Disposing of pollutants in water sources poses risks to human health and the environment, but biosorption has emerged as an eco-friendly, cost-effective, and green alternative for wastewater ...treatment. This work shows the ability of banana peel powder (BPP) biosorbents for efficient sorption of methylene blue (MB), atrazine, and glyphosate pollutants. The biosorbent highlights several surface chemical functional groups and morphologies containing agglomerated microsized particles and microporous structures. BPP showed a 66% elimination of MB in 60 min, with an adsorption capacity (qe) of ~33 mg g−1, and a combination of film diffusion and chemisorption governed the sorption process. The biosorbent removed 91% and 97% of atrazine and glyphosate pesticides after 120 min, with qe of 3.26 and 3.02 mg g−1, respectively. The glyphosate and atrazine uptake best followed the Elovich and the pseudo-first-order kinetic, respectively, revealing different sorption mechanisms. Our results suggest that BPP is a low-cost biomaterial for green and environmentally friendly wastewater treatment.
To evaluate the efficacy and safety of hypofractionated radiotherapy in women with early stage breast cancer after breast conservative surgery.
We performed a search for randomized controlled trials ...(RCTs) that compare conventional fractioning and hypofractioned radiotherapy. The studied outcomes were local and loco-regional recurrence, disease-free survival, mortality, cardiac ischemia, rib fracture and pulmonary fibrosis up to 5 years and 5 years after treatment. Shrinkage of the breast, breast tightening, telangiectasia, breast edema, shoulder stiffness and arm edema were evaluated within 10 years. Cosmesis and acute skin radiation toxicity were evaluated.
Ten publications of six RCTs were included. No statistical difference in local and loco-regional recurrence, disease-free survival, mortality, cardiac ischemia, ribs fracture and pulmonary fibrosis, shrinkage of the breast, breast tightening, shoulder stiffness, arm edema and cosmesis was found. However, there was a significant difference in favor of hypofractionated for breast edema (RR 0.68, 95% CI 0.53 to 0.88, p = 0.003, 4675 patients), telangiectasia (RR 0.41, 95% CI 0.19 a 0.87, p = 0.02, 5167 patients), and acute skin radiation toxicity (RR 0.34, 95% CI 0.19 to 0.61, p = 0.0003, 347 patients).
There is no difference between conventional fractionation and hypofractionated in terms of efficacy when we evaluate local recurrence, loco-regional recurrence, distance recurrence, disease-free survival and mortality. There is also no difference concerning safety when we assess the occurrence of fibrosis, ischemia and ribs fractures. Hypofractionated showed better results in relation to breast edema, telangiectasia, and acute skin radiation toxicity.
•Conventional and hypofractionated radiotherapies are equally efficacious and safe.•Incidence of fibrosis, ischemia, and rib fractures were similar for both therapies.•Hypofractionated radiotherapy resulted in fewer negative outcomes.•Recurrence was reduced, and survival was improved with hypofractionated radiotherapy.•However, hypofractionated radiotherapy may increase the risk of pulmonary fibrosis.
Mammography screening has become widely spread and provided a marked increase in ductal carcinoma in situ (DCIS) diagnosis. In DCIS, the ductal epithelium proliferates without invasion through the ...basal cell membrane. However, histologic underestimation can happen in some cases.
To analyze the rate of histologic underestimation (histopathologic results upgraded to invasive carcinoma after surgery) and the rate of positive results of sentinel lymph node biopsy (SLNB) in patients diagnosed with DCIS in a Brazilian public hospital.
We reviewed medical records of all consecutive patients admitted between 2009 and 2013 whose initial diagnosis was DCIS through core needle biopsy. DCIS cases with a high risk of invasion underwent SLNB. We excluded cases with invasion or micro-invasion components in the first biopsy.
A total of 86 women were included, most with microcalcifications as the primary radiological lesion (73.2%), and underwent preoperative biopsy, with an invasive component in 21 (24.4%) in the final pathology report. Most had invasive carcinoma of no special type (NST): 52.3% (n = 11) and microinvasive tumors (7 cases, 33.3%). The main factors associated with histologic underestimation were nodular lesion (61.9%, p<0.001) and an ultra-sonography-guided biopsy (71.4%, p=0.0005). The positivity rate of SLNB was 4.3%. All these patients underwent mastectomy, and the initial histologic pattern was solid DCIS.
The "histologic underestimation" rate among patients with DCIS was not low, and less than 5% of patients who underwent SLNB had axillary positivity. This result suggests that patients who have DCIS and a high risk of invasion and undergoing mastectomy should have SLNB. As to the patients who will undergo lumpectomy, SLNB could be omitted and could be performed if patients have upgraded to invasive breast cancer.
•Subsurface drip in sugarcane with application of domestic wastewater is part of a pilot study in largest producing area of the world under a very atypical dry season.•Two depths of dripper line ...installation and two water sources, besides the rainfed cultivation.•Physiological attributes, water quality, vegetative growth, productivity and technological quality were measured.•Water management performed by the TDR technique and the irrigated plots were fertigated based on water quality and depths applied.•Treated domestic wastewater applied through subsurface drip increased the sugarcane productivity by almost 100% in relation to the non-irrigated plots.
The water scarcity is one of the main factors contributing to the reduction of productivity in agricultural crops, and the use of alternative water source in the irrigation is an option to minimize water stress. The objective of this study was to evaluate the water relations, vegetative growth, productivity and technological quality of sugarcane irrigated with treated domestic sewage by subsurface drip during its second ratoon. The research was performed at the School of Agricultural Engineering of the State University of Campinas—SP, through a randomized block design with five treatments, with two depths of dripper lines installation and two water sources, which are: irrigation with wastewater from domestic sewage applied to 0.20m depth, and to 0.40m, irrigation with fresh water from a surface reservoir to 0.20m depth and to 0.40m and finally non-irrigated plots. Irrigation management was performed following the soil water balance through the time-domain reflectometry technique and all irrigated treatments were fertigated according to the water source applied. Leaf water potential, chlorophyll, gas exchange, leaf nutrition, vegetative growth, productivity and quality technological were measured during the second ratoon of sugarcane. Soil moisture changed according to the depth of the dripper lines installation, being higher for irrigated treatments. The leaf water potential, chlorophyll, gas exchange and nitrogen and magnesium concentration in the leaves also were higher for irrigated plots. The irrigated treatments with sewage had the largest stem and sugar yield compared with the rainfed, being the dripper line irrigated with sewage to 0.20m presenting the greatest differences reaching 95% and 86% with a productivity of 233.69Mgha−1 and 37.06Mgha−1 for stem and total recoverable sugar, respectively; however, there were not significant differences between the irrigated plots. The technological quality of sugarcane was considered appropriate to all treatments.
to analyze the impact of the use of checklists on the mean time of the operative processes of patients undergoing hip and knee arthroplasties.
cross-sectional and analytical research conducted ...between November/2020 and March/2022 with retrospective consultation in a simple random sample of 291 medical records, distributed in three periods (2010/2013/2016). Descriptive and inferential statistics were used for data analysis; p=0.05 values indicated significance.
there was a reduction in the time of entry-exit from the operating room (p=0.002), surgery (p<0.001) and between the onset-anesthesia and the beginning-incision (p=0.021). There was no difference in time between patients with and without the use of checklists (p=0.05) in relation to the variables onset-anesthesia, onset-incision, time of anesthesia and surgery.
the implementation of checklists potentially contributed to reduce the time of use of the operating room. The nonassociation of its use with the increase in the mean time of the processes in the operating room shows that its application does not interfere negatively in this indicator.
Abstract We evaluated the effect of performing various distinct warm-up exercises on vertical countermovement jump (VCMJ) performance. Eight volleyball players (age 15.4 ± 0.5 yrs) performed five ...different warm-up activities (in a counterbalanced, randomized crossover study) over five days, at 24-h intervals: stretching (4 × 30 s, 30 s between sets), cycloergometer (5 min at 50 W + 5 min at 100 W), resistance exercise (leg press 45°, 3 × 5 repetitions maximum, 3-min pause between sets), specific vertical jumping (4 × 10 VCMJ, 2-min pause between sets), and no warm-up at all (control condition). Beginning 3 min after their warm-up, the players performed 3 attempts (at intervals of 3 min) of VCMJ (on a contact carpet), and each player's best jump was considered in the analysis. All warm-up activities presented higher VCMJ performance (p< 0.05) than the control condition, with the exception of stretching. Vertical jumping revealed a large effect size(0.8) than other interventions. We conclude that in practical terms, vertical jumps are the best warm-up exercise (when applied by itself) to acutely improve VCMJ performance in volleyball players, but that other exercises can make a complementary contribution.
RESUMO Objetivo: analisar o impacto do uso de checklists no tempo médio dos processos operatórios de pacientes submetidos a artroplastias de quadril e joelho. Método: pesquisa transversal e analítica ...realizada entre novembro/2020 e março/2022 com consulta retrospectiva em amostra aleatória simples de 291 prontuários, distribuídos em três períodos (2010/2013/2016). Utilizou-se estatística descritiva e inferencial para análise dos dados; valores de p=0,05 indicaram significância. Resultados: houve redução do tempo de entrada-saída da sala cirúrgica (p=0,002), de cirurgia (p<0,001) e entre o início-anestesia e início-incisão (p=0,021). Não houve diferença no tempo entre os pacientes com e sem o uso dos checklists (p=0,05) com relação às variáveis início-anestesia, início-incisão, tempo de anestesia e de cirurgia. Conclusão: a implantação de checklists potencialmente contribuiu para reduzir o tempo de uso da sala cirúrgica. A não associação de seu uso ao aumento do tempo médio dos processos no centro cirúrgico mostra que sua aplicação não interfere negativamente nesse indicador.
ABSTRACT Objectives: to analyze the impact of the use of checklists on the mean time of the operative processes of patients undergoing hip and knee arthroplasties. Method: cross-sectional and analytical research conducted between November/2020 and March/2022 with retrospective consultation in a simple random sample of 291 medical records, distributed in three periods (2010/2013/2016). Descriptive and inferential statistics were used for data analysis; p=0.05 values indicated significance. Results: there was a reduction in the time of entry-exit from the operating room (p=0.002), surgery (p<0.001) and between the onset-anesthesia and the beginning-incision (p=0.021). There was no difference in time between patients with and without the use of checklists (p=0.05) in relation to the variables onset-anesthesia, onset-incision, time of anesthesia and surgery. Conclusion: the implementation of checklists potentially contributed to reduce the time of use of the operating room. The nonassociation of its use with the increase in the mean time of the processes in the operating room shows that its application does not interfere negatively in this indicator.
Background & Aims
Treating chronic hepatitis C (CHC) in patients with end‐stage renal disease (ESRD) has suboptimal tolerability and cure rates. Safety and efficacy of sofosbuvir plus simeprevir ...regimen in CHC‐infected patients with ESRD on haemodialysis (HD) or glomerular filtration rate (GFR) <30 ml/min is unknown. We evaluated the safety and efficacy of sofosbuvir and simeprevir in this special patient population.
Methods
All (n = 17) patients in the analysis had ESRD on HD or GFR <30 ml/min. All received sofosbuvir 400 mg daily and simeprevir 150 mg daily, without ribavirin for 12 weeks. Safety and efficacy data were collected; including SVR4 and SVR12 data for all patients after completing therapy.
Results
In this 17 patient cohort, eight (47%) were cirrhotic, four (24%) had stage three liver fibrosis and 13 (76%) were genotype 1A. All 17 have completed 12 weeks of therapy. Treatment was overall well tolerated with no treatment discontinuations reported. Four (24%) patients reported mild adverse events (AE). These AEs were insomnia (n = 2), headache (n = 1), nausea (n = 1) and worsening anaemia requiring blood transfusion (n = 1). All 17 patients reached post‐treatment week‐12 follow‐up, and achieved SVR12 or virological cure (100% SVR12).
Conclusions
Daily, full dose of sofosbuvir plus simeprevir for 12 weeks of therapy appears to be well tolerated in patients with ESRD on HD or GFR <30 ml/min. Most common AEs resembled those of healthier CHC patients without significant renal impairment. The cure rates obtained in this cohort treated with sofosbuvir and simeprevir are dramatically superior to any previous treatment regimen studied & published in this special patient population.
See Editorial on Page 791
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