Modelagem de crescimento e produção usando o modelo Simflora.

Importância da modelagem de dinâmica florestal na Amazônia Brasileira; Modelagem de crescimento e produção usando o Simflora; Outros documentos disponíveis; Instalação; Simulações únicas; Dados; Começando; Janelas de exibição; Rodando o modelo; Resultados; Simulando silvicultura; A escolha de módulos e valores dos parâmetros; Exemplo; Simulações múltiplas; Começando uma simulação múltipla; Criando um arquivo de dados de saída; Rodando simulações múltiplas; Examinando e analisando os resultados; Experiências de uso do Simflora e suas implicações para políticas públicas; Indonésia; Guiana Inglesa; Brasil; Padrões observados em relação à exploração madeireira e às lacunas de conhecimento de dinâmica florestal de diferentes países tropicais

Time to endoscopic intervention in patients with upper gastrointestinal patients can be improved with pathway provision

BACKGROUND:Patients with upper gastrointestinal malignancy often require admission to hospital with dysphagia or jaundice requiring therapeutic endoscopy. Endoscopic intervention is often effective permitting rapid discharge. An efficient service would permit rapid discharge for patients who are often at the end of life. We noted that a majority of patients in hospital under the gastroenterological oncology were admitted with symptoms requiring therapeutic endoscopy. METHODS: We conducted an audit cycle of the inpatient days before and after pathway implementation. A wait of 1 day was set as acceptable for patients with bleeding as defined by NICE guidance and we set an arbitrary standard of 2 days for patients without bleeding but requiring therapeutic endoscopy. Between the audit cycles, a pathway was built to accommodate these patients. RESULTS: Inpatient waits improved from a median of 3 days to 1 day. There was no difference in outcome between those presenting with bleeding and other symptoms or any difference in patients requiring different procedures. CONCLUSIONS: Waiting times for endoscopy can be improved with the introduction of a targeted pathway of cancer patients. Further issues including cost, quality of life and nutrition require further intervention

Does body mass index influence surgical options and overall survival in breast cancer patients?

Obesity is a relevant risk factor in breast cancer (BC), but little is known about the effects of overweight and obesity in surgical outcomes of BC patients. The aim of this study is to analyse surgical options and associated overall survival (OS) in overweight and obese women with BC. In this study, 2143 women diagnosed between 2012 and 2016 at the Portuguese Oncology Institute of Porto (IPO-Porto) were included, and the clinicopathological information was retrieved from the institutional database. Patients were stratified by body mass index (BMI). Statistical analysis included Pearson's chi-squared test with statistical significance set at p < 0.05. Multinomial, binary logistic regression and cox proportional-hazards model were also performed to calculate odd ratios and hazard ratios with 95% confidence intervals for adjusted and non-adjusted models. The results revealed no statistical difference in histological type, topographic localization, tumour stage and receptor status and in the number of surgical interventions. Overweight women have increased probability to be subjected to sentinel node biopsy. Obese and overweight women are more likely to be submitted to conservative surgery and contrariwise, less likely to undergo total mastectomy. Patients submitted to conservative surgery and not submitted to total mastectomy had a favourable OS although without statistical significance. No significant differences were observed in OS when stratified by BMI. Our results revealed significant variations regarding the surgical options in overweight and obese patients, but these were not translated in OS difference. More research is recommended to better address treatment options in overweight and obese BC patients.Open access funding provided by FCT vertical bar FCCN (b-on). This research was supported by the FCT - Fundacao para a Ciencia e Tecnologia by a scholarship granted to Carla Luis (SFRH/BD/146489/2019)

Necrotizing Fasciitis Post- Acute Appendicitis

A Fasceíte Necrotizante (FN) é um processo infeccioso da fascia profunda, de evolução rápida e progressiva com necrose secundária do tecido celular subcutâneo. Os autores apresentam um caso de FN da parede abdominal, como complicação extremamente rara de apendicite aguda. Trata-se de uma criança, apendicectomizada por apendicite aguda gangrenada, que evolui para quadro infeccioso grave, com dor e processo inflamatório da parede abdominal. Após diagnóstico, foi submetido a desbridamento cirúrgico da parede abdominal e drenagem de abcesso intraperitoneal. Realizada terapêutica antibiótica, desbridamentos cirúrgicos e pensos sucessivos da lesão e ao 22º dia efectuou-se enxerto dermo-epidérmico de área cruenta residual da parede abdominal. Porque o prognóstico está intimamente relacionado com o tempo decorrido até ao diagnóstico correcto e início de terapêutica adequada, é de extrema importância que este diagnóstico seja considerado

A retrospective study in tumour characteristics and clinical outcomes of overweight and obese women with breast cancer

Introduction Obesity and breast cancer are two major pathologies closely associated with increasing incidence and mortality rates, especially amongst women. The association between both diseases have been thoroughly discussed but much is still to uncover. Aim The aim of this study is to analyse tumour characteristics and clinical outcomes of overweight and obese women to disclosure potential associations and better understand the impact of obesity in breast cancer. Materials and methods Clinicopathological information of 2246 women were extracted from the institutional database of comprehensive cancer centre in Portugal diagnosed between 2012 and 2016. Women were stratified according to body mass index as normal, overweight, and obese. Patients’ demographic information and tumour features (age, family history, topographic localization, laterality, histological type, and receptor status) were taken as independent variables and overall survival, tumour stage, differentiation grade and bilaterality were considered clinical outcomes. Results The main results reveal that overweight and obesity are predominantly associated with worse outcomes in breast cancer patients. Obese patients present larger (p-value: 0.002; OR 1.422; 95% CI 1.134–1.783) and more poorly differentiated tumours (p-value: 0.002; OR 1.480; 95% CI 1.154–1.898) and tend to have lower overall survival although without statistical significance (p-value: 0.117; OR 1.309; 95% CI 0.934–1.833). Overweighted women are more likely to have bilateral breast cancer (p-value: 0.017; OR 3.076; 95% CI 1.225–7.722) than obese women. The results also reveal that overweight women present less distant metastasis (p-value: 0.024; OR 0.525; 95%CI 0.299–0.920). Topographic localization and laterality did not achieve statistical significance.Open access funding provided by FCT|FCCN (b-on). Author C.L. has received research support by “FCT—Fundação para a Ciência e Tecnologia” (Grant number [SFRH/BD/146489/2019])

Competing magnetic orders in the superconducting state of Nd-doped CeRhIn5_{5} under pressure

Applied pressure drives the heavy-fermion antiferromagnet CeRhIn$_{5}$ towards a quantum critical point that becomes hidden by a dome of unconventional superconductivity. Magnetic fields suppress this superconducting dome, unveiling the quantum phase transition of local character. Here, we show that $5\%$ magnetic substitution at the Ce site in CeRhIn$_{5}$, either by Nd or Gd, induces a zero-field magnetic instability inside the superconducting state. This magnetic state not only should have a different ordering vector than the high-field local-moment magnetic state, but it also competes with the latter, suggesting that a spin-density-wave phase is stabilized in zero field by Nd and Gd impurities - similarly to the case of Ce$_{0.95}$Nd$_{0.05}$CoIn$_{5}$. Supported by model calculations, we attribute this spin-density wave instability to a magnetic-impurity driven condensation of the spin excitons that form inside the unconventional superconducting state

Estrutura familiar e geração de renda em assentamentos rurais que desenvolvem atividade pecuária em Tomé-Açu e Paragominas no nordeste e sudeste paraense.

O estudo avaliou os produtores rurais envolvidos com a produção pecuária em assentamentos rurais localizados em Tomé-Açu e Paragominas no Nordeste e Sudeste paraense, respectivamente. Noventa e cinco produtores foram entrevistados quanto à liderança administrativa das propriedades, estado civil, migração, profissões anteriores antes da aquisição da propriedade, escolaridade, idade e renda. A liderança das propriedades é caracterizada por homens casados, ou em regime de união estável, imigrante da Região Norte e Nordeste. Em Paragominas os produtores são mais velhos, com maior índice de analfabetismo e pouco auxílio governamental. Em Tomé-Açu as famílias são mais numerosas e 20% delas recebem auxílio do governo. Os produtores de Tomé-Açu receberam mais subsídios governamentais pelo fato das famílias serem mais numerosas