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The Weddell Sea Polynya (WSP) is a large opening within the sea ice cover of the Weddell Sea sector. It has been a rare event in the satellite period, appearing between 1973 and 1976 and again in 2016/2017. Coupled modelling studies have suggested that there may be a large-scale atmospheric response to the WSP. Here, the direct atmospheric response to the WSP is estimated from atmosphere-only numerical experiments. Three different models, the HadGEM3 UK Met Office model, the ECHAM5 Max Planck Institute model, and the OpenIFS ECMWF model, each at two different resolutions, are used to test the robustness of our results. The use of large ensembles reduces the weather variability and isolates the atmospheric response. Results show a large (∼100–200 W m−2) turbulent air–sea flux anomaly above the polynya. The response to the WSP is local and of short duration (barely outlasting the WSP) with a similar magnitude and spatial pattern of lower-tropospheric warming and increase in precipitation in all six configurations. All models show a weak decrease in surface pressure over the WSP, but this response is small (∼2 hPa) in comparison to internal variability. The dynamic response is inconsistent between models and resolutions above the boundary layer, suggesting a weak or null response that is covered by internal variability aloft. The higher resolution does not alter the pattern of the response but increases its magnitude by up ∼50 % in two of the three models. The response is influenced by natural variability in the westerly jet. The models perform well against ERA5 reanalysis data for the 1974 WSP in spatial response and magnitude, showing a turbulent heat flux of approximately 150 W m−2.

Facilitating a sustainable transition process, whether on a global or local scale, entails crafting an energy mix tailored to meet the specific needs of users. The objective is to pinpoint the most effective future strategy that optimizes both socio-economic benefits and sustainability. To tackle these challenges, a plethora of modeling tools now exists to evaluate various scenarios prior to implementation. However, it is worth noting that modeling tools are primarily geared towards economic optimization, exemplified by the open-source energy modeling system, OSeMOSYS. This paper proposes an optimization methodology encompassing economic, energetic, and environmental sustainability, introducing the most widely referenced estimator as an economic additional cost using the weight sum and monetization methodology. The ramifications of integrating these different estimators in terms of energy matrix design, costs, and emissions are thoroughly evaluated. Furthermore, the optimal selection criteria are delineated based on users’ anticipated objectives. To ensure the reproducibility of the study, we present an exercise utilizing data from Atlantis framework, which shares characteristics of both developing and developed nations. The main results indicate that implementing sustainability, despite not causing significant variations in overall costs (¡0.5%), leads to a 35% decrease in emissions. However, there is a 14.5% increase in investment costs, while residual costs rise by 6%.

Abstract Microbial mats and microbialites are essential tools for reconstructing early life and its environments. To better understand microbial trace element cycling, a microbial mat was collected from the sinkhole systems of the western shores of the Dead Sea, a dynamic environment exhibiting diverse extreme environments. Intense arsenic enrichment was measured (up to 6.5 million times higher than current concentrations in water, and 400 times the bulk concentration in the mat). Arsenic was found predominantly as As(V) in organic molecules, as shown by XANES spectra and high‐resolution elemental mapping. Arsenic cycling genes obtained from metagenomic analysis were associated with arsenic detoxification, supporting an active mechanism of As(V) uptake, As(III) efflux and organoarsenic accumulation in the extracellular polymeric substances (EPS) of the mat. Thus, we propose that such localized As enrichment can be attributed to a transient increase in As(V) concentrations in the circulating subsurface water of the Dead Sea shore and its subsequent incorporation into organoarsenic molecules through microbial detoxification processes. Our data set supports the possibility of metalloid enrichment recorded in very localized facies due to rapid geogenic fluctuations in the chemistry of the water flowing over a biofilm. In this context, this example calls for caution in interpreting metal(loid) enrichment in organic matter‐rich layers and microbialites of Paleoproterozoic origin. Arsenic signatures in Precambrian organic matter and carbonate rocks may host biosignatures, including evidence for extracellular polymeric substances, As‐binding and detoxification processes, without supporting arsenotrophy. However, they provide clues to better assess the paleoenvironmental conditions at the time of microbial mat formation.

Within the 9th European Framework programme, since 2021 EUROfusion is operating five tokamaks under the auspices of a single Task Force called ‘Tokamak Exploitation’. The goal is to benefit from the complementary capabilities of each machine in a coordinated way and help in developing a scientific output scalable to future largre machines. The programme of this Task Force ensures that ASDEX Upgrade, MAST-U, TCV, WEST and JET (since 2022) work together to achieve the objectives of Missions 1 and 2 of the EUROfusion Roadmap: i) demonstrate plasma scenarios that increase the success margin of ITER and satisfy the requirements of DEMO and, ii) demonstrate an integrated approach that can handle the large power leaving ITER and DEMO plasmas. The Tokamak Exploitation task force has therefore organized experiments on these two missions with the goal to strengthen the physics and operational basis for the ITER baseline scenario and for exploiting the recent plasma exhaust enhancements in all four devices (PEX: Plasma EXhaust) for exploring the solution for handling heat and particle exhaust in ITER and develop the conceptual solutions for DEMO. The ITER Baseline scenario has been developed in a similar way in ASDEX Upgrade, TCV and JET. Key risks for ITER such as disruptions and run-aways have been also investigated in TCV, ASDEX Upgrade and JET. Experiments have explored successfully different divertor configurations (standard, super-X, snowflakes) in MAST-U and TCV and studied tungsten melting in WEST and ASDEX Upgrade. The input from the smaller devices to JET has also been proven successful to set-up novel control schemes on disruption avoidance and detachment.

Short, valid and easy to use tools are needed to monitor non-invasive ventilation in clinical practice and for organization of home mechanical ventilation services. The aim of this study was to develop a professional translation and cultural adaptation of the Portuguese S3 non-invasive ventilation questionnaire.234 stable patients (128 male patients, 53.8%) with a mean age of 69.3 years under long-term home non-invasive ventilation were recruited from a single-center outpatient clinic. The most frequent diagnostic groups were obesity hypoventilation syndrome, chronic obstructive pulmonary disease and restrictive chest wall disorders.The Portuguese version of the questionnaire was obtained using translation back-translation process with two professional translators. Internal consistency for the total score was good (Cronbach’s α coefficient of 0.76) as well as for the “respiratory symptoms” and the “sleep and side effects” domains (Cronbach’s α coefficient = 0.68 and Cronbach’s α coefficient = 0.72, respectively). An exploratory factor analysis was performed leading to an explained variance of 54.6%, and resulted in 3 components.The Portuguese version of the S3-NIV questionnaire is a simple and valid tool for the routine clinical assessment of patients receiving home NIV.

Abstract Freshwater transports (Fov) by the Atlantic meridional overturning circulation (AMOC) are sensitive to salinity distributions and may determine AMOC stability. However, climate models show large salinity biases, distorting the relation between Fov and the AMOC. Using free‐running models and ocean reanalyses with realistic salinities but quite different AMOCs, we show that the fresh Antarctic Intermediate Water layer eliminates salinity differences across the AMOC branches at ~1,200 m, ∆S1200m, which decouples Fov from the AMOC south of ~10°N. As the Antarctic Intermediate Water disappears north of ~10°N, a large ∆S1200m allows the AMOC to drive substantial southward Fov in the North Atlantic. In the South Atlantic the 0–300 m zonal salinity contrasts control the gyre freshwater transports Fgyre, which also determine the total freshwater transports. This decoupling makes the southern Fov unlikely to play any role in AMOC stability, leaving indirect Fgyre feedbacks or Fov in the north, as more relevant factors.

Despite the many questions regarding satellite DNA sequences and their cellular roles, the evolutionary history of eukaryotic genomes seems to have been largely influenced by this dynamic and multifaceted genomic component. The bovine genome is highly rich in diverse satDNA sequences that differ in monomer sequence and length, complexity, chromosomal location and abundance, as well as in their sequences’ evolutionary mechanisms. In the evolution of the Bovidae family, the genomes’ repetitive fraction played a central role in karyotype reorganisation, and in the last few decades several studies have demonstrated and reinforced an association between centromeric satDNAs and the process of chromosome evolution in remodelling genomes of Bovidae species. Here, we review different aspects of the molecular nature and genome behaviour of all the satDNA families identified in the bovine genome, including their organisation, abundance, chromosome localisation, variation in sequence, and evolutionary history in the Bovidae family and in particular in the Bovinae subfamily, taking an integrative perspective. “Evolution and satDNA” can be addressed through two complementary views: the satDNA sequence evolution per se, and genome evolution promoted by the satDNA dynamism. SatDNA both provides phylogenetic information and is a critical genomic component that enables sequence and chromosome evolution – features arising from its presence, absence or alteration.

It is well known that there is an infinite number of ways of constructing a globally defined density variable for the ocean, with each possible density variable having, a priori, its own distinct diapycnal diffusivity. Because no globally defined density variable can be exactly neutral, numerical ocean models tend to use rotated diffusion tensors mixing separately in the directions parallel and perpendicular to the local neutral vector at rates defined by the isoneutral and dianeutral mixing coefficients respectively. To constrain these mixing coefficients from observations, one widely used tool is inverse methods based on Walin-type water mass analyses. Such methods, however, can only constrain the diapycnal diffusivity of the globally defined density variable γ – such as σ2 – that underlies the inverse method. To use such a method to constrain the dianeutral mixing coefficient therefore requires understanding the relations between the different diapycnal diffusivities. However, this is complicated by the fact that the effective diapycnal diffusivity experienced by γ is necessarily partly controlled by isoneutral diffusion owing to the unavoidable misalignment between iso-γ surfaces and the neutral directions. Here, this effect is quantified by evaluating the effective diapycnal diffusion coefficient pertaining to five widely used density variables: γn of Jackett and McDougall (1997); the Lorenz reference state density ρref of Saenz et al. (2015); and three potential density variables σ0, σ2 and σ4. Computations are based on the World Ocean Circulation Experiment climatology, assuming either a uniform value for the isoneutral mixing coefficient or spatially varying values inferred from an inverse calculation. Isopycnal mixing contributions to the effective diapycnal mixing yield values consistently larger than 10−3 m2 s−1 in the deep ocean for all density variables, with γn suffering the least from the isoneutral control of effective diapycnal mixing and σ0 suffering the most. These high values are due to spatially localised large values of non-neutrality, mostly in the deep Southern Ocean. Removing only 5 % of these high values on each density surface reduces the effective diapycnal diffusivities to less than 10−4 m2 s−1. The main implication of this work is to highlight the conceptual and practical difficulties of relating the diapycnal mixing diffusivities inferred from global budgets or inverse methods relying on Walin-like water mass analyses to locally defined dianeutral diffusivities. Doing so requires the ability to separate the relative contribution of isoneutral mixing from the effective diapycnal mixing. Because it corresponds to a special case of Walin-type water mass analysis, the determination of spurious diapycnal mixing based on monitoring the evolution of the Lorenz reference state may also be affected by the above issues when using a realistic nonlinear equation of state. The present results thus suggest that part of previously published spurious diapycnal mixing estimates could be due to isoneutral mixing contamination.

The meridional heat transport (MHT) of the South Atlantic plays a key role in the global heat budget: it is the only equatorward basin-scale ocean heat transport and it sets the northward direction of the global cross-equatorial transport. Its strength and variability, however, are not well known. The South Atlantic transports are evaluated for four state-of-the-art global ocean reanalyses (ORAs) and two free-running models (FRMs) in the period 1997–2010. All products employ the Nucleus for European Modelling of the Oceans (NEMO) model, and the ORAs share very similar configurations. Very few previous works have looked at ocean circulation patterns in reanalysis products, but here we show that the ORA basin interior transports are consistently improved by the assimilated in situ and satellite observations relative to the FRMs, especially in the Argo period. The ORAs also exhibit systematically higher meridional transports than the FRMs, which is in closer agreement with observational estimates at 35 and 11° S. However, the data assimilation impact on the meridional transports still greatly varies among the ORAs, leading to differences up to ∼ 8 Sv and 0.4 PW in the South Atlantic Meridional Overturning Circulation and the MHTs, respectively. We narrow this down to large inter-product discrepancies in the western boundary currents (WBCs) at both upper and deep levels explaining up to ∼ 85 % of the inter-product differences in MHT. We show that meridional velocity differences, rather than temperature differences, in the WBCs drive ∼ 83 % of this MHT spread. These findings show that the present ocean observation network and data assimilation schemes can be used to consistently constrain the South Atlantic interior circulation but not the overturning component, which is dominated by the narrow western boundary currents. This will likely limit the effectiveness of ORA products for climate or decadal prediction studies.

Catalyst deactivation in fluid catalytic cracking processes is unavoidably associated with structural changes. Here, the authors visualize the deactivation of zeolite catalysts by ptychography and other imaging techniques, showing pronounced amorphization of the outer layer of the catalyst particles.

The aim of this study was to develop and validate the professional translation and cultural adaptation of the Portuguese Severe Respiratory Insufficiency (SRI) Questionnaire.The sample was composed of 93 patients (50 male patients, 53.8%) with a mean age of 66.3 years. The most frequent diagnostic groups were chronic obstructive pulmonary disease, obesity hypoventilation syndrome and restrictive chest wall disorders.The patients were asked to fill in both the SRI and SF-36 questionnaires. Factor analysis of the SRI questionnaire was performed leading to an explained variance of 73%, and resulted in 13 components. When analyzing the reliability, we obtained values for Cronbach's alpha above 0.70 for most subscales with the reliability of the summary scale being even higher (0.84).This professional translation and cultural adaptation of the Portuguese SRI Questionnaire has good psychometric properties which are similar, not only to the original, but also to other translations. These characteristics make this questionnaire applicable to the Portuguese population receiving home mechanical ventilation for severe respiratory insufficiency. Keywords: Questionnaire, Portuguese, Home mechanical ventilation, Quality of life

Background/purpose: Research tends to focus on understanding the school climate impacts and outcomes on real-life situations and problems while not giving deserved attention to their effects on digital life experiences and behaviors, such as those provided by videogame contexts. This article explores the relationship between school climate openness, sense of self-efficacy, and prosocial gaming behaviors. Materials/methods: A cross-sectional study using a questionnaire-based survey was conducted among 611 college students aged from 17 to 45 years old from 15 higher education institutions in Porto (Portugal). The analytical procedures involved cluster, multivariate, and meditation analyses. Results: The study revealed a relationship between students' perceptions of school climate and their sense of self-efficacy and prosocial gaming behaviors. Students' self-efficacy was proven to mediate the relationship between their perceptions of school experiences and behaviors in gaming communities. Conclusion: The study extends the literature by expanding knowledge about how students' perceptions of school climate openness for discussion, perspective-taking, and social analysis, and their sense of political efficacy, are related to how they exercise their citizenship while participating in videogame communities. The existence of a spillover effect from real to digital life was concluded.

Although estimation of turbulent transport parameters using inverse methods is not new, there is little evaluation of the method in the literature. Here, it is shown that extended observation of the broad-scale hydrography by Argo provides a path to improved estimates of regional turbulent transport rates. Results from a 20-year ocean state estimate produced with the ECCO v4 (Estimating the Circulation and Climate of the Ocean, version 4) non-linear inverse modeling framework provide supporting evidence. Turbulent transport parameter maps are estimated under the constraints of fitting the extensive collection of Argo profiles collected through 2011. The adjusted parameters dramatically reduce misfits to in situ profiles as compared with earlier ECCO solutions. They also yield a clear reduction in the model drift away from observations over multi-century-long simulations, both for assimilated variables (temperature and salinity) and independent variables (biogeochemical tracers). Despite the minimal constraints imposed specifically on the estimated parameters, their geography is physically plausible and exhibits close connections with the upper-ocean stratification as observed by Argo. The estimated parameter adjustments furthermore have first-order impacts on upper-ocean stratification and mixed layer depths over 20 years. These results identify the constraint of fitting Argo profiles as an effective observational basis for regional turbulent transport rate inversions. Uncertainties and further improvements of the method are discussed.

Abstract The fish may experience periods of food deprivation or starvation which produce metabolic changes. In this study, adult Rhamdia quelen males were subjected to fasting periods of 1, 7, 14, and 21 days and of refeeding 2, 4, 6, and 12 days. The results demonstrated that liver protein was depleted after 1 day of fasting, but recovered after 6 days of refeeding. After 14 days of fasting, mobilization in the lipids of the muscular tissue took place, and these reserves began to re-establish themselves after 4 days of refeeding. Plasmatic triglycerides increased after 1 day of fasting, and decreased following 2 days of refeeding. The glycerol in the plasma oscillated constantly during the different periods of fasting and refeeding. Changes in the metabolism of both protein and lipids during these periods can be considered as survival strategies used by R. quelen. The difference in the metabolic profile of the tissues, the influence of the period of fasting, and the type of reserves mobilized were all in evidence.

Tourism services are dominated by multi-national businesses operating on a global scale. South Africa is seen as an emerging outbound tourism market and a future powerhouse for the travel and tourism industry. However, very little information is available regarding South African’s outbound tourism. As far as can be ascertained, no previous study has been conducted to establish the needs-driven forces that influence the South African outbound tourism market. The primary objective of this paper was to determine the needs-driven forces that influence the South African outbound tourism market. The quantitative research approach was utilised whereby a survey was conducted amongst 301 outbound South African travellers. Data was collected with a newly developed structured self-administered questionnaire. Based on the hypothetisised model items pertaining to four selected needs-driven forces were developed. Data was analysed using descriptive and inferential statistics (Pearson productmoment correlation coefficients and Multiple regression analysis). Three statistically significant relationships were found between physical- and stature needs, destination accessibility and outbound tourism demand. This paper provides all tourism businesses with insight on how to design appropriate marketing strategies for a lucrative outbound market such as South Africa.

The Brazilian semiarid region is characterized by dry and hot climate, with low rainfall and poorly distributed over time. In the soils of this region, due to the high temperatures, organic matter (OM) decomposes quickly, resulting in low reserve levels. To improve fertility and reduce the evaporation of these soils, cattle manure has been applied as organic fertilizer and vegetal wastes as mulch, respectively. Based on this, this study aimed at evaluating the effect of elevation of the OM content, irrigation and soil mulching in leaf micronutrient okra. The experiment was carried out at the Agroecology Sector of Paraíba State University, Brazil, during the period from September 2015 to February 2016. The treatments were distributed in randomized blocks in a factorial design 5 x 2 x 2, referring to the following treatments: five rates of cattle manure in sufficient rates to raise the content of OM in the soil from 1.80 (value existent in the soil) to 2.8; 3.8; 4.8 and 5.8%, two water depths (50 and 100%) of crop evapotranspiration (ETc) and soil with and without mulching with plant parsley. At the beginning of flowering (45 days after sowing (DAS)), leaf D was collected from four plants of each treatment to determine the boron (B), copper (Cu) and zinc (Zn) levels to evaluate the nutritional status of the crop.Harvesting started at 64 DAS up until 150 DAS; in this period the average weight of green fruits per plant was obtained (g). The interaction of OM with water slides significantly influenced the Cu contents in okra leaves. However, the interaction of the three factors significantly influenced only B, Zn and fruit weight. The management used in this study improved the nutritional status of the okra plant and increase its production.

Resumo: Introdução: A punção aspirativa transbrônquica guiada por ecoendoscopia brônquica linear (EBUS-TBNA) é um importante procedimento minimamente invasivo para o estadiamento do cancro do pulmão de não pequenas células (CPNPC). ÿ, também, um método válido para o diagnóstico de lesões extraluminais adjacentes à árvore traqueobrônquica. Objetivo: Avaliar o nosso desempenho na execução de EBUS-TBNA relativamente à rentabilidade diagnóstica, segurança e curva de aprendizagem no diagnóstico e estadiamento do cancro do pulmão. Material e métodos: Incluímos todos os doentes submetidos a EBUS-TBNA para diagnóstico ou estadiamento de neoplasia pulmonar. Estes foram posteriormente divididos em 3 grupos diferentes: diagnóstico de massas paratraqueais e parabrônquicas (Grupo 1); diagnóstico e estadiamento de lesões pulmonares periféricas com gânglios mediastínicos aumentados (Grupo 2); estadiamento de doentes com CPNPC (Grupo 3). A curva de aprendizagem foi avaliada em função da sensibilidade diagnóstica, precisão, duração do procedimento, tamanho e número de lesões puncionadas por doente. Resultados: Foram incluídos 179 doentes e puncionadas 372 lesões. A sensibilidade e precisão globais foram 88% e 92.7%, respetivamente. No Grupo 1, 48 doentes foram submetidos ao procedimento com uma sensibilidade de 86,1% e precisão de 87,5%. No Grupo 2, com 87 doentes, a sensibilidade foi de 86,7%, a precisão de 93,1% e a prevalência de neoplasia de 51,7%. No Grupo 3, a sensibilidade e precisão foram 95 e 97,7%, respetivamente. A prática de EBUS-TBNA conduziu a um maior número de locais puncionados por doente, em menor período de tempo, sem complicações. Conclusão: EBUS-TBNA é um método eficaz para o diagnóstico e estadiamento de doentes com cancro do pulmão. ÿ claramente um exame seguro. O número de procedimentos realizados melhora o manuseamento e desempenho da técnica. Abstract: Background: Linear endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is an important minimally invasive procedure for non-small cell lung cancer (NSCLC) staging. It is also a valid method for diagnosing extraluminal lesions adjacent to the tracheobronchial tree. Aim: To evaluate our EBUS-TBNA performance regarding diagnostic yield, safety and learning curve for lung cancer diagnosis and staging. Material and methods: All patients undergoing EBUS-TBNA for lung cancer diagnosis or staging were included. They were divided into three different groups: paratracheal and parabronchial masses sent for diagnosis (Group 1); peripheral lung lesions with abnormal mediastinal lymph nodes sent for diagnosis and staging (Group 2); NSCLC patients sent for mediastinal staging (Group 3). The learning curve was assessed for yield, accuracy, procedure time, size and number of lesions punctured per patient. Results: A total of 179 patients were included and 372 lesions were punctured. The overall yield and accuracy were 88% and 92.7%, respectively. In Group 1, EBUS-TBNA was performed in 48 patients and sensitivity was 86.1% and accuracy was 87.5%. For the 87 patients included in Group 2, yield was 86.7%, accuracy was 93.1% and cancer prevalence was 51.7%. The diagnostic yield and accuracy in Group 3 was 95% and 97.7% respectively. EBUS-TBNA practice led to an increase number of sites punctured per patient in a shorter time, without complications. Conclusion: EBUS-TBNA is an effective method for diagnosing and staging lung cancer patients. The procedure is clearly safe. Handling and performance improves with the number of procedures executed. Palavras-chave: Neoplasia do pulmão, Ecoendoscopia brônquica, Punção aspirativa, Diagnóstico, Estadiamento, Curva de aprendizagem, Keywords: Lung cancer, Endobronchial ultrasound, Fine needle aspiration, Diagnosis, Staging, Learning curve

The Enteral Nutrition Therapy (ENT) has been widely used in hospital and home care assistance. However, research works are needed to make this technique more efficient and cheaper. Objective: Evaluate the nutritional quality of handmade enteral diets used in a charity hospital in the Jequitinhonha Valley, Brazil, and propose qualitative and quantitative adjustments, when necessary, and compare the data available in tables of chemical composition of foods with the data achieved by laboratory analyses. Materials and methods: The study was carried out in partnership with a charity organization of the region and the Universidade Federal dos Vales do Jequitinhonha e Mucuri, where the collection of the handmade enteral diets was performed. The analyses of the physical-chemical and centesimal composition of 36 samples of diets were carried out in the laboratories of the university. Results: It was observed that the daily energy offer of the diets was below the recommended standards and presented a percentage distribution different from that estimated for patients receiving ENT. Besides, it can be seen that the nutrient values of the data achieved in laboratory do not agree with those available in tables of food chemical composition. Conclusions: Significant losses of nutrients were verified during the processing and preparation of handmade enteral diets. It challenges nutritionists to standardize these diets and corroborates the relevance of new studies to determine the nutritional content of handmade enteral diets, since these diets have been widely used in poor regions of Brazil and in other countries.La terapia de nutrición enteral (TNE) se ha utilizado ampliamente en la asistencia hospitalaria y domiciliaria. Sin embargo, se necesitan trabajos de investigación para hacer que esta técnica sea más eficiente y barata. Objetivo: Evaluar la calidad nutricional de dietas enterales elaboradas de forma casera en un hospital de caridad del valle de Jequitinhonha, Brasil, y proponer ajustes cualitativos y cuantitativos, cuando sean necesarios, y comparar los datos disponibles en las tablas de la composición química de los alimentos con los datos obtenidos en los análisis de laboratorio. Materiales y métodos: El estudio se realizó en colaboración con la organización de caridad de la región y la Universidad Federal dos Vales do Jequitinhonha e Mucuri, donde se realizó la recogida de las ditas enterales caseras. Los análisis de la composición fisicoquímica y centesimal de las 36 muestras de las dietas se realizaron en los laboratorios de la universidad. Resultados: Se observó que la oferta energética diaria de las dietas estaba por debajo de las recomendaciones estándar y presentaba un porcentaje de distribución diferente de la estimada para pacientes que reciben TNE. Además, se pudo ver que los valores nutricionales de los datos obtenidos en el laboratorio no concordaban con los disponibles en las tablas de composición química de los alimentos. Conclusiones: Se comprobó una pérdida significativa de nutrientes durante el procesamiento y preparación de las dietas enterales realizadas caseramente. Supone un reto para los nutricionistas para estandarizar estas dietas y corroborar la relevancia de nuevos estudios para determinar el contenido nutricional de las dietas enterales de realización casera, puesto que estas dietas se han empleado ampliamente en regiones pobres de Brasil y otros países.

Numa organização, é comum a existência de uma estratégia definida para as mais diversas áreas e departamentos. No entanto, é raro encontrar uma política integrada de gestão de alarmes. Os alarmes são vitais para identificação de perigos, riscos, alertas de qualidade e segurança, devendo, por isto mesmo, a sua importância ser valorizada desde o design até à entrada em serviço. Uma política uniformizada de gestão de alarmes permite desde logo que a resposta aos acontecimentos seja adequada. Permite igualmente diminuir o tempo de resposta dos acontecimentos, incrementar a qualidade do produto e do meio, segurança das pessoas, equipamentos e instalações. A análise integrada desta informação, permite também identificar oportunidades de melhoria com reflexo na disponibilidade do equipamento e redução de custos de produção e manutenção. Os equipamentos e sistemas actuais dispõem de avançadas tecnologias de informação, comunicação e geração de alarmes, no entanto, são idealizados para a produção de bens, não contemplando, em geral, operações nem aplicações específicas para tratamento de dados, gestão da manutenção e análise de alarmes. O estudo foi desenvolvido numa empresa da indústria farmacêutica, que é composta por vários sectores, sendo um dos mais importantes o da produção de água pura e destilada. A sala de águas é um dos pontos mais importantes da empresa, nela é produzida uma das principais matérias que são incluídas no produto. Foi nesse sector que fizemos uma análise mais detalhada, podendo o resto do trabalho ser aplicado nos outros sectores da empresa.

Resumo: Introdução: Os programas de reabilitação respiratória (PRR) têm demonstrado em doentes com patologia pulmonar crónica, melhoria da capacidade de exercício e do estado de saúde e diminuição da dispneia e da utilização de recursos de saúde. Habitualmente, estes benefícios diminuem após conclusão dos programas. Objetivo: Avaliar a capacidade funcional e o estado de saúde 2 anos após o término de um PRR. Métodos: Estudo retrospetivo de doentes que completaram um PRR. Após o PRR, os doentes que referiam ter adotado um estilo de vida fisicamente ativo foram incluídos no grupo ativo (GA). Os restantes doentes foram considerados como grupo controlo (GC). A capacidade funcional foi avaliada com a prova de marcha dos 6 minutos (PM6m) e o estado de saúde com o questionário de St. George na doença respiratória (SGRQ). Resultados: Foram incluídos 32 doentes, 24 no GA e 8 no GC. Imediatamente após o PRR observou-se, em ambos os grupos, uma melhoria significativa na PM6m e na pontuação total do SGRQ. Após o término do PRR, no GA, observou-se um declínio na distância média percorrida na PM6m aos 6 meses, 1 ano e 2 anos, bem como no estado de saúde.Contudo, 2 anos após o PRR e comparando com os valores avaliados antes do início do PRR, o GA continuava a apresentar uma melhoria na distância percorrida na PM6m, em média de 32 m (p = 0,03) e de pelo menos 4 pontos no SGRQ. No GC observou-se um declínio clinicamente significativo na PM6m (â34 m) e no SGRQ (agravamento de 13 pontos). Conclusão: Embora se verifique uma perda progressiva dos benefícios do PRR após a sua cessação, estes ainda são significativamente positivos até 2 anos após o treino no GA. Um estilo de vida fisicamente ativo parece contribuir para manter os benefícios do Programa de Reabilitação. Abstract: Background: Pulmonary rehabilitation programs (PRP) have been shown to improve exercise capacity and health status and to reduce dyspnoea and use of healthcare resources, in patients with chronic lung disease. These benefits usually wane after the programs conclusion. Aim: Evaluate functional capacity and health status 2 years after the end of a PRP. Methods: Retrospective study of patients who took part in PRP. After PRP, patients who reported a physically active lifestyle were included in the active group (AG). The other patients were considered as the control group (CG). Functional capacity was evaluated with 6 minute walk distance (6MWD) and health status with St George's Respiratory Questionnaire (SGRQ). Results: Thirty-two patients were included, 24 in the AG and 8 in the CG. Immediately after PRP, there was a significant improvement in the 6MWD and SGRQ global score, for both groups. After completing PRP, in the AG, there was a decline in the mean 6MWD when evaluated at 6 months, 1 and 2 years and also in health status.However, after 2 years, the AG continued to show an average improvement of 32 m (p=0.03) in the 6MWD and at least 4 points in SGRQ compared to pre-PRP, while in the CG, there was a clinically significant decline in 6MWD (â34 m) and SGRQ score (13 points worse). Conclusion: Despite the progressive decline of benefits gained after completing PRP, in the AG these are still significantly positive after 2 years. An active lifestyle seems to help maintain the benefits of the Rehabilitation Program. Palavras-chave: Reabilitação pulmonar, Exercício, Estado de saúde, DPOC grave, Keywords: Pulmonary rehabilitation, Exercise, Health status, Severe COPD

Resumo: A tuberculose é uma doença bem conhecida e para a qual há fármacos de reconhecida eficácia. Em Portugal, a incidência da tuberculose tem vindo a diminuir de forma consistente nos últimos anos, mantendo contudo valores acima da média europeia. Uma nova dificuldade surge, associada à resistência aos antibacilares reconhecidamente relacionada com a não adesão ao tratamento e/ou a uma incorrecta escolha do regime terapêutico. Assim, é importante focar a atenção na abordagem inicial do caso de tuberculose, sendo esse o objectivo desta revisão.Rev Port Pneumol 2010; XVI (4): 559-572 Abstract: Tuberculosis is a well-known illness for which there is treatment of recognized effectiveness. In Portugal, tuberculosis incidence has been diminishing although keeping values higher than the rest of the Western Europe. A new challenge is associated with resistance to drugs, admittedly related to treatment noncompliance or incorrect treatment choice. The purpose of this review to focus our attention on the importante of the first approach to the tuberculosis case.Rev Port Pneumol 2010; XVI (4): 559-572 Palavras-chave: Tuberculose, tratamento, efeitos colaterais, Key-words: Tuberculosis, treatment, side effects

Este artículo presenta un estudio experimental sobre el comportamiento a flexión y cortante de vigas de hormigón armado con un contenido de finos (275 kg/m3) superior al límite permitido por la Instrucción EHE-08 (175 kg/m3). En el rango estudiado, el contenido de finos apenas afectó a la respuesta a flexión. La resistencia a cortante de vigas con alto contenido de finos fue menor que la de las vigas de hormigón convencional, en especial para las vigas con cuantía alta de armadura longitudinal y con armadura de cortante, con una reducción de hasta el 23 % en la carga última. Esta reducción se considera debida a la disminución de propiedades mecánicas del hormigón que afecta especialmente al cortante resistido por fricción en la fisura. Por último, los ensayos realizados han permitido verificar un modelo numérico de análisis no lineal evolutivo para predecir el comportamiento de estructuras de hormigón con distintos contenidos de finos.

Neste trabalho propomos e investigamos as propriedades de um modelo de programação inteira e mista para determinar o dimensionamento de lotes de uma fábrica de refrigerantes.

Common Variable Immunodeficiency (CVID), the most prevalent symptomatic primary immunodeficiency, is frequently associated with severe inflammatory complications that determine its morbidity and mortality. We hypothesize that Helicobacter pylori (HP), a very common worldwide infection, may contribute to the clinical and immune phenotype of CVID. We stratified 41 CVID patients into HP+ (n=26) and HPneg (n=15) groups, according to previous urease breath test and/or gastric biopsies, and compared their clinical manifestations and immune profile evaluated by flow cytometry. No genetic variants with known potential impact in HP infection were found upon WES/WGS. Gastric complications were significantly more frequent in HP+ patients. Importantly, the six CVID patients with gastric cancer were infected with HP. In contrast, a significantly higher frequency of cytopenias was observed in the HPneg. Moreover, HP+ did not feature higher prevalence of organ auto-immunity, as well as of lung, liver or intestinal inflammatory manifestations. We observed the same B-cell profiles in HP+ and HPneg groups, accompanied by marked CD4 and CD8 T-cell activation, increased IFNγ production, and contraction of naïve compartments. Notably, HP+ patients featured low CD25 despite preserved Foxp3 levels in CD4 T cells. Overall, HP impact in CVID inflammatory complications was mainly restricted to the gastric mucosa, contributing to increased incidence of early onset gastric cancer. Thus, early HP screening and eradication should be performed in all CVID patients irrespective of symptoms.

Chikungunya (CHIKV) is an arthritogenic alphavirus that causes a self-limiting disease usually accompanied by joint pain and/or polyarthralgia with disabling characteristics. Immune responses developed during the acute phase of CHIKV infection determine the rate of disease progression and resolution. Annexin A1 (AnxA1) is involved in both initiating inflammation and preventing over-response, being essential for a balanced end of inflammation. In this study, we investigated the role of the AnxA1-FPR2/ALX pathway during CHIKV infection. Genetic deletion of AnxA1 or its receptor enhanced inflammatory responses driven by CHIKV. These knockout mice showed increased neutrophil accumulation and augmented tissue damage at the site of infection compared with control mice. Conversely, treatment of wild-type animals with the AnxA1 mimetic peptide (Ac2–26) reduced neutrophil accumulation, decreased local concentration of inflammatory mediators and diminished mechanical hypernociception and paw edema induced by CHIKV-infection. Alterations in viral load were mild both in genetic deletion or with treatment. Combined, our data suggest that the AnxA1-FPR2/ALX pathway is a potential therapeutic strategy to control CHIKV-induced acute inflammation and polyarthralgia.