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BACKGROUND: Bottom-of-the-pyramid (BOP) consumers' significant discretionary purchases of non-essential products, such as apparel, contribute to retail growth. In a turbulent retail environment, store atmospherics presents an innovative cost-effective solution to incorporate BOP consumers' unique motivations for desired apparel behavioural intentions to grow market share. AIM: This study aims to fill the knowledge gap regarding a systematic review of store atmospherics on urban BOP consumers' apparel behavioural intentions in an emerging African market. This study also proposes various purchase antecedents to attitudes, which drive apparel behavioural intentions. The moderation effect of age is investigated to understand the change in purchase antecedents related to attitudes among different urban BOP age groups. SETTING: Interviewer-administered surveys was conducted among urban BOP consumers in Namibia's main urban areas. METHOD: A sample of 881 respondents was selected by purposive, interlocking and convenience sampling methods. Covariance-based structural equation modelling (SEM) confirmed the significant relationships between all constructs in the proposed model. RESULTS: The systematic link between store atmospherics and urban BOP apparel behavioural intentions is primarily because of consumers' perceived value, trust and attitudes. Urban BOP consumers' perceived value, anticipatory emotions and attitudes are moderated by age. CONCLUSION: Overall, this study sheds light on the differences between young and old urban BOP consumers and how they differ or coincide with age groups in more affluent segments. In order to adequately segment the urban BOP market, apparel retailers should emphasise on affordability, quality, emotional goal attainment and trust in their store atmospherics. CONTRIBUTION: In the broad context of store atmospherics, this study specifically uses age categories as a lens to provide valuable insights concerning age differences in urban bottom-of-the-pyramid consumers' perception of store atmospherics which influences their apparel behavioural intentions. Further, this study solidifies that different age categories amongst urban bottom-of-the-pyramid consumers bring forth different behavioural intentions to which marketers should adapt their store atmospheric strategies.

https://doi.org/10.4102/sajems.v27i1.5239

Collaborative Analysis of Observational Data in Healthcare
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McCartan, Charlotte

; King, Sharla

; Roberts, Mary Roduta

New Trends in Qualitative Research

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sep 2023, Volume 16 elocation e786

Abstract: En | Text: En | PDF: En

Abstract Solving complex problems can be challenging as they often involve multiple layers of related issues and factors. Observational research is a helpful tool for understanding healthcare's complex and contextually dependent problems; however, observations can be time-consuming and resource-intensive, particularly when including the analysis process. As a result, researchers may utilize other qualitative methods, such as interviews or focus groups. However choosing a strategy different than observations could miss subtleties of care that happen in practice. It is easy to underestimate the value of data gathered through firsthand observations of patient-provider and team interactions. One solution to making observations a more convenient method in healthcare research is collaborating in the analysis process. Research collaboration involves establishing an interprofessional research team with diverse backgrounds and professional perspectives. In this way, the group comprises individuals from various roles and different professional backgrounds to ensure exhaustive findings and improve the reliability and accuracy of the results. The diversity in the team represents the intricate dynamics in the complex system of care. Although there are guidelines for collaborative analysis in a traditional ethnographic study, there must be more focus on healthcare research. This paper explains the concepts and features of collaborative analysis in interprofessional research. This approach offers a systematic way to construct a code book, which can produce comprehensive and valuable insights into the complex dynamic of care.

https://doi.org/10.36367/ntqr.16.2023.e786

La economía del goteo
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Roberts, Michael

Revista de Economía Institucional

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jun 2023, Volume 25 N. 48 Pages 3 - 11

Abstract: Es Pt En | Text: Es Pt En | PDF: Es | PDF: Pt | PDF: En

Resumen Este artículo critica la política económica promovida por el gobierno del Reino Unido bajo la primera ministra Liz Truss. Según la interpretación convencional, el estancamiento y la crisis de productividad de la economía inglesa obedecen a la carga tributaria excesiva de las grandes corporaciones y la presión fiscal sobre el 1% más rico. Si se redujeran tales obligaciones tributarias, aumentaría la rentabilidad de la inversión, la demanda y la tasa de crecimiento. Lo que se traduciría en mejores ingresos y mayores niveles de empleo. Esta historia se fundamenta en la curva de Laffer y asociada a la hipótesis del "goteo", falseadas por la evidencia empírica. Las reducciones de impuestos a los más ricos desmejoran la distribución del ingreso, y no elevan el ni el empleo. La causa y el efecto son de las ganancias a la inversión y al crecimiento; no del gasto a las ganancias y al crecimiento. JEL: P24, P34, 935

Resumo Este artigo critica a política econômica do lado da oferta promovida pelo governo britânico sob a liderança da primeira-ministra Liz Truss. De acordo com a interpretação convencional, a estagnação e a crise de produtividade na economia britânica se deve à excessiva carga tributária sobre as grandes corporações e à carga tributária sobre os 1% mais ricos. A redução desses passivos fiscais aumentaria a rentabilidade dos investimentos, a demanda e a taxa de crescimento. Isso se traduziria em melhores rendimentos e níveis mais altos de emprego. Esta história é baseada na curva de Laffer e na hipótese do "gotejamento" associada, que é falsificada por evidências empíricas. Os cortes fiscais para os mais ricos pioram a distribuição de renda, e não aumentam a renda ou o emprego. A causa e o efeito é dos lucros para o investimento e o crescimento; não dos gastos para os lucros e o crescimento. JEL: P24, P34, 935

Abstract This paper criticizes the supply-side economic policy promoted by the UK government under Prime Minister Liz Truss. According to the conventional interpretation, the stagnation and productivity crisis in the UK economy is due to the excessive tax burden on large corporations and the tax burden on the richest 1%. If these tax liabilities were reduced, it would increase the profitability of investment, demand and the rate of growth. This would translate into better incomes and higher levels of employment. This story is based on the Laffer curve and associated with the "trickle down" hypothesis, falsified by empirical evidence. Tax reductions for the richest people worsen the distribution of income, and do not raise income or employment. The cause and effect is from profits to investment and growth; not from spending to profits and growth. JEL: P24, P34, 935

https://doi.org/10.18601/01245996.v25n48.02

Tratamiento con HeberFERON( en el carcinoma basal palpebral
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Rojas Rondón, Irene

; García Vega, Yanelda

; Bello Rivero, Iraldo

; Duncan Roberts, Yaquelin

; Ramos López, Meisy

Revista Cubana de Oftalmología

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jun 2023, Volume 36 N. 2 elocation e1729

Abstract: En Es | Text: En Es | PDF: En | PDF: Es

ABSTRACT Palpebral basal carcinoma represents 90% of ocular malignant tumors with high morbidity. Its incidence has a different behavior in different parts of the world and generally increases with age. Positive diagnosis is made by histological evaluation of the specimen by excisional biopsy. The ideal treatment is surgical, although other treatment options are available. Non-surgical treatment is aimed at eliminating the tumor, as well as avoiding the complications or functional and esthetic sequelae of surgery. Numerous options are recognized within the non-surgical therapeutic modality; imiquimod, 5-fluorouracil, Hedgehog pathway inhibitors and interferons. Several studies have demonstrated the usefulness of interferons in monotherapy or as combination therapy in patients not amenable to surgery. For this reason, it was decided to review the current scientific literature on the efficacy and safety of HeberFERON® in the treatment of palpebral basal cell carcinoma. An updated search was carried out taking into account the descriptors corresponding to the key words related to the subject under investigation, in the bibliographic databases Medline (PubMed search engine), SciELO, Ebsco, Clinical Key and Google Scholar. Thirty-five articles were retrieved whose content corresponded to the subject of the study.

RESUMEN El carcinoma basal palpebral representa un 90 % de los tumores malignos oculares con una alta morbilidad. Su incidencia tiene un comportamiento diferente en las distintas partes del mundo y, por lo general, aumenta con la edad. El diagnóstico positivo se realiza por la evaluación histológica de la muestra mediante biopsia escisional. El tratamiento ideal es el quirúrgico, aunque existen otras opciones de tratamiento. El no quirúrgico tiene como objetivo la eliminación del tumor, así como evitar las complicaciones o las secuelas funcionales y estéticas por la cirugía. Se reconocen numerosas opciones dentro de la modalidad terapéutica no quirúrgica; imiquimod, 5-fluorouracilo, inhibidores de la vía de Hedgehog y los interferones. Diversos estudios han demostrado la utilidad de los interferones en monoterapia o como terapia combinada, en pacientes no susceptibles de actuaciones quirúrgicas. Por esta razón, se decidió revisar la literatura científica actual sobre la eficacia y seguridad del HeberFERON® en el tratamiento del carcinoma basal palpebral. Se realizó una búsqueda actualizada teniendo en cuenta los descriptores correspondientes a las palabras clave relacionadas con la temática a investigar, en las bases de datos bibliográficas Medline (buscador PubMed), SciELO, Ebsco, Clinical Key y en Google Académico. Se recuperaron 35 artículos que su contenido respondía al tema de estudio.

College student mortality by causes of death (2004-2018)
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Marconi,, Agustina

; Westaby,, Kate

; Donovan,, Valerie

; Ranum,, Nancy

; Roberts,, Craig

Salud(i)Ciencia

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mar 2023, Volume 25 N. 4 Pages 205 - 215

Abstract: Es En | Text: Es En | PDF: Es | PDF: En

Resumen Introducción: Los estudiantes universitarios representan una subpoblación importante de los Estados Unidos, con más de 19 millones de matriculados anualmente. Sin embargo, hay pocos datos publicados sobre la mortalidad y las causas de muerte en la población universitaria. El propósito de este estudio fue analizar las causas de muerte, basadas en datos de certificados de defunción, de estudiantes matriculados en l University of Winconsin-Madison, desde 2004 hasta 2018. Métodos: Análisis descriptivo de las causas oficiales de muerte de todos los estudiantes fallecidos reportados por la Oficina del Decano de Estudiantes entre 2004 y 2018. Se analizaron frecuencias y tasas anuales. Resultados: El análisis muestra que, contrariamente a los datos publicados y las estadísticas nacionales para los grupos de edad relevantes, las muertes intencionales por autolesión lideran las causas de muerte en los estudiantes matriculados entre esos años. Las autolesiones intencionales son la principal causa de muerte en los estudiantes varones, en los más jóvenes y en los blancos. Las causas incluidas en la categoría indicada como Otras son las principales en las estudiantes mujeres, en las de más edad y en las de color. Conclusiones: Los resultados de este estudio deben compartirse con las diferentes áreas interesadas en todo el campus universitario y con otras instituciones universitarias, para apoyar y evaluar las estrategias de prevención, la aplicación de los medios de restricción y la seguridad ambiental.

Abstract Introduction: College students represent an important subpopulation of the United States, with over 19 million college students in the U.S. enrolled yearly. Methods: Descriptive analysis of the causes of death for all deceased students reported by the UW Dean of Students Office (DSO) between 2004 and 2018. We analyzed frequencies and yearly rates. Results: Our analysis shows that contrary to published data and national statistics for the relevant age groups, intentional by self-harm deaths lead causes of death in enrolled students from 2004 to 2018. Intentional by self-harm is the main cause of death in male students, younger students, and white students. "Other" causes of death is the main cause in female students, older students, and students of color. Conclusions: These results must be shared with different stakeholders across campus as well as with other universities in order to support and evaluate campus-wide prevention strategies for means restriction and environmental safety.

https://doi.org/10.21840/siic/170268

Seguridad de las drogas biológicas y sintéticas dirigidas utilizadas en pacientes con enfermedades reumáticas inmunomediadas.
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Isnardi, Carolina A

; Roberts, Karen

; Exeni, Ida

; De La Sota, Mercedes

; Soriano, Enrique

; Dubinsky, Diana

; Medina, Gustavo

; Berbotto, Guillermo A

; Velozo, Edson J

; Papasidero, Silvia

; Gamba, Julieta

; Saurit, Verónica

; Citera, Gustavo

; Díaz, Mónica

; Catay, Erika

; Gómez, Graciela

; Sacnun, Mónica

; Larroude, María S

; Cavillon, Emilia

; Secco, Anastasia

; Aste, Nora

; Pons-Estel, Bernardo

; García, Mercedes A

; Pisoni, Cecilia

; Bovea, Gladys

; Morales, Liliana

; Granel, Amelia

; Gobbi, Carla

; Savio, Verónica

; Álvarez, Analia P

; Casado, Gustavo

; Soares Souza, Sidney

; Petkovic, Ingrid

; Castro, Cecilia

; Kerzberg, Osvaldo

; Gallardo, María de los Ángeles

; Brigante, Alejandro

; Haye Salinas, María

; Alfaro, María Agustina

; Pons-Estel, Guillermo J

; de la Vega, María Celina

Revista argentina de reumatología

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jan 2023, Volume 34 N. 1 Pages 3 - 15

Abstract: Es En | Text: Es En | PDF: Es | PDF: En

Resumen Introducción: conocer la seguridad de las drogas actualmente disponibles para el tratamiento de las enfermedades reumáticas es muy importante al momento de tomar decisiones terapéuticas objetivas e individualizadas en la consulta médica diaria. Asimismo, datos de la vida real amplían el conocimiento revelado por los ensayos clínicos. Objetivos: describir los eventos adversos (EA) reportados, estimar su frecuencia e identificar los factores relacionados con su desarrollo. Materiales y métodos: se utilizaron datos BIOBADASAR, un registro voluntario y prospectivo de seguimiento de EA de tratamientos biológicos y sintéticos dirigidos en pacientes con enfermedades reumáticas inmunomediadas. Los pacientes son seguidos hasta la muerte, pérdida de seguimiento o retiro del consentimiento informado. Para este análisis se extrajeron datos recopilados hasta el 31 de enero de 2023. Resultados: se incluyó un total de 6253 pacientes, los cuales aportaron 9533 ciclos de tratamiento, incluyendo 3647 (38,3%) ciclos sin drogas modificadoras de la enfermedad biológicas y sintéticas dirigidas (DME-b/sd) y 5886 (61,7%) con DME-b/sd. Dentro de estos últimos, los más utilizados fueron los inhibidores de TNF y abatacept. Se reportaron 5890 EA en un total de 2701 tratamientos (844 y 1857 sin y con DME-b/sd, respectivamente), con una incidencia de 53,9 eventos cada 1000 pacientes/año (IC 95% 51,9-55,9). La misma fue mayor en los ciclos con DME-b/sd (71,1 eventos cada 1000 pacientes/año, IC 95% 70,7-77,5 versus 33,7, IC 95% 31,5-36,1; p<0,001). Las infecciones, particularmente las de la vía aérea superior, fueron los EA más frecuentes en ambos grupos. El 10,9% fue serio y el 1,1% provocó la muerte del paciente. El 18,7% de los ciclos con DME-b/sd fue discontinuado a causa de un EA significativamente mayor a lo reportado en el otro grupo (11,5%; p<0,001). En el análisis ajustado, las DME-b/sd se asociaron a mayor riesgo de presentar al menos un EA (HR 1,82, IC 95% 1,64-1,96). De igual manera, la mayor edad, el mayor tiempo de evolución, el antecedente de enfermedad pulmonar obstructiva crónica, el diagnóstico de lupus eritematoso sistémico y el uso de corticoides se asociaron a mayor riesgo de EA. Conclusiones: la incidencia de EA fue significativamente superior durante los ciclos de tratamientos que incluían DME-b/sd.

Abstract Introduction: knowing the efficacy and safety of the drugs currently available for the treatment of rheumatic diseases is very important when making objective and individualized therapeutic decisions in daily medical consultation. Likewise, real-life data extends the knowledge revealed by clinical trials. Objectives: to describe the reported adverse events (AEs), estimate their frequency and identify factors associated to them. Materials and methods: BIOBADASAR data were used, which is a voluntary, prospective follow-up registry of AEs of biological and synthetic treatments in patients with immune-mediated rheumatic diseases. Patients are followed until death, loss of followup, or withdrawal of informed consent. To carry out this analysis, the data collected up to January 31, 2023 was extracted. Results: a total of 6253 patients were included, who contributed with 9533 treatment periods, including 3647 (38.3%) periods without b/ts-DMARDs and 5886 (61.7%) with b/ts-DMARDs. Among the latter, the most used were TNF inhibitors and abatacept. A total of 5890 AEs were reported in a total of 2701 treatments (844 and 1857 without and with b/ts-DMARDs, respectively), with an incidence of 53.9 events per 1000 patients/ year (95% CI 51.9-55.9). It was higher during the periods with b/ts-DMARDs (71.1 events per 1000 patients/year, 95% CI 70.7-77.5 vs 33.7, 95% CI 31.5-36.1, p<0.001). Infections, particularly those of the upper respiratory tract, were the most frequent AEs in both groups. 10.9% were severe and 1.1% were associated with the death of the patient. 18.7% of the periods with b/ts-DMARDs were discontinued due to an AE, significantly higher than that reported in the other group (11.5%; p<0.001). In the adjusted analysis, b/ts-DMARDs were associated with a higher risk of presenting at least one AE (HR 1.82, 95% CI 1.64-1.96). Similarly, older age, longer evolution time, history of chronic obstructive pulmonary disease, diagnosis of systemic lupus erythematosus, and use of corticosteroids were associated with a higher risk of AE. Conclusions: the incidence of AEs was significantly higher during those treatment periods that included DME-b/sd.

https://doi.org/10.47196/rar.v34i1.726

Plan de Nivelación para estudiantes articulados por reconocimiento de aprendizajes previos. Experiencia Chilena de progresión académica entre liceos hacia carreras técnicas
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Roberts Sánchez, Katherine

; Basso Aránguiz, Matilde

Revista Iberoamericana de Tecnología en Educación y Educación en Tecnología

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jan 2023, N. 34 Pages 39 - 48

Abstract: Es En | Text: Es En | PDF: Es | PDF: En

Resumen Este artículo analiza la efectividad y pertinencia del Plan de Nivelación que el Instituto Tecnológico de la Universidad Católica de la Santísima Concepción implementa para algunos estudiantes novatos, que ingresan a carreras técnicas, vía admisión especial de reconocimiento de aprendizajes previos (RAP). El estudio fue mixto y el diseño descriptivo consideró la participación de dos grupos de sujetos investigados: docentes y estudiantes de la cohorte 2020. Una vez analizados los resultados del grupo de discusión y encuestas de satisfacción, ambos grupos coinciden en una favorable valoración del Plan. Las derivaciones de esta investigación concuerdan con que el mecanismo de articulación RAP favorece en el estudiantado el desarrollo de competencias para el mundo laboral, a partir de itinerarios formativos abreviados que integren y valoren las trayectorias educativas y/o laborales de las personas a lo largo de su vida.

Abstract This article analyzes the effectiveness and relevance of the Leveling Plan that the Technological Institute of the Catholic University of the Santísima Concepción implements for some novice students, who enter technical careers, via special admission for recognition of prior learning (RAP). The study was mixed and the descriptive design considered the participation of two groups of research subjects: teachers and students of the 2020 cohort. Once the results of the discussion group and satisfaction surveys were analyzed, both groups agreed in a favorable assessment of the Plan. The derivations of this research agree that the RAP articulation mechanism favors in the student body the development of skills for the world of work, based on abbreviated training itineraries that integrate and value the educational and/or work trajectories of people throughout their careers his life.

https://doi.org/10.24215/18509959.34.e4

Designing an English language and literacies knowledge and skills test for Initial Teacher Education students in South Africa
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Roberts, Nicky

; Mort, Thelma

Journal of Education (University of KwaZulu-Natal)

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2023, N. 90 Pages 32 - 48

Abstract: En | Text: En | PDF: En

Since 2016 the Primary Teacher Education (PrimTEd) project has assessed first and fourth year student teachers' English language and literacies knowledge and skills with a view to optimising what is offered in teacher education courses. In 2021, after a critical review of these English language assessments, a process of test redesigning that also provides professional development opportunities for language teacher educators, was initiated. In this paper, we report on this process of modifying an existing test and discuss a new design that is still a work in progress, in order to make it more responsive to the English language needs of the student teachers. We argue that the emerging test has the potential to contribute to improved English language teacher education at universities and to improved teaching and learning of languages and literacies in South African primary schools.

https://doi.org/10.17159/2520-9868/i90a02

Business-to-Business sellers' motivations in sales performance - A six-dimensional framework proposition
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Rodriquez, Rocio

; Roberts-Lombard, Mornay

; Høgevold, Nils

; Svensson, Göran

South African Journal of Economic and Management Sciences

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2023, Volume 26 N. 1 Pages 1 - 14

Abstract: En | Text: En | PDF: En

BACKGROUND: Whether internal or external, motivational factors serve as stimulants influencing individual ability to execute sales tasks. A meta-analysis was conducted highlighting three broad categories of individual motivations that are imperative within the context of sales performance, namely cognitive choice, goal orientation, and work engagement. However, marketing and sales management scholars argue that there is a need for further research exploring the influence of intrinsic and extrinsic motivational factors on overall sales performance in multiple business settings AIM: The aim of the study is to test a six-dimensional framework of business-to-business (B2B) sellers' motivations in sales performance SETTING: The application of a six-dimensional framework on sales performance within a Norwegian context. Different companies from multiple industries operating in the product-orientated sector of Norway were selected to measure the relevance of the six-dimensional framework to sales performance in these companies METHOD: In total, 236 usable questionnaires representing multiple industries of different sizes across Norway were used. Data were collected using self-administered questionnaires RESULTS: The findings indicate that the dimensions of B2B sellers' motivations are relevant in a B2B sales setting. Therefore, sales businesses operating in a B2B environment need to become increasingly aware that motivations drive sellers to achieve their goals CONCLUSION: The study offers an increased understanding on how to structure B2B sellers' motivations in a six-dimensional framework, including cognitive choice, goal orientation, and work engagement CONTRIBUTION: The study develops an improved understanding of the intrinsic and extrinsic motivational factors that influence the sales performance of B2B sellers. Furthermore, it contributes to an increased understanding of how to structure B2B sellers' motivations in a six-dimensional framework

https://doi.org/10.4102/sajems.v26i1.4923

10.

Use of mobile apps when purchasing apparel: A young male adult perspective
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Correia, Miguel

; Cunningham, Nicole

; Roberts-Lombard, Mornay

South African Journal of Information Management

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2023, Volume 25 N. 1 Pages 1 - 14

Abstract: En | Text: En | PDF: En

BACKGROUND: Given the increased usage of mobile apps among males when purchasing apparel, it is imperative that retailers develop mobile apps that align with the target market's needs. OBJECTIVES: This article aims to determine the mobile app intention and usage among young male adult consumers when purchasing apparel. METHOD: A positivistic, descriptive research design was followed, and data were collected from 310 young male adults. Structural equation modelling and moderation analysis were used to test the hypotheses. RESULTS: The study found that the behavioural intention of young adult males using mobile apps to purchase apparel is influenced by the perceived usefulness and attitude towards the app, while the attitude towards the app is influenced by perceived usefulness and ease of use. Perceived usefulness was also influenced by innovativeness and perceived ease of use, while ease of use is influenced by collectivism and innovativeness CONCLUSION: The study highlights the significance of perceived ease of use, perceived usefulness and innovativeness as stimuli of young male adult consumers' behavioural intentions towards using mobile apps when purchasing apparel online. It also informs apparel retailers of the role of collectiveness towards the perceived ease of use of mobile apps when purchasing apparel online. CONTRIBUTION: This study provides empirical evidence of the interrelationships between perceived usefulness, perceived ease of use, attitude and its influence on behavioural intention when purchasing menswear apparel via mobile apps. It validates that collectivism leads to lower perceived ease of use, indicating that a greater emphasis should be placed on elevating the perceived ease of use among consumers with collective behaviour.

https://doi.org/10.4102/sajim.v25i1.1745

11.

Deep sea ecosystem exploration and ‘health check’: sampling strategy and methods applied during the iAtlantic_BR10_Petrobras cruise in the Santos Basin, Southwest Atlantic
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Perez, Jose Angel A.

; Barros Neto, Halésio M.C. de

; Arantes, Renata C.M.

; Gaurisas, Daniela Y.

; Silva, Camila F.

; Alves, Fernanda Maria M.

; Costa, Júlia A.

; Eloi, Paula D.C.

; Fonseca, Thayse S.

; Gavazzoni, Lucas

; Lonskis, Isabella da S.

; Nardi, Ricardo U.

; Nascimento, Pedro O.

; Rodrigues, João Vitor M.

; Santos, Ana Lara F. dos

; Santos, Edson C. dos

; Schroeder, Rafael

; Silva, Luis Carlos da

; Souza, Fernanda dos S.S. de

; Bernardino, Ângelo F.

; Cavalcanti, Guarani H.

; Lindner, Alberto

; Mahiques, Michel M. de

; Millo, Christian

; Reis, Priscila

; Sweetman, Andrew K.

; Roberts, J. Murray

Ocean and Coastal Research

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2023, Volume 71 elocation e23046

Abstract: En | Text: En | PDF: En

Abstract The iAtlantic Project has established an international collaborative strategy to improve mapping and characterization of deep and open ocean ecosystems in understudied regions of the Atlantic and evaluate their health. In December 2022, the first iAtlantic expedition in the South Atlantic set off to map and explore seafloor ecosystems in the Santos Basin slope (200-1,000 m depths) in collaboration with the Petrobras ‘Santos Basin - Regional Characterization Project.’ The 17-day ‘iAtlantic_BR10-Petrobras’ cruise was conducted on board the research vessel NPqHOc Vital de Oliveira (Brazilian Navy) and performed (a) water column structure characterization, (b) seafloor morphology mapping, (c) description of benthic habitats and communities by seafloor imagery and biological/ geological sampling, and (d) ex-situ experiments to assess the functioning of sedimentary ecosystems and their responses to climate-related environmental changes. This study describes the rationale behind the iAtlantic_BR10-Petrobras cruise science plan, reports its sampling strategy and methods, and summarizes its collected data and preliminary results.

https://doi.org/10.1590/2675-2824071.23069jaap

12.

Association of opioid use disorder with outcomes of hospitalizations for acute myocardial infarction in the United States
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Ascandar, Nameer

; Vadlakonda, Amulya

; Verma, Arjun

; Chervu, Nikhil

; Roberts, Jacob S.

; Sakowitz, Sara

; Williamson, Catherine

; Benharash, Peyman

Clinics

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2023, Volume 78 elocation 100251

Abstract: En | Text: En | PDF: En

Abstract Objective While Opioid Use Disorder (OUD) has been linked to inferior clinical outcomes, studies examining the clinical outcomes and readmission of OUD patients experiencing Acute Myocardial Infarction (AMI) remain lacking. The authors analyze the clinical and financial outcomes of OUD in a contemporary cohort of AMI hospitalizations. Methods All non-elective adult (≥ 18 years) hospitalizations for AMI were tabulated from the 2016‒2019 Nationwide Readmissions Database using relevant International Classification of Disease codes. Patients were grouped into OUD and non-OUD cohorts. Bivariate and regression analyses were performed to identify the independent association of OUD with outcomes after non-elective admission for AMI, as well as subsequent readmission. Results Of an estimated 3,318,257 hospitalizations for AMI meeting study criteria, 36,057 (1.1%) had a concomitant diagnosis of OUD. While OUD was not significantly associated with mortality, OUD patients experienced superior cardiovascular outcomes compared to non-OUD. However, OUD was linked to increased odds of non-cardiovascular complications, length of stay, costs, non-home discharge, and 30-day non-elective readmission. Conclusions Patients with OUD presented with AMI at a significantly younger age than non-OUD. While OUD appears to have a cardioprotective effect, it is associated with several markers of increased resource use, including readmission. The present findings underscore the need for a multifaceted approach to increasing social services and treatment for OUD at index hospitalization.

https://doi.org/10.1016/j.clinsp.2023.100251

13.

Características clínicas y evolución de la infección por SARS-CoV-2 en pacientes con lupus eritematoso sistémico en Argentina: datos del registro nacional SAR-COVID
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Isnardi, Carolina Ayelén

; Roberts, Karen

; Tissera, Yohana

; Petkovic, Ingrid

; Berbotto, Guillermo

; Gobbi, Carla

; Tanten, Romina

; Cogo, Karina

; Asnal, Cecilia

; Baños, Andrea

; Vivero, Florencia

; Schmid, María Marcela

; Lázaro, María Alicia

; German, Noelia

; Takashima, Lorena

; Scafati, Julia

; Werner, Marina Laura

; Casalla, Luciana

; Matellan, Carla

; Castrillon, Diana M

; Rodríguez, Florencia

; Moyano, Sebastián

; Martín, María Luz

; Cosentino, Vanesa

; Herscovich, Natalia

; Tralice, Elda R

; Barbich, Tatiana

; Vásquez, Dora L

; Buschiazzo, Emilio

; Maid, Pablo

; Ledesma, Ana C

; Yohena, Víctor

; Gómez, Gimena

; Quintana, Rosana

; Pons-Estel, Guillermo J

Revista argentina de reumatología

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oct 2022, Volume 33 N. 4 Pages 188 - 198

Abstract: Es En | Text: Es En | PDF: Es | PDF: En

Resumen Introducción: el lupus eritematoso sistémico (LES) es una enfermedad sistémica que se ha asociado a mayor severidad con la infección por SARS-CoV-2. Particularmente la alta actividad de la enfermedad y algunos inmunosupresores se han vinculado a peores desenlaces. Objetivos: describir las características por SARS-CoV-2 en pacientes con LES en Argentina del registro SAR-COVID y establecer los factores asociados a peor desenlace de la misma. Materiales y métodos: estudio observacional. Se incluyeron pacientes con diagnóstico de LES con infección confirmada por SARS-CoV-2 (RT-PCR y/o serología positiva) del registro SAR-COVID. Los datos se recolectaron desde agosto de 2020 hasta marzo de 2022. El desenlace de la infección se midió mediante la escala ordinal de la Organización Mundial de la Salud (EO-OMS). Se definió COVID-19 severo con un valor EO-OMS ≥5. Análisis descriptivo, test T de Student, test de Mann Whitney U, ANOVA, chi2 y Fisher. Regresión logística múltiple. Resultados: se incluyeron 399 pacientes, el 93% de sexo femenino, con una edad media de 40,9 años (DE 12,2). El 39,6% tenía al menos una comorbilidad. Al momento de la infección, el 54,9% recibía glucocorticoides, el 30,8% inmunosupresores y el 3,3% agentes biológicos. La infección por SARS-CoV-2 fue leve en la mayoría de los casos, mientras que un 4,6% tuvo curso severo y/o falleció. Estos últimos presentaban comorbilidades, usaban glucocorticoides y tenían síndrome antifosfolipídico (SAF) con mayor frecuencia y mayor actividad de la enfermedad al momento de la infección. En el análisis multivariado, la hipertensión arterial, el diagnóstico de SAF y el uso de glucocorticoides se asociaron a hospitalización severa y/o muerte por COVID-19 (EO-OMS ≥5). Conclusiones: en esta cohorte de pacientes con LES con infección por SARS-CoV-2 confirmada, la mayoría cursó de manera sintomática, un 22,1% fue hospitalizado y un 5% requirió ventilación mecánica. La mortalidad fue cercana al 3%. El diagnóstico de SAF, tener hipertensión arterial y el uso de glucocorticoides se asociaron significativamente con COVID-19 severo.

Abstract Introduction: systemic lupus erythematosus (SLE) is a systemic disease that has been associated with greater severity with SARS-CoV-2 infection. Particularly high disease activity and some immunosuppressants have been linked to worse outcomes. Objectives: to describe the characteristics due to SARS-CoV-2 in patients with SLE in Argentina from the SAR-COVID registry and to establish the factors associated with a worse outcome of the same. Materials and methods: observational study. Patients diagnosed with SLE with confirmed SARS-CoV-2 infection (RT-PCR and/or positive serology) from the SAR-COVID registry were included. Data was collected from August 2020 to March 2022. The outcome of the infection was measured using the World Health Organization - ordinal scale (WHO-OS). Severe COVID-19 was defined as an WHO-OS value ≥5. Descriptive analysis, Student's T test, Mann Whitney U, ANOVA, chi2 and Fisher. Multiple logistic regression. Results: a total of 399 patients were included, 93% female, with a mean age of 40.9 years (SD 12.2), 39.6% had at least one comorbidity. At the time of infection, 54.9% were receiving glucocorticoids, 30.8% immunosuppressants, and 3.3% biological agents. SARS-CoV-2 infection was mild in most cases, while 4.6% had a severe course and/or died. The latter had comorbidities, used glucocorticoids and had antiphospholipid syndrome (APS) more frequently and higher disease activity at the time of infection. In the multivariate analysis, high blood pressure, the diagnosis of APS, and the use of glucocorticoids were associated with severe hospitalization and/or death from COVID-19 (WHO-EO ≥5). Conclusions: in this cohort of SLE patients with confirmed SARS-CoV-2 infection, most had a symptomatic course, 22.1% were hospitalized, and 5% required mechanical ventilation. Mortality was close to 3%. The diagnosis of APS, having high blood pressure, and the use of glucocorticoids were significantly associated with severe COVID-19.

https://doi.org/10.47196/rar.v33i4.704

14.

Dosis efectivas asociadas a estudios híbridos SPECT-CT en pacientes adultos
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Rodríguez, Lucas

; Rodríguez, Matías

; Roberts, Agustina

; Viera, Natalia

; Huart, Natalia

; Rodríguez, Sergio

; Silvera, Enzo

; Hermida, Juan Carlos

; Alonso, Omar

Revista Médica del Uruguay

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sep 2022, Volume 38 N. 3 elocation e209

Abstract: Es En Pt | Text: Es En Pt | PDF: Es | PDF: En | PDF: Pt

Resumen: Introducción: la técnica de imagen híbrida de SPECT-CT combina la imagen de la tomografía por emisión de fotón único (SPECT) con el estudio de tomografía computada (TC), obteniendo información funcional y anatómica en un mismo estudio. La dosis efectiva total de radiación ionizante recibida en los estudios SPECT-CT puede ser estimada a partir de la dosis efectiva atribuible a la actividad administrada del radiofármaco y la dosis efectiva del componente de tomografía computada (TC). Objetivos: estimar la dosis efectiva total en los protocolos SPECT-CT utilizados en población adulta y determinar el aporte adicional del estudio TC sobre la dosis efectiva total. Método: se evaluaron 258 estudios SPECT-CT para estimar la dosis efectiva total aportada por la administración de los radiofármacos y los estudios de TC de baja dosis. Para estimar el aporte de ambos componentes se utilizaron factores de conversión específicos de cada radiofármaco y región explorada mediante TC. Resultados: la dosis efectiva total (media ± DS) en los estudios SPECT-CT fueron: 12,4 ± 1,44 mSv en el estudio de perfusión miocárdica, 1,14 ± 0,25 mSv en ganglio centinela de mama, 8,6 ± 0,6 mSv paratiroides, 1,48 ± 1,02 mSv tiroides y los estudios óseos de las regiones de cuello 4,5 ± 0,3, tórax 6,07 ± 0,3 mSv, abdomen y pelvis 6,1 ± 0,3 mSv. La dosis de radiación aportada por el estudio TC se encuentra entre 0,46 mSv para la región del tórax en el estudio de ganglio centinela de mama y 2,3 mSv para el SPECT-CT óseo en la región de abdomen y pelvis. Conclusión: se logró estimar la dosis efectiva en los protocolos SPECT-CT de uso clínico más frecuente en población adulta y el aporte de los estudios TC a la dosis efectiva total siendo relativamente baja comparado con la dosis aportada por los radiofármacos administrados con la excepción del estudio de ganglio centinela donde la contribución del componente TC es aproximadamente la mitad de la dosis efectiva total.

Abstract: Introduction: SPECT-CT Hybrid image technique combines the SPECT (single-photon emission computed tomography) image with the CT (computerized tomography) image to obtain both functional and anatomical images in the same study. The total effective ionizing radiation dose received in SPECT-CT studies may be estimated based on the effective dose from the radiopharmaceutical administered and the effective dose from the CT (computerized tomography) component. Objectives: the study aims to estimate the total effective dose in SPECT-CT protocols applied for the adult population, and to determine the additional contribution from the CT component to the total effective dose. Method: 258 SPECT-CT studies were evaluated to estimate the total effective dose from the administration of radiopharmaceuticals and low dose CT studies. Specific conversion factors for each radiopharmaceutical and area of the body explored with the CT were used to estimate radiation doses from both components. Results: total effective dose (average ± SD) in the SPECT-CT studies was: 12.4 ± 1.44 mSv in the myocardial perfusion study, 1.14 ± 0.25 mSv in the breast sentinel lymph node study, 8.6 ± 0.6 mSv in the parathyroid study, 1.48 ± 1.02 mSv in the thyroid study. As to bone studies, doses found were: 4.5 ± 0.3, in neck studies, 6.07 ± 0.3 mSv in thoracic studies and 6.1 ± 0.3 mSv in abdominal and pelvic studies. The radiation dose from the CT study ranges from 0.46 mSv for the thoracic region on the breast sentinel lymph node study to 2.3 mSv for the bone SPECT-CT study of the abdominal and pelvic region. Conclusions: we managed to estimate the effective dose in the the most frequently used SPECT-CT protocols for the adult population and the contribution of CT studies to the total effective dose. It was found to be relatively low when compared to the dose contributed by the radiopharmaceuticals administered, with the exception of the sentinel lymph node study for which the contribution from the CT study is approximately half the total effective dose.

Resumo: Introdução: a técnica de imagem híbrida SPECT-CT combina a imagem de tomografia por emissão de fóton único (SPECT) com o estudo de tomografia computadorizada (TC), obtendo informações funcionais e anatômicas no mesmo estudo. A dose efetiva total de radiação ionizante recebida em estudos SPECT-CT pode ser estimada a partir da dose efetiva atribuível à atividade administrada do radiofármaco e da dose efetiva do componente de tomografia computadorizada (TC). Objetivos: estimar a dose efetiva total nos protocolos SPECT-CT utilizados na população adulta e determinar a contribuição adicional do estudo de TC na dose efetiva total. Método : 258 estudos SPECT-CT foram avaliados para estimar a dose efetiva total fornecida pela administração de radiofármacos e estudos de TC de baixa dose. Para estimar a contribuição de ambos os componentes, foram utilizados fatores de conversão específicos para cada radiofármaco e região explorada pela TC. Resultados: a dose efetiva total (média ± DP) nos estudos SPECT-CT foi: 12,4 ± 1,44 mSv no estudo de perfusão miocárdica, 1,14 ± 0,25 mSv no linfonodo sentinela mamário, 8,6 ± 0,6 mSv paratireoide, 1,48 ± 1,02 mSv estudos de tireoide e ossos das regiões do pescoço 4,5 ± 0,3, tórax 6,07 ± 0,3 mSv, abdômen e pelve 6,1 ±0,3mSv. A dose de radiação fornecida pelo estudo de TC está entre 0,46 mSv para a região do tórax no estudo do linfonodo sentinela da mama e 2,3 mSv para o SPECT-CT ósseo na região do abdome e pelve. Conclusão: foi possível estimar a dose efetiva nos protocolos de SPECT-CT mais utilizados clinicamente na população adulta e a contribuição dos estudos de TC para a dose efetiva total, sendo relativamente baixa em relação à dose fornecida pelos radiofármacos administrados com a exceção do estudo do linfonodo sentinela onde a contribuição do componente TC é aproximadamente metade da dose efetiva total.

https://doi.org/10.29193/rmu.38.3.9

15.

Pharmacokinetics and pharmacodynamics of beta-lactam antibiotics in critically ill patients
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Sulaiman, Helmi

; Roberts, Jason A

; Abdul–Aziz, Mohd H

Farmacia Hospitalaria

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jun 2022, Volume 46 N. 3 Pages 182 - 190

Abstract: Es En | Text: Es En | PDF: Es | PDF: En

Resumen La terapia antibiótica óptima en los pacientes en estado crítico puede complicarse por la alteración de la fisiología asociada a esta etapa de la enfermedad. La farmacocinética y la exposición a los antibióticos pueden verse alteradas por la enfermedad crítica subyacente y las intervenciones médicas que reciben estos pacientes en la unidad de cuidados intensivos. Además, las cepas que suelen encontrarse en la unidad de cuidados intensivos suelen ser menos susceptibles y “resistentes” a los antibióticos más habituales. De hecho, una dosificación de antibióticos que no tenga en cuenta estas diferencias únicas, probablemente fracasará y dará lugar a resultados clínicos deficientes y a la aparición de resistencia a los antibióticos en la unidad de cuidados intensivos. Los objetivos de esta revisión son describir la farmacocinética de los antibióticos betalactámicos en pacientes críticos, destacar los objetivos farmacocinéticos/farmacodinámicos para los pacientes y exponer algunas estrategias importantes que pueden optimizar la dosificación de los antibióticos betalactámicos en pacientes críticos en la unidad de cuidados intensivos.

Abstract Optimal antibiotic therapy for critically ill patients can be complicated by the altered physiology associated with critical illness. Antibiotic pharmacokinetics and exposures can be altered driven by the underlying critical illness and medical interventions that critically ill patients receive in the intensive care unit. Furthermore, pathogens that are usually isolated in the intensive care unit are commonly less susceptible and “resistant” to common antibiotics. Indeed, antibiotic dosing that does not consider these unique differences will likely fail leading to poor clinical outcomes and the emergence of antibiotic resistance in the intensive care unit. The aims of this narrative review were to describe the pharmacokinetics of beta-lactam antibiotics in critically ill patients, to highlight pharmacokinetic/pharmacodynamic targets for both non-critically ill and critically ill patients, and to discuss important strategies that can be undertaken to optimize beta-lactam antibiotic dosing for critically ill patients in the intensive care unit.

https://doi.org/10.7399/fh.13170

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