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Heterodyne detection based on interband cascade lasers (ICL) has been demonstrated in a wide range of different applications. However, it is still often limited to bulky tabletop systems using individual components such as dual laser setups, beam shaping elements, and discrete detectors. In this work, a versatile integrated ICL platform is investigated for tackling this issue. A RF-optimized, two-section ICL approach is employed, consisting of a short section typically used for efficient modulation of the cavity field and a long gain section. Such a laser is operated in reversed mode, with the entire Fabry–Pérot waveguide utilized as a semiconductor optical amplifier (SOA) and the electrically separated short section as detector. Furthermore, a racetrack cavity is introduced as on-chip single-mode reference generator. The field of the racetrack cavity is coupled into the SOA waveguide via an 800 nm gap. By external injection of a single mode ICL operating at the appropriate wavelength, a heterodyne beating between the on-chip reference and the injected signal can be observed on the integrated detector section of the SOA-detector.

Energy Communities (ECs) are aggregations of users that cooperate to achieve economic benefits by sharing energy instead of operating individually in the so-called “disagreement” case. As there is no unique notion of fairness for the cost/profit allocation of ECs, this paper aims to identify an allocation method that allows for an appropriate weighting of both the interests of an EC as a whole and those of all its members. The novelty is in comparing different optimization approaches and cooperative allocation criteria, satisfying different notions of fairness, to assess which one may be best suited for an EC. Thus, a cooperative model is used to optimize the operation of an EC that includes two consumers and two solar PV prosumers. The model is solved by the “Social Welfare” approach to maximizing the total “incremental” economic benefit (i.e., cost saving and/or profit increase) and by the “Nash Bargaining” approach to simultaneously maximize the total and individual incremental economic benefits, with respect to the “disagreement” case. Since the “Social Welfare” approach could lead to an unbalanced benefit distribution, the Shapley value and Nucleolus criteria are applied to re-distribute the total incremental economic benefit, leading to higher annual cost savings for consumers with lower electricity demand. Compared to “Social Welfare” without re-distribution, the Nash Bargaining distributes 39–49% and 9–17% higher annual cost savings to consumers with lower demand and to prosumers promoting the energy sharing within the EC, respectively. However, total annual cost savings drop by a maximum of 5.5%, which is the “Price of Fairness”.

ObjectiveWe investigated whether there are differences in cancer incidence by geographical area of origin in North-eastern Italy.MethodsWe selected all incident cases recorded in the Veneto Tumour Registry in the period 2015-2019. Subjects were classified, based on the country of birth, in six geographical areas of origin (Italy, Highly Developed Countries-HDC, Eastern Europe, Asia, Africa, South-central America). Age-standardized incidence rates and incidence rate ratio (IRR) were calculated, for all cancer sites and for colorectal, liver, breast and cervical cancer separately.ResultsWe recorded 159,486 all-site cancer cases; 5.2% cases occurred in subjects born outside Italy, the majority from High Migratory Pressure Countries (HMPC) (74.3%). Incidence rates were significantly lower in subjects born in HMPC in both sexes. Immigrants, in particular born in Asia and Africa, showed lower rates of all site cancer incidence. The lowest IRR for colorectal cancer was observed in males from South-Central America (IRR 0.19, 95%CI 0.09-0.44) and in females from Asia (IRR 0.32, 95%CI 0.18-0.70). The IRR of breast cancer appeared significantly lower than Italian natives in all female populations, except for those coming from HDC. Females from Eastern Europe showed a higher IRR for cervical cancer (IRR 2.02, 95%CI 1.57-2.61).ConclusionCancer incidence was found lower in subjects born outside Italy, with differences in incidence patterns depending on geographical area of origin and the cancer type in question. Further studies, focused on the country of birth of the immigrant population, would help to identify specific risk factors influencing cancer incidence.

If delta and estuary areas are observed under the perspective of a double system of dynamic infrastructures, the object of parallel “water/urbanisation” processes, the interface spaces become key nodes. In this perspective, port and waterfront areas can be described as spaces of mediation. The article argues that in the case of Lisbon and the Tagus, as possibly in several other port cities, these edge spaces can be described as “fluid territories.” The pre-eminent characteristic of “fluid territories” is that they are not permanent, neither in space nor time. These areas present accelerated transformations, less defined boundaries, and an increased spatial and management complexity. Moreover, “fluid territories” also mediate (a) the culture-natural environment, with human action appropriating the natural system through infrastructure and urbanisation, and (b) the industrialised economic estuary, with its continuous updating. To demonstrate this hypothesis, two samples of Lisbon’s riverfront are observed, recording its constant variability over the last 200 years of industrialisation, emphasising the “fluidity” of the mediating spaces. The understanding of the “fluid” characteristic of water/land mediation spaces is relevant for the present. Being dynamic and regularly reinventing spaces, spatial planning, public space, and architectural design processes in “fluid territories” should increasingly seek adaptability, flexibility, and openness to change. In the climatic context of continuous uncertainty combined with the need to make room for infrastructure, rethinking mediation areas through the lens of the theoretical concept of the “fluid territory” enables the implementation of urban transformation processes consistent with contemporary challenges.

Reduced-order electrothermal models play a key role in the design and control of lithium-ion cell stacks, calling for accurate model parameter calibration. This paper presents a complete electrical and thermal experimental characterization procedure for the coupled modeling of cylindrical lithium-ion cells in order to implement them in a prototype Formula SAE hybrid racing car. The main goal of the tests is to determine how the cell capacity varies with the temperature and the discharge current to predict the open-circuit voltage of the cell and its entropic component. A simple approach for the characterization of the battery equivalent electrical circuit and a two-step thermal characterization method are also shown. The investigations are carried out on four commercial 18650 NMC lithium cells. The model was shown to predict the battery voltage with an RMS error lower than 20 mV and the temperature with an RMS error equal to 0.5 °C. The authors hope that this manuscript can contribute to the development of standardized characterization techniques for such cells while offering experimental data and validated models that can be used by researchers and BMS designers in different applications.

This article presents the pedagogical process of reading and designing in the design studio course in the first semester of the fourth year in Architecture and Urbanism (2020–2021) held at the Lisbon School of Architecture of the Universidade de Lisboa. The research by design results are inscribed in the Embryo Project “[entra]mar Sea Intertwined City. Interpretation and Design of Portuguese Seashore Streets Vulnerable to Sea Level Rise”, funded by the FCT exploratory projects through CIAUD—Research Center in Architecture, Urbanism and Design at the Lisbon School of Architecture, Universidade de Lisboa (Portugal). The aim of this article is to demonstrate the usefulness of urban morphology in the reading and design process of an urban seafront vulnerable to extreme weather events. The approach to the “Sesimbra [entra]mar” in a pedagogical context confirms morphological interpretation as a key instrument for the formation of students and is consequently valuable for the practice of architecture and urbanism.

Comprehensive characterization of somatic genomic alterations has led to fundamental shifts in our understanding of tumor biology. In clinical practice, these studies can lead to modifications of diagnosis and/or specific treatment implications, fulfilling the promise of personalized medicine. Herein, we describe a 78-yr-old woman under surveillance for long-standing untreated chronic lymphocytic leukemia (CLL). Molecular studies from a peripheral blood specimen revealed a TP53 p.V157F mutation, whereas karyotype and fluorescence in situ hybridization (FISH) identified a 17p deletion, trisomy 12, and no evidence of IGH-CCND1 rearrangement. Positron emission tomography-computed tomography scan identified multistation intra-abdominal lymphadenopathy and a pulmonary nodule, and subsequent pulmonary wedge resection confirmed the presence of a concurrent lung adenocarcinoma. Targeted next-generation sequencing of the lung tumor identified an EGFR in-frame exon 19 deletion, two TP53 mutations (p.P152Q, p.V157F), and, unexpectedly, a IGH-CCND1 rearrangement. Follow-up immunohistochemistry (IHC) studies demonstrated a cyclin D1-positive lymphoid aggregate within the lung adenocarcinoma. The presence of the TP53 p.V157F mutation in the lung resection, detection of an IGH-CCND1 rearrangement, and cyclin D1 positivity by IHC led to revision of the patient's hematologic diagnosis and confirmed the extranodal presence of mantle cell lymphoma within the lung mass, thus representing a "tumor in tumor." Manual review of the sequencing data suggested the IGH-CCND1 rearrangement occurred via an insertional event, whose size precluded detection by original FISH studies. Thus, routine imaging for this patient's known hematologic malignancy led to detection of an unexpected solid tumor, whose subsequent precision medicine studies in the solid tumor redefined the original hematological diagnosis.

Abstract Background Otorhinolaryngology (ORL) surgery is common in children, but hospitalisation, surgery, and home care after discharge are stressful experiences for young patients and their family caregivers. Findings from literature highlight a lack of time in hospitals to support ORL surgery children and their caregivers through the perioperative process, along with the risks of caregivers’ autonomous web or social media resources investigation. Therefore, this study aims to evaluate the effectiveness of a mobile health application with content to support ORL patients and their caregivers in the perioperative period to reduce caregiver anxiety and child distress compared to standard care. Methods An open-label, two-arm randomised control trial design is being adopted. The intervention consists of a mobile health application with content to support ORL patients and their caregivers during the perioperative period. One hundred eighty participants will be enrolled and randomly assigned to the experimental group using the mHealth application or the control group. The control group receives standard information and education about the ORL perioperative period from healthcare providers orally or through brochures. The primary outcome is the difference between the intervention and control groups in preoperative caregiver state anxiety. Secondary outcome measures include children’s distress before surgery and family preparation for hospitalisation. Discussion The results of this study will be critical to the implementation of a new and safe model for the management of care and education in paediatrics. This model can achieve positive organisational and health outcomes by supporting continuity of care and empowering citizens to have informed participation and satisfaction in paediatric health promotion and management. Trial registration Trial identifier: NCT05460689 registry name: ClinicalTrials.gov. Date of registration: July 15, 2022. Last update posted: February 23, 2023.

“Professora, não entendi o problema! O que ele está dizendo?” Essas e outras expressões costumam ser recorrentes em aulas de matemática quando se trabalha com resolução de problemas, principalmente quando em situações que exigem mais leitura e interpretação. Por isso, discute-se, neste artigo, dificuldades apresentadas por estudantes da terceira série do ensino médio quando interpretam enunciados complexos de problemas do ENEM que envolvem volume de sólidos. A partir dos estudos de Polya (1973) e Autor 2, analisa-se dados de um estudo de caso qualitativo, desenvolvido em 2019 com 61 estudantes de uma escola estadual de Itapemirim/ES. Os resultados apontaram que a resolução de problemas pautada na identificação de atributos relevantes auxilia na interpretação de enunciados complexos e possibilita a identificação e a compreensão dos conceitos matemáticos implícitos. Além disso, promove a interação ativa e reflexiva entre professor e aluno durante o processo de produção do conhecimento.

Abstract Background Recent developments in eHealth and mobile health (mHealth), as well as the introduction of information and communication technology innovations in clinical practice, such as telemedicine, telemonitoring, and remote examinations, are already changing the current scenario and will continue to generate innovations in the coming decades. The widespread use of mobile devices, with an estimated nearly 30 billion devices and more than 325,000 apps worldwide, will provide various opportunities for people to take control of their own health. Already in 2017, most of the apps available were focused on pregnancy support, more than any other medical field. There have been some reported experiences with social media and mHealth that could benefit the promotion of maternal physical and mental health during pregnancy. However, many apps targeting the first 1000 days of a child’s life do not consider the continuity between the prenatal and postnatal periods and their joint impact on maternal and child health. The aim of this study is to evaluate the effectiveness of this mHealth app to support women during the first 1000 days (from conception to 24 months of age) and to improve health prevention behaviours such as immunizations during pregnancy, weight gain during pregnancy, abstinence from smoking and alcohol consumption, and adherence to the routine childhood immunization schedule. In addition, the study aims to understand the level of appreciation of this mHealth app as a tool to overcome information and communication gaps between patients and institutions. Methods Conduction of a randomized controlled trial. Discussion Our results will be relevant for improving this mHealth app to promote health and prevention and to support the first 1000 days of life for both mother and child. Our results will be relevant to the future expansion of such an mHealth app to promote positive health-related outcomes in patients and co-user satisfaction and to support the organization of health services. Trial registration ClinicalTrials.gov NCT05500339.

Pediatric ear, nose, and throat (ENT) surgery is very common, and its outcomes may improve with family education. In this regard, mobile health (mHealth) applications (apps), which are on the rise due to digital transformation, can be beneficial in healthcare. This study outlines the user-centered design and development of a mHealth app (version 5.15.0) to support family caregivers during the perioperative process of pediatric ENT surgery. Conducted over two years in an Italian maternal and child health hospital (January 2020–May 2022), the study employed a participatory design method based on the Information System Research (ISR) framework and guided by the principles of Slow Medicine. Utilizing the Relevance, Rigor, and Design cycles of the ISR framework, the mHealth app’s content, functionalities, and technical features were defined and developed. A committee of fifteen experts guided the process with input from 25 family caregivers and 24 healthcare providers enrolled in the study. The mHealth app content was structured around five crucial educational moments characterizing the ENT perioperative period, providing evidence-based information on surgical procedures, strategies for preparing children for hospitalization and surgery, pain management, and post-discharge care. The mHealth app featured a function that sends customized notifications to guide caregivers at specific perioperative stages. The development of mHealth apps by implementing a rigorous, participatory, and Slow design process can foster accessible and family-centered information and care in the field of maternal and child health and beyond.

The increasing penetration of intermittent renewable sources in power generation at local and building-level poses growing issues in balancing generation and demand. To avoid imbalances, it is therefore necessary to ensure adequate levels of flexibility in the building energy system. This can be done both on the generation side, through the coupling of different energy carriers (cogeneration, power-to-heat solutions) and/or the integration of storage systems, and on the demand side, through smart “demand response” programs. This paper considers a tourist facility located in central Germany as a case study to evaluate the energy, economic and environmental benefits that can be obtained from the application of appropriate demand response strategies. The electrical demand data of the facility are monitored at both aggregate and individual load levels and made available by means of a cloud platform. The facility includes two stationary combined heat and power internal combustion engines powered by natural gas and a photovoltaic system. The results show how, thanks to appropriate load management, it is possible, on the one hand, to increase the self-consumption of PV-generated energy and, on the other hand, to keep more constant the load of the engines, which can therefore operate with better efficiencies. This results in both a reduction in energy expenses and a decrease in carbon dioxide emissions attributable to the building.

The article explores the concept of copy, type and invention, such as the mimesis as a design process. The research aims to emphasise the utility and coexistence between theoretical concepts in the construction of architectural and urban design. This article is composed of a theoretical debate in which mimesis is understood as the basic conceptual principle and type, and typological transfer, as the operational principle; both instruments of composition. Case study is the Portuguese coastal landscape, it is possible to acknowledge different forms of urban occupation defined by metrics and rhythms; principles which are relevant to think of an urban transformation in continuity with the inherited landscape. It describes the process of decoding and classifying these ephemeral serial elements present along the coast and the subsequent design process of an architectural type and its application to a specific place. Indeed, according to the concept of typological transfer, defined by Christ and Gatenbein, we might infer that it is possible to transfer the composition rules from the preexistent ephemeral objects present in the space between land and sea to the design of new forms. The use of the concepts of copy, type and invention allows for the transformation and resilience of the vulnerable landscapes by the sea.

The eastern coastline of the Gulf of Trieste (north-eastern Adriatic Sea, Italy) is characterized by the occurrence of coastal and submarine freshwater springs of karstic origin. In one of these areas, we performed a survey with a drone with a thermal camera installed, in tandem with in situ oceanographic sampling with a CTD. Drone images revealed a small time-space scale (i.e., up to a few meters) phenomenon of freshwater plumes floating over seawater. Comparing sea surface temperature data with those acquired in situ revealed that the phenomenon was not clearly detectable by the classical oceanographic monitoring, this surface spring freshwater layer being too thin. Instead, the drone’s thermal camera detected these dynamics with great accuracy, indicating that aerial drones can be efficiently used for studying fine-scale events involving surface waters (e.g., spills/pollution). The experience gained allowed us to discuss some of the advantages and disadvantages of using drone thermal imaging for monitoring alongshore areas.

This review describes the topics covered during eleven meetings held from February 4 to June 17, 2021 within the “Venice in Question” seminar, coordinated by Daniele Dibello (Universiteit Gent) and organized by the Deputazione di Storia Patria per le Venezie, alongside other Venetian institutions. Presenting recent studies on Venetian history, the seminar involved Italian and international scholars, animating a dialogue between different historiographical approaches and traditions. While embracing a broad chronological span, from the Middle Ages to the early 19th century, the seminar pointed out aspects relevant to scholars of the 18th century.

Planning the best path for the energy system decarbonization is currently one of the issues of high global interest. At the European level, the recent policies dealing with the transportation sector have decided to ban the registration of light-duty vehicles powered by internal combustion engines fed by fossil fuels, from 2035. Regardless of the official positions, the major players (industries, politicians, economic and statistical institutions, etc.) manifest several opinions on this decision. In this paper, a mathematical model of a nation’s energy system is used to evaluate the economic impact of this decision. The model considers a superstructure that incorporates all energy conversion and storage units, including the entire transportation sector. A series of succeeding simulations was run and each of them was constrained to the achievement of the decarbonization level fixed, year by year, by the European community road-map. For each simulation, an optimization algorithm searches for a less costly global energy system, by including/excluding from the energy system the energy conversion units, storage devices, using a Mixed Integer Linear approach. Three optimization scenarios were considered: (1) a “free” scenario in which the only constraint applied to the model is the achievement of the scheduled decarbonization targets; (2) an “e-fuels” scenario, in which all new non-battery-electric light-duty vehicles allowed after 2035 must be fed with e-fuels; (3) a “pure electric” scenario, in which all new light-duty vehicles allowed after 2035 are battery-electric vehicles. The comparison of the optimum solutions for the three scenarios demonstrates that the less costly transition to a fully renewable energy system decarbonizes the transportation sector only when the share of renewable energy sources exceeds 90%. E-fueled light-duty vehicles always turn out to be a less expensive alternative than the electric vehicles, mainly because of the very high cost of the energy supply infrastructure needed to charge the batteries. Most of all, the costs imposed to society by the “e-fuels” and “pure electric” light-duty-vehicle decarbonizing scenarios exceed by 20% and 60%, respectively, the “free” transition scenario.

Numerous carbon capture, utilization, and storage (CCUS) technologies are under development to reduce CO2 emissions. To evaluate the status of a CCUS technology under development and identify potential gaps for further advancement, we have established a new technology assessment framework and are developing a decision-making tool, the technology development matrix (TDM), starting with available carbon capture technology (CCT) data. TDM is a data inventory system and screening tool. As a screening tool, it can be used for resource allocation decisions in research, development, and deployment (RD&D) by academia, government, and industry. It shares data with techno-economic analysis (TEA) and life-cycle assessment (LCA) tools as an inventory system. By using available data, this TDM framework has been demonstrated on amine-based (monoethanolamine) absorption post-combustion CO2 capture, for pulverized coal (PC) power plant flue gas, as the best available technology (BAT) for comparison. Three groups of promising post-combustion CCTs under development are presented as Alternative Technology (Alt Tech) case studies, including membrane, solid adsorption, and calcium-based chemical looping. By using available data, preliminary analysis enabled technology benchmarking and highlighted knowledge, data, and technology gaps, all providing potential future RD&D focus.

Permafrost in the NE European Russian Arctic is suffering from some of the highest degradation rates in the world. The rising mean annual air temperature causes warming permafrost, the increase in the active layer thickness (ALT), and the reduction of the permafrost extent. These phenomena represent a serious risk for infrastructures and human activities. ALT characterization is important to estimate the degree of permafrost degradation. We used a multidisciplinary approach to investigate the ALT distribution in the Khanovey railway station area (close to Vorkuta, Arctic Russia), where thaw subsidence leads to railroad vertical deformations up to 2.5 cm/year. Geocryological surveys, including vegetation analysis and underground temperature measurements, together with the faster and less invasive electrical resistivity tomography (ERT) geophysical method, were used to investigate the frozen/unfrozen ground settings between the railroad and the Vorkuta River. Borehole stratigraphy and landscape microzonation indicated a massive prevalence of clay and silty clay sediments at shallow depths in this area. The complex refractive index method (CRIM) was used to integrate and quantitatively validate the results. The data analysis showed landscape heterogeneity and maximum ALT and permafrost thickness values of about 7 and 50 m, respectively. The active layer was characterized by resistivity values ranging from about 30 to 100 Ωm, whereas the underlying permafrost resistivity exceeded 200 Ωm, up to a maximum of about 10 kΩm. In the active layer, there was a coexistence of frozen and unfrozen unconsolidated sediments, where the ice content estimated using the CRIM ranged from about 0.3 – 0.4 to 0.9. Moreover, the transition zone between the active layer base and the permafrost table, whose resistivity values ranged from 100 to 200 Ωm for this kind of sediments, showed ice contents ranging from 0.9 to 1.0. Taliks were present in some depressions of the study area, characterized by minimum resistivity values lower than 10 Ωm. This thermokarst activity was more active close to the railroad because of the absence of insulating vegetation. This study contributes to better understanding of the spatial variability of cryological conditions, and the result is helpful in addressing engineering solutions for the stability of the railway.

In this work, the aromatic characterization of commercially available Prosecco wines with a price range between EUR 7 and 13 was carried out. These wines came from three different areas of origin: Valdobbiadene, Asolo and Treviso. Seventy volatile compounds were identified and quantified in the wines. Quantitatively, the wines were mainly characterized by compounds of fermentation origin (alcohols, acids, esters), and C6-alcohols, and to a lesser extent, terpenes, low molecular weight volatile sulfur compounds (VSC), and benzenoids. To determine their impact on the aroma of Prosecco wine, the respective OAVs were calculated. The molecules with higher OAV were ethyl hexanoate, isoamyl acetate, and β-damascenone. More generally, esters, responsible for fruity notes, seemed to play a major role in the aroma of Prosecco wine. Investigation into the possible effect of different production zones indicated 16 significantly different compounds accounting for differences between the various areas of origin of the wines, being mostly VSC, esters and C6-alcohols. A sensory evaluation through a sorting task highlighted the formation of clusters; wine samples were divided into two main groups partially attributable to the areas of origin. From a chemical point of view, cluster A was richer in esters, while cluster B had, on average, higher concentrations of compounds associated with wine aging such as cyclic terpenes, norisoprenoids (TDN and vitispirane), and VSC.

Resistance to the Bruton's tyrosine kinase (BTK) inhibitor ibrutinib has been attributed solely to mutations in BTK and related pathway molecules. Using whole-exome and deep-targeted sequencing, we dissect evolution of ibrutinib resistance in serial samples from five chronic lymphocytic leukaemia patients. In two patients, we detect BTK-C481S mutation or multiple PLCG2 mutations. The other three patients exhibit an expansion of clones harbouring del(8p) with additional driver mutations (EP300, MLL2 and EIF2A), with one patient developing trans-differentiation into CD19-negative histiocytic sarcoma. Using droplet-microfluidic technology and growth kinetic analyses, we demonstrate the presence of ibrutinib-resistant subclones and estimate subclone size before treatment initiation. Haploinsufficiency of TRAIL-R, a consequence of del(8p), results in TRAIL insensitivity, which may contribute to ibrutinib resistance. These findings demonstrate that the ibrutinib therapy favours selection and expansion of rare subclones already present before ibrutinib treatment, and provide insight into the heterogeneity of genetic changes associated with ibrutinib resistance.

This study revisited the Dohner prognostic hierarchy in a cohort of 1585 well-documented patients with chronic lymphocytic leukaemia. The duration of both time to first treatment (TTFT) and overall survival (OS) were significantly longer than observed previously, and this is at least partly due to improved therapeutic options. Deletion 13q remains the most favourable prognostic group with median TTFT and OS from fluorescence in situ hybridization (FISH) testing of 72 months and >12 years, respectively. Deletion 11q had the poorest median TTFT (22 months) and 17p deletion the poorest median OS (5 years). The percentages of abnormal nuclei were significantly associated with differential TTFT for the trisomy 12, 13q and 17p deletion cohorts but not for the 11q deletion cohort. From the date of the first FISH study, patients with >85% 13q deletion nuclei had a notably shorter TTFT (24 months). Patients with ≤20% 17p deletion nuclei had longer median TTFT and OS from the date of the first FISH study (44 months and 11 years), and were more likely to be IGHV mutated.

Abstract Background Eliciting individual values and preferences of patients is essential to delivering high quality palliative care and ensuring patient-centered advance care planning. Despite advance care planning conserving healthcare costs by up to 36%, reducing psychological distress of patients and caregivers, and ensuring palliative care delivery in line with patient wishes, less than 33% of adults engage in it. We aimed to develop a mobile application intervention to address the challenges related to advance care planning and improve the delivery of palliative care. Methods Design-thinking methodology was used to develop a mobile application, in response to issues prominently identified in current palliative care literature. Results Issues surrounding communication of patient values from both the patient and provider side is identified as a main issue in palliative care. We designed a mobile application intervention prototype to address this. Conclusions Our “Mission Statement” mobile application will allow patients to create a mission statement identifying what they want their care team to know about them, as well as space to identify important values and preferences. Patients will be able to evolve their mission statement and values and preferences over the course of their palliative care journey through the application. Design-thinking methodology is an effective tool to drive healthcare innovation and bridge the gap between research findings and implementation.

Este texto apresenta resultados de uma pesquisa que teve como objetivo identificar os saberes em dança construídos na formação inicial em Educação Física, a partir de atividades de extensão universitária. Com abordagem qualitativa e do tipo descritiva, contou com a colaboração de quatro estudantes do curso de Educação Física que participavam de um projeto de extensão ofertado por uma universidade comunitária do oeste catarinense. O grupo focal foi utilizado como instrumento de coleta de dados e os resultados, analisados pela técnica de análise de temática, sinalizaram para a construção de saberes específicos da dança, além daqueles relacionados à prática pedagógica. Os colaboradores do estudo acenam para a extensão universitária como um espaço no qual ampliam seus conhecimentos e se preparam para a futura atuação pedagógica.

Abstract: Philadelphia chromosome (Ph)–like acute lymphoblastic leukemia (ALL) is a subtype of Ph-negative ALL that molecularly resembles Ph-positive ALL. It shares the adverse prognosis of Ph-positive ALL, but lacks the BCR-ABL1 fusion oncogene. Instead, Ph-like ALL is associated with alternative mutations in signaling pathways. We describe a case of Ph-like ALL that harbored 2 genomic alterations, which activated signaling, an NRASGly12Asp mutation, and an ETV6-NTRK3 rearrangement. Initially, the NRAS mutation was detected at high frequency, whereas the gene fusion was only detectable with a targeted next-generation sequencing-based fusion assay, but not by fluorescence in situ hybridization analysis. The disease failed to respond to multiagent chemotherapy but investigational CD19-directed chimeric antigen receptor T-cell therapy resulted in a complete remission. However, the leukemia relapsed after 6 weeks. Intriguingly, the NRAS mutation was extinguished during the chimeric antigen receptor T-cell therapy and did not contribute to the relapse, which was instead associated with a rise in ETV6-NTRK3. The relapsed leukemia progressed with further chemo- and immunotherapy but was controlled for 6 weeks with substantial leukemic cytoreduction using the TRK inhibitor larotrectinib. Unfortunately, recovery of normal hematopoiesis was only marginal and the patient eventually succumbed to infections. These results demonstrate that larotrectinib has clinical activity in ETV6-NTRK3-associated Ph-like ALL.

Among the European coastal territories most vulnerable to the effects of mean sea level rise, such as flooding and erosion phenomena, are the 943 km of the Portuguese coastline where approximately 70 per cent of the population lives (Bigotte et al, 2014), a percentage that rises to around 80 per cent in the summer months, due to tourism (Andrade et al, 2002), especially in the Algarve region (southern Portugal). The case study of this research is the urban public space in the coastal city of Quarteira, which is particularly vulnerable. This space between the land and the sea has been recently framed in the inter-municipal climate change adaptation plan PIAAC-AMAL (Plano Intermunicipal de Adaptação às Alterações Climáticas do Algarve). The aim of the article is to explore the natural and anthropogenic process of formation and transformation of the urban space between the land and sea that occurred over time, up to the definition of the seashore street. Interpretative drawing is used as a methodology to understand the form of the public space. This is considered the first step for designing the public space between the land and the sea that deals both with the effects of climate change and the seasonal cycles of summer tourism. Through this analysis, it is argued that the understanding of the form (morphological characteristics) of this continuous space between land and sea is fundamental for consistent and robust adaptation design.

Este artigo apresenta ações formativas desenvolvidas em tempos de ensino remoto para aproximar licenciandos em matemática da sala de aula da Educação de Jovens e Adultos (EJA). Mostra algumas possibilidades de efetivação de atividades de estágio supervisionado, destacando aspectos do planejamento, da implementação, da aprendizagem de estudantes e da apreciação da disciplina em si. Além disso, evidencia (re)configurações curriculares realizadas no plano de ensino da disciplina para desenvolvê-la por meio de atividades pedagógicas não presenciais (APNPs). Desse modo, busca mostrar o papel das lives, dos textos e dos contextos para a concretização desta etapa formativa e procura materializar a perspectiva da professora formadora que buscou, no limiar de sua proposta metodológica de estágio supervisionado, promover aprendizagens da docência para futuros professores de matemática. Considera que a compreensão do contexto de uma sala de aula da EJA; o conhecimento do perfil de estudantes (jovem, adulto e idoso); a sensibilidade docente para definir conteúdos matemáticos a serem trabalhados nas turmas de EJA, para atender aos diferentes perfis e interesses formativos e a reflexão sobre as metodologias de ensino, são alguns dos principais resultados obtidos. Ademais, este relato de experiência evidencia algumas contribuições para professores de matemática em exercício na EJA, professores formadores que lecionam disciplinas de estágio supervisionado curricular e futuros professores de matemática; quando possibilita, respectivamente, a partilha de suas práxis e reflexões acerca delas, o planejamento flexível, as discussões coletivas, a avaliação da aprendizagem e da disciplina em si e o conhecimento organizacional das turmas de EJA.

Semi-natural grasslands are characterized by high biodiversity and require multifaceted approaches to monitor their biodiversity. Moreover, grasslands comprise a multitude of microhabitats, making the scale of investigation of fundamental importance. Despite their wide distribution, grasslands are highly threatened and are considered of high conservation priority by Directive no. 92/43/EEC. Here, we investigate the effects of small-scale ecological differences between two ecosites present within the EU habitat of Community Interest of semi-natural dry grasslands on calcareous substrates (6210 according to Dir. 92/43/EEC) occurring on a Mediterranean mountain. We measured taxonomic and functional diversity of plant and ant communities, evaluating the differences among the two ecosites, how these differences are influenced by the environment and whether vegetation affects composition of the ant community. Our results show that taxonomic and functional diversity of plant and ant communities are influenced by the environment. While vegetation has no effect on ant communities, we found plant and ant community composition differed across the two ecosites, filtering ant and plant species according to their functional traits, even at a small spatial scale. Our findings imply that small-scale monitoring is needed to effectively conserve priority habitats, especially for those that comprise multiple microhabitats.

The increasing demand for neodymium (Nd) permanent magnets in electric motors has revived research interest of Nd recovery and separation from other rare earth elements (REEs). Typically, Nd/La separation is necessary for Nd recovery from primary ores and secondary resource recycling. This research used a flat sheet-supported liquid membrane (FSSLM) with different extractant-acid systems to extract Nd from a Nd/La mixture. The recovery and separation of Nd/La with 204P-H2SO4, 507P-HCl, and TBP-HNO3 were discussed. The results showed effective Nd recovery and promising Nd/La selectivity could be achieved in the 507P-HCl system, compared to 204P-H2SO4 and TBP-HNO3. The addition of citric acid to the feed solution was effective for pH buffering but did not improve the Nd transport or Nd/La selectivity. Long-term stability of the 507P-HCl extractant system was demonstrated by extending the processing time from 6 h to 6 days.

BackgroundDespite the availability of thousands of health apps worldwide, when considering those addressing children’s first 1000 days of life, most apps fail to consider the continuity between the prenatal and postnatal stages, and their joint impact on maternal and child health. The reliability, quality, and effectiveness of these apps are largely unknown, and the provided content seems questionable in terms of completeness, updating, and trustworthiness. ObjectiveThis study evaluates available Italian pregnancy and postnatal care apps to highlight the main gaps to be overcome and the resulting future challenges to be met in this mobile health–related field. MethodsA systematic search was conducted on the Apple App Store and Google Play Store, and basic information was collected for all identified apps. After deduplication and further selection based on the exclusion criteria, an in-depth analysis of each app was performed by two researchers independently. A 71-item six-domain questionnaire about the desirable features of apps was used to assess information, functionalities, and technical features, while the Mobile Application Rating Scale (MARS) was employed for app quality evaluation. ResultsFrom an initial sample of 684 apps, 22 were deeply analyzed. Most apps did not fulfill the expectations, as just one achieved 50% of all desirable aspects. Postnatal care and counselling for both the mother and child was the least accomplished domain. Moreover, the quality of app information was generally rated more negatively than the quality of their functionality and esthetic features. The lacking aspects were information about methods for postpartum family planning and birth spacing (1/22, 5%) and immunization (2/22, 9%). ConclusionsThe identified gaps could serve as a basis for designing and implementing increasingly high-quality, targeted, and effective apps for pregnancy and postnatal health care, which provide comprehensive, reliable, and evidence-based information, as well as appropriate esthetic and functional characteristics, with relevant implications in terms of maternal and newborn health prevention and promotion.

Neste artigo se descreve um estudo desenvolvido em sala de aula com base nas pesquisas realizadas pelos autores Hoffman (2012) e Zanon (2011) mediante sua inserção no Grupo de Estudos em Educação Matemática do Espírito Santo [GEEM-ES]. Traz-se um recorte de uma pesquisa qualitativa desenvolvida, em 2016, com 28 alunos de uma turma do quinto ano, em uma escola pública municipal de Vitória-ES. O texto mostra que conceitos de geometria e de língua materna podem ser construídos em um processo dialógico que utiliza o geoplano quadricular e as interlocuções entre aulas de matemática de caráter interdisciplinar. Apresenta e analisa aulas de noções básicas de geometria que foram direcionadas na perspectiva do diálogo realizado ante a manipulação do material concreto, da observação e da pesquisa sobre a própria prática, na ação, como parte do processo de ensino, aprendizagem e avaliação em matemática. Assim, mostra como conduzir atividades interdisciplinares que utilizam leitura e escrita na busca pela construção de conceitos de geometria a partir da exploração do geoplano quadricular e de outros recursos em diferentes espaços. A pesquisa apontou que, em uma perspectiva mais discursiva, é possível mediar a construção de conceitos de geometria, fazendo interlocução entre a língua materna e matemática com suas regras e simbologias próprias. E sugere que o processo de formação do estudante deve ser visto como um todo, em que as diversas áreas do conhecimento dialoguem entre si, evitando sua fragmentação e atribuindo sentido aos conteúdos escolares.

Seismic surveys allow estimating lithological parameters, as P-wave velocity and anelastic absorption, which can detect the presence of fracture and fluids in the geological formations. Recently, a new method has been proposed for high-resolution imaging of anelastic absorption, which combines a macro-model from seismic tomography with a micro-model obtained by the pre-stack depth migration of a seismic attribute, i.e., the instantaneous frequency. As a result, we can get a broadband image that provides clues about the presence of saturating fluids. When the saturation changes sharply, as for gas reservoirs with an impermeable caprock, the acoustic impedance contrast produces “bright spots” because of the resulting high reflectivity at its top. When the fluid content changes smoothly, the anelastic absorption becomes a good detector, as fluid-filled formations absorb more seismic energy than hard rocks. We apply this method for imaging the anelastic absorption in a regional seismic survey acquired by OGS in the Gulf of Trieste (northern Adriatic Sea, Italy).

Nitrate and nitrite supplement deficient endogenous nitric oxide (NO) formation. While these anions may generate NO, recent studies have shown that circulating nitrite levels do not necessarily correlate with the antihypertensive effect of oral nitrite administration and that formation of nitrosylated species (RXNO) in the stomach is critically involved in this effect. This study examined the possibility that RXNO formed in the stomach after oral nitrite administration promotes target protein nitrosylation in the vasculature, inhibits vasoconstriction and the hypertensive responses to angiotensin II. Our results show that oral nitrite treatment enhances circulating RXNO concentrations (measured by ozone-based chemiluminescence methods), increases aortic protein kinase C (PKC) nitrosylation (measured by resin-assisted capture SNO-RAC method), and reduces both angiotensin II-induced vasoconstriction (isolated aortic ring preparation) and hypertensive (in vivo invasive blood pressure measurements) effects implicating PKC nitrosylation as a key mechanism for the responses to oral nitrite. Treatment of rats with the nitrosylating compound S-nitrosoglutathione (GSNO) resulted in the same effects described for oral nitrite. Moreover, partial depletion of thiols with buthionine sulfoximine prevented PKC nitrosylation and the blood pressure effects of oral nitrite. Further confirming a role for PKC nitrosylation, preincubation of aortas with GSNO attenuated the responses to both angiotensin II and to a direct PKC activator, and this effect was attenuated by ascorbate (reverses GSNO-induced nitrosylation). GSNO-induced nitrosylation also inhibited the increases in Ca2+ mobilization in angiotensin II-stimulated HEK293T cells expressing angiotensin type 1 receptor. Together, these results are consistent with the idea that PKC nitrosylation in the vasculature may underlie oral nitrite treatment-induced reduction in the vascular and hypertensive responses to angiotensin II.

This review highlights recent findings about the role that endothelial glycocalyx and caveolae play in vascular homeostasis. We describe the structure, synthesis, and function of glycocalyx and caveolae in vascular cells under physiological and pathophysiological conditions. Special focus will be given in glycocalyx and caveolae that are associated with impaired production of nitric oxide (NO) and generation of reactive oxygen species (ROS). Such alterations could contribute to the development of cardiovascular diseases, such as atherosclerosis, and hypertension.

The increasing demand for freshwater requires the identification of additional and less-conventional water resources. Amongst these, offshore freshwater systems have been investigated in different parts of the world to provide new opportunities to face increasing water requests. Here we focus on the north-eastern Adriatic Sea, where offshore aquifers could be present as a continuation of onshore ones. Geophysical data, in particular offshore seismic data, and onshore and offshore well data, are interpreted and integrated to characterise the hydrogeological setting via the interpretation of seismo-stratigraphic sequences. We focus our attention on two areas located in the proximity of the Tagliamento and Isonzo deltas. Well and seismic data indicate that the Quaternary sediments, that extend from onshore to offshore areas, are the most promising from an offshore freshwater resources point of view, while the several kilometres thick pre-Quaternary carbonate and terrigenous sequences likely host mainly salty waters.

Background:. To determine the superiority of autologous abdominal tissue (AAT) or tissue-expander implant (TE/I) reconstruction, a robust comparative cohort study is required. This study sought to determine the feasibility of a future large pragmatic cohort study comparing clinical and cost-effectiveness of AAT and TE/I at 12 months postoperative. Methods:. Potential participants were screened during consultation with their surgeon. Three health-related quality-of-life scales, the Health Utility Index Mark 3, the 12-Item Short Form Health Survey, and the BREAST-Q were used preoperatively, 1, 6, and 12 months postoperatively. Direct medical costs and postoperative patient/caregiver productivity loss were collected using patient diaries. Feasibility was assessed through patient recruitment rates and compliance of patients and study staff to complete required study documentation. Results:. Sixty-three patients consented to participate, 44 completed baseline questionnaires; the feasibility objective of recruiting 80% of eligible patients was not met. A 90% completion rate for patient questionnaires was seen at 1-month follow-up and decreased up to 12 months. Quality-adjusted life years were calculated at 0.77 and 0.89 for the AAT and TE/I group, respectively. Case report form completion by study staff and patient diary completion was moderate and low, respectively. Collaborating with hospital case-costing specialists to identify direct medical costs was reliable and efficient. Conclusions:. A future large-scale study is feasible. However, due to a diminishing rate of questionnaire completion, almost twice as many patients need to be recruited than expected to have adequate power. Cost data collection from hospital sources was reliable. Case report forms need to be tailored more toward a busy hospital setting.

Background:. Patients who had undergone both autologous abdominal tissue (AAT) and tissue expander and implant (TE/I) breast reconstruction reported satisfaction with their reconstruction. While aesthetics and quality of life are important, the cost associated with these procedures must also be considered when choosing one method over the other. The objective of this study was to determine whether AAT-based breast reconstruction is cost-effective compared with 2-stage TE/I reconstruction at a 12-month follow-up. Methods:. Thirty-five patients consented and complied to participate in the study with a follow-up of 12 months. The effectiveness of both AAT and TE/I was measured using the Health Utilities Index Mark 3 (HUI-3). From the HUI-3 results, quality-adjusted life years were calculated for each reconstructive approach. Direct healthcare and productivity costs were captured from surgeon billing codes, patient files, and patient diaries. The perspectives of both the Ministry of Health and of society were considered. Results:. From the perspectives of both the Ministry of Health and of society, AAT was less effective and more costly when compared with TE/I. Conclusions:. In this economic evaluation, TE/I dominated AAT, in that TE/I was more effective and less costly as compared with AAT from the perspectives of both the Ministry of Health and of society at 12 months of follow-up. This conclusion should be interpreted with caution due to a small sample size, the short timespan of the study, and the nonrandomized study design.

Apresenta-se, neste artigo, uma proposta de trabalho que buscou auxiliar futuros professores de Matemática a pensar em aulas baseadas na Metodologia de Ensino-Aprendizagem-Avaliação de Matemática através da Resolução de Problemas (ALLEVATO; ONUCHIC, 2009; 2014; ONUCHIC, 1999; ONUCHIC; ALLEVATO, 2004; 2011). Tal proposta emerge em decorrência das práticas e da pesquisa de doutorado de Zanon (2019). Foi desenvolvida em 2019/1 com 40 estudantes matriculados na disciplina “Resolução de Problemas” no primeiro período do curso de licenciatura em Matemática do Instituto Federal do Espírito Santo (IFES), Campus Cachoeiro de Itapemirim. Trata-se de uma investigação qualitativa (FIORENTINI; LORENZATO, 2007) que entende a atividade investigativa como potência à prática pedagógica de professores em formação inicial. Desse modo, propõe, através da Resolução de Problemas como perspectiva metodológica, possibilidades para o ensino de Matemática em cursos de licenciatura com vistas à sua aplicabilidade no fazer docente de professores da Educação Básica. Usa do Roteiro de Atividades proposto por Onuchic e Allevato (2011) para que estudantes de licenciatura em Matemática se apropriem de ideias que permitam fazer o uso da Metodologia de Ensino-Aprendizagem-Avaliação de Matemática através da Resolução de Problemas em sala de aula, quando em exercício da docência, como forma de transpor para a prática os estudos teóricos desenvolvidos na universidade.

Loss of the Y chromosome (LOY) is one of the most common somatic genomic alterations in hematopoietic cells in men. However, due to the high prevalence of LOY as the sole cytogenetic finding in the healthy older population, differentiating isolated LOY associated with clonal hematologic processes from aging-associated mosaicism can be difficult in the absence of definitive morphological features of disease. In the past, various investigators have proposed that a high percentage of metaphases with LOY is more likely to represent expansion of a clonal myeloid disease-associated population. It is unknown whether the proportion of metaphases with LOY is associated with the incidence of myeloid neoplasia-associated genomic alterations. To address this question, we identified marrow samples with LOY as isolated cytogenetic finding and used targeted next generation sequencing-based molecular analysis to identify common myeloid neoplasia-associated somatic mutations. Among 73 patients with median age of 75 years (range 29-90), the percentage of metaphases with LOY was

The erector spinae plane block (ESP) is a novel interfascial block described in 2016 by Forero. Although it has been used to provide analgesia for planned abdominal and thoracic surgery, it has never been used as a rescue technique for abdominal surgery. Pain control can be a challenge for anaesthesiologists in laparotomic surgery when epidural analgesia is contraindicated. We report two cases in which the ESP block has been successfully used as a rescue technique to provide pain relief after laparotomic surgery.