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Brazil can provide ecosystem services, food, and combat climate change-related vulnerabilities. However, this possibility is obliterated by the increasing deforestation in the Brazilian Legal Amazon derived from illegalities and political incentives to a business-as-usual economic development model that clears land for real estate speculation or extensive agro-livestock. Recently, the state governments of Amazonas, Acre, and Rondônia, supported by agro-livestock-related institutions, proposed a zone for economic development in a region of confluence accounting for 23.37% of these states’ total area. Formerly “Sustainable Development Zone between the States of Amazonas, Acre, and Rondônia” (AMACRO), it was renamed to “Abunã-Madeira Sustainable Development Zone (SDZ)” to meet sustainability criteria; however, environmental impact studies regarding its implementation still lack. By integrating land tenure and official deforestation datasets from 2012 to 2022, we assess whether this region is becoming a notable deforestation hotspot. Results showed growing deforestation trends for all land tenure classes, alarmingly in protected areas, since 2018, when the project was announced. Unlike possible economic gains, deforestation in this region affects essential edaphoclimatic conditions for Brazil’s agro-livestock, worsening environmental and socioeconomic vulnerabilities. Effective territorial planning, environmental impact studies, and law enforcement are urgently needed before establishing the zone to avoid a regional hecatomb.

Using a novel joint inversion approach, this study tackles the challenge of accurately characterizing subsurface electrical resistivity in vineyards, a critical and strategic aspect of precision viticulture. For the first time, we integrate 3D Galvanic Contact Resistivity with multi-2D Capacitively Coupled Resistivity data. Conducted in a prestigious Sangiovese vineyard in Montalcino (Tuscany, Italy), the data are analyzed utilizing a single algorithm capable of inverting Capacitively Coupled Resistivity, Galvanic Contact Resistivity, and joint datasets. This approach combines data sensitive to different depths and spatial resolutions, resulting in a comprehensive analysis of soil resistivity variations and moisture distribution, thus providing a detailed and coherent subsurface model. The joint inversion produced a high spatial resolution 3D resistivity model with a density of 20.21 data/m3. This model significantly enhances subsurface characterization, delineating root systems and correlating water distribution with resistivity patterns, showing relative variations sometimes greater than 50%. This method reduced data misfit more effectively than individual inversions and identified a low-resistivity volume (

The integration of analytical functions into machine learning-based engine models represents a significant advancement in predictive performance and operational efficiency. This paper focuses on the development of hybrid approaches to model engine combustion and temperature indices and on the synergistic effects of combining traditional analytical methods with modern machine learning techniques (such as artificial neural networks) to enhance the accuracy and robustness of such models. The main innovative contribution of this paper is the integration of analytical functions to improve the extrapolation capabilities of the data-driven models. In this work, it is demonstrated that the integrated models achieve superior predictive accuracy and generalization performance across dynamic engine operating conditions, with respect to purely neural network-based models. Furthermore, the analytical corrective functions force the output of the complete model to follow a physical trend and to assume consistent values also outside the domain of values assumed by the input features during the training procedure of the neural networks. This study highlights the potential of this integrative approach based on the implementation of the effects superposition principle. Such an approach also allows us to solve one of the intrinsic issues of data-driven modeling, without increasing the complexity of the training data’s collection and pre-processing.

Background: Telenursing comprises a set of tools and interventions enabling nurses to provide remote care. This study aims to assess the impact of telenursing interventions on the supportive care needs of patients with melanoma and lung cancer who are receiving targeted therapies. Methods: This six-month monocentric, double-arm, randomised, controlled trial study protocol will assess the effect of telenursing on the supportive care needs (primary outcome) in 40 patients (20 in each group) after one month. The secondary outcomes will be monitored at baseline, one, three and six months: supportive care needs (at three and six months), therapeutic adherence, quality of life, usability and satisfaction, performance status, patient-reported outcomes and main adverse events. The SPIRIT guidelines will be used for the reporting. Results: The results from this trial will assess the impact of a telenursing intervention on cancer care. Conclusions: This trial could be a starting point for more extensive studies on telenursing interventions to promote nurses’ skills, as well as the quality and safety of care in patients with cancer, highlighting the impact of more outstanding nursing contributions on cancer care. Trial and Protocol Registration: The study protocol was approved by the relevant Italian Ethics Committee Lazio Area 5 (RS1851/23, 2773; 6 September 2023) and was registered on ClinicalTrials.gov (trial registry number NCT06254196).

La progresiva introducción del método experimental en la medicina actual ha llevado a que nos encontremos frente a una medicina cada vez más científica. La investigación clínica nos provee de herramientas para desarrollar proyectos en los cuales se muestre nuestra actividad en el campo profesional, pero requiere de una apropiada metodología, que siga los lineamientos del método científico. De este modo, se puede aplicar el método deductivo (de lo general a lo particular), o bien el método inductivo (de las partes al todo). Las ciencias formales (matemáticas) aplican el primer método, mientras que las ciencias fácticas (física, química, medicina) aplican el segundo 1.

The aim of the study was to determine if body symmetry influences establishing stand balance after drop jump. Thirty-two healthy sports students participated in this study, with an average age 19.8 ± 1.4 years, height of 182.9 ± 6.8 cm and weight of 79.1 ± 8.1 kg. Morphological characteristics were assessed by measuring the differences between the left and right side of forearm girth, upper arm girth, calf girth, thigh girth, long shoulder height, lean mass of legs and lean mass of arms. The standing balance result was calculated based on factor scores obtained from nine measurements taken for 30 seconds after jumping from a 25 cm height platform. These measurements included three for normal stand, three for blind stand, and three for deaf stand. The data was collected using a pressure insoles system and by measuring the difference in ground reaction force between the left and right leg. Regression analysis revealed that 27% of the differences in leg load could be explained by differences in morphological characteristics between the left and right side. Two significant predictors were identified: the difference in long shoulder height (explaining 16% of the variance) and the differences in arm lean mass (explaining 11% of the variance). Both variables showed a negative relationship with the factor jump standing. It was observed that imbalances in body symmetry could increase the long-term risk of acute or chronic injuries.

Antecedentes: La picadura de himenópteros puede producir reacciones mediadas por IgE, reacciones tóxicas o reacciones atípicas poco frecuentes. Dentro de las manifestaciones cutáneas por reacciones atípicas se incluye urticaria por frío, y sólo existe un informe de caso de urticaria crónica. Reporte de caso: Paciente femenina de 56 años, quien 60 minutos después de recibir dos picaduras de véspidos manifestó prurito palmoplantar y urticaria generalizada, precisando asistencia sanitaria y varios ciclos de tratamiento domiciliario con antihistamínicos y corticosteroides por vía oral, con curación completa luego de 12 semanas. El estudio alergológico reportó: concentración de triptasa normal y sensibilización primaria al veneno de Polistes dominula. Debido a la profesión de la paciente se inició inmunoterapia con veneno de Polistes dominula al 100%, sin recurrencia de la urticaria después de la administración. Conclusión: El caso aquí expuesto combina una reacción sistémica mediada por IgE seguida de urticaria crónica, de curso autolimitado, cronológicamente relacionada con el mismo desencadenante (picadura de véspidos). Palabras clave: Urticaria crónica; Himenópteros; Véspido; Polistes dominula; Reacción mediada por IgE.

The agro-food industry generates important quantities of by-products, often considered waste, which represent for the companies huge costs of handling and disposal. On the other hand, they contain copious amounts and varieties of compounds that, appropriately extracted, purified, and processed, can be valued in several industrial sectors. Their exploitation generates an improvement of the sustainability performance of the supply chains, since it generates economic advantages, making available new commercial products and reducing disposal costs, improves the environmental performance of the agro-industrial productions, and allows new employment opportunities, thanks to the development of new industrial sectors. The Percival project aims to valorize the by-products of agro-industrial supply chains of South of Italy, converting them into high-added value products, through innovative, efficient, and low environmental impact processes, going for the development of technologies that could represent new business opportunities for this territory. Particularly, the project deals with the development of processes for pretreatment, extraction, separation, and chemical/biotechnological transformation, using a biorefinery cascade approach. Indeed, the study of processes having the purpose of converting the residues from the above-mentioned transformations into advanced biofuels (biomethane) and agricultural products (e.g. soil improver and bio-stimulants) are also included in the project’s scope. The present paper provides an overview of the Percival project, along with the evaluation of the availability of residual biomasses from the supply chains of typical Southern agricultural products, and the valuable bioproducts achievable from these feedstocks, through a biorefinery processing scheme.

Study region: Terminio Mt. karst aquifer, Campania region, southern Italy Study focus: Karst aquifers are largely exploited, but the assessment of groundwater recharge in these aquifers is still considered challenging due to: i) the disregarding of the hydrological role of the soil coverings; ii) the lack of a spatially homogeneous coverage of rain and air temperature monitoring stations. Here we propose a multi-methodological approach to evaluate the groundwater recharge of the Terminio Mt. karst aquifer. This aquifer is mantled by ash-fall pyroclastic soils fostering the development of a luxuriant vegetation. A field and laboratory characterization of soil coverings was performed, and the spatial and temporal variability of groundwater recharge was estimated by the Soil Water Balance code. New hydrological insights for the region: A variability of thickness of ash-fall pyroclastic soils, ranging between 0.40 m and 1.00 m, classified as sandy loam, were found. These features resulted in variable groundwater recharge and evapotranspiration rates depending on land cover classes and thickness of pyroclastic soils. Outcomes show the relevant hydrological role of soil coverings whose relevant water retention, up to 427.8 mm, coupled with the significant precipitation, exceeding 1,000 mm·yr-1 in average, results in a value of the actual evapotranspiration equal to the potential one. The approach proposed advances the understanding of the infiltration-evapotranspiration trade-off which regulates the spatial and temporal variability of groundwater recharge.

Isomers close to the doubly magic nucleus 78Ni (Z=28, N=50) provide essential information on the shell evolution and shape coexistence far from stability. The existence of a long-lived isomeric state in 76Cu has been debated for a long time. We have performed high-precision mass measurements of 76Cu with the JYFLTRAP double Penning trap mass spectrometer at the Ion Guide Isotope Separator On-Line facility and confirm the existence of such an isomeric state with an excitation energy Ex=64.8(25) keV. Based on the ratio of detected ground- and isomeric-state ions as a function of time, we show that the isomer is the shorter-living state previously considered as the ground state of 76Cu. The result can potentially change the conclusions made in previous works related to the spin-parity and charge radius of the 76Cu ground state. Additionally, the new 76Cu(n,γ) reaction Q-value has an impact on the astrophysical rapid neutron-capture process.

La autoría de manuscritos, de capítulos y de libros se vincula directamente a la contribución académica y conlleva un proceso de retribución y satisfacción científica. Según las Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly Work in Medical Journals del International Committee of Medical Journal Editors (ICMJE) 1 (http://www.icmje.org), o grupo Vancouver, los autores deben contribuir con algunas de las siguientes funciones o roles: 1) concepción y diseño; 2) adquisición, análisis e interpretación de datos; 3) redacción y revisión crítica; 4) aprobación final del manuscrito; y 5) responsabilizarse de todos los aspectos del trabajo. Según estas recomendaciones, la exclusiva provisión de pacientes no justifica la autoría.

El 14 de agosto de 2023 fallece el profesor Hernando Abaúnza Orjuela en la ciudad de Bogotá, Colombia, a la edad de 88 años. Al cumplirse un año de su partida, este editorial tiene el objetivo de conmemorar su vida y su legado.

Existen razones para publicar. Al decir de Scott Fitzgerald, “no tienes que escribir porque quieres decir algo, tienes que escribir porque tienes algo que decir”. El continuo incremento en las obligaciones asistenciales, docentes y administrativas, sumado al poco reconocimiento de las instituciones y al escaso estímulo económico atentan contra el desarrollo académico de los cirujanos. Con esos argumentos, la gran mayoría de los cirujanos no consideran importante publicar, sin embargo, la productividad científica aumenta la reputación de los servicios de cirugía e incrementa la posibilidad de obtener recursos económicos. Por este motivo, el rol de las publicaciones científicas es cada vez más importante 1.

Autosomal dominant polycystic kidney disease (ADPKD) is the most common genetic kidney disease. It is characterized by the formation of cysts in kidneys. This condition has a significant impact on people’s lives. It causes not only physical suffering but also psychological suffering. People with ADPKD may experience psychological distress, depending on their personal and health conditions. The inability to accept or adapt to the disease and its resulting changes causes individuals difficulties that appear in different levels of their lives: intrapersonal, interpersonal, social, and occupational. In the context of ADPKD, the psychologist is involved both at clinical and research levels. The psychologist has a crucial role in supporting patients by assessing how they react to the disease, to its related limitations, and to the resulting disabilities. The proposal of psychological support, considered as an intervention instrument, is helpful both at the diagnostic stage and in follow-up, as the disease worsens. The support aims to encourage acceptance and adaptation to the disease, process changes, and physical and mental consequences.

Autosomal dominant polycystic kidney disease (ADPKD) is the most common genetically inherited kidney disease and the fourth leading cause of renal replacement therapy worldwide. It is characterized by the development of multiple cysts in the kidneys and in other organs, the increase in renal volume and the progressive loss of renal function. ADPKD outcome seems to be sensitive to hormonal fluctuations, particularly those of sex hormones. Despite the limited literature available, this review presents the first comprehensive overview of contraception and hormonal replacement therapy in women with ADPKD, delving into the risks and benefits associated with different contraceptive methods, including hormonal, intrauterine devices, and non-hormonal approaches. It also explores personalized strategies for contraception based on the severity of renal disease and the presence of comorbidities. Although the protective role of female sex hormones in slowing the progression of renal failure is acknowledged, hormonal therapy in women with ADPKD remains intricate and challenging due to its potential impact on liver disease progression. Women with ADPKD typically experience a slower progression of renal disease compared to men, largely influenced by hormonal dynamics. This literature review underscores the importance of a multidisciplinary assessment and a thorough patient discussion to identify the most suitable contraceptive method for each woman affected by polycystic kidney disease.

IntroductionWe examined the gut microbiota of travellers returning from tropical areas with and without traveller’s diarrhoea (TD) and its association with faecal lipocalin-2 (LCN2) levels.MethodsParticipants were recruited at the Hospital Clinic of Barcelona, Spain, and a single stool sample was collected from each individual to perform the diagnostic of the etiological agent causing gastrointestinal symptoms as well as to measure levels of faecal LCN2 as a biomarker of gut inflammation. We also characterised the composition of the gut microbiota by sequencing the region V3-V4 from the 16S rRNA gene, and assessed its relation with the clinical presentation of TD and LCN2 levels using a combination of conventional statistical tests and unsupervised machine learning approaches.ResultsAmong 61 participants, 45 had TD, with 40% having identifiable etiological agents. Surprisingly, LCN2 levels were similar across groups, suggesting gut inflammation occurs without clinical TD symptoms. Differential abundance (DA) testing highlighted a microbial profile tied to high LCN2 levels, marked by increased Proteobacteria and Escherichia-Shigella, and decreased Firmicutes, notably Oscillospiraceae. UMAP analysis confirmed this profile’s association, revealing distinct clusters based on LCN2 levels. The study underscores the discriminatory power of UMAP in capturing meaningful microbial patterns related to clinical variables. No relevant differences in the gut microbiota composition were found between travellers with or without TD.DiscussionThe findings suggest a correlation between gut microbiome and LCN2 levels during travel, emphasising the need for further research to discern the nature of this relationship.

Background: Pre-travel consultation and chemoprophylaxis measures for malaria are a key component in the prevention of imported malaria in travelers. In this study we report a predictive tool for assessing personalized malaria risk in travelers based on the analysis of electronic medical records from travel consultations. The tool aims to guide physicians in the recommendation of appropriate prophylaxis prior to their trip. We also provide best-practice recommendations for pre-processing noisy and highly sparse real world evidence data. Methods: We leveraged a large EMR dataset, containing demographic information about travelers and their destination. The data has been previously preprocessed using various strategies to handle missing and unbalanced data. We compared multiple machine learning approaches to assess the risk of malaria acquisition in travelers during their travels. Additionally, a feature importance analysis was performed using SHAP (SHapley Additive Explanations) values to identify patterns associated with malaria risk. Results: Our study revealed that our XGB models achieved high predictive capacity (AUC >0.80). The most significant features predicting malaria infection during travel included travel destinations with low malaria risk, vaccination history, number of countries visited, age, and trip duration. Remarkably, we were able to obtain a reduced model with only five features. When comparing this model with a population of travelers recommended for malaria chemoprophylaxis, we observed that it was deemed necessary in only 40% of these travelers. This suggests that 60% received chemoprophylaxis despite having a low personalized risk of malaria. Conclusion: We have developed an algorithmic tool that utilizes a concise survey to generate a personalized travel risk assessment, effectively minimizing the prescription of unnecessary malaria chemoprophylaxis. Through the identification of patterns linked to predictions, our model significantly enhances the efficacy of pre-travel consultations.

The aim of this retrospective cohort study is to understand if and how much the preventive self-isolation approach might have been a valid model to avoid care-related infection, not only from COVID-19 but also from other non-viral infectious diseases. From March to May 2020, the healthcare and management staff of the Villa Santa Maria long-term care facilities, located in the village of Montenero di Bisaccia (Campobasso, Molise, Italy), decided to carry out a preventive self-isolation plan to safeguard the residents from SARS-CoV-2. The impact on other infectious diseases was evaluated by analyzing the antibiotic therapies prescription trend among the inpatients. Our data showed that although self-isolation protected residents and caregivers from SARS-CoV-2, it can also be associated with mobility reduction, leading to an increase in bedridden pathologies, namely, pressure ulcers and pressure sores. The simultaneous isolation of residents and caregivers in the same location significantly reduced any outside influence as a cause of possible infections.