Feasibility and Short-Term Outcomes in Liver-First Approach: A Spanish Snapshot Study (the RENACI Project).

(1) Background: The liver-first approach may be indicated for colorectal cancer patients with synchronous liver metastases to whom preoperative chemotherapy opens a potential window in which liver resection may be undertaken. This study aims to present the data of feasibility and short-term outcomes in the liver-first approach. (2) Methods: A prospective observational study was performed in Spanish hospitals that had a medium/high-volume of HPB surgeries from 1 June 2019 to 31 August 2020. (3) Results: In total, 40 hospitals participated, including a total of 2288 hepatectomies, 1350 for colorectal liver metastases, 150 of them (11.1%) using the liver-first approach, 63 (42.0%) in hospitals performing <50 hepatectomies/year. The proportion of patients as ASA III was significantly higher in centers performing ≥50 hepatectomies/year (difference: 18.9%; p = 0.0213). In 81.1% of the cases, the primary tumor was in the rectum or sigmoid colon. In total, 40% of the patients underwent major hepatectomies. The surgical approach was open surgery in 87 (58.0%) patients. Resection margins were R0 in 78.5% of the patients. In total, 40 (26.7%) patients had complications after the liver resection and 36 (27.3%) had complications after the primary resection. One-hundred and thirty-two (89.3%) patients completed the therapeutic regime. (4) Conclusions: There were no differences in the surgical outcomes between the centers performing <50 and ≥50 hepatectomies/year. Further analysis evaluating factors associated with clinical outcomes and determining the best candidates for this approach will be subsequently conducted.

PEComa pancreático ¿una neoplasia no tan infrecuente? Revisión sistemática y actualización clínico-terapéutica / Pancreatic PEComa, a not so uncommon neoplasm? Systematic review and therapeutic update

Los PEComas pancreáticos son neoplasias con potencial maligno extremadamente raras, que afectan mayoritariamente a mujeres de mediana edad y que se caracterizan por presentar marcadores melanocíticos y miogénicos en el análisis inmunohistoquímico. No existen síntomas ni pruebas de imagen patognomónicas. El diagnóstico se establece con el análisis de la pieza quirúrgica o de la PAAF obtenida con ecoendoscopia preoperatoria. El tratamiento más habitual consiste en la exéresis radical, adecuando la intervención a la localización del tumor. Hasta la fecha se han descrito 34 casos, no obstante, más del 80% de los mismos han sido reportados en la última década, lo que sugiere que es una patología más frecuente de lo esperado. Se reporta un nuevo caso de PEComa pancreático y se realiza una revisión sistemática de la literatura de acuerdo con las guías PRISMA con el objetivo de difundir su existencia, profundizar en su conocimiento y actualizar su manejo (AU)

Pancreatic PEComas are extremely rare neoplasms with malignant potential, which mostly affect middle-aged women and are characterized by presenting melanocytic and myogenic markers in immunohistochemical analysis. There are no symptoms or pathognomonic imaging tests, so the diagnosis is established with the analysis of the surgical specimen or the FNA obtained with preoperative endoscopic ultrasound. The mean treatment consists on radical excision, adapting the intervention to the location of the tumor. To date, 34 cases have been described; however, more than 80% of them have been reported in the last decade, which suggests that it is a more frequent pathology than expected. A new case of pancreatic PEComa is reported and a systematic review of the literature is carried out according to the PRISMA guidelines with the aim of divulge this pathology, deepening its knowledge and updating its management (AU)

Pancreatic PEComa, a not so uncommon neoplasm? Systematic review and therapeutic update. / PEComa pancreático ¿una neoplasia no tan infrecuente? Revisión sistemática y actualización clínico-terapéutica.

Pancreatic PEComas are extremely rare neoplasms with malignant potential, which mostly affect middle-aged women and are characterized by presenting melanocytic and myogenic markers in immunohistochemical analysis. There are no symptoms or pathognomonic imaging tests, so the diagnosis is established with the analysis of the surgical specimen or the FNA obtained with preoperative endoscopic ultrasound. The mean treatment consists on radical excision, adapting the intervention to the location of the tumor. To date, 34 cases have been described; however, more than 80% of them have been reported in the last decade, which suggests that it is a more frequent pathology than expected. A new case of pancreatic PEComa is reported and a systematic review of the literature is carried out according to the PRISMA guidelines with the aim of divulge this pathology, deepening its knowledge and updating its management.

Office-Based Intraosseous Infiltrations of PRGF as an Effective Treatment for Knee Osteoarthritis: A Retrospective Observational Clinical Study.

The aim of this study was to explore and assess office-based ultrasound-guided intraosseous and intra-articular infiltrations of plasma rich in growth factors (PRGF) in patients with moderate and severe knee osteoarthritis (KOA). Seventy-nine patients (30 women and 49 men) with grade 3-4 KOA according to the Kellgren-Lawrence classification participated in the study. All patients were treated with a minimally invasive technique using local anesthesia WALANT (wide-awake local anesthesia no tourniquet) in the ambulatory setting. A PRGF intra-articular infiltration and two intraosseous infiltrations in the tibial plateau and femoral condyle were performed weekly for a total of three sessions. The evaluation of the results was carried out using knee injury and osteoarthritis outcome score (KOOS) at baseline and post-treatment. After a follow-up period of 11 months (median) [interquartile range, 7-14], all the KOOS domains showed statistically significant improvement (p < 0.001). Moreover, 88% of the patients showed a pain reduction of at least 10 points (minimally clinically important improvement) from pre- to post-treatment. Our retrospective study using the in-office procedure of ultrasound-guided combination of intra-articular and intraosseous infiltrations of PRGF is a safe and efficacious approach for the treatment of grade 3-4 knee osteoarthritis.

Effect of Ultrasound-Guided Percutaneous Neuromodulation of Sciatic Nerve on Hip Muscle Strength in Chronic Low Back Pain Sufferers: A Pilot Study.

Background: Limited hip internal rotation range of motion (IR-ROM) and hip abductor weakness are recognized in low back pain (LBP) sufferers. The main aim was to investigate the effect of a ultrasound (US)-guided percutaneous neuromodulation (PNM) technique on hip strength in people with LBP. A second purpose was to discover whether the location along the sciatic nerve, where percutaneous neuromodulation was applied, could influence the change of strength response in these patients. Methods: Sixty LBP sufferers were recruited and divided randomly into three groups. All participants received an isolated percutaneous electrical stimulation at one of three different locations of the sciatic nerve pathway (proximal, middle, and distal), depending on the assigned group. Pain intensity, hip passive IR-ROM, hip muscle strength, and the Oswestry disability index (ODI) were analyzed. All variables were calculated before the intervention and one week after the intervention. Results: All interventions significantly decreased pain intensity and improved the IR-ROMs, strength, and functionality after one week (p = 0.001). However, between-group (treatment x time) differences were reported for flexion strength in the non-intervention limb (p = 0.029) and ODI (p = 0.021), although the effect size was small (Eta2 = 0.1) in both cases. Conclusions: The application of an isolated intervention of the US-guided PNM technique may be a useful therapeutic tool to increase the hip muscle strength in patients with chronic LBP.

Materials to Be Used in Future Magnetic Confinement Fusion Reactors: A Review.

This paper presents the roadmap of the main materials to be used for ITER and DEMO class reactors as well as an overview of the most relevant innovations that have been made in recent years. The main idea in the EUROfusion development program for the FW (first wall) is the use of low-activation materials. Thus far, several candidates have been proposed: RAFM and ODS steels, SiC/SiC ceramic composites and vanadium alloys. In turn, the most relevant diagnostic systems and PFMs (plasma-facing materials) will be described, all accompanied by the corresponding justification for the selection of the materials as well as their main characteristics. Finally, an outlook will be provided on future material development activities to be carried out during the next phase of the conceptual design for DEMO, which is highly dependent on the success of the IFMIF-DONES facility, whose design, operation and objectives are also described in this paper.

Cross-validation of four different survey methods used to estimate illicit cigarette consumption in Brazil.

OBJECTIVE: To cross-validate estimates of the size of the illicit cigarette trade based on the results of four different survey methods. METHODS: In 2018/2019, four non-industry-funded, large-scale studies were conducted in selected Brazilian cities: packs discarded in household garbage/PDG (1 city), packs littered in the streets/PLS (5 cities), a phone survey of tobacco users' purchase behaviors/VIGITEL (5 cities), and a face-to-face household survey of tobacco users' purchase behaviors/FTF-household (2 cities). The proportions of illicit cigarettes consumed were based on the price paid by smokers in their last purchase (VIGITEL or FTF-household) and/or direct observation of brand names and health warnings (PDG, PLS or FTF-household). RESULTS: Based on PLS, the share of packs that avoided taxation ranged from 30.4% (95% CI 25.6% to 35.7%) in Rio de Janeiro to 70.1% (95% CI 64.6% to 75.0%) in Campo Grande; and PDG conducted in Rio de Janeiro found an even lower proportion point estimate of illicit cigarette use (26.8%, 95% CI 25.1% to 28.6%). In FTF-household, the share of illicit cigarette consumption based on the self-reported price ranged from 29.1% (95% CI 22.4% to 35.7%) in Rio de Janeiro to 37.5% (95% CI 31.2% to 43.7%) in São Paulo, while estimates based on pack observation ranged from 29.9% (95% CI 23.3% to 36.5%) in Rio de Janeiro to 40.7% (95% CI 34.3% to 47.0%) in São Paulo. For all cities, VIGITEL presented the lowest levels of illicit consumption, and most illicit brands were produced in Paraguay. CONCLUSIONS: Small differences in the estimated levels of illicit trade across methods were found, except for the phone survey. The cross-validation of estimates from independent studies is important to help effectively implement tobacco excise tax policy in Brazil and other low-income and middle-income countries.

Potential impact of eliminating illicit trade in cigarettes: a demand-side perspective.

BACKGROUND: The Protocol to Eliminate Illicit Trade in Tobacco Products (the Protocol) entered into force in September 2018, and commits Parties to implement a package of measures to combat this global problem. The aim of this study is to assess the potential impact of eliminating illicit cigarettes on consumption, use and tax revenues. METHODS: We identified 36 countries where an independent (non-industry sponsored) study of the illicit cigarette market was available. We developed a conceptual framework for describing how the elimination of illicit cigarettes might impact on demand (consumption and use) and applied this framework to our sample of countries to assess the impact of eliminating illicit cigarettes across different settings. FINDINGS: Illicit cigarettes account on average for 11.2% of the market in these 36 countries. The elimination of illicit cigarettes would reduce total cigarette consumption by 1.9% across these countries. The decrease in 'group A' countries-where illicit cigarettes are >15% of the market-would average 4.1%. The smoking rate would decrease by 1.0% in relative terms including by 2.2% in group A countries. Tax revenues from the legal sale of cigarettes would increase by 11.2% including by 25.1% in group A countries. CONCLUSIONS: The illicit cigarette market reflects a complex interplay between supply and demand, with an array of different country conditions. Regardless of the situation, our study highlights the contribution that the elimination of illicit trade can make to tobacco control through demand reduction while at the same time generating significant tax revenues.

Contributions of the analysis of discarded cigarette packages in household waste in the Brazilian city of Rio de Janeiro, Brazil, to estimate the illegal market. / Contribuições da análise de embalagens de cigarros descartadas nos resíduos domiciliares do Município do Rio de Janeiro, Brasil, para estimativa de mercado ilegal.

The illicit trade of tobacco products, by enabling access to cheaper cigarettes, favors smoking initiation and hinders its cessation, minimizing the effects of price policy and taxes on reducing the demand for tobacco. This is especially the case among populations with lower income and schooling, where smoking is concentrated. Its confrontation requires multisectoral actions, aligned with the World Health Organization Framework Convention on Tobacco Control, supported by estimates of the illicit trade magnitude and the analysis of its characteristics. This study analyzes, based on samples of household solid waste collected in 2018 in the city of Rio de Janeiro, Brazil, the conformity of discarded cigarette packages with criteria for their regular commercialization in Brazil, classifying them as legal or illegal. The evaluation was also carried out for the 15 Planning Areas (PA) of the municipality. The Social Progress Index (SPI) was chosen to represent heterogeneities among PA. The average percentage of illegal cigarette packs found was 26.79%, ranging from 3.36% to 46.29% among PA. The PAs with high illegality presented lower Social Progress Index and lower percentages of legal cigarette packages with a price equal to or greater than BRL 7.25. Among the illegal packages, 98.07% were manufactured in Paraguay. The study contributes methodologically to measure the consumption of illegal cigarettes in the second economic capital of Brazil, supporting the National Tobacco Control Policy in the struggle against illicit trade of tobacco products and in the effective implementation of the pricing and tax policy on these products.

O comércio ilícito de produtos de tabaco, ao possibilitar acesso a cigarros mais baratos, favorece a iniciação do tabagismo e dificulta sua cessação, minimizando os efeitos da política de preços e impostos sobre a redução da demanda por tabaco, sobretudo entre populações de menor renda e escolaridade, onde se concentra o tabagismo. Seu enfrentamento requer ações multissetoriais, alinhadas à Convenção-Quadro para o Controle do Tabaco da Organização Mundial da Saúde e seus protocolos, e respaldadas em estimativas de sua magnitude e na análise de suas características. O estudo pretende analisar, por meio de amostras de resíduos sólidos domiciliares coletados em 2018 no Município do Rio de Janeiro, Brasil, a conformidade das embalagens de cigarros descartadas com critérios para a sua comercialização regular no país, classificando-as como legais ou ilegais. A avaliação foi feita também para as 15 Áreas de Planejamento (AP) do município. Escolheu-se o Índice de Desenvolvimento Social (IDS) para representar as heterogeneidades entre as AP. O percentual médio de embalagens de cigarros ilegais encontrado foi de 26,79%, variando de 3,36% a 46,29% entre as AP. As AP com alta ilegalidade apresentavam menores IDS e menores percentuais de embalagens de cigarros legais com preço igual ou superior a R$ 7,25. Dentre as embalagens ilegais, 98,07% apresentavam o Paraguai como país fabricante. O estudo contribui metodologicamente para dimensionar o consumo de cigarros ilegais na segunda capital econômica do Brasil, subsidiando a Política Nacional de Controle do Tabaco no combate ao comércio ilícito de produtos de tabaco e na efetiva implementação da política de preços e impostos sobre estes produtos.

El comercio ilícito de productos del tabaco, al posibilitar el acceso a cigarrillos más baratos, favorece la iniciación del tabaquismo y dificulta la interrupción de su consumo, minimizando los efectos de la política de precios e impuestos sobre la reducción de la demanda de tabaco, sobre todo entre poblaciones de menor renta y escolaridad, donde se concentra el tabaquismo. Su combate requiere acciones multisectoriales, alineadas con la Convención-Marco para el Control del Tabaco de la Organización Mundia de la Salud, y sus protocolos, y respaldadas en estimaciones de su magnitud y en el análisis de sus características. El estudio pretende analizar, mediante muestras de residuos sólidos domiciliarios, recogidos en 2018 en el Municipio de Rio de Janeiro, Brasil, la conformidad de los paquetes de cigarrillos tirados a la basura con criterios para su comercialización regular en el país, clasificándolos como legales o ilegales. La evaluación se realizó también para las 15 Áreas de Planificación (AP) del municipio. Se escogió el Índice de Desarrollo Social (IDS) para representar heterogeneidades entre las AP. El porcentaje medio de paquetes de cigarrillos ilegales encontrado fue de un 26,79%, variando de 3,36% a 46,29% entre las AP. Las AP con alta ilegalidad presentaban menores IDS y menores porcentajes de paquetes de cigarrillos legales con un precio igual o superior a BRL 7,25. Entre los embalajes ilegales, un 98,07% presentaban Paraguay como el país fabricante. El estudio contribuye metodológicamente para dimensionar el consumo de cigarrillos ilegales en la segunda capital económica de Brasil, apoyando la Política Nacional de Control del Tabaco en el combate al comercio ilícito de productos del tabaco y en la efectiva implementación de la política de precios e impuestos sobre estos productos.

Correct Sciatic Nerve Management to Apply Ultrasound-Guided Percutaneous Neuromodulation in Patients With Chronic Low Back Pain: A Pilot Study.

BACKGROUND: The objectives of this study were to evaluate the effects of an ultrasound (US)-guided percutaneous neuromodulation (PNM) intervention on the sciatic nerve, regarding pain, hip range of motion (ROM), balance, and functionality in patients with chronic low back pain (LBP); and to determine the optimal anatomical location of sciatic nerve stimulation to obtain therapeutic benefits in such patients. MATERIALS AND METHODS: Thirty patients with chronic LBP were recruited and divided randomly into three groups. All patients received a single percutaneous electrical stimulation intervention on the sciatic nerve, with a different anatomical application location for each group (proximal, middle, and distal). Level of pain, hip passive ROM, dynamic balance, and Oswestry disability index were analyzed. All variables were calculated before the intervention, immediately postintervention, 48 hours and one week after the intervention, except the LBP questionnaire (before, and 48 hours and one week after the intervention). RESULTS: All interventions decreased the level of pain and increased the ROM, balance, and functionality. Besides, these therapeutic effects were maintained during one week, regardless of the anatomical location of application. CONCLUSIONS: The choice of an anatomical location of application of the US-guided PNM on the sciatic nerve by the physiotherapist does not influence the improvement of pain, ROM, balance, and function in patients with chronic LBP.

Magnetic water treatment in a wastewater treatment plant: Part II - Processing waters and kinetic study.

Magnetic sorption process is applied to real wastewater effluents from a Wastewater Treatment Plant. The complex media sorption is done by using different types of magnetic particles (resin and polymeric covered magnetite) giving good results for removing detergents, phosphates and COD and moderate results for the sorption of nitrogen and several heavy metals. Important kinetic parameters were obtained by data fitting for the pseudo first and second order, and for simplified Elovich models. Regeneration and reuse of the magnetic particles using a chemical-free method was also tested, as well as the effect of the concentration of the particles in the removal efficiency (which proved to be relevant).

Magnetic water treatment in a wastewater treatment plant: Part I - sorption and magnetic particles.

The application of magnetic sorption to treat wastewaters is nowadays seen as a potential industrial method. In this work we apply magnetite particles to remediate real wastewater samples, with several contaminants competing for the same active sorption center at the same time. We also apply our studies at three different sampling points of a Wastewater Treatment Plant. In general terms, magnetite particles have shown a very good behaviour concerning the reduction of detergents and COD, while phosphates and total nitrogen, and the majority of heavy metals are high to moderately removed. The influence of the type of wastewater (i.e., sampling point) has also shown to be important especially for high concentration of contaminants.

Revisiting the association between worldwide implementation of the MPOWER package and smoking prevalence, 2008-2017.

BACKGROUND: We revisited the association between progress in MPOWER implementation from 2008 to 2016 and smoking prevalence from 2009 to 2017 and offered an in-depth understanding of differential outcomes for various country groups. METHODS: We used data from six rounds of the WHO Reports on the Global Tobacco Epidemic and calculated a composite MPOWER Score for each country in each period. We categorised the countries in four initial conditions based on their tobacco control preparedness measured by MPOWER score in 2008 and smoking burden measured by age-adjusted adult daily smoking prevalence in 2006: (1) High MPOWER - high prevalence (HM-HP). (2) High MPOWER - low prevalence (HM-LP). (3) Low MPOWER - high prevalence (LM-HP). (4) Low MPOWER - low prevalence (LM-LP). We estimated the association of age-adjusted adult daily smoking prevalence with MPOWER Score and cigarette tax rates using two-way fixed-effects panel regression models including both year and country fixed effects. RESULTS: A unit increase of the MPOWER Score was associated with 0.39 and 0.50 percentage points decrease in adult daily smoking prevalence for HM-HP and HM-LP countries, respectively. When tax rate was controlled for separately from MPOWE, an increase in tax rate showed a negative association with daily smoking prevalence for HM-HP and LM-LP countries, while the MPOWE Score showed a negative association for all initial condition country groups except for LM-LP countries. CONCLUSION: A decade after the introduction of the WHO MPOWER package, we observed that the countries with higher initial tobacco control preparedness and higher smoking burden were able to reduce the adult daily smoking prevalence significantly.

Contribuições da análise de embalagens de cigarros descartadas nos resíduos domiciliares do Município do Rio de Janeiro, Brasil, para estimativa de mercado ilegal / Contribuciones del análisis de paquetes de cigarrillos desechados como residuos domiciliarios en el Municipio de Rio de Janeiro, Brasil, para estimar mercado ilegal / Contributions of the analysis of discarded cigarette packages in household waste in the Brazilian city of Rio de Janeiro, Brazil, to estimate the illegal market

Resumo: O comércio ilícito de produtos de tabaco, ao possibilitar acesso a cigarros mais baratos, favorece a iniciação do tabagismo e dificulta sua cessação, minimizando os efeitos da política de preços e impostos sobre a redução da demanda por tabaco, sobretudo entre populações de menor renda e escolaridade, onde se concentra o tabagismo. Seu enfrentamento requer ações multissetoriais, alinhadas à Convenção-Quadro para o Controle do Tabaco da Organização Mundial da Saúde e seus protocolos, e respaldadas em estimativas de sua magnitude e na análise de suas características. O estudo pretende analisar, por meio de amostras de resíduos sólidos domiciliares coletados em 2018 no Município do Rio de Janeiro, Brasil, a conformidade das embalagens de cigarros descartadas com critérios para a sua comercialização regular no país, classificando-as como legais ou ilegais. A avaliação foi feita também para as 15 Áreas de Planejamento (AP) do município. Escolheu-se o Índice de Desenvolvimento Social (IDS) para representar as heterogeneidades entre as AP. O percentual médio de embalagens de cigarros ilegais encontrado foi de 26,79%, variando de 3,36% a 46,29% entre as AP. As AP com alta ilegalidade apresentavam menores IDS e menores percentuais de embalagens de cigarros legais com preço igual ou superior a R$ 7,25. Dentre as embalagens ilegais, 98,07% apresentavam o Paraguai como país fabricante. O estudo contribui metodologicamente para dimensionar o consumo de cigarros ilegais na segunda capital econômica do Brasil, subsidiando a Política Nacional de Controle do Tabaco no combate ao comércio ilícito de produtos de tabaco e na efetiva implementação da política de preços e impostos sobre estes produtos.

Resumen: El comercio ilícito de productos del tabaco, al posibilitar el acceso a cigarrillos más baratos, favorece la iniciación del tabaquismo y dificulta la interrupción de su consumo, minimizando los efectos de la política de precios e impuestos sobre la reducción de la demanda de tabaco, sobre todo entre poblaciones de menor renta y escolaridad, donde se concentra el tabaquismo. Su combate requiere acciones multisectoriales, alineadas con la Convención-Marco para el Control del Tabaco de la Organización Mundia de la Salud, y sus protocolos, y respaldadas en estimaciones de su magnitud y en el análisis de sus características. El estudio pretende analizar, mediante muestras de residuos sólidos domiciliarios, recogidos en 2018 en el Municipio de Rio de Janeiro, Brasil, la conformidad de los paquetes de cigarrillos tirados a la basura con criterios para su comercialización regular en el país, clasificándolos como legales o ilegales. La evaluación se realizó también para las 15 Áreas de Planificación (AP) del municipio. Se escogió el Índice de Desarrollo Social (IDS) para representar heterogeneidades entre las AP. El porcentaje medio de paquetes de cigarrillos ilegales encontrado fue de un 26,79%, variando de 3,36% a 46,29% entre las AP. Las AP con alta ilegalidad presentaban menores IDS y menores porcentajes de paquetes de cigarrillos legales con un precio igual o superior a BRL 7,25. Entre los embalajes ilegales, un 98,07% presentaban Paraguay como el país fabricante. El estudio contribuye metodológicamente para dimensionar el consumo de cigarrillos ilegales en la segunda capital económica de Brasil, apoyando la Política Nacional de Control del Tabaco en el combate al comercio ilícito de productos del tabaco y en la efectiva implementación de la política de precios e impuestos sobre estos productos.

Abstract: The illicit trade of tobacco products, by enabling access to cheaper cigarettes, favors smoking initiation and hinders its cessation, minimizing the effects of price policy and taxes on reducing the demand for tobacco. This is especially the case among populations with lower income and schooling, where smoking is concentrated. Its confrontation requires multisectoral actions, aligned with the World Health Organization Framework Convention on Tobacco Control, supported by estimates of the illicit trade magnitude and the analysis of its characteristics. This study analyzes, based on samples of household solid waste collected in 2018 in the city of Rio de Janeiro, Brazil, the conformity of discarded cigarette packages with criteria for their regular commercialization in Brazil, classifying them as legal or illegal. The evaluation was also carried out for the 15 Planning Areas (PA) of the municipality. The Social Progress Index (SPI) was chosen to represent heterogeneities among PA. The average percentage of illegal cigarette packs found was 26.79%, ranging from 3.36% to 46.29% among PA. The PAs with high illegality presented lower Social Progress Index and lower percentages of legal cigarette packages with a price equal to or greater than BRL 7.25. Among the illegal packages, 98.07% were manufactured in Paraguay. The study contributes methodologically to measure the consumption of illegal cigarettes in the second economic capital of Brazil, supporting the National Tobacco Control Policy in the struggle against illicit trade of tobacco products and in the effective implementation of the pricing and tax policy on these products.

[Interference by the tobacco industry in data on cigarette consumption in Brazil]. / Interferência da indústria do tabaco sobre os dados do consumo de cigarro no Brasil.

The tobacco industry normally overestimates the illegal market's size in order to reinforce the idea of its direct relationship to the choice to increase taxes by the internal revenue administration. In Brazil, the last increase in taxes on tobacco products was in 2016. The growth of demand for illegal cigarettes has other macrosocial determinants that the industry does not take into account, such as the increase in the economic capacity to purchase legal cigarettes. The article aims to test the hypothesis of the "Brazilian consumer's economic reason" from 2015 to 2019 by comparing the estimated consumptions of illegal cigarettes, based on official government data on legal production and cigarette consumption with an "extraofficial estimate" furnished by the industry. The study also used official national data on monthly income from work. The Brazilian population's "purchasing capacity for legal cigarettes" increased systematically from 2016 to 2019, from 412 packs/month to 460 packs/month. The absolute difference between the estimate by the tobacco industry and the estimate based on official data on the volume of illegal cigarettes that were consumed increased over time, reaching +30.2 billion units in 2019. Meanwhile, legal cigarette consumption, calculated with official data, increased from 2016 through 2019 (+7.8 billion), while the industry estimated a reduction in this consumption (-9.5 billion). Policymakers should seek to base their decisions on estimates generated from official data sources, including macroeconomic data on employment and income, rather than to use estimates produced by the tobacco industry that aim to interfere in public policies.

A indústria de tabaco normalmente superestima o tamanho do mercado ilegal para reforçar a ideia de sua relação direta com a escolha de aumentar impostos feita pela administração tributária. No Brasil, o último aumento de tributos sobre produtos de tabaco foi em 2016. O crescimento da demanda por cigarros ilegais tem outros determinantes macrossociais que a indústria não considera, tal como o aumento da capacidade econômica de adquirir cigarros legais. O objetivo deste artigo é testar essa hipótese da "razão econômica do consumidor brasileiro", entre 2015 e 2019, ao comparar a estimativa do consumo de cigarros ilegais obtida com base em fontes de dados oficiais do governo sobre produção legal e consumo de cigarros com a "estimativa extraoficial" fornecida pela indústria. Utilizaram-se, ainda, os dados oficiais nacionais de rendimento mensal oriundo do trabalho. A "capacidade aquisitiva de cigarros legais" da população brasileira aumentou sistematicamente entre 2016 e 2019, passando de 412 maços/mês para 460 maços/mês. A diferença absoluta entre a estimativa da indústria do tabaco e a estimativa com base em dados oficiais do volume de cigarros ilegais consumidos aumentou no tempo, chegando a +30,2 bilhões de unidades em 2019. Já o consumo de cigarros legais, calculado com dados oficiais, aumentou entre 2016 e 2019 (+7,8 bilhões), sendo que a indústria encontrou uma redução deste consumo (-9,5 bilhões). Os gestores deveriam basear suas decisões em estimativas geradas valendo-se de fontes oficiais de informação, incluindo os dados macroeconômicos de emprego e renda, ao invés de se apoiarem em estimativas geradas pela indústria do tabaco com o intuito de interferir sobre as políticas públicas.

La industria del tabaco normalmente sobrestima el tamaño del mercado ilegal para reforzar la idea de su relación directa con el hecho de aumentar impuestos, por parte de la administración tributaria. En Brasil, el último aumento de tributos sobre productos del tabaco fue en 2016. El crecimiento de la demanda de cigarrillos ilegales tiene otros determinantes macrosociales, que la industria no considera, tales como el aumento de la capacidad económica de adquirir cigarrillos legales. El objetivo de este artículo es probar esa hipótesis de la "razón económica del consumidor brasileño", entre 2015 y 2019, al comparar la estimación de consumo de cigarrillos ilegales, obtenida a partir de fuentes de datos oficiales del gobierno sobre la producción legal, y el consumo de cigarrillos con "estimación extraoficial" proporcionada por la industria. Se utilizaron, además, datos oficiales nacionales de rendimientos mensuales procedentes del trabajo. La "capacidad adquisitiva de cigarrillos legales" de la población brasileña aumentó sistemáticamente entre 2016 y 2019, pasando de 412 cajetillas/mes a 460 cajetillas/mes. La diferencia absoluta entre la estimación de la industria del tabaco, y la estimación en base a datos oficiales del volumen de cigarrillos ilegales consumidos, aumentó en el tiempo, llegando a +30,2 billones de unidades en 2019. En el caso del consumo de cigarrillos legales, calculado con datos oficiales, aumentó entre 2016 y 2019 (+7,8 billones), pese a que la industria encontró una reducción de ese consumo (-9,5 billones). Los gestores deberían basar sus decisiones en estimaciones generadas a partir de fuentes oficiales de información, incluyendo los datos macroeconómicos de empleo y renta, en vez de apoyarse en estimaciones generadas por la industria del tabaco con la intención de interferir sobre las políticas públicas.

The Critical Raw Materials in Cutting Tools for Machining Applications: A Review.

A variety of cutting tool materials are used for the contact mode mechanical machining of components under extreme conditions of stress, temperature and/or corrosion, including operations such as drilling, milling turning and so on. These demanding conditions impose a seriously high strain rate (an order of magnitude higher than forming), and this limits the useful life of cutting tools, especially single-point cutting tools. Tungsten carbide is the most popularly used cutting tool material, and unfortunately its main ingredients of W and Co are at high risk in terms of material supply and are listed among critical raw materials (CRMs) for EU, for which sustainable use should be addressed. This paper highlights the evolution and the trend of use of CRMs) in cutting tools for mechanical machining through a timely review. The focus of this review and its motivation was driven by the four following themes: (i) the discussion of newly emerging hybrid machining processes offering performance enhancements and longevity in terms of tool life (laser and cryogenic incorporation); (ii) the development and synthesis of new CRM substitutes to minimise the use of tungsten; (iii) the improvement of the recycling of worn tools; and (iv) the accelerated use of modelling and simulation to design long-lasting tools in the Industry-4.0 framework, circular economy and cyber secure manufacturing. It may be noted that the scope of this paper is not to represent a completely exhaustive document concerning cutting tools for mechanical processing, but to raise awareness and pave the way for innovative thinking on the use of critical materials in mechanical processing tools with the aim of developing smart, timely control strategies and mitigation measures to suppress the use of CRMs.

Walking Recognition in Mobile Devices.

Presently, smartphones are used more and more for purposes that have nothing to do withphone calls or simple data transfers. One example is the recognition of human activity, which isrelevant information for many applications in the domains of medical diagnosis, elderly assistance,indoor localization, and navigation. The information captured by the inertial sensors of the phone(accelerometer, gyroscope, and magnetometer) can be analyzed to determine the activity performedby the person who is carrying the device, in particular in the activity of walking. Nevertheless,the development of a standalone application able to detect the walking activity starting only fromthe data provided by these inertial sensors is a complex task. This complexity lies in the hardwaredisparity, noise on data, and mostly the many movements that the smartphone can experience andwhich have nothing to do with the physical displacement of the owner. In this work, we exploreand compare several approaches for identifying the walking activity. We categorize them into twomain groups: the first one uses features extracted from the inertial data, whereas the second oneanalyzes the characteristic shape of the time series made up of the sensors readings. Due to the lackof public datasets of inertial data from smartphones for the recognition of human activity underno constraints, we collected data from 77 different people who were not connected to this research.Using this dataset, which we published online, we performed an extensive experimental validationand comparison of our proposals.

Smoke signals: monitoring illicit cigarettes and smoking behaviour in Colombia to support tobacco taxes.

BACKGROUND: A street cross-sectional survey in 2016 with a representative sample of 1697 smokers in five Colombian cities was used to estimate the penetration of illicit cigarettes (PIC). The first wave was collected 3 months before a 100% increase in tobacco excise tax, and a second wave collected data 9 months after tax reform was effective. OBJECTIVE : Analyse changes after a cigarette tax increase in PIC, prices and smoking behaviour patterns for five Colombian cities (63% of the market). Smoking behaviour includes consumption intensity, presentation (stick/pack) and place of purchase. METHODS : Repeated street cross-sectional survey with smokers' self-report on smoking behaviour, last purchase information and direct observation of smokers' packs. Sampling frame: smokers, men and women, aged 12 years or older, all income levels, resident in the five cities with the highest number of smokers representing 63% of cigarette market share (Bogotá, Medellín, Cali, Cartagena and Cúcuta) with 1 733 316 smokers in 2013. Sample size was 1697 per wave, with confidence level 95%, margin of error 3.5% for Bogotá and Medellín and 5% for the other three cities. Smokers in second wave match first wave's location, sex and age group. Illicit cigarettes were identified based on brand, health warnings and price. RESULTS : After the tax hike, the average real price of a 20-stick pack increased by 28.2% and by 23.1% for loose cigarettes. Illicit cigarettes represented 3.4% of total cigarette consumption in 2016 and increased to 6.4% in 2017, lower than the current industry estimate of 18%. Consumption intensity decreased: the proportion of heavy smokers (more than 10 cigarettes per day) wentdown from 37% in 2016 to 26% in 2017. CONCLUSION: After the tax increase, Colombia's PIC remained at low levels, and there is enough space for new tobacco tax hikes.

Interferência da indústria do tabaco sobre os dados do consumo de cigarro no Brasil / Interference by the tobacco industry in data on cigarette consumption in Brazil / Interferencia de la industria del tabaco sobre los datos del consumo de cigarrillos en Brasil

Resumo: A indústria de tabaco normalmente superestima o tamanho do mercado ilegal para reforçar a ideia de sua relação direta com a escolha de aumentar impostos feita pela administração tributária. No Brasil, o último aumento de tributos sobre produtos de tabaco foi em 2016. O crescimento da demanda por cigarros ilegais tem outros determinantes macrossociais que a indústria não considera, tal como o aumento da capacidade econômica de adquirir cigarros legais. O objetivo deste artigo é testar essa hipótese da "razão econômica do consumidor brasileiro", entre 2015 e 2019, ao comparar a estimativa do consumo de cigarros ilegais obtida com base em fontes de dados oficiais do governo sobre produção legal e consumo de cigarros com a "estimativa extraoficial" fornecida pela indústria. Utilizaram-se, ainda, os dados oficiais nacionais de rendimento mensal oriundo do trabalho. A "capacidade aquisitiva de cigarros legais" da população brasileira aumentou sistematicamente entre 2016 e 2019, passando de 412 maços/mês para 460 maços/mês. A diferença absoluta entre a estimativa da indústria do tabaco e a estimativa com base em dados oficiais do volume de cigarros ilegais consumidos aumentou no tempo, chegando a +30,2 bilhões de unidades em 2019. Já o consumo de cigarros legais, calculado com dados oficiais, aumentou entre 2016 e 2019 (+7,8 bilhões), sendo que a indústria encontrou uma redução deste consumo (-9,5 bilhões). Os gestores deveriam basear suas decisões em estimativas geradas valendo-se de fontes oficiais de informação, incluindo os dados macroeconômicos de emprego e renda, ao invés de se apoiarem em estimativas geradas pela indústria do tabaco com o intuito de interferir sobre as políticas públicas.

Abstract: The tobacco industry normally overestimates the illegal market's size in order to reinforce the idea of its direct relationship to the choice to increase taxes by the internal revenue administration. In Brazil, the last increase in taxes on tobacco products was in 2016. The growth of demand for illegal cigarettes has other macrosocial determinants that the industry does not take into account, such as the increase in the economic capacity to purchase legal cigarettes. The article aims to test the hypothesis of the "Brazilian consumer's economic reason" from 2015 to 2019 by comparing the estimated consumptions of illegal cigarettes, based on official government data on legal production and cigarette consumption with an "extraofficial estimate" furnished by the industry. The study also used official national data on monthly income from work. The Brazilian population's "purchasing capacity for legal cigarettes" increased systematically from 2016 to 2019, from 412 packs/month to 460 packs/month. The absolute difference between the estimate by the tobacco industry and the estimate based on official data on the volume of illegal cigarettes that were consumed increased over time, reaching +30.2 billion units in 2019. Meanwhile, legal cigarette consumption, calculated with official data, increased from 2016 through 2019 (+7.8 billion), while the industry estimated a reduction in this consumption (-9.5 billion). Policymakers should seek to base their decisions on estimates generated from official data sources, including macroeconomic data on employment and income, rather than to use estimates produced by the tobacco industry that aim to interfere in public policies.

Resumen: La industria del tabaco normalmente sobrestima el tamaño del mercado ilegal para reforzar la idea de su relación directa con el hecho de aumentar impuestos, por parte de la administración tributaria. En Brasil, el último aumento de tributos sobre productos del tabaco fue en 2016. El crecimiento de la demanda de cigarrillos ilegales tiene otros determinantes macrosociales, que la industria no considera, tales como el aumento de la capacidad económica de adquirir cigarrillos legales. El objetivo de este artículo es probar esa hipótesis de la "razón económica del consumidor brasileño", entre 2015 y 2019, al comparar la estimación de consumo de cigarrillos ilegales, obtenida a partir de fuentes de datos oficiales del gobierno sobre la producción legal, y el consumo de cigarrillos con "estimación extraoficial" proporcionada por la industria. Se utilizaron, además, datos oficiales nacionales de rendimientos mensuales procedentes del trabajo. La "capacidad adquisitiva de cigarrillos legales" de la población brasileña aumentó sistemáticamente entre 2016 y 2019, pasando de 412 cajetillas/mes a 460 cajetillas/mes. La diferencia absoluta entre la estimación de la industria del tabaco, y la estimación en base a datos oficiales del volumen de cigarrillos ilegales consumidos, aumentó en el tiempo, llegando a +30,2 billones de unidades en 2019. En el caso del consumo de cigarrillos legales, calculado con datos oficiales, aumentó entre 2016 y 2019 (+7,8 billones), pese a que la industria encontró una reducción de ese consumo (-9,5 billones). Los gestores deberían basar sus decisiones en estimaciones generadas a partir de fuentes oficiales de información, incluyendo los datos macroeconómicos de empleo y renta, en vez de apoyarse en estimaciones generadas por la industria del tabaco con la intención de interferir sobre las políticas públicas.