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This article is concerned with cultural events and the way they are arranged. It discusses how the implementation of the stringent rules and organizational principles of project management might prove counterproductive in cultural events. The underlying assumption is that cultural events are complex and ever-evolving systems based on creative and artistic processes, so they escape traditional planning and control practices. The complexity of cultural events can be explored through four dimensions. The first concerns the social, cultural, economic, and technological context and the relevance of the influence held by the various stakeholders. The second dimension is related to the multiplicity of objectives underlying each cultural event. The third dimension refers to the concept, the content, and the artistic and cultural creation processes behind the uniqueness of an event. Finally, the last element concerns event management and its iterative dynamic as a project where the four dimensions of complexity are intertwined. Traditional project management usually proposes tools and techniques that tend to dominate and control the project, following a deterministic approach. This attitude may be inadequate to control the environmental, strategic, creative, and managerial complexity of any cultural event, which, rather, must be explored and absorbed. Accordingly, it is suggested that a more systemic perspective be adopted through which routine project management tools are reviewed to pave the way for a new approach when organizing and managing cultural events.

Autologous peripheral blood stem cell transplantation (aPBSCT) provides optimal outcomes in POEMS syndrome but the definition of the best treatment before aPBSCT remains to be defined because of the rarity of the disease and the heterogeneity of published case series. We collected clinical and laboratory data of patients with POEMS syndrome undergoing aPBSCT from 1998 to 2020 in ten Italian centers. The primary endpoint of the study was to evaluate the impact of prior therapies and mobilization regimen on outcome. We divided the patients into three groups: patients who did not receive any treatment before transplant (15 patients, group A: front-line), patients pre-treated with other agents (14 patients, group B) and patients treated with cyclophosphamide as their mobilizing regimen (16 patients, group C). The three groups did not show differences in terms of demographic and clinical characteristics. All 45 patients underwent aPBSCT after a high-dose melphalan conditioning regimen, with a median follow-up of 77 months (range, 37-169 months). The responses were not statistically different between the three groups (P=0.38). Progression-free and overall survival rates at 6 years were: 70% (95% confidence interval: 55-85%) and 91% (95% confidence interval: 82-99) 65%, respectively, and did not differ between the three groups. The cumulative incidence of transplant-related mortality and relapse was 4% and 36%, respectively. In conclusion, in a relatively large number of patients with POEMS syndrome, undergoing an autologous transplant, pre-treatment and disease status at transplant did not appear to have an impact on major transplant outcomes.

Among the many neglected underutilized species, tuberous Andean root crops such as the ahipas (Pachyrhizus ahipa) constitute a promising alternative for increasing diversity in nutrient sources and food security at a regional level. ahipa × P. tuberosus). A significant objective was to determine protein and free amino acids in the roots to evaluate their food quality as protein supply. The interspecific hybrids have been found to possess the root quality to provide the crop with a higher dry matter content. The high dry matter content of the P. tuberosus Chuin materials is retained in the root quality of the hybrids. Food functional components such as carbohydrates, organic acids, and proteins were determined in several ahipa accessions and a stable (non-segregating) progeny of the interspecific hybrid, X207. The X207 roots showed a significantly higher dry matter content and a lower content in soluble sugars, but no significant differences were found in starch content or organic acids compared to the ahipa accessions. Regarding the root mineral contents, Fe and Mn concentrations in X207 were significantly raised compared to the average of ahipa accessions. Among the ahipa and the hybrid, no prominent differences in protein content or protein amino acids were found, being both partially defective in providing sufficient daily intake of some essential amino acids. Root weight, a central component of root yield, was significantly higher in X207, but thorough field studies are required to substantiate the hybrid’s superior yield performance. View Full-Text

Background: Enteroscopy plays an important role in the management of small bowel bleeding. However, current guidelines are not specifically designed for small bowel bleeding and recommendations from different international societies do not always align. Consequently, there is heterogeneity in the definitions of clinical entities, clinical practice policies, and adherence to guidelines among clinicians. This represents an obstacle to providing the best patient care and to obtain homogeneous data for clinical research. Aims: The aims of the study were to establish a consensus on the definitions of bleeding entities and on the role of enteroscopy in the management of small bowel bleeding using a Delphi process. Methods: A core group of eight experts in enteroscopy identified five main topics of small bowel bleeding management and drafted statements on each topic. An expert panel of nine gastroenterologists participated in three rounds of the Delphi process, together with the core group. Results: A total of 33 statements were approved after three rounds of Delphi voting. Conclusion: This Delphi consensus proposes clear definitions and a unifying strategy to standardize the management of small bowel bleeding. Furthermore, it provides a useful guide in daily practice for both clinical and technical issues of enteroscopy.

Children and adolescents with chronic pain are a vulnerable population who often lack the resources to manage their condition. Due to high personal, social, and economic consequences, proper management in its early stages is key to reducing disability. The aim of this project is to co-develop a digital intervention for pediatric chronic pain (Digital SPA) with end-users and to evaluate its effectiveness and implementation outcomes in Spain.(Phase 1) Focus groups with patients, parents, and clinicians (n = 5-6 each) will inform about unmet pain care needs and provide a starting point for co-designing the intervention. (Phase 2) Content creation and usability testing will be based on the results of Phase 1, and the theory-driven development will follow the latest available evidence. The intervention will use validated psychological techniques focused on improving functioning by teaching pain coping skills. (Phase 3) Hybrid effectiveness-implementation trial. Participants (n = 195) will be adolescents aged 12-17 years old with chronic pain and one of their parents. Assessments include physical function, pain, sleep, anxiety, mood, satisfaction and adherence to the treatment, and number of visits to the emergency room. A qualitative framework analysis will be conducted with data from Phase 1. Effects of the intervention will be evaluated using linear multilevel modeling. The Consolidated Framework for Implementation Research (CFIR) and Behavioral Interventions Using Technology (BIT) frameworks will be used to evaluate implementation.This study is expected to produce a co-created evidence-based digital intervention for pediatric chronic pain and a roadmap for successful implementation.ClinicalTrials.gov (registered on 26 June 2023: https://clinicaltrials.gov/study/NCT0591762

The restoration of mining areas, in particular if they are located near towns or villages, is essential to reduce their potential risks for human health and to minimize their visual impacts. In this study, we assess the rehabilitation of a waste rock pile adjacent to the town of Tharsis (SW Spain). We measured vegetation cover and its diversity, and chemical composition of plants and soil, twelve years after remediation by lime amendments, added topsoil and planted vegetation. In general, the applied measures were successful covering with woody vegetation the upper part of the waste rock pile, and providing a greening visual landscape for the town nearby. The most abundant species were the gum rockrose (Cistus ladanifer) and the legume shrub Retama sphaerocarpa, this latter species most probably introduced in the seedbank of the added topsoil. Also in the soil seedbank, probably arrived the invasive Acacia saligna, of fast growth. In contrast, the lower part of the slopes was almost devoid of vegetation. We interpret that partial failure in the rehabilitation process as due to the acid mine drainage, which caused downslope a decrease of soil pH and increased availability of trace elements, thus impeding growth and establishment of plants. In addition, some plants, like C. ladanifer, growing at the base of the rock pile, had concentrations of Cd above the maximum tolerable level for animals, therefore representing a toxicity risk. Finally, we propose here an alternative technique to restore waste rock piles, by sorting and selectively handling the extractive wastes, thus reducing infiltration rates, seepages and the negative effect of the acid mine drainage. Those modified waste rock piles will be rehabilitated by the addition of topsoil and planted vegetation, as successfully worked out in the upper slopes of the study site.

Urban agriculture increased in Seville (South Spain) in the last 20 years and play different roles in the urban context. Edible species can be contaminated by soil and airborne contamination leading to health risks. Samples of different crop and fruit species and their soils were collected in urban and rural gardens, including urban gardens from a mining area to investigate the potential contamination in food and soils. Results show that soils from mining gardens were the most contaminated. In the city, crops were generally not more contaminated those in the rural area. Most differences were observed between species, chard and lettuce were the species that reached the highest level of most elements’ accumulation and fruit always had lower metal accumulation than leafy vegetables. Arsenic, Cd, and Pb concentrations did not exceed the FAO/HWO and European legal maximum levels for vegetables studied, so their consumption would be safe for human health. The concentration of Cr, Cu, Mn, and Ni can be considered in the range cited in the bibliography. Special attention should be paid for leafy green vegetables (lettuce and chard) since high values of Ba and Zn were found, up to 42 and 123 mg kg−1, respectively, and the risk to human health associated with consuming these species should be studied. © 2021 by the authors. Licensee MDPI, Basel, Switzerland.

In Portugal, many abandoned mines are often close to agricultural areas and might be used for plant food cultivation. Soils in the vicinity of two Mn- and Fe-abandoned mines (Ferragudo and Rosalgar, SW of Portugal) were collected to cultivate two different food species (Brassica rapa subsp. pekinensis (Lour.) Hanelt and Origanum vulgare L.). Chemical characterization of the soil–plant system and potential risk of adverse effects for human health posed by plants associated with soil contamination, based on the estimation of hazard quotient (HQ), were assessed in a microcosm assay under greenhouse conditions. In both soils, the average total concentrations of Fe and Mn were above the normal values for soils in the region and their concentration in shoots of both species was very high. Brassica rapa subsp. pekinensis grew better in Ferragudo than in Rosalgar soils, and it behaved as an excluder of Cu, Mn, Fe, S and Zn in both soils. The HQ for Cu, Fe, Mn and Zn in the studied species grown on both soils was lower than unit indicating that its consumption is safe. The high Mn tolerance found in both species might be due in part to the high contents of Fe in the soil available fraction that might contribute to an antagonism effect in the uptake and translocation of Mn. The obtained results emphasize the need of further studies with different food crops before cultivation in the studied soils to assess health risks associated with high metal intake.

The effect of exposure to high Mn concentration was studied in a metallophyte species, Erica andevalensis, using hydroponic cultures with a range of Mn concentrations (0.06, 100, 300, 500, and 700 mg L−1). At harvest, biomass production, element uptake, and biochemical indicators of metal stress (leaf pigments, organic acids, amino acids, phenols, and activities of catalase, peroxidase, superoxide dismutase) were determined in leaves and roots. Increasing Mn concentrations led to a decrease in biomass accumulation, and tip leaves chlorosis was the only toxicity symptom detected. In a similar way, photosynthetic pigments (chlorophylls a and b, and carotenoids) were affected by high Mn levels. Among organic acids, malate and oxalate contents in roots showed a significant increase at the highest Mn concentration, while in leaves, Mn led to an increasing trend in citrate and malate contents. An increase of Mn also induced an increase in superoxide dismutase activity in roots and catalase activity in leaves. As well, significant changes in free amino acids were induced by Mn concentrations higher than 300 mg L−1, especially in roots. No significant changes in phenolic compounds were observed in the leaves, but root phenolics were significantly increased by increasing Mn concentrations in treatments. When Fe supply was increased 10 and 20 times (7–14 mg Fe L−1 as Fe-EDDHA) in the nutrient solutions at the highest Mn concentration (700 mg Mn L−1), it led to significant increases in photosynthetic pigments and biomass accumulation. Manganese was mostly accumulated in the roots, and the species was essentially a Mn excluder. However, considering the high leaf Mn concentration recorded without toxicity symptoms, E. andevalensis might be rated as a Mn-tolerant species.

The study investigated the emissions of volatile organic compounds (VOCs) from a mining soil amended with sewage sludge and irrigated with wastewater with or without tomato plants. The aim is to find out whether amendment and irrigation change VOC emissions from the soil and whether tomato changes emissions compared to uncultivated soil. Soil and plant experiments were done in assembled pots. All pots were placed inside a closed glass chamber inside an isolated and windowless room. Experiments with soil without plants were done independently from experiments with soil and plants. An aspirating pump coupled with Tenax adsorbent tubes was used for sampling of VOCs emitted from pots. Volatile organic compounds trapped in the tubes were quantified by gas chromatography–mass spectrometry detection. The study detected a total of nine VOCs emitted from the polluted soil: benzene, toluene, ethylbenzene, p-xylene, m-xylene, o-xylene, styrene, benzene-1,2,4-trimethyl and tetrachloroethylene, among which the most abundant were toluene, m-xylene and styrene. Differences between pots with or without amendments (C and A-pots) showed a general tendency to a decline of VOCs emissions in the mining soil amended with sewage sludge. Plants contributed to increase significantly the emissions of all VOCs in both A and C-pots. The soil amended with sewage sludge reduced the emission of VOCs: styrene in pots without plants and benzene and xylenes in pots with plants. Tomato plants contributed to increase significantly the emissions of all VOCs except styrene in both amended and non-amended soils.