Intraoperative Extracorporeal Irradiation for the Treatment of the Meningioma-Infiltrated Calvarium.

Objectives Complete removal of infiltrated bone is required to achieve a Simpson Grade 1 meningioma resection. Reconstruction of the resulting bone defect is typically achieved with a nonnative implant that can result in poor cosmesis, foreign body reaction, or infection. Extracorporeal irradiation and reimplantation of tumorous bone has been used for limb-sparing surgery with excellent results, but this treatment option is not routinely considered in meningioma surgery. We present a case of anterior fossa meningioma with tumorous overlying calvarium that was successfully managed with intraoperative extracorporeal irradiation and reimplantation. Design, Setting, and Participant A 37-year-old woman with persistent chronic headaches was found to have an anterior skull base meningioma with extension into the forehead frontal bone. Concurrently with mass resection, the bone flap was irradiated intraoperatively with 120 Gy. After resection of the tumor, the bone flap was replaced in its native position. Main Outcome Measures and Results Twenty-nine months postoperatively, the patient had an excellent cosmetic outcome with no radiographic evidence of tumor recurrence or significant bone flap resorption. Conclusion Intraoperative extracorporeal irradiation of tumorous calvaria during meningioma surgery is an effective, logistically feasible treatment option to achieve local tumor control and excellent cosmetic outcome

Passive strategies for energy optimisation of social housing in the Mediterranean climate

Los objetivos prioritarios del Horizonte 2020 han llevado a la actualización del Documento Básico de Ahorro de la Energía del CTE en 2013, introduciendo un nuevo modelo en las exigencias, basado en parámetros tecnológicos y constructivos, asociado a una mayor valoración de las condiciones arquitectónicas del edificio. Este trabajo pretende analizar la repercusión del nuevo marco normativo en la vivienda social del área mediterránea, en la zona climática B4. Se plantea el análisis energético en un modelo base de bloque lineal entre medianeras al que se incorporan individualmente, distintas estrategias pasivas asociadas a la compacidad, materialidad de la envolvente, control solar, acumulación solar y ventilación, analizando la mejora de la demanda de energía, la calificación energética y el confort interior. La consideración de la orientación, junto con la combinación de la mejora de las prestaciones energéticas de la envolvente térmica, de la tasa de ventilación y de la adecuada protección solar constituyen las principales acciones de mejora energética que permiten conseguir importantes reducciones de la demanda energética, de las emisiones de CO2 y mejora del confort interior.The main goals of Horizon 2020 have led to the updating of the Basic Document on Energy Saving of the Technical Building Code in 2013. The demands of the new model, based on technological and construction parameters, are associated with a more extensive assessment of the architectural conditions of buildings. This study aims to analyze the repercussion of the new regulations on Mediterranean social housing in climate zone B4. It proposes energy analysis on a basic model of a single linear block, adding different individual passive strategies relating to compactness, envelope material, solar control, solar accumulation and ventilation, analyzing the improvement in energy demand, energy rating and indoor comfort. The main energy improvement actions used take into account orientation as well as the combined improvement in energy performance of the thermal envelope, ventilation rate and suitable solar protection. These lead to major reductions in energy demand and CO2 emissions while improving indoor comfort conditions

COPD and cardiovascular disease

COPD is one of the major public health problems in people aged 40 years or above. It is currently the 4th leading cause of death in the world and projected to be the 3rd leading cause of death by 2020. COPD and cardiac comorbidities are frequently associated. They share common risk factors, pathophysiological processes, signs and symptoms, and act synergistically as negative prognostic factors. Cardiac disease includes a broad spectrum of entities with distinct pathophysiology, treatment and prognosis. From an epidemiological point of view, patients with COPD are particularly vulnerable to cardiac disease. Indeed, mortality due to cardiac disease in patients with moderate COPD is higher than mortality related to respiratory failure. Guidelines reinforce that the control of comorbidities in COPD has a clear benefit over the potential risk associated with the majority of the drugs utilized. On the other hand, the true survival benefits of aggressive treatment of cardiac disease and COPD in patients with both conditions have still not been clarified. Given their relevance in terms of prevalence and prognosis, we will focus in this paper on the management of COPD patients with ischemic coronary disease, heart failure and dysrhythmia.Novartis Portugal Novartisinfo:eu-repo/semantics/publishedVersio

Southern European grazing lands: Production, environmental and landscape management aspects

Grazing lands and their management in livestock systems are a matter of special importance in the search for sustainability. Socio-economic and ecological objectives should be considered jointly in considering livestock production. In addition to the general issues of biodiversity and habitat preservation, the challenges for their management vary according to the regional conditions. In Southern European environments, where the past changes in livestock farming have led to a general decrease in their use, the questions under study are how to find ways to meet the threats to landscape amenity, biodiversity, the sustainability of local animal feeding resources and the rural population. Grazing lands and their management is also an important target of EU agri-environmental policy. The multifunctional use of this land, which is currently sought, reinforces the need for animal scientists to consider the use and management of grazing lands in reference not only to the techno-economical efficiency of animal feeding systems but also in reference to the long-term (e.g. biodiversity change) and at larger spatial scales (for example the landscape and watershed). An overview of the current challenges attached to grazing lands and their management in livestock farming systems in South European environments, an understanding of the ways to jointly meet production objectives and the realisation of sociological and ecological functions is presented

The view on teachers and students using virtual classrooms methodology b-learming

El presente estudio se engloba dentro de un proyecto de innovación llevado a cabo en el curso 2010-2011 en la Universidad de La Laguna. Se desarrolló en las distintas asignaturas del campo o ámbito de la "Tecnología Educativa" y que se imparten actualmente en distintas titulaciones de la Facultad de Educación. El objetivo que se pretende es indagar sobre la opinión y valoración que hace el alumnado y el profesorado sobre el uso de las aulas virtuales como herramienta de apoyo en la modalidad semipresencial o “blended-learning”. Así como explorar si el diseño del aula virtual y el uso de determinadas herramientas y actividades de aprendizaje en el entorno de las aulas virtuales está moldeada por el perfil de la titulación, de la asignatura o de la práctica docente de cada profesor La metodología se estructuró en dos líneas atendiendo a la naturaleza de los sujetos participantes: profesorado y alumnado. En el caso del alumnado se elaboraron dos cuestionarios de opinión on line. Y con respecto al profesorado se elaboró una matriz en la que el docente tenía que describir tanto la metodología utilizada como las herramientas y actividades desarrolladas. De los resultados se desprende que en el diseño del aula virtual interviene fundamentalmente la propia estructuración de las asignaturas en créditos teóricos y prácticos. Y en cuanto a la selección de las herramientas digitales y actividades de aprendizaje parece que de alguna manera está influyendo las teorías y prácticas docentes sobre cómo debe desarrollar y adquirir el alumnado determinadas habilidades y conocimientos.This study is part of an innovation project conducted in 2010-2011 at the University of La Laguna. It was developed in the different subjects of the field or area of "Educational Technology" and currently taught in different degrees of the Faculty of Education. The objective sought is to inquire into the opinion and judgment that makes the students and teachers on the use of virtual classrooms as a support tool in a blended- learning or blen. And explore whether the design of the virtual classroom and the use of certain tools and learning activities in the virtual classroom environment is shaped by the degree profile of the subject or of the teaching practice of each teacher. The methodology is structured in two lines based on the nature of the subjects involved: teachers and students. In the case of students prepared two opinion questionnaires online. And with respect to teachers is developed a matrix in which the teacher had to describe both the methodology and the tools and activities. The results show that in the virtual classroom design itself primarily involved structuring of credit courses in theory and practice. And as for the selection of digital tools and learning activities seems that somehow is influencing educational theories and practices on how to develop and acquire certain skills and knowledge students

Rainfall-triggered landslides in the Lisbon region over 2006 and relationships with the North Atlantic Oscillation

International audienceLandslides occurred in the Lisbon area during the last 50 years were almost always induced by rainfall and have been used to establish rainfall thresholds for regional landslide activity. In 2006, three new rainfall-triggered landslide events occurred in the study area, namely on the 20 March, the 25?27 October, and the 28 November. Landslide events occurred in March and October 2006 include shallow translational slides and few debris flows, and the corresponding absolute antecedent rainfall was found to be above the threshold for durations ranging from 4 to 10 days. These events also fit the combined threshold of daily precipitation and 5 days calibrated antecedent rainfall values. Likewise the landslide event that took place in late November 2006 includes some slope movements with deeper slip surfaces, when compared with landslides dating from March and October. Moreover, the corresponding absolute antecedent rainfall was also found to be above the 40-day period rainfall threshold. Here we characterize in detail the short and long-term atmospheric circulation conditions that were responsible for the intense rainfall episodes that have triggered the corresponding landslide events. It is shown that the three rainfall episodes correspond to considerably different synoptic atmospheric patterns, with the March episode being associated to an intense cut-off low system while the October and November episodes appear to be related to more typical Atlantic low pressure systems (and associated fronts) travelling eastwards. Finally, we analyse the role played by the North Atlantic Oscillation (NAO) during those months marked by landslide activity. It is shown that the NAO index was consistently negative (usually associated with above average precipitation) for the months prior to the landslide events, i.e. between October 2005 and March 2006, and again between August and October 2006

Cloud-to-ground lightning in Portugal: patterns and dynamical forcing

An analysis of the cloud-to-ground discharges (CGD) over Portugal is carried out using data collected by a network of sensors maintained by the Portuguese Meteorological Institute for 2003–2009 (7 yr). Only cloud-to-ground flashes are considered and negative polarity CGD are largely dominant. The total number of discharges reveals a considerable interannual variability and a large irregularity in their distribution throughout the year. However, it is shown that a large number of discharges occur in the May–September period (71%), with a bimodal distribution that peaks in May and September, with most of the lightning activity recorded in the afternoon (from 16:00 to 18:00 UTC). In spring and autumn the lightning activity tends to be scattered throughout the country, whereas in summer it tends to be more concentrated over northeastern Portugal. Winter generally presents low lightning activity. Furthermore, two significant couplings between the monthly number of days with discharges and the large-scale atmospheric circulation are isolated: a regional forcing, predominantly in summer, and a remote forcing. In fact, the identification of daily lightning regimes revealed three important atmospheric conditions for triggering lightning activity: regional cut-off lows, cold troughs induced by remote low pressure systems and summertime regional low pressures at low-tropospheric levels combined with a mid-tropospheric cold trough

Earthworm management in tropical agroecosystems

A worldwide survey of earthworms in the humid tropics revealed that 51 exotics and 151 native species are commonly found in tropical agroecosystems. On the basis of frequency records and climatic and edaphic ranges, 21 exotics and 27 native species have been selected as possible candidates for manipulation. A multivariate analysis separated these species into four groups : (i) native species with wide edaphic and medium climatic tolerances ; (ii) exotic species with wide climatic and edaphic tolerances ; (iii) native and exotic species with narrow edaphic tolerances but more resistant to climatic variations ; and (iv) native species with limited tolerance for climatic and edaphic variations. Regarding management, species of group (ii) seem to be the most adaptable, both at regional and local levels (multipurpose species) ; group (i) can be managed for specific climatic conditions whereas group (iii) should be managed in specific soil environments. Species of group (iv) may only be managed at a very local scale. (Résumé d'auteur