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Acute muscle pain is muscle soreness that occurs during or within 24 hours of strenuous activity. Possible causes of acute muscle pain include localized muscle trauma, muscle tear, contusion with acute hemorrhage, or acute compartment syndrome. Isolated ruptures of the rectus femoris muscle are rare clinical conditions that result from excessive muscle strain following an abrupt contraction, incorrect movement, or sudden snap that exceeds the physiological limit of strain that the muscle can withstand. To date, there are few published reports evaluating the results of non-invasive treatment of such injuries. Herein, we report an unusual case of isolated distal rectus femoris tear in a 46-year-old female patient with no risk factors, who initially presented with extensor muscle weakness and pain and was treated conservatively with functional rest, physiotherapy, and cryotherapy.

Introduction: Growing pains are frequent in children, recognizing several causes and sometimes requiring management. Among these conditions, apophysitis and osteochondrosis may interest children who practice sport activities. In this case report, we found an association between a form of osteochondrosis, the Sinding-Larsen-Johansson Disease and a type of apophysitis, the Sever Disease in the same patient. Case Description: A 10-year-old boy presented with a 3-month bilateral non-specific anteroinferior knees and posterior heels pain history with worsening in the last month particularly after athletic activities. Patient presented mild swelling of the bilateral heel face, antalgic gait, bilateral painful palpation over the patella inferior pole and bilateral heel pain. Based on the clinical and instrumental evaluation, bilateral Sinding-Larsen-Johansson Disease and Sever Disease was diagnosed. Temporary abstention from sport and conservative approach led to complete symptoms’ regression after three months and to the gradual return to sport. Discussion and Conclusion: This is a singular case of a combination of Sinding-Larsen-Johansson Disease and the Sever Disease in both lower limbs and with painful symptoms present at the same time. The correct dosage of physical activity and training intensity, education to healthy lifestyle habits, can represent preventive strategies to avoid overuse of childhood diseases.

Abstract The telecommunications of the future rely on the concept of a three-dimensional architecture able to integrate terrestrial and non-terrestrial networks with the goal to ensure a reliable and high-speed connectivity to users located anywhere. In this context, free space optical communications constitute a candidate technology for feeder links, thanks to their advantages in terms of bandwidth and achievable data rates. Nonetheless, due to the propagation impediments encountered by an optical beam travelling through atmosphere, flexible and accurate instruments able to support the design of optical feeder links are needed. Therefore, in this paper a link budget numerical tool able to meet these requirements is presented and the link budget analysis for real optical feeder links is performed demonstrating its prediction accuracy by means of the comparison with experimental results for both low Earth orbit and geostationary Earth orbit based configurations. Finally, the limits of the conventional beam wander model are analyzed and overcome.

The food industry is a cornerstone of the global economy, supporting millions of jobs and generating substantial revenue annually. It also significantly influences public health, environmental sustainability, and social equity. As the world’s population continues to grow, the demand for food is increasing dramatically, necessitating substantial investments in agricultural productivity, infrastructure, and improved food distribution and access. Concurrently, addressing the resulting environmental impact and ensuring sustainability are crucial challenges. The inextricable link between energy, water, and waste in food production underscores the need to reduce loss and waste throughout the supply chain, enhance energy efficiency in food processes, and optimize resource utilization.This work aims to extensively analyze the food industry, focusing on the energy and environmental dimensions. The study provides an in-depth exploration of the food market, employing a comprehensive review approach, with information on diverse geographic regions and major global markets. Moreover, the work sheds light on critical sections that present significant opportunities for efficiency improvements, emphasizing the intricate interplay between food and energy up to introducing a standardized taxonomy and energy planning framework. The paper highlights the environmental implications of food waste and the unsustainable utilization of energy resources and provides valuable insights into the feasibility and applicability of various conventional and innovative energy management strategies. The findings serve as a foundation to guide the development of efficient and sustainable solutions for a cleaner future.

Background: Many data were published about Long-Covid prevalence, very few about the findings of new cardiac alterations (NCA) in COVID-19-recovered people. ARCA-post-COVID is an observational study designed to investigate the prevalence of NCA in patients recovered from Covid-19.Methods: from June 2020 to December 2022, we enrolled 502 patients with a positive nasopharyngeal swab for SARS-CoV2 and a subsequent negative one. We performed anamnesis, lab-test, and routine cardiological tests (ECG, Holter, TTE). Results: The median age was 56 years (IQR 44–67); women were 52.19%; in the acute phase 24.1% of patients were treated in a medical department, 7.2% in the ICU and the others at home. At the visit, 389 patients (77.49%) complained of a broad range of symptoms. We reported patients’ characteristics according to the course of the disease and the persistence of symptoms. NCA were found in 138 patients (27.49%): among them 60 cases (11.95%) of pericardial effusion. Patients with NCA were older (median 60y, IQR: 47–72, vs median 56y, IQR 42–65), had a higher prevalence of smokers (27% vs 17%; p0.014), CAD (11% vs 6%; p0.048) and stroke/TIA (3.6% vs 0.3%; p0.002) and a lower prevalence of hypercholesterolemia (18% vs 30%; p0.007). The prevalence of NCA seems constant with different subtypes of the virus. Conclusion: the prevalence of NCA in patients who recovered from COVID-19 is high and constant since the beginning of the pandemic; it is predictable based on hospitalization and long-lasting symptoms (9.64%–42.52%). Patients with one of these characteristics should undergo cardiological screening.

Abstract Introduction Knee osteoarthritis (KOA) represents a widespread degenerative disease that causes pain and motor disability. Conservative treatments mainly focus on relieving symptoms, improving joint function, and trying to delay surgery. Safety and efficacy of hybrid cooperative complexes (2.4% sodium hyaluronate and 1.6% sodium chondroitin; HA-SC) for symptomatic KOA were investigated in a single-arm, prospective, pilot study. Methods Patients with a visual analogue scale (VAS) pain score ≥ 4 and Kellgren–Lawrence Grade

Introduction: Hip fractures are one of the major disability causes associated with a high morbidity and mortality rate. Early surgery and stable fixation could be associated with better pain control, possibly lower mortality rates, and early recovery of autonomy. Aim: The aim of this study was to analyze a population affected by hip fractures exploring the effects of an early surgery and rehabilitation approach in relation to functional outcomes. Materials and methods: This study included 140 adult patients (mean age 79.35±11.71, range 66-94 years) with hip fractures admitted to the orthopedic unit of the University Hospital of Messina who underwent surgery and a rehabilitation program while hospitalized. Exclusion criteria were patients not surgically treated or discharged with no rehabilitation sessions. Clinical outcomes were evaluated post-surgery and before discharge as follows: pain quantification using the visual analogue scale and functional evaluation using the Barthel Index. A rehabilitation protocol was started within 48 hours after surgery. Results: The study sample resulted in 140 patients. Eighty-seven of them (63.14%) underwent hip replacement surgery, and 53 patients (37.86%) underwent internal fixation surgery. The greater part of the sample (68.42%) had surgery within 48 hours. Patients with more comorbidities had worse clinical outcomes, as shown by the Barthel Index, timing of verticalization and walking, and pain control. Between admission and discharge, the Barthel Index score improved, as did the pain complained of by most patients. Conclusions: A direct connection between orthopedics and the rehabilitation team, even after discharge, should be established and promptly organized to gain the best clinical outcomes. Indeed, we propose the triad early verticalization, pain control, and Barthel Index as a possible tool to define functional quality outcomes in post hip fracture surgery.

This study aimed to investigate the mechanical behavior of resin composites and hybrid glass ionomer cement in class I adhesive dental restorations under loading and shrinkage conditions. Three CAD models of a mandibular first molar with class I cavities were created and restored with different techniques: a bi-layer of Equia Forte HT with Filtek One Bulk Fill Restorative composite (model A), a single layer of adhesive and Filtek One Bulk Fill Restorative (model B), and a single layer of Equia forte HT (model C). Each model was exported to computer-aided engineering software, and 3D finite element models were created. Models A and B exhibited a similar pattern of stress distribution along the enamel–restoration interface, with stress peaks of 12.5 MPa and 14 MPa observed in the enamel tissue. The sound tooth, B, and C models showed a similar trend along the interface between dentine and restoration. A stress peak of about 0.5 MPa was detected in the enamel of both the sound tooth and B models. Model C showed a reduced stress peak of about 1.2 MPa. A significant stress reduction in 4 mm deep class I cavities in lower molars was observed in models where non-shrinking dental filling materials, like the hybrid glass ionomer cement used in model C, were applied. Stress reduction was also achieved in model A, which employed a bi-layer technique with a shrinking polymeric filling material (bulk resin composite). Model C’s performance closely resembled that of a sound tooth.

ABSTRACT Background: Spontaneous regression (SR) is defined as the partial or complete disappearance of a tumor, in the absence of a specific treatment. Evidence of the SR in hepatocellular carcinoma (HCC) is rare. Objective: The authors aimed to review all the cases of SR of HCC in two reference centers of Southern Brazil, highlighting the main characteristics. Methods: Data of all patients with HCC were retrospectively reviewed looking for the occurrence of SR in patients from two tertiary centers in Southern Brazil, in the last five years. The diagnosis of cirrhosis was established according to clinical, laboratory and imaging data, as well as upper endoscopy or histopathological examination when necessary. The diagnosis of HCC was based on typical findings according to radiologic criteria (LIRADS) or histopathological examination. Spontaneous regression was defined as a partial or complete involution of a HCC in the absence of a specific therapy. Results: From all cases of HCC in the last 5 years (n=433), there were five cases of SR. Three (60%) were men, the mean age was 62.6 (50.0-76.0) years, and the etiology was HCV in 3 (60%). Complete regression was observed in three patients (60%), one patient (20%) presented partial regression, and one (20%) relapesed and died. The time of follow-up varied between 12 and 21 months. In this presentation, it was highlighted one case of SR observed after COVID-19 infection in a patient with cirrhosis. The possible mechanisms involved in this situation were reviewed, emphasizing the most common like hypoxia and immunological. There were also one patient submitted to a surgical procedure as a possible fator involved and three patients without obvious risk factors. Conclusion: This phenomenon will possibly contribute to a better understanding of the pathophysiological mechanisms of HCC.

The impact of COVID-19 on sport and physical activity has been a subject of considerable interest and concern. Padel satisfies the desire for social interaction and a return to sport after a period of inactivity. The aim of this study is to show a correlation between return to sport and related injuries in a population of Padel players. The study was carried out in a survey mode, consisting of a questionnaire with four sections and fifty questions on the biographical data of the individual, lifestyle before and after the pandemic, knowledge and playing level of Padel and injuries. The self-administered online questionnaire was developed and validated by a panel of physiotherapists, orthopaedic surgeons, and physiatrists with experience in clinical practice and/or musculoskeletal research. The study was conducted in a survey mode from a smartphone or computer via a link to a multiple-choice document. The link to the questionnaire was distributed via mailing lists, social media, and chat applications.

RESUMO Nos primeiros anos do século XIX, a abertura de uma estrada entre a parte central da Zona da Mata de Minas Gerais e a cidade de Campos dos Goytacazes atuou como catalisador do processo de ocupação das terras por ela atravessadas. Do mesmo modo, assistiu-se ao incremento do comércio entre as duas áreas, sinalizando para a formação de um espaço econômico particular, em grande medida correspondente à bacia hidrográfica do rio Pomba. Este artigo tem por objetivo analisar a produção rural e a circulação de mercadorias nessa região ao longo das primeiras décadas do século XIX com base nos dados dos dízimos e de importação e exportação pelo registro da Barra do Pomba, bem como questionar a validade do conceito de espaço econômico para o período posterior ao declínio da atividade mineradora.

ABSTRACT This is a narrative review that aims to discuss the importance of elastographic methods in the evaluation of clinically significant portal hypertension (CSPH) in cirrhotic patients, where the authors propose an algorithm for evaluating these patients. In compensated advanced chronic liver disease, the goal is to prevent the development of CSPH and, in those already with CSPH, prevent the appearance of gastroesophageal varices (GEV) and other complications of portal hypertension. In compensated cirrhosis, the prevalence of GEV is 30-40%, of which 10-20% are at risk of bleeding. Therefore, using non-invasive methods would exempt the patient from the need of an endoscopy. Hepatic Elastography is a non-invasive, safe, reproducible method, available through many techniques: Vibration-Controlled Transient Elastography (VCTE), Shear Wave Elastography (SWE) and Magnetic Resonance Elastography (MRE). The Baveno VII presented the “rule of 5” for VCTE: liver stiffness measurement (LSM) ≤15 kPa and platelets >150.000/mm3 exclude CSPH, while an LSM ≥25 kPa is highly suggestive of CSPH. Also, the “rule of 4” for SWE has been proposed: patients with ≥17 kPa could be considered as having CSPH. At last, spleen stiffness measurement (SSM) has been proposed as a more specific technique to predict the presence of CSPH. In conclusion, elastography has gained prestige in the non-invasive evaluation of patients with advanced chronic liver disease by allowing prophylactic measures to be taken when suggesting the presence of CSPH.

Abstract Heliconius butterflies, a speciose genus of Müllerian mimics, represent a classic example of an adaptive radiation that includes a range of derived dietary, life history, physiological and neural traits. However, key lineages within the genus, and across the broader Heliconiini tribe, lack genomic resources, limiting our understanding of how adaptive and neutral processes shaped genome evolution during their radiation. Here, we generate highly contiguous genome assemblies for nine Heliconiini, 29 additional reference-assembled genomes, and improve 10 existing assemblies. Altogether, we provide a dataset of annotated genomes for a total of 63 species, including 58 species within the Heliconiini tribe. We use this extensive dataset to generate a robust and dated heliconiine phylogeny, describe major patterns of introgression, explore the evolution of genome architecture, and the genomic basis of key innovations in this enigmatic group, including an assessment of the evolution of putative regulatory regions at the Heliconius stem. Our work illustrates how the increased resolution provided by such dense genomic sampling improves our power to generate and test gene-phenotype hypotheses, and precisely characterize how genomes evolve.

This study delves into the adoption of the organic Rankine cycle (ORC) for recovering waste heat from data centers (DCs). Through a literature review, it examines energy reuse with a focus on electric power generation, the selection of working fluids, and system design principles. The objective is to develop a thorough framework for system design and analysis, beginning with a quantity and quality investigation of waste heat available. Air cooling systems, chosen often for their simplicity, account for about 70% of used cooling methods. Water cooling demonstrates greater effectiveness, albeit less commonly adopted. This study pays close attention to the selection of potential working fluids, meticulously considering the limitations presented by the available sources of heat and cold for vaporization and condensation, respectively. It reviews an ORC-based system setup, incorporating fluid streams for internal processes. The research includes a conceptual case study where the system is designed and simulations are conducted in the DWSIM environment. The simulation model considers hot air or hot liquid water returning from the data center cooling system for ORC working fluid evaporation. Ambient water serves for condensing, with pentane and isopentane identified as suitable organic fluids. Pentane assures ORC net electric efficiencies ranging between 3.1 and 7.1% when operating pressure ratios increase from 2.8 to 6.4. Isopentane systems, meanwhile, achieve efficiencies of 3.6–7.0% across pressure ratios of 2.7–6.0. Furthermore, the investigation provides key performance indicators for a reference data center in terms of power usage effectiveness (PUE), energy reuse factor (ERF), energy reuse effectiveness (ERE), and greenhouse gas (GHG) savings. This study concludes with guidelines for system analysis, including exergy considerations, and details the sizing process for evaporators and condensers.

The majority of urban CO2 emissions come from the transportation sector. To be able to reduce them, it is definitely necessary to replace Internal Combustion Engine (ICE) vehicles with electric ones. In this article, a public transport system is proposed, consisting of a supercapacitor (SC)-powered electric vehicle (EV) charged through a fuel cell-powered (FC) Inductive Power Transfer (IPT) system. The bus runs the usual route and it is charged each time it reaches the terminal, where the charging system is placed. The main advantages of the proposed system are related to the long-term cost of the EV, compared to a classic battery-powered system, to the aspects of ease of use and safety for charging operations and to the possibility of realizing a net-zero-energy transport system thanks to the use of green hydrogen. In addition, the proposed charging methodology allows for better energy utilization avoiding major changes to the main power grid. In this article, the system is presented considering a real case study; it is simulated at system and hardware level, and then validated through the realization of a scaled-down prototype.

Objective: This paper analyses the mechanical response of mini-implants under pull-out, push-in, and shear forces. Materials and methods: The authors have devised a specialized testing apparatus, using a universal testing machine, for the mechanical characterisation of orthodontic mini-implants (OMI) installed in pig hard palate. The experimental investigation encompasses seven screw types, each subjected to pull-out, push-in, and shear forces. Each test was conducted three times to assess the inherent uncertainties, with three torque insertions, with a total of 189 tests. The resulting load-displacement curves provide information on the secant stiffness and ultimate capacity of the tested screws in all three loading scenarios.These findings were used to develop a 3D finite element model to assess the OMI mechanical performance. Results: Torque is particularly influential in push-in tests for both dependent variables. At the same time, the length appears to be more critical in pull-out tests for the capacity. Diameter's influence is consistent across all tests but is especially significant for the secant stiffness in shear tests. Conclusions: Pull-out tests displayed linear behaviour until failure, whereas push-in tests showed increasing stiffness with more significant deformation. Higher torque led to higher capacity with a minor effect on the stiffness. Clinical significance: This paper provides insights into the mechanical behaviour of orthodontic mini-implants, offering guidance to orthodontic practitioners and researchers. Understanding how torque affects stability and performance under different loads informs the selection and design of mini-implants, potentially improving orthodontic treatments and patient outcomes.

Timber, a lightweight and environmentally friendly material, has gained popularity in construction due to its positive impact on sustainability. However, concerns regarding occupant comfort arise from the lightweight of timber, leading to various vibration issues of tall buildings. This study compares the performance of three structural systems: frames, shear walls, and diagrid systems, under wind loads. This research aims to identify the most efficient structural solutions by analyzing deflection, inter-story drift, and peak acceleration under design wind loads. The performance of these structural systems was evaluated based on ISO 10137 comfort level. The results demonstrate that the diagrid system outperforms the frame and shear wall systems regarding withstanding lateral forces, exhibiting higher natural frequencies and lower peak acceleration. Furthermore, considering the deflection of each system, which is influenced by structural stiffness, the diagrid system demonstrates a deflection of only 13.24 mm under design loads, which is lower than that of the frame and shear wall system.

One of the biggest global challenges in the mining industry is managing the risks associated with contamination by potentially toxic elements (PTEs) resulting from their activity. The oxidation of sulfides is the main cause of polluted mine drainage through the leaching of PTEs from mine waste and mine galleries to the water systems. Mine drainage can be highly acidic and often has a high concentration of PTEs, particularly arsenic, one of the environment’s most toxic elements. PTEs endanger the ecosystem’s equilibrium and raise worries about human and animal health. Some species of algae which can be naturally present in mine drainage waters, such as Spirogyra sp. And Chlorella sp., have a high capacity for absorbing PTEs from wastewater and may thrive in harsh environments. As a result, algal-based systems in bioremediation were studied and carefully analyzed, since their capacity to remove heavy metals and hazardous contaminants from polluted mine water have already been shown in previous studies. Biofuels derived from microalgal biomasses are a viable alternative to fossil fuels that can lead to a circular bioeconomy. This study reviews and analyses Chlorophyta-based bioremediation systems with application to mine waters focusing on Spirogyra sp. and Chlorella sp., since they are naturally present in mine drainage and can serve as a study model to better understand their application in bioremediation.

Micro-Raman spectroscopy was carried out to evaluate the localized residual stresses in commercial Gallium-Nitride-based devices, specifically, AlGaN/GaN high-electron-mobility Transistors (HEMTs) with a novel packaging design provided by STMicroelectronics S.r.l. (Catania, Italy). The packaging plays a key role in protecting the device core against the external environment, thus minimizing damages caused by mechanical shocks, exposure to light, and contact with chemicals, conjointly achieving an efficient heat dissipation rate. Even though the packaging is a required step for the proper functioning of ready-to-use electronic devices, its application typically may introduce mechanical stress to AlGaN/GaN HEMTs, which can result in various reliability issues. In this paper, we investigate the impact of packaging on residual stress by analyzing the frequency shift of the E2 Raman peak along GaN layers and at the GaN/Si interface. An extensive evaluation was conducted using both a packaged device and a wafer-level device. The correlation between Raman frequency shifts of the E2 mode was accurately quantified, revealing a stress mitigation of approximately 0.1 GPa. This reduction is ascribed to the compressive stress introduced by the packaging, which partially offsets the intrinsic tensile stress of the wafer-level device. The proposed methodology could, in principle, be implemented to improve the development of packaging.

This paper presents the results of an experimental study that focused on the gradual modification of the modal parameters of reinforced concrete beam–column frames subjected to progressive damage under cyclic loading. As is commonly found in structures of the 1970s, the specimen was characterized by the absence of specific shear reinforcement in the nodal panel. The frame modal parameters were investigated using the ambient vibrations test (AVT) as a modal identification technique. In particular, quasi-static cyclic tests with increasing amplitudes were performed on the reinforced concrete frame specimen and the modal parameters were assessed at various stages of frame degradation. By establishing a correlation between the changes in the modal parameters and the mechanical indicators of the structural damage in the frame, this study aimed to determine whether the ambient vibration tests could offer meaningful insights for evaluating the structural health of this type of structural component. As a result of the damage that occurred in the tested RC frame, the residual experimental value of the first natural frequency of the specimen was found to reduce at 52.7% of the original reference value (undamaged stage). Similarly, the residual value of the frame stiffness was found to be as low as 43.82% of the initial one. Both these results confirmed that changes when monitoring the modal frequencies may provide quantitative indexes to describe the structural health of RC frames. In combination with static tests for a direct measure of the structural stiffness variations, the AVT technique was shown to have interesting potential in detecting the type, level, and distribution of the progressive damage in civil structures. In particular, exponential and polynomial regression curves were defined to describe the decay of the first natural frequency as the structural damage increased in various parts of the frame, and it was shown that the variation in the first natural frequency was determined more by the damage on the beam than by the damage on the joint.

Electromagnetic actuation can support many fields of technology, such as robotics or biomedical applications. In this context, fully understanding the system behavior and proposing a low-cost package for feedback control is challenging. Modeling the electromagnetic force is particularly tricky because it is a nonlinear function of the actuated object’s position and coil’s current. Measuring in real time the position of the actuated object with the precision required for accurate motion control is also nontrivial. In this study, we propose a novel, cost-effective electromagnetic set-up to achieve position control via visual feedback. We actuated vertically and under different experimental conditions a 10 mm diameter steel ball hanging on a low-stiffness spring, demonstrating good tracking performance (the position error remained within ±0.5 mm, with a negligible phase delay in the best scenarios). The experimental results confirm the feasibility of the proposed set-up, which is characterized by minimum complexity and realized with off-the-shelf and cost-effective components. For these reasons, such a contribution helps to understand and apply electromagnetic actuation even further.

Este artigo tem por objetivo propor um esboço do espaço urbano do antigo arraial do Tijuco entre 1735 e 1784 por meio de um conjunto variado de fontes textuais, bem como de mapas elaborados em 1775 e 1784. O período escolhido abrange os primeiros registros de nomes das vias públicas onde se localizavam as lojas ou vendas do arraial do Tijuco, e a lista de logradouros que acompanha a “pequena planta do arraial do Tijuco” elaborada em 1775. O maior desafio a ser enfrentado é sem dúvida a variação dos nomes para os mesmos logradouros. Com base nos elementos aqui expostos, busca-se mostrar que na década de 1730 os estabelecimentos comerciais se concentravam principalmente nas ruas da Quitanda, do Bonfim e do Carmo, mas também na atual praça Conselheiro Mata, rua do Contrato, Rosário e no Macau – basicamente nos logradouros situados entre a igreja de Santo Antônio e o edifício da antiga Intendência dos Diamantes (situado onde hoje é a Mitra Arquidiocesana de Diamantina). Este parece ter sido o eixo em torno do qual novas vias foram sendo constituídas. Trata-se obviamente de um primeiro esforço, e pesquisas posteriores, sem dúvida, poderão refinar esta proposta.

The work presents an integrated system for combined heat and power generation based on a topping biodiesel internal combustion engine (ICE) and a bottoming transcritical organic Rankine cycle (TORC). A 0D/1D mathematical model is developed to evaluate the performance of the innovative biodiesel system in design and off-design conditions for a wide range of rated power and organic fluids. The analysis highlights that the TORC integration improves the total full load electric power by more than 12%, and the engine size significantly influences the integrated system performance. The total electric efficiency increases from 35.0% to 47.9%, whereas the thermal efficiency decreases from 27.2% to 19.8% when the ICE’s nominal power moves from 10 kWel to 500 kWel.Afterward, a multi-objective investigation is carried out to define the most suitable power of the proposed biodiesel system and its capability to satisfy the energy request of specific users. A thermal self-consumption equal to 100%, an electric self-consumption larger than 94%, and a payback time of 5.2 years are found. Lastly, a sensitivity analysis demonstrates the economic feasibility of the proposed biodiesel integrated system for a wide range of prices of energy vectors and system components.

Introduction: Despite successful therapy, acromegalic patients have reduced health-related quality of life (HRQoL) compared to healthy controls. Finding predictors of poor HRQoL can be crucial to improving these patients’ global health state. Aim: The primary objective of the study was to find out predictors of HRQoL. Secondary objectives were: (I) to determine correlations with AcroQoL subscales, and (II) to identify predictors for subscales.Materials and methods: In this cross-sectional study conducted in 2019 at the Messina Policlinic Hospital, 45 acromegalic patients were assessed at the Physical and Rehabilitative Medicine Ambulatory. During routine outpatient clinic attendances, the following questionnaires were administered: Acromegaly Quality of Life Questionnaire (AcroQoL), Patient-Assessed Acromegaly Symptom Questionnaire (PASQ), and Western Ontario and McMaster Universities Arthritis Index (WOMAC). We furthermore included the following variables obtained by medical record review: age, BMI, disease duration, previous surgery (Yes/No), previous radiotherapy (Yes/No), use of GH lowering medications (Yes/No), hypertension (Yes/No), diabetes mellitus (Yes/No), and biochemical control of the disease (Yes/No): immunoradiometric assays were employed to serum GH and IGF-1 measurements to identify biochemical control of the disease. Correlation between outcome measures and AcroQoL has been performed. Pearson’s r was calculated for continuous data following normal distribution (AcroQoL, PASQ, AcroQoL-B, AcroQoL-R, WOMAC-P), while Spearman’s rank order correlation was calculated for non-normally distributed data (WOMAC, WOMAC-F, WOMAC-S, AcroQoL-P) and point-biserial correlation for binary variables (biochemically controlled disease, use of GH lowering medications, radiotherapy, surgery). The same correlation analysis was performed for the AcroQoL subscales.Multiple linear regression with backwards, stepwise analysis was used to assess the influence on AcroQoL of correlated variables.Results: AcroQoL was strongly negatively correlated with PASQ (r=−0.700, p

Central sensitisation is defined as a multifactorial etiopathogenetic condition involving an increase in the reactivity of nociceptive neurons and alterations in pain transmission and perception in the central nervous system. Patients may present with widespread chronic pain, fatigue, sleep disturbance, dizziness, psychological (e.g., depression, anxiety, and anger) and social impairment. Pain can be spontaneous in onset and persistence, characterised by an exaggerated response and spread beyond the site of origin, and sometimes triggered by a non-painful stimulus. Whole-body cryostimulation (WBC) could be an adjuvant therapy in the management of this type of pain because of its global anti-inflammatory effect, changes in cytokines and hormone secretion, reduction in nerve conduction velocity, autonomic modulation, and release of neurotransmitters involved in the pain pathway. In several conditions (e.g., fibromyalgia, rheumatoid arthritis, and chronic musculoskeletal pain), WBC affects physical performance, pain perception, and psychological aspects. Given its multiple targets and effects at different organs and levels, WBC appears to be a versatile adjuvant treatment for a wide range of conditions of rehabilitation interest. Further research is needed to fully understand the mechanisms of analgesic effect and potential actions on pain pathways, as well as to study long-term effects and potential uses in other chronic pain conditions.

Clavicle midshaft fractures are mostly treated surgically by open internal reduction with a superior or anteroinferior plate and screws or by intramedullary nailing. Screw positioning plays a critical role in determining the stress distribution. There is a lack of data on the screw position and the appropriate number of cortices required for plate fixation. The aim of this study is to evaluate the mechanical behavior of an anterior plate implanted in a fractured bone subjected to 120° of lateral elevation compared to a healthy clavicle using numerical simulations. Contact forces and moments used were obtained from literature data and applied to the healthy and fractured finite element models. Stresses of about 9 MPa were found on the healthy clavicle, while values of about 15 MPa were calculated on the plate of the fractured one; these stress peaks were reached at about 30° and 70° of elevation when the stress shielding on the clavicle sums all the three components of the solicitation: compression, flexion, and torsion. The stress distribution in a clavicle fracture stabilized with plates and screws is influenced by several factors, including the plate’s position and design, the type of screw, and the biomechanical forces applied during movements.

Functional neurological disorders (FNDs) are complex disabling conditions requiring a multiple rehabilitation intervention. Here, we propose a new use of whole-body cryostimulation (WBC) that was implemented in a multidisciplinary rehabilitation programme in a wheelchair-ridden woman diagnosed with FND and other comorbidities. WBC is a promising adjuvant treatment in various conditions of rehabilitation interest, mainly because of its wide range of rapid effects, from anti-inflammatory to pain and autonomic modulating effects. The 4-week program included physiotherapy, nutritional intervention, psychological support, and WBC (−110 °C for 2 min). Questionnaires to assess disease impact, pain level, fatigue and sleep quality were administered. At discharge, improvements in body composition, haematological biomarkers, physical performance, and questionnaire scores were observed. The patient was able to walk independently with a walker for medium distances and reported unprecedented improvements, particularly in functional parameters and questionnaire scores. Although the extent to which WBC per se contributed to the measured improvements cannot be ascertained, subjective reports and our clinical observations indicate that WBC, the only intervention not previously experienced by the patient, acted as a booster for the rehabilitation interventions. Further research will be necessary to rule out any possible placebo effect and to confirm the effects of WBC on FND.

Phantom limb pain (PLP) is a challenging condition affecting a significant proportion of amputees. In this article, we describe the case of a 54-year-old Paralympic athlete with phantom limb syndrome following right leg amputation and widespread sports-related enthesitic pain who underwent a whole-body cryostimulation (WBC) cycle, an emerging treatment known for its rapid pain-relieving and anti-inflammatory effects. Assessments were conducted before and after a 10-session WBC cycle, including pain and quality of life assessment and use of medications. A substantial reduction in enthesitic pain, PLP intensity, paresthesia, and tingling related to atmospheric events and improved function and quality of life were reported after the WBC cycle and lasted for two weeks. One month after WBC, the enthesitic pain following sports activity and PLP gradually returned, but with lesser intensity. Similarly, the stump’s sensitivity to atmospheric changes returned, but with lower frequency. Pain at night remained lower than before WBC, with significantly improved quality of sleep. This case study suggests that WBC could be a valuable adjuvant treatment for alleviating PLP. Controlled studies are warranted to validate the findings of this case report and elucidate the mechanisms underlying the positive effects of WBC in this condition.

Il saggio identifica le principali questioni che il futuro ecosistema digitale pone, descrivendo il fenomeno della frammentazione di Internet come uno degli aspetti più complessi e problematici che emergono nell’attuale scenario geopolitico, ove si manifesta la tendenza degli Stati all’elaborazione di politiche “tecnonazionalistiche” volte alla costruzione di una Rete autonoma e indipendente, tecnologicamente difforme dall’originaria architettura distribuita e interoperabile su cui si basa il tradizionale modello operativo dell’Internet globale. Proliferano, infatti, nel panorama globale svariati interventi regolatori che impongono l’uso massivo di strumenti di sorveglianza generale per assicurare il controllo centralizzato della Rete, come obiettivo strategico prioritario di supremazia tecnologica stabilito a presidio delle infrastrutture critiche degli Stati, per evitare il rischio di possibili attacchi esterni in grado di destabilizzarne l’ordinamento interno. Rispetto alla progressiva balcanizzazione della Rete, si sta al contempo rafforzando, come imprevista variabile del mutato ecosistema di Internet, il potere – economico e politico – delle “Big Tech” nella veste di nuovi “players” dominanti che potrebbero dare vita ad un’inedita governance digitale oltre gli Stati.

Background: A post-COVID condition can reduce activity and quality of life, resulting in a significant socioeconomic and health burden. Understanding its impact on patients’ health is important for the development of personalized rehabilitation interventions. An independent association between obesity and post-COVID condition was found because of complications and comorbidities. Methods: Sixteen patients with obesity and post-COVID symptoms (i.e., dyspnea, pain, poor sleep quality, muscle fatigue), admitted to the Istituto Auxologico Italiano, Piancavallo (VB), Italy, were recruited for a four-week rehabilitation program including conventional exercise therapy, nutritional intervention, psychological support and whole-body cryostimulation (WBC). Results: All participants attended all sessions of the program. Anthropometric data showed statistically significant changes in weight, waist circumference and body mass index. Biochemical analyses showed significant reductions in lipid and inflammatory profiles. There was a significant improvement in physical performance, reduction in pain and improvement in psychological well-being. Conclusion: A multidisciplinary rehabilitation protocol including WBC, designed for patients with obesity and a post-COVID condition, is safe and feasible. The overall improvements demonstrate that multidisciplinary rehabilitation was effective on post COVID patients and suggest that the use of WBC is safe and could play a role as a booster in rehabilitation programs.

Regenerative techniques are increasingly applied in endodontic surgery, but different materials may have varying impacts on soft and hard tissue healing. This systematic review aims to evaluate the effectiveness of autologous platelet concentrates (APCs) in clinical and radiographic healing after endodontic surgery. The data for this systematic review were processed following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines for improving the reporting of systematic reviews and meta-analyses. A literature search was conducted until October 2023 on PubMed, Scopus, and Cochrane Databases. Randomized controlled trials and controlled clinical trials addressing the use of APCs in patients who presented persistent periapical lesions and needed periapical surgery were included. Dual publications, narrative reviews, systematic reviews, case series, questionnaires, animal studies, case reports, letters to the editor, in vitro studies, and abstracts were excluded. In total, the search resulted in 14 papers. Clinical and radiographical findings were reported, showing that when APCs were used, patients exhibited less pain and swelling and a greater reduction of apical radiolucency after 12 months follow-up on average. However, the moderate/high risk of bias of included studies and their high heterogeneity, do not allow one to draw definitive conclusions on the effectiveness of APC after endodontic surgery.

Background: Neurological disease patients present an increased risk of developing pressure ulcers. The primary aim of this study is to evaluate the incidence and prevalence of pressure ulcers and their impact on length of stay and functional recovery. Methods: A retrospective study was conducted in a neurorehabilitation unit over a seven-year period. Data collected include demographic data, length of stay, functional evaluation, risk of pressure ulcers development, nutritional status, and skin. Pressure ulcers were classified according to the European Pressure Ulcer Advisory Panel System. Results: Data from 816 patients were analyzed. On admission, the authors found 236 pressure ulcers in 131 patients (about 16%), divided into stage I (25%), stage II (50%), and stage III–IV (25%). The most common sites were the heel (36%) and sacrum (29%). Among the risk factors for the development of pressure ulcers, malnutrition played a significant role, with approximately 76% of patients with pressure ulcers having mild to moderate malnutrition. Conclusion: The presence of pressure ulcers seems to have a negative impact on the functional recovery of patients, as shown by the outcome scales and the average length of stay: 51 days versus 36 days (p < 0.01).

Este trabajo investigativo tiene como objetivo analizar la asignación presupuestaria por parte del Estado hacia las universidades del Ecuador durante el periodo 2016 al 2020, se buscó evidenciar como ha sido el presupuesto asignado a través de los últimos cinco años y conocer que parte del presupuesto del Estado Ecuatoriano está dirigido hacia la educación. Este estudio tiene una metodología de investigación aplicada con un enfoque cualitativo, optando por la modalidad de investigación documental que propo-ne el diagnóstico del impacto que tiene la asignación de recursos por parte del Estado Ecuatoriano para la educa-ción superior en el país. Fundamentalmente obtuvimos de información de artículos científicos y de páginas oficiales de Entidades Gubernamentales, que nos permitan cono-cer la realidad del problema investigado, en la cual desem-peña un rol muy importante en el desarrollo económico y en la generación de empleo, como nos informa el ministerio de economía y finanzas, con la estimación de los recursos financieros que tiene el Ecuador. Describiendo los resul-tados obtenidos de la investigación y con sus respectivas conclusiones.

This paper proposes an equivalent 2d model incorporating translational and rotational springs to simulate constraints in the stability analysis of steel plates under in-plane patch loading. The main objective is to develop an equivalent stability analysis of these plates by accurately calibrating the level of constraint provided by the stiffeners and flanges. The calibration involves determining the spring constants of a 2d equivalent plate model to achieve the same linear elastic critical load and buckled shape as a 3d model. The paper uses the buckling coefficient as the objective function to calibrate the translational and rotational springs. The ultimate goal is to effectively replicate the constraint conditions imposed by the flanges and vertical stiffeners within the structure. The proposed simplified method yields results that closely align with those obtained from the original 3d model, incorporating finite-rigidity restraints.

In structural health monitoring (SHM) paradigm, operational modal analysis (OMA) comprises several techniques and algorithms for estimating the dynamic characteristics of a structure in operational conditions from its vibration response. The OMA method has been spreading in the last years due to multiple advantages compared to input–output identification methods. In the current work the authors present the implementation of a Python module named PyOMA and its Graphical User Interface (GUI) PyOMA_GUI. This software provides a user-friendly framework for the first time in the Python environment for estimating the experimental modal parameters (natural frequencies, mode shapes, damping ratios) of a structure from output-only vibration measurements in operational conditions.

Abstract Inferring the selective forces that orthologous genes underwent across different lineages can help us understand the evolutionary processes that have shaped their extant diversity and the phenotypes they underlie. The most widespread metric to estimate the selection regimes of coding genes—across sites and phylogenies—is the ratio of nonsynonymous to synonymous substitutions (dN/dS, also known as ω). Nowadays, modern sequencing technologies and the large amount of already available sequence data allow the retrieval of thousands of orthologous genes across large numbers of species. Nonetheless, the tools available to explore selection regimes are not designed to automatically process all genes, and their practical usage is often restricted to the single‐copy ones which are found across all species considered (i.e., ubiquitous genes). This approach limits the scale of the analysis to a fraction of single‐copy genes, which can be as low as an order of magnitude in respect to those which are not consistently found in all species considered (i.e., nonubiquitous genes). Here, we present a workflow named BASE that—leveraging the CodeML framework—eases the inference and interpretation of gene selection regimes in the context of comparative genomics. Although a number of bioinformatics tools have already been developed to facilitate this kind of analyses, BASE is the first to be specifically designed to allow the integration of nonubiquitous genes in a straightforward and reproducible manner. The workflow—along with all relevant documentation—is available at github.com/for‐giobbe/BASE.

ABSTRACT BACKGROUND: Non-alcoholic fatty liver disease (NAFLD) is the most prevalent liver disease in the world, and its prevalence is increasing alongside obesity. In United States, NAFLD is already the second leading cause of liver transplantation. The spectrum of the disease ranges from simple steatosis, which has a benign course, to steatohepatitis, which may progress to cirrhosis and its complications. The rising of noninvasive methods for diagnosing and staging non-alcoholic steatohepatitis (NASH) and fibrosis decreases the need of liver biopsy, as well as the costs and the occurrence of complications related to it. OBJECTIVE: To analyze the performance of the triglyceride-glucose index to evaluate steatosis, NASH and liver fibrosis in obese patients with NAFLD. METHODS: This is a retrospective cross-sectional study. Every medical record of patients who were candidates for bariatric surgery at a leading hospital in Southern Brazil were analyzed. The triglyceride-glucose index (TyG Index), a method composed only of two simple laboratory tests (serum triglycerides and fasting glucose levels), was performed prior to surgery. The TyG Index performance regarding the anatomopathological findings was evaluated, and the AUROC curve was calculated to evaluate the best cut-off point for diagnosing steatosis, non-alcoholic steatohepatitis and liver fibrosis grade. Also, the NAFLD fibrosis Score (NFS) was evaluated. RESULTS: A total of 423 patients were evaluated. The TyG Index with a cut-off point of 8.76 excluded significant simple steatosis (grade 2-3) in obese patients, with 67.6% sensitivity, 65.1% specificity, 46.3% positive predictive value (PPV), 81.8% negative predictive value (NPV), 65.8% accuracy and 0.66 AUROC (P=0.005). In the evaluation of NASH, the TyG Index with a cut-off point of 8.82 excluded significant NASH (grade 2-3) with 57.3% sensitivity, 58.6% specificity, 33.7% PPV, 78.8% NPV, 58.2% accuracy and 0.58 AUROC (P=0.022). When evaluating liver fibrosis, the TyG Index with a cut-off point of 8.91 showed a sensitivity of 61.8%, a specificity of 62.5%, a PPV of 13.8 and a NPV of 94.4% for exclusion of advanced fibrosis (F3-4), with a 62.4% accuracy and 0.69 AUROC (P

Stroke is the second cause of disability and death worldwide, highly impacting patient’s quality of life. Several changes in brain architecture and function led by stroke can be disclosed by neurophysiological techniques. Specifically, electroencephalogram (EEG) can disclose brain oscillatory rhythms, which can be considered as a possible outcome measure for stroke recovery, and potentially shaped by neuromodulation techniques. We performed a review of randomized controlled trials on the role of brain oscillations in patients with post-stroke searching the following databases: Pubmed, Scopus, and the Web of Science, from 2012 to 2022. Thirteen studies involving 346 patients in total were included. Patients in the control groups received various treatments (sham or different stimulation modalities) in different post-stroke phases. This review describes the state of the art in the existing randomized controlled trials evaluating post-stroke motor function recovery after conventional rehabilitation treatment associated with neuromodulation techniques. Moreover, the role of brain pattern rhythms to modulate cortical excitability has been analyzed. To date, neuromodulation approaches could be considered a valid tool to improve stroke rehabilitation outcomes, despite more high-quality, and homogeneous randomized clinical trials are needed to determine to which extent motor functional impairment after stroke can be improved by neuromodulation approaches and which one could provide better functional outcomes. However, the high reproducibility of brain oscillatory rhythms could be considered a promising predictive outcome measure applicable to evaluate patients with stroke recovery after rehabilitation.

No Brasil existe um grande número de grupos étnicos de povos indígenas, apesar de o processo de colonização ter exterminado várias outras etnias. A etnia Kanela do Araguaia apresenta características distintas de outras etnias, devido ao seu contexto histórico de expulsão de suas terras e o seu deslocamento para outra região. Diante disso, esse artigo tem como objetivo compreender a inserção de jovens indígenas da etnia Kanela do Araguaia na Universidade Federal de Goiás (UFG), visando identificar as dificuldades enfrentadas por esses jovens no cenário acadêmico. Foram realizadas entrevistas com três acadêmicos indígenas da UFG dos Cursos de Enfermagem, Agronomia e Engenharia Elétrica. A pesquisa possibilitou dar voz aos acadêmicos indígenas que expressaram os seus anseios enquanto portadores do direito ao acesso a uma educação pública e de qualidade. Foi possível compreender através dos relatos que os entrevistados consideram uma grande conquista ingressar em uma universidade pública, no entanto ainda é um grande desafio para os indígenas tanto o ingresso quanto a permanência em uma instituição de ensino superior, dado o contexto de preconceito com esses povos e a dificuldade de inserção no meio, principalmente em relação à língua.

Abstract Background Substrate analysis of the left atrium in patients undergoing atrial fibrillation ablation has limitations when performed by means of simple bipolar acquisition. Objective To evaluate the incidence of low‐voltage zones (LVZs) through maps constructed by means of various catheters: multipolar (MC), omnipolar (OC), and circular catheters (CMCs) with the 3D electro‐anatomical systems (3d‐S) CARTO3 and EnSite Precision. Methods To assess LVZs, we acquired maps by means of CMC and MC in the voltage range 0.05‐0.5 mV in 70 consecutive patients in sinus rhythm. In the case of OC only, we made an intra‐patient comparison of bipolar maps constructed by means of the along and across, and HD‐Wave configurations of the EnSite 3d‐S in the ranges of 0.05‐0.5 and 0.5‐1.0 mV. On the basis of this comparison, we chose the range that best identified LVZs as a set of different colors (SDC) compatible with patchy fibrosis (qualitative analysis). Subsequently, we detected the voltage values corresponding to purple and gray points, close to SDC, and the value inside corresponding to blue, green, and red colors, and we evaluated the color change in other voltage ranges. Finally, we performed a quantitative analysis of LVZs by applying the qualitative characteristics described above. Results On the basis of our settings, for OC, the optimal range identifying LVZs was 0.3‐0.6 mV. OC revealed smaller LVZs than MC (P

ABSTRACT BACKGROUND: Hepatocellular carcinoma (HCC) is the most frequent primary cancer of the liver and cirrhosis is considered a pre-malignant disease. In this context, the evolutionary sequence from low grade dysplastic nodule and high grade dysplastic nodule (HGDN) to early HCC and advanced HCC has been studied. The differential diagnosis between HGDN and early HCC is still a challenge, especially in needle biopsies OBJECTIVE: To evaluate an immunohistochemistry panel to differentiate dysplastic nodules and HCC. METHODS: Patients with cirrhosis who underwent surgical resection or liver transplantation were included. The sensitivity, specificity and accuracy for the diagnosis of neoplasia were analyzed by evaluating five markers: heat shock protein 70, glypican 3, glutamine synthetase, clathrin heavy chain and beta-catenin. P≤0.05 was considered statistically significant. RESULTS: One hundred and fifty-six nodules were included; of these, 57 were HCC, 14 HGDN, 18 low grade dysplastic nodules and 67 regenerative macronodules. Sensitivity of HCC diagnosis was 64.9% for glypican 3 and 77.2% for glutamine syntetase, while specificity was 96.0% and 96.0% respectively. When the panel of four markers was considered (excluding beta catenin), the specificity ranged from 87.9% for one positive marker to 100% for at least three markers. The best accuracy for HCC diagnosis was obtained with at least two positive markers, which was associated with a sensitivity of 82.5% and specificity of 99%. CONCLUSION: Differential diagnosis of dysplastic nodules and HCC by morphological criteria can be challenging. Immunomarkers are useful and should be used for the differential diagnosis between HCC and HGDN.

Haemophilia A (HA) and haemophilia B (HB) are X-linked inherited bleeding disorders caused by the absence or deficiency of coagulation factors VIII (FVIII) and IX (FIX), respectively. Recent advances in the development of effective treatments for haemophilia have led to a significant increase in life expectancy. As a result, the incidence of some comorbidities, including fragility fractures, has increased in people with haemophilia (PWH). The aim of our research was to perform a review of the literature investigating the pathogenesis and multidisciplinary management of fractures in PWH. The PubMed, Scopus and Cochrane Library databases were searched to identify original research articles, meta-analyses, and scientific reviews on fragility fractures in PWH. The mechanism underlying bone loss in PWH is multifactorial and includes recurrent joint bleeding, reduced physical activity with consequent reduction in mechanical load, nutritional deficiencies (particularly vitamin D), and FVIII and FIX deficiency. Pharmacological treatment of fractures in PWH includes antiresorptive, anabolic and dual action drugs. When conservative management is not possible, surgery is the preferred option, particularly in severe arthropathy, and rehabilitation is a key component in restoring function and maintaining mobility. Appropriate multidisciplinary fracture management and an adapted and tailored rehabilitation pathway are essential to improve the quality of life of PWH and prevent long-term complications. Further clinical trials are needed to improve the management of fractures in PWH.

Seedling species with different architectures, e.g., mean leaf angles, are often subjected to the same irrigation management in forest nurseries, resulting in wasted water and fertilizer and reduced seedling quality. We aimed to evaluate whether irrigation volumes applied to tree seedling species with different leaf angles affect the physiological quality in forest nurseries and, consequently, performance after potting. We submitted nine seedling species with different mean leaf angles to four daily water regimes (8, 10, 12, and 14 mm). In the nursery, the following physiological attributes were considered to assess seedling quality: leaf water potential, daily transpiration rate, SPAD value, chlorophyll a and b, anthocyanins, carotenoids, and total nutrient content. After potting, we evaluated height and stem diameter over 120 days. Leaf angle can be used as a criterion for optimizing irrigation in forest nurseries, avoiding water and fertilizer wastage, and increasing physiological seedling quality. Leaf angle measurements combined with concurrent assessments of leaf traits are helpful in further understanding the effects of leaf angle variation and water regime on seedling quality. For positive leaf angles, an irrigation volume of 8 mm is sufficient to increase physiological seedling quality. Conversely, seedlings with negative leaf angles show the opposite response, requiring the largest irrigation volume (14 mm) to increase physiological seedling quality, except when the mean leaf area is small and concentrated in the upper half of the stem, which facilitates the access of irrigation water to the substrate and thus satisfies seedling water requirements. For all species, up to 120 days after planting in pots, the effect of the irrigation volume that provides greater growth and physiological quality at the end of the nursery phase is not overcome by other irrigation volumes applied.

Background: Patellar instability can cause pain and disability. A finite element model of a healthy human knee was performed to analyze the role of quadriceps and medial retinaculum imbalance in patellar instability. Methods: The model was created by matching magnetic resonance and computed tomography images of a normal adult patient’s knee. Muscle force intensities were calculated by static optimization, considering the lower limb muscles, knee movement and the ground reaction during walking. Patellar instability was experimentally generated by progressively uncoupling muscular forces, (90 N versus 110 N), while at the same time, the load derived from the quadriceps was gradually reduced by 20%. Results: This loss in force symmetry of 10 N on the retinaculum may produce a displacement of approximately 7 mm, with an increase in patellar contact forces of approximately 44%. When the quadriceps force is reduced by 10% and the unbalanced medial retinaculum acts together, the displacements are in the order of 14 mm, and the patellar contact forces increase by 84%. Conclusion: A reduced quadriceps force alone is not able to cause significant patellar instability, while an imbalance of forces at the level of the retinaculum could lead to patellar instability, especially when the two effects are combined. A better understanding of joint relationships and muscle synergies can help to improve clinical approaches to patella instability

The coronavirus disease 19 (COVID-19) post pandemic evolution is correlated to the development of new variants. Viral genomic and immune response monitoring are fundamental to the surveillance of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Since 1 January to 31 July 2022, we monitored the SARS-CoV-2 variants trend in Ragusa area sequencing n.600 samples by next generation sequencing (NGS) technology: n.300 were healthcare workers (HCWs) of ASP Ragusa. The evaluation of anti-Nucleocapside (N), receptor-binding domain (RBD), the two subunit of S protein (S1 and S2) IgG levels in 300 exposed vs. 300 unexposed HCWs to SARS-CoV-2 was performed. Differences in immune response and clinical symptoms related to the different variants were investigated. The SARS-CoV-2 variants trend in Ragusa area and in Sicily region were comparable. BA.1 and BA.2 were the most representative variants, whereas the diffusion of BA.3 and BA.4 affected some places of the region. Although no correlation was found between variants and clinical manifestations, anti-N and anti-S2 levels were positively correlated with an increase in the symptoms number. SARS-CoV-2 infection induced a statistically significant enhancement in antibody titers compared to that produced by SARS-CoV-2 vaccine administration. In post-pandemic period, the evaluation of anti-N IgG could be used as an early marker to identify asymptomatic subjects.

The reconstruction works following the 2009 earthquake in L’Aquila evidenced the presence of numerous Timber-Framed (T-F) masonries dating back to the 18th century. These masonries, likely built after the destructive 1703 earthquake in L’Aquila, are quite diverse from each other. In the evolutionary process of the so-called Italian baraccato, the presences found in L’Aquila possibly update the record of Italian traditional T-F masonries: the baraccato Beneventano developed after the earthquake in 1627, the baraccato Calabro after the 1783 earthquake in Calabria and the baraccato Aquilano after the 1703 earthquake in L’Aquila. The authors attempt to classify the traditional T-F structures found in a limited area of the city centre, providing simple descriptions of their geometrical and functional features. Additionally, the authors present a map indicating the recorded presences so far.

ABSTRACT Hepatocellular carcinoma (HCC) is one of the leading causes of cancer-related mortality worldwide. The Brazilian Society of Hepatology (SBH) published in 2015 its first recommendations about the management of HCC. Since then, new data have emerged in the literature, prompting the governing board of SBH to sponsor a single-topic meeting in August 2018 in São Paulo. All the invited experts were asked to make a systematic review of the literature reviewing the management of HCC in subjects with cirrhosis. After the meeting, all panelists gathered together for the discussion of the topics and the elaboration of updated recommendations. The text was subsequently submitted for suggestions and approval of all members of the Brazilian Society of Hepatology through its homepage. The present manuscript is the final version of the reviewed manuscript containing the recommendations of SBH.

Il contributo approfondisce le dinamiche in cui si articola il processo di cooperazione multilaterale esistente, a livello nazionale e internazionale, per la definizione delle politiche di sviluppo dell’ecosistema della Rete. In particolare, viene descritto il ruolo dell’Internet Governance Forum, ripercorrendone le principali tappe evolutive, per poi focalizzare le criticità che nell’immediato futuro pone il governo della Rete, nell’ambito di uno scenario complesso e inedito in cui la gestione di Internet, caratterizzata da una precaria stabilità del suo assetto operativo, risulta progressivamente erosa dal sempre più evidente primato egemonico degli interessi economici di cui sono portatori le grandi multinazionali del settore digitale, con il rischio di indebolire il “peso” dei governi nazionali e delle organizzazioni internazionali. Tutto ciò evidenzia l’importanza strategica di una visione chiara sulla futura governance di Internet, destinata ad incidere sulla tutela dei diritti fondamentali, sui fattori di crescita dello sviluppo economico e sugli standard di libertà degli ordinamenti democratici, costituenti questioni prioritarie dell’attuale agenda politica, ove diventa centrale il tema del controllo della Rete alla ricerca di un delicato equilibrio nei rapporti di forza tra tutti gli attori che partecipano al processo decisionale del governo di Internet in una dimensione sovranazionale esposta ad un’accentuata proliferazione di conflitti tra implicazioni politiche, aspetti tecnici, esigenze di mercato e prerogative giuridiche.

Resumo Alguns dos elementos explicativos fundamentais sobre o crédito no Brasil durante o período colonial começaram a ser gestados há mais de um século, o mais recorrente dos quais, a oferta monetária, assumida como escassa até 1808, quando um conjunto de medidas começou a ser posto em execução no sentido de suprir essa carência de numerário no país. Entre estas, a mais comumente referida é a criação do Banco do Brasil em 12 de outubro de 1808. Este artigo busca discutir a historiografia recente sobre o crédito no Brasil entre os séculos XVII e XVIII, com particular atenção para a sua relação com a oferta monetária. Ademais, refuta a premissa da escassez da moeda e do recurso ao crédito como uma de suas consequências. Por tratar-se de uma revisão historiográfica, escapa ao escopo deste artigo um exame pormenorizado das fontes, mas buscar-se-á enfatizar a necessidade de ampliar os estudos com documentos até agora inexplorados, bem como aprofundar as análises sobre os instrumentos jurídicos de proteção às operações creditícias.

Objectives. The study aims at assessing the accuracy of the process of attachment bonding in aligner treatments. The analysis leads to the error estimation in the faithful reproduction of master model attachments using two types of transfer templates and two light-curing resin-based composites usually used in orthodontics. Methods. The authors have used two transfer templates made of two different materials. The first, named Leone-biocompatible thermoforming material hard/soft, has a lower Young’s modulus and is labelled as soft, while the other, named Leone-biocompatible thermoforming material, is marked as rigid. The resin-based composites possess different mechanical and rheological properties. Specifically, Transbond™ XT Light Cure Paste Adhesive, 3M has a higher viscosity than the TetricEvoflow, Ivoclar Vivadent, a flowable nanohybrid composite. The authors attempt to estimate the performance ranking between the four possible couples obtained by combining the two light-curing resin-based composites and transfer templates. Each combination was repeated in six models and compared with twelve master models, resulting in 36 total samples. A 3-D laser scanner is used to generate a digital model of each model. The comparison between digital models is the base for a comparative assessment in terms of relative and absolute error. The relative error is estimated using scalar performance indicators ranging from 0 to 1, where 1 indicates the optimum matching. The absolute error estimated from the mean square error between the coordinates of each digital model yields the reproduction accuracy in micrometer. Furthermore, the authors attempted to assess the error distribution by evaluating the point-by-point difference between the digital models. Results. This analysis aims at localizing the sources of error in the considered models. The use of Transbond™ XT Light Cure Paste Adhesive, 3M with a rigid transfer template is always associated with significant accuracy and minor dispersion. However, in a few instances, using the soft template or the flowable resin-based composite can lead to bad performances. Significance. The data processing bestowed the following performance ranking from the first with lower reproduction error to the last characterized by the worst performance: (1) attachments bonding with rigid template and Transbond™ XT Light Cure Paste Adhesive, 3M, (2) attachments bonding with soft template and Transbond™ XT Light Cure Paste Adhesive, 3M, (3) attachments bonding with rigid template and TetricEvoflow, Ivoclar Vivadent, and (4) attachments bonding with soft template and TetricEvoflow, Ivoclar Vivadent.