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Rainfall behavior is a fundamental issue in areas with scarce and irregular amounts, such as the Spanish Mediterranean region. We identified 12 spatial patterns that characterized 899 torrential precipitation events (≥150 mm in 24 h) that occurred in the 3,537 rainy precipitation series in the period 1950–2020. Three of these components––eastern and ESE––showed positive and significant trends in their accumulated volumes. We then characterized the mean synoptic causes of the 10 most intense events in each component at both mean sea-level pressure and 500 hPa geopotential height, and also the integrated water-vapor transport between 1,000 and 300 hPa. We found a clear spatial distribution of the pluviometric effects related to unstable atmospheric situations (such as troughs and cut-off lows), and also to SW–SE advection fluxes that brought moist air from the Western Mediterranean. In particular, torrential rainfall in the Balearic Islands related more to E–NE advections than to southeastern ones. We also determined that the major parts of these components occurred in early autumn, especially in September and October. We expect these findings to help our understanding of the processes leading to catastrophic situations along the Spanish Mediterranean coast and to lead to improvements in early alert systems and management plans.

In the European context, social and emotional education (SEE) has been developed from social and emotional learning (SEL) and aims to be a core curriculum element across the region. However, to reach the current development in SEE, apart from the effort of individual nations, the roles of the European Union (EU) in uniting and strengthening the SEE concept across its member states is significant. This paper employs document analysis method as the main tool to accentuate the roles of the EU in this development process. It first identifies the educational context and policies articulated by the EU as the foundation for the induction and inception of SEE into the area, which are reviewed afterward. Finally, the current module of SEE adopted across the EU members is introduced as an illustration of the EU’s effort to bolster SEE in their regional area. This paper presents a good example of how a regional union unites and boosts their regional development in general and particularly educational innovation.

Background: Chronic kidney disease (CKD) is a multifactorial, world public health problem that often develops as a consequence of acute kidney injury (AKI) and inflammation. Strategies are constantly sought to avoid and mitigate the irreversibility of this disease. One of these strategies is to decrease the inflammation features of AKI and, consequently, the transition to CKD. Methods: C57Bl6J mice were anesthetized, and surgery was performed to induce unilateral ischemia/reperfusion as a model of AKI to CKD transition. For acute studies, the animals received the Kinin B1 receptor (B1R) antagonist before the surgery, and for the chronic model, the animals received one additional dose after the surgery. In addition, B1R genetically deficient mice were also challenged with ischemia/reperfusion. Results: The absence and antagonism of B1R improved the kidney function following AKI and prevented CKD transition, as evidenced by the preserved renal function and prevention of fibrosis. The protective effect of B1R antagonism or deficiency was associated with increased levels of macrophage type 2 markers in the kidney. Conclusions: The B1R is pivotal to the evolution of AKI to CKD, and its antagonism shows potential as a therapeutic tool in the prevention of CKD following AKI.

The clinical manifestation of leptospirosis is often misdiagnosed as other febrile illnesses such as dengue. Therefore, there is an urgent need for a precise diagnostic tool at the field level to detect the pathogenic Leptospira lipL32 gene at the molecular level for prompt therapeutic decisions. Quantitative polymerase chain reaction (qPCR) is widely used as the primary diagnostic tool, but its applicability is limited by high equipment cost and the lack of availability in every hospital, especially in rural areas where leptospirosis mainly occurs. Here, we report the development of a CRISPR dFnCas9-based quantitative lateral flow immunoassay to detect the lipL32 gene. The developed assay showed superior performance regarding the lowest detectable limit of 1 fg/mL. The test is highly sensitive and selective, showing that leptospirosis diagnosis can be achieved with a low-cost lateral flow device.

Introduction: Breast cancer has increased progressively in recent years, and with this, the need for diagnosis and earlier treatment has also increased. Currently, in Brazil, breast cancer accounts for 29.7% of cancer cases in women. The reconstruction of the nipple-areolar complex (NAC) has focused on greater attention due to the search for symmetry and naturalness, which is the final stage of this whole process. The objective is to evaluate the maintenance of the size, contour, color, symmetry and shape change of reconstructed NAC after mastectomies associated with radiotherapy. Methods: A retrospective study was conducted analyzing the evolution of reconstructed areolas after total mastectomy associated with adjuvant treatment with radiotherapy. Two groups were selected: group 1 (unilateral reconstruction) and group 2 (bilateral reconstruction). Comparisons were made between the reconstructed NAC areola, group 1, with that of the contralateral NAC and in group 2, between the two reconstructed areolas Results: After the inclusion of 56 patients in the study, 71 reconstructed areolar complexes were included. Symmetry was classified as good in 77.46% of all cases (p=0.706). Twenty-five reconstructions were performed in areas under the effect of radiotherapy, and only 9 cases showed decreased areola size (p=0.050), evolving with an asymmetry in 8 cases, 4 in the radiotherapy region (p=0.706). The areolar contour showed a similarity between cases treated with radiotherapy and untreated (p=0.918). Conclusion: Adjuvant radiotherapy was a predisposing factor for changes that may arise during the postoperative period of reconstruction of the nipple-areolar complex, according to statistical analysis.

AimsPre-existing conditions, such as age, hypertension, obesity, and diabetes, constitute known risk factors for severe COVID-19. However, the impact of prediabetes mellitus (PDM) on COVID-19 severity is less clear. This study aimed to evaluate the influence of PDM in the acute and long-term phases of COVID-19.Materials and methodsWe compared inflammatory mediators, laboratory and clinical parameters and symptoms in COVID-19 patients with prediabetes (PDM) and without diabetes (NDM) during the acute phase of infection and at three months post-hospitalization.ResultsPatients with PDM had longer hospital stays and required intensive care unit admission more frequently than NDM. Upon hospitalization, PDM patients exhibited higher serum levels of interleukin 6 (IL-6), which is related to reduced partial pressure of oxygen (PaO2) in arterial blood, oxygen saturation (SpO2) and increased COVID-19 severity. However, at three months after discharge, those with PDM did not exhibit significant alterations in laboratory parameters or residual symptoms; however, PDM was observed to influence the profile of reported symptoms.ConclusionsPDM seems to be associated with increased risk of severe COVID-19, as well as higher serum levels of IL-6, which may constitute a potential biomarker of severe COVID-19 risk in affected patients. Furthermore, while PDM correlated with more severe acute-phase COVID-19, no long-term worsening of sequelae was observed.

In the study of the construction of curricular knowledge in Portugal between 1970 and 2009, we argue that the practice of the established curriculum guidelines has a close relationship with the personal dimension of its actors. Therefore, it is not possible to separate the life history of each actor from the curricular policy measures they developed. This means that we sought not only to identify who the political actors were, but also how they built their knowledge and the relationship this has with their life story, by making their social and cognitive map. The sources that we used were laws, reports and interviews with political actors. We conclude that the choice of political leaders for education is not innocent or even indifferent to their life policies, since the knowledge built by each one is integrated into their educational proposals. Although the agenda for education is defined at the supranational level, national policies take different directions. Thus, the study also suggests the need to research the relation between the collective and the individual in educational policies.

This paper aims to identify and discuss what constitutes a research-based pedagogical culture in teaching research methods courses in master’s and doctoral programs in education. The discussion draws on empirical results of a set of five focus group interviews with teachers responsible for teaching research methods courses in educational programs in higher education institutions in Portugal. Data are analyzed and interpreted within a situated learning framework that acknowledges the relevance of creating social learning spaces which accommodate the variety of students. The article closes with a characterization of what could be a research-based pedagogical culture in teaching research methods in advanced studies in education in the near future.

The main pathogens of severe respiratory infection in children are respiratory viruses, and the current molecular technology allows for a rapid and simultaneous detection of a wide spectrum of these viral pathogens, facilitating the diagnosis and evaluation of viral coinfection. Methods: This study was conducted between March 2020 and December 2021. All children admitted to the ICU with a diagnosis of SARI and who were tested by polymerase chain reaction on nasopharyngeal swabs for SARS-CoV-2 and other common respiratory viral pathogens were included in the study. Results: The result of the viral panel identified 446 children, with one infected with a single virus and 160 co-infected with two or more viruses. This study employed descriptive analyses, where a total of twenty-two coinfections among SARI-causing viruses were identified. Thus, the five most frequent coinfections that were selected for the study are: hRV/SARS-CoV-2 (17.91%), hRV/RSV (14.18%), RSV/SARS-CoV-2 (12.69%), hRV/BoV (10.45%), and hRV/AdV (8.21%). The most significant age group was 38.1%, representing patients aged between 24 and 59 months (61 individuals). Patients older than 59 months represented a total of 27.5%, comprising forty-four patients. The use of oxygen therapy was statistically significant in coinfections with Bocavirus, other CoVs, Metapneumovirus, and RSV. Coinfections with SARS-CoV-2 and the other different coinfections presented a similar time of use of oxygen therapy with a value of (p > 0.05). In the year 2020, hRV/BoV was more frequent in relation to other types of coinfections, representing a total of 35.1%. The year 2021 presented a divergent profile, with hRV/SARS-CoV-2 coinfection being the most frequent (30.8%), followed by hRV/RSV (28.2%). Additionally, 25.6% and 15.4% represented coinfections between RSV/SARS-CoV-2 and hRV/AdV, respectively. We saw that two of the patients coinfected with hRV/SARS-CoV-2 died, representing 9.52% of all deaths in the study. In addition, both hRV/hBoV and hRV/RSV had death records for each case, representing 8.33% and 6.67% of all deaths, respectively. Conclusion: Coinfections with respiratory viruses, such as RSV and hBoV, can increase the severity of the disease in children with SARI who are admitted to the ICU, and children infected with SARS-CoV-2 have their clinical condition worsened when they have comorbidities.

The eHealth technologies promote parental care practices for preterm infants. Nonetheless, we should underscore the abundant information and available apps and disparities in these resources’ quality, usability, and reliability. This article examines eHealth technologies directed at parents to care for preterm infants. An integrative review was conducted across the principal health databases (Capes, EBSCO, BVS, PubMed, Scholar, and SciELO), selecting works published from 2011 to 2022 in Portuguese and English, focusing on the use of eHealth technologies for the care of preterm infants. We identified 13 articles related to information and communication technologies in strategies for educating and promoting the health of preterm infants and their parents and the importance of evaluating and validating eHealth technologies in maternal and child health promotion. Properly validated eHealth technologies can be crucial in supporting parents in promoting health and providing care for preterm infants after hospital discharge, which, in turn, can drive the evolution of healthcare systems and improve clinical practices. [ABSTRACT FROM AUTHOR]

Morphological and immunohistochemical studies of solid arrangement canine mammary carcinomas have shown that the different histological types may be characterized by proliferation of epithelial and/or myoepithelial cells. However, little is known about immunophenotypes and the importance of inflammation as prognostic factors in these neoplasms. The objective of the present study was to characterize the immunophenotype and degree of inflammation in the solid type of canine mammary neoplasm and to investigate their association with metastasis, Ki-67 index, tumour size, necrosis and survival. Sixty-five carcinomas with solid pattern, basaloid carcinomas, solid papillary carcinomas, malignant adenomyoepitheliomas (MAMEs) or malignant myoepitheliomas (MMEs) were investigated. Luminal A, luminal B HER2 negative and HER2 positive, HER2 overexpressed and triple negative immunophenotypes were immunolabelled as were Ki-67 protein and cyclooxygenase-2 (Cox-2). Histological peritumoural and intratumoural inflammatory infiltrates were graded (distribution × intensity) and the presence of necrosis identified. We found a statistical difference between histological types and immunophenotypes, with MME and MAME having a higher occurrence of luminal A, whereas most neoplasms had the luminal B HER-negative immunophenotype. There was no correlation between immunophenotype and degree of peri- and intratumoural inflammation, nodal metastasis, necrosis or tumour size. An increased degree of peri- and intratumoural inflammation was significantly associated with lymph node metastasis, and more severe intratumoural inflammation was associated with the presence of tumour necrosis. Tumour size, Ki-67 index and Cox-2 score were not associated with inflammation in either peri- or intratumoural regions. No difference was observed in survival in relation to immunophenotype or degree of inflammation, but the Cox regression model revealed that nodal metastasis influenced the risk of death. [ABSTRACT FROM AUTHOR]

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Introduction: Tram (transverse abdominal rectum flap) has remained the most used autologous breast reconstruction method over the last 30 years. First described by Holmström, the flap allows breast reconstruction with analogous tissue, providing natural appearance and consistency and lasting results. Reconstruction of the abdominal wall of the defect installed after flap transposition is a major challenge, and there is no consensus on the form for elevation or closure of the abdominal wall flap. The article aims to present a practical method for abdominal wall reconstructions to reduce morbidity in patients undergoing breast reconstruction with TRAM. Methods: This is a descriptive work of a systematic abdominal wall reconstruction technique using propylene mesh. Result: Once the technique is applied, we have an abdominal wall covered with polypropylene fabric, fully fixed and well adapted. The systematization of abdominal wall reconstruction after reconstruction with TRAM was performed, which is characterized by being easy to reproduce and applicable. Conclusion: The technique is a good alternative in abdominal wall reconstructions for the surgeon, systematizing polypropylene mesh adaptation.

Background and purpose: The novel coronavirus, SARS-CoV-2, which was identified after the outbreak in Wuhan, China, in December 2019, has kept the whole world in tenterhooks due to its severe life-threatening nature of the infection. The World Health Organization (WHO) declared coronavirus disease (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 a pandemic in 2020, an unprecedented challenge, having a high contagious life-threatening condition with unprecedented impacts for worldwide societies and health care systems. Neurologic symptoms related to SARS-CoV-2 have been described recently in the literature, and acute cerebrovascular disease is one of the most serious complications. The occurrence of large-vessel occlusion in young patients with COVID-19 infection has been exceedingly rare. In this article, we describe the profile of patients undergoing decompressive craniectomy for the treatment of intracranial hypertension by stroke associated with COVID-19 published so far. A narrative review of the central issue in focus was designed: decompressive craniectomy in a pandemic time.

Este artigo analisa a evolução do discurso político do líder do partido populista português, André Ventura, após a sua eleição como deputado em 2019 e nos anos de 2020 e 2021, marcados pela pandemia Covid-19 e pelas eleições presidenciais, nas quais obteve um resultado muito superior ao obtido pelo seu partido nas eleições legislativas anteriores. Com base na literatura académica sobre populismo e situações de crise (Brubaker, 2021; Seedhouse, 2020) e em ensaios de académicos publicados em media internacionais (Jenning, 2020; Luciano, 2020), o artigo passa em revista o efeito da pandemia Covid-19 no apoio aos governos a nível internacional independentemente da sua ideologia, e detém-se na circunstância de em Portugal, apesar dos elevados índices de apoio ao governo socialista, o partido populista Chega, na oposição, ter sido o único a crescer. Usando uma metodologia qualitativa baseada na análise de conteúdo de um conjunto de intervenções públicas do líder populista português em momentos-chave do seu percurso político, emitidas em formatos mediáticos diversificados, o artigo conclui que o discurso de André Ventura se manteve focado nos temas nucleares do seu programa populista, independentemente do contexto pandémico. A análise identifica inconsistência e volatilidade no seu discurso e nas suas posições sobre a pandemia Covid-19, com posições ambíguas entre aceitação inicial e negação posterior de restrições e vacinas, adaptando as suas posições às reacções dos seus apoiantes e de grupos inorgânicos, como os negacionistas.

Introduction: Dentin Hypersensitivity (DH) is known to be a relatively common condition that affects a considerable portion of the population, and manifests itself in the form of acute pain, due to the exposure of dentin and open dentinal tubules, after the removal of enamel or root cement. It has a multifactorial aetiology. Aim: To compare the efficacy in DH treatment using Biosilicate and Gluma Desensitiser. Materials and Methods: This randomised clinical trial pilot study with a split-mouth design included seven participants. Two teeth presenting Gingival Recession (GR)-related DH were selected in each participant and allocated to treatment groups by simple randomisation. Gluma® desensitiser (GD) and Biosilicate® (BIO) were applied once a week for four weeks. The pain intensity under a volatile stimulus was measured using a Visual Analogue Scale (VAS) at baseline and after treatment, at 15 days and 6 months follow-up. Data analysis were performed by means of descriptive statistics, Paired t-test for inter-group comparison and Friedman test for intra-group comparison (p-value

The astounding characteristics of the nanomaterials can be crafted to prepare tailor-made interfaces, especially for the development of biomedical applications. In the present study, we illustrate the preparation of a new class of doughnut-shaped manganese nanograins embellished on the graphene sheets to develop hybrid interfaces using a gentle and nontoxic approach. We investigate its potential to detect clinically important biomarkers and glutathione is chosen as a case study. The unprecedented structural morphology and chemical characteristics are described. Two-dimensional sheets of graphene are uniformly occupied by manganese nanograins. Each individual grain is doughnut-shaped with the external diameter of about 5−10 nm, the thickness of 2 nm with a small central cavity of about 1 nm. We show the unique morphology of hybrid offers conducting features of graphene, metallic nature of nanograins, and amelioration of greater surface area to promote enhanced binding capability. Resultantly, the hybrid yields remarkable sensitivity of 7 nM. A binding mechanism has been proposed along with extensive kinetics assessment. The developed hybrid can selectively bind glutathione in comparison of protein and non-protein molecules. The results validate that this approach can be used to design green hybrid materials for accurate diagnosis of biomarkers and metabolites.

During the Civil War, Castelló de la Plana, like other rearguard cities was the target of repeated attacks by land and sea between 1937 and 1939. These bombings made it necessary to take measures to defend the civilian population and, as a result, air-raid shelters were built. After the war ended, these buildings were generally abandoned and forgotten, and only a small fraction of those built still conserved. In recent years their historical value has gradually been recognized as part of attempts to recover the memories of war and contribute to a new culture of peace. The Municipal Historical Archive of Castelló conserves the original plans for the construction of public air-raid shelters, particularly graphic documents. Thanks to their analysis the missing shelters and the forms of graphic representation of the time can be identified.

Abstract Background Metastasis causes the most breast cancer-related deaths in women. Here, we investigated the antitumor effect of solid lipid nanoparticles (SLN-DTX) when used in the treatment of metastatic breast tumors using 4T1-bearing BALB/c mice. Results Solid lipid nanoparticles (SLNs) were produced using the high-energy method. Compritol 888 ATO was selected as the lipid matrix, and Pluronic F127 and Span 80 as the surfactants to stabilize nanoparticle dispersion. The particles had high stability for at least 120 days. The SLNs’ dispersion size was 128 nm, their polydispersity index (PDI) was 0.2, and they showed a negative zeta potential. SLNs had high docetaxel (DTX) entrapment efficiency (86%), 2% of drug loading and showed a controlled drug-release profile. The half-maximal inhibitory concentration (IC50) of SLN-DTX against 4T1 cells was more than 100 times lower than that of free DTX after 24 h treatment. In the cellular uptake test, SLN-DTX was taken into the cells significantly more than free DTX. The accumulation in the G2-M phase was significantly higher in cells treated with SLN-DTX (73.7%) than in cells treated with free DTX (23.0%), which induced subsequent apoptosis. TEM analysis revealed that SLN-DTX internalization is mediated by endocytosis, and fluorescence microscopy showed DTX induced microtubule damage. In vivo studies showed that SLN-DTX compared to free docetaxel exhibited higher antitumor efficacy by reducing tumor volume (p

In this article, we will discuss the relationship between the formation of Brazilian society, the racial issue and the promotion of public policies. We problematize the theme with reference to the process of exploitation and oppression experienced by the black population in capitalist society, within the context of Imperialism and the crisis of capital. We discussed reparations policies as democratic demands and their importance in combating racism. We present the affirmative action policies driven by the action of the black movement materialized in the Brazilian State through the policies of quotas and Law 10.639 / 03, detecting the limits of this action and the democratic demands. Finally, we problematize the challenges of the Brazilian proletariat, in its diversity, electing elements of a possible transitional reparations program that contemplates the demands of race and class.

Intimate Partner Violence (IPV) is a recurring phenomenon in society and can have important repercussions for the lives and health of women worldwide. Even in this alarming global scenario, many health workers still have difficulties approaching IPV with women and providing care for the victims of this type of violence. Given this context, this qualitative study aims at understanding how primary health care professionals provide care for women victims of violence by intimate partners. In view of the methodology design proposed in the Grounded Theory, data collection took place through theoretical sampling. Data collection was carried out in 22 institutions offering primary health care, with 31 female workers from different professional categories being interviewed individually and in depth, including physicians, nurses, dentists, psychologists, and social workers. The results show that, in order to overcome the difficulties encountered in caring for victims of IPV, primary health care workers have been developing strategies for the care of these women. These strategies include identification of such cases through questions about the woman’s intimate relationship, by establishing a bond with the victim so that she feels welcomed, and through articulation with other team professionals to propose expanded health care. The interventions carried out by these professionals include meeting the demands of women in the health institution where they work, referral to other services in the network, if necessary, and notification of IPV cases to epidemiological surveillance. Based on this understanding of the care offered by the professionals to women who are victims of IPV in primary health care, the research aims at contributing to the sensitization of professionals working in health institutions regarding the identification of signs that raise suspicion of IPV, as well as at addressing such cases in a way to fully meet these women’s needs.

Background Inappropriate antibiotic use constitutes one of the most concerning public health issues, being one of the main causes of antibiotic resistance. Hence, to tackle this issue, it is important to encourage the development of educational interventions for health practitioners, namely by using digital health tools. This study focuses on the description of the development and validation process of the eHealthResp online course, a web platform directed to physicians and pharmacists, with the overall goal of improving antibiotic use for respiratory tract infections, along with the assessment of its usability. Methods The eHealthResp platform and the courses, developed with a user-centered design and based on Wordpress and MySQL, were based on a previously developed online course. A questionnaire to assess the usability was distributed among physicians (n = 6) and pharmacists (n = 6). Based on the obtained results, statistical analyses were conducted to calculate the usability score and appraise the design of the online course, as well as to compare the overall scores attributed by both groups. Further qualitative comments provided by the participants have also been analyzed. Results The eHealthResp contains two online courses directed to physicians and pharmacists aiming to aid in the management of respiratory tract infections. The average usability score of the eHealthResp online courses for physicians and pharmacists was of 78.33 (±11.57, 95%CI), and 83.75 (±15.90, 95%CI), respectively. Qualitative feedback emphasized the usefulness of the course, including overall positive reviews regarding user-friendliness and consistency. Conclusions This study led us to conclude that the eHealthResp online course is not recognized as a complex web platform, as both qualitative and quantitative feedback obtained were globally positive.

Inflammatory mammary carcinoma (IMC), a neoplasia affecting women and female dogs, is considered an aggressive cancer with high metastatic potential and a low survival rate. Studies focused on the tumour microenvironment indicate that the aggressive behaviour of this tumour is primarily correlated with immunological factors as well as inflammation. The objective of this study was to analyse the possible strategies used by the tumour cells to suppress the immune response in female dogs with IMC. Forty-six female dogs were divided into three groups: control (C, n = 10), IMC (n = 14) and mammary carcinoma (MC, n = 22). Clinical-pathological evaluations, survival at follow-up, immunophenotyping of leukocytes in peripheral blood and tumours, and immunohistochemical evaluation of CD4+, granzyme B, perforin and FAS-L were performed. Clinical and pathological results showed a higher frequency of the primary form of neoplasia, solid arrays of tumor cells and a lower survival rate in the IMC group (30 days). Morphometric analysis of inflammatory infiltrate revealed more lymphocytes and macrophages in the IMC group. Immunophenotyping analysis of peripheral blood revealed a higher frequency of CD8+ T-cells (p = 0.0017), a lower frequency of CD4+ T-cells (p

Staphylococcus spp. have been associated with cases of healthcare associated infections due to their high incidence in isolates from the hospital environment and their ability to cause infections in immunocompromised patients; synthesize biofilms on medical instruments, in the case of negative coagulase species; and change in genetic material, thus making it possible to disseminate genes that code for the acquisition of resistance mechanisms against the action of antibiotics. This study evaluated the presence of blaZ, femA, and mecA chromosomal and plasmid genes of Staphylococcus spp. using the qPCR technique. The results were associated with the phenotypic expression of resistance to oxacillin and penicillin G. We found that the chromosomal femA gene was present in a greater proportion in S. intermedius when compared with the other species analyzed, while the plasmid-borne mecA gene was prevalent in the S. aureus samples. The binary logistic regression performed to verify the association among the expression of the genes analyzed and the acquisition of resistance to oxacillin and penicillin G were not significant in any of the analyses, p > 0.05.