Copper,an essential metal for the energy transition,is primarily obtained from chalcopyrite through hydrometallurgical and pyrometallurgical methods.The risks and harmful impacts of these processes pose significant co...Copper,an essential metal for the energy transition,is primarily obtained from chalcopyrite through hydrometallurgical and pyrometallurgical methods.The risks and harmful impacts of these processes pose significant concerns for environmental and human safety,highlighting the need for more efficient and eco-friendly hydrometallurgical methods.This review article emphasizes current pro-cesses such as oxidative leaching,bioleaching,and pressure leaching that have demonstrated efficiency in overcoming the complicated chalcopyrite network.Oxidative leaching operates under benign conditions within the leaching media;nevertheless,the introduction of oxidizing agents provides benefits and advantages.Bioleaching,a non-aggressive method,has shown a gradual increase in copper extrac-tion efficiency and has been explored using both primary and secondary sources.Pressure leaching,known for its effectiveness and se-lectivity in copper extraction,is becoming commercially more viable with increased research investments.This research also provides im-portant data for advancing future research in the field.展开更多
Background Milk synthesis in lactating animals demands high energy metabolism,which results in an increased production of reactive oxygen metabolites(ROM)causing an imbalance between oxidants and antioxidants thereby ...Background Milk synthesis in lactating animals demands high energy metabolism,which results in an increased production of reactive oxygen metabolites(ROM)causing an imbalance between oxidants and antioxidants thereby inducing oxidative stress(OS)on the animals.To mitigate OS and postpartum disorders in dairy goats and gain insight into the impact of dietary choices on redox status during lactation,a feeding trial was conducted using alfalfa silage inoculated with a high-antioxidant strain of Lactiplantibacillus plantarum.Methods Twenty-four Guanzhong dairy goats(38.1±1.20 kg)were randomly assigned to two dietary treatments:one containing silage inoculated with L.plantarum MTD/1(RSMTD-1),and the other containing silage inoculated with high antioxidant activity L.plantarum 24-7(ES24-7).Results ES24-7-inoculated silage exhibited better fermentation quality and antioxidant activity compared to RSMTD-1.The ES24-7 diet elevated the total antioxidant capacity(T-AOC),superoxide dismutase(SOD),glutathione peroxi-dase(GSH-Px),and catalase(CAT)activities in milk,serum,and feces of lactating goats(with the exception of T-AOC in milk).Additionally,the diet containing ES24-7 inoculated silage enhanced casein yield,milk free fatty acid(FFA)content,and vitamin A level in the goats’milk.Furthermore,an increase of immunoglobulin(Ig)A,IgG,IgM,inter-leukin(IL)-4,and IL-10 concentrations were observed,coupled with a reduction in IL-1β,IL-2,IL-6,interferon(IFN)-γ,and tumor necrosis factor(TNF)-αconcentrations in the serum of lactating goats fed ES24-7.Higher concentrations of total volatile fatty acid(VFA),acetate,and propionate were observed in the rumen fluid of dairy goats fed ES24-7 inoculated silage.Moreover,the diet containing ES24-7 inoculated silage significantly upregulated the expression of nuclear factor erythroid 2 like 2(NFE2L2),beta-carotene oxygenase 1(BCO1),SOD1,SOD2,SOD3,GPX2,CAT,glu-tathione-disulfide reductase(GSR),and heme oxygenase 1(HMOX1)genes in the mammary gland,while decreased the levels of NADPH oxidase 4(NOX4),TNF,and interferon gamma(IFNG).Conclusions These findings indicated that feeding L.plantarum 24-7 inoculated alfalfa silage not only improved rumen fermentation and milk quality in lactating dairy goats but also boosted their immunity and antioxidant status by modulating the expression of several genes related to antioxidant and inflammation in the mammary gland.展开更多
Background Thermal stress in subtropical regions is a major limiting factor in beef cattle production systems with around$369 million being lost annually due to reduced performance.Heat stress causes numerous physiolo...Background Thermal stress in subtropical regions is a major limiting factor in beef cattle production systems with around$369 million being lost annually due to reduced performance.Heat stress causes numerous physiological and behavioral disturbances including reduced feed intake and decreased production levels.Cattle utilize various physiological mechanisms such as sweating to regulate internal heat.Variation in these traits can help identify genetic variants that control sweat gland properties and subsequently allow for genetic selection of cattle with greater thermotolerance.Methods This study used 2,401 Brangus cattle from two commercial ranches in Florida.Precise phenotypes that contribute to an animal's ability to manage heat stress were calculated from skin biopsies and included sweat gland area,sweat gland depth,and sweat gland length.All animals were genotyped with the Bovine GGP F250K,and BLUPF90 software was used to estimate genetic parameters and for Genome Wide Association Study.Results Sweat gland phenotypes heritability ranged from 0.17 to 0.42 indicating a moderate amount of the phenotypic variation is due to genetics,allowing producers the ability to select for favorable sweat gland properties.A weighted single-step GWAS using sliding 10 kb windows identified multiple quantitative trait loci(QTLs)explaining a significant amount of genetic variation.QTLs located on BTA7 and BTA12 explained over 1.0%of genetic variance and overlap the ADGRV1 and CCDC168 genes,respectively.The variants identified in this study are implicated in processes related to immune function and cellular proliferation which could be relevant to heat management.Breed of Origin Alleles(BOA)were predicted using local ancestry in admixed populations(LAMP-LD),allowing for identification of markers'origin from either Brahman or Angus ancestry.A BOA GWAS was performed to identify regions inherited from particular ancestral breeds that might have a significant impact on sweat gland phenotypes.Conclusions The results of the BOA GWAS indicate that both Brahman and Angus alleles contribute positively to sweat gland traits,as evidenced by favorable marker effects observed from both genetic backgrounds.Understanding and utilizing genetic traits that confer better heat tolerance is a proactive approach to managing the impacts of climate change on livestock farming.展开更多
Brazil has become one of the top producers and exporters of food, fibre, and bionergy in the world.The expansion of livestock and soybean production in the Amazon basin appears to be independent of the sugarcane expan...Brazil has become one of the top producers and exporters of food, fibre, and bionergy in the world.The expansion of livestock and soybean production in the Amazon basin appears to be independent of the sugarcane expansion in southeastern Brazil whereas the impact of sugarcane expansion over areas of soybean plantation in previous Cerrado biome is still unknown. However, the expansion of sugarcane production in the state of S?o Paulohas been shown to cause an increase in the local abundance of rodents and result in the emergence of infectious diseases such as hantaviruses and leptospirosis in humans. In addition, with an increase in the use of agrochemicals there will be an increase in euthrophication of watercourses and soil pollution. Considering that S?o Paulo has a population of approximately 40 million people, these local impacts are relevant. Environmental law should be improved and enforced in Brazil to ensure that sugarcane production is not only economically profitable but also environmentally responsible.展开更多
Follow-up of environmental impacts is an integral part of the Environmental Impact Assessment (EIA) process, closely related to the effectiveness of the instrument. EIA follow-up has been receiving a lot of interest f...Follow-up of environmental impacts is an integral part of the Environmental Impact Assessment (EIA) process, closely related to the effectiveness of the instrument. EIA follow-up has been receiving a lot of interest from scientists and practitioners, though it is recognized as one of the weakest points of EIA systems globally. Also, EIA follow-up is influenced by the context, mainly in terms of the types of projects or activities and their related impacts on the environment. Therefore, the present paper is focused on the investigation of the follow-up stage applied to the activity of seismic survey coupled with offshore oil & gas exploitation in Brazil. Research was based on a qualitative approach that included document analysis and semi-structured interviews with analysts involved in EIA processes, and sought to generate evidence of effectiveness of the EIA follow-up as conducted by the Federal Environment Agency (Ibama) in order to situate the practice of follow-up in the broader context of international best practice principles. Based on the findings, it was concluded that, due to the peculiarities of offshore seismic survey, it is necessary to promote adaptations in the procedures for monitoring impacts in order to ensure proper alignment with the principles and conceptual foundations that guide EIA practice. Specifically, the timing of the execution of the activity imposes challenges for its integration into the “conventional” cycle that has guided the monitoring of the impacts in the EIA of projects.展开更多
A good quality Environmental Impact Statement (EIS) is key for the effectiveness of Environmental Impact Assessment (EIA) processes and consequently to the acceptability of projects subject to EIA. The international l...A good quality Environmental Impact Statement (EIS) is key for the effectiveness of Environmental Impact Assessment (EIA) processes and consequently to the acceptability of projects subject to EIA. The international literature has contributed to the understanding of the essential aspects to be verified regarding the quality of EIS, offering a wide spectrum of good practice examples related to the content of the studies. Even so, there is a need for empirical studies that allow the identification of specific aspects related to the context of application of the EIS, which could lead to the identification of opportunities to improve both the quality of the reports and also the effectiveness of EIA. Therefore, the present paper is focused on the quality review of a number of EIS submitted to the Brazilian Federal Environmental Agency (Ibama) to instruct the assessment of electric power transmission systems. Based on the application of the EIS quality review package as proposed by Lee and Colley (1992), the outcomes reveal opportunities for improving the scope of EIA, analysis of alternatives, prediction of magnitude and the assessment of impact significance. Finally, the development and/or adaptation of a similar tool for the systematic review of the quality of EIA reports is recommended.展开更多
The investigation of contaminated areas in fractured aquifers represents a great technical challenge, due to the frequent conditions of heterogeneity and anisotropy of these environments, which often make it difficult...The investigation of contaminated areas in fractured aquifers represents a great technical challenge, due to the frequent conditions of heterogeneity and anisotropy of these environments, which often make it difficult to identify and predict pathways of subsurface contamination. This work aims to contribute to the development of this subject, through the presentation of the results of an investigation in which geophysical logging tools and straddle packers were used, which allowed the development of a more suitable hydrogeological conceptual model of the study area. Two boreholes were drilled and geophysical logging (gamma, caliper and high resolution acoustic televiewer) were used for the geological-structural characterization of the aquifer. Heatpulse flowmeter and straddle packers were then used to obtain data on hydraulic potentials and flows and for the collection of discrete water samples for chemical analysis. Two types of gneiss rocks were identified below the weathering zone (thickness >30 m), one with predominance of mafic bands, more weathered and with a higher fracture density, up to 65 m, and another deeper one, with the predominance of felsic bands. Seven groups of fractures were defined, being those of Group 1, with low dip angles, the most frequent and important for flow until 65 m, and Group 2 (N to NE-SW with high dips to W and NW) more frequent in deeper felsic gneisses. Downward hydraulic potentials were identified down to 65 m and upward potentials from the bottom up to 65 m. A hydraulic test allowed identifying the occurrence of hydraulic connection between the shallow weathering zone and the underlying fractured aquifer.展开更多
This study evaluates the development of a testing process for the automotive software domain, highlighting challenges stemming from the absence of adequate processes. The research demonstrates the application of Desig...This study evaluates the development of a testing process for the automotive software domain, highlighting challenges stemming from the absence of adequate processes. The research demonstrates the application of Design Science Research methodology in developing, an automotive software testing process—ProTSA, using six functional testing modules. Additionally, the study evaluates the benefits of implementing ProTSA in a specific Original Equipment Manufacturer (OEM) using an experimental single-case approach with industry professionals’ participation through a survey. The study concludes that combining testing techniques with effective communication and alignment is crucial for enhancing software quality. Furthermore, survey data indicates that implementing ProTSA leads to productivity gains by initiating tests early, resulting in time savings in the testing program and increased productivity for the testing team. Future work will explore implementing ProTSA in cybersecurity, over-the-air software updates, and autonomous vehicle testing processes. .展开更多
This article deals with the important experience of regional planning developed by the CESP （Companhia Energ6tica de Silo Paulo）, Brazil, through the implantation of its hydroelectric projects. The company accumulat...This article deals with the important experience of regional planning developed by the CESP （Companhia Energ6tica de Silo Paulo）, Brazil, through the implantation of its hydroelectric projects. The company accumulated a large experience in deploying and managing residential centers built to provide support to the works of their dams. The presence of urban planning was verified in all cases studied, with the participation of different professionals such as architects, planners, engineers and landscape designers, from inside or outside the company. This research shows that they used concepts derived from experiences as company towns of 19th century, the neighborhood unit, the garden city, the urbanistic assumptions from CIAM （Congr^s Internationaux d＇Architecture Moderne） and the TVA （Tennessee Valley Authority）.展开更多
HIV/AIDS has brought to light the challenge of incorporating the many influences between living conditions, social characteristics and health services performance to an adequate care for PLWHA （people living with AID...HIV/AIDS has brought to light the challenge of incorporating the many influences between living conditions, social characteristics and health services performance to an adequate care for PLWHA （people living with AIDS）. Vulnerability of these populations is under the responsibility of specialized care units whose assistance does not always occur according to their real needs and demands. Therefore, this study aimed to analyze demographic, social and clinical profiles of PLWHA, as well as their follow-up in SS （Specialized Health Services） in Ribeir^o Preto, Brazil. It is a descriptive study conducted by the application of structured questionnaires to 253 patients with HIV/AIDS in follow-up during the years of 2012-2013. Variables were analyzed by descriptive statistics procedures. The findings pointed out gender parity, aging population, low education and economic predominance of class C. Regarding clinical characteristics, there was a predominance of asymptomatic individuals, with no clinical manifestations of AIDS or major comorbidities. The main mode of transmission was through sexual contact. The results led to the need of adequating the assistance provided to the specificities inherent to PLWHA. The care provision should cross an interdisciplinary perspective, targeting recognition of problems and ensuring comprehensive health care adequate to users＇ needs and demands.展开更多
The City of Silo Paulo is the largest urban occupation in Brazil, covering 1,500 km^2. Its population is approximately 12 million inhabitants, 12% of them living in subnormal agglomerates, the IBGE （Brazilian Agency ...The City of Silo Paulo is the largest urban occupation in Brazil, covering 1,500 km^2. Its population is approximately 12 million inhabitants, 12% of them living in subnormal agglomerates, the IBGE （Brazilian Agency for Statistics and Geography） denomination for informal settlements, mostly located in fiver floodplain areas or top of hills. The extreme high level of soil sealing and high slopes have a fundamental role to explain the increase the risks of mass movements or landslides, related to precipitation magnitude and duration. This article presents the construction of curves coupling landslides occurrences and precipitation based on the data analysis of different basins in the city of Sao Panlo, considering also the probability and duration of the rainfall event in order to establish a vulnerability index to estimate the vulnerability category of an specific area. Based on the data analysis of instantaneous radar rain records for seven extreme rainfall events where landslides occurrences records were available, it was possible to plot sigmoid curves linking the number of occurrences with the event probability in terms of return period.展开更多
The aim of this work was to characterize and to bring into relationship of the net radiation with the latent heat flux equivalent to water (mm) in a patch of Atlantic Forest within the metropolitan area of Sao Paulo (...The aim of this work was to characterize and to bring into relationship of the net radiation with the latent heat flux equivalent to water (mm) in a patch of Atlantic Forest within the metropolitan area of Sao Paulo (RMSP). The estimation of the latent heat flux (LE) was made by the energy balance equation with the Bowen ratio. Measurements of net radiation and psychometrics gradients were made. Soil heat flux (G) was measured by temperature sensors in two depths. Measurements were made at Park of Science and Technology of Sao Paulo University (CIENTEC), Sao Paulo, Brazil, between 2011 and 2013. Results indicated that evapotranspiration varies seasonally and the amount of water evaporated exceeds 3.0 mm·day-1 in spring/summer and in autumn/winter the amount is approximately 1.0 mm·day-1. The evapotranspiration is increased under RMSP urban climate conditions with higher air temperature and lower moisture especially in summer season.展开更多
Given the frequent co-existence of an aggressive tumor and underlying chronic liver disease,the management of hepatocellular carcinoma(HCC)patients requires experienced multidisciplinary team discussion.Moreover,imagi...Given the frequent co-existence of an aggressive tumor and underlying chronic liver disease,the management of hepatocellular carcinoma(HCC)patients requires experienced multidisciplinary team discussion.Moreover,imaging plays a key role in the diagnosis,staging,restaging,and surveillance of HCC.Currently,imaging assessment of HCC entails the assessment of qualitative characteristics which are prone to inter-reader variability.Radiomics is an emerging field that extracts high-dimensional mineable quantitative features that cannot be assessed visually with the naked eye from medical imaging.The main potential applications of radiomic models in HCC are to predict histology,response to treatment,genetic signature,recurrence,and survival.Despite the encouraging results to date,there are challenges and limitations that need to be overcome before radiomics implementation in clinical practice.The purpose of this article is to review the main concepts and challenges pertaining to radiomics,and to review recent studies and potential applications of radiomics in HCC.展开更多
Introduction: There has been an increase in the proportion of cesarean deliveries, especially in developing countries. Methods: Cross-sectional study of all hospital live births from mothers living in Sao Paulo Metrop...Introduction: There has been an increase in the proportion of cesarean deliveries, especially in developing countries. Methods: Cross-sectional study of all hospital live births from mothers living in Sao Paulo Metropolitan Area, Brazil. Data were obtained from the Live Birth Information System, which is linked to the National Database of Health Establishments. Hospitals were classified as public, private or mixed. Descriptive analysis and exponential regression were conducted to evaluate time trends. Poisson regression was applied to analyze each hospital type to identify risk factors and the attributable risk fraction for cesarean section. Results: There was an annual increase (1.4%) of cesarean deliveries between 2000 and2013. In2009, the percentage of cesarean deliveries was 53% overall and 83% in private hospitals. The primary risk factor for cesarean delivery was delivery in a private hospital. Other risk factors that were stronger in public hospitals included the following: advanced maternal age, high maternal education, nulliparity, high number of prenatal visits, multiple pregnancy, hospital with low annual volume of deliveries, birth outside the city of residence and white skin color. Discussion: These results may be explained by the obstetric care model of private hospitals, which is not multiprofessional. Prenatal care and delivery are conducted by the same doctor and rarely include the input of another professional, such as a midwife. In addition, the mode of delivery influences the professional’s payment.展开更多
The Emerging Timber Bridge Program to Sao Paulo state （ETBPSP） was started in 2001 with the main objective of research and development of new technologies for timber bridge construction. After five years of this pro...The Emerging Timber Bridge Program to Sao Paulo state （ETBPSP） was started in 2001 with the main objective of research and development of new technologies for timber bridge construction. After five years of this program eleven demonstration timber bridges were constructed in the State of Sao Paulo, whereas eight composite timber/concrete bridges, one log timber girder bridge with transversal sawn deck, one transversal lumber prestressed timber bridge and one transversal cellular plywood box prestressed bridge. As a final objective is the divulgation of the constructive and structural systems in extension courses to municipal engineers and in a complete publication of timber bridges project plans with the different structural and constructional systems. This paper describes the goals of the MTBPSP, the accomplishments of the program in the first five years, the information sheet of the bridges and outlines some obstacles and opportunities.展开更多
This article presents the results of empirical research with freelance journalists from the city of Sao Paulo, involving quantitative and qualitative research methods and the theoretical-methodological from the Recept...This article presents the results of empirical research with freelance journalists from the city of Sao Paulo, involving quantitative and qualitative research methods and the theoretical-methodological from the Reception Studies and Ergology. It is a theoretical and empirical approach, whose developments have been used by the Communication and Work Research Group of Communications and Arts School--University of SAo Paulo, Brazil. The reception from the world of work shows how changes in the labor act concretely in daily life subjectively and how they manifest in the sphere of cultural consumption. The research shows how, from the reception, the journalists reveal from which place they talk about the world, the society, and their own work. The reception is revealed as the moment par excellence ＂to talk about work＂. When talking about the other＇s work, the journalists are confronted with their own work and reveal, in their discourse, values and dramas of real activity of communication and work.展开更多
In Brazil and various regions globally, the initiation of landslides is frequently associated with rainfall;yet the spatial arrangement of geological structures and stratification considerably influences landslide occ...In Brazil and various regions globally, the initiation of landslides is frequently associated with rainfall;yet the spatial arrangement of geological structures and stratification considerably influences landslide occurrences. The multifaceted nature of these influences makes the surveillance of mass movements a highly intricate task, requiring an understanding of numerous interdependent variables. Recent years have seen an emergence in scholarly research aimed at integrating geophysical and geotechnical methodologies. The conjoint examination of geophysical and geotechnical data offers an enhanced perspective into subsurface structures. Within this work, a methodology is proposed for the synchronous analysis of electrical resistivity geophysical data and geotechnical data, specifically those extracted from the Light Dynamic Penetrometer (DPL) and Standard Penetration Test (SPT). This study involved a linear fitting process to correlate resistivity with N10/SPT N-values from DPL/SPT soundings, culminating in a 2D profile of N10/SPT N-values predicated on electrical profiles. The findings of this research furnish invaluable insights into slope stability by allowing for a two-dimensional representation of penetration resistance properties. Through the synthesis of geophysical and geotechnical data, this project aims to augment the comprehension of subsurface conditions, with potential implications for refining landslide risk evaluations. This endeavor offers insight into the formulation of more effective and precise slope management protocols and disaster prevention strategies.展开更多
AIM:To determine whether the levator palpebrae superioris(LPS)/superior rectus(SR)muscle complex,can influence the position of the upper lid and fornix in acquired anophthalmic sockets.METHODS:This comparative non-ran...AIM:To determine whether the levator palpebrae superioris(LPS)/superior rectus(SR)muscle complex,can influence the position of the upper lid and fornix in acquired anophthalmic sockets.METHODS:This comparative non-randomized and non-interventional study included retrospective data of 21 patients with unilateral acquired anophthalmic sockets repaired with spheric implants.High-resolution computed tomography(CT)measurements of the LPM/SR muscle complex and clinical topographic position of the upper lid,superior and inferior fornix depth in primary gaze position were evaluated.Demographic data were presented as frequency and percentage proportions and quantitative variables comparing the socket measurements with the normal contralateral orbit was statistically analyzed using non-parametric tests considering P<0.05.RESULTS:The anophthalmic orbits had a significantly shorter LPS length(P=0.01)and significantly thicker SR(P=0.02)than the normal orbit.Lagophthalmos was present in anophthalmic sockets but not in normal orbits(P=0.002),while levator function was normal in both(P>0.05,all comparisons).The superior fornix depth was similar in the anophthalmic socket and the contralateral normal orbit(P=0.192)as well the inferior fornix depth(P=0.351).CONCLUSION:Acquired anophthalmic sockets repaired with spheric implants have shorter LPS,thicker SR,and more lagophthalmos than normal orbits.The relationship of the LPS and SR with other orbital structures,associated with passive or active forces acting in the final position of the lids and external ocular prosthesis should be further investigated.展开更多
AIM: To compare deep sedation with propofol-fentanyl and midazolam-fentanyl regimens during upper gastrointestinal endoscopy. METHODS: After obtaining approval of the research ethics committee and informed consent, 20...AIM: To compare deep sedation with propofol-fentanyl and midazolam-fentanyl regimens during upper gastrointestinal endoscopy. METHODS: After obtaining approval of the research ethics committee and informed consent, 200 patients were evaluated and referred for upper gastrointestinal endoscopy. Patients were randomized to receive propofol-fentanyl or midazolam-fentanyl (n = 100/group).We assessed the level of sedation using the observer's assessment of alertness/sedation (OAA/S) score and bispectral index (BIS). We evaluated patient and physician satisfaction, as well as the recovery time and complication rates. The statistical analysis was performed using SPSS statistical software and included the MannWhitney test, χ 2 test, measurement of analysis of variance, and the κ statistic. RESULTS: The times to induction of sedation, recovery, and discharge were shorter in the propofolfentanyl group than the midazolam-fentanyl group. According to the OAA/S score, deep sedation events occurred in 25% of the propofol-fentanyl group and 11% of the midazolam-fentanyl group (P = 0.014). Additionally, deep sedation events occurred in 19% of the propofol-fentanyl group and 7% of the midazolamfentanyl group according to the BIS scale (P = 0.039). There was good concordance between the OAA/S score and BIS for both groups (κ = 0.71 and κ = 0.63, respectively). Oxygen supplementation was required in 42% of the propofol-fentanyl group and 26% of the midazolam-fentanyl group (P = 0.025). The mean time to recovery was 28.82 and 44.13 min in the propofolfentanyl and midazolam-fentanyl groups, respectively (P < 0.001). There were no severe complications in either group. Although patients were equally satisfied with both drug combinations, physicians were more satisfied with the propofol-fentanyl combination. CONCLUSION: Deep sedation occurred with propofolfentanyl and midazolam-fentanyl, but was more frequent in the former. Recovery was faster in the propofol-fentanyl group.展开更多
AIM: To analyze outcomes in patients who underwent liver transplantation(LT) for hepatocellular carcinoma(HCC) and received autologous intraoperative blood salvage(IBS). METHODS: Consecutive HCC patients who underwent...AIM: To analyze outcomes in patients who underwent liver transplantation(LT) for hepatocellular carcinoma(HCC) and received autologous intraoperative blood salvage(IBS). METHODS: Consecutive HCC patients who underwent LT were studied retrospectively and analyzed according to the use of IBS or not. Demographic and surgical data were collected from a departmental prospective maintained database. Statistical analyses were performed using the Fisher's exact test and the Wilcoxon rank sum test to examine covariate differences between patients who underwent IBS and those who did not. Univariate and multivariate Cox regression models were developed to evaluate recurrence and death,and survival probabilities were estimated using the Kaplan-Meier method and compared by the log-rank test.RESULTS: Between 2002 and 2012,158 consecutive patients who underwent LT in the same medical center and by the same surgical team were identified. Among these patients,122(77.2%) were in the IBS group and 36(22.8%) in the non-IBS group. The overall survival(OS) and recurrence free survival(RFS) at 5 years were 59.7% and 83.3%,respectively. No differences in OS(P=0.51) or RFS(P=0.953) were detected between the IBS and non-IBS groups. On multivariate analysis for OS,degree of tumor differentiation remained as the only independent predictor. Regarding patients who received IBS,no differences were detected in OS or RFS(P=0.055 and P=0.512,respectively) according to the volume infused,even when outcomes at 90 d or longer were analyzed separately(P=0.518 for both outcomes).CONCLUSION: No differences in RFS or OS were detected according to IBS use. Trials addressing this question are justified and should be designed to detect small differences in long-term outcomes.展开更多
基金the Fundação de Amparo àPesquisa do Estado de São Paulo and Capes(grants:2019/11866-5,2020/00493-0,2021/14842-0,and 2023/01032-5 São Paulo Research Foundation)for financial support.
文摘Copper,an essential metal for the energy transition,is primarily obtained from chalcopyrite through hydrometallurgical and pyrometallurgical methods.The risks and harmful impacts of these processes pose significant concerns for environmental and human safety,highlighting the need for more efficient and eco-friendly hydrometallurgical methods.This review article emphasizes current pro-cesses such as oxidative leaching,bioleaching,and pressure leaching that have demonstrated efficiency in overcoming the complicated chalcopyrite network.Oxidative leaching operates under benign conditions within the leaching media;nevertheless,the introduction of oxidizing agents provides benefits and advantages.Bioleaching,a non-aggressive method,has shown a gradual increase in copper extrac-tion efficiency and has been explored using both primary and secondary sources.Pressure leaching,known for its effectiveness and se-lectivity in copper extraction,is becoming commercially more viable with increased research investments.This research also provides im-portant data for advancing future research in the field.
基金supported by the National Natural Science Foundation of China (No. U20A2002)China Postdoctoral Science Foundation (No. 2023T160284)recipient of a research productivity fellowship from CNPq (National Council of Scientific and Technological Development) in Brazil
文摘Background Milk synthesis in lactating animals demands high energy metabolism,which results in an increased production of reactive oxygen metabolites(ROM)causing an imbalance between oxidants and antioxidants thereby inducing oxidative stress(OS)on the animals.To mitigate OS and postpartum disorders in dairy goats and gain insight into the impact of dietary choices on redox status during lactation,a feeding trial was conducted using alfalfa silage inoculated with a high-antioxidant strain of Lactiplantibacillus plantarum.Methods Twenty-four Guanzhong dairy goats(38.1±1.20 kg)were randomly assigned to two dietary treatments:one containing silage inoculated with L.plantarum MTD/1(RSMTD-1),and the other containing silage inoculated with high antioxidant activity L.plantarum 24-7(ES24-7).Results ES24-7-inoculated silage exhibited better fermentation quality and antioxidant activity compared to RSMTD-1.The ES24-7 diet elevated the total antioxidant capacity(T-AOC),superoxide dismutase(SOD),glutathione peroxi-dase(GSH-Px),and catalase(CAT)activities in milk,serum,and feces of lactating goats(with the exception of T-AOC in milk).Additionally,the diet containing ES24-7 inoculated silage enhanced casein yield,milk free fatty acid(FFA)content,and vitamin A level in the goats’milk.Furthermore,an increase of immunoglobulin(Ig)A,IgG,IgM,inter-leukin(IL)-4,and IL-10 concentrations were observed,coupled with a reduction in IL-1β,IL-2,IL-6,interferon(IFN)-γ,and tumor necrosis factor(TNF)-αconcentrations in the serum of lactating goats fed ES24-7.Higher concentrations of total volatile fatty acid(VFA),acetate,and propionate were observed in the rumen fluid of dairy goats fed ES24-7 inoculated silage.Moreover,the diet containing ES24-7 inoculated silage significantly upregulated the expression of nuclear factor erythroid 2 like 2(NFE2L2),beta-carotene oxygenase 1(BCO1),SOD1,SOD2,SOD3,GPX2,CAT,glu-tathione-disulfide reductase(GSR),and heme oxygenase 1(HMOX1)genes in the mammary gland,while decreased the levels of NADPH oxidase 4(NOX4),TNF,and interferon gamma(IFNG).Conclusions These findings indicated that feeding L.plantarum 24-7 inoculated alfalfa silage not only improved rumen fermentation and milk quality in lactating dairy goats but also boosted their immunity and antioxidant status by modulating the expression of several genes related to antioxidant and inflammation in the mammary gland.
基金supported by USDA-NIFA Grants#2017–67007-26143,2020–67015-30820Florida Agricultural Experiment Station Hatch FLAANS-005548+1 种基金supported by USDA NIFA grant 2019–38420-28977Town Creek Farms。
文摘Background Thermal stress in subtropical regions is a major limiting factor in beef cattle production systems with around$369 million being lost annually due to reduced performance.Heat stress causes numerous physiological and behavioral disturbances including reduced feed intake and decreased production levels.Cattle utilize various physiological mechanisms such as sweating to regulate internal heat.Variation in these traits can help identify genetic variants that control sweat gland properties and subsequently allow for genetic selection of cattle with greater thermotolerance.Methods This study used 2,401 Brangus cattle from two commercial ranches in Florida.Precise phenotypes that contribute to an animal's ability to manage heat stress were calculated from skin biopsies and included sweat gland area,sweat gland depth,and sweat gland length.All animals were genotyped with the Bovine GGP F250K,and BLUPF90 software was used to estimate genetic parameters and for Genome Wide Association Study.Results Sweat gland phenotypes heritability ranged from 0.17 to 0.42 indicating a moderate amount of the phenotypic variation is due to genetics,allowing producers the ability to select for favorable sweat gland properties.A weighted single-step GWAS using sliding 10 kb windows identified multiple quantitative trait loci(QTLs)explaining a significant amount of genetic variation.QTLs located on BTA7 and BTA12 explained over 1.0%of genetic variance and overlap the ADGRV1 and CCDC168 genes,respectively.The variants identified in this study are implicated in processes related to immune function and cellular proliferation which could be relevant to heat management.Breed of Origin Alleles(BOA)were predicted using local ancestry in admixed populations(LAMP-LD),allowing for identification of markers'origin from either Brahman or Angus ancestry.A BOA GWAS was performed to identify regions inherited from particular ancestral breeds that might have a significant impact on sweat gland phenotypes.Conclusions The results of the BOA GWAS indicate that both Brahman and Angus alleles contribute positively to sweat gland traits,as evidenced by favorable marker effects observed from both genetic backgrounds.Understanding and utilizing genetic traits that confer better heat tolerance is a proactive approach to managing the impacts of climate change on livestock farming.
基金financed by FAPESP-Biota Program(Proc.No.2006/60954-4)CNPq(Proc.No.557872/2008-1).
文摘Brazil has become one of the top producers and exporters of food, fibre, and bionergy in the world.The expansion of livestock and soybean production in the Amazon basin appears to be independent of the sugarcane expansion in southeastern Brazil whereas the impact of sugarcane expansion over areas of soybean plantation in previous Cerrado biome is still unknown. However, the expansion of sugarcane production in the state of S?o Paulohas been shown to cause an increase in the local abundance of rodents and result in the emergence of infectious diseases such as hantaviruses and leptospirosis in humans. In addition, with an increase in the use of agrochemicals there will be an increase in euthrophication of watercourses and soil pollution. Considering that S?o Paulo has a population of approximately 40 million people, these local impacts are relevant. Environmental law should be improved and enforced in Brazil to ensure that sugarcane production is not only economically profitable but also environmentally responsible.
文摘Follow-up of environmental impacts is an integral part of the Environmental Impact Assessment (EIA) process, closely related to the effectiveness of the instrument. EIA follow-up has been receiving a lot of interest from scientists and practitioners, though it is recognized as one of the weakest points of EIA systems globally. Also, EIA follow-up is influenced by the context, mainly in terms of the types of projects or activities and their related impacts on the environment. Therefore, the present paper is focused on the investigation of the follow-up stage applied to the activity of seismic survey coupled with offshore oil & gas exploitation in Brazil. Research was based on a qualitative approach that included document analysis and semi-structured interviews with analysts involved in EIA processes, and sought to generate evidence of effectiveness of the EIA follow-up as conducted by the Federal Environment Agency (Ibama) in order to situate the practice of follow-up in the broader context of international best practice principles. Based on the findings, it was concluded that, due to the peculiarities of offshore seismic survey, it is necessary to promote adaptations in the procedures for monitoring impacts in order to ensure proper alignment with the principles and conceptual foundations that guide EIA practice. Specifically, the timing of the execution of the activity imposes challenges for its integration into the “conventional” cycle that has guided the monitoring of the impacts in the EIA of projects.
文摘A good quality Environmental Impact Statement (EIS) is key for the effectiveness of Environmental Impact Assessment (EIA) processes and consequently to the acceptability of projects subject to EIA. The international literature has contributed to the understanding of the essential aspects to be verified regarding the quality of EIS, offering a wide spectrum of good practice examples related to the content of the studies. Even so, there is a need for empirical studies that allow the identification of specific aspects related to the context of application of the EIS, which could lead to the identification of opportunities to improve both the quality of the reports and also the effectiveness of EIA. Therefore, the present paper is focused on the quality review of a number of EIS submitted to the Brazilian Federal Environmental Agency (Ibama) to instruct the assessment of electric power transmission systems. Based on the application of the EIS quality review package as proposed by Lee and Colley (1992), the outcomes reveal opportunities for improving the scope of EIA, analysis of alternatives, prediction of magnitude and the assessment of impact significance. Finally, the development and/or adaptation of a similar tool for the systematic review of the quality of EIA reports is recommended.
文摘The investigation of contaminated areas in fractured aquifers represents a great technical challenge, due to the frequent conditions of heterogeneity and anisotropy of these environments, which often make it difficult to identify and predict pathways of subsurface contamination. This work aims to contribute to the development of this subject, through the presentation of the results of an investigation in which geophysical logging tools and straddle packers were used, which allowed the development of a more suitable hydrogeological conceptual model of the study area. Two boreholes were drilled and geophysical logging (gamma, caliper and high resolution acoustic televiewer) were used for the geological-structural characterization of the aquifer. Heatpulse flowmeter and straddle packers were then used to obtain data on hydraulic potentials and flows and for the collection of discrete water samples for chemical analysis. Two types of gneiss rocks were identified below the weathering zone (thickness >30 m), one with predominance of mafic bands, more weathered and with a higher fracture density, up to 65 m, and another deeper one, with the predominance of felsic bands. Seven groups of fractures were defined, being those of Group 1, with low dip angles, the most frequent and important for flow until 65 m, and Group 2 (N to NE-SW with high dips to W and NW) more frequent in deeper felsic gneisses. Downward hydraulic potentials were identified down to 65 m and upward potentials from the bottom up to 65 m. A hydraulic test allowed identifying the occurrence of hydraulic connection between the shallow weathering zone and the underlying fractured aquifer.
文摘This study evaluates the development of a testing process for the automotive software domain, highlighting challenges stemming from the absence of adequate processes. The research demonstrates the application of Design Science Research methodology in developing, an automotive software testing process—ProTSA, using six functional testing modules. Additionally, the study evaluates the benefits of implementing ProTSA in a specific Original Equipment Manufacturer (OEM) using an experimental single-case approach with industry professionals’ participation through a survey. The study concludes that combining testing techniques with effective communication and alignment is crucial for enhancing software quality. Furthermore, survey data indicates that implementing ProTSA leads to productivity gains by initiating tests early, resulting in time savings in the testing program and increased productivity for the testing team. Future work will explore implementing ProTSA in cybersecurity, over-the-air software updates, and autonomous vehicle testing processes. .
文摘This article deals with the important experience of regional planning developed by the CESP （Companhia Energ6tica de Silo Paulo）, Brazil, through the implantation of its hydroelectric projects. The company accumulated a large experience in deploying and managing residential centers built to provide support to the works of their dams. The presence of urban planning was verified in all cases studied, with the participation of different professionals such as architects, planners, engineers and landscape designers, from inside or outside the company. This research shows that they used concepts derived from experiences as company towns of 19th century, the neighborhood unit, the garden city, the urbanistic assumptions from CIAM （Congr^s Internationaux d＇Architecture Moderne） and the TVA （Tennessee Valley Authority）.
文摘HIV/AIDS has brought to light the challenge of incorporating the many influences between living conditions, social characteristics and health services performance to an adequate care for PLWHA （people living with AIDS）. Vulnerability of these populations is under the responsibility of specialized care units whose assistance does not always occur according to their real needs and demands. Therefore, this study aimed to analyze demographic, social and clinical profiles of PLWHA, as well as their follow-up in SS （Specialized Health Services） in Ribeir^o Preto, Brazil. It is a descriptive study conducted by the application of structured questionnaires to 253 patients with HIV/AIDS in follow-up during the years of 2012-2013. Variables were analyzed by descriptive statistics procedures. The findings pointed out gender parity, aging population, low education and economic predominance of class C. Regarding clinical characteristics, there was a predominance of asymptomatic individuals, with no clinical manifestations of AIDS or major comorbidities. The main mode of transmission was through sexual contact. The results led to the need of adequating the assistance provided to the specificities inherent to PLWHA. The care provision should cross an interdisciplinary perspective, targeting recognition of problems and ensuring comprehensive health care adequate to users＇ needs and demands.
文摘The City of Silo Paulo is the largest urban occupation in Brazil, covering 1,500 km^2. Its population is approximately 12 million inhabitants, 12% of them living in subnormal agglomerates, the IBGE （Brazilian Agency for Statistics and Geography） denomination for informal settlements, mostly located in fiver floodplain areas or top of hills. The extreme high level of soil sealing and high slopes have a fundamental role to explain the increase the risks of mass movements or landslides, related to precipitation magnitude and duration. This article presents the construction of curves coupling landslides occurrences and precipitation based on the data analysis of different basins in the city of Sao Panlo, considering also the probability and duration of the rainfall event in order to establish a vulnerability index to estimate the vulnerability category of an specific area. Based on the data analysis of instantaneous radar rain records for seven extreme rainfall events where landslides occurrences records were available, it was possible to plot sigmoid curves linking the number of occurrences with the event probability in terms of return period.
基金APESP(grant 01/13952-2)CNPq(granted 304978/2011-6)FUNDESPA for providing funds to this research.
文摘The aim of this work was to characterize and to bring into relationship of the net radiation with the latent heat flux equivalent to water (mm) in a patch of Atlantic Forest within the metropolitan area of Sao Paulo (RMSP). The estimation of the latent heat flux (LE) was made by the energy balance equation with the Bowen ratio. Measurements of net radiation and psychometrics gradients were made. Soil heat flux (G) was measured by temperature sensors in two depths. Measurements were made at Park of Science and Technology of Sao Paulo University (CIENTEC), Sao Paulo, Brazil, between 2011 and 2013. Results indicated that evapotranspiration varies seasonally and the amount of water evaporated exceeds 3.0 mm·day-1 in spring/summer and in autumn/winter the amount is approximately 1.0 mm·day-1. The evapotranspiration is increased under RMSP urban climate conditions with higher air temperature and lower moisture especially in summer season.
基金the NIH/NCI Cancer Center Support Grant,P30 CA008748。
文摘Given the frequent co-existence of an aggressive tumor and underlying chronic liver disease,the management of hepatocellular carcinoma(HCC)patients requires experienced multidisciplinary team discussion.Moreover,imaging plays a key role in the diagnosis,staging,restaging,and surveillance of HCC.Currently,imaging assessment of HCC entails the assessment of qualitative characteristics which are prone to inter-reader variability.Radiomics is an emerging field that extracts high-dimensional mineable quantitative features that cannot be assessed visually with the naked eye from medical imaging.The main potential applications of radiomic models in HCC are to predict histology,response to treatment,genetic signature,recurrence,and survival.Despite the encouraging results to date,there are challenges and limitations that need to be overcome before radiomics implementation in clinical practice.The purpose of this article is to review the main concepts and challenges pertaining to radiomics,and to review recent studies and potential applications of radiomics in HCC.
文摘Introduction: There has been an increase in the proportion of cesarean deliveries, especially in developing countries. Methods: Cross-sectional study of all hospital live births from mothers living in Sao Paulo Metropolitan Area, Brazil. Data were obtained from the Live Birth Information System, which is linked to the National Database of Health Establishments. Hospitals were classified as public, private or mixed. Descriptive analysis and exponential regression were conducted to evaluate time trends. Poisson regression was applied to analyze each hospital type to identify risk factors and the attributable risk fraction for cesarean section. Results: There was an annual increase (1.4%) of cesarean deliveries between 2000 and2013. In2009, the percentage of cesarean deliveries was 53% overall and 83% in private hospitals. The primary risk factor for cesarean delivery was delivery in a private hospital. Other risk factors that were stronger in public hospitals included the following: advanced maternal age, high maternal education, nulliparity, high number of prenatal visits, multiple pregnancy, hospital with low annual volume of deliveries, birth outside the city of residence and white skin color. Discussion: These results may be explained by the obstetric care model of private hospitals, which is not multiprofessional. Prenatal care and delivery are conducted by the same doctor and rarely include the input of another professional, such as a midwife. In addition, the mode of delivery influences the professional’s payment.
文摘The Emerging Timber Bridge Program to Sao Paulo state （ETBPSP） was started in 2001 with the main objective of research and development of new technologies for timber bridge construction. After five years of this program eleven demonstration timber bridges were constructed in the State of Sao Paulo, whereas eight composite timber/concrete bridges, one log timber girder bridge with transversal sawn deck, one transversal lumber prestressed timber bridge and one transversal cellular plywood box prestressed bridge. As a final objective is the divulgation of the constructive and structural systems in extension courses to municipal engineers and in a complete publication of timber bridges project plans with the different structural and constructional systems. This paper describes the goals of the MTBPSP, the accomplishments of the program in the first five years, the information sheet of the bridges and outlines some obstacles and opportunities.
文摘This article presents the results of empirical research with freelance journalists from the city of Sao Paulo, involving quantitative and qualitative research methods and the theoretical-methodological from the Reception Studies and Ergology. It is a theoretical and empirical approach, whose developments have been used by the Communication and Work Research Group of Communications and Arts School--University of SAo Paulo, Brazil. The reception from the world of work shows how changes in the labor act concretely in daily life subjectively and how they manifest in the sphere of cultural consumption. The research shows how, from the reception, the journalists reveal from which place they talk about the world, the society, and their own work. The reception is revealed as the moment par excellence ＂to talk about work＂. When talking about the other＇s work, the journalists are confronted with their own work and reveal, in their discourse, values and dramas of real activity of communication and work.
文摘In Brazil and various regions globally, the initiation of landslides is frequently associated with rainfall;yet the spatial arrangement of geological structures and stratification considerably influences landslide occurrences. The multifaceted nature of these influences makes the surveillance of mass movements a highly intricate task, requiring an understanding of numerous interdependent variables. Recent years have seen an emergence in scholarly research aimed at integrating geophysical and geotechnical methodologies. The conjoint examination of geophysical and geotechnical data offers an enhanced perspective into subsurface structures. Within this work, a methodology is proposed for the synchronous analysis of electrical resistivity geophysical data and geotechnical data, specifically those extracted from the Light Dynamic Penetrometer (DPL) and Standard Penetration Test (SPT). This study involved a linear fitting process to correlate resistivity with N10/SPT N-values from DPL/SPT soundings, culminating in a 2D profile of N10/SPT N-values predicated on electrical profiles. The findings of this research furnish invaluable insights into slope stability by allowing for a two-dimensional representation of penetration resistance properties. Through the synthesis of geophysical and geotechnical data, this project aims to augment the comprehension of subsurface conditions, with potential implications for refining landslide risk evaluations. This endeavor offers insight into the formulation of more effective and precise slope management protocols and disaster prevention strategies.
文摘AIM:To determine whether the levator palpebrae superioris(LPS)/superior rectus(SR)muscle complex,can influence the position of the upper lid and fornix in acquired anophthalmic sockets.METHODS:This comparative non-randomized and non-interventional study included retrospective data of 21 patients with unilateral acquired anophthalmic sockets repaired with spheric implants.High-resolution computed tomography(CT)measurements of the LPM/SR muscle complex and clinical topographic position of the upper lid,superior and inferior fornix depth in primary gaze position were evaluated.Demographic data were presented as frequency and percentage proportions and quantitative variables comparing the socket measurements with the normal contralateral orbit was statistically analyzed using non-parametric tests considering P<0.05.RESULTS:The anophthalmic orbits had a significantly shorter LPS length(P=0.01)and significantly thicker SR(P=0.02)than the normal orbit.Lagophthalmos was present in anophthalmic sockets but not in normal orbits(P=0.002),while levator function was normal in both(P>0.05,all comparisons).The superior fornix depth was similar in the anophthalmic socket and the contralateral normal orbit(P=0.192)as well the inferior fornix depth(P=0.351).CONCLUSION:Acquired anophthalmic sockets repaired with spheric implants have shorter LPS,thicker SR,and more lagophthalmos than normal orbits.The relationship of the LPS and SR with other orbital structures,associated with passive or active forces acting in the final position of the lids and external ocular prosthesis should be further investigated.
文摘AIM: To compare deep sedation with propofol-fentanyl and midazolam-fentanyl regimens during upper gastrointestinal endoscopy. METHODS: After obtaining approval of the research ethics committee and informed consent, 200 patients were evaluated and referred for upper gastrointestinal endoscopy. Patients were randomized to receive propofol-fentanyl or midazolam-fentanyl (n = 100/group).We assessed the level of sedation using the observer's assessment of alertness/sedation (OAA/S) score and bispectral index (BIS). We evaluated patient and physician satisfaction, as well as the recovery time and complication rates. The statistical analysis was performed using SPSS statistical software and included the MannWhitney test, χ 2 test, measurement of analysis of variance, and the κ statistic. RESULTS: The times to induction of sedation, recovery, and discharge were shorter in the propofolfentanyl group than the midazolam-fentanyl group. According to the OAA/S score, deep sedation events occurred in 25% of the propofol-fentanyl group and 11% of the midazolam-fentanyl group (P = 0.014). Additionally, deep sedation events occurred in 19% of the propofol-fentanyl group and 7% of the midazolamfentanyl group according to the BIS scale (P = 0.039). There was good concordance between the OAA/S score and BIS for both groups (κ = 0.71 and κ = 0.63, respectively). Oxygen supplementation was required in 42% of the propofol-fentanyl group and 26% of the midazolam-fentanyl group (P = 0.025). The mean time to recovery was 28.82 and 44.13 min in the propofolfentanyl and midazolam-fentanyl groups, respectively (P < 0.001). There were no severe complications in either group. Although patients were equally satisfied with both drug combinations, physicians were more satisfied with the propofol-fentanyl combination. CONCLUSION: Deep sedation occurred with propofolfentanyl and midazolam-fentanyl, but was more frequent in the former. Recovery was faster in the propofol-fentanyl group.
文摘AIM: To analyze outcomes in patients who underwent liver transplantation(LT) for hepatocellular carcinoma(HCC) and received autologous intraoperative blood salvage(IBS). METHODS: Consecutive HCC patients who underwent LT were studied retrospectively and analyzed according to the use of IBS or not. Demographic and surgical data were collected from a departmental prospective maintained database. Statistical analyses were performed using the Fisher's exact test and the Wilcoxon rank sum test to examine covariate differences between patients who underwent IBS and those who did not. Univariate and multivariate Cox regression models were developed to evaluate recurrence and death,and survival probabilities were estimated using the Kaplan-Meier method and compared by the log-rank test.RESULTS: Between 2002 and 2012,158 consecutive patients who underwent LT in the same medical center and by the same surgical team were identified. Among these patients,122(77.2%) were in the IBS group and 36(22.8%) in the non-IBS group. The overall survival(OS) and recurrence free survival(RFS) at 5 years were 59.7% and 83.3%,respectively. No differences in OS(P=0.51) or RFS(P=0.953) were detected between the IBS and non-IBS groups. On multivariate analysis for OS,degree of tumor differentiation remained as the only independent predictor. Regarding patients who received IBS,no differences were detected in OS or RFS(P=0.055 and P=0.512,respectively) according to the volume infused,even when outcomes at 90 d or longer were analyzed separately(P=0.518 for both outcomes).CONCLUSION: No differences in RFS or OS were detected according to IBS use. Trials addressing this question are justified and should be designed to detect small differences in long-term outcomes.
