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PURPOSE: Inguinal hernias are highly prevalent worldwide and its surgical repair is one of the most common procedures in general surgery. The broad use of mesh has decreased the recurrence rates of inguinal hernia to acceptable levels, thus centering the attention on Quality of Life as a pivotal postoperative outcome. Carolinas Comfort Scale is a well-studied questionnaire designed to identify Quality of Life changes following hernia repair with mesh techniques. The aim of this study is to validate the CCS in Brazilian Portuguese for inguinal hernias. METHODS: The original CCS was translated into Brazilian Portuguese according to cross-cultural adaptation guidelines. We conducted a cross-sectional study in individuals aged 18 and above who had undergone inguinal laparo-endoscopic hernia repair for at least 6 months prior, between January 2019 and August 2022, at a Brazilian tertiary hospital. Participants answered an online survey containing the Brazilian CCS and the generic Patient-Reported Outcome Measure (PROM) Short-Form Health 36 (SF-36). Participants answered the same questionnaires in the follow-up after at least three weeks, with an additional question about satisfaction with surgery results. RESULTS: The survey was completed by 115 patients, of whom 78 (67%) responded to the follow-up questionnaire after 3 to 10 weeks. CCS showed excellent internal consistency, with Cronbach's α of 0.94. Intraclass correlation coefficient ranged from 0.60 to 0.82 in the test-retest analysis. Compared to SF-36, a strong correlation was observed in the physical functioning dimension, and a moderate correlation was found in role-physical and bodily pain (Pearson's Coefficient Correlation = 0.502, 0.338 and 0.332 respectively), for construct analysis. The mean CCS score was significantly lower (p < 0.001) among satisfied patients compared to the unsatisfied ones. CONCLUSION: The Brazilian version of CCS is a valid and reliable method to assess long-term quality of life after inguinal laparo-endoscopic hernia repair.

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Background and Purpose: The purpose of this study was to map the instruments for assessing the comfort of hospitalized older adults in the scientific literature, identifying those instruments validated and transculturally adapted to the realities of Brazil. Methods: This was a scoping review of 14 articles and a website retrieved from the following databases: MEDLINE/PubMed, CINAHL, EMBASE, Web of Science, Scopus, Science Direct/Elsevier, and gray literature (Oasisbr, Catalog of Theses and Dissertations [CAPES], OATD, BDBTD, and The Comfort Line). Results: Seventeen instruments for assessing the comfort of hospitalized older adults were mapped; however, none were specifically designed for this population, as they were originally intended for adults or individuals with neuropsychiatric conditions. Among these, three have been validated and transculturally adapted to the Brazilian context. Conclusions: This study reveals the need for a specific instrument tailored for hospitalized older adults without neuropsychiatric conditions.

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Escalating global surface temperatures are highlighting the urgent need for energy-saving solutions. Phase-change materials (PCMs) have emerged as a promising avenue for enhancing thermal comfort in the construction sector. This study assessed the impact of incorporating PCMs ranging from 1% to 10% by mass into composite Portland cement partially replaced by fly ash (FA) and nanosilica particles (NS). Mechanical and electrochemical techniques were utilized to evaluate composite cements. The results indicate that the presence of PCMs delayed cement hydration, acting as a filler without chemically interacting within the composite. The combination of FA and PCMs reduced compressive strength at early ages, while thermal conductivity decreased after 90 days due to the melting point and the latent heat of PCMs. Samples with FA and NS showed a significant reduction in the CO2 penetration, attributed to their pozzolanic and microfiller effects, as well as reduced water absorption due to the non-absorptive nature of PCMs. Nitrogen physisorption confirmed structural changes in the cement matrix. Additionally, electrical resistivity and thermal behavior assessments revealed that PCM-containing samples could reduce temperatures by an average of 4 °C. This suggested that PCMs could be a viable alternative for materials with thermal insulation capacity, thereby contributing to energy efficiency in the construction sector.

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INTRODUCTION: Ventral hernia surgery (VHS) has the intent to promote a better quality of life (QoL). VHS results were evaluated by recurrence incidence in the past, however the concept of Patient-Reported Outcomes Measures has changed this scenario. SF-36 is a generic questionnaire with some limitations on the hernioplasty postoperative evaluation. Disease-specific surveys such Hernia-Related Quality of Life Survey (HerQLes) and Carolinas Comfort Scale (CCS) were developed to improve specificity. The aim of this study was to validate a Brazilian version of the CCS as a QoL questionnaire for patients undergoing VHS in Brazil. MATERIALS AND METHODS: The study consists of a retrospective cohort that reviewed the medical records of patients who underwent ventral hernia surgery for incisional hernias in the Hospital de Clínicas de Porto Alegre between January 2019 to December 2020. Participants answered both the HerQles questionnaire and the CCS, then we compared the patients' scores between scales. In-personal evaluations or surveys applied by telemedicine were performed. Intraclass correlation coefficient was utilized to assess the consistency of the agreement between the HerQLes and CCS scales. RESULTS: A sample of 80 patients were evaluated. Most were male (70%), mean age 61.11 years and BMI 28.4. The most common comorbidity was systemic arterial hypertension, one third were smokers and 77.5% of cases were ASA 2. The average HerQLes score was 30.40 and the CCS was 15.46 (SD: 21.81), with an intraclass coefficient of 0.68. CONCLUSION: This study suggests that CCS is a good and robust tool for assessing ventral hernia. Tools to measure QoL are increasingly used in the literature, as QoL seems to be important data to assess surgical success, since it shows the perception of the patient about the results of their surgery. Further studies with larger sample sizes should be performed to confirm our findings.

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A comprehensive analysis is carried out for achieving hygrothermal comfort by using bidirectional heat and mass fluxes between the human skin and its surroundings during cooling seasons, considering the main characteristics of climate, metabolic rate, and clothing fabrics. As hygrothermal comfort is mainly seen as one-direction heat and mass flux from the close surroundings to the human body, without the emitted heat and mass by the human skin, the purpose of the analysis is to find out proper features of the respective clothing fabric according to the inlet boundary conditions, i.e. heat and mass flux from the human body, and the outlet boundary features, i.e. heat and mass flux due to the climate conditions. Thereby, a novel mathematical modelling is developed for heat and mass transfer, respectively. Then, the software Wolfram Mathematica is applied for the numerical solutions of the model. After the model is validated, a sensitivity analysis is carried out. Thereby, it is found that the sensible heat removal by convection, dependent on both airflow and humidity rates, has a great influence on the hygrothermal comfort. Furthermore, solar reflectivity for shortwave radiation, along with longwave radiation from the skin, have influence on the hygrothermal comfort when both ventilation and sweating are set as minimum. Therefore, if the conditions of temperature and relative humidity are proper, both high conductivity and air permeability clothes are recommended. Nevertheless, regarding the reflectivity, it depends on the presence of shortwave radiation, sweating, ventilation, and longwave radiation to consider light-toned or dark colors.

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OBJECTIVE: To assess the anesthetic efficacy of articaine with the needle-free/Comfort-in™ method compared to the conventional needle method. To assess pain during anesthesia application, onset of anesthesia and patient`s self-reported quality of life-related to oral health after the dental emergency appointment. MATERIALS AND METHODS: This parallel, randomized clinical trial was conducted by a single operator/dentist in the state of Maranhao, northeast of Brazil. Included participants were adult dental patients with one molar (maxillary) or premolar (maxillary or mandibular) tooth diagnosed with symptomatic irreversible pulpitis. The primary outcome was the anesthetic efficacy, measured using a combination of electrical and cold pulp tests (cold + EPT) and the Numerical Rating Scale (NRS). Secondary outcomes were pain during anesthesia application, onset of anesthesia, and patient`s quality-of-life (measured with the OHIP-14). RESULTS: 62 patients were randomized in the anesthesia needle-free group and Comfort-in group (34.26 ± 10.786 × 33.29 ± 8.399 years old, respectively). The group of patients in the Comfort-in group had 71.0% success. Patients from the Comfort-in group reported statistically lower pain during the anesthesia application than patients from the conventional group (2.13 ± 2.172 × 6.03 ± 3.146 NRS scores, respectively) as well as immediately after the anesthetic procedure. Patients self-reported negative impact in quality of life was similar between groups before (p > 0.05) and after (p > 0.05) the dental emergency. CONCLUSIONS: Comfort-in™ had similar efficacy to the conventional needle method. CLINICAL RELEVANCE: This trial showed that it is possible to anesthetize patients with tooth pulpits without using needles to provide comfort mainly to anxious patients.

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Personal Comfort Systems (PCS) are equipments that heat and/or cool occupants without affecting surrounding environments, ranging from commonly used devices to innovative technologies, and that tend to be controlled by people. These systems aim to address energy consumption and occupant satisfaction issues related to centralised air-conditioning. Although there are systematic studies on these systems, there is a lack of documentation regarding mediation characteristics between people and the built environment. This article presents a systematic review of PCS using a search of academic literature and patents, classifying PCS based on thermal categories and device typologies while introducing post-phenomenological mediation categories. The results show that most PCS fall into the thermal categories of 'Heating' and 'Cooling and ventilation'. The review also presents a view of the PCS territory based on mediation attributes and technological complexity. Finally, the PCS' characteristics are discussed based on the post-phenomenological concepts of Embodiment, Hermeneutic, and Background providing insights for future research opportunities and PCS development.

Practitioner summary: This study presents a systematic review of Personal Comfort Systems (PCS) found in patents and academic databases, integrating post-phenomenological concepts into PCS discussion. It visualises the PCS territory using a matrix based on mediation relations and technological complexity, providing insights into PCS development and research opportunities.

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This study aims to evaluate agreement among subjective thermal comfort, thermal sensation, thermal perception, and thermal tolerance indices, according to pedestrians in downtown Santa Maria, southern Brazil, which has a humid subtropical climate (Cfa). Between August 2015 and July 2016 (three periods), 1728 questionnaires were applied. Evaluation of the dependence of statistical variables was based on gender and age, at three periods of time: August 2015 (864 respondents), January 2016 (432 respondents), and July 2016 (432 respondents). Statistical evaluation was based on Pearson's chi-square test using RStudio software, and a significance level (α) of 5% for thermal comfort, thermal sensation, thermal preference, and thermal tolerance was used. Results indicated that age and gender affect the relationship between the variables. Thermal comfort and thermal tolerance presented the best correlation and coherence, regardless of age or gender. This study contributes to knowledge on the local microclimate and can contribute to urban planning to implement strategies that improve pedestrians' thermal comfort.

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This study evaluated litter performance, behavioral and physiological parameters, and milk characteristics of sows submitted to different thermal environments. Fifty sows were distributed in a completely randomized design with two treatments: an evaporative cooling system (ECS) and a conventional system (CS). Sow and its litter were characterized as an experimental unit. The animals were weighed at equalization and weaning. Feed intake, milk production, and bromatological characteristics of milk were measured; the sows respiratory rate, rectal, and surface temperature were monitored. Litter uniformity was determined at equalization and weaning. Behaviors of the sows and litters were monitored for 24 h on the 7th and 15th day of lactation. Temperature and relative humidity inside the maternity was 25.00 to 28.00 °C and 26.00 to 32.55 °C and 30.00 to 70.00% and 70.00 to 88.00%, respectively, considering ECS and CS. Nutritional quality of the milk remained stable during lactation in both systems evaluated. ECS improved the average weight of the piglets, weaning weight, and daily milk production by 0.038, 0.699, and 2.31 kg/day, respectively. Sows housed in the ECS had a reduction in physiological parameters and, increase in inactive alert behavior (1.79 percentage points) and breastfeeding behavior. Piglets showed a decrease of 2.43% in the range of feedings at night and 0.15% during the day. ECS provided better comfort to the sows at the expense of the CS and, consequently, better litter performance.

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This study aimed to evaluate and compare the physiological performance of different genetic groups of sheep, by physiological variables and serum hormone levels, in a hot weather environment. Thirty sheep from five genetic groups were used: Santa Inês (SI), ½ Dorper + ½ Santa Inês (DO), ½ Ilê de France + ½ Santa Inês (IF), ½ Suffolk + ½ Santa Inês (SK), and ½ Texel + ½ Santa Inês (TX). The readings and records of physiological parameters (respiratory rate (RR), rectal temperature (RT), auricular cavity temperature (ACT), and surface temperature (ST)) were carried out at 7:00 am, 1:00 pm, and 7:00 pm, in 12 non-consecutive days. The collections of blood samples for hormone analysis (triiodothyronine (T3), thyroxine (T4), and cortisol (CORT)) is in four consecutive days. The environmental conditions of the experimental period caused a thermal discomfort in the sheep, but not a state of thermal stress. The thermolysis mechanisms, sensitive (ST and ACT) and latent (RR) processes, were enough to maintain their homeostasis (RT). The results showed that crossbred breeds presented a higher metabolism and were more efficient at dissipating heat through thermolysis than the SI breed. The crossbred breeds were efficient at dissipating heat through the elevation of body surface temperature and respiratory rate, mainly SK and TX, i.e., crossbred breeds, despite the wool cover, used thermoregulatory mechanisms that promoted lower variation of RT. The analysis of variance showed significant effects (P < 0.05) to the time factor in the responses of T4 and T3, and to the breed factor in the responses of CORT, T4, and T3. We did not observe interaction between the factors to any of the hormonal variables. Therefore, we can state that the effect of time was independent of breed and vice versa. Thyroid hormones presented lower blood concentration in the mornings (4.03 ± 0.82, T4; 65.08 ± 10.6, T3), increasing their concentration in the afternoon (4.60 ± 1.03, T4; 70.16 ± 14.17, T3). The thyroid hormones presented a normal circadian rhythm, with the exception of SK. Air temperature (AT) showed greater correlation with physiological variables than enthalpy (H) did, in the experimental conditions. However, H showed correlation with T4 and T3. The adaptive profile of the genetic groups under study are different, but the IF genetic group showed better performance under environmental conditions.

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