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Objective The transversus abdominis plane (TAP) block is a relatively simple regional anesthesia technique which entails the injection of local anesthetics (LA) into the interfascial plane between the internal oblique and transversus abdominis muscles, where nerves supplying the anterolateral abdominal wall course. It is widely used for acute pain management following abdominal surgical procedures. We describe a series of cases in which TAP blocks were used to aid in the diagnosis and treatment of chronic abdominal wall pain (CAWP). Design Consecutive case series of 5 patients presenting with CAWP. Setting Regional referral Center for Pain Medicine of the academic tertiary hospital of Parma, Italy. Results Five patients received TAP blocks with LA and steroid. Four patients reported ≥50% pain relief within hours of the procedure, and 2 of them maintained low pain intensities at 6 and 12 months’ follow-up calls. Conclusions TAP blocks are a valuable addition to the diagnostic armamentarium of pain physicians confronted with abdominal pain of unclear origin. Although most patients responded to the LA injection, the varying degrees of response duration may have been influenced by the different etiologies underlying each condition and the variable expressions of placebo responses. Once the abdominal wall and/or its nerves are identified as pain generators, the optimal therapeutic management remains to be determined. Available literature as well as our case series show that long-term benefit may be obtained with 1 or more injections, but we speculate that this may only be the case for pain with predominantly neuropathic components. This article is protected by copyright. All rights reserved.

Highlights • Media attitude towards underpinning policy with evidence influences policy decision makers. • Individual skills, attitudes, values of policy makers impact the extent evidence use. • A solid research infrastructure is facilitating but not sufficient for evidence use. • Factors that impact evidence use in policy making differ by country and policy context. • Interventions connecting policy makers and researchers in the policy context seem most promising., The knowledge-practice gap in public health is widely known. The importance of using different types of evidence for the development of effective health promotion has also been emphasized. Nevertheless, in practice, intervention decisions are often based on perceived short-term opportunities, lacking the most effective approaches, thus limiting the impact of health promotion strategies. This article focuses on facilitators and barriers in the use of evidence in developing health enhancing physical activity policies. Data was collected in 2012 by interviewing 86 key stakeholders from six EU countries (FI, DK, UK, NL, IT, RO) using a common topic guide. Content analysis and concept mapping was used to construct a map of facilitators and barriers. Barriers and facilitators experienced by most stakeholders and policy context in each country are analysed. A lack of locally useful and concrete evidence, evidence on costs, and a lack of joint understanding were specific hindrances. Also users’ characteristics and the role media play were identified as factors of influence. Attention for individual and social factors within the policy context might provide the key to enhance more sustainable evidence use. Developing and evaluating tailored approaches impacting on networking, personal relationships, collaboration and evidence coproduction is recommended.

Made available in DSpace on 2022-04-29T08:27:32Z (GMT). No. of bitstreams: 0 Previous issue date: 2018-11-01 Prognostic stratification in acute myeloid leukemia (AML) relies, mostly, on cytogenetics and molecular features of leukemic blasts. The LeukemiaNet prognostic scoring system has been proposed as a standardized way of evaluating prognosis in AML. We have analysed outcomes in 65 AML cases (median age of 54 years, range 18–82) treated at five hematology centers in Brazil stritified according to the European Leukemia Net (ELN) recommendations for cytogenetic and molecular analysis. We classified patients as favorable (N = 13), intermediate-1 (N = 25), intermediate-2 (N = 15), or adverse risk (N = 9). Bone marrow transplantation (BMT) was performed in 13 patients (21%). Median follow-up was 12 months. The median overall survival (OS) for all patients was 12.4 months. Median OS was 19.8, 12.4, 10.1, and 10.4 months (p = 0.24) for patients in the favorable, intermediate-1, intermediate-2, and adverse groups, respectively. Among patients receiving BMT, median OS was 26.8 months. The ELN is a valuable tool for prognostic stratification of AML patients treated in Brazil. Nevertheless, its usefulness is limited when compared to data from developed countries. Centro de Pesquisa Clínica Instituto Israelita de Ensino e Pesquisa Albert Einstein Centro de Oncologia Integrado Hospital Quinta D’Or Complexo Hospitalar Universitário Professor Edgard Santos (HUPES) Universidade Federal da Bahia (UFBA) Universidade Federal do Rio Grande do Norte (UFRN) Hospital Amaral Carvalho Hospital das Clínicas da Faculdade de Medicina de Botucatu Centro de Pesquisa Clínica Instituto Israelita de Ensino e Pesquisa Albert Einstein, Av. Albert Einstein, 627/520 Hospital das Clínicas da Faculdade de Medicina de Botucatu

This article proposes an innovative theoretical framework for applying the Living Lab approach, traditionally adopted in entrepreneurial contexts, to the context of alternating training (AT) at school in co-designing, implementing and evaluating AT scenarios, with the final aim of fostering the role of the school as a social hub connecting several societal actors.

In the last years the debate on competences and their role in the development of a more inclusive societies and in promoting innovation processes has become increasingly crucial at European level. The European Commission identified 8 key competences (basic and transversal competences and soft skills) that have to be attained by all citizens during their learning process. Also employers require from their employees more and more these kind of skills, and this is true also in the scientific education and research context. Indeed “Communication, working with others, problem solving and other similar abilities are considered very important requisites for a recently graduated student by a large section of the research laboratories responsible.” Nevertheless, European school curricula bestow little attention to transversal competences and soft skills. In this framework DESCI1 project, funded by Erasmus + Program, aims to develop a methodological pattern for alternating training in secondary school systems, adopting participatory design methodologies based on a Living Lab environment, to improve the connection between school, research, enterprise and territory and to promote the development of soft and transversal skills in students, needed to allow them to foster the innovation process, to increase their employability, express themselves, acting consciously in the system and driving the innovation and social inclusion in their communities. The DESCI approach undergoes to a continuous and participated evaluation process, under RRI principles, meant in order to explore, in a process of co-creation of knowledge, the ongoing results of the project. The evaluation outputs emerged at this stage of the project confirm that, in the learning AT process, the DESCI approach promote the increase of transversal competences and soft skills in the students, mainly referring to those included in the 8 key competences identified by the EU Commission.

Background Fibular donor site pain management in the early postoperative period can help minimize complications, patient discomfort, and agitation. Traditional management of postoperative pain consists of systemic administration of opioids and NSAIDS. The use of local anesthetics in addition to systemic analgesics has the potential to improve pain control. Purpose of the study is to evaluate the efficacy of mini-catheters used to inject local anesthetic into the fibular donor site after flap harvesting for reconstruction of the head-and-neck area. Methods Prospective study on 31 patients (mean age 52 years) treated for head and neck reconstruction with fibula free flap using minicatheter for local anesthetic injection in the early postoperative time. A bolus of chirochaine (0.125% w/v; 20 mL) was injected through the catheter before the patient regained consciousness. Postoperatively, three consecutive injections (20 mL each) were administered 8, 16, and 24 h after surgery. Pain evaluation before and after local anesthetic injection is used to assess efficacy and overall pain control. Results No major or minor complication occurred. Mean pain value was 1.69. At 8 h, the pain scores before injection ranged from 0 to 10 (mean 4.13 ± 3.06). After injection, the pain scores ranged from 0 to 5 (mean 1 ± 1.34). Similarly, at 16 h, the pain scores ranged from 0 to 8 (mean 2.77 ± 2.42) before injection and from 0 to 6 (mean 0.42 ± 1.2) thereafter. At 24 h, the initial pain score ranged from 0 to 6 (mean 1.71 ± 1.74) and from 0 to 1 (mean 0.1 ± 0.3) after drug administration. Pre and postinjection pain scores differences were statistically significant after all three injections (P

Based on previous research, this study proposed to examine the influences of risk 10 perception of food ingredients on trust and loyalty as well as the moderating role of CSR activities 11 of a restaurant in the relationship. The empirical results demonstrated that when restaurant 12 consumers have higher levels of risk perception of food ingredients, such as food ingredients for 13 restaurant operation and food ingredients management, they are less likely to exhibit trust and 14 loyalty toward a restaurant brand. However, the influences of risk perception of food ingredients 15 will be significantly weaker if the restaurant brand implements CSR activities. Accordingly, this 16 research expanded the food risk literature and provided practical implications for the industry.

Chronic low back pain (CLBP) is a chronic pain syndrome in the lower back region, lasting for at least 3 months. CLBP represents the second leading cause of disability worldwide being a major welfare and economic problem. The prevalence of CLBP in adults has increased more than 100% in the last decade and continues to increase dramatically in the aging population, affecting both men and women in all ethnic groups, with a significant impact on functional capacity and occupational activities. It can also be influenced by psychological factors, such as stress, depression and/or anxiety. Given this complexity, the diagnostic evaluation of patients with CLBP can be very challenging and requires complex clinical decision-making. Answering the question “what is the pain generator” among the several structures potentially involved in CLBP is a key factor in the management of these patients, since a mis-diagnosis can generate therapeutical mistakes. Traditionally, the notion that the etiology of 80% to 90% of LBP cases is unknown has been mistaken perpetuated across decades. In most cases, low back pain can be attributed to specific pain generator, with its own characteristics and with different therapeutical opportunity. Here we discuss about radicular pain, facet Joint pain, sacro-iliac pain, pain related to lumbar stenosis, discogenic pain. Our article aims to offer to the clinicians a simple guidance to identify pain generators in a safer and faster way, relying a correct diagnosis and further therapeutical approach.

Discrepant data exist regarding the incidence and severity of clinical problems related to intra-hospital transport of brain-injured patients and no consensus exists whether modern-day intra-hospital transport represents a safe or potentially problematic environment for neurointensive care unit (NICU) patients. We examined the incidence of clinical complications and physiological derangements that occurred in 160 neurologically injured patients (90 males, 70 females, mean age 57 ± 17 years) who underwent intra-hospital transport (288 cases, 237 scheduled, 51 unscheduled) for computed tomography scans. Our findings indicate that (1) at least one significant complication (predominantly hemodynamic) occurred in over one-third (36 %) of all transports (p = n.s scheduled vs. unscheduled) necessitating the deployment of interventions designed to treat changes in arterial pressure (2) despite the presence of trained medical personnel and availability of specialized equipment, intra-cranial pressure was not adequately monitored during transports (especially in patients with intra-cranial hypertension prior to transport) (3) intra-hospital transfer was associated with minor but statistically significant clinical changes, including a reduction in arterial partial pressure of oxygen ( $$ {\text{Pa}}_{{{\text{O}}_{ 2} }} $$ )/inspired oxygen fraction ( $$ {\text{Fi}}_{{{\text{O}}_{ 2} }} $$ ) (only in the scheduled transport population), decreased arterial lactate levels (scheduled transport population), lowered body temperature (scheduled transport population), and increased arterial partial pressure of carbon dioxide ( $$ {\text{Pa}}_{{{\text{CO}}_{ 2} }} $$ ) (scheduled transport population). Intra-hospital transport of brain-injured NICU patients may present some hazards even if performed by skilled personnel with specialized equipment. In Trauma Centers such as ours, an improvement in the frequency of neuromonitoring [intra-cranial pressure (ICP) and end-tidal CO2 ( $$ {\text{ET}}_{{{\text{CO}}_{ 2} }} $$ )] during transport is recommended.

The article considers how discrete disciplines such as documentary research, participatory methodologies and the public communication of science can, if used synergistically, provide the necessary elements for a public debate on a scientific issue of current interest. In this instance, the debate formed part of a CNR- British Council, Rome branch and the Civil Protection Department project for the communication of science to young people, and the theme chosen for dis- cussion was the freshwater crisis. It is important to ensure that schools offer suitable learning environments and provide innovative teaching techniques to encourage students to explore the social dimensions of the scientific issues they are dealing with.

In this paper we show the results of our studies carried out in the framework of the European Project SciCafe2.0 in the area of Participatory Engagement models. We present a methodological approach built on participative engagements models and holistic framework for problem situation clarification and solution impacts assessment. Several online platforms for social engagement have been analysed to extract the main patterns of participative engagement. We present our own experiments through the SciCafe2.0 Platform and our insights from requirements elicitation.

The paper reports on the methodology and results of a project on the perception and awareness of science, carried out by the Italian National Research Council, the British Council Italy and the Rosselli Foundation. The project, addressed to upper high school and university students, aims to clarify understanding of the interaction between science and society both by means of information and communication technologies (ICT) and by means of public debates with scientists. Different obstacles encountered by the actors involved in the project are also outlined. Three topics have been chosen to stimulate public debate: GMOs, electromagnetic pollution and space exploration. The authors discuss the innovative methodology and the key stages involved in this process of awareness. Each public debate envisages four key steps: (i) setting up and supplying students with scientific documentation on a selected topic in electronic format, in order to highlight the potential of the internet in the process of information dissemination and how it can be effective in a project of science communication to the public; (ii) informed debate in the classroom between teachers and students on the chosen topic; (iii) public debate with Italian and British scientists; and (iv) a final report to be drawn up by the students.

O presente trabalho correlacionou o tempo de ruptura do ligamento cruzado cranial (RLCCr) à lesão em menisco medial e ao tipo de lesão observada em cães tratados por estabilização dinâmica (osteotomias) ou estática (sutura fabelo-tibial). Este estudo retrospectivo avaliou os registros de 104 cães (117 joelhos). As osteotomias foram realizadas em 98 articulações, a sutura fabelo-tibial em 15 joelhos e, em 4 joelhos, foi realizada apenas artrotomia exploratória. A média de idade foi 4,5 anos, 41% dos cães eram machos e 59%, fêmeas e a média da massa corporal foi 32,7kg. Os tipos de lesão do menisco medial observados foram: tipo 1, 2, 3, 4, 6, 7 e associações dos tipos 1-4, 1-6 e 1-7. O tipo 1 foi o mais prevalente, sendo responsável por 32,5% dos casos. Não foram encontradas correlações entre a presença ou não de lesão de menisco medial e o tempo de ocorrência da RLCCr e entre o tipo de lesão de menisco medial e o tempo de RLCCr. The study correlated the time of the cranial cruciate ligament rupture (CCLR) with medial meniscal tears and the type of injury seen in dogs treated with dynamic stabilization (osteotomies) or static (fabellotibial suture). This retrospective study evaluated the records of 104 dogs (117 stifles). The osteotomies were performed in 98 stifles, fabellotibial suture in 15 stifles and exploratory arthrotomy was perform in 4 stifles. The average age was of 4.5 years, 41% of the dogs were male and 59% female and the mean body mass was of 32.7kg. The medial meniscal tears observed were: type1, 2, 3, 4, 6, 7 and associations of types1-4, 1-6 and 1-7. Type 1 was the most prevalent, accounting for 32.5%of cases. No correlation was found between the presence or absence of medial meniscus injury and the time of occurrence of CCLR and between the type of medial meniscal tears and CCLR time.

Background: Research ethics review practices vary considerably across countries and this variability poses a challenge for international research programmes. Although published guidelines exist, which describe underlying principles that should be considered and pragmatic approaches that could be followed in seeking ethics approval, most have roots in biomedical and clinical research. The result is that there is generally less clarity around institutional and/or country-level structures for ethics review of health policy and social sciences research. This is an important gap that needs to be addressed in order to ensure ethical practices in multi-country research programmes.Context and purpose: This paper explores research ethics requirements for a multicountry health policy research programme and provides recommendations based on experiences in seeking ethics approval. The context for this paper is a five-year, cross-country, European Commission-funded international programme: Research into Policy to enhance Physical Activity (REPOPA).Results: Ethics requirements and review processes for health policy and social sciences research varied considerably across the seven REPOPA countries. Specifically, requirements and infrastructure for ethics approval have been influenced by how the purpose and domain of health research are defined in legislation, what types of research have been most prominently funded, and international requirements for ethics approval by external funders and journal editors.Significance: Multi-country research programmes provide an opportunity to enhance and build transparent ethics review practices and to strengthen ethics review structures at all levels. Such programmes also enable reciprocal learning about relevant practices and processes for the ethical conduct of research.Keywords: Ethics committee, research, health policy, physical activity, multi-country research, research programme

Ruptura de ligamento cruzado cranial (RLCCr) é a afecção ortopédica mais frequente no joelho de cães e a sutura fabelo-tibial é frequentemente utilizada na sua correção. Essa técnica pode estar associada com complicações incisionais, lesão tardia de menisco, edema associado ao material de sutura e infecção. O objetivo desta nota foi relatar a ocorrência de fratura proximal de tíbia em um cão, causada por complicação em sutura fabelo-tibial para correção de RLCCr. Um canino atendido em outro serviço foi submetido à osteossíntese com placa 2,0mm para correção de complicação em técnica extra-capsular, na qual houve fratura da tíbia na região do orifício criado para confecção da sutura fabelo-tibial. Houve falha dos implantes e a placa foi removida. A fratura foi estabilizada com fixador esquelético externo circular, sendo constatada, após 120 dias, consolidação. Cranial cruciate ligament rupture (CCLR) is one of the most common orthopedic diseases in dogs and extracapsular suture with nylon is often used for its correction. This technique may be associated with incisional complications, post-surgical meniscus injury, swelling associated with suture material and infection. The objective of this study is to report a tibial fracture in a dog, caused by complications after an extracapsular suture for the repair of CCLR. An adult dog, which suffered a tibial fracture after an extracapsular fixation for a CCLR, underwent surgery for the fixation of the fracture with a 2.0mm plate, by a referring veterinarian, but the implant failed. The plate was removed and the fracture was stabilized with a circular fixator. Bone consolidation was observed after 120 days.

The BIOHEAD-Citizen project was aimed to deepen the understanding of how different aspects of citizenship can be promoted through biology, health and environmental education. Teachers’ conceptions, defined as constructs emerging from the interaction of knowledge, values and social practices (Clement, 2006), and the conceptions implicit in the messages conveyed by science school manuals were the targets of the investigations. This chapter is aimed at presenting an overview of the main findings concerning environmental education (EE) that resulted from the analyses of life sciences manuals carried out in the countries participating in the European project “Biology, Health and Environmental Education for better citizenship”.

The availability of sex-disaggregated data in the fields of research, technology and development is extremely important for supporting the growing political commitment to promote and monitor women participation in the different fields of S&T. During the late 1990s the European Commission identified as a priority the availability of this data. Even if scientific publications and patents are widely accepted indicators of scientific and technological performances, until now it has been impossible to measure bibliometric and patent output by gender in a large set of data. Starting from a feasibility study carried out for the European Commission on the whole set of patents published in 1998 by the European Patent Office and on 30,000 authors of items published in 1995 on scientific journals of international relevance, the paper demonstrates that it is possible to obtain robust gender indicators on S&T output.

Introduction: Mutations that activate the RAS-RAF-MEK-ERK pathway have long been known to occur in patients with solid tumors and hematological malignancies. The most common mutations occur in the Ras family of GTPases (HRAS, NRAS, KRAS) and the Raf family of serine-threonine kinases (ARAF, BRAF, CRAF). In myeloid malignancies, RAS mutations have mainly been described in patients with acute myeloid leukemia, chronic myelomonocytic leukemia (CMML) and myelodysplastic syndrome. There are few studies describing the incidence of mutations of the RAS-RAF-MEK-ERK pathway in patients with MPNs other than CMML. Objective: To describe the incidence, clinical features and prognostic impact of Ras and Raf mutations in patients with Ph-negative MPNs and MPN/MDS-U Methods: Paired DNA (sorted CD66b-granulocytes/skin biopsy) from patients with MPNs or MPN/MDS was subjected to whole exome sequencing on a Illumina HiSeq 2000 platform using Agilent SureSelect kit (see our abstract “Whole Exome Sequencing of Myeloproliferative Neoplasms and Myelodysplastic/Myeloproliferative Disorders”). Tumor coverage was 150x and germline coverage was 60x. Somatic variants calls were generated by combining the output of Somatic Sniper (Washington University), Mutect (Broad Institute) and Pindel (Washington University), followed by in-house filters to reduce false positive calls. Statistical calculations were done in Stata, v11.0. Results: We found clonal activating mutations of the RAS-RAF-MEK-ERK pathway in 8 patients (6.7% of cases). Diagnosis included primary myelofibrosis (PMF; N=5), MDS/MPD-U (N=2) and essential thrombocythemia (ET; N=1). Their clinical features are summarized in Table 1 (three of these patients [UPIs #11, #13, #99] are also described in the abstract “Genomic Profile of Patients with Triple Negative (JAK2, CALR and MPL) Essential Thrombocythemia and Primary Myelofibrosis”). There were 7 NRAS mutations and 1 BRAF mutation. In 5 cases the variant allele fraction (VAF) of reads in the tumor sample indicated that the mutation was present in a subclone at the time of sequencing. We next compared the clinical features of these 8 patients with 79 patients (MF=43, ET=35, MDS/MPD=1) who did not harbor these mutations. Patients with NRAS/BRAF mutations had lower hemoglobin (8.3 vs. 11.8 g/dL, p=0.001), higher white blood cell counts (28.37 vs. 7.7 x109/L, p=0.008) and had higher lactate dehydrogenase (1041 vs. 685 IU/L, p=0.02). They also had worse overall survival compared to unmutated cases (Hazard ratio [HR]=11.57; p=0.001). Most patients with NRAS/BRAF mutations had a high number of concomitant driver mutatons (median 5 vs. 1; p

The image and perception of science and of scientists is a crucial topic, above all with regards to younger generations, the human capital of the future. For this reason, the National Research Council (CNR), in 2004, asked the IRPPS institute (Istituto di ricerche sulla popolazione e le politiche sociali) to carry out a sample survey of 800 people between the ages of 18 and 29 on the topic. Science and new technology emerged as the topics of most interest, in addition to medicine, history and economics. Scientific content in the mass media is considered to be satisfactory, whereas education in the field of science is considered to be less than satisfactory, above all in relation to the work environment. However, if research in Italy seems weak in the eyes of young people, scientists are not seen the same way but are considered society's second most important profession after that of the entrepreneur. The problem of trust in science is due, above all, to the politics of research, which do not encourage adequate investment in public and private sectors. A factor analysis technique was applied in order to identify models of attitude towards science of various subgroups within the population.

This paper explores how and to what extent the appearance and wide use of Information and Communication Technologies (ICTs) may enhance scientific communication and knowledge. The first part analyses the general boundaries of scientific communication, focusing on the use of email. It summarises and develops the results of relevant international studies and surveys on computer‐mediated communication; it identifies, on the one hand, the principal social settings and contexts in which email is used and, on the other, the characteristic features which determine specific communication models. The analysis provides evidence of the various factors which determine the dynamics of electronic communication and which, more specifically, define the difference between business and scientific communication. The second part of the paper explores the close relationship between communication and knowledge in the scientific sector and the role played by ICTs. The assumption that ICTs ought to enhance the acquisition, sharing and transmission of scientific knowledge is questioned by the distinction between explicit and tacit knowledge: ICTs ultimately appear to provide a strong drive only to processes of explicit/coded knowledge handling. Nevertheless, exploring the main components of tacit knowledge in depth, and considering recent ICT‐based applications, it is possible to foresee new opportunities for the creation and dissemination of knowledge through networks.