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Using electron-rich or electron-poor N-substituted oxazolidines as substrates, selective formation of either ammonium or oxonium ylides is possible in the presence of α-imino carbenes. As such, treatment of 5-membered oxazolidine precursors with N-sulfonyl-1,2,3-triazoles under dirhodium catalysis (2 mol%) affords the regiodivergent synthesis of either 8-membered 1,3,6- or 1,4,6-oxadiazocines upon the initial N or O reactivity with the carbene.

Introduction: The prolongation of the second stage of labor in pregnant women, in order to reduce the rate of cesarean sections, constitutes a scientific and clinical dilemma. This controversy is generated because the increase in the prolonged second stage time can increase the maternal and neonatal risks. Objective: To analyze differences in maternal and neonatal outcomes between pregnant women who have a prolonged vs non-prolonged delivery. To study those pregnant women who have prolonged second stage (>180 minutes) and identify differences between them according to mode of delivery (non-operative, operative or cesarean delivery). Material and methods: Prospective cohort study of all nulliparous pregnant women treated at the Hospital Universitario de Fuenlabrada between January 1, 2018 and December 31, 2019. Differences in pregnant women with prolonged versus non-prolonged delivery are analyzed. Those cases in which the prolonged second stage period was equal to or greater than 180 minutes were selected and differences according to the mode of delivery were studied. During the study period, 944 women met the inclusion criteria, of which 445 (47.1%) had prolonged second stage periods equal to or greater than 180 minutes. Results: Prolonged second stage is associated with a higher rate of operative delivery 44.5% vs. 28.1% and a higher rate of cesarean section 6.7% vs. 2% (p: 0.000), a higher rate of shoulder dystocia 3.8% vs. 1.6%, greater weight at birth of the newborn 3279 g vs 3119 g and greater perinatal trauma 13.3 vs 6.6% compared with non-prolonged second stage delivery. By selecting only pregnant women with prolonged delivery, we observed a higher rate of complications of surgical wound in caesarean sections 13.3%, vs 1.5% in operative delivery and 0% in spontaneous vaginal delivery and a higher rate of grade III-IV degree perineal lacerations in deliveries eutocic and instrumental. With respect to the neonate, a greater weight of the newborn is observed in caesarean sections 3445 grams compared to eutocic deliveries 3230 grams and operative delivery 3275 grams (p: 0.001), a higher rate of type III resuscitation in those neonates born by caesarean section 26, 7% vs 4.2% in spontaneous vaginal delivery and 5.6% in operative delivery and a higher rate of admission to the neonatal ICU in caesarean sections 26.7% vs 6.9% spontaneous vaginal delivery and 9.1% operative delivery (p: 0.002) . Conclusion: A higher rate of operative delivery and cesarean sections has been observed in pregnant women with prolonged second stage, as well as a higher rate of shoulder dystocia, newborn weight, and perinatal trauma compared with non-prolonged delivery. When studying the cohort of pregnant women with prolonged second stage, there is a higher rate of cesarean section in pregnant women with a previous suspicion of fetal macrosomia, a higher weight of the newborn at birth, a higher rate of type III neonatal resuscitation and admission of the newborn to the neonatal ICU in pregnant women. that end in caesarean section with respect to spontaneous vaginal delivery or operative delivery.

The microplastics (MPs) pollution has been widely documented in all type of aquatic environment. However, most of the studies focus on the MPs contamination in the surface water and there is a lack of knowledge about contamination in the water column. In the present study, we adapted an aquatic drone to sample MPs both in the water surface (0 – 25 cm) and subsurface (25-50 cm). In a previous study, the aquatic drone has been shown to be more accurate for sampling MPs than the Manta net. The samples of surface and subsurface water were collected in a river with the aquatic drone, while an in-situ pump was used to sample water near the bottom (2 to 3 m depth) of the river. MPs concentrations (n.L-1) and their characteristics (size, morphology, color, shape and polymer nature) were determined and compared between the three sampling compartments. All of the water compartments sampled were contaminated. Our results showed that subsurface water could be as contaminated as the surface water. In terms of shape, fibers and film were a majority on the water surface while fragments were found in greater proportion in subsurface water. This study demonstrates that sampling only the water surface could result in bias for assessing the MPs contamination in aquatic environment. Also see: https://micro2022.sciencesconf.org/426655/document, In MICRO 2022, Online Atlas Edition: Plastic Pollution from MACRO to nano

Rabbit is a reflexively ovulating species. Accordingly, in the practice of artificial insemination (AI) ovulation must be induced via exogenous GnRH (Gonadotropin-Releasing Hormone) administration, which may be performed intramuscularly, subcutaneously, or intravaginally. Unfortunately, the bioavailability of the GnRH analogue when added to the extender is lower due to the proteolytic activity in the seminal plasma and the poor permeability of the vaginal mucosa. The aim of the study was to refine the practice of AI practice in rabbits by replacing parenteral GnRH analogue administration (subcutaneous, intravenous, or intramuscular injection) with intravaginal application, while reducing its concentration in the diluent. Extenders containing the buserelin acetate in chitosan–dextran sulphate and chitosan–alginate nanoparticles were designed and 356 females were inseminated. Reproductive performance of females inseminated with the two experimental extenders, receiving 4 μg of buserelin acetate intravaginally per doe, was compared with that in the control group, the does of which were inseminated with the extender without the GnRH analogue and induced to ovulate with 1 μg of buserelin acetate administered intramuscularly. The entrapment efficiency of the chitosan–dextran sulphate complex was higher than that of chitosan–alginate. However, females inseminated with both systems showed similar reproductive performance. We conclude that both nanoencapsulation systems are an efficient way of intravaginal ovulation induction, allowing a reduction in the level of the GnRH analogue normally used in seminal doses from 15–25 μg to 4 μg.

Este trabalho aborda possíveis acontecimentos inesperados que podem ocorrer na realização de um procedimento estético facial de microagulhamento e fios de PDO; visto que a demanda por serviços na área da estética vem aumentando com o passar do tempo a fim de retardar ou até mesmo minimizar os efeitos do envelhecimento, faz-se necessário o conhecimento e a capacitação do profissional para que além de entregar um resultado satisfatório, esteja preparado para contornar um possível efeito adverso do procedimento. O levantamento do estudo foi feito através da revisão bibliográfica de artigos e livros em base científica online, abordando os conceitos das técnicas nos fios de sustentação de (PDO) e de microagulhamento; as suas possíveis intercorrências, assim como suas indicações e contra indicações; e medidas preventivas na biossegurança. Conhecer possíveis fatores para prevenir e tratar as intercorrências de cada tratamento se torna imprescindível ao profissional biomédico para que este saiba tomar as medidas necessárias para contornar uma situação indesejada; bem como o profissional informar ao paciente o que pode se esperar de cada procedimento após ou durante a sua realização. Considerando a segurança dos profissionais, dos pacientes e a entrega de bons resultados estéticos, este trabalho tem como intuito agregar o conhecimento com foco na prevenção para minimizar as intercorrências faciais através de levantamento de dados ao período observacional de 6 anos., Keywords: AESTHETICS, FACE, INTERCURRENCE, SKIN

Plant myxodiasporous species have the ability to release a polysaccharidic mucilage upon imbibition of the seed (myxospermy) or the fruit (myxocarpy). This is a widespread capacity in angiosperms providing multiple ecological functions including higher germination efficiency under environmental stresses. It is unclear whether myxodiaspory has one or multiple evolutionary origins and why it was supposedly lost in several species. Here, we summarize recent advances on three main aspects of myxodiaspory. (a) It represents a combination of highly diverse traits at different levels of observation, ranging from the dual tissular origin of mucilage secretory cells to diverse mucilage polysaccharidic composition and ultrastructural organization. (b) An asymmetrical selection pressure is exerted on myxospermy-related genes that were first identified in Arabidopsis thaliana. The A. thaliana and the flax intra-species mucilage variants show that myxospermy is a fast-evolving trait due to high polymorphism in a few genes directly acting on mucilage establishment. In A. thaliana, these actors are downstream of a master regulatory complex and an original phylogenetic overview provided here illustrates that this complex has sequentially evolved after the common ancestor of seed plants and was fully established in the common ancestor of the rosid clade. (c) Newly identified myxodiaspory ecological functions indicate new perspectives such as soil microorganism control and plant establishment support.

In pediatric emergency departments (PEDs), seasonal viral outbreaks are believed to be associated with an increase of workload, but no quantification of this impact has been published. A retrospective cross-sectional study aimed to measure this impact on crowding and health care quality in PED. The study was performed in 1 PED for 3 years. Visits related to bronchiolitis, influenza, and gastroenteritis were defined using discharge diagnoses. The daily epidemic load (DEL) was the proportion of visits related to one of these diagnoses. The daily mean of 8 crowding indicators (selected in a published Delphi study) was used. A total of 93,976 children were admitted (bronchiolitis, 2253; influenza, 1277; gastroenteritis, 7678). The mean DEL was 10.4% (maximum, 33.6%). The correlation between the DEL and each indicator was significant. The correlation was stronger for bronchiolitis (Pearson R from 0.171 for number of hospitalization to 0.358 for length of stay). Between the first and fourth quartiles of the DEL, a significant increase, between 50% (patients left without being seen) and 8% (patient physician ratio), of all the indicators was observed. In conclusion, seasonal viral outbreaks have a strong impact on crowding and quality of care. The evolution of "patients left without being seen" between the first and fourth quartiles of DEL could be used as an indicator reflecting the capacity of adaptation of an emergency department to outbreaks.

The rapid growth of the elderly population, associated with longer life expectancy, is associated with a higher prevalenceof chronic non-communicable diseases, such as those of the cardiovascular, renal system and neoplasms. A large portionof these pathologies require hospitalization and their conditions require the use of antibiotics (ATB), whose indiscriminateuse can lead to Acute Kidney Injury (AKI), which has serum creatinine as one of its markers. Therefore, the present studyaimed to evaluate changes in serum creatinine of hospitalized elderly people submitted to antibiotic therapy in a universityhospital. This was a cross-sectional study in which patients over 60 years old were identified during a period of 6 monthsand who used ATB, as well as had their serum creatinine measured. The variables age, gender, length of hospital stays anduse of ATB were considered, as well as serum creatinine values before and after antibiotic therapy. A total of 796 patientsparticipated in the study, 51.4% (409) of whom were male. Ages ranged from 60 to 109 years, with an average of 74.9 (±9.6). It was identified that length of stay and use of ATB are variables that interfere with the increase in creatinine due toantibiotic therapy, which was observed in 75.5% of the patients. This leads to the reflection about a possible indiscriminateprescription of antimicrobials and their correlation to AKI.

Superovulation treatments aim to stimulate multifollicular recruitment, maximizing the number of oocytes or transferable embryos produced. Factors associated with the superovulation protocol, female characteristics and many other factors are determinants in the number and quality of oocytes obtained. An accurate way to assess oocyte quality more precise than morphological appearance is genetic expression. The present study aims to compare the response of nulliparous and multiparous females to superovulatory stimulation, studying its effect on the expression of some genes associated with the activation, growth, development and oocyte-embryo transition of oocytes, as well as its impact on in vivo embryonic development and viability rate at birth. In a first experiment, the effect of stimulation treatment on the ovulation response and the expression of the MSY2, MATER, ITPR1, ITPR2, ITPR3, eIF4E, PAR1, PAPOL-A, PAPOL-G, ZAR1 and YY1 genes in nulliparous and multiparous females were determined. In a second experiment, the implantation and viability at birth of embryos from superovulated nulliparous and multiparous females were analysed. The ovulation rate was significantly higher in the superovulation groups than in the control groups. The ovulation rate was significantly increased in nulliparous females compared with multiparous does. From the eleven genes analysed, only the expression of MATER, PAPOL-A, PAPOL-G and ZAR-1 genes was shown to be different among experimental groups. Finally, in terms of implantation rate and viability at birth, the nulliparous control group showed better results than the rest of the groups. Both hyperstimulation treatment and reproductive female's history seem to alter the transcriptome of important genes related to oocyte maturation and competence acquisition, affecting in vivo embryo viability.

[EN] Preimplantation embryo manipulations during standard assisted reproductive technologies (ART) have significant repercussions on offspring. However, few studies to date have investigated the potential long-term outcomes associated with the vitrification procedure. Here, we performed an experiment to unravel the particular effects related to stress induced by embryo transfer and vitrification techniques on offspring phenotype from the foetal period through to prepuberal age, using a rabbit model. In addition, the focus was extended to the liver function at prepuberal age. We showed that, compared to naturally conceived animals (NC), offspring derived after embryo exposure to the transfer procedure (FT) or cryopreservation-transfer procedure (VT) exhibited variation in growth and body weight from foetal life to prepuberal age. Strikingly, we found a nonlinear relationship between FT and VT stressors, most of which were already present in the FT animals. Furthermore, we displayed evidence of variation in liver function at prepuberal age, most of which occurred in both FT and VT animals. The present major novel finding includes a significant alteration of the steroid biosynthesis profile. In summary, here we provide that embryonic manipulation during the vitrification process is linked with embryo phenotypic adaptation detected from foetal life to prepuberal age and suggests that this phenotypic variation may be associated, to a great extent, with the effect of embryo transfer., This research was funded by Conselleria d'Educacio, Investigacio, Cultura i Esport, Spain, grant number AICO/2019/272. Ximo Garcia-Dominguez was supported by a research grant from the Ministry of Economy, Industry and Competitiveness of Spain (BES-2015-072429).

O presente trabalho se propõe a estudar, em seu contexto histórico, o pensamento da revolucionária marxista Rosa Luxemburgo no tocante à questão nacional. Para isso, é feita uma minuciosa análise de seus textos sobre o tema. Atenção especial é dada aos debates com Lenin neste campo já que a polonesa e o russo formam dois dos mais importantes paradigmas marxistas em relação ao problema das nacionalidades. Inicialmente apresentam-se separadamente os principais textos de ambos os autores sobre nacionalismo em geral, seguidos dos textos em que dialogam especificamente entre si. Encerra o trabalho um balanço deste debate incluindo comentários de observadores abalizados que, como conhecedores profundos das obras desses autores, emitiram julgamento sobre as questões apontadas pelos dois pensadores. The aim of the research is to investigate Rosa Luxemburg\'s thinking about nationalism in its historical context. A detailed analysis of her works about this theme is provided. Special attention is given to her debates with Lenin because both provide two of the most important marxist paradigms on the question of nationalities. The presentation proceeds in the following order. First, we separatly investigate their writings on nationalism in general. Next, we analyze the articles in which they interacted with each other on this question. Finally we critically analyze this debate, including opinions by experts who have academically studied these two authors.

The ability to extrude mucilage upon seed imbibition (myxospermy) occurs in several Angiosperm taxonomic groups, but its ancestral nature or evolutionary convergence origin remains misunderstood. We investigated seed mucilage evolution in the Brassicaceae family with comparison to the knowledge accumulated in Arabidopsis thaliana. The myxospermy occurrence was evaluated in 27 Brassicaceae species. Phenotyping included mucilage secretory cell morphology and topochemistry to highlight subtle myxospermy traits. In parallel, computational biology was driven on the one hundred genes constituting the so-called A. thaliana mucilage secretory cell toolbox to confront their sequence conservation to the observed phenotypes. Mucilage secretory cells show high morphology diversity; the three studied Arabidopsis species had a specific extrusion modality compared to the other studied Brassicaceae species. Orthologous genes from the A. thaliana mucilage secretory cell toolbox were mostly found in all studied species without correlation with the occurrence of myxospermy or even more sub-cellular traits. Seed mucilage may be an ancestral feature of the Brassicaceae family. It consists of highly diverse subtle traits, probably underlined by several genes not yet characterized in A. thaliana or by species-specific genes. Therefore, A. thaliana is probably not a sufficient reference for future myxospermy evo–devo studies.

Aim To investigate the effect of resistance training (RT) on hepatocardiovascular and muscle mitochondrial parameters in rats that were fed a high-calorie diet for 12 weeks. Main methods The animals were divided into four groups: control (C), exercise (E), obese (O), and obese plus exercise (OE). Group E and OE rats performed resistance training by climbing on a vertical ladder with load attached to the end of the tail (1×/day, 3×/week, for 12 weeks). Group O and OE rats were fed a high-calorie diet containing chow and a cafeteria diet for 12 weeks. Under anesthesia, the heart and liver were removed for histopathological analysis, and the gastrocnemius muscle was removed for Western blotting. Key findings Group O rats were heavier, with increased fat mass, elevated fasting glycemia, and total triglycerides, and exhibited a significant number of Kupffer cells and diffuse steatosis in the liver. Group O rats also showed increased thickness of the right ventricle, septum, and pulmonary artery. All of these parameters were attenuated by RT. PGC1-α protein levels were increased in both exercise groups. The protein levels of OXPHOS complexes III, IV, and V were reduced in Group O, while RT prevented this alteration. Significance RT exerts a protective effect against hepato-cardiac alterations and prevents changes in the muscle mitochondrial protein profile induced by a high-calorie diet., Obesity; Resistance training; Mitochondrial biogenesis; Hepato-cardiac alterations.

Background Cannabis is illegal in France but, as in many countries, legalization is under debate. In the United States, an increase of emergency department (ED) visits related to cannabis exposure (CE) in infants and adults was reported. In France, a retrospective observational study also suggested an increase of CE in children under 6 years old. This study only included toddlers and the data sources used did not allow repeated analysis for monitoring. Methods Our study aimed to evaluate the trend in visits for CE in ED in patients younger than 27 years old in Southern France. A cross-sectional study using the Electronic Emergency Department Abstracts (EEDA) included in the national Syndromic Surveillance System. CE visits were defined using International Classification of Disease (ICD-10). Results From 2009 to 2014, 16 EDs consistently reported EEDA with Conclusion These trends occurred despite cannabis remaining illegal. EEDA could be useful for monitoring CE in EDs.

Orientador: Maria Lygia Quartim de Moraes Tese (doutorado) - Universidade Estadual de Campinas, Instituto de Filosofia e Ciências Humanas Resumo: A presente pesquisa analisa o modo como a flexibilização das relações de trabalho afeta a experiência de trabalhadores e trabalhadoras na esfera produtiva, bem como seus efeitos na vida cotidiana e familiar. Para isso, foca em duas atividades profissionais: a de operadora de teleatendimento e a de caixa de super/hipermercados. A escolha de ambos os segmentos se justifica pela forte presença de mulheres na força de trabalho e pelo fato de, neles, as empresas recorrerem a constantes ajustes na organização do trabalho, regulando-a de acordo com o fluxo de clientes e de produção. Essa prática adotada pelas empresas se insere em um amplo processo de flexibilização das relações de trabalho. No Brasil, mudanças na legislação trabalhista deram às empresas maior liberdade para demitir e contratar funcionários, alterar suas atividades, tornar o salário variável de acordo com o desempenho individual e prolongar, reduzir e modificar o tempo de trabalho. Com isso, os elementos centrais do trabalho tornam-se mais imprevisíveis e variáveis. Exigem-se dos trabalhadores e das trabalhadoras maior engajamento e disponibilidade à esfera produtiva, afetando o modo como estes vivenciam o trabalho e o sentido conferido a ele. No entanto, os efeitos dessas novas dinâmicas ultrapassam a esfera produtiva, incidindo também na vida cotidiana e familiar. Homens e mulheres não vivenciam esses efeitos da mesma maneira, sendo as mulheres particularmente afetadas pela flexibilidade. Fruto da divisão sexual do trabalho, elas estão fortemente presentes em postos de trabalho mal remunerados e menos qualificados, além de serem as principais responsáveis pelo trabalho doméstico e de cuidados nos lares. A necessidade de articular trabalho profissional e vida familiar é uma questão que segue circunscrita ao feminino. Nesta pesquisa, analisam-se as estratégias acionadas pelas mulheres para realizar essa articulação diante de um tempo de trabalho cada vez mais variável e de constantes mudanças promovidas pelas empresas em sua atividade, remuneração e jornada. A problemática da disponibilidade apareceu como elemento importante para compreender, no atual contexto, as relações entre trabalho, gênero e a articulação entre trabalho e família Abstract: The present research analyses the consequences of labour relations flexibility on workers¿ experience in the productive sphere as well as its effects on daily and family life. For this purpose, this study focuses two professional activities: that of the telemarketing operator and the super/hypermarket cashier. The choice of those professions is justified by the strong presence of women in their workforce and by the fact that companies in those sectors frequently resort to continuous adjustments in working organization, setting it according to the production and clients flows. This kind of practice is part of a wider process of increasing flexibility of labour relations. Changes in Brazilian labour laws gave companies more liberty to hire and fire employees, change their activities, adopt variable wage according to the workers¿ individual performance, and extend, reduce or modify their working time. Therefore, the central elements of work become more unpredictable and diverse. The result for workers is the requirement of more engagement and availability for the productive sphere, affecting how they experience work and the meaning they give to it. However, effects of these new dynamics transcend the productive sphere, also influencing daily and familiar life. Men and women do not experience those effects the same way, women being particularly affected by flexibility. As a result of the sexual division of labour, women are more likely to occupy underpaid jobs, that require less instruction, besides being mainly responsible for doing housework and care. The need for reconciling work and family life is still a women¿s issue. In this research, we analyze the strategies women adopt to achieve that reconciling, in the context of a varying working time and facing continuous adjustments in their activities, wages and timetables. The availability issue appeared as an important element to comprehend the relations between work, gender and reconciling of work and family Doutorado Sociologia Doutora em Sociologia FAPESP 2011/06611-6, 2013/05517-1 CAPES

“Médulas: El cáncer hematológico en mujeres” es un reportaje audiovisual narrado en primera persona a través de tres valientes mujeres que han padecido, padecen o han superado un cáncer de tipo hematológico. Los testimonios se centran en un punto de vista antropológico: ámbito social, familiar y laboral. Las protagonistas, afectadas de enfermedades como la leucemia o aplasia medular, cuentan de qué forma, estas dolencias influyen para siempre en sus costumbres y especialmente en las de sus allegados, la forma de ver a los demás y de cómo las ven a ellas, los cambios que perciben en cuanto al trato recibido por sus familiares y seres queridos, conocidos y por el resto de la sociedad. Estas mujeres pasaron radicalmente de asumir el papel de cuidadoras familiares, a ser ellas las atendidas y quedarse al margen de su rol habitual, lo cual es algo realmente complejo para ellas, según las voces de las diversas expertas en los campos de salud y trabajo social que comparten su amplia experiencia en el reportaje. Estas profesionales son una Doctora especialista en hematología, una psicóloga y una trabajadora social. Las dos últimas mencionadas, trabajadoras de ASLEUVAL (Asociación para la lucha contra la leucemia de la Comunidad Valenciana). Con las manifiestas diferencias de cada caso en particular, las tres afectadas por enfermedades hematológicas han mostrado una entereza indudable a la hora de afrontar el cáncer que les ha tocado combatir, aunque hayan experimentado momentos, como es lógico, de miedo y desasosiego. De los tres casos expuestos, dos mujeres lograron superar la enfermedad, aunque siempre con el temor de una posible recaída, que por fortuna a fecha de hoy no ha acontecido, y una no logró superarlo por segunda vez, pese a poner todo su empeño en ello en caso de que ocurriese, como relata en el propio reportaje. “Spinal Cords: The Haematological Cancer in Women” is an audio-visual report narrated in first person thanks to three courageous women that have suffered, suffer, or have overcome a haematological cancer. The testimonies are essentially focused on an anthropological point of view regarding their familiar, social, and working sphere. The protagonists, overwhelmed by diseases like leukaemia or aplasia, depict not only the manner by which these illnesses have an influence on their habits and concretely on their immediate family, and they way these women see everyone that surrounds them and how they are seen by people, but also the alterations they perceive concerning the treatment received from their relatives and loved ones, acknowledged by society. These women stopped assuming their role of family caregivers to eventually be assisted, which is undoubtedly complex for them, considering different voices provided by different professionals in the fields of health care and social work that share their broad experience on this report. These experts are a specialized doctor in haematology, a psychologist, and a social worker, being the last two mentioned workers of “ASLEUVAL” (Association for the Fight against Leukaemia of the Valencian Community). Respecting the noteworthy differences present in each particular case, these women afflicted by haematological ailments have shown an unquestionable endurance when they had to face the cancer against they had to fight. Out of the three cases exposed, two women could overcome their disease, although they did it with the recurrent fear of experiencing a relapse that fortunately has never occurred. Nevertheless, the third woman could not defeat her cancer when she suffered a relapse, despite the fact that she fought tenaciously in case it happened again, as it is portrayed on this report.

Objective To systematically review the literature on the use of the transcranial static magnetic stimulation (tSMS) technique in humans and animals, its effects on different areas of the central nervous system (CNS), its influence on neural excitability and on the subject's behavior, and its biological effects and future possibilities. All static magnetic field applications that can be considered to have a physiologically similar effect have been reviewed. Methods We searched studies using key terms in NCBI PubMed, Scopus, PEDro, SciELO, Cochrane, and links to publications (inception to September 2019). Three reviewers independently selected the studies, extracted data, and assessed the methodological quality of the studies using the recommendations described in the Cochrane Handbook for Systematic Reviews of Interventions, PRISMA guidelines. Results We analyzed 27 studies. The reviewed literature suggests that the use of these magnetic fields has an inhibitory effect on different areas of the CNS, such as motor, somatosensory, and visual cortex, cerebellum, and spinal cord. Regarding subject's behavior, the different effects of tSMS appear to be transient and dependent on the stimulated area, such as loss of visual discrimination or improvement of somatosensory perception. In addition, the technique has some therapeutic utility, specifically in pathologies with cortical hyperexcitability. Conclusions These results suggest that tSMS may be a promising tool to modulate cerebral excitability in a safe and non-invasive way. Further investigations could give a better explanation of its precise mechanisms of action and applications.

O objetivo deste trabalho foi avaliar o conhecimento sobre a terapia anticoagulante antes e depois da aplicação de um vídeo educativo em pacientes ambulatoriais em uso de varfarina atendidos por um hospital público. O conhecimento dos pacientes foi avaliado por seis perguntas, sendo calculado o percentual de respostas certas. Identificou-se os pacientes com percentual de acerto ≥ 60%, e para avaliar o conhecimento adquirido com o vídeo foi determinado o acerto antes e depois da visualização para a pergunta sobre qual é a indicação da varfarina. A análise estatística univariada e os testes MacNemer e Mann–Witney foram realizadas no SPSS 21.0. O vídeo foi avaliado por 62 pacientes, sendo que 41 (66,1%) tinham até seis meses de tratamento. O conhecimento sobre a indicação da varfarina aumentou após o vídeo (p = 0,006). Não houve diferença significativa entre o percentual de acertos considerando tempo de tratamento ≥ 6 meses ou < 6 meses (p = 0,775). O vídeo ajudou a esclarecer dúvidas sobre anticoagulação de 98,4% dos pacientes. Os resultados sugerem que o material audiovisual elaborado pode contribuir para ampliar o conhecimento sobre o tratamento com varfarina e, consequentemente, proporcionar aumento das taxas de adesão ao tratamento com anticoagulante e aumentar a segurança dos pacientes.

Background and Aims Tunnelled catheter-related bacteraemia (BRC) of the patient in chronic hemodialysis program results in high morbidity and mortality. Antibiotic catheter lock has been suggested to reduce the incidence of BRC in clinical trials. Aim: To demonstrate the effectiveness of universal aseptic measures in obtaining an optimal BRC rate in a long-term single-centre study. Method Design: Prospective cohort study, single-centre. Follow-up time: 11 years (2008-2018) Tunneled catheters: Optiflow, Hemostar, Hemosplit, Equistream, Hemoglide (Bard Access Systems, New Jersey, USA) and Palindrome (Covidien, - Medtronic, Mansfield, Massachusets, USA). Days / catheter analyzed: 207,320. Catheter placement: Ultrasound-guided interventional radiology equipment, with fluoroscopy and universal aseptic measures + 1 single dose of Vancomycin / cefazolin. Follow-up: Nursing and Nephrology and Infectious physicians. Universal aseptic measures. Heparin lock. BRC is considered to be the presence of a positive blood culture after discarding another focus and related to the negative catheter or blood culture with no other focus than the catheter. All available samples at the time of bacteraemia are analyzed: blood, sputum, urine, faeces, pleural fluid, peritoneal fluid, cerebrospinal fluid, exudates, smears etc, and their results. The BRC rate x 1000 days / catheter is evaluated Results Results BRC 2008 to 2018: 0.57, 0.47, 0.31, 0.1, 0.43, 0.37, 0.42, 0.16, 0.2, 0.18 and 0.04 respectively. The evaluated catheters, follow-up days, catheter-related bacteraemias, germ typing and treatment are analyzed: antibiotic vs. catheter removal in Table 1. Conclusion 1. The use of universal measures only, without the use in the antibiotics lock or anticoagulants other than heparin, can achieve a bacteraemia rate related to the optimal catheter, being cost / effective and avoiding possible resistance to antibiotics and side effects of other anticoagulant drugs. 2. Antibiotic sealing should be reserved for cases of difficult epidemiological control of BRC.

Os levantamentos epidemiológicos são de extrema importância para o conhecimento da prevalência da doença cárie, que revelam a realidade social, epidemiológica e principalmente o estado de saúde atual da população estudada e a eficácia dos serviços de saúde de um determinado local. Este trabalho teve por objetivo analisar a prevalência de cárie para a população de escolares do ensino fundamental da rede municipal de Umuarama /Paraná. Foram examinados 2.350 escolares com a faixa entre 6 e 11 anos. As faixas etárias foram divididas em dois grupos: 6-8 anos, a média CPO-D para este grupo foi 0,25. Com relação à faixa etária de 9 a 11 anos foi observado uma média para o CPO-D 0,6. Para a realização do ceo-d foram examinadas 193 escolares com a faixa etária de 5 anos e a média de ceo-d para este grupo foi de 1,08. Concluindo que a classificação da prevalência de cárie para o município de Umuarama, seguindo os parâmetros da OMS (1982), baseada na média do índice CPO-D para a faixa etária estudada foi classificada como muito baixa (0,0 a 1,1) e a média para o índice ceo-d foi considerada baixa (1,08).Descritores: Cárie Dentária; Criança; Epidemiologia.ReferênciasNarvai PC. Cárie dentária e flúor: uma relação do século XX. Ciênc saúde colet. 2000;5(2):381-92.Cortelli SC, Cortelli JR, Prado JS, Aquino DR, Jorge AOC. Fatores de risco a cárie e CPOD em crianças com idade escolar. Brasil. Ciênc Odontol Bras. 2004;7(2):75-82.Mialhe FL, Melo MM, Berti M, Dobrowolski M. Contribuição das ações de educação em saúde da disciplina de odontologia em saúde coletiva na consolidação das DCN e do SUS: relato de uma experiência. Arq Ciênc Saúde Unipar. 2007;11(3):193-97.Baldani MH, Vasconcelos AGG, Antunes JLF. Associação do índice CPO-D com indicadores sócio-econômicos e de provisão de serviços odontológicos no Estado do Paraná, Brasil. Cad Saúde Pública. 2004;20(1):143-52Baldani MH, Antunes JLF, Pupo YM, Lawder JAC, Silva FFM. Determinantes individuais da utilização recente de serviços odontológicos por adolescentes e adultos jovens de baixa renda. Pesq Bras Odontoped Clin Integr. 2011;11(1):91-8.Ministério da Saúde. Brasil: Coordenação Nacional de Saúde Bucal. Condições de Saúde Bucal Da População Brasileira – Projeto SB Brasil 2003 - [Citado 2010 dez.]. Disponível em: HTTP://portal,saude.gov.br/saude/arquivos/pdf/relatorio_brasil_sorridente.pdf.Geus JL, Luca CMB, Baldani MH, Czlusniak GD. Prevalência de Cárie e Autopercepção da Condição de Saúde Bucal entre Crianças de Escolas Urbanas e Rurais de Ponta Grossa – PR. Pesq Bras Odontoped Clin Integr. 2013;13(1):111-17.Lazzarin HC, Sulzler KE, Kramer IV, Camargo JB. Prevalência de cárie dentária em crianças de uma instituição pública do município de Cascavel – PR, Brasil. Arquivos do MUDI. 2016;20(3):13-24.Vicente VA, Polleto MM, Neiva IF, Pinto JVT, Braga SF, Moreira M et al. Relação entre a prevalência da doença cárie e risco microbiológico. Cienc Odontol Bras 2008;11(2):44-8.Porcelli ICS, Partyka J, Matsuura E, Fracasso MLC, Maciel SM. Prevalência e Associação Entre Cárie Dentária e Má Oclusão em Adolescentes de Londrina, Paraná, Brasil. UNICIÊNCIAS. 2015;19(2):106-11.Baltazara MMM, Giordania MT, Furlanettoa DLC, Bertia M, Bianchia FJ. Levantamento das Condições de Saúde Bucal de Crianças e Adolescentes das Comunidades Rurais Atendidas em Unidade Móvel de Saúde no Oeste do Paraná. UNOPAR Cient Ciênc Biol Saúde. 2011;13(4):257-61.Amaral MA, Ruiz DT, Simm W, Pereira JS, Luiz MAF, Matsuo T. Desgaste Dentario: Estudo Epidemiológico em uma População de Cinco Anos de Sarandi, Paraná. Saúde e Pesquisa. 2008;1(2):151-56.Caldas C, Mialhe F, Silva R. Prevalência de manchas dentais extrínsecas negras e sua relação com a cárie dentária em crianças do município de Santa Terezinha de Itaipu – PR. RFO. 2008;13(2):22-6.Vicente VA, Polleto MM, Neiva IF, Pinto JVT, Braga SF, Moreira M. Relação entre a prevalência da doença cárie e risco microbiológico. Cienc Odontol Bras. 2008;11(2):44-8.Dubinski P, Cardoso SA, Hoeppner MG. Avaliação das Causas das Substituições de Restaurações nas Disciplinas de Dentística II e Clínica Integrada do Curso de Odontologia da UNIPAR - Campus Umuarama. UEPG Ci Biol Saúde. 2005;11(1):7-14.Berti M, Furlanetto DLC, Walker MMS, Baltazar MMM, Bianchi FJ. Levantamento epidemiológico de cárie dentária em escolares de 5 e 12 anos de idade do município de Cascavel, PR. Cad Saúde Colet. 2013;21(4):403-6.Castillo LO, Moro RC, Zanatta FB, Flores DM. Prevalência de cárie dentária nos alunos da Escola Municipal Adelmo Simas Genro, Santa Maria, RS: uma análise descritiva parcial. Dis Scientia. 2016;7(1):121-25Cangussu MCT, Lopes LS. Epidemiologia da Cárie Dentária no Estado da Bahia de 1986 a 2012. Rev baiana saúde pública. 2012;36(3):640-50.

To systematically review the literature on the use of the transcranial static magnetic stimulation (tSMS) technique in humans and animals, its effects on different areas of the central nervous system (CNS), its influence on neural excitability and on the subject's behavior, and its biological effects and future possibilities. All static magnetic field applications that can be considered to have a physiologically similar effect have been reviewed.We searched studies using key terms in NCBI PubMed, Scopus, PEDro, SciELO, Cochrane, and links to publications (inception to September 2019). Three reviewers independently selected the studies, extracted data, and assessed the methodological quality of the studies using the recommendations described in the Cochrane Handbook for Systematic Reviews of Interventions, PRISMA guidelines.We analyzed 27 studies. The reviewed literature suggests that the use of these magnetic fields has an inhibitory effect on different areas of the CNS, such as motor, somatosensory, and visual cortex, cerebellum, and spinal cord. Regarding subject's behavior, the different effects of tSMS appear to be transient and dependent on the stimulated area, such as loss of visual discrimination or improvement of somatosensory perception. In addition, the technique has some therapeutic utility, specifically in pathologies with cortical hyperexcitability.These results suggest that tSMS may be a promising tool to modulate cerebral excitability in a safe and non-invasive way. Further investigations could give a better explanation of its precise mechanisms of action and applications.

El objetivo del proyecto es el desarrollo de un videojuego completo para dispositivos móviles Android e iOS utilizando el motor Unity. El proyecto abarcará todas las fases del desarrollo, desde el diseño hasta su publicación en las diferentes stores móviles. El videojuego será de tipo hyper-casual, siendo éste uno de los géneros de videojuegos más populares en dispositivos móviles, por tratarse de videojuegos con mecánicas sencillas fáciles de aprender, en los que se pueden jugar partidas rápidas.

Durante el trabajo de fin de grado analizo, con profundidad, en qué consiste el proceso penal de menores, así como, los órganos y las partes que van a intervenir en el mismo. También expongo con detalle las diferencias que presenta con respecto al procedimiento de los adultos y las necesarias reformas legislativas que necesitan ambos procesos.

A escola é considerada um espaço potencial para o desenvolvimento do cuidado à saúde. O Fisioterapeuta pode participar de ações de saúde no contexto em questão, principalmente em adoção de hábitos posturais, iniciando com a avaliação de alterações posturais. Este estudo objetivou a avaliação postural de escolares de Ensino Fundamental do município de Presidente Prudente. A metodologia constou da elaboração de Ficha de Avaliação Postural contendo dados individuais; questionários de hábitos corporais e atitudes posturais e avaliação postural estática. Os resultados foram 42 crianças avaliadas; idade média de 9,8 ± 0,9 anos; grupo ativo fisicamente; boa percepção postural durante as atividades cotidianas e alta prevalência de alterações posturais, principalmente nos segmentos cabeça, ombros e coluna lombar. Concluímos que escolares de Ensino Fundamental possuem bons hábitos corporais e posturais, além de grande prevalência de algias e alterações posturais. Esses aspectos reforçam a necessidade de intervenção fisioterapêutica precoce.

Increasing the nitrogen use efficiencyofcrop plants is a result of the improvement in the mechanisms involved in nitrogen uptake, translocation, assimilation and remobilization. In this study, tobacco plants with high accumulation of proline caused by the insertion of the VaP5CSF129Amutant gene under control of the constitutive promoter CaMV35S was used as a model to investigate the effect of overexpression of the transgene in the uptake and utilization of N. For this, an experiment was carried out in a completely randomized design, in a 2x5 factorial arrangement, with two genotypes (transgenic eventand untransformed control) and five levels of nitrogen fertilization (25, 50, 100, 200 and 400 kg N ha-¹), cultivated under greenhouse conditions. Plants were evaluated for height, number of leaves, dry mass, free proline content, nitrogencontent, total protein content and use of the applied N (efficiency of absorption -EAbs, efficiency of leaf utilization –EUtiland efficiency of plant use -EUN). The transgenic plantswith high proline accumulation were less efficient than the control plants in terms of nitrogen absorption (with lowerN levelsin root, leaves and wholeplant), which resulted in lower EAbs. There was no difference between the transgenic and control genotypesfor EUtil. However, the transgenic plants presented lower EUN in comparison tothe control plants. Our data showed thattransgenictobacco plants withhigh proline accumulation do not have potential for direct use in agricultural systems, since the alteration of the biochemical balance between the metabolisms of nitrogen and carbon did not result in plants with higher EUN.

Despite multiple recommendations, intramuscular epinephrine is poorly prescribed in emergency department receiving pediatric anaphylaxis. To evaluate the role of severity symptoms on this use, we included all admissions for a diagnosis linked to possible allergy in the two pediatric emergency departments of our institution between January 2010 and December 2015. Selection and analysis were restricted to children under 18 years fulfilling Sampson's criteria for anaphylaxis. We retrospectively ranked these admissions with the Ring and Messmer anaphylaxis severity score and compared the use of epinephrine according to this classification. Among 422,483 admissions, 204 (0.05%) fulfilled the anaphylaxis criteria (170 (83.3%) grade II anaphylaxis, and 34 (16.7%) grade III; mean age 7.9 years). Previous allergy, anaphylaxis, and asthma were found in respectively 60.8%, 36.8%, and 35.1%. Food allergy was the main suspected causal trigger. Epinephrine was used in 32.7% (n = 65/199), before admission (11.4% (n = 23/201)) or in the emergency department (22.2% (n = 45/202)). Epinephrine was more frequently prescribed in grade III than in grade II anaphylaxis (84.8% vs 22.3%, p 0.001; OR = 19.05 [7.05-54.10]). Upon discharge, epinephrine auto-injectors prescription and allergy referral were rare (31.7% and 44.2%).Conclusion: Pediatricians intuitively adapt their epinephrine use to the severity of the anaphylaxis and contribute to epinephrine underuse in pediatric anaphylaxis. What is known: • Intramuscular epinephrine is the recommended treatment for pediatric anaphylaxis. However, most of the European and North-American studies show a low prescription rate of epinephrine in both prehospital and pediatric emergency department management. • Reasons for such a low prescription rate are unknown. What is new: • This study confirms that intramuscular epinephrine is poorly prescribed in pediatric anaphylaxis (about one case among 10 before admission and one among 5 in pediatric emergency departments). • Despite recommendations, pediatricians intuitively adapt their prescription to the clinical severity of anaphylaxis, with a fourfold increase prescription in grade III compared to grade II anaphylaxis. This medical behavior ascertainment may be in part explained by the delay between the ED admission/management and the anaphylactic episode onset.

Background Emergency department (ED) crowding is a serious international public health issue with a negative impact on quality of care. Despite two decades of research, there is no consensus on the indicators used to quantify crowding. The aim of our study was to select the most valid ED crowding indicators. Materials and methods The Delphi method was used. Selected indicators originated from a literature review and propositions from FEDORU (National Emergency Department Observatory Network) workgroup. Selected national experts were emergency physicians with a special interest in ED crowding. They had to assess each indicator in terms of validity out of a Likert scale from 1 to 9. Indicators withdrawal criteria after each round (consensus) were over 70% of answers of at least 7 with interquartile range less than 3 (positive consensus) or over 70% of answers of at least 4 and interquartile range less than 3 (negative consensus). The decision to stop the delphi procedure was based on the stability of answers between the rounds. Results 41 (89.13%) experts answered the first round and 37 (80.43%) answered the second round. Among the 57 indicators included, 15 reached consensus: four input indicators, six throughput and five output ones. For those three categories of at least 7 answers rates were, respectively, 80.9, 76.9 and 75.0%. Five indicators were deducible from the mandatory Emergency Department Discharge Summary. They obtained 80.2% of at least 7 answers. Conclusion Our study results enable the construction and validation of a crowding measuring tool from indicators approved by experts. It is necessary to further reflect about ED crowding as a concept and what is expected from a complex score.

A artrite reumatoide é uma inflamação das articulações que pode ocorrer por múltiplos fatores. Esta doença pode atingir cerca de 1% da população mundial. O objetivo foi avaliar o uso do ômega 3 no controle desta doença por meio de uma revisão de literatura. Foi possí­vel verificar sua atuação no sistema imune através dos derivados Eicosapentaenoico e Docosahexaenoico que podem diminuir o processo inflamatório. Em contrapartida é necessária cautela com o consumo de peixes e suplementos de ômega 3 que possam conter mercúrio em sua composição, podendo ocasionar danos í saúde, porém não está diretamente relacionado Artrite Reumatoide mas pode agravar a doença. É necessário orientar o paciente a consumir peixes com menor concentração de mercúrio ou suplementar produtos confiáveis.Palavras-chave: ácido eicosapentaenoico, artrite reumatoide, mercúrio, óleos de peixe.

International audience; Children's asthma is multifactorial. Environmental factors like air pollution exposure, meteorological conditions, allergens, and viral infections are strongly implicated. However, place of residence has rarely been investigated in connection with these factors. The primary aim of our study was to measure the impact of particulate matter (PM), assessed close to the children's homes, on asthma-related pediatric emergency hospital visits within the Bouches-du-Rhône area in 2013. In a nested case-control study on 3- to 18-year-old children, each control was randomly matched on the emergency room visit day, regardless of hospital. Each asthmatic child was compared to 15 controls. PM10 and PM2.5, meteorological conditions, pollens, and viral data were linked to ZIP code and analyzed by purpose of emergency visit. A total of 68,897 visits were recorded in children, 1182 concerning asthma. Short-term exposure to PM10 measured near children's homes was associated with excess risk of asthma emergency visits (adjusted odds ratio 1.02 (95% CI 1.01-1.04; p = 0.02)). Male gender, young age, and temperature were other risk factors. Conversely, wind speed was a protective factor.CONCLUSION:PM10 and certain meteorological conditions near children's homes increased the risk of emergency asthma-related hospital visits in 3- to 18-year-old children in Bouches-du-Rhône. What is Known: • A relationship between short-term exposure to air pollution and increase in emergency room visits or hospital admissions as a result of increased pollution levels has already been demonstrated. What is New: • This study confirms these results but took into account confounding factors (viral data, pollens, and meteorological conditions) and is based on estimated pollution levels assessed close to the children's homes, rather than those recorded at the hospital. • The study area, the Mediterranean, is favorable to creation of secondary pollutants in these sunny and dry seasons.

In Marseille, the 2016 EURO football cup days were independently associated with a 43% increase in alcohol-related visits in the Emergency Department (ED). Patients admitted for alcohol consumption were younger (41 vs. 46.6; P < 0.001), more often male (82.8% vs. 60.1%; P < 0.001) and more often admitted as inpatients (24.0% vs. 16.5%; P = 0.03) than those admitted for injury. Unlike reported in previous studies, injury-related visits did not increase. This could be explained by coding practice variability between EDs (alcohol or injury). To account for this variability, both diagnosis groups must be separately included when using ED data for preparing and monitoring major gatherings.

Background Low back pain (LBP) is one of the leading contributors to disease burden worldwide [1]. In 2018, French health care insurance launched a population awareness campaign in order to promote effective behaviour change in France. Because LBP acute episodes often lead to emergency visits, Santé publique France, the French Public Health Agency and the Federation of Observatories for Emergency Medecine, performed a pre-campaign situational analysis of LBP in the French emergency department (ED) involved in the OSCOUR® network. Methods The OSCOUR network is part of the French syndromic surveillance system SurSaUD® [2] coordinated by Santé publique France since 2004. In 2017, the system collects daily individual data from about 700 ED representing 92% of the French ED attendances. Those data contain demographic, administrative and medical information including discharge diagnosis coded according ICD-10. ED attendances with a diagnosis related to LBP were analyzed from 2014 to 2017. Temporal distribution of LBP attendances, hospitalizations after discharge and stay duration in ED services were also analyzed. Results From 2014 to 2017, 504 ED were included in the analysis and LBP represented 1.12% (N = 481,291) of ED all visits. This proportion remained stable over the period. 60% of LBP attendances concerned 18 to 50 years old adults and almost 10% were hospitalized after discharge. This proportion increased with age to reach 43% for the 85 years old and more. LBP attendances were more frequent on Monday. Median stay duration were almost 3 hours but increased with age and for hospitalized patients. Conclusions The broad coverage of the ED OSCOUR® network on the whole territory and the strong partnership between epidemiologists and clinicians enable Santé publique France to produce reliable results which are also consistent with ED physician’s perception. Finally those results can be used as a reference contributing to evaluate potential benefits of this campaign. Key messages This description of low back pain ED attendances is consistent with emergency physicians perception on field and can be used as a reference to evaluate potential benefits of the prevention campaign. The national coverage of the ED OSCOUR® network and the strong partnership with emergency physicians enable Santé publique France to produce relevant description on the main causes of ED attendances.

Objecive The study aims to evaluate the potential impact of the revision of the thesaurus used by ED physicians to code medical diagnoses, on the syndromic indicators used daily to achieve the detection objective of the French syndromic surveillance system. Introduction As part of the French syndromic surveillance system SurSaUD®, the French Public Health Agency (Sante publique France) collects daily data from the emergency department (ED) network OSCOUR® [1]. The system aims to timely identify, follow and assess the health impact of unusual or seasonal events on emergency medical activity. Individual ED data contain demographic (age, gender, residence zip code), administrative (dates of attendances and discharge, ED, etc.) and medical information (chief complaint, main and associated medical diagnoses, severity). Medical diagnoses are encoded using the ICD10 classification. Then syndromic groups are built based on these ICD10 codes for ensuring syndromic surveillance in routine. Even if ICD10 is recommended on the national guidelines for coding ED attendances, this thesaurus offers a too large variety of codes. Particularly, it includes lots of diseases that may never be observed or confirmed in ED. This variety let selection of the appropriate codes difficult for physicians in a reactive use and could discourage them to code diagnoses. In order to encourage appropriate and reactive coding practice, we decided in 2017 to produce a new diagnoses thesaurus with a limited list of ICD10 codes. Then a committee of medical and epidemiological experts was created by the Federation of regional emergency observatories (FedORU), to propose an operational thesaurus that includes relevant codes for both ED in a daily routine practice and syndromic surveillance. Methods The committee has met 10 times since 2017. Since it would have been hard to work on the complete ICD10 list, the work was based on a more limited thesaurus already used by part of French ED. Only codes, which were pertinent regarding ED activity and interest for public health alert, have been considered. The main principles that have guided the selection were to 1) keep codes related to diagnoses that physicians are able to diagnose on a clinical basis or with rapid diagnostic tests, 2) remove diagnoses providing redundant information regarding other variables (such as circumstantial information) and 3) ensure that a substitution code was kept when a removed code was frequently used or was of interest for syndromic surveillance. Among the 86 syndromic groups defined on the basis of a list of ICD10 codes selected in the complete thesaurus, 34 are daily analyzed by Sante publique France for outbreak detection and early assessment of public health events. Those 34 syndromic groups have been recalculated by considering the revised thesaurus on a three-year period (from 2015 to 2017) at national level. In order to measure the potential impact of the revised thesaurus on the syndromic groups, we have considered three evaluation measures: 1. the proportion of ICD10 codes deleted (removal rate) from the initial definition of each syndromic group, due to the limitation of the thesaurus (calculated for the 86 syndromic groups); 2. the mean difference in the daily number of attendances between the initial and the new versions of each syndromic group (calculated for the 34 syndromic groups); 3. the linear correlation coefficient between the daily numbers of attendances of the initial and the new version of each syndromic group, in order to assess if the daily fluctuations of the new syndromic group are similar to those of the initial syndromic group (calculated for the 34 syndromic groups). Results Among the 86 syndromic groups, 75 (85%) have been impacted by the revised thesaurus, which implied codes removal. Among those 75 syndromic groups, the number of ICD10 codes included in their definition has been reduced by 71% on average. This removal rate varied between 17% and 100%. Syndromic groups including initially more than 100 codes have been the most concerned by a limitation of the number of ICD10 codes. Among the 34 syndromic groups daily analyzed for outbreak detection, 32 have been impacted by code removal with a mean removal rate of 68% (0%-97%). On average, 77% of daily attendances have been retained by the new version of syndromic groups, varying from 15% to 100%. Only 3 syndromic groups have kept less than 60% of attendances: Decrease of well-being (36%), Conjunctivitis (32%) and Hypothermia (15%). On average, the correlation coefficient has been of 0.96, varying from 0.57 to 1. The lowest values have been observed for the same three syndromic groups listed above: Decrease of well-being (0.57), Conjunctivitis (0.91) and Hypothermia (0.59). 18 among the 34 syndromic groups had a correlation coefficient higher than 0.99. Conclusions The study showed that most of the syndromic groups were impacted by the revised thesaurus, which resulted in a removal of about two thirds of the ICD10 codes usually considered in daily surveillance. However, more than three quarters of attendances were still retained in the new syndromic groups. This new thesaurus was conceived to rationalize the number of diagnoses codes but a substitution code was systematically proposed to replace removed codes. Those results highlighted that a large number of codes included in the complete ICD10 thesaurus were rarely used and that the most frequent codes were kept in the revised thesaurus version. However, this study showed that a few syndromic groups were strongly impacted by the revised thesaurus and can suffer of reduced performances to detect unusual variations. Based on those results, a second round of exploration of specific parts of the complete ICD10 thesaurus will be necessary to adapt either syndromic groups or the revised thesaurus. Even if the number of attendances may be reduced due to the removal of ICD10 codes, temporal variations remain similar for the majority of syndromic groups. Syndromic surveillance system does not aim to provide exhaustive quantification of attendances for a pathology, but aims to be able to detect expected or unusual public health variations. These evaluation results correspond to the worst-case scenario assuming that ED physicians will not modify their encoding habits by using the substitution codes but keep using their current thesaurus. However, we expect that this new and simplified version will facilitate diagnosis encoding task and lead toward a better diagnosis encoding rate. Once this new thesaurus will be widely used, we can expect a substantial improvement of the quality of ED medical data and then of syndromic surveillance results. Finally, this study enhances the importance that both data providers and epidemiologists in charge of syndromic surveillance work closely, in order to improve system in shared objectives. References [1] Fouillet A, Bousquet V, Pontais I, Gallay A, Caserio-Schonemann C. The French emergency department OSCOUR network: evaluation after a 10-year existence. Online J Public Health Inform. 2015; 7(1): e74.

Artemisia annua is cultivated mainly for isolation of artemisinin, a potent antimalarial compound. Moderate salt stress has been proved to increase the artemisinin synthesis by the plant. The aim of this study was to evaluate the influence of salt stress on physiological parameters and cell wall polysaccharides of A. annua. Plants subjected to salt stress displayed reduction in the biomass and length and showed high damage of cellular membranes. Cell wall polysaccharides extracted from aerial parts with hot water, EDTA and NaOH also exhibited modifications in the yield and monosaccharide composition. The main changes were found in the pectic polysaccharides: increase of homogalacturonan domain, increase of neutral side chains and increase in the methyl esterification. 1H NMR analyses of pectins indicated that for A. annua, arabinans have an important role in coping with salt stress. Hemicellulose domain was also modified under salt stress, with increased xylose contents. The results indicated adaptations in the cell wall of A. annua under salt stress.