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Delivery of essential pediatric congenital surgical care within Brazil’s universal health coverage system:a national survey of pediatric surgeons

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World Journal of Pediatric Surgery 2023年第3期6卷 136-146页

作者： Paul R Truche Abbie E Naus Fabio Botelho Julia Ferreira Alexis Bowder Luke Caddell Kathrin Zimmerman Isabella Maria de Freitas Faria Bellisa Caldas Lopes Eduardo Corrêa Costa Fernanda Lage Lima Dantas Augusto J S A Cavalcante Carlos A L B Carvalho Simone Abib David P Mooney nivaldo alonso Program in Global Surgery and Social Change Harvard Medical SchoolBostonMassachusettsUSA Department of Surgery Rutgers Robert Wood Johnson Medical SchoolNew BrunswickNew JerseyUSA Department of Pediatric Surgery McGill UniversityMontrealQuébecCanada Department of Surgery Medical College of WisconsinMilwaukeeWisconsinUSA Division of Otolaryngology-Head and Neck Surgery Department of SurgeryUniversity of Wisconsin-Madison School of Medicine and Public HealthMadisonWisconsinUSA School of Medicine UFMGBelo HorizonteMinas GeraisBrazil Department of Pediatric Surgery Instituto de Medicina Integral Professor Fernando FigueiraRecifeBrazil Department of Pediatric Surgery Hospital de Clinicas de Porto AlegrePorto AlegreBrazil Department of Pediatric Surgery Federal University of AcreRio BrancoBrazil Department of Pediatric Surgery Hospital Santa Casa de Belo HorizonteBelo HorizonteBrazil Department of Pediatric Surgery Federal University of Mato GrossoCuiabaBrazil Department of Pediatric Surgery UNIFESPSao PauloBrazil Department of Pediatric Surgery Boston Children's HospitalBostonMassachusettsUSA Department of Plastic Surgery University of São Paulo Institute of Biomedical SciencesSao PauloBrazil

Objective In this study,we assess the delivery of congenital pediatric surgical care under Brazil’s system of universal health coverage and evaluate differences in delivery between public and private sectors.Methods A cross-sectional national survey of pediatric surgeons in Brazil was conducted.Participants were asked which of 23 interventions identified through the Disease Control Priorities 3(Surgical Interventions for Congenital Anomalies)they perform and to report barriers faced while providing surgical care.Responses were weighted by state and stratified by sector(public vs private).Results A sample of 352 responses was obtained and weighted to represent 1378 practicing pediatric surgeons registered in Brazil during the survey time.73%spend the majority of their time working in the public sector(‘SistemaÚnico de Saúde’and Foundation hospitals),and most of them also work in the private sector.Generally,Brazilian pediatric surgeons have the expertise to provide thoracic,abdominal,and urologic procedures.Surgeons working mostly in the public sector were more likely to report a lack of access to essential medications(25%vs 9%,p<0.01)and a lack of access to hospital beds for surgical patients(52%vs 32%,p<0.01).Conclusions Brazilian pediatric surgeons routinely perform thoracic,abdominal,and urologic surgery.Those working in government-financed hospitals face barriers related to infrastructure,which may impact Brazilians who rely on Brazil’s universal health coverage system.Policies that support pediatric surgeons working in the public sector may promote the workforce available to provide congenital pediatric surgical care.

关键词： pediatric survey Brazil

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Preliminary stages before nasal reconstruction using forehead flap:restoring perinasal subunits and nostril patency

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Plastic and Aesthetic Research 2015年第1期2卷 34-37页

作者： Victor Diniz de Pochat Fernando César Câmara de Oliveira Felipe Simões da Rocha Mata Marcelo Sacramento Cunha nivaldo alonso JoséValber Lima Meneses Division of Plastic Surgery Federal University of BahiaSalvadorBahia 40110Brazil Division of Plastic Surgery University of São PauloSão Paulo 14040Brazil

Due to the complex three-dimensional structure of the nose,the repair of the nasal defect requires reconstruction of three different layers:skin envelope,osteocartilaginous framework and nasal lining.Before nasal reconstruction can be accomplished,the nose must rest on a stable platform to avoid late nasal obstructions,and septal deviations resulting from scar contraction.We present three cases of nasal reconstruction using a forehead flap in which we performed a preliminary stage to increase reliability of outcomes.

关键词： Forehead flap nasal reconstruction nostril stenosis preliminary stages

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Simulated rainfall in Brazil:An alternative for assesment of soil surface processes and an opportunity for technological development

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International Soil and Water Conservation Research 2024年第1期12卷 29-42页

作者： Camila Calazans da Silva Luz Wilk Sampaio de Almeida Adilson Pacheco de Souza nivaldo Schultz Jamil Alexandre Ayach Anache Daniel Fonseca de Carvalho Postgraduate Program in Agronomy-Soil Sciences Federal Rural University of Rio de JaneiroSeropédicaRJBrazil Agronomy Department Federal Institute of EducationScience and Technology of RondôniaAriquemesROBrazil Federal University of Mato Grosso SinopMTBrazil Federal Rural University of Rio de Janeiro SeropédicaRJBrazil Federal University of Mato Grosso do Sul Campo GrandeMSBrazil

Rainfall simulators(RS)have been used,above all,to evaluate hydrological processes related to soil water infiltration,surface runoff and soil erosion.They allow repeatability of rain application with different precipitation intensities in field and/or laboratory conditions and should produce events with physical characteristics similar to natural rain.In this manuscript,we carried out a bibliometric and scientometric analysis of studies with simulated rainfall in Brazil to assess the temporal evolution of publications,the main topics addressed and the degree of technological development of the equipment.We searched for the terms“rainfall simulator”OR“simulated rainfall”AND“Brazil”in the Scopus,Web of Science,SciELO and Google Scholar databases.We found 143 articles published in the last 37 years(1985-2022).Our findings indicate that the main research areas covered in papers are soil erosion(57.34%),soil water infiltration(24.47%),nutrient losses(9.8%)and RS development and calibration/assessment(8.39%).In recent years,the number of published papers in international high-impact factor journals has increased.Most of the papers(49.65%)refer to studies carried out by institutions located in the south and southeast regions of Brazil.Moreover,there is a large gap of studies on simulated rainfall in other regions of Brazil,where important biomes such as the Cerrado,Amazon,Caatinga,and their transitions are located.This study informs research priorities on soil erosion under simulated rainfall and provides a bibliographic database that can assist in more detailed future analyses.

关键词： Rainfall simulator Soil and water losses Soil water infiltration Bibliometrics Scientific review

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添加脂肪来源间质细胞的脂肪移植在修复颅面短小患者中的应用

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中国美容整形外科杂志 2013年第11期24卷 I0024-I0024页

作者： Daniela Y.S.Tanikawa MeireAguena Daniela F.Bueno. Maria Rita Passos.Bueno nivaldo alonso 魏峰(译者) 高景恒(译者) 袁继龙(译者) 圣保罗大学医学院整形与再造外科中心巴西圣保罗圣保罗大学生物科学学院人类基因研究中心巴西圣保罗《中国美容整形外科杂志》编辑部辽宁省人民医院整形外科

背景与目的尽管有关脂肪来源间质细胞（adipose—derived stromal cells，ADSCs）临床应用的早期报道提示其在软组织增大方面具有可行性和有效性，但仍缺乏随机性对照的临床研究类文献。因此，本研究旨在探讨一种ADSCs的快速分离方法，... 详细信息

背景与目的尽管有关脂肪来源间质细胞（adipose—derived stromal cells，ADSCs）临床应用的早期报道提示其在软组织增大方面具有可行性和有效性，但仍缺乏随机性对照的临床研究类文献。因此，本研究旨在探讨一种ADSCs的快速分离方法，以及ADSCs联合脂肪组织移植在颅面短小患者治疗中提高移植物长期存活能力的方法。方法本组14例颅面短小患者，采取自体脂肪移植治疗，分为联合ADSCs移植的实验组和未联合ADSCs移植的对照组。对脂肪组织移植物加入ADSCs之前和加入ADSCs之后活性细胞的数量进行估算，并利用流式细胞术对此类间质细胞的表面标记物进行检测。对术前和术后6个月两侧面部的CT图像进行评估。结果脂肪组织移植物加入ADSCs之前和加入ADSCs之后活性细胞的数量分别为5．6X10^5个／ml和9．9X10^5个／ml（P=0．015）。流式细胞术显示ADSCs对间质细胞标记物呈阳性（CD73和CDl05阳性率〉95％）。术后6个月，实验组存活的脂肪体积为88％，而对照组为54％（P=0．003）。结论研究结果提示，这种ADSCs的分离方式和将ADSCs加入到移植脂肪组织中的模式是有效的、安全的，其在颅面短小患者的面部塑形治疗中优于传统的脂肪注射方法。（循证医学证据等级：Ⅱ级，疗法）

关键词：脂肪移植间质细胞临床应用患者短小颅面脂肪组织移植 ADSCs

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作者回复：提上唇肌切断术及上唇复位：矫正露龈笑的联合方法

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中国美容整形外科杂志 2014年第6期25卷 I0013-I0013页

作者： Luis Henrique Ishida nivaldo alonso Luiz C. Ishida Marcus Castro Ferriera 圣保罗大学整形外科中心巴两圣保罗

我们带着极大的兴趣阅读了Polo医师关于我们提上唇肌切开术联合上唇重新定位矫治露龈笑一文的评论。我们同样阅读了他在此领域报道过的论文，并祝贺他所取得的成果。

关键词：露龈笑上唇切断术合方矫正复位唇肌作者

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提上唇肌切断术及上唇复位：矫正露龈笑的联合方法

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中国美容整形外科杂志 2014年第6期25卷 I0009-I0011页

作者： Luis H. Ishida Luiz C. Ishida Jorge Ishida Julio Grynglas nivaldo alonso Marcus C. Ferreira 圣保罗大学整形外科中心巴西圣保罗

背景与目的对牙龈过度显露的治疗方法通常包括LeFort嵌入或上颌牙龈切除术。笔者提供一种新的方法，通过降低提上唇肌功能及复位上唇的方式来减少牙龈的显露程度。方法自2008年2月至2009年3月，我们对14例牙龈过度显露的女性患者进行了... 详细信息

背景与目的对牙龈过度显露的治疗方法通常包括LeFort嵌入或上颌牙龈切除术。笔者提供一种新的方法，通过降低提上唇肌功能及复位上唇的方式来减少牙龈的显露程度。方法自2008年2月至2009年3月，我们对14例牙龈过度显露的女性患者进行了手术。分别于术前和术后6个月拍照记录。要求患者最大程度地笑，测量患者牙龈显露的最大值，并使用ImageJ软件进行分析。患者在局部麻醉下进行手术。利用骨膜剥离器，将牙龈黏膜从上颌骨上分离下来。钝性剥离上唇肌肉下方的皮肤和皮下组织。通过系带成形术延长上唇。切开双侧提上唇肌并分离。结果术后所有患者恢复良好。术前牙龈显露程度为（5．22±1．48）mm，而术后6个月为（1．91±1．50）mm。牙龈显露程度减少1．59±1．83mm，平均（1．59±4．83）mm。结论本方法可以有效减少笑时牙龈的显露程度，本组患者均取得满意疗效。

关键词：上唇复位唇肌露龈笑切断术牙龈切除术 ImageJ软件显露程度

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Soil loss and runoff obtained with customized precipitation patterns simulated by InfiAsper

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International Soil and Water Conservation Research 2022年第3期10卷 407-413页

作者： Daniel Fonseca de Carvalho Pietro Menezes Sanchez Macedo Marinaldo Ferreira Pinto Wilk Sampaio de Almeida nivaldo Schultz Department of Engineering Institute of TechnologyFederal Rural University of Rio de JaneiroSeropedicaRio de JaneiroBrazil Postgraduate Program in Agronomy-Soil Sciences Federal Rural University of Rio de JaneiroSeropedicaRio de JaneiroBrazil Agronomy Department Federal Institute of EducationScience and Technology of RondoniaCampus AriquemesRO 257Km 13AriquemesRO76870-000Brazil Department of Soil Science Institute of AgronomyFederal Rural University of Rio de JaneiroSeropedicaRJBrazil

Applying constant precipitation intensity,which does not occur in natural events,is one of the main limitations concerning rainfall simulators in soil erosion studies.The present work evaluated the InfiAsper rainfall simulator operating with a new control panel to program rainfalls with different precipitation intensities(PI).Infiltration rates and soil and water losses were evaluated in a Distrophic Acrisol(clay loam texture)with simulated rainfalls of 30 mm and duration of 40 min,considering advanced(AD),intermediate(IN),delayed(DE),and inverted intermediate(II)patterns,all with PI peaks of 110 mm h^(-1),and a constant(CT)pattern.The experimental design was in randomized blocks with five treatments(rainfall patterns)and experimental units measuring 2.5×2.5 m.The simulator worked satisfactorily,applying the rainfall according to the preconfigured programs.The simulated rainfall with the CT and II patterns did not promote runoff nor soil loss.Infiltration and runoff rates varied according to the applied rainfall pattern,reaching 97.8 and 27.3 mm h^(-1)(AD),82.1 and 39.5 mm h^(-1)(IN),and 76.2 and 49.7 mm h^(-1)(DE),respectively.Soil loss and surface runoff totaled each 4.77 g m^(-2)and 3.9 mm(AD),6.70 g m^(-2)and 6.8 mm(IN),and 6.03 g m^(-2)and 7.0 mm(DE).The InfiAsper simulator modified enables varying precipitation intensity besides obtaining satisfactory results in the field and information consistent with the expected characteristics of natural rainfall patterns.In the intermediate and delayed rainfall patterns,soil and water losses are higher than in the advanced.

关键词： Water erosion Rainfall simulator Precipitation intensity

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Growth of Variable Aspect Ratio ZnO Nanorods by Solochemical Processing

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Journal of Materials Science & Technology 2015年第1期31卷 10-15页

作者： Marivone Gusatti Daniel A.R.Souza nivaldo C.Kuhnen Humberto G.Riella Departamento de Engenharia Química e Engenharia de Alimentos Programa de Pós-Graduacao em Engenharia Química LABMAC Universidade Federal de Santa Catarina (UFSC) Campus UniversitárioCP 476 Florianópolis Santa Catarina 88040-900 Brazil

In this work,variable aspect ratio（length divided by diameter） zinc oxide nanorods were synthesized through a simple solochemical method by reacting a Zn2+precursor with sodium hydroxide at low reaction temperatures.The analysis of the X-ray diffraction data indicated that the samples had hexagonal wurtzite structure and nanometric size crystallites.The transmission electron microscopy（TEM） images of the products prepared at60 and 80 ℃ exhibited rod-like architecture,showing that the reaction temperature did not affect the ZnO morphology.The average aspect ratio of the ZnO nanorods decreased from 3.4 to 2.4 when the reaction temperature was raised from 60 to 80 ℃.The samples presented a blue shift in the excitonic absorption compared to ZnO bulk that increased alongside with reaction temperature.In addition,this research investigated the results obtained by varying the concentration of zinc chloride solution.At the same temperature,it could be verified that when the zinc concentration was increased,the diameter of the ZnO nanorods also slightly increased,and much shorter nanorods were achieved,especially in the reactions performed at 50 and 70 ℃.Finally,the growth mechanism of the ZnO nanostructures was proposed based on the results obtained by changing the zinc precursor concentration and reaction temperature.

关键词： Chemical synthesis ZnO nanorods Growth mechanism

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Water Quality Monitoring of the Bezerra River （Cascavel, Brazil） Using SR-TXRF Technique

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Journal of Chemistry and Chemical Engineering 2014年第6期8卷 587-595页

作者： Phallcha Luízar Obregón Fernando Rodolfo Espinoza-Quinones Aparecido nivaldo Módenes Center for Medical and Pharmaceutical Sciences Paraná West State University Cascavel 85819-110 Brazil Paraná West State University Toledo 85903-000 Brazil

The present study aims to monitor and assess the water quality of the Bezerra River located in the Western Brazilian Parana state. For the monitoring of river waters, six samplings were established per month during one year. As indicators of the water quality, physico-chemical parameters such as water temperature, pH, turbidity, dissolved oxygen and COD (chemical oxygen demand) were chosen, as well as trace and majority element concentrations. It is noteworthy that the mean annual values of conductivity, turbidity and COD have progressively increased along the river with maximum values after the Cascavel western sewage treatment plant. Only 13 elements were found in the six collection points, but the metallic elements Cr, Mn, Fe, Cu and Zn have shown concentrations above the maximum limits recommended by Brazilian environmental legislation, suggesting the presence of highly polluting anthropogenic sources. Correlation analyses were used to determine the spatio-variability of water quality variables. The six collection sites were grouped into two clusters, with the element composition in the first cluster (sites 1, 2 and 6) being due to strong anthropogenic activities. The study of the Bezerra River water quality could help to develop municipal environmental policies and help with the management of water conservation in the Bezerra River basin.

关键词：水质监测 RF技术巴西物理化学参数金属元素化学需氧量污水处理厂时空变异性

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Journal of Pharmacy and Pharmacology 2018年第3期6卷 248-253页

作者： Ana Beatriz Boamorte Cortela Franciele Silva Bernardo Marcos Tadao Kavanishi Vilmar Queiroz de Menezes nivaldo Cortela Faculty of Medicine Centro Universitario de Varzea Grande Varzea Grande 78110-000 Brazil Faculty of Medicine Universidade do Estado de Mato Grosso Caceres 78200-000 Brazil Hospital Regional de Caceres Dr. Antonio Fontes Universidade do Estado de Mato Grosso Caceres 78200-000 Brazil

First described in Hiroshima City Hospital in 1990, Takotsubo Cardiomyopathy emerged as an important differential diagnosis for acute coronary syndrome, since this disease mimics some commemoratives presentations of acute coronary syndrome such as chest symptoms, electrocardiographic changes and cardiac injury biomarker alteration. Also, it"s important to emphasize that, although it commonly occurs among woman, TCC can happen in males, as demonstrated in other studies which 10% of the cases occurred in male sex. In this way, this study shows the importance of Takotsubo Cardiomyopathy as a differential diagnosis for acute coronary syndrome.

关键词： Takotsubo cardiomyopathy apical ballooning broken-heart syndrome

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