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Septic shock 3.0 criteria application in severe COvID-19 patients:An unattended sepsis population with high mortality risk

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World Journal of Critical Care Medicine 2022年第4期11卷 246-254页

作者： JoséPedro Cidade LM Coelho vasco Costa Rui Morais Patrícia Moniz Luís Morais Pedro Fidalgo António Tralhão Carolina Paulino David Nora Bernardino valério v.tor Mendes Camila Tapadinhas Pedro Povoa Polyvalent Intensive Care Unit Hospital São Francisco XavierCentro Hospitalar Lisboa OcidentalLisboa 1449-005Portugal Polyvalent Intensive Care Unit Hospital Sao Francisco XavierCentro Hospitalar Lisboa OcidentalLisbon 1449-005Portugal Polyvalent Intensive Care Unit Hospital São Francisco XavierCentro Hospitalar Lisboa OcidentalLisbon 1449-005Portugal Polyvalent Intesive Care Unit Hospital São Francisco XavierCentro Hospitalar Lisboa OcidentalLisbon 1449-005Portugal Polyvalent Intens Care Unit NOVA Medical SchoolHospital Sao Francisco XavierCentro Hospitalar Lisboa OcidentalLisbon 1449-005Portugal

BACKGROUND Coronavirus disease 2019(COvID-19)can be associated with life-threatening organ dysfunction due to septic shock,frequently requiring intensive care unit(ICU)admission,respi-ratory and vasopressor ***-fore,clear clinical criteria are pivotal for early recognition of patients more likely to need prompt organ *** most patients with severe COvID-19 meet the Sepsis-3.0 criteria for septic shock,it has been increasingly recognized that hyperlactatemia is frequently absent,possibly leading to an underestimation of illness severity and mortality *** To identify the proportion of severe COvID-19 patients with vasopressor support requirements,with and without hyperlactatemia,and describe their clinical outcomes and mortality METHODS We performed a single-center prospective cohort *** adult patients admitted to the ICU with COvID-19 were included in the analysis and were further divided into three groups:Sepsis group,without both criteria;vasoplegic Shock group,with persistent hypotension and vasopressor support without hyperlactatemia;and Septic Shock 3.0 group,with both ***-19 was diagnosed using clinical and radiologic criteria with a severe acute respiratory syndrome coronavirus 2(SARS-Cov-2)positive RT-PCR *** 118 patients(mean age 63 years,87%males)were included in the analysis(n=51 Sepsis group,n=26 vasoplegic Shock group,and n=41 Septic Shock 3.0 group).SOFA score at ICU admission and ICU length of stay were different between the groups(Pvasoplegic Shock and Septic Shock 3.0 groups when compared with the Sepsis group(Pvival curves were also different(P=0.007).ventilator-free days and vasopressor-free days were different between the Sepsis vs vasoplegic Shock and Septic Shock 3.0 groups(both P<0.001),and similar in the last two groups(P=0.128

关键词： COvID-19 Critical care SARS-Cov-2 Septic shock Lactate Sepsis 3.0 criteria

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梦中的橄榄树葡萄牙某别墅

室内设计与装修 2013年第2期 48-54页

作者： v.tor vilhena 秋落

葡萄牙南部的阿尔维加是著名的旅游胜地，阳光，海岸，使这里成为许多英国人首选的度假地点。房屋的主人也是如此热爱这片土地，夏末的某日，在透出温暖色彩的阳光下，他选定了这个地址来建造自己的新别墅。房屋的主人还给这个别墅起了... 详细信息

葡萄牙南部的阿尔维加是著名的旅游胜地，阳光，海岸，使这里成为许多英国人首选的度假地点。房屋的主人也是如此热爱这片土地，夏末的某日，在透出温暖色彩的阳光下，他选定了这个地址来建造自己的新别墅。房屋的主人还给这个别墅起了一个昵称——“MonteLuz”，充满了爱意。建筑所在的区域地形平缓，被数百株橄榄树包围，这里之前有一些旧的建筑存在。那些斑驳的墙面婉转地讲述着建筑百年的历史，旧庄园清晰的身影在橄榄树和角豆树的包围下被夕阳拉长了。

关键词：橄榄树葡萄牙别墅旅游胜地英国人建筑阳光主人

Abdominal Muscular Metastases of a Pulmonar Adenocarcinoma

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Advances in Lung Cancer 2015年第2期4卷 25-27页

作者： Joana de Castro Rocha Pedro Nuno Brandao Ana Rita Cruz v.tor valente Internal Medicine Department Centro Hospitalar do PortoPortoPortugal General Surgery Department Centro Hospitalar do PortoPortoPortugal

Metastases are synonymous of malignant neoplasm in advanced stage and so associated with a poor prognosis. As the first manifestation of cancer disease, the muscle metastasis is very rare. The definitive diagnosis of its presence is made based on histology. The authors presented the case of a patient with a lung adenocarcinoma, being with first manifestation of it, a muscle metastasis only about a month later there were clinical manifestations with imaging appearance that led to the diagnosis of a primary neoplasm. The rare manifestation of the disease motivated the study and surveillance of the patient and lead to the diagnosis.

关键词： Muscular Metastasis Adenocarcinoma Lung

Hydrogeochemical Research of Surface Water of the Córrego Sujo Watershed, Teresópolis, RJ, brazil

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Agricultural Sciences 2017年第5期8卷 435-450页

作者： Paula Coelho Araujo André S. Avelar v.tor dos Santos Costa Maria Isabel Martinez Geoscience Department Federal University of Rio de Janeiro Rio de Janeiro Brazil

The surface water quality was investigated in the Córrego Sujo watershed, located in the municipality of Teresópolis, a mountainous region in the state of Rio de Janeiro, brazil. The emphasis focused on inorganic parameters of water, since there are applications of pesticides in agricultural cultivations. The natural and anthropogenic contributions of the study area were monitored monthly in eight sites in the river channels of the drainage basin. The results were analyzed using an ICP-OES spectrophotometer and subsequently compared to Conama Resolution 357/05. In order to support the interpretation of the results of water quality, flow and precipitation data were measured in the watershed, along with the land use and vegetation cover map produced from a GeoEye satellite image. The study revealed that the surface waters were in high concentrations and above those recommended by Conama Resolution. It was noted also that the lithological and pedological variables influenced the results of water quality. Regarding seasonality, it has not been possible to establish a common standard to all elements in the rainy season or dry season, however, in the analysis of each parameter separately, there was evidence of a concentration distribution in temporal variation. Therefore, the results of this study indicate that it is also necessary to highlight these issues in the territorial planning of the municipality and in the management of the Committee of Rio Piabanha watershed, to avoid the increasing of uncontrolled expansion of irrigated crops and intensive use of agrochemical inputs.

关键词： Hydrogeochemistry Natural and Anthropogenic Influences Land Use Surface Waters Rivers

A PCR and RFLP-based molecular diagnostic algorithm for visceral leishmaniasis

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Asian Pacific Journal of Tropical Medicine 2020年第2期13卷 62-70页

作者： Natalia Souza de Godoy Manoel Sebastiao da Costa Lima-Junior Jose Angelo Lauletta Lindoso vera Lucia Pereira-Chioccola Thelma Suely Okay Lucia Maria Almeida braz Laboratorio de Parasitologia Médica Departamento de Moléstias Infecciosas e Parasitárias do Hospital das Clinicas HCFMUSPFaculdade de MedicinaUniversidade de Sao PauloSao PauloBrazil Laboratorio de Imunopatologia e Biologia Molecular-Instituto Aggeu Magalhaes/IAM-FIOCRUZ RecifeBrazil Laboratorio de Soroepidemiologia e Imunobiologia-FMUSP Sao PauloBrazil Laboratorio de Biologia Molecular de Parasitas e Fungos-Instituto Adolfo Lutz Sao PauloBrazil Laboratorio de Parasitologia-Instituto de Medicina Tropical de Sao Paulo-USP Sao PauloBrazil

Objective:To determine an algorithm for molecular diagnosis of visceral leishmaniasis(vL)by kinetoplast DNA(kDNA)(Rv1/Rv2)and internal transcriber spacer(ITS1)(LITSR/L5.8 S)polymerase chain reaction(PCR),complemented by ITS 1 PCR restriction fragment length polymorphism(RFLP),using peripheral blood or bone marrow aspirate from patients with suspected ***:Biological samples were submitted to the gold standard for the diagnosis of vL and molecular diagnosis represented by ITS 1 PCR,kDNA PCR,and ITS 1 PCR *** samples were obtained from seven groups:groupⅠ,82 samples from patients with confirmed vL;groupⅡ,16 samples from patients under treatment for vL;groupⅢ,14 samples from dogs with canine visceral leishmaniasis(CvL);groupⅣ,a pool of six experimentally infected sandflies(Lutzomya longipalpis);group v,18 samples from patients with confirmed tegumentary leishmaniasis(TL)and groupsⅥandⅦwere from control groups without ***:The following gold standard and molecular examination results were obtained for each of the seven groups:groupⅠ:parasitologic and immunochromatographic tests showed a sensitivity of 76.3%(61 of 80)and 68.8%(55 of 80),respectively,and a sensitivity of 97.6%(80 of 82)and 92.7%(76 of 82)by ITS1 and kDNA PCR,*** ITS1 PCR RFLP(HaeⅢ)analysis of the 80 positive samples,52.5%(42 of 80)generated three fragments of 180,70,and 50 bp,corresponding to the pattern of Leishmania infantum infantum;groupⅡ:negative for the parasitologic methods and positive for IrK39(100%,16 of 16),presented 12.5%(2 of 16)of positivity by ITS 1 PCR and 25.0%(4 of 16)by kDNA PCR;groupⅢ:positive in the parasitologic and serologic tests(100%,14 of 14),presented 85.7%(12 of 14)of positivity by ITS1 PCR and kDNA ***1 PCR RFLP showed that 83.3%(10 of 12)of the canine samples contained parasites with profiles similar to ***;groupⅣpresented amplifications by ITS1 PCR and kDNA ***1 PCR products were analyzed by RFLP,generating a profile similar to

关键词： Leishmania infantum Molecular diagnosis visceral leishmaniasis PCR RFLP

The Graft Thickness in Descemet Stripping Automated Endothelial Keratoplasty:What Is the Importance to the Final visual Outcome?

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Open Journal of Ophthalmology 2017年第3期7卷 167-175页

作者： Diana Cristóvao Ana Fonseca Nuno Alves v.tor Maduro Joao Feijao Pedro Candelária Instituto de Oftalmologia Dr.Gama Pinto(IOGP) LisbonPortugal Centro Hospitalar de Lisboa Central(CHLC) LisbonPortugal

Introduction: Descemet Stripping Automated Endothelial Keratoplasty (DSAEK) is currently considered the procedure of choice for the treatment of endothelial dysfunctions. Despite DSAEK being a promising procedure to improve visual acuity (vA), the ideal graft thickness donor still remains under discussion. Purpose: To analyze the influence of graft thickness on postoperative vA and complications in DSAEK surgery. Methods: Retrospective study of 112 eyes that underwent DSAEK surgery. Donor grafts were obtained by dissection with automatic microkeratome, using different head sizes. Central corneal thickness (CCT) of donor corneas before dissection was measured by ultrasound pachymetry. The choice of the cutting depth was based on CCT measurements and the final desired residual corneal thickness, corresponding to the estimated donor graft thickness (EDGT). The eyes were divided into 3 groups, depending on the EDGT: 200 μm (Group 3). Intraoperative, postoperative complications and the best corrected visual acuity (BCvA) at 6 months postoperatively were evaluated, comparing these 3 groups. Results: The average EDGT was 164 ± 10 μm in Group 1188 ± 7 μm in Group 2 and 234 ± 30 μm in Group 3. At 6 months postoperative the average BCvA was significantly better in Group 1 (BCvA: 0.74 ± 0.20), compared to Group 2 (BCvA: 0.54 ± 0.20) and Group 3 (BCvA: 0.39 ± 0.18). Intraoperative and postoperative complications included: graft perforation during cutting (0.9% of cases), graft rejection (3.6%), primary graft failure (4.5%), and graft detachment (3.6%). Its distribution was uniform between the 3 groups. Conclusion: The study proves that DSAEK is an effective surgical technique for the treatment of endothelial dysfunction, demonstrating that the use of thinner grafts (EDGT ve the final visual outcome, with a significant improvement on BCvA, without increasing the risk of complications.

关键词： DSAEK Graft Thickness visual Acuity Complications

Mixed-Species Allometric Equations to Quantify Stem volume and Tree Biomass in Dry Afromontane Forest of Ethiopia

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Open Journal of Forestry 2022年第3期12卷 263-296页

作者： Mindaye Teshome Carlos Moreira Miquelino Eleto torres Gudeta Weldesemayat Sileshi Patricia Povoa de Mattos Evaldo Muñoz braz Hailemariam Temesgen Samuel José Silva Soares da Rocha Mehari Alebachew Departamento de Engenharia Florestal Universidade Federal de Vi&#231 osa (UFv) Vi&#231 osa MG Brazil Central Ethiopia Environment and Forest Research Centre Addis Ababa Ethiopia University of Kwazulu-Natal Pietermaritzburg South Africa Embrapa Florestas Colombo PR Brazil Department of Forest Engineering Resources and Management College of Forestry Oregon State University Corvallis USA Departamento de Ciências Florestais Universidade Federal de Lavras (UFLA) Lavras MG Brazil

volume and biomass equations are essential tools to determine forest productivity and enable forest managers to make informed decisions. However, volume and biomass estimation equations are scarce for Afromontane forests in Africa in general and Ethiopia in particular. This limits our knowledge of the standing volume of wood, biomass, and carbon stock of the forests therein. In this study, we developed a new mixed-species volume and biomass equations for Afromontane forests and compared them with generic pantropical and local models. A total of 193 sampled trees from seven dominant tree species were used to develop the equations. various volume and biomass equations were fitted using robust linear and nonlinear regression. Model comparison indicated that the best model to estimate stem volume was ln(v)=-9.909+ 0.954*ln(d2h), whereas the best model to estimate biomass was ln(b)=-2.983+ 0.949*ln(ρd2h) . These equations explained over 85% of the variations in the stem volume and biomass measurements. The mean density and basal area of trees in the forest with d ≥ 2 cm was 631.5 stems·ha-1 and 24.4 m2·ha-1. Based on the newly developed equations, the forest has on average 303.0 m3·ha-1 standing volume of wood and 283.8 Mg·ha-1 biomass stock. The newly developed allometric equations derived from this study can be used to accurately determine the stem volume, biomass, and carbon storage in the Afromontane forests in Ethiopia and elsewhere with similar stand characteristics and ecological conditions. By contrast, the generic pan-tropical and other local models appear to provide biased estimates and are not suitable for dry Afromontane forests in Ethiopia. The estimated stem biomass and carbon stock in the Chilimo forest are comparable with the estimates from various tropical forests and woodlands elsewhere in Africa, indicating the importance of dry Afromontane fores

关键词： Carbon Stock Site-Specific Model Robust Regression Natural Forest

Autoimmune hepatitis in a patient infected by HIv-1 and under highly active antiretroviral treatment:Case report and literature review

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World Journal of Immunology 2014年第3期4卷 194-198页

作者： Marta Casal Moura Edite Pereira v.tor braz Catarina Eloy Joanne Lopes Fátima Carneiro José Paulo Araújo Faculdade de Medicina da Universidade do Porto 4200-319 PortoPortugal Servico de Medicina Interna Centro Hospitalar de Sao Joao4200-319 PortoPortugal Serviao de Anatomia Patológica Centro Hospitalar de Sao Joao4200-319 PortoPortugal

Liver disease has recently been described as an important cause of morbidity and mortality in patients infected with human immunodeficiency virus(HIv). Liver test changes are useful surrogates of the burden of liver disease. Previous studies have shown that transaminase elevations are frequent among these patients. The cause of those changes is harder to establish in HIv-patients. We present a 61-year-old caucasian male,diagnosed with HIv type 1 infection since 1998,under highly active antiretroviral treatment(HAART),with virological suppression and immunological recovery. He presented in a follow-up laboratory workup high values of transaminases,arthralgia at the hip joints and hepatomegaly. Liver function tests were normal. The antibodies to hepatitis viruses were negative. However,autoimmune study and liver biopsy were compatible with autoimmune hepatitis(AIH). The AIH is a rare di-agnosis in HIv-infected patients perhaps because the elevation of transaminases and changes in liver function tests are often associated to HAART or to other possible liver diseases,namely viral hepatitis and non-alcoholic steatohepatitis. The diagnosis may be underestimated. There are no specific recommendations available for the treatment of HIv-associated AIH although the immunosupression with slower tapering seems the most reasonable approach.

关键词： Autoimmune hepatitis Human immunode-fciency virus type 1 Highly active antiretroviral treat-ment Liver tests Liver biopsy

Linear scaling Coulomb interaction in the multiwavelet basis,a parallel implementation

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International Journal of Modeling, Simulation, and Scientific Computing 2014年第S1期5卷 28-50页

作者： Stig Rune Jensen Jonas Jusélius Antoine Durdek tor Fl˚a Peter Wind Luca Frediani Department of Physics and Technology Centre for Theoretical and Computational Chemistry UiT The Arctic University of Norway N-9037 TromsøNorway High Performance Computing Group Centre for Theoretical and Computational Chemistry UiT The Arctic University of Norway N-9037 TromsøNorway Department of Mathematics and Statistics Centre for Theoretical and Computational Chemistry UiT The Arctic University of Norway N-9037 TromsøNorway Department of Chemistry Centre for Theoretical and Computational Chemistry UiT The Arctic University of Norway N-9037 TromsøNorway

We present a parallel and linear scaling implementation of the calculation of the electrostatic potential arising from an arbitrary charge *** approach is making use of the multi-resolution basis of *** potential is obtained as the direct solution of the Poisson equation in its Green’s function integral *** the multiwavelet basis,the formally non local integral operator decays rapidly to negligible values away from the main diagonal,yielding an effectively banded structure where the bandwidth is only dictated by the requested *** sparse operator structure has been exploited to achieve linear scaling and parallel *** has been achieved both through the shared memory(OpenMP)and the message passing interface(MPI)*** implementation has been tested by computing the electrostatic potential of the electronic density of long-chain alkanes and diamond fragments showing(sub)linear scaling with the system size and efficent parallelization.

关键词： Multiwavelets electrostatic potentials Poisson equation integral operators linear scaling parallel implementation