Using Analytic Hierarchy Process to Assess Beekeeping Suitability in Portuguese Controlled Areas: A First Approach.

Beekeeping management is greatly influenced by spatial factors (e.g., land use/land cover, roads, or electrical energy networks), so GIS are a powerful tool to overlap and relate a variety of spatial data levels and, consequently, a very useful tool for beekeeping activity planning. This study was developed within the intervention area of three controlled zones managed by Portuguese Beekeepers Associations. The methodology, based on multi-criteria decision analysis, integrates several criteria, such as hydrographic networks, road networks, soil occupation, solar radiation, and electromagnetic radiation sources. These criteria were proposed and evaluated through online questionnaires carried out with beekeepers. Concerning the selected criteria and the respective geographical data, the most relevant were land use/land cover and water availability, with a significance of 44% and 24%, respectively. The beekeeping suitability map enabled us to evaluate the degree of compliance for the actual location of apiaries, with 60% of the apiaries being installed in high potential areas. In the context of beekeeping planning, the potential of the techniques applied seems to be an important tool for optimizing the location of apiaries and the profitability of beekeeping.

Multitemporal Land Use and Cover Analysis Coupled with Climatic Change Scenarios to Protect the Endangered Taxon Asphodelus bento-rainhae subsp. bento-rainhae.

Climate change and land use and land cover (LULC) change are impacting the species' geographic distribution, causing range shifts and reducing suitable habitats. Asphodelus bento-rainhae subsp. bento-rainhae (AbR) is an endangered endemic plant restricted to Serra da Gardunha (Portugal), and knowledge of those changes will help to design conservation measures. MaxEnt was used to model AbR's current distribution and project it into the future, 2050, using the Shared Socioeconomic Pathway SSP3-7. The Portuguese LULC maps from 1951-1980, 1995, 2007, and 2018 were used to assess and quantify LULC changes over time. The results showed that the AbR current predicted distribution matches its actual known distribution, which will not be affected by future predicted climate change. The significant LULC changes were observed during the study periods 1951-1980 to 2018, particularly between 1951-1980 and 1995. Scrubland and Agriculture decreased by 5% and 2.5%, respectively, and Forests increased by 4% in the study area. In the occurrence area, Agriculture increased, and Forests decreased between 1980 and 2018, due to Orchard expansion (34%) and declines in Chestnut (16.9%) and Pine (11%) areas, respectively. The use of species distribution models and the LULC change analysis contributed to understanding current and future species distribution. The LULC changes will have a significant impact on future species distribution. To prevent the extinction of this endemic species in the future, it is crucial to implement conservation measures, namely species monitoring, replantation, and germplasm conservation, in addition to guidelines for habitat conservation.

The role of religiosity and spirituality in interpersonal violence: a systematic review and meta-analysis

Objectives: Religiosity and spirituality (R/S) have been negatively associated with several mental health problems, including delinquency. The study aimed to investigate the relationship between R/S and interpersonal violence using a systematic review. Methods: We conducted a descriptive systematic review followed by meta-analyses using seven different databases. We included observational studies that assessed the relationship between R/S and different types of interpersonal violence (physical and sexual aggression and domestic violence). Results: A total of 16,599 articles were screened in the databases and, after applying the eligibility criteria, 67 were included in the systematic review and 43 were included in the meta-analysis. The results showed that higher levels of R/S were significantly associated with decreased physical and sexual aggression, but not domestic violence. All selected studies evidenced sufficient methodological quality, with 26.8% being cohort studies. In the subanalyses, the role of R/S was more prevalent among adolescents. Conclusion: There is an inverse relationship between R/S and physical and sexual aggression, suggesting a protective role. However, these results were not observed for domestic violence. Healthcare professionals and managers should be aware of their patients' beliefs when investigating interpersonal violence to create tailored interventions for reducing violent behavior.

The role of religiosity and spirituality in interpersonal violence: a systematic review and meta-analysis.

OBJECTIVE: Religiosity and spirituality (R/S) have been negatively associated with several mental health problems, including delinquency. The study aimed to investigate the relationship between R/S and interpersonal violence using a systematic review. METHODS: We conducted a descriptive systematic review followed by meta-analyses using seven different databases. We included observational studies that assessed the relationship between R/S and different types of interpersonal violence (physical and sexual aggression and domestic violence). RESULTS: A total of 16,599 articles were screened in the databases and, after applying the eligibility criteria, 67 were included in the systematic review and 43 were included in the meta-analysis. The results showed that higher levels of R/S were significantly associated with decreased physical and sexual aggression, but not domestic violence. All selected studies evidenced sufficient methodological quality, with 26.8% being cohort studies. In the subanalyses, the role of R/S was more prevalent among adolescents. CONCLUSION: There is an inverse relationship between R/S and physical and sexual aggression, suggesting a protective role. However, these results were not observed for domestic violence. Healthcare professionals and managers should be aware of their patients' beliefs when investigating interpersonal violence to create tailored interventions for reducing violent behavior.

Prediction scenarios of past, present, and future environmental suitability for the Mediterranean species Arbutus unedo L.

Climate change is a challenge for forests in the coming decades, with a major impact on species adaptation and distribution. The Mediterranean Basin is one of the most vulnerable hotspots for biodiversity conservation under climate change in the world. This research aimed at studying a Mediterranean species well adapted to the region: the Arbutus unedo L. (strawberry tree). The MaxEnt, a presence-only species-distribution software, was used to model A. unedo's environmental suitability. The current species potential distribution was accessed based on actual occurrences and selected environmental variables and subsequently projected for the Last Glacial Maximum (LGM), the Mid-Holocene (MH), and the years 2050 and 2070, considering the two Representative Concentration Pathways: RCP4.5 and RCP8.5. Results from the LGM projection suggest the presence of refugia in the core of the Mediterranean Basin, in particular the Iberian Peninsula (IP). The projections for the MH indicate increasing climatic suitability for the species and an eastward expansion, relatively to LGM. The predicted future environmental changes will most likely act as a catalyst for suitable habitat loss and a range shift towards the North is likely to occur.

Guillain-Barre syndrome following COVID-19 vaccines: A scoping review.

Guillain-Barre syndrome following COVID-19 vaccines (GBSfCV19v) is a reported adverse effect that remains unclear. We present a structured review based on two case reports of GBSfCV19v, a systematic review, and Vaccine Adverse Event Reporting System (VAERS) analysis to estimate the risk and describe the clinical characteristics (CC) of these events. We've searched on MEDLINE and Embase, from the inception to May 20, 2021, using the keywords: "Guillain barre syndrome" and cross-referenced with "covid-19 vaccines." We estimated the risk of GBSfCV19v, comparing it with the risk of GBS following the influenza vaccine (GBSfIv), considering the VAERS sensitivity. The clinical characteristics included: age, sex, comorbidities, type of vaccine, administered dose, clinical onset, deaths, cerebrospinal fluid (CSF), and electromyography (EMG) pattern. We found 43 cases, considering the risk of GBSfCV19v lower than GBSfIv (160-320 cases). The patients had a mean age of 54 years and 23 (56%) were male. The types of vaccines used: Pfizer (22), Moderna (9), AstraZeneca (3), Janssen (3), and Johnson & Johnson (1). 24 cases of GBS occurred after the first dose, with clinical onset of 7 days. CSF albuminocytological dissociation was reported in 7 patients, and EMG revealed a predominant demyelinating pattern. GBSfCV19v risk appears to be lower than what was expected from other respiratory virus vaccines. Most cases of GBS were middle-aged males within a week following the first dose of the COVID-19 vaccine, showing a typical demyelinating neuropathy with albuminocytological dissociation.

The role of littoral cliffs in the niche delimitation on a microendemic plant facing climate change.

Obligate coastline taxa generally occupy very limited areas, especially when there is a close affinity with a specific coast type. Climate change can be a meaningful threat for them, reducing suitable habitat or forcing migration events. Cistus ladanifer subsp. sulcatus is an endemic plant of Portugal, known to occur only in the top of its south-western coast's prominent cliffs. In spite of being included in the annexes II and IV of the European Habitats Directive of Natura 2000 Network, this taxon is still understudied, especially regarding the effects of climate change on its distribution. To overcome such gap, Maxent was used to model the current distribution of C. ladanifer subsp. sulcatus and project its future distribution considering different General Circulation Models, periods (2050 and 2070) and Representation Concentration Pathways (4.5 and 8.5). The results suggested an extensive range contraction in the future, and extinction is a possible scenario. The proximity to littoral cliffs is crucial for this plant's occurrence, but these formations are irregularly distributed along the coast, hindering range expansions, further inhibited by a small dispersal capacity. Cistus ladanifer subsp. sulcatus will probably remain confined to south-western Portugal in the future, where it will continue to face relevant threats like human activity, reinforcing the need for its conservation.

Prevalence of dementia among widowed and non-widowed patients and associated clinical and sociodemographic characteristics / Prevalência, características clínicas e sociodemográficas em pacientes viúvos e não viúvos com demência

Abstract Objective: to verify if the prevalence of dementia differs between widowed and non-widowed elderly persons and between genders, and to analyse if there is an association with sociodemographic and clinical characteristics. Method: a retrospective cross-sectional observational study of patients treated at a Behavioral Neurology outpatient clinic from 1999 to 2009 was carried out, employing anamnesis, physical and neurological examination, the Clinical Dementia Rating Scale (CDR) and the Mini Mental State Examination (MMSE). Sociodemographic (schooling and age) and clinical (age of onset of symptoms and time since onset of symptoms, MMSE and CDR) variables were analyzed. The differences were evaluated by the Mann Whitney test, using a significance value of p<0.05. Results: of 208 patients diagnosed with dementia, 73 (35.1%) were widowed and 135 (64.9%) were non-widowed. Those who were widowed were older than those who were non-widowed (p<0.001) when diagnosed with dementia. This difference in age remained when gender (p<0.001), widowed and widowed women (p<0.001) and widowed and non-widowed men (p<0.001) were compared. The time from onset of symptoms to diagnosis was greater in widowed than in non-widowed men [55.6 (± 86.3) vs. 43.4 (± 44.8) months], although the difference was not statistically significant. Widowed patients with dementia had lower schooling, regardless of gender (p<0.05). Conclusion: the prevalence of dementia differed between widowed and non-widowed individuals, being higher among non-widows. There was an association between widowhood and the clinical and sociodemographic characteristics, with differences between the genders. The loss of a spouse can generate different outcomes among men and women, necessitating measures with a specific focus on prevention and strategies of care in dementia.

Resumo Objetivo: Verificar se a prevalência de demência difere entre viúvos e não viúvos, e analisar se há associação com características sociodemográficas e clínicas, bem como diferenças entre os sexos. Método: Estudo observacional transversal retrospectivo que analisou prontuários de pacientes atendidos em um ambulatório de Neurologia do Comportamento de 1999 a 2009 através de anamnese, exame físico e neurológico, Clinical Dementia Rating Scale (CDR) e Miniexame do Estado Mental (MEEM). Avaliou-se variáveis sociodemográficas (escolaridade e idade) e clínicas (idade e tempo do início dos sintomas, MEEM e CDR). As diferenças foram avaliadas pelo teste de Mann Whitney, admitindo-se p<0,05. Resultados: Dos 208 pacientes com diagnóstico de demência, 73 (35,1%) eram viúvos e 135 (64,9%) não viúvos. Os viúvos eram mais velhos que os não viúvos (p<0,001) quando foram diagnosticados com demência. Essa diferença na idade manteve-se comparando os sexos (p<0,001), mulheres viúvas e não viúvas (p<0,001) e homens viúvos e não viúvos (p<0,001). O tempo do início dos sintomas até o diagnóstico foi maior em homens viúvos quando comparado aos não viúvos [55,6 (±86,3) vs 43,4 (±44,8) meses] mas sem significância estatística. Os viúvos com demência tinham menor escolaridade, independente do sexo (p<0,05). Conclusão: A prevalência de demência diferiu entre viúvos e não viúvos, sendo maior nos não viúvos. Houve associação da viuvez com características clínicas e sociodemográficas com diferença entre os sexos. A perda do cônjuge pode gerar diferentes desfechos entre homens e mulheres, necessitando de medidas com enfoque específico na prevenção e estratégias de cuidado na demência.

Transperineal biopsy under ultrasound guidance for prostate cancer detection as an initial and as a repeat biopsy strategy

OBJECTIVE: To present the authors' experience on transperineal prostate sector biopsy (TPSB) in detecting prostate cancer, in identifying both low Gleason prostate cancers as well as clinically significant prostate cancer (Gleason 7 and higher), and in determining anatomical distributions of prostate cancer in both initial and repeat biopsy settings.METHODS: All patients from June 2014 to September 2016 who underwent TPSB, as initial biopsy or repeat biopsy after previous negative transrectal ultrasound-guided biopsy (TRUSPNB) were included. Data for each patient were collected prospectively and subjected to statistical analysis. T test was used for continuous variables while Chi square test or Fisher exact test was used for categorical variables. Multiple logistic regression models were used to identify factors predictive of a positive result.RESULTS: A total 130 patients were included in the study, 73 had TPSB as initial biopsy and 57 as repeat biopsy after previous negative TRUSPNB. The mean patient age of the Initial Biopsy Group (IBG) was 66 years while the mean age for the Repeat Biopsy Group (RBG) was 68 years. The IBG had a lower mean serum PSA level (9.07 ng/mL for IBG and 9.59ng/mL for RBG) and smaller prostate volumes (42.9 mL for the IBG and 44.3mL for the RBG). Prostate cancer was detected in 65.8% (48/73) of the IBG and 40.4% (23/57) of RBG, of which 77.1% (37/48) and 73.9% (17/23) respectively, were clinically significant, defined as a Gleason score of ?7. Of the cancers detected in IBG, 29.2% (14/48) exclusively involved the anterior sector (based on the Ginsburg Study Group's biopsy map), while 30.4% (7/23) were conned exclusively within the anterior sector for the RBG. Increasing PSA level and lower prostate volumes were predictive of cancer detection in RBG, while only increasing PSA level was predictive of a positive result in IBG.CONCLUSION: Transperineal prostate sector biopsy demonstrated a high prostate cancer detection rate for both the initial and repeat biopsy settings. Likewise it provides for excellent sampling of the anterior region of the prostate, as it affords a more accurate sampling of the prostate gland based on a preplanned map and template to sample areas of interests. Similarly, it detects a high proportion of patients with clinically significant prostate cancer. This technique should therefore be highly considered as a first line option for all patients in whom a prostate biopsy is warranted.

Es necesario utilizar relajantes musculares en infusión continua durante la anestesia en pacientes sometidos a cirugía cardíaca? / Is necessary to use infusion of muscle relaxants for anesthesia in patients undergoing cardiac surgery?

El trasplante renopancreático es el tratamiento de elección para el paciente diabético con insuficiencia renal crónica. En el Hospital Universitario, desde junio de 2002 a mayo de 2010 se han realizado 35 trasplantes renopancreáticos. Los receptores presentaban una larga evolución de su diabetes y del tratamiento dialítico, con alta incidencia de patología médica asociada. En todos los pacientes se realizó anestesia general y a la monitorización estándar se agregó: monitorización invasiva de la presión arterial y de la presión venosa central, así como monitorización paraclínica seriada. Se administró insulina en infusión continua para control de la glicemia. La duración promedio del procedimiento fue de 407,9 ± 76,4 min. La reposición intraoperatoria se realizó en base a cristaloides y coloides (4.665 ± 2.127 ml y 1.015 ± 492 ml respectivamente). En 21 pacientes (60%) se administraron glóbulos rojos (858 ± 502 ml). El balance promedio fue positivo: 1.430 ± 832 ml. Para mantener la estabilidad hemodinámica se utilizaron fármacos vasoactivos y aporte de volumen. Ocho pacientes (22,8%) presentaron hipotensión severa transitoria; 14 (40%) presentaron acidosis metabólica, ocho pacientes (22,8%) hipokaliemia leve y tres (8,5%) hipoglicemia. Veintitrés pacientes (65%) requirieron al menos una reintervención en la internación inicial. La mortalidad global fue de 11,4% (cuatro pacientes): 2,8% (un paciente) en las primeras 48 horas. Ocho pacientes (22,8%) presentaron insuficiencia renal desde el inicio del postoperatorio. Se perdieron 15 páncreas (42,8%); cinco de ellos (14,2%) en las primeras 48 horas. Actualmente sobreviven 31 pacientes (88%), 25 preservan la función renal (80,6%) y 20 la función pancreática (64,5%). Se reveló una alta incidencia de complicaciones anestésico-quirúrgicas precoces, las cuales tienen gran importancia sobre los resultados a corto y largo plazo.

Estudio de la utilización de relajantes musculares en servicios de anestesia en Uruguay

The objective of this work is the study of the consumption of neuromuscular blocking drugs in different services of anaesthesia of Uruguay. It is carried out the analysis of the consumption of neuromuscular blocking drugs in retrospective form during a period of two years (1997-1998) in the Department of Anaesthesiology of the Clinicas Hospital , Canelones Hospital, Las Piedras Hospital and Melo Hospital. It is able to define two patterns of consumption of different neuromuscular blocking drugs. The first consumption pattern is defined for the biggest consumption of neuromuscular blocking drugs corresponds to alcuronium, then succinylcholine and then atracurium. Is indicated in most of the anaesthetic acts two neuromuscular blocking drugs. Succinylcholine is the drug more used for the tracheal intubations almost in an exclusive form. Alcuronium is the drug more used for the maintenance of the muscular relaxation almost in an exclusive form. The second consumption is atracurium with the decrease of the consumption of alcuronium. It can be conclude that scarce readiness of neuromuscular blocking drugs exists in the studied centres. The available drugs are atracurium, alcuronium and succinylcholine. It stands out the excessive use of the succinylcholine in the studied hospitals.

Diagnóstico e tratamento dos tumores mediastinais por toracoscopia / Diagnosis and treatment of mediastinal tumors by thoracoscopy

Objetivos: O uso da toracoscopia nos tumores mediastinais ainda é motivo de análise. Setenta e três pacientes foram submetidos à toracoscopia para o diagnóstico e tratamento das massas mediastinais e analisados retrospectivamente, com o objetivo de avaliar a eficácia deste procedimento e suas complicações. Métodos: Entre 1983 e 1999, 21 toracoscopias convencionais e 51 toracoscopias videoassistidas foram realizadas (33 como proposta diagnóstica e 40 como terapêutica). A idade dos pacientes variou de 2 a 81 anos (média de 43,8) e com discreta predominância das mulheres (41 para 32 homens). Todos foram submetidos à anestesia geral com intubação simples (22) ou com duplo lume (51). Resultados: O tipo histológico do tumor foi obtido em todos os pacientes. A conversão para toracotomia foi necessária em nove pacientes que tinham proposta terapêutica, devido ao tamanho do tumor ou invasão de estruturas vizinhas, dificuldade para continuar a dissecção, para fazer uma lobectomia superior e para suturar lesão iatrogênica do diafragma. Quatro pacientes morreram durante os primeiros 30 dias de pós-operatório em conseqüência da patologia de base. Conclusões: A toracoscopia mostrou-se uma alternativa eficaz no diagnóstico e na terapêutica dos tumores mediastinais.

Avaliaçäo do uso de um protocolo econômico para o tratamento da esterilidade conjugal e mensuraçäo da real necessidade de procedimentos de fertilidade assistida em populaçäo de casais estéreis / Evaluation of the use of an economic protocol for the conjugal sterility treatment and measurement of the real need for assisted fertility procedures in sterile couple population

Este foi um trabalho prospectivo, descritivo, que estudou a evoluçäo de 247 pacientes estéreis que procuraram tratamento no Serviço de Reproduçäo Humana do Hospital Brigadeiro em Säo Paulo. O objetivo do estudo foi avaliar a real necessidade de técnicas de fertilizaçäo assistida em uma populaçäo de casais estéreis, após terem sido tratados usando um protocolo econômico. Todos os casais foram acompanhados até obterem a gestaçäo, abandonarem o tratamento, terem diagnóstico de mau prognóstico ou serem descontinuados após uma ano de tratamento. Os tratamenso de penderam do diagnóstico e foram classificados em: a) fator ovulário, b) fator tuboperitoneal, c) fator uterino, d) endometriose, e) varicocele f) fator masculino idiopático g) esterilidade sem causa aparente (ESCA).

Doença neoplásica do pericárdio. Análise de 26 pacientes / Neoplasic pericardial disease. Analysis of 26 patients

Objetivo - Caracterizar os pacientes com doença neoplásica do pericárdio quanto à apresentação clínica, aos achados em exames gerais e específicos e ao tipo histológico do tumor. Métodos - Foram analisados os prontuários de 26 pacientes com doença neoplásica do pericárdio. Resultados - As manifestações clínicas e as alterações observadas na radiografia torácica e no eletrocardiograma demonstram-se inespecíficos, apesar de freqüentes. A maioria desses pacientes foi abordada cirurgicamente. Observamos alta positividade da biópsia pericárdica associada ao estudo citulógico do líquido na determinação do tipo histológico do tumor, particularmente quando o procedimento foi realizado com o auxílio da pericardioscopia. Conclusão - Para o diagnóstico adequado do acontecimento neoplásico do pericárdio é necessário que a suspeita diagnóstica, baseada em achados inespecíficos ao exame clínico e exames de triagem, seja confirmada através de abordagens diagnósticas mais invasivas e eficientes, em particular a pericardioscopia com biópsia e citologia.

Evoluçäo clínica e comportamento da funçäo ventricular no pós-operatório tardio da cardiomioplastia / Clinical evaluation and ventricular function behavior in the late postoperative period of cardiomyoplasty

A cardiomioplastia tem sido proposta, como uma alternativa ao transplante cardíaco, no tratamento de pacientes com insuficiência miocárdica em fase avançada. O objetivo deste trabalho é estudar a evoluçao clínica e o comportamento da funçao ventricular no pós-operatório tardio desse procedimento em 34 pacientes portadores de cardiomiopatia dilatada, que foram operados no período de maio de 1988 a setembro de 1994. Vinte e sete pacientes estavam em classe funcional III e 7 pacientes em classe IV no pré-operatório, apesar do uso de terapêutica clínica otimizada. A mortalidade hospitalar foi de 2,9 por cento e l paciente que evoluiu em choque cardiogênico foi submetido a transplante cardíaco 42 dias após a cardiomioplastia. O tempo de seguimento pós-operatório variou entre 2 e 73 meses, com média de 27,4 meses. Aos 6 meses de pós-operatório, 12 pacientes estavam em classe funcional I, l5 pacientes em classe II e 3 pacientes em classe III (p=O,OOl) em relaçao ao pré-operatório. Quatorze pacientes faleceram até 5 anos de pós-operatório e os índices de sobrevida foram 84,7 por cento em l ano, 67,7 por cento em 2 anos e 39,6 por cento aos 5 anos de seguimento, sendo que, em 9 pacientes, os óbitos ocorreram por progressao da insuficiência cardíaca, e 5 pacientes faleceram subitamente. A análise de regressao de Cox mostrou que a mortalidade nos pacientes operados em classe funcional IV foi 5,5 vezes maior do que nos pacientes operados em classe III (p=O,OO6), cuja sobrevida foi de 52,7 por cento aos 5 anos de pós-operatório. O estudo sistemático da funçao ventricular através da angiografia com radioisótopos, da ecocardiografia com Doppler e do cateterismo cardíaco direito documentou a melhora da fraçao de ejeçao do ventrículo esquerdo (VE) de 19,8 ñ 3 para 23,9 ñ 7,2 por cento (p

Banco de osso: um método simplificado / Bone banks: a simplinfied method

Os autores relatam o emprego de enxerto ósseo homólogo congelado, sua aplicaçäo como um método seguro, eficiente e de baixo custo. Baseando-se em uma metodologia convencional dos bancos de ossos, os autores salientam a viabilidade dos mesmos em locais desprovidos de maiores recursos

Enxerto ósseo descalcificado retardado / Delayed decalcified bone graft

Foi investigado um enxerto alternativo para correçäo de falhas ósseas diafisárias. Cilindros tubulares descalcificados de rádio de coelhos doadores foram implantados durante quatro semanas no músculo reto abdominal de coelhos receptores. Depois disso foram transferidos para uma falha óssea equivalente no rádio destes mesmos animais. O processo de reparaçäo foi seguido durnte oito semanas por radiografia, histológica e fluorescência óssea. Quando comparada com os controles (falha vazia e preenchimento com gelfoam), a falha óssea preenchida pelo enxerto descalcificado foi mais rápida e intensamente preenchida por osso neoformado