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To ensure that technology use benefits all students, it must be accessible with respect to cost and ease of use. Moreover, technology needs to be integrated by considering it from the perspective of the curriculum.

Given the still current scenario of disparity of opportunities regarding groups considered as minorities in several areas, such as education, income and work, cultural diversity in organizations remains relevant and fundamental in order to contribute to improve social conditions. To clarify the theoretical bias and encourage approaches on the topic, that is slowly gaining space, the basic concepts are first considered before going into the central focus of this work regarding potential organizational trends in the management of cultural diversity in Brazil and linked mainly to the processes of attraction and selection of talents. For this purpose, data from a recent survey of 109 Organizations in Brazil, allows to see how the concept management applied in an integral and uniform way in the organizational culture - and permeating all its processes – reflexes positively into business performance in addition to representing the practice of a social responsibility activity that is inherent to the subject. Moreover, results indicate the advantages in recruiting better talents, greater customer orientation, greater employee satisfaction and better decision making. This demonstrates that the gains reach, directly or indirectly, the organizational performance as a whole, and better, guided by principles that permeate an ethics of social responsibility that should be part of the organizational actions.

Objectives We investigated the accuracy of clinical breast carcinoma anatomic staging and the greatest tumor dimension measurements. Methods We compared clinical stage and greatest dimension values with the pathologic reference standard values using 57,747 cases from the 2016 US National Cancer Institute Surveillance, Epidemiology, and End Results program who were treated by surgical resection without prior neoadjuvant therapy. Results Agreement for clinical vs pathologic anatomic TNM group stage, overall, is 74.3% ± 0.4%. Lymph node N staging overall agrees very well (85.1% ± 0.4%). Based on tumor dimension and location, T staging has an agreement of only 64.2% ± 0.4%, worsening to 55% without carcinoma in situ (Tis) cases. In approximately 25% of cases, pathologic T stage is higher than clinical T stage. The mean difference in the greatest dimension is 1.36 ± 9.59 mm with pathologic values being generally larger than clinical values; pathologic and clinical measurements correlate well. T-stage disagreement is associated with histology, tumor grade, tumor size, N stage, patient age, periodic biases in tumor size measurements, and overuse of family T-stage categories. Pathologic measurement biases include rounding and specimen-slicing intervals. Conclusions Clinical and pathologic T-staging values agree only moderately. Pathologists face challenges in increasing the precision of gross tumor measurements, with the goal of improving the accuracy of clinical T staging and measurement.

Puntos para una lectura rapida • Los pacientes en tratamiento con IECA o ARAII no tienen mayor riesgo de infeccion por SARS-COVID, ni mayor riesgo de COVID-19 grave ni de mortalidad. Por ello, deben continuar con el tratamiento, y solo estaria justificada su retirada por motivos clinicos. • Los pacientes con COVID-19 en tratamiento con hipolipemiantes deben continuar con ellos, especialmente aquellos con alto riesgo de enfermedad cardiovascular. Se suspenderan si hay riesgo hepatico o renal o si esta impedida la via oral. Se valorara el cambio de estatina si hay interaccion con el tratamiento para la infeccion. • En pacientes diabeticos con COVID-19 se recomienda suspender los iSGLT-2 (gliflozinas o uricosuricos) en caso de fiebre o diarrea, y vigilar funcion renal y glucemia por si es necesario ajustar el resto de los antidiabeticos. La insulina es el tratamiento de eleccion en caso de retirada del resto de farmacos. • Los medicamentos psicotropicos pueden interactuar con los farmacos utilizados para la COVID-19 y algunos de sus efectos adversos, especialmente los relacionados con la depresion respiratoria, pueden empeorar la evolucion de la infeccion. • No se ha encontrado asociacion entre el uso de inhibidores de la bomba de protones o anti-H2 y la aparicion de COVID-19. La evidencia actual no indica la necesidad de retirar el omeprazol en los casos con clara indicacion. • No hay evidencia cientifica que relacione el uso de antiinflamatorios no esteroideos (AINE) con el empeoramiento de la COVID-19, por lo que pueden usarse en el tratamiento sintomatico de la infeccion y/u otras comorbilidades asociadas. • No se deben interrumpir los tratamientos cronicos con AINE u opiaceos que estan bien indicados. Se recomienda elegir opioides con menos efecto inmunosupresor. • Durante la COVID-19 se recomienda suspender temporalmente los anticonceptivos y continuar con los anticoagulantes o antiagregantes que tomase previamente.

Schizophrenia is a biologically complex disorder with multiple regional deficits in cortical brain morphology. In addition, interindividual heterogeneity of cortical morphological metrics is larger in patients with schizophrenia when compared to healthy controls. Exploiting interindividual differences in the severity of cortical morphological deficits in patients instead of focusing on group averages may aid in detecting biologically informed homogeneous subgroups. The person-based similarity index (PBSI) of brain morphology indexes an individual’s morphometric similarity across numerous cortical regions amongst a sample of healthy subjects. We extended the PBSI such that it indexes the morphometric similarity of an independent individual (eg, a patient) with respect to healthy control subjects. By employing a normative modeling approach on longitudinal data, we determined an individual’s degree of morphometric dissimilarity to the norm. We calculated the PBSI for sulcal width (PBSI-SW) in patients with schizophrenia and healthy control subjects (164 patients and 164 healthy controls; 656 magnetic resonance imaging scans) and associated it with cognitive performance and cortical sulcation index. A subgroup of patients with markedly deviant PBSI-SW showed extreme deficits in cognitive performance and cortical sulcation. Progressive reduction of PBSI-SW in the schizophrenia group relative to healthy controls was driven by these deviating individuals. By explicitly leveraging interindividual differences in the severity of PBSI-SW deficits, neuroimaging-driven subgrouping of patients is feasible. As such, our results pave the way for future applications of morphometric similarity indices for subtyping of clinical populations.

The Fourth Industrial Revolution has arrived, and we are trying to adapt to the innovations. It is changing the way we interact in society, how we consume, live and work. But this agile process already presents a new stage that takes place in conjunction with the new digital age, involving people, technology, sustainability, risks and opportunities: it is the 5.0 Society. This article seeks to understand the impact of ongoing changes and the needs around sustainability, analyzing key indicators that include both movements. With this, we hope to obtain data on the possibility of building the new Sustainable Technology Society, besides investigating the next steps to make this happen in Latin America. In this study, 35 variables were analyzed a sample of 57 countries, including management, business, sustainability, technology, education and Society 5.0 dimensions, among others. We present an analysis of the relationship between the variables and the creation of a synthetic indicator, called S5I (Society 5.0 Index), which allows us to show the position of each country in this ranking. This is the discussion we present here.

This study analyzes the role of passion in engaging users and how it affects purchase intention and participation in social commerce contexts. Based on marketing research, the engagement generation process is studied through the interactions among social presence,interactivity, enjoyment, sPassion, purchase intention and spread of sWOM. The results have empirically confirmed that social interactions and information exchange derived from the process boost user participation and the intention to purchase. At the core of the process, sPassion positively affects the spreading of sWOM. The introduction of the new concept sPassion brings new challenges and opportunities to marketing research, helping to develop the concept of engagement and furthering research on WOM valence. Knowing how sPassion is formed and what factors are key to its creation enable companies to understand the necessary steps to enhance user participation in social commerce contexts.

OBJECTIVE The heart team (HT) approach plays a key role in selecting the optimal treatment strategy for patients with aortic stenosis (AS). However, little is known about the HT decision process and its impact on outcomes. The aim of this study was to identify the factors associated with the HT decision and evaluate clinical outcomes according to the treatment choice. METHODS The study included a total of 286 consecutive patients with AS referred for discussion in the weekly HT meeting in a cardiovascular institute over 2 years. Patients were stratified according to the selected therapeutic approach: medical treatment (MT), surgical (SAVR), or transcatheter (TAVR) aortic valve replacement. Baseline characteristics involved in making a therapeutic choice were identified and a decision-making tree was built using classification and regression tree methodology. RESULTS Based on HT discussion, 53 patients were assigned to SAVR, 210 to TAVR, and 23 to MT. Older patients (≥88 years old) were mainly assigned to TAVR or MT according to the logistic EuroSCORE (

Moving strategically toward the 2030 Agenda for Sustainable Development, the UN organized a Sustainable Development Solutions Network (UNSDSN) and a Platform (HLPF) in order to harness the so-called Data Revolution that could help to achieve systemically the 17 Goals, by attaining local and globally the corresponding targets. For this purpose, there is a need to keep joining efforts and know-how to develop an appropriate framework and roadmap. This paper represents a contribution for monitoring the SDG based on the 5Ps People, Planet, Prosperity, Peace and Partnership; by using data from the Iberoamerican Foresight Network Observatory (ORIBER).

Background The objective was to describe the prevalence and intensity of neuropsychiatric symptoms (NPSs) isolated and grouped into subsyndromes in patients with dementia in primary care (PC) to analyse their distribution based on stages of dementia and the relationship between them and the intensity of symptoms. Methods Design: Cross-sectional study. Setting and population: Patients with dementia, not institutionalized, in a PC follow-up. Variables: Sociodemographic and clinical variables. Assessment instruments: The frequency and intensity of NPSs were measured with the Neuropsychiatric Inventory (NPI), and the stages of dementia with the Global Deterioration Scale (GDS). Statistical analysis: The number of NPSs per patient, the mean NPI value, and the prevalence and intensity of NPSs isolated and grouped into subsyndromes were calculated, as were their 95% confidence intervals (CIs). The analyses were performed on an overall basis and by GDS scores. To analyse the association between the NPI and GDS scores, multivariate analysis was performed with a generalized linear model. Results Overall, 98.4% (95% CI 94.5;99.8) of the patients presented some type of NPS, with an average of five symptoms per patient. The most frequent symptoms were apathy [69.8% (95% CI 61.1;77.5)], agitation [55.8% (95% CI 46.8;64.5)] and irritability [48.8% (95% CI 39.9;57.8)]. The more intense NPSs were apathy [NPI 3.2 (95% CI 2.5;3.8)] and agitation [NPI 3.2 (95% CI 2.5;4.0)]. For subsyndromes, hyperactivity predominated [86.0% (95% CI 78.8;91.5)], followed by apathy [77.5% (95% CI 69.3;84.4]). By phase of dementia, the most common isolated symptom was apathy (60.7–75.0%). Affective symptoms and irritability predominated in the initial stages, and psychotic symptoms predominated in advanced stages. The mean NPI score was 24.9 (95% CI 21.5;28.4) and increased from 15.6 (95% CI 8.2;23.1) for GDS 3 to 28.9 (95% CI 12.6;45.1) for GDS 7. Patients with in the most advanced stages of dementia presented an NPI score 7.6 (95% CI 6.8;8.3) points higher than the score for mild dementia with adjustment for the other variables. Conclusions A high prevalence of NPSs was found among patients with dementia treated in PC. Symptoms change and increase in intensity as the disease progresses. Scales such as the NPI allow these symptoms to be identified, which may facilitate more stage-appropriate management.

Based on expectation disconfirmation theory, this study analyzes how attitudes (satisfaction and loyalty) influence interaction intention (sWOM) and, consequently, active and passive sWOM behavior. It does so by assessing the mediating role of social presence on sWOM intention and behavior. The empirical results provide several contributions. First, knowing how to increase active sWOM contributes to bridging the gap regarding how to enhance interactions between users. Second, fostering active sWOM on social commerce websites will provide companies with more positive user-generated content, since this active sWOM comes from satisfied and loyal users, and it is assumed that they will rate the product positively and report a good experience. Third, companies can benefit more from users if users interact with other users by sharing their experiences. This study sheds light on how social presence can mediate the relationship between intention and behavior, particularly when it comes to increasing active participation and brand promotion. © 2021 by the authors. Licensee MDPI, Basel, Switzerland.

COVID-19 is not only leading to lower student learning levels, but likely resulting in a learning inequality catastrophe. In this chapter, we document the high-levels of learning inequality (within and between countries) that existed before the pandemic and disentangle the different mechanisms through which changes in inequality in learning may happen because of a shock like COVID-19, examining the role of school and family inputs. We show that historically, similar shocks in average learning levels disproportionally affect the most vulnerable students, and that emerging evidence from developed countries, as well as simulations, support the expected significant shifts in the learning distribution. Finally, we present a set of compensatory education policies that countries must urgently implement to reduce the impact of COVID-19 on learning inequality and promote equality of opportunities during and after the pandemic.

Innovation happens as a combination or a result of various phenomena (i.e. entrepreneurship, business environment, interactions, etc.); it is almost impossible for a single discipline to explain it. Given that there are many facets to explore to cover all aspects of innovation, the present paper approaches this theme from the sociological perspective. Innovation is not a solitary, but an interactive phenomenon, which requires firms to cooperate to reach innovation sources, new processes and technologies. As a theoretical reference, this paper develops the argument of the importance of the firms’ interaction linkages and connections and their influence on the efficiency of the innovation system. So, in this context, the authors decided to adopt the survey method to examine whether or not interaction linkages have an impact on micro and small technology-based firms’ innovativeness in Brazil. The findings showed that interactions between firms and other innovation agents such as universities, research centres, financial institutions and other partners is essential for the development of open, collaborative innovation activities and have a direct impact on the level of innovativeness. Finally, this paper concludes that innovation is a result of the combination of various interaction linkages and not an isolated phenomenon restricted to the firm. As such, it may be appropriately fostered.

This article examines the impact of two strategies for using large-scale assessment results to improve school management and classroom instruction in the province of La Rioja, Argentina. In the study, 104 public primary schools were randomly assigned to three groups: a diagnostic-feedback group, in which standardized tests were administered at baseline and two follow-ups and results were made available to schools; a capacity-building group, in which workshops and school visits were conducted; and a control group, in which tests were administered at the second follow-up. After two years, diagnostic-feedback schools outperformed control schools by 0.33 standard deviations (σ) in mathematics and 0.36σ in reading. In fact, feedback schools still performed 0.26σ better in math and 0.22σ better in reading in the national assessment a year after the end of the intervention. Additionally, principals at feedback schools were more likely to use assessment results in making management decisions, and students were more likely to report that their teachers used more instructional strategies and to rate their teachers more favorably. Combining feedback with capacity building does not seem to yield additional improvements, but this could be due to schools assigned to receive both components starting from lower learning levels and participating in fewer workshops and visits than expected.

The goal set for this research is to propose a model of brand management to guide consumer choice to more sustainable options. The model assumes that consumers have varying degrees of awareness on the sustainability of products and services. At the same time, products and services may also be considered in varying degrees of sustainability. Thus the strategy of brands should be to communicate its sustainability aspects in order to reach the consumer who is at the same level. It is expected that from the momentum established by the model, in which more and more information is conveyed about the sustainability aspects of products and services, consumers start to be more aware or at least more informed. The independent variables were the brand’s image and the price. The dependent variable was the participant's intention of purchase. There were 402 consumers subjected to the quasi-experiment. The results were analyzed at brand level and, in general, shows that more sustainable brands grew in participant’s preference after they received information about the sustainability aspects of that type of product, but this gained preference were partially lost when participants were aware of product’s prices.

This paper discusses the sustainable forest management plan in Brazilian context. The theory shows that is relevant in the development of local policies with global impact. These are factors that have been widely promoted by the international community and the mechanism to combat amazon deforestation. This research utilized was the methodological approach of qualitative method and the data collection was through semi-structured interviews, observation and document analysis. We conclude that integration between actors (government, manager forests resource and community) is important for positive results in sustainable environmental.

Purpose The proliferation of social commerce websites has allowed consumers to share and exchange information, experiences, advice and opinions. Recently, information provided by users has been considered more trustworthy than the information shared by companies. However, the way in which users interact with technology can vary with age, and generational cohorts show different shopping behaviors, interests and attitudes. Hence, the way users process information (user-generated vs company-generated) can affect trust differently. Drawing on the trust transfer theory and the generational cohort theory, the purpose of this paper is to analyze the effects on user- and company-generated information in boosting trust of three different cohorts (Generation X, Y and Z). Design/methodology/approach The data were collected through an online survey. The sample comprised 715 users of social commerce websites, aged between 16 and 55 years old. The study was analyzed using partial least squares with the statistical software Smart PLS 3. Findings The empirical results show that generational cohorts show different patterns. Generation X transfers trust to social commerce websites mainly from trust in information generated by companies, while Generation Z transfers trust mainly from information generated by users. Finally, Generation Y, in contrast to previous findings about millennials, develops trust based on company-generated information to an even greater extent than does Generation X. Originality/value The originality of this study lies in its analysis of generational differences when it comes to trusting one type of information over another. This study contributes to the idea that users cannot be considered as a whole but must be segmented into generational cohorts.

This paper studies the relationship between test scores and cognitive skills using two longitudinal data sets that track student performance on a national standardized exam in grades 6, 9, and 12 and post-secondary school outcomes in Mexico. Using a large sample of twins, the analysis finds that primary school test scores are a strong predictor of secondary education outcomes and that this association is mainly driven by the relationship between test scores and cognitive skills, as opposed to family background and other general skills. Using a data set that links results in the national standardized test to later outcomes, the paper finds that secondary school test scores predict university enrollment and hourly wages. These results indicate that, despite their limitations, large-scale student assessments can capture the skills they are meant to measure and can therefore be used to monitor learning in education systems.

Lignocellulosic biomass is described as a three-dimensional polymeric composite material synthesized by plants. It consists mainly of structural components along with other minor nonstructural compounds. The structural compounds are formed by three biopolymers: cellulose, hemicelluloses, and lignin. The lignocellulosic biomass has been known as an energy resource since ancient times by its direct combustion. More recently, the lignocellulosic materials have been used primarily in the chemical industry, furniture industry, and construction due to their abundance, ubiquity, and availability. Finally, in the last decades, lignocellulosic biomass has aroused as a promising alternative to petrochemical fossil resources for the conversion of biomass into energy, biofuels, chemicals, and new materials, which can be applied in many fields such as biomedical applications. Among the structural compounds, cellulose and hemicelluloses are very well-known polysaccharides, which can be used for many different applications in a variety of areas. However, lignin, which is mostly generated as a byproduct in the pulp and paper industry, is mainly burned in industrial boilers, underestimating its enormous potential. The main reason of this limited use of lignin is its high dispersity; difference in type and amount of functional groups, and thermal properties, which vary in accordance with the lignins’ origin and isolation process. Therefore, it is very important to establish different extraction and isolation methods along with its downstream valorization pathways for the production of different bulk chemicals, which can be used in a variety of industries especially in the biomedical field.

Background Hospitals lack intuitive methods to monitor their accuracy of clinical cancer staging, which is critical to treatment planning, prognosis, refinements, and registering quality data. Methods We introduce a tabulation framework to compare clinical staging with the reference-standard pathological staging, and quantify systematic errors. As an example, we analyzed 9,644 2016 U.S. National Cancer Institute SEER surgically-treated non-small cell lung cancer (NSCLC) cases, and computed concordance with different denominators to compare with incompatible past results. Results The concordance for clinical versus pathological lymph node N-stage is very good, 83.4 ± 1.0%, but the tumor length-location T-stage is only 58.1 ± 0.9%. There are intuitive insights to the causes of discordance. Approximately 29% of the cases are pathological T-stage greater than clinical T-stage, and 12% lower than the clinical T-stage, which is due partly to the fact that surgically-treated NSCLC are typically lower-stage cancer cases, which results in a bounded higher probability for pathological upstaging. Individual T-stage categories Tis, T1a, T1b, T2a, T2b, T3, T4 invariant percent-concordances are 85.2 ± 9.7 + 10.3%; 72.7 ± 1.6 + 11.3%; 46.6 ± 1.8 + 10.9%; 54.6 ± 1.6 – 20.5%; 41.6 ± 3.3 – 0.1%; 54.7 ± 2.8 – 24.1%; 55.2 ± 4.7 + 2.6%, respectively. Each percent-concordance is referenced to an averaged number of pathological and clinical cases. The first error number quantifies statistical fluctuations; the second quantifies clinical and pathological staging biases. Lastly, comparison of over and under staging versus clinical characteristics provides further insights. Conclusions Clinical NSCLC staging accuracy and concordance with pathological values can improve. As a first step, the framework enables standardizing comparing staging results and detecting possible problem areas. Cancer hospitals and registries can implement the efficient framework to monitor staging accuracy.

Background: A non-pharmaceutical treatment offered as psychological support is bibliotherapy, which can be described as the process of reading, reflecting, and discussing literature to further a cognitive shift. The coronavirus disease 2019 (COVID-19) pandemic demands a response to prevent a peak in the prevalence of mental health problems and to avoid the collapse of mental health services, which are scarce and inaccessible due to the pandemic. Thus, this study aimed to review articles on the effectiveness of bibliotherapy on different mental health problems.Methods: A systematic review was conducted to examine relevant studies that assess the effectiveness of bibliotherapy in different clinical settings as a treatment capable of enhancing a sense of purpose and its surrounding values. To achieve this, a systematic review, including a bioethical meta-analysis, was performed. A variant of the PICO (Participants, Intervention, Comparison, and Outcome) model was used for the search strategy, and the systematic review was conducted in three databases: PubMed, Bireme, and OVID. Inclusion criteria were relevant studies that included the keywords, excluding documents with irrelevant topics, studies on subjects 15 years or younger, and in languages besides Spanish or English. Starting with 707 studies, after three rounds of different quality criteria, 13 articles were selected for analysis, including a hermeneutic analysis, which was followed by a fourth and final recovery round assessing bibliotherapy articles concerning healthcare workers.Results: Our findings showed that through bibliotherapy, patients developed several capacities, including the re-signification of their own activities through a new outlook of their moral horizon. There are no research road maps serving as guides to conduct research on the use of bibliotherapy to enhance mental health. Additionally, values such as autonomy and justice were closely linked with positive results in bibliotherapy. This implies that bibliotherapy has the potential to have a positive impact in different settings.Conclusions: Our contribution is to offer a road map that presents state-of-the-art bibliotherapy research, which will assist institutions and healthcare professionals to plan clinical and specific interventions with positive outcomes.

El secuestro pulmonar es un tipo de malformación congénita pulmonar poco frecuente, con presentación clínica variable y de usual diagnóstico durante la infancia. Puede coexistir con otras patologías pulmonares, principalmente de tipo infecciosas y su manejo definitivo es mediante un procedimiento quirúrgico. Se presenta el caso de una paciente adulta con secuestro pulmonar, asociado a una infección fúngica, manejada con cirugía mínimamente invasiva.

Rationale and Objectives Examine the accuracy of clinical non–small cell lung cancer staging and tumor length measurements, which are critical to prognosis and treatment planning. Materials and Methods Compare clinical and pathological staging and lengths using 10,320 2016 National Cancer Institute Surveillance, Epidemiology, and End Results (SEER) and 559 2010–2018 non-SEER single-institute surgically-treated cases, and analyze modifiable causes of disagreement. Results The SEER clinical and pathological group-stages agree only 62.3% ± 0.9% over all stage categories. The lymph node N-stage agrees much better at 83.0% ± 1.0%, but the tumor length-location T-stage agrees only 57.7% ± 0.8% with approximately 29% of the cases having a greater pathology than clinical T-stage. Individual T-stage category agreements with respect to the number of pathology cases are Tis, T1a, T1b, T2a, T2b, T3, T4: 89.9% ± 10.0%; 78.7% ± 1.7%; 51.8% ± 1.9%; 46.1% ± 1.3%; 40.5% ± 3.1%; 44.1% ± 2.2%; 56.4% ± 4.7%, respectively. Most of the single-institute results statistically agree with SEER's. Excluding Tis cases, the mean difference in SEER tumor length is ∼1.18 ± 9.26 mm (confidence interval: 0.97–1.39 mm) with pathological lengths being longer than clinical lengths except for small tumors; the two measurements correlate well (Pearson-r >0.87, confidence interval: 0.86–0.87). Reasons for disagreement include the use of family-category descriptors (e.g., T1) instead of their subcategories (e.g., T1a and T1b), which worsens the T-stage agreement by over 15%. Disagreement is also associated with higher tumor grade, larger resected specimens, higher N-stage, patient age, and periodic biases in clinical and pathological tumor size measurements. Conclusions By including preliminary non–small cell lung cancer clinical stage values in their evaluation, diagnostic radiologists can improve the accuracy of staging and standardize tumor-size measurements, which improves patient care.

Aims: Assessment of the coronary circulation has been based largely on pressure ratios (epicardial) and resistance (micro-vessels). Simultaneous assessment of epicardial (CEPI) and microvascular conductance (CMICRO) provides an intuitive approach using the same units for both coronary domains and expressing the actual deliverability of blood. The aim of this study was to develop a novel integral method for assessing the functional severity of epicardial and microvascular disease. Methods and results: We performed intracoronary pressure and Doppler flow velocity measurements in 403 vessels in 261 patients with stable coronary artery disease. Hyperaemic mid-to-late diastolic pressure and flow velocity (PV) relationships were calculated. The slope of the aortic PV indicates the overall conductance and the slope of the distal PV relationship represents CMICRO. The intercept with the x-axis represents zero-flow pressure (Pzf). CEPI was derived from microvascular and overall conductance. Median CEPI was higher compared to CMICRO (4.2 [2.1-8.0] versus 1.3 [1.0-1.7] cm/s/mmHg, p0.8, p=0.797). ROC curves (using FFR and HSR concordant vessels as standard) demonstrated an excellent ability of CEPI to characterise significant stenoses (AUC 0.93). When CEPI

A randomized control trial was conducted to study whether providing 10th grade students with information about the returns to upper secondary and tertiary education, and a source of financial aid for tertiary education, can contribute to improve student performance. The study finds that the intervention had no effects on the probability of taking a 12th grade national standardized exam three years after, a proxy for on-time high school completion, but a positive and significant impact on learning outcomes and self-reported measures of effort. The effects are larger for girls and students from households with a relatively high income. These findings are consistent with a simple model where time discount determines the increase in effort and only students with adequate initial conditions are able to translate increased effort into better outcomes.

The main aim of this article is to identify how the pressures from the external environment, in relation to the adoption of practices for sustainability in the environmental dimension, interfere with the organizational routines of companies involved in the plastic transformation chain. This research used a qualitative method because we sought to understand the meaning of managerial decisions regarding the routines that make up an organizational structure. For this purpose, secondary sources of evidence were used, which provided information on the history, infrastructure and products of 107 companies associated with the Brazilian Association of the Plastic Industry (Abiplast). In addition, six individuals directly linked to the plastics industry were also interviewed in order to obtain more evidence about the changes in the routines of this industry. For the analysis of the data, the constant comparison method was used based on the coding technique to identify patterns of behavior. The qualitative data were analyzed using the Atlas.ti version 7 software. The results demonstrate that the routines can be categorized as isomorphic or evolutionary, which is the main contribution of this research. In addition, the type of routine adopted may be associated with the company being reactive or proactive in relation to the pressures from the external environment. Furthermore, we can also say that the activities involved in the creation of new routines for environment sustainability are linked to three actions: building an infrastructure for sustainability, managing a circular flow of resources and innovation for sustainability.

This paper studies the relationship between test scores and cognitive skills using two longitudinal data sets that track student performance in a national standardized exam in grades 6, 9, and 12 and post-secondary school outcomes in Mexico. Exploiting a large sample of twins to control for all between-family differences in school, household, and neighborhood inputs, we find that primary school test scores are a strong predictor of secondary education outcomes. Using a data set that links results in the national standardized test to later outcomes, we find that secondary school test scores predict university enrollment and hourly wages. These results indicate that, despite their limitations, large-scale student assessments can capture the skills they are meant to measure and can therefore be used to monitor student learning in developing countries.

System dynamics is an approach to analyze the behavior of complex systems, such as the productive chains, strictly considering the inherent characteristics. This approach is based on mathematical concepts of nonlinear processes developed in mathematics and physics and consolidated in engineering. The concepts inherent in this approach assists in creating a mathematical model that represents a production chain by using computer simulation. Thus, the main objective of this paper is to present the formalization of the dynamic model of assessing the sustainability of Brazilian ethanol production. We analyzed the external environment and the scenarios needed for a deeper understanding of relation of cause and effect, causal loops and diagrams of flows and stocks because of the awareness stage, with regard to understanding the problems involved, according to methodology known as design science. RESUMO O objetivo deste trabalho foi apresentar a formalização de um modelo dinâmico de avaliação abordando a sustentabilidade da produção do etanol no Brasil. Foram analisados os ambientes externos e os cenários necessários para uma compreensão mais profunda da relação de causa e efeito, laços causais e diagramas de fluxos e estoques de modo a compreender os problemas envolvidos dentro de uma sistemática conhecida como ciência de design. O comportamento de sistemas complexos, tais como as cadeias produtivas, que possuem características inerentes as quais permitem a análise utilizando-se do conceito de dinâmica de sistemas e a ciência do design. Tal abordagem se baseia em conceitos matemáticos e físicos de processos não lineares consolidadas em aplicações de simulação em engenharia principalmente no que tange à representação de modelos de cadeias de produção.

Background Coronary Aneurysms are a focal dilatation of an artery segment >1.5-fold the normal size of adjacent segments. Although some series have suggested a prevalence of 0.3–12%, data are lacking. In addition, they are not mentioned in practice guidelines. Our aim was investigate its prevalence, management and long-term outcomes. Methods and results The coronary artery aneurysm registry (CAAR) involved 32 hospitals across 9 countries in America and Europe. We reviewed 436,467 consecutive angiograms performed over the period 2004–2016. Finally, 1565 patients were recruited. Aneurysm global prevalence was 0.35%. Most patients were male (78.5%) with a mean age of 65 years and frequent cardiovascular risk factors. The main indication for angiogram was an acute coronary syndrome, 966 cases. The number of aneurisms was ≤2 per patient in 95.8% of the cases, mostly saccular, most frequently found in the left anterior descending and with numbers proportional with coronary stenosis. Aortopathies were related with more aneurysms too. Most patients received any revascularization procedure (69%), commonly percutaneous (53%). After a median follow-up of 37.2 months, 485 suffered a combined event (MACE) and 240 died. Without major differences comparing CABG vs PCI, MACE and death were more frequent in patients who received bare metal stents. Conclusions Coronary artery aneurysms are not uncommon. Usually, they are associated with coronary stenosis and high cardiovascular risk. Antiplatelet therapy seems reasonable and a percutaneous approach is safe and effective.

The article presents a general scenario on the theme of Internet of Things - IoT, aiming to discuss the opportunities, the impacts and the associated risks, highlighting them under the sight of well-being in our lives and society in general. This paper deals with questions regarding accelerated and disruptive high-tech transformations, in order to be strategically prepared and to deal with challenges ahead. It is in the interest of all to know and anticipate the transformations that are underway and those that will be probable in the future, capturing the spirit of accelerated change that is around us, to prevent impacts, to draw personal strategies to seize opportunities and to avoid serious ruptures in our work and in our personal lives. The contribution for other studies is to allow ongoing discussions regarding the possible changes of behaviors coming from this new environment that will be made possible by the use of the IoT. Some of these behaviors are already on its way. Still, others are to be perceived and developed. This article presents, in the first topic, the new environment of the Fourth Industrial Revolution, where it is inserted the concept of IoT. It advances, in the second topic, with the discussion of the extension of the usage of the new technology, its impact and its applications. And it ends discussing the behavioral changes that the massive use of this application may bring us regarding well-being.

The National Institute for Environmental Health Sciences has called for targeted efforts to engage underserved youth in environmental education programs that support environmental literacy and contribute to the development of a diverse workforce pipeline for environmental science-related occupations. Evidence suggests that career knowledge among low income and minority youth is more likely to be incompatible with post-secondary educational opportunities than other racial and ethnic groups. One approach to attenuating discordant college and career expectations among underserved youth is building networks for information sharing between secondary and post-secondary students. The purpose of this commentary is to describe the development and implementation of a high school curriculum on environmental science and environmental justice by Texas A&M University in collaboration with community engagement partners, students, and teachers at Furr High School, an innovative XQ Super School in Houston, Texas.

Las hernias abdominales internas son una causa poco frecuente de obstrucción intestinal, que se presentan por el deslizamiento de los órganos intraabdominales, en especial el intestino delgado, a través de defectos congénitos o adquiridos en el mesenterio o en los espacios intraperitoneales. La hernia supravesical interna es una de las presentaciones menos frecuentes de esta entidad y su diagnóstico es intraoperatorio en la mayoría de los casos. Se presenta el caso de un paciente de sexo masculino que consultó con manifestaciones de obstrucción intestinal, y fue sometido a cirugía de urgencias, con el hallazgo de una hernia supravesical interna.