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Cactus pear biomass has the potential for bioethanol production in dry regions. However, its low solids concentration and pH variations may hinder the process of alcoholic fermentation. The objectives of this study were as follows: (1) to evaluate the effects of harvest time and season on biomass pH and dry matter concentration of cladodes of two cactus pear species commonly used as forage (Nopalea cochenillifera and Opuntia stricta); (2) to compare the hydrolysis of fresh and dried biomass (10% w v−1 solids); (3) to compare increasing periods of two temperatures (65 °C or 105 °C) to concentrate the biomass to 10% and 30% solids; and (4) to perform enzymatic hydrolysis and fermentation of biomass dried to 30% solids. Biomass pH ranged from 3.0 to 5.6, from early morning to late afternoon, with higher diurnal variation during the dry season, when their solids concentrations were higher than in the rainy season (12–16% × 7–10%). Hydrolyzed fresh and dried biomass had similar glucose, xylose, and galacturonic acid concentrations. Drying at 105 °C for 12 h was the best temperature and period to reach 30% of solids. The enzymatic hydrolysis of the biomass dried to 30% solids yielded 65.3 and 80.0 g of glucose L−1. After fermentations (33 °C; 8 h; Saccharomyces cerevisiae), ethanol was produced to 29.4 and 37.5 g L-1 from N. cochenillifera and O. stricta biomasses, respectively. Therefore, early morning during the dry season is the best moment to harvest the cladodes, whose biomass can be partially dried at 105 °C for 12 h to 30% solids load before being hydrolyzed and fermented for bioethanol production. This procedure reduces the time, energy, and inputs needed in the process.

The present study aimed to evaluate the process of anaerobic co-digestion of different proportions of food waste and fresh bovine manure. The experiments were carried out in the laboratory (using 250-mL reactors) and in a pilot-scale biodigester (8 m3). The laboratory experiment was conducted with batch feed systems testing three food waste (FW) and bovine manure (BM) ratios: 0:1, 1:2, and 3:1 (equivalent to 0, 33, and 75 % of food waste in the digester substrate, respectively). The pilot-scale biodigester had a continuous feed system and received a 1:2 FW:BM mixture ratio. The highest accumulated biogas production in the laboratory was 273 mL g-1 of volatile solids (VS) in the treatment with the 1:2 FW:BM ratio. Concentrations of volatile fatty acids (VFA) greater than 8 g L-1 inhibited methane production, except in the treatment without food waste. In the pilot-scale biodigester, concentrations of VFA were below the inhibitory threshold, and the biogas and methane yields were 271 L kgVS-1 and 220 L kgVS-1, respectively. Therefore, food waste can be successfully co-digested with fresh bovine manure in continuous feed digesters, with an initial organic load rate of at least 2.74 kgVS m-3 day-1. Future studies should aim to test progressive increases in food waste load to identify the threshold for inhibition.

Este trabajo investiga las oraciones introducidas por incluso si en el espanol peninsular escrito, comprendidas como hibridas en la literatura porque, segun diferentes compendios, mezclan caracteristicas tanto de oraciones condicionales como de oraciones concesivas. El objetivo de la presente investigacion es analizar las propiedades funcionales de esas estructuras a la luz de la teoria de la Gramatica Discursivo-Funcional a fin de determinar el nivel y el estrato de actuacion de esas relaciones bajo la hipotesis de que incluso constituye una particula escalar de enfasis. El corpus utilizado es el CREA – Corpus de Referencia del Espanol Actual – banco de datos disponible en linea que esta compuesto de textos de diferentes generos, en lengua hablada y en lengua escrita. Los datos ensenan que las oraciones introducidas por incluso si se establecen en los estratos mas altos del Nivel Interpersonal y Representativo, cuando desempenan funcion semantica condicion, funcion retorica concesion o funcion interactiva ‘adenda’. Ese resultado sugiere una nueva perspectiva del fenomeno en analisis, presentado por la literatura como escalar, pero concebido en ese estudio de forma discreta, en terminos de funcion.

Resumo O objetivo deste estudo foi avaliar o efeito da restrição alimentar na resposta de fase aguda em equinos. Vinte cavalos foram submetidos à restrição alimentar por 48 h enquanto outros 12 animais (controle) tiveram livre acesso à água e alimento. Os animais foram monitorados, examinados e amostras de sangue foram coletadas no início (0) do estudo e com 6, 12, 18, 24, 30, 36, 42 e 48 horas de restrição alimentar. Os dados foram submetidos à análise de variância bidirecional com medidas repetidas e a significância estatística foi P ≤ 0,05. Os cavalos toleraram a restrição alimentar sem complicações clínicas relevantes. A restrição alimentar induziu uma resposta de fase aguda caracterizada pela elevação das concentrações séricas de α2-macroglobulina (24-38 h), ceruloplasmina (36-48 h), α1-antitripsina (30-48 h), α1-glicoproteína ácida (42-48 h) e haptoglobina (42-48 h). A privação de nutrientes eleva os níveis de cortisol circulante, que atua no sistema imunológico inato o qual, então induz a resposta de fase aguda. Em conclusão, a restrição alimentar é um fator estressor físico para equinos, capaz de induzir uma reação proteica de fase aguda, caracterizada pelo aumento na produção de α2-macroglobulina, ceruloplasmina, α1-antitripsina, α1-glicoproteína ácida e haptoglobina.

Pre-treatment is one of main economic and technological challenges to render feasible the production of biofuels and chemical compounds from lignocellulosic biomass. Alkaline hydrogen peroxide (AHP) is the most used pre-treatment and recycling of its liquid fraction can help reduce production costs. The effects of four AHP concentrations (1, 3.5, 5 and 7.5% v/v) on the recycling performance of the liquid fraction of pre-treated corn stover was evaluated for five consecutive cycles. Delignification rates increased with increasing AHP concentrations in the first cycle: 15, 26, 43 and 76% with 1, 3.5, 5 and 7.5% v/v H2O2, respectively. In the following cycles, the rates decreased linearly reaching less than 40% in the last two recycles. These delignification rates and hemicellulose solubilization were corroborated by spectroscopic analyses with Fourier transformation showing reductions in lignin and hemicellulose absorbance and increases in crystallinity indices. Considering the low delignification rates in the last two cycles, the pre-treated biomasses obtained until the third cycle were submitted to enzymatic hydrolysis at 1:10 solid–liquid ratio. The delignification rates affected the efficiency of the enzymatic hydrolysis at all AHP concentrations and all recycles. The highest AHP concentration (7.5% v/v) was required to efficiently remove lignin and solubilize hemicellulose, maintaining cellulose conversion into glucose greater than 50% up to three recycles. Therefore, the technology of recycling the liquid solution of AHP pre-treatment is recommended with high initial concentrations (7.5% v/v).

Objective: to investigate the literature produced on the therapeutic aspects and instruments used in the Analysis of Behavior Applied to people in the Spectrum of Autism. Method: It is an Integrative Review of Literature, carried out in a virtual environment, in Latin American and Caribbean Literature in Health Sciences databases - LILACS, Medical Literature Analysis and Retrieval System On-Line - MEDLINE and SciELO - Scientific Electronic Library Online, in the period from 2008 to 2018. Ten studies were identified that met the object of study. Results: ABA is perfectly applicable to people in the Autism Spectrum, being a science that presents strong constructs a body of knowledge that is comprehensible and comprehensible by parents /caregivers and teachers, provided they are duly accompanied by qualified professionals. Moreover, the use of diverse instruments such as scales and even games can be very useful for acquiring the essential skills to life in society and the installation of appropriate behaviors. Conclusion: ABA has been shown to be a fundamental scientific process to identify the functional relations between the observable behavior and the environmental context, and it is possible to affirm that the projection of interventions based on this science can promote an improvement in social welfare and personal, cognitive gains, language and learning.

A presente investigação aborda o desenvolvimento da marca Pastéis Reais que teve como mote a valorização de um conjunto de produtos gastronómicos tradicionais, que passou pelo redesenho de cinco produtos vila-realenses (Covilhete, Pito de Santa Luzia, Gancha de São Brás, Crista de Galo e Cavacório), com o objetivo de os adaptar a uma sociedade contemporânea preocupada com questões dietéticas, valorizando-os diretamente e indiretamente ao território. O projeto envolveu estudos dos produtos gastronómicos tradicionais de Vila Real, a criação da marca Pastéis Reais e respetiva comunicação, incluindo uma coleção de embalagens para acomodar os produtos. Para tal, procedeuse à análise do estado de arte e da revisão da literatura relevante relativa ao tema. Foi ainda aplicado um inquérito de forma a comprovar o nível de reconhecimento dos produtos gastronómicos em estudo e, dessa forma, fundamentar a necessidade de os elevar. Este projeto permitiu concluir sobre o valor do design como mediador, contribuindo para o enaltecimento de produtos gastronómicos regionais, potenciando o território, o turismo gastronómico e a economia local, e permitindo que os produtos e as suas tradições sejam mantidos. This research addresses the development of the Pastéis Reais brand, which had as its motto the enhancement of a set of traditional gastronomic products, which included the redesign of five Vila-Real products (Covilhete, Pito de Santa Luzia, Gancha de São Brás, Crista de Galo and Cavacório), with the aim of adapting them to a contemporary society concerned with dietary issues, valuing them directly and indirectly to the territory. The project involved studies of the traditional gastronomic products of Vila Real, the creation of the Pastéis Reais brand and respective communication, including a collection of packaging to accommodate the products. To this end, we analyzed the state of the art and reviewed the relevant literature on the subject. A survey was also applied in order to prove the level of recognition of the gastronomic products under study and, in this way, substantiate the need to elevate them. This project allowed us to conclude on the value of design as a mediator, contributing to the enhancement of regional gastronomic products, enhancing the territory, gastronomic tourism and the local economy, and allowing products and their traditions to be maintained. Mestrado em Design

Entender as concepções de luxúria no Islã se faz importante para compreender até que ponto a religiosidade influencia na visão de política e sociedade do historiador medieval Ibn Khaldun (1377), que viveu o período de declínio do Império Islâmico. O trabalho apresentado aqui, tem como proposta principal analisar a noção de luxúria na visão religiosa, política e social do historiador medieval, e em sua metodologia procura relacioná-las com referências bibliográficas de autores que trabalharam e pesquisaram Ibn Khaldun e suas obras, e dessa forma, a análise da fonte em si, o Muqqadimah (1377) e a sua relação com estas produções contemporâneas. Através de debates sobre seu contexto histórico, social e religioso, discutiremos o conceito de ‘assabiya para Khaldun e o modelo social tribal ao qual faz referência por diversas vezes na Muqqadimah, e a contraposição destes para com os centros urbanos, bem como suas críticas aos novos sistemas políticos da sociedade urbana que vivia.

Made available in DSpace on 2022-04-28T19:44:55Z (GMT). No. of bitstreams: 0 Previous issue date: 2021-10-01 Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq) Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) Lipase is an important group of biocatalysts, which combines versatility and specificity, and can catalyze several reactions when applied in a high amount of industrial processes. In this study, the lipase produced by Aspergillus japonicus under submerged cultivation, was immobilized by physical adsorption, using clay supports, namely, diatomite, vermiculite, montmorillonite KSF (MKSF) and kaolinite. Besides, the immobilized and free enzyme was characterized, regarding pH, temperature and kinetic parameters. The most promising clay support was MKSF that pre-sented 69.47% immobilization yield and hydrolytic activity higher than the other conditions studied (270.7 U g−1). The derivative produced with MKSF showed high stability at pH and temperature, keeping 100% of its activity throughout 12 h of incubation in the pH ranges between 4.0 and 9.0 and at a temperature from 30 to 50◦ C. In addition, the immobilized lipase on MKSF support showed an improvement in the catalytic performance. The study shows the potential of using clays as support to immobilized lipolytic enzymes by adsorption method, which is a simple and cost-effective process. Department of Engineering of Bioprocesses and Biotechnology School of Pharmaceutical Sciences São Paulo State University (UNESP) Department of Pharmaceutical-Biochemical Technology School of Pharmaceutical Sciences University of São Paulo Department of Engineering of Bioprocesses and Biotechnology School of Pharmaceutical Sciences São Paulo State University (UNESP) CAPES: 2017/11482-7 FAPESP: 2017/11482-7 CAPES: 2018/06908-8 FAPESP: 2018/06908-8 CAPES: 2019/15493-9 FAPESP: 2019/15493-9 CAPES: 2020/08655-0 FAPESP: 2020/08655-0 CAPES: 2020/09592-1 FAPESP: 2020/09592-1

Versão Final Esta versão contém as sugestões do júri Submitted by Iolanda Valente (ivalente@iscap.ipp.pt) on 2021-12-20T11:44:25Z No. of bitstreams: 1 Bárbara_Magalhães_MTIE_2021.pdf: 1719687 bytes, checksum: 4d0927ff4a2bfe59695ef0236d5d333f (MD5) Made available in DSpace on 2021-12-20T11:44:25Z (GMT). No. of bitstreams: 1 Bárbara_Magalhães_MTIE_2021.pdf: 1719687 bytes, checksum: 4d0927ff4a2bfe59695ef0236d5d333f (MD5) Previous issue date: 2021-09-27

Since the beginnings of the science of caring for human beings, religious practices and spirituality face a rigorous look from scientists and researchers. Nursing care must provide care and safety measures to the individual under a biopsychosocial unit model, in all physical, social, economic, spiritual and cultural aspects. In this way, this article aimed to analyze the scientific productions about the benefits of religious practices in the provision of nursing care, and specifically describe the importance of religious practices in health status, highlight the main limitations and challenges in nursing care with cultural-religious healing practices and relating nursing behavior to cultural/religious treatment and/or therapy. This is an integrative literature review, in which the question was formulated: "What are the benefits of the association between religious practices and nursing care in the provision of care?". Using descriptors and keywords, the Bireme, CINAHL and PubMed databases were consulted. We used the available studies in full, published in the years 2015 to 2020, in English, Portuguese and Spanish. The articles showed that religiosity and spirituality are fundamental dimensions in the healing, rehabilitation and overcoming processes, and should be implemented in the science of care by health professionals. It was concluded that it is the duty of nursing and other areas of health to serve the individual with humanized care, respecting their spiritual-religious needs in treatment and/or therapy. Desde los inicios de la ciencia del cuidado del ser humano, las prácticas religiosas y la espiritualidad enfrentan una mirada rigurosa por parte de científicos e investigadores. El cuidado de enfermería debe brindar medidas de cuidado y seguridad al individuo bajo un modelo de unidad biopsicosocial, en todos los aspectos físicos, sociales, económicos, espirituales y culturales. De esta manera, este artículo tuvo como objetivo analizar las producciones científicas acerca de los beneficios de las prácticas religiosas en la prestación de cuidados de enfermería, y específicamente describir la importancia de las prácticas religiosas en el estado de salud, resaltar las principales limitaciones y desafíos en el cuidado de enfermería con los cuidados culturales-religiosos. prácticas curativas y relacionar el comportamiento de enfermería con el tratamiento y / o terapia cultural / religiosa. Se trata de una revisión integradora de la literatura, en la que se formuló la pregunta: "¿Cuáles son los beneficios de la asociación entre prácticas religiosas y cuidados de enfermería en la prestación de cuidados?". Mediante descriptores y palabras clave se consultaron las bases de datos Bireme, CINAHL y PubMed. Se utilizaron los estudios disponibles en su totalidad, publicados en los años 2015 a 2020, en inglés, portugués y español. Los artículos mostraron que la religiosidad y la espiritualidad son dimensiones fundamentales en los procesos de curación, rehabilitación y superación, y deben ser implementadas en la ciencia del cuidado por los profesionales de la salud. Se concluyó que es deber de la enfermería y otras áreas de la salud atender al individuo con cuidados humanizados, respetando sus necesidades espiritual-religiosas en el tratamiento y / o terapia. Desde os primórdios da ciência do cuidado ao ser humano, as práticas religiosas e a espiritualidade enfrentam um olhar rigoroso dos cientistas e pesquisadores. A assistência de enfermagem deve prestar cuidados e medidas de segurança ao indivíduo sob um modelo de unidade biopsicossocial, em todos os aspectos físicos, sociais, econômicos, espirituais e culturais. Nesse caminho, este artigo teve como objetivo geral analisar as produções científicas acerca dos benefícios das práticas religiosas na prestação de cuidados de enfermagem, e especificamente descrever a importância das práticas religiosas no estado de saúde, destacar as principais limitações e os desafios nos cuidados de enfermagem com as práticas de cura cultural-religiosa e relacionar as condutas de enfermagem com o tratamento e/ou terapia cultural/religiosa. Trata-se de uma revisão integrativa da literatura, na qual se formulou a questão: "Quais os benefícios da associação entre as práticas religiosas e assistência de enfermagem na prestação de cuidados?". Com uso de descritores e palavras-chaves, foram consultadas as bases de dados Bireme, CINAHL e PubMed. Utilizou-se os estudos disponíveis em totalidade, publicados nos anos de 2015 até 2020, nos idiomas Inglês, Português e Espanhol. Os artigos apresentaram que religiosidade e espiritualidade são dimensões fundamentais nos processos de cura, reabilitacionais e de superação, e devem ser implementadas na ciência do cuidado pelos profissionais de saúde. Concluiu-se que é dever da enfermagem e de outras áreas da saúde, atender o indivíduo com assistência humanizada, respeitando suas necessidades espiritual-religiosas no tratamento e/ou terapia.

Background and Aims Renal amyloidosis include amyloid A (AA) and light chain (AL) as well as amyloidogenic leukocyte chemotactic factor 2 (ALECT2) and numerous hereditary forms. After identifying amyloidosis by its suggestive pale pink amorphous appearance in optic microscopy (OM) and Congo red positivity, a correct diagnosis of the amyloidogenic precursor protein is determinant to establish prognosis and treatment. Immunohistochemistry (IHC) and immunofluorescence (IF) studies use a limited number of antibodies to detect specific epitopes and may be difficult to interpret. The gold standard has become proteomics but laser microdissection and mass spectroscopy are not routinely available. Other options include electron microscopy with immunogold staining and complementary exams such as scintigraphy with 99mTc-DPD to detect transthyretin-related amyloidosis. Since the cause of amyloidosis vary among regions, analyzing local patterns can help establish a diagnostic procedure. We aimed at describing cases of kidney amyloidosis identified by biopsy during a 4-year interval and discuss possible implication for future diagnosis. Method We analyzed our kidney biopsy database and selected all cases of renal amyloidosis collecting clinical, laboratory and imaging data. Results From January 2016 until December 2019, 194 kidney biopsies were performed at the Hospital of Braga in the Portuguese province of Minho. Among these, 8 (4.1%) revealed amyloidosis. Mean age was 63.8±9.2 years of age, 5 were female, 6 were referred for nephrotic syndrome and 2 for what seemed like acute kidney injury. Mean creatinine at presentation was 3.2±2.3mg/dL. Among them, 2 had AL amyloidosis with light chain restriction by IF, 1 had AA amyloidosis with intense IHC stain and 5 patients had non-AL and non-AA forms of amyloidosis. Of these, 3 had probable fibrinogen A alpha-chain (AFib) amyloidosis, after a heterozygous mutation FGA p.Glu545Val was detected, 1, who did not have IHC performed, was assumed as having AA amyloidosis due to a history of serious recurrent infections and 1 is still under study. Four performed scintigraphy with 99mTc-DPD which was negative. The 2 patients with AL amyloidosis had, by OM, in one case glomerular and tubulointerstitial and on the other, glomerular and vascular involvement and, by IF, both had k light chain restriction. Both had additional cardiac and neurovegetative involvement, were treated with cyclophosphamide-bortezomib-dexamethasone and oral doxycycline with complete hematologic response and stabilization of kidney function. In 1 case, proteinuria only showed a slow decline 2 years after treatment. The 2 patients with AA amyloidosis had glomerular, vascular and tubular deposits. One had bronchiectasis and allergic bronchopulmonary aspergillosis and the other had common variable immunodeficiency with recurrent gastrointestinal and urinary infections with frequent bacteremia. None of them had confirmed extra-renal involvement, although the latter had hepatic fibrosis awaiting biopsy. Both progressed to dialysis soon after diagnosis. The 3 patients with AFib amyloidosis all had glomerular amyloidosis with additional amyloid deposition at tubular, vascular and both respectively. Two had had an increased creatinine and subnephrotic proteinuria for some years whereas 1 had kidney function decline and nephrotic syndrome in the course of few months. All were hypertensive and none had evident extra-renal deposits. Conclusion Identifying the amyloidogenic precursor may be difficult. Algorithms for diagnosis may vary according to local prevalence of specific types and available resources. AFib amyloidosis was very significant in our series. It was also described in 4.5% of hemodialysis patients in the district of Braga making it one of the first causes of amyloidosis in our region. This high prevalence may justify early genetic testing for the specific mutation in non-AL and non-AA forms.

Background and Aims Diabetic kidney disease (DKD) develops in almost half of diabetic patients and is the leading cause of chronic kidney disease (CKD). SGLT2 inhibitors (SGLT2i) have consistently shown to confer kidney protection in patients with type 2 diabetes (T2D). The recent KDIGO guidelines suggest their use as a first line medication along with metformin. After the study CREDENCE was published, in mid-2019, DKD patients at the Nephrology outpatient department of the Hospital of Braga were started on SGLT2i. We aimed at assessing these patients’ clinical and laboratory data after the introduction of the new drug. Method We collected data on age, gender, weight, blood pressure (BP) values, the use of renin-angiotension-aldosterone system inhibitors (RAASi), kidney function, glycated hemoglobin (HbA1c), glycosuria, proteinuria and albuminuria at baseline and during the two next patient assessments. Data was analyzed using SPSS®. Results Twenty-nine DKD patients who started SGLT2i between May 2019 and August 2020 were followed. Mean age was 71.2±13.5 years, 22 patients were male and their mean weight was 86.9±13.9 kg. They had had T2D for a mean of 15.9±10.3 years and a significant percent had end organ damage: 34% had diabetic retinopathy, 24% complaints suggestive of neuropathy, 51% had documented heart failure and 27% had cerebral vascular disease. Most were hypertensive with a mean BP of 156±19/83±11mmHg and 72.4% were taking RAASi. One third were treated with insulin. Most patients were started on canagliflozin (n=28) and one patient started empagliflozin. After starting the drug, patients were evaluated at a mean time of 141±55 days and had a second reevaluation at a mean time of 254±72 days. On the first evaluation they showed a significant reduction in the mean systolic BP to 140±15.1mmHg (p=0.001). Glycated hemoglobin decreased from a mean of 7.4±1.3% to 7.1±1.1% although this difference was not significant (p=0.4). Protein-creatinine urinary ratio was significantly reduced from a median value of 1.48 (IQR 0.24-1.85) to 0.93 (IQR 0.40-1.56). Mean serum creatinine increased significantly from baseline until the first evaluation at 1.96±0.49 to 2.27±0.66mg/dL (p=0.00) but remained stable on the second evaluation (2.29±0.79mg/dL). Seventy percent of the patients developed significant glycosuria (urinary concentration >500mg/dL) after starting SGLT2i. When asked about adherence, most non-glycosuric patients admitted not having started the drug. Conclusion Despite having a weak effect in the reduction of HbA1c, SGLT2i are an exciting drug for kidney protection in DKD. Patient adherence is easy to assess based on glycosuria. In our experience and based on this criterion drug compliance was acceptable (at least 70%) and we were able to reinforce instructions among non-compliant patients. Some of the benefits of SGLT2i were evident soon after they were started such as the improvement in BP and proteinuria. The initial increase in plasma creatinine was expected due to reduction in intraglomerular pressure and hyperfiltration and was noticeable only on the first assessment. We expect to continue SGLT2i use DKD patients.

In this study, sugarcane bagasse hydrolysate supplemented with different proportions of sugar-ethanol industrial waste (vinasse) was used to optimize fermentative ethanol production using two Spathaspora passalidarum yeast strains isolated from decaying wood in Amazonian biome. The bagasse samples were pretreated chemically and enzymatically before using a binary factorial experimental design. The factorial design was carried out in two stages; in the first, a 24 factorial design was done to assess the effects of pretreated sugarcane bagasse hydrolysate and vinasse, ammonium sulfate concentration, yeast biomass concentration, and two different strains of yeast, S. passalidarum; in the second stage, a 23 factorial design was done to provide a more detailed analysis of the effects of vinasse supplementation on the fermentation process—this time, by modifying the ratio of sugarcane bagasse hydrolysate and vinasse and, more significantly, the same factor—biomass concentration. The results showed that the most significant factors for increasing bioethanol production in the 24 factorial design proved to be the following: inoculum and hydrolyzed bagasse supplementation with vinasse (the optimal being 75:25), followed by yeast concentration (optimal at 14% w/v cell wet weight) and then the type of strain used (S. passalidarum UFMG-HMD-14.1). The use of only hydrolyzed bagasse without vinasse (23 factorial design) had no significant influence on the results, nor did varying the concentration of nitrogen. This increase in ethanol production, which allows the same amount of ethanol productivity through a reduction in the carbon source, suggests it can lead to an improved final use for vinasse.

Tuberculosis (TB) is an infectious and endemic infectious disease, caused by Mycobacterium tuberculosis, reaching almost all organs and tissues of the human body. This study aimed to describe the epidemiological aspects of tuberculosis in the city of Caxias in the state of Maranhão in the period 2015-2019. This is a documentary, descriptive, retrospective study, with a quantitative approach to the data, carried out from 2015 to 2019, using data from the Ministry of Health's Notifiable Diseases Information System (SINAN). This study evaluated 325 cases of TB in the mentioned period. It can be observed that there was a prevalence of TB cases in males (67.7%), in which there was a predominance of the age group of 20 to 39 years (33.5%). Regarding race, there was a statistically significant prevalence of brown skin (70.8%), in which most individuals had low education. With regard to prevalence, 2016 had the highest rates (23.7%). The predominant clinical form of the disease was pulmonary (91.4%), in which almost all were new cases (82.8%). In view of the problems encountered, it is clear that TB remains a major public health problem. It is necessary that more actions aimed at combating pathology be put into practice and that governments see the extent of the problem. It is considered that more studies should be carried out in this line of investigation, in order to prove the need to search for new ways to approach the theme, aiming to decrease the number of cases. La tuberculosis (TB) es una enfermedad infecciosa infecciosa y endémica, causada por Mycobacterium tuberculosis, que llega a casi todos los órganos y tejidos del cuerpo humano. Este estudio tuvo como objetivo describir los aspectos epidemiológicos de la tuberculosis en la ciudad de Caxias en el estado de Maranhão en el período 2015-2019. Se trata de un estudio documental, descriptivo, retrospectivo, con abordaje cuantitativo de los datos, realizado de 2015 a 2019, con datos del Sistema de Información de Enfermedades Notificables del Ministerio de Salud (SINAN), que evaluó 325 casos de TB en el mencionado período. Se puede observar que hubo una prevalencia de casos de TB en el sexo masculino (67,7%), en el que hubo predominio del grupo etario de 20 a 39 años (33,5%). En cuanto a la raza, hubo una prevalencia estadísticamente significativa de piel morena (70,8%), en la que la mayoría de los individuos tenía baja escolaridad. En cuanto a la prevalencia, 2016 tuvo las tasas más altas (23,7%). La forma clínica predominante de la enfermedad fue la pulmonar (91,4%), en la que casi todos fueron casos nuevos (82,8%). En vista de los problemas encontrados, está claro que la tuberculosis sigue siendo un problema importante de salud pública. Es necesario que se pongan en práctica más acciones encaminadas a combatir la patología y que los gobiernos vean la magnitud del problema. Se considera que se deben realizar más estudios en esta línea de investigación, con el fin de demostrar la necesidad de buscar nuevas formas de abordar el tema, con el objetivo de disminuir el número de casos. A Tuberculose (TB) é uma doença infectocontagiosa e endêmica, provocada pelo Mycobacterium tuberculosis, chegando a atingir quase todos os órgãos e tecidos do corpo humano. Este estudo teve como objetivo descrever os aspectos epidemiológicos da tuberculose no município de Caxias do Estado do Maranhão no período de 2015-2019. Trata-se de estudo documental, descritivo, retrospectivo, com uma abordagem quantitativa dos dados, realizado no período de 2015 a 2019, utilizando dados do Sistema de Informação de Agravos de Notificação (SINAN) do Ministério da Saúde. Este estudo avaliou 325 casos de TB no período citado. Pode observar que houve prevalência de casos de TB no sexo masculino (67,7%), em que houve predominância da faixa etária de 20 a 39 anos (33,5%). Com relação a raça, houve prevalência estatisticamente significativa da parda (70,8%), em que a maior parte dos indivíduos apresentavam baixa escolaridade. Com relação a prevalência, o ano de 2016 apresentou maiores índices (23,7%). A forma clinica predominante da doença foi a pulmonar (91,4%), em que quase totalidade eram casos novos (82,8%). Diante dos problemas encontrados torna-se claro que a TB continua sendo um grande problema de saúde pública. É necessário que mais ações voltadas ao combate da patologia sejam colocadas em prática e que os governos enxerguem a extensão do problema. Considera-se que mais estudos devem ser realizados nessa linha de investigação, a fim de provar a necessidade de buscar novas formas de abordar a temática, visando diminuir o número de casos.

Labor is a known risk factor for pelvic floor dysfunction (PFD); however, the impact of operative vaginal delivery (OVD), particularly spatulas, remains unclear. The aim of this study was to compare postpartum PFD symptoms in women undergoing spontaneous vaginal delivery (SVD) and those undergoing OVD.An observational prospective study (MOODS: Maternal-neonatal Outcomes in Operative Vaginal Delivery) was enrolled at Hospital de Braga from February to October 2018. All singleton term OVD (Thierry spatulas and vacuum extractor) and a convenience SVD sample were recruited, in a 2:1 ratio. To assess PFD symptoms Pelvic Floor Distress Inventory-20 (PFDI-20) was applied at 3, 6, and 12 months postpartum. The questionnaire is divided into three subscales: Urinary (UDI), Colorectal-Anal (CRADI), and Pelvic Organ Prolapse Distress Inventory (POPDI).Of the 304 women recruited, 207 were included, 34.3% with SVD and 65.7% with OVD. Thierry spatulas were used in 53.7% of women undergoing OVD. Frequency of nulliparous (p 0.001), episiotomy (p 0.001), neuraxial anesthesia (p 0.001), postpartum pain (p = 0.001) and occiput-posterior fetal position (p 0.001) were significantly higher in OVD. Second phase of labor duration was longer in OVD (p = 0.001). At 3 months postpartum, women undergoing OVD and spatula-assisted delivery had higher UDI score, POPDI score, and global score, with no differences at 6 months and 1 year. After controlling for confounding variables, OVD and spatulas were still associated with greater POPDI scores at 3 months postpartum.Operative vaginal delivery, particularly with spatulas, seems to be associated with a higher prevalence of early PFD symptoms, mainly regarding pelvic organ prolapse.

Garlic acts on hypertension in several ways, first, exerting a dilating effect, both by the release of nitric oxide and by the increase in available adenosine, thus contributing to the hypotensive mechanism, and garlic can be considered a strong ally in the treatment of this pathology, the study had as a problem “effectiveness of using garlic extract as herbal medicine in controlling hypertension according to the literature?”. Where the objective was to verify in the available scientific productions the effects of garlic extract in hypertensive individuals. The present study is a bibliographic search of the type Integrative Review (IR) of the literature, the PubMed databases were consulted through descriptors and keywords, BVS, coordinated by BIREME and composed of bibliographic databases produced by the BVS Network, such as LILACS, in addition to the Medline database and CINAHL. At the end, eight (8) articles answered the guiding question and were added to the study and highlighted the use of garlic in clinical practice, the benefits of using garlic as a complementary therapy in the treatment of hypertension and within the diet, in addition to the main side effects. It was concluded that increasing the intake of allium vegetables may be associated with a reduction in triglycerides and creatinine clearance, which provides an improvement in renal function and a decrease in blood pressure. El ajo actúa sobre la hipertensión de varías formas, en primer lugar, al ejercer un efecto dilatador, tanto por la liberación de óxido nítrico como por el aumento de la adenosina disponible, contribuyendo así al mecanismo hipotensor, y el ajo puede considerarse un fuerte aliado en el tratamiento de esta patología, el estudio tuvo como problema “¿Cuál es el eficacia del uso de extracto de ajo como medicina herbal en el control de la hipertensión según la literatura?”. Donde el objetivo fue verificar en las producciones científicas disponibles los efectos del extracto de ajo en hipertensos. El presente estudio es una búsqueda bibliográfica del tipo Revisión Integrativa (RI) de la literatura, se consultaron las bases de datos PubMed mediante descriptores y palabras clave, BVS, coordinada por BIREME y compuesta por bases de datos bibliográficas producidas por la Red BVS, como LILACS, además de la base de datos Medline y CINAHL. Al final, ocho (8) artículos respondieron a la pregunta orientadora y se agregaron al estudio y destacaron el uso del ajo en la práctica clínica, los beneficios del uso del ajo como terapia complementaria en el tratamiento de la HSA y dentro de la dieta, además de los principales efectos secundarios. Se concluyó que el aumento de la ingesta de vegetales allium puede estar asociado con una reducción de los triglicéridos y el aclaramiento de creatinina, lo que proporciona una mejora de la función renal y una disminución de la presión arterial. O alho age na hipertensão de diversas formas, primeiramente exercendo um efeito dilatador, tanto pela liberação de óxido nítrico, quanto pelo aumento da adenosina disponível, contribuindo dessa forma para o mecanismo hipotensor, podendo-se considerar o alho um forte aliado no tratamento desta patologia, o estudo teve como problemática “Qual a eficácia do uso de extrato de alho como fitoterapia no controle da hipertensão de acordo com a Literatura?”. Onde objetivou-se verificar nas produções cientificas disponíveis os efeitos do extrato de alho em indivíduos hipertensos. O presente estudo trata-se de uma pesquisa bibliográfica do tipo Revisão Integrativa (RI) da literatura, consultou-se por meio de descritores e palavras-chave as bases de dados PubMed, BVS, coordenada pela BIREME e composta de bases de dados bibliográficas produzidas pela Rede BVS, como LILACS, além da base de dados Medline e CINAHL. Ao final oito (8) artigos atenderam a questão norteadora e foram adicionados ao estudo e evidenciou o uso do alho na prática clínica, os beneficios da utilização do alho como terapia complementar no tratamento HAS e dentro da dieta, além dos principais efeitos colaterais. Conclui-se que aumentar a ingestão de vegetais allium, pode estar associada a redução de triglicerídeos e depuração de creatinina, o que proporciona uma melhoria da função renal e diminuição da pressão arterial.

Scientifically, the death is a biological, natural and inevitable event that characterizes the end of life, being considered the irreversible collapse of the functioning of organs. This study objectified to investigate how the nursing trainee deals with the process of death and mourning. This is a descriptive-exploratory cross-sectional field research, with a qualitative approach, performed in a general hospital and in a maternity hospital located in a municipality in the state of Maranhão. The sample consisted of 10 nursing trainees. As result, it was found that nursing trainees have difficulties dealing with death and mourning. The main feelings awakened against death were impotence, sadness, failure, frustration, pain, anguish, and coldness. So, to protect themselves, the academics create strategies, of which the acceptance, rationalization, religiosity, distancing and negation stand out. It was also realized that their understanding of the finitude of life is related to the personal experiences of each one, however, it was noted that the death of children, young people and cancer patients are the most difficult to deal with. It is concluded, due the mentioned aspects, the importance of introducing disciplines in the curriculum that approaches the process of death / dying and mourning. It is recommended that the nursing trainee search to accomplish classes, post-graduations and specializations during his professional life, in order to obtain knowlegde about how to deal with terminal situations, providing quality assistance and sharing concepts and experiences. Científicamente, la muerte es un evento biológico, natural e inevitable que caracteriza el final de la vida, considerándose el fallo irreversible de funcionamiento de los órganos. Este estudio tuvo como objetivo investigar cómo el interno de enfermería afronta el proceso de muerte y duelo. Se trata de una investigación de campo, descriptiva-exploratoria, transversal, con abordaje cualitativo, realizada en un hospital general y en una maternidad ubicada en un municipio del estado de Maranhão. La muestra estuvo compuesta por 10 pasantes de enfermería. Como resultado, se encontró que los internos de enfermería tienen dificultades para lidiar con la muerte y el dolor. Los principales sentimientos que se despertaron ante la muerte fueron el desamparo, la tristeza, el fracaso, la frustración, el dolor, la angustia y la frialdad. Así, para protegerse, los académicos crean estrategias, de las que destacan la aceptación, la racionalización, la religiosidad, el desapego y la negación. También se notó que su comprensión de la finitud de la vida está relacionada con las experiencias personales de los demás, sin embargo, se señaló que las muertes de niños, jóvenes y pacientes con cáncer son las más difíciles de manejar. Se concluye, por los aspectos mencionados, la importancia de introducir en el currículo asignaturas que abordan el proceso de muerte / morir y duelo. Se recomienda que el pasante de enfermería busque realizar cursos, posgrados y especializaciones a lo largo de su vida profesional, con el fin de adquirir lecciones sobre cómo enfrentar situaciones terminales, brindando asistencia de calidad y compartiendo conceptos y experiencias. Cientificamente, a morte é um evento biológico, natural e inevitável que caracteriza o final da vida, sendo considerada a falência irreversível do funcionamento dos órgãos. Este estudo objetivou investigar como o estagiário de enfermagem lida com o processo de morte e luto. Trata-se de uma pesquisa de campo, do tipo descritiva-exploratória, transversal, com abordagem qualitativa, realizada em um hospital geral e em uma maternidade localizados em um município do estado do Maranhão. A amostra foi composta por 10 estagiários de enfermagem. Como resultado constatou-se que os estagiários de enfermagem possuem dificuldades em lidar com a morte e o luto. Os principais sentimentos despertados diante da morte foram a impotência, tristeza, fracasso, frustração, dor, angústia e frieza. Assim, para se proteger, os acadêmicos criam estratégias, das quais se destacam a aceitação, racionalização, religiosidade, distanciamento e negação. Percebeu-se, também, que a compreensão deles frente a finitude da vida está relacionada às experiências pessoais de cada um, entretanto, notou-se que a morte de crianças, jovens e pacientes oncológicos são as mais difíceis de lidar. Conclui-se, em razão dos aspectos mencionados, a importância de introduzir na grade curricular disciplinas que abordem o processo de morte/morrer e luto. Recomenda-se que o estagiário de enfermagem busque realizar cursos, pós-graduações e especializações ao decorrer de sua vida profissional, a fim de adquirir aprendizados sobre como lidar com situações de terminalidade, prestando assistência de qualidade e compartilhando conceitos e experiências.

Leprosy is a chronic infectious disease. Its cause is Mycobacterium leprae, a frankly gram-positive and resistant acid-alcoholic bacterium that can infect peripheral nerves. This study aimed to describe the epidemiological aspects of leprosy in the city of Caxias-MA. This is a documentary, descriptive, retrospective and quantitative study, carried out from 2013 to 2017, using data from the Ministry of Health's Notifiable Diseases Information System (SINAN). This study evaluated 349 cases of leprosy in the period from 2013 to 2017 in the municipality of Caxias in the state of Maranhão. The highest coefficients were recorded in 2013 (6.15 / 10000) and 2015 (5.03 / 10000). Regarding the profile of the identified patients, there was a male prevalence with 191 (54.7%) of the cases, in that there was a predominance of the age group from 50 to 59 years (18.6%), the evaluation of the operational classification shows that the multibacillary form was the most frequent (74.5%); as to the percentage of skin lesions due to leprosy, the highest rate is two to five injuries with 151 (43.3%) of the cases, and with regard to the therapeutic scheme, 260 (74.5%) received multibacillary multidrug treatment (PTQ / MB) of 12 doses. Leprosy is still considered a neglected disease, although there are public policies aimed at eradicating it, we are still on a long and slow path to eliminate the disease. However, many screening actions and activities are intensifying for the early diagnosis and treatment of leprosy in order to reduce the high rates of multibacillary cases. La lepra es una enfermedad infecciosa crónica. Su causa es Mycobacterium leprae, una bacteria ácido-alcohólica francamente grampositiva y resistente que puede infectar los nervios periféricos. Este estudio tuvo como objetivo describir los aspectos epidemiológicos de la lepra en la ciudad de Caxias-MA. Se trata de un estudio documental, descriptivo, retrospectivo y cuantitativo, realizado de 2013 a 2017, con datos del Sistema de Información de Enfermedades Notificables del Ministerio de Salud (SINAN), que evaluó 349 casos de lepra en el período comprendido entre 2013 a 2017 en el municipio de Caxias en el estado de Maranhão. Los coeficientes más altos se registraron en 2013 (6,15 / 10000) y 2015 (5,03 / 10000). En cuanto al perfil de los pacientes identificados, hubo una prevalencia masculina con 191 (54,7%) de los casos, en que hubo predominio del grupo de edad de 50 a 59 años (18,6%), la evaluación de la clasificación operativa muestra que la forma multibacilar fue la más frecuente (74,5%); En cuanto al porcentaje de lesiones cutáneas por lepra, la tasa más alta es de dos a cinco lesiones con 151 (43,3%) de los casos, y en cuanto al esquema terapéutico, 260 (74,5%) recibieron tratamiento multibacilar multifármaco (PTQ / MB) de 12 dosis. La lepra sigue siendo considerada una enfermedad desatendida, aunque existen políticas públicas encaminadas a erradicarla, todavía estamos en un camino largo y lento para eliminar la enfermedad. Sin embargo, se están intensificando muchas acciones y actividades de detección para el diagnóstico temprano y el tratamiento de la lepra con el fin de reducir las altas tasas de casos multibacilares. A hanseníase é uma doença infecciosa crônica. Sua causa é o Mycobacterium leprae, uma bactéria ácido-alcoólica francamente gram-positiva e resistente que pode infectar os nervos periféricos. Este estudo teve como objetivo descrever os aspectos epidemiológicos da hanseníase no município de Caxias-MA. Trata-se de um estudo documental, descritivo, retrospectivo e quantitativo, realizado no período de 2013 a 2017, utilizando dados do Sistema de Informação de Agravos de Notificação (SINAN) do Ministério da Saúde. Este estudo avaliou 349 casos de hanseníase no período de 2013 a 2017 no município de Caxias do estado do Maranhão. Os coeficientes mais elevados foram registrados no ano de 2013 (6,15/10000) e 2015 (5,03/10000), Quanto ao perfil dos pacientes identificados houve prevalência do sexo masculino com 191 (54,7%) dos casos, em que houve predominância da faixa etária de 50 a 59 ano (18,6%), a avaliação da classificação operacional mostra que a forma multibacilar foi a mais frequente (74,5%); quanto ao percentual de lesões cutâneas em decorrência da hanseníase o maior índice são de duas a cinco lesões com 151 (43,3%) dos casos, e com relação ao esquema terapêutico, 260 (74,5%) receberam tratamento poliquimioterápico multibacilar (PTQ/MB) de 12 doses. A hanseníase ainda é considerada uma doença negligenciada, apesar de existir politicas púbicas voltadas para erradicação da mesma, ainda estamos numa longa e lenta trajetória para eliminação da doença. Mas muitas ações e atividades de rastreamento veem se intensificando para o diagnóstico e tratamento precoce da hanseníase com objetivo de reduzir as altas taxas de casos multibacilares.

The objective of this study was to evaluate the effect of feed restriction on some physical and blood parameters in horses kept outdoors under natural conditions. Twenty horses were deprived of food for 48 h. They were closely monitored and examined, and blood samples were taken at the beginning (0) of the experiment and 6, 12, 18, 24, 30, 36, 42 and 48 hours afterward. During the experimental period, the control group (12 animals) had free access to water and hay, while the restricted group had free access to water only. Data were submitted to two-way analysis of variance with repeated measures, and statistical significance was P ≤ 0.05. The horses tolerated feed restriction without complications. Feed restriction had no effect on body mass and body condition score, heart rate, respiratory rate, capillary filling time and body temperature. However, feed restriction decreased the intensity of gastrointestinal sounds (P, O objetivo deste estudo foi avaliar o efeito da restrição alimentar sobre parâmetros físicos e sanguíneos em equinos mantidos a pasto de Tifton (Cynodon spp) e em condições naturais. Vinte cavalos foram privados de alimento por 48 h. Eles foram monitorados, examinados e amostras de sangue foram coletadas no início (0) do experimento e 6, 12, 18, 24, 30, 36, 42 e 48 horas depois. Durante o período experimental, o grupo controle (12 animais) teve livre acesso a água e feno, enquanto o grupo restrito teve livre acesso apenas a água. Os dados foram submetidos à análise de variância bidirecional com medidas repetidas e a significância estatística foi P ≤ 0,05. Os cavalos toleraram a restrição alimentar sem complicações. A restrição alimentar por 48 h não teve efeito sobre a massa corporal e escore de condição corporal, frequência cardíaca, frequência respiratória, tempo de enchimento capilar e temperatura corporal. No entanto, o jejum alimentar diminuiu a intensidade dos sons gastrointestinais (P

Introduction: SARS‑CoV2 represents a challenge for hemodialysis (HD). By August 24 2020, the disease had affected 55720 people in Portugal. The northern Minho province has had 4428 cases. The Minho has 870 HD patients among 11 ambulatory HD centers and the Nephrology Department of Braga Hospital. Braga Hospital centralized HD treatments of COVID‑19 patients. We describe our experience managing these patients. Results: We used a 2‑station room and dedicated nurse with PPE but, as numbers increased, HD was performed in the main HD room. Disinfection protocols and specific routes were created. Swabs were repeated 14 days after diagnosis and then weekly until recovery. A total of 17 HD COVID‑19 patients were diagnosed in the Minho, 16 of which performed HD in Braga Hospital. The first patient was diagnosed on March 16 and the last on May 5. Ten were males, mean age 60.6±13.2 years and median dialysis vintage 38.5 months (IQR 23.5‑85.8). Four patients were diabetic and 10 were hypertensive. Only 1 of the 5 hospitalized patients was admitted for symptoms attributable to COVID‑19. One developed severe respiratory insufficiency; 3 took hydroxychloroquine and 1 died. The 11 patients on ambulatory care had mild or no symptoms. At diagnosis, the mean hemoglobin was 10.1±1.8g/dL; mean leukocytes count 6.5±3.4x10/μL; mean platelet count 161±7x10/μL and mean LDH 241±148U/L. Median C reactive protein was 11.3mg/L (IQR 1.6‑ 23.8). Patients’ swabs turned negative after a mean of 22±10 days. No association was found between the duration of a positive swab and gender, diabetes or hypertension. Discussion: Compared with the general population, Minho HD patients had a higher incidence of cases, possibly due to an increased risk and more testing. Incidence and mortality were lower than in other series. Centralizing infected patients may help prevent the spread of the disease and reduce the burden on HD centers.