Case Study: The Surgical Management of Angiokeratoma Resulting from Radiotherapy for Penile Cancer

Angiokeratoma is a rare, benign skin lesion and a recognised complication of radiation therapy. Here we describe a case of extensive angiokeratoma of the groin and external genitalia resulting from external beam radiation to that area in a patient with penile carcinoma. Furthermore, we outline the management of this problem by surgical reconstruction

Total phallic reconstruction after penile amputation for donkey bite: Case report and review of the literature

There are very few reported cases of traumatic amputation of the male genitalia due to animal bite. The management involves thorough washout of the wounds, debridement, antibiotic prophylaxis, tetanus and rabies immunization followed by immediate reconstruction or primary wound closure with delayed reconstruction, when immediate reconstruction is not feasible. When immediate reconstruction is not feasible, long-term good functional and cosmetic results are still possible in the majority of cases by performing total phallic reconstruction. In particular, it is now possible to fashion a cosmetically acceptable sensate phallus with incorporated neourethra, to allow the patient to void while standing and to ejaculate, and with enough bulk to allow the insertion of a penile prosthesis to guarantee the rigidity necessary to engage in penetrative sexual intercourse

Paraganglioma of the Spermatic Cord: Case Report and Review of the Literature

Paragangliomas rarely involve the genitourinary tract. We present a case of a paraganglioma arising from the spermatic cord and review the literature on the topic

A Bundled Approach to Integrative Care for Peripherally Inserted Extracorporeal Membrane Oxygenation Cannula Insertion Site

Purpose and Rationale: This project is designed to translate the collective knowledge and evidence-based interventions surrounding the reduction of central line-associated bloodstream infections (CLABSIs) and use these evidence-based practices to create an extracorporeal membrane oxygenation (ECMO) cannula site bundle. The desired outcome of creating an ECMO cannula-site bundle is increased cannula site integrity, decreased frequency of dressing changes, and minimized risk of cannula-site infections. Synthesis of Evidence: Currently, there are no clinical practice guidelines for ECMO cannula site care to guide bedside practice. The ELSO Infectious Disease Taskforce recommends implementation of a CLABSI bundle for ECMO site care, but many of the products used for CLABSI prevention are not intended for large ECMO cannula sites. Practice Change and Implementation Strategies: The DNP students will create an ECMO cannula site bundle inspired by the CLABSI evidence available, as there is currently no ECMO specific products available. Evaluation: To evaluate project success, the DNP students will investigate the number of dressing changes required for ECMO insertion sites due to saturated and/or not intact dressings comparing pre and post implementation cohorts. Conclusion and Implications for Practice: This project would serve as a mean to standardize approaches to dressing the ECMO cannula insertion site, and potential serve as a clinical practice guideline to cannula site care

Paisajes post ferro-portuarios en Rosario como espacios de oportunidad

The construction of the landscape over time is a continuous and persistent work of the wisdom of nature as much as of constant human anthropization, multiple factors have marked and continue to generate scars and mark deep traces on it. La construcción del paisaje en el tiempo es una obra continua y persistente de la sabiduría de la naturaleza tanto como de la constante antropización humana, múltiples factores han marcado y continúan generando cicatrices y marcan huellas profundas sobre él.A construção da paisagem ao longo do tempo é um trabalho contínuo e persistente tanto da sabedoria da natureza quanto da constante antropização humana, múltiplos fatores marcaram e continuam a gerar cicatrizes e a marcar traços profundos nela

Eficiência de fungicidas no controle de doenças foliares na cultura do trigo

O trigo é o principal cereal produzido durante os meses de outono-inverno, devido as suas propriedades funcionais, tecnológicas e nutricionais. Levando em consideração seu elevado valor econômico, é fundamental que, durante o manejo para a cultura do trigo, sejam controladas as doenças foliares, que são as principais causadoras da diminuição do rendimento de grãos. Tendo em vista o exposto, objetivou-se com este trabalho avaliar diferentes fungicidas, buscando expressar as melhores alternativas para o controle dos diferentes patógenos que se desenvolvem na cultura do trigo. O experimento foi conduzido na Área Experimental da empresa PesquisAgro no município de Soledade/RS, durante a safra de 2022. Foi utilizada a cultivar de trigo TBIO Sinuelo, em delineamento de blocos casualizados (DBC) com 4 blocos e 11 tratamentos. O tratamento T1 consistiu na testemunha, o qual não recebeu nenhuma aplicação de fungicida; T2: Propiconazol; T3: Pidiflumetofem; T4: Fenpropimorfe; T5: Difenoconazol + Ciproconazol; T6: Epoxiconazol + Cresoxim-Metílico; T7: Ciproconazol + Trifloxistrobina; T8: Metconazol + Piraclostrobina; T9: Ciproconazol + Difenoconazol + Benzovindiflupir; T10: Propiconazol + Pidiflumetofeno + Azoxistrobina; e T11: Protioconazol + Bixafem + Trifloxistrobina. Avaliaram-se as severidades de ferrugem da folha, oídio e mancha amarela em trigo, bem como peso hectolitro, peso de mil grãos e produtividade. O controle com o uso de fungicida proporcionou incremento significativo no rendimento de grãos, no peso hectolitro e no peso de mil grãos, sendo que para o controle da ferrugem da folha os tratamentos Epoxiconazol (Tr) + Cresoxim-Metíl (Es), Ciproconazol (Tr) + Trifloxistrobina (Es), Meticonazol (Tr) + Piraclostrobina (Es), Ciproconazol (Tr) + Difenoconazol (Tr) + Benzovindiflupir (Ca), Propiconazol (Tr) + Pidiflumetofeno (Ca) + Azoxistrobina (Es) e Protioconazol (Tr) + Bixafem (Ca) + Trifloxistrobina (Es) proporcionaram os melhores resultados. Os tratamentos Pidiflumetofem (Ca), Epoxiconazol (Tr) + Cresoxim-Metíl (Es), Ciproconazol (Tr) + Difenoconazol (Tr) + Benzovindiflupir (Ca), Propiconazol (Tr) + Pidiflumetofeno (Ca) + Azoxistrobina (Es) e Protioconazol (Tr) + Bixafem (Ca) + Trifloxistrobina (Es) se destacaram com os melhores níveis de controle para mancha amarela. Para o controle de oídio os tratamentos que apresentaram os melhores percentuais de controle são Difenoconazol (Tr) + Ciproconazol (Tr), Ciproconazol (Tr) + Trifloxistrobina (Es) e Propiconazol (Tr) + Pidiflumetofeno (Ca) + Azoxistrobina (Es).Wheat is the main cereal produced during the autumn-winter months, due to its functional, technological and nutritional properties. Taking into account its high economic value, it is fundamental that, during management for the wheat crop, foliar diseases, which are the main causes of the decrease in grain yield, are controlled. In view of the above, the objective of this work was to evaluate different fungicides, seeking to express the best alternatives for the control of the different pathogens that develop in the wheat crop. The experiment was carried out in the Experimental Area of the company PesquisAgro in the municipality of Soledade/RS, during the 2022 harvest. The wheat cultivar TBIO Sinuelo was used, in a randomized block design (DBC) with 4 blocks and 11 treatments. Treatment T1 consisted of the control, which received no fungicide application; T2: Propiconazole; T3: Pidiflumetofem; T4: Fenpropimorph; T5: Difenoconazole + Cyproconazole; T6: Epoxiconazole + Kresoxim-Methyl; T7: Cyproconazole + Trifloxystrobin; T8: Metconazole + Pyraclostrobin; T9: Cyproconazole + Difenoconazole + Benzovindiflupyr; T10: Propiconazol + Pidiflumethofen + Azoxystrobin; and T11: Prothioconazole + Bixafem + Trifloxystrobin. The severity of leaf rust, powdery mildew and yellow spot in wheat, as well as hectoliter weight, thousand-grain weight and yield were evaluated. The control with the use of fungicide provided a significant increase in grain yield, hectoliter weight and thousand-grain weight, and for the control of leaf rust the treatments Epoxiconazole (Tr) + Cresoxim-Methyl (Es), Cyproconazole ( Tr) + Trifloxystrobin (Es), Methiconazole (Tr) + Pyraclostrobin (Es), Cyproconazole (Tr) + Difenoconazole (Tr) + Benzovindiflupyr (Ca), Propiconazole (Tr) + Pidiflumethophene (Ca) + Azoxystrobin (Es) and Prothioconazole ( Tr) + Bixafem (Ca) + Trifloxystrobin (Es) provided the best results. The treatments Pidiflumetofen (Ca), Epoxiconazole (Tr) + Cresoxim-Methyl (Es), Cyproconazole (Tr) + Difenoconazole (Tr) + Benzovindiflupir (Ca), Propiconazole (Tr) + Pidiflumethophene (Ca) + Azoxystrobin (Es) and Prothioconazole (Tr) + Bixafem (Ca) + Trifloxystrobin (Es) stood out with the best control levels for yellow spot. For powdery mildew control, the treatments that presented the best control percentages are Difenoconazole (Tr) + Cyproconazole (Tr), Cyproconazole (Tr) + Trifloxystrobin (Es) and Propiconazole (Tr) + Pidiflumethofen (Ca) + Azoxystrobin (Es)

Ativação de um braço robótico através de sinais mioelétricos e redes neurais artificiais como protótipo para um estudo preliminar de sensibilidade háptica

As próteses de membro superior representam uma alternativa para melhorar a qualidade de vida de pessoas que passaram pelo processo de amputação. Apesar dos benefícios potencialmente propostos, a taxa de rejeição desse tipo de tecnologia é alta. Dentre os motivos, destaca-se a ausência de uma resposta referente à sensibilidade háptica, relacionada à sensação do toque e à propriocepção, o que torna o acionamento da prótese estressante e os períodos de treinamento prolongados. Com o objetivo de avaliar o impacto do retorno háptico no acionamento de próteses mioelétricas de membro superior, foi implementada a ativação de um braço robótico utilizando sinais mioelétricos e um classificador baseado em Redes Neurais Artificiais (RNA), capaz de distinguir entre movimentos e intensidades a partir de características dos sinais de Eletromigrafia de Superfície (sEMG). O sistema é realimentado, fornecendo uma resposta vibrotátil referente à intensidade de movimento realizada pelo dispositivo. Foram realizados testes com voluntários utilizando apenas resposta visual, apenas resposta háptica e as duas respostas em conjunto. Para os testes com resposta apenas visual, a taxa de estabilidade da ativação foi de 81.1% para a intensidade Fraca, 55.6% para a intensidade Média e 78.4% para a intensidade Forte. Utilizando apenas a resposta háptica, as taxas de estabilidade foram 69.3%, 60.0% e 77.9%, respectivamente. Por fim, as taxas de estabilidade utilizando os dois tipos de reposta foi 81.7%, 65.5% e 84.2%, demonstrando preliminarmente que a performance dos usuários foi superior nessa configuração. As respostas dos questionátios preenchidos ao final dos testes endossaram os resultados obtidos. Porém, é importante notar que os estudos na área devem ser continuados para sua correspondente validação.Upper limb prostheses represent an alternative to improve the life quality of people who have undergone an amputation process. Despite the potential benefits proposed, the rejection rate of this type of technology is high. Among the reasons, the absence of a response regarding haptic sensitivity, related to touch sensation and proprioception, stands out, which makes the activation of the prosthesis stressful and the training periods prolonged. With the objective of evaluating the impact of the haptic feedback on the activation of myeloelectric upper limb prostheses, the activation of a myoelectric robotic arm was implemented using a classifier based on Artificial Neural Networks (ANN), capable of distinguishing between movements and intensities using characteristics of Surface Electrographic signs (sEMG). The system loop is closed, providing a vibratory response relative to the movement intensity performed by the device. Tests with volunteers were performed using only visual response, only haptic response and the two responses together. For the visual-only response tests, the activation stability rate was 81, 1% for the Weak intensity, 55, 6% for the Medium intensity, and 78.4% for the intensity Strong. Using only the haptic response, stability rates were 69, 3%, 60, 0% and 77, 9%, respectively. Finally, stability rates using the two types of response were 81, 7%, 65, 5% and 84, 2%, showing preliminarily that the users performance was superior in this configuration. The questionnaire completed at the end of the tests corroborates the preliminary statement. However, it is important to note that continued studies should be carried out for their corresponding validation

A review of macroeconomic modelling tools for analysing industrial transformation

This research presents a thorough evaluation of macroeconomic modelling tools in the context of analysing industrial transformation. It emphasizes the need to link macroeconomic models with energy system models to accurately depict industrial transformation. The study begins with a broad survey of macroeconomic modelling tools. A detailed database of 61 tools is then compiled, providing a critical analysis of the tools' structures and features. From this broad spectrum, the focus is narrowed to Computable General Equilibrium (CGE) models. The study develops a multi-criteria analysis framework, applied specifically to four CGE modelling tools, which encompasses 19 criteria categorized under four main pillars: Industrial/Sectoral representation, Technological change, Employment, and Environment. This framework critically evaluates these tools' suitability in analysing industrial transformation, highlighting the diversity of their capabilities and limitations. Although the GEM-E3 model demonstrates a high level of alignment with the framework's criteria, none of the four tools achieves a full score in any category, indicating potential areas for improvement. The broader analysis of the database's tools reveals issues such as limited accessibility, inadequate representation of social aspects, and insufficient geographical coverage. Additionally, the study notes a general lack of transparent information concerning the full features of macroeconomic modelling tools in public literature. Concluding with recommendations for further research, the study underscores the complexities in macroeconomic modelling and the need for comprehensive tools that effectively address the multifaceted aspects of industrial transformation. Such advancements will assist in making informed decisions towards a transformation that is both environmentally and economically sustainable

Marcas no Second Life : um breve estudo de como a Adidas se relaciona com o consumidor no metaverso

Este trabalho tem por objetivo apresentar um estudo de como as marcas se comportam e se relacionam com o consumidor utilizando novos suportes de media como os universos virtuais. Para tanto, realizou-se um estudo de caso da marca de artigos esportivos Adidas e sua loja virtual dentro do Second Life. O estudo foi baseado em uma pesquisa exploratória por meio de entrevistas abertas viabilizadas por questionário aplicado aos vários freqüentadores da loja. A partir do conjunto de dados analisados, foi possível concluir como a Adidas se posicionou nesse meio e qual sua relação com o consumidor do metaverso