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Background and objectives The impact of death by suicide represents an important public health issue. The current study reports data relating depressive symptoms and psychological well-being to exposure to suicide in the family. Methods A final Portuguese community sample of 266 participants answered a protocol presented on a Google platform. Two groups were defined: a suicide exposure group (n = 45) and a control group (n = 210) who responded to the Echelle de Mesure des Manifestations du Bien-Etre Psychologique (Psychological Well-being Manifestation Measure Scale) and to the Center for Epidemiologic Studies Scale to access psychological well-being and depressive symptoms, respectively. Results Groups differ significantly on psychological well-being, even when contorting for unemployment and having physical disease, differed on depressive symptoms and tended to differ on depressive symptoms when contorting for unemployment and chronic physical disease. Conclusion Based on results, we suggest that therapeutic interventions should focus not only on reducing depressive symptoms in exposed individuals, but as well as promoting well-being. Limitations include the size of the sample and the cross-sectional nature of the design.

We examine the effects of physiology and spiritual sentiment on economic decision-making in the context of Ramadan, an entire lunar month of daily fasting and increased spiritual reflection in the Muslim faith. Using an administrative data set of bank loans originated in Turkey during 2003 to 2013, we find that small business loans originated during Ramadan are 15% more likely to default within two years of origination. Loans originated in hot Ramadans, when adverse physiological effects of fasting are greatest, and those approved by the busiest bank branches perform worse. Despite their worse performance, Ramadan loans have lower credit spreads., NA

Left atrial ejection fraction (LAEF) has been previously shown to accurately distinguish between patients with and without clearly defined left ventricle diastolic dysfunction (LVDD) by ASE/EACVI criteria, but indeterminate cases were excluded. We sought to determine if LAEF could accurately distinguish between normal, indeterminate and LVDD patients. A retrospective cohort of 125 patients who underwent transthoracic echocardiography was studied. Comprehensive echocardiographic study was performed with measurement of validated diastolic parameters. Subjects were assigned LVDF ASE/EACVI categories. ANOVA test was used to compare means between groups and binary logistic regression and ROC curves to assess diagnostic accuracy. Mean LAEF was statistically different between groups (p

SARS-CoV-2 may spread through respiratory droplets released by infected individuals. The viruses are transmitted in moist droplets which cause coronavirus disease. Many countries have mandated the wearing of face masks, to various extents. However, the efficacy of masks is yet to be well rationalised given the limited microstructure information. Here, three common face masks and associated air permeations were revealed by coupling X-ray tomographic imaging and infrared thermal imaging techniques. Quantitative parameters have been extracted from the 3D images. Also, image-based modelling was performed to simulate the permeability to show how droplets pass through the porous structure. Our results show that the N95 mask has the smallest average pore diameter (~30 µm) and the densest nanoscale fibres which provides superior droplet filtration among all cases. Modifications to the N95 masks are proposed to develop the next generation mask with higher efficacy and better breathability. Face masks are key for slowing the spread of COVID-19. Here, the microstructure of three common masks is determined by x-ray tomography, combined with image-based modelling of droplet permeability, revealing that N95 masks are best for droplet filtration.

Bicuspid aortic valve (BAV) is monitored by transthoracic echocardiography and computed tomography (CT) angiography. However, it does not have any early marker of disease progression. This study evaluated speckle-tracking echocardiography (STE) aortic and left ventricular (LV) strain prognostic values, their discriminative power, and their correlation with the degree of valvular regurgitation. We conducted a retrospective analysis of a prospectively enrolled cohort of 45 diagnosed with BAV and 20 gender and age matched controls. We performed 2D-STE aortic and LV strain analysis of the selected population. The cohort was followed-up during a median period of 19.9 months (IQR 12.9–25.2), and outcomes (hospital admission for heart failure (HF), aortic valve replacement (AVR), and death) were determined. The mean patient age was 46.6 ± 15.5 years and 80 % were male. LV indexed volumes and aortic diameter were higher in BAV patients. LV global longitudinal strain (GLS) was impaired (p

Resumo Fundamento A cardiomiopatia hipertrófica (CMH) e a hipertrofia ventricular esquerda (HVE) secundária à hipertensão arterial sistêmica (HAS) podem estar associadas a anormalidades funcionais do átrio esquerdo (AE). Objetivos Caracterizar a mecânica do AE na CMH e na HAS e avaliar qualquer correlação com a extensão da fibrose ventricular esquerda medida por ressonância magnética cardíaca (RMC) em pacientes com CMH. Métodos A função longitudinal do AE derivada do ecocardiograma bidimensional com speckle tracking foi adquirida a partir de cortes apicais de 60 pacientes com CMH e 34 indivíduos controles, pareados por idade. Pacientes com CMH também foram submetidos à RMC, com medida da extensão do realce tardio por gadolínio. A associação com parâmetros de strain do AE foi analisada. Valores p < 0,05 foram definidos como estatisticamente significativos. Resultados A média da fração de ejeção do ventrículo esquerdo não foi diferente entre os grupos. A razão E/e’ estava comprometida no grupo CMH e preservada no grupo controle. A mecânica do AE estava significativamente reduzida na CMH em comparação aos pacientes com HAS. O strain rate do AE nas fases de reservatório (SRrAE) e na fase contrátil (SRctAE) foram os melhores parâmetros de discriminação de CMH com uma área sob a curva (AUC) de 0,8, seguido do strain do AE na fase de reservatório (SrAE) (AUC 0,76). O SRrAE e o SRctAE apresentaram elevada especificidade (89% e 91%, respectivamente), e o SrAE apresentou sensibilidade de 80%. Um decréscimo de 2,79% no strain rate do AE na fase de condução (SRcdAE) foi preditor de um aumento de 1 cm na extensão do RT pelo gadolínio (r2=0,42, β 2,79, p=0,027). Conclusões O SRrAE e o SRctAE foram os melhores fatores de discriminação de HVE secundária à CMH. O SRcdAE foi preditor do grau de fibrose ventricular esquerda avaliada por RMC. Esses achados sugerem que a mecânica do AE pode ser um potencial preditor de gravidade de doença na CMH. Abstract Background Hypertrophic cardiomyopathy (HCM) and left ventricular hypertrophy (LVH) secondary to systemic hypertension (HTN) may be associated with left atrial (LA) functional abnormalities. Objectives We aimed to characterize LA mechanics in HCM and HTN and determine any correlation with the extent of left ventricular (LV) fibrosis measured by cardiac magnetic resonance (CMR) in HCM patients. Methods Two-dimensional speckle tracking-derived longitudinal LA function was acquired from apical views in 60 HCM patients, 60 HTN patients, and 34 age-matched controls. HCM patients also underwent CMR, with measurement of late gadolinium enhancement (LGE) extension. Association with LA strain parameters was analyzed. Statistical significance was set at p

In hydroponic cultivation, monitoring and quantification of nutrients is of paramount importance. Accurate, robust sensors for detection of Nitrogen, Phosphorus and Potassium (NPK) would be desired in horticultural production. Spectroscopy can be used for this, but other nutrients interfere and hinder accurate and reliable quantification. In order to better understand and solve nutrients’ interferences, an orthogonal experimental design has been used, based on Hoagland fertilizer solutions, a widely used complete and complex nutrient mixture. The experimental factorial design consisted of eight orthogonal levels of N, P and K rendered on 83 of different samples of Hoagland solution, each one with its own specific concentration of NPK. Concentration ranges were varied in a target analyte independent style: [N]= [103.17-554.85] ppm; [P]= [15.06-515.35] ppm; [K]= [113.78-516.45] ppm, by dilution from individual stock solutions. This strategy allowed the variation of each parameter individually, maintaining the remaining constant, enabling the individual variations as well as their correlations to be obtained. A UV-Vis-based Artificial Intelligence-enhanced (AI) system was used for quantification of NPK on the analysed samples. It featured an advanced processing algorithm named Self-Learning Artificial Intelligence (SL-AI). From the analysis of the acquired and processed data, it was possible to understand that N spectral features are dominant, whereas P and K will behave as interferents, with information on P properties not being very evident on spectra. The obtained results allowed very good quantifications for N and K, with errors of 6.7% (0.997) and 3.8% (0.987), respectively, to be achieved. Regarding P, as expected, only satisfactory results were obtained, corresponding to a qualitative grade. The developed system can be of great potential for monitoring and quantification of NPK in hydroponic platforms. Acknowledgments: The authors would like to thank the financial support under the ERA-NET Cofund WaterWorks2015 Call, within the frame of the collaborative international consortium AGRINUPES. This ERA-NET is an integral part of the 2016 Joint Activities developed by the Water Challenges for a Changing World Joint Programme Initiative (Water JPI/002/2015). RM acknowledges Fundacao para a Ciencia e Tecnologia (FCT) research contract grant (CEEIND/017801/2018). AFS gratefully acknowledges the financial support provided by FCT (Portugal’s Foundation for Science and Technology) within grant (DFA/BD/9136/2020).

Background The Margin of Stability (MoS) is a widely used objective measure of dynamic stability during gait. Increasingly, researchers are using the MoS to assess the stability of pathological populations to gauge their stability capabilities and coping strategies, or as an objective marker of outcome, response to treatment or disease progression. The objectives are; to describe the types of pathological gait that are assessed using the MoS, to examine the methods used to assess MoS and to examine the way the MoS data is presented and interpreted. Methods A systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Guidelines (PRISMA) in the following databases: Web of Science, PubMed, UCL Library Explore, Cochrane Library, Scopus. All articles measured the MoS of a pathologically affected adult human population whilst walking in a straight line. Extracted data were collected per a prospectively defined list, which included: population type, method of data analysis and model building, walking tasks undertaken, and interpretation of the MoS. Results Thirty-one studies were included in the final review. More than 15 different clinical populations were studied, most commonly post-stroke and unilateral transtibial amputee populations. Most participants were assessed in a gait laboratory using motion capture technology, whilst 2 studies used instrumented shoes. A variety of centre of mass, base of support and MoS definitions and calculations were described. Conclusions This is the first systematic review to assess use of the MoS and the first to consider its clinical application. Findings suggest the MoS has potential to be a helpful, objective measurement in a variety of clinically affected populations. Unfortunately, the methodology and interpretation varies, which hinders subsequent study comparisons. A lack of baseline results from large studies mean direct comparison between studies is difficult and strong conclusions are hard to make. Further work from the biomechanics community to develop reporting guidelines for MoS calculation methodology and a commitment to larger baseline studies for each pathology is welcomed.

The development of civilization and the massive use of traditional energy sources has led to progressive environmental degradation that requires immediate action [...]

The deep peribiliary glands (DPBG) are a niche of progenitor cells in the wall of the biliary duct (BD) and are the second line of multiplication when severe lesion of the epithelium occurs. Previous studies have identified DPBG injury as a cause of post-liver transplant (LT) biliary stenosis; this complication is a major cause of post-LT morbidity. The incidence of biliary stenosis in our center is high (38.1%). This study evaluates the lesion of DPBG in response to ischemia. Graft BD was collected in adult LT between August 2016-July 2017, from donation after brain death. Samples of 45 grafts were collected at 2 moments: BD1-during graft preparation and BD2-before biliary anastomosis. Histological analysis of the samples was performed and then classified according to degree of lesion (0, ≤50%, and >50%). A comparison was made between the degree of lesion and graft ischemia, graft histology, donor, and procurement variables. The DPBG lesion was more frequent in BD2 (20.9% vs 7%, P = .079). BD2 lesions with DPBG lesions had higher medians and means at all times of ischemia. The difference was greater in the warm ischemia time (0: 43.3 ± 12.53 minutes vs ≤50%: 52.4 ± 14.38 minutes, P = .068). The group of BD1 with DPBG lesion presented superior median cold ischemia time (CIT). In the analysis of the remaining variables there were also no statistically significant differences. We concluded that during the period of CIT there is already lesion of the DPBG, which increases after reperfusion of the graft, in greater association with longer warm ischemia time.

AIMS: Increasing evidence points towards the use of epicardial fat (EF) as a reliable biomarker of coronary artery disease extent and severity. We aim to assess the different locations of echocardiographic EF thickness measurement and their relation with the presence, extent, and severity of coronary artery disease (CAD) in patients admitted with acute coronary syndromes (ACS). METHODS: Prospective cohort study including patients admitted for ACS. EF was assessed by transthoracic echocardiography and compared with coronary angiography findings. Spearmen correlation analysis was used to search for EF correlations. Receiver-operating characteristic curve analysis was performed to assess the predictive value of the different sites of measurement of EF thickness for the presence of CAD. To evaluate other potential variables independently associated with CAD, we performed multivariate analysis employing logistic regression. RESULTS: 196 patients were included. Significant CAD was diagnosed in 83.7% of patients. In all views, EF thickness was greater in patients with CAD (p

The agricultural sector plays a fundamental role in our society, where it is increasingly important to automate processes, which can generate beneficial impacts in the productivity and quality of products. Perception and computer vision approaches can be fundamental in the implementation of robotics in agriculture. In particular, deep learning can be used for image classification or object detection, endowing machines with the capability to perform operations in the agriculture context. In this work, deep learning was used for the detection of grape bunches in vineyards considering different growth stages: the early stage just after the bloom and the medium stage where the grape bunches present an intermediate development. Two state-of-the-art single-shot multibox models were trained, quantized, and deployed in a low-cost and low-power hardware device, a Tensor Processing Unit. The training input was a novel and publicly available dataset proposed in this work. This dataset contains 1929 images and respective annotations of grape bunches at two different growth stages, captured by different cameras in several illumination conditions. The models were benchmarked and characterized considering the variation of two different parameters: the confidence score and the intersection over union threshold. The results showed that the deployed models could detect grape bunches in images with a medium average precision up to 66.96%. Since this approach uses low resources, a low-cost and low-power hardware device that requires simplified models with 8 bit quantization, the obtained performance was satisfactory. Experiments also demonstrated that the models performed better in identifying grape bunches at the medium growth stage, in comparison with grape bunches present in the vineyard after the bloom, since the second class represents smaller grape bunches, with a color and texture more similar to the surrounding foliage, which complicates their detection.

Background Mobile health apps have emerged as useful tools for patients and clinicians alike, sharing health information or assisting in clinical decision-making. Prostate cancer (PCa) risk calculator mobile apps have been introduced to assess risks of PCa and high-grade PCa (Gleason score ≥7). The Rotterdam Prostate Cancer Risk Calculator and Coral–Prostate Cancer Nomogram Calculator apps were developed from the 2 most-studied PCa risk calculators, the European Randomized Study of Screening for Prostate Cancer (ERSPC) and the North American Prostate Cancer Prevention Trial (PCPT) risk calculators, respectively. A systematic review has indicated that the Rotterdam and Coral apps perform best during the prebiopsy stage. However, the epidemiology of PCa varies among different populations, and therefore, the applicability of these apps in a Taiwanese population needs to be evaluated. This study is the first to validate the PCa risk calculator apps with both biopsy and prostatectomy cohorts in Taiwan. Objective The study’s objective is to validate the PCa risk calculator apps using a Taiwanese cohort of patients. Additionally, we aim to utilize postprostatectomy pathology outcomes to assess the accuracy of both apps with regard to high-grade PCa. Methods All male patients who had undergone transrectal ultrasound prostate biopsies in a single Taiwanese tertiary medical center from 2012 to 2018 were identified retrospectively. The probabilities of PCa and high-grade PCa were calculated utilizing the Rotterdam and Coral apps, and compared with biopsy and prostatectomy results. Calibration was graphically evaluated with the Hosmer-Lemeshow goodness-of-fit test. Discrimination was analyzed utilizing the area under the receiver operating characteristic curve (AUC). Decision curve analysis was performed for clinical utility. Results Of 1134 patients, 246 (21.7%) were diagnosed with PCa; of these 246 patients, 155 (63%) had high-grade PCa, according to the biopsy results. After confirmation with prostatectomy pathological outcomes, 47.2% (25/53) of patients were upgraded to high-grade PCa, and 1.2% (1/84) of patients were downgraded to low-grade PCa. Only the Rotterdam app demonstrated good calibration for detecting high-grade PCa in the biopsy cohort. The discriminative ability for both PCa (AUC: 0.779 vs 0.687; DeLong’s method: P Conclusions The Rotterdam and Coral apps can be applied to the Taiwanese cohort with accuracy. The Rotterdam app outperformed the Coral app in the prediction of PCa and high-grade PCa. Despite the small size of the prostatectomy cohort, both apps, to some extent, demonstrated the predictive capacity for true high-grade PCa, confirmed by the whole prostate specimen. Following our external validation, the Rotterdam app might be a good alternative to help detect PCa and high-grade PCa for Taiwanese men.

Introduction Chronic thromboembolic pulmonary hypertension (CPTEH) is the result of thromboemboli leading not only to mechanical obstruction but also pulmonary vascular remodelling and progressive increase in right heart afterload. Prognostic assessment in CPTEH is complex and multifactorial. Purpose We used two-dimensional strain echocardiography (2D-STE) to quantify right atrial (RA) mechanics and its correlation with invasive hemodynamics, load-dependent biomarkers and well-known prognostic markers in patients with CTEPH. Methods A total of 44 patients (24 females, mean age 61±15.6 years) with CTEPH were recruited. 2D-STE was used to measure right atrial reservoir strain (RASr) (Figure 1) which was then compared to conventional ultrasound measurements, right heart catheterisation (RHC) measurements, the percentage of obstruction in ventilation-perfusion pulmonary single-photon emission computed tomography (V/Q SPECT), B-type natriuretic peptide (BNP) values and 6-minute walk test (6MWT) performance. All patients underwent transthoracic echocardiographic evaluation with a maximal time distance of three months to RHC. Results There was a significant positive correlation of RASr with RV longitudinal function determined by tricuspid annular plane systolic excursion (TAPSE) (r=0.488, p=0.003), tricuspid annular peak systolic velocity (S') (r=0.490, p=0.002), right ventricular outflow tract velocity time integral (RVOT VTI) (r=0.457, p=0.005), as well as with 6MWT (r=0.491, p=0.004). There was a significant negative correlation of RASr with mean pulmonary artery pressure (r=−0.513, p=0.002), pulmonary vascular resistance (r=−0.439, p=0.011) and right atrial pressure (RAP) (r=−0.513, p=0.002). RASr was also correlated with Log-transformed BNP values (r=−0.552, p Conclusion 2D-STE-derived RA mechanics demonstrated to be a useful, non-invasive, surrogate measurement of RHC parameters. It also predicted important clinical/laboratory prognostic measurements, such as BNP and 6MWT performance. The absence of correlation between 2D-STE values and the percentage of vessel obstruction determined by SPECT may suggest that RV maladaptive response to the obstruction, rather than the degree of obstruction, dictates right heart failure in CTEPH. Right atrial strain components Funding Acknowledgement Type of funding source: None

Introduction Epicardial fat (EF), the true visceral fat depot of the heart, has been strongly correlated with both coronary artery disease (CAD) incidence and severity. However, the methods for its measurement were not always affordable. Its measurement by echocardiography is fast, accessible and easily reproducible, turning it into a promising clinical tool for assessing cardiovascular risk to predict the incidence of CAD. Purpose To determine the correlation between EF tissue dimensions measured by transthoracic echocardiography and the presence of CAD. Methods We prospectively analysed data from 196 consecutive patients admitted for acute coronary syndrome in our coronary care unit. All patients underwent diagnostic coronary angiography and echocardiogram during stay. EF dimensions were obtained with transthoracic echocardiography by measuring maximum EF diameter (mm) at the basal right ventricular free wall (PLAXB) level and mid-right ventricular free wall (PLAXM) level [in paraesternal long-axis view (PLAX)] and maximum right-ventricle free wall EF diameter at basal (PSAXB) level and papillary-muscle (PSAXM) level [in paraesternal short-axis view (PSAX)]. All measures were taken at end-systole. Patients were divided in 2 groups according to the presence of significant CAD (sCAD) or not (nCAD), defined as having at least 1 diseased epicardial vessel with a stenosis >50%. Results One-hundred and sixty-three (83.2%) had significant CAD. 22 patients (11.2%) were admitted for unstable angina, 60 patients (30.6%) for non-ST elevation myocardial infarction and 93 patients (47,4%) for ST-elevation myocardial infarction. Mean EF diameters were as follows: PLAXB (19,3±5.1 mm), PLAXM (11.3±2.6), PSAXB (10,6±2.8), PSAXM (10.5±2.8). We found a direct correlation between number of diseased epicardial coronary vessels and epicardial fat thickness in PLAXB (r=0.506, p Conclusions In a population of high suspicion of acute coronary syndromes, echocardiographic EF is a sensitive and specific marker of the presence of significant coronary disease and could become an important tool for coronary risk prediction. Figure 1 Funding Acknowledgement Type of funding source: None

Background Increasing evidence suggests that left atrial (LA) structural and functional changes have an important role in risk stratification and prediction of clinical outcomes. We know from multiple data that left atrial maximum volume (LAVI), measured at end-systole, is a powerful prognostic marker in multiple patient groups. However, recent studies have suggested that this marker may not be the best representative of diastolic function as it does not image the full spectrum of atrial mechanics. Another measure of LA function is the left atrial emptying fraction (LAEF), which has proved to be a significant prognostic marker in many patient groups. Less known is its role in event prediction in severe aortic stenosis patients, a disease with a very important burden in modern societies. Purpose The authors hypothesised that LAEF is a powerful predictor of clinical outcomes at 1 year in patients with severe aortic stenosis. Methods We retrospectively evaluated 151 patients referred to our echocardiography laboratory with the diagnosis of severe aortic stenosis. All patients underwent transthoracic echocardiography. LA maximum volume was indexed to body surface area. LAEF was calculated as LAVI-LA minimum volume divided by LAVI. Patients were followed for 1 year regarding clinical outcomes. Clinical outcome was defined as a composite of hospital admission for a cardiovascular (CV) cause, emergency department recurrence for a CV cause or CV death. Logistic binary regression was used to evaluate associations of LAEF with the outcome. Results A total of 51.7% of patients (n=78) were males. Mean patient age was 76.6±8.0 years. A total of 38.4% of patients were diabetics (n=56), 96% had dyslipidaemia (n=145) and 25% (n=37) had atrial fibrillation. Mean left ventricular ejection fraction (LVEF) was 60.6±7.3, and mean LAVI was 41.4±12.1. In a multivariable regression model including clinical and echocardiographic markers, higher LAVI and pulmonary artery systolic pressure (PASP) were associated with lower LAEF. Receiver operating characteristic curve analysis showed that the predictive value of LAEF for outcomes at 1 year was 0.693 (AUC=0.693, CI 95% 0.578–0.809, p=0.002), performing better than other echocardiographic markers such as LAVI (AUC=0.567, CI 95% 0.440–0.694, p=0.286), PASP (AUC=0.582, CI 95% 0.451–0.714, p=0.191) and LVEF (AUC=0.590, CI 95% 0.464–0.716, p=0.153). After adjustment of baseline characteristics, a LAEF less than 41.3% remained a good predictor of clinical outcomes at 1 year (OR 2.615, CI 95% 1.085–6.305, p=0.32). Conclusions In this cohort of severe aortic stenosis patients, a reduced LAEF was associated with greater incidence of cardiovascular events, being a stronger predictor than LAVI, PASP or LVEF. This study suggests that LA dysfunction over LA volumes correlates better with clinical outcomes. Funding Acknowledgement Type of funding source: None

Funding Acknowledgements Type of funding sources: None. Background/Introduction: Aortic valve stenosis (AS) is the most common primary valvular heart disease leading to surgical or percutaneous aortic valve replacement (AVR) in Europe. Both symptoms and systolic dysfunction can appear late in the course of the disease, being often synonym of irreversible damage to the myocardium when found. Thus, there is a necessity to find other sensitive markers present at an earlier stage of the disease. Purpose Our primary aim is to clarify the relationship between LA function measured at severe AS diagnosis (evaluated by means of volumetric assessment) and all-cause mortality during follow-up. Methods We retrospectively evaluated patients diagnosed with severe AS for the first time at our echocardiography laboratory. We evaluated all 3 left atrial (LA) functional phases (reservoir, conduit and pump) by measuring LA volumes at different timings of cardiac cycle. Treatment strategy was decided according to heart team consensus and own patient decision. We divided patients into groups according to terciles of LA reservoir, conduit and pump function. Primary outcome was defined by the occurrence of all-cause mortality during follow-up. Results After exclusion criteria, a total of 451 patients were included in the analysis (aged 74 ±11years, 54% male) and were followed during a median period of 73 months (interquartile range 44.5). A total of 55.8% of patients underwent AVR and 45,5% of patients registered the primary outcome. Left atrial emptying fraction (LAEF) was the best LA functional parameter in discriminating primary outcome (AUC 0.840, p Conclusion(s) In patients with a first diagnosis of severe AS in hospital setting, LA function assessed by volumetric parameters is an independent predictor of all-cause mortality. Compared to classical severity parameters, different LA functional parameters were found to be more potent predictors of death. These data can be useful in clinical practice for risk stratification and therefore for decision of timing for AVR. Abstract Figure. Survival of patients stratified by group

Background Aortic valve stenosis (AS) is the most common primary valvular heart disease leading to surgical or percutaneous aortic valve replacement (AVR) in Europe and its prevalence keeps growing. While other risk factors in severe AS are well documented, little is known about the prognostic value of left atrial (LA) function in AS. Our aim is to clarify the relationship between LA function measured at severe AS diagnosis (evaluated by means of volumetric assessment) and all-cause mortality during follow-up. Methods We retrospectively evaluated patients diagnosed with severe AS for the first time at our echocardiography laboratory. We evaluated LA reservoir, conduit and pump function by measuring LA volumes at different timings of cardiac cycle. Treatment strategy was decided according to heart team consensus and patient decision. We divided patients into groups according to terciles of LA reservoir, conduit and pump function. Primary outcome was defined by the occurrence of all-cause mortality during follow-up. Results A total of 408 patients were included in the analysis, with a median follow-up time of 45 months (interquartile range 54 months). 57.9% of patients underwent AVR and 44.9% of patients registered the primary outcome during follow-up. Left atrial emptying fraction (LAEF) was the best LA functional parameter and the best overall parameter in discriminating primary outcome (AUC 0.845, 95%CI 0.81–0.88, P P P = 0.002, respectively). After adjustment for AVR, excess risk of LAEF P P = 0.001, respectively). Conclusions In patients with a first diagnosis of severe AS, LA function, evaluated by means of volumetric assessment, is an independent predictor of all-cause mortality and a more potent predictor of death compared to classical severity parameters. These data can be useful to identify high-risk patients who might benefit of AVR.

Regenerative strategies for human articular cartilage are still challenging despite the presence of resident progenitor cell population. Today, many efforts in the field of regenerative medicine focus on the use of platelet derivatives due to their ability to reactivate endogenous mechanisms supporting tissue repair. While their use in orthopedics continues, mechanisms of action and efficacy need further characterization. We describe that the platelet lysate (PL) is able to activate chondro-progenitor cells in a terminally differentiated cartilage tissue. Primary cultures of human articular chondrocytes (ACs) and cartilage explants were set up from donor hip joint biopsies and were treated in vitro with PL. PL recruited a chondro-progenitors (CPCs)-enriched population from ex vivo cartilage culture, that showed high proliferation rate, clonogenicity and nestin expression. CPCs were positive for in vitro tri-lineage differentiation and formed hyaline cartilage-like tissue in vivo without hypertrophic fate. Moreover, the secretory profile of CPCs was analyzed, together with their migratory capabilities. Some CPC-features were also induced in PL-treated ACs compared to fetal bovine serum (FBS)-control ACs. PL treatment of human articular cartilage activates a stem cell niche responsive to injury. These facts can improve the PL therapeutic efficacy in cartilage applications.

Although screening has reduced mortality rates for colorectal cancer (CRC), about 20% of patients still carry metastases at diagnosis. Postsurgery chemotherapy is toxic and induces drug resistance. Promising alternative strategies rely on repurposing drugs such as aspirin (ASA) and metformin (MET). Here, tumor spheroids were generated in suspension by primary CRCs and metastatic lymph nodes from 11 patients. These spheroids presented a heterogeneous cell population including a small core of CD133+/ESA+ cancer stem cells surrounded by a thick corona of CDX2+/CK20+ CRC cells, thus maintaining the molecular hallmarks of the tumor source. Spheroids were exposed to ASA and/or MET at different doses for up to 7 days to assess cell growth, migration, and adhesion in three-dimensional assays. While ASA at 5 mM was always sufficient to mitigate cell migration, the response to MET was patient specific. Only in MET-sensitive spheroids, the 5 mM ASA/MET combination showed an effect. Interestingly, CRCs from diabetic patients daily pretreated with MET gave a very low spheroid yield due to reduced cancer cell survival. This study highlights the potential of ASA/MET treatments to modulate CRC spreading.

Introduction Estimation of right ventricular (RV) performance by echocardiography is challenging due to its anatomical and functional distinctiveness. RV longitudinal strain (RVLS) by speckle-tracking (STE) is an innovative tool and recent studies show that it can be used with prognostic significance, although it isn’t yet standardized. Purpose In this study, we aimed to evaluate global (G) and free wall (FW) RVLS-STE and its correlation with common RV evaluation methods. Methods We conducted a prospective observational study including 65 patients and 20 healthy controls. G and FW RVLS-STE were correlated to tricuspid annular plane systolic excursion (TAPSE), Doppler tissue tricuspid lateral annular systolic velocity (S`) and left ventricle ejection fraction (LVEF). Following current guidelines, a TAPSE higher than 17mm, a peak S` wave velocity higher than 9.5cm/s and a RVLS-STE inferior to -20% was considered normal. Results Mean age was 66.34 ± 15.45 years with 61.5% males in the patient group and 31.1 ± 7 years with 50% males in the control group. Echocardiographic findings in patient group included 44.6% with reduced LVEF (EF 35mmHg) and 36.9% without significant structural disease. The control group had no pathological signs on echocardiography. Peak S` wave and TAPSE showed a better correlation with FW RVLS-STE (r²=0.41, p Conclusion FW RVLS-STE is better than G RVLS-STE as a RV evaluation method. RVLS-STE is correlated with TAPSE and peak S` wave velocity. It was the only parameter that showed reduction to abnormal values (> -20%) in pathological groups and seems to be an accurate marker of RV function particularly detecting early dysfunction

Introduction Hypertrophic cardiomyopathy (HCM) is characterized by a heterogeneous clinical expression with increased risk of sudden cardiac death (SCD) from ventricular arrhythmias (VAs).Several studies have shown that patients with malignant arrhythmias have increased electrical dispersion and in homogeneity of intraventricular conduction. Strain by echocardiography is an excellent tool for assessing regional and global left ventricular (LV) function and mechanical dispersion reflects heterogeneous myocardial contraction. We aimed to explore the value of strain parameters in prediction of VAs in HCM with LV preserved systolic function. Methods Retrospective observational study including all patients with HCM and ICD implanted in setting of primary prevention in our centre. Patients with LVEF Results The study population included 48 patients, 63.3% of male gender. A family history of HCM was present in 64 pts (43%). All patients were under anti arrhythmic therapy (BB in 95.6%, other anti-arrhythmic in 28.2%). VAs (sustained and non sustained) were documented in 27 (55%) patients. The study groups did not differ regarding to mean age (54 ± 12 vs 56 ± 12 years, p = 0.67), male gender (54% vs 56%, p = 0.87) and BB therapy (91% vs 96%,p = 0.07). Mean LVEF was 58% in group 1 and 61% in group 1, p = 0.56; a LVOT gradient >30mmHg was present in 52% of group 1 pts and 45% of group 2 pts, p = 0.06. Mean wall thickness was 22mm vs 18 mm, p = 0.03, respectively. GLS was significantly lower in group 1 (- 13.9 ±3.4 vs -16.1 ±3.5, p = 0.02), mechanic dispersion was significantly higher in group 1(81 ± 14 vs 60 ± 12ms, respectively, p = 0.01. Using a multivariate logistic regression model including variables included in SCD HCM risk score proposed by ESC mechanical dispersion (OR: 1.54 (1.03–8.7), p = 0,03) was a strong and independent risk predictor of VA. Using optimal cut-off values from ROC analyses, patients with mechanical dispersion >67 ms (AUC = 0.82, p= 0.02) had more VAs. Conclusions Mechanical dispersion and GLS may help to identify HCM patients with high risk of VAs and SCD. Abstract P1541 Figure 1

Introduction Left Ventricular (LV) torsion is an important component of LV performance. With the development of speckle tracking echocardiography, it became possible and feasible to measure rotation and twisting with a high degree of accuracy. No standard normal values are defined for peak torsion, although mean values around 10° are found in normal subjects with a slight increase with age. Purpose In this study we aimed to evaluate torsion in the different types of severe valvular disease. Methods We conducted a retrospective, observational study including patients with severe valvular disease with suitable images for torsion analysis. We included 61 patients (21 with severe aortic stenosis (AS), 20 with severe aortic regurgitation (AR) and 20 with severe mitral regurgitation (MR). Circumferential basal and apical strain was performed, and peak torsion was calculated. Results were compared between groups and were related with echocardiographic parameters, including left ventricle ejection fraction (LVEF). Results Mean age was 70.3 ± 13.6 years with a male preponderance (66%). Mean LVEF was within normal range in the aortic valve disease group; no significant difference was found in LVEF between AS and AR patients (57 ± 7.7% vs 55 ± 9.7%, p = 0.57). In comparison with the aortic disease group, MR patients had a reduced LVEF (48 ± 17.3% vs 56 ± 8.7%, p = 0.05). Mean peak torsion was 8.9 ± 5.1° in AS, 12.6 ± 4.9° in AR and 7.9 ± 3.2° in MR (p = 0.004). Comparing with aortic valve disease patients, MR patients had a reduced mean peak torsion (7.9 ± 3.2° vs 10.7 ± 5.3°, p = 0.03). In relation with patients with AS, those with AR had a higher peak torsion (12.6 ± 4.9° vs 8.9 ± 5.1°, p = 0.024) and a higher left ventricle end-diastolic volume (87.3 ± 29.1 mL.m-² vs 64.5 ± 24.9 mL.m-², p = 0.011). Circumferential apical strain showed a negative correlation with peak torsion (r²=0.203, p = 0.006) and with LVEF (r²=0.290, p Conclusion LV function and peak torsion are more associated with apical than basal circumferential movement. Aortic valve disease is responsible for LV torsion variations in patients with normal ejection fraction, showing an increase in AR and a reduction in AS. In MR patients a reduced LVEF could entails a decrease in peak torsion.

This study is based on a longitudinal in-depth case study, conducted in a Portuguese public-sector organization, where the accountants adopted a strategic business partner role and promoted the implementation of two new accounting information systems (AIS), under the context of increasing business competition. Given their role, we examined how the implementation processes of such AIS were influenced by the accountants’ power strategies, adopting an organizational power narrative inquiry grounded on the four power dimensions proposed in Hardy’s (1996) framework: power over resources, power over decision-making processes, power over meanings and power of the system. As a result, this study contributes to the literature available on AIS by discussing the strategic business partner role of (management) accountants in a specific case; and by offering new insights into AIS research under the topic of accounting change through the exercise of power. Our research also contributes to the literature on organizational power by providing theoretical developments to Hardy’s (1996) power framework.

BACKGROUND Left atrial (LA) mechanics is impaired in mitral valve disease, but it is not clear whether reservoir, conduit or contractile functions are differentially impaired in stenosis (MS) or regurgitation (MR). We aimed to study LA mechanics in patients with moderate MR or moderate MS and identify discriminators of disease. METHODS We conducted a prospective, observational study of 100 patients with isolated moderate MR and 100 patients with moderate MS. LA mechanics with speckle tracking echocardiography (STE) assessed LA reservoir (LA ɛsys and SRs), conduit(LAɛe, SRe), and contractile (LAɛa, SRa) functions. Left ventricle (LV) functional parameters were assessed as well, including LV ejection fraction (LVEF), LV end-diastolic diameter (LVDD) and LV global longitudinal strain (LV-GLS). RESULTS The mean age was 67 ± 14 years and 75% were female. Mean left ventricular ejection fraction (LVEF), LV end-diastolic diameter (LVDD), LV global longitudinal strain (LV-GLS) and systolic pulmonary artery pressure (sPAP) did not differ between MR and MS (table 1).LA indexed volume (LAVi) and LA strain did not vary between MR and MS, but strain rate did. SRs and SRe had better values in MR, whereas SRa had worse values in MR (table 1). SRe ( CONCLUSIONS LA strain rate phases were the only parameters that varied between MR and MS. Contractile phase strain rate was more impaired in MR and conduit phase strain rate in MS. This highly specific data reflect the earlier hemodynamic changes occurring in LA in the setting of mitral valve disease. mMR mMS P value LVEF (±SD,%) 57.4 ± 6.4 59.6 ± 4.6 0.145 LV-GLS (±SD, %) -17.7 ± 4.5 -17.1 ± 3.5 0.587 sPAP (±SD, mmHg) 30.3 ± 10.5 32.4 ± 8.3 0.387 LAVi (± SD, ml/m2) 46.3 ± 6.4 48.2 ± 7.4 0.281 LAɛs (± SD, %) 15.8 ± 7.3 13.3 ± 9 0.062 LAɛe (± SD, %) 8.4 ± 4.7 7.1 ± 5.4 0.074 LAɛa (± SD, %) 6.3 ± 4.8 7.4 ± 4.5 0.081 LA SRs (± SD, %) 0.8 ± 0.4 0.6 ± 0.3 0.004 LA SRe (± SD, %) -0.9 ± 0.5 -0.5 ± 0.3

We find new facts that relate the evolution of firm scope to the changing frictions in external capital markets over the last three decades. We find that large, diversified publicly traded firms increase their scope during times of high external capital market frictions, such as in the recent Great Recession. Moreover, during these times firms diversify their investment needs and cash flow across industries. We also find similar phenomena outside diversified public firms. Examining the mergers and acquisitions activity of stand-alone and diversified private firms, we uncover similar patterns. In aggregate data, we find that the composition of mergers shifts from focused to diversifying and back with changes in external market conditions. Our evidence is broadly consistent with the notion that firms diversify their scope in response to tightening in external capital markets.

With the introduction of high-sensitivity troponin (hsTNI) assays, the clinical significance unstable angina (UA) has become uncertain. We hypothesized that impaired left ventricular (LV) two-dimensional speckle-tracking echocardiography (2D-STE)-derived peak global longitudinal strain (GLS) was able to exclude the presence of significant coronary artery disease (CAD) in UA patients without prior cardiovascular (CV) events and with a normal LV ejection fraction (LVEF). From a cohort of 200 patients admitted with UA, we selected 61 patients without prior CV events and with a normal LVEF; of these, 48 (79%) underwent invasive coronary angiography (ICA) and 24 (39%) had at least ≥ 1 significant stenosis. 2D-STE LV GLS analysis was performed offline using a dedicated automated software program. The mean patient age was 61 ± 12 years and 66% were male. Among the 48 patients selected to undergo ICA, those without significant CAD had a better 2D-STE GLS (− 19.4 vs. − 15.9%, P

The growth of the higher education population and different school paths to access an academic degree has increased the heterogeneity of students inside the classroom. Consequently, the effectiveness of traditional teaching methods has reduced. This paper describes the design, development, implementation and evaluation of a tutoring system (TS) to improve student's engagement in higher mathematics. The TS design was based on the Personalized System of Instruction of the Mastery Learning pedagogical approach and can be implemented in any higher education course with mathematics needs. The TS consists on small self-paced modularized units of educational contents, including tutorial videos, notes and formative e-assessment with personalized feedback. The TS ensures that the student is only allowed to proceed to the next unit after he or she achieves the required mastery criterion of the current unit. The TS was implemented in the Quantitative Methods course of an undergraduate degree and received good acceptance from students. It was also recognized that TS contributed to learning and engagement with the discipline. Through an experimental research experience, it has been shown that the imposition of restrictions on the advance to the next level by a mastery criterion leads to a significant improvement in student's engagement and performance.

Anti-N-methyl-D-aspartate receptor (anti-NMDAR) encephalitis is a rare condition characterized by emotional and behavioral disturbances, dyskinesias, and extrapyramidal signs. It occurs in young women of reproductive age and is classically described as a paraneoplastic phenomenon. We present a 36-year-old, HIV-positive female who was admitted to the hospital in an acute confusional state, with a stiff posture, periods of motor agitation, and myoclonic jerks of the hands. Her mental state progressively deteriorated. Without evidence of infection, the presence of anti-NMDAR antibodies both in serum and cerebrospinal fluid clinched the diagnosis of autoimmune encephalitis. No evidence of neoplastic disease was found, and the beneficial response to immunosuppressive therapy was exceptional. This is the first report of anti-NMDAR encephalitis in an HIV-infected individual, reminding us that autoimmune encephalitis should be included in the differential diagnosis of a young patient presenting in an acute confusional state.

BACKGROUND : Hypertrophic cardiomyopathy (HCM) and left ventricular hypertrophy (LVH) secondary to systemic hypertension (HTN) may be associated with left atrial (LA) functional abnormalities. We aimed to characterize LA mechanics in HCM and HTN and determine any correlation with the extent of fibrosis measured by cardiac magnetic resonance (CMR) in HCM patients. METHODS: Two-dimensional speckle tracking-derived longitudinal LA function was acquired from apical views in 60 HCM patients, 60 HTN patients, and 34 age-matched controls. HCM patients also underwent CMR, with measurement of late gadolinium enhancement (LGE) extension. Association with LA strain parameters was analyzed. RESULTS: The mean LV ejection fraction did not differ across groups. The E/e’ ratio was only preserved in the control group and significantly impaired in the HCM group. LA mechanics were significantly reduced in HCM, compared to the HTN group. LA strain rate in systole (LA-SRs) and late diastole (LA-SRa) were the best discriminators of HCM, with an area under the curve (AUC) of 0.8, followed by LA strain in systole (LA ɛsys) (AUC 0.76). LA-SRs and LA-SRa had high specificity (89% and 91%, respectively) and LA ɛsys had sensitivity of 80%. LA strain rate in early diastole (LA-SRe) was moderately correlated with the extension of LGE (r 2 0.42, p=0.027) CONCLUSIONS: LA-SRs and LA-SRa were the best discriminators for LVH secondary to HCM. LA-SRe was best correlated with the degree of fibrosis assessed by CMR. These findings suggest that LA mechanics can be potential predictors of disease severity in HCM.

Titanium dioxide is the most used photocatalyst in wastewater treatment; its semiconductor capacity allows the indirect production of reactive oxidative species. The main drawback of the application of TiO2 is related to its high band-gap energy. The nonmetal that is most often used as the doping element is nitrogen, which is due to its capacity to reduce the band-gap energy at low preparation costs. There are multiple and assorted methods of preparation. The main advantages and disadvantages of a wide range of preparation methods were discussed in this paper. Different sources of N were also analyzed, and their individual impact on the characteristics of N⁻TiO2 was assessed. The core of this paper was focused on the large spectrum of analytical techniques to detect modifications in the TiO2 structure from the incorporation of N. The effect of N⁻TiO2 co-doping was also analyzed, as well as the main characteristics that are relevant to the performance of the catalyst, such as its particle size, surface area, quantum size effect, crystalline phases, and the hydrophilicity of the catalyst surface. Powder is the most used form of N⁻TiO2, but the economic benefits and applications involving continuous reactors were also analyzed with supported N⁻TiO2. Moreover, the degradation of contaminants emerging from water and wastewater using N⁻TiO2 and co-doped TiO2 was also discussed.

Background There is limited information regarding left atrial (LA) mechanics in aortic valve stenosis (AS). We assessed LA mechanics in AS through speckle-tracking echocardiography (STE) according to severity and prognosis. Methods We included 102 patients diagnosed with severe AS (sAS) and 80 patients with moderate AS (mAS), all with preserved ejection fraction and no coronary artery disease. LA mechanics and left ventricular global longitudinal strain (LV-GLS) were assessed by STE. The cohort was followed-up for a median of 30 (IQR 12.6–50) months, and outcomes were determined (combined outcome of HF, death, and aortic valve replacement). Results In our sample set, values of LV-GLS (− 18.5% vs − 17.1, p = 0.025), E/e’ ratio (15.8 vs 18.4, p = 0.03), and global LA mechanics (LA ɛsys, 23% vs 13.8%, p p p p r2 = 0.6, p r2 = 0.55, p r2 = 0.3 and r2 = 0.25, p = 0.01). Either LV-GLS or LA ɛsys, but not the E/e’ ratio, TAPSE, or RV/RA gradient, were a significant predictors of the combined outcome. Conclusions LA global strain was the best discriminator of severity, surpassing E/e’ ratio and LV-GLS, and a significant predictor of prognosis in AS.

Metabolomics is paramount for precision agriculture. Knowing the metabolic state of the vine and its implication for grape quality is of outermost importance for viticulture and wine industry. The MetBots system is a metabolomics precision agriculture platform, for automated monitoring of vineyards, providing geo-referenced metabolic images that are correlated and interpreted by an artificial intelligence self-learning system for aiding precise viticultural practices. Results can further be used to analyze the plant metabolic response by genome-scale models. In this research, we introduce the system main components: (i) robotic platform; (ii) autonomous navigation; (iii) sampling arm manipulation; (iv) spectroscopy systems; and (v) non-invasive, real-time metabolic hyper-spectral imaging monitoring of vineyards. The full potential of the Metbots system is revealed when metabolic data and images are analyzed by big data AI and systems biology vine plant models, establishing a new age of molecular biology precision agriculture.

BACKGROUND This study evaluates the integration of ferric coagulation, Fenton oxidation (both at lab and industrial scale) and activated sludge (at lab scale) for the treatment of olive mill wastewater. RESULTS Initially, an iron based coagulation at the raw pH of olive mill effluent was performed, leading to 38% of COD abatement at bench scale. This procedure also provided some dissolved iron that can be used as catalyst in the following Fenton's peroxidation step. At lab scale Fenton's process accomplished a COD removal of 75%. Moreover, some biodegradability enhancement was achieved with this procedure with initial BOD5/CODaverage= 0.03 increasing to BOD5/CODaverage=0.37 after the process. This integrated treatment was then applied at the industrial scale and, after further optimization, coagulation and Fenton's processes were able to remove 43% and 62% of COD, respectively. CONCLUSION Based on the interesting results gathered at lab-scale, it was possible to optimize an industrial WWTP (waste water treatment plant).Ferric coagulation followed by Fenton's peroxidation was implemented with efficiency up to 90% and a final COD of 200 mgO2.L−1. The resulting wastewater is adequate to discharge into municipal sewage or can be recycled for reutilization after an in-situ biological treatment.

Universal access to modern energy is required if the world is to reduce poverty and enable sustainable development. Energy poverty is the lack of access to safe and efficient energy carriers. It affects more than 1.3 billion people without electricity and 2.7 billion without appropriate cooking facilities and fuels, particularly in sub-Saharan Africa (SSA). Under these conditions, people rely on traditional biomass to fulfil basic needs. Traditional biomass use causes death and disease associated with indoor air pollution, high labor demands to obtain biomass, and environmental damage due to deforestation. This paper analyzes the potential for modern energy production based on sugarcane in SSA. A standard, business-as-usual (BAU), sugar-based project is explored vis-a-vis more aggressive scenarios for producing modern energy, including electricity, ethanol, and solid fuel pellets. All scenarios considered are based on a single sugarcane mill processing one million tonnes of cane per year, grown in an area of 15 000 hectares. Our simulations show that over 210 000 households could be served with electricity and other 31 000 with modern cooking fuels under the scenarios examined. Less dependence on traditional biomass may also spare wooded environments from deforestation. However, harnessing modern energy from sugarcane does not come without challenges. Economic pitfalls (e.g. investment costs and affordability) coupled with poor political environments are among the main obstacles. Nevertheless, encouraging local and regional trends proved bioenergy a feasible way out of energy poverty and an alternative to sustainable development. © 2016 Society of Chemical Industry and John Wiley & Sons, Ltd

Introduction Advances in neoadjuvant chemotherapy (NCT) have allowed surgical treatment in otherwise unresectable patients with colorectal liver metastases (CRLM). It is well known that NCT induces liver lesions such as sinusoidal obstruction syndrome (SOS) and steatohepatitis (SH). However, whether it affects postoperative morbidity remains controversial. The aim of this study was both to evaluate the impact of NCT on liver parenchyma and postoperative morbidity, and to identify preoperative predictive markers for liver injury. Patients and methods Among 140 patients undergoing liver resection for CRLM between 2010 and 2013, 70 underwent systemic NCT. Liver function tests, pathology, postoperative morbidity and mortality were compared between the two groups. Results Univariate analysis revealed NCT as a cause of sinusoidal dilation (p = 0.09), peliosis (p = 0.028) and moderate and severe SOS (p = 0.004) and bevacizumab as a protective agent against moderate and severe SOS (p = 0.045). Diabetic patients were identified as having a lower incidence of sinusoidal dilation (p = 0.034) and a higher incidence of steatosis (p = 0.003). Multivariate analysis confirmed sinusoidal dilation as an independent cause for morbidity (p = 0.02) and liver-specific complications (p = 0.016). Preoperative level of GGT was identified as predictive factor for moderate and severe SOS and peliosis (p Conclusion The administration of NCT induces SOS-lesions, but can be partially prevented by bevacizumab and diabetes. Sinusoidal dilation is associated with increased postoperative morbidity. Preoperative GGT levels can be useful to predict the presence of SOS.

The last 40 years have witnessed the rapid development of novel strategies to enhance the systemic administration of molecular agents for therapy and imaging. As such, “drug delivery” has become one of the most challenging and scientifically advanced fields of research. Nanoparticles for the systemic delivery of therapeutic and contrast agents have been tested in preclinical studies for the cure and early detection of cancer, cardiovascular and neurodegenerative diseases [1–4]. Compared to conventional molecular agents, drug delivery systems can offer several advantages. Nanoparticles can improve the bioavailability, biodistribution, and longevity in the circulation of the carried molecules. Furthermore, they offer the opportunity of preserving, over long times, the tissue concentration of the drug molecules within proper therapeutic ranges and protect them from enzymatic degradation [5]. Overall, these improvements allow for an enhancement in drug accumulation at the biological target and a reduction of the off-site effects, as compared to the freely administered molecular formulation. In this chapter, first the design and fabrication of polymeric nanoconstructs for the smart delivery of therapeutic and imaging agents will be presented. Then, the role of multimodal imaging and theranostics will be reviewed providing examples available in the open literature and produced by the authors. Finally, the role of in vitro testing and in silico computational modeling in the optimization of polymeric nanoconstructs will be assessed.

International audience; The blooming of different cloud data stores has turned polystore systems to a major topic in the nowadays cloud landscape. Especially, as the amount of processed data grows rapidly each year, much attention is being paid on taking advantage of the parallel processing capabilities of the underlying data stores. To provide data federation, a typical polystore solution defines a common data model and query language with translations to API calls or queries to each data store. However, this may lead to losing important querying capabilities. The polyglot approach of the CloudMdsQL query language allows data store native queries to be expressed as inline scripts and combined with regular SQL statements in ad-hoc integration queries. Moreover, efficient optimization techniques, such as bind join, can still take place to improve the performance of selective joins. In this paper, we introduce the distributed architecture of the LeanXcale query engine that processes polyglot queries in the CloudMdsQL query language, yet allowing native scripts to be handled in parallel at data store shards, so that efficient and scalable parallel joins take place at the query engine level. The experimental evaluation of the LeanXcale parallel query engine on various join queries illustrates well the performance benefits of exploiting the parallelism of the underlying data management technologies in combination with the high expressivity provided by their scripting/querying frameworks.

The aim of the present study was to test whether perceived burdensomeness and thwarted belongingness are related to suicide ideation, when controlling for depressive symptoms. The sample consisted of elderly patients recovering from acute medical conditions who were recruited in a medical recovery clinic. Results demonstrated that depressive symptoms and thwarted belongingness related to the suicide ideation item of the Beck Depression Inventory-II, used as an indicator of suicide ideation. Depressive symptoms and thwarted belongingness also discriminated between participants with suicide ideation and participants without suicide ideation as defined by suicide items of the Symptom-Driven Diagnostic System for Primary Care. Results are discussed in terms of potential cultural influences, and clinical implications are highlighted.

Asteraceae family members are well-known for their medicinal potential, comprising several properties that make them unique among plants. Here we focus on Santolina semidentata, an endemic plant from the Iberian Peninsula, not yet described for its medicinal properties. Phytochemical characterization of S. semidentata was performed, concerning total phenol content, flavonoid content, antioxidant capacity, HPLC-DAD profile, acetylcholinesterase inhibitory capacity, cytotoxicity and neuroprotective effect in a human neurodegeneration cell model. Moreover, essential oil composition and antifungal activity were also analised. This oil might be useful for therapeutical purposes, particularly in the treatment of dermatophytosis. S. semidentata potential for neuroprotection was revealed by acetylcholinesterase inhibitory capacity and also by an effective protective effect in human neuronal cells. Furthermore, different seed conservation protocols, as well as successful in vitro propagation were established which may be useful when integrated in a broad strategy for the conservation of these endemic plants and their sustainable use for potential biotechnological applications. The results presented here greatly contribute to value this species regarding its potential as a source of phytochemicals with prospective neuroprotective health benefits, either as alternative neuroprotective drugs or as leads for synthetizing more effective molecules. The authors wish to thank to “Fundo EDP para a Biodiversidade” for financial support. This work was also supported by “Fundação para a Ciência e a Tecnologia” through grant PEst-OE/EQB/LA0004/2011, BGCT/33418/2008, Green-it: UID/Multi/04551/2013, iNOVA4Health: UID/Multi/04462/2013 and financial support to CNS (IF/01097/20132), RP (SFRH/BD/63615/2009), IF (SFRH/BD/86584/2012) and AG (SFRH/BD/103155/2014). info:eu-repo/semantics/publishedVersion

Dataflow programs are widely used. Each program is a directed graph where nodes are computations and edges indicate the flow of data. In prior work, we reverse-engineered legacy dataflow programs by deriving their optimized implementations from a simple specification graph using graph transformations called refinements and optimizations. In MDE-speak, our derivations were PIM-to-PSM mappings. In this paper, we show how extensions complement refinements, optimizations, and PIM-to-PSM derivations to make the process of reverse engineering complex legacy dataflow programs tractable. We explain how optional functionality in transformations can be encoded, thereby enabling us to encode product lines of transformations as well as product lines of dataflow programs. We describe the implementation of extensions in the ReFlO tool and present two non-trivial case studies as evidence of our work’s generality, We gratefully acknowledge helpful feedback from B. Marker (U. Texas), and from the anonymous reviewers. Rui Gonçalves and João Sobral are funded by ERDF – European Regional Development Fund through the COMPETE Programme (operational programme for competitiveness) and by National Funds through the FCT – Fundação para a Ciência e a Tecnologia (Portuguese Foundation for Science and Technology) within projects FCOMP01-0124-FEDER-010152, FCOMP-01-0124-FEDER-011413 and UID/CEC/00319/2013. Rui Gonçalves is additionally funded by FCT grant SFRH/BD/47800/2008. We also gratefully acknowledge support for this work by NSF grants CCF-0724979, CCF-1421211, and OCI-1148125.

BACKGROUND Pharmaceutical industry generates a large amount of liquid effluents rich in toxic compounds that reach natural water streams, if improperly degraded, being a threat for ecosystems. In this context, ozonation appears as an interesting alternative to conventional treatments. This work aims to study the effect of this technology aided by two ceramic catalysts (the laboratory Mn-Ce-O and the commercial N-150) on the degradation of a mixture of two contaminants: sulfamethoxazole and diclofenac. RESULTS: The presence of the catalysts had no significant impact on pharmaceuticals removal when compared with single ozonation. However, both materials increased the amount of COD removed per mg of ozone applied (0.10 mgCODremoved mg−1O3 and 0.067 mgCODremoved mg−1O3 for catalytic and single ozonation, respectively). The performance of Mn-Ce-O was very dependent upon the solution pH whereas no significant pH impact was detected for N-150. The generalized kinetic model (GKM) was able to satisfactorily describe the lumped kinetic mechanism concerning COD abatement. Moreover, no differences in the degradation results were observed for the Mn-Ce-O system when comparing two types of waters (ultrapure and natural) used to dissolve the pharmaceutical compounds. Importantly, the presence of the solid catalyst improved ozone usage and reduced the effluents' toxicity. CONCLUSION Although work has been published regarding the removal of single emerging contaminants, the analysis of mixtures is not so frequent. The use of Mn-Ce-O truly enhances COD degradation revealing its potential as heterogeneous catalytic material to improve ozone action on pollutants. © 2015 Society of Chemical Industry

Evaluation of vascular mechanics through two-dimensional speckle-tracking (2D-ST) echocardiography is a feasible and accurate approach for assessing vascular stiffening. Degenerative aortic stenosis (AS) is currently considered a systemic vascular disease where rigidity of arterial walls increases. To assess the circumferential ascending aorta strain rate (CAASR) in thoracic aortas of patients with AS, applying 2D-ST technology. 45 patients with indexed aortic valve areas (iAVA) ≤0.85 cm(2)/m(2) were studied. Global CAASR served to assess vascular deformation. Clinical, echocardiographic, and non-invasive hemodynamic data were collected. A follow up (955 days) was also performed. Average age of the cohort was 76. ± 10.3 years, with gender balance. Mean iAVA was 0.43 ± 0.15 cm(2)/m(2). Waveforms adequate for determining CAASR were found in 246 (91 %) of the 270 aortic segments evaluated, for a mean global CAASR of 0.74 ± 0.26 s(-1). Both intra- and inter-observer variability of global CAASR were deemed appropriate. CAASR correlated significantly with age (r = -0.49, p < 0.01), the stiffness index (r = -0.59, p < 0.01), systemic arterial compliance and total vascular resistance. There was a significant positive correlation between CAASR, body surface area (BSA), iAVA, and a negative relationship with valvulo-arterial impedance and E/e' ratio (r = -0.37, p = 0.01). The stiffness index was (β = -0.41, p < 0.01) independently associated with CAASR, in a model adjusted for age, BSA, iAVA and E/e'. Patients with a baseline CAASR ≤0.66 s(-1) had a worse long-term outcome (survival 52.4 vs. 83.3 %, Log Rank p = 0.04). CAASR is a promising echocardiographic tool for studying the vascular loading component of patients with AS. info:eu-repo/semantics/publishedVersion

The system described in this paper combines virtual reality with haptic feedback to increase the level of immersion and invoke the sense of agency in patients with phantom limb pain with the aim of reducing perceived pain. This paper presents three case studies of an on-going clinical study. The initial results suggest an increased sense of embodiment of the virtual limb promotes a decrease in perceived levels of pain. The results strengthen the view that the cortical map does not fully “disappear” yet lays dormant.