Revista Urología Colombiana / Colombian Urology Journal
Precision medicine plays a key role in urological oncology practice nowadays, with the breakthrou... more Precision medicine plays a key role in urological oncology practice nowadays, with the breakthrough of the poly (ADP-ribose) polymerase inhibitors (PARPi), which play a critical role in different DNA damage repair (DDR) pathways, the immune checkpoint inhibitors, the genomic expression profiles and current genome manipulation-directed targeted therapy. Information and technology (IT) are set to change the way we assess and treat patients and should be reviewed and discussed. The aim of the present article is to demonstrate a detailed revision on precision medicine, including novel therapeutic targets, genomic markers, genomic stratification of urological patients, and the top-notch technological breakthroughs that could change our clinical practiceWe performed a review of the literature in four different databases (PubMed, Embase, Lilacs, and Scielo) on any information concerning prostate, bladder, kidney and urothelial cancer novel treatments with PARPi, immune checkpoint inhibitor...
This is the first survey of bryophyte diversity in the mangroves of Panama. The study was done in... more This is the first survey of bryophyte diversity in the mangroves of Panama. The study was done in the mangroves of Bocas del Toro Province, Panama, in September 2016 and, July, May and August 2017. Bryophytes were collected from prop or stilt roots of mangroves, the mid-lower part of the trunks and the lower branches. In areas inundated at high tide, additional samples were collected on the cortex of palms, its rootlets, other angiosperm trees and from decomposing logs. Twenty-six species of liverworts and seven of mosses were identified. The most diverse and predominant liverwort family was the Lejeuneaceae with twenty-two species and two varieties and, among the mosses, the Calymperaceae with three species. Species affinities with other tropical mangroves were analyzed and liverworts were found to be the dominant element. Among the liverworts collected, two are new reports for Panama: Ceratolejeunea confusa and Frullanoides mexicana. Additional surveys of the cryptogamic vegetatio...
Introducción: La ventilación mecánica es una estrategia terapéutica utilizada en las Unidades de ... more Introducción: La ventilación mecánica es una estrategia terapéutica utilizada en las Unidades de Cuidado Intensivo (UCI), el destete es el término utilizado para el proceso de retirada de la Ventilación Mecánica para llegar a la respiración espontanea; en las UCI la debilidad muscular y el desacondicionamiento físico son comunes en pacientes que reciben esta estrategia, especialmente cuando se prolonga. Desde fisioterapia se han propuesto estrategias que podrían limitar o revertir estas secuelas facilitando el destete de forma rápida y evitando fallas en la extubación, definidas como entrenamiento de los músculos respiratorios. Sin embargo no hay información metodológica que estandarice en las UCI el manejo de esta estrategia por esto el objetivo de esta revisión sistemática es recopilar la información para estandarizar un programa de entrenamiento muscular respiratorio en las UCI que facilite el destete ventilatorio.Método: Revisión sistemática de 5 bases de datos (PUBMED, SCIENCE ...
Droughts are a natural, recurrent climate extreme that can inflict longlasting devastation on nat... more Droughts are a natural, recurrent climate extreme that can inflict longlasting devastation on natural ecosystems and socioeconomic sectors. Unlike other natural hazards, drought onset is insidious and often affects a greater spatial extent and prolonged temporal scale. The evolution of drought and its impacts are typically region specific; the West and Southwest U.S. have experienced severe droughts at a higher frequency than the East and parts of the Midwest. While these regions do experience drought, intensified precipitation variability also obscures how drought may be changing in these locations. To better understand these trends, we examine the spatiotemporal trends of drought using self-organizing maps (SOM). SOMs are a novel, competitive learning subset of artificial neural networks (ANN), requiring unsupervised training of inputs. We introduced monthly Palmer Drought Severity Index (PDSI) values to the SOM to identify existing clusters of wetting and drying patterns from 1895-2016. After training, we created cartographic visualizations of the SOM output and conducted a subsequent time-This work would not have been able to reach completion without the unwavering support of my research advisors, Dr. Margaret Sugg, and Dr. Johnathan Sugg, who have both played integral roles in my success as a master's thesis student. Dr. Maggie Sugg has been an especially wonderful mentor as we both navigated through completing a thesis virtually. Her encouragement and attentiveness provided me the tools I needed to succeed during uncertain times, and for this I am sincerely grateful. Dr. Johnathan Sugg has also been a dedicated advisor, whose guidance in my methods was an essential component to the completion of my thesis. I am thankful for his contributions during this process. I would like to acknowledge, and thank fellow committee member, Dr. Baker Perry, whom without I would not have found my passion for research and climatology and embark on the journey of obtaining a masters in Geography. I would also like to recognize and thank Ronnie Leeper with the North Carolina Cooperative Institute for Climate and Satellites (NCICS) for providing the data used to complete this work. Given the unusual circumstances, I was unable to present this work at the Association of American Geographers (AAG) 2021. Regardless, I would still like to recognize the Office of Student Research, an on-campus organization which offered to provide funding for an opportunity to present at the AAG. I would also like to offer special recognition to the Department of Geography and Planning at Appalachian State University for providing a safe, and open environment where students and faculty support each other, both morally and vii academically. Despite the challenges the department has been faced with, our department has shown admirable resilience. A special thanks to our program director Dr. Derek Martin, and our department chair Dr. Saskia Van de Gevel whose devotion to students and higher education have made my experience welcoming and enjoyable. Finally, I would like to acknowledge my family, and my husband who have been patient and caring throughout this entire journey. My mother and father Cristina and Beto, who have only shown me to persevere and challenge myself, I am grateful for their ongoing inspiration. A special thanks to my husband, Brandon Cox, for always encouraging me to pursue all my academic dreams.
Machine Learning studies often involve a series of computational experiments in which the predict... more Machine Learning studies often involve a series of computational experiments in which the predictive performance of multiple models are compared across one or more datasets. The results obtained are usually summarized through average statistics, either in numeric tables or simple plots. Such approaches fail to reveal interesting subtleties about algorithmic performance, including which observations an algorithm may find easy or hard to classify, and also which observations within a dataset may present unique challenges. Recently, a methodology known as Instance Space Analysis was proposed for visualizing algorithm performance across different datasets. This methodology relates predictive performance to estimated instance hardness measures extracted from the datasets. However, the analysis considered an instance as being an entire classification dataset and the algorithm performance was reported for each dataset as an average error across all observations in the dataset. In this paper, we developed a more fine-grained analysis by adapting the ISA methodology. The adapted version of ISA allows the analysis of an individual classification dataset by a 2-D hardness embedding, which provides a visualization of the data according to the difficulty level of its individual observations. This allows deeper analyses of the relationships between instance hardness and predictive performance of classifiers. We also provide an open-access Python package named PyHard, which encapsulates the adapted ISA and provides an interactive visualization interface. We illustrate through case studies how our tool can provide insights about data quality and algorithm performance in the presence of challenges such as noisy and biased data.
Ag gr ra ad de ec ci im me en nt to os s À Deus por ter me dado sabedoria, paciência, saúde e for... more Ag gr ra ad de ec ci im me en nt to os s À Deus por ter me dado sabedoria, paciência, saúde e força, necessários para conduzir este sonho. Aos primeiros responsáveis por isso tudo, à minha base, Mauricio Donizeti Moreno e Maria Cleine Rodrigues Moreno, os melhores pais que Deus poderia ter me dado. Obrigada pelo empenho na minha criação e educação, por muitas vezes terem se abdicado dos seus sonhos para que eu pudesse sonhar os meus. Vocês são exemplos de comprometimento, respeito, responsabilidade, integridade e humanidade. A conclusão desse trabalho é uma maneira de dizer obrigada por tudo, esse título é nosso e eu estou levando ele pra casa. Amo vocês imensuravelmente. À minha orientadora, Profa. Dra. Maria de Lourdes Higuchi, obrigada pela confiança e por ter contribuido tanto com a minha formação pessoal e acadêmica. Agradeço por todo suporte cíentifico ofertado para o desenvolvimento desse trabalho. Ao Prof. Dr. José Antônio Franchini Ramires, por ter confiado em meu trabalho e por ter aberto as portas dessa instituição que tornou-se minha segunda casa e por muitas vezes à primeira. O admiro demasiadamente como pessoa, médico e docente. Aos meus companheiros de trabalho e amigos integrantes do Laboratório de Patologia
This is a literature review that aims to identify what is expressed in the publications of the ma... more This is a literature review that aims to identify what is expressed in the publications of the main nationals journals regarding management, policies, and health practices addressed to the LGBT population, in the period comprehended between 2004 and 2018. The search of documents was carried out through the tool 'integrated search', being selected available articles in their whole that were indexed in the database Scientific Electronic Library Online (SciELO). We analyzed the publications of 10 national periodics and selected 27 publications that addressed health public policies towards the LGBT population. Little expression of related themes regarding the LGBT population was observed, in the 14 years of the temporary cut proposed by this article, since from the articles found, only 92 made reference the LGBT population and only 27 discussed health policies. Thus, it is verified the need for accomplishment of researches addressing the analysis of implantation of health public...
A demanda para atendimento infantil em clinicas psicologicas e servicos de saude mental tem cresc... more A demanda para atendimento infantil em clinicas psicologicas e servicos de saude mental tem crescido consideravelmente nos ultimos anos, sobretudo relacionada a queixas de comportamento, mesmo em idades precoces. Com base na concepcao de que o ambiente pode propiciar vinculos imprescindiveis para o desenvolvimento da crianca e no perfil da dinâmica familiar atual, escolheu-se uma Escola Municipal de Educacao Infantil do municipio de Assis para a realizacao deste projeto de extensao. Este projeto tem como objetivos conhecer as caracteristicas de organizacao, funcionamento e rotina de uma escola de educacao infantil do municipio de Assis; identificar a compreensao, dificuldades, duvidas e principais necessidades dos educadores e pais a respeito das caracteristicas das criancas em cada idade do desenvolvimento; propiciar espacos que permitam reflexoes e discussoes que possam contribuir para a saude e a educacao das criancas. Sao realizados encontros mensais com os pais e educadores por...
La educacion estocastica juega un papel preponderante en la formacion del futuro ciudadano, dentr... more La educacion estocastica juega un papel preponderante en la formacion del futuro ciudadano, dentro de los elementos fundamentales a considerar en esa formacion es la capacidad de interpretacion de graficas, Batanero (2002). El presente informe reporta los resultados de un estudio descriptivo frente a la lectura de pictogramas.
Introducao: A disseccao da aorta ocorre quando o dano a camada mais interna daaorta faz com que o... more Introducao: A disseccao da aorta ocorre quando o dano a camada mais interna daaorta faz com que o sangue passe entre as varias camadas da parede aortica eforce a separacao dessas camadas. A reducao do suprimento de sangue paraoutros orgaos pode causar acidente vascular cerebral ou isquemia mesenterica.Sabendo da importância da arteria aorta, da complexidade, seriedade e extensaodos danos que pode ocasionar, torna-se cada vez mais necessario o estudo,pesquisa e desenvolvimento de novas tecnicas e alternativas de tratamento.Objetivo: Descrever a funcao da circulacao extracorporea em casos de disseccaoda arteria aorta. Metodologia: Constitui uma revisao bibliografica descritivarealizada nas bases de dados eletronicas PubMed e SciELO, atraves da consulta aartigos publicados entre os anos 2000 a 2021. Resultados: Nao existe um consensosobre a canulacao arterial mais indicada para cada caso especifico quando se tratade disseccao de aorta. Elementos importantes para estrategias de canulaca...
Frontiers in Cellular and Infection Microbiology, 2021
BackgroundIdiopathic dilated cardiomyopathy (IDCM) myocardial inflammation may be associated with... more BackgroundIdiopathic dilated cardiomyopathy (IDCM) myocardial inflammation may be associated with external triggering factors such as infectious agents. Here, we searched if moderate/severe heart transplantation rejection is related to the presence of myocardial inflammation in IDCM explanted hearts, associated with microbial communities.MethodReceptor myocardial samples from 18 explanted hearts were separated into groups according to post-transplant outcome: persistent moderate rejection (PMR; n = 6), moderate rejection (MR; n = 7) that regressed after pulse therapy, and no rejection (NR; n = 5)/light intensity rejection. Inflammation was quantified through immunohistochemistry (IHC), and infectious agents were evaluated by IHC, molecular biology, in situ hybridization technique, and transmission electron microscopy (TEM).ResultsNR presented lower numbers of macrophages, as well as B cells (p = 0.0001), and higher HLA class II expression (p ≤ 0.0001). PMR and MR showed higher level...
Microbial communities are considered decisive for maintaining a healthy situation or for determin... more Microbial communities are considered decisive for maintaining a healthy situation or for determining diseases. Acute myocardial infarction (AMI) is an important complication of atherosclerosis caused by the rupture of atheroma plaques containing proinflammatory cytokines, reactive oxygen species, oxidized low-density lipoproteins (oxLDL), damaged proteins, lipids, and DNA, a microenvironment compatible with a pathogenic microbial community. Previously, we found that archaeal DNA-positive infectious microvesicles (iMVs) were detected in vulnerable plaques and in the sera of Chagas disease patients with heart failure. Now, we characterize and quantify the levels of serum microbiome extracellular vesicles through their size and content using morphomolecular techniques to differentiate clinical outcomes in coronary artery disease (CAD). We detected increased numbers of large iMVs (0.8–1.34 nm) with highly negative surface charge that were positive for archaeal DNA, Mycoplasma pneumoniae...
O presente trabalho de cunho historico teve como objetivo mapear as cartilhas e os livros de alfa... more O presente trabalho de cunho historico teve como objetivo mapear as cartilhas e os livros de alfabetizacao que circularam na cidade de Birigui no seculo XX. Para que este objetivo fosse alcancado buscou-se em bibliografia especializada apropriar-se dos temas que envolvem a tematica do estudo. Para o mapeamento das cartilhas e dos livros de alfabetizacao mais usados para ensinar a ler e escrever no presente municipio foi realizado entrevistas e levantamento de dados em todas as bibliotecas da cidade de Birigui. Com o levantamento realizado foi possivel se chegar ao resultado final deste trabalho, que se apresenta dividido em tres partes: na primeira, apresenta-se um breve historico sobre a alfabetizacao, desde o final do seculo XIX, ate a reforma no modelo de ensino com a implantacao do construtivismo; em seguida apresentam-se os manuais de alfabetizacao: as cartilhas e os livros didaticos, discorrendo sobre suas caracteristicas e utilizacao na alfabetizacao brasileira. Na segunda pa...
Drought is a highly destructive natural hazard with wide-ranging impacts on water security, agric... more Drought is a highly destructive natural hazard with wide-ranging impacts on water security, agriculture, energy, and human health. Unlike most natural hazards, droughts can develop anywhere, evolve rapidly within a month or slowly over a season, and span months to decades without a clear beginning or end. Few studies investigate the direct link between drought and drought-related impacts on health and society, and little research has identified critical science gaps in the field of drought-society. This scoping review aims to explore the societal implications of drought and identify knowledge gaps for future drought-society studies. We performed a PRISMA scoping review with a fourelement search model on articles published since 2010. We extracted drought impacts data from 74 articles. Results were synthesized into three main topical areas examining public health impacts, water quality impacts, and water quantity impacts. While studies were heterogeneous in terms of objectives and methods, they illustrated the full breadth of drought impacts. The current body of evidence lacks a standard set of drought indices that can be readily applied to evaluate and monitor societal impacts due to drought. The challenge of defining drought limits a holistic understanding of drought effects and recovery time. More interdisciplinary collaborations are needed to establishes community-wide consensus on the identification of relevant hydrological indicators that best describe an adverse outcome is an understudied research priority.
Revista Brasileira de Pesquisa em Saúde/Brazilian Journal of Health Research, 2016
RESUMO| Introdução: O acolhimento incrementa o acesso e melhora o processo de trabalho nos cenári... more RESUMO| Introdução: O acolhimento incrementa o acesso e melhora o processo de trabalho nos cenários dos serviços de saúde, bem como possibilita o fortalecimento de laços entre usuários, trabalhadores e gestores em defesa do SUS enquanto política pública e não de governo. Objetivo: Desenvolver uma reflexão crítica sobre a percepção e operacionalização do acolhimento a partir de uma revisão literária. Métodos: Trata-se de um estudo descritivo com suporte em uma revisão sistemática da literatura. Inicialmente, foram selecionados 14 artigos, e nove deles foram eleitos criteriosamente, de acordo com as normas de inclusão. Resultados: Da análise, surgiram três eixos temáticos: "o acolhimento de forma real"; "acolhimento sob a perspectiva dos usuários de saúde"; e, por fim, "dificuldades apontadas para a realização do acolhimento". Conclusão: Pode-se compreender que o acolhimento é uma prática que deve ser integrada de modo forte e decisivo às unidades de saúde, pois facilita o processo de trabalho e melhora a qualidade da assistência, mas por vezes não é realizado ou não é praticado como preconizado. Palavras-chave| Acolhimento; Atenção Primária à saúde; Qualidade da assistência à saúde. ABSTRACT| Introduction: "User embracement" improve accessibility and quality of health services, and enables the strengthening of ties between users, workers and managers. It also strengths the view of SUS as a State policy and not a transitory governmental one. Objective: To develop critical reflection on the perception and operationalization of "user embracement", based on relevant literature review. Methods: This is a descriptive study supported by a systematic review of the literature. Fourteen articles were selected initially. Of these, nine met the inclusion criteria. Results: Three main themes emerged from the analysis: "user embracement" in real practice; "user embracement" from the perspective of the users of health facilities; and finally, "user embracement" challenges. Conclusion: "User embracement" is an approach that should be firmly integrated into health units, since it markedly improves the quality of care. However, it is sometimes not performed according to the principles underlying it.
The effect of alcaline and hot water surface treatments of piassava Attalea funifera fibers was i... more The effect of alcaline and hot water surface treatments of piassava Attalea funifera fibers was investigated. The efficiency of each treatment was evaluated by Fourier transform infrared spectroscopy, X-ray diffractometry, optical microscopy, scanning electron microscopy and atomic force microscopy. The alkaline treatments were effective in removing the superficial lignin layer from the fiber, while the hot water treatment was not. Treatment with hot water and NaOH caused fiber defibrillation. NaOH was most effective in promoting both, a decrease in fiber diameter and an increase in fiber surface area. Treatment with Ca(OH) 2 led to the formation of a CaCO 3 layer deposited on the fiber, preventing defibrillation. The crystalline structure of the fiber was not altered by any of the treatments, maintaining type I cellulose.
Journal of Materials Research and Technology, 2019
The search for increasingly biodegradable materials motivated us to investigate composites of pol... more The search for increasingly biodegradable materials motivated us to investigate composites of poly(3-hydroxybutyrate) (PHB) and piassava fiber residue. The composite mixing process for 10 and 30% (w/w) mixtures was conducted in an internal mixer at 180 • C and 60 rpm for 10 min. The fiber residue was washed with a detergent solution, treated in warm water at 50 • C, and then ground to a particle size of smaller than the 270 mesh. The fiber residue had a higher surface area, higher crystallinity index, and smaller particle size than the residue that was only washed. The fiber had thermal stability up to 224 • C. The thermal treatment neither altered the constitution nor crystalline structure of the fiber, which suggested that a major concentration of the thermal fiber led to more effective defibrillation of the fiber residue, which facilitated the mixing process of the 30% (w/w) composite and increased its degree of crystallinity by 8.8%. However, the maximum degradation temperature of the fiber was significantly reduced (by 58 • C) for this composite with respect to PHB. For the other composites, the presence of the residue caused a smaller decrease in the thermal stability of the polymer.
Journal of the American College of Cardiology, 2019
Background: Microbial community has a decisive role in determining health or disease susceptibili... more Background: Microbial community has a decisive role in determining health or disease susceptibility. Archaeal genes present in Trypanosoma cruzi may represent symbionts implicated in the development of heart failure (HF) in 30% of chagasic pts. Extracellular vesicles in peripheral blood, called exosomes smaller than 0.1μm or microvesicles (MV) >0.1μm, in larger numbers in HF. We searched if some MV are derived from archaea. Methods: Exosomes and MVs in serum supernatant from 2 groups were quantified: HF (N= 26), and asymptomatic indeterminate form (IF) (N= 21), by electron microscopy stained with anti-archaemetzincin-1 antibody (AMZ 1, archaea collagenase) and anti-archaeal DNA probe; flow cytometer with the same antibody/probe counted the % positive MVs, and Zymography with casein as substrate determined activity of archaeal collagenase, considering in each gel group, IF value as 100%. Results: Flow cytometer showed higher percentage of AMZ1 MVs in IF (64 vs 36, P=0.02) and higher archaeal DNA positive MVs in HF patients (8.1 vs 0.9, P<0.001). Electron microscopy showed IF with higher median numbers of exosomes/ photo/case versus HF (58.5 vs 25.5, P<0.001), higher nos. exosome containing AMZ1 antigens (2.0 vs 0.0; P<0.001), and lower archaeal DNA content (0.2 ± 0.5 vs 1.5 ± 3.0, P=0.02). A positive correlation between exosomes and AMZ1 content was seen in IF (r=0.5, P<0.001), but not in HF patients (r=0.002, P=0.98). Higher free archaeal DNA (63.0±150 vs 11.1±13.1, P<0.001) in correlation with exosome numbers (r=0.66, P=0.01) was seen in HF but not in IF form in electron microscopy photos (r=0.29, P=0.10). Zymography demonstrated higher collagenase activity in the serum of HF vs IF (165 vs 100, p=0.0003) Conclusion: Higher amount of exosomes in IF Chagasic patients may explain lower archaeal collagenase activity in the serum. Exosomes could act removing and degrading abnormal AMZ1 collagenase in IF. Differently, archaeal MVs and their exosomes could be related to the higher collagenase activity in HF, possibly with through the release of archaeal collagenase. These findings suggest that microbiota dysfunction also occurs in Chagas disease and is a new frontier for understanding development of HF.
Revista Urología Colombiana / Colombian Urology Journal
Precision medicine plays a key role in urological oncology practice nowadays, with the breakthrou... more Precision medicine plays a key role in urological oncology practice nowadays, with the breakthrough of the poly (ADP-ribose) polymerase inhibitors (PARPi), which play a critical role in different DNA damage repair (DDR) pathways, the immune checkpoint inhibitors, the genomic expression profiles and current genome manipulation-directed targeted therapy. Information and technology (IT) are set to change the way we assess and treat patients and should be reviewed and discussed. The aim of the present article is to demonstrate a detailed revision on precision medicine, including novel therapeutic targets, genomic markers, genomic stratification of urological patients, and the top-notch technological breakthroughs that could change our clinical practiceWe performed a review of the literature in four different databases (PubMed, Embase, Lilacs, and Scielo) on any information concerning prostate, bladder, kidney and urothelial cancer novel treatments with PARPi, immune checkpoint inhibitor...
This is the first survey of bryophyte diversity in the mangroves of Panama. The study was done in... more This is the first survey of bryophyte diversity in the mangroves of Panama. The study was done in the mangroves of Bocas del Toro Province, Panama, in September 2016 and, July, May and August 2017. Bryophytes were collected from prop or stilt roots of mangroves, the mid-lower part of the trunks and the lower branches. In areas inundated at high tide, additional samples were collected on the cortex of palms, its rootlets, other angiosperm trees and from decomposing logs. Twenty-six species of liverworts and seven of mosses were identified. The most diverse and predominant liverwort family was the Lejeuneaceae with twenty-two species and two varieties and, among the mosses, the Calymperaceae with three species. Species affinities with other tropical mangroves were analyzed and liverworts were found to be the dominant element. Among the liverworts collected, two are new reports for Panama: Ceratolejeunea confusa and Frullanoides mexicana. Additional surveys of the cryptogamic vegetatio...
Introducción: La ventilación mecánica es una estrategia terapéutica utilizada en las Unidades de ... more Introducción: La ventilación mecánica es una estrategia terapéutica utilizada en las Unidades de Cuidado Intensivo (UCI), el destete es el término utilizado para el proceso de retirada de la Ventilación Mecánica para llegar a la respiración espontanea; en las UCI la debilidad muscular y el desacondicionamiento físico son comunes en pacientes que reciben esta estrategia, especialmente cuando se prolonga. Desde fisioterapia se han propuesto estrategias que podrían limitar o revertir estas secuelas facilitando el destete de forma rápida y evitando fallas en la extubación, definidas como entrenamiento de los músculos respiratorios. Sin embargo no hay información metodológica que estandarice en las UCI el manejo de esta estrategia por esto el objetivo de esta revisión sistemática es recopilar la información para estandarizar un programa de entrenamiento muscular respiratorio en las UCI que facilite el destete ventilatorio.Método: Revisión sistemática de 5 bases de datos (PUBMED, SCIENCE ...
Droughts are a natural, recurrent climate extreme that can inflict longlasting devastation on nat... more Droughts are a natural, recurrent climate extreme that can inflict longlasting devastation on natural ecosystems and socioeconomic sectors. Unlike other natural hazards, drought onset is insidious and often affects a greater spatial extent and prolonged temporal scale. The evolution of drought and its impacts are typically region specific; the West and Southwest U.S. have experienced severe droughts at a higher frequency than the East and parts of the Midwest. While these regions do experience drought, intensified precipitation variability also obscures how drought may be changing in these locations. To better understand these trends, we examine the spatiotemporal trends of drought using self-organizing maps (SOM). SOMs are a novel, competitive learning subset of artificial neural networks (ANN), requiring unsupervised training of inputs. We introduced monthly Palmer Drought Severity Index (PDSI) values to the SOM to identify existing clusters of wetting and drying patterns from 1895-2016. After training, we created cartographic visualizations of the SOM output and conducted a subsequent time-This work would not have been able to reach completion without the unwavering support of my research advisors, Dr. Margaret Sugg, and Dr. Johnathan Sugg, who have both played integral roles in my success as a master's thesis student. Dr. Maggie Sugg has been an especially wonderful mentor as we both navigated through completing a thesis virtually. Her encouragement and attentiveness provided me the tools I needed to succeed during uncertain times, and for this I am sincerely grateful. Dr. Johnathan Sugg has also been a dedicated advisor, whose guidance in my methods was an essential component to the completion of my thesis. I am thankful for his contributions during this process. I would like to acknowledge, and thank fellow committee member, Dr. Baker Perry, whom without I would not have found my passion for research and climatology and embark on the journey of obtaining a masters in Geography. I would also like to recognize and thank Ronnie Leeper with the North Carolina Cooperative Institute for Climate and Satellites (NCICS) for providing the data used to complete this work. Given the unusual circumstances, I was unable to present this work at the Association of American Geographers (AAG) 2021. Regardless, I would still like to recognize the Office of Student Research, an on-campus organization which offered to provide funding for an opportunity to present at the AAG. I would also like to offer special recognition to the Department of Geography and Planning at Appalachian State University for providing a safe, and open environment where students and faculty support each other, both morally and vii academically. Despite the challenges the department has been faced with, our department has shown admirable resilience. A special thanks to our program director Dr. Derek Martin, and our department chair Dr. Saskia Van de Gevel whose devotion to students and higher education have made my experience welcoming and enjoyable. Finally, I would like to acknowledge my family, and my husband who have been patient and caring throughout this entire journey. My mother and father Cristina and Beto, who have only shown me to persevere and challenge myself, I am grateful for their ongoing inspiration. A special thanks to my husband, Brandon Cox, for always encouraging me to pursue all my academic dreams.
Machine Learning studies often involve a series of computational experiments in which the predict... more Machine Learning studies often involve a series of computational experiments in which the predictive performance of multiple models are compared across one or more datasets. The results obtained are usually summarized through average statistics, either in numeric tables or simple plots. Such approaches fail to reveal interesting subtleties about algorithmic performance, including which observations an algorithm may find easy or hard to classify, and also which observations within a dataset may present unique challenges. Recently, a methodology known as Instance Space Analysis was proposed for visualizing algorithm performance across different datasets. This methodology relates predictive performance to estimated instance hardness measures extracted from the datasets. However, the analysis considered an instance as being an entire classification dataset and the algorithm performance was reported for each dataset as an average error across all observations in the dataset. In this paper, we developed a more fine-grained analysis by adapting the ISA methodology. The adapted version of ISA allows the analysis of an individual classification dataset by a 2-D hardness embedding, which provides a visualization of the data according to the difficulty level of its individual observations. This allows deeper analyses of the relationships between instance hardness and predictive performance of classifiers. We also provide an open-access Python package named PyHard, which encapsulates the adapted ISA and provides an interactive visualization interface. We illustrate through case studies how our tool can provide insights about data quality and algorithm performance in the presence of challenges such as noisy and biased data.
Ag gr ra ad de ec ci im me en nt to os s À Deus por ter me dado sabedoria, paciência, saúde e for... more Ag gr ra ad de ec ci im me en nt to os s À Deus por ter me dado sabedoria, paciência, saúde e força, necessários para conduzir este sonho. Aos primeiros responsáveis por isso tudo, à minha base, Mauricio Donizeti Moreno e Maria Cleine Rodrigues Moreno, os melhores pais que Deus poderia ter me dado. Obrigada pelo empenho na minha criação e educação, por muitas vezes terem se abdicado dos seus sonhos para que eu pudesse sonhar os meus. Vocês são exemplos de comprometimento, respeito, responsabilidade, integridade e humanidade. A conclusão desse trabalho é uma maneira de dizer obrigada por tudo, esse título é nosso e eu estou levando ele pra casa. Amo vocês imensuravelmente. À minha orientadora, Profa. Dra. Maria de Lourdes Higuchi, obrigada pela confiança e por ter contribuido tanto com a minha formação pessoal e acadêmica. Agradeço por todo suporte cíentifico ofertado para o desenvolvimento desse trabalho. Ao Prof. Dr. José Antônio Franchini Ramires, por ter confiado em meu trabalho e por ter aberto as portas dessa instituição que tornou-se minha segunda casa e por muitas vezes à primeira. O admiro demasiadamente como pessoa, médico e docente. Aos meus companheiros de trabalho e amigos integrantes do Laboratório de Patologia
This is a literature review that aims to identify what is expressed in the publications of the ma... more This is a literature review that aims to identify what is expressed in the publications of the main nationals journals regarding management, policies, and health practices addressed to the LGBT population, in the period comprehended between 2004 and 2018. The search of documents was carried out through the tool 'integrated search', being selected available articles in their whole that were indexed in the database Scientific Electronic Library Online (SciELO). We analyzed the publications of 10 national periodics and selected 27 publications that addressed health public policies towards the LGBT population. Little expression of related themes regarding the LGBT population was observed, in the 14 years of the temporary cut proposed by this article, since from the articles found, only 92 made reference the LGBT population and only 27 discussed health policies. Thus, it is verified the need for accomplishment of researches addressing the analysis of implantation of health public...
A demanda para atendimento infantil em clinicas psicologicas e servicos de saude mental tem cresc... more A demanda para atendimento infantil em clinicas psicologicas e servicos de saude mental tem crescido consideravelmente nos ultimos anos, sobretudo relacionada a queixas de comportamento, mesmo em idades precoces. Com base na concepcao de que o ambiente pode propiciar vinculos imprescindiveis para o desenvolvimento da crianca e no perfil da dinâmica familiar atual, escolheu-se uma Escola Municipal de Educacao Infantil do municipio de Assis para a realizacao deste projeto de extensao. Este projeto tem como objetivos conhecer as caracteristicas de organizacao, funcionamento e rotina de uma escola de educacao infantil do municipio de Assis; identificar a compreensao, dificuldades, duvidas e principais necessidades dos educadores e pais a respeito das caracteristicas das criancas em cada idade do desenvolvimento; propiciar espacos que permitam reflexoes e discussoes que possam contribuir para a saude e a educacao das criancas. Sao realizados encontros mensais com os pais e educadores por...
La educacion estocastica juega un papel preponderante en la formacion del futuro ciudadano, dentr... more La educacion estocastica juega un papel preponderante en la formacion del futuro ciudadano, dentro de los elementos fundamentales a considerar en esa formacion es la capacidad de interpretacion de graficas, Batanero (2002). El presente informe reporta los resultados de un estudio descriptivo frente a la lectura de pictogramas.
Introducao: A disseccao da aorta ocorre quando o dano a camada mais interna daaorta faz com que o... more Introducao: A disseccao da aorta ocorre quando o dano a camada mais interna daaorta faz com que o sangue passe entre as varias camadas da parede aortica eforce a separacao dessas camadas. A reducao do suprimento de sangue paraoutros orgaos pode causar acidente vascular cerebral ou isquemia mesenterica.Sabendo da importância da arteria aorta, da complexidade, seriedade e extensaodos danos que pode ocasionar, torna-se cada vez mais necessario o estudo,pesquisa e desenvolvimento de novas tecnicas e alternativas de tratamento.Objetivo: Descrever a funcao da circulacao extracorporea em casos de disseccaoda arteria aorta. Metodologia: Constitui uma revisao bibliografica descritivarealizada nas bases de dados eletronicas PubMed e SciELO, atraves da consulta aartigos publicados entre os anos 2000 a 2021. Resultados: Nao existe um consensosobre a canulacao arterial mais indicada para cada caso especifico quando se tratade disseccao de aorta. Elementos importantes para estrategias de canulaca...
Frontiers in Cellular and Infection Microbiology, 2021
BackgroundIdiopathic dilated cardiomyopathy (IDCM) myocardial inflammation may be associated with... more BackgroundIdiopathic dilated cardiomyopathy (IDCM) myocardial inflammation may be associated with external triggering factors such as infectious agents. Here, we searched if moderate/severe heart transplantation rejection is related to the presence of myocardial inflammation in IDCM explanted hearts, associated with microbial communities.MethodReceptor myocardial samples from 18 explanted hearts were separated into groups according to post-transplant outcome: persistent moderate rejection (PMR; n = 6), moderate rejection (MR; n = 7) that regressed after pulse therapy, and no rejection (NR; n = 5)/light intensity rejection. Inflammation was quantified through immunohistochemistry (IHC), and infectious agents were evaluated by IHC, molecular biology, in situ hybridization technique, and transmission electron microscopy (TEM).ResultsNR presented lower numbers of macrophages, as well as B cells (p = 0.0001), and higher HLA class II expression (p ≤ 0.0001). PMR and MR showed higher level...
Microbial communities are considered decisive for maintaining a healthy situation or for determin... more Microbial communities are considered decisive for maintaining a healthy situation or for determining diseases. Acute myocardial infarction (AMI) is an important complication of atherosclerosis caused by the rupture of atheroma plaques containing proinflammatory cytokines, reactive oxygen species, oxidized low-density lipoproteins (oxLDL), damaged proteins, lipids, and DNA, a microenvironment compatible with a pathogenic microbial community. Previously, we found that archaeal DNA-positive infectious microvesicles (iMVs) were detected in vulnerable plaques and in the sera of Chagas disease patients with heart failure. Now, we characterize and quantify the levels of serum microbiome extracellular vesicles through their size and content using morphomolecular techniques to differentiate clinical outcomes in coronary artery disease (CAD). We detected increased numbers of large iMVs (0.8–1.34 nm) with highly negative surface charge that were positive for archaeal DNA, Mycoplasma pneumoniae...
O presente trabalho de cunho historico teve como objetivo mapear as cartilhas e os livros de alfa... more O presente trabalho de cunho historico teve como objetivo mapear as cartilhas e os livros de alfabetizacao que circularam na cidade de Birigui no seculo XX. Para que este objetivo fosse alcancado buscou-se em bibliografia especializada apropriar-se dos temas que envolvem a tematica do estudo. Para o mapeamento das cartilhas e dos livros de alfabetizacao mais usados para ensinar a ler e escrever no presente municipio foi realizado entrevistas e levantamento de dados em todas as bibliotecas da cidade de Birigui. Com o levantamento realizado foi possivel se chegar ao resultado final deste trabalho, que se apresenta dividido em tres partes: na primeira, apresenta-se um breve historico sobre a alfabetizacao, desde o final do seculo XIX, ate a reforma no modelo de ensino com a implantacao do construtivismo; em seguida apresentam-se os manuais de alfabetizacao: as cartilhas e os livros didaticos, discorrendo sobre suas caracteristicas e utilizacao na alfabetizacao brasileira. Na segunda pa...
Drought is a highly destructive natural hazard with wide-ranging impacts on water security, agric... more Drought is a highly destructive natural hazard with wide-ranging impacts on water security, agriculture, energy, and human health. Unlike most natural hazards, droughts can develop anywhere, evolve rapidly within a month or slowly over a season, and span months to decades without a clear beginning or end. Few studies investigate the direct link between drought and drought-related impacts on health and society, and little research has identified critical science gaps in the field of drought-society. This scoping review aims to explore the societal implications of drought and identify knowledge gaps for future drought-society studies. We performed a PRISMA scoping review with a fourelement search model on articles published since 2010. We extracted drought impacts data from 74 articles. Results were synthesized into three main topical areas examining public health impacts, water quality impacts, and water quantity impacts. While studies were heterogeneous in terms of objectives and methods, they illustrated the full breadth of drought impacts. The current body of evidence lacks a standard set of drought indices that can be readily applied to evaluate and monitor societal impacts due to drought. The challenge of defining drought limits a holistic understanding of drought effects and recovery time. More interdisciplinary collaborations are needed to establishes community-wide consensus on the identification of relevant hydrological indicators that best describe an adverse outcome is an understudied research priority.
Revista Brasileira de Pesquisa em Saúde/Brazilian Journal of Health Research, 2016
RESUMO| Introdução: O acolhimento incrementa o acesso e melhora o processo de trabalho nos cenári... more RESUMO| Introdução: O acolhimento incrementa o acesso e melhora o processo de trabalho nos cenários dos serviços de saúde, bem como possibilita o fortalecimento de laços entre usuários, trabalhadores e gestores em defesa do SUS enquanto política pública e não de governo. Objetivo: Desenvolver uma reflexão crítica sobre a percepção e operacionalização do acolhimento a partir de uma revisão literária. Métodos: Trata-se de um estudo descritivo com suporte em uma revisão sistemática da literatura. Inicialmente, foram selecionados 14 artigos, e nove deles foram eleitos criteriosamente, de acordo com as normas de inclusão. Resultados: Da análise, surgiram três eixos temáticos: "o acolhimento de forma real"; "acolhimento sob a perspectiva dos usuários de saúde"; e, por fim, "dificuldades apontadas para a realização do acolhimento". Conclusão: Pode-se compreender que o acolhimento é uma prática que deve ser integrada de modo forte e decisivo às unidades de saúde, pois facilita o processo de trabalho e melhora a qualidade da assistência, mas por vezes não é realizado ou não é praticado como preconizado. Palavras-chave| Acolhimento; Atenção Primária à saúde; Qualidade da assistência à saúde. ABSTRACT| Introduction: "User embracement" improve accessibility and quality of health services, and enables the strengthening of ties between users, workers and managers. It also strengths the view of SUS as a State policy and not a transitory governmental one. Objective: To develop critical reflection on the perception and operationalization of "user embracement", based on relevant literature review. Methods: This is a descriptive study supported by a systematic review of the literature. Fourteen articles were selected initially. Of these, nine met the inclusion criteria. Results: Three main themes emerged from the analysis: "user embracement" in real practice; "user embracement" from the perspective of the users of health facilities; and finally, "user embracement" challenges. Conclusion: "User embracement" is an approach that should be firmly integrated into health units, since it markedly improves the quality of care. However, it is sometimes not performed according to the principles underlying it.
The effect of alcaline and hot water surface treatments of piassava Attalea funifera fibers was i... more The effect of alcaline and hot water surface treatments of piassava Attalea funifera fibers was investigated. The efficiency of each treatment was evaluated by Fourier transform infrared spectroscopy, X-ray diffractometry, optical microscopy, scanning electron microscopy and atomic force microscopy. The alkaline treatments were effective in removing the superficial lignin layer from the fiber, while the hot water treatment was not. Treatment with hot water and NaOH caused fiber defibrillation. NaOH was most effective in promoting both, a decrease in fiber diameter and an increase in fiber surface area. Treatment with Ca(OH) 2 led to the formation of a CaCO 3 layer deposited on the fiber, preventing defibrillation. The crystalline structure of the fiber was not altered by any of the treatments, maintaining type I cellulose.
Journal of Materials Research and Technology, 2019
The search for increasingly biodegradable materials motivated us to investigate composites of pol... more The search for increasingly biodegradable materials motivated us to investigate composites of poly(3-hydroxybutyrate) (PHB) and piassava fiber residue. The composite mixing process for 10 and 30% (w/w) mixtures was conducted in an internal mixer at 180 • C and 60 rpm for 10 min. The fiber residue was washed with a detergent solution, treated in warm water at 50 • C, and then ground to a particle size of smaller than the 270 mesh. The fiber residue had a higher surface area, higher crystallinity index, and smaller particle size than the residue that was only washed. The fiber had thermal stability up to 224 • C. The thermal treatment neither altered the constitution nor crystalline structure of the fiber, which suggested that a major concentration of the thermal fiber led to more effective defibrillation of the fiber residue, which facilitated the mixing process of the 30% (w/w) composite and increased its degree of crystallinity by 8.8%. However, the maximum degradation temperature of the fiber was significantly reduced (by 58 • C) for this composite with respect to PHB. For the other composites, the presence of the residue caused a smaller decrease in the thermal stability of the polymer.
Journal of the American College of Cardiology, 2019
Background: Microbial community has a decisive role in determining health or disease susceptibili... more Background: Microbial community has a decisive role in determining health or disease susceptibility. Archaeal genes present in Trypanosoma cruzi may represent symbionts implicated in the development of heart failure (HF) in 30% of chagasic pts. Extracellular vesicles in peripheral blood, called exosomes smaller than 0.1μm or microvesicles (MV) >0.1μm, in larger numbers in HF. We searched if some MV are derived from archaea. Methods: Exosomes and MVs in serum supernatant from 2 groups were quantified: HF (N= 26), and asymptomatic indeterminate form (IF) (N= 21), by electron microscopy stained with anti-archaemetzincin-1 antibody (AMZ 1, archaea collagenase) and anti-archaeal DNA probe; flow cytometer with the same antibody/probe counted the % positive MVs, and Zymography with casein as substrate determined activity of archaeal collagenase, considering in each gel group, IF value as 100%. Results: Flow cytometer showed higher percentage of AMZ1 MVs in IF (64 vs 36, P=0.02) and higher archaeal DNA positive MVs in HF patients (8.1 vs 0.9, P<0.001). Electron microscopy showed IF with higher median numbers of exosomes/ photo/case versus HF (58.5 vs 25.5, P<0.001), higher nos. exosome containing AMZ1 antigens (2.0 vs 0.0; P<0.001), and lower archaeal DNA content (0.2 ± 0.5 vs 1.5 ± 3.0, P=0.02). A positive correlation between exosomes and AMZ1 content was seen in IF (r=0.5, P<0.001), but not in HF patients (r=0.002, P=0.98). Higher free archaeal DNA (63.0±150 vs 11.1±13.1, P<0.001) in correlation with exosome numbers (r=0.66, P=0.01) was seen in HF but not in IF form in electron microscopy photos (r=0.29, P=0.10). Zymography demonstrated higher collagenase activity in the serum of HF vs IF (165 vs 100, p=0.0003) Conclusion: Higher amount of exosomes in IF Chagasic patients may explain lower archaeal collagenase activity in the serum. Exosomes could act removing and degrading abnormal AMZ1 collagenase in IF. Differently, archaeal MVs and their exosomes could be related to the higher collagenase activity in HF, possibly with through the release of archaeal collagenase. These findings suggest that microbiota dysfunction also occurs in Chagas disease and is a new frontier for understanding development of HF.
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Papers by Camila Moreno