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Barthel’s Index: A Better Predictor for COVID-19 Mortality Than Comorbidities
João Cordeiro da Costa,Manso Maria Conceição,Gregório Susana,Leite Márcia,Pinto João Moreira 대한결핵및호흡기학회 2022 Tuberculosis and Respiratory Diseases Vol.85 No.4
Background: The most consistently identified mortality determinants for the new coronavirus 2019 (COVID-19) infection are aging, male sex, cardiovascular/respiratory diseases, and cancer. They were determined from heterogeneous cohorts that included patients with different disease severity and previous conditions. The main goal of this study was to determine if activities of daily living (ADL) dependence measured by Barthel’s index could be a predictor for COVID-19 mortality.Methods: A prospective cohort study was performed with a consecutive sample of 340 COVID-19 patients representing patients from all over the northern region of Portugal from October 2020 to March 2021. Mortality risk factors were determined after controlling for demographics, ADL dependence, admission time, comorbidities, clinical manifestations, and delay-time for diagnosis. Central tendency measures were used to analyze continuous variables and absolute numbers (proportions) for categorical variables. For univariable analysis, we used t test, chi-square test, or Fisher exact test as appropriate (α=0.05). Multivariable analysis was performed using logistic regression. IBM SPSS version 27 statistical software was used for data analysis.Results: The cohort included 340 patients (55.3% females) with a mean age of 80.6±11.0 years. The mortality rate was 19.7%. Univariate analysis revealed that aging, ADL dependence, pneumonia, and dementia were associated with mortality and that dyslipidemia and obesity were associated with survival. In multivariable analysis, dyslipidemia (odds ratio [OR], 0.35; 95% confidence interval [CI], 0.17–0.71) was independently associated with survival. Age ≥86 years (pooled OR, 2.239; 95% CI, 1.100–4.559), pneumonia (pooled OR, 3.00; 95% CI, 1.362–6.606), and ADL dependence (pooled OR, 6.296; 95% CI, 1.795–22.088) were significantly related to mortality (receiver operating characteristic area under the curve, 82.1%; p<0.001).Conclusion: ADL dependence, aging, and pneumonia are three main predictors for COVID-19 mortality in an elderly population.
Carla de Amorim Lana Dib,Guilherme Henrique dos Santos Ramos,Gregório Sandro Vieira 한국강구조학회 2023 International Journal of Steel Structures Vol.23 No.5
Cold-formed steel (CFS) members stand out among steel structures notably due to their lightness, structural efficiency (high strength-to-weight ratio) and versatility, however, given their high width-to-thickness ratio, are highly susceptible to instability phenomena (buckling). The objective of this research is to analyze the structural behavior of cold-formed steel hat-section beams under non-uniform bending about the major and minor-axis, regarding the risks of distortional failure. Through the Generalized Beam Theory, using the computational program GBTUL, the geometries where the distortional failure is predominant were selected and through the computational program ABAQUS, a shell finite element model was developed to perform the buckling and post-buckling analysis on the selected elements. The results obtained from the developed model—which include critical buckling moments, failure moments, equilibrium paths, deformed configurations and collapse mechanisms—show that the developed model adequately simulates the distortional buckling and post-buckling behavior of the considered CFS beams and demonstrate how loading affects such behaviors.
Beatriz Nomada Hauy,Caio Henrique Peres Oliani,Gabriela Garcia Fracaro,Sandra Maria Barbalho,Élen Landgraf Guiguer,Maricelma da Silva Soares de Souza,Claudemir Gregório Mendes,Manoela dos Santos Bueno 한국식품영양과학회 2021 Journal of medicinal food Vol.24 No.2
The intake of milk has decreased over the past few decades in Western populations and has been replaced by drinks of plant origin. Substitution of cow's milk by vegetable drinks occurs for some reasons, such as the presence of lactose intolerance, reduced calorie intake, prevention of obesity, vegan diets, and concern about the use of hormone therapy and its possible residues in bovine milk. For these reasons, the objective of this study was to evaluate the biochemical and anthropometric profile of animals subjected to a diet supplemented with coconut milk. Animals were divided into six groups (G1–G6), treated, respectively, regular diet and coconut milk or cow's milk, and with a high-protein content diet and coconut milk or cow's milk. Our results showed that the animals treated with coconut milk reduced body weight and visceral fat, and also showed that the use of a high-protein diet in association with coconut milk is a good combination in reducing visceral fat, percentage of weight gain, food intake, cholesterol, and triglycerides. Our results do not show substantial metabolic changes when comparing the use of coconut milk with the use of cow's milk (we cannot say that the coconut milk itself can be better than cow's milk in the evaluated metabolic parameters).
( Greg Marchand ),( Ahmed Taher Masoud ),( Anthony Galitsky ),( Ali Azadi ),( Kelly Ware ),( Janelle Vallejo ),( Sienna Anderson ),( Alexa King ),( Stacy Ruther ),( Giovanna Brazil ),( Kaitlynne Ciemi 대한산부인과학회 2021 Obstetrics & Gynecology Science Vol.64 No.2
Interstitial pregnancy is a rare, life-threatening condition that requires high clinical suspicion for diagnosis. Most cases are discovered after complications have occurred. Many authors have described laparoscopic management. Although previous systematic reviews have compared the attributes and complications associated with interstitial pregnancy, we endeavored to complete the first systematic review and meta-analysis to compare the laparoscopic treatment of interstitial pregnancy with the open approach in the modern age of laparoscopic surgery. We systematically searched PubMed, ClinicalTrials.gov, Scopus, Web of Science, and Cochrane until June 2020 using relevant keywords and screened them for eligibility. We found a statistically significant difference in blood loss between laparoscopic and open surgery (168 mL compared to 1,163 mL). Further, cumulative meta-analysis has revealed that blood loss in laparoscopy has been decreasing over time from 1991 to 2020. Laparoscopic patients took less operative time (63.2 minutes) compared to laparotomy patients (78.2 minutes). Patients in the laparoscopic group spent less time hospitalized (3.7 days) compared to laparotomy patients (5.2 days). Our findings add strength to the position that laparoscopic approaches to interstitial pregnancy can be considered first-line in most situations. The laparoscopic approach was found to have a mean blood loss of 168 mL, and this blood loss seems to decrease over time. Increased gravidity and duration of amenorrhea are positive factors that increase bleeding during the procedure. We are unable to find enough high-quality data to significantly compare successful pregnancy following surgery or risk of mortality in these populations.