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El Comité Editorial quiere brindar a sus lectores una actualización de las escalas de uso corriente. El empleo de tablas y escalas es una práctica muy extendida en la Ortopedia y Traumatología. La medición y la cuantificación de los aspectos clínicos, funcionales y radiográficos se convirtieron en una herramienta imprescindible para la toma de decisiones en diferentes aspectos de la actividad asistencial. Llevamos a cabo una revisión de las escalas más utilizadas, definiendo su uso e incluyendo bibliografía original y actualizada.

Calls continue for the decolonisation of higher education (HE). Based on internationalisation debates, a research team from Africa, Europe and Latin America reviewed published decolonisation voices. Using bibliometric analysis and a conceptual review of abstracts, the authors examined the drivers framing decolonisation in HE and identified the voices in those debates which involved the historically oppressed and those wishing to elicit change in these debates. The paper recognises the importance for decolonisation in education as the tensions explored by the authors often intersect through HE into other domains of the political, social, economic and culturally important areas for replication and change in society.

Balancing conflicting goals among different stakeholders is a challenging problem in various application domains. In this paper, we analyse it in the context of home healthcare. Fairness objective functions for nurses and patients are combined with system-level governance goals of the territorial centers in charge of the assistance service. From the solution of several multi-objective problems including one objective for each actor hierarchically ordered, the best goal for each stakeholder is identified and interesting managerial conclusions are drawn. To efficiently solve large-size instances, we introduce a parallel Adaptive Large Neighborhood Search algorithm with destroy and repair operators customised to solve multi-objective multi-actor problems. The algorithm proves to be highly efficient and effective when compared to a commercial Mixed Integer Programming solver, either in its plain form or enforced by a mild start and a primal heuristic. Additionally, we devise a metaheuristic method to generate the Pareto frontier of an instance. [ABSTRACT FROM AUTHOR]

Abstract Background The aim of this study is to evaluate the extent and associations with patient‐reported disruptions to cancer treatment and cancer‐related care during the COVID‐19 pandemic utilizing nationally representative data. Methods This analysis uses data from the 2020 National Health Interview Survey (NHIS), an annual, cross‐sectional survey of US adults. Adults (age >18) who reported requiring current cancer treatment or other cancer‐related medical care in the second half of 2020 were included. Estimated proportions of patients with self‐reported changes, delays, or cancelations to cancer treatment or other cancer care due to the COVID‐19 pandemic were calculated using sampling weights and associations with sociodemographic and other health‐related variables were analyzed. Results In total, 574 (sample‐weighted estimate of 2,867,326) adults reported requiring cancer treatment and/or other cancer care since the start of the COVID‐19 pandemic. An estimated 32.1% reported any change, delay, or cancelation. On sample‐weighted univariable analysis, patients who were younger, female, had one or fewer comorbidities, and uninsured were significantly more likely to report disruptions. On sample‐weighted, multivariable analysis, patients who were younger and female remained significant predictors. Nearly 90% of patients included in the study reported virtual appointment use. Patients reporting disruptions were also significantly more likely to report feelings of anxiety. Conclusions An estimated 1/3 of patients experienced disruptions to cancer care due to the COVID‐19 pandemic. Patients experiencing disruptions in care were more likely to be female or younger which may reflect risk stratification strategies in the early stages of the pandemic, and also had higher rates of anxiety. The longitudinal impact of these disruptions on outcomes merits further study.

El Comité Editorial quiere brindar a sus lectores una actualización de las escalas de uso corriente. El empleo de tablas y escalas es una práctica muy extendida en la Ortopedia y Traumatología. La medición y la cuantificación de los aspectos clínicos, funcionales y radiográficos se convirtieron en una herramienta imprescindible para la toma de decisiones en diferentes aspectos de la actividad asistencial. Llevamos a cabo una revisión de las escalas más utilizadas, definiendo su uso e incluyendo bibliografía original y actualizada.

Background: Epiphrenic oesophageal diverticula are rare and often asymptomatic. When symptoms are present, minimally invasive diverticulectomy is considered the gold standard of treatment. While there is an agreement on the pre-operative assessment, no consensus is achieved when it comes to surgical technique. In the present study, we report our experience and propose a standardised approach to manage this rare oesophageal disorder. Materials and Methods: We prospectively analysed data of all consecutive patients who underwent three-dimensional (3D) laparoscopic distal oesophageal diverticulum resection during 2015–2020 at Upper gastrointestinal surgical department, St Thomas' Hospital, regarding pre-operative assessment, surgical technique, peri-and post-operative outcomes. Results: Six patients were submitted to 3D laparoscopic diverticulectomy, five of which with additional anterior myotomy and fundoplication and one with additional hiatal hernia repair only. Three patients followed a specific diet in preparation for surgery. Median pre-operative Eckardt symptom score was five. Two patients had normal manometry. Median operative time was 180 min, median estimated blood loss was

High entropy alloys are multi-element random alloys with a strong short range disorder. Here, the authors show that their heat carrying lattice waves, while strongly attenuated by the force-constant disorder, propagate until high energy.

El Comité Editorial quiere brindar a los lectores de la RAAOT una actualización de las escalas de uso corriente. El empleo de tablas y escalas es una práctica muy extendida en la ortopedia y traumatología. La medición y la cuantificación de los aspectos clínicos, funcionales y radiográficos se convirtieron en una herramienta imprescindible para la toma de decisiones en diferentes aspectos de la actividad asistencial. Llevamos a cabo una revisión de las escalas más utilizadas, definimos su uso e incluimos bibliografía original y actualizada. Nivel de Evidencia: V

The Association of Peasants of Fondwa (APF), a grassroots organization led by a visionary Haitian Spiritan priest, established the private nonprofit University of Fondwa (UNIF) in Haiti in 2004. The University aims to fill a gap in educational opportunities for rural youth and to develop community leaders able to steward food security, sustainable farm animal husbandry, and small business development. Since the institution’s foundation, University faculty members have explored low-input sustainable agriculture techniques, which were inspired by strategies shared earlier by Cuban agronomists and adapted to the Fondwa region’s mountainous terrain. While the University has faced and continues to confront many challenges related to its sustainability as an institution, this article describes the processes by which its faculty and students have conducted diagnoses of soils and crop choices, the innovations they have developed and introduced to improve harvest productivity in rural Haiti and, especially, the ways and means by which they have sought to share such (re)thinking of traditional practices with local farmers. We argue that the University of Fondwa faculty’s close collaboration with local farmers and the agricultural techniques they have refined thereby have not only improved food security for the families involved but have also contributed to the creation of social capital in the countryside and enabled participating Haitian farmers to imagine a path toward food sovereignty. In addition, by educating farmers and providing them tools to improve their food production, the University has worked to close the deep inequality gap that exists between urban and rural Haiti.

Isolated mitochondrial respiratory chain Complex IV (Cytochrome c Oxidase or COX) deficiency is the second most frequent isolated respiratory chain defect. Causative mutations are mainly identified in structural COX subunits or in proteins involved in the maturation and assembly of the COX holocomplex. We describe an Italian familial case of mitochondrial myopathy due to a variant in the COX assembly factor 8 gene (COA8). Patient 1 is a 52-year-old woman who presented generalized epilepsy and retinitis pigmentosa at 10 years of age. From her early adulthood she complained about cramps and myalgia after exercise, and bilateral hearing loss emerged. Last neurological examination (52 years of age) showed bilateral ptosis, muscle weakness, peripheral neuropathy, mild dysarthria and dysphonia, cognitive impairment. Muscle biopsy had shown the presence of ragged-red fibers. Patient 2 (Patient 1’s sister) is a 53-year-old woman presenting fatigability, myalgia, and hearing loss. Neurological examination showed ptosis and muscle weakness. Muscle biopsy displayed a diffuse reduction of COX activity staining and ragged-red fibers. Both sisters presented secondary amenorrhea. After ruling out mtDNA mutations, Whole Exome Sequencing analysis identified the novel homozygous COA8 defect c.170_173dupGACC, p.(Pro59fs) in the probands. Loss-of-function COA8 mutations have been associated with cavitating leukoencephalopathy with COX deficiency in 9 reported individuals. Disease course shows an early-onset rapid clinical deterioration, affecting both cognitive and motor functions over months, followed by stabilization and slow improvement over several years. Our findings expand the clinical spectrum of COA8-related disease. We confirm the benign course of this rare disorder, highlighting its (intrafamilial) clinical variability.

Colorectal cancer represents an important oncological challenge both for its incidence, which makes it an important health problem, and for its biological complexity, which has made clinical results very difficult in terms of outcome for this category of patients. To date these diseases should not be treated as a single entity but it is necessary to distinguish colorectal cancers based on characteristics that nowadays are essential to have greater therapeutic benefits. These include the sideness of the disease, the state of microsatellites, the presence of prognostic and predictive mutations of response to treatments currently available in clinical practice, which are associated with new therapeutic targets. The greatest challenge in the future will be to circumvent the resistance mechanisms that make this disease very difficult to treat with good long-term results by studying effective combination treatments with a good toxicity profile. Once such combinations or targeted treatments are consolidated, it will be desirable to shift the best therapies to the first line treatment to make them immediately accessible to the patient. It will also be essential to refine the selection of patients who can benefit from these treatments.

Due to drought stress, durum wheat production in the Mediterranean basin will be severely affected in the coming years. Durum wheat cultivation relies on a few genetically uniform "modern" varieties, more productive but less tolerant to stresses, and "traditional" varieties, still representing a source of genetic biodiversity for drought tolerance. Root architecture plasticity is crucial for plant adaptation to drought stress and the relationship linking root structures to drought is complex and still largely under-explored. In this study, we examined the effect of drought stress on the roots’ characteristics of the “traditional” Saragolla cultivar and the “modern” Svevo. By means of “SmartRoot” software, we demonstrated that drought stress affected primary and lateral roots as well as root hair at different extents in Saragolla and Svevo cultivars. Indeed, we observed that under drought stress Saragolla possibly revamped its root architecture, by significantly increasing the length of lateral roots, and the length/density of root hairs compared to the Svevo cultivar. Scanning Electron Microscopy analysis of root anatomical traits demonstrated that under drought stress a greater stele area and an increase of the xylem lumen size vessel occurred in Saragolla, indicating that the Saragolla variety had a more efficient adaptive response to osmotic stress than the Svevo. Furthermore, for the analysis of root structural data, Artificial Intelligence (AI) algorithms have been used: Their application allowed to predict from root structural traits modified by the osmotic stress the type of cultivar observed and to infer the relationship stress-cultivar type, thus demonstrating that root structural traits are clear and incontrovertible indicators of the higher tolerance to osmotic stress of the Saragolla cultivar. Finally, to obtain an integrated view of root morphogenesis, phytohormone levels were investigated. According to the phenotypic effects, under drought stress,a larger increase in IAA and ABA levels, as well as a more pronounced reduction in GA levels occurred in Saragolla as compared to Svevo. In conclusion, these results show that the root growth and hormonal profile of Saragolla are less affected by osmotic stress than those of Svevo, demonstrating the great potential of ancient varieties as reservoirs of genetic variability for improving crop responses to environmental stresses.

Objetivo: analisar a percepção de mulheres brasileiras em situação de privação de liberdade sobre sua saúde sexual. Método: estudo qualitativo, com 21 mulheres privadas de liberdade institucionalizadas na cadeia pública de Pitanga-Paraná, Brasil. A coleta de dados ocorreu de forma intencional, sendo instrumento uma entrevista semiestruturada. Os dados foram analisados mediante a análise de conteúdo, na modalidade temática. Resultados: o comprometimento da saúde sexual das mulheres pesquisadas foi relacionado a situações vividas pelas mesmas, destacando-se, conflito na relação com o próprio corpo; precocidade no início da atividade sexual; susceptibilidade a aquisição de infecções sexualmente transmissíveis mediada por abuso e violência sexual e dificuldade de acesso para a realização de prática de sexo seguro. Conclusão: mulheres em situação de privação de liberdade compõem uma população vulnerável para o comprometimento de sua saúde sexual.

In systemic mastocytosis, cytoreductive treatment is indicated for advanced systemic mastocytosis (AdvSM) variants. The treatment scenario is rapidly diversifying especially with the introduction of KIT tyrosine kinase inhibitors. Avapritinib is a second-generation potent and selective inhibitor of the mutant KIT D816V that, based on the results of pivotal clinical trials, was approved for the treatment of adults with AdvSM by the regulatory agencies US FDA and EMA. The present article reports the experience of treating SM patients with avapritinib in an Italian compassionate use program. The data from our case series confirm the drug as being active after multiple lines of treatment allowing rapid achievement of profound responses, making it also an effective bridging strategy to allogeneic transplant in eligible patients. However, the anticipated wider use of avapritinib in the near future will require careful monitoring of side effects, especially in heavily pretreated patients.

Introdução/Objetivo: A implementação de Programas de Gerenciamento de Antimicrobianos (PGA) tem por objetivo otimizar o uso de antimicrobianos nos serviços de saúde para garantir o efeito farmacoterapêutico máximo, reduzir a ocorrência de eventos adversos, prevenir a disseminação da resistência microbiana e diminuir os custos relacionados à assistência à saúde. O objetivo deste estudo é apresentar os resultados obtidos em um ano de implantação do PGA do Hospital Santa Rita de Cássia (HSRC) em Vitória, ES. Métodos: Foram analisadas diariamente todas as prescrições de antimicrobianos (ATM) entre 01/06/2022 e 30/05/2022. As variáveis analisadas foram espectro de ação, dose, posologia, duração e via de administração, e as intervenções foram realizadas conforme necessidade. Os dados das prescrições foram coletados através do sistema MV módulo PSIH e lançados em planilha Microsoft Office, que também fora alimentada com as intervenções do time operacional, bem como informações referentes a adesão dos médicos assistentes. Nos pacientes convênio, a economia financeira foi calculada a partir de valores de Material e Medicação (MAT/MED) e número de diárias evitadas. Nos pacientes SUS, calculou-se economia relacionada a MAT/MED e giro de leitos. Resultados: Sete mil oitocentos e três (7803) ATM foram avaliados no período. Destes, em 2091 (26,8%) foram realizadas intervenções do time operacional do PGA, e destas, 1514 (19,4%) foram acatadas pelos médicos assistentes. As principais intervenções realizadas foram redução do tempo dos ATM (22,8%), suspensão dos ATM (18,0%) e transição de via endovenosa para via oral (IV > VO) (17,0%). Os motivos de não adesão foram analisados a partir de janeiro de 2023. Das 349 não adesões no período, em 120 (33,2%) o médico não aderiu baseado em gravidade clínica, em 113 (32,4%) o médico assistente discordou da sugestão, e em 116 (34,4%) não houve justificativa do motivo da não adesão. Dos 7803 ATM prescritos no período, 1514 (19,4%) representavam antibioticoterapia perioperatória. O percentual de adequação à prescrição por até 24h subiu de 21,8% em novembro/22 para 72,2% em maio/23. A economia financeira no período foi da ordem de R$ 229.464,98, incluindo intervenções acatadas nos pacientes SUS e Convênio. O giro de leitos no período foi de 346 dias no SUS e 336 dias no Convênio. Conclusão: A implementação do PGA no HSRC gerou redução do tempo de uso de ATM, redução do tempo de internação e considerável economia financeira.

Para Guattari, uma das principais características de produção na sociedade capitalística é a tentativa de bloquear processos de singularização e instaurar processos de individualização a partir de dois dispositivos: a sujeição social e a servidão maquínica. No entanto, é possível desenvolver modos singulares de subjetivação, que afirmem outras sensibilidades, outras relações com o outro, outros movimentos de criação. Em movimentos de afirmação da vida, este texto apresenta a possibilidade de criação de virtualidades existenciais mutantes para fazer engendrar experimentações curriculares que se afirmam entre vidas e desejos maquínicos. A despeito dos dois domínios da subjetividade, como se confirma o processo de experimentação e de criação curricular? Como podemos criar possíveis no campo curricular que instaurem o atrevimento de singularizar via revoluções moleculares? O artigo utiliza a cartografia, seguindo as linhas imanentes das redes de conversação, baseada em práticas educativas e pensamentos não dogmáticos para a formação de professores, usando os signos artísticos do cinema, da literatura, da fotografia etc. É preciso experimentar — por entre máquinas revolucionárias éticas, estéticas e políticas — o atrevimento de singularizar em agenciamentos para efetuar outros currículos com modos de pensar e inventar culturas, vidas, mundos e política.

Este trabalho procura revisitar a minissérie Anos Rebeldes, levada ao ar em 1992 pela Rede Globo de Televisão, buscando nela salientar o papel desempenhado pelo jornalismo no registro de um período ainda negado em sua magnitude e violência por uma parcela da sociedade brasileira contemporânea. Em larga medida, essa falsificação histórica atende aos interesses de grupos conservadores e de extrema direita que disputam o poder e desejam agir à margem do chamado Estado de Direito, fundamental à ordem democrática. Para tanto, adota-se aqui a pesquisa bibliográfica e documental, bem como a Análise de Conteúdo dos 20 episódios da produção. Pode-se concluir que o jornalismo desempenha um papel de protagonismo institucional na minissérie, fornecendo o cenário no qual se desenrola o melodrama concebido por Gilberto Braga.

This study aims to experimentally investigate the effects of parallel blade–vortex interaction (BVI) on the aerodynamic performances of an airfoil, in particular as a possible cause of blade stall, since similar effects have been observed in literature in the case of perpendicular BVI. A wind tunnel test campaign was conducted reproducing parallel BVI on a NACA 23012 blade model at a Reynolds number of 300,000. The vortex was generated by impulsively pitching a second airfoil model, placed upstream. Measurements of the aerodynamic loads acting on the blade were performed by means of unsteady Kulite pressure transducers, while particle image velocimetry (PIV) techniques were employed to study the flow field over the blade model. After a first phase of vortex characterisation, different test cases were investigated with the blade model both kept fixed at different incidences and oscillating sinusoidally in pitch, with the latter case, a novelty in available research on parallel BVI, representing the pitching motion of a helicopter main rotor blade. The results show that parallel BVI produces a thickening of the boundary layer and can induce local flow separation at incidences close to the stall condition of the airfoil. The aerodynamic loads, both lift and drag, suffer important impulsive variations, in agreement with literature on BVI, the effects of which are extended in time. In the case of the oscillating airfoil, BVI introduces hysteresis cycles in the loads, which are generally reduced. In conclusion, parallel BVI can have a detrimental impact on the aerodynamic performances of the blade and even cause flow separation, which, while not being as catastrophic as in the case of dynamic stall, has relatively long-lasting effects.

Bone tissue engineering (BTE) is the most promising strategy to repair bones injuries and defects. It relies on the utilization of a temporary support to host the cells and promote nutrient exchange (i.e., the scaffold). Supercritical CO2 assisted drying can preserve scaffold nanostructure, crucial for cell attachment and proliferation. In this work, agarose aerogels, loaded with hydroxyapatite were produced in view of BTE applications. Different combinations of agarose concentration and hydroxyapatite loadings were tested. FESEM and EDX analyses showed that scaffold structure suffered from partial closure when increasing filler concentration; hydroxyapatite distribution was homogenous, and Young’s modulus improved. Looking at BTE applications, the optimal combination of agarose and hydroxyapatite resulted to be 1% w/w and 10% w/v, respectively. Mechanical properties showed that the produced composites could be eligible as starting scaffold for BTE, with a Young’s Modulus larger than 100 kPa for every blend.

Since the landing on the lunar surface, the lunar regolith has begun to interact in different ways with landed elements, such as the wheels of a rover, astronaut suits, drills, and plants for extracting oxygen or manufacturing objects. Therefore, a strong effort has been required on Earth to fully characterise these kinds of interactions and regolith utilisation methods. This operation can only be performed by using regolith simulants, soils that are reproduced with the Earth’s rocks and minerals to match the real features. This article presents the main guidelines and tests for obtaining the properties of a generic simulant in terms of composition, physical and mechanical properties, solid–fluid interaction, and thermal properties. These parameters are needed for the designing and testing of payloads under development for planned lunar surface missions. The same tests can be performed on lunar, martian, or asteroid simulants/soils, both in laboratory and in situ. A case study is presented on the lunar simulant NU-LHT-2M, representative of the lunar highlands. The tests are performed in the context of an in situ resource utilisation (ISRU) process that aims to extract oxygen from the lunar regolith using a low-temperature carbothermal reduction process, highlighting the main regolith-related criticalities for an in situ demonstrator plant.

The present study aimed to investigate the capability of mid-fidelity aerodynamic solvers in performing a preliminary evaluation of the static and dynamic stability derivatives of aircraft configurations in their design phase. In this work, the mid-fidelity aerodynamic solver DUST, which is based on the novel vortex particle method (VPM), was used to perform simulations of the static and dynamic motion conditions of the Stability And Control CONfiguration (SACCON): an unmanned combat aerial vehicle geometry developed by NATO’s Research and Technology Organisation (RTO), which is used as a benchmark test case in the literature for the evaluation of aircraft stability derivatives. Two different methods were exploited to extract the dynamic stability derivative values from the aerodynamic coefficient time histories that were calculated with DUST. The results for the mid-fidelity approach were in good agreement with the obtained experimental data, as well as with the results obtained using more demanding high-fidelity CFD simulations. This demonstrates its suitability when implemented in DUST for predicting the static and dynamic behavior of airloads in different conditions, as well as in reliably predicting the values of stability derivatives, with the advantage of requiring limited computational effort with respect to classical high-fidelity numerical approaches and the use of wind tunnel tests.

This work is aimed at investigating the capabilities and limits of the mid-fidelity numerical solver DUST for the evaluation of wind turbines aerodynamic performance. In particular, this study was conducted by analysing the benchmarks NREL-5 MW and Phase VI wind turbines, widely investigated in the literature via experimental and numerical activities. The work was started by simulating a simpler configuration of the NREL-5 MW turbine to progressively integrate complexities such as shaft tilt, cone effects and yawed inflow conditions, offering a detailed portrayal of their collective impact on turbine performance. A particular focus was then given to the evaluation of aerodynamic responses from the tower and nacelle, as well as aerodynamic behavior in yawed inflow condition, crucial for optimizing farm layouts. In the second phase, the work was focused on the NREL Phase VI turbine due to the availability of experimental data on this benchmark case. A comparison of DUST simulation results with both experimental data and high-fidelity CFD tools shows the robustness and adaptability of this mid-fidelity solver for these applications, thus opening a new scenario for the use of such mid-fidelity tools for the preliminary design of novel wind turbine configurations or complex environments as wind farms, characterised by robust interactional aerodynamics.