Endocrine diseases associated with COVID-19 vaccination: case report. / Enfermedades endocrinas asociadas a vacunación por la COVID-19: reporte de casos.

SARS-CoV-2 vaccination is not free of adverse effects. We present two cases of endocrine involvement associated with COVID-19 vaccination. A 46-year-old woman who, after receiving the first COVID-19 vaccination dose, presented persistent fever and signs of thyrotoxicosis after being diagnosed with subacute thyroiditis associated with COVID-19 vaccination; the condition remitted with the use of corticoids. A 71-year-old male, who after COVID-19 vaccination, presented hyperinsulinemic hypoglycemia, testing positive for anti-insulin antibodies; he was diagnosed with autoimmune hypoglycemia associated with COVID-19 vaccination and received treatment with prednisone, controlling the episodes of hypoglycemia. In conclusion, endocrine diseases associated with COVID-19 vaccination are extremely rare and their timely detection allows adequate treatment.

La vacunación contra el SARS-CoV-2 no está exenta de efectos adversos. Se presenta dos casos de afectación endocrina asociada a la vacunación por la COVID-19. Mujer de 46 años que, luego de la primera dosis, presentó fiebre persistente y signos de tirotoxicosis, tras el diagnóstico de tiroiditis subaguda asociada a vacunación por la COVID-19, el cuadro remitió con el uso de corticoides. Varón de 71 años, que luego de la vacunación por la COVID-19, presentó hipoglicemias hiperinsulinemicas, con resultado positivo de anticuerpos antiinsulina. Se le diagnosticó con una hipoglicemia autoinmune asociada a la vacunación por la COVID-19 y recibió tratamiento con prednisona, controlando los episodios de hipoglicemia. En conclusión, las enfermedades endocrinas asociadas a vacunación por la COVID-19 son extremadamente raras y su detección oportuna permite su tratamiento adecuado.

Sulfur Interaction and Regeneration of CaMn0.775Ti0.125Mg0.1O2.9-δ Perovskite as Oxygen Carrier during Combustion of Sour Gas in a 500 Wth Chemical Looping Combustion Unit.

In the present study, the performance of a CaMn0.775Ti0.125Mg0.1O2.9-δ perovskite used as an oxygen carrier to burn sour gas with different H2S concentrations (up to 3000 vppm) in a continuous 500 Wth chemical looping combustion (CLC) prototype was investigated. After 29 h of sour gas combustion, the combustion efficiency had dropped by 18% in comparison with the reference test without sulfur addition. The characterization of the used particles of the perovskite confirmed that the presence of sulfur in the fuel gas had a poisonous effect through the formation of undesired compounds, such as CaSO4. The reactivity with CH4 and oxygen uncoupling capacity decreased, which could explain the decrease in the combustion efficiency. Two regeneration processes, one at high temperature (1273 K) and another one at low temperature (773-873 K), were carried out in a batch fluidized bed reactor to remove the amount of sulfur accumulated in the oxygen carrier particles. The detection of appreciable amounts of gaseous sulfur-based compounds (SO2 and H2S) during the experimentation and the postcharacterization results obtained through different techniques such as X-ray diffraction, ultimate analysis, and thermogravimetric analysis confirmed the effectiveness of both processes. Finally, the feasibility of implementation of the regeneration processes in a commercial CLC unit was thoroughly analyzed.

Enfermedades endocrinas asociadas a vacunación por la COVID-19: Reporte de Casoss / Endocrine diseases associated with COVID-19 vaccination: case reports

La vacunación contra el SARS-CoV-2 no está exenta de efectos adversos. Se presenta dos casos de afectación endocrina asociada a la vacunación por la COVID-19. Mujer de 46 años que, luego de la primera dosis, presentó fiebre persistente y signos de tirotoxicosis, tras el diagnóstico de tiroiditis subaguda asociada a vacunación por la COVID-19, el cuadro remitió con el uso de corticoides. Varón de 71 años, que luego de la vacunación por la COVID-19, presentó hipoglicemias hiperinsulinemicas, con resultado positivo de anticuerpos antiinsulina. Se le diagnosticó con una hipoglicemia autoinmune asociada a la vacunación por la COVID-19 y recibió tratamiento con prednisona, controlando los episodios de hipoglicemia. En conclusión, las enfermedades endocrinas asociadas a vacunación por la COVID-19 son extremadamente raras y su detección oportuna permite su tratamiento adecuado.

SARS-CoV-2 vaccination is not free of adverse effects. We present two cases of endocrine involvement associated with COVID-19 vaccination. A 46-year-old woman who, after receiving the first COVID-19 vaccination dose, presented persistent fever and signs of thyrotoxicosis after being diagnosed with subacute thyroiditis associated with COVID-19 vaccination; the condition remitted with the use of corticoids. A 71-year-old male, who after COVID-19 vaccination, presented hyperinsulinemic hypoglycemia, testing positive for anti-insulin antibodies; he was diagnosed with autoimmune hypoglycemia associated with COVID-19 vaccination and received treatment with prednisone, controlling the episodes of hypoglycemia. In conclusion, endocrine diseases associated with COVID-19 vaccination are extremely rare and their timely detection allows adequate treatment.

Pectin-based aerogel particles for drug delivery: Effect of pectin composition on aerogel structure and release properties.

In this work, nanostructured pectin aerogels were prepared via a sol-gel process and subsequent drying under supercritical conditions. To this end, three commercially available citrus pectins and an in-house produced and enzymatically modified watermelon rind pectin (WRP) were compared. Then, the effect of pectin's structure and composition on the aerogel properties were analysed and its potential application as a delivery system was explored by impregnating them with vanillin. Results showed that the molecular weight, degree of esterification and branching degree of the pectin samples played a main role in the production of hydrogels and subsequent aerogels. The developed aerogel particles showed high specific surface areas (468-584 m2/g) and low bulk density (0.025-0.10 g/cm3). The shrinkage effect during aerogel formation was significantly affected by the pectin concentration and structure, while vanillin loading in aerogels and its release profile was also seen to be influenced by the affinity between pectin and vanillin. Furthermore, the results highlight the interest of WRP as a carrier of active compounds which might have potential application in food and biomedical areas, among others.

Visión global de la VMNI en las tres primeras olas de la COVID-19en la Comunidad de Madrid / Global vision of NIV during the first three waves of COVID-19 in the Community of Madrid

La neumonía COVID ha supuesto un reto para la Neumología que ha respondido de forma rápida y con resultados muy satisfactorios a la demanda de soporte ventilatorio no invasivo que esta enfermedad y sobre todo la sobrecarga en las Unidades de Cuidados Intensivos ha ocasionado. En el caso de la Comunidad Autónoma de Madrid (CAM), la mayoría de los centros hospitalarios ampliaron o implantaron los recursos que facilitaron el uso de esta terapia para miles de pacientes que de otro modo no hubieran tenido la oportunidad de mejorar su situación respiratoria. Mediante este artículo queremos dar a conocer la visión global de esta intervención en 14 centros de la red de hospitales de la CAM (AU)

COVID pneumonia has been a challenge for Pulmonology that has responded quickly and with very satisfactory results to the demand for non-invasive ventilatory support that this disease and especially the overload in Intensive Care Units has caused. In the case of the Autonomous Community of Madrid (CAM), most hospitals expanded or implemented the resources that facilitated the use of this therapy for thousands of patients who otherwise would not have had the opportunity to improve their respiratory situation. Through this article we want to present the global vision of this intervention in 14 centers of the CAM network of hospitals (AU)

Tomography of irregular rough particles using the error-reduction algorithm with multi-views interferometric particle imaging.

This work reports the 3D reconstruction of a particle from a set of three simulated interferometric images of this particle (from three perpendicular angles of view). The reconstruction of each view from its corresponding interferometric pattern uses the error-reduction (ER) algorithm. The 3D reconstruction enables an estimation of the volume of the particle. The method is tested on a dendrite-like particle. An experimental demonstration of the technique is done using a digital micromirror device (DMD) that generates the interferometric images of "programmable" rough particles.

Percepción de los usuarios de la farmacia comunitaria sobre la COVID-19 al final de la alarma y comparación con la situación al inicio / Community pharmacy users' perception of COVID-19 comparingthe beginning and ending situation of the lockdown

OBJETIVOS: evaluar la percepción de los usuarios de las farmacias sobre la repercusión de la COVID-19 en su salud al final del confinamiento y comparar los resultados con los obtenidos al inicio. MATERIAL Y MÉTODOS: estudio observacional transversal aleatorizado, en farmacias de Pontevedra y Ourense, del 10 al 25 de junio de 2020. SUJETOS: ≥ 18 años que acuden en demanda de medicamentos y/o material de protección. Procedimiento: el usuario cumplimentaba un cuestionario anónimo, depositándolo en una bandeja desinfectada diariamente. RESULTADOS: 839 encuestas. 492 (58,6 %) mujeres, edad media 54,6 (DE =1 7,4 años). 144 (17,2 %) viven solos. 771 (91,9 %) creen que la COVID-19 es más peligrosa que la gripe, 233 (27,7 %) desconocen estar en algún grupo de riesgo. 137 (16,4 %) dicen sentirse mal/muy mal con el aislamiento. Aspectos más afectados: familiar 429 (51,1 %) y emocional 377 (44,9 %). La afectación de los aspectos físico 210 (25,0 %) y laboral 183 (21,8 %) mejoraron significativamente en fase final. En 2020/21 piensan vacunarse de la gripe 376 (44,4 %), en 2019/20 lo hicieron 243 (34,4 %). 541 (64,5 %) se vacunarán frente a la COVID-19 cuando exista vacuna. Aumentan los que se vacunarán, aunque no esté financiada: 511 (60,9 %) / 280 (39,7 %). CONCLUSIONES: no ha variado significativamente la percepción sobre la peligrosidad de la COVID-19 y la repercusión en su salud. Los aspectos del bienestar más afectados siguen siendo el familiar y el emocional. Aumenta el número de los que se sintieron mal/muy mal con el confinamiento y el de mayores afectados por la soledad. Aumenta la intención de vacunarse del SARS-CoV-2, aunque no sea financiada

AIM: Assess the perception of pharmacy users about the impact of COVID-19 on their health at the end of confinement and compare the results with those obtained at the beginning. MATERIAL AND METHODS: Randomized cross-sectional observational study, in pharmacies in Pontevedra and Ourense, from 10 to 25 June 2020.Subjects: 18 years of age who come on demand for medicines and/or protective material. PROCEDURE: the user completed an anonymous questionnaire, depositing it in a daily dis-infected tray. RESULTS: 839 surveys. 492 (58,6%) women, an average age of 54.6 (DE-17.4) years. 144 (17,2%) they live alone. 771 (91,9%) COVID-19 is more dangerous than influenza, 233 (27.7%) they don't know how to be in some risk group. 137 (16,4%) say they feel bad/very bad with isolation. Most affected aspects: family 429 (51.1%) emotionally 377 (44.9%). Affecting physical aspects 210 (25.0%) 183 (21.8%) significantly improved in the final phase. In 2020/21 they plan to be vaccinated with influenza 376 (44.4%), in 2019/20 they did so 243 (34.4%). COVID-19 will be vaccinated when there is a vaccine. Those who will be vaccinated increase even if 511(60.9%)/280 (39.7%) is not funded. CONCLUSIONS: The perception of the danger of COVID-19 and the impact on its health has not changed significantly. The aspects of well-being that are most affected remain familiar and emotional. Increases the number of those who felt bad/very bad with confinement and that of adults affected by loneliness. It increases the intention to get vaccinated from SARS-CoV-2, even if it is not funded

La prueba de tuberculina positiva no es sinónimo de tuberculosis latente / The positive tuberculin test is not synonymous with latent tuberculosis

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The Jamaican Haemophilia Registry: Describing the burden of disease.

INTRODUCTION: Jamaica has an estimated 200 persons with haemophilia (PWH), who face significant constraints in access to specialized haemophilia care, including access to clotting factor concentrates. AIM: The aim of this paper is to establish the current burden of disease in PWH in Jamaica. METHODS: PWH were enrolled through the University Hospital of the West Indies, Jamaica. The impact of haemophilia was assessed using a comprehensive battery of heath outcome measures that included the following: laboratory, clinical information and validated outcome measures of joint structure and function, activity, and health-related quality of life (HRQoL) to provide a health profile of the Jamaican haemophilia population. RESULTS: In all, 45 PWH were registered (mean age: 29, range: 0.17-69 years), including 13 children (<18 years of age) and 32 adults. In this sample, 41 had haemophilia A (30 severe) and 4 had haemophilia B (3 severe); 10 patients with haemophilia A were inhibitor positive. The results indicate that adults with haemophilia in Jamaica have significant joint damage: mean Haemophilia Joint Health Score (HJHS) = 42.1 (SD = 17.3); moderate activity levels - mean Haemophilia Activities List (HAL) score = 64.8 (SD = 17.8); and low HRQoL scores - mean Haemo-QoL-A score = 62.3 (SD = 19.4). Results for children are also reported but should be interpreted with caution due to the small sample size. CONCLUSIONS: There is a very high burden of disease in PWH in Jamaica. The health profiles reported in this paper are an essential first step in advocating for a multidisciplinary Comprehensive Care Program for assessment and care of PWH in Jamaica.

Genotype-based selection of treatment of patients with advanced colorectal cancer (SETICC): a pharmacogenetic-based randomized phase II trial.

Background: There has been little progress toward personalized therapy for patients with metastatic colorectal cancer (mCRC). TYMS-3' untranslated region (UTR) 6 bp ins/del and ERCC1-118C/T polymorphisms were previously reported to facilitate selecting patients for fluoropyrimidine-based treatment in combination with oxaliplatin as first-line therapy. We assessed the utility of these markers in selecting therapy for patients with mCRC. Patients and methods: This randomized, open-label phase II trial compared bevacizumab plus XELOX (control) versus treatment tailored according to TYMS-3'UTR 6 bp ins/del and ERCC1-118C/T polymorphisms. Patients randomized to the experimental treatment received bevacizumab plus FUOX, FUIRI, XELIRI, or XELOX depending on their combination of favorable polymorphisms for FUOX treatment (TYMS-3'UTR ins/del or del/del; ERCC1-118T/T). Progression-free survival (PFS) was the primary end point. Results: Overall, 195 patients were randomized (control n = 65; experimental n = 130). The primary objective was not met: median PFS was 9.4 months in the control group and 10.1 months in the experimental group (P = 0.745). Median overall survival was similar in both groups (16.5 versus 19.1 months, respectively; P = 0.797). Patients in the experimental group had a significantly higher overall response rate (ORR; 65% versus 47% in the control group; P = 0.042) and R0 resection rate (86% versus 44%, respectively; P = 0.018). Neuropathy, hand-foot syndrome, thrombocytopenia, and dysesthesia were significantly less common in the experimental group. Conclusions: This study did not show survival benefits after treatment personalization based on polymorphisms in mCRC. However, the improved ORR and R0 resection rate and fewer disabling toxicities suggest that tailoring therapy by TYMS-3'UTR and ERCC1-118 polymorphisms warrants further investigation in patients with mCRC. ClinicalTrials.gov: NCT01071655.

La evaluación de competencias en Medicina / The assessment of medical competencies

Objetivo. Describir las herramientas más utilizadas en la evaluación competencial en Medicina, analizar su prevalencia de uso, sus ventajas e inconvenientes y proponer un modelo apropiado para nuestro contexto. Método. Revisión narrativa de artículos de MEDLINE, siguiendo el protocolo PRISMA. Se analizaron un total de 62 artículos. Resultados. La evaluación competencial es heterogénea, especialmente en el ámbito educativo y profesional. Las competencias específicas o técnicas durante la formación universitaria se evalúan fundamentalmente mediante evaluación clínica objetiva estructurada, mientras que en el ejercicio profesional se valoran competencias nucleares utilizando la técnica 360°. Conclusiones. Se necesita un contraste empírico riguroso de la eficiencia de las herramientas en función del tipo de competencia. Se propone un modelo de gestión competencial sobre el continuo «pregrado/posgrado/profesionales en activo». Su finalidad es contribuir a la mejora de la formación y de la práctica profesional y, por ende, incrementar la calidad de la atención al paciente (AU)

Objective. To describe the most widely used tools in the assessment of medical competencies, analyse their prevalence of use, their advantages and disadvantages and propose an appropriate model for our context. Methods. We conducted a narrative review of articles from MEDLINE, following the PRISM protocol, and analysed a total of 62 articles. Results. The assessment of competencies is heterogeneous, especially in the educational and professional settings. The specific and technical competencies acquired during university education are mainly assessed using the objective structured clinical assessment. In the professional setting, core competencies are assessed using the 360° technique. Conclusions. We need a rigorous empiric comparison of the efficiency of the tools according to the type of competency. We propose a competency management model for the «undergraduate/graduate/active professional» continuum, whose goal is to improve training and professional practice and thereby increase the quality of patient care (AU)

The assessment of medical competencies. / La evaluación de competencias en Medicina.

OBJECTIVE: To describe the most widely used tools in the assessment of medical competencies, analyse their prevalence of use, their advantages and disadvantages and propose an appropriate model for our context. METHODS: We conducted a narrative review of articles from MEDLINE, following the PRISM protocol, and analysed a total of 62 articles. RESULTS: The assessment of competencies is heterogeneous, especially in the educational and professional settings. The specific and technical competencies acquired during university education are mainly assessed using the objective structured clinical assessment. In the professional setting, core competencies are assessed using the 360° technique. CONCLUSIONS: We need a rigorous empiric comparison of the efficiency of the tools according to the type of competency. We propose a competency management model for the «undergraduate/graduate/active professional¼ continuum, whose goal is to improve training and professional practice and thereby increase the quality of patient care.

Comparing the burden of illness of haemophilia between resource-constrained and unconstrained countries: the São Paulo-Toronto Hemophilia Study.

INTRODUCTION: Although the regular replacement of clotting factor concentrates (prophylaxis) has been well established as the standard of care for severe haemophilia, the high cost of factor concentrates has limited access to prophylaxis in countries with under-developed or developing economies. AIMS: We studied the health gap that could be addressed by providing unlimited access to clotting factor concentrates with implementation of long-term prophylaxis initiated from an early age in life. METHODS: We performed a cross-sectional study of a random, representative sample of boys with moderate and severe haemophilia at three haemophilia treatment centres in Sao Paulo, Brazil, and one centre in Toronto, Canada. RESULTS: Canadian subjects were more often treated with prophylaxis, and began treatment at an earlier age. Fewer Canadian subjects had bleeds within the preceding 6 months (19 vs. 34, P = 0.003). Canadian subjects had lower (better) Pettersson radiographic scores (1.5 vs. 6.0, P = 0.0016), lower (better) Hemophilia Joint Health Scores (5.5 vs. 10.5, P = 0.0038), higher (better) Activity Scale for Kids scores (96.6 vs. 92.0, P = 0.033), more time spent in vigorous activity, and higher (better) social participation scores. CONCLUSIONS: Our findings suggest that increasing access to clotting factor concentrates for young boys with severe haemophilia is a global imperative.

Pilot study of once-a-day prophylaxis for youth and young adults with severe haemophilia A.

INTRODUCTION: Standard prophylaxis has been shown to be an effective treatment for severe haemophilia A. According to pharmacokinetic principles, daily factor infusions of smaller doses can maintain similar trough factor VIII (FVIII) levels, and perhaps the same protection as standard prophylaxis. AIM: This multicentre study examined the feasibility of daily prophylaxis for youth and young adults with severe haemophilia A in Montreal and Toronto. METHODS: Bleeding rates, joint status, quality of life and physical activity were monitored for 14 patients during this study. At baseline, subjects continued their regular treatment regimen and switched to daily prophylaxis after 4 months; nine had begun daily prophylaxis before enrolment. Additional visits occurred at 8 and 12 months which included a physical examination, inhibitor testing, HJHS and FISH assessments, the CHO-KLAT/Haemo-QoL-A and PDPAR. Treatment satisfaction was assessed using the Treatment Satisfaction Questionnaire for Medication ver.II and perceived difficulty questions at the end of study. RESULTS AND CONCLUSIONS: There were no significant changes in quality of life except for concerns with the demanding daily infusion schedule. The number of bleeds did not statistically differ from the initial 4 months of the study to the last 8 months. Monthly bleeding rates from the year prior to the study and during the intervention phase were not statistically different. It was also found that daily prophylaxis used 24% less FVIII compared to standard prophylaxis. Taking all of this into account, we have found that providing daily prophylaxis is feasible and that it is feasible to prospectively study daily prophylaxis in youth and young adults.

Validity of the Portuguese CHO-KLAT in Brazil.

INTRODUCTION: It is essential to assess the health-related quality of life outcomes of boys with haemophilia in Brazil. The Canadian Haemophilia Outcomes-Kids Life Assessment Tool (CHO-KLAT) was recently adapted for this population. AIM: To test the construct validity of the Portuguese version of the CHO-KLAT. METHODS: We recruited 50 boys, with moderate [factor VIII (FVIII) level 1-5%] or severe (FVIII level <1%) haemophilia, to participate in a descriptive study to establish a baseline understanding of the current status of boys with haemophilia in Brazil. All boys were required to complete the Brazilian CHO-KLAT and Brazilian Pediatric Quality of Life Inventory (PedsQL) by self-report. We examined the correlation between the CHO-KLAT and PedsQL scores to establish the construct validity of the Brazilian version of the CHO-KLAT. RESULTS: We obtained CHO-KLAT and PedsQL data from 35 boys with severe haemophilia and 15 with moderate haemophilia. They ranged in age from 7.3 to 18.0 years, with a mean of 13.0 years. They reported a mean CHO-KLAT score of 72.3 (range = 44.1-93.9). The mean PedsQL score was 79.9 (range = 45.7-96.7), with physical health (mean of 83.9) being better than psychosocial health (77.8). The Pearson's correlation between CHO-KLAT and PedsQL was 0.47 respectively (P < 0.001). The CHO-KLAT had a moderate and inverse relationship with the degree to which they were bothered by their haemophilia (ρ = -0.53), while the PedsQL had a weaker relationship (ρ = -0.27). CONCLUSION: The results confirm the validity of the Portuguese version of the CHO-KLAT. This measure is now available for clinical trials in boys with haemophilia in Brazil.

Ubicación del nervio ciático a nivel del hueco poplíteo en la población adulta: relación con género y datos antropométricos estudiados. Implicaciones para la práctica diaria / Location of the sciatic nerve at the popliteal fossa in the adult population: Relationship with gender and anthropometric data studied. Implications for daily practice

Objetivo. Explorar si la ubicación del nervio ciático (NC) a nivel del hueco poplíteo se relaciona con variables antropométricas en la población adulta. Identificar posibles variaciones anatómicas y sus posibles implicaciones en la práctica clínica. Material y método. Estudio prospectivo observacional en cirugía ambulatoria programada. Se examinaron por ultrasonografía la profundidad, la lateralidad y la distancia en la que el NC se bifurca a nivel del hueco poplíteo. Se relacionaron estas mediciones según el género y otros datos antropométricos de los pacientes. Resultados. Se incluyeron 62 pacientes, siendo 124 el total de mediciones. Existe una asociación estadísticamente significativa (p < 0,001) entre la profundidad del NC y el diámetro del muslo medido a 10 cm del pliegue poplíteo. La profundidad y la lateralidad promedio, medidas a 10 cm del pliegue poplíteo, fueron de 3,32 ± 0,8 y 1,43 ± 0,9 cm, respectivamente. La distancia de la bifurcación y el diámetro del nervio promedio fueron de 61,78 ± 12 y 7,45 ± 1,17 mm, respectivamente. No hubo diferencias estadísticamente significativas entre las variables medidas y la edad/género. No se encontraron diferencias al analizar ambos miembros inferiores de cada paciente. No existe una asociación estadísticamente significativa entre la talla de los pacientes y la distancia en la que el NC se bifurca. Conclusiones. La profundidad y lateralidad del NC son variables independientes del género, el peso y la talla. La profundidad a la que el NC se localiza a nivel del hueco poplíteo está relacionada con el diámetro del muslo. La bifurcación del NC en el hueco poplíteo no está relacionada con la talla (AU)

Objective. To determine whether the location of the sciatic nerve (SN) at the popliteal fossa is related to anthropometric variables in the adult population, and to identify possible anatomical variations and their possible implications for clinical practice. Materials and method. Prospective observational study in elective ambulatory surgery patients. Patients were examined using ultrasound, looking at depth, laterality and distance at which the SN bifurcates at the level of the popliteal fossa. These measurements were linked to gender and the anthropometric data of the patients. Results. A total of 62 patients were included, with 124 measurements. A statistically significant association was found between SN depth and the diameter of the thigh measured at 10 cm from the popliteal crease (P < .001). Mean depth: 3.32 ± 0.8 cm, mean laterality: 1.43 ± 0.9 cm, mean SN bifurcation distance: 61.78 ± 12 mm and mean SN diameter: 7.45 ± 1.17 mm. There were no statistical differences when comparing the measured variables with the age and gender. Similar results were obtained between measurements when comparing both lower limbs in the same patient. There was no statistical difference between height and distance at which the SN bifurcates. Conclusions. The depth and laterality of SN are independent of gender, weight and height. The depth at which the SN is located at the level of the popliteal fossa is related to the diameter of the thigh. The bifurcation of SN in popliteal fossa is not related to height (AU)

An environmental generalised Luenberger-Hicks-Moorsteen productivity indicator and an environmental generalised Hicks-Moorsteen productivity index.

The purpose of this paper is to introduce an environmental generalised productivity indicator and its ratio-based counterpart. The innovative environmental generalised total factor productivity measures inherit the basic structure of both Hicks-Moorsteen productivity index and Luenberger-Hicks-Moorsteen productivity indicator. This methodological contribution shows that these new environmental generalised total factor productivity measures yield the earlier standard Hicks-Moorsteen index and Luenberger-Hicks-Moorsteen indicator, as well as environmental performance index, as special cases.