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IntroductionMost patients suffering from neurological disorders endure varying degrees of upper limb dysfunction, limiting their everyday activities, with only a limited number regaining full arm use. Robotic and technological rehabilitation has been demonstrated to be a feasible solution to guarantee an effective rehabilitation to recover upper limb performance or to prevent complications of upper limb immobility. However, there is currently a lack of studies which analyze the sustainability of robotic and technological rehabilitation by comparing its costs to conventional rehabilitation pathways.MethodsSince technology-based and conventional rehabilitation of the upper limb have been demonstrated to have comparable efficacy when the rehabilitation dose is matched, our study concentrates on a cost minimization analysis. The aim of the study is to compare the costs of a “mixed” rehabilitation cycle, which combines conventional and technology-based treatments (the latter delivered with a single therapist supervising several patients), with a cycle of purely conventional treatments. This has been done by developing a cost model and retrospectively analyzing the costs sustained by an Italian hospital which has adopted such a mixed model. A sensitivity analysis has been done to identify the parameters of the model that have the greatest influence on cost difference and to evaluate their optimal values in terms of efficiency of mixed rehabilitation. Finally, probabilistic simulations have been applied to consider the variability of model parameters around such optimized values and evaluate the probability of achieving a given level of savings.ResultsWe found a cost difference of 49.60 € per cycle in favor of mixed rehabilitation. The sensitivity analysis demonstrated that, in the situation of the hospital under investigation, the parameter having the largest influence on the cost difference is the number of robotic treatments in a mixed rehab cycle. Probabilistic simulations indicate a probability higher than 98% of an optimized mixed rehabilitation cycle being less expensive than a pure conventional one.ConclusionThrough a retrospective cost analysis, we found that the technology-based mixed rehabilitation approach, within a specific organizational model allowing a single physiotherapist to supervise up to four patients concurrently, allowed cost savings compared to the conventional rehabilitation model.

Uterine intravascular leiomyomatosis (IVL) with extension into the right heart is uncommon, with no more than 400 cases reported in the literature since 1907. The present study aims to report three patients with intracardiac IVL surgically treated in our institution, with long-term follow-up. Three female patients in their third to fifth decades of life, with a history of difficult hysterectomy due to extensive myomatosis, presented with symptoms of right-sided heart failure. Echocardiography and computed tomography were performed, where IVL extending from the pelvis into the right heart was observed. All three patients underwent a one-stage operation under extracorporeal circulation through a right auriculotomy and inferior vena cavotomy, accessed via a sterno-laparotomy. The tumors were extirpated without complications, with ligation of the vena cava or iliac vein. The patients at 10-, 13-, and 37-year follow-up were well and alive with mild lower extremities symptoms.

IntroductionThe heart rate variability (HRV) continually evolves throughout life, reflecting modifications in the architecture of the sinoatrial node (SAN) and in the regulation of heart rate by the autonomic nervous system (ANS). Both can be considerably affected by Chagas disease, causing important changes in the complex nature of HRV. We aim to evaluate the ability of an index based on the false nearest neighbors method (FN10) to reflect these changes during disease progression.MethodsWe perform a retrospective, descriptive, and cross-sectional study analyzing HRV time series of participants with Chagas disease. We determine the dependence of FN10 on age and sex in a healthy population, and then evaluate FN10 in individuals with Chagas disease.Results and discussionIn the healthy population, FN10 has a scaling behavior with age, which is independent of sex. In Chagas disease, some individuals show FN10 values significantly above those seen in the healthy population. We relate the findings to the pathophysiological mechanisms that determine the progression of the disease. The results indicate that FN10 may be a candidate prognostic biomarker for heart disease.

BackgroudScrophularia L., a genus of the Scrophulariaceae, is a group of important medicinal plants used for eliminating heat and detoxifying. East Asia has an abundance of potentially medicinal Scrophularia species, and it serves as a secondary diversity center of the genus. However, the genomic resources available for germplasm identification and pharmaceutical exploration of East Asian Scrophularia are insufficient, hindering its commercial and industrial development. Additionally, the interspecific relationships of most East Asian Scrophularia species remain unclear.MethodsIn this study, we sequenced the leaves of 25 East Asian species of the genus Scrophularia, assembled and annotated the complete chloroplast genomes, and subsequently performed comparative and phylogenetic analyses on these genomes.Results and discussionThe conserved plastome length of these 25 species ranged from 151,582 bp to 153,239 bp, containing a total of 132 coding genes, including 18 duplicated genes and 114 unique genes. Through genome alignment of these 25 species, 38-53 repeated sequences and 7 shared SSRs were identified, along with regions with high nucleotide polymorphism (Pi), which could potentially serve as molecular markers for species identification. The genome structure, gene content, and arrangement showed conservation, while variations were observed in the IR boundary regions and IGS. Phylogenetic inferences based on whole plastomes or on coding sequences (CDS) only yielded congruent results. We categorized the 25 East Asian Scrophularia species into six distinct clades and further explored their interspecies relationships using morphological characteristics, such as flower color, the relative position of stamens and corolla, and plant height. This could lay a genetic basis for future resource development of Scrophularia in East Asia.

Background: Postoperative sore throat is one of the main postoperative complaints in patients undergoing tonsillectomy. As the primary outcome, we aimed to determine whether endotracheal tube cuffs filled with alkalinized lidocaine are associated with a lower incidence of postoperative sore throat and anesthesia emergence phenomena in children undergoing tonsillectomy or adenotonsillectomy. We also assessed the potential additional benefits of IV dexamethasone in reducing postoperative laryngotracheal morbidity. Methods: This is a clinical prospective, randomized, controlled trial. Patients were randomly allocated to one of four groups, as follows: air – endotracheal tube cuff filled with air; air/dex – endotracheal tube cuff filled with air and intravenous dexamethasone; lido – endotracheal tube cuff filled with alkalinized lidocaine; and lido/dex – endotracheal tube cuff filled with alkalinized lidocaine and intravenous dexamethasone. Perioperative hemodynamic parameters and the incidence of postoperative nausea and vomiting, coughing and hoarseness were recorded. Postoperative sore throat was assessed in the postanesthetic care unit and 24 hours post tracheal extubation. Results: In total, 154 children aged 4–12 years, ASA physical status I or II, undergoing general anesthesia for elective tonsillectomy and adenotonsillectomy, were assessed for postoperative sore throat in this study. The incidence of postoperative sore throat 24 hours after tracheal extubation was significantly lower in the lido/dex group compared to groups air and air/dex (p = 0.01). However, no additional reduction in these symptoms was observed from the intravenous administration of dexamethasone when comparing the lido and lido/dex groups. Similarly, there were no differences among groups regarding perioperative hemodynamic variables or postoperative nausea and vomiting, coughing, and hoarseness during the study period. Conclusion: Intracuff alkalinized lidocaine, associated with intravenous dexamethasone, might be effective in reducing sore throat 24 hours post-tonsillectomy or adenotonsillectomy in children when compared to the use of air as the cuff insufflation media.

Abstract This paper presents the strategies and initial implementations of a data culture conversion process at a company in the electricity sector. Solutions are being developed within the scope of the construction management macro-process, which involves multiple sectors of the company, as well as external agents. The strategy is based on implementing Proofs of Concept as tools for converting the data culture within the company and, at the same time, supporting the essential activities of construction management. The proofs of concept aligned with the change in data culture have two components: technology and people. The first consists mainly of intelligent automation and process optimization. The second component involves sensitization, training and developing solutions together with the company's employees. The results involve a reduction in workload since some activities have been partially or totally transferred to the software. Greater assertiveness in estimating numerical data, such as prices and budgets. Increased reliability by reducing human intervention and complex calculations. Greater controllability by monitoring multiple activities and sectors, simplifying management. Finally, the integration of technology and people has shown significant advances in organizational culture, enabling employees to have a greater understanding of advanced tools and methods and to be able to identify opportunities and share solutions within the company.

Este artículo analizó la conmemoración de la Batalla de Boyacá ocurrida en agosto de 1919 en Bogotá, un evento poco abordado por la historiografía colombiana. Algunos estudios recientes de historia urbana se han concentrado en la transformación del espacio físico como variable determinante, descuidando enfoques relevantes que ofrecerían visiones más complejas del acontecimiento. Se propone estudiar esta celebración desde una perspectiva diferente, a partir del análisis sobre cómo el papel desempeñado por un grupo de mujeres determinó el tipo de celebración llevada a cabo y la producción de un modelo específico de ciudad a través de la experiencia de un grupo específico. Para tal efecto, metodológicamente se realizó un análisis espacial de la conmemoración y la búsqueda e interpretación de documentos históricos sometidos a nuevas preguntas. Como conclusión, se señala que la interrelación entre historia urbana e historia de las mujeres puede iluminar procesos urbanos que han sido largamente desestimados.

ABSTRACT The limited temporal completeness and taxonomic accuracy of species lists, made available in a traditional manner in scientific publications, has always represented a problem. These lists are invariably limited to a few taxonomic groups and do not represent up-to-date knowledge of all species and classifications. In this context, the Brazilian megadiverse fauna is no exception, and the Catálogo Taxonômico da Fauna do Brasil (CTFB) (http://fauna.jbrj.gov.br/), made public in 2015, represents a database on biodiversity anchored on a list of valid and expertly recognized scientific names of animals in Brazil. The CTFB is updated in near real time by a team of more than 800 specialists. By January 1, 2024, the CTFB compiled 133,691 nominal species, with 125,138 that were considered valid. Most of the valid species were arthropods (82.3%, with more than 102,000 species) and chordates (7.69%, with over 11,000 species). These taxa were followed by a cluster composed of Mollusca (3,567 species), Platyhelminthes (2,292 species), Annelida (1,833 species), and Nematoda (1,447 species). All remaining groups had less than 1,000 species reported in Brazil, with Cnidaria (831 species), Porifera (628 species), Rotifera (606 species), and Bryozoa (520 species) representing those with more than 500 species. Analysis of the CTFB database can facilitate and direct efforts towards the discovery of new species in Brazil, but it is also fundamental in providing the best available list of valid nominal species to users, including those in science, health, conservation efforts, and any initiative involving animals. The importance of the CTFB is evidenced by the elevated number of citations in the scientific literature in diverse areas of biology, law, anthropology, education, forensic science, and veterinary science, among others.

BackgroundIn obstructive hypertrophic cardiomyopathy (HOCM), disopyramide is used in patients who remain symptomatic despite β-blockers or verapamil. However, effectiveness of disopyramide therapy has not been clearly established due to inconsistent definition of responders and the insufficient length of follow-ups reported in literature. To address these shortcomings, we have conducted a retrospective analysis from detailed databases with long follow-up, from two HCM Referral Centers.Methods62 symptomatic HOCM patients (43% women, age 52 ± 14 years) with left ventricular (LV) outflow tract gradient (LVOTG) ≥ 50 mmHg at rest or during provocation, were recruited from two Italian Centers. Disopyramide was added as second-line therapy in the patients in whom symptoms persisted despite classic pharmacologic treatment. Patients in NYHA class > II at baseline who reached NYHA class II or I, and patients in NYHA class II at baseline who reached NYHA class I or symptoms stabilization were defined as responders.ResultsAt follow-up, (mean 4.4 years, IQR 1.1–6.6 years), 47 patients (76%) were responders, whereas 15 (24%) were no-responders. Responders showed larger LV diastolic volume index (LVEDVi) at baseline as compared to no-responders (61 ± 14 vs. 49 ± 16 ml, respectively, p = 0.018), and, at follow-up, reached lower LVOTG than no-responders (43 ± 32 vs. 66 ± 28 mmHg, respectively, p = 0.013), with a LVOTG

Antecedentes: Las plantas emiten señales florales que resultan atractivas para los polinizadores. Los compuestos volátiles orgánicos florales (COVs), son considerados como una señal clave en la atracción de polinizadores. Sin embargo, ha sido escasamente explorado si las flores de especies del mismo género con el mismo color emiten el mismo aroma y atraen a los mismos visitantes florales. Preguntas: ¿Las especies de Salvia con flores de corola blanca, emiten el mismo aroma floral y a su vez atraen a los mismos visitantes florales? Especie de estudio: Salvia assurgens y S. madrigalii, dos especies de corola blanca pero con distinta morfología floral. Sitio de estudio: Bosque templado al sureste de Morelia, Michoacán. Métodos: El aroma floral se analizó por cromatografía de gases/masas y la observación de visitantes florales se realizó con cámaras de video. Resultados: El perfil químico del aroma floral (composición y cantidad relativa de COVs) difirió significativamente entre S. assurgens y S. madrigalii. En S. madrigalii encontramos 16 COVs y fue visitada exclusivamente por el colibrí Amazilia beryllina y en S. assurgens encontramos 11 COVs y fue visitada por cuatro especies de insectos, siendo el más frecuente la mariposa Thorybes dorantes. El análisis de correspondencia canónica (ACC) mostró que los volátiles florales se correlacionaron significativamente con la frecuencia de visita de los visitantes florales. Conclusiones: Nuestro estudio muestra evidencia que las flores blancas de Salvia de distintas especies con distinta morfología emiten diferente aroma floral y a su vez atrae a visitantes florales particulares.

Cross-taxon congruence, i.e., using certain taxonomic groups as surrogates for others, is receiving growing interest since it may allow decreasing efforts in biodiversity studies. In this work, we investigated the patterns of cross-taxon congruence in species richness and composition between communities of bryophytes, lichens, and vascular plants in different biancana grasslands of a Special Area of Conservation (SAC) of central Italy. We recorded species presence and abundance in 16 plots of 1 × 1 m size and analyzed the data using Procrustes correlation, co-correspondence analysis, and indicator species analysis. We did not highlight any correlation in species richness and composition between the three taxonomic groups. Conversely, the species composition of bryophyte communities was predictive of the species composition of lichen communities. Moreover, lichen richness was negatively correlated with the total cover of vascular plants. Indicator species analysis evidenced the presence of species from the three biotic communities being particularly related, at least at the local scale, to biancana pediments, like the bryophytes Didymodon acutus and Trichostomum crispulum, the lichens Enchylium tenax, Cladonia foliacea, and Psora decipiens, and the vascular plants Brachypodium distachyon, Parapholis strigosa, and Artemisia caerulescens subsp. cretacea. In the biancana pediments, acrocarp mosses, squamulose lichens, therophyte plants and chamaephyte plants coexisted. In spite of the weak cross-taxon congruence between the three taxonomic groups, this study could highlight a locally unique diversity of bryophytes, lichens, and vascular plants related to the extreme environment of biancana pediments, selected by high soil salinity and deposition from the upper eroded slope. Soil erosion and deposition in biancana badlands supports the increase of local multi-taxonomic plant diversity by creating unique ecosystems. Such biodiversity should be considered locally at risk of disappearance, due to the ongoing vanishing of biancana badlands in central Italy.

Este es un artículo de revisión teórica que explora el impacto de las nuevas tecnologías que están transformando los métodos de enseñanza en la educación, con especial énfasis en la inteligencia artificial y su aplicación en la actividad física. El objetivo es investigar, analizar y comprender los efectos de como la inteligencia artificial, se puede personalizar y adaptarse a programas de ejercicios de manera individualizada, mejorando así la condición física a largo plazo. La metodología usada ha sido verificada minuciosamente en la literatura existente, la cual se centró en investigaciones empíricas y teóricas destinadas a revisar el impacto de la actividad física a través de la inteligencia artificial. Los resultados indicaron que esta tecnología está mejorando la participación y motivación de los estudiantes y público en general, permitiendo de esta manera un aprendizaje individualizado, mejor dicho facilita el acceso a la información recogida. Para concluir, el artículo destaca la importancia de abordar los desafíos de una implementación efectiva de la tecnología con los deportes y todo tipo de enseñanza en la actividad física.