Predicting the efficiency of luminescent solar concentrators for solar energy harvesting using machine learning

Building-integrated photovoltaics (BIPV) is an emerging technology in the solar energy field. It involves using luminescent solar concentrators to convert traditional windows into energy generators by utilizing light harvesting and conversion materials. This study investigates the application of machine learning (ML) to advance the fundamental understanding of optical material design. By leveraging accessible photoluminescent measurements, ML models estimate optical properties, streamlining the process of developing novel materials, offering a cost-effective and efficient alternative to traditional methods, and facilitating the selection of competitive materials. Regression and clustering methods were used to estimate the optical conversion efficiency and power conversion efficiency. The regression models achieved a Mean Absolute Error (MAE) of 10%, which demonstrates accuracy within a 10% range of possible values. Both regression and clustering models showed high agreement, with a minimal MAE of 7%, highlighting the efficacy of ML in predicting optical properties of luminescent materials for BIPV.

Proceedings from the CIHLMU 2022 Symposium: "Availability of and Access to Quality Data in Health"

Data is an essential tool for valid and reliable healthcare management. Access to high-quality data is critical to ensuring the early identification of problems, the design of appropriate interventions, and the effective implementation and evaluation of health intervention outcomes. During the COVID-19 pandemic, the need for strong information systems and the value of producing high-quality data for timely response and tracking resources and progress have been very evident across countries. The availability of and access to high-quality data at all levels of the health systems of low and middle-income countries is a challenge, which is exacerbated by multiple parallels and poorly integrated data sources, a lack of data-sharing standards and policy frameworks, their weak enforcement, and inadequate skills among those handling data. Completeness, accuracy, integrity, validity, and timeliness are challenges to data availability and use. "Big Data" is a necessity and a challenge in the current complexities of health systems. In transitioning to digital systems with proper data standards and policy frameworks for privacy protection, data literacy, ownership, and data use at all levels of the health system, skill enhancement of the staff is critical. Adequate funding for strengthening routine information systems and periodic surveys and research, and reciprocal partnerships between high-income countries and low- and middle-income countries in data generation and use, should be prioritized by the low- and middle-income countries to foster evidence-based healthcare practices.

Human Monkeypox: A Comprehensive Narrative Review and Analysis of the Public Health Implications

Recently, numerous cases of monkeypox were reported from several non-endemic countries in Europe, North America, and Oceania, suggesting an unusual and alarming public health issue, particularly considering that the disease is not directly related to human or animal travels. Attention is currently being drawn to this phenomenon since more than 70% of the global population is no longer vaccinated against smallpox. Indeed, the smallpox vaccination also confers some indirect degree of protection against other poxviruses, including monkeypox. We performed a narrative review to describe the existing literature with regard to monkeypox using the MEDLINE, EMBASE, and Scopus databases. This review aims to provide updated evidence of findings on the epidemiology, clinical features, diagnosis, management, and prevention of monkeypox, also considering the concurrent zoonotic pandemic caused by the COVID-19 coronavirus, SARS-CoV-2.

AB1552-HPR HEALTH PERCEPTION OF PATIENTS WITH FIBROMYALGIA IN BRAZIL

Background

Fibromyalgia is a rheumatologic syndrome characterized by chronic pain and symptoms such as fatigue, morning stiffness, sleep disturbances and depression. Health perception is a global assessment of health based on an analysis of the objective and also subjective aspects of each person. Health self-assessment is increasingly researched and shows the health status of the population, considering the individual’s personal perspective and that this information can be useful to propose health promotion strategies.

Objectives

To identify the health perception of patients with fibromyalgia who live in Brazil.

Methods

This is a cross-sectional study that was carried out in Brazil in 2021. They were invited to participate in the research. Individuals with fibromyalgia were invited to participate in the study through the Brazilian Association of Fibromyalgia Patients (ABRAFIBRO) in August 2021. The invitation was sent via email to all people registered with this association in the country. Self-perception of health was questioned through the following response options: bad, fair, good or very good. Data were analyzed using descriptive statistics.

Results

The study consisted of 243 people with fibromyalgia living in different states of Brazil. Most were female (97.5%), married or living with a partner (63.7%), of white race/color (58%), receiving 1 to 2 minimum wages (60.4%), with complete higher education (46.5%) and who administer more than 2 medications per day (65.8%). Regarding the perception of health, the majority reported that their health was regular (42.4%), followed by bad (38.3%), good (16%) and very good (3.3%).

Conclusion

The most prevalent health perception in people with fibromyalgia in Brazil was: “regular”, followed by “bad”, “good” and “very good”. In view of the findings of this study, measures to control and prevent health risks in people with fibromyalgia become necessary. In order to implement policies to promote a healthy life for this population, it is necessary to know the determinants of these indicators of self-reported health morbidity in Brazil. It is also suggested that the results of this investigation be monitored by periodic population-based surveys, in order to verify the determination of the observed associations, being able, in the future, to detect an association with other variables. In addition, these data can guide and evaluate education and health promotion strategies in fibromyalgia.

References

[1]Antunes M, Schmitt A, Marques AP. Ab0912-hpr Amigos de Fibro (Fibro Friends): educational program to promote the health of people with fibromyalgia in Brazil. 2021; Annals of the Rheumatic Diseases 2021;80:1478.

[2]Antunes MD, Couto LA, Bertolini SMMG, Rocha Loures FCN, Schmitt ACB, Marques AP. of interdisciplinary health education programs for individuals with fibromyalgia: A systematic review. Journal of Education and Health Promotion. 2021;10(64):1-8. Doi: https://dx.doi.org/10.4103%2Fjehp.jehp_592_20.

[3]García-Ríos MC, Navarro-Ledesma S, Tapia-Haro RM, Toledano-Moreno S, Casas-Barragán A, Correa-Rodríguez M, et al. Effectiveness of health education in patients with fibromyalgia: a systematic review. European Journal of Physical and Rehabilitation Medicine. 2019;55(2):301–13, 2019. Doi: https://doi.org/10.23736/S1973-9087.19.05524-2

Acknowledgements

This study was financed in part by the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior – Brasil (CAPES) – Finance Code 001

Disclosure of Interests

None declared

AB1539-HPR AMIGOS DE FIBRO (FIBRO FRIENDS): VALIDATION OF AN EDUCATIONAL E-BOOK TO PROMOTE THE HEALTH OF PEOPLE LIVING WITH FIBROMYALGIA IN BRAZIL

Background

In the optimal treatment of fibromyalgia, international recommendations highlight non-pharmacological treatment as the key to success. Health education is one of the main tools to promote the health of patients with fibromyalgia. Educational strategies are essential for the care of patients with fibromyalgia.

Objectives

Develop and validate an e-book to promote the health of people with fibromyalgia who live in Brazil.

Methods

This is a methodological study, initially, through a bibliographic survey, the available publications on the subject were analyzed. Then, this knowledge was used to build the theoretical content addressed and the art and layout of the e-book was elaborated. Finally, the validation of the constructed material was carried out with three groups of specialists: content specialists (n=23), technicians (n=23) and design specialists (n=23). In addition, it was also decided to validate the e-book with individuals who have fibromyalgia (n=45. The e-book was evaluated by specific instruments through the Delphi technique. The data were analyzed, and the reliability was evaluated by the Alpha of Cronbach (αC) and agreement, using the Content Validity Index (CVI).

Results

In the global evaluation, all the judges agreed with the items evaluated in the e-book, presented a considerable minimum of the CVI, being: content (0.79), technical (0.89), design (0.92), and target audience (0.97). Regarding reliability, all groups also had an αC within the acceptable range: content (0.960), technical (0.963), design (0.977), and target audience (1.08).

Conclusion

E-book was prepared and validated in terms of content and relevance, and can be used in Brazil to promote the health of individuals with fibromyalgia, mainly as a complement to treatments already carried out for fibromyalgia. In the future, this e-book may be translated and adapted into new languages.

References

[1]Antunes M, Schmitt A, Marques AP. Ab0912-hpr Amigos de Fibro (Fibro Friends): educational program to promote the health of people with fibromyalgia in Brazil. 2021; Annals of the Rheumatic Diseases 2021;80:1478.

[2]Antunes MD, Couto LA, Bertolini SMMG, Rocha Loures FCN, Schmitt ACB, Marques AP. of interdisciplinary health education programs for individuals with fibromyalgia: A systematic review. Journal of Education and Health Promotion. 2021;10(64):1-8. Doi: https://dx.doi.org/10.4103%2Fjehp.jehp_592_20.

[3]García-Ríos MC, Navarro-Ledesma S, Tapia-Haro RM, Toledano-Moreno S, Casas-Barragán A, Correa-Rodríguez M, et al. Effectiveness of health education in patients with fibromyalgia: a systematic review. European Journal of Physical and Rehabilitation Medicine. 2019;55(2):301–13, 2019. Doi: https://doi.org/10.23736/S1973-9087.19.05524-2

Acknowledgements

This study was financed in part by the Coordenação de

Aperfeiçoamento de Pessoal de Nível Superior - Brasil (CAPES) - Finance Code 001

Disclosure of Interests

None declared

AB1538-HPR AMIGOS DE FIBRO (FIBRO FRIENDS): VALIDATION OF AN EDUCATIONAL PROGRAM TO PROMOTE THE HEALTH OF PATIENTS WITH FIBROMYALGIA IN BRAZIL

Background

Health education is a very important tool in the treatment of people with fibromyalgia. Health education acts as an excellent non-pharmacological treatment to promote health in fibromyalgia.

Objectives

To validate a multidisciplinary educational program to promote the health of people with fibromyalgia in Brazil, called Amigos de Fibro.

Methods

This is a methodological research with 45 individuals with fibromyalgia (target audience) and 23 health professionals (expert judges). Both groups used an instrument to assess the objectives, themes and proposed actions, relevance, writing style and structure of the program using the Delphi technique. The Content Validity Index (CVI) ≥ 0.78 and Kappa Coefficient ≥ 0.61 were used to analyze and validate the data.

Results

All items evaluated in both groups had a considerable minimum CVI and Kappa Coefficient to be valid. In the global assessment of Amigos de Fibro, the CVI of the target audience judges was 0.95, while the expert judges presented a value of 0.90. The Kappa Coefficient of the target audience judges was 0.85 and that of the expert judges was 0.90. Therefore, the instrument proved to be validated.

Conclusion

Amigos de Fibro was considered valid for its content and internal consistency, therefore, valid to be used by health professionals with the target audience in Primary Health Care in Brazil, allowing them to act as promoters of their health.

References

[1]Antunes MD, Couto LA, Bertolini SMMG, Rocha Loures FCN, Schmitt ACB, Marques AP. of interdisciplinary health education programs for individuals with fibromyalgia: A systematic review. Journal of Education and Health Promotion. 2021;10(64):1-8. Doi: https://dx.doi.org/10.4103%2Fjehp.jehp_592_20

[2]Antunes M, Schmitt A, Marques AP. Ab0912-hpr Amigos de Fibro (Fibro Friends): educational program to promote the health of people with fibromyalgia in Brazil. 2021; Annals of the Rheumatic Diseases 2021;80:1478.

[3]García-Ríos MC, Navarro-Ledesma S, Tapia-Haro RM, Toledano-Moreno S, Casas-Barragán A, Correa-Rodríguez M, et al. Effectiveness of health education in patients with fibromyalgia: a systematic review. European Journal of Physical and Rehabilitation Medicine. 2019;55(2):301–13, 2019. Doi: https://doi.org/10.23736/S1973-9087.19.05524-2

Acknowledgements

This study was financed in part by the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - Brasil (CAPES) - Finance Code 001

Disclosure of Interests

None declared

AB0878-HPR EFFECT OF AQUATIC PHYSIOTHERAPY ON PAIN AND QUALITY OF LIFE IN ELDERLY WOMEN WITH FIBROMYALGIA

Background:

Fibromyalgia is defined as a chronic non-articular rheumatic disease, characterized by generalized, diffuse bilateral pain and the presence of tender points in specific anatomical regions. Its symptoms are characterized by a very varied picture and the etiology is considered multifactorial. Today, with difficult treatment, fibromyalgia has been a major challenge for healthcare professionals. Aquatic physiotherapy is currently one of the most commonly used forms of intervention in the management of fibromyalgia, and for this reason it has been used in interdisciplinary rehabilitation programs to promote health.

Objectives:

To evaluate the effects of aquatic physiotherapy on pain and quality of life in patients with fibromyalgia.

Methods:

This is an interventional, quasi-experimental study carried out at the Physiotherapy School Clinic of Universidade Cesumar in the city of Maringá, PR, Brazil. The study was approved by the Human Research Ethics Committee of Unicesumar under opinion No. 1,025,567. Participated in the study, elderly women aged 60 years, with clinical diagnosis of fibromyalgia. To assess the quality of life, the Medical Outcomes Study 36 - Item Short-Form Health Survey (SF-36) instrument was used and to verify the intensity of the pain, the Visual Analogue Scale was used. The aquatic physiotherapy intervention protocol was to perform 10 Watsu sessions, performed twice a week, lasting 40 minutes each. To perform the Watsu method, the following steps of the technique were followed: before starting, opening, delivering the water, dancing the breath in the water, breathing balance and to finish releasing the spine. For data analysis, the Shapiro-Wilk test was initially applied to verify the normality of the variables under study. As the data presented a normal distribution, mean, standard deviation, minimum and maximum were used to characterize the results. To compare the initial and final variables, the dependent student t test was used. The significance adopted was p <0.05.

Results:

The study included 17 elderly women with a mean age of 67.5 ± 4.7 years. When comparing the evaluation and the reassessment, a statistically significant improvement was evidenced in the domains of quality of life: functional capacity (p=0.00445), limitation due to physical aspects (p=0.01347), pain (p=0.00861), vitality (p=0.00044), limitation due to emotional aspects (p=0.02019), mental health (p=0.00748). The domains that did not show statistical increase were the general health status (p=0.30663) and the social aspects (p=0.05037). The pain, on the other hand, was statistically less after the intervention (p=0.00059).

Conclusion:

Aquatic physical therapy provided benefits in reducing pain and improving the quality of life of elderly women with fibromyalgia. It is important to encourage individuals with fibromyalgia to perform non-pharmacological interventions, such as aquatic physiotherapy, to promote their health and quality of life.

References:

[1]Oliveira DV, Ferreira AAM, Oliveira DCD, Leme DEDC, Antunes MD, Nascimento Júnior JRAD. Association of the practice of physical activity and of health status on the quality of life of women with fibromyalgia. Journal of Physical Education. 2019;30(1): e3027. https://doi.org/10.4025/jphyseduc.v30i1.3027.

[2]Antunes MD, Vertuan MP. Miquilin A, Leme DEC, Morales RC, Oliveira DV. Efeitos do Watsu na qualidade de vida e quadro doloroso de idosas com fibromialgia. ConScientiae Saúde. 2016;15(4), 636-641. https://doi.org/10.5585/conssaude.v15n4.6756.

[3]Antunes M, Ferreira A, Oliveira D, Júnior JN, Bertolini S, Marques AP. There is association between the level of physical activity and quality of life of women with fibromyalgia?. Annals of rheumatic diseases. 2019;78(2)650-1. http://dx.doi.org/10.1136/annrheumdis-2019-eular.2835.

Acknowledgements:

This study was financed in part by the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - Brasil (CAPES) - Finance Code 001.

Disclosure of Interests:

None declared

AB0912-HPR AMIGOS DE FIBRO (FIBRO FRIENDS): EDUCATIONAL PROGRAM TO PROMOTE THE HEALTH OF PEOPLE WITH FIBROMYALGIA IN BRAZIL

Background:

Health education is pointed out as the front line in non-pharmacological approaches in fibromyalgia.

Objectives:

To develop an interdisciplinary educational program to promote the health of individuals with fibromyalgia in Brazil.

Methods:

This is a qualitative study, through a focus group, carried out in a Basic Health Unit in the city of São Paulo, SP. The guiding questions were about the needs and demands exposed by patients with fibromyalgia and health professionals who work in primary health care. 12 individuals with fibromyalgia and 10 health professionals participated. The data were analyzed using the content analysis method proposed by Bardin, specifically the thematic content analysis.

Results:

Amigos de Fibro (Fibro Friends) should be conducted through lectures, dynamics and conversation circles. The educational program must include 15 meetings with weekly frequency. The meetings are: 1st to present the program and socialization activities. 2nd: Doctor presents the concepts of fibromyalgia. 3rd: Nurse informs about practices and environments that favor self-care. 4th: Social Worker shows the importance of support. 5th: Physiotherapist shows the main body practices and physical activity. 6th: Nutritionist presents an adequate and healthy diet. 7: Psychologist shows mental health practices. 8th: Pharmacist informs about medicines. 9, 11 and 13: participants perform activities at home. 10: Naturologist presents integrative and complementary practices. 12th: Occupational Therapist encourages methods to save energy. Day 14: Speech therapist helps in the quality of sleep. 15: closing activity.

Conclusion:

Amigos de Fibro is a program that presents interdisciplinary educational information for individuals with fibromyalgia, being considered a trend of care for the future. The next step is to conduct a clinical trial to verify the effect of this intervention and then implement it in the health service in Brazil. Fibro Friends was created from the conjunct action of patients and healthcare professionals, it can be an effective educational tool to be implemented at primary health attention centers, promoting the self-care, life quality and the promotion of health in individuals with Fibromyalgia. Fibro Friends is an excellent tool for patient education and counseling in Brazil.

References:

[1]Antunes M, Ferreira A, Oliveira D, Júnior JN, Bertolini S, Marques AP. There is association between the level of physical activity and quality of life of women with fibromyalgia?. Annals of rheumatic diseases. 2019;78(2)650-1. http://dx.doi.org/10.1136/annrheumdis-2019-eular.2835.

[2]García-Ríos MC, Navarro-Ledesma S, Tapia-Haro RM, Toledano-Moreno S, Casas-Barragán A, Correa-Rodríguez M et al. Effectiveness of health education in patients with fibromyalgia: a systematic review. European Journal of Physical and Rehabilitation Medicine. 2019;55(2):301-13. https://doi.org/10.23736/S1973-9087.19.05524-2.

[3]Oliveira DV, Ferreira AAM, Oliveira DCD, Leme DEDC, Antunes MD, Nascimento Júnior JRAD. Association of the practice of physical activity and of health status on the quality of life of women with fibromyalgia. Journal of Physical Education. 2019;30(1): e3027. https://doi.org/10.4025/jphyseduc.v30i1.3027.

[4]Stuifbergen AK, Blozis SA, Becker H, Phillips L, Timmerman G, Kullberg V, et al. A randomized controlled trial of a wellness intervention for women with fibromyalgia syndrome. Clinical Rehabilitation. 2010;24(4):305-18. https://doi.org/10.1177/0269215509343247.

Acknowledgements:

This study was financed in part by the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - Brasil (CAPES) - Finance Code 001.

Disclosure of Interests:

None declared

Laparoscopy in Low-Income Countries: 10-Year Experience and Systematic Literature Review

Laparoscopy is a procedure that ultimately reduces hospital stay time and speeds up post-operative recovery. It is mainly performed in high-income countries but its implementation in many low- and middle-income countries (LMICs) is increasing. However, no aggregate data exist regarding the outcomes of this procedure in resource-limited settings. We retrospectively reviewed all cases of laparoscopy recorded from January 2007 to March 2017 at the Department of Surgery of Beira to assess the related outcomes. Moreover, we performed a systematic review of the laparoscopic practices and outcomes in low-income countries. Data from the Department of Surgery of Beira identified 363 laparoscopic procedures, mainly relating to gynecological diseases, cholelithiasis, and appendicectomy with only a 1.6% complication rate (6 cases) and a 1.9% conversion rate (7 cases) to open surgery. The systematic review showed a pooled risk of overall complications significantly lower in laparoscopic vs. open appendicectomy (OR = 0.43; 95% CI 0.19-0.97; I² = 85.7%) and a significantly lower risk of infection (OR = 0.53; 95% CI 0.43-0.65; I² = 0.00%). The pooled SMD in operation duration in laparoscopic vs. open appendectomy was 0.58 (95% CI -0.00; 1.15; I² = 96.52), while the pooled SMD in hospitalization days was -1.35 (95% CI -1.87; -0.82; I² = 96.41). Laparoscopy is an expensive procedure to adopt as it requires new equipment and specialized trained health workers. However, it could reduce post-operative costs and complications, especially in terms of infections. It is crucial to increase its accessibility, acceptability, and quality particularly in LMICs, especially during this COVID-19 era when the reduction of patient hospitalization is essential.

Anal high-grade and late-stage cancer management in low-income setting: a case report

The burden of cancer is increasing in sub-Saharan Africa due to ageing, common risk factors and population growth. Anal cancer is a human papillomavirus-related rare disease with an incidence rate of 1.8 per 100 000 persons overall with an increasing incidence of by 2% per year in the last three decades. Despite that gold standard management is well described, in low-income countries, there is no possibility for a proper management. We presented a late-stage anal cancer case that reflects the urgent necessity to create the adequate condition for the development of effective oncologic approach including prevention, diagnosis and management.

Conservative management of Cantrell syndrome: a case report

Cantrell syndrome (CS) is defined as congenital combination of five anomalies: defects at the lower part of the sternum, anterior diaphragm, midline supraumbilical abdominal wall, diaphragmatic pericardium and ectopia cordis. Antenatal screening should be performed to make an accurate prenatal diagnosis. The prognosis is usually poor with a high mortality early in life. The gold standard management is surgery but its prognosis remains poor. In many low-income settings prenatal examinations and surgery treatment are not possible. In the present case, we report a not surgery managed baby affected by CS, with good clinical conditions after 5 months.

Cybersecurity risk analysis in healthcare institutions

Introduction The growing digitization of businesses and its increasing dependence on Internet infrastructure has boosted the concerns related to data privacy and confidentiality. Healthcare institutions have been challenged with specific issues, namely the sensitivity of data, the specificity of networked equipment and the average information technology skills held by of healthcare professionals in Portugal.

Objectives To understand the relationship level established by healthcare professionals with the information security by assessing attitudes and behaviours in cybersecurity; to identify risks and actions that may be taken to enhance the healthcare professional’s cybersecurity awareness.

Methodology The study consists in translating, adjusting and applying two previously validated and published Likert-type response scales to assess health professionals' cybersecurity attitudes and behaviours in the Portuguese health environment. This is an observational, quantitative, cross-sectional and descriptive study in cybersecurity attitudes and behaviours in a healthcare institution in Portugal.

Results The sample was composed by 56 professionals, 71% women and 29% men, divided in four professional groups, where a mean (±SD) of 31.59 (±14.211) points was achieved for the cybersecurity risky behaviour (RScB) scale and 66.41 (±6,26) points for the cybersecurity and cybercrime in business attitudes scale (ATC-IB).

Conclusions There was no-significant statistical differences between the sociodemographic factors and the scores obtained on both scales. However, the points of the scales for the different domains evidences a statistical difference between ages, genders and professional groups by items, which are therefore important points for the development of future studies. The results showed a relationship between acquired behaviours and the attitudes of involvement with work and organizational commitment, establishing a bridge for the quantification in awareness.

AB1319-HPR EFFECT OF SEGMENTAL STABILIZATION AND PILATES ON CHRONIC NON-SPECIFIC LOW BACK PAIN: PILOT STUDY

Background:

Low back pain is an important health condition with major socioeconomic consequences and is associated with high costs for the health system, absenteeism at work and reduced functional performance. It is one of the most relevant health problems in the elderly, with point prevalence estimates higher than other musculoskeletal conditions.

Objectives:

To verify the effect of segmental stabilization versus the Pilates method in the elderly with chronic low back pain.

Methods:

The study included 9 elderly women with chronic low back pain randomized into two groups: Segmental Stabilization Group (SG n = 5; age 65.2 ± 4.32; Body Mass Index - BMI 29.99 ± 4.65) and Pilates Group (PG n = 4; age 67.75 ± 7.13; BMI 26.49 ± 4.06). Both groups underwent 16 individual sessions of 60 minutes twice a week and avaliated before and after 8 weeks. Pain was assessed using the Visual Analogue Pain Scale; functional disability, by Oswestry’s disability index; excessive fear of movement and physical activity, using the Tampa Kinesiophobia Scale; level of confidence in the balance for specific activities, on the Activity-Specific Balance Confidence (ABC) scale and; activation of the transverse muscle of the abdomen, by the pressure biofeedback unit Stabilizer of the Chatanooga brand. The allocation and evaluations of the participants were performed by a blind examiner. The data were analyzed using the Student’s t-test with the level of significance (p≤0.05).

Results:

The data show significant differences in the reduction of pain intensity (p= 0.022) and functional disability (p=0.023) only in SG and improvement in kinesiophobia (p=0.007) only in PG. The level of confidence in the balance for specific activities was better in the SG when compared to the PG (p=0.059). There was no difference in the activation of the transversus abdominis in both groups.

Conclusion:

The results indicate that the segmental stabilization was effective to improve pain and functional disability, Pilates to improve the degree of kinesiophobia and the SG obtained a better result when compared to the PG regarding the level of confidence in the balance for specific activities. Both techniques had a great effect on improving functional capacity and on the level of confidence in the balance for specific activities. It is suggested to carry out studies with a larger number of participants and follow-up evaluation to assess the long-term effects.

References:

[1]Boonstra AM, Preuper HRS, Reneman MF, Posthumus JB, Stewart RE. Reliability and validity of the visual analogue scale for disability in patients with chronic musculoskeletal pain. IJSR 2008; 3(2):165-9.

[2]Marques AP, Mendes YC, Taddei U, Pereira CAB, Assumpção A. Brazilian-Portuguese translation and cross cultural adaptation of the activities-specific balance confidence ABC) scale. Braz J Phys Ther 2013; 17(2): 170-8.

[3]Siqueira FB, Teixeira-Salmela LF, Magalhães LC. Análise das propriedades psicométricas da versão brasileira da escala tampa de cinesiofobia. Acta Orto Bras 2007; 15(1): 19-24.

[4]Viggato R, Alexandre NMC, Correa Filho HR. Development of a Braziliam Portuguese version of the Oswestry Disability Index: cross-cultural adaptation, reliability, and validity. Spine 2007; 32(4):481-6.

Acknowledgments:

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Disclosure of Interests:

None declared

Giant mesenteric cyst: Successful management in low-resource setting

INTRODUCTION

Mesenteric cysts are rare, generally benign intra-abdominal lesions with a wide range of presentation in terms of size, clinical presentation, etiology, radiological features, and pathological characteristics.

PRESENTATION OF CASE

We reported a case of giant mesenteric cyst in a 16-month-old girl successfully managed in a low-resource setting.

DISCUSSION

This case is particularly important not only due to the rarity of the presented case, but also for the highlighted aspects from a public health point of view. We faced of the problem of a late stage disease and the lack of preoperative diagnosis due to cultural and economic reasons and the weaknesses of healthcare systems, as in the majority of low- and middle-income countries.

CONCLUSION

Despite all these limitation, this case illustrates that complex, rare diseases can also be managed successfully in a low-resource setting. It is mandatory to strengthen and improve the health system both in terms of equipment both in terms of public health policies in order to offer a better and more effective quality of care to patients also in low-income countries.

Coronavirus Diseases (COVID-19) Current Status and Future Perspectives: A Narrative Review

At the end of 2019 a novel virus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), causing severe acute respiratory syndrome expanded globally from Wuhan, China. In March 2020 the World Health Organization declared the SARS-Cov-2 virus a global pandemic. We performed a narrative review to describe existing literature with regard to Corona Virus Disease 2019 (COVID-19) epidemiology, pathophysiology, diagnosis, management and future perspective. MEDLINE, EMBASE and Scopus databases were searched for relevant articles. Although only when the pandemic ends it will be possible to assess the full health, social and economic impact of this global disaster, this review represents a picture of the current state of the art. In particular, we focus on public health impact, pathophysiology and clinical manifestations, diagnosis, case management, emergency response and preparedness.

Giant ovarian fibroma with associated Meigs syndrome in low resources setting

Meigs' syndrome is a rare condition characterized by the presence of a benign fibroma of the ovary, ascites and pleural effusion. It very uncommon and diagnosis is made difficult by symptoms that usually mimic disseminated malignancy. The gold standard treatment is laparotomy and, by definition of the syndrome, after tumor removal, the symptoms resolves and the patients become asymptomatic. We presented a giant ovarian fibroma with associated Meigs syndrome, successfully managed in a low resources setting.

Successful management of giant hydrocolpos in a limited-resource setting

Abdominal distention and urinary retention are rare manifestations in newborns. The differential diagnosis of a female neonate presenting these signs, especially when combined, should include hydrocolpos due to imperforate hymen. The prognosis of imperforate hymen is generally good, although it can be associated with serious nephro-urologic and infectious complications. Early diagnosis and drainage of hydrocolpos allow prevention and/or improvement of these possible complications. In limited-resource settings, diagnostic imaging is more difficult to obtain, and, therefore, increased caution and an accurate physical exam with perineal inspection are essential. We report the case of a 8-day-old female neonate showing abdominal distention and urinary retention. She had a final diagnosis of imperforate hymen with giant hydrocolpos, complicated by obstructive uropathy and following urosepsis and bladder perforation.

Physiologically motivated detection of Atrial Fibrillation

Atrial Fibrillation (AF) is the most common arrhythmia and it is estimated to affect 33.5 million people worldwide. AF is associated with an increased risk of mortality and morbidity, such as heart failure and stroke and affects mostly older persons and persons with other conditions (e.g. heart failure and coronary artery disease). In order to prevent such life threatening and life quality reducing conditions it is essential to provide better algorithms, capable of being integrated in low-cost personalized health systems. This paper presents a new algorithm for AF detection, which is based on the analysis of the three physiological characteristics of AF: 1) Irregularity of heart rate and; 2) Absence of P-waves and 3) Presence of fibrillatory waves. Based on these characteristics several features were extracted from 12-lead electrocardiograms (ECG) and selected according to their discrimination ability. The classification between AF and non-AF episodes was performed using a Support Vector Machine (SVM) classification model. Our results show that the identification of the fibrillatory patterns, using the proposed features, extracted from the analysis of 12-lead ECG improves the performance of the algorithm to a sensitivity of 88.5% and specificity 92.9%, when compared to our previous single-channel approach, in the same database.

Correlations between resistance training-induced changes on phase angle and biochemical markers in older women

The main purpose of this study was to investigate the effects of 12 weeks of resistance training (RT) on phase angle (PhA), inflammatory and oxidative stress biomarkers, and to evaluate whether these RT-induced adaptations are related to PhA changes. Fifty-one older women (70.6 ± 5.1 years; 26.9 ± 4.2 kg/m² ) were randomly allocated into a training group (TG) that performed 12-week RT or a nonexercising control group (CG). The PhA (Xitron), body composition (DXA), and blood sample measurements (after a 12 hours fast) were performed before and after the intervention. The TG showed a significant (P < .05) increase in PhA (TG: +7.4±5.9% vs CG: -3.6 ± 8.8%), and interleukin-10 (IL-10; TG: +51.8 ± 71.1% vs CG: -46.6 ± 38.0%), and a decrease in tumor necrosis factor alpha (TNF-α; TG: -15.2 ± 11.1% vs CG: +6.9±17.7%), interleukin-6 (IL-6; TG: -17.9 ± 17.8% vs CG: +6.1 ± 24.8%), and C-reactive protein (CRP; TG: -24.1 ± 19.9% vs CG: +43.8 ± 31.1%). Moreover, TG upregulated catalase (TG: +11.4 ± 15.0% vs CG: -6.7 ± 10.2%). Changes in TNF-α (r = -.71), CRP (r = -.65), lower advanced oxidation protein products (r = -.55), and catalase (r = +.73) after RT were correlated with changes in PhA (P < .05). These results suggest that RT improves PhA, inflammatory and oxidative stress biomarkers, and the changes in inflammatory and oxidative damage markers are correlated with changes in PhA.

Proteostasis in epicardial versus subcutaneous adipose tissue in heart failure subjects with and without diabetes

BACKGROUND

Cardiovascular diseases (CVDs) are leading cause of death and primary cause of morbidity and mortality in diabetic population. Epicardial adipose tissue (EAT) covers the heart's surface and is a source of biomolecules regulating heart and blood vessel physiology. The protective activation of the unfolded protein response (UPR) and autophagy allows the cardiomyocyte reticular network to restore energy and/or nutrient homeostasis and to avoid cell death. However, an excessive or prolonged UPR activation can trigger cell death. UPR activation is an early event of diabetic cardiomyopathies and deregulated autophagy is associated with CVDs.

RESULTS

An upregulation of UPR markers (glucose-regulated protein 78 KDa, glucose-regulated protein 94 KDa, inositol-requiring enzyme 1α, protein kinase RNA-like ER kinase and CCAAT/-enhancer-binding protein homologous protein (CHOP) gene) in EAT compared to subcutaneous adipose tissue (SAT), was observed as well as the UPR-related apoptosis marker caspase-4/procaspase-4 ratio but not in CHOP protein levels. Additionally, levels of ubiquitin and ubiquitinated proteins were decreased in EAT. Moreover, upregulation of autophagy markers (5' adenosine monophosphate-activated protein kinase, mechanistic target of rapamycin, Beclin 1, microtubule-associated protein light chain 3-II, lysosome-associated membrane protein 2, and PTEN-induced putative kinase 1) was observed, as well as an increase in the apoptotic Bim but not the ratio between Bim and the anti-apoptotic Bcl-2 in EAT. Diabetic patients show alterations in UPR activation markers but not in autophagy or apoptosis markers.

CONCLUSION

UPR and autophagy are increased in EAT compared to SAT, opening doors to the identification of early biomarkers for cardiomyopathies and novel therapeutic targets.

Gastroschisis Spiral-like Closure with Umbilical Cord in a Limited-resource Setting: A Case Report

Gastroschisis is one of the most frequent congenital surgical problems in fetuses and neonates, with a continuously increasing incidence worldwide. In limited-resource settings, the management of this condition is difficult, and the mortality rates are much higher than those observed in high-income countries. We report the case of a newborn with gastroschisis and viscero-abdominal disproportion, submitted to abdominal wall closure through utilization of umbilical cord tissue. This technique has not already been applied in low-resource countries, where it can show advantages such as lower risk of abdominal compartment syndrome and local infection, high availability, and low cost.

Reproductive features of the swimming crab Callinectes danae(Crustacea, Portunoidea) on the subtropical coast of Brazil: a sampling outside the estuary

The life cycle of the crab Callinectes danae is estuarine-dependent, and studies on aspects of their biology should also cover marine areas. The present study investigated the sexual maturity, as well as habitat preference by adults in different gonadal stages, and the crabs' reproductive periodicity outside the estuary. Three bays on the subtropical southeastern coast of Brazil were sampled monthly for two years. For each bay, six transects were established, four of them parallel to the beach line (5, 10, 15 and 20 m depth), as well as one transect in an exposed area, and another sheltered from the action of waves. The results showed that the pattern of spatio-temporal distribution of adults C. danae was similar in three bays, although the highest abundance was found in Ubatumirim. Females with developed gonads/ovigerous females were found in greater abundance than females with rudimentary/developing gonads, mainly in deeper transects. Although the areas sampled have different environmental characteristics, the reproductive pattern of the species did not change, showing continuous reproduction throughout, with more abundance of reproductive females on spring and summer. Males reached maturity at larger sizes than females in all three bays.

Assessment of cardiovascular function from multi-Gaussian fitting of a finger photoplethysmogram

Monitoring of cardiovascular function on a beat-to-beat basis is fundamental for protecting patients in different settings including emergency medicine and interventional cardiology, but still faces technical challenges and several limitations. In the present study, we propose a new method for the extraction of cardiovascular performance surrogates from analysis of the photoplethysmographic (PPG) signal alone.We propose using a multi-Gaussian (MG) model consisting of five Gaussian functions to decompose the PPG pulses into its main physiological components. From the analysis of these components, we aim to extract estimators of the left ventricular ejection time, blood pressure and vascular tone changes. Using a multi-derivative analysis of the components related with the systolic ejection, we investigate which are the characteristic points that best define the left ventricular ejection time (LVET). Six LVET estimates were compared with the echocardiographic LVET in a database comprising 68 healthy and cardiovascular diseased volunteers. The best LVET estimate achieved a low absolute error (15.41   ±   13.66 ms), and a high correlation (ρ = 0.78) with the echocardiographic reference.To assess the potential use of the temporal and morphological characteristics of the proposed MG model components as surrogates for blood pressure and vascular tone, six parameters have been investigated: the stiffness index (SI), the T1_d and T1_2 (defined as the time span between the MG model forward and reflected waves), the reflection index (RI), the R1_d and the R1_2 (defined as their amplitude ratio). Their association to reference values of blood pressure and total peripheral resistance was investigated in 43 volunteers exhibiting hemodynamic instability. A good correlation was found between the majority of the extracted and reference parameters, with an exception to R1_2 (amplitude ratio between the main forward wave and the first reflection wave), which correlated low with all the reference parameters. The highest correlation ([Formula: see text] = 0.45) was found between T1_2 and the total peripheral resistance index (TPRI); while in the patients that experienced syncope, the highest agreement ([Formula: see text] = 0.57) was found between SI and systolic blood pressure (SBP) and mean blood pressure (MBP).In conclusion, the presented method for the extraction of surrogates of cardiovascular performance might improve patient monitoring and warrants further investigation.

Prediction of Heart Failure Decompensation Events by Trend Analysis of Telemonitoring Data

This paper aims to assess the predictive value of physiological data daily collected in a telemonitoring study in the early detection of heart failure (HF) decompensation events. The main hypothesis is that physiological time series with similar progression (trends) may have prognostic value in future clinical states (decompensation or normal condition). The strategy is composed of two main steps: a trend similarity analysis and a predictive procedure. The similarity scheme combines the Haar wavelet decomposition, in which signals are represented as linear combinations of a set of orthogonal bases, with the Karhunen-Loève transform, that allows the selection of the reduced set of bases that capture the fundamental behavior of the time series. The prediction process assumes that future evolution of current condition can be inferred from the progression of past physiological time series. Therefore, founded on the trend similarity measure, a set of time series presenting a progression similar to the current condition is identified in the historical dataset, which is then employed, through a nearest neighbor approach, in the current prediction. The strategy is evaluated using physiological data resulting from the myHeart telemonitoring study, namely blood pressure, respiration rate, heart rate, and body weight collected from 41 patients (15 decompensation events and 26 normal conditions). The obtained results suggest, in general, that the physiological data have predictive value, and in particular, that the proposed scheme is particularly appropriate to address the early detection of HF decompensation.

Multi-Gaussian fitting for the assessment of left ventricular ejection time from the photoplethysmogram

The Left ventricular ejection time (LVET) is one of the primary surrogates of the left ventricular contractility and stroke volume. Its continuous monitoring is considered to be a valuable hypovolumia prognostic parameter and an important risk predictor in cardiovascular diseases such as cardiac and light chain amyloidosis. In this paper, we present a novel methodology for the assessment of LVET based the Photoplethysmographic (PPG) waveform. We propose the use of Gaussian functions to model both systolic and diastolic phases of the PPG beat and consequently determine the onset and offset of the systolic ejection from the analysis of the systolic phase 3(rd) derivative. The results achieved by the proposed methodology were compared with the algorithm proposed by Chan et al. [1], revealing better estimation of LVET (15.84 ± 13.56 ms vs 23.01 ± 14.60 ms), and similar correlation with the echocardiographic reference (0.73 vs 0.75).

The novel object recognition memory: neurobiology, test procedure, and its modifications

Animal models of memory have been considered as the subject of many scientific publications at least since the beginning of the twentieth century. In humans, memory is often accessed through spoken or written language, while in animals, cognitive functions must be accessed through different kind of behaviors in many specific, experimental models of memory and learning. Among them, the novel object recognition test can be evaluated by the differences in the exploration time of novel and familiar objects. Its application is not limited to a field of research and enables that various issues can be studied, such as the memory and learning, the preference for novelty, the influence of different brain regions in the process of recognition, and even the study of different drugs and their effects. This paper describes the novel object recognition paradigms in animals, as a valuable measure of cognition. The purpose of this work was to review the neurobiology and methodological modifications of the test commonly used in behavioral pharmacology.