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Xabier Aizpurua-Arruti,1,2 Shalom Charlie I Benrimoj,3 Estibaliz Goyenechea,1 Arantxa Isla,2,4 Ainhoa Oñatibia-Astibia,1 Amaia Malet-Larrea,1 Miguel Ángel Gastelurrutia,1,3 Olatz Cuevas,1 Julen Rodríguez-Castejón,2,4 Saioa Domingo-Echaburu,5 María Ángeles Solinís,2,4 Montserrat García,6 Ana del Pozo-Rodríguez2,4 1Official Pharmacist Association of Gipuzkoa, Donostia / San Sebastián, Spain; 2Pharmacy Practice Research Group, PharmaNanoGene Group, Faculty of Pharmacy, University of the Basque Country UPV/EHU, Vitoria-Gasteiz, Spain; 3Pharmaceutical Care Research Group, Faculty of Pharmacy, University of Granada, Granada, Spain; 4Bioaraba, Microbiology, Infectious Disease, Antimicrobial Agents, and Gene Therapy, Vitoria-Gasteiz, Spain; 5Osakidetza Basque Health Service, Debagoiena Integrated Health Organisation, Pharmacy Service, Arrasate, Spain; 6Basque Country Pharmacovigilance Unit, Osakidetza Basque Health Service, Galdakao-Usansolo Hospital, Galdakao, SpainCorrespondence: Ana del Pozo-Rodríguez, Pharmacy Practice Research Group, PharmaNanoGene Group, Faculty of Pharmacy, University of the Basque Country UPV/EHU, Vitoria-Gasteiz, Spain, Email ana.delpozo@ehu.eusPurpose: Additional monitoring (AM) medicines include (i) medicines containing a new active substance; (ii) biological medicines; (iii) medicines with conditional approval or authorized in special situations; (iv) medicines which require further studies; (v) medicines that have specific requirements regarding the reporting of suspected adverse drug reactions (ADRs). When AM medicines are marketed, their most common ADRs are known, but safety information is limited because relatively rare ADRs are often not detected in clinical trials. Their AM status warrants real-world studies to identify other safety issues; however, such studies are lacking. Correct use and adherence to dosage regimen by patients are key factors for the evaluation of the safety and efficacy of medicines. The objective of this work was assessing the impact on safety, adherence, use and knowledge (U&K) about medicines and patient’s quality of life (QOL), of community pharmacist (CP)-led interventions in a new service focused on AM medicines targeted at three prevalent chronic diseases: diabetes mellitus type 2, chronic obstructive pulmonary disease and cardiovascular disease.Patients and Methods: A prospective interventional cohort study was conducted with a 6-month follow-up in 27 community pharmacies (145 patients). Safety, adherence to treatment, patient U&K and QOL were assessed at follow-up visits (months 0, 3 and 6).Results: The number of detected ADRs was 163 with 41 patients referred to the doctor. At baseline, 24.1% of the patients were non-adherent, mainly due to unintentional causes. After six months and 130 interventions by CPs on adherence, a significant reduction to lower than 5.8% was achieved. The inadequate U&K of medicines also decreased, from 47.6% to 7.9% after 182 interventions. Also, the patient’s QOL improved.Conclusion: A new patient-centered pharmacy service provides some evidence on the important role of CP in assisting the proper and safe use of AM medicines, improving patient health outcomes. Keywords: community pharmacy, medicines under additional monitoring, safety, adherence, use and knowledge, pharmaceutical care

A degradação ambiental vem gerando discussões sobre alternativas mitigadoras referentes à insalubridade dos ambientes. Logo, o presente estudo objetivou analisar a percepção dos moradores do bairro Senhor do Bonfim, no município de Xique-Xique, Bahia, acerca da importância do sistema de esgotamento sanitário e os impactos originários da sua ausência. Os dados foram obtidos por meio de entrevistas com representantes das secretarias municipais e utilizando questionários semiestruturados com 10% das famílias do bairro. Adotou-se o método de amostragem probabilístico casual simples, onde sorteou-se 10% dos quarteirões do bairro e as residências que seriam visitadas. A maioria dos entrevistados possuía ensino fundamental incompleto e mais de 50% desses tinham renda familiar inferior a um salário mínimo. Demonstraram baixo nível de informação quanto ao conceito de “sistema de esgotamento sanitário” e suas influências na qualidade de vida da população. Todavia, mesmo 94% relatando que esse sistema melhora a qualidade de vida e 97% expondo que o esgoto a céu aberto propicia malefícios, não se obteve argumentação plausível a respeito. Notou-se, ainda, que a negligência política se mostra significativa quanto aos aspectos do saneamento básico da cidade, sendo fundamental a articulação do poder público municipal para informar a população e intervir nas práticas inadequadas realizadas corriqueiramente.

Summer temperature extremes can have large impacts on humans and the biosphere, and an increase in heat extremes is one of the most visible symptoms of climate change. Multiple mechanisms have been proposed that would predict faster warming of heat extremes than typical summer days, but it is unclear whether this is occurring. Here, we show that, in both observations and historical climate model simulations, the hottest summer days have warmed at the same pace as the median globally, in each hemisphere, and in the tropics from 1959 to 2023. In contrast, the coldest summer days have warmed more slowly than the median in the global average, a signal that is not simulated in any of 262 simulations across 28 CMIP6 models. The observed stretching of the cold tail indicates that observed summertime temperatures have become more variable despite the lack of hot day amplification. The interannual variability and trend in the warming of both hot and cold extremes compared to the median can be explained from a surface energy balance perspective based on changes in net surface radiation and evaporative fraction. Tropical hot day amplification is projected to emerge in the future (2024-2099, SSP3-7.0 scenario), while Northern Hemisphere heat extremes are expected to continue to follow the median.

Trata-se de texto de apresentação do dossiê temático "Educação em museus: a didática museológica e o caráter educativo dos objetos em contextos patrimoniais".

Objetivo: Descrever o perfil sociodemográfico clínico e terapêutico e as atividades de autocuidado de usuários com diabetes mellitus em um serviço de atenção básica à saúde. Métodos: Estudo transversal, de caráter descritivo, com abordagem quantitativa, desenvolvido em uma Unidade Básica de Saúde, entre outubro de 2015 e outubro de 2016, em uma área urbana do Munícipio de Vitória de Santo Antão, Pernambuco, Brasil, com 164 usuários com diabetes mellitus. Os dados foram obtidos mediante entrevista, utilizando-se dois questionários estruturados e as variáveis foram analisadas através do Statiscal Package for Social Scicenses (SPSS). Resultados: Os resultados apontam para uma situação sociodemográfica, clínica e terapêutica, caracterizada pela prevalência de usuários com média de idade de ± 59,66 anos, uma maior prevalência do sexo feminino (53,7%) e monitorização da glicemia capilar satisfatória (87,8%). Com relação às atividades de autocuidado, percebe-se uma maior pontuação para as práticas medicamentosas. Conclusões: Diante dos resultados obtidos, conclui-se ser necessário o fornecimento de programas de educação por uma equipe multiprofissional, direcionados aos usuários com diabetes mellitus com o intuito de atender à complexidade do cuidado.

Abstract: On seasonal time scales, vapor pressure deficit (VPD) is a known predictor of burned area in the southwestern United States (“the Southwest”). VPD increases with atmospheric warming due to the exponential relationship between temperature and saturation vapor pressure. Another control on VPD is specific humidity, such that increases in specific humidity can counteract temperature-driven increases in VPD. Unexpectedly, despite the increased capacity of a warmer atmosphere to hold water vapor, near-surface specific humidity decreased from 1970 to 2019 in much of the Southwest, particularly in spring, summer, and fall. Here, we identify declining near-surface humidity from 1970 to 2019 in the southwestern United States with both reanalysis and in situ station data. Focusing on the interior Southwest in the months preceding the summer forest fire season, we explain the decline in terms of changes in atmospheric circulation and moisture fluxes between the surface and the atmosphere. We find that an early spring decline in precipitation in the interior region induced a decline in soil moisture and evapotranspiration, drying the lower troposphere in summer. This prior season precipitation decline is in turn related to a trend toward a Northern Hemisphere stationary wave pattern. Finally, using fixed humidity scenarios and the observed exponential relationship between VPD and burned forest area, we estimate that with no increase in temperature at all, the humidity decline alone would still lead to nearly one-quarter of the observed VPD-induced increase in burned area over 1984–2019. Significance Statement: Burned forest area has increased significantly in the southwestern United States in recent decades, driven in part by an increase in atmospheric aridity [vapor pressure deficit (VPD)]. Increases in VPD can be caused by a combination of increasing temperature and decreasing specific humidity. As the atmosphere warms with climate change, its capacity to hold moisture increases. Despite this, there is a decrease in near-surface air humidity in the interior southwestern United States over 1970–2019, which during the summer is likely caused by a decline in early spring precipitation leading to limited soil moisture and evaporation in spring and summer. We estimate that this declining humidity alone, without an increase in temperature, would cause about one-quarter of the VPD-induced increase in burned forest area in this region over 1984–2019.

Arid and semi-arid regions of the world are particularly vulnerable to greenhouse gas-driven hydroclimate change. Climate models are our primary tool for projecting the future hydroclimate that society in these regions must adapt to, but here, we present a concerning discrepancy between observed and model-based historical hydroclimate trends. Over the arid/semi-arid regions of the world, the predominant signal in all model simulations is an increase in atmospheric water vapor, on average, over the last four decades, in association with the increased water vapor-holding capacity of a warmer atmosphere. In observations, this increase in atmospheric water vapor has not happened, suggesting that the availability of moisture to satisfy the increased atmospheric demand is lower in reality than in models in arid/semi-arid regions. This discrepancy is most clear in locations that are arid/semi-arid year round, but it is also apparent in more humid regions during the most arid months of the year. It indicates a major gap in our understanding and modeling capabilities which could have severe implications for hydroclimate projections, including fire hazard, moving forward.

The COVID-19 pandemic presented significant challenges for both students and educators, particularly because of the virtualization of classes and the consequent lack of practical sessions following the closure of laboratories and experimental fields in universities. The absence of interaction among students and practical classes led to a diminished interest in studies, as students found it difficult to connect theoretical knowledge with practical application. This study explores the implementation of a Journal Club (JC) as a collaborative-metacognitive use of the science literature teaching approach (CMSLTA) to enhance theoretical and practical knowledge through the reading and discussion of scientific literature in an e-learning environment. In this approach, students read scientific articles, write essays, and engage in group discussions. The methodology was applied over two consecutive academic semesters in 2021 and 2022 within plant genetics courses. Academic achievement was evaluated through essay assessments, and surveys were conducted at the end of each semester. The results revealed notable progress in student grades throughout the semester, with over 80% of participants endorsing JC implementation and recognizing its relevance to their education. The Journal Club facilitated the integration of theoretical knowledge covered in lectures and equipped students with various digital research tools.

Providing hands-on practical education without access to laboratories during the COVID-19 pandemic has required creativity and innovation. In this paper, co-authored by academic staff and students, we describe an at-home mobile phone-based 'spectrophotometer' experiment used in an introductory undergraduate biology course. Using colour picker apps, a smartphone can be used to quantify concentration, which was used to compare the strengths of different brands of tea. The protocol is designed to be low-cost and safe to perform outside of a laboratory. Students used the methods to learn important biochemical methods such as preparing dilutions, constructing calibration curves, normalising data and testing a hypothesis. We reflect on the experience of developing and using the protocol from a staff and student perspective, which highlights the advantages of this approach in terms of student independence and inclusivity. We also suggest alternative experiments that could be performed using the protocol. We encourage biology educators to think creatively about the possibilities for using mobile phones or at-home experiments in their teaching. Our experience suggests that at-home experiments like this protocol will have value even after the pandemic is over, particularly in terms of inclusivity.

Este texto busca aproximar a pedagogia do educador francês Célestin Freinet da educação patrimonial a partir de uma experiência concreta de pesquisa em um museu. Uma vez que o museu pesquisado se configura como um instrumento de combate à discriminação étnico-racial, a questão-problema que se estabeleceu foi a seguinte: a ação educativa do museu analisado combate a discriminação étnico-racial por meio da prática da educação patrimonial? Apoiando-se em autores que conceituam o que vem a ser educação patrimonial e na relação entre aprendizagem escolar e vida cotidiana presente na pedagogia Freinet, constatou-se que a ação educativa do referido museu não desenvolve a prática da educação patrimonial em suas visitas com grupos agendados provenientes de escolas, o que prejudica a concretização da proposta desse museu, qual seja, a de transformar a discriminação contra os africanos e afrodescendentes em reconhecimento pela importância que tiveram na história do Brasil, participando ativamente para a construção da cultura brasileira.

This letter to the editor responds to comments by Sartor et al regarding recent findings on the clinical relevance of CDK12 pathogenic mutations.

Dynamical downscaling is a crucial process for providing regional climate information for broad uses, using coarser-resolution global models to drive higher-resolution regional climate simulations. The pool of global climate models (GCMs) providing the fields needed for dynamical downscaling has increased from the previous generations of the Coupled Model Intercomparison Project (CMIP). However, with limited computational resources, the need for prioritizing the GCMs for subsequent downscaling studies remains. GCM selection for dynamical downscaling should focus on evaluating processes relevant for providing boundary conditions to the regional models and be inspired by regional uses such as the response of extremes to changes in the boundary conditions. This leads to the need for metrics representing processes of relevance to diverse stakeholders and subregions of a domain. Procedures to account for metric redundancy and the statistical distinguishability of GCM rankings are required. Further, procedures for selecting realizations from ensembles of top-performing GCM simulations can be used to span the range of climate change signals in multiple ways. As a result, distinct weighting of metrics and prioritization of particular realizations may depend on user needs. We provide high-level guidelines for such region-specific evaluations and address how CMIP7 might enable dynamical downscaling of a representative sample of high-quality models across representative shared socioeconomic pathways (SSPs).

Black Veterans have higher a incidence of localized and metastatic prostate cancer compared to White Veterans yet are underrepresented in reports of frequencies of somatic and germline alterations. This retrospective analysis of somatic and putative germline alterations was conducted in a large cohort of Veterans with prostate cancer (N = 835 Black, 1613 White) who underwent next generation sequencing through the VA Precision Oncology Program, which facilitates molecular testing for Veterans with metastatic cancer. No differences were observed in gene alterations for FDA approved targetable therapies (13.5% in Black Veterans vs. 15.5% in White Veterans, P = .21), nor in any potentially actionable alterations (25.5% vs. 28.7%, P =.1). Black Veterans had higher rates of BRAF (5.5% vs. 2.6%, P < .001) alterations, White Veterans TMPRSS2 fusions (27.2% vs. 11.7%, P < .0001). Putative germline alteration rates were higher in White Veterans (12.0% vs. 6.1%, P < .0001). Racial disparities in outcome are unlikely attributable to acquired somatic alterations in actionable pathways.