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This paper provides an introduction about multiobjective optimization concepts in uncertain environment with the aid of the Fuzzy Mathematical Programming paradigm. The goal is to present methodologies based on Fuzzy Mathematical Programming to solve Multiobjective Programming problems, which model optimization problems with several objective functions and, in many cases, conflicting ones. The article also presents an extensive survey of the classic bibliography in this area, such as the Evolutionary Algorithms for Multi-Objective Optimization (MOEAs), which presents a growing development of algorithms and applications in practical problems since the beginning of this century. Besides, one of the steps in modelling practical problems is to deal with the uncertainty in the real-world data and here we show some proposals that use the Fuzzy Sets Theory for this treatment.

The PROpel trial assessed the combination of olaparib+abiraterone acetate (AA) plus prednisone and androgen deprivation therapy (ADT) versus AA plus prednisone and ADT alone as first-line treatment for metastatic castration-resistant prostate cancer (mCPRP). To contextualize the progression free survival (PFS) benefit in PROpel, we performed a systematic review and quasi-individual patient data network meta-analysis on randomized controlled trials of first-line hormonal treatments for mCPRC. Meta-analysis was performed for the PROpel control arm and PREVAIL (enzalutamide) and COU-AA-302 (AA) treatment arms. Kaplan-Meier PFS curves were digitally reconstructed and differences in restricted mean survival time (ΔRMST) were computed. Combination therapy yielded longer PFS (24-mo ΔRMST 1.5 mo, 95% confidence interval 0.6-2.4) in comparison to novel hormonal treatments alone. However, the lack of mature overall survival data, higher complication rates, and higher health care costs are limitations of combination therapy. Ultimately, combining treatments, rather than molecularly targeted sequencing in cases of failure, might not be justified in unselected patients with mCRPC.Patient summaryA recent trial showed that for metastatic prostate cancer that does not respond to hormone treatment, combined therapy with two drugs (olaparib and abiraterone) may prolong survival free from cancer progression. We included these data in an analysis of three trials that confirmed a small benefit. This combination approach has higher complication rates and is more expensive, and longer-term results for overall survival are needed.

Reynolds-averaged Navier–Stokes simulations with submodels of turbulence, chemistry, fluid–surface interaction, and radiation are performed in this work to rebuild the internal ballistics of an experimentally tested hybrid rocket engine with paraffin and gaseous oxygen as propellants. Firstly, the effects of the prechamber and postchamber cavities at the initial, average, and final diameter of a reference burn are assessed to be negligible. Then, numerical simulations modeling the fuel shape change in space and time are compared to simulations performed at uniform port radius. The latter provide reasonable regression rate, pressure, and final grain profile predictions with reduced computational cost. On the other hand, the more computationally expensive fuel shape change simulations improve the model prediction capabilities providing a more accurate comparison with experimental data. The fuel shape change approach is finally applied with success to simulations of a throttled burn.

A single-crystal diamond sample grown by highpressure high temperature (HPHT) technique was used for the fabrication of a metal-semiconductor-metal photoconductor. The sample quality was evaluated by means of spectral photocurrent measurements highlighting the presence of a significant density of defect states within the diamond bandgap, responsible for trapmediated conduction mechanisms. The photoconductor was fully characterized under 6 MeV pulsed X-rays, sourced by a medical linear accelerator, in the 0.05 – 10 Gy and 1 – 6 Gy/min dose and dose-rate ranges, respectively. Photocurrent measurements performed with a conventional precision electrometer showed that the detector performance is strongly affected by charge-trapping phenomena, resulting in a sub-linear dependence with the doserate (power-law dependence with an exponent of 0.86). Measurements were repeated in the same experimental conditions by coupling the detector to a specifically developed gatedintegrator, allowing for a synchronous integration of photocurrent pulses (limited to 40 μs) centered on each impinging X-ray pulse. In this case, the detector photoresponse showed an excellent linearity with both the dose and the dose-rate (power-law dependence with 1.0009 ± 0.0004 and 1.009 ± 0.005 exponents, respectively). Significantly, the proposed synchronous integration technique is then able to mitigate the detrimental effect that defects have on detector performance. The proposed method paves therefore the way to the exploitation of HPHT-diamond as a lowcost alternative to single-crystal CVD-diamond for the fabrication of accurate and linear X-ray dosimeters.

Aims The Heart Failure Association of the European Society of Cardiology (HFA-ESC) proposed a definition of advanced heart failure (HF) that has not been validated, yet. We assessed its prognostic impact in a consecutive series of patients with high-risk HF. Methods and results The HELP-HF registry enrolled consecutive patients with HF and at least one high-risk 'I NEED HELP' marker, evaluated at four Italian centres between 1(st) January 2020 and 30(th) November 2021. Patients meeting the HFA-ESC advanced HF definition were compared to patients not meeting this definition. The primary endpoint was the composite of all-cause mortality or first HF hospitalization. Out of 4753 patients with HF screened, 1149 (24.3%) patients with at least one high-risk 'I NEED HELP' marker were included (mean age 75.1 +/- 11.5 years, 67.3% male, median left ventricular ejection fraction [LVEF] 35% [interquartile range 25%-50%]). Among them, 193 (16.8%) patients met the HFA-ESC advanced HF definition. As compared to others, these patients were younger, had lower LVEF, higher natriuretic peptides and a worse clinical profile. The 1-year rate of the primary endpoint was 69.3% in patients with advanced HF according to the HFA-ESC definition versus 41.8% in the others (hazard ratio [HR] 2.23, 95% confidence interval [CI] 1.82-2.74, p < 0.001). The prognostic impact of the HFA-ESC advanced HF definition was confirmed after multivariable adjustment for relevant covariates (adjusted HR 1.98, 95% CI 1.57-2.50, p < 0.001). Conclusions The HFA-ESC advanced HF definition had a strong prognostic impact in a contemporary, real-world, multicentre high-risk cohort of patients with HF.

We build a one-variable p-adic L-function attached to two Hida families of ordinary p-stabilised newforms f, g, interpolating the algebraic part of the central values of the complex L-series when f and g range over the classical specialisations of f, g on a suitable line of the weight space. The construction rests on two major results: an explicit formula for the relevant complex central L-values, and the existence of non-trivial Λ-adic Shintani liftings and Saito–Kurokawa liftings studied in a previous work by the authors. We also illustrate that, under an appropriate sign assumption, this p-adic L-function arises as a factor of a triple product p-adic L-function attached to f, g, and g.

Background: Adding immunotherapy to first-line chemotherapy might improve outcomes for patients with advanced or recurrent endometrial cancer. We aimed to compare carboplatin and paclitaxel versus avelumab plus carboplatin and paclitaxel as first-line treatment with avelumab given concurrent to chemotherapy and as maintenance after the end of chemotherapy. Methods: MITO END-3 is an open-label, randomised, controlled, phase 2 trial conducted at 31 cancer institutes, hospitals, and universities in Italy. Eligible patients were aged 18 years or older with histologically confirmed advanced (FIGO stage III–IV) or recurrent endometrial cancer, an Eastern Cooperative Oncology Group (ECOG) performance status of 0–1, and no previous systemic anticancer therapy as primary treatment for advanced or metastatic disease. Participants were randomly assigned (1:1) using a computerised minimisation procedure stratified by centre, histology, and stage at study entry, to either receive carboplatin (area under the curve [AUC] 5 mg/mL × min) and paclitaxel (175 mg/m2; standard group) intravenously every 3 weeks for six to eight cycles or avelumab (10 mg/kg intravenously) added to carboplatin and paclitaxel (experimental group) every 3 weeks and then every 2 weeks as a single maintenance treatment after the end of chemotherapy until disease progression or unacceptable toxicity. Patients, treating clinicians, and those assessing radiological examinations were not masked to study treatment. The primary endpoint was investigator-assessed progression-free survival, measured in the intention-to-treat (ITT) population. Patients who received at least one dose of study drug were included in the safety analysis. Experimental group superiority was tested with 80% power and one-tailed α 0·20. This trial is registered with ClinicalTrials.gov (NCT03503786) and EudraCT (2016–004403–31). Findings: From April 9, 2018, to May 13, 2021, 166 women were assessed for eligibility and 39 were excluded. 125 eligible patients were randomly assigned to receive carboplatin and paclitaxel (n=62) or avelumab plus carboplatin and paclitaxel (n=63) and included in the ITT population. The median follow-up was 23·3 months (IQR 13·2–29·6) and was similar between the two groups. 91 progression-free survival events were reported, with 49 events in 62 patients in the standard group and 42 events in 63 patients in the experimental group. The median progression-free survival was 9·9 months (95% CI 6·7–12·1) in the standard group and 9·6 months (7·2–17·7) in the experimental group (HR of progression or death 0·78 [60% CI 0·65–0·93]; one-tailed p=0·085). Serious adverse events were reported more frequently in the experimental group (24 vs seven events in the standard group); neutrophil count decrease was the most frequent grade 3–4 adverse event (19 [31%] of 61 patients in the experimental group vs 26 [43%] of 61 patients in the standard group). Two deaths occurred in the experimental group during treatment (one respiratory failure following severe myositis [possibly related to treatment] and one cardiac arrest [not related to treatment]). Interpretation: Adding avelumab to first-line chemotherapy deserves further testing in patients with advanced or recurrent endometrial cancer, although consideration of mismatch repair status is warranted.

Introduction: Despite successful therapy, acromegalic patients have reduced health-related quality of life (HRQoL) compared to healthy controls. Finding predictors of poor HRQoL can be crucial to improving these patients’ global health state. Aim: The primary objective of the study was to find out predictors of HRQoL. Secondary objectives were: (I) to determine correlations with AcroQoL subscales, and (II) to identify predictors for subscales. Materials and methods: In this cross-sectional study conducted in 2019 at the Messina Policlinic Hospital, 45 acromegalic patients were assessed at the Physical and Rehabilitative Medicine Ambulatory. During routine outpatient clinic attendances, the following questionnaires were administered: Acromegaly Quality of Life Questionnaire (AcroQoL), Patient-Assessed Acromegaly Symptom Questionnaire (PASQ), and Western Ontario and McMaster Universities Arthritis Index (WOMAC). We furthermore included the following variables obtained by medical record review: age, BMI, disease duration, previous surgery (Yes/No), previous radiotherapy (Yes/No), use of GH lowering medications (Yes/No), hypertension (Yes/No), diabetes mellitus (Yes/No), and biochemical control of the disease (Yes/No): immunoradiometric assays were employed to serum GH and IGF-1 measurements to identify biochemical control of the disease. Correlation between outcome measures and AcroQoL has been performed. Pearson’s r was calculated for continuous data following normal distribution (AcroQoL, PASQ, AcroQoL-B, AcroQoL-R, WOMAC-P), while Spearman’s rank order correlation was calculated for non-normally distributed data (WOMAC, WOMAC-F, WOMAC-S, AcroQoL-P) and point-biserial correlation for binary variables (biochemically controlled disease, use of GH lowering medications, radiotherapy, surgery). The same correlation analysis was performed for the AcroQoL subscales. Multiple linear regression with backwards, stepwise analysis was used to assess the influence on AcroQoL of correlated variables. Results: AcroQoL was strongly negatively correlated with PASQ (r=−0.700, prs (43)=−0.530, prs (43)=−0.518, pr (43)=−0.428, p=0.003], WOMAC-Stiffness [rs (43)=−0.393, p=0.007], and radiotherapy [r (43) =−0.314, p=0.035]. After univariate stepwise regression, PASQ was the strongest independent predictor of AcroQoL, with R2 of 0.392 [F (1,43)=27.695, p Conclusions: This study shows that the severity of painful symptoms is the most important predictor of HRQoL in patients with acromegaly; at the same time, acromegalic arthropathy leads to pain and to a variable amount of functional impairment, exerting great impact on the patient’s perception of his health status. Measure of the progression of arthropathy and symptomatic management could lead to a great HRQoL benefit.&nbsp

Background: Clinical and radiographic criteria are traditionally used to determine the need for surfactant therapy in preterm infants. Lung ultrasound is a bedside test that offers a rapid, radiation-free, alternative to this approach. Objective: To conduct a systematic review and meta-analysis to determine the accuracy of a lung ultrasound score (LUS) in identifying infants who would receive at least one surfactant dose. Secondary aims were to evaluate the predictive accuracy for ≥2 doses and the accuracy of a different image classification system based on three lung ultrasound profiles. Methods: PubMed, SCOPUS, Biomed Central, and the Cochrane library between January 2011 and December 2021 were searched. Full articles enrolling preterm neonates who underwent lung ultrasound to predict surfactant administration were assessed and analyzed following Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P) and QUADAS-2 guidelines. Results: Seven prospective studies recruiting 697 infants met the inclusion criteria. Risk of bias was generally low. Oxygen requirement, clinical and radiographic signs of respiratory distress syndrome were used as reference standards for surfactant replacement. The summary receiver operator characteristic (sROC) curve for LUS predicting first surfactant dose showed an area under the curve (AUC) = 0.88 (95% confidence interval [CI]: 0.82-0.91); optimal specificity and sensitivity (Youden index) were 0.83 and 0.81 respectively. Pooled estimates of sensitivity, specificity, diagnostic odds ratio, negative predictive value, and positive predictive value for LUS predicting the first surfactant dose were 0.89 (0.82-0.95), 0.86 (0.78-0.95), 3.78 (3.05-4.50), 0.92 (0.87-0.97), 0.79 (0.65-0.92). The sROC curve for the accuracy of Type 1 lung profile in predicting first surfactant dose showed an AUC of 0.88; optimal specificity and sensitivity were both 0.86. Two studies addressing the predictive accuracy of LUS for ≥2 surfactant doses had high heterogeneity and were unsuitable to combine in a meta-analysis. Discussion: Despite current significant variation in LUS thresholds, lung ultrasound is highly predictive of the need for early surfactant replacement. This evidence was derived from studies with homogeneous patient characteristics and low risk of bias.

Aim: ALK, ROS1, NTRK and RET gene fusions and MET exon 14 skipping alterations represent novel predictive biomarkers for advanced non-small-cell lung cancer (NSCLC). Therefore, testing patients for these genetic variants is crucial for choosing the best selective treatment. Over the last couple of decades, next-generation sequencing (NGS) platforms have emerged as an extremely useful tool for detecting these variants. Materials & methods: In the present study, we report our NGS molecular records produced during a year of diagnostic activity. Results: Overall, our in-house developed NGS workflow successfully analyzed n = 116/131 (88.5%) NSCLC samples. Of these, eight (6.8%) and five (4.3%) out of 116 patients harbored ALK and RET gene rearrangements, respectively: one case harbored ROS1 gene fusion (0.7%). Conclusion: Our results highlight that an RNA-based NGS analysis can reliably detect gene fusion alterations, thereby playing a pivotal role in the management of NSCLC patients.

Tomographic flow cytometry by digital holography is an emerging imaging modality capable of collecting multiple views of moving and rotating cells with the aim of recovering their refractive index distribution in 3D. Although this modality allows us to access high-resolution imaging with high-throughput, the huge amount of time-lapse holographic images to be processed (hundreds of digital holograms per cell) constitutes the actual bottleneck. This prevents the system from being suitable for lab-on-a-chip platforms in real-world applications, where fast analysis of measured data is mandatory. Here we demonstrate a significant speeding-up reconstruction of phase-contrast tomograms by introducing in the processing pipeline a multi-scale fully-convolutional context aggregation network. Although it was originally developed in the context of semantic image analysis, we demonstrate for the first time that it can be successfully adapted to a holographic lab-on-chip platform for achieving 3D tomograms through a faster computational process. We trained the network with input-output image pairs to reproduce the end-to-end holographic reconstruction process, i.e. recovering quantitative phase maps (QPMs) of single cells from their digital holograms. Then, the sequence of QPMs of the same rotating cell is used to perform the tomographic reconstruction. The proposed approach significantly reduces the computational time for retrieving tomograms, thus making them available in a few seconds instead of tens of minutes, while essentially preserving the high-content information of tomographic data. Moreover, we have accomplished a compact deep convolutional neural network parameterization that can fit into on-chip SRAM and a small memory footprint, thus demonstrating its possible exploitation to provide onboard computations for lab-on-chip devices with low processing hardware resources.

To favor the usage of Machine Learning (ML) techniques in High-Energy Physics (HEP) analyses it would be useful to have a service allowing to perform the entire ML pipeline (in terms of reading the data, training a ML model, and serving predictions) directly using ROOT files of arbitrary size from local or remote distributed data sources. The MLaaS4HEP framework aims to provide such kind of solution. It was successfully validated with a CMS physics use case which gave important feedback about the needs of analysts. For instance, we introduced the possibility for the user to provide pre-processing operations, such as defining new branches and applying cuts. To provide a real service for the user and to integrate it into the INFN Cloud, we started working on MLaaS4HEP cloudification. This would allow to use cloud resources and to work in a distributed environment. In this work, we provide updates on this topic, and in particular, we discuss our first working prototype of the service. It includes an OAuth2 proxy server as authentication/authorization layer, a MLaaS4HEP server, an XRootD proxy server for enabling access to remote ROOT data, and the TensorFlow as a Service (TFaaS) service in charge of the inference phase. With this architecture the user is able to submit ML pipelines, after being authenticated and authorized, using local or remote ROOT files simply using HTTP calls

Background: Breast cancer is the most common malignancy in women, with high morbidity and mortality. Molecular alterations in breast cancer involve the expression or upregulation of various molecular targets that can be used for diagnostic nuclear medicine imaging and radiopharmaceutical treatment. Theragnostics is based on the binding of radionuclides to molecular targets. These radionuclides can induce a cytotoxic effect on the specific tumor cell (target) or its vicinity, thus allowing a personalized approach to patients with effective treatment and comparably small side effects. Aim: This review aims to describe the most promising molecular targets currently under investigation for theragnostics and precision oncology in breast cancer. Methods: A comprehensive literature search of studies on theragnostics in breast cancer was performed in the PubMed, PMC, Scopus, Google Scholar, Embase, Web of Science, and Cochrane library databases, between 2010 and 2022, using the following terms: breast neoplasm*, breast, breast cancer*, theragnostic*, theranostic*, radioligand therap*, RLT, MET, FLT, FMISO, FES, estradiol, trastuzumab, PD-L1, PSMA, FAPI, FACBC, fluciclovine, FAZA, GRPR, DOTATOC, DOTATATE, CXC4, endoglin, gastrin, mucin1, and syndecan1. Results: Fifty-three studies were included in the systematic review and summarized in six clinical sections: 1) human epidermal growth factor receptor 2 (HER2); 2) somatostatin receptors (SSTRS); 3) prostate-specific membrane antigen radiotracers (PSMA); 4) fibroblast activation protein-α targeted radiotracers; 5) gastrin-releasing peptide receptor-targeted radiotracers; 6) other radiotracers for theragnostics. Conclusion: The theragnostic approach will progressively allow better patient selection, and improve the prediction of response and toxicity, avoiding unnecessary and costly treatment.

Brown adipose tissue (BAT) controls mammalian core body temperature by non-shivering thermogenesis. BAT is extraordinarily rich in mitochondria, which have the peculiarity of generating heat by uncoupled respiration. Since the mitochondrial activity of BAT is subject to cycles of activation and deactivation in response to environmental temperature changes, an integrated mitochondrial quality control (MQC) system is of fundamental importance to ensure BAT physiology. Here, we provide an overview of the conventional and alternative mechanisms through which thermogenic adipocytes selectively remove damaged parts of mitochondria and how macrophages participate in the MQC system by removing extracellular mitochondrial waste to maintain the thermogenic function of BAT.

Background: Bilateral kidney stones are commonly treated in staged procedures. Objective: To evaluate outcomes after same-sitting bilateral retrograde intrarenal surgery (SSB-RIRS) for renal stones. Design, setting, and participants: Data from adults who underwent bilateral RIRS in 21 centers were retrospectively reviewed (from January 2015 to June 2022). The inclusion criteria were unilateral/bilateral symptomatic bilateral stone(s) of any size/location in both kidneys and bilateral stones on follow-up with symptom/stone progression. Stone-free rate (SFR) was defined as absence of any fragment >3 mm at 3 mo. Outcome measurements and statistical analysis: Continuous variables are presented as medians and 25–75th percentiles. A multivariable logistic regression analysis was performed to evaluate independent predictors of sepsis and bilateral SFR. Results and limitations: A total of 1250 patients were included. The median age was 48.0 (36–61) yr. Of the patients, 58.2% were prestented. The median stone diameter was 10 mm on both sides. Multiple stones were present in 45.3% and 47.9% of the left and right kidneys, respectively. Surgery was stopped in 6.8% of cases. The median surgical time was 75.0 (55–90) min. Complications were transient fever (10.7%), fever/infection needing prolonged stay (5.5%), sepsis (2%), and blood transfusion (1.3%). Bilateral and unilateral SFRs were 73.0% and 17.4%, respectively. Female (odds ratio [OR] 2.97, 95% confidence interval [CI] 1.18–7.49, p = 0.02), no antibiotic prophylaxis (OR 5.99, 95% CI 2.28–15.73, p < 0.001), kidney anomalies (OR 5.91, 95% CI 1.96–17.94, p < 0.001), surgical time ≥100 min (OR 2.86, 95% CI 1.12–7.31, p = 0.03) were factors associated with sepsis. Female (OR 1.88, 95% CI 1.35–2.62, p < 0.001), bilateral prestenting (OR 2.16, 95% CI 1.16–7.66, p = 0.04), and the use of high-power holmium:YAG laser (OR 1.63, 95% CI 1.14–2.34, p < 0.01) and thulium fiber laser (OR 2.50, 95% CI 1.32–4.74, p < 0.01) were predictors of bilateral SFR. Limitations were retrospective study and no cost analysis. Conclusions: SSB-RIRS is an effective treatment with an acceptable complication rate in selected patients with kidney stones. Patient summary: In this large multicenter study, we looked at outcomes after same-sitting bilateral retrograde intrarenal surgery (SSB-RIRS) for renal stones in a large cohort. We found that SSB-RIRS was associated with acceptable morbidity and good stone clearance after a single session.

In the present work, we discuss the employment of a computational fluid dynamics approach to evaluate the specific impulse of solid rocket motors. Particular care is focused on two-phase flow and divergence losses, which represent the most important contributions to the overall nozzle performance loss. A comprehensive parametric study is performed on the Zefiro 9A nozzle with the aim to evaluate the detrimental influence of relevant key features, such as alumina particle dimension, polydispersion, crystallization, and motor operating conditions. The capability of the present model to represent, with good accuracy, the overall performance of solid rocket motors is demonstrated by comparing the experimental specific impulse of several motors with numerical predictions.

The pandemic of the new coronavirus in 2020 caused a serious global health and humanitarian crisis. In the case of the older people, the vulnerabilities were extremely deepened due to the expressive number of infected and dead people worldwide. The objective of this work was to evaluate older people aged 60 years or more in the pandemic of COVID-19, regarding issues of social withdrawal and isolation, fear, frailty, abandonment, and other feelings. The methodology used a broad bibliographic survey, an online questionnaire, with specific questions for locations in the Brazilian federation, in the period from July 06 to 25, 2021, with a quantitative and qualitative approach. A total of 108 people aged 60 to 97 years were interviewed. Through the answers obtained, some impacts on the mental and emotional health of the elderly were observed. The main feelings reported were: (38%) anxiety, (31%) helplessness (27%), fear (26%), and sadness (26%). The highest percentages observed were for the feelings of sadness (60%), anguish (56%), stress (52%) and anxiety (52%) respectively. Therefore, specific public policies for this segment of the population are essential for quality of life and physical and emotional well-being.

O objetivo deste estudo foi analisar etapas da produção de legendas para pessoas surdas ou ensurdecidas e processos de tradução no par linguístico Libras (Língua Brasileira de Sinais) - português. Por meio de uma pesquisa documental e qualitativa, investigamos como tais procedimentos foram desenvolvidos pelo “TradInter Lab: laboratório de tradução audiovisual acessível e interpretação Libras - português” da UFRJ (Universidade Federal do Rio de Janeiro) para promover a acessibilidade comunicativa em conteúdos audiovisuais de eventos acadêmicos. A fundamentação teórica baseia-se em estudos sobre tradução audiovisual e acessibilidade comunicativa, normativos legais brasileiros e reflexos da pandemia de COVID-19 nesses processos. Os resultados preliminares apontam caminhos para uma tradução audiovisual cada vez mais acessível.

Resumo: Com a crescente competitividade no setor de hospedagem, diversas estratégias têm sido utilizadas para conquistar o consumidor e maximizar as vendas de diárias. As plataformas digitais são os meios mais utilizados para que as empresas alcancem essa finalidade. Diante disso, este trabalho teve como objetivo analisar como a percepção de justiça de preço de diárias de meios de hospedagem, em plataformas de leilões digitais, pode ser influenciada pelo valor da marca do destino e o respectivo envolvimento do consumidor por ele. Este estudo descritivo, de natureza quantitativa, adotou o corte transversal único. No total, 416 respondentes compuseram a amostra, cujos dados foram analisados pela técnica de regressão linear múltipla e correlações entre as variáveis. Os resultados indicaram que apenas a relevância demonstrou influência positiva em relação à percepção de justiça de preço. Assim, foi possível constatar que o preço é um elemento de grande importância na negociação e não dependente da relação pessoal que o consumidor tenha com o destino e com os equipamentos que o compõe, nem tão pouco com a representatividade do mesmo. Portanto, o que prevalece para o consumidor é, na negociação, conseguir a maior redução possível do preço e, após isso, adquirir a diária do hotel. Resumen: Con la creciente competitividad en el sector hotelero, se han utilizado varias estrategias para ganarse al consumidor y maximizar las ventas de tarifas diarias. Las plataformas digitales son el medio más utilizado por las empresas para lograr este propósito. Por lo tanto, este estudio tuvo como objetivo analizar cómo la percepción de la justicia de precios de las tarifas diarias de los medios de alojamiento, en las plataformas de subastas digitales, puede verse influenciada por el valor de marca del destino y el respectivo envolvimiento del consumidor por el mismo. Este estudio descriptivo, de naturaleza cuantitativa, adoptó la sección transversal única. En total, 416 encuestados componían la muestra, cuyos datos se analizaron mediante la técnica de regresión lineal múltiple y correlaciones entre las variables. Los resultados indicaron que sólo la relevancia demostró una influencia positiva en relación con la percepción de la justicia de precios. Así, se pudo comprobar que el precio es un elemento de gran importancia en la negociación y no depende de la relación personal que el consumidor tenga con el destino y con los equipos que lo componen, ni tan poco con su representatividad. Por lo tanto, lo que prevalece para el consumidor es, en la negociación, conseguir la mayor reducción de precio posible y, después, comprar la tarifa diaria del hotel. Abstratc: With the growing competitiveness in the hosting sector, several strategies have been used to conquer the consumer and maximize daily sales. Digital platforms are the most used means for companies to achieve this goal. Therefore, this work aimed to analyze how the perception of fair price of hosting media diaries on digital auction platforms can be influenced by the brand value of the destination and the respective involvement of the consumer by it. This descriptive study, of a quantitative nature, adopted the unique cross-section. In total, 416 respondents composed the sample, whose data were analyzed by the multiple linear regression technique and correlations between the variables. The results indicated that only relevance demonstrated a positive influence in relation to the perception of price justice. Thus, it was possible to verify that price is an element of great importance in the negotiation and not dependent on the personal relationship that the consumer has with the destination and the equipment that composes it, nor on its representativeness. Therefore, what prevails for the consumer is, on the negotiation, to get the biggest possible price reduction and, after that, to acquire the hotel's daily.

PurposeAlthough not yet fully defined, natural wine represents a sector that has gained the widespread attention of final consumers and, therefore, also of the restaurant world, because of its promise of sustainability. The objective of this paper is to understand Italian haute cuisine's interest in natural wine, with the aim of analysing what qualifies this product as sustainable.Design/methodology/approachAfter introducing a theoretical framework based on the concept of natural wine, a brief paragraph is dedicated to consumer preferences; subsequently, the analysis focusses on a questionnaire given to restaurateurs to determine the impact that natural wine has had in the Italian context. The results try to identify the importance that restaurateurs give to the characteristics of natural wine and their propensity for using such wine in their own businesses.FindingsThe analysis, conducted on a sample of medium-high range restaurants, highlights their strong interest in natural wine, as a result of the final consumers' attitude towards wine with characteristics attributable to sustainability. The positive perception by restaurateurs is similar across Italy, both geographically and in terms of the size of the restaurant.Originality/valueThe originality of the work is the focus on the world of restaurants. To date, the literature on natural wine remains embryonic and always refers to the final consumer. This research is the first step in a broader study that will involve a greater number of restaurants, extending beyond Italy to all of Europe, with the aim of understanding the real development potential of natural wine.

PURPOSE Although representing the majority of newly diagnosed cancers, patients with breast cancer appear less vulnerable to COVID-19 mortality compared with other malignancies. In the absence of patients on active cancer therapy included in vaccination trials, a contemporary real-world evaluation of outcomes during the various pandemic phases, as well as of the impact of vaccination, is needed to better inform clinical practice. METHODS We compared COVID-19 morbidity and mortality among patients with breast cancer across prevaccination (February 27, 2020-November 30, 2020), Alpha-Delta (December 1, 2020-December 14, 2021), and Omicron (December 15, 2021-January 31, 2022) phases using OnCovid registry participants (ClinicalTrials.gov identifier: NCT04393974 ). Twenty-eight-day case fatality rate (CFR28) and COVID-19 severity were compared in unvaccinated versus double-dosed/boosted patients (vaccinated) with inverse probability of treatment weighting models adjusted for country of origin, age, number of comorbidities, tumor stage, and receipt of systemic anticancer therapy within 1 month of COVID-19 diagnosis. RESULTS By the data lock of February 4, 2022, the registry counted 613 eligible patients with breast cancer: 60.1% (n = 312) hormone receptor–positive, 25.2% (n = 131) human epidermal growth factor receptor 2–positive, and 14.6% (n = 76) triple-negative. The majority (61%; n = 374) had localized/locally advanced disease. Median age was 62 years (interquartile range, 51-74 years). A total of 193 patients (31.5%) presented ≥ 2 comorbidities and 69% (n = 330) were never smokers. In total, 392 (63.9%), 164 (26.8%), and 57 (9.3%) were diagnosed during the prevaccination, Alpha-Delta, and Omicron phases, respectively. Analysis of CFR28 demonstrates comparable estimates of mortality across the three pandemic phases (13.9%, 12.2%, 5.3%, respectively; P = .182). Nevertheless, a significant improvement in outcome measures of COVID-19 severity across the three pandemic time periods was observed. Importantly, when reported separately, unvaccinated patients from the Alpha-Delta and Omicron phases achieved comparable outcomes to those from the prevaccination phase. Of 566 patients eligible for the vaccination analysis, 72 (12.7%) were fully vaccinated and 494 (87.3%) were unvaccinated. We confirmed with inverse probability of treatment weighting multivariable analysis and following a clustered robust correction for participating center that vaccinated patients achieved improved CFR28 (odds ratio [OR], 0.19; 95% CI, 0.09 to 0.40), hospitalization (OR, 0.28; 95% CI, 0.11 to 0.69), COVID-19 complications (OR, 0.16; 95% CI, 0.06 to 0.45), and reduced requirement of COVID-19–specific therapy (OR, 0.24; 95% CI, 0.09 to 0.63) and oxygen therapy (OR, 0.24; 95% CI, 0.09 to 0.67) compared with unvaccinated controls. CONCLUSION Our findings highlight a consistent reduction of COVID-19 severity in patients with breast cancer during the Omicron outbreak in Europe. We also demonstrate that even in this population, a complete severe acute respiratory syndrome coronavirus 2 vaccination course is a strong determinant of improved morbidity and mortality from COVID-19.

O almoxarifado é o setor da organização onde se deposita e armazenam os materiais com devida segurança e preservação da qualidade dos mesmos. Lá que se guardam os objetos de reposição diária, desde pequenas coisas de escritório a grandes peças de máquinas, dependendo da área de atuação da empresa que detém o almoxarifado. De acordo com o que foi analisado e, segundo os critérios de avaliação que foram utilizados, foi possível verificar que o ambiente estudado não atende ao padrão ergonômico ideal, sendo necessário fazer algumas correções de cunho imediato, principalmente no que tange aos problemas posturais, que foram os critérios mais ergonomicamente instáveis. Surge a necessidade de investigar como são tratadas as questões da ergonomia no ambiente de almoxarifado, sob a ótica da satisfação das necessidades dos trabalhadores.

The emulated coupling of a 100 kW SOC reactor with an emulated tail gas recirculation of a Fischer-Tropsch reactor was investigated. Different syngas ratios (H2/CO) were studied, not only experimentally but also with the support of the in-house simulation framework from DLR, TEMPEST, which is specialized for transient simulations on electrochemical reactors. Different operating conditions were evaluated by: (i) adding CH4 at open circuit voltage (OCV) and under current and (ii) by performing an experimental ramp of the emulated Fischer-Tropsch gas composition into the inlet gases of the SOC reactor. These results allowed to evaluate the performance of the SOC reactor with the temperature profile along the cells and the stacks, as well as with the syngas ratio behavior. Operation strategies are analyzed and discussed with the aim to mitigate failure conditions on SOC reactors, while operating in transient conditions in the frame of syngas production via high temperature co-electrolysis.

BACKGROUND: The influence of age and comorbidities during decision-making for patients with renal cell carcinoma remains controversial. OBJECTIVE: To comprehensively review the available evidence regarding the impacts of age and comorbidities on the decision to perform partial nephrectomy (PN). EVIDENCE ACQUISITION: A systematic review was conducted in accordance with PRISMA and registered with PROSPERO (CRD42022344759). Only randomized control trials, prospective cohort studies, registry-based studies, or single/multi-institutional retrospective cohort studies comparing PN to other therapeutic options for cT1N0M0 renal masses were considered. The primary outcome was to assess differences in patients’ baseline characteristics between different treatments in order to investigate how those aspects have influenced clinical decision-making. Finally, perioperative outcomes were compared across the different options. EVIDENCE SYNTHESIS: Overall, patients who underwent PN were 3 to 11 years younger than those who underwent other treatments. Baseline renal function was slightly better in patients who underwent PN than in those who underwent radical nephrectomy (RN), active surveillance (AS), or tumor ablation. Patients undergoing PN had an average pre-treatment eGFR 4 to 6 points (mL/min/1.73 m2) higher than patients undergoing RN or tumor ablation. Likewise, the proportion of baseline chronic kidney disease (CKD) before treatment was higher in patients undergoing other treatments, with a rate of CKD between 6% and 56% higher compared with that for PN. A slightly higher proportion of baseline diabetes mellitus (DM) and cardiovascular comorbidities (CVD) were found in patients who underwent PN than in those who underwent RN (20% vs. 21% for DM and 37% vs. 41% for CVD). On average, patients who underwent AS and tumor ablation had more comorbidities, in terms of Charlson comorbidity index (CCI), DM, and CVD (50% vs. 38% for CCI ≥2; 25% vs. 20% for DM; and 43% vs. 37% for CVD). In terms of Eastern Cooperative Oncology Group (ECOG) Performance Status and American Society of Anesthesiologists (ASA) classification, no major differences were found between PN and other treatments, but a trend emerged whereby more fit patients underwent PN compared with RN (16% of ECOG >1 for PN vs. 18% for RN and 15% of ASA grade ≥3 for PN vs. 26% for RN). Again, tumor ablation was preferred for less fit patients (31% of ASA grade ≥3). No study included in our systematic review reported the baseline frailty status of patients treated for cT1 renal masses. The rates of perioperative complications and length of hospital stay (LOS) were similar between different techniques. CONCLUSIONS: Patients who underwent PN tended to be younger and fitter than those who underwent other available treatments for cT1 renal masses. Since this technique aims at reducing renal function impairment after surgery, a greater effort should be made to optimize patient selection to include more comorbid patients for whom PN might be useful.

O novo Ensino Médio é balizado em documentos normativos vigentes desde o ano de 2018, os quais, a partir de 2022, a totalidade das escolas de educação básica devem considerar, que são a Base Nacional Comum Curricular, no âmbito nacional, e o Referencial Curricular Gaúcho, no contexto específico das escolas do Rio Grande do Sul. De forma coerente com as discussões e perspectivas contidas nos referidos documentos, o presente artigo visa a apresentar uma sequência didática sobre Energia, elaborada no contexto do Estágio Supervisionado em Ensino de Física (ESEF), bem como discutir as possibilidades da mesma para o Ensino de Física/Ciências da Natureza e suas Tecnologias. Nesta linha, os planejamentos das aulas foram construídos com a abordagem temática, a partir do tema “Energia e Humanidade”; ainda, foram estruturados com base nas metodologias ativas denominadas Três Momentos Pedagógicos e Ensino sob Medida. Considerando os desafios do novo Ensino Médio, atrelados àqueles específicos do ESEF, argumenta-se que esta sequência didática constitui possibilidade concreta de desenvolver objetivos mais amplos, atrelados à concepção de conteúdo que, para além dos conceitos, enfatiza procedimentos e atitudes na formação dos educandos.

A large proportion of the insects which have invaded new regions and countries are emerging species, being found for the first time outside their native range. Being able to detect such species upon arrival at ports of entry before they establish in non-native countries is an urgent challenge. The deployment of traps baited with broad-spectrum semiochemical lures at ports-of-entry and other high-risk sites could be one such early detection tool. Rapid progress in the identification of semiochemicals for cerambycid beetles during the last 15 years has revealed that aggregation-sex pheromones and sex pheromones are often conserved at global levels for genera, tribes or subfamilies of the Cerambycidae. This possibly allows the development of generic attractants which attract multiple species simultaneously, especially when such pheromones are combined into blends. Here, we present the results of a worldwide field trial programme conducted during 2018–2021, using traps baited with a standardised 8-pheromone blend, usually complemented with plant volatiles. A total of 1308 traps were deployed at 302 sites covering simultaneously or sequentially 13 European countries, 10 Chinese provinces and some regions of the USA, Canada, Australia, Russia (Siberia) and the Caribbean (Martinique). We intended to test the following hypotheses: 1) if a species is regularly trapped in significant numbers by the blend on a continent, it increases the probability that it can be detected when it arrives in other countries/continents and 2) if the blend exerts an effective, generic attraction to multiple species, it is likely that previously unknown and unexpected species can be captured due to the high degree of conservation of pheromone structures within related taxa. A total of 78,321 longhorned beetles were trapped, representing 376 species from eight subfamilies, with 84 species captured in numbers greater than 50 individuals. Captures comprised 60 tribes, with 10 tribes including more than nine species trapped on different continents. Some invasive species were captured in both the native and invaded continents. This demonstrates the potential of multipheromone lures as effective tools for the detection of ‘unexpected’ cerambycid invaders, accidentally translocated outside their native ranges. Adding new pheromones with analogous well-conserved motifs is discussed, as well as the limitations of using such blends, especially for some cerambycid taxa which may be more attracted by the trap colour or other characteristics rather than to the chemical blend.