This article explores the family organization of work in small-scale dairy farms in Mexico. By drawing attention to the division of labour by sex, the paper explores how gender norms and tradition ...interplay with economic interests of profitability in defining who is able and accountable to perform each task. The article builds on ethnographic research in family dairy farms in Los Altos de Jalisco (Jalisco Highlands), Mexico. Based on qualitative data collected by in-depth interviews, focus groups and observation, the analysis focused on the division of labour by sex and age in the dairy, the fields, and the house. Findings suggest that family well-being emerges as a significant criterion in the allocation of tasks. The production of goods and services and the production of life convey in a unified process that overlap functions of the farm, containing productive activities, and the house, as the realm of the reproduction of life. Welfare emerges as a legitimate element for the analysis of the family economy, downplaying profit maximization and self-interest as the sole elements in decision making.
•The division of labour in family dairy farms is influenced by global economics.•The dairy economy in Western Mexico relies on unpaid work for its survivance.•The division of labour in family dairy farms remains gender-specific and hierarchical.•The family organisation of labour blends productive and reproductive domains.•Self and collective well-being is an axis element in economic decision making.
•Pressure drop is modeled with multidimensional piecewise-linear approximation.•A simple but practical model that captures reservoir behavior in different conditions.•Fast model to carry out subsea ...layout case studies and perform sensitivity analysis.
This paper presents a practical and effective optimization method to design subsea production networks, which accounts for the number of manifolds and platforms, their location, well assignment to these gathering systems, and pipeline diameter. It brings a fast solution that can be easily implemented as a tool for layout design optimization and simulation-based analysis. The proposed model comprises reservoir dynamics and multiphase flow, relying on multidimensional piecewise linearization to formulate the layout design problem as a MILP. Besides design validation, reservoir simulation serves the purpose of defining boundaries for optimization variables and parameters that characterize pressure decrease, reservoir dynamics and well production over time. Pressure drop in pipelines are modeled by piecewise-linear functions that approximate multiphase flow simulators. The resulting optimization model and approximation methodology were applied to a real oilfield with the aim of assessing their effectiveness.
Retrospective studies suggest that online hemodiafiltration (OL-HDF) may reduce the risk of mortality compared with standard hemodialysis in patients with ESRD. We conducted a multicenter, ...open-label, randomized controlled trial in which we assigned 906 chronic hemodialysis patients either to continue hemodialysis (n=450) or to switch to high-efficiency postdilution OL-HDF (n=456). The primary outcome was all-cause mortality, and secondary outcomes included cardiovascular mortality, all-cause hospitalization, treatment tolerability, and laboratory data. Compared with patients who continued on hemodialysis, those assigned to OL-HDF had a 30% lower risk of all-cause mortality (hazard ratio HR, 0.70; 95% confidence interval 95% CI, 0.53-0.92; P=0.01), a 33% lower risk of cardiovascular mortality (HR, 0.67; 95% CI, 0.44-1.02; P=0.06), and a 55% lower risk of infection-related mortality (HR, 0.45; 95% CI, 0.21-0.96; P=0.03). The estimated number needed to treat suggested that switching eight patients from hemodialysis to OL-HDF may prevent one annual death. The incidence rates of dialysis sessions complicated by hypotension and of all-cause hospitalization were lower in patients assigned to OL-HDF. In conclusion, high-efficiency postdilution OL-HDF reduces all-cause mortality compared with conventional hemodialysis.
Bariatric surgery may cause undesirable gastrointestinal symptoms due to anatomical, functional and intestinal microbiota changes.
Purpose
The aim of this study was to evaluate the effect of ...probiotic supplementation on gastrointestinal symptoms and small intestine bacterial overgrowth (SIBO) in patients after Roux-en-Y gastric bypass (RYGB).
Materials and Methods
This is a prospective, randomized, double-blind, placebo-controlled trial. The patients were randomized into Control Group (CG) (
n
= 39) and Probiotic Group (PG) (
n
= 34). The PG received tablets containing
Lactobacillus acidophilus
and
Bifidobaterium lactis
(5 billion CFU/strain) for 90 days, and the CG received tablets with starch. Both the Gastric Symptom Rating Scale (GSRS) questionnaire and 3-day food record were answered before surgery (T0) and after 45 days (T1) and 90 days of surgery (T2). At T0 and T2, hydrogen breath test was used to verify the presence of SIBO.
Results
The prevalence of SIBO was similar among times, and the mean score of GSRS responses did not differ between groups at any time. However, PG patients reported less bloating compared to CG, more abdominal pain at T1 (which reduced at T2), more episodes of soft stools and nausea and less hunger pain after surgery, with no reports of urgent episodes to evacuate, even though they consumed more fat than the CG.
Conclusions
The supplementation of
L. acidophilus
and
B. lactis
is effective in reducing bloating, but without influencing the development of SIBO in the early postoperative period.
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) promotes challenging immune and inflammatory phenomena. Though various therapeutic possibilities have been tested against coronavirus ...disease 2019 (COVID-19), the most adequate treatment has not yet been established. Propolis is a natural product with considerable evidence of immunoregulatory and anti-inflammatory activities, and experimental data point to potential against viral targets. We hypothesized that propolis can reduce the negative effects of COVID-19.
In a randomized, controlled, open-label, single-center trial, hospitalized adult COVID-19 patients were treated with a standardized green propolis extract (EPP-AF®️) as an adjunct therapy. Patients were allocated to receive standard care plus an oral dose of 400 mg or 800 mg/day of green propolis for seven days, or standard care alone. Standard care included all necessary interventions, as determined by the attending physician. The primary end point was the time to clinical improvement, defined as the length of hospital stay or oxygen therapy dependency duration. Secondary outcomes included acute kidney injury and need for intensive care or vasoactive drugs. Patients were followed for 28 days after admission.
We enrolled 124 patients; 40 were assigned to EPP-AF®️ 400 mg/day, 42 to EPP-AF®️ 800 mg/day, and 42 to the control group. The length of hospital stay post-intervention was shorter in both propolis groups than in the control group; lower dose, median 7 days versus 12 days (95% confidence interval CI −6.23 to −0.07; p = 0.049) and higher dose, median 6 days versus 12 days (95% CI −7.00 to −1.09; p = 0.009). Propolis did not significantly affect the need for oxygen supplementation. In the high dose propolis group, there was a lower rate of acute kidney injury than in the controls (4.8 vs 23.8%), (odds ratio OR 0.18; 95% CI 0.03–0.84; p = 0.048). No patient had propolis treatment discontinued due to adverse events.
Addition of propolis to the standard care procedures resulted in clinical benefits for the hospitalized COVID-19 patients, especially evidenced by a reduction in the length of hospital stay. Consequently, we conclude that propolis can reduce the impact of COVID-19.
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•124 hospitalized COVID-19 patients were randomized into three groups.•0, 400 or 800 mg/day of a standardized Brazilian green propolis was provided.•Adjunct treatment with propolis anticipated hospital release by five to six days.•The 800 mg propolis dose reduced kidney damage associated with COVID-19.•Propolis was safe and effective as an adjunct treatment.
Papillary endothelial hyperplasia (PEH) is an uncommon benign vascular proliferation appearing in soft tissues in different body areas including the breast, which may be related to radiation therapy. ...A 48‐year‐old woman previously treated for breast cancer with mastectomy followed by radiation therapy and reconstruction with an implant presented with a newly developing mass in the implant capsule. Pathological diagnosis was PEH. Imaging features of this rare entity are described, and lesions included in differential diagnosis are discussed.
Photo-identification (photo-id) is a method used in field studies by biologists to monitor animals according to their density, movement patterns and behavior, with the aim of predicting and ...preventing ecological risks. However, these methods can introduce subjectivity when manually classifying an individual animal, creating uncertainty or inaccuracy in the data as a result of the human criteria involved. One of the main objectives in photo-id is to implement an automated mechanism that is free of biases, portable, and easy to use. The main aim of this work is to develop an autonomous and portable photo-id system through the optimization of image classification algorithms that have high statistical dependence, with the goal of classifying dorsal fin images of the blue whale through offline information processing on a mobile platform. The new proposed methodology is based on the Scale Invariant Feature Transform (SIFT) that, in conjunction with statistical discriminators such as the variance and the standard deviation, fits the extracted data and selects the closest pixels that comprise the edges of the dorsal fin of the blue whale. In this way, we ensure the elimination of the most common external factors that could affect the quality of the image, thus avoiding the elimination of relevant sections of the dorsal fin. The photo-id method presented in this work has been developed using blue whale images collected off the coast of Baja California Sur. The results shown have qualitatively and quantitatively validated the method in terms of its sensitivity, specificity and accuracy on the Jetson Tegra TK1 mobile platform. The solution optimizes classic SIFT, balancing the results obtained with the computational cost, provides a more economical form of processing and obtains a portable system that could be beneficial for field studies through mobile platforms, making it available to scientists, government and the general public.
Incidence of thrombotic events associated to Coronavirus disease-2019 (COVID-19) is difficult to assess and reported rates differ significantly. Optimal thromboprophylaxis is unclear.
We aimed to ...analyze the characteristics of patients with a confirmed thrombotic complication including inflammatory and hemostatic parameters, compare patients affected by arterial vs venous events and examine differences between survivors and non-survivors. We reviewed compliance with thromboprophylaxis and explored how the implementation of a severity-adjusted protocol could have influenced outcome.
Single-cohort retrospective study of COVID-19 patients admitted, from March 3 to May 3 2020, to the Infanta Leonor University Hospital in Madrid, epicenter of the Spanish outbreak.
Among 1127 patients, 80 thrombotic events were diagnosed in 69 patients (6.1% of the entire cohort). Forty-three patients (62%) suffered venous thromboembolism, 18 (26%) arterial episodes and 6 (9%) concurrent venous and arterial thrombosis. Most patients (90%) with a confirmed thrombotic complication where under low-molecular-weight heparin treatment. Overt disseminated intravascular coagulation (DIC) was rare. Initial ISTH DIC score and pre-event CRP were significantly higher among non-survivors. In multivariate analysis, arterial localization was an independent predictor of mortality (OR = 18, 95% CI: 2.4–142, p < .05).
Despite quasi-universal thromboprophylaxis, COVID-19 lead to a myriad of arterial and venous thrombotic events. Considering the subgroup of patients with thrombotic episodes, arterial events appeared earlier in the course of disease and conferred very poor prognosis, and an ISTH DIC score ≥ 3 at presentation was identified as a potential predictor of mortality. Severity-adjusted thromboprophylaxis seemed to decrease the number of events and could have influenced mortality. Randomized controlled trials are eagerly awaited.
•COVID-19-associated coagulopathy and thrombogenesis are under scrutiny.•Retrospective study of 80 thrombotic events in 69 patients from a 1100-patient cohort•COVID-19 lead to a myriad of arteriovenous thrombotic events despite thromboprophylaxis.•Hemostatic and inflammatory abnormalities are associated with mortality.•Arterial thromboembolic events confer a high risk of death.
In 1950, in Coupe-Gorge cave in Montmaurin (France), at a stratigraphic level dated to the Late Middle Pleistocene (~150ky) a fragmentary mandibular symphysis was discovered. We examined the fossil ...to estimate its age at death and assessed its taxonomical classification based on mandibular morphology. A µ-CT scan was performed on the fossil to study its dental development (the 2 permanent central incisors are included). One reference collection composed of 8 Neandertals was selected, for whic...
Intradialytic hypotension, a complication of intermittent hemodialysis, decreases the efficacy of dialysis and increases long-term mortality. This study was aimed to determine whether different ...predialysis ultrasound cardiopulmonary profiles could predict intradialytic hypotension.
This prospective observational single-center study was performed in 248 critically ill patients with acute kidney injury undergoing intermittent hemodialysis. Immediately before hemodialysis, vena cava collapsibility was measured by vena cava ultrasound and pulmonary congestion by lung ultrasound. Factors predicting intradialytic hypotension were identified by multiple logistic regression analysis.
Intradialytic hypotension was observed in 31.9% (n = 79) of the patients, interruption of dialysis because of intradialytic hypotension occurred in 6.8% (n = 31) of the sessions, and overall 28-day mortality was 20.1% (n = 50). Patients were classified in four ultrasound profiles: (A) 108 with B lines > 14 and vena cava collapsibility > 11.5 mm m
, (B) 38 with B lines < 14 and vena cava collapsibility ≤ 11.5 mm m
, (C) 36 with B lines > 14 and vena cava collapsibility Di ≤ 11.5 mm m
, and (D) 66 with B lines < 14 and vena cava collapsibility > 11.5 mm m
. There was an increased risk of intradialytic hypotension in patients receiving norepinephrine (odds ratios = 15, p = 0.001) and with profiles B (odds ratios = 12, p = 0.001) and C (odds ratios = 17, p = 0.001).
In critically ill patients on intermittent hemodialysis, the absence of hypervolemia as assessed by lung and vena cava ultrasound predisposes to intradialytic hypotension and suggests alternative techniques of hemodialysis to provide better hemodynamic stability.
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