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The environmental conditions to which dams are exposed play a major role in dictating the progression and manifestation of the alkali–aggregate reaction (AAR). However, in the numerical thermal-mechanical simulation of AAR-affected dams, the solar radiation and its associated shadow effects have received little attention. The spatiotemporal distribution of the solar radiation incidence on the dam surfaces has often been addressed in a simplified way or has just been neglected. Yet, far less attention has been given to shadows cast by the dam’s own geometry or the slopes. The main reasons for these simplifications derive from the fact that contrary to other thermal loads, environmental actions vary in daily and annual cycles, with the added complication that solar radiation also depends on the orientation of the surface with respect to the Sun’s rays. In this way, a conventional thermal finite element code should be modified in order to deal with these two particular issues. Therefore, this article starts with the estimation of the solar radiation distribution by recourse to concepts of astronomy and computer graphics. Then, to illustrate the influence of the nonuniform temperature distribution on dam surfaces due to solar radiation and shading, the analysis of an AAR-affected arch dam is presented in this paper. A comparison of the AAR expansions computed on the dam with or without considering the solar radiation and shading is presented.

Abstract The article aims to assess the connection between sustainable leadership and sustainable entrepreneurship, by providing a framework based on the main findings of the clusters relating the effectiveness of that connection. Using the Web of Science databases and applying inclusion and exclusion criteria, 149 articles were retrieved and analysed. The bibliometric analysis was conducted using R-Studio software. The main findings unveil that sustainable leadership and sustainable entrepreneurship are interrelated concepts that play a key role in promoting responsible business practices and formulating solutions to contemporary socio-environmental challenges. The study’s main contribution lies in highlighting the importance of knowledge about sustainable leadership, sustainable entrepreneurship and their links. In practical terms, analysis of the connection between sustainable leadership and sustainable entrepreneurship reveals how the former plays an important role in promoting the latter, inspiring and supporting entrepreneurs in the adoption of sustainable practices, generating a positive socio-environmental impact as well as economic value for the firm. There is a need for more research on sustainable leadership, especially correlating its effectiveness in promoting sustainable entrepreneurship.

The manufacturing and characterization of nanographite films on substrates form the foundation for advances in materials science. Conductive graphite films are challenging products, as isolating graphite oxide is often necessary. In this study, nanographite suspensions containing non-oxidized graphite flakes were used to fabricate novel thin and ultrathin films via blade coating on industry-standard substrates. Films as thin as 346 nm were successfully fabricated. Moreover, it was possible to induce the orientation of the graphite nanoflakes via blade coating. This orientation led to electrical anisotropy; thus, the electrical behavior of the films in each orthogonal direction differed. After adjusting the coating parameters and the concentration of the nanographite flakes, the electrical conductivity ranged from 0.04 S/cm to 0.33 S/cm. In addition, with such adjustments, the transparency of the films in the visible range varied from 20% to 75%. By establishing a methodology for the tuning of both electrical and optical properties via adjustments in the nanographite suspension and coating parameters, we can fabricate resistant, conductive, and transparent films satisfying certain requirements. The results presented here can be extrapolated to enhance applications, especially for photonics and solar cells, in fields that require electrical conductive materials with high levels of transparency.

Abstract Excess sugar is considered one of the primary factors contributing to overweight status. In Brazil, sugar-sweetened beverages (SSBs) contain a significant amount of this nutrient and are consumed excessively. These beverages are associated with adverse health outcomes and impose costs on the healthcare system. The literature currently lacks studies that aim to attribute specific nutrients or foods as causes of diseases and also evaluate their economic impact, especially in middle- and low-income countries. This study aims to estimate the direct and indirect costs of obesity, stratified by sex and age group, resulting from the excessive consumption of sugar-sweetened beverages in Brazil from 2008 to 2020, and to project these costs for the year 2036. The estimation of obesity costs attributable to excessive consumption of SSBs was based on relative risks and the population prevalence of obesity, considering expenditures on hospitalizations and outpatient procedures in the Unified Health System (SUS). Cost information was obtained from the health information systems available at SUS. The highest burden attributable to the consumption of SSBs was observed among younger individuals and progressively decreased with advancing age. The total direct costs in the period between 2008 and 2020 amounted to approximately US$ 6.33 million, 87% of which was related to expenses for females. Additionally, deaths resulting from the consumption of SSBs cost the economy US$ 40 million due to the premature loss of productivity. The total costs of obesity attributable to the consumption of SSBs are substantial, impacting public spending and generating social and productivity losses that burden the economy. It is crucial to develop and implement cost-effective fiscal and regulatory policies aimed at preventing and combating obesity.

This study analyses the role played by organizational ambidexterity and open innovation in innovation outputs, considering business units with different levels of technological intensity (medium-high and high tech, and medium-low and low tech) for countries with different innovation profiles. The countries considered in this paper are i) Estonia and Slovenia as innovation followers; ii) Slovakia, Hungary, Spain, Czech Republic, Italy, Portugal, Norway, and Croatia as moderate innovators; and iii) Bulgaria, Lithuania and Romania as modest innovators. In the empirical approach, the research hypotheses arise from the literature review and are tested using secondary data collected from the Community Innovation Survey (CIS) 2010. The conceptual model is tested using the logistic regression method, which indicates suitable accuracy and reliability for empirical testing purposes. The evidence reveals that for innovation followers, ambidexterity has a greater influence on the practice of eco-innovation, marketing innovation, and product innovation. For moderate innovators, ambidexterity has a greater influence on the practice of product innovation, process innovation, and eco-innovation. Concerning modest innovators, ambidexterity has a greater influence on the practice of product innovation, process innovation, and eco-innovation. With regard to open innovation, for innovation followers, this has a negative influence on product innovation in medium-high and high-tech companies. For moderate innovators, open innovation has a greater influence in process, organizational, and eco-innovation. In the case of modest innovators, open innovation is more significant for innovation outputs in product, organizational, and marketing innovation. Size is not always positively related to innovation outputs.

Flexible learning programmes (FLPs) and similar alternative education initiatives are designed to meet the diversity of needs of young people who have become disengaged from mainstream education. There is emerging evidence of the high prevalence of speech, language and communication needs (SLCN) and language disorders amongst students attending FLPs. This highlights the importance of understanding the views of these young people growing up in challenging psychosocial contexts about their experiences of schooling. We report on the perspectives of 45 students (aged 12-18 years) who had identified SLCN and who attended an FLP. We wanted to understand what they found valuable (and not) in their current FLP and how this compared to their previous schooling experience. The majority of students responded positively when asked about their current high school. Key factors identified via qualitative content analysis included how the FLP class content and environment were suited to them, the responsiveness of staff to their learning and personal needs, how their autonomy was respected, and the positive peer relationships they had developed in the FLP. Understanding these factors will support the design and implementation of educational programmes that foster improved engagement with, and achievement within, both FLPs and mainstream schools.

ABSTRACT Major liver resections require extensive margins. Occasionally, insufficient parenchyma is available after surgery to maintain liver function. In such cases, vascular embolization in the affected lobe is necessary to induce contralateral lobe hypertrophy. We present a case of embolization of the right portal and hepatic veins prior to intrahepatic cholangiocarcinoma resection. Embolization was performed because of insufficient residual parenchyma on imaging studies. The patient recovered well with no signs of liver failure, and remains in remission at 3 years postoperatively. Knowledge of the use of this technique in association with surgical resection can reduce postoperative complications and allow the removal of larger tumors than those previously considered borderline.

Cornelia de Lange syndrome (CdLS, OMIM #122470, #300590, #300882, #610759, and #614701) is a rare congenital disorder that affects the development of multiple organs and is characterized by physical abnormalities and cognitive and behavioral disabilities. Its molecular basis is mainly based on alterations in genes encoding structural and regulatory proteins related to the cohesin complex. Moreover, other transcriptional regulatory factors have been linked to this syndrome. However, additional causative genes are still unknown, since many patients still lack a molecular diagnosis. Herein, we describe a case with multiple affected family members presenting with an intragenic duplication in the AFF2 gene. The direct tandem intragenic duplication of exons 10, 11 and 12 was detected through high-resolution array Comparative Genomic Hybridization and next-generation sequencing technologies. Confirming the X-linked inheritance pattern, the duplication was found in the patient, his mother and his maternal aunt affected (dizygotic twins). Targeted sequencing with Oxford Nanopore Technologies revealed an aberrant transcript which is predominantly expressed in the patient and his aunt. Along with these results, a significant reduction in AFF2 gene expression levels was detected in these two individuals. Clinically both subjects exhibit a classic CdLS phenotype, whereas the mother is mostly unaffected. Consistent with the phenotypical differences observed between the mother and the aunt, there is a marked difference in X-inactivation patterns skewing. Given the crucial role of AFF2 in transcriptional regulation, it is not surprising that AFF2 variants can give rise to CdLS phenotypes. Therefore, the AFF2 gene should be considered for the molecular diagnosis of this syndrome.

Introdução: A malária, uma arbovirose transmitida pela picada da fêmea do mosquito Anopheles, é uma preocupação significativa na região Norte do Brasil, especialmente em Roraima. A exploração ilegal de territórios indígenas por garimpeiros contribui para as altas taxas de infecção, apresentando desafios consideráveis para a redução dos casos. Objetivo: Este estudo visa realizar uma análise epidemiológica dos casos confirmados de malária em Roraima entre 2018 e 2022. Método: Este é um estudo transversal que utiliza análise estatística descritiva. Os dados epidemiológicos foram obtidos da Coordenadoria Geral de Vigilância em Saúde (CGVS) e incluem o número de casos de malária em Roraima, com distinção por município de residência, sexo, raça, idade, escolaridade, profissão e óbito. Resultados: De 2018 a 2022, Roraima registrou 131.093 casos de malária, com a maior incidência na capital, Boa Vista, representando 29,7% do total. A doença também foi prevalente em outros municípios, como Alto Alegre (18%), Amajari (10%) e Caracaraí (5,6%). A população masculina foi a mais afetada, representando 61,8% dos casos. Em termos de etnia, a população parda teve a maior taxa de notificação (46,67%), seguida pela população indígena (45,88%). A faixa etária mais afetada foi de 20 a 29 anos, representando 22,7% dos casos. Entre os indivíduos afetados, a taxa de analfabetismo prevaleceu (20%). A ocupação mais comum entre os afetados foi a mineração, representando 27% dos casos. Quanto ao número de óbitos (101), a etnia indígena (54%), o sexo masculino (54%) e a faixa etária entre 20 e 39 anos (25,7%) foram os mais prevalentes. Conclusão: Os dados indicam um aumento nos casos de malária entre 2018 e 2022, com predominância em homens pardos economicamente ativos. As limitações deste estudo incluem a dificuldade em comparar a prevalência da doença em Roraima com outras regiões do Brasil. Além disso, a influência dos garimpos ilegais contribui para o alto número de casos. Notavelmente, a população indígena, com acesso limitado ao Sistema Único de Saúde (SUS), apresenta maior risco de mortalidade por malária.

Introdução: A Leishmaniose Tegumentar Americana (LTA) é uma infecção parasitária transmitida por flebotomíneos. É causada por protozoários do gênero Leishmania, que infectam preferencialmente as células de Langerhans da pele e os macrófagos da mucosa orofaríngea, explicando assim as formas cutânea e mucosa da doença. No Brasil, a região Norte tem demonstrado grande importância na quantificação do número de casos diagnosticados de LTA, especialmente o estado de Roraima, que passou por profundas mudanças ambientais nos últimos anos, incluindo a ocupação de áreas florestais devido a atividades antrópicas, como a mineração. Isso aproxima a população humana de vetores e reservatórios silvestres, contribuindo para a manutenção do ciclo da leishmaniose. Objetivo: Caracterizar a epidemiologia da Leishmaniose Tegumentar Americana em Roraima. Método: Trata-se de um estudo descritivo sobre os casos confirmados de LTA em Roraima no período de 2018 a 2022. Os dados foram obtidos por meio do Departamento de Informática do Sistema Único de Saúde (DATASUS). Nesse contexto, foram selecionadas as seguintes variáveis: ano de diagnóstico, município de residência, idade, raça, sexo, forma clínica, critério de confirmação e evolução. Resultados: No período estudado, foram notificados 2.123 casos de LTA no estado de Roraima. Os anos de 2021 e 2022 apresentaram a maior porcentagem de casos confirmados (44,32%). Observou-se que o município de Boa Vista teve 42,06% dos casos, seguido por Pacaraima e Caroebe, com 10,17% e 9,70%, respectivamente. Além disso, a raça mais afetada é a parda, representando 58,13% da população. Verificou-se que o sexo masculino é o mais suscetível (81,58%), enquanto a faixa etária predominante é de 20 a 39 anos, equivalente a 49,13%. Em relação à doença, 93,03% são casos novos, prevalecendo a forma clínica cutânea e o critério de diagnóstico clínico-laboratorial. Destaca-se que 85,45% tiveram um bom prognóstico, evoluindo para a cura da doença. Conclusão: Os resultados encontrados demonstram um aumento no número de casos de LTA no último biênio, além de apontar os municípios mais afetados, o perfil dos indivíduos majoritariamente acometidos (homens pardos de 20 a 39 anos) e as características inerentes à doença. Essa análise pode direcionar o planejamento de abordagens para reduzir ou extinguir este problema negligenciado de saúde pública no estado.

BACKGROUND AND OBJECTIVES: Low back pain is a common complaint among the world’s population. Students in the health sector are susceptible to it due to their routines with a heavy study load. The objective of this study was to analyze health students’ understanding of coping attitudes and the red flags of low back pain. METHODS: This is a cross-sectional, descriptive and analytical study carried out at a public university in northeastern Brazil. Between October 2022 and June 2023, a low back pain education training program was carried out, with the application of an online questionnaire through the Google Forms tool, in pre-test and post-test formats, containing six sections of questions from semi-structured questionnaires, interposed by the education program on the subject. The variables investigated were sociodemographic data, prevalence of low back pain, coping attitudes and red flags. RESULTS: A total of 260 students participated in the research, most of whom were in the first semester (61.5%), aged 21 years or older (51.2%), and female (61.2%). The majority had no knowledge about coping attitudes (73.1%) and red flags for low back pain (94.2%) in the pre-test, but acquired it in the post-test (91.9% and 78.5%, respectively). The McNemar inferential test showed that the approach to the topic influenced the appropriate conduct required in the post-test (p

Objective This study aims to explore the educational, occupational and socioemotional experiences of people with developmental language disorder (DLD) across the lifespan to gain insight into risk and protective factors for mental health.Design Qualitative analysis of focus groups and written submissions. Data were combined and analysed using Braun and Clarke’s reflexive thematic analysis approach within a critical realist framework.Setting Southeast England and Western Australia.Participants Six adults with DLD from England and five speech-language therapists from Western Australia participated in focus groups and/or contributed written responses to the research team.Results We developed four themes: ‘perspectives on diagnosis and living with an invisible disability’ explores participants’ perspectives on diagnosis, the difficulty getting a diagnosis and perceptions of DLD as widely misunderstood; ‘school struggles and self-esteem from past to present’ details school experiences and their impact on mental health; ‘DLD across the lifespan’ explores DLD in adulthood with a focus on workplace difficulties, emotional well-being and mental health; ‘A sense of belonging: communication, connection and support’ provides a lived experience account into the social participation difficulties of adults with DLD and the importance of social support.Conclusions and implications Adults with DLD may experience poor self-esteem, anxiety and depression. These mental health concerns may result from (a) exhaustion due to masking/compensating for neurodevelopmental differences, (b) loneliness and/or disempowerment due to difficulties with social interaction and (c) adverse experiences such as bullying, discrimination and a lack of appropriate accommodation at school and in the workplace. A lack of awareness and support for people with DLD from health, education and employment providers was also seen as a contributing factor to poor mental health. Diagnosis may serve a protective function for mental health via self-understanding, self-esteem and self-advocacy.