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The present study aimed to establish, using the bioremediation technique, the most efficient treatment strategy for remediation of a sandy soil that is artificially contaminated with light crude oil. The experiment was conducted for 180 days to monitor the biodegradation of oils and greases (OG’s), aliphatic hydrocarbons (AHs), and polyaromatic hydrocarbons (PAHs). The removal of these compounds was evaluated using three different strategies, the addition of nutrients (III), addition of a biosurfactant produced from Pseudomonas sp. (IV), and the addition of the biosurfactant plus nutrients (V). The remediation strategies were compared with the control containing only soil (I) and the control with natural crude oil attenuation (II). At the end of the study, it was observed that the strategies III and V showed the best OG’s removal rates, i.e., 90.40% and 78.00%, the best AHs removal rates, i.e., 96.82% and 98.35%, and best PAH removal rates, i.e., 83.58% and 72.3% respectively. Based on the above results, it was concluded that the bioestimulation methods are important tools in the remediation of the environment impacted by oil spills. In addition, the study suggests that the knowledge of the native microbiota is important to improve the efficiency of these bioestimulation techniques.

The establishment of monospecific eucalypt plantations has increased considerably over the last half-century. At present, eucalypts are the tree species that are planted most widely across the world, and the common practice of soil mobilization prior to their planting has been associated with negative effects on soil functions such as nutrient and water cycling, carbon sequestration, soil erosion control and soil biodiversity conservation. In Central Portugal, the construction of bench terraces for eucalypt plantations areas has become increasingly common on steep terrain. Bench terrace construction implies the mobilization of large quantities of topsoil and, hence, elevated installation costs that are justified by the advantages in planting, fertilizer application, mechanical and agrichemical weed control and, ultimately, salvage logging and extraction of wood and logging residues. Although terraces are a traditional soil and water conservation technique, the hydrological impacts of bench terracing for forest plantations have been poorly studied. The use of heavy machinery in forests has been reported to increase soil compaction and bulk density and, thereby, decrease soil infiltration capacity and increase runoff generation. At the same time, the flat sections of bench terraces will increase not only infiltration of rainfall but also re-infiltration of run-on, for example from the adjacent risers or diverted forest tracks. In the case of eucalypt plantations, (re-)infiltration patterns may be strongly affected by soil water repellency (SWR), as eucalypts have been widely associated with strong to extreme SWR, especially during dry periods. This study aimed to quantify the short- to long-term impacts of bench terrace construction on SWR in eucalypt plantations along a chrono-sequence. To this end, SWR was measured in-situ, using the Methanol droplet (MED) test, for four different periods of time-since-terracing, i.e. 0, 5, 10 and 17 years after terracing. For each of these periods, three pairs of nearby terraced and non-terraced eucalypt plantations were studied, giving a total of 24 study sites. The MED measurements were done during the dry summer of 2020 (in plain covid-19 crisis conditions). The results showed clear differences in SWR between terraced and non-terraced eucalypt plantations. The median SWR was extreme in all non-terraced sites (MED classes 7 to 8) as opposed to highly variable at the terraced sites, ranging from wettable to strong (MED classes 0 to 6). In the case of the terraced sites, the time elapsed since terrace construction had a major impact. The median SWR was very wettable immediately as well as 5 years after terracing, while it was moderate and strong water repellent 10 and 17 years after terracing.

Play is a very important activity for children development and there are evidences that it can be an added value when used for educational purposes. Research about how to integrate play in education points to the importance of teacher role, namely how children play can be scaffold and guided. However, there is also lack of agreement about how to guide children playing and the impact of the guidance in the activity development and competences promoted. Given the characteristics of automata, especially the fact that they include a narrative and a mechanism, they can be used within a play based pedagogy, to implement activities related to plan and construct toys and to promote competences as observation, problem solving, creativity in the STEM areas. To explore this potential of moving toys to promote STEM in the early years of schooling is the aim of the Erasmus + AutoSTEM project. This work aims to describe the main objectives and resources of the AutoSTEM project, including the description of a workshop to construct a toy with a sliding mechanism, the Jelly Bird. The procedures involved the presentation and observation of the toy, detailed instructions on how to construct it, the decoration and the elaboration of a narrative about it. 23 children from the 2nd year of basic education participated in the workshop. The analysis of the prototypes shows that all the participants built them properly. Also some alternative ideas to the proposal initially presented emerged, as well as a diversity of narratives. These data suggest that the instructions enhanced the construction of the prototype, but did not inhibit the creativity of the work developed.

The motivation and interest of children and young people in science areas remains a challenge for contemporary education, and there is also evidence of the importance of its promotion since the early years of schooling as well as the use of interdisciplinary approaches. The Erasmus + AutoSTEM project aims to analyse the potential of constructing automata or “moving toys” as a motivation strategy for learning in the areas of science, technology, engineering and mathematics (STEM), in the early years of schooling. The characteristics of the automata, namely the fact that they have a narrative part and a mechanism, allow, in a playful approach, to implement activities related to the planning and construction of those toys and to enhance skills such as observation, problem solving, creativity and also skills in the referred STEM areas. In this work, the description of the implementation and evaluation of automata workshops in a school of the 1st year of basic education is made. The data were collected based on direct observation focusing on dimensions of engagement and a questionnaire regarding interest, perception of learning, difficulties experienced, suggestions for improvement. Results evidence that the children showed curiosity for the prototypes presented, having immediately designed their own project, explored materials and completed the construction, in some cases with their own proposals. The perceived difficulties vary according to the age, as well as the type of mechanism chosen.

A hortela ( Mentha x villosa Huds.) consta na Relacao Nacional de Plantas Medicinais de Interesse ao SUS (RENISUS) devido ao reconhecimento de suas propriedades medicinais, dentre elas a atividade antiparasitaria. Dentre as etapas do processamento pos-colheita de plantas medicinais, destaca-se a secagem como etapa critica e essencial para a conservacao dos compostos bioativos vegetais. Desta forma, objetivou-se avaliar o efeito da temperatura de secagem sobre o rendimento e a qualidade fitoquimica do oleo essencial extraido de folhas de hortela. Realizou-se o cultivo em sistema orgânico em Oratorios, Minas Gerais, Brasil. Os ramos de hortela foram colhidos e as folhas destacadas e submetidas a secagem em estufa de circulacao forcada de ar a 40, 50 e 60 °C. A extracao do oleo essencial foi feita por hidrodestilacao em aparelho Clevenger, e para identificacao dos constituintes quimicos utilizou-se a cromatografia gasosa acoplada ao espectrofotometro de massas (CG-MS). Constatou-se reducao (P

Resumen El leiomiosarcoma de la piel se clasifica en tres grupos: dermico, hipodermico y cutaneo metastasico. El dermico se origina de las fibras musculares lisas del musculo erector del pelo, dartos genital o de la areola mamaria. Se considera un tumor de malignidad intermedia, con tendencia a la recidiva local (24%) y un bajo riesgo de metastasis (4%). El leiomiosarcoma hipodermico se origina de las paredes musculares de los vasos, y se caracteriza por presentar una mayor tasa de recidiva local (37%) y metastasis (43%). El sarcoma pelomorfico dermico aparece habitualmente en pacientes ancianos y se localiza caracteristicamente en zonas de piel fotoexpuesta (cuero cabelludo). Comparte caracteristicas histologicas e inmunohistoquimicas con el fibroxantoma atipico, pero con un comportamiento mas agresivo (metastasis en el 10-20%). Los criterios histologicos que lo diferencian son la infiltracion del tejido celular subcutaneo, la infiltracion perineural y la presencia de focos de necrosis.

There are 3 types of leiomyosarcoma of the skin: dermal, subcutaneous, and metastatic cutaneous. Dermal leiomyosarcoma arises from smooth muscle fibers in arrector pili muscles, genital dartos muscles, and the nipple-areola complex. It is an intermediate-grade tumor associated with a tendency for local recurrence (24%) and low metastatic potential (4%). Subcutaneous leiomyosarcoma originates from smooth muscle in blood vessel walls and has higher rates of local recurrence (37%) and metastasis (43%). Plemorphic dermal sarcoma typically affects elderly patients and arises in sun-exposed areas (e.g., the scalp). Its histologic and immunohistochemical characteristics are similar to those of atypical fibroxanthoma, but it is more aggressive (metastasis rate of 10-20%). Histologically, it can be distinguished from atypical fibroxanthoma by the observation of subcutaneous tissue invasion, perineural invasion, and foci of necrosis.

Full list of authors: Morgado, B. E.; Sicardy, B.; Braga-Ribas, F.; Desmars, J.; Gomes-Júnior, A. R.; Bérard, D.; Leiva, R.; Ortiz, J. L.; Vieira-Martins, R.; Benedetti-Rossi, G.; Santos-Sanz, P.; Camargo, J. I. B.; Duffard, R.; Rommel, F. L.; Assafin, M.; Boufleur, R. C.; Colas, F.; Kretlow, M.; Beisker, W.; Sfair, R.; Snodgrass, C.; Morales, N.; Fernández-Valenzuela, E.; Amaral, L. S.; Amarante, A.; Artola, R. A.; Backes, M.; Bath, K. -L.; Bouley, S.; Buie, M. W.; Cacella, P.; Colazo, C. A.; Colque, J. P.; Dauvergne, J. -L.; Dominik, M.; Emilio, M.; Erickson, C.; Evans, R.; Fabrega-Polleri, J.; Garcia-Lambas, D.; Giacchini, B. L.; Hanna, W.; Herald, D.; Hesler, G.; Hinse, T. C.; Jacques, C.; Jehin, E.; Jørgensen, U. G.; Kerr, S.; Kouprianov, V.; Levine, S. E.; Linder, T.; Maley, P. D.; Machado, D. I.; Maquet, L.; Maury, A.; Melia, R.; Meza, E.; Mondon, B.; Moura, T.; Newman, J.; Payet, T.; Pereira, C. L.; Pollock, J.; Poltronieri, R. C.; Quispe-Huaynasi, F.; Reichart, D.; de Santana, T.; Schneiter, E. M.; Sieyra, M. V.; Skottfelt, J.; Soulier, J. F.; Starck, M.; Thierry, P.; Torres, P. J.; Trabuco, L. L.; Unda-Sanzana, E.; Yamashita, T. A. R.; Winter, O. C.; Zapata, A.; Zuluaga, C. A.--This is an Open Access article, published by EDP Sciences, under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited., Context. The Centaur (10199) Chariklo has the first ring system discovered around a small object. It was first observed using stellar occultation in 2013. Stellar occultations allow sizes and shapes to be determined with kilometre accuracy, and provide the characteristics of the occulting object and its vicinity. Aims. Using stellar occultations observed between 2017 and 2020, our aim is to constrain the physical parameters of Chariklo and its rings. We also determine the structure of the rings, and obtain precise astrometrical positions of Chariklo. Methods. We predicted and organised several observational campaigns of stellar occultations by Chariklo. Occultation light curves were measured from the datasets, from which ingress and egress times, and the ring widths and opacity values were obtained. These measurements, combined with results from previous works, allow us to obtain significant constraints on Chariklo's shape and ring structure. Results. We characterise Chariklo's ring system (C1R and C2R), and obtain radii and pole orientations that are consistent with, but more accurate than, results from previous occultations. We confirm the detection of W-shaped structures within C1R and an evident variation in radial width. The observed width ranges between 4.8 and 9.1 km with a mean value of 6.5 km. One dual observation (visible and red) does not reveal any differences in the C1R opacity profiles, indicating a ring particle size larger than a few microns. The C1R ring eccentricity is found to be smaller than 0.022 (3σ), and its width variations may indicate an eccentricity higher than ~0.005. We fit a tri-axial shape to Chariklo's detections over 11 occultations, and determine that Chariklo is consistent with an ellipsoid with semi-axes of 143.8-1.5+1.4, 135.2-2.8+1.4, and 99.1-2.7+5.4 km. Ultimately, we provided seven astrometric positions at a milliarcsecond accuracy level, based on Gaia EDR3, and use it to improve Chariklo's ephemeris. © B. E. Morgado et al. 2021., This work was carried out within the “Lucky Star” umbrella that agglomerates the efforts of the Paris, Granada and Rio teams, which is funded by the European Research Council under the European Community’s H2020 (ERC Grant Agreement No. 669416). This research made use of SORA, a python package for stellar occultations reduction and analysis, developed with the support of ERC Lucky Star and LIneA/Brazil, within the collaboration Rio-Paris-Granada teams. This work has made use of data from the European Space Agency (ESA) mission Gaia (https://www.cosmos.esa.int/gaia), processed by the Gaia Data Processing and Analysis Consortium (DPAC, https://www.cosmos.esa.int/web/gaia/dpac/consortium). Part of this research is suported by INCT do e-Universo, Brazil (CNPQ grants 465376/2014-2). Based in part on observations made at the Laboratório Nacional de Astrofísica (LNA), Itajubá-MG, Brazil. The data include observations taken by the MiNDSTEp team at the Danish 1.54 m telescope at ESO’s La Silla observatory” and “UGJ acknowledges funding from the European Union H2020-MSCA-ITN-2019 under grant no. 860470 (CHAMELEON) and from the Novo Nordisk Foundation Interdisciplinary Synergy Programme grant no. NNF19OC0057374. TRAPPIST-South is funded by the Belgian Fund for Scientific Research (Fond National de la Recherche Scientifique, FNRS) under the grant PDR T.0120.21. The authors acknowledge the use of Sonja Itting-Enke’s C14 telescope and the facilities at the Cuno Hoffmeister Memorial Observatory (CHMO). The following authors acknowledge the respective CNPq grants: BEM 150612/2020-6; FB-R 314772/2020-0; RV-M 304544/2017-f5, 401903/2016-8; JIBC 308150/2016-3 and 305917/2019-6; MA 427700/2018-3, 310683/2017-3, 473002/2013-2. G.B.R. acknowledges CAPES-FAPERJ/PAPDRJ grant E26/203.173/2016 and CAPES-PRINT/UNESP grant 88887.571156/2020-00, MA FAPERJ grant E-26/111.488/2013 and ARGJr FAPESP grant 2018/11239-8. J.L.O., P.S.-S., R.D., and N.M. acknowledge financial support from the State Agency for Research of the Spanish MCIU through the “Center of Excellence Severo Ochoa” award to the Instituto de Astrofísica de Andalucía (SEV-2017-0709), from Spanish project AYA2017-89637-R, and from FEDER. P.S.-S. acknowledges financial support by the Spanish grant AYA-RTI2018-098657-J-I00 “LEO-SBNAF” (MCIU/AEI/FEDER, UE). E. Jehin is a Belgian FNRS Senior Research Associate. R.S. and O.C.W. acknowledge FAPESP grant 2016/24561-0 and CNPq grant 305210/2018-1. T.C.H. acknowledges financial support from the National Research Foundation (NRF; No. 2019R1I1A1A01059609).

Long period gratings (LPGs) inscribed in single mode fibers (SMFs) using CO2 laser irradiation were modelled numerically using the coupled mode method. The model considers the specifications of the inscription technique, such as the shape of the refractive index modulation that mimics the circularly symmetric point-to-point laser irradiation profile. A simple expression for predicting the resonant wavelength was obtained assuming a two-mode coupling model. However, to explain the spectra of the experimental LPGs, it was necessary to assume a reasonably high refractive index change and a multimode coupling model. Furthermore, using the developed model and a genetic algorithm to fit experimental resonances to simulated ones, we were able to estimate the maximum refractive index change, obtaining a value of 2.2 × 10−3, confirming the high refractive index change. The proposed model also predicts a second order resonance for this high value of refractive index change that was confirmed experimentally. Hence, with this model, we found some significant differences in the LPGs behavior when compared with conventional ones, namely, the emergence of coupling between different cladding modes and the competition of first and second order resonances which change the LPG transmission spectrum.

High-sodium diet leads to significant health problems such as high blood pressure, chronic kidney disease, ventricular hypertrophy and stroke. In Brazil, 2008 survey data have shown an average intake of 4.7 g/day of sodium, equivalent to 12 g/day of salt. In 2014, the average ofsalt intake estimated was 9.3 g/day. In both surveys, the numbers are higher than the international recommendation of 5g/day of salt. Considering this excessive consumption and the invisibility of the major consequences of such lifestyle, the aim of this study was to estimate the burden of diseases due to a high-sodium diet in Brazil. We used the high-sodium diet attributable disability-adjusted life-years (DALYs) and deaths estimates of the Global Burden of Disease study in 2017 among Brazilian. The burden of high-sodium diet was assessed using a comparative risk assessment approach, which allows the calculation of the population attributable fraction of each disease that has an established relation with this behavior. Input data from Brazil to reach such estimates have included surveys that report the dietary sodium. Data on disease occurrence and mortality were obtained from health information systems and health surveys. In 2017, high-sodium diet contributed with a significant number of deaths (51,434, 95% U.I.: 9,266-105,118) and DALYs (988,258, 95% U.I.: 139,943-2,149,179) in Brazil. The states of Northern Region presented lower mortality rates (Roraima: 11.1/100,000; 95% U.I.: 1.5-24.0 and Amapa: 10.6/100,000; 1.5-23.5), while those in the Southeast have higher mortality rates (Rio de Janeiro: 33.2/100,000; 95% U.I.: 5.4-68.1 and São Paulo: 32.0/100,000; 95% U.I.: 3.5-49.6). The same pattern by states was observed for DALYs. These findings are significant and support the urgent necessity of strategies to reinforce the promotion of a healthy diet, restricted in ultra-processed foods high in sodium, among the Brazilian population in order to prevent early morbidity and mortality. Key messages Salt consumption in Brazil is high and contributes to a significant number of deaths and DALYs. It is necessary to increase and reinforce actions that promote the Brazilian traditional food, such as the Brazilian Food Guide, and also the sodium reduction agreements with industries.

Wildfires constitute a diffuse source of contamination to aquatic ecosystems. In burnt areas, the increase in surface runoff and associated sediment losses after fire, promotes the mobilization of hazardous substances, such as metals and polycyclic aromatic hydrocarbons (PAHs), posing a risk for the adjacent water bodies. In the present study, post-fire metals and PAHs export by surface runoff was evaluated in 16 m2 bounded plots in a eucalypt stand in Albergaria-a-Velha (Aveiro district, North-Central Portugal) burnt in September 2019. Runoff samples were collected on a weekly to bi-weekly basis, depending on the occurrence of rainfall, during the first 6 months after fire. The metals analyzed in this study were, vanadium (V), chromium (Cr), manganese (Mn), iron (Fe), cobalt (Co), nickel (Ni), copper (Cu), zinc (Zn), arsenic (As), cadmium (Cd) and lead (Pb). As for PAHs, the analyses focused on the 16 compounds classified as priority pollutants by the United States Environmental Protection Agency. Both dissolved and particulate fractions of metals and PAHs in runoff waters were analysed in this work. Preliminary results suggest that metals are more likely to affect the water quality of fire-affected water bodies than PAHs, since low levels of PAHs were found in runoff waters. This work provides valuable information for water managers to minimize the risks of wildfires both to the environment and to public health.

Recently burnt areas have frequently been documented to produce strong to extreme catchment-scale hydrological and erosion responses to major rainfall events, even if these responses have rarely been quantified. These responses have raised important concerns, both among forest owners and managers on the on-site implications of soil (fertility) loss and among water resources managers for the off-side impacts on downstream values-at-risk such as road and hydraulic infrastructures, flood zones, and surface water quality in reservoirs or at river intake points. State-of-the-art emergency stabilization management, as practiced in the USA and Galicia, aims at reducing the hydrological and erosion response at its main source, i.e. the hillslopes. Based on years and decades of experience and pain-staking field monitoring in both the USA and Galicia, mulching is typically preferred over barrier-based methods, especially for being more effective in the case of high-intensity rainfall storms. Even so, the LIFE-REFOREST consortium (LIFE17 ENV/ES/000248) has developed an innovative barrier-based technique that is designed to be implemented easier and faster than log and shrub barriers and, at the same time, to improve vegetation recovery, using seeds of plant species that establish vegetation strips against runoff and erosion and/or seeds of tree and shrub species for re- or afforestation. The REFOREST barriers consists of geotubes containing, besides seeds, a mycotechnosoil as well as straw. The effectiveness of the LIFE-REFOREST geotubes is current being tested under field conditions in summer-2019 burnt areas in north-central Portugal and Galicia, in contrasting forest types (eucalypt vs. pine) on contrasting parent materials (schist vs. granite). Both field trials involve, besides 3 control plots and 3 plots with geotubes, also 3 plots mulched with either eucalypt logging residues or pine needles. The present poster will show preliminary results of the field trial in north-central Portugal, in a second-rotation eucalypt stand where tree crowns were scorched by the fire and soil burn severity was classified as moderate. These results concern the initial monitoring period till early spring 2020. However, this monitoring period has been quite rainy so far, arguably providing rather ideal conditions for testing the effectiveness of barrier-based solutions such as that of LIFE-REFOREST.

The potential of

Associated with cement manufacturing processes, large amounts of carbon dioxide (CO2) are released into the atmosphere, and it is estimated that between 0.65 and 0.90 tons of CO2 are emitted per ton of cement manufactured. By 2050, the demand for this binder is expected to exceed 5000 million tons, which would contribute to an increase of more than 3% of emissions. However, the emissions can be reduced by using supplementary cementitious materials (SCMs); in this sense, calcined clays have a great potential for the reduction of emissions in the manufacture of cement. This has been studied in recent years with low carbon cement or LC3, developed by a joint team of the University of Lausanne and the Central University of Las Villas. The main results are the expansion of production by achieving clinker substitutions of up to 50%. In this sense, the Center for Research and Development of Technologies and Materials (CIDEM) in conjunction with the company IPIAC NERY has committed to the development of a small pilot plant that makes the manufacture of limited quantities of LC3, which allows the study of the process by interacting different sources of raw materials. In this paper, some calculations were for designing a pilot plant, taking into account the balance of mass and energy necessary for its proper functioning, which in turn allows to specify the technology for the scaling of the production in any new industrial plant or adaptation of capacities installed.

The potential of Iris pseudacorus and Typha domingensis to remove the pharmaceutical active compound (PhAC) Furosemide from a nutrient solution was assessed. Both plants were exposed to 2mg L 1 of furosemide during 21 days and the removal of furosemide was monitored. Vessels without furosemide were also implemented as control systems for plants development. Likewise, unplanted vessels with furosemide were employed to assess abiotic removal mechanisms. All vessels were covered with aluminum foil to avoid photodegradation of the compound. Both plants showed potential to remove Furosemide, attaining, at the end of the experiment, a removal of 42.0–66.9% and 40.5–57.8%, for Typha and Iris, respectively. The plants do not presented a visible negative stress response to the exposure to furosemide, having a positive growth rate at the end of the experiment. Biodegradation seems to play an important role in furosemide removal, being enhanced by the presence of the plants. The two macrophytes presented different removal behaviors, particularly in the first 48 h of contact time. FUR removal by Iris follows a pseudo-first order while by Typha is divide in different phases. These results indicate that different plants species seem to have different mechanisms to remove pollutants from water info:eu-repo/semantics/publishedVersion

Background: Primary chemotherapy has been tested as a possible approach for patients with high risk features but predicted clear mesorectal margins on preoperative MRI assessment. This study investigates the prognostic relevance of baseline and post-treatment MRI and pathology staging in rectal cancer patients undergoing primary chemotherapy. Patients and methods: Forty-six patients with T3 tumour> = 2mm from the mesorectal fascia were prospectively treated with Neoadjuvant Capecitabine, Oxaliplatin and Bevacizumab prior to surgery between 2009 and 2011. The baseline and posttreatment MRI: T, Nodal and Extra-mural venous invasion (EMVI) status were recorded as well as post-treatment MRI Tumour regression grade (TRG) and modified-RECIST assessment of tumour length. The post-treatment pathology (yp) assessments of T3 substage, N, EMVI and TRG status were also recorded. Three-year disease-free survival (DFS) and cumulative incidence of recurrence were estimated by using the Kaplan-Meier product-limit method, and Cox proportional hazards models were used to determine associations between staging and response on MRI and pathology with survival outcomes. Results: About 46 patients underwent neoadjuvant chemotherapy alone for high risk margin safe primary rectal cancer. The median follow-up was 41 months, 5 patients died and 11 patients experienced relapse (2 local, 8 distant and 1 both). In total 23/ 46 patients were identified with MRI features of EMVI at baseline. mrEMVI positive status carried independent prognostic significance for DFS (P = 0.0097) with a hazard ratio of 31.33 (95% CI: 2.3-425.4). The histopathologic factor that was of independent prognostic importance was a final ypT downstage of ypT3a or less, hazard ratio: 14.0 (95% CI: 1.5-132.5). Conclusions: mrEMVI is an independent prognostic factor at baseline for poor outcomes in rectal cancer treated with neoadjuvant chemotherapy while

Progress in astrometry and orbital modelling of planetary moons in the last decade enabled better determinations of their orbits. These studies need accurate positions spread over extended periods. We present the results of the 2014-2015 Brazilian campaign for 40 mutual events from 47 observed light curves by the Galilean satellites plus one eclipse of Amalthea by Ganymede. We also reanalysed and updated results for 25 mutual events observed in the 2009 campaign. All telescopes were equipped with narrow-band filters centred at 889 nm with a width of 15 nm to eliminate the scattered light from Jupiter. The albedos' ratio was determined using images before and after each event. We simulated images of moons, umbra, and penumbra in the sky plane, and integrated their fluxes to compute albedos, simulate light curves and fit them to the observed ones using a chi-square fitting procedure. For that, we used the complete version of the Oren-Nayer reflectance model. The relative satellite positions mean uncertainty was 11.2 mas ($\sim$35 km) and 10.1 mas ($\sim$31 km) for the 2014-2015 and 2009 campaigns respectively. The simulated and observed \textsc{ascii} light curve files are freely available in electronic form at the \textit{Natural Satellites DataBase} (NSDB). The 40/25 mutual events from our 2014-2015/2009 campaigns represent a significant contribution of 17%/15% in comparison with the PHEMU campaigns lead by the IMCCE. Besides that, our result for the eclipse of Amalthea is only the 4$^{th}$ such measurement ever published after the three ones observed by the 2014-2015 international PHEMU campaign. Our results are suitable for new orbital/ephemeris determinations for the Galilean moons and Amalthea., 14 pages, 8 figures and 5 tables

Context. Bright stellar positions are now known with an uncertainty below 1 mas thanks to Gaia DR2. Between 2019-2020, the Galactic plane will be the background of Jupiter. The dense stellar background will lead to an increase in the number of occultations, while the Gaia DR2 catalogue will reduce the prediction uncertainties for the shadow path. Aims. We observed a stellar occultation by the Galilean moon Europa (J2) and propose a campaign for observing stellar occultations for all Galilean moons. Methods. During a predicted period of time, we measured the light flux of the occulted star and the object to determine the time when the flux dropped with respect to one or more reference stars, and the time that it rose again for each observational station. The chords obtained from these observations allowed us to determine apparent sizes, oblatness, and positions with kilometre accuracy. Results. We present results obtained from the first stellar occultation by the Galilean moon Europa observed on 2017 March 31. The apparent fitted ellipse presents an equivalent radius of 1561.2 $\pm$ 3.6 km and oblatenesses 0.0010 $\pm$ 0.0028. A very precise Europa position was determined with an uncertainty of 0.8 mas. We also present prospects for a campaign to observe the future events that will occur between 2019 and 2021 for all Galilean moons. Conclusions. Stellar occultation is a suitable technique for obtaining physical parameters and highly accurate positions of bright satellites close to their primary. A number of successful events can render the 3D shapes of the Galilean moons with high accuracy. We encourage the observational community (amateurs included) to observe the future predicted events., Comment: 10 pages, 16 figures, 4 tables, A&A Letter doi:10.1051/0004-6361/201935500

The incidence of chronically ill subjects with prolonged mechanical ventilation has significantly increased over the last decade. Many patients get discharge to Skilled Nursing Facilities with an artificial airway, which do not have the means to properly progress on weaning. In Portugal this prevalence is unknown. Our aim was to establish the prevalence of tracheostomized patients at SNF in the North of Portugal, characterizing these units and its population, in a cross-sectional study, through an online questionnaire answered on the same day. Of the 75 SNF, 30 answered: 13 long-term, 2 medium-term, 2 short-term, 12 had beds of both medium and long-term and 1 had the three typologies. 33 had tracheostomy ventilation (prevalence 3.36%), all admitted at long-term units, the majority transferred from previous hospital admission (n=27, 90%). Only one was under mechanical ventilation. The most frequent reason for tracheostomy placement was acute respiratory failure (n=10, 33.3%). The most commonly presented cannula was the fenestrated non-cuffed (n=17, 59%). Only 4 were performing occlusion training, 21 needed frequent secretion suctioning and 1 used the mechanical in-exsufflation. Regarding motor function, 16 (53.3%) were unable to achieve sitting balance and 20 (66.7%) had no orthostatic balance or walking ability. 14 (46.7%) had percutaneous endoscopic gastrostomy. Although low response rate may induce some bias, this study revealed a significant prevalence of tracheostomized patients at SNF. These facilities do not have the resources to safely and effectively progress on ventilatory weaning. It is essential to establish new referral criteria and create specialized weaning units.

We report six stellar occultations by (Saturn IX) Phoebe, an irregular satellite of Saturn, obtained between mid-2017 and mid-2019. The 2017 July 06 event is the first stellar occultation by an irregular satellite ever observed. The occultation chords were compared to a 3D shape model of the satellite obtained from Cassini observations. The rotation period available in the literature led to a sub-observer point at the moment of the observed occultations where the chords could not fit the 3D model. A procedure was developed to identify the correct sub-observer longitude. It allowed us to obtain the rotation period with improved precision over currently known value from literature. We show that the difference between the observed and the predicted sub-observer longitude suggests two possible solutions for the rotation period. By comparing these values with recently observed rotational light curves and single-chord stellar occultations, we can identify the best solution for Phoebe's rotational period as $9.27365 \pm 0.00002$ h. From the stellar occultations, we also obtained 6 geocentric astrometric positions in the ICRS as realised by the Gaia-DR2 with uncertainties at the 1-mas level., Instituto de Astrofísica de La Plata

The technique of mutual approximations accurately gives the central instant at the maximum apparent approximation of two moving natural satellites in the sky plane. This can be used in ephemeris fitting to infer the relative positions between satellites with high precision. Only the mutual phenomena -- occultations and eclipses -- may achieve better results. However, mutual phenomena only occur every six years in the case of Jupiter. Mutual approximations do not have this restriction and can be observed at any time along the year as long as the satellites are visible. In this work, we present 104 central instants determined from the observations of 66 mutual approximations between the Galilean moons carried out at different sites in Brazil and France during the period 2016--2018. For 28 events we have at least two independent observations. All telescopes were equipped with a narrow-band filter centred at 889 nm with a width of 15 nm to eliminate the scattered light from Jupiter. The telescope apertures ranged between 25--120 cm. For comparison, the precision of the positions obtained with classical CCD astrometry is about 100 mas, for mutual phenomena it can achieve 10 mas or less and the average internal precision obtained with mutual approximations was 11.3 mas. This new kind of simple, yet accurate observations can significantly improve the orbits and ephemeris of Galilean satellites and thus be very useful for the planning of future space missions aiming at the Jovian system., Comment: 12 pages, 7 figures

We present results from three world-wide campaigns that resulted in the detections of two single-chord and one multi-chord stellar occultations by the plutino object (84922) 2003 VS2. From the single-chord occultations in 2013 and 2014 we obtained accurate astrometric positions for the object, while from the multi-chord occultation on 2014 November 7, we obtained the parameters of the best-fitting ellipse to the limb of the body at the time of occultation. We also obtained short-term photometry data for the body in order to derive its rotational phase during the occultation. The rotational light curve present a peak-to-peak amplitude of 0.141 ± 0.009 mag. This allows us to reconstruct the 3D shape of the body, with principal semi-axes of a = 313.8 ± 7.1 km, b = 265.5- + 9.8 8.8 km, and c = 247.3- + 43.6 26.6 km, which is not consistent with a Jacobi triaxial equilibrium figure. The derived spherical volume equivalent diameter of 548.3- + 44.6 29.5 km is about 5% larger than the radiometric diameter of 2003 VS2 derived from Herschel data of 523 ± 35 km, but still compatible with it within error bars. From those results we can also derive the geometric albedo (0.123- + 0.014 0.015) and, under the assumption that the object is a Maclaurin spheroid, the density r = 1400- + 300 1000 for the plutino. The disappearances and reappearances of the star during the occultations do not show any compelling evidence for a global atmosphere considering a pressure upper limit of about 1 microbar for a pure nitrogen atmosphere, nor secondary features (e.g., rings or satellite) around the main body. © 2019. The American Astronomical Society. All rights reserved., G.B.-R. is thankful for the support of the CAPES and FAPERJ/PAPDRJ (E26/203.173/2016) grant. Part of the research leading to these results has received funding from the European Research Council under the European Community's H2020 (2014-2020/ERC grant agreement No. 669416 >LUCKY STAR>). The research leading to these results has received funding from the European Union's Horizon 2020 Research and Innovation Programme, under grant agreement No. 687378 (SBNAF). P.S.-S. and J.L.O. acknowledge the financial support by the Spanish grant AYA-2017-84637-R and the Proyecto de Excelencia de la Junta de Andalucia J.A. 2012-FQM1776. P.S.-S., J.L.O., and R.D. acknowledge financial support from the State Agency for Research of the Spanish MCIU through the >Center of Excellence Severo Ochoa> award for the Instituto de Astrofisica de Andalucia (SEV-2017-0709). Based on observations made with ESO Telescopes at the La Silla Paranal Observatory under program ID 094.C-0352. M. A. thanks CNPq (grants 427700/2018-3, 310683/2017-3, and 473002/2013-2) and FAPERJ (grant E-26/111.488/2013). J.I.B.C. acknowledges CNPq grant 308150/2016-3. R. V.-M. thanks grants: CNPq-304544/2017-5, 401903/2016-8, Faperj: PAPDRJ-45/2013, and E-26/203.026/2015. F.B.-R. acknowledges CNPq grant 309578/2017-5. E.F.-V. acknowledges UFC 2017 Preeminent Postdoctoral Program (P3). TRAPPIST-South is a project funded by the Belgian Fonds (National) de la Recherche Scientifique (F.R.S.-FNRS) under grant FRFC 2.5.594.09. F. E.J. is a FNRS Senior Research Associate. A.A.C. acknowledges support from FAPERJ (grant E-26/203.186/2016) and CNPq grants (304971/2016-2 and 401669/2016-5). B.M. thanks the CAPES/Cofecub-394/2016-05 grant. A.R.G.J. and R.S. thank the financial support of FAPESP (proc. 2018/11239-8, proc. 2011/08171-3, proc. 2016/24561-0). A. M. thanks Caisey Harlingten for the use of his 50 cm telescope. We thank V. Buso and R. Condori for the observation efforts.

Background: Fatigue is one of the most common and distressing symptoms among persons with multiple sclerosis (pwMS). Objective: The aim of this study is to evaluate fatigue as a predictor for disease worsening among pwMS. Methods: In this retrospective cohort study of New York State MS Consortium (NYSMSC) registry, MS patients reporting moderate-to-severe fatigue at study enrollment ( n = 2714) were frequency matched to less-fatigued subjects ( n = 2714) on age, baseline Kurtzke Expanded Disability Status Scale (EDSS), disease duration, and MS phenotype. Change from baseline patient-reported outcomes (PROs), as measured by LIFEware™, categorized participants into two groups: those with stable/improved outcomes and those who worsened. In a subgroup of patients with longitudinal data ( n = 1951), sustained EDSS worsening was analyzed using Cox proportional hazards modeling to explore the effect of fatigue. Results: The median survival time from study enrollment to sustained EDSS worsening was 8.7 years (CI: 7.2–10.1). Participants who reported fatigue at baseline were more likely to experience sustained EDSS worsening during follow-up (HR: 1.4, 95% CI: 1.2–1.7). Patients who were fatigued at baseline were also more likely to report worsening psychosocial limitations (all ps ⩽ 0.01). Conclusion: In addition to being a common symptom of MS, severe fatigue was a significant predictor for EDSS worsening in the NYSMSC.

Fresh-cut wild rocket (Diplotaxis tenuifolia L.) represents a very interesting ready-to eat (RTE) product with a high market value. Scarce information is available on product freshness and on quality attribute deterioration during storage. The aim of this work was to evaluate the respiration rate and functional quality of rocket salad when packaged under passive atmosphere composition in two different permeability bags. Wild rocket was packaged on two different sealed polypropylene bags: macroperforated (P) and a non-permeable (NP) film bag. Bags were stored at 4°C during 15 days and the O2 and CO2 concentrations inside the bags, the respiration rate, the functional quality (ascorbic acid, phenolic compounds, anthocyanins, and chlorophyll) and microbial load of RTE rocket were evaluated at five different time points. Results showed that NP packages generated a passive modified atmosphere, with continuous decrease of O2 concentration (close to anaerobiosis by 14 days) and with increasing CO2 levels up to ca. 8 kPa after 5 days. Rocket preserved in this type of bag showed higher respiration rate in the first 2 days, when compared with rocket packaged in P bags. The evolution of carbon dioxide and oxygen concentration in both systems did not exhibit significant impact in the ascorbic acid and chlorophyll content. A positive effect of oxygen availability inside P packages was observed on total phenolic compounds and total anthocyanin concentration of rocket leaves, but simultaneously higher microbial contamination by day 5 in comparison with NP packages.

Sodium hypochlorite (SH) is a widely used disinfectant. However, due to public health and environmental concerns, alternative disinfectants are required. In this study, the control of Pseudomonas fluorescens planktonic and biofilm cells was assessed with cetyltrimethylammonium bromide (CTAB), SH, 3-bromopropionyl chloride (BPC) and 3-bromopropionic acid (BPA). Their effects were tested against planktonic cells in terms of antimicrobial efficiency and changes on cell surface. CTAB had the lowest minimum inhibitory concentration or minimum bactericidal concentration (20/50g/mL). All chemicals promoted cellular disruption and leakage of intracellular constituents. CTAB, BPC and BPA irreversibly changed surface hydrophobicity and charge. Their action was also assessed in the control of flow-generated biofilms. Modest killing and removal was achieved (maximum killing of 1log and 16% of total biofilm removal) due to the characteristics of the biofilm. In general, both BPC and CTAB had antimicrobial activities similar to SH and therefore demonstrated potential as alternatives to SH in P.fluorescens control. Practical ApplicationsThe potential environmental and health problems caused by the uncontrolled use of sodium hypochlorite (SH) have led to the search for alternatives, maintaining the antimicrobial efficacy. In fact, SH is included in the indicative list of the Directive on Industrial Emissions (2010/75/EU) as a major pollutant for water emissions and on the formation of carcinogenic and mutagenic products in the presence of organic matter. Therefore, in this study, the antimicrobial potential of selected halogen-based products was assessed in order to compare their efficacy with SH in the control of planktonic and biofilm cells. All products caused apparent membrane pore formation as well as hydrophobicity and surface charge modification against planktonic cells. Additionally, 3-bromopropionyl chloride and cetyltrimethylammonium bromide demonstrated similar action to SH in the control of biofilms mimicking an industrial scenario.

Setting: Burkitt’s lymphoma is a rare form of cancer and is an extremely rare diagnosis during pregnancy. This form of lymphoma is a very fast growing B cell neoplasm and chemotherapy is the treatment of choice for the disease in all its stages. Case report: The authors describe the case of a Caucasian 40-year-old nulliparous woman, with previous known Epstein–Barr virus infection, that presents at 28 weeks gestation with supraclavicular adenopathy and multiple bilateral breast nodules, in which biopsy showed non-Hodgkin lymphoma, Burkitt’s type. Discussion: There are few described cases of Burkitt’s lymphoma during pregnancy and in general the outcomes have been poor. In most of the cases, the patients were not treated by current standards or instead had a late diagnosis. This neoplasia is the most rapidly progressive human tumor, and any delay in initiating therapy can adversely aVect patient’s prognosis. The authors discuss treatment options in pregnancy and its perinatal implications.

RESUMO – O PLLA poli (acido L-latico) apresenta propriedades mecânicas satisfatorias como dispositivo biomedico, porem suas caracteristicas hidrofobicas tornam-no de dificil interacao com as celulas. Assim, o objetivo geral deste trabalho foi avaliar a influencia do tratamento de plasma de peroxido de hidrogenio na molhabilidade das superficies das membranas de PLLA. As membranas obtidas por evaporacao de solventes foram expostas ao plasma de H2O2 em diferentes tempos (1 a 5 minutos). Para verificar a influencia do plasma realizou-se Microscopia Eletronica de Varredura (MEV) e Ângulo de Contato. Atraves do MEV observaram-se modificacoes na superficie as mesmas tornaramse irregulares e com morfologias diferenciadas, e atraves do ângulo de contato pode-se notar que, no primeiro minuto de tratamento, a amostra ja apresentava carater hidrofilico. Atraves dos ensaios percebe-se a influencia do plasma de H2O2 sobre a superficie da membrana de PLLA tornando hidrofilica, o que sugere uma maior interacao celula/biomaterial.

Melons are an important component of fresh fruit salads, however, they suffer from limited shelf life. Processing of melon fruit for use in fruit salads induces a number of changes including alterations in colour and texture. In addition, respiration rate and ethylene production are affected. Processing also elicits changes in flavour (sweetness) and aroma (production of volatile organic compounds – VOCs), of critical importance to the consumer. Several parameters govern shelf life; temperature is a critical factor. In this study we tested whether cut size is another parameter that can affect quality indicators. Melon (Cucumis melo ‘Arapaho’) cubes of three sizes were stored at 4°C and assessed for quality at five time-points over a 15-day period. We assessed a number of parameters including firmness, loss of fresh weight, respiration rate, antioxidant capacity, phenolic compounds and carotenoid content. In addition we measured VOC profiles to assess whether there were any qualitative changes associated with storage period and/or cut size. Fresh weight (FW) loss and respiration rate increased significantly with storage time and FW loss was affected by cut size. Total carotenoid levels remained stable during the storage time as did antioxidant capacity in all cut sizes. However, cinnamic acid levels tended to decrease in the last stage of the storage period and changes in β-carotene content correlated with cut size (though not significantly). We were also able to separate the VOC profiles from the different cut sizes indicating that VOCs may be useful markers as indicators of the effects of cut size and storage time on quality.

Hitherto, rings have been found exclusively around the four giant planets in the Solar System. Rings are natural laboratories in which to study dynamical processes analogous to those that take place during the formation of planetary systems and galaxies. Their presence also tells us about the origin and evolution of the body they encircle. Here we report observations of a multichord stellar occultation that revealed the presence of a ring system around (10199) Chariklo, which is a Centaur-that is, one of a class of small objects orbiting primarily between Jupiter and Neptune-with an equivalent radius of 124â â 9â kilometres (ref. 2). There are two dense rings, with respective widths of about 7 and 3 kilometres, optical depths of 0.4 and 0.06, and orbital radii of 391 and 405 kilometres. The present orientation of the ring is consistent with an edge-on geometry in 2008, which provides a simple explanation for the dimming of the Chariklo system between 1997 and 2008, and for the gradual disappearance of ice and other absorption features in its spectrum over the same period. This implies that the rings are partly composed of water ice. They may be the remnants of a debris disk, possibly confined by embedded, kilometre-sized satellites. © 2014 Macmillan Publishers Limited. Fil: Braga Ribas, F.. Observatório Nacional; Brasil Fil: Sicardy, B.. Universite Pierre et Marie Curie; Francia Fil: Ortiz, J.L.. Consejo Superior de Investigaciones Científicas; España Fil: Snodgrass, C.. Max Planck Institute for Solar System Research; Alemania Fil: Roques, F.. Universite Pierre et Marie Curie; Francia Fil: Vieira Martins, R.. Centre National de la Recherche Scientifique; Francia. Universidade Federal do Rio de Janeiro; Brasil Fil: Camargo, J.I.B.. Ministério de Ciencia, Tecnologia e Innovacao. Observatorio Nacional; Brasil Fil: Assafin, M.. Universidade Federal do Rio de Janeiro; Brasil Fil: Duffard, R.. Consejo Superior de Investigaciones Científicas; España Fil: Jehin, E.. Université de Liège; Bélgica Fil: Pollock, J.. Appalachian State University; Estados Unidos Fil: Leiva, R.. Pontificia Universidad Católica de Chile; Chile. Universidad Católica de Chile; Chile Fil: Emilio, M.. Universidade Estadual de Ponta Grossa; Brasil Fil: MacHado, D.I.. Universidade Estadual Do Oeste Do Pará; Brasil Fil: Colazo, C.. Universidad Nacional de Córdoba; Argentina. Ministerio de Educación de la Provincia de Córdoba; Argentina Fil: Lellouch, E.. Universite Pierre et Marie Curie; Francia Fil: Skottfelt, J.. University of Copenhagen; Dinamarca. Geological Museum; Dinamarca Fil: Gillon, M.. Université de Liège; Bélgica Fil: Ligier, N.. Universite Pierre et Marie Curie; Francia Fil: Maquet, L.. Universite Pierre et Marie Curie; Francia Fil: Benedetti Rossi, G.. Ministério de Ciencia, Tecnologia e Innovacao. Observatorio Nacional; Brasil Fil: Gomes, A. Ramos. Universidade Federal do Rio de Janeiro; Brasil Fil: Kervella, P.. Universite Pierre et Marie Curie; Francia Fil: Monteiro, H.. Instituto de Física e Química; Brasil Fil: Sfair, R.. Universidade Estadual Paulista Julio de Mesquita Filho; Brasil Fil: Moutamid, M. El. Universite Pierre et Marie Curie; Francia. Centre National de la Recherche Scientifique; Francia Fil: Tancredi, G.. Observatorio Astronómico Los Molinos; Uruguay. Universidad de la República; Uruguay Fil: Spagnotto, J.. Observatorio El Catalejo la Pampa; Argentina Fil: Maury, A.. San Pedro de Atacama Celestial Explorations; Chile Fil: Morales, N.. Consejo Superior de Investigaciones Científicas; España Fil: Gil Hutton, Ricardo Alfredo. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - San Juan. Complejo Astronómico ; Argentina Fil: Roland, S.. Observatorio Astronómico Los Molinos; Uruguay Fil: Ceretta, A.. Universidad de la República; Uruguay. Observatorio del IPA; Uruguay Fil: Gu, S.-H.. Chinese Academy of Sciences; República de China Fil: Wang, X.-B.. Chinese Academy of Sciences; República de China Fil: Harpsøe, K.. University of Copenhagen; Dinamarca. Geological Museum; Dinamarca Fil: Rabus, M.. Universidad Católica de Chile; Chile. Pontificia Universidad Católica de Chile; Chile. Max Planck Institute for Astronomy; Alemania Fil: Manfroid, J.. Université de Liège; Bélgica Fil: Opitom, C.. Université de Liège; Bélgica Fil: Vanzi, L.. Pontificia Universidad Católica de Chile; Chile. Universidad Católica de Chile; Chile Fil: Mehret, L.. Universidade Estadual de Ponta Grossa; Fil: Lorenzini, L.. Polo Astronômico Casimiro Montenegro Filho; Brasil Fil: Schneiter, E.M.. Universidad Nacional de Córdoba; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Iate-conicet; Argentina Fil: Melia, R.. Universidad Nacional de Córdoba; Argentina Fil: Lecacheux, J.. Universite Pierre et Marie Curie; Francia Fil: Colas, F.. Centre National de la Recherche Scientifique; Francia Fil: Vachier, F.. Centre National de la Recherche Scientifique; Francia Fil: Widemann, T.. Universite Pierre et Marie Curie; Francia Fil: Almenares, L.. Universidad de la República; Uruguay. Observatorio Astronomico Los Molinos; Uruguay Fil: Sandness, R.G.. San Pedro de Atacama Celestial Explorations; Chile Fil: Char, F.. Universidad de Antofagasta; Chile Fil: Perez, V.. Universidad de la República; Uruguay. Observatorio Astronomico Los Molinos; Uruguay Fil: Lemos, P.. Universidad de la República; Uruguay. Observatorio Astronomico Los Molinos; Uruguay Fil: Martinez, N.. Universidad de la República; Uruguay. Observatorio Astronomico Los Molinos; Uruguay Fil: Jørgensen, U.G.. Universidad de Copenhagen; Dinamarca Fil: Dominik, M.. University of St. Andrews; Reino Unido Fil: Roig, F.. Ministério de Ciencia, Tecnologia e Innovacao. Observatorio Nacional; Brasil Fil: Reichart, D.E.. University of North Carolina; Estados Unidos Fil: Lacluyze, A.P.. University of North Carolina; Estados Unidos Fil: Haislip, J.B.. University of North Carolina; Estados Unidos Fil: Ivarsen, K.M.. University of North Carolina; Estados Unidos Fil: Moore, J.P.. University of North Carolina; Estados Unidos Fil: Frank, N.R.. University of North Carolina; Estados Unidos Fil: Garcia Lambas, Diego Rodolfo. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Córdoba. Instituto de Astronomía Teórica y Experimental. Universidad Nacional de Córdoba. Observatorio Astronómico de Córdoba. Instituto de Astronomía Teórica y Experimental; Argentina

Introdução: A capacidade funcional, após evento coronário agudo, é um importante factor de prognóstico vital e funcional. Identificar os factores que a determinam, no contexto de programas de reabilitação cardíaca (PRC), irá possibilitar a adopção e implementação de novos modelos e estratégias de intervenção com vista a maximizar a recuperação funcional obtida e reduzir o grau de incapacidade subsequente. O objectivo deste estudo foi estabelecer os preditores da capacidade funcional numa população de doentes coronários integrados num programa de reabilitação cardíaca de Fase II. Material e Métodos: Análise prospectiva de doentes que completaram programa de reabilitação cardíaca (Fase II) após síndrome coronário agudo recrutados entre Setembro de 2008 e Novembro de 2011. Foi recolhida informação sobre parâmetros sócio-demográficos, clínicos, antropométricos, laboratoriais, ecocardiográficos, funcionais e aplicados questionários para caracterização psicossocial (medidos pela Hospital Anxiety And Depression Scale; depressão/ansiedade se subscores ≥ 8) e da qualidade de vida (Short Form 36 v2). Foi realizada uma análise de regressão linear multivariada, ajustada para a duração da prova de esforço basal, para identificação dos preditores da capacidade funcional no final do PRC, medida pela duração da prova de esforço final. Resultados: Dos 276 doentes avaliados, 97(35,1%) foram excluídos por ausência de dados. Dos 179(54,2%) casos restantes, 160(89,4%) eram homens, com idade [média(DP):53,5(9,8)] anos e nível de escolaridade de [P50(P25-75):6(4-12)] anos. Desta amostra, 30(16,8%) eram diabéticos; 32(17,9%) tinham história prévia de doença coronária; 45(30%) eram deprimidos, apresentando uma percepção de capacidade física algo diminuída com SF 36 v2-componente físico sumário de 46,6(7,7). Na análise multivariada foram identificados como preditores positivos da capacidade funcional, o sexo masculino (p=0,008; β=0,12), o nível de escolaridade (p=0,007; β=0,144) e a percepção da capacidade física (p=0,024; β=0,127); sendo a diabetes mellitus (p=0,005; β= -0,147), a história prévia de doença coronária (p= 0,019; β= -0,123) e a depressão (p=0,05; β= -0,102) preditores negativos. Conclusão: Os determinantes da progressão da capacidade funcional são multifactoriais envolvendo factores clínicos, psico-emocionais e sócio-culturais. Estes achados reforçam a necessidade de uma intervenção multidimensional no âmbito dos PRC afastando-nos do conceito restritivo de um simples programa de recondicionamento ao esforço para uma perspectiva mais holística e integral de reabilitação. Palavras-chave: Doença Coronária; Reabilitação Cardíaca; Capacidade Funcional, Revista da Sociedade Portuguesa de Medicina Física e de Reabilitação, v. 23, n. 1 (2013): Ano 21