ABSTRACT
Effects of anthropogenic activities, including climate change, are modifying fire regimes, and the dynamic nature of these modifications requires identification of general patterns of organisms' responses to fire. This is a challenging task because of the high complexity of factors involved (including climate, geography, land use, and species-specific ecology). We aimed to describe the responses of the reptile community to fire across a range of environmental and fire-history conditions in the western Mediterranean Basin. We sampled 8 sites that spanned 4 Mediterranean countries. We recorded 6064 reptile sightings of 36 species in 1620 transects and modeled 3 community metrics (total number of individuals, species richness, and Shannon diversity) as responses to environmental and fire-history variables. Reptile community composition was also analyzed. Habitat type (natural vs. afforestation), fire age class (time since the last fire), rainfall, and temperature were important factors in explaining these metrics. The total number of individuals varied according to fire age class, reaching a peak at 15-40 years after the last fire. Species richness and Shannon diversity were more stable during postfire years. The 3 community metrics were higher under postfire conditions than in unburned forest plots. This pattern was particularly prevalent in afforested plots, indicating that the negative effect of fire on reptiles was lower than the negative effect of afforestation. Community composition varied by fire age class, indicating the existence of early- and late-successional species (xeric and saxicolous vs. mesic reptiles, respectively). Species richness was 46% higher in areas with a single fire age class relative to those with a mixture of fire age classes, which indicates pyrodiverse landscapes promoted reptile diversity. An expected shift to more frequent fires will bias fire age distribution toward a predominance of early stages, and this will be harmful to reptile communities.
Respuestas de reptiles al fuego en la Cuenca Mediterránea occidental Resumen Los efectos de actividades antropogénicas, incluyendo el cambio climático, están modificando los regímenes de fuego, y la naturaleza dinámica de estas modificaciones requiere la identificación de patrones generales de las respuestas de los organismos al fuego. Esta es una tarea desafiante debido a la gran complejidad de los factores involucrados (incluyendo clima, geografía, uso de suelo y la ecología de cada especie). Nuestro objetivo fue describir las respuestas de la comunidad de reptiles al fuego bajo diversas condiciones ambientales e historias de fuego en la Cuenca Mediterránea occidental. Muestreamos ocho sitios en cuatro países mediterráneos. Registramos 6064 avistamientos de reptiles de 36 especies en 1620 transectos y modelamos tres métricas comunitarias (número total de individuos, riqueza de especies y diversidad de Shannon) como respuestas a las variables ambientales y de historia de fuego. También analizamos la composición de la comunidad de reptiles. El tipo de hábitat (natural versus forestación), la clase de edad del fuego (tiempo transcurrido desde el último incendio), la precipitación pluvial y la temperatura fueron factores importantes en la explicación de estas métricas. El número total de individuos varió de acuerdo con la clase de edad del fuego, alcanzando un pico a los 1540 años después del último incendio. La riqueza de especies y la diversidad de Shannon fueron más estables durante los años posteriores a incendios. Las tres métricas de la comunidad fueron más altas bajo condiciones post incendio que en las parcelas sin historial de fuego. Este patrón fue particularmente prevalente en parcelas forestadas, lo cual indica que el efecto negativo del fuego sobre los reptiles fue menor que el efecto negativo de la forestación. La composición de la comunidad varió por clase de edad del fuego, indicando la existencia de especies sucesionales tempranas y tardías (reptiles xéricos y saxícolas, respectivamente). La riqueza de especie fue 46% mas alta en áreas con una sola clase de edad del fuego que en aquellas con una mezcla de clases de edad del fuego, lo cual indica que los paisajes pirodiversos promovieron la diversidad de reptiles. Un cambio esperado hacia incendios más frecuentes sesgará la distribución de la edad del fuego hacia una predominancia de etapas tempranas, y esto será perjudicial para las comunidades de reptiles.
ABSTRACT
Wildfires are considered a major disturbance to forest ecosystems in the Mediterranean countries of Southern Europe. Although ground-dwelling macroinvertebrates are crucial to many soil functions, there is a fundamental lack of understanding of how wildfires impact this community in the immediate term and of the role of stones in their survival. Hence, in the present study we assessed the immediate effects of wildfires in the ground-dwelling macroinvertebrate community found under stones by comparing communities in burnt and non-burnt Mediterranean oak forests. Our results revealed that stones allowed the survival of many taxa in the burnt area. However, abundance, richness, diversity, and equitability per stone were significantly lower at the burnt than unburnt sites. Furthermore, the results also showed that richness and abundance increased significantly with increasing stone depth and area, both at the burnt and unburnt sites. Significant changes at the trophic level were observed in the burnt area comparing to the unburnt, particularly a decline in predators. No significant differences were identified concerning habitat associations among taxa. Overall, this study stressed the role of stones as microhabitats and refuge for the ground-dwelling macroinvertebrate community during wildfires.
ABSTRACT
Bird nests on transmission lines can cause electrical faults which reduce service reliability. To address this problem, since the mid-90s, the Portuguese Transmission System Operator (TSO) has undertaken management actions to discourage white storks Ciconia ciconia from nesting in hazardous locations of the pylons. Here, we compiled and analyzed an 18-year series of data on electrical faults, TSO management actions to tackle these, and stork nests on transmission pylons in Portugal to: (a) determine the relative importance of bird-related faults over the total number of faults; (b) describe variations in bird-related faults across time (season of the year and time of the day); (c) describe spatial variations in bird-related faults and their association with the occurrence of white stork nests on pylons; and (d) analyze the trends, over the years, of the number of white stork nests on pylons, the TSO management actions and their effectiveness in reducing bird-related fault rates. Overall, birds accounted, on average, for 25.3% of the electrical faults in the transmission network, with the vast majority being attributed to white storks. The seasonal pattern of bird-related faults showed higher rates in April and in October-November. Faults occurred more often during the night period, when storks spend more time on the pylons. We found a positive spatial relationship between the electrical fault rate and the proportion of pylons with stork nests (and the correlated number of nests per 100 km of line). There was, however, considerable variation in the fault rates not explained by the stork nest variables, particularly during the non-breeding season. The TSO management actions (namely removal/translocation of nests in hazardous locations of the pylons, installation of anti-perching devices and provision of alternative nesting platforms) significantly reduced, as a whole, the annual number of bird-related faults between 2001 and 2018, despite the three-fold increase in the number of white stork nests on transmission pylons. A deeper understanding of how white storks use the transmission pylons outside the breeding season is needed, so that targeted management actions can be taken to reduce the remaining bird-related fault rates to residual levels.
Subject(s)
Birds , Animals , Reproducibility of Results , Seasons , PortugalABSTRACT
PURPOSE: The mediator (MED) multisubunit-complex modulates the activity of the transcriptional machinery, and genetic defects in different MED subunits (17, 20, 27) have been implicated in neurologic diseases. In this study, we identified a recurrent homozygous variant in MED11 (c.325C>T; p.Arg109Ter) in 7 affected individuals from 5 unrelated families. METHODS: To investigate the genetic cause of the disease, exome or genome sequencing were performed in 5 unrelated families identified via different research networks and Matchmaker Exchange. Deep clinical and brain imaging evaluations were performed by clinical pediatric neurologists and neuroradiologists. The functional effect of the candidate variant on both MED11 RNA and protein was assessed using reverse transcriptase polymerase chain reaction and western blotting using fibroblast cell lines derived from 1 affected individual and controls and through computational approaches. Knockouts in zebrafish were generated using clustered regularly interspaced short palindromic repeats/Cas9. RESULTS: The disease was characterized by microcephaly, profound neurodevelopmental impairment, exaggerated startle response, myoclonic seizures, progressive widespread neurodegeneration, and premature death. Functional studies on patient-derived fibroblasts did not show a loss of protein function but rather disruption of the C-terminal of MED11, likely impairing binding to other MED subunits. A zebrafish knockout model recapitulates key clinical phenotypes. CONCLUSION: Loss of the C-terminal of MED subunit 11 may affect its binding efficiency to other MED subunits, thus implicating the MED-complex stability in brain development and neurodegeneration.
Subject(s)
Mediator Complex , Microcephaly , Neurodegenerative Diseases , Animals , Humans , Homozygote , Mediator Complex/genetics , Microcephaly/genetics , Neurodegenerative Diseases/genetics , RNA , Zebrafish/geneticsABSTRACT
Anthropogenic structures are increasingly encroaching wildlife habitats, creating conflicts between humans and animals. Scaling up renewable energy requires new infrastructures such as power lines, that cause high mortality among birds since they act as obstacles to flight and are used for perching and nesting, which can result in collisions or electrocutions. These interactions often endanger wildlife populations and may also result in high financial costs for companies. Flight behaviour plays a crucial role in collision risk, and the study of flight altitudes enables us to understand what drives birds to fly at collision risk altitudes. This allows the identification of high-risk areas, conditions and bird behaviours, and the implementation of mitigation measures by power line companies. In this study, we use boosted random tree modelling to identify drivers of white stork (Ciconia ciconia) flight altitudes and to investigate the factors that lead them to fly at collision risk altitudes. We found that the main drivers of flight altitude for this soaring bird species were time of day, distance to the nearest landfill site and cloud cover density. Bird age, habitat type and season were comparatively less important. Collision risk increases during crepuscular hours near landfill sites, also in days with high cloud cover density and during the breeding season. In recent years, hundreds to thousands of storks congregate daily at landfill sites to take advantage of the predictability and superabundance of anthropogenic food waste. Some of these sites have high density of power lines, becoming collision risk hotspots for storks and other landfill users. Despite being susceptible to collision, our results suggest that white storks can avoid power lines to a certain extent, by changing their flight altitude at ca. 80 m from these structures. This study shows that the implementation of mitigation measures for existing power lines should be prioritized in areas in the vicinity of landfill sites within white stork distribution ranges, and the projection of new lines should avoid those areas. These measures would benefit species vulnerable to mortality due to power line collision, and it would also reduce associated power outages and economic costs.
Subject(s)
Altitude , Refuse Disposal , Animals , Birds , Flight, Animal , Food , Humans , Plant Breeding , Waste Disposal FacilitiesABSTRACT
Wind energy production has expanded to meet climate change mitigation goals, but negative impacts of wind turbines have been reported on wildlife. Soaring birds are among the most affected groups with alarming fatality rates by collision with wind turbines and an escalating occupation of their migratory corridors. These birds have been described as changing their flight trajectories to avoid wind turbines, but this behaviour may lead to functional habitat loss, as suitable soaring areas in the proximity of wind turbines will likely be underused. We modelled the displacement effect of wind turbines on black kites (Milvus migrans) tracked by GPS. We also evaluated the impact of this effect at the scale of the landscape by estimating how much suitable soaring area was lost to wind turbines. We used state-of-the-art tracking devices to monitor the movements of 130 black kites in an area populated by wind turbines, at the migratory bottleneck of the Strait of Gibraltar. Landscape use by birds was mapped from GPS data using dynamic Brownian bridge movement models, and generalized additive mixed modelling was used to estimate the effect of wind turbine proximity on bird use while accounting for orographic and thermal uplift availability. We found that areas up to approximately 674 m away from the turbines were less used than expected given their uplift potential. Within that distance threshold, bird use decreased with the proximity to wind turbines. We estimated that the footprint of wind turbines affected 3%-14% of the areas suitable for soaring in our study area. We present evidence that the impacts of wind energy industry on soaring birds are greater than previously acknowledged. In addition to the commonly reported fatalities, the avoidance of turbines by soaring birds causes habitat losses in their movement corridors. Authorities should recognize this further impact of wind energy production and establish new regulations that protect soaring habitat. We also showed that soaring habitat for birds can be modelled at a fine scale using publicly available data. Such an approach can be used to plan low-impact placement of turbines in new wind energy developments.
Subject(s)
Birds , Flight, Animal , Animals , Climate Change , EcosystemABSTRACT
The expansion of overhead power lines worldwide challenges companies of energy transmission and distribution, regulators and environmental consultants, among other stakeholders, to effectively mitigate their negative impacts on wildlife. Wire-marking is currently the most widespread and recommended measure to reduce bird collisions with these infrastructures. Nevertheless, and despite its importance for a bird-friendly development of energy projects, there is still much uncertainty about what explains wire-marking effectiveness. We performed an extensive literature review and meta-analysis to evaluate the overall effectiveness of wire-marking in reducing bird collisions with power lines, including the possible influencing factors of power line voltage, habitat and type of device. We gathered data from 35 field studies across the world (which included 66 trials) assessing the effectiveness of wire-marking based on regular carcass searches beneath power lines. Overall, wire-marking reduced bird collisions with power lines by half (50.4%; 95% Confidence Interval Estimate: 40.4-58.8%), although this estimate of effectiveness is lower than the one reported in a meta-analysis performed in 2011. Despite the effort to include both peer-reviewed and grey literature studies in the present meta-analysis, the risk of publication bias could not be entirely excluded and may be still overestimating the true overall effect of wire-marking. High heterogeneity among the study outcomes hindered the power to detect clear moderating effects, with none of explanatory variables being statistically significant. Large between-study heterogeneity is (to some extent) explained by the variety of anti-collision devices available, wire-marking intensities used and ecological circumstances in which the experiments were carried out. Nonetheless, it may be also related to within-study methodological biases and reporting gaps in the existing field studies. Robust experimental designs (ideally using Before-After-Control-Impact approaches), comprehensive reporting of results and broad dissemination of study findings are needed to increase the statistical power of future meta-analyses. Ways to achieve these improvements in field studies are presented in detail. Their inclusion in future meta-analyses will increase the knowledge on the drivers of wire-marking effectiveness, which is critical to better inform decision-making processes and environmental management plans.
Subject(s)
Animals, Wild , Birds , Animals , EcosystemABSTRACT
The Mediterranean region is projected to be extremely vulnerable to global change, which will affect the distribution of typical forest types such as native oak forests. However, our understanding of Mediterranean oak forest responses to future conditions is still very limited by the lack of knowledge on oak forest dynamics and species-specific responses to multiple drivers. We compared the long-term (1966-2006) forest persistence and land cover change among evergreen (cork oak and holm oak) and deciduous oak forests and evaluated the importance of anthropogenic and environmental drivers on observed changes for Portugal. We used National Forest Inventories to quantify the changes in oak forests and explored the drivers of change using multinomial logistic regression analysis and an information theoretical approach. We found distinct trends among oak forest types, reflecting the differences in oak economic value, protection status and management schemes: cork oak forests were the most persistent (62%), changing mostly to pines and eucalypt; holm oak forests were less persistent (53.2%), changing mostly to agriculture; and deciduous oak forests were the least persistent (45.7%), changing mostly to shrublands. Drivers of change had distinct importance across oak forest types, but drivers from anthropogenic origin (wildfires, population density, and land accessibility) were always among the most important. Climatic extremes were also important predictors of oak forest changes, namely extreme temperatures for evergreen oak forests and deficit of precipitation for deciduous oak forests. Our results indicate that under increasing human pressure and forecasted climate change, evergreen oak forests will continue declining and deciduous oak forests will be replaced by forests dominated by more xeric species. In the long run, multiple disturbances may change competitive dominance from oak forests to pyrophytic shrublands. A better understanding of forest dynamics and the inclusion of anthropogenic drivers on models of vegetation change will improve predicting the future of Mediterranean oak forests.
Subject(s)
Climate Change , Forests , Quercus , Agriculture , PortugalABSTRACT
Car surveys (CS) are a common method for assessing the distribution of alien invasive plants. Google Street View (GSV), a free-access web technology where users may experience a virtual travel along roads, has been suggested as a cost-effective alternative to car surveys. We tested if we could replicate the results from a countrywide survey conducted by car in Portugal using GSV as a remote sensing tool, aiming at assessing the distribution of Eucalyptus globulus Labill. wildlings on roadsides adjacent to eucalypt stands. Georeferenced points gathered along CS were used to create road transects visible as lines overlapping the road in GSV environment, allowing surveying the same sampling areas using both methods. This paper presents the results of the comparison between the two methods. Both methods produced similar models of plant abundance, selecting the same explanatory variables, in the same hierarchical order of importance and depicting a similar influence on plant abundance. Even though the GSV model had a lower performance and the GSV survey detected fewer plants, additional variables collected exclusively with GSV improved model performance and provided a new insight into additional factors influencing plant abundance. The survey using GSV required ca. 9 % of the funds and 62 % of the time needed to accomplish the CS. We conclude that GSV may be a cost-effective alternative to CS. We discuss some advantages and limitations of GSV as a survey method. We forecast that GSV may become a widespread tool in road ecology, particularly in large-scale vegetation assessments.
Subject(s)
Environmental Monitoring/methods , Eucalyptus , Geographic Mapping , Introduced Species/statistics & numerical data , Plant Weeds , Remote Sensing Technology , Internet , Portugal , Surveys and QuestionnairesABSTRACT
Cluster (or island) statistics and topological statistical mechanics based properties were employed in the analyses of hydrogen bond (H-bond) networks of t-butanol, n-butanol and ammonia aqueous solutions. These networks were generated from equilibrated Monte Carlo simulations at mixture compositions covering the entire range of miscibility and a fine grid of points around the topological transitions. We found that these H-bond networks changed from a percolation regime in water rich mixtures to a non-percolating behavior at non-aqueous component rich compositions. Topological analysis of local (clustering coefficients, average degrees) semi-global (path lengths) and global (spectral densities) properties indicated the presence of small-world patterns for the H-bond networks in mixtures at mole fraction compositions larger than ca. 0.6. These small-world patterns are characterized by highly clustered networks with small path lengths. Spectral densities show high order moment contributions that correlate with small-world patterns, thus corroborating the robustness of these statistical mechanics based topological analyses. The degree distributions of these networks were partially rationalized by the differences in the water-water and solute-solute H-bonds.
ABSTRACT
The study aimed to analyse incidence and characteristics of time-loss injuries and illnesses during the FIFA World Cup Qatar 2022. Of 838 male football players, 705 consented to participate. Team medical staff reported 82 time-loss injuries, corresponding to an injury event incidence of 5.6 injuries/1000 h of total exposure (95%CI 4.5 to 7.0 injuries/1000 h), with a median of 2 time-loss injury events per team (IQR, 1 to 4.5, range 0-7). The total injury burden was 103 (95% CI 61 to 152) days per 1000 h. Muscle/tendon injuries had the highest incidence of tissue types (48 cases, 3.3/1000 h (95% CI 2.5 to 4.4), and hamstring muscle injuries were the most frequent diagnosis (16 cases, incidence 1.1/1000 h, 95% CI 0.6 to 1.8). Match injury event incidence was 20.6/1000 h (15.0 to 27.7) and training injury event incidence was 2.1/1000 h (1.4 to 3.1). The majority (52%) of sudden-onset injuries were non-contact injuries, 40% direct contact and 8% indirect contact. We recorded 15 time-loss illnesses, corresponding to an illness event incidence of 1.1 per 1000 competition days, (95% CI: 0.6 to 1.8), and illness burden of 2.1 (1.0 to 3.4) days lost per 1000 competition days. The most common illness was respiratory infection (12 cases, 80%). Match injury event incidence was the lowest in any FIFA World Cup since injuries have been monitored.
ABSTRACT
Introduction: Small bowel adenocarcinoma is a rare but well-known complication of Crohn's disease. Diagnosis can be challenging, as clinical presentation may mimic an exacerbation of Crohn's disease and imaging findings may be indistinguishable from benign strictures. The result is that the majority of cases are diagnosed at the time of operation or postoperatively at an advanced stage. Case Presentation: A 48-year-old male with a previous 20-year history of ileal stenosing Crohn's disease presented with iron deficiency anemia. The patient reported melena approximately 1 month earlier but was currently asymptomatic. There were no other laboratory abnormalities. Anemia was refractory to intravenous iron replacement. The patient underwent computerized tomography enterography, which revealed multiple ileal strictures with features suggesting underlying inflammation and an area of sacculation with circumferential thickening of adjacent bowel loops. Therefore, the patient underwent retrograde balloon-assisted small bowel enteroscopy, where an area of irregular mucosa and ulceration was found at the region of ileo-ileal anastomosis. Biopsies were performed and histopathological examination revealed tubular adenocarcinoma infiltrating the muscularis mucosae. The patient underwent right hemicolectomy plus segmental enterectomy of the anastomotic region where the neoplasia was located. After 2 months, he is asymptomatic and there is no evidence of recurrence. Discussion: This case demonstrates that small bowel adenocarcinoma may have a subtle clinical presentation and that computed tomography enterography may not be accurate enough to distinguish benign from malignant strictures. Clinicians must, therefore, maintain a high index of suspicion for this complication in patients with long-standing small bowel Crohn's disease. In this setting, balloon-assisted enteroscopy may be a useful tool when there is raised concern for malignancy, and it is expected that its more widespread use could contribute to an earlier diagnosis of this severe complication.
Introdução: O adenocarcinoma do intestino delgado é uma complicação rara mas bem estabelecida da doença de Crohn. O seu diagnóstico pode ser desafiante, na medida em que a apresentação clínica pode mimetizar uma agudização da doença de Crohn e os achados imagiológicos podem ser indistinguíveis de estenoses benignas. Em consequência, a maioria dos casos são diagnosticados durante ou após a cirurgia em estadio avançado. Descrição do caso: Um homem de 48 anos com antecedentes de doença de Crohn ileal estenosante, com 20 anos de evolução, apresentou-se com anemia ferropénica. O doente referia melenas aproximadamente um mês antes, mas encontrava-se atualmente assintomático. Não apresentava outras alterações laboratoriais de relevo. A anemia era refratária a suplementação com ferro endovenoso. Foi submetido a enterografia por tomografia computorizada, que revelou múltiplas estenoses ileais com caraterísticas sugestivas de atividade inflamatória e uma área de saculação com espessamento circunferencial das ansas de intestino delgado adjacentes. Assim, foi submetido a enteroscopia assistida por balão, onde se identificou uma área de mucosa irregular e ulceração na região da anastomose ileo-ileal. Biópsias desta área revelaram a presença de adenocarcinoma tubular com infiltração até à muscularis mucosae. O doente foi submetido a hemicolectomia direita com enterectomia segmentar da região da anastomose onde a neoplasia se encontrava localizada. Ao fim de 2 meses, o doente encontra-se assintomático e sem evidência de recorrência. Discussão: Este caso demonstra que o adenocarcinoma do intestino delgado pode ter uma apresentação clínica subtil e que a enterografia por tomografia computorizada pode não ter precisão suficiente para distinguir estenoses benignas de neoplasias malignas. Os clínicos devem, portanto, manter um elevado índice de suspeição diagnóstica para esta complicação em doentes com doença de Crohn ileal de longa duração. Neste contexto, a enteroscopia assistida por balão pode ser uma ferramenta útil em casos de suspeita de neoplasia maligna, esperando- se que possa contribuir para um diagnóstico mais precoce desta complicação severa.
ABSTRACT
Alternative migratory strategies can coexist within animal populations and species. Anthropogenic impacts can shift the fitness balance between these strategies leading to changes in migratory behaviors. Yet some of the mechanisms that drive such changes remain poorly understood. Here we investigate the phenotypic differences, and the energetic, behavioral, and fitness trade-offs associated with four different movement strategies (long-distance and short-distance migration, and regional and local residency) in a population of white storks (Ciconia ciconia) that has shifted its migratory behavior over the last decades, from fully long-distance migration toward year-round residency. To do this, we tracked 75 adult storks fitted with GPS/GSM loggers with tri-axial acceleration sensors over 5 years, and estimated individual displacement, behavior, and overall dynamic body acceleration, a proxy for activity-related energy expenditure. Additionally, we monitored nesting colonies to assess individual survival and breeding success. We found that long-distance migrants traveled thousands of kilometers more throughout the year, spent more energy, and >10% less time resting compared with short-distance migrants and residents. Long-distance migrants also spent on average more energy per unit of time while foraging, and less energy per unit of time while soaring. Migratory individuals also occupied their nests later than resident ones, later occupation led to later laying dates and a lower number of fledglings. However, we did not find significant differences in survival probability. Finally, we found phenotypic differences in the migratory probability, as smaller sized individuals were more likely to migrate, and they might be incurring higher energetic and fitness costs than larger ones. Our results shed light on the shifting migratory strategies in a partially migratory population and highlight the nuances of anthropogenic impacts on species behavior, fitness, and evolutionary dynamics.
Subject(s)
Animal Migration , Birds , Humans , Animals , Seasons , Breeding , Energy MetabolismABSTRACT
Background: Inflammatory bowel diseases' (IBD) increasing incidence and prevalence place a heavy health and economic burden on society. Objectives: This study assesses the burden and cost of IBD in Portugal to support the definition of health policies, resource allocation, and patient care. Methods: The burden of disease was expressed using disability-adjusted life years (DALY). Costs were estimated considering the societal perspective, using a prevalence-based model and prices established by law. An expert panel composed of 5 expert Portuguese gastroenterologists and a patient-reported study were conducted to support the cost analysis and fill in information gaps. Results: In Portugal, with a prevalence of 24,069 IBD patients and an incidence of 15/100,000, the burden of disease was estimated at 6,067 DALYs: 507 resulting from premature deaths and 5,560 from disability. Total cost was estimated at EUR 146 million per year, with direct costs representing 59%. Average yearly cost per IBD patient is EUR 6,075, where 60% is related to Crohn's disease and 40% to ulcerative colitis (UC). Conclusion: This study estimates the annual health burden and cost of IBD in Portugal, thus generating information with the intent to raise awareness of the need to advance health policies as well as better clinical and economic decisions in this pathology.
Contexto: A crescente incidência e prevalência das Doenças Inflamatórias Intestinais (DII) representam um pesado fardo para a saúde e economia na sociedade. Objetivos: Este estudo avalia o custo e a carga da DII em Portugal, com o objetivo de suportar a definição de políticas de saúde, alocação de recursos e cuidados com o doente. Métodos: A carga da doença foi calculada utilizando anos de vida ajustados à incapacidade (DALY). Os custos foram estimados tendo em conta a perspetiva da sociedade, utilizando um modelo baseado na prevalência e preços estabelecidos por lei. Foi realizado um painel de peritos, composto por 5 gastroenterologistas portugueses, assim como um estudo de mercado a doentes, de forma a suportar a análise de custos e colmatar lacunas de informação. Resultados: Em Portugal, com uma prevalência de 24,069 doentes e uma incidência de 15/100,000, o peso das DII foi estimado em 6.067 DALYs: 507 dos quais resultantes de mortes prematuras e 5.560 de incapacidade. O custo total foi estimado em 146 milhões de euros por ano, com os custos diretos a representarem 59% do total. O custo médio anual por doente de DII é de 6.075 EUR, onde 60% está relacionado com Doença de Crohn (DC) e 40% com Colite Ulcerosa. Conclusão: Este estudo estima os encargos anuais para a saúde e o custo da DII em Portugal, gerando informação relevante, com o intuito de alertar para a necessidade de uma evolução nas políticas de saúde, assim como como suportar melhores decisões clínicas e económicas nesta patologia.
ABSTRACT
BACKGROUND: Hidradenocarcinoma is a rare malignant sweat gland tumour, characterized by a slow but aggressive course, with high rates of local recurrence and metastasis. Due to its rarity, histological criteria and therapeutic guidelines are poorly defined, posing a major challenge for clinicians and pathologists. OBJECTIVES: To present two new cases of metastatic hidradenocarcinoma as well as a review of the literature. MATERIALS & METHODS: We describe two case studies and a review of the literature based on a search using the MEDLINE (PubMed) electronic database. RESULTS: The first patient was a 61-year-old woman with a perimamillary hidradenocarcinoma that arose from the malignant transformation of a benign childhood lesion and developed regional lymph node metastases after wide excision and adjuvant radiotherapy. The second patient was a 63-year-old man who developed cutaneous and renal metastases several years after the complete excision of a lumbar hidradenocarcinoma. As far as we can ascertain, kidney metastasis from hidradenocarcinoma has not previously been described. CONCLUSION: Most authors recommend wide excision as the treatment of choice for hidradenocarcinoma, however, optimal adjuvant therapy remains to be determined. Our cases add to the limited knowledge available, but high-quality studies to find new effective treatments are needed.
Subject(s)
Carcinoma, Skin Appendage , Kidney Neoplasms , Skin Neoplasms , Sweat Gland Neoplasms , Male , Female , Humans , Child , Middle Aged , Sweat Gland Neoplasms/surgery , Combined Modality Therapy , Databases, FactualABSTRACT
Background: The first months of the coronavirus disease 2019 (COVID-19) pandemic demanded rapid re-organization of available local resources. This study evaluated the performance of a private hospital in the Brazilian state of Ceará that was swiftly repurposed into a public tertiary COVID-19 centre during the first wave of the COVID-19 pandemic, and how it improved in the second wave. Methods: This retrospective cohort study included 2492 patients with COVID-19 at Hospital Estadual Leonardo da Vinci (HELV) during the first and second waves. Demographic, clinical and laboratory data were collected using a dedicated web platform (ResCOVID). A Poisson regression model was used to estimate factors associated with in-hospital mortality. Results: Differences in demographics and clinical features were found between the two waves. There was reduced in-hospital mortality during the second wave (36.2%) in comparison with the first wave (48.8%). Invasive mechanical ventilation showed the strongest association with increased risk of death in both waves {first wave: relative risk (RR) 4.28 [95% confidence interval (CI) 2.86-6.41], P<0.001; second wave: RR 12.94 (95% CI 3.4-49.12), P<0.001}. Conclusions: HELV was a pillar in the strategic public health plan to respond to COVID-19 in Ceará, helping to assist a group of moderate-to-severe cases and reduce the pressure on emergency and primary care facilities. Although mortality in intubated individuals remained high, there was an overall decrease in the in-hospital mortality rate in the second wave.
ABSTRACT
Molecular classification of medulloblastoma is critical for the treatment of this brain tumor. Array-based DNA methylation profiling has emerged as a powerful approach for brain tumor classification. However, this technology is currently not widely available. We present a machine-learning decision support system (DSS) that enables the classification of the principal molecular groups-WNT, SHH, and non-WNT/non-SHH-directly from quantitative PCR (qPCR) data. We propose a framework where the developed DSS appears as a user-friendly web-application-EpiGe-App-that enables automated interpretation of qPCR methylation data and subsequent molecular group prediction. The basis of our classification strategy is a previously validated six-cytosine signature with subgroup-specific methylation profiles. This reduced set of markers enabled us to develop a methyl-genotyping assay capable of determining the methylation status of cytosines using qPCR instruments. This study provides a comprehensive approach for rapid classification of clinically relevant medulloblastoma groups, using readily accessible equipment and an easy-to-use web-application.t.
ABSTRACT
An increase in the incidence of arboviral, microbial and parasitic infections, and to disorders related to oxidative stress has encouraged the development of adjuvant therapies based on natural formulations, such as those involving plant extracts. Thus, to expand the repertoire of the available therapeutic options, this study aimed to describe the versatility of Tephrosia toxicaria (Sw.) (Pers., 1807) extracts for the control of arbovirus vectors, as well as their antioxidant, antileishmanial, and antimicrobial potential. Among the aqueous and hydroethanolic extracts obtained, the hydroethanolic extract from roots (RHA) was identified as the most active larvicide extract demonstrating, respectively, the lowest lethal concentration (mg/mL) for 50%, 90% and 99% of Aedes aegypti (L., 1762) and Aedes albopictus (S., 1894) larvae, observed at 24 h (0.33, 0.84 and 1.80; 0.32, 0.70 and 1.32) and 48 h (0.17, 0.51 and 1.22; 0.26, 0.47 and 0.78) post-exposure. Field assays revealed that RHA (0.84 mg/mL) is a potential oviposition deterrent, reducing egg-laying by approximately 90%. RHA (0.1 mg/mL) also exhibited antioxidant activity for the following tests: total antioxidant capacity (286.86 mg AAE/g), iron (87.16%) and copper (25.64%) chelation, and superoxide scavenging (10%). In the cell culture assays, RHA (0.1 mg/mL) promoted regeneration of metabolic activity (92% cell viability) in cells exposed to oxidative stress. Furthermore, RHA displayed weak antileishmanial activity (IC50 = 3.53 mg/mL) against Leishmania amazonensis and not exhibit antimicrobial activity. The extraction favored the concentration of carbohydrates in RHA, in addition to lectins and protease inhibitors, with molecular masses estimated between 10 and 24 kDa. Cytotoxicity and phytotoxicity analyses of RHA suggested its biosecurity. Thus, RHA is a multivalent extract with insecticide and antioxidant properties at low and safe concentrations. However, others studies on its indirect toxic effects are ongoing to ensure the complete safety of RHA.
Subject(s)
Aedes , Anti-Infective Agents , Antiprotozoal Agents , Tephrosia , Animals , Female , Antioxidants/pharmacology , Mosquito Vectors , Plant Extracts/toxicity , Antiprotozoal Agents/pharmacology , Anti-Infective Agents/pharmacologyABSTRACT
The concept of fire regime can be used to describe, with different degrees of complexity, the spatial and temporal patterns of fires and their effects within a given area and over a given period. In this work, we explore the relations between fire regime and a set of potential biophysical controls at a local scale, for 972 civil parishes in central Portugal. The fire regime was characterized with reference to a 44-year period (1975-2018) using three properties: cumulative percentage of parish area burned, area-weighted total number of wildfires, and the Gini concentration index of burned area over time. Potential control variables included topography, seasonal temperature and rainfall, and land use/land cover type and patch fragmentation. Ordinal logistic regression was used to model the relations between the fire regime properties and the potential control factors. Results show that the fire regime properties have important spatial contrasts within the study area, and that land use/land cover distribution, spring rainfall and summer temperatures are the major controls over their variability. The percentage of each parish occupied by shrubland and spontaneous herbaceous vegetation is the single most important factor influencing cumulative percentage of parish area burned and the Gini concentration index of burned area, whereas spring rainfall is the foremost factor regarding area-weighted total number of wildfires. Along with the role of spring rainfall in promoting fuel availability later in the year, our results highlight the importance of the speed of regrowth of shrubland and spontaneous herbaceous vegetation after burning, pointing out the need of tailoring fuel management strategies to the properties of each parish.
Subject(s)
Fires , Wildfires , Ecosystem , Portugal , TemperatureABSTRACT
Evaluating species responses to anthropogenic infrastructures and other habitat changes is often used to assess environmental impacts and to guide conservation actions. However, such studies are generally carried out at the population level, disregarding inter-individual variability. Here, we investigate population- and individual-level responses toward power lines of a territorial raptor, the Bonelli's eagle Aquila fasciata. We used GPS-PTT tracking data of 17 adult eagles to model space use as a function of distance to transmission and distribution lines, while accounting for other habitat features known to affect this species. At population level, eagles increased the intensity of space use in the proximity of power lines (up to 1,000 m), suggesting an attraction effect. At individual level, some eagles shared the general population attraction pattern, while others showed reduced intensity of space use in the proximity of power lines. These differential responses were unrelated to the sex of individuals, but were affected by the characteristics of the power grid, with a tendency for apparent attraction to be associated with individuals occupying home ranges with a denser network of transmission lines and transmission pylons. However, the study could not rule out the operation of other potentially influential factors, such as individual idiosyncrasies, the spatial distribution of prey availability, and the availability of natural perches and nesting sites. Overall, these results suggest that power lines may drive different behaviors and have differential impacts across individuals, with those attracted to the proximity of power lines potentially facing increased risk of mortality through electrocution and collision, and those avoiding power lines being potentially subject to exclusion effects. More generally, our results reinforce the need to understand individual variability when assessing and mitigating impacts of anthropogenic infrastructures.