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Qualitative research investigating pharmacists' participation in Long-Term Care (LTC) within interdisciplinary teams is scarce.To characterize how pharmacists' participation in a national network of LTC is perceived by healthcare professionals and other key stakeholders.Individual, in-depth, semi-structured interviews of participants (nurses, physicians, pharmacists, and LTC researchers) enrolled purposively or through snowballing sampling techniques, with the final sample being comprised of fourteen participants. Data analysis followed a deductive coding approach framed by Role Theory and supplemented with an inductive coding for additional themes.Four Role Theory constructs were identified from the primary data-role identity, overqualification, ambiguity, underqualification. Clinical pharmacy services, logistics and educational activities were pointed out as representing the identity of pharmacists' interventions. Despite the clear identification of LTC pharmacists' interventions, pharmacist expertise on medicine optimization seemed to be underused (role overqualification), as a result of lack of time, lower proactivity in healthcare teams' integration, and the absence of a legal framework targeted to LTC pharmacy practice (role ambiguity). Additional clinical training, including in the management of older people's health conditions, nutrition, and palliative care were missing (role underqualification).LTC pharmacists can provide essential services (e.g., clinical pharmacy, logistics, educational interventions), although additional training and a clearer legal framework are missing to better define pharmacists' roles in LTC pharmacy practice.

In this paper we address the question of epigenetics by evidencing some mechanisms related to gene expression, which, we understand, can in a way be used as metaphors for movements occurring during the psychotherapeutic process. The possibility of a dialogue between epigenetics and analytical psychology begins with the hereditary and archetypal question and takes shape in the dimension of the analytical encounter. Through the Jungian attitude model, we propose a way of moving between the two sciences. This paper provides a brief review of the concept of archetype, covering recent publications. It then describes the main mechanisms of epigenetics and, finally, addresses the analytical process and presents the authors' proposal to consider the archetypal expression in the light of epigenetics.Dans cet article nous étudions la question de l’épigénétique en montrant quelques mécanismes en lien avec l’expression d’un gène. Nous pensons que, d’une certaine manière, ces mécanismes peuvent être utilisés en tant que métaphores des mouvements qui se produisent durant le processus thérapeutique. La possibilité d’un dialogue entre l’épigénétique et la psychologie analytique commence par la question héréditaire et archétypale, et prend forme dans la dimension de la rencontre analytique. A travers le modèle de l’attitude Jungienne nous proposons une manière de circuler d’une science à l’autre. Cet article offre un bref examen du concept d’archétype, couvrant les publications récentes. Il décrit ensuite les mécanismes principaux de l’épigénétique et s’occupe finalement du processus analytique en présentant la proposition de l’auteur qui est de considérer l’expression archétypale à la lumière de l’épigénétique.In diesem Beitrag gehen wir der Frage der Epigenetik nach, indem wir einige Mechanismen im Zusammenhang mit der Genexpression aufzeigen, die unseres Erachtens in gewisser Weise als Metaphern für Bewegungen verwendet werden können, die während des therapeutischen Prozesses auftreten. Die Möglichkeit eines Dialogs zwischen Epigenetik und Analytischer Psychologie beginnt mit der Frage nach dem Erblichen und dem Archetypischen und nimmt in der Dimension der analytischen Begegnung Gestalt an. Mit Hilfe des Jungianische Einstellungsmodell schlagen wir einen Weg vor, sich zwischen zwei Wissenschaften zu bewegen. Dieser Aufsatz bietet einen kurzen Überblick über das Konzept des Archetyps und deckt aktuelle Veröffentlichungen ab. Anschließend werden die Hauptmechanismen der Epigenetik beschrieben, schließlich der analytische Prozeß thematisiert und der Vorschlag des Autors vorgestellt, den archetypischen Ausdruck im Lichte der Epigenetik zu betrachten.In questo articolo affrontiamo la questione dell’epigenetica mettendo in evidenza alcuni meccanismi legati all’espressione genica che, comprendiamo, possono in un certo senso essere usati come metafore per i movimenti che si verificano durante il processo terapeutico. La possibilità di un dialogo tra epigenetica e psicologia analitica inizia con la questione ereditaria ed archetipica e prende forma nella dimensione dell’incontro analitico. Attraverso il modello junghiano, proponiamo un modo di muoversi tra le due scienze. Questo articolo fornisce una breve rassegna del concetto di archetipo, coprendo le pubblicazioni recenti. Descrive quindi i principali meccanismi dell’epigenetica e, infine, affronta il processo analitico e presenta la proposta degli Autori di considerare l’espressione analitica alla luce dell’epigenetica.В данной статье мы обращаемся к вопросам эпигенетики и рассматриваем ряд механизмов, связанных с экспрессией генов и спобоных, по нашему мнению, служить метафорами изменений, происходящих в ходе терапевтического процесса. Началом возможного диалога между эпигенетикой и аналитической психологией может стать вопрос о наследственности и архетипах, а полностью он разворачивается в контексте аналитической встречи. Мы предлагаем вариант диалога между этими двумя направлениями, базирующийся на юнгианской модели отношений. В данной статье представлен краткий обзор последних публикаций по теме архетипов. Затем описываются основные механизмы эпигенетики, и, наконец, разбирается аналитический процесс и приводится предложение автора рассматривать архетипическую экспрессию через призму эпигенетики.En este trabajo abordamos el tema de la epigenética al evidenciar algunos mecanismos relacionados con la expresión genética, la cual puede ser utilizada como metáforas para los movimientos que suceden durante el proceso terapéutico. La posibilidad de un diálogo entre epigenética y psicología analítica comienza con la pregunta sobre la herencia y el arquetipo y toma forma en la dimensión del encuentro analítico. A través del modelo de actitud analítica, proponemos una forma de movimiento entre dos ciencias. El presente trabajo ofrece una breve revisión del concepto de arquetipo, abarcando publicaciones recientes. Luego describe los mecanismos principales de la epigenética y finalmente, aborda el proceso analítico y presenta la propuesta de las autoras de considerar la expresión arquetípica a la luz de la epigenética.原型与表观遗传学:近似:表观遗传学对分析心理学临床实践的贡献 在本文中, 我们通过证明一些与基因表达相关的机制来理解表观遗传学的问题, 据我们了解, 这些机制在某种程度上可以作为一种隐喻来比喻治疗过程中正在发生的运动。 表观遗传学和分析心理学之间对话的可能性始于遗传和原型问题, 并在分析性相遇的维度中得以成型。通过荣格的态度模型, 我们提出了一种在两种科学之间移动的方法。 本文简要回顾了原型的概念, 并涵盖了最近的出版物。然后描述了表观遗传学的主要机制, 探讨了分析性的过程, 并提出了作者的建议, 即根据表观遗传学来考虑原型的表达。.Neste artigo, abordamos a questão da epigenética evidenciando alguns mecanismos relacionados à expressão gênica, que, entendemos, podem de certa forma ser usados como metáforas para movimentos que ocorrem durante o processo terapêutico. A possibilidade de um diálogo entre epigenética e psicologia analítica começa com a questão hereditária e arquetípica e toma forma na dimensão do encontro analítico. Através do modelo de atitude junguiana, propomos uma maneira de nos mover entre duas ciências. Este artigo fornece uma breve revisão do conceito de arquétipo, abrangendo publicações recentes. Em seguida, descreve os principais mecanismos da epigenética e, finalmente, aborda o processo analítico e apresenta a proposta do autor de considerar a expressão arquetípica à luz da epigenética.

Among the aspects with major impacts on the energy and environmental performance of a building, the thermal insulation of the opaque elements of its envelope stands out. This work assesses the influence of the application of thermal insulation to the opaque elements of the building’s envelope on the thermal comfort conditions indoors; moreover, the influence of the thermal insulation on the energy, environmental, and economic costs over the building’s complete life cycle is evaluated. For this purpose, the three most commonly used thermal insulating materials (expanded polystyrene—EPS, extruded polystyrene—XPS, and mineral wool—MW), thicknesses between 0 (without insulation) and 40 cm, five climates (hot, warm, moderate, cold, and very cold), and six types of use (apartment, housing, clinic, school, bank branch, and supermarket) were considered. EPS reveals itself to be the most promising thermal insulation material, both in economic and environmental terms, so it was selected for this study. The EPS’ optimal thickness depends on the building’s type of use, the climate, and the perspective from which the assessment is carried out (energy, environmental, or economic). The results show that the economically optimal thicknesses of thermal insulation are significantly lower than the corresponding ones in environmental terms. Furthermore, the application of thermal insulation to the opaque building’s envelope is more beneficial in energy and environmental terms than from an economic perspective.

The Agulhas rings transport warm and salty waters that feed the surface limb of the Atlantic Meridional Overturning Circulation. Some studies have focused on the conveying capacity of ocean eddies, and recently, the role of the Agulhas rings in advecting water masses and organisms has been explored. Here we show evidence that the Agulhas rings are responsible for the advection of mode waters from the Cape Basin to the western side of the Atlantic. We analyzed more than 3,200 temperature profiles and 2,400 salinity profiles from historical databases collocated with 52 long-lived Agulhas rings tracked from 1993 through 2016. An automated algorithm was used to identify thermostads in the profiles acquired within the rings. The data revealed mode water layers trapped inside 88% of the rings. The joint distribution of temperature and salinity indicated two types of mode waters in the range 16.2 ± 0.6°C, 35.6 ± 0.1 (Type I) and 12.9 ± 0.7°C, 35.2 ± 0.1 (Type II). The majority (67%) of the rings carrying mode waters had both types detected inside. Moreover, considering only those rings sampled west of the Mid-Atlantic Ridge, we found that 45% of them advected mode waters to the western basin. Therefore, our results demonstrate that, despite the long journey, interaction with the bottom topography and other vortices, ocean-atmosphere exchanges, and decay, the Agulhas rings are responsible for spreading mode waters initially available at the Cape Basin throughout the South Atlantic, contributing to a positive anomaly in temperature and salinity along the eddy corridor joining the Cape Basin to the Brazil Basin.

This article proposes a denoiser for hyperspectral (HS) images that consider, not only spatial features, but also spectral features. The method starts by projecting the noisy (observed) HS data onto a lower dimensional subspace and then learns a Gaussian mixture model (GMM) from 3-D patches or blocks extracted from the projected data cube. Afterward, the minimum mean squared error (MMSE) estimates of the blocks are obtained in closed form and returned to their original positions. Experiments show that the proposed algorithm is able to outperform other state-of-the-art methods under Gaussian and Poissonian noise and to reconstruct high-quality images in the presence of stripes.

A methodology that combines a 24-year long (January 1993 to December 2016) global dataset of eddy trajectories, derived from altimetry, with vertical temperature and salinity profiles from the EN4.2.0 database, derived from XBTs/MBTs, CTDs and Argo floats, was used to reconstruct the mean vertical structure of North Brazil Current (NBC) rings, and to calculate some of their properties. The number of NBC rings formed each year varied from 2 to 8, with an annual-mean formation of 5.3 ± 1.5. During the analyzed period, 112 rings were sampled at least once, at various distances from the center of the rings, leading to a total of 1323 (604) temperature (salinity) profiles available to compute the mean NBC ring, depicting a large, surface intensified, and relatively shallow ring, with intense temperature and salinity anomalies. The meridional volume transport was estimated in 1.3 Sv (1Sv = 106 m3s-1) per ring, leading to an annualized transport of ~7 ± 2 Sv. The amount of South Atlantic Water (SAW) within the mean ring was estimated in ~40 to 60% of the ring volume. According to these estimates, NBC rings may be responsible in different years for approximately 20 to 80% of the northward volume transport associated with the upper limb of the Atlantic Meridional Overturning Circulation (AMOC), and approximately 15 to 55% of the meridional heat transport in the tropical Atlantic.

Aggregate segregation in concretes, especially in lightweight aggregate concretes (LWAC), is a pathology that can seriously impact on different material properties, both in terms of mechanical strength and durability. Some studies have already analysed the impact of this phenomenon in the compressive strength of LWAC , almost always adopting segregation quantification methods based on the comparison of variables such as weight or density measured in sections extracted from cylindrical samples. Although the methods used so far are simple and easy to apply, in certain circumstances they may not offer sufficient accuracy to measure the phenomenon. Moreover, the analysis of segregation in LWAC, which due to the lower density of aggregates in relation to the mortar matrix occurs in the opposite direction to the segregation of conventional concretes (from bottom to top), has not been widely studied so far. The analysis of the cross sections of cylindrical concrete samples through image analysis techniques has been increasingly used to estimate parameters related to the distribution of materials inside them. This study aims to measure the impact of segregation on the compressive strength of LWAC cylindrical specimens, employing an image analysis technique capable of quantifying the phenomenon with a more accurate segregation index. During the experimental campaign 22 scenarios were defined, combining different types of aggregate, vibration methods and vibration times, to achieve different levels of segregation. Among the main results it can be noted that the impact of the type of moulding (one layer vs. two layers) considerably affected the mechanical properties of concrete, with concretes vibrated in two layers showing a maximum reduction in compressive strength due to segregation of 9%, while concretes vibrated in only one layer showed reductions ranging from 63% to 118%. Analyzing the type of rupture of the samples, the study identifies the appearance of well-defined compression cones in samples where segregation is excessive, with 90% of the cases presenting this type of rupture and that the size of the compression cone increases as the effect of segregation is accentuated. This research was funded by the University of Alicante ((GRE13-03) and (VIGROB-256)).

Submitted by Jorge Silva (jorgelmsilva@ufrrj.br) on 2022-05-11T20:05:44Z No. of bitstreams: 1 2022 - M?rcio Alves Afonso.pdf: 1053166 bytes, checksum: c87246ce1b3d2120d4a3ed1690d3e35f (MD5) Made available in DSpace on 2022-05-11T20:05:44Z (GMT). No. of bitstreams: 1 2022 - M?rcio Alves Afonso.pdf: 1053166 bytes, checksum: c87246ce1b3d2120d4a3ed1690d3e35f (MD5) Previous issue date: 2022-01-06 CAPES - Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior This paper addressed the teaching of mathematics contextualized in elementary school II with the aim of analyzing dissertations that used contextualization as a pedagogical tool for teaching mathematics. We present in this work, through the teaching of contextualized mathematics, possible ways to make classes more enjoyable and achieve a better understanding of the concepts by the students. Thus, we searched in the literature ways to enrich our understanding of the meaning of using mathematical contextualization in classroom. The question that guided this dissertation was: how has contextualization been used to promote teaching and makeclasses more interesting and enjoyable? To answer this question, we basedthis dissertation on the importance of using authors who defend the use of mathematical contextualization in a school teaching system. To achieve our general objective, we analyzed fourteen dissertations that addressed the topic of contextualization in elementary school in the period from 2016 to 2020 present in CAPES's directory of theses and dissertations. After analyzing the dissertations in dialogue with our theoretical frame, it was possible to conclude that, yes, it is possible to provide quality teaching with more enjoyable classes. Este trabalho abordou o ensino de Matem?tica contextualizado no Ensino Fundamental II com o objetivo de analisar disserta??es que utilizaram a contextualiza??o como instrumento pedag?gico para o ensino de Matem?tica. Apresentamos neste trabalho, por meio do ensino da matem?tica contextualizada, poss?veis caminhos para tornar as aulas mais agrad?veis e alcan?ar um melhor entendimento dos conceitos pelos alunos. Assim, buscamos na literatura meios de enriquecer nosso entendimento sobre o significado da utiliza??o da contextualiza??o matem?tica em sala de aula. A quest?o que norteou esta disserta??o foi: como a contextualiza??o vem sendo utilizada de modo a promover o ensino e tornar as aulas mais interessantes e prazerosas? Para responder a esta pergunta, buscamos fundamentar esta disserta??o destacando a import?ncia de utilizar autores que defendam a utiliza??o desta contextualiza??o matem?tica em um sistema de ensino escolar. Para alcan?armos nosso objetivo geral, analisamos quatorze disserta??es que abordaram o tema contextualiza??o no Ensino Fundamental no per?odo de 2016 a 2020 presentes no cat?logo de teses e disserta??es da CAPES. Ap?s analisarmos as disserta??es dialogando com nosso referencial te?rico, foi poss?vel concluir que, sim, ? poss?vel proporcionar ensino de qualidade com aulas mais agrad?veis.

Synthetic Aperture Radar (SAR) provides high resolution images for a multitude of applications. The main purpose of this work is to provide the reader to get accustomed to application oriented SAR data processing and visualization. This goal is achieved using BAE SYSTEMS SOCET GXP® software tool. The obtained results present a solid approach by using the tool for the exploitation of SAR images as a source for geospatial information and data regarding water resource detection, terrain feature extraction, vegetation health assessment among other applications.

A series of workshops and exchanges have been conducted in the last years in order to increase the precision of age estimation of European hake (1997, 1999, 2001, 2003). The last exchange in 2003 was undertaken mainly due to uncertainty in age estimation of older fish. In 2002 the ICES Working Group on Hake, Monk and Megrim (WGHMM) had shown difficulties in the assessment of hake stocks because of older ages primarily. This has led the WGHMM to continue to use a 8+ group. To address these problems a hake otolith exchange programme focused mainly on older fish was recommended between readersand subsequently an international workshop to discuss the results. Ages were estimated using internationally agreed ageing criteria, which have not been validated. The results of the 2003 otolith exchange programme indicate that the precision of age readings has decreased compared with the precision of the 2001 exchange and a strong bias has been found in estimates of older fish. The overall Average Percent of Error (APE) and coefficient of variation (CV) obtained in 2003 were 35 and 48% respectively while those obtained in 2001 were 19 and 25%, respectively. This loss of precision highlights the problems associated with applying ageing criteria, which are not validated. A second reading of a subset of the otolith collection used in the 2003 was done during the 2004 workshop. The results indicate that ageing fish older than 3 years is not possible with an acceptable level of precision. In addition, recent results from mark-recapture experiments have provided evidence that ages estimated using the internationally agreed criteria are overestimated (De Pontual et al., 2003). Taking into account the two aspects referred, the used of age readings data in stock assessment can introduce high uncertainty. Therefore, the workshop recommends to interrupt the supply of age reading data to elaborate Age Length Keys (ALK) for the WGHMM until validated ageing criteria become available.

Supplementary Materials - The following are available online at https://www.mdpi.com/article/10.3390/pharmacy9040194/s1, Table S1: Summary of the identified Prescribing-Assessment Tools., Medicines are the most used health technology in Long-Term Care. The prevalence of potentially inappropriate medicines amongst Long-Term Care patients is high. Pharmacists, assisted by prescribing-assessment tools, can play an important role in optimizing medication use at this level of care. Through a modified RAND/UCLA Appropriateness Method, 13 long-term care and hospital pharmacists assessed as ‘appropriate’, ‘uncertain’, or ‘inappropriate’ a collection of commonly used prescribing-assessment tools as to its suitability in assisting pharmacy practice in institutional long-term care settings. A qualitative analysis of written or transcribed comments of participants was pursued to identify relevant characteristics of prescribing-assessment tools and potential hinders in their use. From 24 different tools, pharmacists classified 9 as ‘appropriate’ for pharmacy practice targeted to long-term care patients, while 3 were classified as ‘inappropriate’. The tools feature most appreciated by study participants was the indication of alternatives to potentially inappropriate medication. Lack of time and/or pharmacists and limited access to clinical information seems to be the most relevant hinders for prescribing-assessment tools used in daily practice.

Leveraging current state-of-the-art denoisers to tackle other inverse problems in imaging is a challenging task, which has recently been the topic of significant research effort. In this paper, we present several contributions to this research front, based on two fundamental building blocks: 1) the recently proposed plug-and-play framework, which allows combining iterative algorithms for imaging inverse problems with state-of-the-art image denoisers, used in black-box fashion; and 2) patch-based denoisers, using Gaussian mixture models (GMM). We exploit the adaptability of GMM to learn class-adapted denoisers, which opens the door to embedding a patch classification step in the algorithmic loop, yielding simultaneous restoration and semantic segmentation. We apply the proposed approach to several standard imaging inverse problems (deblurring, compressive sensing reconstruction, and super-resolution), obtaining results that are competitive with the state of the art.

Near-inertial oscillations (NIO) are intermittent motions with a frequency close to the inertial frequency and represent an important fraction of the energy to the currents in the upper ocean. Based on hourly velocity records at the shelf break covering the top 50 m of the water column in 5 locations and one additional location at Cabo Frio upwelling system (22° S) covering the top 200 m of water column with hourly velocity and temperature measurements, the aim of the present study is to characterize NIO along the Brazilian continental shelf break (16° S–31.5° S) describing the spatial variability of inertial energy in the mixed layer and the role of the NIO in the high-frequency hydrodynamic. The sites between 31.5° S and 28.5° S were those that revealed more near-inertial energy and higher relative importance of the near-inertial band for the variance of the currents (29% and 31%, respectively). This is associated with the proximity between the inertial frequency and the sea breeze frequency in this region, which delimits an inertial resonance area for the NIO around 30° S. The near-inertial currents between 31.5° S and 23.5° S range between 30 and 50 cm s−1 and decrease toward the locations at lower latitudes, where the range is between 5 and 25 cm s−1. Vertical shear of the order of 10−3 s−1 was reached during NIO events between 31.5° S and 23.5° S in the upper layer of the ocean (mixed layer, seasonal thermocline, and upper permanent thermocline) and can play an important role in the vertical mixing along the Brazilian continental shelf break. The NIO events analyzed at Cabo Frio upwelling system exhibited a mean duration of around 7.6 days, upward vertical phase velocity of the order of 10−1 cm s−1, vertical wavelengths of the order of 102 m, and vertical downward group velocity of the order of 10−2 cm s−1. Nevertheless, the magnitude of the vertical propagation of energy and duration of the events demonstrate the importance of NIO as a source of kinetic energy to the ocean interior.

Ionic liquids are critical reagents for science and technical processes nowadays. Metals are the most used reagents in the industry. It is crucial to have a deeper understanding of how ionic liquids and metals could interact. In this article the interaction of those two families of compounds is accessed. The dissolution (reaction) of metals with ionic liquids is studied, namely the influence of temperature, redox potential, and availability of an oxidant in the process. The final state achieved by the iron metal samples was also addressed by Mössbauer spectroscopy.

CRISPR interference (CRISPRi) is a powerful tool to link essential and nonessential genes to specific phenotypes and to explore their functions. Here we describe a protocol for CRISPRi screenings to assess genome-wide gene fitness in a single sequencing step (CRISPRi-seq). We demonstrate the use of the protocol in Streptococcus pneumoniae, an important human pathogen; however, the protocol can easily be adapted for use in other organisms. The protocol includes a pipeline for single-guide RNA library design, workflows for pooled CRISPRi library construction, growth assays and sequencing steps, a read analysis tool (2FAST2Q) and instructions for fitness quantification. We describe how to make an IPTG-inducible system with small libraries that are easy to handle and cost-effective and overcome bottleneck issues, which can be a problem when using similar, transposon mutagenesis-based methods. Ultimately, the procedure yields a fitness score per single-guide RNA target for any given growth condition. A genome-wide screening can be finished in 1 week with a constructed library. Data analysis and follow-up confirmation experiments can be completed in another 2-3 weeks.

Key summary pointsAim To investigate pharmacists' interventions and impact at institutional Long-Term Care (LTC) settings, particularly the therapeutic outcomes in elderly populations. Findings LTC pharmacists deliver a comprehensive set of activities, especially in clinical pharmacy (e.g. medication review, deprescribing) and education, addressing elderly populations under LTC and their therapeutic needs. Message Pharmacists' expertise in medicines optimisation is a useful resource in improving healthcare towards institutionalised LTC patients, often a geriatric population. Purpose Long-Term Care (LTC) systems have experienced recent developments driven by changes in healthcare and demography (e.g. population ageing). As well, pharmacists are changing from traditional roles to more patient-oriented services. The present study aimed to identify and assess pharmacists' and/or pharmacy-based interventions in institutional LTC settings, also mapping relevant medications. Methods The review was undertaken in general accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), using three main literature databases (PubMed, Scopus, and Web of Knowledge). A set of 16 keywords, divided into three domains (professional, type of care and type of setting), were combined into search equations. Selected studies were assessed through the Quality Assessment Tool for Quantitative Studies. Results Twenty-six studies met the inclusion criteria, out of 794 initial hits. Most studies (12) described pharmacist/pharmacy-driven interventions assessing Medication Management Reviews' impact in different endpoints or outcomes. Other studies (3) assessed pharmacists' interventions on specific medication groups. Good Administration Practices, new pharmaceutical care models, antibiotic stewardship programs, and studies assessing other pharmacists' interventions, such as pharmacy-managed informatics and education, were addressed by 11 other papers. Six studies were classified as Strong after quality assessment. Conclusion LTC is a clinically complex type of care benefiting from interdisciplinary work. Despite the overall lower quality of the identified studies, pharmacists perform in a wide array of LTC areas. The broad implementation of pharmaceutical activities in institutional LTC settings opens opportunities to optimise medicines' use. info:eu-repo/semantics/publishedVersion

Background: Community pharmacy teams (CPTs) have an established role in assisting self-medication, contributing to the safe and effective use of non-prescription medicines. Objective: The study aimed to describe CPTs’ performance in self-medication consultation, client-reported outcomes, and satisfaction. A secondary purpose was to develop an explanatory model for better understanding clients’ satisfaction with this service. Methods: Descriptive, cross-sectional exploratory study. Data were collected in a purposive sample of pharmacy clients recruited in six community pharmacies in Portugal. CPTs adopted a structured approach to self-medication consultations, encompassing 11 quality criteria (five for case evaluation and six for counselling). An evaluation score, a counselling score and an overall quality score were estimated. Client-reported outcomes and satisfaction were ascertained via a follow-up telephone interview. Besides descriptive statistics, the association with several independent variables on the clients’ overall satisfaction was explored, using linear regression. Results: Product-based dispensing was more frequent for lower educated clients. Reported compliance with the criteria by CPTs was overall high (93.95% of maximum compliance), mostly missing the ‘other medication’ questioning. Most clients (93%) reported improvement after the consultation. Clients’ satisfaction score was 4.70 out of 5. The variables that seem to better explain clients’ overall satisfaction are pharmacy loyalty, the evaluation score, and the female gender. Conclusions: Clients’ reported outcomes were favourable, as well as satisfaction with the service. Clients’ satisfaction appears to be determined by consultation quality (evaluation score), suggesting the advancement of the pharmacists’ clinical role. A larger study is warranted to confirm these findings.

Background: Community pharmacy teams (CPTs) have an established role in assisting self-medication, contributing to the safe and effective use of non-prescription medicines. Objective: The study aimed to describe CPTs’ performance in self-medication consultation, client-reported outcomes, and satisfaction. A secondary purpose was to develop an explanatory model for better understanding clients’ satisfaction with this service. Methods: Descriptive, cross-sectional exploratory study. Data were collected in a purposive sample of pharmacy clients recruited in six community pharmacies in Portugal. CPTs adopted a structured approach to self-medication consultations, encompassing 11 quality criteria (five for case evaluation and six for counselling). An evaluation score, a counselling score and an overall quality score were estimated. Client-reported outcomes and satisfaction were ascertained via a follow-up telephone interview. Besides descriptive statistics, the association with several independent variables on the clients’ overall satisfaction was explored, using linear regression. Results: Product-based dispensing was more frequent for lower educated clients. Reported compliance with the criteria by CPTs was overall high (93.95% of maximum compliance), mostly missing the ‘other medication’ questioning. Most clients (93%) reported improvement after the consultation. Clients’ satisfaction score was 4.70 out of 5. The variables that seem to better explain clients’ overall satisfaction are pharmacy loyalty, the evaluation score, and the female gender. Conclusions: Clients’ reported outcomes were favourable, as well as satisfaction with the service. Clients’ satisfaction appears to be determined by consultation quality (evaluation score), suggesting the advancement of the pharmacists’ clinical role. A larger study is warranted to confirm these findings. publishersversion published

Coastal ocean observing and modeling systems (coastal observatories), connected with regional and global ocean systems, improve the quality of information and forecasts for effective management of safe and sustainable maritime activities. The public availability of systematic and long-term information of the ocean is an engine for the Blue Economy, boosting economic growth, employment, and innovation. An overview of some Brazilian initiatives is presented in this paper, involving universities, private companies, federal and state agencies, covering institutions from south to north of Brazil. Although these initiatives focus mainly on ocean physics, integrated efforts can extend the scope to include biogeochemistry and marine biodiversity, helping to address interdisciplinary problems. Existing initiatives can be connected, and new ones fostered, to fill in the gaps of temporal and spatial coverage of ocean monitoring in the vast oceanic area under Brazilian jurisdiction (nationally referred to as the Blue Amazon, in reference to the similar richness of the Amazon Forest). The alignment among national and regional initiatives, as well as with international programs, can be promoted if coordinated by a national-level organization, maximizing the return of public investment and socioeconomic benefits. In light of international examples, possible future institutional arrangements are discussed, leveraging from existing national public policies and international cooperation that Brazil is taking part. The United Nations Decade of Ocean Science for Sustainable Development is a timely opportunity to encourage an institutional arrangement to support and articulate an integrated network of coastal observatories in Brazil.

Long-Term Care (LTC) systems have experienced recent developments driven by changes in healthcare and demography (e.g. population ageing). As well, pharmacists are changing from traditional roles to more patient-oriented services. The present study aimed to identify and assess pharmacists' and/or pharmacy-based interventions in institutional LTC settings, also mapping relevant medications.The review was undertaken in general accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), using three main literature databases (PubMed, Scopus, and Web of Knowledge). A set of 16 keywords, divided into three domains (professional, type of care and type of setting), were combined into search equations. Selected studies were assessed through the Quality Assessment Tool for Quantitative Studies.Twenty-six studies met the inclusion criteria, out of 794 initial hits. Most studies (12) described pharmacist/pharmacy-driven interventions assessing Medication Management Reviews' impact in different endpoints or outcomes. Other studies (3) assessed pharmacists' interventions on specific medication groups. Good Administration Practices, new pharmaceutical care models, antibiotic stewardship programs, and studies assessing other pharmacists' interventions, such as pharmacy-managed informatics and education, were addressed by 11 other papers. Six studies were classified as Strong after quality assessment.LTC is a clinically complex type of care benefiting from interdisciplinary work. Despite the overall lower quality of the identified studies, pharmacists perform in a wide array of LTC areas. The broad implementation of pharmaceutical activities in institutional LTC settings opens opportunities to optimise medicines' use.

Objective: To evaluate the training and standardization methods of multiple simulated patients (SPs) performing a single scenario in a multicenter study. Methods: A prospective quasi-experimental study, using a multicenter approach, evaluated the performance of five different individuals with the same biotype during a simulation session in a high-fidelity environment. The SPs training and standardization process consisted of four steps and six web or face-to-face mediated: Step 1: simulation scenario design and pilot test. Step 2: SPs selection, recruitment and beginning training (Session 1: performance instructions and memorization request.) Session 2: check the SPs’ performances and adjustments). Step 3 and session 3: training role-play and performance's evaluation. Step 4: SPs’ standardization and performances’ evaluation (Sessions 4 and 5: first and second rounds of SPs’ standardization assessment. Session 6: Global training and standardization evaluation. SPs performance consistency was estimated using Cronbach's alpha and ICC. Results: In the evaluation of training results, the Maastricht Simulated Patient Assessment dimensions of SPs performances “It seems authentic”, “Can be a real patient” and “Answered questions naturally”, presented “moderate or complete agreement” of all evaluators. The dimensions “Seems to retain information unnecessarily”, “Remains in his/her role all the time”, “Challenges/tests the student”, and “Simulates physical complaints in an unrealistic way” presented “moderate or complete disagreement” in all evaluations. The SPs “Appearance fits the role” showed “moderate or complete agreement” in most evaluations. In the second round of evaluations, the SPs had better performance than the first ones. This could indicate the training process's had good influence on SPs performances. The Cronbach's alpha in the second assessment was better than the first (varied from 0.699 to 0.978). The same improvement occurred in the second round of intraclass correlation coefficient that was between 0.424 and 0.978. The SPs were satisfied with the training method and standardization process. They could perceive improvement on their role-play authenticity. Conclusions: The SPs training and standardization process revealed good SPs reliability and simulation reproducibility, demonstrating to be a feasible method for SPs standardization in multicenter studies. The Maastricht Simulated Patient Assessment was regarded as missing the assessment of the information consistency between the simulation script and the SPs provision.

We propose a new approach to image fusion, inspired by the recent plug-and-play (PnP) framework. In PnP, a denoiser is treated as a black-box and plugged into an iterative algorithm, taking the place of the proximity operator of some convex regularizer, which is formally equivalent to a denoising operation. This approach offers flexibility and excellent performance, but convergence may be hard to analyze, as most state-of-the-art denoisers lack an explicit underlying objective function. Here, we propose using a scene-adapted denoiser (i.e., targeted to the specific scene being imaged) plugged into the iterations of the alternating direction method of multipliers (ADMM). This approach, which is a natural choice for image fusion problems, not only yields state-of-the-art results, but it also allows proving convergence of the resulting algorithm. The proposed method is tested on two different problems: hyperspectral fusion/sharpening and fusion of blurred-noisy image pairs.

The shedding of Agulhas rings is the primary process connecting the Indian and Atlantic oceans. The rings transport warm and salty waters that feed the surface limb of the Atlantic Meridional Overturning Circulation. Early studies suggest that Agulhas rings decay and diffuse their contents within the South Atlantic subtropical gyre. In this paper, we update the ring census using an automated algorithm to detect and track eddies over more than 23 years of satellite altimetry data (1993–2016) and calculate their main characteristics. While 140 rings spawned from the Agulhas Retroflection, their following splitting and merging resulted in 74 long-lived rings that crossed the Walvis Ridge and translated towards the west. Eventually, three rings reached the western boundary. For one of them, we use in situ measurements to document its interaction with the Brazil Current and two cyclonic eddies, which resulted in a current velocity increase by three times. Although already hypothesized, this interaction had not been demonstrated with in situ evidence until now.

Associações simbióticas de espécies arbóreas com fungos micorrízicos podem proporcionar o maior crescimento e nutrição das mudas, sendo alternativas importantes para o estabelecimento no campo, principalmente em áreas com restrições edáficas ou para espécies com alta exigência nutricional. No Brasil, o cultivo de Tectona grandis (teca) tem sido realizado em regiões do cerrado, em solos de baixa fertilidade. O presente trabalho objetivou avaliar o efeito da inoculação de fungos micorrízicos arbusculares (FMAs) sobre o crescimento e nutrição mineral de mudas de teca. O experimento foi realizado em delineamento em blocos casualizados (seis blocos), com quatro tratamentos: 1) Testemunha (sem inoculação de fungos micorrízicos); 2) Inoculação com Rhizophagus clarus; 3) Inóculo de FMAs obtido de plantio de teca no Mato Grosso (inóculo MT) com vinte anos; e 4) Inóculo de FMAs nativos de cava de extração de argila de Campos dos Goytacazes (inóculo de Campos). As plântulas foram inoculadas e cultivadas em vasos de 6 dm3, por 135 dias, e foram avaliadas quanto à altura e ao diâmetro da base do caule. Amostras de raízes foram coletadas para avaliação da porcentagem de colonização com FMAs. As raízes e a parte aérea foram secas, separadamente, em estufa de circulação forçada de ar (a 650C por 72 horas) e em seguida determinada a massa seca e teores de P, K e S. A inoculação com fungos micorrízicos, principalmente o isolado de Rhizophagus clarus e o inóculo de Campos, proporcionou maior crescimento e maior aquisição em relação a K e S das mudas de teca. A inoculação com os fungos micorrízicos proporcionou maior eficiência de utilização de nutrientes.

The objective of this study is to apply data-based models to improve sea level prediction along the southeastern Brazilian coast. Focus is placed on the atmospheric-forced low-frequency variability ( ∼ 0,3 to 0,03 day −1), which is associated primarily with propagation of Coastal Trapped Waves along the continental shelf, and possibly with local wind forcing. Process-based hydrodynamic models, that solve complex physical equations to simulate a dynamical system, have been traditionally used to predict sea level. These models, however, may present inaccuracies related to their physical formulation, numerical approximations, unresolved small scale processes, model parameterizations, or initial and boundary conditions. A combined approach, using a neural network to update the outputs of a hydrodynamic model (Hycom) in order to correct the errors, allows for the integration of all available knowledge to generate more reliable predictions. Time series of coastal sea level at three stations (Cananeia, Ilha Fiscal and Imbituba) and atmospheric data from the CFSR reanalysis were used to train the data-based model. A novel methodology to preprocess the input data is presented, and it was critical to the reduction of predictions errors. Correlation maps between coastal sea level and the atmospheric forcing were calculated, and the areas of highest correlation were defined. While a purely data-based model is able to match the predictions of the hydrodynamic model for these stations, the combined approach goes a step further, reducing the errors in ∼ 50% for the frequency band of the atmospherically forced sea level variability.

Background: Patients who have experienced a cardiovascular clinical event such as a myocardial infarction or stroke qualify for intensive risk factor evaluation and management. The aim of this study is to explore lifestyle changes as well as the achievement of targets for risk factors in patients with established cardiovascular disease. Methods: Cross-sectional study conducted in primary care practices. The study was carried out in six European countries (Croatia, France, Portugal, Slovenia, Spain and Turkey). Patients with established cardiovascular disease (coronary heart disease and stroke) attended in primary care were selected and assessed from January to June 2016. Patients were recruited and assessed at the practice by research assistants between 6 months and 3 years after the event. Statistical comparisons were done with the unpaired two-sided Student's t-test for continuous variables and Chi-square test for categorical variables. Results: Nine hundred and seventy-three patients (32.4% females) were assessed. About 14% of them were smokers, 32% were physically inactive, and 30% had nutritionally poor eating behaviours. LDL cholesterol target value below 70 mg/dl was achieved in about 23% of patients, and in general, women were less cardio-protected by drugs than men. Conclusions: Many patients with established cardiovascular disease who attended in general practice still fail to achieve the lifestyle, risk factor, and therapeutic targets set by European guidelines. These results are relevant to general practitioners because these patients have a high risk of subsequent cardiovascular events, including MI, stroke, and death. © 2019 The Author(s). Slovenia Institute of Infection and Immunity Sveucilište u Zagrebu: Croatia National coordinators obtained approval from local research ethics committees in each country to conduct the survey. The approval of the ethics committee of the coordinating centre was done on June 10th 2015, with the reference number 4R15/117 (IDIAP Jordi Gol). The approval of the ethics committee of other centres were done by the Commitee for Medical Ethics of Heath Ministry of Slovenia (Slovenia), the Ethics Committee of the Yeditepe University, Faculty of Medicine (Turkey), Comité de Protection des Personnes (CPP) Sud-Ouest et Outre Mer III and Comité Consultatif sur le Traitement de l'Information en matière de Recherche dans le domaine de la Santé (CCTIRS), (France), the Ethics Commitee of Medical faculty University of Zagreb (Croatia) and the Health Ethics Committee of the Regional Health Administration of Northern Portugal (Portugal).

This study investigates the propagation of coastal trapped waves (CTWs) along the Brazilian continental shelf between 34°S and 11°S using in situ data combined with the outputs from a high-resolution ocean simulation with HYCOM. The CTWs generation area covers a wide region ranging from the Patagonian shelf to the southern Brazilian shelf. The spectral analysis of coastal sea level series between 54°S and 10.5°S shows three bands of high energy associated with periods from 5 to 12 days, 15–22 days, and 25–40 days. The energy of the CTWs decreases along their propagation for all frequency bands, showing a drastic reduction north of 22°S, due to abrupt variations in the width and depth of the continental shelf between Tubarao Bight and Abrolhos Bank. Their phase speed propagation varies along the coast, being faster (>25 m/s) in the southernmost region (between 42°S and 41°S), reaching ~11 m/s north of 41°S, and reducing to ~3 m/s further north (equatorward of 24°S). The free Continental Shelf Wave theory supports the notion that the intense deceleration north of 24°S can be explained by the narrowing of the continental shelf. The stratification parameter indicates that the Brazilian continental shelf has a barotropic response to wind-generated disturbances.

L’articolo analizza la relazione tra "memoria e complesso". Le autrici discutono la psicologia complessa proposta da Jung e il possibile nesso con l’ipotesi della transdisciplinarieta. La teoria junghiana contempla la possibilita strutturale di usufuire di vari tipi di conoscenze: scientifiche, religiose, filosofiche, mitologiche, alchemiche e cosi via. Le autrici cercano di lavorare dalla stessa prospettiva che le teorie della transdisciplinarieta assegnano al concetto di identita. La vera sfida consiste nel lavorare in maniera integrata, provando ad analizzare i singoli aspetti senza che nessuno predomini, riuscendo a considerare ogni fenomeno in tutte le sue sfaccettature.

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info:eu-repo/semantics/publishedVersion

It is very important for investors, market regulators, and policy makers to possess a trustworthy ex-ante tool capable of anticipating price exuberance events. This paper proposes a new statistical mechanism to predict speculative bubbles by inferring a significant probability of exuberance at least one step ahead of a bubble peak period. Contrary to other approaches, we combine asset pricing modeling and non-stationarity statistical analysis and use both in the context of adaptive learning to build a dynamic model specification. Monte Carlo simulations show that the ex-ante prediction is improved enormously by adding the estimated abnormal returns into the model. In some cases our mechanism predicts 100% of the last bubbles of the sample up to five periods before the peak. Furthermore, the mechanism is able to successfully anticipate the technological bubble observed in the 1990’s by estimating a probability greater than 90%, one month before the bubble peak. Thus, this new mechanism provides an advantage for investors interested in performing a very profitable “bubble surfing” strategy and for market regulators whose responsibility is to maintain market efficiency. info:eu-repo/semantics/publishedVersion

Lagrangian floats and current meter measurements from two moored arrays are analyzed, in combination with altimetry data, in order to investigate the recirculation of Antarctic Intermediate Waters (AAIW), and of the Intermediate Western Boundary Current (IWBC) at the Tubarao Bight, in the vicinity of the Vitoria-Trindade Ridge (VTR), Brazil. Results from a high-resolution numerical simulation provide a complementary view of the flow at intermediate and surface levels. The data depict a topographically-induced cyclonic recirculation at intermediate levels, and five Argo floats are successively trapped inside the bight for two-and-a-half years, performing a total of 10 closed clockwise gyres during this period of time. In situ measurements at the western side of the bight show an intense alongshore flow at intermediate levels, with averaged velocities at 800 m of ~30 cm/s, and peak velocities exceeding 50 cm/s, magnitudes comparable to the Brazil Current (BC) flow at surface levels. The recirculation extends from at least 1000 m deep up to 370 m, reaching sometimes depths as shallow as 150 m, but is mostly uncoupled from the surface flow during the one-and-a-half year long current meter record. Three different flow patterns are observed, and simulated, at surface levels inside the bight during the time the recirculation is well established at intermediate levels: a shallow cyclonic circulation, somewhat akin to the Vitoria Eddy; a recurrent anticyclonic flow that encompasses the entire bight; and a southwestward-oriented circulation, associated with the BC being reorganized in a coherent flow after negotiating its way through the VTR channels. A significant portion (about 50% according to the model) of the inflow of intermediate waters recirculates, enhancing the flow of the IWBC within the bight, and increasing the age of AAIW that will eventually cross the VTR on its way to lower latitudes. Although the data are not conclusive about a preferential pathway of the intermediate flow across the VTR, the simulation indicates that up to 70% will exit through the main channel located between the Besnard Bank and the Vitoria Seamount, while 30% will follow eastward to the south of the VTR, in a region of intense mesoscale activity, and then cross the ridge farther east.

Contains fulltext : 175752.pdf (Publisher’s version ) (Closed access) BACKGROUND: Medical education in Sub-Saharan Africa is in need of reform to promote the number and quality of physicians trained. Curriculum change and innovation in this region, however, face a challenging context that may affect curriculum outcomes. Research on outcomes of curriculum innovation in Sub-Saharan Africa is scarce. We investigated curriculum outcomes in a Sub-Saharan African context by comparing students' perceived preparedness for practice within three curricula in Mozambique: a conventional curriculum and two innovative curricula. Both innovative curricula used problem-based learning and community-based education. METHODS: We conducted a comparative mixed methods study. We adapted a validated questionnaire on perceived professional competencies and administered it to 5th year students of the three curricula (n = 140). We conducted semi-structured interviews with 5th year students from these curricula (n = 12). Additional contextual information was collected. Statistical and thematic analyses were conducted. RESULTS: Perceived preparedness for practice of students from the conventional curriculum was significantly lower than for students from one innovative curriculum, but significantly higher than for students from the other innovative curriculum. Major human and material resource issues and disorganization impeded the latter's sense of preparedness. Both innovative curricula, however, stimulated a more holistic approach among students toward patients, as well an inquiring and independent attitude, which is valuable preparation for Sub-Saharan African healthcare. DISCUSSION: In Sub-Saharan Africa, risks and benefits of curriculum innovation are high. Positive outcomes add value to local healthcare in terms of doctors' meaningful preparedness for practice, but instead outcomes can be negative due to the implementation challenges sometimes found in Sub-Saharan African contexts. Before embarking on innovative curriculum reform, medical schools need to assess their capability and motivation for innovation.

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Los isoprenoides forman la familia más amplia de metabolitos naturales y son especialmente diversos en el reino vegetal. Muchos isoprenoides vegetales con funciones esenciales y especializadas derivan del geranilgeranil difosfato (GGPP). La biosíntesis de este precursor es catalizada por la familia de proteínas GGPP sintasa (GGPPS), que ha sido estudiada principalmente en Arabidopsis thaliana. Esta planta modelo consta de cinco genes parálogos que codifican para GGPPSs con diferentes localizaciones subcelulares. Curiosamente, sólo la ausencia del gen que codifica para la isoforma AtG11 produce letalidad, ya que es esencial para el desarrollo embrionario y del cloroplasto. Poco se sabe acerca de las enzimas GGPPS y su regulación en especies vegetales de interés humano. Los objetivos de esta tesis han sido (1) descifrar el mecanismo molecular responsable de la dualidad de fenotipos letales observados en diferentes alelos de pérdida de función del gen AtG11, y (2) identificar los miembros de la familia GGPPS en tomate (Solanum lycopersicum) y caracterizar el papel de las isoformas plastídicas en la biosíntesis de nutrientes beneficiosos para la salud que derivan del GGPP como son los carotenoides. En la primera parte de la tesis demostramos que el gen AtG11 produce tránscritos de diferente longitud que resultan en dos enzimas GGPPS diferencialmente localizadas. Las transcripciones largas se traducen en una proteína de localización plastídica que produce GGPP para la síntesis de isoprenoides involucrados en la fotosíntesis, como clorofilas y carotenoides. La pérdida de función de esta isoforma resulta en un fenotipo albino letal. Los tránscritos cortos, en cambio, carecen del primer codón ATG pero se traducen a partir de un segundo codón ATG que mantiene el marco de lectura. La proteína resultante mantiene la actividad GGPPS pero permanece en el citoplasma debido a la pérdida del péptido de tránsito al plasto en la región N terminal. Esta isoforma corta produce GGPP citosólico que es necesario para la progresión del desarrollo embrionario más allá de la etapa de corazón. En el segundo capítulo mostramos que los cinco genes que codifican para posibles GGPPSs en tomate dan lugar a proteínas con diferente distribución subcelular. Entre ellos encontramos que tres isoformas se localizan en plastos (SlG1, SlG2 y SlG3) y que están asociadas a la síntesis de carotenoides de forma específica en diferentes tejidos vegetales. El gen SlG1 se induce durante la micorrización donde se necesitan metabolitos derivados de carotenoides. La expresión de SlG2 se asocia principalmente a procesos fotosintéticos donde los carotenoides actúan como fotoprotectores. Finalmente, encontramos que el gen SlG3 se activa mayoritariamente durante la maduración del fruto donde se acumulan pigmentos de tipo carotenoide de alto valor nutricional. Los perfiles de expresión específicos y la localización subcelular diferencial sugieren una fuerte subfuncionalización de estos genes. Los datos presentados en esta tesis contribuyen a entender mejor la complejidad de la familia GGPPS en plantas. Esta información será útil para diseñar estrategias genéticas para generar plantas que produzcan metabolitos derivados de GGPP de alto interés en tejidos o compartimentos celulares particulares de forma más sostenible. Isoprenoids form the largest family of metabolites in nature and are especially abundant and diverse in the plant kingdom. Many plant isoprenoids with essential and specialized functions derive from geranylgeranyl diphosphate (GGPP). The biosynthesis of this isoprenoid precursor is catalyzed by the GGPP synthase (GGPPS) protein family. The GGPPS family has been most studied in Arabidopsis thaliana. In this model plant, five gene paralogs encode differentially localized GGPPS isoforms. Strikingly, only the disruption of the gene encoding the AtG11 isoform results in lethality as it is essential for chloroplast and embryo development. Little is known about GGPPS enzymes and their regulation in other plant species of human interest. The goals of this thesis have been (1) to unveil the molecular mechanism responsible for the duality of lethal phenotypes observed in AtG11 loss-of-function alleles, and (2) to identify the members of the GGPPS family in Solanum lycopersicum (tomato) and characterize the contribution of the plastidial isoforms to the biosynthesis of GGPP-derived health-promoting nutrients such as carotenoids. In the first part of the thesis we demonstrate that the AtG11 gene produces transcripts of different lengths that result in two differentially targeted GGPPS enzymes. Longer transcripts encode a plastid-targeted enzyme that produces GGPP for isoprenoids involved in photosynthesis, including chlorophylls and carotenoids. Loss of function of this activity results in an albino-lethal phenotype. Shorter transcripts, instead, lack the first ATG codon but are translated from a second in-frame ATG codon. The resulting protein retains GGPPS activity but remains in the cytosol due to the loss of the N-terminal plastid-targeting peptide. This shorter isoform produces GGPP that is required for the progression of embryo development beyond the heart stage. In the second chapter, we show that the five putative GGPPS-encoding genes that are present in the tomato genome encode proteins with different subcellular localizations. Among them, three GGPPS isoforms were found to be targeted to plastids (SlG1, SlG2 and SlG3) and to be specifically associated with carotenoid biosynthesis in particular plant tissues. The SlG1 gene was induced during root mycorrhization where carotenoid-derived metabolites are required. SlG2 expression was mainly associated to photosynthetic processes, where carotenoids act as photoprotectants. Finally, SlG3 was mostly activated during fruit ripening, when carotenoid pigments with high nutritional value are accumulated. The isoform-specific transcriptional profiles and the differential subcellular distribution suggest a strong subfunctionalization of these paralog genes. The data provided in this thesis contribute to understand the complexity of the GGPPS protein family in plants. This information will be useful to design sustainable strategies to manipulate plants for optimal production of specific groups of GGPP-derived metabolites in particular tissues and subcellular compartments.

RESUMO Associações simbióticas de espécies arbóreas com fungos micorrízicos podem proporcionar o maior crescimento e nutrição das mudas, sendo alternativas importantes para o estabelecimento no campo, principalmente em áreas com restrições edáficas ou para espécies com alta exigência nutricional. No Brasil, o cultivo de Tectona grandis (teca) tem sido realizado em regiões do cerrado, em solos de baixa fertilidade. O presente trabalho objetivou avaliar o efeito da inoculação de fungos micorrízicos arbusculares (FMAs) sobre o crescimento e nutrição mineral de mudas de teca. O experimento foi realizado em delineamento em blocos casualizados (seis blocos), com quatro tratamentos: 1) Testemunha (sem inoculação de fungos micorrízicos); 2) Inoculação com Rhizophagus clarus; 3) Inóculo de FMAs obtido de plantio de teca no Mato Grosso (inóculo MT) com vinte anos; e 4) Inóculo de FMAs nativos de cava de extração de argila de Campos dos Goytacazes (inóculo de Campos). As plântulas foram inoculadas e cultivadas em vasos de 6 dm3, por 135 dias, e foram avaliadas quanto à altura e ao diâmetro da base do caule. Amostras de raízes foram coletadas para avaliação da porcentagem de colonização com FMAs. As raízes e a parte aérea foram secas, separadamente, em estufa de circulação forçada de ar (a 650C por 72 horas) e em seguida determinada a massa seca e teores de P, K e S. A inoculação com fungos micorrízicos, principalmente o isolado de Rhizophagus clarus e o inóculo de Campos, proporcionou maior crescimento e maior aquisição em relação a K e S das mudas de teca. A inoculação com os fungos micorrízicos proporcionou maior eficiência de utilização de nutrientes. ABSTRACT Symbiotic associations between tree species and mycorrhizal fungi may lead to better growth and nutrition of seedlings and so it becomes an important alternative to the establishment in the field, mainly in edaphic restriction areas, or to species of high nutritional demands. The cultivation of Tectona grandis (teca) in Brazil has been conducted in Cerrado areas with low fertility soils. The aim of the present study is to assess the effect of arbuscular mycorrhizal fungi (AMF) inoculation on the growth and mineral nutrition of teca seedlings. The experiment was performed in randomized blocks (six blocks), with four repetitions: 1) witness (inoculation-free mycorrhizal fungi); 2) inoculation with Rhizophagus clarus; 3) native AMF inoculum from twenty-year old teca cultivation in Mato Grosso state (MT inoculum); and 4) native AMF inoculum from clay extraction in Campos do Goytacazes (Campos inoculum). The plantlets were inoculated and cultivated in 6 dm³ pots for 135 days and assessed for stem hight and diameter of the stem base. Root samples were collected in order to assess the percentage of AMF colonization. The roots and the aerial part were dried, separately, in a forced air circulation oven at 65°C for 72 hours. Subsequently, the dry weight and the content of P, K AND S were determined. The mycorrhizal fungi inoculation, mainly the Rhizophagus clarus isolate and the Campos inoculum, has promoted better growth and K and S acquisition by teca seedlings. The inoculation using mycorrhizal fungi allowed greater nutrient use efficiency.

In the present work, nine years of altimetry data are analyzed in combination with sea surface temperature and ocean color images in order to track Brazil Current eddies generated at Cape Sao Tome, Brazil. Direct evidences are presented that at least six eddies detach from the main current during this period giving rise to isolated rings. Two rings move southward, bordering the current, while four migrate northward, and translate in the direction of the Tubarao Bight. These rings eventually reach the bight, leading to a cyclonic circulation in that region that is analogous, at surface levels, to what would be observed during formation of the Vitoria Eddy. For one ring, the observations are complemented by in situ measurements: a Lagrangian surface drifter, an expandable bathythermograph section during the ring formation at Cape Sao Tome, and acoustic Doppler current profiler data during the ring formation and inside the bight. The cyclonic circulation within the bight in this occasion reaches levels much deeper than those previously reported for locally-generated eddies. These results indicate that properties of shelf and slope waters near Cape Sao Tome can be carried upstream the Brazil Current, eventually influencing the coastal waters further north, with possible ecological and environmental implications.

Inclui bibliografia. Este trabalho apresenta as primeiras observações diretas de maré interna na região da Cadeia Vitória Trindade (CVT). Uma linha de fundeio instrumentada foi lançada próximo ao Monte Montague, onde permaneceu por 8 meses registrando dados de temperatura, sa

Objective: To update the recommendations for the treatment of axial spondyloarthritis (axSpA) with biological therapies, endorsed by the Portuguese Society of Rheumatology. Methods: These treatment recommendations were formulated by Portuguese rheumatologists based on lite - rature evidence and consensus opinion. At a national meeting, the recommendations included in this document were discussed and updated. A draft of the full text of the recommendations was then circulated and suggestions were incorporated. A final version was again circulated before publication and the level of agreement among Portuguese Rheumatologists was anonymously assessed using an online survey. Results: A consensus was achieved regarding the initiation, assessment of response and switching of biological therapies in patients with axSpA. In total, se ven recommendations were produced. The first recommendation is a general statement indicating that biological therapy is not a first-line drug treatment option and should only be used after conventional treatment has failed. The second recommendation is also a ge - neral statement about the broad concept of axSpA adopted by these recommendations that includes both non-radiographic and radiographic axSpA. Recommendations 3 to 7 deal with the definition of active di - sease (including the recommended threshold of 2.1 for the Ankylosing Spondylitis Disease Activity Score [ASDAS] or the threshold of 4 [0-10 scale] for the Bath Ankylosing Spondylitis Disease Activity Index [BASDAI]), conventional treatment failure (nonsteroidal anti-inflammatory drugs being the first-line drug treatment), assessment of response to treatment (based on an ASDAS improvement of at least 1.1 units or a BASDAI improvement of at least 2 units [0-10 scale] or at least 50%), and strategy in the presence of an ina -dequate response (where switching is recommended) or in the presence of long-term remission (where a process of biological therapy optimization can be consi - dered, either a gradual increase in the interval between doses or a decrease of each dose of the biological the - rapy). Conclusion: These recommendations may be used for guidance in deciding which patients with axSpA should be treated with biological therapies. They co - ver a rapidly evolving area of therapeutic intervention. As more evidence becomes available and more biological therapies are licensed, these recommendations will have to be updated. publishersversion published

The recently proposed plug-and-play (PnP) framework allows leveraging recent developments in image denoising to tackle other, more involved, imaging inverse problems. In a PnP method, a black-box denoiser is plugged into an iterative algorithm, taking the place of a formal denoising step that corresponds to the proximity operator of some convex regularizer. While this approach offers flexibility and excellent performance, convergence of the resulting algorithm may be hard to analyze, as most state-of-the-art denoisers lack an explicit underlying objective function. In this paper, we propose a PnP approach where a scene-adapted prior (i.e., where the denoiser is targeted to the specific scene being imaged) is plugged into ADMM (alternating direction method of multipliers), and prove convergence of the resulting algorithm. Finally, we apply the proposed framework in two different imaging inverse problems: hyperspectral sharpening/fusion and image deblurring from blurred/noisy image pairs., Submitted

Thyroid carcinoma is the most common endocrine neoplasia. Differentiated thyroid carcinomas (DTCs) represent the majority of cases, which usually follow an indolent clinical course with low mortality rates. The authors describe two cases of well DTC without classic histological poor prognosis features, presenting as extensive and unresectable osteolytic bone metastases. DTCs are considered harmless tumours, due to their benign and silent behaviour. The authors want to underline the importance of clinical awareness during follow-up in cases of DTC, which can be aggressive in presentation and behaviour. Timely identification and diagnosis of these tumours are essential for prompt treatment initiation and improvement of overall survival.

This paper proposes using both spatial and spectral regularizers/priors for hyperspectral image sharpening. Leveraging the recent plug-and-play framework, we plug two Gaussian-mixture-based denoisers into the iterations of an alternating direction method of multipliers (ADMM): a spatial regularizer learned from the observed multispectral image, and a spectral regularizer trained using the hyperspectral data. The proposed approach achieves very competitive results, improving the performance over using a single regularizer. Furthermore, the spectral regularizer can be used to classify the image pixels, opening the door to class-adapted models.

Item does not contain fulltext BACKGROUND: Evidence tailored to sub-Saharan Africa on outcomes of innovations in medical education is needed to encourage and advance their implementation in this region. AIM: To investigate preparedness for practice of students and graduates from an innovative and a conventional medical curriculum in a sub-Saharan African context. METHODS: Using mixed methods we compared junior doctors and fifth-year students from two Mozambican medical schools: one with an innovative problem- and community-based curriculum and one with a conventional lecture- and discipline-based curriculum. A questionnaire on professional competencies was administered, semi-structured interviews were conducted, and work diaries were collected. The findings were integrated in a conceptual model. RESULTS: Six areas of tension between global health care ideals and local health care practice emerged from the data that challenged doctors' motivation and preparedness for practice. Four elements of the innovative curriculum equipped students and graduates with skills, attitudes and competencies to better cope with these tensions. Students and graduates from the innovative curriculum rated significantly higher levels on various competencies and expressed more satisfaction with the curriculum and its usefulness for their work. CONCLUSION: An innovative problem- and community-based curriculum can improve sub-Saharan African doctors' motivation and preparedness to tackle the challenges of health care practice in this region.

Objective: To characterize the inclusion of the teaching of communication skills in the curriculum of Pharmacy Schools of Federal Institutions of Higher Education. Methods: An exploratory study of documental analysis of curriculum of Pharmacy Schools was carried out. A convenience sample was selected from undergraduate pharmacy courses of Federal Institutions of Higher Education (IFES). The variables collected were related to the identification of the course, its nature (elective or mandatory), workload, semester, and program content. Results: Among the 49 undergraduate pharmacy courses of IFES, 35 (71.4%) had their curriculum available online. The teaching of communication in health was identified in 26 (74.3%) curriculum. In this study, three courses (7.2%) specifically aimed at teaching communication skills, while 39 (92.9%) had content related to this subject. Most courses (22; 52.4%) belonged to the field of Social, Behavioral, and Administrative Sciences. As for the course period, there was a concentration in the third (19%) and fourth (28.6%) years. The main content present in the curriculum was related to the principles and techniques of health communication (42.8%). Conclusions: Data obtained enabled the identification of gaps in the curricula of undergraduate courses in pharmacy concerning the inclusion of the teaching of communication skills. These results can be used to reflect the current models adopted in Brazil for the teaching of this skills, especially after the recent publication of the new curricular guidelines for undergraduate pharmacy courses.

This paper addresses the problem of fusing hyperspectral (HS) images of low spatial resolution and multispectral (MS) images of high spatial resolution into images of high spatial and spectral resolution. By assuming that the target image lives in a low dimensional subspace, the problem is formulated with respect to the latent representation coefficients. Our major contributions are: (i) using patch-based spatial priors, learned from the MS image, for the latent images of coefficients; (ii) exploiting the so-called plug-and-play approach, wherein a state-of-the-art denoiser is plugged into the iterations of a variable splitting algorithm.