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Abstract Healthy aging often entails a decline in cognitive and motor functions, affecting independence and quality of life in older adults. Brain stimulation shows potential to enhance these functions, but studies show variable effects. Previous studies have tried to identify responders and non-responders through correlations between behavioral change and baseline parameters, but results lack generalization to independent cohorts. We propose a method to predict an individual’s likelihood of benefiting from stimulation, based on baseline performance of a sequential motor task. Our results show that individuals with less efficient learning mechanisms benefit from stimulation, while those with optimal learning strategies experience none or even detrimental effects. This differential effect, first identified in a public dataset and replicated here in an independent cohort, was linked to one’s ability to integrate task-relevant information and not age. This study constitutes a further step towards personalized clinical-translational interventions based on brain stimulation.

Fracture injection/shut-in tests are commonly used to measure the state of stress in the subsurface. Injection creates a hydraulic fracture (or in some cases, opens a preexisting fracture), and then the pressure after shut-in is monitored to identify fracture closure. Different interpretation procedures have been proposed for estimating closure, and the procedures sometimes yield significantly different results. In this study, direct, in-situ strain measurements are used to observe fracture reopening and closure. The tests were performed as part of the EGS Collab project, a mesoscale project performed at 1.25 and 1.5 km depth at the Sanford Underground Research Facility. The tests were instrumented with the SIMFIP tool, a double-packer probe with a high-resolution three-dimensional borehole displacement sensor. The measurements provide a direct observation of the fracture closure signature, enabling a high-fidelity estimate of the fracture closure stress (ie, the normal stress on the fracture). In two of the four tests, injection created an opening mode fracture, and so the closure stress can be interpreted as the minimum principal stress. In the other two tests, injection probably opened preexisting natural fractures, and so the closure stress can be interpreted as the normal stress on the fractures. The strain measurements are compared against different proposed methods for estimating closure stress from pressure transients. The shut-in transients are analyzed with two techniques that are widely used in the field of petroleum engineering – the ‘tangent’ method and the ‘compliance’ method. In three of the four tests, the tangent method significantly underestimates the closure stress. The compliance method is reasonably accurate in all four tests. Closure stress is also interpreted using two other commonly-used methods – ‘first deviation from linearity’ and the method of (Hayashi and Haimson, 1991). In comparison with the SIMFIP data, these methods tend to overestimate the closure stress, evidently because they identify closure from early-time transient effects, such as near-wellbore tortuosity. In two of the tests, microseismic imaging provides an independent estimate of the size of the fracture created by injection. When combined with a simple mass balance calculation, the SIMFIP stress measurements yield predictions of fracture size that are reasonably consistent with the estimates from microseismic. The calculations imply an apparent fracture toughness 2-3x higher than typical laboratory-derived values.

Propõe-se uma modelagem das velocidades mensais de ventos através de distribuições Weibull triparamétricas, na geração de cenários de ventos mensais correlacionados com afluências às usinas hidrelétricas, em um esquema de Programação Dinâmica Dual Estocástica-PDDE. A abordagem constitui-se de duas etapas. Na primeira, os parâmetros da distribuição Weibull dos resíduos das velocidades mensais históricas do vento são estimados pelo Método dos Momentos de 3a Ordem. Se a assimetria das velocidades sintéticas for suficientemente próxima da histórica, o algoritmo para. Caso contrário, a estimativa do parâmetro posição, obtida na primeira etapa é utilizada como valor inicial para calcular estimativas dos outros dois parâmetros (forma e escala) por meio do Método dos Momentos de 2a Ordem. Em seguida, de forma iterativa, o algoritmo atualiza a estimativa inicial do parâmetro posição com vistas a reduzir a diferença entre as assimetrias das velocidades sintéticas e históricas do vento, até que se atinja um valor considerado aceitável. Procura-se, assim, assegurar precisão com o menor esforço computacional possível. A aplicação a parques eólicos do Nordeste e Sul do Brasil, em diferentes meses e assimetrias, aponta para a sua robustez, apresentando desempenho sempre superior a 17 outros métodos avaliados.

Abstract Primary health care (PHC) has increased in global relevance as it has been demonstrated to be a useful strategy to promote community access to health services. Multilateral organizations and national governments have reached a consensus regarding the basic principles of PHC, but the application of these varies from country to country due to the particularities of local health systems. This article aims to review and summarize PHC strategies and the configuration of health networks in Latin American and Caribbean countries. The review was carried out using keywords in at least 9 databases. Papers in languages other than English, Portuguese, and Spanish were excluded, while non-refereed articles and regional gray literature were incorporated. As a result, 1,146 papers were identified. After three instances of analysis, 142 articles were selected for this investigation. Data were analyzed according to an analysis by theme. The evidence collected on health reforms in the region reflects the need to intensify care strategies supported by PHC and care networks. These must be resilient to changes in the population’s needs and must be able to adapt to contexts of epidemiological accumulation.

El propósito es analizar la relación entre el mantenimiento de creencias sexistas y la violencia de género. Se han comparado las puntuaciones en sexismo hostil y sutil, percepción de gravedad, celos y tendencia a la agresividad entre una muestra de varones de la población general y condenados por delitos de violencia de género realizando el Programa de Rehabilitación e Intervención en Agresores. Se realizaron comparaciones antes y después de la aplicación del programa, para comprobar si tras la intervención, los penados han reducido las puntuaciones en los factores de riesgo igualando a la población general. Los resultados indican diferencias significativas en las variables analizadas entre ambos grupos antes de la asistencia al programa y diferencias menores después de la asistencia al mismo. Se concluye que, aun cuando el programa de intervención ha tenido un resultado positivo sobre los agresores sería necesario analizar en mayor profundidad el efecto de cada componente.

Aging populations face significant cognitive challenges, particularly in working memory (WM). Transcranial alternating current stimulation (tACS) offer promising avenues for cognitive enhancement, especially when inspired by brain physiology. This study (NCT04986787) explores the effect of multifocal tACS on WM performance in healthy older adults, focusing on fronto-parietal network modulation. Individualized physiology-inspired tACS applied to the fronto-parietal network was investigated in two blinded cross-over experiments. The first experiment involved monofocal/bifocal theta-tACS to the fronto-parietal network, while in the second experiment cross-frequency theta-gamma interactions between these regions were explored. Participants have done online WM tasks under the stimulation conditions. Network connectivity was assessed via rs-fMRI and multichannel electroencephalography. Prefrontal monofocal theta tACS modestly improved WM accuracy over sham (d = 0.30). Fronto-parietal stimulation enhanced WM task processing speed, with the strongest effects for bifocal in-phase theta tACS (d = 0.41). Cross-frequency stimulations modestly boosted processing speed with or without impairing task accuracy depending on the stimulation protocol. This research adds to the understanding of physiology-inspired brain stimulation for cognitive enhancement in older subjects.

Abstract Aims Iron deficiency (ID) is associated with an impaired cardiac function and remodelling in heart failure (HF). Treatment with ferric carboxymaltose (FCM) has been showed recently to improve biventricular systolic function and ventricular strain parameters in patients with HF with reduced ejection fraction and ID, but there is no evidence on the benefit of FCM on the left atrium (LA). In this study, we aimed to evaluate the effect of FCM on LA longitudinal strain (LA‐LS). Methods and results This is a post hoc subanalysis of a double‐blind, placebo‐controlled, randomized clinical trial that enrolled 53 ambulatory patients with HF, left ventricular ejection fraction (LVEF)

Abstract Background: Currently, there is no uniform and official terminology in Portuguese for reflectance confocal microscopy analysis, despite the increasing number of Brazilian dermatologists using this new tool. Objective: To present the terminology in Brazilian Portuguese for the description of reflectance confocal microscopy and establish the first Brazilian consensus on terms related to normal skin and cutaneous tumors. Methods: 10 Brazilian specialists from different institutions and states of Brazil were selected to evaluate the best corresponding terms in Portuguese for normal skin, melanocytic and non-melanocytic tumors. The terms used were translated from international consensuses in the English language. The modified Delphi method was used to create the consensus in 3 steps. Results: The terms considered the most appropriate in the Portuguese language to describe the findings of normal skin, melanocytic and non-melanocytic lesions in the reflectance confocal microscopy analysis were presented. Study limitations: The limitations of the present study include the number of participants and limited regional representation (only two of the five Brazilian regions were represented). Conclusion: This Brazilian consensus represents an opportunity for dermatologists and physicians specializing in cutaneous oncology to become familiar with reflectance confocal microscopy, propagating the technique in clinical and research environments to stimulate national and international publications on this subject.

The EGS Collab project, supported by the US Department of Energy, is performing intensively monitored rock stimulation and flow tests at the 10-m scale in an underground research laboratory to address challenges in implementing enhanced geothermal systems (EGS). Data and observations from the field tests are compared to simulations to understand processes and build confidence in numerical modeling of the processes. We have completed Experiment 1 (of 3), which examined hydraulic fracturing in a well-characterized underground fractured phyllite test bed at a depth of approximately 1.5 km at the Sanford Underground Research Facility (SURF) in Lead, South Dakota. Testbed characterization included fracture mapping, borehole acoustic and optical televiewers, full waveform sonic, conductivity, resistivity, temperature, campaign p- and s-wave investigations and electrical resistance tomography. Borehole geophysical techniques including passive seismic, continuous active source seismic monitoring, electrical resistance tomography, fiber-based distributed strain, distributed temperature, and distributed acoustic monitoring, were used to carefully monitor stimulation events and flow tests. More than a dozen stimulations and nearly one year of flow tests were performed. Quality data and detailed observations were collected and analyzed during stimulation and water flow tests using ambient temperature and chilled water. We achieved adaptive control of the tests using real-time monitoring and rapid dissemination of data and near-real-time simulation. More detailed numerical simulation was performed to answer key experimental design questions, forecast fracture propagation trajectories and extents, and analyze and evaluate results. Data are freely available from the Geothermal Data Repository. Experiment 2 examines the potential for hydraulic shearing in amphibolite at a depth of about 1.25 km at SURF. This site has a different set of stress and fracture conditions than Experiment 1. The Experiment 2 testbed consists of nine subhorizontal boreholes configured in two fans of two boreholes which surround the testbed and contain grouted-in electrical resistance tomography, seismic sensors, active seismic sources and distributed fiber sensors. A “five-spot” set of test wells that extends from a custom mined alcove includes an injection well and four production/monitoring wells. The testbed was characterized geophysically and hydrologically, and three stimulations have been performed using the Step-Rate Injection Method for Fracture In-Situ Properties (SIMFIP) tool to measure strains, and a new strain quantifying tool (downhole robotic strain analysis tool -DORSA) was deployed in a monitoring hole during stimulation. Real-time data were broadcast during stimulations to allow real-time response to arising issues.

The EGS Collab project is performing well-monitored rock stimulation and flow tests at the 10-m scale in an underground research laboratory to inform challenges in implementing enhanced geothermal systems (EGS). This project, supported by the US Department of Energy, is gathering data and observations from the field tests and comparing these to simulation results to understand processes and to build confidence in numerical modeling of the processes. Experiment 1 (now complete) examined hydraulic fracturing in an underground test bed at the Sanford Underground Research Facility (SURF) in Lead, South Dakota, at a depth of approximately 1.5 km in a well-characterized phyllite. Geophysical monitoring instrumentation in six of eight sub-horizontal boreholes monitored stimulation events and flow tests. The other two boreholes were used to perform and carefully measure water injection and production. More than a dozen stimulations and nearly one year of flow tests in the testbed were performed. Detailed observations of processes occurring during stimulation and dynamic flow tests were collected and analyzed. Flow tests using ambient-temperature and chilled water were performed with intermittent tracer tests to examine system behavior. We achieved adaptive control of the tests using close monitoring of rapidly disseminated data and near-real-time simulation. Numerical simulation was critical in answering key experimental design questions, forecasting fracture behavior, and analyzing results. We were successful in performing many simulations in near-real-time in conjunction with the field experiments, with more detailed simulations performed later. The primary objective of Experiment 2 is to examine hydraulic shearing of natural fractures at a depth of 1.25 km in amphibolite at SURF. The stresses, rock type, and fracture conditions are different than in Experiment 1. The testbed consists of 9 boreholes, in addition to two earlier-drilled characterization boreholes. One borehole is used for injection, two fans of 2 monitoring wells have several geophysical measurement tools grouted in, and four open boreholes surrounding the injection hole are adaptively used for production and monitoring. We have encountered approximately five fracture set orientations in the testbed, and designed our testbed accordingly to maximize the potential for shear stimulation. Three stimulations have been performed to date from the injection borehole, each intersecting at least one production borehole. Different methods have been used for each stimulation, including a ramped flow, a high flow rate, and oscillating pressure.

The final version of the above article was posted prematurely on 16 July 2021, owing to a technical error. The final, corrected version of record will be made fully available at a later date.

AbstractA new public policy was instituted in Argentina for free distribution of subdermal contraceptive implants to women aged 15–24 years old in the public healthcare system. The objective of this study is to determine the extent to which this population adhered to the implant, as well as predictors of continuation. The retrospective cohort study was based on a telephone survey of a random sample of 1101 Ministry of Health-registered implant users concerning the continuation of use, satisfaction with the method and side-effects, and reasons for removal. Descriptive statistics and multivariate regression analysis were used to explore the association between adherence and having received contraceptive counselling, satisfaction, and side effects. We found high levels of adherence (87%) and satisfaction (94%). Common reported side effects were amenorrhoea or infrequent bleeding, perceived weight gain, increased menstrual bleeding and headaches. Multivariate regression analysis indicates that, among adolescents, having received contraceptive counselling increased comfort, while frequent bleeding at six months hindered trust. Participants who had a history of a prior delivery or who had themselves primarily chosen the method were less likely to request the removal of the implant. Our results support the public policy of free implant distribution in the public health sector. This is a sustainable public policy that contributes to equity and access to effective contraception. It is appropriate for adolescents and young women and will also reduce unintended pregnancies. Our results suggest that counselling patients is key prior to insertion of the implant, as it improves acceptability and continuation.

The EGS Collab project, supported by the US Department of Energy, is addressing challenges in implementing enhanced geothermal systems (EGS). This includes improving understanding of the stimulation of crystalline rock to create appropriate flow pathways, and the ability to effectively simulate both the stimulation and the flow and transport processes in the resulting fracture network. The project is performing intensively monitored rock stimulation and flow tests at the 10-m scale in an underground research laboratory. Data and observations from the field test are compared to simulations to understand processes and to build confidence in numerical modeling of the processes. In Experiment 1, we examined hydraulic fracturing an underground test bed at the Sanford Underground Research Facility (SURF) in Lead, South Dakota, at a depth of approximately 1.5 km. We drilled eight sub-horizontal boreholes in a well-characterized phyllite. Six of the boreholes were instrumented with many sensor types to allow careful monitoring of stimulation events and flow tests, and the other two boreholes were used for water injection and production. We performed a number of stimulations and flow tests in the testbed. Our monitoring systems allowed detailed observations and collection of numerous data sets of processes occurring during stimulation and during dynamic flow tests. Long-term ambient temperature and chilled water flow tests were performed in addition to many tracer tests to examine system behavior. Data were rapidly analyzed, allowing adaptive control of the tests. Numerical simulation was used to answer key experimental design questions, to forecast fracture propagation trajectories and extents, and to analyze and evaluate results. Many simulations were performed in near-real-time in conjunction with the field experiments, with more detailed process study simulations performed on a longer timeframe. Experiment 2 will examine hydraulic shearing in a test bed being built at the SURF at a depth of about 1.25 km in amphibolite under a different set of stress and fracture conditions than Experiment 1. Five sets of fracture orientations were considered in design, and three orientations seem to be consistently observed.

Enhanced Geothermal Systems could provide a substantial contribution to the global energy demand if their implementation could overcome inherent challenges. Examples are insufficient created permeability, early thermal breakthrough, and unacceptable induced seismicity. Here we report on the seismic response of a mesoscale hydraulic fracturing experiment performed at 1.5-km depth at the Sanford Underground Research Facility. We have measured the seismic activity by utilizing a 100-kHz, continuous seismic monitoring system deployed in six 60-m length monitoring boreholes surrounding the experimental domain in 3-D. The achieved location uncertainty was on the order of 1 m and limited by the signal-to-noise ratio of detected events. These uncertainties were corroborated by detections of fracture intersections at the monitoring boreholes. Three intervals of the dedicated injection borehole were hydraulically stimulated by water injection at pressures up to 33 MPa and flow rates up to 5 L/min. We located 1,933 seismic events during several injection periods. The recorded seismicity delineates a complex fracture network comprised of multistrand hydraulic fractures and shear-reactivated, preexisting planes of weakness that grew unilaterally from the point of initiation. We find that heterogeneity of stress dictates the seismic outcome of hydraulic stimulations, even when relying on theoretically well-behaved hydraulic fractures. Once hydraulic fractures intersected boreholes, the boreholes acted as a pressure relief and fracture propagation ceased. In order to create an efficient subsurface heat exchanger, production boreholes should not be drilled before the end of hydraulic stimulations.

We investigate the influence of foliation orientation and fine-scale folding on the static and dynamic elastic properties and unconfined strength of the Poorman schist. Measurements from triaxial and uniaxial laboratory experiments reveal a significant amount of variability in the static and dynamic Young’s modulus depending on the sample orientation relative to the foliation plane. Dynamic P-wave modulus and S-wave modulus are stiffer in the direction parallel to the foliation plane as expected for transversely isotropic mediums with average Thomsen parameters values 0.133 and 0.119 for epsilon and gamma, respectively. Static Young’s modulus varies significantly between 21 and 117 GPa, and a peculiar trend is observed where some foliated sample groups show an anomalous decrease in the static Young’s modulus when the symmetry axis (x3-axis) is oriented obliquely to the direction of loading. Utilizing stress and strain relationships for transversely isotropic medium, we derive the analytical expression for Young’s modulus as a function of the elastic moduli E1, E3, ν31, and G13 and sample orientation to fit the static Young’s modulus measurements. Regression of the equation to the Young’s modulus data reveals that the decrease in static Young’s modulus at oblique symmetry axis orientations is directly influenced by a low shear modulus, G13, which we attribute to shear sliding along foliation planes during static deformation that occurs as soon as the foliation is subject to shear stress. We argue that such difference between dynamic and static anisotropy is a characteristic of near-zero porosity anisotropic rocks. The uniaxial compressive strength also shows significant variability ranging from 21.9 to 194.6 MPa across the five sample locations and is the lowest when the symmetry axis is oriented 45° or 60° from the direction of loading, also a result of shear sliding along foliation planes during static deformation.

Abstract Background Data regarding cardiovascular magnetic resonance (CMR) reference values in athletes have not been well determined yet. Using CMR normal reference values derived from the general population may be misleading in athletes and may have clinical implications. Aims To determine reference ventricular dimensions and function parameters and ratios by CMR in high performance athletes. Methods Elite athletes and age‐ and gender‐matched sedentary healthy controls were included. Anatomical and functional variables, including biventricular volumes, mass, systolic function, wall thickness, sphericity index and longitudinal function were determined by CMR. Results A total of 148 athletes (29.2 ± 9.1 years; 64.8% men) and 124 controls (32.1 ± 10.5 years; 67.7% men) were included. Left ventricular (LV) mass excluding papillary muscles was 67 ± 13 g/m2 in the control group and increased from 65 ± 14 g/m2 in the low intensity sport category to 83 ± 16 g/m2 in the high cardiovascular demand sport category; P

A pesar de que cada día la complejidad de las infraestructuras (TI) que se operan en Cuba crece, no están definidos los requisitos que deben cumplir las personas para desempeñarse como especialistas de ciberseguridad, sin embargo, estos especialistas tienen que ser capaces de adquirir una serie de competencias que les permita realizar las tareas necesarias del rol que están desarrollando. Este proceso no se realiza de ninguna manera, dígase, manuscrito o digital, por lo que el país al no tener definido este elemento a nivel nacional necesita contar con un sistema informático que apoye dicho proceso. Los objetivos que se persigue con el trabajo es favorecer la centralización, accesibilidad, disponibilidad, completitud e integridad de los datos. Por lo que al finalizar la investigación se obtiene como resultado un sistema informático para la gestión de la información de los roles asociados a la ciberseguridad en Cuba. Se utiliza la metodología Extreme Programming (XP) para el desarrollo del marco teórico y sistémico que se usa para la resolución del problema.

La necesidad de diseñar una agenda estratégica hacia sistemas alimentarios más saludables y sustentables es incuestionable. Ello resulta particularmente complejo en países como la Argentina, con una tradición productiva fuerte en el sector agroganadero y patrones marcados de consumo basados en carnes. A tal fin, este artículo desarrolla un análisis de los actores locales vinculados a la agenda y al debate público sobre la transición hacia sistemas de alimentación más saludables y sostenibles, considerando una secuencia de tres pasos. Primero, se identifican los actores y sus principales perspectivas e intereses con relación a estas temáticas. Segundo, se establecen agrupamientos o clústeres de actores que comparten posiciones similares. Tercero, se mapea la matriz de relaciones de estos actores entre sí, explorando sus principales vínculos de cooperación y tensión. Entre otros hallazgos, el artículo muestra que para avanzar hacia sistemas alimentarios más saludables y sostenibles en la Argentina, la agenda pública está compartimentada y fragmentada; incluso, al interior de las instituciones ministeriales del gobierno nacional. En general, existen diferentes subsistemas de política pública y redes de actores que, a pesar de contar con conocimiento sobre aspectos específicos de la agenda de sistemas alimentarios, ofrecen un bajo nivel de articulación temática y de integración entre sí.