Summary Non-communicable diseases, including cancer, are overtaking infectious disease as the leading health-care threat in middle-income and low-income countries. Latin American and Caribbean ...countries are struggling to respond to increasing morbidity and death from advanced disease. Health ministries and health-care systems in these countries face many challenges caring for patients with advanced cancer: inadequate funding; inequitable distribution of resources and services; inadequate numbers, training, and distribution of health-care personnel and equipment; lack of adequate care for many populations based on socioeconomic, geographic, ethnic, and other factors; and current systems geared toward the needs of wealthy, urban minorities at a cost to the entire population. This burgeoning cancer problem threatens to cause widespread suffering and economic peril to the countries of Latin America. Prompt and deliberate actions must be taken to avoid this scenario. Increasing efforts towards prevention of cancer and avoidance of advanced, stage IV disease will reduce suffering and mortality and will make overall cancer care more affordable. We hope the findings of our Commission and our recommendations will inspire Latin American stakeholders to redouble their efforts to address this increasing cancer burden and to prevent it from worsening and threatening their societies.
Modern road vehicles are employing features of driver assistance systems (DAS) to improve drivability performance, comfort, and safety. In the future perspective, the advances in this field will lead ...these systems to the level of autonomous and cooperative driving, based on sensors networks and sensor fusion. This paper aims to present the readers a novel strategy for lane detection and tracking, which fits as a functional requirement to deploy DAS features like Lane Departure Warning and Lane Keeping Assist. To achieve the presented results, the digital image processing was divided into three levels. At the low-level, the input image dimensionality is reduced from three to one layer, the sharpness is improved, and region of interest is defined based on the minimum safe distance from the vehicle ahead. The feature extractor for lane edges detection design is part of the mid-level processing. The lane tracking strategy development is discussed in the high-level stage; Hough Transform and a shape-preserving spline interpolation are used to achieve a smooth lane fitting. The experimental outcomes were qualitatively and quantitatively evaluated using a ground truth comparison. The strategy shows good accuracy levels, including scenarios with shadows, curves, and road slope.
The identification of combustion and detonation in spark ignition (SI) engines is very important to its control within optimized and efficient boundaries. While they are generally identified ...respectively by phase and knock sensors, this investigation provides additional evidences that the ion current could be used as a sensing device to replace those two sensors, in order to identify both phenomena. The cylinder under combustion could be determined with the ion current signal, by sampling and computing the area under the signal curve. In order to monitor detonation, the correlation between the energy of a frequency band of the ion current signal and the energy of the knock sensor signal was established. The results indicated the viability to use the ion current to detect combustion and detonation in several situations, such as variations in the fuel mixture, mileage of the spark plug, and area size of the spark plug electrode.
This paper validates and analyzes the robustness of the proportional-integral-derivative (PID) action controller from an open transfer function that integrates a proportional-integral (PI) action ...controller to obtain the response of a robust action control during the automatic parking maneuver of a vehicle where the simulations are based on 3 adjustment methods: Ziegler-Nichols (ZN), Chien-Hrones-Reswick (CHR), and Cohen-Coon (CC), and as a result of the computer simulations, it is determined the best performance index of the PID controller represented by mathematical and graphic equations with the help of MATLAB/Simulink software.
This paper describes the mathematical modeling corresponding to the kinematics and dynamics of a vehicle with 4-wheels (light vehicles), to determine that the vehicle design meets and guarantees ...better driveability on a local road or highway. The mathematical modeling referring to the kinematics and dynamics (factors influencing vehicle performance) is proposed for traction on the front 2-wheels and for the 4-wheels of the vehicle, allowing to classify the type of vehicle and where it can be implemented. Is presented and justified the computational simulation of kinematic variable that directly influences vehicle dynamics.
The current industrial revolution demands a revolution on teaching methodologies at all levels, particularly for higher education. Here, we present an efficient model to teach technologies associated ...with Industry 4.0 (I4.0) in undergraduate engineering courses. The first step was identifying the main skills required for an I4.0 practitioner and how those subjects are currently taught worldwide. Then, a multicriteria model is created to identify the appropriate teaching strategy. From this, a framework of a differentiated model for studying Industry 4.0-related subjects was created, which was labelled Educational Test Bed 4.0. Finally, this educational framework was applied at the Federal University of Technology - Paraná (UTFPR) undergraduate courses, with effective outcomes and improvement over previous methodologies, becoming part of the engineering curriculums.
Psychotherapeutic treatment of adolescents requires age-specific approaches and thus plausibly also involves different change mechanisms than adult psychotherapy. To guide further research and ...improve therapeutic outcomes for adolescents, we reviewed all RCTs investigating mechanisms of change in the psychological treatment of adolescents to identify the most promising age-, disorder- or treatment-specific mediators. Following the preferred reporting items for systematic reviews (PRISMA), 106 studies were included that reported 252 statistical mediation tests assessed with 181 different measures. Most often studied and significant mediators were cognitive, followed by family-related, and behavioral variables. Several mediators were identified to be promising for future investigations: changes in negative thoughts, dysfunctional beliefs and metacognitive skills; family functioning and parenting skills; as well as successful engagement in therapy activities and increased impulse control. Symptom change during therapy was least often a mediator for other therapeutic changes. Relational and emotional mediators were largely understudied, whereas peer-influence appeared a promising mediator for intervention outcomes. Adolescence-specific mediators were most commonly investigated. Majority of studied mediators were not disorder-specific. There was a tendency to mainly test change mechanisms of specific theoretical models without considering other possible change theories. Further, virtually no studies fulfilled all criteria for rigorously investigating mediation and only nine were classified with an overall good study quality. While bearing in mind the current limitations in study designs, methodological rigor and reporting, there appears to be substantial evidence for transdiagnostic age-specific change models in the psychological treatment of adolescents. For future research, need for consensus on a core set of transdiagnostic and transtheoretical mediators and measures is highlighted. These should address likely core mechanisms of change, as well as take into account age-relevant developmental challenges and biological markers.
Cutaneous leishmaniasis (CL) is a neglected disease and a public health problem in Latin America. The diagnosis of CL in poor hyperendemic regions relies to large extent on the identification of ...amastigotes in Giemsa-stained smears. There is an urgent need for a rapid, sensitive and low cost diagnostic method for use in field conditions for CL as current modalities are not readily available. The primary objective of this study was to determine the sensitivity and specificity of the FDA-cleared CL Detect Rapid Test in Peru, using modified test procedures rather than the instructions-for-use, by 1) increasing the extraction time and 2) increasing the volume of the sample added to the test strip. CL Detect Rapid Test results were compared against microscopy and kDNA-PCR, for the diagnosis of CL in ulcerated lesions. In addition, we compared two collection methods the dental broach used and mentioned in the CL Detect insert and the standard less invasive and easier to conduct scrapping method.
Participants were patients who presented for medical consultation due to a suspected CL lesion. Four samples from the index lesion were collected using a dental broach, per package insert, and lancet scraping and tested by the modified CL Detect Rapid Test, microscopy, and PCR.
A total of 156 subjects were eligible and evaluated. The modified CL Detect sensitivity was higher in specimens obtained by scraping (83.3%) than those from dental broach (64.2%). The specificity was lower in scrapings (77.8%) with a false positive rate of 22.2% compared with dental broach samples (91.7%) with a false positive rate of 8.3%. However, molecular analysis showed that all 8 false negative microscopy scrapings (those positive by modified CL Detect and negative by microscopy) were positive by kDNA-PCR, meaning that the modified CL Detect was more sensitive than microscopy.
These modifications to the package insert that resulted in a diagnostic sensitivity (83.3%) comparable to microscopy for species found in Peru may enable earlier anti-leishmanial drug treatment decisions based on a positive result from the CL Detect Rapid Test alone until further diagnostic tests like microscopy and PCR can be performed.
NCT03762070; Clinicaltrials.gov.
Summary
This study evaluated the influence of moderate physical exercise on the myenteric neurons in the colonic intestinal wall of mice that had been infected with Trypanosoma cruzi. Parasitology ...and immunological aspects of the mice were considered. Forty‐day‐old male Swiss mice were divided into four groups: Trained Infected (TI), Sedentary Infected (SI), Trained Control (TC), and Sedentary Control (SC). The TC and TI were subjected to a moderate physical exercise program on a treadmill for 8 weeks. Three days after finishing exercise, the TI and SI groups were inoculated with 1,300 blood trypomastigotes of the Y strain‐T. cruzi. After 75 days of infection results were obtained. Kruskal‐Wallis or Analyze of variance (Tukey post hoc test) at 5% level of significance was performed. Moderate physical exercise reduced both the parasite peak (day 8 of infection) and total parasitemia compared with the sedentary groups (P < 0.05). This activity also contributed to neuronal survival (P < 0.05). Exercise caused neuronal hypertrophy (P < 0.05) and an increase in the total thickness of the intestinal wall (P < 0.05). The TI group exhibited an increase in the number of intraepithelial lymphocytes (P > 0.05). In trained animals, the number of goblet cells was reduced compared with sedentary animals (P < 0.05). Physical exercise prevented the formation of inflammatory foci in the TI group (P < 0.05) and increased the synthesis of TNF‐α (P < 0.05) and TGF‐β (P > 0.05). The present results demonstrated the benefits of moderate physical exercise, and reaffirmed the possibility of that it may contribute to improving clinical treatment in Chagas' disease patients.
The engine management system (EMS) is arguably one of the most critical and complex components of a spark ignition (SI) engine. Modern EMS incorporates various components (like sensors, actuators, ...control strategies, etc.) to achieve an appropriate engine response. Even though EMS has been researched for a long time, most existing studies have just focused on individual control modules with no consideration about their interaction or how they work when brought together. For this reason, this paper presents the entire design, implementation and testing of EMS for a SI system. In particular, this investigation shows each EMS module, along with tests of the EMS. In addition, we carried out numerous experimental tests (such as stability analysis, reference tracking, and disturbance rejection) to assess the custom EMS. From vehicle performance test, we obtained a slight power (1.2%) and torque (1.3%) percentage errors between custom and original EMS. Similarly, percentage error obtained for vehicle emission tests for hydrocarbons (HC), carbon monoxide (CO), and nitrogen oxides (NO
x
) are 29.2%, 21.4% and 65.9%, respectively, which highlighted a slightly richer mixture once compared to custom with the original EMS. Lastly, experiment results show the success of the proposed EMS.
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