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Background: Adding immunotherapy to first-line chemotherapy might improve outcomes for patients with advanced or recurrent endometrial cancer. We aimed to compare carboplatin and paclitaxel versus avelumab plus carboplatin and paclitaxel as first-line treatment with avelumab given concurrent to chemotherapy and as maintenance after the end of chemotherapy. Methods: MITO END-3 is an open-label, randomised, controlled, phase 2 trial conducted at 31 cancer institutes, hospitals, and universities in Italy. Eligible patients were aged 18 years or older with histologically confirmed advanced (FIGO stage III–IV) or recurrent endometrial cancer, an Eastern Cooperative Oncology Group (ECOG) performance status of 0–1, and no previous systemic anticancer therapy as primary treatment for advanced or metastatic disease. Participants were randomly assigned (1:1) using a computerised minimisation procedure stratified by centre, histology, and stage at study entry, to either receive carboplatin (area under the curve [AUC] 5 mg/mL × min) and paclitaxel (175 mg/m2; standard group) intravenously every 3 weeks for six to eight cycles or avelumab (10 mg/kg intravenously) added to carboplatin and paclitaxel (experimental group) every 3 weeks and then every 2 weeks as a single maintenance treatment after the end of chemotherapy until disease progression or unacceptable toxicity. Patients, treating clinicians, and those assessing radiological examinations were not masked to study treatment. The primary endpoint was investigator-assessed progression-free survival, measured in the intention-to-treat (ITT) population. Patients who received at least one dose of study drug were included in the safety analysis. Experimental group superiority was tested with 80% power and one-tailed α 0·20. This trial is registered with ClinicalTrials.gov (NCT03503786) and EudraCT (2016–004403–31). Findings: From April 9, 2018, to May 13, 2021, 166 women were assessed for eligibility and 39 were excluded. 125 eligible patients were randomly assigned to receive carboplatin and paclitaxel (n=62) or avelumab plus carboplatin and paclitaxel (n=63) and included in the ITT population. The median follow-up was 23·3 months (IQR 13·2–29·6) and was similar between the two groups. 91 progression-free survival events were reported, with 49 events in 62 patients in the standard group and 42 events in 63 patients in the experimental group. The median progression-free survival was 9·9 months (95% CI 6·7–12·1) in the standard group and 9·6 months (7·2–17·7) in the experimental group (HR of progression or death 0·78 [60% CI 0·65–0·93]; one-tailed p=0·085). Serious adverse events were reported more frequently in the experimental group (24 vs seven events in the standard group); neutrophil count decrease was the most frequent grade 3–4 adverse event (19 [31%] of 61 patients in the experimental group vs 26 [43%] of 61 patients in the standard group). Two deaths occurred in the experimental group during treatment (one respiratory failure following severe myositis [possibly related to treatment] and one cardiac arrest [not related to treatment]). Interpretation: Adding avelumab to first-line chemotherapy deserves further testing in patients with advanced or recurrent endometrial cancer, although consideration of mismatch repair status is warranted.

β-lactoglobulin I (β-Lg I) is one of the most important whey proteins in donkey milk. However to our knowledge, there has been no study focusing on the full nucleotide sequences of this gene (BLG I). Current investigation of donkey BLG I gene is very limited with only two variants (A and B) characterized so far at the protein level. Recently, a new β-Lg I variant, with a significantly higher mass (+1915 Da) than known variants has been detected. In this study, we report the whole nucleotide sequence of the BLG I gene from two donkeys, whose milk samples are characterized by the β-Lg I SDS-PAGE band with a normal electrophoretic mobility (18,514.25 Da, β-Lg I B1 form) the first, and by the presence of a unique β-Lg I band with a higher electrophoretic mobility (20,428.5 Da, β-Lg I D form) the latter. A high genetic variability was found all over the two sequenced BLG I alleles. In particular, 16 polymorphic sites were found in introns, one in the 5’ flanking region, three SNPs in the 5’ untranslated region (UTR) and one SNP in the coding region (g.1871G/A) located at the 40th nucleotide of exon 2 and responsible for the amino acid substitutions p.Asp28>Asn in the mature protein. Two SNPs (g.920-922CAC>TGT and g.1871G/A) were genotyped in 93 donkeys of two Italian breeds (60 Ragusana and 33 Amiatina, respectively) and the overall frequencies of g.920-922CAC and g.1871A were 0.3065 and 0.043, respectively. Only the rare allele g.1871A was observed to be associated with the slower migrating β-Lg I. Considering this genetic diversity and those found in the database, it was possible to deduce at least five different alleles (BLG I A, B, B1, C, D) responsible for four potential β-Lg I translations. Among these alleles, B1 and D are those characterized in the present research, with the D allele of real novel identification. Haplotype data analysis suggests an evolutionary pathway of donkey BLG I gene and a possible phylogenetic map is proposed. Analyses of mRNA secondary structure showed relevant changes in the structures, as consequence of the g.1871G>A polymorphism, that might be responsible for the recognition of an alternative initiation site providing an additional signal peptide. The extension of 19 amino acids sequence to the mature protein, corresponding to the canonical signal peptide with an additional Alanine residue, is sufficient to provide the observed molecular weight of the slower migrating β-Lg I encoded by the BLG I D allele

We perform molecular dynamics simulationsin order tostudy thermodynamicsand the structure of supercooled aqueous solutions of lithium chloride(LiCl) at concentrations c = 0.678 and 2.034 mol/kg.We model the solvent using the TIP4P/2005 potential and the ions usingthe Madrid-2019 force field, a force field particularly suited forstudying this solution. We find that, for c = 0.678mol/kg, the behavior of the equation of state, studied in the P-T plane, indicates the presenceof a liquid-liquid phase transition, similar to what was previouslyfound for bulk water. We estimate the position of the liquid-liquidcritical point to be at T (c) approximate to 174K, P (c) approximate to 1775 bar, and rho(c) approximate to 1.065 g/cm(3). When the concentration istripled to c = 2.034 mol/kg, no critical point isobserved, indicating its possible disappearance at this concentration.We also study the water-water and water-ions structurein the two solutions, and we find that at the concentrations examinedthe effect of ions on the water-water structure is not strong,and all the features found in bulk water are preserved. We also calculatethe hydration number of the Li and Cl ions, and in line with experiments,we find the value of 4 for Li+ and between 5.5 and 6 forCl(-), confirming the good performances of the Madrid-2019force field.

Objective: Studies on the relationship between depression and cognition on patients with multiple sclerosis (MS) are inconsistent and it is not clear whether higher depression levels are associated with impairment of specific cognitive domains or processes. This meta-analytic study aimed at evaluating the possible association between depressive symptomatology and performance on cognitive tests assessing several cognitive domains (global cognition, attention, processing speed, verbal, spatial and working memory, verbal fluency, inhibitory control, set-shifting) in individuals living with MS. Method: The literature search on three electronic databases yielded 5402 studies (4333 after the duplicates removal); after the evaluation of titles, abstracts full-text articles, 37 studies were included in the meta-analytic study. A random-effect model meta-analysis was performed and mean weighted effect sizes (ESs) were calculated using Hedges' g. Results: Small ESs were found for the relationship between depression and verbal memory (g = 0.25, p

Polydactyly, or hyperdactyly, is a frequent malformation, with a reported incidence between 0.37 and 1.2 per 1000 live births. Most cases encountered in medical practice are sporadic cases, usually presenting one-sided manifestations. More frequently, polydactyly can be detected prenatally through an ultrasound examination, if not, it is usually diagnosed at birth, during the first physical examination. Although the clinical diagnosis is relatively easy in patients with manifest cases, it can sometimes be present with mild or partial forms that are not clinically evident on physical examination, resulting in later diagnosis and treatment. We reported a particular case of polydactyly of the foot not clinically manifest, diagnosed in a 39-year-old Caucasian Male patient with a history of recurrent localized pain in the big toe often associated with subungual bleeding, since he was a child who came to our emergency room following a car accident. Polydactyly is a frequently reported congenital malformation which may present in many different varieties of deformities. In this case, the X-ray, which was required after a car accident, leads to the incidental diagnosis of polydactyly in an adult patient. As described, because of the functional limitations related to this malformation, as well as to limit recurrent pain, and subungual anomalies, the patient underwent to a surgical correction to improve its quality of life.

In order to provide useful tools for researchers in the design of actions to promote participation in web surveys, it is key to study the characteristics that define the profile of a “web respondent”, so that specific interventions can be planned. In this contribution, which draws on data collected during the 2019 housing population census in Italy, we define the set of familial and geographical characteristics that correspond to a greater probability that the interviewed household will choose to respond online, by estimating a multilevel model. The profile of a “computer-assisted web interview household” (CAWI-H) is then defined, on the basis of the structural characteristics of this population. Moreover, the geographical distribution of households is studied according to their distance from the CAWI-H profile. The results show that households that are more distant from the CAWI-H profile have characteristics that correspond to segments of the population generally affected by economic and social fragility; they are mainly elderly, foreigners, residents in small towns, and people with a low level of education. It is to these households in particular that survey designers can address specific actions that can enhance their willingness to participate in web surveys.

Background: Magnetic resonance cholangiopancreatography (MRCP) is the gold standard for diagnosis of patients with primary sclerosing cholangitis (PSC). The semi-quantitative MRCP-derived Anali scores proposed for risk stratification, have poor-to-moderate inter-reader agreement. Aims: To evaluate the prognostic performance of quantitative MRCP metrics in PSC. Methods: This is a retrospective study of PSC patients undergoing MRCP. Images were processed using MRCP+ software (Perspectum Ltd, Oxford) that provides quantitative biliary features, semi-automatically extracted by artificial intelligence-driven analysis of MRCP-3D images. The prognostic value of biliary features has been assessed for all hepato-biliary complications. Results: 87 PSC patients have been included in the analysis. Median follow-up from MRCP to event/censoring of 30.9 months (Q1-Q3=13.6–46.6). An adverse outcome occurred in 27 (31.0%) patients. The number of biliary strictures (HR=1.05 per unit, 95%CI 1.02–1.08, p < 0.0001), spleen length (HR=1.16 per cm, 95%CI 1.01–1.34, p = 0.039), adjusted for height, age at MRCP, and time from diagnosis to MRCP predicted higher risk of hepatobiliary complications. These were incorporated into a the quantitative MRCP-derived PSC (qMRCP-PSC) score (C-statistic=0.80). After 3-fold cross-validation, qMRCP-PSC outperformed the Anali score in our cohort (C-statistic of 0.78 vs 0.64) and enabled the discrimination of survival of PSC patients (log-rank p < 0.0001). Conclusions: The qMRCP-PSC score identified patients at higher risk of hepatobiliary complications and outperformed the available radiological scores. It represents a novel quantitative biomarker for disease monitoring and a potential surrogate endpoint for clinical trials.

Electric vehicles (EVs) and the recent pandemic outbreak give cities a new trend to primarily private and shared mobility with low noise and less air pollution. Crucial factors for the widespread of EVs are the electrical charging infrastructure, driving range, and the reduction of the cost of battery packets. For this reason, there is a massive effort from manufacturers, governments, and the scientific community to reduce battery costs and boost sustainable electrical production and distribution. Battery reuse is an alternative to reduce batteries’ costs and environmental impacts. Second-life batteries can be used in a wide variety of secondary applications. Second-life batteries can be connected with off-grid or on-grid photovoltaic and wind systems, vehicle charging stations, forklifts, and frequency control. The present work aims to analyze the main challenges imposed on the reuse of batteries, the leading technologies for their reuse, and the different types of batteries in terms of their feasibility for second-life use. The main novelty of this work is the discussion about the barriers, opportunities, uncertainties, and technologies for the second life market. Here we summarize the present state of the art in reusing lithium-ion batteries discussing technical and economic feasibility, environmental impacts, and perspectives. The results show five business models that have been proposed in the literature, three types of markets for trading second-life batteries, and the main opportunities and barriers for each actor in the battery supply chain.

In the frame of the project FISR_04543 “CRESCIBLUREEF - Grown in the blue: new technologies for knowledge and conservation of Mediterranean reefs”, we present preliminary data on the ecological and depositional implications of micritic sediments in a coralligenous bioconstruction formed along the Mediterranean shelf in front of the Marzamemi village (Sicily, Italy). The framework of the build- up is mainly built by crustose coralline algae, which in turn create the substrate for a high-diversified epi- and infaunal community. Two types of microcrystalline calcite, tentatively interpreted as allochthonous and autochthonous micrite, strictly related to fine skeletal debris, have been detected. The allochthonous micrite derive from abiotic accumulation of fine sediments in the framework cavities. The autochthonous micrite is deposited in situ through organic-mediated processes. The occurrence of this component allows hypothesizing a possible contribution of non-skeletal carbonate in the strengthening of the primary framework due to its syndepositional cementation.

PurposeThe recent innovations of Industry 4.0 have made it possible to easily collect data related to a production environment. In this context, information about industrial equipment – gathered by proper sensors – can be profitably used for supporting predictive maintenance (PdM) through the application of data-driven analytics based on artificial intelligence (AI) techniques. Although deep learning (DL) approaches have proven to be a quite effective solutions to the problem, one of the open research challenges remains – the design of PdM methods that are computationally efficient, and most importantly, applicable in real-world internet of things (IoT) scenarios, where they are required to be executable directly on the limited devices’ hardware.Design/methodology/approachIn this paper, the authors propose a DL approach for PdM task, which is based on a particular and very efficient architecture. The major novelty behind the proposed framework is to leverage a multi-head attention (MHA) mechanism to obtain both high results in terms of remaining useful life (RUL) estimation and low memory model storage requirements, providing the basis for a possible implementation directly on the equipment hardware.FindingsThe achieved experimental results on the NASA dataset show how the authors’ approach outperforms in terms of effectiveness and efficiency the majority of the most diffused state-of-the-art techniques.Research limitations/implicationsA comparison of the spatial and temporal complexity with a typical long-short term memory (LSTM) model and the state-of-the-art approaches was also done on the NASA dataset. Despite the authors’ approach achieving similar effectiveness results with respect to other approaches, it has a significantly smaller number of parameters, a smaller storage volume and lower training time.Practical implicationsThe proposed approach aims to find a compromise between effectiveness and efficiency, which is crucial in the industrial domain in which it is important to maximize the link between performance attained and resources allocated. The overall accuracy performances are also on par with the finest methods described in the literature.Originality/valueThe proposed approach allows satisfying the requirements of modern embedded AI applications (reliability, low power consumption, etc.), finding a compromise between efficiency and effectiveness.

Angelo Ruggiero, Gabriella Fabbrocicni, Sara Cacciapuoti, Luca Potestio, Lucia Gallo, Matteo Megna Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, ItalyCorrespondence: Angelo Ruggiero, Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Via Pansini 5, Naples, 80131, Italy, Tel +39-081-7462457, Fax +39-081-7462442, Email angeloruggiero1993@libero.itBackground: Tildrakizumab, an anti-IL-23, showed promising efficacy and safety profiles in two randomized clinical-trials (reSURFACE-1 and reSURFACE-2), comparing tildrakizumab superiority to placebo and etanercept. Due to its recent availability in clinical-practice, real-life data are still limited.Objective: To assess the efficacy and safety of tildrakizumab in a real-world-practice in patients suffering from moderate-to-severe psoriasis.Methods: A 52-week observational retrospective study enrolled patients suffering from moderate-to-severe plaque-psoriasis, starting tildrakizumab treatment.Results: A total of 42 patients were included in the study. Mean PASI showed a significant reduction at each follow-up (p< 0.001), reducing from 13.5± 5.9 at baseline, 2.8± 3.8 at week-28, resulting stable up to week-52. High rates of patients reached both PASI90 and PASI100 responses at both week 16 (PASI90: 52.4%, PASI100: 33.3%) and week 28 (PASI90: 76.1%, PASI100: 61.9%), maintaining these up to week 52 (PASI90: 73.8%, PASI100: 59.5%). The impact of treatment on patient’s quality of life has been evaluated with DLQI, which showed a significant reduction during follow-ups.Conclusion: Our data confirm tildrakizumab as an effective and generally safe treatment for the management of moderate-to-severe psoriasis, with high rates of both PASI90 and PASI100 responses, and very few reported adverse events, up to 52 weeks of follow-up.Keywords: guselkumab, risankizumab, tildrakizumab, real-world practice, psoriasis, anti-IL-23, biologics

This study aims to identify the main determinants of students' performances in reading and maths across eight European Union countries (i.e. Austria, Croatia, Germany, Hungary, Italy, Portugal, Slovakia, and Slovenia). Based on student level data from the OECD-PISA 2018 survey and by means of the application of efficient algorithms, we highlight that the number of books at home or a variable combining the type and location of school represent the most important predictors of the students' performance in all the analysed countries, while other school characteristics are rarely relevant. Econometric results show that students attending vocational schools perform significantly worse than those in general schools. Looking at differences between students attending schools in big cities and those in small cities, they are never statistically significant except in Portugal. Through the Gelbach decomposition method, which allows to measure the relative importance of observable characteristics to explain a gap, we show that the differences in test scores between big and small cities depend on the schools' characteristics, while the differences between general and vocational schools are mainly explained by the families' social status. Results appear robust to the hierarchical model approach.

In space propulsion hydrogen peroxide is a “green” solution that overcomes the problem of toxicity related to hydrazine-based systems. This work aims at designing, developing, and characterizing a monopropellant thruster for small satellites, based on hydrogen peroxide. The engine is intended for use on a 12-Unit CubeSat in Low Earth Orbit. Based on mission requirements a catalytic chamber and a nozzle were designed and a ground-test breadboard was manufactured. The prototype was assembled and tested on ground and measured engine performances are discussed highlighting their dependence on the nozzle throat diameter, that primarily affects the chamber pressure. Finally, effects of the mass flow rate on the system reactivity and steady state conditions are also investigated.

Aim: Head and neck squamous cell cancer (HNSCC) is the ninth most common tumor worldwide. Neck lymph node (LN) status is the major indicator of prognosis in all head and neck cancers, and the early detection of LN involvement is crucial in terms of therapy and prognosis. Diffusion-weighted imaging (DWI) is a non-invasive imaging technique used in magnetic resonance imaging (MRI) to characterize tissues based on the displacement motion of water molecules. This review aims to provide an overview of the current literature concerning quantitative diffusion imaging for LN staging in patients with HNSCC. Methods: This systematic review performed a literature search on the PubMed database (https://pubmed.ncbi.nlm.nih.gov/) for all relevant, peer-reviewed literature on the subject following the preferred reporting items for systematic reviews and meta-analyses (PRISMA) criteria, using the keywords: DWI, MRI, head and neck, staging, lymph node. Results: After excluding reviews, meta-analyses, case reports, and bibliometric studies, 18 relevant papers out of the 567 retrieved were selected for analysis. Conclusions: DWI improves the diagnosis, treatment planning, treatment response evaluation, and overall management of patients affected by HNSCC. More robust data to clarify the role of apparent diffusion coefficient (ADC) and DWI parameters are needed to develop models for prognosis and prediction in HNSCC cancer using MRI.

Background and purpose Some studies have shown that air pollution, often assessed by thin particulate matter with diameter below 2.5 µg/m3 (PM2.5), may contribute to severe COVID‐19 courses, as well as play a role in the onset and evolution of multiple sclerosis (MS). However, the impact of air pollution on COVID‐19 has never been explored specifically amongst patients with MS (PwMS). This retrospective observational study aims to explore associations between PM2.5 and COVID‐19 severity amongst PwMS. Methods Data were retrieved from an Italian web‐based platform (MuSC‐19) which includes PwMS with COVID‐19. PM2.5 2016–2018 average concentrations were provided by the Copernicus Atmospheric Monitoring Service. Italian patients inserted in the platform from 15 January 2020 to 9 April 2021 with a COVID‐19 positive test were included. Ordered logistic regression models were used to study associations between PM2.5 and COVID‐19 severity. Results In all, 1087 patients, of whom 13% required hospitalization and 2% were admitted to an intensive care unit or died, were included. Based on the multivariate analysis, higher concentrations of PM2.5 increased the risk of worse COVID‐19 course (odds ratio 1.90; p = 0.009). Conclusions Even if several other factors explain the unfavourable course of COVID‐19 in PwMS, the role of air pollutants must be considered and further investigated., Air pollution, often assessed by particulate matter with diameter below 2.5 µg/m3, may contribute to severe COVID‐19 courses. 1087 patients were included, of whom 13% required hospitalization and 2% were admitted to an intensive care unit or died. Even if several other factors explain the unfavourable course of COVID‐19 in patients with multiple sclerosis, the role of air pollutants must be considered and further investigated.

Introduction: The ANC plays an important role in monitoring the health status of the fetus but also in the monitoring of the mother, by allowing the tracking of several conditions. It makes it possible to retain the woman with the health structure, thus promoting childbirth in ideal conditions. The objective of this study was to identify the determinants of ANC in the Kolda and Sédhiou regions. Method: It was a descriptive and analytical cross-sectional survey. The study focused on women who gave birth between February 2013 and January 2014. Sampling was two-stage random. The data collected during an individual interview focused on the socio-demographic characteristics, knowledge and practices of the women surveyed. The data was analyzed using the R software. Results: A total of 1216 women were surveyed. The results of the study show that 62.3% had no level of education, 48% had no IGA, 57.6% were within 5 km of a health facility and 44.1% were multiparous. Participation in awareness-raising activities involved 53% of women. The percentage of women who had completed their ANC was 24% while 34% had completed ANC1 on time. The results of the multivariate analysis showed that timely ANC1 practice was related to proximity to the health facility (1.7 [1.31-2.2)], simple multiparity (1.46 [1.14-1.89]) and participation in the awareness programme (1.4 [1.08-1.81]). Completion of all ANCs was associated with schooling (79 [1.34-2.39]), knowledge of the number and importance of ANC and the fact that the woman lived within 15 minutes of the structure (1.52 [1.14-2.04]). Conclusion: The results of the study show that the useof reproductive health services for ANC was linked to environmental, economic, cultural and structural factors. Improving the accessibility of these services requires joint actions by the government, NGOs, community actors and the involvement of the population.

The umbrella term cognitive reserve-enhancing factors refers to those experiential and lifestyle factors (such as intellectual activities, regular physical exercise, healthy nutrition, educational attainment, etc.) that may help individuals to compensate for age-related neural deterioration, thus enabling them to maintain relatively stable cognitive functioning during senescence. In the last 10 years, mounting evidence has shown that speaking a second language is a powerful cognitive reserve contributor, which could mitigate the consequences of healthy aging and contribute to the delay of dementia onset. In this piece, we argue that bilingualism may play a unique role among the well-known cognitive reserve-enhancing factors, thus contributing to the achievement of successful aging in a distinctive fashion. After reviewing behavioral and neuroimaging evidence for bilingualism-induced protection against healthy and pathological cognitive aging, we discuss theoretical reasons and experimental findings supporting the view that bilingualism should be granted an individual spot among reserve-enhancing life experiences.

La afección cardiovascular en entidades como Erdheim-Chester (EEC), una rara histiocitosis de células no Langerhans, y la enfermedad relacionada con IgG4 (ER-IgG4), una afección fibrinoinflamatoria inmunomediada, es muy variada y habitualmente asintomática hasta su progresión a daños irreversibles cuando no es sospechada. Ante la dificultad de realizar biopsias por el sitio anatómico, es fundamental valerse de características clínicas, demográficas o imagenológicas que puedan diferenciarlas de otras entidades, como las arteritis de grandes vasos. Población masculina, los mayores de 60 años con compromiso a nivel de la aorta abdominal infrarrenal o aneurismas a nivel de la aorta ascendente con o sin compromiso de otros órganos, son orientativos de ER-IgG4. En la EEC es característico el tejido blando concéntrico que recubre la aorta (aorta recubierta) y sobre todo ante la presencia de fibrosis retroperitoneal, compromiso de huesos largos, hidronefrosis, lesión renal aguda posrrenal e hipertensión arterial, existencia de tejido fibrótico perirrenal, engrosamiento de la fascia renal y tejido adiposo perirrenal (signo del riñón peludo).

The use of hands for gathering rich sensory information is essential for proper interaction with the environment; therefore, the restoration of sensation is critical for reestablishing the sense of embodiment in hand amputees. Here, we show that a noninvasive wearable device can be used to provide thermal sensations on amputees’ phantom hands. The device delivers thermal stimuli to specific regions of skin on their residual limb. These sensations were phenomenologically similar to those on the intact limbs and were stable over time. Using the device, the subjects could successfully exploit the thermal phantom hand maps to detect and discriminate different thermal stimuli. The use of a wearable device that provides thermal sensation can increase the sense of embodiment and improve life quality in hand amputees.

This study aimed to assess the environmental impact (cradle-to-farm gate LCA) of milk production of cereal-based dairy farms in northern Italy and to analyse which traits related to farm management (MAN_F), lactating cows’ ration composition (DIET_F), and animal responses (ANI_F) could be identified as main determinants to address specific mitigation strategies. Data originated from 28 dairy farms. The functional unit was 1 kg of fat- and protein-corrected milk (FPCM). Impact categories were global warming (GWP), acidification (AP) and eutrophication (EP) potentials and land occupation (LO). Impact values were analysed with a linear model to test separately the effects of MAN_F, DIET_F and ANI_F variables. One kg FPCM was associated with an average impact of 1.10 kg CO2-eq (GWP), 17.1 g SO2-eq (AP), 6.0 g PO4-eq (EP), and 1.3 m2/y (LO). Regarding MAN_F, GWP and LO linearly decreased with increasing values of stocking rate and feed self-sufficiency (FSS), whereas minimum EP was found for intermediate FSS values (50% DM). Regarding DIET_F, GWP linearly decreased at increasing levels of dietary inclusion of cereal silages, whereas AP and EP linearly decreased at decreasing dietary crude protein (CP) content values. Among ANI_F, GWP and EP were quadratically associated with milk yield (MY), evidencing the lowest values at intermediate MY (9100 ± 477 kg FPCM/cow per 305d-lactation). The GWP, AP and EP decreased with decreasing age at first calving. These results can contribute at drawing good practices for farmers and consultants to promote more environmentally sustainable dairy production while supporting farm functioning and farmers’ income.HIGHLIGHTSFarm and animal determinants of Life Cycle Assessment of cereal-based dairy farms were studied.Mitigation effects can be achieved by operating on farm organisation, cow’s diet, and animal responses.Good practices for farmers and consultants can be proposed for a better dairy production sustainability. Farm and animal determinants of Life Cycle Assessment of cereal-based dairy farms were studied. Mitigation effects can be achieved by operating on farm organisation, cow’s diet, and animal responses. Good practices for farmers and consultants can be proposed for a better dairy production sustainability.

La pandemia ha tenido un impacto profundo en la sociedad a nivel mundial, dejando a su paso pérdidas humanas, pobreza extrema y desafíos en diferentes ámbitos, incluyendo el educativo. El objetivo de esta investigación fue analizar la conexión entre los contenidos curriculares y las habilidades del siglo XXI durante la pandemia reflexionando sobre la construcción de nuevos paradigmas pedagógicos que permitieron adaptarse a la crisis sanitaria. El estudio fue teórico basado en la revisión documental de investigaciones sociales en la educación realizados en la pandemia, desde tres dimensiones que influyeron en la construcción de nuevos paradigmas pedagógicos: los contenidos curriculares, habilidades del siglo XXI y adaptación a la crisis sanitaria. Los resultados indican que se ha producido un cambio significativo de cómo se entiende la educación y se desarrollan las habilidades del siglo XXI; la pandemia aceleró la introducción de nuevas tecnologías e implementación de nuevas estrategias pedagógicas en la educación. Se concluye que la pandemia permitió incorporar nuevos enfoques pedagógicos orientados a la tecnología, es necesario trabajar en la construcción de nuevos paradigmas pedagógicos basados en una reflexión crítica y profunda sobre las necesidades y desafíos para la postpandemia.

Practices such as tree felling, pruning, logging and chipping wood can produce significant amount of wood particles that can be inhaled by agricultural and forestry workers, triggering an important risk to the health of workers. Especially finest fractions of dust, less than 4 µm in diameter (the respirable fraction) may cause respiratory and dermal diseases, until to the risk of developing nose and sinus adenocancer. The aim of this work was to assess the particle size distribution of wood dust produced during chainsaw operations. In two separate trials (July and December), wood logs of three different species (Eucalyptus sp., Pinus radiata and Quercus cerris) were employed in cutting tests. Two chainsaws, one electric powered by batteries and one endothermic, were employed. To characterize the particle size distribution, samplings were carried out with a dust particle counter placed in the area surrounding the tests’ site. Results showed that the dust was characterized by a major fraction of fine particles around 0.3 µm (72% of the particles from 0.3 to 10 µm). The chainsaw with endothermic engine produced more fine dust of the electric one. Obtained amounts of inhalable wood dust were very variable in values, however attention should be paid to the exposure to wood dust considering potential risks, especially in case of long times of exposure.

Starting from the data measured in several static firings of two laboratory-scale hybrid rocket engines of different sizes burning gaseous oxygen with either a liquefying fuel or a pyrolyzing polymer, a mechanism for the combustion instability observed only with liquefying fuel is suggested. With the latter type of fuels, regression rate is increased for the formation of an unstable liquid layer on the grain surface, for which liquid fuel structures are entrained into the gas stream and burn, upon vaporization and mixing, far from the surface. Based on this circumstance, the hypothesis of a time delay to burn, with the resulting effect of triggering longitudinal acoustic modes of the system, is formulated. A simplified analytical acoustic model of a series of interconnected ducts with different cross sections and gas properties is preliminarily addressed, which allowed demonstrating the acoustic nature of the main pressure oscillation peaks measured in three firing tests along with the influence of the oxygen-feeding line on the system acoustics. Finally, by leveraging an existing acoustic model of the hybrid rocket combustion chamber including the effects of cross-sectional discontinuities and distributed fuel mass addition and combustion, the linear stability of the system is analyzed, whose results are apt to reproduce the experimental findings.

A Atenção Primária à Saúde (APS) é uma estratégia para orientar a organização do sistema de saúde. Neste sentido, países desenvolvidos têm reorganizado o acesso na APS através do uso do modelo Acesso Avançado (AA). Este protocolo buscou identificar e sintetizar as melhores evidências disponíveis sobre as experiências da equipe multidisciplinar com o processo de implantação do modelo de acesso avançado na APS. Trata-se de um protocolo de revisão sistemática qualitativa elaborado a partir das orientações do Instituto Joana Brigs para revisões sistemáticas de evidências qualitativas e usando a lista de verificação de avaliação crítica JBI para pesquisa qualitativa. A estratégia de busca terá como objetivo localizar literatura publicada e cinzenta. Estes serão agrupados em categorias e sintetizados com a utilização do JBI SUMARI® pela abordagem de meta-agregação. Estes resultados serão então submetidas à síntese para produzir um conjunto único, abrangente e não redundante de achados que apresente uma base para a prática baseada em evidências.

We report a detailed analysis of the XMM-Newton spectra of six Narrow-Line Seyfert 1 (NLS1) galaxies at redshift z = 0.35--0.92. Compared with the NLS1s at lower redshift in the previously most-studied sample, these NLS1s have larger black hole (BH) masses ($\log\,M_\text{BH}>7.5$) with similar or even lower Eddington ratios. Our extended XMM-Newton sample of NLS1s shows strong soft X-ray excess emission below 2 keV. The quantified soft excess strength does not show an obvious discrepancy from previous studies of the lower-redshift NLS1s. The systematic effect in the measurement of the Eddington ratio mainly lies in the bolometric correction factor. We also tentatively fit the spectra assuming two more physical models for the soft excess: warm Comptonization and relativistic reflection from the inner accretion disk. In the first scenario, we confirm the ubiquity of a warm and optically thick corona. The behavior of a single source can be better explained by relativistic reflection, although we cannot distinguish which model is a more favorable explanation for the soft excess based on the best-fit statistics., 13 pages, 10 figures