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Objective Describe the population of babies who do and do not receive postnatal corticosteroids for prevention or treatment of bronchopulmonary dysplasia (BPD).Design Retrospective cohort study using data held in the National Neonatal Research Database.Setting National Health Service neonatal units in England and Wales.Patients Babies born less than 32 weeks gestation and admitted to neonatal units from 1 January 2012 to 31 December 2019.Main outcomes Proportion of babies given postnatal corticosteroid; type of corticosteroid; age at initiation and duration, trends over time.Secondary outcomes Survival to discharge, treatment for retinopathy of prematurity, BPD, brain injury, severe necrotising enterocolitis, gastrointestinal perforation.Results 8% (4713/62019) of babies born

Chronic social stress has been epidemiologically linked to increased risk for cardiovascular disease, yet the underlying pathophysiological mechanisms are still largely elusive. Mitochondrial (dys)function represents a potential intersection point between social stress exposure and (mal)adaptive cardiac responses. In this study, we used a rodent model of social stress to study the extent to which alterations in the cellular mechanical properties of the heart were associated with changes in indexes of mitochondrial function. Male adult rats were exposed to repeated episodes of social defeat stress or left undisturbed (controls). ECG signals were recorded during and after social defeat stress. Twenty-four hours after the last social defeat, cardiomyocytes were isolated for analyses of mechanical properties and intracellular Ca2+ dynamics, mitochondrial respiration, and ATP content. Results indicated that social defeat stress induced potent cardiac sympathetic activation that lasted well beyond stress exposure. Moreover, cardiomyocytes of stressed rats showed poor contractile performance (e.g., slower contraction and relaxation rates) and intracellular Ca2+ derangement (e.g., slower Ca2+ clearing), which were associated with indexes of reduced reserve respiratory capacity and decreased ATP production. In conclusion, this study suggests that repeated social stress provokes impaired cardiomyocyte contractile performance and signs of altered mitochondrial bioenergetics in the rat heart. Future studies are needed to clarify the causal link between cardiac and mitochondrial functional remodeling under conditions of chronic social stress.

A gestão participativa de uma unidade de conservação pode ser entendida como a coordenação equilibrada dos componentes técnicos, operacionais e dos recursos naturais da área e o gerenciamento desses componentes se faz juntamente com os atores sociais envolvidos direta ou indiretamente com a unidade de conservação. Avaliar a gestão participativa de uma unidade de conservação é analisar sua capacidade de executar as ações relacionadas com seus objetivos de conservação e preservação. O presente trabalho teve como objetivo avaliar a gestão da Floresta Nacional do Assungui, utilizando como ferramenta a metodologia APAS, “Análise da Participação Social em Unidades de Conservação, elaborada para analisar a efetividade da gestão participativa, considerando os principais instrumentos de participação social previstos na Lei do SNUC, consulta pública, plano de manejo e conselho gestor. Os resultados mostraram que a unidade de conservação atingiu um percentual de 68,97% de efetividade de gestão, o que indica que a área possui uma gestão participativa moderadamente satisfatória, possuindo elementos mínimos para sua gestão, porém, com deficiências que dificultam o estabelecimento de uma base sólida para uma gestão participativa eficaz, o que pode ocasionar no descumprimento de alguns objetivos estabelecidos para a conservação da unidade.

ABSTRACT The efficiency of the agricultural tractor can be increased with its assertive operational adequacy, ballasting being one of the fundamental factors for obtaining good performance levels, as it is closely related to energy and operational performance. Thus, the objective of this experiment was to evaluate the effect of hydraulic and solid ballast, under different fractions, on the performance of the agricultural tractor. The banded experiment was conducted in a randomized block design, with the treatments consisting of the five configurations of base mass (B0), B0 + 40% hydraulic (HB 40%), B0 + 40% solid (SB 40%), B0 + 75% hydraulic (HB 75%) and B0 + 75% solid (SB 75%), and four target speeds, with five repetitions, totaling 100 experimental units. To determine the efficiency of the tractor, 4 x 2 AFWD with a rated power of 125.2 kW, the parameters of wheel slip, engine rotation, hourly and specific fuel consumption, power, power, and efficiency in the drawbar, operating speed and thermal efficiency of the engine were monitored. The collected data were subjected to analysis of variance/ when significant, submitted to the Tukey test and regression analysis. The obtained results verified that using the hydraulic ballast in the fraction of 75% presented superiority in the energetic and operational performance, highlighting the engine rotation, force in the drawbar, operational speed, and specific fuel consumption. The increase in operational speed can provide gains in energy and operational efficiency; however, it can generate overload on the engine in some ballast configurations.

IntroductionAction Observation Treatment (AOT) and Motor Imagery (MI) represent very promising cognitive strategies in neuro-rehabilitation. This study aims to compare the effectiveness of the two cognitive strategies, taken alone or combined, in Parkinson's disease patients.Material and methodsThis study is designed as a prospective randomized controlled trial, with four arms. We estimated a sample size of 64 patients (16 in each treatment group) to be able to detect an effect size of F = 0.4 with a statistical significance of 0.05. Primary outcomes will be functional gains in the FIM and UPDRS scales. Secondary outcome measure will be functional gain as revealed by kinematic parameters measured at Gait Analysis.DiscussionThe results of this trial will provide insights into the use of AOT and MI, taken alone or combined, in the rehabilitation of Parkinson's disease patients.Ethics and disseminationThe study protocol was approved by the Ethics Committee of the Don Gnocchi Foundation. The study will be conducted in accordance with the 1996 World Medical Association guidelines and according to good clinical practice. The study has been registered on clinicaltrial.gov under the following code: AOTPRFDG. Dissemination will include both submission of the study to peer-reviewed journals and discussion of the study protocol at conferences.

Abstract The Paranaguá Estuarine Complex (PEC) is one of Brazil's largest southwest Atlantic estuarine systems, possessing a rich microalgae diversity that remains to be fully explored. Therefore, due to the increasing interest in the microalgae biotechnological potential, this study isolated and identified diatoms found in the PEC. The diatoms were purified and analyzed with light and scanning electron microscopy for morphological identification, while DNA sequences were used for molecular identification. Although a diatoms rich diversity was obtained, only a few were viable after the cultivation period. The two best-selected strains were identified as belonging to two genera, Nitzschia and Navicula. The rbcL region was found to be the most informative for species identification. Morphological and molecular analyses allowed for the identification of species Nitzschia inconspicua and Navicula pseudoantonii, which was understood as the first report of N. pseudoantonii in the American continent.

Myeloid sarcoma is a hematologic malignancy consisting of extramedullary tissue involvement by myeloid blasts, usually considered as acute myeloid leukemia and treated accordingly. The disease itself, together with chemotherapy and disease-associated factors, may have an impact in increasing the risk of developing severe and frequently life-threatening infections. Herein, we describe the case of a patient with a right breast skin lesion, histologically diagnosed myeloid sarcoma, who developed a severe disseminated fungal infection by Saprochaete clavata (Magnusiomyces clavatus), during the first consolidation course of chemotherapy. Despite maximum antifungal therapy, the infection progressed and the fungus continued to be isolated until granulocyte transfusion therapy was initiated. Our experience suggests that patients with profound and long-lasting neutropenia could benefit from granulocyte transfusions as additional therapy in severe fungal infections resistant to broad-spectrum antimicrobial therapy.

This study proposed a new workflow for co-registering prostate PET images from a dual-tracer PET/MRI study with histopathological images of resected prostate specimens. The method aims to establish an accurate correspondence between PET/MRI findings and histology, facilitating a deeper understanding of PET tracer distribution and enabling advanced analyses like radiomics. To achieve this, images derived by three patients who underwent both [68Ga]Ga-PSMA and [68Ga]Ga-RM2 PET/MRI before radical prostatectomy were selected. After surgery, in the resected fresh specimens, fiducial markers visible on both histology and MR images were inserted. An ex vivo MRI of the prostate served as an intermediate step for co-registration between histological specimens and in vivo MRI examinations. The co-registration workflow involved five steps, ensuring alignment between histopathological images and PET/MRI data. The target registration error (TRE) was calculated to assess the precision of the co-registration. Furthermore, the DICE score was computed between the dominant intraprostatic tumor lesions delineated by the pathologist and the nuclear medicine physician. The TRE for the co-registration of histopathology and in vivo images was 1.59 mm, while the DICE score related to the site of increased intraprostatic uptake on [68Ga]Ga-PSMA and [68Ga]Ga-RM2 PET images was 0.54 and 0.75, respectively. This work shows an accurate co-registration method for histopathological and in vivo PET/MRI prostate examinations that allows the quantitative assessment of dual-tracer PET/MRI diagnostic accuracy at a millimetric scale. This approach may unveil radiotracer uptake mechanisms and identify new PET/MRI biomarkers, thus establishing the basis for precision medicine and future analyses, such as radiomics.

Heartbeat rhythms are related to a complex dynamical system based on electrical activity of the cardiac cells usually measured by the electrocardiogram (ECG). This paper presents a mathematical model to describe the electrical activity of the heart that consists of three nonlinear oscillators coupled by delayed Duffing-type connections. Coupling alterations and external stimuli are responsible for different cardiac rhythms. The proposed model is employed to build synthetic ECGs representing a variety of responses including normal and pathological rhythms: ventricular flutter, torsade de pointes, atrial flutter, atrial fibrillation, ventricular fibrillation, polymorphic ventricular tachycardia and supraventricular extrasystole. Moreover, the sinoatrial rhythm variations are described by time-dependent frequency, representing transient disturbances. This kind of situation can represent transitions between different pathological behaviors or between normal and pathological physiologies. In this regard, a nonlinear dynamics perspective is employed to describe cardiac rhythms, being able to represent either normal or pathological behaviors.

This paper presents a radio-frequency (RF) antenna as a sensor to detect Horseradish peroxidase (HRP). At the core of the proposed approach is a graphene film deposited on a stub connected to an RF antenna. The graphene film is doctor bladed on the stub. The film is then properly chemically functionalized in order to detect the presence of Horseradish peroxidase (HRP). We validate the proof-of-concept operation of HRP concentration detection by measuring the frequency shift of the reflection coefficient of the antenna using very small concentration of HRP (0.03 mM to 0.6 mM).

Colibacillosis is a disease caused by Escherichia coli and remains a major concern in poultry production, as it leads to significant economic losses due to carcass condemnation and clinical symptoms. The development of antimicrobial resistance is a growing problem of worldwide concern. Lysogenic bacteriophages are effective vectors for acquiring and disseminating antibiotic resistance genes (ARGs). The aim of this study was to investigate the complete genome of Escherichia coli isolates from the femurs of Brazilian broiler chickens in order to investigate the presence of antimicrobial resistance genes associated with bacteriophages. Samples were collected between August and November 2021 from broiler batches from six Brazilian states. Through whole genome sequencing (WGS), data obtained were analyzed for the presence of antimicrobial resistance genes. Antimicrobial resistance genes against the aminoglycosides class were detected in 79.36% of the isolates; 74.6% had predicted sulfonamides resistance genes, 63.49% had predicted resistance genes against β-lactams, and 49.2% of the isolates had at least one of the tetracycline resistance genes. Among the detected genes, 27 have been described in previous studies and associated with bacteriophages. The findings of this study highlight the role of bacteriophages in the dissemination of ARGs in the poultry industry.

O mixossarcoma (MXS) é classificado como uma neoplasia rara, como grande parte dos Sarcomas de Tecidos Moles (STM), se manifesta como um tumor de caráter invasivo, com margem mal definida, baixo potencial metastático e crescimento lento. Acomete animais de meia idade a idosos, sem predileção sexual, e devido à pouca resposta aos protocolos quimioterápicos, o tratamento de eleição é a remoção cirúrgica. O objetivo foi relatar o atendimento de uma cadela idosa com diagnóstico de mixossarcoma de pele. O animal foi encaminhado para consulta apresentando aumento de volume na região cervical cranial. No exame físico apresentou massa com consistência mole, aderida em região tóraco-esternal. A paciente foi submetida a citologia e procedimento de exérese de neoplasia cutânea. Como protocolo terapêutico, foi prescrito anti-inflamatório, antibiótico e medicação para controle de dor. O caso apresentou duas recidivas em um período de 61 dias após a primeira cirurgia, com a realização da retirada cirúrgica em três momentos. No segundo procedimento, o tutor aceitou encaminhar material para histopatologia, confirmando diagnóstico de mixossarcoma. No terceiro procedimento cirúrgico para exérese de material neoplásico cutâneo recidivante, animal veio a óbito. Este trabalho demonstra a importância do diagnóstico precoce, por meio de exame histopatológico e assim uma conduta terapêutica precoce com uma ampla margem cirúrgica.

Abstract Background Several studies that aim to enhance the understanding of malaria transmission and persistence in urban settings failed to address its underlining complexity. This study aims at doing that by applying qualitative and participatory-based system analysis and mapping to elicit the system’s emergent properties. Methods In two experts’ workshops, the system was sketched and refined. This system was represented through a causal loop diagram, where the identification of leverage points was done using network analysis. Results 45 determinants interplaying through 56 linkages, and three subsystems: urbanization-related transmission, infection-prone behaviour and healthcare efficiency, and Plasmodium resistance were identified. Apart from the number of breeding sites and malaria-positive cases, other determinants such as drug prescription and the awareness of householders were identified by the network analysis as leverage points and emergent properties of the system of transmission and persistence of malaria. Conclusion Based on the findings, the ongoing efforts to control malaria, such as the use of insecticide-treated bed nets and larvicide applications should continue, and new ones focusing on the public awareness and malaria literacy of city dwellers should be included. The participatory approach strengthened the legitimacy of the recommendations and the co-learning of participants.

Introdução: A punção venosa central é um procedimento médico tradicionalmente realizado seguindo os marcadores anatômicos como referência para atingir o vaso, às cegas. No entanto, nem sempre o sucesso nessa técnica é alcançado, fato que se deve principalmente às variações anatômicas. A ultrassonografia point of care (US-POC) é utilizada para auxiliar a cateterização central por visualização direta do vaso, aumentando a segurança do procedimento. Objetivo: Avaliar a prevalência das variações anatômicas de vasos femorais através da utilização da US-POC por estudantes de medicina submetidos a curto período de treinamento. Materiais e Métodos: Cinco estudantes de medicina, sem experiência prévia em US-POC, foram submetidos a oito horas de treinamento teórico-prático. Foram avaliados os vasos femorais de cem voluntários. Resultados: A veia femoral direita foi encontrada mais frequentemente na posição medial (43%) em relação à artéria femoral direita. À esquerda, a posição posteromedial foi a mais observada (45%). Conclusão: A técnica tradicional de punção de acesso central se baseia em marcadores anatômicos e não leva em consideração as variações anatômicas existentes. Um treinamento de curto período para uso da US-POC é capaz de capacitar o profissional para reconhecer o posicionamento real dos vasos e evitar punções inadvertidas.

The world’s largest extant fish, the whale shark Rhincodon typus, is one of the most-studied species of sharks globally. The discovery of predictable aggregation sites where these animals gather seasonally or are sighted year-round – most of which are coastal and juvenile-dominated – has allowed for a rapid expansion of research on this species. The most common method for studying whale sharks at these sites is photographic identification (photo-ID). This technique allows for long-term individual-based data to be collected which can, in turn, be used to evaluate population structure, build population models, identify long-distance movements, and assess philopatry and other population dynamics. Lagged identification rate (LIR) models have fewer underlying assumptions than more traditional capture mark recapture approaches, making them more broadly applicable to marine taxa, especially far-ranging megafauna species like whale sharks. However, the increased flexibility comes at a cost. Parameter estimations based on LIR can be difficult to interpret and may not be comparable between areas with different sampling regimes. Using a unique data-set from the Philippines with ~8 years of nearly continuous survey effort, we were able to derive a metric for converting LIR residency estimates into more intuitive days-per-year units. We applied this metric to 25 different sites allowing for the first quantitatively-meaningful comparison of sightings-derived residence among the world’s whale shark aggregations. We validated these results against the only three published acoustic residence metrics (falling within the ranges established by these earlier works in all cases). The results were then used to understand residency behaviours exhibited by the sharks at each site. The adjusted residency metric is an improvement to LIR-based population modelling, already one of the most widely used tools for describing whale shark aggregations. The standardised methods presented here can serve as a valuable tool for assessing residency patterns of whale sharks, which is crucial for tailored conservation action, and can cautiously be tested in other taxa.

A timely, confirmed diagnosis of Idiopathic Pulmonary Fibrosis (IPF) has a significant impact on the evolution of the disease. The current model of care in the Lazio region (in Italy) was assessed on the basis of real-world data provided by the four reference centers responsible for diagnosing and treating IPF. The 5-year, population-based, retrospective longitudinal study provided the data that is at the basis of the current proposal for a new clinical and therapeutic pathway (DTCP) and has been shared with regional decision makers. A DTCP must be defined and based on four pillars: GPs, pulmonologists, IPF centers, and telemedicine. Each must play a role within a sort of hub-and-spoke model. IPF centers remain the hubs, while spokes are identified in trained GPs and pulmonologists.

Evolution of myeloproliferative neoplasms (MPN) to acute myeloid leukemia (AML) occurs in 2-10% of patients, whereas the reverse path from AML to MPN has been rarely reported. We herein present a 75-year-old woman with AML, in whom a JAK2-V617F positive polycythemia vera (PV) emerged during follow-up, 19 months from end of consolidation treatment. JAK2-V617F mutation screening retrospectively performed by Next Generation Sequencing (NGS) and JAK2 MutaScreen was negative on the bone marrow sample collected at AML diagnosis. However, using droplet digital PCR (ddPCR), we detected a minor JAK2-V617F mutated clone present at AML onset. A TET2 R550 mutated clone persisted at stable levels throughout the disease course. This case shows that a very small MPN clone masked at AML diagnosis may expand after treatment end, and be erroneously interpreted as MPN evolving from AML. Very sensitive techniques as ddPCR may help to unravel the true disease history in these cases.

The purpose of this study is to test a theoretical model concerning the role of self-esteem as a mediator between university students' automatic thoughts and their levels of hopelessness. The participants consisted of 338 students (197 females (58.3%) and 141 males (41.7%) from various departments at the Celal Bayar University. The research data was obtained by utilizing the Automatic Thoughts Scale, the Beck Hopelessness Scale, the Rosenberg Self-Esteem Scale, and a personal information form. In this study, the direct and indirect relationship between the university students' self-esteem and automatic thoughts as well as their levels of hopelessness were tested using structural equation modeling. The proposed structural model, based on the measurement models, was confirmed as a result of the analyses. In addition, the findings show that the fit indices of the model generally met the conditions of acceptance value, and that the t-values pertaining to the relationships among all of the variables were meaningful. Accordingly, automatic thoughts and self-esteem significantly predict the onset of hopelessness, whereas self-esteem does not serve as a mediator between automatic thoughts and hopelessness.

Hydrophobins produced by the Fusarium genus in brewing barley in connection with gushing phenomenon have been studied in many different countries. However, the presence of proteins associated with gushing in grains harvested in Brazil is currently unknown. The surface active class 2 hydrophobin Hyd5 has been identified as a possible causative agent for gushing of beer. For this reason, the objective of this study was to evaluate the presence of Hyd5 in isolated Fusarium strains from Brazilian barley samples. This was followed by gushing tests. The Hyd5 gene was identified in all fungal isolates and phylogenetic analysis exhibited four main linages. Gushing tests demonstrated that among the 21 analysed malt samples 8 were positive considering overfoaming at the bottle opening. Levels ranged from 8 to 124 g/bottle of gushing. No correlation between phylogenetic analysis and gushing was observed when they were evaluated together. This is due to positive isolates for gushing which are scattered throughout the phylogenetic tree. The other cause may be that all main clades contain at least one positive isolate for gushing. More research regarding hydrophobins and gushing should be carried out in the future due to the fungi isolated in Brazilian samples. These results offer excellent support that could help the brewing industry to prevent its losses and to provide further understanding of the gushing phenomenon in beer.

Concentration and memory impairment (named “brain fog”) represents a frequent and disabling neuropsychological sequela in post-acute COVID-19 syndrome (PACS) patients. The aim of this study was to assess whether neurocognitive function could improve after a multidisciplinary rehabilitation program enhanced with individualized neuropsychological treatment. A prospective monocentric registry of PACS patients consecutively admitted to our Rehabilitation Unit was created. The Montreal Cognitive Assessment (MoCA) was used to assess cognitive impairment at admission and discharge. A total of sixty-four (64) PACS patients, fifty-six (56) of them with brain fog, were treated with a day-by-day individualized psychological intervention of cognitive stimulation (45 min) on top of a standard in-hospital rehabilitation program. The mean duration of the acute-phase hospitalization was 55.8 ± 25.8 days and the mean in-hospital rehabilitation duration was 30 ± 10 days. The mean age of the patients was 67.3 ± 10.4 years, 66% of them were male, none had a previous diagnosis of dementia, and 66% of the entire sample had experienced severe COVID-19. At admission, only 12% of the patients had normal cognitive function, while 57% showed mild, 28% moderate, and 3% severe cognitive impairment. After psychological treatment, a significant improvement in the MoCA score was found (20.4 ± 5 vs. 24.7 ± 3.7; p < 0.0001) as a result of significant amelioration in the following domains: attention task (p = 0.014), abstract reasoning (p = 0.003), language repetition (p = 0.002), memory recall (p < 0.0001), orientation (p < 0.0001), and visuospatial abilities (p < 0.0001). Moreover, the improvement remained significant after multivariate analysis adjusted for several confounding factors. Finally, at discharge, 43% of the patients with cognitive impairment normalized their cognitive function, while 4.7% were discharged with residual moderate cognitive impairment. In conclusion, our study provides evidence of the effects of multidisciplinary rehabilitation enhanced with neuropsychological treatment on improvement in the cognitive function of post-acute COVID-19 patients.

The widespread use of the lung ultrasound (LUS) has not been followed by the development of a comprehensive standardized tool for its reporting in the intensive care unit (ICU) which could be useful to promote consistency and reproducibility during clinical examination. This work aims to define the essential features to be included in a standardized reporting tool and provides a structured model form to fully express the diagnostic potential of LUS and facilitate intensivists in the use of a LUS in everyday clinical ICU examination. We conducted a modified Delphi process to build consensus on the items to be integrated in a standardized report form and on its structure. A committee of 19 critical care physicians from 19 participating ICUs in Italy was formed, including intensivists experienced in ultrasound from both teaching hospitals and referral hospitals, and internationally renowned experts on the LUS. The consensus for 31 statements out of 33 was reached at the third Delphi round. A structured model form was developed based on the approved statements. The development of a standardized model as a backbone to report a LUS may facilitate the guidelines’ application in clinical practice and increase inter-operator agreement. Further studies are needed to evaluate the effects of standardized reports in critically ill patients.

Abstract Background Nanotoxicology is an increasingly relevant field and sound paradigms on how inhaled nanoparticles (NPs) interact with organs at the cellular level, causing harmful conditions, have yet to be established. This is particularly true in the case of the cardiovascular system, where experimental and clinical evidence shows morphological and functional damage associated with NP exposure. Giving the increasing interest on cobalt oxide (Co3O4) NPs applications in industrial and bio-medical fields, a detailed knowledge of the involved toxicological effects is required, in view of assessing health risk for subjects/workers daily exposed to nanomaterials. Specifically, it is of interest to evaluate whether NPs enter cardiac cells and interact with cell function. We addressed this issue by investigating the effect of acute exposure to Co3O4-NPs on excitation-contraction coupling in freshly isolated rat ventricular myocytes. Results Patch clamp analysis showed instability of resting membrane potential, decrease in membrane electrical capacitance, and dose-dependent decrease in action potential duration in cardiomyocytes acutely exposed to Co3O4-NPs. Motion detection and intracellular calcium fluorescence highlighted a parallel impairment of cell contractility in comparison with controls. Specifically, NP-treated cardiomyocytes exhibited a dose-dependent decrease in the fraction of shortening and in the maximal rate of shortening and re-lengthening, as well as a less efficient cytosolic calcium clearing and an increased tendency to develop spontaneous twitches. In addition, treatment with Co3O4-NPs strongly increased ROS accumulation and induced nuclear DNA damage in a dose dependent manner. Finally, transmission electron microscopy analysis demonstrated that acute exposure did lead to cellular internalization of NPs. Conclusions Taken together, our observations indicate that Co3O4-NPs alter cardiomyocyte electromechanical efficiency and intracellular calcium handling, and induce ROS production resulting in oxidative stress that can be related to DNA damage and adverse effects on cardiomyocyte functionality.

Residential short-term energy consumption forecasting plays an essential role in modern decentralized power systems. The rise of innovative prediction methods able to handle the high volatility of users’ electrical load has posed the basis to accomplish this task. However these methods, which mostly rely on Artificial Neural Networks, require that a huge amount of users’ fine-grained sensitive consumption data are centrally collected to train a generalized forecasting model, with implications on privacy and scalability. This paper proposes an innovative architecture specifically designed to overcome this need. By exploiting Federated Learning and Edge Computing capabilities, many Long Short-Term Memory (LSTM) models are locally trained by different users based on their own historical energy consumption samples. Such models are then aggregated by a specific-purpose node to build a generalized model that is re-distributed for improved forecasting at the edge. For better forecasting, our proposed local training procedure takes as input relevant features related to calendar (i.e., hour, weekday and average consumption of previous days) and weather conditions (i.e., clustered apparent temperature), and the architecture can group users according to consumption similarities (using K-means) or socioeconomic affinities. We thoroughly evaluate the approach through simulations, showing that it can lead to similar forecasting performance than a state-of-the-art centralized solution in terms of Root Mean Square Error (RMSE), but with up to an order of magnitude lower training time and up to 50 times less exchanged data when samples are recorded at finer granularity than one hour. Nonetheless, it keeps sensitive data local and therefore guarantees users’ privacy.

When targeting mission critical applications, the design of the electronic actuation systems needs to consider many requirements and constraints not typical in standard industrial applications. One of these is tolerance to faults, as the unplanned shutdown of a critical subsystem, if not handled correctly, could lead to financial harm, environmental disaster, or even loss of life. One way this can be avoided is through the design of an electric drive systems based on multi-phase machines that can keep operating, albeit with degraded performance, in a partial configuration under fault conditions. Distributed architectures are uniquely suited to meet these challenges, by providing a large degree of isolation between the various components. This paper presents a system architecture suitable for scalable and high-performance fault tolerant machine drive systems. the effectiveness of this system is demonstrated through theoretical analysis and experimental verification on a six-phase machine.

In applications that require a high availability and high performance (for example aerospace),modular power electronics and multi-phase machines represent an advantageous choice. In this framework, a control system able to handle a high number of PWM signals and communication interfaces as well as featuring a high computational power is required. This paper proposes a novel HDL plus soft-core approach to be implemented on System-on-Chip hardware which allows for the efficient and modular implementation of the modern control techniques with strong guarantees in terms of determinism. The proposal lies in the adoption of a very simplified and optimized floating-point soft-core, the femtocore (fCore) and its tool-chain, which allows C-like implementation of complex algorithms in a HDL-design power electronics control framework. Several fCore units can be arranged for parallel processing to handle the time requirements of a complex modular system even with low sampling time (100 kHz or more). The proposed architecture is experimentally validated in a proof-of-concept, six-phase electric machine including a comparison against a traditional method.

Global navigation satellite system-reflectometry (GNSS-R) can retrieve Earth's surface parameters, such as soil moisture (SM) using the reflected signals from GNSS constellations with advantages of noncontact, all-weather, real-time, and continuity, particularly the space-borne cyclone GNSS (CYGNSS) mission. However, the accuracy and efficiency of SM estimation from CYGNSS still need to improve. In this article, the global SM is estimated using machine learning (ML) regression aided by a preclassification strategy. The total observations are classified by land types and corresponding subsets are built for constructing ML regression submodels. Ten-fold cross-validation technique is adopted. The overall performance of SM estimation with/without preclassification is compared, and the results show that the SM estimations using different ML algorithms all have substantial improvement with the preclassification strategy. Then, the optimal XGBoost predicted model with root-mean-square error (RMSE) of 0.052 cm3/cm3 is adopted. In addition, the satisfactory daily and seasonal SM prediction outcomes with an overall correlation coefficient value of 0.86 and an RMSE value of 0.056 cm3/cm3 are achieved at a global scale, respectively. Furthermore, the extensive temporal and spatial variations of CYGNSS SM predictions are evaluated. It shows that the reflectivity plays a main role among the predictors in SM estimation, and the next is vegetation. In some extremely dry places, the roughness may become more important. The value of SM is positively correlated with RMSE and also another limit condition that will constrain the variation of predictors, thus affecting correlation coefficient R and RMSE. Also, we compare both SMAP and CYGNSS SM predictions against in situ SM measurements from 301 stations. Similar low-median unbiased RMSEs are obtained, and the daily averaged CYGNSS-based SM against the in situ networks is 0.049 cm3/cm3. The presented approach succeeds in providing SM estimation at a global scale with employing the least ancillary data with superior results and this article reveals the spatio-temporal heterogeneity for SM estimation using CYGNSS data.

Abstract Background During the ongoing pandemic of coronavirus disease 2019 (COVID-19), lockdown periods have changed the way that people and communities live, work and interact. Case presentation This case report describes an uncommon but important presentation of allergic bronchopulmonary aspergillosis (ABPA) in a previously healthy male, who decided to live in the basement of his house when Italy entered a nationwide lockdown during the COVID-19 pandemic. As high resolution computed tomography (HRCT) of the chest on admission showed diffuse miliary nodules, a miliary tuberculosis was initially suspected. However, further investigations provided a diagnosis of unusual presentation of ABPA. Conclusions This case highlights the importance of maintaining awareness of Aspergillus-associated respiratory disorders during the COVID-19 pandemic, especially because lifestyle changes associated with home isolation carry an increased risk of exposure to mold spores present in some indoor environments.

ABSTRACT OBJECTIVE To understand management practices in the care of people living with the human immunodeficiency virus (HIV) in primary health care in a Brazilian capital, in times of the new coronavirus (covid-19) pandemic. METHOD Qualitative research, anchored in the methodological-analytical framework of the grounded theory, constructivist aspect. Data were collected by using intensive online interviews with nurses from health centers and managers of the municipal health department. Data collection and analysis occurred concomitantly in two phases of analysis: initial and focused coding. RESULTS They point to the development of best care practices, with emphasis on initiatives for coordination of care, decentralization of clinical management for primary health care services, establishment of protocols and flows, agreement of intersectoral partnerships, use of groups and social networks, use of tools such as teleconsultation and health surveillance spreadsheet and formation of support networks. CONCLUSION The Brazilian capital restructured its network of health services with the implementation of clinical and management protocols, seeking to maintain care for people living with HIV. We highlighted the incorporation of non-face-to-face care technologies and the facilitation of routines, as strategies for expanding access.

Acute promyelocytic leukemia (APL) accounts for 10–15% of newly diagnosed acute myeloid leukemias (AML) and is typically caused by the fusion of promyelocytic leukemia with retinoic acid receptor α (RARA) gene. The prognosis is excellent, thanks to the all-trans retinoic acid (ATRA) and arsenic trioxide (ATO) combination therapy. A small percentage of APLs (around 2%) is caused by atypical transcripts, most of which involve RARA or other members of retinoic acid receptors (RARB or RARG). The diagnosis of these forms is difficult, and clinical management is still a challenge for the physician due to variable response rates to ATRA and ATO. Herein we review variant APL cases reported in literature, including genetic landscape, incidence of coagulopathy and differentiation syndrome, frequent causes of morbidity and mortality in these patients, sensitivity to ATRA, ATO, and chemotherapy, and outcome. We also focus on non-RAR rearrangements, complex rearrangements (involving more than two chromosomes), and NPM1-mutated AML, an entity that can, in some cases, morphologically mimic APL.

The p75 neurotrophin receptor is important in multiple physiological actions including neuronal survival and neurite outgrowth during development, and after central nervous system injury. We have discovered a novel piperazine-derived compound, EVT901, which interferes with p75 neurotrophin receptor oligomerization through direct interaction with the first cysteine-rich domain of the extracellular region. Using ligand binding assays with cysteine-rich domains-fused p75 neurotrophin receptor, we confirmed that EVT901 interferes with oligomerization of full-length p75 neurotrophin receptor in a dose-dependent manner. Here we report that EVT901 reduces binding of pro-nerve growth factor to p75 neurotrophin receptor, blocks pro-nerve growth factor induced apoptosis in cells expressing p75 neurotrophin receptor, and enhances neurite outgrowth in vitro Furthermore, we demonstrate that EVT901 abrogates p75 neurotrophin receptor signalling by other ligands, such as prion peptide and amyloid-β. To test the efficacy of EVT901 in vivo, we evaluated the outcome in two models of traumatic brain injury. We generated controlled cortical impacts in adult rats. Using unbiased stereological analysis, we found that EVT901 delivered intravenously daily for 1 week after injury, reduced lesion size, protected cortical neurons and oligodendrocytes, and had a positive effect on neurological function. After lateral fluid percussion injury in adult rats, oral treatment with EVT901 reduced neuronal death in the hippocampus and thalamus, reduced long-term cognitive deficits, and reduced the occurrence of post-traumatic seizure activity. Together, these studies provide a new reagent for altering p75 neurotrophin receptor actions after injury and suggest that EVT901 may be useful in treatment of central nervous system trauma and other neurological disorders where p75 neurotrophin receptor signalling is affected.

ABSTRACT Studies on the longitudinal distribution of seeds in the sowing row seek to improve crop homogeneity, thus generating high productivity. In this context, seed tubes must be analyzed for their angular curvature. Thus, this study aimed to evaluate the influence of the seed tube curvature on the longitudinal distribution of corn and soybean seeds at different speeds. Two experiments were conducted completely randomized in a double factorial design. The first factor consisted of the seed tube curvature (straight and curved) and the second factor consisted of sowing speeds (1.11, 1.39, and 1.67 m s−1 for corn and 1.39, 1.67, 1.94, and 2.22 m s−1 for soybean), with five replications. The parameters analyzed to measure the longitudinal distribution were the number of seeds per meter, average spacing, double, flawed, and acceptable spacings, coefficient of variation, and precision index. The results were subjected to normality and homogeneity tests of residuals, followed by an analysis of variance and Tukey test, when significant. The curved seed tube showed the highest efficiency in the measured parameters for both corn and soybean. The increase in sowing speed had a negative influence on the evaluated parameters, especially in the soybean crop.

Abstract The bats usually inhabit shelters with favorable conditions for fungal proliferation, including pathogenic and opportunistic species. The fungal diversity present on bats is little known and the studies are scarce in Brazil, which only a work has been performed in Cerrado and Pantanal biomes. Therefore, the objective of this study was evaluating the occurrence of filamentous fungi on the rostral region of Molossus molossus in an Atlantic Forest remnant of Brazil. The bats were captured with mist nets installed outside a shelter located in the municipality of Treviso, (28°29'23”S and 49°31'23”W), south region of state Santa Catarina. With a swab sterile moistened in saline solution, samples from the rostral region were obtained from all captured M. molossus individuals. The samples were taken to the laboratory for analysis and isolation in different culture media, followed of identification of fungal through the microculture technique. In total, 15 individuals were captured, which five fungal genus and 19 taxa were identified. Among the taxa registered, Aspergillioides sp.2, (47%), Penicillium sp.1 (33%), Chrysonilia sp. (33%), Cladosporium sp. (27%) were classified as little constant. In terms of abundance, Penicillium sp.1 (34%), Aspergillioides sp.2 (21%) and Aspergillus sp.2 (11%) were the most abundant in the samples. The results showed the occurrence of high diversity fungal in the rostral region of M. molossus in the Atlantic Forest, which is higher than observed in others Brazilian biomes. Some fungal genera found may harbor pathogenic and opportunistic species that need to be identified for preventing potential disease well as for bat conservation projects.

ABSTRACT The technological innovation in agriculture seeks to improve the performance of mechanized assemblies and, currently, rubber half-tracks are a valuable solution for agricultural tractors, combining traction performance and less soil compaction. The objective of the experiment was to evaluate the operational and energy performance of double wheeled versus rubber half-tracked agricultural tractors in the soybean sowing. The experiment was conducted in a strip-plot design with a double factorial arrangement (2×3). The first factor consisted of a tractor with double wheels on the front and rear axles versus a tractor with single wheels on the front axle and rubber half-tracks on the rear axle, while the second factor consisted of three different gears, with five replications, totaling 30 experimental units. The collected data were subjected to analysis of variance and, when significant, to the Tukey test. The sowing operation carried out with the half-tracked tractor was the most efficient in most of the analyzed parameters, allowing higher operational and energy efficiency in the soybean sowing.

Abstract Background Regular physical activity (PA) is a valued part of cystic fibrosis (CF) care. Although the accelerometer, SenseWear Armband (SWA), accurately measures habitual PA in CF, it is mostly used for research purposes. For the first time, we analyzed different methods of measuring PA in daily life by the use of smartphones and other electronic devices such as smartwatch and Fitbit. Methods Twenty-four stable adults with CF (mean age 37.5 ± 11.5SD yrs.; FEV1 58 ± 19% predicted, BMI 22.9 ± 3.2) were studied. Daily PA was monitored for seven consecutive days. All patients wore the accelerometer SWA and at the same time they monitored PA with the electronic device they used routinely. They were allocated into one of four arms according to their device: Smartwatch, Fitbit, Android smartphones and iOS smartphones. PA related measurements included: duration of PA, energy expenditure, number of steps. Results There was a good agreement between SWA and Fitbit for number of steps (p = 0.605) and energy expenditure (p = 0.143). iOS smartphones were similar to SWA in monitoring the number of steps (p = 0.911). Significant differences were found between SWA and both Smartwatch and Android smartphones. Conclusions Fitbit and iOS smartphones seem to be a valuable approach to monitor daily PA. They provide a good performance to measure step number compared to SWA.

ABSTRACT The hydraulic remote control system allows the transfer of energy from the engine through a flow of hydraulic oil to engines and implements pulled by agricultural tractors, which can interfere with its energy and operational performance. This study aimed to evaluate the interference of the number of remote control valves in use on the operational and energy performance of an agricultural tractor, using a productivity management system. The experiment was conducted in a strip-plot design, with five replications and three treatments, which consisted of the number of remote control valves in use (1, 2, or 3), totaling 15 experimental units. The results were subjected to normality and homogeneity tests and analysis of variance, followed by the Tukey test when it was significant. The highest number of valves in use interfered with the operational speed, power and efficiency on the drawbar, specific fuel consumption, and engine thermal efficiency, thus reducing the energy and operational performance of the agricultural tractor.

Abstract Hypersensitivity reactions (HRs) to contrast media (CM) can be distinguished in immune-mediated (including allergic reactions) and non-immune-mediated reactions, even if clinical manifestations could be similar. Such manifestations range from mild skin eruptions to severe anaphylaxis, making it important for radiologists to know how to identify and manage them. A panel of experts from the Società Italiana di Radiologia Medica e Interventistica (SIRM) and the Società Italiana di Allergologia, Asma e Immunologia Clinica (SIAAIC) provided a consensus document on the management of patients who must undergo radiological investigations with CM. Consensus topics included: the risk stratification of patients, the identification of the culprit CM and of a safe alternative by an allergy workup, as well as the use of premedication and the correct procedure to safely perform an elective (i.e., scheduled) or urgent examination. The most important recommendations are: (1) in all patients, a thorough medical history must be taken by the prescribing physician and/or the radiologist to identify at-risk patients; (2) in patients with hypersensitivity reactions to CM, the radiologist must consider an alternative, non-contrast imaging study with a comparable diagnostic value, or prescribe a different investigation with another class of CM; (3) if such options are not feasible, the radiologist must address at-risk patients to a reference centre for an allergy evaluation; (4) if timely referral to an allergist is not viable, it is recommended to use a CM other than the responsible one, taking into account cross-reactivity patterns; in the case of patients with histories of severe reactions, the presence of an anesthesiologist is also recommended and a premedication is suggested.

Abstract Background Urticaria is a disorder affecting skin and mucosal tissues characterized by the occurrence of wheals, angioedema or both, the latter defining the urticaria-angioedema syndrome. It is estimated that 12–22% of the general population has suffered at least one subtype of urticaria during life, but only a small percentage (estimated at 7.6–16%) has acute urticaria, because it is usually self-limited and resolves spontaneously without requiring medical attention. This makes likely that its incidence is underestimated. The epidemiological data currently available on chronic urticaria in many cases are deeply discordant and not univocal, but a recent Italian study, based on the consultation of a national registry, reports a prevalence of chronic spontaneous urticaria of 0.02% to 0.4% and an incidence of 0.1–1.5 cases/1000 inhabitants/year. Methods We reviewed the recent international guidelines about urticaria and we described a methodologic approach based on classification, pathophysiology, impact on quality of life, diagnosis and prognosis, differential diagnosis and management of all the types of urticaria. Conclusions The aim of the present document from the Italian Society of Allergology, Asthma and Clinical Immunology (SIAAIC) and the Italian Society of Allergological, Occupational and Environmental Dermatology (SIDAPA) is to provide updated information to all physicians involved in diagnosis and management of urticaria and angioedema.

Climate and tectonics impact water and sediment fluxes to fluvial systems. These boundary conditions set river form and can be recorded by fluvial deposits. Reconstructions of boundary conditions from these deposits, however, is complicated by complex channel–network interactions and associated sediment storage and release through the fluvial system. To address this challenge, we used a physical experiment to study the interplay between a main channel and a tributary under different forcing conditions. In particular, we investigated the impact of a single tributary junction, where sediment supply from the tributary can produce an alluvial fan, on channel geometries and associated sediment-transfer dynamics. We found that the presence of an alluvial fan may either promote or prevent the movement of sediment within the fluvial system, creating different coupling conditions. By analyzing different environmental scenarios, our results reveal the contribution of both the main channel and the tributary to fluvial deposits upstream and downstream from the tributary junction. We summarize all findings in a new conceptual framework that illustrates the possible interactions between tributary alluvial fans and a main channel under different environmental conditions. This framework provides a better understanding of the composition and architecture of fluvial sedimentary deposits found at confluence zones, which can facilitate the reconstruction of the climatic or tectonic history of a basin.

Electric drives applications have been worldwide adopted for the transportation electrification. An electric drive system is constituted by two main components: the power electronics converter and the electrical machine. Traditionally the design workflow consisted in the separate realization of these two parts, by different teams or even organizations. This requires strong assumptions regarding operating conditions and may lead to actual performance at system level far from the one expected. In this article, a unified design methodology of the two sub-systems is presented considering the true operating conditions, allowing a more accurate assessment of power losses at system level and identifying the influence of the converter design choices on the electric machine performance. As a case study, this article presents a comparative analysis among three different converter topologies designed to drive a 8.5 kW-120 krpm surface PMSM. The study aims at comparing the considered systems in terms of overall efficiency, losses distribution and system complexity. At first converters are simulated in Matlab-Simulink to estimate the losses and the current waveforms, that are then used in the Finite Element model of the electrical machine to estimate the loss components in a real scenario. The models developed are then validated by means of experimental measurements. This article highlights the new understanding that can be gained by considering the interactions between sub-systems, allowing a more conscious choice of the converter topology to achieve optimal overall performance.

RESUMO Objetivo: Avaliar se os achados eletromiográficos podem prever a mortalidade na unidade de terapia intensiva em pacientes sépticos sob ventilação mecânica e sedação profunda. Métodos: Conduziu-se estudo prospectivo de coorte, que inscreveu, de forma consecutiva, pacientes com síndrome do desconforto respiratório agudo moderada a grave (pressão parcial de oxigênio/fração inspirada de oxigênio < 200) com idade ≥ 18 anos, dependentes de ventilação mecânica por 7 ou mais dias, e mantidos sob sedação profunda (escala de agitação e sedação de Richmond ≤ -4). Realizaram-se estudos eletromiográficos dos membros inferiores em todos os pacientes entre o sétimo e o décimo dia de ventilação mecânica. Registraram-se os potenciais de ação dos nervos sensitivos nos nervos mediano e sural, bem como os potenciais de ação compostos para os nervos mediano (músculo abdutor curto do polegar) e fibular comum (músculo extensor curto dos dedos). Resultados: Foram inscritos 17 pacientes durante os 7 meses de duração do estudo. Nove pacientes (53%) tinham sinais eletromiográficos de miopatia ou polineuropatia da doença crítica. O risco de óbito durante o tempo de permanência na unidade de terapia intensiva foi mais elevado nos pacientes com sinais eletromiográficos de miopatia ou polineuropatia da doença crítica, em comparação com aqueles sem esses diagnósticos (77,7% versus 12,5%; log-rank p = 0,02). Conclusão: A presença de sinais eletromiográficos de miopatia ou polineuropatia da doença crítica, entre o sétimo e décimo dias de ventilação mecânica, pode se associar com mortalidade na unidade de terapia intensiva em pacientes com síndrome do desconforto respiratório agudo moderada a grave mantidos sob sedação profunda, nos quais não é possível proceder à avaliação clínica da força muscular.

The air yam (Dioscorea bulbifera) is an unconventional vegetable that produces a reserve stem, which has polysaccharides in its composition. These biopolymers, in turn, have aroused industrial interest due to many of their properties and applications in several areas, such as agro-food, chemical, pharmaceutical, textile, metallurgical, oil, among others. The objective of this work is to characterize the polysaccharide present in the raw and pre-purified air yams, as well as to verify its potential antioxidant capacity. The FTIR analysis showed in the two samples, a characteristic OH band at approximately 3250 cm−1, which is characteristic of polysaccharides. Through the SEM it was possible to analyze the morphology of the samples and verify that they are composed of films or “sheets” without measurable format. Furthermore, by XRD the samples were found to be an amorphous material, with peaks of crystallinity being observed at approximately 21.54° and 23.62° 2θ. Thermal analysis indicates that the NDP sample presents three regions of mass loss, the first one running up to 100 °C and may be associated with water loss; the second occurs from 150 °C, and occurs in several steps that can be visualized by DTG, and the third from 550 °C. The organic matter present in the sample was about 84%. The DP (Dialysed Polysaccharide) sample, in turn, also presented three regions of mass loss, the first one occurring up to 150 °C, the second from 175 °C and the third, from 425 °C. All these mass losses occur in only one stage. The organic matter present in the sample was approximately 80%. The samples presented potential antioxidant activity when analyzed by DPPH, ABTS, FRAP, OH radical removal, H2O2 removal and reducing power. The obtained results are very important, as they reveal information about the chemical characteristics and potential bioactivity of the dialysed and non-dialysed polysaccharide of D. bulbifera. Keywords: Antioxidants, XRD, FTIR, SEM, Thermal Analysis