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A case of a solitary pulmonary nodule due to Scedosporium apiospermum (Pseudallescheria boydii) is related. A review of the pertinent literature was done and, in addition, similar lesions caused by other opportunistic fungi are commented.

Objective: Total thyroidectomy is associated with a high risk of postoperative hypoparathyroidism, mainly due to the unintended surgical damage to the parathyroid glands or their blood supply. It is possible that surgeons who also perform parathyroid surgery see lower rates of postoperative hypoparathyroidism. In a single institution, we investigated the effects of restricting total thyroidectomy oper ations for Graves’ disease to two surgeons who performed both thyroid and parathyroid surgeries. We aimed to evaluate the rates of postoperative hypoparathyroidism in a 10-year period with primary attention toward patients with Graves’ disease. Design: Retrospective cohort study from a single institution. Methods: We defined the rate of permanent hypoparathyroidism after total thyroidectomy as the need for active vitamin D 6 months postoperatively. Between 2012 and 2016, seven surgeons performed all thyroidectomies. From January 2017, only surgeons also performing parathyroid surgery carried out thyroidectomies for Graves’ disease. Results: We performed total thyroidectomy in 543 patients. The rate of permanent hypoparathyroidism decreased from 28% in 2012–2014 to 6% in 2020–2021. For patients with Graves’ disease, the rate of permanent hypoparathyroidism decreased from 36% (13 out of 36) in 2015–2016 to 2% (1 out of 56) in 2020–2021. In cancer patients, the rate of permanent hypoparathyroidism decreased from 30% (14 out of 46) in 2012–2014 to 10% (10 out of 51) in 2020–2021. Conclusion: Restricting thyroidectomy to surgeons who also performed parathyroid operations reduced postoperative hypoparathyroidism markedly. Accordingly, we recommend centralisation of the most difficult thyroid operations to centres and surgeons with extensive experience in parathyroid surgery. Significance statement: Thyroid surgery is performed by many different surgeons with marked differences in outcome. Indeed, the risk of postoper ative permanent hypoparathyroidism may be very high in low-volume centres. This serious condition affects the quality of life and increases long-term morbidity and the patients develop a life-long dependency of medical treatments. We encountered a high risk of hypoparathyroidism after the operation for Graves’ disease and restricted the number of surgeons to two for these operations. Further, these surgeons were experienced in both thyroid and parathyroid surgeries. We show a dramatic reduction in postoperative hypoparathyroidism after this change. Accordingly, we recommend centralisation of total thyroidectomy to surgeons with experience in both thyroid and parathyroid procedures.

Abstract Background Post-transplant diabetes mellitus (PTDM) is a specific subtype of diabetes with an uncertain impact on mortality and morbidity in post-transplant patients. Diabetic retinopathy is the most common microvascular complication of diabetes mellitus, but the long-term clinical progression in PTDM is unknown. New technologies are being used to assess pre-clinical signs of retinal changes, such as swept-source optical coherence tomography (OCT) and OCT-angiography. The aim of this study was to detect pre-clinical structural and vascular changes in the retina using swept-source-OCT and OCT-angiography in patients with PTDM. Methods In this retrospective cohort study, post-kidney transplant patients were divided into PTDM and non-PTDM (control) groups. Both eyes of eligible PTDM patients and controls were included in this study. Inner retinal layer thickness was measured with swept-source-OCT. Retinal capillary density and the foveal avascular zone were measured with OCT-angiography. Results In the PTDM group, reduced thickness was found in the inferior ganglion cell layer plus inner plexiform layer (95% CI -8.76 to -0.68; p = 0.022) and the temporal inferior segment (95% CI -10.23 to -0.76; p = 0.024) of the inner retina, as well as in the retinal nerve fiber layer in the temporal (95% CI -34.78 to -9.28 p = 0.001) and temporal inferior segments (95% CI -33.26 to -5.03 p = 0.008). No significant differences were found in the vascular capillary plexus between groups at all depths, segments, or foveal avascular zone (p = 0.088). Conclusions According to OCT-angiography, PTDM patients had reduced inner neurosensory retinal layers but no significant change in vascular density, which suggests that early neuroretinal degeneration might occur prior to vascular changes secondary to PTDM. Prospective studies could help elucidate the clinical course of retinal neuropathy and microvascular pathology in PTDM and provide a better understanding of PTDM complications.

Background Evaluation and treatment of primary and secondary headaches is a global public health challenge. Recognizing the epidemiological impact of headaches, a group of researchers linked to the Brazilian Headache Society proposed the Brazilian Headache Registry and drew up its initial protocol.

Abstract It is widely assumed that transformative societal action is required to address the world's many sustainability challenges of today. This is especially true in an urban context, since urban sustainability may assist in improving the conditions of the urban environment and the quality of life of humans. Nevertheless, and despite the many advantages that urban sustainability may bring about, there is a need for studies that look at the role that transformative learning may play in influencing it. This study will address this need. It provides an analysis of the subject matter of transformative learning and how it may be practised and experienced in an urban context, thus contributing to urban sustainability in practical terms. It reports on a survey specifically directed to the teaching staff, on the extent to which transformative learning is being deployed in Higher Education Institutions (HEIs) in supporting urban sustainability efforts. In addition, the study ends by listing and presenting examples of approaches, methods, and initiatives in transformative learning within an urban sustainability context, and provides an analysis of its main features and learned lessons. It concludes with some best practices for transformative learning that could assist in designing and implementing urban sustainability teaching at HEIs, on a broader scale. It can be stated that not only can sustainability thought improve the urban conditions, but as the developing world gets further urbanised, sustainability in the urban context specifically becomes a matter of particular relevance.

Abstract Introduction Benign metastasising leiomyoma refers to a type of lesion characterised by leiomyomatous alterations without any indication of malignancy. It presents as either a singular nodule or multiple nodules of proliferating smooth muscle cells and is generally found in the lungs of women who have undergone a hysterectomy. The purpose of this case report is to contribute to the knowledge of this rare disease by presenting evidence and experience of a patient case. In particular, this report seeks to investigate the therapeutic approaches in order to understand whether a standard of care can be prescribed and whether the use of prophylaxis therapy with progesterone as a follow-up to surgery serves as a reasonable treatment in certain cases diagnosed as benign metastasising leiomyoma. Case presentation We present the case of a 52-year-old Caucasian woman who developed a pelvic relapse and a pulmonary localisation of benign metastasising leiomyoma following a hysterectomy for myomatous uterus. Conclusion Our literature review revealed a single case of the use of chemoprophylaxis as treatment of a benign metastasising leiomyoma. The role of chemoprophylaxis in preventing future recurrences remains unclear. The use of progesterone as an adjuvant therapy for benign metastasising leiomyoma could simply be palliative, with associated psychological benefits, or it could be of therapeutic significance.

Abstract Background The role of episiotomy as a protective factor against pelvic floor disorders postpartum has been debated for many years, but its routine use has been hitherto discouraged in the literature. Comparisons between restrictive and routine use of episiotomy in existent literature, however, fail to include any consideration relating to quality of life. The aim of this study, therefore, is to state the role of episiotomy in preserving the perineum from damage, in order to prevent the influence of pelvic floor disorders on women's psycho-physical wellness after the sixth month postpartum. Methods A follow-up telephone interview was performed among 377 primiparous and secondiparous Caucasian women who had a child by spontaneous or operative vaginal delivery in 2006 using a self-created questionnaire and King's Health Questionnaire (KHQ). Results The mean age at delivery was 35.26 (±4.68) years and episiotomy was performed in 59.2% of women. Multivariate linear regression shows episiotomy associated to higher quality of life after the sixth month postpartum by correlating with inferior values of King's Health Questionnaire (p < 0.05). Conclusions Episiotomy appears to be a protective factor for women's wellness. Women who had episiotomy and who experienced perineal symptoms have a better psycho-physical health status in the 12.79 months (±3.3) follow-up.

We present the analysis results of the editorial policy of 32 Brazilian journals indexed in the area of Science Education regarding the ethical principles followed by authors. The policies were analyzed according to the ethical precepts in the guidelines for authors; the ways ethical aspects of articles should be communicated to editors; the procedures for cases of scientific misconduct and retractions to authors, editors and reviewers. The obtained data indicated that (a) 40.6% of the journals do not mention any ethical precept in their editorial policy; (b) 31.2% of journals report that ethical aspects must be included in the text submitted to editors, 3.1% by sending a signed document, 25% by presenting a copy of the institution’s Research Ethics Committee approval and/or the Free and Informed Consent Form, 12.5% imply that the study was carried out within the norms, standards or ethical principles without requiring any type of information and 43.8% did not present any reference to the authors; (c) 34.4% do not include considerations about scientific misconduct and (d) only 15% of the journals have a topic that explains the retractions for cases of misconduct. The importance of including in their editorial policies the aspects related to good scientific practices is discussed in this work. Such aspects include investigations carried out with the collaboration of human beings, as well as the expansion of the debate on ethical issues in teaching and research institutions, aiming the ethical training of future professionals and researchers.

Apresentamos os resultados da análise da política editorial de 32 periódicos brasileiros indexados da área de Educação em Ciências quanto aos princípios éticos a serem seguidos pelos autores de artigos. As políticas foram analisadas de acordo com os preceitos éticos contidos nas diretrizes aos autores; as maneiras pelas quais os aspectos éticos dos artigos devem ser informados aos editores; os procedimentos para casos de más condutas científicas; e as retratações para autores, editores e pareceristas. Os dados obtidos indicaram que: (a) 40,6% dos periódicos não citam qualquer preceito ético na política editorial; (b) 31,2% das revistas informam que os aspectos éticos devem ser incluídos no texto submetido aos editores, 3,1% por meio do envio de documento assinado, 25% mediante cópia de aprovação do Comitê de Ética em Pesquisa (CEP) da instituição e/ou do Termo de Consentimento Livre e Esclarecido (TCLE) aprovado, 12,5% deixa subtendido que o estudo foi realizado dentro das normas, padrões ou princípios éticos, sem a exigência de qualquer tipo de informação, e 43,8% não apresentam nenhuma referência aos autores; (c) 34,4% não inclui considerações sobre as más condutas científicas; e (d) apenas 15% das revistas apresentam algum tópico que explicita as retratações para os casos de má conduta. Argumentamos acerca da importância de os periódicos incluírem, em suas políticas editoriais, aspectos relativos às boas práticas científicas, o que inclui as investigações realizadas com a colaboração de seres humanos, bem como da ampliação do debate acerca das questões éticas nas instituições de ensino e pesquisa, com vistas a uma formação ética dos futuros profissionais e pesquisadores.

Purpose: Smart campuses can be seen as the future of higher education efforts, especially for their contributions to sustainability and to encourage innovation. This paper aims to present the benefits of smart practices in a Higher Education Institutions and highlights its connections to the sustainable development goals (SDGs). Design/methodology/approach: The methodology is divided into three steps: first, an international search and assessment of smart practices at universities; second, the identification of smart practices in a university campus in southern Brazil; and third, the presentation of the benefits of smart practices and their relationship with the SDGs. Findings: The results showed that globally, the area most covered by smart practices in universities is the environment and, specifically, focused on waste reduction. in the context of this case study, the benefits of implementing smart practices mainly reach SDGs 4 and SDG 9, especially due to aspects of teaching technologies for the new classroom models and the optimization of campus infrastructure management. Practical implications: The study encourages other universities to implement smart practices in their campuses, to becoming smart campuses while they also collaborate in achieving the SDGs while raising the discussion on the importance of committed actions taken on a university campus with the UN SDGs, to leverage synergies on campus operations at universities. Originality/value: This paper presents a set of smart practices that universities are applying both globally and locally (in southern Brazil). In addition, it contributes to sustainability research by showing how smart practices have the potential to promote SDGs in universities, especially through campus operations.

Purpose: This paper aims to analyse the extent to which the sustainable development goals (SDGs) are being considered at higher education institutions (HEIs) and propose and test the possible acceptance of a list of indicators to evaluate the contribution of HEIs to the SDGs. Design/methodology/approach: The methodology consisted of the collection of indicators of sustainable development based on the existing bibliography. Afterwards, a set of indicators related to the SDGs were selected, based on the most frequent SDGs' expressions found in the selected indicators. A sample of researchers was also asked to indicate to which extent this set of indicators is perceived as relevant. Findings: The results indicated an initial list with 432 indicators, of which 268 were selected for having at least one of the keywords searched for, related to the SDG descriptions and targets. Thus, redundant indicators were excluded and, when necessary, indicators were aggregated, resulting in a final list of 61 indicators. Originality/value: The set of indicators resulted from this analysis was considered appropriate to evaluate the contribution of HEIs towards the SDGs, demonstrating that it might not be necessary to create new indicators for that purpose.

Resumo Rankings universitários globais são importantes indicadores, que medem a capacidade das universidades de impactar a sociedade positivamente. Neste estudo, teve como objetivo analisar os fatores determinantes no desempenho acadêmico e de sustentabilidade das universidades por continentes participantes do Ranking THE. Quanto ao método, classifica-se como um estudo de descritivo, quantitativo, que considerou para análises o Produto Interno Bruto, e o nível de Sustentabilidade dos países em que as universidades se situam - no desempenho acadêmico das Universidades, mensurado por meio do ranking World University da Times Higher Education (THE). Como principais resultados, destacam-se: verificou-se uma forte relação entre as características em nível de país como PIB, IDH e a Pontuação no World University Rankings do Times Higher Education, o que sugere que as características do país influenciam no desempenho e no nível de sustentabilidade de cada universidade. Do mesmo modo, os grupos pesquisa e ensino são os mais impactantes a Pontuação Geral de melhor universidade.

Resumo Este artigo apresenta um estado da arte sobre grupos de pesquisa em educação matemática. É feita a análise de um conjunto de 25 trabalhos encontrados na Biblioteca Digital Brasileira de Teses e Dissertações e no Google Acadêmico. Os principais resultados evidenciaram a presença de artigos publicados em periódicos pelo Grupo de Pesquisa História Oral e Educação Matemática e de trabalhos que analisam/descrevem aspectos de trajetória, constituição, identidade, habitus científico, funcionamento, colaboração e/ou produção científica dos grupos de pesquisa. Conclui-se que pesquisas futuras podem privilegiar a magnitude dos grupos de pesquisa em educação matemática no Brasil.

Abstract NF-Y is a trimeric transcription factor whose binding site -the CCAAT box- is enriched in cancer-promoting genes. The regulatory subunit, the sequence-specificity conferring NF-YA, comes in two major isoforms, NF-YA long (NF-YAl) and short (NF-YAs). Extensive expression analysis in epithelial cancers determined two features: widespread overexpression and changes in NF-YAl/NF-YAs ratios (NF-YAr) in tumours with EMT features. We performed wet and in silico experiments to explore the role of the isoforms in breast -BRCA- and gastric -STAD- cancers. We generated clones of two Claudinlow BRCA lines SUM159PT and BT549 ablated of exon-3, thus shifting expression from NF-YAl to NF-YAs. Edited clones show normal growth but reduced migratory capacities in vitro and ability to metastatize in vivo. Using TCGA, including upon deconvolution of scRNA-seq data, we formalize the clinical importance of high NF-YAr, associated to EMT genes and cell populations. We derive a novel, prognostic 158 genes signature common to BRCA and STAD Claudinlow tumours. Finally, we identify splicing factors associated to high NF-YAr, validating RBFOX2 as promoting expression of NF-YAl. These data bring three relevant results: (i) the definition and clinical implications of NF-YAr and the 158 genes signature in Claudinlow tumours; (ii) genetic evidence of 28 amino acids in NF-YAl with EMT-promoting capacity; (iii) the definition of selected splicing factors associated to NF-YA isoforms.

Condition Monitoring (CM) is an extremely critical application of the Internet of Things (IoT) within Industry 4.0 and Smart City scenarios, especially following the recent energy crisis. CM aims to monitor the status of a physical appliance over time and in real time in order to react promptly when anomalies are detected, as well as perform predictive maintenance tasks. Current deployments suffer from both interoperability and management issues within their engineering process at all phases– from their design to their deployment, to their management–, often requiring human intervention. Furthermore, the fragmentation of the IoT landscape and the heterogeneity of IoT solutions hinder a seamless onboarding process of legacy devices and systems. In this paper, we tackle these problems by first proposing an architecture for CM based on both abstraction layers and toolchains, i.e., automated pipelines of engineering tools aimed at supporting the engineering process. In particular, we introduce four different toolchains, each of them dedicated to a well-defined task (e.g., energy monitoring). This orthogonal separation of concerns aims to simplify both the understanding of a complex ecosystem and the accomplishment of independent tasks. We then illustrate our implementation of a complete CM system that follows said architecture as a real Structural Health Monitoring (SHM) pilot of the Arrowhead Tools project, by describing in detail every single tool that we developed. We finally show how our pilot achieves the main objectives of the project: the reduction of engineering costs, the integration of legacy systems, and the interoperability with IoT frameworks.

Purpose The learning curve cumulative summation (LC-CUSUM) test is commonly used as a quantitative assessment of the individual learning process. This study aimed to evaluate the skill acquisition process for performing ultrasound staging of endometrial cancer using the LC-CUSUM test. Methods Sixty-seven ultrasound examinations performed by two operators were evaluated using the LC-CUSUM test according to their rate of success or failure to correctly stage myometrial invasion, serosa involvement, and pelvic and para-aortic lymph node involvement. The reference standard was the pathologic result. After the learning phase, the cumulative summation (CUSUM) test was applied to assess performance maintenance. Results The processes achieved satisfactory performance in the majority of the cases according to the established definitions. Operator 1 reached adequate performance within the 30th procedure for all the locations considered, while operator 2 performed fewer than 30 ultrasound examinations by the audit time. The CUSUM test confirmed that the target quality was preserved after the learning phase. Moreover, the ultrasound staging for endometrial cancer was highly accurate. Conclusion Using the LC-CUSUM test made it possible to monitor the achievement and maintenance of a satisfactory performance quantitatively. The LC-CUSUM test could be a valuable instrument to survey diagnostic pathways in gynecological ultrasonography quantitatively.