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Active gust load alleviation techniques exhibit a high potential in significantly reducing the transient gust loads on aircraft. In this work the aerodynamic potential of trailing-edge flaps and leading-edge flaps is numerically studied with the purpose to significantly reduce the structural gust loads. The utilized spanwise-segmented flaps represent slight modifications of existing devices for high-lift and maneuvering. The investigations based on unsteady Reynolds-averaged Navier–Stokes computations are conducted by employing a generic wing–fuselage aircraft configuration at transonic flow conditions. Idealized discrete “[Formula: see text]”-type vertical gusts that are relevant for the certification process are used as representative atmospheric disturbances. The focus of this paper is to introduce a practicable prediction method for required trailing- and leading-edge flap deflections for a significant mitigation of gust-induced wing loads. The three-dimensional flap deflections are determined by parametric two-dimensional simulations at representative wing sections. Different extensions of the estimation approach are investigated to assess the influence of the wing planform, the finite wing span, the aerodynamic phase lags, and the flap scheduling. It is shown that the trailing- and leading-edge flaps are promising in terms of alleviation of gust-induced wing bending and wing torsional moments, respectively. However, at high leading-edge flap deflections that are necessary for a full compensation of the wing torsional moment large-scale flow separation is identified. The introduced gust load alleviation approach indicates a good transferability between two-dimensional airfoil and three-dimensional wing aerodynamics for unsteady flap deflections.

Deep cryogenic treatment (DCT) has arisen as a promising green technology to modify the properties of metallic materials. Here we present a substantial (55%) improvement to the wear resistance of an Al-Mg-Si alloy using DCT without any deterioration of other mechanical properties. This improvement is attributed to a slight hardness increase resulting from multiscale microstructural modifications. DCT modifies the morphology of dispersoids as well as the organization and morphology of β’’ precipitates that increase their fraction (25%) at the expense of β’ precipitates. These effects are related to the greater nanoscale mobility and segregation of the alloying elements (Mg, Si) following DCT, resulting from lattice defect recombination. This research provides a fundamental breakthrough in understanding the DCT effect on aluminum alloys, confirming DCT as a feasible CO2-free treatment step towards improvement of aluminum alloys.

In this study we investigate the effect of deep cryogenic treatment (DCT) on a high-alloy ferrous alloy (HAFA) to understand the resulting chemical and physical changes to the HAFA’s microstructure and properties. Using multiple materials analysis techniques, we uncover the fundamental chemical changes to the HAFA with DCT, and link changes in material properties to changes in the microstructure. The increased carbide nucleation with DCT is linked to greater solute mobility resulting from the modified stress state of the material and modified chemical bonding of the solutes with the matrix. In turn this provides the possibility of prior formation of nucleation points for primordial carbide formation that act as accelerators for both nucleation and evolution of carbides. These result in modified chemical and microstructural homogeneity of the material that fundamentally led to changes in the surface properties and applicability of HAFA in advanced wear, corrosion and fatigue resistance demanding conditions.

Background: Cardiac magnetic resonance imaging (CMR) remains underutilized as an exercise imaging modality, mostly because of the limited availability of MR-compatible exercise equipment. This study prospectively evaluates the clinical feasibility of a newly developed MR-conditional pedal ergometer for exercise CMR Methods: Ten healthy volunteers (mean age 44 ± 16 years) and 11 patients (mean age 60 ± 9 years) with known or suspected coronary artery disease (CAD) underwent rest and post-exercise cinematic 3T CMR. Visual analysis of wall motion abnormalities (WMA) was rated by 2 experienced radiologists, and volumes and ejection fractions (EF) were determined. Image quality was assessed by a 4-point Likert scale for visibility of endocardial borders. Results: Median subjective image quality of real-time Cine at rest was 1 (IQR 1–2) and 2 (IQR 2–2.5) for post-exercise real-time Cine (p = 0.001). Exercise induced a significant increase in heart rate (62 [62–73] to 111 [104–143] bpm, p < 0.0001). Stroke volume and cardiac index increased from resting to post-exercise conditions (85 ± 21 to 101 ± 19 mL and 2.9 ± 0.7 to 6.6 ± 1.9 L/min/m 2 , respectively; both p < 0.0001), driven by a reduction in end-systolic volume (55 ± 20 to 42 ± 21 mL, p < 0.0001). Patients (2/11) with inducible regional WMA at high-resolution post-exercise cine imaging revealed significant coronary artery stenosis in subsequently performed invasive coronary angiography. Conclusion: Exercise-CMR using our newly developed 3T MR-conditional pedal ergometer is clinically feasible. Imaging of both cardiac response and myocardial ischemia, triggered by dynamic stress, is rapidly conducted while the patient is near their peak heart rate.

In this retrospective cohort study, we evaluated the level of biomarkers of inflammation like phagocyte-related S100 proteins and a panel of cytokines in 128 children with pre-B ALL and 22 with T-ALL. The biomarkers were evaluated at diagnosis and during antileukemic therapy (day 29 and after six months) and we evaluated their correlation with basic laboratory values. Further, for the children with pre-B ALL, we evaluated whether the biomarkers could predict the outcome of ALL expressed as minimal residual disease (MRD), relapse, and death.The levels of S100A9, S100A12, IL-1beta, IL-12p70, IL-13, IL-17, IL-18, and MPO serum levels increased significantly as chemotherapy was initiated. The difference was most pronounced for S100A9 and S100A12, which had strong positive correlations with the neutrophil counts. In contrast, TNF-alpha, IL-6, IL-10, CCL-2, MMP-3, and CD25 serum levels decreased after chemotherapy. Although none of these biomarkers appear to be an independent predictor of outcomes, in predictive models with MRD as the outcome, AUC increased from 76% (95% CI 68-84%) when using initial risk group stratification alone to 83% (95% CI 73-91%) in a multivariate predictive model including initial risk group stratification and the biomarkers S100A12, TNF-alpha, and IL-10. In this retrospective cohort study, we evaluated the level of biomarkers of inflammation like phagocyte-related S100 proteins and a panel of cytokines in 128 children with pre-B ALL and 22 with T-ALL. The biomarkers were evaluated at diagnosis and during antileukemic therapy (day 29 and after six months) and we evaluated their correlation with basic laboratory values. Further, for the children with pre-B ALL, we evaluated whether the biomarkers could predict the outcome of ALL expressed as minimal residual disease (MRD), relapse, and death.The levels of S100A9, S100A12, IL-1beta, IL-12p70, IL-13, IL-17, IL-18, and MPO serum levels increased significantly as chemotherapy was initiated. The difference was most pronounced for S100A9 and S100A12, which had strong positive correlations with the neutrophil counts. In contrast, TNF-alpha, IL-6, IL-10, CCL-2, MMP-3, and CD25 serum levels decreased after chemotherapy. Although none of these biomarkers appear to be an independent predictor of outcomes, in predictive models with MRD as the outcome, AUC increased from 76% (95% CI 68-84%) when using initial risk group stratification alone to 83% (95% CI 73-91%) in a multivariate predictive model including initial risk group stratification and the biomarkers S100A12, TNF-alpha, and IL-10.

The short-video app TikTok saw a large increase in usage during the COVID-19 lockdown because it provided entertainment, distraction, and social interaction based on video content engagement. We present results from an interview study with 28 U.S. TikTok users on how they shared and engaged with lived pandemic experiences on TikTok to cope with and socialize after the U.S. imposed its first lockdown. Participants had already established TikTok as a peer community platform on which sharing lived experiences felt appropriate. Due to COVID-19 restrictions, participants started to look for TikTok videos of shared lived pandemic experiences to interact with others when physical interaction was made impossible. We find that TikTok videos facilitated communication and parasocial interaction based on known audiovisual styles. Participants were able to communicate through video creation based on shared ways of presenting short-video content during COVID-19 physical distancing.

The present paper investigates the feasibility of gust load alleviation at transonic speeds on a backward swept and a forward swept transport aircraft configuration. Spanwise-distributed control surfaces at the leading and trailing edges are employed to control gust-induced wing bending as well as wing torsion moments. The deflection amplitude and temporal flap actuation are determined by a novel scheme that builds on the aerodynamic strip theory. The aerodynamic effectiveness of the actuators is taken from a data base, computed from either 2D infinite swept wing simulations, or from yawed computations that take the effects of boundary-layer cross flow and the local sweep angle of the control surface into account. The present numerical flow simulations reveal that careful application of control laws at the trailing edge alleviates wing bending moments caused by strong vertical gusts by 85–90%, for both aircraft configurations. The application of leading-edge flaps introduces significant nonlinear aerodynamic interactions, that make the control of torsional moments comparably challenging. Here, the present results indicate that about 60% of wing torsion loads due to strong gusts can be removed.

O trabalho visa abordar o tratamento dado à pessoa idosa pelo Código Penal e Processual Penal Brasileiro, levando-se em consideração o aumento de pessoas na faixa etária de 60 anos ou mais no país e o crescimento exponencial da população carcerária no Estado do Rio Grande do Sul, em análise da obra “Vulnerabilidade Etária: Idosos e Cárcere no Brasil” (GHIGGI, 2020).

O presente trabalho é sobre a importância das relações humanas. Este apresenta uma pesquisa bibliográfica sobre o assunto. Dentro desta temática, definiu-se importante apresentar informações referentes a relações humanas; conceituar e caracterizar líder e liderança e, apontar informações indispensáveis sobre gestão de pessoas. Atualmente as relações entre líderes e liderados é motivo para problemas instituicionais, assim, são adiconadas diferentes informações sobre líder e liderança. Bem como os tipos de líderes existentes e suas caracterísiticas. Referenciais teóricos são apresentados para que fique explícito o quão é importante os grupos e suas relações. Todas as instiuições são compostas por pessoas, assim, cada vez mais é necessário estudar as diferentes relações e a importância do ser humano. Uma vez que o poder nos grupos sociais tem de ser exercito com capacidade e eficiência e, para tal, a atualidade exige um líder e uma liderança aptos para esta atividade. Sendo assim, o líder deste século precisa apresentar determinadas características indispensáveis como: carisma, simpatia, capacidade de interação, dentre ouras.

Na história da humanidade, existem relatos dos nascidos “castigados” por Deus, pois, por muito tempo, toda pessoa que apresentava uma doença mental era uma aberração da natureza, um castigo. Juntamente com o desenvolvimento social e científico, passou-se a estudar cada vez mais as alterações cerebrais. Já no século XIX, existiam os hospitais psiquiátricos, verdadeiros depósitos de gente. Além disso, estes locais foram usados como castigo para pessoas que não seguiam os padrões sociais. E hoje, conta-se com diferentes estudos que apresentam as mais diversas doenças mentais, desde as genéticas que surgem nas primeiras semanas de gestação como as síndromes, até as que surgem como resultado de um traumatismo craniano ou derrame que pode gerar uma deficiência ou perda de habilidades. Diante desta realidade diferenciada, os portadores de deficiência, necessidades especiais ou superdotação, por lei,devem ser matriculados nas escolas regulares. E, muitos dos professores, despreparados e sem conhecimento suficiente para uma prática docente com diferentes alunos enfrentam dificuldades em seu cotidiano. O que o governo oferece são cursos e teorias sobre como portar-se diante desta realidade imposta e, como ajuda, oferece, quando possível, um monitor para cada aluno especial. Com um olhar pedagógico, para o sucesso educacional, se faz necessário muita dedicação e estudo por parte de todo professor que pretende atuar na rede educacional. E ainda, é indispensável um estudo para quais os alunos “especiais” esta realidade é benéfica.

This study investigates rock glacier destabilization based on the results of a unique in situ and remote-sensing-based monitoring network focused on the kinematics of the rock glacier in Äußeres Hochebenkar (Austrian Alps). We consolidate, homogenize, and extend existing time series to generate a comprehensive dataset consisting of 14 digital surface models covering a 68-year time period, as well as in situ measurements of block displacement since the early 1950s. The digital surface models are derived from historical aerial imagery and, more recently, airborne and uncrewed-aerial-vehicle-based laser scanning (ALS and ULS, respectively). High-resolution 3D ALS and ULS point clouds are available at annual temporal resolution from 2017 to 2021. Additional terrestrial laser scanning data collected in bi-weekly intervals during the summer of 2019 are available from the rock glacier front. Using image correlation techniques, we derive velocity vectors from the digital surface models, thereby adding rock-glacier-wide spatial context to the point-scale block displacement measurements. Based on velocities, surface elevation changes, analyses of morphological features, and computations of the bulk creep factor and strain rates, we assess the combined datasets in terms of rock glacier destabilization. To additionally investigate potential rotational components of the movement of the destabilized section of the rock glacier, we integrate in situ data of block displacement with ULS point clouds and compute changes in the rotation angles of single blocks during recent years. The time series shows two cycles of destabilization in the lower section of the rock glacier. The first lasted from the early 1950s until the mid-1970s. The second began around 2017 after approximately 2 decades of more gradual acceleration and is currently ongoing. Both destabilization periods are characterized by high velocities and the development of morphological destabilization features on the rock glacier surface. Acceleration in the most recent years has been very pronounced, with velocities reaching 20–30 m a−1 in 2020–2021. These values are unprecedented in the time series and suggest highly destabilized conditions in the lower section of the rock glacier, which shows signs of translational and rotational landslide-like movement. Due to the length and granularity of the time series, the cyclic destabilization process at the Äußeres Hochebenkar rock glacier is well resolved in the dataset. Our study highlights the importance of interdisciplinary, long-term, and continuous high-resolution 3D monitoring to improve process understanding and model development related to rock glacier rheology and destabilization.

Studies on maternal microRNA expression have emerged to better understand regulatory mechanisms during the gestational period, since microRNA expression has been associated with pregnancy disorders.This study aims to investigate the association between the expression of the maternal microRNAs miR-let-7d-3p and miR-451a during the second gestational trimester and neuropsychomotor development at 90 days of life of infants.This is a case-control study nested within a cohort, with the groups being divided into dyads in which pregnant women presented Major Depressive Episode (MDE) (n = 64), these being the cases, and their respective controls (no MDE; n = 64). The Bayley Scale III was used to assess the outcome of child development, and MDE was assessed through the Mini International Neuropsychiatric Interview Plus. The analysis of miR-let-7d-3p and miR-451a was done via serum from the pregnant women, utilizing the qRT-PCR (n = 128).The results indicated a negative association between expression levels of miR-451a (β -3.3 CI95% -6.4;-0.3) and a positive associated of the miR-let-7d-3p with the cognitive development domain (β 1.7 CI95% 0.1; 3.0), and a positive association between expression of miR-let-7d-3p with motor development of the infants (β 1.6 CI95% 0.3; 2.9).This is a pioneering study on the topic that indicates a biological interrelationship between the miRNAs miR-let-7d-3p and miR-451a evaluated during the pregnancy and the motor and cognitive domains of infant development at 90 days postpartum.

The analysis of single motor unit (SMU) activity provides the foundation from which information about the neural strategies underlying the control of muscle force can be identified, due to the one-to-one association between the action potentials generated by an alpha motor neuron and those received by the innervated muscle fibers. Such a powerful assessment has been conventionally performed with invasive electrodes (i.e., intramuscular electromyography (EMG)), however, recent advances in signal processing techniques have enabled the identification of single motor unit (SMU) activity in high-density surface electromyography (HDsEMG) recordings. This matrix, developed by the Consensus for Experimental Design in Electromyography (CEDE) project, provides recommendations for the recording and analysis of SMU activity with both invasive (needle and fine-wire EMG) and non-invasive (HDsEMG) SMU identification methods, summarizing their advantages and disadvantages when used during different testing conditions. Recommendations for the analysis and reporting of discharge rate and peripheral (i.e., muscle fiber conduction velocity) SMU properties are also provided. The results of the Delphi process to reach consensus are contained in an appendix. This matrix is intended to help researchers to collect, report, and interpret SMU data in the context of both research and clinical applications.

This study investigates the impact of deep cryogenic treatment (DCT) on microstructure and properties of a martensitic stainless steel AISI 431. The reasonably simplistic microstructure tailoring with DCT delivers a novel pathway towards advanced 3rd generation high-strength steels (AHSS), whilst utilizing existing alloys and chemistry. The resulting microstructural changes deliver improved strength and hardness of the material, whilst still sustaining good elongation properties. DCT reduces the material's toughness but improves its deformation resistance and wear resistance. The study reveals that DCT modifies the microstructural evolution during tempering. During the conventional treatment, AISI 431 develops austenite reversion transformation (ART), which allows the high strength and elongation capabilities formed with transformation-induced plasticity (TRIP). In contrast, DCT progresses the microstructure even further by retransforming the reverted austenite formed through ART into tertiary α-martensite, ε-martensite and carbides that increase the strength and deformation behavior of AISI 431. The novel microstructural modification that we have entitled cryogenic austenite retransformation (CAR), is both experimentally and theoretically assessed. The underlying transformation mechanisms of CAR and individual stages of DCT were evaluated with ex-situ electron backscatter diffraction and transmission electron microscopy. The impact of DCT on the modified transformation capabilities of AISI 431 is discussed in relation to possible implementation in automotive industry as a universally applicable treatment procedure.

This study focuses on influence of alloying content and type of manufacturing on the effectiveness of deep cryogenic treatment (DCT) on properties of selected high-alloyed ferrous alloys (HAFA): EN HS6-5-2, EN HS6-5-2-5, EN HS6-5-3 and EN HS12-1-4. In order to evaluate the dependency of DCT performance on chemical composition and manufacturing type, the microstructure, hardness, impact and fracture toughness and fatigue properties were analyzed. Additionally, the fatigue data was evaluated using an adapted strain-life model in order to understand the unique effects of DCT with selected factors and provide a model for estimating the fatigue limit of DCT HAFA. The study indicates that DCT affects carbide precipitation, size and morphology of nanocarbides, average distance between carbides and nanocarbides, as well as the base matrix (martensitic laths). The induced microstructural changes cause an overall positive change of mechanical properties in selected HAFA, which correlates well with individual alloying and manufacturing differences. Overall, DCT has greater effect on wrought HAFA than powder metallurgy manufactured HAFA, at which high content of W and Co generally degenerates the DCT induced microstructure modifications.

Rose-ringed parakeets (Psittacula krameri) are one of the most widespread invasive avian species worldwide. This species was introduced to the island of Kaua‘i, Hawai‘i, USA, in the 1960s. The rapidly increasing population has caused substantial economic losses in the agricultural and tourism industries. We evaluated the efficacy of a roost culling program conducted by an independent contractor from March 2020 to March 2021. We estimated island-wide minimum abundance was 10,512 parakeets in January 2020 and 7,372 in April 2021. Over 30 nights of culling at four roost sites, approximately 6,030 parakeets were removed via air rifles with 4,415 (73%) confirmed via carcasses retrieval. An estimated average of 45 parakeets were removed per hour of shooter effort. The proportion of adult females removed in 2020 was 1.9 × greater when culled outside of the estimated nesting season. Of the four roosts where culling occurred, the parakeets fully abandoned three and partially abandoned one site. Of the three fully abandoned roosts, an estimated average of 29.6% of birds were culled prior to roost abandonment. The roost culling effort was conducted during the COVID-19 pandemic, when tourist numbers and foot traffic were greatly reduced. It is unknown how public perception of roost culling in public areas may impact future efforts. Findings suggest roost culling can be utilized for management of nonnative rose-ringed parakeet populations when roost size is small enough and staff size large enough to cull entire roosts in no greater than two consecutive nights (e.g., if two shooters are available for three hours per night, roost culling should only be attempted on a roost with ≤ 540 rose-ringed parakeets).

Prior to the early 2000s, patients with advanced gastrointestinal stromal tumors (GIST) had very poor prognoses owing to a lack of effective therapies. The development of tyrosine kinase inhibitors at the turn of the century significantly improved the overall survival for patients with GIST. The resounding success of imatinib in the first clinical trial of a tyrosine kinase inhibitor to treat GIST led to its approval for first-line therapy for advanced GIST; this study was open to all comers and not restricted to any GIST subtype(s). The trials that led to the approvals of second-, third-, and fourth-line therapy for advanced GIST were also open to all patients with advanced/metastatic GIST. Only in retrospect do we realize the role that the molecular subtypes played in the results observed in these studies. In this review, we discuss the studies that led to the US Food and Drug Administration approval of imatinib (first line), sunitinib (second line), regorafenib (third line), and ripretinib (fourth line) for advanced KIT-mutant GIST. In addition, we review how information about GIST molecular subtypes has been used to accelerate the approval of other targeted therapies for non-KIT mutant GIST, leading to the approval of five additional drugs indicated for the treatment of specific GIST molecular subtypes. We also discuss how our understanding of the molecular subtypes will play a role in the next generation of therapeutic approaches for treating advanced GIST.

Advances in the understanding and management of glenoid bone loss in shoulder instability have led to the development of alternative bony reconstruction techniques to the Latarjet using free bone grafts, but little is known about surgeon adoption of these procedures. This study sought to characterize surgeon variation in the use of glenoid bone reconstruction procedures for shoulder instability and ascertain reasons underlying procedure choice.A 9-question survey was created and distributed to 160 shoulder surgeons members of the PacWest Shoulder and Elbow Society, of whom 65 (41%) responded. The survey asked questions regarding fellowship training, years in practice, surgical volume, preferred methods of glenoid bone reconstruction, and reasons underlying treatment choice.All surgeons completed a fellowship, with an equal number of sports medicine fellowship-trained (46%) and shoulder and elbow fellowship-trained (46%) physicians. The majority had been in practice for at least 6 years (6-10 years: 25%;10 years: 59%). Most (78%) performed ≤10 glenoid bony reconstructions per year, and 66% indicated that bony procedures represented10% of their total annual shoulder instability case volume. The open Latarjet was the preferred primary reconstruction method (69%), followed by open free bone block (FBB) (22%), arthroscopic FBB (8%), and arthroscopic Latarjet (1%). Distal tibia allograft (DTA) was the preferred graft (74%) when performing an FBB procedure, followed by iliac crest autograft (18%), and distal clavicle autograft (6%). The top 5 reasons for preferring Latarjet over FBB were the sling effect (57%), the autologous nature of the graft (37%), its robust clinical evidence (22%), low cost (17%), and availability (11%). The top 5 reasons for choosing an FBB procedure were less anatomic disruption (58%), lower complication rate (21%), restoration of articular cartilage interface (16%), graft versatility (11%), and technical ease (11%). Only 20% of surgeons indicated always performing a bony glenoid reconstruction procedure in the noncontact athlete with less than 20% glenoid bone loss. However, that percentage rose to 62% when considering a contact athlete with the same amount of bone loss.Although open Latarjet continues to be the most popular glenoid bony primary reconstruction procedure in shoulder instability, nearly 30% of shoulder surgeons in the western United States have adopted FBB techniques as their preferred treatment modality--with DTA being the most frequently used graft. High-quality comparative clinical effectiveness research is needed to reduce decisional conflict and refine current evidence-based treatment algorithms.

Body-size distributions of organisms across environments in space and time are a powerful source of information on ecological and evolutionary processes. However, most studies only focus on selected parameters of size distributions (e.g., central tendency or extremes) and rarely take into account entire distributions and how they are affected by the collection style and facies. Here we analyze the impact of facies, region, taxonomy, and collection style over size distributions using diameter as a proxy of Late Devonian ammonoids in their entirety using non-metric multidimensional scaling and PERMANOVA based on Kolmogorov distance. The effects are then compared with effects on mean sizes. In all analyses, lithology was the dominant effect, with sizes greater by 59% in marls and by 33% in limestones, as compared to black shales. The effect of complete sampling style was a decrease in size by 11%. Kurtosis was an important parameter differentiating size distributions, with platykurtic distributions in marls and leptokurtic distributions in limestones, suggesting that this parameter may reflect different degrees of time averaging. Most size distributions were positively skewed, but most strongly in marls. Complete sampling led to skewness values close to zero (symmetrical distributions) and high kurtosis. Samples from higher paleolatitudes were on average smaller, but contained outliers with the largest sizes, highlighting the need to analyze entire distributions. Lithology and collection differences need to be accounted for when evaluating size differences across space (polar gigantism) and time (Lilliput effect). Similarly, differences in facies may affect species determination.

OBJECTIVE To describe the relationships between the cumulative incidences of long-term complications in individuals with type 1 diabetes (T1D) and assess whether observed associations are independent of age, duration of diabetes, and glycemic levels. METHODS Proliferative diabetic retinopathy (PDR), clinically significant macular edema (CSME), reduced estimated glomerular filtration rate (eGFR), amputations, cardiovascular disease (CVD), and mortality were assessed in the Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications Study over ∼30 years. RESEARCH DESIGN AND RESULTS The cumulative incidence of complications ranged from 3% (amputations) to 37% (CSME). There were large differences in the cumulative incidence of PDR between participants with versus without prior CSME (66% vs. 15%), reduced eGFR (59% vs. 29%), and amputation (68% vs. 32%); reduced eGFR with or without prior PDR (25% vs. 9%), amputation (48% vs. 13%), and CVD (30% vs. 11%); CVD with or without prior reduced eGFR (37% vs. 14%) and amputation (50% vs. 16%); and mortality with or without prior reduced eGFR (22% vs. 9%), amputation (35% vs. 8%), and CVD (25% vs. 8%). Adjusted for age, duration of T1D, and mean updated HbA1c, the complications and associations with higher risk included PDR with CSME (hazard ratio [HR] 1.88; 95% CI 1.42, 2.50), reduced eGFR (HR 1.41; 95% CI 1.01, 1.97), and CVD (HR 1.43; 95% CI 1.06, 1.92); CSME with higher risk of PDR (HR 3.94; 95% CI 3.18 4.89), reduced eGFR (HR 1.49; 95% CI 1.10, 2.01), and CVD (HR 1.35; 95% CI 1.03, 1.78); reduced eGFR with higher risk of CVD (HR 2.09; 95% CI 1.44, 3.03), and death (HR 3.40; 95% CI 2.35, 4.92); amputation(s) with death (HR 2.97; 95% CI 1.70, 2.90); and CVD with reduced eGFR (HR 1.59; 95% CI 1.08, 2.34) and death (HR 1.95; 95% CI 1.32, 2.90). CONCLUSIONS Long-term micro- and macrovascular complications and mortality are highly correlated. Age, diabetes duration, and glycemic levels do not completely explain these associations.

An integrated design environment (IDE) has been developed that allows the capture of design ideas, virtual compounds, and design hypotheses for medicinal chemistry projects. Specific consideration for rational molecular design, including design strategy and tactics, as well as comparator reference compounds have been incorporated to more easily convey the proposed design idea. A hierarchical tree architecture and customizable layouts allow for facile browsing across multiple programs and rapid examination of both ongoing and newly designed virtual compounds enabling centralized team discussions to ensure the most efficient prosecution of a queue of these target compounds. Additionally, a "whiteboard" module was incorporated for the rapid evaluation of virtual compounds against a suite of computational models enabling real-time design and triage. Finally, aggregation of cross-project design data enables broader analyses that can indicate portfolio-wide design challenges.

Sarcopenia increases with age and is associated with poor survival outcomes in patients with cancer. By using a deep learning-based segmentation approach, clinical computed tomography (CT) images of the abdomen of patients with newly diagnosed multiple myeloma (NDMM) were reviewed to determine whether the presence of sarcopenia had any prognostic value.Sarcopenia was detected by accurate segmentation and measurement of the skeletal muscle components present at the level of the L3 vertebrae. These skeletal muscle measurements were further normalized by the height of the patient to obtain the skeletal muscle index for each patient to classify them as sarcopenic or not.The study cohort consisted of 322 patients of which 67 (28%) were categorized as having high risk (HR) fluorescence in situ hybridization (FISH) cytogenetics. A total of 171 (53%) patients were sarcopenic based on their peri-diagnosis standard-dose CT scan. The median overall survival (OS) and 2-year mortality rate for sarcopenic patients was 44 months and 40% compared to 90 months and 18% for those not sarcopenic, respectively (p .0001 for both comparisons). In a multivariable model, the adverse prognostic impact of sarcopenia was independent of International Staging System stage, age, and HR FISH cytogenetics.Sarcopenia identified by a machine learning-based convolutional neural network algorithm significantly affects OS in patients with NDMM. Future studies using this machine learning-based methodology of assessing sarcopenia in larger prospective clinical trials are required to validate these findings.

Citrus is a fruit of great importance in Brazil, mainly in the socio-economic issue as it generates employment and income due to the production and export of concentrated orange juice, as well as other products. In view of the above, this work aimed to evaluate the dormancy overcoming of citrus seeds of the cultivars: Flying Dragon, San Diego, Índio, Cravo Santa Cruz, Riverside, BRS Sunki Tropical, Volkamerian, as well as the species Poncirus trifoliata. The seeds from Embrapa (Brazilian Agricultural Research Corporation) Clima Temperado, located in Pelotas-RS, as well as from Embrapa Cassava e Fruticultura, located in Cruz das Almas-BA, were submitted to the germination test as written in the Seed Analysis Rules and a germination test in which a small cut was made in the seed coat on the side of the embryo, around 0.1 mm with the help of a stylet, which was used 200 seeds (4 samples of 50 seeds per repetition) on germitest® paper, moistened with distilled water in an amount equivalent to 2.5 times its weight and kept inside a germinator at a constant temperature of 25 °C, photoperiod of 12 hours. The evaluations were carried out at the end of the 21 days after the installation of the test, providing data that were expressed in percentage of normal and abnormal seedlings and non-germinated seeds (hard, dormant or dead). of citrus seedlings at the end of the tests and the data obtained were submitted to analysis of variance and the means were compared by the Tukey test at a 5% significance level (p≤0.05), with the aid of the R- bio. It is concluded that, when evaluating germination and shoot and root length of seedlings cultivars Flying Dragon, Índio, Cravo Santa Cruz, BRS Sunki Tropical, Riverside and Volkameriano, San Diego and the species P. trifoliata, were satisfactory when submitted in the dormancy breaking process, but further studies are needed.

Aims Remote monitoring (RM) is the standard of care for follow up of patients with cardiac implantable electronic devices. The aim of this study was to compare smartphone-based RM (SM-RM) using patient applications (myMerlinPulse™ app) with traditional bedside monitor RM (BM-RM). Methods and results The retrospective study included de-identified US patients who received either SM-RM or BM-RM capable of implantable cardioverter defibrillators or cardiac resynchronization therapy defibrillators (Abbott, USA). Patients in SM-RM and BM-RM groups were propensity-score matched on age and gender, device type, implant year, and month. Compliance with RM was quantified as the proportion of patients enrolling in the RM system (Merlin.net™) and transmitting data at least once. Connectivity was measured by the median number of days between consecutive transmissions per patient. Of the initial 9714 patients with SM-RM and 26 679 patients with BM-RM, 9397 patients from each group were matched. Remote monitoring compliance was higher in SM-RM; significantly more patients with SM-RM were enrolled in RM compared with BM-RM (94.4 vs. 85.0%, P < 0.001), similar number of patients in the SM-RM group paired their device (95.1 vs. 95.0%, P = 0.77), but more SM-RM patients transmitted at least once (98.1 vs. 94.3%, P < 0.001). Connectivity was significantly higher in the SM-RM, with patients transmitting data every 1.2 (1.1, 1.7) vs. every 1.7 (1.5, 2.0) days with BM-RM (P < 0.001) and remained better over time. Significantly more SM-RM patients utilized patient-initiated transmissions compared with BM-RM (55.6 vs. 28.1%, P < 0.001). Conclusion In this large real-world study, patients with SM-RM demonstrated improved compliance and connectivity compared with BM-RM.

Ceramics 5(4), 947-960 (2022). doi:10.3390/ceramics5040068 special issue: "Special Issue "Advances in Ceramics" / Special Issue Editor: Prof. Dr. Gilbert Fantozzi, Guest editor", Published by MDPI, Basel

Mitral annular disjunction (MAD) represents the detachment of the mitral leaflet hinge-point from the ventricular myocardium. Its role in patients with ST-segment-elevation myocardial infarction (STEMI) is unknown. This study aims to investigate the prevalence of MAD by cardiac magnetic resonance imaging (CMR) in STEMI-patients and its association with serious adverse events.STEMI-patients (n = 621) underwent CMR 4 days [interquartile range (IQR) 2-5] after percutaneous coronary intervention. Presence and longitudinal extent of MAD were obtained in long-axis cine-images, infarct characteristics in late gadolinium enhancement-images. During a median follow-up time of 366 days (IQR 136-454), patients were observed for the occurrence of major adverse cardiac events (MACE), comprising death, myocardial reinfarction, and congestive heart failure.Overall, 307 patients (49 %) had MAD. Longitudinal MAD-distance was 4.6 ± 1.7 mm and the P3-segment was affected most frequently (n = 262, 85 % of MAD-patients). MAD-patients had a significantly smaller infarct size, lower prevalence of microvascular obstruction, and intramyocardial hemorrhage as well as a higher ejection fraction (all p 0.03). During follow-up period, MACE occurred in 52 patients (8 %) and did not show significant difference between patients with and without MAD (7 % vs. 9 %, p = 0.424). Cardiovascular death occurred significantly more often in patients without MAD (n = 10, 3.2 % vs. n = 2, 0.7 %, p = 0.021).MAD is a rather common finding in patients presenting with STEMI. Patients with MAD had less severe infarct characteristics, however, they were not more commonly affected by MACE. Further confirmation and longer follow-up intervals are necessary to define the exact role of MAD in STEMI patients.

According to control mastery theory, patients in psychotherapy try to master their problems by disconfirming their pathogenic beliefs. This can be done by testing the therapist. So far, there is hardly any evidence on what concrete interventions or statements of therapists are specifically helpful in passing those tests. In our study, we analyzed the verbal utterances of therapists in test situations to determine whether there is a difference in statements used for passing or failing tests. A total of 168 session transcripts of 21 patients were selected from a total of six therapists, two each in psychoanalytic therapy, psychodynamic therapy, and cognitive behavioral therapy. Test situations were identified, and therapist responses were coded using the helping skills system. There were significant differences in the therapists' reactions to test situations. In particular, closed questions, approval, interpretation, and reflection of the patients' feelings by therapists were associated with a high probability of passing tests. These findings can especially support therapists-in-training to obtain an orientation on how to deal with their patients' test situations that may be perceived as challenging and are important for therapy success while respecting the individuality of their patients. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Background: Sarcopenia, characterized by the loss of muscle mass, has emerged as a negative prognostic factor in cancer patients. It has been associated with poorer outcomes and increased treatment-related morbidity. Post-mastectomy breast radiation therapy (RT) increases the likelihood of reconstructive complication, with up to 20% of reconstructed women requiring implant removal. The factors that lead to these complications are poorly understood and likely multifaceted. We investigated the relationship between pre-radiation therapy sarcopenia and post-mastectomy reconstruction outcomes. Methods: Chart review was performed to determine demographic, medical, and treatment variables, including reconstruction complication events and failures in breasts treated with mastectomy, immediate reconstruction, and RT. Reconstruction failure was defined as tissue expander or implant removal, resulting in no final reconstruction or autologous reconstruction only. Reconstruction complications included surgical site infection, late infection (1 year post-RT), seroma development, flap necrosis, nipple necrosis, wound dehiscence, capsular contracture, hematoma, extrusion, leak, venous congestion, and unplanned reoperation. An axial slice at the L2 or L3 vertebral body from the radiation therapy planning CT scan was analyzed for skeletal muscle area using a previously validated algorithm, with manual review and adjustment as indicated. Sarcopenia was defined by skeletal muscle index (SMI, skeletal muscle area in cm2 divided by patient’s height squared) below 34.4 cm2/m2. Chi-square, Kaplan Meier, and univariate Cox regression tests were used for analysis. Results: Ninety-nine women with breast cancer who underwent mastectomy, reconstruction, and RT were included in this study. All women had immediate reconstruction: 93 women had tissue expander placement while six women had permanent implant placement. Mean age was 47.5 years (SD 10.6) at diagnosis and median BMI was 24.8. Seventy-six percent were non-smokers, 24% were former smokers, and only 16 (16.2%) and 3 (3.0%) had hypertension or diabetes, respectively. Median follow-up was 2.7 years. Median SMI was 38 cm2/m2 and 18 (18%) met criteria for sarcopenia (SMI < 34.4 cm2/m2). Mastectomy was bilateral in 79 women, skin-sparing in 61, and nipple sparing in 31. Bilateral mastectomy was less frequent amongst women with sarcopenia (61%) compared to 84% of those without sarcopenia (p=0.03). After RT, twenty-three women required unplanned reoperation. Within these 23 women, there were 45 total complications. Complications included surgical site infection (n=18), capsular contracture (n=12), seroma (n=4), wound dehiscence (n=3), and others (n=8). However, only 8 women had reconstructive failure and none were sarcopenic at the time of the RT planning scan. Any complication or failure after RT occurred in similar proportions of patients with and without sarcopenia: 38% and 30%, respectively. Kaplan-Meier curves and univariate Cox regression models showed no significant difference in time to failure (p = 0.380) or time to any event (complication or failure) (p=0.53), between sarcopenic and non-sarcopenic patients. Conclusion: Sarcopenia, using SMI < 34.4 cm2/m2 on pre-radiotherapy planning scans, was not associated with an increased risk of post-radiotherapy reconstructive complication or failure in this selected cohort of non-smokers. Few women had sarcopenia at the time of operation, and results should be validated in a larger series. Citation Format: Yasamin Sharifzadeh, Robert Gao, William S. Harmsen, Jason Klug, Panagiotis Korfiatis, Kimberly Gergelis, Dean A. Shumway, Robert Mutter, Kimberly Corbin. Sarcopenia and Post-Mastectomy Breast Reconstruction Outcomes after Radiation Therapy [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr P3-05-52.

Este artigo tem como objetivo discutir as percepções das professoras sobre a Base Nacional Comum Curricular (BNCC) para a Educação Infantil, compreendendo as implicações do documento às práticas docentes. O corpus analítico compreende dados de um estudo de caso realizado em uma escola pública do Litoral Norte do Rio Grande do Sul. O trabalho fundamenta-se teoricamente em autores da Educação Infantil e do Currículo, e em políticas e documentos que normatizam a primeira etapa da educação brasileira. A análise dos dados está organizada em dois eixos. O primeiro versa sobre as compreensões das professoras em relação à BNCC e ao currículo. O segundo discute as implicações da BNCC nas práticas pedagógicas, indicando os campos de experiência como uma possibilidade de valorização do cotidiano na Educação Infantil. Os resultados evidenciam que uma apropriação contextual e reflexiva da BNCC pode contribuir para repensar a ação docente com as crianças.

This empirical study undertakes a categorization of the core concept of Control Mastery Theory: mostly unconscious testing of pathogenic beliefs that patients exhibit in relating to their therapist to work on their problems. The focus lays on latent meanings of manifest tests.We qualitatively analyze transcripts of 172 psychotherapy sessions with 23 patients for sequences in which significant patient-therapist interactions occur, and systematize identified tests into thematic categories based on what tests intent to achieve (ICC= .68). Guided by theory, the analysis is attending to complexity, individuality, and the unconscious.Tests circle around striving for independence, deserving/self-worth, acceptance, and entitlement. Individual tests have various underlying meanings, are interrelated, and may be multidimensional.Meanings of tests must be confirmed within the psychotherapeutic process. Incorporating the treating clinician thus seems important.

Objectives: Children with acute lymphoblastic leukemia (ALL) have a tendency to gain weight during treatment. As overweight and obesity associate with health problems, prophylactic interventions are warranted. Therefore, it is important to identify the children most prone to gain weight. Methods: Patients aged 2.0–17.9 years at ALL diagnosis were identified from the NOPHO ALL2008 registry. Registry data was complemented with height and weight at the end of therapy from questionnaires. Body mass index (BMI) was classified according to international age- and sex-adjusted International Obesity Task Force BMI cut-offs. BMI values were transformed into standard deviation scores (SDS) to calculate the difference in BMISDS during treatment. Results: Data on BMI change were available for 765 children. Overweight and obesity doubled during treatment: 9.7% were overweight and 2.1% obese at diagnosis and 21.8% and 5.4% at the end of therapy, respectively. The mean BMISDS change was +0.64. Younger (2.0–5.9 years) and healthy weight children were most prone to become overweight (mean change in BMI SDS +0.85 and + 0.65, respectively). Conclusions: Younger children (2.0–5.9 years) with healthy weight at diagnosis were most prone to becoming overweight and therefore are an important group to target while considering interventions.