DMA Health Strategies

This study addresses a persistent problem in rail corridor infrastructure: service disruptions and accelerated asset deterioration reduce reliability, yet decision makers often lack quantitative evidence showing how advanced engineering materials and performance-based design governance jointly translate into resilience outcomes. The purpose was to test whether Advanced Engineering Materials Integration (AEMI) and Performance Based Design Maturity (PBDM) predict Rail Corridor Resilience Performance (RCRP) using a quantitative, cross sectional, case-based design across enterprise rail projects. Data were collected from 212 rail engineering and operations professionals (mean experience 9.7 years, SD 4.8), and 83.0 percent reported direct involvement in the studied corridor cases. Measures showed strong reliability: AEMI (8 items, Cronbach alpha 0.86), PBDM (8 items, alpha 0.88), and RCRP (8 items, alpha 0.84). Descriptively, respondents reported moderate to high implementation (AEMI M 3.68, SD 0.59; PBDM M 3.74, SD 0.63) and comparatively higher resilience performance (RCRP M 3.81, SD 0.56); durability improvement was the strongest AEMI facet (M 3.92, SD 0.71), while restoration time target integration was the weakest PBDM facet (M 3.41, SD 0.83). The analysis plan applied descriptive statistics, internal consistency testing, Pearson correlations, and multiple regression with controls for perceived hazard exposure severity and asset age or condition pressure, plus an interaction term. Correlations supported the hypothesized relationships (AEMI to RCRP r 0.58, PBDM to RCRP r 0.62, AEMI to PBDM r 0.55; all p < .001). In regression, AEMI (beta 0.28, p < .001) and PBDM (beta 0.39, p < .001) jointly explained 49 percent of variance in RCRP (R2 0.49, Adj. R2 0.48); adding controls improved fit to R2 0.52 and effects remained significant (AEMI beta 0.25; PBDM beta 0.36; both p < .001). The AEMI by PBDM interaction was positive but small (beta 0.10, p = .031), indicating that performance-based maturity amplifies the resilience payoff of advanced materials. These results suggest procurement and standards teams should institutionalize performance verification workflows and data logging to sustain long term gains. Implications are that corridor programs should pair materials upgrades with verifiable performance requirements, especially restoration time criteria, to maximize resilience returns and support evidence-based capital planning.

The article presents the results of research on the development of effective methods for processing mineral raw materials with high recovery of valuable components. In addition, the results of experiments on processing waste from copper concentration factories and their granulometric, mineralogical and chemical compositions are presented. Storing this waste involves large material costs and at the same time causes some damage to the environment.

Rail–urban interface constraints in metropolitan transportation systems reduce reliability and safety because dense stations, corridor conflict points, and community exposure can turn small disruptions into network-wide delays and crowding. This study examined whether computational modeling and simulation capability (CMSC) improves constraint-management effectiveness (CME) in an enterprise-scale metro rail case were cloud and enterprise analytics support scenario testing and decisions. Using a quantitative, cross-sectional, case-based design, a 5-point Likert survey was administered to N = 312 professionals from operations/control (26.3%), planning/timetabling (20.5%), station management (17.9%), engineering/maintenance (19.9%), and safety/risk (15.4%); 41.0% were direct model users and 37.8% indirect users. Key variables were rail–urban interface constraint severity (RICS), CMSC, decision integration (DI), and CME. Data screening showed mean missingness of 1.8% and Harman single-factor variance of 32.6%. Reliability was strong (α: RICS .88, CMSC .91, DI .87, CME .90). The most severe constraints were station crowding/circulation (M = 4.21, SD = 0.62) and peak dwell-time variability (M = 4.08, SD = 0.67). CMSC was moderate-high (M = 3.78, SD = 0.64), with scenario analysis strongest (M = 3.92) and validation weakest (M = 3.49). CMSC and DI correlated positively with CME (r = .62 and .58; p < .001), while RICS correlated negatively (r = −.41; p < .001). Regression was significant (R² = .51): CMSC (β = .38) and DI (β = .29) increased CME, and RICS reduced it (β = −.17); CMSC benefits were stronger at higher DI (ΔR² = .03). Implications emphasize station-area actions, stronger validation governance, and institutionalized use of simulation outputs in routine decisions.

se corticoide inalatrio (CI) em baixas doses e B2 se necessrio.Na etapa 3, recomenda-se CI em doses moderadas e B2 se necessrio.Como alternativa etapa 3, possvel realizar baixa dose de CI em associao a um antileucotrieno.A ultima etapa engloba o referenciamento a um especialista.

Anais do VI Congresso Internacional de Saúde Única e II Simpósio Internacional Pluriprofissional de Saúde (978-85-5722-750-7) - Diferença Entre Alergia À Proteína Do Leite E Intolerância À Lactose E Os Seus Desafios

É perceptível com muita frequência, excessos de ansiedade, no contexto escolar. Para fundamentar tais reflexões devem ser utilizados autores como Gaudêncio Frigotto, Marise Ramos, Ricardo Ribeiro, Dermeval Saviani, o Manual Diagnóstico e Estatístico de Transtornos Mentais: DSM-5. Dessa forma, o objetivo geral desta pesquisa é analisar as manifestações dos níveis de ansiedade em estudantes do último ano do ensino médio integrado do Instituto Federal de Educação de Pernambuco do Campus Afogados da Ingazeira. Para tanto, pretende-se realizar uma metodologia com finalidade aplicada, por meio de pesquisa documental e bibliográfica, de campo e com abordagem quali- quantitativa. A aplicação da pesquisa se dará por meio da utilização de questionário semiestruturado e teste psicológico com alunos concluintes do ensino médio integrado do Instituto Federal de Educação de Pernambuco, Campus Afogados da Ingazeira. Acredita-se que essa pesquisa poderá trazer reflexões sobre o tema e apresentar ao final do estudo, contribuições para uma melhor compreensão e auxílio na qualidade de vida das pessoas que possuem transtornos ansiosos, além da prevenção e promoção da saúde mental no âmbito escolar.

There is currently no bibliometric study on teratomas in the literature. This study aims to analyze the published articles on teratomas to provide an overview of the subject, determine global productivity, and identify current research trends. Additionally, data on different components of scientific output (countries, journals, institutions, authors) were analyzed. A total of 4209 articles published on teratomas between 1980 and 2022 were analyzed using various bibliometric and statistical methods. Bibliometric network visualization maps were used to determine trending topics, citation analyses, and international collaborations. Spearman correlation coefficient was used for correlation analysis. The top 3 countries that made the most contributions to the literature were the USA (1041, 24.7%), Japan (501, 11.9%), and India (310, 7.3%). The top 3 active institutions were the University of California System (n = 78), University of London (64), and Harvard University (62). The top 3 productive journals were the Journal of Pediatric Surgery (n = 141), Pediatric Surgery International (n = 70), and Journal of Pediatric Surgery Case Reports (69). The most productive author was Ulbright TM. (n = 18). The most studied topics from past to present were ovarian cancer/ovarian teratoma/ovarian torsion, mature cystic teratoma/dermoid cyst, sacrococcygeal teratoma, germ cell tumors, immature teratoma, malignant transformation, mediastinal teratoma/mediastinum, neonate/newborn/infant, prenatal diagnosis, testis/testicular cancer/teratoma, ultrasonography/ultrasound, magnetic resonance imaging, chemotherapy, growing teratoma syndrome, surgery, retroperitoneal teratoma/retroperitoneum, laparoscopic surgery/laparoscopy, children/child, and fetal surgery/fetus. We identified trend research topics in the field of teratomas in recent years, including mature cystic teratoma, ovarian teratoma/neoplasm, ovarian cancer, ovarian torsion, growing teratoma syndrome, recurrence, pediatric, testicular cancer, anti-n-methyl-d-aspartate receptor encephalitis, immature teratoma, retroperitoneal, struma ovarii, and carcinoid. The research leadership in the development of teratoma literature was determined by countries with major economies such as the USA, Japan, India, the UK, China, Turkey, South Korea, and other European countries (France, Germany, Italy).

O livro "Diagnóstico de Parasitoses Intestinais e Teciduais" oferece uma exploração abrangente e especializada do complexo mundo das infecções parasitárias que afetam tanto o trato intestinal quanto os tecidos do corpo humano. Esta obra é uma leitura obrigatória para profissionais de saúde, estudantes e pesquisadores interessados em aprimorar suas habilidades de diagnóstico.Dentro das páginas deste livro, os leitores encontrarão uma análise detalhada das técnicas mais atualizadas para a identificação precisa de parasitas, abrangendo desde os princípios básicos da coleta de amostras até a aplicação de métodos.

No curta-metragem Maranhão 66, o cineasta Glauber Rocha expõe de modo empírico os princípios basilares do conceito de “estética da fome”, num ambiente regional de transição política vivenciado no Estado do Maranhão, no qual um coronelismo subsumia e um populismo com viés coronelista emergia. O objetivo deste artigo é retomar o legado de Maranhão 66 para compreender o seu significado na trajetória de Glauber e na construção de uma narrativa sobre a política maranhense e brasileira.

In <b><i>Top-Down Portfolio Implications of Climate Change</i></b>, which appeared in <b><i>The Journal of Portfolio Management</i></b> special 2021 issue on novel risks, authors <b>Yesim Tokat-Acikel</b>, <b>Marco Aiolfi</b>, <b>Lorne Johnson</b>, <b>John Hall</b>, and <b>Jessica (Yiwen) Jin</b> of <b>PGIM Quantitative Solutions</b> explore the economic impacts of climate change from a top-down macroeconomic perspective. Climate change presents a significant source of uncertainty for the long-term investor. The authors’ stated goal is to quantitatively assess the impacts of climate change on long-term expected returns across major public assets and then explore strategic portfolio allocations. They provide a review of the significant academic and policy research done on climate change and its impact within the environmental, social, and governance (ESG) framework. The authors’ forecasts incorporate selected studies and data in order to quantitatively assess both an optimistic climate scenario and a pessimistic one.