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Breakfast processed products are remarkably at risk of fungal contamination. This research surveyed the fumonisins concentration in different breakfast products and carried out in vitro experiments measuring fumonisins content in different substrates inoculated with Fusarium verticillioides. The pipeline started with the identification of combinations of ingredients for 58 breakfast products. Twenty-three core ingredients, seven nutritional components and production types were analyzed using a Pearson correlation, k-means clustering, and principal component analysis to show that no single factor is responsible for high fumonisins detection in processed cereals products. Consequently, decision tree regression was used as a means of determining and visualizing complex logical interactions between the same factors. We clustered the association of ingredients in low, medium, and high risk of fumonisin detection. The analysis showed that high fumonisins concentration is associated with those products that have high maize concentrations coupled especially with high sodium or rice. In an in vitro experiment, different media were prepared by mixing the ingredients in the proportion found in the first survey and by measuring fumonisins production by Fusarium verticillioides. Results showed that (1) fumonisins production by F. verticillioides is boosted by the synergistic effect of maize and highly ready carbohydrate content such as white flour; (2) a combination of maize > 26% (w/w), rice > 2.5% (w/w), and NaCl > 2.2% (w/w) led to high fumonisins production, while mono-ingredient products were more protective against fumonisins production. The observations in the in vitro experiments appeared to align with the decision tree model that an increase in ingredient complexity can lead to fumonisins production by Fusarium. However, more research is urgently needed to develop the area of predictive mycology based on the association of processing, ingredients, fungal development, and mycotoxins production.

A crescente valorização da participação das autarquias na educação, reforçada pela publicação do Decreto-Lei n.º 21/2019, de 30 de janeiro, obriga à construção de instrumentos estratégicos de planeamento que contextualizem e orientem as políticas educativas locais. Assim, torna-se indispensável perceber a influência da Carta Educativa, como instrumento do planeamento estratégico e do reordenamento prospetivo das redes municipais de oferta de educação e formação, e a forma como este documento se relaciona e contribui para a efetivação das políticas educativas locais. O estudo qualitativo que aqui se apresenta, incide na Carta Educativa de 2007 e no Relatório Preliminar da Carta Educativa 20-30 do concelho de Leiria. Foi feita uma analise documental dos dois documentos e foram realizadas entrevistas aos gestores escolares, à vereadora da educação e à técnica municipal responsável pela elaboração da próxima Carta Educativa. Aferimos que a Carta Educativa de 2.ª geração, ainda em elaboração, aprofundará a sua relação com as políticas educativas locais pela inclusão do Plano Educativo Municipal e de outras intervenções na área da educação, e que estão em curso dinâmicas que promovem a participação de diversos atores com responsabilidades na educação na elaboração das cartas. Podemos perceber ainda que na opinião de diretores das escolas e da autarquia a Carta Educativa é um documento maleável, ajustável às mudanças na realidade local e que não interfere com a autonomia das escolas.

International audience; The application of riblets on a typical regional turboprop configuration is discussed in this paper. The effect of the riblets is modeled as a singular roughness problem by a proper boundary condition at the wall. The model, already proposed in a previous paper, is briefly described. The drag prediction capabilities are verified by showing some airfoil flow applications. Then a typical wing-body of a regional aircraft is considered. The configuration has been designed to have extended natural laminar flow in cruise conditions. Riblets are applied at flow specifications representative of cruise in combination with the natural laminar flow technology and in climb/descent conditions. A comparison of the two technologies in terms of drag reduction is presented. Their combined application can result in a cruise drag reduction of more than 20%. The resulting fuel savings during a typical operational day are evaluated.

This paper examines productivity growth in Romania using balance sheet data for a census of Romanian firms in 2011-17. Three measures of productivity are estimated: labor productivity, revenue total factor productivity, and revenue total factor productivity adjusted for markups. Drawing from these measures, the paper follows a two-step approach to answer two fundamental questions: (i) who are the firms -- and what are their key characteristics -- driving and dragging productivity growth in Romania? and (ii) what are the drivers behind productivity expansion? A first step of the analysis characterizes productivity leaders and laggards, finding that companies at the domestic productivity frontier are older and larger, have higher capital intensity, and pay higher wages. Domestic market leaders charge higher markups, especially in manufacturing, but are not becoming more efficient. A second step of the analysis decomposes aggregate productivity growth and finds that reallocation of market shares to more efficient players has been the main driver in manufacturing but not in services, which are typically more sheltered from competition. At the same time, individual firms are becoming less productive, suggesting that there is scope to improve firm capabilities, particularly in services. These findings suggest a policy agenda for Romania centered on removing distortions to competition and boosting human capital.

In this study three phenolic extracts were examined, without volatile fraction, against common food pathogens. The samples, all suitable for food application, were from the leaves of Rosmarinus officinalis L., Vitis vinifera L., and the root of Polygonum cuspidatum L. The microorganisms tested were Escherichia coli O157:H7, Salmonella Enteritidis, Salmonella Typhi, Yersinia enterocolitica and Listeria monocytogenes, well-known as important food pathogens. The results demonstrated a microbicidal activity of all the tested compounds at different concentrations; the rosemary extract showed greater efficacy than the other compounds against the tested microorganisms. In particular, the best results were obtained with rosemary extract against E. coli O157:H7 and L. monocytogenes with values of 200 and 270 μg/mL, respectively. Our results show that rosemary extract, often present as a natural antioxidant in food, can also be proposed as a natural disinfectant in the food field.

Vaccination is traditionally considered as a measure addressed to infants and children. Indeed, in natural conditions, vaccine-preventable infections are mainly spread at a young age. The implementation of routine and mass vaccination programmes has led to the eradication of smallpox and to the elimination of poliomyelitis in many regions of the world, together with the control of once life-threatening diseases like diphtheria and tetanus. In more recent times, the development of new generation vaccines and the changing epidemiological profile of many vaccine-preventable diseases have greatly changed the objectives and the target of today’s immunization strategies. The objective of this article is to highlight and discuss the evolution of vaccination strategies from measures aimed at protecting children to a practice that is needed throughout life. Adolescents and adults need immunization for several reasons: they may not have received the vaccines usually administered in childhood; new vaccines tailored for adolescents and adults have become available; immunity acquired thanks to immunization in childhood can fade; and older adults or those who are chronically ill are more susceptible to vaccine-preventable diseases and to their complications. The changing demographic profile of both industrialized countries and of countries in transition towards an ‘aging’ population, and the shift of several infectious diseases towards adulthood make it imperative that new infrastructures to deliver vaccines and new investments in immunization are investigated. Such a change of perspective is needed both to preserve health and to guarantee the sustainability of health systems.

Rationale, aims and objectives In 2012, health care spending in Italy reached €114.5 billion, accounting for 7.2% of the Gross Domestic Product (GDP) and 14.2% of total public spending. Therefore, reducing waste in health facilities could generate substantial cost savings. The objective of this study is to show that Lean Six Sigma represents an appropriate methodology for the development of a clinical pathway which allows to improve quality and to reduce costs in prosthetic hip replacement surgery. Methods The methodology used for the development of a new clinical pathway was Lean Six Sigma. Problem solving in Lean Six Sigma is the DMAIC (Define, Measure, Analyse, Improve, Control) roadmap, characterized by five operational phases which make possible to reach fixed goals through a rigorous process of defining, measuring, analysing, improving and controlling business problems. Results The following project indicated several variables influencing the inappropriate prolongation of the length of stay for inpatient treatment and corrective actions were performed to improve the effectiveness and efficiency of the process of care. The average length of stay was reduced from 18.9 to 10.6 days (-44%). Conclusion This article shows there is no trade-off between quality and costs: Lean Six Sigma improves quality and, at the same time, reduces costs.

Este estudo, parte do pressuposto de que ensinar uma língua vai além das classificações gramaticais de que essa se constitui. Assim, no intuito de propiciar aos alunos, de um contexto público de ensino, uma aprendizagem mais significativa, propõe-se aqui uma metodologia diferenciada no ensino da língua inglesa, a partir do uso de textos autênticos (originais, do contexto real), na intenção de construir oportunidades de desenvolver a habilidade de leitura e a capacidade discursiva diante dos significados atribuídos aos textos, motivando o senso crítico-reflexivo dos aprendizes. Para tanto, o suporte teórico adotado, está vinculado às questões de leitura e criticidade, tendo por base os estudos de Freire (1989), Rajagopalan (2003), Lima (2009), Liberali (2009), Marcuschi (2010), dentre outros especialistas, os quais fundamentam a pesquisa. Acredita-se, portanto, que a metodologia adotada se destaca no desenvolver da leitura e da habilidade crítica-discursiva dos indivíduos, além de contribuir, possivelmente, para a sua formação social, política e ideológica.

Summary To evaluate the effects of airborne Aspergillus contamination during and after the renovation work of a Florentine haematology unit, we conducted (November 2003–January 2005) a strict programme of environmental fungal surveillance. Air samples were taken from patients’ rooms, along the corridors inside the wards, along the corridor between wards and outside the building. The concentration of Aspergillus fumigatus was high along the corridor between the two haematology wards (2.98 CFU m−3), lower in the non-neutropenic patients’ rooms and outside the hospital building (1.53 and 1.42 CFU m−3, respectively), very low in the neutropenic patients’ rooms (0.09 CFU m−3). During this period, three proven cases (A. fumigatus), two probable ones and two possible cases of invasive pulmonary aspergillosis were documented in 97 patients with acute leukaemia (7%). The three cases of proven aspergillosis coincided with the period of renovation work and with the period in which we have found the maximum concentration of A. fumigatus along the corridor. These data suggest a possible relationship between environmental fungal contamination and the incidence of invasive aspergillosis, and underline the importance of environmental surveillance.

Recently, the attention of researchers regarding Artemisia annua has been focused on the antimicrobial activity of the essential oil. This oil, rich in mono- and sesquiterpenes, has a strong activity against some Gram-negative and Gram-positive bacteria. The aim of our study is to further contribute to the knowledge of the antibacterial activity of an Artemisia annua essential oil collected in Tuscany and its three most represented compounds (artemisia ketone, 1,8-cineole and camphor). The essential oil obtained by hydrodistillation gave a yield of 0.37% (w/w fresh plant material). The composition of the essential oil extracted from flowering aerial parts was determined by gas chromatography (GC/FID and GC/MS). The essential oil and compounds were tested for activity against Escherichia coli O157, Salmonella Enteritidis, Salmonella Typhi, Yersinia enterocolitica and Listeria monocytogenes , all of which have great significance in foodborne infections. The antibacterial activity was tested using disk diffusion method and broth microdilution assay. The microorganisms tested were all sensitive to the A. annua essential oil in toto and to all its components, which often have lower activity than oil in toto .

2011 - 2012, The laminar-turbulent transition is a complex phenomenon involved in several multidisciplinary design issues, such as skin friction drag reduction, anti-icing and de-icing system performance prediction and heat transfer rates assessment. An accurate prediction of the boundary layer state is needed in order to control its thickness by active or passive systems. The state of the boundary layer is of high importance since skin friction drag and heat transfer rates in a turbulent boundary layer can be several times higher than those expected in laminar one. Furthermore, predicting the state of the boundary layer in wind tunnels and ensuring the same state during the real flight, by taking disturbances resulting from the experimental set up into account, leads to the design of transition triggering devices.[edited by author], XI n.s.

Artemisia annuaL. (Asteraceae) is native to China, now naturalised in many other countries, well known as the source of the unique sesquiterpene endoperoxide lactone artemisinin, and used in the treatment of the chloroquine-resistant and cerebral malaria. The essential oil is rich in mono- and sesquiterpenes and represents a by-product with medicinal properties. Besides significant variations in its percentage and composition have been reported (major constituents can be camphor (up to 48%), germacrene D (up to 18.9%), artemisia ketone (up to 68%), and 1,8 cineole (up to 51.5%)), the oil has been subjected to numerous studies supporting exciting antibacterial and antifungal activities. Both gram-positive bacteria (Enterococcus,Streptococcus,Staphylococcus,Bacillus, andListeriaspp.), and gram-negative bacteria (Escherichia,Shigella,Salmonella,Haemophilus,Klebsiella, andPseudomonasspp.) and other microorganisms (Candida,Saccharomyces, andAspergillusspp.) have been investigated. However, the experimental studies performed to date used different methods and diverse microorganisms; as a consequence, a comparative analysis on a quantitative basis is very difficult. The aim of this review is to sum up data on antimicrobial activity ofA. annuaessential oil and its major components to facilitate future approach of microbiological studies in this field.

Romania's European Union accession in 2007 has resulted in a substantial reduction of the formal barriers to integration with the European Union Single Market. This study takes stock of the progress by benchmarking product market policies in Romania to those of European Union countries, as measured by the OECD indicators of Product Market Regulation. These indicators allow for a comprehensive mapping of policies affecting competition in product markets. Comparison with European Union countries reveals that, for half of the policy areas covered by the study, Romania's product market policies are more restrictive of competition than most direct comparators in the region, whereas for other indicators Romania is on a par with the European Union average or has achieved best practice. Nonetheless, these results should be interpreted in light of the fact that the Product Market Regulation approach measures officially adopted policies and does not capture implementation. Future reforms should be directed both at improving official regulation and, where policies that favor competition are already in place, toward effective enforcement.

Inappropriate regulation can influence productivity performance by affecting incentives to invest and adopt new technologies, as well as by directly curbing competitive pressures. Results of a labor productivity growth model for European countries suggest that improving the regulatory environment -- proxied by the Worldwide Governance Indicators regulatory quality indicator -- and boosting effective exposure to competition through increasing trade integration -- expressed as the ratio of exports plus imports to gross domestic product -- have positive effects on productivity growth. In Romania a 10 percent increase in openness to global trade over 1995-2010 would have boosted productivity growth by 9.7 percent per year. A 10 percent increase in openness to European Union trade, in particular, would have led to an annual increase in productivity of 7 percent. Realizing the benefits from trade integration depends to some extent on regulation. In this regard, the effects of regulation on productivity growth are found to be positive, regardless of the indicator used to measure regulation, and both through direct and indirect channels (by increasing the speed at which a country catches up with productivity leaders). Simulation results also show how countries with different levels of regulatory quality would benefit from a regulatory improvement: had Romania improved its regulatory environment to the same level as Denmark in 2010, its annual productivity growth would have been 14 percent higher over 1995-2010.

This paper examines whether natural resource dependence has a negative influence on various indicators of institutional quality when controlling for the potential effects of other geographic, economic and cultural initial conditions. Analysis of a panel of countries from 1996 to 2010 indicates that a high degree of resource dependence, measured as the share of mineral fuel exports in a country's total exports, is associated with worse government effectiveness, as well as with reduced levels of competition across the economy. Furthermore, estimation of long-run elasticities suggests that government effectiveness and the intensity of domestic competition decrease over time as the dependence on natural resources increases. An illustration of the Russian case shows that the negative effects accumulate in the long run, leading to a worse deterioration of government effectiveness in Russia than in Canada, a country with a comparable resource endowment but far better overall institutional quality. This result is corroborated by a significant negative correlation found between regional resource dependence and an indicator of regulatory capture in Russian regions, which indicates that the regulatory environment is more likely to be subverted in regions that are more dependent on extractive industries. Overall, the findings would be consistent with a situation in which a generally weak institutional environment would allow resource interests to wield the bidding power accruing from export revenues to subvert the content of laws and regulations, as well as their enforcement. The fact that this is associated with negative externalities for the rest of the economy, notably by undermining a level playing field across non-resource sectors, sheds light on a potential channel for the resource curse.

Using enterprise data for the economies of Central and Eastern Europe and the Commonwealth of Independent States, this study examines the effects of corruption on productivity. Corruption is defined as a 'bribe tax' and is compared with another form of institutional inefficiency, which is often believed to be closely linked with corruption: the 'time tax' imposed on firms by red tape. When testing their effects in the full sample, only the bribe tax appears to have a negative effect on firm-level productivity, while the effect of the time tax is insignificant. At the same time, there is no evidence of a trade-off between the time and the bribe taxes, implying that bribing does not emerge as a second-best option to achieve higher productivity by helping circumvent cumbersome bureaucratic requirements. When the sample is split between European Union and non-European Union countries, the time tax turns out to have a negative effect only in European Union countries and the bribe tax only in non-European Union countries. This suggests that the institutional environment influences the way in which firm behavior affects firm performance. In particular, the impact of bribing for individual firms appears to vary depending on overall institutional quality: in countries where corruption is more prevalent and the legal framework is weaker, bribery is more harmful for firm-level productivity.

Less restrictive product market policies are crucial in promoting convergence to higher levels of GDP per capita. This paper benchmarks product market policies in Bulgaria to those of OECD countries by estimating OECD indicators of Product Market Regulation (PMR). The PMR indicators allow a comprehensive mapping of policies affecting competition in product markets. Comparison with OECD countries reveals that Bulgaria has made substantial progress towards less restrictive product market policies but also emphasizes a number of areas where further reform is needed. These include adoption of a regulatory process based on incentive-based rather than command-and-control approach, reduction of state interference in the decision of state-owned enterprises, further streamlining of business licensing procedures, and improvement in the communication of rules and procedures to affected parties.

The control of microbial air contamination in hospital wards has assumed great importance particularly for those hospital infections where an airborne infection route is hypothesised, such as aspergillosis. Invasive aspergillosis represents one of the most serious complications in immunocompromised patients. For some authors there is a direct association between this pathology and the concentrations of Aspergillus conidia in the air; in addition, reports of aspergillosis concurring during building construction have been frequent. In this study, two haematology wards were monitored for about 2 years in order to make both a qualitative and quantitative evaluation of fungal burden in the air, also in relation to major construction and demolition work taking place in the same building. Air samples were taken from the hospital rooms of neutropenic patients, in the corridors of their ward and outside the building. Total fungal concentration resulted higher outside (mean 572 Colony Forming Units/m3 of air), lower in the corridors (147 CFU/m3) and even lower in the rooms (50 CFU/m3). In all the samples we found the development of at least one fungal colony. Cladosporium was the most frequently isolated genus (57%), in contrast to Aspergillus spp. (2%). The average concentration of Cladosporium spp. was 24 CFU/m3 in the rooms, 78 CFU/m3 in the corridors and 318 CFU/m3 outside. The average concentration of Aspergillus spp. was 1.2 CFU/m3 in the rooms, 3.5 CFU/m3 in the corridors, 5.6 CFU/m3 outside. Our observations show low concentrations of Aspergillus fumigatus and A. flavus in all the environments examined and particularly in the rooms (0.09 and 0.10 CFU/m3 respectively); this observation could explain the absence of cases of invasive aspergillosis during the period of air monitoring in the two haematology wards.

Purpose Septic knee arthritis following arthroscopy is a rare but dreaded complication. Definition and management of knee deep infections are quite discussed in literature. In this review, literature regarding infections after knee arthroscopy is analyzed highlighting the incidence, causative bacteria, risk factors as well as clinical outcomes. Methods We performed a review of the literature matching the following key words: “septic arthritis” OR “infection” AND “arthroscopy” AND “knee.” Knee arthroscopic procedures, such as debridement, meniscectomy, meniscus repair, synovectomy, microfracture, and lateral release, were considered. Complex procedures, such as ligament reconstruction, fractures, or complex cartilage repair techniques, were not included. Results Thirteen studies were included in this review. Incidence of infection ranged from 0.009 to 1.1% in patients undergoing simple arthroscopic procedures. Staphylococci are the most commonly isolated organisms from postarthroscopy infection. Use of intraoperative intra-articular steroids, smoking, obesity, male sex, diabetes, number of procedures performed during surgery, time of surgery, and tourniquet time of more than 60 minutes have been certified as risk factors for knee infection. Conclusion Postarthroscopy septic arthritis of the knee causes significant morbidity, usually requiring readmission to the hospital, at least one additional operation, and prolonged antibiotic therapy, both intravenous and oral. Prompt diagnosis and treatment are associated with a high success rate. Level of Evidence Level IV, systematic review of I-IV studies.

Background Autologous chondrocyte implantation (ACI) represents a valid surgical option for symptomatic full-thickness chondral lesions of the knee. Here we report long-term clinical and MRI results of first-generation ACI. Materials and methods Fifteen patients (mean age 21.3 years) underwent first-generation ACI for symptomatic chondral defects of the knee between 1997 and 2001. The mean size of the lesions was 5.08 cm2 (range 2–9 cm2). Patients were evaluated using the International Knee Documentation Committee (IKDC) Knee Examination Form, the Tegner Activity Scale, and the Knee Injury and Osteoarthritis Outcome Score (KOOS). High-resolution MRI was used to analyze the repair tissue with nine variables (the MOCART scoring system). Results The mean follow-up period was 148 months (range 125–177 months). ACI resulted in substantial improvements in all clinical outcome parameters, even as much as 12 years after implantation. A significant decrease in the MOCART score was recorded at final measurement. Reoperation was required in 2 patients; failure was caused by partial detachment of the graft in both cases. Conclusion Autologous chondrocyte implantation is an effective and durable solution for the treatment of large, full-thickness cartilage and osteochondral lesions, even in young and active middle-aged patients. High-resolution MRI is a useful and noninvasive method for evaluating the repaired tissue. Level of evidence IV.

International audience; The application of the riblets to a typical regional turbo-prop configuration is discussed in this paper. The effect of the riblets is modelled as a singular roughness problem by a proper boundary condition proposed by University of Napoli. The model is described and first its application to 2D flows is presented. Then a typical wing-body of a regional aircraft is considered. The configuration has been designed to have a natural laminar flow for a large extent of the wing in cruise conditions. Riblets are applied at flow specifications representative of cruise in combination with the laminar flow technology and in climb/descent conditions. The save of fuel achievable in a typical operative day of such an aircraft has been also estimated.

Purpose The aims of this paper are to report the rate and risk factors for the failure of the most common cartilage repair technique, and analyze the most important factors that could influence the choice of a specific surgical treatment to revise a failed cartilage repair. Methods A review of the literature was performed focusing on failed cartilage repair and related treatments. Two of the authors independently screened articles. Conflicts about the inclusion of a paper was resolved by further evaluation by the senior author. Review articles, articles written in languages different from/other than English, case reports, and papers that did not evaluate the outcomes of interest were excluded. Full-text version of each included paper was obtained and relevant data were extracted and collected in a database. Results At the end of the screening process, 31 articles were included. Microfractures and mosaicplasty showed a nonnegligible failure rate at short- and midterm. Better results, especially in terms of time to failure or revision, were reported with the use of autologous chondrocyte implantation (ACI) and osteochondral allograft (OCA) transplantation. Regarding the treatment of failed cartilage repair, the use of OCA transplantation in patients with previous failed cartilage repair may be a safe option. The revision of failed OCA transplantation with further OCA seems to have a greater failure rate. Patients with previous failed ACI or matrix-induced autologous chondrocyte implantation (MACI) who underwent further MACI or ACI reported acceptable results. Otherwise, ACI in patients with history of previous subchondral marrow stimulation (SMS) demonstrated a greater failure rate. Conclusion From the analysis of the literature, OCA transplantation seems to be the most reliable treatment of a failed SMS. ACI or MACI showed acceptable results in patients with previously failed MACI or ACI. Level of Evidence Level IV, systematic review of level I-IV studies.

Background Anterior cruciate ligament tears (ACL) are associated with meniscal lesions, that could involve the posterior horn of the medial meniscus (PHMM). A variety of techniques has been proposed to better visualise the postero-medial (PM) compartment. The aim of the study is to evaluate the prevalence of longitudinal tears of peripheral attachment of the PHMM during arthroscopic ACL reconstruction, and to describe a diagnostic algorithm. Methods 115 patients who underwent arthroscopic ACL reconstruction were enrolled for the study. An anterior and an intercondylar notch visualisation were ordinarily performed. A postero-medial (PM) portal was performed when the instability of the posterior horn was detected. Statistical significance was assessed by a Chi-squared or Fisher's Exact Test for categorical variables, and by a Mann-Whitney U test for continuous variables. Results We recorded a 9.6% prevalence of lesions of the peripheral attachment of PHMM. Nine ramp lesions and two hidden lesions were diagnosed. Patients treated within 6 months from injury, revealed a statistically significant correlation with a higher prevalence of these lesions. Conclusion Ramp and hidden lesions are very common ACL rupture associated injuries. Our diagnostic algorithm is a valid and safe option to diagnose these kinds of lesions. A correlation between a longer time from injury than 6 months and a reduced prevalence of these lesions was recorded in our population. Level of evidence IV.