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Enquadramento: O contexto de ensino clínico e a vivência da pandemia COVID-19 são potencialmente stressores e/ou ansiogénicos em estudantes de enfermagem. Objetivo: Avaliar a eficácia do programa “Aprender a Relaxar” na redução do stresse e ansiedade em estudantes de enfermagem. Metodologia: Estudo pré-experimental, longitudinal, com amostra de sete estudantes seguidos na consulta de ansiedade. Concebido e implementado Programa “Aprender a Relaxar” baseado nas técnicas de respiração diafragmática e relaxamento muscular progressivo, com oito sessões, em cinco semanas. Avaliação inicial, final e follow-up utilizada Escala de Perceção de Stresse e Questionário de Autoavaliação de Ansiedade de Zung. Resultados: Redução dos níveis de stresse entre avaliação inicial e avaliação final (p = 0,069) e diminuição significativa entre avaliação inicial e follow-up (p = 0,033). Diminuição significativa da ansiedade entre avaliação inicial e avaliação final (p = 0,033) e entre avaliação inicial e follow-up (p = 0,006). Conclusão: Programa demonstrou efeito positivo na gestão do stresse, autocontrolo da ansiedade e sintomatologia associada, sendo um recurso terapêutico útil na intervenção com estudantes de enfermagem.

As Portugal prepares to implement surrogacy legislation, it enters a realm fraught with legal, ethical, and psychological complexities. Across the globe, jurisdictions exhibit diverse approaches to surrogacy, reflecting cultural, ethical, and legal diversity. This necessitates a comprehensive understanding of the implications of surrogacy within different legal systems. Moreover, the psychological impact on surrogates, intended parents, and offspring demands careful examination. As Portugal embarks on this journey, it must navigate ethical challenges, ensuring the protection of all parties involved. Furthermore, addressing research gaps and ethical dilemmas will be paramount in crafting legislation that upholds the rights and well-being of all individuals affected by surrogacy arrangements.

Abstract Routine tumor-node-metastasis (TNM) staging of colorectal cancer is imperfect in predicting survival due to tumor pathobiological heterogeneity and imprecise assessment of tumor spread. We leveraged Bayesian additive regression trees (BART), a statistical learning technique, to comprehensively analyze patient-specific tumor characteristics for the improvement of prognostic prediction. Of 75 clinicopathologic, immune, microbial, and genomic variables in 815 stage II–III patients within two U.S.-wide prospective cohort studies, the BART risk model identified seven stable survival predictors. Risk stratifications (low risk, intermediate risk, and high risk) based on model-predicted survival were statistically significant (hazard ratios 0.19–0.45, vs. higher risk; P

Este estudo tem por objetivo relatar a aplicação de um método de Dimensionamento da Força de Trabalho (DFT) que permitiu a uma organização pública brasileira do poder judiciário identificar e integrar o perfil profissional por competências aos seus processos de DFT. A pesquisa envolveu a coleta de dados relacionados à rotina de trabalho de 111 unidades de uma instituição do sistema judiciário brasileiro, tais como produtividade, quantidade e duração. Os resultados indicaram o perfil profissional necessário a cada uma das 111 unidades participantes bem como apontaram um déficit de 98 servidores. Com base nisso, a metodologia aplicada pode indicar à instituição pesquisada, de forma técnica, como levantar e captar o quantitativo de pessoal adequado com base no perfil de competências dos servidores. Espera-se que essa abordagem possa ajudar a organização estuda a alcançar uma gestão mais eficiente de sua força de trabalho e, consequentemente, melhorar suas práticas de pessoal.

Background Pancreatic ductal adenocarcinoma (PDAC) is a challenging target for immunotherapy because it has an immunosuppressive tumor microenvironment. Neoadjuvant chemoradiotherapy can increase tumor-infiltrating lymphocyte (TIL) density, which may predict overall survival (OS). We hypothesized that adding programmed cell death protein 1 (PD-1) blockade to chemoradiotherapy would be well tolerated and increase TILs among patients with localized PDAC.Methods Patients were randomized 2:1 to Arm A (receiving pembrolizumab plus chemoradiotherapy (capecitabine and external beam radiation)) or Arm B (receiving chemoradiotherapy alone) before anticipated pancreatectomy. Primary endpoints were (1) incidence and severity of adverse events during neoadjuvant therapy and (2) density of TILs in resected tumor specimens. TIL density was assessed using multiplexed immunofluorescence histologic examination.Results Thirty-seven patients were randomized to Arms A (n=24) and B (n=13). Grade ≥3 adverse events related to neoadjuvant treatment were experienced by 9 (38%) and 4 (31%) patients in Arms A and B, respectively, with one patient experiencing dose-limiting toxicity in Arm A. Seventeen (71%) and 7 (54%) patients in Arms A and B, respectively, underwent pancreatectomy. Median CD8+ T-cell densities in Arms A and B were 67.4 (IQR: 39.2–141.8) and 37.9 (IQR: 22.9–173.4) cells/mm2, respectively. Arms showed no noticeable differences in density of CD8+Ki67+, CD4+, or CD4+FOXP3+ regulatory T cells; M1-like and M2-like macrophages; or granulocytes. Median OS durations were 27.8 (95% CI: 17.1 to NR) and 24.3 (95% CI: 12.6 to NR) months for Arms A and B, respectively.Conclusions Adding pembrolizumab to neoadjuvant chemoradiotherapy was safe. However, no convincing effect on CD8+ TILs was observed.

Abstract Background Stroke is a leading cause of death and disability worldwide. A major factor in brain damage following ischemia is excitotoxicity caused by elevated levels of the neurotransmitter glutamate. In the brain, glutamate homeostasis is a primary function of astrocytes. Amburana cearensis has long been used in folk medicine and seed extract obtained with dichloromethane (EDAC) have previously been shown to exhibit cytoprotective activity in vitro. The aim of the present study was to analyse the activity of EDAC in hippocampal brain slices. Methods We prepared a dichloromethane extract (EDAC) from A. cearensis seeds and characterized the chemical constituents by 1H and 13C-NMR. Hippocampal slices from P6-8 or P90 Wistar rats were used for cell viability assay or glutamate uptake test. Hippocampal slices from P10-12 transgenic mice SOX10-EGFP and GFAP-EGFP and immunofluorescence for GS, GLAST and GLT1 were used to study oligodendrocytes and astrocytes. Results Astrocytes play a critical role in glutamate homeostasis and we provide immunohistochemical evidence that in excitotoxicity EDAC increased expression of glutamate transporters and glutamine synthetase, which is essential for detoxifying glutamate. Next, we directly examined astrocytes using transgenic mice in which glial fibrillary acidic protein (GFAP) drives expression of enhanced green fluorescence protein (EGFP) and show that glutamate excitotoxicity caused a decrease in GFAP-EGFP and that EDAC protected against this loss. This was examined further in the oxygen–glucose deprivation (OGD) model of ischemia, where EDAC caused an increase in astrocytic process branching, resulting in an increase in GFAP-EGFP. Using SOX10-EGFP reporter mice, we show that the acute response of oligodendrocytes to OGD in hippocampal slices is a marked loss of their processes and EDAC protected oligodendrocytes against this damage. Conclusion This study provides evidence that EDAC is cytoprotective against ischemia and glutamate excitotoxicity by modulating astrocyte responses and stimulating their glutamate homeostatic mechanisms.

The historical use of plants as sources of natural compounds has persisted over time. Increasing the intake of bioactive substances shows significant potential for promoting overall well-being and health. This study delves into the pigments, phenolic composition, and profile, along with antioxidant properties, of leaf extracts rich in bioactives from plants in the Azores region, contributing to sustainable primary food production. Analyses encompassed chlorophylls, carotenoids, total phenols, ortho-diphenols, and flavonoids, as well as antioxidant capacity assessment, polyphenolic profiling, and quantification. Psidium guajava L. and Smallanthus sonchifolius (Poepp.) H.Rob. exhibited elevated chlorophyll content, while Colocasia esculenta (L.) Schott displayed the highest carotenoid levels. Annona cherimola Mill., Eriobotrya japonica (Thunb.) Lindl, and Psidium guajava L. demonstrated pronounced total phenols, ortho-diphenols, and flavonoids. These findings align with heightened antioxidant capacity. HPLC–DAD (high-performance liquid chromatography with diode-array detection) characterization unveiled elevated hydroxycinnamic acids in E. japonica and Ipomea batatas (L.) Lam. compared to A. cherimola Mill., while C. esculenta exhibited increased flavone content. Among the quantified compounds, flavonols were the ones that predominantly demonstrated contribution to the antioxidant capacity of these leaves. This research highlights Azorean leaf plants’ antioxidant potential, fostering natural product development for better health.

Introdução: A transmissão de infecção pelo HIV de mãe para filho, durante a gestação, o trabalho de parto, o nascimento e o aleitamento ainda constituem um grave problema de saúde pública no Brasil. O objetivo geral do presente estudo foi investigar a transmissão vertical (TV), retenção ao tratamento de HIV e adesão à medicação antirretroviral de mulheres nos na gestação e primeiros doze meses após o parto. Método: Este é um estudo do mundo real, baseado em uma amostra de conveniência obtida em centro especializado na assistência às gestantes com HIV na Bahia (Centro Estadual Especializado em Diagnóstico, Assistência e Pesquisa, CEDAP). Desenho longitudinal, retrospectivo, com coleta de dados das gestantes maiores de 18 anos, em acompanhamento pré-natal no CEDAP nos anos de 2015 e 2018, com seguimento de até 12 meses no pós-parto. Além disso, foram avaliados os neonatos expostos ao HIV até o desfecho sobre a TV. Resultados: Participaram 235 mulheres com HIV, 42,6% gestantes em 2015 e 57,4% em 2018. A média de idade foi 28,4 (±6,7) e variou de 18 a 41 anos. As gestantes, em sua maior parte, tinham baixo nível de escolaridade, eram solteiras, se autodeclararam pretas e pardas, procedentes de Salvador e com diagnóstico do HIV anterior à gestação atual. A gravidez foi não planejada, para a maioria, e muitas tiveram diagnóstico de sífilis no período do acompanhamento pré-natal. A taxa de não detecção da carga viral (CV) foi superior a 60% no período mais próximo do parto, e mais de 90% estavam com adequação às recomendações do protocolo de prevenção da TV. No entanto, observou-se redução nas taxas de adesão e retenção (53% e 28%, respectivamente), considerando os períodos pré e pós-parto. A taxa de TV foi de 2,6% e a CV do parto, não detectável, foi considerada fator de proteção para transmissão vertical (p = 0,014; RR = 0,928). As gestantes não experimentadas e aquelas que tiveram diagnóstico de sífilis no período pré-natal apresentaram maior risco de TV para o RN (p < 0,01; RR = 1,1; p < 0,01; RR = 6,4, respectivamente). Conclusão: As gestantes que descobrem o HIV na gestação e aquelas com diagnóstico de sífilis no período pré-natal apresentaram maior risco de TV para o RN. Por outro lado, a CV não detectada pré-parto foi considerada fator de proteção para transmissão vertical. Os resultados encontrados apontam um melhor desempenho das mulheres durante o período do pré-natal do que no período do pós-parto.

O presente artigo procura, em a alguma aparente imprecisão sobre o tema, contribuir para lançar alguma luz sobre a perda de benefícios previsto no artigo 1791.º do Código Civil para o caso de divórcio ou separação de pessoas e bens, á luz da letra e do espírito do regime jurídico do divórcio que resulta da reforma de 2008. Particularmente, procura deixar claro que benefícios possam significar também doações, o artigo 1791.º não só não abrange toda e qualquer doação como não pretende instituir uma caducidade, automática, mas implica, ao menos na falta de acordo entre as partes, a alegação e prova de que tiveram na base “a consideração do estado de casado”.

Eine erfolgreiche Projektarbeit erfordert heute ein breites Spektrum methodischer und sozialer Kompetenzen, die mit einem hohen Maß an Verständnis für komplexe Situationen und Interdependenzen verbunden sein müssen. Die International Competence Baseline 4.0 (ICB4) der IPMA bietet dafür einen standardisierten Kompetenzrahmen und der Ansatz des Systemdenkens (Systems Thinking) liefert eine Methodik zum Umgang mit Komplexität. Im vorgestellten Simulationsspiel „Connect Rollout“ wird anhand von Szenarien der Kompetenzerwerb nach ICB4 und das Erlernen von Methoden des Systemdenkens innerhalb eines internationalen Projektumfelds im Fokus stehen. Auf diese Weise können erfahrungsbasierte Lernprozesse ohne Risiko ermöglicht und der Lernerfolg eines jeden Studierenden gesteigert werden.

Introduction: Adolescent development involves building autonomy and progressive independence from parental supervision. Challenges that are more complex when they have a diagnosis of type 1 diabetes and have to take responsibility for managing their condition. At this age, it is crucial to implement interventions to promote self-management skills in adolescents with type 1 diabetes. Objective: The aim of this scoping review is to identify and map interventions that promote self-management skills in adolescents with type 1 diabetes. Methods: The methodology will follow the Joanna Briggs Institute recommendations for scoping reviews. Studies published in English, Portuguese and Spanish between 2009-2021 will be considered, with no geographical or cultural limitations. The process of data analysis, extraction, and synthesis will be performed by two independent reviewers, based on the inclusion criteria. The results of the study selection will be presented in a Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) flow diagram for scoping reviews. This protocol is registered at Open Science Framework https://osf.io/z6wbj. Results: Mapping the interventions for adolescents with type 1 diabetes, may constitute a tool for the design of a structured intervention to promote self-management behaviour in adolescents with type 1 diabetes and contribute to the dissemination of available evidence on the topic. Conclusion: The results from this review are expected to gather relevant information that will serve as a basis for the development of a nursing intervention for adolescents with diabetes.

Objetivo: avaliar o potencial terapêutico da vitamina D e seus análogos em paciente com DRC. Método: Trata-se de uma revisão sistemática, conforme os passos propostos pela metodologia Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Foram usadas as bases de dados SciELO, Medline, PubMed e LILACS para o levantamento dos artigos. A qualidade metodológica das investigações foi realizada por meio do método de Jadad e Newcastle-Ottawa (NOS). Resultados: Foram identificados 132 artigos iniciais, dos quais 5 foram selecionados para revisão atendendo a todos os critérios de elegibilidade. Os resultados indicaram que o uso da vitamina D como terapia medicamentosa em pacientes com DRC contribuiu para melhorar a função endotelial dos vasos através da diminuição da rigidez vascular, apresentou ação protetora contra infecções através de imunomodulação, diminuição do paratormônio (PTH) e estabilização da taxa de filtração glomerular (TFG). Considerações Finais: Nesse sentido, pode-se concluir que a vitamina D torna-se um agente terapêutico para múltiplos tecidos contribuindo na qualidade de vida dos pacientes com DRC.

Background: The domain of Biomedical and Health Informatics (BMHI) lies in the intersection of multiple disciplines, making it difficult to define and, consequently, characterise the workforce, training needs and requirements in this domain. Nevertheless, to the best of our knowledge, there isn’t any aggregated information about the higher education programmes in BMHI currently being delivered in Portugal, and which knowledge, skills, and competencies these programmes aim to develop. Aim: Our aim is to map BMHI teaching in Portugal. More specifically, our objective is to identify and characterise the: a.) programmes delivering relevant BMHI teaching; b.) geographical distribution and chronological evolution of such programmes; and c.) credit distribution and weight. Methods: We conducted a descriptive, cross-sectional study to systematically identify all programmes currently delivering any core BMHI modules in Portugal. Our population included all graduate-level programmes being delivered in the 2021/2022 academic year in any Portuguese higher education institution. Results: We identified 23 programmes delivering relevant teaching in BMHI in Portugal. Of these, eight (35%) were classified as dedicated educational programmes in BMHI, mostly delivered in polytechnic institutes at a master’s level (5; 63%) and located preferentially in the northern part of the country (7). Currently, there are four programmes with potential for accreditation but still requiring some workload increase in certain areas in order to be eligible.

The residues generated in the wine industry (pomace, stems, seeds, wine lees, and grapevine shoots) are a potential source of bioactive compounds that can be used in other industries despite being sometimes underestimated. Different extraction methods using various solvents and extraction conditions are currently being investigated. Due to its natural occurrence in wines, safe behavior, and low toxicity when compared to other organic solvents, ethanol is used as an extracting agent. The aim of this study was to identify the winery by-product from the Região Demarcada do Douro and its corresponding extraction solvents that yields the most favorable results in (poly)phenols content and antioxidant capacity. To achieve this, five different ratios of ethanol: water, namely 0:100, 25:75, 50:50, 75:25, and 100:0 (v/v), for extracting the phenolic compounds were employed. Afterwards, the determination of total phenolic content (TPC), ortho-diphenols content (ODC), and flavonoid content (FC) as well as the antioxidant capacity of the obtained extracts using three different methods was performed. Since the best results of the spectrophotometric assays were obtained mostly with hydroethanolic extracts of stems (50:50, v/v), identification by HPLC-DAD has carried out. It was possible to conclude that the Tinta Roriz variety displayed the highest number of identified (poly)phenols.

To provide meat safety and consumer protection, appropriate hygiene control measures at an abattoir are required. This study aimed to evaluate the influence of visual fecal contamination level (VFCL) and lairage time (LT) on pig skin (PS) and external (ECS) and internal (ICS) carcass surfaces. The presence of Enterobacteriaceae, Escherichia coli (E. coli) and Salmonella in PS, ECS, and ICS were evaluated. A total of 300 paired samples were collected from 100 pigs. Results underlined the importance of the skin (Enterobacteriaceae: 3.27 ± 0.68 log CFU/cm2; E. coli: 3.15 ± 0.63 log CFU/cm2; Salmonella: 21% of samples) as a direct or indirect source of carcass contamination. Although VFCL revealed no significant effect (p > 0.05), the increase of LT had a significant impact (p < 0.001) on Enterobacteriaceae and E. coli levels across all analysed surfaces, and Salmonella presence on ICS (p < 0.01), demanding attention to LT. Also, the ICS showed a higher level of these bacteria compared to ECS. These results highlight the need of food business operators to consider ICS as an alternative area to sample for Salmonella, as a criterion for process hygiene based on EC Regulation No. 2073/2005, and as a potential contamination source to be integrated in the hazard analysis critical control point (HACCP) plans.

Chromium is a toxic metal widely used in several industrial activities, being frequently found in industrial effluents. The presence of chromium in its soluble ionic form Cr(III) is related to health risks, damage to living beings and to the environment. In this work, the capture of Cr(III) using alginate extraction residue (RES) from the Sargassum filipendula algae was evaluated to investigate the adsorption properties of this waste material. The study steps included batch and continuous adsorption assays, characterizations, and desorption evaluation. The adsorbent residue was not submitted to pre-treatment steps. The investigation of chromium adsorption and the fluid dynamic study are presented in this work. The equilibrium and thermodynamic studies indicated that the uptake of Cr(III) by the RES occurred spontaneously, endothermic, and energetically favorable on a heterogeneous surface with energetically distinct sites, mainly by chemisorption. The Freundlich and Dubinin-Radushkevich, and pseudo-second order models showed better fit to the equilibrium and kinetic experimental data, respectively. In the continuous fixed-bed system, the breakthrough curves showed a smaller mass transfer zone under flow rate and Cr(III) inlet concentration conditions of 0.5 mL/min and 1.0 mmol/L, respectively. The low desorption percentages corroborate the chemical nature of the bonds involved in adsorption. The best result of 67.5% was obtained with the combined eluent of HCl and CaCl2, both at 1 mol/L. SEM and EDX analyzes showed that ion exchange is involved in the adsorptive process with a reduction in the amount of light ions (Na, Ca, Mg, and K) on the RES surface. The characterization analyzes indicated that hydroxyls are the main group involved in the adsorption of metal that occurred on the surface of the RES.

This study examines the influence of the particle size, extrusion rate and sintering temperature on the characteristics of kaolin hollow fibre membranes. In addition, the produced membranes were applied for bacteria removal from an aqueous suspension. The milling process reduced the size of kaolin particles from 8.7 to 5.1 μm and greatly enhanced the morphology and mechanical resistance of the produced membranes. The increase in the sintering temperature up to 1250°C caused crystallographic phase modifications in the crude kaolin, which were mainly assigned to transformations of quartz and kaolinite to mullite and cristobalite phases. The fibres sintered at 1250°C have bending strength of 145MPa, but this relatively high sintering temperature caused a substantial particle densification and drastic decrease of the membrane water permeability. The kaolin hollow fibre membranes enabled almost total removal of the Enterobacter bacteria from an aqueous suspension.

Da insolvência de um consumidor casado num regime de comunhão resultará necessariamente a apreensão para a massa insolvente de todos os seus bens próprios e de todos os bens comuns do casal. A adequada proteção do cônjuge não insolvente depende da correta interpretação e aplicação das normas do Código de Insolvência e Recuperação de Empresa com as regras substantivas das dívidas entre cônjuges e da garantia patrimonial por estas dívidas que resulta do Código Civil, bem como do regime do Código de Processo Civil, designadamente, com consagração no artigo 740.º. O presente artigo visa lançar alguma luz sobre essa harmonização, que tem sido objeto de alguma incompreensão nos processos de insolvência que correm nos Tribunais portugueses.

A intensificação de produção das pastagens no Brasil é altamente dependente da adubação nitrogenada. O objetivo foi avaliar a produtividade do capim Zuri, em manejo de cortes sucessivos, quando submetido ao consórcio com leguminosas forrageiras e incorporação de resíduos orgânicos em substituição à adubação com ureia. Foi utilizado o delineamento em blocos completos casualizados, com seis fontes de nitrogênio (ureia; esterco bovino; cama de frango; nabo forrageiro; amendoim forrageiro; calopogônio e soja perene), em quatro repetições. Os resíduos e a ureia foram aplicados no início do experimento e a semeadura das leguminosas forrageiras foi realizado no mesmo dia do capim. Foram realizados três cortes no capim, quando este atingiu 90 cm de altura. Avaliaram-se os seguintes parâmetros: altura, índice relativo de clorofilas, biomassa fresca e seca da parte aérea, concentração de nitrogênio, percentual de proteína e no terceiro corte, a quantidade de perfilhos e o perfilhamento. Observou-se também que houve boa produção do capim, expresso pelos índices de biomassa fresca e biomassa seca, bem como com a alta produção, independente do tratamento utilizado. É possível obter alta taxa de crescimento e desenvolvimento do capim Zuri, expresso pelo perfilhamento e produção de biomassa seca, com fornecimento de N com o uso de qualquer uma das fontes nitrogenadas utilizadas.