Leonardo (France)

Abstract Objectives Urethroplasty is one of the recommended options to treat bulbar urethral strictures. Some complications are reduced ejaculation force and postmicturition dribble. These complications may be correlated to the bulbospongiosus muscle and perineal nerves dissection. The video shows a novel technique consisting of a one-sided dorso-lateral graft urethral augmentation, which allows the sparing of the bulbospongiosus muscle and perineal nerves. Methods The surgery starts with a perineal incision until the exposure of the bulbospongiosum muscle. At that point, the muscle dissection is conducted only from the left side, to leave it undamaged. Then, the urethra is partially dissected from the corpora cavernosa, along its left dorso-lateral side. Subsequently, a dorso-lateral incision of the restricted urethra is made and a preputial skin graft harvested through a partial circumcision is used for urethral augmentation. The preputial graft is fixed onto the corpora cavernosa and finally, the urethra is closed over the graft. By this procedure, the bulbospongiosum muscles and the perineal nerves are preserved. Successful urethral reconstruction was defined as normal voiding without the need for any postoperative procedure. Sexual disorders were investigated using a validated questionnaire. Results Nine patients have been operated on for medio-proximal bulbar urethral strictures using this technique. The median follow-up was 9 months and the mean stricture length was 2 cm. All patients have been successfully treated and no ejaculatory complications or post-void dribbling was seen during follow-up. Conclusions One-sided anterior urethroplasty is a useful technique that can spare the bulbospongiosus muscle and perineal nerves, allowing the preservation of the neurovascular support, and reducing the impact on ejaculatory function and post-void dribbling. Conflicts of Interest none.

Introdução: Os transplantes de órgãos representam uma das maiores conquistas da medicina moderna, oferecendo uma segunda chance de vida para milhares de pacientes em todo o mundo. Este artigo explora as inovações recentes no campo dos transplantes, os desafios éticos envolvidos na doação e recepção de órgãos, bem como as barreiras enfrentadas para aumentar a disponibilidade de doadores. Além disso, discute o impacto dessas práticas na sociedade e a necessidade de políticas que garantam uma distribuição justa e equitativa dos recursos médicos. Objetivo: Analisar as inovações tecnológicas e científicas no campo dos transplantes de órgãos. Metodologia: A pesquisa foi realizada através do acesso online às bases de dados Documentação em Ciências da Saúde da América Latina e do Caribe (LILACS), Centro de Informação em Ciências da Saúde da América Latina e do Caribe (Bireme), Scientific Electronic Library Online (SCIELO) e Biblioteca Virtual em Saúde (BVS), durante o mês de agosto de 2024.Resultados e Discussão: Os resultados deste estudo indicam avanços significativos na tecnologia de transplantes de órgãos, como o desenvolvimento de técnicas de preservação de órgãos, impressoras 3D para tecidos e órgãos artificiais, e a edição genética para compatibilidade aumentada. Essas inovações têm o potencial de aumentar a viabilidade dos órgãos transplantados e reduzir o tempo de espera na fila de transplante. No entanto, persistem desafios éticos consideráveis, incluindo a definição de critérios justos para a alocação de órgãos, a proteção dos direitos dos doadores e receptores, e a prevenção de práticas comerciais ou coerção na doação de órgãos. Além disso, o estudo destaca as desigualdades no acesso aos transplantes, com certos grupos sociais enfrentando maiores dificuldades para receber transplantes, seja por questões econômicas, geográficas ou de discriminação. Considerações Finais: Em conclusão, os avanços tecnológicos e científicos no campo dos transplantes de órgãos oferecem esperanças promissoras para melhorar a vida de pacientes que necessitam desses procedimentos. No entanto, é crucial abordar os desafios éticos e as desigualdades no acesso aos transplantes para garantir um sistema justo e eficaz. A combinação de inovação tecnológica, políticas públicas aprimoradas e maior conscientização da sociedade pode levar a um futuro onde a doação e a recepção de órgãos sejam mais equitativas e acessíveis para todos.

We present new distribution records of birds from Ecuador that have been evaluated by the Committee for Ecuadorian Records in Ornithology (CERO) between October 2019 and November 2021. We incorporate records of three new species in the national list: Hydrocoloeus minutus and Pterodroma externa from Galapagos, and Tachycineta leucorrhoa from mainland Ecuador. In addition, we include documented records of rare or infrequent species in mainland Ecuador, the Galapagos archipelago and the country’s territorial sea, which include seven species considered hypothetical, rare, and erratic throughout Ecuador: Netta erythrophthalma, Limnodromus scolopaceus, Pluvialis fulva, Chroicocephalus philadelphia, Spheniscus humboldti, Egretta rufescens, and Tyrannus dominicensis. We present the first documentation of two species in Ecuadorian territory, Numenius americanus and Macronectes halli from the mainland and territorial sea, respectively. In addition, we include 16 species considered hypothetical or accidental in Galapagos: Sarkidiornis sylvicola, Spatula clypeata, Phoenicopterus chilensis, Fulica americana, Limosa fedoa, Calidris canutus, Calidris subruficollis, Stercorarius parasiticus, Larus belcheri, Pelagodroma marina, Ardenna creatopus, Butorides virescens, Petrochelidon pyrrhonota, Catharus ustulatus, Quiscalus mexicanus, and Parkesia noveboracensis. We also include notable records for both the mainland and Galapagos of Spatula cyanoptera, Thalasseus sandvicensis, Neocrex erythrops, Sula leucogaster, Ardea herodias, Butorides virescens, Buteo swainsoni, Pipreola jucunda, Protonotaria citrea, Geothlypis philadelphia, and Cacicus latirostris. Finally, we validated distributional expansions of nine species: Dendrocygna autumnalis, Cairina moschata, Sarkidiornis sylvicola, Anas georgica, Aramus guarauna, Attagis gayi, Nycticorax nycticorax, Eudocimus ruber, and Paroaria gularis. Likewise, we evaluated 12 records that were not accepted based on erroneous identifications and 5 records whose acceptance was postponed because of insufficient descriptive support. Lastly, we discuss records of Aix galericulata and Spheniscus magellanicus, both correctly identified and well documented, but possibly originated by human intervention. After this review and update by CERO, the national list of birds of Ecuador totals 1722 species: 1673 confirmed documented with evidence and 49 species that still require solid voucher evidence.

Background: Increased Blood Pressure (BP) Variability (BPV) may represent an alteration in physiological homeostatic patterns, typical of late life, and has been associated with cerebrovascular disease, cognitive impairment and dementia, including Alzheimer’s disease. Accumulation of Brain beta amyloid (Aβ) and neurofilament light chain (NFL) release are typical biomarkers of neurodegeneration, whose assessment requires neuroimaging and cerebrospinal fluid (CFS) measurements, thus limiting their use in large-scale screening of the aging populations. Nevertheless, plasma Aβ42/40 ratio is associated with CSF Aβ42/40 ratio, similarly plasma NFL levels correlate with NFL in CFS. Furthermore, blood progranulin (PGL) is also considered a neurodegenerative biomarker, since deficiency exerts pleiotropic effects on the development, maintenance, stress response, and ageing of neural circuit. Objective: We aimed to explore the association of visit-to-visit BPV with blood concentrations of neurodegenerative biomarkers in a population of older adults. Methods: Participants were selected among community-dwelling participants aged ≥70 years from the Multidomain Alzheimer Preventive Trial (MAPT) Study. Plasma blood sample was collected 12 months after enrolment and BP was assessed every six months from enrollment (0, 6, 12 months). Systolic BPV (SBPV) and diastolic BPV (DBPV) were determined through several indicators considering BP change over time, the order of measurements and formulas independent of mean BP levels. Multivariable linear regressions were used to assess the association between visit-to-visit BPV and either PGL, Aβ42/40 and NFL. Results: The study population consisted of 470 participants (mean age 75.7 ± 4.5 years; female, 59.7%). Visit-to-visit BPV (all indicators, both systolic and diastolic) was not associated with blood levels of neurodegenerative biomarkers after adjustment for demographics, BMI, MAPT randomization group, education, baseline BP, antihypertensive drugs, diabetes mellitus, ischemic heart disease, atrial fibrillation, stroke: per 1-SD increase in systolic BPV (coefficient of variation %): Aβ42/40: adjusted β (SE) = -0.07 (0.04), p=0.13 and NFL: adjusted β (SE) = -0.06 (0.04), p=0.19. Conclusion: Neither systolic nor diastolic visit-to-visit BPV were associated with neurodegenerative blood biomarkers (Aβ42/40, NFL, and PGL) in a population of older adults. Further studies with longer-term assessment of BPV are needed.

La precipitación engelante consiste en la caída de hidrometeoros en estado líquido en una región en la que la temperatura en superficie es inferior a 0 °C. Al impactar sobre la superficie de los objetos, las gotas se congelan, pudiendo provocar incidencias potencialmente peligrosas en determinadas actividades como en el transporte terrestre, el suministro eléctrico, etc. En esta nota técnica se describen los principales mecanismos que dan lugar a este fenómeno. Así mismo se propone una guía de ayuda a su pronóstico, en la que se integran en tiempo real diferentes productos para asistir al predictor en la identificación de este tipo de precipitación, entre ellos un esquema de toma de decisiones. Un elemento clave y novedoso de esta guía son los campos de modelos numéricos que dan información sobre el tipo de precipitación. Se propone integrar esta guía en la cadena operativa de AEMET, así como revisar determinados procedimientos de observación. Para ello, se presenta un esquema práctico, que incorpora diferentes herramientas meteorológicas, orientado a mejorar la toma de decisiones de los predictores operativos en la evaluación del diagnóstico del riesgo de precipitación engelante. Ello contribuirá a tener un mejor conocimiento de fenómeno, aumentar los registros, validar los pronósticos y, en definitiva, poder facilitar predicciones de precipitación engelante a la sociedad. A pesar de ser poco frecuente, su adecuado pronóstico contribuirá, sin duda, a mejorar la seguridad de vidas y bienes.

Developing countries are undoubtedly confronting a major challenge with the COVID-19 outbreak, as their debilitated health care systems are facing the dichotomy of allocating resources on either semi-structured units of care or trying to amplify the already struck facilities. Moreover, many were already depleted of medical equipment prior to the outbreak. The rationale behind, was to describe the factors that conditioned an unfavorable environment to face the pandemic. On March 10th 2020, Honduras reported the first case of COVID 19. After 181 days, authorities confirmed 64,764 cases. The fatality rate at the beginning of the pandemic was alarmingly high fluctuating between 2% and as high as 17%. Moreover, frontline healthcare workers were among the first to die, reflecting a remarkably initial scarcity of personal protective equipment (Guan et al., 2019; SINAGER, s.f). Unsurprisingly, data surfacing amidst the outbreak is showing a variability in terms of fatality rates and severity factors across different regions. Large-scale testing has been identified as an effective strategy leading to early detection and consequently rapid isolation.

This research investigates the governance role of voluntary disclosures especially in reducing agency problems measured by the level of free cash flow (FCF). In addition, it also shows the moderating effect of family ownership and governance mechanisms on this relation. Our research was conducted on a sample of 138 listed French firms between 2009 and 2013. To avoid the endogeneity problem caused by the voluntary disclosure variable we used the 2SLS regression method. The results show, on the one hand, that transparency provided by voluntary disclosures reduces the level of FCF and by the way agency problems. But family owners tend to accumulate FCF. On the other hand, the governance role of voluntary disclosure turns to be ineffective in family firms. This suggests a high risk of expropriation of minority shareholders by family ones. In addition, we demonstrate that governance mechanisms, especially board independence, gender diversity and audit committee independence, contribute to the strengthening of the governance role of voluntary disclosure.

El Proyecto Yuri es una actividad divulgativa y científica que surge de la colaboración entre el Departamento de Física y Química del IES Valle del Saja y la Delegación Territorial de AEMET en Cantabria, Textil Santanderina, Meteológica y la Consejería de Educación, Cultura y Deporte del Gobierno de Cantabria. La presente memoria recoge el Proyecto Yuri. Se trata de un documento comprensivo, que incluye todos los extremos de la experiencia: sus objetivos y principios, su planificación, su desarrollo, sus resultados y sus conclusiones. También todos aquellos cálculos y tareas que han sido necesarios para llevarla a cabo.

[pt] A análise de fluxo de água sob condição transiente não saturada requer o conhecimento das propriedades hidráulicas do solo. Essas relações constitutivas, denominadas curva característica e função de condutividade hidráulica, são descritas através de modelos empíricos que geralmente possuem vários parâmetros que devem ser calibrados com relação a dados coletados. Muitos dos parâmetros nos modelos constitutivos não podem ser medidos diretamente em campo ou laboratório, mas somente podem ser inferidos de forma significativa a partir de dados coletados e da modelagem inversa. Para obter os parâmetros do solo com a análise inversa, um algoritmo de otimização de busca local ou global pode ser aplicado. As otimizações globais são mais capazes de encontrar parâmetros ótimos, no entanto, a solução direta, por meio da modelagem numérica é computacionalmente custosa. Portanto, soluções analíticas (modelo substituto) podem superar essa falha acelerando o processo de otimização. Nesta dissertação, apresentamos a Regressão Polinomial Evolucionária (EPR) como uma ferramenta para desenvolver modelos substitutos do fluxo não saturado. Um rico conjunto de dados de parâmetros hidráulicos do solo é usado para calibrar o nosso modelo, e dados do mundo real são utilizados para validar nossa metodologia. Nossos resultados demonstram que o modelo da EPR prevê com precisão os dados de carga de pressão. As simulações do modelo se mostram concordantes com as simulações do programa Hydrus.

The celebration of a Jubilee Year in perpetuity is a privilege which the town of Caravaca de la Cruz shares with just a handful of world cities, including Rome, Jerusalem and Santiago de Compostela. On the occasion of its Jubilee Year 2017, Spain's State Meteorology Agency (AEMET) is updating an earlier brochure, published in 2003, on the climate of this town in Murcia. Compiled by AEMET's Murcia Regional Office, this brochure (edited in Spanish and English) seeks to give travellers and pilgrims basic information about weather and climate conditions which they may find useful when planning their visit