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Risk Factors for Surgical Site Infection after Hip Arthroplasty: A Multicentric Study

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Surgical Science 2016年第2期7卷 58-64页

作者： Gabriel B. Tofani gustavo P. Irffi Lucas F. silva Cynthia C. M. da silva Bráulio R. G. M. Couto Gilberto D. Miranda Carlos E. F. Starling Institute of Biological Sciences Centro Universitário de Belo Horizonte—UniBH Belo Horizonte Brazil Institute of Engineering and Technology Centro Universitário de Belo Horizonte—UniBH Belo Horizonte Brazil Faculdade de Ciências Médicas e da Saúde de Juiz de Fora—SUPREMA Juiz de Fora Brazil Hospitals Life Center Vera Cruz and Baleia Belo Horizonte Brazil

The objective of this study is to answer three main questions: What is the risk of wound infection for patients undergoing hip arthroplasty? What are the main etiologicagents of surgical site infection (SSI)? What are the risk factors most associated with surgical site infection? Method: This was a multicentric, retrospective cohort study which analyzed data collected in five general hospitals in Belo Horizonte, Brazil, between the period of January 2009 and December 2013. The continuous parameters studied were age, length of hospital stay before surgery, duration of surgery, number of professionals at surgery and number of hospital admissions. Categorical variables were surgical wound classification (clean, clean contaminated, contaminated, dirty/infected), American Society of Anesthesiologists (ASA) score (I, II, III, IV, V), type of surgery (elective, emergency), general anesthesia (yes, no), prophylactic antibiotic (yes, no), trauma surgery (yes, no) and Nosocomial Infections Surveillance (NNIS) risk index (IRIC = 0, 1, 2, 3). Results: Estimated SSI risk was 3.2% (95% C.I. = 2.6% to 4.1%) and risk of osteomyelitis was 0.6% (95% C.I. = 0.4% to 1.1%). ASA score > 2, general anesthesia, length of hospital stay before surgery higher than four days, more than two professionals at surgical field and duration of surgery higher than five hours were risk factors for SSI after hip prosthesis (p 0.100). Each modified NNIS risk category increased the chance of a patient being infected by almost three times, when compared with the previous category (OR = 2.82;p = 0.011).

关键词： Surgical Site Infection Hip Arthroplasty Hip Replacement Risk Factors

Construction Processes Paradigm and Reinforcement Alternatives for Tailings dam Soil

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Journal of Environmental Protection 2023年第3期14卷 213-229页

作者： Magno André Oliveira Lucas Redoan Cecílio Campos Marcela Cristina Costa Branco Junia Lúcio de Castro Borges gustavo Filemon Costa Lima Alan Rodrigues Teixeira Machado Augusto Cesar da silva Bezerra School of Mines Geotechnics Nucleus Federal University of Ouro Preto Ouro Preto Brazil Institute of Geosciences Federal University of Pará Belém Brazil Transport Engineering Department Federal Center for Technological Education of Minas Gerais Belo Horizonte Brazil Department of Geography Federal University of Minas Gerais Belo Horizonte Brazil Department of Exact Sciences University of the State of Minas Gerais João Monlevade Brazil

In the last decade, Brazil was the scene of two of the world’s biggest disasters related to mining tailings dams. The collapse of the Mariana and Brumadinho dams was catastrophic event that brought to light major environmental and humanitarian crises. Facts like this incite debate on the safety of dam construction methods and highlight the need for a broad discussion of dam safety legislation in the country. From the above, this paper promotes a review of various forms of construction of tailings dams and their associated problems, as well as discusses the techniques for soil reinforcement and their construction methods. The work also brings an overview of the Brazilian dams from April to July 2019, tracing the context of the Brazilian tailings dams months after the tragedy of Brumadinho. The methodology includes a robust literature review and discourse analysis. In Brazil, the number of ruptured dams is alarming, especially in the state of Minas Gerais, in which more than 7 have broken in the last two decades. Among the damages, the deaths impact society abruptly and were cataloged 455 deaths, of which 216 correspond to the rupture of the dam of the Córrego do Feijão mine in Brumadinho. To evaluate and diagnose a dam, one should consider ordinance N ° 70,389, 2017 revoked by Resolution ANM n ° 95, of February 7, 2022. In this context, in March 2019, we experienced several disturbing situations regarding dam instability in the state of Minas Gerais, being categorized as risky structures. To exemplify, one can cite dams classified as level 2 risk that became level 3. Due to the above facts, several studies are being conducted to improve soil aspects. For example, we highlight the increase in soil resistance that can be done using commercial and alternative materials available in the environment.

关键词： dams Reinforcement Rupture Minas Gerais

Evaluation of the Eta Simulations Nested in Three Global Climate Models

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American Journal of Climate Change 2014年第5期3卷 438-454页

作者： Sin Chan Chou André Lyra Caroline Mourao Claudine Dereczynski Isabel Pilotto Jorge Gomes josiane Bustamante Priscila Tavares Adan silva daniela Rodrigues Diego Campos Diego Chagas gustavo Sueiro Gracielle Siqueira Paulo Nobre josé Marengo National Institute for Space Research Cachoeira PaulistaBrazil Department of Meteorology Federal University of Rio de JaneiroRio de JaneiroBrazil Centre for Monitoring and Warning of Natural Disasters Cachoeira PaulistaBrazil

To provide long-term simulations of climate change at higher resolution, Regional Climate Models (RCMs) are nested in global climate models (GCMs). The objective of this work is to evaluate the Eta RCM simulations driven by three global models, the HadGEM2-ES, BESM, and MIROC5, for the present period, 1961-1990. The RCM domain covers South America, Central America, and Caribbean. These simulations will be used for assessment of climate change projections in the region. Maximum temperatures are generally underestimated in the domain, in particular by MIROC5 driven simulations, in summer and winter seasons. Larger spread among the simulations was found in the minimum temperatures, which showed mixed signs of errors. The spatial correlations of temperature simulations against the CRU observations show better agreement for the MIROC5 driven simulations. The nested simulations underestimate precipitation in large areas over the continent in austral summer, whereas in winter overestimate occurs in southern Amazonia, and underestimate in southern Brazil and eastern coast of Northeast Brazil. The annual cycle of the near-surface temperature is underestimated in all model simulations, in all regions in Brazil, and in most of the year. The temperature and precipitation frequency distributions reveal that the RCM and GCM simulations contain more extreme values than the CRU observations. Evaluations of the climatic extreme indicators show that in general hot days, warm nights, and heat waves are increasing in the period, in agreement with observations. The Eta simulations driven by HadGEM2-ES show wet trends in the period, whereas the Eta driven by BESM and by MIROC5 show trends for drier conditions.

关键词： South America Climate Downscaling Model Evaluation Climatic Extreme Indicators Eta Model

Keloid of Ears: Recurrence and Its Complications

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Modern Plastic Surgery 2021年第1期11卷 6-13页

作者： josé Humberto Cardoso Resende Ana Paula Rodrigues de Souza Ellen Karoliny de Souza Arruda Guilherme Portilho Soares Gumercindo Joã o de Morais silva gustavo Ferreira Rocha Pedro Martins Milani Thiago Calandria Obeid Tiesca Câ ndida de Melo Emídio silva Falcã o Brasileiro UNIFAN Aparecida de Goiania Brasil

In this case report, we present a male patient who arrived at the hospital for the first time at the age of 8 with giant keloids in both ears and diagnosed by the Dermatology and Plastic Surgery as having the “Disease of Jorge Lobo”, which is a fungal infection due to the story of the endemic characteristics. After the first surgical intervention, he received guidance from the team for keloids and left the hospital using elastic mesh and a request to change the place where he lived to reduce his contact with the fungi. Fourteen years later, the patient returned to the Plastic Surgery Service having even larger keloids in both ears, twice the size than the first time. We did the second surgical intervention to remove it, but with the patient’s commitment that he would correctly comply with the guidelines determined by the surgical team. After finishing all the steps and a post-operative for the case, we observed the satisfaction and the increase of the patient’s mood, happier and without the embarrassment of that physical defect.

关键词： Keloid Fibrosis Disease Syndrome Scar Relapse

Fatty liver disease,an emerging etiology of hepatocellular carcinoma in Argentina

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World Journal of Hepatology 2018年第1期10卷 41-50页

作者： Federico Pinero josefina Pages Sebastián Marciano Nora Fernández Jorge silva Margarita Anders Alina Zerega Ezequiel Ridruejo Beatriz Ameigeiras Claudia D’Amico Luis Gaite Carla Bermúdez Manuel Cobos Carlos Rosales gustavo Romero Lucas McCormack Virginia Reggiardo Luis Colombato Adrián Gadano Marcelo silva Hepatology and Liver Transplantation Unit Hospital Universitario AustralBuenos Aires 1629Argentina Hepatology Section Liver Transplant ProgramDepartment of Academic ResearchHospital Italiano from Buenos AiresBuenos Aires 1424Argentina Sanatorio Trinidad San Isidro Buenos Aires 1642Argentina Clínica Privada San Fernando Buenos Aires 2013Argentina Hepatology and Gastroenterology Hospital BritánicoBuenos Aires 1280Argentina Hepatobiliary Surgery Hospital G RawsonSan Juan 5400Argentina Department of Hepatology and Liver Transplant Program Hospital AlemanBuenos Aires 1118Argentina Department of Hepatology and Liver Transplantation Sanatorio AllendeCórdoba 5016Argentina Hepatology Section Department of MedicineCentro de Educación Médica e Investigaciones Clínicas Norberto Department of Hepatology Hospital Ramos MejíaBuenos Aires 1221Argentina Department of Hepatology Centro Especialidades Medicas Ambulatorias(CEMA)Mar del Plata 7600Argentina Department of Hepatology and Liver Transplantation Clínica de Nefrología de Santa FeSanta Fe 3000Argentina Department of Hepatology and Gastroenterology Hospital C Bonorino UdaondoBuenos Aires 1264Argentina Department of Hepatology and Gastroenterology Hospital CentenarioSanta Fe 2002Argentina

AIM To investigate any changing trends in the etiologies of hepatocellular carcinoma(HCC) in Argentina during the last years. METHODS A longitudinal cohort study was conducted by 14 regional hospitals starting in 2009 through 2016. All adult patients with newly diagnosed HCC either with pathology or imaging criteria were included. Patients were classified as presenting non-alcoholic fatty liver disease(NAFLD) either by histology or clinically, provided that all other etiologies of liver disease were ruled out, fatty liver was present on abdominal ultrasound and alcohol consumption was excluded. Complete follow-up was assessed in all included subjects since the date of HCC diagnosis until death or last medical *** A total of 708 consecutive adults with HCC were included. Six out of 14 hospitals were liver transplant centers(n = 484). The prevalence of diabetes mellitus was 27.7%. Overall, HCV was the main cause of liver disease related with HCC(37%) including cirrhotic and non-cirrhotic patients, followed by alcoholic liver disease 20.8%, NAFLD 11.4%, cryptogenic 9.6%, HBV 5.4% infection, cholestatic disease and autoimmune hepatitis 2.2%, and other causes 9.9%. A 6-fold increase in the percentage corresponding to NAFLDHCC was detected when the starting year, i.e., 2009 was compared to the last one, i.e., 2015(4.3% vs 25.6%; P < 0.0001). Accordingly, a higher prevalence of diabetes mellitus was present in NAFLD-HCC group 61.7% when compared to other than NAFLD-HCC 23.3%(P < 0.0001). Lower median AFP values at HCC diagnosis were observed between NAFLD-HCC and non-NAFLD groups(6.6 ng/m L vs 26 ng/m L; P = 0.02). Neither NAFLD nor other HCC etiologies were associated with higher *** The growing incidence of NAFLD-HCC documented in the United States and Europe is also observed in Argentina, a confirmation with important Public Health implications.

关键词： Hepatocellular carcinoma Etiology Fatty liver South America

Comparative Study of Collagen Stimulation Using Semi-Ablative and Non-Ablative Radiofrequency

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Journal of Biosciences and Medicines 2022年第6期10卷 79-89页

作者： Patrícia Froes Meyer Rodrigo Marcel Valentim da silva Eneida De Morais Carreiro Rafaella Rêgo Maia Stephany Luanna Queiroga Farias Ciro dantas Soares Yuri Alexander Afonso gustavo Felipe Pasqual Silene Bazi Ribeiro Roberto Tiago Alves Pinheiro University Centre of Rio Grande do Norte (UNIRN) Natal Brazil Estácio de Sá University Natal Brazil Federal University of Rio Grande do Norte Natal Brazil Potiguar University (UNP) Natal Brazil Campinas State University (UNICAMP) Campinas Brazil Brazilian Society of Plastic Surgery Brazil FSG University Centre of Serra Gaúcha Caxias do Sul Brazil MARC Institute Miami USA

Objective: Comparison between semi-ablative and non-ablative radiofrequency for collagen stimulation. Method: Three volunteers with scheduled surgical procedures of abdominoplasty were selected. After the evaluation, the abdominal area was divided into three quadrants, with the right region receiving monopolar non-ablative radiofrequency (RF) application. In contrast, the left region received fractionated radiofrequency (FRF) application, using three different needle sizes (0.5, 1.5, and 3.0 mm), and the intermediate area was kept as a control. After 24 hours, surgery was performed, and the skin flaps were collected for histological and immunohistochemical analyses. Results: An increase in total collagen and type I collagen was observed in the treated groups. There was also an increase in the expression of COX-2, CD68 positive cells (macrophages), and lymphocyte markers (CD3, CD20, and NK-CD57). Furthermore, it was seen that only the use of 3.0-mm needles kept the channels open in the superficial tissue after 24 hours. There were no significant differences between the modalities. Conclusion: Non-ablative and sub-ablative radiofrequency have positive and effective results for flaccidity, demonstrating the success in collagen production. Furthermore, this study is the first to present channel opening and permanence time, which are important to optimize the action of drug delivery.

关键词： Collagen Flaccidity Radiofrequency Drug Delivery

Residual Effect of Zinc Application Doses and Methods on Nutrition and Productivity of Corn

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American Journal of Plant Sciences 2015年第2期6卷 298-305页

作者： Gabriela Furtado Mari Renato de M. Prado Anelisa de Aquino Vidal Lacerda Soares gustavo Caione Cid Naudi silva Campos Departamento de Solos e Adubos Faculdade de Ciências Agrárias e Veterinárias Univesidade do Estado de S&atildeo Paulo/UNESP Jaboticabal Brazil Agência Paulista de Tecnologia dos Agronegócios Marília Brazil Universidade do Estado do Mato Grosso (UNEMAT) Alta Floresta Brazil

Zinc is the micronutrient that presents the greatest response in corn grain production. However, the mode of application and the dose used are decisive factors with respect to fertilizer efficiency in the crop. Thus, the objective of the present study was to evaluate the residual effect of zinc application methods and rates on corn nutrition and productivity. The experiment was conducted in the experimental area of the Teaching, Research and Production Farm of the FCAV/UNESP. Soil in the area is classified as dystrophic dark-Red Latosol (dRL). The experimental setup consisted of a randomized complete block design with four replications. Treatments included three localized Zn doses applied to the soil (planting row);three Zn doses incorporated into the soil at depth of 0 - 20 cm;foliar application, seed application and treatment without addition of Zn. Two evaluations of growth during cultivation were performed. Grain productivity of the crop and the zinc content in soil, leaves and seeds were evaluated. Foliar spraying with Zn simultaneously promoted increased leaf Zn content and basal diameter of the plant. The Zn contents in grains and in the soil, as well as grain yield, were not affected by the Zn application methods or the applied doses. The residual effect of incorporated Zn doses was observed only in the basal diameter and number of leaves at 60 days after emergence.

关键词： Zea mays L. Fertilization Fertilizer Management Micronutrient

Situations of Domestic Violence against Children and Adolescents in a Northeastern Brazilian Capital

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Open Journal of Nursing 2016年第9期6卷 633-642页

作者： Eliane Santos Cavalcante Francisco Arnoldo Nunes de Miranda Lannuzya V. e Oliveira Glauber W. dos Santos silva gustavo Ávila Dias Romeika C. F. de Sena Suerda Lillian da Fonseca Lins Cleonice A. A. Cavalcante Izaura Luzia Silvério Freire João E. da Costa Health School Federal University of Rio Grande do Norte Natal Brazil Nursing Department Postgraduate Program in Nursing Federal University of Rio Grande do Norte Natal Brazil Natal Health City Department Natal Brazil

Objective: To describe the epidemiological profile of children and adolescents who are victims of domestic violence. Method: This is a cross sectional and descriptive study, following a quantitative approach, conducted from September to December 2013, at the SOS CHILD service, in the city of Natal, Rio Grande do Norte, Brazil. The research protocol was approved by CEP/UFRN under CAAE 0166.***.051.000-11. Results: In the analysis of 69 children, the results were presented from three points of view: 1) the victim—female (56.5%), aged one to 11 years old (66.7%) and lived with one of the parents (43.5%);2) the abuser—female (60.9%) in the 14 - 23 years old and 34 - 43 years old, with the same percentage (24.6%), history of alcohol use and abuse (42.0%), the mother was the one who attacked the most (34.7%);3) types of violence, among the physical ones, the most frequent were slaps (43.2%) and punches (18.9%);the prevalence, among the psychological violence, were curses (35.4%) and abuse (27.8%);negligence, omission of care (73.5%), deprivation of care for personal appearance (18.4%);among sexual violence: sexual caresses (57.1%) and forced sex (42.9%). Conclusion: Children and adolescents placed in an unfavorable social-economic context, under the care of mothers with a history of use and abuse of alcohol and other drugs, are more vulnerable to intra-domiciliary violence.

关键词： Exposure to Violence Domestic Violence Child Health Adolescent Health

A Notation to Support Exploring Collaboration in Design Teams

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Journal of Civil Engineering and Architecture 2020年第12期14卷 644-657页

作者： Gil Garcia de Barros Luiz gustavo Bertocchi Alves da silva School of Architecture and Urban Design University of Sao Paulo(FAUUSP)Rua do Lago876Sao PauloSP 05508-080Brazil

Collaboration in large projects is a major challenge for contemporary architectural practice and this paper presents a notation for describing and analyzing how these collaborations can take *** on an extensive literature review some opportunities were found for the development of a notation that combined three particular aspects:network diagrams,Euler diagrams and a model from architectural *** exploratory case study was conducted based on the collaboration during a complex architectural project,which combined three approaches:document analysis,semi-structured interviews with key stakeholders and a comparison of the documents with results from the *** notation demonstrated to be suitable for two purposes:to improve the understanding of particular design events and as support material for presenting and exploring *** indicate that the notation was suitable,comprehensible and flexible,and it demonstrated good value when used in speculative ways,such as an intermediary design artifact that supports discussion and improvements in the collaboration process,which indicates promising future *** can also be argued that,similar to a sketch,the notation can also support the process of planning and“designing”the interaction between teams in design fields and even in other project-based organizations.

关键词： Architectural design collaboration in design design methods design artifacts design cognition design tools visualization techniques