Severe Covid-19 in pregnant and postpartum women admitted to an intensive care unit: A retrospective cohort study.

BACKGROUND: SARS-CoV-2 infection is associated with worse maternal and fetal outcomes. This study aims to describe the characteristics of pregnant and postpartum women with severe Covid-19 admitted to ICU. METHODS AND FINDINGS: It's a retrospective cohort study evaluating pregnant and postpartum women referenced to a specialized ICU between May 2020 and June 2022. Covid-19 was confirmed with RT-PCR or rapid antigen test on a nasopharyngeal swab. Variables were described by median and IQR when numerical, and by frequency and percentage when categorical. OR with 95% CI were calculated for the evaluation of factors related to death. P-values were calculated using Pearson's ꭓ2-test, Fisher's exact test, Wilcoxon rank sum test, and Kruskall-Wallis test, and statistical significance was established as < 0·05. Missing data were excluded. All statistical analysis were performed using R software version 4.2.2. Of the 101 admissions, 85 (84·2%) were of pregnant women. Obesity (23·0%) and systemic arterial hypertension (13·0%) were the most prevalent medical conditions. Sixty-six (65·3%) were admitted using some type of oxygen support. Forty-seven (46·5%) evolved to mechanical ventilation. There were 61 events considered obstetric complications, with 8 stillbirths/fetal losses. The overall lethality was 15·8%. Pregnancy interruption, need for non-invasive mechanical ventilation, level of oxygen support at admission, prone maneuver, hemodialysis, and healthcare-related infections were factors associated with death. Evaluating the WHO 7-category ordinary scale, there was a trend of increase in the risk of death with higher punctuation, with a statistically significant difference of women with 5 (OR = 7·27; 95% IC = 1·17-194; p = 0·031) or 6 points (OR = 12·0; 95% IC = 1·15-391; p = 0·038) when compared to the ones with 3 points, i.e., of women admitted with a high-flow non-rebreathing mask or invasive mechanical ventilation, compared with the ones admitted at room air, respectively. The main limitations of this study are the relatively small number of participants, and the use of data derived of medical records-which are susceptible to misclassification and variable amounts of missing data. CONCLUSIONS: Pregnant and postpartum women with severe Covid-19 have high lethality and a high incidence of clinical and obstetric complications. These findings support that this population should be prioritized in public health strategies that address Covid-19.

Pharmacological Chemolysis of Uric Acid Lithiasis in A Patient with Crohn’s Disease

Patients with chronic diarrhoea or ileostomies suffer from electrolyte and urinary disorders and are prone to developing uricacid or calcium oxalate stones. Evidence is lacking regarding the management of uric acid stones in patients with inflammatorybowel diseases. We present the case of a male patient with Crohn’s disease and carrying an ileostomy. He was diagnosed with uricacid urolithiasis (stone size of 11 mm located in the left pyeloureteral junction) after presenting to the emergency room during anepisode of left renal colic. Results of the 24-hour urinalysis showed an acidic pH (pH <5), consistent with hyperuricosuria. Thesuspicion of uric acid lithiasis was confirmed after performing an X-ray diffraction analysis of a lithiasic fragment that passedduring acute renal colic. The patient was prescribed with urinary alkalinisers (medical treatment) and dietary recommendations.After 12 months of treatment and urine pH monitoring, the patient achieved complete chemolysis while maintaining the stabilityof his underlying Crohn’s disease. The patient had no complications during follow-up, referring adequate gastrointestinal toleranceto treatment and denying side effects. The patient remains asymptomatic and is being followed-up on an outpatient basis.He continues on prophylactic treatment (Lit-Control® pH Up) to maintain the pH in the non-acidic range. (AU)

Saúde mental dos estudantes de enfermagem do Instituto Politécnico de Santarém durante a pandemia de COVID-19 / Mental health of nursing students at the Polytechnic Institute of Santarem during the COVID-19 pandemic / Salud mental de estudiantes de enfermería del Instituto Politécnico de Santarém durante la pandemia de COVID-19

Resumo Introdução: A pandemia do coronavírus (COVID-19) no ensino superior causou consequências perturbadoras na vida e na saúde mental dos estudantes. Pretendemos avaliar os níveis de ansiedade, depressão e stress dos estudantes de enfermagem do Instituto Politécnico de Santarém. Método: Estudo exploratório, observacional descritivo e correlacional. Estudantes: 183 estudantes, selecionados por amostragem de conveniência. Instrumento de medida: Escala de Ansiedade, Depressão e Stress - EADS-21 validada para a população portuguesa, aplicada entre 19 de novembro e 4 de dezembro de 2020. Os dados recolhidos foram analisados com o Software IBM SPSS Statistics for Windows, versão 27.0. Conclusões: Os achados mostraram que a maioria dos estudantes apresentou um nível normal de depressão (82,5%), ansiedade (88,0%) e stress (94,0%). Cerca de 1,6% dos estudantes relataram nível moderado de stress; 5,5% e 1,6% um nível moderado e grave, respetivamente, de ansiedade e 6% e 0,5% depressão um nível moderado e grave, na devida ordem. Foram encontradas diferenças significativas entre as médias (teste t de Student) na comparação entre género (p < 0,001), com os maiores scores, nas três dimensões, no género feminino que apresentou mais stress (M = 7,59 + 4,728), depressão (M = 5,83 + 4,503) e ansiedade (M =3,87 + 3,869), ou seja, os estados afetivos do género feminino foram mais negativos.

Abstract Introduction: The coronavirus (COVID-19) pandemic in higher education has had disturbing consequences on the lives and mental health of students. We intend to evaluate the levels of anxiety, depression, and stress of nursing students at the Polytechnic Institute of Santarem. Method: Exploratory, observational, descriptive, and correlational study. Students: 183 students, selected by convenience sampling. Measurement instrument: Anxiety, Depression and Stress Scale - EADS-21 validated for the Portuguese population, applied between November 19 and December 4, 2020. The collected data were analyzed using the IBM SPSS Statistics for Windows Software, version 27.0. Conclusions: The findings showed that most students had a normal level of depression (82.5%), anxiety (88.0%) and stress (94.0%). About 1.6% of students reported a moderate level of stress; 5.5% and 1.6% a moderate and severe level, respectively, of anxiety and 6% and 0.5% depression a moderate and severe level, in due order. Significant differences were found between means (Student's t test) in the comparison between gender (p < 0.001), with the highest scores, in the three dimensions, in the female gender that presented more stress (M = 7.59 + 4.728), depression (M = 5.83 + 4.503) and anxiety (M =3.87 + 3.869), that is, the affective states of the female gender were more negative.

Resumen Introducción: La pandemia del coronavirus (COVID-19) en la educación superior ha tenido consecuencias preocupantes en la vida y salud mental de los estudiantes. Pretendemos evaluar los niveles de ansiedad, depresión y estrés de estudiantes de enfermería del Instituto Politécnico de Santarém. Método: Estudio exploratorio, observacional, descriptivo y correlacional. Estudiantes: 183 estudiantes, seleccionados por muestreo por conveniencia. Instrumento de medición: Escala de Ansiedad, Depresión y Estrés - EADS-21 validada para la población portuguesa, aplicada entre el 19 de noviembre y el 4 de diciembre de 2020. Los datos recolectados fueron analizados utilizando el software IBM SPSS Statistics para Windows, versión 27.0. Conclusiones: Los hallazgos mostraron que la mayoría de los estudiantes presentaba un nivel normal de depresión (82,5%), ansiedad (88,0%) y estrés (94,0%). Alrededor del 1,6% de los estudiantes reportaron un nivel moderado de estrés; 5,5% y 1,6% un nivel moderado y severo, respectivamente, de ansiedad y 6% y 0,5% depresión un nivel moderado y severo, en su debido orden. Se encontraron diferencias significativas entre las medias (prueba t de Student) en la comparación entre género (p < 0,001), con las puntuaciones más altas, en las tres dimensiones, en el género femenino que presentó más estrés (M = 7,59 + 4,728), depresión (M = 5,83 + 4,503) y ansiedad (M =3,87 + 3,869), es decir, los estados afectivos del género femenino fueron más negativos.

Inequivalent Solvation Effects on the N 1s Levels of Self-Associated Melamine Molecules in Aqueous Solution.

This work shows how the N 1s photoemission (PE) spectrum of self-associated melamine molecules in aqueous solution has been successfully rationalized using an integrated computational approach encompassing classical metadynamics simulations and quantum calculations based on density functional theory (DFT). The first approach allowed us to describe interacting melamine molecules in explicit waters and to identify dimeric configurations based on π-π and/or H-bonding interactions. Then, N 1s binding energies (BEs) and PE spectra were computed at the DFT level for all structures both in the gas phase and in an implicit solvent. While pure π-stacked dimers show gas-phase PE spectra almost identical to that of the monomer, those of the H-bonded dimers are sensibly affected by NH···NH or NH···NC interactions. Interestingly, the solvation suppresses all of the non-equivalences due to the H-bonds yielding similar PE spectra for all dimers, matching very well our measurements.

Quality of life of higher education students at the Polytechnic Institutes of Santarem and Leiria during the COVID-19 pandemic / Qualidade de vida dos estudantes do ensino superior dos Politécnicos de Santarém e Leiria no período da pandemia COVID-19 / Calidad de vida de los estudiantes de educación superior de los Institutos Politécnicos de Santarém y Leiria durante la pandemia del COVID-19

Objective: This study aims to determine the quality of life of higher education students at the Polytechnic Institutes of Santarem and Leiria during the COVID-19 pandemic. Methods: The population consists of 6483 students attending higher education, from both Institutes. A total of 775 participants selected by convenience sampling, participated in the study. Study with a quantitative, descriptive, correlational character, aiming to describe phenomena and, in addition, identify and explore possible relationships between variables. The WHOQOL-Bref instrument adapted from WHO was applied. The data treatment and analysis were performed using descriptive, correlational, and inferential statistics. Results: Students' self-assessment about Quality of Life is globally superior to the self-assessment with their satisfaction with health, where the female students have lower average values than the male students. The WHOQOL-Bref domains referring to Quality of Life with higher values were the Physical and Environment domain, with the Social Relations and Psychological domains having the lowest values. Conclusion: The results point to the need for intervention to promote the Quality of Life of students, focusing on psychosocial factors, due to the conditions imposed during the confinement period, by the pandemic COVID-19. (AU)

Objetivo: Este estudo teve como objetivo determinar a qualidade de vida dos estudantes do ensino superior dos Institutos Politécnicos de Santarém e Leiria no período da pandemia COVID-19.Métodos: A população é constituída 6483 estudantes que frequentam o ensino superior, dos dois Institutos. Um total de 775 participantes selecionados por amostragem de conveniência participaram no estudo. Estudo de caráter quantitativo, descritivo-correlacional, visando descrever fenómenos e posteriormente identificar e explorar possíveis relações entre as variáveis. Aplicou-se o instrumento WHOQOL-Bref adaptado da WHO. O tratamento e análise dos dados foi realizado com recurso à estatística descritiva, correlacional e inferencial. Resultados: A autoavaliação dos estudantes relativamente à Qualidade de Vida é globalmente superior à autoavaliação com a sua satisfação com a saúde, sendo os estudantes do género femininoque apresentam valores médios inferiores aos estudantes do género masculino. Os domínios do WHOQOL-Bref referentes à Qualidade de Vida com valores superiores foram o domínio físico e meio ambiente, sendo os domínios das relações sociais e psicológico, os que apresentam valores menores. Conclusão: Os resultados apontam para a necessidade de intervenção na promoção da Qualidade de Vida dos estudantes, com foco em fatores psicossociais, decorrente das condicionantes impostas no período de confinamento, pela pandemia COVID-19. (AU)

Objetivo:Este estudio tuvo como objetivo determinar la calidad de vida de los estudiantes de educación superior de los Institutos Politécnicos de Santarém y Leiria durante la pandemia del COVID-19. Métodos:La población está formada por 6483 estudiantes de educación superior, de ambos Institutos. Participaron en el estudio un total de 775 participantes seleccionados por muestreo de conveniencia. Estudio cuantitativo, descriptivo, correlacional, con el objetivo de describir fenómenos y posteriormente identificar y explorar posibles relaciones entre variables. Se aplicó el instrumento WHOQOL-Bref adaptado de la OMS. El tratamiento y análisis de los datos se realizó mediante estadística descriptiva, correlacional e inferencial. Resultados:La autoevaluación de los estudiantes con respecto a la calidad de vida es globalmente superior a la autoevaluación de su satisfacción con la salud, siendo las estudiantes las que tienen valores promedio más bajos que los estudiantes. Los dominios WHOQOL-Bref referentes a la Calidad deVida con valores más altos fueron los dominios físico y ambiental, siendo los dominios de relaciones sociales y psicológicas los de menor valor. Conclusión:Los resultados apuntan a la necesidad de una intervención para promover la Calidad de Vida de los estudiantes, con foco en los factores psicosociales, debido a las condiciones impuestas durante el período de encierro, por la pandemia COVID-19. (AU)

Multicomponent Exercise Program to Improve the Immediate Sequelae of COVID-19: A Prospective Study with a Brief Report of 2-Year Follow-Up.

COVID-19 placed teams of professionals in a hostile and unfamiliar environment where the lack of knowledge of its pathology led to the adaptation of programs used so far for other conditions to try to address the immediate sequelae of COVID-19 infection. That is why the aim of this study was to assess the effects of a multicomponent exercise program (MEP) in improving cardio-respiratory performance, health status, disability due to dyspnea, aerobic capacity and endurance, and the immediate sequelae of COVID-19. Thirty-nine patients referred from different hospital services were included in this study. An intervention of seven weeks with sessions twice a week was carried out, where patients underwent intervallic training sessions followed by strengthening exercises and individualized respiratory physiotherapy exercises. The results of this study show a significant improvement in cardio-respiratory performance, health status, disability due to dyspnea, and aerobic capacity and endurance after intervention; and an increase in health status and reduction in disability due to dyspnea at the 2-year follow-up. In addition, none of the patients had any adverse effects either pre-post treatment or at the 2-year follow-up. Individualized and monitored MEP in survivors of COVID-19 showed positive effects in a pre-post evaluation and the 2-year follow up, improving the immediate sequelae of post-COVID-19 patients. This highlights the importance of the professional background of the rehabilitation teams in adapting to an unknown clinical environment.

The use of TikTok among children and adolescents with Eating Disorders: experience in a third-level public Italian center during the SARS-CoV-2 pandemic.

BACKGROUND: Recent research has documented the potential associations existing between the use of social media (SM) and the occurrence/development and treatment of Eating Disorders (ED). However, the literature directly addressing the use of SM TikTok among children and adolescents with ED is still scarce. METHODS: In January-February 2021, during the second Italian national lockdown due to the SARS-CoV-2 pandemic, an anonymous paper survey was conducted in an Italian third-level center for ED in childhood and adolescence. Demographics, frequency of use of TikTok, frequently viewed topics and hashtags, experienced body-shaming, as well as the use of TikTok (active search, use of proposed contents) and perceived influences of this SM on eating attitudes and self-esteem were assessed. Groups of patients with different perceived SM-induced effects were compared to determine the frequency of their interaction with 3 specific contents (diet, Pro-Anorexia Nervosa (pro-Ana) and pro-ED recovery). RESULTS: Seventy-eight patients (93.6% females, mean age 14.5 ± 2.1 years) were enrolled in the study. For 62.8%, TikTok represented the main SM, used for 1.4 ± 1.0 h/day, with diet (21.8%) as the most frequently used topic category. Pro-Ana and pro-ED recovery contents ("#foryou" and "#edrecovery" as the most frequent, respectively) were both actively searched by patients and proposed by the SM in a significant number of cases. For 59.0%, using TikTok reduced self-esteem, while 26.9% reported TikTok-related significant changes in their daily lives, and 3.8% reported experiences of body-shaming. Patients describing a negative effect of TikTok on their self-esteem more frequently searched and browsed "diet" (p = 0.007) and pro-ED recovery (p = 0.007) contents. Positive qualitative feedback on the SM was also reported. CONCLUSIONS: This study documents the use of the SM TikTok among children and adolescents with ED. Individuals with a perceived negative effect of this SM on their self-esteem may show greater interaction with specific content. Further studies are needed to investigate the psychopathological factors influencing the relationship between ED and the use of SM.

Acidic pH Promotes Refolding and Macroscopic Assembly of Amyloid ß (16-22) Peptides at the Air-Water Interface.

Assembly by amyloid-beta (Aß) peptides is vital for various neurodegenerative diseases. The process can be accelerated by hydrophobic interfaces such as the cell membrane interface and the air-water interface. Elucidating the assembly mechanism for Aß peptides at hydrophobic interface requires knowledge of the microscopic structure of interfacial peptides. Here we combine scanning force microscopy, sum-frequency generation spectroscopy, and metadynamics simulations to probe the structure of the central fragment of Aß peptides at the air-water interface. We find that the structure of interfacial peptides depends on pH: at neutral pH, the peptides adopt a less folded, bending motif by forming intra-hydrogen bonds; at acidic pH, the peptides refold into extended ß-strand fibril conformation, which further promotes their macroscopic assembly. The conformational transition of interfacial peptides is driven by the reduced hydrogen bonds, both with water and within peptides, resulting from the protonation of acidic glutamic acid side chains.

An open quantum system theory for polarizable continuum models.

The problem of a solute described by Quantum Chemistry within a solvent represented as a polarizable continuum model (PCM) is here reformulated in terms of the open quantum systems (OQS) theory. Using its stochastic Schrödinger equation formulation, we are able to provide a more comprehensive picture of the electronic energies and the coupling between solute and solvent electronic dynamics. In particular, the OQS-PCM proves to be a unifying theoretical framework naturally including polarization and dispersion interactions, the effect of solvent fluctuations, and the non-Markovian solvent response. As such, the OQS-PCM describes the interplay between the solute and the solvent typical electronic dynamical times and yields both the standard PCM and the so-called Born-Oppenheimer solvation regime, where the solvent electronic response is considered faster than any electronic dynamics taking place in the solute. In analyzing the OQS-PCM, we obtained an expression for the solute-solvent dispersion (van der Waals) interactions, which is very transparent in terms of a physical interpretation based on fluctuations and response functions. Finally, we present various numerical tests that support the theoretical findings.

Atomistic insight into the aggregation of [Au25(SR)18] q nanoclusters.

Atomically precise nanoclusters have been proven to give solid state aggregates with intriguing optical properties. However, the mechanism that regulates this aggregation remains unclear. Here, the aggregation of two Au25 nanoclusters in solution is investigated through enhanced sampling molecular dynamics simulations. To understand how the free energy of the systems depends on the nanocluster features, calculations were performed on three nanocluster pairs which differ in charge states and substituent nature and dimension. Our results show that the choice of the ligands heavily affects the free energy profile of the systems when the structures are nearby and, in some cases, the formation of a dimeric phase is observed. This phase is particularly stable in long-chain substituted nanoclusters, where the long alkane chains can generate bundles and the gold cores are closer compared to the short-chain ligands. We found a remarkable agreement between our calculations and the literature-available solid-state structures, especially for the orientation of the interacting nanoclusters. Moreover, some of the dimeric structures are prodromal to the formation of the aurophilic intercluster bond observed in the crystal structures, meaning that the dimer can act as a precursor and can drive the whole crystallization mechanism toward the formation of stable crystal species.

Seasonal changes in immune response and reproductive investment in a biparental beetle.

Immunity and reproduction are physiologically demanding processes, therefore trade-offs are expected between these life history traits. Furthermore, investments in these traits are also known to be affected by factors such as sex, body size, individual condition, seasonal changes and parasite infection. The relationship between immunity and reproduction and the effect of other factors on this relationship were investigated in many species, but there are a small number of studies on these patterns in biparental invertebrates. Lethrus apterus is an iteroparous biparental beetle with predominant female care in respect of collecting and processing food for larvae. Males guard the nest built underground and also their mate. Here we investigate how sex, body size, time within the reproductive season and parasite load may influence the relationship between immunocompetence and reproductive investment in this species. In beetles from a natural population we quantified immune response by measuring the encapsulation response, antimicrobial activity of hemolymph, the investment into reproductive tissues by measuring the size of testis follicles in males and total egg size in females, and parasite load by counting the number of mites on the beetles. We found that the encapsulation response is condition-dependent, as large individuals showed significantly higher encapsulation ability than small ones. Antimicrobial capacity was significantly higher in females than in males. In case of antimicrobial activity there was also a seasonal change in the relationship between immunity and reproductive investment, but only under heavy mite load. Reproductive investment was influenced by the interaction between body size and season (in females) and by body size and season (in males). Furthermore in females the interaction between antimicrobial activity and season indicated that reproductive investment increased with antimicrobial activity early in the reproductive season. By investigating the relationship between immunity and reproductive investment in a natural population of a biparental beetle species, we can conclude that investments into these important life history traits are governed by complex interactions between physiological and environmental factors. Our results are discussed in the context of life history evolution, highlighting the role of the assessed factors in shaping trade-offs themselves (in invertebrates).

Quantum optimal control theory for solvated systems.

In this work, we generalize the quantum optimal control theory (QOCT) of molecules subject to ultrashort laser pulses to the case of solvated systems, explicitly including the solvent dielectric properties in the system's quantum Hamiltonian. A reliable description of the solvent polarization is accounted for within the polarizable continuum model (PCM). The electron dynamics for the molecules in solution is coupled with the dynamics of the surrounding polarizable environment, which affects the features of the optimized laser pulse. To illustrate such effects, numerical applications of the developed method to the study of optimal population of selected excited states of two molecular solvated systems are presented and discussed.

Unraveling the molecular mechanisms of color expression in anthocyanins.

Anthocyanins are a broad family of natural dyes, increasingly finding application as substitutes for artificial colorants in the food industry. In spite of their importance and ubiquity, the molecular principles responsible for their extreme color variability are poorly known. We address these mechanisms by computer simulations and photoabsorption experiments of cyanidin-3-O-glucoside in water solution, as a proxy for more complex members of the family. Experimental results are presented in the range of pH 1-9, accompanied by a comprehensive systematic computational study across relevant charge states and tautomers. The computed spectra are in excellent agreement with the experiments, providing unprecedented insight into the complex behavior underlying color expression in these molecules. Besides confirming the importance of the molecule's charge state, we also unveil the hitherto unrecognized role of internal distortions in the chromophore, which affect its degree of conjugation, modulating the optical gap and in turn the color. This entanglement of structural and electronic traits is also shared by other members of the anthocyanin family (e.g. pelargonidin and delphinidin) highlighting a common mechanism for color expression across this important family of natural dyes.

A classical picture of subnanometer junctions: an atomistic Drude approach to nanoplasmonics.

The description of optical properties of subnanometer junctions is particularly challenging. Purely classical approaches fail, because the quantum nature of electrons needs to be considered. Here we report on a novel classical fully atomistic approach, ωFQ, based on the Drude model for conduction in metals, classical electrostatics and quantum tunneling. We show that ωFQ is able to reproduce the plasmonic behavior of complex metal subnanometer junctions with quantitative fidelity to full ab initio calculations. Besides the practical potentialities of our approach for large scale nanoplasmonic simulations, we show that a classical approach, in which the atomistic discretization of matter is properly accounted for, can accurately describe the nanoplasmonics phenomena dominated by quantum effects.

Adsorption Mechanisms of Nucleobases on the Hydrated Au(111) Surface.

The solution environment is of fundamental importance in the adsorption of molecules on surfaces, a process that is strongly affected by the capability of the adsorbate to disrupt the hydration layer above the surface. Here we disclose how the presence of interface water influences the adsorption mechanism of DNA nucleobases on a gold surface. By means of metadynamics simulations, we describe the distinctive features of a complex free-energy landscape for each base, which manifests activation barriers for the adsorption process. We characterize the different pathways that allow each nucleobase to overcome the barriers and be adsorbed on the surface, discussing how they influence the kinetics of adsorption of single-stranded DNA oligomers with homogeneous sequences. Our findings offer a rationale as to why experimental data on the adsorption of single-stranded homo-oligonucleotides do not straightforwardly follow the thermodynamics affinity rank.

Willingness to initiate a fight but not contest behaviour depends on intruder size in Lethrus apterus (Geotrupidae).

In resident-intruder contests, residents are expected to win more often than intruders unless the intruder has significantly higher competitive ability that is often determined by its size. Therefore, small intruders are expected to be less motivated to engage in contests than large ones and intruder size is predicted to have a positive relationship with the duration and escalation of the encounters. In a field experiment we tested these hypotheses in Lethrus apterus, a biparental beetle breeding in underground tunnels, by placing either a small or a large male in front of a tunnel occupied by a resident male. In agreement with our predictions residents won most of the encounters. Small intruders were less willing to engage in a contest and were less successful in their takeover attempts than large intruders. Contrary to many studies however, the duration and escalation (measured by the occurrence and latency of the different contest stages) of the fight in front of the burrow did not differ between the two intruder size categories. These findings suggest that in this species, small and large intruders adjust their prior decisions to their competitive abilities but once a fight started, they behave similarly during the contest.

Satisfação dos utentes atendidos pelos enfermeiros da Linha de Saúde Pública- DGS / Satisfaction of users assisted by nurses from the Public Health Line - DGS

O presente trabalho consiste num relatório crítico e reflexivo tradutor das atividades desenvolvidas ao longo da formação pós-graduada em Enfermagem Comunitária em contexto da Linha de Saúde Pública da Direção Geral da Saúde. A Enfermagem Comunitária implica uma diversidade de áreas de intervenção pelo que, o Enfermeiro com esta especialidade, deve estar capacitado para intervir em qualquer problema de saúde identificado na comunidade, grupo ou pessoa refletindo o desenvolvimento e a aquisição de competências no cuidado em enfermagem avançada. Após a realização do diagnóstico de enfermagem, desenvolvido no Estágio I, aos enfermeiros da LSP de onde emergiu a necessidade/ problema de avaliar a satisfação dos utentes com o serviço prestado, analisamo-la numa perspetiva de intervenção como indicador de avaliação da qualidade enquanto preocupação atual e crescente no contexto da prestação de cuidados de saúde. Procuramos a partir daqui perceber a satisfação dos utentes da LSP, segundo entrevista telefónica com recurso a ICD da DGS. Com a análise dos dados daqui resultantes que evidenciam globalmente a satisfação com o serviço prestado pelos enfermeiros da LSP, surge a sugestão da necessidade de divulgação deste serviço à população em geral. Neste sentido, orientámos o 2º Estágio para esta última área, e perante a necessidade identificada por parte dos utentes da LSP de divulgação do serviço, com base nas competências do Enfermeiro Especialista em Enfermagem Comunitária e especificamente as competências G2. "Contribui para o processo de capacitação de grupos e comunidades" e G2.3. "Procede à gestão da informação em saúde aos grupos e comunidade", propusemonos perceber que estratégias promovem a procura de informação pelas comunidades e que instrumentos se adequam à disseminação de informação deste tipo de serviço inovador, com recurso à revisão sistemática da literatura. A partir desta desenvolvemos um programa de intervenção para com os enfermeiros da LSP perspetivando estratégias de divulgação fundamentadas numa prática baseada na evidência, contextualizado no modelo de decisão e inovação. No desenvolvimento do nosso percurso de mestrado, refletimos sobre a dimensão da satisfação, que analisámos à luz da política de qualidade proposta pela DGS, enquanto matriz orientadora de uma análise critica, da qual emergiram algumas sugestões estratégicas e inovadoras. Neste relatório refletimos ainda os principais contributos inerentes ao percurso realizado no sentido do desenvolvimento de competências especializadas

The present work consists in a critical and reflective report that translates the activities developed along the postgraduate training in Community Nursing in context of the public health line (PHL)of the General Direction of Health (GDH). Community Nursing implies a diversity of areas of intervention, the Nurse with this specialty, must be able to intervene in any health problem identified in the community group or person reflecting the development and acquisition of advanced nursing care skills. After the completion of nursing diagnosis, developed in Internship I, the nurses of PHL where emerged the need/problem to assess users ' satisfaction with the service provided, we analysed it in a perspective of intervention as an indicator for assessing the quality as a current and growing concern in the context of the delivery of health care. We tried from here to realize the satisfaction of users of the PHL, according to a telephone interview using DCI of the GDH. With the analysis of the resulting data that show overall satisfaction with the service provided by the nurses of the PHL, outcomes suggestion of the need for dissemination of this service to the public in general. In this sense, we oriented the 2nd Internship to this last area, and to the need identified by the users of the PHL service disclosure, based on the skills of nurses and nurse specialist skills specifically G2. "It contributes to the process of empowerment of groups and communities" and G2.3 "To manage health information to groups and community", we aimed to understand what strategies promote the demand for information by communities and which instruments are suited for dissemination of information of this kind of innovative service, using the review systematic literature. From this, we developed a program of intervention for the nurses of the PHL foreseeing disclosure strategies grounded in evidencebased, contextualized in decision-making and innovation model. In the development of our master branch of studies, we reflect on the extent of satisfaction that we have looked at in the light of the quality policy proposed by the GDH, while guiding a critical analysis matrix, from which emerged a few strategic and innovative suggestions. In this report, we also reflect the main contributions inherent to our route held in order to development of expertise skills

Sampling Molecular Conformers in Solution with Quantum Mechanical Accuracy at a Nearly Molecular-Mechanics Cost.

We introduce a method to evaluate the relative populations of different conformers of molecular species in solution, aiming at quantum mechanical accuracy, while keeping the computational cost at a nearly molecular-mechanics level. This goal is achieved by combining long classical molecular-dynamics simulations to sample the free-energy landscape of the system, advanced clustering techniques to identify the most relevant conformers, and thermodynamic perturbation theory to correct the resulting populations, using quantum-mechanical energies from density functional theory. A quantitative criterion for assessing the accuracy thus achieved is proposed. The resulting methodology is demonstrated in the specific case of cyanin (cyanidin-3-glucoside) in water solution.

Multimodel Approach to the Optical Properties of Molecular Dyes in Solution.

We introduce a multimodel approach to the simulation of the optical properties of molecular dyes in solution, whereby the effects of thermal fluctuations and of dielectric screening on the absorption spectra are accounted for by explicit and implicit solvation models, respectively. Thermal effects are treated by averaging the spectra of molecular configurations generated by an ab initio molecular-dynamics simulation where solvent molecules are treated explicitly. Dielectric effects are then dealt with implicitly by computing the spectra upon removal of the solvent molecules and their replacement with an effective medium, in the spirit of a continuum solvation model. Our multimodel approach is validated by comparing its predictions with those of a fully explicit-solvation simulation for cyanidin-3-glucoside (cyanin) chromophore in water. While multimodel and fully explicit-solvent spectra may differ considerably for individual configurations along the trajectory, their time averages are remarkably similar, thus providing a solid benchmark of the former and allowing us to save considerably on the computer resources needed to predict accurate absorption spectra. The power of the proposed methodology is finally demonstrated by the excellent agreement between its predictions and the absorption spectra of cyanin measured at strong and intermediate acidity conditions.

Male-biased sex ratio does not promote increased sperm competitiveness in the seed beetle, Callosobruchus maculatus.

Sperm competition risk and intensity can select for adaptations that increase male fertilisation success. Evolutionary responses are examined typically by generating increased strength of sexual selection via direct manipulation of female mating rates (by enforcing monandry or polyandry) or by alteration of adult sex ratios. Despite being a model species for sexual selection research, the effect of sexual selection intensity via adult sex-ratio manipulation on male investment strategies has not been investigated in the seed beetle, Callosobruchus maculatus. We imposed 32 generations of experimental evolution on 10 populations of beetles by manipulating adult sex ratio. Contrary to predictions, males evolving in male-biased populations did not increase their testes and accessory gland size. This absence of divergence in ejaculate investment was also reflected in the fact that males from male-biased populations were not more successful in either preventing females from remating, or in competing directly for fertilisations. These populations already demonstrate divergence in mating behaviour and immunity, suggesting sufficient generations have passed to allow divergence in physiological and behavioural traits. We propose several explanations for the absence of divergence in sperm competitiveness among our populations and the pitfalls of using sex ratio manipulation to assess evolutionary responses to sexual selection intensity.