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Thesis advisor: Joyce Edmonds / Background: Systemic racism contributes to the persistent and large inequities in perinatal health outcomes for pregnant people of color, particularly Black pregnant people. Poor communication between pregnant people of color and their providers contributes to these health inequities and perpetuates systemic racism in perinatal health. Pregnant people of color report being dismissed, ignored, discriminated against, and disrespected within the perinatal care system. One of the ways that patients communicate with their providers is via the patient portal. According to the Health Information National Trends Survey, around 80% of U.S. adults utilized information technology, such as patient portals, to track health data or communicate with their provider. Researchers have identified lower usage of patient portals in pregnant people of color compared to their White counterparts. Lower levels of utilization may perpetuate the digital divide for the low-resourced communities of color. Aims: The dissertation has three aims. The first aim was to synthesize and critically analyze patient-provider communication in pregnant people of color. The second aim was to examine the relationship between the quality of patient-provider communication (PPC) and the extent of patient portal use in pregnant people of color and to determine if digital health literacy is a moderating factor in this relationship. The third aim was to explore pregnant people of color’s access, use and perceptions of the patient portal in order to identify barriers and facilitators to quality digital communication with their prenatal providers. Methods: An integrative review method was applied to the empirical literature to achieve aim one. A multi-method, cross-sectional survey study with a non-probability convenience sample of 130 pregnant people of color receiving prenatal care at a large safety net hospital in Boston was conducted for aims two and three. Logistic regression and moderation models were utilized to analyze the quantitative survey data to achieve the second aim. Content analysis was used to analyze the responses to four open-ended survey questions to achieve the third aim. Results: A three-manuscript dissertation was completed. In the first manuscript, 26 articles were identified and the factors, outcomes and recommendations from communication between pregnant people of color and their prenatal providers were evaluated. There were two overarching themes: Racism and Discrimination and Unmet Information Needs along with multiple factors, outcomes and recommendations. The second manuscript reported on the quantitative results responses from 130 pregnant people of color. Participants that did not use the patient portal and who had public insurance had lower odds of rating higher quality PPC. Digital health literacy was found to be a moderating factor in the association between PPC and portal use at the level of portal users. The third manuscript reported on the content analysis and found main facilitators to communication between pregnant people of color and their providers were Provider behaviors and functionality of myChart and barriers were quality of response, multiple providers and digital access and literacy. Conclusions: The findings from this dissertation may be translated into clinical practice by informing perinatal providers on the pregnant people of color’s ratings of respectful communication and facilitators and barriers to quality health communication. Policies and strategies may be developed to improve digital health communication in order to provide inclusive and person-centered care in pregnancy. / Thesis (PhD) — Boston College, 2024. / Submitted to: Boston College. Connell School of Nursing. / Discipline: Nursing.

API, Application Program Interface, enables users to interact with data. However, access to an API often depends on programming proficiency, which can limit its usage. This study explored ways to improve API usage by developing and implementing a custom portal for Power BI’s API, called AdminPortal (AdP).         To address the first research question, which investigated whether AdP improved API usage compared to the existing portal, a System Usability Scale (SUS) survey was conducted. The second research question was studied through qualitative methods, including open-ended questions and documentation of use cases, to gain deeper insights into how AdP could be utilized and how it improved the workflow for Power BI administration. The results showed a statistically significant difference between AdP and the existing portal, with AdP receiving higher SUS scores. Additionally, comparing workflows with and without AdP highlighted two use cases, where AdP simplified tasks by providing a user-friendly interface, in contrast to the manual processes or coding requirements of the existing portal.   AdP demonstrated the feasibility of accessing API benefits without coding. While offering advantages like automation and flexibility, AdP also presented challenges such as information selection and user interface complexity. / API, Application Program Interface, gör det möjligt för användare att interagera med data. Tillgängligheten till API är ofta beroende av programmeringskunskaper. Detta medför begränsningar i användandet av API. Denna studie har genom att utveckla och implementera en anpassad portal för Power BI:s API, kallad AdminPortal (AdP), studerat möjligheten till en förbättring av användningen av API.  I studien användes en kombination av kvantitativa och kvalitativa metoder. Den första forskningsfrågan fokuserar på om AdP förbättrade användningen av API jämfört med att använda den befintliga Power BI-portal, vilket undersöktes med hjälp av System Usability Scale (SUS). Den andra forskningsfrågan studerar djupare insikter i hur AdP kan användas för att förbättra arbetsflödet för administration av Power BI. För detta användes kvalitativa metoder, inklusive öppna frågor under SUS-undersökningen och dokumentation av användarfall.  Resultaten visar en statistiskt signifikant skillnad mellan AdP och den befintliga portal som tillhandhålls av Power BI, där AdP får högre SUS-poäng. Dessutom, jämfördes två användarfall, med eller utan AdP, där AdP visar på mer användarvänlighet jämfört med de manuella processerna eller kodningskompetensen som krävs för den befintliga Power BI-portalen.  AdP visar möjligheten att få tillgång till fördelar av API utan kodning. Samtidigt som AdP erbjuder fördelar som automatisering och flexibilitet, har även AdP utmaningar relaterade till informationsurval och användargränssnittets komplexitet.

Pesquisadores da área de Ciências Humanas da Universidade de São Paulo participaram de investigação sobre o uso do portal de periódicos CAPES Coordenação de Aperfeiçoamento de Pessoal de Nível Superior, em que são referenciados artigos consagrados pelo meio científico do mundo inteiro. O objetivo foi contribuir com a geração de novos valores e conhecimentos, indicando dificuldades no acesso e divulgação da produção científica. Foi realizada uma pesquisa descritiva-exploratória que utilizou dados quantitativos extraídos de questionários. O trabalho mostra o processo de mudança na sociedade, causado pelas novas tecnologias, e a facilidade na obtenção de informações para o enriquecimento do debate acadêmico e para o progresso da ciência. / Researchers at the Human Sciences, University of São Paulo participated in study on the use of journal portal CAPES - Coordination for the Improvement of Higher Education, which are referenced by the scientific articles on the world. The objective was to contribute to the generation of new knowledge and values, indicating difficulties in access and dissemination of scientific production. We performed a descriptive and exploratory research that used quantitative data extracted from questionnaires. The work shows the process of change in society caused by new technologies, and ease in getting information to enrich the academic debate and the progress of science.

This master thesis deals with design and implementation of a web portal for remote mentoring. It analyzes the issues of e-learning, coaching and mentoring and then defines the target audience and its needs. At the same time, it deals with technological startups and describes the process of building the portal in the context of the startup. The practical part focuses on the development itself, project management and project sustainability.

Nesta tese, a Orla Portal da Amazônia foi investigada em sua relação com a produção urbana da cidade de Belém-PA, objetivando compreendê-la por meio de diversos olhares: frequentadores; moradores da área; população de Belém; representantes do Estado; e pesquisadores. A metodologia utilizada envolveu pesquisa bibliográfica, documental e empírica, seguindo uma abordagem qualiquantitativa. Dentre os principais resultados obtidos, afirma-se que a nova Orla foi construída como parte de uma estratégia urbana do poder público local, de mercantilização da cidade e busca por novas centralidades espaciais e econômicas. As melhorias na Infraestrutura básica, não foram destinadas aos seus antigos moradores, uma vez que a Prefeitura lhes ofereceu a oportunidade de migração permanente a outros conjuntos habitacionais distantes da Orla. Hoje, é lócus disputa envolvendo Estado, sociedade e iniciativa privada, que divergem quanto aos interesses em torno da área e do que nela será construído. A população que foi remanejada e aguarda há quase uma década pelo recebimento de nova residência resiste em permanecer às proximidades da Orla, alegando ter ali laços culturais, sociais e relações de trabalho. Esta resistência tem dificultado a concretização, tanto dos projetos do Estado, quanto da iniciativa privada, que visam a transformação da cidade de Belém em uma grande orla, que vai da Universidade Federal do Pará até o distrito de Icoaraci. No entanto, desde a inauguração da primeira etapa, no ano de 2012, o espaço vem conformando-se como lócus de lazer dos moradores da cidade, que o utilizam preferencialmente nos finais de semana, mas não exclusivamente. Nele, tem sido comum a frequência por pessoas de diferentes bairros e níveis sociais, que o compreendem como elemento importante ao embelezamento urbano e valorização da área. As críticas dos usuários do espaço foram direcionadas à falta de segurança, banheiros e áreas cobertas. / This study investigated the Orla Portal da Amazônia and its relation with the production of the city Belém/PA, starting from the understanding of elements present in the history of the local urban sprawl. It aimed to understand the public space of leisure, besides simple physical form, reaching its understanding as a locus of dispute involving State, society and private initiative. Issues pertinent to the entrepreneurship of the contemporary city are highlighted in the results obtained during the empirical research, revealing to be in accordance with the ideology propagated by the international capital. In this context, the entrepreneurship of the city of Belém shows itself as an unquestionable fact from the point of view of the local state. The understanding of the Orla Portal da Amazônia was sought through different points of view: goers; area residents; population of Belém; representatives of the State and researchers. The methodology involved bibliographical, documentary and empirical research, following a qualitative-quantitative approach. The existing theoretical contribution on public space served as a basis for the elaboration of a definition consistent with the research questions outlined in this thesis, presenting the Public Space of Leisure as: Physical-social space in the city, favorable to the encounter between different, who have as a common goal, to seek for pleasure. In this sense, it is considered in its analysis, besides the physical form, the wide possibilities of uses and symbolic meaning, the free access and the freedom of choice as to the sharing, or not, of experiences. They are socio-cultural spaces in which the architectural, landscape and environmental quality predominates, besides a certain vigilance. It is common that its users can enjoy free the physical infrastructure, such as the sports equipment and the programs offered. Among the main results obtained, it is affirmed that the new Orla was built as part of an urban strategy of the local state of mercantilization of city and search for new spatial and economic centralities. The improvements in basic infrastructure were not intended for their former residents, since the city hall offered them the opportunity of permanent migration to other housing complexes far from Orla. Today, there is a dispute involving State, society and private initiative, which diverge as to the interests around the area and what will be built in it. The population that was relocated and wait for almost a decade to get a new residence resists to remain near the Orla, claiming to have there cultural, social and labor relations. This resistance difficults the implemetation of both state and private projects to transform the city of Belém into a large orla, from the Universidad Federal do Pará to the district of Icoarací. However, since the inauguration of the first stage, in 2012, the space has been conforming as a locus of leisure for the city\'s residents, who use it preferably on weekends, but not exclusively. In it, it has been common the frequency by people of different neighborhoods and social levels, that understand it as important element to the urban beautification and valorization of the area.

Nesta tese, a Orla Portal da Amazônia foi investigada em sua relação com a produção urbana da cidade de Belém-PA, objetivando compreendê-la por meio de diversos olhares: frequentadores; moradores da área; população de Belém; representantes do Estado; e pesquisadores. A metodologia utilizada envolveu pesquisa bibliográfica, documental e empírica, seguindo uma abordagem qualiquantitativa. Dentre os principais resultados obtidos, afirma-se que a nova Orla foi construída como parte de uma estratégia urbana do poder público local, de mercantilização da cidade e busca por novas centralidades espaciais e econômicas. As melhorias na Infraestrutura básica, não foram destinadas aos seus antigos moradores, uma vez que a Prefeitura lhes ofereceu a oportunidade de migração permanente a outros conjuntos habitacionais distantes da Orla. Hoje, é lócus disputa envolvendo Estado, sociedade e iniciativa privada, que divergem quanto aos interesses em torno da área e do que nela será construído. A população que foi remanejada e aguarda há quase uma década pelo recebimento de nova residência resiste em permanecer às proximidades da Orla, alegando ter ali laços culturais, sociais e relações de trabalho. Esta resistência tem dificultado a concretização, tanto dos projetos do Estado, quanto da iniciativa privada, que visam a transformação da cidade de Belém em uma grande orla, que vai da Universidade Federal do Pará até o distrito de Icoaraci. No entanto, desde a inauguração da primeira etapa, no ano de 2012, o espaço vem conformando-se como lócus de lazer dos moradores da cidade, que o utilizam preferencialmente nos finais de semana, mas não exclusivamente. Nele, tem sido comum a frequência por pessoas de diferentes bairros e níveis sociais, que o compreendem como elemento importante ao embelezamento urbano e valorização da área. As críticas dos usuários do espaço foram direcionadas à falta de segurança, banheiros e áreas cobertas. / This study investigated the Orla Portal da Amazônia and its relation with the production of the city Belém/PA, starting from the understanding of elements present in the history of the local urban sprawl. It aimed to understand the public space of leisure, besides simple physical form, reaching its understanding as a locus of dispute involving State, society and private initiative. Issues pertinent to the entrepreneurship of the contemporary city are highlighted in the results obtained during the empirical research, revealing to be in accordance with the ideology propagated by the international capital. In this context, the entrepreneurship of the city of Belém shows itself as an unquestionable fact from the point of view of the local state. The understanding of the Orla Portal da Amazônia was sought through different points of view: goers; area residents; population of Belém; representatives of the State and researchers. The methodology involved bibliographical, documentary and empirical research, following a qualitative-quantitative approach. The existing theoretical contribution on public space served as a basis for the elaboration of a definition consistent with the research questions outlined in this thesis, presenting the Public Space of Leisure as: Physical-social space in the city, favorable to the encounter between different, who have as a common goal, to seek for pleasure. In this sense, it is considered in its analysis, besides the physical form, the wide possibilities of uses and symbolic meaning, the free access and the freedom of choice as to the sharing, or not, of experiences. They are socio-cultural spaces in which the architectural, landscape and environmental quality predominates, besides a certain vigilance. It is common that its users can enjoy free the physical infrastructure, such as the sports equipment and the programs offered. Among the main results obtained, it is affirmed that the new Orla was built as part of an urban strategy of the local state of mercantilization of city and search for new spatial and economic centralities. The improvements in basic infrastructure were not intended for their former residents, since the city hall offered them the opportunity of permanent migration to other housing complexes far from Orla. Today, there is a dispute involving State, society and private initiative, which diverge as to the interests around the area and what will be built in it. The population that was relocated and wait for almost a decade to get a new residence resists to remain near the Orla, claiming to have there cultural, social and labor relations. This resistance difficults the implemetation of both state and private projects to transform the city of Belém into a large orla, from the Universidad Federal do Pará to the district of Icoarací. However, since the inauguration of the first stage, in 2012, the space has been conforming as a locus of leisure for the city\'s residents, who use it preferably on weekends, but not exclusively. In it, it has been common the frequency by people of different neighborhoods and social levels, that understand it as important element to the urban beautification and valorization of the area.

A desconexão ázigo-portal e esplenectomia (DAPE) é a operação mais aceita e realizada em nosso meio para a profilaxia da recidiva hemorrágica por ruptura de varizes esofágicas ou gástricas em pacientes portadores de esquistossomose hepato-esplênica. Menores índices de ressangramento são obtidos através da associação da DAPE com escleroterapia ou ligadura elástica endoscópica das varizes esofágicas realizada no pós-operatório. Faltam trabalhos mostrando a evolução, a longo prazo, dos doentes esquistossomóticos submetidos a este tratamento. Este estudo retrospectivo tem como objetivo avaliar a evolução destes pacientes com tempo mínimo de seguimento de 5 anos. Foram analisados os prontuários dos pacientes operados no Serviço de Cirurgia de Fígado e Hipertensão Portal da Disciplina de Cirurgia do Aparelho Digestivo do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, no período compreendido entre março de 1989 a março de 2001 e que foram acompanhados prospectivamente. Avaliamos dados clínicos, laboratoriais, endoscópicos e ultra-sonográficos de 97 pacientes com seguimento de 116,4 ± 46,7 meses. Nenhum paciente cursou com insuficiência hepática clínica ou laboratorial. Ocorreu, no pós-operatório tardio, correção da anemia, leucopenia e plaquetopenia, diminuição dos níveis de bilirrubinas total e indireta séricas e aumento do tempo de atividade da protrombina. Houve significativa redução do número e calibre das varizes esofágicas, assim como da presença de sinais de manchas vermelhas e de varizes gástricas. Houve aumento na freqüência de gastropatia congestiva, entretanto, sem repercussão clínica significativa. A recidiva hemorrágica xviii ocorreu em 24,7% dos pacientes, sendo em 14,6% quando considerada apenas por varizes esofágicas, gástricas ou duodenais. A probabilidade estimada de não ocorrer ressangramento em 20 anos é de 67,1%, sendo de 82,5% quando considerada recidiva por varizes. Em quatro pacientes a recidiva hemorrágica ocorreu por varizes, mesmo após o relato, em exame endoscópico prévio, de erradicação das varizes esofágicas. À avaliação ultrassonográfica observou-se redução do calibre da veia porta no pósoperatório tardio, em comparação ao pré-operatório. Concluímos que a desconexão ázigo-portal com esplenectomia, associada ao tratamento endoscópico de varizes esofágicas no pós-operatório, propicia bons resultados do ponto de vista clínico com baixa morbidade e mortalidade; permite melhora laboratorial da função hepática e correção do hiperesplenismo; determina a redução da incidência dos sinais endoscópicos preditivos de sangramento digestivo por hipertensão portal (varizes esofágicas de grosso calibre, sinais de manchas vermelhas e varizes de fundo gástrico), porém, a gastropatia congestiva é mais freqüente; permite adequada profilaxia da recidiva hemorrágica em 67% dos pacientes ao longo de 20 anos. A recidiva hemorrágica por varizes pode ocorrer mesmo após a erradicação das varizes esofágicas, tanto por recidiva de varizes como por varizes de outro sítio (gástrica ou duodenal). Ocorre redução do calibre da veia porta no pós-operatório tardio, observado em exame ultrassonográfico em comparação ao pré-operatório. / Esophagogastric devascularization and splenectomy (EGDS) is nowadays the most performed operation for esophageal varices bleeding recurrence prophylaxis in hepatosplenic schistosomiasis. Lower rebleeding rates are obtained through the association of EGDS with postoperative endoscopic sclerotherapy or elastic bandage of esophageal varices, however, there is a lack of studies showing long term results. The objectives of this study were to evaluate retrospectively EGDS results in patients with at least five years of follow-up. Clinical, laboratorial, endoscopic and ultrasonographic data of 97 patients submitted to EGDS from March 1989 to March 2001 were analyzed. The mean follow-up was 116.4 months. There was no postoperative clinical or laboratorial hepatic insufficiency. In the late follow-up we observed normalization of preexisting anemia, leucopenia, thrombocytopenia, hyperbilirubinemia, and a prothrombin activity time increase. There was a significant esophageal varices caliber and number reduction, cherry red spots signs and gastric varices decrease. Congestive gastropathy was observed more frequently but without clinical importance. Bleeding recurrence occurred in 24.7% of the patients, however, in 14.6% when esophageal varices hemorrhage was considered. Estimated probability of rebleeding prophylaxis over 20 years is 67.1% and 82.5% when variceal recurrence was considered. Bleeding recurrence occurred in four patients even after endoscopic evaluation showing esophageal varices eradication. There was a significant portal vein caliber reduction on late ultrasound assessment, compared to preoperative. We concluded that the EGDS with postoperative endoscopic treatment leads to good clinical results with low morbidity and mortality; provides laboratorial liver function improve and xx hypersplenism correction; determines endoscopic predictive signs of portal hypertension digestive bleeding decrease (large esophageal varices, cherry red spots signs and gastric varices), however congestive gastropathy is more frequent; allows appropriate bleeding prophylaxis in 67% of the patients over 20 years. Variceal hemorrhagic recurrence may occur even when esophageal varices eradication is reached suggesting the need of an endoscopic surveillance even in this group of patients.

Embora esteja comprovada a superioridade da ligadura elástica sobre a esclerose endoscópica na profilaxia secundária da hemorragia varicosa, ainda há discussão se esta vantagem também é observada no tratamento da fase aguda do sangramento. O presente estudo tem como objetivo comparar os resultados da ligadura elástica com a esclerose endoscópica em pacientes admitidos no Pronto-Socorro (PS) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP) por hemorragia digestiva alta provocada por rotura de varizes de esôfago. Tratase de estudo unicêntrico, prospectivo, com alocação aleatória dos pacientes sem crossover. A fim de se detectar diferença de 20% entre a capacidade de hemostasia de cada um dos métodos, cada grupo deveria ser constituído por 260 pacientes, considerando poder estatístico de 80% e nível de significância inferior a 5%. Após diagnóstico endoscópico de rotura de varizes de esôfago, foi realizado sorteio para inclusão dos pacientes em dois grupos: esclerose endoscópica (EE) x ligadura elástica (LE). A esclerose foi realizada através da injeção intravasal de oleato de etanolamina a 3%, em alíquotas de 5ml, acima e abaixo do ponto de ruptura, respeitando o valor máximo por sessão de 20ml. No grupo LE, procurou-se ligar a variz sobre o ponto de ruptura. Se isto não foi possível, procurou-se ligar todo o tecido varicoso dos 3cm finais do esôfago. Foi utilizado o kit de ligadura MBL-6 e cateter VINF 23 (Cook, E. Tamusssino). As variáveis estudadas foram: a taxa de hemostasia inicial (até 5 dias), recidiva hemorrágica precoce (5 dias a 6 semanas), complicações e mortalidade. De maio de 2005 a maio de 2007, foram admitidos, no PS do HCFMUSP, 480 pacientes com hemorragia digestiva alta (HDA) provocada por hemorragia varicosa esofágica. Destes, 380 foram excluídos pelos seguintes motivos: mais de um tratamento prévio com ligadura ou esclerose (n=180), não randomização (n=85), uso de outra técnica hemostática como adesivo tissular de cianoacrilato (n=62) ou tratamento clínico incompleto no momento do exame endoscópico (n=53). Cem pacientes, 50 no grupo EE e 50 no LE foram incluídos no estudo. Destes, 72 eram homens e 28 mulheres, média de idade 52 anos. Os grupos se mostraram homogêneos quanto ao sexo, idade, Child-Pugh, hemoglobinemia à admissão, presença de choque hipovolêmico e calibre das varizes. Não foram encontradas diferenças estatisticamente significantes entre os grupos com relação ao controle inicial do sangramento (5 dias), ressangramento precoce (5 dias a 6 semanas), complicações e mortalidade (9 no grupo EE e 10 no grupo LE). Ao final de 6 semanas, 36 (80%) pacientes no grupo esclerose e 33 (77%) no grupo ligadura elástica estavam vivos e sem sinais de sangramento. Foi encontrada associação estatisticamente significante entre a classificação de Child-Pugh e mortalidade (p<0,001), que foi de 16% nos graus A ou B e 84% nos pacientes Child-Pugh C. Os resultados obtidos com esta casuística limitada sugerem que EE e a LE são igualmente eficazes no controle da hemorragia varicosa aguda. / Despite the superiority of banding over endoscopic sclerosis for secondary prophylaxis of variceal bleeding, there is still debate if this advantage is also observed for the acute bleeding setting. The study aims to compare band ligation (BL) with endoscopic sclerosis (SCL) in patients admitted to the emergency unit for rupture of esophageal varices. Prospective study carried out in a single center, with random allocation of the patients without crossover. In order to detect a 20% difference between the results of each method, each group should consist of 260 patients, considering an 80% statistical power and level of significance less than 5%. After an endoscopic diagnosis of rupture of esophageal varices, the patients were randomly allocated in two groups: SCL and BL. Sclerosis was performed by ethanolamine oleate intravascular injection, above and below the rupture point (maximum volume of 20 ml). In the BL group, banding was attempted at the point of rupture followed by ligation of the whole variceal tissue of the distal esophagus. Six-shooter® and VINF23® catheter (Cook, W. Salem, USA) were employed. Studied variables were initial failure in control bleeding (5 days), early rebleeding rates (5 days to 6 weeks), complications and mortality. From May 2005 to May 2007, 480 patients with an episode of variceal bleeding were admitted to the emergency room. From them, 380 were excluded because more than one previous treatment with SCL or BL (n=180), non-randomization (n=85), the use of another hemostatic technique such as cyanoacrylate tissular adhesive (n=62) and incomplete clinical treatment (n=53).One hundred patients, 50 in the SCL and 50 in the BL group were included in the study (72 male, 28 female, mean age 52 years). No differences between the groups were detected regarding gender, age, Child-Pugh status, the presence of shock at admission, mean hemoglobin levels and varices size. No statistically significant differences were found between the groups regarding control bleeding (5 days) and early rebleeding rates (5 days to 6 weeks), complications and mortality (9 in the SCL vs. 10 in the BL group). By the end of 6 weeks 36 (80%) patients in the SCL group and 33 (77%) in the EBL group were alive and free of bleeding. A statistically significant association was found between Child-Pugh status and mortality (p<0,001), which was 16% for A and B grades and 84% for grade C patients. The results obtained with this limited number of patients suggest that SCL and BL are equally efficient in the control of acute variceal bleeding.