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As on land, oceans exhibit high temporal and spatial temperature variation. This ocean weather contributes to the physiological and ecological processes that ultimately determine the patterns of species distribution and abundance, yet is often unrecognized, especially in tropical oceans. Here, we tested the paradigm of temperature stability in shallow waters (

Higher Education Institutions are expected to stimulate the innovation system and to contribute to the development of societies in a global perspective. Within this context, there is an increasing focus on internationalization. HEIs are developing institutional mechanisms to support internationalization while academics are expected to carry specific practices that allow them to improve the internationalization of knowledge production. At the same time, they are encouraged to engage with non-academic partners to co-produce and transfer knowledge, contributing, in this way, to economic and social development. Although there is some research on the impact of internationalization on academic entrepreneurship, studies on the effects in other dimensions of academic engagement with society are almost absent. This paper aims to fill this gap by analyzing the relationship between academics' internationalization practices and perceptions and the development of different types of academic engagement. Our analysis draws on quantitative analysis with data provided by an international survey (APIKS) and explores the Portuguese context. Findings show that the different practices and perspectives on internationalization impact differently on the way scientists engage. While there are positive effects of internationalization of research on engagement, the time academics stay abroad and the high focus on publishing in internationally high-rated journals may negatively affect academics' orientation towards the local community. This paper contributes to the debate on the role of the internationalization in the context of a knowledge-based society, considering different dimensions and a broad spectrum of knowledge-based engagement activities.

Abstract Effective leaders increase organizational success. The Leadership Efficacy Model suggests that leaders’ efficacy increases when leaders are perceived as congruent; that is, when employees perceive the leader to do (practical cycle of leadership) what s/he says will (conceptual cycle of leadership) and there is a close match between what employees expect from leaders and what leaders display. This recent theoretical framework also acknowledges that a number of factors can interfere with the relationship between leadership cycle congruence and leadership efficacy. Such antecedent factors include group members’ characteristics (e.g., organizational seniority). This study aimed to test the assumption that leadership cycles congruence positively predicts leadership efficacy (measured by organizational commitment and job satisfaction, and that this relationship is moderated by employees’ seniority. 318 employees (55% male, with an average seniority of 8 years) completed a questionnaire assessing leadership cycles, organizational commitment, and job satisfaction. Path analysis results showed that the higher leadership cycles congruence, the higher employees’ organizational commitment and job satisfaction. Furthermore, the relationship between leadership cycle congruence and organizational commitment was stronger for more senior members of the organization (but not for job satisfaction). The results highlight the importance of leaders act in a congruent manner with their ideas and of meeting employees’ needs. Moreover, it shows that senior members of the organization are particularly sensitive to leadership congruency.

Introduction: Recently, university counseling services have been faced with an increasing number of students seeking psychological support. However, human resources and time constraints limit the services to respond adequately. Recently, national guidelines for Mental Health Services in Higher Education recommended the stepped care approach to increase efficiency. The present study aimed to explore the implementation of a stepped care model in a Portuguese public university, analyzing students’ sociodemographic and clinical characteristics, and presenting the flow of the stepped care approach and the students’ waiting periods in each step. Methods: An observational study was conducted in the University of Coimbra’s health services between May 2019 and June 2021. Descriptive statistics were performed to describe the sociodemographic and clinical characteristics of the sample, the flow of the stepped care approach, and students’ waiting periods. Results: We enrolled 295 students in the present study. The findings of this study revealed that over 40% had a clinical diagnosis of anxiety or depressive disorders. In terms of students’ flow within the stepped care model, 82% of students sought psychological help through self-referral. Concerning the implementation of the stepped care model, results have shown that most students wait less than a month to access each step. Discussion/Conclusions: Although preliminary, our results suggest that the stepped care model might be a useful service organization, mainly in a community in which accessibility to services and speed of response are particularly important. Most students being self-referred highlight the importance of direct contact between the university community and the health services. Additionally, anxiety and mood disorders were the most prevalent diagnoses in our sample, which also points to the relevance of a stepped care approach, since other studies have highlighted its advantages for this kind of clinical population.

This work aims to contribute to a deeper understanding of cryptocurrencies, which have emerged as a unique form within the financial market. While there are numerous cryptocurrencies available, most individuals are only familiar with Bitcoin. This knowledge gap and the lack of literature on the subject motivated the present study to shed light on the key characteristics of cryptocurrencies, along with their advantages and disadvantages. Additionally, we seek to investigate the integration of cryptocurrencies within the financial market by applying a dynamic equicorrelation model. The analysis covers ten cryptocurrencies from June 2nd, 2016 to May 25th, 2021. Through the implementation of the dynamic equicorrelation model, we have reached the conclusion that the degree of integration among cryptocurrencies primarily depends on factors such as trading volume, global stock index performance, energy price fluctuations, gold price movements, financial stress index levels, and the index of US implied volatility.

Abstract Diabetic foot infection imposes a significant burden and is the major cause of nontraumatic limb amputation. Adequate patient management with effective antibiotic therapy is crucial. This retrospective cohort study aimed to characterize the microbiology and resistance patterns of moderate to severe neuropathic diabetic foot infection in patients hospitalized at a tertiary referral hospital between January 2020 and June 2023. Deep tissue specimens from ulcers were collected for culture. Sixty inpatients were included (62% male, mean age 59.1 ± 11.5 years). Osteomyelitis was present in 90% of the patients. Among 102 microorganisms (average of 1.91 ± 1.25 pathogens per patient), 60.8% were gram-positive bacteria, 31.4% were gram-negative, 3.92% were anaerobic bacteria, and 3.92% were fungi. Staphylococcus aureus (19%) and Enterococcus faecium (17%) were the most common. Pseudomonas aeruginosa (8%) and bacteria of the Enterobacterales family (24%) accounted for all the isolated gram-negative bacteria. Sixteen percent of Staphylococcus aureus and 67% of coagulase-negative Staphylococci were resistant to methicillin. Resistance to ampicillin was found in 11% of Enterococci. All Pseudomonas aeruginosa isolates were sensitive to piperacillin-tazobactam, ceftazidime, or cefepime. Among the Enterobacterales, resistance rates were 35% for piperacillin-tazobactam, 38% for ceftazidime, 21% for cefepime, and 13% for carbapenems. Although the prevalence of methicillin-resistant staphylococci was lower than that in other studies, carbapenem resistance among gram-negative bacteria warrants attention. This study highlights the importance of understanding local epidemiology for effective diabetic foot infection management and resistance mitigation.

Abstract Background Assessing the historical dynamics of key food web components is crucial to understand how climate change impacts the structure of Arctic marine ecosystems. Most retrospective stable isotopic studies to date assessed potential ecosystem shifts in the Arctic using vertebrate top predators and filter-feeding invertebrates as proxies. However, due to long life histories and specific ecologies, ecosystem shifts are not always detectable when using these taxa. Moreover, there are currently no retrospective stable isotopic studies on various other ecological and taxonomic groups of Arctic biota. To test whether climate-driven shifts in marine ecosystems are reflected in the ecology of short-living mesopredators, ontogenetic changes in stable isotope signatures in chitinous hard body structures were analysed in two abundant squids (Gonatus fabricii and Todarodes sagittatus) from the low latitude Arctic and adjacent waters, collected between 1844 and 2023. Results We detected a temporal increase in diet and habitat-use generalism (= opportunistic choice rather than specialization), trophic position and niche width in G. fabricii from the low latitude Arctic waters. These shifts in trophic ecology matched with the Atlantification of the Arctic ecosystems, which includes increased generalization of food webs and higher primary production, and the influx of boreal species from the North Atlantic as a result of climate change. The Atlantification is especially marked since the late 1990s/early 2000s. The temporal patterns we found in G. fabricii’s trophic ecology were largely unreported in previous Arctic retrospective isotopic ecology studies. Accordingly, T. sagittatus that occur nowadays in the high latitude North Atlantic have a more generalist diet than in the XIXth century. Conclusions Our results suggest that abundant opportunistic mesopredators with short life cycles (such as squids) are good candidates for retrospective ecology studies in the marine ecosystems, and to identify ecosystem shifts driven by climate change. Enhanced generalization of Arctic food webs is reflected in increased diet generalism and niche width in squids, while increased abundance of boreal piscivorous fishes is reflected in squids’ increased trophic position. These findings support opportunism and adaptability in squids, which renders them as potential winners of short-term shifts in Arctic ecosystems.

This bibliographic survey identifies teachers training models that address the teachers training for assignments in mathematics in the Elementary School with DICT. We use, as a theoretical foundation, the training models of José Contreras, and the documentary research methodology of the chronicle type. We have investigated a total of ten articles which were published between 2013 and 2022, in the SBEM journals, and in articles from the ENEM annals. The analysis showed the implicit predominance of the reflective training model for teachers. Thus, we point out the need for research that theoretically explains the training models being used and that addresses the use of DICT from the perspective of the critical intellectual model of mathematics teachers training.

As feiras livres se apresentam como um espaço para a prática comercial varejista, do produtor familiar, de produtos in natura e processados, sendo um dos principais ambientes de preservação da cultura local e de interação entre o rural e o urbano, especialmente importante para a economia de cidades interioranas. O presente estudo objetivou identificar as melhores práticas utilizadas nos ambientes organizacionais da feira livre do município de Iporá (GO) e do centro de comercialização em Barra do Garças (MT), por meio da ferramenta de gestão denominada benchmarking, sendo utilizadas, como procedimento metodológico, entrevistas com os representantes das feiras de Iporá e Barra do Garças, bem como aplicação de questionário a 30 feirantes de ambas as localidades. Constatou-se a existência de desafios para a implantação do centro de comercialização em Iporá a partir da percepção dos feirantes sobre a relevância da adequada estrutura física e do efetivo suporte da vigilância sanitária para o rearranjo do ambiente. Quanto a Barra do Garças, o centro de comercialização modificou o espaço físico e padronizou os processos, reduzindo o número de frequentadores e vendas dos produtos. Conclui-se que, em ambos os locais de comercialização, quaisquer alterações no “espaço feira” devem resguardar as particularidades da modalidade tradicional de produção e venda.

BackgroundDepression is a highly prevalent psychopathological condition among older adults, particularly those institutionalized in nursing homes (NHs). Unfortunately, it is poorly identified and diagnosed. NH residents are twice as likely to fall as community-dwelling older adults. There is a need for more knowledge about the mechanisms and relationships between depression and falls. ObjectiveThis study aims to identify, analyze, and synthesize research on the relationships between depression and falls among NH residents. MethodsA literature search was conducted in October 2023 in the following bibliographic databases: MEDLINE ALL Ovid, Embase, CINAHL with Full Text EBSCO, APA PsycInfo Ovid, Web of Science Core Collection, the Cochrane Database of Systematic Reviews Wiley, and ProQuest Dissertations & Theses A&I. Clinical trials were searched for in the Cochrane Central Register of Controlled Trials Wiley, ClinicalTrials.gov, and the World Health Organization International Clinical Trials Registry Platform. Additional searches were performed using Google Scholar, the DART-Europe E-theses Portal, and backward citation tracking. The Newcastle-Ottawa Scale and the Appraisal tool for Cross-Sectional Studies were used to evaluate study quality. ResultsThe review included 7 quantitative studies published in 7 different countries from 3 continents; of these, 6 (86%) were cross-sectional studies, and 1 (14%) was a prospective cohort study. Results suggested high frequencies of depressive symptoms and falls among older adults living in NHs, and depressive symptoms were considered a risk factor for falls. The 15-item and 10-item versions of the Geriatric Depression Scale were the most commonly used measurement tools, followed by the Cornell Scale for Depression in Dementia and the Resident Assessment Instrument-Minimum Data Set 2.0. The prevalence of depression was heterogeneous, varying from 21.5% to 47.7% of NH residents. The studies used heterogeneous descriptions of a fall, and some considered the risk of falls, recurrent fallers, and near falls in their data. The prevalence of fallers was disparate, varying from 17.2% to 63.1%. Of the 7 retained studies, 6 (86%) reported a relationship between depression and falls or the risk of falls. Among the 19 other risk factors identified in the review as being associated with falls among NH residents were a history of falls in the last 180 days, >1 fall in the past 12 months, and respiratory illnesses. ConclusionsThere is a paucity of research examining falls among older adults with depressive symptoms in NHs. These findings should alert nurses to the need to consider depression as a risk factor in their work to prevent falls. More research is needed to gain a comprehensive understanding of fall risk among NH residents with depressive symptoms. International Registered Report Identifier (IRRID)RR2-10.2196/46995

ABSTRACT Objective: to analyze the preparation of nurses from the Brazilian Expeditionary Force to work in the air transport of wounded people during World War II. Method: historical-social study, of a qualitative nature, based on the work entitled “Nurses with the FAB on the Italian front: 1944-1945”, written by nurse Izaura Barbosa Lima. The data results from a bibliographic survey, the use of documentary sources and database consultations, with the material being treated using Thematic Content Analysis. Results: the following categories emerged: Professional trajectory of Nurse Izaura; Commuting between the United States and Italy; and the Nursing Air Evacuation Course. Conclusion: the study highlights the pioneering role of nurses in the Brazilian troops sent to Italy, the necessary preparation and completion of the course to join the air transport service for the wounded. Its achievement assumes relevance for contributing new elements to the History of Brazilian Nursing, particularly regarding the establishment of the foundations of Brazilian female military nursing.

IntroductionCystic fibrosis (CF) is a hereditary autosomal recessive disease driven by deleterious variants of the CFTR gene, leading, among other symptoms, to increased lung infection susceptibility. Mucus accumulation in the CF lung is, as of yet, considered as one important factor contributing to its colonization by opportunistic pathogens such as Pseudomonas aeruginosa. However, in recent years evidence was provided that alveolar macrophages, which form the first line of defense against airborne pathogens, seem to be intrinsically defective with regard to bactericidal functionality in the CF lung. To assess the impact of CFTR deficiency in human macrophages only insufficient systems are available.MethodsTo address this problem and to evaluate the role of CFTR in human macrophages, we successfully differentiated human induced pluripotent stem cells (iPSC) from a CF p.Phe508del homozygous individual and a healthy donor into primitive macrophages (iMacΔF508 and iMacWT), respectively, and compared the bactericidal functionality in the relevant cell type.ResultsiMacΔF508 showed impaired P. aeruginosa clearance and intracellular killing capacity in comparison to iMacWT. Furthermore, iMacΔF508 exhibited a less acidic lysosomal pH, and upon P. aeruginosa infection, there were signs of mitochondrial fragmentation and autophagosome formation together with a hyperinflammatory phenotype and deficient type I interferon response.ConclusionIn summary, we present a defective phenotype in iMacΔF508 upon P. aeruginosa infection, which will constitute an ideal platform to further study the role of macrophages in the context of CF.

INTRODUCTION: Proximal lower extremity deep vein thrombosis (DVT) occurs in 5-10/10000 patients annually. Left untreated, there's a notable risk of pulmonary embolism development and the onset of long-term limb complications linked to post-thrombotic syndrome (PTS). Traditionally, these patients were treated with conservative therapy, namely anticoagulation and compression stockings. Nowadays, new and more aggressive treatments have emerged. Endovascular therapies, such as thrombectomy devices, catheter-directed thrombolysis (CDT), percutaneous transluminal angioplasty (PTA), and stent placement, provide a highly effective treatment option with minimal patient risk of complications. METHODS: We retrospectively studied all patients with proximal lower extremity DVT who were treated with endovascular therapy in our center between the years of 2018 and 2021. We choose as primary outcomes symptoms of PTS (Villalta Score) and quality of life (VEINES-QoL/Sym questionnaire) and as secondary outcomes treatment efficacy (grade of thrombolysis), treatment safety, and primary patency. RESULTS: A total of 20 patients were treated by endovascular treatment. The majority of these patients were women (95%); 60% of them had DVT of the left limb, and 30% had phlegmasia alba dolens. Seven patients were treated with the AngiojetTM system (35%), four with the PenumbraTM system (20%) and nine with CDT alone (45%). Two patients presented with mild PTS symptoms, and the mean VEINES-QoL/Sym questionnaire score was 84.8% +/- 13.6%. There were no cases of major bleeding or pulmonary embolism after the procedure. Two patients had small vein ruptures with no need for additional treatment. The average length of stay in a high surveillance unit for vigilance was 2.2 days. At the end of treatment, 75% of the patients had complete thrombolysis, 15% had partial thrombolysis (50–99% thrombus removal), and 10% showed minimal or no thrombolysis (< 50% thrombus removal). The primary patency rate was 88% after 12 months. CONCLUSION: Our experience has shown that endovascular therapy for acute proximal lower extremity DVT is a safe and effective treatment associated with a very low incidence of PTS and recurrent venous thromboembolism. However, life-threatening complications such as major bleeding can occur. As such, while under treatment, close monitoring of these patients in a high surveillance unit is mandatory.

IntroductionCarrying out studies using data from Food and Nutritional Monitoring is crucial given the current epidemiological scenario. This scenario reveals a coexistence of malnutrition and nutritional deficiencies alongside overweight and obesity, particularly among adult women in Brazil. Analyzing the microdata generated by the system is essential for accurately representing food and nutrition indicators in the country.ObjectiveTo analyze the association of food consumption markers and sociodemographic factors with changes in the Body Mass Index (BMI) among adult women.MethodologyA cohort study with a final sample of 30,354 women evaluated through individual records between the years 2015 and 2019. Nutritional status was assessed using body mass index (BMI). Food consumption markers used were the ones available in the system, which referred to foods consumed the previous day. Linear regression was used to evaluate factors associated with BMI and multiple Poisson regression was used to estimate the relative risk of obesity incidence.ResultsThere was an increase in BMI between 2015 and 2019. The average increase in BMI was lower in women who consumed, in the previous day, beans (β = −0,25; CI95%: −0.36; −0.13) and vegetables and/or legumes (β = −0.12; CI95%: −0.21; −0.04) and the increase was greater when they consumed hamburgers and/or sausages (β = 0.1; CI95%: 0.02; 0.19) adjusted by age, region and skin color. There was a 14% lower incidence of obesity in the group that consumed beans (RR = 0.86; 95% CI: 0.79; 0.93), and a 9% lower incidence when they consumed filled cookies, candies or treats (RR = 0.91; 95% CI 0.86; 0.96). The incidence of obesity was 11% higher in the group that consumed sweetened drinks (RR = 1.11; 95% CI: 1.05; 1.18) and 9% higher in the group that consumed instant noodles, packaged snacks or savory biscuits on the day before the 2015 registration (RR = 1.09; 95% CI: 1.03; 1.15).ConclusionThere was an increase in BMI in the population of adult women, rising nationally between 2015 and 2019, with the notable influence of diet on this change.

Immune checkpoint inhibitor and tyrosine kinase inhibitor combinations have become the new standard of care in the first-line treatment of metastatic clear cell renal cell carcinoma. However, there is a growing concern regarding severe immune-related adverse events. A 78-year-old man with metastatic clear cell renal cell carcinoma, treated with pembrolizumab and axitinib, was admitted to the emergency department 30 days after initiating treatment due to rapidly progressive myositis. Myocarditis with severe ventricular dysfunction was identified. Muscular biopsy findings were compatible with inflammatory myopathy associated with immune checkpoint inhibitors. Initial treatment with high-dose corticosteroids showed an insufficient response. Therapeutic escalation on the third day with methylprednisolone, immunoglobulin, and abatacept resulted in clinical improvement. On the eleventh day, a sudden malignant arrhythmia occurred, followed by cardiac arrest. This represents one of the first case reports describing myocarditis and myositis during treatment with pembrolizumab-axitinib. While immune checkpoint inhibitor may play a major role, it is also possible that the tyrosine kinase inhibitor, while attempting to promote immune modulation, also increases severe toxicities.