Stereotactic anatomy of the third ventricle.

PURPOSE: Endoscopic third ventriculostomy (ETV) is a surgical procedure that can lead to complications and requires detailed preoperative planning. This study aimed to provide a more accurate understanding of the anatomy of the third ventricle and the location of important structures to improve the safety and success of ETV. METHODS: We measured the stereotactic coordinates of six points of interest relative to a predefined stereotactic reference point in 23 cadaver brain hemi-sections, 200 normal brain magnetic resonance imaging (MRI) scans, and 24 hydrocephalic brain MRI scans. The measurements were statistically analyzed, and comparisons were made. RESULTS: We found some statistically significant differences between genders in MRIs from healthy subjects. We also found statistically significant differences between MRIs from healthy subjects and both cadaver brains and MRIs with hydrocephalus, though their magnitude is very small and not clinically relevant. Some stereotactic points were more posteriorly and inferiorly located in cadaver brains, particularly the infundibular recess and the basilar artery. It was found that all stereotactic points studied were more posteriorly located in brains with hydrocephalus. CONCLUSION: The study describes periventricular structures in cadaver brains and MRI scans from healthy and hydrocephalic subjects, which can guide neurosurgeons in planning surgical approaches to the third ventricle. Overall, the study contributes to understanding ETV and provides insights for improving its safety and efficacy. The findings also support that practicing on cadaveric brains can still provide valuable information and is valid for study and training of neurosurgeons unfamiliar with the ETV technique.

Drug repurposing of dopaminergic drugs to inhibit ataxin-3 aggregation.

The accumulation of mutant ataxin-3 (Atx3) in neuronal nuclear inclusions is a pathological hallmark of Machado-Joseph disease (MJD), also known as Spinocerebellar Ataxia Type 3. Decreasing the protein aggregation burden is a possible disease-modifying strategy to tackle MJD and other neurodegenerative disorders for which only symptomatic treatments are currently available. We performed a drug repurposing screening to identify inhibitors of Atx3 aggregation with known toxicological and pharmacokinetic profiles. Interestingly, dopamine hydrochloride and other catecholamines are among the most potent inhibitors of Atx3 aggregation in vitro. Our results indicate that low micromolar concentrations of dopamine markedly delay the formation of mature amyloid fibrils of mutant Atx3 through the inhibition of the earlier oligomerization steps. Although dopamine itself does not cross the blood-brain barrier, dopamine levels in the brain can be increased by low doses of dopamine precursors and dopamine agonists commonly used to treat Parkinsonian symptoms. In agreement, treatment with levodopa ameliorated motor symptoms in a C. elegans model of MJD. These findings suggest a possible application of dopaminergic drugs to halt or reduce Atx3 accumulation in the brains of MJD patients.

Mycotoxins in Rice Correlate with Other Contaminants? A Pilot Study of the Portuguese Scenario and Human Risk Assessment.

Rice is the second most important cereal crop and is vital for the diet of billions of people. However, its consumption can increase human exposure to chemical contaminants, namely mycotoxins and metalloids. Our goal was to evaluate the occurrence and human exposure of aflatoxin B1 (AFB1), ochratoxin A (OTA), zearalenone (ZEN), and inorganic arsenic (InAs) in 36 rice samples produced and commercialized in Portugal and evaluate their correlation. The analysis of mycotoxins involved ELISA, with limits of detection (LODs) of 0.8, 1 and 1.75 µg kg-1 for OTA, AFB1, and ZEN, respectively. InAs analysis was carried out by inductively coupled plasma mass spectrometry (ICP-MS; LOD = 3.3 µg kg-1). No sample showed contamination by OTA. AFB1 was present in 2 (4.8%) samples (1.96 and 2.20 µg kg-1), doubling the European maximum permitted level (MPL). Concerning ZEN, 88.89% of the rice samples presented levels above the LOD up to 14.25 µg kg-1 (average of 2.75 µg kg-1). Regarding InAs, every sample presented concentration values above the LOD up to 100.0 µg kg-1 (average of 35.3 µg kg-1), although none surpassed the MPL (200 µg kg-1). No correlation was observed between mycotoxins and InAs contamination. As for human exposure, only AFB1 surpassed the provisional maximum tolerable daily intake. Children were recognized as the most susceptible group.

Gender and Tobacco Consumption among University Students.

In 2019, an estimated 155 million people aged between 15 and 24 were smokers. It is also known that 82.6% of current smokers started smoking between 14 and 25 years old. Tobacco uses in adolescents and young adults can lead to the development of serious and potentially life-threatening health problems. The aim of the present investigation is to identify and describe the practices related to the consumption of tobacco products and their distribution according to gender among students at the University of Algarve. This is an exploratory, cross-sectional study with a quantitative approach. For inferential statistics, a non-parametric analysis (χ2) was performed. The sample consisted of 326 university students, 75.5% female, with an average age of 26.03 years. In this sample, 45% of men and 57.7% of women reported never having smoked. In male students, the pattern of combined consumption is more frequent, with female students preferring conventional cigarettes. Statistically significant differences were found between genders for the pattern of tobacco consumption, the number of colleagues/peers who smoke, the opinion about tobacco-free outdoor spaces and the knowledge about new forms of tobacco/nicotine consumption. The university campus is identified by students as the second space where they most consume tobacco products and where they are most exposed to tobacco smoke. This fact forces a reflection on the strategies to be implemented to develop a healthier university.

A Robust Assay to Monitor Ataxin-3 Amyloid Fibril Assembly.

Spinocerebellar ataxia type 3 (SCA3) is caused by the expansion of a glutamine repeat in the protein ataxin-3, which is deposited as intracellular aggregates in affected brain regions. Despite the controversial role of ataxin-3 amyloid structures in SCA3 pathology, the identification of molecules with the capacity to prevent aberrant self-assembly and stabilize functional conformation(s) of ataxin-3 is a key to the development of therapeutic solutions. Amyloid-specific kinetic assays are routinely used to measure rates of protein self-assembly in vitro and are employed during screening for fibrillation inhibitors. The high tendency of ataxin-3 to assemble into oligomeric structures implies that minor changes in experimental conditions can modify ataxin-3 amyloid assembly kinetics. Here, we determine the self-association rates of ataxin-3 and present a detailed study of the aggregation of normal and pathogenic ataxin-3, highlighting the experimental conditions that should be considered when implementing and validating ataxin-3 amyloid progress curves in different settings and in the presence of ataxin-3 interactors. This assay provides a unique and robust platform to screen for modulators of the first steps of ataxin-3 aggregation-a starting point for further studies with cell and animal models of SCA3.

Chemical Characterization and Bioactivity of Commercial Essential Oils and Hydrolates Obtained from Portuguese Forest Logging and Thinning.

Essential oils (EOs) and hydrolates (Hds) are natural sources of biologically active ingredients with broad applications in the cosmetic industry. In this study, nationally produced (mainland Portugal and Azores archipelago) EOs (11) and Hds (7) obtained from forest logging and thinning of Eucalyptus globulus, Pinus pinaster, Pinus pinea and Cryptomeria japonica, were chemically evaluated, and their bioactivity and sensorial properties were assessed. EOs and Hd volatiles (HdVs) were analyzed by GC-FID and GC-MS. 1,8-Cineole was dominant in E. globulus EOs and HdVs, and α- and ß-pinene in P. pinaster EOs. Limonene and α-pinene led in P. pinea and C. japonica EOs, respectively. P. pinaster and C. japonica HVs were dominated by α-terpineol and terpinen-4-ol, respectively. The antioxidant activity was determined by DPPH, ORAC and ROS. C. japonica EO showed the highest antioxidant activity, whereas one of the E. globulus EOs showed the lowest. Antimicrobial activity results revealed different levels of efficacy for Eucalyptus and Pinus EOs while C. japonica EO showed no antimicrobial activity against the selected strains. The perception and applicability of emulsions with 0.5% of EOs were evaluated through an in vivo sensory study. C. japonica emulsion, which has a fresh and earthy odour, was chosen as the most pleasant fragrance (60%), followed by P. pinea emulsion (53%). In summary, some of the studied EOs and Hds showed antioxidant and antimicrobial activities and they are possible candidates to address the consumers demand for more sustainable and responsibly sourced ingredients.

Avaliação da síndrome de burnout em profissionais de enfermagem em unidade de terapia intensiva neonatal / Evaluación del síndrome de quemadura en profesionales de enfermería de la unidad de cuidados intensivos neonatales / Assessment of burnout syndrome in nursing professionals in a neonatal intensive care unit

Objetivo: Descrever a avaliação preliminar da Síndrome de Burnout nos profissionais de Enfermagem, atuantes em Unidade de Terapia Intensiva Neonatal. Método: Estudo descritivo, transversal, quantitativo realizado com 60 profissionais de Enfermagem atuantes em uma maternidade-escola na cidade de Fortaleza-CE-Brasil. A coleta de dados ocorreu mediante a aplicação de um questionário com características sociodemográficas e do questionário preliminar de Burnout proposto por Jbeili. Resultados: Os resultados foram apresentados em tabela e figura, com análise estatística descritiva fundamentada na literatura. Evidenciou-se que 63,3% dos participantes encontravam-se na fase inicial da síndrome; 35,0% tiveram possibilidade de desenvolver e um deles sendo diagnosticado. Dentre as dimensões, 50,0% apresentaram baixa realização e motivação profissional. Conclusão: Conclui-se que o nível mais evidente da síndrome foi em sua fase inicial e a dimensão predominante foi a baixa realização profissional.(AU)

Objective: To describe the preliminary assessment of Burnout Syndrome in Nursing professionals working in the Neonatal Intensive Care Unit. Method: Descriptive, cross-sectional, quantitative study carried out with 60 nursing professionals working in a teaching maternity hospital in the city of Fortaleza-CE-Brazil. Data collection occurred through the application of a questionnaire with sociodemographic characteristics and the preliminary Burnout questionnaire proposed by Jbeili. Results: The results were presented in table and figure, with descriptive statistical analysis based on the literature. It was evident that 63.3% of the participants were in the initial phase of the syndrome; 35.0% were able to develop and one of them was diagnosed. Among the dimensions, 50.0% had low achievement and professional motivation. Conclusion: It is concluded that the most evident level of the syndrome was in its initial phase and the predominant dimension was low professional achievement.(AU)

Objetivo: Describir la evaluación preliminar del Síndrome de Burnout en profesionales de enfermería, que trabajan en la Unidad de Cuidados Intensivos Neonatales. Método: Estudio descriptivo, transversal, cuantitativo realizado con 60 profesionales de enfermería que trabajan en una maternidad-escuela en la ciudad de Fortaleza-CE-Brasil. La recolección de datos se produjo en 2017, mediante la aplicación de un cuestionario con características sociodemográficas y el cuestionario preliminar Burnout propuesto por Jbeili. Resultados: Los resultados fueron presentados en tabla y figura, con análisis estadístico descriptivo basado en la literatura. Se evidenció que el 63,3% de los participantes se encontraban en la fase inicial del síndrome; el 35,0% fueron capaces de desarrollarse y uno de ellos fue diagnosticado. Entre las dimensiones, el 50,0% presentó bajo rendimiento y motivación profesional. Conclusión: Se concluyó que el nivel más evidente del síndrome se encontraba en su fase inicial y la dimensión predominante era el bajo rendimiento profesional(AU)

Cultural probes for environmental education: Designing learning materials to engage children and teenagers with local biodiversity.

Direct contact with nature is paramount in deepening children's and teenagers' interest in biodiversity. Learning materials chosen to convey information and engage participants during outings in nature-rich environments are varied and can support rich learning experiences. For this purpose, learning materials can be acquired "off-the-shelf" or developed for site-specific locations or projects. However, there is little guidance on potential techniques for those wishing to generate contextually relevant materials. With the view of responding to this challenge, we propose the cultural probes technique. We demonstrate that the technique, commonly used in qualitative research to generate novel insights in conversation with participants, can instigate innovative and thoughtful approaches to materials designed for children and teenagers to explore nature. We present a toolkit that draws on the literature on cultural probes, inquiry-based learning, and the value of sensory, emotional, and aesthetic experiences in environmental education for structuring interactions with participants. To test our approach, we applied a descriptive research design and mixed-methods approach for collecting questions from youths between the ages of 10 and 18, inspired by a nature walk and a set of exploratory tasks executed through the toolkit. Specifically, we tested our toolkit along a trail in the Nature Park of Terceira, situated in the Azores, a Portuguese volcanic archipelago in the North Atlantic. Here, we present and reflect on the data collected during one visit organized over two days with two groups of participants and one post-trail activity directed at both groups. Results demonstrate that the open-ended and playful nature of cultural probes offers a novel way to engage youths with nature-rich environments through questioning. This contribution further highlights the potential of cultural probes for instigating encounters that tap into the value of sensory, emotional, and aesthetic experience in nature, with positive outcomes for participants.

Arsenic in Portuguese Rice: Is There Any Risk?

Arsenic is a metalloid with natural and anthropogenic sources and its inorganic form is toxic to humans. Rice is highly consumed worldwide and is prone to arsenic contamination; therefore, this study evaluated the inorganic arsenic content of 70 Portuguese rice samples. These were analysed through inductively coupled plasma mass spectrometry (ICP-MS) with a detection limit of 3.3 µg kg-1. The average contamination was of 29.3 µg kg-1, with brown and short rice presenting higher values than white and long rice. The highest concentration, 100 µg kg-1, equalled the maximum residue limit (MRL) for rice destined for infants' consumption. The estimated daily intake (EDI) surpassed the benchmark dose (lower confidence limit 10%) (BMDL10) of 0.3 µg kg-1 of bw/day considering children in the 95th percentile of rice consumption and the worst-case scenario concentration. However, other sources also contribute to the EDI and some population groups can exceed the BMDL10.

Real-world effectiveness of palbociclib plus fulvestrant in advanced breast cancer: Results from a population-based cohort study.

BACKGROUND: Real-world (RW) data may provide valuable information on the effectiveness and safety of medicines, which is particularly relevant for clinicians, patients and third-party payers. Evidence on the effectiveness of palbociclib plus fulvestrant is scarce, which highlights the need of additional studies. The aim of this study was to evaluate the effectiveness of palbociclib plus fulvestrant in advanced breast cancer (ABC). MATERIALS AND METHODS: We conducted a population-based retrospective cohort study and cases of interest were identified through the Portuguese National Cancer Registry database and additional data sources. Patients aged≥18 years, diagnosed with ABC and exposed to palbociclib plus fulvestrant between May 31, 2017 and March 31, 2019 were included. Patients were followed-up until death or cut-off date (February 28, 2021). Primary outcome was rw-progression-free survival (rwPFS). Secondary outcomes were rw-overall survival (rwOS), rw-time to palbociclib failure (rwTPF) and rw-time to next treatment (rwTTNT). RESULTS: A total of 210 patients were included. Median age was 58 years (range 29-83) and 99.05% were female. Median follow-up time was 23.22 months and, at cut-off date, treatment had been discontinued in 189 patients, mainly due to disease progression (n = 152). Median rwPFS was 7.43 months (95% confidence interval [CI] 6.28-9.05) and 2-year rwPFS was 16.65% (95%CI 11.97-22.00). Median rwOS was 24.70 months (95%CI 21.58-29.27), median rwTPF was 7.5 months (95%CI 6.51-9.08) and median rwTTNT was 11.74 months (95%CI 10.33-14.08). CONCLUSION: Palbociclib plus fulvestrant seems an effective treatment for ABC in real-world context. Compared to registrations studies, rwPFS and rwOS were shorter in real-life setting.

A coinfecção tuberculose/HIV com enfoque no cuidado e na qualidade de vida / Tuberculosis/HIV coinfection focused on care and quality of life

Resumo Objetivo Descrever e analisar as percepções de pessoas que vivenciam a coinfecção tuberculose/ vírus da imunodeficiência humana, quanto à qualidade de vida e ao cuidado em saúde. Métodos Estudo exploratório, descritivo, com abordagem qualitativa, realizado com dez pessoas que vivenciavam a coinfecção e que recebiam atendimento em um centro de referência do município de São Paulo. Para a coleta de dados, foi utilizado um questionário semiestruturado, composto por questões fechadas e questões norteadoras. A análise dos depoimentos baseou-se na teoria da determinação social do processo saúde-doença. Resultados Os participantes apontaram que as condições precárias de vida interferiam na qualidade de vida e referiram satisfação em relação ao cuidado ofertado e com a rede de atenção à saúde. Vivenciar a coinfecção tuberculose/vírus da imunodeficiência humana acarretou sofrimento, isolamento social e estigma, o que pode contribuir para ideação suicida e diminuição da qualidade de vida. Na percepção dos participantes, os profissionais de saúde contribuem para a manutenção da qualidade de vida, por meio do estabelecimento de vínculo e atenção humanizada. Conclusão Intervenções voltadas à redução das desigualdades sociais, que apoiem a diminuição de estigma e do preconceito e que incrementem a interação humanizada nos serviços de saúde, de forma a atender às necessidades de saúde dos usuários podem repercutir positivamente na percepção sobre a qualidade de vida e o cuidado em saúde daqueles que vivenciam a coinfecção tuberculose/vírus da imunodeficiência humana.

Resumen Objetivo Describir y analizar las percepciones de personas que presentan la coinfección tuberculosis/virus de la inmunodeficiencia humana con relación a la calidad de vida y al cuidado de la salud. Métodos Estudio exploratorio, descriptivo, con enfoque cualitativo realizado con diez personas que presentaron la coinfección y que recibían atención en un centro de referencia del municipio de São Paulo. Para la recopilación de datos se utilizó un cuestionario semiestructurado, compuesto por preguntas cerradas y preguntas orientadoras. El análisis de los relatos se basó en la teoría de la determinación social del proceso salud-enfermedad. Resultados Los participantes señalaron que las condiciones precarias de vida interferían en la calidad de vida y relataron satisfacción con relación al cuidado ofrecido y a la red de atención en salud. Tener la coinfección tuberculosis/virus de la inmunodeficiencia humana conlleva sufrimiento, aislamiento social y estigma, lo que puede contribuir con ideación suicida y reducción de la calidad de vida. Bajo la percepción de los participantes, los profesionales de la salud contribuyen para mantener la calidad de vida, mediante el establecimiento de vínculos y atención humanizada. Conclusión Intervenciones orientadas a la reducción de las desigualdades sociales, que apoyen la disminución del estigma y los prejuicios y que aumenten la interacción humanizada en los servicios de salud, a fin de atender las necesidades de salud de los usuarios, pueden repercutir positivamente en la percepción sobre la calidad de vida y el cuidado de la salud de aquellas personas que padecen la coinfección tuberculosis/virus de la inmunodeficiencia humana.

Abstract Objective To describe and analyze the perceptions of people who experience tuberculosis/human immunodeficiency virus coinfection in relation to quality of life and health care. Methods An exploratory, descriptive, qualitative study conducted with ten people experiencing coinfection who received care at a reference center in the city of São Paulo. A semi-structured questionnaire composed of closed questions and guiding questions was used for data collection. The analysis of testimonies was based on the Theory of Social Determination of the Health-Disease Process. Results Participants mentioned that precarious conditions of life interfered in the quality of life and reported satisfaction with the care provided and the health care network. Experiencing tuberculosis/human immunodeficiency virus coinfection caused suffering, social isolation and stigma, which can contribute to suicidal ideation and lower quality of life. In the perception of participants, health professionals contribute to maintain the quality of life by developing bonds and humanized care. Conclusion Interventions aimed at reducing social inequalities that support the reduction of stigma and prejudice and increase humanized interaction in health services in order to meet users' health needs can exert positive impact on the perception of quality of life and health care of those experiencing tuberculosis/human immunodeficiency virus coinfection.

Percepções de pessoas com tuberculose/HIV em relação à adesão ao tratamento / Perceptions of people with tuberculosis/HIV regarding treatment adherence

Resumo Objetivo Analisar aspectos relacionados à adesão ao tratamento da tuberculose em pessoas que vivem com coinfecção tuberculose/vírus da imunodeficiência humana. Métodos Trata-se de um estudo exploratório, do tipo descritivo, com abordagem qualitativa sobre a adesão ao tratamento da tuberculose entre pessoas que apresentam a coinfecção tuberculose/vírus da imunodeficiência humana. O cenário do estudo foi um centro de referência para vírus da imunodeficiência humana/síndrome da imunodeficiência adquirida do estado de São Paulo, localizado na capital. O instrumento de coleta de dados continha questões relacionadas ao perfil sóciodemográfico e de saúde. Para a análise do material empírico foi utilizado o método de análise de discurso que permitiu a depreensão de frases temáticas. Resultados Foram entrevistadas 16 pessoas, sendo a maioria do sexo masculino, da cor parda, na faixa etária entre 30 a 39 anos, com 9 a 12 anos de estudo, que moravam sozinhos, solteiros e que se declararam homossexuais. Da análise dos depoimentos emergiram três categorias de análise: Processo saúde doença: o impacto do diagnóstico e os significados de viver a coinfecção; Tratamento medicamentoso: motivos para o seguimento, facilidades e dificuldades envolvidas; e Cuidado no serviço de saúde: acolhimento e redes de apoio que favorecem a adesão ao tratamento. Conclusão A adesão ao tratamento na coinfecção tuberculose/vírus da imunodeficiência humana mostrou-se relacionada à forma como a pessoa está inserida na sociedade, suas condições de vida e trabalho. Ressalta-se também que o cuidado nos serviços de saúde interfere na adesão, dada a importância do vínculo entre o profissional de saúde e o usuário.

Resumen Objetivo Analizar los aspectos relacionados con la adherencia al tratamiento de tuberculosis en personas que viven con la coinfección tuberculosis/virus de la inmunodeficiencia humana. Métodos Se trata de un estudio exploratorio, tipo descriptivo, con enfoque cualitativo, sobre la adherencia al tratamiento de tuberculosis en personas que presentan la coinfección tuberculosis/virus de la inmunodeficiencia humana. El escenario de estudio fue un centro de referencia del virus de la inmunodeficiencia humana/síndrome de inmunodeficiencia adquirida del estado de São Paulo, ubicado en la capital. El instrumento de recopilación de datos contenía preguntas relacionadas con el perfil sociodemográfico y de salud. Para analizar el material empírico se utilizó el método de análisis de discurso que permitió extraer frases temáticas. Resultados Se entrevistaron 16 personas, de las cuales la mayoría era de sexo masculino, de color pardo, del grupo de edad entre 30 y 39 años, con 9 a 12 años de estudios, que vivían solos, solteros y que se declararon homosexuales. Del análisis de los relatos surgieron tres categorías de análisis: Proceso de salud y enfermedad: el impacto del diagnóstico y los significados de vivir la coinfección; Tratamiento farmacológico: motivos para el acompañamiento, facilidades y dificultades relacionadas, y Cuidado en el servicio sanitario: contención y redes de apoyo que favorecen la adherencia al tratamiento. Conclusión La adherencia al tratamiento de la coinfección tuberculosis/virus de la inmunodeficiencia humana demostró estar relacionada con la forma como la persona está insertada en la sociedad, su condición de vida y trabajo. También se observó que el cuidado en los servicios de salud interfiere en la adherencia, debido a la importancia del vínculo entre los profesionales de la salud y los usuarios.

Abstract Objective To analyze aspects related to adherence to tuberculosis treatment in people living with tuberculosis/human immunodeficiency virus coinfection. Methods This is an exploratory, descriptive, qualitative study on adherence to tuberculosis treatment among people with tuberculosis/human immunodeficiency virus coinfection. The study setting was a reference center for human immunodeficiency virus/acquired immunodeficiency syndrome located in the capital of the state of São Paulo. The data collection instrument contained socio-demographic and health profile related questions. The discourse analysis method was used for the analysis of the empirical material, which allowed the comprehension of thematic phrases. Results Sixteen people were interviewed. Most were male, mixed race, in the age group of 30-39 years, with 9-12 years of study, living alone, single and declared themselves homosexuals. Three categories of analysis emerged from the analysis of testimonies: Health-disease process: the impact of the diagnosis and the meanings of living with coinfection; Drug treatment: reasons for follow-up, facilities and difficulties involved; and Care in the health service: embracement and support networks that favor treatment adherence. Conclusion Adherence to treatment in the tuberculosis/human immunodeficiency virus coinfection has shown a relation to the way people are inserted in society, their living and working conditions. The fact that care in health services interferes with adherence is also noteworthy, given the importance of the bond between the health professional and the user.

Desejando parir naturalmente: perspectiva de mulheres sobre o parto domiciliar planejado com uma enfermeira obstétrica / Wanting to give birth naturally: women's perspective on planned homebirth with a nurse midwife / Deseando parir naturalmente: perspectiva de mujeres sobre el parto domiciliario planificado con una enfermera obstétrica

Objetivo: descrever a escolha do parto domiciliar planejado acompanhado por enfermeira obstétrica em um centro urbano de grande porte, na perspectiva de mulheres brasileiras. Métodos: estudo qualitativo guiado pela Grounded Theory. Foram entrevistadas dez mulheres com idade entre 20 e 41 anos que tiveram parto domiciliar planejado acompanhadas por enfermeiras obstétricas. As participantes foram recrutadas por meio de rede social, acessando um grupo de mulheres que escreveram sobre seu parto domiciliar. Resultados: Emergiram duas categorias: Não vendo possibilidade de parir naturalmente no ambiente hospitalar e Pensando na segurança do parto domiciliar planejado. O hospital representou vários aspectos desfavoráveis como intervenções desnecessárias e solidão. As mulheres consideravam o lar um lugar seguro para parir, conectado aos cuidados de enfermeiras obstétricas. Conclusão: há mulheres que não desejam parir no hospital, preferindo parir em casa e do ponto de vista dos direitos humanos e dos cuidados desmedicalizados, as enfermeiras obstétricas devem apoiar as mulheres nessa sua decisão.

Objective: to describe the choice of planned homebirth attended by a nurse midwife in a large urban centre, from the perspective of Brazilian women. Methods: in this Grounded Theory study, ten women aged 20 to 41 years, who had a planned homebirth accompanied by a nurse midwife, were interviewed. Participants were recruited through a social network by accessing a group of women who wrote about their homebirth. Results: two categories emerged: seeing no possibility of giving birth naturally in the hospital environment; and thinking about the safety of a planned homebirth. Hospital represented several unfavourable aspects, such as unnecessary interventions and loneliness. Women thought of home as a safe place to give birth, connected with nurse midwife care. Conclusion: there are women who do not wish to give birth in hospital, but prefer to give birth at home and, from the point of view of human rights and de-medicalized care, nurse midwives should support women in their decision.

Objetivo: describir la elección del parto domiciliario planificado con enfermera obstétrica en un gran centro urbano, desde la perspectiva de mujeres brasileñas. Métodos: estudio cualitativo guiado por la Grounded Theory. Se entrevistó a diez mujeres entre 20 y 41 años que tuvieron parto domiciliario planificado, siendo acompañadas de enfermeras obstétricas. Las participantes fueron reclutadas a través de red social, accediendo a un grupo de mujeres que escribieron sobre su parto en domicilio. Resultados: surgieron dos categorías: las que no veían posibilidad de dar a luz naturalmente en el hospital y las que pensaron en la seguridad del parto domiciliario planificado. El hospital representó varios aspectos desfavorables como intervenciones innecesarias y soledad. Las mujeres consideraban que el hogar era un ambiente seguro para dar a luz, vinculado al cuidado de enfermeras obstétricas. Conclusión: hay mujeres que no desean dar a luz en el hospital, prefieren hacerlo en casa y, desde el punto de vista de los derechos humanos y de los cuidados sin la intervención de un médico, las enfermeras obstétricas deben apoyarlas en esa decisión.

Light therapy for the treatment of delayed sleep-wake phase disorder in adults: a systematic review.

Delayed sleep-wake phase disorder (DSWPD) is characterized by sleep onset times, beyond the usual schedules and social conveniences, which potentially impacts on health as well as on school and professional performance. The most common treatment for DSWPD is the light administration (light therapy), through light devices, with or without behavioral instructions. Since there is no consensus in the literature about its efficacy and how it should be processed, this study aims to evaluate the light therapy effectiveness in the delayed sleep-wake phase disorder therapeutics. A systematic review was conducted using the MEDLINE/PubMed, Virtual Health Library Brazil, PsycINFO, Web of Science and Scopus databases along with a hand search until September 2020. The included studies presented participants diagnosed with insomnia or DSWPD, over 18-years old, treated only with morning light therapy, mentioning the light intensity (lux) used, and investigations with a control group. Studies reporting individuals with neurological or psychiatric disorders, shift-workers, or evaluating other sleep disorders were excluded. Among the 411 studies identified, five were selected for this review, resulting in a total sample of 140 individuals. Only two studies produced long-term results, showing that the benefits did not persist. In most studies, there were no statistically significant differences in the variables when comparing the intervention group and the control group. However, there were substantial clinical and laboratory advances in the sleep phase using light therapy when comparing phase advances for the same group concerning baseline values of sleep variables.

Investigations of Olive Oil Industry By-Products Extracts with Potential Skin Benefits in Topical Formulations.

The by-products of olive oil industry are a major ecological issue due to their phenolic content, highly toxic organic load, and low pH. However, they can be recovered and reused, since their components have antioxidant, anti-inflammatory, and photoprotector properties. In this work, oil-in-water creams containing three different olive oil industry by-products extracts were produced without the use of organic solvents. First, the extracts were thoroughly characterized in vitro for cytotoxicity, inhibition of skin enzymes, and antioxidant and photoprotection capacities. Safety studies were then performed, including ocular and skin irritation tests, ecotoxicity evaluation, and in vivo Human Repeat Insult Patch Test. The results obtained in this initial characterization supported the incorporation of the extracts in the cream formulations. After preparation, the creams were characterized for their organoleptic, physicochemical, droplet size and rheological properties, and microbial contamination. The results showed that all formulations were semi-solid creams, with stable pH, compatible with the skin, without microbial contamination, and with the expected droplet size range. The rheological analysis showed shear-thinning behavior with yield stress, with the viscosity decreasing with increasing shear rate. The oscillatory results suggest that the creams have a strong network structure, being easily rubbed into the skin. Finally, compatibility, acceptability and antioxidant efficacy were evaluated in vivo, in human volunteers. No adverse reactions were observed after application of the formulations on skin and the cream with the highest concentrations of phenolic compounds showed the highest antioxidant efficiency. In conclusion, the results suggest that olive oil industry by-products extracts have valuable properties that favor their re-use in the cosmetic industry. The example presented here showed their successful incorporation into creams and their impact in these formulations' appearance, pH, and rheological performance, as well as their in vivo compatibility with skin and antioxidant efficiency.

Diversity and regional distribution of harmful algal events along the Atlantic margin of Europe.

The IOC-ICES-PICES Harmful Algal Event Database (HAEDAT) was used to describe the diversity and spatiotemporal distribution of harmful algal events along the Atlantic margin of Europe from 1987 - 2018. The majority of events recorded are caused by Diarrhetic Shellfish Toxins (DSTs). These events are recorded annually over a wide geographic area from southern Spain to northern Scotland and Iceland, and are responsible for annual closures of many shellfish harvesting areas. The dominant causative dinoflagellates, members of the morphospecies 'Dinophysis acuminata complex' and D. acuta, are common in the waters of the majority of countries affected. There are regional differences in the causative species associated with PST events; the coasts of Spain and Portugal with the dinoflagellates Alexandrium minutum and Gymnodinium catenatum, north west France/south west England/south Ireland with A. minutum, and Scotland/Faroe Islands/Iceland with A. catenella. This can influence the duration and spatial scale of PST events as well as the toxicity of shellfish. The diatom Pseudo-nitzschia australis is the most widespread Domoic Acid (DA) producer, with records coming from Spain, Portugal, France, Ireland and the UK. Amnesic Shellfish Toxins (ASTs) have caused prolonged closures for the scallop fishing industry due to the slow depuration rate of DA. Amendments to EU shellfish hygiene regulations introduced between 2002 and 2005 facilitated end-product testing and sale of adductor muscle. This reduced the impact of ASTs on the scallop fishing industry and thus the number of recorded HAEDAT events. Azaspiracids (AZAs) are the most recent toxin group responsible for events to be characterised in the ICES area. Events associated with AZAs have a discrete distribution with the majority recorded along the west coast of Ireland. Ciguatera Poisoning (CP) has been an emerging issue in the Canary Islands and Madeira since 2004. The majority of aquaculture and wild fish mortality events are associated with blooms of the dinoflagellate Karenia mikimotoi and raphidophyte Heterosigma akashiwo. Such fish killing events occur infrequently yet can cause significant mortalities. Interannual variability was observed in the annual number of HAEDAT areas with events associated with individual shellfish toxin groups. HABs represent a continued risk for the aquaculture industry along the Atlantic margin of Europe and should be accounted for when considering expansion of the industry or operational shifts to offshore areas.

Plastics in our ocean as transdisciplinary challenge.

This conference report summarizes the current challenges of researching microplastics pollution in the ocean as debated by international experts and stakeholders at a workshop held in San Sebastián, Spain, 1-2 October 2019. The transdisciplinary, co-learning approach of this report stressed the need to incorporate multiple perspective in solving the problem of microplastics and resulted in three proposed actions: (i) filtering microplastics from waste waters; (ii) mandatory ecolabels on plastic products packages; and (iii) circular economy of packaging plastics.