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Use of regression trees to predict overweight trucks from historical weigh-in-motion data

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Journal of Traffic and Transportation Engineering(English Edition) 2020年第6期7卷 843-859页

作者： Mariana Bosso Kamilla L.Vasconcelos Linda Lee Ho Liedi L.B.Bernucci Department of Transportation Engineering University of Sao Paulo(USP)Sao PauloBrazil Department of Production Engineering University of Sao Paulo(USP)Sao PauloBrazil

The traffic of overloaded trucks is a critical problem in highways.It affects pavement performance life,reduces the service life of bridges,and has a negative impact on road safety,average speed and level of service.There are several practices to prevent the truck overloading issue,i.e.,enforcement activities to verify the truck’s compliance with the legal weight limits.This paper investigates the development of a method that uses available weigh-in-motion(WIM)data to identify overloaded truck weight and travel patterns.The proposed approach is based on regression trees method,a simple and easily understandable analytic tool used to build prediction models from a large set of data.An overall analysis of the overloaded truck regression tree model shows that the most important variable to classify and predict overloading is the truck type.Regarding the axle overloading,the most significant variable is the time of the day(most of the overloaded trucks travel at late night or early morning).The regression tree results can be used to optimize the efficiency of administration activities by planning truck enforcement operations based on the more critical scenarios.Also,the results improve the knowledge about the load characteristics of trucks,which can lead to more effective pavement management systems and more assertive pavement structure designs.

关键词： Regression piecewise Overloaded trucks Travel patterns Axle loading RPART package Enforcement activities

Intestinal complications in Brazilian patients with ulcerative colitis treated with conventional therapy between 2011 and 2020

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World Journal of Gastroenterology 2023年第8期29卷 1330-1343页

作者： Adalberta Lima Martins Rodrigo Galhardi Gasparini Ligia Yukie Sassaki Rogerio Saad-Hossne Alessandra Mileni Versut Ritter Tania Biatti Barreto Taciana Marcolino Claudia Yang Santos Espirito Santo Health Office State Office for Pharmaceutical AssistanceEspirito Santos 29056-030Brazil Department of Gastroenterology Specialized Medical CenterMarília 17502-020Brazil Department of Gastroenterology Sao Paulo State UniversityMedical SchoolBotucatu 18618-687Brazil Real World Evidence IQVIA BrazilSao Paulo 04719-002Brazil Department of Gastroenterology Takeda Pharmaceuticals BrazilSao Paulo 04794-000Brazil

BACKGROUND This was an observational, descriptive, and retrospective study from 2011 to 2020 from the Department of Informatics of the Brazilian Healthcare System database.AIM To describe the intestinal complications(IC) of patients with ulcerative colitis(UC) who started conventional therapies in Brazil’s public Healthcare system.METHODS Patients ≥ 18 years of age who had at least one claim related to UC 10th revision of the International Statistical Classification of Diseases and Related Health Problems(ICD-10) code and at least 2 claims for conventional therapies were included. IC was defined as at least one claim of: UC-related hospitalization, procedures code for rectum or intestinal surgeries, and/or associated disease defined by ICD-10 codes(malignant neoplasia of colon, stenosis, hemorrhage, ulcer and other rectum or anus disease, megacolon, functional diarrhea volvulus, intussusception and erythema nodosum). Descriptive statistics, annual incidence, and incidence rate(IR) [per 100 patient-years(PY)] over the available follow-up period were calculated.RESULTS In total, 41229 UC patients were included(median age, 48 years;65% women) and the median(interquartile range) follow-up period was 3.3(1.8-5.3) years. Conventional therapy used during follow-up period included: mesalazine(87%), sulfasalazine(15%), azathioprine(16%) or methotrexate(1%) with a median duration of 1.9(0.8-4.0) years. Overall IR of IC was 3.2 cases per 100 PY. Among the IC claims, 54% were related to associated diseases, 20% to procedures and 26% to hospitalizations. The overall annual incidence of IC was 2.9%, 2.6% and 2.5% in the first, second and third year after the first claim for therapy(index date), respectively. Over the first 3 years, the annual IR of UC-related hospitalizations ranged from 0.8% to 1.1%;associated diseases from 0.9% to 1.2%-in which anus or rectum disease, and malignant neoplasia of colon were the most frequently reported;and procedure events from 0.6% to 0.7%, being intestinal resection and polyp removal the mos

关键词： Ulcerative colitis Brazil Conventional therapy Intestinal complications Real world Public healthcare

Comparing shoulder maneuvers to magnetic resonance imaging and arthroscopic findings in patients with supraspinatus tears

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World Journal of Orthopedics 2022年第1期13卷 102-111页

作者： Fabio Anauate Nicolao Joao Alberto Yazigi Junior Fabio Teruo Matsunaga Nicola Archetti Netto Joao Carlos Belloti Marcel Jun Sugawara Tamaoki Orthopedics and Traumatology Department Escola Paulista de Medicina–Universidade Federal de São Paulo–UNIFESPSao Paulo 04038-001Brazil Orthopedics and Traumatology Discipline Universidade de Santo Amaro–UNISASao Paulo 04829-300Brazil

BACKGROUND Shoulder maneuvers and magnetic resonance imaging(MRI)are performed to diagnose supraspinatus tendon tears regardless of arthroscopy exam.Although there are many studies on this subject,there is a lack of studies comparing the sensitivity(Se)and specificity(Sp)of shoulder maneuvers and MRI to arthroscopic findings(intact,partial,or full thickness supraspinatus tendon tear).AIM To compare the diagnostic values of shoulder maneuvers with MRI for supraspinatus tendon tears in patients undergoing shoulder arthroscopy.METHODS A total of 199 consecutive patients from four orthopedic centers met the eligibility criteria of shoulder pain persisting for at least four weeks.They were prospectively enrolled in this study from April 2017 to April 2019.Seven clinical tests(full can,empty can,drop arm,Hawkins’,painful arc,Neer’s sign and resisted external rotation)and MRI were performed,and all were compared with surgical findings.Full can,empty can and resisted external rotation tests were interpreted as positive in the case of pain and/or weakness.We assessed the Se,Sp,accuracy,positive predictive value(PPV)and negative predictive value(NPV),positive and negative likelihood ratio and diagnostic odds ratio for overall,partial and fullthickness supraspinatus tears.RESULTS MRI had the highest Se for overall(0.97),partial(0.91)and full-thickness(0.99)tears;moreover,MRI had the highest NPV:0.90,0.88 and 0.98 for overall,partial and full-thickness tears,respectively.For overall supraspinatus tears,the Se and PPV were:Painful arc(Se=0.85/PPV=0.91),empty can(pain)(Se=0.80/PPV=0.89),full can(pain)(Se=0.78/PPV=0.90),resisted external rotation(pain)(Se=0.48/PPV=0.87),drop arm(Se=0.19/PPV=0.97),Neer’s sign(Se=0.78/PPV=0.93)and Hawkins’(Se=0.80/PPV=0.88).MRI had the highest PPV(0.99).The Hawkin’s test had the highest false positive rate in patients with intact tendons(0.36).The Sp of the empty can and full can(both tests positive for pain and weakness),drop arm and MRI were:0.93,0.91,0.98 and 0.96,respectively.For partial and

关键词： Rotator cuff injuries Physical examination Magnetic resonance imaging Arthroscopy

Physical properties of sandstone reservoirs: Implication for fluid mobility

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Energy Geoscience

Energy Geoscience 2022年第4期3卷 349-359页

作者： Richardson M.Abraham-A Fabio Taioli Anthony I.Nzekwu Institute of Energy and Environment University of Sao Paulo(IEE-USP)Sao PaloBrazil Department of Applied Geophysics Federal University of TechnologyAkure(FUTA)Ondo StateNigeria

Core samples representing depths of hydrocarbon-bearing zones are not readily accessible for reservoir evaluations.On the other hand,wireline logs with incorporated seismic data,which can be archived over a more extended period while retaining their original forms,are typically more available for research purposes.Therefore,the study relies on wireline logs with seismic data to predict the reservoirs'fluid mobility by evaluating the hydraulic(flow)units,reservoir depths,fluid saturations,and geothermal gradients.It also indicates the associated water cut(C_(w))within Ritchie oil and gas field,Niger Delta considering a three-phase(oil-gas-water-bearing)reservoir(R_(A))and an oil-saturated reservoir(R_(B))delineated across three wells(R_(W1),R_(W2) and R_(W3)).Research activities combining the presented factors to achieve the stated objectives are not quite common within the study location.It shows lower,average and upper limits of the flow unit factors and irreducible water saturation(S_(wirr))within the reservoirs.The study shows the relationship between hydraulic units/fluid saturations and fluid mobility/associated C_(w) within the sandstone reservoirs.It maximises porosity(Ф)for the theoretical flow units'prediction during qualitative and quantitative estimation based on the adopted expressions.Therefore,the study reveals that water saturation(S_(w))and hydrocarbon/water ratios substantially control C_(w),and other contributing factors include thermal gradients and S_(wirr).The flow unit factors are also significant and will encourage fluid mobility.The evaluated reservoirs(R_(A) and R_(B))are below 10400 ft(3170 m)across wells R_(W1),R_(W2) and R_(W3) within the Agbada Formation of a geothermal gradient up to 2.7℃/100 m;therefore,they have good thermal conditions to enhance hydrocarbon mobility and increase S wirr.Hence,the reservoir should feature significant hydrocarbon extraction via primary recovery.The average water cut(C_(w-avg).)(12.3%)estimated for reservoir R_(A) is within the acceptable range;theref

关键词： Water cut Thermal gradient Fluid saturations Hydrocarbon mobility Sandstone reservoir Reservoir quality Agbada Formation Niger Delta

Functional Roux-en-Y Gastric Bypass (F-RYGB), with Preservation of Duodenal Access: Report of Two Revisional Cases of Sleeve Gastrectomy

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Surgical Science 2024年第3期15卷 135-158页

作者： Victor Ramos Mussa Dib Carlos Augusto Scussel Madalosso paulo Reis Esselin de Melo Rui Ribeiro Paula Volpe Carlos Eduardo Domene Victor Dib Institute Manaus Brazil Gastrobese Clinic Passo Fundo Brazil paulo Reis Institute of Bariatric Surgery Goi&#226nia Brazil Alfredo Nasser university Center (UNIFAN) Goi&#226nia Brazil Lusíadas Amadora Hospital Lisboa Portugal Integrated Center for Advanced Medicine (CIMAMED) S&#227o Paulo Brazil

Objective: This case report aimed to demonstrate a possible neuromuscular effect of Latarjet nerves transection or truncal vagotomy, in association with sleeve gastrectomy plus antrojejunostomy, in order to reproduce a Roux-en-Y gastric bypass (RYGB) mechanistic principles, in patients with previous Sleeve Gastrectomy (SG) who had had weight regain, with or without concomitant gastroesophageal reflux disease (GERD). Background: Sleeve gastrectomy (SG) is one of the most frequently performed bariatric operations worldwide. Nevertheless, weight regain and gastroesophageal reflux disease (GERD) have been consistently demonstrated, in association with this technique, which may require a revisional procedure. RYGB is an option in such a situation but, implies in gastrointestinal exclusions, which represents a shortcoming of this revision. Surpassing this inconvenient would be of great value for the patients. Methods: We describe herein two cases of SG revision for weight regain and GERD, with a follow-up of one year. Gastroesophageal reflux disease was evaluated by validated questionnaire, upper endoscopy, seriography, high resolution manometry (HRM) and impedance pHmetry (I-pHmetry), in the pre and postoperative periods. A re-Sleeve Gastrectomy with antrojejunal anastomosis was done in both cases, after informed consents. The Latarjet nerves were transected in one case, due to a bleeding in the left gastric vessels and a truncal vagotomy was required in the other, to appropriately treat an associated hiatal hernia. Results: In the postoperative evaluation it was observed a pyloric spasm in both cases, during seriography and endoscopy, kept until the one-year follow-up. There was unidirectional contrast flow to the gastrointestinal anastomosis, filling the jejunal limb, in radiologic contrast study. No contrast passed through the pylorus. Nonetheless, the duodenum was kept endoscopically accessible. In the one-year evaluation, weight loss was adequate and GERD resolution was obtained in both cases, confirmed by endosc

关键词： Roux-en-Y Gastric Bypass Sleeve Gastrectomy Jejuno Gastric Bypass Vagus Nerve Vagotomy Bariatric Surgery

Advances in surgical techniques for gastric cancer:Indocyanine green and near-infrared fluorescence imaging.Is it ready for prime time?

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Chinese Journal of Cancer Research 2022年第6期34卷 587-591页

作者： Erica Sakamoto Adriana Vaz Safatle-Ribeiro Ulysses Ribeiro Jr Department of Gastroenterology Instituto do Cancer do Estado de Sao PauloHospital das ClinicasFaculdade de MedicinaUniversidade de Sao

Surgery is still the primary curative treatment for gastric cancer,which includes resection of the tumor with adequate margins and extended lymphadenectomy.In order to improve the operative results and the quality of life of patients,several endeavors have been made toward precision medicine through image-guided surgery,allowing access to real-time intraoperative anatomy and accurate tumor staging.The goal of the surgeon is to achieve a more precise,individualized,and less invasive surgery without compromising oncological efficiency and safety.In this perspective,we have demonstrated the role of indocyanine green(ICG)and near-infrared(NIR)fluorescence imaging method in gastric cancer surgery.This technique may be used to improve localization of the tumor,detection of sentinel lymph nodes(SLN),real-time lymphatic mapping,and blood flow assessment(anastomosis perfusion).

关键词： Indocyanine green near-infrared fluorescence imaging gastric cancer lymphatic mapping

Intestinal complications in patients with Crohn's disease in the Brazilian public healthcare system between 2011 and 2020

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World Journal of Clinical Cases 2023年第14期11卷 3224-3237页

作者： Ligia Yukie Sassaki Adalberta Lima Martins Rodrigo Galhardi-Gasparini Rogerio Saad-Hossne Alessandra Mileni Versut Ritter Tania Biatti Barreto Taciana Marcolino Bruno Balula Claudia Yang-Santos Department of Internal Medicine São Paulo State University-UNESPMedical School18618687BotucatuBrazil Department of Gastroenterology State Office for Pharmaceutical Assistance at Espírito Santo Health OfficeVitoria 29017-010Espirito SantoBrazil Department of Gastroenterology SETE–Specialized Medical CenterMarilia 17502-020Sao PauloBrazil Department of Surgery São Paulo State University-UNESPMedical School18618687BotucatuBrazil Real World Evidence IQVIA Brazil04719-002Sao PauloBrazil Medical Affairs Takeda Pharmaceuticals Brazil04794-000Sao PauloBrazil Clinical Research Takeda Pharmaceuticals Brazil04794-000Sao PauloBrazil

BACKGROUND This is a secondary database study using the Brazilian public healthcare system database.AIM To describe intestinal complications(ICs)of patients in the Brazilian public healthcare system with Crohn’s disease(CD)who initiated and either only received conventional therapy(CVT)or also initiated anti-tumor necrosis factor(anti-TNF)therapy between 2011 and 2020.METHODS This study included patients with CD[international classification of diseases–10th revision(ICD-10):K50.0,K50.1,or K50.8](age:≥18 years)with at least one claim of CVT(sulfasalazine,azathioprine,mesalazine,or methotrexate).IC was defined as a CD-related hospitalization,pre-defined procedure codes(from rectum or intestinal surgery groups),and/or associated disease(pre-defined ICD-10 codes),and overall(one or more type of ICs).RESULTS In the 16809 patients with CD that met the inclusion criteria,the mean follow-up duration was 4.44(2.37)years.In total,14697 claims of ICs were found from 4633 patients.Over the 1-and 5-year of follow-up,8.3%and 8.2%of the patients with CD,respectively,presented at least one IC,of which fistula(31%)and fistulotomy(48%)were the most commonly reported.The overall incidence rate(95%CI)of ICs was 6.8(6.5–7.04)per 100 patient years for patients using only-CVT,and 9.2(8.8–9.6)for patients with evidence of anti-TNF therapy.CONCLUSION The outcomes highlighted an important and constant rate of ICs over time in all the CD populations assessed,especially in patients exposed to anti-TNF therapy.This outcome revealed insights into the real-world treatment and complications relevant to patients with CD and highlights that this disease remains a concern that may require additional treatment strategies in the Brazilian public healthcare system.

关键词： Crohn’s disease Intestinal complications Anti-tumor necrosis factor Conventional therapy Public healthcare system

Downregulation of TNFR2 decreases survival gene expression,promotes apoptosis and affects the cell cycle of gastric cancer cells

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World Journal of Gastroenterology 2022年第24期28卷 2689-2704页

作者： Ana Flávia Teixeira Rossi Fernanda da Silva Manoel-Caetano Joice Matos Biselli Ágata Silva Cabral Marilia de Freitas Calmon Saiki Marcelo Lima Ribeiro Ana Elizabete Silva Department of Biological Sciences Sao Paulo State University(UNESP)São Josédo Rio Preto 15054-000São PauloBrazil Clinical Pharmacology and Gastroenterology Unit São Francisco University(USF)Bragança Paulista 12916-900São PauloBrazil

BACKGROUND Chronic inflammation due to Helicobacter pylori(H.pylori)infection promotes gastric carcinogenesis.Tumour necrosis factor-α(TNF-α),a key mediator of inflammation,induces cell survival or apoptosis by binding to two receptors(TNFR1 and TNFR2).TNFR1 can induce both survival and apoptosis,while TNFR2 results only in cell survival.The dysregulation of these processes may contribute to carcinogenesis.AIM To evaluate the effects of TNFR1 and TNFR2 downregulation in AGS cells treated with H.pylori extract on the TNF-αpathway.METHODS AGS cell lines containing TNFR1 and TNFR2 receptors downregulated by specific shRNAs and nonsilenced AGS cells were treated with H.pylori extract for 6 h.Subsequently,quantitative polymerase chain reaction with TaqMan®assays was used for the relative quantification of the mRNAs(TNFA,TNFR1,TNFR2,TRADD,TRAF2,CFLIP,NFKB1,NFKB2,CASP8,CASP3)and miRNAs(miR-19a,miR-34a,miR-103a,miR-130a,miR-181c)related to the TNF-αsignalling pathway.Flow cytometry was employed for cell cycle analysis and apoptosis assays.RESULTS In nonsilenced AGS cells,H.pylori extract treatment increased the expression of genes involved in cell survival and inhibited both apoptosis(NFKB1,NFKB2 and CFLIP)and the TNFR1 receptor.TNFR1 downregulation significantly decreased the expression of the TRADD and CFLIP genes,although no change was observed in the cellular process or miRNA expression.In contrast,TNFR2 downregulation decreased the expression of the TRADD and TRAF2 genes,which are both important downstream mediators of the TNFR1-mediated pathway,as well as that of the NFKB1 and CFLIP genes,while upregulating the expression of miR-19a and miR-34a.Consequently,a reduction in the number of cells in the G0/G1 phase and an increase in the number of cells in the S phase were observed,as well as the promotion of early apoptosis.CONCLUSION Our findings mainly highlight the important role of TNFR2 in the TNF-αpathway in gastric cancer,indicating that silencing it can reduce the expression of survival and anti-apoptotic genes

关键词： Gastric cancer Helicobacter pylori Tumour necrosis factor-αsignalling pathway TNFR1 TNFR2 miRNAs

Mindfulness interventions during pregnancy:A narrative review

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Journal of Integrative Medicine 2020年第6期18卷 470-477页

作者： Leandro Lucena Cristina Frange Ana Claudia Amorim Pinto Monica Levy Andersen Sergio Tufik Helena Hachul Department of Psychobiology Universidade Federal de Sao Paulo(UNIFESP)Sao Paulo 04023062Brazil Department of Neurology and Neurosurgery Universidade Federal de Sao Paulo(UNIFESP)Sao Paulo 04039002Brazil Department of Gynecology Universidade Federal de Sao Paulo(UNIFESP)Sao Paulo 04024002Brazil

Pregnancy is a period of major transformations in a woman’s life;increased stress,and mood and sleep disorders are frequent.This review evaluates mindfulness interventions during pregnancy and their ability to help manage stress,anxiety,depression,emotional regulation,level of mindfulness and sleep quality.A search of English language scientific literature relevant to mindfulness interventions for pregnant women was conducted using PubMed,Scopus and Web of Science,without restriction on publication date.Inclusion criteria were randomized clinical trials with pregnant women,using mindfulness as an intervention for at least three weeks,in one of our main areas of interest,and using only validated scales to measure outcomes.Two hundred and thirty studies were identified in our searches of research databases,and thirteen were included in our analysis.We found a large diversity of mindfulness programs,heterogeneity among the instruments used to evaluate outcomes,and inconsistency in the gestational periods used in the studies.Mindfulness interventions were beneficial for stress,anxiety and depression.Mindfulness was also effective when applied in pregnant women with a history of depression or experiencing depression.Considering emotional regulation and the level of mindfulness,there were signs of improvement,but more studies are needed.None of the studies evaluated sleep quality.Our review provides information about current mindfulness programs,an overview of the effects of mindfulness interventions,a description of the measurements used so far,and recommendations for developing highquality mindfulness protocols for pregnant women.

关键词： Mindfulness Pregnancy Anxiety Stress Depression Sleep