; ou com 21% de nitrogênio ureico em sua composição. O manejo do pastejo de ponta melhorou o consumo e a digestibilidade dos nutrientes. O suplemento contendo ureia excretou 47% a mais de N urina (g/dia) em comparação ao suplemento sem ureia. A combinação entre o suplemento sem ureia e o manejo de pastejo ponta apresentou maior ingestão e retenção de nitrogênio e maior N retido (%N digerido). A combinação entre o suplemento contendo 21% de nitrogênio ureico e o pastejo de ponta pode ser utilizada sem prejuízos aos parâmetros nutricionais e produtivos das vacas.
Hypertension (HTN) is the main cause of cardiovascular diseases accounting for one-third of global mortality. Physical exercise reduces the incidence and prevalence of HTN and cardiovascular ...morbidity and mortality. Exercises recommended for hypertensive patients include supervised cardiac rehabilitation, which occurs in rehabilitation centers, and partly supervised rehabilitation, with the individual prescription of exercises conducted at patients' residences.
Compare clinical and functional parameters of hypertensive patients subjected to two cardiac rehabilitation protocols: supervised and partly supervised.
Hypertensive patients stage I or II were randomly divided into group one (G1) (partly supervised cardiac rehabilitation) and group two (G2) (supervised cardiac rehabilitation). All patients performed a warm-up, aerobic exercise, strength training and cool-down. Participants' assessments conducted before and after intervention included: physical examination, six-minute walk test, cardiac stress test, metabolic tests, and central and peripheral blood pressure measurements.
A total of 61 patients (mean age 60.3±11.3 years, 78.7% women) were randomized (30 in G1 and 31 in G2). At the end of the intervention, G1 increased 30.6 meters (p=0.004) and G2 increased 55.0 meters (p>0.001) the distance covered in the six-minute walk test. G2 showed an increase in the maximum oxygen consumption from 24.7±8.6 mlO2/Kg/min to 28.4±7.5 mlO2/Kg/min (p=0.003). Compliance with the intervention was similar in G1 and G2 (77.5±11% x 82±10%; p=0.654).
Participants from both groups improved their physical fitness and showed satisfactory compliance and tolerability to the interventions. The supervised exercise was more effective in improving muscle strength and some physical fitness parameters.
Con el aumento creciente de la conciencia ambiental y social, las presiones externas, provenientes de las partes interesadas, ejercen nuevas fuerzas sobre las organizaciones. Las empresas deben ser ...transparentes tanto en lo que respecta a sus operaciones como a la información que brindan a la sociedad, lo que requerirá nuevas formas de medir, controlar y publicar las actividades comerciales, como la percepción de los grupos de interés sobre el compromiso de las empresas con las estrategias de sostenibilidad a largo plazo. , sin perder de vista la rentabilidad a corto plazo, son la base para crear un diferencial competitivo.
Abstract Aim: To verify the association between insufficient level of physical activity and multiple health risk behaviors (HRB) in adolescents. Methods: This is an epidemiological study with ...cross-sectional design carried out in 2016 with 3,617 adolescents aged 14-19 years and enrolled in the public-school system of Sergipe, northeast Brazil. Data were collected using the Global School-based Student Health Survey (GSHS/WHO). The insufficient level of physical activity was defined as not achieving at least 60 minutes of moderate to vigorous physical activity for 5 days a week. The HRB analyzed were smoking, alcohol consumption, low fruit consumption and exposure to sedentary behavior. The analysis of prevalence odds ratio was used to identify the association between insufficient level of physical activity and HRB, as well as unadjusted and adjusted binary logistic regression for the association between socioeconomic and demographic variables. Results: The prevalence of insufficient level of physical activity was 83.3%. There was association between physical inactivity and low fruit consumption and alcohol consumption (p<0.001). Insufficient level of physical activity was also associated with female sex (OR=1.90, 95% CI, 1.56-2.32), family income of up to 2 minimum wages (OR=1.57, 95% CI, 1.17-2.11), maternal schooling less than 8 years (OR=1.55, 95% CI, 1.28-1.86) and exposure to two different HRB at the same time (OR=1.76, 95% CI, 1.27-2.45). Conclusion: The prevalence of insufficient level of physical activity is high and was associated with multiple HRBs in this understudied population. These findings may support interventions focusing on the cluster of risk behaviors in youth.
Hazardous waste management is a current worldwide concern for academics, society, and governmental agencies. The objective of this work is to formulate a composition for Solidification and ...Stabilization (S/S) of galvanic solid waste, concomitantly with ornamental rock solid waste, with minimal Ordinary Portland Cement (OPC) consumption, without additions and avoiding consumption of energy and environmental resources. A 23-full factorial experimental design focused on the influence of the three studied entrance variables (mass of galvanic solid waste, ornamental rock solid waste, and OPC as well as their interactions) on the response variable: the contaminant retention in the solid matrix. As sustainability was the aim, physical, chemical, and thermal treatment or additions to S/S where executed beforehand. Unconfined compressive strength, leaching, scanning electron microscope-X-ray, and chemical analyses were carried out to support the screening and S/S optimization procedures. Optimization tests at 7 days of curing indicate the 0.06 formulation mass ratio of OPC for each kilogram of wastes successfully reached unconfined compression resistance strength above 1 MPa and 97% of toxic retention. At 24 and 56 days of curing, 3.2 MPa was obtained, and retention efficiencies were 99% for toxic metals and organics, except for aluminum (95%) and iron (98%). The main retention mechanism was correlated to the sorption and electronegative density of the hydroxyl groups from fine particles of ornamental rock solid waste, which are rich in phyllosilicates. Therefore, this novel S/S formulation could contribute to the proper management of hazardous and industrial wastes while avoiding the consumption of energy and resources.
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•Ornamental rock solid waste was discovered as a key solidifying inerting agent.•Experimental design tools and statistical models supported the optimization tests.•Retentions greater than 99% for metals and organics was achieved by S/S formulation.•Developed S/S formulation enabled great reduction of cement consumption and resources.
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