Search

ABSTRACT Objective To characterize laparoscopy teaching in Medical Residency Programs in Gynecology and Obstetrics in Brazil, and to evaluate preceptors’ characteristics in laparoscopy programs and map laparoscopic training practice scenarios. Methods This descriptive cross-sectional study evaluated questionnaire responses from coordinators of the Medical Residency Programs in Gynecology and Obstetrics from 2019 to 2021. Results The questionnaire was sent to 175 programs, and 90 responses were received (51.4%). From the 85 valid responses, it was noted that 67 programs had laparoscopic training. Of the 64 responses received regarding location, 32 replies (50%) indicated the Southeast of Brazil, particularly some country’s capitals. In 37.3% (n=25) of the cases, the program coordinator performed laparoscopy. The chief of the laparoscopy sector has advanced experience in most 52.5% (n=10) medical residency services; the preceptors also had advanced experience in 89.4% (n=59) of the services. Residents received laboratory training in 39.4% (n=26) of the services. In most cases, training was performed using a physical simulator. Of the 26 medical residency services with laparoscopy training outside the operating room, 80.8% (n=21) performed them as part of the curriculum, 61.5% (n=16) had a schedule for the same, and only 3.9% (n=1) were objectively evaluated. Conclusion Laparoscopy teaching in Brazil is heterogeneous, with only a few programs offering any training in laparoscopy. The preceptors had advanced experience and participated in laboratory and operating room training. Only a few programs have their own laboratories or training centers, and most teaching programs do not plan to set up training centers.

Este artigo analisa 32 estudos sobre o conhecimento interfonológico de aprendentes do português europeu como língua não materna, selecionados a partir de critérios rigorosamente definidos. A análise incide sobre os objetivos e as metodologias assumidos, procurando identificar as estruturas fonológicas e os grupos de aprendentes estudados. Concomitantemente, identificam-se as lacunas descritivas a colmatar em trabalhos futuros, tendo em vista o avanço no conhecimento do desenvolvimento interfonológico de aprendentes do PLNM e a possibilidade de aproveitamento de dados desta natureza para fins pedagógicos.

The purpose of this paper is to raise important issues in engineering education in the face of contemporary challenges and demands through the voices of different stakeholders in engineering curricula and in the practice of professional engineering. Several challenges and future perspectives are based on important skills, like soft skills, which are required by employers and include communication, decision-making, problem-solving, leadership and emotional intelligence, as well as the ability to work with people of different backgrounds and apply technical knowledge. A qualitative data analysis of interviews with students, alumni, teachers and employers revealed the demand for more balanced qualified curricula for higher education institutions in the field of engineering. This includes the promotion of collaborative learning spaces, authentic learning experiences based on engaging students in real situations, project-based learning, industrial visits, guest lectures and problem-solving methodologies that are perceived by these stakeholders as essential in the construction of a curriculum, in line with the specific technical competences of each area.

We live in a society in constant scientific and technological change, where engineering education is required to develop the competences needed for future engineers to be able to respond to the complex and interdisciplinary problems that arise from this. It is no longer enough just to provide updated scientific and technological training to students, but it is also required to articulate the needs of society with the design of the curriculum and the expectations of the different stakeholders. The present paper's goal is to present the perceptions about engineering education through the lens of different institutional stakeholders, following a qualitative design study, through semi-structured interviews with seven key-stakeholders representing different scientific and professional institutions. These interviewees play an important role in the definition of guidelines for the engineering profession and in (re)thinking curricula reflecting the interaction with society, training and research. In this sense, it aims to explore the following objectives: (i) to know the perception about the profession, the profile of engineers and the engineering curricula; (ii) to identify the challenges posed to engineers in the job market and in society, today and in the future; and (iii) to reflect on a desirable profile to be attained by engineering students at the end of their Higher Education path. From the interviewees' perspective, competences development effectively involves learning approaches that realize which problem-solving strategies, concepts and capacities for social action should be developed in students, which are not restricted to disciplinary or specific content, but which allow (de)constructing curricula that reflect the different needs of society. In fact, as well as including the point of view of renowned international associations, this article reinforces the idea that the integration of science, technology, engineering and maths (STEM) into curricula is not only a challenge, but also a growing and inevitable phenomenon in response to society's needs. The curriculum, the competences to be privileged, the importance of interdisciplinarity, and the contribution of STEM and STEAM approaches from an integrated engineering perspective are interpreted as difficulties but also the target opportunities.

Several studies on intermittent rivers and ephemeral streams (IRES) have focused on the ecology of populations and communities, and very few explored the biogeochemistry and bioavailability of key elements, such as phosphorus (P) and nitrogen (N). In this study, we aimed to explore the role of environmental seasonality on P bioavailability in an intermittent river in Northeastern Brazil and the implications for nutrient dynamics to downstream ecosystems, such as the estuaries. The study was performed at the Cruxati River, located in the Litoral Hydrographic Basin on the coast of Ceará State, Brazil. We sampled riverine sediments during three hydroperiods (i.e., dry, rewetting, and flow) according to the theoretical model for research in intermittent rivers. We performed a geochemical fractionation of different P forms and determined the physicochemical parameters, particle size distribution, mineralogy, and total organic carbon of the sediments. Mean values were compared using the Kruskal–Wallis non-parametric statistical test (p-value < 0.05) and by discriminant function analysis. We observed that the predominant fractions of P were associated with Fe-oxides, silicates, and refractory organic matter, but there were no statistical differences among these fractions for all hydroperiods. The exchangeable-P form was higher in the dry and flow periods than in the rewetting period. On the opposite side, P associated with humic acids and carbonates was lower in the dry and flow periods but higher in the rewetting period. We concluded that seasonality influences the bioavailability of P in intermittent rivers, being strongly influenced by the organic fraction, including the humic acid fraction and the refractory organic matter, which are important sources of P in the aquatic system. Furthermore, the IRES may act as a source or a sink of nutrients throughout the cycles of wetting and drying, which may release P from the sediments to the aquatic environment. Hence, IRES plays an important role in transporting nutrients to estuaries and maintaining their ecosystem services.

Societal Impact Statement Despite comprising a small proportion of global agricultural land use, irrigated agriculture is enormously important to the global agricultural economy. Burgeoning food demand driven by population growth—together with reduced food supply caused by the climate crisis—is polarising the existing tension between water used for agricultural production versus that required for environmental conservation. We show that sustainable intensification via more diverse crop rotations, more efficient water application infrastructure and greater farm area under irrigation is conducive to greater farm business profitability under future climates. Summary Research aimed at improving crop productivity often does not account for the complexity of real farms underpinned by land‐use changes in space and time. Here, we demonstrate how a new framework—WaterCan Profit—can be used to elicit such complexity using an irrigated case study farm with four whole‐farm adaptation scenarios (Baseline, Diversified, Intensified and Simplified) with four types of irrigated infrastructure (Gravity, Pipe & Riser, Pivot and Drip). Without adaptation, the climate crisis detrimentally impacted on farm profitability due to the combination of increased evaporative demand and increased drought frequency. Whole‐farm intensification—via greater irrigated land use, incorporation of rice, cotton and maize and increased nitrogen fertiliser application—was the only adaptation capable of raising farm productivity under future climates. Diversification through incorporation of grain legumes into crop rotations significantly improved profitability under historical climates; however, profitability of this adaptation declined under future climates. Simplified systems reduced economic risk but also had lower long‐term economic returns. We conclude with four key insights: (1) When assessing whole‐farm profit, metrics matter: Diversified systems generally had higher profitability than Intensified systems per unit water, but not per unit land area; (2) gravity‐based irrigation infrastructure required the most water, followed by sprinkler systems, whereas Drip irrigation used the least water; (3) whole‐farm agronomic adaptation through management and crop genotype had greater impact on productivity compared with changes in irrigation infrastructure; and (4) only whole‐farm intensification was able to raise profitability under future climates.

Functional foods are those that, in addition to offering nutrients, promote one or more benefits to the human body. Among them, those that carry probiotic microorganisms stand out. The artisanal Minas cheese, traditionally made with raw milk in rural properties from Minas Gerais State, Brazil, presents a great microbial diversity, including some with probiotic potential. Lactic acid bacteria (LAB) found in that cheese are of great relevance and are characterized by fermenting lactose to produce lactic acid; therefore, they are widely used in food processing. The development of research with the purpose of increasing knowledge about the microbiota present in artisanal Minas cheese and its potential probiotic effects provides new perspectives to improve food quality and safety, also helping to preserve the desirable microorganisms. Due to the great economic and cultural importance of artisanal Minas cheese and the beneficial health effects associated with probiotics, the present work aimed to carry out a literature review on the probiotic potential of LAB isolated from that cheese variety. The analysis of scientific papers, according to results of in vitro and in vivo tests, revealed that microorganisms isolated from that cheese showed desirable results regarding the potential probiotic effects; however, some of them presented resistance to antimicrobials. The artisanal Minas cheese represents an important source of desirable microorganisms, and further studies should be conducted in order to identify candidates for use as probiotics.

Introduction Invasive non-typhoidal Salmonellosis (iNTS) is mainly caused by Salmonella enterica serovars Typhimurium and Enteritidis and is estimated to result in 77 500 deaths per year, disproportionately affecting children under 5 years of age in sub-Saharan Africa. Invasive non-typhoidal Salmonellae serovars are increasingly acquiring resistance to first-line antibiotics, thus an effective vaccine would be a valuable tool in reducing morbidity and mortality from infection. While NTS livestock vaccines are in wide use, no licensed vaccines exist for use in humans. Here, a first-in-human study of a novel vaccine (iNTS-GMMA) containing S. Typhimurium and S. Enteritidis Generalised Modules for Membrane Antigens (GMMA) outer membrane vesicles is presented.Method and analysis The Salmonella Vaccine Study in Oxford is a randomised placebo-controlled participant-observer blind phase I study of the iNTS-GMMA vaccine. Healthy adult volunteers will be randomised to receive three intramuscular injections of the iNTS-GMMA vaccine, containing equal quantities of S. Typhimurium and S. Enteritidis GMMA particles adsorbed on Alhydrogel, or an Alhydrogel placebo at 0, 2 and 6 months. Participants will be sequentially enrolled into three groups: group 1, 1:1 randomisation to low dose iNTS-GMMA vaccine or placebo; group 2, 1:1 randomisation to full dose iNTS-GMMA vaccine or placebo; group 3, 2:1 randomisation to full dose or lower dose (dependant on DSMC reviews of groups 1 and 2) iNTS-GMMA vaccine or placebo.The primary objective is safety and tolerability of the vaccine. The secondary objective is immunogenicity as measured by O-antigen based ELISA. Further exploratory objectives will characterise the expanded human immune profile.Ethics and dissemination Ethical approval for this study has been obtained from the South Central—Oxford A Research Ethics Committee (Ethics REF:22/SC/0059). Appropriate documentation and regulatory approvals have been acquired. Results will be disseminated via peer-reviewed articles and conferences.Trial registration number EudraCT Number: 2020-000510-14.

The emergence of COVID-19 (SARS-CoV-2) has introduced significant global challenges for healthcare systems, healthcare professionals and patients. This current climate creates an opportunity to learn from equitable health systems and move toward making fundamental changes to healthcare systems. Our ethnographic analysis of Wakanda’s healthcare system in Black Panther, from the Marvel Cinematic Universe, offers opportunities for system-level transformation across healthcare settings. We propose four healthcare system themes within the context of Wakandan identity: (1) technology as an instrument (blending bodies and technology, blending technology with tradition); (2) reimagining medication; (3) warfare and rehabilitation; and (4) preventative approaches to health (prioritising collective health, deprofessionalisation of healthcare services). The preceding themes represent core elements of Wakandan health systems that allow the people of Wakanda to thrive. Wakandans retain a strong identity and cultural traditions while embracing modern technologies. We found that effective upstream approaches to health for all are embedded in anti-colonial philosophies. Wakandans embrace innovation, embedding biomedical engineering and continuous improvement into care settings. For global health systems under strain, Wakanda’s health system identifies equitable possibilities for system change, reminding us that culturally relevant prevention strategies can both decrease pressure on health services and allow all people to thrive.

Adipose tissue-derived stromal cells (ADSCs) have generated considerable interest in the field of veterinary medicine, particularly for their potential in therapeutic strategies focused on bone regeneration. These cells possess unique biological characteristics, including their regenerative capacity and their ability to produce bioactive molecules. However, it is crucial to recognize that the characteristics of ADSCs can vary depending on the animal species and the site from which they are derived, such as the subcutaneous and visceral regions (SCAT and VAT, respectively). Thus, the present work aimed to comprehensively review the different traits of ADSCs isolated from diverse anatomical sites in companion animals, i.e., dogs, cats, and horses, in terms of immunophenotype, morphology, proliferation, and osteogenic differentiation potential. The findings indicate that the immunophenotype, proliferation, and osteogenic potential of ADSCs differ according to tissue origin and species. Generally, the proliferation rate is higher in VAT-derived ADSCs in dogs and horses, whereas in cats, the proliferation rate appears to be similar in both cells isolated from SCAT and VAT regions. In terms of osteogenic differentiation potential, VAT-derived ADSCs demonstrate the highest capability in cats, whereas SCAT-derived ADSCs exhibit superior potential in horses. Interestingly, in dogs, VAT-derived cells appear to have greater potential than those isolated from SCAT. Within the VAT, ADSCs derived from the falciform ligament and omentum show increased osteogenic potential, compared to cells isolated from other anatomical locations. Consequently, considering these disparities, optimizing isolation protocols becomes pivotal, tailoring them to the specific target species and therapeutic aims, and judiciously selecting the anatomical site for ADSC isolation. This approach holds promise to enhance the efficacy of ADSCs-based bone regenerative therapies.

The State of Minas Gerais stands out in the production of cheese, with eight regions traditionally characterized as producing Minas Artisanal Cheese: Serro, Canastra, Araxá, Cerrado, Campo of the Vertentes, Triângulo Mineiro, Serra do Salitre and Serras de Ibitipoca. The Instituto Mineiro de Agropecuária (IMA), in February 2014 recognized the Triângulo Mineiro (TM) as the sixth producing region of Minas Artisanal Cheese. The Minas Artisanal Cheese (MAC) is characterized using raw milk in its manufacture and the addition of natural starter cultures known as "pingo", following a simple, familiar, and customary manufacturing process. Five producers in the TM region registered in some inspection service (IMA, SIF, or SIM) was selected by Emater. In the selected properties, cheese samples were collected, at pre-defined day intervals up to 22 days of ripening, during the rainy and dry season of 2021, for microbiological analysis. The ripening period contributed to the reduction in counts positive Staphylococcus, coliforms at 35° e 45°C. Salmonella spp. was detected in cheeses from a single producer after ten days of ripening, in the dry season. The Listeria genus was not detected in any sample of milk or cheese. Given the plurality of results of each producer, it is concluded that defining a ripening period for each individualized property is more appropriate than defining the same for a particular producing region of MAC.

Introdução: Apreensão de medicamentos vem aumentando no Brasil nos últimos anos, esses produtos muitas vezes são contrabandeados, podendo ser ainda, adulterados ou falsificados. Segundo a OMS um medicamento falsificado é um produto embalado e etiquetado de forma incorreta, deliberadamente ou fraudulenta, que não respeita identidade da formulação original. Medicamentos para disfunção erétil, esteróides anabolizantes, emagrecedores e antineoplásicos são os de maior comercialização. Os estados do Sul e Sudeste apresentam o maior número de apreensões de medicamentos, que não cumprem a legislação sanitária quanto a exigência de registro na Agência Nacional Vigilância Sanitária. Os motivos para esse fenômeno são a localização geográfica, poder aquisitivo e a busca por um padrão de beleza. Objetivos: Calcular o valor movimentado de medicamentos em correspondências apreendidas pela Secretaria da Receita Federal do Rio Grande do Sul nos anos de 2016 à 2017 e as classes farmacológicas mais presentes. Método: A partir de valores praticados no mercado e pela Empresa Brasileira de Correios e Telégrafos, 117 caixas de correspondências padrão PAC/Sedex apreendidas com produtos farmacêuticos foram previamente catalogadas, descritas e tabuladas em planilhas Excel. Os produtos foram classificados por classe farmacológica, quando possível e as correspondências correlacionados a partir da sua origem até seu destino. A análise dos dados foi realizada através do banco de dados criados no Excel. Resultados: O valor calculado inicialmente para as caixas padronizadas pela Empresa Brasileira de Correios e Telegrafos e o transporte das 117 caixas tipo PAC/Sedex foi de R$ 3.800,00 a partir de pesquisa no site dos correios em junho de 2019. Os produtos mais encontrados nas encomendas foram anabolizantes 82%; medicamentos para disfunção erétil 2,6%; antineoplásicos 1,7%; abortivos 0,9%; emagrecedores 0,9%; 1,7% classificados como outros produtos e 10,3% não possuíam identificação, apenas letras ou sinais representativos escritos à mão. Os anabolizantes foram remetidos de 9 estados: RS, SP, PR, ES, BA, DF, MG, TO e PB, tendo como destino 7 estados: RS, MG, SP, RJ, BA, DF e MT. Os antineoplásicos apresentavam remetentes de SC e RS, no entanto, eram destinados apenas ao RS. Os medicamentos de combate à disfunção erétil, possuíam remetentes do RS e eram destinados aos estados do RS e BA. Os medicamentos abortivos foram remetidos de SC para o RS, já os emagrecedores do RS para SP. Conclusão:Os esteróides anabolizantes foram os produtos mais presentes nas caixas apreendidas. O valor calculado para embalagem e transporte pelos correios é considerado baixo, o que colabora muito para esse comércio ilegal. O alto valor desses medicamentos e a necessidade de prescrição médica levam ao seu consumo. Esses medicamentos podem apresentar risco à saúde, pois não se sabe sua condição de produção, armazenamento, dose e princípio ativo. Logo, podem não causar os efeitos terapêuticos esperados.

O combate a disseminação de notícias falsas e a desinformação em saúde tem sido apontado como um dos maiores desafios atuais dentro da saúde coletiva mundial. A psiquiatria e as áreas relacionadas à saúde mental são especialmente impactadas pela falta de educação em saúde, uma vez que estas ainda são fortemente relacionadas a estigmas e a marginalização social. Neste artigo, abordaremos as vantagens e as limitações do uso de tecnologias de informação e comunicação como ferramentas de psicoeducação, apontando futuros direcionamentos para o desenvolvimento dessas tecnologias.

We are living in a fast-changing world promoted by anthropogenic actions and ecosystems’ functioning has been constantly changed. One example is the globally reduction of river flow that can lead to more than 50% of the rivers and streams around the world becoming intermittent. However, the relationship between environmental changes and biological communities has been limited to taxonomic approach, rather than the functional approach. Functional structure determines how individuals interact with the environment and evaluating the effects of hydrological changes in functional variation can elucidate the responses of aquatic biota under climate changes. Thus, we hypothesized that hydrological phases (dry, re-wetting and wet) would influence both environmental conditions and fish composition (i.e., taxonomic richness and functional structure) in one intermittent river. In addition, we expected that: 1) fish assemblages will have higher values of species richness and Functional Diversity indexes—Richness (FRic), Dispersion (FDis), Specialization (FSpe), and Originality (FOri) in drier phases (dry and re-wetting); and 2) higher values of Functional Diversity indexes related to evenness (FEve) and divergence (FDiv) in the wet phase, due to the predominance of species with high dispersal capacity when sites are connected. Sampling was conducted in the Cruxati river during the three hydrological phases along four sites (250 m each). Functional diversity analysis, involving traits of dispersion, life history and trophic ecology were used to apply Functional Diversity indexes. Indexes were compared from null models and all species were ordered in a multidimensional functional space using principal coordinate analysis (PCoA). In the dry phase, taxonomic richness and FRic between communities is higher, as well as FSpe and FOri, showing that each assemblage has unique characteristics with different strategies allowing the establishment in this hydrological phase. However, communities are less functionally dispersed. In the wet phase, when the river is connected, FDis between communities is higher and species abundances are more equitable with regular distribution in the functional space. Therefore, we conclude that local ecological processes (i.e., dynamics of hydrology) may promote the establishment of species according to their functional traits and thereby the functional structure of local assemblages.

One of the major challenges in forensic document analysis is estimating the age of ink deposition on a manually written document. The present work aims to develop and optimise a methodology, based on the evaporation of 2-phenoxyethanol (PE) over time, that can contribute to ink age estimation. A black BIC® Crystal Ballpoint Pen was purchased in a commercial area, and ink deposition began in September 2016 over 1095 days. For each ink sample, 20 microdiscs were subjected to n-hexane extraction in the presence of an internal standard (ethyl benzoate) followed by derivatisation with a silylation reagent. A gas chromatography-mass spectrometry (GC/MS) method was optimised for PE-trimethylsilyl (PE-TMS) to characterise the ageing curve. The developed method presented good linearity between 0.5 and 50.0 μg mL−1, as well as limits of detection and quantification of 0.026 and 0.104 μg mL−1, respectively. It was possible to characterise PE-TMS concentration over time, which reveals a two-phase decay behaviour. First, there was a substantial decline between the 1st and the 33rd day of deposition, followed a by a stabilisation of the signal, which allowed to detect the presence of PE-TMS up to 3 years. Two unknown compounds were also present and allowed to identify three dating time frames for the same ink stroke: (i) between time 0 and 33 days, (ii) between time 34 and 109 days, and (iii) more than 109 days. The developed methodology allowed to characterise the behaviour of PE over time and to establish a relative dating of three-time frames.

Introduction: The first presentation of ulcerative colitis may be an acute flare in about 15% of patients, requiring hospital admission. In acute severe steroid-refractory ulcerative colitis, cytomegalovirus (CMV) should be sought because it is a frequent cause of refractory disease. Herpes simplex colitis constitutes a rarer event in ulcerative colitis patients and it is usually associated with immunosuppression. Case Presentation: We report a case of a first presentation of ulcerative colitis complicated by CMV and herpes simplex type 2 coinfection. After a long period of systemic corticosteroids, the diagnosis of both CMV and herpes colitis was made. Despite antiviral treatment, colectomy was required due to a contained perforation. Discussion/Conclusion: This report highlights the importance of a high degree of suspicion for opportunistic infections in steroid/immunomodulator refractory ulcerative colitis, even in the first flare.

Background: Intracerebral hemorrhage (ICH) recurrence risk is known to be higher in patients with cerebral amyloid angiopathy (CAA) as compared to other causes of ICH. Risk factors for ICH recurrence are not completely understood, and our goal was to study specific imaging microangiopathy markers. Methods: Retrospective case-control study of patients with non-traumatic ICH admitted to a single center between 2014 and 2017 who underwent magnetic resonance imaging (MRI). Clinical characteristics of the index event and occurrence of death and ICH recurrence were collected from clinical records. MRI images were independently reviewed by 2 neuroradiologists. Groups of patients with CAA-related and CAA-unrelated ICH defined were compared. Presence of CAA was defined according to the Boston modified criteria. Survival analysis with Kaplan-Meier curves and Cox-regression analyses was performed to analyze ICH recurrence-free survival. Results: Among 448 consecutive patients with non-traumatic ICH admitted during the study period, 104 were included in the study, mean age 64 years (±13.5), median follow-up of 27 months (interquartile range, IQR 16–43), corresponding to 272 person-years of total follow-up. CAA-related ICH patients presented higher burden of lobar microbleeds (p < 0.001), higher burden of enlarged perivascular spaces (EPVS) in centrum semiovale (p < 0.001) and more frequently presented cortical superficial siderosis (cSS; p < 0.001). ICH recurrence in patients with CAA was 12.7 per 100 person-years, and no recurrence was observed in patients without CAA. Variables associated with ICH recurrence in the whole population were age (hazard ratio [HR] per 1-year increment = 1.05, 95% CI 1.00–1.11, p = 0.046), presence of disseminated cSS (HR 3.32, 95% CI 1.09–10.15, p = 0.035) and burden of EPVS in the centrum semiovale (HR per 1-point increment = 1.80, 95% CI 1.04–3.12, p = 0.035). Conclusions: This study confirms a higher ICH recurrence risk in patients with CAA-related ICH and suggests that age, disseminated cSS, and burden of EPVS in the centrum semiovale are associated with ICH recurrence.

Este estudo teve como objetivo analisar a prevalência de limitação na mobilidade funcional autorreferida e os fatores associados no período entre os anos 2000 e 2015, em idosos residentes no Município de São Paulo, Brasil. Para as presentes análises foram utilizados os dados das quatro ondas (2000, 2006, 2010 e 2015) do Estudo Saúde, Bem Estar e Envelhecimento (SABE). Foram conduzidos modelos de regressão para analisar as características demográficas, socioeconômicas, comportamentais e relativas à saúde dos indivíduos associadas à limitação da mobilidade em cada onda do estudo, e análise multinível para a comparação entre as quatro ondas. Os resultados indicaram aumento nas prevalências de limitações na mobilidade autorreferida, mais evidente no ano de 2006. Foi observado, ainda, associação com condições crônicas de saúde, como a história de AVC (RP = 1,43; IC95%: 1,29; 1,58, em 2000), a presença de doenças osteoarticulares (RP = 1,35; IC95%: 1,23; 1,49, em 2015), e a queixa de “dor nas costas” (RP = 1,33; IC95%: 1,22; 1,45, em 2006), bem como com aspectos socioeconômicos, como a renda insuficiente (RP = 1,17; IC95%: 1,07; 1,28, em 2010). Em um contexto de envelhecimento populacional acelerado, esses resultados trazem informações relevantes para a promoção de políticas públicas voltadas à prevenção de declínio da mobilidade em pessoas idosas.

Objective: To describe the process of elaboration, by the team of the Community Care Unit Vallis Longus, of a procedure for the handling of Personal Protective Equipment (PPE) during homecare visits (HCV) within the scope of COVID19. Method: The preparation of the PPE handling procedure in the context of HCV followed the following steps sequentially: a) review of the available literature; b) team discussion on the respondent's viability in the previous point; c) theoretical elaboration of the procedure; d) practical test of the procedure; e) preparation of the final version of the procedure; f) development of a video demonstrating the procedure. Results and discussion: The elaboration of the PPE management procedure in the context of the HV implies the assessment of its viability, both in terms of the necessary material resources and in terms of the use of the procedure in the real context of home care provision. The described phases made it possible to adapt what was described in the literature, so that it could be fully implemented in the daily organization of the unit and, consequently, in the direct provision of care. The production of a video facilitated the training actions related to the procedure, which mostly acquired a virtual character due to the pandemic COVID19. Conclusion: The context of the COVID19 pandemic created the need to review the PPE handling procedures inherent in HV to prevent the spread of infection. The development, in a discussion team, of a procedure based on the combination of the literature and the practical feasibility of its implementation allowed to put into operation an effective and sustainable PPE management model.

The Rivulidae fish family, which includes Neotropical seasonal killifishes, is one of the most diverse taxonomic groups in the aquatic systems of Caatinga in Brazil. Cynolebias and Hypsolebias genera, with 20 and 35 endemic species, respectively, concentrate the greatest diversity of rivulid species in the semiarid. Sixty-eight years after the first records of annual killifishes in the Mid-Northeastern Caatinga ecoregion (MNCE), only four valid species have been sampled in this area. Here we combined bibliographic surveys and recent samplings to investigate the distribution of seasonal rivulids in MNCE. Twenty-one records were obtained, nine of which are new localities, expanding the distribution of three species: Hypsolebias martinsi, H. antenori and Cynolebias microphthalmus. Hypsolebias longignatus is still only known from its type locality in Ceará, near the Environmental Protection Area in Pacoti River, and has not been sampled ever since its description in 2008. Among the four species present in MNCE, H. antenori is the only species occurring within the limits of a conservation unit in the Furna Feia National Park. Anthropogenic impacts were observed in most temporary habitats visited, which ranged from river channel to small ponds in cave entrances. All records are found in coastal basins that discharge in the northern coast of the MNCE, in Ceará and Rio Grande do Norte states, which are crucial for the conservation of the Caatinga’s killifishes. The results also evidenced the importance of karstic habitats in the Jandaíra Formation as potential biotopes for seasonal fish in MNCE. This information must be used to update the conservation status of these species and highlight the importance of strategies for preserving the Caatinga’s temporary aquatic habitats, which should be considered for environmental licensing purposes.

Resumo Desde 2012, o testamento vital é direito legalmente protegido em Portugal. Este estudo, exploratório-descritivo, questionou médicos e enfermeiros de um hospital português sobre verificação e compartilhamento de informação relativa ao testamento vital. A maioria dos profissionais (57%) nunca verificou a existência do documento, embora considere ato importante (95%), compartilhe essa informação quando tem acesso a ela (82%) e julgue que o não compartilhamento tem implicações relevantes na prática de cuidados (86%). Os resultados mostram que verificar a existência de testamento vital não é, no hospital estudado, prática corrente. São necessários novos estudos que identifiquem as motivações subjacentes a esse comportamento e verifiquem se é comum em outras instituições de saúde, propondo medidas para promover prática profissional em consonância com o estabelecido pela lei.

Sibutramine is a serotonin-norepinephrine-dopamine reuptake inhibitor, initially developed as a potential antidepressant and later approved for the management of obesity. Sibutramine use is also associated with psychiatric symptoms, namely mania, panic attacks, and, less frequently, psychosis. We report the case of a 32-year-old man, admitted to our hospital due to a suicide attempt in the context of sibutramine-associated psychosis. The symptoms remitted completely after discontinuation of sibutramine and a brief period of antipsychotic medication. The aim of this manuscript is to highlight the importance of the recognition of sibutramine-associated psychosis, to discuss the possible pathophysiology and the proper clinical and therapeutic management.

Introduction: Since the publication of endovascular treatment trials and European Stroke Guidelines, Portugal has re-organized stroke healthcare. The nine centers performing endovascular treatment are not equally distributed within the country, which may lead to differential access to endovascular treatment. Our main aim was to perform a descriptive analysis of the main treatment metrics regarding endovascular treatment in mainland Portugal and its administrative districts. Material and Methods: A retrospective national multicentric cohort study was conducted, including all ischemic stroke patients treated with endovascular treatment in mainland Portugal over two years (July 2015 to June 2017). All endovascular treatment centers contributed to an anonymized database. Demographic, stroke-related and procedure-related variables were collected. Crude endovascular treatment rates were calculated per 100 000 inhabitants for mainland Portugal, and each district and endovascular treatment standardized ratios (indirect age-sex standardization) were also calculated. Patient time metrics were computed as the median time between stroke onset, first-door, and puncture. Results: A total of 1625 endovascular treatment procedures were registered. The endovascular treatment rate was 8.27/100 000 inhabitants/year. We found regional heterogeneity in endovascular treatment rates (1.58 to 16.53/100 000/year), with higher rates in districts closer to endovascular treatment centers. When analyzed by district, the median time from stroke onset to puncture ranged from 212 to 432 minutes, reflecting regional heterogeneity. Conclusion: The overall national rate of EVT in the first two years after the organization of EVT-capable centers is one of the highest among European countries, however, significant regional disparities were documented. Moreover, stroke-onset-to-first-door times and in-hospital procedural times in the EVT centers were comparable to those reported in the randomized controlled trials performed in high-volume tertiary hospitals.

In obsessive-compulsive disorder, pedophilia-themed obsessions-distressing intrusive thoughts about being sexually attracted to, or sexually abusing, children-are the most distressing for patients and the most misdiagnosed among healthcare professionals. Our aim is to present a case report highlighting the role stigma plays in delaying treatment, the clinical challenges in the diagnosis, and in the treatment of pedophilia-themed obsessive-compulsive disorder, in order to address the lack of literature on the subject. The case concerns a 33-year-old man with suicidal thoughts associated with the unbearable suffering caused by pedophilia-themed obsessions he had been having over the previous decade, without ever asking for help. This situation was highly disabling, leaving him mostly isolated in his bedroom. After the differential diagnosis was made, a treatment plan combining pharmacological and cognitive-behavioural therapy was implemented. After 18 months he showed a degree of remission that made it possible for him to apply for a job.

Mesenchymal stromal cells (MSCs) have gained special relevance in bone tissue regenerative applications. MSCs have been isolated from different depots, with adipose tissue being acknowledged as one of the most convenient sources, given the wide availability, high cellular yield, and obtainability. Recently, the falciform ligament (FL) has been regarded as a potential depot for adipose tissue-derived stromal cells (FL-ADSCs) isolation. Nonetheless, the osteogenic capability of FL-ADSCs has not been previously characterized. Thus, the present study aimed the detailed characterization of FL-ADSCs’ functionality upon osteogenic induction through a classic (dexamethasone-based-DEX) or an innovative strategy with retinoic acid (RA) in a comparative approach with ADSCs from a control visceral region. Cultures were characterized for cell proliferation, metabolic activity, cellular morphology, fluorescent cytoskeletal and mitochondrial organization, and osteogenic activity–gene expression analysis and cytochemical staining. FL-derived populations expressed significantly higher levels of osteogenic genes and cytochemical markers, particularly with DEX induction, as compared to control ADSCs that were more responsive to RA. FL-ADSCs were identified as a potential source for bone regenerative applications, given the heightened osteogenic functionality. Furthermore, data highlighted the importance of the selection of the most adequate osteogenic-inducing program concerning the specificities of the basal cell population.

BackgroundSerious video games have now been used and assessed in clinical protocols, with several studies reporting patient improvement and engagement with this type of therapy. Even though some literature reviews have approached this topic from a game perspective and presented a broad overview of the types of video games that have been used in this context, there is still a need to better understand how different game characteristics and development strategies might impact and relate to clinical outcomes. ObjectiveThis review assessed the relationship between the characteristics of serious games (SGs) and their relationship with the clinical outcomes of studies that use this type of therapy in motor impairment rehabilitation of patients with stroke, multiple sclerosis, or cerebral palsy. The purpose was to take a closer look at video game design features described in the literature (game genre [GG], game nature [GN], and game development strategy [GDS]) and assess how they may contribute toward improving health outcomes. Additionally, this review attempted to bring together medical and game development perspectives to facilitate communication between clinicians and game developers, therefore easing the process of choosing the video games to be used for physical rehabilitation. MethodsWe analyzed the main features of SG design to obtain significant clinical outcomes when applied to physical rehabilitation of patients recovering from motor impairments resulting from stroke, multiple sclerosis, and cerebral palsy. We implemented a PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) database-adjusted electronic search strategy for the PubMed, IEEE Xplore, and Cochrane databases. ResultsWe screened 623 related papers from 2010-2021 and identified 12 that presented results compatible with our inclusion criteria. A total of 512 participants with stroke (8 studies, 417 participants), cerebral palsy (1 study, 8 participants), and multiple sclerosis (2 studies, 46 participants) were included; 1 study targeting the elderly (41 participants) was also included. All studies assessed motor, sensory, and functional functions, while some also measured general health outcomes. Interventions with games were used for upper-limb motor rehabilitation. Of the 12 studies, 8 presented significant improvements in at least one clinical measurement, of which 6 presented games from the casual GG, 1 combined the casual, simulation, and exergaming GGs, and 2 combined the sports and simulation GGs. ConclusionsOf the possible combinations of game design features (GG, GN, and GDS) described, custom-made casual games that resort to the first-person perspective, do not feature a visible player character, are played in single-player mode, and use nonimmersive virtual reality attain the best results in terms of positive clinical outcomes. In addition, the use of custom-made games versus commercial off-the-shelf games tends to give better clinical results, although the latter are perceived as more motivating and engaging.

The present text deals with the deployment of images of a mutilated body as means of expressing, celebrating, and overcoming pain, loss and trauma. Based on a true story, a violent crime against a 52-year-old woman shot at point-blank by a former boyfriend, her 20-year-old daughter, trying to initiate a form of healing process, depicted in a series of photographs and literary references the unfathomed manner her mother’s life was shattered, on a February night in 2020. The visual story will be analysed under the notions presented by Maurice Merleau-Ponty, Susan Sontag, and Rita Charon, among others, bearing in mind the concepts of illness, perception, the body as narrative, and the underlying urge to produce an enduring artistic testament to illustrate and crystallize that epistemological break marking life before and after the tragedy.

ABSTRACT Remote sensing coupled with the measurement of physical, chemical and biological variables is an important tool in water resource management. The aim of this study, therefore, was to evaluate the dynamics of the physical, chemical and biological variables of the waters of an intermittent river and an artificial surface reservoir using multivariate analysis and in response to land use and occupation in the hydrographic basin. The study was carried out in the hydrographic basin of the River Cruxati in four study areas (three river areas and one artificial reservoir), with images obtained from the OLI sensor of the Landsat-8 satellite. The limnological variables measured were pH, electrical conductivity, dissolved oxygen, turbidity, nutrients (total nitrogen and total phosphorus) and chlorophyll a. The limnological variables were analysed using Principal Component Analysis - PCA, Tukey's test and Cluster Analysis. Eutrophication of the areas under study was calculated using the Trophic State Index. The PCA allowed three components to be selected that indicated the quality of the surface water, river and artificial reservoir, explaining 88.57% of the total variance. The limnological variables responsible for the grouping were electrical conductivity, dissolved oxygen and turbidity. Land use and occupation has influenced water quality in the stretches of river. Anthropisation has had an influence on the levels of dissolved oxygen, and the presence of agricultural areas has caused an increase in turbidity. However, the most conserved landscape (artificial reservoir) had the highest degree of eutrophication due to the difference in water dynamics between the lentic and lotic environments.

AbstractIntroduction Synthetic cannabinoids (SC) are potent agonists of cannabinoid receptors, that mime the psychoactive effect of Δ9-tetrahydrocannabinol (Δ9-THC), the principal psychoactive component of cannabis [1]. JWH-018 was the first novel psychoactive SC found in the recreational drug marketplace in 2008. A few years later, JWH-018 started to be controlled by authorities, so alternative molecules started to emerge. THJ-018 was designed to replace JWH-018, having a similar structural skeleton and also a naphthalene and pentyl chain connected via a middle core substructure. Eventually, THJ-018 was scheduled and alternatives emerged, such as EG-018 [2]. This practice makes almost impossible to characterise SC toxicological profiles on an acceptable time scale, mostly due to the time-consuming experiments that must be held in animal models or human cells by standard methods. The yeast Saccharomyces cerevisiae shares highly conserved molecular and cellular mechanisms with human cells and has been used before for synthetic cathinones [3]. The present work has studied the best carbon source (glucose or galactose) to measure the impact of synthetic cannabinoids on S. cerevisiae growth, aiming to develop a method able to profile synthetic cannabinoids toxicity in a short time scale. The difference between carbon sources is that in Crabtree-positive yeast strains, glucose induce a strong inhibition of mitochondrial oxidative phosphorylation [4].Materials and methods The effect of EG-018 was evaluated by its impact on S. cerevisiae BY4741 (WT) growth on minimal medium with 2% Glucose or 1% Galactose as sole carbon sources, in the presence and absence of the SC, followed at OD600nm. Growth rates at each condition was fitted to a logistic equation.Results Figure 1 shows OD600max obtained from the non-linear regression to the logistic equation in the presence of different concentrations of EG-018. While in galactose there is no effect, in 2% Glucose the results points to a growth decrease with EG-018. Discussion and conclusions: Comparing the two carbon sources, yeast growth on glucose is more susceptible to EG-018. Recent studies points that JWH-018, a similar SC, exerts an effect on glycolytic and pentose phosphate pathway at high concentrations of glucose (personal communication). As yeast growth in galactose proceeds simultaneously via respiration and fermentation due to the “Crabtree effect” [4] an impact of EG-018 on glycolysis might be less effective. These results, suggest that glucose is the best carbon source to develop a yeast based toxicity sensor for SC.[Figure: see text]

AbstractIntroduction Synthetic cannabinoids (SCs) are novel psychoactive substances that mimic the effects of cannabis [1–3]. These products were sold via online shops and consisted of herbal mixtures sprayed with SCs [3]. Since then, a deluge of chemical variations of SCs has been occurring worldwide due to their synthesis in clandestine laboratories, often based on pharmaceutical research and patents, posing a growing challenge for authorities regarding regulation of these substances [1,3]. More recently, several highly potent compounds have emerged on the drug market, synthesised as stated in the patent application of Bowden and Williamson (“SGT-compounds”). These drugs are characterised by a cumyl substituent, which is attached to an indole, indazole or azaindole structure. One of the first cumyl-derivatives, CUMYL-PEGACLONE, was found in 2016 on the German drug market, being sold under the street name SGT-151 [1,2]. The present study aims to understand what is inside of a SGT-151 package sold in the internet as a ‘research chemical’.Materials and methods The cannabinoid identification was based on its mass spectra using the Cayman database (Chemical C. Cayman Spectral Library, vol. v08302018). GC/MS was the technique used to analyse the compound using a MEGA–5 MS capillary column (0.25 µm, 0.32 mm, 30m). Chromatographic analysis was carried out under the following conditions: injection volume 1 µL and splitless injection at 280 °c. The initial oven temperature was 100 °C for 3 min, ramped to 310 °C at a rate of 30 °C/min and held at 310 °C for 10 min. The MS conditions were as follows: ionisation energy was set at 70 eV; acquisition was carried out in a scan mode range of m/z 30–450. Helium was used as the carrier gas. For purification, a HPLC/DAD, operated by Clarity software, was used with a reversed-phase column. The mobile phase was a solvent gradient system consisting of (A) 5% 10 mM ammonia format and (B) 95% acetonitrile, optimised to achieve the best resolution. The results were recorded at λ = 252 nm.Results Figure 1(A) shows the GC/MS chromatogram of SGT-151. It is clear the presence of a peak corresponding to SGT-151 and several other peaks from other compounds. It was not possible to identify the remaining peaks. Figure 1(B) shows a GC/MS chromatogram after purification of the package content. Discussion and conclusions: The data gathered in this study shows that SGT-151 contains a significant amount of impurities. This working progress data is the initial step of a bigger project aiming to understand whether there are differences in the toxicity of pure and non-pure SGT-151 on human cell lines, once it is important to understand if the impurities may have any influence on the cytotoxicity, compared to substances in their pure form, since most of the times the substances that are sold on the streets are not 100% pure.[Figure: see text]

AbstractIntroduction 2-Phenoxyethanol (PE) is a volatile compound present in the composition of inks. After the deposition in a document, it starts to evaporate over time. This ageing process potentially allow to estimate the date of an ink in a document [1], however this is a complex system where the PE derivatization with different derivatization agents and methods can contribute to improve ink dating validation [2]. The aim of this work is to determine if PE derivatization with MSTFA:TMCS, will increase the sensitivity of the method contributing to the estimation of the ink age for a longer period of time.Materials and methods In order to compare peak resolution between PE and derivatized PE, a solution of 50 µg/ml of PE was prepared in hexane. The derivatized sample was prepared using chemical derivatization with MSTFA:TMCS (95:5) at a 80ºC during 30 min. The samples were analysed using GC/MS with an Agilent Technologies 5973 − 6890 N. GC MEGA-5 MS; 0.25µm, 0.32mm, 30 m capillary column was used. Chromatographic analysis was carried out under the following conditions: injection volume 2 µl, split ratio of 2:1 and injection temperature at 280 ºC. The oven temperature program starting at 90 ºC during 8 min, then ramped at 10 ºC min−1 to 100 ºC, and increased to 240 ºC at a rate of 30 ºC min−1 during 4.67 min. The MS analysis was carried out in SIM mode, which m/z of PE was 77, 94, 138 and PE-TMS was 151, 195, 210.Results The chromatogram results (Figure 1) showed that PE-TMS has a longer retention time (23.2 min) and a better resolution than PE (retention time of 13.2 min). Discussion and conclusions: This preliminary study showed an increase of the sensitivity of the PE-TMS. Our results revealed that PE derivatization with MSTFA:TMCS, might be useful in ink dating determination and can contribute to the decreasing of LOQ. However, more work has to be done. In conclusion, derivatization proves to be promising in the field of ink ageing, allowing getting sensitivity to estimate the age of an ink, in a long period of time.[Figure: see text]

AbstractIntroduction Nowadays, there is a trend to enrich food and food supplements (FS) with Vitamin D3. Economic operators who places FS on the market does not have to perform running safety trials, but only to comply with the food safety regulations applicable in the European Union [1]. This scenario may present public health and legal issues. To overcome these challenges, it is mandatory to know accurately the amount of vitamin D3 in FS and if it corresponds to the label value. HPLC methods are a preferential approach to determine accurately the content of vitamin D3 in pharmaceuticals and supplements. Actually, HPLC/MS has become the technique of choice for vitamin D3 determination in complex matrixes. Notwithstanding, this analysis must be preceded by time-consuming sample preparation. In fact, the success to measure accurately vitamin D3 depends heavily in a reliable sample preparation. Moreover, it becomes even more critic when dealing with different formulations of vitamin D3, such has gel pills, solid pills, liquid or cutaneous applications. There are literature validating methodology to determinate vitamin D3 in various matrixes according to the International Conference on Harmonisation (ICH) guidelines by HPLC-UV [2]. However, this published study does not use an internal standard (IS). The internal standard is useful to improve the precision of quantitative analysis, removing the error of losing sample during sample preparation. Our aim is to test o-cresol as an internal standard to future validation the methodology.Materials and methods Vit D3 present in FS was analysed by HPLC/DAD. Sample was spiked with internal standard (o-cresol) and liquid extraction coupled to an ultrasound bath was used has an extraction procedure. After a centrifuged step the supernatant was filtered. The separation was performed using a C18 column with a solvent gradient consisted in (A) 0.1% formic acid and (B) acetonitrile. The acquisition was performed on DAD-detector at 265 nm.Results Figure 1 shows a chromatogram of a FS containing Vit D3. Two major peaks are present, corresponding to o-cresol (RT 5.45 min) and Vit D3 (RT 11.20 min). Discussion and conclusions: The results show the capacity of the chromatographic method to separate and resolve the two chromatographic peaks. These preliminary results show that o-cresol can be used as an internal standard to determine Vit D3 in FS, normalising the loss of Vit D3 during preparation step. Since in Europe and USA, the association of vitD toxicity with the use of FS has been described, this methodology will be useful to confirm the VitD composition stated on the label.[Figure: see text]

AbstractPhytocannabinoids are psychotropic substances found in cannabis that bind to the endocannabinoid receptors regulating a variety of physiological processes in human body, including synaptic activity in the central nervous system and metabolic effects in the peripheric nervous system among many others [1,2]. Synthetic cannabinoids emerged as popular alternative to cannabis. Most of these substances are synthetic analogues of Δ9-THC, the psychotropic compound of cannabis, binding with higher affinity to the endocannabinoid receptor CB1 and eliciting a stronger and long-lasting effect on brain cells. Molecular structure of synthetic cannabinoids is always changing escaping the control by authorities and increasing the hazard for general population. The popularity of cannabis and its derivatives may lead, and often does, to child’s exposure to cannabinoids both in utero and through breastfeeding by a drug-consuming mother. Prenatal exposure to cannabis has been associated with higher risk of newborn morbidity [2,3], altered rate of mental development and significant changes in nervous system functioning [4,5]. However, direct evidence that these effects are mediated through the binding of cannabinoids to endocannabinoid receptors is still lacking. Thus, it is paramount to better understand the psychoactive effects of natural and synthetic cannabinoids on the developing human brain.We conveyed a pilot study in which human induced pluripotent stem cells (hiPSCs) were induced into neural differentiation and treated with a non-psychotropic component of cannabis, cannabidiol, known to bind the CB2 receptor, and two synthetic Δ9-THC analogues, THJ-018 and EG-018. Neuronal differentiation and functional maturation were assessed by immunofluorescence, qRT-PCR and single cell calcium imaging. Our results indicate that all three substances have profound impact on the differentiation, maturation and functioning of developing CNS neurons, providing a new evidence for the importance of thorough research of the impact of pre-natal exposure to natural and synthetic cannabinoids.

AbstractIntroduction Novel psychoactive substances (NPS) represent a rising public health threat due to the associated side effects and the lack of success on their control policies. NPS are freely sold, mostly on the internet, as legal and safe replacements of controlled drugs of abuse. Synthetic cannabinoids (SCs) represent one of the largest groups of NPS and are designed as mimetics of Δ9-tetrahydrocannabinol from cannabis [1]. After the identification of JWH-018, the first SC appearing on the market, many countries took measures to control the free circulation of these products [2]. Nevertheless, efforts to control them are rapidly contoured, since clandestine manufacturers are constantly changing their chemical structures leading to previously unknown SCs [3]. The aim of this study is to show how chemical changes on recent generations of SCs to evade the law lead to the production of more harmful compounds, with potential application in forensic context. With that purpose, the toxicity of three SCs, representatives of the first, second and third generations [4], was assessed.Materials and methods The SC JWH-018 was obtained as >98.5% pure powders from Lipomed AG Switzerland. SCs THJ-018 and EG-018 were bought through an internet website (www.chem.eu). THJ-018 and EG-018 were purified through HPLC/DAD and confirmed by GC/MS. Pure SCs stock solutions were prepared in 100% DMSO accordingly to the stipulated final concentrations and diluted into the culture medium prior addition to cells. The neuroblastoma human cell line SH-SY5Y was exposed, for 24 h, to several concentrations of each SC. Cell toxicity was evaluated through MTT assays.Results Figure 1 shows the MTT results for SH-SY5Y viability in the presence of JWH-018, THJ-018 and EG-018. SH-SY5Y cells viability does not decrease in the presence of JWH-018 at the range of concentrations used. However, when the same cell line is exposed to THJ-018 or EG-018 there is a decrease in cell viability with the increase in the concentration of these substances. Discussion and conclusions: The results from the present study points THJ-018 and EG-018, JWH-018 analogues of 2nd and 3rd generations, as more toxic to the neuroblastoma cells than JWH-018, the first SC found on the street market. These results suggest that emerging modified SCs, to avoid the law, are becoming more toxic and dangerous. Given the emergence of this situation, it is time to rethink current legislation to prevent rise on public health issues derived from consumption of molecules of unknown toxicological profile.[Figure: see text]

ABSTRACT: Urinary bladder damages leading to few viable bladder tissue available might demand a challenging reconstructive surgery. In this context, biomaterials are valid alternatives for bladder reconstruction. This study evaluated the bovine tunica albuginea fragment as graft material for cystoplasty in rats and honey-preserved implant viability.Thirty Wistar rats were assigned to two groups: (1) a test group (T) with a circular 1.0-cm-diameterbovine tunica albuginea graft application in the apex region by a continuous absorbable (Polyglactin 910 5-0) suture with stitching of all bladder layers and (2) a simulation group (S) in which animals underwent only partial cystectomy. In addition, each of these groups was further divided into three subgroups according to euthanasia period on post-surgery day 7, 15 and 30.Two animals had self-limiting hematuria at postsurgical period. At necropsy, frequent crystals and adhesion to the peritoneum were observed. At the histopathological evaluation, animals from the T group euthanized by 15th postoperative day had layers disorganization and initial muscle development, while T group rats euthanized by 30th postoperative day showed complete urothelization. Urothelization pattern was similar in both groups. Moreover, the muscular layer formation was present in both groups, but more evident in S group animals. Nevertheless, inflammatory infiltrate and neovascularization were remarkably more intense in T group rats.It might be concluded that bovine tunica albuginea graft was successful in repairing rats’ bladder, being a good biomaterial option in reconstructive urinary vesicle surgery.

The wine market is very heterogeneous and complex, being the knowledge of the behaviour and attitudes of consumers a key tool to design efficient marketing plans, namely in countries that are traditionally wine producers and consumers, such as Portugal. In this country, Port wine is an economic and cultural icon, but, in the last decade, total sales have been decreasing. Despite this trend the domestic consumption has been gaining relevance and therefore a focus to reverse the negative cycle of total sales. The main goal of this paper is to analyse the profile and behaviour of domestic Port wine consumers, identifying homogeneous market segments. For this purpose, an online survey was applied and random sample of 678 Portuguese Port wine consumers was collected. Using multivariate statistical techniques, three profiles of purchasers/consumers emerged: experienced, less experienced and inexperienced consumers. This segmentation shows that Port wine consumers can be grouped according to their involvement with the product, consumption occasion and price they are willing to pay. In addition to the academic contribution of wine market segmentation, the paper provides useful insights to be used in designing marketing plans, both by institutional stakeholders and wineries.

Abstract It is necessary to better understand the context in which intimate partner violence occurs. This study aimed to examine the occurrence of physical violence between intimate partners, based on the reports of women involved in these situations, by identifying the circumstances in which the physical violence occurs and the presence of controlling behavior in these relationships. We conducted a community survey using probabilistic sampling (144 women), administering the following instruments: socio-demographic questionnaire, CTS2, AUDIT. Fifty-seven women of our sample reported episodes of physical violence and were invited to participate in a semi-structured qualitative interview. Most of the reports obtained in the interviews did not confirm the episodes of physical violence initially identified by the scale, showing disagreements between the research instruments. Personal characteristics of the perpetrator of the violence, male alcohol use and aspects of the affective relationship were identified as important triggers of intimate partner violence. Controlling behaviors in combination with physical violence revealed varying degrees of domination occurring in the dyads.

Phytocannabinoids are psychotropic substances ofcannabis with the ability to bind endocannabinoid (eCB) receptors that regulate synaptic activity in the central nervous system (CNS). Synthetic cannabinoids (SCs) are synthetic analogs of Δ9-tetrahydrocannabinol (Δ9-THC), the psychotropic compound of cannabis, acting as agonists of eCB receptor CB1. SC is an easily available and popular alternative to cannabis, and their molecular structure is always changing, increasing the hazard for the general population. The popularity of cannabis and its derivatives may lead, and often does, to a child’s exposure to cannabis both in utero and through breastfeeding by a drug-consuming mother. Prenatal exposure to cannabis has been associated with an altered rate of mental development and significant changes in nervous system functioning. However, the understanding of mechanisms of its action on developing the human CNS is still lacking. We investigated the effect of continuous exposure to cannabinoids on developing human neurons, mimicking the prenatal exposure by drug-consuming mother. Two human induced pluripotent stem cells (hiPSC) lines were induced to differentiate into neuronal cells and exposed for 37 days to cannabidiol (CBD), Δ9-THC, and two SCs, THJ-018 and EG-018. Both Δ9-THC and SC, at 10 μM, promote precocious neuronal and glial differentiation, while CBD at the same concentration is neurotoxic. Neurons exposed to Δ9-THC and SC show abnormal functioning of voltage-gated calcium channels when stimulated by extracellular potassium. In sum, all studied substances have a profound impact on the developing neurons, highlighting the importance of thorough research on the impact of prenatal exposure to natural and SC.

The transformative experience of engaged presence in teaching and learning fosters trust and supports learners and teachers to explore, learn, and grow in their understanding of who they are becoming. Enacting presence in teaching becomes an act of care and creates an embodied space for learners to engage in authentic learning and enter the realm of self-authorship. Self-authorship encourages the cultivation of one’s internal voice to construct beliefs, identity, and social relationships to be able to give up one way of making meaning to adopt a deeper meaning (Baxter Magolda, 2009, 2014). This reflective writing circle captures the essence of a master’s student and two educators’ transformative learning as they journey together in relationship towards a deeper understanding of their Indigenous and Settler identities and respond to the Calls to Action. Keywords: presence, authentic learning, self-authorship, Calls to Action, writing circle

O objetivo geral deste artigo é divulgar a proposta de um jogo didático como metodologia de ensino, o qual tem como escopo o estudo de questões acerca do meio ambiente, com destaque para o conhecimento de aspectos socioambientais do rio Mundaú, um dos principais fluxos de água da Bacia do Litoral do Ceará, Brasil. O jogo de trilha, Caminhando pelo rio Mundaú: conhecer e preservar, composto por vários elementos, é direcionado aos alunos com idade a partir de 12 anos. Espera-se que a ludicidade produzida com o uso dessa proposta contribua para a formação do participante, instigando habilidades como a imaginação e a criatividade e potencializando a motivação e a interação, e que a representação de situações enfrentadas no dia a dia, discutidas a partir de um jogo, forneça subsí­dios para a percepção ambiental consciente, preservacionista e sustentável.

Objectives. This study seeks to determine the prevalence of chronic diseases and analyze the association between multimorbidity and all-cause mortality by sex. Methods. This is a 16-year longitudinal study of follow-up. We used sample data of the SABE (Health, Well-Being and Aging) study cohort and mortality data obtained through the Mortality Information Improvement Program of the City of São Paulo (PRO-AIM) from the 2000–2016 period. Survival analysis was performed using Cox proportional hazard models. Results. Hypertension (HT) was the most prevalent disease in older adults (52.93%), followed by musculoskeletal disorders (MSDs) (27.09%), cardiovascular diseases (CD) (17.79%), diabetes mellitus (DM) (16.95%), mental disorders (MD) (15.43%), and respiratory diseases (RD) (9.72%). The highest mortality rate in women was observed in the combination of HT/MSDs/DM/MD (HR = 6.15, 95% CI = 2.32, 16.32), while in men was in the combination of HT/CD/MSDs/DM (HR = 5.72, 95% CI = 1.72, 19.06). Conclusion. Similar to previous studies carried out in developed countries, we found that all-cause mortality increased as diseases are added to an individual. Women and men presented different mortality patterns according to multimorbidity. Therefore, we suggest that additional longitudinal studies should be performed in order to analyze mortality by sex.

Protein Engineering is a highly evolved field of engineering aimed at developing proteins for specific industrial, medical, and research applications. Here, we present a practical teaching course to demonstrate fundamental techniques used to express, purify and analyze a recombinant protein produced in Escherichia coli—the enhanced green fluorescent protein (eGFP). The methodologies used for eGFP production were introduced sequentially over six laboratory sessions and included (i) bacterial growth, (ii) sonication (for cell lysis), (iii) affinity chromatography and dialysis (for eGFP purification), (iv) bicinchoninic acid (BCA) and fluorometry assays for total protein and eGFP quantification, respectively, and (v) sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) for qualitative analysis. All groups were able to isolate the eGFP from the cell lysate with purity levels up to 72%. Additionally, a mass balance analysis performed by the students showed that eGFP yields up to 46% were achieved at the end of the purification process following the adopted procedures. A sensitivity analysis was performed to pinpoint the most critical steps of the downstream processing.

Background: Novel psychoactive substances (NPS) are compounds of natural and synthetic origin, similar to traditional drugs of abuse. NPS are involved in a contemporary trend whose origin lies in a thinner balance between legitimate therapeutic drug research and legislative control. The contemporary NPS trend resulted from the replacement of MDMA by synthetic cathinones in ‘ecstasy’ during the 2000s. The most common NPS are synthetic cannabinoids and synthetic cathinones. Interestingly, during the last 50 years, these two classes of NPS have been the object of scientific research for a set of health conditions. Methods: Searches were conducted in the online database PubMed using boolean equations. Results: Synthetic cannabinoids displayed protective and therapeutic effects for inflammatory, neurodegenerative and oncologic pathologies, activating the immune system and reducing inflammation. Synthetic cathinones act similarly to amphetamine-type stimulants and can be used for depression and chronic fatigue. Conclusions: Despite the scientific advances in this field of research, pharmacological application of NPS is being jeopardized by fatalities associated with their recreational use. This review addresses the scientific achievements of these two classes of NPS and the toxicological data, ending with a reflection on Illicit and NPS control frames.

Abstract Objective: to assess the prevalence of elderly persons living alone in Brazil, based on covariates of health status, behavior and socio-demographic characteristics. Method: data from 11,967 individuals (aged 60 or over) were obtained from the National Health Survey (Brazil, 2013). Living alone was defined as residing in a one-person household. The prevalence of individuals living alone was stratified by socio-demographic conditions and geographic region. Living alone was also assessed as a factor for outcomes of physical functioning, behavior and health conditions. Poisson regression models were used to evaluate the prevalence ratios and a 95% confidence interval was applied. Results: in Brazil, 15.3% of people aged 60 years and over live alone. This condition is more prevalent in higher income regions; however, more lower-income individuals were affected. Prevalence was higher among women and individuals aged 75 years or more. Living alone was associated with difficulties in instrumental activities of daily living (prevalence ratio 1.15; 95% confidence interval 1.04-1.28); the reporting of an illness in the two prior to the study (PR=1.35; 95%CI=1.16-1.57); watching television (five or more hours daily) (PR=1.40; 95%CI=1.26-1.56) and falls in the previous year (PR=1.35; 95%CI=1.10-1.66). Elderly persons living alone also had worse eating habits, with a less frequent intake of meat, beans and salads than their counterparts who lived with others. Conclusion: elderly persons living alone in Brazil have a worse health status and health-related habits. These findings represent a challenge and should motivate social and health policies aimed at fulfilling the greater needs of adults who grow old alone.

Co-teaching has been explored in the field of education but is a relatively new phenomenon in higher education. Its benefits and challenges are well documented; however, what is lacking is substantive evidence highlighting the influence of co-teaching amongst undergraduate students. Particularly, in practice-based professions like teaching, nursing, and social work, active participation in collaborative teams is more the norm than the exception. Undergraduate students need to have opportunities to learn how to be collaborative, as well as observe modeling of collaborative teaching practice. In the article, we report on a 2-year mixed-methods research study that investigated students’ and instructors’ experiences with co-teaching in a Nurse as Educator course. The findings from three cohorts engaged in the research suggest co-teaching to be an effective teaching and learning strategy. However, for co-teaching to be a positive experience for both students and instructors, purposeful scaffolding and supports need to be in place. Also outlined are recommendations for higher education with regard to designing and modeling co-teaching practice.

Introduction: In the last decades, the great technological development increased Internet popularity, emerging the concern about its overuse. The objectives of this study were to assess and characterize Internet use in adolescence, determine Internet addiction and clarify its association with sleep disorders and excessive daytime sleepiness. Material and Methods: It was performed an observational, cross sectional and community-based study. The target were students attending 7th and 8th grades, to whom was applied an online self-report questionnaire to assess sociodemographic features, Internet use, Internet dependence, sleep characteristics and excessive daytime sleepiness. Results: A total of 727 adolescents were included with a mean age 13 ± 0.9 years. Three-quarters of teenagers use Internet daily and 41% do it for three or more hours/day, mainly at home. The phone and laptop were the main devices used. Online games and social networks use were the main activities performed. Internet dependence was observed in 19% of adolescents, and it was associated with male gender, social networks use, mainly Twitter and Instagram use, self-perceived sleep problems, initial and middle insomnia and excessive daytime sleepiness (p < 0.05). Discussion: The results confirm the highlight that Internet has in adolescents routine, who prioritize in their use access to social networks and online games, using single devices, less subject to parental control. Conclusion: The Internet addiction rate observed and its association with sleep alterations and daytime sleepiness emphasizes the importance of this issue.

Introdução: As crises epiléticas são a urgência neurológica pediátrica mais frequente. Este trabalho pretendeu caracterizar as primeiras crises em apirexia, a sua abordagem diagnóstica e terapêutica e estimar a recorrência de crise na população estudada. Métodos: Estudo retrospetivo dos casos admitidos num Serviço de Pediatria de um hospital de nível II por primeira crise epilética em apirexia, entre janeiro de 2010 e setembro de 2013. Resultados: Incluíram-se 72 doentes. A maioria apresentou crise generalizada (66,7%), em vigília (84,7%) e com duração inferior a 15 minutos (80,6%). Identificou-se fator de risco para crise em 34,7%. Em 75% dos casos não se identificaram alterações de novo no exame neurológico, 22,2% apresentaram alteração da consciência e 2,8% sinais motores focais. A abordagem diagnóstica incluiu estudo analítico (100%) e exame toxicológico (61,1%). A maioria realizou eletroencefalograma (alterado em 40,3%) e neuroimagem.Das 9 lesões de novo identificadas, 6 tinham implicações na terapêutica/ prognóstico. Em 56,9% dos casos foi iniciada terapêutica com anti--epilético após primeira crise. A decisão de iniciar anti-epilético relacionou-se com alterações no eletroencefalograma. Houve recorrência em 45,8%. Conclusão: A abordagem diagnóstica dos casos foi globalmente concordante com as orientações da Academia Americana de Neurologia. Verificou-se uma elevada proporção de instituição de anti-epiléticos após primeira crise. A percentagem de recorrência foi sobreponível à de outros estudos. Conhecer as características da nossa população justifica a divulgação de séries locais, potenciais rampas para estudos nacionais.

Introdução: O resveratrol é uma fitoalexina natural cujos principais benefícios devem-se às suas propriedades antiinflamatórias e antioxidantes. Os seus efeitos sugerem que este é um suplemento útil para a redução da inflamação, podendo desempenhar um papel fundamental na prevenção das doenças cardiovasculares. Este promove a vasodilatação pela indução da síntese de óxido nítrico (NO), possui atividade antitrombótica e evita a agregação plaquetária. O fator de crescimento endotelial vascular (VEGF) é responsável pela angiogénese, sendo a sua expressão influenciada pelo resveratrol. Objetivos: Avaliar o efeito do resveratrol no perfil vascular pela determinação da pressão arterial e dos biomarcadores interleucina-6 (IL-6), proteína C reativa (PCR), VEGF e NO. Material e Métodos: 27 alunos com idades compreendidas entre os 18 e os 22 anos foram divididos em grupo controlo (GC) e grupo de intervenção (GI), que consumiram placebo e 100 mg de resveratrol por dia, respetivamente, durante 1 mês. A pressão arterial foi medida com aparelho automático validado. Os níveis de PCR foram obtidos por imunoturbidimetria, os de IL-6 e VEGF por slot blot e a quantificação de NO por espectrofotometria. Resultados: Entre os grupos observou-se uma diminuição da pressão arterial braquial e central (??0.05). A variação negativa no NO apresentou-se superior no GC apesar das diferenças não serem significativas (p>0,05). Nos restantes marcadores avaliados não se observaram diferenças significativas. Conclusões: A ingestão regular de resveratrol parece ser uma abordagem preventiva a nível vascular, dado que modula positivamente o perfil vascular, reduzindo a pressão arterial. A variação nos níveis de NO poderá ajudar a explicar os benefícios verificados.