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Abstract Background Pulmonary fibrosis (PF) represents the pathologic end stage of several interstitial lung diseases (ILDs) associated with high morbidity and mortality rates. However, current treatments can only delay disease progression rather than provide a cure. The role of inflammation in PF progression is well-established, but new insights into immune regulation are fundamental for developing more efficient therapies. c-MET signaling has been implicated in the migratory capacity and effector functions of immune cells. Nevertheless, the role of this signaling pathway in the context of PF-associated lung diseases remains unexplored. Methods To determine the influence of c-MET in immune cells in the progression of pulmonary fibrosis, we used a conditional deletion of c-Met in immune cells. To induce pulmonary fibrosis mice were administered with bleomycin (BLM) intratracheally. Over the course of 21 days, mice were assessed for weight change, and after euthanasia at different timepoints, bronchoalveolar lavage fluid cells and lung tissue were assessed for inflammation and fibrosis. Furthermore, c-MET expression was assessed in cryobiopsy sections, bronchoalveolar lavage fluid cells samples and single cell RNA-sequencing dataset from human patients with distinct interstitial lung diseases. Results c-MET expression was induced in lung immune cells, specifically in T cells, interstitial macrophages, and neutrophils, during the inflammatory phase of BLM-induced PF mouse model. Deletion of c-Met in immune cells correlated with earlier weight recovery and improved survival of BLM-treated mice. Moreover, the deletion of c-Met in immune cells was associated with early recruitment of the immune cell populations, normally found to express c-MET, leading to a subsequent attenuation of the cytotoxic and proinflammatory environment. Consequently, the less extensive inflammatory response, possibly coupled with tissue repair, culminated in less exacerbated fibrotic lesions. Furthermore, c-MET expression was up-regulated in lung T cells from patients with fibrosing ILD, suggesting a potential involvement of c-MET in the development of fibrosing disease. Conclusions These results highlight the critical contribution of c-MET signaling in immune cells to their enhanced uncontrolled recruitment and activation toward a proinflammatory and profibrotic phenotype, leading to the exacerbation of lung injury and consequent development of fibrosis.

Objective: To determine the epidemiological profile of patients with type 2 diabetes mellitus in a teaching unit. Method: In this observational, cross-sectional, and descriptive study, data from the medical records of consultations conducted between February 2020 and May 2022 at an endocrinology outpatient clinic in a teaching unit in Northeast Brazil were evaluated. A descriptive analysis of the data was performed, with percentage values, medians, and interquartile ranges (IQRs) reported. Result: Data were collected from the medical records of 118 patients, and the medical records of 95 patients were used for statistical analysis after the exclusion of records with insufficient data. Seventy patients (73.6%) were female, with a median age of 57 years (IQR 51.5-65), a median body mass index (BMI) of 28.9 kg/m2 (IQR 25.7-33.1) and a median age at diagnosis of 47.5 years (IQR 38-55). The median glycated hemoglobin (HbA1c) and fasting blood glucose levels during follow-up were 7.6% (IQR 6.6-9.7) and 132.8 mg/dL (IQR 113.5-201.7), respectively, and only 36.8% (n=35) of patients were within their HbA1C therapeutic target range. Approximately 73.6% (n=70) of the patients used statins, but only 18 (18.9%) had LDL-c within their therapeutic target range. Twenty-seven patients (28.4%) had kidney dysfunction, either albuminuria or a glomerular filtration rate (GFR) reduction, and 6 of them (22.2%) did not use any nephroprotective medication. Fewer than half of the patients underwent fundoscopy, and 32.5% of them showed some degree of retinopathy. Neuropathy was present in 33 patients (34.7%), with 3 patients (3.16%) presenting with amputations.

Iberian peatlands have been severely affected by land use and land cover (LULC) changes. Despite these pressures, some peatlands persist in the region, although their susceptibility to LULC change remains poorly understood. This study presents the most detailed and extensive distribution data for Iberian peatlands to date and analyzes the dynamics and drivers of LULC in Iberian peatlands and their surrounding areas. We compiled peatland records from various sources and used Corine Land Cover Change layers to determine LULC shifts in their surrounding areas for 1990, 2000, 2006, 2012, and 2018. Environmental and socioeconomic variables were used to create Boosted Regression Tree models explaining spatial variations in the mean percentage of changed area. Analysis of 270 peatland locations in the Iberian Peninsula revealed that forests and seminatural areas constituted over 80% of the peatland’s surroundings. Agricultural areas expanded the most, except between 2006 and 2012 when the artificial areas showed more gains. While most surrounding areas experienced an average change of 0%-9.51% of the total area, between 1990 and 2018, lowland peatlands (littoral and sublittoral) suffered more intense changes (9.51% to 38.43%). Our models showed that only elevation and agricultural area density were relevant predictors of the spatial distribution of changes. Upland Iberian peatlands showed lower susceptibility to LULC change, while lowland peatlands underwent remarkable transformations. This study substantially expands previous knowledge about the distribution and conservation needs of these ecosystems in the Iberian Peninsula, especially those in littoral and sublittoral lowlands.

No século XXI, a implementação da educação doutoral em Geografia resultou num aumento do número de teses enquadradas na especialização em Geografia Física. No entanto, pouco é conhecido sobre a dinâmica inerente às técnicas de trabalho de campo, métodos e temas estudados. Com o objetivo de compreender melhor a tendência de aumento e evolução associada, este artigo analisa os 78 estudos de doutoramento publicados em cinco instituições públicas de ensino superior, entre 2000 e 2021. Foi realizada uma análise quantitativa de forma a investigar as fontes de dados, as técnicas de trabalho de campo e os métodos de análise utilizados nos estudos que abrangem as temáticas Biogeografia, Climatologia, Hidrologia, Geomorfologia e Risco e Ordenamento. A partir de 2007, verificou-se um aumento de trabalhos em Risco e Ordenamento, reforçando a componente da Geografia Física aplicada às problemáticas do ordenamento do território. A utilização de Sistemas de Informação Geográfica, análise estatística e quantitativa evidenciam o peso das bases de dados e análises em gabinete. O contexto territorial em que se localizam as instituições estudadas parece influenciar a escolha das áreas de estudo e temáticas associadas. O processo de Bolonha, a atribuição de bolsas de doutoramento pela Fundação para a Ciência e Tecnologia e o aumento dos projetos de investigação com financiamento justificam parcialmente a diversidade de temáticas identificadas e métodos.

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.

Acute respiratory distress syndrome (ARDS) is a life-threatening lung injury that currently lacks effective clinical treatments. Evidence highlights the potential role of glycogen synthase kinase-3 (GSK-3) inhibition in mitigating severe inflammation. The inhibition of GSK-3α/β by CHIR99021 promoted fetal lung progenitor proliferation and maturation of alveolar epithelial cells (AECs). The precise impact of CHIR99021 in lung repair and regeneration during acute lung injury (ALI) remains unexplored. This study intends to elucidate the influence of CHIR99021 on AEC behaviour during the peak of the inflammatory phase of ALI and, after its attenuation, during the repair and regeneration stage. Furthermore, a long-term evaluation was conducted post CHIR99021 treatment at a late phase of the disease. Our results disclosed the role of GSK-3α/β inhibition in promoting AECI and AECII proliferation. Later administration of CHIR99021 during ALI progression contributed to the transdifferentiation of AECII into AECI and an AECI/AECII increase, suggesting its contribution to the renewal of the alveolar epithelial population and lung regeneration. This effect was confirmed to be maintained histologically in the long term. These findings underscore the potential of targeted therapies that modulate GSK-3α/β inhibition, offering innovative approaches for managing acute lung diseases, mostly in later stages where no treatment is available.

Prostate cancer (PCa) remains a significant global health concern, being a major cause of cancer morbidity and mortality worldwide. Furthermore, profound understanding of the disease is needed. Prostate inflammation caused by external or genetic factors is a central player in prostate carcinogenesis. However, the mechanisms underlying inflammation-driven PCa remain poorly understood. This review dissects the diagnosis methods for PCa and the pathophysiological mechanisms underlying the disease, clarifying the dynamic interplay between inflammation and leukocytes in promoting tumour development and spread. It provides updates on recent advances in elucidating and treating prostate carcinogenesis, and opens new insights for the use of bioactive compounds in PCa. Polyphenols, with their noteworthy antioxidant and anti-inflammatory properties, along with their synergistic potential when combined with conventional treatments, offer promising prospects for innovative therapeutic strategies. Evidence from the use of polyphenols and polyphenol-based nanoparticles in PCa revealed their positive effects in controlling tumour growth, proliferation, and metastasis. By consolidating the diverse features of PCa research, this review aims to contribute to increased understanding of the disease and stimulate further research into the role of polyphenols and polyphenol-based nanoparticles in its management.

Human capital is considered the most important resource in any organization. However, most companies are concerned with external customer satisfaction, without devoting much attention to the satisfaction of their employees. Indisputably, employee satisfaction is fundamental and determines the success or failure of what the customer experiences. Technological developments have changed our lives and habits, and even the way we relate to others, so the online increasingly influences the offline. The purpose of this manuscript was to examine the relationship between the Digital Communication of companies and their Employer Branding, with a special focus on the close relationship that employees feel with the company. To perform this analysis, a case study was carried out using a qualitative approach. Interviews with seven managers from three different companies, two of whom are responsible for the Digital Communication of their organizations, were performed. With the analysis of the data obtained, it is concluded that the Employer Branding perceived by the employees is of a positive image of the company, but they do not feel emotionally more connected with the organization through the Digital Communication practiced by it. With this study, it is expected that organizations recognize the importance that an online presence has in the image of their brand as a whole, and that it is important to invest in Digital Communication, but it has to be performed with an action plan to achieve the objectives intended. From an interdisciplinary perspective, the manuscript presents insights for marketing (digital marketing and employer branding) and for socially responsible behavior by organizations (in a Portuguese context).

Large-scale production of microalgae and their bioactive compounds has steadily increased in response to global demand for natural compounds. Spirulina, in particular, has been used due to its high nutritional value, especially its high protein content. Promising biological functions have been associated with Spirulina extracts, mainly related to its high value added blue pigment, phycocyanin. Phycocyanin is used in several industries such as food, cosmetics, and pharmaceuticals, which increases its market value. Due to the worldwide interest and the need to replace synthetic compounds with natural ones, efforts have been made to optimize large-scale production processes and maintain phycocyanin stability, which is a highly unstable protein. The aim of this review is to update the scientific knowledge on phycocyanin applications and to describe the reported production, extraction, and purification methods, including the main physical and chemical parameters that may affect the purity, recovery, and stability of phycocyanin. By implementing different techniques such as complete cell disruption, extraction at temperatures below 45 °C and a pH of 5.5–6.0, purification through ammonium sulfate, and filtration and chromatography, both the purity and stability of phycocyanin have been significantly improved. Moreover, the use of saccharides, crosslinkers, or natural polymers as preservatives has contributed to the increased market value of phycocyanin.

Abstract Objective To verify whether, regardless of the screw placement technique, there is a safe distance or angle in relation to the facets that can prevent violation of the facet joint when the screws are placed. Methods Retrospective, single, comparative, non-randomized center. We evaluated by axial computed tomography: the angle of the screw/rod in relation to the midline, the angle of the center of the facets in relation to the midline, the distance between the head of the screw/rod to the midline, and the distance from the center of the facets to the midline; the violation of the facet joint will be evaluated in a gradation of 0 to 2. Also will be measured the difference between the angle os the facets and the angle of the screws (Δ Angle) and, the difference between the facet distance and the screw distance (Δ Distance). Results A total of 212 patients and 397 facets were analyzed (196 on the left and 201 on the right). Of these, 303 were not violated (grade 0), corresponding to 76,32%, and 94 suffered some type of violation (grade 1 and 2), corresponding to 23,68%. The mean of Δ angle was 9.87° +/− 4.66° (grade 0), and of 3.77° +/− 4.93° in facets (grade 1 and 2) (p< 0.001), and the Δ mean distance in cases in which there was no violation was 0.94 arbitrary units (a.u.) +/− 0.39 a.u., while the Δ distance in G1 and G2 cases was 0.56 a.u. +/− 0.25 a.u. (p< 0.001). Conclusion The measurements of angle and distance between facet and screw can help in the placement of screws. These parameters can be used as safety measures with the most frequent use of surgical navigation techniques.

Resumo: Introdução e objetivos: No enfarte agudo do miocárdio com supradesnivelamento do segmento ST (EAMcST) é inequívoco o benefício do uso de dupla antiagregação plaquetar. O tempo ideal para administrar a dose de carga do inibidor do recetor P2Y12 (DC‐iP2Y12) é pouco consensual e motivo de debate. O principal objetivo do trabalho foi caracterizar a prática usada em Portugal e avaliar o impacto prognóstico da estratégia de administração da DC-iP2Y12, se antes ou durante/após angioplastia primária (AP). Métodos: Estudo multicêntrico, retrospetivo, baseado no Registo Nacional de Síndromes Coronárias Agudas, com inclusão de doentes com EAMcST e AP realizada de 1/10/2010 a 19/09/2017. Estabelecidos dois grupos: DC‐iP2Y12 pré‐AP (PRE‐DC‐iP2Y12) e DC‐iP2Y12 durante ou após AP (CAT‐DC‐iP2Y12). Resultados: Incluídos 4123 doentes, 66,3% do grupo PRE‐DC‐iP2Y12 e 32,4% do grupo CAT‐DC‐iP2Y12. Numa análise multivariada o uso de PRE‐DC‐iP2Y12 foi preditor de HEMATS (endpoint composto por hemorragia major, transfusão de sangue e queda de hemoglobina (Hb > 2 g/dL), queda de Hb>2 g/dL e reenfarte. Não se verificaram diferenças entre grupos no MACE (endpoint composto por morte hospitalar, acidente vascular cerebral e reenfarte) e morte hospitalar. Conclusões: O uso de PRE‐DC‐iP2Y12 associou‐se a um aumento do risco hemorrágico, sendo preditor do outcome composto de hemorragia (HEMATS) e de queda de Hb>2 g/dL, sem diferenças significativas na mortalidade e no MACE, o que coloca em questão o benefício desta estratégia. Abstract: Introduction and Objectives: In ST‐segment elevation myocardial infarction (STEMI) the benefit of dual antiplatelet therapy is unequivocal, but the optimal time to administer the loading dose (LD) of a P2Y12 inhibitor is the subject of debate and disagreement. The main aim of this study was characterize current practice in Portugal and to assess the prognostic impact of P2Y12 inhibitor LD administration strategy, before versus during or after primary percutaneous coronary intervention (PCI). Methods: This multicenter retrospective study based on the Portuguese National Registry on Acute Coronary Syndromes included patients with STEMI and PCI performed between October 1, 2010 and September 19, 2017. Two groups were established: LD before PCI (LD‐PRE) and LD during or after PCI (LD‐CATH). Results: A total of 4123 patients were included, 66.3% in the LD‐PRE group and 32.4% in the LD‐CATH group. Prehospital use of a P2Y12 inhibitor was a predictor of the composite bleeding endpoint (major bleeding, need for transfusion or hemoglobin [Hb] drop >2 g/dl), Hb drop >2 g/dl and reinfarction. There were no differences between groups in major adverse events (MAE) (in‐hospital mortality, reinfarction and stroke) or in‐hospital mortality. Conclusions: Prehospital use of a P2Y12 inhibitor was associated with an increased risk of bleeding, predicting the composite bleeding outcome and Hb drop >2 g/dl, with no differences in mortality or MAE, calling into question the benefit of this strategy.

Resumo: Introdução: O score EGSYS para avaliação do doente com síncope em contexto de urgência utiliza variáveis de ordem clínica e foi validado para diferenciar entre síncope de etiologia cardíaca (SC) ou não cardíaca (SNC). Este trabalho pretende determinar se o score tem a mesma aplicabilidade no contexto de consulta. Métodos: Estudo retrospetivo a partir dos registos eletrónicos dos doentes observados em consulta externa de síncope entre janeiro de 2015 e dezembro de 2016. Foi calculado o score EGSYS para cada doente e determinada a sensibilidade e especificidade para a predição de etiologia cardíaca em doentes com score 3. Resultados: Foram avaliados 224 doentes, com média de 64,3 ± 21,7 anos, 116 (51,8%) eram do sexo masculino. Nos 163 (72,7%) com síncope confirmada, o diagnóstico foi de SC em 27 (16,6%) e SNC em 136 (83,4%). O score EGSYS foi 3 em 40 (20,0%) doentes com SNC e em 13 (48,1%) com SC. Um score 3 teve uma sensibilidade de 48,2% (IC 95%: 28,7‐68,1), uma especificidade de 77,9% (CI 95%: 70,0‐84,6), um valor preditivo positivo e negativo de 30,2% (CI 95%: 20,8 – 41,8) e 88,3% (CI 95: 83,9 – 91,7) respetivamente. Conclusão: O score EGSYS tem utilidade limitada no contexto de consulta de síncope, que recebe doentes filtrados por avaliação médica prévia. Dada a sua elevada especificidade e valor preditivo negativo, poderá ter utilidade como tranquilizador do doente e parentes no contexto clínico apropriado. Abstract: Introduction: The EGSYS score uses clinical variables to predict which patients may have cardiac (CS) or non‐cardiac syncope (NCS) and has been validated in the emergency department setting. This study aims to determine whether the score has the same applicability in an outpatient setting. Methods: In this retrospective study of all patients observed in the outpatient setting of a hospital with a syncope unit between January 2015 and December 2016, the EGSYS score was calculated for each patient, and its sensitivity and specificity were determined for the prediction of CS in patients with score ≥3. Results: A total of 224 patients, mean age 64.3±21.7 years, 116 (51.8%) male, were analyzed. In the 163 (72.7%) patients with confirmed syncope, CS was diagnosed in 27 (16.6%) and NCS in 136 (83.4%). The EGSYS score was ≥3 in 40 (20.0%) patients with NCS and in 13 (48.1%) with CS. A positive score had a sensitivity of 48.2% (95% CI: 28.7‐68.1), a specificity of 77.9% (95% CI: 70.0‐84.6), and a positive and negative predictive value of 30.2% (95% CI: 20.8‐41.8) and 88.3% (95% CI: 83.9‐91.7), respectively. Conclusion: The EGSYS score has limited usefulness in an outpatient setting, where observed patients have already been been medically assessed. Given its high specificity and negative predictive value, it may be useful to reassure low‐risk patients and family members.

Introdução/objetivos: A partir de janeiro de 2021, começou em todo país a vacinação, priorizando os mais idosos, seguindo orientações do Plano Nacional de Operacionalização da Vacinação Contra a COVID-19. Até o dia 26/09/21, havia, no estado, 1.278.906 casos confirmados e 65.613 óbitos. O trabalho objetiva analisar epidemiologicamente a variação dos óbitos decorrentes da COVID-19, por faixa etária, nos meses de 2021, no RJ, epicentro da variante delta no país, para contribuir no enfrentamento à pandemia. Métodos: Trata-se de um estudo analítico com observação de registros de óbitos por COVID-19, por faixa etária, de janeiro a setembro de 2021. Os dados de casos confirmados e de óbitos foram retirados, respectivamente, do Painel de Casos de COVID-19 e do Registro Civil, acessados em 24/09/21, para o RJ. Resultados: De janeiro a maio de 2021, as faixas etárias mais elevadas (90-99, 80-89 e 70-79 anos) obtiveram queda percentual no total de óbitos, enquanto as inferiores obtiveram elevação. Já, de maio a setembro de 2021, o inverso foi observado, havendo retorno do % dentre os óbitos por faixa etária a um patamar semelhante ao primeiro mês do ano. Em janeiro de 2021 o percentual de óbitos para as faixas-etárias de 90-99, 80-89, 70-79, 60-69, 50-59, 40-49 e 30-39 anos foram de 8,21, 22,83, 28,89, 22,47, 10,41, 4,41, 4,39 e 1,60%. Em maio, o mesmo ocorreu com 3,16, 10,26, 16,94, 28,07, 21,89, 12,92 e 4,74%. E, por fim, em setembro do mesmo ano a relação estava em 7,38, 24,16, 30,23, 18,61, 9,50, 4,77, 2,94%, seguindo a mesma ordem. Sabe-se que as pessoas mais idosas apresentam mais comorbidades e redução da resposta imunológica devido ao processo de envelhecimento. Conclusão: A mortalidade por COVID-19, em 2021, sofreu uma variação notável, com redução do percentual dos mais idosos afetados, acompanhando o avançar da vacinação dessas faixas, associado a um aumento percentual dos óbitos em faixas etárias ainda não vacinadas, questionando-se sobre uma possível relação entre esses fatores. Ademais, a partir de maio, o retorno ao padrão inicial pode estar associado à maior vacinação em mais jovens e a queda da imunidade vacinal dos mais idosos, pelo tempo ou pela nova variante. Novos estudos devem ser realizados para qualificar essas informações, para subsidiar a tomada de decisão e comprovar a efetiva relação entre eles. Reforça-se a necessidade de priorizar a vacinação com a dose de reforço para a população idosa a fim de salvar vidas.

A progressive fibrosing phenotype is critical in several lung diseases. It is irreversible and associated with early patient mortality. Growing evidence has revealed pulmonary macrophages’ role as modulators of the fibrotic processes. The proportion, phenotype, and function of alveolar (AM) and interstitial macrophages (IM) at the early stages of bleomycin-induced pulmonary fibrosis have not been clearly described. In this way, our study aimed to characterize these macrophage populations and investigate the effect on fibroblast activation. C57BL/6 mice were intratracheally injected with bleomycin and were sacrificed at day 3, 5, and 7 for the performance of flow cytometry and fluorescent-activated cell sorting analysis for protein and gene expression quantification. After bleomycin administration, the proportion of IM was significantly higher than that of AM, which showed a decay during the inflammatory phase, and peaked at day 7. At day 7 of the inflammatory phase, AM started shifting their phenotype from M1-like towards M2, while IM showed a M2-like phenotype. Conditioned medium derived from IM sorted at day 7 induced fibroblast activation and differentiation in myofibroblasts in vitro. Our findings indicate that IM are the largest macrophage population at the early stages of experimental pulmonary fibrosis and are secreted mediators able to activate fibroblasts, pointing to macrophage modulation as a potential therapeutic strategy to restrain progressive fibrosing lung disorders.

Introduction: Functional mobility (FM) is a concept that incorporates the capacity of a person to move independently and safely to accomplish tasks. It has been proposed as a Parkinson's disease (PD) functional and global health outcome. In this study, we aimed to identify which kinematic and clinical outcomes changes better predict FM changes when PD patients are submitted to a specialized multidisciplinary program.Methods: PD patients engaged in a pre-defined specialized multidisciplinary program were assessed at admission and discharge. Change from baseline was calculated for all kinematic and clinical outcomes, and Timed Up and Go (TUG) was defined as the primary outcome for FM. A stepwise multivariate linear regression was performed to identify which outcome measures better predict TUG changes.Results: Twenty-four patients were included in the study. The changes in TUG Cognitive test, supervised step length, and free-living (FL) step time asymmetry were identified as the best predictors of TUG changes. The supervised step length and FL step time asymmetry were able to detect a small to moderate effect of the intervention (d values ranging from −0.26 to 0.42).Conclusions: Our results support the use of kinematic outcome measures to evaluate the efficacy of multidisciplinary interventions on PD FM. The TUG Cognitive, step length, and FL step time asymmetry were identified as having the ability to predict TUG changes. More studies are needed to identify the minimal clinically important difference for step length and FL step time asymmetry in response to a multidisciplinary intervention for PD FM.

Objetivo: avaliar a infusão da nutrição enteral em pacientes adultos internados em unidade de terapia intensiva. Método: estudo descritivo, quantitativo e longitudinal, desenvolvido ao longo de quatro meses em hospital público de alta complexidade, com pacientes em uso da terapia nutricional enteral. Foram realizadas análises estatísticas descritivas com média, desvio-padrão e percentual. Resultados: a administração da nutrição enteral ocorreu de forma precoce após a admissão na unidade de terapia intensiva na maioria dos casos (64%). Em 71% dos pacientes, o volume de infusão da nutrição enteral foi entre 80 e 100% do prescrito. Os fatores que mais limitaram a infusão foram complicações no uso da sonda de alimentação (14%), instabilidade hemodinâmica e clínica (12%), e estase gástrica (12%). Conclusão: a infusão da nutrição enteral mostrou-se satisfatória, e dentre os fatores que limitaram a infusão muitos são passíveis de prevenção com o aprimoramento dos cuidados de enfermagem, requerendo a capacitação da equipe. Descritores: Nutrição Enteral. Unidades de Terapia Intensiva. Cuidados de Enfermagem.

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Tree growth and survival differ strongly between canopy trees (those directly exposed to overhead light), and understory trees. However, the structural complexity of many tropical forests makes it difficult to determine canopy positions. The integration of remote sensing and ground-based data enables this determination and measurements of how canopy and understory trees differ in structure and dynamics. Here we analyzed 2 cm resolution RGB imagery collected by a Remotely Piloted Aircraft System (RPAS), also known as drone, together with two decades of bi-annual tree censuses for 2 ha of old growth forest in the Central Amazon. We delineated all crowns visible in the imagery and linked each crown to a tagged stem through field work. Canopy trees constituted 40% of the 1244 inventoried trees with diameter at breast height (DBH) > 10 cm, and accounted for ~70% of aboveground carbon stocks and wood productivity. The probability of being in the canopy increased logistically with tree diameter, passing through 50% at 23.5 cm DBH. Diameter growth was on average twice as large in canopy trees as in understory trees. Growth rates were unrelated to diameter in canopy trees and positively related to diameter in understory trees, consistent with the idea that light availability increases with diameter in the understory but not the canopy. The whole stand size distribution was best fit by a Weibull distribution, whereas the separate size distributions of understory trees or canopy trees > 25 cm DBH were equally well fit by exponential and Weibull distributions, consistent with mechanistic forest models. The identification and field mapping of crowns seen in a high resolution orthomosaic revealed new patterns in the structure and dynamics of trees of canopy vs. understory at this site, demonstrating the value of traditional tree censuses with drone remote sensing.

Laboratories consume great amounts of hazardous chemicals substances and consequently generate wastewater containing them, for example formaldehyde. This substance is widely utilized to preserve biological samples generating many liters of this residue every year. The present work proposes the use of the photo-Fenton process to treat formaldehyde wastewater using sunlight irradiation. Some aspects were investigated such as the iron source, sample and hydrogen peroxide concentration and also the use of stirred systems. The use of ferrioxalate (0.5 mmol L-1) improved the efficiency of the process in relation to the use of iron nitrate, while at least 1.0 mol L-1 H2O2 is necessary to treat the sample of the 500 mg C L-1. Under these conditions, every formaldehyde detectable was degradeted and 89% of the dissolved organic carbon was removed in two hours of exposure to sunlight. These results are satisfaction considerate for São Paulo State Environmental Agency.

Heatwaves are an extreme meteorological event in which affected populations may also be exposed to deteriorated air quality conditions due to the increase in air pollutant concentrations, such as PM10 (particulate matter < 10 µg/m3). In order to identify heatwaves (1973–2019) in the region of Faro (Algarve) during the hot season (April–September), the Excess Heat Factor (EHF) index was applied. The Mann–Kendall test revealed an upward trend in three heatwave metrics in Faro, and the trend of accumulated heat load (EHF load) was also positive as would be expected, but its signal was not statistically significant. An inventory of North African dust events (2006–2019) was made, and their simultaneous occurrence with heatwaves was assessed, pointing to only 20% of dust events of the Sahara occurring simultaneously with heatwave days. A cluster analysis was conducted on daily geopotential height fields at 850 hPa level over the 2006–2019 period, and four distinct patterns were identified as the most prominent synoptic circulations promoting both heatwave conditions and North African dust over the Algarve.

A incidência de neoplasias cutâneas nos pequenos animais cresce diariamente. Com isso, também aumenta-se as opções de tratamento cirúrgico por meio das técnicas reconstrutivas. O diagnóstico específico de cada neoplasia pode ser sugerido por exames citológicos, mas sua confirmação usualmente é feita pela análise histopatológica. Objetivou-se relatar o caso de um paciente canino com neoplasia cutânea em região frontoparietal que obteve sucesso após a exérese cirúrgica do tumor e confecção de um retalho subdérmico de avanço. Foi atendido um canino, 3 anos, SRD, 7 kg, com tumoração cutânea ulcerada em região frontoparietal de 5 cm de diâmetro com evolução de 10 meses. O exame citológico foi sugestivo de sarcoma. Deste modo, optou-se pela exérese cirúrgica com margem de segurança. Iniciou-se a cirurgia com a retirada do tecido cutâneo e subcutâneo em forma retangular com 1 cm de margem a partir do tumor. Após a observação do grande defeito criado, realizou-se um retalho de padrão subdérmicos de avanço a partir da região cervical dorsal do paciente. O retalho foi criado com o mesmo comprimento e largura do defeito. A pele doadora foi aposicionada junto a pele receptora em padrão simples isolado com fio de sutura de náilon 3-0. Antes de se completar toda a sutura, um dreno de Penrose foi instalado na região. Foram utilizados no pós-operatório: antibiótico, analgésico, anti-inflamatório e protetor gástrico; uso de colar elisabetano e limpeza da ferida a cada 24 horas. No quinto dia pós-operatório, o animal apresentou deiscência da sutura do dreno. O dreno foi retirado neste mesmo dia e o tutor foi orientado a continuar com a limpeza da ferida e manter o uso do antibiótico. Como previsto, a ferida foi cicatrizada com excelência em 15 dias após a cirurgia. O exame histopatológico foi realizado e descartou-se a suspeita de tumoração maligna. A cirurgia reconstrutiva com retalho de avanço da região cervical dorsal foi impereterível para recobrir o grande defeito criado após a exérese da neoplasia, mantendo boa vascularização da região; sem alterar a posição anatômica das pálpebras superiores e pinas. Conclui-se que o procedimento cirúrgico feito, teve pleno sucesso no caso relatado.

ABSTRACT Buttresses and other natural structures modify the shape of stems in Amazonia and change the diameter at breast height (DBH) measured at 1.3 m at ground level. The lack of adequate measurement techniques affects negatively forest dynamics analyses and biomass estimating. The study evaluated an indirect method of measuring diameters in trees with DBH > 40 cm using principles of digital photogrammetry. The results obtained with two cameras (smartphone and Sony) were compared with direct measurements using diametric tape and a ladder. The technique is adequate to measure the diameters of trees with measurement point above 2 m of ground, with a confidence interval of ±1cm. The use of photogrammetry as a supplementary tool to the diametric tape (IC ± 0.24 cm) is recommended, helping to measure trees with diameter above the reach of the technician in forest inventories.

El artículo es un intento de entender las percensiones de los profesores de las Universidades de Piauí, Maranhão y Rio Grande do Norte con respecto a la gestión de la cadena de suministro verde en el sector de la hostelería. La metodología utilizada fue una investigación cualitativa exploratoria con la aplicación de tres cuestionarios relacionados con las prácticas ambientales en la industria de la hospitalidad a los profesores de turismo de dichas universidades. Los resultados del estudio indicaron que los profesores entienden perfectamente las mejores prácticas ambientales en la industria de la hostelería, como el uso eficiente del agua y la energía y la reducción de los residuos sólidos, pero que este conocimiento no se filtra al sector empresarial, lo que impide la gestión de la cadena de suministro verde en la práctica.

The influence of some operational parameters such as stirring the solution during solar irradiation and the solution flow rate into artificial irradiation photoreactor were evaluated on the photodegradation of 2-chlorophenol (2CP) and 2,4-diclorophenol (DCP) by photo-Fenton process mediated by ferrioxalate. After evaluation of these parameters, the systems were applied to photodegradation of phenol and mono (2-chlorophenol and 4-clorophenol), di (2,4-dichlorophenol) and tri (2,4,6-trichlorophenol) chlorophenols to evaluate the photodegradation efficiency of these compounds under solar as well as artificial irradiation. Small differences in the percentages of total organic carbon (TOC) removal and generation of chloride ions were observed with and without stirring the solution during solar irradiation of 2CP. Under artificial irradiation, the increase of flow rate resulted in lower TOC removal, while a higher rate of TOC removal was obtained due to a shorter irradiation time. An intermediate flow rate of 33.4 mL min-1 was then used. Under solar irradiation, 15 minutes irradiation were necessary for complete removal of all chlorophenols, however, the complete removal of phenol was achieved in 20 minutes. Under artificial irradiation, the chlorophenols were removed between 4.5 and 6.5 minutes of irradiation. The degradation rates increased slightly with the increase of the number of chlorides bonded to the aromatic ring under solar as well as artificial irradiation.

O artigo analisa a relação entre a organização do trabalho familiar no extrativismo e a participação em programas de políticas públicas no estado de Sergipe. Com abordagem predominantemente qualitativa, a pesquisa foi realizada com mulheres autodesignadas catadoras de mangaba e marisqueiras, reconhecidas como pertinentes ao segmento dos denominados povos e comunidades tradicionais e afiliadas ao Programa Bolsa Família (PBF), ao Seguro Desemprego do Pescador Artesanal (SDPA) e ao Programa de Aquisição de Alimentos (PAA). A metodologia constou de observações e entrevistas com diferentes atores envolvidos na atividade extrativista e nos programas de políticas públicas. As principais conclusões mostram que os programas de políticas públicas influenciam: i) na reorganização do cotidiano do trabalho no extrativismo, principalmente no tocante à diminuição do envolvimento de crianças e jovens na atividade e quanto à intensidade das jornadas; ii) no reforço aos papéis tradicionais de homens e mulheres, no caso do PBF, e na diluição de fronteiras entre esses mesmos papéis no PAA; iii) na diminuição do volume de trabalho no caso do SDPA e no aumento no PAA; e iv) nos diferentes sentidos que são atribuídos ao trabalho.

As infeções do trato urinário associadas à cateterização são muito frequentes no contexto comunitário e hospitalar. Existem atualmente várias recomendações para sua prevenção, contudo, quando abordado o soluto a utilizar no meato urinário previamente à algaliação continuam a persistir dúvidas. Assim, este estudo procurou determinar a eficácia da limpeza do meato urinário com água ou soro fisiológico comparativamente à sua assepsia por meio de uma revisão sistemática com metanálise. Para isso foram seguidos os princípios propostos pelo Cochrane Handbook , a análise crítica realizada por dois investigadores e a análise estatística com recurso ao programa STATA 11.1. Podemos concluir que a limpeza ou desinfeção do meato urinário previamente à cateterização vesical não é estatisticamente significativa (OR=1,07, IC 95%=0,68-1,68, p=0,779), existindo alguma evidência de que a utilização de água/soro fisiológico reduz as taxas de ITU.

This article examines the perceptions of students of tourism in UFRN, about the study of the dimensions of touristic sustainability along the Course. The specific objectives were: to draw the learners’ profile; to verify awareness, competence and preparation of students in relation to the dimensions of touristic sustainability; to identify the concerns of students in relation to the Course. The methodology had a descriptive-exploratory character, with qualitative-quantitative approach, through analyzes using a statistical software. It was found that most learners are young and does not work in the area, despite their capacitation; they are aware about the environmental issues, but they are unreliable to deal with some social aspects, they have concerns about the disciplines and the conciliation of theory with practice.

A utilização de sistemas de informação geográfica (SIG) no planejamento florestal possibilita a análise e o reconhecimento de padrões espaciais das espécies florestais em perfil bidimensional e tridimensional. O objetivo deste estudo foi demonstrar a eficiência do método de coordenadas cartesianas e espaciais (MCCE), método de correção da localização das coordenadas UTM das árvores em concordância com a localização de campo ou cartesianas (X,Y), aliado ao cálculo do índice do vizinho natural (ANND) no reconhecimento e análise de padrões espaciais de quatro espécies comerciais madeireiras em área de manejo florestal em Caracaraí, RR, Brasil. O ANND pressupõe completa aleatoriedade espacial.Simulações foram realizadas em 9 ha, subdivididos em 100 subparcelas de 100 m2 cada. Foram coletados: o diâmetro (DAP > 10 cm), alturas comercial e total, volume comercial e as coordenadas cartesianas (X,Y) e espaciais (UTM). Foram observados padrões espaciais aleatórios para Eschweilera bracteosa e Manilkara huberi. Os padrões espaciais dispersos e raros foram mais observados em Cedrelinga cateniformis e Dinizia excelsa. O MCCE demonstrou ser um método eficiente para o reconhecimento e análise de padrões espaciais de espécies nativas da floresta tropical amazônica, facilitando o planejamento florestal mediante simulações 2D e 3D da floresta.

This paper is a theoretical essay focused on the conceptual relations of ecotourism in the process of globalization and the contradictions involving economic growth and development. In the methodological procedures rose the following hypothesis: community-based ecotourism is an ally of the construction of the development of local peoples. It had been worked on issues such as the involvement of social economy, community tourism and ecotourism in the prospect of collaborating with the insertion of the local community in tourism. In this context, this work addresses issues ofcommunity-based ecotourism, questioning the development imperative in the formation of well-being of humans and also noting its benefits to the local community.

The concern about aquatic ecosystems and the potential risk of drinking water contamination by pharmaceuticals have stimulated the study of processes for the efficient degradation of these contaminants, since the conventional treatment have been inefficient on that purpose. The advanced oxidation processes (AOPs) appear as viable alternatives due to their efficiency on the degradation of different classes of organic contaminants. This review presents an overview of the main AOP (O3, H2O2/UV, TiO2/UV, Fenton and photo-Fenton) which have been applied to the degradation of different pharmaceuticals. The main results obtained, intermediates identified and toxicity data are presented.

Sediment samples from the Barigui River in Curitiba, south of Brazil, were evaluated following granulometric composition, organic carbon content, nitrogen, phosphorus and metals such as zinc, lead, chrome, nickel and cadmium. The sediments shown high percentage of phosphorus and nitrogen. Also the elemental organic C:N:P exceed the Redfield ratios possible because the large amount of sewage input into river. The presence of metals is also high, however the metal cadmium has not been found. But the other metals are in greater concentrations and possibly the presence of these metals is given by industrial and domestic sewage.

The objective of this work was to evaluate the environmental distribution of benzo(a)pirene, a polycyclic aromatic hydrocarbon, by the EQC model. The modeling of the contaminant distribution was accomplished by means of the fugacity model applied to a hypothetical scenario constituted by air, water, soil and sediment. The modeling and simulations revealed that the soil is the preferential compartment. We also discuss the implications of the results about fate and ecological risks associated with benzo(a)pirene. We concluded that the emissions of HPAs can not be ignored and bioaccumulation among others risks can be induced.

Substantial amounts of organic matter (OM) from terrestrial ecosystems are buried as sediments in inland waters. It is still unclear to what extent this OM constitutes a sink of carbon, and how much of it is returned to the atmosphere upon mineralization to carbon dioxide (CO2). The construction of reservoirs affects the carbon cycle by increasing OM sedimentation at the regional scale. In this study we determine the OM mineralization in the sediment of three zones (river, transition and dam) of a tropical hydroelectric reservoir in Brazil as well as identify the composition of the carbon pool available for mineralization. We measured sediment OC mineralization rates and related them to the composition of the OM, bacterial abundance and pCO2 of the surface water of the reservoir. Terrestrial OM was an important substrate for the mineralization. In the river and transition zones most of the OM was allochthonous (56 % and 48 %, respectively) while the dam zone had the lowest allochthonous contribution (7 %). The highest mineralization rates were found in the transition zone (154.80 ± 33.50 mg C m-2 d-1) and the lowest in the dam (51.60 ± 26.80 mg C m-2 d-1). Moreover, mineralization rates were significantly related to bacterial abundance (r2 = 0.50, p < 0.001) and pCO2 in the surface water of the reservoir (r2 = 0.73, p < 0.001). The results indicate that allochthonous OM has different contributions to sediment mineralization in the three zones of the reservoir. Further, the sediment mineralization, mediated by heterotrophic bacteria metabolism, significantly contributes to CO2 supersaturation in the water column, resulting in higher pCO2 in the river and transition zones in comparison with the dam zone, affecting greenhouse gas emission estimations from hydroelectric reservoirs.

Este artículo examina las percepciones de los estudiantes de turismo en la UFRN, sobre el estudio de las dimensiones de la sostenibilidad turística a lo largo del Curso. Los objetivos específicos fueron: trazar el perfil de los alumnos; verificar la concienciación, competencia y preparación de los estudiantes en relación a las dimensiones de la sostenibilidad turística; identificar las preocupaciones de los estudiantes en relación al Curso. La metodología tuvo un carácter descriptivo-explorativo, con enfoque cualitativo-cuantitativo, a través de análisis con un software estadístico. Se encontró que la mayoría de los estudiantes son jóvenes y no trabajan en el área, a pesar de su capacitación; están conscientes de los temas ambientales, pero no son confiables para tratar algunos aspectos sociales, tienen inquietudes sobre las disciplinas y la conciliación de la teoría con la práctica.