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Background: Current management practices and outcomes in weaning from invasive mechanical ventilation are poorly understood. We aimed to describe the epidemiology, management, timings, risk for failure, and outcomes of weaning in patients requiring at least 2 days of invasive mechanical ventilation. Methods: WEAN SAFE was an international, multicentre, prospective, observational cohort study done in 481 intensive care units in 50 countries. Eligible participants were older than 16 years, admitted to a participating intensive care unit, and receiving mechanical ventilation for 2 calendar days or longer. We defined weaning initiation as the first attempt to separate a patient from the ventilator, successful weaning as no reintubation or death within 7 days of extubation, and weaning eligibility criteria based on positive end-expiratory pressure, fractional concentration of oxygen in inspired air, and vasopressors. The primary outcome was the proportion of patients successfully weaned at 90 days. Key secondary outcomes included weaning duration, timing of weaning events, factors associated with weaning delay and weaning failure, and hospital outcomes. This study is registered with ClinicalTrials.gov, NCT03255109. Findings: Between Oct 4, 2017, and June 25, 2018, 10 232 patients were screened for eligibility, of whom 5869 were enrolled. 4523 (77·1%) patients underwent at least one separation attempt and 3817 (65·0%) patients were successfully weaned from ventilation at day 90. 237 (4·0%) patients were transferred before any separation attempt, 153 (2·6%) were transferred after at least one separation attempt and not successfully weaned, and 1662 (28·3%) died while invasively ventilated. The median time from fulfilling weaning eligibility criteria to first separation attempt was 1 day (IQR 0–4), and 1013 (22·4%) patients had a delay in initiating first separation of 5 or more days. Of the 4523 (77·1%) patients with separation attempts, 2927 (64·7%) had a short wean (≤1 day), 457 (10·1%) had intermediate weaning (2–6 days), 433 (9·6%) required prolonged weaning (≥7 days), and 706 (15·6%) had weaning failure. Higher sedation scores were independently associated with delayed initiation of weaning. Delayed initiation of weaning and higher sedation scores were independently associated with weaning failure. 1742 (31·8%) of 5479 patients died in the intensive care unit and 2095 (38·3%) of 5465 patients died in hospital. Interpretation: In critically ill patients receiving at least 2 days of invasive mechanical ventilation, only 65% were weaned at 90 days. A better understanding of factors that delay the weaning process, such as delays in weaning initiation or excessive sedation levels, might improve weaning success rates. Funding: European Society of Intensive Care Medicine, European Respiratory Society.

Background: While the pandemic brought many challenges and disruption to an individual’s life, it also presented individuals with the opportunity to develop coping strategies and seek changes in their lives. Brazilians experiencing that moment disclosed the uniqueness of learned lessons. Methods: A commentary written by the interviewers and transcription team of 93 interviews conducted with Brazilians living in Canada and their relatives living in Brazil, identified trends in the experiential learning acquired during the pandemic. The Bloom’s taxonomy framed the review of team’s insights about learned lessons and newest skills and organization of evidence within the domains of cognitive, affective, and psychomotor learning. Results: Overall, there was a significant number and diversity of evidence about new learning and successful strategies that the participants implemented that promoted opportunities for learning. Identified evidence was in the affective (n=26), psychomotor (n=11) and cognitive (n=8) domains. Learning occurred in the affective domain which contributed to new self-perception, expanded awareness, new life priorities, renewed humanistic thoughts, increased valorization of time, life, and interpersonal relations. Conclusions: The findings of the lessons learnt from Brazilian participants are significant and highlight the unique perspectives of the positive benefits that resulted from a negative experience due to the pandemic. The significance of this interesting set of evidence indicates that in a near future the multidisciplinary community of scientists may definitively recalibrate the research focus and further explore how individuals learn and react during a pandemic.

Este estudo teve como tema a funcionalidade familiar em gestantes por considerar a família como um grande suporte e apoio social para a mulher no período gravídico-puerperal. Objetivou-se avaliar a funcionalidade familiar por meio do APGAR de Família descrevendo os domínios mais prevalentes referidos pelas gestantes. Estudo transversal com amostra composta por 66 grávidas. Observou-se uma média de idade de 29,8 anos, sendo a maioria com idade entre 18-35 anos (81,8%), raça não branca, escolaridade ensino médio, convivendo com companheiro e ocupação do lar. No tocante às relações familiares, houve maior prevalência de gestantes com famílias classificadas com boa funcionalidade familiar e os domínios que mais se destacaram nesse grupo foram o do “Partneship” e “Growth”, ambos com 83,7% nas famílias funcionais. Nas gestantes com disfuncionalidade familiar, prevaleceram os domínios “Affection”, “Partnership”, “Growth” e “Resolve”. Estes achados permitem a identificação precoce da disfuncionalidade familiar, com possibilidades de atuação da equipe multidisciplinar que atende essas gestantes, sobretudo aos domínios diretamente afetados.

Background Efficacy and safety of OAGB/MGB (one anastomosis/mini gastric bypass) have been well documented both as primary and as revisional procedures. However, even after OAGB/MGB, revisional surgery is unavoidable in patients with surgical complications or insufficient weight loss. Methods A questionnaire asking for the total number and demographics of primary and revisional OAGB/MGBs performed between January 2006 and July 2020 was e-mailed to all S.I.C. OB centres of excellence (annual caseload > 100; 5-year follow-up > 50%). Each bariatric centre was asked to provide gender, age, preoperative body mass index (BMI) and obesity-related comorbidities, previous history of abdominal or bariatric surgery, indication for surgical revision of OAGB/MGB, type of revisional procedure, pre- and post-revisional BMI, peri- and post-operative complications, last follow-up (FU). Results Twenty-three bariatric centres (54.8%) responded to our survey reporting a total number of 8676 primary OAGB/MGBS and a follow-up of 62.42 ± 52.22 months. A total of 181 (2.08%) patients underwent revisional surgery: 82 (0.94%) were suffering from intractable DGER (duodeno-gastric-esophageal reflux), 42 (0.48%) were reoperated for weight regain, 16 (0.18%) had excessive weight loss and malnutrition, 12 (0.13%) had a marginal ulcer perforation, 10 (0.11%) had a gastro-gastric fistula, 20 (0.23%) had other causes of revision. Roux-en-Y gastric bypass (RYGB) was the most performed revisional procedure (109; 54%), followed by bilio-pancreatic limb elongation (19; 9.4%) and normal anatomy restoration (19; 9.4%). Conclusions Our findings demonstrate that there is acceptable revisional rate after OAGB/MGB and conversion to RYGB represents the most frequent choice. Graphical abstract

Machine learning has proved invaluable for a range of different tasks, yet it also proved vulnerable to evasion attacks, i.e., maliciously crafted perturbations of inputs designed to force mispredictions. In this article we propose a novel technique to certify the security of machine learning models against evasion attacks with respect to an expressive threat model, where the attacker can be represented by an arbitrary imperative program. Our approach is based on a transformation of the model under attack into an equivalent imperative program, which is then analyzed using the traditional abstract interpretation framework. This solution is sound, efficient and general enough to be applied to a range of different models, including decision trees, logistic regression and neural networks. Our experiments on publicly available datasets show that our technique yields only a minimal number of false positives and scales up to cases which are intractable for a competitor approach.

Structured morning rounds have been used to improve communication, provide learning opportunities, and support patient care in various healthcare settings. The leadership team in an inner-city Inpatient Mental Health Unit identified a gap in the structure of morning rounds; to remedy this, a standardized reporting tool and structured morning rounding process were implemented. This short communication reports on an evaluation of staff...s perceptions on the outcomes of using a standardized reporting tool and structured rounding process to improve efficiency and communication regarding patient care among an interprofessional team. Feedback was provided on logistics, attendance, supporting factors that ensured ease of use for the new structure, and benefits of the program. While this evaluation focuses on the opinions of nurses, it serves as an example for leadership in various healthcare units on the benefits of a structured rounding program, and key factors that contribute to making the process successful. This short communication also provides an example for an efficient communication tool that can be adapted to meet the needs of various groups of healthcare disciplines.

As Information Retrieval (IR) researchers, we not only develop algorithmic solutions to hard problems, but we also insist on a proper, multifaceted evaluation of ideas. The IR literature on the fundamental topic of retrieval and ranking, for instance, has a rich history of studying the effectiveness of indexes, retrieval algorithms, and complex machine learning rankers and, at the same time, quantifying their computational costs, from creation and training to application and inference. This is evidenced, for example, by more than a decade of research on efficient training and inference of large decision forest models in Learning to Rank (LtR). As we move towards even more complex, deep learning models in a wide range of applications, questions on efficiency have once again become relevant with renewed urgency. Indeed, efficiency is no longer limited to time- and space-efficiency; instead it has found new, challenging dimensions that stretch to resource-, sample- and energy-efficiency with ramifications for researchers, users, and the environment. As a step towards bringing together experts from industry and academia and creating a forum for a critical discussion and the promotion of efficiency in the era of Neural Information Retrieval (NIR), we held the ReNeuIR workshop on July 15 th , 2022 as a hybrid event---in person in Madrid, Spain along with online attendees---in conjunction with ACM SIGIR 2022. Recognizing the importance of this topic, approximately 80 participants answered our call and attended the workshop over three sessions. The event included a total of two keynotes and eight paper presentations, and concluded with a lively discussion where participants helped identify gaps in existing research and brainstormed future research directions. We had consensus in recognizing that efficiency is not simply latency, that a holistic, concrete definition of efficiency is needed to guide researchers and reviewers alike, and that more research is necessary in the development of efficiency-centered evaluation metrics and standard benchmark datasets, platforms, and tools. Date: 15 July, 2022. Website: https://ReNeuIR.org.

This article explores the meaning and function of Lycurgus in Machiavelli’s thought. I show that, while the exemplarity of the mythical Spartan legislator progressively fades in Machiavelli’s thought in favour of the Roman model, Lycurgus’ reforms are central in Machiavelli’s works on two issues of primary importance: wealth and land distribution. In the first part of the article, I analyse Machiavelli’s use of the ancient sources on both Lycurgus and other Spartan legislators. I show how Machiavelli builds a selective and strategically balanced reading of the ancient sources to build the image of Lycurgus as a pro-popular ruler and of the subsequent Spartan reformers as followers not only of the mythical legislator generally, but also of his most controversial and popularly oriented attempts to reform property ownership in ancient Sparta. Lycurgus reveals how Machiavelli, far from seeing mixed government as the best form of government, promotes a strongly anti-aristocratic model. In the second part of the article, I show that in Machiavelli’s thought the Spartan question can largely be seen as a background for his reading of Roman history, particularly its most crucial, conflictual and controversial period, the Gracchi brothers’ attempt to achieve agrarian reform.

Background. Complete surgical resection represents one of the most important prognostic factors for thymomas. However, surgery is usually not considered when there is invasion of the pulmonary hilum and mediastinal veins because of technical considerations or potential perioperative morbidity and mortality. Case Presentation. We present the case of a 37-year-old woman with a giant thymoma infiltrating the superior vena cava, left brachiocephalic vein, and most of the right lung. Following 3 cycles of chemotherapy with minimal tumour response, she was hospitalised with COVID-19 and refused further systemic treatment. She subsequently underwent surgery after a thorough preoperative evaluation. Surgical resection of the tumour was performed with concomitant right pneumonectomy and reconstruction of the superior vena cava and left brachiocephalic vein using expanded-polytetrafluoroethylene grafts through a median sternotomy combined with a clamshell incision. Histopathological analysis of the resected specimens demonstrated a type B2, Masaoka-Koga stage IVa thymoma that was completely resected. Following an uneventful course, she was discharged home on the ninth postoperative day with anticoagulation therapy. She has remained free of disease or adverse events after a 12-month follow-up. Conclusions. Complete surgical resection of invasive thymomas with concomitant pneumonectomy and venous graft reconstruction is a feasible and safe procedure. Careful patient selection and adequate postoperative anticoagulation are crucial for successful clinical outcomes.

O objetivo deste estudo foi sistematizar o conhecimento acerca dos efeitos da má qualidade do sono no período pós-parto para a saúde da mulher. Trata-se de revisão integrativa da literatura, com coleta nas bases de dados PubMed®, LILACs e SciELO, em trabalhos publicados entre 2015 e 2020. Foram encontrados sete artigos, e foi alta a incidência de distúrbios do sono e sua relação com o comprometimento da qualidade de vida no puerpério. A má qualidade do sono constitui um agravo reversível na saúde da mulher pós-parto. Portanto, faz-se necessário o desenvolvimento de intervenções direcionadas à melhoria desses sintomas, em especial na redução do risco de transtornos mentais no período pós-parto.

Se presentan los resultados de un estudio con enfoque cualitativo, cuya intención fue indagar el sentido de la formación pedagógica e interpretar la vinculación entre la formación pedagógica y disciplinar en salud en dos universidades públicas. Se implementaron cuestionarios y entrevistas a docentes de carreras del área de salud en Argentina (n=18) y Chile (n=14). Se trabajó desde el método de las comparaciones constantes propuesto por Glaser y Strauss. Los resultados evidencian tres categorías de análisis: la formación pedagógica focalizada en diversos modos de referencia vinculados a la docencia; la formación pedagógica como una cuestión que se desplaza entre la intuición y la necesidad y la vinculación entre lo pedagógico y lo disciplinar. El estudio muestra la necesidad de potenciar la formación pedagógica y la vinculación entre lo pedagógico y disciplinar en el ejercicio de la docencia en educación superior en el área de salud.

El presente trabajo propone una lectura analítica de historias de vida, en clave de narrativas, de experiencias de maestrandos y egresados que incursionan durante el período 2020-2021 en la investigación educativa. Se funda en un enfoque interpretativo con herramientas metodológicas biográfico-narrativas de investigación en ciencias sociales. De este modo, la historia de vida se inscribe tanto como perspectiva socioantropológica de registro de diversa información proporcionada por los sujetos cuanto como género documental, aspecto este desde el cual se ponen de manifiesto sus caracteres discursivos. Los textos ofrecen en primera persona el recorte de un momento vital que -en el marco de la pandemia COVID-19- no solo se hace eco de este suceso de alto valor condicionante de futuras transformaciones, sino que además permite la posibilidad de reflexionar sobre las vivencias, contradicciones, interrogantes y aprendizajes que la experiencia del ingreso al equipo de investigación les permite construir como registro subjetivo.

Resumo O impacto da pandemia de COVID-19 está mudando drasticamente a vida das pessoas. O distanciamento social representa evitar o contato durante o surto de uma doença para minimizar a exposição. Essa condição também pode contribuir para o agravamento de determinados transtornos mentais. O presente estudo teve como objetivo avaliar em que medida características de personalidade e ansiedade social podem contribuir para uma maior dificuldade em lidar com o distanciamento social. Foram avaliados 1.120 indivíduos por meio da Escala de Ansiedade Social de Liebowitz (LSAS), marcadores da personalidade. A análise de regressão logística mostrou que neuroticismo, ansiedade social e as horas adicionais em casa revelaram-se preditores significativos de uma maior dificuldade. Conclui-se que o transtorno de ansiedade social apresenta especificidades em sua manifestação durante a pandemia.

O estudo objetivou construir um modelo de educação permanente em atenção a pacientes que tentaram suicídio destinado à equipe interdisciplinar de uma Unidade de Terapia Intensiva. Trata-se de uma Pesquisa Convergente-Assistencial (PCA) de análise qualitativa, aplicada à uma equipe multidisciplinar que atua com pacientes suicidas, na UTI de hospital do sudeste goiano, composta por 21 profissionais de diversas áreas de atuaçao. A pesquisa foi realizada em quatro fases: a) a concepção, b) a instrumentação, c) a perscrutação e d) a análise e interpretação dos resultados, sendo a primeira etapa o diagnóstico situacional. Por meio da análise de conteúdo, emergiu a categoria temática central, cuidado e concepção, constituída de três subcategorias, quais sejam: sentimentos; por quê? (base conceitual) e como cuida. A análise do material empírico utilizado no estudo resultou em duas categorias temáticas: autorreflexão e movimento e acolhimento/acompanhamento com profissionais. O uso de uma metodologia interventiva na realidade dos profissionais da área da saúde destacou a inovação no processo de educação permanente em saúde para profissionais atuantes em UTI. Sendo assim, concluiu-se que a PCA como método, resultou na inovação na assistência à pessoa que tentou o suicídio durante sua permanência na UTI.

Water rockets can be used in a variety of ways, from schools to planetariums, with very young kids or adults. We propose here simple forms to work with water rockets, going one step further than a simple launch. A smartphone can be used to film the launch and analyze its motion with video analysis or it can even be attached to the rocket, using its acceleration sensor. We present both experimental techniques, theory, and a discussion about the propelling phase of the rocket’s motion. The results show amazing features that are frequently neglected when discussing parabolic motion.

The management of nitrogen by the assessment of agronomic and environmental indicators ensures satisfactory productivity with higher environmental quality. The objective of this study was to propose more sustainable management of nitrogen use in wheat, considering the supply of full and fractioned doses with an estimate of technical, economic efficiency, and expected productivity. Two experiments were conducted, one to quantify biomass productivity and the other to evaluate grain yield. The experimental design consisted of a randomized block with four repetitions in a 5 × 3 factorial, for N-fertilizer doses (0, 30, 60, 90, and 120 kg ha-1) and nutrient supply form [full condition (100%) in the phenological stage V3 (the third leaf expanded); fractionated (70/30%) in the phenological stage V3/V6 (third and sixth leaf expanded) and; fractionated (70/30%) in the phenological stage V3/R1 (beginning of anthesis)], respectively. The most sustainable management of nitrogen in wheat was obtained with the expected yield rate of 3 t ha-1 by manual fertilization, with nitrogen supplied in full dose at the V3 phenological stage.

Aim: Critical virus reagents in regulated bioanalytical assays require stability monitoring. Although stability at ultra-low frozen temperatures is generally assumed, published data are limited and real-time studies are time consuming. Materials & methods: The authors reviewed literature data, typical mechanisms of molecular degradation, glass transition temperatures of commonly used buffers and available real-time storage data to model frozen virus reagent stability. Results: Storage at ultra-low temperatures below the glass transition temperature was critical for virus stability. Modeling of real-time data suggested that virus potency remained within 0.5 log10 of its starting potency at a probability of >99, 90 and 73% after 10, 20 and 30 years, respectively. Conclusion: The study supports the practice of virus storage at -70°C or below for 20–30 years.

Background and Objectives: Pulmonary hypertension (PH) secondary to left-sided valvular heart disease is associated with poor cardiac surgical outcome compared with patients without PH. Our objective was to investigate the prognostic factors of surgical outcome in patients with PH undergoing mitral valve (MV) and tricuspid valve (TV) surgery, in order to risk stratify their management. Materials and Methods: This is a retrospective observational study on patients with PH who underwent MV and TV surgery from 2011 to 2019. The primary outcome was all-cause mortality. The secondary outcomes were post-op respiratory and renal complications, length of intensive care unit stay and length of hospital stay. Results: Seventy-six patients were included in this study. The all-cause mortality was 13% (n = 10), with mean survival of 92.6 months. Among the patients, 9.2% (n = 7) had post-op renal failure requiring renal replacement therapy and 6.6% (n = 5) had post-op respiratory failure requiring intubation. Univariate analysis demonstrated that pre-operative left ventricular ejection fraction (LVEF), peak systolic tissue velocity at the tricuspid annulus (S’) and etiology of MV disease were associated with respiratory and renal failure. Tricuspid annular plane systolic excursion (TAPSE) was associated with respiratory failure only. S’, type of operation, LVEF, urgency of surgery, and etiology of MV disease were found to be predictive of mortality. After excluding redo mitral surgery, all statistically significant findings remain unchanged, with the addition of right ventricular (RV) size being associated with respiratory failure. In the subgroup analysis of routine cases (n = 56), patients with primary mitral regurgitation who underwent mitral valve repair had better survival outcome. Conclusions: Urgency of surgery, etiology of MV disease, type of operation (replacement or repair), S’ and pre-op LVEF are prognostic indicators in this small cohort of patients with PH undergoing MV and TV surgery. A larger prospective study is warranted to validate our findings.

Abstract: Oral candidiasis is an opportunistic infection of the oral mucosa sustained by fungi of the genus Candida. Various Candida species, with a predominance of C. albicans, normally a saprophyte of the oral cavity, may become virulent and infect the oral mucosa with variegated clinical presentation, in case of imbalance of the oral microbiota, the presence of local predisposing factors and systemic conditions that weaken the immune system. Conventionally, oral candidiasis eradication is done with the help of antifungal drugs. However, the growing phenomena of drug resistance and the increase in infections sustained by non-albicans species being less responsive to common antifungals have orientied researches towards the experimentation of alternative therapies. The present review considered the most promising alternative therapeutic proposals. The use of plant derivatives with phytotherapy is a promising option, such as probiotics, to rebalance the oral microbiota in case of dysbiosis. Finally, antimicrobial photodynamic therapy (aPDT), with highly selective fungicidal activity and free of side effects, is also being studied as a powerful alternative to drug administration. All these therapies are alternatives or supportive to the conventional treatment of recurrent and non-drug-responsive forms of oral candidiasis. However, further studies are needed to define the most active compounds, the efficacy of the therapies compared with the conventional ones, and the planning of regulated and standardized protocols.

UGUAGLIANZA ARITMETICA E UGUAGLIANZA GEOMETRICA: METAFORE DELLA GIUSTIZIA NELLA FILOSOFIA POLITICA E GIURIDICA MODERNA

Purpose Overweight and obesity affects 60% of adults causing more than 1.2 million deaths across world every year. Fight against involved different specialist figures and multiple are the approved weapons. Aim of the present survey endorsed by the Italian Society of Bariatric Surgery (SICOB) is to reach a national consensus on obesity treatment optimization through a Delphi process. Methods Eleven key opinion leaders (KOLs) identified 22 statements with a major need of clarification and debate. The explored pathways were: (1) Management of patient candidate to bariatric/metabolic surgery (BMS); (2) Management of patient not eligible for BMS; (3) Management of patient with short-term (2 years) weight regain (WR) or insufficient weight loss (IWL); (4) Management of the patient with medium-term (5 years) WR; and (5) Association between drugs and BMS as WR prevention. The questionnaire was distributed to 65 national experts via an online platform with anonymized results. Results 54 out of 65 invited panelists (83%) respond. Positive consensus was reached for 18/22 statements (82%); while, negative consensus (s20.4; s21.5) and no consensus (s11.5, s17) were reached for 2 statements, respectively (9%). Conclusion The Delphi results underline the importance of first-line interdisciplinary management, with large pre-treatment examination, and establish a common opinion on how to properly manage post-operative IWL/WR. Level of evidence V Report of expert committees.

Archaeological areas often become hotspots for biodiversity and refugia for plant species. The management activity of a site permits the conservation of natural habitats. This first contribution to the floristic assessment of an Iranian archaeological site, aims to preserve its natural values. The Pasargadae World Heritage Site (sixth century BC) located at the border between the Zagros mountains and the Irano-Turanian region, showed a richness of 244 species, belonging to 38 families and 163 genera. The most represented families are Asteraceae (56), Poaceae (34) and Fabaceae (22). Herbaceous species represented 90% of the flora [therophytes (42%), hemicryptophytes (39%) and geophytes (9%)]. Asiatic, Irano-Turanian and Mediterranean species are the most recurrent species with a high component of endemic ones. Astragalus ghashghaicus, Taraxacum plicatulum, Acantholimon serotinum and Linaria farsensis were among the more interesting floristic elements. The comparison with past data, even if limited in quantity, indicated a good floristic conservation status. This research also showed the need to deepen our knowledge of the taxonomic features of this Iranian flora, sometimes still resulting in an ambiguous or unresolved status. The collected floristic data will help in elaborating management protocols, to enhance the cultural and natural value of the site.

Objectives Oral lichen planus with exclusive keratotic reticular, papular, and/or plaque-like lesions (K-OLP) is a clinical pattern of OLP that may be associated with a complex symptomatology and psychological alteration. The aim of the study was to evaluate the prevalence of anxiety (A) and depression (D) in patients with K-OLP, analyzing the potential predictors which can affect mental health status. Methods Three hundred K-OLP patients versus 300 healthy controls (HC) were recruited in 15 Italian universities. The Numeric Rating Scale (NRS), Total Pain Rating Index (T-PRI), and Hamilton Rating Scales for Depression and for Anxiety (HAM-D and HAM-A) were administered. Results The K-OLP patients showed statistically higher scores in the NRS, T-PRI, HAM-D, and HAM-A compared with the HC (p-value **). A and D were found in 158 (52.7%) and 148 (49.3%) K-OLP patients. Strong linear correlations were identified between HAM-A, HAM-D, NRS, T-PRI, and employment status and between HAM-D, HAM-A, NRS, T-PRI, employment status, and female gender. Multivariate logistic regression revealed that HAM-D and HAM-A showed the greatest increase in the R2 value for A and D in the K-OLP patients, respectively (DR2 = 55.5% p-value p-value Conclusions The prevalence of A and D is higher in the K-OLP patients compared with the HC, also found in K-OLP subjects without pain, suggesting that the processing of pain may be in a certain way independent of the processing of mood. Clinical relevance Mood disorders and pain assessment should be carefully performed in relation to K-OLP to obtain a complete analysis of the patients.

Parkinson's disease (PD) is identified by the loss of dopaminergic neurons in the Substantia Nigra pars compacta (SNpc), and is correlated to aggregates of proteins such as α-synuclein, Lewy's bodies. Although the PD etiology remains poorly understood, evidence suggests a main role of oxidative stress on this process. Lippia grata Schauer, known as "alecrim-do-mato", "alecrim-de-vaqueiro", "alecrim-da-chapada", is a native bush from tropical areas mainly distributed throughout the Central and South America. This plant species is commonly used in traditional medicine for relief of pain and inflammation conditions, and that has proven antioxidant effects. We evaluated the effects of essential oil of the L. grata after its complexed with β-cyclodextrin (LIP) on PD animal model induced by reserpine (RES). Behavioral assessments were performed across the treatment. Upon completion the treatment, the animals were euthanized, afterwards their brains were isolated and processed for immunohistochemical and oxidative stress analysis. The LIP treatment delayed the onset of the behavior of catalepsy, decreased the number of oral movements and prevented the memory impairment on the novel object recognition task. In addition, the treatment with LIP protected against dopaminergic depletion in the SNpc and dorsal striatum (STRd), and decreased the α-syn immunoreactivity in the SNpc and hippocampus (HIP). Moreover, there was reduction of the oxidative stability index. These findings demonstrated that the LIP treatment has neuroprotective effect in a progressive parkinsonism model, suggesting that LIP could be an important source for novel treatment approaches in PD.

Introduction: The objective of the current study was to design and pilot-test a nonverbal intelligence test for children and adolescents with visual impairment (i.e., blindness and low vision) aged 10 to 16 years. Method: A three-dimensional haptic matrix test of nonverbal cognitive abilities (3-DHMT-CA), initially developed for adults with visual impairment, was adapted and administered to 25 juveniles with severe low vision or blindness and 25 sighted peers. The test consisted of 22 tactual matrices with a missing element, and juveniles were asked to understand the logical scheme underlying each matrix and to complete it. Convergent validity was assessed in the sighted group with the Standard Progressive Matrices. Divergent validity was measured with the Verbal Comprehension Index (VCI) and the Working Memory Index (WMI) of the Italian version of the Wechsler Intelligence Scale for Children–Fourth Edition. Between-group differences were analyzed with Student’s t-test and ANOVA. Results: Results show a high correlation with the convergent measure (with the Standard Progressive Matrices), and the moderate correlations with divergent measures (VCI and WMI). Between-group differences showed significantly higher scores for sighted peers than juveniles with visual impairment at 3-DHMT-CA, and non-significant differences at VCI and WMI. Discussion: This haptic nonverbal cognitive test showed good psychometric properties, but it needs to be validated in a larger sample with a qualitative analysis of solution strategies because juveniles with visual impairment seem to use different verbal and working memory strategies. Implications for Practitioners: The 3-DHMT-CA and the haptic two-hands modality seem to be suitable to test nonverbal cognitive abilities in juveniles with visual impairment. Practitioners should focus on empowering verbal and working memory abilities, since they may affect nonverbal cognitive abilities as well.

Urban rivers may perform important ecological roles and provide many ecosystem services, especially in urban contexts. Considering this, River Contracts were officially introduced in 2000, during the Second Forum of the World Water Council, as participative agreements aimed at managing the complexity of fluvial ecosystems. Collecting data on fluvial and riparian biodiversity, establishing ecological relationships among biological components, and evaluating their resistance and resilience to anthropic impacts are needed to assess the ecological sustainability of the anthropic actions. Here, we provide a review of literature and regulation on River Contracts, and a methodological contribution to the evaluation of different environmental components, their ecological connections, and the role of anthropic impacts. To address the aim, we performed a critical analysis of the existing data on the Tiber River close to Rome. We used the information to identify the actions that should be included in the Tiber River Contract to improve its natural value and its potential ecosystem services. Several areas emerged where information was lacking such as the human impact on these ecosystems. Data highlight the disappearance of rare Mediterranean species and of those linked to wetland habitats, as well as an increase in alien species and species typical of disturbed areas. Further research on biodiversity and management is required to support nature conservation.

In this contribution, new data concerning the distribution of vascular flora alien to Italy are presented. It includes new records, confirmations, exclusions for Italy or for Italian administrative regions. Nomenclatural and distribution updates, published elsewhere, and corrections are provided as Suppl. material 1.

With the ongoing integration of Machine Learning models into everyday life, e.g. in the form of the Internet of Things (IoT), the evaluation of learned models becomes more and more an important issue. Tree ensembles are one of the best black-box classifiers available and routinely outperform more complex classifiers. While the fast application of tree ensembles has already been studied in the literature for Intel CPUs, they have not yet been studied in the context of ARM CPUs which are more dominant for IoT applications. In this paper, we convert the popular QuickScorer algorithm and its siblings from Intel's AVX to ARM's NEON instruction set. Second, we extend our implementation from ranking models to classification models such as Random Forests. Third, we investigate the effects of using fixed-point quantization in Random Forests. Our study shows that a careful implementation of tree traversal on ARM CPUs leads to a speed-up of up to 9.4 compared to a reference implementation. Moreover, quantized models seem to outperform models using floating-point values in terms of speed in almost all cases, with a neglectable impact on the predictive performance of the model. Finally, our study highlights architectural differences between ARM and Intel CPUs and between different ARM devices that imply that the best implementation depends on both the specific forest as well as the specific device used for deployment., 12 pages, 2 figures, 4 algorithms

Resumo Objetivo Identificar os usuários de um Centro de Atenção Psicossocial que apresentam dependência de cuidador e seus fatores associados. Métodos Estudo ecológico, com coleta de dados secundários de prontuários de pessoas que vivem com transtorno mental, ocorrida no ano de 2018 em um Centro de Atenção Psicossocial no Centro-Oeste brasileiro. Na análise, usou-se como variável dependente “necessidade de cuidador”. Resultados Na amostra de 360 prontuários, houve prevalência do sexo feminino (220; 61,1%), idade entre 35 a 59 anos (190; 52,8%), tempo de tratamento ≤5 anos (164; 45,6%), cuidado exercido por família/amigos (162; 45,0%), diagnóstico principal de transtornos psicóticos (128; 35,6%) e em uso de antipsicóticos (275; 76,4%). Na análise múltipla, permaneceram associadas as variáveis ter escolaridade não letrado/fundamental (p=0,041), possuir transtorno psicótico (p=0,009) e usar antidepressivo (p=0,026). Conclusão O estudo apontou que fatores como ser do sexo masculino, possuir escolaridade não letrado/fundamental, ter transtorno psicótico e fazer uso de antidepressivo possuem maiores índices para dependência de cuidados e devem ser considerados e investigados pela equipe dos Centros de Atenção Psicossocial. Resumen Objetivo Identificar los usuarios de un Centro de Atención Psicosocial que presentan dependencia de cuidador y los factores asociados. Métodos Estudio ecológico, con recopilación de datos secundarios de historias clínicas de personas que viven con trastorno mental, realizada en el año 2018 en un Centro de Atención Psicosocial en la región Centro-Oeste brasileña. En el análisis, se utilizó como variable dependiente “necesidad de cuidador”. Resultados En la muestra de 360 historias clínicas, hubo prevalencia del sexo femenino (220; 61,1 %), edad entre 35 y 59 años (190; 52,8 %), tiempo de tratamiento ≤5 años (164; 45,6 %), cuidado ejercido por familia/amigos (162; 45,0 %), diagnóstico principal de trastornos psicóticos (128; 35,6 %) y en uso de antipsicóticos (275; 76,4 %). En el análisis múltiple, estuvieron asociadas las variables tener escolaridad no letrada/primaria (p=0,041), poseer trastorno psicótico (p=0,009) y tomar antidepresivos (p=0,026). Conclusión El estudio indicó que factores como ser de sexo masculino, tener escolaridad no letrada/primaria, tener trastorno psicótico y tomar antidepresivos poseen mayores índices para la dependencia de cuidados y deben ser considerados e investigados por el equipo de los Centros de Atención Psicosocial. Abstract Objective To identify users of a Psychosocial Care Center who have caregiver dependence and their associated factors. Method This is an ecological study, with collection of secondary data from medical records of people living with mental disorders, which occurred in 2018 in a Psychosocial Care Center in the Brazilian Midwest. In the analysis, the dependent variable “need for caregiver” was used as a dependent variable. Results In the sample of 360 medical records, there was a prevalence of women (220; 61.1%), aged between 35 and 59 years (190; 52.8%), treatment time ≤5 years (164; 45.6%), care provided by family/friends (162; 45.0%), main diagnosis of psychotic disorders (128; 35.6%) and antipsychotic use (275; 76.4%). In the multiple analysis, the variables non-literacy/elementary school (p=0.041), having psychotic disorder (p=0.009) and antidepressant (p=0.026) remained associated. Conclusion The study pointed out that factors such as being men, non-literate/elementary school, having a psychotic disorder and using antidepressants have higher rates of dependence on care and should be considered and investigated by the Psychosocial Care Center team.

Filming atomic motion within molecules is an active pursuit of molecular physics and quantum chemistry. A promising method is laser-induced Coulomb Explosion Imaging (CEI) where a laser pulse rapidly ionizes many electrons from a molecule, causing the remaining ions to undergo Coulomb repulsion. The ion momenta are used to reconstruct the molecular geometry which is tracked over time (i.e., filmed) by ionizing at an adjustable delay with respect to the start of interatomic motion. Results are distorted, however, by ultrafast motion during the ionizing pulse. We studied this effect in water and filmed the rapid “slingshot” motion that enhances ionization and distorts CEI results. Our investigation uncovered both the geometry and mechanism of the enhancement which may inform CEI experiments in many other polyatomic molecules.

Subsea pipeline repair connectors have been used in the oil & gas industry for many years and are considered a valid and safe way of repairing major damages and restoring the original pipeline condition in case of an emergency repair; they can also be used for tie-ins to allow extensions by connection of new pipeline sections to an existing one and they have an extensive track record mainly on carbon steel pipelines but are fit also for stainless steel and duplex pipelines. The increasing number of subsea pipelines with internal CRA cladding which have been deployed in recent years and are foreseen in the future poses new technological challenges since conventional sealing solutions are not suitable for or have limitations in this specific application: in this case the repair connector not only needs to be designed to be compliant with the sour product but it also needs to protect the pipeline carbon steel wall from coming into contact with the internal fluid. This paper presents a new concept of a pipeline repair connector that has been developed from the beginning specifically to target repairs on sour service lines and in particular on clad lines. This innovative repair connector is based on a metal to metal sealing technology that offers permanent repair without any reduction of the pipeline's internal diameter, provides a versatile diver/diver-less solution, can deal with multiple wall thicknesses and can also be applied to other types of pipelines, such as those for sour service with internal corrosion allowance since it can manage pipe wall thickness reduction over time. The design of the mechanical connector has been carried out in compliance with DNV pipeline codes after a comprehensive technology qualification testing campaign under DNV certification and focused on medium size pipes. A full-scale 26″ prototype connector has been designed and fabricated for completing the qualification testing program including all required pressure and loading conditions. FEM analyses of the testing configurations have been carried out for comparison with test data so to validate the FEM models and extend results to other sizes within a predefined range. The matching between the experimental data and FEM calculations has allowed setting up a Type Approval process with DNV and, after a design effort covering various pipeline sizes and types, the connector will be certified for a wide range of large bore pipelines and design conditions and be ready for release to the market.

International audience; We report results for XUV-IR two-photon ionization of Ar, Ne, NO, and O2, where an XUV attosecond pulse train is superimposed with a synchronized IR pulse, obtained at the ATTOLab laser facility using electron–ion coincidence 3D momentum spectroscopy. Temporally resolved photoelectron angular distributions providing angle-resolved time-delays for np ionization of Ar and Ne, achieved by reconstruction of attosecond beating by interference of two-photon transitions through a unified formalism (Joseph et al. in J Phys B At Mol Opt Phys 53:184007, 2020), are summarized. For inner valence XUV-IR dissociative photoionization of NO and O2 molecules, we report electron–ion kinetic energy correlation diagrams and disentangle the dissociative photoionization processes relying on parallel XUV experiments at Synchrotron SOLEIL. For ionization into the NO+(c3Π) ionic state, extending the formalism developed for single-photon ionization, we focus on photoelectron angular distributions averaged on the delay between the XUV and the IR field in the field frame, molecular frame, and electron frame of reference.

University INSPIRE Office of Flexible Learning recognizes that a large gap exists in the skills, knowledge, and expectations of first-year students transitioning from high school to university. As a result, the INSPIRE intersession learning courses were designed to help incoming first-year students transition into their first year of university. McMaster Research Shop collected feedback on the experiences of first and second-year McMaster University students to identify course topics and a structure that would be appropriate for INSPIRE courses.

Background Long-term care (LTC) homes have been disproportionately impacted during COVID-19. Purpose To explore the perspectives of stakeholders across Canada around implementing a palliative approach in LTC home during COVID-19. Methods Qualitative, descriptive design using one-to-one or paired semi-structured interviews. Results Four themes were identified: (1) the influence of the pandemic on implementing a palliative approach, (2) families are an essential part of implementing a palliative approach, (3) prioritizing advance care planning (ACP) and goals of care (GoC) discussions in anticipation of the overload of deaths and (4) COVID-19 highlighting the need for a palliative approach as well as several subthemes. Conclusion The COVID-19 pandemic influenced the implementation of a palliative approach to care, where many LTC homes faced an overwhelming number of deaths and restricted the presence of family members. A more concentrated focus on home-wide ACP and GoC conversations and the need for a palliative approach to care in LTC were identified.

Background: Onabotulinum toxin A (OnA) is a well-tolerated and effective treatment for chronic migraine (CM). However, based on research indications that incobotulinum toxin A (InA) would be equally effective, a Veterans’ Health Administration Medical Center mandated a 2-year trial of InA as more cost-effective alternative to OnA. Although InA is used for many similar indications as OnA, it is not Food and Drug Administration approved for treating CM, and complications occurred in several patients with CM following this treatment change. We conducted this retrospective analysis to evaluate differences in the efficacy of OnA and InA and identify the reasons for the adverse effects of InA in some of these patients. Methods: We performed a retrospective review of 42 patients who had been effectively treated with OnA and were then switched to InA. The differences between treatment responses to OnA and InA were assessed through the evaluation of pain on injection, number of headache days, and duration of action. Patients received injections at 10- to 13-week intervals. Those who reported excessive pain on injection of InA were switched back to OnA. Findings: Severe burning pain on injection was reported by 16 (38%) patients for InA only and by 1 (2%) patient for both InA and OnA. Neither migraine suppression nor the duration of effect was significantly different between OnA and InA. Conclusions: Reformulation of InA with a pH-buffered solution may eliminate the difference in pain on injection. InA would then be a good alternative to OnA for treating CM.

Resumo: Devem ser conhecidos e descritos cenários de má conduta acadêmica que envolvam mestrandos e doutorandos, para permitir a produção de evidências na gestão das melhores práticas pelas instituições formadoras. O objetivo deste estudo foi construir um instrumento de caracterização de condições sociodemográficas e de comportamento de estudantes de pós-graduação stricto sensu em cenários de má conduta acadêmica. O instrumento nomeado Questionário de Integridade Acadêmica foi construído após revisão da literatura do tema. A versão final do instrumento apresentou 13 questões de identificação, 12 cenários dispostos em sete áreas de importância do tema e uma questão aberta para livre expressão do participante. O alfa de Cronbach foi de 0,722. O instrumento obteve índice de confiabilidade relevante, podendo ser utilizado para avaliar o comportamento de mestrandos e doutorandos em cenários de má conduta acadêmica.