Endoscopic Retrograde Cholangiopancreatography on Pediatric Patients: Experience of a Portuguese Adult Gastroenterology Department.

Introduction: Experience with endoscopic retrograde cholangiopancreatography (ERCP) in the pediatric population is limited. Few medical centers have experts specifically trained in pediatric therapeutic endoscopy. As a result, patients are generally referred to adult endoscopists with high experience in the procedure. The aim of this study was to characterize the experience of an adult endoscopy unit with ERCP on pediatric patients, with a special focus on very young patients. Methods: We retrospectively analyzed indications, technical success rate, final clinical diagnosis, and complications of ERCPs in children <18 years at our tertiary referral hospital center between January 1994 and June 2022. Results: Sixty-five ERCPs were performed on 57 children with a median age of 13 years (range 1-17 years). Eleven ERCPs were performed on 9 patients up to 5 years old. Indications for ERCP were as follows: biliary obstruction (n = 40), mainly due to choledocholithiasis, lithiasic acute pancreatitis (n = 19), recurrent pancreatitis (n = 3), stent extraction (n = 2), and post-operative biliary fistula (n = 1). The cannulation success rate was 95.1%. Therapeutic interventions were performed in 79% of ERCP. All patients were followed up as inpatients. Complications were recorded in two procedures (3.1%), and no procedure-related mortality occurred. Conclusion: In our experience, ERCP in children can be safely performed with high success rates by advanced adult-trained expert endoscopists at a high-volume center.

Introdução: Existe pouca experiência na realização de colangiopancreatografia retrógrada endoscópica (CPRE) na população pediátrica. A maioria dos centros carece de especialistas especificamente treinados em endoscopia terapêutica pediátrica, sendo os doentes geralmente referenciados para Gastroenterologistas de adultos com elevada experiência na técnica. O objectivo deste estudo foi caracterizar a experiência de um departamento de Gastrenterologia de adultos em CPRE pediátrica, com destaque particular nos doentes muito novos. Métodos: Foram analisadas retrospectivamente as indicações, sucesso técnico, diagnósticos e complicações das colangiopancreatografias retrógradas endoscópicas (CPREs) realizadas no nosso hospital terciário em crianças <18 anos, entre Janeiro de 1994 e Junho de 2022. Resultados: Foram realizadas 65 CPREs em 57 crianças com idade mediana 13 anos (1­17 anos). Doze procedimentos foram realizados em 9 crianças com idade até 5 anos. As indicações para CPRE foram: obstrução biliar (n = 40), sobretudo devido a coledocolitíase, pancreatite aguda litiásica (n = 19), pancreatite recorrente (n = 3), extracção de prótese (n = 2) e fístula biliar pós cirurgia (n = 1). A taxa de sucesso de canulação foi 95.4%. Foram realizados procedimentos terapêuticos em 80.0% das CPREs. Todos os doentes foram vigiados em regime de internamento, tendo-se registado complicações em dois exames (3.1%). Não existiram mortes relacionadas com a técnica. Discussão/ Conclusão: A CPRE pode ser realizada na população pediátrica com segurança e elevada taxa de sucesso por Gastrenterologistas de adultos com experiência na técnica, num centro com elevado volume de exames.

Family Nursing Care during the Transition to Parenthood: A Scoping Review.

BACKGROUND: Family-centered care places the family at the core of care, with family nurses playing a pivotal role in supporting and guiding members through pregnancy and the transition to parenthood and acknowledging the significant adjustments during these phases. AIM: To map the evidence concerning family nurses' care for families during the transition to parenthood. METHOD: The scoping review followed the Joanna Briggs Institute (JBI) methodology, focusing on family-centered care during pregnancy adaptation and the initial months of parenthood. Using a PCC (population, concept, and context) strategy, the research covered various databases: Scopus; Web of Science; and CINAHL Complete, MedLine Complete, and MedicLatina by EBSCOhost. RESULTS: A Preferred Reporting Items for Systematic Reviews and Meta-analyses extension for Scoping Reviews (PRISMA-ScR) flow diagram was used to present the results. Eighteen articles were included, mainly from the Middle East and Europe, including cross-sectional studies and reviews. Key findings addressed the transitioning process to parenthood, the impact of family characteristics, and the role of family nurses in enhancing these processes. CONCLUSION: Home care is considered vital during this transition. Family nursing should concentrate on both individuals and the parental subsystem, addressing social determinants equitably. Through these efforts, they empower families to establish an optimal environment for children's development.

Role of sesquiterpenes in biogenic new particle formation.

Biogenic vapors form new particles in the atmosphere, affecting global climate. The contributions of monoterpenes and isoprene to new particle formation (NPF) have been extensively studied. However, sesquiterpenes have received little attention despite a potentially important role due to their high molecular weight. Via chamber experiments performed under atmospheric conditions, we report biogenic NPF resulting from the oxidation of pure mixtures of ß-caryophyllene, α-pinene, and isoprene, which produces oxygenated compounds over a wide range of volatilities. We find that a class of vapors termed ultralow-volatility organic compounds (ULVOCs) are highly efficient nucleators and quantitatively determine NPF efficiency. When compared with a mixture of isoprene and monoterpene alone, adding only 2% sesquiterpene increases the ULVOC yield and doubles the formation rate. Thus, sesquiterpene emissions need to be included in assessments of global aerosol concentrations in pristine climates where biogenic NPF is expected to be a major source of cloud condensation nuclei.

Planting Date of Cotton in the Brazilian Cerrado Drives Boll Weevil (Coleoptera: Curculionidae) Infestation.

Although the boll weevil (BW), Anthonomus grandis grandis (Coleoptera: Curculionidae) has been attributed to the significant losses caused to cotton yield in the Americas, the categorization as a quarentenary pest in places where it is still not occurring has increased its relevance worldwide. In areas where it is widespread, pest suppression relies on many broad-spectrum insecticide applications. However, other control tactics are sought. Considering that early-flowering cultivars escape from boll weevil infestation, we investigated if three different planting dates (November, December, and January) could alter the plant life cycle, allowing the plants to escape from boll weevil infestation. Field trials were run in two seasons (2014/2015 and 2017/2018), and variables (days required to reach each flowering stage, fruiting plant structures-undamaged and damaged by the BW, and totals-number of boll weevils on plants and that had emerged from fallen structures on the ground) were assessed over 29 and 33 weeks, respectively. Based on the number of days required to initiate and terminate the flowering stage, the time to reach the economic threshold (ET), the number of undamaged, damaged, and the total reproductive structures, we concluded that planting dates in December for the Central Cerrado of Brazil should be preferred over the other two tested dates. Cultivations run at this planting date, anticipating the flowering period initiation and termination, reduced infested flowering structures, and delayed the decision making to control the pest, when compared to the other two planting dates.

A non-destructive X-ray fluorescence method of analysis of formalin fixed-paraffin embedded biopsied samples for biomarkers for breast and colon cancer.

In this work we present a methodology for the non-destructive elemental determination of formalin-fixed paraffin-embedded (FFPE) human tissue samples based on the Fundamental Parameters method for the quantification of micro Energy Dispersive X Ray Fluorescence (micro-EDXRF) area scans. This methodology intended to overcome two major constraints in the analysis of paraffin embedded tissue samples - retrieval of optimal region of analysis of the tissue within the paraffin block and the determination of the dark matrix composition of the biopsied sample. This way, an image treatment algorithm, based on R® tool to select the regions of the micro-EDXRF area scans was developed. Also, different dark matrix compositions were evaluated using varying combinations of H, C, N and O until the most accurate matrix was found: 8% H, 15% C, 1% N and 60% O for breast FFPE samples and 8% H, 23% C, 2% N and 55% O for colon. The developed methodology was applied to paired normal-tumour samples of breast and colon biopsied tissues in order to gauge potential elemental biomarkers for carcinogenesis in these tissues. The obtained results showed distinctive biomarkers for breast and for colon: there was a significant increase of P, S, K and Fe in both tissues, while a significant increase of Ca an Zn concentrations was also determined for breast tumour samples.

Assessment of a Side-Row Continuous Canopy Shaking Harvester and Its Adaptability to the Portuguese Cobrançosa Variety in High-Density Olive Orchards.

The olive tree is an important crop in Portugal, where different levels of intensification coexist. The traditional olive orchards present profitability problems, mainly due to harvesting, so there has been a drastic reconversion towards high-density or super-high-density olive orchards. The latter present major constraints due to very specific needs for their use, being practically destined for new orchards. Consequently, the possibility of using systems based on canopy shakers in high-density olive orchards with local varieties is promising. The objective of this work is to evaluate a prototype canopy shaker for the harvesting of high-density olive orchards of the Portuguese variety 'Cobrançosa'. The evaluation is based on the study of canopy shaking in order to adapt canopy training and the adaptability of the machine. For this purpose, the vibration of 72 points of the tree canopy was recorded and a qualitative assessment of the harvest was carried out. Differences were found between the different zones according to the direction of the forward movement of the harvester and the distance to the trunk. These differences were associated with the values obtained for fruit detachment, and a greater quantity of fruit was harvested in the areas of the canopy in contact with the rods.

Hypericum perforatum and Its Potential Antiplatelet Effect.

BACKGROUND: Hypericum perforatum (HP) is currently one of the most consumed medicinal plants in the world. In traditional Chinese medicine, the herb hypericum (Guan Ye Lian Qiao) belongs to the group of plants that clarify heat. It is also used to treat various types of infection and inflammation. In contrast to the extensive literature on the antidepressant effects of HP, little is known about its action on platelets. The main objective of this work was to investigate the possible relevance of HP to platelet function. METHODS: We characterized the profile of platelet activation in the presence of HP extracts through an evaluation of molecular markers by flow cytometry: mobilization of intracellular Ca++ and expression of platelet receptors such as activated GPIIbIIIa and P-selectin (CD62). RESULTS: The results indicated a possible inhibitory effect of HP on the platelet activation response, which could be explained by the effect on intracellular calcium mobilization and the expression of activated GPIIbIIIa receptors. Despite of the limitations of an in vitro study, our results provide evidence of the possible mechanisms of action of HP. CONCLUSIONS: Further studies are needed to elucidate the effect of HP on hemostasis, but it may be recognized as a substance with antiplatelet properties.

Antibody Fc characteristics and effector functions correlate with protection from symptomatic dengue virus type 3 infection.

Preexisting cross-reactive antibodies have been implicated in both protection and pathogenesis during subsequent infections with different dengue virus (DENV) serotypes (DENV1-4). Nonetheless, humoral immune correlates and mechanisms of protection have remained elusive. Using a systems serology approach to evaluate humoral responses, we profiled plasma collected before inapparent or symptomatic secondary DENV3 infection from our pediatric cohort in Nicaragua. Children protected from symptomatic infections had more anti-envelope (E) and anti-nonstructural protein 1 (NS1) total immunoglobulin G (IgG), IgG4, and greater Fc effector functions than those with symptoms. Fc effector functions were also associated with protection from hemorrhagic manifestations in the pre-symptomatic group. Furthermore, in vitro virological assays using these plasma samples revealed that protection mediated by antibody-dependent complement deposition was associated with both lysis of virions and DENV-infected cells. These data suggest that E- and NS1-specific Fc functions may serve as correlates of protection, which can be potentially applied toward the design and evaluation of dengue vaccines.

The Bradyrhizobium uaiense strain UFLA 03-164T enhanced yield performance of cowpea in soils with low or high phosphorus content

The objective of this study was to evaluate the agronomic efficiency of rhizobia strains already approved or in the selection stage for cowpea, in the Recôncavo da Bahia region, Brazil. Two field experiments were performed in the municipalities of Cruz das Almas and Maragogipe, Bahia, Brazil. A randomized block design was used with seven nitrogen sources and four replicates. Nitrogen sources consisted of the strains UFRB FA51B1, UFRB BA72C2-1, UFLA 03-164T, UFLA 03-84, INPA 03-11B, and two controls without inoculation, one with mineral nitrogen and another without. All the strains nodulated cowpea. The efficiency of the strains was determined by the number of nodules, nodule dry matter, total dry matter, grain yield, nitrogen accumulation in shoots and grain, and relative efficiency. The strain UFLA 03-164T can be recommended for biomass production, green manure, and promotion of grain yields in both soils. In Maragogipe, the UFLA 03-84 and INPA 03-11B strains can be recommended for biomass production, green manure, and promotion of grain yields. The UFLA 03-164T strain showed great potential to promote and grain yield in the two municipalities studied. The strain INPA 03-11B can be recommended for Maragogipe soil. UFLA 03-84 can also be recommended to increase grain yield in Cruz das Almas.

Oxidative [4 + 2] annulation of 1-naphthols with alkynes accelerated by an electron-deficient rhodium(III) catalysts.

The 1,3-diethoxycarbonyl-2,4,5-trimethylcyclopentadienyl (CpE) rhodium(III) complex displayed high efficacy in the catalytic oxidative annulation of 1-naphthols with internal alkynes under mild conditions. DFT calculations revealed that lower activation energies for the concerted metalation-deprotonation and the reductive elimination steps are the key to improved reactivity.

A Bipartite Geminivirus with a Highly Divergent Genomic Organization Identified in Olive Trees May Represent a Novel Evolutionary Direction in the Family Geminiviridae.

Olea europaea Geminivirus (OEGV) was recently identified in olive in Italy through HTS. In this work, we used HTS to show the presence of an OEGV isolate in Portuguese olive trees and suggest the evolution direction of OEGV. The bipartite genome (DNA-A and DNA-B) of the OEGV-PT is similar to Old World begomoviruses in length, but it lacks a pre-coat protein (AV2), which is a typical feature of New World begomoviruses (NW). DNA-A genome organization is closer to NW, containing four ORFs; three in complementary-sense AC1/Rep, AC2/TrAP, AC3/REn and one in virion-sense AV1/CP, but no AC4, typical of begomoviruses. DNA-B comprises two ORFs; MP in virion sense with higher similarity to the tyrosine phosphorylation site of NW, but in opposite sense to begomoviruses; BC1, with no known conserved domains in the complementary sense and no NSP typical of bipartite begomoviruses. Our results show that OEGV presents the longest common region among the begomoviruses, and the TATA box and four replication-associated iterons in a completely new arrangement. We propose two new putative conserved regions for the geminiviruses CP. Lastly, we highlight unique features that may represent a new evolutionary direction for geminiviruses and suggest that OEGV-PT evolution may have occurred from an ancient OW monopartite Begomovirus that lost V2 and C4, gaining functions on cell-to-cell movement by acquiring a DNA-B component.

Analysis of human tissues using Energy Dispersive X Ray Fluorescence - Dark matrix determination for the application to cancer research.

BACKGROUND: X ray Fluorescence has been essayed as a suitable technique for the elemental quantification of trace element in human tissues, namely comparison of normal and cancerous tissue. However, accurate results depend on a robust quantification approach, namely correct evaluation of the samples' dark matrix. METHODS: In order to determine the most suitable dark matrix composition for the quantification of such samples using the Fundamental Parameter approach, we have measured several Certified Reference Materials and essayed different dark matrix compositions to achieve the most accurate results. The resulting dark matrix was then applied to normal and tumor ovarian and prostate tissue samples, and the obtained results were compared with the ones obtained with a comparative method using external standard calibration curves. RESULTS: Using a dark matrix composed of 10 % - H, 22 % - C, 3 % - N and 60 % - O yielded the best compromise in accuracy for the light and heavy elements. For the reduced sample size and conditions of this study, for both organs, the concentrations of transition metals decrease in tumor tissues, while the concentration of lighter elements, P and Cl, increases. On the other hand, there are elements that showed different behavior between the two types of tissue, namely Zn and S, that increase in prostate tumor tissue and decrease in ovarian tissue. CONCLUSION: An increase in precision was one of the improvements found with the newly developed method, as the FP-approach contemplates matrix effects and the influence of other elements in the analytes' quantification. Additionally, the determined dark matrix can be employed in any tissue analysis application by means of EDXRF.

Assessment of Qigong Effects on Anxiety of High-school Students: A Randomized Controlled Trial.

CONTEXT: Students are vulnerable to developing anxiety, a psychiatric disorder closely related to emotional stress, when systematically stressed by classes, homework, and evaluations. Qigong integrates physical, respiratory, and mental exercises, inducing vegetative biofeedback with significant effects on physiological regulation. OBJECTIVE: The current study aimed to assess the potential effects of specific Qigong exercises on students' anxiety levels and evaluate the feasibility of practical integration in a daily school context. DESIGN: The research team developed a randomized controlled trial. SETTING: This study was performed in Cedros and Horizonte private schools located in Vila Nova de Gaia in Portugal. PARTICIPANTS: Participants were 104 high-school students at the schools. INTERVENTION: Participants were randomly divided into three groups: (1) an intervention group, the Qigong (QG) group (n = 34), which performed Qigong exercises; (2) a control group, the TV documentary (TVD) group (n = 34), which watched a TV documentary; and (3) a second control group, the typical school duties (TSD) group (n = 36), which performed regular school duties. OUTCOME MEASURES: Anxiety levels were assessed through a psychological test, the State-Trait Anxiety Inventory (STAI) and salivary cortisol tests. RESULTS: Psychological and biochemical variables assessed at baseline and postintervention showed a greater decrease in anxiety levels in the QG group than in the other two groups. CONCLUSIONS: Qigong seems to be an efficient tool to reduce anxiety and control the stress of high-school students.

Photo-Induced ortho-C-H Borylation of Arenes through In Situ Generation of Rhodium(II) Ate Complexes.

Photoinduced in situ "oxidation" of half-sandwich metal complexes to "high-valent" cationic metal complexes has been used to accelerate catalytic reactions. Here, we report the unprecedented photoinduced in situ "reduction" of half-sandwich metal [Rh(III)] complexes to "low-valent" anionic metal [Rh(II)] ate complexes, which facilitate ligand exchange with electron-deficient elements (diboron). This strategy was realized by using a functionalized cyclopentadienyl (CpA3) Rh(III) catalyst we developed, which enabled the basic group-directed room temperature ortho-C-H borylation of arenes.

Country-by-Country Reporting: A Step Towards Unitary Taxation?

Multinational companies are now obliged to deliver an annual report to the tax authorities with information disaggregated by country (country-by-country reporting) in order to show where the assets and workers are allocated, how profits are distributed and to whom taxes are paid. Unfortunately, these reports are not made public in the European Union, thus preventing public scrutiny about the strategies used by multinational companies to displace profits to tax havens. This article applies the Unitary Taxation regime proposed by the European Commission to US multinational companies. The results confirm a strong bias among the profits distribution towards countries with lower corporate tax rates. Likewise, they confirm the capacity of the Unitary Taxation to promote a fairer distribution of tax revenues. These results can be a good contribution to the current Portuguese presidency of the European Union, which managed to gather important support to move forward with the European public country-by-country reporting directive.

Role of iodine oxoacids in atmospheric aerosol nucleation.

Iodic acid (HIO3) is known to form aerosol particles in coastal marine regions, but predicted nucleation and growth rates are lacking. Using the CERN CLOUD (Cosmics Leaving Outdoor Droplets) chamber, we find that the nucleation rates of HIO3 particles are rapid, even exceeding sulfuric acid-ammonia rates under similar conditions. We also find that ion-induced nucleation involves IO3 - and the sequential addition of HIO3 and that it proceeds at the kinetic limit below +10°C. In contrast, neutral nucleation involves the repeated sequential addition of iodous acid (HIO2) followed by HIO3, showing that HIO2 plays a key stabilizing role. Freshly formed particles are composed almost entirely of HIO3, which drives rapid particle growth at the kinetic limit. Our measurements indicate that iodine oxoacid particle formation can compete with sulfuric acid in pristine regions of the atmosphere.

Stakeholder views of source separation collection programme in East São Paulo, Brazil.

The investigation of the views of the stakeholders involved in the municipal solid waste separate collection programme (CP) performed in the East Zone of the city of São Paulo is presented in this paper. Aiming to obtain the necessary information to be analysed, interviews with the manager of the Municipal Urban Cleaning Authority (MUCA) of the city, with leaders of recycling worker cooperatives (WCs), and citizens were performed using semi-structured questionnaires. The analysis was performed using the software "IRAMUTEQ". The results show that, in the view of the manager of the MUCA of the city and the WCs' leaders, the low adhesion of the population to the separate CP is the greatest obstacle to a further expansion of the existing programme. At the same time, the citizens have blamed the low diffusion made by the municipality about the separate CP in the East Zone of São Paulo. Thus, it can be concluded that the separate CP available in the East Zone of São Paulo is still flawed; since neither the public power, the WCs, nor the population are satisfied and point out several flaws. This situation highlights the need to establish better venues for discussion between the population, WCs, and the municipality to jointly design a separate collection system with a more participatory approach.

Coronally advanced flap achieved higher esthetic outcomes without a connective tissue graft for the treatment of single gingival recessions: a 4-year randomized clinical trial.

OBJECTIVES: Limited long-term data are available when comparing the esthetic outcomes of coronally advanced flap (CAF) with or without a connective tissue graft (CTG). The aim of this study was to compare the 4-year esthetic outcomes of CAF vs CAF + CTG for the treatment of isolated maxillary gingival recessions. MATERIAL AND METHODS: Forty-eight patients were randomly assigned for treatment either with CAF (control; N = 24) or to CAF + CTG (test group; N = 24). Patients were followed after the surgery until the final evaluation. A professional esthetic evaluation was performed using the Root coverage Esthetic Score (RES). Recession reduction, mean root coverage, and complete root coverage were also evaluated. RESULTS: Forty-two patients completed the study at the 4-year recall. A significant recession reduction was evident at 4 years, without significant intergroup differences. The CAF group showed a statistically significant higher final RES compared with the CAF + CTG group (9.14 ± 1.08 vs 7.25 ± 1.29, respectively, p < 0.001). Regarding the individual components of RES, gingival margin and marginal tissue contour were significantly higher in the CAF group compared with that in the CAF + CTG group. CONCLUSIONS: CAF presented with a significantly higher overall esthetic score than CAF + CTG, and in the individual RES components of marginal tissue contour and gingival margin after 4 years. CLINICAL RELEVANCE: CAF without the addition of CTG provided higher esthetic outcomes for the treatment of isolated gingival recessions.

Photo-oxidation of Aromatic Hydrocarbons Produces Low-Volatility Organic Compounds.

To better understand the role of aromatic hydrocarbons in new-particle formation, we measured the particle-phase abundance and volatility of oxidation products following the reaction of aromatic hydrocarbons with OH radicals. For this we used thermal desorption in an iodide-adduct Time-of-Flight Chemical-Ionization Mass Spectrometer equipped with a Filter Inlet for Gases and AEROsols (FIGAERO-ToF-CIMS). The particle-phase volatility measurements confirm that oxidation products of toluene and naphthalene can contribute to the initial growth of newly formed particles. Toluene-derived (C7) oxidation products have a similar volatility distribution to that of α-pinene-derived (C10) oxidation products, while naphthalene-derived (C10) oxidation products are much less volatile than those from toluene or α-pinene; they are thus stronger contributors to growth. Rapid progression through multiple generations of oxidation is more pronounced in toluene and naphthalene than in α-pinene, resulting in more oxidation but also favoring functional groups with much lower volatility per added oxygen atom, such as hydroxyl and carboxylic groups instead of hydroperoxide groups. Under conditions typical of polluted urban settings, naphthalene may well contribute to nucleation and the growth of the smallest particles, whereas the more abundant alkyl benzenes may overtake naphthalene once the particles have grown beyond the point where the Kelvin effect strongly influences the condensation driving force.

Use of construction and demolition solid wastes for basket gabion filling.

Construction and demolition wastes have been studied by technical means aiming at the development of management tools to reduce their environmental impacts. Among these, recycling can be highlighted. This paper aims at the technical assessment of basket gabions filled with construction and demolition solid waste. Gabions are usually used for retaining walls construction, and these are commonly filled with rocks. Retaining walls are essential for earthfill slopes stabilization, and they must have proper characteristics of strength. However, depending on the slope height or the technical responsibility of the retaining wall, alternative materials with proper characteristics could be used to fill the gabions. The use of recycled material for gabion filling could reduce environmental impacts and costs caused by retaining wall construction. So, basket gabion cells were filled with construction solid waste and basaltic rocks, both crushed into coarse granulometry aiming to compare technical characteristics among them. The performed laboratory tests showed that the horizontal and vertical displacements determined for gabion filled with wastes were near to those obtained for gabions filled with basaltic rocks for a retaining wall of 5 m and up. In conclusion, it can be drawn that basket gabions filled with construction and demolition waste may be a technical alternative for civil construction, reducing environmental impacts and raw material consumption for retaining wall execution.