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Estimating the flow velocity and discharge in rivers is of particular interest for monitoring, modeling, and research purposes. Instruments for measuring water level and surface velocity are generally mounted on bridge decks, and this poses a challenge because the bridge structure, with piers and abutments, can perturb the flow field. The current research aims to investigate the applicability of entropy theory to estimate the velocity distribution and the discharge in the vicinity of river bridges. For this purpose, a computational fluid dynamics (CFD) model is used to obtain three-dimensional flow fields along a stretch of the Paglia River (central Italy), where a historical multi-arch bridge strongly affects flood flows. The input data for the entropy model include the cross-sectional bathymetry and the surface velocity provided by the numerical simulations. A total of 12 samples, including three different flow conditions at four cross-sections, one upstream and three downstream of the bridge, are considered. It is found that the entropy model can be reliably applied upstream of the bridge, also when forced with a single (i.e., the maximum) value of the surface velocity, with errors on total discharge below 13 % in the considered case. By contrast, downstream of the bridge, the wakes generated by the bridge piers strongly affect the velocity distribution, both in the spanwise and in the vertical directions and for very long distances. Here, notwithstanding the complex and multimodal spanwise distribution of flow velocity, the entropy model estimates the discharge with error lower than 8 % if forced with the river-wide distribution of the surface velocity. The present study has important implications for the optimal positioning of sensors and suggests the potential of using CFD modeling and entropy theory jointly to foster greater knowledge of river systems.

Abstract Background The current Italian scenario of pediatric palliative care (PPC) services is characterized by inadequate coverage of the territory. Therefore, it is important to improve the referral of patients to the most appropriate setting (community care, general PPC, or specialized PPC) and to improve the delivery of PPC care. Methods Aiming at obtaining information about the referrals to the Padua Pediatric Hospice that could help estimate the investments needed to improve the provision of care, a retrospective analysis has been carried out. The rate of proper referral and discharge, the number of patients followed at the hospice, the mortality rate, and the length of follow-up were analyzed, and, when possible, data were stratified by oncological and non-oncological diseases. Results The analysis showed that of the 870 patients referred to the Padua Pediatric Hospice between 2008 and 2022, 76% were affected by non-oncological conditions. 82% of patients referred were taken in charge and most of the remaining patients have been inappropriately referred. The analysis showed a growing number of total referrals, which increased by 195% from 2008 to 2022. An increase in proper referrals and referrals of non-oncological patients was observed alongside a decrease in oncological patient referrals and a trend toward a decrease in discharge rates. A decreased mortality was observed in patients with non-oncological conditions, with only 6% of deceased patients in 2022. Moreover, a longer survival with a median follow-up length of 43 months was observed among patients with non-oncological conditions who were followed up at the Padua Pediatric Hospice for more than 12 months. Conversely, the short survival rate observed for oncological patients suggests that those patients should have been referred to PPC earlier to benefit from palliative care for longer periods. Conclusions Considering these data, it is expected that the number of patients needing PPC services will steadily increase in the next years. Hence, there is a need to invest resources to provide the best care delivery model encompassing specific pathways for the transition into adulthood, the establishment of networks within all the Italian regions, and an efficient referral to the more suitable setting of care.

O setor energético global vem modernizando seus sistemas de conversão de energia, substituindo os meios tradicionais de geração de potência por sistemas de conversão de energia renovável para reduzir os impactos ambientais inerentes aos sistemas de produção de potência ultrapassados. Nas últimas décadas, a geração de potência usando energia eólica como fonte primária de energia vem continuamente aumentando sua participação no suprimento desta demanda. Nestes sistemas, geradores síncronos de ímãs permanentes são largamente utilizados devido suas diversas vantagens, sendo o controle orientado a campo, composto por dois controladores proporcionais-integrais independentes, uma das estratégias de controle mais eficientes para regular as correntes em coordenadas dq. Neste viés, este trabalho apresenta um procedimento sistemático para parametrização deste controlador usando o algoritmo grasshopper optimizer. Para orientar os projetistas de controle que queiram utilizar a metodologia proposta, seis configurações diferentes do otimizador são discutidas para avaliar o impacto da configuração do otimizador na qualidade das soluções propostas ao problema de controle avaliado. Uma comparação com o método de sintonia clássico de Chien, Hrone e Reswick também é apresentado, onde o procedimento proposto demonstra superioridade.

Este artigo convida a pensar a perspectiva pós-estruturalista nas pesquisas educacionais, em específico no campo da educação de surdos, no cenário da educação inclusiva. Para tanto, procurou movimentar, a partir de um estudo de mestrado, o conceito de trajetividade de Virilio (1993) como um operador teórico-metodológico alinhado a uma perspectiva pós-estruturalista, enquanto potência na composição de uma escrita-vida-pesquisa que se ocupa de pensar os modos de produção de uma docência e educação outra com surdos na escola comum. Mobiliza-se a potência deste conceito, reconhecendo a produção de uma docência trajetiva na educação e na pesquisa como modos outros de docência e educação de surdos, como possibilidade de tensionamento das relações de saber-poder-verdade. A trajetividade, enquanto caminho teórico-metodológico, acolhe a escrita ensaística como (de)formação de um eu que vai constituindo-se trajetivo com outros-juntos e com suas relações na educação, produzindo sua existência-docência pela andarilhagem da escrita-vida-pesquisa que compõe. A professora-pesquisadora-trajetiva operou novas relações consigo, com o outro e com os processos de escolarização na escola comum à medida que se colocou em trajetividade com as experiências-marcas de sua docência. Elegeram-se alguns recortes da trajetividade no processo investigativo de mestrado para anunciar a possibilidade de experimentar modos investigativos outros, que possam transgredir caminhos de pesquisa fixos, hegemônicos e estruturalizantes. Dessa forma, o artigo anuncia a trajetividade como um movimento que se faz ao caminhar no entre de uma vida-pesquisa, compondo um devir-pesquisa pelo exercício da escrita ensaística. Diante disso, propõe-se o convite-desejo de acolher a trajetividade como possibilidade de uma moviment(ação) subjetiva de pensamento e de relações nos contextos educacionais. Também, apresenta-se a trajetividade como possibilidade de fratura e transgressão aos processos investigativos dominantes de se fazer pesquisa pelo movimento ético e estético de vida que ela assume.

Quantifying the effects of external climatic and anthropogenic stressors on aquatic ecosystems is an important task for scientific purposes and management progress in the field of water resources. In this study, we propose an innovative use of biotic communities as real-time indicators, which offers a promising solution to directly quantify the impact of these external stressors on the aquatic ecosystem health. Specifically, we investigated the influence of natural river floods on riverine biotic communities using freshwater mussels (FMs) as reliable biosensors. Using the valvometry technique, we monitored the valve gaping of FMs and analysed both the amplitude and frequency. The valve movement of the FMs was tracked by installing a magnet on one valve and a Hall effect sensor on the other valve. The magnetic field between the magnet and the sensor was recorded using an Arduino board, and its changes over time were normalised to give the opening percentage of the FMs (how open the mussels were). The recorded data were then analysed using continuous wavelet transform (CWT) analysis to study the time-dependent frequency of the signals. The experiments were carried out both in a laboratory flume and in the Paglia River (Italy). The laboratory experiments were conducted with FMs in two configurations: freely moving on the bed and immobilised on vertical rods. Testing of the immobilised configuration was necessary because the same configuration was used in the field in order to prevent FMs from packing against the downstream wall of the protection cage during floods or from breaking their connection wires. These experiments allowed us to verify that immobilised mussels show similar responses to abrupt changes in flow conditions as free mussels. Moreover, immobilised mussels produced more neat and interpretable signals than free-moving mussels due to the reduced number of features resulting from movement constraints. We then analysed the response of 13 immobilised mussels under real river conditions during a flood on 31 March 2022. The FMs in the field showed a rapid and significant change in valve gap frequency as the flood escalated, confirming the general behaviour observed in the laboratory in the presence of an abrupt increase in the flow. These results highlight the effectiveness of using FMs as biosensors for the timely detection of environmental stressors related to natural floods and emphasise the utility of CWT as a powerful signal-processing tool for the analysis of valvometry data. The study proposes the integration of FM valvometry and CWT for the development of operational real-time biological early-warning systems (BEWSs) with the aim of monitoring and protecting aquatic ecosystems. Future research should focus on extending the investigation of the responsiveness of FMs to specific stressors (e.g. turbidity, temperature, and chemicals) and on testing the applications of the proposed BEWSs to quantify the impact of both natural stressors (e.g. heat waves and droughts) and anthropogenic stressors (e.g. hydropeaking, reservoir flushing, and chemical contamination).

Em 2012, o "Marco de Referência de Educação Alimentar e Nutricional para Políticas Públicas" (Marco de EAN) apresentou uma nova concepção e princípios norteadores para a Educação Alimentar e Nutricional (EAN). O objetivo deste estudo foi analisar se o referencial proposto pelo Marco foi contemplado nas ações de Educação Alimentar e Nutricional (EAN) desenvolvidas por escolas. Realizou-se estudo qualitativo e exploratório, no qual foram convidadas a participar as 125 escolas públicas municipais de Educação Infantil e Ensino Fundamental I de Florianópolis, Santa Catarina. Para coleta de dados, foi utilizado questionário on-line semiestruturado sobre o desenvolvimento das ações de EAN em 2019. As respostas foram submetidas a análise temática, agrupando respostas semelhantes em categorias e subcategorias, para identificar quais princípios do Marco de EAN foram atendidos. Participaram 94 escolas públicas, sendo os diretores os principais respondentes. Identificaram-se nove categorias de ações de EAN: Atividades lúdicas, musicais e teatrais, contação de história e recursos audiovisuais; Atividades pedagógicas; Elaboração de materiais e atividades práticas; Formação, reuniões, palestras e informativos; Horta Pedagógica; Oficinas culinárias; Oferta de alimentação escolar; Projeto refeitório; e Visitas a feiras agroecológicas. Os princípios atendidos em todas as ações foram: diversidade de cenários de prática, intersetorialidade e planejamento, avaliação e monitoramento. Constatou-se que, em uma única ação, diferentes princípios foram atendidos. É fundamental capacitar continuamente os profissionais do ambiente escolar para utilização do Marco de EAN como referência para realização das ações de EAN.

This article provides a comprehensive analysis, including static, dynamic, and experimental validation, of a voltage-doubler Ćuk rectifier operating in the discontinuous conduction mode (DCM) for single-phase applications. The proposed topology integrates two classic Ćuk rectifiers through a three-position switch, allowing for either a doubled output voltage or reduced voltage efforts compared to the conventional topology. The voltage gain is increased while maintaining the step-up/step-down characteristic of the Ćuk family, and power components are activated only in a half cycle of the electrical grid, thus reducing the current efforts in the semiconductors. These features make the Ćuk converter suitable for higher voltage applications. The proposed topology is analyzed in DCM, where a high power factor is naturally achieved without a current control loop. An experimental prototype of 1 kW is built to verify the theoretical analysis, and the results show an efficiency of 94.68% with an input current total harmonic distortion of 1.86% at a rated power, including an output voltage control loop. Furthermore, the proposed topology is compared to the conventional Ćuk rectifier, both operating in DCM and with power factor correction.

Abstract The presynaptic serotonin transporter (SERT) clears extracellular serotonin following vesicular release to ensure temporal and spatial regulation of serotonergic signalling and neurotransmitter homeostasis. Prescription drugs used to treat neurobehavioral disorders, including depression, anxiety, and obsessive-compulsive disorder, trap SERT by blocking the transport cycle. In contrast, illicit drugs of abuse like amphetamines reverse SERT directionality, causing serotonin efflux. Both processes result in increased extracellular serotonin levels. By combining molecular dynamics simulations with biochemical experiments and using a homologous series of serotonin analogues, we uncovered the coupling mechanism between the substrate and the transporter, which triggers the uptake of serotonin. Free energy analysis showed that only scaffold-bound substrates could initiate SERT occlusion through attractive long-range electrostatic interactions acting on the bundle domain. The associated spatial requirements define substrate and inhibitor properties, enabling additional possibilities for rational drug design approaches.

Este artigo apresenta uma metodologia para síntese de topologias de alto ganho a partir da conexão diferencial entre conversores cc-cc básicos. Tais conversores básicos podem ser iguais ou diferentes, mas devem compartilhar referência comum entre entrada e saída e tensões de saída de mesma polaridade. Além da metodologia e da análise de alguns dos conversores sintetizados em modo de condução contínua, o artigo discute sobre processamento parcial de potência, redução de componentes, adição de células de ganho, modelagem e estratégias de controle. A metodologia proposta é verificada por meio de dez protótipos derivados da conexão diferencial entre conversores básicos, considerando tensão de entrada de 20 V, razão cíclica de 0,75 e potência nominal de 100 W. Três novos conversores cc-cc de ultra alto ganho também são sintetizados a partir da inserção de células de ganho nos conversores diferenciais propostos, sendo dois deles avaliados experimentalmente, apresentado rendimentos máximos próximo de 97%.

BackgroundMethylene blue is an interesting approach in reducing fluid overload and vasoactive drug administration in vasodilatory shock. The inhibition of guanylate cyclase induced by methylene blue infusion reduces nitric oxide production and improves vasoconstriction. This systematic review and meta-analysis aimed to assess the effects of methylene blue administration compared to placebo on the hemodynamic status and clinical outcomes in patients with sepsis and septic shock.MethodsThe authors specifically included randomized controlled trials that compared the use of methylene blue with placebo in adult patients with sepsis and septic shock. The outcomes were length of intensive care unit stay, hemodynamic parameters [vasopressor use], and days on mechanical ventilation. We also evaluated the abnormal levels of methemoglobinemia. This systematic review and meta-analysis were recorded in PROSPERO with the ID CRD42023423470.ResultsDuring the initial search, a total of 1,014 records were identified, out of which 393 were duplicates. Fourteen citations were selected for detailed reading, and three were selected for inclusion. The studies enrolled 141 patients, with 70 of them in the methylene blue group and 71 of them in the control group. Methylene blue treatment was associated with a lower length of intensive care unit stay (MD −1.58; 95%CI −2.97, −0.20; I2 = 25%; p = 0.03), decreased days on mechanical ventilation (MD −0.72; 95%CI −1.26, −0.17; I2 = 0%; p = 0.010), and a shorter time to vasopressor discontinuation (MD −31.49; 95%CI −46.02, −16.96; I2 = 0%; p

Abstract Background Carotid web (CaW) and carotid free-floating thrombus (CFFT) are rare yet critical causes of ischemic stroke in young adults. Case presentation A 54-year-old woman presented with a fluctuating right sensory-motor faciobrachial syndrome. A brain MRI scan revealed multiple small recent asynchronous cortico-subcortical ischemic foci in the vascular territory of the left internal carotid artery. A CT angiography identified a CFFT in the left internal carotid artery arising from an underlying CaW. The patient was treated with excellent clinical outcomes with carotid artery stenting and dual antiplatelet therapy. Conclusions We provide a structured pathophysiological rationale connecting CaW and CFFT and highlight pivotal therapeutic implications. Further studies are needed to investigate this relationship and guide assessment and treatment.

Abstract Osteoarthritis (OA) is a chronic degenerative joint disease characterized by pain and cartilage damage. Intra-articular (i.a) viscosupplementation with hyaluronic acid (HA) is frequently used for the management of OA. Preclinical studies have reported that bisphosphonates (BPs) may have a therapeutic potential to slow down or reverse the progression of OA. Among these, alendronate (ALN) has demonstrated chondroprotective effects in both in vitro and vivo experiments. This study evaluated the effects of a novel alendronate-hyaluronic acid (ALN-HA) conjugate on an OA in vivo model induced by medial meniscus destabilization (DMM). DMM surgery was performed on the knees of Sprague Dawley rats that received, after four weeks, one intra-articular (i.a.) injection of: (1) ALN-HA; (2) HA; (3) sodium chloride (NaCl). Sham-operated rats were used as control. Allodynia was assessed by Von Frey test. Joint degeneration was evaluated eight weeks after treatment by micro-computed tomography (micro-CT), histology, and immunohistochemistry. Collagen cross-linked C-telopeptides (CTX-I and CTX-II) serum levels were determined by ELISA. Paw withdrawal threshold increased in ALN-HA group when compared to rats treated with NaCl or HA. Micro-CT did not show differences between ALN-HA, HA and NaCl groups. ALN-HA injection produced significant improvements in articular cartilage degeneration showing an OARSI score lower than those of HA and NaCl, and reduced matrix metalloproteinase (MMP)-13, MMP-3, interleukin-6, vascular endothelial growth factor and Caspase-3 expression. CTX-I was reduced after ALN-HA treatment when compared to NaCl. Our results indicate that i.a. use of ALN after conjugation with HA limits OA development and progression in the rat DMM model, and may lead to the development of novel therapeutic strategies in OA management.

Gliomas present a complex challenge in neuro-oncology, often accompanied by the debilitating complication of epilepsy. Understanding the biological interaction and common pathways between gliomagenesis and epileptogenesis is crucial for improving the current understanding of tumorigenesis and also for developing effective management strategies. Shared genetic and molecular mechanisms, such as IDH mutations and dysregulated glutamate signaling, contribute to both tumor progression and seizure development. Targeting these pathways, such as through direct inhibition of mutant IDH enzymes or modulation of glutamate receptors, holds promise for improving patient outcomes. Additionally, advancements in surgical techniques, like supratotal resection guided by connectomics, offer opportunities for maximally safe tumor resection and enhanced seizure control. Advanced imaging modalities further aid in identifying epileptogenic foci and tailoring treatment approaches based on the tumor’s metabolic characteristics. This review aims to explore the complex interplay between gliomagenesis, epileptogenesis, and neural circuit remodeling, offering insights into shared molecular pathways and innovative treatment strategies to improve outcomes for patients with gliomas and associated epilepsy.

Staphylococcus aureus bacteraemia (SAB) is a life-threatening bloodstream infection. Improved adherence to quality-of-care indicators (QCIs) can significantly enhance patient outcomes. This quasi-experimental study evaluated the impact of a bundle of interventions on QCI adherence in adult patients with SAB. Additionally, a molecular rapid diagnostic test (mRDT) for S. aureus and methicillin resistance was introduced during weekdays. We compared pre-intervention (January–December 2022) and post-intervention (May 2023–April 2024) data on QCI adherence and time to appropriate treatment. A total of 56 and 40 SAB episodes were included in the pre- and post-intervention periods, respectively. Full QCI adherence significantly increased from 28.6% to 67.5% in the post-intervention period (p < 0.001). The mRDT diagnosed SAB in eight cases (26.6%), but the time to achieve appropriate target therapy did not improve in the post-intervention period (54 h (IQR 30–74) vs. 72 h (IQR 51–83), p = 0.131). The thirty-day mortality rate was comparable between the two periods (17.9% vs. 12.5%, p = 0.476). This study demonstrates that a bundle of interventions can substantially improve adherence to SAB management QCIs.

Cochlear implantation is the therapy used for patients with severe to profound sensorineural hearing loss. For the success of the surgery, it is important that each surgical step is performed with meticulous precision, starting from the correct patient position on the operating table. In elderly or obese patients, this can be difficult to achieve due to cervical rigidity. With this technical note, we want to describe a new position from orthopedic surgery to perform a posterior tympanotomy accurately, ensuring a safe procedure and avoiding unpleasant complications.