Brocade (United States)

Abstract Background Atrial fibrillation (AF) is a major cause of morbidity and mortality, which is reduced by ablation. However, predicting response is difficult and mostly done using static chart data, since it is difficult to interpret AF electrogram features or link them with clinical presentation. There is a need for a metric that can accurately predict responders to AF ablation. Hypothesis We hypothesized that mapping AF waves for repeating patterns (fig. A) near the pulmonary veins (PV), using novel artificial-intelligence (AI) tools developed from multipolar data in AF, may reflect response to ablation and clinical phenotypes. Methods We developed an AI-system to identify potentially repeating AF waves on multipolar catheters (fig A), trained on >10 million electrograms in N=229 richly characterized AF patients (68.2±8.7 years old, 71.6 % persistent AF). In Fig B., AI was used to track AF waves near the PVs for 1 minute in a validation cohort population (26,640 electrograms, N=37). We compared peri-PV AF vectors to ablation outcome, classification (persistent vs non-paroxysmal AF), stroke risk factor (CHADS2-VASc), and left ventricular ejection fraction (LVEF). Results In Fig. B, wave vectors varied over 1 min yet predominantly exited PVs in a 60 Y man with PeAF and successful ablation, and did not predominantly exit PVs in a 70 Y woman with failed ablation at 1 year. In Fig. C, PV-exiting AF waves were more likely in successful vs failed ablation (<0.05), but did not reflect AF type (p=NS), CHADS2-VASc <2 vs >2 (p=NS) nor LVEF <50% vs >50% (p=NS). Conclusions A novel AI-based system to track AF waves trained using millions of electrograms identified ablation responders vs non-responders by AF waves exiting pulmonary veins. Future studies should examine if AF wave tracking, a novel metric of organization, is independent of other clinical AF classifications.Figure 1

A psorase uma doena de pele crnica e inflamatria que afeta diversas faixas etrias, incluindo os idosos. A psorase em idosos apresenta particularidades clnicas e consideraes especiais em relao ao tratamento, devido s caractersticas fisiolgicas e condies de sade associadas idade avanada. Esta reviso explora as manifestaes clnicas distintas da psorase em idosos e examina as abordagens de tratamento adaptadas a essa populao. OBJETIVOS: descrever as caractersticas clnicas da psorase em idosos

A residência é uma modalidade de ensino do tipo lato sensu, onde o enfermeiro tem a oportunidade de realizar a especialização ao se inserir no ambiente da especialidade, tendo uma maior carga horária prática. Nesta modalidade de formação os enfermeiros devem ser acompanhados por preceptores, que geralmente são os próprios profissionais do serviço onde estão inseridos. OBJETIVOS: Relatar a experiência vivenciada durante a preceptoria de residentes em Enfermagem Obstétrica e as contribuições do preceptor para a formação. RELATO DE EXPERIÊNCIA: O estudo foi desenvolvido através da preceptoria de uma turma de Residência Uniprofissional em Enfermagem Obstétrica dos anos 2021 a 2022, em uma maternidade terciária de Fortaleza Ceará. Os enfermeiros residentes vivenciam diversas experiências e sentimentos durante os dois anos de formação, sendo o preceptor o maior exemplo de como se deve agir em diversas situações comuns ao serviço. Nesse período de intensa carga física e emocional o preceptor deve agir como principal apoio ao enfrentamento aos desafios inerente ao desenvolvimento de novos conhecimentos e habilidades em enfermagem obstétrica. DISCUSSÃO: Faz-se necessário que o enfermeiro preceptor esteja capacitado pedagogicamente, busque sempre estar atualizado com as novas evidências científicas e possua habilidade técnica na sua área de atuação para contribuir de forma efetiva na formação do residente. O preceptor torna-se um elo entre o serviço e a instituição formadora, no qual o estudante deverá desenvolver uma visão crítica, ética e reflexiva das duas práticas profissionais. CONCLUSÃO: O impacto gerado pelas experiências vividas na residência influencia a formação e conduta profissional dos especialistas formados pelo programa, destaca-se a importância do preceptor como orientador neste processo.

Objetivo: Avaliar o impacto da pandemia do COVID-19 nos pacientes com artrose de joelho e que estavam aguardando a realização de artroplastia. Métodos: Avaliação de 87 pacientes que tiveram cirurgia eletiva de prótese total de joelho adiada durante a pandemia do COVID-19 que estavam na fila de cirurgia pelo SUS (Sistema Único de Saúde) através de entrevista telefônica com questões sobre a disposição para operar durante a pandemia, qualidade de vida e aplicação de questionário de função do joelho. Resultados: Avaliação completa com 60 pacientes. A disposição para a cirurgia diminuiu significativamente com o início da pandemia(p<0001). Vinte a quatro (40%) dos pacientes já haviam sido acometidos pela COVID-19. Cinquenta e nove pacientes(98,3%) afirmaram que a artrose de joelho já afetava sua vida antes do início da pandemia, e 50 pacientes(83,3%) responderam que a espera pela cirurgia, durante esse período pandêmico, fez a qualidade de vida deles serem mais prejudicadas(p=0.008). Quando comparamos esse grupo de pacientes com um grupo de 60 pacientes que avaliamos nesse mesmo ambulatório, 2 anos antes do início da pandemia, encontramos melhores resultados no grupo que aguardava a cirurgia durante a pandemia(p<0,0001). Conclusões: Os pacientes com artrose de joelho que aguardavam a cirurgia durante a pandemia relataram piora na qualidade de vida e menor disposição para realizar a cirurgia, mesmo assim 76,6% ainda aceitariam internar para a cirurgia. Não identificamos piores resultados funcionais no grupo estudado em comparação com pacientes que aguardavam a cirurgia antes do início da pandemia.

This article aims to identify scientific production related to Marketing and Communication in university libraries and to analyse the focus of applied studies. The qualitative methodology adopted comprises an exploratory approach through the literature review. From the results obtained we highlight: the gradual dissemination and promotion of the university library services through tools provided by Web 2.0; the growing use of social networks as means of communication; the contradiction between Marketing principles, which emphasise the importance of the customer at the centre of decisions on promotional strategies, and library practice, which places service managers and information professionals at the centre. All in all, the focus of applied studies is on the perspective of information professionals or institutions. A change in the Marketing and Communication strategies adopted by university libraries is considered urgent and it is essential to identify the real needs and information profile of the client, as well as to periodically evaluate the results of the Marketing and Communication strategies implemented.

All the contents of this work, except where otherwise noted, is licensed under a Creative Commons Attribution 4.0 International license. Todo o conteúdo deste trabalho, exceto quando houver ressalva, é publicado sob a licença Creative Commons Atribição 4.0. Todo el contenido de esta obra, excepto donde se indique lo contrario, está bajo licencia de la licencia Creative Commons Reconocimento 4.0.

Utilizando 50 pré-molares humanos recentemente extraÍdos e uma solução corante de azul tripan 0,5%, o autor estudou rnateriais de selamento de curativos em canais radiculares como Cavit, cimentos de óxido de zinco e eugenol e de fosfato de zinco, gutapercha e gutapercha corn cimento de fosfato de zinco. O Cavit apresentou as melhores condições e o cimento de óxido de zinco e eugenol as piores, o que surpreende.

Background. Phytoplankton is considered an important indicator of natural and anthropogenic processes that take place in basins and coastal environments. An example of these systems is the formed by the El Car- men, Pajonal and La Machona lagoons, in which there is intense fishing and oyster farming activity, as well as agricultural activities, oil extraction and forestry in their surroundings. Goals.Identifying the phytoplankton species, with emphasis on the potentially harmful and / or toxic ones, their distribution and differences between the samplings, north winds (2015) and rainy (2016), as well as reporting the physicochemical variables was the aimed of this work. Methods. Net samples with a mesh size of 20 μm were taken and physicoche- mical variables were measured with a water quality sonde. 300 organisms were counted and the specific richness, relative abundances and diversity index were calculated. To identify differences between the two seasons sampled the Mann-Whitney U test was performed. In addition, the most important physicochemical variables were identified to explore their relationship with the species through a distance-based redundancy analysis (dbRDA). Results. A total of 86 species were identified, of which ten are new records and 15 are potentially harmful and / or toxic ones. The taxonomic group with the most species in both seasons was Bacillaryophyta (43 Northeast and 22 Rains). Specific richness was significantly different between seasons. In the north winds season, the most abundant species were from the Cyanoprokaryota and Bacillaryophyta groups, while for rainy season they were from the Dinoflagellata. Conclusions. Water temperature and salinity were the physicochemical variables that defined the phyto- plankton composition in the CPM lagoons; the presence of potentially toxic species is an alert for the lagoon system because it reflects a latent situation that could trigger blooms at any time.

Tractography of the facial nerve based on single-shell diffusion MR imaging is thought to be helpful before surgery for resection of vestibular schwannoma. However, this paradigm can be vitiated by the isotropic diffusion of the CSF, the convoluted path of the facial nerve, and its crossing with other bundles. Here we propose a multishell diffusion MR imaging acquisition scheme combined with probabilistic tractography that has the potential to provide a presurgical facial nerve reconstruction uncontaminated by such effects. Five patients scheduled for vestibular schwannoma resection underwent multishell diffusion MR imaging (b-values = 0, 300, 1000, 2000 s/mm2). Facial nerve tractography was performed with a probabilistic algorithm and anatomic seeds located in the brain stem, cerebellopontine cistern, and internal auditory canal. A single-shell diffusion MR imaging (b-value = 0, 1000 s/mm2) subset was extrapolated from the multishell diffusion MR imaging data. The quality of the facial nerve reconstruction based on both multishell diffusion MR imaging and single-shell diffusion MR imaging sequences was assessed against intraoperative videos recorded during the operation. Single-shell diffusion MR imaging-based tractography was characterized by failures in facial nerve tracking (2/5 cases) and inaccurate facial nerve reconstructions displaying false-positives and partial volume effects. In contrast, multishell diffusion MR imaging-based tractography provided accurate facial nerve reconstructions (4/5 cases), even in the presence of ostensibly complex patterns. In comparison with single-shell diffusion MR imaging, the combination of multishell diffusion MR imaging-based tractography and probabilistic algorithms is a more valuable aid for surgeons before vestibular schwannoma resection, providing more accurate facial nerve reconstructions, which may ultimately improve the postsurgical patient's outcome.

El Mercadeo Social (MS) son las acciones estratégicas dirigidas a diferentes actores que están directamente relacionados con una situación objeto de cambio, con el fin de lograr cambios de comportamiento o conducta que mejoren la calidad de vida de individuos y comunidades. En su evolución ha sido objeto de investigación de Escuelas como la de Macromarketing y la de pensamiento de investigación transformadora del consumidor (TCR); ha recibido aportes de la teoría de movimiento social, la teoría de red de actores y la teoría de la práctica social y se proyecta una tendencia en la implementación del Marketing Macro-Social para cambiar comportamientos en la sociedad y el Modelo de Mercadeo Social con enfoque Sostenible (MSsS) para planear cambios de comportamiento en la era de los Objetivos de Desarrollo Sostenible (ODS) .