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Reactor relevant fusion devices will use tungsten (W) for their plasma facing components (PFCs) due to its thermomechanical properties and low tritium retention. However, W introduces high-Z impurities into the plasma, degrading its performance. Different wall conditioning methods have been developed to address this issue, including coating of W PFCs with layers of low-Z material. Wall conditioning by boron (B) powder injection using an impurity powder dropper (IPD) is being studied in WEST. Two series of experiments were conducted since the installation of the new ITER grade full W divertor. During the first series in 2023 ∼ 1 g of B powder was injected in total at a maximum rate of ∼ 58 mg/s, both of which are three times greater than respective values in the initial WEST powder injection experiments. The second series of experiments included injection of B and BN powders for comparison of their effects on plasma performance. The presence of an instantaneous conditioning effect is suggested by visible spectroscopy measurements of low-Z impurity lines and a rollover of total radiated power past an injection rate of ∼ 20 mg/s was observed. Presence of B coating layer formation is supported by the evolution of the average radiance of visible lines of B, W and oxygen (O). To understand B transport, an interpretative modeling workflow is employed, utilizing the SOLEDGE-EIRENE fluid boundary plasma code and the Dust Injection Simulator (DIS) code. Parameters like B perpendicular diffusivity and recycling coefficients are varied to match experimental results to see if the initial assumption of B sticking to the PFCs immediately after the contact with the wall is adequate for correctly modelling its distribution on the PFCs.

Introduction: Obstructive Sleep Apnea (OSA) in children is characterized by repeated episodes of partial or complete obstruction of the upper airways that impair normal ventilation and cause hypoxia and sleep disruption. These episodes activate innate and adaptive immunity resulting in the production of proinflammatory cytokines: IL-1β, IL-6, TNF-α, and reactive oxygen species. The hypothalamic–pituitary–adrenal (HPT) axis is also activated with alteration of the circadian rhythm of cortisol synthesis. OSA in children, and even more in adults, induces a systemic inflammatory condition that contributes to the genesis of clinical complications: poor growth, learning disabilities, cardiovascular changes, insulin resistance, and metabolic syndrome. Methods: A total of 42 non-obese children (age 1–15 years) were enrolled among those sent to our sleep center to perform full polysomnography (PSG). After PSG, 6 children did not show OSA (controls), 20 had mild OSA (m OSA), and 16 had medium-severe OSA (MS OSA). In vitro IL-1β, TNF-α, and serum cortisol levels were measured at 2 and 8 am in the analyzed groups. Results: Cortisol levels did not differ between controls and OSA children. At 2 am, there were no differences between controls and OSA in TNF-α production, whereas at 8 am, TNF-α was reduced in MS-OSA. IL-1β production showed no differences between OSA and controls. Conclusions: In our population, only TNF-α production is suppressed in MS-OSA: this might indicate a role of OSA severity in inducing inflammation. In adults, the phenomenon is more pronounced due to the habitual greater severity/duration of OSA, presence of comorbidities (cardiovascular and metabolic), and different immune system function.

Abstract Traumatic brain injury (TBI) is a leading cause of mortality and disability worldwide. Acute neuroinflammation is a prominent reaction after TBI and is mostly initiated by brain-resident glial cells such as microglia, NG2-glia and astrocytes. The magnitude of this reaction paves the way for long-lasting consequences such as chronic neurological pathologies, for which therapeutic options remain limited. The neuroinflammatory response to TBI is mostly studied with craniotomy-based animal models that are very robust but also rather artificial. Here, we aimed to analyze the reaction of glial cells in a highly translational but variable closed head injury (CHI) model and were able to correlate the severity of the trauma to the degree of glial response. Furthermore, we could show that the different glial cell types react in a temporally and spatially orchestrated manner in terms of morphological changes, proliferation, and cell numbers in the first 15 days after the lesion. Interestingly, NG2-glia, the only proliferating cells in the healthy brain parenchyma, divided at a rate that was correlated with the size of the injury. Our findings describe the previously uncharacterized posttraumatic response of the major brain glial cell types in CHI in order to gain a detailed understanding of the course of neuroinflammatory events; such knowledge may open novel avenues for future therapeutic approaches in TBI.

Abstract In this article, we address the question of electric bus planning and operation under stochastic travel time and energy consumption. Uncertainties in the environment may cause disruptions to the planning and operation of electric buses, and a transportation planner must anticipate such conditions and be able to respond appropriately. One of the preconditions for planning robust strategies is understanding the existence and impact of multiple trade-off scenarios, which is the basis for this study. We model the travel time delays and trip energy consumption using estimated probability density functions and use a stochastic, mixed-integer formulation with chance constraints to evaluate several trade-off scenarios for electric bus fleets under uncertainty. The results show the existence of trade-off scenarios that lead to varying degrees of impacts related to network and environment. Careful fleet planning, dispatch, and charge control enable us to make the balance between these trade-offs and achieve better operational performances under uncertainty.

Abstract Deploying real-time control on large-scale fleets of electric vehicles (EVs) is becoming pivotal as the share of EVs over internal combustion engine vehicles increases. In this paper, we present a Vehicle-to-Grid (V2G) algorithm to simultaneously schedule thousands of EVs charging and discharging operations, that can be used to provide ancillary services. To achieve scalability, the monolithic problem is decomposed using the alternating direction method of multipliers (ADMM). Furthermore, we propose a method to handle bilinear constraints of the original problem inside the ADMM iterations, which changes the problem class from Mixed-Integer Quadratic Program (MIQP) to Quadratic Program (QP), allowing for a substantial computational speed up. We test the algorithm using real data from the largest carsharing company in Switzerland and show how our formulation can be used to retrieve flexibility boundaries for the EV fleet. Our work thus enables fleet operators to make informed bids on ancillary services provision, thereby facilitating the integration of electric vehicles.

O reconhecimento de novas situações lesivas passíveis de reparação culmina na ampliação do espectro de abrangência da reponsabilidade civil. Em razão da incorporação de inéditos tipos de danos, doutrinariamente propõe-se o rearranjo da taxonomia das lesões não patrimoniais. Desta feita, propõe-se investigar a pertinência da readequação da classificação dos danos em virtude da identificação de novos interesses merecedores de tutela. Historicamente, a origem dos chamados novos danos decorre da aplicação da teoria dos efeitos da lesão, a qual distingue a lesão (dano-evento), enquanto violação de um interesse juridicamente tutelado, do dano (dano-consequência), como repercussão concreta daquela na vítima. Utilizando-se de pesquisa teórico-bibliográfica e método dedutivo, identifica-se a impropriedade de se readequar a taxonomia das lesões não patrimoniais em razão da proteção de novos interesses juridicamente relevantes, haja vista que o fator determinante da tipologia do dano não é o bem jurídico tutelado, mas o prejuízo concretamente experimentado pelo ofendido. Portanto, mostra-se dogmaticamente inadequado e historicamente incoerente alterar a classificação das lesões de natureza extrapatrimoniais em virtude do reconhecimento da proteção de novos interesses juridicamente relevantes, pois o critério distintivo do tipo de dano funda-se no prejuízo concretamente sofrido e não no bem jurídico violado.

Abstract We develop a thermoelectric generator based on catalytic combustion and operating in the low power range (up to 10 W). Considering the target of small-scale thermoelectric generators, the additive technique was chosen as an enabling technology to customize the different parts of the presented device. The generator consists of a hexagonal shaped combustion chamber coupled to commercial thermoelectric modules, water-cooled at the cold side. Thanks to the components design, heat transfer across each part of the system is properly driven enhancing the thermal management of the system. Moreover, in order to improve the overall efficiency, exhausts outlet is designed to promote heat recovery. The generator is characterized achieving an electrical power output close to 9 W in continuous regime, with an overall efficiency of 3.55%. The compact size, the light weight, the simple design and the reliability in continuous operating conditions are all promising features of the device described. Furthermore, the materials chosen for the device can suggest a way to fabricate cheaper heat exchangers, actually one of the main costs of the device development.

Abstract Background Inflammaging represents an accepted concept where the immune system shifts to a low-grade chronic pro-inflammatory state without overt infection upon aging. In the CNS, inflammaging is mainly driven by glia cells and associated with neurodegenerative processes. White matter degeneration (WMD), a well-known process in the aging brain, manifests in myelin loss finally resulting in motor, sensory and cognitive impairments. Oligodendrocytes (OL) are responsible for homeostasis and maintenance of the myelin sheaths, which is a complex and highly energy demanding process sensitizing these cells to metabolic, oxidative and other forms of stress. Yet, the immediate impact of chronic inflammatory stress like inflammaging on OL homeostasis, myelin maintenance and WMD remains open. Methods To functionally analyze the role of IKK/NF-κB signaling in the regulation of myelin homeostasis and maintenance in the adult CNS, we established a conditional mouse model allowing NF-κB activation in mature myelinating oligodendrocytes. IKK2-CAPLP−CreERT2 mice were characterized by biochemical, immunohistochemical, ultrastructural and behavioral analyses. Transcriptome data from isolated, primary OLs and microglia cells were explored by in silico pathway analysis and validated by complementary molecular approaches. Results Chronic NF-κB activation in mature OLs leads to aggravated neuroinflammatory conditions phenocopying brain inflammaging. As a consequence, IKK2-CAPLP−CreERT2 mice showed specific neurological deficits and impaired motoric learning. Upon aging, persistent NF-κB signaling promotes WMD in these mice as ultrastructural analysis revealed myelination deficits in the corpus callosum accompanied by impaired myelin protein expression. RNA-Seq analysis of primary oligodendrocytes and microglia cells uncovers gene expression signatures associated with activated stress responses and increased post mitotic cellular senescence (PoMiCS) which was confirmed by elevated senescence-associated β-galactosidase activity and SASP gene expression profile. We identified an elevated integrated stress response (ISR) characterized by phosphorylation of eIF2α as a relevant molecular mechanism which is able to affect translation of myelin proteins. Conclusions Our findings demonstrate an essential role of IKK/NF-κB signaling in mature, post-mitotic OLs in regulating stress-induced senescence in these cells. Moreover, our study identifies PoMICS as an important driving force of age-dependent WMD as well as of traumatic brain injury induced myelin defects. Graphical Abstract

ABSTRACT Objective: To identify and analyze the scientific literature, both national and international, concerning the primary maternal concerns about caring for premature newborns at home. Methods: This integrative review is based on the guiding question: “What scientific publications from 2012 to 2021 address maternal concerns about the care of premature newborns at home?”. Searches were conducted in the electronic databases: Embase, Medline, Web of Science, Lilacs, Scielo, and Cochrane Library. Results: A total of 21 articles were identified. The qualitative analysis showed that maternal concerns pertained to breastfeeding, hygiene, sunbathing practices, managing infant colic, identifying signs, symptoms, and clinical changes, temperature control, and the third phase of the kangaroo method. Conclusions: Maternal uncertainties underscore the importance of enhancing strategies focused on supporting families and ensuring continued care for neonates at home.

Abstract The debate about the conceptual model of mud volcanoes functioning is still alive in the literature. A large part of the literature focuses on the characterization of the deep reservoir where expelled fluids are expected to originate. Another part of literature is focused on the study of the shallow system of mud volcanoes, which could influence the short‐term variations in mud volcanoes activity. We present and analyze a new data set of micro‐gravimetric data to study the area of the Nirano Salse, Italy. Unlike what is commonly assumed for the study area, our results suggest that the geomorphology of the Nirano Salse is not related to a caldera collapse above a shallow mud chamber, but to the surface expression of slip distribution of a fault termination along which the fluids ascended to the surface. We believe that gravimetric data can significantly improve the study of hydrocarbon seeps and mud volcanism.

Optimal behind-the-meter energy management often requires a day-ahead electric load forecast capable of learning non-linear and non-stationary patterns, due to the spatial disaggregation of loads and concept drift associated with time-varying physics and behavior. There are many promising machine learning techniques in the literature, but black box models lack explainability and therefore confidence in the models’ robustness can’t be achieved without thorough testing on data sets with varying and representative statistical properties. Therefore this work adopts and builds on some of the highest-performing load forecasting tools in the literature, which are Long Short-Term Memory recurrent networks, Empirical Mode Decomposition for feature engineering, and k-means clustering for outlier detection, and tests a combined methodology on seven different load data sets from six different load sectors. Forecast test set results are benchmarked against a seasonal naive model and SARIMA. The resultant skill scores range from −6.3% to 73%, indicating that the methodology adopted is often but not exclusively effective relative to the benchmarks.

The fast increase in electric vehicle (EV) usage in the last 10 years has raised the need to properly forecast their energy consumption during charge. Lithium-ion batteries have become the major storage component for electric vehicles, avoiding their overcharge can preserve their health and prolong their lifetime. This paper proposes a Machine Learning model based on the K-Nearest Neighbors classification algorithm for EV charging session duration forecast. The model forecasts the duration of the charge by assigning the event to its correct class. Each class contains the charging events whose duration is comprised of a certain interval. The only information used by the algorithm is the one available at the beginning of the charging event (arrival time, starting SOC, calendar data). The model is validated on a real-world dataset containing records of charging sessions from more than 100 users, a sensitivity analysis is performed to assess the impact of different information given as input. The effectiveness of the model with respect to the benchmark models is demonstrated with an increase in performance.

The increasing adoption of electric vehicles poses new problems for the electrical distribution network. For this reason, proper electric vehicle forecasting will be of fundamental importance for a predictive energy management system, which could greatly help the operation of the grid. This paper proposes a comprehensive novel methodology to forecast single charging sessions of electric vehicle and the resulting cumulative energy forecast of the charging infrastructure. Historical charging sessions are first clustered on the basis of similar user characteristics and their respective probability density functions are defined. From this, every charging session is predicted with a triplet of parameters, namely the arrival time, the charging duration and the average power expected during the process. The proposed method has been evaluated by considering a real case study. The results showed the ability to greatly improve the accuracy with respect to the chosen benchmark, both in terms of energy required by the station and the predicted number of charging sessions. The overall performance measured by Skill Score is 0.37 for the year 2019.

In extreme temperature environments, a newly emerging engineering application involves both the active and passive control of structures using cryogenic shape memory alloys, which are smart materials able to recover high deformation below the freezing point. With the objective of carrying out new advances in this area, the present work aims to investigate the Cu-7.5Al-13.5Mn (wt.%) shape memory alloy. Thermal, microstructural, and thermomechanical analyses of as-cast and hot-rolled specimens were performed, taking into account the effects of annealing and solubilization. It was observed that the phase transition occurs at temperatures below 120 K and changes according to the thermo-mechanical path. Specifically, hot-rolling lowers the phase transition temperature range with respect to the as-cast condition–from 34 K to 23 K for Mf, and from 89 K to 80 K for Af. Additionally, when the annealing temperature rises, the phase transformation temperature increases as well, and the alloy loses its cryogenic features when heat treated above 473 K. Finally, loss factors of 0.06 and 0.088, which were respectively found in dynamic and static settings, validate the material’s good damping response.

The DIII-D tokamak has elucidated crucial physics and developed projectable solutions for ITER and fusion power plants in the key areas of core performance, boundary heat and particle transport, and integrated scenario operation, with closing the core-edge integration knowledge gap being the overarching mission. New experimental validation of high-fidelity, multi-channel, non-linear gyrokinetic turbulent transport models for ITER provides strong confidence it will achieve Q ⩾ 10 operation. Experiments identify options for easing H-mode access in hydrogen, and give new insight into the isotopic dependence of transport and confinement. Analysis of 2,1 islands in unoptimized low-torque IBS demonstration discharges suggests their onset time occurs randomly in the constant β phase, most often triggered by non-linear 3-wave coupling, thus identifying an NTM seeding mechanism to avoid. Pure deuterium SPI for disruption mitigation is shown to provide favorable slow cooling, but poor core assimilation, suggesting paths for improved SPI on ITER. At the boundary, measured neutral density and ionization source fluxes are strongly poloidally asymmetric, implying a 2D treatment is needed to model pedestal fuelling. Detailed measurements of pedestal and SOL quantities and impurity charge state radiation in detached divertors has validated edge fluid modelling and new self-consistent ‘pedestal-to-divertor’ integrated modeling that can be used to optimize reactors. New feedback adaptive ELM control minimizes confinement reduction, and RMP ELM suppression with sustained high core performance was obtained for the first time with the outer strike point in a W-coated, compact and unpumped small-angle slot divertor. Advances have been made in integrated operational scenarios for ITER and power plants. Wide pedestal intrinsically ELM-free QH-modes are produced with more reactor-relevant conditions, Low torque IBS with W-equivalent radiators can exhibit predator-prey oscillations in T _e and radiation which need control. High- β _P scenarios with q _min > 2, q _95 –7.9, β _N > 4, β _T –3.3% and H _98y2 > 1.5 are sustained with high density ( $\bar n$ = 7E19 m ^−3 , f _G –1) for 6 τ _E , improving confidence in steady-state tokamak reactors. Diverted NT plasmas achieve high core performance with a non-ELMing edge, offering a possible highly attractive core-edge integration solution for reactors.

Recently, experiments on basic plasma physics issues for solving future problems in fusion energy have been performed on a Large Helical Device. There are several problems to be solved in future devices for fusion energy. Emerging issues in burning plasma are: alpha-channeling (ion heating by alpha particles), turbulence and transport in electron dominant heating helium ash exhaust, reduction of the divertor heat load. To solve these problems, understanding the basic plasma physics of (1) wave–particle interaction through (inverse) Landau damping, (2) characteristics of electron-scale (high- k ) turbulence, (3) ion mixing and the isotope effect, and (4) turbulence spreading and detachment, is necessary. This overview discusses the experimental studies on these issues and turbulent transport in multi-ion plasma and other issues in the appendix.

Tuberous sclerosis complex (TSC) is an autosomal dominant disease characterised by abnormal cell proliferation and differentiation that affects multiple organs and can lead to the growth of hamartomas. Tuberous sclerosis complex is caused by the disinhibition of the protein mTOR (mammalian target of rapamycin). In the past, various therapeutic approaches, even if only symptomatic, have been attempted to improve the clinical effects of this disease. While all of these therapeutic strategies are useful and are still used and indicated, they are symptomatic therapies based on the individual symptoms of the disease and therefore not fully effective in modifying long-term outcomes. A new therapeutic approach is the introduction of allosteric inhibitors of mTORC1, which allow restoration of metabolic homeostasis in mutant cells, potentially eliminating most of the clinical manifestations associated with Tuberous sclerosis complex. Everolimus, a mammalian target of the rapamycin inhibitor, is able to reduce hamartomas, correcting the specific molecular defect that causes Tuberous sclerosis complex. In this review, we report the findings from the literature on the use of everolimus as an effective and safe drug in the treatment of TSC manifestations affecting various organs, from the central nervous system to the heart.

Este artigo aborda a experiência de construção de recursos educativos, um livro e um jogo, no contexto do curso Educação Popular e Plantas Medicinais na Atenção Básica à Saúde, que objetiva formar trabalhadores da atenção básica do Sistema Único de Saúde para o desenvolvimento de ações de reconhecimento, valorização e integração dos saberes tradicionais de plantas medicinais no cuidado. A partir da exposição da experiência, são feitas reflexões que apontam caminhos dialógicos e participativos na construção de recursos educativos fundamentados em princípios da educação popular, que preservam uma abertura para inserção na realidade e nos territórios de vida e trabalho dos educandos e educadores. Conclui-se que recursos educativos, na perspectiva da educação popular, colaboram com leituras críticas da realidade, e que as plantas medicinais, como tema gerador, possibilitam a análise de diferentes elementos estruturantes do processo de saúde, doença e cuidado.

The adoption of blockchain technology is emerging as a promising approach in managing decentralized local energy markets (LEM). In this study we analyze the issues related to the deployment of a blockchain-based LEM on devices as much as possible similar to modern smart meters. The presented LEM is based on an automated market-making mechanism. Buying and selling prices are dynamically determined by the amount of energy consumed and produced within a local energy community. We implemented the market in a blockchain application based on the Cosmos framework, which was deployed on embedded devices in a test pilot consisting of 18 residential buildings in Southern Switzerland. The sustainability of the application was investigated by analyzing the resources required by the blockchain to operate. The obtained results show how the developed application uses a small part of the resources of the embedded devices, approximately 100 MB for the memory usage and about 4% as regards the CPU. Thus, while the application deployment on smart meters is still troublesome, especially for memory requirements, the deployment at the data concentrator level is reasonable and feasible. Finally, we propose possible improvements and extensions that can be implemented in future versions of the presented solution.

A variedade de teorias sobre o nexo de causalidade evidencia a dificuldade de se estabelecer um conceito suficiente do instituto. O caráter ontológico da relação causal torna sua definição jurídica problemática, pois a natureza deontológica do Direito implica na inadequação do seu instrumental à caracterização daquela relação. A análise das principais teorias sobre o nexo de causalidade, entendidas como as mais comumente tratadas pela doutrina, permite visualizar a deficiência do tratamento jurídico dado ao instituto, sobretudo com a expansão das hipóteses de responsabilidade civil objetiva, nas quais a culpa não mais opera como elemento refratário de identificação do autor do dano. Por meio de pesquisa teórico-bibliográfica e jurisprudencial, expõe-se como a evolução da responsabilidade civil e o seu processo de objetivação, dispensando o elemento culpa enquanto limitador da cadeia de identificação do autor do dano, culmina na necessidade de se emprestar um conceito jurídico mais bem delimitado ao nexo causal, em razão da sua centralidade no regime de imputação. O caráter axiológico e teleológico das normas de responsabilidade civil acaba por trazer elementos estranhos ao instituto do nexo causal quando de sua conceituação, na tentativa de se atender ao senso de equidade. Admite-se, portanto, a verificação do elo causal mesmo quando incerto, contentando-se a imputação com a probabilidade ou até a mera possibilidade de sua ocorrência, sobretudo com o objetivo de se amparar a vítima por medida de justiça.

Abstract Electrification of the transportation sector provides several advantages in favor of climate protection and a shared economy. At the same time, the rapid growth of electric vehicles also demands innovative solutions to mitigate risks to the low-voltage network due to unpredictable charging patterns of electric vehicles. This article conceptualizes a stochastic reinforcement learning agent that learns the optimal policy for regulating the charging power. The optimization objective intends to reduce charging time, thus charging faster while minimizing the expected voltage violations in the distribution network. The problem is formulated as a two-stage optimization routine where the stochastic policy gradient agent predicts the boundary condition of the inner non-linear optimization problem. The results confirm the performance of the proposed architecture to control the charging power as intended. The article also provides extensive theoretical background and directions for future research in this discipline.

Abstract Background The diagnosis of the active phase of labor is a crucial clinical decision, thus requiring an accurate assessment. This study aimed to build and to validate a predictive model, based on maternal signs and symptoms to identify a cervical dilatation ≥4 cm. Methods A prospective study was conducted from May to September 2018 in a II Level Maternity Unit (development data), and from May to September 2019 in a I Level Maternity Unit (validation data). Women with singleton, term pregnancy, cephalic presentation and presence of contractions were consecutively enrolled during the initial assessment to diagnose the stage of labor. Women

Mid-point Transverse process to Pleura Block (MTPB) is an alternative approach to paravertebral block. We retrospectively assessed hemodynamic stability, inadvertent pleural puncture and antalgic effectiveness of this approach compared with traditional paravertebral block. Moreover, being used to add methylene bleu to local anesthetic solution as a tracer, we compared the diffusion pattern in paravertebral space of the two techniques. We reported retrospectively 40 patients underwent lung lobectomy from July to October 2021 in Monaldi Hospital (Naples, Italy) receiving thoracic paravertebral block (n=20) or mid-point transverse process to pleura block (n=20). The primary outcomes were a 20% mean arterial pressure variation from the base line, chest wall or pleural hematoma and technique failure. Analgesic effectiveness was assessed comparing remifentanil consumption to keep nociception index level < 25 and patient’s VAS in post anesthesia care unit or daycare surgical unit at 60’. Also the methylene blue spread was assessed by a surgeon, blinded to patient’s name reviewing surgery videorecord of every cases. MAP decrease > 20% was greater in the TPVB. No significative differences were reported for pleural punctures, chest wall hematomas or failure of the technique in the two groups. Methylene blue was evident in all patients of the TPVB, while it was not visible in any of the patients of the MTPB group. Remifentanil consumption, nociception index level and postoperative 60’ VAS were greater in the MTPB.Antalgic power and local anesthetic spread of TPVB seems to be superior to the MTPB, even if the safety profile of the latter seems to be better. Due to the retrospective nature of the study and the small number of cases in the sample, further studies are needed.

O transporte de equinos tem sido um dos fatores de risco mais associados ao desenvolvimento da pleuropneumonia, isso porque há um grande estresse vivido por esses animais durante o embarque, na viagem e no desembarque, levando a uma queda de imunidade. O sistema respiratório de equinos atletas é um dos mais importantes, uma vez que interfere no seu desempenho. O objetivo desse trabalho, foi relatar um caso atendido no Hovet da Universidade Federal do Mato Grosso – Cuiabá. O animal chegou com histórico de pleuropneumonia após ser transportado por longa distância e com recidivas ao tratamento. Para confirmação do diagnóstico e análise do quadro clínico atual, foram realizados exames laboratoriais e de imagem, incluindo hemograma, perfil bioquímico, citologia, cultivo, antibiograma e ultrassonografia torácica, indicando a presença de pleuropneumonia crônica. A terapia foi realizada com antimicrobianos de amplo espectro e baseados no antibiograma, anti-inflamatórios não esteroidais, mucolítico e cuidados de suporte. Após 29 dias de tratamento, apresentou remissão dos sintomas e fluído pleural, apto à alta hospitalar. A pleuropneumonia tem prognóstico reservado, dependendo da gravidade do quadro e rapidez nas tomadas de decisões. O sucesso do caso, deve-se ao diagnóstico correto e condutas terapêuticas assertivas, resultando em bom prognóstico.

Abstract Background Multisystem inflammatory syndrome in children (MIS-C) is a novel condition temporally associated with SARS-CoV2 infection. Cardiovascular involvement is mainly evident as acute myocardial dysfunction in MIS-C. The aim of this study was to describe the cardiac dysfunction in patients with MIS-C, defining the role of severity in the clinical presentations and outcomes in a single cohort of pediatric patients. Methods A single-center retrospective study on patients diagnosed with MIS-C, according to the Center for Disease Control and Prevention (CDC) definition, and referred to Vittore Buzzi Children’s Hospital in Milan from November 2020 to February 2021. Patients were managed according to a local approved protocol. According to the admission cardiac left ventricular ejection fraction (LVEF), the patients were divided into group A (LVEF

Abstract Background Derangement of body composition has been associated with dismal long-term survival in several gastrointestinal cancers including rectal tumors treated with neoadjuvant therapies. The role of specific preoperative anthropometric indexes on the oncologic outcomes of patients undergoing upfront surgery for rectal cancer has not been investigated. The aim of the study is to evaluate the association of body composition and overall survival in this specific cohort. Methods Lumbar computed tomography images, obtained within the 30 days previous to surgery, between January 2009 and December 2016, were used to calculate population-specific thresholds of muscle mass (sarcopenia), subcutaneous and visceral adiposity, visceral obesity, sarcopenic obesity, and myosteatosis. These body composition variables were related with overall survival (OS), tumor-specific survival (TSS), and disease-free survival (DFS). OS, TSS, and DFS were evaluated by the Kaplan-Meier method. Cox regression analysis was used to identify independent predictors of mortality, tumor-specific mortality, and recurrence, and data were presented as hazard ratio (HR) and 95% confidence interval (CI). Results During the study period, 411 patients underwent rectal resection for cancer, and among these, 129 were without neoadjuvant chemoradiation. The median follow-up was 96.7 months. At the end of the follow-up, 41 patients (31.8%) had died; of these, 26 (20.1%) died for tumor-related reasons, and 36 (27.1%) experienced disease recurrence. One-, three-, and five-year OS was 95.7%, 86.0%, and 76.8% for non-sarcopenic patients versus 82.4%, 58.8%, and 40.0% for sarcopenic ones respectively (p < 0.001). Kaplan-Meier survival curves comparing sarcopenic and non-sarcopenic patients showed a significant difference in terms of OS (log-rank

Day-ahead power forecasting is an effective way to deal with the challenges of increased penetration of photovoltaic power into the electric grid, due to its non-programmable nature. This is significantly beneficial for smart grid and micro-grids application. Machine learning and hybrid approaches are well assessed techniques, able to provide effective forecasting with a data-driven approach based on previous measurements from existing power plants. Ensemble methods can be employed to increase solar power forecasting accuracy, by running several independent forecasting models in parallel. In this paper, a novel selective approach is proposed and assessed, where independently trained neural networks are evaluated in terms of accuracy, in order to properly select a suitable forecasting. Moreover, in order to reduce the associated computational burden, suitably developed new normalization approaches are proposed and evaluated. The considered experimental case study shows that the combination of the proposed procedures is able to increase accuracy and to mitigate the overall computational load, resulting in a simple and lightweight algorithm. Additionally, a comparison with other commonly used techniques has shown that the proposed approach is robust with respect to dataset limited size and discontinuities.

Shape memory alloys (SMA) are functional materials known for their shape memory and pseudoelastic properties, which originated from a thermoelastic phase transition between two solid phases: austenite and martensite. The ranges of temperature at which austenite and martensite are stable depend primarily on the chemical composition and the thermomechanical history of the alloy. This work presents a broad overview of shape memory alloys presenting the thermoelastic phase transition at cryogenic temperatures—that is, at temperatures below the freezing point of water. Currently, this class of SMA is not very well explored due to the difficulties in conducting both structural and functional experimentations at very low temperatures. However, these materials are of great importance for extreme environments such as space. In this work, the different classes of cryogenic SMA will first be presented as a function of their phase transformation temperatures. Hints of their mechanical performance will also be reported. Cu-based systems have been identified as cryogenic SMA presenting the lowest phase transformation temperatures. The lowest measured Ms (45 K) was found for the Cu-8.8Al-13.1Mn (wt.%) alloy.

Abstract Aim To evaluate mothers’ satisfaction with childbirth experience in a cohort of women who delivered during COVID pandemia and to compare them to a pre‐COVID cohort. Design We performed a cross‐sectional study in a low‐risk Maternity Unit. Methods Women who delivered during COVID‐19 pandemic were compared to a pre‐COVID cohort recruited in 2018 in the same setting. Italian version of the Birth Satisfaction Scale‐Revised (I‐BSS‐R) was used. Results Three hundred and seventy‐seven women were included (277 pre‐COVID and 100 during COVID pandemic). No differences in terms of satisfaction at birth were reported (I‐BSS‐R mean 27.0, SD 5.3 versus mean 27.6, SD 6.1, p 0.34), despite an increased rate of active intrapartum interventions. Intrapartum variables that significantly reduced satisfaction were the same in the two groups: epidural analgesia (p

(1) Background: Anaemia is a common finding in patients with colon cancer and is commonly corrected by blood transfusion prior to surgery. However, the prognostic role of perioperative transfusions is still debated. The aim of the present study was to investigate the role of preoperative anaemia and preoperative blood transfusion in influencing the prognosis in colon cancer. (2) Patients and Methods: Patients undergoing elective surgery for colon cancer at a tertiary referral university hospital between January 2010 and December 2018 were included in a retrospective review of a prospectively collected database. Univariate and regression analyses were performed to identify the prognostic role of preoperative anaemia and preoperative transfusions in this homogeneous cohort of patients. (3) Results: A total of 780 patients were included in the final analysis. The estimated five-year overall survival rate was significantly worse in the anaemic group (83.8% in non-anaemic patients, 60.6% in mild anaemic patients, 61.3% in moderate anaemic patients and 58.4% in severe anaemic patients; log-rank < 0.001 vs. non-anaemic patients). Anaemic status was found to be an independent adverse prognostic factor (hazard ratio (HR): 1.46; 95% confidence interval (CI): 1.02–2.07) during multivariate analysis. Among moderate to severe anaemic patients, no significant association was found between preoperative transfusions and the risk of mortality or recurrence. (4) Conclusions: Preoperative anaemia, regardless of its severity, and not preoperative blood transfusion, was independently associated with a worse prognosis after surgery in patients with colonic cancer.

The increasing penetration of Renewable Energy Sources (RESs) in the energy mix is determining an energy scenario characterized by decentralized power production. Between RESs power generation technologies, solar PhotoVoltaic (PV) systems constitute a very promising option, but their production is not programmable due to the intermittent nature of solar energy. The coupling between a PV facility and a Battery Energy Storage System (BESS) allows to achieve a greater flexibility in power generation. However, the design phase of a PV+BESS hybrid plant is challenging due to the large number of possible configurations. The present paper proposes a preliminary procedure aimed at predicting a family of batteries which is suitable to be coupled with a given PV plant configuration. The proposed procedure is applied to new hypothetical plants built to fulfill the energy requirements of a commercial and an industrial load. The energy produced by the PV system is estimated on the basis of a performance analysis carried out on similar real plants. The battery operations are established through two decision-tree-like structures regulating charge and discharge respectively. Finally, an unsupervised clustering is applied to all the possible PV+BESS configurations in order to identify the family of feasible solutions.

A experiência com a produção textual propiciou o constante trabalho de corrigir e de orientar para a escrita e para a reescrita. Inserido nessa conjuntura, esse artigo tem como objetivo refletir se as indicações do docente para a reescrita podem contribuir para a qualidade do texto final do aluno. Para atingir essa meta, foram selecionados textos elaborados por estudantes do Ensino Médio produzidos a partir das orientações apresentadas em sala de aula e os bilhetes escritos nas produções. Para sustentar nossas ponderações, busca-se respaldo, principalmente nos conceitos de “mediação” e nos enunciativodiscursivos. Além desse constructo investigativo e metodológico, apresentamos as contribuições sobre o “texto” e “produções textuais”.

Background While perioperative red blood cell transfusion has been widely associated with poor surgical outcomes, few studies have focused specifically on the preoperative transfusional risk–benefit ratio. The aim of the present study was to evaluate the effects of preoperative red blood cell transfusion on short-term surgical outcomes in a cohort of anemic colon cancer patients. Methods Moderate and severe anemic patients undergoing colectomy for cancer were divided into two groups based upon the receipt of preoperative transfusion and compared in terms of short-term outcomes. Results A total of 271 patients with moderate or severe anemia were identified, 93 (34.3%) of whom were preoperatively transfused with a median of two units of packed red blood cells per patient (interquartile range: 2–4 units). The overall morbidity rate did not differ significantly between the two groups (35.5% vs. 36.2%; p = 0.63), while an increased incidence of major morbidity (Clavien–Dindo grade > 3a) observed in transfused patients [14% vs. 6.2% respectively; odds ratio (OR): 2.47, 95% confidence interval (CI): 1.06–5.75; p = 0.03]. The increase in major morbidity was confirmed by multivariate analysis, adjusted for potential confounders (OR: 3.45; 95% CI: 1.32–9.04; p = 0.01). Conclusions Preoperative blood transfusion is associated with severe postoperative complications following colectomy in moderate and severe anemic cancer patients. Further studies are needed to establish an optimal preoperative transfusional cutoff value to optimize postoperative outcomes and balance clinical costs.

ABSTRACT Objective: To analyze the effect of an educational intervention on the attitudes of university professors towards suicidal behavior. Methods: Experimental study, which carried out an educational intervention with 100 university professors, divided into two groups, control and intervention, developed in three moments, pre-assessment, intervention, and post-assessment, using the Eskin’s Attitudes Towards Suicide Scale (E-ATSS). Comparisons before and after intervention in the same group were performed using the paired t-test for dependent samples and the Wilcoxon Signed Rank Test, and for comparisons between groups the paired t-test for independent samples and the Mann-Whitney U test were used, the significance level adopted was p < 0.05. Results: There was a change in the attitude of professors in the two domains of the suicide scale such as mental illness (p

Groin hernia is one of the most common surgical diagnoses worldwide. The indication for surgery in asymptomatic or mildly symptomatic patients is discussed. Some trials have demonstrated the safety of a watchful waiting strategy. During the pandemic, waiting lists for hernia surgery dramatically increased the opportunity to evaluate the natural history of groin hernias. The present study aimed to evaluate the incidence of emergency hernia surgery in a large cohort of patients that were selected and were waiting for elective surgery. This is a retrospective cross-sectional cohort study including all patients evaluated and selected for elective groin hernia surgery at San Gerardo Hospital between 2017 and 2020. Elective and emergency hernia surgeries were recorded for all patients. The incidence of adverse events was also evaluated. Overall, 1423 patients were evaluated, and 964 selected patients (80.3%) underwent elective hernia surgery, while 17 patients (1.4%) required an emergency operation while waiting for an elective operation. A total of 220 (18.3%) patients were still awaiting surgery in March 2022. The overall cumulative risk levels for emergency hernia surgeries were 1%, 2%, 3.2%, and 5% at 12, 24, 36, and 48 months, respectively. There was no association between longer waiting periods and an increased need for emergency surgery. Our study indicates that up to 5% of patients with groin hernia require emergency surgery at 48 months from the evaluation; the increased waiting time for surgery for elective groin hernia repair was not associated with an increased incidence of adverse events.

Abstract Primary vasopressor efficacy of epinephrine during cardiopulmonary resuscitation (CPR) is due to its α-adrenergic effects. However, epinephrine plays β1-adrenergic actions, which increasing myocardial oxygen consumption may lead to refractory ventricular fibrillation (VF) and poor outcome. Effects of a single dose of esmolol in addition to epinephrine during CPR were investigated in a porcine model of VF with an underlying acute myocardial infarction. VF was ischemically induced in 16 pigs and left untreated for 12 min. During CPR, animals were randomized to receive epinephrine (30 µg/kg) with either esmolol (0.5 mg/kg) or saline (control). Pigs were then observed up to 96 h. Coronary perfusion pressure increased during CPR in the esmolol group compared to control (47 ± 21 vs. 24 ± 10 mmHg at min 5, p

In the history of the Dutch-Japanese relations, Shizuki Tadao is recognised as an extraordinary scholar. However, his translations of European books from Dutch into Japanese only paint a partial picture of his research. In fact, he also developed valuable theories on language that allowed the Japanese to better grasp Dutch. Furthermore, he introduced European grammatical concepts and terminology in Japan. A lesser-known interest of Shizuki was poetry, evidenced by three citations from the Dutch poet Jacob Cats (1577‑1660), found in Shizuki’s works on language, by two Dutch poems attributed to him, and by an additional indirect reference to Shizuki’s knowledge on the theory of poetry. The present article aims at better understanding the figure of Shizuki as a scholar of Dutch and to add a piece to the research on the spreading of Cats’ emblems.

Background: Cardiac rhabdomyomas (CRs) are the most common cardiac tumors in newborns. Approximately 80–90% of cases are associated with tuberous sclerosis complex (TSC). In selective cases, Everolimus has resulted in a remarkable tumoral regression effect in children with TS. The optimal dosage for neonates is still unknown. Case presentation: We describe the use of Everolimus in a neonate with multiple biventricular CRs, causing subaortic obstruction, in which a low-dose treatment (0.1 mg/die), in an effort to maintain serum trough levels of 3–7 ng/mL, was successfully used off-label, without adverse effects. Conclusions: We showed that a low-dose Everolimus regimen may be an effective and safe treatment for CR regression in TS neonates, when the minimum therapeutic range was maintained.

Accurate forecast of aggregate end-users electric load profiles is becoming a hot topic in research for those main issues addressed in many fields such as the electricity services market. Hence, load forecast is an extremely important task which should be understood more in depth. In this research paper, the dependency of the day-ahead load forecast accuracy on the basis of the data typology employed in the training of LSTM has been inspected. A real case study of an Italian industrial load with samples recorded every 15 min for the year 2017 and 2018 was studied. The effect in the load forecast accuracy of different dataset cleaning approaches was investigated. In addition, the Generalised Extreme Studentized Deviate hypothesis testing was introduced to identify the outliers present in the dataset. The populations were constructed on the basis of an autocorrelation analysis that allowed for identifying a weekly correlation of the samples. The accuracy of the prediction obtained from different input dataset has been therefore investigated by calculating the most commonly used error metrics, showing the importance of data processing before employing them for load forecast.

Nowadays, Information and Communication Technology (ICT) infrastructures play a crucial role for human beings, providing essential services at astonishing speed. Nevertheless, such a centrality of those infrastructures attracts the interest of ill-motivated actors that target such infrastructures with cyberattacks that are every day more sophisticated and more disruptive. In this alarming context, selecting the optimal set of countermeasures represents a primary need to react against the appearance of potentially dangerous threats effectively. With the motivation to contribute to develop ing faster and more effective response capabilities against them, the paper at hand introduces a novel cybersecurity reaction methodology based on Artificial Immune Systems (AIS), for which the evolutionary computing paradigm has been adopted. By leveraging the outstanding properties of these bio-inspired techniques, the selected countermeasures to defeat cyberthreats through cloning and mutation phases in an effort to improve the quality of the solution from a quantitative perspective, being able to adjust the risk to which the assets of the protected system are exposed. Exhaustive experiments demonstrate the feasibility of the proposed approach, reducing the risk in a more than acceptable time lapse.

Boron (B) powder injection is a potential alternative to glow discharge boronization as a wall conditioning method for tokamaks. This technique is currently being studied in WEST experiments, during which B powder is injected by an Impurity Powder Dropper developed by PPPL. In order to interpret and analyse experimental trends, and to help develop future experiments, a modelling workflow using a boundary plasma simulation (SOLEDGE-EIRENE) and powder ablation simulation (Dust Injection Simulator) was developed and tested. The effect of adding a B neutral source to simulated deuterium + oxygen (D + O) plasmas was compared to experimental data from the WEST C5 campaign, where B powder was injected in a dedicated experiment. While the impact of B injection on radiated power ${P_{{\text{rad}}}}$ measurements at the upper divertor was similar, there were significant differences in measurements of ${P_{{\text{rad}}}}$ , outer strike point electron temperature $T_{\text{e}}^{{\text{OSP}}}$ and O-II line intensity at the lower divertor between experiment and simulation. This discrepancy suggests that those parameters were affected by phenomena not present in the simulations, with the most likely candidates being reduced D recycling and a reduced O sourcing from the divertor.

Global gyrokinetic simulations of electrostatic microturbulent transport for discharge # 166256 of the Large Helical Device stellarator in the presence of boron impurity show the co-existence of the ion temperature gradient (ITG) turbulence and trapped electron mode (TEM) turbulence before and during boron powder injection. ITG turbulence dominates in the core, whereas TEM dominates near the edge, consistent with the experimental observations. Linear TEM frequency increases from ${\sim}80$ kHz to ${\sim}100$ kHz during boron injection, and ITG frequency decreases from ${\sim}20$ kHz to ${\sim}13$ kHz, consistent with the experiments. The poloidal wave number spectrum is broad for both ITG (0–0.5 mm ^−1 ) and TEM (0–0.25 mm ^−1 ). The nonlinear simulations with boron impurity show a reduction in the heat conductivity compared to the case without boron. The comparison of the nonlinear transport before and during boron injection shows that the ion heat transport is substantially reduced in the region where the TEM is dominant. However, the average electron heat transport throughout the radial domain and the average ion heat transport in the region where the ITG is dominant are similar. The simulations with boron show the effective heat conductivity values qualitatively agree with the estimate obtained from the experiment.

Recently an improved confinement regime, characterized by reduced turbulent fluctuations has been observed in the Large Helical Device upon the injection of boron powder into the plasma (Nespoli et al 2022 Nat. Phys. 18 350–56). In this article, we report in more detail the experimental observations of increased plasma temperature and the decrease of turbulent fluctuations across the plasma cross section, on an extended database. In particular, we compare powders of different materials (B, C, BN), finding similar temperature improvement and turbulence response for the three cases. Modeling of the powder penetration into the plasma and of neoclassical electric field and fluxes support the interpretation of the experimental results. Additionally, we report evidence of the temperature improvement increasing with powder injection rates and decreasing for both increasing density and heating power. Though, plasma turbulence response varies depending on the initial conditions of the plasma, making it difficult to draw an inclusive description of the phenomenon.

Very-short-term photovoltaic power forecast, namely nowcasting, is gaining increasing attention to face grid stability issues and to optimize microgrid energy management systems in the presence of large penetration of renewable energy sources. In order to identify local phenomena as sharp ramps in photovoltaic production, whole sky images can be used effectively. The first step in the implementation of new and effective nowcasting algorithms is the identification of Sun positions. In this paper, three different techniques (solar angle-based, image processing-based, and neural network-based techniques) are proposed, described, and compared. These techniques are tested on real images obtained with a camera installed at SolarTechLab at Politecnico di Milano, Milan, Italy. Finally, the three techniques are compared by introducing some performance parameters aiming to evaluate of their reliability, accuracy, and computational effort. The neural network-based technique obtains the best performance: in fact, this method is able to identify accurately the Sun position and to estimate it when the Sun is covered by clouds.

Abstract In the context of a pilot project, the Lugaggia Innovation Community (LIC), we address the problem of non-intrusive load monitoring for the purpose of demand side management on low voltage grids in presence of distributed power generation (photovoltaic). From the power readings of smart meters, we estimate the photovoltaic production and detect the activation of major loads (heatpumps and domestic water heaters). Experiments, conducted with real data and in silico, show that exploiting meter readings only, we can estimate PV production with MAPE ranging from 4.6% (best case) to 41.9% (worst case). Even with non negligible photovoltaic production estimation errors, the proposed method is capable of detecting the activation of heatpumps and domestic water heaters.

The increasing penetration of non-programmable renewable energy sources (RES) is enforcing the need for accurate power production forecasts. In the category of hydroelectric plants, Run of the River (RoR) plants belong to the class of non-programmable RES. Data-driven models are nowadays the most widely adopted methodologies in hydropower forecast. Among all, the Artificial Neural Network (ANN) proved to be highly successful in production forecast. Widely adopted and equally important for hydropower generation forecast is the HYdrological Predictions for the Environment (HYPE), a semi-distributed hydrological Rainfall–Runoff model. A novel hybrid method, providing HYPE sub-basins flow computation as input to an ANN, is here introduced and tested both with and without the adoption of a decomposition approach. In the former case, two ANNs are trained to forecast the trend and the residual of the production, respectively, to be then summed up to the previously extracted seasonality component and get the power forecast. These results have been compared to those obtained from the adoption of a ANN with rainfalls in input, again with and without decomposition approach. The methods have been assessed by forecasting the Run-of-the-River hydroelectric power plant energy for the year 2017. Besides, the forecasts of 15 power plants output have been fairly compared in order to identify the most accurate forecasting technique. The here proposed hybrid method (HYPE and ANN) has shown to be the most accurate in all the considered study cases.

Hotel architectural design plays a critical role in the hospitality experiences of consumers, and it is important to consider that people may have different aesthetic cognitions toward the sensory properties of nature (i.e., the architecture of the hotel), such as its color and texture, as well as the landscape. While neuroaesthetics has emerged as a nascent field in hospitality research, few studies have investigated how nature reflects aesthetic experiences in the human brain. Moreover, the neuroaesthetic interpretation of architecture through the aesthetic triad is a novel interdisciplinary field. A field survey conducted at Amanfayun, a hotel in Hangzhou, China, in support of our propositions proves that sensory-motor, knowledge-meaning, and emotion valuation systems play key roles in appreciating architectural aesthetics. This study demonstrates that the evaluation of fluency, complexity, and naturalistic patterns of an architectural masterpiece is achieved through the sensory-motor systems. Our results also prove that familiarity, expectations, context, and cultural background directly affect the aesthetic knowledge of an individual and the meaning of architecture. Moreover, the interaction of sensory-motor and knowledge elements is uniformly moderated by the emotion valuation systems, resulting in a balanced appreciation of aesthetic architecture. Finally, the study reveals the central roles of culture and nature in cognitive rejuvenation.

Apresenta-se uma reflexão a respeito dos sentidos e possibilidades do “popular” nas práticas de educação em saúde, considerando a atual conjuntura de incertezas sociais e político-econômicas agravadas pela incidência da pandemia por Covid-19 no Brasil. Discute-se brevemente o uso do qualificativo “popular” na relação entre profissionais de saúde, serviços, academia e população, e destaca-se o contexto relativo aos modos de viver das classes populares na conjuntura de pandemia. Conclui-se em favor da importância da educação popular para uma contextualização das novas condições da vida humana.

Abstract Prenatal DA closure due to early maternal intake of high‐dose paracetamol and selective serotonin reuptake inhibitors. MC twin pregnancy uncomplicated by TTTS with discordant prenatal DA closure.