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Abstract Objective: To evaluate exclusive breastfeeding at discharge and hospital length-of-stay in pre-term infants undergoing or not the Kangaroo-Mother Care Method (KMC). Methods: A retrospective cohort study was conducted including preterm infants < 1800 g admitted to the neonatal unit of a KMC reference center. The infants were grouped into the KMC group and the non-KMC group. Multiple logistic and Poisson regressions were performed to evaluate the association between the KMC and two outcomes, exclusive breastfeeding at discharge, and hospital length-of-stay, adjusted for potential confounders. Results: 115 mother-infant dyads were included, 78 in the KMC group and 37 in the non-KMC group. In the bivariate analysis, the KMC group had a lower prevalence of maternal adverse conditions (6% vs. 32%, p < 0.001), a higher number of prenatal visits (median 6 vs. 3.5, p < 0.001), higher gestational ages (median 32 vs. 31 weeks, p < 0.05), higher birth weights (median 1530 vs. 1365 g, p < 0.01), a lower prevalence of necrotizing enterocolitis (3.8% vs. 16.2%, p < 0.05), parenteral nutrition (50% vs. 73%, p < 0.05), and deep vascular access (49.7% vs. 78.4%, p < 0.01), a higher prevalence of exclusive breastfeeding (65% vs. 8%, p < 0.001) and a shorter length of hospital stay (median 28 vs. 42 days, p < 0.001). In the multiple regression analysis, the KMC group was 23 times more likely to be exclusively breastfed at discharge (OR = 23.1; 95% CI = 4,85-109,93) and had a 19% reduction in the hospital length-of-stay (IDR = 0.81; 95% CI = 0.76-0.86) compared to the non-KMC group. Conclusions: The KMC is associated with better short-term neonatal outcomes and should be encouraged in all Brazilian maternity hospitals.

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Graphene-based surface plasmon resonance (SPR) biosensors have emerged as a promising technology for the highly sensitive and accurate detection of biomolecules. This study presents a comprehensive theoretical analysis of graphene-based SPR biosensors, focusing on configurations with single and bimetallic metallic layers. In this study, we investigated the impact of various metallic substrates, including gold and silver, and the number of graphene layers on key performance metrics: sensitivity of detection, detection accuracy, and quality factor. Our findings reveal that configurations with graphene first supported on gold exhibit superior performance, with sensitivity of detection enhancements up to 30% for ten graphene layers. In contrast, silver-supported configurations, while demonstrating high sensitivity, face challenges in maintaining detection accuracy. Additionally, reducing the thickness of metallic layers by 30% optimizes light coupling and enhances sensor performance. These insights highlight the significant potential of graphene-based SPR biosensors in achieving high sensitivity of detection and reliability, paving the way for their application in diverse biosensing technologies. Our findings pretend to motivate future research focusing on optimizing metallic layer thickness, improving the stability of silver-supported configurations, and experimentally validating the theoretical findings to further advance the development of high-performance SPR biosensors.

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In this paper, the development of a 3D adaptive probabilistic explicit cracking model for concrete is reported. The contribution offered herein consists in a new adaptive mesh strategy designed to optimize the use of interface elements in probabilistic explicit cracking models. The proposed adaptive mesh procedure is markedly different from other strategies found in the literature, since it takes into account possible influences on the redistribution of stresses after cracking and can also be applied to purely deterministic cracking models. The process of obtaining the most appropriate adaptive mesh procedure involved the development and evaluation of three different adaptivity strategies. Two of these adaptivity strategies were shown to be inappropriate due to issues related to stress redistribution after cracking. The validation results demonstrate that the developed adaptive probabilistic model is capable of predicting the scale effect at a level similar to that experimentally observed, considering the tensile failure of plain concrete specimens. The results also show that different softening levels can be obtained. The proposed adaptive mesh strategy proved to be advantageous, being able to promote significant reductions in the simulation time in comparison with the classical strategy commonly used in probabilistic explicit cracking models.

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INTRODUCTION: Mitotane (o,p'-DDD) is the drug of choice for Adrenocortical Carcinomas (ACC) and its measurement in plasma is essential to control drug administration. OBJECTIVE: To develop and validate a simple, reliable and straightforward method for mitotane determination in plasma samples. METHOD: Drug-free plasma samples were collected in potassium-ethylenediamine tetraacetate (K-EDTA) tubes and spiked with 1.0, 2.5, 10.0, 25.0 and 50.0 µg/mL of mitotane (DDD). The p,p'-DDD was used as an Internal Standard (IS) and was added at 25.0 µg/mL concentration to all samples, standards and controls. Samples were submitted to protein precipitation with acetonitrile and then centrifuged. 50 uL of the supernatant was injected into an HPLC system coupled to a Diode Array Detector (DAD). DDD and IS were detected at 230 nm in a 12 min isocratic mode with a solvent mixture of 60 % acetonitrile and 40 % formic acid in water with 0.1 % pump mixed, at 0.6 mL/min flow rate, in a reversed-phase (C18) chromatographic column kept at 28°C. The sensitivity, selectivity, precision, presence of carry-over, recovery and matrix-effect, linearity, and method accuracy were evaluated. RESULTS: The present study's method resulted in a symmetrical peak shape and good baseline resolution for DDD (mitotane) and 4,4'-DDD (internal standard) with retention times of 6.0 min, 6.4 mim, respectively, with resolutions higher than 1.0. Endogenous plasma compounds did not interfere with the evaluated peaks when blank plasma and spiked plasma with standards were compared. Linearity was assessed over the range of 1.00-50.00 µg/mL for mitotane (R2 > 0.9987 and a 97.80 %‒105.50 % of extraction efficiency). Analytical sensitivity was 0.98 µg/mL. Functional sensitivity (LOQ) was 1.00 µg/L, intra-assay and inter-assay coefficient of variations were less than 9.98 %, and carry-over was not observed for this method. Recovery ranged from 98.00 % to 117.00 %, linearity ranged from 95.00 % to 119.00 %, and high accuracy of 89.40 % to 105.90 % with no matrix effects or interference was observed for mitotane measurements. Patients' sample results were compared with previous measurements by the GC-MS method with a high correlation (r = 0.88 and bias = -10.20 %). CONCLUSION: DDD determination in plasma samples by the developed and validated method is simple, robust, efficient, and sensitive for therapeutic drug monitoring and dose management to achieve a therapeutic index of mitotane in patients with adrenocortical cancer.

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This article aims to measure energy poverty in Colombia in its thirty-two departments and its capital city from 2018 to 2022, using a composite approach. To achieve this, a Multidimensional Energy Poverty Index (MEPI) was designed, according to the methodology proposed by Nussbaumer et al. (2012; 2013) [1,2]. Twenty-eight variables were used, which were distributed across seven dimensions, and recorded by the National Quality of Life Survey (ECV, Spanish acronym), administered by the National Administrative Department of Statistics (DANE) of Colombia. In addition, a nested weighting method was used to assign weights within the index. Subjective weights were given to the dimensions, and an entropy method was used for each of the component variables. The results show that energy poverty has an increasing trend in Colombia throughout the period, especially in the municipal capitals. There are significant differences between urban and rural areas in all territories, and the departments located in the most remote areas of the country have a higher energy poverty. This is consistent with the low population density, as well as with off-grid areas. The results obtained will allow decision makers to conduct a preliminary evaluation of the management and effects of the specific public policy programs and plans that have been implemented in the different territories of the country.

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A multi-orbital ionic Hamiltonian is presented to analyze the many-body properties of the d-transition metal atoms. This Hamiltonian considers all the atomic states obeying the first Hund's rule and also includes all orbital degeneracy, as well as the interaction of the atom with a metal. We analyze the solution of this ionic Hamiltonian by means of the equation of Motion method up to the fourth order,V4, in the atom-metal interaction. Equations for the appropriate Green-functions for analyzing the chemical and transport properties of the system are given for different atom occupancies. In particular, we introduce a full analysis of the multi-orbital Hamiltonian including atomic configurations withN, N+ 1 andN- 1 electrons, and discuss its Kondo properties. The shellsd1,d2andd3are analyzed in detail and Kondo energies are deduced in all these cases showing good agreement with the conventional known results.

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The compositional nutrient diagnosis-CND method is a standard tool for evaluating plant nutritional status. Adjustments are crucial to elevate accuracy. The effectiveness of such methodological refinements should be rigorously assessed through accuracy tests that are benchmarked against the prescient diagnostic analysis-PDA methodology. The objective of this investigation was to refine the CND technique for a more precise evaluation of N, P, and B nutrient status in cotton. The study's database encompasses 144 data points pertaining to crop yield and foliar nutrient concentrations from cotton plantations in the Cerrado biome of Brazil. Subsequently, the CND norms were established through rigorous calibration. Three separate nutrient-dose trials, each featuring four levels of N, P and B, were carried out to assess plant true nutritional status. Adjustments were made to the nutrient responsiveness range-NRr (0.5 and 1.0), while yield response-YR were scrutinized at threshold levels (5% and 10%). The prerequisites for achieving high diagnostic accuracy were nutrient specific. For N, maximal accuracy was linked only to the YR parameter (YR = 10%). For P, the most precise outcomes were attained with a NRr = 0.5 and YI = 5%. For B, highest diagnostic accuracy when the NRr = 1.0 and YI = 10%. These insights highlight the need to fine-tune the CND method for reliable nutritional evaluations and cotton crop productivity optimization.

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OBJECTIVE: To look into the effects of different anesthesia methods on the labor process and the expression of serum estrogen and progesterone in primiparas with painless labor. METHODS: 60 primiparas receiving painless labor were selected as the research objects, and they were divided into either a Spinal & Continuous epidural anesthesia group (n = 30) or a continuous epidural anesthesia group (n = 30), anesthesia is administered using the corresponding anesthesia method. The authors compared serum estrogen and progesterone, inflammatory index expression, pain degree and neonatal health status in different periods. RESULTS: At T2 and T3, serum P, LH, FSH and E2 levels in the Spinal & Continuous epidural anesthesia group were signally lower than those in the Spinal & Continuous epidural anesthesia group (p < 0.05). Spinal & Continuous epidural anesthesia group harbored faster onset and longer duration of sensory block and motor block than the Continuous epidural anesthesia group (p < 0.05). SAS and SDS scores of the Spinal & Continuous epidural anesthesia group were clearly lower than those of the Continuous epidural anesthesia group (p < 0.05). VAS score and serum TNF-α, IL-6 levels of pregnant women in the Spinal & Continuous epidural anesthesia group were memorably lower than those in the Continuous epidural anesthesia group at T2 and T3 (p < 0.05). The total incidence of postoperative complications in the Spinal & Continuous epidural anesthesia group was distinctively lower than that in the Continuous epidural anesthesia group (p < 0.05). CONCLUSION: Spinal anesthesia combined with continuous epidural anesthesia has a better anesthesia effect in the painless labor of primiparas, which can effectually ameliorate the labor process and the expression of serum estrogen and progesterone.

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A validation of the factorial, Taguchi and response surface methodology (RSM) statistical models is developed for the analysis of mechanical tests of hybrid materials, with an epoxy matrix reinforced with natural Chambira fiber and synthetic fibers of glass, carbon and Kevlar. These materials present variability in their properties, so for the validation of the models a research methodology with a quantitative approach based on the statistical process of the design of experiments (DOE) was adopted; for which the sampling is in relation to the design matrix using 90 treatments with three replicates for each of the study variables. The analysis of the models reveals that the greatest pressure is obtained by considering only the source elements that are significant; this is reflected in the increase in the coefficient of determination and in the predictive capacity. The modified factorial model is best suited for the research, since it has an R2 higher than 90% in almost all the evaluated mechanical properties of the material; with respect to the combined optimization of the variables, the model showed an overall contribution of 99.73% and global desirability of 0.7537. These results highlight the effectiveness of the modified factorial model in the analysis of hybrid materials.

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PURPOSE: The objective of this study was to describe a planning method for medial unicompartmental knee arthroplasty (UKA) implantation using preoperative stress radiographs to measure the thickness of tibial and femoral bone resections and to validate this method with data from an image-based robotic surgery system. Having such method for preoperative planning would be of interest for surgeons performing UKA in order to anticipate optimal bone resection on both tibia and femoral sides. METHODS: A new planning method for medial UKA based on valgus stress knee radiographs validated it with an image-based robotic surgery system (Restoris MCK, MAKO®, Stryker Corporation) was proposed. This retrospective study involved radiographic measurements of 76 patients who underwent image-based robotic medial UKA between April 2022 and February 2023. Preoperative anteroposterior stress radiographs of the knee were used to simulate UKA implantation. The UKA technique was based on Cartier's angle and aimed at restoring the joint line. The total dimension measured was 14 mm (8 mm for minimal tibial component and polyethylene insert + 4 mm for femoral component + 2 mm for safety laxity). Bone resections were measured in the preoperative valgus stress radiographs and then against the intraoperative bone resection data provided by the robotic system. Inter- and intra-observer reliability was assessed using 25 measurements. RESULTS: The mean planned tibial resection measured in the radiographs was 4.3 ± 0.4 [2.9-5.8], while the mean robotic resection was 4.2 ± 0.5 [2.7-5.8] (mean difference = 0.15 mm, 95% confidence interval [CI] [-0.27 to 0.57]). There was a strong correlation between these two values (Pearson's rank R = 0.79, p < 0.001). Intra- and inter-observer reliability were also very strong (Pearson's rank R = 0.91, p < 0.001, and Pearson's rank R = 0.82, p < 0.001, respectively). The mean planned femoral bone resection measured in the radiographs was 2.7 ± 0.7 mm [1-4.5], while the mean robotic resection was 2.5 ± 0.9 [1-5] (mean difference = 0.21 mm, 95% CI [-0.66 to 1.08]). There was a strong correlation between these two values (Pearson's rank R = 0.82, p < 0.001). Intra- and inter-observer reliability were also strong (Pearson's rank R = 0.88, p < 0.001, and Pearson's rank R = 0.84, p < 0.001, respectively). CONCLUSION: This study describes and validates with robotic information a simple and reproducible preoperative planning method to determine femoral and tibial bone resection for medial UKA implantation using antero-posterior valgus stress knee radiographs, leaving a medial safety laxity of 2 mm. It represents a very valuable contribution to the understanding of UKA principles, which can serve to extend its indications and increase reproducibility of the surgical technique. LEVEL OF EVIDENCE: III. Retrospective cohort study.