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OBJECTIVE: This study examined the association of weight loss following bariatric surgery with self-reported sleep quality after accounting for other sleep-related factors. METHODS: Participants were from the Bariatric Experience Long Term (BELONG) study. Participants completed a survey up to 6 months before surgery and approximately 1 year after surgery. The Pittsburgh Sleep Quality Index (PSQI) was used to measure sleep quality. One-year percentage total weight loss (%TWL) was determined from electronic medical records. Covariates included demographics, Charlson Comorbidity Index, geocoded variables to assess neighborhood quality, and physical activity. The authors assessed the association between %TWL at 1 year and PSQI component scores with separate cumulative logit models. RESULTS: There were 997 participants in the analytic cohort. Participants were 86.2% women, 37.0% Hispanic, and 13.7% Black adults. Mean one-year %TWL was 26.3 (SD 8.7). Each 1% increase in %TWL was associated with a 3% better daytime dysfunction score (odds ratio = 1.03; 95% CI: 1.02–1.05) and a 2% better sleep quality score (odds ratio = 1.02; 95% CI: 1.00–1.03). No significant differences were found for the other PSQI components. CONCLUSIONS: Weight loss from bariatric surgery was associated with better self-reported sleep at 1 year. For people undergoing bariatric surgery, there may be an added benefit of better sleep.

Highlights • Primary hepatic neuroendocrine tumors are rare neoplasms, with less than 200 cases reported. • The clinical presentation of PHNETs is non-specific and its radiologic features are intensely diversified. • Surgical resection with clear margins is the mainstay treatment for PHNETs, with very positive results. • For unresectable tumors, liver transplantation and transcatheter arterial chemoembolization are the main options., Introduction Primary hepatic neuroendocrine tumors (PHNETs) are extremely rare, having less than 200 cases reported in the literature. Presentation of case A 51-year-old woman presenting with mild intensity sharp pain in the upper abdomen that started 4 years ago. Preoperative Magnetic Resonance Imaging (MRI) suggested hepatocellular adenoma. Surgical exploration found a tumor occupying the whole segment IV of the liver, therefore a left hepatectomy was performed. Pathology and immunohistochemistry indicated to be a low-grade neuroendocrine tumor of the liver. The patient is enjoying a good quality of life, free of disease, presenting no signs of recurrence nor metastases 12 months after the procedure. Conclusion The clinical presentation of PHNETs is non-specific and its radiologic features are intensely diversified, frequently leading to misdiagnosis of other hepatic neoplasms.

BackgroundThe characterization of differential molecular endotypes in osteoarthritis (OA) is essential for enabling patient stratification to enhance clinical trials, facilitate the development of targeted and individualized treatments.ObjectivesThis study aimed to characterize the profile and dynamics over 24 months (24M) of proteins present in the sera from patients in the IMI-Applied Public-Private Research enabling OsteoArthritis Clinical Headway (APPROACH) cohort who exhibited structural (radiographic) and pain progression compared to participants who did not progressed during this period.MethodsForty-five patients enrolled in the IMI-APPROACH cohort were selected for the proteomic analysis. Among these, 15 showed the highest structural progression (group S) and 15 the highest pain progression (group P) at 24M, according to the APPROACH criteria [1], while 15 did not progressed neither in S nor in P. Baseline (BL) and 24M serum samples were depleted of the top 14 most abundant proteins and then analysed by liquid chromatography coupled to tandem mass spectrometry (LC-MS/MS) on a nanoElute-LC coupled to a high-resolution TIMS-QTOF (timsTOF Pro, Bruker Daltonics). Proteins were identified and quantified using the LFQ algorithm of MaxQuant software. Further statistical and bioinformatic analyses were performed using Perseus and OmicsAnalyst software.ResultsThe proteomic analysis resulted in the identification of 558 proteins (10,466 peptides) in the serum samples. A label-free quantification algorithm was employed to quantify 468 proteins in the samples. Hierarchical clustering of the data showed the differences in protein abundance were more relevant longitudinally (BL to 24M) than in cross-sectional comparisons between the three groups under study (N, P or S). Sixty-three proteins were significantly altered (fold change >=1.5, pThe overlapping of these proteomic profiles was analyzed between groups and is shown in the Figure 1. Proteins modulated specifically in the N group may be associated with mechanisms related with joint repair. On the other hand, six proteins (including two apolipoproteins) were increased at 24M only in the P group. Finally, 30 proteins were modulated only in the S group: five of them increased and 25 decreased. Remarkably, this latter group includes lubricin, chaperones and proteins related with proteoglycan binding, such as COMP, fibronectin or histidine-rich glycoprotein.Figure 1.Circulating proteins identified as modulated after 24M follow-up in 45 patients from the APPROACH cohort that progressed in structure (S group; n=15), pain (P group; n=15) or did not progressed (N group; n=15). The numbers with arrows indicate those proteins that decrease (arrow pointing down) or increase (arrow pointing up) compared to baseline.ConclusionThe modulation of specific protein profiles in serum were identified as associated with the progression in structure, pain or non-progression in patients from the APPROACH cohort. Proteomic changes found specifically in the S group may be interesting circulating markers of the structural affectation occurring in the joint.References[1]van Helvoort EM, et al., BMJ Open. 2020 Jul 28;10(7):e035101. doi: 10.1136/bmjopen-2019-035101.Disclosure of InterestsCristina Ruiz-Romero: None declared, Patrik Önnerfjord: None declared, Valentina Calamia: None declared, Patricia Fernández Puente: None declared, Lucía Lourido: None declared, Rocío Paz González: None declared, Pawel Widera: None declared, Jaume Bacardit: None declared, Anne-Christine Bay-Jensen Shareholder of: Nordic Bioscience, Employee of: Nordic Bioscience, Francis Berenbaum Consultant of: AstraZeneca, Boehringer, Bone Therapeutics, CellProthera, Expanscience, Galapagos, Gilead, Grunenthal, GSK, Eli Lilly, Merck Sereno, MSD, Nordic, Nordic Bioscience, Novartis, Pfizer, Roche, Sandoz, Sanofi, Servier, UCB, Peptinov, 4P Pharma, 4Moving Biotech, Grant/research support from: TRB Chemedica, Ida K. Haugen Consultant of: Abbvie and Novartis, Grant/research support from: Pfizer, Margreet Kloppenburg Consultant of: Abbvie, Pfizer, Levicept, GlaxoSmithKline, Merck-Serono, Kiniksa, Flexion, Galapagos, Jansen, CHDR, Novartis, UCB, Simon Mastbergen: None declared, Jonathan Larkin Shareholder of: GlaxoSmithKline, Employee of: GlaxoSmithKline, Ali Mobasheri Consultant of: Merck KGaA, Kolon TissueGene, Pfizer Inc., Galapagos-Servier, Image Analysis Group (IAG), Artialis SA, Aché Laboratórios Farmacêuticos, AbbVie, Guidepoint Global, Alphasights, Science Branding Communications, GSK, Flexion Therapeutics, Pacira Biosciences, Sterifarma, Bioiberica, SANOFI, Genacol, Kolon Life Science, BRASIT/BRASOS, GEOS, MCI Group, Alcimed, Abbot, Laboratoires Expansciences, SPRIM Communications, Frontiers Media and University Health Network (UHN) Toronto, Grant/research support from: Merck KGaA, Kolon TissueGene, Pfizer Inc., Galapagos-Servier, Image Analysis Group (IAG), Artialis SA, Aché Laboratórios Farmacêuticos, AbbVie, Guidepoint Global, Alphasights, Science Branding Communications, GSK, Flexion Therapeutics, Pacira Biosciences, Sterifarma, Bioiberica, SANOFI, Genacol, Kolon Life Science, BRASIT/BRASOS, GEOS, MCI Group, Alcimed, Abbot, Laboratoires Expansciences, SPRIM Communications, Frontiers Media and University Health Network (UHN) Toronto, Francisco J. Blanco Consultant of: Gedeon Richter Plc., Bristol-Myers Squibb International Corporation (BMSIC), Sun Pharma Global FZE, Celgene Corporation, Janssen Cilag International N.V, Janssen Research & Development, Viela Bio, Inc., Astrazeneca AB, UCB BIOSCIENCES GMBH, UCB BIOPHARMA SPRL, AbbVie Deutschland GmbH & Co.KG, Merck KGaA, Amgen, Inc., Novartis Farmacéutica, S.A., Boehringer Ingelheim España, S.A, CSL Behring, LLC, Glaxosmithkline Research & Development Limited, Pfizer Inc, Lilly S.A., Corbus Pharmaceuticals Inc., Biohope Scientific Solutions for Human Health S.L., Centrexion Therapeutics Corp., Sanofi, TEDEC-MEIJI FARMA S.A., Kiniksa Pharmaceuticals, Ltd., Fundación para la Investigación Biomédica Del Hospital Clínico San Carlos, Grünenthal and Galapagos, Grant/research support from: Pfizer

Background Tumor Treating Fields (TTFields) are alternating electric fields disrupting cellular processes critical for cancer cell replication and tumor progression. TTFields therapy is approved for treatment of newly diagnosed glioblastoma (GBM), recurrent GBM, and unresectable malignant pleural mesothelioma, and is currently under clinical investigation for treating other solid tumors, such as ovarian cancer, non-small cell lung carcinoma (NSCLC), and hepatocellular carcinoma (HCC). The research herein aimed to identify potential treatment escape mechanisms and explore the possibility of targeted inhibition of these pathways for re-sensitizing the cells to TTFields. Material and Methods GBM U-87 MG, ovarian A2780, and NSCLC H1299 cells were treated with TTFields (1.7 V/cm RMS, 200 or 150 kHz) for continuous long-term application (7 or 13 days, specific conditions depending on the cell line). Changes in signaling pathways in these cells relative to cells exposed to short term TTFields application (3 or 7 days, depending on cell line) were examined by Luminex multiplex assay. Specific pathway markers were examined by immunohistochemistry of tumor sections from sham or TTFields-treated rats bearing N1S1 HCC tumors. TTFields were then co-applied with relevant pathway inhibitors, followed by cell count measurements and western blot examinations for specific pathway markers. The concomitant application of TTFields with a selected inhibitor was tested in mice inoculated orthotopically with MOSE-L firefly luciferase (FFL) ovarian cancer cells. Tumor volume was measured at study end by luciferin signal detection using the In Vivo Imaging System (IVIS). Results Cancer cells exposed to long-term application of TTFields displayed decreased sensitivity to TTFields. The PI3K/AKT/mTOR pathway was activated in these cells, with significant increases in AKT and RPS6 phosphorylation levels also observed in HCC tumors from rats treated with TTFields. PI3K inhibitors re-sensitized the cells to TTFields cytotoxicity, with associated down regulation of AKT phosphorylation. Application of TTFields concomitant with the PI3K inhibitor alpelisib resulted in enhanced efficacy in the ovarian cancer mouse model. Conclusions The current research demonstrated that PI3K/AKT/mTOR signaling pathway activation was involved in the response to long-term application of TTFields, with increased phosphorylation of key proteins observed both in vitro and in vivo. Concomitant treatment with PI3K inhibitors and TTFields re-sensitized the cells to TTFields, as it alleviated TTFields-induced AKT activation.

Patient: Female, 58-year-old Final Diagnosis: Mixed adenoneuroendocrine carcinoma of the gallbladder Symptoms: Abdominal pain • asthenia Medication: — Clinical Procedure: — Specialty: Surgery Objective: Rare disease Background: Mixed adenoneuroendocrine carcinoma of the gallbladder (gMANEC) is an extremely rare cancer. Most of the cases are reported in Asia, North America, and Europe, with no cases reported in Latin America; this is the first report for this region, and the 24th case reported worldwide. Case Report: A 68-year-old woman was referred to our department due to asthenia and moderate abdominal pain in the right upper quadrant for 6 months, with imaging examinations showing a solid heterogeneous expansive lesion in gallbladder topography and segment IV of the liver. The MRI displayed an expansive and heterogeneous lesion with inaccurate limits in the gallbladder affecting segment IVb of the liver, in addition to lymphadenopathy in the hepatic hilum. A cholecystectomy with resection of segments IV-B and V of the liver (radical cholecystectomy) and hepatic hilar lymphadenectomy were performed. Anatomopathological examination and immunohisto-chemistry confirmed a primary mixed adenoneuroendocrine carcinoma of the gallbladder. The patient received adjuvant chemotherapy and radiotherapy; however, after the patient reported experiencing low back pain, a CT was performed, revealing retroperitoneal metastasis, and the radiotherapy was interrupted. Currently, the patient has a stable disease, following a protocol of 5-Fluorouracil and somatostatin, and she reports having low back pain of low intensity. Conclusions: This is the 24th gMANEC case reported in the literature. The tumor was successfully resected; however, the patient presented retroperitoneal metastasis 6 months after surgery, despite combined adjuvant therapy.

In recent years, the biomedical industry has shown increased interest in using numerical methods to assist in the R&D of medical devices. The long-term goal is to reduce the costly and lengthy process that clinical trials take for the US Food and Drug Administration (FDA) to approve a medical device. For this reason, both the FDA and academia are working together to create laboratory experiments that will help the industry gain confidence in numerical techniques as well as provide software developers with insights into the strengths and weaknesses of numerical software. In this article, three benchmarks proposed by the FDA are used to compare experimental results with those of a finite element method formulation and enhanced particle finite element method (PFEM-2). The first benchmark problem is the flow in a nozzle containing both, a gradual and a sudden change in diameter with the goal of predicting hemolysis (not studied in this work). The second problem studies the flow in a simplified centrifugal blood pump under various operation conditions. Finally, the third benchmark studies the steady flow in a patient-averaged inferior vena cava. PFEM-2 is regarded as a tool with great potential, mainly because no stabilization is needed for the Galerkin approximation of the advection term in the transport equations. This could be a big advantage in problems with flows at high Reynolds number. The improved time integration along streamlines provide a more accurate way to analyze a problem with a large time step. This paper is an effort to test PFEM-2 in engineering applications.

BackgroundThe presence of anti-cytokine autoantibodies (ACAAs) seems to be a physiologic mechanism to control the immune response and regulate cytokine activity. Biological therapies also regulate cytokine activities and have greatly improved the quality of life of RA patients. However, alteration of the cytokine network by the use of these treatments may lead to a disbalance in the regulatory system of ACAAs. We hypothesize the ACAAs network may influence the course of immune response in RA patients and may be useful to predict the therapy efficacy.ObjectivesWe aimed to explore the potential of circulating ACAAs to predict flare in a cohort of RA patients treated with biological therapy.MethodsWe employed sera at baseline from 194 RA patients of the clinical trial OPTIBIO1 (A Coruña), whose primary endpoint is to evaluate the usefulness of standardized protocol strategies of dose reduction in patients with RA in clinical remission treated with biologics. These patients were treated with TNF inhibitors (Etanercept, N=47; Infliximab, N=12; Adalimumab, N=35; Certolizumab (CTZ), N=17; Golimumab, N=5), Tocilizumab (TCZ, N=60) and Abatacept (ABA, N=18). Patients were in clinical remission (DAS 28 ResultsThe levels of anti-17A and anti-IL-1α were increased in the sera from patients who suffered a flare during the follow-up period (N= 76), compared to those who remained in remission (N= 118), showing an area under the curve (AUC) of 0.586 and 0.594, respectively. Segregating by treatment, the levels of anti-17A were specifically increased in those relapsing patients under CTZ (N=6), ABA (N=12) and TCZ (N=20) treatment. The AUC of anti-17A within these three therapies was 0.867, 0.903 and 0.682, respectively. Logistic regression analysis also associated the levels of anti-17A with the risk of suffering a flare in TCZ-treated patients (OR=1.11; p=0.015, for 100 MFI increase). In addition, the TCZ-treated patients who suffered a flare also showed higher levels of anti-IL17F, anti-IL-1α, and anti-IL-18 compared to those that remained in remission, showing AUCs of 0.689, 0.657 and 0.698, respectively. Anti-IL-18 was also associated with the risk of flare in these patients (OR=1.65; p=0.028, for 100 MFI increase). The presence of these three ACAAs was also higher in the TCZ-treated patients who suffered a flare compared to those in remission.ConclusionAlthough further validation of our results is needed, we present a ground-breaking study showing the potential of anti-IL17A, anti-IL-1α, and anti-IL18 to predict flare in RA patients under biological therapies.References[1]Bejerano C, et al. Clinical evaluation usefulness of standardized protocol strategies of dose reduction in patients with RA in clinical remission treated with biologic therapies. The Optibio Study. Arthritis Rheumatol. 2016; 68 (suppl 10): 649.Table 1.Table showing a summary of the results. CI: confidence interval• Treatments• ACAAs• AUC (CI 95%; p)Allanti-IL17A0.586 (0.504-0.668; 0.044)anti-IL-1α0.594 (0.512-0.676; 0.028)CTZanti-IL17A0.867 (0.675,1.000; 0.017)ABAanti-IL17A0.903 (0.761-1.000; 0.007)TCZanti-IL-1α0.657 (0.494-0.820; 0.049)anti-IL-17F0.689 (0.551-0.827; 0.018)anti-IL17A0.682 (0.528-0.835; 0.023)anti-IL180.698 (0.545-0.850; 0.013)Disclosure of InterestsNone declared.

BackgroundThe differential diagnosis of Rheumatoid Arthritis (RA) and Psoriatic arthritis (PsA) is often difficult due to the similarity of symptoms and the unavailability of reliable clinical biomarkers. Molecular alterations have been suggested to contribute to the pathophysiological processes in the knee joint, and it is known that chronic inflammation induces significant changes in the synovial tissue (ST) and synovial fluid (SF) lipidome and proteome.ObjectivesWe aimed to evaluate whether specific characteristics in the molecular profiles from ST and SF could support the differential diagnosis of these diseases.MethodsST frozen samples of patients affected by RA (n=6), PsA (n=12) and control donors (n=10) were compared using Matrix-Assisted Laser Desorption Ionization Mass Spectrometry Imaging (MALDI-MSI) for spatially resolved lipid analysis. To this end, tissue sections were measured on a RapifleX MALDI-TOF/TOF instrument. Next, a targeted approach based on multiple reaction monitoring (MRM-MS) was performed to further validate the lipidomic alterations reported by MALDI-MSI between RA and PsA tissues. In this case, lipids extracted from SF (control donors (n=4), RA (n=21) and PsA (n=27)) were analyzed in a QTRAP 4000 mass spectrometer for the targeted analysis of 84 lipid species. Finally, a quantitative proteomic analysis was carried out on FFPE ST from RA (n=13), PsA (n=13) and controls (n=8) by nLC-MS/MS analysis using a TimsTOF Pro system (Bruker). Statistical analyses were performed using GraphPad Prism, Metaboanalyst and Perseus software.ResultsLipid profiles in ST from PsA and RA were unequivocally distinguished by MALDI-MSI followed by PCA-DA, and were also different comparing with control tissues. Interestingly, several lipid species, including sphingomyelins, phosphatidylcholines (PC) and phosphatidylethanolamines (PE), presented the greatest separation power to classify RA and PsA tissue samples. ANOVA analysis found 35 lipid species significantly different among the study groups, most of them significantly increased in RA and PsA compared to controls. Particularly, 11 lipids showed higher levels in PsA tissues compared with RA, including several PC and PE. The spatial distribution of these PE species was associated with areas of the sublining layer with increased vascularity and inflammatory cell infiltrates, according to MALDI-MSI images. On the other hand, RA and PsA patients were also correctly classified based on the SF levels of all quantified lipid species according to PCA and clustering analysis. Finally, the proteomic analysis quantified around 2,500 distinct proteins in the ST, including several related with lipid metabolism. Near 300 proteins showed altered abundance in the pathological tissues compared to healthy controls (FDR 0.01%, Figure 1A), being the small subset increased in controls mainly extracellular matrix proteins. The comparison between RA and PsA ST led to the identification of a panel of 36 proteins discriminating the two tissues with high statistical significance (p-value Figure 1.Results from the proteomic analysis carried out on synovial tissues. A) Heatmap showing the differential protein profiles between synovial tissues (PsA and RA) and healthy controls (CTL), at FDR 0.01. B) Characteristic protein panel discriminating PsA and RA tissues (p-value < 0.01). C) Discriminant analysis performed using this protein panel.ConclusionOur study shows distinct molecular profiles between RA and PsA synovial tissue and synovial fluid, and reports potential clinically useful lipid and protein markers for the differential diagnosis of these diseases.Disclosure of InterestsNone declared.

PurposeThe Bariatric Experience Long Term (BELONG) prospective study cohort was created to address limitations in the literature regarding the relationship between surgical weight loss and psychosocial, health, behaviour and environmental factors. The BELONG cohort is unique because it contains 70% gastric sleeve and 64% patients with non-white race/ethnicity and was developed with strong stakeholder engagement including patients and providers.ParticipantsThe BELONG cohort study included 1975 patients preparing to have bariatric surgery who completed a baseline survey in a large integrated health system in Southern California. Patients were primarily women (84%), either black or Hispanic (59%), with a body mass index (BMI) of 45.1±7.4 kg/m2, age 43.3±11.5 years old, and 32% had at least one comorbidity.Findings to dateA total of 5552 patients were approached before surgery between February 2016 and May 2017, and 1975 (42%) completed a baseline survey. A total of 1203 (73%) patients completed the year 1 and 1033 (74%) patients completed the year 3 postoperative survey. Of these survey respondents, 1341 at baseline, 999 at year 1, and 951 at year 3 were included in the analyses of all survey and weight outcome data. A total of 803 (60% of eligible patients) had survey data for all time points. Data collected were self-reported constructs to support the proposed theoretical model. Height, weight and BMI were abstracted from the electronic medical record to obtain the main outcomes of the study: weight loss and regain.Future plansWe will collect self-reported constructs and obtain height, weight and BMI from the electronic medical record 5 years after bariatric surgery between April 2022 and January 2023. We will also collect patient experiences using focus groups of 8–12 patients each throughout 2022.

Background Liposarcoma of the gallbladder is an extremely rare sarcoma, with only five cases reported in the literature according to our knowledge. Case presentation A 71-year-old woman was referred to the Surgical Oncology Division of Napoleão Laureano Hospital (João Pessoa, PB, Brazil) due to a solid mass at the right side of the abdomen and fever, with no signs of jaundice. Abdominal ultrasonography and computed tomography (CT) evidenced an extensive gallbladder lobular formation adhered to the inferior border of the right hepatic lobe and cholelithiasis. The CT report suggested gallbladder liposarcoma. A cholecystectomy associated with resection of segments IV-B and V of the liver were performed. Intraoperative frozen sections were compatible with gallbladder sarcoma. Anatomopathological examination and immunohistochemistry confirmed dedifferentiated liposarcoma with foci of heterologous leiomyosarcomatous differentiation and undifferentiated fusocellular areas of high histological grade. Conclusion This is the first case of dedifferentiated liposarcoma of the gallbladder to be reported.

Background Migrant populations usually report higher smoking rates. Among those migrant populations, Turkish- and Kurdish-speaking migrants are often overrepresented. Providing equal access to health services is one of major challenges of our time. The need for adapted smoking-cessation treatments for Turkish-speaking populations to achieve equity in health led, in 2006, to the development and implementation of the Tiryaki-Kukla smoking-cessation program in Switzerland. Since 2006, 5'305 Turkish-speaking migrants in Switzerland were reached with tobacco-related information and the offer of tailored treatment. In short, the treatment was grounded in behavioral therapy and was adapted from the weekly group-counseling sessions applied by the Cancer League Zurich. The adaptation focused on language, cultural and health literacy issues. The aims of the study were to evaluate one-year quit rates for smoking-cessation courses held from 2006 to 2018 and investigate whether certain characteristics predict long-term abstinence. Methods Evaluation of the program included a pre/post questionnaire (session 1/ 3 months after the quit day) and a follow-up telephone call twelve months after the quit day. To elucidate factors associated with long-term abstinence, Cox regression analysis and Weighted Generalized Equation Models were used. Results Of the 478 who participated in smoking-cessation courses, 45.4% declared themselves non-smokers at one-year follow-up. Characteristics associated with long-term abstinence were length of the course (eight vs. six sessions), adherence to the course, use of pharmacotherapy or NRT products, and baseline level of dependence. Conclusions Our findings are consistent with existing evidence supporting culturally-adapted smoking cessation interventions to reduce health inequity in migrant populations. However, achieving harm reduction in smokers with higher dependence scores remains challenging. Key messages A culturally-adapted smoking cessation course showed effective to reduce health inequity. One challenge remains: Achieving harm reduction in migrants with higher dependence scores.

Background Life-skills trainings conducted within the school curriculum are effective in preventing the onset and escalation of substance use among adolescents. However, their dissemination is impeded due to their large resource requirements. Life-skills training provided via mobile phones might represent a more economic and scalable approach. Methods The efficacy of a mobile phone-based life-skills training to prevent substance use among adolescents is currently tested in comparison to an assessment only control group, within a cluster-randomised controlled trial with follow-up assessments after 6 and 18 months. The fully automated program is based on social cognitive theory and addresses self-management skills, social skills, and substance use resistance skills. Participants of the intervention group receive up to 4 individually-tailored text messages per week for a period of 6 months. The study started in 2019 and aims for 1,312 study participants between the ages of 14 and 16 years from approx. 100 secondary school classes in Switzerland. Outcomes are 1) problem drinking, 2) cigarette smoking, 3) perceived stress and 4) interpersonal competences. Results So far, 1'611 students within 88 secondary school classes were invited to participate in the study. Of these, 1,450 (90.0%) consented to participate. To date, 24 out of 726 (3.3%) participants of the intervention group discontinued the program and 945 (65.2%) were invited for 6-month follow-up. Of these, 752 (79.6%) completed the assessment. Preliminary analyses showed a beneficial effect of the intervention for the subscale negative assertion, assessed by the brief version of the Interpersonal Competence Questionnaire. Conclusions A large proportion of adolescents participated in this first study testing the efficacy of a mobile phone-based life-skills training for substance use prevention and the majority of them participated at 6-month follow-up. Key messages A novel, mobile phone-based life-skills training seems widely accepted by secondary students. Given its effectiveness, it could be economically implemented within secondary schools.

Background With the hypothesis that equine dorsal lamellar tissue can be desensitized by anesthesia injection into distal interphalangeal joint (DIPJ), the objective was to assess the mechanical nociceptive threshold of hoof dorsal lamellae following intra-articular (IA) administration of lidocaine into this joint. Methods The DIPJ of the forelimbs of six adult healthy horses were injected with either 5 mL of lidocaine, or 5 mL of lactated Ringer’s solution. Treatments were randomly distributed, with each forelimb undergoing a single treatment. The hooves were evaluated pre- and post-injection at pre-selected times over 4 h, using a pressure algometry model. Mechanical nociceptive thresholds (MNTs) were recorded for the sole (dorsal, palmarolateral, and palmaromedial regions), coronary band (medial, lateral, and dorsal regions), heel bulbs (medial and lateral), and dorsal lamellar region (2 cm and 4 cm distal to the coronary band). The MNT means were compared over time using the Friedman test and between treatments using the Wilcoxon signed-rank test, with values of P Results There were no differences between treatments for any region of the hoof during the evaluation period. However, MNT values indicating analgesia were recorded in the dorsal lamellar region in 50% of hooves following adminstration of lidocaine into the DIPJ. Conclusion The administration of 5 mL of lidocaine into the DIPJ does not significantly increase the mechanical nociceptive threshold of the equine hoof.

RESUMEN Introducción: Actualmente la cirugía laparoscópica es el gold standard de la mayoría de las cirugías ginecológicas benignas. Se estima una tasa de complicaciones en cirugía ginecológica por laparoscopía de 3.2 por 1000 pacientes, donde alrededor del 50% ocurren al momento de la primera entrada. Existen numerosas clasificaciones de las complicaciones quirúrgicas, entre ellas, la clasificación Clavien-Dindo se centra en el tratamiento postquirúrgico y tiene como objetivo unificar criterios y hacerlas comparables entre distintos centros. Objetivo: Describir las complicaciones en cirugía laparoscópica ginecológica en el Hospital Padre Hurtado, destacando el subgrupo de primera entrada y su clasificación Clavien-Dindo. Metodología: Cohorte retrospectiva que incluyó a todas las pacientes operadas por laparoscopía en el pabellón de ginecología del Hospital Padre Hurtado desde el año 2014 al 2017. Se utilizó el software SPSS statistics v25, con prueba X2 para el análisis de las variables no paramétricas y t de Student para las variables paramétrica, considerando una significación estadística con pIII B, lo que correspondió a un 0,39%. Conclusión: En nuestro grupo hubo una baja incidencia de complicaciones quirúrgicas y de primera entrada lo que es comparable con otras series publicadas.

The Osteoarthritis Initiative (OAI) is a public-private partnership comprised of five contracts (N01-AR-2-2258; N01-AR-2-2259; N01-AR-2-2260; N01-AR-2-2261; N01-AR-2-2262) funded by the National Institutes of Health, a branch of the Department of Health and Human Services, and conducted by the OAI Study Investigators. Private funding partners include Pfizer, Inc.; Novartis Pharmaceuticals Corporation; Merck Research Laboratories; and GlaxoSmithKline. Private sector funding for the OAI is managed by the Foundation for the National Institutes of Health. This work has been supported by grants from Fondo Investigación Sanitaria (PI16/02124, PI17/00404, PI19/01206, DTS17/00200, CIBER-CB06/01/0040 and RETIC-RIER-RD16/0012/0002), integrated in the National Plan for Scientific Program, Development and Technological Innovation 2013–2016 and funded by the ISCIII-General Subdirection of Assessment and Promotion of Research-European Regional Development Fund (FEDER) “A way of making Europe”. This study has been also supported by grants IN607A2017/11, IN607D2020/10 and AE CICA-INIBIC (ED431E 2018/03) from Xunta de Galicia. The Proteomics Unit of GIR belongs to ProteoRed, PRB3- ISCIII (PT17/0019/0014). L.L. is supported by Xunta de Galicia (IN606B-2016/2005) and Contrato Sara Borrell (CD19/00229) Fondo de Investigación Sanitaria, ISCIII. I.R.P. is supported by Contrato Miguel Servet-II Fondo de Investigación Sanitaria (CPII17/00026). This work was also supported by the KTH Center for Applied Precision Medicine funded by the Ehrling Persson foundation, as well as the Human Protein Atlas project funded by Knut and Alice Wallenberg Foundation Xunta de Galicia; IN607A2017/11 Xunta de Galicia; IN607D2020/10 Xunta de Galicia; ED431E 2018/03 Xunta de Galicia; IN606B-2016/2005

Approximately 75% of cardiac tumors are benign, and 25% are malignant cardiac tumors. Of these, sarcomas are extremely rare and have been described in isolated case reports. Due to its rarity, there is no published guideline for the management of this pathological entity. We present a case of an 85-year-old female who presented to our hospital with a chief complaint of shortness of breath and pinpointed left-sided chest pain. Computed tomography of the chest showed a filling defect in the left atrium concerning a mass versus thrombus. A transesophageal echocardiogram showed a 4 cm multi-lobular echogenic mass with calcifications in the left atrium likely arising from the pulmonary vein suspicious for malignancy. Cardiovascular surgery department scheduled the patient for surgical debulking/removal via a minimally invasive approach. The specimen was reported to be multi-lobular and was resected in several fragments of tan, fleshy, and somewhat gelatinous appearing tissue in aggregate. Histopathology showed spindle cell malignant neoplasm with small foci of bone and cartilaginous formation, suggestive of osteosarcoma. Expert consultation at John Hopkins reported this to be a high-grade sarcoma with focal osteosarcomatous differentiation. Cardiac synovial sarcomas are less than 0.1% of all primary cardiac tumors reported in the literature. Cardiac synovial sarcomas are not extensively described in literature due to their low incidence and prevalence. Thus, it is important to report cases and follow outcomes. This case reports an extremely rare diagnosis that has been reported in less than seven case reports.

Quality tools such as Kano’s model, SERVQUAL, and Quality Function Deployment (QFD) have been used to design and improve services. Although these tools can be used separately, their integration can provide a deep analysis of the service quality, generating opportunities for its improvement. However, the effective integration of these tools requires the proper handling of their variables, which contains imprecision and uncertainties since they are based on customer’s perceptions. Fuzzy approaches are feasible alternatives to overcome these limitations and integrate these tools. Nevertheless, sophisticated fuzzy methods can deal better with these limitations. This article proposes an integrative framework involving SERVQUAL, Analytical Kano (A-Kano), and QFD using fuzzy approaches (Fuzzy Inference System and 2-tuple fuzzy linguistic representation). The framework comprises four main phases concerning (i) the identification of quality attributes and service processes using the A-Kano and SERVQUAL; (ii) the integration of these two quality tools using the Fuzzy Inference System (FIS); (iii) the integration between A-Kano and SERVQUAL output and QFD matrix using 2-tuple fuzzy linguistic representation; and (iv) the identification of improvement projects to address the opportunities identified in the previous phases. The proposed integrative framework was tested and validated in an entrepreneurial education company that provides experiential services. It contributes to providing a new method to assess the service quality perceptions, categorizing these perceptions according to their effects on customer satisfaction, prioritizing improvements, and identifying technical requirements. Mainly, this study presents a new proposal for integrating the SERVQUAL, A-Kano, and QFD using advanced fuzzy techniques, which contributes to overcoming the limitations found in the extant literature.

Purpose/Objective(s) Tumor Treating Fields (TTFields) therapy is a clinically applied loco-regional, non-invasive, anti-mitotic treatment modality delivering to the tumor low intensity (1-3 V/cm) alternating electric fields (100-300 kHz). While TTFields therapy has demonstrated proven efficacy in management of glioblastoma and malignant pleural mesothelioma, tumor recurrence still occurs in some patients. In order to anticipate potential molecular mechanisms of resistance to TTFields, we developed TTFields-resistant cancer cell lines, and analyzed the changes in their signaling pathways. We also examined the in vitro efficacy of TTFields when combined with agents targeting the molecular candidates that possibly confer resistance to TTFields. Materials/Methods To evaluate the mechanisms of cellular resistance to TTFields, we developed resistant ovarian (A2780), glioma (U-87-MG), and non-small cell lung carcinoma (H1299) cancer cell lines through continued long-term application of TTFields (one or two weeks, depending on the cell line), without treatment breaks. We then assessed the concomitant changes in cellular signaling pathways using an immunoassay followed by Western blot analysis. Finally, we characterized the mechanism of resistance by examining the in vitro efficacy of continued long-term application of TTFields in combination with pharmacological inhibitors including a PI3K/mTOR dual inhibitor (BGT226), and Pan- and isoform-specific inhibitors of PI3K (alpelisib, pictilisib, and BKM120), using cell count, apoptosis, and colony formation assays. Results Continued long-term application of TTFields resulted in reduced sensitivity to TTFields in all tested cell lines. Immunoassay and Western blot analysis showed significant activation of the PI3K/AKT/mTOR signaling pathway in response to TTFields treatment. The combination therapy of TTFields with either alpelisib, pictilisib, BKM120 or BGT226, inhibited AKT S473 phosphorylation and sensitized cancer cells to “long-term” TTFields application. Conclusion Our study demonstrates that the PI3K/ AKT/ mTOR signaling pathway confers resistance to TTFields. This provides a rationale for the combined targeting of PI3K in patients treated with TTFields.

No Estado do Pará, a diversidade territorial fez com que a Covid-19 impactasse a ativi-dade turística de forma diferenciada em suas sub-regiões. Neste sentido, levando-se em consideração uma abordagem da produção do espaço turístico, em contexto pandêmico, este artigo analisa as particularidades do impacto da Covid-19 nas seguintes regiões tu-rísticas paraenses referentes ao ano de 2020: Região Metropolitana de Belém, Região dos Campos do Marajó, Região Baixo Tapajós e Região Carajás. Nessas quatro regiões selecionadas são apresentados os impactos da Covid-19 nos fluxos de transportes e atra-tivos na região, no caso da Região do Tapajós; as contradições da pandemia da Covid-19 na região do Carajás, no que se refere aos dados de restaurantes e outros estabeleci-mentos de serviços de alimentação e bebidas e hotéis; e para a região Metropolitana de Belém e dos Campos Marajó são apresentados os impactos nos empregos no setor de Hospedagem, assim como na movimentação na atividade de organização de eventos. E, por fim, os principais impactos da pandemia apontados pelos agentes entrevistados nes-sas duas últimas regiões. A partir de dados estatísticos de instituições que fazem levan-tamento de informações periódicas, conclui-se que em todas as regiões selecionadas para análise dos impactos do turismo, ocorreu um significativo endividamento do setor du-rante o ano de 2020 a despeito das medidas adotadas pelo Estado para dirimir esses impactos. Nesse sentindo, o baixo nível de capital dos estabelecimentos e a falta de pre-visão de retomada total das atividades dos agentes do setor tem inviabilizado a retoma-da do turismo no território paraense.

Both modern humans (MHs) and Neanderthals successfully settled across western Eurasian cold-climate landscapes. Among the many adaptations considered as essential to survival in such landscapes, changes in the nasal morphology and/or function aimed to humidify and warm the air before it reaches the lungs are of key importance. Unfortunately, the lack of soft-tissue evidence in the fossil record turns difficult any comparative study of respiratory performance. Here, we reconstruct the internal nasal cavity of a Neanderthal plus two representatives of climatically divergent MH populations (southwestern Europeans and northeastern Asians). The reconstruction includes mucosa distribution enabling a realistic simulation of the breathing cycle in different climatic conditions via computational fluid dynamics. Striking across-specimens differences in fluid residence times affecting humidification and warming performance at the anterior tract were found under cold/dry climate simulations. Specifically, the Asian model achieves a rapid air conditioning, followed by the Neanderthals, whereas the European model attains a proper conditioning only around the medium-posterior tract. In addition, quantitative-genetic evolutionary analyses of nasal morphology provided signals of stabilizing selection for MH populations, with the removal of Arctic populations turning covariation patterns compatible with evolution by genetic drift. Both results indicate that, departing from important craniofacial differences existing among Neanderthals and MHs, an advantageous species-specific respiratory performance in cold climates may have occurred in both species. Fluid dynamics and evolutionary biology independently provided evidence of nasal evolution, suggesting that adaptive explanations regarding complex functional phenotypes require interdisciplinary approaches aimed to quantify both performance and evolutionary signals on covariation patterns. Fil: de Azevedo, Soledad. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Centro Nacional Patagónico. Instituto Patagónico de Ciencias Sociales y Humanas; Argentina Fil: González, M. F.. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Centro Nacional Patagónico. Instituto Patagónico de Ciencias Sociales y Humanas; Argentina Fil: Cintas, Celia. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Centro Nacional Patagónico. Instituto Patagónico de Ciencias Sociales y Humanas; Argentina Fil: Ramallo, Virginia. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Centro Nacional Patagónico. Instituto Patagónico de Ciencias Sociales y Humanas; Argentina Fil: Quinto Sanchez, Mirsha Emmanuel. Universidad Nacional Autónoma de México; México Fil: Marquez, Federico. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Centro Nacional Patagónico. Instituto de Biología de Organismos Marinos; Argentina Fil: Hünemeier, Tábita. Universidade de Sao Paulo; Brasil Fil: Paschetta, Carolina Andrea. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Centro Nacional Patagónico. Instituto Patagónico de Ciencias Sociales y Humanas; Argentina Fil: Ruderman, Anahí. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Centro Nacional Patagónico. Instituto Patagónico de Ciencias Sociales y Humanas; Argentina Fil: Navarro, Jose Pablo. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Centro Nacional Patagónico. Instituto Patagónico de Ciencias Sociales y Humanas; Argentina Fil: Pazos, Bruno Alfredo. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Centro Nacional Patagónico. Instituto Patagónico de Ciencias Sociales y Humanas; Argentina Fil: Silva de Cerqueira, Caio Cesar. Superintendência da Polícia Técnico-Científica do Estado de São Paulo, Equipe de Perícias Criminalísticas de Ourinhos; Brasil Fil: Velan, O.. Hospital Italiano; Argentina Fil: Ramírez Rozzi, F.. Anthropologie Moléculaire et Imagerie de Synthèse; Francia Fil: Calvo, N.. Universidad Nacional del Litoral; Argentina Fil: Castro, Hugo Guillermo. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Nordeste. Instituto de Modelado e Innovación Tecnológica. Universidad Nacional del Nordeste. Facultad de Ciencias Exactas Naturales y Agrimensura. Instituto de Modelado e Innovación Tecnológica; Argentina Fil: Paz, Rodrigo Rafael. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Livermore Software Technology Corporation.; Estados Unidos Fil: González José, Rolando. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Centro Nacional Patagónico. Instituto Patagónico de Ciencias Sociales y Humanas; Argentina

The interest in synthetic methods relies in the fact that reliability of methodologies such as large eddy simulations (LES) or direct numerical simulations strongly depends on how well the developed turbulence is characterized, which generally leads to computationally expensive simulations. Turbulence generation methods allow the initialization and up-keeping of the velocity fluctuations field to promote the observed/needed turbulence in the flow. In this work the methodology known as ‘modified discretizing and synthesizing random flow generation’ (MDSRFG) jointly with a LES method is analyzed for its use in the study of tall building aerodynamics. A comparison with other generation techniques, that are closely related by their features and their conceptual origins, is presented with particular emphasis on the correct representation of the coherence of the velocity field. Particularly, an expression for the coherency function for the MDSRFG is derived. After an analysis and revision of these generation methodologies, the turbulent air flow around a rectangular prismatic model is computationally simulated. A comparison of the results obtained from different methods is performed. The resulting wind loads on the model, along with the statistical characteristics of the flow, show that the MDSRFG technique allows to represent a field of spatially correlated velocities correctly. Fil: Castro, Hugo Guillermo. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad Tecnológica Nacional. Facultad Regional Resistencia. Grupo de Investigación en Mecanica de Fluidos; Argentina Fil: Paz, Rodrigo Rafael. Livermore Software Technology Corporation; Estados Unidos. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Santa Fe. Centro de Investigaciones en Métodos Computacionales. Universidad Nacional del Litoral. Centro de Investigaciones en Métodos Computacionales; Argentina Fil: Mroginski, Javier Luis. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad Nacional del Nordeste. Facultad de Ingeniería; Argentina Fil: Storti, Mario Alberto. Universidad Nacional del Litoral; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Santa Fe. Centro de Investigaciones en Métodos Computacionales. Universidad Nacional del Litoral. Centro de Investigaciones en Métodos Computacionales; Argentina

Context: uropathogenic Escherichia coli (ECUP) is one of the main etiologic agents in uncom-plicated urinary tract infections (UTIs),(70-95%). The end point of antibiotic therapy is a full clinical and microbiological response. Objective: to identify bacterial resistance profiles to firstline antibiotics, used to treat uncomplicated UTI’s within indigenous communities in Ecuador, where the empiric treatment approach is based mainly on the use of trime-thoprim/sulfamethoxazole, ampicillin and ciprofloxacin.Methods: a total of 335 urine samples were collected and analysed during a four-month period (February- May 2016) in Zumbahua, Colta and Guamote. The samples were incubated for 24 and 48 hours in Eosin Methylene Blue (EMB) and subsequently identified at the genus and species level by biochemical tests. The Kirby-Bauer method (disc diffusion) was performed for phenotypic profiling of antibiotic susceptibility, and for the minimum inhibitory concentration (MIC), Vitek 2 broth micro-dilution was used. The double disk method was used for the identification of extended spectrum beta-lactamases (ESBL).Results: 90/335 (26,9%) urine samples were compatible with ITU (significant count of ≥105 colony forming units cfu/ml). The most frequently microorganism recov-ered was E.coli (n=75; 83,3%). The antibiotic resistance found in E. coli was trime-thoprim/sulfamethoxazole 56,7%; 52,5% to ampicillin; 43.3% to nalidixic acid; 32.5% to ciprofloxacin; 28.3% to norfloxacin; 25% to levofloxacin; 15.85% to cefazolin; 17.5% to cefoxitin, 15%; to cefuroxime; 15% to ceftazidime, cefotaxime, and ceftriaxone; 15% to cefepime; 7,5% to nitrofurantoin and 1,7% to phosphomycin. Seven extended spectrum betalactamases (ESBL) isolates were identified.Conclusion: these results drive to the recommendation of not using ampicillin, trimethoprim/sulfamethoxazole, nor quinolones in the area studied. We recommend empirical therapy with phosphomycin or nitrofurantoin Contexto: Escherichia coli uropatógena (ECUP) se presenta como uno de los principales agentes etiológicos en infecciones del tracto urinario (ITUs) no complicadas (70-95%). El objetivo del tratamiento de ITUs no complicadas es obtener curación clínica y microbiológica. Para ello, es de particular importancia el conocimiento de las tasas de resistencia antibiótica local.Objetivo: identificar los perfiles de resistencia a antibióticos de primera línea para ITUs no complicadas en poblaciones nativas amerindias Kichwas ecuatorianas, en donde el tratamiento empírico se basa en trimetoprim/sulfametoxazol, ampicilina, y ciprofloxacina mayoritariamente.Métodos: se analizaron 335 muestras de orina procedentes de las poblaciones de Zumbahua, Colta y Guamote, en un periodo de 4 meses (febrero-mayo 2016). Las muestras fueron incubadas por 24 y 48 horas en agar Eosin Methylene Blue (EMB), para luego ser identificadas en género y especie por pruebasbioquímicas. Para determinar la susceptibilidad antibiótica, se realizó la técnica de difusión en disco de Kirby-Bauer. Para la Concentración Inhibitoria Mínima (CIM), se utilizó la técnica de microdilución en caldo (Vitek 2). El método de doble disco fue la técnica utilizada para la detección de betalactamasas deespectro extendido (BLEE).Resultados: noventa (26,9%) muestras mostraron un recuento significativo de ≥105 (ufc)/ml, compatibles con ITUs. El microorganismo identificado con mayor frecuencia fue E. coli (n=75; 83,3%). La resistencia antibiótica encontrada para los aislados de E. coli fue de 56,7% a trimetoprim/sulfametoxazol, 52,5% aampicilina, 43.3% a ácido nalidíxico, 32.5% a ciprofloxacina, 28.3% a norfloxacina, 25% a levofloxacina, 15.85% a cefazolina, 17.5% a cefoxitina, 15% a cefuroxima, 15% a ceftazidima, cefotaxima, y ceftriaxona, 15% a cefepima, 7,5% a nitrofurantoina y 1,7% a fosfomicina. Se identificaron 7 aislados productores de betalactamasas de espectro extendido (BLEE).Conclusión: con los resultados obtenidos se recomienda no utilizar ampicilina, trimetoprim/sulfametoxazol, ni quinolonas en la zona estudiada como terapia empírica. Se sugiere instaurar tratamiento empírico con fosfomicina o nitrofurantoina para ITUs no complicadas

Experiential avoidance (EA)—or psychological (in)flexibility—is a central concept in contextual therapies, and it has been proposed as a transdiagnostic dimension of psychopathology. We intended to test whether EA and other coping strategies independently predict both state and trait-anxiety. We administered a set of measures (the AAQ-II, a modified version of the Brief COPE, and the STAI) to 284 undergraduates from a public university in Lima, Peru. Results showed that EA, lack of problem solving, self-blame, and substance use were all significantly related to state and trait-anxiety. However, after submitting these variables to multiple regression analyses, only EA, lack of problem solving, and self-blame remained significant predictors of trait-anxiety; of these, only EA made a significant improvement to the model (ΔR² = .16). On the other hand, none of the variables under study were significant predictors of state-anxiety. We concluded that the effort to avoid unpleasant thoughts and emotions constitutes a central aspect of trait-anxiety. We discussed these findings in light of previous studies, and gave suggestions for future research.

Objective: To perform a systematic review and meta-analysis of executive functions (EF) and episodic memory in bipolar disorder (BD). Methods: A literature search was conducted on three electronic databases. Results were combined using random-effects meta-analysis. Results: A total of 126 studies (6424 patients with BDI, 702 with BDII, and 8276 controls) were included. BDI was associated with moderate to large impairments across all cognitive functions and BDII with small-tomedium impairments. Small significant differences were identified between BDI and BDII on all cognitive functions except inhibition. The Trail Making Test (TMT) (g = 0.74, 95% CI: 0.67–0.80), Hayling Test (g = 0.58, 95% CI: 0.34–0.81), Digit Span Total (g = 0.79, 95% CI: 0.57– 1.01), and Category Fluency (g = 0.59, 95% CI: 0.45–0.72) tasks were most sensitive to cognitive impairment in BDI. The TMT (g = 0.65, 95% CI: 0.50–0.80) and Category Fluency (g = 0.56, 95% CI: 0.37–0.75) were also sensitive to cognitive alterations in patients with BDII. Conclusion: BD type I was associated with more severe and widespread impairments than BDII, which showed smaller impairments on all functions except inhibition, where impairments were larger. Education and (hypo)manic symptoms should be further investigated in future studies due to their possible influence on the neuropsychological profile of BD. The instruments identified in this review should be considered for inclusion in cognitive assessment batteries in BD. Fil: Cotrena, Charles. Pontificia Universidade Católica do Rio Grande do Sul; Brasil Fil: Damiani Branco, Laura. Pontificia Universidade Católica do Rio Grande do Sul; Brasil Fil: Ponsoni, André. Pontificia Universidade Católica do Rio Grande do Sul; Brasil Fil: Samame, Cecilia. Universidad de Buenos Aires. Facultad de Psicología; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Saavedra 15. Centro Interdisciplinario de Investigaciones en Psicología Matemática y Experimental Dr. Horacio J. A. Rimoldi; Argentina Fil: Milman Shansis, Flávio. Universidad de Vale do Rio dos Sinos; Brasil Fil: Paz Fonseca, Rochele. Pontificia Universidade Católica do Rio Grande do Sul; Brasil

Este trabalho aborda a formação tecno-científica na área de administração rural, partindo da necessidade de proposição e desenvolvimento de um modelo metodológico sistêmico que busque apreender a especificidade da lógica e racionalidade organizacional e administrativa da unidade de produção, a partir de uma análise do desempenho dos sistemas de produção presentes na agricultura, de modo a subsidiar a tomada de decisão estratégica no âmbito da gestão da organização da produção agrícola. Neste trabalho, foi definido como objeto de estudo empírico para aplicação de modelo, um estudo dirigido em uma unidade de produção agrícola familiar presente na agricultura do município de Santo Antônio das Missões/RS (Brasil). Os procedimentos metodológicos de levantamentos de dados qualitativos e quantitativos dos subsistemas produtivos foram sistematizados em uma planilha eletrônica, a qual permitiu estabelecer modelos globais de análise de desempenho organizacional partir do valor agregado e da renda agrícola, determinando a dinâmica de funcionamento da unidade de produção, com perspectivas de estabelecer uma gestão estratégica para uma produção competitiva e promoção da reprodução social do agricultor.

This paper presents a mathematical deterministic adaptive distance protection formulation for UPFC compensated transmission lines. The proposed formulation is developed using a phase component approach and considers and compensates for various UPFC operation conditions and non-zero fault resistances. The proposed methodology is completely adaptive and independent of system characteristics (such as changes in transmission line impedances) or operating conditions (such as different load conditions and controlled reference parameters). Moreover, the proposed formulation uses local and remote end voltage and current signals as input data. The comparative test results demonstrate potential beneficial aspects of the proposed formulation for real-time applications.