Search

Introduction and objectives: Chronic obstructive pulmonary disease (COPD) is a major public health problem. The aim of this study was to ascertain the prevalence of COPD and whether such prevalence was positively or negatively associated with COPD admissions, using all the data of a regional health care system. Materials and methods: We designed a descriptive cross-sectional study which included all subjects aged over 45 years, diagnosed with COPD in primary care in 2013. We also calculated the number of such patients who had a record of hospital admissions due to this disease. COPD prevalence and incidence of admissions were calculated. Poisson regression models were then used to analyse the association between cases with diagnosis of COPD and admissions due to COPD, by sex, adjusting for socio-demographic variables and distance to hospital. Sensitivity subanalyses were performed by reference to the respective municipal rurality indices. Results: Median municipal prevalence of COPD was 5.29% in men and 2.19% in women. Among patients with COPD, 28.22% of men and 16.00% of women had at least one hospital admission. The relative risk of admission per unit of the standardised prevalence ratio was 0.37 (95% CI 0.34–0.41) for men and 0.39 (95% CI 0.34–0.45) for women. Conclusions: There is a significant negative association between COPD prevalence and hospital admissions due to this disease. The proportion of admissions is lower in municipalities lying furthest from hospitals. There is considerable municipal variability in terms of COPD prevalence and proportion of admissions. In-depth attention should be given to disease-management training programmes. Keywords: Pulmonary disease, Chronic obstructive, Exacerbations (COPD), Prevalence, Health information systems, Hospital admissions, Ecological study

This article aims at contributing to a body of work about children and families by exploring the importance of socio‐economic context and social capital for understanding the ways in which money is perceived, obtained and used by children. Alleged contrasts in terms of money management, consumption priorities and postponement of gratification, especially among middle and working classes, have already been debated. It seems thus relevant to investigate if these presumable contrasts apply to children and why. Do children from different socio‐economic contexts reveal the traits that have been attributed to their households? To this end, a mixed methods research project was developed involving 245 children attending different primary schools in Portugal—one private school targeted at upper class children and one state‐sponsored school located in a working‐class area. The results revealed significant differences by school and household typology.

This work was supported by Fundac¸ão para a Ciência e a Tecnologia (Portugal) grants PTDC/AGR-ALI/118590/2010 and PTDC/BIA-EVF/118618/2010 (J.P.S., P.G.), and UID/ Multi/04378/2013 (A.P., J.P.S., P.G.). This work was supported by Conselho Nacional de Desenvolvimento Cientifico e Tecnológico (CNPq—Brazil, process numbers 407415/2013 and 0457499/2014-1, C.A.R.), Fundac¸ão do Amparo a Pesquisa do Estado de Minas Gerais (FAPEMIG, process number APQ-01525-14, C.A.R.). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. The study of microbe domestication has witnessed major advances that contribute to a better understanding of the emergence of artificially selected phenotypes and set the foundations of their rational improvement for biotechnology. Several features make Saccharomyces cerevisiae an ideal model for such a study, notably the availability of a catalogue of signatures of artificial selection and the extensive knowledge available on its biological processes. Here, we investigate with population and comparative genomics a set of strains used for cachaça fermentation, a Brazilian beverage based on the fermentation of sugar cane juice. We ask if the selective pressures posed by this fermentation have given rise to a domesticated lineage distinct from the ones already known, like wine, beer, bread, and sake yeasts. Our results show that cachaça yeasts derive from wine yeasts that have undergone an additional round of domestication, which we define as secondary domestication. As a consequence, cachaça strains combine features of wine yeasts, such as the presence of genes relevant for wine fermentation and advantageous gene inactivations, with features of beer yeasts like resistance to the effects of inhibitory compounds present in molasses. For other markers like those related to sulfite resistance and biotin metabolism our analyses revealed distributions more complex than previously reported that support the secondary domestication hypothesis. We propose a multilayered microbe domestication model encompassing not only transitions from wild to primarily domesticated populations, as in the case of wine yeasts, but also secondary domestications like those of cachaça yeasts. authorsversion published

Introduction KPC carbapenemase-producing Klebsiella pneumoniae (KPC-KP) has become a major public health challenge. Accordingly, this study sought to use a systematic review of the scientific literature to ascertain the mortality of KPC-KP infection, and analyze such mortality by country, year of publication, hospital ward, and type of interpretation used to define carbapenem resistance. Methodology A search without language restrictions was made of the MEDLINE, CENTRAL, EBSCO, LILACS and EMBASE databases from 1996 through June 2017, to locate all studies which had determined the existence of KPC-KP infection. We then performed a meta-analysis of all studies that reported KPC-KP infection-related mortality, and analyzed mortality by subgroup in accordance with standard methodology. Results A total of 51 papers were included in the systematic review. From 2005 through 2017, data on KPC-KP infection were reported in 5124 patients, with an average of 465 patients per year. The most widely studied type of infection was bacteremia (28∙0%). The meta-analysis showed that overall mortality for the 37 studies was 41.0% (95%CI 37.0–44.0), with the highest mortality rates being observed in oncology patients, 56.0% (95%CI 38.1–73.0), and Brazil, 51.3% (95%CI 43.0–60.0). Conclusion KPC-KP infection-related mortality is high, is manifested differently in some countries, and is highest among oncology patients.

This experimental research is inserted in the universe of people with special needs and intends to develop a new technology to design the structure of wheelchair. This structure consists of a tensegrity module composed of bamboo sticks and tensioned cables and adopts all the anthropometric standards with the observance to the ergonomic studies and individual needs of the use of the wheelchair users. This new concept of structure design, as it is unprecedented, results in an innovative product and allows new interpretations and unfolding. This research also initiates a new interpretation of tensegrity by its application to orthotics for rehabilitation that is currently widely diffused in the plastic arts, architecture, but incipient in product design. The use of tensegrity can meet some needs as a favorable body adaptation due to the malleability of the structure that absorbs the more sudden movements that can cause discomfort, injury and bad accommodation of the user to the wheelchair, besides providing a product of low cost and of easy production , because the structure is assembled by fit and wired.

RESUMO A pesquisa mostra que o nascimento da contabilidade está atrelado de modo fundamental a existência da igreja e ao se estudar história da contabilidade nas doutrinas existentes isso não está escrito, não se mostra a importância dos movimentos religiosos para a ascenção da ciência e o quanto a religião teve uma importância fundamental na evolução da contabilidade. Este estudo tem como objetivo mostrar a contribuição da igreja para a evolução da contabilidade . O desejo é mostrar como uma ciência voltada para o estudo da riqueza patrimonial teve como contribuição para o seu nascimento, a religião. O método utilizado foi o bibliográfico e os resultados alcançados comprovaram que sem a religião a contabilidade não teria o alcance científico outrora conquistado.Palavras – chave: Contabilidade; História; Religião

Sugarcane is one of the crops responsible for the high consumption of fertilizers in Brazil. To minimize this demand a sustainable alternative is to increase the studies to evaluate the beneficial effects of the relationship between plants/microorganisms, mainly plant growth-promoting bacteria. The objectives of this study were: a) to evaluate potentially diazotrophic bacteria isolates from sugarcane in adverse environmental conditions; b) inoculate these bacteria in sugarcane to evaluate their ability in plant growth-promotion. The study was carried in the Northeast of Brazil. Bacterial genera Burkholderia sp., Pantoea sp., Stenotrophomonas sp. and Enterobacter sp. were evaluated in different culture medium and later the bacterial isolates were inoculated in sugarcane evaluating the plant growth-promotion. Stenotrophomonas sp. and Pantoea sp. were tolerant to salinity and to different sources of carbon in acid medium and too tolerated high concentrations of pesticides and produced quorum sensing ...

Deep brain stimulation (DBS) is an effective treatment for essential tremor or tremor in Parkinson's disease. The effectiveness of DBS in reducing tremors that develop after a structural lesion of the central nervous system (such as Holmes' tremor – HT) has only been addressed in case reports or series. We conducted a systematic review of all published original reports of DBS in central nervous system lesion-related tremor (excluding demyelinating disorders due to their non-static nature). Where available, we extracted data regarding each patient's demographic, tremor and surgical details. Improvement was calculated as a percentage of change in any objective tremor rating scale. We identified 35 publications reporting on 82 patients. The ventral intermedius nucleus(VIM) of the thalamus was the preferred target (63.6%) and 18.2% targeted globus pallidus pars interna(GPi). Median improvement was 77.5% and 71.4% for patients with post-stroke and post-traumatic tremor respectively. Seven subjects (13.5%) had less than 50% improvement. Therapeutic effectiveness was not associated with age, tremor duration, age of onset or follow-up time. A large range of stimulation parameters were used with median voltage, pulse width and frequency values higher for GPi (4.80 V, 105 us, 170 Hz) than for thalamic stimulation (3.0 V, 90 us, 140 Hz). DBS reports for Holmes' and lesional tremors treatment are scarce and highly heterogeneous limiting a proper summary analysis and comparisons. Even facing a probable report bias, a high number of subjects with good long-term tremor control were found. These results should promote the creation of tremor registries before clinical trials.

Amyloid-β (Aβ) is a peptide deposited in the brain parenchyma in Alzheimer’s disease and in cerebral blood vessels, causing cerebral amyloid angiopathy (CAA). Aβ pathology is transmissible experimentally in animals and through medical procedures in humans, such as contaminated growth hormone or dura mater transplantation in the context of iatrogenic prion disease. Here, we present four patients who underwent neurosurgical procedures during childhood or teenage years and presented with intracerebral haemorrhage approximately three decades later, caused by severe CAA. None of these patients carried pathogenic mutations associated with early Aβ pathology development. In addition, we identified in the literature four patients with a history of neurosurgical intervention and subsequent development of CAA. These findings raise the possibility that Aβ pathology may be transmissible, as prion disease is, through neurosurgical procedures. Electronic supplementary material The online version of this article (10.1007/s00401-018-1822-2) contains supplementary material, which is available to authorized users.

O artigo pretende apontar o método pragmatista como instrumento útil na compreensão da prática científica, partindo do diálogo com os filósofos William James e Charles Sanders Peirce. Além disso, fará considerações gerais sobre a ciência e alguns dos critérios de demarcação que a diferem de outros conhecimentos. Por último, estabelecer- se-á um posicionamento sobre a natureza e o objetivo da ciência segundo a abordagem pragmatista.

Considerando que todas organizacoes sao fundamentais para a reducao dos impactos ambientais e combate as mudancas climaticas, o presente trabalho apresenta um diagnostico preliminar sobre as emissoes de Gases de Efeito Estufa (GEE) e gestao dos residuos solidos (RS) sob a otica da contabilidade ambiental em uma empresa de pequeno porte (EPP) em 2015. A contabilidade permite disponibilizar informacoes que possibilitam maior eficiencia na gestao da interacao com o meio ambiente e novas oportunidades de posicionamento do negocio. A pesquisa exploratoria e descritiva, utilizou analise bibliografica e visitas ao estabelecimento. Os resultados mostram que foram emitidas 32,46 tCO2-e. com receita ambiental estimada de R$3.387,00. A empresa ja desenvolve praticas sustentaveis, reciclando e evitando o lancamento de 110,37 tCO2-e, contudo, nao realiza a gestao ambiental. Destaca-se que diagnosticos parciais e metodologias simplificadas podem permitir que EPPs tambem contribuam para uma melhor performance ambiental, economica e social visando o desenvolvimento sustentavel nacional.

Background Transcatheter aortic valve replacement (TAVR) is often associated with intraventricular conduction disturbances. We aimed to determine the association between implantation depth assessed by multidetector computed tomography (MDCT) and new-onset conduction abnormalities after TAVR. Methods Retrospective single-center study including patients consecutively submitted to TAVR, between August/2007 and October/2016, who underwent routine MDCT 3 months after the procedure. The endpoint of conduction disturbances included permanent pacemaker implantation and/or new-onset left bundle-branch block. Implantation depth was determined as the distance between the ventricular end of the prothesis and the native ring, at the level of the non-coronary cusp. Results 138 patients were included (female gender 52.2%, mean age 78.7 ± 6.9 years). The EuroSCORE II was 4.0 ± 3.9% and 57.2% were treated with self-expanding prosthesis. The endpoint of conduction abnormalities was found in 45.7% (n = 63). The implantation depth was greater in the group with conduction disturbances (7.7 vs 6.4 mm, p = 0.006). Chronic obstructive pulmonary disease, oversizing and implantation depth were independent predictors of conduction abnormalities. Implantation depth had an AUC of 0.64 (p = 0.004) for the prediction of conduction abnormalities and a cut-off value of 7.1 mm predicted the composed endpoint with a sensitivity and specificity of 65% and 70%, respectively. Conclusions Implantation depth assessed by MDCT is associated with new-onset conduction disturbances after TAVR. In patients with conduction abnormalities, which do not qualify for the immediate implantation of pacemaker, the assessment of implantation depth by MDCT may be an additional marker of risk to aid decision-making.

Este estudo investiga percepções e crenças relacionadas à fauna cinegética na comunidade Cruz, no município de Delmiro Gouveia, Estado de Alagoas. As informações foram obtidas por meio de entrevistas semiestruturadas e conversas informais realizadas com 17 moradores no período de maio a dezembro de 2016. Segundo a percepção dos entrevistados, as espécies cinegéticas mais abundantes são gambá (n=12), rolinha (n=10) e mocó (n=6). A respeito da fauna silvestre que se tem tornado rara na região, os entrevistados citaram tatu (n=10), tamanduá (n=4), seriema (n=4) e porco-do-mato (n=4). As representações da fauna cinegética na comunidade Cruz se caracterizam por mitos, crenças, saberes e tabus alimentares, que constituem práticas culturais e ecológicas relevantes, uma vez que as crenças associadas aos animais disciplinam a prática de caça e são importantes estratégias para uso sustentável dos recursos faunísticos.

Advancing age is a well-known risk factor for Parkinson's disease (PD). With population ageing it is expected that the total number of patients with PD onset at oldage increases. Information on the motor but particularly on non-motor phenotype of this late-onset population is lacking. We recruited 24 patients with PD onset at or over 75 years. Each patient was matched with 1 control patient with PD onset between the ages of 40 and 65 and matched for disease duration. Both groups were assessed with the UPDRS, the Non-motor symptoms scale (NMSS) and other scales to assess non-motor symptoms. Groups were compared with conditional logistic regression analysis. Old-age onset PD was, on average, 80 years at the time of PD onset while middle-age onset were 59. Disease duration was approximately 5 years in both groups. While no difference was observed in the total UPDRS-III scores, old-age onset PD was associated with higher axial symptoms (7.42 vs. 4.63, p = 0.011) and a higher frequency of dementia (7/24 vs. 0/24, p = 0.009). While no difference in the total number of non-motor symptoms was observed (6.79 vs. 6.22, p = 0.310), old-age onset patients had a higher prevalence of gastrointestinal symptoms (20/24 vs. 12/24, p = 0.037). For the same disease duration, older age onset is associated with worse axial motor dysfunction and dementia in PD patients. Beside gastrointestinal symptoms, non-motor symptoms are not associated with age.

Introduction: Reliable cause-of-death statistics are an important source of information on trends and differentials in population health. In Brazil, the Mortality Information System is responsible for compiling cause of death (CoD) data. Despite the success in reducing R-codes ill-defined causes of death, other garbage codes (GC), classified as causes that cannot be the underlying CoD, according to the Global Burden of Disease study, remain a challenge. The Ministry of Health (MoH) aims to decrease the proportion of all GCs, and a pilot study tested a comprehensive strategy to investigate GC deaths that occurred in 2015. Methods: The research was conducted in seven Brazilian cities during five months in 2016: two rural cities, one metropolitan area, and four capitals. For all GCs selected, municipal healthcare workers collected information about the terminal disease from hospital records, autopsies, family health teams, and home investigation. The fieldwork was coordinated at Federal level in partnership with State and municipal teams. Results: Out of 1,242 deaths selected, physicians analyzed the information collected and certified the CoD in 1,055 deaths, resulting in 92.6% of cases having their underlying cause changed to a usable ICD-10 code. Discussion: It is noteworthy the capacity the health teams in the seven cities showed during the implementation of the pilot. Conclusion: After results analysis, the GC investigation protocol was modified, and the implementation scaled up to 60 cities in 2017. RESUMO Introdução: Estatísticas confiáveis em mortalidade são importante fonte de evidências de tendências e diferenciais na saúde da população. No Brasil, o Sistema de Informação sobre Mortalidade é responsável por compilar dados da causa de morte (CM). Embora tenha havido sucesso na redução de causas mal definidas de morte, ainda há um problema com outros códigos garbage (GC), classificados como causas de morte que não devem ser registradas como básicas, segundo o estudo de Carga Global de Doença. O Ministério da Saúde estabeleceu uma meta para diminuir a proporção de todos os GC e testou em estudo piloto uma estratégia abrangente para investigar as mortes. Métodos: A pesquisa foi realizada em 7 cidades do Brasil durante 4 meses: 2 em áreas rurais, 1 em área metropolitana e 4 em capitais. Os agentes municipais de saúde coletaram informações sobre a doença terminal obtida nos registros hospitalares, autópsias, equipes de saúde da família e investigação domiciliar. O trabalho de campo foi coordenado pelo nível federal, juntamente com as equipes estaduais e municipais. Resultados: Dos 1.242 óbitos selecionados, médicos analisaram as informações coletadas e certificaram a CM em 1.055 óbitos, resultando em 92,6% dos casos tendo sua causa subjacente alterada para código específico da CID-10. Discussão: Destaca-se a capacidade de articulação que as equipes de saúde apresentaram no cumprimento das etapas propostas para o trabalho. Conclusão: Após o estudo piloto, o protocolo de investigação foi modificado e sua implementação foi ampliada para 60 cidades em 2017.

Background: J-point elevation in the inferior and/or lateral leads is associated with an increased incidence of sudden cardiac death (SCD) in hypertrophic cardiomyopathy (HCM), although the exact underlying mechanism is not known. As severe left ventricular hypertrophy and late gadolinium enhancement (LGE) are important risk factors for SCD in this population, we aimed to assess whether there was an association between an early repolarization pattern (ERP) and greater left ventricular mass (LVM) and LGE extent among patients with HCM. Methods: This was a retrospective cohort study of 85 consecutive patients with HCM who underwent cardiac magnetic resonance (CMR) and had an electrocardiogram without confounders (intraventricular conduction delay, complete left or right bundle branch block, or ventricular paced rhythm). Baseline characteristics and MRI-derived LVM and LGE extent were compared between patients with and without ERP. Results: ERP was present in 9 out of 85 patients (10.6%). Patients with ERP had greater indexed LVM compared to those without (112.5 ± 26.3 vs. 87.8 ± 24.6 g/m2, p = 0.006). Logistic regression analysis revealed a 4.2-fold increase in the odds of prevalent ERP per standard deviation increase in body surface area-indexed LVM (odds ratio 4.2; 95% CI 1.54–11.4, p = 0.005). There were no statistically significant differences regarding LGE extent between groups. Conclusion: ERP is associated with greater CMR-derived LVM among patients with HCM. This finding could partially explain the association between J waves and a higher risk of SCD in this population. There were no differences in LGE extent. Further studies are needed to confirm this association and evaluate the importance of ERP as a marker of increased risk of SCD in HCM.

Introduction The use of venoarterial extracorporeal membrane oxygenation (VA-ECMO) to support patients in cardiogenic shock has been increasing in Portugal over the past few years. Nonetheless, epidemiologic, prognostic and clinical outcome data are scarce. Purpose We aim to identify clinical variables with prognostic significance in this challenging population, as well as the performance of various risk scores in mortality prediction. Methods All patients that underwent VA-ECMO support at our Cardiac ICU between 2011 and 2018 were included in the analysis. Logistic regression analysis was used to assess the relationship between clinical variables and outcomes. Results Short-term mechanical support with VA-ECMO was given to 40 patients, with a mean age of 52±11 years. At the time of the implant, the mean SOFA score was 11.2±4.0, and mean SAVE score was −4.75±4.6. Mean ECMO support duration was 116±96 hours. In 70% (N=28) of patients, VA-ECMO was successfully weaned. In-hospital mortality was observed in 52.5% of patients, which was in accordance with the predicted mortality by SOFA score (22.5% to 82% in our population risk range) and by SAVE score (60 to 70%). Those who placed the VA-ECMO as a bridge to transplant or to long-term mechanical LV assist device had greater in-hospital mortality rates (91.6 vs 41.9%, p=0.013), as well as those under ≥2 inotropic/vasopressors (69.2 vs 21.4%, p=0.012) or when adrenaline use was needed (100% vs 44.1%, p=0.01). No other between-group differences were observed in what concerns short-term mortality. After logistic regression analysis, independent predictors of in-hospital mortality included AMI setting, number of vasoactive amines used, and necessity of a LV venting device. SAVE score had the greater predictive ability in these patients (AUC = 0.638) among the most utilized clinical risk scores (SOFA score AUC = 0.37; APACHE II score AUC = 0.59; SAPS II score AUC = 0.54). Conclusion In our analysis, patients in profound cardiogenic shock on VA-ECMO support had slightly better survival rates than predicted by classical Risk Scores. The SAVE score may be the most accurate tool to predict in-hospital mortality in this specific, and yet heterogeneous, clinical subset. Other well recognized clinical markers of severity may also help refine short-term prognosis, and potentially improve organ transplant or other destination therapy prioritization.

Background Strain techniques, such as feature tracking cardiac magnetic resonance (FT-CMR), have emerged as a promise for more accurate evaluation of cardiac function compared to ejection fraction. In hypertrophic cardiomyopathy (HCM) patients, impaired myocardial deformation measured by FT-CMR has been associated with severity of hypertrophy and presence of late gadolinium enhancement (LGE) but associations with clinical severity and prognosis are scarce. Purpose To analyse the association between left ventricular strain measured by FT-CMR, morphologic features and prognostic markers in patients with HCM. Methods Retrospective analysis of clinical, echocardiography, Holter and CMR data of HCM patients aged ≥16 years followed at two referral centres. Ventricular arrhythmias (VA) were defined as non-sustained or sustained ventricular tachycardia or sudden cardiac arrest. Sudden cardiac death (SCD) risk was evaluated using the score proposed by the European Society of Cardiology. LGE extension was evaluated using the American Heart Association 17-segment model. FT-CMR was used to evaluate global peak systolic longitudinal (GLS), radial (GRS) and circumferential (GCS) strains - GLS was averaged from three standard longitudinal views while GRS and GCS were averaged from the basal, mid and apical LV short-axis planes. Results A total of 109 HCM patients (59.2±16.2 years old; 60.6% males) were included; mean follow-up was 39±25 months. Mean LV mass was 170.6±70.3g, LVEF was 63.7±10.0% and the number of segments with LGE was 3.14±3.32. Mean GLS, GRS and GCS were −14.8±4.0%, 34.4±13.3% and −17.5±4.8%, respectively. Impaired strain was associated with higher LV mass (GLS: r=0.46, GRS: r=−0.46, GCS: r=0.47, p SCD risk score was 3.12%±2.98 (8 patients scored as high risk) and VA were documented in 26 patients (26%). Patients with VA had worse strain values than those without (GLS −13.2±4.12 vs −15.5±3.71, p=0.011; GCS −15,8±5.22 vs −18.3±4.24, p=0.017). Patients with high estimated risk of SCD also had worse strain values than those at low/intermediate risk (GLS −12.2±3.57 vs −15.1±3.83, p=0.048; GCS −14.5±4.26 vs −17.9±4.54, p=0.047). A correlation between SCD risk and GLS and GCS was observed (r=0.32, p=0.004; r=0.23, p=0.03, respectively). Conclusions In our population, worse strain measurements were associated with a more severe HCM phenotype, presence of VA and a higher estimated risk of SCD. Strain assessed by FT-CMR may improve risk stratification in HCM patients.

The phorbol esters in the seeds of Jatropha curcas are a major hindrance to the full exploitation of the potential of this oil crop as a source of raw material for the production of biodiesel. Here, various quantitative proteomic strategies are used to establish the proteomes of roots, leaves, and endosperm of two genotypes of J. curcas with contrasting levels of phorbol esters in the seeds. In total 4532, 1775, and 503 proteins are identified respectively in roots, leaves, and endosperm, comprising 5068 unique proteins; of this total, 185 are differentially abundant in roots, 72 in leaves, and 20 in the endosperm. The biosynthetic pathways for flavonoids and terpenoids are well represented in roots, including the complete set of proteins for the mevalonate and non-mevalonate/Deoxyxylulose 5-Phosphate pathways, and proteins involved in the branches which lead to the synthesis tricyclic diterpenoids and gibberellins. Also, casbene synthase which catalyzes the first committed step in the biosynthesis of tigliane-type diterpenes is identified in roots of both genotypes, but not in leaves and endosperm. This dataset will be a valuable resource to explore the biochemical basis of the low toxicity of Jatropha genotypes with low concentration of phorbol esters in the seeds.

Doubts persist regarding the influence of Parkinson's disease (PD) on mortality. Our objective was to assess mortality rates in a prospectively followed cohort of PD patients and the impact of motor and non-motor symptoms in survival. 130 consecutive PD patients were followed during a 4-year period or until death. Baseline assessment included motor function (UPDRSIII, Hoehn and Yahr-HY), incapacity (Schwab and England-S&E, UPDRS II), Health-Related quality of life (EuroQol), non-motor symptoms (Non-Motor Symptom Scale-NMSS, MoCA, REM sleep behavior disorder symptoms questionnaire) and comorbidity burden (Charlson Comorbidity Index-CCI). These were used as predictor variables. Standardized mortality rates (SMR) were calculated, comparing with the general population. The association between mortality and predictors was tested with univariate and multivariate Cox proportional hazard regression models. Overall and gender-related SMRs were similar to the general population. SMR for pneumonia was five times higher than in the general population. Age, disease duration, CCI, EuroQol, dementia, MoCA, S&E, NMSS Hallucinations, HY, and PIGD motor phenotype were significantly associated with mortality. Adjusting for age, gender and disease duration, S&E remained significantly associated with mortality. In multivariate logistic regression analysis, death was significantly associated with disease duration, CCI and NMSS-mood/cognition scores. PD was not associated with an excess of mortality, but conferred a higher probability of dying from pneumonia. Comorbidity was a major determinant, but disease duration, baseline incapacity, cognition, psychosis, mood complaints and HRQL also contributed significantly to mortality.

Neste artigo, pretende-se compreender como os videojogos online gratuitos podem beneficiar da comunicação de marketing para atrair gamers. Recorreu-se à análise de conteúdos digitais de websites de produtoras e de fóruns online de videojogos, bem como a entrevistas semiestruturadas a gamers. Conclui-se que, embora as produtoras de videojogos utilizem uma variedade de técnicas de comunicação, sobretudo digitais, tiram principalmente partido de fenómenos comunicacionais gerados na própria comunidade gamer, como o electronic-word-of-mouth e o user-generated-content, nos quais os líderes de opinião online adquirem um papel preponderante. Sugere-se maior investigação destes fenómenos para potencial aplicação a outras áreas de negócio. This article intends to appreciate how free-to-play online video games can benefit from marketing communication to attract gamers. Digital content analysis from producer websites and online video game forums, as well as semi-structured interviews with gamers, were undertaken. We concluded that, although video game producers use a variety of communication techniques, mostly digital ones, they mainly resort to communicational phenomena generated amongst the gamer community, such as electronic-word-of-mouth and user-generated-content, in which online opinion leaders take a leading role. Further investigation of these phenomena is suggested for potential application to other business areas.

Subjective cognitive complaints (SCC) are frequent in elderly populations. PD patients report SCC more often than healthy controls. The association between SCC, objective cognitive impairment and affective symptoms remains controversial. We assessed consecutive PD patients between March 2014 and March 2015. Presence of SCC was defined as a score ≥ 1 in the Non-Motor Symptom Assessment Scale for Parkinson’s Disease (NMSS) Domain 5. MoCA was used for cognitive impairment assessment. Pill Questionnaire measured the impact in daily activities. PD with Dementia (PDD) and PD with Mild Cognitive Impairment (PDMCI) were defined as the presence of cognitive impairment with or without impact on daily activities. Anxiety and depression were assessed using the Hospital Anxiety and Depression Scales. Significance was set at p

ObjectiveThe goal of this study was to explore the surveillance data about mandatory reporting diseases, included in the official information systems, and evaluate the historical trend analysis in prisoners in Brazil.DesignA time trends study was performed using secondary data from prisons’ health units.SettingNationwide representative data of Brazilian prisoners obtained from 2007 to 2014 health and prison information systems database were analysed. These data are carried out by units identified as prison health facilities.Primary outcome measuresDiseases diagnosis and individual data were available at the National System of Disease Notification (in Portuguese SINAN), Mortality Information System (in Portuguese SIM) and Prison Registration Systems (in Portuguese INFOPEN and GEO prisons). Analyses of the notification data performed in the SINAN at the national level. SINAN was consolidated with SIM, INFOPEN and GEO prison data.ResultsA total of 23 235 cases of compulsory disease notification causing morbidity were reported in prison units in Brazil; of these cases, 20 003 (85.6%) were men and 3362 (14.4%) were women. Over time, the proportion of prisoners increased from 1.92 per 1000 inhabitants in 2007 to 2.77 per 1000 inhabitants in 2014 (rising trend). From a total of 27 states, 12 of them presented a growth in disease notifications, 14 were stable and in only one state was there a decrease in notifications. There was an increase in notifications in the country as a whole. Tuberculosis (64.4%), dengue (9.1%), AIDS (9.0%) and viral hepatitis (5.9%) were among the most frequently reported diseases during the study period.ConclusionDespite showing stable tendencies, our results show high rates of diseases in Brazilian prisons. Prison health services should not be isolated but integrated into regional and national health and justice systems.

The aim of this study was to describe and evaluate access to oral health services among adolescents enrolled in public schools of Campina Grande, Paraíba, Brazil, a large-size municipality in the Northeast of Brazil. An observational, descriptive, analytical, quantitative, and cross-sectional study was carried out through a school survey, in which four validated questionnaires were applied to 438 adolescents aged 12 to 19 years. Data were processed using the SPSS statistical software version 20.0, with bivariate analysis and multivariate analysis through Poisson regression. About 90.9% of adolescents reported having visited the dentist at least once; however, when considering the last 6 months, this percentage fell to 48.4%. Adolescents used private services (50.2%) or the public service (49.8%). About 70.6% of interviewees reported dental treatment (61.1%) as the main reason for seeking the service. Through multivariate analysis, it was observed that the demand for the service was higher among female adolescents (60.5%, p

As estimativas sobre a expansão dos casos da Doença de Alzheimer (DA) no mundo indicam a necessidade de constantes estudos sobre essa patologia ainda sem cura. Os estudos têm investigado a DA em modelos animais não-humanos utilizando substâncias químicas que induzem à DA. O presente estudo teve por objetivo realizar uma revisão da literatura sobre as substâncias usadas em laboratório para reproduzir a DA em ratos. Foram selecionados 44 de 111 estudos analisados, mantendo apenas os artigos que induziram a DA por substâncias químicas. As substâncias identificadas foram o alumínio, a beta-amiloide, a colchicina, a d-galactose, a escopolamina, a estreptozocina e a homocisteína. Verificou-se que dos 44 artigos, a substância mais utilizada foi a beta-amiloide, principal biomarcador da DA. Embora diferentes estudos tenham replicado resultados que simulam a ocorrência de DA em ratos e os tratamentos realizados com ratos em laboratório pareçam promissores, nenhuma cura foi encontrada ainda.

Cabo Verde é um destino turístico com aumento regular da procura, ao qual se aponta grande potencial futuro. A comunicação de um destino é imprescindível para divulgá‑lo e torná‑lo conhecido. Neste artigo, descreve‑se como se processa a promoção turística do destino Cabo Verde para o mercado exterior, com enfoque no mercado português. Identifica‑se o papel de cada interveniente turístico público e privado, cabo‑verdiano e português, neste processo. Visa‑se, adicionalmente, avaliar o conhecimento e a atitude dos turistas portugueses relativamente a tal promoção. Para responder a estes objetivos recorreu‑se a entrevistas realizadas a entidades envolvidas na promoção do destino e aplicou‑se inquéritos a 291 turistas portugueses. Verificou‑se que a comunicação turística do destino depende muito de operadores turísticos ou intervenientes privados, tendo sido, por isso, recomendadas melhorias à estratégia de comunicação turística de Cabo Verde. Cape Verde is a growingly sought‑after tourist destination with great future potential. The communication of a destination is paramount to make it known. In this article, we describe how Cape Verde has been promoted in external markets, namely in the Portuguese. The intention is to identify the role played by both Cape‑Verdean and Portuguese public and private stakeholders. Additionally, the objetive is to assess the knowledge and attitude of Portuguese tourists as regards the communication and promotion of Cape Verde. To answer these questions, interviews were carried out to organizations involved in the promotion of the destination and 291 Portuguese tourists were surveyed. Results show that tourist communication of a destination is much dependent of tour operators and private actors. In face of these conclusions, it is recommended that the communication strategy of Cape Verde should be improved.

Jatropha curcas L. is worth mentioning among the oleaginous species potential for the production of biofuels. The plant presents high oil content in its seeds, and the residue generated from the extraction of the oil, its pie, has characteristics that can increase the economic value of the crop. However, the pie use is limited due to toxic compounds, phorbol esters (PE). Although the toxicity and its disadvantages are well defined, the breeding of the species in order to reduce these compounds is still not efficient due to the lack of information about its biosynthesis. This work aimed at the proteomic study of endosperm, leafes and roots of jatropha, of two accessions with contrasting levels of PE, in order to identify proteins involved in the biosynthesis of such compounds and establish the tissue where it is synthesized. For this purpose, endosperm, leafs and roots of physic nut had their proteins extracted in pyridine / SDS buffer, underwent enzymatic trypsin hydrolysis, and the peptides obtained after the digestion were submitted to quantitative analysis by mass spectrometry using isobaric labeling with the iTRAQ reagent as well as free labeling strategies. Proteomic analysis of the three tissues resulted in the identification of a total of 5068 proteins. Of these, only 283 are shared between the three tissues, corresponding to 5.6% of the total identifications; 115 proteins are endosperm exclusive, 403 leaf exclusive and 3091 proteins appeared exclusively in roots, considering the parameters established in this study. Metabolic pathways of interest were analyzed, liposome biosynthesis in endosperm revealed proteins such as oleosins and lipases in both accesses, and although some oil storage related proteins were only identified in the highcontent access of phorbol esters, the correlation between toxicity and oil production can not be well established without additional testing. In the leafes the proteins related to protein biosynthesis were the most abundant, followed by those related to photosynthesis, with emphasis on the high content of phorbol esters. When the synthesis of terpenes was verified, most of the identified proteins were located in the jatropha roots, among them we identified proteins such as geranil geranyl diphosphate synthase and the casbene synthase (CS), both involved in the biosynthesis of diterpene precursors, emphasizing that the CS has not been verified in proteomic analyzes in this species until the moment. Also, in the roots, terpene transporters were also identified. The results obtained in this study suggest that the phorbol esters, although accumulated in jatropha seeds, are synthesized in their roots and transported to the other parts of the plant. Therefore, these results serve as subsidies for further studies, aimed at reducing the toxic components in the crop, which guarantees the best use of its potential. O pinhão manso (Jatropha curcas L.) merece destaque dentre as espécies oleaginosas potenciais para produção de biocombustíveis. A planta apresenta alto teor de óleo em suas sementes, e o resíduo gerado a partir da extração do óleo, sua torta, possui características que podem aumentar o valor econômico da cultura. No entanto, o uso da torta é limitado devido a compostos tóxicos, os ésteres de forbol (EF). Apesar de bem definida a toxicidade e suas desvantagens, o melhoramento da espécie, a fim de reduzir esses compostos, ainda não é eficiente devido à falta de informações sobre sua biossíntese. Este trabalho objetivou o estudo proteômico de endosperma, folhas e raízes de pinhão manso, de dois acessos com teores contrastantes de EF, visando identificar proteínas envolvidas na biossíntese dos EF e estabelecer o tecido onde o mesmo é sintetizado. Para tanto, endosperma, folhas e raízes de pinhão manso tiveram suas proteínas extraídas em tampão piridina/SDS, passaram por hidrólise enzimática fazendo uso de tripsina, e os peptídeos obtidos após a digestão foram submetidas a análises quantitativas por espectrometria de massas. Utilizaram-se a marcação isobárica com o reagente iTRAQ e estratégias livres de marcação. A análise proteômica dos três tecidos resultou na identificação de um total de 5068 proteínas. Destas, apenas 283 são compartilhadas entre os três tecidos, o que corresponde a 5,6% do total de identificações; 115 proteínas são exclusivas de endosperma, 403 exclusivas de folha e 3091 proteínas apareceram exclusivamente em raízes, considerando os parâmetros estabelecidos neste estudo. As vias metabólicas de interesse foram analisadas, a biossíntese de lipídeos em endosperma revelou proteínas como oleosinas e lipases em ambos os acessos, e apesar de algumas proteínas relacionadas ao armazenamento de óleo terem sido identificadas apenas no acesso de alto teor de ésteres de forbol, a relação entre a toxicidade e a produção de óleo não pode ser bem estabelecida sem testes adicionais. Nas folhas, as proteínas relacionadas a biossíntese de proteínas foram as mais abundantes, seguidas daquelas relacionadas a fotossíntese, com destaque para o acesso de alto teor de ésteres de forbol. Quando verificada a síntese de terpenos, a maior parte das proteínas identificadas estava localizada nas raízes de pinhão manso, dentre elas identificamos proteínas como o geranil geranil difosfato sintase e a enzima casbeno sintase, ambas envolvidas na biossíntese de precursores de diterpenos, ressaltando que a casbeno sintase não havia sido verificada em análises proteômicas nesta espécie até o momento. Ainda nas raízes também foram identificados transportadores de terpenos. Os resultados obtidos nesse estudo sugerem que os ésteres de forbol apesar de acumulados nas sementes de pinhão manso, são sintetizados em suas raízes e transportados para as demais partes da planta. Sendo assim, tais resultados servem como subsídios para estudos posteriores que visem à redução dos componentes tóxicos na cultura, o que garantirá o melhor aproveitamento de seu potencial.

Dissertação de mestrado em Ciências da Comunicação (área de especialização em Informação e Jornalismo), A democratização da Internet redefiniu os espaços comunicacionais, revolucionou a organização e produção mediáticas e reestruturou a comunicação dos média com as audiências. Ao mesmo tempo, surgiram novos hábitos de consumo de notícias. Protagonistas das mudanças sociais e do futuro da democracia, os jovens adultos parecem não estar convencidos com as matrizes tradicionais do jornalismo, revelando práticas, experiências e necessidades mediáticas que diferem das gerações mais velhas (Costera Meijer, 2007; Broersma & Peters, 2013). De facto, há uma clara preferência pelo digital por parte das gerações mais jovens (Pew Research Center, 2012; The Media Insight Project, 2015; ERC, 2016; Instituto Reuters, 2017). Assim, o ciberjornalismo – enquanto género jornalístico com características interativas, multimédias e personalizadas – poderá ser um caminho para um relacionamento mais próximo entre os jovens adultos e o jornalismo. Na tentativa de combater esta lacuna, o P3 surge, em setembro de 2011, como uma iniciativa totalmente inovadora no âmbito mediático por querer explorar narrativas e linguagens adequadas ao digital e ao público-alvo – os jovens adultos (18-35 anos). Após uma reflexão acerca da experiência de estágio de três meses no Público, com passagem pelo P3, e da literatura consultada, o presente estudo procura conhecer o processo comunicacional entre aquele projeto jornalístico e o seu público-alvo. Olhando para os estudos de produção e de receção mediática de forma articulada pretende-se contribuir para o entendimento sobre se o que está a ser feito no P3 corresponde ao que é expectável e necessário, tendo por base os interesses do público-alvo. Para tal, foi elaborado uma análise de conteúdo quantitativa a 174 artigos do P3, uma análise de conteúdo qualitativa de entrevistas semidiretivas com três fundadores do projeto e uma análise quantitativa de 382 questionários aplicados a jovens entre os 18 e os 35 anos. As conclusões da presente investigação revelam que o P3 parece estar a cumprir com os objetivos a que se propõe, no sentido de aproximar os jovens adultos ao jornalismo, ainda que haja um caminho a percorrer quer na abordagem de temas que, numa primeira leitura, seriam desinteressantes para os jovens (como o caso da política), quer no dinamismo das tecnologias utilizadas (como o recurso ao vídeo)., The democratization of the Internet has redefined communication spaces, revolutionized media organizations and productions, and restructured media communication with audiences. At the same time, new media consumption habits have emerged. Main characters of the social changes and of the future of the democracy, young adults don’t seem to be convinced by the traditional journalism standards, revealing media practices, experiences and needs that differ from older generations (Costera Meijer, 2007; Broersma & Peters, 2013). In fact, there’s a clear preference for the digital among younger generations (Pew Research Center, 2012; The Media Project, 2015; ERC, 2016; Reuters Institute, 2017). Therefore, ciberjournalism - as journalistic type with interactive, multimedia and personalized characteristics – could be a path for a closer relationship between young adults and the media. Thus, P3 emerges in September 2011 as a totally innovative initiative in the media field by intending to explore narratives and languages more suitable to the digital and target group - young adults (18-35 years). After some reflection on the three months internship in Público, with involvement in P3, and with the literature consulted, this study aims at understanding the communication process between the project and the target. By looking at the production and reception media studies in an articulated way, we intend to contribute to understand if P3 is corresponding to the expected and needed result by considering the interests of the target group. With that purpose, it has been done a quantitative analysis on the content of 174 P3’s articles as well as a qualitative analysis on the content of three semi-directional interviews conducted with the project founders. Differently, it has also been done a quantitative analysis of 382 questionnaires filled in by young people with age between 18 t0 35. The present investigation shows that P3 seems to be achieving its goals since it has been able to fill the gap between young adults and journalism. Even if there is need to work on the themes that are apparently less interesting for young generations (such as politics), as well as the dynamic of the technologies used (such as the use of video).