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Abstract Freiberg disease is a rare condition whose diagnosis requires a high clinical suspicion. Avascular necrosis of the metatarsal head progresses with articular collapse, leading to forefoot pain and limitation of the daily activities. Several surgical techniques have been described to address the disease, and since it is usually diagnosed in later-stages, most of them include joint-destructive procedures. The use of arthroscopy on the small joint of the foot has arisen in the last few years, but its application in Freiberg disease is still scant. Joint-preserving procedures have been advocated for cases of early-stage disease, aiming to relieve symptoms while preventing the progression of the disease. In the present report, we describe a successful treatment of a 12-year-old patient with early-stage Freiberg disease using core decompression and bone marrow graft through a minimally-invasive approach assisted by arthroscopy.

The usage of bio-fibres and recycled materials is a growing approach to address the ecological problems being faced today. Inspired by the guidelines defining the Waste for Life initiative, the present study reports new composite materials, based on the recycling of high-impact polystyrene, found, for instance in yogurt cups, and paper plastic laminates, deriving from disposable paper cups. Given their recycling incompatibility, paper plastic laminates are either dumped in landfills or incinerated after their first usage, threatening the environmental condition. Therefore, through the development of a new composite solution, the goal was to reduce this damaging environmental impact by providing a second life to both paper plastic laminates and high-impact polystyrene. Samples presented overall good mechanical properties, from which it is highlighted a Young’s Modulus of 1.75 GPa and a Tensile Strength of 21.2 MPa, encouraging the application of the present material to identified global obstacles.

Abstract We present a unified model where the same scalar field can drive inflation and account for the present dark matter abundance. This scenario is based on the incomplete decay of the inflaton field into right-handed neutrino pairs, which is accomplished by imposing a discrete interchange symmetry on the inflaton and on two of the right-handed neutrinos. We show that this can lead to a successful reheating of the Universe after inflation, while leaving a stable inflaton remnant at late times. This remnant may be in the form of WIMP-like inflaton particles or of an oscillating inflaton condensate, depending on whether or not the latter evaporates and reaches thermal equilibrium with the cosmic plasma. We further show that this scenario is compatible with generating light neutrino masses and mixings through the seesaw mechanism, predicting at least one massless neutrino, and also the observed baryon asymmetry via thermal leptogenesis.

Bone is an outstanding, well-designed composite. It is constituted by a multi-level structure wherein its properties and behavior are dependent on its composition and structural organization at different length scales. The combination of unique mechanical properties with adaptive and self-healing abilities makes bone an innovative model for the future design of synthetic biomimetic composites with improved performance in bone repair and regeneration. However, the relation between structure and properties in bone is very complex. In this review article, we intend to describe the hierarchical organization of bone on progressively greater scales and present the basic concepts that are fundamental to understanding the arrangement-based mechanical properties at each length scale and their influence on bone’s overall structural behavior. The need for a better understanding of bone’s intricate composite structure is also highlighted.

Aim: The purpose of this systematic literature review is to check papers to find the best method for measuring association between health interventions and productivity and find best intervention in workplace for increasing productivity. Method: This systematic review was performed based on PRISMA statement methodology and performed on all papers about association between productivity with intervention for increasing physical activity, published from 2007 until June 2017. The search was limited to English language items. Conclusion: The results of this systematic review demonstrate that providing interventions for workers in various workplaces have a low to high affecting on productivity, as measured by objective and organization specific metrics or subjective and self-report questionnaires. The Analyze of result showed that using different methods simultaneously can make more accuracy and precision. Also it’s better that before filling the self-report questionnaires researchers train all workers about the purpose of the study.

Musculoskeletal disorders are becoming an ever-growing societal burden and, as a result, millions of bone replacements surgeries are performed per year worldwide. Despite total joint replacements being recognized among the most successful surgeries of the last century, implant failure rates exceeding 10% are still reported. These numbers highlight the necessity of technologies to provide an accurate monitoring of the bone−implant interface state. This study provides a detailed review of the most relevant methodologies and technologies already proposed to monitor the loosening states of endoprosthetic implants, as well as their performance and experimental validation. A total of forty-two papers describing both intracorporeal and extracorporeal technologies for cemented or cementless fixation were thoroughly analyzed. Thirty-eight technologies were identified, which are categorized into five methodologies: vibrometric, acoustic, bioelectric impedance, magnetic induction, and strain. Research efforts were mainly focused on vibrometric and acoustic technologies. Differently, approaches based on bioelectric impedance, magnetic induction and strain have been less explored. Although most technologies are noninvasive and are able to monitor different loosening stages of endoprosthetic implants, they are not able to provide effective monitoring during daily living of patients.

The use of fiber reinforced plastics has increased in the last decades due to their unique properties. Advantages of their use are related with low weight, high strength and stiffness. Drilling of composite plates can be carried out in conventional machinery with some adaptations. However, the presence of typical defects like delamination can affect mechanical properties of produced parts. In this paper delamination influence in bearing stress of drilled hybrid carbon+glass/epoxy quasi-isotropic plates is studied by using image processing and analysis techniques. Results from bearing test show that damage minimization is an important mean to improve mechanical properties of the joint area of the plate. The appropriateness of the image processing and analysis techniques used in the measurement of the damaged area is demonstrated.

ABSTRACT Synovial chondromatosis is a rare proliferative disease, characterized by the occurrence of metaplasia in the synovium of the joints. These lesions become pedunculated; with the evolution of the disease they become detached, leading to intra-articular loose-bodies. It occurs more frequently in males between the third and fifth decades of life, usually affecting large joints such as the knee and hip. Smaller joints, such as the ankle, are less frequently affected. Patients report articular pain, blockage, and limited range of motion caused by the loose fragments. As the disease progresses, the joint undergoes degenerative changes. This report describes a case of synovial chondromatosis of the ankle, treated by arthroscopy. The patient, a 59 year-old male, complained of pain and swelling of the left ankle. Physical evaluation showed limited tibiotarsal mobility (plantar flexion of 20° and dorsiflexion of 5°). After physical and imaging evaluation, the patient underwent ankle arthroscopy due to impingement of the joint, with limitation of mobility. Arthroscopic treatment allowed easy access to the joint, removal of loose bodies, and partial synovectomy, with low morbidity and early rehabilitation. The final prognosis was excellent.

This paper presents a mesoscale damage model for composite materials and its validation at the coupon level by predicting scaling effects in un-notched carbon-fiber reinforced polymer (CFRP) laminates. The proposed material model presents a revised longitudinal damage law that accounts for the effect of complex 3D stress states in the prediction of onset and broadening of longitudinal compressive failure mechanisms. To predict transverse failure mechanisms of unidirectional CFRPs, this model was then combined with a 3D frictional smeared crack model. The complete mesoscale damage model was implemented in ABAQUS®/Explicit. Intralaminar damage onset and propagation were predicted using solid elements, and in-situ properties were included using different material cards according to the position and effective thickness of the plies. Delamination was captured using cohesive elements. To validate the implemented damage model, the analysis of size effects in quasi-isotropic un-notched coupons under tensile and compressive loading was compared with the test data available in the literature. Two types of scaling were addressed: sublaminate-level scaling, obtained by the repetition of the sublaminate stacking sequence, and ply-level scaling, realized by changing the effective thickness of each ply block. Validation was successfully completed as the obtained results were in agreement with the experimental findings, having an acceptable deviation from the mean experimental values. [ABSTRACT FROM AUTHOR]

La supervivencia de la tortuga verde y su éxito reproductivo resultan obstaculizados por múltiples factores durante todo su ciclo de vida. La etapa reproductiva, en particular, es un proceso de muy alto riesgo. Las características y la influencia del hombre en las diferentes etapas del ciclo reproductivo, constituyen incógnitas importantes. La aplicación de métodos de estimación de riesgo puede contribuir al conocimiento de los principales factores que afectan el ciclo reproductivo de las tortugas y cuáles pueden ser manejados con la finalidad de prever, controlar o mitigar dichos riesgos. El método de matriz de riesgo tridimensional puede contribuir a un análisis detallado por su carácter descriptivo de secuencias accidentales, así como un análisis semicuantitativo en la estimación del riesgo. El estudio permitió identificar 25 secuencias de fallo del ciclo distribuidas en cinco etapas. El balance de riesgos aporta dos riesgos muy altos y nueve riesgos altos para el ciclo de vida de estos quelonios. Se demuestra la influencia preponderante de factores humanos en los riesgos resultantes de la depredación y la contaminación del hábitat a lo largo de su ciclo de vida. Las defensas más efectivas para el control de los riesgos están relacionadas con mecanismos naturales de sobrevivencia de la especie mientras las medidas de protección implementadas por el hombre tienen poco impacto en la salvaguarda del ciclo reproductivo de las tortugas. La incorporación al patrón de riesgo modelado de mecanismos naturales de sobrevivencia, en forma de defensas constituye una novedad que permite extender el método al estudio de riesgo de otros ciclos naturales.

Highlights: • This study proposes the practical utility of an immersive Virtual Reality (VR) experience for the dissemination and study of Palaeolithic Rock Art. • Thanks to a series of multidisciplinary studies, a virtual reconstruction of the archaeological context of an area with rock art has been achieved. • The Palaeolithic lighting systems documented in Atxurra cave have been virtually recreated, allowing real-time interaction through VR. Abstract: The Upper Palaeolithic period (ca. 45000 - 12000 BP) was the time when figurative art chiefly produced by Homo sapiens emerged and developed. The Upper Palaeolithic rock art entails a multisensory experience that goes beyond depicted images observation: it includes aspects related to the cognitive development of human mind, the spatial dimensions, the type of rock surface, artificial lighting, and challenges of navigating the underground environment. Traditionally, the study of Palaeolithic art in caves has focused on paintings and illustrated subjects' graphic analysis. However, a recent shift in methodological focus has favoured a comprehensive and interdisciplinary study of rock art. This new perspective has allowed the investigation of surrounding elements that significantly influence the art and its interpretation. Combining this with new digital technologies, it is now possible to reconstruct Palaeolithic artistic creation and contemplation environments with precision, offering researchers an immersive and interactive experience through virtual reality (VR). The two documented Palaeolithic lighting systems in the sector J “Ledge of the Horses” have been virtually recreated. The lighting simulation parameters are based on those obtained from an anthracological study of the charcoal remains found in the cave and the subsequent experimental program. The study included analysing both three-dimensional (3D) models of the cave, obtained through photogrammetry and laser scanning, and the lighting systems in the graphics engine ©Unreal Engine 5; this allowed the researchers to create an interactive VR environment that faithfully reflects the current state of scientific knowledge about the cavity. Using VR is a substantial methodological advancement, regarding both knowledge transmission and the creation of more robust and coherent archaeological interpretations through sensory perception and historical empathy. This approach has been applied to the main decorated sector of the Atxurra Cave (Basque Country, Spain), a space containing dozens of engraved and painted representations, and surface archaeological material, subjected to a comprehensive multidisciplinary study.

Abstract Metabolic and bariatric surgery (MBS) is widely considered the most effective option for treating obesity, a chronic, relapsing, and progressive disease. Recently, the American Society of Metabolic and Bariatric Surgery (ASMBS) and the International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO) issued new guidelines on the indications for MBS, which have superseded the previous 1991 National Institutes of Health guidelines. The aim of this study is to establish the first set of consensus guidelines for selecting procedures in Class I and II obesity, using an Expert Modified Delphi Method. In this study, 78 experienced bariatric surgeons from 32 countries participated in a two-round Modified Delphi consensus voting process. The threshold for consensus was set at an agreement or disagreement of ≥ 70.0% among the experts. The experts reached a consensus on 54 statements. The committee of experts reached a consensus that MBS is a cost-effective treatment option for Class II obesity and for patients with Class I obesity who have not achieved significant weight loss through non-surgical methods. MBS was also considered suitable for patients with Type 2 diabetes mellitus (T2DM) and a body mass index (BMI) of 30 kg/m2 or higher. The committee identified intra-gastric balloon (IGB) as a treatment option for patients with class I obesity and endoscopic sleeve gastroplasty (ESG) as an option for patients with class I and II obesity, as well as for patients with T2DM and a BMI of ≥ 30 kg/m2. Sleeve gastrectomy (1) and Roux-en-Y gastric bypass (RYGB) were also recognized as viable treatment options for these patient groups. The committee also agreed that one anastomosis gastric bypass (OAGB) is a suitable option for patients with Class II obesity and T2DM, regardless of the presence or severity of obesity-related medical problems. The recommendations for selecting procedures in Class I and II obesity, developed through an Expert Modified Delphi Consensus, suggest that the use of standard primary bariatric endoscopic (IGB, ESG) and surgical procedures (SG, RYGB, OAGB) are acceptable in these patient groups, as consensus was reached regarding these procedures. However, randomized controlled trials are still needed in Class I and II Obesity to identify the best treatment approach for these patients in the future.

This study focuses on the relationship between hotel sites (current and planned) and exposure to hurricanes in Cuba. The hypothesis focused on demonstrating that Cuban tourist areas have differing degrees of exposure to tropical cyclones according to the month. The results indicate that although the whole Cuban archipelago is exposed to hurricanes, the tourist regions in Cuba’s western provinces have a greater chance of being affected than those located in the center, east, and south. The tourism development that will take place by 2030 in Cuba includes significant hotel expansion in coastal areas that are highly exposed to hurricanes. Information on the risk of hurricanes in tourist regions provides information that could enable the creation of the organizational conditions needed to tackle these phenomena in the short to medium term and to refine spatial and tourism planning approaches in the long term.

Bone is an outstanding, well-designed composite. It is constituted by a multi-level structure wherein its properties and behavior are dependent on its composition and structural organization at different length scales. The combination of unique mechanical properties with adaptive and self-healing abilities makes bone an innovative model for the future design of synthetic biomimetic composites with improved performance in bone repair and regeneration. However, the relation between structure and properties in bone is very complex. In this review article, we intend to describe the hierarchical organization of bone on progressively greater scales and present the basic concepts that are fundamental to understanding the arrangement-based mechanical properties at each length scale and their influence on bone's overall structural behavior. The need for a better understanding of bone's intricate composite structure is also highlighted. [ABSTRACT FROM AUTHOR]

Background/Objectives: This study investigated the impact of the FLUYE school-based intervention on children’s lifestyle behaviors, Mediterranean diet adherence, and emotional well-being in Spain. The objective was to promote healthy habits through nutrition education, physical activity, and emotional support within the school environment, with a focus on addressing the needs of both normal-weight and overweight/obese children. Methods: A total of 552 children aged 3 to 12 years participated in the study, with data collected at baseline (T0) and follow-up (T1). The intervention was designed to integrate health education into the school curriculum, emphasizing the development of personal competencies in diet, physical activity, and emotional well-being. The analysis included changes in dietary habits, screen time, physical activity, and psychosocial outcomes, with comparisons made between the normal-weight and overweight/obese groups. Results: Significant improvements were observed in water consumption and reductions in sugar-sweetened beverage intake across both weight groups. However, an increase in screen time, particularly among normal-weight children, highlighted ongoing challenges in reducing sedentary behavior. Adherence to the Mediterranean diet improved more significantly in the overweight/obese group, suggesting the program’s effectiveness in promoting healthier eating patterns among at-risk children. Emotional well-being and self-esteem also saw significant enhancements, with children reporting increased feelings of pride and positivity post-intervention. Conclusions: The FLUYE program effectively improved various aspects of children’s lifestyle behaviors, particularly in dietary habits and emotional well-being. These findings underscore the importance of comprehensive, school-based interventions that address both physical and psychosocial aspects of health, especially for children at higher risk for obesity.

Background: SmartAction-VR uses virtual reality to simulate daily life tasks and assess cognitive performance based on the multi-errand paradigm. This study explored whether this new task could provide insights into the executive functioning of children and adolescents with ADHD in their everyday activities. Methods: A cross-sectional study was conducted between November 2021 and December 2022. It consisted of one session and was divided into two parts (cognitive tests; and SmartAction-VR). The sample comprised 76 children and adolescents with a median age (IQR) of 13 (11–14) years and an age range of 9–17 years. Of these participants, 60.50% (n = 46) were males. Out of this sample, 40 participants were in the ADHD group and 36 were in the neurotypical group. The following instruments were used: Waisman Activities of Daily Living Scale, Assessment of Sensory Processing and Executive Functioning, Pediatric Simulator Disease Questionnaire, Digit span subtest, Stroop test, NEPSY-II Subtest of Auditory Attention and Cognitive Flexibility, Trail Making Test, Zoo Map Test, and SmartAction-VR. Results: The ADHD group demonstrated lower accuracy (U = 406, p = 0.010), higher values for total errors (U = 292, p = 0.001), more commissions (U = 417, p = 0.003), new actions (U = 470, p = 0.014), and forgetting actions (U = 406, p = 0.010), as well as fewer perseverations compared to the neurotypical group (U = 540.5, p = 0.029). Additionally, participants who forgot more actions were found to have lower independence in daily life (r = −0.281, p = 0.024). Conclusions: The correlations between the results of SmartAction-VR and activities of daily living, as well as cognitive tests, suggest that this new task could be useful for evaluating executive functioning in daily life.

Abstract Atxurra cave has a decorated assemblage composed of more than a hundred engraved animal depictions. All of them are located in deep parts of the cave and most of them are hidden in raised areas, away from the main path. The main sector is the “Ledge of the Horses”, located at 330 m from the entrance of the cave. It is a space of 12 m long and 1.5 m wide, elevated 4 m above the cave floor. This area includes almost fifty engraved and painted animals accompanied by a dozen flint tools, three fireplaces, and around one hundred charcoal fragments from torches. This extraordinary archaeological record allows us to value the complexity of the artistic production inside the caves during the Upper Palaeolithic. Our study has confirmed that there is planning prior to artistic production, both in terms of the iconographic aspects (themes, techniques, formats), its location (visibility, capacity), and the lighting systems. Furthermore, the data indicates the panel was decorated to be seen by third parties from different positions and was expressly illuminated for this purpose. This evidence supports the role of rock art as a visual communication system in Upper Palaeolithic societies.

Contrary to what was once thought, direct cancer originating from normal stem cells seems to be extremely rare. This is consistent with a preneoplastic period of telomere length reduction/damage in committed cells that becomes stabilized in transformation. Multiple observations suggest that telomere damage is an obligatory step preceding its stabilization. During tissue turnover, the telomeres of cells undergoing differentiation can be damaged as a consequence of defective DNA repair caused by endogenous or exogenous agents. This may result in the emergence of new mechanism of telomere maintenance which is the final outcome of DNA damage and the initial signal that triggers malignant transformation. Instead, transformation of stem cells is directly induced by primary derangement of telomere maintenance mechanisms. The newly modified telomere complex may promote survival of cancer stem cells, independently of telomere maintenance. An inherent resistance of stem cells to transformation may be linked to specific, robust mechanisms that help maintain telomere integrity.

Using large volumes of synthetic chemical fertilizers is a general practice in modern agriculture at a high economic and environmental cost. Biostimulants have become an alternative to this routine due to their ability to stimulate plant physiological processes without polluting soil and water. In Ecuador, however, little research has been carried out on the effect of biostimulants on the yield of crops of agricultural interest. The objective of this research was to determine the effect of foliar application of a biostimulant based on bovine manure vermicompost (VCLB) leachates on physiological variables and the yield of corn, cotton, and peanuts under field conditions and chard and five pepper hybrids in semi-protected cultivation under the agro-climatic conditions of the province of Manabí, Ecuador. The nine experiments carried out with the species and hybrids included various dilutions of VCLB and controls consisting of fertilization with nitrogen, phosphorus, and potassium, depending on the species, and soil without fertilizer. In all species, VCLB-induced plant length, chlorophyll content, and crop yield exhibit equal or higher statistical differences than those achieved under chemical fertilization (NPK). These results demonstrate the potential of this biostimulant as a sustainable alternative to produce these crops, reducing potentially the adverse effects of production on the environment under the tropical conditions of Manabí, Ecuador. We recommend corroborating these results with production-scale research.

El virus de la Necrosis Hipodérmica y Hematopoyética Infecciosa es responsable en los últimos 30 años del decrecimiento productivo y la baja supervivencia de algunas especies de camarones penaeidos cultivados. En la actualidad esta enfermedad es tema de discusión y análisis en numerosos foros internacionales, debido a su incremento en los últimos cinco años. A pesar de que la enfermedad no se encuentra presente en Cuba, existe una gran preocupación por parte de las autoridades competentes del país debido a los movimientos de organismos vivos y refrigerados que se realizan, dentro y desde fuera de la nación. El presente estudio se realizó con el objetivo de determinar líneas de bioseguridad específicas para este virus en el cultivo del camarón Penaeus vannamei. Aunque los métodos matriciales son comunes en los análisis de riesgo biológico, el de matriz de riesgo tridimensional, resulta más abarcador por incluir el rol de las defensas en las secuencias accidentales que representan la introducción y propagación de la enfermedad. Para aplicar el método se empleó el código SECURE-MR-FMEA. Los resultados identifican los riesgos más contribuyentes para la camaronicultura en el escenario de Cuba, basados en la degradación de las defensas que caracterizan las buenas prácticas en un caso ideal, así como describen las medidas de defensa más trascendentes en dichas condiciones. El empleo del método y sus resultados constituyen una novedad en el campo de las investigaciones de bioseguridad. La investigación contribuye a la preparación de una estrategia de bioseguridad específica para esta patología del camarón, que constituye un importante riesgo económico para este rubro productivo. Recibido: 21.02.2023 Aceptado: 22.07.2023 Editor: Laida Ramos Trujillo